Search

Abstract Even among the subjects classified as cognitively normal, there exists a subset of individuals at a given chronological age (CA) who harbor white matter hyperintensity (WMH) while another subset presents with low or undetectable WMH. Here, we conducted a comprehensive MRI segmentation of neuroanatomic structures along with WMH quantification in groups of cognitively normal (CN), cognitively impaired (CI) individuals, and individuals with an etiological diagnosis of cognitive impairment owing to Alzheimer’s Disease (CI-AD) across the early (50–64 years), intermediate (65–79 years), and late (≥80 years) age groups from the NACC cohort. Neuroanatomic volumetry quantification revealed that thinning of the parahippocampal gyrus in the early (p = 0.016) and intermediate age groups (p = 0.0001) along with an increase in CSF (p = 0.0009) delineates between CI and CI-AD subjects. Although, a significant loss of ~5–10% in volume of gray matter (p(CN vs CI)

Major depressive disorder (MDD) is a mental ailment marked by a loss of interest in activities, persistent depression, and hopelessness. MDD has been on the rise in society in recent decades for varied reasons and has spurred suicidal tendencies among individuals. Early detection, continuous monitoring, and effective treatment are crucial for its impact on quality of life and society. EEG signal models the brain’s electrical activities and has emerged as a potential tool to assess the depression status of a person. Due to advancements in sensor technology, fast, convenient, and cost-effective EEG acquisition is now possible, resulting in many EEG-based healthcare monitoring applications in recent years. This work proposes an EEG-headset-based smart monitoring system for real-time diagnosis of MDD in the Internet of Medical Things (IoMT) framework. In this study, we proposed a novel Linear Graph Convolution Network-Transformer-based deep learning approach for categorizing MDD through a time-frequency analysis of EEG signals. The Stockwell transform (S-transform) is employed to exploit the spectro-temporal information from the EEG and the resulting 2D representation is then fed into customized Linear Graph Convolution Network for MDD detection. We have utilized the Weighted Focal Binary Hinge Loss function, specifically designed for customized Linear Graph Convolution Network, to improve learning and handle unbalanced input. Subsequently, a novel Transformer model is designed to refine the MDD classification further. The proposed methodology named SLiTRANet, blends spectral analysis with the S-transform, graph-based learning with Linear Graph Convolution Network, and the sequence modeling capability of the Transformer. The proposed SLiTRANet model can be further integrated within an IoMT framework for automated real-time MDD diagnosis using EEG signals. The proposed methodology is evaluated on two publicly available datasets, MODMA and HUSM datasets. The evaluation results demonstrate the superior performance of the proposed SLiTRANet framework against the existing pre-trained and hybrid deep learning models, achieving remarkable accuracy, sensitivity, specificity, and precision rates of 99.92%, 99.90%, 99.95%, and 99.97%, respectively on HUSM dataset followed by an equally good performance on MODMA dataset with an accuracy of 99.68%. The proposed comprehensive approach implemented on two varied datasets highlights significant advancements in depression detection by outperforming state-of-art approaches.

Abstract Women carry a higher burden of Alzheimer’s disease (AD) compared to men, which is not accounted entirely by differences in lifespan. To identify the mechanisms underlying this effect, we investigated sex-specific differences in the progression of familial AD in humans and in APPswe/PS1ΔE9 mice. Activity dependent protein translation and associative learning and memory deficits were examined in APPswe/PS1ΔE9 mice and wild-type mice. As a human comparator group, progression of cognitive dysfunction was assessed in mutation carriers and non-carriers from DIAN (Dominantly Inherited Alzheimer Network) cohort. Female APPswe/PS1ΔE9 mice did not show recall deficits after contextual fear conditioning until 8 months of age. Further, activity dependent protein translation and Akt1-mTOR signaling at the synapse were impaired in male but not in female mice until 8 months of age. Ovariectomized APPswe/PS1ΔE9 mice displayed recall deficits at 4 months of age and these were sustained until 8 months of age. Moreover, activity dependent protein translation was also impaired in 4 months old ovariectomized APPswe/PS1ΔE9 mice compared with sham female APPswe/PS1ΔE9 mice. Progression of memory impairment differed between men and women in the DIAN cohort as analyzed using linear mixed effects model, wherein men showed steeper cognitive decline irrespective of the age of entry in the study, while women showed significantly greater performance and slower decline in immediate recall (LOGIMEM) and delayed recall (MEMUNITS) than men. However, when the performance of men and women in several cognitive tasks (such as Wechsler’s logical memory) are compared with the estimated year from expected symptom onset (EYO) we found no significant differences between men and women. We conclude that in familial AD patients and mouse models, females are protected, and the onset of disease is delayed as long as estrogen levels are intact.

