Pectin hydrogels for controlled drug release: Recent developments and future prospects.

Pectin hydrogels have emerged as a highly promising medium for the controlled release of pharmaceuticals in the dynamic field of drug delivery. The present review sheds light on the broad range of applications and potential of pectin-based hydrogels in pharmaceutical formulations. Pectin, as a biopolymer, is a versatile candidate for various drug delivery systems because of its wide range of properties and characteristics. The information provided on formulation strategies and crosslinking techniques provides researchers with tools to improve drug entrapment and controlled release. Furthermore, this review provides a more in-depth understanding of the complex factors influencing drug release from pectin hydrogels, such as the impact of environmental conditions and drug-specific characteristics. Pectin hydrogels demonstrate adaptability across diverse domains, ranging from applications in oral and transdermal drug delivery to contributions in wound healing, tissue engineering, and ongoing clinical trials. While standardization and regulatory compliance remain significant challenges, the future of pectin hydrogels appears to be bright, opening up new possibilities for advanced drug delivery systems.

Assessing variations in land cover-land use and surface temperature dynamics for Dehradun, India, using multi-time and multi-sensor landsat data.

Rapid urbanisation and industrialisation coupled with overpopulation have altered land cover/land use (LCLU) and surface temperature (ST) patterns in Dehradun. Monitoring these changes through satellite-based remote sensing is required to ensure the sustained development of this ecologically fragile region. Here, LU and ST dynamics of the Dehradun municipal area have been estimated using Landsat-5 datasets for 1991, 1998, and 2008 and Landsat-8 dataset for 2018. LU maps have been extracted using a Gaussian Maximum Likelihood classifier with an overall accuracy of over 88% and Kappa coefficients above 0.85. Results reveal that the urban region expanded by 80.6% in the 27 years while dense vegetation and dry river bed classes have declined sharply. Sparse vegetation has risen by 3 km2, whereas bare ground has decreased by about 4.3 km2. Mean ST has increased above 9 °C from 1991 to 2018 in every season. A seasonal influence is evident on the mean ST per LU class's trend, which rose between 8 °C and 12 °C for every LU class, indicating significant warming across each LU class. ST probably has non-linear relationships with its causal factors represented by spectral indices, elevation, and population density. Urban heat island (UHI) formation is thus evinced, promulgating the administration's urgent action to save the environment and redrawing policies for ambitious projects like smart cities.

Potential of DESIS and PRISMA hyperspectral remote sensing data in rock classification and mineral identification:a case study for Banswara in Rajasthan, India.

Remote sensing datasets and methods are suitable for mapping and managing the natural resources like minerals, clean water, and energy and also govern their sustainability nowadays. Hyperspectral (HS) imaging has immense potential for rock type classification, mineral mapping, and identification. This work demonstrates the potential of feature extraction techniques and unsupervised machine learning methods for the space-borne hyperspectral remote sensing data in characterizing and identifying mineral and classifying rock type in Banswara, Rajasthan, India. Feature extraction techniques can reveal variations within the data, which can help identify geological areas, reduce noise, and check the dimensionality of the data. Singular value decomposition (SVD)-based principal component analysis (PCA), kernel PCA (KPCA), minimum noise fraction (MNF), and independent component analysis (ICA) were tested for lithological mapping using recently launched DLR Earth Sensing Imaging Spectrometer Hyperspectral (DESIS) and PRecursore IperSpettrale della Missione Applicativa (PRISMA) data in order to map geologically significant areas. Unsupervised machine learning methods, such as Iterative Self-Organizing Data Analysis Technique (ISODATA) and K-means, were also employed. Vertex component analysis (VCA) was utilized to check for similarity and identify various spectral features. Our work demonstrates the advantages of using feature extraction algorithms such as PCA and KPCA over MNF and ICA in geological mapping and interpretability. We recommend K-means as the preferred method for lithological classification of hyperspectral remote sensing data. Our work highlights the potential of advanced feature extraction algorithms for mineral mapping using hyperspectral data, providing different ways to identify minerals and ultimately leading to better mineral resource management.

