Background: Appendicitis is a common cause of emergency department visits and appendectomies in the US, with 250,000 appendectomies performed annually. Current diagnostic methods, such as clinical findings, lead to inaccuracies and missed diagnoses, increasing morbidity and mortality. The only solution is surgery, but current hematological tests are not reliable and may lead to unnecessary surgery if the underlying etiology is self-limiting or requires medical treatment. This study explores the role of MRI as a diagnostic modality that can replace US/CT and supplement traditional clinical diagnostic signs while avoiding ionizing radiation and intravenous contrast medium. The purpose of this meta-analysis is to determine the accuracy of MRI as a diagnostic modality in diagnosing appendicitis, addressing concerns about diagnostic modalities and their adverse effects, and addressing the necessity and success of relevant interventions. Methods: Medical literature was comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library, and Google Scholar databases for all relevant literature formulated in English. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. Meta Analysis was performed for 5206 patients, with 35 RCTs being selected. Analysis was done using the QualSyst tool, wherein two writers independently assessed the caliber of each study as well as the use of the Cochrane tool for bias risk apprehension. The statistical software packages RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20), and Excel in Stata 14 were used to perform the statistical analyses along with other analytical software. Results: MRI had an overall sensitivity of over 95%, an overall specificity of 94.2% with a PPV of 0.875 in comparison to CT scan in the diagnosis and intervention regarding appendicitis. Conclusion: These findings strongly suggest that MRI is a reasonable alternative to CT for the diagnosis of appendicitis in hospitals with appropriate access to this technology for reasons about accuracy, reliability, and reproducibility as well as addressing safety concerns.

Cytokine and AMH profiling were done in prepubertal Murrah buffalo heifers post-progesterone supplementation and co-synchronization protocol. Cytokines: IFNγ, IL6, IL1, IL13, TNFα, and TGFβ, and, AMH, Progesterone and Estrogen hormone estimations were done. Ovarian follicular pattern and fertility outcome were recorded. Eighteen prepubertal heifers, 15-17 months of age, 250-300 kg BWt were randomly divided into 3 groups, Group1: n=6, supplemented with altrenogest 0.044mg/kg/day/heifer orally for 14 days along with Co-synch programme; Group2: n=6, administered CIDR for 14 days and co-synch programme, Group3: n=6, received co-synch programme. Ultrasonography was done to ovarian follicle status on respective days of sampling. Pregnancy diagnosis was done around 45 and 60 post-AI. Estradiol 17-β level remained constant in altrenogest group, CIDR implanted and Control groups during the Progesterone treatment and Co-synch treatment. Estradiol levels during Co-synch were significantly less on day 9 of Co-synch (14.41 ± 1.97 pg/mL) than day 0 and on day7 in pre pubertal buffalo heifers in altrenogest group. However, no significance was observed in other groups. Progesterone levels in buffalo heifers subjected to synchronisation protocols varied significantly (P< 0.05) on day 7 of P4 treatment between altrenogest supplemented and CIDR implanted groups, as well as, Co-synch groups. Supplementation of altrenogest showed a significant (P= 0.043) increase in Progesterone levels by day 14 of altrenogest treatment. Progesterone varied significantly in all Groups on day 9 of co synch protocol [ Group 1 (P= 0.02), Group 2 (P= 0.041) and Group 3 (P= 0.007)]. Cytokine IFN-γ showed high correlation with progesterone, indicating the role of IFN-γ in puberty in buffalo heifers (r= 0.626, P< 0.01). AMH had a significant positive correlation supplemented with altrenogest with IFN-γ (r= 0.673, P< 0.01) and TGF-β (r= 0.463, P< 0.01), whereas, with TNF-α it was a negatively correlated (r= -0.34, P< 0.05). Based on Karl Pearson correlation coefficients, IL-13 and TGF-β could be considered as markers for puberty in buffalo heifers.

Introduction: Clostridium difficile is a gram-positive, spore-forming anaerobe and a leading cause of healthcare-associated diarrhea globally, primarily linked to antibiotic use. Its enzyme, Glutamate Dehydrogenase (GDH), plays a critical role in the metabolism of glutamate, and its detection has become a key diagnostic marker for C. difficile infection (CDI). This meta-analysis evaluates various diagnostic modalities used for GDH detection, focusing on their sensitivity, specificity, and clinical utility. Methods: A systematic search of PubMed, Google Scholar, and Cochrane Library was conducted. Studies comparing GDH testing with gold-standard methods (PCR, toxigenic culture) for CDI diagnosis were included. Data were extracted from eligible studies, and statistical analyses were performed to calculate pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC). Results: The pooled sensitivity and specificity of GDH testing were 93% and 92%, respectively. The DOR was calculated to be 30.98, and the AUC was 0.9794, indicating high diagnostic accuracy. GDH testing proved effective in identifying both infected and non-infected individuals, reducing false positives and negatives. Conclusion: GDH testing is a highly sensitive and specific diagnostic tool for CDI, supporting its role in clinical settings for early detection and intervention. Despite its strengths, variability in test performance suggests the need for further research to refine GDH-based protocols and ensure consistent outcomes across diverse healthcare environments.

Sustainability experienced significant global momentum in recent decades. The emergence of the sustainability movement in the Financial Sector was prompted by the increasing global climate change resulting from environmental deterioration. Primarily associated with the Financial Sector, it has increasingly been recognised that Financial Institutions are significant contributors to global climate change, both via direct and indirect means. This has resulted in a heightened emphasis and demand from stakeholders for the implementation of Sustainability Principles on a worldwide scale. This study presents a methodology that utilises the various dimensions of Sustainable Finance through the concept of Triple Bottom Line to determine the factors influencing the Sustainability Performance of Financial Institutions. The suggested approach is grounded and supported by the current body of literature. The study presents a hypothesis to investigate the correlation between factors of Green Finance Practices and Sustainability Performance of Banking Sector. The suggested framework can be utilised by regulatory bodies and individual financial institution of a country to identify the elements that influence the Sustainability Performance of Banking Sector.

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is one of the most frequent maternally inherited mitochondrial disorders.MELAS syndrome is a multi-organ disease that presents with a wide range of symptoms, such as dementia, epilepsy, lactic acidemia, myopathy, hearing loss, stroke-like episodes, diabetes, short stature, and myopathy. MELAS primarily affects tissue with high energy demands such as the brain, muscles, and heart. With 65–76% of affected people presenting at or before the age of 20, childhood is the typical age of onset. Genetic testing, imaging tests such as magnetic resonance imaging (MRI) scans, and other techniques, tests of blood, urine, and cerebrospinal fluid in addition to muscle biopsy (if necessary) may be used to diagnose MELAS syndrome. Management of MELAS remains largely supportive, focusing on symptom alleviation and metabolic stabilization. The long-term prognosis of MELAS is variable, influenced by factors such as age of onset, severity of symptoms, and presence of comorbidities. While some patients experience a relatively stable course with intermittent exacerbations, others may exhibit progressive neurological deterioration and multiorgan involvement. Early recognition, prompt intervention, and close monitoring are essential for optimizing outcomes and mitigating complications.Presenting here a case report of an occurrence of MELAS in a 31-year old male patient with chief complaints of perspiration, uneasiness and weight loss with increase in appetite and past history of bilateral hearing loss and vision loss in left eye.

In this research work, we describe the preparation process, characterization, and photo-physical studies of an ionic liquid (IL) based semiconductor Zinc Oxide (ZnO) nanoparticles synthesized by an economical wet chemical precipitation method. For the first time, an IL was synthesized with the help of a chemical reaction between triethylamine (TEA) and bromoacetic acid (BAA). A polyamide dye was prepared by a reaction between two monomers, ethylenediamine (EDA) and trimesoylchloride (TMC), under room temperature conditions. The polyamide dye was capped on ZnO nanoparticles, and the final product was divided into three different samples, A, B, and C, according to level of concentrations of IL and Polyamide dye. These samples were characterized with X-Ray Diffraction (XRD), Field Emission Scanning Electron Microscopy (FESEM), Dynamic Light Scattering (DLS) spectra, Ultraviolet-Visible (UV-Vis), and Fluorescence spectroscopies. The formation of polyamide linkages in the ionic liquid has been confirmed by a spectroscopic method using Fourier Transform Infrared (FTIR) spectroscopy. The capping of polyamide dye molecules on the surface of ZnO nanoparticles revealed two things: (i) improved UV absorption spectra and (ii) enhanced luminescence in the photoluminescence spectra. Hence, during investigations, broad absorption bands were observed at peaks 263 nm, 278 nm, and 276 nm respectively for samples A, B, and C. Further, IL was used as an electrolyte or redox mediator and polyamide as a dye material in the fabrication of ZnO Dye-Sensitized Solar Cells (DSSCs). The samples A, B, and C were used in the fabrication of photo-anode assemblies for ZnO DSSCs. The ZnO DSSCs were tested under strong simulated light at Air Mass (AM) 1.5 solar irradiations. The observed photovoltaic results shown that solar cell SCB generated a maximum power conversion efficiency (η) of 5.65%, higher than the power conversion efficiencies of solar cells SCA (3.99%) and SCC (4.46%) respectively. The Incident Photon to Current Conversion Efficiency (IPCE) spectra values of ZnO DSSCs shown a significant improvement in the incident photon to current conversion efficiency of solar cell SCB (IPCE=61%) as compared to SCC (enhanced by 6%) and SCA (enhanced by 4%). Such solar cell assemblies can be suitable for green and clean energy applications.

Alcoholic liver disease (ALD) develops when the immunotolerant environment of the liver is compromised due to excessive alcohol consumption. ALD progression involves variations in the expression of multiple genes, resulting in liver inflammation and the development of a leaky gut. Molecular mechanism involved for ALD progression is still unclear, and due to that there are currently no FDA-approved drugs available for its treatment. In this study, the protective effects of Graphene oxide nanoparticles (GO) was investigated against ethanol-induced damage in the gut-liver axis in in vitro. GO was synthesized using a modified Hummer's method and characterization was done. Given the general concerns regarding nanoparticle toxicity, assessment of cell viability, lipid accumulation, DNA damage, cell death, and the generation of reactive oxygen species (ROS) were conducted using various techniques. Furthermore, gene expression of pro- and anti-inflammatory cytokines was done using RT-qPCR. The findings revealed that GOs promoted cell viability even against ethanol treatment. Additionally, lipid accumulation significantly decreased when cells were treated with GO alongside ethanol compared to ethanol treatment alone, with similar trends observed for other assays. Gene expression analysis indicated that GO treatment reduced the expression of proinflammatory cytokines while enhancing the expression of antioxidant genes. Moreover, GO treatment led to improvements in gut permeability and a reduction in proinflammatory cytokines in colon cells damaged by ethanol. These findings suggest that GO holds promise as a drug carrier, exhibiting no observed toxic effects. By shedding light on the protective effects of GO against ethanol-induced damage, this study contributes to the burgeoning field of nanoparticle-mediated therapy for ALD.

The electronic cigarette or e-cigarette is the new alternative method to deliver nicotine. In 2007, the United States introduced vaping devices on the market. Due to their attractive taste and lack of adverse effects, these vaping devices have gained popularity among youth and adults. However, there has been increasing evidence that vaping can cause severe lung injury, and these devices release toxic chemicals into the body. E-cigarettes are recognized as a global threat to public health. Nicotine, the most prevalent chemical in vaping devices, is associated with neurological problems and cognitive decline. Long-term use of e-cigarettes can cause adverse health problems, including respiratory illnesses, asthma, bronchitis, and lung inflammation. In 2019, the Centers for Disease Control and Prevention (CDC) officially declared vaping-associated illness EVALI (e-cigarette or Vaping Product Associated Lung Injury). The US Surgeon General published an alarm in December 2016 that e-cigarette consumption among adolescents and teens in the US is a "major public health concern" and that more young people are now vaping than smoking traditional cigarettes and cigars. Since its commercial introduction in 2003, modern electronic cigarettes (or E-cigarette s) have become increasingly popular with smokers, non-smokers, and those who used to smoke who have switched to them. With such a rise in consumption, people are becoming more aware of the irritating, harmful, and perhaps cancer-causing effects on the lungs. (Chadi et al., 2019; Dinardo & Rome, 2019; Lyzwinski et al., 2022; Marrocco et al., 2022; O’Callaghan et al., 2022)

Sample size using prevalence has been one of the most important medical research methodologies and has been used in original articles more often than any other statistical tool available. The simple formula consists of variables interdependent and it is as important to understand how they influence each other as it is to learn to use the formula to calculate the sample size. With the choice of different amounts of precision and levels of confidence available to a medical researcher, it should be of paramount importance to understand what a slight change in choosing the parameter would mean at the end of the research. Understanding of different Z values, Levels of precision, and ranging Prevalence is required to understand the effect on the sample size and subsequently on the research. Topological representation using parameter ranges can be used to demonstrate this relationship.

Background/objectives: The health benefits of resistant starch are well known, but there have not been many studies available documenting the effect of basmati rice products containg resistant starch upon blood glucose level and lipid profile in vivo efficacy. Methods: Common cooking methods were used to prepare basmati rice products including two boiling methods viz. boiling 1 (boiling by absorption), boiling 2 (boiling in extra amount of water), frying and pressure cooking. The cooked rice were held at various temperatures and times: it was made fresh (T1), kept at room temperature (20–22°C) for 24 h (T2), kept at 4°C for 24 h (T3), and then reheated after being kept at 4°C for 24 h(T4). Next, the products' proximate composition, total dietary fibre (soluble and insoluble), resistant starch (RS), and In vitro starch digestion rate (rapidly and slowly digested starch) were examined. The effect of RS on blood glucose and lipid profile were measured in humans and rats. Histopathological study of liver and pancreas in rats were also observed. Results: The basmati rice prepared by boiling 1 and stored with T3 was found more effective to control blood glucose and lipid profile. Similarly in rats, the blood glucose level, cholesterol, triglycerides and LDL were reduced about 29.7, 37.9, 31.3 and 30.5% respectively, after consumption of basmsti rice prepared by boiling 1 and stored at T3. Conclusion: Rice products stored at 4⁰C have a high amount of resistant starh, insoluble dietary fibre, slowly digestible starch and low glycemic index. Thus helps to inhibit glycogen and lipid synthesis.

