25-Hydroxy vitamin-D, obesity, and associated variables as predictors of breast cancer risk and tamoxifen benefit in NSABP-P1.

Observational studies suggest that host factors are associated with breast cancer risk. The influence of obesity, vitamin-D status, insulin resistance, inflammation, and elevated adipocytokines in women at high risk of breast cancer is unknown. The NSABP-P1 trial population was used for a nested case-control study. Cases were drawn from those who developed invasive breast cancer and controls selected from unaffected participants (≤4 per case) matched for age, race, 5 year Gail score, and geographic location of clinical center as a surrogate for latitude. Fasting serum banked at trial enrolment was assayed for 25-hydroxy vitamin-D (25OHD), insulin, leptin (adipocytokine), and C-reactive protein (CRP, marker of inflammation). Logistic regression was used to test for associations between study variables and the risk of invasive breast cancer. Two hundred and thirty-one cases were matched with 856 controls. Mean age was 54, and 49% were premenopausal. There were negative correlations for 25OHD with body mass index (BMI), insulin, CRP, and leptin. BMI ≥ 25 kg/m(2) was associated with higher breast cancer risk (odds ratio [OR] 1.45, p = 0.02) and tamoxifen treatment was associated with lower risk (OR = 0.44, p < 0.001). Suboptimal 25OHD (<72 nmol/l) did not influence breast cancer risk (OR = 1.06, p = 0.76). When evaluated as continuous variables, 25OHD, insulin, CRP, and leptin levels were not associated with breast cancer risk (all p > 0.34). In this high risk population, higher BMI was associated with a greater breast cancer risk. Serum levels of 25OHD, insulin, CRP, and leptin were not independent predictors of either breast cancer risk or tamoxifen benefit

Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance.

To estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers

Remarkable dynamics of nanoparticles in the urban atmosphere

Nanoparticles emitted from road traffic are the largest source of respiratory exposure for the general public living in urban areas. It has been suggested that the adverse health effects of airborne particles may scale with the airborne particle number, which if correct, focuses attention on the nanoparticle (less than 100 nm) size range which dominates the number count in urban areas. Urban measurements of particle size distributions have tended to show a broadly similar pattern dominated by a mode centred on 20–30 nm diameter particles emitted by diesel engine exhaust. In this paper we report the results of measurements of particle number concentration and size distribution made in a major London park as well as on the BT Tower, 160 m high. These measurements taken during the REPARTEE project (Regents Park and BT Tower experiment) show a remarkable shift in particle size distributions with major losses of the smallest particle class as particles are advected away from the traffic source. In the Park, the traffic related mode at 20–30 nm diameter is much reduced with a new mode at <10 nm. Size distribution measurements also revealed higher number concentrations of sub-50 nm particles at the BT Tower during days affected by higher turbulence as determined by Doppler Lidar measurements and indicate a loss of nanoparticles from air aged during less turbulent conditions. These results suggest that nanoparticles are lost by evaporation, rather than coagulation processes. The results have major implications for understanding the impacts of traffic-generated particulate matter on human health

Universal Wellbeing Practices in Schools: Framing Evidence-Informed Practice Within the Five Ways to Wellbeing

In 2017, the UK Government published Transforming Children and Young People’s Mental Health Provision: A Green Paper (Department for Education & Department of Health, 2017), making clear that their intention is to place schools at the forefront of a national strategy to improve the mental wellbeing of children. The Special Educational Needs and Disability Code of Practice (SEND CoP; Department for Education & Department of Health, 2015) includes Social, Emotional and Mental Health as one primary area of SEND, emphasising a graduated approach to intervention, beginning with high-quality teaching. Taken together, the clear implication is that schools should arrange provision to promote children’s wellbeing at the universal level, not just at the targeted and specialist levels. With its emphasis upon evidence-based actions, the New Economics Foundation’s (NEF’s) Five Ways to Wellbeing (Aked et al., 2008) is proposed here as a framework for organising provisions. Relevant evidence-based programs, as well as strategies and procedures, are presented, each of which is universally applicable, relevant across primary and secondary phases, and linked to the NEF’s Five Ways

Testing for sexually transmitted infections in a population-based sexual health survey: development of an acceptable ethical approach

