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Diabetes Mellitus (DM) is the group of diseases where the patient suffers from higher levels of sugar in blood over a prolonged time. Machine learning classifier helps to predict the disease based on the condition of the symptom suffered by the patient. The aim of this paper is to compare the performance of the machine learning tree classifiers in predicting Diabetes Mellitus (DM). Machine learning tree classifiers such as Random Forest, C4.5, Random Tree, REPTree, and Logistic Model Tree (LMT) were analyzed based on their accuracy and True Positive Rate (TPR). In this analysis of predicting diabetes mellitus Logistic Model Tree (LMT) machine learning tree classifier achieved higher accuracy of 79.31%, True Positive Rate (TPR) of 0.739 and an execution time of 1.09 sec than other classifiers under study.

Background: Women with triple-negative breast cancer (TNBC) have a more aggressive clinical course, with a higher propensity to metastasize and a worse outcome due to a lack of effective therapies and significant intratumoral and intertumoral heterogeneity. Development of novel therapeutic strategies represents a clear unmet need. We have developed a first-in-class compound, an oligobenzamide, ERX-41, that has anti-proliferative activity against all six molecular subtypes of TNBC. Methods: In vitro activity of ERX-41 on TNBC cell lines was tested using CellTiter glo, MTT, and apoptosis assays. Efficacy of ERX-41 was tested using TNBC patient derived explants (PDEs) ex vivo, cell line-derived xenografts (CDXs), and patient derived xenografts (PDX) in vivo. To examine the mechanism, we conducted mass spec analyses using total lysates of TNBC cells treated with vehicle or ERX-41. Results: ERX-41 demonstrated potent activity in both blocking proliferation and inducing apoptosis in 30 distinct cell line models of TNBC, (representing all six molecular subtypes of TNBC), with an IC50 that ranges from 50-250nM. Incubation of ERX-41 with PDEs from primary TNBC patient tumors ex vivo caused a significant reduction in proliferation indices, as measured by Ki67 staining. ERX-41 also decreased proliferation and increased apoptosis in explants from TNBC CDX and PDX tumors cultured ex vivo. Oral administration of ERX-41 (10 mg/kg/daily) was shown to be non-toxic and dramatically limited the growth of CDX tumors derived from MDA-MB-231, SUM-159 or D2A1 syngeneic tumors. Importantly, ERX-41 treatment also significantly reduced tumor progression in four TNBC PDX (PDX-1, PDX-89, PDX-96 and PDX-98) models compared to the vehicle treated control group. Our ultrastructural and molecular studies indicate that ERX-41 induces significant endoplasmic reticulum (ER) stress within TNBC cells but not in primary epithelial cells. Global mass spectrometry studies indicated that ERX-41 treatment resulted in the alteration [down regulation (265 proteins) or upregulation (218 proteins)] of 483 proteins out of ~4000 proteins quantified with two or more peptides. Reactome pathway analysis indicated that the top pathways modulated by ERX-41 included Intra-Golgi and retrograde Golgi-to-ER traffic, membrane trafficking and TP53 mediated apoptosis. ER stress induced by ERX-41 blocks de novo protein synthesis, and triggers ER-assisted degradation (ERAD) pathways, causing TNBC apoptotic cell death. Conclusions: ERX-41 is orally bioavailable, non-toxic, and demonstrated activity in primary PDEs, CDXs and PDXs. The ability of ERX-41 to induce ER stress and apoptotic cell death in multiple types of TNBC suggests that this drug targets a fundamental weakness in TNBC cells (the high basal level of ER stress) and can effectively overcome the heterogeneity of TNBC. These studies strongly support the further clinical translation of ERX-41. Citation Format: Suryavathi Viswanadhapalli, Xihui Liu, Shi-Hong Ma, Tae-Kyung Lee, Mengxing Li, Weiwei Tang, Junhao Liu, Xiaonan Li, Gangadhara R. Sareddy, Rajeshwar Rao Tekmal, Jung-Mo Ahn, Ratna K. Vadlamudi, Ganesh V. Raj. Preclinical evaluation of ERX-41 in triple negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1237.

