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Background: Alzheimer’s disease is a serious and widespread neurodegenerative illness in the modern healthcare scenario. GSK-3β and BuChE are prominent enzymatic targets associated with Alzheimer’s disease. Co-targeting GSK3β and BChE in Alzheimer’s disease helps to modify disease progression and enhance cognitive function by addressing both tau pathology and cholinergic deficits. However, the treatment arsenal for Alzheimer’s disease is extremely inadequate, with present medications displaying dismal success in treating this never-ending ailment. To create novel dual inhibitors, we have used molecular docking and dynamics analysis. Our focus was on analogs formed from the fusion of tacrine and amantadine ureido, specifically tailored to target GSK-3β and BuChE. Methods: In the following study, molecular docking was executed by employing AutoDock Vina and molecular dynamics and ADMET predictions were performed using the Desmond and Qikprop modules of Schrödinger. Results: Our findings unveiled that compounds DKS1 and DKS4 exhibited extraordinary molecular interactions within the active domains of GSK-3β and BuChE, respectively. These compounds engaged in highly favorable interactions with critical amino acids, including Lys85, Val135, Asp133, and Asp200, and His438, Ser198, and Thr120, yielding encouraging docking energies of −9.6 and −12.3 kcal/mol. Additionally, through extensive molecular dynamics simulations spanning a 100 ns trajectory, we established the robust stability of ligands DKS1 and DKS4 within the active pockets of GSK-3β and AChE. Particularly noteworthy was DKS5, which exhibited an outstanding human oral absorption rate of 79.792%, transcending the absorption rates observed for other molecules in our study. Conclusion: In summary, our in silico findings have illuminated the potential of our meticulously designed molecules as groundbreaking agents in the fight against Alzheimer’s disease, capable of simultaneously inhibiting both GSK-3β and BuChE.

A highly competent teacher workforce is a necessary foundation for improving children's educational outcomes, especially for those who rely most on schools for their success. Yet in the United States, shortages in the teaching force have been growing across the country, reaching crisis proportions in some teaching fields--such as mathematics, science, and special education--and in locations where wages and working conditions are least attractive. We analyzed recent research and representative survey data to identify the drivers of teacher recruitment and retention. We also reviewed the policy literature to identify district, state, and federal policy strategies that have been effective at addressing the factors influencing teachers' professional decisions. These policies include increasing their compensation and improving their preparation, professional support, and working conditions, as well as improving district and school management practices that otherwise create obstacles to recruitment and retention.

Background: The world population is expected to increase from 8 billion currently to 9.7 billion in 2050. China (1.4 billion) and India (1.4 billion) remain the two most populous countries of the world representing 18 percent of the world’s population respectively. Unmet need for contraception and unintended pregnancy are important public health concerns for India in this context. Objectives: 1. To estimate the prevalence of unmet need for family planning among eligible couples. 2. To assess the knowledge and attitude towards contraceptive usage among the eligible couples Methodology: After obtaining the approval of institutional ethics committee, a cross sectional study was conducted in Shirva, a rural area of Udupi district, Karnataka. List of eligible couples residing in areas coming under the sub centres of CHC Shirva which is a field practice area of the Department of Community Medicine, KMC, Manipal was obtained. Married women of the age group 18-49 years who are were included in the study. Data was collected by personal interviews using a semi structured, pre -designed, pre-tested questionnaire. Data was analyzed using SPSS version 26. Regression analyses was performed to find out the independent effect of various factors. Results: From the preliminary analysis of 539 participants, the unmet need for family planning was found to be 43.4%. The mean age was found to be 33.68 with a standard deviation of 6.27. The mean age at marriage and the mean age at birth of first child were found to be 22.40 and 22.97 respectively. Most of participants belonged to Hindu religion (57%), followed by Muslims (38.2%) and Christians (4.6%). 36.7% were educated up to secondary school and 21.3% up to graduation and above. Conclusion: From this study, the unmet need for family planning was found to be high.

