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Thyroid malignancies are one of the fastest growing cancers in the world, with the majority being papillary thyroid cancer. Follicular variant of papillary thyroid cancer accounts for about 10%–20% of papillary thyroid carcinomas. The usual sites for metastases of these tumours are lungs and bones with renal metastases being extremely rare. We describe a case of a 64-year-old woman who presented with abdominal pain. On subsequent imaging, she was found to have a colonic mass with metastatic lesions in the lungs and tumour involving left kidney. On biopsy and immunohistochemical staining, the renal mass showed positivity for thyroid cancer markers. Thyroid scan was noted to be negative and the patient was placed on active surveillance after undergoing chemotherapy for colonic adenocarcinoma.

Aim/Purpose: This paper highlights an innovative and impactful online operating system algorithms e-learning tool in engineering education. Background: Common teaching methodologies make it difficult to teach complex algorithms of operating systems. This paper presents a solution to this problem by providing simulations of different complex algorithms to enable students to visualize and perform hands-on experiments. Developing these simulations offered different hurdles, which included step-by-step precise computations, managing edge circumstances, creation of dynamic representations like Gantt charts and disk scheduling graphs, strong input validation, user-friendly customization, and real-time performance. The developed simulations also observed some limitations, like the Process Scheduling simulator, which can be improved from the aspect of context switching overheads. Disk Scheduling simulators can include different evaluation parameters, such as fairness and starvation avoidance. Banker’s Algorithm can address circumstances such as invalid resource requests, resource deadlock, and resource exhaustion to model real-world system behavior. Methodology: The study focuses on the development of an e-learning tool that consists of the simulation of 13 different operating system algorithms, such as Process Scheduling, Disk Scheduling, and Banker’s Algorithm. Contribution: This paper contributes to the body of knowledge by providing an innovative educational tool that bridges the gap between theory and practice in operating system algorithms, thus enhancing student engagement and understanding. Findings: The findings of the work comprise the analysis of 276 student feedbacks demonstrating a significant favorable influence on students’ learning and engagement with operating system algorithms through the use of the built-in e-learning tool. Recommendations for Practitioners: It is advised that educators integrate this e-learning tool into their curriculum to boost student understanding and engagement in operating system courses. Recommendation for Researchers: Future studies should aim to broaden the range of algorithms contained in the tool and analyze its potential for applicability in other areas of computer science education. Impact on Society: Operating system algorithms have a profound societal impact by enabling the development of efficient, reliable, and secure software systems that power everything from personal devices to critical infrastructure. Through engineering education, students learn these foundational principles, allowing them to innovate and create software solutions that enhance productivity, security, and connectivity in daily life. This knowledge contributes to the advancement of technology, fostering societal progress in areas like healthcare, communication, and automation while promoting digital security and accessibility. Future Research: Future research should focus on the development of different e-learning tools for different disciplines of engineering education and evaluate their efficiency in different ways of learning.

Optical character recognition (OCR) tool is a boon and greatest advancement in today’s emerging technology which has proven its remarkability in recent years by making it easier for humans to convert the textual information in images or physical documents into text data making it useful for analysis, automation processes and improvised productivity for different purposes. This paper presents the designing, development and implementation of a novel OCR tool aiming at text extraction and recognition tasks. The tool incorporates advanced techniques such as computer vision and natural language processing (NLP) which offer powerful performance for various document types. The performance of the tool is subject to metrics like analysis, accuracy, speed, and document format compatibility. The developed OCR tool provides an accuracy of 98.8% upon execution providing a character error rate of 2.4% and word error rate (WER) of 2.8%. OCR tool finds its applications in document digitization, personal identification, archival of valuable documents, processing of invoices, and other documents. OCR tool holds an immense amount of value for researchers, practitioners and many organizations which seek effective techniques for relevant and accurate text extraction and recognition tasks.

