Multimodal hyperspectroscopy screening in women at risk of cervical cancer: Results of a pilot study in a developing country

Background: Screening and treatment of pre‑cancerous lesions is important for prevention of cervical cancer. Currently, most available screening tests for cervical cancer are limited by low sensitivity, prohibitive costs, logistics and technical concerns. This study evaluates the role of multimodal hyperspectroscopy (MHS) as a cost‑effective, sensitive and user‑friendly point‑of‑care machine for early detection in women at risk of pre‑cancer lesions.Materials and Methods: Multimodal hyperspectroscopy of the cervix using the LuViva® Advanced Cervical Scan was performed first in a 1‑minute procedure among 100 previously screened for cervical cancer using either visual inspection after application of acetic acid (VIA) or cytology within the last 120 days. This was then followed by obtaining human papilloma virus (HPV) samples and biopsies from women for histology.Results: Of the 22 women with abnormal Pap tests of at least low‑grade squamous intraepithelial lesion, 3 had CIN2+, 6 had  CIN1, 4 were free of dysplasia at  histopathology while 9 had cervicitis. All 3 of the CIN2+ recorded high likelihood of CIN2+ by MHS. However, HPV was negative for all 3 women. The machine classified 1 of 1 CIN1s and 7 of the 13 women without dysplasia or cervicitis as low or  moderate risk for CIN2+ (40% specificity); of the 37 women who were VIA+, 81% were classified as high risk, and 66% of 37 women with normal Pap tests and biopsy were either at moderate or low risk.Conclusions: The findings from this pilot study show that MHS reduced the  percentage of unnecessary colposcopy and biopsy by 37.5%. It was also able to differentiate between VIA+ and Pap negative women suggesting its potential of being a point‑of‑care primary and objective screening test.Key words: Cervix; hyperspectroscopy; pre‑cancer; screening; sensitive

Separation of Powers Under the 1999 Nigerian Constitution: The Core Legal Dilemmas

At the core of Nigeria's constitutional practice lies the doctrine of separation of powers. The application of the principle is such that power under Nigeria's presidential cum federal system is delineated both horizontally and vertically. Even though the doctrine has a major feature of every constitution in the world, its implementation does not seem satisfactory given the insults that have been carried out by successive governments. This paper examines the doctrine of separation of powers and its complicatedness as regards to its practice in Nigeria's constitutional democracy. Reflecting on the history of Nigeria, this paper will discuss the eroded implementation of the principle of separation. As a result, it seems to be that the concept of "separation" is not going well and tends to fuse the function of executive and legislative institutions. In this situation, the principle is in a dilemma. This paper further offers a flicker of hope by pointing to the fact that all hopes do not appear lost, as the Judiciary still maintains some level of ‘separateness,' except that only time will tell as to how much this lasts

Knowledge of the Human Papilloma Virus vaccines, and opinions of Gynaecologists on its implementation in Nigeria

The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrolment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in Nigeria (Afr J Reprod Health 2013); 17[2]:150-156).L'objectif de cette étude était de déterminer la connaissance et la perception des obstétriciens et gynécologues du Nigeria vers l'utilisation du virus du papillome humain au Nigeria. Une étude transversale a été menée auprès des participants qui ont assisté à la 42e Conférence de la Société de la Gynécologie et d'Obstétrique du Nigeria. Les résultats ont révélé que 44,5% connaissaient le propre calendrier de vaccination contre le VPH. En ce qui concerne la mise en œuvre au Nigeria, 87,4% ont suggéré son incorporation dans le programme national de vaccination et environ un tiers étaient d’accord qu'il devrait être une condition préalable à la scolarisation. L'analyse de régression a montré que les habitants plus âgés étaient plus susceptibles d'avoir une connaissance suffisante du vaccin par rapport aux jeunes habitants (AOR 7,181 IC 95% OR = 1,792 à 28,782). Nous concluons qu’il y a une mauvaise connaissance de l'admissibilité et le calendrier. Il est recommandé que des informations adéquates soient fournies à ce groupe de personnel de santé en raison de leur position stratégique dans sa mise en œuvre au Nigeria. (Afr J Reprod Health 2013); 17[2]:150-156)

A Comparison of Vaccine Hesitancy of COVID-19 Vaccination in China and the United States

Objectives: To investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, namely, China and the United States (U.S.). Method: A cross-national survey was conducted in both China and the United States, and discrete choice experiments, as well as Likert scales, were utilized to assess vaccine preference and the underlying factors contributing to vaccination acceptance. Propensity score matching (PSM) was performed to enable a direct comparison between the two countries. Results: A total of 9077 (5375 and 3702 from China and the United States, respectively) respondents completed the survey. After propensity score matching, over 82.0% of respondents from China positively accepted the COVID-19 vaccination, while 72.2% of respondents from the United States positively accepted it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the U.S. respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the United States attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint, that the cost of vaccination covered the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Additionally, respondents from China tended to be much more concerned about the adverse effect of vaccination (19.68% vs. 6.12%) and have a lower perceived severity of being infected with COVID-19. Conclusion: Although the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between these countries were observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in the two countries, vaccine rollout strategies should be nation-dependent

Acceptance of and Preference for COVID-19 Vaccination in India, the United Kingdom, Germany, Italy, and Spain: An International Cross-Sectional Study

