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.

Research evolution of limestone calcined clay cement (LC3), a promising low-carbon binder - A comprehensive overview.

Limestone calcined clay cement (LC3) is a recently developed binder with huge potential to reduce the clinker factor in cement and the environmental impact. This study aimed to evaluate the evolution of the research on LC3 by conducting a bibliometric analysis, evaluating key metrics such as publications, authorships, sources, or countries, to provide greater knowledge and a strategic vision of this technology. This work provides an important perspective of the field and elucidates the research trends and path that the LC3 technology followed from its beginning to date. The analysis reveals a noticeable increase in technology readiness and researchers' interest, as indicated by a significant rise in publications' number over time. Also, the authorship metrics reveal an important cooperation between communities in the development of this technology. The research on LC3 is essential since the technology is a viable and reliable approach to decreasing the cement industry's carbon footprint.

Mapping the research landscape of bauxite by-products (red mud): An evolutionary perspective from 1995 to 2022.

The global population growth has significantly impacted energy and raw material consumption, unmatched since the Industrial Revolution. Among metals, aluminium ranks second only to steel, with annual production exceeding 69 million tonnes. Due to its high demand, bauxite, the primary ore from which aluminium is extracted, is now classified as a critical material in the EU and the US, given the potential risk of supply shortages for essential applications. Geographical and production challenges surround bauxite, presenting geo-economic and environmental challenges. A critical concern in aluminium production is managing by-products, notably red mud, a bauxite residue, generating over 175 million tonnes annually worldwide. Comprehensive bibliometric research is imperative due to the high amount of bibliographical resources related to this topic, encompassing circular economy, re-valorisation, sustainability, and disposal. This study employs bibliometric methods to assess red mud valorisation, offering insights into research topics, influential authors, and key journals, shedding light on the past, present, and future of red mud research. Such bibliometric analysis not only highlights the current state of the field but also serves as a valuable tool for decision-making, enabling researchers and policymakers to identify trends, gaps, and areas for further exploration, fostering informed and sustainable advancements in the by-products of the aluminium industry.

PHB production by Bacillus megaterium strain MNSH1-9K-1 using low-cost media.

Plastics are widely used for diverse applications due to their versatility. However, their negative impact on ecosystems is undeniable due to their long-term degradation. Thus, there is a rising need for developing eco-friendlier alternatives to substitute fossil-based plastics, like biopolymers. PHA are synthesized intracellularly by microorganisms under stressful conditions of growth and have similar characteristics to conventional polymers, like their melting point, transition temperatures, crystallinity, and flexibility. Although it is feasible to use biopolymers for diverse industrial applications, their elevated production cost due to the supplies needed for microbiological procedures and the low productivity yields obtained have been the main limiting factors for their commercial success. The present study assessed the ability of Bacillus megaterium strain MNSH1-9K-1 to produce biopolymers using low-cost media from different kinds of fruit-peel residues. The results show that MNSH1-9K-1 can produce up to 58 g/L of PHB when grown in a medium prepared from orange-peel residues. The data obtained provide information to enhance the scalability of these kinds of biotechnological processes.

Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study.

PURPOSE: The RESPIRA cohort aims to describe the nature, magnitude, time course and efficacy of the immune response to SARS-CoV-2 infection and vaccination, population prevalence, and household transmission of COVID-19. PARTICIPANTS: From November 2020, we selected age-stratified random samples of COVID-19 cases from Costa Rica confirmed by PCR. For each case, two population-based controls, matched on age, sex and census tract were recruited, supplemented with hospitalised cases and household contacts. Participants were interviewed and blood and saliva collected for antibodies and PCR tests. Participants will be followed for 2 years to assess antibody response and infection incidence. FINDINGS TO DATE: Recruitment included 3860 individuals: 1150 COVID-19 cases, 1999 population controls and 719 household contacts from 304 index cases. The age and regional distribution of cases was as planned, including four age strata, 30% rural and 70% urban. The control cohort had similar sex, age and regional distribution as the cases according to the study design. Among the 1999 controls recruited, 6.8% reported at enrolment having had COVID-19 and an additional 12.5% had antibodies against SARS-CoV-2. Compliance with visits and specimens has been close to 70% during the first 18 months of follow-up. During the study, national vaccination was implemented and nearly 90% of our cohort participants were vaccinated during follow-up. FUTURE PLANS: RESPIRA will enable multiple analyses, including population prevalence of infection, clinical, behavioural, immunological and genetic risk factors for SARS-CoV-2 acquisition and severity, and determinants of household transmission. We are conducting retrospective and prospective assessment of antibody levels, their determinants and their protective efficacy after infection and vaccination, the impact of long-COVID and a series of ancillary studies. Follow-up continues with bimonthly saliva collection for PCR testing and biannual blood collection for immune response analyses. Follow-up will be completed in early 2024. TRIAL REGISTRATION NUMBER: NCT04537338.

