Enhancing healthcare recommendation: transfer learning in deep convolutional neural networks for Alzheimer disease detection.

Neurodegenerative disorders such as Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI) significantly impact brain function and cognition. Advanced neuroimaging techniques, particularly Magnetic Resonance Imaging (MRI), play a crucial role in diagnosing these conditions by detecting structural abnormalities. This study leverages the ADNI and OASIS datasets, renowned for their extensive MRI data, to develop effective models for detecting AD and MCI. The research conducted three sets of tests, comparing multiple groups: multi-class classification (AD vs. Cognitively Normal (CN) vs. MCI), binary classification (AD vs. CN, and MCI vs. CN), to evaluate the performance of models trained on ADNI and OASIS datasets. Key preprocessing techniques such as Gaussian filtering, contrast enhancement, and resizing were applied to both datasets. Additionally, skull stripping using U-Net was utilized to extract features by removing the skull. Several prominent deep learning architectures including DenseNet-201, EfficientNet-B0, ResNet-50, ResNet-101, and ResNet-152 were investigated to identify subtle patterns associated with AD and MCI. Transfer learning techniques were employed to enhance model performance, leveraging pre-trained datasets for improved Alzheimer's MCI detection. ResNet-101 exhibited superior performance compared to other models, achieving 98.21% accuracy on the ADNI dataset and 97.45% accuracy on the OASIS dataset in multi-class classification tasks encompassing AD, CN, and MCI. It also performed well in binary classification tasks distinguishing AD from CN. ResNet-152 excelled particularly in binary classification between MCI and CN on the OASIS dataset. These findings underscore the utility of deep learning models in accurately identifying and distinguishing neurodegenerative diseases, showcasing their potential for enhancing clinical diagnosis and treatment monitoring.

Fracture Resistance of Zirconia Surveyed Crowns With Digitally Designed and Hand-Modified Occlusal Rest Seats.

Background In light of the trend of using zirconia crowns, clinicians will likely face abutment included in removable partial dentures (RPD) designs with existing zirconia. However, the decision to replace the existing crown with a surveyed crown or modify the existing crown to accept the RPD is unclear. To the best of our knowledge, there is a lack of literature on the effect of preparing a rest seat on the existing monolithic zirconia crown in the patient's mouth on the fracture resistance of the crown. Therefore, in this study, we aimed to evaluate the fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia surveyed crowns with digitally designed rest seats and hand-modified rest seats. Methods Thirty CAD/CAM zirconia surveyed crowns were digitally designed and fabricated and divided into groups (n=10 per group) as follows: Group 1 comprised surveyed crowns with no occlusal rest seat; Group 2 comprised surveyed crowns with a digitally designed mesial rest seat; and Group 3 comprised surveyed crowns with a hand-modified mesial rest seat. Then, with all the crowns cemented to metal dies, the specimens were subjected to a fracture resistance test using a universal testing machine (Model 8501 Instron, Norwood, MA, USA). Results Surveyed crowns without any rest seat and those with digitally created and hand-modified rest seats displayed different fracture resistances: crowns with no rest seat offered the highest fracture resistance (5831 ± 895.15 N), followed by those with a digitally designed and milled rest seat (5280 ± 1673.33 N). Crowns with a hand-modified rest seat provided the lowest fracture resistance (4976 ± 322.5 N). Based on our results, surveyed crowns without a rest seat displayed higher fracture resistance than those with a rest seat. Conclusion The fracture resistance of crowns with a digitally designed and milled rest seat was statistically similar to that of control crowns with no rest seat, whereas hand-modified rest seats significantly reduced the fracture resistance of surveyed zirconia crowns.

Explainable lung cancer classification with ensemble transfer learning of VGG16, Resnet50 and InceptionV3 using grad-cam.

