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Adults with Down syndrome are less likely to have hypertension than neurotypical adults. However, whether blood pressure measures are associated with brain health and clinical outcomes in this population has not been studied in detail. Here, we assessed whether pulse pressure is associated with markers of cerebrovascular disease and is linked to a diagnosis of dementia in adults with Down syndrome via structural imaging markers of cerebrovascular disease and atrophy. The study included participants with Down syndrome from the Alzheimers Disease - Down Syndrome study (n = 195, age = 50.6 ± 7.2 years, 44% women, 18% diagnosed with dementia). Higher pulse pressure was associated with greater global, parietal and occipital white matter hyperintensity volume but not with enlarged perivascular spaces, microbleeds or infarcts. Using a structural equation model, we found that pulse pressure was associated with greater white matter hyperintensity volume, which in turn was related to increased neurodegeneration, and subsequent dementia diagnosis. Pulse pressure is an important determinant of brain health and clinical outcomes in individuals with Down syndrome despite the low likelihood of frank hypertension.

INTRODUCTION: Virtually all people with Down syndrome (DS) develop neuropathology associated with Alzheimers disease (AD). Atrophy of the hippocampus and entorhinal cortex (EC), as well as elevated plasma concentrations of neurofilament light chain (NfL) protein, are markers of neurodegeneration associated with late-onset AD. We hypothesized that hippocampus and EC gray matter loss and increased plasma NfL concentrations are associated with memory in adults with DS. METHODS: T1-weighted structural magnetic resonance imaging (MRI) data were collected from 101 participants with DS. Hippocampus and EC volume, as well as EC subregional cortical thickness, were derived. In a subset of participants, plasma NfL concentrations and modified Cued Recall Test scores were obtained. Partial correlation and mediation were used to test relationships between medial temporal lobe (MTL) atrophy, plasma NfL, and episodic memory. RESULTS: Hippocampus volume, left anterolateral EC (alEC) thickness, and plasma NfL were correlated with each other and were associated with memory. Plasma NfL mediated the relationship between left alEC thickness and memory as well as hippocampus volume and memory. DISCUSSION: The relationship between MTL gray matter and memory is mediated by plasma NfL levels, suggesting a link between neurodegenerative processes underlying axonal injury and frank gray matter loss in key structures supporting episodic memory in people with DS.

This case report describes the imaging findings of an older-aged male presenting with infectious respiratory symptoms. Evaluation with routine contrast-enhanced CT of the chest demonstrated pulmonary artery filling defects initially treated as a pulmonary embolism. However, short-term repeat imaging during pulmonary angiographic and delayed phases demonstrated retrograde filling through a systemic arterial-pulmonary arterial shunt. Given the high prevalence of pulmonary embolism which is also the leading cause of pulmonary angiographic filling defects, this case highlights the importance for clinicians to maintain a differential diagnosis and consider alternative etiologies.

Abstract The purpose of the study was to assess the effects of a novel technique involving facial stretching of the unaffected side along with a structured exercise for the affected side on facial symmetry and facial functions as compared to conventional exercise. A hospital-based parallel-group randomized trial was completed among patients with acute Bell’s palsy in Mangalore, India. Participants were randomized to receive facial stretching and a structured exercise program (experimental group) or the conventional exercise regimen (conventional group). Primary outcomes were facial symmetry and voluntary movement; assessed by the Sunnybrook Facial Grading System (SFGS). Both regimens were given for 3 weeks, with baseline, 10th day, and 20th day assessments. Out of 31 participants screened, 24 were eligible and 12 participants each were assigned to experimental and conventional groups. Change scores revealed greater improvement in the SFGS score (p = 0.002) for the experimental group participants. Facial stretching and structured exercise program exhibited promising results in enhancing facial symmetry and function in acute Bell’s palsy when compared to conventional exercise regimen.

