Wednesday, 27 June 2018

Neuroscience | Neurology Conference 2018 | Submit Your Abstracts | CME Conference


Submit your Abstracts here 

Effective verbal communication depends on one’s ability to retrieve and select the appropriate words to convey an intended meaning. For many, this process is instinctive, but for someone who has suffered a stroke or another type of brain damage, communicating even the most basic message can be arduous.

Scientists know that a brain region called the left inferior frontal gyrus (LIFG) is critical for language production and word processing. However, it remains unclear how exactly the LIFG interacts with the brain’s complex networks to facilitate controlled language performance — or how these interactions might go awry in a damaged brain.

Using a magnetic brain stimulation technique — the same method sometimes used to treat depressive symptoms — and network control theory, researchers at Drexel University and the University of Pennsylvania have taken a novel approach to understanding how networks in the brain interact to make word-choice decisions. Their results, published this month in the Journal of Neuroscience, pave the way for the treatment of aphasia and other language disorders.

“Our ability to understand neural systems is fundamentally related to our ability to control them,” said John Medaglia, PhD, an assistant professor of psychology at Drexel University and the study’s primary author. “This research provides direct evidence that how we choose the words we want to say in natural language is related to the capability of the brain to integrate and segregate activity across major networks.”

“Network neuroscience provides computational methods to uncover structure in brain imaging data.”
Medaglia, along with his colleague and study co-author Danielle Bassett, PhD, at the University of Pennsylvania, seek to map out the entire landscape of the brain and to uncover how stimulating one network might connect to or affect another depending on experiences — a new, emerging field of research called network neuroscience.

Network neuroscience provides computational methods to uncover structure in brain imaging data. In turn, knowledge about this structure allows us to better understand how signals travel naturally across the brain’s highways, and also how stimulation can alter that travel in a way that supports better cognitive function,” Bassett said.
To see how the LIFG brain region is involved with different neural networks depending on various language tasks, the research team used a technique called transcranial magnetic stimulation, or TMS, which uses an external magnetic field to induce currents in parts brain.


Twenty-eight study subjects were asked to complete two different kinds of language tasks while the research team administered the noninvasive brain stimulation. In the first type of task, study participants completed open-ended sentences such as, “They left the dirty dishes in the…” and were instructed to say a single word that would appropriately complete it. In the second type of task, study participants were asked to name specific images or numerals presented to them.

For each task, the researchers measured the participants’ response times and administered brain stimulation. After collecting the data, the researchers used mathematical formulas to study the controllability of the brain’s network systems. They were focused on how the language tasks affected two distinct network control features: modal controllability, which is the ability of a brain region to drive a network into “difficult to reach” states and boundary controllability, the theoretical ability of a brain region to guide distinct brain networks to communicate with each other.

The researchers found that boundary controllability represented a process important for responding in the open-ended language tasks, when participants needed to retrieve and select a single word in the face of competing, alternative responses. By contrast, modal controllability was closely related to closed-ended language tasks. This suggests that the LIFG’s ability to integrate and segregate communication between brain networks may not play an important role when people are selecting a single, correct word, rather than choosing among several possibilities.
Medaglia says his group was surprised to find this very clear distinction between how the brain responds to two similar language tasks.

“It was also surprising to me that you could find this effect when studying the whole brain, whereas a lot of traditional views on language would have you focus on a much more specific area.”
“I thought our results would be more muddied. There are debates about how unique these processes truly are, and now we have evidence that you can make a clear distinction between them,” Medaglia said. “It was also surprising to me that you could find this effect when studying the whole brain, whereas a lot of traditional views on language would have you focus on a much more specific area.”
Next, the research team is using the same type of techniques in stroke patients to see if stimulating certain areas of the brain can help them to improve their speech.

Study co-author Roy Hamilton, MD, a behavioral neurologist in the Perelman School of Medicine at the University of Pennsylvania, suggests that these findings may someday benefit patients with aphasia (acquired language loss due to stroke). For patients with aphasia, partial language recovery is often associated with the reorganization of the language system in the brain — language functions performed by damaged areas of the brain shift to new areas that had not previously been involved in language processing.


