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We report a 6-month-old female baby, with dysmorphic facies, recurrent respiratory tract infections, and failure to thrive. A detailed search for genetic causes of failure to thrive including next-generation sequencing revealed the diagnosis of a very rare entity; Marshall–Smith syndrome, a syndrome with very high early mortality. On further evaluation, she was noted to have disordered osseous maturation. She is now on regular follow-up for early intervention and rehabilitation.

The aim of this article is to depict the role of removable appliances in current, con- impermanent orthodontics, and to examine how this job has changed as of late. For the reasons for this article we will not talk about removable appliances that are utilized consistently and effectively for development modication (Functional appliances) or retention (retainers). This article will zero in on removable utilized as dynamic appliances. How removable appliances work. Removable appliances work by straightforward tipping developments of the crowns of the teeth about a support near the center of the Tooth. They likewise permit differential emission of teeth, for instance by utilizing nibble planes. They contrast from xed appliances, which are equipped for complex developments of multiple teeth, including in essence movement, root force and revolution.

The relationship between temporal lobe epilepsy and psychopathology has had a long and contentious history with diverse views regarding the presence, nature and severity of emotional–behavioural problems in this patient population. To address these controversies, we take a new person-centred approach through the application of unsupervised machine learning techniques to identify underlying latent groups or behavioural phenotypes. Addressed are the distinct psychopathological profiles, their linked frequency, patterns and severity and the disruptions in morphological and network properties that underlie the identified latent groups. A total of 114 patients and 83 controls from the Epilepsy Connectome Project were administered the Achenbach System of Empirically Based Assessment inventory from which six Diagnostic and Statistical Manual of Mental Disorders-oriented scales were analysed by unsupervised machine learning analytics to identify latent patient groups. Identified clusters were contrasted to controls as well as to each other in order to characterize their association with sociodemographic, clinical epilepsy and morphological and functional imaging network features. The concurrent validity of the behavioural phenotypes was examined through other measures of behaviour and quality of life. Patients overall exhibited significantly higher (abnormal) scores compared with controls. However, cluster analysis identified three latent groups: (i) unaffected, with no scale elevations compared with controls (Cluster 1, 37%); (ii) mild symptomatology characterized by significant elevations across several Diagnostic and Statistical Manual of Mental Disorders-oriented scales compared with controls (Cluster 2, 42%); and (iii) severe symptomatology with significant elevations across all scales compared with controls and the other temporal lobe epilepsy behaviour phenotype groups (Cluster 3, 21%). Concurrent validity of the behavioural phenotype grouping was demonstrated through identical stepwise links to abnormalities on independent measures including the National Institutes of Health Toolbox Emotion Battery and quality of life metrics. There were significant associations between cluster membership and sociodemographic (handedness and education), cognition (processing speed), clinical epilepsy (presence and lifetime number of tonic–clonic seizures) and neuroimaging characteristics (cortical volume and thickness and global graph theory metrics of morphology and resting-state functional MRI). Increasingly dispersed volumetric abnormalities and widespread disruptions in underlying network properties were associated with the most abnormal behavioural phenotype. Psychopathology in these patients is characterized by a series of discrete latent groups that harbour accompanying sociodemographic, clinical and neuroimaging correlates. The underlying neurobiological patterns suggest that the degree of psychopathology is linked to increasingly dispersed abnormal brain networks. Similar to cognition, machine learning approaches support a novel developing taxonomy of the comorbidities of epilepsy.

The usage of probiotics is becoming more common because of the mounting body of research demonstrating its advantages for human health. Of late probiotics have transitioned to a highly promising prophylactic measure that affords colonization resistance against multitude of pathogens. A crucial defence mechanism in the human body against numerous illnesses, especially urogenital ones, is the vaginal microbiota. The present study focuses on screening and isolation of culturable vaginal commensal microbiota from 54 healthy Indian women, and explore its putative probiotic traits such as coaggregation, antagonistic action against uropathogens, ability to form biofilms, antibiotic sensitivity, adhesion properties, etc. In addition, how oestradiol might affect isolated vaginal probiotics in both planktonic and biofilm states were also explored. The purpose of this work was to build a preliminary probiotics topography, specifically a Lactobacilli cartography, from a healthy Indian women cohort, characterize them at the molecular level, and interpret the key activities which were needed for the design and use probiotics as an antimicrobial sparing therapy to curtail UTI infection on the face of rising antimicrobial resistance. Our long-term goal of this work is to develop feminine hygiene product that is incorporated with probiotics to protect against pathogen colonisation without creating dysbiosis and improve women's quality of life.

