Endoscopic Removal of Intrauterine Contraceptive Device From the Descending Colon: A Case Report.

Intrauterine contraceptive device (IUCD) is a popular method of contraception used worldwide. Although successful, it can get dislodged from its primary position and perforate the uterine wall. Migration to the colon is an uncommon complication. The patient's symptoms may mimic that of irritable bowel syndrome (IBS), including abdominal pain and changes in bowel movements. The correct diagnosis may be missed for long periods of time, leading to unnecessary suffering and potential complications. It is important for healthcare providers to consider the possibility of intrauterine contraceptive device dislodgement and migration while evaluating patients with a history of IUCD presenting with these symptoms, especially if they have a history of IUCD use. We describe a case where an IUCD was found to be dislodged in the colon and successfully removed through colonoscopy. This case highlights the importance of thorough investigation and follow-up in cases of suspected IUCD migration, as well as the potential for endoscopic removal as a safe and effective method for extracting migrated IUCDs in the bowel.

Sensorineural hearing loss among type 2 diabetic patients and its association with peripheral neuropathy: a cross-sectional study from a lower middle-income country.

INTRODUCTION: Despite potential links between diabetes and sensorineural hearing loss (SNHL), routine hearing assessments for diabetic patients are not standard practice. Our study aimed to investigate the prevalence of SNHL and its association with diabetes-related factors among patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: This cross-sectional study was conducted at the Diabetes Clinic, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from May to September 2021. A total of 396 patients fulfilling the inclusion criteria participated after informed consent. Data collection involved a sociodemographic profile, Michigan Neuropathy Screening Instrument examination followed by pure-tone audiometry and laboratory tests including haemoglobin A1C (HbA1c). HL was defined using better ear four-frequency pure-tone average of ≥26 dB HL and graded as per WHO criteria. Statistical analyses were performed using SPSS. χ2, independent t-test and multinomial logistic regression analyses were applied. P<0.05 at 95% CI was considered significant. RESULTS: Our study revealed a high prevalence of SNHL among patients with T2DM. Mild HL was seen in 55.8%, while 18.7% suffered from moderate HL. Common audiological symptoms included difficulty understanding speech in noisy surroundings (44.2%), balance problems (42.9%), sentence repetition (35.9%), tinnitus (32.3%) and differentiating consonants (31.1%). Hearing impairment predominantly affected low (0.25-0.5 kHz) and high (4-8 kHz) frequencies with a significant difference at 4 kHz among both sexes (t (394)=2.8, p=0.004). Peripheral neuropathy was significantly associated with SNHL on multinomial logistic regression after adjusting with age, sex, body mass index and the presence of any comorbidities. Diabetes duration, HbA1c or family history of diabetes was found unrelated to SNHL severity. CONCLUSIONS: The study highlights the substantial prevalence of SNHL among patients with T2DM and emphasises the importance of targeted audiological care as part of a holistic approach to diabetes management. Addressing HL early may significantly improve communication and overall quality of life.

Diagnosis of the Initial Stage of Hepatocellular Carcinoma: A Review.

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. There may be more than a million instances of hepatocellular carcinoma by 2025, making it a persistent concern for global health. The most common form of hepatocellular carcinoma accounts for more than 90% of cases. There is no known cure for hepatocellular carcinoma, which is usually detected late in life. Unlike most other common malignancies, such as lung, prostate, and breast cancers, where mortality rates are declining, rates of death are rising by around 2-3% every year. It is extremely difficult to diagnose hepatocellular carcinoma in its early stages. Alpha-fetoprotein serology studies and ultrasonography (US) monitoring were historically the primary methods for early detection of hepatocellular cancer. However, the sensitivity or specificity of ultrasonography/alpha-fetoprotein (US/AFP) is not high enough to detect hepatocellular carcinoma in its early stages. Alpha-fetoprotein, or AFP, is an amino acid that is normally produced by the liver or yolk sac of an embryonic baby. In adults, AFP levels are typically modest. Adults with high levels of AFP have been associated with several illnesses, the most well-known of which are certain types of cancer. It is still possible to diagnose hepatocellular carcinoma early because of current technological advancements. We address the advancements in the diagnosis of hepatocellular carcinoma in this article, with a focus on new imaging techniques and diagnostic markers for early-stage tumor identification.

