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Loss of nervous system tissue after severe brain injury is a main determinant of poor functional recovery. Cell transplantation is a promising method to restore lost tissue and function, yet it remains unclear if transplanted neurons can demonstrate the population level dynamics important for movement control. Here we present a comprehensive approach for long-term single neuron monitoring and manipulation of transplanted embryonic cortical neurons after cortical injury in adult male mice performing a prehension task. The observed patterns of population activity in the transplanted network strongly resembled that of healthy networks. Specifically, the task-related spatiotemporal activity patterns of transplanted neurons could be represented by latent factors that evolve within a low dimensional manifold. We also demonstrate reliable modulation of the transplanted networks using minimally invasive epidural stimulation. Our approach may allow greater insight into how restoration of cell-type specific network dynamics in vivo can restore motor function.

Background: Thyroid dysfunction evaluation during pregnancy is important for the mother’s health, obstetric outcomes, and the child’s cognitive development. This study is conducted to know various thyroid disorders that can occur during antenatal and their impact on mother and fetus outcomes. Materials and Methods: This observational research was conducted over two years at a tertiary center in Western Rajasthan, India. Seven hundred and seventy-two low-risk singleton pregnant patients who met the inclusive criteria were recruited. The estimation of T3, T4, and TSH was done along with a routine investigation in antenatal women. Antenatal having abnormal thyroid profiles were then analyzed for mother and fetus problems. Results: The prevalence of thyroid dysfunction in antenatal women is 16.5%. Subclinical hypothyroidism (SCH) was seen in 12.5% of cases, overt hypothyroidism in 3.36%, and subclinical hyperthyroidism in only 0.51% of cases. Anti-TPO was positive in 46 (41.44%) women with hypothyroidism and 1 (25%) with hyperthyroidism. Compared to euthyroid women, women with overt hypothyroid (19.23% vs 3.1%, P = 0.002) and subclinical hypothyroid (9.27% vs 3.1%, P = 0.003) were found to be associated with a higher risk of hypertensive disease. Concerning fetal outcomes. There was a high risk for preterm (12.37% v/s 4.9%, P = 0.004) and fetal growth retardation (FGR) in patients with SCH (7.21% v/s 3.1%, P = 0.04). Conclusion: Considering the significant influence of thyroid disorders on mother and fetus outcomes, the screening for thyroid during pregnancy should be considered universally, particularly in developing countries with high prevalent rates, such as India.

Abstract Background Transgender people comprise an estimated 0.3–0.5% (25 million) of the global population. The public health agenda focuses on understanding and improving the health and well-being of gender minorities. Transgender (TG) persons often have complex healthcare needs and suffer significant health disparities in multiple arenas. The international literature suggests that this community is at a higher risk of depression, and other mental health problems, including HIV. Many transgender people experience gender dysphoria and seek specific medical needs such as sex reassignment surgeries, implants, hormonal therapies, etc., but are unable to access these services due to financial or social reasons. The objective of this study was to assess the healthcare needs and associated barriers experienced by transgender people in Western Rajasthan. Methodology: A qualitative study was carried out in which multilevel stakeholder interviews were conducted using interview and focus group discussion guides. Data was analyzed using the qualitative thematic analysis technique. Results: Findings reveal that transgender people have expressed their need to access health services for general health needs, including but not limited to mental health, non-communicable diseases, and infectious diseases. Barriers to healthcare services were identified on 3 levels: health system, social and personal. Health system barriers include policy, accessibility, affordability, and acceptability issues. Social factors such as inadequate housing, education, and job opportunities also play an important role in affecting the individual’s health-seeking behavior. The knowledge of healthcare providers in this context was also limited in context of health insurance schemes, package of services available for transgenders and the importance of gender sensitive healthcare. Conclusion: Transgender people expressed the need for mental health services, programs targeting nutritional improvement, gender-affirmation procedures besides regular screening of non-communicable diseases as operational for males and females. Levels of barriers have been identified at various levels ranging from absence of targeted policies to individual behavior.

