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Small-volume biopsies (SVBs) including fine-needle aspiration (FNA), cell block, and needle core biopsies (NCB) are increasingly utilized to diagnose and guide the clinical management of lymphoma. We established a multi-institutional interdisciplinary collaboration of cytopathologists, hematopathologists, and oncologists focused on the role of SVB in the management of patients with follicular lymphoma (FL). To assess the performance characteristics of SVB in this setting, we evaluated all consecutive SVBs performed for clinical indications of initial diagnosis, recurrence, or transformation of FL over a 5-year period and focused on the 182 that had at least one subsequent biopsy within 3 months as part of the same clinical work-up. The most common outcome of a subsequent biopsy as part of the same clinical work-up was a more specific diagnosis usually assigning the pathologic grade (111/182, 61%), followed by a complete agreement with the SVB (24/182, 13%), and change from nondiagnostic on initial biopsy to diagnostic on subsequent biopsy (21/182, 12%). A minority resulted in a diagnostic change from benign to lymphoma (17/182, 9%), a change in FL grade (5/182, 3%), or change in the lymphoma diagnostic category (4/182, 2%). There were no cases where an initial diagnosis of lymphoma was overturned. The distribution of discrepancies was similar across initial SVB types (FNA, FNA + cell block, NCB with or without FNA). Tissue limitations were noted in a minority of cases (53/182, 29%) and were enriched among initially nondiagnostic biopsies (16/21, 76%). Flow cytometry immunophenotyping was performed in the majority of cases both at the first and last biopsy (147/182, 81%). SVB can be a powerful method to detect FL in various clinical indications, with discrepant cases mostly resulting from a refinement in the initial diagnosis.

[This corrects the article DOI: 10.1371/journal.pone.0250426.].

Background & aimWomen with HIV/HPV coinfection and cervical lesions are at increased risk of developing HPV related anal cancer. Self-collection of anal swabs may facilitate HPV molecular testing in anal cancer screening, especially in high-risk groups, and yet it is not adequately studied. We evaluated level of agreement between self-collected anal swabs (SCAS) and clinician-collected anal swabs (CCAS) when used for HPV genotyping. We also described the anal HPV genotype distribution and HIV/HPV coinfection.MethodsWe performed a cross sectional study with participants from a visual-inspection-with-acetic-acid and cervicography (VIAC) clinic, in Harare, Zimbabwe. In a clinic setting, the women aged ≥18 years provided anal swabs in duplicate; first CCAS and then SCAS immediately after. HPV detection and genotyping were performed using next generation amplicon sequencing of a 450bp region of the HPV L1 gene. Level of agreement of HPV genotypes between CCAS and SCAS was calculated using the kappa statistic. McNemar tests were used to evaluate agreement in the proportion of genotypes detected by either method.ResultsThree-hundred women provided 600 samples for HPV genotyping. HPV genotypes were detected in 25% of SCAS and in 22% of CCAS. The most common genotypes with CCAS were HPV52, HPV62 and HPV70 and with SCAS were HPV62, HPV44, HPV52, HPV53 and HPV68. Total HPV genotypes detected in CCAS were more than those detected in SCAS, 32 versus 27. The agreement of HPV genotypes between the two methods was 0.55 in kappa value (k). The test of proportions using McNemar gave a Chi-square value of 0.75 (p = 0.39). Multiple HPV infections were detected in 28/75 and 29/67 women for CCAS and SCAS respectively.ConclusionsSCAS and CCAS anal swabs showed moderate agreement, with no statistically significant difference in the proportion of genotypes detected by either methods. Although the differences between the two methods were not statistically significant, CCAS detected more HPV genotypes than SCAS and more HPV infections were detected in SCAS than in CCAS. Our data suggest that self-collected anal swabs can be used as an alternative to clinician-collected anal swabs for HPV genotyping.