Implementation of Learning Management Systems (LMS) in higher education systems through bipolar complex hesitant fuzzy Aczel-Alsina power aggregation operators: A case review for China.

A learning management system (LMS) is a web-based application or software platform computed to facilitate the development, tracking, management, reporting, and delivery of education and training programs. Many valuable and dominant factors are working behind the Learning Management System (LMS), but no one can find which factor is most important and valuable for LMS during COVID-19 among the following five alternatives, called Improved Accessibility, Blended Learning, Collaboration and Communications, Assessment and Evaluation, and Administrative Efficiency. For this, first, we derive the techniques of bipolar complex hesitant fuzzy (BCHF) sets, and then we evaluate some flexible operational laws, called Algebraic operational laws and Aczel-Alsina operational laws. Secondly, using the above techniques, we elaborate the technique of BCHF Aczel-Alsina power averaging (BCHFAAPA), BCHF Aczel-Alsina power weighted averaging (BCHFAAPWA), BCHF Aczel-Alsina power geometric (BCHFAAPG), and BCHF Aczel-Alsina power weighted geometric (BCHFAAPWG) operators. Some basic properties are also investigated for each proposed operator. Further, to evaluate the problem concerning LMS, we compute the multi-attribute decision-making (MADM) techniques for invented operators. Finally, we select some prevailing operators and try to compare their ranking results with our proposed results to enhance the worth and capability of the invented theory.

Seasonal changes in hepatic lipid metabolism and apoptosis in Chinese soft-shelled turtle (Pelodiscus sinensis).

Chinese soft-shelled turtle (Pelodiscus sinensis) hibernates without eating and drinking when the ambient temperature is very low. To better understand the characteristics of energy utilization during hibernation, the turtles in the physiological phases of summer active (SA), Pre-Hibernation (Pre-H), Mid-Hibernation (Mid-H) and early arousal (EA) were sampled. The results showed that the levels of serum triglyceride and hepatic lipid droplet were markedly increased in Pre-H and decreased in Mid-H compared with that in SA, indicating that P. sinensis experiences lipid accumulation in Pre-H and lipid is the predominant energy reserve during hibernation. The mRNA expression levels of genes (FABP and CPT-2) involved in lipolysis and lipid oxidation were up-regulated in Mid-H, while the genes related to lipid synthesis (FAS, ACSL-1, ACC, elovl5, and SCD1) were inhibited in Mid-H. Meanwhile, the mRNA expression levels of endoplasmic reticulum stress marker gene Bip and key genes (ATF4, ATF6, and IRE1α) involving the unfolded protein response were significantly increased in Mid-H and EA. Also, the expression levels of genes (ASK1, JNK1, and Bax) associated with cell apoptosis increased in Mid-H and EA, however, the expression of Bcl2 was inhibited in Mid-H. Therefore, hibernation can cause endoplasmic reticulum stress and apoptosis. The findings will provide a theoretical framework for an animal's cold adaptation and offer insights into preventing and managing metabolic syndrome.

Archimedean Heronian mean operators based on complex intuitionistic fuzzy sets and their applications in decision-making problems.

In this article, we derive the Archimedean aggregation operators for complex intuitionistic fuzzy sets, for this, first, we evaluate some Archimedean operational laws based on complex intuitionistic fuzzy values and then we discuss their special cases because the Archimedean norms are the general form of all existing norms, for instance, algebraic, Einstein, Hamacher, and Frank operational laws. Furthermore, we present the complex intuitionistic fuzzy Archimedean Heronian aggregation operator and complex intuitionistic fuzzy weighted Archimedean Heronian aggregation operator. Several special cases and the basic properties of the above-proposed operators are also diagnosed, because proposing the Heronian mean operators based on Archimedean norms are very challenging and complicated tasks, because of their features and structure. Additionally, a decision-making process is developed under the identified operators by using complex intuitionistic fuzzy information. Finally, we illustrate several examples to show the multi-attribute decision-making technique is more flexible than the prevailing works with the help of sensitive analysis between explored and certain prevailing works.