“This study gives us new insight into the underlying properties of areas like the LIFG that enable the brain to process language,” Hamilton said. “But there are still questions we’re looking to answer. For example, what determines which new areas of the brain will be recruited for language processing? What properties make them good candidates? With further research, we can begin to uncover which areas of the brain are likely to be utilized if there’s an injury to the language system. This approach may provide exciting new targets for treatment with focal therapies, including neuromodulation


Source Internet 

Monday, 25 June 2018

Neurology Conference 2018 | Human Brain | Neurology 2018

 A human brain is the largest, the developed structure in the anatomy of human beings and other well-organized organisms. The brain is made up of about 100 billion neurons and it weighs about 1300g or 3lbs.
The brain is called the Central Nervous System as it performs our body’s decision and is the communication center for organs and activities. The  Peripheral Nervous System and the spinal cord is composed of nerves. The daily activities starting from breathing, blinking of our eyes to reflex action and to memorize the facts are altogether controlled by these two systems –
  1. The central nervous system – CNS
  2. The Peripheral Nervous System – PNS.
The brain is the part of the central nervous system present in the head and is protected by the skull, both laterally and dorsally. Cranium,  a bony structure is called as the house for the brain which is located within the skull. It is also known as the centralized command for the nervous system, as brain receives information from the sensory organs and sends output through the muscles.
The brain is made up of different chambers and compartments for various functions. A human brain works continuously day and night by sending instructions to different organs of our body and function as per the requirements.

Submit your abstracts  here

Thursday, 21 June 2018

Neurology Conference 2018 | Abstracts Invited | CME | Berlin | Germany

(CME Accredited Neurology Conference)
4th International Conference on Neurology and Healthcare
September 17-18, 2018 Berlin, Germany

The Conference serves as a platform to discuss the growing trends in Neurology and Neuroscience which could unleash the buckles of many unrecognised research works which are in a developing phase. The trend towards the developing strategies of surgical methods also widens the opportunity for the researchers and scientists to establish their own signature in the field, thereby witnessing a tremendous change in the work field.  


Pulsus Conferences hosts the 4th International Conference on Neurology and Healthcare (CME ACCREDITED) which outsources the new research standards in neurocare and advanced healthcare , providing the most integrated approach in academic and research part of healthcare studies. Neurology 2018 will be unique in the series of conferences which will provide interactive sessions regarding Neurocare and quality aspects followed in healthcare industries along with recent advances in the field of neuro robotics. It also provides an opportunity to showcase your research works and innovative works in front of the world for the global recognition. The event is held at Berlin from September 17-18 ,2018. CME Credits are Awarded for the Conference
Neurology 2018 will witness the gathering of International blend of people from neurological field, pharmaceutical, biotech & medical devices companies, business entrepreneurs, neurology consultants, R&D heads and decision makers from healthcare, contract research, clinical trials, leading universities and research institutions making it the largest endeavor from Pulsus Conferences.

If you would like to know more information about this conference,
Contact:
Chris Isaac
Program Manager | Neurology 2018


Neurology Conference 2018 | Impulse control | Parkinson's Disease | Abstract Submission

Impulse control disorders in Parkinson’s patients may be higher than thought- Neurology2018

Neurology 2018 - Submit Your Abstracts 


Nearly half of patients with Parkinson’s disease who were taking dopamine agonist treatment experienced impulse control disorders over a follow-up of 5 years, according to recently published results of a longitudinal study.
The 5-year cumulative incidence of impulse control disorders was approximately 45% in the study, which included 411 patients with a high prevalence of dopamine agonist use and disease duration of 5 years or less at baseline.
There was a strong association between dopamine agonist use and impulse control disorders in the study, which was conducted by Jean-Christophe Corvol, MD, of Publique Hôpitaux de Paris and his co-investigators.
Impulse disorders increased in incidence with both duration and dose of dopamine agonists and resolved progressively after discontinuation of those agents, the investigators reported online June 20 in Neurology. The investigators used item 1.6 of part I of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale to determine the presence of an impulse control disorder.
“Given the high cumulative incidence of impulse control disorders in patients with Parkinson’s disease, these adverse effects should be carefully monitored in patients ever treated with dopamine agonists,” Dr. Corvol and his coauthors wrote.
The results came from the ongoing Drug Interaction With Genes in Parkinson’s Disease (DIGPD) study, a longitudinal cohort study including Parkinson’s disease patients consecutively recruited between 2009 and 2013 at eight French hospitals. All patients had no more than 5 years of disease duration at recruitment, and follow-up included annual evaluations by movement disorder specialists.
At baseline, the majority of patients (302, or 73.5%) had taken dopamine agonists within the past 12 months.
Over the course of 5 years, the prevalence of impulse control disorders increased from 19.7% at baseline to 32.8%, Dr. Corvol and his colleagues reported.
Among 306 patients with no impulse control disorders at baseline, 94 developed one, for a 5-year cumulative incidence of 46.1%, they added. Only 4 of the 94 new cases occurred in patients who never used dopamine agonists.
Dopamine agonist use in the previous 12 months was associated with a 2.23-fold higher prevalence of impulse control disorders (P less than .001), with prevalence increasing along with average daily dose and cumulative dose duration over that time period, according to the investigators.
These findings suggests tools are needed to screen for impulse control disorders and identify high-risk patients, they said.
“Further studies are needed to understand the mechanisms involved in the relation between [dopamine agonists] and [impulse control disorders], in particular the role of apathy, anxiety, and depression,” they added.

