Screening every five years safe for women who test negative for HPV, study confirms

Peer-Reviewed Publication

KING'S COLLEGE LONDON

A study of 1.3 million women in England has provided evidence to support the extension of cervical cancer screening intervals from three years to five years for those that have a negative screen result.

The study, published today in the British Medical Journal by researchers from King’s College London and funded by Cancer Research UK, provides reassurance to women and people with a cervix aged 24-49 years who test negative for the human papillomavirus (HPV), that screening at five-year intervals prevents as many cancers as screening at three-year intervals, even if they are not vaccinated against HPV.

The study confirms that women in this age group are much less likely to develop clinically relevant cervical lesions (high-grade cervical intraepithelial neoplasia, which are abnormal changes of the cells that line the cervix and are otherwise known as CIN3+) and cervical cancer, three years after a negative HPV screen compared to a negative smear test. This risk is more than halved.

Lead author Dr Matejka Rebolj, Senior Epidemiologist at King’s College London said: “These results are very reassuring. They build on previous research that shows that following the introduction of HPV testing for cervical screening, a 5-year interval is at least as safe as the previous 3-year interval. Changing to 5-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.”

Almost all cervical cancers are caused by HPV infection. Usually, the immune system gets rid of the virus on its own, but if it doesn’t HPV can cause abnormal cells to develop in the cervix. If these abnormal cells are not treated, they can turn into cancer. This is a process that often takes 10-15 years, and sometimes even longer.

Before 2019, cytology tests, otherwise known as smear tests, checked cervical cells for abnormalities first. If found, some of the samples would then be tested for HPV. These tests were recommended every three years. In 2019, following expert scientific evidence, the NHS Cervical Screening Programme in England fully implemented primary high-risk HPV testing using cytology as a triage test, whilst keeping the same screening intervals (3 years for those aged 24-49 years). Now samples taken during cervical screening are tested for HPV first. As having HPV infection comes before having abnormal cells, HPV testing detects more women at risk of cervical cancer.

The study shows that the HPV test is more accurate than a cytology test. Researchers from King’s College London, the University of Manchester, and the NHS have analysed data the from the NHS Cervical Screening Programme in England. They followed those attending screening for two rounds, the first from 2013-2016 with a follow up by end of 2019.

Researchers found that people eligible for screening under fifty who had a negative HPV screen in the first round had a lower risk of detection of CIN3+ in the second round compared to cytology. 1.21 in 1000 people had a detection of CIN3+ after a negative HPV screen compared to 4.52 in 1000 people after a negative cytology.

Currently in the UK, where the HPV screen is negative, the NHS Cervical Screening Programme in England invites women and people with a cervix aged 25-49 years to test every three years and people aged 50-64 years to test every five years or three years if they test positive.  Scotland and Wales are the first to implement the new intervals. England has introduced HPV testing but continue to invite those eligible under fifty every three years and over fifty to test every five years. Northern Ireland currently use cytology tests but will switch to HPV primary screening in the future.

Dr Rebolj added: “This monumental study relied on a multidisciplinary team including those in the NHS Cervical Screening Programme in England, working with women undergoing screening and their samples, and our academic partners. This partnership provides evidence that will best serve the millions of women invited for screening throughout most of their adult lives. These promising results show most women and people with a cervix do not need to be screened as frequently as they are now.”

Michelle Mitchell, Cancer Research UK’s chief executive, said: “This large study shows that offering cervical screening using HPV testing effectively prevents cervical cancer, without having to be screened as often. This builds on findings from years of research showing HPV testing is more accurate at predicting who is at risk of developing cervical cancer compared to the previous way of testing. As with any change to a screening programme, this will be monitored to ensure that cervical screening is as effective as possible for all who take part.

“It’s important to remember, screening is for people without symptoms. So, if you notice any unusual changes for you, do not wait for a screening invitation - speak to your doctor.”

ENDS

NOTES TO EDITORS:

About Cervical Screening & HPV

 

High-risk Human Papillomavirus (HPV) DNA is found in over 99% of all cervical cancers. Cervical screening now primarily tests for the presence of this high-risk HPV infection, which is a common virus that most people will get at some point. HPV primary screening is a more sensitive and accurate test than the previous method (cytology alone) and is the best way to find out who is at higher risk of developing the cervical cell changes that over time could potentially lead to cervical cancer.

 

While the risk for people with high-risk HPV of getting cervical cancer is low, any abnormal changes can be identified early. If HPV is detected, the sample is then checked for any changes in the cells of the cervix. Cell changes are easily treated if caught early, so they don’t get a chance to turn into cervical cancer. 

 

For further information about cervical screening, please visit www.nhs.uk/cervicalscreening.   

