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Quality of home spirometry performance amongst adults with cystic fibrosis
No full textSpirometry is usually performed under the supervision of a trained respiratory scientist to ensure acceptability and repeatability of results. To evaluate the quality of spirometry performance by adult cystic fibrosis (CF) patients with and without observation by a trained respiratory scientist, an observational, single centre study was conducted between February to December 2020. 74 adults were recruited and instructed to perform spirometry without supervision within 24 hours of their remote CF clinic consultation. Spirometry was repeated at their consultation, supervised by a respiratory scientist using video conferencing. The majority of patients achieved grade A (excellent) or B (very good) spirometry quality with (95%) and without supervision (93%) independent of lung function severity. Similarly, forced expiratory volume in 1 second demonstrated no significant differences with paired spirometry performed within a 24-hour period. For a large proportion of adult CF patients, unsupervised portable spirometry produces acceptable and repeatable results
Targeting regulators of lipogenesis in drug-tolerant persister cells
No full textGlioblastoma is a fatal brain tumour, with a median survival of less than 15 months. There has been no change to the standard-of-care since 2005.
CMPD1 is a small-molecule microtubule-targeting agent with a cytotoxic effect on glioblastoma cells. However, a subpopulation of cells can survive CMPD1 exposure, termed drug-tolerant persister cells (DTPs). Upon treatment withdrawal, DTPs regain the same chemosensitivity as treatment-naïve cells, using reversible and transient mechanisms to withstand therapy.
We questioned whether activation of LXR, a nuclear receptor regulating cholesterol homeostasis and lipid metabolism, could reduce the number of surviving persister cells. We found that CMPD1 and LXR agonist combination therapy decrease persister cell survival, potentially through lipogenesis.
A lipidomic screen of CMPD1-tolerant cells revealed that CMPD1 induces lipidomic reprogramming. DTPs exhibit low SCD1 expression, an enzyme desaturating saturated fatty acids into monounsaturated fatty acids. Investigation into lipid-associated behaviours in DTPs revealed increased lipid saturation, heightened membrane rigidity and activation of the unfolded protein response - a possible consequence of low SCD1 expression.
Hence, we overexpressed SCD1 in glioblastoma stem cells at two different levels, demonstrating that various levels of SCD1 overexpression can either reduce or increase the number of surviving CMPD1-tolerant persisters compared to CMPD1-treated cells with endogenous SCD1 expression. Investigation in naïve cells showed different levels of SCD1 overexpression regulate behaviours including membrane fluidity, proliferation and triglyceride levels.
However, targeting LXR and SCD1 did not eliminate all persister cells, prompting us to investigate whether persister cell survival is influenced by cellular heterogeneity. We found that naïve RKI1-derived clones exhibit differential sensitivity to CMPD1, which were associated with transcriptomic differences
Windows of change as precursors to changing travel behaviour aligned with sustainable mobility
No full textThere is increasingly a greater focus on ways in which we can achieve behavioural change associated with improved
sustainability outcomes in the transport sector. In societies where the car is the dominant passenger transport mode with
all of its associated interpretations of convenience, we continue to search for ways to change travel habits that result in a switch
out of the car in favour of public transport and active modes. The focus of this paper is on identifying windows of change
(WoC) that have subsequently had an influence on the travel mobility preferences of individuals, hopefully in ways that
support sustainability outcomes. We categorise the WoCs into four broad areas: lifestyle and household changes (e.g.,
changes in living arrangements, family structure, or personal habits), work and commuting-related changes (e.g., changes in
employment, workplace incentives or commuting patterns), transport and mobility changes (e.g., changes in vehicle
ownership, public transport use or travel habits), and social and environmental considerations (including awareness and
influence of others). A series of negative binomial count models are estimated to identify the relationship between the
WoCs and modal one-way trip frequency in a typical week, after controlling for various socioeconomic effects and country
dummy variables. Data is collected from over 4,000 respondents spread across Australia, Finland, New Zealand, the
United States, the United Kingdom, Singapore, and Sweden, investigating respondents’ WoC over the period 2023–2025
and their most recent weekly travel patterns. The findings provide a rich array of policy advice on what key WoC
influences suggest actionable ways to support the switch to more sustainable modes, and what remain as clear barriers to
achieving such an outcome
POLITICISING DISABILITY: Women with Intellectual Disabilities Negotiating the National Disability Insurance Scheme
No full textThis thesis draws on intersectionality and embodiment to present a feminist inquiry into the experience of women with intellectual disabilities in the NDIS. The thesis and project centre on the question: What are the experiences of women with intellectual disabilities in the NDIS? I locate concepts of disability – be this historical, social, or cultural - in the views of those with jurisdiction over the Scheme, such as legislators, advocates and the women themselves.
