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Introduction: Chemotherapy, postchemotherapy retroperitoneal lymph node dissection (pcRPLND), and metastasectomy remain the standard of care for the management of advanced nonseminomatous germ cell tumor (NSGCT). Methods: We retrospectively studied 73 patients who had pcRPLND at a single tertiary-care center (2003-2022). Surgical and clinicopathological features and oncological outcomes are presented. Results: The mean age was 28.27 years (15-48). Three-fourths had Stage III disease at diagnosis. International Germ Cell Cancer Collaborative Group risk stratification was 54.54 and 21.21 in intermediate risk, and poor risk, respectively. Sixty-two patients had Standard, 7 had Salvage and 4 underwent Desperation pcRPLND. Eleven patients (15.06) required adjunctive procedures. Thirteen patients (17.8) had ≥ class 3 Clavien-Dindo complications and postoperative mortality occurred in 5 (6.8) patients. The histopathologies (HPE) of the pcRPLNDs were necrosis, teratoma, and viable tumor in 39.7, 45.2, and 15.1, respectively. Seven patients underwent metastasectomy. An 85 size reduction in the size of RPLN predicted necrosis. There was 71.4 concordance between pcRPLND and metastasectomy HPEs. The median follow-up was 26.72 months (inter-quartile range - 13.25-47.84). The 2-year recurrence-free survival (RFS) rate was 93 (95 confidence interval [CI]-83-97) and the overall survival (OS) rate was 90 (95 CI-80-95). This is the largest series of pcRPLND for NSGCT in India to our knowledge. Conclusion: Although most of the cohort belonged to stage III, an RFS and OS rate of >90 at 2 years was achieved. We believe that successful management of postchemotherapy residual masses in NSGCT is contingent on the availability of multidisciplinary expertise and is therefore best done at tertiary-care referral centers., Author(s): Rakesh Kumar [1,2]; Madhuri Evangeline Sadanala [2]; Santosh Nagasubramanian [2]; Anjana Joel [3]; Arun Joseph Philip George [2]; S Mahasampath Gowri [4]; Partho Mukherjee [2]; Ashish Singh [3]; Rajiv [...]

Abstract The worldwide usage of Internet of Things (IoT) applications enhanced the utilization of consumer devices, such as smartphones, computers, screening equipment used in hospitals that merely rely on imaging techniques. Numerous images got generated over the cloud platform in a daily basis ad create storage complexity. On the other hand, securing the data stored in the cloud is important. Instead of storing large amount of data into the cloud, lightweight dynamic processing of data suppresses the complex issues in cloud security. Here secure cloud-based image processing architecture is discussed. Privacy preserving medical data communication is considered as the specific research scope. Cryptographic technique used to encode the original data and decode the data at the other end is currently in usage as conventional design. Providing privacy to the medical records through adding noise and denoising the same records is the proposed idea. The proposed work is keenly focused on creating a light weight cloud architecture that communicates the medical data effectively with privacy perseverance using deep learning technique. In the proposed system, the design of an efficient image denoising scheme with a hybrid classification model is created to ensure reliable and secure communication. Deep learning algorithms merged to form a Pseudo-Predictive Deep Denoising Network (PPDD). The proposed system's benefit is ensuring added security in Dark Cloud using a newly structured algorithm. The original data is packed in the Deep cloud using the Gaussian noise act as a key. The complete packing and unpacking of medical data is encapsulated by the transformed images. Over the cloud premise, the data is highly secured and invisible to the malicious users. To reduce the storage complexity, the dynamic data is unpacked and denoise process is applied at the edge devices. During the authorized access period alone, the data is decrypted and accessible at the edge nodes. The maximum process is dynamically happen in the cloud without depending on the storage boundary. The performance of proposed PPDD network model is evaluated through Signal to noise ratio (SNR), Similarity index (SI),Error Rate(ER) and Contrast to noise ratio(CNR). The proposed architecture is comparatively validated with existing state-of-art approach.

