Exploring the anti-EBV potential of suberoylanilide hydroxamic acid: Induction of apoptosis in infected cells through suppressing BART gene expression and inducing lytic infection.

Epstein-Barr virus (EBV) is linked to lymphoma and epithelioma but lacks drugs specifically targeting EBV-positive tumors. BamHI A Rightward Transcript (BART) miRNAs are expressed in all EBV-positive tumors, suppressing both lytic infection and host cell apoptosis. We identified suberoylanilide hydroxamic acid (SAHA), an inhibitor of histone deacetylase enzymes, as an agent that suppresses BART promoter activity and transcription of BART miRNAs. SAHA treatment demonstrated a more pronounced inhibition of cell proliferation in EBV-positive cells compared to EBV-negative cells, affecting both p53 wild-type and mutant gastric epithelial cells. SAHA treatment enhanced lytic infection in wild-type EBV-infected cells, while also enhancing cell death in BZLF1-deficient EBV-infected cells. It reduced BART gene expression by 85% and increased the expression of proapoptotic factors targeted by BART miRNAs. These findings suggest that SAHA not only induces lytic infection but also leads to cell death by suppressing BART miRNA transcription and promoting the apoptotic program.

Adherence to COVID-19 preventive measures among residents in selected townships, Yangon Region, Myanmar: a community-based cross-sectional study.

BACKGROUND: To fight the current coronavirus disease (COVID-19) pandemic, many countries have implemented various mitigation measures to contain the spread of the disease. By engaging with health service providers, the community's participation in adherence to preventive measures is certainly required in the implementation of COVID-19 mitigation strategies. Therefore, this study aimed to assess the level of adherence to COVID-19 preventive measures and its associated factors among the residents, Yangon Region, Myanmar. METHODS: A community-based cross-sectional study was carried out among 636 residents in Yangon Region, Myanmar, from October to December 2021. A multistage non-probability sampling method, purposively selected for three townships in Yangon Region and convenience sampling for 212 participants from each township, was applied and the data were collected by face-to-face interviews using structured and pretested questionnaires. Data were entered, coded, and analyzed using IBM SPSS version 25.0. Simple and multiple logistic regression analysis were performed to identify the significant variables of adherence to COVID-19 preventive measures. RESULTS: As a level of adherence to COVID-19 preventive measures, the proportion of residents who had good adherence was 39.3% (95% CI 35.5-43.2%), moderate adherence was 37.6% (95% CI 33.8-41.5%), and poor adherence was 23.1% (95% CI 19.9-26.6%). The age group of 31-40 years (AOR: 3.13, 95% CI 1.62-6.05), 30 years and younger (AOR: 3.22, 95% CI 1.75-5.92), Burmese ethnicity (AOR: 2.52, 95% CI 1.44-4.39), own business (AOR: 3.19, 95% CI 1.15-8.87), high school education level and below (AOR: 1.64, 95% CI 1.02-2.69), less than 280.90 USD of monthly family income (AOR: 1.51, 95% CI 1.01-2.29), low knowledge about COVID-19 (AOR: 1.90, 95% CI 1.26-2.88) were significantly associated with poor adherence to COVID-19 preventive measures. CONCLUSIONS: In this study, nearly one-fourth of the residents were experiencing poor adherence to COVID-19 preventive measures. Therefore, building up the risk communication through the community using widely used mainstream media, the continuation of disease surveillance and announcement of updated information or advice for the public to increase awareness towards COVID-19, and enforcement to follow the recommended directions and regulations of health institutions are vital to consider for improving the adherence to preventive measures against COVID-19 among the residents.

Electrical transport behavior of the oxygen vacancies-rich LaAlO3/SrTiO3heterogeneous interface at high temperature.

Oxygen vacancy is one of the original mechanisms of the two-dimensional electron gas (2DEG) at the LaAlO3(LAO) and SrTiO3(STO) heterogeneous interface, and it has an important impact on the electrical properties of LAO/STO heterojunction. In this work, the LAO thin films were grown on the STO substrates by pulsed laser deposition, and the electrical transport behavior of the LAO/STO interface at high temperature and high vacuum were systematically studied. It was found that at high temperature and high vacuum, the oxygen vacancies-rich LAO/STO heterojunction would undergo a metal-insulator transition, and return to metal conductivity when the temperature is further increased. At this time, the conduction mechanism of the sample is drift mode and the thermal activation energy is 0.87 eV. While during the temperature decreasing, the conduction mechanism would transfer to hopping conduction with the thermal activation energy of 0.014 eV and the resistance would increase dramatically and present a completely insulated state. However, when the oxygen vacancies-rich sample is exposed to air, the resistance would gradually decrease and recover.