Key Clinical Message This case report highlights the importance of recognizing and accurately diagnosing ganglioneuroblastoma, an uncommon variant of neuroblastic tumors in children. Ganglioneuroblastomas have diverse clinical and morphological presentations, and histopathological examination is paramount in guiding treatment decisions, especially in cases with ambiguous symptoms. Early detection is crucial, as the prognosis varies significantly based on the subtype and the presence of metastatic disease. Clinicians should maintain a high index of suspicion and utilize radiological examinations to promptly identify and treat these tumors. Abstract Children are frequently affected by neuroblastic tumors, which grow from the sympathoadrenal lineage of the neural crest during its development. However, intermixed ganglioneuroblastomas are far less common within the same tumor spectrum, the diagnosis of which could become challenging amidst an unusual presentation. In our case report, we present a 4‐year‐old boy who had complaints of fever and difficulty in walking, with a supra‐renal mass on ultrasound, which was diagnosed as ganglioneuroblastoma‐intermixed type on histopathological examination. This report aims to contribute to the understanding of the diverse clinical and morphological spectrum of ganglioneuroblastomas and the importance of multidisciplinary collaboration and histopathological examination to enhance decision‐making in such ambiguous scenarios.

Background: The progressively worsening performance of students in classroom, the health problems induced due to stress, below average academic accomplishments of students in classroom and in hospital postings is directly attributable to the tremendous stress, medical students undergo during their course to become future doctors of the country. We conducted this research survey to find out the magnitude of stress as perceived by medical undergraduate students and to measure the association of such stress with various factors which may influence it. Methodology: About 612 students studying in private medical colleges in Mangalore from first year to final year were interviewed after obtaining their informed consent. The data collection tool used for this study consisted of a pre-designed questionnaire which contained social and demographic variables of study participants and a perceived stress scale developed by Cohen et al. Results: The immenseness of curriculum which was the academic stressor that was cited, financial and family issues were psychological stressors and accommodation which was the environmental stressor were some of the significant factors contributing towards perceived stress. Conclusion: Only one of the coping strategies adopted by students was found to be significantly associated with perceived stress.

Background: Proper nutrition and balanced diet have profound influence on mental wellbeing. Nutritional psychiatry plays an important role in influencing healthy mind and body. The animal model of chronic unpredictable stress has been considered as the effective model to explore research on anxiety and depression. Aim: The present study was aimed to explore the protective role of cod liver oil on various biochemical and neuronal analysis in the hippocampus tissue of Wistar rat model of comorbid depression. Methods: Healthy adult albino rats of Wistar strain weighing (120-160 grams) were divided into control group and experimental groups. These groups were further categorized into various subgroups based on the stress exposure, cod liver oil and antidepressant treatment. Six animals were taken in each group. The duration of stress exposure was for 15 days. After the experimentation procedure, the animals were anaesthetized, and hippocampus was dissected for the estimations of various biochemical and neurological parameters. Results: The combination of cod liver oil with the antidepressant significantly (P [Open Vet J 2023; 13(4.000): 473-480]

Abstract Dengue (DENV) and chikungunya (CHIKV) viruses are among the most preponderant arboviruses. Although primarily transmitted through the bite of Aedes aegypti mosquitoes, Aedes albopictus and Aedes malayensis are competent vectors and have an impact on arbovirus epidemiology. Here, to fill the gap in our understanding of the molecular interactions between secondary vectors and arboviruses, we used transcriptomics to profile the whole-genome responses of A. albopictus to CHIKV and of A. malayensis to CHIKV and DENV at 1 and 4 days post-infection (dpi) in midguts. In A. albopictus, 1793 and 339 genes were significantly regulated by CHIKV at 1 and 4 dpi, respectively. In A. malayensis, 943 and 222 genes upon CHIKV infection, and 74 and 69 genes upon DENV infection were significantly regulated at 1 and 4 dpi, respectively. We reported 81 genes that were consistently differentially regulated in all the CHIKV-infected conditions, identifying a CHIKV-induced signature. We identified expressed immune genes in both mosquito species, using a de novo assembled midgut transcriptome for A. malayensis, and described the immune architectures. We found the JNK pathway activated in all conditions, generalizing its antiviral function to Aedines. Our comprehensive study provides insight into arbovirus transmission by multiple Aedes vectors.