This paper deals with the r-dynamic chromatic problem of the direct product of a path with a fan graph Fm,n. The problem is completely solved except for the case n

Introduction Biases in communication can be harmful to patient perceptions of care and the medical team's decision-making. Optimal communication must be taught and practiced similarly to the optimal management of the complex medical conditions associated with sickle cell disease (SCD). This simulation is designed to teach about biases, optimizing communication to and about a patient with SCD, and appropriately diagnosing and managing pediatric osteomyelitis as a complication of SCD. Methods We designed and implemented a simulation case targeting emergency medicine residents and fellows to raise awareness about biases associated with SCD care and the complication of osteomyelitis in children with SCD. The case was delivered as a scheduled educational activity. Guided debriefing about optimizing care and communication for this patient population followed the simulation. We measured outcomes based on facilitator field notes and participant evaluations (Likert-scale and open-response questions). Results Forty learners of varying medical practice proficiencies, societal experiences, and demographics participated, with 30 completing the postsimulation feedback survey. A majority (97%) of participants indicated that the experience was useful and would improve their clinical performance. Participants learned from each other's language and communication styles and reflected on their own communication. Discussion Overall, participants found the simulation very useful as a review of the medical diagnosis and management of osteomyelitis in pediatric SCD. Moreover, they were very engaged and interested in the opportunity to learn about communication biases, particularly as these relate to SCD, to optimize their patient care.

Owing to the energy crisis and environmental pollution deterioration, people are working to develop new kinds of electrical energy storage systems. Bimetallic oxides have been considered potential candidates for supercapacitors (SCs) due to their relatively high electric conductivity and abundant redox reactions. Herein, we designed and synthesized nanostructured Ag2Mo2O7 by the simple chemical route and further examined the sample with different kinds of spectral and analytical tools. The Fourier Transform Infrared Spectroscopy (FTIR) studies analyzed the different vibration and starching modes of metal oxide and the pure phase of the obtained Ag2Mo2O7. The morphology nature of nanoflakes Ag2Mo2O7 can be easily identified from field emission scanning electron microscopy (FE-SEM) can be observed. X-ray photon spectroscopy (XPS) studies the oxidation states of the Ag 3d, Mo 3d and O 1 s, which validates the XRD data. The as-prepared Ag2Mo2O7 nanostructure was used as supercapacitor (SC) electrode material, and it exhibited pseudocapacitive performance with noticeable specific capacity (Cs) of 430 C g−1 at 1 A g−1 and significant cycling stability of 93.7% capacitance retention with the coulombic efficiency of 85.2% even up to 5000 GCD cycles at 1 A g−1. The morphological investigations indicated that the higher Cs values were mainly caused by the significant increase in active sites as well as active surface area. The Bode phase angle plot of Ag2Mo2O7 exhibited a low frequency intercept, with emphasis at approximately − 50.6° phase angle, which indicated a superior redox signature. The results infer that these highly electroactive binary metal oxide nanostructures are promising candidates for high performance energy storage applications. [ABSTRACT FROM AUTHOR]

Background: Carcinoma breast is the second most common malignancy among women which evolves silently and ends in devastation. Tumor cell death induces antinuclear antibody (ANA) production that can be measured by enzyme linked immunosorbent assay (ELISA). Hence this study was undertaken to determine the utility of ANA ELISA in early diagnosis of carcinoma breast. Methods: This cross-sectional study was performed among 3 groups of participants who were age and gender matched. Each group had 30. Group A with carcinoma breast, group B with carcinoma of body sites other than breast and group C had normal, healthy people. From each participant, 5ml venous blood was collected. ANA IgG ELISA test was performed for all the serum samples. Results: ANA IgG was detected in 14 (15.55%) patients. It was detected in 8 (26.66%) of group A, 3 (10%) in group B and 3 (10%) in group C. ANA positivity among carcinoma breast patients was statistically significant p <0.05 (0.0397). Conclusion: Carcinoma breast patients had a higher ANA seropositivity (26.66%) compared to other two groups. ANA tests for multiple autoantigens along with other tools such as mammography can diagnose carcinoma breast at an early stage. [ABSTRACT FROM AUTHOR]

In the present work, rare earth metal oxides composed of cerium tungstate/polyaniline (Ce2(WO4)3/PANI) composites were prepared by an in situ chemical oxidative polymerization process and their supercapacitive behavior was evaluated. The structural and morphological properties of the Ce2(WO4)3/PANI composites were characterized via spectral and analytical techniques. X-ray diffraction revealed that the two prominent peaks for Ce2(WO4)3 and PANI located at 2θ = 28.3° and 25.4° were in good accordance with the observed 2θ values in Ce2(WO4)3/PANI composite. Field-emission scanning electron microscopy (FESEM) studies of Ce2(WO4)3/PANI had a nano-spherical interconnected with a layer-like morphology, which results in a rapid electron exchange. Electrochemical analysis revealed that Ce2(WO4)3/PANI exhibited an increased supercapacitor electrode response with a significant specific capacity (Cs) of 399 C g−1 at 1 Ag−1 and exhibited a remarkable capacity retention of 90.5% even after 3000 galvanostatic charge-discharge (GCD) cycles with 84% columbic efficiency, suggesting its promising electrode material for SCs. [ABSTRACT FROM AUTHOR]