BackgroundWomen in low- and middle-income countries are at the highest risk of cervical cancer yet have limited access to and participation in cervical cancer screening programs. Integrating self-collected, community-based screening offers a potential primary screening method in areas of limited resources. In this paper, we present a study evaluating knowledge, attitudes, and practices of cervical cancer and Human Papilloma Virus (HPV) in rural Zimbabwe.MethodsWe performed a community-based cross-sectional knowledge, attitudes and practices of HPV and cervical cancer study in rural Zimbabwe from January 2017-May 2017. Women were selected for the study via random number generation from complete lists of inhabitants in the study area if they satisfied the inclusion criteria (≥30-years-old, ≤65-years-old, not pregnant, intact uterus). If selected, they participated in a 19-question structured knowledge, attitudes and practices survey. The questionnaire included questions on demographics, education, knowledge of HPV, cervical cancer, and risk factors. Chi-squared tests were evaluated comparing knowledge, attitudes and practices relating to HPV and cervical cancer screening with actual infection with HPV. Women were also offered a voluntary HIV and self-collected HPV screening.ResultsSix hundred seventy-nine women were included in the knowledge, attitudes and practices survey. Most women (81%) had heard of cervical cancer while the majority had not heard of HPV (12%). The number of women that had been screened previously for cervical cancer was low (5%). There were no significant differences between and within groups regarding knowledge of cervical cancer and actual overall infection with HR-HPV, HPV 16, and HPV 18/45 test results.ConclusionsMost women in rural Zimbabwe have heard of cervical cancer, but the number that had been screened was low. Extending existing outreach services to include cervical cancer screening, potentially including HPV screening, should include cervical cancer/HPV education and screening triage. This approach would serve to bridge the gap between knowledge and screening availability to address some of the barriers to cervical cancer care still affecting women in many regions of the world.

BackgroundIn low- and middle-income countries (LMIC), women have limited access to and uptake of cervical cancer screening. Delayed diagnosis leads to poorer outcomes and early mortality, and continues to impede cancer control disproportionately in LMIC. Integrating self-collected, community-based screening for High Risk-Human Papilloma Virus (HR-HPV) into existent HIV programs is a potential screening method to identify women at high risk for developing high-risk cervical lesions.MethodsWe implemented community-based cross-sectional study on self-collection HR-HPV screening in conjunction with existing community outreach models for the distribution of antiretroviral therapy (ART) and the World Health Organization Expanded Program on Immunization (EPI) outreach in villages in rural Zimbabwe from January 2017 through May 2017.ResultsOverall, there was an 82% response rate: 70% of respondents participated in self-collection and 12% were ineligible for the study (inclusion criteria: age 30-65, not pregnant, with an intact uterus). Women recruited in the first 2-3 months of the study had more opportunities to participate and therefore significantly higher participation: 81% participation (additional 11% ineligible), while those with fewer opportunities also had lower participation: 63% (additional 13% ineligible) (p

ObjectivesHigh-risk human papilloma viruses (hrHPV) are the causative agents of cervical cancer, the leading cause of cancer deaths among Zimbabwean women. The objective of this study was to describe the hrHPV types found in Zimbabwe for consideration in cervical cancer screening and vaccination efforts.Design and methodsTo determine hrHPV prevalence and type distribution in Zimbabwe we implemented a community-based cross-sectional study of self-collected cervicovaginal samples with hrHPV screening using near-point-of-care Cepheid GeneXpert HPV.ResultsThe hrHPV prevalence was 17% (112/643); 33% (41/123) vs. 14% (71/520) among HIV-1-positive and -negative participants, respectively (p=2.3E-07). Typing via Xpert HPV showed very good overall agreement (77.2%, kappa=0.698) with the Seegene Anyplex II HPV HR Detection kit. The most common types were HPV16, HPV18, HPV35, HPV52, HPV58, HPV68, HPV18, and HPV51, each of which appeared in 14-20% of infections. 37% (28/76) of women with positive cytology results (ASCUS+) had a type not included in the basic vaccine and 25% (19/76) had a type not currently in the nine-valent vaccine.ConclusionshrHPV type distribution includes less common high-risk types in rural Zimbabwe. The distribution and carcinogenicity of hrHPV type distribution should be considered during screening assay design, program development, as well as vaccine distribution and design.