Delineation of agricultural fields in arid regions from Worldview-2 datasets based on image textural properties.

Barren lands are being transformed into agricultural fields with the growing demand for agriculture-based products. Hence, monitoring these regions for better planning and management is crucial. Surveying with high-resolution RS (remote sensing) satellites like Worldview-2 provides a faster and cheaper solution than conventional surveys. In the study, the arid region comprising cropland and barrenlands are efficiently and autonomously delineated using its spectral and textural properties using state-of-the-art random forest (RF) ensemble classifiers. The textural information window size is optimized and at a GLCM (gray-level co-occurrence matrix) window size of 13, a stable trend in classification accuracy was observed. A further rise in window sizes did not improve the classification accuracy; beyond GLCM 19, a decline in accuracy was observed. Comparing GLCM-13 RF with the no-GLCM RF classifier, the GLCM-based classifiers performed better; thus, the textural information assisted in removing isolated crop-classified outputs that are falsely predicted pixel groups. Still, it also obscured information about barren lands present within croplands. Delineation accuracy was 93.8 % for the no-GLCM RF classifier, whereas, for the GLCM-13 RF classifier, an accuracy of 97.3 % was observed. Thus, overall, a 3.5 % improvement in accuracy was observed while using the GLCM RF classifier with window size 13. The textural information with proper calibration over high-spatial resolution datasets improves crop delineation in the present study. Henceforth, a more accurate cropland identification will provide a better estimate of the actual cropland area in such an arid region, which will assist in formulating a better resource management policy.

Age Alters Prevalence of Left Atrial Enlargement and Nonstenotic Carotid Plaque in Embolic Stroke of Undetermined Source.

BACKGROUND: Nonstenotic carotid plaque and undetected atrial fibrillation are potential mechanisms of embolic stroke of undetermined source (ESUS), but it is unclear which is more likely to be the contributing stroke mechanism. We explored the relationship between left atrial enlargement (LAE) and nonstenotic carotid plaque across age ranges in an ESUS population. METHODS: A retrospective multicenter cohort of consecutive patients with unilateral, anterior circulation ESUS was queried (2015 to 2021). LAE and plaque thickness were determined by transthoracic echocardiography and computed tomography angiography, respectively. Descriptive statistics were used to compare plaque features in relation to age and left atrial dimensions. RESULTS: Among the 4155 patients screened, 273 (7%) met the inclusion criteria. The median age was 65 years (interquartile range [IQR] 54-74), 133 (48.7%) were female, and the median left atrial diameter was 3.5 cm (IQR 3.1-4.1). Patients with any LAE more frequently had hypertension (85.9% versus 67.2%, P<0.01), diabetes (41.0% versus 25.6%, P=0.01), dyslipidemia (56.4% versus 40.0%, P=0.01), and coronary artery disease (22.8% versus 11.3%, P=0.02). Carotid plaque thickness was greater ipsilateral versus contralateral to the stroke hemisphere in the overall cohort (median 1.9 mm [IQR 0-3] versus 1.5 mm [IQR 0-2.6], P<0.01); however, this was largely driven by the subgroup of patients without any LAE (median 1.8 mm [IQR 0-2.9] versus 1.5 mm [IQR 0-2.5], P<0.01). Compared with patients ≥70 years, younger patients had more carotid plaque ipsilateral versus contralateral (mean difference 0.42 mm±1.24 versus 0.08 mm±1.54, P=0.047) and less moderate-to-severe LAE (6.3% versus 15.3%, P=0.02). CONCLUSIONS: Younger patients with ESUS had greater prevalence of ipsilateral nonstenotic plaque, while the elderly had more LAE. The differential effect of age on the probability of specific mechanisms underlying ESUS should be considered in future studies.

Weak task synchronization of default mode network in task based paradigms.