This article presents a narrative review of neonatal and paediatric complications in post-dated pregnancy and covers scientific views on the aetiology, pathology, risk factors, symptoms and complications of post-dated pregnancy. A pregnancy extending beyond 42 weeks of gestation is termed as a post term pregnancy. There are multiple complications that can occur in the perinatal period, some of the most common ones are stillbirth, asphyxia, meconium aspiration syndrome, fetal distress syndrome, etc which are found to be greater in post-dated pregnancy and hence ultimately leads to increased mortality and morbidity of the new born. Studies have shown that post-term pregnancy also causes increased risk of developing behavioural and emotional problems in children of paediatric age group. It is surprising not much importance has been given to the maternal and neonatal consequences of post- term pregnancies. It is not well understood why some women experience post-dated pregnancies. It is found that factors such as hormones and genetic build up, are responsible for causing post-term pregnancy in an obese female. The treatment and management of a post-term pregnancy still poses a challenge to clinicians in determining the right choice and right time for a particular intervention so that both mother and fetus can be prevented from having complications.

During the conceptual and preliminary design stage of a ship, designers need to ensure that the selected principal dimensions and parameters are good enough to deliver a stable ship (statically and dynamically) besides deadweight and speed. To support this, the initial intact stability of the proposed ship is required to be calculated, and in doing so, the lightship weight and its detailed breakdown are necessary to be known. After hull steel weight, machinery weight, mainly, marine propulsion and power generation machinery, play a vital role in the lightship weight estimate of a ship due to its robustness. The correct estimation of respective weights improves the accuracy of calculating a ship's initial stability typically to be designed and built. Hence, it would be advantageous for the designer to convince the ship owner. A total of 3006 marine propulsion (main marine diesel) engines and 348 power generation (auxiliary marine diesel) engines/generators of various power output (generators output for auxiliary engines), engine RPM and cylinder number of different engine makers are collected. These are analyzed and presented in both tabular and graphical forms to demonstrate the possible relationship between marine propulsion engine weight and power generation engine weight, and their respective power output, RPM, cylinder number, power-RPM ratio and power-RPM ratio per cylinder.In this article, the authors have attempted to investigate the behavior of marine propulsion engine weight and power generation engine/generator weight regarding engine power output, generator power output, engine RPM and cylinder number (independent variables). Further attempts have been made to identify those independent variables that influence the weight of the marine propulsion engine and power generation engine/generator (dependent variables), and their interrelationships. A mathematical model has thus been developed and proposed, as a guiding tool, for the designer to estimate the weight of main and auxiliary engines more accurately during the conceptual and preliminary design stage.

Parkinson's Disease (PD) is a neurodegenerative disorder that affects the motor system of the human body. Currently, the available treatments are limited and often have undesirable side effects. In this context, the aim of this study was to develop a novel combinational formulation of Apomorphine and Quetiapine and evaluate its efficacy in a rat model of PD. The formulation was prepared using the solvent evaporation technique and characterized for its physicochemical properties. The in-vitro drug release was evaluated using the Franz diffusion cell method, and the pharmacokinetics of the combination was studied in rats. The behavioural and biochemical parameters were evaluated in the rats using the Rotarod, pole test, and biochemical assays. The results showed that the developed formulation had satisfactory physicochemical properties and exhibited sustained drug release. The pharmacokinetic studies showed that the combination exhibited a longer residence time than the individual drugs. The behavioural and biochemical parameters showed that the combination was effective in improving motor function and reducing oxidative stress. In conclusion, the developed Apomorphine and Quetiapine combination formulation showed promising results in improving motor function and reducing oxidative stress in rat model of PD. Further studies are required to evaluate the safety and efficacy of the developed formulation in humans.

Although, Artificial intelligence (AI) helps experts with crime analysis, research, and understanding, it has a favourable influence on cyber security. It strengthens the tools that businesses use to safeguard their networks, clients, and workers against dangerous online behaviour. However, artificial intelligence is infamous for requiring a lot of resources. It may not, however, always be relevant. Additionally, it can provide hackers a new tool and advance their abilities. Actually, the VPN industry benefits from AI in the same way. The threat posed by machine learning in AI to user data privacy may be lessened by using a VPN on all of your devices. Because they use machine learning algorithms, VPNs are better equipped to shield their users from internet-based threats. Artificial intelligence (AI) has reportedly being investigated as a means of enhancing internet security for a considerable amount of time, according to Smart Data Collective. We anticipated that AI and machine learning will have a substantial impact on the future of cyber security around two years ago.

Rapidly progressive glomerulonephritis, the term coined for a subtype of nephritic syndrome, is characterized by a state of acute loss of renal function, along with those components of renal damage on urinalysis, over a relatively short period (a few weeks or months). It is the aftermath of an acute, severe glomerular injury. RPGN, famously known as Crescentic glomerulonephritis (cGN) is not a single disease entity but a pattern that can occur in a variety of glomerular diseases caused by different pathologic lesions leading to the development of necrosis in the glomerular capillaries seen in both, systemic and kidney-restricted diseases. While still little is known about the exact etiologic cause behind the primary injury to the capillary wall leading to the development of the condition, many mechanisms are put forth to describe the pathogenesis leading to the progression. Immunopathologic studies have demonstrated that rapidly progressive glomerulonephritis can result from glomerular antibody deposition, can be immune complex-mediated, or from some as yet undefined mechanism that doesn’t involve glomerular antibody deposition. The condition is often severe with poor prognosis as it develops so rapidly and with extensive glomerular involvement, the damage is almost irreversible. Many elements can be associated with the occurrence and progression of the disease but it often involves a disruptive immune response one way or the other. RPGN’s morphological hallmark, the extensive extra-capillary cellular proliferation into the bowman’s space, commonly known as crescent formation which is often observed by electron microscopic view of the tissue biopsy, is considered one of the great diagnostic approaches for the detection of the disease. Also, the severity of the disease is related to the nature and type of immunologic process causing the disease and (in part) to the degree of crescent formation, that can only be observed by histopathological studies. This activity attempts to explain the etiology and pathogenesis involved in the development leading to the rapid progression of the disease.

Osteoporotic vertebral fracture is the most common fracture from osteoporosis, and are largely undiagnosed due to the mostly asymptomatic nature of the condition. It increases the risk of subsequent fractures and contributes to societal burden. Risk factors for osteoporotic fractures are found in the WHO fracture risk assessment model and used as a tool for monitoring bone health. Vertebral fractures are diagnosed from anteroposterior and lateral spine radiographs and are confirmed with an approximate loss of 20% vertebral height as compared to adjacent vertebrae. One of the most used grading for vertebral fractures is the SQ grading. Mild vertebral fractures could easily be misdiagnosed due to some peculiarities of the vertebral column. CT scan is useful for planning surgical intervention while an MRI scan can provide information about the recency of the fracture and rule out cancer-related fractures. Management depends on the severity of the fracture which could range from conservative management to surgical vertebral augmentation and decompression. Bisphosphonates are used to treat osteoporosis in acute and long-term management of fractures. Osteoimmunological therapies such as denosumab and romosozumab are new therapeutic interventions for osteoporosis while there are many other potential treatment options. Precision medicine provides an individualized treatment approach while regenerative medicine utilizes mesenchymal stem cells for fracture repair.

Cosmetic surgery is the subfield of plastic surgery that enhances appearance mainly for aesthetic reasons. Currently, cosmetic surgery interventions are highly considered appealing and popular all around the world. Several factors have contributed in this rapidly evolving field such as scientific and economic development, breaking down barriers and cultural norms, globalization, social media and mental disorders. Nowadays, the morality of cosmetic surgery is facing many dilemmas due to its benefits and drawbacks. It is proven that the advantages of cosmetic surgery include improved body confidence, mental health, and function. Additionally, aesthetic corrections can upscale the quality of life and create career opportunities for special targeted groups. Also, cosmetic surgery has a major impact in gender affirmation procedures. Although, herein we also describe the disadvantages of this widely developing field such as minor and major medical complications, potential postoperative risks and addiction in plastic surgeries associated with damaging economic issues. Lack in self-confidence, altered mental health status and ethical crisis consist another negative aspects of aesthetic surgery’s impact.

Monitoring of clients living with HIV encompasses a specific array of activities that routinely check on various aspects of ART following its initiation depending on the availability of resources in that particular state, among other factors as per guidelines from the World Health Organisation. This is a significant practice as it promotes positive health outcomes for patients and efficient utilisation of ART regimens to reduce resistance to the medication – hence it is a measure to guard avoidable costs. It also forms a basis on which decisions are made from. It can be done clinically by assessing for signs e.g., skin rash and symptoms e.g., nausea and vomiting, checking vital organ function and measuring weights across all populations, or can be also be done by assessing specimens for their respective viral loads, white blood cell count, pregnancy status or other infections such as hepatitis B. There have not been any special indications required for one to be eligible for monitoring during ART in developing countries; all qualify for routine monitoring even though some may be more frequent than others in cases of comorbidities such as renal failure where medications can be attributed to exacerbating the condition.

SUDEP is a sudden death in a person with epilepsy, without evidence of a seizure before death. While its cause is still unclear, various factors have been linked to seizure onset and cardiopulmonary function. Studies have shown that although 91.3% of epilepsy patients want information on premature death, only 31% of them receive it. The numbers emphasize the need for open and sensitive communication by medical professionals. It is important to choose the appropriate moment for the conversation, avoiding periods of stress and ensuring emotional stability in the patient, as well as clear, appropriate and easy to comprehend information about SUDEP. To facilitate this, knowing the patient's level of knowledge is essential. Education on the warning signs of seizures and SUDEP can help take precautions and can decrease the incidence of the phenomenon itself. Effective epilepsy care requires a comprehensive plan, including medication adherence and lifestyle changes. Regular communication and collaboration between the patient, caregiver and health professionals are essential for the effective management of epilepsy, so just as epilepsy has a fluid, changeable course of disease and follow-up appointments are very important, the topic of SUDEP is not a one-time conversation either.

Drydocking a ship is essential to the routine maintenance process during its service/operational life. During the drydocking time, various surveys/inspections are carried out per requirements of the classification society, flag administration, and statutory bodies, particularly the underwater items. For shipyards, optimum utilization of drydock capacity (deadweight) is the most considered factor to optimize the physical performance indicators like drydock occupancy rate, capacity utilization rate, and drydock utilization. However, in real life, even after mobilizing all available resources to achieve the optimum usage rate, the overall physical performance could be higher or lower or not up to the expectation. The average size (deadweight) of ships calling to the drydock is observed to be far below the expected capacity, resulting in under-utilization of installed capacity. However, although the drydock occupancy rate is satisfactory, even 100%. For a substantial amount of time, the drydock has been under-utilized in terms of capacity utilization and drydock utilization rate. Drydocking activities of ships in two (2) drydocks of a shipyard are collected and analyzed. Various physical performance indicators (PPIs) are calculated. They are diagnosed year-wise and presented in tabular and graphical form to demonstrate their behavior over the operating period. Authors have investigated the behavior of the above-mentioned physical performance indicators to justify, technically, the selection of capacity of a drydock. A further attempt has been made to propose some recommendations and guidelines from technical viewpoints for the selection criteria of a drydock capacity based on available resources.

Diagnosing skin lesions can be a challenging task. Dermatologic lesions are hard to differentiate especially for an untrained eye. However, carefully analyzing every aspect of the lesion can help clinicians reach an accurate diagnosis. If diagnosed correctly with the naked eye, many lesions can be treated without the need for further histopathology or investigations. Those aspects include morphology, color, distribution, configuration and arrangement, texture and consistency, and any evolutions or changes within the lesion. Clinicians must also contextualize those lesions into the patient’s history and overall systemic symptoms and signs. Risk factors should be taken into consideration and whether there are evolutionary changes in the lesions. Clinicians should also look for patterns as they might be the key to diagnosis. If definitive diagnosis is still not reached, biopsy, dermatoscopy, cultures, skin scrapings, patch testing, blood tests, and imaging studies may be necessary for confirmation. Integrating these methods with clinical judgment and patient history significantly enhances the accuracy of diagnosis in dermatology. Treatment for dermatologic lesions varies depending on the underlying cause.

Distinguishing the level of pathology in the lungs through the sound of a cough is a complicated process that includes many factors. This paper explores the challenges of diagnosing lung pathology based solely on cough sounds. It emphasizes that while cough type can offer initial clues, it is just one piece of a complex diagnostic puzzle. For example, the differentiation of dry, productive, barking, hacking, and wheezing coughs provides initial insights into potential pathologies, which can range from respiratory infections to chronic diseases. The examination of cough characteristics, such as frequency, strength, and persistence, aids in identifying the severity of underlying conditions. Moreover, associated respiratory and systemic symptoms further contribute to the diagnostic landscape, with manifestations such as dyspnea, wheezing, chest pain, and hemoptysis offering valuable clinical information. Diagnostic tests, such as imaging studies and laboratory analyses, play a pivotal role in confirming diagnoses. However, challenges in diagnosis based solely on cough sounds require a more holistic approach, taking into consideration the complexity of lung pathologies. The paper concludes that accurately diagnosing lung pathologies based on cough sounds alone is difficult and requires careful consideration of multiple factors and stresses on contextualizing cough characteristics with other clinical features and diagnostic tests for an accurate assessment and comprehensive treatment planning.

