North Queensland Research Articles

The characteristics and clinical course of patients with melioidosis and cancer.

Patients with an active cancer are more likely to develop melioidosis, but the characteristics and clinical course of melioidosis in patients with cancer have not been examined in detail. Trimethoprim/sulfamethoxazole (TMP-SMX) prophylaxis is prescribed to prevent melioidosis in patients receiving immune suppressing anti-cancer therapy in some jurisdictions-and is recommended in national Australian guidelines-however the risks and benefits of this strategy are incompletely defined. The study took place in Far North Queensland (FNQ) in tropical Australia. The characteristics and clinical course of patients with melioidosis diagnosed in the FNQ region between January 1, 1998, and June 1, 2023, who had-and did not have-an active cancer were compared. We also determined the subsequent incidence of melioidosis in patients receiving immune suppressing anti-cancer therapy in the FNQ region between January 1, 2008, and June 1, 2023, who did-and did not-receive TMP-SMX chemoprophylaxis for Pneumocystis jirovecii infection. An active cancer was present in 47/446 (11%) cases of melioidosis diagnosed between January 1, 1998, and June 1, 2023; there was no association between melioidosis and any cancer type. Patients with melioidosis and cancer were more likely to be older (odds ratio (OR) (95% confidence interval (CI): 1.05 (1.03-1.08) P<0.0001) and immunosuppressed (OR (95% CI): 11.54 (5.41-24.6), p<0.0001) than patients without cancer. Immune suppressing anti-cancer therapy had been prescribed to 17/47 (36%) in the 12 months prior to their diagnosis of melioidosis. Only 10/47 (21%) with cancer and melioidosis in the cohort had received no immune suppressing anti-cancer therapy and had no other risk factors for melioidosis. Twelve months after the diagnosis of melioidosis, 25/47 (53%) were still alive; 9/22 (41%) deaths were due to melioidosis and 13/22 (59%) were due to the underlying cancer. Between 2008 and June 2023, there were 4400 individuals who received myelosuppressive anti-cancer therapy in the FNQ region. There was no significant difference in the incidence of melioidosis between patients who did-and did not-receive TMP-SMX chemoprophylaxis with their myelosuppressive anti-cancer therapy (1/737 (0.15%) versus 16/3663 (0.44%); relative risk (95% confidence interval): 0.31 (0.04-2.34), p = 0.20) and no significant difference in the incidence of fatal melioidosis (0/737 versus 3/3663 (0.08%), p = 0.58). Patients with cancer are predisposed to developing melioidosis and immune suppressing anti-cancer therapy increases this risk further. However, in this region of Australia, there was no significant difference in the subsequent development of melioidosis in patients who did-and did not-receive TMP-SMX chemoprophylaxis during their myelosuppressive anti-cancer therapy.

Community-led diphtheria vaccination campaign to manage a diphtheria outbreak in a remote Aboriginal community.

In 2022, five cases of diphtheria were identified in and around Wujal Wujal, a discrete Aboriginal community in Far North Queensland. This prompted a mass diphtheria vaccination campaign in the community which increased the proportion of residents aged ≥ 14 years receiving a diphtheria containing vaccine in the prior twelve months from 5% to 74%. No further cases were detected in the subsequent twenty-two months.

A review of emergency laparoscopic cholecystectomies in Far North Queensland.

Access to laparoscopic cholecystectomy is more limited for remote communities and Indigenous patients internationally. To date, studies exploring the incidence of gallstone disease and access to laparoscopic cholecystectomy in Australian regional communities are limited. This study examined the rates and outcomes of emergency laparoscopic cholecystectomy (EMLC) in Far North Queensland, specifically in Indigenous and remote populations. We retrospectively examined all patients who underwent an EMLC at Cairns Hospital between 2016 and 2021. Over the study period, 634 EMLCs were undertaken. The average annual rate of 56 cases per 100 000 was considerably lower than national estimates. However, rates of EMLC were significantly higher in remote communities and Indigenous patients compared with the remaining cohort. Patients from remote communities were more likely to have pre-existing gallstone disease but were less likely to have been seen in a surgical outpatient clinic prior to admission. Despite this, surgical outcomes for EMLC were comparable to national and international standards. This study highlights the challenges in surgical healthcare provision for gallstone disease in a regional centre. The requirement for EMLC disproportionately effects geographically isolated communities and Australian Indigenous people. Addressing the healthcare barriers to management of GD in regional Australia should be a priority.