Abstract Objective Epilepsy surgery is an effective treatment for drug‐resistant patients. However, how different surgical approaches affect long‐term brain structure remains poorly characterized. Here, we present a semiautomated method for quantifying structural changes after epilepsy surgery and compare the remote structural effects of two approaches, anterior temporal lobectomy (ATL), and selective amygdalohippocampectomy (SAH). Methods We studied 36 temporal lobe epilepsy patients who underwent resective surgery (ATL = 22, SAH = 14). All patients received same‐scanner MR imaging preoperatively and postoperatively (mean 2 years). To analyze postoperative structural changes, we segmented the resection zone and modified the Advanced Normalization Tools (ANTs) longitudinal cortical pipeline to account for resections. We compared global and regional annualized cortical thinning between surgical treatments. Results Across procedures, there was significant cortical thinning in the ipsilateral insula, fusiform, pericalcarine, and several temporal lobe regions outside the resection zone as well as the contralateral hippocampus. Additionally, increased postoperative cortical thickness was seen in the supramarginal gyrus. Patients treated with ATL exhibited greater annualized cortical thinning compared with SAH cases (ATL: −0.08 ± 0.11 mm per year, SAH: −0.01 ± 0.02 mm per year, t = 2.99, P = 0.006). There were focal postoperative differences between the two treatment groups in the ipsilateral insula (P = 0.039, corrected). Annualized cortical thinning rates correlated with preoperative cortical thickness (r = 0.60, P

We report Bayesian inference of the mass, radius, and hot X-ray emitting region properties—using data from the Neutron Star Interior Composition ExploreR (NICER)—for the brightest rotation-powered millisecond X-ray pulsar, PSR J0437−4715. Our modeling is conditional on informative tight priors on mass, distance, and binary inclination obtained from radio pulsar timing using the Parkes Pulsar Timing Array (PPTA; Reardon et al.), and we use NICER background models to constrain the nonsource background, cross-checking with data from XMM-Newton. We assume two distinct hot emitting regions and various parameterized hot region geometries that are defined in terms of overlapping circles; while simplified, these capture many of the possibilities suggested by detailed modeling of return current heating. For the preferred model identified by our analysis, we infer a mass of M = 1.418 ± 0.037 M _⊙ (largely informed by the PPTA mass prior) and an equatorial radius of $R={11.36}_{-0.63}^{+0.95}$ km, each reported as the posterior credible interval bounded by the 16% and 84% quantiles. This radius favors softer dense matter equations of state and is highly consistent with constraints derived from gravitational wave measurements of neutron star binary mergers. The hot regions are inferred to be nonantipodal and hence inconsistent with a pure centered dipole magnetic field.

Abstract Background Among persons with diabetes on treatment, hypoglycemia is the most common iatrogenic acute metabolic complication. Many factors influence hypoglycemia, highlighting the need for diabetic patients to recognize, and manage these potential factors in order to reduce the rate of hypoglycemia. In this study, we assessed the knowledge, experiences of hypoglycemia, and associated risk factors among Ghanaians with diabetes mellitus (DM). Methods This cross‐sectional study included 444 clinically diagnosed DM patients from the Suntreso Government Hospital, who were on treatment for at least a year. A structured validated questionnaire was used to collect sociodemographic, lifestyle, and clinical data from the participants. Statistical analyses were performed using SPSS Version 20.0 and GraphPad Prism 8.0. Results More than half (52.7%) of the study participants had poor knowledge of hypoglycemia. Moreover, 52.9% of diabetics had experienced hypoglycemia. Participants who were in the age groups of 55–64 and 65–80 years, being retired, being diagnosed with diabetes for 11–20 years and more than 20 years, taking in alcohol, and having adequate knowledge were independent determinants of experiencing hypoglycemia. Conclusion Knowledge level of hypoglycemia among Ghanaian diabetics is low. Prompt recognition of risk factors of hypoglycemia and the careful monitoring and management of glycemic levels in high‐risk groups are important to lessen the prevalence of hypoglycemia in these populations.

