Department of Culture and the Arts

BACKGROUND: The use of springs in craniofacial surgery originated at Sahlgrenska University Hospital in 1997 as a way of remodeling the cranial vault postoperatively. METHODS: The hospital records of the first 100 operations involving spring placement were analyzed retrospectively. Demographic, perioperative, and postoperative data were recorded. RESULTS: Two hundred forty-six springs were used in 96 patients. Results for sagittal, metopic, bicoronal, multiple synostoses, and midface surgery are presented. In total, five patients (5 percent) required further surgery because of undercorrection. There were no major complications. Spring dislodgement (5 percent) was the most common complication in early cases. Raised intracranial pressure resulted in a protocol change with the use of compressive springs. The data compare favorably with those of standard craniofacial procedures performed in the same unit. CONCLUSIONS: This therapeutic modality in craniofacial surgery has allowed minimization of the extent of surgery without compromising clinical outcomes. Springs have now become part of the authors' treatment protocol for craniosynostosis and midface surgery. The authors have shown the use of these techniques to be safe and, in selected situations, to offer significant advantages over other methods of treatment.

The aim of this study was to validate the CogState Brief Battery, which assesses psychomotor, attentional, working memory, and visual learning functions, in healthy older people and in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), enrolled in the Australian Imaging, Biomarkers and Lifestyle (AIBL) study. In healthy older adults, weak relationships between demographic variables (e.g., education, depression) and cognitive performance were observed. In AD and MCI groups, the magnitude of impairment was greatest for tasks of working memory and memory, with a negative influence of apolipoprotein E ϵ4 status on learning but not working memory. These results suggest that the CogState Brief Battery can be used to screen for AD-related cognitive changes.

BACKGROUND: Immediate implant placement followed by an immediate restoration has proven to be a viable technique in the anterior maxillary region. PURPOSE: This prospective study evaluated the mid-long term (2-5 years) tissue changes around immediately placed and restored implants in the anterior maxilla using flapless surgery and simultaneous hard tissue augmentation. MATERIALS AND METHODS: Thirty AstraTech implants were immediately placed in 30 patients, followed by the delivery of an immediate provisional restoration on the same day. All participating 30 patients underwent the same treatment strategy that involved flapless removal of a failing maxillary anterior tooth, immediate implant placement, simultaneous augmentation with a deproteinized particulate xenograft, followed by the connection of a screw-retained provisional restoration. Radiographs and photographs were used to measure hard and soft tissue changes. Aesthetic evaluation was performed using the Pink Esthetic Score (PES). RESULTS: All implants remained osseointegrated during the follow up period of 2-5 years (mean 47 ± 15 months). Twelve of the thirty patients completed the 5 year follow up. Radiographic evaluation revealed average gains in bone levels of 0.18 and 0.34 mm mesially and distally, respectively. Soft tissue evaluation showed a mean tissue loss of 0.05 ± 0.64 mm and 0.16 ± 0.63 mm at the mesial and distal papillae, respectively, while mid-facial mucosal recession was 0.29 ± 0.74 mm. A significant improvement in the Pink Esthetic Scores was seen at the final follow-up (mean PES 11.50), as compared to the baseline (mean PES 10.27) (P = .001). CONCLUSIONS: In addition to a favorable implant success rate and peri-implant bony response, the soft tissue levels and overall aesthetics around single immediately placed and restored implants can also be maintained in the mid-long term.

Herbal treatments are often used as a treatment for migraine. Therefore, an evaluation of their safety and efficacy is important. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and Cochrane Collaboration's tool for assessing the risk of bias, a systematic literature review of randomised, controlled human trials assessing the effects of herbal treatments delivered as a single ingredient for the acute or prophylactic treatment of migraine were conducted. Studies were identified through electronic database searches on Medline (Pubmed), Cochrane Library, Scopus, and CINAHL. Nineteen studies were identified examining the effects on migraine of feverfew, butterbur, curcumin, menthol/peppermint oil, coriander, citron, Damask rose, chamomile, and lavender. Overall, findings on the efficacy of feverfew were mixed and there was positive, albeit limited evidence for butterbur. There were positive, preliminary findings on curcumin, citron, and coriander as a prophylactic treatment for migraine, and the use of menthol and chamomile as an acute treatment. However, the risk of bias was high for many studies. The results of this systematic review suggest that several herbal medicines, via their multifactorial physiological influences, present as potential options to enhance the treatment of migraine. However, further high-quality research is essential to examine their efficacy and safety as a treatment for migraine.

