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Background To evaluate outcomes of laparoscopic retroperitoneal para-aortic lymphadenectomy for stage 1b3-3b cervical cancer.Methods Pathology databases searched for all para-aortic lymphadenectomy cases 2005–2016. Descriptive statistics were used to analyse baseline characteristics, cox models for treatment affect after accounting for variables, and Kaplan Meier curves for survival (STATA v15).Results 191 patients had 1b3-3b cervical cancer of which 110 patients had Para-aortic lymphadenectomy. 8 (7.3%) patients stage 1b3, 82 (74.6%) stage 2b, and 20 (18.1%) stage 3b cervical cancer. Mean lymph node count 11.7 (SD7.6). The intra-operative and post-operative 30 day complication rates were 8.8% (CI: 4.3%, 15.7%) and 5.3% (CI: 1.9%, 11.2%) respectively.Para-aortic nodes were apparently positive on CT/MRI in 5/110 (5%) cases. Cancer was found in 10 (8.9%, CI: 4.3%, 15.7%) cases on histology, all received extended field radiotherapy. Only 2 were identified on pre-operative CT/MRI imaging. 3 of 10 suspected node-positive cases on CT/MRI had negative histology. Para-aortic lymphadenectomy led to alteration in staging and radiotherapy management in 8 (8%, CI: 3.7%, 14.6%) patients. Mean overall survival 42.81 months (SD = 31.79 months). Survival was significantly higher for women undergoing PAN (50.57 (SD 30.7) months) compared to those who didn’t (31.27 (SD 32.5) months)Conclusion Laparoscopic retroperitoneal para-aortic lymphadenectomy is an acceptable procedure which can guide treatment in women with locally advanced cervical cancer.

Urbanisation and water developments in South Africa have created numerous challenges in managing water resources. Consequently, the native fish species Oreochromis mossambicus, prominent to freshwater ecosystems in South Africa now faces the threat of extinction amidst introductions of alien Oreochromis species. The species has recently been classified as Vulnerable on the IUCN Red List. Despite the economic importance of O. mossambicus within the South African region, little is known about the genetic and population dynamics of the species. In this study, we aimed to establish baseline genetic and population data, and determine the impact of water management practices on population structure. This data is crucial for the conservation and monitoring of this species across South Africa. The study revealed relatively low genetic diversity within sample localities but significant differentiation among populations. The analyses identified 16 geographically correlated genetic clusters, indicating substantial differentiation across catchments. Anthropogenic activities, changes in catchment use, and water management strategies significantly influenced the genetic population structure in the studied regions. Given the distinct genetic patterns, conservation-oriented management should prioritise maintaining existing genetic diversity to ensure the long-term survival of this vulnerable species.

Agribusiness has an annual economic impact of US $51.8 billion in South Carolina (South Carolina Department of Agriculture, n.d.). It is supported by underserved farmers and ranchers who represent 9.3% of all South Carolina farms and 8% of all farmland acres (USDA, 2024). Further, almost 35% of South Carolina farmers or producers are female (USDA, 2024). This small group of farmers and ranchers represents an important economic sector in agriculture and could benefit from participation in the U.S. Department of Agriculture Natural Resources Conservation Service (USDA NRCS) climate-smart agriculture programs to enhance or increase their farming operations. In addition, implementing climate-smart agricultural practices can help to offset the negative impacts of the increased frequency and intensity of disturbances (e.g., drought and flooding). However, previous research has shown that underserved farmers and ranchers do not participate in USDA NRCS pro­grams at the same rate as other farmers (Gilbert et al., 2002; Minkoff-Zern & Sloat, 2017; Russell et al., 2021). This research sought to (1) identify the barriers to participation in USDA NRCS programs and (2) develop recommendations for overcoming the barriers. Eight focus groups were conducted between June 2022 and March 2023 either virtually (n = 5) or in-person (n = 3) with underserved farm­ers and ranchers (n = 22) around the state to iden­tify barriers to participation in USDA NRCS cli­mate-smart agricultural programs. Program participants were self-selected using a nonproba­bility sampling technique (snowball sampling) and were recruited by contacts provided to the researchers by Clemson Extension agents and non­governmental organizations that represent histori­cally socially disadvantaged farmers and ranchers. Three primary barriers were identified: (1) lack of program clarity and visibility, (2) lack of accounta­bility, and (3) lack of NRCS support. Recommen­dations are provided to address and overcome each barrier.