IntroductionRice is a primary food source almost for more than 50% of the total world's population. Glycemic index (GI) is high in most of the rice varieties, limiting their consumption by diabetic and obese people. As a result, developing new rice varieties with low GI necessitates a thorough understanding of starch biogenesis gene expression and its interrelationship.MethodsA total 200 rice genotypes were analyzed for total starch content (TSC), amylopectin content (APC), and amylose content (AC). The clustering of these rice genotypes was done based on their AC. Further, these genotypes were categorized into three groups up to 10% amylose-low, 10–26% amylose-medium, and more than 26% amylose-high. Among them, six genotypes 1 from low AC (NJ-72), 2 from medium AC (UPRI-2003-18, PRR-126), and 3 from high AC (RNRM-7, Urvashi and Ananga) were selected. The genotypes selected from the medium and high AC groups were having 2% amylose variation among themselves respectively and they were further used to study the level of RS, protein content (PC), fatty acid (FA) profiles, and granule morphology along with low group sample.ResultsResistant starch (RS) content ranged from 0.33–2.75%, and fatty acid profiling revealed high levels of palmitic, linoleic, and oleic acids. The degree of crystallinity and APC% were found to be positively correlated. Ananga, the genotype with the highest RS, displayed compact starch granules. Further, NJ-72 showing low RS and Ananga with high RS were selected for investigation of enzymatic activities of starch biosynthesis, metabolites accumulation, and expressions of 20 starch biogenesis genes in developing endosperm. Starch branching enzymes (SBE) and starch synthase (SS) activities peaked at 13 days after anthesis (DAA), while starch debranching enzymes (DBE) were most active at 18 DAA. In Ananga, TSC, AC, APC, and RS levels progressively increased from 3 to 23 DAA. Ananga showed 1.25-fold upregulation of granule-bound starch synthase I (GBSSI) at 18DAA. Higher expressions of SSI and SBEIIb were observed in NJ-72 at 13DAA. PUL2 was predominantly expressed followed by ISA1. GBSSI was positively correlated with both AC and RS while SS, SBE, and DBE were positively related to APC.ConclusionThis research could lead to the development of rice varieties with improved nutritional qualities, such as higher RS content, which is beneficial for human health due to its role in lowering glycemic response and promoting gut health. Additionally, the study provides insights into how the modulation of key genes and enzymes can affect starch composition, offering strategies to breed rice varieties tailored for specific dietary needs or industrial applications.

Brain tumors are one of the most severe medical conditions that require immediate attention and treatment. The early detection of brain tumors is of utmost importance, as it can significantly improve the chances of successful treatment outcomes and increase the patient's quality of life. This study proposes a novel methodology for the early detection of brain tumors in magnetic resonance imaging (MRI) images using a modified VGG16 neural network architecture. The dataset comprises both tumor and non-tumor MRI images collected from Kaggle and has preprocessing techniques applied to optimize the model's performance. The proposed approach delivers an impressive accuracy rate of 99.08%, demonstrating its efficacy in precise brain tumor detection. This new methodology is expected to aid doctors in accurate diagnosis and treatment planning, thereby helping to save more lives and improve the quality of life of patients suffering from brain tumors.

Background: The coronavirus (COVID-19) pandemic has affected people's economies, lifestyles, and physical, emotional, and sleep health. This research aimed to estimate the prevalence of insomnia and symptoms of stress, anxiety, and depression among teachers with the resumption of in-person instruction at schools following a hiatus after COVID-19 lockdowns in India. We also studied the association of teachers' insomnia with psychological symptoms and demographic variables. Methods: We conducted a cross-sectional survey between October –November 2021 after schools had reopened during the COVID-19 pandemic. Data was collected using standard questionnaires online among schoolteachers. We explored the association of insomnia with teachers' symptoms of stress, anxiety, depression, sex, school boards, and age groups. Results: Of 124 schoolteachers surveyed, the prevalence of insomnia was 37.9% (subthreshold in 25% and clinical in 12.9%). The prevalence of stress, depression, and anxiety was 20.2%, 30.6%, and 45.2%, respectively. There was a significant association (p