Characteristics and outcomes of patients with cardiac conditions requiring emergency medical retrieval from the Great Barrier Reef, Australia.

There is limited published data on the burden of cardiac disease among patients requiring emergency medical evacuation from the Great Barrier Reef, a popular tourist destination in Far North Queensland, Australia. The aim of this study was to examine the characteristics and outcomes of patients with cardiac conditions who were retrieved from the northern Great Barrier Reef to Cairns Hospital. This observational study was a planned substudy of a broader analysis of medical retrievals from the Cairns/Cooktown section of the Great Barrier Reef. It included all patients retrieved to Cairns Hospital between July 2016 and January 2020 who were assigned a cardiac diagnosis during their hospital stay. Data were collected about electrocardiograph, cardiac troponin blood test and invasive coronary angiography results as well as final hospital diagnosis. During the study period, 120 patients were retrieved from the Great Barrier Reef to Cairns Hospital, of which 46 (38%) were subsequently diagnosed with a primary cardiac condition(s) or other disease process with clinically significant cardiac involvement. The most common diagnoses were type 2 myocardial infarction (20; 16.7% of all retrievals), primary cardiac arrhythmia (14; 12.5%) and acute coronary syndrome (5; 4.2%). An elevated troponin was recorded in 30% of all retrievals and in 78% of those with a cardiac diagnosis. A total of 14 (30.4%) of patients with a cardiac diagnosis died during their hospital admission. Invasive coronary angiography was performed in 18 cases, of which six patients had obstructive coronary artery disease. Four patients required percutaneous coronary intervention. A high proportion of patients retrieved to Cairns Hospital from the Great Barrier Reef were diagnosed with a primary cardiac condition. This data may assist tourism operators, retrieval organisations and health services to plan for, and respond to, cardiac events among visitors to the reef.

Efficacy of the Nutrition Education and Screening Tool as a Foundation for Exploring Perinatal Diet and Determinants in Aboriginal and Torres Strait Islander Women of Far North Queensland.

Assessing perinatal diet and its determinants in Australia's Aboriginal and Torres Strait Islander women remains challenging, given the paucity of tools that incorporate Aboriginal ways of knowing, being, and remembering within a quantitative framework. This study aimed to explore the determinants of perinatal nutrition in this population and to evaluate the efficacy of the Nutrition Education and Screening Tool (NEST) in collecting diet-related data in this population. This study employed a Participatory Action Research approach using the NEST as a foundation for structured research inquiry. Self-reported diet and determinants were collected from a cross-sectional cohort of Aboriginal and Torres Strait Islander women from Far North Queensland. Participants (n = 30) declared excess consumption of meat and alternatives, fruit, vegetables and legumes, and dairy and alternatives. Grain and cereal consumption aligned with recommendations; wild-harvested foods comprised a mean 19.75% of their protein intake. Food frequency data were supported by participants' descriptions of how they eat, combine, rotate, and cook these foods. Standard food frequency questionnaires are challenging for Aboriginal and Torres Strait Islanders as their concepts of time and ways of remembering are different from Western understanding. Use of the NEST allowed food frequency items to be explored, clarified, and cross-referenced; yarning provided a degree of support for quantitative data. The results of this study translate to future public health research, practice, and policy. Alternative quantitative measures to determine food frequency should be considered in future studies. These may include the cyclical approach to time that is well understood and integrated by Indigenous cultures.