The brain's Default mode network (DMN) is generally characterized by brain areas that gets deactivated upon the presentation of a wide variety of externally focused, attention demanding tasks. These areas also exhibit significant intra-DMN functional connectivity and significant negative functional connectivity with other brain areas, especially with attention networks, in both resting state and task conditions. Therefore, the DMN has been hypothesized to be involved in internally directed cognitive activities such as autobiographical recall of the past, future planning and mind wandering. Recent research has discovered the role of bottom-up attention in modulating the behaviour of DMN. We hypothesize that the de-engagement of the DMN regions upon the presentation of an externally-focused attention-demanding stimulus may not be strictly stimulus locked and may exhibit significant trial-to-trial as well as subject-to-subject variability. Due to the involvement of frontoparietal control network in modulating the anticorrelations between DMN and dorsal attention network (DAN), we expect the DMN regions to have lower inter-trial and inter-subject synchronization in their fMRI BOLD responses as compared to the bottom-up early-sensory task-positive regions. To test this hypothesis, we designed new statistical methods called Inter Trial Temporal Synchronization Analysis (IT-TSA) and Inter Subject TSA (IS-TSA) to analyse variability across trials and subjects respectively. We analysed four publicly available datasets (total 223 subjects) across seven tasks related to different cognitive modalities and found out that there is significantly low stimulus-locked synchronization across trials and subjects in the DMN regions as compared to early sensory task positive regions. Our study challenges the understanding of DMN as a strictly task-negative region and supports the recent findings that DMN acts as an active component associated with intrinsic processing which deactivates differentially and non-linearly across trials and subjects in the presence of extrinsic processes.

Machine learning based reanalysis of clinical scores for distinguishing between ischemic and hemorrhagic stroke in low resource setting.

BACKGROUND: Identifying ischemic or hemorrhagic strokes clinically may help in situations where neuroimaging is unavailable to provide primary-care prior to referring to stroke-ready facility. Stroke classification-based solely on clinical scores faces two unresolved issues. One pertains to overestimation of score performance, while other is biased performance due to class-imbalance inherent in stroke datasets. After correcting the issues using Machine Learning theory, we quantitatively compared existing scores to study the capabilities of clinical attributes for stroke classification. METHODS: We systematically searched PubMed, ERIC, ScienceDirect, and IEEE-Xplore from 2001 to 2021 for studies that validated the Siriraj, Guys Hospital/Allen, Greek, and Besson scores for stroke classification. From included studies we extracted the reported cross-tabulation to identify and correct the above listed issues for an accurate comparative analysis of the performance of clinical scores. RESULTS: A total of 21 studies were included. Comparative analysis demonstrates Siriraj Score outperforms others. For Siriraj Score the reported sensitivity range (Ischemic Stroke-diagnosis) 43-97% (Median = 78% [IQR 65-88%]) is significantly higher than our calculated range 40-90% (Median = 70% [IQR 57-73%]), also the reported sensitivity range (Hemorrhagic Stroke-diagnosis) 50-95% (Median = 71% [IQR 64-82%]) is higher than our calculated range 34-86% (Median = 59% [IQR 50-79%]) which indicates overestimation of performance by the included studies. Guys Hospital/Allen and Greek Scores show similar trends. Recommended weighted-accuracy metric provides better estimate of the performance. CONCLUSION: We demonstrate that clinical attributes have a potential for stroke classification, however the performance of all scores varies across demographics, indicating the need to fine-tune scores for different demographics. To improve this variability, we suggest creating global data pool with statistically significant attributes. Machine Learning classifiers trained over such dataset may perform better and generalise at scale.

Comparison of intracervical Foley catheter combined with a single dose of vaginal misoprostol tablet or intracervical dinoprostone gel for cervical ripening: a randomised study.

