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Hypertensive encephalopathy is a rare condition which is a clinically and radiologically diagnosed disorder. It usually presents in known hypertensive cases among young- and middle-aged adults. Although it presents with altered consciousness and other multisystem manifestations, symptoms of psychosis are rarely seen; management of the disorder is proper blood pressure control. Now, we present two cases of de novo hypertension and a case of chronic hypertension with no history of psychiatric illness and presented with symptoms of irritability, confusion, and hallucinations. To our knowledge, these are the few case reports showing psychosis in hypertensive patients presented with hypertensive encephalopathy. Categories: Internal Medicine, Psychiatry, Neurology

The differential settlement and excessive deflection in expansive subgrade soils lead to low volumetric stability upon moisture imbalance and cause severe damage to highway and airport field pavement surfaces. The present paper attempts to strengthen the stability behavior of expansive subgrade soil using an envirosafe alkaline binder (AB) with polypropylene fiber (PLF). AB was produced by combining dry aluminosilicate precursors (steel slag [SS] and sugarcane bagasse ash [SBA]) with a liquid activator (mixture of sodium hydroxide [NaOH] and sodium silicate [Na2SiO3]) in 0.4 water to binder (w/b) ratio. California bearing ratio (CBR) based resilient modulus, shear strength ratio (Sr), and consolidation tests were conducted as performance indicators of expansive subgrade soil reinforced with discrete PLF (0–0.5%) in 6% lime and 6% alkaline binder. The study also proposes the optimal sugarcane bagasse ash-steel slag-PLF dosage in the AB-stabilized subgrade layer. Moreover, mineralogical and morphological studies using powder X-ray diffraction (XRD) and field emission scanning electron microscopy (FE-SEM) were also carried out to understand the crystalline compounds and micro surface texture of the soil-fiber mixture. It was revealed that AB-fiber-soil exhibits higher interfacial frictional bonding and interlocking density than lime-fiber-soil. Also, 2D finite element analyses were carried out to compare the behavior of subgrade under the influence of vehicular load on the surface. PLF-AB soil mixture shows 72% lower vertical deformation than unstabilized expansive soil. Based on the findings of this study, recommendations for the practical application of stabilizing expansive subgrade soils were proposed.

Abstract Rydberg excitons in Cu2O feature giant optical nonlinearities. To exploit these nonlinearities for quantum applications, the confinement must match the Rydberg blockade size, which in Cu2O could be as large as a few microns. Here, in a top-down approach, we show how exciton confinement can be realised by focused-ion-beam etching of a polished bulk Cu2O crystal without noticeable degradation of the excitonic properties. The etching of the crystal to micron sizes allows for tuning the energies of Rydberg excitons locally, and precisely, by optically induced temperature change. These results pave the way for exploiting the large nonlinearities of Rydberg excitons in micropillars for making non-classical light sources, while the precise tuning of their emission energy opens up a viable pathway for realising a scalable photonic quantum simulation platform.

Abstract Breast cancer is a complex and heterogeneous disease, encompassing various subtypes characterized by distinct molecular features, clinical behaviors, and treatment responses. Categorization of subtypes is based on the presence or absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), leading to subtypes such as luminal A, luminal B, HER2-positive, and triple-negative breast cancer (TNBC). TNBC, comprising around 20% of all breast cancers, lacks expression of ER, PR, and HER2 receptors, rendering it unresponsive to targeted therapies and presenting significant challenges in treatment. TNBC is associated with aggressive behavior, high rates of recurrence, and resistance to chemotherapy. Tumor initiation, progression, and treatment resistance in TNBC are attributed to breast cancer stem cells (BCSCs), which possess self-renewal, differentiation, and tumorigenic potential. Surface markers, self-renewal pathways (Notch, Wnt, Hedgehog signaling), apoptotic protein (Bcl-2), angiogenesis inhibition (VEGF inhibitors), and immune modulation (cytokines, immune checkpoint inhibitors) are among the key targets discussed in this review. However, targeting the BCSC subpopulation in TNBC presents challenges, including off-target effects, low solubility, and bioavailability of anti-BCSC agents. Nanoparticle-based therapies offer a promising approach to target various molecular pathways and cellular processes implicated in survival of BSCS in TNBC. In this review, we explore various nanocarrier-based approaches for targeting BCSCs in TNBC, aiming to overcome these challenges and improve treatment outcomes for TNBC patients. These nanoparticle-based therapeutic strategies hold promise for addressing the therapeutic gap in TNBC treatment by delivering targeted therapies to BCSCs while minimizing systemic toxicity and enhancing treatment efficacy. Graphical abstract

Abstract Rydberg excitons (analogues of Rydberg atoms in condensed matter systems) are highly excited bound electron-hole states with large Bohr radii. The interaction between them as well as exciton coupling to light may lead to strong optical nonlinearity, with applications in sensing and quantum information processing. Here, we achieve strong effective photon–photon interactions (Kerr-like optical nonlinearity) via the Rydberg blockade phenomenon and the hybridisation of excitons and photons forming polaritons in a Cu2O-filled microresonator. Under pulsed resonant excitation polariton resonance frequencies are renormalised due to the reduction of the photon-exciton coupling with increasing exciton density. Theoretical analysis shows that the Rydberg blockade plays a major role in the experimentally observed scaling of the polariton nonlinearity coefficient as ∝ n 4.4±1.8 for principal quantum numbers up to n = 7. Such high principal quantum numbers studied in a polariton system for the first time are essential for realisation of high Rydberg optical nonlinearities, which paves the way towards quantum optical applications and fundamental studies of strongly correlated photonic (polaritonic) states in a solid state system.

