Effects of Rucksack Military Accessory on Gait Dynamic Stability

Various factors are responsible for injuries that occur in the U.S. Army soldiers. In particular, rucksack load carriage equipment influences the stability of the lower extremities and possibly affects gait balance. The objective of this investigation was to assess the gait and local dynamic stability of the lower extremity of five subjects as they performed a simulated rucksack march on a treadmill. The Motek Gait Real-time Interactive Laboratory (GRAIL) was utilized to replicate the environment of the rucksack march. The first walking trial was without a rucksack and the second set was executed with the All-Purpose Lightweight Individual Carrying Equipment (ALICE), an older version of the rucksack, and the third set was executed with the newer rucksack version, Modular Lightweight Load Carrying Equipment (MOLLE). In this experiment, the Inertial Measurement Unit (IMU) system, Dynaport was used to measure the ambulatory data of the subject. This experiment required subjects to walk continuously for 200 seconds with a 20kg rucksack, which simulates the real rucksack march training. To determine the dynamic stability of different load carriage and normal walking condition, Local Dynamic Stability (LDS) was calculated to quantify its stability. The results presented that comparing Maximum Lyapunov Exponent (LyE) of normal walking was significantly lower compared to ALICE (P=0.000007) and MOLLE (P=0.00003), however, between ALICE and MOLLE rucksack walking showed no significant difference (P=0.441). The five subjects showed significantly improved dynamic stability when walking without a rucksack in comparison with wearing the equipment. In conclusion, we discovered wearing a rucksack result in a significant (P \u3c 0.0001) reduction in dynamic stability

Dramatic Intracerebral Hemorrhagic Presentations of Reversible Cerebral Vasoconstriction Syndrome: Three Cases and a Literature Review

Reversible cerebral vasoconstriction syndrome (RCVS) refers to a number of disorders characterized by severe and sudden-onset (“thunderclap”) headaches and angiographic features of reversible, segmental, multifocal vasoconstriction of cerebral arteries. Although RCVS generally resolves without significant sequelae, a rare and possibly underrecognized hemorrhagic presentation has a worse potential course. We report three cases of hemorrhagic RCVS and review the literature. Three females (42, 54, and 33 years old, resp.) presented with severe headache, neurological deficits, and dramatic intracerebral hemorrhage (ICH). Patient 1 presented comatose with a 9 × 4 × 6.6 cm left deep intraparenchymal hemorrhage (IPH) and 1 cm midline shift. She underwent emergent surgical intervention. Patient 2 had a 3.3 × 1.5 cm left superior frontal IPH that enlarged to 4 × 2.5 cm within 12 hours with worsening headache and neurological deficits. She was successfully managed nonoperatively. Patient 3, after uncomplicated pregnancy and delivery, presented with a 1.5 cm left superior parietal IPH on postpartum day 7. Two days later, she acutely developed right hemiplegia. Repeat CT demonstrated a new 3.3 × 1.7 cm left frontal IPH. She was also successfully managed nonoperatively. Many diverse conditions are grouped within the category of RCVS. Dramatic ICH remains a rare and possibly underrecognized presenting feature. Prompt diagnosis and management are essential for obtaining the best outcome

Age-related changes in cervical sagittal range of motion and alignment

Study Design Retrospective cohort study. Objective To compare sagittal cervical range of motion (ROM) and alignment in young versus middle-aged adults. Methods One hundred four asymptomatic adults were selected randomly out of 791 subjects who underwent lateral cervical radiographs in neutral, flexion, and extension positions. They were divided into two groups: young (age 20 to 29, 52 people) and middle-aged adults (age 50 to 59, 52 people). We determined the ROMs of upper cervical (occipital–C2 angle), midcervical (C2–C7 angle), and cervicothoracic spine (cervicosternal angle). We compared the alignment differences of the two groups by calculating the distances between C2 and C7 plumb lines, and C2 central-offset distance. Results In neutral position, there was no significant difference between young and middle-aged adults. However, in flexion, C2–C7 angle, distance between C2–C7 plumb lines, and C2 central-offset distance decreased with age. In extension, C2–C7 angle and C2 central-offset distance decreased with age. During flexion and extension, midcervical ROM and the range of C2 central-offset distance decreased in the middle-aged group. However, there was no difference between the two age groups in the ROM of the upper cervical and the cervicothoracic regions during flexion and extension. Conclusion We found that, despite of the presence of age-related cervical alignment changes, the only difference between the two groups was in the sagittal ROM of the midcervical spine during flexion and extension. Only the ROM of the midcervical spine appears to change significantly, consistent with findings that these levels are most likely to develop both symptomatic and asymptomatic degenerative changes