The Community Engagement Alliance (CEAL) Against COVID-19 Disparities aims to conduct community-engaged research and outreach. This paper describes the Texas CEAL Consortium’s activities in the first year and evaluates progress. The Texas CEAL Consortium comprised seven projects. To evaluate the Texas CEAL Consortium’s progress, we used components of the RE-AIM Framework. Evaluation included estimating the number of people reached for data collection and education activities (reach), individual project goals and progress (effectiveness), partnerships established and partner engagement (adoption), and outreach and education activities (implementation). During the one-year period, focus groups were conducted with 172 people and surveys with 2107 people across Texas. Partners represented various types of organizations, including 11 non-profit organizations, 4 academic institutions, 3 civic groups, 3 government agencies, 2 grassroots organizations, 2 faith-based organizations, 1 clinic, and 4 that were of other types. The main facets of implementation consisted of education activities and the development of trainings. Key recommendations for future consortiums relate to funding and research logistics and the value of strong community partnerships. The lessons learned in this first year of rapid deployment inform ongoing work by the Texas CEAL Consortium and future community-engaged projects.

Kaposi sarcoma (KS) is a vascular neoplasm caused by human gammaherpesvirus 8 (HHV-8). Four subtypes of KS are described: classic (Mediterranean), epidemic (acquired immunodeficiency syndrome (AIDS)-associated), endemic (sub-Saharan Africa), and iatrogenic. Iatrogenic KS due to tumor necrosis factor-alpha (TNF-α) inhibitor therapy is particularly rare. A 66-year-old female with a history of seropositive rheumatoid arthritis (RA) presented with a skin lesion on her right second toe. Diagnosed with RA four years prior, she failed to respond to methotrexate, hydroxychloroquine, and etanercept. As a result, she was started on adalimumab. Approximately two months into therapy, she presented to the emergency room with a dark brown skin lesion on her right second toe. She underwent excisional biopsy of the mass, which demonstrated a tumor composed of spindle cells forming slit-like spaces with extravasated red blood cells. The tumor was positive for cluster of differentiation 31 (CD31), CD34, and HHV-8 immunostains and negative for smooth muscle antibody (SMA) and desmin immunostains, consistent with Kaposi sarcoma. Human immunodeficiency virus (HIV) serology was negative. The patient was diagnosed with iatrogenic KS. Adalimumab was discontinued. The patient was started on alitretinoin and underwent adjuvant radiation therapy to minimize recurrence. TNF-α is a pro-inflammatory cytokine that has been implicated in many inflammatory diseases and in cell apoptosis. While anti-TNF-α agents have improved outcomes in many immune-mediated diseases, higher rates of infections and malignancy have also been reported. The incidence of KS with anti-TNF-α therapy remains a rare entity. Therefore, it is extremely important for patients receiving biologic agents, including TNF-α inhibitors, to have a close follow-up and receive routine skin evaluation for malignancy. Clinicians should have a high index of suspicion for KS in such non-HIV patients started on immunosuppressive agents.

Aims: Programs to notify the public about water quality at beaches are developed at the state and local levels. We sought to characterize the messages and message delivery options in use, and information about the effectiveness of these beach notification programs. Methods: A telephone survey of 37 US state, tribal and territorial and 18 county, city or local beach programs was conducted to characterize current public notification practices and any evaluations of those practices. Results: Beach notification practices vary substantially at the state and local levels. Color-coded signs or flags are commonly used, but not universally, and the color schemes and their meanings vary. New communication approaches utilizing text messaging and the internet are in use or under development for local use. Few communication methods had undergone systematic evaluations of their content, delivery methods or effectiveness in promoting behavior change. Conclusion: The prevention of waterborne illness requires communications that effectively promote the avoidance of swimming when water quality is impaired. Current communication practices are variable and generally have not undergone formal evaluations for their effectiveness. It is not known whether or how they impact health risk.

