Dental clinicians' perceptions on the use of tele-dentistry consultations during COVID-19 within public dental clinics in Sydney, Australia

BACKGROUND

Although well accepted by clinicians and patients, teledentistry is not currently a widely used model of care within Australian public oral health services. This qualitative study aimed to review and evaluate dental clinicians' perceptions, by determining the acceptability and appropriateness of teledentistry as a model of care.

METHODS

A purposive sample of 12 public dental practitioners employed by a Local Health District in Sydney, and who had participated in teledentistry consultations, were recruited to participate in focus groups. Focus group discussions were transcribed verbatim and subjected to thematic analysis.

RESULTS

Teledentistry was a novel concept for most participants and was well accepted. Participants valued the use of a standardized consultation template as well as effective communication with other dental clinicians to support the practice of teledentistry. However, many found attempting contact with patients over the telephone difficult as well as the perceived patient frustration with the administration process and technological difficulties experienced.

CONCLUSION

Teledentistry has the potential for growth and expansion in the public health system. From the opinions in this study, the authors propose further research is needed into the efficacy of teledentistry to assist with the development of a model of care that would be beneficial for dental clinicians and their patients. © 2023 Australian Dental Association.

Factors associated with bovine respiratory disease case fatality in feedlot cattle

Bovine respiratory disease (BRD) is the primary cause of morbidity and mortality in cattle feedlots. There is a need to understand what animal health and production factors are associated with increased mortality risk due to BRD. The aim of the present study was to explore factors associated with BRD case fatality in feedlot cattle. Four pens totaling 898 steers were monitored daily for visual signs of BRD such as difficult breathing and coughing, and animals exhibiting signs of BRD were taken to the hospital shed for further examination and clinical measures. Blood samples were obtained at feedlot entry and at time of first BRD pull from animals diagnosed with BRD (n = 121) and those that died due to BRD confirmed by postmortem examination (n = 16; 13.2% case fatality rate). Mixed-effects linear regression models were used to estimate differences in animal health and production factors and the relative concentrations of 34 identified blood metabolites between animals that survived versus those that died. Generalized linear mixed-effects models were used to obtain the odds of being seronegative (at both feedlot entry and first BRD pull) to 5 BRD viruses and having a positive nasal swab result at the time of first pull in died and survived animals. Animals that died from BRD had lower average daily gain (ADG), reduced weight at first BRD pull, higher visual BRD scores and received more treatments for BRD compared with animals that survived BRD (P < 0.05). The odds of being seronegative for bovine viral diarrhea virus 1 (BVDV-1) were 5.66 times higher for animals that died compared with those that survived (P = 0.013). The odds of having a positive bovine coronavirus nasal swab result were 13.73 times higher in animals that died versus those that survived (P = 0.007). Animals that died from BRD had higher blood concentrations of α glucose chain, β-hydroxybutyrate, leucine, phenylalanine, and pyruvate compared with those that survived (P < 0.05). Animals that died from BRD had lower concentrations of acetate, citrate, and glycine compared with animals that survived (P < 0.05). The results of the current study suggest that ADG to first BRD pull, weight at first BRD pull, visual BRD score, the number of BRD treatments, seronegativity to BVDV-1, virus positive to BCoV nasal swab, and that certain blood metabolites are associated with BRD case fatality risk. The ability of these measures to predict the risk of death due to BRD needs further research.

Cold adaptation and replicable microbial community development during long-term low-temperature anaerobic digestion treatment of synthetic sewage

The development and activity of a cold-adapting microbial community was monitored during low-temperature anaerobic digestion (LtAD) treatment of wastewater. Two replicate hybrid anaerobic sludge bed-fixed-film reactors treated a synthetic sewage wastewater at 12°C, at organic loading rates of 0.25-1.0 kg chemical oxygen demand (COD) m-3 d-1, over 889 days. The inoculum was obtained from a full-scale anaerobic digestion reactor, which was operated at 37°C. Both LtAD reactors readily degraded the influent with COD removal efficiencies regularly exceeding 78% for both the total and soluble COD fractions. The biomass from both reactors was sampled temporally and tested for activity against hydrolytic and methanogenic substrates at 12°C and 37°C. Data indicated that significantly enhanced low-temperature hydrolytic and methanogenic activity developed in both systems. For example, the hydrolysis rate constant (k) at 12°C had increased 20-30-fold by comparison to the inoculum by day 500. Substrate affinity also increased for hydrolytic substrates at low temperature. Next generation sequencing demonstrated that a shift in a community structure occurred over the trial, involving a 1-log-fold change in 25 SEQS (OTU-free approach) from the inoculum. Microbial community structure changes and process performance were replicable in the LtAD reactors.

Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle

Results obtained from a nationwide longitudinal study were extended to estimate the population-level effects of selected risk factors on the incidence of bovine respiratory disease (BRD) during the first 50days at risk in medium-sized to large Australian feedlots. Population attributable fractions (PAF) and population attributable risks (PAR) were used to rank selected risk factors in order of importance from the perspective of the Australian feedlot industry within two mutually exclusive categories: 'intervention' risk factors had practical strategies that feedlot managers could implement to avoid exposure of cattle to adverse levels of the risk factor and a precise estimate of the population-level effect while 'others' did not. An alternative method was also used to quantify the expected effects of simultaneously preventing exposure to multiple management-related factors whilst not changing exposure to factors that were more difficult to modify. The most important 'intervention' risk factors were shared pen water (PAF: 0.70, 95% credible interval: 0.45-0.83), breed (PAF: 0.67, 95% credible interval: 0.54-0.77), the animal's prior lifetime history of mixing with cattle from other herds (PAF: 0.53, 95% credible interval: 0.30-0.69), timing of the animal's move to the vicinity of the feedlot (PAF: 0.45, 95% credible interval: 0.17-0.68), the presence of Bovine viral diarrhoea virus 1 (BVDV-1) in the animal's cohort (PAF: 0.30, 95% credible interval: 0.04-0.50), the number of study animals in the animal's group 13days before induction (PAF: 0.30, 95% credible interval: 0.10-0.44) and induction weight (PAF: 0.16, 95% credible interval: 0.09-0.23). Other important risk factors identified and prioritised for further research were feedlot region, season of induction and cohort formation patterns. An estimated 82% of BRD incidence was attributable to management-related risk factors, whereby the lowest risk category of a composite management-related variable comprised animals in the lowest risk category of at least four of the five component variables (shared pen water, mixing, move timing, BVDV-1 in the cohort and the number of animals in the animal's group-13). This indicated that widespread adoption of appropriate interventions including ensuring pen water is not shared between pens, optimising animal mixing before induction, timing of the animal's move to the vicinity of the feedlot, and group size prior to placing animals in feedlot pens, and avoiding BVDV-1 in cohorts could markedly reduce the incidence of BRD in medium-sized to large Australian feedlots.

Alphaherpesvirus-associated disease in greater bilbies (Macrotis lagotis)

CASE REPORT

A captive breeding colony of 9 greater bilbies (Macrotis lagotis) exhibited mild upper respiratory signs and sudden deaths with 100% mortality over a 2-week period. Histologically, acute necrotising and erosive epithelial lesions throughout the upper respiratory system and bronchi were associated with eosinophilic intranuclear inclusion bodies. Inclusions were also present in hepatocytes and adrenocortical cells, but were not always associated with necrosis. Transmission electron microscopy of lung sections revealed nucleocapsids forming arrays within some nuclei. A pan-herpesvirus PCR yielded a 440-bp product, with sequencing confirming homology with the alphaherpesviruses. Viral culture in a marsupial cell line resulted in cytopathic effect consistent with an alphaherpesvirus.

CONCLUSION

This is the first report of a herpesvirus-associated disease in greater bilbies.

Associations between prior management of cattle and risk of bovine respiratory disease in feedlot cattle

