Role of ACR-TIRADS in risk stratification of thyroid nodules

Background: This study was performed to prospectively investigate the diagnostic reliability of the daily use of ACR-TIRADS classification system, in differentiating between a benign and a malignant lesion.Methods: In this prospective observational study, 50 patients with thyroid nodules underwent ultrasound examination and fine needle aspiration. The ultrasound studies were evaluated according to the ACR-TIRADS greyscale characteristics of composition, echogenicity, margins, shape, and echogenic foci. Each feature in a particular USG characteristic was scored and ACR-TIRADS categorization done from 1 to 5. This was compared to FNAC/histopathology findings and risk of malignancy was calculated for each feature and ACR-TIRADS category.Results: Of the 50 nodules included in the study, 38 were found to be benign and 12 were found to be malignant. Risk of malignancy for all ultrasound features showed an increasing trend with higher scored feature. Risk of malignancy for various features were as follows: Composition-cystic (0%), spongiform (0%), solid-cystic (0%) and solid (36%); echogenicity-anechoic(0%), hyperechoic (4%), isoechoic (11%), hypoechoic (47%) and markedly hypoechoic (100%); shape-wider-than-tall (21%) and taller-than-wide (66%); margins-smooth (18%), illdefined (0%), lobulated/irregular (38%) and extrathyroid extension (100%); echogenic foci-none (13%), large comet-tail artefacts (0%), macrocalcification (42%), rim calcification (50%) and punctate echogenic foci (50%). Amongst ACR-TIRADS(TR) categories TR1, TR2 and TR3 had 0% risk while TR4 had 30% and TR5 had 56% risk of malignancy with p value of 0.001.Conclusions: ACR-TIRADS is a high specific, accurate classification system for categorizing the thyroid nodules based on ultrasound features, for assessing the risk of malignancy

Systematic Review of Primary Hyperparathyroidism in India: The Past, Present, and the Future Trends

Primary hyperparathyroidism (PHPT) has become an asymptomatic disease in the Western world with the introduction of routine calcium screening. However, the same phenomenon is not observed in India. We have now systematically reviewed the status of PHPT in India. While there is a paucity of literature on PHPT from India when compared to Western countries, some information can be gleaned upon. Most patients present with symptomatic disease whereas very few are screen-detected cases (bone disease 77%, renal disease 36%, and 5.6% asymptomatic). Mean calcium, parathyroid hormone (PTH), and alkaline phosphate levels are high while Vitamin D levels are low. The average parathyroid gland weight is large and the majority being parathyroid adenomas (89.1%). Hungry bone syndrome (HBS) is common in the postoperative period. The disease-related mortality rate is 7.4%, recurrence 4.16%, and persistent disease 2.17%. We suggest that dedicated efforts are needed to pick up asymptomatic disease in India by methods like incorporating calcium estimation in the routine health check-up programs

PIM FLOODING MECHANISM AND SOURCE DISCOVERY (PFM-SD) EXTENSION TO AVOID FLOOD BETWEEN MULTI HOME PEER

Techniques are provided to support an extension to PFM-SD that avoids multicast traffic flooding across multi-home provide edge nodes, and maintains a faster convergence capability provided by multi-homing. These techniques allow a last hop router to create two trees, and provides a framework to ensure that Ethernet Segment failure has minimum traffic close for a receiver. In addition, these techniques involve a mechanism to avoid traffic flood over a core network between peers

Parallel triplet formation pathways in a singlet fission material

Harvesting long-lived free triplets in high yields by utilizing organic singlet fission materials can be the cornerstone for increasing photovoltaic efficiencies potentially. However, except for polyacenes, which are the most studied systems in the singlet fission field, spin-entangled correlated triplet pairs and free triplets born through singlet fission are relatively poorly characterized. By utilizing transient absorption and photoluminescence spectroscopy in supramolecular aggregate thin films consisting of Hamilton-receptor-substituted diketopyrrolopyrrole derivatives, we show that photoexcitation gives rise to the formation of spin-0 correlated triplet pair 1(TT) from the lower Frenkel exciton state. The existence of 1(TT) is proved through faint Herzberg-Teller emission that is enabled by vibronic coupling and correlated with an artifact-free triplet-state photoinduced absorption in the near-infrared. Surprisingly, transient electron paramagnetic resonance reveals that long-lived triplets are produced through classical intersystem crossing instead of 1(TT) dissociation, with the two pathways in competition. Moreover, comparison of the triplet-formation dynamics in J-like and H-like thin films with the same energetics reveals that spin-orbit coupling mediated intersystem crossing persists in both. However, 1(TT) only forms in the J-like film, pinpointing the huge impact of intermolecular coupling geometry on singlet fission dynamics

