Toward Planetary Health Ethics? Refiguring Bios in Bioethics

In responding to perceived crises-such as the COVID-19 pandemic-in routinized ways, contemporary bioethics can make us prisoners of the proximate. Rather, we need bioethics to recognize and engage with complex configurations of global ecosystem degradation and collapse, thereby showing us paths toward co-inhabiting the planet securely and sustainably. Such a planetary health ethics might draw rewardingly on Indigenous knowledge practices or Indigenous philosophical ecologies. It will require ethicists, with other health professionals, to step up and become public advocates for environmental sustainability. The COVID-19 pandemic should be seen as opening a portal to planetary health ethics or ecologized bioethics.

Mavacamten induces a clinical, hemodynamic, and biomarker response beyond the primary endpoint in EXPLORER-HCM: results from a post hoc machine learning analysis

Introduction

Mavacamten, a first-in-class selective inhibitor of cardiac myosin, was demonstrated in EXPLORER-HCM (NCT03470545) to be superior to placebo in achieving a primary endpoint of either (1) a ≥1.5 mL/kg/min increase in peak oxygen consumption (pVO2) and at least one New York Heart Association (NYHA) class reduction, or (2) a ≥3.0 mL/kg/min pVO2 increase without NYHA class worsening, in adults with obstructive hypertrophic cardiomyopathy (oHCM). However, the observed benefits of mavacamten were broader than the primary endpoint, suggesting a complex effect of the drug beyond improvements in these two parameters.

Purpose

A post hoc investigation of mavacamten clinical effects beyond the primary endpoint of EXPLORER-HCM.

Methods

EXPLORER data at week 30 were analyzed to evaluate improvements from baseline in primary (specified above), secondary (e.g. postexercise left ventricular outflow tract gradient and Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score) and exploratory endpoints (e.g. circulating NT-ProBNP and cardiac Troponin I). Responses were classified as improved or not improved based on published thresholds, clinical standards and analyses of the EXPLORER data. Patients were grouped according to their improvement status using unsupervised hierarchical clustering.

Results

The cluster analysis resulted in four main groups with the following trends (Table); Group 1 = patients who met the primary endpoint and showed improvement in secondary/exploratory endpoints; Group 2 = patients with improvement in secondary/exploratory endpoints who did not meet the primary endpoint; Group 3 = patients who met the primary endpoint without substantial secondary/exploratory endpoint responses; Group 4 = patients without appreciable improvement in any endpoint. A substantially larger proportion of patients in Group 1 received mavacamten compared with placebo (88% vs. 12%, respectively). A similar trend was observed in Group 2 patients who exhibited improvements in secondary/exploratory endpoints (85% mavacamten vs. 15% placebo). Group 3 consisted predominantly of placebo-treated patients who met the primary endpoint but had negligible responses to secondary/exploratory endpoints (5% mavacamten vs. 95% placebo). Group 4 consisted predominantly of placebo-treated patients without appreciable clinically relevant responses from this analysis (10% mavacamten vs. 90% placebo).

Conclusions

Mavacamten was associated with clinical improvements beyond the primary endpoint of EXPLORER-HCM and was predominantly accompanied by amelioration of other measures associated with oHCM pathophysiology. In contrast, most placebo-treated patients who met the primary endpoint did not exhibit improvement in the underlying pathophysiology. These findings suggest a potential underestimation of mavacamten clinical impact based on the primary endpoint and prompt a deeper examination of mavacamten efficacy in patients with oHCM based on other clinically relevant endpoints.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): MyoKardia, Inc., a wholly owned subsidiary of Bristol Myers Squibb

Immunities of the Herd in Peace, War, and COVID-19

Intermittently, the concept of herd immunity has been a potent, if sometimes ambiguous and controversial, means of framing the global response to the COVID-19 pandemic and envisaging its end. Realizing the full meaning of human herd immunity requires further attention to its connections after World War I with British social theory. Distracted by "obvious" yet unsubstantiated correspondences with veterinary research, historians of the concept have not engaged with the more proximate influence of discussions of social psychology and group dynamics on postwar epidemiology. Understanding the openness of early 20th century epidemiology to social thought deepens our appreciation of the significance of herd or population immunity, as well as suggests new avenues for exchange between public health and contemporary social sciences. (Am J Public Health. Published online ahead of print August 4, 2022:e1-e6. https://doi.org/10.2105/AJPH.2022.306931).

