Deoxyribonucleic Acid Testing Research Articles

Research on Correlation between DNA Typing and Trace Characteristics of Blood after Thermal Exposure

The identification of biological evidence is particularly important for criminal detection, and the deoxyribonucleic acid (DNA) analysis plays a significant role in reconstructing events. However, bloodstains after thermal exposure in fires are quite unique compared to those in other scenes. Previous results regarding DNA recovery in bloodstains after heating are inconsistent with each other, which limits guidance for forensic science. In order to confirm the influence of heat on DNA recovery, the important physical evidence, bloodstain, was selected for its common occurrence, and a standard heat source, the Cone Calorimeter, was used to simulate high temperatures in fire scenes. A series of bloodstains were prepared under different heating conditions, and the results of short tandem repeat (STR) typing were systematically correlated with the trace characteristics of bloodstains. The findings indicate that heating bloodstains below 150oC for less than 10mins has minimal effect on DNA testing. After heating bloodstains at 150oC for 20mins or at 180oC for 5mins, partial DNA profiles were obtained, accompanied by blackening and cracking of the bloodstains. After exposure to 180oC for 20mins or 200oC for 10mins, no DNA profiles were obtained with bloodstains exhibiting metallic lusters and black bulges. Furthermore, from the perspective of chemical bond energy, the C-N, C-O, C-C, and P-O bonds in DNA molecules are prone to breaking during heating. The C-N bond serves as the primary connection between the four bases and the strand, while the C-O, C-C, and P-O bonds are significant connections within the DNA strand. It is thus hypothesized that the breakage of any bond aforementioned during heating results in the failure of DNA typing. Understanding the correlation between trace characteristics of bloodstains and DNA typing results after thermal exposure is crucial for comprehending DNA recovery from physical evidence collected from fire scenes.

Risk Factors for Cervical Cancer in Ghana.

The major burden of cervical cancer occurs in low- and middle-income countries. In Ghana, it is the second most common cancer among women. Infection with high-risk human papilloma virus (HPV) has been established as the cause of cervical cancer. As such, it is important to identify risk factors that may affect progression from HPV infection to cancer. We assessed the risk factors assocaited with cervical cancer in Ghana. To identify the risk factors for cervical cancer, we conducted an unmatched case-control study in two hospitals in Ghana where most cervical cancer cases are diagnosed. Women with histologically confirmed cervical cancer were the cases, whereas women without cancer seeking care at the two hospitals were controls. A structured questionnaire was administered to the women, after which cervical samples were sent for HPV deoxyribonucleic acid (DNA) testing. Overall, 206 cases and 230 controls were recruited. After adjusting for possible confounders, women with the highest educational level had a significantly lower risk of cervical cancer than those with no or little formal education. Parity was a major risk factor (odd ratio [OR] for five or more children = 7.9; 95% CI: 2.3-27.6), with risk increasing with increasing parity (p for trend <0.001). Women reporting the use of a homemade sanitary towel during menstruation also had an increased risk of cervical cancer compared with women who used a pad (OR: 7.3; 95% CI: 2.5-22.0). In this Ghanaian population, high parity and poor personal hygienic conditions were the main contributing factors to the risk of cervical cancer after adjustment for the presence of high-risk HPV genotypes.

Predictors of stool deoxyribonucleic acid test use in the United States: Implications for outreach to under-resourced populations

ObjectiveAlthough colorectal cancer screening (CRCS) is a public health priority, uptake is suboptimal in under-resourced groups. Noninvasive modalities, including stool deoxyribonucleic acid (sDNA) testing, may mitigate economic, geographic, cultural, or impairment-related barriers to CRCS. We assessed use of sDNA testing and other CRCS modalities in U.S. residents, comparing subgroups defined by several social determinants of health (SDOH). MethodsA nationally representative sample of community-dwelling respondents aged 50–75 years self-reported use of CRCS modalities in the 2020 Behavioral Risk Factor Surveillance System Survey. Statistical analyses assessed up-to-date screening status and choice of modality in the recommended screening interval. ResultsOf 179,833 sampled respondents, 60.8% reported colonoscopy, 5.7% sDNA testing, 5.5% another modality. The rate of up-to-date screening was 72.0% overall and negatively associated with Hispanic ethnicity (63.6%), lower educational and annual income levels (e.g., <high school, 63.7%, <$20,000, 67.2%), and cost-related difficulty accessing physician care (57.4%; all p < 0.001) but not with Black non-Hispanic race/ethnicity (74.6%) or sensory, cognitive, or physical impairments (73.1%–73.9%). Choice of sDNA instead of colonoscopy was made by 8.5% overall and was more common in the same SDOH groups (Hispanic ethnicity, 17.7%; <high school, 17.4%; <$20,000, 16.8%; cost-related difficulty accessing care, 12.0%); Black non-Hispanic race/ethnicity (11.6%); and impairments (sensory, 12.0%; other cognitive or physical, 12.9%). ConclusionsUnder-resourced persons were more likely than better-resourced persons to access sDNA testing, possibly offsetting screening barriers in some groups. Findings suggest opportunities to increase CRCS with heightened communication about sDNA testing to those who may experience difficulty accessing other modalities.

