Human papillomavirus infection in esophageal squamous cell carcinoma and esophageal adenocarcinoma: a concise review

The causal link between high-risk human papillomavirus (hr-HPV) infection and cervical, anogenital, and some oropharyngeal malignancies has been established by both molecular and epidemiological data. The association between HPV and esophageal squamous cell carcinoma (ESCC) remains controversial, as is the true prevalence of HPV infection in ESCC. The wide range in reported rates reflects variability in the primary literature, with some larger scale case–control studies suggesting the infection rates range from 0% to 78%. Interactions between HPV and the Barrett's metaplasia–dysplasia–carcinoma sequence have been explored, and these studies have shown some conflicting data. Overall, systematic reviews have reported the prevalence of HPV-positive DNA in esophageal adenocarcinoma patients of between 13% and 35%. Postulated reasons for discrepancies in HPV prevalence rates in esophageal cancer include variations in testing methodology and assay sensitivities; technical issues, including the lack of a gold-standard primer; types of specimens utilized (fresh-frozen versus formalin-fixed tissue); geographical variation; cross-contamination; and small sample sizes. Thus, efforts must be undertaken to (1) standardize HPV testing, ideally in a central laboratory and utilizing tests that detect viral transcriptional activity; (2) avoid cross-contamination; and (3) recruit large numbers of patients to accurately ascertain HPV rates in esophageal malignancy

Pancreatectomy is underused in NSW regions with low institutional surgical volumes: A population data linkage study

© 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Objective: To examine differences in the proportions of people diagnosed with pancreatic cancer who underwent pancreatectomy, post-operative outcomes and 5-year survival in different New South Wales administrative health regions of residence. Design, setting and participants: Retrospective analysis of NSW data on pancreatic cancer incidence and surgery, 2005e2013. Main outcome measures: The proportion of newly diagnosed patients with pancreatic cancer who were resected in each region; 90-day post-operative mortality; one-year post-operative survival; 5-year post-diagnosis survival. Results: 14% of people diagnosed with pancreatic cancer during 2010e2013 (431 of 3064) underwent pancreatectomy, an average of 108 resections per year. After adjusting for age, sex and comorbidities, the proportion that underwent resection varied significantly between regions, ranging between 8% and 21% (P<0.001). Higher resection rates were not associated with higher post-operative 90-day mortality or lower one-year survival (unadjusted and risk-adjusted analyses). Higher resection rates were associated with higher 5-year post-diagnosis survival: the mean survival in regions with resection rates below 10% was 3.4%, compared with 7.2% in regions with rates greater than 15% (unadjusted and adjusted survival analyses; P<0.001). There was a positive association between regional resection rate and the pancreatectomy volume of hospitals during 2005e2009. An additional 32 people would be resected annually if resection rates in low rate regions were increased to the 80th percentile regional resection rate (18%). Conclusion: There is significant geographic variation in the proportion of people with pancreatic cancer undergoing pancreatectomy, and the 5-year survival rate is higher in regions where this proportion is higher

Management of acute appendicitis during the COVID-19 pandemic : a retrospective cohort study

Background: The Coronavirus Disease 2019 (COVID-19) pandemic profoundly impacted delivery of health care. South Western Sydney Local Health District (SWSLHD) experienced some of the highest cases, admissions and deaths during the Delta and Omicron waves in New South Wales. This study aims to determine the impact of the pandemic on emergency surgery services for adults presenting with acute appendicitis. Methods: A retrospective review of patient records was performed of adults presenting with acute appendicitis between 1st March 2021 and 31st March 2022, which was compared to a pre-COVID control period of the same dates in 2019–2020. Patients managed operatively or conservatively were included. Results: 1556 patients were included in the operative arm; 723 and 833 respectively in the study and control groups, which were comparable at baseline. 1.66% were COVID positive. During the pandemic, patients were significantly more likely to be investigated with computered tomography (CT) scan (p ≤ 0.001), present with complicated appendicitis (p = 0.03), and require caecectomy (p = 0.005). They had higher American Society of Anaesthesiology (ASA) scores (p = 0.001) and significantly lower negative appendectomy rates (p = 0.001). Fifty-two patients were included in the conservative arm; 29 and 23 respectively in the pandemic and control groups. Patients were comparable at baseline. There were two COVID positive patients. During the pandemic, there was a significant reduction in complications (p = 0.033), readmissions (0.044) and interval appendicectomy (p = 0.0044). Conclusion: We identified higher rates of complicated appendicitis, caecectomies and greater reliance on CT imaging preoperatively during the pandemic in SWSLHD

