Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis

Background More than 10 years have elapsed since human papillomavirus (HPV) vaccination was implemented. We did a systematic review and meta-analysis of the population-level impact of vaccinating girls and women against human papillomavirus on HPV infections, anogenital wart diagnoses, and cervical intraepithelial neoplasia grade 2+ (CIN2+)to summarise the most recent evidence about the effectiveness of HPV vaccines in real-world settings and to quantify the impact of multiple age-cohort vaccination.Methods In this updated systematic review and meta-analysis, we used the same search strategy as in our previous paper. We searched MEDLINE and Embase for studies published between Feb 1, 2014, and Oct 11, 2018. Studies were eligible if they compared the frequency (prevalence or incidence) of at least one HPV-related endpoint (genital HPV infections, anogenital wart diagnoses, or histologically confirmed CIN2+) between pre-vaccination and post-vaccination periods among the general population and if they used the same population sources and recruitment methods before and after vaccination. Our primary assessment was the relative risk (RR) comparing the frequency (prevalence or incidence) of HPV-related endpoints between the pre-vaccination and post-vaccination periods. We stratified all analyses by sex, age, and years since introduction of HPV vaccination. We used random-effects models to estimate pooled relative risks.Findings We identified 1702 potentially eligible articles for this systematic review and meta-analysis, and included 65 articles in 14 high-income countries: 23 for HPV infection, 29 for anogenital warts, and 13 for CIN2+.After 5\u20138 years of vaccination, the prevalence of HPV 16 and 18 decreased significantly by 83% (RR 0\ub717, 95% CI 0\ub711\u20130\ub725) among girls aged 13\u201319 years, and decreased significantly by 66% (RR 0\ub734, 95% CI 0\ub723\u20130\ub749) among women aged 20\u201324 years. The prevalence of HPV 31, 33, and 45 decreased significantly by 54% (RR 0\ub746, 95% CI 0\ub733\u20130\ub766) among girls aged 13\u201319 years. Anogenital wart diagnoses decreased significantly by 67% (RR 0\ub733, 95% CI 0\ub724\u20130\ub746) among girls aged 15\u201319 years, decreased significantly by 54% (RR 0\ub746, 95% CI 0.36\u20130.60) among women aged 20\u201324 years, and decreased significantly by 31% (RR 0\ub769, 95% CI 0\ub753\u20130\ub789) among women aged 25\u201329 years. Among boys aged 15\u201319 years anogenital wart diagnoses decreased significantly by 48% (RR 0\ub752, 95% CI 0\ub737\u20130\ub775) and among men aged 20\u201324 years they decreased significantly by 32% (RR 0\ub768, 95% CI 0\ub747\u20130\ub798). After 5\u20139 years of vaccination, CIN2+ decreased significantly by 51% (RR 0\ub749, 95% CI 0\ub742\u20130\ub758) among screened girls aged 15\u201319 years and decreased significantly by 31% (RR 0\ub769, 95% CI 0\ub757\u20130\ub784) among women aged 20\u201324 years.Interpretation This updated systematic review and meta-analysis includes data from 60 million individuals and up to 8 years of post-vaccination follow-up. Our results show compelling evidence of the substantial impact of HPV vaccination programmes on HPV infections and CIN2+ among girls and women, and on anogenital warts diagnoses among girls, women, boys, and men. Additionally, programmes with multi-cohort vaccination and high vaccination coverage had a greater direct impact and herd effects

Preliminary safety and efficacy of first-line pertuzumab combined with trastuzumab and taxane therapy for HER2-positive locally recurrent or metastatic breast cancer (PERUSE).

BACKGROUND: Pertuzumab combined with trastuzumab and docetaxel is the standard first-line therapy for HER2-positive metastatic breast cancer, based on results from the phase III CLEOPATRA trial. PERUSE was designed to assess the safety and efficacy of investigator-selected taxane with pertuzumab and trastuzumab in this setting. PATIENTS AND METHODS: In the ongoing multicentre single-arm phase IIIb PERUSE study, patients with inoperable HER2-positive advanced breast cancer (locally recurrent/metastatic) (LR/MBC) and no prior systemic therapy for LR/MBC (except endocrine therapy) received docetaxel, paclitaxel or nab-paclitaxel with trastuzumab [8\u2009mg/kg loading dose, then 6\u2009mg/kg every 3\u2009weeks (q3w)] and pertuzumab (840\u2009mg loading dose, then 420\u2009mg q3w) until disease progression or unacceptable toxicity. The primary end point was safety. Secondary end points included overall response rate (ORR) and progression-free survival (PFS). RESULTS: Overall, 1436 patients received at least one treatment dose (initially docetaxel in 775 patients, paclitaxel in 589, nab-paclitaxel in 65; 7 discontinued before starting taxane). Median age was 54\u2009years; 29% had received prior trastuzumab. Median treatment duration was 16\u2009months for pertuzumab and trastuzumab and 4\u2009months for taxane. Compared with docetaxel-containing therapy, paclitaxel-containing therapy was associated with more neuropathy (all-grade peripheral neuropathy 31% versus 16%) but less febrile neutropenia (1% versus 11%) and mucositis (14% versus 25%). At this preliminary analysis (52 months' median follow-up), median PFS was 20.6 [95% confidence interval (CI) 18.9-22.7] months overall (19.6, 23.0 and 18.1\u2009months with docetaxel, paclitaxel and nab-paclitaxel, respectively). ORR was 80% (95% CI 78%-82%) overall (docetaxel 79%, paclitaxel 83%, nab-paclitaxel 77%). CONCLUSIONS: Preliminary findings from PERUSE suggest that the safety and efficacy of first-line pertuzumab, trastuzumab and taxane for HER2-positive LR/MBC are consistent with results from CLEOPATRA. Paclitaxel appears to be a valid alternative taxane backbone to docetaxel, offering similar PFS and ORR with a predictable safety profile. CLINICALTRIALS.GOV: NCT01572038

