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Metastatic lesions to thyroid cartilage are very rare and can be often missed on conventional imaging. Anatomical and functional fused positron emission tomography/computed tomography (PET/CT) imaging has higher sensitivity as compared to conventional CT imaging and can thus identify such atypical sites of metastasis. Here, we present four cases of thyroid cartilage metastases detected on 18fluorodeoxyglucose PET/CT scan from carcinoma lung, breast, stomach and urinary bladder. [ABSTRACT FROM AUTHOR]

New onset refractory status epilepticus (NORSE), is a rare, neurological condition characterised by prolonged periods of refractory epileptic seizure with no readily identifiable cause in otherwise healthy individuals. Anatomical imaging like MRI and serology is usually unremarkable. In patients who have underlying etiology as auto-immune encephalitis without any evidence of auto-antibodies FDG PET may help in early diagnosis and treatment response as it tends to accumulate in the neuronal tissue whenever there is increased blood flow, metabolic demand or increased electrical activity which reverts back with clinical recovery. [ABSTRACT FROM AUTHOR]

Introduction: Radical prostatectomy (RP) and radical radiotherapy (RT) are well established primary curative options for localized prostate cancer. Despite technical improvements, prostate-specific antigen (PSA)-recurrence after RP and RT is a common clinical scenario. We aimed to assess the role of 68Gallium (68Ga) prostate-specific membrane antigen positron emission tomography computed tomography (PSMA PET/CT) in patients with biochemical recurrence of prostate cancer after RP or RT for the detection and localization recurrent and metastatic disease. Materials and Methods: We ambispectively (70 retrospective and 100 prospective) analyzed the data of men with biochemical recurrence post-RP and post-RT who were evaluated by 68Ga PSMA PET/CT at our institute. We aimed to assess the relationship between serum PSA levels and the probability of having a positive scan in patients with recurrent prostate cancer. Results: The study included 170 men, all had adenocarcinoma of the prostate, 124/170 had previous RP and 46/170 had prior RT. The median serum PSA in the RP group was 1.8 ng/ml and 5.2 ng/ml in the RT group. In the post-RP cohort, the detection rate of 68Ga PSMA PET/CT was 39.3% for PSA 0.2 to <0.5 ng/ml, 47.3% for PSA 0.5 to <1 ng/ml, 68.4% for PSA 1 to <2 ng/ml and 93.1% for PSA ≥2 ng/ml. In the post-RT group, the detection rate was 88.8% for PSA 2 to <4 ng/ml and 100% for PSA ≥4 ng/ml. Conclusions: 68Ga PSMA PET/CT provides a novel imaging modality for the detection of prostate cancer recurrence and metastases at low posttreatment PSA levels, which may help in directing appropriate salvage treatments. [ABSTRACT FROM AUTHOR]

AbstractErlotinib, a potent epidermal growth factor receptor (EGFR) inhibitor, faces bioavailability challenges due to poor water solubility and stability. This study aims to optimize erlotinib-loaded PLGA nanoparticles using a 32 factorial design to enhance drug delivery and therapeutic efficacy. The effects of PLGA concentration (R1) and NaTPP concentration (R2) on nanoparticle characteristics, including particle size, zeta potential, and polydispersity index (PDI), were investigated. The optimal formulation (F5) was identified and characterized, showing a particle size of 169.1 nm, a zeta potential of 20.0 mV, and a PDI of 0.146, indicating uniform and stable nanoparticles. Transmission electron microscopy (TEM) confirmed spherical nanoparticles with minimal aggregation, while X-ray diffraction (XRD) indicated an amorphous state of erlotinib. Formulation F5 demonstrated an entrapment efficiency of 81.9% and a yield of 83.0%. In-vitro drug release studies revealed a sustained release pattern with 90.0% cumulative release at 48 h, following Zero Order kinetics. Cytotoxicity assays showed low cytotoxicity across various cell lines. Statistical analysis confirmed the significant impact of formulation variables on nanoparticle properties. The systematic optimization of erlotinib-loaded nanoparticles has successfully identified formulation F5 as an optimal candidate with favorable characteristics, including minimal particle size, high stability, controlled drug release, and a safe cytotoxicity profile. Notably, the optimized formulation (F5) enhances therapeutic efficacy through improved bioavailability and targeted delivery, addressing the limitations of conventional therapies. These findings suggest that the optimized erlotinib-loaded nanoparticles hold significant potential for enhanced drug delivery and therapeutic efficacy. [ABSTRACT FROM AUTHOR]

Rhabdomyosarcoma (RMS) is a rare soft tissue tumour, accounting for 3% of all childhood cancers. RMS can arise virtually anywhere in the body as it originates in embryonal mesenchyme. Embryonal Rhabdomyosarcoma (ERMS) and Alveolar Rhabdomyosarcoma (ARMS) are the most prevalent subtypes of RMS but arise through diverse biological mechanisms. RMS generally presents as an expanding mass that tends to be very painful and causes symptoms related to the compression of structures present nearby. Metastases of such tumours are common and can occur in bone, lungs and other organs leading to pain, difficulty with respiration, pleural effusion, anaemia, thrombocytopenia, and neutropenia. In this article, two unusual presentations of ERMS have been reported. First case is of a 28-year-old adult male who presented in surgical Out Patient Department (OPD) with recurrent episodes of painful acute urinary retention since one year. Another case was of a six-year-old girl presenting with aural fullness and serosanginous discharge from right ear, ear pain and decreased hearing since two years. Since five year survival rate of such tumour is less than 30%, therefore, an awareness of the typical signs and symptoms, radiological features, histomorphological features in a case of paediatric and adult ERMS can help a pathologist to consider this tumour in the differential diagnoses, even at unusual sites. [ABSTRACT FROM AUTHOR]

