Canadian oncogenic human papillomavirus cervical infection prevalence: Systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Oncogenic human papillomavirus (HPV) infection prevalence is required to determine optimal vaccination strategies. We systematically reviewed the prevalence of oncogenic cervical HPV infection among Canadian females prior to immunization.</p> <p>Methods</p> <p>We included studies reporting DNA-confirmed oncogenic HPV prevalence estimates among Canadian females identified through searching electronic databases (e.g., MEDLINE) and public health websites. Two independent reviewers screened literature results, abstracted data and appraised study quality. Prevalence estimates were meta-analyzed among routine screening populations, HPV-positive, and by cytology/histology results.</p> <p>Results</p> <p>Thirty studies plus 21 companion reports were included after screening 837 citations and 120 full-text articles. Many of the studies did not address non-response bias (74%) or use a representative sampling strategy (53%).</p> <p>Age-specific prevalence was highest among females aged < 20 years and slowly declined with increasing age. Across all populations, the highest prevalence estimates from the meta-analyses were observed for HPV types 16 (routine screening populations, 8 studies: 8.6% [95% confidence interval 6.5-10.7%]; HPV-infected, 9 studies: 43.5% [28.7-58.2%]; confirmed cervical cancer, 3 studies: 48.8% [34.0-63.6%]) and 18 (routine screening populations, 8 studies: 3.3% [1.5-5.1%]; HPV-infected, 9 studies: 13.6% [6.1-21.1%], confirmed cervical cancer, 4 studies: 17.1% [6.4-27.9%].</p> <p>Conclusion</p> <p>Our results support vaccinating females < 20 years of age, along with targeted vaccination of some groups (e.g., under-screened populations). The highest prevalence occurred among HPV types 16 and 18, contributing a combined cervical cancer prevalence of 65.9%. Further cancer protection is expected from cross-protection of non-vaccine HPV types. Poor study quality and heterogeneity suggests that high-quality studies are needed.</p

Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions

Background: A typical squamous cells of undetermined significance (ASCUS) and low-grade squamous intra-epithelial lesions (LSIL) are minor lesions of the cervical epithelium, detectable by cytological examination of cells collected from the surface of the cervix of a woman. Usually, women with ASCUS and LSIL do not have cervical (pre-) cancer, however a substantial proportion of them do have underlying high-grade cervical intra-epithelial neoplasia (CIN, grade 2 or 3) and so are at increased risk for developing cervical cancer. Therefore, accurate triage of women with ASCUS or LSIL is required to identify those who need further management. This review evaluates two ways to triage women with ASCUS or LSIL: repeating the cytological test, and DNA testing for high-risk types of the human papillomavirus (hrHPV) - the main causal factor of cervical cancer. Objectives Main objective: To compare the accuracy of hrHPV testing with the Hybrid Capture 2 (HC2) assay against that of repeat cytology for detection of underlying cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) or grade 3 or worse (CIN3+) in women with ASCUS or LSIL. For the HC2 assay, a positive result was defined as proposed by the manufacturer. For repeat cytology, different cut-offs were used to define positivity: Atypical squamous cells of undetermined significance or worse (ASCUS+), low-grade squamous intra-epithelial lesions or worse (LSIL+) or high-grade squamous intra-epithelial lesions or worse (HSIL+). Secondary objective: To assess the accuracy of the HC2 assay to detect CIN2+ or CIN3+ in women with ASCUS or LSIL in a larger group of reports of studies that applied hrHPV testing and the reference standard (coloscopy and biopsy), irrespective whether or not repeat cytology was done. Search methods: We made a comprehensive literature search that included the Cochrane Register of Diagnostic Test Accuracy Studies; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE (through PubMed), and EMBASE (last search 6 January 2011). Selected journals likely to contain relevant papers were handsearched from 1992 to 2010 (December). We also searched CERVIX, the bibliographic database of the Unit of Cancer Epidemiology at the Scientific Institute of Public Health (Brussels, Belgium) which contains more than 20,000 references on cervical cancer. More recent searches, up to December 2012, targeted reports on the accuracy of triage of ASCUS or LSIL with other HPV DNA assays, or HPV RNA assays and other molecular markers. These searches will be used for new Cochrane reviews as well as for updates of the current review. Selection criteria: Studies eligible for inclusion in the review had to include: women presenting with a cervical cytology result of ASCUS or LSIL, who had undergone both HC2 testing and repeat cytology, or HC2 testing alone, and were subsequently subjected to reference standard verification with colposcopy and colposcopy-directed biopsies for histologic verification. Data collection and analysis: The review authors independently extracted data from the selected studies, and obtained additional data from report authors. Two groups of meta-analyses were performed: group I concerned triage of women with ASCUS, group II concerned women with LSIL. The bivariate model (METADAS-macro in SAS) was used to assess the absolute accuracy of the triage tests in both groups as well as the differences in accuracy between the triage tests. Main results: The pooled sensitivity of HC2 was significantly higher than that of repeat cytology at cut-off ASCUS+ to detect CIN2+ in both triage of ASCUS and LSIL (relative sensitivity of 1.27 (95% CI 1.16 to 1.39; P value < 0.0001) and 1.23 (95% CI 1.06 to 1.4; P value 0.007), respectively. In ASCUS triage, the pooled specificity of the triage methods did not differ significantly from each other (relative specificity: 0.99 (95% CI 0.97 to 1.03; P value 0.98)). However, the specificity of HC2 was substantially, and significantly, lower than that of repeat cytology in the triage of LSIL (relative specificity: 0.66 (95% CI 0.58 to 0.75) P value < 0.0001). Authors' conclusions: HPV-triage with HC2 can be recommended to triage women with ASCUS because it has higher accuracy (significantly higher sensitivity, and similar specificity) than repeat cytology. When triaging women with LSIL, an HC2 test yields a significantly higher sensitivity, but a significantly lower specificity, compared to a repeat cytology. Therefore, practice recommendations for management of women with LSIL should be balanced, taking local circumstances into account