The implications of COVID-19 on regional journalism in far north Queensland: Measuring the heart rate of local communities

In 2020, COVID-19 thrust newsrooms into lockdown, affecting how journalists source, gather and report news. According to media giant News Corp, the pandemic fast-tracked its axing of more than 112 community newspapers, already vulnerable following a decade of gradual decline exacerbated by the arrival of digital technology. Consequently, hundreds of jobs were slashed and ‘news deserts’ were created across vast swathes of rural Australia, including far north Queensland. This article looks closely at the mediascape in far north Queensland from a journalism industry perspective during COVID-19, a time which saw a raft of differing and, sometimes, conflicting pressures exerted on journalists – from complying with health and safety regulations to fulfilling the community’s insatiable hunger for information. Through an online survey and long-form interviews with journalists, the study informing this article focuses on what happens when newsrooms are centralized, diminished in resources and the most senior journalists are made redundant and, as such, no longer available to mentor or control journalistic quality. It also observes the arrival of a new and independent press or ‘green shoots’ while casting an eye on the future of local news.

The Effects of Planting Density, Training System and Cultivar on Vegetative Growth and Fruit Production in Young Mango (Mangifera indica L.) Trees

Increasing the planting density of mango orchards appears promising for obtaining higher yields, particularly during the first productive years. However, the challenge is to maintain a good balance between vegetative growth and fruit production in the longer term. The objective of this study was to decipher the effects of planting density, training system and cultivar on young mango trees’ growth and production. The experiment, conducted in North Queensland, consisted of five combinations of planting density and training system applied to the cultivars Keitt, Calypso and NMBP-1243. The planting densities were low (208 tree ha−1), medium (416 tree ha−1) and high (1250 tree ha−1). The closed vase conventional training system was applied at each density. Single leader and espalier on trellis training systems were applied at medium and high densities, respectively. The tree canopy dimensions were measured every 6 months from planting, and tree production was recorded from the third to the fifth years after planting. Vegetative growth and fruit production were the results of complex interactions between planting density, training system, cultivar and/or time. The expected increase in orchard yield with higher planting density was observed from the first productive year, despite lower individual tree production at high planting density. Lower vegetative growth and fruit production at high planting density were probably caused by competition between trees. NMBP-1243 and Keitt showed more rapid vegetative growth. Keitt was the most productive cultivar during the first three productive years. The detailed results of this study provide avenues to further explore the behaviour of mango trees at high planting densities.

An overview of Buruli ulcer in Australia.

Buruli ulcer (BU) is caused by Mycobacterium ulcerans, an environmental pathogen that causes severe skin and soft-tissue necrosis. In Australia, cases of BU are acquired in endemic regions, which include Victoria and Far North Queensland, but those who have visited these regions can present to health practitioners anywhere. This article provides Australian general practitioners with an overview of BU, including its epidemiology, transmission, clinical features, diagnosis and management. BU can manifest as an ulcer or as a non-ulcerated skin lesion, such as a plaque, nodule or oedema. Diagnosis can be achieved with a dedicated Mycobacterium ulcerans polymerase chain reaction (PCR) test performed on a wound swab. Swabs on non-ulcerated disease have a high false negative rate, and a PCR test should be performed on a tissue biopsy to confirm disease. Most cases are managed with prolonged antibiotic therapy - commonly a combination of oral rifampicin and clarithromycin or fluroquinolone (moxifloxacin or ciprofloxacin) - and wound dressings.

Clinical prediction rules for surgical site infection after minor surgery in general practice.

