The age‐specific prevalence of human papillomavirus and risk of cytologic abnormalities in rural Nigeria: Implications for screen‐and‐treat strategies

Cervical screening for carcinogenic human papillomavirus (HPV) infection is being considered for low‐income countries. Effectiveness requires targeted screening in older women in whom prevalent infections are more likely to be persistent and predictive of precancer. Some studies in West Africa have found unusually high HPV prevalences across all adult ages, which may reduce the positive predictive value (PPV) of HPV‐based screening, if positivity in older women does not sufficiently predict elevated risk. We conducted a population‐based study in rural Nigeria to identify HPV prevalence and associated cervical abnormalities. Using stratified random sampling, we enrolled women age 15+. Nonvirgins had a cervical exam including liquid‐based cytology and PCR HPV DNA testing from residual cytology specimens. Two‐thirds of invited women participated, and 14.7% had detectable carcinogenic HPV, a proportion that did not decline with age ( p ‐trend = 0.36) and showed slight peaks in the 15–29 and 60–69 age groups. Among women of the age typically considered for screen‐and‐treat programs (30–49 years), 12.8% were HPV positive, and the PPV for high‐grade or worse cytology was 16.4%. Comparatively, women age < 30 were more likely to be HPV positive (18.9%, p = 0.03) with a lower PPV (4.2% p = 0.05). Among women age 50+ (typically excluded from screening in resource‐poor settings because inexpensive treatment is not available), HPV positivity was 14.2% with a PPV of 13.9%. In Irun and similar settings where HPV does not decline with age, HPV‐based screen‐and‐treat programs might be feasible for mid‐adult women because prevalence is sufficiently low and positivity predicts elevated risk of more easily treated precancer.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90127/1/26211_ftp.pd

Sistem Otomatis Pendeteksi Wajah Bermasker Menggunakan Deep Learning

COVID-19 merupakan virus yang telah dinyatakan sebagai pandemi oleh WHO, dan di indonesia sendiri menetapkan COVID-19 sebagai bencana nasional melalui Keputusan Presiden Nomor 12 Tahun 2020. Sumber utama transmisi dari virus ini berasal dari percikan pernapasan atau droplet yang salah satu pencegahan penyebarannya adalah dengan penggunaan masker. Saat ini, pemerintah sedang memberlakukan new normal. Walaupun beraktivitas di lingkungan luar, protokol kesehatan wajib diikuti dan seluruh masyarakat harus disiplin dalam menjalaninya. Pada studi ini dirancang sebuah sistem otomatis pendeteksi wajah bermasker menggunakan deep learning dalam menjalankan fungsinya. Sistem yang dirancang menggabungkan model deep learning, detektor wajah, dan program tracking dan counting menjadi sebuah sebuah sistem otomatis yang dibantu oleh Graphic User Interface (GUI) serta sebuah perangkat alarm dan platform Internet of Things dalam pemakaiannya. Berdasarkan hasil pengujian yang dilakukan mengikuti batasan masalah yang telah dirumuskan, model memiliki tingkat akurasi klasifikasi pada dataset test sebesar 99%. Implementasi pada Raspberry Pi 4 menunjukkan sistem berbasis model deep learning yang telah dibuat sukses melakukan deteksi, tracking dan counting yang datanya dikirimkan kepada alarm yang dirancang dan sebuah platform IoT, Ubidots. Performa deteksi maksimal dicapai saat objek deteksi bergerak 0,7 m/s, pencahayaan ≥ 100 lux, dan penggunaan modul TensorFlow Lite pada sistem dengan akurasi sebesar 85,7%. Hasil perbandingan dengan metode deteksi lain menunjukkan karakterisasi model deep learning memiliki akurasi deteksi sebesar 82%, lebih tinggi dari metode Haar Classifier dengan akurasi 53

Tumor Cells and Tumor-Associated Macrophages: Secreted Proteins as Potential Targets for Therapy

Inflammatory pathways, meant to defend the organism against infection and injury, as a byproduct, can promote an environment which favors tumor growth and metastasis. Tumor-associated macrophages (TAMs), which constitute a significant part of the tumor-infiltrating immune cells, have been linked to the growth, angiogenesis, and metastasis of a variety of cancers, most likely through polarization of TAMs to the M2 (alternative) phenotype. The interaction between tumor cells and macrophages provides opportunities for therapy. This paper will discuss secreted proteins as targets for intervention

DNA methylation as a triage tool for cervical cancer screening - A meeting report.