Background: Neuraxial ultrasound (US), a newer modality, can be used for neuraxial imaging, helping in visualizing and aiding in epidural space catheterization. The aim of this study was to evaluate the efficacy of the US for cervical epidural access and to determine the failure rate and complication associated with this technique. Methods: A prospective single-arm pilot study was conducted on 21 participants. The neuraxial US image quality assessment by Ultrasound Visibility Score (UVS), epidural space depth measurement by US and by conventional loss of resistance (LOR) technique, and post-procedure epidural catheter confirmation by real-time US were the study parameters. Any procedural complications or failure rate were recorded. The Kolmogorov–Smirnov test, paired-samples t-test, and Chi-square test were used for the statistical comparison. Results: The pre-procedural UVS by the transverse interlaminar view (x/21) was 2.81 ± 1.94 and by the oblique paramedian sagittal view was 16.66 ± 2.39 with UVS being best in the paramedian oblique sagittal view (P- value < 0.05). The comparison of depth of the epidural space identified by USG and that by the LOR technique was statistically insignificant (P = 0.83). The average puncture attempts were 1.1 ± 0.3. Post-procedure US epidural catheter confirmation score (x/3) was 1.44 ± 0.44 with either epidural space expansion or microbubbles seen or both. Conclusion: The pilot study has successfully demonstrated the implication of US for visualizing and aiding in epidural space catheterization. Also, the failure rate and procedural complications were drastically minimized with the help of US as compared to the traditional blind technique.

Abstract Recognizing entities and their corresponding roles are important in human activity recognition. In light of recent advancements, the primary emphasis is recognizing the abstract activities involving person‐person interaction. The contribution of this work is proposing an architecture, which utilizes the knowledge of the human body parts coordinates in role detection of each individual. The network preprocesses the coordinates to build intra‐body and inter‐body features. The extracted features build the relationship between the interacting bodies and learn the temporal relation corresponding to each role using the human memory‐inspired hierarchical temporal memory. The model is tested on vague samples of mutual actions in the experimental work. The model is found robust in action and role recognition tasks and performed well per expectations.

Alzheimer’s disease (AD) is an ascending, neurodegenerative disorder that attacks the brain’s nerve cells, i.e., neurons, resulting in loss of memory, language skills, and thinking and behavioural changes. It is one of the most common causes of dementia, a group of disorders that is marked by the decline of cognitive functioning. Probiotics are living microorganisms that are beneficial for human well-being. They help in balancing the extent of bacteria in the gut and support the defensive immune system of the body. Studies have found that probiotics can help with a variety of conditions, including mental health. Probiotics are beneficial bacteria that can help to maintain and strengthen a healthy gut microbiome. The gut microbiome is important for healthy brain function, as it is linked to the production of neurotransmitters and hormones that regulate mood and behaviour. This review article includes detailed review on the origination of probiotics and its significance in the treatment of AD.

The Internet of Things (IoT) is an emerging technology, which comprises wireless smart sensors and actuators. Nowadays, IoT is implemented in different areas such as Smart Homes, Smart Cities, Smart Industries, Military, eHealth, and several real-world applications by connecting domain-specific sensors. Designing a security model for these applications is challenging for researchers since attacks (for example, zero-day) are increasing tremendously. Several security methods have been developed to ensure the CIA (Confidentiality, Integrity, and Availability) for Industrial IoT (IIoT). Though these methods have shown promising results, there are still some security issues that are open. Thus, the security and authentication of IoT based applications become quite significant. In this paper, we propose TD2SecIoT (Temporal, Data-Driven and Dynamic Network Layer Based Security Architecture for Industrial IoT), which incorporates Elliptic Curve Cryptography (ECC) and Nth-degree Truncated Polynomial Ring Units (NTRU) methods to ensure confidentiality and integrity. The proposed method has been evaluated against different attacks and performance measures (quantitative and qualitative) using the Cooja network simulator with Contiki-OS. The TD2SecIoT has shown a higher security level with reduced computational cost and time.

