Female breast cancer in New South Wales, Australia, by country of birth: implications for health-service delivery.

Background NSW has a multicultural population with increasing migration from South East Asia, the Western Pacific and Eastern Mediterranean. Objective To compare cancer stage, treatment (first 12 months) and survival for 12 country of birth (COB) categories recorded on the population-based NSW Cancer Registry. Design Historic cohort study of invasive breast cancers diagnosed in 2003–2016. Patients Data for 48,909 women (18+ ages) analysed using linked cancer registry, hospital inpatient and Medicare and pharmaceutical benefits claims data. Measurement Comparisons by COB using multivariate logistic regression and proportional hazards regression with follow-up of vital status to April 30th, 2020. Results Compared with the Australia-born, women born in China, the Philippines, Vietnam and Lebanon were younger at diagnosis, whereas those from the United Kingdom, Germany, Italy and Greece were older. Women born in China, the Philippines, Vietnam, Greece and Italy lived in less advantaged areas. Adjusted analyses indicated that: (1) stage at diagnosis was less localised for women born in Germany, Greece, Italy and Lebanon; (2) a lower proportion reported comorbidity for those born in China, the Philippines and Vietnam; (3) surgery type varied, with mastectomy more likely for women born in China, the Philippines and Vietnam, and less likely for women born in Italy, Greece and Lebanon; (4) radiotherapy was more likely where breast conserving surgery was more common (Greece, Italy, and Lebanon) and the United Kingdom; and (5) systemic drug therapy was less common for women born in China and Germany. Five-year survival in NSW was high by international standards and increasing. Adjusted analyses indicate that, compared with the Australian born, survival from death from cancer at 5 years from diagnosis was higher for women born in China, the Philippines, Vietnam, Italy, the United Kingdom and Greece. Conclusions There is diversity by COB of stage, treatment and survival. Reasons for survival differences may include cultural factors and healthier migrant populations with lower comorbidity, and potentially, less complete death recording in Australia if some women return to their birth countries for treatment and end-of-life care. More research is needed to explore the cultural and clinical factors that health services need to accommodate

Multilocus genetic characterization of phytoplasmas

Classification of phytoplasmas into 16S ribosomal groups and subgroups and \u2018Candidatus Phytoplasma\u2019 species designation have been primarily based on the conserved 16S rRNA gene. However, distinctions among closely related \u2018Ca. Phytoplasma\u2019 species and strains based on 16S rRNA gene alone have limitations imposed by the high degree of rRNA nucleotide sequence conservation across diverse phytoplasma lineages and by the presence in a phytoplasma genome of two, sometimes sequence heterogeneous, copies of this gene. Thus, in recent years, moderately conserved genes have been used as additional genetic markers with the aim to enhance the resolving power in delineating distinct phytoplasma strains among members of some 16S ribosomal subgroups. The present chapter is divided in two parts: the first part describes the non-ribosomal single-copy genes less conserved (housekeeping genes) such as ribosomal protein (rp), secY, secA, rpoB, tuf, and groEL genes, which have been extensively used for differentiation across the majority of phytoplasmas; the second part describes the differentiation of phytoplasmas in the diverse ribosomal groups using multiple genes including housekeeping genes and variable genes encoding surface proteins

Multilocus genetic characterization of phytoplasmas

Classification of phytoplasmas into 16S ribosomal groups and subgroups and \u2018Candidatus Phytoplasma\u2019 species designation have been primarily based on the conserved 16S rRNA gene. However, distinctions among closely related \u2018Ca. Phytoplasma\u2019 species and strains based on 16S rRNA gene alone have limitations imposed by the high degree of rRNA nucleotide sequence conservation across diverse phytoplasma lineages and by the presence in a phytoplasma genome of two, sometimes sequence heterogeneous, copies of this gene. Thus, in recent years, moderately conserved genes have been used as additional genetic markers with the aim to enhance the resolving power in delineating distinct phytoplasma strains among members of some 16S ribosomal subgroups. The present chapter is divided in two parts: the first part describes the non-ribosomal single-copy genes less conserved (housekeeping genes) such as ribosomal protein (rp), secY, secA, rpoB, tuf, and groEL genes, which have been extensively used for differentiation across the majority of phytoplasmas; the second part describes the differentiation of phytoplasmas in the diverse ribosomal groups using multiple genes including housekeeping genes and variable genes encoding surface proteins