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Papillomavirus Research (Amsterdam,... Jun 2019In cervical cancer screening, HPV testing is best at reassuring women when they are negative, but proper management of HPV positives is still evolving. Most HPV...
In cervical cancer screening, HPV testing is best at reassuring women when they are negative, but proper management of HPV positives is still evolving. Most HPV infections are benign, and over-reacting clinically to HPV positivity can cause psychological and possible iatrogenic physical (e.g., obstetrical) harm. We describe the built-in false positives in current tests, and the real harm that can result when the meaning of such false positive HPV tests is misunderstood. We suggest steps that could reduce harm being done by flawed tests and excessive clinical responses to positive HPV testing. We focus the discussion by presenting an illustrative case.
Topics: Early Detection of Cancer; False Positive Reactions; Female; Humans; Molecular Diagnostic Techniques; Papillomaviridae; Uterine Cervical Neoplasms
PubMed: 31029852
DOI: 10.1016/j.pvr.2019.04.012 -
Journal of Thrombosis and Haemostasis :... Dec 2023Triple positivity for all 3 criteria antiphospholipid antibodies confers high risk of symptom development in carriers, and recurrence in antiphospholipid syndrome (APS)....
BACKGROUND
Triple positivity for all 3 criteria antiphospholipid antibodies confers high risk of symptom development in carriers, and recurrence in antiphospholipid syndrome (APS). Most triple-positivity studies report lupus anticoagulant (LA) testing as positive without distinguishing between positivity with dilute Russell's viper venom time (dRVVT) and activated partial thromboplastin time (APTT) and single-assay positivity or only perform dRVVT. Single LA assay repertoires remain in use in some centers, which risks missing some triple positives. Positivity with both assays may identify higher risk.
OBJECTIVES
The aim of this study is to investigate the frequency of single LA assay positivity in triple-positive patients.
METHODS
Three hundred forty-two triple-positive profiles from nonanticoagulated patients (237 APS, 45 systemic lupus erythematosus without APS symptoms, and 60 nonclinical criteria) were identified from laboratory databases and assessed for LA positivity by dRVVT and/or APTT.
RESULTS
Seventy-three of 237 (30.8%) APS samples were LA-positive with 1 assay, 40/237 (16.9%) by dRVVT only, and 33/237 (13.9%) with APTT only. Nineteen of 45 (42.2%) were LA-positive with 1 assay in the systemic lupus erythematosus cohort; 12/45 (26.7%) with dRVVT only and 7/45 (15.5%) with APTT only. Thirty-three of 60 (55.0%) were LA-positive with 1 assay in the nonclinical criteria cohort; 24/60 (40.0%) with dRVVT only and 9/60 (15.0%) with APTT only. The most common solid-phase assay profile was elevated immunoglobulin G aCL and aβ2GPI.
CONCLUSION
Up to 55.0% of triple-positive samples were positive in 1 LA assay, representing significant potential for misdiagnosis and inappropriate management via single LA assay repertoires.
Topics: Humans; Antiphospholipid Syndrome; Lupus Coagulation Inhibitor; Blood Coagulation Tests; Antibodies, Antiphospholipid; Prothrombin Time; Partial Thromboplastin Time; Lupus Erythematosus, Systemic
PubMed: 37597725
DOI: 10.1016/j.jtha.2023.08.009 -
PLoS Neglected Tropical Diseases Feb 2022Lymphatic filariasis (LF) has been targeted for global elimination as a public health problem since 1997. The primary strategy to interrupt transmission is annual mass...
BACKGROUND
Lymphatic filariasis (LF) has been targeted for global elimination as a public health problem since 1997. The primary strategy to interrupt transmission is annual mass drug administration (MDA) for ≥5 years. The transmission assessment survey (TAS) was developed as a decision-making tool to measure LF antigenemia in children to determine when MDA in a region can be stopped. The objective of this study was to investigate potential sampling strategies for follow-up of LF-positive children identified in TAS to detect evidence of ongoing transmission.
