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Background: The prognostic significance of human epidermal growth factor receptor 2 (HER2) as assessed by immunohistochemistry (IHC) in high-risk endometrial carcinoma (EC) is worth evaluating, owing to limited literature for the Asian population. Objectives: The primary objective of the study was to evaluate the role of HER2 expression as a prognostic indicator of recurrence-free survival in patients with high-risk endometrial cancer. The secondary objectives were to evaluate overall survival and the frequency of HER2 expression, along with other clinicopathological profiles. Materials and Methods: This retrospective cohort study was conducted in Gynecological oncology Department of Amrita Institute of Medical Sciences, Kochi, India, a tertiary care oncology center. The study included high-risk prognostic group of patients with EC from January 2014 to December 2020. HER2 immunohistochemistry was done using EP3 (HER2 neu antibody) clone, with complete basolateral membrane staining of >30% of tumor cells (3+) considered positive. Outcome data were analyzed for both HER2-positive and HER2-negative groups. Results: Thirty-one HER2-positive and 39 HER2-negative patients were eligible for survival analysis. HER2-positive status was significantly associated with non-endometrioid histotype (P, 0.044). HER2 positivity was observed in 42.9% (18/42) of serous carcinomas, and 40% (4/10) of carcinosarcomas. In the HER2-positive group, 22.5% (7/31) experienced recurrence, compared to 43.5% (17/39) in the HER2-negative group. Mortality rates were 38.4% (15/39) in the HER2-negative group and 41.9% (13/31) in the HER2-positive group. Mean recurrence-free survival (RFS) at 4 years and overall survival (OS) at 5 years were not statistically significant between the two groups (P, 0.097, and P, 0.813, respectively). The mean RFS at 4 years was 34.89 months (95% CI, 30.11- 39.66 months) in the HER-2 negative group and 38 months (95% CI, 31.36-44.64 months) in HER2-positive group. Mean OS at 5 years was 41.68 months (95% CI, 34.83-48.52 months) in HER2-negative and 39.58 months (95% CI, 31.08-48.09 months) in HER2-positive group. Conclusion: HER2 overexpression was not found to be an independent prognostic indicator of RFS or OS in high-risk EC in this study.

IntroductionHealth care providers caring for youth with physical disabilities encourage them to be as independent as possible, which includes obtaining higher education when feasible. However, little is known about the experiences of higher education students in managing their toileting.MethodsWe performed 1:1 semi-structured interviews with 13 current college students with physical disabilities (4 male, 9 female), of whom six were on a formal bladder and/or bowel management program. Three researchers analyzed all transcripts using constructivist grounded theory procedures.ResultsWe identified six themes, including: (1) adherence to prescribed programs, (2) importance of time management, (3) interfering with class, (4) balancing intake and toileting, (5) campus bathroom experiences, and (6) acclimating to new living situations. Students needed strong personal skills in time management, adaptability, and self-advocacy to both manage their toileting needs and engage in academic and social activities. This often took time to develop while in college. They faced barriers such as a lack of private, well-maintained bathrooms.ConclusionsHealth care providers should encourage their patients to develop these personal skills prior to starting college, while colleges need to better support these students through honoring their accommodation needs and ensuring the availability of private, accessible bathrooms.

Objective: To determine the detection rates and location of sentinel nodes as well as to determine intraoperative and postoperative surgico-pathological outcomes in endometrial cancer patients who underwent laparoscopic staging with sentinel node biopsy using ICG dye. Materials and Methods: This retrospective study was conducted in a tertiary care oncology centre, Amrita Institute of medical sciences, Kochi from April 2021 to March 2023. All cases of biopsy proven early stage endometrial carcinoma that underwent laparoscopic staging with SLN mapping using the ICG dye were included. All histological types were included, as long as the disease was confined to the uterus, clinically and on MRI. Results: A total of 80 patients were found eligible for the study. Only the patients with apparent uterine confined disease on preoperative MRI were selected for sentinel mapping, 80 % of whom had IA disease on MRI, and 20 % had IB, 13.5 % were high grade histology.The overall SLN detection rate was 93.75%, and bilateral detection rate was 92.5 %. Most common location was external iliac in 40.8% cases. Only 1 patient was found to harbour nodal micro metastasis on ultrastaging. Final histopathology identified stage IA in 63 (78.75%) patients, IB in 14 (17.5%), Stage II in 2 (2.5%) and Stage IIIC1 in 1 (1.25%) patient. Conclusion: Laparoscopic staging with SLNB using ICG is a practicable approach for uterine limited disease on preoperative evaluation. It extends the benefits of minimally invasive surgery to these patients, while overcoming the limitations of prohibitive cost or availability of expensive robotic equipment.

