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Recovery of critical metals such as Li and Co from the spent lithium-ion batteries is necessary to alleviate resource scarcity and mitigate supply risk. The present study emphasizes the carbothermal and hydrogen reduction of lithium cobalt oxide (LCO) and the recovery of Li and Co from spent LCO-based batteries. Carbothermal reduction (CR) and hydrogen reduction (HR) at 500–900 °C followed by water leaching was carried out for Li recovery. Complete reduction with hydrogen was achieved at 500 °C, whereas a significant reduction for CR was achieved at 700 ℃. Characterization analysis of the reduced products affirms the decomposition of the layered LCO structure with the evolution of new phases. CR favored the Li2CO3 formation, while the LiOH phase was observed in the HR products. Both reductive treatments yielded metallic Co, but CoO was also found in the CR products. The hydrogen reduction was found better compared to carbothermal reduction for both Li and Co recovery. CR process at 900 °C resulted in 61% Li dissolution and 76.5% Co recovery, while HR at 500 °C yielded much higher Li dissolution (93%) and Co recovery (86.5%). [ABSTRACT FROM AUTHOR]

Breast cancer, an exceptionally hormone-dependent tumor, exhibits a diverse clinical profile. Its therapeutic categorization relies on the expression of key receptors, namely, estrogen receptor (ER), progesterone receptor (PR), and Her2neu. The androgen receptor (AR), a member of the nuclear receptor superfamily, is a biomarker gaining attention in breast cancer research, particularly for triple-negative breast cancers. We conducted an analysis of AR expression in 113 primary breast cancer cases, using a cutoff criterion of ≥ 10% tumor cell positivity. ER, PR, and Her2neu statuses were determined based on the 2023 ASCO-CAP criteria. AR expression was then correlated with various clinicopathological factors, including age, menopausal status, centricity, histological type, grade, tumor size, nodal status, lymphovascular and perineural invasion, and ER, PR, and HER2neu statuses. Among the 113 cases, 57 (50.4%) showed positive AR expression. No statistically significant associations were found between AR expression and age, menopausal status, histological type, histological grade, nodal status, or ER and PR expression. Notably, all multicentric tumors (n = 7, 100%) were AR negative. AR expression was linked to smaller tumor sizes. Positive AR cases exhibited an association with Her2neu overexpression, particularly in ER and PR-negative tumors. Of note, 35% of triple-negative tumors displayed AR positivity. AR emerges as a promising marker in breast cancers, particularly in triple-negative cases. Larger-scale studies are warranted to comprehensively assess the relationship between AR expression and histopathological parameters, as well as other immunohistochemical markers. [ABSTRACT FROM AUTHOR]

Angiomyxomas, also known as vascular myxolipomas, are a rare type of soft tissue tumor characterized by the proliferation of adipose tissue within a myxoid stroma accompanied by multiple vascular channels. They represent a distinct variant of lipomas and require differentiation from other benign and malignant lipoma subtypes. Despite their rarity, only a few cases of angiomyxolipoma have been documented in medical literature. We present a case of angiomyxolipoma occurring in the cheek of a 40-year-old female patient who presented with a long-standing history of swelling on the left side of her face. Histopathological examination revealed alternating nests of myxoid and adipose tissue containing dilated blood vessels, which confirmed the diagnosis of angiomyxolipoma. This case underscores the importance of recognizing and accurately diagnosing rare soft tissue tumors like angiomyxolipoma to guide appropriate management and follow-up care. [ABSTRACT FROM AUTHOR]

Embryonal rhabdomyosarcoma is the malignant mesenchymal proliferation of undifferentiated skeletal muscle. It is the most common soft tissue tumour found in children. Head and neck location accounts for 40% of the cases with the most common variants being of embryonal Nasopharyngeal RMS is a type of parameningeal RMS (arising from tissues adjacent to the meninges) having propensity for CNS and known for having a poorer prognosis, early recurrence, rapid growth and invasion to adjacent structures. Other types of RMS include orbital and non-orbital/non-parameningeal. Here, we encountered a rare case of a 5 year old boy presenting with complaints of epistaxis. On anterior rhinoscopy of the nose, no apparent mass could be visualised. However, on oral examination, a right sided oropharyngeal bulge was noted. Clinical evidence was corroborated radiologically with MRI neck findings which suggested a hyperintense lesion with heterogeneous enhancement in the region of right side of nasopharynx extending laterally into parapharyngeal region and carotid space, encasing the right internal carotid artery with narrowing of nasopharyngeal airway. Hence, biopsy was taken from the nasopharynx and a diagnosis of embryonal rhabdomyosarcoma - botryoid type was made which was confirmed with IHC markers. [ABSTRACT FROM AUTHOR]

Background: To compare the diagnostic utility of computed tomography (CT) and ultrasonography (USG) for preoperative determination of metastatic lymph nodes. Methods: Head and neck squamous cell carcinoma (HNSCC) cases planned for neck dissection were included. All underwent preoperative neck USG and CT followed by histopathological evaluation after surgery. Sensitivity, specificity, positive and negative predictive value along with accuracy was calculated for each outcome variable. Efficacy was calculated by comparing these to postoperative histopathology. Both imaging modalities were compared with lymph nodal volume. Results: Eighty-seven lymph nodes were selected from 30 patients. Median volume on CT was 5412.15 mm3 for metastatic and 237.7 mm3 for benign nodes and on ultrasound, 4168.92 mm3 for metastatic and 233.1 mm3 for benign nodes (p < 0.001). Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for volume on USG were 81.8%, 98.7%, 96.6%, 90%, and 97.4% and on CT were 81.8%, 100%, 97.7%, 100%, and 97.4% respectively. Conclusions: Lymph nodal volume had higher sensitivity and specificity for detection of metastatic cervical lymphadenopathy and individually or in combination should be included as one of the criteria in preoperative assessment of HNSCC. [ABSTRACT FROM AUTHOR]

Hair cell bundles consist of stereocilia arranged in rows of increasing heights, connected by tip links that transmit sound-induced forces to shorter stereocilia tips. Auditory mechanotransduction channel complexes, composed of proteins TMC1/2, TMIE, CIB2, and LHFPL5, are located at the tips of shorter stereocilia. While most components can interact with the tip link in vitro, their ability to maintain the channel complexes at the tip link in vivo is uncertain. Using mouse models, we show that an additional component, LOXHD1, is essential for keeping TMC1-pore forming subunits at the tip link but is dispensable for TMC2. Using SUB-immunogold-SEM, we showed that TMC1 localizes near the tip link but mislocalizes without LOXHD1. LOXHD1 selectively interacts with TMC1, CIB2, LHFPL5, and tip-link protein PCDH15. Our results demonstrate that TMC1-driven mature auditory channels require LOXHD1 to stay connected to the tip link and remain functional, while TMC2-driven developmental channels do not. The Grillet lab identified an additional component of the auditory mechanotransduction Machinery, the protein LOXHD1, which is indispensable to keep the ion channel subunit TMC1 next to the tip-link, where the force induced-by sound is transmitted. [ABSTRACT FROM AUTHOR]

