Decentralisation of radiation therapy. Is it possible and beneficial to patients? Experience of the first 5 years of a satellite radiotherapy unit in the province of Tarragona,Spain

Background

The concept of satellite radiotherapy originates in countries whose populations are largely dispersed in order to treat homogenously the population by a unique fixed team.

Aim

This report describes the creation and management of a satellite radiotherapy unit in Spain (RUTE-Radiotherapy Unit, Terres de l’Ebre). It is managed by the Radiation Oncology Department at Hospital Universitari Sant Joan de Reus. We report the benefit gained in the comfort of patients and the economic benefit gained by reducing the expense of transport for the health care system.

Materials and methods

RUTE is equipped with a linear accelerator. A team of 10 physicians, specialised in different oncology pathologies, travel to RUTE on a rotational basis from the main Radiation Oncology Department. Simulation and planning of treatment is managed at the Radiation Oncology Department in Reus. Patients from RUTE only have to visit the centre in Reus once throughout the treatment process.

Results

Since August 2008, 1500 patients have completed treatment in the satellite unit. The implementation of RUTE has greatly improved the comfort of patients and along with that, there have been important savings in transport costs to the regional health care system.

Conclusions

Despite the high technological requirements of our speciality, decentralising radiotherapy is feasible. We can guarantee the highest standards of treatment with no differences from attending the main centre. It implies a clear benefit for the comfort of the patients and an economic benefit by decreasing transport costs.     

Microbial community composition and dynamics in a semi-industrial-scale facility operating under the MixAlco™ bioconversion platform

Aims:  To monitor microbial community dynamics in a semi‐industrial‐scale lignocellulosic biofuel reactor system and to improve our understanding of the microbial communities involved in the MixAlco? biomass conversion process. Methods and Results:  Reactor microbial communities were characterized at six time points over the course of an 80‐day, mesophilic, semi‐industrial‐scale fermentation using community qPCR and 16S rRNA tag‐pyrosequencing. We found the communities to be dynamic, bacterially dominated consortia capable of changing quickly in response to reactor conditions. Clostridia‐ and Bacteroidetes‐like organisms dominated the reactor communities, but ultimately the communities established consortia containing complementary functional capacities for the degradation of lignocellulosic materials. Eighteen operational taxonomic units were found to share strong correlations with reactor acid concentration and may represent taxa integral to fermentor performance. Conclusions:  The results of this study indicate that the emergence of complementary functional classes within the fermentor consortia may be a trait that is consistent across scales, and they suggest that there may be flexibility with respect to the specific identities of the organisms involved in the fermentor’s degradation and fermentation processes. Significance and Impact of the Study:  This study provides new information regarding the composition, dynamics and potential flexibility of the microbial communities associated with the MixAlco? process and is likely to inform the improvement of this and other applications that employ mixed microbial communities.     

Does the setup of Monte Carlo simulations influence the calculated properties and effect of gold nanoparticles in radiation therapy?

PurposeTo investigate whether the dose-scoring process of Monte Carlo (MC) simulations of Gold nanoparticles (GNPs) in radiation therapy affects the results.MethodsThe GATE MC toolkit was used to simulate the irradiation of a water phantom containing a single solid or hollow GNP with 250 kVp and 6 MV photons. The dose was scored in 20 nm × 20 nm × 50 μm, 100 nm × 100 nm × 50 μm and 200 nm × 200 nm × 50 μm volumes using dose-scoring voxels of size 1 nm × 1 nm × 50 μm, 10 nm × 10 nm × 50 μm, 50 nm × 50 nm × 50 μm and 100 nm × 100 nm × 50 μm Εxcess dose depth-dose (EDDD) curves and lateral beam profiles were used to compare the dose-scoring voxels.ResultsIn a given volume, neither the EDDD curves nor the lateral beam profiles are affected by the size of the dose-scoring voxels, subject to noise and uncertainty. Certain features of the EDDD curves are clearly seen in larger volumes, but hidden within the uncertainty and noise levels in smaller volumes. For the lateral beam profiles, it is the larger volumes that result in misleading results and the smaller ones that give the expected results. However, the limited statistics result in asymmetries and skewness in the profiles.ConclusionFor a given volume, the dose curves are not affected by the size of the dose-scoring voxels. However, the voxel size may hide or reveal the finer structure of the dose curves and/or may result in misleading curves.     