My project entails deconstructing experience by adopting intersectionality and embodiment. Intersectionality is understood here as a theoretical perspective that looks at power relations to centre the perspectives of those ‘marginalised’. Embodiment describes the relationships between systems and those that use them, centring on the body to move away from the mind. My enquiry, then, is strongly influenced by the approach of feminists, but I counter their indifference to intellectual disabilities by considering insights from feminist disability scholars.
The primary method of investigation has been through mixed methods that contrast the voices of people with intellectual disability with more abstract representations of these groups in policy, reports and NDIS plans. The findings reveal that legislators saw gender in narrow terms, failing to understand interconnections to broader structural barriers. Advocacy groups focus on bodily autonomy and the state's role in regulating gender. In contrast, the NDIS plans and the photovoice highlight that women and men were concerned with community, discrimination, socialising and planning issues. Themes within these narratives spoke to complex problems of identity, power, subjugation and exclusion. The findings propose that disability support systems must address gender with other aspects of identity. Disability and gender are constantly in dialogue, and I have suggested the requirement to conceptualising disability in the NDIS in alternative ways
Oral Health Research Connect - July 2025 - Guest Speaker: Dr Padma Gadiyar & Dr Shalinie King
No full textAI-Driven Innovation in Oral Health: Advancing Early Assessment, Access, and Triage Pathways - Dr Padma Gadiyar
Dr Gadiyar will introduce Smilo.ai - an AI-powered digital health platform designed to transform dental care through virtual checkups, smile simulations, remote monitoring, and a 24/7 AI voice receptionist. She will walk through the core product features, the communities Smilo.ai serves, and the impact it has made so far. Dr Gadiyar will also share the team's goals for the future and explore opportunities for collaboration with the University of Sydney -particularly in clinical validation and co-developing innovative solutions to improve patient care, reduce waiting times, and enhance the efficiency of the oral healthcare system.
Oral Health Research at WARC - Dr Shalinie King
The Westmead Applied Research Centre (WARC) was established by the University of Sydney in collaboration with the Western Sydney Local Health District to create and apply innovation to addressing chronic health conditions.
WARC brings together multidisciplinary experts to co-design, evaluate and translate innovative solutions into healthcare and prevention. It partners with industry, government, not-for-profit organisations. As programme lead for oral health research at WARC Dr King will provide an overview of the oral health related research activity at WARC and discuss opportunities for engagement and collaboration with the Dental School
Acculturation and Distress in Second-Generation Chinese-Australians
No full textAustralia’s evolving multicultural landscape has seen a significant increase in its Chinese-Australian population. This thesis examines the complex relationship between acculturation, identity development, and psychological distress in second-generation Chinese- Australians. The introductory section of the thesis establishes the research context by highlighting the significant, yet underexplored psychological challenges faced by second- generation Chinese-Australians. Chapter 2 provides a comprehensive literature review on the acculturation experiences of Chinese-Australians, with a particular focus on second-generation individuals. Chapter 3 presents a meta-synthesis of qualitative research exploring the identity negotiation of diasporic Chinese across Western multicultural societies. Chapter 4 critically examines the model minority myth and its psychological, social, and structural consequences. Chapter 5 employs narrative inquiry to explore the lived experiences of second-generation Chinese-Australians as they navigate acculturation, identity development, and psychological well-being. Chapter 6 examines the role of culturally responsive mental health practices in supporting second-generation Chinese-Australians, focusing on the challenges and strategies mental health professionals encounter when working with this population. The conclusion synthesises the key findings of the thesis, emphasising the complex interplay between acculturation, identity negotiation, mental health, and societal expectations in shaping the experiences of second-generation Chinese-Australians. This thesis contributes to the broader discourse on multiculturalism, mental health, and acculturation, reinforcing the importance of actionable insights and inclusive societal structures that foster the well-being and sense of belonging of second-generation Chinese-Australians
Evaluation of sentinel node biopsy in accurately staging oral cavity squamous cell carcinoma
No full textEarly oral cancer (EOC) is defined as patient diagnosed with a T1 or T2 primary and a clinically N0 neck – according to AJCC – TNM staging these are cancers <4 cm in maximum dimension and <10 mm in maximum depth of invasion (DOI) and both clinically/radiologically absent of neck nodal metastases.
Traditional treatment is surgery with appropriate resection of the primary and simultaneous excision of upper cervical neck nodes. However, following neck dissection microscopic metastases are present in only 15-20% of T1 and 25-35% of T2 cancers, respectively. Consequently, up to 80% of patients with a T1 cancer and 65% of T2 cancer undergo surgery to the neck with no oncological or survival benefit yet have been exposed to the risks and complications of a neck dissection.