Source  https://www.mdedge.com/clinicalneurologynews/article/168551/movement-disorders/impulse-control-disorders-parkinsons 

Wednesday, 13 June 2018

Neurosurgery | Ancient Methods | Trepanation | Advanced ? | Neurology 2018

Skull-drilling: The ancient roots of modern neurosurgery 




Over the years, archaeologists across the world have unearthed many ancient and medieval skeletons with mysterious holes in their skulls. It turned out that these holes were evidence of trepanation, an "ancestor" of modern brain surgery.

skull with a hole
Ancient Peruvians may have been better at handling skull perforation procedures than their modern-day counterparts.
Evidence of holes being drilled into the skull for medical purposes, or "trepanation," has been traced back to the Neolithic period — about 4000 B.C. — and it might have been practiced even earlier.
When it comes to the reasons why trepanation was practiced at all, opinions differ.
The operation may have been performed for various reasons across civilizations and eras.
Some of the trepanations may have been done for ritualistic purposes, but many others were probably performed to heal.
In a medical context, research has shown that trepanation was likely used to treat various types of head injuries and to relieve intracranial pressure.
Fascinatingly, the most cases of ancient trepanation have been found in Peru, where it was also also seen to have the highest survival rate.
A new study, in fact, shows that trepanation performed in the Incan period (early 15th–early 16th century) had higher survival rates than even modern trepanation procedures, such as those that were performed during the American Civil War (1861–1865) on soldiers who had suffered head trauma.
Dr. David S. Kushner, a clinical professor of physical medicine and rehabilitation at the University of Miami Miller School of Medicine in Florida, alongside world expert on Peruvian trepanantion John W. Verano and his former graduate student Anne R. Titelbaum, explain — in an article that is now published in the World Neurosurgery journal — that trepanation was surprisingly well developed in the Inca Empire.
"There are still many unknowns about the procedure and the individuals on whom trepanation was performed, but the outcomes during the Civil War were dismal compared to Incan times," says Dr. Kushner.
Dr. Kushner also believes that the Peruvians may have used something akin to anesthetic to make the procedure more bearable, and his first guess is coca leaves — which have been used for medicinal purposes by Andean populations for centuries.At the same time, he admits, "We do not know how the ancient Peruvians prevented infection, but it seems that they did a good job of it."
"[We still do not] know what they used as [anesthetic], but since there were so many [cranial surgeries] they must have used something — possibly coca leaves," Dr. Kushner surmises, though he concedes that other substances may also have been employed.
The fact that the ancient Peruvians were clearly doing something well when it came to trepanation is supported by the evidence of over 800 prehistoric skulls bearing between one and seven precision holes.
All of these skulls were discovered along the coasts or in the Andean regions of Peru, with the earliest skulls dated as early as 400 B.C.
Very high survival rates for ancient patients
Combined evidence — detailed by John Verano and colleagues in a book published 2 years ago, Holes in the Head: The Art and Archaeology of Trepanation in Ancient Peru — suggests that the ancient Peruvians had spent many a decade perfecting their trepanation knowledge and skills.
At first, in around 400–200 B.C., the survival rates following a trepanation weren't all that high, and about half of the patients did not survive, the researchers argue. The team was able to assess the outcomes by looking at how much — if at all — the bone surrounding the trepanation holes had healed after the procedure.
Where no healing seemed to have occurred, the team thought it safe to conclude that the patient had either survived for a short period of time or had died during the procedure.
When, to the contrary, the bone showed extensive remodeling, the researchers took it as a sign that the person operated upon had lived to tell the tale.
Dr. Kushner and team found that, based on these signs, in 1000–1400 A.D., trepanation patients saw very high survival rates, of up to 91 percent in some cases. During the Incan period, this was 75–83 percent, on average.
This, the researchers explain in their paper, is due to ever-improving techniques and knowledge that the Peruvians acquired over time.
One such important advance was understanding that they should be careful not to penetrate the dura mater, or the protective layer found just under the skull, which protects the brain.
"Over time," says Dr. Kushner, "from the earliest to the latest, they learned which techniques were better, and less likely to perforate the dura." He continues, "They seemed to understand head anatomy and purposefully avoided the areas where there would be more bleeding."
Based on the evidence offered by the human remains uncovered in Peru, the researchers saw that other advances in trepanation practice also occurred.
Dr. Kushner goes on to explain, "[The ancient Peruvians] also realized that larger-sized trepanations were less likely to be as successful as smaller ones. Physical evidence definitely shows that these ancient surgeons refined the procedure over time."
He calls this ancient civilization's progress when it came to this risky procedure "truly remarkable."
It is these and similar practices that — directly or indirectly — have shaped modern neurosurgery, which has a high rate of positive outcomes.
"Today, neurosurgical mortality rates are very, very low; there is always a risk but the likelihood of a good outcome is very high. And just like in ancient Peru, we continue to advance our neurosurgical techniques, our skills, our tools, and our knowledge," says Dr. Kushner.
https://www.medicalnewstoday.com/articles/322109.php