While the benefits of early antiretroviral therapy (ART) initiation in perinatally infected infants are well documented, early initiation is not always possible in postnatal pediatric HIV infections. The timing of ART initiation is likely to affect the size of the latent viral reservoir established, as well as the development of adaptive immune responses, such as the generation of neutralizing antibody responses against the virus. How these parameters impact the ability of infants to control viremia and the time to viral rebound after ART interruption is unclear and has never been modeled in infants. To investigate this question we used an infant nonhuman primate Simian/Human Immunodeficiency Virus (SHIV) infection model. Infant Rhesus macaques (RMs) were orally challenged with SHIV.C.CH505 375H dCT and either given ART at 4-7 days post-infection (early ART condition), at 2 weeks post-infection (intermediate ART condition), or at 8 weeks post-infection (late ART condition). These infants were then monitored for up to 60 months post-infection with serial viral load and immune measurements. To gain insight into early after analytic treatment interruption (ATI), we constructed mathematical models to investigate the effect of time of ART initiation in delaying viral rebound when treatment is interrupted, focusing on the relative contributions of latent reservoir size and autologous virus neutralizing antibody responses. We developed a stochastic mathematical model to investigate the joint effect of latent reservoir size, the autologous neutralizing antibody potency, and CD4+ T cell levels on the time to viral rebound for RMs rebounding up to 60 days post-ATI. We find that the latent reservoir size is an important determinant in explaining time to viral rebound in infant macaques by affecting the growth rate of the virus. The presence of neutralizing antibodies can also delay rebound, but we find this effect for high potency antibody responses only. Finally, we discuss the therapeutic implications of our findings.

Millimeter wave communication systems design requires accurate pathloss prediction as well as optimization. Traditional pathloss models gives less accuracy therefore pathloss models using deep learning is alternative solution for traditional method. These methods overcome the time consuming pathloss prediction parameter prediction based on large dataset which is available for different frequencies. In this proposed work, for prediction of pathloss, Convolutional Neural Network (CNN) and for optimization of pathloss Particle Swarm Optimization (PSO) is proposed. Towards implementation of the same, outdoor scenario with two roads and one cross section is used and dataset is generated using DeepMIMO generic dataset. The simulation result shows that using optimization technique reduces pathloss and CNN give accurate prediction of 95.7 %. Furthermore, root mean square error value of 6.6 dB has been achieve which is less in comparison to alternative approaches designed for outdoor environments. The forthcoming development of multifrequency path loss models has sparked significant interest due to their forecasting ability to support higher frequency bands and address blockage scenarios within future wireless networks.

Abstract The global warming crisis, together with environmental concerns, has already led governments to replace traditional fossil‐fuel cars with low‐emission Electric Vehicles (EVs). This replacement has resulted in the addition of a large number of EVs capable of connecting to the grid. A coordinated charging method is needed to promote EVs on a large scale while preventing grid overloading. In this work, EVs are categorized based on their battery capacity, as cars, trucks, and buses. A charging/discharging mechanism based on Real Time Pricing for each hour is developed for a 20‐min block that has been formed. The locations of EV charging stations have been identified using Voltage Stability Index. In the present work, the power loss when Distributed Generator (DG) units are deployed after the EVs are located in the system for charging and discharging is analyzed. The DGs are considered as solar‐based or wind‐based generators for studying the economic benefit of such an investment under two different weather scenarios and topologies on standard test systems. The results thus obtained give an insight into the various technical and economic benefits.