Population-based research is enhanced by biological measures, but biological sampling raises complex ethical issues. The third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) will estimate the population prevalence of five sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV), HIV and Mycoplasma genitalium) in a probability sample aged 16e44 years. The present work describes the development of an ethical approach to urine testing for STIs, including the process of reaching consensus on whether to return results. The following issues were considered: (1) testing for some STIs that are treatable and for which appropriate settings to obtain free testing and advice are widely available (Natsal-3 provides all respondents with STI and healthcare access information), (2) limits on test accuracy and timeliness imposed by survey conditions and sample type, (3) testing for some STIs with unknown clinical and public health implications, (4) how a uniform approach is easier to explain and understand, (5) practical difficulties in returning results and cost efficiency, such as enabling wider STI testing by not returning results. The agreed approach, to perform voluntary anonymous testing with specific consent for five STIs without returning results, was approved by stakeholders and a research ethics committee. Overall, this was acceptable to respondents in developmental piloting; 61% (68 of 111) of respondents agreed to provide a sample. The experiences reported here may inform the ethical decision making of researchers, research ethics committees and funders considering population-based biological sampling

Interpretation of particle number size distributions measured across an urban area during the FASTER campaign

Abstract. Particle number size distributions have been measured simultaneously by scanning mobility particle sizers (SMPSs) at five sites in central London for a 1 month campaign in January–February 2017. These measurements were accompanied by condensation particle counters (CPCs) to measure total particle number count at four of the sites and Aethalometersmeasuringblackcarbon(BC)atfivesites.The spatialdistributionandinter-relationshipsoftheparticlesize distribution and SMPS total number counts with CPC total number counts and black carbon measurements have been analysed in detail as well as variations in the size distributions. One site (Marylebone Road) was in a street canyon with heavy traffic, one site (Westminster University) was on a rooftop adjacent to the Marylebone Road sampler, and a further sampler was located at Regent’s University within a major park to the north of Marylebone Road. A fourth sampler was located nearby at 160m above ground level on the BT tower and a fifth sampler was located 4km to the west of the main sampling region at North Kensington. Consistent with earlier studies it was found that the mode in the size distribution had shifted to smaller sizes at the Regent’s University (park) site, the mean particle shrinkage rate being 0.04nms−1 with slightly lower values at low wind speeds and some larger values at higher wind speeds. There was evidence of complete evaporation of the semi-volatile nucleation mode under certain conditions at the elevated BT Tower site. While the SMPS total count and black carbon showed typical traffic-dominated diurnal profiles, the CPC count data typically peaked during night-time as did CPC/SMPS and CPC/BC ratios. This is thought to be due to the presence of high concentrations of small particles (2.5–15nm diameter) probably arising from condensational growth from traffic emissions during the cooler night-time conditions. Such behaviour was most marked at the Regent’s University and Westminster University sites and less so at Marylebone Road, while at the elevated BT Tower site the ratio of particle number(CPC) to black carbon peaked during the morning rush hour and not at night-time, unlike the other sites. An elevation in nucleation mode particles associated with winds from the west and WSW sector was concluded to result from emissions from London Heathrow Airport, despite a distance of 22km from the central London sites

Performance of human papillomavirus DNA detection in residual specimens taken for Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acid amplification testing in men who have sex with men

