46 research outputs found
Technologies for the global energy transition
The availability of reliable, affordable and mature technologies is at the basis of an effective decarbonization strategy, that should be in turn supported by timely and accurate policies. Due to the large differences across sectors and countries, there is no silver bullet to support decarbonization, but a combination of multiple technologies will be required to reach the challenging goal of decarbonizing the energy sector. This chapter presents a focus on the current technological solutions that are available in four main sectors: power generation, industry, transport and buildings. The aim of this work is to highlight the main strengths and weaknesses of the current technologies, to help the reader in understanding which are the main opportunities and challenges related to the development and deployment of each of them, as well as their potential contribution to the decarbonization targets. The chapter also provides strategies and policy recommendations from a technology point of view on how to decarbonize the global energy systems by mid-century and of the necessity to take a systems approach
Impact of cervical screening on cervical cancer mortality: estimation using stage-specific results from a nested case-control study
Cancer Research UK (A16892 to P.S.)
Human papillomavirus ‘reflex' testing as a screening method in cases of minor cytological abnormalities
The aim was to evaluate human papillomavirus (HPV) ‘reflex genotyping' in cases of minor cytological abnormalities detected in the gynaecological screening programme in Stockholm, Sweden. Liquid-based cytology samples showing minor cytological abnormalities were analysed using HPV genotyping (Linear Array, Roche diagnostics). Colposcopically directed cervical biopsies were obtained and the HPV test results were correlated with the histological results. In all, 63% (70/112) of the samples were high-risk (HR) HPV (HR-HPV) positive. A statistically significant correlation was found between high-grade cervical lesions and HR-HPV (P=0.019), among which HPV 16, 18, and 31 were the most important. The negative predictive value of HR-HPV detection for histologically confirmed high-grade lesions was 100%. An age limit for HPV reflex testing may be motivated in cases of low-grade squamous intraepithelial neoplasia (LSIL), because of high HR-HPV prevalence among younger women. By using HPV reflex genotyping, additional extensive workup can safely be avoided in about 50% of all cases of atypical squamous cells of undetermined significance (ASCUS) and LSIL among women ⩾30 years. This screening strategy could potentially reduce the total abnormal cytology-reporting rate in the Swedish screening programme by about 1% and provide more accurately directed follow-up, guided by cytological appearance and HPV test results
Treatment of irritable bowel syndrome with diarrhoea using titrated ondansetron (TRITON): study protocol for a randomised controlled trial
Background: Irritable bowel syndrome with diarrhoea (IBS-D) affects up to 4% of the general population. Symptoms
include frequent, loose, or watery stools with associated urgency, resulting in marked reduction of quality of life and
loss of work productivity. Ondansetron, a 5HT3 receptor antagonist, has had an excellent safety record for over 20 years
as an antiemetic, yet is not widely used in the treatment of IBS-D. It has, however, been shown to slow colonic transit
and in a small randomised, placebo-controlled, cross-over pilot study, benefited patients with IBS-D.
Methods: This trial is a phase III, parallel group, randomised, double-blind, multi-centre, placebo-controlled trial, with
embedded mechanistic studies. Participants (n = 400) meeting Rome IV criteria for IBS-D will be recruited from
outpatient and primary care clinics and by social media to receive either ondansetron (dose titrated up to 24 mg daily)
or placebo for 12 weeks. Throughout the trial, participants will record their worst abdominal pain, worst urgency, stool
frequency, and stool consistency on a daily basis.
The primary endpoint is the proportion of “responders” in each group, using Food and Drug Administration (FDA)
recommendations. Secondary endpoints include pain intensity, stool consistency, frequency, and urgency. Mood and
quality of life will also be assessed.
Mechanistic assessments will include whole gut transit, faecal tryptase and faecal bile acid concentrations at baseline
and between weeks 8 and 11. A subgroup of participants will also undergo assessment of sensitivity (n = 80) using the
barostat, and/or high-resolution colonic manometry (n = 40) to assess motor patterns in the left colon and the impact
of ondansetron.
Discussion: The TRITON trial aims to assess the effect of ondansetron across multiple centres. By defining
ondansetron’s mechanisms of action we hope to better identify patients with IBS-D who are likely to respond