Search Results (707)

Objective: This study aimed to identify risk factors associated with high-grade cervical intraepithelial neoplasia (CIN3+) in young adults with abnormal Pap smears. Methods: We performed a retrospective chart review of women ≤30 years who underwent loop electrosurgical excision procedure (LEEP) for abnormal Pap results (atypical squamous cells of undetermined significance [ASCUS] or higher), between 2012 and 2022 at Dongtan Sacred Heart Hospital. Clinical characteristics, including age, HPV infection, prior gynecologic surgery, pelvic inflammatory disease (PID), complete blood count, and Pap smear screening history were collected. Women with CIN3+ based on punch biopsy or LEEP were designated as CIN3+. Results: A total of 158 women underwent LEEP. Of these, 61.4% were diagnosed with CIN3+ and 8.2% with invasive cervical cancer. Independent predictors of CIN3+ included age >28 years, smoking, lack of regular Pap screening, and high-risk HPV infection. Subgroup analysis suggested age ≥28 years and neutrophil-to-lymphocyte ratio >2.12 were risk factors for invasive cervical cancer. Conclusions: Young Korean women with abnormal Pap smears and risk factors such as older age, smoking, high-risk HPV infection, and irregular screening histories are at increased risk for CIN3+. These findings highlight the importance of timely intervention; however, because our cohort included only women who underwent LEEP, it may represent a higher-risk subset and thus introduce selection bias. Validation in larger multicenter, prospective studies incorporating fertility and recurrence outcomes are needed before definitive recommendations can be made. Full article

Chemotherapy-induced neurotoxicity (CIN) is a major barrier against optimal anticancer treatment. This study investigated the neuroprotective effects of the naturally occurring antioxidant, Coenzyme Q10 (CoQ10), against CIN using a model of induced pluripotent stem cell (iPSC)-derived neurons. iPSCs have consistently proven to be reliable for disease modeling and drug discovery. We employed cell viability, oxidative stress, and mitochondrial function assays to measure the effect of 10 μM CoQ10 on iPSC-derived motor neuron progenitors (iPSC-MNPs) that were exposed to five chemotherapeutic agents: 5-Fluorouracil, methotrexate, paclitaxel (0, 1, and 10 μM) and doxorubicin, and vincristine (0, 0.1, and 1 μM). Our findings show that CoQ10 significantly reversed the reduction in cell viability inflicted by the exposure of iPSCs-MNPs to all five chemotherapeutics. Moreover, CoQ10 treatment resulted in a marked reduction in intracellular ROS levels and enhancement of mitochondrial membrane potential (MMP) in a drug- and dose-dependent manners, highlighting its role in preserving mitochondrial health. This study is the first to explore the protective effects of CoQ10 against CIN using an iPSC-derived neuronal platform, offering insights into its potential therapeutic use. Further investigation is essential to validate these findings and to determine the behavioral effects of CoQ10 in in vivo models of CIN. Full article

Background: Cervical intraepithelial neoplasia grade 2 (CIN2) represents a controversial lesion in cervical cancer prevention. Traditionally included in the aggregate CIN2+ endpoint for reasons of diagnostic stability and statistical power, isolated CIN2 has unique biological characteristics: greater interobserver variability, a high probability of spontaneous regression and a lower risk of progression compared to CIN3. Objectives: To critically describe the epidemiology, natural history and management strategies of CIN2, integrating data from clinical and population-based studies and comparing the recommendations of the main international guidelines. Methods: A narrative review was conducted using a search of PubMed and Scopus (1990–January 2025). Prospective and retrospective studies on isolated CIN2, screening and vaccination trials with CIN2+ endpoints, biomarker research, and consensus documents (ASCCP, ESGO, GISCi, Ministry of Health, WHO) were included. Results: Clinical studies have shown a high probability of CIN2 regression (50–70% within two years, >70% in those <25 years), compared to a 10–15% risk of progression, especially in the presence of persistent HPV16. Screening trials and vaccine evaluations with CIN2+ endpoints have documented the efficacy of the HPV test and a dramatic reduction in lesions in vaccinated cohorts, which was also confirmed for isolated CIN2. The most recent guidelines have progressively adopted a risk-based approach, which allows for active surveillance in young women or those seeking to conceive, while the WHO maintains a screen-and-treat model in resource-limited countries. Conclusions: CIN2 is not a lesion to be treated automatically, but rather a paradigmatic model for personalized management. Integrating epidemiological and clinical data, supported by biomarkers, allows for reducing overtreatment without compromising oncological safety. Full article