History and philosophy of science takes form

During the past hundred years the strength of the amalgam of history and philosophy of science (HPS) has waxed and waned, while assuming multiple forms and acquiring different imprints. In the 1940s and 1950s, philosopher Gerd Buchdahl and colleagues in Melbourne, Australia, assembled a methodologically powerful version of HPS, drawing on their readings, with general historians, of the philosophical works of R.G. Collingwood and Ludwig Wittgenstein, among others. Buchdahl later tried to export this pioneering conceptualization to Cambridge University, where he came to lead a new department of HPS. To appreciate the qualities and dimensions of the innovative mode of inquiry, it is necessary to understand the ecology of knowledge that promoted its emergence in an out-of-the-way settler colonial society, a productively marginal site where unanticipated filiations and alliances might be licensed to unsettled émigré scholars such as Buchdahl. Accordingly, this essay brushes off a forgotten genealogy of the relations of history and philosophy and science, thereby revealing a neglected past cognitive identity of HPS and suggesting a means to re-imagine its future.

A Service Evaluation of Dental Assessments Prior to Treatment for Head and Neck Cancer in NHS Grampian

To minimise the risk of Osteoradionecrosis (ORN) following radiotherapy, dental assessments are carried out by Restorative Consultants to determine teeth of poor prognosis requiring extraction before the commencement of radiotherapy for oncological treatment. Social deprivation is a high-risk factor for poor oral health and head and neck cancer (HANC), consequently highlighting the importance of the prehabilitation pathway, including dental assessment.

AIM

To retrospectively assess the demographics of the HAN oncology patient cohort, treatment modality, prehabilitation pathway and timeframe within NHS Grampian and highlight the role of the Restorative Dental Consultant.

MATERIALS AND METHODS

Retrospective assessment of 120 HANC patients' clinical records from May 2018 to December 2019. The patients were selected as a continuous cohort from Restorative Consultant dental assessment clinics.

RESULTS

Radiotherapy was the most common treatment modality, with 91% of patients receiving treatment; the mean time between completing dental extractions and commencing radiotherapy for oncological treatment was 17.98 days.

CONCLUSION

The HANC prehabilitation pathway should be conducted in a timeframe that allows patients to have sufficient time for healing between extractions and oncological treatment commencing to reduce ORN risk. The study also demonstrates an increased incidence of HANC in areas of higher social deprivation.

Cycles and circulation: a theme in the history of biology and medicine

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent 'canonical icons', cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations.

The model crisis, or how to have critical promiscuity in the time of Covid-19

During the past forty years, statistical modelling and simulation have come to frame perceptions of epidemic disease and to determine public health interventions that might limit or suppress the transmission of the causative agent. The influence of such formulaic disease modelling has pervaded public health policy and practice during the Covid-19 pandemic. The critical vocabulary of epidemiology, and now popular debate, thus includes R₀, the basic reproduction number of the virus, 'flattening the curve', and epidemic 'waves'. How did this happen? What are the consequences of framing and foreseeing the pandemic in these modes? Focusing on historical and contemporary disease responses, primarily in Britain, I explore the emergence of statistical modelling as a 'crisis technology', a reductive mechanism for making rapid decisions or judgments under uncertain biological constraint. I consider how Covid-19 might be configured or assembled otherwise, constituted as a more heterogeneous object of knowledge, a different and more encompassing moment of truth - not simply as a measured telos directing us to a new normal. Drawing on earlier critical engagements with the AIDS pandemic, inquiries into how to have 'theory' and 'promiscuity' in a crisis, I seek to open up a space for greater ecological, sociological, and cultural complexity in the biopolitics of modelling, thereby attempting to validate a role for critique in the Covid-19 crisis.

The Whiteness of Bioethics

A discussion of whiteness as an "ethos" or "relational category" in bioethics, drawing on examples from medical and historical research.

Coherent Structures Modulate Atmospheric Surface Layer Flux-Gradient Relationships

Since its inception in the 1940s, Monin-Obukhov similarity theory (MOST), which relates turbulent fluxes to mean vertical gradients in the lower atmosphere, has become ubiquitous for predicting surface fluxes of quantities transported by the flow in numerical weather, climate, and hydrological forecasting models. Despite its widespread use, MOST does not account for the effects of large coherent structures in the flow, which modulate the amplitude of turbulent fluctuations, and are responsible for a large fraction of the total transport. Herein, we demonstrate that the incorporation of the large-scale streamwise velocity u_{l}(x,t)=G_{δ}⋆u(x,t), where G_{δ} is a low-pass filtering kernel, into dimensional analysis leads to an additional dimensionless parameter α(x,t), which captures the modulating influence of these structures on flux-gradient relationships. Atmospheric observations and large-eddy simulations are used to demonstrate that observed deviations from MOST can indeed be explained by this new parameter; coherent structures induce an alternating loading and unloading of the mean velocity gradient near the surface.