Introduction: The Papanicolaou Society of Cytopathology System for reporting Pancreaticobiliary Cytology (PSCPC) is a reliable method to classify pancreatic fine needle aspiration cytology (FNAC) smears. However, it is not without practical problems which can diminish the diagnostic accuracy of the cytological diagnosis. Aims and Objectives: To determine the diagnostic pitfalls while reporting cytomorphology of pancreatic lesions according to PSCPC on correlating FNAC findings with histopathology. Materials and Methods: Retrospective analysis of pancreatic FNAC smears received in the Department of Pathology of our tertiary care institute over a period of 2 years was done. The cytological diagnoses were classified according to the Papanicolaou Society of Cytopathology system of reporting pancreaticobiliary cytology and correlated with histopathology. The reasons of cyto-histological discordance were analyzed. Results: Out of 50 cases in which both FNAC and biopsy of pancreatic lesions were done, 34 cases were positive/malignant (Category VI), eight cases were suspicious for malignancy (Category V), three cases were neoplastic (Category IV), two cases were atypical (Category III), two cases were negative for malignancy (Category II), and one case was non-diagnostic (Category I). Out of 50 cases, histopathology was non-diagnostic due to inadequate material in six cases. The cytological diagnoses were compared with histopathology in the remaining 44 cases. Categories III, IV V, and VI were considered as positive for neoplastic pathology. The sensitivity of FNAC to predict neoplastic pathology was 97.5%, while the specificity was 25%. The positive predictive value was 92.9%. Two cases reported as atypical (Category III) turned out to be adenocarcinoma on histopathology. One case reported as neuroendocrine tumor and two cases reported as adenocarcinoma on cytology displayed features of chronic pancreatitis on histology. One case reported as neoplastic mucinous cyst (Category IV) turned out to be adenocarcinoma on histology (limited concordance). Conclusion: The cytopathologist needs to be wary of the potential pitfalls to improve the diagnostic accuracy of FNACs.

ABSTRACT: Purpose: The pathological hallmarks of Alzheimer's disease (AD), amyloid, tau, and associated neurodegeneration, are present in the cortical gray matter (GM) years before symptom onset, and at significantly greater levels in carriers of the apolipoprotein E4 (APOE4) allele. Their respective biomarkers, A/T/N, have been found to correlate with aspects of brain biochemistry, measured with magnetic resonance spectroscopy (MRS), indicating a potential for MRS to augment the A/T/N framework for staging and prediction of AD. Unfortunately, the relationships between MRS and A/T/N biomarkers are unclear, largely due to a lack of studies examining them in the context of the spatial and temporal model of T/N progression. Advanced MRS acquisition and post-processing approaches have enabled us to address this knowledge gap and test the hypotheses, that glutamate-plus-glutamine (Glx) and N-acetyl-aspartate (NAA), metabolites reflecting synaptic and neuronal health, respectively, measured from regions on the Braak stage continuum, correlate with: (i) cerebrospinal fluid (CSF) p-tau181 level (T), and (ii) hippocampal volume or cortical thickness of parietal lobe GM (N). We hypothesized that these correlations will be moderated by Braak stage and APOE4 genotype. Methods: We conducted a retrospective imaging study of 34 cognitively unimpaired elderly individuals who received APOE4 genotyping and lumbar puncture from pre-existing prospective studies at the NYU Grossman School of Medicine between October 2014 and January 2019. Subjects returned for their imaging exam between April 2018 and February 2020. Metabolites were measured from the left hippocampus (Braak II) using a single-voxel semi-adiabatic localization by adiabatic selective refocusing sequence; and from the bilateral posterior cingulate cortex (PCC; Braak IV), bilateral precuneus (Braak V), and bilateral precentral gyrus (Braak VI) using a multi-voxel echo-planar spectroscopic imaging sequence. Pearson and Spearman correlations were used to examine the relationships between absolute levels of choline, creatine, myo-inositol, Glx, and NAA and CSF p-tau181, and between these metabolites and hippocampal volume or parietal cortical thicknesses. Covariates included age, sex, years of education, Fazekas score, and months between CSF collection and MRI exam. Results: There was a direct correlation between hippocampal Glx and CSF p-tau181 in APOE4 carriers (Pearson's r = 0.76, p = 0.02), but not after adjusting for covariates. In the entire cohort, there was a direct correlation between hippocampal NAA and hippocampal volume (Spearman's r = 0.55, p = 0.001), even after adjusting for age and Fazekas score (Spearman's r = 0.48, p = 0.006). This relationship was observed only in APOE4 carriers (Pearson's r = 0.66, p = 0.017), and was also retained after adjustment (Pearson's r = 0.76, p = 0.008; metabolite-by-carrier interaction p = 0.03). There were no findings in the PCC, nor in the negative control (late Braak stage) regions of the precuneus and precentral gyrus. Conclusions: Our findings are in line with the spatially- and temporally-resolved Braak staging model of pathological severity in which the hippocampus is affected earlier than the PCC. The correlations, between MRS markers of synaptic and neuronal health and, respectively, T and N pathology, were found exclusively within APOE4 carriers, suggesting a connection with AD pathological change, rather than with normal aging. We therefore conclude that MRS has the potential to augment early A/T/N staging, with the hippocampus serving as a more sensitive MRS target compared to the PCC.

