RFFE - Random Forest Fuzzy Entropy for the classification of Diabetes Mellitus.

Diabetes is a category of metabolic disease commonly known as a chronic illness. It causes the body to generate less insulin and raises blood sugar levels, leading to various issues and disrupting the functioning of organs, including the retinal, kidney and nerves. To prevent this, people with chronic illnesses require lifetime access to treatment. As a result, early diabetes detection is essential and might save many lives. Diagnosis of people at high risk of developing diabetes is utilized for preventing the disease in various aspects. This article presents a chronic illness prediction prototype based on a person's risk feature data to provide an early prediction for diabetes with Fuzzy Entropy random vectors that regulate the development of each tree in the Random Forest. The proposed prototype consists of data imputation, data sampling, feature selection, and various techniques to predict the disease, such as Fuzzy Entropy, Synthetic Minority Oversampling Technique (SMOTE), Convolutional Neural Network (CNN) with Stochastic Gradient Descent with Momentum (SGDM), Support Vector Machines (SVM), Classification and Regression Tree (CART), K-Nearest Neighbor (KNN), and Naïve Bayes (NB). This study uses the existing Pima Indian Diabetes (PID) dataset for diabetic disease prediction. The predictions' true/false positive/negative rate is investigated using the confusion matrix and the receiver operating characteristic area under the curve (ROCAUC). Findings on a PID dataset are compared with machine learning algorithms revealing that the proposed Random Forest Fuzzy Entropy (RFFE) is a valuable approach for diabetes prediction, with an accuracy of 98 percent.

Molecular characterization and expression profile of interferon-stimulated gene 15 (ISG15) in the endometrium of goat (Capra hircus).

Interferon-stimulated gene 15 (ISG15), a ubiquitin-like protein, is responsible for uterine receptivity, implantation and conceptus development in different ruminant species, but in goat (Capra hircus) its role is yet to be explicated. In the present study, the ISG15 gene was cloned, characterized and its temporal expression profile was examined in the endometrium of caprine (cp). A fragment of cpISG15 gene, 1033 bp in length, was amplified, cloned and sequenced from genomic DNA covering the coding region. Sequence analysis of cpISG15 gene revealed that it was comprised of two exons of 59 bp and 496 bp encoding a peptide of 157 amino acids. Complementary DNA (cDNA) and deduced amino acid sequences of cpISG15 exhibited 99 and 98, 93 and 88, 94 and 89, 76 and 66, and 73 and 62% identity with that of sheep, cattle, buffalo, human and mice, respectively. Further, relative expression of cpISG15 mRNA and protein was determined by quantitative real-time PCR (qPCR) and Western blot, respectively, in the endometrium of pregnant and cyclic does. Both cpISG15 mRNA and protein were expressed maximally (P < 0.05) in the endometrium during early stage of pregnancy (16-24 d) as compared to cyclic does, but no significant difference was observed in cpISG15 mRNA and protein expression in the endometrium between the later stage of pregnancy (25-40 d) and cyclic does. It is concluded that cpISG15 is almost similar in structure and probably in function also to other species as it has been found significantly upregulated during early pregnancy.

Pegylated interferon alpha - 2a is clinically effective and tolerable in myeloproliferative neoplasm patients treated off clinical trial.

Polycythemia vera, essential thrombocytosis, and myelofibrosis are chronic Philadelphia-negative myeloproliferative neoplasms that are characterized by clonal hematopoiesis, splenomegaly, risk of hemorrhagic and thrombotic sequelae, and profound symptom burden. We review the outcomes of 75 myeloproliferative neoplasm patients treated with pegylated interferon alpha 2a off study at an academic medical center. In the 56 treated polycythemia vera and essential thrombocytosis patients, a complete or partial response was obtained in 78.6% of patients per ELN/IWG-MRT revised criteria, with >80% of polycythemia vera patients becoming phlebotomy independent and 60% of essential thrombocytosis patients having platelet normalization with therapy. In the 19 treated myelofibrosis patients, stable disease was seen in 63.2% of patients. Vascular events occurred in 2/75 (2.6%) of treated patients while on therapy. Grade 3 toxicity was uncommon with leukopenia noted in 1 patient (1.3%). The most common adverse event overall was grade 1 fatigue in 18.7%. This retrospective single center analysis demonstrates pegylated interferon alpha 2a is active and well-tolerated therapy outside the support of a clinical trial. These results substantiate the previously reported efficacy of pegylated interferon alpha 2a in myeloproliferative neoplasms. Further prospective and randomized clinical trial data is required to better delineate pegylated interferon alpha 2a's use in myeloproliferative disease, with emphasis placed on comprehensive molecular characterization, allelic burden quantification, and measurement of histologic response.