3D seismic analysis of mine planning using Aczel-Alsina aggregation operators based on T-spherical fuzzy information.

3D seismic attributes analysis can help geologists and mine developers associate subsurface geological features, structures, faults, and ore bodies more precisely and accurately. The major influence of this application is to evaluate the usage of the 3D seismic attributes analysis in gold mine planning. For this, we evaluate the novel theory of complex T-spherical hesitant fuzzy (CTSHF) sets and their operational laws. Furthermore, we derive the CTSHF Aczel-Alsina weighted power averaging (CTSHFAAWPA) operator, CTSHF Aczel-Alsina ordered weighted power averaging (CTSHFAAOWPA) operator, CTSHF Aczel-Alsina weighted power geometric (CTSHFAAWPG) operator, and CTSHF Aczel-Alsina ordered.com weighted power geometric (CTSHFAAOWPG) operator. Some properties are also investigated for the above operators. Additionally, we evaluate the problems of 3D seismic attributes analysis to mine planning under the consideration of the proposed operators, for this, we illustrate the problem of the multi-attribute decision-making (MADM) technique for the above operators. Finally, we demonstrate some examples for making the comparison between prevailing and proposed information to improve the worth of the derived operators.

Neuropathy, its Profile and Experimental Nerve Injury Neuropathic Pain Models: A Review.

Neuropathy is a terrible disorder that has a wide range of etiologies. Drug-induced neuropathy, which happens whenever a chemical agent damages the peripheral nerve system, has been linked here to the iatrogenic creation of some drugs. It is potentially permanent and causes sensory impairments and paresthesia that typically affects the hands, feet, and stockings; motor participation is uncommon. It might appear suddenly or over time, and the long-term outlook varies. The wide range of chronic pain conditions experienced by people has been one of the main obstacles to developing new, more effective medications for the treatment of neuropathic pain. Animal models can be used to examine various neuropathic pain etiologies and symptoms. Several models investigate the peripheral processes of neuropathic pain, whereas some even investigate the central mechanisms, such as drug induce models like vincristine, cisplatin, bortezomib, or thalidomide, etc., and surgical models like sciatic nerve chronic constriction injury (CCI), sciatic nerve ligation through spinal nerve ligation (SNL), sciatic nerve damage caused by a laser, SNI (spared nerve injury), etc. The more popular animal models relying on peripheral nerve ligatures are explained. In contrast to chronic sciatic nerve contraction, which results in behavioral symptoms of less reliable stressful neuropathies, (SNI) spared nerve injury generates behavioral irregularities that are more feasible over a longer period. This review summarizes the latest methods models as well as clinical ideas concerning this mechanism. Every strongest current information on neuropathy is discussed, along with several popular laboratory models for causing neuropathy.

Deep learning-assisted IoMT framework for cerebral microbleed detection.

The Internet of Things (IoT), big data, and artificial intelligence (AI) are all key technologies that influence the formation and implementation of digital medical services. Building Internet of Medical Things (IoMT) systems that combine advanced sensors with AI-powered insights is critical for intelligent medical systems. This paper presents an IoMT framework for brain magnetic resonance imaging (MRI) analysis to lessen the unavoidable diagnosis and therapy faults that occur in human clinical settings for the accurate detection of cerebral microbleeds (CMBs). The problems in accurate CMB detection include that CMBs are tiny dots 5-10 mm in diameter; they are similar to healthy tissues and are exceedingly difficult to identify, necessitating specialist guidance in remote and underdeveloped medical centers. Secondly, in the existing studies, computer-aided diagnostic (CAD) systems are designed for accurate CMB detection, however, their proposed approaches consist of two stages. Potential candidate CMBs from the complete MRI image are selected in the first stage and then passed to the phase of false-positive reduction. These pre-and post-processing steps make it difficult to build a completely automated CAD system for CMB that can produce results without human intervention. Hence, as a key goal of this work, an end-to-end enhanced UNet-based model for effective CMB detection and segmentation for IoMT devices is proposed. The proposed system requires no pre-processing or post-processing steps for CMB segmentation, and no existing research localizes each CMB pixel from the complete MRI image input. The findings indicate that the suggested method outperforms in detecting CMBs in the presence of contrast variations and similarities with other normal tissues and yields a good dice score of 0.70, an accuracy of 99 %, as well as a false-positive rate of 0.002 %. © 2017 Elsevier Inc. All rights reserved.

