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We present a case of a male neonate with refractory and persistent neonatal hypoglycaemia not responding to octreotide. On evaluation for hypoglycaemia, his cortisol was within the reference range while the serum insulin concentrations were high. Gallium-68 dotatate scan (GA-68 DOTA) showed diffuse pancreatic involvement. Genetic diagnosis of congenital hyperinsulinaemic hypoglycaemia due to

We present a case of a young girl who presented with hypertensive crisis and recent onset weight gain with hirsutism. On evaluation for Cushing syndrome (CS), her cortisol concentration was high, showed a paradoxical cortisol rise on dexamethasone suppression and the adrenocorticotropic hormone (ACTH) was low. Adrenal imaging showed normal adrenal morphology. Genetic diagnosis of primary pigmented nodular adrenal disease (PPNAD) was made. She was operated for bilateral adrenalectomy and histopathology confirmed the diagnosis of PPNAD. Our case highlights the rare aetiology of PPNAD as a cause of CS resulting in a hypertensive crisis. To the best of our knowledge, this is the youngest case of ACTH independent CS presenting as hypertensive encephalopathy.

Background: The open-label, single-arm, multicenter ORZORA trial (NCT02476968) evaluated the efficacy and safety of maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer (PSR OC) who had tumor BRCA mutations (BRCAm) of germline (g) or somatic (s) origin or non-BRCA homologous recombination repair mutations (HRRm) and were in response to their most recent platinum-based chemotherapy after ≥2 lines of treatment. Methods: Patients received maintenance olaparib capsules (400mg twice daily) until disease progression. Prospective central testing at screening determined tumor BRCAm status and subsequent testing determined gBRCAm or sBRCAm status. Patients with predefined non-BRCA HRRm were assigned to an exploratory cohort. The co-primary endpoints were investigator-assessed progression-free survival (PFS; modified Response Evaluation Criteria in Solid Tumors v1.1) in BRCAm and sBRCAm cohorts. Secondary endpoints included health-related quality of life (HRQoL) and tolerability. Results: 177 patients received olaparib. At the primary data cut-off (17 April 2020), the median follow-up for PFS in the BRCAm cohort was 22.3months. The median PFS (95% CI) in BRCAm, sBRCAm, gBRCAm and non-BRCA HRRm cohorts was 18.0 (14.3-22.1), 16.6 (12.4-22.2), 19.3 (14.3-27.6) and 16.4 (10.9-19.3) months, respectively. Most patients with BRCAm reported improvements (21.8%) or no change (68.7%) in HRQoL and the safety profile was as expected. Conclusions: Maintenance olaparib had similar clinical activity in PSR OC patients with sBRCAm and those with any BRCAm. Activity was also observed in patients with a non-BRCA HRRm. ORZORA further supports use of maintenance olaparib in all patients with BRCA-mutated, including sBRCA-mutated, PSR OC.

Abstract: The gut microbiota is an essential part of the gastrointestinal tract and recent research, including clinical and preclinical studies, shed light on the interaction between the gut and the brain. A rising amount of evidence strongly proves the involvement of gut microbes in brain function and their contribution in altering behavior, mood, and ultimately in the pathogenesis of certain neurological conditions. The gut microbiota produces and modulates neurotransmitters such as GABA, serotonin, dopamine, glutamate, etc. Furthermore, there is a presence of a biological link between the microbiota, immune signaling, and CNS suggesting that microbial metabolites could regulate both neurological and immunological activities in the brain. Thus, this review focuses on the bidirectional communication between the gut and brain, its impact and role in the modulation of various neurological disorders, such as schizophrenia, depression, anxiety, etc., and attempts to explore the underlying mechanism for the same. The article also discusses studies involving germ-free mice, studies on the effects of faeces transfer of microbiota, and research involving gut microbiota composition in animal models. The effects of probiotics and prebiotics on neurological disorders are also discussed, along with the clinical studies for each of them. In a nutshell, extensive studies are required to explore this bidirectional communication between the gut and brain, which might help researchers develop new therapeutic targets in treating neurological disorders and increase our understanding of the gut-brain axis.