Hermetic microfluidic device for point-of-care viral nucleic acid testing

There is an unmet clinical and public health need for rapid and accurate point-of-care (POC) diagnosis and management of infectious pathogens, especially in resource-limited environments. In this work, we present a microfluidic deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) rapid test (μDART) device for POC detection of various viral pathogens. This platform hermetically integrates the modules of extraction-free sample lysis, loop-mediated isothermal amplification (LAMP) with lyophilized reagent beads, and real-time colorimetric signal sensing to realize "sample-in and result-out" in 15–30 min. Test results can be sent to a mobile phone for remote monitoring. Automated high-precision liquid handling is achieved by a combination of negative-pressure-driven microchambers and self-sealing valves, thus simplifying manual operations and eliminating the leakage of nucleic acid aerosols. The limit of detection (LOD) of the device is as low as ∼53 copies/mL or ∼2 copies/reaction for SARS-CoV-2, which is as sensitive as the gold standard of nucleic acid testing. To validate our device’s clinical applications, we tested both DNA and RNA viruses as representative pathogens including 537 clinical nasal swab samples for SARS-CoV-2, 74 cervical swab samples for human papillomavirus 16/18 (HPV16/18) and 82 pet swab samples for feline cupripoxvirus (FCV) and feline herpesvirus (FHV). Across these tests, the clinical sensitivity and specificity were 92.5% - 97.7% and 99.7%-100%, respectively. We demonstrate that the μDART is able to provide a quick and accurate result for POCT and self-testing, and can connect to health care wirelessly to achieve remote monitoring.

Current role of viral biomarkers in cervical carcinogenesis

Viral biomarkers for cervical cancer screening are valuable in improving timely diagnosis and detection at early stage. The various biomarkers currently there is evidence include high-risk human papillomavirus (hrHPV) deoxyribonucleic acid (DNA) testing, there is place for further research for biomarkers such as hrHPV genotyping hrHPV transcriptional status, and host DNA methylation. Though the evidence is conclusive for hrHPV DNA testing, there is place for further research for biomarkers such as hrHPV genotyping hrHPV transcriptional status, and host DNA methylation. This application of these biomarkers in context of low resource settings has its limitations despite high prevalence of the disease. Improved women participation can be achieved by use of self-samples thereby improving diagnoses rate of the disease and higher cost effectiveness of the screening programme. In due course, biomarkers will be made available in the screening programmes together with self-sampling that will detect hrHPV infections and low-grade squamous intraepithelial lesions (LSIL) before they progress to high-grade squamous intraepithelial lesions (HSIL), and from there to malignancy. This would facilitate prudent timely clinical decisions, reduced patient anxiety, reduction in over referral and unnecessary treatments in women, especially in developing countries.

An Analysis of the Challenges Encountered by the Cauayan City Crime Laboratory Office in Deoxyribonucleic Acid Testing

DNA profiling is a cornerstone of modern forensic investigation due to its unique ability to identify individuals. This study explored the challenges encountered by the Cauayan City Crime Laboratory Office (CCCLO) in Isabela, Philippines, in conducting Deoxyribonucleic acid (DNA) analyses. Employing a descriptive qualitative design, data were collected through in-depth interviews with seven CCCLO personnel using purposive sampling. The study conducted from June 2020 to July 20202. Thematic analysis revealed primary challenges to include lack of core DNA analysis equipment, shortage of DNA analysts, and the absence of dedicated DNA laboratory facility. While the CCCLO has implemented strategies such as DNA sample transportation to National Head Quarters-Crime Laboratory Division and limited training initiatives, these measures appear insufficient to address the identified problems. The findings underscore the critical need for enhanced resources and capacity building to optimize DNA analysis capabilities in Philippine crime laboratories.