Surgical site infection (SSI) after dermatological surgery is associated with poor outcomes. Developing clinical prediction rules based on the predicted probability of infection might encourage guided prophylaxis and judicious prescribing. The purpose of this study was to develop a clinical prediction rule based on identified risk factors for SSI in a large general practice patient cohort. We examined a large, pooled dataset from four randomised controlled trials performed in a regional centre of North Queensland, Australia. Multivariable logistic regression identified a prediction model. Bootstrapping was used for internal validation. A scoring system was based on predicted probabilities of infection. The final prediction rule included age >55years and the anatomical site, histology and complexity of the excision. The area under the curve was 0.704. Our prediction rule encourages judicious use of prophylaxis in clinical practice.

The Permian Watershed tungsten deposit (northeast Queensland, Australia): fluid inclusion and stable isotope constraints

The Watershed scheelite deposit is located in an extinct fore-arc basin in the Mossman Orogen of North Queensland. This fore-arc region comprises multiply deformed, Ordovician–Silurian metasedimentary rocks of the Hodgkinson Formation, and it was intruded by Carboniferous–Permian granites of the Kennedy Igneous Association. At Watershed, the Hodgkinson Formation includes strongly deformed skarn-altered conglomerate, psammite and slate units, which record four deformation events that evolved from ductile (D1–3) to brittle–ductile (D4). Early, D1–2 scheelite mineralisation in Carboniferous monzonite and skarn-altered conglomerate formed during regional prograde metamorphism, which reached upper greenschist to lower amphibolite facies conditions. Permian, D4 scheelite mineralisation was deposited in transtensional, shear-related veins, vein haloes and skarn-altered conglomerate during retrograde, lower greenschist facies metamorphism. During D4, four stages of retrograde alteration (retrograde stages 1–4) affected the rocks. Fluid inclusion assemblages in retrograde stage 2, vein scheelite and quartz are characterised by a low-salinity H2O–NaCl ± CH4 fluid (XCH4 <0.01, 1.4–8.0 wt% NaCleq). The fluid inclusions show evidence for fluid mixing between a low (∼0 wt% NaCleq) and a medium (<8 wt% NaCleq) saline fluid. Scheelite mineralisation P–T conditions were determined at ∼300 °C and 1–1.8 kbar (i.e. a depth of 3.7–6.7 km), indicative of a high geothermal gradient (35–75 °C/km), which was likely caused by the heat from the Permian granites. The presence of pyrrhotite and arsenopyrite in D4 veins (retrograde stage 4), plus graphite and methane in the fluid inclusions in scheelite, indicates reduced mineralisation conditions. Oxygen isotope compositions (δ18OVSMOW) of retrograde stage 2 scheelite (+3.8 to +7.3‰), plagioclase (+7.0 to +11.8‰) and quartz (+12.6 to +15.5‰) indicate a fluid temperature of 306 ± 56 °C with δ18OVSMOW values between +4.7 and +8.3‰. Retrograde stage 3 muscovite δDVSMOW (−73.4 to −62.7‰) and δ18OVSMOW (+11.5 to +13.2‰) values were used to calculate the O–H isotopic compositions of the fluids in equilibrium with the minerals at various possible temperatures (250–300 °C). The results are consistent with a metamorphic origin for the mineralising fluid. Sulfur isotope compositions (δ34SCDT between −2.5 and +2.8‰) for vein-hosted, retrograde stage 4 sulfides indicate that sulfur could have come from seawater or seawater sulfate, which is consistent with the local geology, even though this range overlaps with magmatic sulfur isotope compositions. Metamorphic fluids probably originated from devolatilisation reactions in the Hodgkinson Formation during prograde metamorphism. Permian intrusions acted as heat source enhancing metamorphic fluid flow and metal transport.

"It Empowers You to Empower Them": Health Professional Perspectives of Care for Hyperglycaemia in Pregnancy Following a Multi-Component Health Systems Intervention.

