Evidence-Based Consensus Recommendations for Colposcopy Practice for Cervical Cancer Prevention in the United States.

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of colposcopy and directed biopsy for cervical cancer prevention in the United States (US). The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. An extensive literature review was conducted and supplemented by a systematic review and meta-analysis of unpublished data. In addition, a survey of practicing colposcopists was conducted to assess current colposcopy practice in the US. Recommendations were approved by the working group members, and the final revisions were made based on comments received from the public. The recommendations cover terminology, risk-based colposcopy, colposcopy procedures, and colposcopy adjuncts. The ASCCP Colposcopy Standards recommendations are an important step toward raising the standard of colposcopy services delivered to women in the US. Because cervical cancer screening programs are currently undergoing important changes that may affect colposcopy performance, updates to some of the current recommendations may be necessary in the future.

ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice.

OBJECTIVES: The American Society for Colposcopy and Cervical Pathology Colposcopy Standards address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. Working Group 1 was tasked with defining the role of colposcopy, describing benefits and potential harms, and developing an official terminology. METHODS: A systematic literature review was performed. A national survey of American Society for Colposcopy and Cervical Pathology members provided input on current terminology use. The 2011 International Federation for Cervical Pathology and Colposcopy terminology was used as a template and modified to fit colposcopic practice in the United States. For areas without data, expert consensus guided the recommendation. Draft recommendations were posted online for public comment and presented at an open session of the 2017 International Federation for Cervical Pathology and Colposcopy World Congress for further comment. All comments were considered for the final version. RESULTS: Colposcopy is used in the evaluation of abnormal or inconclusive cervical cancer screening tests. Colposcopy aids the identification of cervical precancers that can be treated, and it allows for conservative management of abnormalities unlikely to progress. The potential harms of colposcopy include pain, psychological distress, and adverse effects of the procedure. A comprehensive colposcopy examination should include documentation of cervix visibility, squamocolumnar junction visibility, presence of acetowhitening, presence of a lesion(s), lesion(s) visibility, size and location of lesions, vascular changes, other features of lesion(s), and colposcopic impression. Minimum criteria for reporting include squamocolumnar junction visibility, presence of acetowhitening, presence of a lesion(s), and colposcopic impression. CONCLUSIONS: A recommended terminology for use in US colposcopic practice was developed, with comprehensive and minimal criteria for reporting.

Academic satisfaction among Latino/a and White men and women engineering students.

The current study tests a model of academic satisfaction in engineering based on Lent, Brown, and Hackett's (1994, 2000) social cognitive career theory among a sample of 527 engineering majors attending a Hispanic serving institution. The findings indicated that (a) an alternative bidirectional model fit the data for the full sample; (b) all of the hypothesized relations were significant for the full sample, except the path from engineering interests to goals; (c) social cognitive career theory predictors accounted for a significant amount of variance in engineering goals (26.6%) and academic satisfaction (45.1%); and (d) the model parameters did not vary across men and women or across Latino/a and White engineering undergraduate students. Implications for research and practice are discussed in relation to persistence in engineering among women and Latinos/as.

Application of carbon nanotube technology for removal of contaminants in drinking water: a review.

Carbon nanotube (CNT) adsorption technology has the potential to support point of use (POU) based treatment approach for removal of bacterial pathogens, natural organic matter (NOM), and cyanobacterial toxins from water systems. Unlike many microporous adsorbents, CNTs possess fibrous shape with high aspect ratio, large accessible external surface area, and well developed mesopores, all contribute to the superior removal capacities of these macromolecular biomolecules and microorganisms. This article provides a comprehensive review on application of CNTs as adsorbent media to concentrate and remove pathogens, NOM, and cyanobacterial (microcystin derivatives) toxins from water systems. The paper also surveys on consideration of CNT based adsorption filters for removal of these contaminants from cost, operational and safety standpoint. Based on the studied literature it appears that POU based CNT technology looks promising, that can possibly avoid difficulties of treating biological contaminants in conventional water treatment plants, and thereby remove the burden of maintaining the biostability of treated water in the distribution systems.

Adsorption of Bacillus subtilis on single-walled carbon nanotube aggregates, activated carbon and NanoCeram.

Adsorption equilibrium and kinetics of Bacillus subtilis spores on single-walled carbon nanotube aggregates were investigated to explore the possibility of using single-walled carbon nanotubes for concentration, detection and removal of pathogens from contaminated water sources. Batch adsorption experiments were conducted to determine adsorption kinetics and adsorption equilibrium of B. subtilis spores on single-walled carbon nanotube aggregates, activated carbon and NanoCeram. The adsorption kinetics data were analyzed with both the Lagergren pseudo first order and a pseudo second order models. The adsorption equilibrium data on three porous media were quantified by the Henry's law constant. It was observed that both the Lagergren first order rate model and the pseudo second order model correlate the adsorption kinetic data well although the calculated adsorption rate constants vary with adsorbate concentrations. The Henry's law adsorption equilibrium constant of B. subtilis spores on single-walled carbon nanotube aggregates is about 27-37 times higher than those on activated carbon and NanoCeram. The high adsorption affinity of carbon nanotubes towards the B. subtilis spores is due to the mesoporous structure and unique surface properties of carbon nanotubes. These results suggest that single-walled carbon nanotube aggregates are good candidates as biosensors and adsorbent media for concentrating, detecting and removal of pathogens from contaminated water resources.

Adsorption kinetics of Escherichia coli and Staphylococcus aureus on single-walled carbon nanotube aggregates.