Bovine respiratory disease (BRD) is the major cause of clinical disease and death in feedlot populations worldwide. A longitudinal study was conducted to assess associations between risk factors related to on-farm management prior to transport to the feedlot and risk of BRD in a population of feedlot beef cattle sourced from throughout the cattle producing regions of Australia. Exposure variables were derived from questionnaire data provided by farmers supplying cattle (N=10,721) that were a subset of the population included in a nationwide prospective study investigating numerous putative risk factors for BRD. Causal diagrams were used to inform model building to allow estimation of effects of interest. Multilevel mixed effects logistic regression models were fitted within the Bayesian framework. Animals that were yard weaned were at reduced risk (OR: 0.7, 95% credible interval: 0.5-1.0) of BRD at the feedlot compared to animals immediately returned to pasture after weaning. Animals that had previously been fed grain (OR: 0.6, 95% credible interval: 0.3-1.1) were probably at reduced risk of BRD at the feedlot compared to animals not previously fed grain. Animals that received prior vaccinations against Bovine viral diarrhoea virus 1 (OR: 0.8, 95% credible interval: 0.5-1.1) or Mannheimia haemolytica (OR: 0.8, 95% credible interval: 0.6-1.0) were also probably at reduced risk compared to non-vaccinated animals. The results of this study confirm that on-farm management before feedlot entry can alter risk of BRD after beef cattle enter feedlots.

Risk factors for bovine respiratory disease in Australian feedlot cattle: use of a causal diagram-informed approach to estimate effects of animal mixing and movements before feedlot entry

A nationwide longitudinal study was conducted to investigate risk factors for bovine respiratory disease (BRD) in cattle in Australian feedlots. After induction (processing), cattle were placed in feedlot pens (cohorts) and monitored for occurrence of BRD over the first 50 days on feed. Data from a national cattle movement database were used to derive variables describing mixing of animals with cattle from other farms, numbers of animals in groups before arrival at the feedlot, exposure of animals to saleyards before arrival at the feedlot, and the timing and duration of the animal's move to the vicinity of the feedlot. Total and direct effects for each risk factor were estimated using a causal diagram-informed process to determine covariates to include in four-level Bayesian logistic regression models. Mixing, group size and timing of the animal's move to the feedlot were important predictors of BRD. Animals not mixed with cattle from other farms prior to 12 days before induction and then exposed to a high level of mixing (≥4 groups of animals mixed) had the highest risk of developing BRD (OR 3.7) compared to animals mixed at least 4 weeks before induction with less than 4 groups forming the cohort. Animals in groups formed at least 13 days before induction comprising 100 or more (OR 0.5) or 50-99 (OR 0.8) were at reduced risk compared to those in groups of less than 50 cattle. Animals moved to the vicinity of the feedlot at least 27 days before induction were at reduced risk (OR 0.4) compared to cattle undergoing short-haul transportation (<6h) to the feedlot within a day of induction, while those experiencing longer transportation durations (6h or more) within a day of induction were at slightly increased risk (OR 1.2). Knowledge of these risk factors could potentially be used to inform management decisions to reduce the risk of BRD in feedlot cattle.

In vivo delivery of bovine viral diahorrea virus, E2 protein using hollow mesoporous silica nanoparticles

Our work focuses on the application of mesoporous silica nanoparticles as a combined delivery vehicle and adjuvant for vaccine applications. Here we present results using the viral protein, E2, from bovine viral diarrhoea virus (BVDV). BVDV infection occurs in the target species of cattle and sheep herds worldwide and is therefore of economic importance. E2 is a major immunogenic determinant of BVDV and is an ideal candidate for the development of a subunit based nanovaccine using mesoporous silica nanoparticles. Hollow type mesoporous silica nanoparticles with surface amino functionalisation (termed HMSA) were characterised and assessed for adsorption and desorption of E2. A codon-optimised version of the E2 protein (termed Opti-E2) was produced in Escherichia coli. HMSA (120 nm) had an adsorption capacity of 80 μg Opti-E2 per mg HMSA and once bound E2 did not dissociate from the HMSA. Immunisation studies in mice with a 20 μg dose of E2 adsorbed to 250 μg HMSA was compared to immunisation with Opti-E2 (50 μg) together with the traditional adjuvant Quillaja saponaria Molina tree saponins (QuilA, 10 μg). The humoral responses with the Opti-E2/HMSA nanovaccine although slightly lower than those obtained for the Opti-E2 + QuilA group demonstrated that HMSA particles are an effective adjuvant that stimulated E2-specific antibody responses. Importantly the cell-mediated immune responses were consistently high in all mice immunised with Opti-E2/HMSA nanovaccine formulation. Therefore we have shown the Opti-E2/HMSA nanoformulation acts as an excellent adjuvant that gives both T-helper 1 and T-helper 2 mediated responses in a small animal model. This study has provided proof-of-concept towards the development of an E2 subunit nanoparticle based vaccine.