Stereotactic body radiation therapy and radiofrequency ablation for the treatment of liver metastases: How and when?

Limited liver metastases represent a clinical challenge. Surgical approach is the most frequently reported treatment option, however, some patients are not eligible for surgical interventions. Relatively recent technologic advances have permitted the safe use of ablative techniques employed in the cure of hepatic metastases. Among these, radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) have emerged as valid treatments in a significant proportion of patients with intrahepatic oligometastatic disease. This review offers an up-to-date of current available literature on this issue focusing on the use and outcomes of RFA and SBRT, according to the PICO (Population, Intervention, Comparison and Outcomes) criteria.     

Adsorption of tetracyanoquinodimethane and tetrathiafulvalene on aluminium (100) surface – a first principle study of structural and electronic properties

Possible adsorption configurations and electronic properties, such as charge analysis, density of states, work function and Schottky barrier height of tetracyanoquinodimethane (TCNQ) and tetrathiafulvalene (TTF) on Aluminium (100) surface is studied by using density functional theory methods with local density approximation (LDA), generalised gradient approximation (GGA), PBE and PBE-D2 methods. TCNQ is strongly adsorbed on Al(100) with adsorption energy of ?3.66?eV. The charge is transferred from Al(100) to TCNQ and charge transfer occurs mainly through cyano group of TCNQ. Adsorption on Al(100) surface leads to downshift in energy difference between highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) of TCNQ by 2.5?eV as result of hybridisation of p orbital of carbon and nitrogen atoms of TCNQ and p orbital of surface Al atoms. Compared to TCNQ adsorption, TTF adsorption on Al(100) surface is having less adsorption energy and type of interaction is physisorption. The charge transfer from TTF to Al(100) surface leads to decrease in work function of Al by 0.24?eV. The n-type Schottky barrier height of TCNQ/Al(100) and p-type Schottky barrier height of TTF/Al(100) is 0.68eV and 1.97?eV, respectively showing that TCNQ and Al(100) are suitable for organic photovoltaic and electrochemical applications.     

Elucidating substrate and inhibitor binding sites on the surface of GSK-3β and the refinement of a competitive inhibitor

A molecular understanding of substrate recognition of protein kinases provides an important basis for the development of substrate competitive inhibitors. Here, we explored substrate recognition and competitive inhibition of glycogen synthase kinase (GSK)-3β using molecular and computational tools. In previous work, we described Gln89 and Asn95 within GSK-3β as important substrates binding sites. Here, we show that the cavity bordered by loop 89-QDKRFKN-95, located in the vicinity of the GSK-3β catalytic core, is a promiscuous substrate binding subsite. Mutations within this segment highlighted Phe93 as an additional essential contact residue for substrates' recognition. However, unlike Gln89 and Asn95, Phe93 was also important for the binding of our previously described substrate competitive inhibitor, L803 [KEAPPAPPQS(p)P], and its cell-permeable variant L803-mts. The effects of the substitution of charged or polar residues within L803 further suggested that binding to GSK-3β is governed by hydrophobic interactions. Our computational model of GSK-3β bound to L803 was in agreement with the experimental data. It revealed L803 binding with a hydrophobic surface patch and identified interactions between Pro8 (L803) and Phe93 (GSK-3β). Computational modeling of new L803 variants predicted that inhibition would be strengthened by adding contacts with Phe93 or by increasing the hydrophobic content of the peptide. Indeed, the newly designed L803 variants showed improved inhibition. Our study identified different and overlapping elements in GSK-3β substrate and inhibitor recognition and provides a novel example for model-based rational design of substrate competitive inhibitors for GSK-3.     