Abstract With the slowdown of improvement in conventional von Neumann systems, increasing attention is paid to novel paradigms such as Ising machines. They have very different approach to solving combinatorial optimization problems. Ising machines have shown great potential in solving binary optimization problems like MaxCut. In this paper, we present an analysis of these systems in boolean satisfiability (SAT) problems. We demonstrate that, in the case of 3-SAT, a basic architecture fails to produce meaningful acceleration, largely due to the relentless progress made in conventional SAT solvers. Nevertheless, careful analysis attributes part of the failure to the lack of two important components: cubic interactions and efficient randomization heuristics. To overcome these limitations, we add proper architectural support for cubic interaction on a state-of-the-art Ising machine. More importantly, we propose a novel semantic-aware annealing schedule that makes the search-space navigation much more efficient than existing annealing heuristics. Using numerical simulations, we show that such an “Augmented” Ising Machine for SAT is projected to outperform state-of-the-art software-based, GPU-based and conventional hardware SAT solvers by orders of magnitude.

As empirical research into access to justice burgeons around the world, contemporary work offers opportunities for integration and synthesis, generating insights that can inform both policy priorities and practical decisions about program design and implementation. Access to justice is historically a problem-focused research field, but an important strand of contemporary access to justice research focuses on solutions, or a deeper understanding “what works.” This paper offers a three-part framework for thinking about how research about “what works” in one jurisdiction can inform understanding of what might work in others. We propose a common core of research questions; a framework for conceptualizing the objects of study (in the example here, programs); and a framework for conceptualizing the contexts in which those programs might operate.

Background: Required maintenance elements such as feed, shelter, and water are not evenly distributed within pasture environments, leading horses to focus their activities around concentrated resources and creating the potential risk of overgrazing. Aims: To determine if 1) varying positions of required elements feed (F), shelter (S), and water (W) affected horse presence within 23 m (P23) of required elements and 2) placement of required elements had an effect on the grazing distribution and behavior of horses. Materials and Methods: In a completely randomized block design, six mature mares were assigned to graze three-element configurations (CONF). Individual pairs grazed one of six pasture plots for 4-7-d periods. Horse location was monitored by global positioning systems and behaviors were visually assessed and recorded daily. Linear mixed models were developed that related occurrence of behaviors or horse presence within 23m of CONF and element. An ANOVA was used to determine if the fixed effects were significant, followed by Fisher’s protected LSD to compare means. Results: There was an effect of element on P23 (P < 0.01), with F being the most influential (P < 0.05) in that horses spent the most time within P23 for F in comparison to S and W. Horses spent more time grazing (P < 0.05) than other observed behaviors, regardless of CONF, followed by standing/resting, free movement, and eating grain. Conclusion: Moving feeding location frequently may alter grazing location, thus distributing animal concentration accordingly and decreasing the risk of overgrazing. Future studies investigating moving feed only may illuminate new methods of pasture management.

Abstract Background During trials that span decades, new evidence including progress in statistical methodology, may require revision of original assumptions. An example is the continued use of a constant-effect approach to analyse the mortality reduction which is often delayed in cancer-screening trials. The latter led us to re-examine our approach for the upcoming primary mortality analysis (2020) of long-term follow-up of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (LTFU UKCTOCS), having initially (2014) used the proportional hazards (PH) Cox model. Methods We wrote to 12 experts in statistics/epidemiology/screening trials, setting out current evidence, the importance of pre-specification, our previous mortality analysis (2014) and three possible choices for the follow-up analysis (2020) of the mortality outcome: (A) all data (2001–2020) using the Cox model (2014), (B) new data (2015–2020) only and (C) all data (2001–2020) using a test that allows for delayed effects. Results Of 11 respondents, eight supported changing the 2014 approach to allow for a potential delayed effect (option C), suggesting various tests while three favoured retaining the Cox model (option A). Consequently, we opted for the Versatile test introduced in 2016 which maintains good power for early, constant or delayed effects. We retained the Royston-Parmar model to estimate absolute differences in disease-specific mortality at 5, 10, 15 and 18 years. Conclusions The decision to alter the follow-up analysis for the primary outcome on the basis of new evidence and using new statistical methodology for long-term follow-up is novel and has implications beyond UKCTOCS. There is an urgent need for consensus building on how best to design, test, estimate and report mortality outcomes from long-term randomised cancer screening trials. Trial registration ISRCTN22488978 . Registered on 6 April 2000.