Summary: Cortical gradients in endogenous and stimulus-evoked neurodynamic timescales, and long-range cortical interactions, provide organizational constraints to the brain and influence neural populations’ roles in cognition. It is unclear how these functional gradients interrelate and which influence behavior. Here, intracranial recordings from 4,090 electrode contacts in 35 individuals map gradients of neural timescales and functional connectivity to assess their interactions along category-selective ventral temporal cortex. Endogenous and stimulus-evoked information processing timescales were not significantly correlated with one another suggesting that local neural timescales are context dependent and may arise through distinct neurophysiological mechanisms. Endogenous neural timescales correlated with functional connectivity even after removing the effects of shared anatomical gradients. Neural timescales and functional connectivity correlated with how strongly a population’s activity predicted behavior in a simple visual task. These results suggest both interrelated and distinct neurophysiological processes give rise to different functional connectivity and neural timescale gradients, which together influence behavior.

Assisted colonisation that involves the planned introduction of threatened species has generated intense debates on its merits, such as mitigating habitat loss due to climate change impacts, and challenges, such as the risk of invasion by introduced species. Here, we assess the feasibility of Assisted Colonisation of the Narcondam Hornbill, a species confined to a 6.8 km2 island in the Andaman Sea, onto other islands in the Andaman archipelago. Utilising IUCN’s framework for species introductions, we evaluate the rationale for assisted colonisation and identify potential knowledge gaps that are critical for consideration. Based on the status of the Narcondam Hornbill population and its legally protected habitat, there is limited support for the assisted colonisation of the species to other islands as per IUCN’s guidelines. However, if introduction is contemplated, we need to evaluate aspects like fruit availability on the new island, impacts of hornbill on endemic frugivores (especially those that are absent on Narcondam), influence of predators on introduced hornbill populations, low genetic diversity of Narcondam Hornbills and potential social impacts of introducing the hornbill on other islands. Given the restricted range of the species and vulnerability to stochastic events, systematic monitoring of Narcondam Hornbill populations and demography, minimising threats from avian disease and invasive rodents and potentially establishing a conservation breeding population in captivity with guidance from experts with experience in conservation breeding of hornbills is vital.

Endotoxic shock was produced in 5 apparently healthy male buffalo calves aged between 4 month and 1 year by i/v infusion of Escherichia coil endotoxin @ 5 µg/kg BW/h for 3 h. The animals were further observed for 7 days. A general hypoproteinemia was observed during endotoxin infusion along with significant hypoalbuminemia, hypoglycemia, hypofibrinogenemia, decrease in plasma globulin, creatinine while plasma blood urea nitrogen, sodium, potassium, and chloride showed nonsignificant alterations during endotoxin infusion for 3 h. All the endotoxemic buffalo calves were infused i/v hypertonic saline solution (7.2% NaCI acq.) @ 4 ml/kg BW in 6.5 min followed by flunixin meglumine @ 1.1 mg/kg BW as one time infusion and plasma proteins showed a significant decrease at 4 h but increased significantly on day 2 while albumin showed a declining trend throughtout the observation period with a signigicant fall at 4 h of start of endotoxin infusion. While plasma globulin decreased, plasma fibrin increased significantly on second and third day. Hypoglycemia continued from day 1-6 accompanied by a nonsignificant fall in BHU within normal range throughtout the 7 day observation period. The plasma creatinine increased significantly at 5 and 7 h of day 1 and on day 2 of observation. Plasma sodium and chloride did not alter significantly indicating that this treatment combination does not greatly affect the biochemical profiles during bovine endotoxemia.

