Cervical cancer, the most common cancer affecting women in developing countries, is caused by persistent infection with "high-risk" genotypes of human papillomaviruses (HPV). The most common oncogenic HPV genotypes are 16 and 18, causing approximately 70% of all cervical cancers. Types 6 and 11 do not contribute to the incidence of high-grade dysplasias (precancerous lesions) or cervical cancer, but do cause laryngeal papillomas and most genital warts. HPV is highly transmissible, with peak incidence soon after the onset of sexual activity.A quadrivalent (types 6, 11, 16 and 18) HPV vaccine has recently been licensed in several countries following the determination that it has an acceptable benefit/risk profile. In large phase III trials, the vaccine prevented 100% of moderate and severe precancerous cervical lesions associated with types 16 or 18 among women with no previous infection with these types. A bivalent (types 16 and 18) vaccine has also undergone extensive evaluation and been licensed in at least one country. Both vaccines are prepared from non-infectious, DNA-free virus-like particles produced by recombinant technology and combined with an adjuvant. With three doses administered, they induce high levels of serum antibodies in virtually all vaccinated individuals. In women who have no evidence of past or current infection with the HPV genotypes in the vaccine, both vaccines show > 90% protection against persistent HPV infection for up to 5 years after vaccination, which is the longest reported follow-up so far. Vaccinating at an age before females are exposed to HPV would have the greatest impact. Since HPV vaccines do not eliminate the risk of cervical cancer, cervical screening will still be required to minimize cancer incidence. Tiered pricing for HPV vaccines, innovative financing mechanisms and multidisciplinary partnerships will be essential in order for the vaccines to reach populations in greatest need.
Counterdiabatic (CD) driving presents a way of generating adiabatic dynamics at arbitrary pace, where excitations due to non-adiabaticity are exactly compensated by adding an auxiliary driving term to the Hamiltonian. While this CD term is theoretically known and given by the adiabatic gauge potential, obtaining and implementing this potential in many-body systems is a formidable task, requiring knowledge of the spectral properties of the instantaneous Hamiltonians and control of highly nonlocal multibody interactions. We show how an approximate gauge potential can be systematically built up as a series of nested commutators, remaining well-defined in the thermodynamic limit. Furthermore, the resulting CD driving protocols can be realized up to arbitrary order without leaving the available control space using tools from periodically-driven (Floquet) systems. This is illustrated on few-and many-body quantum systems, where the resulting Floquet protocols significantly suppress dissipation and provide a drastic increase in fidelity.
There is a need for a thorough discussion among all those concerned of the ethical and legal aspects of re-infibulation, medicalization of FGM and cosmetic vaginal surgery.
We propose an extension of the numerical approach for integrable Richardson-Gaudin models based on a new set of eigenvalue-based variables [A. Faribault et al., Phys. Rev. B 83, 235124 (2011); O. El Araby et al., ibid. 85, 115130 (2012)]. Starting solely from the Gaudin algebra, the approach is generalized towards the full class of XXZ Richardson-Gaudin models. This allows for a fast and robust numerical determination of the spectral properties of these models, avoiding the singularities usually arising at the so-called singular points. We also provide different determinant expressions for the normalization of the Bethe ansatz states and form factors of local spin operators, opening up possibilities for the study of larger systems, both integrable and nonintegrable. Remarkably, these results are independent of the explicit parametrization of the Gaudin algebra, exposing a universality in the properties of Richardson-Gaudin integrable systems deeply linked to the underlying algebraic structure.
The pap smear had the highest specificity (94.6%) and HPV testing the highest sensitivity (94.4%). The visual methods, VIA and cervicography, were similar and showed an accuracy in between the former two tests.
After discussing advantages and risks, only a third of the 290 HIV-infected women included in an intervention study to reduce mother-to-child transmission of HIV in Mombasa, Kenya, informed their partners of their results. Despite careful counselling, 10% subsequently experienced violence or disruption of their relationship. To increase the uptake of interventions to reduce perinatal HIV transmission safely, we recommend the involvement of partners in HIV testing. In addition, the counselling of women has to address methods and skills to deal with violence.
The pattern of HPV distribution in this population was different from that in other regions in the world, which has important consequences for HPV vaccine development.
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