Understanding HPV and cervical screening

Cervical cancer is preventable and curable. Sarah Butler and Yvonne Wilkinson explain how the cervical screening programme has changed from a cytology based test to HPV primary screening Screening for human papillomavirus is now the primary test for cervical screening in England, Wales and Scotland. Cervical screening for those individuals with a cervix routinely occurs every 3 years for those aged 25–49 (24½ in England) and every 5 years for those aged 50–64. Over 99.7% of cervical cancers are caused by human papillomavirus. Cervical cancer is preventable and curable; primary HPV screening can detect early changes in cervical cells allowing for effective monitoring and treatment.

Testing the Impact of the Waste Product from Biogas Plants on Plant Germination and Initial Root Growth

During biogas production, anaerobic digestion of plant material rich in nutrients results in the so-called whole digestate. The application of nutrient-rich material present in digestate could have fertilising effects, especially in intensively used agricultural soils, andin crop yields that can affect the nutrient cycle. The aim of this article is to inform about possibilities of using mixture of digestate andhaylage (use the fertilizing effect of both matters), and at the same time contribute to the improvement of agrochemical properties ofsoil. This study evaluates the effect of applying the mixture of digestate and haylage on germination and early stages of plant development. This article deals with primary test mixtures of digestate and haylage at ratios 10:1, 5:1 and 3:1 and compares the results withwhole digestate applications. Simplified statistically calculated quantities showed that all examined mixtures better fertilizing effect incomparison with the control growing media. Based on the chemical analysis of the growing medias, a growing media with mixtures ofdigestate and haylage characterizing as growing medias with a high content of nutrients and a low amount of hazardous metal wasinvestigated. The examined growing media thus met the limits for organic and commercial fertilizers. Fertilizing effects of growingmedia with mixture of digestate an haylage can also be noted on increasing the proportion of macronutrients in the soil, reducingfertilization only throughout whole digestate.

Lung clearance index: a new measure of ventilation inhomogeneity in childhood respiratory diseases

: Conventional spirometry has long been considered the primary test for assessing respiratory function deficits in children and adults. However, the need to perform forced breathing maneuvers can make it challenging to perform these examinations in an uncooperative child. For these reasons, techniques such as gas dilutions and the multiple-breath-washout (MBW) method have been implemented because they allow for early assessment of damage to the small airways. These methods permit the determination of the possible presence of ventilatory inhomogeneity in the lungs by analyzing the clearance of an inert gas used as a tracer. The equipment consists of a mass spectrometer combined with a flow meter. The Lung Clearance Index (LCI) is most often used to evaluate ventilatory inhomogeneity. This narrative review aimed to review the literature on technical and practical aspects of the MBW test and evaluate the clinical implications of the LCI in pediatric respiratory disease.

Moodle as e-learning system for esp class

The aim of the paper is to examine the correlation of the knowledge gained by students in online and offline classes, consequently, the overall performance of e-learning, as well as the effectiveness of the certain language skills among the main four (listening, speaking, reading, writing) by virtue of students’ feedback and objective experimental results using statistical methods data processing. The paper demonstrates the results of the e-learning experimental research conducted during the academic year 2020/21, including the remote learning period due to the Covid19 pandemic situation in the spring semester, at the State Agrarian and Engineering University in Podilya, Kamianets-Podilskyi, Ukraine. Online study support for ESP was personally created as a four-credit course due to ECTS in the Moodle Learning Management System (LMS) with the application of Big Blue Button. The research sample is represented by 100 students majoring in veterinary medicine and enrolled in the mandatory subject of English for Specific Purposes. The group of students was enrolled in the lessons based on their bachelor curriculum. The subjects, referred to as experimental and control groups, accordingly, both wrote the primary test, at the beginning of the course, and the final one at the end. For pre-test content, the online standard test for B1 level was applied. The post-test was created by the educators, who were involved in the experiment. Due to the results procession and test analysis, it is admitted that the students of the experimental group showed slightly worse results in listening comprehension section, while having the same indicators concerning writing skills, and they had essentially worse outcomes in speaking and reading comprehension if compared to their peers from the control group. Mann-Whitney and Wilcoxon non-parametrical pair tests were selected to check the statistical hypotheses, due to the character of input data.

The Assessment of Risk Factors for Development of Disability in Children with Congenital Hypothyroidism in Uzbekistan within a Neonatal Screening