We describe siblings born from non-consanguineous parents, with older sibling having asymptomatic hyperglycaemia while younger sibling presented with low birth weight and persistent hyperglycaemia from first month of life. Our case, the older sibling was heterozygous for paternally inherited

We present a 12-year-old girl with recent onset weight gain and purple striae over the abdomen. Examination revealed her to be hypertensive. On evaluation for Cushing syndrome (CS), her cortisol and adrenocorticotropic hormone (ACTH) were found to be high. MRI brain showed a suspicious lesion (thought to be pituitary microadenoma). Inferior petrosal sinus sampling was not conclusive of pituitary source of ACTH. High dose dexamethasone suppression test confirmed an ectopic source of ACTH secretion and CT scan revealed a mass in the right kidney which was laparoscopically excised. Histopathology and immunohistochemistry confirmed Ewing sarcoma. Our case highlights the rare presentation of renal Ewing sarcoma (RES) as CS. To the best of our knowledge, this is only the second case report of RES/primitive neuroectodermal tumour of the kidney presenting as CS in paediatric age group and first with a concomitant pituitary incidentaloma.

Aims: This work uses the MACE method to synthesize SiNWs- NiNPs/NiONPs to degrade organic pollutants by photocatalysis. Background: Photocatalytic degradation has been applied as an attractive solution to remove several organic pollutants. Heterostructured nanomaterials have become an interesting platform for investigation. Metal-assisted chemical etching (MACE) stands out as a promising technique because it is simple, low cost, and fast. Objective: Attain the degradation of methyl orange (MO) in the presence of silicon nanowires (SiNWs) in heterojunction with Nickel/Nickel Oxide nanoparticles (NiNPs-NiONPs). Methods: SiNWs were synthesized by metal (Ag) assisted chemical etching (MACE) of monocrystalline silicon wafers. NiNPs were non-electrolytically deposited on the SiNWs (electroless method). The morphology of the SiNWs- NiNPs/NiONPs was observed by SEM. Results: Heterogeneous photocatalytic degradation of methyl orange (C14H14N3NaO3S) in an aqueous solution at a concentration of 20 ppm had an efficiency of 66.5% after 180 min under UV irradiation. The MO degradation percentage was determined using UV-visible spectrophotometry. Conclusion: The SiNWs-NiNPs/NiONPs were obtained composed mainly of Si covered by SiO2 decorated on the tips with Ni (II) in the form of NiO and a small amount of nickel metal. The removal efficiency obtained at 180 min of light exposure was 66.5%. After the photocatalysis tests, further oxidation of the NiNPS into NiONPS, was attributed to the reactive oxygen species in the aqueous medium based on the changes of the oxygen and Ni2p3/2 peaks by XPS. Other: Through XPS, the oxidation state of the SiNWs- NiNPs/NiONPs was analyzed.

Renal artery stenosis (RAS) is a major contributor to the prevalence of secondary hypertension. Fibromuscular dysplasia and atherosclerosis are commonly responsible for the occurrence of the disease. Medical therapy is the primary means of treatment for RAS. However, surgical interventions for revascularization are also considered, in selected group of patients, which can effectively cure hypertension and chronic kidney disease. An older man presented at Venus hospital, Surat, Gujarat with the complaints of severe dyspnea, edema, uncontrolled hypertension and renal insufficiency. He was diagnosed RAS and was operatively managed with percutaneous transluminal renal angioplasty. Written consent was taken from the patient mentioned in the study. During the procedure, the renal artery got ruptured, which was managed by placing a covered stent. The patient was successfully treated for RAS, in spite of comorbidities and intraoperative complication. In the subsequent clinical follow-up, the patient was asymptomatic. There was marked reduction in serum creatinine levels and even the blood pressure improved significantly. Absence of post-operative complications and positive recovery of the patient signifies the fact that management of renal artery rupture with a covered stent is a convenient approach in acquiring effective haemostasis. This approach can be useful in managing any sort of vessel rupture, related to revascularization procedures.