The use of sanitary napkins during menstruation is inevitable. However, they pose a menace to the environment because of the associated non-biodegradability. Conventional sanitary napkins are composed of around 90% plastic, which goes to landfill and remains there for centuries leading to an increased carbon footprint. A study conducted on major brands of sanitary napkins in India revealed that the presence of various phthalate groups harms neurological, cardiovascular, and reproductive systems in women and volatile organic compounds show harmful neurological effects including paralysis and memory loss. To overcome this environmental mayhem and severe pathological effects, various approaches have been undertaken by researchers and government authorities. Plant-based alternatives aid the dire need to manufacture sanitary napkins which can decompose and leave no threat to biodiversity. The use of organic materials like cotton, jute, bamboo, banana fibers, and neem leaves in making sanitary napkins holds magnanimous potential. The utilization of sansevieria and water hyacinth to produce sanitary napkins served the dual purpose of recreating life in water bodies and providing financial independency to the local women in Africa. Leftovers of many natural products during their processing end up creating an increased amount of waste material. Incorporating the industrial waste in the absorbent layer to generate eco-friendly napkins retains the sustainable tripod and also reduces the cost which will make napkins affordable by women of every class in society. This review sheds light on the grave issue of disposal and non-biodegradability of currently used marketed sanitary napkins, various biodegradable approaches and their importance over conventional sanitary napkins, that can be adopted to overcome this environmental problem. [ABSTRACT FROM AUTHOR]

The evolution of recommendation systems has revolutionized user experiences by providing personalized recommendations. Although conventional systems such as collaborative and content-based filtering are reliable, they still suffer from inherent limitations. We introduce a hybrid recommendation system that combines content-based filtering using TF-IDF and cosine similarity with collaborative filtering and SVD to address these challenges. We bolster our model through supervised machine learning algorithms like decision trees (DT), random forests (RF), and support vector regression (SVR). To amplify predictive prowess, boosting algorithms including CatBoost and XGBoost are harnessed. Our experiments are performed on the benchmark dataset MovieLens 1M, which highlights the superiority of our hybrid method over more traditional alternatives with SVR being the best-performing algorithm consistently. Our hybrid model achieved an MSLE score of 2.3 and an RMSLE score of 1.5, making SVR consistently the best-performing algorithm in the recommendation system. This combination demonstrates the potential of collaborative-content hybrids supported by cutting-edge machine-learning techniques to reshape the field of recommendation systems. [ABSTRACT FROM AUTHOR]

Purpose: Seizures are a common clinical occurrence in high-grade glioma (HGG). While many studies have explored seizure incidence and prevalence in HGG, limited studies have examined the prognostic effect of seizures occurring in the post-diagnosis setting. This study aims to assess the impact of seizure presentation on HGG survival outcomes. Methods: Single-center retrospective review identified 950 patients with histologically-confirmed high-grade glioma. Seizure presentation was determined by clinical history and classified as early onset (occurring within 30 days of HGG presentation) or late onset (first seizure occurring after beginning HGG treatment). The primary outcome, hazard ratios for overall survival and progression-free survival, was assessed with multivariable Cox proportional-hazards models. IDH1 mutation status (assessed through immunohistochemistry) was only consistently available beginning in 2015; subgroup analyses were performed in the subset of patients with known IDH1 status. Results: Epileptic activity before (HR = 0.81, 95% CI = 0.68–0.96, P = 0.017) or after (HR = 0.74, 95% CI = 0.60–0.91, P = 0.005) HGG diagnosis associated with improved overall survival. Additionally, late seizure onset significantly associated with lower odds of achieving partial (OR = 0.25, 95% CI = 0.12–0.53, P = < 0.001) or complete (OR = 0.30, 95% CI = 0.18–0.50, P < 0.001) seizure control than patients with early seizure onset. Conclusions: Clinical seizures both at the time of diagnosis and later during the HGG treatment course are associated with improved overall survival. This association potentially persists for both IDH1-wildtype and IDH1-mutant patients, but further study is required. [ABSTRACT FROM AUTHOR]

Variant anatomy in the axillary region is of great clinical significance. It is one of the most frequently accessed regions for radical dissection surgery. During routine dissection of embalmed cadavers, we found a rare case of two accessory muscular slips emerging from the lateral border of latissimus dorsi (LD) and the inferolateral border of pectoralis major (PM), crossing the neurovascular structures in the axilla and merging distally together to the brachial fascia at the upper end of humerus below the bicipital groove. The accessory slip from LD is commonly referred to as the "axillary arch" in literature. We identified the accessory slip from the PM crossing over the axilla as pectoralis quartus. These aberrant slips can cause neurovascular compression in the axilla and can have clinical implications. Prior knowledge of the variant anatomy is the key to successful surgery in the axilla, thereby avoiding inadvertent injuries and post-operative complications. [ABSTRACT FROM AUTHOR]

The historical use of the term non-alcoholic fatty liver disease (NAFLD) in obese/overweight children has been controversial as to the appropriateness of this terminology in children, and lately, in adults too. Newer game-changer terminology, metabolic (dysfunction)-associated fatty liver disease (MAFLD), for this condition signifies a positive step forward that addresses the limitations of the previous definition for both adults and children. The prevalence of MAFLD has surged in tandem with the global rise in obesity rates, establishing itself as a predominant cause of chronic liver disease in both adult and pediatric populations. The adoption of the recently proposed nomenclature reflects a more encompassing comprehension of the disease and its etiology compared to its predecessor, NAFLD. Notably, the revised terminology facilitates the recognition of MAFLD as an autonomous condition while acknowledging the potential coexistence of other systemic fatty liver disorders. Particularly in children, this includes various paediatric-onset genetic and inherited metabolic disorders, necessitating thorough exclusion, especially in cases where weight loss interventions yield no improvement or in the absence of obesity. MAFLD presents as a multifaceted disorder; evidence suggests its origins lie in a complex interplay of nutritional, genetic, hormonal, and environmental factors. Despite advancements, current non-invasive diagnostic biomarkers exhibit limitations in accuracy, often necessitating imaging and histological evaluations for definitive diagnosis. While dietary and lifestyle modifications stand as cornerstone measures for MAFLD prevention and management, ongoing evaluation of therapeutic agents continues. This article provides an overview of the latest developments and emerging therapies in the realm of paediatric MAFLD. [ABSTRACT FROM AUTHOR]