Abstract Background There is a trend to increasing use of routinely collected health data to ascertain outcome measures in trials. We report on the completeness and accuracy of national ovarian cancer and death registration in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Methods Of the 202,638 participants, 202,632 were successfully linked and followed through national cancer and death registries of Northern Ireland, Wales and England. Women with registrations of any of 19 pre-defined ICD-10 codes suggestive of tubo-ovarian cancer or notification of ovarian/tubal/peritoneal cancer from hospital episode statistics or trial sites were identified. Copies of hospital and primary care notes were retrieved and reviewed by an independent outcomes review committee. National registration of site and cause of death as ovarian/tubal/peritoneal cancer (C56/C57/C48) obtained up to 3 months after trial censorship was compared to that assigned by outcomes review (reference standard). Results Outcome review was undertaken in 3110 women on whom notification was received between 2001 and 2014. Ovarian cancer was confirmed in 1324 of whom 1125 had a relevant cancer registration. Sensitivity and specificity of ovarian/tubal/peritoneal cancer registration were 85.0% (1125/1324; 95% CI 83.7–86.2%) and 94.0% (1679/1786; 95% CI 93.2–94.8%), respectively. Of 2041 death registrations reviewed, 681 were confirmed to have a tubo-ovarian cancer of whom 605 had relevant death registration. Sensitivity and specificity were 88.8% (605/681; 95% CI 86.4–91.2%) and 96.7% (1482/1533, 95% CI 95.8–97.6%), respectively. When multiple electronic health record sources were considered, sensitivity for cancer site increased to 91.1% (1206/1324, 95% CI 89.4–92.5%) and for cause of death 94.0% (640/681, 95% CI 91.9–95.5%). Of 1232 with cancer registration, 8.7% (107/1232) were wrongly designated as ovarian/tubal/peritoneal cancers by the registry and 4.0% (47/1172) of confirmed tubo-ovarian cancers were mis-registered. In 656 with death registrations, 7.8% (51/656) were wrongly assigned as due to ovarian/tubal/peritoneal cancers while 6.2% (40/645) of confirmed tubo-ovarian cancer deaths were mis-registered. Conclusion Follow-up of trial participants for tubo-ovarian cancer using national registry data will result in incomplete ascertainment, particularly of the site due in part to the latency of registration. This can be reduced by using other routinely collected data such as hospital episode statistics. Central adjudication by experts though resource intensive adds value by improving the accuracy of diagnoses. Trial registration ISRCTN: ISRCTN22488978 . Registered on 6 April 2000

Abstract Background Chronic liver disease (CLD) is usually asymptomatic but earlier detection is critical to permit life-saving interventions for those at risk due to high alcohol consumption and increased body mass index (BMI). The aim of this study was to estimate the association between the Enhanced Liver Fibrosis (ELF) test and liver-related events (LRE) and its performance in predicting LRE in postmenopausal women with risk factors in a nested case-control study within the United Kingdom Trial of Ovarian Cancer Screening (UKCTOCS). Methods In a cohort of 95,126 we performed a case-control study measuring ELF in blinded samples from 173 participants with self-reported high alcohol use and / or BMI ≥25 kg/m2 comprising all 58 cases who developed LRE and 115 controls matched for age, alcohol and BMI who did not develop LRE during median follow-up of 8.5 years. Results Using Cox regression at an ELF threshold of 10.51 hazard ratios (HR) for LRE were 4.88 (95% confidence interval (CI) 2.37–10.03) (unadjusted model) and 4.62 (95% CI 2.12–10.08) (adjusted for deprivation and self-reported hypertension, heart disease, hypercholesterolaemia and diabetes). At a threshold of 9.8 HR for LRE were 2.21 (95% CI 1.22–3.97) (unadjusted model) and 2.18 (95% CI 1.19–4.01) (adjusted). ELF was evaluated as a time dependent variable by generating time-dependent Cox models; HRs at an ELF threshold of 10.51 were 1.94 (95% CI 1.10–3.39) (unadjusted) and 2.05 (95% CI 1.16–3.64) (adjusted) and at a threshold of 9.8 HRs were 1.85 (95% CI 1.09–3.15) (unadjusted) and 1.80 (95% CI 1.04–3.13) (adjusted). Area under the receiver operating characteristic curve for recruitment ELF predicting LRE was 0.58 (95% CI 0.49–0.68), and for second subsequent ELF 0.61 (95% CI 0.52–0.71). Conclusion This study demonstrates the association between ELF and CLD in postmenopausal women with risk factors for liver disease, creating the opportunity to intervene to reduce liver-related mortality and morbidity. Although larger studies are required, these results demonstrate the potential of ELF as a prognostic tool in health checks in primary care. Trial registration This study is nested in UKCTOCS. UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978 . Registered 06/04/2000.