Batch adsorption studies to determine adsorption kinetics of Escherichia coli (E.coli) K12 and Staphylococcus aureus (S.aureus) SH 1000 bacterial cells on single-walled carbon nanotube aggregates were performed at two different initial concentrations. The diffusivity of E. coli cells in single-walled carbon nanotube aggregates obtained was 6.54 x 10(-9) and 8.98 x 10(-9) cm(2)/s, whereas that of S. aureus was between 1.00 x 10(-7) and 1.66 x 10(-7) cm(2)/s respectively. In addition to batch adsorption studies, electron microscopy studies were also conducted. The results suggest that diffusion kinetics of bacterial cells is concentration dependent as well as bacteria dependent. Diffusivity of S. aureus is two orders of magnitude greater than E. coli cells. This proves to be beneficial from an adsorption perspective where it is desired to filter microorganisms (water pretreatment and wastewater post treatment) and from nanotube biosensor perspective where it is desired to simultaneously capture and detect biothreat agents in a shorter span of time.

Helical tomotherapy superficial dose measurements.

Helical tomotherapy is a treatment technique that is delivered from a 6 MV fan beam that traces a helical path while the couch moves linearly into the bore. In order to increase the treatment delivery dose rate, helical tomotherapy systems do not have a flattening filter. As such, the dose distributions near the surface of the patient may be considerably different from other forms of intensity-modulated delivery. The purpose of this study was to measure the dose distributions near the surface for helical tomotherapy plans with a varying separation between the target volume and the surface of an anthropomorphic phantom. A hypothetical planning target volume (PTV) was defined on an anthropomorphic head phantom to simulate a 2.0 Gy per fraction IMRT parotid-sparing head and neck treatment of the upper neck nodes. A total of six target volumes were created with 0, 1, 2, 3, 4, and 5 mm of separation between the surface of the phantom and the outer edge of the PTV. Superficial doses were measured for each of the treatment deliveries using film placed in the head phantom and thermoluminescent dosimeters (TLDs) placed on the phantom's surface underneath an immobilization mask. In the 0 mm test case where the PTV extends to the phantom surface, the mean TLD dose was 1.73 +/- 0.10 Gy (or 86.6 +/- 5.1% of the prescribed dose). The measured superficial dose decreases to 1.23 +/- 0.10 Gy (61.5 +/- 5.1% of the prescribed dose) for a PTV-surface separation of 5 mm. The doses measured by the TLDs indicated that the tomotherapy treatment planning system overestimates superficial doses by 8.9 +/- 3.2%. The radiographic film dose for the 0 mm test case was 1.73 +/- 0.07 Gy, as compared to the calculated dose of 1.78 +/- 0.05 Gy. Given the results of the TLD and film measurements, the superficial calculated doses are overestimated between 3% and 13%. Without the use of bolus, tumor volumes that extend to the surface may be underdosed. As such, it is recommended that bolus be added for these clinical cases. For cases where the target volume is located 1 to 5 mm below the surface, the tumor volume coverage can be achieved with surface doses ranging from 56% to 93% of the prescribed dose.

Marketing a hard-to-swallow message: recommendations for the design of media campaigns to increase awareness about the risks of binge drinking.

BACKGROUND: Binge drinking, commonly defined as having more than five drinks on a single occasion, is a public health issue affecting two thirds of Canadian young adults between the ages of 19-24 years. To educate young adults about alcohol poisoning, a network of 16 Ontario Health Units developed and implemented a mass-media campaign. The focus of this article is to report on post-secondary students' perceptions about key media campaign strategies, elements and messages for future campaigns designed to increase awareness about the risks of binge drinking. METHODS: As part of a multi-method process evaluation, nine focus groups were facilitated to explore the young adults' knowledge, attitudes and beliefs about binge drinking and the campaign messages. Participants were also asked to identify specific marketing messages and techniques that would increase their level of awareness about the risks of binge drinking. RESULTS: Participants recommended that campaigns be targeted towards parents and high school and post-secondary school students. Participants provided recommendations for the types of messages, images, and language they perceived would capture the attention of young adults. Television, posters and the internet were identified as key media channels for disseminating health information about the risks associated with excessive alcohol consumption. CONCLUSION: The problem of binge drinking is pervasive across Canadian campuses and students are largely unaware of the risks associated with excessive alcohol consumption. To reach this target population, it is important for future media campaign developers to utilize language, definitions, graphics and channels of communication to which this group relates.

Computer simulations of adsorption and diffusion for binary mixtures of methane and hydrogen in titanosilicates.

Equilibrium molecular dynamics (MD) simulations of equimolar mixtures of hydrogen and methane were performed in three different titanosilicates: naturally occurring zorite and two synthetic titanosilicates, ETS-4 and ETS-10. In addition, single-component MD simulations and adsorption isotherms generated using grand canonical Monte Carlo simulations were performed to support the mixture simulations. The goal of this study was to determine the best membrane material to carry out hydrogen/methane separations. ETS-10 has a three-dimensional pore network. ETS-4 and zorite have two-dimensional pore networks. The simulations carried out in this study show that the increased porosity of ETS-10 results in self-diffusion coefficients for both hydrogen and methane that are higher in ETS-10 than in either ETS-4 or zorite. Methane only showed appreciable displacement in ETS-10. The ability of the methane molecules to move in all three directions in ETS-10 was demonstrated by the high degree of isotropy shown in the values of the x, y, and z components of the self-diffusion coefficient for methane in ETS-10. From our simulations we conclude that ETS-10 would be better suited for fast industrial separations of hydrogen and methane. However, the separation would not result in a pure hydrogen stream. In contrast, ETS-4 and zorite would act as true molecular sieves for separations of hydrogen and methane, as the methane would not move through membranes made of these materials. This was indicated by the near-zero self-diffusion coefficient of methane in ETS-4 and zorite.