La résistance des moustiques aux insecticides chimiques conventionnels demeure une préoccupation majeure pour les programmes de lutte anti-vectorielle. Les recherches s’orientent actuellement vers l’utilisation d’alternatives naturelles, les bio insecticides. L’activité insecticide de certaines plantes comme le Calotropis procera (Ait.) R.br (Apocynaceae) pourrait avoir un grand intérêt dans ce domaine. Dans cette étude, nous avons effectués un criblage des extraits de feuilles de C. procera (aqueux, hydro- éthanolique, méthanolique et éthanolique) par HPTLC, puis mesurer leur teneur en stérol, triterpène et en cardénolides. Nous avons étudié également l’activité larvicide des extraits aqueux et hydro- éthanolique contre le vecteur de la dengue Aedes aegypti selon la méthodologie décrite par l’OMS. Le profil chimique des différents extraits montre la présence de flavonoïdes, tanins, stérols et triterpènes, coumarines, alcaloïdes et cardénolides. La plus grande activité larvicide a été obtenue avec l’extrait hydro-éthanolique provenant de feuilles récoltées en saison sèche dans la localité de Kombissiri (partie Centre Sud du Burkina) avec une DL50 de (1,58 mg/ml ± 1,51 ; 1,66 mg/ml) Les résultats obtenus indiquent que l’extrait hydro-éthanolique de C. procera pourrait servir à la formulation d’un bio-insecticide écologique et peu coûteux pour lutter contre les larves d'Aedes aegypti.

AbstractThis review offers a summary of the epoxy-nanoclay nanocomposites research that has been performed. Epoxy-nanoclay nanocomposites have an across-the-board variety of aerospace, defense, construction, and automobile applications. Nanoclay is one of the ideal nano-reinforcement for epoxy because of its ease of workability, environmental accessibility, well-versed chemistry, and lower cost. The significant addition of a smaller quantity of nanoclay, mostly ≤5 wt.%, may efficiently improve polymer composites’ properties. This review aims to provide a state-of-the-art overview of epoxy-nanoclay nanocomposites, including their preparation methods, mechanical, hygrothermal, and wear properties. The discussion highlights the nanoclay influence on the properties listed above and the morphology of epoxy-nanoclay nanocomposites.

AbstractDuring machinability, the combination of machining process parameters and the material properties of the component to be machined plays an important role. Material properties depend upon the type of phase form present and the grain size of the formed phases, which in turn depends upon the prior treatment given to alter the initial room temperature types and form. Accordingly, spheroidization treatment was carried out on medium carbon steel (AISI1040) by altering the initial room temperature structure through normalizing and hardening treatment. Machinability experiments were performed on CNC machine by varying machining process constraints. Tool wear and surface roughness of the machined component obtained by turning were analyzed and correlated. Using Minitab and full factorial design, the ANOVA study was carried out. With the help of regression analysis, residual and main effect plots combined optimization (tool wear and surface roughness) was targeted. ANOVA result shows excellent machinability for the as-bought-spheroidized condition where feed has a 67% contribution to tool wear (TW) whereas the depth of cut has a 71.91% contribution to surface roughness (SR). Also, the optimized regression values obtained for machining parameters are feed (0.39 mm/rev), depth of cut (0.6 mm), and spindle speed (780 rpm) with composite desirability of 0.8174. TW and SR experimental values for the optimized machining parameters are 0.039 mm and 2.89 μm, respectively, and the difference between the actual and optimized values is less than 5%.