This paper reports a plasma reactive oxygen species (ROS) method for decontamination of PPE (N95 respirators and gowns) using a surface DBD source to meet the increased need of PPE due to the COVID-19 pandemic. A system is presented consisting of a mobile trailer (35 m3) along with several Dielectric barrier discharge sources installed for generating a plasma ROS level to achieve viral decontamination. The plasma ROS treated respirators were evaluated at the CDC NPPTL, and additional PPE specimens and material functionality testing were performed at Texas A&M. The effects of decontamination on the performance of respirators were tested using a modified version of the NIOSH Standard Test Procedure TEB-APR-STP-0059 to determine particulate filtration efficiency. The treated Prestige Ameritech and BYD brand N95 respirators show filtration efficiencies greater than 95% and maintain their integrity. The overall mechanical and functionality tests for plasma ROS treated PPE show no significant variations.

Blaine County, Idaho, a rural area with a renowned resort, experienced a COVID-19 outbreak early in the pandemic. We undertook an epidemiologic investigation to describe the outbreak and guide public health action. Confirmed cases of COVID-19 were identified from reports of SARS-CoV-2-positive laboratory test results to South Central Public Health District. Information on symptoms, hospitalization, recent travel, healthcare worker status, and close contacts was obtained by medical record review and patient interviews. Viral sequence analysis was conducted on a subset of available specimens. During March 13-April 10, 2020, a total of 451 COVID-19 cases among Blaine County residents (1,959 cases per 100,000 population) were reported, with earliest illness onset March 1. The median patient age was 51 years (interquartile range [IQR]: 37-63), 52 (11.5%) were hospitalized, and 5 (1.1%) died. The median duration between specimen collection and a positive laboratory result was 9 days (IQR: 4-10). Forty-four (9.8%) patients reported recent travel and an additional 37 cases occurred in out-of-state residents. Healthcare workers comprised 56 (12.4%) cases; 33 of whom worked at the only hospital in the county, leading to a 15-day disruption of hospital services. Among 562 close contacts monitored by public health authorities, laboratory-confirmed COVID-19 or compatible symptoms were identified in 51 (9.1%). Sequencing results from 34 specimens supported epidemiologic findings indicating travel as a source of SARS-CoV-2, and identified multiple lineages among hospital workers. Community mitigation strategies included school and resort closure, stay-at-home orders, and restrictions on incoming travelers. COVID-19 outbreaks in rural communities can disrupt health services. Lack of local laboratory capacity led to long turnaround times for COVID-19 test results. Rural communities frequented by tourists face unique challenges during the COVID-19 pandemic. Implementing restrictions on incoming travelers and other mitigation strategies helped reduce COVID-19 transmission early in the pandemic.

ObjectivesWe aimed to derive and validate a triage tool, based on clinical assessment alone, for predicting adverse outcome in acutely ill adults with suspected COVID-19 infection.MethodsWe undertook a mixed prospective and retrospective observational cohort study in 70 emergency departments across the United Kingdom (UK). We collected presenting data from 22445 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. The primary outcome was death or organ support (respiratory, cardiovascular, or renal) by record review at 30 days. We split the cohort into derivation and validation sets, developed a clinical score based on the coefficients from multivariable analysis using the derivation set, and the estimated discriminant performance using the validation set.ResultsWe analysed 11773 derivation and 9118 validation cases. Multivariable analysis identified that age, sex, respiratory rate, systolic blood pressure, oxygen saturation/inspired oxygen ratio, performance status, consciousness, history of renal impairment, and respiratory distress were retained in analyses restricted to the ten or fewer predictors. We used findings from multivariable analysis and clinical judgement to develop a score based on the NEWS2 score, age, sex, and performance status. This had a c-statistic of 0.80 (95% confidence interval 0.79-0.81) in the validation cohort and predicted adverse outcome with sensitivity 0.98 (0.97-0.98) and specificity 0.34 (0.34-0.35) for scores above four points.ConclusionA clinical score based on NEWS2, age, sex, and performance status predicts adverse outcome with good discrimination in adults with suspected COVID-19 and can be used to support decision-making in emergency care.RegistrationISRCTN registry, ISRCTN28342533, http://www.isrctn.com/ISRCTN28342533.