Angiectatic nasal polyps (ANP) are rare pseudo-neoplastic lesions that might raise intriguing pathophysiological issues and present a significant diagnostic challenge. They are also referred to as inflammatory granuloma telangiectaticum, vascular granuloma, pseudo-angioma, and angiomatous/angiectatic polyp. However, the name angiectatic polyp refers to the fact that the lesion is not a true tumour and is clinically distinguished by ectatic vasculature, haemorrhage, and persistent proliferation. The most confusing aspect of this polyp is its clinical appearance, which resembles a juvenile nasal angiofibroma. Despite its typical imaging characteristics, this lesion is difficult to differentiate radiologically. Hence, histopathology is paramount for establishing diagnosis. We report a rare case of a young adult who presented with complaints of nasal block and epistaxis. Examination revealed a vascular nasal mass and CT scan demonstrated the lesion to be epicentred in right nasal cavity extending to multiple sinuses with adjacent bone erosion. Patient underwent endoscopic excision of the mass with JNA as the predominant differential and only following histopathological examination, the final diagnosis was confirmed. [ABSTRACT FROM AUTHOR]

This article primarily focuses on the single-valued and multi-valued cases of the class of nonlinear Caputo two-term fractional differential equation with three-point integral boundary conditions. In the single-valued case, we employ Schaefer’s fixed point theorem and the Banach fixed point theorem to establish results regarding the existence and uniqueness of solutions, using linear growth and Lipschitz conditions. Furthermore, we delve into the stability analysis of the single-valued problem using Ulam–Hyers and Ulam–Hyers–Rassias stabilities. In addition to the above, we address the multi-valued scenario and provide results on the existence of solutions. This is achieved by employing the Covitz–Nadler FPT and the nonlinear alternative for contractive maps. As an application of our fundamental findings, we present illustrative examples that validate our results. These examples have been implemented using MATLAB. [ABSTRACT FROM AUTHOR]

The mixing of N3 and N719 metal-complex dyes was investigated in this work to determine the effects of the combination of dyes on TiO2film for application in dye-sensitized solar cells (DSSCs). The dyes were mixed in a ratio of 1:1, and their performance in the DSSCs was measured using current–voltage curves and electrochemical impedance spectroscopy (EIS). The results indicated that the efficiency of the DSSCs increased to 7% with the addition of the N719 dye to the N3 dye. The surface morphology revealed a smooth and homogeneous distribution of TiO2 nanoparticles, and the mixed dyes showed broad absorption spectra in the visible region. The EIS results indicated a low electron recombination rate and long electron lifetime for the mixed dye-sensitized solar cells. Overall, the study demonstrated the potential for using a combination of N3 and N719 dyes to improve the efficiency of DSSCs. The employment of mixed dye as a photosensitizer in DSSCs may offer a promising approach for achieving high-performance and cost-effective DSSCs. [ABSTRACT FROM AUTHOR]

A printed circuit board (PCB) is an essential and central component of electronic waste and comprises majorly valuable metallic values (Sn, Pb, Cu). This study utilizes a short, fast-heating, low-temperature pyrolysis process to recover value-added tin-based alloy from spent cathode ray tube (CRT) PCB. The optimized process condition (550 °C, 10 minutes) resulted in ~ 62 wt pct solid, ~ 8.5 wt pct oil, and ~ 29.5 wt pct gas products. Sn recovery of ~ 75 pct in the Pb-Sn metallic droplet form with the purity of Sn + Pb ~ 85.2 pct at 550 °C within 10 minutes is obtained. Sn-based alloy does not form at 400 °C due to incomplete decomposition of the polymeric fraction and limited surface tension, as revealed by characterization. At higher temperatures (550 °C), the molten alloy spreads over the PCB Cu tracks due to enhanced wetting force, leading to diffusion of Sn in Cu and separation of Pb. The diffusion of Sn in Cu leads to the formation of intermetallics (Cu3Sn, Cu6Sn5) at higher residence times and temperatures, inhibiting the recovery of the alloy. Further, the quenching causes spinodal decomposition, leading to a zebra stripe pattern in the alloy, and XPS confirmed the absence of Br in the alloy. The organic functional group disappears from the residual solid char with temperature, as revealed by FT-IR. The gaseous product comprises CH4, CO, CH3OH, C2H6, C2H4, and CO2 with gross heating value of ~ 310 kJ/m3. The pyrolyzed oil comprised ~ 60 pct phenol and phenolic compounds and can be re-utilized for synthesizing phenolic resins and epoxy resin. ~ 0.19 kg of Sn-based alloy (~ 85.2 pct purity) can be recovered from 1 kg of PCB as a feedstock for the tin-making industry and soldering applications. [ABSTRACT FROM AUTHOR]

To evaluate the utility of CD43 and CD200 in differentiating chronic lymphocytic leukemia (CLL) from other mature B-cell neoplasms. This was a cross-sectional study on patients diagnosed with B-cell neoplasms on flowcytometry. The median fluorescence intensity (MFI) of CD43, CD200 expressing neoplastic B-cells were compared between the CLL and non-CLL B-cell neoplasms followed by receiver operating characreristic curve (ROC) analysis. In addition, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CD43 and CD200 in diagnosing CLL were analysed. A total of 137 patients were included. The CLL group consisted 87 patients and non-CLL group consisted 50 patients. The Mann–Whitney U test showed significant CD43 expression (U = 997.5, Z= − 5.265, p < 0.001) and CD200 expression (U = 932.0, Z = − 5.5, p < 0.01) in CLL patients compared to non-CLL patients. The area under the curve were 0.771 and 0.786 for MFI of CD43 and CD200 in differentiating CLL from non-CLL group respectively. The optimal cut-off of MFI for CD43 and CD200 were 1323 and 1775 respectively. The sensitivity, specificity, PPV and NPV of CD43 in diagnosing CLL cases were 97.7%, 66%, 83.3% and 94.2% respectively. The sensitivity, specificity, PPV and NPV of CD200 in diagnosing CLL cases were 100%, 32%, 71.9% and 100% respectively. CD43 and CD200 are useful markers in differentiating CLL from other mature B-cell neoplasms with higher MFI expression of both markers found in CLL. [ABSTRACT FROM AUTHOR]

Fake news being spread on social media platforms has a disruptive and damaging impact on our lives. Multimedia content improves the visibility of posts more than text data but is also being used for creating fake news. Previous multimodal works have tried to address the problem of modeling heterogeneous modalities in identifying fake news. However, these works have the following limitations: (1) inefficient encoding of inter-modal relations by utilizing a simple concatenation operator on the modalities at a later stage in a model, which might result in information loss; (2) training very deep neural networks with a disproportionate number of parameters on small multimodal datasets result in higher chances of overfitting. To address these limitations, we propose GAME-ON, a Graph Neural Network based end-to-end trainable framework that allows granular interactions within and across different modalities to learn more robust data representations for multimodal fake news detection. We use two publicly available fake news datasets, Twitter and Weibo, for evaluations. GAME-ON outperforms on Twitter by an average of 11% and achieves state-of-the-art performance on Weibo while using 91% fewer parameters than the best comparable state-of-the-art baseline. For deployment in real-world applications, GAME-ON can be used as a lightweight model (less memory and latency requirements), which makes it more feasible than previous state-of-the-art models. [ABSTRACT FROM AUTHOR]

