Doctor of Philosophy

dissertationTemporal reasoning denotes the modeling of causal relationships between different variables across different instances of time, and the prediction of future events or the explanation of past events. Temporal reasoning helps in modeling and understanding interactions between human pathophysiological processes, and in predicting future outcomes such as response to treatment or complications. Dynamic Bayesian Networks (DBN) support modeling changes in patients' condition over time due to both diseases and treatments, using probabilistic relationships between different clinical variables, both within and across different points in time. We describe temporal reasoning and representation in general and DBN in particular, with special attention to DBN parameter learning and inference. We also describe temporal data preparation (aggregation, consolidation, and abstraction) techniques that are applicable to medical data that were used in our research. We describe and evaluate various data discretization methods that are applicable to medical data. Projeny, an opensource probabilistic temporal reasoning toolkit developed as part of this research, is also described. We apply these methods, techniques, and algorithms to two disease processes modeled as Dynamic Bayesian Networks. The first test case is hyperglycemia due to severe illness in patients treated in the Intensive Care Unit (ICU). We model the patients' serum glucose and insulin drip rates using Dynamic Bayesian Networks, and recommend insulin drip rates to maintain the patients' serum glucose within a normal range. The model's safety and efficacy are proven by comparing it to the current gold standard. The second test case is the early prediction of sepsis in the emergency department. Sepsis is an acute life threatening condition that requires timely diagnosis and treatment. We present various DBN models and data preparation techniques that detect sepsis with very high accuracy within two hours after the patients' admission to the emergency department. We also discuss factors affecting the computational tractability of the models and appropriate optimization techniques. In this dissertation, we present a guide to temporal reasoning, evaluation of various data preparation, discretization, learning and inference methods, proofs using two test cases using real clinical data, an open-source toolkit, and recommend methods and techniques for temporal reasoning in medicine

Analysis of aminoacids pattern in receptor tyrosine kinase using Boolean Association Rule

Cancers are characterized by unrestricted cell division and independency of growth factor and other external signal responsiveness. Eukaryotic parental cells of tumors, on the other hand, constitute tissues and other higher structures like organs and systems and are capable of performing various functions in a highly co-ordinated fashion. Hence, cancer cells may be considered as entities capable of incessant growth and cell division but lacking any evolutionarily advanced intracellular or intercellular regulation. Since receptor tyrosine kinases are highly altered and exist in deregulated/constitutively active forms in cancer cells - achieved through various epigenetic mechanisms - we hypothesize the functional RTKs in cancer cells to resemble their counterparts in more primitive species. Analysis of RTK sequences of various species and of cancer is, therefore, expected to prove this hypothesis. Association rule in data mining can reveal the hidden biological information. This study utilizes the Boolean association rule to mine the occurrence pattern of glycine, arginine and alanine in receptor tyrosine kinases (RTKs) of invertebrates, vertebrates and cancer related vertebrate RTKs based on protein sequence informations. The results reveal that vertebrate cancer RTKs resembles prokaryotes and invertebrate RTKs showing an increasing trend of glycine, alanine and decreasing trend in arginine composition. The aminoacid compositions of vertebrates: invertebrates: prokaryotes: vertebrate cancer with respect to Glycine (>=6.1) were 42.86: 50.0: 85.71: 100%, Alanine (>=6.2) were 10.72: 66.67: 85.71: 100%, whereas Arginine (>=5.9) were 21.43: 16.67: 14.29: 0%, respectively. In conclusion, results from this study supports our hypothesis that cancer cells may resemble lower organisms since functionally cancer cells are unresponsive to external signals and various regulatory mechanisms typically found in higher eukaryotes are largely absent

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1.14 billion (95% uncertainty interval 1.13-1.16) individuals were current smokers, who consumed 7.41 trillion (7.11-7.74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27.5% [26. 5-28.5] reduction) and females (37.7% [35.4-39.9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0.99 billion (0.98-1.00) in 1990. Globally in 2019, smoking tobacco use accounted for 7.69 million (7.16-8.20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20.2% [19.3-21.1] of male deaths). 6.68 million [86.9%] of 7.69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7.69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a dear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Bacterial diversity of Murlen National Park located in Indo-Burman Biodiversity hotspot region: A metagenomic approach

Paired end Illumina Mi-Seq sequencing of 16S rRNA gene amplicon was carried out to study the bacterial community in the soil of Murlen National Park located in Indo-Burman Biodiversity hotspot region. Metagenome consisted of 302,416 reads with 151.81 Mb data and G + C content of 56.48%. More than 85% sequence was having a Phred score >=Q30 and individual sequence length was 251 bp. Metagenome sequence data are available at NCBI under the Bioproject database with accession no. SRP057136. Community metagenomics revealed a total of 1802 species belonging to 29 different phyla dominated by Acidobacteria (39.45%), Proteobacteria (26.95%) and Planctomycetes (7.81%). Our data detected a wide group of bacterial community which will be useful in further isolating and characterizing the economic importance of bacteria from this region

Illumina based whole mitochondrial genome of Junonia iphita reveals minor intraspecific variation