Partitioned dual Maclaurin symmetric mean operators based on picture fuzzy sets and their applications in multi-attribute decision-making problems.

The partitioned Dual Maclaurin symmetric mean (PDMSM) operator has the supremacy that can justify the interrelationship of distinct characteristics and there are a lot of exploration consequences for it. However, it has not been employed to manage "multi-attribute decision-making" (MADM) problems represented by picture fuzzy numbers. The basic inspiration of this identification is to develop the novel theory of picture fuzzy PDMSM operator, and weighted picture fuzzy PDMSM operator and to identify their important results (Idempotency, Monotonicity, and Boundedness). Further, to identify the best decision, every expert realized that they needed the best way to find the beneficial optimal using the proper decision-making procedure, for this, we diagnosed the MADM tool in the consideration of deliberated approaches based on PF information. Finally, to drive the characteristics of the invented work, several examples are utilized to test the manifest of the comparative analysis with various more existing theories, which is a fascinating and meaningful technique to deeply explain the features and exhibited of the proposed approaches.

Toxicological effects of copper on bioaccumulation and mRNA expression of antioxidant, immune, and apoptosis-related genes in Chinese striped-necked turtle (Mauremys sinensis).

Heavy metals are among the most ubiquitous environmental pollutants of recent decades. Copper is commonly used to control algal blooms or macrophyte and waste infestations, its ambient concentration has increased significantly, indicating possible environmental risk. To investigate the effects of copper exposure on bioaccumulation, antioxidant defense, immune response, and apoptosis in the Chinese Striped-necked Turtle Mauremys sinensis, three experimental groups, control (0.0 mg/L), Cu2 (2 mg/L) and Cu4 (4 mg/L) were designed, and sampled at 14 and 28 days. Results showed that copper accumulates in different organs depending on the concentration and exposure time, Liver > Kidney > Gut > Heart > Brain > Muscle and the time order was 28 days > 14 days. The liver enzymes AST, ALT, and ALP decreased when the turtles were exposed to copper stress, while the contents of bilirubin TBIL, DBIL, IBIL, and LDH showed a significant upward trend. Similarly, the mRNA expression level of acetylcholinesterase AChE in the brain was significantly downregulated upon copper exposure. An upward trend was noticed in the liver Metallothionein MT mRNA expression levels compared to the control group. The mRNA expression levels of antioxidant enzymes CAT, SOD, MnSOD, and GSH-PX1 in the liver increased initially and then significantly decreased. Furthermore, the relative mRNA expression levels of inflammatory cytokines IL-1ß, IL-8, TNF-α, and IFN-γ involved in inflammatory response significantly upregulated. Copper significantly increased the hepatic mRNA transcription of heat shock proteins HSP70 and HSP90 at different exposure durations. In addition, the relative mRNA levels of caspase3, caspase8, and caspase9 related to the caspase-dependent apoptotic pathway significantly increased under copper stress. These results explain that copper toxicity causes bioaccumulation, promotes oxidative stress, obstructs immunity, and induces inflammation and apoptosis by altering their gene expression levels in M. sinensis.

Congenital Immature Grade ΙΙΙ Teratoma of the Neck: A Case Report.

Teratoma is a rare type of germ cell tumor that consists of structures derived from all three germ layers of the embryo with varying proportions. While most of these are benign, some can turn malignant. The most common location of teratomas is the sacrococcygeal region, while their occurrence in the neck region is very rare. Broadly classified, immature teratomas contain poorly differentiated tissues, while mature ones have well-differentiated tissues. Here, the authors present a case of a 12-month-old child who presented with a huge neck mass. Radiological imaging studies were performed. Under a multidisciplinary team approach, the child was treated successfully with surgical excision. Histopathology revealed the mass to be an immature teratoma of grade III. Postoperatively, no recurrence has been noted.