The Northern Territory (NT) and Far North Queensland (FNQ) have a high proportion of Aboriginal and Torres Strait Islander women birthing who experience hyperglycaemia in pregnancy. A multi-component health systems intervention to improve antenatal and postpartum care in these regions for women with hyperglycaemia in pregnancy was implemented between 2016 and 2019. We explored health professional perspectives on the impact of the intervention on healthcare. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) underpinned this mixed-methods evaluation. Clinicians were surveyed before (n = 183) and following (n = 137) implementation. The constructs explored included usual practice and satisfaction with care pathways and communication between services. Clinicians, policymakers and the implementation team were interviewed (n = 36), exploring the impact of the health systems intervention on practice and systems of care. Survey and interview participants reported improvements in clinical practice and systems of care. Self-reported glucose screening practices improved, including the use of recommended tests (72.0% using recommended first-trimester screening test at baseline, 94.8% post-intervention, p < 0.001) and the timing of postpartum diabetes screening (28.3% screening at appropriate interval after gestational diabetes at baseline, 66.7% post-intervention, p < 0.001). Health professionals reported multiple improvements to care for women with hyperglycaemia in pregnancy following the health systems intervention.

Understanding environmental generational amnesia through urban school garden learning experiences in Gimuy/Cairns, Australia

ABSTRACT This paper explores the potential role of school garden learning experiences in remediating Environmental Generational Amnesia (EGA). EGA is a generational type of environmental forgetting brought about by prolonged disconnection from “natural” landscapes, with symptoms manifesting as poor motor skills, deficient food origin knowledge, a lack of environmental moral affiliation and undeveloped connections to place. Drawing on interviews with teachers, parents, counsellors, groundskeepers, and administrators at a Far North Queensland primary school, this paper explores how school garden learning experiences foster interaction patterns that combat EGA’s symptoms. We find that urban school gardens offer new possibilities for reassembling students into more-than-human local ecologies in ways that can remediate the manifestation of EGA.

Age of hepatitis B e antigen loss in Aboriginal, Torres Strait Islander and non-Indigenous residents of tropical Australia; implications for clinical care.

This study determined the hepatitis B e antigen (HBeAg) status of people living with chronic hepatitis B (CHB) in Far North Queensland (FNQ), Australia and their age of HBeAg loss. It was hoped that this would provide data to explain the stark difference in the incidence of hepatocellular carcinoma (HCC) between Aboriginal and Torres Strait Islander individuals living with CHB in FNQ, a finding that has been hypothesised to relate to differences in hepatitis B virus genotype. We identified every FNQ resident with CHB, determined their country of birth, their HBeAg status, the age they lost HBeAg and whether they identified as an Aboriginal, a Torres Strait Islander or a non-Indigenous individual. We then ascertained whether these demographic and virological variables were correlated. Of 1,474 individuals living with CHB in FNQ, 278 (19%) were Aboriginal, 507 (34%) were Torres Strait Islanders and 689 (47%) were non-Indigenous. Aboriginal individuals were less likely to be HBeAg positive (26/278, 9%) than Torres Strait Islander (91/507, 18%) and non-Indigenous (126/689, 18%) individuals, p < 0.0001. Aboriginal individuals lost HBeAg at an earlier age (median (interquartile range): 30 (23-39) years) than Torres Strait Islander (38 (29-49) years) and non-Indigenous (36 (29-47) years) individuals, p < 0.0001. Aboriginal individuals with CHB in FNQ are more likely to be HBeAg negative than Torres Strait Islander and non-Indigenous individuals and lose HBeAg at a younger age. This provides a biological basis for local clinicians' observation that Aboriginal individuals with CHB in FNQ are at a lower risk of HCC and data to support the principle of genotype-based care in the region.