Cervical cancer screening and treatment costing in Senegal.

in Senegal, cervical cancer is the leading cause of cancers among women. This study estimated the costs associated with cervical cancer screening and treatment for precancerous lesions from the health system perspective. we estimated costs for screening, diagnostics, and treatment. We conducted a cross-sectional study in seven regions with primary data collected from 50 health facilities. Data collection included structured questionnaires, with secondary data from the Ministry of Health and other sources. A mixed-methods approach combined ingredients-based costing and financial expenditures to estimate direct medical and non-medical costs. All costs are reported in 2019 USD. average costs were $3.71 for visual inspection with acetic acid, $16.49 for Pap smear, and $46.65 for human papillomavirus deoxyribonucleic acid (HPV DNA) testing. Screening cost drivers were clinical exam supplies and clinical equipment for visual inspection with acetic acid, offsite processing of specimens for Pap smear, and lab equipment costs for HPV DNA procedure. The average cost of diagnosis via colposcopy alone was $25.73, and colposcopy with biopsy/endocervical curettage was $74.96. The average cost of treatment followed by one visit for pre-cancerous lesions was $195.24 for loop electrosurgical excision, $47.35 for cryotherapy, and $32.35 for thermal ablation. Clinical equipment and lab costs were the largest contributors to colposcopy and endocervical curettage/biopsy expenses. Clinical equipment made up the largest portion of cryotherapy, loop electrosurgical excision, and thermoablation costs. this study is the first to estimate the costs of HPV screening and treatment in Senegal, which can be used to inform decision-making on cervical cancer investments.

Developing a Nomogram for Predicting Colorectal Cancer and Its Precancerous Lesions Based on Data from Three Non-Invasive Screening Tools, APCS, FIT, and sDNA.

This study aimed to develop and validate a nomogram for predicting positive colonoscopy results using the data from non-invasive screening strategies. The volunteers participated in primary colorectal cancer (CRC) screenings using Asia-Pacific colorectal screening (APCS) scoring, faecal immunochemical testing (FIT) and stool deoxyribonucleic acid (sDNA) testing and underwent a colonoscopy. The positive colonoscopy results included CRC, advanced adenoma (AA), high-grade intraepithelial neoplasia (HGIN), and low-grade intraepithelial neoplasia (LGIN). The enrolled participants were randomly selected for training and validation sets in a 7:3 ratio. A model for predicting positive colonoscopy results was virtualized by the nomogram using logistic regression analysis. Among the 179 enrolled participants, 125 were assigned to training set, while 54 were assigned to validation set. After multivariable logistic regression was done, APCS score, FIT result, and sDNA result were all identified as the predictors for positive colonoscopy results. A model that incorporated the above independent predictors was developed and presented as a nomogram. The C-index of the nomogram in the validation set was 0.768 (95% CI, 0.644-0.891). The calibration curve demonstrated a good agreement between prediction and observation. The decision curve analysis (DCA) curve showed that the model achieved a net benefit across all threshold probabilities. The AUC of the prediction model for predicting positive colonoscopy results was much higher than that of the FIT + sDNA test scheme. The nomogram for predicting positive colonoscopy results was successfully developed based on 3 non-invasive screening tools (APCS scoring, FIT and sDNA test).

Cost-utility and budget impact analyses of cervical cancer screening using self-collected samples for HPV DNA testing in Thailand

