Urine biomarkers for the early detection of ovarian cancer – are we there yet?

Ovarian cancer affects around 7500 women in the United Kingdom every year. Despite this, there is no effective screening strategy or standard treatment for ovarian cancer. If diagnosed during stage I, ovarian cancer has a 90% 5-year survival rate; however, there is usually a masking of symptoms which leads to an often late-stage diagnosis and correspondingly poor survival rate. Current diagnostic methods are invasive and consist of a pelvic examination, transvaginal ultrasonography, and blood tests to detect cancer antigen 125 (CA125). Unfortunately, surgery is often still required to make a positive diagnosis. To address the need for accurate, specific, and non-invasive diagnostic methods, there has been an increased interest in biomarkers identified through non-invasive tests as tools for the earlier diagnosis of ovarian cancer. Although most studies have focused on the identification of biomarkers in blood, the ease of availability of urine and the high patient compliance rates suggest that it could provide a promising resource for the screening of patients for ovarian cancer

Antarctic atmospheric boundary layer observations with the Small Unmanned Meteorological Observer (SUMO)

Between&nbsp;January&nbsp;2012 and June&nbsp;2017 a small unmanned aerial system (sUAS), known as the Small Unmanned Meteorological Observer (SUMO), was used to observe the state of the atmospheric boundary layer in the Antarctic. During six Antarctic field campaigns, 116 SUMO flights were completed. These flights took place during all seasons over both permanent ice and ice-free locations on the Antarctic continent and over sea ice in the western Ross Sea. Sampling was completed during spiral ascent and descent flight paths that observed the temperature, humidity, pressure and wind up to 1000&thinsp;m above ground level and sampled the entire depth of the atmospheric boundary layer, as well as portions of the free atmosphere above the boundary layer. A wide variety of boundary layer states were observed, including very shallow, strongly stable conditions during the Antarctic winter and deep, convective conditions over ice-free locations in the summer. The Antarctic atmospheric boundary layer data collected by the SUMO sUAS, described in this paper, can be retrieved from the United States Antarctic Program Data Center (https://www.usap-dc.org, last access: 8&nbsp;March&nbsp;2021). The data for all flights conducted on the continent are available at https://doi.org/10.15784/601054 (Cassano, 2017), and data from the Ross Sea flights are available at https://doi.org/10.15784/601191 (Cassano, 2019). </div

Effects of Airplane Cabin Interiors on Egress I: Assessment of Anthropometrics, Seat Pitch, and Seat Width on Egress, DOT-FAA-AM_21/01 [supporting datasets: videos]

6973GH-19-C-00102Because of the very large file sized of these videos, patrons will need to download the video files directly, using the "Direct Download" links provided in the README.These 60 video recordings represent the visual recordings of the measurement of the two research objectives of the study \u201cEffects of Airplane Cabin Interiors on Egress I: Assessment of Anthropometrics, Seat Pitch, and Seat Width on Egress," DOT/FAA/AM-21/01. The first objective was to determine what percentage of the American population, based on anthropometric measurements, would not be able to sit in transport airplane passenger seats at the currently narrowest and even narrower seat pitch. Second, this study sought to determine the effect of seat pitch and seat width on individual egress time during an aircraft evacuation.The 12 videos with file names which contain with the phrase "ExpSeatingMockupDay..." record participants sitting in or attempting to sit in a seat mock-up that matched the narrowest seat pitch they would experience in the evacuation trials, and to attempt to sit in or to sit in a seat mock-up of a narrower seat pitch than what would be presented in the evacuation trials. (See pages 9 and 10 of the related report for more information.) Each video is about 2 hours long, and shows a single camera view from the perspective of the left wall of an aircraft. The video records participant actions as each participant attempts to sit in the center seat of the third of three rows, and then the center seat of the second of three rows. The recordings are color video, without a soundtrack. Participant faces are blurred to protect individual privacy.The 48 videos with file names that start with "R01.mp4" and increment to "R48.mp4" are the recordings of the evacuations from CAMI FlexSim. (See pages 11 through 13 of the related report for more information.) Each video is about 45 seconds long, with the frame divided into 4 quarters, showing three views of the evacuation, and a single title slide with the date of the evacuation trial, and the trial number, which matches the file number on the recording. The view in the upper left of the frame is a view overhead and behind the flight attendant supervising the evacuation. The view in the upper right of the frame shows the exterior of the simulator to record how participants exit. The view in the lower right of frame shows the view from the rear of the simulator, as participants evacuate away from the camera to the front of the simulator. The lower left of the frame is the title slide. In the center of the frame is a timer, counting up the total time of the evacuation. The recordings are color video, without a soundtrack. Participant faces are blurred to protect individual privacy.The videos can be viewed on any modern video player