Increase in anthropogenic pressures on freshwater ecosystems, globally and locally in South Africa, has made it difficult to meet environmental flow requirements and maintain these systems. The Letaba-Olifants catchment is one such example, where the upstream water demands place pressure on the river downstream as it flows through the Kruger National Park. We used the activity rates of Hydrocynus vittatus as a line of evidence to assess (1) the effects of telemeter tagging on their activity rates in three potential post-tagging recovery periods and (2) their vulnerability to predation and the causality related to the environmental stressors placed on the river catchment in the Olifants River Gorge, Kruger National Park, South Africa. We determined H. vittatus activity rates as locomotive movement using radio telemetry methods linked remotely to an online data management system. We telemeter tagged nine individuals from 08 May to 28 June 2018. However, only seven fish were successfully tracked for the duration of our study, and two individuals moved out of range of the remote network shortly after release and could not be located. The tagged H. vittatus individuals were found to have reduced activity at least within the first 7 days after tagging compared with the time after that. The results showed that three individuals were preyed on by predators after the tagging procedure recovery period. This coincided with abnormal low flow conditions, where the Letaba River ran dry. African fish eagles Haliaeestus vocifer were the only confirmed predator, whilst predation by other species was also evident. Conservation implications: Monitoring of H. vittatus using telemetry is a viable tool to use when assessing environmental stressors in remote locations. The abnormally low water levels in the Olifants and Letaba Rivers (cessation of flow in the Letaba River) during our study may have compromised the predator avoidance strategies of tagged H. vittatus and may further be affecting the viability of the H. vittatus populations in Kruger National Park. The synergistic effects of natural and anthropogenic stressors impact negatively H. vittatus populations and potentially other aquatic biotas.

Abstract Background We investigated the risk of chronic liver disease (CLD) due to alcohol consumption and body mass index (BMI) and the effects of their interaction in a prospective cohort study of women recruited to the UKCTOCS trial. Methods 95,126 post-menopausal women without documented CLD were stratified into 12 groups defined by combinations of BMI (normal, overweight, obese) and alcohol consumption (none,

The desire to remain living in one’s own home rather than a care home by those in need of 24/7 care is one that requires a level of understanding for the actions of an environment’s inhabitants. This can potentially be accomplished with the ability to recognise Activities of Daily Living (ADLs); however, this research focuses first on producing an unobtrusive solution for pose recognition where the preservation of privacy is a primary aim. With an accurate manner of predicting an inhabitant’s poses, their interactions with objects within the environment and, therefore, the activities they are performing, can begin to be understood. This research implements a Convolutional Neural Network (CNN), which has been designed with an original architecture derived from the popular AlexNet, to predict poses from thermal imagery that have been captured using thermopile infrared sensors (TISs). Five TISs have been deployed within the smart kitchen in Ulster University where each provides input to a corresponding trained CNN. The approach is evaluated using an original dataset and an F1-score of 0.9920 was achieved with all five TISs. The limitations of utilising a ceiling-based TIS are investigated and each possible permutation of corner-based TISs is evaluated to satisfy a trade-off between the number of TISs, the total sensor cost and the performances. These tests are also promising as F1-scores of 0.9266, 0.9149 and 0.8468 were achieved with the isolated use of four, three, and two corner TISs, respectively.

[This corrects the article DOI: 10.1371/journal.pone.0163890.].