Time-delayed Spatial Patterns in a Two-dimensional Array of Coupled Oscillators

We investigated the effect of time delays on phase configurations in a set of two-dimensional coupled phase oscillators. Each oscillator is allowed to interact with its neighbors located within a finite radius, which serves as a control parameter in this study. It is found that distance-dependent time-delays induce various patterns including traveling rolls, square-like and rhombus-like patterns, spirals, and targets. We analyzed the stability boundaries of the emerging patterns and briefly pointed out the possible empirical implications of such time-delayed patterns.Comment: 5 Figure

Nearest pattern interaction and global pattern formation

We studied the effect of nearest pattern interaction on a globally pattern formation in a 2-dimensional space, where patterns are to grow initially from a noise in the presence of periodic supply of energy. Although our approach is general, we found that this study is relevant in particular to the pattern formation on a periodically vibrated granular layer, as it gives a unified perspective of the experimentally observed pattern dynamics such as oscillon and stripe formations, skew-varicose and crossroll instabilities, and also a kink formation and decoration

Mutation spectrum and biochemical features in infants with neonatal Dubin-Johnson syndrome

Abstract Background Dubin-Johnson syndrome (DJS) is an autosomal recessive disorder presenting as isolated direct hyperbilirubinemia.DJS is rarely diagnosed in the neonatal period. The purpose of this study was to clarify the clinical features of neonatal DJS and to analyze the genetic mutation of adenosine triphosphate-binding cassette subfamily C member 2 (ABCC2). Methods From 2013 to 2018, 135 infants with neonatal cholestasis at Seoul National University Hospital were enrolled. Genetic analysis was performed by neonatal cholestasis gene panel. To clarify the characteristics of neonatal DJS, the clinical and laboratory results of 6 DJS infants and 129 infants with neonatal cholestasis from other causes were compared. Results A total of 8 different ABCC2 variants were identified among the 12 alleles of DJS. The most common variant was p.Arg768Trp (33.4%), followed by p.Arg100Ter (16.8%). Three novel variants were identified (p.Gly693Glu, p.Thr394Arg, and p.Asn718Ser). Aspartate transaminase (AST) and alanine transaminase (ALT) levels were significantly lower in infants with DJS than in infants with neonatal cholestasis from other causes. Direct bilirubin and total bilirubin were significantly higher in the infants with DJS. Conclusions We found three novel variants in 6 Korean infants with DJS. When AST and ALT levels are normal in infants with neonatal cholestasis, genetic analysis of ABCC2 permits an accurate diagnosis

Detailed analysis of phenotypes and genotypes in megalencephaly-capillary malformation-polymicrogyria syndrome caused by somatic mosaicism of PIK3CA mutations

Abstract Background Megalencephaly-capillary malformation-polymicrogyria syndrome (MCAP) belongs to a group of conditions called the PIK3CA-related overgrowth spectrum (PROS). The varying phenotypes and low frequencies of each somatic mosaic variant make confirmative diagnosis difficult. We present 12 patients who were diagnosed clinically and genetically with MCAP. Genomic DNA was extracted mainly from the skin of affected lesions, also from peripheral blood leukocytes and buccal epithelial cells, and target panel sequencing using high-depth next-generation sequencing technology was performed. Results Macrocephaly was present in 11/12 patients (92%). All patients had normal body asymmetry. Cutaneous vascular malformation was found in 10/12 patients (83%). Megalencephaly or hemimegalencephaly was noted in all 11 patients who underwent brain magnetic resonance imaging. Arnold–Chiari type I malformation was also seen in 10 patients. Every patient was identified as having pathogenic or likely pathogenic variants of the PIK3CA gene. The variant allele frequency (VAF) ranged from 6.3 to 35.3%, however, there was no direct correlation between VAF and the severity of associated anomalies. c.2740G > A (p.Gly914Arg) was most commonly found, in four patients (33%). No malignancies developed during follow-up periods. Conclusions This is the first and largest cohort of molecularly diagnosed patients with MCAP in Korea. Targeted therapy with a PI3K-specific inhibitor, alpelisib, has shown successful outcomes in patients with PROS in a pilot clinical study, so early diagnosis for genetic counseling and timely introduction of emerging treatments might be achieved in the future through optimal genetic testing

Design and baseline characteristics of a prospective cohort study for determinants of osteoporotic fracture in community-dwelling elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study

