A framework to distinguish healthy/cancer renal CT images using the fused deep features.

Introduction: Cancer happening rates in humankind are gradually rising due to a variety of reasons, and sensible detection and management are essential to decrease the disease rates. The kidney is one of the vital organs in human physiology, and cancer in the kidney is a medical emergency and needs accurate diagnosis and well-organized management. Methods: The proposed work aims to develop a framework to classify renal computed tomography (CT) images into healthy/cancer classes using pre-trained deep-learning schemes. To improve the detection accuracy, this work suggests a threshold filter-based pre-processing scheme, which helps in removing the artefact in the CT slices to achieve better detection. The various stages of this scheme involve: (i) Image collection, resizing, and artefact removal, (ii) Deep features extraction, (iii) Feature reduction and fusion, and (iv) Binary classification using five-fold cross-validation. Results and discussion: This experimental investigation is executed separately for: (i) CT slices with the artefact and (ii) CT slices without the artefact. As a result of the experimental outcome of this study, the K-Nearest Neighbor (KNN) classifier is able to achieve 100% detection accuracy by using the pre-processed CT slices. Therefore, this scheme can be considered for the purpose of examining clinical grade renal CT images, as it is clinically significant.

Polycystic ovary syndrome: An exploration of unmarried women's knowledge and attitudes.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder among women of reproductive age and a chief cause of subfertility attributed to ovulation. Besides, lack of knowledge about PCOS, its treatment, and lifestyle changes influence the prognosis. The present qualitative inquiry investigates the knowledge and attitudes of unmarried women towards the syndrome, associated treatment, and necessary lifestyle changes in the fight against the same. A total of 15 participants with PCOS were selected using purposive sampling (n from southern parts of India viz. Kerala and Tamil Nadu states. The telephonic interviews were conducted in late November and early December 2020. He conventional content analysis emerged with six major themes. The themes capsulated women's knowledge, causes, complications and risk factors, treatment of PCOS their perceived importance of health promotive behaviours such as physical activity, sleep patterns, and perceived support from society. The importance of diet, exercise and a healthy lifestyle were additional relevant factors stressed by the respondents. Although the medicines helped participants attain regular menstrual cycles, they also had side effects reported in the discussion. Few respondents reported that they lacked the necessary awareness of PCOS when diagnosed at a younger age. The study enhances the understanding of PCOS from a qualitative approach that has cultural relevance apart from pertinent clinical and lifestyle implications.

Techno Trend Awareness and Its Attitude Towards Social Connectedness and Mitigating Factors of COVID-19.

While COVID-19 has taken a toll on many professions and livelihood of all walks of lives, technology has amplified its intrusion to ease the necessities. Innovative technology, therefore, has improved the glitches and provided the software to adhere to these new normal. However, individuals' awareness and attitude toward the advancements of these technological trends need to be addressed. Although the government has taken measures to prevent and curb the growing cases for COVID-19 with the help of technology, the support from the individuals would depend mostly on their level of awareness and the attitude toward those measures. The present qualitative study explored the techno trend awareness, perception and attitudes of techno experts and technical professionals toward social connectedness and mitigating factors of COVID-19. Besides, it also explained individuals' shift toward virtual interaction to maintain social connections during the pandemic. The thematic analysis generated four prominent themes. Social Connectedness, emphasized on the emotional connections that created a positive feeling of belongingness. Technological Advancement provided three sub-themes highlighting perception, techno trend awareness and desirable attitudes toward the mitigation of COVID-19. The categories under Treatment and Preventive Measures indicated the enhanced self-care of individuals and also the tendencies to minimize the spread of diseases. The emergence of the theme Inclination toward Indigenous Knowledge, which is an important finding, indicated the techno-experts inclination toward the indigenous knowledge amid vague scientific shreds of evidence.

Is preoperative neutrophil-to-lymphocyte ratio a red flag which can predict high-risk pathological characteristics in renal cell carcinoma?

