Vitamin D Receptor (VDR) Gene Polymorphisms and High-Turnover Renal Osteodystrophy or Secondary Hyperparathyroidism in End-Stage Renal Disease: A Systematic Review.

Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are often complicated by high-turnover renal osteodystrophy (HTRO) and secondary hyperparathyroidism (SHPT), characterized by disturbances in mineral metabolism and skeletal abnormalities. Genetic variations within the vitamin D receptor (VDR) gene, known as VDR gene polymorphisms, have been implicated in modulating the susceptibility to HTRO and SHPT. This systematic review aims to evaluate the existing literature on the association between VDR gene polymorphisms and the development of these complications in ESRD and hemodialysis patients. A comprehensive literature search across multiple databases was conducted, and studies investigating VDR gene polymorphisms and HTRO or SHPT in ESRD or hemodialysis patients were included. The included studies examined various VDR gene polymorphisms, such as BsmI, ApaI, TaqI, and FokI, and their associations with clinical outcomes like parathyroid hormone (PTH) levels, bone mineral density, and the development of SHPT or HTRO. The findings suggest that certain VDR gene polymorphisms, notably the ApaI "aa" genotype, BsmI "bb" genotype, TaqI "tt" genotype, and FokI variant, may contribute to the pathogenesis of SHPT and HTRO by affecting PTH levels, bone turnover markers, and vitamin D sensitivity. However, the studies had relatively small sample sizes and were conducted in different populations, limiting generalizability. Further larger-scale studies, functional investigations, and exploration of gene-environment interactions are warranted to elucidate the underlying mechanisms and facilitate personalized treatment approaches for CKD and ESRD patients with mineral and bone disorders.

Analysis of genome-wide association studies of low-temperature germination in Xian and Geng rice.

Rice is the leading global staple crop. Low temperatures pose negative impacts on rice's optimal growth and development. Rice cultivars acclimating to low temperatures exhibited improved seedling emergence under direct-seeded sowing conditions, yet little is known about the genes that regulate germination at low temperatures (LTG). In this research investigation, we've performed whole genome sequencing for the 273 rice plant materials. Using the best linear unbiased prediction (BLUP) values for each rice material, we identified 7 LTG-related traits and performed the efficient genetic analysis and genome-wide association study (GWAS). As a result of this, 95 quantitative trait loci (QTLs) and 1001 candidate genes associated with LTG in rice were identified. Haplotype analysis and functional annotation of the candidate genes resulted in the identification of three promising candidate genes (LOC_Os08g30520 for regulating LTG4 and LTG5, LOC_Os10g02625 for regulating LTG6, LTg7 and LTG8, and LOC_Os12g31460 for regulating LTG7, LTg8 and LTG9) involving in the regulation of LTG in rice. This research provides a solid foundation for addressing the LTG issue in rice and will be valuable in future direct-seeded rice breeding programs.

Gerascophobia or Excessive Fear of Aging Scale (GEFAS): Development, validation, and exploration of psychometric properties of a brief instrument using classical testing theory and item response theory.

BACKGROUND: Gerascophobia, or excessive fear of aging, is thought to be caused by a mixture of cognitive, experiential, and physiological factors acting on a person at particular time points. Measurement tools for evaluating geraschophobia remain insufficiently developed, despite this commonplace fear's distress. OBJECTIVE: The objective of the current study was to develop and validate the Gerascophobia or Excessive Fear of Aging Scale (GEFAS) and analyze its psychometric properties. METHODS: Three successive investigations were carried out with a total of 1594 participants. Exploratory and confirmatory factor analyses were conducted to evaluate the construct validity of the GEFAS. Convergent and discriminant validity was assessed by examining relationships with measures of depression, anxiety, stress, death anxiety, psychosocial illness, and life satisfaction. Multiple linear regression was used to investigate factors that predict fear of aging. RESULTS: The GEFAS demonstrated high reliability (Cronbach alpha >0.8). Factor analysis supported a single-factor solution for the scale (fitness indices CFI, TLI, NNFI, NFI, RFI, and MFI all > 0.95; RMSEA=0.06. Significant positive correlations were found between fear of aging and depression (r = 0.270; p < 0.01), anxiety (r = 0.311; p < 0.01), stress (r = 0.285; p < 0.01), death anxiety (r = 0.600; p < 0.01), and psychosocial illness (r = 0.243; p < 0.01). A significant inverse correlation was observed with life satisfaction. Gender differences were also noted, with women exhibiting greater fear of aging than men (p < 0.01; d = 0.488). CONCLUSION: The GEFAS fills a significant gap in the psychological/psychiatric literature as a useful tool for evaluating the fear of aging. The study concludes that the excessive fear of aging contributes to poor mental health.