Binary encoding of peptide sequences into differential antimicrobial mechanisms is reported. Such sequences are random in composition, but controllable in chain length, are assembled from the same two amino acids, but differ in the stereochemistry of one. Regardless of chirality, the sequences lyse bacteria including the "superbugs" methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). Sequences with the same chirality, so-called homochiral sequences, assemble into antimicrobial pores and form contiguous helices that are biologically promiscuous and hemolytic. By contrast, heterochiral sequences that lack such persistence selectively attack bacterial membranes without oligomerizing into visible pores. These results offer a mechanistic rationale for designing membrane-selective and sequence-independent antimicrobials.

Atoll societies have adapted their environments and social systems for thousands of years, but the rapid pace of climate change may bring conditions that exceed their adaptive capacities. There is growing interest in the use of 'nature-based solutions' to facilitate the continuation of dignified and meaningful lives on atolls through a changing climate. However, there remains insufficient evidence to conclude that these can make a significant contribution to adaptation on atolls, let alone to develop standards and guidelines for their implementation. A sustained programme of research to clarify the potential of nature-based solutions to support the habitability of atolls is therefore vital. In this paper, we provide a prospectus to guide this research programme: we explain the challenge climate change poses to atoll societies, discuss past and potential future applications of nature-based solutions and outline an agenda for transdisciplinary research to advance knowledge of the efficacy and feasibility of nature-based solutions to sustain the habitability of atolls. This article is part of the theme issue 'Nurturing resilient marine ecosystems'.

Traditional forms of marine wildlife research are often restricted to coarse telemetry or surface-based observations, limiting information on fine-scale behaviours such as predator-prey events and interactions with habitat features. We use contemporary animal-attached cameras with motion sensing dataloggers, to reveal novel behaviours by white sharks, Carcharodon carcharias, within areas of kelp forest in South Africa. All white sharks tagged in this study spent time adjacent to kelp forests, with several moving throughout densely kelp-covered areas, navigating through channels and pushing directly through stipes and fronds. We found that activity and turning rates significantly increased within kelp forest. Over 28 h of video data revealed that white shark encounters with Cape fur seals, Arctocephalus pusillus pusillus, occurred exclusively within kelp forests, with seals displaying predator evasion behaviour during those encounters. Uniquely, we reveal the use of kelp forest habitat by white sharks, previously assumed inaccessible to these large predators.

To evaluate the safety and efficacy of a novel bilateral hypoglossal nerve stimulation (HNSBL) device for the treatment of obstructive sleep apnea. Adult patients with moderate-to-severe obstructive sleep apnea who refused, failed, or did not tolerate positive airway pressure therapy underwent implantation and nightly use of HNSBL. The coprimary endpoints at 12 months were (1) a minimum of 50% reduction in the 4% apnea-hypopnea index (AHI) from baseline with a final AHI of less than 20 events/h, and (2) a minimum of 25% reduction in the 4% oxygen desaturation index. Objective secondary endpoints included changes in mean AHI, oxygen desaturation index, and sleep time with blood oxygen saturation less than 90%. Self-reported secondary endpoints included changes in Epworth Sleepiness Scale, the short Functional Outcomes of Sleep Questionnaire score, the Symptoms of Nocturnal Obstruction and Related Events score, and bedpartner assessment of snoring. HNSBL was implanted in 113 participants. Eleven serious adverse events occurred in 10 (8.7%) participants. The coprimary endpoints were completed by 89 (77.4%) participants. AHI and oxygen desaturation index responses were achieved in 63.5% (73/115, P = .002) and 71.3% (82/115, P < .001), respectively. Secondary endpoint analysis revealed significant changes in mean AHI (−18.3 ± 11.8 events/h, P < .001), oxygen desaturation index (−17.7 ± 14.6 events/h, P < .001), and sleep time with blood oxygen saturation less than 90% (6.9 ± 10.7%, P < .001). Significant changes were observed in all secondary endpoints (P < .001). This pivotal clinical trial of HNSBL demonstrated an acceptable safety profile with clinically significant improvements in obstructive sleep apnea severity and quality-of-life metrics. HNSBL is a promising new treatment option for select patients with obstructive sleep apnea. Clinical Trial Registration: Registry: ClinicalTrials.gov; Name: Dual-sided Hypoglossal NeRvE StimulAtion for the TreatMent of Obstructive Sleep Apnea (DREAM); URL: https://clinicaltrials.gov/study/NCT03868618 ; Identifier: NCT03868618. Woodson BT, Kent DT, Huntley C, et al. Bilateral hypoglossal nerve stimulation for obstructive sleep apnea: a nonrandomized clinical trial. J Clin Sleep Med. 2025;21(11):1883–1891.