Medical imaging stands as a critical component in diagnosing various diseases, where traditional methods often rely on manual interpretation and conventional machine learning techniques. These approaches, while effective, come with inherent limitations such as subjectivity in interpretation and constraints in handling complex image features. This research paper proposes an integrated deep learning approach utilizing pre-trained models-VGG16, ResNet50, and InceptionV3-combined within a unified framework to improve diagnostic accuracy in medical imaging. The method focuses on lung cancer detection using images resized and converted to a uniform format to optimize performance and ensure consistency across datasets. Our proposed model leverages the strengths of each pre-trained network, achieving a high degree of feature extraction and robustness by freezing the early convolutional layers and fine-tuning the deeper layers. Additionally, techniques like SMOTE and Gaussian Blur are applied to address class imbalance, enhancing model training on underrepresented classes. The model's performance was validated on the IQ-OTH/NCCD lung cancer dataset, which was collected from the Iraq-Oncology Teaching Hospital/National Center for Cancer Diseases over a period of three months in fall 2019. The proposed model achieved an accuracy of 98.18%, with precision and recall rates notably high across all classes. This improvement highlights the potential of integrated deep learning systems in medical diagnostics, providing a more accurate, reliable, and efficient means of disease detection.

Effect of Dentin Contamination with Hemostatic Agents and Cleaning Techniques on Bonding with Self-Adhesive Resin Cement.

BACKGROUND Dentin contamination with hemostatic agents before bonding indirect restorations negatively affects the bond strength. However, the consensus on which materials could be used to clean contamination of hemostatic agents has not been explored. The aim of this study was to assess the effect of Katana Cleaner applied on the surface of dentin contaminated with hemostatic agents on the shear bond strength (SBS) of self-adhesive resin cement by comparing it with three other surface cleaners. MATERIAL AND METHODS Ninety dentin specimens were divided into a no contamination group (control) (n=10), 4 groups contaminated with 25% aluminum chloride (Viscostat Clear) (n=40), and 4 groups contaminated with 20% ferric sulfate (Viscostat) (n=40). Subsequently, 4 different cleaners were used for each contamination group (water rinse, phosphoric acid, chlorhexidine, and Katana Cleaner). Then, self-adhesive resin cement was directly bonded to the treated surfaces. All specimens were subjected to 5000 thermal cycles of artificial aging. The shear bond strength was measured using a universal testing machine. RESULTS Two-way analysis of variance showed that the contaminant type as the main factor was statistically non-significant (p=0.655), cleaner type as the main factor was highly significant (p<0.001), and interaction between the contaminant and cleaner was non-significant (p=0.51). The cleaner type was the main factor influencing the bond strength. Phosphoric acid and chlorhexidine showed better performance than Katana Cleaner. CONCLUSIONS Cleaning dentin surface contamination with phosphoric acid and chlorhexidine had better performance than with Katana Cleaner.

Orthodontic treatment in adults: Challenges, outcomes, and factors affecting compliance and satisfaction.

BACKGROUND: The demand for orthodontic treatment among adults has witnessed a substantial rise in recent years. This study aims to explore the complexities of adult orthodontics, focusing on challenges faced, treatment outcomes, and the influence of factors such as age, gender, and education on patient compliance and satisfaction. METHODS: A multi-dimensional approach was employed, combining a review of clinical records with structured patient surveys. Descriptive statistics summarized demographic characteristics, treatment duration, and orthodontic problems addressed. Inferential statistics included Pearson correlation, Chi-squared tests, and analysis of variance to examine age compliance, gendersatisfaction, and education-orthodontic problem relationships. Qualitative analysis enriched findings, and statistical software facilitated data processing. RESULTS: The analysis revealed a statistically significant negative correlation between age and compliance (r = -0.28, P < 0.05), indicating that younger participants demonstrated higher compliance rates. Gender emerged as a significant factor influencing patient satisfaction (P = 0.024), with females reporting notably higher levels of satisfaction than males. Furthermore, participants with advanced education levels (Master's/Ph.D.) were significantly more likely to have orthodontic issues related to malocclusion (P = 0.041). CONCLUSION: The study provides an insight into the multi-dimensional aspects of adult orthodontics, recognizing the challenges, compliance, and satisfaction levels. Tailored approaches considering age, gender, and education are essential. This research contributes to a deeper understanding of orthodontic treatment in adults and its potential implications for enhanced patient care.