About extended screening intervals

• The National Screening Committee recommended that, following the introduction of primary HPV screening in the cervical screening programme screening invites should be changed from 3 to 5 years for 24.5 to 49 year olds for anyone that is found not to have high-risk HPV at their routine screening test.
• The NHS in England has not changed cervical screening invites to every five years for eligible people aged 24.5 to 49 years old if their screen shows they don’t have high-risk HPV.
• The NHS Cervical Screening Programme in England invites over 4.5m people each year. NHS Digital is working with NHS England and NHS Improvement at pace to prepare for the safe and smooth transition to a new IT system for cervical screening which would safely and effectively support any changes to the programme. This is a major piece of work which the programme is working closely with NHS Digital, to implement.

King’s College London

 

King's College London is one of the top 35 UK universities in the world and one of the top 10 in Europe (QS World University Rankings, 2020/21) and among the oldest in England. King's has more than 31,000 students (including more than 12,800 postgraduates) from some 150 countries worldwide, and some 8,500 staff.

 

King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF), eighty-four per cent of research at King’s was deemed ‘world-leading’ or ‘internationally excellent’ (3* and 4*).

 

Since our foundation, King’s students and staff have dedicated themselves in the service of society. King’s will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King's strategic vision to take the university to the 200th anniversary of its founding.

 

World-changing ideas. Life-changing impact: https://www.kcl.ac.uk/news/headlines.aspx

 

About Cancer Research UK

• Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through research, influence and information.
• Cancer Research UK’s pioneering work into the prevention, diagnosis and treatment of cancer has helped save millions of lives.
• Cancer Research UK has been at the heart of the progress that has already seen survival in the UK double in the last 40 years.
• Today, 2 in 4 people survive their cancer for at least 10 years. Cancer Research UK wants to accelerate progress and see 3 in 4 people surviving their cancer by 2034.
• Cancer Research UK supports research into the prevention and treatment of cancer through the work of over 4,000 scientists, doctors and nurses.
• Together with its partners and supporters, Cancer Research UK is working towards a world where people can live longer, better lives, free from the fear of cancer.

For further information about Cancer Research UK's work or to find out how to support the charity, please call 0300 123 1022 or visit www.cancerresearchuk.org. Follow us on Twitter and Facebook. 

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JOURNAL

BMJ

DOI

10.1136/bmj-2021-068776 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Extension of cervical screening intervals with primary human papillomavirus testing: observational study of English screening pilot data

Mandating flu jab, but not COVID-19 jab, ethically justified for healthcare staff

Peer-Reviewed Publication

BMJ

Few side effects; cuts infection risks; minimises staff shortages and presenteeism

And professional obligations to patients trump curbs on personal freedom, argue ethicists

Mandating the flu jab for healthcare staff is ethically justified, but the same can’t be said of the COVID-19 jab, argue leading ethicists in an extended essay published online in the Journal of Medical Ethics.

Unlike the COVID-19 jab, the pros outweigh the cons for all age groups: the flu jab is safe and has few side effects; it cuts the risk of infection; and it minimises staff shortages and ‘presenteeism’, they suggest. 

And healthcare workers have professional obligations to protect patients from a virus that is particularly deadly for older people who are overrepresented among hospital patients. Such obligations trump curbs on personal freedom, the authors contend.

In light of the infection control issues raised by the pandemic, and the steps taken by various countries to overcome vaccine hesitancy, the authors compare the ethical criteria for mandating vaccination of healthcare staff against COVID-19 and seasonal flu.

A vaccine mandate for healthcare workers would align with existing professional requirements, based on preventing harm to patients. But not every professional obligation is also a legal requirement. 

Further ethical criteria are therefore required to justify such a policy, the authors explain. These include the pros and cons of the vaccines and the availability of less restrictive alternatives to achieve comparable health benefits.

During the pandemic, several countries mandated COVID-19 vaccination for healthcare workers: France; Italy; many US states; several Canadian provinces; and Australia.

The UK government also planned to do the same, but stopped short amid fears of staff losses and perceived heavy-handedness in light of the emergence of the milder Omicron variant.

However, it did consult on mandating the seasonal flu jab for healthcare workers, around 1 in 4 of whom don’t get vaccinated against the virus. 

Flu kills more than 11,000 people every year in England alone, a toll that rose to more than 22,000 in 2017-18.

Data from London University College hospitals during the 2018–2019 flu season suggest that 15% of inpatients with flu caught the infection while in hospital (nosocomial infection).

In some flu seasons large numbers of unvaccinated staff fall ill, prompting shortages or ‘presenteeism’---where staff with the infection keep on working—so heightening the risk of spreading it to patients and colleagues.

“Vaccine mandates are typically controversial as they entail limitations of individual liberties for the sake of the collective good,” acknowledge the authors. 

“However, when it comes to [healthcare workers], liberty-based counter-arguments are more difficult to apply. Quite simply, [healthcare workers] have an ethical and professional obligation not to harm patients, or to minimise the risk of harm to patients, which other people do not have,” they point out.

“It is already commonly accepted that [healthcare workers] should take on at least some additional health risk for the sake of their patients…The issue at stake is not if this is justified, but how much extra risk is justifiable by contractual and professional obligations,” they add.