We compared two combined methods for cervical ripening before induction of labour (IOL) Women (n = 150) were randomised into Foley's-misoprostol (n = 75) and Foley's-dinoprostone (n = 75) groups. A single dose of vaginal misoprostol tablet (25 µg) or intracervical dinoprostone gel (0.5 mg) were used alongwith intracervical Foley's. The primary outcome was induction-delivery interval (IDI) and secondary outcomes were change in Bishop's score, oxytocin requirement, caesarean section (CS) rate, chorioamnionitis and neonatal outcome. The mean parity, gestation and indications for IOL were similar in the two groups. The IDI (19 h 37 min and 19 h 20 min; p = .683), cervical ripening time, oxytocin requirement, CS rate (18.7 and 25.4%, p = .322) and neonatal outcome were similar. Hyperstimulation developed in 2.7% women with Foley's-misoprostol and in 1.3% with Foley's-dinoprostone (p = .55). No woman had chorioamnionitis. Thus, these two combined methods of cervical ripening and IOL were observed to be similarly efficacious. A low incidence of hyperstimulation and no chorioamnionitis may be attributed to using a single dose of prostaglandins. Misoprostol may be substituted for dinoprostone in resource limited countries.Impact statementWhat is already known on this subject? Combined methods for cervical ripening (intracervical Foley's plus prostaglandins) before induction of labour (IOL) may be similarly or more efficacious than individual methods. Most studies comparing various combined methods have used repeated doses of prostaglandins. A combined method using repetitive doses of prostaglandins may increase the risk of hyperstimulation and also of infection consequent to repeated vaginal examination to administer prostaglandins. These two concerns may be offset by combining a single dose of prostaglandin with intracervical Foley's catheter.What do the results of this study add? Two combined methods for cervical ripening using a single dose of vaginal misoprostol (25 µg) or intracervical dinoprostone gel (0.5 mg) co-administered with intracervical Foley's catheter were found to be similarly efficacious. The IDI (19 h 37 min and 19 h 20 min; p = .683), cervical ripening time, oxytocin requirement, CS rate (18.7 and 25.4%, p = .322) and neonatal outcome were similar. The incidence of hyperstimulation was low (2.7 and 1.3% with Foley's-misoprostol and Foley's-dinoprostone, respectively) and no woman had chorioamnionitis.What are the implications of these findings for clinical practice and/or further research? Combined methods for cervical ripening using a single dose of prostaglandins (misoprostol or dinoprostone) were observed to be similarly efficacious. Misoprostol is a cheaper alternative to dinoprostone and may be utilised in resource limited countries. These methods may be compared with each other in more number of women in order to identify which combined method is more efficient and safe. Clinical Trials Registry of India: CTRI/2017/12/010738.

Progress and challenges of graphene and its congeners for biomedical applications.

Nanomaterials by virtue of their small size and enhanced surface area, present unique physicochemical properties that enjoy widespread applications in bioengineering, biomedicine, biotechnology, disease diagnosis, and therapy. In recent years, graphene and its derivatives have attracted a great deal of attention in various applications, including photovoltaics, electronics, energy storage, catalysis, sensing, and biotechnology owing to their exceptional structural, optical, thermal, mechanical, and electrical. Graphene is a two-dimensional sheet of sp2 hybridized carbon atoms of atomic thickness, which are arranged in a honeycomb crystal lattice structure. Graphene derivatives are graphene oxide (GO) and reduced graphene oxide (rGO), which are highly oxidized and less oxidized forms of graphene, respectively. Another form of graphene is graphene quantum dots (GQDs), having a size of less than 20 nm. Contemporary graphene research focuses on using graphene nanomaterials for biomedical purposes as they have a large surface area for loading biomolecules and medicine and offer the potential for the conjugation of fluorescent dyes or quantum dots for bioimaging. The present review begins with the synthesis, purification, structure, and properties of graphene nanomaterials. Then, we focussed on the biomedical application of graphene nanomaterials with special emphasis on drug delivery, bioimaging, biosensing, tissue engineering, gene delivery, and chemotherapy. The implications of graphene nanomaterials on human health and the environment have also been summarized due to their exposure to their biomedical applications. This review is anticipated to offer useful existing understanding and inspire new concepts to advance secure and effective graphene nanomaterials-based biomedical devices.

