Embolic stroke of undetermined source: A cardiovascular approach to diagnostic uncertainty.

Embolic stroke of undetermined source (ESUS) is a clinical event with an undelineated embolic etiology after the initial stroke workup. Once stroke specialists confirm ESUS, evaluation of rhythm disorders such as atrial fibrillation, specific cardiac pathologies (cardiomyopathy, left atrial cardiopathy, left-atrial septal pouch, aortic or mitral valve disease, cardiac neoplasm, right-to-left shunts, or device-related thrombus), and acquired hypercoagulable states, which may occasionally be related to malignancy, should be performed. While most ESUS patients require appropriate antiplatelet therapy, certain subsets may require oral anticoagulation.

Identification of Spatial Hot spots Clustering and Geographically Weighted Regression Analysis to Assess Predictors of Cesarean Section Delivery in Northeastern States, India.

Background: It is difficult to achieve health related Sustainable Development Goals when a higher proportion of birth delivery occurs through cesarean section (CS) than vaginal delivery without considerable medical benefits. This study aims to identify the spatial hot spot clustering and determinants of cesarean section in northeastern states, India.

Methods: The study utilized data from the fifth round of the National Family Health Survey (NFHS-5, 2019-2021), which included responses from 34,222 mothers who delivered live births in the five years preceding the survey.

The association of COVID-19 with the development of acute avascular necrosis of the head of the femur, apart from steroid usage.

The SARS-CoV-2 pandemic (COVID-19) has significantly impacted global health, with emerging evidence indicating potential long-term complications affecting various organ systems, including the musculoskeletal system, like avascular necrosis (AVN) of the femoral head. This retrospective study aims to investigate the incidence and risk factors of AVN in patients treated for COVID-19. We conducted a cross-sectional retrospective study in the department of orthopedics at a tertiary care teaching hospital in Central India from July 2022 to December 2023.

HETEROGENEITY ANALYSIS OF ASSOCIATIONS INVOLVING THE LARGE SCALE ONLINE MINDCROWD SURVEY MEMORY TEST.

Alzheimer's disease and related disorders (ADRD), as well as general age-related cognitive decline, are known to be multifactorial with heterogeneous etiologies. Identifying and accommodating heterogeneity in any one data set can be pursued using different analytical techniques, each with different assumptions or purposes. Whereas a great deal of research has explored clustering individuals of variables that exhibit greater similarity in some way, little research has explored evidence for heterogeneity in the relationships between relevant outcomes, such as a performance on a memory test, and risk factors such as environmental exposures, behaviors or genetic factors among individuals.

Anti-metastatic cancer potential of 4H-chromene derivatives targeting JNK in Scribble knockdown induced epithelial cancer model: In vivo and in silico studies.

Building on our previous work on the synthesis of a series of 4H-chromene derivatives, we report herein for the first time the in vivo and in silico studies of ten chromene derivatives 5a-j as potential anti-metastatic cancer agents targeting through c-Jun N-terminal kinase (JNK). Compounds 5a-j were resynthesized using the protocol previously reported by our research group. Out of these, 5c, 5f-h and 5j showed good anti-metastatic cancer activity in Drosophila in vivo model, with 5f being the most active.

MindCrowd-Expanded: An Online Multi-Domain Assessment of Cognitive Aging.

Background: Numerous factors, including some modifiable factors as well as demographic factors, are associated with risk for age-related cognitive impairment. Evaluating the complex interaction of these factors and their trajectories across the adult lifespan requires large sample sizes with diverse cohorts. Online research has the potential to overcome barriers to research participation and provide the statistical power required to examine individual differences in cognitive functions.

COVID-19 vaccine acceptance and associated factors among parents of children between 6 and 12 years: a multicenter mixed method study in India.

Background: It is well recognized that parents play a central role in making decisions for their children. Understanding willingness of parents to vaccinate their children against COVID-19 is important as it helps to develop effective strategies for maximizing vaccination coverage. We aimed to evaluate parental acceptance regarding COVID-19 vaccination for children between 6 and 12 years of age in India.

Antibody-Free Immunopeptide Nanoconjugates for Brain-Targeted Drug Delivery in Glioblastoma Multiforme.