Background: Urinary incontinence (UI) is an unintentional or involuntary loss of urine. Stress and urge incontinence are the most common types. Many women feel embarrassed to seek medical care, and it affects their quality of life to a greater extent and is usually a neglected problem among rural communities. Objective: The objective of the study was to estimate the prevalence and to determine the factors associated with UI among peri- and postmenopausal women. Methodology: A community-based cross-sectional study was done among 200 peri- and postmenopausal women of age ≥40 years. The sample size was calculated using a prevalence of 25% from previous studies with a 95% confidence interval and absolute precision of 6%. A simple random sampling technique was employed. A semi-structured questionnaire consisting of the Questionnaire for Urinary Incontinence Diagnosis scale was used for data collection. Data analysis was performed in SPSS version 20.0. P ≤ 0.05 was considered statistically significant. Results: The prevalence of UI was 24% (48 out of 200 women), of which stress incontinence was seen in 15% and urge incontinence in 17% of women. Mixed incontinence was seen in 8% of women. Factors such as increasing age, attainment of menopause, chronic constipation, diabetes, and recurrent UTIs were significantly associated with UI. Conclusion: Two out of every ten peri- and postmenopausal women were found to have UI. Identification of women at risk, educating them regarding preventive measures, following a healthy diet, and encouraging them to seek medical care can greatly reduce their chance of developing UI and aid in improving their quality of life.

Context: Emphasis on grossing to reporting for the assessment of histopathological parameters predicting outcomes in Wilms tumor. Aims: To analyze various clinicopathological parameters that effect outcomes in treatment naïve and post chemotherapy Wilms tumor specimens. Settings and Design: This was a retrospective observational study. Subjects and Methods: All patients diagnosed with Wilms tumor between 2012 and 2018 at our institute will be included with their clinical findings, laboratory reports, and radiological findings. The patients will be categorized into two groups based on treatment protocol (Society of Pediatric Oncology (SIOP) or the National Wilms Tumor Study Group/Children's Oncology Group (COG) guidelines) used. Details of Grossing and reporting protocols used for the in pre treatment and post treatment specimens will be analyzed. Follow-up till December 2020 will be analyzed. Statistical Analysis Used: Chi-square and Fisher's exact tests were used for statistical analysis. Results: A total of 36 patients with the diagnosis of Wilms tumor were included in the present study. The mean age of presentation was 3.9 ± 0.7 years, and males were more common than females. Most of them presented as abdominal mass and few with isolated hematuria. Twenty-six (72%) patients were treated under SIOP protocol with preoperative neoadjuvant chemotherapy. Ten patients underwent upfront surgery as per COG protocol. In SIOP group patients, the mean tumor size was 9.3cm. Forty percent (n = 10) we mixed histological type followed by blastemal type constituting (32%, n = 8). Regressive and epithelial histological types constituted 16% (n = 4) and 12% (n = 3), respectively. In the SIOP group 72% (n = 19) had no anaplasia and 28% (n = 7) had anaplasia. Fifty seven percent (n = 15) cases were Stage I, followed by 26.9% n = 7) and 11.5% (n = 3) being Stage II and Stage III, respectively. Ten patients underwent upfront surgery as per COG protocol. The mean tumor size among this group was 8 cm ranging from 7 cm to 11 cm. Eight (80%) cases had favorable histology and two cases showed focal anaplasia. Heterologous differentiation is seen in 3 (70%). Out of the 10 cases, one case was Stage I, six were Stage 2, one was Stage III, and two were clinical Stage IV. None of the cases showed either vessel or lymph node metastasis. All the patients received adjuvant chemotherapy postsurgery and were followed up till December 2020 for (at least 3 years). Of 25 patients in the SIOP group, 18 (72%) had complete remission with no radiological evidence of residual disease. Of the 10 patients in the COG group, 6 (70%) had complete remission. Conclusions: Histopathological evaluation of Wilms tumor is a critical aspect in the management of Wilms tumor, as tumor characteristics are different in the tumors treated under SIOP and COG protocols, which will ultimately affect the prognostic risk stratification. This necessitates the knowledge of the important grossing and reporting of these tumors under the two protocols.

Trypsin enzyme has gained recognition as a potential biomarker in several tumors, such as colorectal, gastric, and pancreatic cancer, highlighting its importance in disease diagnosis. In response to the demand for rapid, cost-effective, and real-time detection methods, we present an innovative strategy utilizing the design and synthesis of NIR-sensitive dye–peptide conjugate (SQ-3 PC) for the sensitive and selective monitoring of trypsin activity by fluorescence ON/OFF sensing. The current research deals with the design and synthesis of three unsymmetrical squaraine dyes SQ-1, SQ-2, and SQ-3 along with a dye–peptide conjugate SQ-3-PC as a trypsin-specific probe followed by their photophysical characterizations. The absorption spectral investigation conducted on both the dye alone and its corresponding dye–peptide conjugates in water, utilizing SQ-3 and SQ-3 PC respectively, reveals enhanced dye aggregation and pronounced fluorescence quenching compared to observations in DMSO solution. The absorption spectral investigation conducted on dye only and corresponding dye–peptide conjugates in water utilizing SQ-3 and SQ-3 PC, respectively, reveals not only the enhanced dye aggregation but also pronounced fluorescence quenching compared to that observed in the DMSO solution. The trypsin-specific probe SQ-3 PC demonstrated a fluorescence quenching efficiency of 61.8% in water attributed to the combined effect of aggregation-induced quenching (AIQ) and fluorescence resonance energy transfer (FRET). FRET was found to be dominant over AIQ. The trypsin-mediated hydrolysis of SQ-3 PC led to a rapid and efficient recovery of quenched fluorescence (5-fold increase in 30 min). Concentration-dependent changes in the fluorescence at the emission maximum of the dyes reveal that SQ-3 PC works as a trypsin enzyme-specific fluorescence biosensor with linearity up to 30 nM along with the limit of detection and limit of quantification of 1.07 nM and 3.25 nM, respectively.

