How protective is cervical cancer screening against cervical cancer mortality in developing countries? The Colombian case

<p>Abstract</p> <p>Background</p> <p>Cervical cancer is one of the top causes of cancer morbidity and mortality in Colombia despite the existence of a national preventive program. Screening coverage with cervical cytology does not explain the lack of success of the program in reducing incidence and mortality rates by cervical cancer. To address this problem an ecological analysis, at department level, was carried out in Colombia to assess the relationship between cervical screening characteristics and cervical cancer mortality rates.</p> <p>Methods</p> <p>Mortality rates by cervical cancer were estimated at the department level for the period 2000-2005. Levels of mortality rates were compared to cervical screening coverage and other characteristics of the program. A Poisson regression was used to estimate the effect of different dimensions of program performance on mortality by cervical cancer.</p> <p>Results</p> <p>Screening coverage ranged from 28.7% to 65.6% by department but increases on this variable were not related to decreases in mortality rates. A significant reduction in mortality was found in departments where a higher proportion of women looked for medical advice when abnormal findings were reported in Pap smears. Geographic areas where a higher proportion of women lack health insurance had higher rates of mortality by cervical cancer.</p> <p>Conclusions</p> <p>These results suggest that coverage is not adequate to prevent mortality due to cervical cancer if women with abnormal results are not provided with adequate follow up and treatment. The role of different dimensions of health care such as insurance coverage, quality of care, and barriers for accessing health care needs to be evaluated and addressed in future studies.</p

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Clustering of Necropsy-Confirmed Porcine Cysticercosis Surrounding Taenia solium Tapeworm Carriers in Peru

The pork tapeworm, Taenia solium, is among the leading causes of preventable epilepsy in the world and is common in rural areas of developing countries where sanitation is limited and pigs have access to human feces. Prior studies in rural villages of Peru have observed clusters of T. solium cysticercosis among pigs that live near human tapeworm carriers. Such spatial analyses, however, have been limited by incomplete participation and substandard diagnostic tests. In this study, we evaluated the association between necropsy-confirmed cysticercosis in pigs and their distance to T. solium tapeworm carriers in six villages in northern Peru. A total of six (1.4%) tapeworm carriers were detected using copro-antigen enzyme-linked immunosorbent assay and seven of 10 (70%) pigs belonging to the tapeworm carriers were found with viable cyst infection on necropsy. This was significantly greater than the prevalence of viable cyst infection among pigs living \u3c 500 m (11%) and \u3e 500 m (0.5%) from a tapeworm carrier (P \u3c 0.001 for distance trend). Similar statistically significant prevalence gradients were observed after adjustment for possible confounders and for other pig-level outcomes including infection with \u3e 10 viable cysts, degenerated cyst infection, and serological outcomes. This investigation confirms that porcine cysticercosis clusters strongly around tapeworm carriers in endemic rural regions of northern Peru and supports interventions that target these hotspots

Thermal architecture for the QUBIC cryogenic receiver

QUBIC, the QU Bolometric Interferometer for Cosmology, is a novel forthcoming instrument to measure the B-mode polarization anisotropy of the Cosmic Microwave Background. The detection of the B-mode signal will be extremely challenging; QUBIC has been designed to address this with a novel approach, namely bolometric interferometry. The receiver cryostat is exceptionally large and cools complex optical and detector stages to 40 K, 4 K, 1 K and 350 mK using two pulse tube coolers, a novel 4He sorption cooler and a double-stage 3He/4He sorption cooler. We discuss the thermal and mechanical design of the cryostat, modelling and thermal analysis, and laboratory cryogenic testing

Performance of NbSi transition-edge sensors readout with a 128 MUX factor for the QUBIC experiment

QUBIC (the Q and U Bolometric Interferometer for Cosmology) is a ground-based experiment which seeks to improve the current constraints on the amplitude of primordial gravitational waves. It exploits the unique technique, among Cosmic Microwave Background experiments, of bolometric interferometry, combining together the sensitivity of bolometric detectors with the control of systematic effects typical of interferometers. QUBIC will perform sky observations in polarization, in two frequency bands centered at 150 and 220 GHz, with two kilo-pixel focal plane arrays of NbSi Transition-Edge Sensors (TES) cooled down to 350 mK. A subset of the QUBIC instrument, the so called QUBIC Technological Demonstrator (TD), with a reduced number of detectors with respect to the full instrument, will be deployed and commissioned before the end of 2018. The voltage-biased TES are read out with Time Domain Multiplexing and an unprecedented multiplexing (MUX) factor equal to 128. This MUX factor is reached with two-stage multiplexing: a traditional one exploiting Superconducting QUantum Interference Devices (SQUIDs) at 1K and a novel SiGe Application-Specific Integrated Circuit (ASIC) at 60 K. The former provides a MUX factor of 32, while the latter provides a further 4. Each TES array is composed of 256 detectors and read out with four modules of 32 SQUIDs and two ASICs. A custom software synchronizes and manages the readout and detector operation, while the TES are sampled at 780 Hz (100kHz/128 MUX rate). In this work we present the experimental characterization of the QUBIC TES arrays and their multiplexing readout chain, including time constant, critical temperature, and noise properties

QUBIC: the Q and U bolometric interferometer for cosmology

QUBIC, the Q & U Bolometric Interferometer for Cosmology, is a novel ground-based instrument that has been designed to measure the extremely faint B-mode polarisation anisotropy of the cosmic microwave background at intermediate angular scales (multipoles o

Simulations and performance of the QUBIC optical beam combiner

QUBIC, the Q & U Bolometric Interferometer for Cosmology, is a novel ground-based instrument that aims to measure the extremely faint B-mode polarisation anisotropy of the cosmic microwave background at intermediate angular scales (multipoles o

Performance of NbSi transition-edge sensors readout with a 128 MUX factor for the QUBIC experiment

QUBIC (the Q&U Bolometric Interferometer for Cosmology) is a ground-based experiment which seeks to improve the current constraints on the amplitude of primordial gravitational waves. It exploits the unique technique, among Cosmic Microwave Background experiments, of bolometric interferometry, combining together the sensitivity of bolometric detectors with the control of systematic effects typical of interferometers. QUBIC will perform sky observations in polarization, in two frequency bands centered at 150 and 220 GHz, with two kilopixel focal plane arrays of NbSi Transition-Edge Sensors (TES) cooled down to 350 mK. A subset of the QUBIC instrument, the so called QUBIC Technological Demonstrator (TD), with a reduced number of detectors with respect to the full instrument, will be deployed and commissioned before the end of 2018. The voltage-biased TES are read out with Time Domain Multiplexing and an unprecedented multiplexing (MUX) factor equal to 128. This MUX factor is reached with two-stage multiplexing: a traditional one exploiting Superconducting QUantum Interference Devices (SQUIDs) at 1 K and a novel SiGe Application-Specific Integrated Circuit (ASIC) at 60 K. The former provides a MUX factor of 32, while the latter provides a further 4. Each TES array is composed of 256 detectors and read out with four modules of 32 SQUIDs and two ASICs. A custom software synchronizes and manages the readout and detector operation, while the TES are sampled at 780 Hz (100kHz/128 MUX rate). In this work we present the experimental characterization of the QUBIC TES arrays and their multiplexing readout chain, including time constant, critical temperature, and noise properties