Friday, 8 June 2018

Abstracts Invited | Deep brain stimulation | Neurology 2018

Deep brain stimulation | Neurology 2018

 https://neurology.cmesociety.com/  
Deep brain stimulation (DBS) is a surgical procedure used to treat several disabling neurological symptoms—most commonly the debilitating motor symptoms of Parkinson’s disease (PD), such as tremor, rigidity, stiffness, slowed movement, and walking problems. The procedure is also used to treat essential tremor and dystonia.  At present, the procedure is used only for individuals whose symptoms cannot be adequately controlled with medications. However, only individuals who improve to some degree after taking medication for Parkinson’s benefit from DBS. A variety of conditions may mimic PD but do not respond to medications or DBS.  DBS uses a surgically implanted, battery-operated medical device called an implantable pulse generator (IPG) - similar to a heart pacemaker and approximately the size of a  stopwatch to - deliver electrical stimulation to specific areas in the brain that control movement, thus blocking the abnormal nerve signals that cause PD symptoms.
Before the procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) scanning to identify and locate the exact target within the brain for surgical intervention. Some surgeons may use microelectrode recording - which involves a small wire that monitors the activity of nerve cells in the target area - to more specifically identify the precise brain area that will be stimulated. Generally, these areas are the thalamus, subthalamic nucleus, and globus pallidus. There is a low chance that placement of the stimulator may cause bleeding or infection in the brain.
The DBS system consists of three components: the lead, the extension, and the IPG. The lead (also called an electrode)—a thin, insulated wire—is inserted through a small opening in the skull and implanted in the brain. The tip of the electrode is positioned within the specific brain area.  
The extension is an insulated wire that is passed under the skin of the head, neck, and shoulder, connecting the lead to the implantable pulse generator. The IPG (the "battery pack") is the third component and is usually implanted under the skin near the collarbone. In some cases it may be implanted lower in the chest or under the skin over the abdomen.
Once the system is in place, electrical impulses are sent from the IPG up along the extension wire and the lead and into the brain. These impulses block abnormal electrical signals and alleviate PD motor symptoms.

Treatment


Unlike previous surgeries for PD, DBS involves minimal permanent surgical changes to the brain. Instead, the procedure uses electrical stimulation to regulate electrical signals in neural circuits to and from identified areas in the brain to improve PD symptoms. Thus, if DBS causes unwanted side effects or newer, more promising treatments develop in the future, the implantable pulse generator can be removed, and the DBS procedure can be halted. Also, stimulation from the IPG is easily adjustable—without further surgery—if the person’s condition changes. Some people describe the pulse generator adjustments as "programming."


