CYTOLOGICAL, ULTRASOUND AND BIOCHEMICAL CORRELATION IN HASHIMOTO’S THYROIDITIS, FARIDABAD, INDIA: A RETROSPECTIVE CROSS-SECTIONAL ANALYSIS.

Background Hashimoto’s thyroiditis, an autoimmune disorder that impairs thyroid hormone production via antibody-mediated destruction of thyroid cells, affects women more frequently and presents symptoms like weight gain and fatigue. This study investigates the correlation between cytomorphological, biochemical, and radiological findings in diagnosing this condition, utilizing Fine Needle Aspiration Cytology (FNAC) as a key diagnostic tool. Materials and methods A retrospective analysis of cytological, radiological, and biochemical parameters was done for 84 patients who underwent FNAC for Hashimoto’s Thyroiditis. The blood concentration of thyroid hormones was evaluated by the Thyroid Function Test (TFT). Thyroid ultrasound was done using a high-frequency linear ultrasound transducer. Results This study found Hashimoto's thyroiditis more common in females (95%) and primarily in those aged 20-40 years. Biochemical hypothyroidism (Thyroid function test) was observed in 50% of the selected patients, euthyroidism was observed in about 43% of the patients, and hyperthyroidism was observed in 7 % of the patients. Cytological findings showed mild, moderate, and dense lymphocytic infiltration in 32.15%, 41.66%, and 26.20% of patients across Grades I, II, and III, respectively. Moreover, 51% of the patients were affected with diffuse thyroiditis, 35% of the patients were affected with goiter, 8% of the patients were affected with thyroid nodules, and the remaining 6% of the patients were seen to be normal in the ultrasound findings.  Conclusion Hashimoto’s Thyroiditis is more prevalent in females, with elevated biochemical results linked to higher FNAC grades. Early detection of diffuse thyroiditis using ultrasound assists in predicting the disease before clinical signs appear. Integrating biochemical, cytology, and ultrasound findings can identify subclinical hypothyroidism.  Recommendation For early detection and precise staging of Hashimoto’s Thyroiditis, integrating cytomorphological, biochemical, and radiological diagnostics is advised. Future research should aim at refining treatment strategies based on these findings

Federal Forum Provisions and the Internal Affairs Doctrine

A key question at the intersection of state and federal law is whether corporations can use their charters or bylaws to restrict securities litigation to federal court. In December 2018, the Delaware Chancery Court answered this question in the negative in the landmark decision Sciabacucchi v. Salzberg. The court invalidated “federal forum provisions” (“FFPs”) that allow companies to select federal district courts as the exclusive venue for claims brought under the Securities Act of 1933 (“1933 Act”). The decision held that the internal affairs doctrine, which is the bedrock of U.S. corporate law, does not permit charter and bylaw provisions that restrict rights under federal law. In March 2020, the Delaware Supreme Court overturned the Chancery’s decision in Salzberg v. Sciabacucchi, holding, among others, that in addition to “internal” affairs, charters and bylaws can regulate “intra-corporate” affairs, including choosing the forum for Securities Act claims. This Article presents the first empirical analysis of federal forum provisions. Using a hand-collected data set, we examine the patterns of adoption of such provisions and the characteristics of adopting firms. We show that adoption rates are higher for firms with characteristics, such as belonging to a particular industry, that make them more vulnerable to claims under the 1933 Act. We also show that adoption rates substantially increased after the Supreme Court case Cyan Inc. v. Beaver County Employees Retirement Fund, which validated concurrent jurisdiction for both federal and state courts for 1933 Act claims. We also find that the firms that adopt FFPs at the initial public offering (“IPO”) stage tend to share characteristics that have been associated with relatively good corporate governance. To assess the impact of the Sciabacucchi decision, we also conduct an event study. We find that the decision is associated with a large negative stock price effect for companies that had FFPs in their charters or bylaws. The effect is robust even for firms that had better governance features, that underpriced their stock at the IPOs, and whose stock price traded at or above the IPO price prior to the Sciabacucchi decision. In light of the empirical findings suggesting that federal forum provisions may serve shareholders’ interests by mitigating excessive 1933 Act litigation, we consider alternative legal theories for validating federal forum provisions in corporate charters and bylaws. We suggest two possible approaches: (1) allowing corporate charters and bylaws to address matters that are technically external but deal with the “affairs” of the corporation; and (2) adopting a more “flexible” internal affairs doctrine that could view 1933 Act claims as being “internal” to a corporation’s affairs. The Delaware Supreme Court’s decision can be viewed as being more consistent with the first, rather than the second, approach. We examine the possible implications of adopting either approach, particularly with respect to the existing Delaware statute on exclusive forum provisions and to mandatory arbitration provisions

