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Background According to international guidelines, Human Papillomavirus (HPV) DNA tests represent a valid alternative to Pap Test for primary cervical cancer screening, provided that they guarantee balanced clinical sensitivity and specificity for cervical intraepithelial neoplasia grade 2 or more (CIN2+) lesions. The study aimed to assess whether HPV Selfy (Ulisse BioMed – Trieste, Italy), a full-genotyping HPV DNA test that detects and differentiates 14 high-risk HPV (HR-HPV) types, meets the criteria for primary cervical cancer screening described in the international guidelines, on clinician-collected as well as on self-collected samples. Methods For each participant woman, consecutively referring to Azienda Sanitaria Universitaria Giuliano Isontina (Trieste, Italy) and CRO—National Cancer Institute (Aviano, Italy) for the cervical cancer screening program, the following samples were tested: (a) a clinician-collected cervical specimen, analyzed with the reference test (Hybrid Capture®2 test, HC2) and HPV Selfy; and (b) a self-collected vaginal sample, analyzed with HPV Selfy. Enrolled women were also asked to fulfill a questionnaire about self-sampling acceptability. As required by guidelines, a non-inferiority test was conducted to compare the clinical performance of the test under evaluation with its reference test. Results HPV Selfy clinical sensitivity and specificity resulted non-inferior to those of HC2. By analysis of a total of 889 cervical liquid-based cytology samples from a screening population, of which 98 were from women with CIN2+, HPV Selfy showed relative sensitivity and specificity for CIN2+ of 0.98 and 1.00 respectively (non-inferiority score test: P  = 0.01747 and P  = 0.00414, respectively); the test reached adequate intra- and inter-laboratory reproducibility. Moreover, we demonstrated that the performance of HPV Selfy on self-collected vaginal samples was non-inferior to the performance obtained on clinician-collected cervical specimen (0.92 relative sensitivity and 0.97 relative specificity). Finally, through HPV Selfy genotyping, we were able to describe HPV types prevalence in the study population. Conclusions HPV Selfy fulfills all the requirements of the international Meijer’s guidelines and has been clinically validated for primary cervical cancer screening purposes. Moreover, HPV Selfy has also been validated for self-sampling according to VALHUDES guidelines. Therefore, at date, HPV Selfy is the only full-genotyping test validated both for screening purposes and for self-sampling. Trial registration ASUGI Trieste n. 16008/2018; CRO Aviano n.17149/2018

By analysis of a total of 889 cervical liquid-based cytology samples from a screening population, of which 98 were from women with CIN2+, HPV Selfy showed relative sensitivity and specificity for CIN2+ of 0.98 and 1.00 respectively (non-inferiority score test: P = 0.01747 and P = 0.00414, respectively); the test reached adequate intra- and inter-laboratory reproducibility. [...]we demonstrated that the performance of HPV Selfy on self-collected vaginal samples was non-inferior to the performance obtained on clinician-collected cervical specimen (0.97 relative sensitivity and 0.97 relative specificity). [...]through HPV Selfy genotyping, we were able to describe HPV types prevalence in the study population. [...]we needed to assess whether HPV testing on vaginal self-samples was as accurate as HPV testing on a cervical sample taken by a clinician. HPV Selfy testing in self-collected samples was found similarly sensitive (93/96; relative sensitivity 0.97; 95% CI 0.90–1.04) and specific (722/745; relative specificity 0.97; 95% CI 0.95–0.99) to detect CIN2+ in the total study population (Table 4), in comparison with HPV Selfy performed on paired ThinPrep. [...]HPV Selfy assay fulfills VALHUDES requirements for use of HR-HPV DNA tests on self-collected samples according to non-inferiority analysis (relative sensitivity > 0.90 with T = 1.70, p = 0.044; relative specificity > 0.95 with T = 1.87, p =0.031).