Impact of Diffuse Large B-Cell Lymphoma on Mammography and Bone Density Testing in Women.

Women with diffuse large B-cell lymphoma (DLBCL) are at an increased risk of mortality from breast cancer and osteoporosis. However, the impact of DLBCL on rates of mammography and bone density testing (BDT) is unknown. We compared female DLBCL and non-cancer patients utilizing the Surveillance, Epidemiology, and End Results-Medicare dataset to analyze the predictors of mammography and BDT. Guided by the Social Ecological Model (SEM), we used multivariable logistic regressions with inverse probability treatment weighting to examine the association of intrapersonal, interpersonal, healthcare system, and community factors with mammography and BDT. The rates of mammography (59.8%) and BDT (18.5%) in women with DLBCL were similar to those without cancer (60.2% and 19.6%, respectively). After adjusting for the SEM factors, DLBCL patients were less likely to get mammography and BDT than non-cancer patients. The treatments of radiotherapy and stem cell transplant were not associated with either mammography or BDT. DLBCL diagnosis was associated with lower rates of mammography and BDT rates among women with DLBCL, as compared to non-cancer patients. To reduce the morbidity and mortality from breast cancer and fractures in women with DLBCL, providers should increase their recommendations for mammography in those receiving radiotherapy and BDT in stem cell transplant patients.

Illness Representations of Pertussis and Predictors of Child Vaccination Among Mothers in a Strict Vaccination Exemption State.

Background Vaccine preventable diseases are making a comeback in the US. However, research is lacking on illness representations of vaccine preventable diseases and their application in improving childhood immunization. Objective We utilized the common sense model of self-regulation to examine illness representations of pertussis and their associations with child's receipt of any vaccine, up-to-date vaccination status, and mothers' intentions to follow the recommended vaccination schedule in the future. Methods We developed vaccine worry and vaccine hassles scales to assess mothers' worries and hassles for child vaccination, and used an open ended question to assess mother's illness representations of pertussis. We surveyed mothers with children <3 years old (N = 160) in the Appalachian state of West Virginia, which only allows medical vaccine exemptions. Results Some children (5.0%) had received no vaccination, 15.0% were not up-to-date with the recommended vaccination schedule, and 13.8% mothers reported no intention to follow the recommended schedule in future (future intention). Illness representations included identity (17.8%), timeline (61.8%), consequences (58.6%), cause (35.0%), and cure/control (56.7%). Higher vaccine worry was associated with child receiving no vaccine. Not using daycare, higher vaccine worry, and difficulty breathing (identity) were associated with child not being up-to-date. Higher vaccine worry, cough (identity), and belief that vaccines are ineffective (cure/control) were associated with no future intention. Conclusions Vaccination interventions need to address mothers' worry regarding vaccine safety. 'Common Sense' beliefs regarding vaccines need to be reconciled with scientific data about vaccine safety and effectiveness, even among those with high socio-economic status in a strict vaccination state.

Enamel Surface Roughness after Debonding: A Comparative Study using Three Different Burs.