METHODOLOGY/PRINCIPLE FINDINGS
Nippes Department in Haiti passed TAS 1 with 2 positive cases and stopped MDA in 2015; however, 8 positive children were found during TAS 2 in 2017, which prompted a more thorough assessment of ongoing transmission. Purposive sampling was used to select the closest 50 households to each index case household, and systematic random sampling was used to select 20 households from each index case census enumeration area. All consenting household members aged ≥2 years were surveyed and tested for circulating filarial antigen (CFA) using the rapid filarial test strip and for Wb123-specific antibodies using the Filaria Detect IgG4 ELISA. Among 1,927 participants, 1.5% were CFA-positive and 4.5% were seropositive. CFA-positive individuals were identified for 6 of 8 index cases. Positivity ranged from 0.4-2.4%, with highest positivity in the urban commune Miragoane. Purposive sampling found the highest number of CFA-positives (17 vs. 9), and random sampling found a higher percent positive (2.4% vs. 1.4%).
CONCLUSIONS/SIGNIFICANCE
Overall, both purposive and random sampling methods were reasonable and achievable methods of TAS follow-up in resource-limited settings. Both methods identified additional CFA-positives in close geographic proximity to LF-positive children found by TAS, and both identified strong signs of ongoing transmission in the large urban commune of Miragoane. These findings will help inform standardized guidelines for post-TAS surveillance.
Topics: Animals; Antigens, Helminth; Child; Elephantiasis, Filarial; Filaricides; Follow-Up Studies; Haiti; Humans; Mass Drug Administration; Prevalence; Wuchereria bancrofti
PubMed: 35213537
DOI: 10.1371/journal.pntd.0010231 -
PloS One 2022The purpose of this study was to analyse whether contextual (perception of motivational climate and positive and negative spontaneous self-talk in sports), personal...
The purpose of this study was to analyse whether contextual (perception of motivational climate and positive and negative spontaneous self-talk in sports), personal (positivity) and situational variables (positive and negative spontaneous self-talk employed in competition and precompetitive anxiety) predict performance in a competition of ensembles of rhythmic gymnastics. 258 female gymnasts between ages14 and 20 (M = 15.24, SD = 1.46) participated in the study, completing pre- and post-competition measures. The results of the path-analysis showed that both the task-involving climate and positivity predicted positive self-talk in sport. This predicted self-confidence which, in turn, positively predicted positive situational self-talk in competition. For its part, the perception of an ego-involving climate positively predicted the use of both negative and positive self-talk in sport. Negative self-talk in sports predicted negative situational self-talk in competition and somatic and cognitive anxiety. In turn, cognitive anxiety positively predicted negative situational self-talk. Finally, performance was positively predicted by positive situational self-talk and negatively by negative situational self-talk. These results explain the functioning of spontaneous self-talk at different levels of generality and its relationship with sports performance.
Topics: Anxiety; Athletic Performance; Female; Gymnastics; Humans; Male; Motivation; Self Concept
PubMed: 35325003
DOI: 10.1371/journal.pone.0265809 -
Cognition Nov 2023There is abundant evidence of a self-bias in cognition, with prioritised processing of information that is self-relevant. There is also abundant evidence of a...
There is abundant evidence of a self-bias in cognition, with prioritised processing of information that is self-relevant. There is also abundant evidence of a positivity-bias in cognition, with prioritised processing of information that is positively valenced (e.g., positive emotional expressions, rewards). While the effects of self-bias and positivity-bias have been well documented in isolation, they have seldom been examined in parallel, so it is unclear whether one or other of these stimulus classes is prioritised or whether they interact. Addressing this gap, the current research aimed to establish the relative primacy of self-bias and positivity-bias using a classification task that paired self-relevant information with emotional expressions (i.e., Expt. 1) or reward information (i.e., Expt. 2). When the self was paired with relatively more positive information (i.e., smiling faces or high reward) we found evidence of a self-bias but no evidence of a positivity-bias. Whereas when the self was paired with relatively less positive information (i.e., neutral faces or low reward) we found evidence of a positivity-bias but no evidence of a self-bias. These results suggest the relative primacy of prioritised processing is flexible, context dependent and might be caused by a drive towards self-enhancement and the self-positivity bias.