Dose uncertainty and resolution of polymer gel dosimetry using an MRI guided radiation therapy system’s onboard 0.35 T scanner

Magnetic Resonance Imaging (MRI) scanners are widely used for 3D gel dosimeters readout. However, limited access to MRI scanners is a challenge in MRI-based gel dosimetry. Recent clinical implementation of MRI-guided radiation therapy machines provides potential opportunities for onboard gel dosimetry using its MRI subsystem. The objective of this study was to investigate the feasibility of gel dosimetry using ViewRay’s onboard 0.35 T MRI scanner. A BANG® polymer gel dosimeter was irradiated by three beams of 3 × 3 cm² field size. The T₂ relaxation rate (R₂) of the irradiated gel was measured using a Philips 1.5 T Ingenia MRI and a ViewRay 0.35 T onboard MRI and spin-echo pulse sequences. The number of signal averages (NSA) was set to 16 for the ViewRay acquisitions and one for the Philips 1.5 T MRI to achieve similar signal-to-noise ratios. The in-plane spatial resolution was 1.5 × 1.5 mm² and the slice thickness was 5 mm. The relative dose uncertainty was obtained using R₂ versus dose curves to compare the performance of dosimetry using the two different MRIs and field strengths. The dose uncertainty decreased from 12% at 2 Gy to 3.5% at 7.5 Gy at 1.5 T. The dose uncertainty decreased from 13% at 2 Gy to 4% at 7.5 Gy with NSA = 16 and 3 × 3 mm² pixel size, and from 10.5% at 2 Gy to 3.2% at 7.5 Gy with NSA = 16 and denoised R₂ maps (1.5 × 1.5 mm² pixel size) at 0.35 T. The mean of dose resolution was 0.4 Gy at 1.5 T while the mean of dose resolution was 0.8 Gy and 0.64 Gy at 0.35 T by downsampling and denoising the R2 map, respectively. Therefore, comparable dose uncertainty was achievable using the ViewRay’s onboard 0.35 T and Philips 1.5 T MRI scanners. 3D gel dosimetry using onboard low-field MRI scanner provides ViewRay users a 3D high resolution dosimetry option besides film and ionization chamber.     

The effect estimation and channel testing of the technological progress on China’s regional environmental performance

To study the effects of and approaches to technological progress on China’s regional environmental performance, this study first estimates China’s regional environmental performance and its variation indexes by applying a slack-based model (SBM) and an entropy-based model (EBM). The results indicate that the environmental performance in different regions of China has improved, but the rate of improvement differs greatly. This may be attributed to heterogeneous characteristics and changes in the green technology innovation level in different regions. Considering the overflow effect of environmental pollution among different regions, we study the impact of various technological progress patterns on China’s regional environmental performance using spatial econometrics, and we find that there are significant spatial effects of technology innovation, technology transfer, and imitative innovation on China’s regional environmental performance. Also, different technological progress patterns have different effects. Specifically, independent innovation has failed to effectively improve regional environmental performance, whereas the introduction of technology and imitative innovation have significantly improved this performance. Moreover, after the cross-items of independent innovation and human capital are introduced, the effects of technology introduction and imitative innovation on China’s regional environmental performance through the absorptive capacity of human capital remain significant, whereas the effect of independent innovation on regional environmental performance via the absorptive capacity of human capital becomes more obvious. Based on this and from the perspective of environmental enhancement, we believe that China should strengthen human capital accumulation and give consideration to imitative innovation and technology introduction while emphasizing independent innovation.     

MD Simulations and first principles to evaluate the role of binary Fe–V alloys layer on the radiation resistance in the alpha-iron

Radiation damage in reactor materials caused by the collision of the fast neutrons has a great impact on the reliability and safety of nuclear reactors. The element vanadium has attracted interest in many fields due to its advantageous properties in alloys. Thus, molecular dynamics simulation (MD) and first-principles calculation have been executed here to explore the radiation-resistant properties of five materials adding a layer in the bulk (pure iron and four types of Fe–V alloys containing 10%-40% V). The following results were inferred from these simulations. Firstly, the number of Frenkel pairs (FPs) at the stable quenching stage in the bulk decreases when the Fe–V alloy is added as an anti-radiation layer to the bulk. These benefits are evident for the Fe₈₀V₂₀ and alloy layers with more vanadium. The main reason is that the Fe–V binding energy is greater than the Fe-Fe binding energy, which can make the Primary Knock-On atom (PKA) lose more energy at the Fe–V alloy layer. Secondly, the average value of point-defect, cluster and defect clustered fractions in the bulk of Fe–V alloy is smaller than that in the pure iron at the stable quenching stage, especially for the Fe₈₀V₂₀ alloy.     

Biomarker response and therapy prediction in renal denervation therapy – the role of MR-proadrenomedullin in a multicenter approach

Background: Renal denervation has been proposed as a therapeutic option in patients with resistant hypertension. Circulating blood borne biomarkers might be helpful to identify individuals responding to RDN therapy. MR-proADM is a strong prognostic marker in patients with cardiovascular disease. The aim of this multicenter study was to evaluate the effect of RDN on MR-proADM concentrations.

Methods and results: We measured MR-proADM, BNP, and MR-proANP in 110 patients before and after RDN in a multicenter setting. All patients were followed up after 1 and 6 months by office and ambulatory blood pressure (BP) measurements. The mean office BP decreased from 165/89 to 152/87?mmHg 6 months after RDN (systolic: p?<?0.001; diastolic: ns), the responder-rate was 74%. Intriguingly MR-proADM concentrations increased from 0.66 to 0.69?nmol/L (p?<?0.001) and were significantly associated with reduction of systolic office BP after 6 months in multivariate analyses (coefficient ?0.0018, p?<?0.001). In therapy-responders MR-proADM concentrations showed a significantly higher increase over time (coefficient 0.0105, p?<?0.05), as compared to non-responders. There were no significant differences in BP change for individuals with low and high baseline MR-proADM (BP-Delta low MR-proADM ?23/?4?mmHg vs. high MR-proADM ?24/?5?mmHg). The natriuretic biomarkers BNP and MR-proANP did not change significantly after 6 months. Biomarkers at baseline were not able to predict for therapy-responder.

Conclusion: In patients undergoing RDN, baseline measurements of various biomarkers had no prognostic use for therapy success in this short time follow-up period in a multicenter approach. Intriguingly, MR-proADM showed a significant association with BP reduction after 6 months.     

Effect of the cross-linker on the general performance and temperature dependent behaviour of a molecularly imprinted polymer catalyst of a Diels–Alder reaction

Here we present a series of molecularly imprinted polymers capable of catalysing the Diels–Alder reaction between benzyl 1,3-butadienylcarbamate (1) and N,N-dimethyl acrylamide (2). The polymer systems studied here demonstrated an unusual cross-linker and temperature dependent behaviour, namely that polymer catalysis of the Diels–Alder reaction was lower at elevated temperature, in contrast to the solution reaction. Furthermore, not only was the catalytic activity significantly influenced by the choice of cross-linker, but in a similar fashion also the extent of the temperature effect, indicating a close relationship between catalysis and the observed inhibition. Molecular dynamics simulations of both the polymer systems studied were used to provide insight into the molecular background of transition state stabilisation, and differences in properties of the systems based on different cross-linkers.     

Assessment of a conventional volumetric-modulated arc therapy knowledge-based planning model applied to the new Halcyon© O-ring linac in locoregional breast cancer radiotherapy

IntroductionThe aim of this study was to evaluate the performance of a knowledge-based planning (KBP) model for breast cancer trained on plans performed on a conventional linac with 6 MV FF (flattening filter) beams and volumetric-modulated arc therapy (VMAT) for plans performed on the new jawless Halcyon© system with 6 MV FFF (flattening filter-free) beams.Materials and methodsBased on the RapidPlan© (RP) KBP optimization engine, a DVH Estimation Model was first trained using 56 VMAT left-sided breast cancer treatment plans performed on a conventional linac, and validated on another 20 similar cases (without manual intervention). To determine the capacity of the model for Halcyon©, an additional cohort of 20 left-sided breast cancer plans was generated with RP and analyzed for both TrueBeam© and Halcyon© machines. Plan qualities between manual vs RP (followed by manual intervention) Halcyon© plans set were compared qualitatively by blinded review by radiation oncologists for 10 new independent plans.ResultsHalcyon© plans generated with the VMAT model trained with conventional linac plans showed comparable target dose distribution compared to TrueBeam© plans. Organ sparing was comparable between the 2 devices with a slight decrease in heart dose for Halcyon© plans. Nine out of ten automatically generated Halcyon© plans were preferentially chosen by the radiation oncologists over the manually generated Halcyon© plans.ConclusionA VMAT KBP model driven by plans performed on a conventional linac with 6 MV FF beams provides high quality plans performed with 6 MV FFF beams on the new Halcyon© linac.     

