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\"Your Future Is Bright! After all, your mother is a robot, your father has joined the alien hive mind, and your dinner will be counterfeit 3D-printed steak. Even though your worker bots have staged a mutiny, and your tour guide speaks only in memes, you can always sell your native language if you need some extra cash.\" -- From publisher's description.

Hepatocellular carcinoma (HCC) is the leading cause of cancer-related death in Thailand. However, most Thai patients at high risk of HCC lack access to routine surveillance programs. This study used ultrasound- or biomarker-based screening approaches to assess the cost-utility analysis of routine HCC surveillance in patients with compensated liver cirrhosis (CLC). The model utilized a Markov-style microsimulation framework to simulate outcomes from alternative HCC surveillance methods for Thai patients. The model was designed to represent Thai patients and healthcare as accurately as possible, and novel Thai patient data was used to estimate treatment and survival associated with screening. Outcomes included diagnostic performance, total costs, and overall health expressed as quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) was assessed according to the Thai willingness-to-pay threshold (฿160,000 = 4,800 USD). Results suggest that routine HCC surveillance is likely cost-effective in Thai patients with CLC. Among the biomarker-based approaches, GAAD score, which combined gender, age, alpha-fetoprotein (AFP), and des-gamma carboxyprothrombin (DCP), was the most cost-effective due to its high detection of HCC while resulting in comparably few false positive diagnoses. Compared to no routine surveillance, GAAD surveillance is suggested to be cost-effective (ICER: $4,631). Compared to ultrasound plus AFP - the recommended standard of care - GAAD is suggested to be dominant, resulting in better overall health at a lower cost. Bi-annual routine HCC surveillance is suggested to be cost-effective for the Thai healthcare system when used for patients with CLC. Among biomarker-based approaches, GAAD appears to be the most cost-effective and could maximize the benefits of HCC surveillance in high-risk patients.

This book constructs scenarios from Shanghai to Edinburgh, Seoul to California encompassing complex topics such as human trafficking, conferences, transport, food tourism or technological innovation. This is a blue skies thinking book about the future of tourism and a thought-provoking analytical commentary.

Persistent high-risk type Human papillomavirus (HPV) infection is recognized as a necessary cause of cervical cancer. This study aimed to compare the HPV prevalence and risk factors between women residing in Hong Kong (HK) and Guangzhou (GZ) region of China. A total of 1,570 and 1,369 women were recruited from HK and GZ, respectively. The cytology samples were collected and tested for HPV infection. The overall and type-specific HPV prevalence and the potential risk factors for acquisition of HPV infection were studied. Women with normal cytology in the GZ cohort had significantly higher HPV prevalence (10%) than those in the HK cohort (6.2%, p<0.001). The patterns of the age-specific HPV prevalence were also different between the two cohorts. In the HK cohort, women at the age of 20-29 years old had the highest prevalence and a second peak was observed in the age of ≥ 60 years old. In the GZ cohort, the highest HPV prevalence was also observed in 20-29 years old but declined as the age increased and a second peak was not seen. HPV16 and HPV52 were the most common high-risk types found in the HK and GZ cohorts, respectively. Age was the most consistently observed independent risk factor for HPV infection in the HK, while the number of sexual partners had association in the GZ cohort. Our study provides the current status and the epidemiological characteristics of HPV prevalence in Southern Chinese women. The results strongly suggested that population education and the effective cervical cancer screening would be vital in the prevention of cervical cancer.