Glioblastoma Multiforme (GBM) represents a significant clinical challenge among central nervous system tumors, with a dismal mean survival rate of less than 8 months, a statistic that has remained largely unchanged for decades (National Brain Society, 2022). The specialized intricate anatomical features of the brain, notably the blood-brain barrier (BBB), pose significant challenges to effective therapeutic interventions, limiting the potential reach of modern advancements in immunotherapy to impact these types of tumors. This study introduces an innovative, actively targeted immunotherapeutic nanoconjugate (P-12/AP-2/NCs) designed to serve as an immunotherapeutic agent capable of traversing the BBB via LRP-1 receptor-mediated transcytosis.

Advancing NASICON-structured solid-state sodium-ion batteries through compositional and interfacial engineering.

NASICON-type ceramics are promising solid electrolytes (SEs) for next-generation solid-state batteries (SSBs), but their practical application is constrained by moderate ionic conductivity and high interfacial resistance. This article reviews recent advancements in overcoming these challenges through a dual strategy: (1) compositional engineering- co-doping NaZrSiPO with Yb/Sc, Ce/Sc, and Mg/Si-to enhance Na conductivity through structural modifications; and (2) interfacial engineering-including wetting agent insertion, composite cathode formation, and the use of infiltrated cathodes-to enlarge interfacial solid-solid contact between cathode and rigid SE and improve electrochemical stability. By integrating these approaches, this work offers a unified framework for the rational design of NASICON-based SSBs.

Non coverage of Hepatitis B immunization among children and its predictors in northeastern states of India: A multiscale geographically weighted regression analysis.

Background: Hepatitis B, a viral infection, is a vaccine-preventable disease and is a significant public health challenge globally. Child immunization is a safe and effective way to prevent Hepatitis B virus infection. The Universal Immunization Programme (UIP) of India, which effectively reduces the chronic burden, aims to reach immunization of nearly 2.

Perioperative outcomes of atrial fibrillation in patients undergoing transcatheter aortic valve replacement: a national inpatient sample study.

Background: Transcatheter aortic valve replacement (TAVR) has transformed the management of patients with severe symptomatic aortic stenosis who are unfit for surgical aortic valve replacement. Atrial fibrillation is one of the most common arrhythmias observed in patients with aortic stenosis undergoing TAVR. Our study explores the impact of Afib on perioperative outcomes in patients undergoing TAVR.

Deciphering pericyte-induced temozolomide resistance in glioblastoma with a 3D microphysiological system mimicking the biomechanical properties of brain tissue.

Glioblastoma (GBM) is a highly aggressive malignancy with a poor prognosis and frequent resistance to temozolomide (TMZ), the standard-of-care chemotherapy. The complex mechanisms underlying GBM chemoresistance, particularly the role of pericytes, remain poorly understood due to the lack of physiologically relevant in vitro models replicating the complex tumor microenvironment (TME). Here, we present a biomimetic 3D GBM microphysiological system that replicates the biomechanical properties of brain tissue (G'∼800Pa, G"∼100Pa) and enables the study of pericyte-mediated TMZ resistance.

Steady or Swaying? Assessing the Reliability of the HUMAC Balance System in Athletes With Chronic Low Back Pain.

Background: Balance is a fundamental component of athletic performance. Chronic low back pain (CLBP) is a prevalent issue in athletes, impacting performance. Balance assessment plays a crucial role in CLBP rehabilitation.

Advancement in Nanotablet Research: An Overview.

Modern technologies such as nanotechnology are being applied in almost every sector to deliver affordable, environmentally friendly products. The integration of nanotechnology in medicine has revolutionized drug delivery systems, with nanotechnology emerging as a promising frontier. This review explores the synthesis and characterization of nanotablet drug formulations designed to enhance their potential across various applications.

Recent Advancements Towards the Use of Vitamin D Isoforms and the Development of Their Synthetic Analogues as New Therapeutics.

Vitamin D and its metabolites are essential in various physiological processes, including muscle strength, metabolism, antifibrotic activity, and immune regulation. Researchers are focusing on developing vitamin D derivatives with optimized receptor selectivity and reduced systemic toxicity, enhancing their therapeutic efficacy against cancer, autoimmune disorders, and inflammatory diseases. Several analogues, such as alfacalcidol, paricalcitol, and falecalcitriol, are used for managing CKD-related bone disorders, while eldecalcitol is effective for osteoporosis, and calcipotriol against psoriasis.

Hybrid deep learning method to identify key genes in autism spectrum disorder.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a strong genetic component. This research aims to identify key genes associated with autism spectrum disorder using a hybrid deep learning approach. To achieve this, a protein-protein interaction network is constructedand analyzed through a graph convolutional network, which extracts features based on gene interactions.