INTRODUCTION: Renal cell carcinoma (RCC) is known to invoke both immunological and inflammatory responses. While the neutrophils mediate the tumor-induced inflammatory response, the lymphocytes bring about the various immunological events associated with it. The neutrophil-to-lymphocyte ratio (NLR) is a simple indicator of this dual response. We investigated the association between preoperative NLR and histopathological prognostic variables of RCC intending to find out whether it can be of value as a red flag capable of alerting the clinician as to the biological character of the tumor under consideration. METHODS: Preoperative NLR and clinicopathological variables, namely histological subtype, nuclear grade, staging, lymphovascular invasion, capsular invasion, tumor necrosis, renal sinus invasion, and sarcomatoid differentiation of 60 patients who underwent radical or partial nephrectomy, were analyzed to detect the association between the two. RESULTS: We found that mean preoperative NLR was significantly higher in clear-cell carcinomas (3.25 ± 0.29) when compared with nonclear-cell carcinomas (2.25 ± 0.63). There was a linear trend of NLR rise as the stage of the disease advanced. A significant rise in preoperative NLR was noted in tumors with various high-risk histopathological features such as tumor size, capsular invasion, tumor necrosis, and sarcomatoid differentiation. CONCLUSION: Preoperative measurement of NLR is a simple test which may provide an early clue of high-risk pathological features of renal cell cancer.

Do Social Connections and Digital Technologies Act as Social Cure During COVID-19?

Although COVID-19 pandemic has re-orientated humans to be more physically healthy and hygienic, it has also persuaded humans to create affiliations and experience a sense of belongingness through social networks and digital technologies. However, amidst these changes, experiences of COVID-19 patients and their perception of the outside world's attitudes toward them appears to be less attended in literature which formed the basis for the current study's objectives. Using qualitative methodology, the present study explored the experiences, perceptions and attitudes of patients and their care-givers' toward COVID-19. The thematic analysis emerged with four major themes. Psychological Experiences of People was generated prominently with sub-themes indicating the perceived experiences like fear of spreading diseases to others, and the need for psychological counseling. Attitude of others toward patients and caregivers revealed that family members and relatives played a major positive role on the patient's mental health, however, the neighbor's stigmatized attitude led to several undesired behaviors. Social Connectedness was another major theme derived from the study. Altruistic volunteers, a sub-theme of Social connectedness have indicated that amidst these negative factors, one can spread social harmony by motivating and supporting the victims with basic needs, financial support, hope and social empathy. Opinions of participants for digital technology through technological aids and preventive measures emphasized an overall positive attitude as it helped the society, in general to maintain social connections as well to curb the rate of COVID-19 cases.

Role of Preoperative Renal Stone Complexity Assessment by Guy's Stone Score as a Predictor of Percutaneous Nephrolithotomy Outcomes.

INTRODUCTION: Various nephrolithometric scoring systems have recently emerged to predict the outcomes of percutaneous nephrolithotomy (PCNL). However, there is no consensus upon an ideal tool. The current study aimed to assess the correlation between Guy's stone score (GSS) and PCNL outcomes. METHOD: This was a hospital-based observational study of 2-year duration. All patients electively undergoing PCNL for renal stones during the study period were included. Based on the imaging findings, the stones were categorized as simple (GSS I & II) and complex (GSS III & IV). The association between GSS and duration of the procedure, the number of percutaneous tracts needed, stone-free rate (SFR), and the severity of complications based on modified Clavien classification and postoperative stay were assessed. RESULTS: Total number of the patients studied were 100 (n = 100), and most of the patients were in the category of GSS II (51%). Post-extrapolation of χ2 to Pearson's test, GSS demonstrated a significant association with duration of surgery, the number of percutaneous tracts needed, the severity of complications, and SFR. CONCLUSIONS: Preoperative assessment of stone complexity by using GSS effectively correlated with SFR as well as other PCNL outcomes. Hence, we recommend utilizing this predictive tool for standardized documentation, preoperative planning, and better patient counseling.

Apathy Classification Based on Doppler Radar Image for the Elderly Person.

Apathy is a disease characterized by diminished motivation not attributable to a diminished level of consciousness, cognitive impairment, or emotional distress. It is a serious problem facing the elderly in today's society. The diagnosis of apathy needs to be done at a clinic, which is particularly inconvenient and difficult for elderly patients. In this work, we examine the possibility of using doppler radar imaging for the classification of apathy in the elderly. We recruited 178 elderly participants to help create a dataset by having them fill out a questionnaire and submit to doppler radar imaging while performing a walking action. We selected walking because it is one of the most common actions in daily life and potentially contains a variety of useful health information. We used radar imaging rather than an RGB camera due to the greater privacy protection it affords. Seven machine learning models, including our proposed one, which uses a neural network, were applied to apathy classification using the walking doppler radar images of the elderly. Before classification, we perform a simple image pre-processing for feature extraction. This pre-processing separates every walking doppler radar image into four parts on the vertical and horizontal axes and the number of feature points is then counted in every separated part after binarization to create eight features. In this binarization, the optimized threshold is obtained by experimentally sliding the threshold. We found that our proposed neural network achieved an accuracy of more than 75% in apathy classification. This accuracy is not as high as that of other object classification methods in current use, but as an initial research in this area, it demonstrates the potential of apathy classification using doppler radar images for the elderly. We will examine ways of increasing the accuracy in future work.