Cancer immunoediting 1 is a hallmark of cancer 2 that predicts that lymphocytes kill more immunogenic cancer cells to cause less immunogenic clones to dominate a population. Although proven in mice 1 , 3 , whether immunoediting occurs naturally in human cancers remains unclear. Here, to address this, we investigate how 70 human pancreatic cancers evolved over 10 years. We find that, despite having more time to accumulate mutations, rare long-term survivors of pancreatic cancer who have stronger T cell activity in primary tumours develop genetically less heterogeneous recurrent tumours with fewer immunogenic mutations (neoantigens). To quantify whether immunoediting underlies these observations, we infer that a neoantigen is immunogenic (high-quality) by two features—‘non-selfness’  based on neoantigen similarity to known antigens 4 , 5 , and ‘selfness’  based on the antigenic distance required for a neoantigen to differentially bind to the MHC or activate a T cell compared with its wild-type peptide. Using these features, we estimate cancer clone fitness as the aggregate cost of T cells recognizing high-quality neoantigens offset by gains from oncogenic mutations. With this model, we predict the clonal evolution of tumours to reveal that long-term survivors of pancreatic cancer develop recurrent tumours with fewer high-quality neoantigens. Thus, we submit evidence that that the human immune system naturally edits neoantigens. Furthermore, we present a model to predict how immune pressure induces cancer cell populations to evolve over time. More broadly, our results argue that the immune system fundamentally surveils host genetic changes to suppress cancer. The human immune system naturally edits cancers of high-quality neoantigens.

Tendons injuries frequently result in scar-like tissue with poor biochemical structure and mechanical properties. We have recently reported that CD146 perivascular originated tendon stem/progenitor cells (TSCs), playing critical roles in tendon healing. Here, we identified highly efficient small molecules that selectively activate endogenous TSCs for tendon regeneration. : From a pool of ERK1/2 and FAK agonists, Oxo-M and 4-PPBP were identified, and their roles in tenogenic differentiation of TSCs and tendon healing were investigated. Controlled delivery of Oxo-M and 4-PPBP was applied via PLGA µS. Signaling studies were conducted to determine the mechanism for specificity of Oxo-M and 4-PPBP to CD146 TSCs. : A combination of Oxo-M and 4-PPBP synergistically increased the expressions of tendon-related gene markers in TSCs. , delivery of Oxo-M and 4-PPBP significantly enhanced healing of fully transected rat patellar tendons (PT), with functional restoration and reorganization of collagen fibrous structure. Our signaling study suggested that Oxo-M and 4-PPBP specifically targets CD146 TSCs via non-neuronal muscarinic acetylcholine receptors (AChR) and σ1 receptor (σ1) signaling. : Our findings demonstrate a significant potential of Oxo-M and 4-PPBP as a regenerative therapeutics for tendon injuries.

Background Effective education is considered by the American Heart Association (AHA) as a vital variable in improving outcomes of cardiac arrest. Studies have shown that the level of knowledge and attitude of non-healthcare providers towards resuscitation training varies widely across the globe. While some training methods and barriers to training have been discussed, the literature is still quite vague and unclear regarding resuscitation training, particularly in the Middle East. This study’s focus on the efficacy of resuscitation training in this region of the world may help dictate how to better implement education initiatives aimed towards non-healthcare providers in developing countries. Methodology A systematic review and meta-analysis were conducted on studies published from inception until March 2023. Observational studies assessing CPR knowledge and skills among non-healthcare workers in Arab countries were included. Data were extracted from PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus. Data analysis was performed using Rstudio with a random effects model. Results 50 studies were included in this review and meta-analysis, revealing that 55% of participants had prior knowledge of CPR, while only 28% considered their knowledge sufficient. The majority (76%) supported mandatory CPR training, and 86% were willing to attend training if offered. This study found that prior knowledge of cardiopulmonary resuscitation (CPR) varied among populations. This meta-analysis also compiled results regarding CPR technique defined by correct compression to ventilation ratio, compression depth, compression rate, location of chest compression, and correct sequence. The overall results from this meta-analysis showed that, of these factors, compression rate and depth were the two factors that were most often administered incorrectly. In all, the results from this study demonstrated that CPR training in Arab countries was favorably viewed overall, with the majority of participants indicating both support for mandatory CPR training and general willingness to attend training if offered the opportunity. Conclusion Given the overall positive view and willingness to learn CPR skills, healthcare policy makers should adopt a more comprehensive focus on strategies that enhance the accessibility and opportunity for CPR training for non-healthcare populations in Arab countries. Future training programs should implement strategies to highlight the ideal combination of compression rates and depth to learners to ensure correct and efficacious delivery of CPR with increased focus on the practical portion during refresher courses to promote retention.