ObjectiveTo evaluate the risk of progression to high-grade squamous intraepithelial lesion (HSIL) (CIN2-3) or invasive cancer in women with histopathological diagnosis of low-grade squamous intraepithelial lesion (LSIL) (CIN1), managed in a long-term observational approach up to 5 years.DesignRetrospective cohort study.SettingFour tertiary referral hospital.Participants434 women with adequate colposcopy and complete colposcopic charts were included in the present analysis. Women with glandular lesions on the referral cytology or previous diagnosis of cervical dysplasia or invasive cervical cancer or with synchronous vaginal, or with HIV infection or immunodepression were excluded.Primary and secondary outcome measuresThe main study outcome was the rate of progression to histopathological HSIL (CIN2-3) or invasive cancer at any time during 5 years of follow-up. The possible risk factors were also evaluated. As secondary outcome, we analysed the possible risk factors at the 24-month evaluation for histopathological HSIL (CIN2-3) or invasive cancer progression between 2 and 5 years from initial diagnosis.ResultsA progression to histopathological HSIL (CIN2-3) was found in a total of 32 (7.4%) cases during 5 years of follow-up. A histopathological diagnosis of HSIL (CIN3) was found in four patients (0.9%) and no case of invasive cancer was detected. High-grade cytology at inclusion and the presence of a positive high-risk human papillomavirus (HR-HPV) DNA test at 2 years from inclusion maintained a significant correlation with the risk of histopathological progression to HSIL (CIN2-3).ConclusionsThe results of our study showed a low rate (7.4%) of histopathological progression to HSIL (CIN2-3) in women with LSIL (CIN1) diagnosis during long-term follow-up up to 5 years. In case of positive HR-HPV DNA test at the 2 years evaluation an excisional treatment could be the preferred choice to prevent progression to HSIL (CIN2-3) in the following years, preferring a continuation of follow-up in case of HR-HPV DNA negative result.

The aim of this study was to investigate the effect of childbirth and breastfeeding on uterine fibroids and to identify the factors associated with size variations. This was a monocenter observational study carried on women with a sonographic diagnosis of uterine fibroids from January 2007 to December 2016, with no indication for immediate treatment, and who became pregnant within one year from diagnosis. All patients were re-evaluated six months after delivery. Fibroid diameters were compared between pre-pregnancy period, first, second, third trimester and post-delivery. The rate of “regressed” (growth of diameter <−40%), “unchanged” (growth of diameter between −40% and +40%) or “increased” (growth of diameter >+40%) fibroids at the post-delivery evaluation with respect to the pre-pregnancy state was calculated. One-hundred fifty-seven women were included in the final analysis. At the post-delivery ultrasound, a significant reduction of the fibroid diameter with respect to all previous examinations was observed, and there was no evidence of 67 (37.2%) fibroids. Ongoing breastfeeding was positively associated with an “unchanged” or “regressed” fibroid diameter (adOR 3.23, 95%CI: 1.35–7.70, p < 0.01). Smaller pre-gravidic fibroids were more likely to return to pre-pregnancy dimensions or to regress, with a cut-off of 32 mm for lactating women and of 26 mm for non-lactating women. In conclusion, fibroids seem to return to pre-pregnancy dimensions or to regress in the post-partum period. This process may be sustained by uterine involution and hormonal variations, with an additional role of breastfeeding.

• The widespread occurrence of anastomoses and nuclear migration in intact extraradical arbuscular mycorrhizal (AM) networks is reported here. • Visualization and quantification of intact extramatrical hyphae spreading from colonized roots into the surrounding environment was obtained by using a two-dimensional experimental model system. • After 7 d the length of extraradical mycelium in the AM symbiont Glomus mosseae ranged from 5169 mm in Thymus vulgaris to 7096 mm in Prunus cerasifera and 7471 mm in Allium porrum, corresponding to 10, 16 and 40 mm mm-1 root length, respectively. In mycelium spreading from colonized roots of P. cerasifera and T. vulgaris, contacts leading to hyphal fusion were 64% and 78%, with 0.46 and 0.51 anastomoses mm-1 of hypha, respectively. Histochemical localization of succinate dehydrogenase activity in hyphal bridges demonstrated protoplasmic continuity, while the detection of nuclei in the hyphal bridges confirmed the viability of anastomosed hyphae. • The ability of AM extraradical mycelium to form anastomosis and to exchange nuclei suggests that, beyond the nutritional flow, an information flow might also be active in the network.

Biomass and length of intraradical and extraradical mycorrhizal mycelium under ambient (aCO2) and elevated (eCO2 ) atmospheric CO2 was investigated using a non-destructive in vivo experimental model system. Time-course experiments allowed measurements of intact extraradical mycelium spreading from mycorrhizal roots of Prunus cerasifera micropropagated plants inoculated with the arbuscular mycorrhizal fungus Glomus mosseae, in controlled environmental chambers. The length of extraradical mycelium was significantly increased at the highest CO2 concentration, ranging from 10.7 to 20.3 m at aCO2 and eCO2, respectively. The biochemical determination of mycelial glucosamine content allowed the evaluation of intraradical and extraradical fungal biomass, which were 2 and 3 times larger at eCO2 than at aCO2. Present data show that Glomus mosseae responds to increases of CO2 concentrations producing larger mycorrhizal networks which may potentially represent carbon sink agents in soil ecosystems.