Although most individuals still need to take medication after undergoing DBS, many people with Parkinson’s disease experience considerable reduction of their motor symptoms and are able to reduce their medications. The amount of reduction varies but can be considerably reduced in most individuals, and can lead to a significant improvement in side effects such as dyskinesias (involuntary movements caused by long-term use of levodopa). In some cases, the stimulation itself can suppress dyskinesias without a reduction in medication.  DBS does not improve cognitive symptoms in PD and indeed may worsen them, so it is not generally used if there are signs of dementia.  DBS changes the brain firing pattern but does not slow the progression of the neurodegeneration.

Attractions In Berlin | Enjoy your conference | September Season


About Berlin

Berlin is the capital and the largest city located in northeastern part of Germany on the banks of rivers spree and have. Berlin serves with a temperate seasonal climate and one-third of city's area is composed of forests, parks, gardens, rivers, canals and lakes.  Its a city of culture, politics, media and science and also serves as a continental hub for air and rail traffic and has essential public transportation network. Berlin was named as the city of design UNESCO in 2005. Berlin's nightlife has been celebrated as one of the most diverse and vibrant of its kind. German is the official language spoken in Berlin. The most-commonly-spoken foreign languages in Berlin are Turkish, English, Russian, Arabic, Polish, Kurdish, Serbo-Croatian, Italian, Vietnamese, and French.








Being a tourist attraction city Berlin has the third place among most visited city in the European Union. Munich and Hamburg are the most visited places. Brandenburg Gate is an iconic landmark of Berlin which stands as a symbol of European history and of unity and peace. The East Side Gallery is an open-air exhibition of art painted directly on the last existing portions of the Berlin Wall. It is the largest remaining evidence of the city's historical division. The Gendarmenmarkt is a neoclassical square in Berlin, the name of which derives from the headquarters of the famous Gens d'armes regiment located here in the 18th century. It is bordered by two similarly designed cathedrals, the Französischer Dom with its observation platform and the Deutscher Dom. The Konzerthaus (Concert Hall), home of the Berlin Symphony Orchestra, stands between the two cathedrals.  Apart from this Berlin is famous for its cuisine and stay.


Neuroscience Research Institutions in Berlin

l  Institute for Theoretical Biology
l  Max Delbrück Center for Molecular Medicine  
l  Cluster of Excellence "Neurocure"
l  Leibniz Institute for Molecular Pharmacology   
l  Bernstein Center for Computational Neuroscience        
l  Center for Stroke Research Berlin (CSB)          
l  Berlin School of Mind and Brain

l  Berlin Neuro imaging Center


Wednesday, 6 June 2018

Neurological Disorders | Neurology Conference 2018 | Conference Tracks | Abstract Submission | Neurology 2018

What Causes a Neurological Disorder?

If you suspect that you or a loved one may be suffering from one of these issues, you may also be wondering about what causes a neurological disorder. The causes of such dysfunction can be quite diverse. Both the spinal cord and brain are insulated by numerous membranes that can be vulnerable to force and pressure. The peripheral nerves located deep under the skin can also be vulnerable to damage. Neurological disorders can affect an entire neurological pathway or a single neuron. Even a small disturbance to a neuron’s structural pathway can result in dysfunction. As a result, neurological disorders can result from a number of causes, including:
  • Lifestyle-related causes
  • Infections
  • Genetics
  • Nutrition-related causes
  • Environmental influences
  • Physical injuries

What Are the Signs of Neurological Disorders?

The signs of neurological disorders can vary significantly, depending upon the type of disorder as well as the specific area of the body that is affected. In some instances, you might experience emotional symptoms while in other cases physical symptoms may be the result.

Emotional Symptoms of Neurological Problems

While many people often first look for physical symptoms of a disorder, it is important to understand that there can also be emotional symptoms of neurological problems. For instance, you might experience mood swings or sudden outbursts. Individuals who suffer from neurological problems may also experience depression or delusions.
It should be understood that these symptoms could also be indicative of other disorders and conditions. If you have noticed these symptoms in yourself or someone close to you, it is important to seek help right away.

