Cervical cancer prevention in China: where are we now, and what's next?

Cervical cancer(CC) epidemiology CC, the fourth most frequently diagnosed malignancy in women worldwide, is a major global health challenge, particularly in low-resource regions. Approximately 88.1% of the 604,000 CC new cases occurred in low-and middle-income countries in 2020, and more than 90% of the 342,000 CC deaths occurred in low-and middle-income countries in 2020~1.

Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lymphatic systems in a patient with Alzheimer’s disease

Recently,the glymphatic system has been recognised as an important‘waste solutes transport channel’within the brain.1 Studies have shown that blockage of the glymphatic system leads to increased beta-amyloid deposits,accelerating the onset and progression of Alzheimer’s disease(AD).12 Given that cervical lymph nodes receive cerebrospinal fluid from the brain’s glymphatic system,34 we speculated that decompression of the lymphatic trunk and cervical lymphatic-venous anastomosis(LVA)could facilitate the flow of cerebrospinal fluid in the cranial glymphatic system,potentially accelerating the clearance of harmful beta-amyloid and tau proteins.We collaborated with surgeons who specialise in LVA supermicrosurgery for maxillofacial tumours and lymphoedema to develop a procedure to relieve the blockage of the glymphatic system.This surgery employs supermicrosurgery techniques to create LVA connecting the bilateral cervical,deep lymphatic vessels to the veins,resulting in lymphatic trunk decompression,which allows the lymph fluid in the high-pressure lymphatic vessels to flow into the low-pressure venous system.The goal of the minimally invasive surgery is to enhance the removal of proteins,such as beta-amyloid and tau,from the brain’s lymphatic systems to the maxillofacial lymphatic vessels,unclogging protein blockages within the brain.This extracranial procedure is safer than intracranial approaches.

Assessment of soil erosion in the Irga watershed on the eastern edge of the Chota Nagpur Plateau,India

Human activities to improve the quality of life have accelerated the natural rate of soil erosion.In turn,these natural disasters have taken a great impact on humans.Human activities,particularly the conversion of vegetated land into agricultural land and built-up area,stand out as primary contributors to soil erosion.The present study investigated the risk of soil erosion in the Irga watershed located on the eastern fringe of the Chota Nagpur Plateau in Jharkhand,India,which is dominated by sandy loam and sandy clay loam soil with low soil organic carbon(SOC)content.The study used the Revised Universal Soil Loss Equation(RUSLE)and Geographical Information System(GIS)technique to determine the rate of soil erosion.The five parameters(rainfall-runoff erosivity(R)factor,soil erodibility(K)factor,slope length and steepness(LS)factor,cover-management(C)factor,and support practice(P)factor)of the RUSLE were applied to present a more accurate distribution characteristic of soil erosion in the Irga watershed.The result shows that the R factor is positively correlated with rainfall and follows the same distribution pattern as the rainfall.The K factor values in the northern part of the study area are relatively low,while they are relatively high in the southern part.The mean value of the LS factor is 2.74,which is low due to the flat terrain of the Irga watershed.There is a negative linear correlation between Normalized Difference Vegetation Index(NDVI)and the C factor,and the high values of the C factor are observed in places with low NDVI.The mean value of the P factor is 0.210,with a range from 0.000 to 1.000.After calculating all parameters,we obtained the average soil erosion rate of 1.43 t/(hm^(2)•a),with the highest rate reaching as high as 32.71 t/(hm^(2)•a).Therefore,the study area faces a low risk of soil erosion.However,preventative measures are essential to avoid future damage to productive and constructive activities caused by soil erosion.This study also identifies the spatial distribution of soil erosion rate,which will help policy-makers to implement targeted soil erosion control measures.

Diagnostic challenges and individualized treatment of cervical adenocarcinoma metastases to the breast:A case report