Follicle-stimulating hormone-induced rescue of cumulus cell apoptosis and enhanced development ability of buffalo oocytes.

The effect of follicle-stimulating hormone (FSH) on apoptotic status of cumulus cells, expression of proapoptotic and antiapoptotic genes, and development rate of in vitro fertilization-produced buffalo embryos were investigated. FSH supplementation in in vitro maturation-medium resulted in a dose-dependent reduction in the expression of proapoptotic genes namely, BCL2-associated X protein (BAX), cytochrome c, and caspase-3 and increase in the expression of antiapoptotic genes such as B-cell lymphoma 2 (BCL2) and X-linked inhibitor of apoptosis protein (XIAP) in cumulus cells of mature oocyte. Cumulus expansion, oocyte maturation, cleavage, and blastocyst development rates were significantly higher (P < 0.05) in 5 and 10-µg/mL FSH-supplemented groups as compared with control. Significant increase in the expression of FSH receptor messenger RNA was also found with 5 and 10-µg/mL FSH (P < 0.05). Terminal deoxynucleotidyl transferase dUTP nick end labeling assay confirmed that the population of apoptotic cumulus cells of matured oocytes was reduced in the FSH-treated groups as compared with control (P < 0.05). In conclusion, our data suggest that FSH may attenuate apoptosis in cumulus cells via mitochondria-dependent apoptotic pathway by increasing XIAP expression, resulting in a more favorable ratio of BCL2/BAX expression and decreasing the cytochrome c and caspase-3 expression, eventually contributing to developmental competence of oocytes. The information generated will help in improving the in vitro embryo production program in buffalo.

18F-FDG PET/CT in diagnosis and response evaluation in an unusual case of antisynthetase syndrome presenting as pyrexia of unknown origin.

Anti-histidyl (Jo-1) antibodies have been implicated in the pathogenesis of anti-synthetase syndrome (ASS). A case is presented of a 55-year-old male patient presenting with pyrexia of unknown origin and inconclusive routine investigations. (18)F-FDG PET/CT was performed to locate any abnormal focus, which showed increased FDG uptake in the proximal shoulder muscles, as well as lung lesions. Subsequent investigation showed the presence of anti Jo-1 antibody, and diagnosed as an anti-synthetase syndrome. The patient was successfully treated with glucocorticoids and cyclophosphamide, and the response was assessed with symptomatic relief and disappearance of FDG uptake in lung and muscle lesions on post-treatment FDG PET/CT.

Non-articular Felty's syndrome: An uncommon diagnosis.

Felty's syndrome is a triad of rheumatoid arthritis, neutropenia, and splenomegaly. We hereby report an unusual case of non-articular Felty's syndrome and its management along with discussing the importance of appropriately ruling out alternate causes of neutropenia with splenomegaly.

Follow-up (99m)Tc EC renal dynamic scintigraphy and DMSA-III SPECT/CT in unmasking a masqueraded case of Horseshoe kidney.

Hydronephrosis is a common finding in urinary tract outflow obstruction. Chronically obstructed hydronephrotic system may be associated with parenchymal changes. Ultrasound, intravenous urography, micturating cysto-urethrogram and scintigraphy are commonly performed to evaluate the cause of obstruction. In childhood, pelviureteric junction obstruction is a common cause of the hydronephrosis. Hydronephrosis can also be present in horseshoe kidneys due to poor drainage. However, a large sized hydronephrotic cavity may obscure the finding of horseshoe kidney. A case was reported, and it was diagnosed as horseshoe kidney on follow-up renal dynamic scan and confirmed with the help of dimercaptosuccinic acid SPECT/CT.

Diagnostic accuracy of integrated (18)F-FDG PET/CT for restaging patients with malignant germ cell tumours.