<p>Abstract</p> <p>Background</p> <p>Osteoporosis and osteoporotic fracture in men are significant public health problems in an aging society. However, information on male osteoporosis remains impressively lacking, especially for Asians. We designed the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study as an ancillary study of a cohort study, the Fujiwara-kyo study, to determine risk factors for osteoporotic fractures in Japanese men.</p> <p>Methods/Design</p> <p><it><b>Design</b></it>: A community-based single-centre prospective cohort study with at least a 5-year follow-up</p> <p><it><b>Subjects</b></it>: All the male participants of the Fujiwara-kyo study who were living in the four cities studied, aged 65 years and older, and able to walk without aid from others.</p> <p><it><b>Primary outcome</b></it>: Incidence of osteoporotic fractures including vertebral and clinical non-vertebral fractures.</p> <p><it><b>Additional outcomes</b></it>: Change in bone mineral density (BMD), change in hip geometry, onset of receiving benefits from Long-term Care Insurance (LCI), health-related quality of life, and mortality.</p> <p><it><b>Baseline measurements</b></it>: BMD at the lumbar spine (LS) and hip (TH), hip geometry, vertebral deformity assessment, bone turnover markers, physical and cognitive performance, various medical and lifestyle factors, and geriatric psychosocial measures confirmed by interviews based on self-administrated questionnaires.</p> <p><it><b>Outcome surveillance</b></it>: Annual mail surveys and a follow-up survey at the fifth year comprising similar items to the baseline study will be used to determine the outcomes. Receipt of benefits from LCI and mortality will be obtained from the city governments.</p> <p><it><b>Current status</b></it>: The baseline study was conducted for 2174 eligible men, and 2012 completed the study and were eligible for follow-up. Prevalence rates of osteoporosis (BMD 2.5 SD or more below the young adult mean (YAM)) and low BMD (BMD 1 SD or more below YAM) in at least one of LS and TH were calculated to be 4.4% and 41.8%, respectively. The proportion of men with low BMD only at TH showed a significant increasing trend with aging (p < 0.0001) while that only at LS showed a decreasing trend (p = 0.0386). The prevalence rate of osteoporosis was underestimated when diagnosed using only BMD at LS. Other baseline measurements were successfully obtained.</p> <p>Discussion</p> <p>FORMEN baseline study was performed as designed and the FORMEN cohort study was successfully launched.</p

The MOSDEF Survey: Neon as a Probe of ISM Physical Conditions at High Redshift

We present results on the properties of neon emission in $z\sim2$ star-forming galaxies drawn from the MOSFIRE Deep Evolution Field (MOSDEF) survey. Doubly-ionized neon ([NeIII]3869) is detected at $\geq3\sigma$ in 61 galaxies, representing $\sim$25% of the MOSDEF sample with H$\alpha$, H$\beta$, and [OIII]$5007$ detections at similar redshifts. We consider the neon emission-line properties of both individual galaxies with [NeIII]3869 detections and composite $z\sim2$ spectra binned by stellar mass. With no requirement of [NeIII]3869 detection, the latter provide a more representative picture of neon emission-line properties in the MOSDEF sample. The [NeIII]3869/[OII]3727 ratio (Ne3O2) is anti-correlated with stellar mass in $z\sim2$ galaxies, as expected based on the mass-metallicity relation. It is also positively correlated with the [OIII]$5007$/[OII]$3727$ ratio (O32), but $z\sim2$ line ratios are offset towards higher Ne3O2 at fixed O32, compared with both local star-forming galaxies and individual H~II regions. Despite the offset towards higher Ne3O2 at fixed O32 at $z\sim2$, biases in inferred Ne3O2-based metallicity are small. Accordingly, Ne3O2 may serve as an important metallicity indicator deep into the reionization epoch. Analyzing additional rest-optical line ratios including [NeIII]$3869$/[OIII]$5007$ (Ne3O3) and [OIII]$5007$/H$\beta$ (O3H$\beta$), we conclude that the nebular emission-line ratios of $z\sim2$ star-forming galaxies suggest a harder ionizing spectrum (lower stellar metallicity, i.e., Fe/H) at fixed gas-phase oxygen abundance, compared to systems at $z\sim0$. These new results based on neon lend support to the physical picture painted by oxygen, nitrogen, hydrogen, and sulfur emission, of an ionized ISM in high-redshift star-forming galaxies irradiated by chemically young, $\alpha$-enhanced massive stars.Comment: 7 pages, 5 figures, accepted to ApJ Letter

Observation of B0→pΛˉD(∗)−B^{0} \rightarrow p\bar{\Lambda} D^{(*)-}

We report the first observation of the decays $B^0 \rightarrow p\bar{\Lambda} D^{(*)-}$. The data sample of $711$ fb$^{-1}$ used in this analysis corresponds to $772$ million $B\bar{B}$ pairs, collected at the $\Upsilon(4S)$ resonance by the Belle detector at the KEKB asymmetric-energy $e^{+}e^{-}$ collider. We observe $19.8\sigma$ and $10.8\sigma$ excesses of events for the two decay modes and measure the branching fractions of $B^0 \rightarrow p\bar{\Lambda} D^{-}$ and $B^0 \rightarrow p\bar{\Lambda} D^{*-}$ to be $(25.1\pm2.6\pm3.5)\times10^{-6}$ and $(33.6\pm6.3\pm4.4)\times10^{-6}$, respectively, where the first uncertainties are statistical and the second are systematic. These results are not compatible with the predictions based on the generalized factorization approach. In addition, a threshold enhancement in the di-baryon ($p\bar{\Lambda}$) system is observed, consistent with that observed in similar $B$ decays.Comment: 16 pages, 3 figures and 3 tables, submitted to PR