AbstractThis article presents the thermal stability of flax, jute and ultrahighmolecular weight polyethylene (UHMWPE) fibers and their composites. Composites are fabricated using a combination of hand layup and compression moulding. Two types of resins namely phenol formaldehyde (PF) and melamine formaldehyde (MF) are considered. Stacking of eight layers of individual fabric was utilised to produce composite panels of 4 mm thickness. Alkali treatment of the flax and jute showed an enhancement in thermal behaviour, whereas UHMWPE fibers sustained the thermal degradation till 474°C. Among the two resin systems, neat MF resin degraded at 278°C with 84% mass loss, whereas PF resin had a final mass loss of 52.54% at 600°C. The thermogravimetric analysis confirmed an increase in thermal stability of the composites considering both resin systems. Density functional theory (DFT) calculation on a small molecular unit of PF, MF, and their complexes with cellulose and molecular unit of UHMWPE indicated that the composites with natural fibers and MF matrix exhibited better thermal stability, while PF resin showed better binding characteristics for composites with UHMWPE fibers. The plausible intermolecular interactions between fibers and the matrix are discussed. The proposed application of the composites is to be used as intermediate wall linings of the furnaces.

AbstractFiber-reinforced polymer (FRP) composites undergo different environmental conditions in the designed life span. An investigation on aging of FRPs in water helps to enhance the material’s durability. This article aims to explore the effect of different types of water soaking (viz., tap, sea, and rain water) and re-drying conditions on the tensile and flexural strengths of glass fiber-epoxy composites (GFEC). The prepared specimens are placed in the sea, tap, and rain water for 10 weeks. Some specimens are re-dried at 50°C for 5 weeks. The water uptake (%) of seawater aged specimens decreases compared to tap and rain water-aged specimens at the end of 10 weeks. Water soaking of composites has reduced the tensile and flexural strengths of GFEC by 14 to 17%. The strength of water-soaked composite specimens is partly retrieved in specimens that have been re-dried. More than 90% of the original value is retrieved for the strength of GFECs (as-made specimens). SEM analysis of the tensile specimen fracture surface reveals the causes of the specimen failure as well as the impact of water soaking, followed with re-drying.

Cholestatic liver disease in late childhood has a comprehensive list of aetiologies, requiring a multidimensional approach. Among these, the genetic aetiology can range from having a self-limiting course to being associated with morbidity and mortality, requiring liver transplantation. Progressive Familial Intrahepatic Cholestasis (PFIC) and Benign Recurrent Intrahepatic Cholestasis (BRIC) are two rare inherited autosomal recessive cholestatic disorders. Both are related to mutations in the bile formation transport system and typically manifest in infancy or early childhood. Among the PFIC types, The PFIC type 3 rapidly progresses to end-stage liver disease, while BRIC follows a benign course with intermittent asymptomatic periods. Here, authors describe two (17-year-old male, 19-year-old male) such unusual inherited autosomal recessive cholestatic disorders in late childhood: PFIC (type 3) and BRIC, which have distinct clinical presentations and liver function derangements.

Abstract Trends of kidney cancer cases worldwide are expected to increase persistently and this inspires the modification of the traditional diagnosis system to respond to future challenges. Renal Cell Carcinoma (RCC) is the most common kidney cancer and responsible for 80–85% of all renal tumors. This study proposed a robust and computationally efficient fully automated Renal Cell Carcinoma Grading Network (RCCGNet) from kidney histopathology images. The proposed RCCGNet contains a shared channel residual (SCR) block which allows the network to learn feature maps associated with different versions of the input with two parallel paths. The SCR block shares the information between two different layers and operates the shared data separately by providing beneficial supplements to each other. As a part of this study, we also introduced a new dataset for the grading of RCC with five different grades. We obtained 722 Hematoxylin & Eosin (H &E) stained slides of different patients and associated grades from the Department of Pathology, Kasturba Medical College (KMC), Mangalore, India. We performed comparable experiments which include deep learning models trained from scratch as well as transfer learning techniques using pre-trained weights of the ImageNet. To show the proposed model is generalized and independent of the dataset, we experimented with one additional well-established data called BreakHis dataset for eight class-classification. The experimental result shows that proposed RCCGNet is superior in comparison with the eight most recent classification methods on the proposed dataset as well as BreakHis dataset in terms of prediction accuracy and computational complexity.

