The Relationship Between the Cervical Microbiome and Cervical Cancer Risk in Sub-Saharan Africa

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Dysbiosis of the cervicovaginal microbiota, particularly involving sexually transmitted infections, is associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better understanding of the regional cervicovaginal microbiome is required. In this study, I establish the relationship between cervical cancer, HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiome in sub-Saharan Africa. To investigate the role of the bacterial microbiome in cervical dysplasia, cytobrush samples were collected directly from cervical lesions of 144 Tanzanian women and analyzed using 16s metagenomic sequencing. I found that cervical microbiota varied significantly depending on HIV infection, HPV infection, and the presence of cervical lesions. The bacterial family ‘Mycoplasmataceae’ in particular was associated with the presence of pre-cancerous cervical lesions. Mycoplasmataceae infection in sub-Saharan Africa is not well understood, especially when considering the differences between sexually transmitted species. To establish the prevalence of common Mycoplasmataceae cervical infections and evaluate their relationship with risk factors for cervical cancer, a cohort of 1160 Tanzanian women responded to an epidemiological questionnaire and were tested for HIV, HPV, cervical lesions, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma spp., and Lactobacillus iners. I found that Mycoplasmataceae infection was present in 66% of women tested. In particular, Mycoplasma hominis was associated with HPV and HIV infection, and significantly increased in relative abundance among women with pre-cancerous cervical lesions. The results of this study suggest that intracellular, inflammatory infections like M. hominis are prevalent and relate to the development of pre-cancerous cervical lesions. The prevalence of cervical cancer in sub-Saharan Africa may be partially attributed to the high prevalence of cervical infections like M. hominis. Advisor: Peter C. Angelett

What Do We Know About Interpersonal Skills? A Meta-analytic Examination Of Antecedents, Outcomes, And The Efficacy Of Training

Despite extensive statements about the importance of possessing good interpersonal skills, little quantitative evidence has been brought forth to investigate these claims. At the same time, training in soft, or interpersonal, skills continues for organizational managers, customer service representatives, and members of formal work teams. Based on these considerations, the current research was guided by five broad questions. First, are gender and the Big Five personality variables important predictors in the use and effectiveness of interpersonal skills? Second, what is the relationship between various interpersonal skills and important personal and workplace outcomes? Third, given that training in interpersonal skills is prevalent in organizations today, does this training work? Further, and perhaps more importantly, under what conditions do these training interventions result in optimal outcomes? Lastly, does job complexity moderate the relationship between interpersonal skills and outcomes? To answer these questions, a series of meta-analytic investigations was conducted. The results of these analyses provided evidence for the existence of meaningful antecedents of interpersonal skills. In addition, relationships between interpersonal skills and outcomes were identified, with hypotheses in this area confirmed. The results of this research demonstrate the beneficial impact of interpersonal skills training for improving interpersonal skills. Finally, in line with predictions, job complexity was identified as a moderator of the relationship between interpersonal skills and outcomes. The current document concludes with recommendations both for researchers interested in furthering the science of interpersonal skills research, and for practitioners charged with improving the interpersonal skills of their workforce

The Relationship Between the Cervical Microbiome and Cervical Cancer Risk in Sub-Saharan Africa

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Dysbiosis of the cervicovaginal microbiota, particularly involving sexually transmitted infections, is associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better understanding of the regional cervicovaginal microbiome is required. In this study, I establish the relationship between cervical cancer, HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiome in sub-Saharan Africa. To investigate the role of the bacterial microbiome in cervical dysplasia, cytobrush samples were collected directly from cervical lesions of 144 Tanzanian women and analyzed using 16s metagenomic sequencing. I found that cervical microbiota varied significantly depending on HIV infection, HPV infection, and the presence of cervical lesions. The bacterial family ‘Mycoplasmataceae’ in particular was associated with the presence of pre-cancerous cervical lesions. Mycoplasmataceae infection in sub-Saharan Africa is not well understood, especially when considering the differences between sexually transmitted species. To establish the prevalence of common Mycoplasmataceae cervical infections and evaluate their relationship with risk factors for cervical cancer, a cohort of 1160 Tanzanian women responded to an epidemiological questionnaire and were tested for HIV, HPV, cervical lesions, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma spp., and Lactobacillus iners. I found that Mycoplasmataceae infection was present in 66% of women tested. In particular, Mycoplasma hominis was associated with HPV and HIV infection, and significantly increased in relative abundance among women with pre-cancerous cervical lesions. The results of this study suggest that intracellular, inflammatory infections like M. hominis are prevalent and relate to the development of pre-cancerous cervical lesions. The prevalence of cervical cancer in sub-Saharan Africa may be partially attributed to the high prevalence of cervical infections like M. hominis. Advisor: Peter C. Angelett