The paper proposes a generative pedestrian trajectory modeling framework named HISS - Human Interactions in Shared Space. The trajectory modeling framework is based on a receding horizon optimization approach utilizing pedestrian behavior and interactions that seeks to capture pedestrian trajectory planning and execution. The benefit of the proposed dynamic optimization trajectory generation approach is that it requires minimal calibration data under a variety of traffic scenarios. In this paper, we formalize several pedestrian-pedestrian interaction scenarios and implement trajectories’ conflict avoidance through mixed integer linear programming (MILP). We validate the proposed framework on two benchmark datasets - DUT and TrajNet++. The paper shows that when the framework’s parameters are tuned to certain initial conditions and pedestrian behavior and interaction rules, the framework generates pedestrian trajectories similar to those observable in real-world scenarios, justifying the framework’s capability to provide explanations and solutions to various traffic situations. This feature makes the proposed framework useful for modelers and urban city planners in making policy decisions.

Urbanization is bringing together various modes of transport, and with that, there are challenges to maintaining the safety of all road users, especially vulnerable road users (VRUs). There is a need for street designs that encourages cooperation between road users. Shared space is a street design approach that softens the demarcation of vehicles and pedestrian traffic by reducing traffic rules, traffic signals, road marking, and regulations. Understanding the interactions and trajectory formations of various VRUs will facilitate the design of safer shared spaces. In line with this goal, this paper aims to develop a methodology for generating VRUs trajectories that accounts for behaviors and social interactions. We develop a receding horizon optimization-based pedestrian trajectory planning algorithm capable of modeling pedestrian trajectories in a variety of shared space scenarios. Focusing on three scenarios-group interactions, unidirectional interaction, and fixed obstacle interaction-case studies are performed to demonstrate the strengths of the resulting generative model. Additionally, generated trajectories are validated using two benchmark datasets – DUT and TrajNet++. The three case studies are shown to yield low or near-zero Mean Euclidean Distance and Final Displacement Error values supporting the performance validity of the models. We also analyze gait parameters (step length and step frequency) to further demonstrate the model’s capability at generating realistic pedestrian trajectories.

Evaluating the epigenetic landscape in the stem cell compartment at the single-cell level is essential to assess the cells’ heterogeneity and predict their fate. Here, using a genome-wide transcriptomics approach in vivo, we evaluated the allelic expression imbalance in the progeny of single hematopoietic cells (HSCs) as a read-out of epigenetic marking. After 4 months of extensive proliferation and differentiation, we found that X-chromosome inactivation (XCI) is tightly maintained in all single-HSC derived hematopoietic cells. In contrast, the vast majority of the autosomal genes did not show clonal patterns of random monoallelic expression (RME). However, a persistent allele-specific autosomal transcription in HSCs and their progeny was found in a rare number of cases, none of which has been previously reported. These data show that: 1) XCI and RME in the autosomal chromosomes are driven by different mechanisms; 2) the previously reported high frequency of genes under RME in clones expanded in vitro (up to 15%) is not found in clones undergoing multiple differentiation steps in vivo; 3) prior to differentiation, HSCs have stable patterns of autosomal RME. We propose that most RME patterns in autosomal chromosomes are erased and established de novo during cell lineage differentiation.

Allele-specific expression in diploid organisms can be quantified by RNA-seq and it is common practice to rely on a single library. Here, the authors show that the standard approach has variable error rate and present Qllelic as a tool to improve reproducibility of allele-specific RNA-seq analysis.

