Graph learning methods to extract empathy supporting regions in a naturalistic stimuli fMRI

Functional MRI (fMRI) research, employing naturalistic stimuli like movies, explores brain network interactions in complex cognitive processes such as empathy. The empathy network encompasses multiple brain areas, including the Insula, PFC, ACC, and parietal regions. Our novel processing pipeline applies graph learning methods to whole-brain timeseries signals, incorporating high-pass filtering, voxel-level clustering, and windowed graph learning with a sparsity-based approach. The study involves two short movies shown to 14 healthy volunteers, considering 54 regions extracted from the AAL Atlas. The sparsity-based graph learning consistently outperforms, achieving over 88% accuracy in capturing emotion contagion variations. Temporal analysis reveals a gradual induction of empathy, supported by the method's effectiveness in capturing dynamic connectomes through graph clustering. Edge-weight dynamics analysis underscores sparsity-based learning's superiority, while connectome-network analysis highlights the pivotal role of the Insula, Amygdala, and Thalamus in empathy. Spectral filtering analysis emphasizes the band-pass filter's significance in isolating regions linked to emotional and empathetic processing during empathy HIGH states. Key regions like Amygdala, Insula, and Angular Gyrus consistently activate, supporting their critical role in immediate emotional responses. Strong similarities across movies in graph cluster labels, connectome-network analysis, and spectral filtering-based analyses reveal robust neural correlates of empathy. These findings advance our understanding of empathy-related neural dynamics and identify specific regions in empathetic responses, offering insights for targeted interventions and treatments associated with empathetic processing.Comment: 9 figures, 2 table

Recurrent vulval fibroepithelial polyp with pregnancy: a rare presentation

A fibroepithelial polyp (FEP) is a relatively uncommon benign condition of vulva, mainly of reactive origin, occurs in women of reproductive age, mostly during pregnancy. Here is a case which presented with bilateral vulval mass, for that she underwent surgical excision. Histopathological examination revealed bilateral fibroepithelial vulval polyp. After 4 years of uneventful interval same female came with term pregnancy with a huge vulval mass on left side, having similar characteristic features as previous one. Emergency cesarean section followed by excision of polyp in the same sitting done. Histopathological report confirmed the finding of fibroepithelial polyp this time also. Only few cases of recurrent fibroepithelial polyp of vulva associated with pregnancy have been reported till date

A review on determinants and barriers affecting the transition from curative care to palliative care in patients suffering from terminal cancer

The integration of palliative care into comprehensive cancer care has become increasingly recognized as an essential aspect of cancer treatment. Palliative care can improve patient outcomes, symptom management, and overall satisfaction with care. However, despite the benefits of palliative care, several barriers exist that prevent its widespread implementation, including lack of awareness and understanding of palliative care, lack of access to palliative care services, and stigma associated with palliative care. The decision to transition from curative to palliative care is complex and influenced by several factors, including patient preferences, disease stage, and prognosis, symptom burden, comorbidities, and social support. Effective communication between healthcare providers, patients, and families is essential in ensuring that patients are informed about their options and can make informed decisions about their care. This literature review aims to explore the factors that influence the decision to transition to palliative care and to identify the barriers to the implementation of palliative care in cancer patients. The review also discusses strategies to overcome these barriers and highlights the importance of integrating palliative care into cancer care from the time of cancer diagnosis.

Study of drug use in outdoor pediatric patients of upper respiratory tract infections in a tertiary care hospital

Background: Upper respiratory tract infections (URTI) are the most common and frequent occurring infections in the pediatric population. URTI is mostly viral in origin and requires mostly symptomatic treatment. The present study was undertaken to analyze the pattern of drug use in the management of URTI in the pediatric age group.Methods: It is a retrospective study to assess the pattern of drug use in URTI in pediatric outpatient department during the 5 months period from January 2015 to May 2015.Results: A total of 2256 prescriptions were analyzed. Most of the pediatric patients belonged to 1-5 years age group and 58.33% were males, and 41.66% were females. A total of 6332 drugs were prescribed out of which the antibiotics used was 1341. The average number of drugs per prescription used was 2.81. The percentage of prescriptions containing antibiotics was found to be 59.44%. Amoxicillin (70.91%) was the most frequent prescribed antibiotic followed by cotrimoxazole (10.21%). Antihistaminic and expectorant combinations were found to be the most common prescribed class of drugs (29.34%) followed by analgesic and antipyretics (26.45%) and antibiotics (21.17%).Conclusions: The study revealed that the majority of children were below 5 years of age. The most common class of drugs prescribed was antihistaminics and expectorant combinations followed by analgesics and antipyretics. Although the majority of the patients received antibiotics, 40.55% of patients received symptomatic treatment. This is a welcome step as inappropriate use of the antibiotics can potentiate to the increasing trend of antimicrobial resistance

A comparative study between flipped classroom and traditional lecture-based classroom in first year medical students

Introduction: Flipped classroom is a new pedagogical model in which students are provided with study resource material to develop a basic understanding of the topic before class, and in-class precious time is used for learner-centric activities. Accordingly the study objectives were to compare the effect of flipped and traditional classroom teaching method and to determine the student’s perception of flipped and traditional teaching method.Method: This was a non-randomized experimental study. A detailed multiple choice question based test was used to assess the knowledge gain. Another structured questionnaire on students’ perception on flipped classroom teaching and traditional teaching technique was used for both the groups.Results: A total of 112 students participated in this study. The mean assessment scores in the flipped and traditional classroom were not statistically significant. We observed in the current study that the qualitative response was better as compared to quantitative response.Conclusion: As per our qualitative observation, a hybrid of both traditional and flipped classroom teaching method can be used in the transition period until the acceptance for new innovative methods increase. Long term learning gain may be attained by improving motivation and engagement of students in learning process

Significance of Immunohistochemistry Testing in the Diagnosis and Subtyping of Lung Carcinomas- A Retrospective Study from a Tertiary Care Centre in Southern Rajasthan

Introduction: In the present era, the classification of lung carcinoma is not confined to Small Cell Lung Carcinoma (SCLC) and Non Small Cell Lung Carcinoma (NSCLC). Precise subtyping of lung carcinoma has a direct impact on patient management and prognosis. Further molecular study helps in identifying adenocarcinoma receptors, such as Epidermal Growth Factor Receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK), which are useful in targeted therapy. Aim: To assess the role of Immunohistochemistry (IHC) in accurate diagnosis and subtyping of lung carcinoma and to analyse the prevalence of EGFR mutations and ALK rearrangement in lung adenocarcinoma. Materials and Methods: A retrospective hospital-based, observational study was conducted at the Department of Pathology of American International Institute of Medical Sciences, Udaipur, Rajasthan from January 2020 to August 2021. Total of 105 cases of guided core needle biopsies from lung and bronchoscopic biopsies were included. IHC markers were applied based on histopathological diagnosis from a panel of p63, Cytokeratin 7 (CK7), AE1/AE3, Thyroid Transcription Factor (TTF1), Napsin A, p40, synaptophysin, chromogranin, CD56 and Ki67. Adenocarcinoma cases were further analysed for EGFR mutations and ALK rearrangements. Data was tabulated and analysed statistically using Microsoft Excel to determine the percentage frequency distribution of cases. Results: Among 105, there were 88 males and 17 females and the mean age of the population was 60.57 years. The most prevalent subtype of lung malignancy was squamous cell carcinoma (44.7%) followed by adenocarcinoma (29.5%). The diagnostic accuracy of squamous cell carcinomas and adenocarcinomas on morphology was 93.1% and 84.6%, respectively and for small cell carcinoma it was 100%. Amongst 28 cases of adenocarcinoma, EGFR mutation was found in 46.42% cases whereas ALK mutation was found only in 21.42% cases. Conclusion: The study highlights the importance of IHC, and a substantial prevalence of EGFR mutations was found in patients with lung carcinoma

Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019

BACKGROUND: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. FUNDING: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)