Background: We report on a unique audit of seven sonographers self-reporting high visualization rates of normal postmenopausal ovaries in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). This audit was ordered by the trial’s Ultrasound Management Subcommittee after an initiative taken in 2008 to improve the quality of scanning and the subsequent increase in the number of sonographers claiming very high ovary visualisation rates. Methods: Seven sonographers reporting high rates (>89%) of visualizing normal postmenopausal ovaries in examinations performed between 1st January and 31st December 2008 were identified. Eight experts in gynaecological scanning reviewed a random selection of exams performed by these sonographers and assessed whether visualization of both ovaries could be confirmed (cVR-Both) in the examinations. A random effects bivariate probit model was fitted to analyse the results. Results: The eight experts reviewed images from 357 examinations performed on 349 postmenopausal women (mean age 60.0 years, range 50.2-73.3) by the seven sonographers. The mean cVR-Both obtained from the model for these sonographers was 67.2% with a range of 47.6-86.5% (95%CI 63.9-70.5%). The range of cVR-Both between the experts was 47.3-88.3% and the intra-class correlation coefficient (ICC) for left and right ovary confirmation was 0.39. Conclusions: The audit suggests that self-reported visualization of postmenopausal ovaries is unreliable, as visualisation of both ovaries could not be confirmed in almost a third of examinations. The agreement for visualization of both ovaries based on review of a static image between experts and sonographers and between expert reviewers alone was only moderate. Further research is needed to develop reliable Quality Control metrics for transvaginal ultrasound.

Breast cancer development in BRCA1/2 mutation carriers is a net consequence of cell-autonomous and cell nonautonomous factors which may serve as excellent targets for cancer prevention. In light of our previous data we sought to investigate the consequences of the BRCA-mutation carrier state on RANKL/osteoprotegerin (OPG) signalling. We analysed serum levels of RANKL, OPG, RANKL/OPG complex, oestradiol (E2), and progesterone (P) during menstrual cycle progression in 391 BRCA1/2-mutation carriers and 782 noncarriers. These studies were complemented by analyses of RANKL and OPG in the serum and mammary tissues of female cynomolgus macaques (n = 88) and serum RANKL and OPG in postmenopausal women (n = 150). BRCA-mutation carriers had lower mean values of free serum OPG in particular in BRCA1-mutation carriers (p = 0.018) compared with controls. Among BRCA1/2 mutation carriers, lower OPG levels were associated with germline mutation locations known to confer an increased breast cancer risk (p = 0.003). P is associated with low OPG levels in serum and tissue, particularly in BRCA-mutation carriers (rho = −0.216; p = 0.002). Serum OPG levels were inversely correlated (rho = −0.545, p

High rates of respiratory symptoms (14%) and new-onset asthma in previously healthy soldiers (6.6%) have been reported among military personnel post-deployment to Iraq and Afghanistan. The term Iraq/Afghanistan War-Lung Injury (IAW-LI) is used to describe the constellation of respiratory diseases related to hazards of war, such as exposure to burning trash in burn pits, improvised explosive devices, and sandstorms. Burnpits360.org is a nonprofit civilian website which voluntarily tracks medical symptoms among soldiers post-deployment to the Middle East. Subsequent to initiation of the Burnpits360.org website, the Department of Veterans Affairs started the Airborne Hazards and Open Burn Pit registry. This paper: (a) analyzes the latest 38 patients in the Burnpits360.org registry, validated by DD214 Forms; (b) compares strengths and weaknesses of both registries as outlined at the National Academy of Sciences Institute of Medicine Burn Pits Workshop; (c) further characterizes the spectrum of disease in IAW-LI; (d) describes the risk factors of affected populations; (e) summarizes current practices regarding management of the condition; and (f) defines future research objectives.

Background: Tubo-ovarian cancer (OC) continues to be the most lethal of all gynaecological cancers. Over half of women are diagnosed with late stage (III/IV) disease, which has a five-year survival rate of 11%. Socioeconomic status (SES) has been shown to have an impact on outcomes of several cancer types, including OC. This study aims to investigate any potential association between SES and stage at diagnosis of OC. Methods: Women from the non-screening arm of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) with a confirmed diagnosis of OC prior to 01 January 2015 and an English index of multiple deprivation (IMD) score were eligible for the study. The association between IMD and OC stage (FIGO) was analysed using an ordinal logistic regression model adjusted for age at diagnosis and BMI. Results: Four-hundred and fifty seven women were eligible for inclusion in the primary analysis. The odds of being diagnosed with the higher dichotomization of stage (I vs. II/III/IV; I/II vs. III/IV; I/II/III vs. IV) was 1.29 (p = 0.017; 95% CI: 1.048−1.592) per unit SD (standard deviation) increase in IMD. This translates to a 29% increase in odds of being diagnosed at the higher stage per each unit SD increase in IMD. Conclusion: Increased deprivation is consistently associated with a higher probability of being diagnosed with later stage OC.