Expression and functional activity of pro-oxidants and antioxidants in murine heart exposed to acute hypobaric hypoxia

AbstractUnder hypobaric hypoxia, antioxidant defenses of the heart are stressed by the enhanced production of ROS. Mammalian heart acclimatizes to hypoxia through altered gene expression, which we studied in murine heart exposed to 10h of acute hypobaric hypoxia (AHH), equivalent to 15000ft, using cDNA arrays. Functional classification of genes with a ⩾2-fold change revealed a number of pro-oxidants like Cyba, Xdh, Txnip, Ppp1r15b and antioxidants like Cat, Gpx1, Mt1, Mgst1. Interestingly, the protein level of Cyba, a subunit of NADPH oxidase, was markedly decreased in AHH exposed heart, suggesting the involvement of some stress response pathways. The AHH exposure also caused a significant reduction (50%) in the level of GSH (P<0.05). The present study provides a retrospective insight on the cellular antioxidant defense mechanisms under AHH

Antifungalno i antiaflatoksikogeno djelovanje kumarinil tiosemikarbazida na plijesan Aspergillus flavus NRRL 3251

The antifungal and antiaflatoxigenic effects of two series of coumarinyl thiosemicarbazides on Aspergillus flavus NRRL 3251 were studied. Fungi were grown in YES medium for 72 h at 29 °C in the presence of 0, 0.1, 1, and 10 μg mL-1 of coumarinyl thiosemicarbazides: one series with substitution in position 7 and another with substitution in position 4 of the coumarin core. Dry mycelia weight determination was used for antifungal activity estimation, while the aflatoxin B1 content in YES media, determined by the dilute and shoot LC-MS/MS technique, was used for the antiaflatoxigenic effect estimation. Standard biochemical assays were used for oxidative status marker (TBARS, SOD, CAT, and GPX) determination in A. flavus NRRL 3251 mycelia. Results show that 7-substituted-coumarinyl thiosemicarbazides possess a better antifungal and antiaflatoxigenic activity than 4-substituted ones. The most prominent substituted compound was the compound 3, N-(4-chlorophenyl)-2-(2-((4-methyl-2-oxo-2H-chromen-7-yl)oxy)acetyl)hydrazine-1-carbothioamide, which completely inhibited aflatoxin production at the concentration of 10 μg mL-1. Oxidative stress response of A. flavus exposed to the selected compounds points to the modulation of oxidative stress as a possible reason of aflatoxin production inhibition.Ispitano je antifungalno i antiaflatoksikogeno djelovanje dviju serija kumarinskih tiosemikarbazida na plijesan Aspergillus flavus NRRL 3251. Plijesan je uzgojena u YES mediju tijekom 72 sata na 29 °C u prisutnosti kumarinskih tiosemikarbazida, koncentracija 0, 0,1, 1 i 10 μg mL-1, jedne serije gdje je kumarin supstituiran u položaju 4 i druge sa supstitucijom u položaju 7 kumarinske jezgre. Antifungalna aktivnost određena je mjerenjem mase suhog micelija, a sadržaj aflatoksina B1 određen je u YES mediju dilute and shoot LC/MS-MS metodom. Za određivanje markera oksidativnoga statusa u miceliju A. flavus NRRL 3251 koristili su se standardni biokemijski testovi (TBARS, SOD, CAT i GPX). Rezultati su pokazali da tiosemikarbazidi na kumarinu supstituiranom u položaju 7 imaju bolju antifungalnu i antimikotoksigenu aktivnost nego oni s kumarinom supstituiranom u položaju 4. Od ispitivanih spojeva valja istaknuti spoj 3, N-(4-klorofenil)-2-(2-((4-metil-2-okso-2H-kromen-7-il)oksi)acetil)hidrazin-1-karbotioamid, koji je pri koncentraciji 10 μg mL-1 potpuno inhibirao produkciju aflatoksina. Iz dobivenih rezultata može se pretpostaviti da je vjerojatni uzrok inhibicije produkcije aflatoksina oksidacijski stres uzrokovan ispitanim spojevima