COVID-19 vaccines are associated with a small risk of blood clots and myocarditis (inflammation of the heart muscle), and given the relatively low risk of serious illness from COVID-19 among younger staff, the cons may very well outweigh the pros, they suggest.

Nor do the current crop of COVID-19 vaccines seem very effective at preventing spread, while the protection they afford against symptoms tails off within months.

What’s more, COVID-19 illness severity has reduced, due to changes in the circulating form of the virus, high vaccine uptake in those at highest risk, high rates of natural immunity and increasingly more treatments becoming available, point out the authors.

These issues don’t apply to the seasonal flu vaccine, which has been used for decades, has a well established safety profile, and few and mostly minor side effects, they highlight.

Higher flu jab uptake minimises risk of harm to patients, not just by reducing the risk of infection, but also by reducing the risk of staff shortages due to illness. And the evidence suggests that compulsory flu jabs increase uptake more than less severe measures, say the authors.

But the question remains as to what level of coercion is ethically acceptable. “One way to strike a balance between individual freedom and patients’ interests is to make vaccination a condition of entry into the profession rather than mandating those already employed, and adopt a conditional mandate if at all possible for those already in the profession,” they write. 

“Ultimately, there is an ethical balance to be drawn between protecting patients (including their own right to not acquire serious but preventable nosocomial infections) and coercing some healthcare professionals into having a vaccine that they would prefer not to receive.”

They conclude: “For reasons that we have given above, the balance of risks and benefits suggests that an influenza vaccine mandate, but not a COVID-19 mandate, would currently be ethically proportionate.”

But they caution: “Mandates should be introduced on a disease-specific and vaccine-specific basis. The problem must be a significant one; the vaccines must be safe and effective at preventing illness and/or transmission; mandatory measures must be superior to less coercive alternatives; and the costs in loss of liberty and risk to health professionals must be proportionate in professional terms to the benefits to patients.”

 

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JOURNAL

Journal of Medical Ethics

DOI

10.1136/medethics-2022-108229 

METHOD OF RESEARCH

Commentary/editorial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Vaccine mandates for healthcare workers beyond COVID-19

Violent incidents at GP practices double in five years, BMJ investigation finds

Peer-Reviewed Publication

BMJ

The number of violent incidents recorded by police forces at UK general practices has almost doubled in the past five years, finds an investigation published by The BMJ today.

Worryingly these figures also show a near doubling of assaults that cause physical harm, causing some GPs and their staff to leave their jobs, reports Gareth Iacobucci.

GP leaders said the “appalling” figures highlighted how assaults, harassment, and other forms of abuse aimed at doctors and their staff had worsened during the pandemic, as services have been under increased pressure and some sections of the media have perpetuated the notion that GP services were “closed.” 

The BMJ sent freedom of information requests to the 45 police forces in the UK asking for the number of recorded crimes committed at general practices and how each crime was categorised. A total of 42 forces (93%) had sent responses by the time of publication, 32 of which (71%) were able to provide complete and comparable data for the past five years. 

In total, the 32 police forces recorded 1068 incidents of violence at health centres and GP surgeries in 2021-22, compared to 791 in 2020-21 and 586 in 2017-18. These figures include all incidents defined in the category of “violence against the person”, which include all forms of assault and harassment.

Within this number there were 182 assaults resulting in injury last year, the highest for five years and almost double the 98 recorded in 2017-18. 

And also within this number, recorded incidents of stalking and harassment at GP surgeries have almost tripled over the past five years, with 223 instances last year compared to 85 in 2017-18. This is to a large extent driven by a surge in malicious communications - which can include sending letters or emails - which increased from 25 in 2017-18 to 92 last year. 

As well as a rise in incidents of violence, public order offences such as threatening behaviour rose by 24% last year from 438 to 541 and are up 40% on five years ago (387).

Richard Van Mellaerts, a GP in Kingston Upon Thames and an executive officer for the BMA’s GP Committee, said the figures obtained by The BMJ matched the experiences of doctors on the frontline, including his own. “I regularly hear abuse directed at reception staff in my practice, we've had to call the police several times over the last year,” he said. 

Meanwhile, Richard Vautrey, a GP in Leeds and former chair of the BMA’s GP committee, said the police crime figures are only “the tip of a much, much bigger iceberg” of the incidents occurring in general practice, citing “often daily abuse that staff are having to deal with.”

Van Mellaerts noted that as well as the police and courts taking action against perpetrators of violent crimes, it was crucial to understand why the increase in abuse and violence was happening to try to tackle the problem. 

He points to possible drivers for some of the aggression, including a dramatic increase in remote consultations, and fewer GPs doing more and more, but says the rise in violent incidents and abuse aimed at GPs and staff will only exacerbate the staff shortages which are contributing to difficulties in accessing care. 