Dirofilariasis is an infection caused by the filarial nematode Dirofilaria. Dirofilaria immitis primarily causes pulmonary dirofilariasis, while subcutaneous dirofilariasis is usually caused by Dirofilaria tenuis and Dirofilaria repens but can rarely be caused by Dirofilaria immitis as well. Here we report a rare case where in a 26-year-old with a history of international travel presented with swelling over the nasal dorsum. Following surgical excision, histopathological examination revealed dirofilariasis. Although uncommon, this zoonosis should be taken into consideration as a differential diagnosis of facial swellings. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to compare the anesthetic efficacy of 4% articaine, 0.5% bupivacaine and 0.5% ropivacaine (with 1:200,000 adrenaline) during surgical removal of impacted mandibular third molars. Materials and methods: The study included 75 patients randomly divided into three equal groups of 25 patients each. The study variables were: onset of anesthetic action, duration of surgery and anesthesia and postoperative analgesia. A visual analog scale was used to assess pain at different time intervals. Statistical analysis revealed insignificant difference among groups in terms of volume of anesthetic solution used, quality of anesthesia, surgical difficulty and duration of surgery. Results: The mean onset time was significantly (P < 0.001) shorter for articaine (1.14 min) than ropivacaine (2.18 min) and bupivacaine (2.33 min). However, the duration of anesthesia as well as analgesia was significantly (P < 0.001) longer for bupivacaine (483.6 min and 464 min) and ropivacaine (426.6 min and 459 min) as compared to articaine (232.8 min and 191.4 min), respectively. Also, on comparing three groups pain scores at 6th postoperative hour were significant (P < 0.01). Conclusion: Ropivacaine and bupivacaine can be safely used in patients where longer duration of surgery is anticipated. [ABSTRACT FROM AUTHOR]

Adult muscle tissue largely comprised of differentiated myofibers also harbors quiescent muscle-resident stem cells (MuSCs) that are responsible for its maintenance, repair and regeneration. Emerging evidence suggests that quiescent MuSCs exhibit a specific metabolic state, which is regulated during physiological and pathological alterations. However, a detailed understanding of the metabolic state of quiescent MuSCs and its alteration during activation and repair is lacking. Direct profiling of MuSCs in vivo is challenging because the cells are rare and dispersed, while isolation and enrichment leads to their activation and loss of quiescence. In this study, we employed 1H-nuclear magnetic resonance (NMR) spectroscopy to profile metabolites in an established culture model of quiescent MuSC-derived myoblasts and compared with activated, proliferative and differentiated muscle cells to determine the state-specific metabolome. We report that the proliferating and differentiated cells are highly enriched in metabolites involved in energy generation, the quiescent state is enriched in metabolites related to phospholipid catabolism (glycerophosphocholine and choline) and depleted for phosphocholine which is enriched in proliferating cells. We propose that the ratio of these metabolites may be useful as a biomarker of MuSC quiescence. [ABSTRACT FROM AUTHOR]

Naturally occurring canine invasive urinary carcinoma (iUC) closely resembles human muscle invasive bladder cancer in terms of histopathology, metastases, response to therapy, and low survival rate. The heterogeneous nature of the disease has led to the association of large numbers of risk loci in humans, however most are of small effect. There exists a need for new and accurate animal models of invasive bladder cancer. In dogs, distinct breeds show markedly different rates of iUC, thus presenting an opportunity to identify additional risk factors and overcome the locus heterogeneity encountered in human mapping studies. In the association study presented here, inclusive of 100 Shetland sheepdogs and 58 dogs of other breeds, we identify a homozygous protein altering point mutation within the NIPAL1 gene which increases risk by eight-fold (OR = 8.42, CI = 3.12–22.71), accounting for nearly 30% of iUC risk in the Shetland sheepdog. Inclusion of six additional loci accounts for most of the disease risk in the breed and explains nearly 75% of the phenotypes in this study. When combined with sequence data from tumors, we show that variation in the MAPK signaling pathway is an overarching cause of iUC susceptibility in dogs. [ABSTRACT FROM AUTHOR]

Recursive Least Square (RLS) is a popular algorithm for noise cancellation in non-stationary signals; however, it demands more computational resources and more difficult mathematical operations. Also, RLS has less performance stability. The present research explores a novel idea of an RLS adaptive noise cancellation through a modified method that uses an RLS adaptive filter by introducing an additional constant multiplier, along with their in-depth analysis. The proposed algorithm is analyzed using three primary performance metrics: mean square error (MSE), signal-to-noise ratio (SNR), and convergence rate. The obtained results demonstrate that the proposed algorithm has reduced the MSE by 79.65%, which leads to an improvement in SNR by 86.16% compared to the traditional RLS algorithm. The additional constant multiplier is optimized for SNR, and the optimized value is found to be equal to 0.65, which gives the best possible SNR value of 19.38 dB. Also, the proposed algorithm has been successfully applied to a real-world scenario in acoustic echo cancellation (AEC). The experimental setup for the echo canceller is simulated on MATLAB to measure the echo canceller efficiency in terms of MSE and echo return loss enhancement. Based on performance evaluation, the proposed algorithm has been found to better echo cancellation in AEC as compared to traditional RLS. [ABSTRACT FROM AUTHOR]

Simultaneous measurement of strain and temperature is crucial for various applications that operate in diverse environments. Fiber Bragg gratings, known for their sensitivity to both strain and temperature, can serve as effective sensors for such simultaneous measurements. However, achieving discrimination between strain and temperature in FBG sensors requires the incorporation of a distinct mechanism in their design. This present a novel approach to dual sensing by exploring the impact of modulation depth of refractive index in cascaded FBGs. Modulation depth of refractive index is a significant spectral parameter of FBGs, influencing the grating's strength. By cascading two gratings with different modulation depths, the reflection spectrum exhibits two peaks, and their amplitudes are influenced by the modulation depth. Notably, the proposed sensor design eliminates the need for complicated packaging, which is often time-consuming and expensive. The study includes a simulation analysis of the proposed sensor, consisting of two FBGs with distinct modulation depths of refractive index. This technique demonstrates a linear variation in both Bragg wavelength and normalized peak difference (M) in response to changes in strain and temperature. The obtained strain and temperature sensitivities in this study were 1.19 pm/με and 11.4 pm/°C, respectively. [ABSTRACT FROM AUTHOR]