IntroductionCervical cancer ranks as the third most prevalent cancer among women in Thailand. However, the effectiveness of cervical cancer screening programs is limited by several factors that impede the screening rate. The utilization of self-collected samples for screening purposes has the potential to alleviate barriers to screening in Thai women. This study assessed the cost-utility and budget impact of implementing cervical cancer screening using self-collected samples for human papillomavirus (HPV) deoxyribonucleic acid (DNA) testing in Thailand.Materials and methodsWe employed a decision tree integrated with a Markov model to estimate the lifetime costs and health benefits associated with the cervical cancer screening program for women aged 25–65. The analysis was conducted from a societal perspective. Four screening policy options were compared: (1) additional self-collected samples for HPV DNA testing, (2) clinician-collected samples for HPV DNA testing only, (3) clinician-collected samples for cytology test (i.e., status quo), and (4) no screening. The model inputs were based on unvaccinated women. The screening strategies and management in those with positive results were assumed followed to the Thai clinical practice guideline. Costs were reported in 2022 Thai baht. Sensitivity analyses were conducted. The ten-year budget impacts of the additional self-collected samples for HPV DNA testing were calculated from a payer perspective.ResultsAll screening policies were cost-saving compared to no screening. When comparing the additional self-collected samples for HPV DNA testing with the clinician-collected samples policy, it emerged as the dominant strategy. The incremental benefit in cervical cancer prevention achieved by incorporating self-collected samples for screening was observed at any additional screening rate that could be achieved through their use. Sensitivity analyses yielded consistently favorable results for the screening policies. The average annual budget impact of the additional self-collected samples for screening policy amounted to 681 million Thai baht. This budget allocation could facilitate cervical cancer screening for over 10 million women.ConclusionsAn addition of self-collected samples for HPV DNA testing into the cervical cancer screening program is cost-saving. The benefits of this screening policy outweigh the associated incremental costs. Policymakers should consider this evidence during the policy optimization process.

NON-NECROTIZING DIFFUSE ANTERIOR SCLERITIS AS AN ISOLATED OCULAR MANIFESTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE REPORT

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disorder with heterogeneous clinical manifestation in numerous organ systems, including the eye. Ocular involvements have been reported in up to one-third of patients with SLE, although scleritis is considered a less common manifestation of the disease found in only about 1% of cases Case Report: A 46-year-old female patient presented with a painful right eye for 1 week. She reported having the same symptom last year which resolved without treatment. There was no known history of systemic immune-mediated diseases and no prior ocular trauma. Ophthalmological examination revealed dilatation of deep scleral vessels on the right eye. The patient tested positive for the antinuclear antibody and anti-double-stranded deoxyribonucleic acid tests. She was diagnosed with non-necrotizing diffuse anterior scleritis caused by SLE and was treated with topical prednisolone acetate and systemic methylprednisolone. After 1 week of treatment, the patient showed an improvement in ocular signs and symptoms. Discussion: Scleritis is a rare inflammatory disease usually associated with systemic immune-mediated diseases such as SLE. It can cause significant visual loss and may be life-threatening. We reported a non-necrotizing diffuse anterior subtype of scleritis presented as an isolated manifestation in SLE, which benefited from early diagnosis and treatment of corticosteroids. Conclusion: Scleritis may present as an early or isolated manifestation of systemic immune-mediated disease. Therefore, a comprehensive examination is of the essence to exclude multisystem disease and treat the underlying cause even when there is no systemic manifestation.

Deoxyribonucleic acid test results in both paternity cases and assisted reproductions: rebuttals of the presumption of legitimacy under Section 165 of the “Nigerian Evidence Act”, 2011?

Section 165 of the Nigerian Evidence Act, 2011, presumes the legitimacy of a child given birth to during the existence of a valid marriage between the mother of such a child and any man, or within 280 days after the dissolution of any such marriage - if the mother remains unmarried after the dissolution of the marriage. Being a presumption, the legitimacy of such a child may be displaced upon adducing credible evidence to prove that the child is not fathered by the man during the continuance of the marriage or within 280 days immediately after the dissolution of the marriage. This Article therefore, discusses the use of Deoxy Ribonucleic Acid tests results to rebut the presumption of legitimacy in Section 165 of the Evidence Act using paternity cases and In Vitro Fertilization of embryos, particularly where there are medical mistakes or malpractices by clinicians and embryologists. Keywords: Deoxyribonucleic Acid; Paternity; In Vitro Fertilization; Presumption; Evidence Act

Evaluation of a Quantitative Dual-Target EBV DNA Test on a Fully Automated Molecular Testing System.