0806 Prescription Correlates of Nightmare Disorder Among Veterans

Introduction

In the James A. Haley Veterans Administration (JAHVA) Vista database, the ICD-9 code 307.47 for Nightmare disorder (ND) is infrequently used and appears independently of codes for PTSD. We wanted to determine if certain drugs that may affect sleep are associated with ND.

Methods

All patients with ND visiting JAHVA between 2007 and 2011 were selected along with control patients who visited JAHVA on one of 20 random days, one day each quarter year. Controls were assigned an index date reflecting their selection quarter. Associations with prescriptions for opioids, antidepressants (SSRI’s, SSNI’s, Tricyclics), antihistamines and benzodiazepine/Z-drugs were initially investigated. Two analyses were performed: risk factor analysis- patients with ND diagnosis dates (cases) or index dates (controls) prior to 2008 were excluded and only prescription dates that preceded the ND diagnosis or index date were considered; treatment analysis- cases and controls with a ND diagnosis date or index date after 2010 were excluded and only prescription dates that were subsequent to the ND diagnosis or index date respectively were considered. Logistic regression adjusting for age, gender, race and Hispanic ethnicity was used to determine the association between drug groups and ND.

Results

In risk factor analysis (667 cases, 14,739 controls), opioids and antihistamines were significantly less prevalent among would-be ND patients than controls (OR=0.627 and 0.610 respectively); no drug group was predictive of ND. In contrast, all drug groups were significantly associated with ND in treatment analysis (803 cases, 15,530 controls). The strongest associations were seen with benzodiazepine (OR=3.026; 95% CI: 2.472, 3.703) and SSRI (OR=2.789; 95% CI=2.316, 3.358) prescriptions.

Conclusion

Our data suggest that some JAHVA providers may be treating ND with medication, most notably with benzodiazepines/Z-drugs and antidepressants. The role of anti-histamine and opioid prescriptions needs further elucidation. The ramifications of these treatment decisions should be explored.

Support

This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans’ Hospital.

Epidemiology, social history, and the beginnings of medical anthropology in the highlands of New Guinea

Shirley Lindenbaum’s study in the early 1960s of the origins and transmission of kuru among the Fore people of the eastern highlands of New Guinea is one of the earliest examples of an explicitly medical anthropology. Lindenbaum later described her investigations as assembling ‘an epidemiology of social relations’. How might the emergence of medical anthropology, then, be related to the concurrent development of the social history of medicine and global epidemic intelligence? Are these alternative genealogies for medical anthropology?

Cardiopulmonary interactions with beta-blockers and inhaled therapy in COPD

BACKGROUND

Beta-blockers remain underused in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular disease.

AIM

We compared how different inhaled therapies affect tolerability of bisoprolol and carvedilol in moderate to severe COPD.

DESIGN

A randomized, open label, cross-over study.

METHODS

We compared the cardiopulmonary interactions of bisoprolol 5 mg qd or carvedilol 12.5 mg bid for 6 weeks in conjunction with: (i) triple: inhaled corticosteroid/long acting beta-agonist/long acting muscarinic antagonist (ICS + LABA + LAMA), (ii) dual: ICS + LABA and (iii) ICS alone.

RESULTS

Eighteen patients completed, all ex-smokers, mean age 65 years, forced expiratory volume in 1 s (FEV1) 52% predicted. Bisoprolol and carvedilol produced comparable significant reduction in resting and exercise heart rate. FEV1, forced vital capacity and lung compliance (AX) were significantly lower with carvedilol vs. bisoprolol while taking concomitant ICS/LABA (P < 0.05) but not ICS/LABA/LAMA.

CONCLUSIONS

In summary, bisoprolol was better tolerated than carvedilol on pulmonary function at doses which produced equivalent cardiac beta-1 blockade. Worsening of pulmonary function with carvedilol was mitigated by concomitant inhaled LAMA (tiotropium) with LABA (formoterol), but not LABA alone. Registered at clinicaltrials.gov: NCT01656005.