Adenomyomatous hyperplasia and adenomyoma are rare benign inflammatory pseudotumors of the gallbladder arising from Rokitansky-Aschoff sinuses. Occurrence of these hyperplastic conditions in the Vaterian and biliary system is extremely rare and is a concern for gastroenterologists and surgeons in distinguishing them from primary malignancies of the biliary system. Definitive diagnosis by imaging or cytopathological examination is difficult; thus, surgical resection becomes the only choice in such cases to relieve the obstruction. Here, we report two extremely rare cases of adenomyomatous hyperplasia of the extrahepatic bile duct after an extensive diagnostic workup, followed by Whipple's procedure. [ABSTRACT FROM AUTHOR]

Lyophilization also known as freeze-drying is a technique that has been employed to enhance the long-term durability of nanoparticles (NPs) that are utilized for drug delivery applications. This method is used to prevent their instability in suspension. However, this dehydration process can cause stress to the NPs, which can be alleviated by the incorporation of excipients like cryoprotectants and lyoprotectants. Nevertheless, the freeze-drying of NPs is often based on empirical principles without considering the physical–chemical properties of the formulations and the engineering principles of freeze-drying. For this reason, it is crucial to optimize the formulations and the freeze-drying cycle to obtain a good lyophilizate and ensure the preservation of NPs stability. Moreover, proper characterization of the lyophilizate and NPs is of utmost importance in achieving these goals. This review aims to update the recent advancements, including innovative formulations and novel approaches, contributing to the progress in this field, to obtain the maximum stability of formulations. Additionally, we critically analyze the limitations of lyophilization and discuss potential future directions. It addresses the challenges faced by researchers and suggests avenues for further research to overcome these limitations. In conclusion, this review is a valuable contribution to the understanding of the parameters involved in the freeze-drying of NPs. It will definitely aid future studies in obtaining lyophilized NPs with good quality and enhanced drug delivery and therapeutic benefits. [ABSTRACT FROM AUTHOR]

A comparative analysis with methyl ammonium lead iodide and methyl ammonium tin iodide as absorber layers in a perovskite solar cell (PSC) is done through modelling and simulation in SCAPS-1D. Four lead-based and lead-free models with similar transporting layers are optimized with respect to the donor and acceptor densities of transporting layers as well as absorber keeping other parameters like total defect density and thickness same. It is observed that lead-free tin-based PSCs shows best performance than the lead-based PSC with similar transporting materials. With Cu2O and TiO2 as hole and electron transport layers respectively, lead and lead-free PSC exhibits 20.18 and 28.76% conversion efficiencies. On the other hand, CuI and PCBM taken as corresponding layers the conversion efficiencies reach 17.86 and 24.16% efficiencies for lead and lead-free PSCs respectively. The study enforces the use of non-toxic lead-free PSC with better performance than lead-based PSCs. [ABSTRACT FROM AUTHOR]

This article explores the Hilfer fractional derivative within the context of fractional differential equations and investigates a mathematical model formulated as a three-point boundary value problem (BVP). The primary focus is on the application of these models to analyze the jet flow of the Antarctic Circumpolar Current. The study establishes the existence of stream functions using Schaefer's fixed point theorem under the assumption of the continuity of the vorticity function Φ . Furthermore, the article delves into the existence and uniqueness results of the stream functions by employing the Banach fixed point theorem. This analysis is conducted under the condition that the vorticity function Φ is Lipschitz continuous with respect to the stream function. Additionally, the stability of the stream functions of the BVP is explored through Ulam–Hyers and generalized Ulam–Hyers stability analyses. In contrast to the foundational results presented for the three-point BVP, the article includes illustrative examples aimed at validating the findings. [ABSTRACT FROM AUTHOR]

Background: The repurposing of FDA-approved drugs for anti-cancer therapies is appealing due to their established safety profiles and pharmacokinetic properties and can be quickly moved into clinical trials. Cancer progression and resistance to conventional chemotherapy remain the key hurdles in improving the clinical management of colon cancer patients and associated mortality. Methods: High-throughput screening (HTS) was performed using an annotated library of 1,600 FDA-approved drugs to identify drugs with strong anti-CRC properties. The candidate drug exhibiting most promising inhibitory effects in in-vitro studies was tested for its efficacy using in-vivo models of CRC progression and chemoresistance and patient derived organoids (PTDOs). Results: Albendazole, an anti-helminth drug, demonstrated the strongest inhibitory effects on the tumorigenic potentials of CRC cells, xenograft tumor growth and organoids from mice. Also, albendazole sensitized the chemoresistant CRC cells to 5-fluorouracil (5-FU) and oxaliplatin suggesting potential to treat chemoresistant CRC. Mechanistically, Albendazole treatment modulated the expression of RNF20, to promote apoptosis in CRC cells by delaying the G2/M phase and suppressing anti-apoptotic-Bcl2 family transcription. Conclusions: Albendazole, an FDA approved drug, carries strong therapeutic potential to treat colon cancers which are aggressive and potentially resistant to conventional chemotherapeutic agents. Our findings also lay the groundwork for further clinical testing. [ABSTRACT FROM AUTHOR]

The present paper provides a new perspective of previously published findings by Siwak (Food Chem 141:1227–1241, 2013) which showed that 15 structurally diverse flavonoids reduced toxicity (i.e., enhanced cell viability) from hypochlorite using the MTT assay within a pre-conditioning experimental protocol, with each agent showing a similar biphasic concentration response relationship. We use this Commentary to point out that each of the concentration response relationships are consistent with the hormetic dose response. The paper of Siwak (Food Chem 141:1227–1241, 2013) is unique in that it provides a comparison of a relatively large number of agents using the identical experimental protocol. [ABSTRACT FROM AUTHOR]

An on-time and accurate analysis of the problem is essential to prevent and treat any illness. The utilization of machine learning (ML) for diagnosing a wide range of diseases is increasingly prevalent in the field of medical science based on symptoms experienced during diseases. The main objective of the research is to make a comparative analysis of different ML models that accurately predicts diseases based on symptoms. To do so, the dataset obtained from Kaggle comprises information related to 41 diseases including their symptoms which are in 17 columns with their weights. In other words, we have a group of 17 symptoms, independent variables (symptoms differ for each patient except some), and 1 target variable (disease). Furthermore, preprocessing is applied to data to make it suitable for the various machine learning approaches. After that, three scaling techniques are used: standard scaling, min-max, and PCA (principal component analysis) for normalization. The present study utilized a variety of ML models, which includes LGB classifier, KNN, random forest (RF), CatBoost, support vector machine (SVM), XGBoost, and a hybrid model that combined two existing approaches (SVM and XGBoost). Each scaling technique was assessed using various evaluative parameters such as root mean squared error (RMSE), cross-validation score, R2 score, mean squared error and accuracy. Random forest, LGB classifier, and XGBoost demonstrated superior performance when compared and evaluated to one another with regards to accuracy, R2 score, and RMSE, achieving scores of 98, 96, and 2.08% respectively. Also, the RF algorithm required less computation time in contrast to other scaling techniques, particularly in standard scaling, with a time of only 0.129 s. [ABSTRACT FROM AUTHOR]