BackgroundAldo-keto reductase 1B10 (AKR1B10) is a secretory protein that is upregulated in breast cancer.ObjectiveThis case-controlled pilot study evaluated the serum level of AKR1B10 in healthy women and patients with a localized or metastatic breast cancer.MethodsAKR1B10 levels were measured by ELISA and IHC in several patient cohorts.ResultsOur data showed that serum AKR1B10 was significantly elevated in patients with localized (6.72 ± 0.92 ng/ml) or metastatic (7.79 ± 1.13 ng/ml) disease compared to cancer-free healthy women (1.69 ± 0.17 ng/ml) (p

Abstract Background It is not established beyond doubt whether improvements in functional outcome after total knee arthroplasty (TKA) are maintained in the long term. We therefore investigated the temporal patterns of functional outcome [using range of motion (ROM), American Knee Society (AKS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Health Survey (SF-36) score] over a 5-year period after uncomplicated TKA, and whether these patterns differed by implant type and patient age. Materials and methods This prospective study evaluated 138 patients who underwent unilateral TKA with either a mobile-bearing (MB) or fixed-bearing (FB) posterior-stabilized prosthesis. An independent investigator evaluated the functional outcome at five time points: preoperatively and at 6-month, 1-year, 2-year, and 5-year follow-up. Differences in functional outcomes between adjacent time points were evaluated by mixed-effect model repeat measurement (MMRM). Results The different functional outcome scores showed improvement till 6 months–2 years, followed by a variable decline. In patients aged ≥ 68 years with an MB implant, most of the functional outcome scores declined between 2 and 5 years after variable initial improvement till 6 months–2 years, whereas the parameters plateaued after 2 years in those aged

2D electronic spectroscopy enables a spatially-averaged view of the electronic structure of a heterogeneous system. Here, the authors extend it to sub-micron resolution and ~106 times better sensitivity, to resolve spatially varying excitonic structure in a heterogeneous mixture of photosynthetic cells.

Purpose: Ensuring compliance to treatment protocol, especially regular visit to treating facility, is an important aspect of clubfoot management. However, the factors affecting compliance to follow-up schedule are myriad. Methods: A cross-sectional study was undertaken among caregivers of clubfoot patients from a tertiary referral clubfoot clinic in a developing country. Hospital records were reviewed to collect demographic data and subjects were classified as either “regular” or “irregular” if they missed ≤3 and >3 scheduled hospital visits, respectively. Various factors that could affect compliance such as family size, number of children, literacy of caregiver, occupation of breadwinner, and time taken to travel to hospital were studied. Caregivers were probed regarding the reason for their irregularity. Results: A total of 238 patients were included, of which 138 formed the “regular” group and the rest 100 formed the “irregular” group. Patients in the regular group were significantly younger (mean age 43.8 months) compared to the irregular group (59.8 months; p = 0.001). The mean follow-up period in the regular group was 28.1 months and in the irregular group was 33.8 months. On univariate analysis, age, duration of follow-up, and transport duration were found to be significant between the two groups. However, multivariate analysis revealed that female children with clubfoot are more likely to be irregular as compared to males ( p = 0.038). Conclusion: In a developing country setting, higher age and being a female child are associated with irregularity to hospital visit protocol. At clubfoot clinics, identifying these children and counseling their caregivers might improve compliance.

PRES, a reversible white matter lesion characterized by cerebral edema, found in 7–20% of the patients with preeclampsia and eclampsia, needs early diagnosis and therapeutic intervention. We report PRES in a young preeclamptic primigravida and the role of dexmedetomidine in controlling her uncontrollable blood pressure in ICU. Dexmedetomidine, has cerebroprotective cardioprotective and renoprotective properties all of which, helped the patient improving clinically.

Health-related limitations prohibit a human from working in hazardous environments, due to which cognitive robots are needed to work there. A robot cannot learn the spatial semantics of the environment or object, which hinders the robot from interacting with the working environment. To overcome this problem, in this work, an agent is computationally devised that mimics the grid and place neuron functionality to learn cognitive maps from the input spatial data of an environment or an object. A novel quadrant-based approach is proposed to model the behavior of the grid neuron, which, like the real grid neuron, is capable of generating periodic hexagonal grid-like output patterns from the input body movement. Furthermore, a cognitive map formation and their learning mechanism are proposed using the place–grid neuron interaction system, which is meant for making predictions of environmental sensations from the body movement. A place sequence learning system is also introduced, which is like an episodic memory of a trip that is forgettable based on their usage frequency and helps in reducing the accumulation of error during a visit to distant places. The model has been deployed and validated in two different spatial data learning applications, one being the 2D object detection by touch, and another is the navigation in an environment. The result analysis shows that the proposed model is significantly associated with the expected outcomes.