How the Cervical Microbiota Contributes to Cervical Cancer Risk in Sub-Saharan Africa

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Particular states of the cervicovaginal microbiota and viral infections are associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better knowledge of the regional cervicovaginal microbiome is required This review establishes current knowledge of HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiota in sub-Saharan Africa. Because population statistics are not available for the region, estimates are derived from smaller cohort studies. Microbiota associated with cervical inflammation have been found to be especially prevalent in sub-Saharan Africa, and to associate with increased cervical cancer risk. In addition to high prevalence and diversity of HIV and HPV, intracellular bacterial infections such as Chlamydia, Gonorrhea, and Mycoplasma hominis are much more common than in regions with a low burden of cervical cancer. This suggests the prevalence of cervical cancer in sub-Saharan Africa may be partially attributed to increased cervical inflammation resulting from higher likelihood of cervical infection and/or microbial dysbiosis

Equine Endometrial Explants Undergo Significant Degenerative Changes in Culture

The current study evaluated equine endometrial explants following 12, 24, and 48 hours in culture. Measurement of an indicator of cell death in explant supernatant, light microscopy, and gene expression of biomarkers of endometrial function and cellular stress, were used to compare the effect of six different media on explant viability and morphology. Viability of explants was assessed indirectly through measuring LDH activity in the culture supernatant. Regardless of culture medium composition, a significant increase in LDH activity was observed within 12 hours of culture, indicating occurrence of cell damage. Morphological analysis through light microscopy revealed degenerative changes occurring within 12 hours and after 48 hours there is nearly complete loss of luminal and superficial glandular epithelium and diffuse detachment of deep glandular epithelium. Transcript abundance of prostaglandin-endoperoxide synthase 2 (PTGS2), estrogen receptor 1 (ESR1), and vascular endothelial growth factor (VEGF) was assessed as biomarkers of endometrial function. A marked increase in PTGS2 and VEGF expression occurred, ESR1 displayed more or less steady expression levels. Above described changes were seen irrespective of cell culture medium used. The marked increase in expression in PTGS2 expression presents a limitation to using endometrial explants in the current culture system to study aspects of endometrial function such as the inflammatory response to insemination

Towards machine learning approach for digital-health intervention program

Digital-Health intervention (DHI) are used by health care providers to promote engagement within community. Effective assignment of participants into DHI programs helps increasing benefits from the most suitable intervention. A major challenge with the roll-out and implementation of DHI, is in assigning participants into different interventions. The use of biopsychosocial model [18] for this purpose is not wide spread, due to limited personalized interventions formed on evidence-based data-driven models. Machine learning has changed the way data extraction and interpretation works by involving automatic sets of generic methods that have replaced the traditional statistical techniques. In this paper, we propose to investigate relevance of machine learning for this purpose and is carried out by studying different non-linear classifiers and compare their prediction accuracy to evaluate their suitability. Further, as a novel contribution, real-life biopsychosocial features are used as input in this study. The results help in developing an appropriate predictive classication model to assign participants into the most suitable DHI. We analyze biopsychosocial data generated from a DHI program and study their feature characteristics using scatter plots. While scatter plots are unable to reveal the linear relationships in the data-set, the use of classifiers can successfully identify which features are suitable predictors of mental ill health

Changes in the genetic structure of an invasive earthworm species (Lumbricus terrestris, Lumbricidae) along an urban – rural gradient in North America