Radiotherapy, also known as radiation therapy, is a treatment modality based on the use of high energy rays or radioactive substances, to damage tumoral cells and halt their growth and division. It is an effective tool for treating cancer of different kinds for more than 100 years with remarkable outcomes for cancer patients. This technique is characterised by notable technological innovations and methodologies, enhanced precision and effectiveness. Initially, precision and efficacy of radiotherapy are improved by technological advancements, such as the development of linear accelerators and brachytherapy. As a result, Radiotherapy has transformed the prognosis for cancer patients enhancing survival rates and improving quality of life. Also, it offers targeted and personalized treatment with advancements in imaging techniques such as Intensity-Modulated Radiation Therapy (IMRT) and Stereotactic Body Radiation Therapy (SBRT) and innovations like Image-Guided Radiation Therapy (IGRT), Adaptive Radiotherapy (ART) and Artificial Intelligence (AI). Additionally, techniques like proton therapy result in reduced side effects and collateral damage. Although, among the challenges and future perspectives we note the issue of affordability and accessibility. Ongoing research into immunotherapy and nanotechnology and their synergy with radiation therapy shows potential for further improving treatment outcomes. In conclusion, the evolution of radiotherapy has been a transformative journey, reshaping the prognosis and outcomes for cancer patients.

Background: COVID-19, a member of corona virus family is spreading its tentacles across the world due to lack of drugs at present. Associated with its infection are cough, fever and respiratory problems causes more than 15% mortality worldwide. It is caused by a positive, single stranded RNA virus from the enveloped coronaviruse family. However, the main viral proteinase (Mpro/3CLpro) has recently been regarded as a suitable target for drug design against SARS infection due to its vital role in polyproteins processing necessary for coronavirus reproduction.Objectives: The present in silico study was designed to evaluate the effect of Eucalyptol (1,8 cineole), a essential oil component from eucalyptus oil, on Mpro by docking study.Methods: In the present study, molecular docking studies were conducted by using 1-click dock and swiss dock tools. Protein interaction mode was calculated by Protein Interactions Calculator.Results: The calculated parameters such as RMSD, binding energy, and binding site similarity indicated effective binding of eucalyptol to COVID-19 proteinase. Active site prediction further validated the role of active site residues in ligand binding. PIC results indicated that, Mpro/eucalyptol complexes forms hydrophobic interactions, hydrogen bond interactions and strong ionic interactions.Conclusions: Therefore, eucalyptol may represent potential treatment potential to act as COVID-19 Mpro inhibitor. However, further research is necessary to investigate their potential medicinal use.

Still’s disease, also known as systemic juvenile idiopathic arthritis, is an autoimmune disorder with a triad of fever, salmon pink rash, and inflammatory polyarthritis. Its diagnosis is quite challenging due to the lack of specific symptoms and overlap with many other rheumatological and autoimmune disorders. However, recent studies have shown that high serum ferritin levels can act as a biomarker for this disease. Ferritin is an intracellular iron storage protein that acts as a pro-inflammatory reactant. There are various explanations indicating the presence of higher ferritin levels in Still's disease. High ferritin tells us about disease severity, and prognosis and can also predict life-threatening complications that can be easily prevented and thus it helps in reducing mortality associated with Still's disease. However, there are certain limitations to the use of ferritin as the only diagnostic marker for Still's disease. Overcoming those limitations can take the diagnosis of Still's disease to a higher level.

Measuring the impact of land use regulation on the land market involves identifying and classifying relevant impact factors related to the land market. The objective of this study was to identify land market impact factors in the context of the introduction of land use regulation in Nepal. A desktop review was carried out to identify preliminary set of impact factors, which were reclassified through intuitive analysis based on the degree of thematic closeness. Perspective-based impact factors were identified through the qualitative analysis of primary data collected through semi-structured interviews with the Nepalese land market stakeholders. These independently derived impact factors were compared with the desktop literature review impact factors resulting in fourteen land market impact factors across four dimensions, including transaction cost, valuation, mortgage availability, taxation, and compensation across the economic dimension; lot size, subdivision restrictions, and coordination across the institutional dimension; awareness, expectation and proximity across the social dimension; and risk reduction, quality of residential land, and suitability of zoning classification across the environmental dimension. There was significant overlap and commonality across factors identified from both the literature review and semi-structured interviews. The land market impact factors determined in the study may be adapted and generalized across other countries and could be utilized to better understand the impacts of land policy decisions on urban planning and development. Further research is recommended on the process to operationalize the use of these factors to quantify the impact of land use regulation on different land markets.

Internet of things security will be a big challenge for the enterprises working behind the build-up of the internet of things, and it’s application. With IoT, another buzzword is blockchain-based cryptocurrency bitcoin. Blockchain technology has proven itself as one of the most secured existing technology. In this paper, we have discussed the significant challenges that will come up in identity management due to the heterogeneity of devices. We have proposed a solution for privacy preservation using secure identity management and possible communication methodology by using public key-based cryptography used in the blockchain. We have taken the ecosystem of smart home management and smart health management. At last, we have concluded with the discussion of futuristic applications of blockchain in other applications of the internet of things.

Aim of study:Aim of this meta-analysis is to evaluate post-operative procalcitonin as a marker to predict post- operative infectious complications after pancreatic surgeries.Material and Methods:Systemic literature search was performed using MEDLINE, EMBASE and to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) as a predictor for detecting infectious complications on postoperative days (POD) 3 and 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters for POD 3 and 5 were derived. Geometric means were calculated for PCT cut offs. Results:6 studies included day 3 PCT analysis, 2 studies included both day 3 and day 5 analysis. Total data of 471 patients were derived. 161 patients developed infectious complications. Pooled sensitivity, specificity, pooled area under curve, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 3 PCT were 74%,79%,0.8453, 11.03,3.17 and 0.31 respectively. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 5 PCT were 83%,70%,12.91,2.91 and 0.25 respectively. Geometric means for PCT cut off for day 3 and 5 were 0.80 and 0.43. Conclusion:Postoperative procalcitonin particularly day 3 procalcitonin levels predict post-operative infectious complications following pancreatic surgeries.

Genetic variability in rice breeding program plays the very crucial role. It provides outstanding pool of superior alleles governing better agronomic and quality characters through association mapping. For the understanding of population structure and genetic relationship among the different rice lines is indispensable prior to setting of correlation among dynamic alleles and traits. In the present investigation, genetic diversity and population structure of 116 rice accessions by using 64 polymorphic SSR markers was targeted for the evaluation of the genetic relatedness and diversity. Genotyping assessment based on SSR markers revealed a total of 225 alleles, with an average PIC value of 0.755. The germplasm lines were classified into three distinct subgroups through population structure analysis, utilizing both model and distance-based approaches. AMOVA analysis showed that 11% of the total variation could be attributed to differences between groups, while the remaining 89% of the variation was likely due to differences within groups. The study suggests that the population structure and genetic relatedness should be considered when working with the core collection of 116 rice germplasm lines for association mapping, aiming to establish marker-trait associations.

Aims: Primary AIM of the study was to evaluate effect of prolonged hospital stay on Surgical site infections We also evaluated effect of prolonged hospital stay on overall morbidity in Gastrointestinal and Hepatobiliary Surgery as secondary outcome. Methods: We retrospectively analysed all the patients who underwent gastrointestinal and hepatobiliary surgery between April 2017 to March 2020. On our analysis we found mean hospital stay in patient who did not develop SSI and/or morbidity was 4 days (Total hospital stay) vs 6 days who developed morbidity (hospital stay before diagnosis of SSI or diagnosis or morbid event). Based on this to avoid selection bias, we did 1:1 propensity score analysis between patients who had 4 or less than hospital stay vs patients who had 5 or more hospital stay before diagnosis of surgical site infection and/or morbid event. We took all the preoperative and intraoperative factors like Age, sex, malignant disease, ASA score, CDC grade of surgery, open or laparoscopic surgery, HPB surgeries, colorectal surgeries, Upper Gastrointestinal surgeries and small intestinal surgeries as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: We included 348 patients operated between April 2017 and March 2020 in our analysis. After 1:1 propensity score matching 58 patients included in study arm (prevent hospital stay more than 4 days) and 56 patients in control arm. Both groups were comparable with regard to Age, Sex, Surgery for malignant disease, ASA score, CDC grade of surgery, HPB surgeries, Small intestinal surgeries, Colorectal surgeries, upper gastrointestinal surgeries, intraoperative blood product requirement, intraoperative hypotension or any other event, operative time. Prolonged hospital stay (> 4 days) was significantly associated with surgical site infections (p<0.0001), morbidity (p=0.001). Open surgeries were associated with prolonged hospital stay. (p=0.032). Conclusion: Prolonged Hospital stay is associated with increase surgical site infection and morbidity in Gastrointestinal and Hepatobiliary Surgery.

Brown-Séquard Syndrome (BSS) is a rare spinal cord injury characterized by asymmetrical motor and sensory dysfunction. Trauma to the spinal cord, particularly the hemi section, is the primary cause. Diagnosis involves a thorough medical history, physical examination, and imaging studies. Treatment focuses on stabilization, rehabilitation, and potential emerging therapies. This article provides a comprehensive overview of BSS, including its causes, symptoms, diagnosis, and treatment.

AIM: Aim of our study was to evaluate incidence and causative factors for acute kidney injury in gastrointestinal and hepatobiliary surgeries. Material and methods: All the gastrointestinal surgeries performed between April 2018 to March 2020, in our institution have been analysed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi square test and continuous variables by Mann Whitney U test. Statistical analysis was done using SPSS version 23. P< 0.05 was considered significant Results: We performed 331 gastrointestinal and hepatobiliary surgery from April 2018 to March 2020. After exclusion 317 patients were included in study population.14 patients (4.4%) were defined as having acute kidney injury according to acute kidney injury network classifications. On univariate analysis acute kidney injury was associated with open surgery (p= 0.002, Intra operative hypotension (p=0.006), CDC grade of surgery (p<0.001), increased used to blood products (p=0.004), higher ASA grade (p<0.0001), increased operative time(p<0.0001). On multivariate logistic regression analysis higher ASA grade (p=0.001) and increased operative time (0.015) independently predicted acute kidney injury. Acute kidney injury was also significantly associated with 90 days mortality. ( p= <0.0001) Conclusion:Post-operative acute kidney injury was associated with significant mortality in gastrointestinal and hepatobiliary surgery. Open surgery, higher CDC grade surgery, more blood products, higher ASA grades, increase operative time predicted acute kidney injury in post operative periods. Higher ASA grades and increased operative time predicted acute kidney injury.

Historically, urban development has always been centered on coastal areas – with access to waterbodies – seas, rivers and canals being a significant advantage for movement and trade. With most of the world’s megapolises located on coasts, land reclamation offers a solution for the expansion of city centers which are otherwise restricted by the coastline. The current understanding of urban regeneration and development on reclaimed lands is defined in this study, answering the basic questions of what, why and how. This study aims to assess the urban regeneration on reclaimed coastal land based on the principles of sustainable development defined by existing studies. The literature review establishes a theoretical framework and defines performance-based benchmarks identifying the spatial indicators of urban development. Composite indicators namely open space coverage, land use mix, percentage of coast for people, accessibility to public transportation and amenities, availability of pedestrian paths and cycling tracks and adequate road networks are considered for this framework. The conclusions are drawn based on the results of the analysis of spatial layout using GIS as a tool to map and empirically measure each indicator. The framework is validated using a major land reclamation project, West Bay, in the coastal urban area of ​​the city of Doha. The results determine that West Bay has achieved a good level of sustainability, although there are areas that could be enhanced to further improve the overall sustainability of urban development. These findings can serve as a guide for policymakers and various stakeholders for sustainable urban planning on reclaimed coastal lands.

Aim: Aim of our study to evaluate various factors responsible for surgical site infection after gastrointestinal and hepatobiliary surgeries. Material and Methods: Patient who underwent gastrointestinal and hepatobiliary surgery in our department were evaluated retrospectively. Various factors associated with surgical site infection were evaluated using univariate and multivariate analysis. Surgical site infection was defined as any culture positive discharge from the wound within 30 days of surgery.Statistical analysis was done using SPSS version 23. Results: We evaluated total 331 patients operated between April 2018 to March 2020. 14 patients were lost to follow up after discharge and before completing post operative day 30. 18 patients expired before 30 days without developing SSI and were excluded from the study as per exclusion criteria. 299 patient included in the study. Total 20 patients developed surgical site infection. It showed SSI rate in our study population was 6.68%. On univariate analysis prolonged hospital stay, more blood product used, higher cdc grade of surgery, higher ASA grade, more operative time, open surgeries,colorectal and HPB surgeries were associated with surgical site infections. On multivariate analysis only prolonged hospital stay independently predicted Surgical Site Infectins. (p=0.014,0dds ratio 1.223, 95% confidence interal 1.042-1.435). Conclusion: Prolonged hospital stay independently predicts surgical site infections after gastrointestinal and hepatobiliary surgery.

Epilepsy, a disorder of unprovoked recurring seizures, continues to be seen as a growing medical concern worldwide. It represents the most common, non-communicable brain disorder, affecting persons of all ages. Every year over five million persons are formally diagnosed with epilepsy when seeking medical care. Often diagnosed as a young child, most persons can live a seizure-free life once there is an early diagnosis, proper patient education, and keen clinical management. However, the reoccurrence of status epilepticus, a neurological emergency, can be linked to untreated underlying causes and lead to serious morbidity and even early mortality if not properly managed. The prognosis is heavily reliant on the discovery of the underlying cause. Epilepsy, in recent times, provides a terminology for ease of identification of the associated clinical symptomology. Epilepsy, an umbrella term, can manifest differently as either idiopathic, symptomatic, or cryptogenic. However, distinguishing epilepsy from other seizure mimics is critical to preventing complications. Epilepsy research, like many other neurological symptoms, is limited in low-resource areas. Therefore, through greater awareness of epilepsy and public education campaigns, better health outcomes can be achieved. There is huge utility in clear communication of medical information among healthcare providers as well as in optimizing treatment plans.

Head trauma or any traumatic injury can cause damage to parts of the brain. The most important part regulating the body are the hormones and the two centers of brain which are main ones for this regulation are the most prone to getting injured. The hypothalamus and pituitary regulate a lot many functions and the loss of these organs can cause Adrenal Insufficiency, SIADH, Diabetes Insipidus, and many more.

Individuals with BPD grapple with unstable relationships, marked by extreme emotional swings and interpersonal conflicts. Emotional instability, a distorted self-image, and impulsivity further complicate matters, often leading to self-harm and suicide attempts as desperate coping mechanisms. Genetics and adverse childhood experiences contribute to BPD's development, shaping brain function and emotional regulation. Diagnosis involves meticulous assessments, paving the way for personalized treatments like dialectical behavior therapy and, in severe cases, hospitalization. Early intervention, professional support, and societal understanding are pivotal for positive outcomes, and challenging mental health stigma.

Multi-morbidity and polypharmacy are common in older people and pose a challenge for health and social care systems especially in context of global population ageing. They are complex and interrelated concepts in the care of older people that require early detection and patient centred decision making that are underpinned by the principles of multidisciplinary led comprehensive geriatric assessment (CGA). Personalised care plans need to remain responsive and adaptable to the needs of a patient, enabling an individual to maintain their independence.

Mesothelioma of the peritoneum is the second most prevalent type. The peritoneum, the membrane lining the abdomen and abdominal organs, is affected in this type of cancer. A common risk factor is exposure to asbestos. There isn’t a cure, but surgery, chemotherapy, and palliative care can improve your prognosis and quality of life. Here we present a case of a 47-year-old female with peritoneal mesothelioma.

Diabetic striatopathy (DS) is characterized by a hyperglycaemic state associated with chorea/ballism, and/or striatal hyper density on computed tomography, or hyperintensity on T1-weighted magnetic resonance imaging. To date, there have been only a few case series reported in the literature on this topic. We present an acute case of DS which delineates the clinical presentation, imaging and instrumental examinations, typical radiological findings, and therapeutic approach of this condition. The purpose of this case report is to to remind clinicians to consider DS when poor-controlled diabetic patients present with symptoms such as altered sensorium, sudden-onset choreiform and ballistic movements.

The present study aims to elucidate the effect of melatonin (MEL) on dexamethasone (DEX)-induced reproductive impairments in rats. Rats were procured and acclimatized with adequate food and water ad libitum. Twenty-four rats were divided into four groups (six in each) of Control, DEX (70µg/100g bw), DEX plus MEL, and MEL (200µg/100g bw) for 21 days. After completion, rats were sacrificed, and testes were dissected, weighed, and processed for biochemical, and receptor expression. Serum was collected for hormonal assay. DEX-treated rats showed a significant increase in lipid peroxidation (TBARS), a decrease in weight of the body and testes, and the level of antioxidative enzymes (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione oxidase (GSH), glutathione reductase (GR), glucose 6-phosphate dehydrogenase (G6PDH), glutathione S-transferase (GST)), total cellular protein content, serum testosterone, corticosterone, LH, FSH, melatonin levels, AR, MT1, and MT2 receptor expression. Marked cellular alterations were noted in the testis histology of the DEX group. Melatonin treated in DEX rats showed recovery and restoration in gravimetric, serum hormonal, biochemical parameters, receptor expression, and cellularity of testes. Therefore, findings suggest that melatonin improved defence against DEX-induced testicular damages suggesting its therapeutic potential for the management of male reproductive health.

The COVID-19 pandemic has highlighted the need for a robust medical infrastructure and crisis management strategy as part of smart-city applications, with technology playing a crucial role. The Internet of Things (IoT) has emerged as a promising solution, leveraging sensor arrays, wireless communication networks, and artificial intelligence (AI)-driven decision-making. Advancements in Edge Computing (EC), Deep Learning (DL), and Deep Transfer Learning (DTL) have made IoT more effective in healthcare and pandemic-resilient infrastructure. When combined with medically oriented IoT setups, DL-architectures are suitable for integrating into pandemic-compliant medical infrastructure. The development of intelligent pandemic-compliant infrastructure requires combining IoT, edge and cloud computing, image processing, and AI tools to monitor adherence to social distancing norms, mask-wearing protocols, and contact tracing. The proliferation of 5G wireless communication has enabled ultra-wide broadband wireless communication, with high reliability and low latency, thereby enabling seamless medical support as part of smart-city applications. Such set-ups are designed to be ever-ready to deal with virus-triggered pandemic-like medical emergencies. This study presents the design of a pandemic-compliant mechanism leveraging IoT optimized for healthcare applications, edge- and cloud-computing frameworks, and a suite of DL-tools. The framework uses a composite attention-driven framework incorporating various DL-pre-trained models (DPTM) for protocol adherence and contact tracing. When connected to public networks, it can detect specific cyber-attacks. The results confirm the effectiveness of the proposed methodologies.

This paper presents a novel approach to designing beam codebooks for downlink multiuser hybrid multiple input multiple output (MIMO) wireless communication systems, leveraging multi-agent reinforcement learning (MARL). The primary objective is to develop an environment-specific beam codebook composed of non-interfering beams, learned by cooperative agents within the MARL framework. Machine learning (ML) based beam codebook design for downlink communications have been based on channel state information (CSI) feedback or only reference signal received power (RSRP) consisting of an offline training and user clustering phase. In massive MIMO, the full CSI feedback data is of large size and is resource-intensive to process, making it challenging to implement efficiently. RSRP alone for a stand-alone base station is not a good marker of the position of a receiver. Hence, in this work, uplink CSI estimated at the base station along with feedback of RSRP and binary acknowledgment of the accuracy of received data is utilized to design the beamforming codebook at the base station. Simulations using sub-array antenna and ray-tracing channel demonstrate the proposed system’s ability to learn topography-aware beam codebook for arbitrary beams serving multiple user groups simultaneously. The proposed method extends beyond mono-lobe and fixed beam architectures by dynamically adapting arbitrary shaped beams to avoid inter-beam interference, enhancing overall system performance. This work leverages MARL’s potential in creating efficient beam codebooks for hybrid MIMO systems, paving the way for enhanced multiuser communication in future wireless networks.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of the coronavirus disease 2019 (COVID-19) pandemic which has been a topic of major concern to global human health. The challenge to restrain the COVID-19 pandemic is further compounded by the emergence of several SARS-CoV-2 variants viz. B.1.1.7, B.1.351, P1 and, B.1.617., which show in-creased transmissibility and resistance towards vaccines and therapies. Importantly, the likelihood of susceptibility to SARS-CoV-2 infection among individuals with dysregulated immune response or comorbidities needs greater attention. Herein, we provide a comprehensive perspective regarding ongoing vaccine (mRNA, protein-based, viral vector based etc.) and therapeutic (mono-clonal antibodies, small molecules, plasma therapy, etc.) modalities designed to curb the COVID-19 pandemic. We also discuss in detail the challenges posed by different SARS-CoV-2 variants of concern (VOC) identified across the globe and their effects on therapeutic and prophylactic interventions.

Abstract: The glucocorticoid receptor (GR), including both alternative spliced isoforms (GRa and GRb), has been implicated in the development of primary open-angle glaucoma (POAG) and iatrogenic glucocorticoid-induced glaucoma (GIG). POAG is the most common form of glaucoma, which is the leading cause of irreversible vision loss and blindness in the world. Glucocorticoids (GCs) are commonly used therapeutically for ocular and numerous other diseases/conditions. One serious side effect of prolonged GC therapy is the development of iatrogenic secondary ocular hypertension (OHT) and OAG (i.e. GC-induced glaucoma (GIG)) that clinically and pathologically mimics POAG. GC-induced OHT is caused by pathogenic damage to the trabecular meshwork (TM), a tissue involved in regulating aqueous humor outflow and intraocular pressure. TM cells derived from POAG eyes (GTM cells) have lower expression of GRb, a dominant negative regulator of GC activity, compared to TM cells from age-matched control eyes. Therefore, GTM cells have a greater pathogenic response to GCs. Almost all POAG patients develop GC-OHT when treated with GCs, in contrast to a GC responder rate of 40% in the normal population. Increased expression of GRb can block GC-induced pathogenic changes in TM cells and reverse GC-OHT in mice. Endogenous expression of GRb in the TM may relate to differences in the development of GC-OHT among the normal population. A number of studies have suggested increased levels of endogenous cortisol in POAG patients as well as differences in cortisol metabolism, suggesting that GCs may be involved in the development of POAG. Additional studies are warranted to better understand the molecular mechanisms involved in POAG and GIG in order to develop new disease modifying therapies to better treat these two sight threatening forms of glaucoma.

The Voltammetric and polarographic methods are proposed to determine the short time corro-sion rates of brass in 1N HCl solution. It should be noted that it is also possible to determine the corrosion rates of each species present in the solution, simultaneously like Cu (II) and Zn (II) in brass. Samples extracted from bark of Babul (ESBB) is used as corrosion inhibitors. The corrosion inhibition efficiency is 96% at 24h after the test started. These results are compared with the av-erage corrosion rates obtained by using gravimetric (PIT) and some electrochemical methods i.e. galvanostatic and potentiodynamic polarization measurements.

Background: There is ongoing debate regarding the usefulness of laparoscopic pancreaticoduodenectomy. This study aimed to analyze all the randomized control trials published including the most recent one. Material and methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2. The random-effects models were used to summarise the relative risks, odds ratios, and mean differences as appropriate.Results:4 RCTs were included consisting of 818 patients. 411 patients were in the laparoscopic group and 407 in the open pancreaticoduodenectomy group. Weighted baseline patient characteristics were similar except more patients with pancreatic adenocarcinoma and more males were there in the open pancreaticoduodenectomy group. There was no difference in-hospital stay,90 days complications rate, 90 days mortality, R1 resection, postoperative pancreatic fistula, delayed gastric emptying, post pancreatectomy hemorrhage, bile leak between the two groups. Operative time was more in the laparoscopic group. Blood loss [mean difference -132.12 ml (-172.60,-91.65)] and surgical site infection [Risk ratio 0.41 ( 0.17-1.0)] were significantly lesser in laparoscopic group.Conclusion:There was no benefit in-hospital stay or clinical outcomes after laparoscopic pancreaticoduodenectomy. Blood loss and surgical site infection were lesser in laparoscopic pancreaticoduodenectomy.

Aims and objectives: The primary aim of our study was to evaluate morbidity and mortality following feeding jejunostomy in pancreaticoduodenectomy compared to the control group. We also evaluated individual complications like delayed gastric emptying; post operative pancreatic fistula, superficial and deep surgical site infection. Material and Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2.the random-effects model was used. Results: Four studies including Total of 1639 patients were included in the analysis. Total 843 patients were included in Feeding jejunostomy group and 796 patients included in control group without feeding jejunostomy. Over all morbidity was significantly higher in feeding jejunostomy group. (P = 0.001). There was no significant difference between both the groups. (P=0.07). Delayed gastric emptying was significantly higher in feeding jejunostomy group. [P=0.021]. There was no significant difference in development of pancreatic fistula between the two groups. Deep surgical site infection was significantly higher in feeding jejunostomy group. (P=0.013). Hospital stay was significantly more in feeding jejunostomy group (p<0.0001). There was no significant difference between readmission; TPN requirement and time to start oral feed. Conclusion: Feeding jejunostomy seems to be associated with increased morbidity and increased length of stay.

How to align leg segments between the four groups of arthropods (insects, crustaceans, myriapods, and chelicerates) has tantalized researchers for over a century. By comparing the loss-of-function phenotypes of leg patterning genes in diverged arthropod taxa, including a crustacean, insects, and spiders, we show that all arthropod legs can be aligned in a one-to-one fashion. We propose a model wherein insects incorporated two proximal leg segments into the body wall, which moved the ancestral leg lobe (exite) up onto the back to later form wings. For myriapods and chelicerates with seven leg segments, it appears that one proximal leg segment was incorporated into the body wall. According to this model, the chelicerate exopod and the crustacean exopod emerge from different leg segments, and are therefore proposed to have arisen independently. A framework for how to align arthropod appendages now opens up a powerful system for studying the origins of novel structures, the plasticity of developmental fields, and convergent evolution.

The importance of a properly regulated immune response has been explored through various research-oriented methods. It has proved that having an effective and well-regulated immune response helps prevent many minors and serious diseases. Any kind of dysregulation in the working of the immune system may lead to severe consequences. An autoimmune disorder is one such consequence in which the component of the immune system starts targeting self-cells of the body, treating them as self-antigen producing autoantibodies and immune complexes resulting from the failure of immune responses both at a central and peripheral level. Currently, many autoimmune disorders are prevailing across the world, and new diseases need attention.In this review, we have written about the functions of T cell, LncRNAs and also some interactions between the LncRNAs and miRNAs in the pathogenesis of Multiple sclerosis (MS), Systemic lupus erythematosus (SLE), Type 1 diabetes (T1D), Rheumatoid arthritis (RA). To find the functions of these autoimmune disorders we have done intensive literature search during this we also found that GAS5 and MALAT are common in MS, SLE, T1D, RA. And finally, we have also mentioned the therapeutic drugs which neutralizes the different cluster of differentiation (CDs) and also suppresses the T cell differentiation in MS, SLE and RA. For T1D therapeutic strategies and various types of insulin are mentioned.

BackgroundHeart failure is a life-threatening disease affecting millions worldwide. Tolvaptan is the first FDA-approved orally active nonpeptide vasopressin 2 receptor antagonist to be used in hypervolemic hyponatremia, heart failure, cirrhosis, etc. In clinical trials, tolvaptan impacts short-term in increasing water excretion, and restoring Na+ and dyspnoea. Aims & ObjectivesThe objective is to analyze the outcomes of tolvaptan in existing cases of heart failure. MethodologyWe conducted a database search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials and RCTs till 1st September 2019 were included following PRISMA guidelines after being matched with inclusion and exclusion criteria. 21 RCTs were included with 7,357 patients receiving tolvaptan and 7,273 patients being the control group. We used the MESH strings such as 'tolvaptan', 'vasopressin V2 receptor blocker', 'acute heart failure', and 'acute decompensated heart failure'. ResultsMeta-analysis showed that Tolvaptan was associated with a significant reduction in edema (RR = 1.05, 95% CI = 1.019-1.081, p=0.001) and significant body weight reduction (Control-SMD = -0.489, 95% CI =-0.637 to -0.342, p<0.001)&(Placebo-SMD = -0.425, 95% CI = -0.425 to -0.382, p<0.001) It shows significant decrease in serum sodium levels (SMD = 0.678, 95% CI = 0.609 to 0.748, p<0.001). There was no significant decrease in all-cause mortality (Control-RR = 0.855, 95% CI 0.470 to 1.555, p=0.607)(Placebo-RR= 0.972, 95% CI = 0.879-1.074, p=0.575). Results for Worsening renal function in heart failure (Placebo-RR = 0.798 95% CI 0.619 to 1.028, p=0.081)(Control-RR = 1.349, 95% CI=0.927-1.964, p=0.118). ConclusionAlthough tolvaptan may significantly reduce edema, congestive symptoms and decreased body weight, it has no impact on all-cause mortality and worsening renal function in heart failure.

Rhombencephalosynapsis (RES) is a rare, congenital developmental disorder of the central nervous system. Even after many years of its identification, the etiology and pathogenesis of RES remain unclear. It occurs in combination with many syndromes and thus has overlapping symptoms. The clinical presentation of this disorder varies depending on the severity of the maldevelopment of vermis. Here, we present a case of a 60-year-old Indian female diagnosed with Rhombencephalosynapsis. Clinical and MRI characteristics of RES along with treatment options have been discussed.

Presenting a case report about a 14-year-old female patient presenting with a history of weakness in all four limbs since the age of 5. The patient has a history of difficulty in walking, wearing footwear, climbing stairs, and performing fine motor tasks. During the neurological examination showed mild spasticity, muscle weakness, areflexia, ill-sustained clonus, and sensory deficits. Radiological examination, including a contrast-enhanced MRI of the brain was done which showed findings that are consistent with Megalencephalic leukoencephalopathy with subcortical cysts, also known as Van der Knaap disease.

CLIPPERS which stand for Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids, is a chronic inflammatory disorder of the central nervous system. The aetiology of CLIPPERS remains unclear, although its pathogenesis shows immune-mediated processes. The diagnosis of CLIPPERS is challenging without a specific biomarker hence, it is important to consider if both the clinical and radiological features are consistent with the diagnosis, or rather any other disease that mimics CLIPPERS. The Authors present a case of a 40-year-old Female patient diagnosed with CLIPPERS syndrome in India. Differential diagnosis, clinical and MRI characteristics of CLIPPERS syndrome, and treatment approaches are discussed.

Presenting a case report about an occurrence of duodeno-duodenal intussusception in a 17-year-old female patient. Intussusception is typically observed in children. The patient has a history of recurrent pain and vomiting for four days. During the examination tenderness in the epigastric area worsened when the legs were elevated. An initial X-ray of the abdomen was done and the findings were normal. Subsequent ultrasound and abdominal CECT scans of the abdomen revealed intussusception involving the 2^nd, 3^rd, and 4^th part of the duodenum ampulla of Vater and pancreas without any identifiable cause for this condition. There was no abnormal thickening of the wall. This case shows how using radiological imaging and surgical management helps to prevent severe complications in cases like duodeno-duodenal intussusception in adults.

Background: World Health Organization (WHO) declared that COVID-19 as a pandemic on March 11, 2020. There is sudden need of statistical modeling due to onset of COVID-19 pandemic across the world. But health planning and policy requirements the estimates of disease problem form clinical data. Objective: To predict recovery rate, cases load rate on the basis of cumulative confirmed Novel Corona virus (NCV) cases, recovered cases and deaths form COVID-19 in India. Methods: The reported COVID-19 cases in the country were obtained from website (https://datahub.io/core/covid-19#resource-covid-19_zip/). The cumulative NCV confirmed cases; recovery cases and deaths were used for estimating recovery rate, cases load rate and death rate till date 24 April 2020. Results: A total of 24530 NCV confirmed cases were reported nationwide in India on 24 April 2020. It is found that the recovery rate increased 22% and case load rate decreased 74%. Death rate is found to be very low 3%. The difference of cases load rate and recovery rate (delta) coincide at 50 % then NCV cases expected would be declined. Conclusion: The epidemic in the country was mainly caused by the importation of India. Lockdown as restricting the migration of population and decided to quarantine of population may greatly reduce the risk of continued spread of the epidemic in India. This study predicts that by 20 May 2020, the cases load rate lesser than recovery rate there after COVID-19 patients would be started to reducing.

Lung cancer, globally recognized as the leading cause of cancer-related mortality, presents a pressing need for innovative treatment strategies. Increasing evidence points towards the potential of monoamine oxidase (MAO) inhibitors in modulating cancer progression, primarily due to their role in regulating cellular metabolism and apoptotic pathways. This extraordinary study delves into the multifaceted therapeutic implications of MAO inhibitors in lung cancer management, elucidating their ability to pave the way for clinical advancement via novel targets and pathways. Capitalizing on recent advances in molecular biology, this research explores the molecular mechanisms underlying the anticancer actions of MAO inhibitors. By examining their impact on cell proliferation, migration, invasion, and apoptosis in lung cancer cell lines, we provide insight into the intricate signaling pathways and biochemical processes modulated by these compounds. The study also investigates the synergistic effects of MAO inhibitors in combination with established chemotherapeutic agents, elucidating their potential to enhance treatment efficacy and reduce cytotoxicity. Furthermore, we delve into the implications of MAO inhibitors on the tumor microenvironment, evaluating their influence on angiogenesis, immune regulation, and the epithelial-mesenchymal transition. This comprehensive analysis enables the identification of novel molecular targets, which hold promise for the development of advanced therapeutics tailored for specific lung cancer subtypes. To substantiate our findings, in this review, we thoroughly analyze the existing literature using state-of-the-art bioinformatics tools." in vivo orthotopic lung cancer models, and clinical patient cohorts. This robust and multidisciplinary approach permits the generation of clinical evidence supporting the integration of MAO inhibitors in lung cancer management. Conclusion: This ground-breaking study establishes the therapeutic potential of monoamine oxidase inhibitors in lung cancer management by unearthing novel pathways and targets for clinical advancement. The outcomes open doors for the development of innovative treatment strategies and inspire continued research efforts to combat the global burden of lung cancer.

In recent years, antimicrobial resistance in many human pathogens has become a serious health concern. Since infections with resistant pathogens cannot be treated with traditional antimicro-bial drugs, new strategies are necessary to fight bacterial infections. Hybrid nano-systems may provide a solution to this problem, by combining multiple mechanisms for killing bacteria to synergistically increase the effectiveness of the antimicrobial treatment. In this review, we high-light recent advances in the development of hybrid nano-systems for the treatment of bacterial infections. We discuss the use of hybrid nano-systems for combinational therapy, focusing on various triggering mechanisms for drug release and the development of biomimetic nanomateri-als. We also examine inherently antimicrobial nano-systems and their uses in preventing infec-tions due to wounds and medical implants. This review summarizes recent advances and pro-vides insight into the future development of antimicrobial treatments using hybrid nanomateri-als.

Aims and Objectives: Our primary aim was to study association between nonsurgical techniques related complications and mortality and our secondary aim was to determine factors responsible for non surgical technique related complications. Material and Methods: All gastrointestinal and hepatobiliary procedures performed in last 3 years have been evaluated retrospectively. Nonsurgical procedure related postoperative complications were defined as perioperative complications nonrelated to surgical procedures or techniques and related to patients’ physiological health or comorbidities. To avoid selection bias in attempt to evaluate effect of non-surgical procedural related complication on mortality, we did 1:1 propensity score matching analysis with nonsurgical technique related complications as dependent factor. Propensity scores were calculated using logistic regression. Pre operative confounding factors like age, sex, American society of Anesthesia score (ASA), emergency surgery, type of surgeries like HPB surgeries, Upper gastrointestinal surgeries, small bowel surgeries, colorectal surgeries, hernia surgeries, open or laparoscopic surgeries were entered in model as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: Total 348 patients underwent various abdominal surgeries (gastrointestinal and hepatobiliary) in our department from April 2017 to March 2020. Total 24 patients developed nonsurgical technique related complications. Before Propensity score matching nonsurgical technique related complications were significantly higher in Upper Gastrointestinal surgeries (gastric and esophageal), emergency surgeries, Open surgeries, in patients who developed intraoperative hypotension, patients operated for malignancies, patients with higher ASA grades, patients in whom more blood products were used and patient who had more operative time. ASA scores independently predicted nonsurgical technique related complications. [P=0.001. Odds Ratio 3.955 (95% C.I.) 1.774-8.813)]. After Matching 24 patients patients were included in nonsurgical complication related complication group and they were compared with 23 matched controls. After matching also nonsurgical procedural related complications were significantly associated with mortality. (p< 0.0001). No intraoperative factors like intraoperative hypotension, blood product requirement, operative time predicted non-surgical technique related complication. Surgery related complications were not associated with mortality after matching. Conclusion: Nonsurgical technique related complications are associated with significant increase risk of mortality.

Aim: Aim of our study was to evaluate incidence and causative factors for acute kidney injury in hepatopancreaticobiliary (HPB) surgeries. Material and Methods: All the HPB surgeries performed between April 2018 to March 2020, in our institution have been analysed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi square test and fisher t test wherever approptiate and continuous variables by Mann Whitney U test. Statistical analysis was done using SPSS version 23. P< 0.05 was considered significant. Results: We performed 195 HPB surgeries between April 2018 to March 2020, Which included 114 biliary surgeries, 57 liver surgeries and 23 pancreas surgeries. 10 patients developed Acute Kidney Injuries. (AKI) On Univariate analysis AKI was associated with open surgeries, intra operative hypotension and liver surgeries, higher ASA grade, increase operative time, more blood products used, higher CDC grade of surgery and more hospital stay before diagnosis of AKI. However on multivariate analysis only higher ASA score independently predicted Acute Kidney Injury. (p=0.003, odds ratio 15.659, 95% confidence interval 2.54-93.36). AKI was also significantly associated with mortality. (p <0.0001). Conclusion: Pre operative higher ASA grade independently predicted post operative acute kidney injury. Post operative AKI is significantly associated with mortality.

Chest trauma is a critical medical condition that encompasses a range of injuries and can result from various causes. Prompt and accurate diagnosis is crucial in managing chest trauma patients and radiology plays a pivotal role in this aspect. Imaging modalities in chest trauma aid in precise diagnosis and treatment planning. Especially, X-rays remain the initial imaging modality of choice due to their accessibility, speed, and ability to detect acute life-threatening conditions. Computed Tomography (CT) Scan offers detailed cross-sectional images allowing for comprehensive evaluation of chest trauma and surgical planning when necessary. Ultrasound (US) is increasingly valuable tool due to its portability and real-time imaging capabilities, aiding in rapid assessment at the bedside. Magnetic Resonance Imaging (MRI) is less commonly used due to time constraints and limited availability. Radiological imaging serves various purposes in the diagnosis and management of chest trauma such as early detection and triage, characterization and severity assessment, surgical planning, follow-up and monitoring of chest trauma. Reduction of radiation exposure, advancements in imaging technology (dual-energy CT, contrast-enhanced imaging) and Artificial Intelligence (AI) algorithms are crucial challenges and deserve attention. A multidisciplinary approach integrating radiological expertise remains fundamental in ensuring optimal outcomes for patients with chest trauma.

We report a theoretical derivation of the Cabibbo-Kobayashi-Maskawa (CKM) matrix parameters and the accompanying mixing angles. These results are arrived at from the exceptional Jordan algebra applied to quark states, and from expressing flavor eigenstates (i.e. left-chiral states) as superposition of mass eigenstates (i.e. the right-chiral states) weighted by square-root of mass. Flavor mixing for quarks is mediated by the square-root mass eigenstates, and the mass ratios used have been derived in earlier work from a left-right symmetric extension of the standard model. This permits a construction of the CKM matrix from first principles. There exist only four normed division algebras, they can be listed as follows - the real numbers $\mathbb{R}$, the complex numbers $\mathbb{C}$, the quaternions $\mathbb{H}$ and the octonions $\mathbb{O}$. The first three algebras are fairly well known; however, octonions as algebra are less studied. Recent research has pointed towards the importance of octonions in the study of high energy physics. Clifford algebras and the standard model are being studied closely. The main advantage of this approach is that the spinor representations of the fundamental fermions can be constructed easily here as the left ideals of the algebra. Also the action of various Spin Groups on these representations too can be studied easily. In this work, we build on some recent advances in the field and try to determine the CKM angles from an algebraic framework. We obtain the mixing angle values as $\theta_{12}=11.093^o, \theta_{13}=0.172^o, \theta_{23}=4.054^o$. In comparison, the corresponding experimentally measured values for these angles are $13.04^o \pm 0.05^o, 0.201^o \pm 0.011^o, 2.38^o \pm 0.06^o $. The agreement of theory with experiment is likely to improve when running of quark masses is taken into account.

An iconic feature of insects is the apparent lack of legs on the abdomen, which is believed to be due to the repression of the leg-patterning gene Distalless (Dll) by abdominal Hox genes. However, in contrast to these molecular observations, it is not widely appreciated that the embryos of most insect groups do in fact form paired protrusions on most abdominal segments that appear to be homologous to the thoracic legs. However, these degenerate before hatching to form the abdominal body wall. To resolve this discordance between molecular and morphological observations, the expression patterns of pannier and araucan, genes known to distinguish proximal leg segments in all arthropods, are examined in embryos of the flour beetle Tribolium castaneum. In Tribolium embryos, all pregenital abdominal segments develop leg-like paired protrusions, and the stripes of pannier and araucan expression that delineate the proximal leg segments of the thorax are also expressed in the same configuration around these abdominal protrusions. This suggests that insect abdominal legs are homologous to only the proximal portion of the thoracic legs, which in insect adults forms the body wall (lateral tergum and pleura). These cryptic, truncated abdominal legs – likely inherited from their crustacean ancestors – appear to be an important wellspring for new functions in insects, such as caterpillar prolegs, gills, and structures for camouflage¹⁶ and aposematic warning.

Schizoaffective disorder and its classification have always been a topic of discrepancy among researchers. The overlapping presentations of schizoaffective disorder, schizophrenia and psychotic bipolar disorder makes it difficult to classify and diagnose. This study is a narrative review of literatures and genetic and epidemiological research evidences, done to determine the similarities and differences between schizoaffective and psychotic bipolar disorder. Beginning from the introduction of schizoaffective disorder as "schizoaffective psychosis" by Kasanin in 1933, various researchers have proposed different views regarding the diagnosis and classifications for schizoaffective disorder. DSM-III considered schizoaffective disorder as a diagnosis of exclusion as it fails to fit the definite diagnostic criteria of schizophrenia, major affective disorders, or schizophreniform disorder. DSM-V updated the criteria of schizoaffective disorder and stated it as a life time illness rather than being an episodic disorder as in DSM-IV and hence is more reliable. However, some studies show that schizoaffective disorder patients are more like schizophrenia than mood disorder. It still remains unclear whether schizoaffective disorder is a heterogenous disease, a form of schizophrenia, a form of mood disorder or a midpoint in the continuation spectrum of schizophrenia and psychotic bipolar disease.

Offshore vessels (OVs) often requires precise station-keeping and some vessels, for example, vessel involves in geotechnical drilling generally use Spread Mooring (SM) or Dynamic Positioning (DP) systems. Most of these vessels are equipped with both systems to cover all ranges of water depths. However, determining which systems to use for a particular operational scenario depends on many factors and requires significant balancing in terms of cost-benefit. Therefore, this research aims to develop a platform that will determine the cost factors for both the SM and DP station keeping systems. Operational information and cost data are collected for several field operations, and Artificial Neural Networks (ANN) is trained using those data samples. After that, the trained ANN is used to predict the components of cost for any given environmental situation, fieldwork duration and water depth. Later, the total cost is investigated against water depth for both DP and SM systems to determine the most cost-effective option. The results are validated using two operational scenarios for a specific geotechnical vessel. This decision-making algorithm can be further developed by adding up more operational data for various vessels and can be applied in the development of sustainable decision-making business models for OVs operators.

In the contemporary era, there has been a notable surge in the systematic utilization of therapeutic drugs that exhibit stimulus-responsive drug release patterns in specific target areas. However, challenges such as premature drug release and limited biocompatibility persist. To address these issues, the application of a lipid coating on mesoporous silica nanoparticles (MSNs) has emerged as a promising strategy. This lipid coating not only enhances the stability and biocompatibility of nanocarriers but also facilitates targeted drug delivery to diseased cells while minimizing drug release throughout the body. MSNs, renowned for their unique attributes including high porosity, morphology, and controllable pore size, have been widely recognized as suitable platforms for drug/gene delivery systems. Furthermore, graphene-based nanomaterials such as graphene oxide and reduced graphene oxide have garnered significant interest in the fields of biology and biomedicine. These materials possess exceptional characteristics such as a large surface area, distinct surface properties, high biocompatibility, and pH sensitivity, making them ideal candidates for incorporating drugs, genes, photosensitizers, and other cargo to design innovative drug delivery systems. This study aims to emphasize the ongoing efforts and advancements in enhancing the capacity and versatility of nanocomposites comprising graphene MSN composites for applications in drug delivery.

In India, epilepsy is often viewed with superstition, considered a curse rather than a medical condition. Unfortunately, many affected individuals never receive proper medical attention from neurologists, leading them to seek out alternative remedies, including sorcery. Presently, the number of neurologists in India stands at approximately 3000, a concerning figure given the prevalence of epilepsy, which is reported to affect 5.59 to 10 individuals per 1000. This equates to over one million epilepsy patients across the country, representing more than 1% of the total population. Alarmingly, rural areas experience a higher incidence of epilepsy, around 2%, compared to urban centres, where the incidence is approximately 0.5%. This stark contrast underscores the urgent need for improved access to neurological care, particularly in underserved regions.The term "epilepsy" originates from the Greek verb meaning "to seize" or "to get hold of," forming the basis of its etymology. In certain societies, epilepsy is still interpreted as a "penalty for involvement in a forbidden ritual," although perceptions vary among different cultural groups. Individuals diagnosed with epilepsy (PWE) often exhibit behaviours that have led some to speculate about demonic possession or past-life transgressions as causative factors. Consequently, the term "epilepsy" carries diverse social connotations, leading to variations in treatment approaches based on differing perspectives of the condition. Regrettably, some negative attitudes towards epilepsy have fueled stigma, enduring disability, and significant adverse outcomes for those living with the condition.The majority of unreported cases turn to sorcery, exacerbating the already high mortality rates associated with epilepsy disorder and status epilepticus. Various treatment modalities exist for patients with epilepsy to manage their seizures. Given the debilitating and life-altering nature of epilepsy, India offers a range of options including medications (antiepileptic drugs or AEDs), devices, and surgical interventions. When an individual receives a diagnosis of epilepsy (defined as experiencing at least two unprovoked seizures within a short timeframe), life can be dramatically impacted. Several cases highlight the challenges patients face, leading to an increase in Disability Adjusted Life Years (DALY) overall. For newly born infants, constant vigilance from the mother is essential to monitor for any signs of seizure activity around the clock. When a pediatric patient is enrolled in school, their education is often profoundly disrupted. Should the patient be female, her existence would undergo a profound transformation, marked by societal perceptions deeming her as unfortunate and rendering the prospect of marriage untenable. Seizures in young adults precipitate job loss, thereby exacerbating societal burdens. Conclusion: There is a pressing need to raise awareness about epilepsy among the general populace of India. Dispelling misconceptions surrounding epilepsy is essential to steer individuals away from reliance on superstition, and instead, encourage them to seek guidance from certified specialists in nervous system disorders. Thankfully, by following the treatment regimen prescribed by a qualified neurologist, patients can significantly increase their chances of living a life free from seizures, thereby enhancing their overall quality of life and personal fulfilment.

Background: Thyroid nodules are common, affecting nearly 65% of the general population. While they are widespread, it's crucial to recognize that the majority of these nodules are not cancerous and can be effectively managed through careful monitoring. Thyroid ultrasound is commonly used to evaluate thyroid nodules owing to its low cost, wide availability and technical ease of application. In sonography, it's crucial to assess characteristics and vascular flow. Yet, conventional color and power Doppler ultrasound may not always effectively capture small vessels and low velocities due to their limitations. Superior Microvascular Imaging can display the blood flow of small vessels and low-velocity blood flow, which is difficult to visualize with conventional Doppler ultrasound. Meanwhile other thyroid scans, that utilize either [99mTc] pertechnetate or (18)F-fluorodeoxyglucose, can categorize nodules as hyperactive ('hot'), exhibiting normal activity ('warm'), or having reduced/no activity ('cold'). Thus, the main goal of screening and tracking thyroid nodules is to improve the management of potentially worrisome thyroid malignancies. Methodology: The study was conducted within the structural framework of a network meta-analysis, with the index tests being - SMI, Radionuclide Scanning and Color Doppler, and the general link between them being the reference gold standard. The data collection involved searching for all pertinent literature using PubMed, Google Scholar, and the Cochrane Library databases. The essential data was extracted following the application of specific inclusion and exclusion criteria.This meta-analysis included 7 RCTs with 1,152 patients for Radionuclide Scanning, 10 RCTs with 1,847 patients for SMI and 8 RCTs with 4,480 patients for Color Doppler. They were analyzed using the QualSyst tool and the risk of bias was evaluated by using QUADAS-2 analysis.The statistical software packages MetaDiSc 1.4, RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20) and Excel in Stata 14 were used to perform the statistical analyses. Result: According to the findings, the sensitivity for Radionuclide Scanning is calculated as 0.79 (range: 0.76 to 0.81) and specificity as 0.55 (range: 0.50 to 0.60) with a 95% confidence interval. The overall diagnostic odds ratio (DOR) for Radionuclide Scanning Is 10.54.Additionally, with a 95% confidence interval, SMI exhibits a sensitivity of 0.82 (with a range of 0.79 to 0.84) and a specificity of 0.86 (with a range of 0.84 to 0.88), while the overall DOR is approximately 25.73. Color Doppler demonstrates a calculated sensitivity of 0.71 (ranging from 0.69 to 0.74) and specificity of 0.81 (ranging from 0.79 to 0.83) with a 95% confidence interval, while its DOR is 13.48.Conclusion: As evidenced by this meta-analysis, blood flow dependent imaging techniques are superior in their abilities to be used as diagnostic tests, especially in conjunction with their use in detecting thyroid nodules. This study offers a starting point for delving deeper into the utilization of Radionuclide Imaging, Superior Microvascular Imaging and Color Doppler in diagnosing thyroid nodules in a clinical setting. Key Words: - Thyroid Nodule, Radionuclide Scanning, Superior Microvascular Imaging, Color Doppler Diagnosis, Sensitivity, Specificity, Diagnostic imaging

Abstract: Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from parents to children. The aim was to review research focusing on food-related parenting practices (FPPs) used by parents with overweight/obesity. Web of Science, PubMed and PsycINFO were searched. Twenty studies were included in the review. Single studies suggest differences between parents with healthy-weight vs overweight/obesity with respect to; food accessibility, food availability and modelling. Multiple studies suggest that several parenting strategies do not differ according to parental weight status (child involvement, praise, use of food to control negative emotions, use of food-based threats and bribes, pressure, restriction, meal and snack routines, monitoring, and rules and limits). There was inconclusive evidence with respect to differences in parental control, encouragement and use of unstructured FPPs among parents with healthy-weight vs overweight/obesity. The findings of this review imply some differences between parents with overweight/obesity and healthy-weight and the use of some food-related parenting practices, however they should be interpreted with caution since research remains limited and is generally methodologically weak. The review highlights opportunities for further research and to improve current measures of FPPs and help clarify current study findings.

Glaucoma poses a serious public health concern as it is the second leading cause of blindness after cataracts, while also being the leading cause of irreversible blindness worldwide. Glaucoma is more prevalent among Black, Latino, and Asian populations and it is essential to examine both racial and ethnic disparities that exist in treatment and prevention. As the number of people with glaucoma continues to grow, it is important to review aspects of this condition in order to better care for those affected. This article will review significant forms of glaucoma and what differentiates them in a diagnosis, treatment options, and recommendations on prevention and improving awareness

Introduction: COVID-19 is an unprecedented global public health emergency currently impacting India in an unprecedented manner. Aim of this study was to assess knowledge, awareness, perceptions and related factors of Indian dentists on COVID-19. Methodology: A cross-sectional, on-line questionnaire-based study was conducted over one week between 3rd May, 2020 to 10th May, 2020. The sample comprised 403 Indian dentists in solo, group practices and in the academic arena. The self-administered questionnaire assessed 1) knowledge/awareness on factors related to COVID-19 patient identification and symptomatology, 2) knowledge/awareness of COVID-19 transmission and 3) perceptions of COVID-19 history taking procedure. Statistical analyses were conducted using Statistical Package for Social Sciences for Windows, version 21.0 (IBM Corp., Armonk, NY., USA). Frequency distributions and logistic regression analyses were used. Results: Indian dentists demonstrated an overall modest level of knowledge on identification of patients with COVID-19. Moreover, they had a high level of awareness of the COVID-19 transmission means, and the generally accepted procedural perceptions on patient history taking. However, there were some gaps in specific aspects of knowledge and perceptions. Those who were aged ≥ 30-years had a significantly higher level of knowledge of patient identification means than those who were < 30-years (OR=1.78:1.12-2.83); p=0.01. Moreover, specialized dentists were significantly knowledgeable of COVID-19 transmission means than the general dentists (OR=1.89:1.22-2.93; p=0.004). Conclusions: Our findings demonstrate identifiable gaps in knowledge/awareness and perceptions of COVID-19 in Indian dental professionals. These gaps should be fulfilled, at the earliest, due to the rising burden of COVID-19 in India, to ensure safe dental care delivery.

DIPA-CRISPR is a revolutionary gene editing technology that has set new benchmarks in precision and efficacy. It builds upon the CRISPR-Cas9 system, introducing unparalleled specificity and minimizing unintended effects. Its potential applications in addressing complex genetic disorders offer hope for more effective disease management. The integration of DIPA-CRISPR into gene therapy research signifies a monumental leap forward in medical science and biotechnology. This article explores the DIPA-CRISPR methodology, its core principles, and recent technological strides in refining the technique. It highlights the implications of these developments on the treatment of genetic conditions and discusses future prospects and innovations within the field. The transformative potential of DIPA-CRISPR in disease management and the broader spectrum of genetic engineering is underscored, heralding a new age of medical and scientific discovery. The emphasis on addressing both technical and ethical challenges underscores the complexity and responsibility that accompanies such powerful technological advancements. The future prospects of DIPA-CRISPR, from pest management to combating global infectious diseases and transforming oncology, underscore the need for continued innovation coupled with rigorous ethical oversight.

Introduction:ASPECTS (Alberta Stroke Program Early CT Score) help in detecting early ischemic changes in stroke patients. This scoring system helps in predicting the stroke outcome, treatment options like thrombolysis and prognosis. It is a 10-point scaling system based on anatomical regions supplied by the middle cerebral artery and each point is subtracted for areas with ischemic changes. Aims and objectives:To study the effectiveness of the ASPECTS scoring in the assessment of the anterior and posterior cerebral circulation stroke. Materials and methods:A retrospective study was performed on stroke patients referred to our institute for an NCCT scan. 40 stroke patients with a mean age of 59+/-3 years were selected and patients with intracranial hemorrhage or hemorrhagic transformation of infarct were excluded. Scans were performed on a 128-slice multidetector CT PHILIPS Perspective scanner. The ASPECTS score was determined using standardised axial CT cuts. Result: In this case series study of 40 patients, a total of 28 patients (70%) had a score of 7 or more and these patients had better prognoses with proper treatment and follow-up.The remaining 12 patients (30%) had a score of less than 7 and even with treatment and sequential follow-up, they had no neurological recovery. Conclusion: Thus, it can be concluded that the ASPECTS can be used as a tool for predicting treatment outcomes in stroke patients. A score of 7 or more is associated with a good prognosis.

This report elucidates a case of papillary carcinoma of the Thyroglossal Duct Cyst in a 19-year-old female. The swelling at presentation was suprahyoid, fixed and non-mobile with deglutition or tongue protrusion. Papillary carcinoma was diagnosed post-op through histopathological examination and a follow-up total thyroidectomy was planned. As the origin of TGDC papillary carcinoma is highly debated, no evidence-based guidelines yet exist as to the best line of treatment, however, Sistrunk’s procedure followed by total/near total thyroidectomy is widely considered the standard management practice in such cases.

Subacute sclerosing panencephalitis (SSPE) is a progressive neurological complication that affects the central nervous system. It occurs as a late complication of the measles infection the young children and adolescents who are commonly affected present with personality changes and neurological deficits. The diagnosis can be done via clinical features, electroencephalography, and cerebrospinal fluid analysis. At present, there is no cure for SSPE. The immunisation against measles is the main strategy in preventing this condition. Here, we present a case of a 22-year-old Indian male diagnosed with Subacute sclerosing panencephalitis.

Presenting a rare case of adult-onset mature cystic teratoma of the spinal cord in the thoracolumbar spinal cord in a 54-year-old male whose chief complaint was lower back pain radiating to both legs while other findings were normal. X-ray images of the thoracolumbar spine showed early degenerative changes and unfused posterior elements noted in lower sacral vertebral levels. Magnetic resonance images of the lumbar spine showed a well-defined non-enhancing intramedullary altered intensity lesion noted at the level of conus at the L1-L2 vertebral level. The resected tumour was histopathologically diagnosed as a mature cystic teratoma. The patient's symptoms improved following the surgery.

Diastematomyelia, also known as split cord syndrome, is a congenital disorder of the spinal cord. As the name suggests, the spinal cord is split into two resulting in neurological complaints associated with cutaneous symptoms. Although the diagnosis can be done clinically, for disease confirmation, various radiological investigations are used for the diagnosis of this condition. Here, we present a case of a 54-year-old Indian female diagnosed with diastematomyelia. The clinical features, diagnostic modalities, treatment options and prognosis of this condition have been discussed.

A rare neurological condition known as Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, facial asymmetry, contralateral motor impairment, and seizures. Cerebral hypoplasia, ventriculomegaly, paranasal sinus hyper-pneumatization, and compensatory osseous expansion are classic imaging findings. The relationship between clinical and neuroimaging findings provides the basis for the diagnosis of DDMS. DDMS is treated with anticonvulsant medication and physical therapy. This is the case of a 26-year-old male, with a known case of cerebral palsy and on antiepileptics for 15 years, who presented with complaints of generalized weakness, vomiting, difficulty walking, recurrent convulsions, and a recent episode of generalized tonic-clonic seizures. Neuroimaging revealed findings significant of Dyke Davidoff Masson Syndrome. Understanding its imaging and clinical characteristics facilitates prompt and precise diagnosis, permitting appropriate management.

Borreliosis is a widely spreading bacterial infection caused by corkscrew-shaped spirochete Borrelia burgdorferi transmitted via the bite of an infected tick. The disease manifests in three stages: early localized, early disseminated, and late stages. Clinical symptoms range from non-specific erythema migrans, fever, fatigue, etc. to system-specific features like carditis, peripheral nerve palsy, etc. The diagnosis mainly relies on clinical findings and serologic testing is done for disease confirmation. The treatment of Lyme disease is an antibiotic with doxycycline as the primary choice. Prophylactic doxycycline is given under specific criteria. Here, we describe a case of a 64-year-old Indian male diagnosed with Lyme disease.

Pneumatosis intestinalis is the presence of air within the two layers of the wall of the gastrointestinal tract, specifically in the small and large intestines. This accumulation of gas can cause thicker walls of the intestines in X-ray or CT scans. Superior Mesenteric Artery (SMA) Thrombosis occurs due to the formation of blood clots within the SMA. As it supplies from the ampulla in the second part of the duodenum to the splenic flexure of the large intestine its thrombosis can cause ischemia in any part depending upon its branch. A 67-year-old male patient presented to the hospital with the complaint of generalized abdominal pain for 5 days along with fever, nausea, vomiting, obstipation, and postprandial fullness. On further investigation with the help of an MDCT scan and X-ray, proximal jejunal loops showed circumferential air within the walls giving the diagnosis of Pneumatosis Intestinalis along with Superior Mesenteric Artery Thrombosis causing jejunal infarct.

Balo’s concentric sclerosis is a rare disease and a subtype of multiple sclerosis. A 38-year-old male patient presented to the hospital with the complaint of numbness in the left-sided upper and lower limb, slurring of speech and left-sided headache for 15 days. Further investigation was done and in ECG ‘Delta wave’ was identified along with tachycardia. Diagnosis of Wolff Parkinson White syndrome was made. The patient’s MRI Brain has shown a non-enhancing intra-axial altered signal intensity lesion at the callose-septal interface adjacent to both lateral ventricles, which was identified as Balo’s concentric sclerosis.

Headache is considered to be one of the most common causes of medical treatment and evaluation worldwide in both acute and outpatient settings. It is the most common neurological symptom seen worldwide affecting all genders, ages, ethnicities, and socioeconomic levels. It’s impact is noted in educational decline in school-aged children and decreased productivity through sick leave in adults. Its overall burden is well documented in well-resourced countries but limited data is seen low resourced countries. While many underlying causes bring about secondary headaches, primary headaches and more specifically migraines have been more widely explored. Migraines have a distinct criterion that is inclusive of one day duration (4 hours to 7 days, unilateral distribution, nausea and vomiting and disability as a few examples. However, migraines can vary and proper documentation through a migraine diary can help to guide treatment. Management of migraines can vary. Lifestyle modification is a key factor in the overall prevention and reduction of triggers in migraines. In addition to this, pharmacotherapy can be given in a tier-based approach based on overall severity and frequency of the migraine. Interventions have progressed from botox injection and have seen the advent of new medications such as nasal sprays to novel formulations of pre-existing drug formulations. Nonetheless, there is great room for further studies of headaches and migraines. Research specifically in low-resource countries can prove to beneficial.

In this paper, we introduce Syntax-Enhanced Transformer Model (SET), a groundbreaking approach in the realm of Transformer-based language modeling that seeks to redefine the boundaries of linguistic analysis and comprehension. SET innovatively combine (i) the well-established high-level performance, scalability, and adaptability of traditional Transformers with (ii) a sophisticated analysis of syntactic structures. This synergy is enabled by a novel attention mechanism tailored to parse syntactic nuances and a deterministic process adept at transforming linearized parse trees into meaningful linguistic representations. Our comprehensive experiments reveal that SET significantly advance the field by surpassing existing benchmarks in sentence-level language modeling perplexity. They exhibit exceptional proficiency in tasks that require an acute awareness of syntax, setting new standards for language models in understanding complex linguistic structures. Furthermore, SET demonstrate an enhanced capability to grasp nuanced linguistic patterns that have traditionally been challenging for standard Transformer models. However, our studies also uncover a unique aspect of SET: while they excel in sentence-level tasks, their representation of sentences as singular vectors—owing to the syntactic composition constraints intrinsic to their design—introduces certain limitations in document-level language modeling. This observation points to an intriguing area for future exploration; it suggests the potential need for an alternative or complementary memory mechanism within Transformer models, one that functions independently from, yet in harmony with, syntactic structures. Such a mechanism could be pivotal in enhancing the model's ability to comprehend and process long-form texts effectively. In conclusion, SET mark a significant stride in the journey towards more sophisticated, syntax-aware language models. They offer promising insights into the integration of deep linguistic knowledge with cutting-edge machine learning techniques, potentially opening doors to a new era of natural language understanding and processing.

The paradigm of leveraging code as a dataset has recently gained traction, offering innovative solutions in domains such as automated commit message generation, pull request description automation, and program repair mechanisms. Consider the challenge in generating commit messages: traditional methods treat source code as a mere token sequence, applying neural machine translation models. This approach, however, overlooks the critical syntactic structures inherent in programming languages, which could offer deeper insights and improved accuracy. Building upon prior research, specifically the Code2Seq framework, which utilized Abstract Syntax Tree (AST) structural data for source code representation to automate method name generation, this paper extends and refines this concept. We introduce "CSR", a novel methodology adapted to represent code edits effectively. This paper investigates the impact of employing syntactic structure, focusing on the classification of code edits. Drawing inspiration from Code2Seq, "CSR" utilizes AST's structural properties, particularly the paths connecting leaf nodes, to enhance the task of code edit classification. This approach is rigorously evaluated on two distinct datasets, comprising fine-grained syntactic edits. Our comprehensive experiments reveal that incorporating syntactic structures does not significantly outperform simpler methodologies. While methods like Code2Seq and our proposed "CSR" show potential, our findings highlight that there is considerable scope for improvement and refinement before such techniques can be universally applied for learning representations of code edits. We anticipate that our findings will spark further research in this field, paving the way for more effective use of syntactic structures in code representation.

Contemporary advanced models for aspect-targeted opinion word extraction (ATOWE), which predominantly utilize BERT-based encoders at a word level, have shown limited advancements when integrated with graph convolutional networks (GCNs) for syntactic tree assimilation. Recognizing the prowess of BERT subwords in encapsulating rare or context-poor words, this study pivots from syntactic trees to BERT subwords, omitting GCNs from the structural framework. Our approach, named Aspect-Enhanced Wordpiece Extraction Model (AEWEM), focuses on refining aspect representation during encoding. We propose an input format of paired sentence-aspect, diverging from traditional single-sentence inputs. AEWEM demonstrates superior performance on benchmark datasets, establishing a robust foundation for future explorations in this domain.

The Transformer architecture, while adept at capturing context through self-attention, falls short in encapsulating complex syntactic structures effectively. Addressing this gap, we introduce the Linguistic Structure through Graphical Interpretation with BERT (LSGIB) approach in Machine Translation (MT) frameworks. Combining the strengths of Graph Attention Network (GAT) and BERT, LSGIB intricately captures syntactic dependencies as explicit knowledge from the source language. This enhances the source language representation and aids in more accurate target language generation. Our empirical analysis leverages gold-standard syntax-annotated sentences and employs a Quality Estimation (QE) model. This approach enables us to assess translation improvements in terms of syntactic accuracy, extending beyond traditional BLEU score metrics. The LSGIB model demonstrates superior translation quality across diverse MT tasks, maintaining robust BLEU scores. Our study delves into the optimal sentence lengths benefiting from LSGIB and identifies which syntactic dependencies are more precisely captured. We observe that GAT's ability to learn specific dependency relations directly influences the translation quality of sentences with those relations. Additionally, we discover that incorporating syntactic structure into BERT's intermediate and lower layers offers a novel approach to modeling linguistic structure in source sentences.

The field of program classification, a critical aspect of software engineering, facilitates understanding and categorization of code across various applications, including anomaly detection, and code quality assessment. The advancement of cross-language program classification opens up avenues for efficient code translation among different programming languages, significantly aiding developers in rapid coding and reducing development cycles. Existing research primarily focuses on semantic code analysis, with limited emphasis on cross-linguistic challenges. To address this, we introduce an innovative neural network model, CodeSemanticsNN, which leverages a refined Syntax Structure (SS) approach. This model consists of two integral mechanisms: first, it adopts a novel SS representation that combines sequential and graph-based SS structures, enhancing semantic feature capture. Second, it employs a 'unified vocabulary' strategy to bridge the gap between diverse programming languages, facilitating efficient cross-language classification. Additionally, we have compiled a comprehensive dataset of 20,000 files spanning five programming languages, serving as a benchmark for cross-language classification. Our experiments on this dataset demonstrate that CodeSemanticsNN surpasses existing models in four key metrics: Precision, Recall, F1-score, and Accuracy.

The evolution of sentence representation learning, especially with parse tree encoders, has shown remarkable progress. Traditional approaches predominantly rely on recursive encoding of tree structures, which impedes parallel processing capabilities. Additionally, these methods often overlook the significance of dependency tree arc labels. To overcome these limitations, we introduce the Syntax-Enhanced Transformer (SET), incorporating a novel dual-attention mechanism that integrates relation-focused attention alongside traditional self-attention. This design effectively encodes both dependency and spatial positional relationships within sentence dependency trees. Our approach innovatively incorporates syntactic information into the Transformer framework without compromising its inherent parallelizability. The SET demonstrates superior or comparable performance to contemporary methods across various sentence representation tasks, significantly enhancing computational efficiency.