Handy EKG: A Low-Cost Electrocardiograph for Primary Care.

Background Cardiovascular diseases constitute the majority of noncommunicable disease deaths worldwide. In Honduras, cardiovascular diseases represent the fifth cause of death among individuals aged 45 to 49 years, while 20% of emergency room visits are due to cerebrovascular events, heart failure, and acute myocardial infarction. Methodology A low-cost three-lead electrocardiograph (ECG) (Handy EKG) was designed and manufactured for primary care. The device is supported by Bluetooth connectivity and machine learning. Device readings were collected from volunteers and compared to those obtained with a conventional 12-lead ECG. Results The device provided readings of lead one of a TDOU model CMS600G 12-lead ECG to monitor and diagnose bradyarrhythmia and tachyarrhythmias. Overall, 96% (49) of the readings showed a similarity in morphology, amplitude, and duration of waves, segments, and complexes compared to a 12-lead ECG. The device showed potential for application in primary care and intrahospital settings due to its continuous monitoring capabilities, portability, and possible connectivity with mobile devices. Conclusions The results indicate that the designed platform is safe, offers good quality in its operation at all levels, and provides ECG results equivalent to those of a conventional ECG in most cases (considering only one lead).

Towards Visual-Tactile Integration of Shoulder and Hand Using Immersive Virtual Reality.

Shoulder-controlled hand neuroprostheses are wearable devices designed to assist hand function in people with cervical spinal cord injury (SCI). They use preserved shoulder movements to control artificial actuators. Due to the concurrent afferent (i.e., shoulder proprioception) and visual (i.e., hand response) feedback, these wearables may affect the user's body somatosensory representation. To investigate this effect, we propose an experimental paradigm that uses immersive virtual reality (VR) environment to emulate the use of a shoulder-controlled hand neuroprostheses and an adapted version of a visual-tactile integration task (i.e., Crossmodal Congruency Task) as an assessment tool. Data from seven non-disabled participants validates the experimental setup, with preliminary statistical analysis revealing no significant difference across the means of VR and visual-tactile integration tasks. The results serve as a proof-of-concept for the proposed paradigm, paving the way for further research with improvements in the experimental design and a larger sample size.

Epidemiological Patterns of Common Cancers in Costa Rica: An Overview up to 2020.

Introduction: The increasing cancer incidence and mortality rates in Costa Rica have become a public health concern, with prostate, breast, and colorectal cancers being the most prevalent. This study aimed to analyze the trends in cancer incidence and mortality rates by tumor type, sex, age group, and geographic region using data from the Costa Rican National Cancer Registry. Methods: In this retrospective study, we analyzed cancer incidence and mortality anonymized data from the Costa Rican National Cancer Registry between 2010 and 2020. The study included data on cancer cases diagnosed and deaths attributable to cancer within the population. Results: Our findings revealed variations in cancer incidence and mortality rates based on geographic region, age group, and tumor type. Cancer was most predominant in the province of San Jose, followed by Alajuela, Heredia, Cartago, Guanacaste, and Puntarenas. Breast cancer, colorectal cancer, and prostate cancer were the leading causes of cancer in both sexes. Mortality rates due to gastric cancer and prostate cancer were highest among men, while breast cancer was the leading cause of cancer mortality among women. Conclusion: The results of this study underscore the need for targeted prevention and screening programs, improved access to treatment for patients living in rural areas, and a comprehensive cancer control program in Costa Rica. By implementing evidence-based interventions, such as tobacco control programs, cancer screening initiatives, and equitable access to cancer treatment, the cancer burden in Costa Rica can be mitigated, ultimately improving the overall health of the population.

Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study.

Background: Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30-64 years participating in the ESTAMPA study. Methods: Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings: 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0-53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3-96.7). Specificity was 96.5% (95% CI: 96.3-96.7) using cytology and 88.7% (95% CI: 88.3-89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%-100% and 83.6-90.8%, respectively). Interpretation: The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America. Funding: IARC/WHO, UNDP, HRP/WHO, NCI and local funders.