“We appreciate patients’ frustrations and upset with delays in their care, but those frustrations need to be channelled into holding governments to account in order that they invest appropriately in general practice and solve these systemic issues, not taken out on their GPs and practice staff.”

In response to The BMJ’s findings, a Department of Health and Care spokesperson said, “Deliberate violence or abuse directed at NHS staff, who continue to work tirelessly to provide care, is unacceptable – all staff, including GPs and their teams, deserve to work in a safe and secure environment.
 
“The NHS violence reduction programme aims to protect the workforce and ensure offenders are punished quickly and effectively, and the government has taken action to support this – including by passing legislation to double the maximum sentence for assaults on emergency workers, including those in the NHS.
 
“Security measures including CCTV, panic buttons and screens at reception have also been rolled out across GP surgeries.”

NHS England also recently updated its Primary Medical Care Policy and Guidance Manual for service commissioners to add a new chapter on managing inappropriate and unacceptable patient behaviours.

An NHS spokesperson said: “The NHS will not tolerate abuse or violence towards its staff and, despite the despicable actions of a minority, is grateful for the overwhelming sense of national support NHS workers have received from the wider public over the last two years as it stepped up to fight covid.

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JOURNAL

The BMJ

DOI

10.1136/bmj.o1333 

Citizen power mobilized to fight against mosquito borne diseases

Citizen scientists use phone apps to work in collaboration with researchers to collect huge amounts of data on disease carrying mosquitoes as part of a WHO-supported series on vector-borne diseases

Peer-Reviewed Publication

GIGASCIENCE

 

IMAGE: YELLOW FEVER MOSQUITO HAVING A BLOOD-MEAL. view more 

CREDIT: AUTHOR: JAMES GATHANY SOURCE CDC - PHIL

The latest from Mosquito Alert, a citizen science system for investigating and managing disease-carrying mosquitoes, has collected and released 13,700 new database records on the presence, location, and spread of these mosquitos. These data, hosted in the Global Biodiversity Information Facility (GBIF), are part of an ongoing world-wide collaboration between citizen volunteers, who use a specifically designed app to photograph mosquitos and report bites and locations of potential breeding sites, and entomological experts, who validate the findings to determine if the collected information provides evidence of the presence of any of the mosquito species of top concern. This study is part of a WHO-sponsored series on vector borne human diseases, which collects and presents biodiversity data for a range of different disease vectors and promotes data sharing to increase the speed at which researchers can assess and address human health threats. In this particular study, an entire community of citizen scientists have been actively engaged in furthering the acquisition of information in a cost-effective, as well as publicly educational, manner. In addition to providing a large, widespread, valuable resource for studying and containing infectious diseases, this work serves as an excellent model for bringing together the mobilizing power of citizens and scientists to address important health issues. This study has been published in the open-access, open-data journal GigaByte.

Vector-borne diseases account for more than 17% of all human infectious diseases, with mosquito-borne diseases causing the greatest health burden on society based on case numbers, deaths, and resultant disabilities. While there has been significant progress in the fight against malaria, this progress is currently slowing. Whereas, progress on combating other mosquito-driven diseases, such as dengue, chikungunya, yellow fever, and Zika, are expanding, due to the increasing number of cases and fatalities for these diseases. To best combat these health risks, researchers must fill the large gaps in knowledge related to the presence, spread, and activity of mosquitos that spread these diseases, Data mobilization campaigns serve as one of the best means to improve geographical data coverage. Harnessing the collective power of citizen scientists across the globe has served the scientific community well with regard to being able to collect massive amounts of information across the globe, especially in the areas of biology, conservation, and ecology. It is currently a major weapon in the fight against mosquito-borne diseases.

The work presented in the article was carried out by Mosquito Alert, which provided the first detection of the Asian bush mosquito Aedes japonicus in Spain in 2018. This finding was a striking observation as it was an isolated population of mosquitos that were located 1,300 km from its previously nearest known location in Europe. Since this species was not expected to appear in this region, it had not been targeted by any local surveillance program. This served as clear indication of the danger of monitoring specific species in areas that were primarily in and close to regions they were known to exist. However, budget and manpower limitations, make it nearly impossible to collect data across expansive ranges.  Mosquito Alert, by harnessing a largely free resource of manpower, were able to extend their work to identify and track other invasive mosquitoes across a much larger geographical range. They armed a cadre of citizen scientists with a phone app aimed at collecting usable types of data and developing a harmonized methodology for collecting and validating these data by experts. The information collected in the apps are updated on a daily basis, and thus, provide near real-time information on the status of deadly disease-carrying mosquitos.

This form of combined data collection strategies provides an incredible addition to governmental vector screening programs, which require huge resources to fill all geographical corners of their countries. Since citizens with mobile devices are everywhere, the potential to use this approach as an early warning system of invasive species of all types can move from city-scale to continental scale, and, with continued growth, global scale.

Of this huge potential, first author Dr Živko Južnič-Zonta says: “Because of its daily update, this dataset could help to optimize vector control, as citizen scientists provide information about nuisance and presence of mosquitoes at almost real time.”