AIM: To compare effects of three different burs, i.e., tungsten carbide bur, composite bur, and fiber glass bur on the surface roughness of enamel after debonding evaluated by means of profilometry. MATERIALS AND METHODS: The present study was conducted in the Department of Orthodontics and Dentofacial Orthopedics, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India, from August 2011 to December 2012 on 36 extracted premolars. After mounting the samples in acrylic blocks with their buccal surfaces exposed, initial measurement of the surface roughness was made using profilometry. Teeth were then etched and brackets were bonded with light cure adhesive. After 3 days, the brackets were debonded using three different rotating burs at low speed, i.e., tungsten carbide bur, fiber glass bur, and composite bur. Enamel surface roughness values were obtained and assessed using paired t-test, one-way analysis of variance (ANOVA) test, and post hoc multiple tests. RESULTS: Surface roughness of enamel increased significantly for tungsten carbide bur when compared with fiber glass bur and composite bur. But there was no significant difference in the surface roughness value when fiber glass bur was compared with the composite bur. CONCLUSION: Composite and fiber glass burs used for resin removal after orthodontic debonding produced a smoother enamel surface as compared with the tungsten carbide bur. CLINICAL SIGNIFICANCE: After an orthodontic treatment, restoring the enamel surface to its pretreatment condition without inducing any iatrogenic damage after debonding is a clinical challenge. Residual resin removal through proper means ensures a smooth surface, and, hence, a plaque-free environment. Finishing requires as much planning and execution as planned for the fixed therapy itself.

Impact of Genetic Counseling and Testing on Altruistic Motivations to Test for BRCA1/2: a Longitudinal Study.

Despite the importance of altruism in an individual's participation in genetic counseling and testing, little research has explored the change in altruistic motivations to test over time. This study analyzed altruistic motivations to test and change in altruistic motivations after genetic counseling and testing among individuals (N = 120) at elevated risk for BRCA1/2 mutations. The perceived benefits of genetic testing were assessed and utilized in a mixed-methods, repeated measures design at three time points: pre-counseling, counseling and post-genetic testing, along with transcripts of genetic counseling sessions. Qualitative analysis using an immersion/crystallization method resulted in six common perceived benefits of testing: cancer prevention, awareness, family's survival, relief from anxiety, for science, and future planning. Perceived benefits were then coded into three categories according to Hamilton's kin selection theory: altruistic motivation, personal motivation, and motivation for mutual benefit. At pre-counseling, those with a personal cancer history (p = 0.003) and those with one or more children (p = 0.013), were significantly more likely to cite altruistic motivations to test. Altruistic motivations significantly increased post-counseling (p = 0.01) but declined post-testing (p < 0.001). Labov's narrative analysis further elucidated the context of altruistic and personal motivations. The possibility of a positive test result might have led those with personal history of cancer to have altruistic motivations for testing. Genetic counseling may have increased altruistic motivations to help family and may be a prime opportunity to discuss other forms of altruism.

Consistent movement of viewers' facial keypoints while watching emotionally evocative videos.

Neuropsychological research aims to unravel how diverse individuals' brains exhibit similar functionality when exposed to the same stimuli. The evocation of consistent responses when different subjects watch the same emotionally evocative stimulus has been observed through modalities like fMRI, EEG, physiological signals and facial expressions. We refer to the quantification of these shared consistent signals across subjects at each time instant across the temporal dimension as Consistent Response Measurement (CRM). CRM is widely explored through fMRI, occasionally with EEG, physiological signals and facial expressions using metrics like Inter-Subject Correlation (ISC). However, fMRI tools are expensive and constrained, while EEG and physiological signals are prone to facial artifacts and environmental conditions (such as temperature, humidity, and health condition of subjects). In this research, facial expression videos are used as a cost-effective and flexible alternative for CRM, minimally affected by external conditions. By employing computer vision-based automated facial keypoint tracking, a new metric similar to ISC, called the Average t-statistic, is introduced. Unlike existing facial expression-based methodologies that measure CRM of secondary indicators like inferred emotions, keypoint, and ICA-based features, the Average t-statistic is closely associated with the direct measurement of consistent facial muscle movement using the Facial Action Coding System (FACS). This is evidenced in DISFA dataset where the time-series of Average t-statistic has a high correlation (R2 = 0.78) with a metric called AU consistency, which directly measures facial muscle movement through FACS coding of video frames. The simplicity of recording facial expressions with the automated Average t-statistic expands the applications of CRM such as measuring engagement in online learning, customer interactions, etc., and diagnosing outliers in healthcare conditions like stroke, autism, depression, etc. To promote further research, we have made the code repository publicly available.