The aim of this study was to detect the most significant risk factors leading to disability in children with congenital hypothyroidism (CH) in the autonomous Republic of Karakalpakstan (RK) during neonatal screening (NS). Methods and Results: We used data of patients with CH registered within NS in the RK in 1998-2019 by the Center for Screening of Mother and Child. To predict and calculate the most significant risk factors for disability in children with CH, we used the method of normalizing intensive indicators by E. Shigan, based on the Bayes theorem. The study recruited 111 patients with CH aged from 2 months to 20 years. Among the patients, there were 79(71.2%) girls and 32(28.8%) boys. Additionally, 34(30.6%) children with CH had been disabled since childhood. The lack of compensation after the start of treatment had the highest and most significant degree of disability risk (RR=6.39, 95% CI: 7.4-1.2). Among patients diagnosed outside of screening, disability developed 4.1 times more often than with the results of NS (RR=4.0, 95% CI: 1.1-10.6). In CH patients diagnosed outside of screening, “absence of reagents” was a significant factor increasing the risk of disability by 6.1 times (RR=6.1, 95% CI: 1.8-11.2). Such risk factors as “home delivery” and “parental refusal of the primary test” increased the risk of disability by 3.4 times (RR=3.4, 95% CI: 2.5-8.4) and 1.6 times (RR=2.4, 95% CI: 2.93-7.12), respectively. The possible errors or false-negative answers in the “normal” secondary test and the “normal” primary test increased the risk of disability by 3.3 times (RR=4.0, 95% CI: 3.2-10.7) and 2.4 times (RR=2.42, 95% CI: 2.93-7.12), respectively. Factors such as the “late response to retesting” (RR=0.82 95% CI: 0.65-0.54), “late awareness on the part of the medical staff” (RR=0.29, 95% CI: 0.27- 0.08), and "parental refusal of treatment" (RR=1.03, 95% CI: 0.81-0.84) showed less significance in patients' disability. The “starting treatment after 1 month” factor was 4.2 times more likely to result in disability than “starting treatment before 1 month” (RR=4.2, 95% CI: 4.5 -1.1). Cancellation of levothyroxine by parents for children up to 3 years of age and cancellation of treatment by parents after 3 years more likely resulted in disability by 1.4 times (RR=1.43, 95% CI: 1.4 -2.01) and 3.3 times (RR=3.33, 95% CI: 3.3-10.9), respectively. Conclusion: the most significant risk factors for the development of disability in children with CH in the RK were (in descending order): no compensation after starting treatment, no reagents for screening, starting treatment after 1 year, diagnostics outside of screening, cancellation of L-T4 by parents before and after age 3 years, false-negative secondary TSH test, false-negative primary test, parents refusing the primary test, and childbirth at home.

Automatic detection of 39 fundus diseases and conditions in retinal photographs using deep neural networks

Retinal fundus diseases can lead to irreversible visual impairment without timely diagnoses and appropriate treatments. Single disease-based deep learning algorithms had been developed for the detection of diabetic retinopathy, age-related macular degeneration, and glaucoma. Here, we developed a deep learning platform (DLP) capable of detecting multiple common referable fundus diseases and conditions (39 classes) by using 249,620 fundus images marked with 275,543 labels from heterogenous sources. Our DLP achieved a frequency-weighted average F1 score of 0.923, sensitivity of 0.978, specificity of 0.996 and area under the receiver operating characteristic curve (AUC) of 0.9984 for multi-label classification in the primary test dataset and reached the average level of retina specialists. External multihospital test, public data test and tele-reading application also showed high efficiency for multiple retinal diseases and conditions detection. These results indicate that our DLP can be applied for retinal fundus disease triage, especially in remote areas around the world.

A Comparative Study for License Application Regulations on Proprietary Chinese Medicines in Hong Kong and Canada

Ethnopharmacological Relevance: Chinese Medicine plays a symbolic role among traditional medicines. As Chinese Medicine products are widely used around the globe, regulations for Chinese Medicine products are often used as models for the efficient regulation of natural products that are safe, and high-quality.Aim of the Study: We aimed to compare the regulatory registration requirements for Proprietary Chinese Medicines in Hong Kong and Canada.Materials and Methods: We compared registration requirements for Proprietary Chinese Medicine in Hong Kong and Canada based on publicly available information provided by the respective Regulators. A marketed product, Zhizhu Kuanzhong Capsule (SFDA approval number Z20020003; NPN approval number 80104354), was used as a case study to demonstrate the similarities and differences of the requirements in both Hong Kong and Canada.Results: There were similarities and differences between the two regulatory systems in terms of the quality, safety and efficacy requirements. Despite the superficial appearance of similar categories and groups/classes, Hong Kong requires significantly more primary test data compared to Canada's reliance on attestation to manufacturing according the standards outlined in approved reference pharmacopeias/texts.Conclusion: Improved understand of the similarity and differences will enable applicants to plan appropriate strategies for gaining product approval. Exploring ways to harmonize the regulatory process has the potential to benefit manufacturers, regulators, and patients by increasing efficiency and decreasing costs.

Evaluation of methods for detection of β-lactamase production in MSSA

Objectives Correct determination of penicillin susceptibility is pivotal for using penicillin in the treatment of Staphylococcus aureus infections. This study examines the performance of MIC determination, disc diffusion and a range of confirmatory tests for detection of penicillin susceptibility in S. aureus. Methods A total of 286 consecutive penicillin-susceptible S. aureus blood culture isolates as well as a challenge set of 62 MSSA isolates were investigated for the presence of the blaZ gene by PCR and subjected to penicillin-susceptibility testing using broth microdilution MIC determination, disc diffusion including reading of the zone edge, two nitrocefin tests and the cloverleaf test. Results Using PCR-based detection of blaZ as the gold standard, both broth microdilution MIC testing and disc diffusion testing resulted in a relatively low accuracy (82%–93%) with a sensitivity ranging from 49%–93%. Among the confirmatory tests, the cloverleaf test performed with 100% accuracy, while zone edge interpretation and nitrocefin-based tests increased the sensitivity of β-lactamase detection to 96%–98% and 82%–96% when using MIC determination or disc diffusion as primary test, respectively. Conclusions This investigation showed that reliable and accurate detection of β-lactamase production in S. aureus can be obtained by MIC determination or penicillin disc diffusion followed by interpretation of the zone edge as a confirmatory test for apparently penicillin-susceptible isolates. The more cumbersome cloverleaf test can also be used. Nitrocefin-based tests should not be used as the only test for confirmation of a presumptive β-lactamase-negative isolate.