Topics: Humans; Bias; Cognition; Reward
PubMed: 37604029
DOI: 10.1016/j.cognition.2023.105600 -
Frontiers in Psychology 2021Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examine how distinct positive...
Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examine how distinct positive emotions are perceived and whether individuals' perceptions are linked to how societies evaluate those emotions. Participants from Hong Kong and Netherlands rated 23 positive emotions based on their individual perceptions (positivity, arousal, and socially engaging) and societal evaluations (appropriate, valued, and approved of). We found that (1) there were cultural differences in judgments about all six aspects of positive emotions; (2) positivity, arousal, and social engagement predicted emotions being positively regarded at the societal level in both cultures; and (3) that positivity mattered more for the Dutch participants, although arousal and social engagement mattered more in Hong Kong for societal evaluations. These findings provide a granular map of the perception and evaluation of distinct positive emotions in two cultures and highlight the role of cultures in the understanding how positive emotions are perceived and evaluated.
PubMed: 34122207
DOI: 10.3389/fpsyg.2021.579474 -
Journal of Pathology Informatics 2021Human immunodeficiency virus (HIV) screening has improved significantly in the past decade as we have implemented tests that include antigen detection of p24....
BACKGROUND
Human immunodeficiency virus (HIV) screening has improved significantly in the past decade as we have implemented tests that include antigen detection of p24. Incorporation of p24 detection narrows the window from 4 to 2 weeks between infection acquisition and ability to detect infection, reducing unintentional spread of HIV. The fourth- and fifth-generation HIV (HIV5G) screening tests in low prevalence populations have high numbers of false-positive screens and it is unclear if orthogonal testing improves diagnostic and public health outcomes.
METHODS
We used a cohort of 60,587 HIV5G screening tests with molecular and clinical correlates collected from 2016 to 2018 and applied machine learning to generate a classifier that could predict likely true and false positivity.
RESULTS
The best classification was achieved by using support vector machines and transformation of results with principle component analysis. The final classifier had an accuracy of 94% for correct classification of false-positive screens and an accuracy of 92% for classification of true-positive screens.
CONCLUSIONS
Implementation of this classifier as a screening method for all HIV5G reactive screens allows for improved workflow with likely true positives reported immediately to reduce infection spread and initiate follow-up testing and treatment and likely false positives undergoing orthogonal testing utilizing the same specimen already drawn to reduce distress and follow-up visits. Application of machine learning to the clinical laboratory allows for workflow improvement and decision support to provide improved patient care and public health.
PubMed: 34934521
DOI: 10.4103/jpi.jpi_7_21 -
Lupus Jun 1996Recurrent fetal loss and pregnancy complications, especially severe early-onset preeclampsia, are frequently associated with anti-phospholipid antibodies. We report a... (Review)
Review
Recurrent fetal loss and pregnancy complications, especially severe early-onset preeclampsia, are frequently associated with anti-phospholipid antibodies. We report a case of post-partum cardiac involvement leading to dilated cardiomyopathy in a woman with a persistent positivity for anti-cardiolipin and anti-nuclear antibodies. Her clinical and obstetric record reported two previous fetal losses but no other signs characteristic of the anti-phospholipid syndrome or diagnostic for a systemic lupus erythematosus. Post-partum cardiomyopathy might be another cardiac presentation of the anti-phospholipid syndrome, in addition to the well known valvular involvement. In patients with persistent positivities for anti-phospholipid antibodies, a prompt identification of such a complication in the post-partum period should be taken into account by physicians. Adequate cardiologic treatment associated with antiaggregant and steroid therapy might be useful to prevent further complications in these patients.