Exomoons have so far eluded ongoing searches. Several studies have exploited transit and transit timing variations and high-resolution spectroscopy to identify potential exomoon candidates. One method of detecting and confirming these exomoons is to search for signals of planet-moon interactions. In this work, we present the first radio observations of the exomoon candidate system WASP 69b. Based on the detection of alkali metals in the transmission spectra of WASP-69b, it was deduced that the system might be hosting an exomoon. WASP 69b is also one of the exoplanet systems that will be observed as part of JWST cycle-1 GTO. This makes the system an excellent target to observe and follow up. We observed the system for 32 hrs at 150 MHz and 218 MHz using the upgraded Giant Metrewave Radio Telescope (uGMRT). Though we do not detect radio emission from the systems, we place strong $3\sigma$ upper limits of 3.3 mJy at 150 MHz and 0.9 mJy at 218 MHz. We then use these upper limits to estimate the maximum mass loss from the exomoon candidate., Comment: Accepted in MNRAS, 8 pages, 4 Figures

Abstract: The accurate assessment or diagnosis of breast cancer depends on image acquisition and image analysis and interpretation. The accurate assessment or diagnosis of breast cancer depends on image acquisition and image analysis and interpretation. The expert radiologist makes image interpretation, and this process has been greatly benefited by computer technology. For image acquisition, various imaging modalities have been developed and used over the years. This research examines several imaging modalities and their associated benefits and drawbacks. Commonly used parameters such as sensitivity and specificity are also offered to evaluate the usefulness of different imaging modalities. The main focus of the research is on mammograms. Despite the availability of breast cancer datasets of imaging modalities such as MRI, ultrasounds, and thermograms, mammogram datasets are used mainly by the domain researcher. They are considered an international gold standard for the early detection of breast cancer. We discussed and analyzed widely used and publicly available mammogram repositories. We further discussed some common key constraints related to mammogram datasets to develop the deep learning based computer-aided diagnosis (CADx) systems for breast cancer. The ideas for their improvements have also been presented.

After the paper of Molodtsov [Molodtsov D. Soft set theory — First results, Computers and Mathematics with Applications, 1999, vol. 37, no. 4-5, pp. 19-31.] first appeared, soft set theory grew at a breakneck pace. Several authors have introduced various operations, relations, results, etc. as well as other aspects in soft set theory and hybrid structures incorrectly, despite their widespread use in mathematics and allied areas. In his paper [Molodtsov D.A. Equivalence and correct operations for soft sets, International Robotics and Automation Journal, 2018, vol. 4, no. 1, pp. 18-21.], Molodtsov, the father of soft set theory, pointed out several wrong results and notions. Molodtsov [Molodtsov D.A. Structure of soft sets, Nechetkie Sistemy i Myagkie Vychisleniya, 2017, vol. 12, no. 1, pp. 5-18.] also stated that the concept of soft set had not been fully understood and used everywhere. As a result, it is important to revisit the quirks of those conceptions and provide a formal account of the notion of soft set equivalency. Molodtsov already explored many correct operations on soft sets. We use some notions and results of Molodtsov [Molodtsov D.A. Structure of soft sets, Nechetkie Sistemy i Myagkie Vychisleniya, 2017, vol. 12, no. 1, pp. 5-18.] to create matrix representations as well as related operations of soft sets, and to quantify the similarity between two soft sets.