Clinical and therapeutic implications of sex steroid hormone receptor status in urothelial bladder cancer.

Studies on the clinical profile of urothelial bladder cancer (UBC) have shown significant gender differences, namely, higher occurrence in males (male-to-female ratio of 3.5:1) and an advanced stage of disease at the time of diagnosis with rapid progression of the disease after initial diagnosis seen more commonly in females. The relationship between gender and UBC is complex and probably influenced by biological and epidemiological factors. Potential contributory factors such as sex steroid hormone pathway, gender difference in environmental carcinogen exposure, metabolic enzyme activity, and disparities in the intensity of diagnostic evaluation could probably explain the demographic trends in UBC. This comprehensive review of Medline publications during the period 2009-2019 attempts to identify the possible role of sex hormone receptors in gender variation and sexual dimorphism in the occurrence and progression of UBC. The clinical implications of identifying sex steroid receptors on factors such as disease prognostication and the therapeutic role of anti-androgens in the prevention and progression of UBC are critically reviewed. There is now significant evidence in literature to suggest the possible role of sex steroid hormone receptor-mediated signals in the genesis and progression of UBC. These receptors include androgen receptors, estrogen receptors, progesterone receptors, and various other orphan receptors. Excessive or reduced expression of these receptors, as well as alterations in their upstream or downstream pathways, correlate well with the clinical and therapeutic outcomes of UBC.

Schwannoma: An uncommon dweller in the adrenal gland.

An elderly adult woman presented with upper abdominal pain to the urology department. Imaging studies revealed a right adrenal lesion with central necrosis, abutting the large vessels and suggestive of malignancy. Histopathology showed an encapsulated spindle cell tumor with marked nuclear atypia, cystic change, and hemorrhage. S100 immunomarker was strongly and diffusely positive. Final diagnosis was ancient schwannoma with secondary change. Schwannomas are rare in the adrenal gland, with <50 cases reported in the literature. These incidentally detected nonfunctional adrenal tumors need confirmation with histopathology and ancillary studies.

Renal salvage, an achievable goal in patients with emphysematous pyelonephritis: Outcomes of an algorithmic renal preserving strategy.

INTRODUCTION: Emergency nephrectomy has been the time-honored treatment of choice for emphysematous pyelonephritis (EPN), a fatal gas-forming necrotizing infection. Recent years have seen a shift toward nonextirpative approach aimed to achieve higher rates of renal salvage, limiting the indications for nephrectomy to severe grades of the disease. This study aimed at analyzing the role of initial renal preserving measures algorithmically applied across grades of EPN. MATERIALS AND METHODS: We prospectively analyzed the clinical data and outcome of 36 consecutive patients of EPN in 5 years' study period, treated by renal preserving measures, which include aggressive resuscitation, parenteral antibiotics, effective drainage of infected fluid/gas, and relieving the urinary tract obstruction. Huang-Tseng computed tomography-based classification system was used to categorize the patients as well as to employ suitable treatment modality. RESULTS: The mean age of the patients was 57.5 ± 12 years with female preponderance (2:1). Diabetes mellitus (97%) was the most common associated factor. Escherichia coli was (72%) the most frequent causative organism found. Urinary tract obstruction was seen in 27 patients (75%) attributable to ureteric calculi, renal papillary necrosis, ureteric stricture, and fungal bezoar in the descending order of frequency. Only 2 (6%) out of 36 patients managed according to our hospital renal salvage protocol required salvage nephrectomy. The overall survival rate was 94%. CONCLUSION: Our hospital-based algorithmic renal preserving strategy not only improved the survival but also decreased the need for nephrectomy.

A quantitative validation of segmented colon in virtual colonoscopy using image moments.

BACKGROUND: Evaluation of segmented colon is one of the challenges in Computed Tomography Colonography (CTC). The objective of the study was to measure the segmented colon accurately using image processing techniques. METHODS: This was a retrospective study, and the Institutional Ethical clearance was obtained for the secondary dataset. The technique was tested on 85 CTC dataset. The CTC dataset of 100-120 kVp, 100 mA, and ST (Slice Thickness) of 1.25 and 2.5 mm were used for empirical testing. The initial results of the work appear in the conference proceedings. Post colon segmentation, three distance measurement techniques, and one volumetric overlap computation were applied in Euclidian space in which the distances were measured on MPR views of the segmented and unsegmented colons and the volumetric overlap calculation between these two volumes. RESULTS: The key finding was that the measurements on both the segmented and the unsegmented volumes remain same without much difference noticed. This was statistically proved. The results were validated quantitatively on 2D MPR images. An accuracy of 95.265±0.4551% was achieved through volumetric overlap computation. Through pairedt-test, at α=5%, statistical values were p=0.6769, and t=0.4169 which infer that there was no much significant difference. CONCLUSION: The combination of different validation techniques was applied to check the robustness of colon segmentation method, and good results were achieved with this approach. Through quantitative validation, the results were accepted at α=5%.

