Reporting and Assessing the Quality of Diagnostic Accuracy Studies for Cervical Cancer Screening and Management.

ObjectiveWe adapted the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool for studies of cervical cancer screening and management and used the adapted tool to evaluate the quality of studies included in a systematic review supporting the 2019 Risk-Based Management Consensus Guidelines.MethodsWe evaluated the quality of all studies included in our systematic review for postcolposcopy (n = 5) and posttreatment (n = 23) surveillance using QUADAS-2 criteria. Subsequently, we adapted signaling questions to indications of cervical cancer screening and management. An iterative process was carried out to evaluate interrater agreement between 2 study authors (M.A.C. and N.W.). Discrepant ratings were discussed, and criteria were adapted accordingly. We also evaluated the influence of study quality on risk estimates and between study variation using stratified subgroup meta-analyses.ResultsTwelve signaling questions for bias assessment that were adapted to or newly developed for cervical cancer screening and management are described here. Interrater agreement on bias assessment increased from 70% to 83% during the adaptation process. Detailed assessment of bias and applicability showed that all studies on postcolposcopy management and 90% of studies on posttreatment management had high risk of bias in at least 1 domain. Most commonly, high risk of bias was observed for the patient selection domain, indicating the heterogeneity of study designs and clinical practice in reported studies.ConclusionsThe adapted QUADAS-2 will have broad application for researchers, evidence evaluators, and journals who are interested in designing, conducting, evaluating, and publishing studies for cervical cancer screening and management

Wesson's IMT with a Weylian bulk

The foundations of Wesson's induced matter theory are analyzed. It is shown that the 5D empty bulk must be regarded rather as a Weylian space than as a Riemannian one.The framework of a Weyl-Dirac version of Wesson's theory is elaborated and discussed. The bulk possesses in addition to the metric tensor a Weylian connection vector as well Dirac's gauge function; there are no sources (mass, current) in the bulk. On the 4D brane one obtains a geometrically based unified theory of gravitation and electromagnetism with mass, currents and equations induced by the 5D bulkComment: 29 page

Position-momentum local realism violation of the Hardy type

We show that it is, in principle, possible to perform local realism violating experiments of the Hardy type in which only position and momentum measurements are made on two particles emanating from a common source. In the optical domain, homodyne detection of the in-phase and out-of-phase amplitude components of an electromagnetic field is analogous to position and momentum measurement. Hence, local realism violations of the Hardy type are possible in optical systems employing only homodyne detection.Comment: 10 pages, no figures, to be published in Physical Review

Creation of fundamental particles in Wesson's IMT

Fundamental particles, regarded as the constituents of quarks and leptons, are described classicaly in the framework of the Weyl-Dirac version of Wesson's Induced Matter Theory. There are neutral particles and particles having charge Q=+/-(1/3e). The particles appear on the 4D brane, our universe, and are filled with a substance induced by the 5D bulk. This substace is taken to have mass density, charge density, pressure and is characterized by the prematter eq. of state P+\rho=0. The interior is separated from the surrounding vacuum by a boundary surface where the 4D metric tensor satisfies an a'la Schwarzschild condition. Outside of the boundary holds the Schwarzschild, or the Reissner-Nordstroem Metric, while the particles are characterized by mass, radius, charge.Comment: 29 pages. Submitted for publication in the Gen. Rel. and Grav. Journa

The efficacy and safety of Tipapkinogen Sovacivec therapeutic HPV vaccine in cervical intraepithelial neoplasia grades 2 and 3 : Randomized controlled phase II trial with 2.5 years of follow-up

Background. While prophylactic human papillomavirus (HPV) vaccination exists, women are still developing cervical intraepithelial neoplasia (CIN) grade 2 or 3 for which an immunotherapeutic, non-surgical, approach may be effective. The primary aim was to assess the efficacy of tipapkinogen sovacivec (TS) vaccine in achieving histologic resolution of CIN2/3 associated with high risk (HR) HPV types. Methods. Women 18 years and older who had confirmed CIN2/3 were enrolled in a randomized, double blind, placebo-controlled phase II trial and assigned to drug in a 2:1 ratio (vaccine:placebo). The primary endpoint occurred at month 6 when the excisional therapy was performed; cytology and HR HPV typing were performed at months 3, 6 and every six months through month 30. The safety population included all patients who received at least one dose of study drug. Results. Of the 129 women randomized to vaccine and 63 to placebo, complete resolution was significantly higher in the vaccine group than placebo for CIN 2/3 regardless of the 13 HR HPV types assayed (24% vs. 10%, p <0.05); as well as for only CIN 3 also regardless of HR HPV type (21% vs. 0%, p <0.01). Irrespective of baseline HPV infection, viral DNA clearance was higher in the vaccine group compared to placebo (p <0.01). The vaccine was well tolerated with the most common adverse events being injection site reactions. Conclusions. The TS vaccine provides histologic clearance of CIN 2/3 irrespective of HR HPV type in one third of subjects and is generally safe through 30 months. (C) 2019 The Authors. Published by Elsevier Inc.Peer reviewe

Collapse to Black Holes in Brans-Dicke Theory: I. Horizon Boundary Conditions for Dynamical Spacetimes

We present a new numerical code that evolves a spherically symmetric configuration of collisionless matter in the Brans-Dicke theory of gravitation. In this theory the spacetime is dynamical even in spherical symmetry, where it can contain gravitational radiation. Our code is capable of accurately tracking collapse to a black hole in a dynamical spacetime arbitrarily far into the future, without encountering either coordinate pathologies or spacetime singularities. This is accomplished by truncating the spacetime at a spherical surface inside the apparent horizon, and subsequently solving the evolution and constraint equations only in the exterior region. We use our code to address a number of long-standing theoretical questions about collapse to black holes in Brans-Dicke theory.Comment: 46 pages including figures, uuencoded gz-compressed postscript, Submitted to Phys Rev

Quantum Kinetic Theory I: A Quantum Kinetic Master Equation for Condensation of a weakly interacting Bose gas without a trapping potential

A Quantum Kinetic Master Equation (QKME) for bosonic atoms is formulated. It is a quantum stochastic equation for the kinetics of a dilute quantum Bose gas, and describes the behavior and formation of Bose condensation. The key assumption in deriving the QKME is a Markov approximation for the atomic collision terms. In the present paper the basic structure of the theory is developed, and approximations are stated and justified to delineate the region of validity of the theory. Limiting cases of the QKME include the Quantum Boltzmann master equation and the Uehling-Uhlenbeck equation, as well as an equation analogous to the Gross-Pitaevskii equation.Comment: 37 pages, 4 figure

The unexpected resurgence of Weyl geometry in late 20-th century physics

Weyl's original scale geometry of 1918 ("purely infinitesimal geometry") was withdrawn by its author from physical theorizing in the early 1920s. It had a comeback in the last third of the 20th century in different contexts: scalar tensor theories of gravity, foundations of gravity, foundations of quantum mechanics, elementary particle physics, and cosmology. It seems that Weyl geometry continues to offer an open research potential for the foundations of physics even after the turn to the new millennium.Comment: Completely rewritten conference paper 'Beyond Einstein', Mainz Sep 2008. Preprint ELHC (Epistemology of the LHC) 2017-02, 92 pages, 1 figur