Cervical cancer remains a leading cause of mortality among women, particularly in regions with limited resources. Persistent high-risk human papillomavirus (HR-HPV) infection is the main etiological factor for CIN and cervical cancer. This study aimed to evaluate the association between HPV genotypes, age, and cytological findings and the presence of CIN2–3 in women presenting with abnormal cervical cytology. This cross-sectional study included 189 women with abnormal cytology who attended a tertiary center in Peru. All participants underwent partial HPV genotyping using the Cobas 4800 assay, colposcopic evaluation, and colposcopically directed biopsies, which served as the diagnostic reference. Sociodemographic characteristics and reproductive histories were also collected. Multiple logistic regression was performed to assess the associations among specific HPV genotypes, age, cytological results, and CIN2–3 outcomes. Most participants were between 30 and 59 years of age (76.7%), and multiparity was common (77.8%). The most frequent cytological abnormalities were ASC-US (36.0%) and LSIL (28.0%), followed by HSIL (20.1%). HPV16 was detected in 24.3% of cases, HPV18 in 2.1%, and other HR-HPV types in 73.6%. HSIL cytology showed high concordance with histological CIN2–3 (>95%). Logistic regression demonstrated that age ≥ 30 years (aOR 4.50, 95% CI 1.90–10.65) and HPV16 infection (aOR 4.19, 95% CI 1.95–9.00) were the strongest independent predictors of high-grade disease. HPV18 was rare and not significantly associated, whereas other HR-HPV types showed an inverse association with CIN2–3. HPV16 and age ≥ 30 years were the most significant predictors of CIN2–3 in women with abnormal cytology, underscoring the dominant oncogenic role of HPV16. Integrating HPV genotyping, cytological findings, and age into risk-stratified algorithms could optimize cervical cancer prevention, ensuring timely detection of high-grade lesions while minimizing overtreatment in low-risk populations. Full article

Background/Objectives: Most cervical intraepithelial neoplasias (CINs) regress over time. Diagnostic screenings are limited and cannot identify the disease trend, which leads to the risk of overtreatment. Reliable methods are needed to preselect patients who will probably progress. The diagnostic GynTect^® assay offers sensitive and specific CIN identification from cervical scrapes, measuring the methylation of six marker genes. We studied the main marker (ZNF671) methylation on formalin-fixed paraffin-embedded (FFPE) material to determine if the kit provides prognostic information too. Methods: We tested 289 FFPE samples from 139 patients with varying CIN grades and disease trends, including regressive, persistent, progressive, and recurrent disease. Additionally, we correlated age and human papillomavirus (HPV) status with the results. Results: Although there are differences between FFPE material and cervical scrapes, we achieved a similar increase in ZNF671 methylation with increasing neoplasia grade (dysplasia-free: 0%, CIN 1: 8.20%, CIN 2: 26.73%, CIN 3: 32.43%, carcinoma: 100%). In addition, ZNF671 is more likely to detect recurring (27.12% of positives) and progressive (59.32% of positives) neoplasia. Patients with regressive (1.69% of positives) or persistent (11.86% of positives) trends less frequently show ZNF671 methylation. Interestingly, patients with HPV 16 infection (52.54% of positives) and >30 years (89.83% of positives) are more likely to appear ZNF671 methylation-positive. However, patients < 30 years with persistent neoplasia (42.86% of positives) also show methylation more frequently. Conclusions: The methylation of ZNF671 is measurable in cervical FFPE material and has prognostic value. Since ZNF671-methylated samples are most likely to be progressing, we recommend the closer monitoring of patients with GynTect^®-positive test results. Full article

Ilha de Moçambique is an island off the northern coast of Mozambique, covering an area of 1.5 km². Recognized as a UNESCO World Heritage Site since 1991, the island is currently under threat due to the increasing frequency and intensity of extreme weather events caused by climate change. Cyclonic events and pluvial floods have led to the progressive degradation of buildings and are compromising the integrity of the site. Furthermore, the island’s economic and social vulnerability is also worsening. The article aims to critically review the strategic planning approaches adopted for climate adaptation on Ilha de Moçambique. The objective is to identify and assess the planning instruments implemented to protect coastal urban heritage in light of contemporary challenges. Methodologically, a literature review is conducted based on the analysis of a collection of plans dedicated to adapting to climate change and heritage preservation. The results reveal that current planning approaches remain fragmented and insufficient, reducing their practical impact. There is a notable absence of planning instruments specifically designed to integrate cultural heritage preservation with urban climate adaptation. In conclusion, although some initiatives are underway, significant gaps persist in the strategic planning framework, underscoring the urgent need for inclusive integrated and adaptive measures to safeguard the island’s urban heritage and community in the long term. Full article