BACKGROUND Cervical cancer is a rare primary tumor resulting in metastases to the breast with few cases reported in literature.Breast metastases are associated with poor prognosis.The following case highlights the diagnostic challenges associated with metastatic cervical cancer to the breast along with individualized treatment.CASE SUMMARY A 44-year-old G7P5025 with no significant past medical or surgical history presented with heavy vaginal to an outside emergency department where an exam and a pelvic magnetic resonance imaging showed a 4.5 cm heterogenous lobulated cervical mass involving upper two thirds of vagina,parametria and lymph node metastases.Cervical biopsies confirmed high grade adenocarcinoma with mucinous features.A positron emission tomography/computed tomography(PET/CT)did not show evidence of metastatic disease.She received concurrent cisplatin with external beam radiation therapy.Follow up PET/CT scan three months later showed no suspicious fluorodeoxyglucose uptake in the cervix and no evidence of metastatic disease.Patient was lost to follow up for six months.She was re-imaged on re-presentation and found to have widely metastatic disease including breast disease.Breast biopsy confirmed programmed death-ligand 1 positive metastatic cervical cancer.The patient received six cycles of carboplatin and paclitaxel with pembrolizumab.Restaging imaging demonstrated response.Patient continued on pembrolizumab with disease control.CONCLUSION Metastatic cervical cancer to the breast is uncommon with nonspecific clinical findings that can make diagnosis challenging.Clinical history and immunohistochemical evaluation of breast lesion,and comparison to primary tumor can support diagnosis of metastatic cervical cancer to the breast.Overall,the prognosis is poor,but immunotherapy can be considered in select patients and may result in good disease response.

Numerical simulation on sand sedimentation and erosion characteristics around HDPE sheet sand barrier under different wind angles

For the safety of railroad operations,sand barriers are utilized to mitigate wind-sand disaster effects.These disasters,characterized by multi-directional wind patterns,result in diverse angles among the barriers.In this study,using numerical simulations,we examined the behavior of High Density Polyethylene(HDPE)sheet sand barriers under different wind angles,focusing on flow field distribution,windproof efficiency,and sedimentation erosion dynamics.This study discovered that at a steady wind speed,airflow velocity varies as the angle between the airflow and the HDPE barrier changes.Specifically,a 90°angle results in the widest low-speed airflow area on the barrier’s downwind side.If the airflow is not perpendicular to the barrier,it prompts a lateral airflow movement which decreases as the angle expands.The windproof efficiency correlates directly with this angle but inversely with the wind’s speed.Notably,with a wind angle of 90°,wind speed drops by 81%.The minimum wind speed is found at 5.1H(the sand barrier height)on the barrier’s downwind side.As the angle grows,the barrier’s windproof efficiency improves,extending its protective reach.Sedimentation is most prominent on the barrier’s downwind side,as the wind angle shifts from 30°to 90°,the sand sedimentation area on the barrier’s downwind side enlarges by 14.8H.As the angle grows,sedimentation intensifies,eventually overtakes the forward erosion and enlarges the sedimentation area.

Erosion control of Chinese loess using polymer SH and ryegrass

The China Loess Plateau is subjected to severe soil erosion triggered by intense rainfall,resulting in significant harm and losses to both human society and the natural surroundings.In this study,a novel technique for managing loess erosion is introduced,which involves the utilization of a combined polymer SH and ryegrass.A comprehensive series of tests were undertaken,including rainfall erosion tests,disintegration experiments,and scanning electron microscopy examinations,to assess the accumulative sediment yield(ASY),disintegration ratio,and microstructural features of both untreated and treated loess samples.The results showed a significant reduction in ASY with increased dry density of untreated loess.Furthermore,the combined technique effectively controlled erosion,limiting ASY to 266.2 g/cm^(2)in 60 minutes.This was approximately one-sixth,one-ninth,and one-fifteenth of the ASY in SH-treated loess(L-SH),ryegrass-treated loess(L-R),and untreated loess,respectively.It resisted disintegration better than ryegrass alone but slightly less than SH.This improvement was due to the combined effect of SH and ryegrass,which reduced raindrop impact,improved loess microstructure,and boosted ryegrass growth.The innovative technique holds the potential to be applied as a field-scale technique in the Loess Plateau region of China.

Research on the solid particle erosion wear of pipe steel for hydraulic fracturing based on experiments and numerical simulations