Health-risk behaviours co-occur among adults with tooth loss.

INTRODUCTION: Health-risk behaviours tend to co-occur among the same sectors of the population. The aim of this study is to examine the association between an aggregate of multiple health-risk behaviours and tooth loss among American Adults. METHODS: We used data from the Behavioural Risk Factor Surveillance System (BRFSS) 2022, a nationally representative survey of non-institutionalized American. We included participants aged 18 years and older. An aggregate variable of health-risk behaviours which included smoking, heavy alcohol consumption, lack of physical activities, overweight/obesity, infrequent dental visits and infrequent medical check-up was created. Tooth loss was indicated by losing one tooth or more. Logistic Regression analysis was conducted to test the association between the aggregate of behaviours and tooth loss adjusting for income, education, ethnicity and health insurance. RESULTS: The analysis included 326,561 participants. The mean number of health-risk behaviours was 2.13 and 1.72 among participants with tooth loss and without tooth loss, respectively. The aggregate of health-risk behaviours was significantly associated with tooth loss with odds ratios 1.23 (95% CI, 1.21, 1.26) in a model adjusting for age, gender, education, income ethnicity and health insurance. CONCLUSION: This study demonstrated that an aggregate of health-risk behaviours, with some not directly linked to oral health, is associated with tooth loss among American adults. The study highlights the importance of considering different risk factors when planning health promotion policies to tackle oral health.

Capsaicin ameliorate pulmonary fibrosis via antioxidant Nrf-2/ PPAR- γ pathway activation and inflammatory TGF-ß1/ NF-κB/COX II pathway inhibition.

Bleomycin is an effective antibiotic with a significant anticancer properties, but its use is limited due to its potential to induce dose-dependent pulmonary fibrosis. Therefore, this study aimed to assess the therapeutic potential of Capsaicin as an additional treatment to enhance patient tolerance to Bleomycin compared to the antifibrotic drug Pirfenidone. Pulmonary fibrosis was induced in rats through by a single intratracheal Bleomycin administration in day zero, followed by either Capsaicin or Pirfenidone treatment for 7 days. After the animals were sacrificed, their lungs were dissected and examined using various stains for macroscopic and histopathological evaluation. Additionally, the study assessed various antioxidant, anti-inflammatory, and antifibrotic parameters were assessed. Rats exposed to Bleomycin exhibited visible signs of fibrosis, histopathological alterations, increased collagen deposition, and elevated mucin content. Bleomycin also led to heightened increased inflammatory cells infiltration in the bronchoalveolar lavage, elevated fibrosis biomarkers such as hydroxyproline, alpha-smooth muscle actin (α-SMA) and transforming growth factor-beta (TGF-ß1), increased inflammatory markers including tumor necrosis factor-alpha (TNF-α), interlukine-6 (Il-6), interlukine-1ß (Il-1ß) nuclear factor-kappa B (NF-κB), and Cyclooxygenase-2 (COX-2), and transforming growth factor-beta (TGF-ß1),. Furthermore, it reduced the expression of peroxisome proliferator-activated receptor-gamma (PPAR-γ), increased oxidative stress biomarkers like nitric oxide (NO), malondialdehyde (MDA), myeloperoxidase (MPO) and protein carbonyl. Bleomycin also decreased the expression of nuclear factor erythroid 2-related factor 2 (Nrf-2), reduced glutathione (GSH), total antioxidant capacity, and the activities of catalase and superoxide dismutase (SOD). Treating the animals with Capsaicin and Pirfenidone following Bleomycin exposure resulted in improved lung macroscopic and microscopic characteristics, reduced collagen deposition (collagen I and collagen III) and mucin content, decreased inflammatory cell infiltration, lowered levels of hydroxyproline, α-SMA, and TGF-ß1, decreased TNF-α, Il-6, Il-1ß, NF-κB, and COX-2, increased PPAR-γ and Nrf-2 expression, and improvement improved in all oxidative stress biomarkers. In summary, Capsaicin demonstrates significant antifibrotic activity against Bleomycin-induced lung injury that may be attributed, at least in part, to the antioxidant and anti-inflammatory activities of Capsaicin mediated by upregulation of PPAR-γ and Nrf-2 expression and decreasing. TGF-ß1, NF-κB and COX II proteins concentrations.