Title: Relationship of HIF-1α and tumor infiltrating lymphocytes in patients with HER2-negative early-stage breast cancer treated with neoadjuvant chemotherapy Authors: Grabinski VF, Oza HH, Gilkes DM, Shah MY, Cimino-Mathews A, Gabrielson E, Zhi I, Pipa Z, Lehman J, Ibanez HE, Ke S, Tsai HL, Stearns V, Santa-Maria CA Introduction: Hypoxia inducible factor 1α (HIF-1α) is an oxygen-dependent transcription factor expressed in areas of hypoxia associated with regulation of immune escape mechanisms, metabolism (CAIX), and results in cancer treatment resistance. High stromal tumor infiltrating lymphocytes (sTILs) are associated with pathologic complete response (pCR) to neoadjuvant chemotherapy (NACT) in breast cancer. We investigated associations between HIF-1α, sTILs and their relationship with pCR after NACT in patients with HER2-negative early-stage breast cancer. Methods: We identified patients with early-stage HER2-negative breast cancer at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center from 2000-2009 who received NACT, and had accessible breast tissue from biopsy and/or surgery. A pathologist scored nuclear HIF-1α (0, 1, 2, or 3), membranous CAIX (0, 1, 2, or 3), sTILs (0-100) from baseline (ie pre-NACT) and surgical tissue (if non-pCR). Statistical analysis considered the following variables: age, histology, race, menopausal status, tumor size, and node status. Chemotherapy regimens were divided into either anthracycline AND taxane versus anthracycline OR taxane. Wilcoxon rank-sum, Fisher exact, and Jonckheere trends tests were utilized to assess differences between groups. Results: 43 patients met the predefined criteria and were included in the analysis, 16% (n=7) obtained a pCR. Patient race, ethnicity, clinical tumor size, histology, clinical subtype (estrogen receptor positive (ER+) vs. triple negative (TN)), and NACT regimen were not associated with pCR. Older age (p=0.019), postmenopausal status (p=0.009), smaller surgical tumor size (p < 0.001), and surgical node-negative status (p < 0.001) were associated with pCR. Mean TILs score was 32.5% in patients achieving pCR versus 20% in those with non-pCR (p=0.46); mean HIF-1α was 2.42 in pCR group versus 2.57 in non-pCR (p=0.84). There was a trend of lower baseline sTILs with increasing nuclear HIF-1α score (p=0.085). Membranous CAIX was not associated with nuclear HIF-1α or baseline TILs, however, in the small proportion of patients (n=11) with CAIX scoring, higher membranous CAIX score at baseline (1 vs. 0) was associated with pCR (p=0.024). Conclusions: We observed that patients with pCR had a numerically higher sTILs level at baseline consistent with other studies, but did not find a correlation of HIF-1α and pCR. Patients with higher HIF-1α scores tended to have lower sTILS, suggesting that hypoxia may be leading to an immunosuppressive tumor microenvironment. Further characterizing the HIF-1α pathway and its effects on the immune microenvironment may help identify resistance mechanisms to chemotherapy and immunotherapy. Citation Format: Harsh Oza, Victoria Grabinski, Hector Ibanez, Ines Godet, Daniele Gilkes, Ashley Cimino-Mathews, Edward Gabrielson, Mirat Shah, W. Iris Zhi, Zoe Pipa, Jennifer Lehman, Suqi Ke, Hua-Ling Tsai, Vered Stearns, Cesar Augusto Santa-Maria. Relationship of HIF-1α and tumor infiltrating lymphocytes in patients with HER2-negative early-stage breast cancer treated with neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-20-14.

PURPOSE In SOLO1/GOG 3004 (ClinicalTrials.gov identifier: NCT01844986 ), maintenance therapy with the poly(ADP-ribose) polymerase inhibitor olaparib provided a sustained progression-free survival benefit in patients with newly diagnosed advanced ovarian cancer and a BRCA1 and/or BRCA2 (BRCA) mutation. We report overall survival (OS) after a 7-year follow-up, a clinically relevant time point and the longest follow-up for any poly(ADP-ribose) polymerase inhibitor in the first-line setting. METHODS This double-blind phase III trial randomly assigned patients with newly diagnosed advanced ovarian cancer and a BRCA mutation in clinical response to platinum-based chemotherapy to maintenance olaparib (n = 260) or placebo (n = 131) for up to 2 years. A prespecified descriptive analysis of OS, a secondary end point, was conducted after a 7-year follow-up. RESULTS The median duration of treatment was 24.6 months with olaparib and 13.9 months with placebo, and the median follow-up was 88.9 and 87.4 months, respectively. The hazard ratio for OS was 0.55 (95% CI, 0.40 to 0.76; P = .0004 [ P < .0001 required to declare statistical significance]). At 7 years, 67.0% of olaparib patients versus 46.5% of placebo patients were alive, and 45.3% versus 20.6%, respectively, were alive and had not received a first subsequent treatment (Kaplan-Meier estimates). The incidence of myelodysplastic syndrome and acute myeloid leukemia remained low, and new primary malignancies remained balanced between treatment groups. CONCLUSION Results indicate a clinically meaningful, albeit not statistically significant according to prespecified criteria, improvement in OS with maintenance olaparib in patients with newly diagnosed advanced ovarian cancer and a BRCA mutation and support the use of maintenance olaparib to achieve long-term remission in this setting; the potential for cure may also be enhanced. No new safety signals were observed during long-term follow-up.