Although surgical biopsy remains the gold standard for the diagnosis of lymphoma, small‐volume biopsies including fine‐needle aspiration and core needle biopsy are increasingly being used as a first line diagnostic tool. Small‐volume biopsies are safe, rapid and cost effective; however, diagnostic utility varies by lymphoma subtype. It is important for pathologists and clinicians to recognize both the strengths and limitations of such biopsies. [ABSTRACT FROM AUTHOR]

Past research has largely focused on the negative aspects of well-being of autistic young adults during the post-school transition. Research that meaningfully includes autistic individuals and captures their perspectives of positive well-being is essential for stakeholders to better understand how to provide services that respond to the needs and wants of the autistic community. In the current study, 14 autistic young adults in a post-school transition program participated in a Photovoice project and used photos to express their ideas about well-being. A participatory action research approach was used to support participants' active engagement in the research processes and to encourage meaningful expression of their first-person perspectives. Results revealed an account of well-being reflecting expressions of individuality and growth, the significance of having close relationships, and a sense of connection with the community. This study has implications for research and practice that promotes well-being among the autistic community using approaches that are ethically informed and inclusive of autistic voices.

Background/Purpose: Autism spectrum disorders encompass a group of neurodevelopmental disorders whose defining features include deficits in social communication across multiple contexts (American Psychological Association, 2011). The prevalence of autism has been increasing at an alarming rate stemming from changes in diagnostic criteria, genetic risk factors, and growing awareness of the condition. Objective: This primary objective of this article is to provide an overview of a customized transition program, The Learning Academy (TLA), for students with autism. Method: Pretest/posttest survey tool. Findings: Fifty-eight percent (n=15) of respondents reported employment after attending TLA. Of these individuals, 80% (n=12) report they are currently working. Data from a prior survey year captured information from a larger percentage of TLA graduates (85% response rate; n=51) with a total of 63% (n=32) reporting that they had obtained competitive or self-employment. Conclusions: Preliminary evidence indicates that the TLA program is effective in improving postsecondary education and employment rates in graduates. Implications for rehabilitation counseling research, policy, and education are presented.

Researchers examined six undergraduate pre-engineering majors' self-regulatory behaviours, ability to self-regulate, self-efficacy beliefs, and intentions to persist using a qualitative methodology. The data collection procedure relied heavily on interviews focusing on participants' engineering interests, beliefs in their abilities to successfully complete an engineering degree, beliefs in their ability to self-regulate, sources of self-efficacy, and self-regulatory behaviour. Through transcription analysis, coding, and cross-coding processes, our findings indicate that the triadic and cyclical nature self-regulation was fundamental to pre-engineering majors' persistence. Students' prior mastery experiences, beliefs in their ability to self-regulate, vicarious experiences, and verbal persuasions contributed to students' self-efficacy beliefs and engineering interests. Time management, prioritising, help-seeking behaviour, knowing professors' expectations, and critical self-evaluation were essential behaviours for pre-engineering students' persistence.

Conservation translocations may be a useful tool for the restoration of declining freshwater invertebrates, but they are poorly represented in the literature. We conducted a before‐after/control‐impact (BACI) experiment to test the efficacy of conservation translocation for re‐establishing abundant populations of the amphipod Gammarus lacustris, a declining species and wildlife food resource in depressional wetlands in the upper Midwest of the United States of America. Each study site (n = 19) contained at least one treatment wetland receiving translocated G. lacustris from a local donor and one control wetland. We selected study wetlands based on a suite of wetland characteristics and randomly assigned recipient versus control treatment. Gammarus lacustris was detected post‐translocation at only 2 of 22 recipient wetlands (1 of 19 sites). Overall, there was a statistical increase in G. lacustris density in recipient wetlands compared to controls; however, the results were of minimal biological significance due to being driven by a single site with low G. lacustris densities. Accordingly, our results suggest that future conservation translocations of amphipods might be successful if limited to recently restored wetlands or informed by a more complex habitat suitability model to differentiate dispersal limitations from habitat limitations. To develop such a model would involve identifying the fewest, most influential physical and biological factors (e.g. wetland size/structure, fish, aquatic vegetation, and water chemistry) from the numerous inter‐related factors that correlate with the abundance of naturally occurring G. lacustris; candidate wetlands to receive amphipods would be those for which the model predicts abundant G. lacustris but in which they do not presently occur. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a fatal and intricate neurodegenerative disease that impacts upper and lower motor neurons within the central nervous system, leading to their progressive destruction. Despite extensive research, the pathogenesis of this multifaceted disease remains elusive. The United States Food and Drug Administration (FDA) has granted approval for seven medications designed to address ALS and mitigate its associated symptoms. These FDA-sanctioned treatments are Qalsody, Relyvrio, Radicava, Rilutek, Tiglutik, Exservan, and Nuedexta. In this review, the effects of these seven drugs on ALS based on their mechanism of action, dosing, and clinical presentations are comprehensively summarized. Each medication offers a distinct approach to manage ALS, aiming to alleviate the burdensome symptoms and slow the disease's progression, thereby improving the quality of life for individuals affected by this neurological condition. However, despite these advancements in pharmaceutical interventions, finding a definitive cure for ALS remains a significant challenge. Continuous investigation into ALS pathophysiology and therapeutic avenues remains imperative, necessitating further research collaborations and innovative approaches to unravel the complex mechanisms underlying this debilitating condition. [ABSTRACT FROM AUTHOR]