Stroke and high-risk TIA outcomes with reduction of treatment duration when treatment initiated in emergency rooms (SHORTER-study).

BACKGROUND: Following transient ischemic attack (TIA) and minor stroke, the risk of recurrent stroke can be significantly reduced with short-duration dual antiplatelet therapy (DAPT). We wish to investigate whether 10 days of DAPT is as effective as 21 days' treatment. STUDY DESIGN: This is an open-label, randomized, parallel-group study comparing whether 10 days of DAPT treatment (ASA + clopidogrel) is non-inferior to 21 days of DAPT in patients with acute ischemic stroke (AIS) or high-risk TIA. In both groups, DAPT is started within 24 hours of symptom onset. This study is being conducted in approximately 15 study sites in the Kingdom of Saudi Arabia. The planned sample size is 1932. OUTCOMES: Non-inferiority of 10 days compared to 21 days of DAPT in the prevention of the composite endpoint of stroke and death at 90 days in AIS/TIA patients. The primary safety outcome is major intra-cranial and systemic hemorrhage. STUDY PERIOD: Enrolment started in the second quarter of 2023, and the completion of the study is expected in the fourth quarter of 2025. DISCUSSION: The trial is expected to show that 10 days of DAPT is non-inferior for the prevention of early recurrence of vascular events in patients with high-risk TIAs and minor strokes.

Flexural strength, flexural modulus and microhardness of milled vs. fused deposition modeling printed Zirconia; effect of conventional vs. speed sintering.

BACKGROUND: Various methods can be used for creating zirconia dental restorations, including 3-dimensional (3D) printing and computer-aided design/ computer-aided manufacturing (CAD/CAM) milling. The fused deposition modeling (FDM) printing method for zirconia presents numerous advantages, albeit research on the mechanical properties of these materials and resultant restorations remains scarce. Such developments are undeniably intriguing and warrant further investigation. The objective of the present study was to evaluate the impact of the sintering firing cycle (Conventional vs. Speed sintering) on the flexural strength, flexural modulus, and Vickers Microhardness of milled vs. FDM printed zirconia. METHODS: A total of 60 bars (2 × 5 × 27 mm) were fabricated for flexural strength testing, along with 40 discs (12 × 1.5 mm) for Vickers microhardness testing. Half of the specimens underwent conventional sintering, while the other half underwent a speed sintering cycle. The flexural strength and modulus were determined by a three-point bending test in a universal testing machine. The microhardness of the specimens was evaluated using a Vickers microhardness tester. Statistical analysis was performed using a two-way ANOVA test with a post-hoc Tukey test (p < 0.05). RESULTS: CAD/CAM milled zirconia had significantly higher flexural strength and modulus than FDM-printed zirconia. The sintering process did not significantly affect the flexural strength or modulus of milled or FDM-printed zirconia. The milled speed sintering group had significantly higher values in the Vickers microhardness test compared to the other groups. CONCLUSIONS: The mechanical properties of FDM-printed zirconia specimens were not found to be comparable to those of milled zirconia. Speed sintering cycle may produce milled zirconia restorations with similar flexural strength and modulus to conventional sintering, and even higher Vickers Microhardness values.

A rare diagnosis: Acute bilateral vasitis mimicking incarcerated bilateral inguinal hernia.

