Department of Culture and the Arts

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.

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.

The lung is the largest organ exposed to the environment. It has an alveolar surface area of around 70 m2 and comprises a complex series of branches leading to gas exchanging units that are critical to life.1 It is a very adaptable organ and exchanges 10 000 L of air/day. In addition, it can increase oxygen consumption from 250 to 5500 mL/min and blood flow from 4 to 40 L/min.1 This significant capacity to adapt has conferred an evolutionary survival advantage as we can respond to ventilatory stresses in our ‘fight or flight’ response. The lung has many other roles with host defence being of major importance, and these need to be considered when disease management arises. The lung begins at the nasal passages and through a series of branches ends with the alveoli. The extensive branching of the trachea to bronchioles serves to filter potentially harmful organic and inorganic environmental agents. Branching also increases the area for gas exchange. However, the diffuse structure of the lung makes it susceptible to a variety of diseases that affect all locations. This unique organ can present with anatomically specific conditions such as allergic rhinitis and sinusitis that are distinct from bronchitis, bronchiolitis or diseases affecting the alveoli such as hypersensitivity pneumonitis. In addition, the pleura and mediastinum are further sites for disease. Apart from the anatomical location of disease, the common drivers of pathology fall into the usual broad categories of: infective, inflammatory, malignant, occupational, toxic/environmental and developmental, while the time course can be classified as acute, subacute, and chronic-stable or progressive. The major lung diseases include cystic fibrosis, chronic obstructive pulmonary disease, bronchiectasis, asthma, pneumonia, lung cancer, tuberculosis, acute lung injury, idiopathic pulmonary fibrosis, sarcoidosis, interstitial pneumonias and occupational lung disease. There are no cures for these diseases or we do not fully understand their aetiology and pathogenesis. Chronic respiratory diseases cause approximately 7% of all deaths worldwide and represent 4% of the global burden of disease with major associations between diseases such as tuberculosis and human immunodeficiency virus/acquired immune deficiency syndrome, influenza and asthma, chronic obstructive pulmonary disease and lung cancer, and lung infection and acute lung injury.2, 3 Although it will be the third leading cause of death worldwide by 2020, chronic obstructive pulmonary disease is frequently not diagnosed or its severity underestimated.4 In the US, chronic lung diseases represent $154 billion in health-care costs each year. The cost of lung disease runs into hundreds of billions of dollars globally each year and threatens to overwhelm public health services.5 This is compounded by nearly half of the world's population being exposed to poor air quality. Notably, tobacco is still legal despite tobacco smoking being responsible for the death of more than 5 million people each year, including 1.3 million from lung cancer, and adversely influencing the health of hundreds of thousands who are exposed to its second-hand effects.4 The range of conditions affecting the lung ensures that lung illnesses remains among the top five causes of disease in all communities worldwide. Inflammation is a critical first step in many diseases. It is caused by both infective and non-infective causes. An injury, such as incurred from cigarette smoke or infection, usually causes infiltration by neutrophils, lymphocytes and macrophages at the site. There is injury of structural cells including the epithelium, endothelium and mesenchyme of the lung. Central to a normal repair are two major processes: epithelium and endothelium restitution, and an intact basement membrane on which the epithelial and endothelial cells can proliferate and repair damaged tissue. If the epithelial and endothelial repair is normal, the lung is able to return to normal function. However if there is inadequate restitution of these tissues, then a fibroproliferative phase occurs in which the lung develops scar tissue that limits the extension of injury.6, 7 Although collagen I is the predominant extracellular matrix deposited, there are other extracellular matrices also present. Early collagen deposition may be reversible, while chronic collagen deposition is irreversible and, in the lung, leads to airway remodelling and loss of gas exchange units. Furthermore, with smoking, there is increased matrix metalloproteinase production and decreased tissue inhibitors of matrix metalloproteinase production that results in elastin breakdown.8 Elastin is a critical extracellular matrix for lung mechanics, and the loss of elastin causes gas trapping and chest hyperinflation. Smoking also causes airway inflammation and epithelial as well as endothelial damage. Repair leads to recovery of the lung; however, progressive lung disease is a major cause of morbidity and mortality. The mechanisms of disease progression need to be elucidated. One of several potential factors causing ongoing injury is increased oxidative stress. Recently, it was shown that cellular senescence upregulated the expression of adhesion molecules, thereby promoting inflammation. Other mechanisms include impaired telomerase function resulting in defective repair due to cellular senescence.9 The interaction of bacteria with the diseased lung is becoming increasingly important. In cystic fibrosis, for example, there is dehydration of the air surface liquid layer, the accumulation of tenacious secretions and the formation of biofilms by bacteria. The defective clearance of bacteria would also influence the inflammatory response, impair repair and would result in progressive lung damage.10 Therefore, epithelial and endothelial restitution or the replacement of defective tissue is critical for normal repair. For airway diseases, therapies are limited to bronchodilators and inhaled steroids.11 The bronchodilators include beta adrenergic agents and anticholinergics. Recently, long-acting and ultralong-acting inhalers have been developed.12 Inhaled corticosteroids have been used with success in asthma but have limited effects in chronic obstructive pulmonary disease, cystic fibrosis and bronchiectasis.13 Oral steroids, despite their side-effects, are still used in inflammatory and interstitial lung diseases. Anti-inflammatory agents such as azathioprine and cyclophosphamide are also used for interstitial lung disease. The role of newer anti-inflammatory agents such as mycophenolate and sirolimus are evolving.14 Previously, they were used mainly in post-transplant management but are now increasingly used