Establishing an Anal Neoplasia Screening Service for a Unique HIV Positive Patient Population in a Small City: Lessons Learned

Mortality from human papillomavirus (HPV) mediated squamous carcinoma of the uterine cervix has dramatically decreased in recent decades as a result of broad scale population screening for early detection of cervical cancer precursors. Concomitantly, deaths associated with HPV related carcinomas of the anus have oppositely trended upward. At this time, there are no national guidelines for anal screening. We herein report our experience with establishing an anal cytology screening program for HIV infected patients in a small city. The HIV positive population studied is unique in that 75% of patients had undetectable viral loads by PCR with average CD4+ cell/uL counts of 550. In addition 40% are adult females. 45% of patients in this relatively healthy HIV+ population were discovered to have atypical squamous cells or worse on entry into screening, and 20% of patients were ultimately shown on high resolution anoscopic biopsy histology to harbor high grade squamous intraepithelial lesions (AIN 2/3). Meaningful small scale anal cytology screening programs are possible with clinical and anoscopic collaborations. It seems possible that this simple and inexpensive test may prevent morbidity and mortality from HPV mediated anal carcinoma

Risk Factors for Cervical Precancer and Cancer in HIV-Infected, HPV-Positive Rwandan Women

Background: Although cervical cancer is an AIDS-defining condition, infection with human immunodeficiency virus (HIV) may only modestly increase the risk of cervical cancer. There is a paucity of information regarding factors that influence the natural history of human papillomavirus (HPV) in HIV-infected women. We examined factors associated with cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) in Rwandan women infected with both HIV and HPV (HIV+/HPV+).Methods: In 2005, 710 HIV+ Rwandan women ≥25 years enrolled in an observational cohort study; 476 (67%) tested HPV+. Each woman provided sociodemographic data, CD4 count, a cervical cytology specimen and cervicovaginal lavage (CVL), which was tested for >40 HPV genotypes by MY09/MY11 PCR assay. Logistic regression models calculated odds ratios (OR) and 95% confidence intervals (CI) of associations of potential risk factors for CIN3+ among HIV+/HPV+ women.Results: Of the 476 HIV+/HPV+ women 42 (8.8%) were diagnosed with CIN3+. Factors associated with CIN3+ included ≥7 (vs. 0-2) pregnancies, malarial infection in the previous six months (vs. never), and ≥7 (vs. 0-2) lifetime sexual partners. Compared to women infected by non-HPV16 carcinogenic HPV genotypes, HPV16 infection was positively associated and non-carcinogenic HPV infection was inversely associated with CIN3+. CD4 count was significantly associated with CIN3+ only in analyses of women with non-HPV16 carcinogenic HPV (OR = 0.62 per 100 cells/mm3, CI = 0.40-0.97).Conclusions: In this HIV+/HPV+ population, lower CD4 was significantly associated with CIN3+ only in women infected with carcinogenic non-HPV16. We found a trend for higher risk of CIN3+ in HIV+ women reporting recent malarial infection; this association should be investigated in a larger group of HIV+/HPV+ women.</p

Ursinus College Alumni Journal, August 1963

The President writes • The uses and limitations of words • Commencement 1963 • 3,032 pledge $509,081; 2,809 contribute$192,568 • Loyalty Fund committee reorganized • Joseph J. Lynch, college steward • A description of the new dining hall • Chemistry changes • NSF grants for bio profs • Teaching awards • Pilot project: Physics chemistry mathematics • The not-so-ugly American • Best track season in Ursinus history • Double your dollars • Things are looking up • Preliminary thoughts on wills • Reading, writing, and Mazurkiewicz • The augmented Roman alphabet • Edwin C. Myers, \u2764 and Frederic W. Yocum, Jr. \u2764 • Eugene J. Bradford, \u2736 • Robert A. Petersen, \u2760 • Sue Harman, \u2765 • Results of the 1963 Loyalty Fund campaign • The leaders • Contributors to the 1963 Loyalty Fund • Ursinus alumni at Methacton High School • Class notes • Weddings • Births • Necrology • Our role as alumnihttps://digitalcommons.ursinus.edu/alumnijournal/1077/thumbnail.jp