This paper introduces a novel graph polynomial approach for differentiating tree structures in dependency grammar. Utilizing this polynomial representation, we develop a metric to assess the similarity in syntax. This approach offers a detailed and inclusive analysis of the dependency structures and relationships in sentence construction. We employ this polynomial method to examine sentence structures across various languages in the Parallel Universal Dependencies treebanks. Our analysis includes comparing the syntax of original sentences and their translated counterparts in diverse languages, alongside a comprehensive study of syntactic typologies within these treebanks. Additionally, we explore the application of our methodology in evaluating the syntactic diversity within language corpora.

Recent advancements in neural language models, particularly attention-based architectures like the Transformer, have substantially surpassed traditional methods in various natural language processing tasks. These models adeptly generate nuanced token representations by considering contextual relations within a sequence. However, augmenting these models with explicit syntactic knowledge, such as part of speech tags, has been found to remarkably bolster their effectiveness, especially under constrained data scenarios. This study introduces the Linguistic Enhanced Transformer (LET), which integrates multiple syntactic features, showing a notable increase in translation accuracy, evidenced by an improvement of up to 1.99 BLEU points on subsets of the WMT '14 English-German dataset. Furthermore, this paper demonstrates that enriching BERT models with syntax-aware embeddings enhances their performance on several GLUE benchmark tasks.

Conventional text style transfer (TST) methodologies primarily utilize style classifiers to segregate the content and stylistic elements of text for effective style transformation. Despite the pivotal role of these classifiers, their influence on TST techniques remains largely unexplored. This study embarks on a detailed exploration of the limitations inherent in style classifiers within current TST frameworks. We reveal that these classifiers often inadequately comprehend sentence syntax, leading to diminished performance in TST models. In response, we introduce the Syntax-Enhanced Style Transfer (SEST) model, a groundbreaking approach incorporating a syntax-sensitive style classifier. This classifier ensures that the extracted style representations robustly encapsulate syntax nuances, enhancing TST effectiveness. Rigorous evaluations across diverse TST benchmarks demonstrate that SEST significantly surpasses contemporary models in performance. Additionally, our case studies highlight SEST's proficiency in producing syntactically coherent sentences that aptly retain original content.

Convolutional Neural Networks (CNNs) and Recurrent Neural Networks (RNNs) have been utilised to forecast the foreign exchange market (Forex). However, such models usually exhibit unstable behaviour, as data perturbations often downgrade the functionality of the entire network due to their monolithic architecture. Hence, this study proposes a novel neuroscience-informed modular network applied to the closing prices and the sentiments retrieved from Yahoo Finance and Twitter APIs, aiming to anticipate better price fluctuations in Euro to British Pound Sterling (EUR/GBP) rather than monolithic methods. The proposed model is based on a new modular CNN, replacing pooling layers with orthogonal kernel initialisation RNNs coupled with Monte Carlo Dropout (MCD), namely MCoRNNMCD. It combines two modules: i) a convolutional simple RNN and ii) a convolutional Gated Recurrent Unit (GRU), where orthogonality and MCD are added to reduce the overfitting, assessing each module's uncertainty. These parallel feature extraction modules concatenate their outputs to a final three-layer Artificial Neural Network (ANN) decision-making module. A comprehensive comparison viewing objective evaluation metrics such as the Mean Square Error (MSE) proved that the proposed MCoRNNMCD-ANN outperformed single CNN, LSTM, GRU, and the state-of-the-art hybrid BiCuDNNLSTM, CLSTM, CNN-LSTM, and LSTM-GRU in forecasting hourly EUR/GBP closing price fluctuations.

Navigation is the most challenging issue in autonomous vehicles. Researchers in the current era have developed many Artificial Intelligence techniques to navigate, generate paths, and avoid obstacles for optimum path planning for autonomous vehicles. Different studies have investigated bio-inspired techniques to overcome the navigation issue, including obstacle avoidance. This paper uses new meta-heuristic optimization techniques called Dragonfly Algorithm (DA) to set the goal by detecting and avoiding obstacles with minimum human interference. For effective results, the Dragonfly-Fuzzy hybrid algorithm is analyzed over the unstructured environment because individual techniques may not be sure of an optimal solution over all configurations. The main advantage of the proposed hybrid controller is that it combines the multiple features of different approaches into a single controller. This paper compares simulation and experimental findings over various environmental conditions to the individual algorithm. Regarding time and path optimization, the hybrid Dragonfly-Fuzzy controller performs better than the respective controller.

The most common type of non-Hodgkin lymphoma in adults is diffuse large B-cell (DLBCL). There is a historical unmet need for more effective therapies in the 2nd and 3rd line setting. Emerging immunochemotherapies have shown activity in small studies of heavily pre-treated patients with prolonged remissions achieved in some patients. Anti-CD19 CAR (chimeric antigen receptor) T cells are potentially curative in the 3rd line and beyond setting and are under investigation in earlier lines of therapy.1 Antibody-drug conjugates (ADC’s) such as polatuzumab vedotin targeting the pan-B-cell marker CD79b has proven effectiveness in multiply-relapsed DLBCL patients. Tafasitamab (MOR208) is an anti-CD19 monoclonal antibody producing prolonged remissions when combined with Lenalidomide in patients who were not candidates for salvage chemotherapy or autologous stem cell transplant. Selinexor, an oral, small-molecule selective inhibitor of XPO1-mediated nuclear export (SINE), demonstrated prolonged activity against heavily-pretreated DLBCL without cumulative toxicity and is being investigated as part of an oral, chemotherapy-free regimen for relapsed aggressive lymphoma. This article reviews current strategies and novel therapies for relapsed/refractory DLBCL.

Acetaminophen use during pregnancy and early childhood was accepted in the 1970s, but is now a subject of considerable concern. Careful analysis shows that initial acceptance of the drug was based on false assumptions and ignorance of the impact of the drug on brain development. Fourteen studies now indicate that prenatal exposure to acetaminophen is associated with neurodevelopmental problems. Based on corrections for confounding factors applied to the analyses of available data, it can be concluded that prenatal exposure to acetaminophen causes statistically significant risks of one subtype of autism spectrum disorder (ASD), developmental delays, and attention deficit hyperactivity disorder. In contrast, data regarding postnatal exposure to acetaminophen are limited, and several factors impede a classic multivariate analysis of data to resolve the issue. However, circumstantial evidence regarding postnatal exposure to the drug is abundant, and it can be concluded beyond a reasonable doubt that postnatal exposure to acetaminophen in susceptible children is responsible for many if not most cases of ASD. Circumstantial evidence includes at least three otherwise unexplained temporal relationships, data from laboratory animal studies, several miscellaneous and otherwise unexplained correlations, and the lack of alternative suspects that fit the evidence-derived profile.

Adult mesenchymal stem cells (MSCs) are a promising cell source for tissue regeneration. However, ex vivo expansion results in cell senescence; cells lose their proliferation and differentiation capacity. Fetal MSCs can be an alternative due to their robust proliferation and differentiation capacities as well as immune privilege properties. Given the rejuvenation effect of decellularized extracellular matrix (dECM) on adult MSCs, it remains unknown whether dECM influences the regenerative potential of fetal stem cells. In this study, passage five fetal nucleus pulposus cells (fNPCs) and fetal synovium-derived stem cells (fSDSCs) were expanded on dECMs deposited by fNPCs (NECM) and fSDSCs (SECM) for one passage with expansion on tissue culture plastic (Plastic) as a control. We found that dECM expanded fNPCs and fSDSCs exhibited both similarities and differences in expression of stemness genes and surface markers. Expanded fNPCs yielded more differentiated pellets after chondrogenic induction but no adipogenic differentiation following adipogenic induction in both Plastic and dECM groups than the corresponding fSDSC group. Despite a significant increase in fNPCs, dECM expanded fSDSCs exhibited no increase in chondrogenic potential; however, compared to the Plastic group, dECM expanded fSDSCs exhibited a small increase in osteogenic potential and a great increase in adipogenic potential. These results suggest that fNPCs are more sensitive to NECM rejuvenation for cartilage tissue engineering and regeneration; in contrast, dECMs exhibited limited effects on fSDSC rejuvenation in chondrogenic capacity except for enhanced adipogenic capacity following expansion on SECM.

Magnetron sputtering was used for producing Titanium Vanadium Nitride (TiVN) coatings on a variety of substrates. In this research, we investigate how changing the sputtering power and nitrogen: argon (N2:Ar) gas ratio affects the structural and tribological properties of TiVN coatings. Scanning Electron Microscope (SEM) technique was used to examine TiVN coating surface morphology. Both variants showed a gradual increase in the intensity of the TiVN coating's (111) and (222) peaks. TiVN coating's tribological properties were examined using a pin-on-disc tribometer with varying loads, speeds, and sliding distances. The wear rates of TiVN-coated brass pins were in the range of 2.5×10-4 to 9.14×10-4 mm3/Nm depending on load, sliding distance, and gas ratio variation, when compared to the wear rates of TiVN-coated brass pins deposited at various power, which ranged from 1.76×10-3 to 5.87×10-3 mm3/Nm.

Marine macroalgae have garnered significant attention in the field of cosmeceutical research due to their rich abundance of bioactive compounds. These compounds offer remarkable skin benefits without inducing any adverse effects on human health, such as cytotoxicity, reproductive toxicity, genotoxicity, mutagenicity, or carcinogenicity. Among the various bioactive compounds found in brown algae, phenolic compounds exhibit diverse chemical structures and are present in high concentrations. In addition to phenolic compounds, brown algae also contain terpenoids, bro-mophenols, mycosporine amino acids (MAAs), and flavonoids, with the well-studied poly-phenol compound, phlorotannin, being particularly prominent. Marine macroalgae further possess an array of pigments derived from their natural pigmentation, including chlorophylls, carotenoids (such as fucoxanthin and β-carotene), phycobiliproteins (such as phycoerythrin and phycocyanin), and melanin. These pigments have been extensively investigated for their potential cos-meceutical applications. The phenolic compounds and pigments derived from marine macroalgae have been thoroughly studied for their beneficial effects on the skin, including skin whitening, moisturizing, photoprotection, anti-aging, anti-wrinkle, anti-melanogenic, and anti-oxidant properties. This comprehensive review aims to explore the extraction, characterization, and skin cosmetic effects of phenolic compounds and pigments derived from marine macroalgae, as documented in the existing literature, thereby enhancing our understanding of their therapeutic potential.

The cosmetic industry recognizes the importance of natural sources for functional active constit-uents in meeting consumer expectations for safer and more sustainable beauty care products. Ma-rine macroalgae have emerged as promising resources, offering diverse bioactive constituents with potential applications in cosmetics. In this study, we investigated the biochemical profile of Padina boergesenii, a marine macroalga, using various methods to assess its potential as a cosmetic ingre-dient. The Fourier Transform Infrared (FTIR) analysis revealed the presence of distinct bioactive functional groups associated with numerous skin-beneficial compounds. Furthermore, the ethanolic and methanolic extracts of P. boergesenii were subjected to Gas Chromatography-Mass Spectrom-etry (GC-MS) analysis, which identified a total of six and fifteen significant phytocompounds, re-spectively. Additionally, a comprehensive phytochemical profiling of P. boergesenii was performed using High-Resolution Liquid Chromatography-Mass Spectrometry Quadrupole Time-of-Flight (HRLCMS-Q-TOF), highlighting the presence of various terpenoids, alkaloids, peptides, fatty acids, derivatives, and coumarins with potential cosmetic applications. To further assess its potential as a cosmetic ingredient, P. boergesenii was subjected to several additional estimations. Pigment estima-tion revealed the presence of specific pigments, while the determination of total phenol content and total protein content highlighted the richness of these bioactive components. The antioxidant analysis using the DPPH method demonstrated the antioxidant potential of P. boergesenii extracts, suggesting their ability to combat oxidative stress-related skin damage. Moreover, the tyrosinase inhibition assay indicated the inhibitory effect of P. boergesenii extracts on tyrosinase activity, which is relevant for addressing hyperpigmentation concerns. Furthermore, the elemental composition of P. boergesenii was evaluated using Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES), revealing that silicon (Si) exhibited the highest concentration among the measured elements, while copper (Cu) displayed the lowest concentration. Additionally, HRLCMS-Q-TOF analysis was employed to quantify 21 amino acids, with aspartic acid exhibiting the highest con-centration (2034.99 nmol/mL), and tyrosine demonstrating the lowest concentration (233.26 nmol/mL). The accuracy of all the measured elements and amino acids was deemed acceptable. Taken together, the findings of this study highlight the potential of P. boergesenii as an effective ingredient for enhancing skin health. The incorporation of seaweed-based bioactive components, such as P. boergesenii, into cosmetic products is increasingly common due to their beneficial effects on the skin. Further exploration of the potential applications of P. boergesenii in the cosmetics in-dustry is warranted to harness its valuable bioactive properties.

Understanding the subtle signs of carpal instability and other unique injury patterns in the wrist is a critical skill for radiologists. Proper patient management and outcomes are directly dependent on the accurate interpretation of wrist imaging studies. This review will provide a detailed overview of typical imaging features of carpal trauma and instability, management, and complications, using multimodality imaging and original medical illustrations. A detailed overview of the osseous, ligamentous, arterial anatomy of the wrist, arcs of Gilula, and zones of vulnerability will be provided. Carpal fractures, dislocations, special radiographic views, and imaging pearls will be discussed. Instability patterns and the myriad of associate abbreviations (CID, CIND, CIC, CIA, VISI, DISI, SLD, LTD, MCI, SLAC, SNAC) will be clarified. Expected outcomes, potential complications, and management will be reviewed.