Healing with hierarchy: Hierarchical attention empowered graph neural networks for predictive analysis in medical data.

In healthcare, predictive analysis using unstructured medical data is crucial for gaining insights into patient conditions and outcomes. However, unstructured data, which contains valuable patient information such as symptoms and medical histories, often presents challenges, including lengthy text sequences and incomplete data. To address these issues, we introduce a new framework named Hierarchical Attention-based Integrated Learning (HAIL), designed to predict in-hospital mortality and the duration of stay in the intensive care unit.

Caesarean section delivery & determining factors in northeastern State, India: A Bayesian spatio-temporal analysis of areal data.

Background & objectives Caesarean Section (CS) is a crucial life-saving surgical procedure for maternal delivery when normal delivery is ruled out for the safety of mother and infant. This study investigated the spatio-temporal pattern of CS rates to assess the significant factors boosting this delivery in the northeastern States of India. Methods We analysed cross-sectional data from three rounds of the National Family Health Survey (NFHS 3, NFHS 4, and NFHS 5).

Evaluating the efficacy and impact of neutropenic diet in pediatric hematology patients: a longitudinal cohort study on adherence, clinical outcomes, and socioeconomic factors.

Background And Aim: A neutropenic diet aims to reduce hospitalizations from febrile neutropenia and sepsis in pediatric hematology patients during chemotherapy. This study aimed to evaluate its effectiveness in improving mortality, morbidity, and overall outcomes while considering limitations, adherence rates, and its impact on hospital admissions and culture positivity.

Method: A prospective 18-month observational study was conducted on pediatric hematology patients in a pediatric department at a tertiary care center.

Antibody-Free Immunopeptide Nano-Conjugates for Brain-Targeted Drug Delivery in Glioblastoma Multiforme.

Glioblastoma Multiforme (GBM) represents a significant clinical challenge amongst central nervous system (CNS) tumors, with a dismal mean survival rate of less than 8 months, a statistic that has remained largely unchanged for decades (National Brain Society, 2022). The specialized intricate anatomical features of the brain, notably the blood-brain barrier (BBB), pose significant challenges to effective therapeutic interventions, limiting the potential reach of modern advancements in immunotherapy to impact these types of tumors. This study introduces an innovative, actively targeted immunotherapeutic nanoconjugate (P12/AP-2/NCs) designed to serve as an immunotherapeutic agent capable of traversing the BBB via LRP-1 receptor-mediated transcytosis.

Deep transfer learning hybrid techniques for precision in breast cancer tumor histopathology classification.

The breast cancer is one of the most prevalent causes of cancer-related death globally. Preliminary diagnosis of breast cancer increases the patient's chances of survival. Breast cancer classification is a challenging problem due to dense tissue structures, subtle variations, cellular heterogeneity, artifacts, and variability.

Isometric Back Extensor Endurance and Chronic Low Back Pain in University Athletes: A Cross-Sectional Study.

Context: Chronic low back pain (CLBP) is a common problem among university athletes, negatively affecting their performance and overall health. Deconditioned back muscles due to CLBP can reduce endurance. However, there is limited research on CLBP in university athletes, especially comparing those with and without the condition.

Advancing precision cancer immunotherapy drug development, administration, and response prediction with AI-enabled Raman spectroscopy.

Molecular characterization of tumors is essential to identify predictive biomarkers that inform treatment decisions and improve precision immunotherapy development and administration. However, challenges such as the heterogeneity of tumors and patient responses, limited efficacy of current biomarkers, and the predominant reliance on single-omics data, have hindered advances in accurately predicting treatment outcomes. Standard therapy generally applies a "one size fits all" approach, which not only provides ineffective or limited responses, but also an increased risk of off-target toxicities and acceleration of resistance mechanisms or adverse effects.

Unified Mobile App for Streamlining Verbal Autopsy and Cause of Death Assignment in India: Design and Development Study.

Background: Verbal autopsy (VA) has been a crucial tool in ascertaining population-level cause of death (COD) estimates, specifically in countries where medical certification of COD is relatively limited. The World Health Organization has released an updated instrument (Verbal Autopsy Instrument 2022) that supports electronic data collection methods along with analytical software for assigning COD. This questionnaire encompasses the primary signs and symptoms associated with prevalent diseases across all age groups.