Background/Objectives: Cardiovascular diseases are among the leading causes of death worldwide. Early diagnosis of these conditions minimizes the risk of future death. Listening to heart sounds with a stethoscope is one of the easiest and fastest methods for diagnosing heart conditions. While heart sounds are a quick and easy diagnostic method, they require significant expert interpretation. Recently, artificial intelligence models trained based on these expert interpretations have become popular in the development of decision support systems. Methods: The proposed approach uses the popular 2016 PhysioNet/CinC Challenge dataset for PCG signals. Spectrogram image transformation was then performed to increase the representativeness of these signals. A deep learning-based model that allows for the simultaneous training of residual and attention blocks and the MLP-mixer model was used for feature extraction. A new algorithm combining the strengths of NCA and ReliefF algorithms was proposed to select the strongest features in the feature set. The SVM algorithm was used for classification. Results: With this proposed approach, over 98% success was achieved in all accuracy, sensitivity, specificity, precision, and F1-score metrics. Conclusions: As a result, an artificial intelligence-based decision support system that detects cardiovascular diseases with high accuracy is presented. Full article

While nutrition is often considered a protective factor against cancer, there is a scarcity of strong, conclusive evidence supporting its direct impact on cervical cancer (CC) prevention. This study aims to review the existing literature on the relationship between women’s nutrition and infection by the human papillomavirus (HPV) and the development of CC. It explores the key nutrients, foods, and dietary patterns that may influence the onset and progression of this disease, including research carried out in sub-Saharan Africa, other low-income countries, and worldwide. The review process revealed that, despite the large initial pool of articles, the majority were excluded because they were not focused on nutrition and CC. However, the articles that met the inclusion criteria suggested an association between diet and lower susceptibility to persistent HPV infections, which could progress into cervical lesions or cancer. Notably, lower folate intake was associated with up to a nine-fold higher risk of CIN3+ lesions (OR 8.9, 95% CI 3.4–24.9), while increased consumption of certain vitamins and antioxidant-rich foods consistently correlated with lower HPV persistence and progression. These results could indicate that consuming antioxidant compounds, certain vitamins, dietary patterns, and functional foods may offer protective benefits against developing this disease and its progression. By emphasizing nutrition as a modifiable factor, this review seeks to raise awareness and propose a holistic approach to CC prevention—integrating public health, dietary considerations, and equity-driven strategies. Full article

Background: Chromosomal instability (CIN) may underlie a subset of idiopathic infertility, and chronic periodontitis could contribute to genomic fragility. We tested whether periodontal status is associated with cytogenetic instability in adults with idiopathic infertility. Methods: This was a cross-sectional study of 60 adults aged 20–40 years, comprising idiopathic infertility (n = 30) and fertile controls (n = 30), each with 18 women and 12 men. Significant exclusions included systemic inflammatory disease, pregnancy/lactation, recent antibiotics/NSAIDs, and periodontal therapy within 6 months. Periodontal examination recorded probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP). Cytogenetic testing used mitomycin C-induced chromosomal breakage to derive the Breakage Index (BI); CIN was defined as BI ≥ 4.0. Analyses compared infertile with CIN (n = 19), infertile without CIN (n = 11), and controls (n = 30). Results: Infertile participants with CIN had a higher periodontitis burden compared to infertile participants without CIN and to controls (moderate–severe: 89.5% vs. 54.5% vs. 26.7%); mean BI also differed (5.2 ± 0.9 vs. 1.3 ± 0.5 vs. 0.4 ± 0.2). Periodontal measures followed the same gradient, with greater CAL and PD in CIN-positive infertility. Conclusions: In idiopathic infertility, CIN was cross-sectionally associated with more severe periodontitis, and the BI correlated with CAL, PD, and BOP. Causality cannot be inferred and residual confounding cannot be excluded. Periodontal screening is a feasible adjunct that may help identify a modifiable inflammatory burden; prospective and interventional studies are warranted. Full article