Abstract Objective: To identify peri-conceptional diet patterns among women in Bangalore and examine their associations with risk of gestational diabetes mellitus (GDM). Design: BAngalore Nutrition Gestational diabetes LifEstyle Study, started in June 2016, was a prospective observational study, in which women were recruited at 5–16 weeks’ gestation. Peri-conceptional diet was recalled at recruitment, using a validated 224-item FFQ. GDM was assessed by a 75-g oral glucose tolerance test at 24–28 weeks’ gestation, applying WHO 2013 criteria. Diet patterns were identified using principal component analysis, and diet pattern–GDM associations were examined using multivariate logistic regression, adjusting for ‘a priori’ confounders. Setting: Antenatal clinics of two hospitals, Bangalore, South India. Participants: Seven hundred and eighty-five pregnant women of varied socio-economic status. Results: GDM prevalence was 22 %. Three diet patterns were identified: (a) high-diversity, urban (HDU) characterised by diverse, home-cooked and processed foods was associated with older, more affluent, better-educated and urban women; (b) rice-fried snacks-chicken-sweets (RFCS), characterised by low diet diversity, was associated with younger, less-educated, and lower-income, rural and joint families; and (c) healthy, traditional vegetarian (HTV), characterised by home-cooked vegetarian and non-processed foods, was associated with less-educated, more affluent, and rural and joint families. The HDU pattern was associated with a lower GDM risk (adjusted odds ratio (aOR): 0·80/sd, 95 % CI (0·64, 0·99), P = 0·04) after adjusting for confounders. BMI was strongly related to GDM risk and possibly mediated diet–GDM associations. Conclusions: The findings support global recommendations to encourage women to attain a healthy pre-pregnancy BMI and increase diet diversity. Both healthy and unhealthy foods in the patterns indicate low awareness about healthy foods and a need for public education.

Abstract Introduction Achalasia cardia is characterized by failure of the lower esophageal sphincter to relax in response to swallowing and by an absence of peristalsis in the esophageal body. Absence of a gastric air bubble is a well known radiological finding. Pneumatic balloon dilatation results in reappearance of the gastric bubble. Case presentation We report the case of a 43-year-old Indian man with achalasia cardia whose chest X-ray at the time of presentation showed an air bubble in the gastric region causing a diagnostic quandary. Successful dilatation of the lower esophageal sphincter resulted in the appearance of another air bubble in the gastric region. Proper analysis showed that the first bubble was actually a colonic air bubble of the splenic flexure and the appearance of the second bubble was the anticipated gastric air bubble. Conclusion In patients presenting with achalasia cardia, a colonic air bubble may be seen in the gastric region causing diagnostic difficulty. In these patients, a gastric air bubble may appear after pneumatic dilatation. At the end of the procedure, there will be two air bubbles ("double bubble"): a colonic and a gastric air bubble. To our knowledge, this finding has not been reported in the literature thus far.

Whereas large-scale statistical analyses can robustly identify disease-gene relationships, they do not accurately capture genotype-phenotype correlations or disease mechanisms. We use multiple lines of independent evidence to show that different variant types in a single gene, SATB1, cause clinically overlapping but distinct neurodevelopmental disorders. Clinical evaluation of 42 individuals carrying SATB1 variants identified overt genotype-phenotype relationships, associated with different pathophysiological mechanisms, established by functional assays. Missense variants in the CUT1 and CUT2 DNA-binding domains result in stronger chromatin binding, increased transcriptional repression, and a severe phenotype. In contrast, variants predicted to result in haploinsufficiency are associated with a milder clinical presentation. A similarly mild phenotype is observed for individuals with premature protein truncating variants that escape nonsense-mediated decay, which are transcriptionally active but mislocalized in the cell. Our results suggest that in-depth mutation-specific genotype-phenotype studies are essential to capture full disease complexity and to explain phenotypic variability.