The Meme Stock Frenzy: Origins and Implications

In 2021, several publicly traded companies, such as GameStop and AMC, became “meme stocks,” experiencing a sharp rise in their stock prices through a dramatic influx of retail investors into their shareholder base. Analyses of the meme stock surge and its implications for corporate governance have focused on the idiosyncratic creation of online communities around particular stocks during the COVID-19 pandemic. In this Article, we argue that the emergence of meme stocks is part of longer-running digital transformations in trading, investing, and governance. On the trading front, the sudden abolition of commissions by major online brokerages in 2019 reduced entry costs for retail investors. Zero-commission trading represents a modification of the payment for order flow (PFOF) system, which is itself a product of technological disruptions in the financial markets in the 1980s. With respect to investing, the emergence of social media communication amplified retail investors’ pre-existing dependence on social networks to make decisions regarding stock market entry and portfolio construction. It also allowed them to coordinate their investing activities and affect the market price while expressing their non-financial interests. Finally, while some startups have attempted to bring the shareholder experience into the digital age and help retail investors participate in governance, these developments have been relatively modest. After tracing the meme stock phenomenon, we sketch a research agenda for law and finance scholars to explore the concrete effects of meme investing on corporate governance outcomes. First, we ask whether retail traders can transform into enthusiastic retail shareholders engaged in corporate governance. Second, we propose a broader metric for “meme-ness”: future scholarship can use modern advances in data science to better identify which companies are vulnerable to meme surges and social media-driven investing unrelated to their financial fundamentals

Laproscopic intravesical vesicovaginal fistula repair after removal of an old vaginal drain tube-a rare case

The management of vesicovaginal fistula is difficult and challenging We are presenting a rare case of a 24-year-old unmarried girl with history of vaginoplasty and multiple surgeries done in the past, with a vaginal drain tube kept for 12 years and a Vesicovaginal fistula at the bladder trigone. Patient was successfully treated with a laproscopic Intravesical vesicovaginal Fistula repair. As advances in understanding the etiology of VVF have been made, the laproscopic approach has become the gold standard. Laparoscopy allows an excellent view, good exposure of pelvic structures, provides direct access to the fistula and for repair of complex VVF that may not be amenable to vaginal repair

Extra-skeletal Ewing’s Sarcoma of Caecum Causing Intussusception: First such Reported Case

Introduction: Ewing’s sarcoma is a tumor of primitive cells which primarily affects long bones. Extra-skeletal Ewing’s sarcoma has been rarely reported in small bowel. Its presentation can be varied but it is an extremely unlikely cause of an Ileo-Colic Intussusception as seen in present case.Case Presentation: A 32 years old male patient presented with symptoms suggestive of bowel obstruction. CT scan was suggestive of Ileo-colic intussusception. Patient underwent diagnostic laparoscopy and right hemicolectomy. Histopathology examination of specimen revealed Ewing sarcoma of colon.Conclusion: Extra-skeletal Ewing’s sarcoma is a rare entity. To the best of our knowledge this is the first reported case in English literature, of a Caecal Ewing’s sarcoma causing Intussusception. Further study of such cases may help in better understanding and establishing treatment protocol for this condition

