Publications by authors named "Rajan D"

Single cells can perform surprisingly complex behaviors and computations, including primitive forms of learning like habituation. New work highlighted here uses mathematical modeling to show that relatively simple biochemical networks can recapitulate many features of habituation in animals.

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Objective: To explore the historical evolution of surgical techniques for otosclerosis treatment, viewed through the lens of human temporal bone pathology to aid in understanding the disease and refining surgical interventions.

Data Sources: A review of historical literature on otosclerosis, surgical techniques, and otopathological findings was conducted. Eight temporal bone specimens from the Paparella Otopathology & Pathogenesis Laboratory, University of Minnesota, and one from the University of California, Los Angeles, were analyzed.

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Background: This retrospective observational study compared outcomes of arthroscopic rotator cuff surgery using double row anchor repair (DRR) versus transosseous anchorless repair (TAR) in patients with small to large full-thickness rotator cuff tears.

Methods: A total of 42 patients underwent DRR (n=20) or TAR (n=22) between January 2022 and May 2023. Patients were matched based on age, sex, body mass index, and tear severity.

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Ataxia telangiectasia.

Semin Pediatr Neurol

December 2024

Ataxia telangiectasia (AT) is a rare neurocutaneous syndrome that results from biallelic pathogenic variants in the ataxia telangiectasia mutated (ATM) gene, named for its characteristic cerebellar ataxia in the early toddler years and variable oculocutaneous telangiectasias in the school age years. While its name only hints at neurologic and cutaneous manifestations, this multisystemic disorder also has important immunologic, oncologic, respiratory, and endocrinologic implications. This article will review the function of the ATM gene, the neurologic manifestations of AT, non-neurologic complications, mimickers of AT (including other disorders of defective DNA repair), and the realm of therapeutic research for AT.

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Article Synopsis
  • The study observes the single-celled organism *coeruleus* displaying habituation to mechanical stimuli, indicating basic learning capabilities even in simple cells, but the mechanism behind this learning is still unclear.
  • Researchers developed a biochemistry-based model that explains how mechanoreceptors in *coeruleus* sense stimuli, leading to changes in cell behavior such as action potential generation and internalization of receptors, a process that could facilitate learning.
  • Simulations based on this model successfully replicated key features of habituation, suggesting a link between receptor dynamics and response to stimuli, while new experiments confirmed predictions about habituation patterns in the cell.
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The policy-making process for health financing in most places lacks equity, failing to adequately consider the voices of ordinary citizens, residents, and especially those facing significant disadvantage. Procedural fairness is about addressing this imbalance, which requires a recalibration of power dynamics, ensuring that decision-making incorporates a more diverse range of perspectives. In this comment, we highlight the important contributions made by the report 'Open and inclusive: Fair processes for financing universal health coverage' in furthering the understanding and importance of procedural fairness in health financing decision-making especially as it relates to the three sub-functions of financing - revenue raising, pooling, and purchasing.

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Objective: The study aimed to assess coronavirus disease 2019 (COVID-19) knowledge among dental patients seeking treatment at a tertiary care center.

Materials And Methods: A cross-sectional study was conducted at the Government Dental College Thrissur to assess dental patients' COVID-19 awareness. Patients over 18 who attended the dental department and agreed to participate were included after obtaining the informed consent.

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Introduction: Rehabilitation after Total Knee Arthroplasty (TKA) often includes proprioceptive exercises to prevent falls, but studies on proprioceptive training have yielded conflicting findings. This study aims to explore impact of proprioceptive training on functional performance after TKA.

Methods: Eighty patients who underwent unilateral TKA were randomly assigned to a proprioceptive exercise (PE) group or a routine exercises (RE) group.

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  • The concept of "venous outflow stenosis" is better understood as "inflow-outflow imbalance," where the outflow capacity of arteriovenous (AV) access can't adequately handle the blood inflow volume (Qa) without increased pressure.
  • This imbalance leads to higher outflow resistance and intraluminal pressure, causing various clinical issues that impact patient health.
  • The authors suggest that assessing access flow is crucial for treatment planning, advocating for a dual treatment strategy of angioplasty for low or normal Qa cases and flow reduction for those with excessive Qa.
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The study of evolution at the cellular level traditionally has focused on the evolution of metabolic pathways, endomembrane systems, and genomes, but there has been increasing interest in evolution of more complex cellular structures and behaviors, particularly in the eukaryotes. Ciliates have major advantages for such studies due to their easily visible surface patterning and their dramatic and complex behaviors that can be easily analyzed. Among the ciliates, the genus epitomizes the features that are useful for studying evolution: they are widespread in freshwater environments, easy to visualize because of their large size, and capable of complex behaviors such as learning, decision-making, and phototaxis.

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Article Synopsis
  • * Researchers examined temporal bones from donors with otosclerosis to assess RW obliteration and its relation to other otosclerosis patterns.
  • * Findings indicate a significant rate of RW involvement, with continuous lesions from the oval window leading to complete RW obliteration, potentially improving future prognostic evaluations for otosclerosis patients.
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Background: The average rate of patient dissatisfaction following total knee arthroplasty (TKA) is 10%. Multi-modal analgesia is the present standard of pain management after TKA. Studies show that with multi-modal analgesia, approximately 60% of patients experience severe knee pain following surgery, while around 30% experience moderate pain.

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Objective: To conduct a systematic review on the effects of multisectoral interventions for health on health system performance.

Methods: We conducted a systematic review according to the preferred reporting items for systematic review and meta-analysis protocols. We searched for peer-reviewed journal articles in PubMed®, Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Database of Systematic Reviews on 31 August 2023 (updating on 28 February 2024).

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  • The study focuses on creating a deep learning digital pathology tool for accurately detecting, segmenting, and classifying nuclei in cancer tissues, addressing challenges in quantifying nuclear morphology in histologic images.
  • This tool was trained on nucleus annotations to analyze H&E-stained slides from various cancer cohorts (BRCA, LUAD, PRAD), revealing significant differences in nuclear features like shape and size linked to genomic instability and cancer prognosis.
  • Results highlighted that certain nuclear characteristics, particularly in fibroblasts, were associated with patient survival outcomes and gene expression related to tumor biology, paving the way for better understanding of cancer biomarkers.
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  • * A total of 107 patients showed significant improvements in knee function, measured by the Lysholm Knee Scoring Scale and Knee Outcome Sports Activity Scale, with most patients returning to sports activities after treatment.
  • * GACI demonstrated low complication and revision rates, indicating it is a viable option for addressing large cartilage defects in the knee.
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Purpose: To assess multicenter two-year patency outcomes of endovascular arteriovenous fistulas (endoAVF) created with the WavelinQ device.

Materials And Methods: Patients who had fistulas created at three centers from January 2018 to December 2020 were included in this retrospective study. In total, 112 patients underwent endoAVF creation [40 females, 72 males; mean age 60 years (range 18-88)].

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Mesenchymal stromal cells (MSCs) are investigated as cellular therapeutics for inflammatory bowel diseases and associated perianal fistula, although consistent efficacy remains a concern. Determining host factors that modulate MSCs' potency including their secretion of angiogenic and wound-healing factors, immunosuppression, and anti-inflammatory properties are important determinants of their functionality. We investigated the mechanisms that regulate the secretion of angiogenic and wound-healing factors and immune suppression of human bone marrow MSCs.

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Study Background: Mechanical alignment has always been considered as the gold standard in total knee arthroplasty (TKA), but various other coronal alignment strategies have been proposed to enhance native knee kinematics and thus elevate patient satisfaction levels. Coronal plane alignment of the knee (CPAK) classification introduced by MacDessi is a simple yet comprehensive system to classify knees based on their coronal plane alignment. It categorizes knees into nine phenotypes based on medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA).

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Introduction: Effective management of postoperative pain in total knee arthroplasty (TKA) poses a significant challenge for surgeons. Achieving rapid recovery without pain and promoting early ambulation in immediate and early postoperative periods are essential for patient satisfaction. There are many pain management protocols including nerve blocks.

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Article Synopsis
  • Pontocerebellar hypoplasia (PCH) is linked to mutations in the X-linked CASK gene, causing microcephaly and cerebellar degeneration, particularly in females, while being more lethal in males.
  • Researchers created knockout mice to study the impacts of CASK deletion at different developmental stages, revealing that deletion post-adulthood leads to cerebellar degeneration and ataxia but not immediate death.
  • Findings suggest that damaging mutations in boys can cause microcephaly and brain dysfunction without PCH, indicating CASK has both shared functions across species and unique roles in the vertebrate brain, particularly in the forebrain and cerebellum.
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Metachromatic leukodystrophy (MLD) is a fatal, progressive neurodegenerative disorder caused by biallelic pathogenic mutations in the ARSA (Arylsulfatase A) gene. With the advent of presymptomatic diagnosis and the availability of therapies with a narrow window for intervention, it is critical to define a standardized approach to diagnosis, presymptomatic monitoring, and clinical care. To meet the needs of the MLD community, a panel of MLD experts was established to develop disease-specific guidelines based on healthcare resources in the United States.

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