in managing other lung diseases. Biological agents such as humanized monoclonal antibodies, including anti-immunoglobulin E and anti-interleukin 5 for asthma and anti-tumour necrosis factor α for sarcoidosis15, 16 are also increasingly effective. There is a limited number of antifibrotic agents. Interferon γ, which was initially promising, has not been shown to be useful for lung fibrosis in clinical trials. Pirfenidone, an anti-transforming growth factor β agent has shown some efficacy in the management of idiopathic pulmonary fibrosis.16 Notably, there is no effective treatment for acute lung injury. Certain therapies are useful for certain diseases. Inhaled bronchodilators and corticosteroids are effective in most phenotypes of asthma, while immunomodulating therapies are useful for several lung diseases driven by inflammation. However, these agents do not address effective wound repair by augmenting epithelial and endothelial restitution. They address aspects of the complex inflammatory pathways but not structural consequences of injury. Therefore, they do not directly impact on the formation of healthy airway or gas exchanging units. In addition, the agents have significant side-effects that limit their use. Furthermore, we use these agents across the spectrum of lung diseases, while there is a need for ‘personalized’ medicine. In chronic and progressive lung diseases, the treatments are ineffective, and lung transplantation is the only viable option. A stem cell is a cell that is usually derived from a clonal population has unlimited doubling and can differentiate into many cell types.17 These cells can also influence the inflammatory pathways and/or replace damaged lung tissue. Several cells have been shown to be significantly anti-inflammatory. These include mesenchymal stem cells (MSC) derived from different sources18 and cells derived from the placenta.19 Embryonic stem cells (ESC) and induced pluripotent cells (iPS) have the potential for differentiation into lung cells. ESC is derived from the blastocyst and can differentiate into cells from all three germ layers. Therefore, there has been a strong focus on differentiating these cells into lung cells. The Nobel Prize for Physiology and Medicine 2012 was awarded to two scientists for their pioneering work on cellular reprogramming. Professor Yamanaka created iPS by transfecting fibroblasts with four genes critical to the pluripotent state: c-myc, Klf4, Oct4 and Sox-2.20 The iPS cells have similar properties to ESC and are pluripotent. As these cells are derived from an individual's own fibroblasts, they bypass the significant issue of rejection during cell transplantation.21 In addition, both ESC and iPS can be derived to investigate genetic diseases for therapeutic purposes. A cystic fibrosis line could be generated to investigate the interactions and interrelationships between the genotype and phenotype as well as to test therapeutic agents in an individualized cell line of this disease. Recently innovative experiments have been undertaken to repopulate a decellularized matrix of the lung. In this model, a matrix was derived from a rat lung, and epithelium and endothelium were cultured and propagated on this matrix.22 Whole lung was formed and transplanted into a rodent with the animal surviving. With iPS, this provides an opportunity to decellularize a lung and fabricate a whole lung from the patients' own cells. Different stem cells have different therapeutic properties. The anti-inflammatory properties of MSC are a tremendous advantage in inflammatory diseases. In addition, MSC may have trophic effects that improve the repair of epithelial and endothelial cells. Significantly, placenta-derived cells also have anti-inflammatory properties and some capacity to differentiate.19 Placenta-derived cells are abundantly available. ECS and iPS can differentiate into lung tissue and form the basis for lung regeneration. This could be pursued either with the view to specific cell replacement or alternatively with the aim of organ fabrication using decellularized matrix. It is important to appreciate that stem cells can have multiple benefits at several levels. They can reduce inflammation, augment repair and create new lung tissue. As such, stem cells could significantly extend present therapeutic options by addressing fundamental issues relating to disease progression and loss of healthy airways or gas-exchange units. As with all therapies, the potential for adverse effects always exist. However, progress has been made in cellular therapy that confirms that MSC is safe for human application. Tumour formation is a concern for ESC and iPS.23 ESC can form teratomas, and a single cell is sufficient to cause this outcome following cell transplantation. iPS may have some genetic instability and might have the potential for tumourogenesis.23 Although studies using MSC have not revealed any significant rejection, this still remains a possibility for all adult stem cells and ESC that are differentiated for transplantation. The most controversial cell line is ESC because they are derived from a blastocyst and an embryo is destroyed in the process. The ethical implications regarding the loss of the embryo are complex. However, iPS may solve the ethical problems associated with ESC. Adult stem cells derived from adult tissue are relatively free of ethical issues. The fabrication of organs using cadaveric lung may hold ethical implications because people may be induced to donate lungs following death for pecuniary gain. Furthermore, medical tourism does have ethical implications. Many patients with a chronic and progressive condition are desperate for assistance and would fall prey to clinics selling ‘miracle cures’ using stem cell therapy. It is unethical to sell unrealistic expectations to patients, and this practice would require further regulation. In this series, we have invited world experts to provide their insights into cell therapy of the lung. We will examine the role of the developmental pathways in differentiating ESC and iPS into lung tissue. The role of stem cells in the treatment of acute as well as chronic lung disease will be explored. The potential for lung fabrication from stem cells will be reviewed. Lung cancer is a major cause of mortality, and the existence of cancer stem cells will be discussed as well as the capacity to target these cells, which would have important therapeutic potential. We will also investigate the controversies of ESC and iPS as well as ethical aspects with regard to stem cell therapy. The first of these reviews24 appears in this issue of Respirology and discusses the role of MSC in the cellular therapy of lung disease. MSC is derived from a variety of sources and have significant anti-inflammatory properties that could play a major role in the treatment of lung disease.