OBJECTIVE: Evaluation of utility of fluorine-18 fludeoxyglucose ((18)F-FDG) positron emission tomography/CT (PET/CT) for restaging patients with primary malignant germ cell tumours (GCTs). METHODS: Data of 92 patients (age, 31.94 ± 10.1 years; male/female, 86/6) with histopathologically confirmed malignant GCTs (gonadal, 88; mediastinal, 4; seminomatous, 47 and non-seminomatous, 45) who underwent (18)F-FDG PET/CT for restaging (suspected recurrence/post-therapy evaluation) were retrospectively analysed. Two experienced nuclear medicine physicians reviewed the PET/CT images in consensus, qualitatively and semi-quantitatively [maximum standardized uptake value (SUVmax)]. Histopathology (if available) and clinical/imaging/biochemical follow-up (minimum of 6 months) were employed as the reference standard. RESULTS: (18)F-FDG PET/CT was interpreted as positive in 59 and negative in 33 patients. Local disease was seen in 5, nodal disease in 50 and distant metastasis in 22 patients. PET/CT was true positive in 49, false positive in 10, true negative in 30 and false negative in 3 patients. (18)F-FDG PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 94.2%, 75.0%, 83.0%, 90.9% and 85.8% overall; 90.0%, 74.0%, 72.0%, 90.9% and 80.8% in seminomatous GCT; and 96.8%, 76.9%, 91.1%, 90.9% and 91.1% in non-seminomatous GCT, respectively. Difference in PET/CT accuracy for seminomatous and non-seminomatous GCTs was not significant (p = 0.263). PET/CT demonstrated disease in 13 patients with negative/equivocal conventional imaging findings and in 9 patients with normal tumour markers. No site- or histology-based difference was seen in SUVmax. CONCLUSION: (18)F-FDG PET/CT demonstrates high diagnostic accuracy for restaging patients with malignant GCTs. It has comparable diagnostic performance in both seminomatous and non-seminomatous malignant GCTs. ADVANCES IN KNOWLEDGE: The present article demonstrates high diagnostic accuracy of (18)F-FDG PET/CT for restaging both seminomatous and non-seminomatous malignant GCTs in a large patient population.

Characterization of oocyte-expressed GDF9 gene in buffalo and mapping of its TSS and putative regulatory elements.

Summary In spite of emerging evidence about the vital role of GDF9 in determination of oocyte competence, there is insufficient information about its regulation of oocyte-specific expression, particularly in livestock animals. Because of the distinct prominence of buffalo as a dairy animal, the present study was undertaken to isolate and characterize GDF9 cDNA using orthologous primers based on the bovine GDF9 sequence. GDF9 transcripts were found to be expressed in oocytes irrespective of their follicular origin, and shared a single transcription start site (TSS) at -57 base pairs (bp) upstream of ATG. Assignment of the TSS is consistent with the presence of a TATA element at -23 of the TSS mapped in this study. Localization of a buffalo-specific minimal promoter within 320 bp upstream of ATG was consolidated by identification of an E-box element at -113bp. Presence of putative transcription factor binding sites and other cis regulatory elements were analyzed at ~5 kb upstream of TSS. Various germ cell-specific cis-acting regulatory elements (BNCF, BRNF, NR2F, SORY, Foxh1, OCT1, LHXF etc.) have been identified in the 5' flanking region of the buffalo GDF9 gene, including NOBOX DNA binding elements and consensuses E-boxes (CANNTG). Presence of two conserved E-boxes found on buffalo sequence at -520 and -718 positions deserves attention in view of its sequence deviation from other species. Two NOBOX binding elements (NBE) were detected at the -3471 and -203 positions. The fall of the NBE within the putative minimal promoter territory of buffalo GDF9 and its unique non-core binding sequence could have a possible role in the control of the core promoter activity.

Zero order spectrophotometric method for estimation of escitalopram oxalate in tablet formulations.

A new, simple, fast and reliable zero order spectrophotometric method has been developed for determination of Escitalopram Oxalate in bulk and tablet dosage forms. The quantitative determination of drug was carried out using the zero order values (absorbance) measured at 238 nm. Calibration graph constructed at 238 nm was linear in concentration range of 2-20 µg/ml with correlation coefficient 0.9999. The method was found to be precise, accurate, specific, and validated as per ICH guidelines and can be used for determination of Escitalopram Oxalate in tablet formulations.

Imaging features of peripheral primitive neuroectodermal tumours.

Primitive neuroectodermal tumours (PNETs) are a rare group of extremely aggressive small round cell tumours. Most commonly, they occur within the central nervous system. However, they also sporadically involve extracranial sites (peripheral PNETs). The chest wall is the most common of these sites, the imaging features of which have been well described in earlier studies. The present pictorial essay illustrates the imaging features of PNETs at various extracranial locations.

Fibrolipomatous hamartoma of median nerve.

Fibrolipomaous hamartoma is a benign neoplasm of nerves, resulting from anomalous growth of fibroadipose tissue of the nerve sheath. The median nerve is the most commonly involved nerve. Magnetic resonance imaging (MRI) features are pathognomonic, showing a coaxial cable-like appearance on axial images and spaghetti-like appearance on coronal images. Preferred management of the lesion is conservative.