Topics: Adult; Antibodies, Anticardiolipin; Antibodies, Antinuclear; Antiphospholipid Syndrome; Cardiomyopathy, Dilated; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Puerperal Disorders
PubMed: 8803899
DOI: 10.1177/096120339600500315 -
European Journal of Ageing Sep 2016Although physical activity is an effective way to cope with ageing-related impairments, few older people are motivated to turn their sedentary lifestyle into an active...
Although physical activity is an effective way to cope with ageing-related impairments, few older people are motivated to turn their sedentary lifestyle into an active one. Recent evidence suggests that walking can be more effectively promoted in older adults with positive messages about the benefits of walking than with negative messages about the risks of inactivity. This study examined motivation and memory as the supposed mechanisms underlying the greater effectiveness of positively framed compared to negatively framed messages for promoting activity. Older adults ( = 53, age 60-87 years) were introduced to six physical activity programmes that were randomly paired with either positively framed or negatively framed messages. Participants indicated how motivated they were to participate in each programme by providing ratings on attractiveness, suitability, capability and intention. They also completed surprise free recall and recognition tests. Respondents felt more motivated to participate in physical activity programmes paired with positively framed messages than in those with negatively framed ones. They also had better recognition memory for positively framed than negatively framed messages, and misremembered negatively framed messages to be positively framed. Findings support the notion that socioemotional selectivity theory-a theory of age-related changes in motivation-is a useful basis for health intervention design.
PubMed: 28804382
DOI: 10.1007/s10433-016-0368-1 -
Scandinavian Journal of Gastroenterology Oct 2010Antigliadin antibodies (AGA) show good sensitivity but low specificity for celiac disease and can also be found in healthy individuals. However, data suggest that AGA...
OBJECTIVE
Antigliadin antibodies (AGA) show good sensitivity but low specificity for celiac disease and can also be found in healthy individuals. However, data suggest that AGA positivity might be related to distinct disease entities such as allergy and gluten ataxia. Our aim here is to explore the clinical relevance of positive AGA in the elderly population.
MATERIAL AND METHODS
Serum IgA- and IgG-class AGA and IgA-class tissue transglutaminase antibodies (tTGA) were determined in 2815 individuals aged 52-74 years. Equal numbers of AGA- and tTGA-negative participants of similar age and gender, but without known celiac disease, were randomly selected as controls. Information on clinical history was obtained from hospital records in all groups.
RESULTS
Altogether 381 persons were positive for IgA/IgG-class AGA; 38 (14%) of them were also positive for tTGA. Out of the biopsied subjects, 34 (100%) in the AGA+ tTGA+ group and five (9%) in AGA+ tTGA- group had celiac disease. Rheumatoid arthritis and depression were found significantly more often in AGA-positives than controls. The significance remained even when tTGA-positive and known celiac disease cases were excluded. No statistical differences were found in the occurrence of neurological diseases, diabetes, allergic and cardiovascular diseases or malignancies.
CONCLUSIONS
Although AGA positivity is of clinical relevance only in a subset of elderly people, it seems to be related to rheumatoid arthritis and depression, both conditions linked to celiac disease. Further studies are needed to reveal the mechanisms underlying this. The poor specificity of AGA for celiac disease was here once more in evidence.
Topics: Aged; Aged, 80 and over; Aging; Arthritis, Rheumatoid; Autoantibodies; Biomarkers; Case-Control Studies; Celiac Disease; Depression; Diagnosis, Differential; Female; Fluorescent Antibody Technique; Gliadin; Humans; Immunoglobulin A; Immunoglobulin G; Immunologic Factors; Male; Middle Aged; Predictive Value of Tests; Sensitivity and Specificity
PubMed: 20545470
DOI: 10.3109/00365521.2010.496491