Physical Symptoms of Neurological Problems

Physical symptoms of neurological problems may include the following:
  • Partial or complete paralysis
  • Muscle weakness
  • Partial or complete loss of sensation
  • Seizures
  • Difficulty reading and writing
  • Poor cognitive abilities
  • Unexplained pain
  • Decreased alertness

Short-Term and Long-Term Effects of Neurological Instability

If left untreated, neurological disorders can result in a number of serious consequences. The short-term and long-term effects of neurological instability can vary greatly, depending upon the disorder and the severity of your condition. For instance, according to MSWatch, 50 percent of individuals who suffer from multiple sclerosis experience depression at least once. The University of Miami Health System reports that the symptoms of Parkinson’s disease become more severe over time, as this is a progressive disease. The most important step you can take if you believe that you or someone you care about may be suffering from a neurological disorder is to seek assistance without delay.

Is There a Test or Self-Assessment I Can Do?

If you are concerned about a possible neurological disorder, it is important to seek professional medical assistance. A number of medical examinations can be performed to diagnose the presence of a possible neurological condition. Such tests may include genetic screening, a neurological exam, brain scans and other tests. Even though all self-administered tests or self-assessments cannot positively identify the presence of a neurological disorder, if you have noticed any of the following complaints, you may wish to seek professional assistance:
  • Headaches
  • Blurry vision
  • Fatigue
  • Changes in behavior
  • Numbness in the legs or arms
  • Changes in coordination or balance
  • Weakness
  • Slurred speech
  • Tremors

Medication: Drug Options for Neurological Issues

While it is understandable that the thought of being diagnosed with a neurological disorder may be frightening, it is important to understand that drug options for neurological issues are available. Such options can help you or your loved one to better manage your condition, reduce symptoms and improve your quality of life.

Neurological Drugs: Possible Options

The type of medication that may be used for the treatment of your neurological disorder will depend on your condition. Possible options for neurological drugs may include corticosteroids, which are often indicated for the treatment of multiple sclerosis. This type of medication may assist with decreasing inflammation. Dopamine-affecting drugs, such as Levodopa, are commonly used in the treatment of Parkinson’s to help with rigidity and tremors.

Medication Side Effects

When taking medication for the treatment of any condition or disorder, it is important to understand that you may experience certain side effects. Medication side effects related to the treatment of neurological disorders can vary based on your own situation and the type of medication in question. In some instances, it may be possible to develop dependence to the medication you are taking. This can occur even if it is a prescription medication, and you are taking it for the treatment of a serious health problem, such as a neurological disorder.

Drug Addiction, Dependence and Withdrawal

If you have developed a drug addiction, dependence and withdrawal are two critical components you need to understand. Dependence can develop when you take medication over a period of time. Depending on the addictive nature of the medication and your own personal situation, dependence can sometimes develop quickly. If you do become dependent on your medication, you will experience withdrawal symptoms when you abruptly stop taking the medication. Symptoms can include headaches, nausea and tremors.
Addiction generally means you also have a psychological dependence on the medication in addition to a physical dependence.

Medication Overdose

The potential for medication overdose is quite real and should not be taken lightly. In instances where an individual has become dependent on a medication, they may begin taking increasingly larger doses of the medication in order to achieve the same effects. This can result in an overdose – a serious medical situation that can be fatal.
If you believe that you or someone you know may be taking too much medication and could be at risk for overdose, it is important to seek help right away.

Depression and Neurological Problems

Depression and neurological problems are often interrelated. Due to the debilitating nature of depression, individuals who suffer from it as well as neurological problems may find recovery to be challenging without professional assistance. Many different treatment options are available that can assist you with the treatment of your depression, including therapy in combination with medication.

Dual Diagnosis: Addiction and Neurological Disorders


Seeking help from a facility that offers the ability to make a dual diagnosis, such as a diagnose of an addiction compounded by a neurological disorder, is critical for achieving an optimal recovery. If one issue is treated but the other is left untreated, the chances of achieving a full recovery can be diminished. In a treatment facility that focuses on addressing both addiction and neurological issues, you will be able to receive the critical help you need for your addiction while at the same time ensuring that your neurological disorder is also treated.

Courtesy : internet 

Neurology 2019 is a grand event which is focused on the theme “Panoramic view of Neurology and Healthcare” and ensures better advancement...