Effects of rapeseed‐press cake glucosinolates and iodine on the performance,the thyroid gland and the liver vitamin a status of pigs

Rapeseed press cake (per kg DM 181 g EE, 341 g CP and 23.3 mmol glucosinolates) was tested in a long‐term experiment with a total of sixty pigs (live weight range 24 to 104 kg). The 3×2 factorial design consisted of three rapeseed press cake levels (no rapeseed press cake ‐ control, 75g or 150g rapeseed press cake per kg diet) each with two iodine dosages (125 or 250 μg supplementary iodine per kg diet). Reduced feed intake and depressed weight gain were found in groups receiving 150 g rapeseed press cake per kg diet, which correspond to 3.2mmol glucosinolates per kg diet. At an inclusion level of 75 g rapeseed‐press cake per kg diet no differences in feed intake and growth intensity were recorded in comparison to the rape feed free control. The rapeseed‐press cake diet increased the weight of thyroid gland and liver and decreased the serum thyroxine (T₄) concentration. Higher iodine dosage increased the serum T₄ concentration of pigs receiving 75 g rapeseed press cake per kg diet ( = 1.6 mmol glucosinolates per kg diet) to the level of the control group and retarded the enlargement of the thyroid gland. Intake of rapeseed products lowered the iodine content of the thyroid gland, however, there was no significant difference between groups given 1.6 and 3.2 mmol glucosinolates per kg diet. The vitamin A content of the whole liver and the vitamin A serum concentration were not influenced by the diets tested. However, rapeseed press cake and the glucosinolates, respectively, decreased the vitamin A concentration per gram liver due to the organ enlargement and the resulting dilution effect.     

Does microbiological testing of foods and the food environment have a role in the control of foodborne disease in England and Wales?

This review looks at the contribution of microbiological sampling to the safety of retail foods in England and Wales. It compares sampling methods available and assesses the value of testing as part of outbreaks of foodborne disease, as part of routine management by local authorities, as part of work done or commissioned by the food industry, and as part of research. It confirms that microbiological testing has a role during outbreaks as it makes a significant contribution to help identify foods and other areas of greatest risk for future study. The review suggests that routine testing by local authorities is often of limited use and could be improved by more targeted surveillance. Testing could be better used to validate primary control methods, such as Hazard Analysis and Critical Control Point (HACCP) system. Any public health benefit from testing in the food industry is often restricted by client confidentiality. Microbial research on foods is important as it can lead to significant improvements in safety. Current microbiological methods are slow and, in future, rapid molecular methods may make an even bigger contribution to the control of foodborne disease.     

Electromyographic activity of the rectus abdominis during a traditional crunch and the basic jackknife exercise with the Ab Lounge™

The use of nontraditional exercise devices such as the Ab Lounge? has been promoted as being as effective as the traditional abdominal crunch in strengthening the abdominal musculature. Evidence for this is lacking, however. The purpose of this study was to compare the degree of activation of the upper and lower rectus abdominis using electromyography (EMG) during a traditional crunch with the basic jackknife using the Ab Lounge?. Twenty-two subjects (6 men and 16 women) were randomly selected from the student population at the University of the West Indies (Mona Campus). The mean age of the participants was 20.5 ± 1.5 years, height 166.4 ± 6.2 cm, weight 64 ± 10.3 kg, and waist-hip ratio 0.7 ± 0.1. Surface EMG was used to assess the muscle activity from the upper and lower rectus abdominis while each exercise was performed. The EMG data were full-wave rectified and normalized using a mathematical model that was set up in Microsoft Excel for Windows XP. Statistical analysis was performed on the data using a univariate analysis of variance with gender as a covariate. Significance was determined by p < 0.05. The mean EMG data recorded for the upper rectus abdominis was significantly higher with the traditional crunch when compared with the basic jackknife performed on the Ab Lounge? (F = 4.39, p = 0.04). The traditional crunch produced a higher level of activity in the lower rectus abdominis when compared with the basic jackknife, but this was not statistically significant (F = 0.249, p = 0.62). There was no significant interaction between gender and the effect of the type of exercise on upper and lower rectus abdominis activation. These results suggest that the traditional abdominal crunch is more effective than the basic jackknife is in activating the rectus abdominis musculature.     

The surface structure of a complex substrate revealed by enzyme kinetics and Freundlich constants for α-amylase interaction with the surface of starch

Background

Starch is a main source of carbohydrate in human diets, but differences are observed in postprandial glycaemia following ingestion of different foods containing identical starch contents. Such differences reflect variations in rates at which different starches are digested in the intestine. In seeking explanations for these differences, we have studied the interaction of α-amylase with starch granules. Understanding this key step in digestion should help with a molecular understanding for observed differences in starch digestion rates.