The availability of such a large public collection of validated mosquito images not only allows researchers themselves to work directly with these data, this enormous dataset can also be used to train machine-learning models for vector detection and classification, further increasing the power of these data to serve as part of an arsenal to improve global human health.

The value of such data collected by an army of citizen scientists in concert with experts also shows the need for developing a new publication credit system to evaluate contributions from multiple and diverse collaborators, which, for this study, included university researchers, entomologists, and other non-academics such as independent researchers and citizen scientists. For this article, the authors carefully considered and designed such a credit system. As research that makes use of citizens as a major, and free, component of research programs continues to grow, the credit system used in this article sets forth a process to allow such large consortium to provide clear credit to the entire cadre of individuals involved in any study, which is long past due.

This work is part of a series of articles that assess the range and diversity of a wide variety of vector-borne diseases. GigaScience Press has partnered with GBIF, which has been supported by TDR, the Special Programme for Research and Training in Tropical Diseases, hosted at the World Health Organization. Through this, GBIF are releasing the first 11 Data Release papers on vectors of human disease in a thematic series in the journal GigaByte. To better incentivize the sharing of these extremely important datasets, the article processing charges to authors have been waived for these easy-to-write descriptions that are associated with public domain datasets in the GBIF database to assist with the global call for novel data. This effort has led to the release of newly digitized location data for over 600,000 vector specimens observed across the Americas and Europe.

 

GigaByte’s novel, end-to-end XML publishing platform, means publication can be done in a quicker and more interactive manner than traditional scientific publications. Papers in this biodiversity series include interactive maps, embedded protocols, and multilingual options for several of these articles, allowing Portuguese and Spanish speakers to better comprehend the implications of important work relating to the public health of their communities.

 

Further Reading

Južnič-Zonta Ž, et al. Mosquito alert: leveraging citizen science to create a GBIF mosquito occurrence dataset. GigaByte 2022. doi: 10.46471/gigabyte.54

Mosquito Alert website: http://www.mosquitoalert.com/en/project/what-is-mosquito-alert

Mosquito Alert App: http://www.mosquitoalert.com/en/project/envia-datos

 

Mosquito Alert website: http://www.mosquitoalert.com/en/project/what-is-mosquito-alert

Mosquito Alert App: http://www.mosquitoalert.com/en/project/envia-datos

Read more, see the GigaScience Blog at: http://gigasciencejournal.com/blog/publishing-mosquito-alert-data

To see all of the articles in this WHO-sponsored vector-borne disease series go to: https://doi.org/10.46471/GIGABYTE_SERIES_0002

 

Media contacts:

GigaScience Editor-in-Chief:

Scott Edmunds, Scott@gigasciencejournal.com, Office: +852 3610 3531 Cell: +852 92490853

Sharing on social media?

Find GigaScience online on twitter @GigaScience; Facebook https://www.facebook.com/GigaScience/, and keep up-to-date with our blog http://gigasciencejournal.com/blog/

About GigaScience Press

GigaScience Press is BGI's Open Access Publishing division, which publishes scientific journals and data. Its publishing projects are carried out with international publishing partners and infrastructure providers, including Oxford University Press and River Valley Technologies. It currently publishes two data-centric journals: its premier journal GigaScience (launched 2012) and its new journal GigaByte (launched 2020). It also publishes data, software, and other research objects via its GigaDB.org database. To encourage transparent reporting of scientific research as well as enable future access and analyses, it is a requirement of manuscript submission to all GigaScience Press journals that all supporting data and source code be made available in GigaDB or in a community approved, publicly available repository. See GigaSciencePress.com

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JOURNAL

Gigabyte

DOI

10.46471/gigabyte.54 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Mosqu

Tired mosquitoes would rather catch up on sleep than bite you

By understanding the mosquitoes’ circadian rhythms, researchers hope to find better ways to prevent infection.

Peer-Reviewed Publication

UNIVERSITY OF CINCINNATI

 

IMAGE: UC BIOLOGISTS DISCOVERED THAT OVERTIRED MOSQUITOES CHOOSE TO CATCH UP ON SLEEP RATHER THAN SEEK A BLOOD MEAL. view more 

CREDIT: ANDREW HIGLEY/UC CREATIVE

Turns out you’re not the only one who needs a good night's rest to function well the next day.

Researchers with the University of Cincinnati found that mosquitoes whose slumber is disrupted are more interested in catching up on their sleep than looking for food the next day. The research demonstrates how vital this biological function is even among insects.

“It was a bit surprising. Sleep deprived or not, a blood meal should appeal to them,” UC doctoral student and study lead author Oluwaseun Ajayi said.

The study was published online on May 3 and in print on June 1 in the Journal of Experimental Biology.

The phenomenon of catching up on missed sleep, called sleep rebound, has been observed in other animals such as honeybees, fruit flies and people.