Protective lung ventilation is the mainstay ventilation strategy for patients on extracorporeal membrane oxygenation (ECMO), as prolonged mechanical ventilation increases morbidity and mortality; the technicalities of ventilation with ECMO have evolved in the last decade. ECMO on the other end of the spectrum is a complete or total extracorporeal support, which supplies complete physiological blood gas exchanges, normally performed by the native lungs and thus is capable of delivering oxygen (O2) and removing CO equal to the metabolic needs of the patient, it requires higher flows, is more complex, and uses bigger cannulas, higher dose of heparin and higher blood volume for priming. This review describes in detail carbon dioxide removal on ECMO.

Background: Maternal determinants influence the outcome of pregnancy and child’s health in early years. Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures. Methods: Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker. Results: Relevant information could be gathered from 96 mothers. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p

Background: Severe acute malnutrition is a major cause of mortality in children under 5 years of age in developing countries. Dehydration and Shock are the common serious complications of SAM and require cautious treatment. We carried out this study to compare 2 different guidelines given by WHO and IAP in patient of SAM with shock to compare their outcome and complications. Methods: A randomized controlled trial was conducted during January 2019 to October 2019 at tertiary care centre of central Gujarat. Total 40 patients were enrolled according to inclusion criteria and randomized into two groups equally, Group A (following WHO guidelines) and Group B (following IAP guidelines). Rehydration therapy was given accordingly and patients were assessed for improvement in shock, developing complications and outcome as discharge or death. Results: Out of 20 patients in each group, after bolus, not a single patient in group A showed improvement after 1 hour while in Group B 3/20 (15%) patients were improved. In Group A 8/20 (40%) and in Group B 12/20 (60%) patients showed improvement within 12 hours of bolus. In Group A 7/20 (35%) patients and in Group B 6/20 (30%) patients developed complication of fluid overload. In Group A 12/20 (60%) while in Group B 8/20 (40%) patients expired during the treatment. Conclusions: Rehydration therapy according to IAP guidelines showed better improvement in shock, less incidence of complications and better outcome as compared to WHO Guidelines in SAM patients, however no significant difference was achieved due to smaller sample size.

The said article is reflecting various technical and legal aspects in terms of language, laws, statistics, etc. related to the impact on the fundamental rights of senior citizens of India. the main purpose of this article is to highlight the availing facilities provided by the State and Union to senior citizen and its impact as senior citizens. Age is the criterion which is affecting one life, as soon as they reach sixty plus, they became dependent or dependable in all respects i.e., physically, mentally, economically, socially, etc. Economically charges made him paralyzed and dependable. At this juncture what he/she/they need is protection through various Constitutional rights as good rules, regulations, and amendment formed and framed, by the Government for them

This study presents the design and fabrication of an urban solar food cooking system with a phase change material (PCM) as a heat storage tank. The effort has been taken to test the system experimentally and explore its thermal performance under actual climatic conditions of Mumbai, India. The solar heat energy is stored in the tank using commercial-grade erythritol as PCM in current research work. A heat exchanger is well designed and fabricated to regulate the flow of solar heat energy from the storage tank to the cooking vessel, similar to the domestic liquefied petroleum gas (LPG) cooking system. This solar cooker is designed to cook food twice a day for four family members (equivalent to an energy of 5000 KJ). Cooking experiments were conducted on 19 April 2019 for the afternoon and evening slots with rice and potato as cooking loads, respectively. The time taken for cooking rice and potato are from 12:30 pm to 12:52 pm (22 minute) and from 05:30 pm to 05:59 pm (29 minutes), respectively. The heat transfer rate was also observed at different storage tanks and cooking unit points. The experiments show cooking is possible twice a day and considered as convenient as domestic LPG stoves. Furthermore, it was found that comparatively less time was required for cooking food than other existing solar cookers.