Drivers' liability-based comparative severity analysis of motorized two-wheeler crashes.

OBJECTIVE: This study aims to investigate comparative severity analysis of motorized two-wheeler (MTW) crashes based on drivers' liability using police-reported a crash data base. METHODS: Using crash data from 2016 to 2020, this study examines and analyses the key factors affecting the severity of MTW injuries in Dehradun. For analysis, the ordinal logistic approach is used because severity levels are attributed with natural ordering. Differentiating from past studies, this research distinguished between collisions in which MTW crashes were considered as first party (crash in which MTW rider is accountable) and second person (crash in which MTW rider is a victim). RESULTS: Result suggests that age, pillion passenger, type of collision, road network, and impacting vehicle increase the seriousness of a crash in both cases. However, crash day, crash time, and light condition were found to be significant in the case of second-party crashes. Similarly, crash seriousness tends to decrease in first-party crashes, whereas it increases in the context of second-party crashes. CONCLUSION: The statistical results were correlated with past studies to provide proper justification in order to provide a better understanding of small-displacement MTW fatal accidents in developing countries. Additionally, this research aids in the development of mitigation strategies and future research directions to improve the safety of MTW users.

Functional connectivity changes in meditators and novices during yoga nidra practice.

Yoga nidra (YN) practice aims to induce a deeply relaxed state akin to sleep while maintaining heightened awareness. Despite the growing interest in its clinical applications, a comprehensive understanding of the underlying neural correlates of the practice of YN remains largely unexplored. In this fMRI investigation, we aim to discover the differences between wakeful resting states and states attained during YN practice. The study included individuals experienced in meditation and/or yogic practices, referred to as 'meditators' (n = 30), and novice controls (n = 31). The GLM analysis, based on audio instructions, demonstrated activation related to auditory cues without concurrent default mode network (DMN) deactivation. DMN seed based functional connectivity (FC) analysis revealed significant reductions in connectivity among meditators during YN as compared to controls. We did not find differences between the two groups during the pre and post resting state scans. Moreover, when DMN-FC was compared between the YN state and resting state, meditators showed distinct decoupling, whereas controls showed increased DMN-FC. Finally, participants exhibit a remarkable correlation between reduced DMN connectivity during YN and self-reported hours of cumulative meditation and yoga practice. Together, these results suggest a unique neural modulation of the DMN in meditators during YN which results in being restful yet aware, aligned with their subjective experience of the practice. The study deepens our understanding of the neural mechanisms of YN, revealing distinct DMN connectivity decoupling in meditators and its relationship with meditation and yoga experience. These findings have interdisciplinary implications for neuroscience, psychology, and yogic disciplines.

Prospective comparative evaluation of intraoperative joint stability and component placement between posterior approach to hip and its quadriceps coxae sparing modification for primary hip arthroplasty.

Background: Efforts at minimizing the propensity of posterior approach of hip for post-operative dislocation after total hip arthroplasty have been a subject of continual research. We comparatively evaluated the posterior approach to hip and its quadriceps coxae sparing (QCS) modification with regard to joint stability and component placement.Questions/Purposes: (1) Does sparing of Quadriceps Coxae tendons vis a vis their sectioning in posterior approach help in achieving better intraoperative stability? (2) Does sparing of Quadriceps Coxae tendons come in the way of adequate surgical exposure sufficient to place hip components accurately? (3) Does sparing of Quadriceps Coxae tendons result in better early functional outcome? Methods: Seventy-two patients requiring THA were enrolled prospectively and randomized into two groups: group A (posterior approach) and group B quadriceps coxae sparing (QCS) approach. They were compared for intraoperative joint stability, accuracy of component placement, duration of surgery, blood loss, any event of hip dislocation, and functional outcome. Results: QCS approach resulted in better intraoperative hip stability as the hips tolerated a higher value of 43.50±3.5° mean internal rotation (at 90° of flexion and 20° of adduction) in this group versus a mean value of 33.50±5.5° in posterior approach group (p < 0.01). No significant difference was observed for femoral version, acetabular inclination, and acetabular version in the two groups (p > 0.05). There was no difference between the two groups in terms of duration of surgery, intraoperative blood loss, and functional outcome at one year (p > 0.05). No event of hip dislocation was observed in QCS approach, whereas, one such event happened in the posterior-approach group. Conclusion: Preservation of the QC tendons improves the intraoperative stability of THA and they do not cause any hindrance in the exposure required for optimum component placement.