Exploring constituency-level estimates for the 2017 British general election

Most opinion polls conducted during British general election campaigns report on each party’s estimated national vote share. Although of considerable interest, these data do not put the spotlight on the marginal seats, the constituencies targeted by the parties for intensive canvassing; these are where the contest for a majority in the House of Commons is won and lost. There have been some polls covering those constituencies as a whole, but very few of individual constituencies so there was very little reporting of the outcome for each party in those individual constituencies. That changed with the 2017 general election, when three analysts published estimates on the internet of each party’s vote share separately for each constituency and with those data predicted which party would win each seat. This paper explores the veracity of those estimates, finding that although in general terms they accurately represented the relative position of each constituency in the share of each party’s votes, nevertheless their estimates of which marginal seats would be won by each were not as accurate. The implications of such polls, especially as their predictive ability is improved, is discussed

1936 The Freshman, vol. 3, no. 10

The Freshman was a weekly, student newsletter issued on Mondays throughout the academic year. The newsletter included calendar notices, coverage of campus social events, lectures, and athletic teams. The intent of the publication was to create unity, a sense of community, and class spirit among first year students. Coverage includes the story of first year student John Stinchfield being rescued by his roommate Frank Chadwick after falling through the ice while ice skating

1936 The Freshman, vol. 3, no. 11

The Freshman was a weekly, student newsletter issued on Mondays throughout the academic year. The newsletter included calendar notices, coverage of campus social events, lectures, and athletic teams. The intent of the publication was to create unity, a sense of community, and class spirit among first year students. Coverage in this issue includes the search for Olga W. Ashby, wife of Professor Stanley R. Ashby, who went missing on January 27

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study)

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, -0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types

Risk Factors for Cervical Precancer and Cancer in HIV-Infected, HPV-Positive Rwandan Women

Although cervical cancer is an AIDS-defining condition, infection with human immunodeficiency virus (HIV) may only modestly increase the risk of cervical cancer. There is a paucity of information regarding factors that influence the natural history of human papillomavirus (HPV) in HIV-infected women. We examined factors associated with cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) in Rwandan women infected with both HIV and HPV (HIV+/HPV+).In 2005, 710 HIV+ Rwandan women ≥25 years enrolled in an observational cohort study; 476 (67%) tested HPV+. Each woman provided sociodemographic data, CD4 count, a cervical cytology specimen and cervicovaginal lavage (CVL), which was tested for >40 HPV genotypes by MY09/MY11 PCR assay. Logistic regression models calculated odds ratios (OR) and 95% confidence intervals (CI) of associations of potential risk factors for CIN3+ among HIV+/HPV+ women.Of the 476 HIV+/HPV+ women 42 (8.8%) were diagnosed with CIN3+. Factors associated with CIN3+ included ≥7 (vs. 0-2) pregnancies, malarial infection in the previous six months (vs. never), and ≥7 (vs. 0-2) lifetime sexual partners. Compared to women infected by non-HPV16 carcinogenic HPV genotypes, HPV16 infection was positively associated and non-carcinogenic HPV infection was inversely associated with CIN3+. CD4 count was significantly associated with CIN3+ only in analyses of women with non-HPV16 carcinogenic HPV (OR = 0.62 per 100 cells/mm(3), CI = 0.40-0.97).In this HIV+/HPV+ population, lower CD4 was significantly associated with CIN3+ only in women infected with carcinogenic non-HPV16. We found a trend for higher risk of CIN3+ in HIV+ women reporting recent malarial infection; this association should be investigated in a larger group of HIV+/HPV+ women

Neigbourhood ethnic composition and social participation of young people in England

We analyse how neighbourhood ethnic diversity and segregation affect adolescents' social participation in England. We distinguish between participation in `purposeful activities' - such as sports and volunteering - and hanging around with friends. We suggest a novel identification strategy to address the problem of endogeneity of ethnic diversity and segregation. We find that ethnic diversity decreases hanging around, while ethnic segregation increases it. No effects are found on participation in purposeful activities

Teaching converged media through news coverage of the 2008 US Presidential election and inauguration

This commentary provides insights into how the journalism faculty at Howard University in Washington, DC tested the efficacy of its approach to teaching converged media techniques during the US presidential election on November 4, 2008 and the Inauguration of President Barack Obama on January 20, 2009. Coverage of both events were conducted by students supervised by faculty mentors