Traumatic brain injury (TBI) is a major public health problem. Caused by external mechanical forces, a major characteristic of TBI is the shearing of axons across the white matter, which causes ...structural connectivity disruptions between brain regions. This diffuse injury leads to cognitive deficits, frequently requiring rehabilitation. Heterogeneity is another characteristic of TBI as severity and cognitive sequelae of the disease have a wide variation across patients, posing a big challenge for treatment. Thus, measures assessing network‐wide structural connectivity disruptions in TBI are necessary to quantify injury burden of individuals, which would help in achieving personalized treatment, patient monitoring, and rehabilitation planning. Despite TBI being a disconnectivity syndrome, connectomic assessment of structural disconnectivity has been relatively limited. In this study, we propose a novel connectomic measure that we call network normality score (NNS) to capture the integrity of structural connectivity in TBI patients by leveraging two major characteristics of the disease: diffuseness of axonal injury and heterogeneity of the disease. Over a longitudinal cohort of moderate‐to‐severe TBI patients, we demonstrate that structural network topology of patients is more heterogeneous and significantly different than that of healthy controls at 3 months postinjury, where dissimilarity further increases up to 12 months. We also show that NNS captures injury burden as quantified by posttraumatic amnesia and that alterations in the structural brain network is not related to cognitive recovery. Finally, we compare NNS to major graph theory measures used in TBI literature and demonstrate the superiority of NNS in characterizing the disease.
In this study, we propose a novel normative graph theoretical measure to assess injury burden in moderate‐to‐severe traumatic brain injury patients, which captures properties of the disease that are not well captured by standard graph theory measures. We demonstrate the utility of our measure by showing its relationship with cognitive measures. We also investigated the longitudinal change in cognitive measures as well as proposed measure and demonstrated an inverse relationship between the two, potentially indicating the network level effects of neural degeneration in TBI patients over time.
Journaling techniques are widely used to guarantee file system consistency of battery-powered mobile devices such as smartphones and tablets. In a journaling file system, system recovery is ...facilitated by first writing updated data blocks to a journal area and then periodically writing them to their home locations. However, these duplicated writes degrade the performance and shorten the lifetime of NAND flash storage in mobile devices. In particular, a lightweight database library, which is mainly used to manage application data in mobile devices, is a major cause of excessive journaling because it frequently triggers the costly file synchronization to guarantee the atomicity of transactional execution and thus generates a significant amount of synchronous random write traffic. This paper presents a novel journaling scheme, called Delta Journaling (DJ), to resolve this problem efficiently by using small-sized nonvolatile random access memory (NVRAM). DJ is based on a unique update pattern found in mobile devices, where file system updates are mostly very small. By exploiting the byteaddressable and the nonvolatile characteristics of NVRAM, DJ stores a journal block as a compressed delta in the smallsized NVRAM only when the compressed delta is small enough. Experimental results show that DJ outperforms a traditional journaling file system by up to 16.8 times for synthetic workloads. For a real-world workload, it enhances transaction throughput by 25.5% and 29.2% in ordered and journal modes, respectively, with only 16 MB NVRAM. Also, DJ enhances the lifetime of NAND flash storage by eliminating almost all journal writes without any loss of reliability.
Lumbar spinal stenosis is a common spinal degenerative condition. Minimally invasive interlaminar full-endoscopic decompressive laminectomy provides greater patient satisfaction and faster recovery ...than open decompressive laminectomy. The aim of our randomized controlled trial will be to compare the safety and efficacy of interlaminar full-endoscopic laminectomy and open decompressive laminectomy. Our trial will include 120 participants (60 per group) who will undergo surgical treatment for lumbar spinal stenosis. The primary outcome will be the Oswestry Disability Index measured at 12 months postoperatively. Secondary patient-reported outcomes will include back and radicular leg pain measured via a visual analog scale; the Oswestry Disability Index; the Euro-QOL-5 Dimensions score measured at 2 weeks and at 3, 6, and 12 months postoperatively; and patient satisfaction. The functional measures will include time to return to daily activities postoperatively and walking distance/time. The surgical outcomes will include postoperative drainage, operation time, duration of hospital stay, postoperative creatine kinase (an indicator of muscle injury) level, and postoperative surgical scarring. Magnetic resonance and computed tomography images and simple radiographs will be obtained for all patients. The safety outcomes will include surgery-related complications and adverse effects. All evaluations will be performed by a single assessor at each participating hospital who will be blinded to group allocation. The evaluations will be conducted preoperatively and at 2 weeks and 3, 6, and 12 months postoperatively. The randomized, multicenter design of the trial, blinding, and justification of the sample size will reduce the risk of bias in our trial. The results of the trial will provide data regarding the use of interlaminar full-endoscopic laminectomy as an alternative to open decompressive laminectomy that results in similar surgical findings with less invasiveness. Trial registration: This trial is registered at cris.nih.go.kr. (KCT0006198; protocol version 1; 27 May 2021).