Real-time lab analysis is needed to support clinical decision making and research on human missions to the Moon and Mars. Powerful laboratory instruments, such as flow cytometers, are generally too cumbersome for spaceflight. Here, we show that scant test samples can be measured in microgravity, by a trained astronaut, using a miniature cytometry-based analyzer, the rHEALTH ONE, modified specifically for spaceflight. The base device addresses critical spaceflight requirements including minimal resource utilization and alignment-free optics for surviving rocket launch. To fully enable reduced gravity operation onboard the space station, we incorporated bubble-free fluidics, electromagnetic shielding, and gravity-independent sample introduction. We show microvolume flow cytometry from 10 μL sample drops, with data from five simultaneous channels using 10 μs bin intervals during each sample run, yielding an average of 72 million raw data points in approximately 2 minutes. We demonstrate the device measures each test sample repeatably, including correct identification of a sample that degraded in transit to the International Space Station. This approach can be utilized to further our understanding of spaceflight biology and provide immediate, actionable diagnostic information for management of astronaut health without the need for Earth-dependent analysis.

Point-of-care (PoC) testing of platelet count (PLT) provides real-time data for rapid decision making. The goal of this study is to evaluate the accuracy and precision of platelet counting using a new microvolume (8 μL), absolute counting, 1.5 kg cytometry-based blood analyzer, the rHEALTH ONE (rHEALTH) in comparison with the International Society of Laboratory Hematology (ISLH) platelet method, which uses a cytometer and an impedance analyzer. Inclusion eligibility were healthy adults (M/F) ages 18-80 for donation of fingerprick and venous blood samples. Samples were from a random N = 31 volunteers from a single U.S. site. Samples were serially diluted to test thrombocytopenic ranges. Interfering substances and conditions were tested, including RBC fragments, platelet fragments, cholesterol, triglycerides, lipids, anti-platelet antibodies, and temperature. The concordance between the rHEALTH and ISLH methods had a slope = 1.030 and R2 = 0.9684. The rHEALTH method showed a correlation between capillary and venous blood samples (slope = 0.9514 and R2 = 0.9684). Certain interferents changed platelet recovery: RBC fragments and anti-platelet antibodies with the ISLH method; platelet fragments and anti-platelet antibodies on the rHEALTH; and RBC fragments, platelets fragments, triglycerides and LDL on the clinical impedance analyzer. The rHEALTH's precision ranged from 3.1-8.0%, and the ISLH from 1.0-10.5%. The rHEALTH method provides similar results with the reference method and good correlation between adult capillary and venous blood samples. This demonstrates the ability of the rHEALTH to provide point-of-care assessment of normal and thrombocytopenic platelet counts from fingerprick blood with high precision and limited interferences.

Background Successful implementation of Basic life support (BLS) is critical to improving survival rates and outcomes, especially among healthcare workers. To our knowledge, there is no available literature pertaining to the level of BLS knowledge of health care professionals in Yemen. Methods Data was collected for this cross-sectional descriptive study from June to August 2020, using a 10-item questionnaire related to cardiopulmonary resuscitation (CPR) and BLS, along with questions on socio-demographic characteristics. Participants were nurses in public and private hospitals located in Al-Rahida and Al-dimna cities, Taiz governance and Hodeidah city, Hodeidah governance in Yemen. Results Out of 220 distributed questionnaires, 200 were returned with a response rate of 90.9%. More than a half (53.65%) of answer choices for BLS knowledge were correct. There was a significant difference in knowledge score based on level of education where those who had Bachelor degree had more knowledge ( P  = 0.000). Those who said they had received training in CPR or received information about CPR had significantly higher scores than those who did not receive ( P  = 0.000). Conclusions BLS knowledge among nurses in Yemen is below an acceptable level to ensure maximum survival in the event of cardiac arrest. Disseminating BLS information and training in a cost effective and efficient manner will provide a large benefit in terms of lives saved with minimal costs.