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Background:Nordic countries' data offer a unique possibility to evaluate the long-term benefit of cervical cancer screening in a context of increasing risk of human papillomavirus infection.Methods:Ad hoc-refined age-period-cohort models were applied to the last 50-year incidence data from Denmark, Finland, Norway and Sweden to project expected cervical cancer cases in a no-screening scenario.Results:In the absence of screening, projected incidence rates for 2006–2010 in Nordic countries would have been between 3 and 5 times higher than observed rates. Over 60 000 cases or between 41 and 49% of the expected cases of cervical cancer may have been prevented by the introduction of screening in the late 1960 s and early 1970 s.Conclusions:Our study suggests that screening programmes might have prevented a HPV-driven epidemic of cervical cancer in Nordic countries. According to extrapolations from cohort effects, cervical cancer incidence rates in the Nordic countries would have been otherwise comparable to the highest incidence rates currently detected in low-income countries.

A wide variety of space occupying lesions may be encountered in the orbit. CT and MR imaging frequently help confirm the presence of a mass and define its extent. Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations. This review focuses on some of the common orbital masses. Common vascular lesions that are reviewed include: capillary (infantile) hemangioma, cavernous hemangioma (solitary encapsulated venous-lymphatic malformation), and lymphangioma (venous-lymphatic malformation). Benign tumors that are reviewed include: optic nerve sheath meningioma, schwannoma, and neurofibroma. Malignancies that are reviewed include: lymphoma, metastasis, rhabdomyosarcoma, and optic glioma. Key imaging features that guide radiological diagnosis are discussed and illustrated.

The United Arab Emirates is committed to integrating technology into higher education. In this study the researchers aim to explore the perspectives of university students on online assessments. An understanding of students' views can help identify obstacles and promotors in embracing online assessments at the undergraduate level. The social constructivist epistemology has been used in this qualitative study to understand students' preferences, apprehensions and acceptance of online assessments. Semistructured focus group discussions were carried out after recruiting 41 university students, using convenience and snowball sampling methods. Thematic content analysis was applied to the data. This study highlighted that students did not comprehend the need for online assessments. Concerns regarding technological incompetence of students and teachers alongside distrust in the technology infrastructure were stressed. Students felt online assessments were restrictive for the science courses and had resulted in falling grades; probably due to the increasing dependence on multiple choice questions. Students also expressed the importance of constructive, timely and personalized feedback. Students need to be convinced of the usefulness of the transition to online assessment before they agree with it. It is evident through this study that student acceptance would increase with a gradual transition towards online assessments alongside technological training for both students and faculty. Active individualized interaction with instructors is important to students, furthermore preferences and concerns emphasized by students should be addressed to successfully integrate online assessments into higher education.

The 4D MUSIC technique may represent a new paradigm in MR evaluation of cardiovascular anatomy and function in children with complex congenital heart disease.

Background Late Gadolinium Enhancement (LGE) MRI of ventricular scar has been shown to be accurate for detection and characterization of arrhythmia substrates. However, the majority of patients referred for ventricular tachycardia (VT) ablation have an implantable cardioverter defibrillator (ICD), which obscures image integrity and the clinical utility of MRI. Objective To develop and validate a wideband LGE MRI technique for device artifact removal. Methods A novel wideband LGE MRI technique was developed to allow for improved scar evaluation on patients with ICDs. The wideband technique and the standard LGE MRI were tested on 18 patients with ICDs. VT ablation was performed in 13 of 18 patients with either endocardial and/or epicardial approach and the correlation between the scar identified on MRI and electroanatomical mapping was analyzed. Results Hyper-intensity artifact was present in 16/18 of patients using standard MRI, which was eliminated using the wideband LGE and allowed for MRI interpretation in 15/16 patients. All patients had ICD lead characteristics confirmed as unchanged post- MRI and had no adverse events. LGE scar was seen in 11/18 patients. Among the 15 patients where wideband LGE allowed visualization of myocardium, 10 had LGE scar and 5 had normal myocardium in the regions with image artifacts when using the standard LGE. The left ventricular scar size measurements using wideband MRI and EAM were correlated with R2=0.83, P=0.00003. Conclusions The wideband LGE-MRI improves the ability to visualize myocardium for clinical interpretation, which correlated well with EAM findings during VT ablation.

This paper reports on the results of a literature survey involving 166 different species of plants used in the Ayurvedic pharmacopoeia, based on a sampling of the literature available to us. We found a wide range of clinical and other in vivo studies for many of the plant-based therapies utilized in the Ayurvedic system. Of the 166 plants investigated, 72 (43%) had at least one or more human studies and 103 (62%) had one or more animal studies. These results appear to contradict the generally held notion that herbal remedies used in non-Western systems of botanical medicine have not been evaluated in human or in vivo trials. Some of these studies are not always as large or methodologically rigorous as clinical studies reported in major medical journals. Indeed, a critical assessment of the research according to the standards of evidence-based medicine would eliminate many of these studies for lack of rigor according to criteria of randomization, sample size, adequacy of controls, etc. However, the studies do suggest which species might be appropriate for larger and better-controlled trials in the future. Accordingly, a synopsis of the plants, their therapeutic applications, and their clinical or experimental evaluations is presented.

Background Closure of an abdominal stoma, a common elective operation, is associated with frequent complications; one of the commonest and impactful is incisional hernia formation. We aimed to investigate whether biological mesh (collagen tissue matrix) can safely reduce the incidence of incisional hernias at the stoma closure site. Methods In this randomised controlled trial (ROCSS) done in 37 hospitals across three European countries (35 UK, one Denmark, one Netherlands), patients aged 18 years or older undergoing elective ileostomy or colostomy closure were randomly assigned using a computer-based algorithm in a 1:1 ratio to either biological mesh reinforcement or closure with sutures alone (control). Training in the novel technique was standardised across hospitals. Patients and outcome assessors were masked to treatment allocation. The primary outcome measure was occurrence of clinically detectable hernia 2 years after randomisation (intention to treat). A sample size of 790 patients was required to identify a 40% reduction (25% to 15%), with 90% power (15% drop-out rate). This study is registered with ClinicalTrials.gov, NCT02238964.