Brain-computer interface (BCI)-mediated functional electrical stimulation (FES) of stroke impaired upper extremity motor function has been shown to improve motor capacity but accurate dosing of BCI-FES has not been determined. This analysis seeks to determine whether participants with a greater number of FES runs realized greater change in the Stroke Impact Scale-Hand Function subdomain (SIS-hf) as a result of intervention. Participants (n = 14, 8 females, mean age = 61.3 ± 11.5 yr) in an ongoing study completed up to 30 hours of BCI-FES intervention. These participants were grouped post hoc into two groups, high (greater than 184 runs) and low (less than 184 runs) dosages of BCI-FES intervention. All participants underwent a series of behavioral tests at baseline and completion which included the Stroke Impact Scale-hand function (SIS-hf) domain. Group mean change in SIS-hf scores were compared using an independent samples t-test. Participants who completed 15 intervention sessions with fewer than 184 BCI-FES runs (n = 7) had a greater mean increase in SIS-hf scores (group mean difference = 2.29 ± 4.65) compared to those who completed more than 184 runs with paired FES (n = 7, group mean difference = 0.86 ± 1.68). These group mean differences as a result of intervention were not statistically significant t (7.54) = 0.77, p = 0.47. As expected, SIShf scores increased in both low-dose and high-dose groups of participants; however, the present results suggest that increasing the dose (i.e., number of runs) of BCI-FES intervention may not necessarily result in greater motor recovery in stroke participants.

Musicians with absolute pitch ability show better spatial ability, but little is known about whether non-musicians’ pitch identification (PI) ability is associated with their spatial ability. In the present study, a PI test, two mental rotation (MR) tests (Three-Dimensional Mental Rotation [3DMR] and Spatial Relationship [SR]), and eight executive function (EF) tests were administered to a large sample ( N = 525) of Chinese college students who were non-music majors. A subsample with superior PI ability ( n = 42) was identified and compared with a sample with average PI ability matched in age and IQ ( n = 42). Two-way analysis of covariance (ANCOVA) (PI ability x musical training, with gender as a covariate due to a minor difference in matching by gender) revealed that superior PI ability was associated with better performance on MR and various EF tests. Musical training was associated with performance on select visual and EF tests (i.e., visual perception, working memory, and executive attention control), but not with MR performance. Additional ANCOVA showed that PI ability was significantly associated with 3DMR, but not SR, even after scores on EF tests were included as covariates. These results indicate a unique association between PI ability and 3DMR, which helps shed light on the cognitive mechanisms related to PI ability.

In the modern era, inclination towards a more conservative approach is being advocated and this has become possible through various innovative machinery and techniques. A conservative tooth preparation helps in retaining more of a tooth structure which would determine the prognosis of the treatment and the fate of the tooth in the long run. Even though we have a high focus on the conservative approach, we should keep in mind that there is always a chance of errors which is caused due to inadequate access to the canals. It is ultimately the clinicians call to decide between the benefit to the risk ratio and also its feasibility, all of which should result in good prognosis as well as a fruitful qualitative treatment outcome for the patient. Keywords : Conservation,Endodontics,CBCT,Prognosis,Clinician,Treatment