Introduction: To analyze the pattern of brain metastasis (BM), and to use intensity modulated radiation therapy (IMRT) for target dose escalation in cases with ≤3 metastatic lesions (oligometastases). Materials and Methods: Thirty-two consecutive cases of BM treated during September 2009 to August 2012 were analyzed retrospectively. Results: The study comprised 13 males (40.62%) and 19 females (59.37%). Thirteen (40%) patients presented with disseminated intracranial metastases, while 19 (60%) had ≤3 foci. In 25 cases (78%), the primary was located either in the breast (14 cases) or lung (11 cases). The 13 patients with disseminated intracranial metastases received whole brain radiation therapy to a dose of 30 Gy/10-12 daily fractions (Group A) while the 19 cases with ≤3 lesions received an additional dose of 6-10 Gy to gross lesions using a simultaneous integrated boost (SIB) with IMRT thus receiving a total dose of 36-40 Gy/12-15 fractions (Group B). Overall survival (OS) for the breast primary was 6.3 and lung primary was 5.3 months, respectively. The mean OS for breast cases in Group B was higher (9.5 months) as compared to Group A cases (1.9 months) and was statistically significant (P = 0.0056). Similarly, primary lung cancer cases in Group B showed a mean OS of 8.75 months versus 2.6 months for Group A cases (P = 0.213). Conclusions: IMRT is a safe and effective technique in cases with oligometastases for dose escalation in the form of SIB.

Introduction: The prevalence of Head and Neck Cancers (HNC) is very high in the Indian subcontinent. Radiotherapy is an essential modality in the management of HNC. Aim: The aim of the present study was to compare toxicities of two radiotherapy fractionation regimen (conventional fractionation and concomitant boost technique) for the management of HNC. Materials and Methods: A total of 60 patients (n=30 in each arm) were assigned to receive either conventional fractionation or concomitant boost radiotherapy. Toxicities were analysed weekly during the treatment, and one and three month after treatment completion. The radiation therapy oncology group acute radiation morbidity scoring system was used to document the severity. Toxicities assessed were mucositis, skin reactions, dysphagia and xerostomia. Statistical analysis was done by the online Graphpad software using Chi-square test. A value of p

Alzheimer’s disease (AD) is an age-related neurodegenerative disorder, characterized by progressive loss of cognitive functions and memory. Excessive intake of aluminum chloride in drinking water is associated with amyloid plaques and neurofibrillary tangles in the brain, which are the hallmark of AD. We have evaluated brain energy metabolism in aluminum chloride (AlCl3) mouse model of AD. In addition, effectiveness of Rasa Sindoor (RS), a formulation used in Indian Ayurvedic medicine, for alleviation of symptoms of AD was evaluated. Mice were administered AlCl3 (40 mg/kg) intraperitoneally once a day for 60 days. The memory of mice was measured using Morris Water Maze test. The 13C labeling of brain amino acids was measured ex vivo in tissue extracts using 1H-[13C]-NMR spectroscopy with timed infusion of [1,6-13C2]glucose. The 13C turnover of brain amino acids was analyzed using a three-compartment metabolic model to derive the neurotransmitter cycling and TCA cycle rates associated with glutamatergic and GABAergic pathways. Exposure of AlCl3 led to reduction in memory of mice. The glutamatergic and GABAergic neurotransmitter cycling and glucose oxidation were found to be reduced in the cerebral cortex, hippocampus, and striatum following chronic AlCl3 treatment. The perturbation in metabolic rates was highest in the cerebral cortex. However, reduction in metabolic fluxes was higher in hippocampus and striatum following one month post AlCl3 treatment. Most interestingly, oral administration of RS (2 g/kg) restored memory as well as the energetics of neurotransmission in mice exposed to AlCl3. These data suggest therapeutic potential of RS to manage cognitive functions and memory in preclinical AD.

Objective: To evaluate the prognostic significance of serum Zinc (S.Zn) in locally advanced cancer cervix (LACC) patients treated with chemo-irradiation. Materials and Methods: S.Zn values in 34 females with histopathologically (HP) proven LACC (>/= stage II B) were prospectively measured using atomic absorption spectrophotometer pre- and post-treatment. Thirty-four age- and sex-matched healthy individuals were also evaluated for the parameter during the course of the study. After completion of treatment, the patients were divided into 2 groups based on the response, 1 - Complete response (CR) and 2 - Partial/No response (PR/NR). These groups were compared based on the observations of the studied parameter. Results: The mean post-treatment S.Zn values were significantly higher in group 1 as compared to group 2 (P < 0.05). Conclusion: In our study, patients achieving CR had higher mean levels of S.Zn compared to patients achieving PR/NR. We advocate further in-depth studies to evaluate the role of S.Zn in the prognosis of LACC patients treated with chemo-irradiation.