Модель тестування уразливостей мобільних програмних застосунків

Security testing of mobile software applications is performed to confirm the level of security of information processed by the software application. Testing is performed to verify the software application to confirm the confidentiality, integrity, and availability of information, processed by the mobile software application. Currently, almost all organizations involved in standardization and certification have developed their own testing methods, which are based on or in most testing cases refer to the methodology and standard OWASP MASVS. But there is a lack of a formalized security testing model that describes the stages of testing and the dependence of each stage on the initial conditions under which the testing takes place and the configuration of the test environment. The purpose of the study is to form a testing model, the use of which should ensure optimal use of existing testing methods. Security testing of mobile software applications is performed to confirm the level of security of information processed by the software application. Testing is performed to verify the software application to confirm the confidentiality, integrity, and availability of information processed by the mobile software application. Currently, almost all organizations involved in standardization and certification have developed their own testing methods, which are based on or in most testing cases refer to the methodology and standard OWASP MASVS. But there is no formalized model of security testing, which describes the stages of testing and the dependence of each of the stages on the initial conditions under which the testing and configuration of the test environment. The purpose of the study is to form a testing model, the use of which should ensure optimal use of existing testing methods.Збереженість властивостей конфіденційності, цілісності та доступності інформації мобільних програмних застосунків важлива як для користувача, так й організації і держави загалом. Запобігання цьому досягається завдяки тестуванню їхніх уразливостей. Однак, на практиці цим здебільшого або нехтують, або приділяють мало уваги. Це обумовлено зосередженістю на перевірянні задоволеності функціональних вимог до мобільних програмних застосунків. До того ж встановлено орієнтованість типових підходів до тестування уразливостей на окремі аспекти їхнього використання. Водночас мобільні програмні застосунки тестуються за настановами міжнародних, національних нормативних документів. Методологічною основою цих документів є настанови OWASP. Незважаючи на загальну прийнятність їхнє використання на практиці обмежується орієнтованістю на клієнтську частину мобільного програмного застосунку, з одного боку. З іншого – суб’єктивністю обирання етапів і їхньої послідовності при тестуванні уразливостей. Наявність таких обмежень призводить до довільності використання зазначених засобів при перевірянні реалізованості вимог безпеки мобільних програмних застосунків. Подолання обмежень запропоновано завдяки встановленню залежностей між етапами тестування з огляду на співвідношення між ними. На основі цього розроблено модель тестування уразливостей мобільних програмних застосунків. Її використання дозволяє формалізувати обирання його етапів при перевірянні реалізованості вимог безпеки та отримувати відтворювані результати

The usage of dependency graphs to test the security of mobile software applications

Testing the security of mobile software applications by OWASP guidelines was analyzed. Attention is drawn to three levels of requirements in OWASP MASVS and their implementation under the OWASP MSTG guidelines. This guide identifies the processes and methods of testing mobile software applications for vulnerability. This leads to the arbitrary usage of these tools when verifying the feasibility of security requirements for mobile software applications. Overcoming the constraints is suggested by using dependency graphs, given the relationship between the testing stages.Testing the security of mobile software applications by OWASP guidelines was analyzed. Attention is drawn to three levels of requirements in OWASP MASVS and their implementation under the OWASP MSTG guidelines. This guide identifies the processes and methods of testing mobile software applications for vulnerability. This leads to the arbitrary usage of these tools when verifying the feasibility of security requirements for mobile software applications. Overcoming the constraints is suggested by using dependency graphs, given the relationship between the testing stages