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.

Dynamic colour change is widespread in ectothermic animals, but has primarily been studied in the context of background matching. For most species, we lack quantitative data on the extent of colour change across different contexts. It is also unclear whether and how colour change varies across body regions, and how overall sexual dichromatism relates to the extent of individual colour change. In this study, we obtained reflectance measures in response to different stimuli for males and females of six species of agamid lizards (Agamidae, sister family to Chameleonidae) comprising three closely related species pairs. We computed the colour volume in a lizard-vision colour space occupied by males and females of each species and estimated overall sexual dichromatism based on the area of non-overlapping male and female colour volumes. As expected, males had larger colour volumes than females, but the extent of colour change in males differed between species and between body regions. Notably, species that were most sexually dichromatic were not necessarily those in which males showed the greatest individual colour change. Our results indicate that the extent of colour change is independent of the degree of sexual dichromatism and demonstrate that colour change on different body regions can vary substantially even between pairs of closely related species.

The literature on the health of, and services for, older Aboriginal and Torres Strait Islander populations is relatively sparse. This study explored the development and implementation of a locally designed community service model of care for older people, people with disability and/or mental health problems in remote Aboriginal Australia. Based on extensive community consultation with older people, families, carers, community members and stakeholders, a model of care was developed to address unmet needs for the target population and their carers in the remote community of Looma, Kimberley. The model was implemented and evaluated over 12 months. The main outcome measures included the number of services (including home services, meals, transport, respite, personal care and advocacy) provided. Outcomes of community participation, capacity building, resources, partnerships, workforce, service delivery and cultural protection were assessed qualitatively by an external evaluator. The number of people receiving community care services in Looma increased from 8 to 22, and services increased in all domains from 140 total services delivered for one month at baseline to a total of 2395 by the final month of the program. Home services included cleaning, laundry, shopping, yard maintenance and social support. Respite included fishing, camping, art activities, hunting, BBQ picnic and others. Advocacy included initiating and ensuring completion (including provision of equipment and maintenance of equipment) of all types of services for clients, and also liaison between services. Staff education totalled 29 training sessions, including 5 completing Aged care certificate 3 part 1 courses, mental health first aid and dehydration training. 6 people were employed within the community. The Lungoora Ngoora community care service model pilot project demonstrated a successful collaborative service model that addressed the care needs of the older person, and those with disability and mental illness, and their carers in the remote community of Looma, Kimberley. The developmental approach, and model structure, could serve as a template for future delivery of services in remote Aboriginal communities.