The opportunistic use of radiological examinations for disease detection can potentially enable timely management. We assessed if an index created by an AI software to quantify chest radiography (CXR) findings associated with heart failure (HF) could distinguish between patients who would develop HF or not within a year of the examination. Our multicenter retrospective study included patients who underwent CXR without an HF diagnosis. We included 1117 patients (age 67.6 ± 13 years; m:f 487:630) that underwent CXR. A total of 413 patients had the CXR image taken within one year of their HF diagnosis. The rest (n = 704) were patients without an HF diagnosis after the examination date. All CXR images were processed with the model (qXR-HF, Qure.AI) to obtain information on cardiac silhouette, pleural effusion, and the index. We calculated the accuracy, sensitivity, specificity, and area under the curve (AUC) of the index to distinguish patients who developed HF within a year of the CXR and those who did not. We report an AUC of 0.798 (95%CI 0.77–0.82), accuracy of 0.73, sensitivity of 0.81, and specificity of 0.68 for the overall AI performance. AI AUCs by lead time to diagnosis (

Aim: The fabrication of an accurate prosthesis depends mainly on precise recording of the maxillo—mandibular relationship of the patient and transferring it to the articulator. BDIMPRESS is a new thermoplastic material that has been proposed as a potential material to be used as an inter-occlusal registration, but there has been no literature evidence regarding its application as a bite registration. The main purpose of this study is to evaluate and compare the dimensional stability, detail reproduction, and compressive resistance of new interocclusal recording material with other two commonly used materials. Settings and Design: In Vitro Comparative study. Materials and Methods: The study was conducted according to ADA Specification standards of testing for dimensional stability, detail reproduction and compressive resistance. Specimens were prepared for three different materials (Thermoplastic resin, Polyvinyl siloxane, and Bis- acrylic) with 12 samples each. Statistical Analysis Used: One way ANOVA was done for statistical analysis. Results: Polyvinyl siloxane material was dimensionally stable (mean at 1 hr: 24.928 mm; 24 hrs: 24.919 mm & 48 hrs: 24.912 mm) followed by Bis- acrylic material (mean at 1 hr: 24.851 mm; 24 hrs: 24.825 mm & 48 hrs: 24.815 mm). On one way ANOVA, strong significance was observed between groups (P = 0.00). Thermoplastic resin showed higher amount of detail reproduction with 10 (out of 12 samples) samples showing satisfactory results. While bis- acrylic material showed the least compressive resistance (Strain %: 0.484%; Displacement- 0.0990mm). One-way ANOVA showed presence of significance between the groups (P = 0.024). Conclusion: Polyvinyl siloxane showed superior dimensional stability, thermoplastic resin showed better detail reproduction and bis- acrylic showed high resistance to compression over other materials.

Introduction: Loss of hearing during early infancy leads to delayed development of language, communication, and cognition which affects the social, emotional, and academic achievements of a child. Early identification of hearing impairment improves age-related language and communication skills. Aim & Objectives: To find out the prevalence and profile of hearing loss among high-risk neonates in a hospital setup. Material and Methods: This was a prospective observational study being conducted over two years at VIMSAR, Bulra, Sambalpur, Odisha. 264 high-risk neonates admitted to Neonatal Intensive Care Unit were screened using evoked otoacoustic emission (EOAE) and Brainstem Evoked Response Audiometry (BERA). Neonates who tested refer on EOAE were subjected to BERA and those having a unilateral or bilateral hearing threshold for more than 40 dB in BERA were defined as hearing impaired. Results: Most of the study neonates were having multiple significant risk factors. Multivariate logistic regression analysis of significant risk factors for hearing loss revealed gestational diabetes of the mother, mechanical ventilation for more than 5 days, hyperbilirubinemia requiring exchange transfusion, hypo-glycemia during the early neonatal period, and duration of hospitalization for more than 5 days were the independent risk factors associated with hearing loss. Conclusion: This study implies a high incidence of hearing impairment in neonatal intensive care unit(NICU) graduates and a change in the distribution of risk factors for hearing loss. Gestational diabetes, mechanical ventilation for more than 5 days, hyperbilirubinemia with exchange transfusion, neonatal hypoglycemia, and NICU stay for more than 5 days were significant independent clinical risk factors for predicting hearing impairment in high-risk neonates. Recommendation: Universal newborn screening for hearing loss in high-risk neonates and early identification of risk factors and exposure reduction should be done, so that the devastating effects of hearing impairment could be prevented before it starts.

We present an unusual case of placental chorangioma in a 32-year-old female with poor antenatal care. Abdominopelvic ultrasound revealed polyhydramnios with no fetal cardiac activity and suspected placental cyst. An emergency caesarean was performed, and she had still birth of male baby. The cut specimen of the placenta revealed a well-circumscribed marginal mass of 4 cm. Our case emphasizes the importance of regular antenatal screening for early detection of placental abnormalities. While chorangiomas are rare, they should be considered in the differential diagnosis of placental masses. Prompt diagnosis and appropriate management are essential to reduce the maternal and fetal complications associated with chorangiomas. Histological examination of the placenta plays a vital role in differentiating chorangioma from other placental abnormalities with different clinical implications.