Pediatric liver transplantation remains the gold standard for life-threatening acute and chronic liver diseases and multiple liver-based inherited metabolic defects. Advances in surgical techniques, better perioperative care and immunosuppression regimes have resulted in excellent long-term graft and patient survival. The success of pediatric liver transplantation does however bring the additional challenge of long-term patient outcomes including graft hepatitis-related fibrosis and suboptimal biopsychosocial outcomes. In this review, authors will explore the current landscape of pediatric liver transplantation including indications, timing of referral for liver transplantation, surgical techniques and long-term outcomes such as recurrence of pre-transplant liver disease, idiopathic graft hepatitis and biopsychosocial outcomes. Ultimately, early identification and management of potential issues long-term helps ensure our recipients achieve a "meaningful survival". [ABSTRACT FROM AUTHOR]

Chemical leaching of coals would be required to produce cleaner coals for some special applications where physical beneficiation may not be effective enough. This would also help in recovering Li and rare earth metals besides in the sequestration of CO2. About 20 Indian coals having complexly distributed moderate to high ash contents were sequentially treated with various alkali–acid such as NaOH-HCl, HF, HCl, HCl-HF, and NaOH-HCl-HF leaching. This aimed to establish and design the best stepwise sequential process for the highest degree of demineralisation through a chemical leaching process. Kinetics and process intensification studies were carried out. More than 80% demineralisation of Madhaipur and Neemcha coals was observed using the best sequential treatment designed presently. The repeated stepwise treatment of the alkali and the acid was also studied, which was found to significantly enhance the degree of demineralisation of coals. The integrated process of alkali–acid leaching followed by solvent extraction (Organo-refining) and vice versa of the treated coal was also studied for producing cleaner coals. [ABSTRACT FROM AUTHOR]

This work proposes a unique and compact architecture for a 2D photonic crystal (PhC) based all-optical 3-bit binary to gray and gray to binary code converters (BGCC and GBCC). The proposed designs incorporate all-optical XOR gates operating at a wavelength of 1.55 μ m with air holes in a silicon background arranged in the hexagonal (triangular) lattice structure. The linear interference effect is the basis for operation for the proposed all-optical 3-bit BGCC and GBCC in which the input beam phase is maintained at ϕ = 0 0 while appropriate phase difference is introduced at reference ports 1, 2, resulting in minimal power consumption. The proposed architectures are aimed to be scalable and compatible with Optical Integrated Circuits (OICs) while simultaneously reducing the size. In order to compute and analyse the specified performance metrics, the Plane wave expansion (PWE) and Finite Difference Time Domain (FDTD) approaches were implemented. The proposed designs have been optimized with respect to their structural parameters, namely, the radius of holes and lattice constant. All-optical XOR gates have been cascaded in a single stage to design the proposed all-optical 3-bit binary to gray code and gray to binary code converters. The simulation results show that the all-optical 3-bit binary to gray code and gray to binary code converters have shown 12.88 and 22.06 dB of contrast ratio, 0.32 and 0.76 ps of response period and a high bit rate of 3.12 and 1.31 Tbps respectively. [ABSTRACT FROM AUTHOR]

From July 2020 to June 2021, 248 wild house mice (Mus musculus), deer mice (Peromyscus maniculatus), brown rats (Rattus norvegicus), and black rats (Rattus rattus) from Texas and Washington, USA, and British Columbia, Canada, were tested for SARS-CoV-2 exposure and infection. Two brown rats and 11 house mice were positive for neutralizing antibodies using a surrogate virus neutralization test, but negative or indeterminate with the Multiplexed Fluorometric ImmunoAssay COVID-Plex, which targets full-length spike and nuclear proteins. Oro-nasopharyngeal swabs and fecal samples tested negative by RT-qPCR, with an indeterminate fecal sample in one house mouse. Continued surveillance of SARS-CoV-2 in wild rodents is warranted. [ABSTRACT FROM AUTHOR]

Myoepitheliomas are uncommon neoplasms of major and minor salivary glands. These tumours are encapsulated and slow growing in nature and are benign in majority of the cases. The mean age of presentation is 40 years and this entity is rarely reported in younger age groups. Here, we seek to report a rare case of a 10-year-old patient who presented with a swelling below the right ear. Clinical and radiological evaluation revealed a mass in the parotid gland. This patient was treated with a superficial parotidectomy and subsequent histopathological examination revealed it to be a myoepithelioma. [ABSTRACT FROM AUTHOR]

Introduction: The objective was to evaluate the efficacy of biochemical markers (WBC, CRP and fibrinogen) and the course of odontogenic space infections in 50 patients. Material and Methods: Blood samples were taken preoperatively and postoperatively at day 0, day 4, day 8 and day 12 for measuring the levels of all three biomarkers. The trends of the biomarkers were observed and compared with assessment parameters such as dental etiology, number of teeth involved, number of spaces involved, mouth opening and pain. Active pus discharge, dysphagia, hoarseness and swelling were assessed and scored accordingly. Results: The data were subjected to paired 't' test, McNemar's and Pearson's bivariate correlation as appropriate. Statistical analysis found strong correlation between laboratory values of markers and parameters used to measure severity of infection. All three biomarkers (WBC, CRP and fibrinogen) are significant markers for hospital stay (p < 0.01). Prospective analysis indicates that only one biomarker cannot be used to rule out specific diagnosis. Conclusion: The combination of three biochemical markers assessed in the present study (WBC, CRP and fibrinogen) should be used as prognostic factor in assessment, clinical severity and efficacy of treatment regime for patients as these can reliably predict the clinical course of odontogenic infection. [ABSTRACT FROM AUTHOR]

Pressure determination is an essential measure for safety assessment in modern applications. Conventional methods for measuring pressure have been replaced by fiber Bragg grating (FBG) sensors owing to inherent benefits. However, enhancing pressure sensitivity at the low-pressure range (< 10 kPa) is still a challenge for FBG sensors. Low pressure fails to induce significant strain on FBG, reducing the sensor's sensitivity. Therefore, a sensitizing mechanism must be incorporated into the sensor design along with a proper selection of materials. This paper presents mathematical modeling and simulation analysis of an FBG pressure sensor that uses a circular diaphragm and a flexure hinge-based beam made of acrylonitrile butadiene styrene as a sensing mechanism unit. A cascaded FBG is fixed on the notch surface of the flexure hinge beam which provides the measuring signal is based on Bragg wavelength. The sensor also eliminates the effect of temperature cross-sensitivity using cascade FBG. This mechanical configuration amplifies the low pressure to strain on the FBG. This design has the advantage of high sensitivity, compact size and high linearity. Here, the analysis of circular diaphragm and circular flexure hinge-based beam structure through finite element analysis and theoretical calculation has been carried out. Comparative analysis with the stainless steel sensor indicates the sensitivity of 80 pm/kPa for the ABS sensor which is 16 times greater than that of the stainless steel sensor. Such a sensor can be widely used for low-pressure measurements such as gas and oil pipelines, aircraft wall pressure, and heating, ventilation and air-conditioning. [ABSTRACT FROM AUTHOR]

