Striatal lateral inhibition regulates action selection in a mouse model of levodopa-induced dyskinesia.

Striatal medium spiny neurons (MSNs) integrate multiple external inputs to shape motor output. In addition, MSNs form local inhibitory synaptic connections with one another. The function of striatal lateral inhibition is unknown, but one possibility is in selecting an intended action while suppressing alternatives.

Neurobehavioral Outcomes of Children with Antenatal Exposure to Antiseizure Medications.

Objectives: To evaluate the effect of antiepileptic medications prescribed to mothers during pregnancy on the development and behavior of children.

Methods: From the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group.

Clinical outcomes of adaptive intracavitary and interstitial brachytherapy technique in locally advanced cervical cancer: A real-world data.

Purpose: To evaluate clinical outcomes of CT-based adaptive intracavitary and interstitial brachytherapy (IC followed by IC-ISBT) in locally advanced cervical cancer (LACC) in resource-constrained settings.

Methods And Materials: LACC patients treated with adaptive brachytherapy techniques were analyzed to evaluate treatment characteristics and clinical outcomes. The Kaplan-Meier method was used for survival analysis, and the log-rank test for univariate analysis.

Familial and Social Implications of Breast and Gynaecological cancer in Kerala, India.

Background: Due to the paucity of reliable data to determine the components of family-based comprehensive care for cancer in India, we explored the familial implications of gynaecological and breast cancer diagnosis and treatment through a mixed-method study.

Methods: The mixed method study included 130 women aged above 18 with a confirmed diagnosis of gynaecological or breast cancer recruited from three selected tertiary hospitals in Kerala, India. Information on quality of life (36-Item Short Form Survey (SF-36)), psychological distress (distress thermometer), and the familial, interpersonal, social, and community impacts of cancer (semi-structured interview guide) were elicited.

Cognitive factors associated with hypertension and diabetes control among diagnosed and treated patients; findings from a community cohort in India.

Uncontrolled hypertension and diabetes are a challenge for healthcare providers worldwide. The research documenting the underlying risk factors of uncontrolled chronic illnesses in community cohorts from India is negligible. The current cross-sectional household door-knock survey conducted among 759 participants aged 30 and above from a geographically well-defined area examines the cognitive risk factors associated with hypertension and diabetes control in the Indian population.

Development of immersive learning framework (ILF) in achieving the goals of higher education: measuring the impact using a pre-post design.

Emerging technological tools like Artificial Intelligence-based Chatbots, digital educational alternatives and market-driven educational systems pose a challenge to the fundamental aim of the higher education system; comprehensive education for well-being. Therefore, this research aims to devise and evaluate strategies to impart new-age competencies to innovate socially and morally appropriate solutions in a modern competitive innovative society. The 8-month-long immersive learning framework (ILF), was designed based on the volatility, uncertainty, complexity, and ambiguity (VUCA) paradigm.

Prevalence and risk factors for falls in community-dwelling older population in Kerala; results from a cross sectional survey.

Background: Falls and their incapacitating effects are a significant concern for older people, especially in low- and middle-income countries. Falls are a significant concern among older people which requires immediate public health action. The current study examines multiple fall risk factors among community-dwelling older people in Kerala, India, to devise prevention strategies.

Prevalence of Specific Learning Disorders (SLD) Among Children in India: A Systematic Review and Meta-Analysis.

Background: Specific learning disorders (SLD) comprise varied conditions with ongoing problems in one of the three areas of educational skills-reading, writing, and arithmetic-which are essential for the learning process. There is a dearth of systematic reviews focused exclusively on the prevalence of SLD in India. Hence, this study was done to estimate the prevalence of SLD in Indian children.

Quality Improvement Process with Incident Learning Program Helped Reducing Transcriptional Errors on Telecobalt Due to Mismatched Parameters in Different Generations.

Purpose: Higher frequency of transcriptional errors in the radiotherapy electronic charts for patients on telecobalt was noted. We describe the impact of the quality improvement (QI) initiative under the department's incident learning program (ILP).

Materials And Methods: The multidisciplinary quality team under ILP was formed to identify the root cause and introduce methods to reduce (smart goal) the current transcription error rate of 40% to <5% over 12 months.

Protective Role of Social Networks for the Well-Being of Persons with Disabilities: Results from a State-Wide Cross-Sectional Survey in Kerala, India.

The current study presents the findings from a cross-sectional survey on social factors associated with the well-being of persons with disabilities (PWDs) in Kerala, India. We conducted a community-based survey across three geographical zones, North, Central, and South of Kerala state, between April and September 2021. We randomly selected two districts from each zone using a stratified sample method, followed by one local self-government from each of these six districts.

Sigmoid dose accumulation and reporting for multifractionated brachytherapy for cervical cancer: Methodological development of sigmoid points through virtual endoscopic method.

Purpose: The sigmoid is an important organ at risk for gynecological brachytherapy (BT). However, the reliability of localization of high-dose regions during multi-fractionated treatment is limited. This work reports the methodological development of sigmoid points to summate multi-fractionated doses.

Clinical outcomes of patients treated with template-based high-dose-rate interstitial brachytherapy boost for post-operative recurrent gynecological malignancies: A retrospective analysis.

Purpose: To report the clinical outcomes in patients treated with Martinez universal perineal interstitial template (MUPIT)-based interstitial brachytherapy boost for primary and recurrent vault and vaginal cancers, and to perform a comparative analysis with our previously published series of similar patients.

Material And Methods: One hundred and seventeen patients treated between January, 2009 and December, 2015 were evaluated. Descriptive statistics for the patterns of relapse, local recurrence-free survival (LRFS), disease-free survival (DFS), overall survival (OS), and late toxicities were carried out.

Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic.

Purpose: Brachytherapy (BT) for cervix cancer was listed as a level I priority and reduced number of implants and multiple fractions were recommended during COVID-19 pandemic. We present early clinical outcome of this approach.

Methods And Materials: Patients treated with (chemo)radiotherapy and BT with single implant and multiple fractions BT were included.

Risks and Barriers in Substitute Care for the Children of Parents with Serious Mental Illness: A Mixed-Method Study in Kerala, India.

Background: Mental illness in parents impairs their parenting capability, which has a lifelong detrimental impact on their children's physical and psychological health. In the current Indian context, due to weak social security nets, family is the only plausible intervention to ensure adequate substitute child care. Therefore, this study explores various risk factors and barriers to providing substitute family care.

Task sharing and stepped referral model for community mental health promotion in low- and middle-income countries (LMIC): insights from a feasibility study in India.

Background: This study is a low-cost community mental health task-sharing model driven by university students to strengthen the mental health workforce in poor resource settings. This article presents the feasibility of a stepped referral model using the community health workforce and university students. The primary feasibility objective is to detect and refer people with mental illness from the community using a task-sharing approach.

Localization of chemical synapses and modulatory release sites in the cardiac ganglion of the crab, Cancer borealis.

The crustacean cardiac ganglion (CG) comprises nine neurons that provide rhythmic drive to the heart. The CG is the direct target of multiple modulators. Synapsin-like immunoreactivity was found clustered around the somata of the large cells (LC) and in a neuropil at the anterior branch of the CG trunk of Cancer borealis.

Determinants of very low birth weight in India: The National Family Health Survey - 4.

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India and compare it with the determinants of LBW based on the National Family Health Survey - 4 (NHFS-4) Methods Data from the NFHS-4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant-mother pairs were included.

Challenges of diabetes care in India: Results from a Family Cohort Study.

Objectives: Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies.

Design: A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam.

Patterns of Relapse After Adjuvant Chemoradiation for Cervical Cancer in a Phase 3 Clinical Trial (PARCER): An Evaluation of Updated NRG Oncology/RTOG Target Delineation Guidelines.

Purpose: The Radiation Therapy Oncology Group (RTOG) under NRG Oncology recently published updated contouring guidelines for intensity modulated radiation therapy in postoperative treatment for endometrial and cervical cancer. The present study was designed to evaluate the implications of newly published guidelines.

Methods And Materials: We recruited 300 patients in a phase 3 randomized controlled trial of adjuvant chemoradiation therapy for cervical cancer (NCT01279135) to understand patterns of relapse.

Modified Houdek vault applicator for high-dose-rate brachytherapy: a technical report and case series.

Purpose: Treatment of isolated post-surgical vault recurrence of cervical and endometrial cancers in previously unirradiated patients includes external beam radiotherapy (EBRT) ± concomitant chemotherapy, followed by brachytherapy (BT) boost. Supra-vaginal component of vault disease often requires interstitial BT for optimal dose coverage. We describe technical details and preliminary case series using modified Houdek vault applicator (MHVA) developed at our institution for limited intra-cavitary plus interstitial high-dose-rate (HDR) vault BT.

A Nine-Item Red Flag Sign Card for Identification of Autism Spectrum Disorder among Toddlers Aged 12 to 18 Months.

There is a dearth of validated red flags measures for early identification of autism spectrum disorder (ASD) among toddlers. Hence, a new screening measure was developed. Item generation was done through literature search.