Background: Hypertrophy of inferior turbinate (IT) may arise from soft tissue and/or bony enlargement and is most related to inflammatory rhinitis. We aimed to study and compare the histopathological changes in the IT mucosa, submucosa, and bone in chronic rhinosinusitis with (CRSwNP) and without nasal polyps (CRSsNP). Methods: The specimens of the IT in patients who underwent endoscopic sinus surgery and inferior turbinoplasty (ITplasty) were included and studied under the microscope in the high-power field. The changes in the mucosa, submucosa, and bone were studied, graded accordingly, and compared between the 2 groups. Results: In the mucosa, there was no significant difference in the polymorphonuclear neutrophils (PMN) and lymphocytic counts; however, the eosinophilic count in the mucosa was significantly higher in CRSwNP (P = .001). There was no significant difference in basement membrane thickness or subepithelial oedema. However, the lymphocyte count was higher in CRSsNP (P = .003), and the eosinophilic count was higher in CRSwNP (P = .001). The bone did not show inflammation. The significant osteitic changes in the bone were periosteal thickening with osteoblastic activity (P = .016). Conclusion: The mucosa and submucosa had a significant change in CRSwNP related to the eosinophilic infiltrates. In the submucosa, the lymphocyte count was significantly higher in CRSsNP. The osteitic changes seen were limited to periosteal thickening with minimal osteoblastic activity in both groups, but were significantly higher in CRSsNP. Hence, we can resect only the effected mucosa and spare bone during ITplasty in cases of CRSwNP, and IT bone may be partly resected in CRSsNP patients.

Abstract UK Biobank is a large-scale epidemiological resource for investigating prospective correlations between various lifestyle, environmental, and genetic factors with health and disease progression. In addition to individual subject information obtained through surveys and physical examinations, a comprehensive neuroimaging battery consisting of multiple modalities provides imaging-derived phenotypes (IDPs) that can serve as biomarkers in neuroscience research. In this study, we augment the existing set of UK Biobank neuroimaging structural IDPs, obtained from well-established software libraries such as FSL and FreeSurfer, with related measurements acquired through the Advanced Normalization Tools Ecosystem. This includes previously established cortical and subcortical measurements defined, in part, based on the Desikan-Killiany-Tourville atlas. Also included are morphological measurements from two recent developments: medial temporal lobe parcellation of hippocampal and extra-hippocampal regions in addition to cerebellum parcellation and thickness based on the Schmahmann anatomical labeling. Through predictive modeling, we assess the clinical utility of these IDP measurements, individually and in combination, using commonly studied phenotypic correlates including age, fluid intelligence, numeric memory, and several other sociodemographic variables. The predictive accuracy of these IDP-based models, in terms of root-mean-squared-error or area-under-the-curve for continuous and categorical variables, respectively, provides comparative insights between software libraries as well as potential clinical interpretability. Results demonstrate varied performance between package-based IDP sets and their combination, emphasizing the need for careful consideration in their selection and utilization.

Abstract Electric Vehicles (EV) have the potential to completely transform the transportation industry, reduce carbon emissions significantly, and pave the road for significant climate progress. According to surveys, worries regarding range and charging accessibility are a significant barrier to EV customer adoption. The electricity grid will be significantly impacted by EV charging. A coordinated charging approach that facilitates EV charging while avoiding the power grid from overloading is required to manage EV charging. In this work, the EVs are classified based on their charging capacity. This classification includes car, truck, and bus. With this a charging discharging scheme has been established using Real Time Pricing for each hour for a 20‐min block. The Voltage Stability Index (VSI) for the system is calculated for the system and the strongest bus is identified for locating the EVs to charge/discharge. Augmenting this, in the present work, the power loss is analyzed when Distributed Generation (DG) units are installed after the EVs are located in the system for charging and discharging. The DG units are installed in each feeder, considering the VSI and Penetration Level (PL) and the power losses incurred due to the presence of EVs. The Monetary benefit of such an investment is analyzed for different topologies of IEEE‐33 and 69 bus systems and compared with the existing methods where DGs are installed before the EVs are located in the system for charging and discharging.