European earthworms were introduced to North America by European settlers about 400 years ago. Human-mediated introductions significantly contributed to the spread of European species, which commonly are used as fishing bait and are often disposed deliberately in the wild. We investigated the genetic structure of Lumbricus terrestris in a 100km range south of Calgary, Canada, an area that likely was devoid of this species two decades ago. Genetic relationships among populations, gene flow, and migration events among populations were investigated using seven microsatellite markers and the mitochondrial 16S rDNA gene. Earthworms were collected at different distances from the city and included fishing baits from three different bait distributors. The results suggest that field populations in Alberta established rather recently and that bait and field individuals in the study area have a common origin. Genetic variance within populations decreased outside of the urban area, and the most distant populations likely originated from a single introduction event. The results emphasise the utility of molecular tools to understand the spatial extent and connectivity of populations of exotic species, in particular soil-dwelling species, that invade native ecosystems and to obtain information on the origin of populations. Such information is crucial for developing management and prevention strategies to limit and control establishment of non-native earthworms in North America.Peer reviewe

Evidence based policy making and the 'art' of commissioning - How English healthcare commissioners access and use information and academic research in 'real life' decision-making: An empirical qualitative study

© 2015 Wye et al. Background: Policymakers such as English healthcare commissioners are encouraged to adopt 'evidence-based policy-making', with 'evidence' defined by researchers as academic research. To learn how academic research can influence policy, researchers need to know more about commissioning, commissioners' information seeking behaviour and the role of research in their decisions. Methods: In case studies of four commissioning organisations, we interviewed 52 people including clinical and managerial commissioners, observed 14 commissioning meetings and collected documentation e.g. meeting minutes and reports. Using constant comparison, data were coded, summarised and analysed to facilitate cross case comparison. Results: The 'art of commissioning' entails juggling competing agendas, priorities, power relationships, demands and personal inclinations to build a persuasive, compelling case. Policymakers sought information to identify options, navigate ways through, justify decisions and convince others to approve and/or follow the suggested course. 'Evidence-based policy-making' usually meant pragmatic selection of 'evidence' such as best practice guidance, clinicians' and users' views of services and innovations from elsewhere. Inconclusive or negative research was unhelpful in developing policymaking plans and did not inform disinvestment decisions. Information was exchanged through conversations and stories, which were fast, flexible and suited the rapidly changing world of policymaking. Local data often trumped national or research-based evidence. Local evaluations were more useful than academic research. Discussion: Commissioners are highly pragmatic and will only use information that helps them create a compelling case for action. Therefore, researchers need to start producing more useful information. Conclusions: To influence policymakers' decisions, researchers need to 1) learn more about local policymakers' priorities 2) develop relationships of mutual benefit 3) use verbal instead of writtencommunication 4) work with intermediaries such as public health consultants and 5) co-produce local evaluations

How the Cervical Microbiota Contributes to Cervical Cancer Risk in Sub-Saharan Africa

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Particular states of the cervicovaginal microbiota and viral infections are associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better knowledge of the regional cervicovaginal microbiome is required This review establishes current knowledge of HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiota in sub-Saharan Africa. Because population statistics are not available for the region, estimates are derived from smaller cohort studies. Microbiota associated with cervical inflammation have been found to be especially prevalent in sub-Saharan Africa, and to associate with increased cervical cancer risk. In addition to high prevalence and diversity of HIV and HPV, intracellular bacterial infections such as Chlamydia, Gonorrhea, and Mycoplasma hominis are much more common than in regions with a low burden of cervical cancer. This suggests the prevalence of cervical cancer in sub-Saharan Africa may be partially attributed to increased cervical inflammation resulting from higher likelihood of cervical infection and/or microbial dysbiosis

Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study

Objective - To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. Design - A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. Subjects - Records of 17,753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980–2012, and 70,758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. Main outcome measures - Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. Results - After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0–6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months–2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2–15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. Conclusions - Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required that facilitates identification of at-risk patients and appropriate treatment pathways, to reduce the long-term morbidity associated with burns