Although pluripotent stem cells hold great promise in the fields of human disease modeling and regenerative medicine, the molecular basis of Oct‐4, Sox2, Klf4, and c‐Myc (OSKM)‐induced cellular ...reprogramming remains unclear. To investigate the molecular mechanisms involved in cellular reprogramming, we studied the immediate effects of expression of the OSKM reprogramming factors on mouse embryonic fibroblasts (MEFs) in this study. Induction of the OSKM reprogramming factors significantly altered primary MEF growth properties. Although MEFs not expressing the reprogramming factors underwent replicative senescence within 9–12 days in culture, MEFs expressing the four reprogramming factors proliferated continuously throughout the duration of the experiment, suggesting that the expression of the OSKM reprogramming factors inhibits or delays replicative senescence. Cell cycle progression by the reprogramming factors was accompanied by the accumulation of Cyclin D1 through the early stages of reprogramming in MEFs, leading us to hypothesize that it might play a positive role in cellular reprogramming. Consistent with this hypothesis, forced Cyclin D1 expression enhanced reprogramming if administered concomitant with expression of the OSKM reprogramming factors. Most importantly, unlike wild‐type MEFs expressing reprogramming factors, the number of emerging alkaline phosphatase‐positive cyclin D1‐null colonies was significantly reduced and cyclin D1‐null MEFs were unable to initiate mesenchymal‐to‐epithelial transition. Our studies demonstrate that cyclin D1 is an essential gene in the reprogramming process and that activation of cyclin D1 by reprogramming factors is an important process for somatic cell reprogramming.
Unlike wild‐type MEFs expressing reprogramming factors, the number of emerging alkaline phosphatase‐positive cyclin D1‐null colonies was significantly reduced and cyclin D1‐null MEFs were unable to initiate mesenchymal‐to‐epithelial transition. The gene cyclin D1 is essential in the reprogramming process and that activation of cyclin D1 by reprogramming factors is an important process for somatic cell reprogramming.
Although many studies have reported an association between self-reported physical activity and metabolic syndrome (MetS), there is limited information on the optimal level of physical activity ...required to prevent MetS. This study aimed to determine the association between objectively measured physical activity and MetS in middle-aged Japanese individuals. We also determined the optimal cutoff value for physical activity required to decrease the risk of developing MetS.
A total of 179 men and 304 women, aged between 30 and 64 years, participated in this study. Participants were divided into two groups using the Japanese criteria for MetS as those with MetS or pre-MetS, and those without MetS. Participants were considered to be physically active if they achieved a physical activity level of 23 metabolic equivalents (METs) h/week, measured using a triaxial accelerometer. The association between physical activity and MetS was analyzed using logistic regression with the following covariates: sex, age, sedentary time, low intensity activity, calorie intake, smoking, menopause and body mass index. We also evaluated the factors that determined the association between the prevalence of MetS and pre-MetS and the physical activity cutoff value using classification and regression tree (CART) analysis.
The odds ratio for MetS and pre-MetS was 2.20 for physically inactive participants (< 23 METs h/week), compared with physically active participants (≥ 23 METs h/week). The corresponding odds ratios for men and women were 2.27 (P < 0.01) and 1.95 (not significant), respectively. CART analyses revealed that moderate-vigorous physical activity of > 26.5 METs h/week was sufficient to decrease the prevalence of MetS and pre-MetS in middle-aged Japanese men and women.
The results of this cross-sectional study indicate that the Exercise and Physical Activity Reference for Health Promotion 2006 is inversely associated with the prevalence of MetS in men. Our results also suggest that moderate physical activity of > 26.5 METs h/week may decrease the risk of developing MetS and pre-MetS in middle-aged Japanese individuals.
The use of non-invasive techniques for the estimation of structural brain networks (i.e. connectomes) opened the door to large-scale investigations on the functioning and the architecture of the ...brain, unveiling the link between neurological disorders and topological changes of the brain network. This study aims at assessing if and how the topology of structural connectomes estimated non-invasively with diffusion MRI is affected by the employment of tractography filtering techniques in structural connectomic pipelines. Additionally, this work investigates the robustness of topological descriptors of filtered connectomes to the common practice of density-based thresholding.
We investigate the changes in global efficiency, characteristic path length, modularity and clustering coefficient on filtered connectomes obtained with the spherical deconvolution informed filtering of tractograms and using the convex optimization modelling for microstructure informed tractography. The analysis is performed on both healthy subjects and patients affected by traumatic brain injury and with an assessment of the robustness of the computed graph-theoretical measures with respect to density-based thresholding of the connectome.
Our results demonstrate that tractography filtering techniques change the topology of brain networks, and thus alter network metrics both in the pathological and the healthy cases. Moreover, the measures are shown to be robust to density-based thresholding.
The present work highlights how the inclusion of tractography filtering techniques in connectomic pipelines requires extra caution as they systematically change the network topology both in healthy subjects and patients affected by traumatic brain injury. Finally, the practice of low-to-moderate density-based thresholding of the connectomes is confirmed to have negligible effects on the topological analysis.
This paper investigates a low-Earth orbit (LEO) satellite downlink for high-speed data communication in interference situations. A choke ring horn type antenna is used as the data transmitting ...antenna with an isoflux pattern in the LEO satellite, which has a beam coverage of ±51.6° and a bore-sight gain of 4.4 dBi at 8 GHz. The receiving antenna on the ground station is a parabolic type antenna with a diameter of 11.3 m, and it has a half-power beam width (HPBW) of 0.2° with a maximum gain of 59 dBi at 8 GHz. The jamming-to-signal ratio (J/S) is calculated assuming that the LEO satellite transmits signals to the ground station, and an elevation angle of the interference source varies from 0° to 90° at an altitude of 10 km. Applying antenna characteristics, such as HPBWs and side lobes, to the calculated space wave path loss makes it possible to predict the J/S results according to the location of the interference source and the satellite. The results show that it is necessary to consider the space environment to accurately analyze the LEO satellite downlink, especially at the low elevation angle of the satellite.
Imaging detection of brain perfusion alterations after traumatic brain injury (TBI) may provide prognostic insights. In this study, we used arterial spin labeling (ASL) to quantify cross-sectional ...and longitudinal changes in cerebral blood flow (CBF) after TBI and correlated changes with clinical outcome. We analyzed magnetic resonance imaging scans from adult participants with TBI requiring hospitalization in the acute (2 weeks post-injury,
= 33) and chronic (6 months post-injury,
= 16) phases, with 13 participants scanned longitudinally at both time points. We also analyzed 18 age- and sex-matched healthy controls. Whole-brain CBF maps were derived using a three-dimensional pseudo-continuous arterial spin label technique. Mean CBF across tissue-based regions (whole brain, gray matter, and white matter) was compared cross-sectionally and longitudinally. In addition, individual-level clusters of abnormal perfusion were identified using voxel-based
-score analysis of relative CBF maps, and number and volume of abnormally hypo- and hyperperfused clusters were assessed cross-sectionally and longitudinally. Finally, all CBF measures were correlated with clinical outcome measures. Mean global and gray matter CBF were significantly elevated in acute and chronic TBI participants compared to controls. Participants with better outcome at 6 months post-injury tended to have higher CBF in the acute phase compared to those with poorer outcome. Acute TBI participants had a significantly greater volume of hypo- and hyperperfused brain tissue compared to controls, with these regions partially normalizing by the chronic phase. Our findings demonstrate global elevation of CBF with focal hypo- and hyperperfusion in the early post-injury period and suggest a reparative role for acute elevation in CBF post-TBI.
OBJECTIVES Although the surfing-related injuries has been increasing with growing numbers of recreational surfers worldwide, lack of epidemiological evidence about the surfing injuries. Therefore, ...the purpose of this study was to identify the types and mechanism of injury in recreational surfers. We also aimed to determine the differences in the type and mechanism of injury according to surfer’s characteristics (sex and surfing experience).METHODS A total of 227 participants (149 male and 78 female) were recruited and analyzed for this study. To identify the surfing-related injuries, we investigated the types, locations, season, and mechanism of injury using a questionnaire.RESULTS The highest frequency of injury was found in skin, followed by muscle and tendon, and joints. There were not significant differences in the injury types according to the sex and surfing experience (≤12 versus >12 months). An upper limb and arm injury was significantly higher in male (p<0.01) and the torso injury was higher in female (p<0.05). Moreover, the less experience (≤12 months) of surfing was associated with higher rates of injury caused by falling or collision with other surfers.CONCLUSIONS To the best of our knowledge, this is the first epidemiological study presented the surfingrelated injury among Korean population. We found the injuries mainly occurred on the skin, and muscle and tendon. In addition, our results suggest that surfers with insufficient experience may be vulnerable to injuries from falls and contact with other surfers. Consequently, these epidemiological data may be utilized to prevent and manage the injury in surfers according to surfer’s characteristic and experience.
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