Phenanthriplatin forms DNA mono-adducts and induces ribosome biogenesis stress. Using a semi-rational strategy, Ru(ii) complexes were created that act as biological mimics of phenanthriplatin with improved properties.

Silicon nanowires (SiNWs) have been studied due to their interesting properties, such as light trapping and catalytic activity for removing organic molecules.

Purpose:To evaluate sitravatinib, an inhibitor of multiple receptor tyrosine kinases (RTK), for the treatment of well-differentiated/dedifferentiated liposarcoma (WD/DD LPS).Patients and Methods:This multicenter, open-label, Phase II trial enrolled patients with advanced WD/DD LPS who had received at least one prior systemic regimen and had progression within 12 weeks of enrollment. Patients received sitravatinib 150 mg (later amended to 120 mg) orally daily. A Simon two-stage design was used to evaluate for an improvement in the primary endpoint, progression-free rate at 12 weeks (PFR12), from 20% to 40%. Secondary endpoints included antitumor activity and safety. A subset of patients underwent paired biopsies analyzed using reverse-phase protein array.Results:Twenty-nine patients enrolled. Median age was 62 years and 31% had received 3 or more prior lines. Most patients (93%) had DDLPS or mixed WD/DD LPS. Overall, 12 of 29 patients (41%) were alive and progression-free at 12 weeks and the study met the primary endpoint. There were no confirmed responses. Median progression-free survival was 11.7 weeks [95% confidence interval (CI): 5.9–35.9] and median overall survival was 31.7 weeks (95% CI: 18.1–90.1). The most common treatment-related adverse events were diarrhea (59%), hypertension (52%), hoarseness (41%), mucositis (31%), and nausea (31%). Baseline expression of phospho-RTKs was not significantly different between patients with and without clinical benefit from sitravatinib, but the number of samples was small.Conclusions:Sitravatinib provided a PFR12 of 41% and meaningful disease control in a subset of patients with advanced, progressive WD/DD LPS.

21st century appears with digitization, industrialization, and globalization. The introduction of ICT changes the whole scenario. The working pattern changed in every field. Traditional working replaces by machine or internet. Work becomes easier and faster. To adapt this change is not easy for everyone. Considering the commerce library, researcher studied changes occur in library and information science field. The study includes the change in library source and service due to digitization and how libraries cope with the situation to exist. For finding the solution researcher adopts a survey method and collected data from 7 different commerce college libraries of Rajkot and their views will be studies on how they improve their skills to meet the challenges that occurred because of ICT and the barrier they faced to improve their skills and competencies.

A legal fiction is a knowingly false assumption that is given effect in a legal proceeding and that participants are not permitted to disprove. I offer a semantic pretence theory that shows how fiction-involving legal reasoning works.

Background: Olaparib has significantly improved outcome and patient-centered endpoints in BRCA1/2-mutated patients with recurrent platinum-sensitive ovarian cancer (PSOC). Specific information on efficacy and safety of olaparib for older patients appears of special interest. Methods: 295 patients from the SOLO2 trial randomly assigned to olaparib or placebo were categorized according to age-cutoff at 65 years. Efficacy, tolerability, and quality of life (QoL) of olaparib relative to placebo within in each age group was analyzed. Results: Baseline characteristics were similar in patients ≥65 years (N = 62;21.0%) compared to patients