The measurement of Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA) is key to diagnosing and managing EBV-associated complications in transplant recipients. The performance of the new Conformité Européenne (CE) and Food and Drug Administration (FDA)-cleared quantitative Roche cobas EBV real-time PCR assay was determined by using EDTA-plasma dilution panels and clinical samples that were spiked with either the World Health Organization's EBV international standard or high-titer EBV lambda stock. Correlation with the Abbott Realtime EBV assay was assessed in clinical specimens and conducted at two independent laboratories. An in silico analysis revealed that the dual-target test (EBNA1 and BMRF2) was 100% inclusive for the known diversity of EBV. The overall limit of detection (LoD) was 16.6 IU/mL for genotype 1 (GT1). GT2 LoD was verified at 18.8 IU/mL. The linear ranges were from 1.40 × 101 to 2.30 × 108 IU/mL and from 2.97 × 101 to 9.90 × 107 IU/mL for GT1 and GT2, respectively. Accuracy was confirmed across the linear range (mean difference not exceeding ±0.18 log10). Precision was not influenced by the factors analyzed (standard deviation of 0.02 to 0.17 log10), including the presence of potentially interfering endogenous or exogenous substances. Plasma samples were stable under several conditions (variable time points, storage, and freeze/thaw cycles). In clinical EBV DNA-positive samples, correlation between the cobas EBV test and the comparator was high (n = 126 valid results; R2 = 0.96) with a 0.1 mean log10 titer difference. The cobas EBV test is an accurate, sensitive, specific, and reproducible assay for the detection of EBV DNAemia in plasma. In general, high levels of automation and calibration to the international standard will lead to improvements in the harmonization of quantitative EBV DNA test results across laboratories.

Tumor residue in patients with stage II–IVA nasopharyngeal carcinoma who received intensity-modulated radiation therapy: development and validation of a prediction nomogram integrating postradiotherapy plasma Epstein–Barr virus deoxyribonucleic acid, clinical stage, and radiotherapy dose

BackgroundTo develop and validate a predictive nomogram for tumor residue 3–6 months after treatment based on postradiotherapy plasma Epstein–Barr virus (EBV) deoxyribonucleic acid (DNA), clinical stage, and radiotherapy (RT) dose in patients with stage II–IVA nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT).MethodsIn this retrospective study, 1050 eligible patients with stage II–IVA NPC, who completed curative IMRT and underwent pretreatment and postradiotherapy (-7 to +28 days after IMRT) EBV DNA testing, were enrolled from 2012 to 2017. The prognostic value of the residue was explored using Cox regression analysis in patients (n=1050). A nomogram for predicting tumor residues after 3–6 months was developed using logistic regression analyses in the development cohort (n=736) and validated in an internal cohort (n=314).ResultsTumor residue was an independent inferior prognostic factor for 5-year overall survival, progression-free survival, locoregional recurrence-free survival and distant metastasis-free survival (all P<0.001). A prediction nomogram based on postradiotherapy plasma EBV DNA level (0 vs. 1–499 vs. ≥500 copies/ml), clinical stage (II vs. III vs. IVA), and RT dose (68.00–69.96 vs. 70.00–74.00 Gy) estimated the probability of residue development. The nomogram showed better discrimination (area under the curve (AUC): 0.752) than either the clinical stage (0.659) or postradiotherapy EBV DNA level (0.627) alone in the development and validation cohorts (AUC: 0.728).ConclusionsWe developed and validated a nomogram model integrating clinical characteristics at the end of IMRT for predicting whether tumor will residue or not after 3–6 months. Thus, high-risk NPC patients who might benefit from immediate additional intervention could be identified by the model, and the probability of residue can be reduced in the future.

Examining the Admissibility or Otherwise of Evidence Generated from Closed-Circuit Television (CCTV) and Deoxyribonucleic Acid (DNA) Test as Means of Proof of Zina Under Islamic Law

This article examines the admissibility of evidence generated from CCTV and DNA tests as a means of proving adultery according to Islamic Law with a critical and argumentative study. This article reveals that hadd punishment cannot be imposed based on evidence generated from CCTV and DNA tests because the admission of such evidence will erode and neutralize the Qur'anic requirement of four reliable eyewitnesses before punishment. On the other hand, such evidence cannot be used to replace the provisions of the Qur'an and Sunnah because they are circumstantial and therefore subject to doubt. The author's main finding is that the only acceptable evidence for adultery is that prescribed by the Qur'ān or Sunnah, namely the oral testimony of four reliable eyewitnesses and confession. The article recommends that evidence generated from CCTV and DNA tests should be good evidence and equally admissible in all non-hudud offenses especially when there is no human interference or interruption tainting or affecting the evidence.