The resurgence of estrogens in the treatment of castration-resistant prostate cancer.

Use of exogenous estrogens in manipulating the androgenestrogen equilibrium was one of the earliest therapeutic strategies developed to treat prostate cancer which followed close on heels the discovery of hormone dependence of this tumor. Despite its well-documented benefit, estrogen therapy fell out of favor with the advent of other forms of androgen deprivation therapy (ADT) as the former registered a higher incidence of cardiovascular complications and poorer overall survival. Clearer understanding of the mechanism of action of estrogen coupled with the adoption of alternative routes of administration has triggered a renewed interest in estrogen therapy. Since then, many studies have not only proved the therapeutic benefit of estrogens but also explored the ways and means of minimizing the dreaded side effects deterring its use. Further, the fact that estrogen therapy offered a clear advantage of reduced cost of treatment over other treatments has led many countries to readopt it in the treatment of advanced prostatic cancer. We reviewed the published data on the use of estrogens in CRPC, which may affect its revival as an efficacious treatment option having minimal side effects, with modified dosage and route of administration. Estrogen therapy would be a less expensive option having equivalent or even better therapeutic effect than ADT in advanced carcinoma of prostate.

A novel sorbent Ulva lactuca-derived biochar for remediation of Remazol Brilliant Orange 3R in packed column.

An up-flow fixed column study was conducted to remediate Remazol Brilliant Orange 3R (RBO3R) from contaminated solutions using biochar derived from Ulva lactuca biomass. The influences of column parameters on dye sorption were studied in detail, which include initial RBO3R concentration, bed depth, and flow rate. Optimization experiments indicated that maximum RBO3R column uptake of 0.114 mmol/g was observed at 0.25 mmol/L (initial RBO3R concentration), 0.3 L/hr (flow rate), and 25 cm (U. lactuca bed depth). Modeling of column sorption data was performed using the Yoon-Nelson, modified dose-response and Thomas models. The spent biochar was desorbed and rejuvenated using 0.01 M NaOH. The elutant (0.01 M NaOH) exhibited 99.7% efficiency, and the process was completed in 115 min with high overall concentration factor of 8.4. PRACTITIONER POINTS: This study explores the impact of column parameters on the dye removal potential of U. lactuca-derived biochar. At optimized condition, the biochar bed exhibited highest Remazol Brilliant Orange 3R uptake capacity of 0.114 mmol/g. The regeneration and desorption of U. lactuca-derived biochar bed was possible with NaOH (0.01 M) as elutant.

Domain-Based Analysis of Colon Polyp in CT Colonography Using Image-Processing Techniques

Background: The purpose of the research was to improve the polyp detection accuracy in CT Colonography (CTC) through effective colon segmentation, removal of tagged fecal matter through Electronic Cleansing (EC), and measuring the smaller polyps. Methods: An improved method of boundary-based semi-automatic colon segmentation with the knowledge of colon distension, an adaptive multistep method for the virtual cleansing of segmented colon based on the knowledge of Hounsfield Units, and an automated method of smaller polyp measurement using skeletonization technique have been implemented. Results: The techniques were evaluated on 40 CTC dataset. The segmentation method was able to delineate the colon wall accurately. The submerged colonic structures were preserved without soft tissue erosion, pseudo enhanced voxels were corrected, and the air-contrast layer was removed without losing the adjacent tissues. The smaller polyp of size less than <10mm was detected correctly. The results were statistically validated qualitatively and quantitatively. Segmented colons were validated through volumetric overlap computation, and accuracy of 95.826±0.6854% was achieved. In polyp measurement, the paired t-test method was applied to compare the difference with ground truth and at α=5%, t=0.9937 and p=0.098 was achieved. The statistical values of TPR=90%, TNR=82.3% and accuracy=88.31% were achieved. Conclusion: An automated system of polyp measurement has been developed starting from colon segmentation to improve the existing CTC solutions. The analysis of domain-based approach of polyp has given good results. A prototype software, which can be used as a low-cost polyp diagnosis tool, has been developed.

