Multidisciplinary, evidence-based consensus guidelines for human papillomavirus (HPV) vaccination in highrisk populations, Spain, 2016

Introduction: Although human papillomavirus (HPV) routine vaccination programmes have been implemented around the world and recommendations have been expanded to include other high-risk individuals, current recommendations often differ between countries in Europe, as well as worldwide. Aim: To find and summarise the best available evidence of HPV vaccination in high-risk patients aiding clinicians and public health workers in the day-to-day vaccine decisions relating to HPV in Spain. Methods: We conducted a systematic review of the immunogenicity, safety and efficacy/effectiveness of HPV vaccination in high-risk populations between January 2006 and June 2016. HPV vaccination recommendations were established with levels of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: A strong recommendation about HPV vaccination was made in the following groups: HIV infected patients aged 9-26 years; men who have sex with men aged 9-26 years; women with precancerous cervical lesions; patients with congenital bone marrow failure syndrome; women who have received a solid organ transplant or hematopoietic stem cell transplantation aged 9-26 years; and patients diagnosed with recurrent respiratory papillomatosis. Conclusions: Data concerning non-routine HPV vaccination in populations with a high risk of HPV infection and associated lesions were scarce. We have developed a document to evaluate and establish evidence- based guidelines on HPV vaccination in highrisk populations in Spain, based on best available scientific evidence

Unitarity bounds on low scale quantum gravity

We study the unitarity of models with low scale quantum gravity both in four dimensions and in models with a large extra-dimensional volume. We find that models with low scale quantum gravity have problems with unitarity below the scale at which gravity becomes strong. An important consequence of our work is that their first signal at the Large Hadron Collider would not be of a gravitational nature such as graviton emission or small black holes, but rather linked to the mechanism which fixes the unitarity problem. We also study models with scalar fields with non minimal couplings to the Ricci scalar. We consider the strength of gravity in these models and study the consequences for inflation models with non-minimally coupled scalar fields. We show that a single scalar field with a large non-minimal coupling can lower the Planck mass in the TeV region. In that model, it is possible to lower the scale at which gravity becomes strong down to 14 TeV without violating unitarity below that scale.Comment: 15 page

Nustar and Chandra Insight into the Nature of the 3-40 Kev Nuclear Emission in Ngc 253

We present results from three nearly simultaneous Nuclear Spectroscopic Telescope Array (NuSTAR) and Chandra monitoring observations between 2012 September 2 and 2012 November 16 of the local star-forming galaxy NGC 253. The 3-40 kiloelectron volt intensity of the inner approximately 20 arcsec (approximately 400 parsec) nuclear region, as measured by NuSTAR, varied by a factor of approximately 2 across the three monitoring observations. The Chandra data reveal that the nuclear region contains three bright X-ray sources, including a luminous (L (sub 2-10 kiloelectron volt) approximately few 10 (exp 39) erg per s) point source located approximately 1 arcsec from the dynamical center of the galaxy (within the sigma 3 positional uncertainty of the dynamical center); this source drives the overall variability of the nuclear region at energies greater than or approximately equal to 3 kiloelectron volts. We make use of the variability to measure the spectra of this single hard X-ray source when it was in bright states. The spectra are well described by an absorbed (power-law model spectral fit value, N(sub H), approximately equal to 1.6 x 10 (exp 23) per square centimeter) broken power-law model with spectral slopes and break energies that are typical of ultraluminous X-ray sources (ULXs), but not active galactic nuclei (AGNs). A previous Chandra observation in 2003 showed a hard X-ray point source of similar luminosity to the 2012 source that was also near the dynamical center (Phi is approximately equal to 0.4 arcsec); however, this source was offset from the 2012 source position by approximately 1 arcsec. We show that the probability of the 2003 and 2012 hard X-ray sources being unrelated is much greater than 99.99% based on the Chandra spatial localizations. Interestingly, the Chandra spectrum of the 2003 source (3-8 kiloelectron volts) is shallower in slope than that of the 2012 hard X-ray source. Its proximity to the dynamical center and harder Chandra spectrum indicate that the 2003 source is a better AGN candidate than any of the sources detected in our 2012 campaign; however, we were unable to rule out a ULX nature for this source. Future NuSTAR and Chandra monitoring would be well equipped to break the degeneracy between the AGN and ULX nature of the 2003 source, if again caught in a high state