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Medium‐ to large‐scale marine protected areas (MPAs) are playing an increasingly important role in global marine biodiversity conservation. A key question is "how do we collect relevant data on biodiversity and population trends to inform their design and measure success?"This question is particularly relevant for marine taxa that are difficult to survey, such as sharks and rays, and where populations may occur over vast areas. Environmental DNA (eDNA) metabarcoding has proven to be an effective sampling method and may provide a solution to these challenges; however, it remains unclear how its sampling effectiveness compares with traditionally used methods for elasmobranch surveying.Here, we directly compared the efficacy of eDNA metabarcoding and demersal longline deployments to survey elasmobranchs across 31 sites over a 55,000 km2 area of the Kimberley and Roebuck Australian Marine Parks in Australia's North‐west Marine Parks Network.In total, we documented 49 unique elasmobranch taxa, 36 of which were detected by eDNA and 32 (from a total of 815 captured sharks) by longline. A combined approach yielded over 34% more elasmobranch taxa than either method alone.Site community compositions varied between the two survey methods; notably eDNA was able to detect species from outside of the immediate sampling area, although this was still consistent with a detection radius of a few kilometres, highlighting a particular use in rugose reef habitats where it is difficult to deploy longlines.In investigating the quantitative use of eDNA data, we report that eDNA metabarcoding read abundance (count) data was poorly correlated with longline aggregate catch (count and biomass) data across raw, relative and rank abundance measures. However, we found that in multivariate analyses, both binary (presence–absence) and abundance (after square‐root transformation) datasets produced highly similar ordination patterns, largely segregating method (eDNA vs. longline), followed by latitude and depth.Lastly, we identified required levels of eDNA replication and longline deployments to maximize captured elasmobranch diversity.This study sets an integrated, georeferenced baseline and long‐term monitoring approach for the management and conservation of elasmobranch diversity within this unique marine park network. [ABSTRACT FROM AUTHOR]

A severe lack of distribution data for aquatic reptiles in northern Australia leaves many taxa vulnerable to extirpation and extinction. Environmental DNA (eDNA) technologies offer sensitive and non-invasive genetic alternatives to trapping and visual surveys and are increasingly employed for the detection of aquatic and semi-aquatic reptiles. However, these eDNA approaches have largely applied species-specific primers that do not provide a cost-effective avenue for the simultaneous detection of multiple reptilian taxa. Here, we present a mitochondrial 16S rRNA metabarcoding assay for the broad detection of aquatic and semi-aquatic reptile species. This assay is tested on water samples collected at multiple sampling sites at two tropical locations, including 12 marine and estuarine sites in Roebuck Bay, Western Australia, and four estuarine sites in Cooktown, Queensland, Australia. In total, nine reptile taxa were detected from 10 of the 16 sampled sites, including marine and freshwater turtles, aquatic, semi-aquatic and terrestrial snakes, and terrestrial skinks. However, inconsistencies in the detection of previously observed aquatic reptiles at our sampled sites, such as saltwater crocodile and sea snakes, indicated that further research is required to assess the reliability, strengths and limitations of eDNA methods for aquatic reptile detection before it can be integrated as a broad-scale bioassessment tool. Environmental DNA (eDNA) technologies offer a new genetic approach for the non-invasive detection of reptile species in the environment. Here, we develop a mitochondrial 16S rRNA metabarcoding assay, capable of detecting multiple aquatic and semi-aquatic reptile species from environmental samples. This assay successfully detected marine and freshwater turtles, aquatic, semi-aquatic and terrestrial snakes, and terrestrial skinks at two northern Australian locations. [ABSTRACT FROM AUTHOR]

Introduction: Regular tumour‐specific peer review meetings (TPRMs) were established by our group during 2016. A dedicated Quality Assurance Radiation Therapist (QART) was employed in 2018 to co‐ordinate the meetings and for each patient, complete the Peer Review Audit Tool (PRAT) of the Royal Australian and New Zealand College of Radiologists (RANZCR). The aim of the current quality assurance study was to investigate the impact of the TPRMs and appointment of the QART on compliance to relevant RANZCR Radiation Oncology Practice Standards (ROPS). Methods: Tumour‐specific peer review meetings for eight tumour sites were assessed across our group's three hospitals from January 2017 to December 2019. Data from meetings were collected using the PRAT or from paper‐based minutes and assessed against four ROPS (ROPS 3, 4, 8 and 9). Compliance with each of the four standards was measured by presence of the required documentation and presentation at TPRM, as recorded by the PRAT. Results: There was an increase in the overall number of peer review cases audited from 173 in the 2017 calendar year to 469 in 2018 and 619 in 2019, representing 7%, 18% and 22% of all treatment courses started during these years, respectively. Staging was the most incompletely documented item across all years for audited patients. The request for radiation treatment plan modifications increased year‐on‐year: modifications were requested for 5% of plans in 2017 (8/172), 18% in 2018 (81/452) and 19% (119/619) in 2019. Conclusion: This study has shown that an increase in the number of cases for peer‐review audit corresponded to the QART‐facilitated TPRMs. Application of the PRAT has identified radiation treatment plan modifications that would otherwise go undetected and without opportunity to improve the quality of patients' treatment or avoid harm. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine dosimetric factors, such as mean dose and oesophageal length, which may influence the incidence and severity of oesophagitis in breast cancer patients receiving radiotherapy to the supraclavicular nodes.Methods: This was a single-arm prospective observational study. Toxicity grading was undertaken twice weekly to determine the onset of grade 2 oesophagitis in consecutive patients prescribed IMRT to the breast or chest wall and supraclavicular fossa (SCF) nodes. Recorded variables included mean and maximum doses to the oesophagus, oesophageal length and pharynx length within the treatment area. Multivariate logistic regression and Fishers' exact test were used with a 0.05 significance level to compare the onset of grade 2 oesophagitis with these variables.Results: A total of 77 patients were included in the study. Twenty-four (31%) patients reported grade 2 oesophagitis. There was a higher incidence of grade 2 oesophagitis in patients receiving a mean oesophageal dose of ≥31 Gy compared to those receiving < 31 Gy (18/24 versus 6/24, respectively, P = 0.025). There was a significant difference in the onset of grade 2 toxicity in patients who had ≥ 1 cm of pharynx included in SCF fields compared with those with <1 cm (15/24 versus 9/24, respectively, P = 0.0116). The odds ratios for developing grade 2 oesophagitis were 3.2 (95% CI = 1.05-9.62, P = 0.04) for a mean dose of ≥31 Gy and 3.4 (95% CI = 1.19-9.5, P = 0.022) for ≥1 cm of pharynx in the SCF field.Conclusion: By limiting the mean dose to the irradiated oesophagus to <31 Gy during the planning process and ensuring that <1 cm of pharynx is included in the radiation field, oesophageal toxicity may be minimised. [ABSTRACT FROM AUTHOR]