The NuroSleeve, a user-centered 3D printed hybrid orthosis for individuals with upper extremity impairment.

BACKGROUND: Active upper extremity (UE) assistive devices have the potential to restore independent functional movement in individuals with UE impairment due to neuromuscular diseases or injury-induced chronic weakness. Academically fabricated UE assistive devices are not usually optimized for activities of daily living (ADLs), whereas commercially available alternatives tend to lack flexibility in control and activation methods. Both options are typically difficult to don and doff and may be uncomfortable for extensive daily use due to their lack of personalization. To overcome these limitations, we have designed, developed, and clinically evaluated the NuroSleeve, an innovative user-centered UE hybrid orthosis. METHODS: This study introduces the design, implementation, and clinical evaluation of the NuroSleeve, a user-centered hybrid device that incorporates a lightweight, easy to don and doff 3D-printed motorized UE orthosis and a functional electrical stimulation (FES) component. Our primary goals are to develop a customized hybrid device that individuals with UE neuromuscular impairment can use to perform ADLs and to evaluate the benefits of incorporating the device into occupational therapy sessions. The trial is designed as a prospective, open-label, single-cohort feasibility study of eight-week sessions combined with at-home use of the device and implements an iterative device design process where feedback from participants and therapists informs design improvement cycles. RESULTS: All participants learned how to independently don, doff, and use the NuroSleeve in ADLs, both in clinical therapy and in their home environments. All participants showed improvements in their Canadian Occupational Performance Measure (COPM), which was the primary clinical trial outcome measure. Furthermore, participants and therapists provided valuable feedback to guide further development. CONCLUSIONS: Our results from non-clinical testing and clinical evaluation demonstrate that the NuroSleeve has met feasibility and safety goals and effectively improved independent voluntary function during ADLs. The study's encouraging preliminary findings indicate that the NuroSleeve has met its technical and clinical objectives while improving upon the limitations of the existing UE orthoses owing to its personalized and flexible approach to hardware and firmware design. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04798378, https://clinicaltrials.gov/ct2/show/NCT04798378 , date of registration: March 15, 2021.

Factors Predictive of Development of Acute Kidney Injury in Patients With COVID-19 in Brunei Darussalam.

INTRODUCTION: Acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19) patients affects their health outcomes. Incidence and outcomes varied in the literature, particularly with different population and epidemiological demographics. Data remain scarce in the Southeast Asia region. We report the incidence, outcomes, pattern, types of AKI, and factors that influence AKI patient outcomes in Brunei Darussalam. METHODS: All patients (N = 930) with COVID-19 who were admitted to the National Isolation Center (between 7th August 2021 and 30thSeptember 2021) were included in the study. The confirmation of AKI was based on the KDIGO (Kidney Disease Improving Global Outcomes) criteria. RESULTS: The mean age of the patients was 41.9 ± 14.4 years with diabetes mellitus (DM), hypertension (HT), and chronic kidney disease (CKD) accounting for 11.7%, 29.1%, and 4.8% of comorbidities, respectively. Overall, 109 (11.7%) had AKI (KDIGO Stage 1 [67.9%], 2 [13.8%], and 3 [18.3%]), while 75.2% of the cases occurred pre-admission and 26.6% were cases of acute exacerbation of CKD. Univariate analysis identified age (odd ratio [OR] 1.06), male gender (OR 1.63), local nationality (OR 8.03), DM (OR 4.44), HT (OR 5.29), vascular disease (OR 6.08), presence of gastrointestinal symptoms (OR 2.08), antibiotic (OR 3.70) and nephrotoxins exposures (OR 8.57) as significant variables. Multivariate analysis showed age (adjusted OR [AOR] 1.04), male gender (AOR 1.67), gastrointestinal symptoms (AOR 1.61), antibiotic (AOR 2.34), and nephrotoxins exposure (AOR 4.73) as significant. CONCLUSIONS: Our study showed that one in nine patients with COVID-19 developed AKI with almost a third having stages 2 and 3 AKI. Older age, male gender, presence of GI symptoms, and antibiotic and nephrotoxin exposures were significant predictors of AKI. Patients with these factors should be prioritized for admission and treatment. Even though manifestations are generally now less severe, findings from this study can guide the management of COVID-19 as the disease enters the endemic stage. Furthermore, lessons learned from the COVID-19 pandemic will provide useful information and knowledge for future viral outbreaks or pandemics.