Abstract Snow thickness on sea ice is a largely undersampled parameter yet of importance for the sea ice mass balance and for satellite‐based sea ice thickness estimates and thus our general understanding of global ice volume change. Traditional direct thickness measurements with meter sticks can provide accurate but only spot information, referred to as “needles” due to their pinpoint focus and information, while airborne and satellite remote sensing snow products, referred to as “the haystack,” have large uncertainties due to their scale. We demonstrate the remarkable accuracy and applicability of ground‐penetrating radar (GPR) snow thickness measurements by comparing them with in situ meter stick data from two field campaigns to Antarctica in late winter/early spring. The efficiency and millimeter‐to‐centimeter accuracy of GPR enables practitioners to acquire extensive, semiregional data with the potential to upscale needles to the haystack and to potentially calibrate satellite remote sensing products that we confirm to derive roughly 30% of the in situ thickness. We find the radar wave propagation velocity in snow to be rather constant (± 6%), encouraging regional snow thickness surveys. Snow thinner than 10 cm is under the detection limit with the off‐the‐shelf GPR setup utilized in our study.

Abstract The absence of known prehistoric underwater cultural heritage (UCH) sites on the Australian inner shelf stands in stark contrast to the thousands of sites revealed elsewhere in the world. Two recent claims—Dortch et al. (D2019) and Benjamin et al. (B2020)—put forward the first in situ (i.e., primary context) UCH sites in the shallow waters of the Dampier Archipelago, North West Australia, each arguing that the stone artefact scatters are at least 7000 years old and are now submerged because of postglacial sea‐level rise. We present new hydrodynamic modelling and data on coastal erosion and bathymetry, and reassess each site's sedimentary setting and archaeological site‐formation history. D2019 and B2020 clearly present lithic cultural artefacts, but the arguments for their sites being of primary context and reflecting early Holocene land surfaces are mistaken. Rather, these sites occur in the intertidal zone, and many or all artefacts are likely to have been reworked. Sites of secondary context, if treated appropriately, can inform our understanding of site‐formation process and change, and may support more powerful contributions to submerged archaeology than attempts to seek the first or the oldest.

BACKGROUND: Breslow thickness, patient age and ulceration are the three most valuable clinical and pathological predictors of melanoma survival. A readily available reliable online tool that accurately considers these and other predictors could be valuable for clinicians managing melanoma patients. OBJECTIVE: To compare online melanoma survival prediction tools that request user input on clinical and pathological features. METHODS: Search engines were used to identify available predictive nomograms. For each, clinical and pathological predictors were compared. RESULTS: Three tools were identified. The American Joint Committee on Cancer tool inappropriately rated thin tumours as higher risk than intermediate tumours. The University of Louisville tool was found to have six shortcomings: a requirement for sentinel node biopsy, unavailable input of thin melanoma or patients over 70 years of age and less reliable hazard ratio calculations for age, ulceration and tumour thickness. The LifeMath.net tool was found to appropriately consider tumour thickness, ulceration, age, sex, site and tumour subtype in predicting survival. LIMITATIONS: The authors did not have access to the base data used to compile various prediction tools. CONCLUSION: The LifeMath.net prediction tool is the most reliable for clinicians in counselling patients with newly diagnosed primary cutaneous melanoma regarding their survival prospects.