Background/Objectives: In Romania, where cervical cancer incidence remains among the highest in the European Union, a risk-based management strategy could support more precise allocation of limited resources. The aim of this study was to test the prognostic utility of immediate pre-treatment and post-treatment risk predictions, derived from the American Society of Colposcopy and Cervical Pathology (ASCCP) risk-based management guidelines for the prediction of progression, regression or persistence of high-grade cervical dysplasia. Methods: In this prospective cohort study, we included 223 patients aged over 30 years who underwent self-referred or targeted screening with or without histologically confirmed cervical intraepithelial neoplasia (CIN) of any grade. We employed Fine and Gray’s subdistribution hazard model that evaluated the cumulative incidence function for each specific outcome, treating other outcomes as competing events. These outcomes were further stratified depending on the type of high-grade dysplasia. Results: The immediate post-treatment risk was significantly associated with subsequent progression of cervical dysplasia. For a cut-off of 60%, the immediate post-treatment risk was able to significantly predict the progression of both CIN2+ and CIN3+. On the other hand, the immediate pre-treatment risk > 60% was significantly associated with progression of CIN3+, but not of CIN2+. Also, the immediate pre-treatment risk was significantly associated with regression, but this observation did not persist at the >60% threshold. Both pre- and post-treatment risk > 60% were strongly associated with persistence across histologic subgroups. Conclusions: The ASCCP-derived immediate risk estimates, especially post-treatment risk > 60%, proved effective in predicting progression and persistence of high-grade cervical dysplasia. Full article

The integration of essential oils (EOs) with biological control agents offers a promising alternative to synthetic pesticides, though compatibility remains unclear. This study evaluated nutmeg (Myristica fragrans, NM), cinnamon (Cinnamomum verum, CIN), and clove (Syzygium aromaticum, CL) specifically on S. oryzae and L. distinguendus. Olfactory and behavioral responses to whole EOs and major constituents (myristicin, cinnamaldehyde, eugenol) were analyzed using the area preference method (APM) and two-choice behavioral bioassay (TCB), with confirmation by gas chromatography–mass spectrometry (GC-MS). In S. oryzae, APM showed attraction to all three EOs (PI = 0.14 to 0.56). A paradox emerged, however, as single constituents were mostly repellent (eugenol: PI = −0.58 to −0.70; cinnamaldehyde: PI shifted from 0.16 to −0.20), underscoring the complexity of EO mixtures where multiple compounds act jointly rather than individually. In contrast, L. distinguendus strongly avoided CL and CIN in TCB, with fewer than 30% of parasitoids choosing the EO-treated side (χ² test, p < 0.05). CIN therefore demonstrated selective potential, simultaneously attracting S. oryzae while repelling L. distinguendus. These findings highlight the dual role of EOs as botanical pest control tools, while stressing the need to consider non-target effects before practical application. Full article

This paper presents ModuLab, a modular, low-cost sensor platform designed to simplify real-time environmental monitoring for laboratory research and educational settings. Centered on the APP-All MCU 2023 development board with an AVR128DA48 microcontroller (Microchip Technology Inc., Taiwan) ModuLab supports plug-and-play integration of multiple sensor types—including temperature, pH, light, and humidity—using a robust I²C communication protocol. The system features configurable sampling rates, built-in signal conditioning, and a Python-based interface for real-time data visualization. As a proof-of-concept, ModuLab was operated continuously for 48 h to evaluate system stability and filtering capabilities. However, due to institutional data ownership and confidentiality policies, the underlying datasets cannot be disclosed in this submission. The architecture and implementation details described herein are intended to guide future users and research groups seeking accessible alternatives to conventional data acquisition solutions. Comprehensive performance validation and open-access data sharing are planned as the next steps in this ongoing project. Full article

