https://hdl.handle.net/20.500.14178/908 2026-09-29T10:23:02Z 2026-09-29T10:23:02Z Kapp, Philipp Schmucker, Christine Siemens, Waldemar Brugger, Timo Gorenflo, Lea Röbl-Mathieu, Marianne Grummich, Kathrin Thörel, Eberhard Askar, Mona Brotons, Maria Andersen, Peter Henrik Konopnicki, Deborah Lynch, Judi Ruta, Simona Saare, Liisa Swennen, Beatrice Tachezy, Ruth Takla, Anja Učakar, Veronika Vänskä, Simopekka Zavadska, Dace Adel Ali, Karam Olsson, Kate Harder, Thomas Meerpohl, Joerg J. https://hdl.handle.net/20.500.14178/3954 2026-09-16T01:00:26Z 2025-01-01T00:00:00Z

Human papillomavirus (HPV) vaccination in women with conisation Kapp, Philipp; Schmucker, Christine; Siemens, Waldemar; Brugger, Timo; Gorenflo, Lea; Röbl-Mathieu, Marianne; Grummich, Kathrin; Thörel, Eberhard; Askar, Mona; Brotons, Maria; Andersen, Peter Henrik; Konopnicki, Deborah; Lynch, Judi; Ruta, Simona; Saare, Liisa; Swennen, Beatrice; Tachezy, Ruth; Takla, Anja; Učakar, Veronika; Vänskä, Simopekka; Zavadska, Dace; Adel Ali, Karam; Olsson, Kate; Harder, Thomas; Meerpohl, Joerg J. RATIONALE: Cervical cancer is the fourth most common cancer affecting women worldwide, caused by persistent infection with oncogenic human papillomavirus (HPV) types. While HPV infections usually resolve spontaneously, persistent infections with high-risk HPV types can progress to premalignant glandular or - mostly - squamous intraepithelial lesions, usually classified in cervical intraepithelial neoplasia (CIN). Women with CIN 2 and CIN 3 (i.e. high-grade CIN) typically undergo cervical conisation to remove precancerous cervical lesions. While conisation is effective, there is a risk of recurrence and progression to invasive cervical cancer. Additionally, women who have undergone conisation are at higher risk of HPV-associated anogenital precancerous lesions and cancers in other locations. HPV vaccination is an important measure to prevent HPV-related cancer. It is unclear to what extent HPV vaccination offers protection to women with conisation. Of note, the term 'with conisation' is interchangeably used for all time points of HPV vaccination relative to the conisation procedure for the purpose of this review. OBJECTIVES: To investigate the benefits and harms of HPV vaccination (given shortly before, at, or after conisation) in comparison to no HPV vaccination in women with conisation. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and Clarivate Web of Science (May 2023). We also searched ClinicalTrials.gov to identify ongoing studies. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSI) if they compared an HPV vaccine (nonavalent, quadrivalent, or bivalent) with no HPV vaccine, placebo, or other vaccines not directed against HPV in women of any age with conisation for treating precancerous lesions following HPV infection. OUTCOMES: Critical outcomes: CIN 2+ (irrespective of HPV type and related to HPV 16/18), CIN 3+ (irrespective of HPV type and related to HPV 16/18), incident invasive cervical cancer (irrespective of HPV type and related to HPV 16/18), persistent HPV infection (irrespective of HPV type and related to HPV 16/18) and incident HPV infection (irrespective of HPV type and related to HPV 16/18). RISK OF BIAS: We evaluated RCTs using the Cochrane RoB 2 tool and NRSI using the 'Risk of Bias in Non-randomised Studies of Interventions' tool (ROBINS-I). SYNTHESIS METHODS: Two review authors independently screened, extracted data, and assessed risk of bias. We used random-effects meta-analyses for our primary analyses. We rated the certainty of evidence using the GRADE approach. INCLUDED STUDIES: The search identified 13 studies (2 