Biologists in UC’s College of Arts and Sciences and Virginia Tech’s Department of Biochemistry spent more than a year developing protocols to study mosquito sleep. While observations can affect the outcome of virtually any experiment — a phenomenon called the observer effect — UC biologist Joshua Benoit said this was especially true when studying mosquito sleep.

Mosquitoes are able to sense people through their body heat, odors, movement, vibrations and the carbon dioxide they exhale from their lungs and emit from their skin.

“It’s really hard to quantify sleep in mosquitoes when, as soon as you walk in the room, you’re considered their Thanksgiving dinner,” Benoit said.

So researchers set up the experiment in a quiet part of Crosley Tower on UC’s Uptown campus, where the mosquitoes were separated from passersby by multiple rooms within rooms. Researchers set up cameras and infrared sensors that could record when the mosquitoes were moving without disturbing them.

Mosquitoes in the lab sleep a lot — between 16 and 19 hours a day depending on the species and the stimulation around them.

Recognizing a sleeping mosquito takes some skill. When they’re not looking for food, mosquitoes perch for long periods of time to conserve energy. But researchers discovered a subtle telltale sign the mosquitoes were asleep.

“When mosquitoes enter a sleep-like state, their hind legs droop and their body comes closer to the surface,” Ajayi said.

Virginia Tech researcher and study co-author Clément Vinauger used video observations to document this behavior in several mosquito species.

The experiment examined three species of mosquitoes, each responsible for transmitting disease to people: Aedes aegypti, a “day biter,” Culex pipiens, which seeks a meal at dusk; and Anopheles stephensi, which is most active at night.

Researchers studied the mosquitoes’ sleep and feeding behavior for about a week after they were acclimatized to their new experimental habitat. In a second experiment, researchers subjected them to sleep deprivation during their normal bedtime by vibrating their enclosures at regular intervals during the day or night.

While more than 75% of mosquitoes that were not subjected to sleep deprivation sought a blood meal, less than one-quarter of them had any interest in food after a sleepless night. This represented a 54% decrease in the propensity to feed among sleep-deprived mosquitoes.

“What’s surprising to me is that as much as mosquitoes need blood to produce eggs, they will give it up to recover the sleep they lost,” Benoit said. “They might not be aroused as much because of the need to catch up on sleep.”

The overtired mosquitoes also were less likely to land on a host in both laboratory and field settings, suggesting that the same behaviors would occur in natural settings like your back yard.

Lucas Gleitz participated in the research project as a UC undergraduate biology student. After graduation this year, he plans to attend medical school.

The study’s findings were relatable given the sleepless nights most college students endure.

“As a college student, we joke that we eat sleep for dinner,” Gleitz said.

Sleep is tied to immune and restorative functions such as tissue repair and protein synthesis, Gleitz said. Research has also demonstrated how important sleep is to memory and brain function.

“We learned that sleep is a very crucial aspect of living organisms. Those internal clocks keep running, even for mosquitoes,” he said.

Mosquitoes cause more human suffering than any other animal, according to the World Health Organization. Malaria alone kills more than 400,000 people annually. And mosquitoes carry pathogens for other deadly diseases such as dengue and yellow fever.

By understanding the mosquitoes’ circadian rhythms, researchers hope to find better ways to prevent infection.

“It’s important to understand their sleep dynamics — when they feed and when they sleep,” Benoit said.

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JOURNAL

Journal of Experimental Biology

DOI

10.1242/jeb.244032 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Behavioral and postural analyses establish sleep-like states for mosquitoes that can impact host landing and blood feedingito alert: leveraging citizen science to create a GBIF mosquito occurrence dataset

Survey finds most men think they’re naturally healthier than others, a third don’t think they need annual health screenings

Doctors stress the importance of preventive care to keep minor issues from becoming life-threatening

Reports and Proceedings

ORLANDO HEALTH

 

VIDEO: A NEW NATIONAL SURVEY BY ORLANDO HEALTH FINDS A THIRD OF MEN DON’T THINK THEY NEED ANNUAL HEALTH SCREENINGS. DOCTORS STRESS THAT IN ORDER TO TAKE CARE OF THOSE YOU CARE ABOUT, YOU MUST FIRST TAKE CARE OF YOURSELF, AND THAT INCLUDES AN ANNUAL CHECKUP WITH YOUR PRIMARY CARE PHYSICIAN. view more 

CREDIT: ORLANDO HEALTH

Orlando, Fla — We all know we should eat well and exercise to stay healthy, but a new national survey conducted online by The Harris Poll on behalf of Orlando Health finds an alarming number of men might be skipping a simple yet critical step in a healthy lifestyle: an annual checkup with their doctor. The survey found a third of men (33%) don’t think they need annual health screenings and almost two-thirds (65%) believe they are naturally healthier than others in general.