Objective: India and Europe have large populations, a large number of Coronavirus disease 2019 (COVID-19) cases, and different healthcare systems. This study aims to investigate the differences between the hesitancy toward and preference for COVID-19 vaccines in India and four European countries, namely, the United Kingdom (UK), Germany, Italy, and Spain. Methodology: We conducted a cross-national survey for distribution in India, the UK, Germany, Italy, and Spain. More specifically, a discrete choice experiment (DCE) was conducted to evaluate vaccine preferences, and Likert scales were used to probe the underlying factors that contribute to vaccination acceptance. Propensity score matching (PSM) was performed to directly compare India and European countries. Results: A total of 2565 respondents (835 from India and 1730 from the specified countries in Europe) participated in the survey. After PSM, more than 82.5% of respondents from India positively accepted the COVID-19 vaccination, whereas 79.9% of respondents from Europe had a positive attitude; however, the proportion in Europe changed to 81.6% in cases in which the vaccine was recommended by friends, family, or employers. The DCE found that the COVID-19 vaccine efficacy was the most important factor for respondents in India and the four European nations (41.8% in India and 47.77% in Europe), followed by the vaccine cost (28.06% in India and 25.88% in Europe). Conclusion: Although most respondents in both regions showed high acceptance of COVID-19 vaccines, either due to general acceptance or acceptance as a result of social cues, the vaccination coverage rate shows apparent distinctions. Due to the differences in COVID-19 situations, public health systems, cultural backgrounds, and vaccine availability, the strategies for COVID-19 vaccine promotion should be nation-dependent

Health Communication About Hospice Care in Chinese Media: Digital Topic Modeling Study

BackgroundHospice care, a type of end-of-life care provided for dying patients and their families, has been rooted in China since the 1980s. It can improve receivers’ quality of life as well as ease their economic burden. The Chinese mass media have continued to actively dispel misconceptions surrounding hospice care and deliver the latest information to citizens. ObjectiveThis study aims to retrieve and analyze news reports on hospice care in order to gain insight into whether any differences existed in heath information delivered over time and to evaluate the role of mass media in health communication in recent years. MethodsWe searched the Huike (WiseSearch) news database for relevant news reports from Chinese mass media released between 2014 and 2019. We defined two time periods for this study: (1) January 1, 2014, to December 31, 2016, and (2) January 1, 2017, to December 31, 2019. The data cleaning process was completed using Python. We determined appropriate topic numbers for these two periods based on the coherence score and applied latent Dirichlet allocation topic modeling. Keywords for each topic and corresponding topics’ names were then generated. The topics were plotted into different circles, and their distances on the 2D plane was represented by multidimensional scaling. ResultsAfter removing duplicated and irrelevant news articles, we obtained a total of 2227 articles. We chose 8 as the suitable topic number for both study periods and generated topic names and associated keywords. The top 3 most reported topics in the first period were patient treatment, hospice care stories, and development of health care services and health insurance, accounting for 18.68% (178/953), 16.58% (158/953), and 14.17% (135/953) of the collected reports, respectively. The top 3 most reported topics in the second period were hospice care stories, patient treatment, and development of health care services, accounting for 15.62% (199/953), 15.38% (15.38/953), and 14.27% (182/953), respectively. ConclusionsTopic modeling of news reports gives us a better understanding of the patterns of health communication about hospice care by mass media. Chinese mass media frequently reported on hospice care in April of every year on account of a traditional Chinese festival. Moreover, an increase in coverage was observed in the second period. The two periods shared 6 similar topics, of which patient treatment outstrips hospice care stories was the most reported topic in the second period, implying the humanistic spirit behind the reports. Based on the findings of this study, we suggest stakeholders cooperate with the mass media when planning to update policies

The Impact of Public Health Events on COVID-19 Vaccine Hesitancy on Chinese Social Media: National Infoveillance Study

BackgroundThe ongoing COVID-19 pandemic has brought unprecedented challenges to every country worldwide. A call for global vaccination for COVID-19 plays a pivotal role in the fight against this virus. With the development of COVID-19 vaccines, public willingness to get vaccinated has become an important public health concern, considering the vaccine hesitancy observed worldwide. Social media is powerful in monitoring public attitudes and assess the dissemination, which would provide valuable information for policy makers. ObjectiveThis study aimed to investigate the responses of vaccine positivity on social media when major public events (major outbreaks) or major adverse events related to vaccination (COVID-19 or other similar vaccines) were reported. MethodsA total of 340,783 vaccine-related posts were captured with the poster’s information on Weibo, the largest social platform in China. After data cleaning, 156,223 posts were included in the subsequent analysis. Using pandas and SnowNLP Python libraries, posts were classified into 2 categories, positive and negative. After model training and sentiment analysis, the proportion of positive posts was computed to measure the public positivity toward the COVID-19 vaccine. ResultsThe positivity toward COVID-19 vaccines in China tends to fluctuate over time in the range of 45.7% to 77.0% and is intuitively correlated with public health events. In terms of gender, males were more positive (70.0% of the time) than females. In terms of region, when regional epidemics arose, not only the region with the epidemic and surrounding regions but also the whole country showed more positive attitudes to varying degrees. When the epidemic subsided temporarily, positivity decreased with varying degrees in each region. ConclusionsIn China, public positivity toward COVID-19 vaccines fluctuates over time and a regional epidemic or news on social media may cause significant variations in willingness to accept a vaccine. Furthermore, public attitudes toward COVID-19 vaccination vary from gender and region. It is crucial for policy makers to adjust their policies through the use of positive incentives with prompt responses to pandemic-related news to promote vaccination acceptance