Inflammation of the vas deferens or what known as acute vasitis is an under-reported condition that usually presents with scrotal or inguinal pain and swelling which can be misdiagnosed and treated as many other conditions. Here, we present one of the first cases to be reported in the literature with bilateral manifestation. A 28-year-old male patient presented complaining of bilateral testicular and inguinal pain associated with inguinal swelling for 3 days. Initially, the patient was being evaluated as a case of incarcerated bilateral inguinal hernia, but with the aid of radiological imaging, the patient was diagnosed correctly and the unnecessary surgical intervention was prevented.

Incidence and risk factors of contrast-induced nephropathy in acute stroke patients undergoing computed tomography angiography: A single-center study.

OBJECTIVES: To investigate the prevalence and risk factors linked to contrast-induced nephropathy in this specific patient population, aiming to ensure the highest quality of clinical care. METHODS: In a retrospective analysis, all patients who presented with an acute stroke to King Fahad Hospital, Jeddah, Emergency Department from March until November 2022 and underwent Computed Tomography Angiography (CTA) brain, Inclusion criteria were as follows: a baseline creatinine results and CTA examination performed within 24 hours of symptom onset and an available early (<5 days after CTA) follow-up creatinine result. RESULTS: Among 246 stroke patients in the emergency, 182 underwent brain CTA and 8.24% had Contrast-Induced Nephropathy (CIN). intracerebral hemorrhage (ICH) increased CIN risk 7-fold (OR=6.7; 95% CI: 1.23-33.3). Abnormal baseline raised CIN risk 8-fold (OR=7.8; 95% CI: 1.74-35.1). hypertension doubled the risk for CIN (OR=2.1; 95% CI: 1.26-6.98) CONCLUSION: The incidence of CIN was 8.2%, particularly elevated in patients with ICH, hypertension, tissue plasminogen administration, and abnormal baseline, necessitating vigilance in managing acute stroke cases.

Effect of Repressing Lithium Disilicate Glass Ceramics on The Shear Bond Strength of Resin Cements.

The aim of this study was to investigate the effect of repeated pressing of lithium disilicate ceramic on the shear bond strength (SBS) of three types of resin cement. METHODOLOGY: A lithium disilicate ceramic (IPS e.max® Press) was first heat-pressed to form rectangular disk specimens. Then, leftovers were used for the second and third presses. A total of 90 specimens were prepared and separated, according to the number of pressing cycles, into three groups: 1st, 2nd, and 3rd presses (n = 30). Each group was further subdivided into three groups (n = 10) according to the type of resin cement used, as follows: Multilink N (MN), Variolink Esthetic DC (VDC), and Variolink Esthetic LC (VLC). All the cement was bonded to the ceramic surface, which was etched with hydrofluoric acid and primed with Monobond Plus. All samples were light-cured and stored for 24 h. Shear bond strength was tested on a universal testing machine. RESULTS: A two-way ANOVA was used to evaluate the influence of repeated pressing cycles and cement type as well as their interaction. The results indicated that cement type has a significant impact (p < 0.001) but not the number of pressing cycles (p = 0.970) or their interaction (p = 0.836). The Bonferroni post-hoc test showed that the SBS of MN was significantly higher than that of VDC and VLC in the first press and second press cycles, respectively. The SBS of MN was significantly higher than that of VDC and VLC cements in the third pressing cycle. There was no significant difference in the SBS between VLC and VDC in all three pressing cycles. CONCLUSION: The results of the current study did not report a detrimental effect of repeated pressing up to three cycles on the shear bond strength of the IPS e.max® Press. Multilink resin cement showed the highest SBS to IPS e.max® Press at the third pressing cycle. For all types of cement and heat pressing cycles, the majority of cement failures were adhesive. No cohesive failures occurred in any of the tested resin cements, regardless of the cement type or the number of heat pressing cycles tested.

An Unusual Cause of Recurrent Visible Hematuria; Posterior Urethral Hemangioma: A Case Report and Review of Literature.