The impact of civil commitment laws for substance use disorder on opioid overdose deaths.

Objective: Our study analyzed the impact of civil commitment (CC) laws for substance use disorder (SUD) on opioid overdose death rates (OODR) in the U.S. from 2010-21. Methods: We used a retrospective study design using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset to analyze overdose death rates from any opioid during 2010-21 using ICD-10 codes. We used t-tests and two-way ANOVA to compare the OODR between the U.S. states with the law as compared to those without by using GraphPad Prism 10.0. Results: We found no significant difference in the annual mean age-adjusted OODR from 2010-21 between U.S. states with and without CC SUD laws. During the pre-COVID era (2010-19), the presence or absence of CC SUD law had no difference in age-adjusted OODR. However, in the post-COVID era (2020-21), there was a significant increase in OODR in states with a CC SUD law compared to states without the law (p = 0.032). We also found that OODR increased at a faster rate post-COVID among both the states with CC SUD laws (p < 0.001) and the states without the law (p = 0.019). Conclusion: We found higher age-adjusted OODR in states with a CC SUD law which could be due to the laws being enacted in response to the opioid crisis or physicians' opposition to or unawareness of the law's existence leading to underutilization. Recent enactment of CC SUD law(s), a lack of a central database for recording relapse rates, and disparities in opioid overdose rate reductions uncovers multiple variables potentially influencing OODR. Thus, further investigation is needed to analyze the factors influencing OODRs and long-term effects of the CC SUD laws.

Linking Generalized Ligamentous Laxity to Musculoskeletal Injury: A Study in the Indian Population.

Introduction Generalized ligamentous laxity (GLL) is defined as an increased range of motion across multiple joints in an individual beyond the mean range of motion in the general population, with a reported prevalence between 5% and 15%. It becomes less common with age and is more common in females and in the lower limbs. Musculoskeletal injury (MSI) is damage to musculoskeletal systems, usually due to strenuous activity. There is conflicting literature regarding whether the risk of MSI during strenuous activity is higher in individuals with GLL and a dearth of evidence from the Indian subcontinent regarding GLL. This study determines if GLL predisposes to musculoskeletal injuries among patients. Materials and methods One hundred eighty patients each were selected as cases and controls after obtaining informed consent, a Beighton score assessment, and a questionnaire regarding injury-filled in all participants with GLL. Result Thirty-three participants (18.33%) in the case group and 16 participants (8.89%) in the control group were found to have GLL. An odds ratio of 2.30 (using a 2x2 RC table) was calculated between participants with GLL among the cases and controls with a Beighton score of 4/9, and a significantly higher mean Beighton score (p=0.018) was found among participants presenting with MSI (cases) than participants without MSI (controls). Discussion The study found that there was a significant prevalence of GLL in the adult population, especially in females compared to males. The younger age group was also comparatively much more involved. It also proved that GLL was more common in patients with MSI and that hyper-mobile people had a twofold chance of injury compared to the general population. The joints of the lower limb were more frequently involved, probably the weight-bearing joints, the most common being the ankle and knee. People with GLL also had higher chances of repeating injuries. Conclusion This study has implications for the prevention of injuries in people with GLL. Screening such individuals to identify those with GLL using the Beighton score could be beneficial. Though orthopedic surgeons primarily manage people with MSI, they rarely identify individuals with GLL, and making a diagnosis regarding the same definitely helps these individuals live pain-free lives.