Erosion wear is a common failure mode in the oil and gas industry.In the hydraulic fracturing,the fracturing pipes are not only in high-pressure working environment,but also suffer from the impact of the high-speed solid particles in the fracturing fluid.Beneath such complex conditions,the vulnerable components of the pipe system are prone to perforation or even burst accidents,which has become one of the most serious risks at the fracturing site.Unfortunately,it is not yet fully understood the erosion mechanism of pipe steel for hydraulic fracturing.Therefore,this article provides a detailed analysis of the erosion behavior of fracturing pipes under complex working conditions based on experiments and numerical simulations.Firstly,we conducted erosion experiments on AISI 4135 steel for fracturing pipes to investigate the erosion characteristics of the material.The effects of impact angle,flow velocity and applied stress on erosion wear were comprehensively considered.Then a particle impact dynamic model of erosion wear was developed based on the experimental parameters,and the evolution process of particle erosion under different impact angles,impact velocities and applied stress was analyzed.By combining the erosion characteristics,the micro-structure of the eroded area,and the micro-mechanics of erosion damage,the erosion mechanism of pipe steel under fracturing conditions was studied in detail for the first time.Under high-pressure operating conditions,it was demonstrated through experiments and numerical simulations that the size of the micro-defects in the eroded area increased as the applied stress increased,resulting in more severe erosion wear of fracturing pipes.

Effectiveness of Co-Testing in Cervical Cancer Screening Program in Macao SAR

Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.

Combining neural progenitor cell transplant and rehabilitation for enhanced recovery after cervical spinal cord injury

Efforts to promote recovery of function after human spinal cord injury(SCI) will likely require interventions to rgeting the corticospinal tract(CST) motor system:the most important pathway for voluntary motor control in humans.This system has historically been the most refractory to regenerative efforts after SCI.The "nonregeneration" of the CST changed when robust regeneration of the CST into spared tissue was demonstrated by the inactivation of phosphatase and tensin homolog and delivery of inosine.

Research on Leading Edge Erosion and Aerodynamic Characteristics of Wind Turbine Blade Airfoil

The effects of the erosion present on the leading edge of a wind turbine airfoil(DU 96-W-180)on its aerodynamic performances have been investigated numerically in the framework of a SST k–ωturbulence model based on the Reynolds Averaged Navier-Stokes equations(RANS).The results indicate that when sand-induced holes and small pits are involved as leading edge wear features,they have a minimal influence on the lift and drag coefficients of the airfoil.However,if delamination occurs in the same airfoil region,it significantly impacts the lift and resistance characteristics of the airfoil.Specifically,as the angle of attack grows,there is a significant decrease in the lift coefficient accompanied by a sharp increase in the drag coefficient.As wear intensifies,these effects gradually increase.Moreover,the leading edge wear can exacerbate flow separation near the trailing edge suction surface of the airfoil and cause forward displacement of the separation point.

Erratum to:Influence law of modified glutinous rice-based materials on gravel soil reinforcement and water erosion process

The original online version of this article was revised.The first author is“ZHANG Weng-xiang”in the original article.The first author’s name has been corrected to“ZHANG Wen-xiang”.

Trans-PRK for recurrent epithelial corneal erosion induced by cooking oil accidentally after EVO ICL

Dear Editor,We report a case with trans-photorefractive keratectomy(PRK)for recurrent epithelial corneal erosion caused by cooking oil after EVO-implantable contact lens(ICL)(EVO Visian ICL;STAAR Surgical AG,Switzerland),which should be distinguished from postoperative complications of EVO-ICL.Most corneal burns are classified as chemical and thermal burns,referring to direct contact injury to the cornea.

Retraction:miR-181a-5p Promotes Proliferation and Invasion and Inhibits Apoptosis of Cervical Cancer Cells via Regulating Inositol Polyphosphate-5-Phosphatase A(INPP5A)

Following the publication,concerns have been raised about a number of figures in this article.An unexpected area of similarity was identified in terms of the cellular data,where the results from differently performed experiments were intended to have been shown,although the areas immediately surrounding this area featured comparatively different distributions of cells.In addition,the western blots in this article were presented with atypical,unusually shaped and possibly anomalous protein bands in many cases.

Effect of Some Physical Factors on Interrill Erosion of Soils in Gidan-Kwanu Area, Nigeria

Savanna regions in Nigeria face environmental degradation and barren land, negatively impacting food and agricultural productivity. Inter-rill erosion occurs due to raindrop impact and transport, particularly on hill slopes. A study was conducted using a sprinkler rainfall simulator and plot experiment to study soil erosion processes. Soil samples were collected from four farms in Gidan Kwanu, with varying moisture content. Sand content ranged from 46.0% to 76.20%, silt from 11.30% to 23.50%, and clay from 11.0% to 30.0%. Uncultivated and bare land had a higher average porosity (15.47% and 14.99%), while cultivated land had lower porosity (14.4%). The study found that most people in Gidan-Kwanu primarily practice farming, which is season-dependent and rain-fed. Soil type and texture significantly contribute to inter-rill erosion, with cultivated and uncultivated soil being more resistant to erosion than bare land soil. The study concluded that farming practices in Gidan-Kwanu are primarily season-dependent and rain-fed. Soil type and texture significantly contribute to inter-rill erosion, with cultivated and uncultivated soil being more resistant to erosion than bare land soil.

