Morbidity after surgical management of cervical cancer in low and middle income countries: A systematic review and meta-analysis

Objective: To investigate morbidity for patients after the primary surgical management of cervical cancer in low and middle-income countries (LMIC). Methods: The Pubmed, Cochrane, the Cochrane Central Register of Controlled Trials, Embase, LILACS and CINAHL were searched for published studies from 1st Jan 2000 to 30th June 2017 reporting outcomes of surgical management of cervical cancer in LMIC. Randomeffects meta-analytical models were used to calculate pooled estimates of surgical complications including blood transfusions, ureteric, bladder, bowel, vascular and nerve injury, fistulae and thromboembolic events. Secondary outcomes included five-year progression free (PFS) and overall survival (OS). Findings: Data were available for 46 studies, including 10,847 patients from 11 middle income countries. Pooled estimates were: blood transfusion 29% (95%CI 0.19–0.41, P = 0.00, I 2 = 97.81), nerve injury 1% (95%CI 0.00–0.03, I 2 77.80, P = 0.00), bowel injury, 0.5% (95%CI 0.01–0.01, I 2 = 0.00, P = 0.77), bladder injury 1% (95%CI 0.01–0.02, P = 0.10, I 2 = 32.2), ureteric injury 1% (95%CI 0.01–0.01, I 2 0.00, P = 0.64), vascular injury 2% (95% CI 0.01– 0.03, I 2 60.22, P = 0.00), fistula 2% (95%CI 0.01–0.03, I 2 = 77.32, P = 0.00,), pulmonary embolism 0.4% (95%CI 0.00–0.01, I 2 26.69, P = 0.25), and infection 8% (95%CI 0.04–0.12, 2 95.72, P = 0.00). 5-year PFS was 83% for laparotomy, 84% for laparoscopy and OS was 85% for laparotomy cases and 80% for laparoscopy. Conclusion: This is the first systematic review and meta-analysis of surgical morbidity in cervical cancer in LMIC, which highlights the limitations of the current data and provides a benchmark for future health services research and policy implementation

Evolving Ensemble Models for Image Segmentation Using Enhanced Particle Swarm Optimization

In this paper, we propose particle swarm optimization (PSO)-enhanced ensemble deep neural networks and hybrid clustering models for skin lesion segmentation. A PSO variant is proposed, which embeds diverse search actions including simulated annealing, levy flight, helix behavior, modified PSO, and differential evolution operations with spiral search coefficients. These search actions work in a cascade manner to not only equip each individual with different search operations throughout the search process but also assign distinctive search actions to different particles simultaneously in every single iteration. The proposed PSO variant is used to optimize the learning hyper-parameters of convolutional neural networks (CNNs) and the cluster centroids of classical Fuzzy C-Means clustering respectively to overcome performance barriers. Ensemble deep networks and hybrid clustering models are subsequently constructed based on the optimized CNN and hybrid clustering segmenters for lesion segmentation. We evaluate the proposed ensemble models using three skin lesion databases, i.e., PH2, ISIC 2017, and Dermofit Image Library, and a blood cancer data set, i.e., ALL-IDB2. The empirical results indicate that our models outperform other hybrid ensemble clustering models combined with advanced PSO variants, as well as state-of-the-art deep networks in the literature for diverse challenging image segmentation tasks

Delocalized hypervalent silyl radical supported by amidinate and imino substituents

The reaction of the amidinato silylsilylene with a functionalized diaminochlorosilyl substituent [LSiSi(Cl){(NtBu)2C(H)Ph}] (1, L = PhC(NtBu)2) with ArN=C=NAr (Ar = 2,6-iPr2C6H3) in toluene afforded the delo-calized hypervalent silyl radical [LSi(-CNAr)2Si{(NtBu)2C(H)Ph}] (2). It possesses a hypervalent silyl radical, which delocalizes throughout the Si2C2 ring

Protocol to electroporate DNA plasmids into Ciona robusta embryos at the 1-cell stage

Electroporation is a technique to introduce DNA constructs into cells using electric current. Here, we present a protocol to electroporate DNA plasmids into Ciona robusta embryos at the 1-cell stage. We describe steps for setting up and conducting electroporation. We then detail procedures for collecting, fixing, and mounting embryos and counting expression. This protocol can be used to study the expression of enhancers via reporter assays, manipulating cells using genes or modified genes such as dominant negatives, and genome editing. For complete details on the use and execution of this protocol, please refer to Song, et al.1

Enhanced volcanic activity and long-term warmth in the middle Eocene revealed by mercury and osmium isotopes from IODP Expedition 369 Site U1514

Rapid plate reorganization may have influenced global climate during the Eocene; however, its linkage remains poorly constrained, particularly during the middle Eocene. To elucidate this tectonic–climatic relationship, here, we conducted a comprehensive analysis based on high-resolution mercury (Hg) and osmium (Os) abundance and isotope data obtained from the complete Eocene sedimentary sequence of Site U1514, drilled in the Mentelle Basin off southwest Australia. The Hg signals in this sedimentary sequence, which are characterized by significantly high enrichment and insignificant mass-independent fractionation (Δ199Hg) signal, confirm that the middle Eocene (∼45–38 Ma) was a period of persistent, increased volcanism, accompanied by intense tectonic activity. In particular, a remarkable seafloor volcanic eruption persisted for approximately 1.5 million years (∼42.0–40.5 Ma), immediately preceding the Middle Eocene Climate Optimum (MECO). Contemporaneously, the trends toward a slightly more radiogenic seawater 187Os/188Os (Osi) composition denote the prevalence of intensified continental weathering under a warm, humid climate during the middle Eocene, a phenomenon particularly evident during the MECO. Importantly, the Hg and Os records from Site U1514 reveal the occurrence of a multi-million-year warming reversal amid the long-term Eocene cooling trend, which likely contributed to significant CO2 reduction during the late Eocene. These findings significantly enhance our understanding of Eocene climate dynamics, which are fundamentally linked to intensive tectonic-driven volcanic activity and associated continental chemical weathering