RCTs, 11 NRSI), with 21,453 women with conisation. Studies were conducted in Europe (10), China (1), South Korea (1), and Iran (1), and published between 2013 and 2023. The length of follow-up after conisation was up to 36 months in RCTs and up to greater than 60 months in NRSI. Eight studies included women older than 25 years. The remaining studies included women across different age groups (range 17 to greater than 50 years). In 10 studies, the treatment for cervical lesions included loop electrosurgical excision procedures or large loop excision of the transformation zone as the conisation procedure. The spectrum of precancerous lesions (in terms of baseline characteristics) varied widely between women. Seven studies used the quadrivalent HPV vaccine, one used the nonavalent HPV vaccine, four used various HPV vaccine types, and one did not specify the HPV vaccine type. All studies compared the HPV vaccine with no intervention. SYNTHESIS OF RESULTS: Critical outcomes HPV vaccination compared to no HPV vaccination in women with conisation may reduce the risk of CIN 2+ (evidence from RCTs: risk ratio (RR) 0.40, 95% confidence interval (CI) 0.26 to 0.63; 2 RCTs, 420 women; evidence from NRSI: hazard ratio (HR) 0.49, 95% CI 0.27 to 0.89; 5 NRSI, 19,059 women; odds ratio (OR) 0.23, 95% CI 0.05 to 0.97; 3 NRSI, 928 women; RR 0.24, 95% CI 0.13 to 0.46; 3 NRSI, 1027 women; low-certainty evidence). There were similar results for CIN 2+ (related to HPV 16/18) (evidence from NRSI: RR 0.38, 95% CI 0.21 to 0.68; 7 NRSI, 2970 women; low-certainty evidence). Effects on CIN 3+ varied between studies. One study suggested similar effects to CIN 2+ favouring HPV vaccination (evidence from NRSI: OR 0.20, 95% CI 0.10 to 0.60; 1 NRSI, 285 women; low-certainty evidence), while the remaining evidence was very uncertain (evidence from NRSI: RR 0.53, 95% CI 0.15 to 1.90; 2 NRSI, 17,472 women; very low-certainty evidence). The evidence on CIN 2+ (related to HPV 16/18) based on RCT evidence was very uncertain. The evidence on CIN 3+ (related to HPV 16/18), incident invasive cervical cancer (irrespective of HPV type), and persistent HPV infections (irrespective of HPV type and related to HPV 16/18) was very uncertain. Adverse events One RCT reported minor local reactions (redness and rash: 127/138 (92%) women; headache: 11/138 (8%) women) and severe allergies (2/158 (1%) women). AUTHORS' CONCLUSIONS: HPV vaccination given around the time of conisation in comparison to no HPV vaccination in women with conisation may reduce the risk of CIN 2+ and CIN 2+ (related to HPV 16/18; evidence based on NRSI). Effects on CIN 3+ (irrespective of HPV type) varied, with one NRSI suggesting similar effects to CIN 2+, while the remaining evidence was very uncertain. The evidence on other outcomes was predominantly very uncertain or inconclusive. Overall, the existing evidence for HPV vaccination in women with conisation is largely based on NRSI with serious or critical risk of bias and low- to very low-certainty evidence. Evidence from RCTs is limited (i.e. only two RCTs are available). Additional RCTs with a placebo intervention in the control group to evaluate the efficacy and safety of HPV vaccination (particularly with the nonavalent vaccine) as an adjuvant to conisation would provide more robust evidence. Future RCTs should also aim to assess how effects of vaccination around the time of conisation vary according to whether a previous HPV vaccine for primary prevention was received, timing of HPV vaccination related to conisation, and different age groups. FUNDING: EU4Health Programme. REGISTRATION: PROSPERO (CRD42023428998).