BACKGROUND: Few studies have examined the effectiveness and duration of mindfulness-based therapies for tics in Tourette's syndrome. This study combined habit reversal therapy (HRT) with acceptance and commitment therapy (ACT). OBJECTIVES: To evaluate the efficacy and response duration of HRT + ACT in reducing tic severity in adults with Tourette's Syndrome. METHODS: Tic severity was assessed at baseline, post-intervention, and at 6- and 12-month follow-ups using the Yale Global Tic Severity Scale (YGTSS) and video assessments. The intervention included eight weekly 1-h sessions. RESULTS: Mixed-effects regression showed significant reductions in tic severity post-treatment (b = -10.36, P = 0.002), maintained at 6 months (b = -8.19, P = 0.012) and 12 months (b = -8.82, P = 0.009). Video assessments confirmed these findings. CONCLUSION: The HRT + ACT protocol effectively reduced tic severity, with benefits lasting 12 months. These results support further trials to compare HRT + ACT with HRT alone.

Abstract Binary encoding of peptide sequences into differential antimicrobial mechanisms is reported. Such sequences are random in composition, but controllable in chain length, are assembled from the same two amino acids, but differ in the stereochemistry of one. Regardless of chirality, the sequences lyse bacteria including the “superbugs” methicillin‐resistant Staphylococcus aureus (MRSA) and vancomycin‐resistant Enterococci (VRE). Sequences with the same chirality, so‐called homochiral sequences, assemble into antimicrobial pores and form contiguous helices that are biologically promiscuous and hemolytic. By contrast, heterochiral sequences that lack such persistence selectively attack bacterial membranes without oligomerizing into visible pores. These results offer a mechanistic rationale for designing membrane‐selective and sequence‐independent antimicrobials.

G.S.M. has received grant or research support from National Health and Medical Research Council, Australian Rotary Health, NSW Health, American Foundation for Suicide Prevention, Ramsay Research and Teaching Fund, Elsevier, AstraZeneca, Janssen-Cilag, Lundbeck, Otsuka and Servier; and has been a consultant for AstraZeneca, Janssen-Cilag, Lundbeck, Otsuka and Servier. P.B. has received research support from the National Health and Medical Research Council, speaker fees from Servier, Janssen and the Australian Medical Forum, educational support from Servier and Lundbeck, has been a consultant for Servier, served on an advisory board for Lundbeck, has served as DSMC Chair for Douglas Pharmaceuticals and has served on the Medicare Schedule Review Taskforce (Psychiatry Clinical Committee). R.B. has received grant support in the last 5 years from the National Health and Medical Research Council, the Australian Research Council, TAL Insurance and support for travel for advisory meetings to the World Health Organization. M.H. has received grant or research support in the last 5 years from the National Health and Medical Research Council, Medical Research Future Fund, Ramsay Health Research Foundation, Boehringer-Ingleheim, Douglas, Janssen- Cilag, Lundbeck, Lyndra,Otsuka, Praxis and Servier; and has been a consultant for Janssen-Cilag, Lundbeck, Otsuka and Servier and has served on the Medicare Schedule Review Taskforce (Psychiatry Clinical Committee). R.M. has received support for travel to education meetings from Servier and Lundbeck, speaker fees from Servier and Committee fees from Janssen. R.P. has received support for travel to educational meetings from Servier and Lundbeck and uses software for research at no cost from Scientific Brain Training Pro. G.M. (Greg Murray) has received grant support in the last 5 years from the National Health and Medical Research Council, the Mental Illness Research Fund, Victorian Medical Research Acceleration Fund, Canadian Institutes of Health Research, Readiness, SiSU Wellness and Barbara Dicker Foundation. D.B. has received funding to host webinars by Lundbeck. A.B.S. has shares/options in Incite Health Pty Ltd (diagnostics company), has received speaking honoraria from Servier, Lundbeck and Otsuka Australia. The authors E.B., R.B., A.H., P.H. G.M. (Grace Morris) and B.L. declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. Data sharing is not applicable to this article as no new data were created or analyzed in this study.