Signs and symptoms of serious illness in infants aged up to 6 months:rapid review of clinical guidelines

BACKGROUND: There is a need to empower parents and carers of young infants to recognise signs of serious illness and to act on these appropriately. Compiling the signs and symptoms of serious illness in infants found in clinical guidelines will support the evidence-based update of the 30+-year-old content of the Baby Check App to empower parents and carers.OBJECTIVE: To systematically review clinical guidelines for signs and symptoms related to serious illness in infants aged 6 months and below.METHODS: A rapid review was carried out by searching PubMed, CINAHL, NICE, Cochrane and Embase for clinical guidelines reporting signs and symptoms of serious illness in young infants. The time period was restricted from 2018 to 2023. Only guidelines published in English were included.RESULTS: Fourteen clinical guidelines from 2307 retrieved articles were reviewed. Sixty signs and symptoms indicative of serious illness in infants were identified from the clinical guidelines. The guidelines originated from the UK (n=9, 65%), Italy (n=1, 7%), South Africa (n=1, 7%), Switzerland (n=1, 7%), USA (n=1, 7%), UK and USA (n=1, 7%). The 10 most frequent signs and symptoms were decreased consciousness, tachypnoea, looks seriously unwell to a health professional, high fever, central cyanosis, apnoea, seizures, frequent vomiting, non-blanching rash and noisy breathing.CONCLUSIONS: Knowledge of the most frequently occurring signs and symptoms that were found in the reviewed guidelines will contribute to the update of the content of the Baby Check App. This will ensure that guidance for parents and carers is consistent with the current evidence base.</p

Swimming Upstream: Identifying student anxieties and solutions

This study explores some of the sources of stress faced by students in higher education. Research identifies an association between stress levels and students’ academic performance. This study aims to determine the sources, level and impact of perceived stresses among students in terms of age, gender, ethnicity, years of study and degree major. Participatory action research was explored as a means of developing strategies and solutions for students experiencing stress-related problems. Eleven undergraduate students were recruited initially as co-researchers with four academic staff and one research assistant. One student continued throughout the cycle with two others having to withdraw because of academic work pressures. A collaborative process took place using narrative storytelling and discussions alongside extra-sessional research. A range of outcomes is anticipated related to the students’ experience and academic achievements. Academic staff responsiveness and concern for student wellbeing and successful achievement will contribute to increased student satisfaction. Identification and development of systematic and effective ways of managing anxieties and sharing this with other HEIs will contribute to student wellbeing. In terms of academic outputs, a paper based on the pilot will be developed and acknowledgement of co-authorship appropriately made. A wider research proposal - inclusive of other universities and programmes can be developed for the future

Investigating the Role of Culture on Negative Emotion Expressions in the Wild

Even though culture has been found to play some role in negative emotion expression, affective computing research primarily takes on a basic emotion approach when analyzing social signals for automatic emotion recognition technologies. Furthermore, automatic negative emotion recognition systems still train data that originates primarily from North America and contains a majority of Caucasian training samples. As such, the current study aims to address this problem by analyzing what the differences are of the underlying social signals by leveraging machine learning models to classify 3 negative emotions, contempt, anger and disgust (CAD) amongst 3 different cultures: North American, Persian, and Filipino. Using a curated data set compiled from YouTube videos, a support vector machine (SVM) was used to predict negative emotions amongst differing cultures. In addition a one-way ANOVA was used to analyse the differences that exist between each culture group in-terms of level of activation of underlying social signal. Our results not only highlighted the significant differences in the associated social signals that were activated for each culture, but also indicated the specific underlying social signals that differ in our cross-cultural data sets. Furthermore, the automatic classification methods showed North American expressions of CAD to be well-recognized, while Filipino and Persian expressions were recognized at near chance levels

A functional genetic toolbox for human tissue-derived organoids.

Funder: Alzheimers Research UK Stem Cell Research CentreHuman organoid systems recapitulate key features of organs offering platforms for modelling developmental biology and disease. Tissue-derived organoids have been widely used to study the impact of extrinsic niche factors on stem cells. However, they are rarely used to study endogenous gene function due to the lack of efficient gene manipulation tools. Previously, we established a human foetal lung organoid system (Nikolić et al., 2017). Here, using this organoid system as an example we have systematically developed and optimised a complete genetic toolbox for use in tissue-derived organoids. This includes 'Organoid Easytag' our efficient workflow for targeting all types of gene loci through CRISPR-mediated homologous recombination followed by flow cytometry for enriching correctly-targeted cells. Our toolbox also incorporates conditional gene knock-down or overexpression using tightly-inducible CRISPR interference and CRISPR activation which is the first efficient application of these techniques to tissue-derived organoids. These tools will facilitate gene perturbation studies in tissue-derived organoids facilitating human disease modelling and providing a functional counterpart to many on-going descriptive studies, such as the Human Cell Atlas Project