INTRODUCTION: DNA methylation is proposed as a novel biomarker able to monitor molecular events in human papillomavirus (HPV) infection pathophysiology, enabling the distinction between HPV-induced lesions with regression potential from those that may progress to HPV-related cancer. METHODS: This meeting report summarises the presentations and expert discussions during the HPV Prevention and Control Board-focused topic technical meeting on DNA methylation validation in clinician-collected and self-collected samples, novel DNA methylation markers discovery, implementation in cervical cancer screening programs, and their potential in women living with human immunodeficiency virus (HIV). RESULTS: Data presented in the meeting showed that HPV-positive, baseline methylation-negative women have a lower cumulative cervical cancer incidence than baseline cytology-negative women, making DNA methylation an attractive triage strategy. However, additional standardised data in different settings (low- versus high-income settings), samples (clinician-collected and self-collected), study designs (prospective, modelling, impact) and populations (immunocompetent women, women living with HIV) are needed. CONCLUSION: Establishing international validation guidelines were identified as the way forward towards accurate validation and subsequent implementation in current screening programs

Detection of HPV and the role of p16INK4A overexpression as a surrogate marker for the presence of functional HPV oncoprotein E7 in colorectal cancer

<p>Abstract</p> <p>Background</p> <p>Based on the well-recognized etiological role of human papillomavirus (HPV) in cervical, anogenital and oropharyngeal carcinogenesis, a potential role of HPV in colorectal carcinogenesis has been suggested. For that reason, the aim of the present study was to investigate the presence of HPV DNA in colorectal carcinomas (CRC) and to study overexpression of p16^INK4Aas a marker for the presence of an active HPV oncoprotein E7. These findings were correlated with clinical and pathological prognostic factors of CRC.</p> <p>Methods</p> <p>The presence of HPV was assessed using a multiplex PCR system of 10 non-biotinylated primers. The amplified fragments of HPV positive samples were further analyzed by a highly sensitive, broad spectrum SPF10 PCR and subsequently genotyped using reverse hybridization in a line probe assay.</p> <p>P16^INK4Aprotein expression was investigated in a subset of 90 (30 HPV positive and 60 HPV negative) CRC samples by immunohistochemistry.</p> <p>Results</p> <p>HPV DNA was found in 14.2% of the CRC samples with HPV16 as the most prevalent type. No significant differences in clinical and pathological variables were found between HPV positive and negative CRCs, except for age. HPV positive patients were significantly younger (p = 0.05). There was no significant correlation between the presence of HPV and overexpression of p16^INK4A(p = 0.325).</p> <p>Conclusions</p> <p>In conclusion, the presence of oncogenic HPV DNA in a small cohort of CRC samples may suggest that HPV may be involved in the carcinogenesis of some CRC. However, contrary to what has been observed in head and neck squamous cell cancer and cancer of the uterine cervix, p16^INK4Adoes not seem to be a surrogate marker for an active HPV infection in CRC. Therefore, further functional analyses are necessary to elucidate the role of HPV in CRC.</p

Prevention and control of HPV infection and HPV-related cancers in Colombia- a meeting report.

The Human Papillomavirus (HPV) Prevention and Control Board is an independent multidisciplinary board of international experts that disseminates relevant information on HPV to a broad array of stakeholders and provides guidance on strategic, technical and policy issues in the implementation of HPV control programs. In response to drastic drop of vaccine coverage following the adverse event crisis in Carmen del Bolivar, Colombia, the HPV Prevention and Control Board in collaboration with the Colombian National Cancer Institute and Colombian League Against Cancer convened a meeting in Bogota, Columbia (November 2018). The goal of the meeting was to bring together national and international group of experts to report the disease burden, epidemiology and surveillance of HPV and HPV-related cancers, to discuss the successes and especially the challenges of HPV vaccination and screening in Colombia, as well as the lessons learnt from neighbouring countries. The meeting provided a platform to confer various stakeholder's perspectives, including the role of the Colombian healthcare system and to catalyse various parts of the public health community in Colombia into effective action. The conclusion of the meeting included following suggestions to strengthen HPV prevention and control: 1) Re-introducing school-based vaccine programs, 2) Integrating primary and secondary prevention programs, 3) Developing an innovative crisis communication plan targeting healthcare workers, teachers and general population, 4) Building trust through efficient and timely communication, 5) Building strong relationship with media to ensure a stable vaccination campaign support, and 6) Promoting empathy among healthcare professionals towards patients to build trust and communicate effectively

Overcoming barriers in HPV vaccination and screening programs

The Human Papillomavirus Prevention and Control Board brought together experts to discuss optimizing HPV vaccination and screening programs. Board members reviewed the safety profile of licensed HPV vaccines based on clinical and post-marketing data, reaching a consensus that current safety data is reassuring. Successful vaccination programs used well-coordinated communication campaigns, integrating (social) media to spread awareness. Communication of evidence supporting vaccine effectiveness had beneficial effects on the perception of the vaccine. However, anti-vaccination campaigns have threatened existing programs in many countries. Measurement and monitoring of HPV vaccine confidence over time could help understand the nature and scale of waning confidence, define issues and intervene appropriately using context-specific evidence-based strategies. Finally, a broad group of stakeholders, such as teachers, health care providers and the media should also be provided with accurate information and training to help support prevention efforts through enhanced understanding of the risks and benefits of vaccination. Similarly, while cervical cancer screening through population-based programs is highly effective, barriers to screening exist: awareness in countries with population-based screening programs, access for vulnerable populations, and access and affordability in low-and middle-income countries. Integration of primary and secondary prevention has the potential to accelerate the decrease in cervical cancer incidence