Impact of fire return interval on pyrogenic carbon stocks in a tropical savanna, North Queensland, Australia

Impact of fire return interval on pyrogenic carbon stocks in a tropical savanna, North Queensland, Australia

Seroprevalence of canid alphaherpesvirus-1 and associated risk factors in domestic dogs in North Queensland, Australia

Canid alphaherpesvirus-1 (CaHV-1) may cause a highly fatal haemorrhagic disease in neonatal pups and is associated with reproductive, respiratory and ocular disease in older dogs. Although assumed to have a world-wide distribution, there have been few reports of CaHV-1 in Australia. The aim of this study was to investigate the seroprevalence of CaHV-1 in household dogs in a residential suburb in Townsville, as well as in dogs attending two dog shows in the region. Study participants were recruited through door-to-door non-probability sampling (Douglas dogs, n = 185) or invited to participate (Show dogs; n = 76). Dog owners completed a questionnaire that investigated possible risk factors for recent exposure to CaHV-1. A serum sample from each dog was assayed for anti-CaHV-1 antibodies using a commercially available ELISA. Associations between seropositive dogs and owner-reported risk factors were analysed using univariable analysis and multivariable logistic regression models. The seroprevalence of CaHV-1 was 11.4 % (95 % CI 6.8–15.9 %) and 17.1 % (95 % CI 5.5–28.8) for the Douglas and Show dogs, respectively, with a pooled seroprevalence of 13 % (95 % CI 8.3–17.7 %). Dogs that had suffered from conjunctivitis within the previous 3 months or were involved in breeding were more likely to be seropositive to CaHV-1. No other significant risk factors were identified. In conclusion, CaHV-1 is circulating in dogs in North Queensland and may be contributing to foetal and neonatal losses in this region.

Revision of Australian Brachysandalus with the description of nine new species including one cavernicolous species (Hemiptera: Heteroptera: Reduviidae), and observations on male extragenital structure and leg teratology

The Australian species of the genus Brachysandalus Stål, 1867 (Hemiptera: Heteroptera: Reduviidae: Peiratinae) are revised. A total of 21 species are recognised, including nine new species: B. ayyammae Malipatil &amp; Liu, sp. nov., B. flavidus Malipatil &amp; Liu, sp. nov., B. fulvipes Malipatil &amp; Liu, sp. nov., B. gunbalanyae Malipatil &amp; Liu, sp. nov., B. howarthi Malipatil &amp; Liu, sp. nov., B. longifemoratus Malipatil &amp; Liu, sp. nov., B. maculatus Malipatil &amp; Liu, sp. nov., B. pallidus Malipatil &amp; Liu, sp. nov. and B. westraliensis Malipatil &amp; Liu, sp. nov. Redescriptions of the genus Brachysandalus and all 12 previously described Australian species of the genus as recognised in this study, are presented. Lectotypes are designated for Brachysandalus helluo Stål, 1867, B. lurco Stål, 1867, B. punctorius Stål, 1867, Pirates (Brachysandalus) alutaceus Reuter, 1881, P. (Brachysandalus) brevicoxis Stål, 1874, P. (Brachysandalus) crassifemur Reuter, 1881, P. (Brachysandalus) flavo-pictus Stål, 1874, P. (Brachysandalus) limbatus Reuter, 1881, P. (Brachysandalus) melanolestoides Stål, 1874, P. (Brachysandalus) setosus Stål, 1874, P. fuliginosus Erichson, 1842, P. fulvipennis Walker, 1873, P. sepulchralis Distant, 1902 and Reduvius (Pirates) ephippiger White, 1843. Pirates fulvipennis Walker, 1873 is removed from synonymy with B. punctorius Stål, 1867, and revalidated with the new combination as B. fulvipennis (Walker, 1873), stat. rev. &amp; comb. nov. Pirates (Brachysandalus) flavopictus Stål, 1874, is removed from synonymy with B. punctorius Stål, 1867, and confirmed as synonym of B. fulvipennis (Walker, 1873). Reduvius semifasciatus Walker, 1873 is removed from synonymy with Brachysandalus fuliginosus (Erichson, 1842), and because the former not considered to be a peiratine species is placed here as “Incertae sedis”. Pirates erythromelas Walker, 1873 is transferred to Brachysandalus as B. erythromelas (Walker, 1873), comb. nov. A key to species is provided together with images of the habitus of type specimens and some other males and females with different wing forms, and major structures of male genitalia to assist distinguishing these species. Based on morphology, brief comments are provided on putative species groups within the studied species. Brachysandalus howarthi Malipatil &amp; Liu, sp. nov. collected from Bayliss Cave, north Queensland, is morphologically and behaviourally adapted to live in caves and is regarded to be an obligate subterranean species, further details and some biological information is provided. Detailed observations of the male extragenital structure that is present on the left side of sternite VII, were made in all species of Brachysandalus considered in the present study. Fourteen of the 21 species studied have been recorded to possess an externally visible extragenital process, that varies greatly in size, shape and development between species; these details are illustrated and discussed including their probable function in mating process, and potential value in species diagnoses. Cases of leg teratology, specifically morphological abnormalities of tarsi and tarsal claws, were observed in a few specimens of four species, i.e., Brachysandalus lurco Stål, 1867, B. helluo Stål, 1867, B. flavidus Malipatil &amp; Liu, sp. nov. and B. gunbalanyae Malipatil &amp; Liu, sp. nov.; details are illustrated and discussed.