OBJECTIVE: Cognitive loss in older adults is a growing issue in our society, and there is a need to develop inexpensive, simple, effective in-home treatments. This study was conducted to explore the use of olfactory enrichment at night to improve cognitive ability in healthy older adults. METHODS: Male and female older adults (N = 43), age 60-85, were enrolled in the study and randomly assigned to an Olfactory Enriched or Control group. Individuals in the enriched group were exposed to 7 different odorants a week, one per night, for 2 h, using an odorant diffuser. Individuals in the control group had the same experience with de minimis amounts of odorant. Neuropsychological assessments and fMRI scans were administered at the beginning of the study and after 6 months. RESULTS: A statistically significant 226% improvement was observed in the enriched group compared to the control group on the Rey Auditory Verbal Learning Test and improved functioning was observed in the left uncinate fasciculus, as assessed by mean diffusivity. CONCLUSION: Minimal olfactory enrichment administered at night produces improvements in both cognitive and neural functioning. Thus, olfactory enrichment may provide an effective and low-effort pathway to improved brain health.

The perforant path, the white matter bundle connecting the entorhinal cortex (ERC) with the hippocampal formation deteriorates with age-related cognitive decline. Previous investigations using diffusion-weighted MRI to quantify perforant path integrity in-vivo have been limited due to image resolution or have quantified the perforant path using methods susceptible to partial volume effects such as the tensor model and without consideration of its 3-dimensional morphology. In this investigation, we use quantitative-anisotropy informed tractography derived from ultra-high resolution diffusion imaging (ZOOMit) to investigate structural connectivity of the perforant path and other medial temporal lobe (MTL) pathways in older adults (63 to 98 years old, n = 51). We show that graph density within the MTL declines with age and is associated with lower delayed recall performance. We also show that older age and poorer delayed recall are associated with reduced streamlines connecting the ERC and dentate gyrus of the hippocampus (the putative perforant path). This work suggest that intra-MTL connectivity may new candidate biomarkers for age-related cognitive decline.

White matter hyperintensities are a marker of small vessel cerebrovascular disease that are strongly related to cognition in older adults. Similarly, medial temporal lobe atrophy is well-documented in aging and Alzheimer's disease and is associated with memory decline. Here, we assessed the relationship between lobar white matter hyperintensities, medial temporal lobe subregional volumes, and hippocampal memory in older adults. We collected MRI scans in a sample of 139 older adults without dementia (88 females, mean age (SD) = 76.95 (10.61)). Participants were administered the Rey Auditory Verbal Learning Test (RAVLT). Regression analyses tested for associations among medial temporal lobe subregional volumes, regional white matter hyperintensities and memory, while adjusting for age, sex, and education and correcting for multiple comparisons. Increased occipital white matter hyperintensities were related to worse RAVLT delayed recall performance, and to reduced CA1, dentate gyrus, perirhinal cortex (Brodmann area 36), and parahippocampal cortex volumes. These medial temporal lobe subregional volumes were related to delayed recall performance. The association of occipital white matter hyperintensities with delayed recall performance was fully mediated statistically only by perirhinal cortex volume. These results suggest that white matter hyperintensities may be associated with memory decline through their impact on medial temporal lobe atrophy. These findings provide new insights into the role of vascular pathologies in memory loss in older adults and suggest that future studies should further examine the neural mechanisms of these relationships in longitudinal samples.

