Benjamin writes:

Dear TWiV team

Greeting from Oslo, Norway and thanks for another interesting episode!

Uterine (endometrial) cancer is not necessarily caused by HPV. Studies are inconsistent, and geography may be important, but most studies suggest a limited or no role of HPV.

Self-sampling seems to be done in five of the 21 regions in Sweden – though maybe a moving target? – and it can still be done in office, as I understand it. It might have improved the screening rate and be cost-effective. Importantly, to eliminate cervical cancer involves continuing with the cancer screening, because what they usually find is either a pre-cancerous lesion or even just an asymptomatic HPV infection (if the PCR is positive but there is no visible lesion yet).

In terms of avoided office visits from the self-sampling, you mentioned that there is other useful stuff that would be done during a “check-up.” I am coming at this more from an internist’s point of view, but routine visits for no acute reason every two years or so are considered unnecessary by many – especially for younger people (most guidelines recommend ceasing to screen for cervical cancer around age 65). How useful a visual inspection of the vagina and vulva is, remains unclear (the pap smear with or without HPV testing is the most important part from a public health standpoint!). Also, many if not most pap smears are done by gynecologists, and they often do not follow all the stuff that is recommended by, for example, the U.S. Preventive Services Task Force – say screen appropriate patients for diabetes, lung or colorectal cancer, or aortic abdominal aneurysm, or offer statin medications to selected patients.

Yours sincerely,

Benjamin

Anne writes:

Hello Dr. Racaniello,

So appreciated the diversion re: snow walls in Japan on today’s TWiV. The videos and other info provided by your listeners was a treat. I’ve never been to the snow walls (I lived in Tokyo for 7 years) but skied elsewhere in western Japan and the snow was always impressive.

At any rate, I heard your comments re: Hokusai, and thought you might be interested in an exhibit that is coming to my neck of the woods. Should you happen to make it to the Chicago area for this, please be in touch as I’d enjoy meeting up with you (other TWiV listeners in the area would no doubt enjoy it too!). So please let us know if you’re coming this way!  May 31- Sept.21, 2025

Regards,

Anne

https://www.cod.edu/news/2025/january/hokusai-tickets.html

Katy writes:

Vincent, Daniel & Team: 

Writing from the Denver Metro Area, where it’s a clear, cold 19F. A note of thanks to you all for your excellence in science comms via podcasts. I’m the daughter of a now-retired radiation oncologist, and had the good fortune of growing up around interesting science-minded conversation at the dinner table, even though I didn’t go into that sector myself. 

Thank you for your consistent push back on “wellness” industry nonsense and mis/disinformation. And thanks for taking the time to sit and record in the first place! You have saved my sanity many times as I look around at the worst timeline in the USA with disbelief and think to myself “am I overreacting?” And I realize I’m not, I’m just informed and my general social circles are not super science-minded. Your platforms – already vital – become even more so now. I’m happy to be a new Patreon subscriber and supporter.

As an aside, I heard the most recent TWIV when you shared about the death of your friend and colleague Dickson. Sending my sincere condolences to you all.

Sincerely,

Katy in Colorado

Aldo writes:

Dear all,

I extremely enjoy all the episodes of TWIV, I listen to them driving to and from work. In episode 1199 there was a discussion on Biosafety levels, and indicating that international organisations do not have standards.

The WHO biosafety manual can be found at:

https://iris.who.int/bitstream/handle/10665/337956/9789240011311-eng.pdf?sequence=1

However they moved from biosafety levels to a risk-based approach. But in the previous version they still had the biosafety levels

https://iris.who.int/bitstream/handle/10665/42981/9241546506_eng.pdf?sequence=1

The virus that was handled in China had a moderate individual risk and a low community risk. Although the virus was present in Bats for presumably a long time, there were no human infections. There are in humans a large number of coronaviruses that can cause infection with a low or moderate individual risk and only 3 – 4 with a high individual risk and perhaps only SARS-CoV-2 with a high community risk.

As scientists we should do the risk analysis and not assume a zero risk attitude. So, in my opinion the classification of the Chinese laboratory was correct. It is easy to say that to prevent possible huge consequences we classify it as BSL3, but that is not science based. And we should stick to science.

The VSV virus was presented as safe, but I did a pig infection study in a BSL-3 animal facility with air protection. But the pig did not sleep that well, and during intradermal injection in the snout it moved and the needle ended in my finger (2 latex gloves do not protect against needles). I had a fever the next day, and 2 weeks later a bacterial infection in my tendons which caused problems for 9 months (in hindsight our biosafety officer should have put me on antibiotics because the needle had been in the skin of the pig).

BSL-3 only has an additional protection against airborne infections and many viruses (especially those from the gut) do not spread airborne. We should not overestimate the safety of a BSL-3 facility, in a BSL-2 facility most of the airborne infection is controlled in a class II safety cabinet.

Best wishes,

Aldo Dekker

Project leader Vesicular Diseases

 Wageningen Bioveterinary Research

Virology & Molecular Biology

David writes:

Hello,

I am the author of Vincent’s Pick of the Week in TWiV 1203: 

Science Based Medicine, The Use of placebo controls in clinical trials, Why the value of placebo controls is not an affirmation of a powerful placebo effect.

It is gratifying that you found my article useful.  Thanks for the shout-out. 

I have tried to volunteer some of my time to good science communication in a time when it is sorely needed. Science Based Medicine has afforded me a great platform to do so. It’s nice to know that other science communicators are noticing.

Best wishes.

David Weinberg

Walt writes:

I think approximately everyone, including Science deniers, acknowledges that Flu viruses mutate. And in so doing, may become more pathogenic in humans

So I think you should call it out: our dangerously wrong-headed HHS Secretary is calling for BioSafety Level Zero, gain of function quasi-experimentation that could accelerate the next pandemic’s onset.