Effectiveness and Cost-effectiveness of Human Papillomavirus (HPV) Vaccines in Cervical Cancer Prophylaxis

Human papillomavirus (HPV) infection is the main cause of cervical cancer. Cervical cancer patients go through painful long-term treatments and high medical costs. Prevention is better than cure. Hence, regular cervical screening is recommended for Hong Kong women to prevent this disease. Some studies have been conducted in Western countries to show that cost-effectiveness can be achieved by combining HPV vaccines with regular screening. The study is guided by three research groups on the future implication of the cost-effectiveness of three cervical cancer prevention strategies: (1) annual Pap smear for women aged 25–42, (2) HPV vaccination at age 12, and (3) HPV vaccination at age 12 combined with annual Pap smear screening at age 25–42. The three groups are compared in terms of their total lifetime cost, cost-effectiveness ratio and incremental life expectancy. The Markov model software is used as the main analytical tool. After analyzing, annual Pap smear screening is a cost-effective method to prevent cervical cancer that the total lifetime cost was approximately USD145.69; cost-effectiveness ratio was USD8.80/DALY; and incremental life expectancy was 2.72 years. Moreover, HPV vaccination combined with annual Pap smear screening is an effective way to prolong the life expectancy of women regardless of race that the total lifetime cost was approximately USD545.12; cost-effectiveness ratio was USD29.56/DALY; and incremental life expectancy was 2.84 years. Such result provides important insight for the formulation of a health care policy to prevent cervical cancer. This policy can save lives and reduce local treatment costs

Synergy of importin α recognition and DNA binding by the yeast transcriptional activator GAL4

AbstractThe N-terminus of the yeast transcriptional activator GAL4 contains partially overlapping nuclear targeting and DNA binding functions. We have previously shown that GAL4 is recognised with high affinity by importin β and not by the conventional nuclear localisation sequence binding importin α subunit of the importin α/β heterodimer. The present study uses ELISA-based binding and electrophoretic mobility shift assays to show that recognition of GAL4 by importin α can occur, but only when GAL4 is bound to its specific DNA recognition sequence. Intriguingly, binding by importin α enhances DNA binding on the part of GAL4, implying a synergistic co-operation between these two functions. The results implicate a possible role for importin α in the nucleus additional to its established role in nuclear transport, as well as having implications for the use of GAL4 as a DNA carrier in gene therapy applications

First year medical students’ learning style preferences and their correlation with performance in different subjects within the medical course

Background: Students commencing their medical training arrive with different educational backgrounds and a diverse range of learning experiences. Consequently, students would have developed preferred approaches to acquiring and processing information or learning style preferences. Understanding first-year students’ learning style preferences is important to success in learning. However, little is understood about how learning styles impact learning and performance across different subjects within the medical curriculum. Greater understanding of the relationship between students’ learning style preferences and academic performance in specific medical subjects would be valuable. Methods: This cross-sectional study examined the learning style preferences of first-year medical students and how they differ across gender. This research also analyzed the effect of learning styles on academic performance across different subjects within a medical education program in a Central Asian university. A total of 52 students (57.7% females) from two batches of first-year medical school completed the Index of Learning Styles Questionnaire, which measures four dimensions of learning styles: sensing-intuitive; visual-verbal; active-reflective; sequential-global. Results: First-year medical students reported preferences for visual (80.8%) and sequential (60.5%) learning styles, suggesting that these students preferred to learn through demonstrations and diagrams and in a linear and sequential way. Our results indicate that male medical students have higher preference for visual learning style over verbal, while females seemed to have a higher preference for sequential learning style over global. Significant associations were found between sensing-intuitive learning styles and performance in Genetics [β = −0.46, B = −0.44, p < 0.01] and Anatomy [β = −0.41, B = −0.61, p < 0.05] and between sequential-global styles and performance in Genetics [β = 0.36, B = 0.43, p < 0.05]. More specifically, sensing learners were more likely to perform better than intuitive learners in the two subjects and global learners were more likely to perform better than sequential learners in Genetics. Conclusion: This knowledge will be helpful to individual students to improve their performance in these subjects by adopting new sensing learning techniques. Instructors can also benefit by modifying and adapting more appropriate teaching approaches in these subjects. Future studies to validate this observation will be valuable

Feedback assessment of Science report writing for first year Genetics students

In an effort to identify and help correct the observed inadequacies in scientific report writing, we designed a procedure which we introduced as part of the required exercises early in the first year of the Genetics course. An assessment scheme was given to students in which one group received two consecutive cycles of feedback. They had to prepare a short scientific report based on a set of data collected for an experiment. The first draft of the scientific report was submitted to a laboratory partner for a round of peer review. This was returned to them for revision before submission to the laboratory demonstrator for a second round of feedback. Only after two rounds of review and revision were the reports finally submitted for assessment. This was carried out in parallel with two other groups of students who had either a self review using a checklist followed by the peer review or self review followed by the demonstrator’s feedback. Results from these three groups of students indicated the usefulness of the various cycles of feedback. Although we were unable to show any significance difference between the different treatments to the final grades of their reports, a number of key areas of need in the area of scientific report writing were identified. The exercise sets the stage for a longer term study and has provided a means to sort out those very week ones who are in need of further attention at an early and critical stage of their university life

Framing of 1Malaysia Development Berhad (1MDB) financial scandal by english and chinese newspapers published in Malaysia

The study compared how the 1Malaysia Development Berhad (1MDB) financial scandal was framed in English and Chinese online newspapers published in Malaysia. Content analysis was conducted for 200 articles for two English newspapers (The Star, 50; Malaysiakini English, 50) and two Chinese newspapers (Sin Chew Daily, 50; Malaysiakini Chinese, 50). The four newspapers were similar in the reliance on episodic framing and government sources of information, and the valence of the articles. Government sources is the opinion leader in 1MDB events but space is given to the voices of the opposition, foreign entities and the public. The English newspapers and Malaysiakini Chinese have more articles with a positive valence (46%-56%) in favour of investigations to resolve the financial corruption case and about 31% of the articles had a negative valence. However, Sin Chew Daily is more critical of the investigations than the other three newspapers. There are significant differences among the newspapers in frame dimensions of news headlines. The responsibility frame is used in close to 80% of the 1MDB articles in the Chinese newspapers but only in 40%-50% of the 1MDB articles in the English newspapers. Instead the English newspapers highlight the economic consequences of 1MDB and the conflict between individuals and groups, as well as contradictions between rumour and fact. The findings suggest that framing of controversial high-profile financial corruption case may differ due to the readership of the English and Chinese newspapers

Human Papillomavirus Infection and Cervical Cancer: Epidemiology, Screening, and Vaccination-Review of Current Perspectives

https://www.hindawi.com/journals/jo/2019/3257939/Viral infections contribute as a cause of 15–20% of all human cancers. Infection by oncogenic viruses can promote different stages of carcinogenesis. Among many types of HPV, around 15 are linked to cancer. In spite of effective screening methods, cervical cancer continues to be a major public health problem. There are wide differences in cervical cancer incidence and mortality by geographic region. In addition, the age-specific HPV prevalence varies widely across different populations and showed two peaks of HPV positivity in younger and older women. There have been many studies worldwide on the epidemiology of HPV infection and oncogenic properties due to different HPV genotypes. However, there are still many countries where the population-based prevalence has not yet been identified. Moreover, cervical cancer screening strategies are different between countries. Organized cervical screening programs are potentially more effective than opportunistic screening programs. Nevertheless, screening programs have consistently been associated with a reduction in cervical cancer incidence and mortality. Developed countries have achieved such reduced incidence and mortality from cervical cancer over the past 40 years. This is largely due to the implementation of organized cytological screening and vaccination programs. HPV vaccines are very effective at preventing infection and diseases related to the vaccine-specific genotypes in women with no evidence of past or current HPV infection. In spite of the successful implementation of the HPV vaccination program in many countries all over the world, problems related to HPV prevention and treatment of the related diseases will continue to persist in developing and underdeveloped countries

Enhanced annealing of mismatched oligonucleotides using a novel melting curve assay allows efficient in vitro discrimination and restriction of a single nucleotide polymorphism