Characterization, potential valuable metals recovery and remediation of historic wolframite mining waste

The understanding of tungsten (W) mineral weathering and mobilization in nature remains limited due to W being a transition element with a wide range of oxidation states, which enables it to form a variety of complex chemical compounds. This study examined W mining waste at the abandoned Wolfram Camp mine in North Queensland, Australia, to address this gap. The mineralogical analysis showed the W tailings primarily consisted of silicates, including quartz, illite/mica, plagioclase, and K-Feldspar, with low WO3 content. Static acid mine drainage (AMD) tests indicated most tailings were non-acid forming, while groundwater samples exhibited acidification, with pH ranging from 3.8 to 5.2. The reprocessing trials using gravity separation and bioleaching demonstrated promising results, suggesting both techniques could effectively recover resource and decontaminate the mining waste. The gravity separation reprocessing test has successfully recovered 48.4% W from the tailings, with the resulting W concentrate achieving a 21.6% WO3 grade. On the other hand, the bioleaching reprocessing exhibited a remarkable 44-fold enrichment of W from the tailings, with 2.2% W in the AMD sediment. Synchrotron-based XFM/μ-XANES imaging analysis revealed significant wolframite weathering in reprocessed W concentrates. This study proposed a comprehensive approach, integrating environmental remediation and resource recovery technologies, to repurpose abandoned W mining waste. Passive treatment appears to be an economical option for remediating abandoned W mine sites. The findings provide valuable insights for sustainable W mining waste management and the rehabilitation of the abandoned Wolfram Camp W mine site.

Utilisation Trends of Perflutren Definity Contrast Before and After the Institution of Prescribing Standing Orders and Intravenous Cannulation Competency Development for Sonographers. A Retrospective Analysis of Definity Use in ST-Segment Elevated Myocardial Infarction and Heart Failure with Reduced Ejection Fraction at a Regional Tertiary-Level Cardiac Centre in North Queensland

Utilisation Trends of Perflutren Definity Contrast Before and After the Institution of Prescribing Standing Orders and Intravenous Cannulation Competency Development for Sonographers. A Retrospective Analysis of Definity Use in ST-Segment Elevated Myocardial Infarction and Heart Failure with Reduced Ejection Fraction at a Regional Tertiary-Level Cardiac Centre in North Queensland

Takotsubo Storm in North Queensland—Seven Close Encounters

Takotsubo Storm in North Queensland—Seven Close Encounters

Leadless Pacemakers: A Retrospective Analysis of Efficacy, Safety, and Applicability in High-Risk Patients at a Single Centre in North Queensland

Leadless Pacemakers: A Retrospective Analysis of Efficacy, Safety, and Applicability in High-Risk Patients at a Single Centre in North Queensland