2025-01-01T00:00:00Z Drahota, Petr Mihaljevič, Martin Ettler, Vojtěch https://hdl.handle.net/20.500.14178/3939 2026-09-15T01:00:16Z 2026-01-01T00:00:00Z

Mineral and pedogenic controls on metal(loid) retention in contaminated agricultural topsoils Drahota, Petr; Mihaljevič, Martin; Ettler, Vojtěch Arsenic concentrations reached up to 2000 mg/kg, while soils impacted by historical mining were enriched in Sb (< 540 mg/kg), Cu (< 1600 mg/kg), Pb (< 4460 mg/kg), and Zn (< 3630 mg/kg). These contaminants accumulated in the <10 mu m fraction, posing increased health risk from wind transport and inhalation. Iron (oxyhydr) oxides in soil aggregates were dominant hosts of As, Cu, Pb, and Zn, with minor contribution from Mn (oxyhydr) oxides. In contrast, Sb was primarily associated with clay-rich aggregates, indicating stronger affinity for clays. Among discrete minerals, arsenates and (hydroxy)sulfates were the most common metal(loid)-bearing minerals. Ammonium sulfate extractions revealed a moderate potential mobility of As, Sb, Cu, and Zn (0.6-1.0%), while Pb was much less extractable (<0.05%). The patterns of potential mobility followed soil pH, increasing for As, Sb, and Cu at higher pH and for Zn and Pb at lower pH, reflecting their distinct adsorption behavior in soils. Our results highlight the key role of mineralogical associations in controlling the potential mobility of metal(loid)s in contaminated agricultural soils, with Sb showing notably different behavior from As.

2026-01-01T00:00:00Z Lypianin, Anton Blažek, Jiří https://hdl.handle.net/20.500.14178/3938 2026-09-15T11:12:01Z 2026-01-01T00:00:00Z

Offshore companies in global production and financial networks: the case of the Ukrainian sunflower oil industry Lypianin, Anton; Blažek, Jiří Despite efforts to regulate offshore firms, these entities remain widespread and influential in the global economy - yet their role in studies on global production has been understudied. This paper addresses this gap by examining the strategic importance of offshore firms in Ukraine's sunflower oil industry, a globally significant sector. Our findings show that although offshore enterprises make up just over one-third of the firms analysed, they dominate the sector in terms of revenues and exports. Alongside firms' ownership (foreign, offshore, and domestic), we investigated the role of other structural factors on value capture, such as firm size, position within production network (seed producers, oil producers, and exporters), and level of production diversification across two periods: before and after the 2014 Russian aggression. A firm's position in the production network proves crucial for the level of value capture. While foreign-owned firms achieved the highest relative value capture, offshore firms secured the largest absolute value. The results indicate that legal protection and international reputation, rather than tax avoidance, may be important motives for offshore registration in this industry.

2026-01-01T00:00:00Z Ettler, Vojtěch Lichovník, Martin Mihaljevič, Martin Kříbek, Bohdan Nyambe, Imasiku Ziwa, Gabriel https://hdl.handle.net/20.500.14178/3935 2026-09-09T01:00:19Z 2026-01-01T00:00:00Z

Resource potential of slags from Zambian copper smelters Ettler, Vojtěch; Lichovník, Martin; Mihaljevič, Martin; Kříbek, Bohdan; Nyambe, Imasiku; Ziwa, Gabriel Millions of tonnes of pyrometallurgical slags from copper smelters in the Copperbelt Province and North-Western Province of Zambia have been deposited on dumps near mining and ore processing operations and represent potential sources of valuable elements for the future. Here, we analysed archived and freshly collected copper slag samples (n = 48) from five historical and currently operating Zambian copper smelters to assess their chemical compositions, solid speciation of valuable elements, and resource potential. Elevated values of Cu (mean: 1.43 wt%, up to 9.5 wt %), Co (mean: 4450 mg/kg, up to 2.4 wt%), Ni (mean: 69.2 mg/kg, up to 935 mg/kg) and Mo (mean: 169 mg/kg, up to 422 mg/kg) were detected, predominantly bound in the entrapped matte and metallic droplets. The image analysis of scanning electron micrographs (SEM) was used for the assessment of the size distribution of sulfide/metallic droplets and indicated that copper slags from Nkana (Kitwe) and Mufulira, with the most abundant fraction >100 mu m, are the best candidates for further reprocessing by crushing, milling, and flotation. Nevertheless, slag reprocessing must be carried out in an environmentally friendly way to limit dust generation, which can have implications for the environment (soil systems) and human health.

2026-01-01T00:00:00Z