Time-to-hepatitis C treatment initiation among people who inject drugs in Melbourne, Australia.

This study aims to understand the time-to-treatment initiation pre and post DAA access to inform strategies to improve HCV care. The data for our study were derived from the SuperMIX cohort study of people who inject drugs in Melbourne, Australia. Time-to-event analysis using Weibull accelerated failure time was performed for data collected between 2009 and 2021, among a cohort of HCV-positive participants. Among 223 participants who tested positive for active hepatitis C infection, 102 people (45.7%) reported treatment initiation, with a median time-to-treatment of 7 years. However, the median time-to-treatment reduced to 2.3 years for those tested positive after 2016. The study found that treatment with Opioid Agonist Therapy (TR 0.7, 95% CI 0.6-0.9), engagement with health or social services (TR 0.7, 95% CI 0.6-0.9), and having a first positive HCV RNA test after March 2016 (TR 0.3, 95% CI 0.2-0.3) were associated with a reduced time-to-treatment initiation. The study highlights the need for strategies to improve engagement with health services, including drug treatment services into routine HCV care to achieve timely treatment.

MC180295 Inhibited Epstein-Barr Virus-Associated Gastric Carcinoma Cell Growth by Suppressing DNA Repair and the Cell Cycle.

DNA methylation of both viral and host DNA is one of the major mechanisms involved in the development of Epstein-Barr virus-associated gastric carcinoma (EBVaGC); thus, epigenetic treatment using demethylating agents would seem to be promising. We have verified the effect of MC180295, which was discovered by screening for demethylating agents. MC180295 inhibited cell growth of the EBVaGC cell lines YCCEL1 and SNU719 in a dose-dependent manner. In a cell cycle analysis, growth arrest and apoptosis were observed in both YCCEL1 and SNU719 cells treated with MC180295. MKN28 cells infected with EBV were sensitive to MC180295 and showed more significant inhibition of cell growth compared to controls without EBV infection. Serial analysis of gene expression analysis showed the expression of genes belonging to the role of BRCA1 in DNA damage response and cell cycle control chromosomal replication to be significantly reduced after MC180295 treatment. We confirmed with quantitative PCR that the expression levels of BRCA2, FANCM, RAD51, TOP2A, and CDC45 were significantly decreased by MC180295. LMP1 and BZLF1 are EBV genes with expression that is epigenetically regulated, and MC180295 could up-regulate their expression. In conclusion, MC180295 inhibited the growth of EBVaGC cells by suppressing DNA repair and the cell cycle.

Unilateral nasal obstruction affects development of cortical orofacial motor representation in the cortical masticatory area of growing rats.

The cortical masticatory area (CMA) regulates masticatory movements. However, there is limited information regarding the effect of respiratory disturbances on the functional development of the CMA. This study aimed to examine the effect of chronic unilateral nasal obstruction (UNO) on the CMA during the growth period. Forty-eight 8-day-old male Wistar albino rats were randomized into control (CONT, n = 24) and UNO (n = 24) groups. Arterial oxygen saturation (SpO2) and the number of positive intracortical microstimulation (ICMS) sites in the anterior digastric (AD) muscle were recorded at 5, 7, and 9 weeks of age. ICMS was performed under anesthesia. The CONT group exhibited significantly higher SpO2 values than the UNO group at each age. Furthermore, the number of positive ICMS sites in the AD muscle was significantly higher in the UNO group than in the CONT group at each age. The right AD was more strongly affected by UNO than the left AD. In addition, it was found that the P-area was more strongly affected by UNO than the A-area. These findings suggest that UNO during development induces changes in the motor representation in the CMA, which may affect respiratory and orofacial functions in rats. Therefore, we suggest that the development of respiratory dysfunction needs to be monitored and corrected promptly to avoid complications in physiological function.