OBJECTIVE: To report an alternative clinical and laboratory protocol for same-day implant fixed full-arch provisional rehabilitation that may overcome limitations associated with traditional immediate provisional denture conversion rehabilitation protocols. CLINICAL CONSIDERATIONS: The traditional denture conversion fabrication method of an immediate full-arch fixed provisional involves the conversion of a complete denture into a provisional fixed implant-support prosthesis. The conversion technique has several shortcomings which compromise structural integrity, longevity, ease of modification, and the need for a silicone impression. CONCLUSIONS: The "Same day" implant bridge (SDIB) concept provides clinical and laboratory advantages which overcome the limitations of the traditional denture conversion technique. This article reviews the rationale, clinical stages, and conventional fabrication sequence of the SDIB concept. CLINICAL SIGNIFICANCE: Compared to the traditional denture conversion method for immediate implant bridge fabrication, the SDIB technique offers the following advantages for implant-supported fixed rehabilitation: rapid fabrication, improved structural integrity and rigidity, elimination of all silicone impressions, ease of modification to promote comfort, function and adaptability, and favorable esthetics.

). Thus, we need to develop methods to deploy aversion-inducing baits in the field, in ways that maximize uptake by vulnerable species (but not other taxa). We constructed and field-tested baiting devices, in situ with wild animals. Apparatus were set next to waterbodies and baited concurrently at multiple locations (over water, water's edge, and on the bank). Baits were checked and replaced twice daily during the trial; remote cameras recorded visitation by native predators. Bait longevity was compared at sun-exposed and shaded locations over 12 h. The strength required to remove baits from apparatus was measured in varanids and crocodiles. The device promoted high rates of bait uptake by freshwater crocodiles (47% baits consumed), varanid lizards (19% baits consumed), and non-target taxa (34% baits consumed). Targeting specific predators can be achieved by manipulating bait location and time of deployment, as well as the force required to dislodge the bait. Crocodiles were best targeted with over-water baits, whereas varanid lizards preferred baits located at the edges of waterbodies. When testing bait longevity in ambient conditions, during the daytime baits desiccated fully within 12 h, and faster in the sun than in the shade. Based on studies using captive animals, the "pulling force" strength of reptilian predators scaled with body size and was greater in crocodiles than in varanid lizards. We present the first conservation baiting protocol designed specifically for reptiles. Our results demonstrate the feasibility of widespread and taxon-specific deployment of aversion-inducing baits to buffer the impacts of invasive cane toads, and our methods are applicable (with modification) to other research and management programs globally.

OBJECTIVES: The aim of this article is to discuss the possible mechanisms of action (MOAs) and results of a pilot study of a novel, anatomically placed, and paresthesia-independent, neurostimulation waveform for the management of chronic intractable pain. MATERIALS AND METHODS: A novel, multilayered pulsed stimulation pattern (PSP) that comprises three temporal layers, a Pulse Pattern layer, Train layer, and Dosage layer, was developed for the treatment of chronic intractable pain. During preliminary development, the utility was evaluated of anatomical PSP (aPSP) in human subjects with chronic intractable pain of the leg(s) and/or low back, compared with that of traditional spinal cord stimulation (T-SCS) and physiological PSP. The scientific theory and testing presented in this article provide the preliminary justification for the potential MOAs by which PSP may operate. RESULTS: During the pilot study, aPSP (n = 31) yielded a greater decrease in both back and leg pain than did T-SCS (back: -60% vs -46%; legs: -63% vs -43%). In addition, aPSP yielded higher responder rates for both back and leg pain than did T-SCS (61% vs 48% and 78% vs 50%, respectively). DISCUSSION: The novel, multilayered approach of PSP may provide multimechanistic therapeutic relief through preferential fiber activation in the dorsal column, optimization of the neural onset response, and use of both the medial and lateral pathway through the thalamic nuclei. The results of the pilot study presented here suggest a robust responder rate, with several subjects (five subjects with back pain and three subjects with leg pain) achieving complete relief from PSP during the acute follow-up period. These clinical findings suggest PSP may provide a multimechanistic, anatomical, and clinically effective management for intractable chronic pain. Because of the limited sample size of clinical data, further testing and long-term clinical assessments are warranted to confirm these preliminary findings.