Mnemonic discrimination, a cognitive process that relies on hippocampal pattern separation, is one of the first memory domains to decline in aging and preclinical Alzheimer's disease. We tested whether functional connectivity (FC) within the entorhinal-hippocampal circuit, measured with high-resolution resting state fMRI, is associated with mnemonic discrimination and amyloid-β (Aβ) pathology in a sample of 64 cognitively normal human older adults (mean age, 71.3 ± 6.4 years; 67% female). FC was measured between entorhinal-hippocampal circuit nodes with known anatomical connectivity, as well as within cortical memory networks. Aβ pathology was measured with 18F-florbetapir-PET, and neurodegeneration was assessed with subregional volume from structural MRI. Participants performed both object and spatial versions of a mnemonic discrimination task outside of the scanner and were classified into low-performing and high-performing groups on each task using a median split. Low object mnemonic discrimination performance was specifically associated with increased FC between anterolateral entorhinal cortex (alEC) and dentate gyrus (DG)/CA3, supporting the importance of this connection to object memory. This hyperconnectivity between alEC and DG/CA3 was related to Aβ pathology and decreased entorhinal cortex volume. In contrast, spatial mnemonic discrimination was not associated with altered FC. Aβ was further associated with dysfunction within hippocampal subfields, particularly with decreased FC between CA1 and subiculum as well as reduced volume in these regions. Our findings suggest that Aβ may indirectly lead to memory impairment through entorhinal-hippocampal circuit dysfunction and neurodegeneration and provide a mechanism for increased vulnerability of object mnemonic discrimination.SIGNIFICANCE STATEMENT Mnemonic discrimination is a critical episodic memory process that is performed in the dentate gyrus (DG) and CA3 subfield of the hippocampus, relying on input from entorhinal cortex. Mnemonic discrimination is particularly vulnerable to decline in older adults; however, the mechanisms behind this vulnerability are still unknown. We demonstrate that object mnemonic discrimination impairment is related to hyperconnectivity between the anterolateral entorhinal cortex and DG/CA3. This hyperconnectivity was associated with amyloid-β pathology and neurodegeneration in entorhinal cortex, suggesting aberrantly increased network activity is a pathological process. Our findings provide a mechanistic explanation of the vulnerability of object compared to spatial mnemonic discrimination in older adults and has translational implications for choice of outcome measures in clinical trials for Alzheimer's disease.

Cerebrovascular disease is associated with symptoms and pathogenesis of Alzheimer's disease (AD) among adults with Down syndrome (DS). The cause of increased dementia-related cerebrovascular disease in DS is unknown. We explored whether protein markers of neuroinflammation are associated with markers of cerebrovascular disease among adults with DS. Participants from the Alzheimer's disease in Down syndrome (ADDS) study with magnetic resonance imaging (MRI) scans and blood biomarker data were included. Support vector machine (SVM) analyses examined the relationship of blood-based proteomic biomarkers with MRI-defined cerebrovascular disease among participants characterized as having cognitive decline (n = 36, mean age ± SD = 53 ± 6.2) and as being cognitively stable (n = 78, mean age = 49 ± 6.4). Inflammatory and AD markers were associated with cerebrovascular disease, particularly among symptomatic individuals. The pattern suggested relatively greater inflammatory involvement among cognitively stable individuals and greater AD involvement among those with cognitively decline. The findings help to generate hypotheses that both inflammatory and AD markers are implicated in cerebrovascular disease among those with DS and point to potential mechanistic pathways for further examination.

Medial temporal lobe (MTL) atrophy is a core feature of age-related cognitive decline and Alzheimer's disease (AD). While regional volumes and thickness are often used as a proxy for neurodegeneration, they lack the sensitivity to serve as an accurate diagnostic test and indicate advanced neurodegeneration. Here, we used a submillimeter resolution diffusion weighted MRI sequence (ZOOMit) to quantify microstructural properties of hippocampal subfields in older adults (63-98 years old) using tensor derived measures: fractional anisotropy (FA) and mean diffusivity (MD). We demonstrate that the high-resolution sequence, and not a standard resolution sequence, identifies dissociable profiles for CA1, dentate gyrus (DG), and the collateral sulcus. Using ZOOMit, we show that advanced age is associated with increased MD of the CA1 and DG as well as decreased FA of the DG. Increased MD of the DG, reflecting decreased cellular density, mediated the relationship between age and word list recall. Further, increased MD in the DG, but not DG volume, was linked to worse spatial pattern separation. Our results demonstrate that ultrahigh-resolution diffusion imaging enables the detection of microstructural differences in hippocampal subfield integrity and will lead to novel insights into the mechanisms of age-related memory loss.