This retrospective study reports the 1-year outcome in women who underwent mesh-augmented Prolift surgery performed from 2006 to 2008. There were a total of 254 patients, with 128, 106 and 20 patients receiving total, anterior and posterior Prolift, respectively.Incidence of thigh pain was lower in 2008 compared to 2006 and 2007 (p0.0001). The percentage of patients requiring blood transfusions (p = 0.09), duration of IDC ≥ 7 days (p = 0.27), wound dehiscence and re-operation rate were lower in 2008 in contrast to 2006 and 2007 (p = 0.43). Only 209 patients (82.3%) were available for review at 1 year. There were two (1.0%) cases of recurrent vault prolapse.The subjective and objective cure rates at 1 year after this mesh implant surgery in 2006, 2007 and 2008 were 92.1% and 92.1%; 97.0% and 92.4% and 100% and 97%, respectively. The mesh erosion rate was remarkably lower in 2008 as compared to 2007 and 2006 (p0.001).This synthetic mesh-augmented implant surgery is effective and safe, and surgical outcome appears related to the learning curve of the surgeon.

Multiple stab wounds are very common features of homicidal stabbing. The common findings differentiating homicidal and suicidal stabbing are well described in the medical literature. Among the features mentioned are location, shape, and direction of the wounds. These features are vital in differentiating suicide from homicide. However, this case has an unusual presentation. We discuss the importance of interpretation and differentiation of the stab wounds to determine the manner of death and facilitate the investigation. A 29-year-old male presented with multiple stab wounds. There was no witness at the time of the incident. The body was discovered in his room with pools of blood. A knife was present on his body. No tentative cuts were present on the body. Scene investigation and postmortem examination determined the cause and manner of death.

Five different species of Eimeria viz. E. acervulina , E. maxima, E. necatrix, E. tenella and E. brunetti were identified. The highest percentage (50%) was found with mixed infection. Specieswise infection with E. tenella was recorded in the present study. Monthwise highest prevalence rate (50%) was observed in March and the lowest (10%) in the months of April and September. Seasonwise prevalence showed the highest prevalence rate (33%) in the summer and spring, and the least (14%) in the autumn. The agewise prevalence was the highest (48%) in the 31-45 days age group and the least (6%) in 0-15 days age group of layers. The coccidiosis was found highly prevalence in mud/mud+brick type floor than in concrete type floor farms. Key words: Coccidiosis; Eimeria; infection; layers; percentage; summer; spring Journal of Natural History Museum Vol. 23, 2008 Page 45-50

A serological study to know the antibody titer against rabies virus in human beings, who are at occupational risk, was conducted in Nepal in 2014. A total 44 serum samples were collected out of which 21 samples were collected from medical professionals (working at Sukraraj Tropical Hospital) and 23 were collected from veterinary professionals (working at Central Veterinary Hospital, Central Veterinary Laboratory and Rabies Vaccine Production Laboratory) in Kathmandu. Among the 44 samples, 4 were collected from unvaccinated persons. The other 40 people sampled were vaccinated with inactivated rabies vaccine. All samples were subjected to the Rabies Fluorescent Focus Inhibition Test (RFFIT) test at Centre for Disease Control and Prevention, Atlanta, USA. The antibody level of 7 persons was found to be less than the WHO recommended titer of 0.5 IU/ml. Six medical professionals and one veterinary professional had a low rabies virus neutralizing antibody titer. The 4 samples collected from unvaccinated persons, and 3 collected from vaccinated persons had a titer below 0.5 IU/ml. This study shows that medical and veterinary professionals who are responsible to nurse or handle rabies patients, rabid animals or rabies virus are still at high risk. This underscores the importance of recommendations for regular serological testing of occupationally exposed individuals and vaccinating booster dose when necessary.

A regional survey was conducted in Nepal for antibody to Japanese encephalitis virus (JEV) in domestic animals. Sera from pigs, and limited numbers of ducks and horses were collected from 16 districts in 2002-2003 and subjected to three serological tests. Of 270 porcine sera tested by C-ELISA, 55% were found positive for the presence of antibodies against Japanese encephalitis virus. Additional testing for IgM antibody to JEV revealed less than 2% of C-ELISA positive sera had evidence of recent JEV infection. Plaque reduction neutralisation tests (PRNT) using JEV, Murray Valley encephalitis (MVEV) and Kunjin (KUNV) viruses implicated JEV as the flavivirus associated with the observed antibody response in most sero-positive pigs. However, eight porcine sera with predominant neutralising antibody for KUNV (an Australasian subtype of West Nile Virus) provided evidence for the circulation of West Nile virus in Nepal.

