Expenditure and resource utilisation for cervical screening in Australia

BACKGROUND The National Cervical Screening Program in Australia currently recommends that women aged 18-69 years are screened with conventional cytology every 2 years. Publicly funded HPV vaccination was introduced in 2007, and partly as a consequence, a renewal of the screening program that includes a review of screening recommendations has recently been announced. This study aimed to provide a baseline for such a review by quantifying screening program resource utilisation and costs in 2010. METHODS A detailed model of current cervical screening practice in Australia was constructed and we used data from the Victorian Cervical Cytology Registry to model age-specific compliance with screening and follow-up. We applied model-derived rate estimates to the 2010 Australian female population to calculate costs and numbers of colposcopies, biopsies, treatments for precancer and cervical cancers in that year, assuming that the numbers of these procedures were not yet substantially impacted by vaccination. RESULTS The total cost of the screening program in 2010 (excluding administrative program overheads) was estimated to be A$194.8M. We estimated that a total of 1.7 million primary screening smears costing$96.7M were conducted, a further 188,900 smears costing $10.9M were conducted to follow-up low grade abnormalities, 70,900 colposcopy and 34,100 histological evaluations together costing$21.2M were conducted, and about 18,900 treatments for precancerous lesions were performed (including retreatments), associated with a cost of $45.5M for treatment and post-treatment follow-up. We also estimated that$20.5M was spent on work-up and treatment for approximately 761 women diagnosed with invasive cervical cancer. Overall, an estimated $23 was spent in 2010 for each adult woman in Australia on cervical screening program-related activities. CONCLUSIONS Approximately half of the total cost of the screening program is spent on delivery of primary screening tests; but the introduction of HPV vaccination, new technologies, increasing the interval and changing the age range of screening is expected to have a substantial impact on this expenditure, as well as having some impact on follow-up and management costs. These estimates provide a benchmark for future assessment of the impact of changes to screening program recommendations to the costs of cervical screening in Australia

PROCESSING OF FACIAL EXPRESSIONS BY OLDER AND YOUNGER ADULTS

Older adults tend to show overall recognition deficits and qualitatively different patterns in the particular expressions that are most difficult to identify (Ruffman et al., 2008). In the current study, 23 younger (18-33 years old) and 23 older (60-80 years old) adults performed a 4AFC (angry, fearful, happy, sad) facial expression categorization task varying orientation (upright/inverted) and stimulus duration (100, 500, 1000 ms). For both groups, happiness was the easiest expression to identify and fear and sadness were the most difficult. Compared to younger adults, older adults were more affected by stimulus orientation, and generally benefit less from increased stimulus duration. For upright faces, there was no age difference in response accuracy but response latency was longer in older subjects. For inverted faces, older adults showed lower accuracy and longer latencies for expressions of anger, fear, and sadness. Recognition of inverted happy faces was spared in older adults for accuracy, but not response latency. These findings could not be explained by impaired detection sensitivity, as no systematic age differences were found for perceived intensity ratings. Finally, the expressions that were most to least difficult to identify was the same in each age group at both orientations. Overall, these results suggest that older individuals process expressive faces in a qualitatively similar way to their younger counterparts, but are less efficient at extracting the diagnostic information.Master of Science (MSc

Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial

Background Accelerated partner therapy (APT) is a promising partner notification (PN) intervention in specialist sexual health clinic attenders. To address its applicability in primary care, we undertook a pilot randomised controlled trial (RCT) of two APT models in community settings. Methods Three-arm pilot RCT of two adjunct APT interventions: APTHotline (telephone assessment of partner(s) plus standard PN) and APTPharmacy (community pharmacist assessment of partner(s) plus routine PN), versus standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health (CASH) services in London and south coast of England, randomised between 1 September 2011 and 31 July 2013. Results 199 women described 339 male partners, of whom 313 were reported by the index as contactable. The proportions of contactable partners considered treated within 6 weeks of index diagnosis were APTHotline 39/111 (35%), APTPharmacy 46/100 (46%), standard patient referral 46/102 (45%). Among treated partners, 8/39 (21%) in APTHotline arm were treated via hotline and 14/46 (30%) in APTPharmacy arm were treated via pharmacy. Conclusions The two novel primary care APT models were acceptable, feasible, compliant with regulations and capable of achieving acceptable outcomes within a pilot RCT but intervention uptake was low. Although addition of these interventions to standard PN did not result in a difference between arms, overall PN uptake was higher than previously reported in similar settings, probably as a result of introducing a formal evaluation. Recruitment to an individually randomised trial proved challenging and full evaluation will likely require service-level randomisation