Abstract Loss of nervous system tissue after severe brain injury is a main determinant of poor functional recovery. Cell transplantation is a promising method to restore lost tissue and function, yet it remains unclear if transplanted neurons can demonstrate the population level dynamics important for movement control. Here we present a comprehensive approach for long-term single neuron monitoring and manipulation of transplanted embryonic cortical neurons after cortical injury in adult male mice performing a prehension task. The observed patterns of population activity in the transplanted network strongly resembled that of healthy networks. Specifically, the task-related spatiotemporal activity patterns of transplanted neurons could be represented by latent factors that evolve within a low dimensional manifold. We also demonstrate reliable modulation of the transplanted networks using minimally invasive epidural stimulation. Our approach may allow greater insight into how restoration of cell-type specific network dynamics in vivo can restore motor function.

Objective Due to its comprehensive, reliable, and valid format, the objective structured clinical examination (OSCE) is the gold standard for assessing the clinical competency of medical students. In the present study, we evaluated the importance of the OSCE as a learning tool for postgraduate (PG) residents assessing their junior undergraduate students. We further aimed to analyze quality improvement during the pre-coronavirus disease (COVID) and COVID periods. Methods This quality-improvement interventional study was conducted at the Department of Obstetrics and Gynecology. The PG residents were trained to conduct the OSCE. A formal feedback form was distributed to 22 participants, and their responses were analyzed using a five-point Likert scale. Fishbone analysis was performed, and the ‘plan-do-study-act’ (PDSA) cycle was implemented to improve the OSCE. Results Most of the residents (95%) believed that this examination system was extremely fair and covered a wide range of clinical skills and knowledge. Further, 4.5% believed it was more labor- and resource intensive and time-consuming. Eighteen (81.8%) residents stated that they had learned all three domains: communication skills, time management skills, and a stepwise approach to clinical scenarios. The PDSA cycle was run eight times, resulting in a dramatic improvement (from 30% to 70%) in the knowledge and clinical skills of PGs and the standard of OSCE. Conclusion The OSCE can be used as a learning tool for young assessors who are receptive to novel tools. The involvement of PGs in the OSCE improved their communication skills and helped overcome human resource limitations while manning various OSCE stations.

Abstract Background Gestational diabetes mellitus (GDM) is one of the most common medical conditions affecting pregnancy and increasing the risk for maternal and perinatal complications. The present study aimed at determining the role of ultrasonographic measurement of fetal epicardial fat pad thickness (f EFT) and fetal cardiac interventricular septal thickness (f IVST) at 24–32 weeks of gestation in the prediction of GDM. Results A prospective observational case–control study was conducted including a total of 35 GDM patients and 35 normal pregnancies who were subjected to ultrasonographic measurement of the f EFT and f IVST at 24–32 weeks of gestation. Statistical analysis and the receiver operating characteristic curves were used to find out the cutoff value, sensitivity, specificity and diagnostic accuracy of these two parameters for the prediction of GDM. When an f EFT value of 1.3 was accepted as a cutoff value, GDM could be predicted with a sensitivity of 68.6% and specificity of 91.4%, PPV of 88.9%, NPV of 74.4% and diagnostic accuracy of 80%. When an f IVST value of 2.6 was accepted as a cutoff value, GDM could be predicted with a sensitivity of 80%, specificity of 77.14%, PPV of 77.8%, NPV of 79.4% and diagnostic accuracy of 78.5%. Conclusion The ultrasonographic measurements of fetal epicardial fat pad thickness and fetal cardiac interventricular septal thickness were statistically significantly higher in GDM pregnancies (p value