The hydrolysis and biogas production of complex cellulosic substrates using three anaerobic biomass sources

In this study, the ability of various sludges to digest a diverse range of cellulose and cellulose-derived substrates was assessed at different temperatures to elucidate the factors affecting hydrolysis. For this purpose, the biogas production was monitored and the specific biogas activity (SBA) of the sludges was employed to compare the performance of three anaerobic sludges on the degradation of a variety of complex cellulose sources, across a range of temperatures. The sludge with the highest performance on complex substrates was derived from a full-scale bioreactor treating sewage at 37 °C. Hydrolysis was the rate-limiting step during the degradation of complex substrates. No activity was recorded for the synthetic cellulose compound carboxymethylcellulose (CMC) using any of the sludges tested. Increased temperature led to an increase in hydrolysis rates and thus SBA values. The non-granular nature of the mesophilic sludge played a positive role in the hydrolysis of solid substrates, while the granular sludges proved more effective on the degradation of soluble compounds.

Temperature effects on the trophic stages of perennial rye grass anaerobic digestion

Continuous Stirred Tank Reactors (CSTRs), operated in batch mode, were used to evaluate the feasibility of psychrophilic (low temperature) digestion of perennial rye grass in a long term experiment (150 days) for the first time. The reactors were operated in parallel at 3 different temperatures, 10, 15 and 37 degrees C. Hydrolysis, acidification and methanogenesis were assessed by VS degradation, by soluble chemical oxygen demand (SCOD) and volatile fatty acids (VFA) production, and by methane production, respectively. Hydrolysis was the rate-limiting step at all temperatures and the rates and extent of hydrolysis were considerably lower at 15 and 10 degrees C, than at 37 degrees C. The total VS degradation was 53%, 34% and 19% at 37, 15 and 10 degrees C, respectively. Acidification was not affected by temperature and VFA production and consumption was balanced in all cases, except at 10 degrees C. Methane yields were 0.215 m3 CH4 kg(-1) VS(-1) added, 0.160 m3 CH4 kg(-1) VS(-1) added and 0.125 m3 CH4 kg(-1) VS(-1) added at 37, 15 and 10 degrees C, respectively. Methanogenesis was not strongly affected at 15 C but it became rate-limiting at 10 degrees C. Overall, the solid degradation and methane production performance under psychrophilic conditions was encouraging and greater than previously reported. Considering the non-acclimated, mesophilic nature of the inoculum, there are grounds to believe that low-temperature anaerobic digestion of grass could be feasible if coupled to efficient hydrolysis of the biomass.

A Lucilia cuprina excretory-secretory protein inhibits the early phase of lymphocyte activation and subsequent proliferation

The development of a protective immune response in sheep towards the presence of the larval stage of Lucilia cuprina has not been reported in the field. Upon investigation of the effects of larval excretory/secretory material on ovine T lymphocyte proliferation, we isolated a 56 kDa protein capable of inhibiting lymphocyte proliferation by at least 70%, compared with that in the presence of mitogen alone. This protein inhibited proliferation induced through cross-linking of the T-cell receptor as well as proliferation induced pharmacologically through the stimulation of the protein kinase C (PKC) pathway. The protein, named blowfly larval immunosuppressive protein (BLIP), was shown to bind directly to lymphocytes. Further investigation revealed that the BLIP prevented a proportion of lymphocytes from entering the first division following stimulation, by affecting the early events in lymphocyte activation. Subsequently, the BLIP reduced CD25 expression on T lymphocytes, reduced IL-2 mRNA expression, in addition to IFN-gamma, IL-4, IL-10 and IL-13 mRNA expression. Conversely, TNF-alpha and TGF-beta gene expression was up-regulated in response to the BLIP. These effects suggest suboptimal activation of T lymphocytes in the presence of the BLIP, and we propose that the BLIP presents an effective immune evasion tactic for the larvae of L. cuprina.