Individual and simultaneous electrochemical determination of metanil yellow and curcumin on carbon quantum dots based glassy carbon electrode.

Adulteration of medicinally valuable curcumin (CU) with harmful chemicals as metanil yellow (MY) in recent years have demanded for quick detection techniques of the adulterants. The voltammetric behavior of CU and MY on bare glassy carbon electrode (BGCE) and carbon quantum dots modified glassy carbon electrode (CQDs/GCE) was studied by both cyclic voltammetry (CV) and differential pulse voltammetry (DPV) in phosphate buffer solution of pH 5.4. The MY responded to the CQDs/GCE with two anodic peaks at -0.004 V and 0.136 V and two cathodic peaks at -0.112 and -0.048 V. Under similar conditions CU exhibited two anodic peaks at 0.28 V and 0.55 V and one cathodic peak at 0.25 V. The overlapped voltammogram obtained for CU and MY on BGCE was well separated on the CQDs/GCE. The interference studies revealed that the compounds, demethoxycurcumin and bisdemethoxycurcumin, which are commonly associated with CU, did not interfere with the detection of MY. Real sample was analyzed with fabricated electrode and the recovery values >98% were obtained.

Mixed epithelial and stromal tumor - A solid-cystic renal neoplasm undergoing malignant transformation: A rare case report.

We present a case of 53-year-old female who came with the complaints of mass on the right side of the abdomen noticed 3 weeks back. There was no history of localized swelling or rise of temperature, no history of weight loss, or evening rise of temperature. On examination, there was a flank mass which was bimanually palpable and tender. Routine laboratory investigations were within normal limits, except for the presence of hematuria in routine urinalysis. Computed tomography scan abdomen revealed a large multiloculated solid-cystic mass lesion with septation in the right-sided kidney. Cystic renal cell carcinoma was suspected and conventional open right radical nephrectomy was done. Grossly, the tumor was solid-cystic containing blood-tinged fluid. Microscopy revealed a complex tumor with both epithelial and stromal proliferation and with the aid of immunohistochemistry a diagnosis of mixed epithelial and stromal tumor undergoing malignant transformation was concluded.

Measurement of smaller colon polyp in CT colonography images using morphological image processing.

PURPOSE: Automated measurement of the size and shape of colon polyps is one of the challenges in Computed tomography colonography (CTC). The objective of this retrospective study was to improve the sensitivity and specificity of smaller polyp measurement in CTC using image processing techniques. METHODS: A domain knowledge-based method has been implemented with hybrid method of colon segmentation, morphological image processing operators for detecting the colonic structures, and the decision-making system for delineating the smaller polyp-based on a priori knowledge. RESULTS: The method was applied on 45 CTC dataset. The key finding was that the smaller polyps were accurately measured. In addition to 6-9 mm range, polyps of even <5 mm were also detected. The results were validated qualitatively and quantitatively using both 2D MPR and 3D view. Implementation was done on a high-performance computer with parallel processing. It takes [Formula: see text] min for measuring the smaller polyp in a dataset of 500 CTC images. With this method, [Formula: see text] and [Formula: see text] were achieved. CONCLUSIONS: The domain-based approach with morphological image processing has given good results. The smaller polyps were measured accurately which helps in making right clinical decisions. Qualitatively and quantitatively the results were acceptable when compared to the ground truth at [Formula: see text].

Human coronaviruses in severe acute respiratory infection (SARI) cases in southwest India.

Acute viral respiratory infections (AVRI) are a leading cause of morbidity and mortality among all age groups globally. Except for Influenza virus and Respiratory Syncytial virus, mostly viral aetiology of AVRI remains undiagnosed. Lately, human coronaviruses (HCoVs) have emerged as an important aetiology of AVRI. A laboratory based retrospective cross sectional study was conducted in which respiratory samples (throat swabs) of patients (n = 864), with Influenza negative SARI, of all age groups between Jan 2011-Dec 2012 were tested for HCoVs including MERS-CoV using Conventional and real time PCR assays. The prevalence of HCoV among SARI cases was 1.04% (9/864) [95% CI: 0.36-1.72]. Of these four (44.44%) were identified as HCoV OC43, three (33.33%) as HCoV NL63 and two (22.22%) as HCoV 229E. No HCoV HKU1 was detected. The samples were also negative for SARS-CoV and MERS-CoV. The results of this study documents low prevalence of human coronaviruses in SARI cases in south western India and the absence of highly pathogenic human coronaviruses. As the study included only SARI cases the prevalence reported could be an under estimate when it is extrapolated to community.