This study presents a comprehensive investigation into the design and optimization of capacitive pressure sensors (CPSs) for their integration into capacitive touch buttons in electronic applications. Using the Finite Element Method (FEM), various geometries of dielectric layers were meticulously modeled and analyzed for their capacitive and sensitivity parameters. The flexible elastomer polydimethylsiloxane (PDMS) is used as a diaphragm, and polyvinylidene fluoride (PVDF) is a flexible material that acts as a dielectric medium. The Design of Experiment (DoE) techniques, aided by statistical analysis, were employed to identify the optimal geometric shapes of the CPS model. From the prediction using the DoE approach, it is observed that the cylindrical-shaped dielectric medium has better sensitivity. Using this optimal configuration, the CPS was further examined across a range of dielectric layer thicknesses to determine the capacitance, stored electrical energy, displacement, and stress levels at uniform pressures ranging from 0 to 200 kPa. Employing a 0.1 mm dielectric layer thickness yields heightened sensitivity and capacitance values, which is consistent with theoretical efforts. At a pressure of 200 kPa, the sensor achieves a maximum capacitance of 33.3 pF, with a total stored electric energy of 15.9 × 10−12 J and 0.468 pF/Pa of sensitivity for 0.1 dielectric thickness. These findings underscore the efficacy of the proposed CPS model for integration into capacitive touch buttons in electronic devices and e-skin applications, thereby offering promising advancements in sensor technology.

Effective fault detection in chemical processes is of utmost importance to ensure operational safety, minimize environmental impact, and optimize production efficiency. To enhance the monitoring of chemical processes under noisy conditions, an innovative statistical approach has been introduced in this study. The proposed approach, called Multiscale Principal Component Analysis (PCA), combines the dimensionality reduction capabilities of PCA with the noise reduction capabilities of wavelet-based filtering. The integrated approach focuses on extracting features from the multiscale representation, balancing the need to retain important process information while minimizing the impact of noise. For fault detection, the Kantorovich distance (KD)-driven monitoring scheme is employed based on features extracted from Multiscale PCA to efficiently detect anomalies in multivariate data. Moreover, a nonparametric decision threshold is employed through kernel density estimation to enhance the flexibility of the proposed approach. The detection performance of the proposed approach is investigated using data collected from distillation columns and continuously stirred tank reactors (CSTRs) under various noisy conditions. Different types of faults, including bias, intermittent, and drift faults, are considered. The results reveal the superior performance of the proposed multiscale PCA-KD based approach compared to conventional PCA and multiscale PCA-based monitoring methods.

Introduction: Bronchiectasis is the clinical condition of irreversible widening of the airways, which can occur due to any cause of obstruction, recurrent infections, aspirations, anatomical variations of airways, etc. Under certain conditions, a retained foreign body (FB) in the airways can lead to secondary bronchiectasis, which can completely resolve once the removal is performed completely. Here, we discuss the case of a 4-year-old patient who presented with recurrent episodes of cough and fever for 4 years. Case description: There was history of FB (areca nut) ingestion during the first year of life, and bronchoscopic removal of the same was carried out at a hometown hospital. His symptoms still persisted and at 4 years of age computed tomography (CT) thorax showed evidence of residual piecemeal FB with a secondary left-lower lobe bronchiectasis. Complete removal was done and his symptoms regressed. Repeat CT thorax revealed full reversal of bronchiectasis. There were no further complications.

Background: Bladder carcinoma (BC) ranks second among the genitourinary cancers worldwide. Influence of androgens and expression of androgen receptors in neoplasms are recent findings which were implicated in the development of BC. We aimed to study androgen receptor (AR) expression in bladder urothelial neoplasms and correlate its expression with grade and stage of the tumor. Methods: Immunohistochemistry (IHC) was done on samples collected in a tertiary care hospital over one year consisting of 71 urothelial BC and 20 non-neoplastic urothelial conditions. Two pathologists graded the IHC and nuclear staining was considered as positive expression. Results: AR was expressed in 23.9% (17/71) of bladder urothelial neoplasms. AR was expressed in 25.7% and 22.3% of high and low-grade tumors and 25% and 22.3% of non muscle-invasive and muscle-invasive BC. AR expression had no significant correlation with gender, age (> 50 years), muscle invasion or grade. AR expression was significantly absent in non-neoplastic conditions (p = 0.018). Conclusions: AR has varied expression in BC and it is relatively lower in this study population.

Abstract Background and Aim Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub‐Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives. Methods This cross‐sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well‐structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p‐value of