Field experience with the 8-HPV-type oncoprotein test for cervical cancer screening among HPV-positive women living with and without HIV in LMICs.

Overexpression of HPV-oncoproteins E6 and E7 is necessary for HPV-driven cervical carcinogenesis. Hence, these oncoproteins are promising disease-specific biomarkers. We assessed the technical and operational characteristics of the 8-HPV-type OncoE6/E7 Cervical Test in different laboratories using cervical samples from HPV-positive women living with (WLWH) and without HIV. The 8-HPV-type OncoE6/E7 Test (for short: "OncoE6/E7 test") was performed in 2833 HIV-negative women and 241 WLWH attending multicentric studies in Latin America (ESTAMPA study), and in Africa (CESTA study). Oncoprotein positivity were evaluated at each testing site, according to HIV status as well as type-specific agreement with HPV-DNA results. A feedback questionnaire was given to the operators performing the oncoprotein test to evaluate their impression and acceptability regarding the test. The OncoE6/E7 test revealed a high positivity rate heterogeneity across all testing sites (I2: 95.8%, p < .01) with significant lower positivity in WLWH compared to HIV-negative women (12% vs 25%, p < .01). A similar HPV-type distribution was found between HPV DNA genotyping and oncoprotein testing except for HPV31 and 33 (moderate agreement, k = 0.57). Twenty-one laboratory technicians were trained on oncoprotein testing. Despite operators' concerns about the time-consuming procedure and perceived need for moderate laboratory experience, they reported the OncoE6/E7 test as easy to perform and user-friendly for deployment in resource-limited settings. The high positivity rate variability found across studies and subjectivity in test outcome interpretation could potentially results in oncoprotein false positive/negative, and thus the need for further refinements before implementation of the oncoprotein testing in screen-triage-and-treat approaches is warranted.

The delay in the start time of classes significantly increases adolescent performance, a reflection for Public Health in Ecuador: a narrative review

Contexto: en el Ecuador no existen estudios publicados sobre las horas de sueño por grupos de edad u horarios de inicio de clases enfocados al rendimiento académico de la población, en especial adolescentes. Discusión: al recopilar los datos de estudios realizados en niños y adolescentes, se demuestra que los adolescentes necesitan dormir lo suficiente para funcionar bien a diario y mejorar los efectos cognitivos que se presentan por la falta de sueño. Considerando solo el 14% al 27% de los adolescentes duermen más de 9 horas en las noches escolares, y peor aún, hasta el 25% duermen menos de 6 horas, no es sorprendente que la mayoría de los adolescentes se despierten sintiéndose cansados. Se recomienda planificar las horas de sueño con los padres, horario de tareas en casa y horarios de actividad física, para entrenar la mente y tener una buena higiene del sueño Conclusión: el retraso de la hora de inicio de clases aumenta notablemente el desempeño en los adolescentes, por lo cual se debe cambiar las políticas públicas para permitir que la hora de ingreso a clases sea pasada las 9:00 horas.

Context: In Ecuador, there are no published studies on the hours of sleep by age groups, or start times of classes focused on the academic performance of the population, especially adolescents. Discussion: When collecting data from studies conducted in children and adolescents, adolescents need enough sleep to function well daily, and improve the cognitive effects that occur due to lack of sleep. Considering that only 14% to 27% of adolescents sleep more than 9 hours on school nights, and worse, up to 25% sleep less than 6 hours, it is not surprising that most adolescents wake up feeling tired. It recommends to plan the sleep hours with parents, homework schedule, and physical activity schedules, to train the mind and have good sleep higiene Conclusion: The delay of the start time of classes significantly increases the performance in adolescents, so public policies have be changed to allow the time of entry to classes to be past 9 am.