Human Papillomavirus and Oropharyngeal Carcinoma in Indigenous Australians

Current trends suggest that the prevalence of oropharyngeal squamous cell carcinomas (OPSCC) associated with human papillomavirus (HPV) is increasing. Although Indigenous Australians have high rates of OPSCC, the incidence of oral HPV and the associated risk factors in this group are unknown. This thesis is an embedded component of a larger National Health and Medical Research Council (NHRMC) funded project titled 'Human Papillomavirus and Oropharyngeal Carcinoma amongst Indigenous Australians'. This thesis primarily explores the prevalence of HPV infections, accompanied by a qualitative insight regarding awareness and prevention strategies amongst Indigenous populations. The thesis is broadly divided into seven sections, with each section comprising twelve Chapters. Section A is an introduction of the thesis and includes Chapter 1, which is an overview of HPV, oropharyngeal carcinoma, and cancer burden amongst Indigenous Australians. Chapter 2 includes a review of the literature summarizing the prevalence of oral HPV amongst Indigenous populations globally and the prevalence of high-risk HPV infections amongst Indigenous populations. The Chapter concludes by highlighting identified gaps in research, followed by the aim and a basic outline of this thesis. Section B comprises Chapter 3, which describes the objectives of the larger HPV project and outlines the nested aims and expected contributions covered in this thesis. It describes the methodology and study design highlighting the research questions explored. Section C includes Chapter 4, which comprises comparative research highlighting the general health and oral health inequalities faced by Indigenous Australians. It includes analyses of the data collected as a part of the broader HPV project. Section D comprises three Chapters (Chapters 5 to 7), which provide details of HPV infection more broadly among Indigenous Australians. Chapter 5 is a systematic review and meta- analysis on the prevalence of HPV infection amongst Indigenous Australians. Chapter 6 is an analysis of the risk factors associated with incidence, persistence, and clearance of oral HPV infection at 12 months, as observed in the HPV project. Baseline findings of the HPV project showed an unexpectedly high prevalence of HPV 13 and 32, which are frequently associated with Heck's Disease (asymptomatic, benign neoplastic condition caused by HPV 13 or 32). Chapter 7 is a critical review of literature for Heck's disease and provides an insight into the age, sex, clinical presentation, genetic predisposition, ethnic association, global burden, and available treatment strategies. Section E is the qualitative component of this thesis, and includes Chapters 8 and 9. Chapter 8 addresses the high risk of Indigenous populations at a global level in experience of both HPV infection and HPV-related cancers. It presents a social-ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women, offering a holistic and practical approach for Indigenous health policymakers. Chapter 9 is the psychological evaluation of the different emotions felt by Indigenous participants after hearing about cancer in the family or community. It discusses the critical importance of psycho-oncology, and the considerations for Indigenous peoples. Section F includes Chapter 10, involving the discussion of future objectives arising from this research. Clinical examinations are to be included in the next phase of this project and this Chapter is a proposition of using confocal imaging as a suitable screening tool and its diagnostic test of accuracy. This thesis identifies the general and oral health inequalities faced by Indigenous Australians, and the increased burden of HPV infection and its associated carcinomas. An ethnic predisposition to Heck's disease was identified with a large proportion of affected people having an Indigenous origin. The qualitative component identified a large gap regarding the awareness and prevention of HPV infection amongst Indigenous populations. It also produces a model to address this gap at an individual, family, community, and system level. The psycho- oncological evaluation demonstrated that, for Indigenous peoples, the experience of cancer care is complex as the health of an individual is determined by the emotional, cultural, social, and physical well-being of an entire community. The diagnostic test of accuracy for confocal laser endomicroscopy shows exceptionally high sensitivity and specificity for diagnosing oral squamous cell carcinoma. The next step would be its transference to a clinical setting and its adaptation as a portable tool for screening of oropharyngeal cancer amongst Indigenous Australians.Thesis (Ph.D.) -- University of Adelaide, Adelaide Dental School, 202

Ras hyperactivation versus overexpression : Lessons from Ras dynamics in Candida albicans

We thank Prof. Neta Dean for the CIp10ADH1-Cherry plasmid and Prof. Aaron Mitchell for the BWP17 strain. We gratefully acknowledge Prof. Sudipta Maiti, TIFR, Mumbai, India for providing the data acquisition software. We also appreciate the feedback and discussions with Dr. Rohini Muthuswami, SLS, JNU as well as from the Protein Society group, New Delhi while this study was taking shape. We thank Prof. Alok Bhattacharya for Cytochalasin D. The GC-MS and fluorescence lifetime measurements were carried out at the Advanced Instrumentation Research Facility (AIRF), JNU. Confocal images were recorded either at the central instrumentation facility (CIF), SLS, JNU or at AIRF, JNU. This work was supported by project grants from Department of Biotechnology (DBT, Project grant no. BT/PR20410/BRB/10/1542/2016) and Department of Science and Technology (DST, Project grant no. SB/SO/BB-011/2014), India to S.S.K; and project grants from Department of Information Technology, (DIT, Project grant no. 12(4)/2007-PDD), India to S.S. for FCS setup. In addition, both S.S. and S.S.K. thank DBT-BUILDER for funding support (Project grant no. BT/PR5006/INF/153/2012). S.S.K. also acknowledges funding support from UGC Resource Networking grant to the School of Life Sciences. We thank DST-PURSE and JNU for assistance with funding for publication. G.S.V. and S.C.S. received a fellowship from UGC; V.A.P., B.Y., P.J., N.P., M.F.K. acknowledge CSIR for fellowships. S.L.S. received a fellowship from ICMR. D.T.H. and M.F.K. thank DBT-BUILDER for funding.Peer reviewedPublisher PD