“It is statistically impossible for the majority of men to be healthier than the majority of men,” said Thomas Kelley, MD, family medicine specialist at Orlando Health Physician Associates. “Even if you think you’re healthy and you’re not experiencing any symptoms, there can be developing issues that often go unnoticed and can also be life-threatening if left unchecked. Some of those include rising blood pressure that can be a ticking time bomb for a heart attack or stroke, as well as colon cancer, which is one of the most deadly yet preventable cancers that exist.”

As a primary care physician, Dr. Kelley has heard every excuse for men skipping their appointments, but he says the underlying reason for avoiding the doctor’s office is often fear.

“If you're a man and you haven't been to the doctor in a while, you don't really know what to expect.” Kelley said. “One of the big things that makes it less scary is having that great relationship with a primary care physician, and most men find the process to be easier than they thought. It takes about half an hour and by the end of the appointment you have the big picture about where you stand, what you’re at risk for and what you need to do for your health in the future.”

While that first appointment back can be nerve-racking, Kelley says building trust with your doctor can help make conversations more comfortable and is what keeps many patients coming back year after year.

But before doctors can build that relationship, they need to get patients in the door. The survey found that 38% of men often get medical advice from social media, which can be extremely problematic if they are not referencing reputable medical sources. Nearly two in five men (38%) also admit that they tend to focus on their pet’s health more than their own, something that is not surprising to Dr. Kelley.

“Men tend to put their health last after their family, and apparently even after their dog or their cat,” Kelley said. “But in order to take care of others in your life, you first have to take care of yourself, and that includes making that yearly appointment with your primary care doctor.”

It’s a message that Dexter Grant, 34, finally heard loud and clear after 15 years without a check-up with his doctor.  

“I went all of my adult life up to this point without a check-up, something I certainly do not recommend to anyone,” Grant said. “In your 30s you start to worry that every ache and pain could be the thing that takes you out, but you can’t just avoid the issue out of fear of what your doctor is going to tell you.”

CAPTION

Dexter Grant finally made an appointment with his primary care doctor after 15 years without a checkup. Like many men, he assumed he was healthy. In fact, a new national survey finds two-thirds of men believe they are naturally healthier than others.

CREDIT

Orlando Health

With a clean bill of health, Grant is relieved to know that he is as healthy as he feels. He worked with his doctor on clear action steps for the future, which will always include an annual wellness exam. 

“Just having the peace of mind that there aren’t any lingering issues that can cause serious problems in the next year makes me a lot more confident that I’m on the right path,” Grant said. “The process was surprisingly easy, and after a quick exam and some routine blood work, my first thought was that I should have done this a long time ago.”

It’s never too late to get caught up on routine appointments and screenings, but Kelley says the sooner you can take control of your health, the better. Combining annual exams with things like exercising regularly, keeping your diet in check, drinking plenty of water and finding ways to reduce stress can make a big difference in your overall health. 

“It’s much easier to go to the doctor once a year for a wellness checkup and make certain that you’re not developing diabetes, high blood pressure or a heart problem, than to find yourself in an intensive care unit needing heart bypass surgery because you didn't look into those things,” Kelley said.

CAPTION

As a primary care physician, Thomas Kelley, MD, has heard a lot of excuses about why men skip their checkups. A new national survey by Orlando Health finds a third of men don’t think they need annual screenings, but Kelley says they are critical to identifying developing health issues.

CREDIT

Orlando Health

Survey Method:

This survey was conducted online within the United States by The Harris Poll on behalf of Orlando Health from May 9 - 11, 2022 among 893 U.S. adult men ages 18 and older. The sampling precision of Harris online polls is measured by using a Bayesian credible interval.  For this study, the sample data is accurate to within + 2.8 percentage points using a 95% confidence level. For complete survey methodology, including weighting variables and subgroup sample sizes, please contact ben@mediasourcetv.com 

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METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

Eating problems are common among older home care clients

Peer-Reviewed Publication

UNIVERSITY OF EASTERN FINLAND

Eating problems are common among older home care clients, a new study from the University of Eastern Finland shows. Nearly 30% of the 250 older care clients studied reported poor appetite, 20% had problems with chewing, 14% had problems with swallowing, and nearly 20% reported eating problems related to teeth or dentures.

The study constitutes part of the Nutrition, Oral Health and Medication (NutOrMed) study at the University of Eastern Finland, and the findings were reported in Clinical and Experimental Dental Research.

The study sample included 250 home care clients aged 75 and older, living in the eastern part of Finland. The participants were interviewed in their home by their own home care nurse as well as by a clinical nutritionist, a pharmacist, and a dental hygienist. The study examined the prevalence and determinants of eating problems when screened by a clinical nutritionist and a dental hygienist.

Eating problems are associated with decreased food intake and poorer nutritional status

Eating problems were divided into loss of appetite, problems with chewing, problems with swallowing, and oral health-related eating problems. The researchers found that all reported eating problems were associated with the participants’ poorer nutritional status and decreased food intake during the past 3 months.