Background/Objectives: The diagnostic performance of CINtec^® PLUS can be influenced by numerous patient characteristics and risk factors. The aim of this retrospective study was to evaluate and model the risk factors associated with CINtec^® PLUS test positivity in patients undergoing cervical cancer screening and to assess their predictive performance for the prediction of cervical intraepithelial neoplasia (CIN) 2/3 using an unsupervised machine learning-based model. Methods: Medical data of 134 patients with human papillomavirus (HPV) infection who underwent CINtec^® PLUS testing were used to model the impact of risk factors on dual-stain cytology positivity and to evaluate the predictive performance for CIN2/3. Results: The gradient boosting classifier for the prediction of CINtec^® PLUS positivity using clinical risk factors had a precision of 75%, an overall accuracy of 0.62, and an area under the curve (AUC) value of 0.77. Body mass index and age were the most important variables in this model. HSIL, ASC-US, and other high-risk HPV strains increased the likelihood of a positive outcome. Overall AUC values for a positive test alone were 0.74 and 0.69 for CIN2 and CIN3 prediction, respectively. For CIN2 prediction, the XGBoost model performed well, with 71% sensitivity, 85% specificity, and an AUC value of 0.90. However, the model had 96% sensitivity, 25% specificity, and 0.58 AUC for CIN3 prediction. Conclusions: Patient characteristics and risk factors can influence CINtec^® PLUS positivity rates and they need to be carefully considered before choosing a specific management. Full article

Cervical cancer remains a significant public health concern, ranking as the 10th most common cancer among women in Greece. Current screening programs primarily rely on cytology and HPV DNA testing; however, their positive predictive value (PPV) for detecting high-grade cervical intraepithelial neoplasia (CIN2+) remains limited. This study aimed to compare the clinical performance of the HPV mRNA test with that of the HPV DNA test, focusing on their PPV for detecting CIN1+ lesions in a cohort of Greek women. A total of 114 women undergoing routine cervical cancer screening were tested using an HPV DNA assay (detecting 41 HPV types), Pap smear, and were referred for colposcopy and biopsy when indicated. Among them, 29 women aged 18 to 65 years (mean age: 35.1 ± 10.8 years) who tested positive for one or more of the five high-risk HPV types (16, 18, 31, 33, 45) were further assessed using the PreTect HPV-Proofer^® mRNA assay. Of these 29 women, 11 (37.9%) had negative biopsy findings, 16 (55.2%) were diagnosed with CIN1, and 2 (6.9%) with CIN2, corresponding to a positive predictive value (PPV) of 55.2% for CIN1 and 6.9% for CIN2 with the HPV DNA test. Among the 17 women who tested positive for HPV mRNA, 13 were diagnosed with CIN1 and 2 with CIN2. Among the 12 women who tested negative for HPV mRNA, 3 had CIN1 and 9 had negative biopsy results. Based on these findings, the PPV of the HPV mRNA test for CIN1 was 76.5%, the negative predictive value (NPV) was 75.0%, and the clinical sensitivity for CIN1 was 81.3%. For CIN2, the PPV was 11.8%, while the clinical sensitivity and NPV were 100%. These findings highlight the potential of HPV mRNA testing to improve specificity in cervical cancer screening by more accurately identifying clinically significant lesions and reducing unnecessary colposcopies. Full article

Background: Cervical cancer remains a major global health burden, particularly in regions with limited early detection. The Loop Electrosurgical Excision Procedure (LEEP) is commonly used to diagnose and treat cervical intraepithelial neoplasia (CIN). The lymphocyte-to-monocyte ratio (LMR) is a potential biomarker for cancer risk stratification. It reflects immune function and tumor-related inflammation. Lower LMR values suggest reduced antitumor immunity and increased tumor-promoting inflammation, which are linked to cancer development and progression. This study examines relationships between preoperative LMR and histopathological outcomes after LEEP. Methods: This retrospective study included 374 patients undergoing the LEEP for cervical dysplasia. Preoperative LMR values were compared across four histopathological categories: negative, low-grade, high-grade lesions, and invasive carcinoma. The Kruskal–Wallis test assessed group differences, with Mann–Whitney U tests for pairwise comparisons. ROC curve analysis (n = 369) evaluated LMR’s diagnostic performance, and logistic regression evaluated its independent predictive value. Results: LMR significantly differed across cytological (p = 0.04) and histological groups (p = 0.036). Post hoc analysis revealed significantly lower LMR in invasive carcinoma versus low-grade lesions in cytology and for both low- and high-grade lesions in histology. ROC analysis yielded an AUC of 0.680. An LMR cutoff <4.49 showed 82.6% sensitivity and 50.0% specificity. Stricter cutoff (<3.89) increased specificity (66.8%) but decreased sensitivity (60.9%). Both had high negative predictive values (97.7% and 96.2%) but low positive predictive values (9.9% and 10.9%). Conclusions: LMR may serve as a complementary biomarker to predict higher-grade cervical lesions and help rule out invasive disease, aiding patient triage in resource-limited settings. Full article