Traumatic brain injury (TBI) can lead to movement and balance deficits. In addition to physical therapy, brain-based neurorehabilitation efforts have begun to show promise in improving these deficits. The present study investigated the effectiveness of translingual neural stimulation (TLNS) on patients with mild-to-moderate TBI (mmTBI) and related brain connectivity using a resting-state functional connectivity (RSFC) approach.Resting-state images with 5-min on GE750 3T scanner were acquired from nine participants with mmTBI. Paired t-test was used for calculating changes in RSFC and behavioral scores before and after the TLNS intervention. The balance and movement performances related to mmTBI were evaluated by Sensory Organization Test (SOT) and Dynamic Gait Index (DGI).Compared to pre-TLNS intervention, significant behavioral changes in SOT and DGI were observed. The analysis revealed increased RSFC between the left postcentral gyrus and left inferior parietal lobule and left Brodmann Area 40, as well as the increased RSFC between the right culmen and right declive, indicating changes due to TLNS treatment. However, there were no correlations between the sensory/somatomotor (or visual or cerebellar) network and SOT/DGI behavioral performance.Although the limited sample size may have led to lack of significant correlations with functional assessments, these results provide preliminary evidence that TLNS in conjunction with physical therapy can induce brain plasticity in TBI patients with balance and movement deficits.

A good night sleep is required for wellbeing of every organism. Humans though considered as an intelligent among living beings, seldom understand the importance of sleep impulse and ignore it. This ignorance has paved way for many health issues. Impulses are generated for maintenance of body and must be managed at proper time. Sleep impulse is essential for various brain functions, production of various hormone like growth hormone, cognitive power, good immune response etc. Today in highly competitive world human have forgotten his body needs. Earlier handful of persons suffered from sleep disturbance unlike today, where sleep disturbance is very common factor almost in every household. This article is an attempt to pull in the importance of sleep impulse and the ill effects if not attended on time.

Central nervous system effects of lingual strengthening exercise to treat dysphagia remain largely unknown. This pilot study measured changes in microstructural white matter to capture alterations in neural signal processing following lingual strengthening exercise.Diffusion-weighted images were acquired from seven participants with dysphagia of varying etiologies, before and after lingual strengthening exercise (20 reps, 3×/day, 3 days/week, 8 weeks), using a 10-min diffusion sequence (9 b0, 56 directions with b1000) on GE750 3T scanner. Tract-Based Spatial Statistics evaluated voxel-based group differences for fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity and local diffusion homogeneity (LDH). Paired t-tests evaluated treatment differences on each metric (P 0.05).After lingual strengthening exercise, lingual pressure generation increased (avg increase = 46.1 hPa; nonsignificant P = 0.52) with these changes in imaging metrics: (1) decrease in fractional anisotropy, forceps minor; (2) increase in mean diffusivity, right inferior fronto-occipital fasciculus (IFOF); (3) decrease in mean diffusivity, left uncinate fasciculus; (4) decrease in axial diffusivity, both left IFOF and left uncinate fasciculus; (5) increase in LDH, right anterior thalamic radiation and (6) decrease in LDH, temporal portion of right superior longitudinal fasciculus. There was a positive correlation between diffusion tensor imaging metrics and change in lingual pressure generation in left IFOF and the temporal portion of right superior longitudinal fasciculus.These findings suggest that lingual strengthening exercise can induce changes in white matter structural and functional properties in a small group of patients with dysphagia of heterogeneous etiologies. These procedures should be repeated with a larger group of patients to improve interpretation of overall lingual strengthening exercise effects on cortical structure and function.

