Pap Smear Readability on Google: An Analysis of Online Articles Regarding One of the Most Routine Medical Screening Tests

Background: The Papanicolaou smear (Pap smear, Pap test) is one of the most routine screening tests performed in medicine. The development and widespread use of this test has brought a considerable decrease in the incidence of cervical cancer. Unfortunately, this disease process continues to convey significant morbidity and mortality. These persistent phenomena may be the result of inadequate compliance with routine Pap smear screening, in which limited education is thought to play a role, particularly among ethnic minority groups. Methods: A Google search using the phrase “pap smear” was performed and the first fourteen web addresses were analyzed using four standardized readability indices: the Flesh-Kinkaid Grade Level, the Simple Measure of Gobbledygook, the Gunning Fog Index and the Automated Readability Index. The average grade level readability was then compared to the American Medical Association recommendation that health care information should be written at a 5th or 6th-grade reading level (i.e., ages 10-12 years). Results: The average grade-level readability values of the fourteen analyzed sites using the four aforementioned indices were 8.9, 8.8, 11.9, and 8.4, respectively. The mean readability of all four indices was 9.5. Conclusion: The grade-level readability of commonly accessed internet information regarding Pap smears is above the recommendation of the American Medical Association. Health care providers and website authors should be cognizant of this, as it may impact compliance. This is particularly important given that this routine healthcare test is recommended for nearly fifty percent of the world’s population at various points throughout their lifetime

Feasibility of Electrified Propulsion for Ultra-Efficient Commercial Aircraft Final Report

MIT, Aurora Flight Sciences, and USC have collaborated to assess the feasibility of electric, hybridelectric, and turbo-electric propulsion for ultra-efficient commercial transportation. The work has drawn on the team expertise in disciplines related to aircraft design, propulsion-airframe integration, electric machines and systems, engineering system design, and optimization. A parametric trade space analysis has been carried out to assess vehicle performance across a range of transport missions and propulsion architectures to establish how electrified propulsion systems scale. An optimization approach to vehicle conceptual design modeling was taken to enable rapid multidisciplinary design space exploration and sensitivity analysis. The results of the analysis indicate vehicle aero-propulsive integration benefits enabled by electrification are required to offset the increased weight and loss associated with the electric system and achieve enhanced performance; the report describes the conceptual configurations than can offer such enhancements. The main contribution of the present work is the definition of electric vehicle design attributes for potential efficiency improvements at different scales. Based on these results, key areas for future research are identified, and extensions to the trade space analysis suitable for higher fidelity electrified commercial aircraft design and analysis have been developed

State-Dependent Effects of Ventromedial Prefrontal Cortex Continuous Thetaburst Stimulation on Cocaine Cue Reactivity in Chronic Cocaine Users

Cue-induced craving is a significant barrier to obtaining abstinence from cocaine. Neuroimaging research has shown that cocaine cue exposure evokes elevated activity in a network of frontal-striatal brain regions involved in drug craving and drug seeking. Prior research from our laboratory has demonstrated that when targeted at the medial prefrontal cortex (mPFC), continuous theta burst stimulation (cTBS), an inhibitory form of non-invasive brain stimulation, can decrease drug cue-related activity in the striatum in cocaine users and alcohol users. However, it is known that there are individual differences in response to repetitive transcranial magnetic stimulation (rTMS), with some individuals being responders and others non-responders. There is some evidence that state-dependent effects influence response to rTMS, with baseline neural state predicting rTMS treatment outcomes. In this single-blind, active sham-controlled crossover study, we assess the striatum as a biomarker of treatment response by determining if baseline drug cue reactivity in the striatum influences striatal response to mPFC cTBS. The brain response to cocaine cues was measured in 19 cocaine-dependent individuals immediately before and after real and sham cTBS (110% resting motor threshold, 3600 total pulses). Group independent component analysis (ICA) revealed a prominent striatum network comprised of bilateral caudate, putamen, and nucleus accumbens, which was modulated by the cocaine cue reactivity task. Baseline drug cue reactivity in this striatal network was inversely related to change in striatum reactivity after real (vs. sham) cTBS treatment (ρ = -.79; p < .001; R2Adj = .58). Specifically, individuals with a high striatal response to cocaine cues at baseline had significantly attenuated striatal activity after real but not sham cTBS (t9 = -3.76; p ≤ .005). These data demonstrate that the effects of mPFC cTBS on the neural circuitry of craving are not uniform and may depend on an individual’s baseline frontal-striatal reactivity to cues. This underscores the importance of assessing individual variability as we develop brain stimulation treatments for addiction

Targeting quiescent leukemic stem cells using second generation autophagy inhibitors

In chronic myeloid leukemia (CML), tyrosine kinase inhibitor (TKI) treatment induces autophagy that promotes survival and TKI-resistance in leukemic stem cells (LSCs). In clinical studies hydroxychloroquine (HCQ), the only clinically approved autophagy inhibitor, does not consistently inhibit autophagy in cancer patients, so more potent autophagy inhibitors are needed. We generated a murine model of CML in which autophagic flux can be measured in bone marrow-located LSCs. In parallel, we use cell division tracing, phenotyping of primary CML cells, and a robust xenotransplantation model of human CML, to investigate the effect of Lys05, a highly potent lysosomotropic agent, and PIK-III, a selective inhibitor of VPS34, on the survival and function of LSCs. We demonstrate that long-term haematopoietic stem cells (LT-HSCs: Lin−Sca-1+c-kit+CD48−CD150+) isolated from leukemic mice have higher basal autophagy levels compared with non-leukemic LT-HSCs and more mature leukemic cells. Additionally, we present that while HCQ is ineffective, Lys05-mediated autophagy inhibition reduces LSCs quiescence and drives myeloid cell expansion. Furthermore, Lys05 and PIK-III reduced the number of primary CML LSCs and target xenografted LSCs when used in combination with TKI treatment, providing a strong rationale for clinical use of second generation autophagy inhibitors as a novel treatment for CML patients with LSC persistence

I read it on reddit: Exploring the role of online communities in the 2016 US elections news cycle

Reddit has developed into a significant platform for political discussion among Millennials. In this exploratory study, we examine subscription trends on three political sub-forums on Reddit during the 2016 US presidential elections: /The_Donald, /SandersForPresident, and /HillaryClinton. As a theoretical framework, we draw from work on online communities’ group identity and cohesion. Concretely, we investigate how subscription dynamics relate to positive, negative and neutral news events occurring during the election cycle. We classify news events using a sentiment analysis of event-related news headlines. We observe that users who supported Sanders displayed no consolidation of support for Clinton after she won the Democratic Party’s presidential nomination. Secondly, we show that negative news events affected Sanders and Clintons subscription trends negatively, while showing no effect for Donald Trump. This gives empirical credence to Trump’s controversial claim that he could “stand in the middle of 5th Avenue and shoot somebody and not lose any voters”. We offer a number of explanations for the observed phenomena: the nature of the content of the three subreddits, their cultural dynamics, and changing dynamics of partisanship. We posit that the ‘death of expertise’ expresses itself on Reddit as a switch in persuasion tactics from a policy-based to an emotions-based approach, and that group members’ agreement on policy proved a weak marker for online communities’ group identity and cohesion. We also claim that strong partisanship coupled with weak party affiliation among Millennials contributed to the low levels of Democratic support consolidation after Clinton won the nomination

Immunity status of adults and children against poliomyelitis virus type 1 strains CHAT and Sabin (LSc-2ab) in Germany

<p>Abstract</p> <p>Background</p> <p>In October 2007, the working group CEN/TC 216 of the European Committee for standardisation suggested that the Sabin oral poliovirus vaccine type 1 strain (LSc-2ab) presently used for virucidal tests should be replaced by another attenuated vaccine poliovirus type 1 strain, CHAT. Both strains were historically used as oral vaccines, but the Sabin type 1 strain was acknowledged to be more attenuated. In Germany, vaccination against poliomyelitis was introduced in 1962 using the oral polio vaccine (OPV) containing Sabin strain LSc-2ab. The vaccination schedule was changed from OPV to an inactivated polio vaccine (IPV) containing wild polio virus type 1 strain Mahoney in 1998. In the present study, we assessed potential differences in neutralising antibody titres to Sabin and CHAT in persons with a history of either OPV, IPV, or OPV with IPV booster.</p> <p>Methods</p> <p>Neutralisation poliovirus antibodies against CHAT and Sabin 1 were measured in sera of 41 adults vaccinated with OPV. Additionally, sera from 28 children less than 10 years of age and immunised with IPV only were analysed. The neutralisation assay against poliovirus was performed according to WHO guidelines.</p> <p>Results</p> <p>The neutralisation activity against CHAT in adults with OPV vaccination history was significantly lower than against Sabin poliovirus type 1 strains (Wilcoxon signed-rank test P < 0.025). In eight sera, the antibody titres measured against CHAT were less than 8, although the titre against Sabin 1 varied between 8 and 64. Following IPV booster, anti-CHAT antibodies increased rapidly in sera of CHAT-negative adults with OPV history. Sera from children with IPV history neutralised CHAT and Sabin 1 strains equally.</p> <p>Conclusion</p> <p>The lack of neutralising antibodies against the CHAT strain in persons vaccinated with OPV might be associated with an increased risk of reinfection with the CHAT polio virus type 1, and this implies a putative risk of transmission of the virus to polio-free communities. We strongly suggest that laboratory workers who were immunised with OPV receive a booster vaccination with IPV before handling CHAT in the laboratory.</p