Myiasis in Ulcerated Breast Carcinoma: First Case Record in Myanmar.

Myiasis is an infestation of maggot, which is frequently associated with poor personal hygiene and environmental sanitation. A 78-year-old female breast cancer patient visited clinic complaining of irritation, itching, and pain within the ulcerous cancer lesion for 3 weeks. Many maggots were found in the lesion. A total of 30 maggots were removed and identified to be 3rd stage of larvae of metallic fly. This is the first case of wound myiasis in advanced breast carcinoma as a complication of untreated or drug-induced ulcer.

Nasal obstruction during the growth period modulates the Wnt/ß-catenin pathway and brain-derived neurotrophic factor production in association with tyrosine kinase receptor B mRNA reduction in mouse hippocampus.

There is accumulating evidence that nasal obstruction induces high-level brain dysfunction, including memory and learning deficits. We previously demonstrated that unilateral nasal obstruction (UNO) during the growth period increases the expression of brain-derived neurotrophic factor (BDNF). The expression of BDNF is regulated by the Wnt/ß-Catenin pathway, which is linked to neuronal differentiation, proliferation, and maintenance. However, little is known about whether Wnt3a protein expression could be an index for modulations analyses in the Wnt/ß-Catenin pathway caused by UNO during the growth period. This study aimed to investigate the effects of UNO during the growth period on the Wnt/ß-Catenin pathway in the hippocampus using combined behavioural, biochemical, and histological approaches. Male BALB/C mice were randomly divided into the control (CONT; n = 6) and experimental (UNO; n = 6) groups. Blood oxygen saturation (SpO2 ) levels were measured, and a passive avoidance test was performed in mice aged 15 weeks. Brain tissues were subjected to immunohistochemistry, real-time reverse transcription-polymerase chain reaction, and western blot analysis. Compared with control mice, UNO mice had lower SpO2 levels and exhibited memory/learning impairments during behavioural testing. Moreover, Wnt3a protein, BDNF mRNA, and tyrosine kinase receptor B (TrkB) mRNA expression levels were significantly lower in the hippocampus in the UNO group than in the CONT group. Our findings suggested that UNO during the growth period appeared to modulate the hippocampal Wnt/ß-catenin pathway and BDNF production in association with TrkB mRNA reduction, thereby resulting in memory and learning impairments.

Genomic Tracking of SARS-CoV-2 Variants in Myanmar.

In December 2019, the COVID-19 disease started in Wuhan, China. The WHO declared a pandemic on 12 March 2020, and the disease started in Myanmar on 23 March 2020. In December 2020, different variants were brought worldwide, threatening global health. To counter those threats, Myanmar started the COVID-19 variant surveillance program in late 2020. Whole genome sequencing was done six times between January 2021 and March 2022. Among them, 83 samples with a PCR threshold cycle of less than 25 were chosen. Then, we used MiSeq FGx for sequencing and Illumina DRAGEN COVIDSeq pipeline, command line interface, GISAID, and MEGA version 7 for data analysis. In January 2021, no variant was detected. The second run, during the rise of cases in June 2021, showed Alpha, Delta, and Kappa variants. The third and the fourth runs in August and December showed only a Delta variant. Omicron and Delta variants were detected during the fifth run in January 2022. The sixth run in March 2022 showed only Omicron BA.2. Amino acid mutation at the receptor binding domain of Spike glycoprotein started since the second run coupling with high transmission, recurrence, and vaccine escape. We also found the mutation at the primer targets used in current RT-PCR platforms, but there was no mutation at the existing antiviral drug targets. The occurrence of multiple variants and mutations claimed vigilance at ports of entry and preparedness for effective control measures. Genomic surveillance with the observation of evolutionary data is required to predict imminent threats of the current disease and diagnose emerging infectious diseases.

Myiasis in Ulcerated Breast Carcinoma: First Case Record in Myanmar

Myiasis is an infestation of maggot, which is frequently associated with poor personal hygiene and environmental sanitation. A 78-year-old female breast cancer patient visited clinic complaining of irritation, itching, and pain within the ulcerous cancer lesion for 3 weeks. Many maggots were found in the lesion. A total of 30 maggots were removed and identified to be 3rd stage of larvae of metallic fly. This is the first case of wound myiasis in advanced breast carcinoma as a complication of untreated or drug-induced ulcer.

Learning Generalized Representations of EEG between Multiple Cognitive Attention Tasks.

Attention can be measured by different types of cognitive tasks, such as Stroop, Eriksen Flanker, and Psychomotor Vigilance Task (PVT). Despite the differing content of the three cognitive tasks, they all require the use of visual attention. To learn the generalized representations from the electroencephalogram (EEG) of different cognitive attention tasks, extensive intra and inter-task attention classification experiments were conducted on three types of attention task data using SVM, EEGNet, and TSception. With cross-validation in intra-task experiments, TSception has significantly higher classification accuracies than other methods, achieving 82.48%, 88.22%, and 87.31% for Stroop, Flanker, and PVT tests respectively. For inter-task experiments, deep learning methods showed superior performance over SVM with most of the accuracy drops not being significant. Our experiments indicate that there is common knowledge that exists across cognitive attention tasks, and deep learning methods can learn generalized representations better.

Farmer social networks: The role of advice ties and organizational leadership in agroforestry adoption.

With the decline in public budgets for agricultural extension support, ties between members of farmer groups are becoming more important to facilitate information transfer about agroforestry. This paper examines the role of social network ties in predicting organizational leadership in an agroforestry-based farmer group. Using social network data derived from interviews with members of farming groups based in the Ayeyarwady Delta of Myanmar, we established a positive relationship between advice-seeking ties and organizational leadership. In other words, farmers who were highly sought for agroforestry advice were more likely to be elected as leaders of the farmer group. Results show the frequency of interactions through advice-seeking ties also had a positive influence on the probability of farmers holding leadership positions. We found a core-periphery structure for the advice networks, whereby farmer leaders were overrepresented at the network core. Interestingly, general members of the farmer group were also in the core of the core-periphery structure, suggesting that engaging with farmers without leadership roles can also effectively disseminate agroforestry information to peripheral farmers. We conclude that farmer groups are valuable in agroforestry adoption and persistence and further analyses of formal leadership structures are needed to support more transparent and accountable governance.

Hepatitis C elimination in Myanmar: Modelling the impact, cost, cost-effectiveness and economic benefits.

BACKGROUND: Myanmar has set national hepatitis C (HCV) targets to achieve 50% of people diagnosed and 50% treated by 2030. The WHO has additional targets of reducing incidence by 80% and mortality by 65% by 2030. We aimed to estimate the impact, cost, cost-effectiveness and net economic benefit of achieving these targets. METHODS: Mathematical models of HCV transmission, disease progression and the care cascade were calibrated to 15 administrative regions of Myanmar. Cost data were collected from a community testing and treatment program in Yangon. Three scenarios were projected for 2020-2030: (1) baseline (current levels of testing/treatment); and testing/treatment scaled up sufficiently to reach (2) the national strategy targets; and (3) the WHO targets. FINDINGS: Without treatment scale-up, 333,000 new HCV infections and 97,000 HCV-related deaths were estimated to occur in Myanmar 2020-2030, with HCV costing a total $100 million in direct costs (testing, treatment, disease management) and $10.4 billion in lost productivity. In the model, treating 55,000 people each year was sufficient to reach the national strategy targets and prevented a cumulative 40,000 new infections (12%) and 25,000 HCV-related deaths (25%) 2020-2030. This was estimated to cost a total $189 million in direct costs ($243 per DALY averted compared to no treatment scale-up), but only $9.8 billion in lost productivity, making it cost-saving from a societal perspective by 2024 with an estimated net economic benefit of $553 million by 2030. Reaching the WHO targets required further treatment scale-up and additional direct costs but resulted in greater longer-term benefits. INTERPRETATION: Current levels of HCV testing and treatment in Myanmar are insufficient to reach the national strategy targets. Scaling up HCV testing and treatment in Myanmar to reach the national strategy targets is estimated to generate significant health and economic benefits. FUNDING: Gilead Sciences.

Effects of low occlusal loading on the neuromuscular behavioral development of cortically-elicited jaw movements in growing rats.