Minimally invasive vs. conventional mitral valve surgery: a meta-analysis of randomised controlled trials.

Objective: The evidence underlying the efficacy and safety of minimally invasive mitral valve surgery (MIMVS) is inconclusive. We conducted a meta-analysis to evaluate whether MIMVS improves clinical outcomes compared with conventional sternotomy. Methods: We searched MEDLINE (via PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov from inception to January 2024 for all randomised controlled trials (RCTs), comparing MIMVS with conventional mitral valve surgery. RevMan 5.4 was used to analyse the data with risk ratio (RR) and mean difference (MD) as the effect measures. Results: Eight studies reporting data on 7 RCTs were included in our review. There was no significant difference in all-cause mortality, the number of patients requiring blood product transfusion, and the change from baseline in the SF-36 physical function scores between the MIMVS and conventional sternotomy groups. MIMVS reduced the length of hospital stay (MD -2.02 days, 95% CI: -3.66, -0.39) but did not affect the length of ICU stay, re-operation for bleeding, and the incidence of renal injury, wound infection, neurological events, and postoperative moderate or severe mitral regurgitation. MIMVS was associated with a trend toward lower postoperative pain scores (MD -1.06; 95% CI: -3.96 to 0.75). Conclusions: MIMVS reduced the number of days spent in the hospital and showed a trend toward lower postoperative pain scores, but it did not decrease the risk of all-cause mortality or the number of patients needing blood product transfusions. Further large-scale RCTs are required to inform definitive conclusions, particularly with regard to quality-of-life outcomes investigating functional recovery. Systematic Review Registration: PROSPERO (CRD42023482122).

Postponed Application of Phosphorus and Potassium Fertilizers Mitigates the Damage of Late Spring Coldness by Improving Winter Wheat Root Physiology.

Late spring coldness (LSC) is the main limiting factor threatening wheat yield and quality stability. Optimal nutrient management is beneficial in mitigating the harms of LSC by improving wheat root physiology. This study proposed a nutrient management strategy that postponed the application of phosphorus (P) and potassium (K), effectively strengthening wheat's defense against LSC. This experiment used the winter cultivar "Yannong19" (YN 19) as plant material for two consecutive years (2021-2022 and 2022-2023). Two fertilizer treatments were used: traditional P and K fertilizers application (R1: base fertilizer: jointing fertilizer = 10:0) and postponed P and K fertilizers application (R2: base fertilizer: jointing fertilizer = 5:5); wheat plants at the anther connective formation stage shifted to temperature-controlled phytotrons for normal (T0, 11 °C/4 h) and low temperatures (T1, 4 °C/4 h; T2, -4 °C/4 h) as treatments of LSC. The results showed that under low temperature (LT) treatment, compared with R1, the R2 treatment increased the concentrations of osmotic adjustment substances (soluble sugars and soluble protein contents by 6.2-8.7% and 3.0-8.9%), enhanced activities of antioxidant enzymes (superoxide dismutase, peroxidase and catalase activities by 2.2-9.1%, 6.2-9.7% and 4.2-8.4%), balanced the hormone concentrations (increased IAA and GA3 contents by 2.8-17.5% and 10.4-14.1% and decreased ABA contents by 7.2-14.3%), and reduced the toxicity (malondialdehyde, hydrogen peroxide content and O2·- production rate by 5.7-12.4%, 17.7-22.8% and 19.1-19.1%) of the cellular membranes. Furthermore, the wheat root physiology in R2 significantly improved as the root surface area and dry weight increased by 5.0-6.6% and 4.7-6.6%, and P and K accumulation increased by 7.4-11.3% and 12.2-15.4% compared to R1, respectively. Overall, the postponed application of P and K fertilizers enhanced the physiological function of the root system, maintained root morphology, and promoted the accumulation of wheat nutrients under the stress of LSC.

Self-rated health and risk of incident cardiovascular events among individuals with hypertension.