Computational Cardiology: The Door to the Future of Interventional Cardiology

Precision medicine in cardiology has opened up new avenues for phenotypically personalized, integrative, and patient-centered treatment.1 Interventional cardiology is not untouched either (Figure 1). With the developments in artificial intelligence (AI), the computational models have revolutionized not only the ‘precision’ of the therapy but also the outcomes. Interventional cardiology, as a specialty, relies on the structural anatomy of the heart, more precisely banking on existing patient data. Computational cardiology allows an extension to the design by predicting outcomes of an intervention in individual patients utilizing integrated patient data sets and models based on physiology and physics (as opposed to population statistics). Further, it satisfies the need for patient-specific models in direct pharmaceutical therapy

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Oral Cavity: An insight to forensic diagnosis

Forensics is a branch of medicine that deals with the legal implications of healthcare, determines and interprets causes of disease, injury and death. Various causes of death are known to show different features in the entire human body including oral cavity. These features of the oral cavity can be used as a remote identity to assess the cause of death. The oral cavity can be considered as a region with tremendous potential especially in regard to coming to a final forensic diagnosis, but this aspect of forensic medicine is relatively undiscovered and overlooked. This article revolves around this concept and reviews the different manifestations in the oral cavity observed post mortem

UBC Electronic Waste Management Marketing Plan

Disclaimer: “UBC SEEDS provides students with the opportunity to share the findings of their studies, as well as their opinions, conclusions and recommendations with the UBC community. The reader should bear in mind that this is a student project/report and is not an official document of UBC. Furthermore readers should bear in mind that these reports may not reflect the current status of activities at UBC. We urge you to contact the research persons mentioned in a report or the SEEDS Coordinator about the current status of the subject matter of a project/report.”Business, Sauder School ofUnreviewedUndergraduat

Younger Generation: Our Global Edge

These words by Franklin D. Roosevelt, set the tone for the inauguration ceremony of the International Conference On Youth And Adolescent Health (ICYAH), held on the 14th of April, 2017at the New Delhi Municipal Council (NDMC) Convention Centre, New Delhi. The occasion was graced by the presence of eminent dignitaries, doctors, parents, teachers and various stakeholders concerning adolescent health. Following a floral welcome and the lighting of the lamp, residents from the Department of Community Medicine at VardhamanMahavirMedical College (VMMC) and Safdarjung Hospital, livened the atmosphere with a melodious song. Dr. M.R. Surwade, Conference Chairperson welcomed the august gathering; following which Dr. Prema Bali, Founding President of the Indian Association for Adolescent Health (IAAH) highlighted the various issues of adolescents and elaborated on the theme of the conference- “Young Generation: Our Global Edge”. The Guests of Honour, Shri Naresh Kumar, Chairman NDMC; and Dr. A.K. Panda, Additional Secretary and Mission Director, Ministry of Health and Family Welfare, Government of India, further highlighted the challenges of the youth and described the various government interventions and programs in place for the betterment of adolescents. The Chief Guest, PadmashreeDr.Jagdish Prasad, Director General of Health Services emphasized the role of the family in the upbringing of the children and the youth.The Souvenir of the Conference was released in inauguration. Correspondenc

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Not AvailableKhesari dhal (Lathyrus sativus L) or grass pea is one of the richest source of protein among pulses, however its utilization is limited owing to the presence of a neurotoxin i.e. β-Oxalyl-di-amino propionic acid (β-ODAP). β-ODAP is a water soluble neurotoxin, hence, aqueous extraction of protein followed by isolation through precipitation may reduce/remove its concentration in protein isolates. . This study was aimed to optimize the process parameters for production of protein isolates from Khesari dhal (var. Mahateora). Four process parameters i. e extraction pH (8–10), extraction duration (40–80 min), extraction temperature (40–60 °C) and salt (sodium chloride) concentration (0.1–0.3%) were selected. Experiments were designed using response surface methodology (RSM) and executed accordingly. Maximum protein extraction (94.66%), recovery (81.04%), yield (23.10%) and purity (92.91%) was obtained at, pH 9; extraction duration, 58 min; temperature, 53 °C and salt concentration of 0.2% at khesari dhal: water ratio of 1:10. β-ODAP was not detectable in protein isolates and functional properties namely protein solubility, foaming and emulsification capacity, water and oil absorption capacity and least gelling concentration were at par with other legumes protein isolates.Not Availabl

Network psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) in Aboriginal and/or Torres Strait Islander Australians: a Hierarchical Exploratory Graph Analysis

This study aims to investigate the psychometric properties of the MSPSS within an Aboriginal and/or Torres Strait Islander population through the employment of network psychometrics with Hierarchical Exploratory Graph Analysis (Borsboom et al., 2021; Alexander P. Christensen, Golino, & Silvia, 2020) to evaluate the instrument’s: (1) network structure, stability, and fit; (2) measurement invariance; (3) criterion validity; and (4) reliability