In the present study, the near complete mitochondrial genome (mitogenome) of Junonia iphita (Lepidoptera: Nymphalidae: Nymphalinae) was determined to be 14,892 bp. The gene order and orientation are identical to those in other butterfly species. The phylogenetic tree constructed from the whole mitogenomes using the 13 protein coding genes (PCGs) defines the genetic relatedness of the two J. iphita species collected from two different regions. All the Junonia species clustered together, and were further subdivided into clade one consisting of J. almana and J. orithya and clade two comprising of the two J. iphita which were collected from Indo and Indochinese subregions separated by river barrier. Comparison between the two J. iphita sequences revealed minor variations and Single Nucleotide Polymorphisms were identified at 51 sites amounting to 0.4% of the entire mitochondrial genome

Identification of novel AKT1 inhibitors from Sapria himalayana bioactive compounds using structure-based virtual screening and molecular dynamics simulations

Abstract Through the experimental and computational analyses, the present study sought to elucidate the chemical composition and anticancer potential of Sapria himalayana plant extract (SHPE). An in vitro analysis of the plant extract was carried out to determine the anticancer potential. Further, network pharmacology, molecular docking, and molecular dynamic simulation were employed to evaluate the potential phytochemical compounds for cervical cancer (CC) drug formulations. The SHPE exhibited anti-cancerous potential through inhibition properties against cancer cell lines. The LC-MS profiling showed the presence of 14 compounds in SHPE. Using network pharmacology analysis, AKT1 (AKT serine/threonine kinase 1) is identified as the possible potential target, and EGFR (Epidermal Growth Factor Receptor) is identified as the possible key signal pathway. The major targets were determined to be AKT1, EGFR by topological analysis and molecular docking. An in silico interaction of phytoconstituents employing molecular docking demonstrated a high binding inclination of ergoloid mesylate and Ergosta-5,7,9(11),22-tetraen-3-ol, (3.beta.,22E)- with binding affinities of -15.5 kcal/mol, and -11.3 kcal/mol respectively. Further, MD simulation and PCA analyses showed that the phytochemicals possessed significant binding efficacy with CC protein. These results point the way for more investigation into SHPE compound’s potential as CC treatment. Graphical Abstrac

Prevalence of multi drug resistant enteropathogenic and enteroinvasive Escherichia coli isolated from children with and without diarrhea in Northeast Indian population

Abstract Background Diarrheagenic Escherichia coli are associated with infantile diarrhea in the developing countries. The present study was conducted to determine the occurrence and antimicrobial resistance pattern of enteropathogenic and enteroinvasive E. coli associated with diarrhoea among the paediatric patients. Methods A total of 262 stool samples were collected from children with and without diarrhea from Mizoram, Northeast India. E. coli were isolated and subjected to multiplex PCR to detect virulent genes of EPEC (eaeA and bfpA) and EIEC (ial). Isolates were subjected to antimicrobial sensitivity assay using disc diffusion method. Selected eaeA genes were sequenced for identification and genetic relationship. Results A total of 334 E. coli was isolated, of which 17.37% were carrying at least one virulent gene. Altogether, 14.97 and 2.40% isolates were categorized as EPEC and EIEC, respectively. Among the DEC isolates, 4.79% were EPEC and 7.78% were EIEC. A total of 8 (2.40%) isolates were EIEC (ial+), of which 6 (1.80%) and 2 (0.60%) were from diarrhoeic and non-diarrhoeic patients, respectively. A total of 24 (41.40%) DEC isolates were MDR (resistance against ≥5 antimicrobials). Conclusions A high frequency of EPEC pathotypes associated with paediatric diarrhea was observed in Mizoram, Northeast India and majority of the isolates are resistant to antibiotics with a high frequency of MDR, which is a matter of concern to the public health. This also raises an alarm to the world communities to monitor the resistance pattern and analyse in a global scale to combat the problems of resistance development

Five Years Record on Cancer Incidence from a Diagnostic Centre in Mizoram, Northeast India: Cancer trend in Mizoram

Cancer has become leading cause of death in Northeast Indian population. The main reason being poor knowledge of prevention and diagnosis combined with modern lifestyle of the Mizo population. All cancers have been reported in Mizo population including the cancers of stomach, cervix, lungs, breast, oesophagus, rectum, prostate, liver, bladder, oral etc. The cause of such high incidence rates of these cancers may be inherited or genetic and environmental factors such as life style and food habits, especially high consumption of tobacco and alcohol. A peculiar habit of tobacco smoke-infused water (Tuibur) is also in practice in this population. In view of these facts, the present article describes the status of various types of cancers in Mizo population. Besides, attempts have been made to describe the main causes of cancer in this population with their frequency and grading. In this study, increasing number of cancer patients in different age group was observed from 2011 – 2015. The highest incidence of cancer was observed in the patients with age group 50 - 60, followed by age groups above 60. In age group 20-30 years, the breast and cervix cancers were more prevalent, throughout all the years. In middle age group (30-40 and 40-50 years), the cervix, stomach and oesophagus cancers were more prevalent. The common type of cancer in female includes cervical cancer, followed by breast cancer which is shown to be increasing with age of the patients and also increasing each year within this 5 year period from 2011 – 2015. In 2014 and 2015, adenocarcinoma (AC) and squamous cell carcinoma (SCC) are both commonly seen. This study will help in understanding the etiology of cancer and also in developing preventive measures in future