OBJECTIVES: Testosterone concentrations in men decline with advancing age. However, the cause of the decline is yet to be fully elucidated. Therefore, the aims of this study were to examine the associations between chronic diseases such as obesity and type 2 diabetes mellitus (T2DM) with total testosterone (TT) and sex hormone-binding globulin (SHBG), using a large nationally-representative data set (National Health and Nutrition Examination Survey; NHANES). METHODS: NHANES is a cross-sectional survey, physical examination, and laboratory evaluation of a nationally-representative sample of a non-institutionalized United States population. Male participants aged ≥18 years during the NHANES 2013-2014 and NHANES 2015-2016 survey periods were selected for this analysis. The analysis included the following data: body mass index (BMI), oral glucose tolerance test (OGTT), homeostatic model assessment of insulin resistance (HOMA-IR), insulin, glucose, and age. RESULTS: An overweight or obese condition was significantly inversely associated with TT and SHBG, even after adjusting for other variables. Several variables associated with T2DM (OGTT, HOMA-IR, insulin, and glucose) were also inversely associated with TT; however, only the associations between OGTT and insulin with TT remained significant after adjusting for the other variables. Insulin and HOMA-IR levels were significantly inversely associated with SHBG; however, only the association between SHBG and pre-diabetic HOMA-IR levels remained significant after adjusting for the other variables. OGTT became significantly associated with SHBG after adjusting for the other variables. Age was significantly inversely associated with TT, but positively associated with SHBG, even after adjusting for other variables. CONCLUSION: The results of the present study, which is the largest to date, indicate that a marker of obesity, BMI, and some markers of T2DM are both independently and significantly inversely associated with TT and SHBG.

Abstract The restoration of diverse self‐sustaining ecosystems requires re‐establishment of functional interactions among species. For plant communities, pollinators are usually essential for pollination, seed set and seed quality. A common assumption in ecological restoration for plants pollinated by animals is one of ‘build it and they will come’, which is rarely tested. Beyond seed set, there may be negative genetic consequences for seed quality if pollinators and their behaviour do not reflect those in reference populations. Here, we conduct an ecological genetic assessment of seed quality via mating system parameters in Lambertia multiflora (Proteaceae), a species dependent on nectar‐feeding birds for pollination. Four populations of L. multiflora in disturbed sites that were rehabilitated following mineral sands mining were compared with four native reference populations, near Eneabba, Western Australia. In each population, approximately 10 offspring from each of 10 maternal plants were genotyped with 11 highly polymorphic microsatellite markers. From these data, genetic diversity and mating system parameters were assessed, and found to be equivalent across all populations. Mean allelic diversity and heterozygosity across loci were very high. All populations were completely outcrossing with no bi‐parental inbreeding. Mean correlated paternity, sibship and effective population size estimates for restored and natural populations were not significantly different and reflected uniformly high paternal diversity and wide outcrossing. Equivalent genetic results for restored and natural reference populations indicate successful restitution of bird‐pollinator services for L. multiflora in these post‐mining rehabilitation sites. Synthesis and applications. Reviewing our results with other published studies to date suggests a resilience of bird‐pollinator services in restored plant communities. These findings provide some reassurance to restoration practitioners working in these global south systems where bird pollination is a feature, at least for similar landscape scenarios. Our study also highlights the global contribution of ecological genetics to the objective assessment of functional species interactions in ecological restoration, an increasingly important goal of land managers and regulators seeking to improve restoration standards.

Constructed wetlands have been utilized for some time in the treatment of wastewater and have been recognized for the treatment of stormwater runoff and flood protection in the last couple of decades. Constructed wetlands are built to remove sediment and nutrients, primarily phosphorus and nitrogen, from contaminated water. However, with increased urbanization and enhanced climate change, these constructed wetlands need to be managed and their treatment effectiveness monitored and maintained especially at the post-construction phase. In addition, a greater understanding of the role of these systems in the urbanized environment and how they treat wastewater are needed to optimize their performance. As more advanced computer modeling is developed there is a need to ascertain what parameters and how these changes overtime and what skills are required to enable the adoption of constructed wetlands for future planning and management. There has been limited research into constructed wetlands for flood mitigation and with some receiving inflows larger than their design intent, it is necessary to determine if these systems would still be able to treat pollutants. This chapter involves a review of the literature to address these concerns relating to constructed wetlands.