Identifying and characterizing young populations of star-forming regions are crucial to unraveling their properties. In this regard, Gaia-DR3 data and machine-learning tools are very useful for studying large star-forming complexes. In this work, we analyze the ∼7.1 deg ^2 area of one of our Galaxy’s dominant feedback-driven star-forming complexes, i.e., the region around Trumpler 37. Using the Gaussian mixture and random-forest classifier methods, we identify 1243 highly probable members in the complex, of which ∼60% are new members and are complete down to the mass limit of ∼0.1–0.2 M _⊙ . The spatial distribution of the stars reveals multiple clusters toward the complex, where the central cluster around the massive star HD 206267 reveals two subclusters. Of the 1243 stars, 152 have radial velocity, with a mean value of −16.41 ± 0.72 km s ^−1 . We investigate stars’ internal and relative movement within the central cluster. The kinematic analysis shows that the cluster’s expansion is relatively slow compared to the whole complex. This slow expansion is possibly due to newly formed young stars within the cluster. We discuss these results in the context of hierarchical collapse and feedback-induced collapse mode of star formation in the complex.

Introduction: The causes of iron deficiency may be either due to excessive loss or, less frequently, decrease absorption. Data related to etiology are not available from this part of the country. Objective: A study to evaluate the etiology of iron-deficiency anemia at a teaching hospital in the northeastern part of India. Materials and Methods: In this cross-sectional study, cases of iron-deficiency anemia were selected from the OPD and indoor, after taking proper written consent. Iron-deficiency anemia was diagnosed by sending the complete hematological investigations. Other specific investigations including imaging were done in selected patients as per indications. Results: A total of 102 patients of iron-deficiency anemia were included in the study. The age of the selected population was between 18 and 80 years. 37.3% were male and 62.7% were female patients. Upper gastrointestinal endoscopy was done in 56, out of these, 9.7% had antral gastritis and 2.9% had a duodenal ulcer. Lower gastrointestinal endoscopy was done in 30 patients and out of these seven patients had hemorrhoids, one patient had multiple ulcers in the colon, one had ulcers in the sigmoid colon, and one had ulceroproliferative mass in the transverse colon. Biopsy through the upper gastrointestinal endoscopy showed chronic duodenitis in three patients (2.9%), carcinoma stomach in one (0.98%), and periampullary carcinoma in one (0.98%). Biopsy after lower gastrointestinal endoscopy showed one case each of carcinoma colon, ulcerative colitis, nonspecific colitis, and nonspecific enteritis. Conclusion: Diagnosis of iron-deficiency anemia is not sufficient without the diagnosis of underlying etiology. Special concern will be taken to gastrointestinal malignancies like colorectal cancers in which iron-deficiency anemia may be the only manifestation and diagnosis that can be missed if we do not investigate properly.

Although, the growth in the cryptocurrency market slowed down after the meteoric rise in late 2017, the market is still enjoying steady capital inflow. This has made the study of market dynamics between the cryptocurrencies and equity market indispensable. In this paper, the study of the volatility spillovers and correlation between the two has been undertaken by considering five Asian stock indices and four cryptocurrencies ranging from November 2014 to December 2018, to cover three phenomena- Leverage effect, Volatility spillovers and Time varying correlation using EGARCH, Diagonal BEKK and DCC tests respectively. Firstly, the EGARCH test reveals the absence of leverage effect in the returns of cryptocurrenices. Secondly, the multivariate GARCH test shows, out of all the cryptocurrencies taken, the past innovations in Bitcoin affect the future volatility of the equity market returns the most. Lastly, the DCC model reveals evidence of time varying correlation between the markets and Bitcoin.Keywords: Cryptocurrencies; Asian equity market; Volatility spillovers; Dynamic conditional correlationJEL Classifications: G12, G14, G17, C15, C32DOI: https://doi.org/10.32479/ijefi.8624

Accurately quantifying animal activity and movements is of fundamental importance in a broad range of disciplines, from biomedical research to behavioral ecology. In many instances, it is desirable to measure natural movements in controlled sensory environments in which the animals are not physically or chemically restrained, but their movements are nevertheless constrained to occur within a fixed volume. Here, we describe a novel device to quantify the movements of small animals in response to sensory stimulation. The device consists of an Arduino controlled inertial measurement unit that senses angular velocity (along three axes) of a suspended mesh enclosure that temporarily houses the animal subject. We validated the device by measuring the phonotaxis behavior of gravid female frogs in response to acoustic broadcasts of male mating calls. The system, as designed, proved effective at measuring natural movements made in response to acoustic stimulation.