Intramedullary Thoracic Spinal Cord Abscess Mimicking an Intramedullary Tumor: A Case Report.

An intramedullary abscess is an extremely rare form of infection of the spinal cord, with only about 100 cases reported in the literature. It typically presents with back pain, neurological deficits, and, occasionally, fever. The purpose of this article is to report a case of an intramedullary thoracic spinal cord abscess that was initially misdiagnosed as an intramedullary tumor. A 48-year-old female presented with chronic inter-scapular pain and lower limb weakness. The patient was initially misdiagnosed as a case of intramedullary spinal cord tumor, primarily due to the rarity of intramedullary spinal cord abscess (ISCA) as well as the absence of ring enhancement in the lesion on MRI. However, during a surgical procedure for the excision of the lesion, it was found to be a case of ISCA. The purulent contents of the lesion were evacuated, and the patient was treated with IV antibiotics, leaving the patient with a slight residual lower limb weakness on the follow-up examination. This case highlights the importance of considering intramedullary abscess as a possible diagnosis in patients with back pain and neurological deficits, even in the absence of ring enhancement on imaging. Prompt surgical intervention should be considered in probable cases of intramedullary spinal cord tumors.

A fast, low-cost, robust and high-throughput method for viral nucleic acid isolation based on NAxtra magnetic nanoparticles.

The year of 2020 was profoundly marked by a global pandemic caused by a strain of coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19). To control disease spread, a key strategy adopted by many countries was the regular testing of individuals for infection. This led to the rapid development of diagnostic testing technologies. In Norway, within a week, our group developed a test kit to quickly isolate viral RNA and safely detect SARS-CoV-2 infection with sensitivity comparable to available kits. Herein, the procedure employed for the detection of SARS-CoV-2 in swab samples from patients using the NTNU-COVID-19 test kit is described in detail. This procedure, based on NAxtra magnetic nanoparticles and an optimized nucleic acid extraction procedure, is robust, reliable, and straightforward, providing high-quality nucleic acids within 14 min. The NAxtra protocol is adaptable and was further validated for extraction of DNA and RNA from other types of viruses. A comparison of the protocol on different liquid handling systems is also presented. Due to the simplicity and low cost of this method, implementation of this technology to diagnose virus infections on a clinical setting would benefit health care systems, promoting sustainability.

The ORFans' tale: new insights in plant biology.

Orphan genes (OGs) are protein-coding genes without a significant sequence similarity in closely related species. Despite their functional importance, very little is known about the underlying molecular mechanisms by which OGs participate in diverse biological processes. Here, we discuss the evolutionary mechanisms of OGs' emergence with relevance to species-specific adaptations. We also provide a mechanistic view of the involvement of OGs in multiple processes, including growth, development, reproduction, and carbon-metabolism-mediated immunity. We highlight the interconnection between OGs and the sucrose nonfermenting 1 (SNF1)-related protein kinases (SnRKs)-target of rapamycin (TOR) signaling axis for phytohormone signaling, nutrient metabolism, and stress responses. Finally, we propose a high-throughput pipeline for OGs' interspecies and intraspecies gene transfer through a transgenic approach for future biotechnological advances.

Dynamic Enrichment for Evaluation of Protein Networks (DEEPN): A High Throughput Yeast Two-Hybrid (Y2H) Protocol to Evaluate Networks.

Proteins are the building blocks of life, and a vast array of cellular processes is handled by protein-protein interactions (PPIs). The protein complexes formed via PPIs lead to tangled networks that, with their continuous remodeling, build up systematic functional units. Over the years, PPIs have become an area of interest for many researchers, leading to the development of multiple in vitro and in vivo methods to reveal these interactions. The yeast-two-hybrid (Y2H) system is a potent genetic way to map PPIs in both a micro- and high-throughput manner. Y2H is a technique that involves using modified yeast cells to identify protein-protein interactions. For Y2H, the yeast cells are engineered only to grow when there is a significant interaction between a specific protein with its interacting partner. PPIs are identified in the Y2H system by stimulating reporter genes in response to a restored transcription factor. However, Y2H results may be constrained by stringency requirements, as the limited number of colony screenings through this technique could result in the possible elimination of numerous genuine interactions. Therefore, DEEPN (dynamic enrichment for evaluation of protein networks) can be used, offering the potential to study the multiple static and transient protein interactions in a single Y2H experiment. DEEPN utilizes next-generation DNA sequencing (NGS) data in a high-throughput manner and subsequently applies computational analysis and statistical modeling to identify interacting partners. This protocol describes customized reagents and protocols through which DEEPN analysis can be utilized efficiently and cost-effectively.