We propose a unique, minimal assumption, approach based on variance analyses (compared with standard approaches) to investigate genetic influence on individual differences on the functional connectivity of the brain using 65 monozygotic and 65 dizygotic healthy young adult twin pairs' low-frequency oscillation resting state fMRI data from the Human Connectome Project. Overall, we found high number of genetically-influenced functional (GIF) connections involving posterior to posterior brain regions (occipital/temporal/parietal) implicated in low-level processes such as vision, perception, motion, categorization, dorsal/ventral stream visuospatial, and long-term memory processes; midline brain regions (cingulate) implicated in attentional processes, and emotional responses to pain. We found low number of GIF connections involving anterior to anterior/posterior brain regions (frontofrontalfrontoparietal, frontotemporal, frontooccipital) implicated in high-level processes such as working memory, reasoning, emotional judgment, language, and action planning. We found very low number of GIF connections involving subcortical/noncortical networks such as basal ganglia, thalamus, brainstem, and cerebellum. In terms of sex-specific individual differences, males were more genetically influenced while females were more environmentally influenced in terms of the interplay of interactions of Task positive networks (brain regions involved in various task-oriented processes and attending to and interacting with environment), extended Default Mode Network (a central brain hub for various processes such as internal monitoring, rumination, and evaluation of self and others), primary sensorimotor systems (vision, audition, somatosensory, and motor systems), and subcortical/noncortical networks. There were8.5-19.1 times more GIF connections in males than females. These preliminary (young adult cohort-specific) findings suggest that individual differences in the resting state brain may be more genetically influenced in males and more environmentally influenced in females; furthermore, based on standard approaches, environmental influences on individual differences may be substantially greater than that of genetics, for either sex, frontally and brain-wide.

Introduction: Non-invasive electroencephalographic (EEG) based brain-computer interface (BCI) therapy has been shown to increase upper extremity mobility in stroke survivors with persistent upper extremity motor impairment. Previous studies have shown that in order to evoke movement from a particular motor system, sensory cues are combined in an essentially linear model. That is, the feedback from each sensory system is summed and torque is generated as a function of the summed signal. This subanalysis aims to evaluate the efficacy of EEG-based BCI-functional electrical stimulation (FES). The goal was to determine whether greater sensory feedback improves BCI task performance in stroke survivors with upper extremity motor impairment. Methods: Data were acquired from 31 ischemic stroke patients, with persistent upper extremity motor impairment (mean age = 66 years old, F = 14, M = 17, mean time since stroke onset = 100 months). Participants were kept in one group and all patients received two types of therapies: BCI-only therapy followed by BCI-FES therapy. Participants were instructed to move either their left or right hand to control a virtual cursor in a cursor and target task. A successful trial was recorded if the participant successfully moved the cursor into the target area. The task was first performed with only visual stimulation, then participants received cutaneous stimulation via the paired FES in addition to the visual display of the cursor and target. EEG data was acquired using BCI2000 software and a 16 channel EEG cap. Results: Although improvement was seen for participants when they received BCI therapy as well as when they received BCI-FES therapy, BCI performance scores over time were not significantly different from one another (p = 0.13). The BCI-only and BCI-FES pre-study averages were 5.58 (SD = 1.64) and 5.86 (SD = 1.66) respectively and the post-study averages were 5.99 (SD = 1.41) and 6.33 (SD = 1.75) respectively. Conclusions: For chronic stroke survivors, both BCI visual only and BCI-FES intervention may help promote restoration of upper extremity motor function at similar rates.

Functional resonance magnetic imaging (fMRI) allows for identification of eloquent cortex in pre-treatment planning. Previous studies have shown a correlation among lesion to activation distance (LAD) measures and morbidity and mortality. This study investigates the relationship between LAD, well-established language centers (Wernicke’s and Broca’s), and language performance measures. We included a sample population of brain tumor patients that received language fMRI (verbal fluency and sentence verification) for pre-treatment assessment (n = 51). LAD to the nearest language area was measured and divided into groups ≤ 10 mm and > 10 mm. Verbal fluency scores were compared between these groups. Additionally, patients were divided into similar groups based on LAD to either Broca’s or Wernicke’s areas, and the verbal fluency scores and sentence verification accuracy (n = 29) were subsequently compared between groups. Brain tumor patients with LAD ≤ 10 mm to either language area had significantly lower verbal fluency scores (p = 0.028). The difference in verbal fluency scores between groups with LAD ≤ 10 mm and > 10 mm to Wernicke’s area trends toward significance (p = 0.067). The sentence verification accuracy was significantly lower in patients with LAD ≤ 10 mm to either language area (p = 0.039). These findings suggest that there exists a significant relationship between LAD to language centers and measures; greater language deficits are seen when LAD ≤ 10 mm.