Two-phase-based heat spreaders are highly sought electronics cooling solutions due to their superior thermal performance over conventional conduction plates. Along with good thermal performance, Pulsating Heat Pipes (PHPs) potentially have thickness, shape matching and cost benefits over Embedded Heat Pipe (EHP) heat spreader solutions. In this manuscript, the thermal performance of PHP charged with three different fluids-propylene, R245fa, and acetone was experimentally determined for different sink temperatures and compared to an EHP heat spreader. A mathematical model to predict the thermal performance of the PHP was developed and validated against experimental results. It was determined that at low sink temperatures, PHP charged with propylene performs better than or similar to an EHP heat spreader with up to 7.8 times higher effective thermal conductivity over a conduction plate. However, at moderate temperatures above >40 °C, propylene PHP dries out faster than the EHP plate. PHP performance with R245fa and acetone improves with increasing heater power. Effective thermal conductivity improved by 2.5 times with R245fa PHP and by 4 times with acetone PHP over the conventional plate but was lower than the EHP plate whose effective thermal conductivity was 17.3 times higher. However, weight comparison showed PHP to be lighter than the EHPs.

Chymotrypsin, a crucial enzyme in human digestion, catalyzes the breakdown of milk proteins, underscoring its significance in both health diagnostics and dairy quality assurance. Addressing the critical need for rapid, cost-effective detection methods, we introduce a groundbreaking approach utilizing far-red technology and HOMO-Förster resonance energy transfer (FRET). Our novel probe, SQ-122 PC, features a unique molecular design that includes a squaraine dye (SQ), a peptide linker, and SQ moieties synthesized through solid-phase peptide synthesis. Demonstrating a remarkable quenching efficiency of 93.75% in a tailored H2O:DMSO (7:3) solvent system, our probe exhibits absorption and emission properties within the far-red spectrum, with an unprecedented detection limit of 0.130 nM. Importantly, our method offers unparalleled selectivity towards chymotrypsin, ensuring robust and accurate enzyme detection. This pioneering work underscores the immense potential of far-red-based homo-FRET systems in enabling the sensitive and specific detection of chymotrypsin enzyme activity. By bridging the gap between cutting-edge technology and biomedical diagnostics, our findings herald a new era of enzyme sensing, promising transformative advancements in disease diagnosis and dairy quality control.

Utilizing a comprehensive dataset featuring daily information such as sunrise time, sunset time, minimum and maximum temperatures, this study's primary aim is to ascertain the duration necessary for a solar panel installation to become profitable and reach the breakeven point. Users provide input parameters, including the solar panel area to be installed, location, cost per unit of current, and installation charges. Employing time series analysis and forecasting techniques, the system takes into account various environmental factors, energy generation potential, and local energy prices. The ultimate goal is to predict when the cumulative income from the solar panel installation will surpass the initial installation costs, facilitating an estimation of the point at which the solar panel system will break even and commence generating a net profit. This solar panel profitability analysis holds considerable significance individuals and organizations for contemplating investments in renewable energy. It equips stakeholders with the information required to make informed decisions regarding the feasibility and financial viability of solar panel installations at specific locations. This, in turn, promotes a sustainable and cost-effective transition to renewable energy sources, aligning with the broader goal of reducing our reliance on non-renewable energy and fostering environmentally responsible practices.

Key Clinical Message Feeding jejunostomy (FJ) is one of the frequently performed surgical procedures for enteral nutrition, but intussusception a very rare complication with quite challenging clinical outcome. It symbolizes a surgical emergency requiring prompt diagnosis. Abstract Feeding jejunostomy (FJ) is a minor surgical intervention, which might lead to consequences that are potentially fatal. Mechanical issues such as infection, tube dislocation or migration, electrolyte and fluid imbalances, as well as complaints of gastrointestinal tract, are the most frequent consequences. A 76‐year‐old female, who is a known case of carcinoma (CA) esophagus: Stage 4 with Eastern Cooperative Oncology Group (ECOG) Class 3 presented with complaints of difficulty in swallowing and vomiting. As a part of palliative treatment, FJ is done and patient was discharged on postoperative day (POD) 2. Patient again presented to emergency department after 2 months with complaints of pain abdomen, unable to pass flatus and stools for 2 days. Contrast‐enhanced computed tomography was done, which revealed intussusception of jejunum with lead point as tip of feeding tube. Intussusception of jejunal loops is noted 20 centimeters distal to the site of insertion of FJ tube with tip of feeding tube as lead point. Reduction of bowel loops was achieved by gentle compression of distal part and are found to be viable. FJ tube was then removed and repositioned after which the obstruction got relieved. Intussusception is an extremely rare complication of FJ, where the clinical presentation can be likely to the various causes of small bowel obstruction. The fatal complications like intussusception in FJ can be prevented by remembering some technical considerations, such as attaching a 4–5 cm segment of the jejunum to the abdominal wall rather than a single‐point fixation and maintaining a minimum distance of 15 cm between the duodenojejunal (DJ) flexure and the FJ site.