The GstLAL Search Analysis Methods for Compact Binary Mergers in Advanced LIGO's Second and Advanced Virgo's First Observing Runs

After their successful first observing run (September 12, 2015 - January 12, 2016), the Advanced LIGO detectors were upgraded to increase their sensitivity for the second observing run (November 30, 2016 - August 26, 2017). The Advanced Virgo detector joined the second observing run on August 1, 2017. We discuss the updates that happened during this period in the GstLAL-based inspiral pipeline, which is used to detect gravitational waves from the coalescence of compact binaries both in low latency and an offline configuration. These updates include deployment of a zero-latency whitening filter to reduce the over-all latency of the pipeline by up to 32 seconds, incorporation of the Virgo data stream in the analysis, introduction of a single-detector search to analyze data from the periods when only one of the detectors is running, addition of new parameters to the likelihood ratio ranking statistic, increase in the parameter space of the search, and introduction of a template mass-dependent glitch-excision thresholding method.Comment: 12 pages, 7 figures, to be submitted to Phys. Rev. D, comments welcom

The GstLAL template bank for spinning compact binary mergers in the second observation run of Advanced LIGO and Virgo

We describe the methods used to construct the aligned-spin template bank of gravitational waveforms used by the GstLAL-based inspiral pipeline to analyze data from the second observing run of Advanced LIGO and Virgo. The bank expands upon the parameter space covered during the first observing run, including coverage for merging compact binary systems with total mass between 2 $\mathrm{M}_{\odot}$ and 400 $\mathrm{M}_{\odot}$ and mass ratios between 1 and 97.989. Thus the systems targeted include merging neutron star-neutron star systems, neutron star-black hole binaries, and black hole-black hole binaries expanding into the intermediate-mass range. Component masses less than 2 $\mathrm{M}_{\odot}$ have allowed (anti-)aligned spins between $\pm0.05$ while component masses greater than 2 $\mathrm{M}_{\odot}$ have allowed (anti-)aligned between $\pm0.999$. The bank placement technique combines a stochastic method with a new grid-bank method to better isolate noisy templates, resulting in a total of 677,000 templates.Comment: 9 pages, 13 figure