Mapping the Stellar Dynamics of M31

Using the Planetary Nebula Spectrograph, we have observed and measured the velocities for some 2764 PNe in the disk and halo of the Andromeda galaxy. Preliminary analysis using a basic ring model shows a rotation curve in good agreement with that obtained from HI data out to ~20kpc. Some substructure has also been detected within the velocity field, which can be modeled as the continuation of the tidal-remnant known as the Southern Stream, as it passes through Andromeda's disk.Comment: 5 pages, 3 figures, to appear in the proceedings of the ESO-Workshop "Planetary Nebulae beyond the Milky Way", May 19 - 21 (2004), ed. J. R. Walsh, L. Stanghellini, Springer-Verla

Augmenting forearm crutches with wireless sensors for lower limb rehabilitation

Forearm crutches are frequently used in the rehabilitation of an injury to the lower limb. The recovery rate is improved if the patient correctly applies a certain fraction of their body weight (specified by a clinician) through the axis of the crutch, referred to as partial weight bearing (PWB). Incorrect weight bearing has been shown to result in an extended recovery period or even cause further damage to the limb. There is currently no minimally invasive tool for long-term monitoring of a patient's PWB in a home environment. This paper describes the research and development of an instrumented forearm crutch that has been developed to wirelessly and autonomously monitor a patient's weight bearing over the full period of their recovery, including its potential use in a home environment. A pair of standard forearm crutches are augmented with low-cost off-the-shelf wireless sensor nodes and electronic components to provide indicative measurements of the applied weight, crutch tilt and hand position on the grip. Data are wirelessly transmitted between crutches and to a remote computer (where they are processed and visualized in LabVIEW), and the patient receives biofeedback by means of an audible signal when they put too much or too little weight through the crutch. The initial results obtained highlight the capability of the instrumented crutch to support physiotherapists and patients in monitoring usage

Tracing the star stream through M31 using planetary nebula kinematics

We present a possible orbit for the Southern Stream of stars in M31, which connects it to the Northern Spur. Support for this model comes from the dynamics of planetary nebulae (PNe) in the disc of M31: analysis of a new sample of 2611 PNe obtained using the Planetary Nebula Spectrograph reveals ∼20 objects with kinematics inconsistent with the normal components of the galaxy, but which lie at the right positions and velocities to connect the two photometric features via this orbit. The satellite galaxy M32 is coincident with the stream both in position and velocity, adding weight to the hypothesis that the stream comprises its tidal debri

A deep kinematic survey of planetary nebulae in the Andromeda galaxy using the Planetary Nebula Spectrograph

We present a catalogue of positions, magnitudes and velocities for 3300 emission-line objects found by the Planetary Nebula Spectrograph in a survey of the Andromeda galaxy, M31. Of these objects, 2615 are found likely to be planetary nebulae (PNe) associated with M31. The survey area covers the whole of M31's disc out to a radius of . Beyond this radius, observations have been made along the major and minor axes, and the Northern Spur and Southern Stream regions. The calibrated data have been checked for internal consistency and compared with other catalogues. With the exception of the very central, high surface brightness region of M31, this survey is complete to a magnitude limit of m5007∼ 23.75, 3.5 mag into the PN luminosity function. We have identified emission-line objects associated with M31's satellites and other background galaxies. We have examined the data from the region tentatively identified as a new satellite galaxy, Andromeda VIII, comparing it to data in the other quadrants of the galaxy. We find that the PNe in this region have velocities that appear to be consistent with membership of M31 itself. The luminosity function of the surveyed PNe is well matched to the usual smooth monotonic function. The only significant spatial variation in the luminosity function occurs in the vicinity of M31's molecular ring, where the luminosities of PNe on the near side of the galaxy are systematically ∼0.2 mag fainter than those on the far side. This difference can be explained naturally by a modest amount of obscuration by the ring. The absence of any difference in luminosity function between bulge and disc suggests that the sample of PNe is not strongly populated by objects whose progenitors are more massive stars. This conclusion is reinforced by the excellent agreement between the number counts of PNe and the R-band light. The number counts of kinematically selected PNe also allow us to probe the stellar distribution in M31 down to very faint limits. There is no indication of a cut-off in M31's disc out to beyond four scalelengths, and no signs of a spheroidal halo population in excess of the bulge out to 10 effective bulge radii. We have also carried out a preliminary analysis of the kinematics of the surveyed PNe. The mean streaming velocity of the M31 disc PNe is found to show a significant asymmetric drift out to large radii. Their velocity dispersion, although initially declining with radius, flattens out to a constant value in the outer parts of the galaxy. There are no indications that the disc velocity dispersion varies with PN luminosity, once again implying that the progenitors of PNe of all magnitudes form a relatively homogeneous old population. The dispersion profile and asymmetric drift results are shown to be mutually consistent, but require that the disc flares with radius if the shape of its velocity ellipsoid remains invarian