Methods

For enzymes acting upon solid substrates, a Freundlich equation relates reaction rate to enzyme adsorption at the surface. The Freundlich exponent (n) equals 2/3 for a liquid-smooth surface interface, 1/3 for adsorption to exposed edges of ordered structures and 1.0 for solution–solution interfaces. The topography of a number of different starch granules, revealed by Freundlich exponents, was compared with structural data obtained by differential scanning calorimetry and Fourier transform infrared spectroscopy with attenuated total internal reflectance (FTIR-ATR).

Results

Enzyme binding rate and FTIR-ATR peak ratio were directly proportional to n and Δ_gelH was inversely related to n. Amylase binds fastest to solubilised starch and to granules possessing smooth surfaces at the solid–liquid interface and slowest to granules possessing ordered crystalline surfaces.

Conclusions

Freundlich exponents provide information about surface blocklet structures of starch that supplements knowledge obtained from physical methods.

General Significance

Nanoscale structures at the surface of starch granules influence hydrolysis by α-amylase. This can be important in understanding how dietary starch is digested with relevance to diabetes, cardiovascular health and cancer.     

Assessment of unloaded and loaded squat jump performance with a force platform: Which jump starting threshold provides more reliable outcomes?

This study aimed to explore the influence of different onset thresholds on the between-session reliability and magnitude of squat jump (SJ) performance. Twenty men were tested on two sessions separated by 48 h against external loads of 0.5, 30 and 60 kg. The initiation of the jump was defined as the first instant in which the vertical ground reaction force exceeded system weight by 10 N (10 N), 50 N (50 N), 1% of system weight (1%SW), 10% of system weight (10%SW) and five standard deviation of system weight minus 30 ms (5SDSW). The following variables were calculated from the force-time signal collected on a force platform: mean, peak and time to peak values of force, power and velocity, average rate of force development, peak rate of force development, rate of force development index, impulse, jump height, and push-off time. The 50 N, 10%SW and 5SDSW thresholds generally revealed a higher reliability than the 10 N and 1%SW thresholds (97 and 21 out of 252 comparisons for the coefficient of variation and intraclass correlation coefficient, respectively). The magnitude of most of the variables calculated using the 50 N and 10%SW thresholds significantly differed with respect to the 10 N, 1%SW and 5SDSW thresholds (P < 0.05). These results suggest that both the reliability and magnitude of SJ performance variables are influenced by the jump starting threshold. The 50 N, 10%SW and 5SDSW thresholds maximise the reliability of SJ performance variables, while the 5SDSW should be recommended since it considers more force signal than the 50 N and 10%SW thresholds.     

Terrigenous sediment-dominated reef platform infilling: an unexpected precursor to reef island formation and a test of the reef platform size–island age model in the Pacific

Low-lying coral reef islands are considered highly vulnerable to climate change, necessitating an improved understanding of when and why they form, and how the timing of formation varies within and among regions. Several testable models have been proposed that explain inter-regional variability as a function of sea-level history and, more recently, a reef platform size model has been proposed from the Maldives (central Indian Ocean) to explain intra-regional (intra-atoll) variability. Here we present chronostratigraphic data from Pipon Island, northern Great Barrier Reef (GBR), enabling us to test the applicability of existing regional island evolution models, and the platform size control hypothesis in a Pacific context. We show that reef platform infilling occurred rapidly (~4–5 mm yr⁻¹) under a “bucket-fill” type scenario. Unusually, this infilling was dominated by terrigenous sedimentation, with platform filling and subsequent reef flat formation complete by ~5000 calibrated years BP (cal BP). Reef flat exposure as sea levels slowly fell post highstand facilitated a shift towards intertidal and subaerial-dominated sedimentation. Our data suggest, however, a lag of ~1500 yr before island initiation (at ~3200 cal BP), i.e. later than that reported from smaller and more evolutionarily mature reef platforms in the region. Our data thus support: (1) the hypothesis that platform size acts to influence the timing of platform filling and subsequent island development at intra-regional scales; and (2) the hypothesis that the low wooded islands of the northern GBR conform to a model of island formation above an elevated reef flat under falling sea levels.