Most chemical engineering firms value carbon dioxide as a valuable commodity and the main greenhouse gas that is alarming climate change. The importance of limiting CO2 emissions while also providing sectors with beneficial CO2 is paramount. The current work defines the viability of CO2 capture via gas hydrates, followed by storage and transportation. 0.5 wt% of l-methionine amino acid powder is used as an additive. The experiments were performed in non-stir conditions, and the CO2 hydrate nucleation was observed at 268.3 ± 2.2 K and 2370.7 ± 56.2 kPa. l-methionine accelerated the gas uptake kinetics, and 90% of the hydrate conversion was within 28.7 ± 4.6 minutes, which is 6.25 times faster than the bulk system (without additive). It acted as a catalyst and did not alter the hydrate's structural characteristics. The stochastic nature of hydrate nucleation is abated, and water reuse yielded a similar conversion. The maximum achieved CO2 hydrate yield is 100.3 ± 1.5 v/v, accounting for ∼67% of the maximum feasible value (149.3 v/v). For viable transportation of the captured CO2 in hydrate form, the self-preservation phenomenon is experimentally evaluated at ∼268 K. The study established the prolonged stability of CO2 hydrates in the self-preservation zone for 50 hours. The hydrate preservation is interrelated to the ice capping theory, which describes how a thin layer of liquid water forms on the surface of the hydrate and eventually freezes to form the ice cap. The boil-off observed due to the hydrate melting, and self-annealing was 25% of the total gas. Regasification is easy and accomplished by raising the temperature over the ice melting point. The findings highlight the significance of more extended hydrate stability in the self-preservation window, which could be a valuable tool for CO2 storage and transportation under milder pressure-temperature conditions.

Abstract Hidden renal cell carcinoma (RCC) is not evident during severe inflammation such as acute pyelonephritis. We presented a 62‐year‐old male presenting with features of obstructive pyelonephritis managed with simple nephrectomy. However, the histopathology findings suggested unilateral papillary RCC. Our case showed that RCC might present with features of obstructive pyelonephritis.

Abstract Rocaglates are a class of eukaryotic translation initiation inhibitors that are being explored as chemotherapeutic agents. They function by targeting eukaryotic initiation factor (eIF) 4A, an RNA helicase critical for recruitment of the 40S ribosome (and associated factors) to mRNA templates. Rocaglates perturb eIF4A activity by imparting a gain-of-function activity to eIF4A and mediating clamping to RNA. To appreciate how rocaglates could best be enabled in the clinic, an understanding of resistance mechanisms is important, as this could inform on strategies to bypass such events as well as identify responsive tumor types. Here, we report on the results of a positive selection, ORFeome screen aimed at identifying cDNAs capable of conferring resistance to rocaglates. Two of the most potent modifiers of rocaglate response identified were the transcription factors FOXP3 and NR1I3, both of which have been implicated in ABCB1 regulation—the gene encoding P-glycoprotein (Pgp). Pgp has previously been implicated in conferring resistance to silvestrol, a naturally occurring rocaglate, and we show here that this extends to additional synthetic rocaglate derivatives. In addition, FOXP3 and NR1I3 impart a multi-drug resistant phenotype that is reversed upon inhibition of Pgp, suggesting a potential therapeutic combination strategy.

Triple-negative breast cancer (TNBC) is the most aggressive and heterogeneous cancer subtypes. High rates of metastasis, poor prognosis, and drug resistance are the major problems associated with TNBC. The current chemotherapeutics eliminate only the bulk tumor cells (non-BCSCs) and do not affect breast cancer stem cells (BCSCs). The BCSCs which are left behind after chemotherapy is reported to promote recurrence and metastasis of TNBC. Death receptor-5 (DR-5) is exclusively expressed in TNBCs and mediates the extrinsic pathway of apoptosis. DR-5, therefore, can be exploited for targeted drug delivery and to induce apoptosis. Gamma-secretase mediated Notch signaling in BCSCs regulates its proliferation, differentiation, and metastasis. The endogenous ligand, Delta-like ligand 4 (DLL4), is reported to activate this Notch signaling in TNBC. Blocking this signaling pathway using both gamma-secretase inhibitors (GSIs) and DLL4 monoclonal antibody (mAb) may produce synergistic benefits. Further, the GSIs (DAPT, LY-411575, RO4929097, MK0752, etc.) suffer from poor bioavailability and off-target side effects such as diarrhea, suppression of lymphopoiesis, headache, hypertension, fatigue, and ventricular dysfunctions. In this hypothesis, we discuss Solid lipid nanoparticles (SLNs) based drug delivery systems containing GSIs and surface modified with DR-5 and DLL4 monoclonal antibodies (mAb) to effectivity target and treat TNBC. The delivery system is designed to deliver the drug cargo precisely to TNBCs through its DR-5 receptors and hence expected to reduce the off-target side effects of GSIs. Further, DLL4 mAb and GSIs are expected to act synergistically to block the Notch signal mediated BCSCs proliferation, differentiation, and metastasis.

Gastric adenocarcinoma usually has a poor prognosis due to its late diagnosis in most cases. Gastric adenocarcinomas account for 95% of all malignant tumors of the stomach. In this report, we described a case of a 63-year-old man who presented with pain in the epigastric region for 1 month which was associated with hematemesis and loss of appetite. The upper gastrointestinal endoscopy (UGIE) revealed an ulcer of size 3 cm × 3 cm in the lesser curvature of the stomach. The patient underwent open total gastrectomy, dissection D2, and a jejunal pouch of 30 ml additional capacity was created 20 cm distal to duodenojejunal flexure and passed retrocolic from a rent in transverse mesocolon. The patient was sent to chemoradiotherapy after the surgery and discharged on the 24th day after surgery. Postoperative biopsy revealed tumor tissue showing irregular, ill-defined, and glandular clouding with loss of polarity. Infiltration was up to the muscularis layer and mesenteric lymph nodes showed partial effacement of architecture with reactive changes and few multinucleated foreign body giant cells confirming the diagnosis as poorly differentiated adenocarcinoma of the stomach of II B class (T2 N2 M0) as per the Union for International Cancer Control guidelines.