High prevalence of dyslipidaemia in children and adolescents with type-1 diabetes (T1D) places them at increased risk of developing atherosclerosis leading to mortality caused by cardiovascular disease(CVD). Thus, screening for fasting blood lipids when diabetes is stabilized in children aged 11 years and above is routinely recommended with follow-up every 5 years.(1) To characterize the lipid profile of children and adolescents with respect to diabetes duration. (2) To describe longitudinal changes in lipid profile over a 5-year period in patients with T1D.This longitudinal 5-year follow-up study included 112 patients with T1D aged 3-18 years. Demographic data, anthropometry and laboratory measurements were performed using standard protocols at baseline and endline. P value 0.05 was considered significant.The prevalence of dyslipidaemia in our study was 49.5% with abnormal LDL as the most frequently deranged parameter. Duration of illness played a major role in deterioration of lipid profile mediated by triglyceride and VLDL. Duration of illness and fibre intake in diet significantly predicted the change in lipid profile which were driven by triglycerides and VLDL. Glycemic control, insulin sensitivity and serum TSH also significantly altered components of lipid profile with no impact on overall dyslipidaemia. A total of 6.5% subjects had LDL concentrations130 mg/dl and the same proportion had non-HDL cholesterol concentrations145 mg/dl at baseline while at endline, 11.9% subjects had LDL concentrations130 mg/dl and 15.6% subjects had non-HDL cholesterol concentrations145 mg/dl. 28.6% subjects with LDL 130 mg/dl and non-HDL cholesterol145 mg/dl at baseline had persistently elevated concentrations while 10.3% and 14.4% additional subjects developed elevated LDL and non-HDL cholesterol concentrations respectively during the study period.The deterioration of lipid profile in T1D, due to increase in disease duration was chiefly mediated by increase in serum triglyceride and VLDL concentrations which may be prevented by improving glycaemic control, insulin sensitivity and fibre intake in diet.

Summary Efforts are under way to define the role of minimally invasive strategies for molecular monitoring and risk stratification in endometrial cancer. A recent publication aims to define the association between circulating tumor DNA level and disease stage in patients with newly diagnosed endometrial cancer and determine whether sequencing of longitudinal cell-free DNA samples can be used for disease monitoring and detection of progression or recurrence. These results accelerate the current knowledge of molecular follow-up in endometrial cancer. See related article by Ashley et al., p. 410

A double-blind, randomized, placebo-controlled, phase 2 trial assessed gemcitabine in combination with the wee1 inhibitor adavosertib or placebo in platinum resistant or refractory high grade serous ovarian cancer (HGSOC), demonstrating improved progression free and overall survival favouring the adavosertib/gemcitabine arm. An exploratory objective of the study included the PRO-CTCAE assessment, to capture self-reporting of frequency, severity and/or interference of symptomatic adverse events (syAEs).PRO-CTCAE items at baseline, days 1 and 15 of each cycle and off treatment, were completed in two centres, with the objective of characterizing syAEs in the first three months of therapy. The maximum post-baseline score proportion for each syAE was tabulated per patient. The 12-week area under the curve (AUC12w) as a measure of syAE over-time and incremental AUC12w (iAUC12w) for adjustment to baseline syAEs.Sixty-one patients were approached for PRO-CTCAE surveys and 55 were evaluable. Among patients with HGSOC, 28 received gemcitabine/adavosertib (arm A) and 19 gemcitabine/placebo (arm B). Survey completion rates were high. The proportion of participants with positive (≥1) PRO-CTCAE scores was higher for difficulty swallowing with gemcitabine/adavosertib (arm A 35.7% vs arm B 5.3%, p = 0.02). The high score (≥3) syAEs showed more frequent diarrhea with gemcitabine/adavosertib (arm A 25% vs arm B 0%, p = 0.03). The proportions of worsening syAEs over time were higher in patients receiving gemcitabine/adavosertib for difficulty swallowing (arm A 35.7% vs arm B 5.3%; p = 0.03) and fatigue severity (arm A 71.43% vs arm B 42.1%; p = 0.04).The longitudinal assessment of patient self-reported tolerability showed greater difficulty swallowing and fatigue severity in patients receiving gemcitabine/adavosertib, compared to gemcitabine/placebo. PRO-CTCAE provides complementary and objective assessment of drug tolerability from a patient's perspective.

