Development of biomarkers for the risk stratification and targeted therapy of Barrett's oesophagus and oesophageal adenocarcinoma

Barrett's oesophagus is the most important risk factor for the development of oesophageal adenocarcinoma (OA), but progression is unpredictable. Dysplasia predicts which Barrett’s patients are at greatest risk for OA but achieving the diagnosis can be challenging. Immunohistochemistry with p53 is recommended as an adjunct to assist with dysplasia diagnosis. This thesis will examine if replication licensing factors and DNA ploidy status are as good if not better than p53 to assist in the diagnosis of dysplasia. Overexpression of HER2 in foregut cancer is an indication for HER2 targeted treatments. Its influence on prognosis is less understood. The relationships between clinicopathological variables, HER2 overexpression and prognosis will next be evaluated. Current ablative techniques for Barrett’s neoplasia are limited to superficial disease. Photodynamic therapy was a treatment for Barrett’s that could penetrate more deeply into diseased tissue but was limited by the side effects of off-target photosensitivity. Combining targeting vehicles such as antibodies to newer and more deeply penetrating photosensitiser drugs, may overcome the previous limitations of this technology. A photosensitive ADC against HER2 will be created and its efficacy in vitro and in vivo evaluated. However, even the most effective ADC against HER2 will not treat the majority of cancers, as we will show HER2 is only expressed in the minority of foregut tumours. The final experiments will look to characterise the mucin MUC1 in Barrett’s and associated neoplasia. Studies have previously shown it to be present in up to 100% of cancers while others say far fewer. We will show proof of principle data for the development of a MUC1 targeting photosensitive ADC in vitro and postulate how it may in future enable treatment of locoregional invasive tumours endoscopically

Why Have Immunization Efforts in Pakistan Failed to Achieve Global Standards of Vaccination Uptake and Infectious Disease Control?

Immunization is one of the most successful public health initiatives in recent times. It is, therefore, worrying to learn the level of under-vaccination in Pakistan. Diseases that have been successfully eliminated through the aid of vaccination in other countries have not been eliminated in Pakistan. The reasons for this vary and show the uniqueness of the economic, healthcare and environmental landscape of Pakistan, through which public health programmes need to be implemented. The "Expanded Programme of Immunization" (EPI) is the main programme through which routine immunization is provided to the public. Within Pakistan, it has encountered many problems since its inception. This includes logistical obstacles, inefficient health worker attitudes, parental and female awareness, and education, the influence of religious community leaders and the complications that accompany conflict. When compared to globally standardised targets for immunization, Pakistan is trailing behind. Not achieving these targets is worrying from both a global perspective and within the national healthcare landscape of Pakistan. Research is necessary to bring together findings on the failings of routine immunization and polio campaigns; there are many intersecting factors that global health bodies and the Department of Health in Pakistan must address in order to relieve the burden of vaccine-preventable diseases (VPDs)

Self-concatenated coding and multi-functional MIMO aided H.264 video telephony

Abstract— Robust video transmission using iteratively detected Self-Concatenated Coding (SCC), multi-dimensional Sphere Packing (SP) modulation and Layered Steered Space-Time Coding (LSSTC) is proposed for H.264 coded video transmission over correlated Rayleigh fading channels. The self-concatenated convolutional coding (SECCC) scheme is composed of a Recursive Systematic Convolutional (RSC) code and an interleaver, which is used to randomise the extrinsic information exchanged between the self-concatenated constituent RSC codes. Additionally, a puncturer is employed for improving the achievable bandwidth efficiency. The convergence behaviour of the MIMO transceiver advocated is investigated with the aid of Extrinsic Information Transfer (EXIT) charts. The proposed system exhibits an Eb /N0 gain of about 9 dB at the PSNR degradation point of 1 dB in comparison to the identical-rate benchmarker scheme

Use of the Ilizarov apparatus to improve alignment in proximal humeral fractures treated initially by a unilateral external fixator

One of the recommended methods for the management of displaced unstable proximal humeral fractures is the unilateral external fixator. In polytrauma cases this method may be especially useful for the stabilisation of these fractures. However, problems may arise if the fracture is fixed in a malaligned or distracted position. Conversion of the treatment concept to other modalities is difficult because of the problem of pin tract infection. The Ilizarov apparatus provides an useful method in such situations, as it allows distraction, translation and compression without the need for further anaesthesia and additional fixation

Open reduction and internal fixation in a case with transscaphoid perilunate dislocation 8 months after the injury: a patient with a 5-year follow-up

The management of perilunate dislocations diagnosed later than three months continue to elicit debate with literature being scarce. We report a 22-year-old male with transscaphoid perilunate dislocation who reported to our hospital 8 months after sustaining the injury. Open reduction was done along with bone grafting. Five years after the surgery the patient is symptom-free with an excellent range of motion

1,4-Bis(4-amino­phen­oxy)benzene

The title compound, C18H16N2O2, is a precusor for the synthesis of polyimides. The mol­ecule is located on a crystallographic inversion center and the terminal amino­phen­oxy rings are almost perpendicular to the central benzene ring with a dihedral angle of 85.40 (4)°. The mol­ecular conformation is stabilized by N—H⋯O and N—H⋯N inter­molecular hydrogen-bonding inter­actions

Determinants of Marital Fertility in Pakistan: An Application of the "Synthesis Framework"

The fertility phase of the demographic transition has increasingly been viewed as a movement from high to low levels of fertility, and as a shift from natural fertility to deliberately controlled fertility. In an attempt to gain more insight into this process, the present study, in the context of Pakistan, is based on intensive National Population, Labour Force, and Migration Survey data covering 10,000 households. It aims to focus on the determinants of fertility in Pakistan, specifically the determinants of the adoption of deliberate fertility regulations. The role of socio-economic modernisation and cultural factors in the determination of the potential family size and the adoption of deliberate fertility control through a knowledge of fertility regulations have also been explored. The 'Synthesis Framework' of fertility determination, applied to Sri Lanka and Colombia by Easterlin and Crimmins (1982), and with its recent modifications by Ahmed (1987), is the main vehicle for the study.