<p>Abstract</p> <p>Background</p> <p>Many SNP discrimination strategies employ natural restriction endonucleases to discriminate between allelic states. However, SNPs are often not associated with a restriction site and therefore, a number of attempts have been made to generate sequence-adaptable restriction endonucleases. In this study, a simple, sequence-adaptable SNP discrimination mechanism between a 'wild-type' and 'mutant' template is demonstrated. This model differs from other artificial restriction endonuclease models as <it>cis- </it>rather than <it>trans-</it>orientated regions of single stranded DNA were generated and cleaved, and therefore, overcomes potential issues of either inefficient or non-specific binding when only a single variant is targeted.</p> <p>Results</p> <p>A series of mismatch 'bubbles' that spanned 0-5-bp surrounding a point mutation was generated and analysed for sensitivity to S1 nuclease. In this model, generation of oligonucleotide-mediated ssDNA mismatch 'bubbles' in the presence of S1 nuclease resulted in the selective degradation of the mutant template while maintaining wild-type template integrity. Increasing the size of the mismatch increased the rate of mutant sequence degradation, until a threshold above which discrimination was lost and the wild-type sequence was degraded. This level of fine discrimination was possible due to the development of a novel high-resolution melting curve assay to empirically determine changes in Tm (~5.0°C per base-pair mismatch) and to optimise annealing conditions (~18.38°C below Tm) of the mismatched oligonucleotide sets.</p> <p>Conclusions</p> <p>The <it>in vitro </it>'cleavage bubble' model presented is sequence-adaptable as determined by the binding oligonucleotide, and hence, has the potential to be tailored to discriminate between any two or more SNPs. Furthermore, the demonstrated fluorometric assay has broad application potential, offering a rapid, sensitive and high-throughput means to determine Tm and annealing rates as an alternative to conventional hybridisation detection strategies.</p

2021 Asian Pacific Society of Cardiology Consensus Recommendations on the Use of P2Y12 Receptor Antagonists in the Asia-Pacific Region: Special Populations

Advanced age, diabetes, and chronic kidney disease not only increase the risk for ischaemic events in chronic coronary syndromes (CCS) but also confer a high bleeding risk during antiplatelet therapy. These special populations may warrant modification of therapy, especially among Asians, who have displayed characteristics that are clinically distinct from Western patients. Previous guidance has been provided regarding the classification of high-risk CCS and the use of newer-generation P2Y12 inhibitors (i.e. ticagrelor and prasugrel) after acute coronary syndromes (ACS) in Asia. The authors summarise evidence on the use of these P2Y12 inhibitors during the transition from ACS to CCS and among special populations. Specifically, they present recommendations on the roles of standard dual antiplatelet therapy, shortened dual antiplatelet therapy and single antiplatelet therapy among patients with coronary artery disease, who are either transitioning from ACS to CCS; elderly; or with chronic kidney disease, diabetes, multivessel coronary artery disease and bleeding events during therapy

No Reliable Association between Runs of Homozygosity and Schizophrenia in a Well-Powered Replication Study

It is well known that inbreeding increases the risk of recessive monogenic diseases, but it is less certain whether it contributes to the etiology of complex diseases such as schizophrenia. One way to estimate the effects of inbreeding is to examine the association between disease diagnosis and genome-wide autozygosity estimated using runs of homozygosity (ROH) in genome-wide single nucleotide polymorphism arrays. Using data for schizophrenia from the Psychiatric Genomics Consortium (n = 21,868), Keller et al. (2012) estimated that the odds of developing schizophrenia increased by approximately 17% for every additional percent of the genome that is autozygous (β = 16.1, CI(β) = [6.93, 25.7], Z = 3.44, p = 0.0006). Here we describe replication results from 22 independent schizophrenia case-control datasets from the Psychiatric Genomics Consortium (n = 39,830). Using the same ROH calling thresholds and procedures as Keller et al. (2012), we were unable to replicate the significant association between ROH burden and schizophrenia in the independent PGC phase II data, although the effect was in the predicted direction, and the combined (original + replication) dataset yielded an attenuated but significant relationship between Froh and schizophrenia (β = 4.86,CI(β) = [0.90,8.83],Z = 2.40,p = 0.02). Since Keller et al. (2012), several studies reported inconsistent association of ROH burden with complex traits, particularly in case-control data. These conflicting results might suggest that the effects of autozygosity are confounded by various factors, such as socioeconomic status, education, urbanicity, and religiosity, which may be associated with both real inbreeding and the outcome measures of interest