Objectives To audit patient hospital records to evaluate the performance of acute general and mental health services in delivering inpatient care to people with learning disability and explore the influence of organisational factors on the quality of care they deliver.Setting Nine acute general hospital Trusts and six mental health services.Participants Adults with learning disability who received inpatient hospital care between May 2013 and April 2014.Primary and secondary outcome measures Data on seven key indicators of high-quality care were collected from 176 patients. These covered physical health/monitoring, communication and meeting needs, capacity and decision-making, discharge planning and carer involvement. The impact of services having an electronic system for flagging patients with learning disability and employing a learning disability liaison nurse was assessed.Results Indicators of physical healthcare (body mass index, swallowing assessment, epilepsy risk assessment) were poorly recorded in acute general and mental health inpatient settings. Overall, only 34 (19.3%) patients received any assessment of swallowing and 12 of the 57 with epilepsy (21.1%) had an epilepsy risk assessment. For most quality indicators, there was a non-statistically significant trend for improved performance in services with a learning disability liaison nurse. The presence of an electronic flagging system showed less evidence of benefit.Conclusions Inpatient care for people with learning disability needs to be improved. The work gives tentative support to the role of a learning disability liaison nurse in acute general and mental health services, but further work is needed to confirm these benefits and to trial other interventions that might improve the quality and safety of care for this high-need group.

To provide accurate activity recognition within a smart environment, visible spectrum cameras can be used as data capture devices in solution applications. Privacy, however, is a significant concern with regards to monitoring in a smart environment, particularly with visible spectrum cameras. Their use, therefore, may not be ideal. The need for accurate activity recognition is still required and so an unobtrusive approach is addressed in this research highlighting the use of a thermopile infrared sensor as the sole means of data collection. Image frames of the monitored scene are acquired from a thermopile infrared sensor that only highlights sources of heat, for example, a person. The recorded frames feature no discernable characteristics of people; hence privacy concerns can successfully be alleviated. To demonstrate how thermopile infrared sensors can be used for this task, an experiment was conducted to capture almost 600 thermal frames of a person performing four single component activities. The person’s position within a room, along with the action being performed, is used to appropriately predict the activity. The results demonstrated that high accuracy levels, 91.47%, for activity recognition can be obtained using only thermopile infrared sensors.

In this work, we detail a methodology based on Convolutional Neural Networks (CNNs) to detect falls from non-invasive thermal vision sensors. First, we include an agile data collection to label images in order to create a dataset that describes several cases of single and multiple occupancy. These cases include standing inhabitants and target situations with a fallen inhabitant. Second, we provide data augmentation techniques to increase the learning capabilities of the classification and reduce the configuration time. Third, we have defined 3 types of CNN to evaluate the impact that the number of layers and kernel size have on the performance of the methodology. The results show an encouraging performance in single-occupancy contexts, with up to 92 % of accuracy, but a 10 % of reduction in accuracy in multiple-occupancy. The learning capabilities of CNNs have been highlighted due to the complex images obtained from the low-cost device. These images have strong noise as well as uncertain and blurred areas. The results highlight that the CNN based on 3-layers maintains a stable performance, as well as quick learning.

Thrombocytes are nucleated platelets involved in immune functions such as pathogen recognition and release of pro-inflammatory bioactive compounds when exposed to bacterial and viral molecules. However, the complete role of these cells in innate and adaptive immune responses is not understood, and little is known about their biology at the molecular-genetic level. Highly sensitive RNA-sequencing technologies were used to analyze the complete transcriptome of thrombocytes for the first time with analytical resolution focused on cell-based components of the immune system/response. Amongst all the genes listed in the current chicken genome assembly, 10,041 gene transcripts were found in the chicken thrombocyte. After 1-hour in vitro stimulation with lipopolysaccharide (LPS, Salmonella minnesota), 490 genes were upregulated and 359 genes were downregulated, respectively, with at least a 1-fold change relative to unexposed thrombocytes. Additionally, by constructing a de novo assembly, we were able to identify a total of 3,030 novel genes in the thrombocyte transcriptome. The information generated here is useful in development of novel solutions to lower the economic burden and zoonotic threat that accompanies infectious diseases for birds and fish. In addition, the resources created here have translational utility as a model system to find orthologous genes and genes related to its enucleated counterpart, the platelet.