Lifestyle Disease Prediction

Abstract: Conditions that are associated with the way a person or group of people live are known as life conditions. Healthcare assiduity collects enormous complaint- related data that's unfortunately not booby-trapped to discover retired information that could be used for effective decision timber. This study aims to understand support vector machine and use it to prognosticate life conditions that an individual might be susceptible to. also, we propose and pretend an profitable machine literacy model as an volition to deoxyribonucleic acid testing that analyzes an existent’s life to identify possible pitfalls that form the foundation of individual tests and complaint forestallment, which may arise due to unhealthy diets and inordinate energy input, physical dormancy, etc. The simulated model will prove to be an intelligent low- cost volition to descry possible inheritable diseases caused by unhealthy cultures.

A global perspective on cervical cancer screening: a literature review

Cervical cancer is a significant health issue for women globally, with over 600,000 new cases and 342,000 deaths in 2020. Effective cervical screening programs, including primary screening methods such as Pap tests, human papillomaviruses (HPV) deoxyribonucleic acid (DNA) testing, and liquid-based cytology, can prevent and detect early cancer cases, improving morbidity and mortality rates. However, screening uptake varies widely across countries, with high-income countries have achieved over 70% uptake but low- and middle-income countries lagging due to a lack of recommendations and centralised screening systems. Even in high-income countries in the Middle East, uptake remains low, requiring further investigation. This review explores barriers to screening programme delivery and highlights centralised and multi-level interventions that have proven effective worldwide. Future research should focus on culturally sensitive approaches, healthcare infrastructure strengthening, and community education and outreach programs to address uptake disparities and barriers.

A Comparison of Single and Combined Schemes of Asia-Pacific Colorectal Screening, Faecal Immunochemical and Stool Deoxyribonucleic Acid Testing for Community Colorectal Cancer Screening.

To compare the screening efficacy of colonoscopy and pathologically confirmed single and combined Asia-Pacific colorectal screening (APCS), faecal immunochemical testing (FIT) and stool deoxyribonucleic acid (sDNA) testing protocols. From April 2021 to April 2022, 842 volunteers participated in primary colorectal cancer (CRC) screenings using APCS scoring, FIT and sDNA testing and 115 underwent a colonoscopy. One hundred high-risk participants were then identified from the results of both processes. The differences in the three CRC screening tests in combination with the colonoscopy pathology diagnostics were evaluated using Cochran's Q test, the Dunn-Bonferroni test and area under the receiver operating characteristic curve (AUC) value analysis. Both FIT and sDNA testing demonstrated a 100% performance in detecting CRC. For advanced adenoma, the sensitivity of the FIT + sDNA test scheme (double positive) was 29.2%, and the sensitivities of the combined FIT + sDNA test and APCS scoring + sDNA test schemes were 62.5% and 95.8%, respectively. The FIT + sDNA testing kappa value of advanced colorectal neoplasia was 0.344 (p = 0.011). The sensitivity for nonadvanced adenoma of the APCS score + sDNA test scheme was 91.1%. In terms of positive results, the sensitivity of the APCS score + FIT + sDNA detection protocol was significantly higher than that of the APCS score, FIT, sDNA detection, and FIT + sDNA detection methods (adjusted p < 0.001, respectively). For the FIT + sDNA test, the kappa value was 0.220 (p = 0.015) and the AUC was 0.634 (p = 0.037). The specificity of the FIT + sDNA test scheme was 69.0%. The FIT + sDNA test scheme demonstrated superior diagnostic efficacy, and the combined APCS score + FIT + sDNA test scheme demonstrated remarkable improvements in CRC screening efficiency and sensitivity for detecting positive lesions.

Human papillomavirus genotype distribution among women with and without cervical cancer: Implication for vaccination and screening in Ghana.