A Multi-epitope Vaccine Candidate Against Bolivian Hemorrhagic fever Caused by Machupo Virus.

Bolivian hemorrhagic fever (BHF) caused by Machupo virus (MACV) is a New World arenavirus having a reported mortality rate of 25-35%. The BHF starts with fever, followed by headache, and nausea which rapidly progresses to severe hemorrhagic phase within 7 days of disease onset. One of the key promoters for MACV viral entry into the cell followed by viral propagation is performed by the viral glycoprotein (GPC). GPC is post-transcriptionally cleaved into GP1, GP2 and a signal peptide. These proteins all take part in the viral infection in host body. Therefore, GPC protein is an ideal target for developing therapeutics against MACV infection. In this study, GPC protein was considered to design a multi-epitope, multivalent vaccine containing antigenic and immunogenic CTL and HTL epitopes. Different structural validations and physicochemical properties were analysed to validate the vaccine. Docking and molecular dynamics simulations were conducted to understand the interactions of the vaccine with various immune receptors. Finally, the vaccine was codon optimised in silico and along with which immune simulation studies was performed in order to evaluate the vaccine's effectiveness in triggering an efficacious immune response against MACV.

WASPAS method and Aczel-Alsina aggregation operators for managing complex interval-valued intuitionistic fuzzy information and their applications in decision-making.

Aczel-Alsina t-norm and t-conorm are a valuable and feasible technique to manage ambiguous and inconsistent information because of their dominant characteristics of broad parameter values. The main theme of this analysis is to explore Aczel-Alsina operational laws in the presence of the complex interval-valued intuitionistic fuzzy (CIVIF) set theory. Furthermore, we derive the theory of aggregation frameworks based on Aczel-Alsina operational laws for managing the theory of CIVIF information. The CIVIF Aczel-Alsina weighted averaging (CIVIFAAWA), CIVIF Aczel-Alsina ordered weighted averaging (CIVIFAAOWA), CIVIF Aczel-Alsina hybrid averaging (CIVIFAAHA), CIVIF Aczel-Alsina weighted geometric (CIVIFAAWG), CIVIF Aczel-Alsina ordered weighted geometric (CIVIFAAOWG) and CIVIF Aczel-Alsina hybrid geometric (CIVIFAAHG) operators are proposed, and their well-known properties and particular cases are also detailly derived. Further, we derive the theory of the WASPAS method for CIVIF information and evaluate their positive and negative aspects. Additionally, we demonstrate the multi-attribute decision-making (MADM) strategy under the invented works. Finally, we express the supremacy and dominancy of the invented methods with the help of sensitive analysis and geometrical shown of the explored works.

The Lost and Found: Unraveling the Functions of Orphan Genes.

Orphan Genes (OGs) are a mysterious class of genes that have recently gained significant attention. Despite lacking a clear evolutionary history, they are found in nearly all living organisms, from bacteria to humans, and they play important roles in diverse biological processes. The discovery of OGs was first made through comparative genomics followed by the identification of unique genes across different species. OGs tend to be more prevalent in species with larger genomes, such as plants and animals, and their evolutionary origins remain unclear but potentially arise from gene duplication, horizontal gene transfer (HGT), or de novo origination. Although their precise function is not well understood, OGs have been implicated in crucial biological processes such as development, metabolism, and stress responses. To better understand their significance, researchers are using a variety of approaches, including transcriptomics, functional genomics, and molecular biology. This review offers a comprehensive overview of the current knowledge of OGs in all domains of life, highlighting the possible role of dark transcriptomics in their evolution. More research is needed to fully comprehend the role of OGs in biology and their impact on various biological processes.