Highly pathogenic avian influenza has not been reported in Nepal to date. Surveillance for the presence of avian influenza viruses was conducted in 16 districts of Nepal from February 2004 to December 2005. Four hundred forty-six serum samples were collected from ducks, chickens, and pigeons and tested for antibodies to all influenza A viruses by competitive enzyme-linked immunosorbent assay (C-ELISA). Any sera positive by C-ELISA were tested for antibodies to H5, H7, and H9 influenza viruses by hemagglutination inhibition tests. One hundred and thirty-five cloacal swabs from healthy ducks and chickens were tested by commercial avian influenza antigen detection kits. A further 13 tissue samples from diseased birds were tested for the presence of virus by virus isolation in eggs, cell culture, and immunohistochemistry. No influenza viruses were detected in any of the tissues or swabs. All serum samples collected before October 2005 were negative for antibodies. The first sera positive for antibodies were collected on October 13, 2005, which were determined to be of the H9N2 subtype. This is the first report of serologic evidence of an avian influenza virus infection in Nepal.

Japanese encephalitis (JE) is an emerging disease of animals and humans in Nepal. A serological study for antibody to JE virus was conducted in Nepal from September 2003 to August 2004 by collecting 280 sera from pigs, ducks, and horses covering 10 districts of the country. These sera were tested by performing competitive enzyme-linked immunosorbent assay for the detection of antibodies against JE virus. The total number of tested sera was 280, of which 43.92% were found positive for the presence of antibodies against JE virus infection in Nepal. Sero-prevalence of JE in pigs, ducks, and horses was 48.11%, 26.79%, and 50.0%, respectively.

Rabies is a zoonotic disease that is endemic in many parts of the developing world, especially in Africa and Asia. However its epidemiology remains largely unappreciated in much of these regions, such as in Nepal, where limited information is available about the spatiotemporal dynamics of the main etiological agent, the rabies virus (RABV). In this study, we describe for the first time the phylogenetic diversity and evolution of RABV circulating in Nepal, as well as their geographical relationships within the broader region. A total of 24 new isolates obtained from Nepal and collected from 2003 to 2011 were full-length sequenced for both the nucleoprotein and the glycoprotein genes, and analysed using neighbour-joining and maximum-likelihood phylogenetic methods with representative viruses from all over the world, including new related RABV strains from neighbouring or more distant countries (Afghanistan, Greenland, Iran, Russia and USA). Despite Nepal's limited land surface and its particular geographical position within the Indian subcontinent, our study revealed the presence of a surprising wide genetic diversity of RABV, with the co-existence of three different phylogenetic groups: an Indian subcontinent clade and two different Arctic-like sub-clades within the Arctic-related clade. This observation suggests at least two independent episodes of rabies introduction from neighbouring countries. In addition, specific phylogenetic and temporal evolution analysis of viruses within the Arctic-related clade has identified a new recently emerged RABV lineage we named as the Arctic-like 3 (AL-3) sub-clade that is already widely spread in Nepal., Author Summary Rabies is endemic in most Asian countries and represents a serious public health issue, with an estimated 31,000 people dying each year of this disease. The majority of human cases are transmitted by domestic dogs, which act as the principal reservoir host and vector. However, molecular epidemiology and evolutionary dynamics of the main etiological agent, the rabies virus (RABV), remains largely unappreciated in some regions such as in Nepal. Based on a subset of 24 new Nepalese isolates collected from 2003 to 2011 and representative RABV strains at a global scale, phylogenetic analysis based on the complete nucleoprotein and glycoprotein genes sequences revealed the presence of a surprising wide genetic diversity of RABV circulating in this country. The presence of three different co-existing phylogenetic groups was identified: an Indian subcontinent clade and two different Arctic-like sub-clades within the Arctic-related clade, namely Arctic-like (AL)-1, lineage a (AL-1a), and AL-3. Among these clusters, the AL-3 sub-clade appears as the major Nepalese phylogroup which emerged relatively recently in this country, within the last 30 years. These data has raised some concerns about the exchange of RABV between different countries, and provided key elements for implementation of effective control measures of rabies in Nepal.

A tricyclic intermediate with the potentials to be elaborated to a A-ring aromatic or non-aromatic steroid system, bearing a methyl at C8 carbon, has been synthesized via an oxy-Cope rearrangement from the readily available α-tetralone.