Carbon-based catalysts: Synthesis and applications

This paper summarizes the main results obtained by the Fuel Combustion Group in three applications: (1) carbon-based catalysts for the selective catalytic reduction (SCR) process of NOx, (2) Pt and Pt–Ru catalysts for direct alcohol fuel cells, (3) carbon-supported catalysts for the electroreduction of CO2. Concerning the first aspect, low-cost catalysts able to work at lower temperatures have been prepared and compared with commercial catalysts; for the second one, new catalysts for methanol and ethanol electrochemical oxidation exhibiting current densities that are double those of the commercial ones have been developed; as regards the third one, carbon-supported catalysts for the electroreduction of CO2 based on Fe and Pd were synthesized and tested. Formic acid was obtained as the main product on all Fe/C electrodes

Electrocatalizadores para pilas de combustible de membrana de intercambio prot\uf3nico.

Electrocatalizadores para pilas de combustible de membrana de intercambio prot\uf3nico. Procedimiento de obtenci\uf3n de un material de carbono mesoporoso (SMC) que comprende: la adici\uf3n de s\uedlice coloidal a un precursor polim\ue9rico de carbono; el curado t\ue9rmico; el carbonizado del compuesto obtenido; lavado del compuesto carbonizado con \ue1cido fluorh\ueddrico (HF) o NaOH; y la oxidaci\uf3n del material lavado. Adem\ue1s la invenci\uf3n se refiere a un catalizador para pilas de combustible de electrolito polim\ue9rico basado en la utilizaci\uf3n del nuevo soporte carbonoso mesoporoso

Intestinal Lipid Metabolism Genes Regulated by miRNAs

MicroRNAs (miRNAs) crucial roles in translation repression and post-transcriptional adjustments contribute to regulate intestinal lipid metabolism. Even though their actions in different metabolic tissues have been elucidated, their intestinal activity is yet unclear. We aimed to investigate intestinal miRNA-regulated lipid metabolism-related genes, by creating an intestinal-specific Dicer1 knockout (Int-Dicer1 KO) mouse model, with a depletion of microRNAs in enterocytes. The levels of 83 cholesterol and lipoprotein metabolism-related genes were assessed in the intestinal mucosa of Int-Dicer1 KO and Wild Type C57BL/6 (WT) littermates mice at baseline and 2 h after an oral lipid challenge. Among the 18 genes selected for further validation, Hmgcs2, Acat1 and Olr1 were found to be strong candidates to be modulated by miRNAs in enterocytes and intestinal organoids. Moreover, we report that intestinal miRNAs contribute to the regulation of intestinal epithelial differentiation. Twenty-nine common miRNAs found in the intestines were analyzed for their potential to target any of the three candidate genes found and validated by miRNA-transfection assays in Caco-2 cells. MiR-31-5p, miR99b-5p, miR-200a-5p, miR-200b-5p and miR-425-5p are major regulators of these lipid metabolism-related genes. Our data provide new evidence on the potential of intestinal miRNAs as therapeutic targets in lipid metabolism-associated pathologies

Entomofauna asociada al cultivo de jamaica (Hibiscus sabdariffa L.) en el municipio de Chiautla de Tapia, Puebla

In Chiautla de Tapia, Puebla, samplings were carried out at two-week intervals in three cultivated lots with jamaica (Hibiscus sabdariffa L.) from June to September in 2007. The collections were made by means of an entomologic aspirator in a manual way and with beating sheets. Stems, knots, inter-knots, leaves (front and back) and flowers were revised to make an entomofauna diagnosis. A total of 1,856 specimens were collected, of which, were determined 17 species, comprised in 6 orders, 11 families and 19 genera; while 5 morphospecies were not determined. The insects plague that were found causing serious damages to the crop were: Atta mexicana, Sphenarium purpurascens, Melanoplus spp. and Aphis gossypii, and amongst the beneficial insects are San Miguel’s fly, Allograpta sp. (pollinator), Hippodamia convergens and Polister apachus (depredatory species).En Chiautla de Tapia, Puebla, mediante muestreos realizados cada 15 días de junio a septiembre del 2007, se efectuaron colectas en tres parcelas cultivadas con jamaica (Hibiscus sabdariffa L.), utilizando un aspirador entomológico manual y una red de golpeo. Se revisaron los tallos, nudos, entre nudos, hojas (haz y envés) y flores para hacer un diagnóstico de la entomofauna. Un total de 1,856 ejemplares fueron colectados, de los cuales se determinaron 17 especies, comprendidas en 6 órdenes, 11 familias y 19 géneros; mientras que 5 morfoespecies no fueron determinadas. Los insectos plaga que se encontraron ocasionando daños considerables al cultivo fueron: Atta mexicana, Sphenarium purpurascens, Melanoplus spp. y Aphis gossypii. Entre los insectos benéficos se encontró a la mosca de San Miguel, Allograpta sp (polinizadora), Hippodamia convergens y Polister apachus (especies depredadoras)