Tubercular liver abscess is one of the rare form of extrapulmonry tuberculosis (TB). It is usually secondary to tuberculosis of lung or gastrointestinal tract, the isolated form is even rarer. But it should be kept as one of the differentials of the mass lesions in liver. This patient presented with fever and pain abdomen for 15 days, turned out to be a case of isolated tubercular abscess. He was successfully treated with percutaneous drainage and systemic Anti Tubercular Treatment.

Introduction: Chronic kidney disease and anemia, both independently have been shown to be a causative factor in the development of Cardiovascular diseases. The aim of the study is to establish that both CKD and Anemia are risk factors for adverse CVD outcomes in the general population. Methods: This cross-sectional, observational, single-centre, study comprising of 108 patients. A diagnosis of acute coronary syndrome was made in each patient after obtaining an ECG and cardiac biomarkers (Troponin-T/ Troponin-I) when indicated. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected, then a nonparametric test was used. A p value of

Studying the molecular consequences of rare genetic variants has the potential to identify novel and hitherto uncharacterized pathways causally contributing to phenotypic variation. Here, we characterize the functional consequences of a rare coding variant of TAO3, previously reported to contribute significantly to sporulation efficiency variation in Saccharomyces cerevisiae. During mitosis, the common TAO3 allele interacts with CBK1—a conserved NDR kinase. Both TAO3 and CBK1 are components of the RAM signaling network that regulates cell separation and polarization during mitosis. We demonstrate that the role of the rare allele TAO3(4477C) in meiosis is distinct from its role in mitosis by being independent of ACE2—a RAM network target gene. By quantitatively measuring cell morphological dynamics, and expressing the TAO3(4477C) allele conditionally during sporulation, we show that TAO3 has an early role in meiosis. This early role of TAO3 coincides with entry of cells into meiotic division. Time-resolved transcriptome analyses during early sporulation identified regulators of carbon and lipid metabolic pathways as candidate mediators. We show experimentally that, during sporulation, the TAO3(4477C) allele interacts genetically with ERT1 and PIP2, regulators of the tricarboxylic acid cycle and gluconeogenesis metabolic pathways, respectively. We thus uncover a meiotic functional role for TAO3, and identify ERT1 and PIP2 as novel regulators of sporulation efficiency. Our results demonstrate that studying the causal effects of genetic variation on the underlying molecular network has the potential to provide a more extensive understanding of the pathways driving a complex trait.

Abernethy malformation, also known as congenital extrahepatic portosystemic shunts (CEPS) is a rare clinical entity and manifests with different clinical symptoms. CEPS are abnormalities of vascular development where there is shunting of portal blood into the systemic venous system. Multidetector computed tomography (MDCT) is a fast and effective modality for evaluation of CEPS. CT displays all the information desired by the surgeon as well as the clinician including the anatomy of the splenic and superior mesenteric veins, size and site of the shunt, presence or absence of the portal vein radicles, and helps to plan the therapy and even the follow-up of these patients. Contrast-enhanced magnetic resonance imaging (MRI) has also emerged as a promising tool for the evaluation of liver lesions associated with the malformation. The Radiologist should be aware of the various imaging appearances of this entity including its complications. In this article, we describe the imaging appearances of CEPS, their complications, and their imaging appearances on CT and MRI. We have also described various associated anomalies.

In post-transplant patients, de novo malignancies such as post-transplant lymphoproliferative disease (PTLD), lung carcinoma, renal cell carcinoma, cutaneous malignancies, and Kaposi sarcoma are now seen. The immunotherapy used to prevent graft failure indirectly increases their risk. We present a rare case of visceral Kaposi sarcoma in a patient with orthotopic liver transplant.

Even with identification of multiple causal genetic variants for common human diseases, understanding the molecular processes mediating the causal variants' effect on the disease remains a challenge. This understanding is crucial for the development of therapeutic strategies to prevent and treat disease. While static profiling of gene expression is primarily used to get insights into the biological bases of diseases, it makes differentiating the causative from the correlative effects difficult, as the dynamics of the underlying biological processes are not monitored. Using yeast as a model, we studied genome-wide gene expression dynamics in the presence of a causal variant as the sole genetic determinant, and performed allele-specific functional validation to delineate the causal effects of the genetic variant on the phenotype. Here, we characterized the precise genetic effects of a functional MKT1 allelic variant in sporulation efficiency variation. A mathematical model describing meiotic landmark events and conditional activation of MKT1 expression during sporulation specified an early meiotic role of this variant. By analyzing the early meiotic genome-wide transcriptional response, we demonstrate an MKT1-dependent role of novel modulators, namely, RTG1/3, regulators of mitochondrial retrograde signaling, and DAL82, regulator of nitrogen starvation, in additively effecting sporulation efficiency. In the presence of functional MKT1 allele, better respiration during early sporulation was observed, which was dependent on the mitochondrial retrograde regulator, RTG3. Furthermore, our approach showed that MKT1 contributes to sporulation independent of Puf3, an RNA-binding protein that steady-state transcription profiling studies have suggested to mediate MKT1-pleiotropic effects during mitotic growth. These results uncover interesting regulatory links between meiosis and mitochondrial retrograde signaling. In this study, we highlight the advantage of analyzing allele-specific transcriptional dynamics of mediating genes. Applications in higher eukaryotes can be valuable for inferring causal molecular pathways underlying complex dynamic processes, such as development, physiology and disease progression.

Integrating network theory approaches over time-resolved genome-wide gene expression data, we proposed a network-based framework, which considered intricate dynamic regulatory relationships of transcription factors and target genes, for assessing the molecular underpinnings underlying extreme phenotypic differences between two strains of the yeast, Saccharomyces cerevisiae. Using network attributes which have demonstrated tremendous success in understanding and predicting behaviors in a wide range of complex biological and social systems, we identified factors and candidate genes that acted as crucial regulators of sporulation in the highly sporulating SK1 strain. We then carried out independent network-based investigations of S288c gene expression profiles and identified the molecular events that occur in SK1 strain but fail to occur in S288c strain, which eventually lead to low sporulation efficiency of S288c. Results suggested that late appearance of known early sporulation regulators and a delay in crosstalk between functional modules can be construed as the prime reasons behind low sporulation efficiency of the S288c. Revelation of meiosis-associated genes for SK1 and mitotic genes for S288c through weak ties analysis and late appearance of hierarchical modularity were further indications of delay in regulatory activities essential to initiate sporulation in S288c. Our results demonstrate the potential of this framework in identifying candidate nodes contributing to phenotypic diversity of developmental processes in natural populations.

Background: Non-communicable diseases (NCDs) are the leading causes of death globally, out of 57 million global deaths in year 2008, 63%, were due to NCDs. Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths from chronic obstructive pulmonary disease, occur in low-and middle-income countries. A large percentage of NCDs are preventable through the reduction of their four main behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet. Thus, there is a need to carryout rigorously implemented surveys that estimate the risk factors of NCDs among Medical students. Objective: This study was undertaken to estimate the Load of lifestyle associated risk factors& their correlates in apparently healthy medical students. Materials and Methods: The cross sectional study will be carried out among students of Medical Institute in Western Uttar Pradesh, India. Student’s interview will be done through an age appropriate modified Global school based student health survey structured self-administrated questionnaire on life style associated risk factors. The statistical analysis will be done using SPSS 17- Chi-square test, t-test and ANOVA. Result: This study documented a prevalence rate of active smoking among the study population 6.4% as against 84.2% for non-smoking. Drinking of alcohol as one of the behavioural risk factors for NCDs was also documented by this present study is 1.8% for binge drinking status and 3.8% for heavy drinking status. Conclusion: The study shows a high prevalence of NCD related risk factors in medical students. Primary prevention may be one way to lower the risk burden of NCDs.