OBJECTIVES: Rectal swab specimens, either alone or pooled with first-void urine (FVU) and pharyngeal swab specimens, are used to test for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection in men who have sex with men (MSM). Following introduction of human papillomavirus (HPV) vaccination for MSM attending UK sexual health services (SHSs), HPV testing of residual CT/NG test specimens has been proposed to monitor HPV prevalence in this population. Performance of HPV detection in such specimens has not been evaluated previously. METHODS: MSM attending a UK SHS provided three specimens: (1) rectal swab for CT/NG, (2) pooled rectal/pharyngeal/FVU specimen for CT/NG and (3) dedicated anal swab for HPV. Specimen 3 and residual material from specimens 1 and 2 were tested for type-specific HPV DNA. HPV detection was by an in-house multiplex PCR and luminex-based genotyping assay. RESULTS: A total of 129 MSM were recruited with a mean age of 38.1 years; 24% were HIV-positive. Of the 129 MSM, 92 (71%) had any type-specific HPV DNA in ≥1 specimen; 80 (62%) had high risk (HR) HPV. Of 123 participants with sufficient residual pooled and dedicated specimens, 70 (56.9%) had detectable HPV on both, and 40 (32.5%) were negative on both; overall concordance was 89% (95% CI 83% to 94%), and kappa statistic was 0.78 (95% CI 0.66 to 0.89). Pooled samples had a 4.1% (95% CI -1.9% to 10.0%) higher test positivity rate than dedicated samples.Of 125 participants with sufficient residual rectal and specimens, 74 (59.2%) had detectable HPV on both, and 36 (28.8%) were negative on both; overall concordance was 88% (95% CI 81% to 93%), and kappa statistic was 0.74 (95% CI 0.61 to 0.86). Residual rectal samples had 5.6% (95%CI -0.6% to 11.8%) higher test positivity than dedicated samples. CONCLUSIONS: We observed high concordance between the dedicated and residual STI test specimens. Our data support the strategy of testing residual specimens for HPV prevalence monitoring in MSM to evaluate the impact of the targeted vaccination programme

City Scale Traffic Monitoring Using WorldView Satellite Imagery and Deep Learning: A Case Study of Barcelona

Accurate traffic data is crucial for a range of different applications such as quantifying vehicle emissions, and transportation planning and management. However, the availability of traffic data is geographically fragmented and is rarely held in an accessible form. Therefore, there is an urgent need for a common approach to developing large urban traffic data sets. Utilising satellite data to estimate traffic data offers a cost-effective and standardized alternative to ground-based traffic monitoring. This study used high-resolution satellite imagery (WorldView-2 and 3) and Deep Learning (DL) to identify vehicles, road by road, in Barcelona (2017–2019). The You Only Look Once (YOLOv3) object detection model was trained and model accuracy was investigated via parameters such as training data set specific anchor boxes, network resolution, image colour band composition and input image size. The best performing vehicle detection model configuration had a precision (proportion of positive detections that were correct) of 0.69 and a recall (proportion of objects in the image correctly identified) of 0.79. We demonstrated that high-resolution satellite imagery and object detection models can be utilised to identify vehicles at a city scale. However, the approach highlights challenges relating to identifying vehicles on narrow roads, in shadow, under vegetation, and obstructed by buildings. This is the first time that DL has been used to identify vehicles at a city scale and demonstrates the possibility of applying these methods to cities globally where data are often unavailable

Reduction in HPV 16/18 prevalence in sexually active young women following the introduction of HPV immunisation in England.

BACKGROUND: Reduction in the prevalence of vaccine type HPV infection in young women is an early indication of the impact of the HPV immunisation programme and a necessary outcome if the subsequent impact on cervical cancer is to be realised. METHODS: Residual vulva-vaginal swab (VVS) specimens from young women aged 16-24 years undergoing chlamydia screening in community sexual health services (formerly known as family planning clinics), general practice (GP), and youth clinics in 2010-2012 were submitted from 10 laboratories in seven regions around England. These specimens were linked to demographic and sexual behaviour data reported with the chlamydia test, anonymised, and tested for type-specific HPV DNA using a multiplex PCR and Luminex-based genotyping test. Estimated immunisation coverage was calculated and findings were compared to a baseline survey conducted prior to the introduction of HPV immunisation in 2008. RESULTS: A total of 4664 eligible specimens were collected and 4178 had a valid test result. The post-immunisation prevalence of HPV 16/18 infection was lowest in this youngest age group (16-18 years) and increased with age. This increase with age was a reversal of the pattern seen prior to immunisation and was inversely associated with estimates of age-specific immunisation coverage (65% for 16-18 year olds). The prevalence of HPV 16/18 infection in the post-immunisation survey was 6.5% amongst 16-18 year olds, compared to 19.1% in the similar survey conducted prior to the introduction of HPV immunisation. CONCLUSIONS: These findings are the first indication that the national HPV immunisation programme is successfully preventing HPV 16/18 infection in sexually active young women in England. The reductions seen suggest, for the estimated coverage, high vaccine effectiveness and some herd-protection benefits. Continued surveillance is needed to determine the effects of immunisation on non-vaccine HPV types