They also found that participants who estimated their oral health to be poor were more likely to report problems with chewing and swallowing. Edentulousness, on the other hand, increased the likelihood of problems with chewing and oral health problems. A high number of drugs in regular use was associated with loss of appetite and oral health-related eating problems. Edentulous participants and those who had toothache or problems with dentures were more likely to report eating problems when interviewed by a dental hygienist. The feeling of dry mouth increased the likelihood of eating problems. 

“It is important for older people to maintain good oral health because it affects eating,” says Dentist Annina Salmi, the first author of the article.

“In this study, loss of appetite was the most common finding, suggesting that eating problems are multifaceted. Another thing we observed was that clients talk about their eating-related problems differently with different health care professionals, which is why eating problems should be screened continuously and in different ways, in interprofessional collaboration.”

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JOURNAL

Clinical and Experimental Dental Research

DOI

10.1002/cre2.585 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Eating problems among old home care clients

New study shows fewer suicide attempts in women using hormonal contraceptives

Findings go against previous fears about attempted suicide and contraception

Reports and Proceedings

EUROPEAN PSYCHIATRIC ASSOCIATION

 

IMAGE: DR ELENA TOFFOL view more 

CREDIT: DR ELENA TOFFOL

Hormonal contraceptives, such as the birth control pill, are amongst the most widely used pharmaceutical products. Recent studies had suggested that hormonal contraceptives were associated with a higher risk of attempted suicides, prompting concerns about safety. Now a new in-depth study shows that rates of attempted suicides in women using hormonal contraception are actually lower than in women who do not use hormonal contraception.

Presenting the research at the European Congress of Psychiatry, Lead Researcher, Dr Elena Toffol (University of Helsinki) said:

“We set out to verify previous data, so this is not what we expected, and it’s good news for contraceptive users”.

She continued:

“Women, especially younger women, have higher rates of depression and attempted suicide than men of similar ages. Many women using hormonal contraceptives, especially contraceptive pills, report mood changes as a side effect. Initial reports from 2018 and 2020 had indicated that use of hormonal contraceptives was associated with a higher number / risk of suicides and suicide attempts. We set out to confirm this data”.

The researchers, from the University of Helsinki, used several Finnish national databases to compare attempted suicide rates of hormonal contraceptives users and non-users using data from the 2017-2019 period. They took results from 587,823 women, which represents around 50% of the total number of women in the 15-49 age group in Finland. Half of these women had used hormonal contraceptives, including pills, implants, patches, and rings.

The research team found that attempted suicide rates between hormonal contraceptive users and non-users were similarly high in women between 15-19 (in general, suicide rates are higher in younger women and decrease with age), but suicide rates dropped in older age groups, with a greater drop in hormonal contraceptive users relative to non-users in the 20-24 and 25-29 age groups. In total the researchers saw 474* cases of attempted suicide in women who didn’t use hormonal contraceptives, with only 344 attempts in women who used hormonal contraceptives. Women not using contraceptives had a 37% greater odds of attempting suicide in comparison with those using hormonal contraceptives.

Dr Toffol continued

“The strength of this study is the large size, and that we broke the data down according to suicide attempts, psychiatric history, age and contraceptive use. We included a wider age range than the other studies, and importantly, we used a ‘nested’ study design, where we were able to pair each attempted suicide to 4 control subjects, which allows us see if contraceptive use in the previous six months was a factor in the attempt. After doing this we found that women with no psychiatric history and using hormonal contraceptives, specifically those containing ethinylestradiol had a significantly reduced risk of attempting suicide than women not using any hormonal contraception.

The data indicates redeemed prescriptions, and of course it may be that some of these prescriptions were redeemed but not used. Overall though, we think we have been able to account for most confounding factors. Our next step is to use data from this same population to examine the risk of depression associated with hormonal contraception use”.

 

Commenting, Professor Andrea Fiorillo (University of Campania, Naples) said:

“This interesting study focused on the complex relationship between hormonal contraception exposure and suicidal behaviour. Previous studies found a relationship between hormonal contraceptives use and higher risk of attempted suicide. The study by Toffol disconfirms this finding, showing that the rates of suicide attempts are actually lower in women using hormonal contraception. Of course, this striking finding deserves a careful evaluation and needs to be replicated in different cohorts of women and controlled for the impact of several psychosocial stressors, such as economic upheavals, social insecurity and uncertainty due to the COVID pandemic. The clinical implications of the study are obvious and may help to destigmatize the use of hormonal contraceptives.”

This is an independent comment, Professor Fiorillo was not involved in this study. Professor Fiorillo is Treasurer of the European Psychiatric Association and Editor in Chief of the journal European Psychiatry.

*The researchers observed 474 cases of AS (IR 0.81 per 1000 person-years, 95% CI 0.74–0.88), while among HC users there were 344 AS cases (IR 0.59, 95% CI 0.53–0.65). The incidence rate ratio (IRR) of HC vs. no-HC users was 0.73 (0.63–0.83).

 

ENDS