Effects of Airplane Cabin Interiors on Egress I: Assessment of Anthropometrics, Seat Pitch, and Seat Width on Egress

6973GH-19-C-00102Within the Federal Aviation Administration (FAA) Reauthorization Act of 2018, Pub. L. No. 115-254 \ua7 577, Congress required that \u201c\u2026the Administrator of the Federal Aviation Administration shall issue regulations that establish minimum dimensions for passenger seats on aircraft operated by air carriers in interstate air transportation or intrastate air transportation, including minimums for seat pitch, width, and length, and that are necessary for the safety of passengers.\u201d This research project was developed to provide information to rule-makers within the FAA to meet this requirement

Effects of Airplane Cabin Interiors on Egress I: Assessment of Anthropometrics, Seat Pitch, and Seat Width on Egress, DOT-FAA-AM_21/01 [supporting datasets]

6973GH-19-C-00102Within the Federal Aviation Administration (FAA) Reauthorization Act of 2018, Pub. L. No. 115-254 \ua7 577, Congress required that \u201c\u2026the Administrator of the Federal Aviation Administration shall issue regulations that establish minimum dimensions for passenger seats on aircraft operated by air carriers in interstate air transportation or intrastate air transportation, including minimums for seat pitch, width, and length, and that are necessary for the safety of passengers.\u201d A total of 775 participants were recruited to assist with meeting two research objectives: first, to determine what percentage of the American population, based on anthropometric measurements, would be unable to sit in transport airplane passenger seats at the currently narrowest width and even narrower seat pitch. The second objective was to determine the effect of seat pitch and seat width on individual egress time. The study included 718 participants assigned to 12 groups who participated in up to four evacuations from the FAA\u2019s Flexible Aircraft Cabin Simulator (FlexSim), with various seat pitch and width combinations. Based on this study's results, currently flying seat pitches using seats of similar size or smaller than those used in this project can accommodate and not impede egress for 99% of the American population. This project also concluded that, similar to previous evacuation research, as long as ergonomic minimums are maintained, the transport airplane's interior configuration, including seat pitch and width, has not been shown to influence evacuations. This research project was developed to provide information to rule-makers within the FAA to meet this requirement

Early Secreted Antigen ESAT-6 of Mycobacterium tuberculosis Promotes Protective T Helper 17 Cell Responses in a Toll-Like Receptor-2-dependent Manner

Despite its relatively poor efficacy, Bacillus Calmette-Guérin (BCG) has been used as a tuberculosis (TB) vaccine since its development in 1921. BCG induces robust T helper 1 (Th1) immune responses but, for many individuals, this is not sufficient for host resistance against Mycobacterium tuberculosis (M. tb) infection. Here we provide evidence that early secreted antigenic target protein 6 (ESAT-6), expressed by the virulent M. tb strain H37Rv but not by BCG, promotes vaccine-enhancing Th17 cell responses. These activities of ESAT-6 were dependent on TLR-2/MyD88 signalling and involved IL-6 and TGF-β production by dendritic cells. Thus, animals that were previously infected with H37Rv or recombinant BCG containing the RD1 region (BCG::RD1) exhibited improved protection upon re-challenge with virulent H37Rv compared with mice previously infected with BCG or RD1-deficient H37Rv (H37RvΔRD1). However, TLR-2 knockout (TLR-2-/-) animals neither showed Th17 responses nor exhibited improved protection in response to immunization with H37Rv. Furthermore, H37Rv and BCG::RD1 infection had little effect on the expression of the anti-inflammatory microRNA-146a (miR146a) in dendritic cells (DCs), whereas BCG and H37RvΔRD1 profoundly induced its expression in DCs. Consistent with these findings, ESAT-6 had no effect on miR146a expression in uninfected DCs, but dramatically inhibited its upregulation in BCG-infected or LPS-treated DCs. Collectively, our findings indicate that, in addition to Th1 immunity induced by BCG, RD1/ESAT-6-induced Th17 immune responses are essential for optimal vaccine efficacy

Which method is best for the induction of labour?: A systematic review, network meta-analysis and cost-effectiveness analysis

Background: More than 150,000 pregnant women in England and Wales have their labour induced each year. Multiple pharmacological, mechanical and complementary methods are available to induce labour. Objective: To assess the relative effectiveness, safety and cost-effectiveness of labour induction methods and, data permitting, effects in different clinical subgroups. Methods: We carried out a systematic review using Cochrane methods. The Cochrane Pregnancy and Childbirth Group’s Trials Register was searched (March 2014). This contains over 22,000 reports of controlled trials (published from 1923 onwards) retrieved from weekly searches of OVID MEDLINE (1966 to current); Cochrane Central Register of Controlled Trials (The Cochrane Library); EMBASE (1982 to current); Cumulative Index to Nursing and Allied Health Literature (1984 to current); ClinicalTrials.gov; the World Health Organization International Clinical Trials Registry Portal; and hand-searching of relevant conference proceedings and journals. We included randomised controlled trials examining interventions to induce labour compared with placebo, no treatment or other interventions in women eligible for third-trimester induction. We included outcomes relating to efficacy, safety and acceptability to women. In addition, for the economic analysis we searched the Database of Abstracts of Reviews of Effects, and Economic Evaluations Databases, NHS Economic Evaluation Database and the Health Technology Assessment database. We carried out a network meta-analysis (NMA) using all of the available evidence, both direct and indirect, to produce estimates of the relative effects of each treatment compared with others in a network. We developed a de novo decision tree model to estimate the cost-effectiveness of various methods. The costs included were the intervention and other hospital costs incurred (price year 2012–13). We reviewed the literature to identify preference-based utilities for the health-related outcomes in the model. We calculated incremental cost-effectiveness ratios, expected costs, utilities and net benefit. We represent uncertainty in the optimal intervention using cost-effectiveness acceptability curves. Results: We identified 1190 studies; 611 were eligible for inclusion. The interventions most likely to achieve vaginal delivery (VD) within 24 hours were intravenous oxytocin with amniotomy [posterior rank 2; 95% credible intervals (CrIs) 1 to 9] and higher-dose (≥ 50 μg) vaginal misoprostol (rank 3; 95% CrI 1 to 6). Compared with placebo, several treatments reduced the odds of caesarean section, but we observed considerable uncertainty in treatment rankings. For uterine hyperstimulation, double-balloon catheter had the highest probability of being among the best three treatments, whereas vaginal misoprostol (≥ 50 μg) was most likely to increase the odds of excessive uterine activity. For other safety outcomes there were insufficient data or there was too much uncertainty to identify which treatments performed ‘best’. Few studies collected information on women’s views. Owing to incomplete reporting of the VD within 24 hours outcome, the cost-effectiveness analysis could compare only 20 interventions. The analysis suggested that most interventions have similar utility and differ mainly in cost. With a caveat of considerable uncertainty, titrated (low-dose) misoprostol solution and buccal/sublingual misoprostol had the highest likelihood of being cost-effective. Limitations: There was considerable uncertainty in findings and there were insufficient data for some planned subgroup analyses. Conclusions: Overall, misoprostol and oxytocin with amniotomy (for women with favourable cervix) is more successful than other agents in achieving VD within 24 hours. The ranking according to safety of different methods was less clear. The cost-effectiveness analysis suggested that titrated (low-dose) oral misoprostol solution resulted in the highest utility, whereas buccal/sublingual misoprostol had the lowest cost. There was a high degree of uncertainty as to the most cost-effective intervention