Urinary tract hemangiomas are uncommon entity to urologists, despite their benign nature and course; they can cause significant patient's hemodynamic instability or distress if not recognized and managed properly. Here, we present a case of urethral hemangioma with its treatment, follow-up course and review of literature of similar cases. Introduction: Bloody urine or urethral bleeding can be the initial presentation of a number of different medical and surgical conditions, some of which are benign and others are malignant, when encountered, they are alarming and must be evaluated thoroughly. As a cause, urethral hematomas are faced rarely, among all urinary tract sites; they are the second least common(1). Due to their paucity in clinical practice, there is no agreed approach on their management and each case has to be individualized. In the literature, different assessment and treatment methods were tried with satisfactory outcomes in each one. Here we report a case with detailed, concise explanation of such pathology and a comprehensive comparison in light of previous literature. Keywords: Urethral hemangioma, urethral bleeding, benign urinary tract tumors.

Regional Myopericarditis Mimicking Inferior Myocardial Infarction Following COVID-19 Vaccination: A Rare Adverse Event.

We present the case of a 41-year-old man who developed myopericarditis after receiving the Pfizer COVID-19 vaccine. The patient experienced a sudden onset of chest and abdominal pain 16 days after vaccination. Electrocardiogram findings revealed deep T-wave inversion and minimal ST-segment elevation. Further investigation through coronary artery angiography and computed tomography identified an anomalous left main coronary artery. Magnetic resonance imaging confirmed the diagnosis of myopericarditis. This case highlights the importance of considering myopericarditis as a potential cause of chest pain and elevated cardiac biomarkers following COVID-19 vaccination, particularly in young individuals. Clinicians should be aware of this adverse event and include it in the differential diagnosis for patients presenting with similar symptoms after vaccination.

Sustainable Resource Allocation and Reduce Latency Based on Federated-Learning-Enabled Digital Twin in IoT Devices.

In this article, we utilize Digital Twins (DT) with edge networks using blockchain technology for reliable real-time data processing and provide a secure, scalable solution to bridge the gap between physical edge networks and digital systems. Then, we suggest a Federated Learning (FL) framework for collaborative computing that runs on a blockchain and is powered by the DT edge network. This framework increases data privacy while enhancing system security and reliability. The provision of sustainable Resource Allocation (RA) and ensure real-time data-processing interaction between Internet of Things (IoT) devices and edge servers depends on a balance between system latency and Energy Consumption (EC) based on the proposed DT-empowered Deep Reinforcement Learning (Deep-RL) agent. The Deep-RL agent evaluates the performance action based on RA actions in DT to distribute its bandwidth resources to IoT devices based on iteration and the actions taken to generate the best policy and enhance learning efficiency at every step. The simulation results show that the proposed Deep-RL-agent-based DT is able to exploit the best policy, select 47.5% of computing activities that are to be carried out locally with 1 MHz bandwidth and minimize the weighted cost of the transmission policy of edge-computing strategies.

Hand Knob Syndrome Secondary to Ipsilateral Concomitant Carotid Fibromuscular Dysplasia and Proximal Atherosclerotic Disease.

One of the uncommon stroke presentations is the isolated wrist drop syndrome, caused by a stroke affecting the hand knob area, with the embolic mechanism being the most commonly identified mechanism. Here, we present the case of a 62-year-old female patient who presented with acute-onset isolated wrist drop secondary to right internal carotid artery fibromuscular dysplasia with a string of beads appearance and coexisting proximal atherosclerotic severe stenosis. The patient underwent successful carotid artery stenting. Patients with hand knob stroke may present a diagnostic dilemma and can be misdiagnosed as having peripheral neuropathy due to the absence of pyramidal signs and other symptoms of cortical involvement, leading to delayed or inappropriate treatment.

Mechanical Properties of Three-Dimensional Printed Provisional Resin Materials for Crown and Fixed Dental Prosthesis: A Systematic Review.