The effect of altered occlusal force on masticatory-related neuromuscular control, which projects from the anterior part of the cortical masticatory area (A-CMA), during growth remains unclear. This study sought to evaluate the effect of occlusal hypofunction on neuromuscular development of jaw muscle activities and cortically-induced rhythmic jaw movements (RJMs) in growing rats. Sixty-four 2-week-old male albino Wistar rats were divided into the control (fed normal diet) and experimental (fed soft diet) groups soon after weaning. Electromyographic activity was recorded at 5, 7, 9, and 11 weeks from the right masseter and anterior digastric along with RJMs. We found a significantly longer onset latency and smaller peak-to-peak amplitude in the experimental group than that in the control group. The RJMs showed an increase in gape size and lateral excursion until up to 9 weeks in both groups. However, both the average gape size and lateral excursion were significantly smaller in the experimental group than that in the control group after 9 weeks. The jaw movement pattern also showed a significant decrease at the maximum opening period in the experimental group. Our findings indicate that inadequate occlusal function during growth alters neuromuscular control of masticatory behaviors and impairs the pattern of RJMs.

Functional Analysis of Rhythmic Jaw Movements Evoked by Electrical Stimulation of the Cortical Masticatory Area During Low Occlusal Loading in Growing Rats.

The maturation of rhythmic jaw movements (RJMs) and related neuromuscular control has rarely been studied in animals, though this process is essential for regulating the development of stomatognathic functions. Previous studies have shown that occlusal hypofunction during growth alters masticatory performance. However, little is known about patterns of cortically-induced RJMs under conditions of soft-diet feeding during development. The aim of this study is to clarify the effect of low occlusal loading on the pattern of cortically induced RJMs and related neuromuscular responses in growing rats. Sixty-four 2-week-old male albino Wistar rats were randomly divided into two groups and fed on either a normal diet (control) or soft diet (experimental) soon after weaning. At 5, 7, 9, and 11 weeks of age, electromyographic (EMG) activity was recorded from the right masseter and anterior digastric muscles along with corresponding kinematic images in RJMs during repetitive intracortical microstimulation of the left cortical masticatory area (CMA). Rats in both groups showed an increase in gape size and lateral excursion until 9 weeks of age. The vertical jaw movement speed in both groups showed no significant difference between 5 and 7 weeks of age but increased with age from 9 to 11 weeks. Compared to the control group, the average gape size and vertical speed were significantly lower in the experimental group, and the pattern and rhythm of the jaw movement cycle were similar between both groups at each recording age. EMG recordings showed no age-related significant differences in onset latency, duration, and peak-to-peak amplitude. Moreover, we found significantly longer onset latency, smaller peak-to-peak amplitude, and greater drop-off mean and median frequencies in the experimental group than in the control group, while there was no significant difference in the duration between groups. These findings indicate that a lack of enough occlusal function in infancy impedes the development of patterns of RJMs and delays the neuromuscular response from specific stimulation of the CMA.

The forecasting of dynamical Ross River virus outbreaks: Victoria, Australia.

Ross River virus (RRV) is Australia's most epidemiologically important mosquito-borne disease. During RRV epidemics in the State of Victoria (such as 2010/11 and 2016/17) notifications can account for up to 30% of national RRV notifications. However, little is known about factors which can forecast RRV transmission in Victoria. We aimed to understand factors associated with RRV transmission in epidemiologically important regions of Victoria and establish an early warning forecast system. We developed negative binomial regression models to forecast human RRV notifications across 11 Local Government Areas (LGAs) using climatic, environmental, and oceanographic variables. Data were collected from July 2008 to June 2018. Data from July 2008 to June 2012 were used as a training data set, while July 2012 to June 2018 were used as a testing data set. Evapotranspiration and precipitation were found to be common factors for forecasting RRV notifications across sites. Several site-specific factors were also important in forecasting RRV notifications which varied between LGA. From the 11 LGAs examined, nine experienced an outbreak in 2011/12 of which the models for these sites were a good fit. All 11 LGAs experienced an outbreak in 2016/17, however only six LGAs could predict the outbreak using the same model. We document similarities and differences in factors useful for forecasting RRV notifications across Victoria and demonstrate that readily available and inexpensive climate and environmental data can be used to predict epidemic periods in some areas. Furthermore, we highlight in certain regions the complexity of RRV transmission where additional epidemiological information is needed to accurately predict RRV activity. Our findings have been applied to produce a Ross River virus Outbreak Surveillance System (ROSS) to aid in public health decision making in Victoria.