Availability government web resources monitoring system

Постійне підвищення ролі інформаційних технологій призводить до відмовляння від традиційного документообігу на користь електронного. Зі зростом його обсягів зростає і зацікавленість електронними документами з боку різноманітних осіб і численних хакерських угруповань, спецслужб інших країн. Найбільшого деструктивного впливу зазнають державні веб-ресурси. Для унеможливлення такого впливу забезпечується непорушність насамперед їх цілісності та доступності. Для постійного контролювання доступності державних веб-ресурсів пропонується система моніторингу на основі рішення Nagios. Тоді як процес пошуку доменних імен державних веб-ресурсів автоматизовано за допомогою скриптової мови програмування Bash. Завдяки цьому стало можливим забезпечення постійного контролювання доступності державних веб-ресурсів і швидке інформування про початок атаки на них або їх технічні несправності.The constant increase in the role of information technology leads to the denial of the traditional paper workflow for electronic. With the increase used of electronic documents increases and interest for this electronic documents from various people and many hacker groups, also the intelligence services of other countries. The most destructive influence befalls government web-resources. To prevent such exposure is provided primarily inviolability of their integrity and availability. To control the accessibility government web resources used monitoring systems. However, there are no guidelines for the selection of software systems and, consequently, the isolation of their best and worst. Therefore, constant monitoring the availability of government web resources offered to carry through the development of monitoring systems based solution Nagios. This is due to the ability to store settings in configuration files, a simple file format, ease of configuration using any recording tools, and lots of plugins to extend functionality. The process of finding domain names government web resources using automated scripting language Bash. This system is aimed at solving such problems as the definition of early attacks “denial of service” display technical problems on servers which operate a Web resource; mapping software problems working web resource. This will be possible to ensure continuous monitoring of the availability of government web resources and quick information about the beginning of an attack on them or their technical malfunction.Постоянное повышение роли информационных технологий приводит к отказу от традиционного документооборота в пользу электронного. С ростом его объемов растет и заинтересованность электронными документами со стороны разнообразных лиц и многочисленных хакерских группировок, спецслужб других стран. Наибольшее деструктивное влияние испытывают государственные веб-ресурсы. Для того чтоб сделать невозможным такое влияние обеспечивается сохранность в первую очередь их целостности и доступности. Для постоянного контролирования доступности государственных веб-ресурсов предлагается система мониторинга на основе решения Nagios. Тогда как процесс поиска доменных имен государственных веб-ресурсов автоматизируется с помощью скриптового языка программирования Bash. Благодаря этому стало возможным обеспечение постоянного контролирования доступности государственных веб-ресурсов и быстрое информирование о начале атаки на них или быстрое выявление их технических неисправностей

Rapid Genotyping of Hepatitis C Virus by Primer-Specific Extension Analysis

Quick and accurate genotyping of hepatitis C virus (HCV) is becoming increasingly important for clinical management of chronic infection and as an epidemiological marker. Furthermore, the incidence of HCV infection with mixed genotypes has clinical significance that is not addressed by most genotyping methods. We have developed a fluorescence-based genotyping assay called primer-specific extension analysis (PSEA) for the most prevalent HCV genotypes and have demonstrated the capacity of PSEA-HCV for detecting mixed-genotype HCV infections. PSEA-HCV detects genotype-specific sequence differences in the 5′ untranslated region of HCV in products amplified by the COBAS AMPLICOR HCV Test, v2.0. Simulated mixed HCV infection of plasma with RNase-resistant RNA controls demonstrates that PSEA-HCV can detect as many as five genotypes in one specimen. Furthermore, in dual-genotype simulations, PSEA-HCV can unequivocally detect both genotypes, with one genotype representing only 3.1% of the mixture (313/10,000 IU in starting plasma). Compared to INNO-LiPA HCV II, both assays determined the same genotype for 191/199 (96%) patient specimens (175 subtype and 16 genotype-only identifications). Following the initial evaluation, PSEA-HCV was used routinely to genotype HCV from patient specimens submitted to our laboratory (n = 312). Seventeen (5.4%) mixed infections were identified. The distribution of single-infection HCV genotypes in our population was 60.9% type 1 (n = 190), 12.8% type 2 (n = 40), 20.2% type 3 (n = 63), 0.3% type 4 (n = 1), and 0.3% other (n = 1). In conclusion, PSEA-HCV provides an inexpensive, high-throughput screening tool for rapid genotyping of HCV while reliably identifying mixed HCV infections