Penelitian ini bertujuan untuk menguji pengaruh religiusitas dan love of money terhadap kepatuhan wajib pajak UMKM dengan sanksi pajak sebagai variabel moderasi yang terdaftar di KPP Pratama Pekanbaru Senapelan. Data yang digunakan adalah data primer yang diperoleh dari penyebaran kuesioner (angket) kepada wajib pajak UMKM yang terdaftar di KPP Pratama Pekanbaru Senapelan sebanyak 100 wajib pajak UMKM yang menjadi sampel dalam penelitian ini. Dengan metode pengambilan sampel menggunakan metode Slovin. Penelitian ini adalah penelitian kuantitatif yang diolah menggunakan SPSS versi 20. Hipotesis diuji menggunakan analisis regresi moderasi (Moderated Regression Analysis) MRA. Hasil penelitian menunjukkan bahwa religiusitas dan love of money berpengaruh terhadap kepatuhan wajib pajak UMKM yang terdaftar di KPP Pratama Pekanbaru Senapelan, sanksi pajak dapat memoderasi pengaruh religiusitas dan love of money terhadap kepatuhan wajib pajak UMKM yang terdaftar di KPP Pratama Pekanbaru Senapelan.

Objectives The double burden of malnutrition accompanied by micronutrient deficiency is referred to as the triple burden of malnutrition (TBM). Very few studies have highlighted the TBM in children with type-1 diabetes. We conducted this study with the objective of estimating the TBM in Indian children and youth with type-1 diabetes (T1D) and to study role of anaemia in the development of complications associated with T1D. Methods This cross-sectional observational study included 394 subjects with T1D. Demographic data, anthropometry, blood pressure, biochemical measurements, dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography were performed using standard protocols. Estimated glucose disposal rate (eGDR) and estimated glomerular filtration rate (eGFR) were calculated for all subjects. Results We report a 16, 5.8, and 16.2% prevalence of anaemia, underweight and overweight/obese suggesting TBM with microcytic hypochromic anaemia as the most common morphological form. Haemoglobin concentrations showed positive correlation with systolic and diastolic blood pressure. The presence of anaemia was a significant predictor of eGDR and macrovascular complications in T1D which could not be attributed to glycemic control. Bone health of anaemic T1D subjects was poor than subjects without anaemia on DXA scan after adjusting for confounders. No systematic pattern between Hb concentrations and eGFR or ACR was found. Conclusions TBM in Indian children and youth with T1D is a significant health problem and anaemia is an important predictor in the development of macrovascular complications and poor bone health associated with T1D. However, its role in development of microvascular complications remains to be explored.

Nowadays, cosmetics are becoming more high demand in daily life and it was used frequently by many of people per year. Mankind uses various products to enhance beauty and elegance to look young and charming. Cosmetics thus play a vital role in human life. Now days, herbal cosmetic are widely used because of the belief that they have fewer side effects and better safety. Hair is one of the primary parts of the body which acts as a protective appendage. The main objective of the present work is to develop an herbal hair serum for general purpose (daily use) using various herbs with this evaluate the characteristics of cosmetic serum and to identify the best formulation of cosmetic serum. Three formulations of cosmetic serum (H1, H2 and H3) with different concentration of excipients have been developed. They were evaluated for its physical appearance, pH, homogeneity test, viscosity, spreadability test and stability test. All the parameters were found to be good and within the standards. Current research has revealed that herbal formulations are effective in enhancing hair consistency.

Mammograms are essential radiological images used to diagnose breast cancer well in advance. However, an accurate diagnosis also depends on the quality of mammogram images. Therefore, removal of artefacts and mammogram enhancement are necessary pre-processing steps. Artefact removal helps exclude unsolicited regions in the mammograms and limits the search for suspicious regions without excessive impact from the background. Mammogram enhancements improve apparent visual details and improve some features of an image. In this paper, we propose a method for mammogram pre-processing. These pre-processed mammograms are then fed into Deep Convolutional Neural Network for the classification process. Two approaches are used and compared to classify mammograms; Training model from scratch and Transfer Learning. Transfer Learning is an excellent approach to dealing with the small-sized training set, allowing us to consume the extendibility of deep learning entirely. By employing VGG16 as a pre-trained network on the pre-processed MIAS dataset, we improved training accuracy (96.14\%) compared to the model developed from scratch and other strategies described in the literature.