Effects of aging on face perception: Exploring efficiency, noise & orientation

Face perception is impaired in a variety of ways in older adults, but the mechanisms underlying these changes remain unclear. A central theme of this dissertation is that task performance is constrained by two factors intrinsic to the observer: sources of random variability -- internal noise -- and the efficiency with which task-relevant stimulus information is utilized. This thesis uses several behavioural, psychophysical methods to examine how age-related changes in one or both of these factors affect face processing. Chapter 2 used the classification image (CI) method to characterize the spatial sampling patterns of younger and older observers performing a face discrimination task. Compared to younger adults, older adults used information in the eye/brow region less consistently and instead relied on relatively less informative regions such as the forehead. The differences in CIs accounted for the lower absolute efficiency that was found in older observers. Chapter 3 estimated internal noise and calculation efficiency by measuring threshold-vs.-noise (TvN) curves and response consistency in a face discrimination task. Compared to younger observers, older observers had higher additive internal noise and lower calculation efficiency, but the magnitude of multiplicative internal noise did not differ between age groups. Previous studies have shown that younger adults have a bias to rely on horizontal structure to discriminate and identify faces, and the magnitude of this so-called horizontal bias is correlated with identification accuracy. The experiments in Chapter 4 measured horizontal bias in younger and older adults, and found that age differences in horizontal bias account for some, but not all, of the age difference in face identification accuracy. In summary, my work demonstrates that additive (but not multiplicative) internal noise is greater in older adults, and that they are less efficient at sampling information that is conveyed by structure at different locations and orientations in a face.DissertationDoctor of Science (PhD)Our experience of the visual environment results from perceptual processes in the brain. Many of these processes change with age, such as our ability to identify someone from a photograph of their face. Performance is influenced by both random variability, or "noise", within the observer and how efficiently we use task-relevant information in the visual environment. By systematically manipulating the amount of available stimulus information I assessed the contribution of these factors to older adults' judgements of facial identity, and characterized the information on which these decisions are based. These experiments are the first to consider how face perception in older adults is constrained by the combined effects of internal noise and the efficiency with which the visual system utilizes various sources of information. The results provide a number of directions for future research in the fields of face perception and age-related changes in complex pattern vision

Exploring Stress Mindset and Perceived Stress between College Student-Athletes and Non-Athletes

International Journal of Exercise Science 15(5): 1554-1562, 2022. One’s beliefs about the nature of stress (e.g., stress mindset) play a large role in the extent to which one experiences the detrimental or beneficial outcomes of stress. Stress mindset has been explored in college students, but there is limited research on stress mindsets in student-athletes. Sport can serve as a buffer to the negative impacts of stress for some student-athletes; however, pressures associated with sport participation increase stress in other student-athletes. Therefore, the purpose was to examine potential differences in stress mindset and perceived stress between non-athletes and college student-athletes. We hypothesized college student-athletes would report higher stress mindset scores but lower perceived stress scores. A total of 272 students (n = 87 student-athletes; n = 185 non-athletes) completed a demographic questionnaire, the Perceived Stress Scale, and the Stress Mindset Measure via an online survey. No significant differences were observed between student-athletes’ and non-athletes’ stress mindset scores; however, significant differences were observed between student-athletes’ and non-athletes’ perceived stress. Thus, student-athletes and non-athletes shared a similar view of stress, but student-athletes reported a lower level of perceived stress than non-athletes. While there appears to be no statistically significant differences in stress mindset between college non-athletes and student-athletes, both groups reported holding a stress-is-debilitating mindset. Implications for practitioners working with the college population are discussed

RNA-Seq Differentiates Tumour and Host mRNA Expression Changes Induced by Treatment of Human Tumour Xenografts with the VEGFR Tyrosine Kinase Inhibitor Cediranib.

Pre-clinical models of tumour biology often rely on propagating human tumour cells in a mouse. In order to gain insight into the alignment of these models to human disease segments or investigate the effects of different therapeutics, approaches such as PCR or array based expression profiling are often employed despite suffering from biased transcript coverage, and a requirement for specialist experimental protocols to separate tumour and host signals. Here, we describe a computational strategy to profile transcript expression in both the tumour and host compartments of pre-clinical xenograft models from the same RNA sample using RNA-Seq. Key to this strategy is a species-specific mapping approach that removes the need for manipulation of the RNA population, customised sequencing protocols, or prior knowledge of the species component ratio. The method demonstrates comparable performance to species-specific RT-qPCR and a standard microarray platform, and allowed us to quantify gene expression changes in both the tumour and host tissue following treatment with cediranib, a potent vascular endothelial growth factor receptor tyrosine kinase inhibitor, including the reduction of multiple murine transcripts associated with endothelium or vessels, and an increase in genes associated with the inflammatory response in response to cediranib. In the human compartment, we observed a robust induction of hypoxia genes and a reduction in cell cycle associated transcripts. In conclusion, the study establishes that RNA-Seq can be applied to pre-clinical models to gain deeper understanding of model characteristics and compound mechanism of action, and to identify both tumour and host biomarkers

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin