-
Preventive Medicine Reports Feb 2024Cervical cancer screening coverage remains low in many countries worldwide. Self-sampling approach for cervical cancer screening has a good potential to improve the... (Review)
Review
OBJECTIVE
Cervical cancer screening coverage remains low in many countries worldwide. Self-sampling approach for cervical cancer screening has a good potential to improve the screening coverage. This study aims to compare different types of HPV self-sampling devices for cervical cancer screening to identify the most accurate and acceptable device(s).
METHODS
A systematic review was performed on data extracted from all studies specific to HPV self-sampling devices by searching relevant articles in PubMed, Google Scholar, Scopus, Web of Science, ScienceDirect, Cochrane Library, and EBSCO published from 2013 to October 2023. The study was registered in PROSPERO (CRD42022375682).
RESULTS
Overall, 70 papers met the eligibility criteria for this systematic review and were included in the analysis: 22 studies reported self-sampling devices diagnostic accuracy, 32 studies reported self-sampling devices acceptability and 16 studies reported both (accuracy and acceptability). The most popular self-sampling devices were Evalyn Brush, FLOQ Swab, Cervex-Brush, and Delphi Screener. Out of overall 38 studies analyzing self-sampling devices' diagnostic accuracy, 94.7% of studies reported that self-collected specimens provided sensitivity and specificity comparable with clinician-collected samples; acceptability of Evalyn Brush, FLOQ Swab, Delphi Screener, and Colli-Pee, varied between 84.2% and 100%.
CONCLUSION
The self-sampling approach has a good potential to increase cervical cancer screening coverage. Evalyn Brush, Cervex-Brush, FLOQ Swab, and Delphi Screener self-sampling devices for HPV detection were the most commonly utilized and found to be the most accurate, and patient-acceptable. HPV detection accuracy using these self-sampling devices had no significant difference compared to the sampling performed by healthcare providers.
PubMed: 38283967
DOI: 10.1016/j.pmedr.2024.102590 -
Endoscopy Sep 2023BACKGROUND : The diagnosis of cholangiocarcinoma in patients with a biliary stricture without mass syndrome can be obtained by biliary brushing with a sensitivity of... (Randomized Controlled Trial)
Randomized Controlled Trial Clinical Trial
Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome.
BACKGROUND : The diagnosis of cholangiocarcinoma in patients with a biliary stricture without mass syndrome can be obtained by biliary brushing with a sensitivity of ~50 %. We performed a multicenter randomized crossover trial comparing the aggressive Infinity brush with the standard RX Cytology Brush. The aims were to compare sensitivity for cholangiocarcinoma diagnosis and cellularity obtained. METHODS : Biliary brushing was performed consecutively with each brush, in a randomized order. Cytological material was studied with blinding to the brush type used and order. The primary end point was sensitivity for cholangiocarcinoma diagnosis; the secondary end point was the abundance of cellularity obtained with each brush, with cellularity quantified in order to determine if one brush strongly outperformed the other. RESULTS : 51 patients were included. Final diagnoses were cholangiocarcinoma (n = 43; 84 %), benign (n = 7; 14 %), and indeterminate (n = 1; 2 %). Sensitivity for cholangiocarcinoma was 79 % (34 /43) for the Infinity brush versus 67 % (29/43) for the RX Cytology Brush ( = 0.10). Cellularity was rich in 31/51 cases (61 %) with the Infinity brush and in 10/51 cases (20 %) with the RX Cytology Brush ( < 0.001). In terms of quantification of cellularity, the Infinity brush strongly outperformed the RX Cytology Brush in 28/51 cases (55 %), while the RX Cytology Brush strongly outperformed the Infinity brush in 4/51 cases (8 %; < 0.001). CONCLUSIONS : This randomized crossover trial showed that the Infinity brush is not significantly more effective than the RX Cytology Brush for biliary stenosis without mass syndrome in terms of sensitivity for cholangiocarcinoma diagnosis, but does offer a significantly higher abundance of cellularity.
Topics: Humans; Constriction, Pathologic; Cholangiopancreatography, Endoscopic Retrograde; Sensitivity and Specificity; Cholestasis; Cholangiocarcinoma; Bile Duct Neoplasms; Bile Ducts, Intrahepatic
PubMed: 36849106
DOI: 10.1055/a-2041-7687 -
ACS Biomaterials Science & Engineering Mar 2024Brush cytology is a sampling technique extensively used for mucosal surfaces, particularly to identify malignancies. A sample is obtained by rubbing the brush bristles...
Brush cytology is a sampling technique extensively used for mucosal surfaces, particularly to identify malignancies. A sample is obtained by rubbing the brush bristles over the stricture or lesion several times until cells are trapped. Brush cytology detection rate varies, with malignancy confirmed in 15-65% of cases of adenocarcinoma-associated biliary strictures and 44-80% of cases of cholangiocarcinoma. Despite the widespread use of brush cytology, there is no consensus to date defining the optimal biliary brushing parameters for the collection of suspicious lesions, such as the number of passes, brushing rate, and force applied. The aim of this work is to increase the brush cytology diagnostic yield by elucidating the underlying mechanical phenomena. First, the mechanical interactions between the brush bristles and sampled tissue are analyzed. During brushing, mucus and detached cells are transferred to the space between the bristles through the capillary rise and flow eddies. These mass transfer mechanisms and their dependence on mucus rheology as a function of pH, brush displacement rate, and bristle geometry and configuration are examined. Lastly, results from brushing experiments performed on porcine stomachs are presented. Clinical practitioners from a variety of disciplines can apply the findings of this study to outline clear procedures for cytological brushing to increase the sensitivity and specificity of the brushings.
Topics: Humans; Cholangiopancreatography, Endoscopic Retrograde; Cytology; Cytodiagnosis; Cholestasis; Sensitivity and Specificity
PubMed: 38373217
DOI: 10.1021/acsbiomaterials.3c00935 -
World Haptics Conference. World Haptics... Jul 2023Pleasant brush therapies may benefit those with autism, trauma, and anxiety. While studies monitor brushing velocity, hand-delivery of brush strokes introduces...
Pleasant brush therapies may benefit those with autism, trauma, and anxiety. While studies monitor brushing velocity, hand-delivery of brush strokes introduces variability. Detailed measurements of human-delivered brushing physics may help understand such variability and subsequent impact on receivers' perceived pleasantness. Herein, we instrument a brush with multi-axis force and displacement sensors to measure their physics as 12 participants pleasantly stroke a receiver's forearm. Algorithmic procedures identify skin contact, and define four stages of arrival, stroke, departure, and airtime between strokes. Torque magnitude, rather than force, is evaluated as a metric to minimize inertial noise, as it registers brush bend and orientation. Overall, the results of the naturally delivered brushing experiments indicate force and velocity values in the range of 0.4 N and 3-10 cm/s, in alignment with prior work. However, we observe significant variance between brushers across velocity, force, torque, and brushstroke length. Upon further analysis, torque and force measures are correlated, yet torque provides distinct information from velocity. In evaluating the receiver's response to individual differences between brushers of the preliminary case study, higher pleasantness is tied to lower mean torque, and lower instantaneous variance over the stroke duration. Torque magnitude appears to complement velocity's influence on perceived pleasantness.
PubMed: 38618516
DOI: 10.1109/whc56415.2023.10224489 -
Journal of Colloid and Interface Science Feb 2024Understanding the complex interactions between polymers and surfactants is required to optimise commercially relevant systems such as paint, toothpaste and detergent....
HYPOTHESIS
Understanding the complex interactions between polymers and surfactants is required to optimise commercially relevant systems such as paint, toothpaste and detergent. Neutral polymers complex with surfactants, forming 'pearl necklace' structures that are often conceptualised as pseudo-polyelectrolytes. Here we pose two questions to test the limits of this analogy: Firstly, in the presence of salt, do these polymer-surfactant systems behave like polyelectrolytes? Secondly, do polymer-surfactant complexes resist geometric confinement like polyelectrolytes?
EXPERIMENTS
We test the limits of the pseudo-polyelectrolyte analogy through studying a poly(N-isopropylacrylamide) (PNIPAM) brush in the presence of sodium dodecylsulfate (SDS). Brushes are ideal for interrogating pseudo-polyelectrolytes, as neutral and polyelectrolyte brushes exhibit distinct and well understood behaviours. Spectroscopic ellipsometry, quartz crystal microbalance with dissipation monitoring (QCM-D), and neutron reflectometry (NR) were used to monitor the behaviour and structure of the PNIPAM-SDS system as a function of NaCl concentration. The ability of the PNIPAM-SDS complex to resist geometric confinement was probed with NR.
FINDINGS
At a fixed SDS concentration below the zero-salt CMC, increasing NaCl concentration <100 mM promoted brush swelling due to an increase in osmotic pressure, not dissimilar to a weak polyelectrolyte. At these salt concentrations, the swelling of the brush could be described by a single parameter: the effective CMC. However, at high NaCl concentrations (e.g., 500 mM) no brush collapse was observed at all (non-zero) concentrations of SDS studied, contrary to what is seen for many polyelectrolytes. Study of the polymer-surfactant system under confinement revealed that the physical volume of surfactant dominates the structure of the strongly confined system, which further differentiates it from the polyelectrolyte case.
PubMed: 37944374
DOI: 10.1016/j.jcis.2023.10.101 -
Lasers in Medical Science Apr 2024Alopecia, also known as hair loss, is a highly prevalent condition affecting millions of men and women in the United States and worldwide, making it one of the most... (Review)
Review
Alopecia, also known as hair loss, is a highly prevalent condition affecting millions of men and women in the United States and worldwide, making it one of the most common complaints by patients presenting to a dermatologist. The symptomology on the presentation of alopecia can be highly variable, ranging from diffuse thinning of hair, discrete and localized patches completely absent of hair, or noticing significant shedding when brushing and showering. Although alopecia does not have a direct negative health impact on patients, it is nonetheless a debilitating disease as it can profoundly impact an individual's self-image and psychosocial well-being. There are multiple treatment options available to patients with alopecia, and they are typically tailored to the patient's needs and preferences. The most common of these is the Food and Drug Administration-approved drugs for alopecia, minoxidil, and finasteride. However, both of these are known to be partially efficacious for all patients, so clinicians often use different modalities in conjunction with them, in particular laser-based therapies. This review article will provide a comprehensive assessment of lasers and other light therapies that may be used to manage the two most common types of alopecia: androgenetic alopecia and alopecia areata.
Topics: Male; Humans; Female; Alopecia Areata; Hair; Lasers; Minoxidil
PubMed: 38630348
DOI: 10.1007/s10103-024-04054-7 -
Plant Disease Jul 2023Astragalus scaberrimus Bunge, a perennial herb, is widely distributed in North and central China, Russia, and Mongolia (POWO, 2023). Due to its tolerance to drought,...
Astragalus scaberrimus Bunge, a perennial herb, is widely distributed in North and central China, Russia, and Mongolia (POWO, 2023). Due to its tolerance to drought, cold, high salt, low nutrients and alkaline soil, this plant is widely cultivated in China as a forage crop, for water and soil conservation, and for its medicinal properties (Meng, 2015). In 2022, powdery mildew-like signs and symptoms were seen on leaves of A. scaberrimuns cultivated on the campus of Inner Mongolia Agricultural University, Hohhot, Inner Mongolia China. White powder-like masses covered up to 99% of the leaf area with infected plants showing weak growth and senescence. More than 70% of plants (n = 180) exhibited these powdery mildew-infected symptoms. Conidiophores were 70-120 μm long (n = 20) and composed of a basal foot cell, followed by two cells and a conidium. Cylindrical- or ovoid-shaped conidia were 30-45µm long by 9-15 µm wide (n = 20). Brown or light-brown chasmothecia were 100-140 μm in diameter, with flexuous appendages. Based on these morphological characteristics, the fungus was tentatively identified as an Erysiphe sp. (Braun and Cook, 2012; Schmidt and Braun, 2020). Fungal structures were isolated from diseased leaves and genomic DNA of the pathogen was extracted utilizing the method described by Zhu et al. (2022). The internal transcribed spacer (ITS) region was amplified by PCR employing the primers PMITS1/PMITS2 (Cunnington et al., 2003) and the amplicon sequenced by Invitrogen (Shanghai, China). The sequence for the powdery mildew fungus (GenBank accession no.: MW142495) showed 100% identity (645/645 bp) with Erysiphe astragali, which was reported on A. glycyphyllos in Golestan province, Iran (accession no. OP806834). Pathogenicity tests were conducted by brushing the conidia from infected A. scaberrimus leaves onto leaves of four healthy plants, while, the four control plants were brushed in the same manner. All the treated plants were placed in separate growth chambers maintained at 19℃, 65% humidity, with 16 h light/8 h dark photoperiod. Nine days post inoculation, powdery mildew disease signs appeared on inoculated plants, whereas control plants remained asymptomatic. The same results were obtained for two repeated pathogenicity experiments. The powdery mildew fungus was reisolated and identified as E. astragali based on morphological and molecular analysis, thereby fulfilling Koch's postulates. E. astragali causing powdery mildew on A. glycyphyllus were previously reported in Germany with Genbank accesion number of MZ265150 and MZ265151 (Bradshaw et al., 2022). This, to our knowledge, is the first report of powdery mildew caused by E. astragali on A. scaberrimus. The severe occurrence of this destructive powdery mildew disease on A. scaberrimus may adversely affect the utility of the plant for soil conservation or cultivation for medicinal purposes. Identifying the causal agent of powdery mildew will support efforts for the future control and management of diseases on A. scaberrimus.
PubMed: 37467127
DOI: 10.1094/PDIS-03-23-0550-PDN -
JDR Clinical and Translational Research Jul 2023Treatment for head and neck cancer (HNC) such as radiotherapy (RT) can lead to numerous acute and chronic head and neck sequelae, including dental caries. The goal of...
BACKGROUND
Treatment for head and neck cancer (HNC) such as radiotherapy (RT) can lead to numerous acute and chronic head and neck sequelae, including dental caries. The goal of the present study was to measure 2-y changes in dental caries after radiotherapy in patients with HNC and test risk factors for caries increment.
METHODS
Cancer and dental disease characteristics, demographics, and oral health practices were documented before and 6, 12, 18, and 24 mo after the start of RT for 572 adult patients with HNC. Patients were eligible if they were age 18 y or older, diagnosed with HNC, and planned to receive RT for treatment of HNC. Caries prevalence was measured as decayed, missing, and filled surfaces (DMFS). The association between change in DMFS and risk factors was evaluated using linear mixed models.
RESULTS
On average, DMFS increased from baseline to each follow-up visit: 6 mo, +1.11; 12 mo, +2.47; 18 mo, +3.43; and 24 mo, +4.29 ( < 0.0001). The increase in DMFS during follow-up was significantly smaller for the following patient characteristics: compliant with daily fluoride use ( = 0.0004) and daily oral hygiene (brushing twice daily and flossing daily; = 0.015), dental insurance ( = 0.004), and greater than high school education ( = 0.001). DMFS change was not significantly associated with average or maximum RT dose to the parotids ( > 0.6) or salivary flow ( > 0.1). In the subset of patients who had salivary hypofunction at baseline ( = 164), lower salivary flow at follow-up visits was associated with increased DMFS.
CONCLUSION
Increased caries is a complication soon after RT in HNC. Fluoride, oral hygiene, dental insurance, and education level had the strongest association with caries increment after radiotherapy to the head and neck region. Thus, intensive oral hygiene measures, including fluoride and greater accessibility of dental care, may contribute to reducing the caries burden after RT in HNC.
KNOWLEDGE TRANSFER STATEMENT
The results of this study can be used by clinicians when deciding how to minimize oral complications related to cancer therapy for patients with head and neck cancer. Identification of modifiable factors (e.g., oral hygiene and prescription fluoride compliance) associated with increased caries risk can minimize radiation caries burden.
Topics: Adult; Humans; Adolescent; Dental Caries; Fluorides; Head and Neck Neoplasms; Oral Health; Risk Factors
PubMed: 35403479
DOI: 10.1177/23800844221086563 -
Annals of Medicine Dec 2023This study aimed to identify the appropriate signature veins for the right adrenal gland using a 3D model fused with adrenal venography images and to verify their...
BACKGROUND
This study aimed to identify the appropriate signature veins for the right adrenal gland using a 3D model fused with adrenal venography images and to verify their accuracy through the selectivity index (SI) >2.
METHODS
We analyzed the right adrenal venography images of 41 patients who underwent adrenal venous sampling (AVS). These images were merged with a 3D structure of the adrenal gland to identify the signature veins of the right adrenal gland. We then used the signature veins observed during adrenal venography to determine the optimal position of the catheter tip during AVS for 53 other patients. Finally, we verified the accuracy of this method according to the SI.
RESULTS
We successfully fused the 3D models of 41 cases with adrenal venography images. We identified the trunk branch type as the major venous morphology in the right anterior oblique at degrees of 30 (38 cases, 92.7%). In addition, the central vein, brush vein, uvula vein, and capsular vein were identified as signature veins for the right AVS. The accuracy of AVS was 100% in the other 53 patients, as verified by an SI >2.
CONCLUSIONS
Our study identified the right adrenal signature veins, including the previously overlooked uvula vein, which can be used to determine the position of the catheter tip and improve the success rate of AVS.
Topics: Humans; Hyperaldosteronism; Catheterization; Adrenal Glands; Phlebography; Retrospective Studies; Aldosterone
PubMed: 37452706
DOI: 10.1080/07853890.2023.2234934 -
Journal of Dentistry Sep 2023This study compared the surface change on natural and polished enamel exposed to a joint mechanical and chemical wear regimen. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
This study compared the surface change on natural and polished enamel exposed to a joint mechanical and chemical wear regimen.
METHODS
Human enamel samples were randomly assigned to natural (n = 30) or polished (n = 30) groups, subjected to erosion (n = 10, 0.3% citric acid, 5 min), abrasion (n = 10, 30 s), or a combination (n = 10). Wear in the form of step height was measured with a non-contact profilometer, and surface changes were inspected with SEM on selected sections. Data was normalised and underwent repeated measures MANOVA, accounting for substrate and erosive challenge as independent variables, with Bonferroni correction for significant post hoc interactions.
RESULTS
After four cycles, polished samples had mean step heights of 3.08 (0.40) μm after erosion and 4.08 (0.37) μm after erosion/abrasion. For natural samples, these measurements were 1.52 (0.22) μm and 3.62 (0.39) μm, respectively. Natural surfaces displayed less wear than polished surfaces under erosion-only conditions (p<0.0001), but the difference disappeared with added abrasion. SEM revealed a shallow subsurface layer for polished surfaces and natural ones undergoing only erosion. However, natural surfaces exposed to both erosion and abrasion showed deeper subsurface changes up to 50 µm.
CONCLUSION
Natural enamel, when exposed to erosion alone, showed less wear and minimal subsurface alterations. But with added abrasion, natural enamel surfaces saw increased wear and notable subsurface changes compared to polished ones.
CLINICAL SIGNIFICANCE
The pronounced subsurface lesions observed on eroded/abraded natural enamel surfaces highlight how combined wear challenges may accelerate tooth tissue loss.
Topics: Humans; Tooth Abrasion; Tooth Attrition; Tooth Erosion; Tooth Wear; Toothbrushing
PubMed: 37544352
DOI: 10.1016/j.jdent.2023.104652