It has been said and observed that dexamethasone which is a synthetic glucocorticoid has dermatological effect. But there is no such evidence of dexamethasone being a promising drug for skin disease. The main purpose of my thesis is to check whether the dexamethasone concentration can reach to minimum effective concentration in the dermis after giving an iv-infusion which is required to be effective for any pharmacological action. If the concentration in the skin reaches to MEC then there are chances that drug may have any further dermatological action. Dexamethasone has a lipophilic nature. Dexamethasone 21-phosphate sodium is the ester pro-drug which is an available hydrophilic pro-drug of dexamethasone. It readily converts in to active drug dexamethasone in vivo with the help of phosphatase enzyme. For simultaneous determine of dexamethasone and dexamethasone 21-phosphate sodium (ester pro-drug) in microdialysis and plasma samples a new High Performance Liquid Chromatographic (HPLC) method has been developed. A reverse phase C18 column was used and mobile phase consist of methanol: 10 mM TBA (pH 3) (53: 47% v/v), flow rate of mobile phase was kept 1 ml/min and a UV detector was used with detection wavelength of 240 nm. The calibration curves for microdialysis were linear (R2 correlation coefficient was always greater than 0.99) for the range of 50-10,000 ng/ml and 100-10,000 ng/ml for DXM and DSP respectively. The calibration curves for plasma were linear (R 2 correlation coefficient was always greater than 0.99) for the range of 3000-50,000 ng/ml and 500-50,000 ng/ml for DXM and DSP respectively. As we know only the unbound drug concentration at the site of action is pharmacologically active, and we need needed the concentration of dexamethasone at a particular site of action that is skin. There are several techniques by which we can monitor the concentration on site of animal or human such as biopsies, saliva and skin blister fluid sampling, imaging techniques, microdialysis. But with thesis techniques only a limited number of time points samples were taken where as with Microdialysis MD sequential sampling over a long period of time was possible which could lead to better results. Moreover Microdialysis is semi invasive method. Female pathogen-free New Zealand albino rabbit was selected to check the kinetics of dexamethasone and dexamethasone 21-phosphate sodium in vivo. The rabbit were tranquilized using appropriate dose of acetopromazine (intramuscular), microdialysis probes were implanted into the skin of rabbit. Retrodialysis was performed first in which the probe were perfused with dexamethasone-dexamethasone 21-phsphate sodium solution to assess probe recovery which was further used to correct the dialysate concentration to reflect the actual interstitial fluid concentration. For recovery the probes were perfused with lactated ringer's solution. Short intra venous infusions of two different doses of dexamethasone 21-phosphate sodium were administered to rabbit. The two separate doses were 1 and 2 mg/kg. Blood and microdialysis samples were collected at predetermined time intervals. About 100% of plasma dexamethasone 21-phosphate sodium gets converted in to dexamethasone in 20 min after IV-Infusion. Plasma dexamethasone gets highest concentration in 20 min after infusion. All in vivo microdialysis recovery study (for both two doses of IV-Infusions) shows that skin only detects dexamethasone and gets equilibrated within approximately 90 min. After the peak concentrations of analytes, skin (dexamethasone) and plasma (dexamethasone 21-phosphate sodium and dexamethasone) decline differently.

Phloretin and Hesperetin are bioflavonoid belongs to two different classes, and are reported to show potent inhibitory effects on cell proliferation in different cell lines. However, very few studies conducted to check the effect of combination of bioflavonoid on the different cell lines. This bioflavonoid may play essential roles in inhibition of tumor progression in DU-145 cell line. Therefore, we investigated the expression of different pro-apoptotic and anti-apoptotic protein after treatment of DU-145 cells with phloretin and hesperetin alone and in combination in order to compare the effects of these flavonoids in cancer. We also performed an experiment to find out the effect of these flavonoids on the cell morphology, viability and proliferation on DU-145 cells. Our data indicate that after 72 hour treatment with the hesperetin shows more potent inhibitory effect than 24 hours of treatment. Almost same results we found with the Phloretin treatment up 72 hours, but phloretin shows more potent inhibitory effect than hespereitn. The combination of hesperetin and phloretin is also shows more potent inhibitory effect on cell proliferation. To find out the possible mechanism for cell death we also carried out western blot analysis and we checked the expression of pro-apoptotic proteins BAD, Cyt c and Apaf-1. We also checked the Bcl-2 and Bcl-xl anti-apoptotic protein expressions. And we confirmed the occurrence of apoptosis by performing DNA fragmentation experiments in response to bioflavonoid treatment. In summary, these studies demonstrate that hesperetin and phloretin alone and in combination of this bioflavonoid significantly inhibit ell proliferation by inducing apoptosis by mitochondrial Cyt c pathway. These studies also show that combination of bioflavonoid is more effective at 48 hours when compared to each bioflavonoid alone. Further studies must be performed to investigate the combination of bioflavonoid response at 72 hours and thee possible reason for their ineffectiveness.