Introduction: Stereotactic ablative radiotherapy (SABR) for lung cancer is a modality of treatment that has improved outcomes for lung cancer patients. However, radiotherapy for lung cancer is underutilized and fewer than half of elderly patients with non‐small cell lung cancer (NSCLC) receive active treatment. The purpose of this study is to report on a collaboration in implementing an NSCLC SABR (stereotactic ablative body radiation) program safely, efficiently, and uniformly across several centers, including regional sites. The first aim of this paper is to detail the collaboration and implementation that started in 2013 and is ongoing. The second aim of this paper is to document early toxicities and quality of life outcomes. Method: A tripartite approach was used to develop the protocol and networks required for the implementation of SABR across multiple sites in NSW. Departments starting the programmes were supported and physics credentialing with central site submission was required before commencing the treatment. Additional ongoing support was available via an email discussion group involving all members of the collaboration. Results: Between July 22, 2013 and February 22, 2016, 41 patients were enrolled with 34 patients in active follow up. The toxicity profile so far is similar to those of published studies with no appreciable effect on quality of life outcomes. Conclusion: The collaboration formed an effective framework in facilitating the implementation of SABR across several sites in NSW and could be used as a model for the safe and uniform implementation of new technologies in Australia. [ABSTRACT FROM AUTHOR]

Introduction: The multidisciplinary team meeting (MDTM) approach is accepted as standard of care to optimise treatment for patients diagnosed with cancer. This retrospective audit reviews the proportion of patients whose care is being discussed at cancer MDTMs within the Sunshine Coast Hospital and Health Service (SCHHS).Methods: Patients included were those diagnosed with cancer within the SCHHS between 2010 and 2015, and subsequently referred to a public MDTM for discussion. Data were extracted from the Queensland Cancer Control Analysis Team (QCCAT) database regarding the incidence of breast, lung, upper gastrointestinal (GI), colorectal, genitourinary and malignant haematological cancers and the number of patients referred to the corresponding MDTM.Results: Data from 2015 show referral rates to MDTMs as follows: lung 100%, upper gastrointestinal 100%, colorectal 64%, breast 60%, malignant haematology 40% and genitourinary 28%. Of the genitourinary presentations, 70% were prostate cases and 14% bladder cases. Review of genitourinary MDTM outcomes found that, of the patients with prostate cancer discussed, 30% were metastatic, 19% were poor surgical candidates and 15% had biochemical recurrence.Conclusion: This audit demonstrates variable utilisation of MDTMs between tumour streams. Our study shows a high and increasing referral rate to all tumour stream MDTMs except for genitourinary. This suggests a possible underutilisation of genitourinary MDTMs to discuss treatment options for patients with genitourinary cancer. Collaborative research is warranted to further investigate whether this is a local or widespread issue. [ABSTRACT FROM AUTHOR]

Introduction: Stereotactic ablative radiotherapy (SABR) for lung cancer is a modality of treatment that has improved outcomes for lung cancer patients. However, radiotherapy for lung cancer is underutilized and fewer than half of elderly patients with non-small cell lung cancer (NSCLC) receive active treatment. The purpose of this study is to report on a collaboration in implementing an NSCLC SABR (stereotactic ablative body radiation) program safely, efficiently, and uniformly across several centers, including regional sites. The first aim of this paper is to detail the collaboration and implementation that started in 2013 and is ongoing. The second aim of this paper is to document early toxicities and quality of life outcomes., Method: A tripartite approach was used to develop the protocol and networks required for the implementation of SABR across multiple sites in NSW. Departments starting the programmes were supported and physics credentialing with central site submission was required before commencing the treatment. Additional ongoing support was available via an email discussion group involving all members of the collaboration., Results: Between July 22, 2013 and February 22, 2016, 41 patients were enrolled with 34 patients in active follow up. The toxicity profile so far is similar to those of published studies with no appreciable effect on quality of life outcomes., Conclusion: The collaboration formed an effective framework in facilitating the implementation of SABR across several sites in NSW and could be used as a model for the safe and uniform implementation of new technologies in Australia., (© 2019 John Wiley & Sons Australia, Ltd.)