The emergence of digital dentistry has led to the introduction of various three-dimensional (3D) printing materials in the market, specifically for provisional fixed restoration. This study aimed to undertake a systematic review of the published literature on the Mechanical Properties of 3D- Printed Provisional Resin Materials for crown and fixed dental prosthesis (FDP). The electronic database on PubMed/Medline was searched for relevant studies. The search retrieved articles that were published from January 2011 to March 2023. The established focus question was: "Do provisional 3D-printed materials have better mechanical properties than conventional or milled provisional materials?". The systematically extracted data included the researcher's name(s), publication year, evaluation method, number of samples, types of materials, and study outcome. A total of 19 studies were included in this systematic review. These studies examined different aspects of the mechanical properties of 3D-printed provisional materials. Flexural Strength and Microhardness were the frequently used mechanical testing. Furthermore, 3D-printed provisional restorations showed higher hardness, smoother surfaces, less wear volume loss, and higher wear resistance compared to either milled or conventional, or both. 3D-printed provisional resin materials appear to be a promising option for fabricating provisional crowns and FDPs.

Risk Factors for Mortality in Patients With Cerebral Palsy: A Systematic Review and Meta-Analysis.

Cerebral palsy (CP) is a developmental and physical disorder with different degrees of severity. Since CP manifests itself in early childhood, numerous research studies have concentrated on children with CP. Patients with CP encounter different severity of motor impairments attributed to the damage or disturbance to the fetal or infant developing brain, which begins in early childhood and persists through adulthood. Patients with CP are more prone to mortality compared to the general population. This systematic review and meta-analysis aimed to assess the risk factors that predict and influence mortality in patients with CP. Systematic search for studies assessing the risk factors for mortality in CP patients that were conducted from 2000 to 2023 in Google Scholar, PubMed, and Cochrane Library was performed. R-One Group Proportion was used for statistical analysis and Newcastle-Ottawa Quality Assessment Scale (NOS) for quality appraisal. Of the 1791 total database searches, nine studies were included. Based on the NOS tool for quality appraisal, seven studies were of moderate quality, and two studies were rated as of high quality. The risk factors included pneumonia and other respiratory infections, neurological disorders, circulatory diseases, gastrointestinal infections, and accidents. Pneumonia (OR = 0.40, 95% CI = 0.31 - 0.51), neurological disorders (OR = 0.11, 95% CI = 0.08 - 0.16), respiratory infections (OR = 0.36, 95% CI = 0.31 - 0.51), cardiovascular and circulatory diseases (OR = 0.11, 95% CI = 0.04 - 0.27), gastrointestinal and metabolic causes (OR = 0.12, 95% CI = 0.06 - 0.22), and accidents (OR = 0.05, 95% CI = 0.04 - 0.07) were the risk factors assessed. It was concluded that multiple factors predict the risk of mortality in patients with CP. Pneumonia and other respiratory infections are associated with a high risk of mortality. Cardiovascular and circulatory diseases, gastrointestinal and metabolic disorders, and accidents are strongly linked to mortality in CP patients.

Reversible CT Scan Hypodensity in Acute Ischemic Stroke Patient With Low Initial Alberta Stroke Program Early CT Score (ASPECTS) Following Endovascular Thrombectomy: A Case Report.

According to current American and European guidelines, mechanical thrombectomy is recommended only for patients with an Alberta Stroke Program Early CT Score (ASPECTS) of 6 or higher. However, recent literature suggests that the potential benefits of reperfusion therapy should not be solely determined by baseline ASPECTS. In this case report, we present a young female patient with a low initial ASPECTS (4-5), who underwent mechanical thrombectomy and showed marked improvement in both CT imaging and clinical symptoms. Our findings potentially show that mechanical thrombectomy may be beneficial even for patients with an initial ASPECTS ≤ 5. These results may contribute to the growing evidence supporting the use of mechanical thrombectomy as a viable treatment option for acute ischemic stroke patients with low baseline ASPECTS.