Determining the high-risk human papillomavirus (HR-HPV) genotypes burden in women with and without cervical cancer afford a direct comparison of their relative distributions. This quest is fundamental to implementing a future population-based cervical cancer prevention strategy in Ghana. We estimated the cervical cancer risk by HPV genotypes, and the HPV vaccine-preventable proportion of cervical cancer diagnosed in Ghana. An unmatched case-control study was conducted at the two largest cervical cancer treatment centres in Ghana from 1st October 2014 to 31st May 2015. Cases were women diagnosed with cervical cancer and controls were women without cervical cancer who were seeking care at the two hospitals. Nested multiplex polymerase chain reaction (NM-PCR) was used to detect HPV infection in cervical samples. Logistic regression was used to determine the association between the risk of cervical cancer and identified HPV infection. P ≤0.05 was considered statistically significant. HPV deoxyribonucleic acid (DNA) data were analysed for 177 women with cervical cancer (cases) and 201 without cancer (controls). Cervical cancer was diagnosed at older ages compared to the age at which controls were recruited (median ages, 57 years vs 34 years; p < 0.001). Most women with cervical cancer were more likely to be single with no formal education, unemployed and less likely to live in metropolitan areas compared to women without cervical cancer (all p-value <0.001). HPV DNA was detected in more women with cervical cancer compared to those without cervical cancer (84.8% vs 45.8%). HR-HPV genotypes 16, 18, 45, 35 and 52 were the most common among women with cervical cancer, while 66, 52, 35, 43 and 31 were frequently detected in those without cancer. HPV 66 and 35 were the most dominant non-vaccine genotypes; HPV 66 was more prevalent among women with cervical cancer and HPV 35 in those without cervical cancer. Cervical cancer risk was associated with a positive HPV test (Adjusted OR (AOR): 5.78; 95% CI: 2.92-11.42), infection with any of the HR-HPV genotypes (AOR: 5.56; 95% CI: 3.27-13.16) or multiple HPV infections (AOR: 9.57 95% CI 4.06-22.56). Women with cervical cancer in Ghana have HPV infection with multiple genotypes, including some non-vaccine genotypes, with an estimated cervical cancer risk of about six- to ten-fold in the presence of a positive HPV test. HPV DNA tests and multivalent vaccine targeted at HPV 16, 18, 45 and 35 genotypes will be essential in Ghana's cervical cancer control programme. Large population-based studies are required in countries where cervical cancer is most prevalent to determine non-vaccine HPV genotypes which should be considered for the next-generation HPV vaccines.

Experiences in successive forensic analysis of GSR and DNA traces collected on a single tape lift stub.

Gunshot residue (GSR) and deoxyribonucleic acid (DNA) analyses are used in the reconstruction of shooting incidents involving firearms. In both fields, adhesive tapes are commonly applied to recover traces. Using a simultaneous sampling approach for retrieving both types of traces from objects related to a shooting can be powerful. We present the results for DNA testing and GSR analysis using "DNA stubs" to recover both types of traces in one sampling. The analyses are successive: stubs are first examined with scanning electron microscopy for the presence of GSR and next subjected to DNA extraction and short tandem repeat (STR) typing. The results show no negative effect on the DNA and GSR results. The risk of DNA contamination during GSR analysis is addressed, showing that it is negligible. Our experiences in casework show that the approach can be successfully implemented.

Diagnostic accuracy of menstrual blood for human papillomavirus detection in cervical cancer screening: a systematic review.

Globally, cervical cancer is the fourth most common cancer among females and a major public health problem in low- and middle-income countries (LMICs). There are several screening tests available for cervical cancer screening; however, due to a lack of organised screening facilities as well as factors such as low participation rates in screening programmes, many women die due to cervical cancer. To reach out to a large number of women, an easy, non-invasive and time-saving screening method is required. Evidence supports that cervical cancer screening with human papillomavirus deoxyribonucleic acid (HPV DNA) testing is the most effective technique for lowering the incidence and mortality associated with cervical cancer when compared to other screening methods. Furthermore, a small number of studies have reported that menstrual blood can be used as an alternative sample for HPV detection for cervical cancer screening. We have done a systematic review of the studies that have reported the diagnostic accuracy of menstrual blood to detect HPV. We found five studies in our literature search. The studies showed the diagnostic accuracy of menstrual blood in terms of sensitivity ranging from 82.8% to 97.7% and specificity ranging from 50.0% to 98.0% in cervical intraepithelial neoplasia or HPV infection detection. This review supports the use of menstrual blood as a screening tool for cervical cancer especially in LMICs where women are reluctant to participate in cervical cancer screening due to issues such as embarrassment and discomfort to test procedures as well as busy schedules. However, further studies are required to compare the diagnostic accuracy of menstrual blood in detecting HPV compared to other self-sampled HPV detection methods. This is one of the methods that can be explored further for use as a cervical cancer screening test.