What factors are most influential in increasing cervical cancer screening attendance? An online study of UK-based women1

Objective: Cervical cancer is the fourth most commonly occurring cancer in women worldwide. The UK has one of the highest cervical screening rates in Europe, yet attendance has been decreasing. This study aimed to identify barriers and facilitators to screening attendance and assess the perceived importance of these factors. Methods: 194 women living in the UK were recruited via an online research recruitment website to an online survey. Most participants (N = 128, 66.0%) were currently up-to-date with cervical screening, 66 participants (34.0%) had never been screened, or were overdue for screening. Participants identified barriers and facilitators to cervical screening attendance via free-text responses and were also asked to rate a list of factors as most to least influential over decision making. Results were analysed using thematic content analysis and ratings analysed using multivariable analyses. Results: The most commonly reported barriers were: Pain/discomfort; Embarrassment; and Time. These were also rated as most influential for decision making. The most commonly reported facilitators were: Ease of making appointments; Peace of mind; and Fear of cancer/preventing serious illness. While importance rating of barriers did not differ by previous screening behaviour, ratings of some facilitators significantly differed. Up-to-date women rated believing screening is potentially life-saving and part of personal responsibility as significantly more important than overdue/never screened women. Conclusion: This study confirmed that factors which encourage screening are key to the decision of whether to attend screening. Women suggested several improvements that might make attending easier and improve uptake, including flexibility of screening locations to fit around work hours and childcare arrangements. Psychological facilitators included the peace of mind that screening brings and the belief that cervical cancer screening is potentially life-saving. Public health interventions should target factors which facilitate screening and how these interplay with barriers in order to improve uptake

Optimizing real time fMRI neurofeedback for therapeutic discovery and development

While reducing the burden of brain disorders remains a top priority of organizations like the World Health Organization and National Institutes of Health, the development of novel, safe and effective treatments for brain disorders has been slow. In this paper, we describe the state of the science for an emerging technology, real time functional magnetic resonance imaging (rtfMRI) neurofeedback, in clinical neurotherapeutics. We review the scientific potential of rtfMRI and outline research strategies to optimize the development and application of rtfMRI neurofeedback as a next generation therapeutic tool. We propose that rtfMRI can be used to address a broad range of clinical problems by improving our understanding of brain–behavior relationships in order to develop more specific and effective interventions for individuals with brain disorders. We focus on the use of rtfMRI neurofeedback as a clinical neurotherapeutic tool to drive plasticity in brain function, cognition, and behavior. Our overall goal is for rtfMRI to advance personalized assessment and intervention approaches to enhance resilience and reduce morbidity by correcting maladaptive patterns of brain function in those with brain disorders

Development of innovative automated solutions for the assembly of multifunctional thermoplastic composite fuselage

In this study, the development of innovative tooling and end-effector systems for the assembly of a multifunctional thermoplastic fuselage is presented. The increasing demand for cleaner and new aircraft requires utilising novel materials and technologies. Advanced thermoplastic composites provide an excellent material option thanks to their weldability, low density, low overall production cost, improved fracture toughness and recyclability. However, to fully appreciate their potentials, new manufacturing approaches and techniques are needed. Hence, this project develops three end-effector solutions to demonstrate the feasibility of assembling a full-scale multifunctional-integrated thermoplastic lower fuselage shell, including the integration of a fully equipped floor and cargo structure. The developed assembly solution comprises three individual yet well-integrated tooling systems that allow housing the skin and assembly; picking, placing and welding of the assembly parts, i.e. clips and stringers; and welding of frames and floor beam sub-assemblies. The process of developing these systems including the end-user requirements, technical challenges, tooling and end-effectors design and manufacturing process are detailed in this paper.This study is part of the TCTool project, which has received funding from the Clean Sky 2 Joint Undertaking under the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 865131. Project partners: GKN-Fokker Aerospace (Topic Manager), TWI Ltd., Andalusian Foundation for Aerospace Development – Advanced Center for Aerospace Technologies, Brunel University London (Brunel Composites Centre), London South Bank University, Acroflight Ltd., and Smart Advanced Manufacturing XL (SAM|XL)

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Computational Methods for Pigmented Skin Lesion Classification in Images: Review and Future Trends

Skin cancer is considered as one of the most common types of cancer in several countries, and its incidence rate has increased in recent years. Melanoma cases have caused an increasing number of deaths worldwide, since this type of skin cancer is the most aggressive compared to other types. Computational methods have been developed to assist dermatologists in early diagnosis of skin cancer. An overview of the main and current computational methods that have been proposed for pattern analysis and pigmented skin lesion classification is addressed in this review. In addition, a discussion about the application of such methods, as well as future trends, is also provided. Several methods for feature extraction from both macroscopic and dermoscopic images and models for feature selection are introduced and discussed. Furthermore, classification algorithms and evaluation procedures are described, and performance results for lesion classification and pattern analysis are given