Context: Childhood-onset of depression is often associated with childhood family adversity, parental neglect, and problematic peer relationships. Emotional and behavioral problems and high rates of depression were more common in orphans when compared to nonorphan. Aim: The aim was to study and compare the depression and behavioral problems among children residing at welfare hostels and orphanages. Materials and Methods: This study is a cross-sectional and descriptive study. Three welfare hostels and four orphanages run by nongovernment organizations were approached, and children between the ages of six and fourteen were recruited. Children residing at home were taken as controls. Children's Depression Rating Scale and Rutter's Behavior Scale for Children were applied to assess depression and behavioral problems, respectively. Statistical Analysis Used: Statistical analysis was done using Epi Info software. Results: Depression is found to a greater extent among children in the orphanages' group than in the welfare group. Rutter's score ≥9 was observed in 15%, 8.3%, and 5% of children in the welfare hostels' group, orphanages' group, and controls' group, respectively. Conclusions: The prevalence of depression is found to be more among orphanage children, followed by children residing at welfare hostels compared to the control group. Behavior problems are more among children residing at welfare hostels than children residing at orphanages.

Objective: To assess whether Healthy Eating Index (HEI) can predict Error correction code (ECC) in children of 3–6 year old. Materials and Methods: Our sample included 350 3–6 year old children attending outpatient department of Pedodontia. Caries score was assessed using decayed, missing, and filled teeth index and HEI was used to evaluate the diet quality. Results: About 65.9% of the children who were breast feeding and bottle feeding at night had higher S-ECC and it was statistically significant (P = 0.001). Conclusion: HEI scores were inversely related to caries severity, i.e. HEI score was significantly higher in simple ECC (57.4) and lesser in S-ECC (53.2).

Malaria is one of the prevalent tropical diseases caused by the parasitic protozoan of the genus Plasmodium spp. With an estimated 228 million cases, it is a major public health concern with high incidence of morbidity and mortality worldwide. The emergence of drug-resistant parasites, inadequate vector control measures, and the non-availability of effective vaccine(s) against malaria pose a serious challenge to malaria eradication especially in underdeveloped and developing countries. Malaria treatment and control comprehensively relies on chemical compounds, which encompass various complications, including severe toxic effects, emergence of drug resistance, and high cost of therapy. To overcome the clinical failures of anti-malarial chemotherapy, a new drug development is of an immediate need. However, the drug discovery and development process is expensive and time consuming. In such a scenario, nanotechnological strategies may offer promising alternative approach for the treatment and control of malaria, with improved efficacy and safety. Nanotechnology based formulations of existing anti-malarial chemotherapeutic agents prove to exceed the limitations of existing therapies in relation to optimum therapeutic benefits, safety, and cost effectiveness, which indeed advances the patient's compliance in treatment. In this review, the shortcomings of malaria therapeutics and necessity of nanotechnological strategies for treating malaria were discussed.

We report an extremely low-birth-weight neonate with new onset unilateral facial palsy on ninth day of life. The child had neonatal sepsis, meningitis was ruled out and ear discharge was noted from the ipsilateral ear. Otoscopy suggested acute suppurative otitis media, while magnetic resonance imaging was suggestive of mastoiditis. The facial weakness improved with physiotherapy over next two weeks.

One of the key challenges in the practical realization of industrial internet of things (IoT) is overcoming Faraday shielding of free space electromagnetic waves emanating from the antennas of wireless systems used for power and data transfer. Metallic structures, machinery, pipeline, etc., cause interference resulting in the loss of signal connectivity among sensor network. Currently available techniques based on ultrasonic-electromagnetic transducers pose severe limitations on frequency, efficiency, and alignment. Here we demonstrate exciting Zenneck type interface waves propagating as localized charge oscillations (modes) along the metal profile, which overcomes the restrictions on frequency, metal obstacles, partial enclosures, and alignment. A finite element methods (FEM) model developed to predict the signal reception and power transfer efficiency across metal infrastructure shows excellent agreement with the experimental results. Electrical power transfer using Zenneck, under open conditions, show 4% drop for distance of 1 to 8 meters (68 to 64%), and 9% drop under shielded conditions for the same range (66 to 57%). For data transmission results, we demonstrate a feasibility, for an input power of 0dBm with several metallic pipelines as obstacles show received power of -11.8 dBm and -19.01 dBm at 6 and 25 meters, respectively.

A disorder called cardiomegaly has no symptoms. Heart hypertrophy and ventricular hypertrophy are two subtypes of the early symptoms of cardiac hypertrophy. Blowup, include pulsations, tightness in the chest, and shortness of breath. Their fundamental causes and therapeutic approaches differ. Making decisions on when to provide drugs and execute operations can be aided by the early detection of cardiomegaly. Along with the problems with home inspection. Similar to how time-consuming it is and how visitors and mortal interpretations are needed, a supporting tool is needed to automatically detect and distinguish between a normal heart and an enlarged heart.In medical procedures Based on examinations of chest X-rays (CXR) in anterior poster anterior view, this study suggests merging Convolution neural network, 2D and 1D grounded classifiers for quick cardiomegaly detection. The initial feature extraction and pattern recognition tests were performed using the original CXR image is enhanced and undesired noises are removed using the 2D and 1D convolution methods as well as a multilayer linked classification network. The classifier’s performance is validated using K-fold cross-validation after it has been trained using Using the testing dataset, the training dataset was analyzed. Recall, accuracy, precision, and F1 score of the rapid-fire cardiomegaly screening performance are demonstrated by experimental results.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a postinfection immune-mediated condition, seen four to six weeks after Coronavirus Disease-2019 (COVID-19). Multisystem Inflammatory Syndrome in Neonates (MIS-N) is a similar hyperinflammatory syndrome seen among neonates. The exact mechanism of MIS-N is not clear. The transplacental transfer of antibodies from Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infected mothers may lead to hyperinflammatory response among the neonates. In the current case report, the first 36-week-gestational-age male baby presented with respiratory symptoms and increased coronary Z scores which responded well to Intravenous Immunoglobulins (i.v. IG), steroids, and aspirin. The second 36-week-gestational-age male baby presented with unusual recurrent apnoeic attacks for that gestation (36 weeks) which responded dramatically to i.v IG and steroids. Immunoglobulins play a key role in the management of MIS-N.

The advancements in digital technologies have found a widespread application in fabrication of dental restoration with adequate precision and accuracy. Digital methods which are commonly used for fabrication of prosthesis include subtractive methods such as milling and additive methods such as photomelting and photopolymerizing. Digitalization and accuracy are paving the way toward additive technology. The main purpose of this short communication is to mention the advantages, applications, and studies comparing additive and subtractive technology.

Polariton lasing is coherent emission that originates from macroscopic accumulation of polariton population in the ground state and is a promising route toward efficient coherent light sources as population inversion is not necessary. Unlike most Wannier–Mott excitons in inorganic semiconductors, Frenkel excitons created in organic semiconductors have high oscillator strength and high exciton binding energy, which sustain stable exciton–polaritons at room temperature. Herein, room temperature polariton lasing from a novel class of ladder‐type oligo(p‐phenylene)s is demonstrated. The polariton lasers exhibit a nonlinear increase of their spectrally integrated emission, a reduction in spectral linewidth, blueshift of emission peaks, and long‐range spatial coherence when the pump fluence is increased above threshold. By tuning the π‐conjugation length of the molecular structure, the polariton lasing wavelength can be changed from 430 to 457 nm. Optically pumped thresholds of 12 and 17 μJ cm−2 are observed, which are among the lowest values reported for polariton lasing in organic semiconductors.

Objective: Radiomics and deep transfer learning are two popular technologies used to develop computer-aided detection and diagnosis (CAD) schemes of medical images. This study aims to investigate and to compare the advantages and the potential limitations of applying these two technologies in developing CAD schemes. Methods: A relatively large and diverse retrospective dataset including 3000 digital mammograms was assembled in which 1496 images depicted malignant lesions and 1504 images depicted benign lesions. Two CAD schemes were developed to classify breast lesions. The first scheme was developed using four steps namely, applying an adaptive multi-layer topographic region growing algorithm to segment lesions, computing initial radiomics features, applying a principal component algorithm to generate an optimal feature vector, and building a support vector machine classifier. The second CAD scheme was built based on a pre-trained residual net architecture (ResNet50) as a transfer learning model to classify breast lesions. Both CAD schemes were trained and tested using a 10-fold cross-validation method. Several score fusion methods were also investigated to classify breast lesions. CAD performances were evaluated and compared by the areas under the ROC curve (AUC). Results: The ResNet50 model-based CAD scheme yielded AUC = 0.85 ± 0.02, which was significantly higher than the radiomics feature-based CAD scheme with AUC = 0.77 ± 0.02 (p < 0.01). Additionally, the fusion of classification scores generated by the two CAD schemes did not further improve classification performance. Conclusion: This study demonstrates that using deep transfer learning is more efficient to develop CAD schemes and it enables a higher lesion classification performance than CAD schemes developed using radiomics-based technology.

Pasture yield in dairy grazing systems is critical to supplying sufficient feed for milking cows and maintaining productivity. In the Australian dairy industry, ryegrass and clover are common grasses used in grazed pastures. Dairy shed effluent (DSE), the wastewater produced from washing down the dairy holding yards during and after milking, is generally managed through application to pasture as a fertilizer substitute/supplement following partial treatment in stabilization ponds. The aim of this study is to assess the benefits of applying sludge and supernatant collected from two-stage DSE pond systems to ryegrass pasture. A pot experiment was conducted which involved applying pond sludges and supernatant to soil seeded with ryegrass. The application rates of the pond by-products were set according to their labile (plant available) phosphorus content. Ryegrass yield and leachate generated from each of the pots were recorded, and samples were collected for analysis of nutrients and other parameters. The ryegrass grown in soil treated with pond sludge and supernatant yielded greater dry matter (DM) with higher nutrient content than untreated control pots. In addition, pots treated with pond sludge exhibited lower rates of phosphorus leaching from the soil compared with pots treated with supernatant. Thus, pond sludge retained more plant available phosphorus in soil than both the control and pond supernatant treatment. The potassium to calcium/magnesium ratios in the ryegrass in the pots treated with pond sludge and supernatant were below the recommended upper limit for grazing. Therefore, the application of pond sludges on the dairy paddocks was found to be superior to applying supernatant in terms of utilization and conservation of phosphorus within the dairy farm and presents low risks of groundwater pollution and grass tetany.

Trastuzumab binding to tumor cells depends on the availability of HER2 at the cell membrane. Here the authors show that caveolin-1 (CAV1) regulates HER2 density at the cell membranes and that CAV1 gene knockdown or protein depletion via the cholesterol modulator lovastatin, increases trastuzumab binding and anti-tumor activity.

Radionuclides that emit alpha particles (charged helium nuclei) are currently used clinically to treat cancers including prostate cancer. Here, the authors combine a humanized antibody to an alpha particle emitter, specifically to target a downstream effector of the androgen receptor and create a feed forward loop that increases the therapeutic efficacy.

Abstract In geographic routing, position updates and load distribution are crucial to achieve a good performance. There is a concern with load distribution when it comes to dense network where there are large number of connections and huge traffic. Load balanced, Adaptive Position Update (LAPU) routing protocol solves the problem of load distribution among paths in a network with reduced position updates occurring adaptively and next hop decisions based on node’s congestion status in geographic routing. In our proposed work, to achieve load balancing, a node selects two best nodes available to the destination based on node mobility and queue length and it divides the load among them, i.e., it transfers the packets in both paths. Parameters such as end-to-end delay of packet transmission, energy consumption, throughput, and routing overhead are considered to compare the performance of the proposed work.

Introduction: Generic medicines play a prominent role in pharmaco-economics by providing medicines at a much less price. Generic formulations usage is increasing as they provide the same therapeutic effect as branded medicines at a much more economical price. Attitude towards the usage of generic medicines plays a key role in the usage of these medicines by the pharmacist and clinicians. As limited data is available in this area the current study focuses on attitude towards the generic medicine usage of physicians and pharmacists. Materials and Methods: The current study was conducted at KMC&H and Hindu college of pharmacy. After prior ethical clearance, attitude towards the generic formulations was measured using ATGM scale and questionnaire among the physicians, pharmacy professionals and general population. Statistical analysis was done using EPIINFO software. Results and Conclusion: Both Groups believe that Generic medicines do not produce more side-effects than brand name medicines. Pharmacy group has more positive attitude towards most of the items in this questionnaire. In conclusion, more Positive attitude is observed in the pharmacy group than the medical group. This indicates there is a need to increase the awareness among the medical professionals regarding generic formulations.

Aim: The aim of the study is to compare silk sutures and n-butyl-2-cyanoacrylate tissue adhesive in intraoral wound closure and contrast the effects through the assessment of time taken to close the wound, time taken for securing hemostasis, postoperative pain, swelling, bleeding, incidence of postoperative wound infection, and wound dehiscence. Materials and Methods: This study included a total of 20 patients of both genders who required alveoloplasty either bilateral in the same arch or in the upper and lower arches. In the selected patients, the surgical sites were randomly divided into two treatment groups. In group I, surgical wounds closed with n-butyl-2-cyanoacrylate tissue adhesive and silk sutures were used for group II wound closure and the parameters were assessed. Results: Clinically and statistically, there was significant improvement in cyanoacrylate-treated wounds. The time taken for wound closure with n-butyl-2-cyanoacrylate was lesser. Early hemostasis was achieved with n-butyl-2-cyanoacrylate. The postoperative pain, swelling, and bleeding were less with n-butyl-2-cyanoacrylate. Higher incidence of wound infection and wound dehiscence were observed in wounds treated with silk sutures. Conclusion: Cyanoacrylate causes less tissue reaction and achieves immediate hemostasis. The procedure is relatively painless and quicker. There are benefits of protection from wound infection and wound dehiscence. So it may be concluded that n-butyl-2-cyanoacrylate can be used for intraoral wound closure effectively.

Context: The serotonin system is involved in the pathophysiology of anxiety disorders, but it is not practical to measure the serotonin levels inside the brain. Peripheral serotonin activity may reflect the central serotonergic function. An affordable and easy measure of peripheral serotonergic function is the mean platelet volume (MPV). Hence, MPV could possibly be used as a measure of central serotonergic function and hence could be a predictor of treatment outcome and response in panic disorder. Aims: This study aims to study the changes in MPV in patients with panic disorder with or without agoraphobia compared to healthy controls, thereby elucidating the relationship between panic disorder and MPV. Subjects and Methods: Patients (n = 65) who fulfilled the selection criteria and healthy controls (n = 65) were taken up for the study. Sociodemographic details and clinical variables were recorded in a special pro forma prepared for the study. Mini International Neuropsychiatry Interview-Plus was used for screening psychiatric morbidity. The diagnosis of panic disorder was made using the International Classification of Diseases-10 diagnostic criteria. Panic disorder severity scale and panic and agoraphobia scale were administered to all patients. MPV was assessed, and variations in MPV were studied between the groups. Statistical Analysis Used: Two-tailed independent sample t-test was used to compare the cases and controls. Results: It was observed that MPV values were higher for patients with panic disorder than healthy controls. Conclusion: MPV values were higher in panic disorder patients when compared to the healthy controls, so they could serve as predictors/indicators of treatment outcome and response in panic disorder.

We report a newborn born to a consanguineous couple with antenatally detected dilatation of third ventricle, unilateral talipes, and intra uterine growth retardation. On examination, there was facial dysmorphism, hypotonia, encephalopathy, joint laxity and muscle hypertrophy in addition to left foot talipes. On evaluation, there were renal cortical cysts, rhizomelia, chondrodysplasia punctata and elevated muscle enzymes, along with a dilated third ventricle. As the phenotype was not consistent with any of the muscular dystrophies or the peroxisomal disorders, an exome sequencing was requested. It revealed a combination of Zellweger syndrome and Ullrich congenital muscular dystrophy type 1.

In this paper, we report on the development of a highly sensitive and humidity-tolerant metal-oxide-based volatile organic compound (VOC) sensor, capable of rapidly detecting low concentrations of VOCs. For this, we successfully fabricated two different thicknesses of nickel oxide (NiO) sensors using a spin-coating technique and tested them with seven different common VOCs at 40% r.h. The measured film thickness of the spin-coated NiO was ~5 μm (S-5) and ~10 μm (S-10). The fastest response and recovery times for all VOCs were less than 80 s and 120 s, respectively. The highest response (Rg/Ra = 1.5 for 5 ppm ethanol) was observed at 350 °C for both sensors. Sensors were also tested in two different humidity conditions (40% and 90% r.h.). The humidity did not significantly influence the observed sensitivity of the films. Furthermore, S-10 NiO showed only a 3% drift in the baseline resistance between the two humidity conditions, making our sensor humidity-tolerant compared to traditional n-type sensors. Thus, we propose thick-film NiO (10 μm) sensing material as an interesting alternative VOC sensor that is fast and humidity-tolerant.