Tracing the star stream through M31 using planetary nebula kinematics

We present a possible orbit for the Southern Stream of stars in M31, which connects it to the Northern Spur. Support for this model comes from the dynamics of planetary nebulae (PNe) in the disk of M31: analysis of a new sample of 2611 PNe obtained using the Planetary Nebula Spectrograph reveals ~20 objects whose kinematics are inconsistent with the normal components of the galaxy, but which lie at the right positions and velocities to connect the two photometric features via this orbit. The satellite galaxy M32 is coincident with the stream both in position and velocity, adding weight to the hypothesis that the stream comprises its tidal debris.Comment: 6 pages, 2 figures, MNRAS Letters, accepted; for hi-res version see http://as1.chem.nottingham.ac.uk/~Aaron/m31stream.pdf (pdf) or http://as1.chem.nottingham.ac.uk/~Aaron/m31stream.ps.gz (ps

Planetary Nebula Velocities in the Disk and Bulge of M31

We present radial velocities for a sample of 723 planetary nebulae (PNe) in the disk and bulge of M31, measured using the WYFFOS fibre spectrograph on the William Herschel telescope. Velocities are determined using the [OIII] 5007 Angstrom emission line. Rotation and velocity dispersion are measured to a radius of 50 arcminutes (11.5 kpc), the first stellar rotation curve and velocity dispersion profile for M31 to such a radius. Our kinematics are consistent with rotational support at radii well beyond the bulge effective radius of 1.4kpc, although our data beyond a radius of 5kpc are limited. We present tentative evidence for kinematic substructure in the bulge of M31 to be studied fully in a later work. This paper is part of an ongoing project to constrain the total mass, mass distribution and velocity anisotropy of the disk, bulge and halo of M31.Comment: 27 pages, accepted for publication in MNRA

Lost in translation: Returning germline genetic results in genome-scale cancer research

Background: The return of research results (RoR) remains a complex and well-debated issue. Despite the debate, actual data related to the experience of giving individual results back, and the impact these results may have on clinical care and health outcomes, is sorely lacking. Through the work of the Australian Pancreatic Cancer Genome Initiative (APGI) we: (1) delineate the pathway back to the patient where actionable research data were identified; and (2) report the clinical utilisation of individual results returned. Using this experience, we discuss barriers and opportunities associated with a comprehensive process of RoR in large-scale genomic research that may be useful for others developing their own policies. Methods: We performed whole-genome (n = 184) and exome (n = 208) sequencing of matched tumour-normal DNA pairs from 392 patients with sporadic pancreatic cancer (PC) as part of the APGI. We identified pathogenic germline mutations in candidate genes (n = 130) with established predisposition to PC or medium-high penetrance genes with well-defined cancer associated syndromes or phenotypes. Variants from candidate genes were annotated and classified according to international guidelines. Variants were considered actionable if clinical utility was established, with regard to prevention, diagnosis, prognostication and/or therapy. Results: A total of 48,904 germline variants were identified, with 2356 unique variants undergoing annotation and in silico classification. Twenty cases were deemed actionable and were returned via previously described RoR framework, representing an actionable finding rate of 5.1%. Overall, 1.78% of our cohort experienced clinical benefit from RoR. Conclusion: Returning research results within the context of large-scale genomics research is a labour-intensive, highly variable, complex operation. Results that warrant action are not infrequent, but the prevalence of those who experience a clinical difference as a result of returning individual results is currently low