Sentinel lymph node biopsy (SLNB) is a novel technique, which can overcome the disadvantages of unnecessary neck surgery. In this procedure a radioactive dye is injected around the primary tumour and single photon emission CT images are obtained to locate the SLN. The SLN is the “first node to drain the region of interest” with tumour spread to this SLN prior to spread to any other nodes of the basin – a concept well established in other solid organ cancers such as breast and melanoma. Handheld gamma probe is used to locate SLN during the surgery and typically one or two nodes are excised, if these prove to be negative the patient has been saved an unnecessary neck dissection. In the setting of a positive SLNB the patient proceeds to a neck dissection as a second surgical procedure. SLNB thus de-escalates treatment related morbidity while not compromising on oncological outcomes
Investigation of host-microbiota communication through diverse signalling pathways
No full textThe gut microbiota plays a fundamental role in shaping host physiology, influencing
immune homeostasis, metabolism, and overall health. Disruptions in gut homeostasis, driven by altered dietary patterns and antibiotic exposure, are strongly linked to the rising incidence of non-communicable diseases (NCDs) through microbiota-mediated mechanisms. However, identifying precise signalling pathways and their contributions to disease remains challenging, partly due to the vast diversity of microbiota-derived molecules that can influence host processes. While microbial metabolites and microbe-associated molecular patterns (MAMPs) are well-established mediators of the gut-host axis, emerging evidence suggests that gut microbiota extracellular vesicles (MEVs) represent an additional pathway that integrates metabolite and MAMP signalling.
Although specific MEV strains and total MEV profiles are increasingly studied as potential therapeutics and biomarkers, their physiological role in gut-host interactions remains poorly understood. This thesis explores how gut microbiota and MEVs influence key aspects of host physiology, focusing on their roles in immunity, metabolism, and maternal-fetal interactions.
Collectively, this thesis explores the relationship between microbiota and host physiology, examining how antibiotics and diet influence this interplay and identifying
MEVs as key mediators in this cross-talk. While further studies are needed to elucidate the precise molecular mechanisms by which MEVs regulate host biology, these findings highlight their potential as both a therapeutic target and a novel intervention to modulate microbiota-driven pathways in NCD development
Indocyanine green in breast cancer and reconstruction surgery
No full textFluorescence-guided surgery using indocyanine green (ICG) is an emerging technique in breast cancer and reconstruction surgery, offering real-time insights into tissue perfusion and lymphatic mapping. This dissertation investigates its application in mastectomy with reconstruction and sentinel lymph node (SLN) biopsy.
Skin-sparing and nipple-sparing mastectomy followed by reconstruction aim to treat cancer while preserving cosmesis. However, mastectomy skin flap necrosis (MSFN), with rates up to 24%, remains a significant complication. Traditional intraoperative assessment of skin perfusion is subjective. Retrospective studies using ICG angiography demonstrated reduced flap necrosis rates and improved outcomes over time. A standardised protocol for ICG use was developed, and cost-effectiveness analysis confirmed its value in reducing ischaemic complications. A machine learning algorithm was also created to quantify ICG angiography and predict complications, addressing the lack of standardised interpretation methods.
SLN biopsy is essential for staging early breast cancer. Conventional tracers (blue dye and technetium-99m) are effective but have drawbacks including allergic reactions, radiation exposure, and infrastructure demands. ICG fluorescence offers a safer alternative. Two large prospective trials compared ICG to traditional methods, showing equivalency in SLN identification and metastatic node detection, with ICG proving less costly long-term. These findings support ICG as a viable alternative or supplement to existing techniques.
This research fills gaps in current literature and supports broader adoption of ICG fluorescence in breast cancer surgery. Continued validation may lead to improved surgical precision, reduced complications, and enhanced patient outcomes
On the Molecular Dissection of Venom: Action and Antidotes
No full textVenom is a specialised weapon, a secretion that is actively delivered into anotherorganism, generally for predation or defence. It is a remarkable example of convergentevolution having appeared independently across many bacteria, plant, fungi, and animallineages. Interaction with venomous organisms affect millions of people annually resultingin significant morbidity, mortality, and associated economic burden. The advent of -omicstechnologies has allowed for great advances in the venom field. This includes whole-genome CRISPR screening approaches to look at how venoms act from the hostperspective. Using this technology, we surveyed a wide variety of snakes and otherorganisms and uncovered genes and pathways that are newly implicated in venom action.We also discovered that venom from Spitting Cobras (Naja pallida and Naja nigricollis),the Australian bluebottle jellyfish (Physalia utriculus), and the Atlantic Sea Nettle jellyfish(Chrysaora quinquecirrha) all require the heparan/heparin proteoglycan biosynthesispathway to cause cell death. These findings were confirmed genetically andpharmacologically and the results used to predict new drugs that could act as venomantidotes. The heparinoid drug class was observed to have broad anti venom activity andcould have translational promise for preventing the dermonecrosis seen in cobra bites andthe pain associated with jellyfish envenoming. We reason that as venoms need to hijackthe physiological pathways of host cells, diverse venoms utilise overlapping strategies togain cell entry or cause damage. By providing fundamental new insight into venom actionand helping us develop broad spectrum antidotes for medically relevant and painfulvenoms, the incorporation of functional genomics and CRISPR screens is an importantaddition to the “venomics” arsenal