Energy-Efficient Object Detection and Tracking Framework for Wireless Sensor Network

Object detection and tracking is one of the key applications of wireless sensor networks (WSNs). The key issues associated with this application include network lifetime, object detection and localization accuracy. To ensure the high quality of the service, there should be a trade-off between energy efficiency and detection accuracy, which is challenging in a resource-constrained WSN. Most researchers have enhanced the application lifetime while achieving target detection accuracy at the cost of high node density. They neither considered the system cost nor the object localization accuracy. Some researchers focused on object detection accuracy while achieving energy efficiency by limiting the detection to a predefined target trajectory. In particular, some researchers only focused on node clustering and node scheduling for energy efficiency. In this study, we proposed a mobile object detection and tracking framework named the Energy Efficient Object Detection and Tracking Framework (EEODTF) for heterogeneous WSNs, which minimizes energy consumption during tracking while not affecting the object detection and localization accuracy. It focuses on achieving energy efficiency via node optimization, mobile node trajectory optimization, node clustering, data reporting optimization and detection optimization. We compared the performance of the EEODTF with the Energy Efficient Tracking and Localization of Object (EETLO) model and the Particle-Swarm-Optimization-based Energy Efficient Target Tracking Model (PSOEETTM). It was found that the EEODTF is more energy efficient than the EETLO and PSOEETTM models

Delayed retrieval of embolized ductal stent: A surgical challenge

Retrieval of embolized ductal stents from the pulmonary or systemic circulation can be challenging. Most children benefit from surgical shunts in such scenarios. Although early retrieval is advised, stents lodged in the peripheral pulmonary tree can be inaccessible, making the removal complicated. In such patients, stents can be “parked” in the segmental pulmonary arterial branches for retrieval later. In the low-pressure single ventricle pulmonary circulation, partially expanded embolized stents, if left in situ, can precipitate pulmonary arterial thrombosis. This subset of patients may benefit from meticulous anticoagulation and antiplatelet agents. In our case report, we describe the successful extraction of an embolized ductal stent without damage to the right lower lobe pulmonary artery (PA). In the follow-up evaluation, the growth of the right PA is good

Modeling vibronic spectra of linear aggregates in MATLAB

Molecular aggregates display a rich array of photophysical properties quite different from the isolated molecules that have applications in photovoltaics and display technology. Hence, understanding their absorption and emission spectra gives clues about packing and coherence properties, essential for energy transport. We attempt to calculate the steady-state spectra of linear aggregates. We approached this problem by following the vibronic excitonic framework discussed by Spano and co-workers [Hestand & Spano, Chem. Rev. 2018, 118, 7069-7163]. The framework allows us to incorporate the influence of nuclear relaxation energy through the one-particle and two-particle states. We also study the effects of local static disorder, finite temperature, and periodic boundary conditions. We implement the calculation of the photoluminescence and absorption spectra in the user-friendly language MATLAB in a manner that allows sequentially increasing the complexity of the model by considering more effects as needed. The calculated spectra have been validated by matching them with spectra produced by Spano et al. Hence, we have implemented a robust code that can model spectra from linear aggregates of any size and orientation, subject to computational limitations. We are currently using these codes to assign the steady state spectra and speculate the morphology of several types of thin films made of donor-acceptor dyes obtained by an experimental collaborator at SSCU; these dyes are being put forward for use for increasing the efficiency of photovoltaic cells through the multi-exciton generation mechanism of singlet fission. The high-level language implementation allows usage without a programming background as long as the theoretical model is understood