Experimental and numerical simulation study on the erosion behavior of the elbow of gathering pipeline in shale gas field

During the production period of shale gas, proppant particles and rock debris are produced together,which will seriously erode the elbows of gathering pipelines. In response to this problem, this paper takes the elbow of the gathering pipeline in the Changning Shale Gas Field as an example to test the erosion rate and material removal mechanism of the test piece at different angles of the elbow through experiments and compares the four erosion models with the experimental results. Through analysis, it is found that the best prediction model for quartz sand-carbon steel erosion is the Oka model. Based on the Oka model, FLUENT software was used to simulate and analyze the law of erosion of the elbow of the gas gathering pipeline under different gas flow velocities, gas gathering pressure, particle size, length of L1,and bending directions of the elbow. And a spiral pipeline structure is proposed to reduce the erosion rate of the elbow under the same working conditions. The results show that this structure can reduce erosion by 34%.

Pregnancy and Obstetrical Outcomes Following Treatment for Cervical Intra-Epithelial Neoplasia (CIN) in Two Hospitals of a Low-Resource Country

Objective: In Cameroon, more than 80% of women suffering from cervical intraepithelial neoplasia (CIN) are within the reproductive age. This study intended to analyze the pregnancy outcomes following cervical treatment in Cameroon. Methods: This was a cohort study with two years retrospective data collection involving 82 women who underwent cervical treatment for CIN in two Cameroonian hospitals from January 2015 to December 2017. Data were collected from CIN treatment to end of pregnancy where applicable. Data analysis was done using Epi Info software version 3.5.4. Results: We collected data from 82 patients aged 27 to 48 years, with a mean age of 36.5 (SD: 5.3) years. During the study period, 33 out of 82 participants became pregnant 40.2 [29.56 - 51.66]%. The factor associated with pregnancy occurrence after treatment was age less than 35 years (Odds ratio = 4.37 [1.7 - 11.2]. From the 33 pregnancies recorded, 17 (51.5%) ended in a delivery, amongst which 15 (88.2%) were vaginal. Conclusion: Pregnancy frequency over two years following cervical treatment for CIN was relatively good, and younger women (age 35 years) were significantly more like to have conceived compared to their older counterparts. Post-treatment delivery outcomes seem to be similar to those in the general population.

Soil erosion susceptibility mapping of Hangu Region,Kohat Plateau of Pakistan using GIS and RS-based models

Soil erosion is a crucial geo-environmental hazard worldwide that affects water quality and agriculture,decreases reservoir storage capacity due to sedimentation,and increases the danger of flooding and landslides.Thus,this study uses geospatial modeling to produce soil erosion susceptibility maps(SESM)for the Hangu region,Khyber Pakhtunkhwa(KPK),Pakistan.The Hangu region,located in the Kohat Plateau of KPK,Pakistan,is particularly susceptible to soil erosion due to its unique geomorphological and climatic characteristics.Moreover,the Hangu region is characterized by a combination of steep slopes,variable rainfall patterns,diverse land use,and distinct soil types,all of which contribute to the complexity and severity of soil erosion processes.These factors necessitate a detailed and region-specific study to develop effective soil conservation strategies.In this research,we detected and mapped 1013 soil erosion points and prepared 12 predisposing factors(elevation,aspect,slope,Normalized Differentiate Vegetation Index(NDVI),drainage network,curvature,Land Use Land Cover(LULC),rainfall,lithology,contour,soil texture,and road network)of soil erosion using GIS platform.Additionally,GIS-based statistical models like the weight of evidence(WOE)and frequency ratio(FR)were applied to produce the SESM for the study area.The SESM was reclassified into four classes,i.e.,low,medium,high,and very high zone.The results of WOE for SESM show that 16.39%,33.02%,29.27%,and 21.30%of areas are covered by low,medium,high,and very high zones,respectively.In contrast,the FR results revealed that 16.50%,24.33%,35.55%,and 23.59%of the areas are occupied by low,medium,high,and very high classes.Furthermore,the reliability of applied models was evaluated using the Area Under Curve(AUC)technique.The validation results utilizing the area under curve showed that the success rate curve(SRC)and predicted rate curve(PRC)for WOE are 82%and 86%,respectively,while SRC and PRC for FR are 85%and 96%,respectively.The validation results revealed that the FR model performance is better and more reliable than the WOE.