Nowhere to run, rabbit: the cold-war calculus of disease ecology

During the cold war, Frank Fenner (protégé of Macfarlane Burnet and René Dubos) and Francis Ratcliffe (associate of A. J. Nicholson and student of Charles Elton) studied mathematically the coevolution of host resistance and parasite virulence when myxomatosis was unleashed on Australia's rabbit population. Later, Robert May called Fenner the "real hero" of disease ecology for his mathematical modeling of the epidemic. While Ratcliffe came from a tradition of animal ecology, Fenner developed an ecological orientation in World War II through his work on malaria control (with Ratcliffe and Ian Mackerras, among others)-that is, through studies of tropical medicine. This makes Fenner at least a partial exception to other senior disease ecologists in the region, most of whom learned their ecology from examining responses to agricultural challenges and animal husbandry problems in settler colonial society. Here I consider the local ecologies of knowledge in southeastern Australia during this period, and describe the particular cold-war intellectual niche that Fenner and Ratcliffe inhabited.

Applying a southern solvent: an interview with Warwick Anderson

An interview by the editor and a member of the scientific board of História, Ciências, Saúde - Manguinhos with Warwick Anderson, a leading historian of science and race from Australia. He talks about his training, positions he held at US universities, his publications, and his research at the University of Sydney. He discusses his current concern with the circulation of racial knowledge and biological materials as well as with the construction of networks of racial studies in the global south during the twentieth century. He also challenges the traditional historiography of science, which conventionally has been told from a Eurocentric perspective.

Improved Delivery through Biological Membranes. Synthesis, Characterization and Antiviral Activity of a Series of Ribavirin Chemical Delivery Systems: 5 and Carboxamide Derivatives

A number of 1-methyl-1,4-dihydrotrigonellinate derivatives of ribavirin and various ribavirin esters were prepared as potential brain-targeting delivery forms. Systemic administration of a model system (1-[5′-(1-methyl-3-carbonyl-1,4-dihydropyridine)-2′,3′-bis-O-isobutyrate-β-D-ribofuranosyl]1,2,4-triazol-3-carboxamide) resulted in a significant brain concentration of the corresponding pyridinium salt. Antiviral testing accomplished with the aid of a mouse model, in which a Phlebovirus (Punta Toro virus) was intracranially inoculated, showed that while ribavirin itself was without effect, several ribavirin chemical delivery systems (CDS) exerted significant activity. These responses included increased number of survivors and increased mean survival time. It is suggested that the CDS approach may improve the efficacy of ribavirin towards various RNA viral encephalitis diseases.

Postcolonial Ecologies of Parasite and Host: Making Parasitism Cosmopolitan

The interest of F. Macfarlane Burnet in host-parasite interactions grew through the 1920s and 1930s, culminating in his book, Biological Aspects of Infectious Disease (1940), often regarded as the founding text of disease ecology. Our knowledge of the influences on Burnet's ecological thinking is still incomplete. Burnet later attributed much of his conceptual development to his reading of British theoretical biology, especially the work of Julian Huxley and Charles Elton, and regretted he did not study Theobald Smith's Parasitism and Disease (1934) until after he had formulated his ideas. Scholars also have adduced Burnet's fascination with natural history and the clinical and public health demands on his research effort, among other influences. I want to consider here additional contributions to Burnet's ecological thinking, focusing on his intellectual milieu, placing his research in a settler society with exceptional expertise in environmental studies and pest management. In part, an ''ecological turn'' in Australian science in the 1930s, derived to a degree from British colonial scientific investments, shaped Burnet's conceptual development. This raises the question of whether we might characterize, in postcolonial fashion, disease ecology, and other studies of parasitism, as successful settler colonial or dominion science.

'The Right Time and the Right Place': An Interview with Jacques Miller

Professor Jacques F.P. Miller spoke about his career in immunology with Warwick Anderson on 3 February 2014. Born in Nice, France, Miller attended high school and medical school in Sydney, Australia. As a Ph.D. student and postgraduate researcher in London, Miller discovered the immunological function of the thymus gland. Spending the rest of his career at the Walter and Eliza Hall Institute for Medical Research in Melbourne, Miller conducted pioneering research in lymphocyte population dynamics and the mechanisms of the human immune response. With Graham Mitchell, he demonstrated that mammalian lymphocytes can be divided into what became known as T cells and B cells, which interact to produce antibodies.