Phylogenetic analysis of betanodavirus isolates from Australian finfish

In Australia, disease caused by betanodavirus has been reported in an increasing number of cultured finfish since the first report of mortalities in 1990. Partial coat protein gene sequences from the T2 or T4 regions of 8 betanodaviruses from barramundi Lates calcarifer, sleepy cod Oxyeleotris lineolata, striped trumpeter Latris lineata, barramundi cod Cromileptes altivelis, Australian bass Macquaria novemaculata and gold-spotted rockcod Epinephelus coioides from several Australian states were determined. Analysis of the 606 bp nucleotide sequences of the T2 region of 4 isolates demonstrated the close relationship with isolates from the red-spotted grouper nervous necrosis virus (RGNNV) genotype and the Cluster Ia subtype. Comparison of a smaller 289 bp sequence from the T4 region identified 2 distinct groupings of the Australian isolates within the RGNNV genotype. Isolates from barramundi from the Northern Territory, barramundi, sleepy cod, barramundi cod and gold-spotted rockcod from Queensland, and striped trumpeter from Tasmania shared a 96.2 to 99.7% nucleotide identity with each other. These isolates were most similar to the RGNNV genotype Cluster Ia. Isolates from Australian bass from New South Wales and from barramundi from South Australia shared a 98.6% sequence identity with each other. However, these isolates only shared an 85.8 to 87.9% identity with the other Australian isolates and representative RGNNV isolates. The closest nucleotide identity to sequences reported in the literature for the New South Wales and South Australian isolates was to an Australian barramundi isolate (Ba94Aus) from 1994. These 2 Australian isolates formed a new subtype within the RGNNV genotype, which is designated as Cluster Ic.

Low temperature anaerobic biotreatment of priority pollutants

The effect of low operating temperature and pollutant concentration on the performance of five anaerobic hybrid reactors was investigated. Stable and efficient long-term (>400 days) treatment of a cold (6-13 degrees C), volatile fatty acid (VFA)-based, wastewater was achieved at applied organic loading rates (OLRs) of 5 kg chemical oxygen demand (COD) m(-3) d(-1) with COD removal efficiencies c. 84% at 6 degrees C (sludge loading rate (SLR) 1.04-1.46 kg COD kg [VSS](-1) d(-1)). VFA-based wastewaters, containing up to 14 g pentachlorophenol (PCP) m(-3) d(-1) or 155 g toluene m(-3) d(-1) were successfully treated at applied OLRs of 5-7 kg COD m(-3) d(-1). Despite transient declines in reactor performance in response to increasing toxicant loading rates, stable operation (COD removal efficiencies > 90%) and satisfactory toxicant removal efficiencies (>88%) were demonstrated by the systems.

Determination and localisation of in situ substrate uptake by anaerobic wastewater treatment granular biofilms

Radiotracer incubation experiments and beta microimaging, along with fluorescent in situ hybridisation (FISH), are proposed as a complementary approach to specific methanogenic activity testing and measurement of in vitro substrate utilisation rates to understand better the ecophysiology of anaerobic granular biofilms from wastewater treatment reactors.

Application and biomolecular monitoring of psychrophilic anaerobic digestion

Thirteen anaerobic hybrid expanded granular sludge bed-anaerobic filter bioreactors were used for psychrophilic (15-18 degrees C) anaerobic digestion of a variety of synthetic and non-synthetic wastewaters, including: food-processing, dairy, aromatic- and aliphatic-containing and brewery discharges. Specific methanogenic activity assays were employed to assess temporal physiological activity dynamics. Terminal restriction fragment length polymorphism genetic fingerprinting and fluorescent in situ hybridization were used to monitor shifts in the structure of the microbial communities in the bioreactors in response to operating conditions. Treatment efficiencies obtained were comparable to previous mesophilic (37 degrees C) trials. Methanogenic activity developed under psychrophilic conditions and putative psychrophilic populations were detected within otherwise psychrotolerant mesophilic communities. Shifts in the population structure of archaeal (methanogenic) communities were more indicative of process disruption than bacterial communities. Biomolecular techniques were demonstrated as valuable tools for anaerobic wastewater treatment plant monitoring.