BACKGROUND: The relationship between self-rated health (SRH) and cardiovascular events in individuals with hypertension, but without diabetes mellitus, is understudied. METHODS: We performed a post hoc analysis of data from SPRINT (Systolic Blood Pressure Intervention Trial). SRH was categorized into excellent, very good, good and fair/poor. Using multivariable Cox regression, we estimated hazard ratios and 95% confidence intervals (CIs) for the association of SRH with both all-cause mortality and a composite of cardiovascular events (the primary outcome), which was defined to include myocardial infarction (MI), other acute coronary syndromes, stroke, acute decompensated heart failure, and cardiovascular death. RESULTS: We included 9319 SPRINT participants (aged 67.9 ±â€Š9 years, 35.6% women) with a median follow-up of 3.8 years. Compared with SRH of excellent, the risk [hazard ratio (95% CI)] of the primary outcome associated with very good, good, and fair/poor SRH was 1.11(0.78-1.56), 1.45 (1.03-2.05), and 1.87(1.28-2.75), respectively. Similarly, compared with SRH of excellent, the risk of all-cause mortality [hazard ratio (95% CI)] associated with very good, good, and fair/poor SRH was 1.13 (0.73-1.76), 1.72 (1.12-2.64), and 2.11 (1.32-3.38), respectively. Less favorable SRH (LF-SRH) was also associated with a higher risk of each component of the primary outcome and serious adverse events (SAE). CONCLUSION: Among individuals with hypertension, SRH is independently associated with the risk of incident cardiovascular events, all-cause mortality, and SAE. Our study suggest that guidelines should consider the potential significance of including SRH in the clinical history of patients with hypertension.

Continuous Patient-Independent Estimation of Respiratory Rate and Blood Pressure Using Robust Spectro-Temporal Features Derived From Photoplethysmogram Only.

Objective: A patient-independent approach for continuous estimation of vital signs using robust spectro-temporal features derived from only photoplethysmogram (PPG) signal. Methods: In the pre-processing stage, we remove baseline shifts and artifacts of the PPG signal using Incremental Merge Segmentation with adaptive thresholding. From the cleaned PPG, we extract multiple parameters independent of individual patient PPG morphology for both Respiration Rate (RR) and Blood Pressure (BP). In addition, we derived a set of novel spectral and statistical features strongly correlated to BP. We proposed robust correlation-based feature selection methods for accurate RR estimates. For fewer computations and accurate measurements of BP, the most significant features are selected using correlation and mutual information measures in the feature engineering part. Finally, RR and BP are estimated using breath counting and a neural network regression model, respectively. Results: The proposed approach outperforms the current state-of-the-art in both RR and BP. The RR algorithm results in mean absolute errors (median, 25th-75th percentiles) of 0.4 (0.1-0.7) for CapnoBase dataset and 0.5(0.3-2.8) for BIDMC dataset without discarding any data window. Similarly, BP approach has been validated on a large dataset derived from MIMIC-II ([Formula: see text]1700 records) which has errors (mean absolute, standard deviation) of 5.0(6.3) and 3.0(4.0) for systolic and diastolic BP, respectively. The results meet the American Association for the Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) Class A criteria. Conclusion: By using robust features and feature selection methods, we alleviated patient dependency to have reliable estimates of vitals.

Applying a Primary Health Care Approach to Closing the Human Resource for Health Gaps for Immunization.

This perspective is focused on the evidence on human resources for health (HRH) solutions for immunization, as a part of a primary health care (PHC) approach.. In the wake of the COVID-19 pandemic and 50 years since the Expanded Program on Immunization (EPI) clocks 50 years since its inception. was initiated, evidence and experience demonstrate the significant HRH gaps in many countries and globally, and how countries are seeking innovative ways of closing them with limited resources. The aim of this perspective article is to highlight the growing gap between the needs and the realities related to health workforce for PHC, including immunization, and to call for increasing the visibility of HRH within global and national immunization agendas. This perspective highlights key guidelines and tools to improve HRH, such as integrating immunization and primary health care, addressing the mental health needs of the health workforce, addressing gender-related issues, rationalizing the roles and composition of PHC workforce teams, and meeting the surge requirements related to health emergencies.

Delayed Presentation of a Post-infarction Ventricular Septal Rupture.

Ventricular septal rupture, a formidable complication of acute myocardial infarction (AMI), is linked to significant morbidity and mortality. The clinical manifestation typically involves pronounced hemodynamic compromise necessitating prompt surgical intervention. This report outlines the case of a 60-year-old male presenting with acute heart failure 3 weeks post a presumed AMI. On evaluation, a substantial ventricular septal defect with left-to-right shunt was observed. The patient, although hemodynamically stable with mild symptoms, underwent surgical closure of the defect and coronary artery bypass graft for multivessel coronary artery disease. This case contributes to the literature on the delayed presentation of post-myocardial infarction (MI) ventricular septal rupture, a scenario deviating from the anticipated severe hemodynamic instability given the timing of the MI and the extent of the septal defect.