Global implementation of genomic medicine: We are not alone

Around the world, innovative genomic-medicine programs capitalize on singular capabilities arising from local health care systems, cultural or political milieus, and unusual selected risk alleles or disease burdens. Such individual efforts might benefit from the sharing of approaches and lessons learned in other locales. The U.S. National Human Genome Research Institute and the National Academy of Medicine recently brought together 25 of these groups to compare projects, to examine the current state of implementation and desired near-term capabilities, and to identify opportunities for collaboration that promote the responsible practice of genomic medicine. Efforts to coalesce these groups around concrete but compelling signature projects should accelerate the responsible implementation of genomic medicine in efforts to improve clinical care worldwide.

Comparative analysis of portal hepatic infiltrating leucocytes in acute drug-induced liver injury, idiopathic autoimmune and viral hepatitis

Drug-induced liver injury (DILI) is often caused by innate and adaptive host immune responses. Characterization of inflammatory infiltrates in the liver may improve understanding of the underlying pathogenesis of DILI. This study aimed to enumerate and characterize leucocytes infiltrating liver tissue from subjects with acute DILI (n = 32) versus non-DILI causes of acute liver injury (n = 25). Immunostains for CD11b/CD4 (Kupffer and T helper cells), CD3/CD20 (T and B cells) and CD8/CD56 [T cytotoxic and natural killer (NK) cells] were evaluated in biopsies from subjects with acute DILI, either immunoallergic (IAD) or autoimmune (AID) and idiopathic autoimmune (AIH) and viral hepatitis (VH) and correlated with clinical and pathological features. All biopsies showed numerous CD8(+) T cells and macrophages. DILI cases had significantly fewer B lymphocytes than AIH and VH and significantly fewer NK cells than VH. Prominent plasma cells were unusual in IAD (three of 10 cases), but were associated strongly with AIH (eight of nine) and also observed in most with AID (six of nine). They were also found in five of 10 cases with VH. Liver biopsies from subjects with DILI were characterized by low counts of mature B cells and NK cells in portal triads in contrast to VH. NK cells were found only in cases of VH, whereas AIH and VH both showed higher counts of B cells than DILI. Plasma cells were associated most strongly with AIH and less so with AID, but were uncommon in IAD.

Wandering anatomists and itinerant anthropologists: the antipodean sciences of race in Britain between the wars

While the British Empire conventionally is recognized as a source of research subjects and objects in anthropology, and a site where anthropological expertise might inform public administration, the settler-colonial affiliations and experiences of many leading physical anthropologists could also directly shape theories of human variation, both physical and cultural. Antipodean anthropologists like Grafton Elliot Smith were pre-adapted to diffusionist models that explained cultural achievement in terms of the migration, contact and mixing of peoples. Trained in comparative methods, these fractious cosmopolitans also favoured a dynamic human biology, often emphasizing the heterogeneity and environmental plasticity of body form and function, and viewing fixed, static racial typologies and hierarchies sceptically. By following leading representatives of empire anatomy and physical anthropology, such as Elliot Smith and Frederic Wood Jones, around the globe, it is possible to recover the colonial entanglements and biases of interwar British anthropology, moving beyond a simple inventory of imperial sources, and crediting human biology and social anthropology not just as colonial sciences but as the sciences of itinerant colonials.

Racial conceptions in the global south

What happens to twentieth-century race science when we relocate it to the Global South? North Atlantic debates have dominated the conceptual history of race. Yet there is suggestive evidence of a "southern" or antipodean racial distinctiveness. We can find across the Southern Hemisphere greater interest in racial plasticity, environmental adaptation, mixing or miscegenation, and blurring of racial boundaries; endorsement of biological absorption of indigenous populations; and consent to the formation of new or blended races. Once we recognize the Global South as a site of knowledge making, and not just data extraction, the picture of race science in the twentieth century changes. Once situated, or displaced, the conventional North Atlantic history of race science in the twentieth century comes to seem exceptional--and no longer normative.

Getting ahead of one's self? The common culture of immunology and philosophy

During the past thirty years, immunological metaphors, motifs, and models have come to shape much social theory and philosophy. Immunology, so it seems, often has served to naturalize claims about self, identity, and sovereignty--perhaps most prominently in Jacques Derrida's later studies. Yet the immunological science that functions as "nature" in these social and philosophical arguments is derived from interwar and Cold War social theory and philosophy. Theoretical immunologists and social theorists knowingly participated in a common culture. Thus the "naturalistic fallacy" in this case might be reframed as an error of categorization: its conditions of possibility would require ceaseless effort to purify and separate out the categories of nature and culture. The problem--inasmuch as there is a problem-therefore is not so much the making of an appeal to nature as assuming privileged access to an independent, sovereign category called "nature".