Voice assessment before and after treatment helps the clinician to assess the effectiveness of the treatment given and facilitates comparison between different treatment modalities. Voice handicap index -10(VHI-10) questionnaire is a tool which allows the voice to be evaluated subjectively from the patient's perspective. PRAAT is a freely available, software programme that acoustically analyse voice signals. Smart phones are widely used and the high quality of the embedded microphone in it makes it a suitable and easily available voice recording device. This study aims at using PRAAT and VHI-10 questionnaire in evaluating voice before and after treatment. The utility of smart phones as a voice acquisition device is also explored in the study. Prospective, observational study, carried out from 1st November 2019 to 30th September 2021in the ENT out- patient department at a tertiary hospital in Punjab. 58 patients complaining of dysphonia were enrolled consecutively in the study. All patients underwent detailed history, examination of the larynx using 70-degree rigid laryngoscope. The voice handicap was scored by (VHI-10) questionnaire and acoustic evaluation of voice was done using the PRAAT software. Patients' voice was further evaluated 3 months post-therapy with VHI 10 questionnaire and acoustic analysis. The parameters measured on PRAAT were mean pitch, jitter (local), shimmer (local), and mean harmonics to noise ratio (HNR). The voice was recorded using a smart phone and later transferred onto a laptop for analysis. The pre and post treatment acoustic parameters and VHI-10 scores were compared and correlated. There was significant difference (p < 0.001) between the pre and post treatment VHI-10 scores and all the acoustic parameters measured except for median pitch (p = 0.995). A poor positive correlation was found between the pre treatment VHI-10 scores and jitter(r = 0.188, p = 0.157) and shimmer (r = 0.288, p = 0.028) values. A negative correlation was observed between pre treatment VHI-10 scores and pitch (r = − 0.151, p = 0.259) and HNR(r = − 0.424, p = 0.001). Post treatment VHI-10 scores showed positive correlation with jitter (r = 0.302, p = 0.021) and shimmer (0.162, p = 0.225) values and negative correlation with pitch (r = − 0.10, p = 0.457) and HNR (r = − 0.356, p = 0.006) values. We found significant differences in the VHI-10 scores and PRAAT voice analysis results before and after treatment in patients complaining with voice change (dysphonia). VHI-10 questionnaire and PRAAT are good and convenient tools for assessing the voice subjectively and objectively. Only a poor to fair correlation was found between VHI-10 scores and PRAAT analysis results. More studies must be done to confirm the utility of smart phones as a voice acquisition device and PRAAT software in voice analysis. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To compare the efficacy of titanium 2.0-mm curved locking strut plate and 2.0-mm straight locking miniplate with regard to their intraoperative use and the stability of fixation achieved both, clinically and radiographically. Materials and Methods: Forty patients with 62 sites of mandibular fractures requiring open reduction and internal fixation were included in the study. The sample was divided into two groups of twenty patients each depending upon whether patient received three-dimensional 2.0-mm locking curved strut plate (group A) or 2.0-mm straight locking miniplates (group B). Mouth opening, teeth in the fracture line, degree of displacement, time taken, neurosensory and bite force evaluation were done preoperatively, 1st, 7th day, 2nd week, 4th week, 6th week and 12th week postoperatively. Results: Positive correlation was found between preoperative and postoperative bite force values at subsequent follow-up weeks. At 3rd month evaluation, the change in bite force from the previous follow-up visit was significantly greater in group A (locking strut plate) than group B (locking miniplate) in the incisor, left molar and right molar region. Statistically significant difference was observed between the two groups regarding time taken (P < 0.016) depicting less time taken for placement of three-dimensional 2.0-mm locking curved strut plate(group A) 20.30 ± 4.85 min as compared to 27.30 ± 6.82 min for fixation with 2.0 mm straight locking miniplates in group B. Conclusion: The findings were suggestive that the both systems had better adaptation during fixation, comparable radiographic reduction and increased stability in postoperative period. However, 3D locking strut plate took relatively lesser operative time, offered good rigidity and better stabilization of fractured segments in three dimensions along with significant improvement in the masticatory bite force postoperatively. [ABSTRACT FROM AUTHOR]

Purpose of Review: Recombinant adeno-associated virus (rAAV) is the commonest viral vector used in gene therapies. With the increase in the number of such therapies being employed in human clinical trials and approved clinical use, the associated adverse events are increasingly observed. Hepatotoxicity is the most common adverse event. Recent Findings: Although mild in most, hepatotoxicity may affect gene therapy efficacy, lead to acute liver failure, death and persisting hepatitis necessitating prolonged use of immunosuppressants. There has been an increase in the referrals of such cases to hepatologists. Summary: There is a lack of good quality evidence on the use of reactive immunosuppressants. There is a need to devise empiric protocols to diagnose and treat hepatotoxicity based on the side-effect profile of individual gene therapy, the present understanding of immunological basis of hepatotoxicity, the experience with various immunosuppressants in other disorders and the unique challenges and requirements of gene therapy. [ABSTRACT FROM AUTHOR]

The first two years of life is a critical window for good nutrition. Promoting infant and young child feeding (IYCF) practices in the first two years can help improve child survival and promote healthy growth and development. Assessment of IYCF practices is important, especially in developing countries like India where optimal IYCF practices can potentially prevent 12% of all deaths under 5 years of age, to promote awareness and intervene appropriately. The objective of our study is to generate evidence for the association between different types of mass media and appropriate IYCF practices in India, including optimal breastfeeding and appropriate complementary feeding practices. A positive association between them can point to intervention at scale. We analyzed data from India's National Family Health Survey 5 (NFHS-5), 2019–2021. Multivariable logistic regression was used to examine the association of appropriate IYCF practices with mass media exposure. After controlling for demographics and socioeconomic status, the analyses showed that, overall, women who had exposure to television followed by newspaper and movies, had higher odds of adopting the recommended IYCF practices. The results also showed that the association of media exposure varied for different IYCF practices by geography. For instance, in the rural areas, television exposure was positively associated with all the IYCF practices, but in the urban areas, television exposure was positively associated with only early initiation of breastfeeding [OR 1.25; (95% CI 1.1–1.42)]. The study strengthens our understanding that an appropriate selection of mass media channels for intervention programs can promote IYCF practices at scale. Appropriately selecting the type of mass media to create awareness about different IYCF practices, in specific urban–rural settings, could help customize intervention programs to successfully influence IYCF behaviors. [ABSTRACT FROM AUTHOR]