Effect of vigorous-intensity physical activity on incident cognitive impairment in high-risk hypertension.

INTRODUCTION: We investigated the effect vigorous physical activity (VPA) on the risk of incident mild cognitive impairment (MCI) and probable dementia among individuals with high-risk hypertension. METHODS: Baseline self-reported frequency of VPA was categorized into low VPA (<1 session/week), and high VPA (≥1 session/week). We used multivariate Cox regression analysis to examine the association of VPA categories with incident MCI and probable dementia events. RESULTS: Participants in the high VPA category, compared with low VPA, experienced lower events rates (per 1000 person-years) of MCI (13.9 vs 19.7), probable dementia (6.3 vs 9.0), and MCI/probable dementia (18.5 vs 25.8). In the multivariate Cox regression model, high VPA, compared with low VPA, was associated with lower risk of MCI, probable dementia, and MCI/probable dementia (HR [95% CI]: 0.81 [0.68-0.97], 0.80 [0.63-1.03], and 0.82 [0.70-0.96]), respectively. DISCUSSION: This study provides evidence that VPA may preserve cognitive function in high-risk patients with hypertension. HIGHLIGHTS: Hypertension is associated with an increased risk of cognitive impairment Physical activity (PA) is associated with a lower risk of decline in cognition The effect of ≥1 sessions of vigorous-intensity PA (VPA) per week was assessed This analysis included SPRINT MIND trial participants with high-risk hypertension ≥1 VPA sessions/week was associated with lower risk of future cognitive impairment.

Titania-Graphene Oxide Nanocomposite-Based Philadelphia-Positive Leukemia Therapy.

Philadelphia-positive (Ph+) leukemia is a type of blood cancer also known as acute lymphoblastic leukemia (ALL), affecting 20-30% of adults diagnosed worldwide and having an engraved prognosis as compared to other types of leukemia. The current treatment regimens mainly rely on tyrosine kinase inhibitors (TKIs) and bone marrow transplants. To date, several generations of TKIs have been developed due to associated resistance and frequent relapse, with cardiovascular system anomalies being the most devastating complication. Nanotechnology has the potential to address these limitations by the targeted drug delivery and controlled release of TKIs. This study focused on the titanium dioxide (TiO2) and graphene oxide (GO) nanocomposite employment to load nilotinib and ponatinib TKIs for therapy of Ph+ leukemia cell line (K562) and Ba/F3 cells engineered to express BCR-ABL oncogene. Meanwhile, after treatment, the oncogene expressing fibroblast cells (Rat-1 P185) were evaluated for their colony formation ability under 3D conditions. To validate the nanocomposite formation, the TiO2-GO nanocomposites were characterized by scanning electron microscope, DLS, XRD, FTIR, zeta potential, EDX, and element mapping. The TKI-loaded TiO2-GO was not inferior to the free drugs after evaluating their effects by a cell viability assay (XTT), apoptosis induction, and colony formation inhibition. The cell signaling pathways of the mammalian target of rapamycin (mTOR), signal transducers and activators of transcription 5 (STAT5), and extracellular signal-regulated kinase (Erk1/2) were also investigated by Western blot. These signaling pathways were significantly downregulated in the TKI-loaded TiO2-GO-treated groups. Based on the findings above, we can conclude that TiO2-GO exhibited excellent drug delivery potential that can be used for Ph+ leukemia therapy in the future, subject to further investigations.

Saraiki language characters dataset (SLCD).

About 26 million people worldwide use the Saraiki language [1]. In the southern part of Punjab and Sindh, Saraiki language is extensively spoken. One of the most important Saraiki cultural hubs is Dera Ghazi Khan. In Dera Ghazi Khan, the Saraiki language is spoken by over 90 % of the population. Calligraphers use a sophisticated script to write this language. Despite the vast body of Optical Character Recognition (OCR) literature and research dedicated to other languages, a fully functional OCR system is still needed for Saraiki language [2,3]. This work presents a genuine dataset of Saraiki handwritten characters, consisting of 50,000 scanned photos, and makes it accessible to the public for use. All of the photographs include handwritten text contributed by teachers and students from Pak-Austria Fachhochschule for Applied Sciences and Technology, Pakistan. Around 1000 people, roughly half men and half women, contributed in writing this text. For scientific research, the dataset will be made accessible to the general public.