Distribution assessment of soil erosion with revised RUSLE model in Tianshan Mountains

aSoil degradation caused by soil erosion is one of the world's most critical environmental issues.Soil erosion in the Tianshan Mountains has caused various environmental problems in the surrounding areas.This study used remote sensing data to analyze the distribution of the factors influencing soil erosion,and the revised universal soil loss equation(RUSLE)to calculate the total amount and distribution characteristics of soil erosion in the Tianshan Mountains in 2019.Due to the large error of RUSLE in soil erosion estimation in mountainous areas,this study modified RUSLE equation based on the characteristics of snow cover in the Tianshan Mountains.The results show that the average soil erosion was 1690.3 t/(km^(2)·year),of which insignificant erosion,slight erosion and moderate erosion accounted for 42,8%,22.4%and 9.9%,respectively.Severe erosion and above accounted for 13.3%.The accuracy of the soil erosion modulus calculated by the RUSLE was only 61.9%,with an average error of 1631.9 t/(km^(2)·year).The average error of the double-coefficient correction method was 1259.1 t/(km^(2)·year),and the average error of the modified formula method was reduced by 40.3%compared with the RUSLE,reaching 973.7 t/(km^(2)·year),and its accuracy reached 76.2%.Very severe erosion and catastrophic erosion are distributed on mountain ridges with higher elevation and on the northern area with higher precipitation.Snow cover has a certain inhibitory effect on soil erosion,and snow cover in alpine mountains is a factor that cannot be ignored in soil erosion research.

Effect of coir geotextile and geocell on ephemeral gully erosion in the Mollisol region of Northeast China

The unique geomorphological features and farming methods in the Mollisol region of Northeast China increase water catchment flow and aggravate the erosion of ephemeral gully(EG).Vegetation suffers from rain erosion and damage during the growth stage,which brings serious problems to the restoration of grass in the early stage.Therefore,effects of coir geotextile and geocell on EG erosion under four confluence intensities were researched in this study.Results of the simulated water discharge erosion test showed that when the confluence strength was less than 30 L/min,geocell and coir geotextile had a good effect on controlling EG erosion,and sediment yield of geocell and coir geotextile was reduced by 25.95%–37.82%and 73.73%–88.96%,respectively.However,when confluence intensity increased to 40 L/min,protective effect of coir geotextile decreased,and sediment yield rate increased sharply by 189.03%.When confluence intensity increased to 50 L/min,the protective effect of coir geotextile was lost.On the other hand,geocell showed that the greater the flow rate,the better the protective effect.In addition,with the increase in confluence intensity,erosion pattern of coir geotextile developed from sheet erosion to intermittent fall and then to completion of main rill,and the protective effect was gradually weakened.In contrast,the protective effect of EG under geocell was gradually enhanced from the continuous rill to the intermittent rill and finally to the intermittent fall.This study shows that coir geotextile and geocell can prevent EG erosion,and the effect of geocell is better than that of coir geotextile on the surface of EG.

Artificial intelligence strengthens cervical cancer screening–present and future

Cervical cancer is a severe threat to women’s health.The majority of cervical cancer cases occur in developing countries.The WHO has proposed screening 70%of women with high-performance tests between 35 and 45 years of age by 2030 to accelerate the elimination of cervical cancer.Due to an inadequate health infrastructure and organized screening strategy,most low-and middle-income countries are still far from achieving this goal.As part of the efforts to increase performance of cervical cancer screening,it is necessary to investigate the most accurate,efficient,and effective methods and strategies.Artificial intelligence(AI)is rapidly expanding its application in cancer screening and diagnosis and deep learning algorithms have offered human-like interpretation capabilities on various medical images.AI will soon have a more significant role in improving the implementation of cervical cancer screening,management,and follow-up.This review aims to report the state of AI with respect to cervical cancer screening.We discuss the primary AI applications and development of AI technology for image recognition applied to detection of abnormal cytology and cervical neoplastic diseases,as well as the challenges that we anticipate in the future.