Formation of monochloropropane-1,2-diol and its esters in biscuits during baking

The formation of free monochloropropane-1,2-diol (3-MCPD and 2-MCPD) and its esters (bound-MCPD) was investigated in biscuits baked with various time and temperature combinations. The effect of salt as a source of chloride on the formation of these processing contaminants was also determined. Kinetic examination of the data indicated that an increasing baking temperature led to an increase in the reaction rate constants for 3-MCPD, 2-MCPD, and bound-MCPD. The activation energies of formation of 3-MCPD and 2-MCPD were found to be 29 kJ mol(-1). Eliminating salt from the recipe decreased 3-MCPD and 2-MCPD formation rate constants in biscuits by 57.5 and 85.4%, respectively. In addition, there was no formation of bound-MCPD in biscuits during baking without salt. Therefore, lowering the thermal load or limiting the chloride concentration should be considered a means of reducing or eliminating the formation of these contaminants in biscuits. Different refined oils were also used in the recipe to test their effect on the occurrence of free MCPD and its esters in biscuits. Besides the baking process, the results also confirmed the role of refined oil in the final concentration of these contaminants in biscuits.

Hermannsburg, 1929: turning aboriginal "primitives" into modern psychological subjects

In 1929, the Lutheran mission at Hermannsburg (Ntaria), central Australia, became an extraordinary investigatory site, attracting an array of leading psychologists wishing to define the "primitive" mentality of the Arrernte, who became perhaps the most studied people in the British Empire and dominions. This is a story of how scientific knowledge derived from close encounters and fraught entanglements on the borderlands of the settler state. The investigators-Stanley D. Porteus, H. K. Fry, and Géza Róheim-represent the major styles of psychological inquiry in the early-twentieth century, and count among the vanguard of those dismantling rigid racial typologies and fixed hierarchies of human mentality. They wanted to evaluate "how natives think," yet inescapably they found themselves reflecting on white mentality too. They came to recognise the primitive as an influential and disturbing motif within the civilised mind-their own minds. These intense interactions in the central deserts show us how Aboriginal thinking could make whites think again about themselves-and forget, for a moment, that many of their research subjects were starving.

Additional exposure of the Irish adult population to dioxins and PCBs from the diet as a consequence of the 2008 Irish dioxin food contamination incident

In 2008, the discovery of elevated levels of dioxins and PCBs in a porcine fat sample taken as part of the national residues monitoring programme led to the detection of a major feed contamination incidence in the Republic of Ireland. To estimate additional exposure to dioxins and PCBs due to the contamination incident, all data associated with the contamination incident were collected and reviewed. An exposure model was devised that took into account the proportion of contaminated product reaching the final consumer during the contamination incident window and which utilised all additional information that became available after the incident occurred. Exposure estimates derived for both dioxins and PCBs showed that the body burden of the general population remained largely unaffected by the contamination incident and only approximately 10% were exposed to elevated levels of dioxins and PCBs. Whilst this proportion of the population experienced quite a significant additional load to the existing body burden, the estimated exposure values do not suggest that these would be associated with adverse health effects, based on current knowledge. The exposure period was also limited in time to approximately 3 months, following the recall of contaminated meat immediately on detection of the contamination.

Fashioning the immunological self: the biological individuality of F. Macfarlane Burnet

During the 1940s and 1950s, the Australian microbiologist F. Macfarlane Burnet sought a biologically plausible explanation of antibody production. In this essay, we seek to recover the conceptual pathways that Burnet followed in his immunological theorizing. In so doing, we emphasize the influence of speculations on individuality, especially those of philosopher Alfred North Whitehead; the impact of cybernetics and information theory; and the contributions of clinical research into autoimmune disease that took place in Melbourne. We point to the influence of local experimental and intellectual currents on Burnet's work. Accordingly, this essay describes an arc distinct from most other tracings of Burnet's conceptual development, which focus on his early bacteriophage research, his fascination with the work of Julian Huxley and other biologists in the 1920s, and his interest in North Atlantic experimental investigations in the life sciences. No doubt these too were potent influences, but they seem insufficient to explain, for example, Burnet's sudden enthusiasm in the 1940s for immunological definitions of self and not-self. We want to demonstrate here how Burnet's deep involvement in philosophical biology - along with attention to local clinical research - provided him with additional theoretic tools and conceptual equipment, with which to explain immune function.