Assessing walking ability using a robotic gait trainer: opportunities and limitations of assist-as-needed control in spinal cord injury.

BACKGROUND: Walking impairments are a common consequence of neurological disorders and are assessed with clinical scores that suffer from several limitations. Robot-assisted locomotor training is becoming an established clinical practice. Besides training, these devices could be used for assessing walking ability in a controlled environment. Here, we propose an adaptive assist-as-needed (AAN) control for a treadmill-based robotic exoskeleton, the Lokomat, that reduces the support of the device (body weight support and impedance of the robotic joints) based on the ability of the patient to follow a gait pattern displayed on screen. We hypothesize that the converged values of robotic support provide valid and reliable information about individuals' walking ability. METHODS: Fifteen participants with spinal cord injury and twelve controls used the AAN software in the Lokomat twice within a week and were assessed using clinical scores (10MWT, TUG). We used a regression method to identify the robotic measure that could provide the most relevant information about walking ability and determined the test-retest reliability. We also checked whether this result could be extrapolated to non-ambulatory and to unimpaired subjects. RESULTS: The AAN controller could be used in patients with different injury severity levels. A linear model based on one variable (robotic knee stiffness at terminal swing) could explain 74% of the variance in the 10MWT and 61% in the TUG in ambulatory patients and showed good relative reliability but poor absolute reliability. Adding the variable 'maximum hip flexor torque' to the model increased the explained variance above 85%. This did not extend to non-ambulatory nor to able-bodied individuals, where variables related to stance phase and to push-off phase seem more relevant. CONCLUSIONS: The novel AAN software for the Lokomat can be used to quantify the support required by a patient while performing robotic gait training. The adaptive software might enable more challenging training conditions tuned to the ability of the individuals. While the current implementation is not ready for assessment in clinical practice, we could demonstrate that this approach is safe, and it could be integrated as assist-as-needed training, rather than as assessment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02425332.

Competition Increases the Effort Put Into a Physical Interaction Task.

Physical interaction can enhance motor learning, but it remains unclear what type of interaction is best suited to increasing the active effort put into a task, which should support learning. Here, we used the same interactive tracking task with different instructions to induce three training conditions: competition, collaboration, and self-improvement, where partners improve their own performance while interacting haptically with each other. The effort was gauged by measuring the total normalized muscle activity. Feedback of task performance and the haptic dynamics were identical in all three training conditions, so the effort needed to complete the task was the same. Only the instructions to 'compete with the partner', 'improve your and your partner's accuracy' and 'improve your accuracy' were different among the competition, collaboration, and self-improvement conditions, respectively. Despite having the same goal of maximizing self-performance during competition and self-improvement, participants exerted significantly more effort during competition, and their tracking accuracy was highest during competitive practice. Least effort was put into collaboration but tracking accuracy during collaboration was comparable to self-improvement. Our results suggest that interactive haptic competition can induce higher active drive or effort than either collaborative training or self-focused practice.

Assessing the Larvicidal Properties of Endemic Campeche, Mexico Plant Piper cordoncillo var. apazoteanum (Piperaceae) against Aedes aegypti (Diptera: Culicidae) Mosquitoes.

The research aims to investigate the mortality effect of essential oil from Piper cordoncillo var. apazoteanum, an endemic plant from Campeche, Mexico, on early second-instar Aedes aegypti larvae; it also aims to identify the volatile compounds present in the fresh leaves of the plant. To test the effectiveness of the essential oil, we followed World Health Organization Standard Procedures. Larvae were observed for 17 consecutive days after treatment to determine the mortality and growth-inhibitory effect exerted by the essential oil. The results showed that the essential oil was effective in controlling mosquito populations. At a concentration of 800 ppm, the oil achieved an effectiveness rate of 70.00 ± 8.16% after 24 h, increasing to 100.00 ± 0.01% mortality after 72 h. With a concentration of 400 ppm, the effectiveness was 98.33 ± 0.17% by the end of the experiment. Furthermore, the obtained results demonstrated that the LC50 value was 61.84 ± 6.79 ppm, while the LC90 value was 167.20 ± 11.49 ppm. Essential oil concentrations inhibited the growth of immature insect stages, with concentrations between 800-100 ppm demonstrating very high inhibitory activity, and the lowest concentration of 50 ppm showing high inhibitory activity. The study also identified 24 chemical compounds representing 86.71% of the volatile compound composition of the fresh leaves of P. cordoncillo; the most abundant compounds were Safrole, Caryophyllene oxide, E-Nerolidol, and Calarene epoxide. The method used to extract the volatile compounds, solvent-free microwave extraction (SFME), is a promising alternative to traditional methods that avoids the use of potentially harmful solvents, making it more ecologically friendly and potentially safer for professionals handling the extracted compounds. Overall, the study demonstrates the potential of P. cordoncillo essential oil as an effective means of controlling mosquito populations, and provides valuable information on the chemical composition of the plant.Moreover, our study is the first to report on the biological activity and chemical composition of P. cordoncillo worldwide.

Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study.

BACKGROUND: Colposcopy, currently included in WHO recommendations as an option to triage human papillomavirus (HPV)-positive women, remains as the reference standard to guide both biopsy for confirmation of cervical precancer and cancer and treatment approaches. We aim to evaluate the performance of colposcopy to detect cervical precancer and cancer for triage in HPV-positive women. METHODS: This cross-sectional, multicentric screening study was conducted at 12 centres (including primary and secondary care centres, hospitals, laboratories, and universities) in Latin America (Argentina, Bolivia, Colombia, Costa Rica, Honduras, Mexico, Paraguay, Peru, and Uruguay). Eligible women were aged 30-64 years, sexually active, did not have a history of cervical cancer or treatment for cervical precancer or a hysterectomy, and were not planning to move outside of the study area. Women were screened with HPV DNA testing and cytology. HPV-positive women were referred to colposcopy using a standardised protocol, including biopsy collection of observed lesions, endocervical sampling for transformation zone (TZ) type 3, and treatment as needed. Women with initial normal colposcopy or no high-grade cervical lesions on histology (less than cervical intraepithelial neoplasia [CIN] grade 2) were recalled after 18 months for another HPV test to complete disease ascertainment; HPV-positive women were referred for a second colposcopy with biopsy and treatment as needed. Diagnostic accuracy of colposcopy was assessed by considering a positive test result when the colposcopic impression at the initial colposcopy was positive minor, positive major, or suspected cancer, and was considered negative otherwise. The main study outcome was histologically confirmed CIN3+ (defined as grade 3 or worse) detected at the initial visit or 18-month visit. FINDINGS: Between Dec 12, 2012, and Dec 3, 2021, 42 502 women were recruited, and 5985 (14·1%) tested positive for HPV. 4499 participants with complete disease ascertainment and follow-up were included in the analysis, with a median age of 40·6 years (IQR 34·7-49·9). CIN3+ was detected in 669 (14·9%) of 4499 women at the initial visit or 18-month visit (3530 [78·5%] negative or CIN1, 300 [6·7%] CIN2, 616 [13·7%] CIN3, and 53 [1·2%] cancers). Sensitivity was 91·2% (95% CI 88·9-93·2) for CIN3+, whereas specificity was 50·1% (48·5-51·8) for less than CIN2 and 47·1% (45·5-48·7) for less than CIN3. Sensitivity for CIN3+ significantly decreased in older women (93·5% [95% CI 91·3-95·3] in those aged 30-49 years vs 77·6% [68·6-85·0] in those aged 50-65 years; p<0·0001), whereas specificity for less than CIN2 significantly increased (45·7% [43·8-47·6] vs 61·8% [58·7-64·8]; p<0·0001). Sensitivity for CIN3+ was also significantly lower in women with negative cytology than in those with abnormal cytology (p<0·0001). INTERPRETATION: Colposcopy is accurate for CIN3+ detection in HPV-positive women. These results reflect ESTAMPA efforts in an 18-month follow-up strategy to maximise disease detection with an internationally validated clinical management protocol and regular training, including quality improvement practices. We showed that colposcopy can be optimised with proper standardisation to be used as triage in HPV-positive women. FUNDING: WHO; Pan American Health Organization; Union for International Cancer Control; National Cancer Institute (NCI); NCI Center for Global Health; National Agency for the Promotion of Research, Technological Development, and Innovation; NCI of Argentina and Colombia; Caja Costarricense de Seguro Social; National Council for Science and Technology of Paraguay; International Agency for Research on Cancer; and all local collaborative institutions.