OPV strains circulation in HIV infected infants after National Immunisation Days in Bangui, Central African Republic

<p>Abstract</p> <p>Background</p> <p>Humans are the only host of polioviruses, thus the prospects of global polio eradication look reasonable. However, individuals with immunodeficiencies were shown to excrete vaccine derived poliovirus for long periods of time which led to reluctance to prolong the vaccination campaign for fear of this end result. Therefore, we aimed to assess the duration of excretion of poliovirus after the 2001 National Immunization Days according to Human immunodeficiency virus status.</p> <p>Findings</p> <p>Fifty three children were enrolled. Sequential stool samples were collected in between National Immunisation Days rounds and then every month during one year. Children were classified into 2 groups: no immunodepression (n = 38), immunodepression (n = 15) according to CD4+ lymphocytes cells count. Thirteen poliovirus strains were isolated from 11 children: 5 Human immunodeficiency virus positive and 6 Human immunodeficiency virus negative. None of the children excreted poliovirus for more than 4 weeks. The restriction fragment length polymorphism analysis showed that all strains were of Sabin origin including a unique Polio Sabine Vaccine types 2 and 3 (S2/S3) recombinant.</p> <p>Conclusions</p> <p>From these findings we assume that Human immunodeficiency virus positive children are not a high risk population for long term poliovirus excretion. More powerful studies are needed to confirm our findings.</p

Gender differences in local and systemic reactions to inactivated influenza vaccine, established by a meta-analysis of fourteen independent studies

In order to determine whether there is a difference between genders in reported adverse reactions to inactivated influenza vaccine, a computerized database of serological studies was investigated. A standardized questionnaire was used to evaluate vaccine reactogenicity. A total of 1,800 vaccinees in 14 studies were analyzed separately for two age groups ( or = 60 years of age). Females reported significantly more local reactions than males. The pooled odds ratio for the outcome measure "any local reaction" was 0.32 (95% confidence interval, 0.26-0.40, significant) and 0.54 (95% Cl, 0.41-0.70, significant) for young and elderly adults, respectively. Similar results were obtained for the outcome measure "any systemic reaction." Previous exposure to influenza or influenza vaccine had no influence on reactogenicity. There were no gender differences in sero-responses. In conclusion, gender should be regarded as a predictor of reported reactions to influenza vaccine in both young and elderly adults and should be addressed in future study designs

A Biological Model for Influenza Transmission: Pandemic Planning Implications of Asymptomatic Infection and Immunity

Background: The clinical attack rate of influenza is influenced by prior immunity and mixing patterns in the host population, and also by the proportion of infections that are asymptomatic. This complexity makes it difficult to directly estimate R0 from the attack rate, contributing to uncertainty in epidemiological models to guide pandemic planning. We have modelled multiple wave outbreaks of influenza from different populations to allow for changing immunity and asymptomatic infection and to make inferences about R0. \ud \ud Data and Methods. On the island of Tristan da Cunha (TdC), 96% of residents reported illness during an H3N2 outbreak in 1971, compared with only 25% of RAF personnel in military camps during the 1918 H1N1 pandemic. Monte Carlo Markov Chain (MCMC) methods were used to estimate model parameter distributions. \ud \ud Findings. We estimated that most islanders on TdC were non-immune (susceptible) before the first wave, and that almost all exposures of susceptible persons caused symptoms. The median R0 of 6.4 (95% credibility interval 3.7–10.7) implied that most islanders were exposed twice, although only a minority became ill in the second wave because of temporary protection following the first wave. In contrast, only 51% of RAF personnel were susceptible before the first wave, and only 38% of exposed susceptibles reported symptoms. R0 in this population was also lower [2.9 (2.3–4.3)], suggesting reduced viral transmission in a partially immune population. \ud \ud Interpretation: Our model implies that the RAF population was partially protected before the summer pandemic wave of 1918, arguably because of prior exposure to interpandemic influenza. Without such protection, each symptomatic case of influenza would transmit to between 2 and 10 new cases, with incidence initially doubling every 1–2 days. Containment of a novel virus could be more difficult than hitherto supposed