Author(s): Matthew J. Maiden [sup.1] [sup.2] [sup.3] , Allison Bone [sup.1] , Megan Fitzpatrick [sup.1] , Naomi Hammond, Serena Knowles, Annie Gao, Yang Li, John Myburgh, Ian Seppelt, Sarah Grattan, [...]

Despite making major advances in educational provision, Maori and Pasifika children continue to lag behind other groups, in New Zealand, achieving disproportionately lower results on national averages. Key to educational success for Maori and Pasifika children is the acknowledgement that they are culturally located and the recognition that effective education must embrace culture. Early childhood education has an important role in building strong learning foundations for young children, however achieving this is a complex process especially with regard to Maori and Pasifika children in early childhood education. This article reports on the first phase of a TLRI research project, Te Whatu Kete Matauranga: Weaving Maori and Pasifika Infant and Toddler Theory and Practice in Early Childhood Education (2015-2016). The research aims to support culturally embedded infant and toddler provision in Maori and Pasifika early childhood services, and to provide contextually located, culturally relevant theory and practice guidelines for early childhood teachers and services.

Background: Few studies have evaluated diagnostic yield of small volume biopsies (SVB) for the diagnosis and management of follicular lymphoma (FL). Methods: The authors performed a multi‐institutional retrospective analysis of SVBs including fine‐needle aspiration (FNA) and needle core biopsy (NCB) for initial FL diagnosis and suspected recurrence or transformation of FL. A total of 676 workups beginning with SVB were assessed for the mean number of biopsies per workup, the proportion of workups requiring multiple biopsies, and the proportion with a complete diagnosis including grade, on initial biopsy. Results: Compared to workups performed for question transformation/recurrence, those done for initial FL diagnosis were significantly more likely to require multiple biopsies (p <.01), had a higher mean number of biopsies per workup (1.7 vs. 1.1, absolute standardized difference = 1.1), and a lower complete diagnosis rate at initial biopsy (39% vs. 56%). At initial FL diagnosis, NCB +/− FNA was associated with fewer biopsies per workup compared to FNA +/− CB (1.2 vs. 1.9), fewer workups requiring multiple biopsies (23% vs. 83%), and a higher complete diagnosis rate (71% vs. 18%). In contrast, during assessment for transformation/recurrence, NCB and FNA showed a similar mean number of biopsies per workup (1.2 vs. 1.2) and few workups required multiple biopsies (6% vs. 19%). Conclusions: SVB at initial FL diagnosis often required additional biopsies to establish a complete diagnosis. In contrast, when assessing for transformed/recurrent FL, additional biopsies were generally not obtained regardless of SVB type, suggesting that in these clinical settings SVB may be sufficient for clinical decision‐making. Small volume biopsies obtained for initial diagnosis of follicular lymphoma are likely to require a subsequent biopsy, especially when fine–needle aspiration‐based procedures are performed. In contrast, small volume biopsies performed to determine follicular lymphoma recurrence or transformation infrequently requires a subsequent biopsy regardless of biopsy type. [ABSTRACT FROM AUTHOR]