Objective: To identify variables predictive of durable clinical success after MRI-guided focused ultrasound (MRgFUS) treatment of uterine fibroids. Materials and methods: In this prospective, multicenter trial, 99 women with symptomatic uterine fibroids were treated using MRgFUS. Pelvic MRI was obtained at baseline and treatment day. The Uterine Fibroid Symptom-Quality of Life questionnaire was used to calculate a symptom severity score (SSS) at baseline and 6, 12, 24, and 36 months following treatment. Clinical, imaging, and treatment variables were correlated with symptom reduction sustained through the 12- and 24-month time points using univariable and multivariable logistic regression analyses. A novel parameter, the ratio of non-perfused volume to total fibroid load (NPV/TFL), was developed to determine association with durable outcomes. Results: Post-treatment, mean symptom severity decreased at the 6-, 12-, 24-, and 36-month follow-ups (p < 0.001, all time points). In univariable analysis, three variables predicted treatment success (defined by ≥ 30-point improvement in SSS) sustained at both the 12-month and 24-month time points: increasing ratio of NPV/TFL (p = 0.002), decreasing total fibroid load (p = 0.04), and the absence of T2-weighted Funaki type 2 fibroids (p = 0.02). In multivariable analysis, the NPV/TFL was the sole predictor of durable clinical success (p = 0.01). Patients with ratios below 30% had less improvement in SSS and lacked durable clinical response compared with those between 30–79 (p = 0.03) and ≥ 80% (p = 0.01). Conclusion: Increased non-perfused volume relative to total fibroid volume was significantly associated with durable reduction of symptoms of abnormal uterine bleeding and bulk bother. Clinical relevance statement: Patient selection for sustained clinical benefit should emphasize those with likelihood of achieving high ablation ratios, as determined by imaging (e.g., device access, Funaki type) and by considering the total fibroid load, not just the primary symptomatic fibroid. Trial registration: Clinical trial ID: NCT01285960. Key Points: • Patient selection/treatment approach associated with durable symptom relief in MRI-guided focused ultrasound ablation of uterine fibroids remains unclear. • The ablation ratio, non-perfused volume/total fibroid volume, was positively associated with sustained symptom relief in both bleeding and bulk bother at 1- and 2-year follow-ups. • Selecting patients with imaging features that favor a high ratio of ablation to total fibroid load (including non-targeted fibroids) is the main factor in predicting durability of symptom relief after uterine fibroid treatment. [ABSTRACT FROM AUTHOR]

We assess the theoretical feasibility of percutaneous posterior sacral foramen (pSF) needle puncture of the sacral dural sac (DS) by studying the three-dimensional imaging anatomy of pSFs relative to the sacral canal (SC). On CT images of 40 healthy subjects, we retrospectively studied sacral alae passageways from SC to pSFs in all three planes to determine if an imaginary spinal needle could theoretically traverse S1 or S2 pSFs in a straight path toward DS. If not straight, we measured multiplane angulations and morphometrics of this route. We found no straight connections between S1 or S2 pSFs and SC. Instead, there were bilateral spatially complex dorsoventral M-shaped "foraminal conduits" (FCs; common, ventral, and dorsal) from SC to anterior SFs and pSFs that would prevent percutaneous straight needle puncture of the DS. This detailed knowledge of the sacral FCs will be useful for accurate imaging interpretation and interventional procedures on the sacrum. [ABSTRACT FROM AUTHOR]

Purpose: SARS-CoV-2 had a significant impact on public health since its declaration as a pandemic. It is linked to a high rate of multiple organ dysfunction syndrome (MODS) and a slew of long-term symptoms that are yet to be thoroughly investigated. Among these, genitourinary symptoms of an overactive bladder (increased frequency, urgency, and nocturia) have recently been identified and labeled as COVID-associated cystitis (CAC). This current research is performed to review this phenomenon. Methods: A literature search was performed in MEDLINE, Cochrane, and Google Scholar databases and 185 articles were obtained in total, including reviews and trials involving CAC, which were screened using various methods, and 42 articles were gathered for the review. Results: Among its multitude of symptoms, overactive bladder (OAB) leads to poorer outcomes. The inflammatory mediator-based theory and the ACE-2 receptor-based theory are two probable theories for how it harms the bladder urothelium. The expression of ACE-2 receptors during the pathogenesis of CAC warrants further investigation as ACE modulation may reveal more information about COVID-19 complications. Other comorbidities, immunocompromised patients, or patients with a history of urinary tract infections can also exacerbate this condition. Conclusion: The scarce literature collected related to CAC gives us an insight into the symptomatology, pathophysiology, and possible treatment plans. Treatment choices are diverse among COVID-19-afflicted and unaffected patients for treating urinary symptoms which highlights the importance to distinguish between the two. CAC shows greater prevalence and morbidity when linked to other conditions, thereby warranting future developments in it. [ABSTRACT FROM AUTHOR]

Background: Fistulizing perianal Crohn's disease (CD) is a debilitating condition associated with significant morbidity and reduction in the quality of life. Magnetic resonance imaging (MRI) of the pelvis is the preferred imaging modality for the comprehensive assessment of the perianal fistula. There is a paucity of data from India on the MRI spectrum of complex perianal fistula in CD. Methods: A single-centre cross-sectional analysis of patients with fistulizing perianal CD, who underwent pelvic MRI between January 2020 and December 2021, was performed. The clinical (age, sex, disease duration, disease location and behavior, disease activity [Perianal Disease Activity Index, PDAI] and treatment received) and radiological (number and location of fistulae, extensions, number and location of internal and external openings, fistula activity, presence or absence of perianal abscess and associated proctitis) characteristics of complex perianal fistula (defined according to the American Gastroenterological Association classification) were recorded. Results: Of total 175 patients with CD who attended the gastroenterology clinic during the study period, 27 (15.42%) (mean age 42±15.5 years, 62.96% females and median disease duration four years) had complex perianal fistula and were included in the analysis. The mean PDAI was 5.48±2.53. The median Van Assche Index was 17 (interquartile range [IQR] 13–19). A majority (96.29%) of the fistulae were trans-sphincteric and four (14.81%) fistulae extended into the supralevator space. All fistulae were active on MRI. Concomitant perianal abscess and proctitis were seen in 59.26% (n=16) and 62.96% (n=17) of patients, respectively. Combination therapy with biologics and antibiotics/immune-suppressants were the most commonly prescribed medical therapy. Six (22.22%) patients underwent combined medical and surgical (non-cutting seton, fistulectomy, fecal diversion) treatment. Conclusion: The cumulative risk of the development of fistulizing perianal CD in a northern Indian cohort was similar to the western populations. Complex perianal fistulae were predominantly trans-sphincteric and commoner in females. MRI evaluation is pivotal for the delineation of fistula anatomy, assessment of disease extent and activity and the evaluation of concomitant perianal abscess and other complications. [ABSTRACT FROM AUTHOR]