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- Villa, Luisa L., et al.
(författare)
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Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions
- 2007
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 356:19, s. 1915-1927
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide. A phase 3 trial was conducted to evaluate a quadrivalent vaccine against HPV types 6, 11, 16, and 18 (HPV-6/11/16/18) for the prevention of high-grade cervical lesions associated with HPV-16 and HPV-18. METHODS: In this randomized, double-blind trial, we assigned 12,167 women between the ages of 15 and 26 years to receive three doses of either HPV-6/11/16/18 vaccine or placebo, administered at day 1, month 2, and month 6. The primary analysis was performed for a per-protocol susceptible population that included 5305 women in the vaccine group and 5260 in the placebo group who had no virologic evidence of infection with HPV-16 or HPV-18 through 1 month after the third dose (month 7). The primary composite end point was cervical intraepithelial neoplasia grade 2 or 3, adenocarcinoma in situ, or cervical cancer related to HPV-16 or HPV-18. RESULTS: Subjects were followed for an average of 3 years after receiving the first dose of vaccine or placebo. Vaccine efficacy for the prevention of the primary composite end point was 98% (95.89% confidence interval [CI], 86 to 100) in the per-protocol susceptible population and 44% (95% CI, 26 to 58) in an intention-to-treat population of all women who had undergone randomization (those with or without previous infection). The estimated vaccine efficacy against all high-grade cervical lesions, regardless of causal HPV type, in this intention-to-treat population was 17% (95% CI, 1 to 31). CONCLUSIONS: In young women who had not been previously infected with HPV-16 or HPV-18, those in the vaccine group had a significantly lower occurrence of high-grade cervical intraepithelial neoplasia related to HPV-16 or HPV-18 than did those in the placebo group.
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- Trodahl, Marta, et al.
(författare)
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The Regeneration of the Lofoten Vortex through Vertical Alignment
- 2020
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Ingår i: Journal of Physical Oceanography. - 0022-3670 .- 1520-0485. ; 50:9, s. 2689-2711
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Tidskriftsartikel (refereegranskat)abstract
- Observations from the past decades have promoted the idea of a long-lived anticyclonic vortex residing in the Lofoten Basin. Despite repeatedly recorded intense anticyclones, the observations cannot firmly decide whether the signature is of a single vortex or a succession of ephemeral vortices. A vortex persisting for decades requires some reinvigoration mechanism. Wintertime convection and vortex merging have been proposed candidates. We examine Lofoten Basin vortex dynamics using a high-resolution regional ocean model. The model is initialized from a coarser state with a weak eddy field. The slope current intensifies and sheds anticyclonic eddies that drift into the basin. After half a year, an anticyclone arrives at the center, providing the nucleus for a vortex that remains distinct throughout the simulation. Analyses show that this vortex is regenerated by repeated absorption and vertical stacking of lighter anticyclones. This compresses and—in concert with potential vorticity conservation—intensifies the combined vortex, which becomes more vertically stratified and also expels some fluid in the process. Wintertime convection serves mainly to vertically homogenize and densify the vortex, rather than intensifying it. Further, topographic guiding of anticyclones shed from the continental slope is vital for the existence and reinvigoration of the Lofoten vortex. These results offer a new perspective on the regeneration of oceanic anticyclones. In this scenario the Lofoten vortex is maintained through repeated merging events. Fluid remains gradually exchanged, although the vortex is identifiable as a persistent extremum in potential vorticity.
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