Optimization of switching charge and recoverable energy density mediated by structural transformation in Sr-substituted BaNiO3 perovskites.

Because of their distinctive characteristics, ferroelectric perovskites are considered among the most potent and auspicious candidates for energy storage and pulsed power devices. But their energy storage properties and switching capabilities need to be further enhanced which can be done by substitutions of appropriate cations. Hence, a series of lead-free Ba1-xSrxNiO3 (x = 0.00, 0.33, 0.67, and 1.00) ceramics was fabricated using a sol-gel auto combustion technique. Rietveld's refinement of X-ray diffraction plots verified the complete development of the required hexagonal perovskite structure. Scanning electron microscopy images revealed a gradual increase in average grain sizes and agglomeration with the increase in Sr-content. Moreover, the existence of all the constituent elements exactly in proportion to their stoichiometric ratios was verified by energy dispersive X-ray spectroscopy. The characteristic parameters of ferroelectric materials such as ferroelectric response, electrical conductivity, and switching charge density were also determined. The P-E loops indicated that with the increase in Sr-content, the coercive field, remanent polarization, and maximum polarization all decreased gradually, but the recoverable energy density (Wrec) increased as the loops became slimmer. The maximum value of Wrec was found in the Ba0.33Sr0.67NiO3 sample. Moreover, SrNiO3 exhibited minimum energy loss with the highest efficiency of ∼47.21%. The existence of a current barrier in all the samples was proved from the low leakage current values (∼10-7 A). In addition, the pure SrNiO3 showed a low electrical conductivity and minimum value of switching charge density. All these findings make SrNiO3 a promising candidate for fast switching and energy storage applications.

Experiment and Analysis of Variance for Stabilizing Fine-Grained Soils with Cement and Sawdust Ash as Liner Materials.

Due to volume change and low strength, fine-grained soils are problematic in construction. Stabilization with cement and sawdust ash (SDA) by-products can improve engineering properties. This study aimed to investigate the effectiveness of cement and sawdust ash (SDA) in stabilizing fine-grained soils for liner applications. Varying proportions of cement (0-9%) and SDA (0-10%) were added to soil samples (n = 24). Specimens were tested for unconfined compressive strength (UCS), hydraulic conductivity (HC), and volumetric shrinkage strain (VSS). Two-way ANOVA analyzed stabilization effects. Optimal stabilization occurred with 6% cement and 6% SDA, resulting in significant increases in UCS (51 to 375 kN/m2) and decreases in HC (1.7 × 10-8 to 4.7 × 10-10 m/s) and VSS (12.8 to 3.51%) compared to untreated soil. ANOVA indicated that both cement and SDA had statistically significant (p < 0.05) effects on improving all three engineering properties. The addition of 6% cement and 6% SDA significantly improved the expansive soil's strength, hydraulic conductivity, and volume change properties. ANOVA confirmed the quantitative improvements and the significance of both stabilizers. Stabilization using the by-product SDA has the potential to be a sustainable soil improvement method.

Surgical outcome of angular deformity correction of lower limbs in rickets: a cross-sectional study.

PURPOSE: This study aims to compare the functional and radiological outcomes following both guided growth surgery (GGS) and acute corrective osteotomy (ACO) correction of angular deformities in children with rickets. METHODS: A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records. A radiographic evaluation of the leg was performed to determine the tibiofemoral angle. For functional evaluation, the Active Scale for Kids (ASK) and Lower Extremity Functional Scale (LEFS) instruments were used for children below and above 15 years old, respectively. RESULTS: In terms of the tibiofemoral angle, the GGS group documented greater angle changes compared to the ACO group, but the difference was not significant. In terms of functional outcomes, the overall score percentage of both groups was comparable with the GGS group showing a trend of higher score percentage compared to the ACO group. The GGS group presented no complication while 2 neurovascular injuries and 1 implant failure were recorded in the ACO group. CONCLUSION: Both GGS and ACO procedures resulted in similar radiographic and functional outcomes for the treatment of rickets in children. GGS may be advantageous in terms of reducing complications of surgery. Nevertheless, the choice of surgical intervention should be made based on the patient's circumstances and the surgeon's preference.

Toward robust and privacy-enhanced facial recognition: A decentralized blockchain-based approach with GANs and deep learning.