Biomass and length of intraradical and extraradical mycorrhizal mycelium under ambient (aCO sub(2)) and elevated (eCO sub(2) ) atmospheric CO sub(2) was investigated using a non-destructive in vivo experimental model system. Time-course experiments allowed measurements of intact extraradical mycelium spreading from mycorrhizal roots of Prunus cerasifera micropropagated plants inoculated with the arbuscular mycorrhizal fungus Glomus mosseae, in controlled environmental chambers. The length of extraradical mycelium was significantly increased at the highest CO sub(2) concentration, ranging from 10.7 to 20.3 m at aCO sub(2) and eCO sub(2), respectively. The biochemical determination of mycelial glucosamine content allowed the evaluation of intraradical and extraradical fungal biomass, which were 2 and 3 times larger at eCO sub(2) than at aCO sub(2). Present data show that Glomus mosseae responds to increases of CO sub(2) concentrations producing larger mycorrhizal networks which may potentially represent carbon sink agents in soil ecosystems.

The influence of the gaseous composition of the atmosphere inside culturing vessels on somatic embryogenesis and on adventitious root formation was investigated in the quince clone (Cydonia oblonga Mill.) BA29. Leaves taken from in vitro-grown shoots were cultured in glass Petri dishes and exposed to ventilation with atmospheric air (flow rate$25 ml min^{-1}$) for 0, 5, 10, 20, and 40 d. Twenty days of ventilation reduced the frequency of embryogenic leaves and a further decrease was observed after 40 d of treatment. Conversely, adventitious root formation in the ventilated dishes was never different from the untreated cultures. In a second test, leaves were incubated in atmospheres containing different levels of oxygen (0, 5.0, 10.0, and 21.0%) or carbon dioxide (0, 0.04, 0.15, 1.5, and 3.0%). Anoxia conditions almost completely inhibited somatic embryo and adventitious root formation, but without compromising callus formation and explant viability. In contrast, embryo and root regeneration occurred even in totally CO2-free atmosphere. Oxygen seemed to influence somatic embryogenesis according to a quadratic response; a similar relationship was also observed for root regeneration. Instead, no clear trend could be inferred between embryo or root regeneration and CO2levels. Furthermore, in dishes flushed with gas mixtures containing oxygen or carbon dioxide somatic embryo formation was almost always lower than in confined dishes. A different result was observed for root regeneration, since the number of roots was never lower than in the control and increased appreciably with 3.0% CO2. These results demonstrate that atmosphere composition of the culture head-space can influence somatic embryogenesis in quince. The finding that both vessel ventilation and atmosphere replacement with different gas mixtures reduced somatic embryo formation suggests that gaseous compounds, different from O2an CO2, present in the gaseous environment may promote embryogenesis in this species.

Plum shoot proliferation was investigated in terms of two distinct processes: axillary bud differentiation and axillary shoot development. Results showed that light quality influenced bud differentiation and interacted with apical dominance in determining shoot outgrowth, resulting in a differentiated structure of shoot clusters and type of branching. Results suggested that blue light, acting through its photoreceptor, increased the number of axillary buds differentiated from apical meristem, but did not remove the apical dominance. Red light removed apical dominance, while reducing the formation of axillary buds; both events appeared to be dependent on the putative amount of phytochrome active form, and independent of light photon fluence rate. On the contrary, blue light action appeared to be dependent on photon fluence rate. In addition, apparent blue-red interactions related to photomorphogenic events fit an antagonistic model for branching regulated by light via cryptochrome and phytochrome photoreceptors. Our results show that the dynamics of shoot cluster development is the product of two events: the formation of new axillary buds and their release from apical dominance.

The effects of different macroelement combinations on somatic embryogenesis of quince (Cydonia oblonga Mill.) were tested. Leaves were excised from shoot cultures of quince clones and cultured on macroelement combinations of 8 different growth media. Callus production varied depending on the medium and the clone combinations. The influence of genotype and macronutrient combination on somatic embryo and root regeneration was also observed. Clone BA 29 showed the highest embryogenic properties and Murashige and Skoog-based medium appeared to be the most favourable for somatic embryo formation. Root regeneration was higher on Woody Plant Medium and Schenck and Hildebrandt-based media. Interactive effects between genotypes and macroelement combinations were also detected both for embryo and root formation. In all treatments, somatic embryos underwent early developmental arrest and failed to convert into plants. Differences in embryo and root regeneration observed among macroelement combinations may be ascribable to different levels of medium nitrogen and probably to the ratio between nitrate and ammonium.