WDR13 expresses from the X chromosome and has a highly conserved coding sequence. There have been multiple associations of WDR13 with memory. However, its detailed function in context of brain and behavior remains unknown. We characterized the behavioral phenotype of two months old male mice lacking the homologue of WDR13 gene (Wdr13-/0). Taking cue from analysis of its expression in the brain, we chose hippocampus for molecular studies to delineate its function. Wdr13-/0 mice spent less time in the central area of the open field test and with the novel object in novel object recognition test as compared to the wild-type. However, these mice didn’t show any significant changes in total time spent in arms or frequency of arm entries in elevated plus maze. In the absence of Wdr13, there was a significant upregulation of synaptic proteins, viz., SYN1, RAB3A, CAMK2A etc accompanied with increased spine density of hippocampal CA1 neurons and better spatial memory in mice as measured by increased time spent in target quadrant of Morris water maze during probe test. Parallel study from our lab has established c-JUN, ER α/ β and HDAC 1,3,7 as interacting partners of WDR13. WDR13 represses transcription from AP1 (c-JUN responsive) and ERE (Estrogen Receptor Element) promoters. We hypothesized that absence of Wdr13 would resulted in de-regulated expression of a number of genes including multiple synaptic genes leading to the observed phenotype. Knocking down Wdr13 in Neuro2a cell lines led to increased transcripts of Camk2a and Nrxn2 consistent with in-vivo results. Summarily, our data provides functional evidence for the role of Wdr13 in brain.

Background: The incidence of cancer is increasing throughout the world. One of the prime aims of its management is early diagnosis and therapeutic intervention. Factors causing delay to either of these goals should be identified and rectified. Aim: To identify the factors causing delayed initial diagnosis and subsequent management in patients presenting to the Oncology department. Materials and Methods: Three hundred proven cancer patients were prospectively evaluated for the pattern of presentation to the outpatient Department of Radiation Oncology of a Government Medical College (MC) in Central India. Results: The mean age of presentation was 51.05 years (range 7 months-77 years). The number of male patients was 168 while females were 132. The duration of symptoms ranged from 20 days to 3 years. The number of patients with little/no education presented mainly in advanced stages as compared to their educated counterpart and this difference was statistically significant (p

Abstract: An ecological optimization along with a detailed parametric study of an irreversible regenerative Brayton heat engine with isothermal heat addition have been carried out with external as well as internal irreversibilities. The ecological function is defined as the power output minus the power loss (irreversibility) which is ambient temperature times the entropy generation rate. The external irreversibility is due to finite temperature difference between the heat engine and the external reservoirs while the internal irreversibilities are due to nonisentropic compression and expansion processes in the compressor and the turbine respectively and the regenerative heat loss. The ecological function is found to be an increasing function of the isothermal-, sink- and regenerative-side effectiveness, isothermal-side inlet temperature, component efficiencies and sink-side temperature while it is found to be a decreasing function of the isobaric-side temperature and effectiveness and the working fluid heat capacitance rate. The effects of the isobaric-side effectiveness are found to be more than those of the other parameters and the effects of turbine efficiency are found to be more than those of the compressor efficiency on all the performance parameters of the cycle.

A total of 51 cases of young females aged between 18-35 years were prospectively studied for the presentation in a Rural Charitable Cancer hospital in north India during the period August 2011 to April 2012. Breast related symptoms comprised 27 (52.94%) cases, out of which 10 (19.60%) were proven malignant. Other cases seen were Gynecological (Gyn) 8 (15.68%), Head and Neck (H and N) 5 (9.80%), Gastrointestinal (GI) 4 (7.84%), Lymphomas 3 (5.88%) and 2 (3.92%) cases each of Bone Tumors and Central Nervous System (CNS) tumors. Breast related symptoms constituted the major presentation in young females (aged 18-35 years) in our Rural Cancer Hospital. This high percentage of Breast related symptoms points towards the increasing trend of Breast malignancies possibly overtaking cancer cervix in rural India, as already in the urban settlements of India as well as the increasing awareness in the females of rural India regarding early symptoms of carcinoma Breast.

The present study investigates the impact that Job Satisfaction (JS) has on the Organizational Commitment (OC) level of industrial workers and also finds out whether Job Involvement (JI) moderates the relationship between JS and OC. The study has been conducted on 600 employees belonging to different departments of Diesel Locomotive Works (DLW), which is one of the public sector giants of India. Relationship between JS and OC has been established with the help of a 2 × 2 factorial design, and moderation effect of JI on the relationship between JS and OC has been checked with the help of hierarchical multiple regression analysis. The results of the investigation have come out with the findings that OC is positively related to JS. Also, JI does moderate the relationship between JS and OC but in a negative way, and the impact has been found to be weak.