In recent years, the extensive use of facial recognition technology has raised concerns about data privacy and security for various applications, such as improving security and streamlining attendance systems and smartphone access. In this study, a blockchain-based decentralized facial recognition system (DFRS) that has been designed to overcome the complexities of technology. The DFRS takes a trailblazing approach, focusing on finding a critical balance between the benefits of facial recognition and the protection of individuals' private rights in an era of increasing monitoring. First, the facial traits are segmented into separate clusters which are maintained by the specialized node that maintains the data privacy and security. After that, the data obfuscation is done by using generative adversarial networks. To ensure the security and authenticity of the data, the facial data is encoded and stored in the blockchain. The proposed system achieves significant results on the CelebA dataset, which shows the effectiveness of the proposed approach. The proposed model has demonstrated enhanced efficacy over existing methods, attaining 99.80% accuracy on the dataset. The study's results emphasize the system's efficacy, especially in biometrics and privacy-focused applications, demonstrating outstanding precision and efficiency during its implementation. This research provides a complete and novel solution for secure facial recognition and data security for privacy protection.

Advancing brain tumor detection: harnessing the Swin Transformer's power for accurate classification and performance analysis.

The accurate detection of brain tumors through medical imaging is paramount for precise diagnoses and effective treatment strategies. In this study, we introduce an innovative and robust methodology that capitalizes on the transformative potential of the Swin Transformer architecture for meticulous brain tumor image classification. Our approach handles the classification of brain tumors across four distinct categories: glioma, meningioma, non-tumor, and pituitary, leveraging a dataset comprising 2,870 images. Employing the Swin Transformer architecture, our method intricately integrates a multifaceted pipeline encompassing sophisticated preprocessing, intricate feature extraction mechanisms, and a highly nuanced classification framework. Utilizing 21 matrices for performance evaluation across all four classes, these matrices provide a detailed insight into the model's behavior throughout the learning process, furthermore showcasing a graphical representation of confusion matrix, training and validation loss and accuracy. The standout performance parameter, accuracy, stands at an impressive 97%. This achievement outperforms established models like CNN, DCNN, ViT, and their variants in brain tumor classification. Our methodology's robustness and exceptional accuracy showcase its potential as a pioneering model in this domain, promising substantial advancements in accurate tumor identification and classification, thereby contributing significantly to the landscape of medical image analysis.

Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database.

Background: Posterior cerebral circulation ischemic stroke (PCS) comprises up to 25% of all strokes. It is characterized by variable presentation, leading to misdiagnosis and morbidity and mortality. We aim to describe PCS in large multiethnic cohorts. Methods: A retrospective review of a large national stroke database from its inception on the 1st of January 2014 till 31 December 2020. Incidence per 100,000 adult population/year, demographics, clinical features, stroke location, and outcomes were retrieved. We divided the cohort into patients from MENA (Middle East and North Africa) and others. Results: In total, 1,571 patients were identified. The incidence of PCS was observed to be rising and ranged from 6.3 to 13.2/100,000 adult population over the study period. Men were 82.4% of the total. The mean age was 54.9 ± 12.7 years (median 54 years, IQR 46, 63). MENA patients comprised 616 (39.2%) while others were 954 (60.7%); of these, the majority (80.5%) were from South Asia. Vascular risk factors were prevalent with 1,230 (78.3%) having hypertension, 970 (61.7%) with diabetes, and 872 (55.5%) having dyslipidemia. Weakness (944, 58.8%), dizziness (801, 50.5%), and slurred speech (584, 36.2%) were the most commonly presenting symptoms. The mean National Institute of Health Stroke Score (NIHSS) score was 3.8 ± 4.6 (median 3, IQR 1, 5). The overall most frequent stroke location was the distal location (568, 36.2%). The non-MENA cohort was younger, less vascularly burdened, and had more frequent proximal stroke location (p < 0.05). Dependency or death at discharge was seen in 39.5% and was associated with increasing age, and proximal and multilocation involvement; while at 90 days it was 27.4% and was associated with age, male sex, and having a MENA nationality (p < 0.05). Conclusion: In a multiethnic cohort of posterior circulation stroke patients from the MENA region and South Asia, we noted a rising incidence over time, high prevalence of vascular risk factors, and poor outcomes in older men from the MENA region. We also uncovered considerable disparities between the MENA and non-MENA groups in stroke location and outcome. These disparities are crucial factors to consider when tailoring individualized patient care plans. Further research is needed to thoroughly investigate the underlying reasons for these variations.