Autoimmune encephalitis can be followed by treatment-resistant epilepsy. Understanding its predictors and mechanisms are crucial to future studies to improve autoimmune encephalitis outcomes. Our objective was to determine the clinical and imaging predictors of postencephalitic treatment-resistant epilepsy. We performed a retrospective cohort study (2012–2017) of adults with autoimmune encephalitis, both antibody positive and seronegative but clinically definite or probable. We examined clinical and imaging (as defined by morphometric analysis) predictors of seizure freedom at long term follow-up. Of 37 subjects with adequate follow-up data (mean 4.3 yrs, SD 2.5), 21 (57 %) achieved seizure freedom after a mean time of 1 year (SD 2.3), and one third (13/37, 35 %) discontinued ASMs. Presence of mesial temporal hyperintensities on the initial MRI was the only independent predictor of ongoing seizures at last follow-up (OR 27.3, 95 %CI 2.48–299.5). Morphometric analysis of follow-up MRI scans (n = 20) did not reveal any statistically significant differences in hippocampal, opercular, and total brain volumes between patients with postencephalitic treatment-resistant epilepsy and those without. Postencephalitic treatment-resistant epilepsy is a common complication of autoimmune encephalitis and is more likely to occur in those with mesial temporal hyperintensities on acute MRI. Volume loss in the hippocampal, opercular, and overall brain on follow-up MRI does not predict postencephalitic treatment-resistant epilepsy, so additional factors beyond structural changes may account for its development. •Over half of autoimmune encephalitis survivors become seizure-free.•The presence of mesial temporal FLAIR hyperintensities is associated with postencephalitic epilepsy.•There are no structural differences between those with and without postencephalitic epilepsy.

Background Ulcerative colitis (UC) is a subtype of inflammatory bowel disease (IBD), characterized by chronic and recurrent inflammation of the colonic tract. This condition is marked by dysregulated immune responses, leading to sustained intestinal inflammation. Despite the efficacy of current treatments, there remains a critical need for more targeted and effective interventions. Main text Immunotherapy, which involves modulating the immune system to treat diseases, has emerged as a promising strategy for managing UC. Both innate and adaptive immunotherapies have shown considerable potential in treating colitis. Innate immunotherapies target the body’s first line of defense, offering an appealing option for colitis treatment by addressing components like macrophages and dendritic cells. Conversely, adaptive immunotherapies focus on specific immune cell subsets, such as T-cells, which are crucial in the pathogenesis of colitis. These therapies aim to modulate the abnormal immune response to reduce immuno-inflammation. Various forms of immunotherapies, including monoclonal antibodies, small molecules, and cellular therapies, have been extensively studied for their effectiveness in treating colitis and shown encouraging results. Monoclonal antibodies have been particularly promising, offering targeted action against specific components of the immune response. Small molecule therapies provide another avenue by modulating signaling pathways involved in inflammation. Cellular therapies, including stem cell treatments, represent an innovative approach, potentially offering long-term benefits by repairing damaged tissues and restoring immune balance. Conclusion This review offers a comprehensive overview of the current landscape of innate and adaptive immunotherapies for the treatment of UC. It details their mechanisms of action, potential benefits, and limitations. Overall, the significant promise of these therapies in combating colitis is underscored, highlighting their continued development and utilization in UC treatment. The potential of combining innate and adaptive immunotherapies could represent a dynamic duo in treating this debilitating condition, ultimately improving patient outcomes and quality of life. Graphical abstract