We present a case of Anti-IgLON 5 encephalitis with Lewy body dementia. 18F fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan and 99 mTc-TRODAT-1 SPECT/CT scan were done. 99 mTc-TRODAT-1 scan findings revealed severely reduced concentration of dopamine transporter in bilateral basal ganglia, suggestive of a degenerative parkinsonian disorder. 18F-FDG PET scan findings were suggestive of moderate-to-severe hypometabolism in the bilateral parieto-temporal and bilateral occipital cortices including the primary visual cortices, supporting Lewy body spectrum disease with associated hypermetabolism in the bilateral sensorimotor cortices, bilateral basal ganglia, thalami, brain stem, and bilateral cerebellar hemispheres suggestive of inflammatory pathology. [ABSTRACT FROM AUTHOR]

Despite growing recognition that GDP measures everything except deeper and meaningful aspects of life, conventional development approaches continue to centrally measure poverty, implement policy and operationalize practice in narrow economic and technical terms, without adequate attention paid to the holistic and interconnected nature of development as lived and experienced by those intended as its beneficiaries. The Royal Kingdom of Bhutan represents a rare context for the study and operationalization of a living development alternative that challenges GDP-metrics. The nation is best known for the articulation and practice of an innovative alternative and sustainable development path, exemplified in Gross National Happiness (GNH). In the contemporary context, it continues to be at the forefront of developing and advancing GNH as a unique and holistic development approach that values happiness and wellbeing of people and sentient beings. However, GNH is prone to popular misunderstandings of its concept, principles and manifestations within Bhutan, and subject to superficial and problematic scholarly analysis, hurried comprehension and limited due diligence in the international context. This paper makes a modest but concerted effort to respond to the dilemmas and challenges of understanding facing GNH by exploring its epistemological and historical foundations, and disentangling multiple meanings manifested in eight different forms. In doing so, it aims to contribute greater clarity to a growing body of multifarious writings on the subject, and more specifically, to an emerging body of scholarly literature on GNH by shedding explanatory light to the way it is conceptualized, operationalized, practiced, understood, internalized, and continuously undergoing change as it is refined and deepened over time. [ABSTRACT FROM AUTHOR]

Celiac disease can reduce bone mineral density. We sought to determine the prevalence and risk factors for low areal bone mineral density (aBMD) in children with celiac disease. We performed a retrospective cohort study of 673 children with celiac disease (63% female; median age at diagnosis, 10.6 y; interquartile range, 7.8–13.9) who underwent dual x-ray absorptiometry (DXA) from 2009 through 2016 at the Children's Hospital of Philadelphia. We collected demographic, clinical, and laboratory data from medical records. We performed logistic regression analysis to identify factors associated with low (Z less than -2) lumbar spine aBMD Z (aBMD-Z) scores at initial and subsequent tests. The time between diagnosis of celiac disease and first DXA was 0 days (interquartile range, -11 to 31 d). The mean aBMD-Z score at the children's initial scan was -0.4 ± 1.2; 46 children had aBMD-Z scores less than -2 (6.8%; 95% CI, 5.2%–9.0%). Those who had a second DXA analysis (n = 108; 16.0%) had a significant increase in aBMD-Z score (mean change, 0.29; P =.0005). Higher body mass index (BMI) was associated with lower odds of a low aBMD-Z score at the initial DXA analysis (odds ratio, 0.46, 95% CI, 0.35–0.50). BMI-Z scores greater than -0.4 identified children with a low aBMD-Z at their initial DXA analysis with a 95% negative predictive value. Approximately 7% of subjects with celiac disease had a low aBMD-Z score, determined by DXA, at the time of diagnosis; this value was nearly 3-fold higher than expected from a population of children of this age and sex distribution. BMI-Z scores could be used to identify children with celiac disease at risk for low BMD who should receive DXA screening. [ABSTRACT FROM AUTHOR]

Skin metastases are rare from systemic malignancy, and incidence reported is between 0.7% and 9% in various malignancies and usually occur in advanced stage. Here, we report three cases, one each of carcinoma esophagus, carcinoma breast, and carcinoma lung, where patients presented with metastatic cutaneous lesions and positron-emission tomography-computed tomography (PET-CT) scan whole body helped in localizing the primary site. Whole-body fluorodeoxyglucose PET-CT scan helps in scanning whole body at once and detect occult primary and metastatic sites. [ABSTRACT FROM AUTHOR]

• Various optimization techniques in AGC are critically reviewed. • Role of demand side management in AGC is also addressed. • Impact of electric vehicle integration to the grid is studied. Load and generation must be balanced for the system to be stable, which implies frequency deviation must be minimal. Whenever load perturbation takes place in the network, frequency diverges from its nominal value and unplanned exchange of power leads to unfortunate consequences. This will cause the mal-operation of electrical equipment such as change in speed, low efficiency, vibrations, harmonics, inaccuracy etc. Automatic Generation Control (AGC) provides a signal to alter the actual output power of multiple generators within a certain range based on changes in system frequency. For this purpose, several control techniques were employed in the system. This paper focuses on various approaches in the domain of automatic generation control for microgrid based hybrid power system. AI based techniques shows progressive results as compared to other classical and cascaded approaches. Machine learning and deep learning based controlling schemes has also been studied and study shows that these techniques provides loftier performance in comparison of other AI methods due to the availability of large number of trained data sets of controlled variable. Further massive data of controlled variables can be used to restore the system after cyber-attack. It is also addressed how to integrate electric vehicles with the power grid for Load Frequency Control. At the end of this article, some research gap such as role of demand response, protection and control issues, resilient controllers for cyber threats etc. are also addressed which will be useful for researcher working in this area. [ABSTRACT FROM AUTHOR]