Meme Corporate Governance

Can retail investors revolutionize corporate governance and make public companies more responsive to social concerns? The U.S. stock market offered an unusual experiment to test the impact of retail investors in 2021, when there was a dramatic influx of retail investors into the shareholder base of companies such as GameStop and AMC. The meme surge phenomenon elicited a variety of reactions from scholars and practitioners. While some worried that affected companies’ share prices were becoming disjointed from their financial fundamentals, others predicted that retail shareholders will reduce the power of large institutional investors and democratize corporate governance. This Article presents the first empirical analysis of the impact of retail investors on the governance of companies affected by the “meme stock surge.” The Article presents three principal findings. First, we show how the “meme stock” frenzy was affected by the introduction of the commission-free trading platform, such as Robinhood, in 2019. We show that the meme stock companies experienced higher abnormal stock returns when commission-free trading was widely introduced, and saw elevated trading volumes afterward. Second, we examine how the influx of retail shareholders has directly affected the governance outcomes at the meme stock companies. Notwithstanding the promise of a more active retail shareholder base, we show that meme stock companies have experienced a significant decrease in participation by their shareholders with respect to voting. Shareholder proposals under Rule 14a-8 have also been extremely limited, with most meme firms seeing no proposals brought after the rapid increase in retail ownership. Third, we examine whether the increase in retail shareholder base had any indirect effect on corporate governance and performance. While board gender diversity at these firms is broadly unchanged, their ESG scores have gotten worse subsequent to the meme surge. Examining meme firms’ use of corporate funds, we find decreases in research and development and capital expenditures after the meme surge. Collectively, our findings suggest that the influx of retail shareholders at these companies have not translated into more “democratic” governance regimes or reduced agency costs, even at firms the scholarly and popular commentary had highlighted as the cynosure of the retail investor storm

The New Frontier of Cybersecurity: Emerging Threats and Innovations

In today's digitally interconnected world, cybersecurity threats have reached unprecedented levels, presenting a pressing concern for individuals, organizations, and governments. This study employs a qualitative research approach to comprehensively examine the diverse threats of cybersecurity and their impacts across various sectors. Four primary categories of threats are identified and analyzed, encompassing malware attacks, social engineering attacks, network vulnerabilities, and data breaches. The research delves into the consequences of these threats on individuals, organizations, and society at large. The findings reveal a range of key emerging threats in cybersecurity, including advanced persistent threats, ransomware attacks, Internet of Things (IoT) vulnerabilities, and social engineering exploits. Consequently, it is evident that emerging cybersecurity threats pose substantial risks to both organizations and individuals. The sophistication and diversity of these emerging threats necessitate a multi-layered approach to cybersecurity. This approach should include robust security measures, comprehensive employee training, and regular security audits. The implications of these emerging threats are extensive, with potential consequences such as financial loss, reputational damage, and compromised personal information. This study emphasizes the importance of implementing effective measures to mitigate these threats. It highlights the significance of using strong passwords, encryption methods, and regularly updating software to bolster cyber defenses.Comment: 6 pages, 2 Table

ZSON: Zero-Shot Object-Goal Navigation using Multimodal Goal Embeddings

We present a scalable approach for learning open-world object-goal navigation (ObjectNav) -- the task of asking a virtual robot (agent) to find any instance of an object in an unexplored environment (e.g., "find a sink"). Our approach is entirely zero-shot -- i.e., it does not require ObjectNav rewards or demonstrations of any kind. Instead, we train on the image-goal navigation (ImageNav) task, in which agents find the location where a picture (i.e., goal image) was captured. Specifically, we encode goal images into a multimodal, semantic embedding space to enable training semantic-goal navigation (SemanticNav) agents at scale in unannotated 3D environments (e.g., HM3D). After training, SemanticNav agents can be instructed to find objects described in free-form natural language (e.g., "sink", "bathroom sink", etc.) by projecting language goals into the same multimodal, semantic embedding space. As a result, our approach enables open-world ObjectNav. We extensively evaluate our agents on three ObjectNav datasets (Gibson, HM3D, and MP3D) and observe absolute improvements in success of 4.2% - 20.0% over existing zero-shot methods. For reference, these gains are similar or better than the 5% improvement in success between the Habitat 2020 and 2021 ObjectNav challenge winners. In an open-world setting, we discover that our agents can generalize to compound instructions with a room explicitly mentioned (e.g., "Find a kitchen sink") and when the target room can be inferred (e.g., "Find a sink and a stove").Comment: code: https://github.com/gunagg/zso

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes