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To mitigate excess of nitrate-N (NO 3 - -N removal in wetlands. We studied a pilot plant with three series (169 m 3 - -N removal in wetlands. We studied a pilot plant with three series (169 m 2 ) of hybrid CWs over the first two years of functioning to examine: i) the effect of adding different C-rich substrates (natural soil vs. biochar) to gravel on NO 3 - -N removal in a subsurface flow (Phase I), ii) the role of a second phase with a horizontal surface flow (Phase II) as a source of dissolved organic C (DOC), and its effect in a consecutive horizontal subsurface flow (Phase III) on NO 3 - -N removal, and iii) the contribution of each phase to global NO 3 - -N removal. Our results showed that the addition of a C-rich substrate to gravel had a positive effect on NO 3 - -N removal in Phase I, with mean efficiencies of 40% and 17% for soil and biochar addition, respectively, compared to only gravel (0.75%). In Phase II, the algae growth turned into a DOC concentration increase, but it did not enhance NO 3 - -N removal in Phase III. In series with C-rich substrate addition, the largest contribution to NO 3 - -N removal was found in Phase I. However, in series with only gravel, Phase II was the most effective on NO 3 - -N removal. Contribution of Phase III to NO 3 - -N removal was almost negligible., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

WHO/UNICEF estimates for HPV vaccination coverage from 2010 to 2019 are analyzed against the backdrop of the 90% coverage target for HPV vaccination by 2030 set in the recently approved global strategy for cervical cancer elimination as a public health problem. As of June 2020, 107 (55%) of the 194 WHO Member States have introduced HPV vaccination. The Americas and Europe are by far the WHO regions with the most introductions, 85% and 77% of their countries having already introduced respectively. A record number of introductions was observed in 2019, most of which in low- and middle- income countries (LMIC) where access has been limited. Programs had an average performance coverage of around 67% for the first dose and 53% for the final dose of HPV. LMICs performed on average better than high- income countries for the first dose, but worse for the last dose due to higher dropout. Only 5 (6%) countries achieved coverages with the final dose of more than 90%, 22 countries (21%) achieved coverages of 75% or higher while 35 (40%) had a final dose coverage of 50% or less. When expressed as world population coverage (i.e., weighted by population size), global coverage of the final HPV dose for 2019 is estimated at 15%. There is a long way to go to meet the 2030 elimination target of 90%. In the post-COVID era attention should be paid to maintain the pace of introductions, specially ensuring the most populous countries introduce, and further improving program performance globally., (Copyright © 2020. Published by Elsevier Inc.)

Extensive multiple-age cohort human papillomavirus (HPV) vaccination has proved to be highly effective. We aimed to determine the 8-year population impact of a female single-age cohort HPV vaccination programme on the incidence of anogenital warts (AGW). In 2008, Catalonia initiated a school-based quadrivalent HPV vaccination programme targeting 11-year-old girls, achieving coverage over 80%. Data on diagnoses of AGW and genital herpes were obtained from a population-based database of electronic health records covering 74% of the population. The annual incidence rates from 2009 to 2016 were calculated, stratified by age and sex using Joinpoint regression to estimate trends and annual percentage changes (APC). Among women aged 16-19 years, the AGW incidence decreased by 61% from 2012 to 2016 (APC -19.4%; 95% CI: -30.0 to -7.3). In contrast, the incidence of genital herpes in same-aged women increased throughout the study period (APC 11.1%; 95% CI: 7.2-15.2). Among men aged 20-22 years, the increasing incidence of AGW shifted to a downward trend in 2013 (APC 2009-2013: 17.0%; 95% CI: 8.2-26.5; and APC 2013-2016: -4.5%; 95% CI: -14.6 to 6.9). A similar pattern was observed among men aged 23-25 years (APC 2009-2014: 16.0%; 95% CI: 12.0-20.2; and APC 2014-2016: -6.0%; 95% CI: -18.4 to 8.3). In contrast to AGW, among men aged 20-25 years, the incidence of genital herpes increased over this period. Our study strongly suggests that a single-cohort HPV vaccination strategy with high vaccine uptake not only provides direct benefit in the vaccinated cohorts but also extends protection through a herd effect to unvaccinated men., Competing Interests: Declaration of competing interest F. Xavier Bosch has received scientific advisory board fees, speaker's fees, or travel grants from GlaxoSmithKline, Merck and Co., Inc. and IMS Health and unrestricted institutional research grants from GlaxoSmithKline and Merck and Co., Inc. The Cancer Epidemiology Research Programme (with which Maria Brotons, Laura Monfil, Esther Roura, F. Xavier Bosch, Silvia de Sanjosé and Laia Bruni are affiliated) has received sponsorship for grants from Merck and Co., Inc. and GSK. The rest of the authors declare no conflicts of interest., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)