Primary cell cultures isolated from Penaeus monodon prawns

We have devised a cell culture system for Penaeus monodon prawn cells that uses a defined synthetic medium. Organs were removed from adult prawns ranging in size from 13--19cm rostrum-to-telson length. Cultures consisted of either a blend of hematopoietic and lymphoid cells or ovarian cells. The cells divide rapidly in culture, doubling on average once per week for 5 to 6 weeks. These cultures continue to survive for at least 5 months but the rates of cell division are low after the first 5--6 weeks. In the literature, unicellular eukaryotic marine organisms such as chytrids may contaminate marine cell cultures. In some cases these eukaryotic contaminants may be difficult to distinguish from prawn cells unless detailed ultrastructure or characteristic developmental stages such as zoospores can be observed. Alternatively, we prepared molecular probes from repeated DNA sequences 100--400 bp in length in the P. monodon genome. These species-specific probes were hybridised to genomic DNA from cell culture to confirm proliferation of P. monodon cells in our cultures.

Reactivation of a macropodid herpesvirus from the eastern grey kangaroo (Macropus giganteus) following corticosteroid treatment

The family Herpesviridae is a large group of viruses which contain double stranded DNA genomes. Biological characteristics, such as host signs, site of replication and site of latency have been used to describe three major subfamilies, Alphaherpesvirinae, Betaherpesvirinae and Gammaherpesvirinae within the family Herpesviridae. Macropodid herpesviruses (MaHV) have been implicated in fatal outbreaks amongst the captive marsupial populations of Australia. These outbreaks have resulted in the isolation of nine MaHV strains which have been classified into two species called macropodid herpesvirus 1 and 2 (MaHV-1 and MaHV-2). Biological characteristics have been used to place MaHV-1 and -2 within the subfamily Alphaherpesvirinae. Molecular phylogenetic reconstructions indicate an unusual position for MaHV-1 and -2 within the alphaherpesviruses. Current isolates of MaHVs have all been obtained from marsupials exhibiting clinical disease. A common biological characteristic of herpesviruses is the establishment of latent infections in nervous tissue. We have determined that MaHV are able to latently infect eastern grey kangaroos through reactivating and isolating a herpesvirus by inducing immunosuppression. We have investigated the possible sites of latency for MaHV-1 using molecular techniques. Detection of herpesvirus DNA in the trigeminal ganglia taken from two naturally infected eastern grey kangaroos indicates dissemination via a respiratory route.

Macropodid herpesviruses 1 and 2 occupy unexpected molecular phylogenic positions within the Alphaherpesvirinae

The molecular phylogeny of macropodid herpesviruses 1 and 2 (MaHV-1 and -2) has been investigated by cloning and sequencing the genes encoding glycoprotein B from both viruses. Phylogenetic reconstructions based on the putative amino acid sequences of glycoprotein B indicate that MaHV-1 and -2 are most closely related to the subfamily Alphaherpesvirinae. Within the Alphaherpesvirinae, MaHV-1 and -2 are closely associated with those herpesviruses that infect primates. This phylogenetic relationship does not fit the constraints of the proposed co-evolution theory described for other members of the Alphaherpesvirinae which have mammalian hosts.

Linkage of genes encoding enolase (eno) and CTP synthase (pyrG) in the beta-subdivision proteobacterium Nitrosomonas europaea

The gene encoding enolase (eno) from the ammonia oxidising bacterium Nitrosomonas europaea has been cloned and sequenced. The deduced amino acid sequence for enolase from N. europaea was 65% identical (76% similar) to its Bacillus subtilis orthologue. An incomplete open reading frame located 432 bp 5' of eno was identified as pyrG, which encodes CTP synthase. These two genes are therefore organised in N. europaea, a beta-subdivision proteobacterium, in the same way as in the gamma-subdivision proteobacterium Escherichia coli.

Nucleotide sequence of the histone gene cluster in the coral Acropora formosa (Cnidaria; Scleractinia): features of histone gene structure and organization are common to diploblastic and triploblastic metazoans

We report the nucleotide sequence of the core histone gene cluster from the Cnidarian Acropora formosa. This is the first histone gene cluster to be sequenced from a diploblastic organism and the predicted amino acid sequences most resemble those of sea urchin equivalents. Each of the Cnidarian histone genes has two conserved regions 3' of the coding sequences and these closely resemble those of the metazoan alpha-class histone genes. In A. formosa the core histone genes are arranged as opposed (H3/H4 and H2A/H2B) pairs, a pattern common to the nondeuterostome metazoa, and tandem repetition is the predominant pattern of organization in the Cnidarian. With the recent identification of several classes of homeobox genes in Cnidarians these features clearly align the Cnidaria with triploblastic metazoans, supporting a monophyletic origin of the metazoa.