Enhancing the stability and efficiency of MAPbI3 perovskite solar cells by theophylline-BF4 - alkaloid derivatives, a theoretical-experimental approach.

Perovskite solar cells (PSCs) are an evolving photovoltaic field with the potential to disrupt the established silicon solar cell market. However, the presence of many transport barriers and defect trap states at the interfaces and grain boundaries has negative effects on PSCs; it decreases their efficiency and stability. The purpose of this work was to investigate the effects on efficiency and stability achieved by quaternary theophylline additives in MAPbI3 PSCs with the structure FTO/TiO2/perovskite/spiro-OMeTAD/Ag. The X-ray photoelectron spectroscopy (XPS) and theoretical calculation strategies were applied to study the additive's interaction in the layer. The tetrafluoroborinated additive results in an increase in device current density (J SC) (23.99 mA cm-1), fill factor (FF) (65.7%), and open-circuit voltage (V OC) (0.95 V), leading to significant improvement of the power conversion efficiency (PCE) to 15.04% compared to control devices (13.6%). Notably, films exposed to controlled humidity of 30% using the tetrafluoroborinated additive maintained their stability for more than 600 hours (h), while the control films were stable for less than 240 hours (h).

Trends in incidence rates of head and neck squamous cell carcinomas overall and by potential relatedness to human papillomavirus, Costa Rica 2006 to 2015.

In Costa Rica (CR), only one report on head and neck cancer (HNC) incidence trends (1985-2007) has been published and no investigations on the epidemiology of potentially human papillomavirus (HPV)-related and HPV-unrelated HNCs have been done. We examined the age-standardized incidence rates (IRs) and trends of head and neck squamous cell carcinomas (HNSCC) and compared incidence trends of potentially HPV-related and HPV-unrelated HNSCCs. We obtained all available HNC cases for the period 2006-2015 from the Costa Rican National Cancer Registry of Tumors and the population estimates from the Costa Rican National Institute of Statistics and Census. The analysis was restricted to invasive HNSCCs (n = 1577). IRs and incidence rate ratios were calculated using SEER*Stat software and were age-standardized for the 2010 Costa Rican population. Joinpoint regression analysis program was used to calculate trends and annual percent changes (APCs) in rates. For all HNSCCs, the age-standardized IR was 34.0/million person-years; 95% CI 32.4, 35.8. There was a significant decline in the incidence of nasopharyngeal cancer (APC: -5.9% per year; 95% CI -10.8, -0.7) and laryngeal cancer (APC: -5.4% per year; -9.2, 1.5). The incidence trends for hypopharyngeal, oropharyngeal and oral cavity cancers each remained stable over time. HNSCCs were categorized by their potential relatedness to HPV infection. Though the APCs were not statistically significant, IRs of potentially HPV-related HNSCCs trended upward, while HPV-unrelated HNSCCs trended downward. HNSCCs are uncommon in CR and decreased over time. We observed a divergent pattern of decreasing HPV-unrelated with increasing HPV-related HNSCCs that should be further informed by HPV genotyping tumor samples.

Microalgae, a current option for the bioremediation of pharmaceuticals: a review.

In this review, research on the use of microalgae as an option for bioremediation purposes of pharmaceutical compounds is reported and discussed thoroughly. Pharmaceuticals have been detected in water bodies around the world, attracting attention towards the increasing potential risks to humans and aquatic biota. Unfortunately, pharmaceuticals have no regulatory standards for safe disposal in many countries. Despite the advances in new analytical techniques, the current wastewater treatment facilities in many countries are ineffective to remove the whole presence of pharmaceutical compounds and their metabolites. Though new methods are substantially effective, removal rates of drugs from wastewater make the cost-effectiveness ratio a not viable option. Therefore, the necessity for investigating and developing more adequate removal treatments with a higher efficiency rate and at a lower cost is mandatory. The present review highlights the algae-based removal strategies for bioremediation purposes, considering their pathway as well as the removal rate and efficiency of the microalgae species used in assays. We have critically reviewed both application of living and non-living microalgae biomass for bioremediation purposes considering the most commonly used microalgae species. In addition, the use of modified and immobilized microalgae biomass for the removal of pharmaceutical compounds from water was discussed. Furthermore, research considering various microalgal species and their potential use to detoxify organic and inorganic toxic compounds were well evaluated in the review. Further research is required to exploit the potential use of microalgae species as an option for the bioremediation of pharmaceuticals in water.

Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study.

Background: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. Methods: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. Results: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. Conclusion: High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a "culture of quality" should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening.

Optimization and Its Implementation Impact of Two-Modes Controller Fractional Approximation for Buck Converters.

Additional degrees of freedom in a fractional-order control strategy for power electronic converters are well received despite the lack of reliable tuning methods. Despite artificial/swarm intelligence techniques have been used to adjust controller parameters to improve more than one characteristic/property at the same time, smart tuning not always leads to realizable structures or reachable parameter values. Thus, adjustment boundaries to ensure controller viability are needed. In this manuscript the fractional-order approach is described in terms of El-Khazali biquadratic module, which produces the lowest order approximation, instead of using a definition. A two-modes controller structure is synthesize depending on uncontrolled plant needs and parameters are adjusted through particle swarm and genetic optimization algorithms for comparison. Two error-based minimization criteria are used to consider output performance into the process. Two restrictions complement the optimization scheme, one seeks to ensure desired robustness while the other prevents from synthesizing a high-gain controller. Optimization results showed similarity between minima obtained and significant difference between parameters of those controller optimized without the proposed constraints was determined. Numerical and experimental results are provide to validate proposed approach effectiveness. Effective regulation, good tracking characteristic and robustness in the presence of load variations are the main results.

Black-Box Mathematical Model for Net Photosynthesis Estimation and Its Digital IoT Implementation Based on Non-Invasive Techniques: Capsicum annuum L. Study Case.

Photosynthesis is a vital process for the planet. Its estimation involves the measurement of different variables and its processing through a mathematical model. This article presents a black-box mathematical model to estimate the net photosynthesis and its digital implementation. The model uses variables such as: leaf temperature, relative leaf humidity, and incident radiation. The model was elaborated with obtained data from Capsicum annuum L. plants and calibrated using genetic algorithms. The model was validated with Capsicum annuum L. and Capsicum chinense Jacq. plants, achieving average errors of 3% in Capsicum annuum L. and 18.4% in Capsicum chinense Jacq. The error in Capsicum chinense Jacq. was due to the different experimental conditions. According to evaluation, all correlation coefficients (Rho) are greater than 0.98, resulting from the comparison with the LI-COR Li-6800 equipment. The digital implementation consists of an FPGA for data acquisition and processing, as well as a Raspberry Pi for IoT and in situ interfaces; thus, generating a useful net photosynthesis device with non-invasive sensors. This proposal presents an innovative, portable, and low-scale way to estimate the photosynthetic process in vivo, in situ, and in vitro, using non-invasive techniques.

Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America.

The proportion of HPV16 and 18-associated cervical cancer (CC) appears rather constant worldwide (≥70%), but the relative importance of the other HR-HPV differs slightly by geographical region. Here, we studied the HPV genotype distribution of HPV positive Latin American (LA) women by histological grade, in a sub-cohort from the ESTAMPA study; we also explored the association of age-specific HPV genotypes in severe lesions. Cervical samples from 1,252 participants (854 ≤CIN1, 121 CIN2, 194 CIN3 and 83 CC) were genotyped by two PCRs-Reverse Blotting Hybridization strategies: i) Broad-Spectrum General Primers 5+/6+ and ii) PGMY9/11 PCRs. HPV16 was the most frequently found genotype in all histological grades, and increased with the severity of lesions from 14.5% in ≤ CIN1, 19.8% in CIN2, 51.5% in CIN3 to 65.1% in CC (p < 0.001). For the remaining HR-HPVs their frequency in CC did not increase when compared to less severe categories. The nonavalent vaccine HR-types ranked at the top in CC, the dominant ones being HPV16 and HPV45. HR-HPV single infection occurs, respectively, in 57.1% and 57.0% of ≤CIN1 and CIN2, increasing to 72.2% and 91.6% in CIN3 and CC (p<0.001). No association between age and HPV type was observed in CC, although the risk of HPV16 infection in CIN3 cases increased with age. Results confirm the relevance of HPV16 in the whole clinical spectrum, with a strong rise of its proportion in CIN3 and cancer. This information will be relevant in evaluating the impact of HPV vaccination, as a baseline against which to compare genotype changes in HPV type-specific distribution as vaccinated women participate in screening in LA region. Likewise, these data may help select the best HPV testing system for HPV-based efficient, affordable, and sustainable screening programmes.