Machine learning approach to classifying declines of physical function and muscle strength associated with cognitive function in older women: gait characteristics based on three speeds

BackgroundThe aging process is associated with a cognitive and physical declines that affects neuromotor control, memory, executive functions, and motor abilities. Previous studies have made efforts to find biomarkers, utilizing complex factors such as gait as indicators of cognitive and physical health in older adults. However, while gait involves various complex factors, such as attention and the integration of sensory input, cognitive-related motor planning and execution, and the musculoskeletal system, research on biomarkers that simultaneously considers multiple factors is scarce. This study aimed to extract gait features through stepwise regression, based on three speeds, and evaluate the accuracy of machine-learning (ML) models based on the selected features to solve classification problems caused by declines in cognitive function (Cog) and physical function (PF), and in Cog and muscle strength (MS).MethodsCognitive assessments, five times sit-to-stand, and handgrip strength were performed to evaluate the Cog, PF, and MS of 198 women aged 65 years or older. For gait assessment, all participants walked along a 19-meter straight path at three speeds [preferred walking speed (PWS), slower walking speed (SWS), and faster walking speed (FWS)]. The extracted gait features based on the three speeds were selected using stepwise regression.ResultsThe ML model accuracies were revealed as follows: 91.2% for the random forest model when using all gait features and 91.9% when using the three features (walking speed and coefficient of variation of the left double support phase at FWS and the right double support phase at SWS) selected for the Cog+PF+ and Cog–PF– classification. In addition, support vector machine showed a Cog+MS+ and Cog–MS– classification problem with 93.6% accuracy when using all gait features and two selected features (left step time at PWS and gait asymmetry at SWS).ConclusionOur study provides insights into the gait characteristics of older women with decreased Cog, PF, and MS, based on the three walking speeds and ML analysis using selected gait features, and may help improve objective classification and evaluation according to declines in Cog, PF, and MS among older women

Granzyme A-producing T helper cells are critical for acute graft-versus-host disease

et al.Acute graft-versus-host disease (aGVHD) can occur after hematopoietic cell transplant in patients undergoing treatment for hematological malignancies or inborn errors. Although CD4+ T helper (Th) cells play a major role in aGVHD, the mechanisms by which they contribute, particularly within the intestines, have remained elusive. We have identified a potentially novel subset of Th cells that accumulated in the intestines and produced the serine protease granzyme A (GrA). GrA+ Th cells were distinct from other Th lineages and exhibited a noncytolytic phenotype. In vitro, GrA+ Th cells differentiated in the presence of IL-4, IL-6, and IL-21 and were transcriptionally unique from cells cultured with either IL-4 or the IL-6/IL-21 combination alone. In vivo, both STAT3 and STAT6 were required for GrA+ Th cell differentiation and played roles in maintenance of the lineage identity. Importantly, GrA+ Th cells promoted aGVHD-associated morbidity and mortality and contributed to crypt destruction within intestines but were not required for the beneficial graft-versus-leukemia effect. Our data indicate that GrA+ Th cells represent a distinct Th subset and are critical mediators of aGVHD.The work in the study was supported by NIH grants R21 AI117380 and R01 AI095282 to MHK. Support provided by the Herman B Wells Center was in part from the Riley Children’s Foundation. TI was supported by the Department of Pediatrics through the Project Development Team within the IIndiana Clinical and Translational Sciences Institute NIH/National Center for Research Resources grant number UL1TR001108. MRO had support from Purdue University Public Health Service Grant T32AR062495 and from the Showalter Trust. S Paczesny had support from NIH/National Cancer Institute grant R01CA168814, and BG had support from NIH/National Institute of Diabetes and Digestive and Kidney Diseases grant T32DK007519. TAH was supported by Public Health Service grant T32AI060519. Core facility usage was also supported by Indiana University Simon Cancer Center Support Grants P30CA082709 and U54 DK106846. Work by MK was supported by NIH/National Heart, Lung, and Blood Institute 5K22HL125593. Work in the JP laboratory is funded by FEDER (Fondo Europeo de Desarrollo Regional), Gobierno de Aragón (Group B29_17R), Ministerio de Ciencia, Innovación e Universidades (MCNU), Agencia Estatal de Investigación (Blood Institute 5K22HL125593. Work in the JP laboratory is funded by FEDER (Fondo Europeo de Desarrollo Regional), Gobierno de Aragón (Group B29_17R), Ministerio de Ciencia, Innovación e Universidades (MCNU), Agencia Estatal de Investigación (SAF2017-83120-C2-1-R), Fundacion Inocente Inocente, ASPANOA, and Carrera de la Mujer de Monzón. The authors gratefully acknowledge the support of Purdue Biological Evaluation shared resource from the Purdue Center for Cancer Research, NIH grant P30 CA023168. W), Fundacion Inocente Inocente, ASPANOA, and Carrera de la Mujer de Monzón. The authors gratefully acknowledge the support of Purdue Biological Evaluation shared resource from the Purdue Center for Cancer Research, NIH grant P30 CA023168.Peer reviewe

Bone Regeneration Effect of Hyperbaric Oxygen Therapy Duration on Calvarial Defects in Irradiated Rats

Objective. In this study, we evaluated changes in bone remodeling in an irradiated rat calvarial defect model according to duration of hyperbaric oxygen therapy. Materials and Methods. The 28 rats were divided into four groups. Radiation of 12 Gy was applied to the skull, and 5-mm critical size defects were formed on both sides of the skull. Bone grafts were applied to one side of formed defects. From the day after surgery, HBO was applied for 0, 1, and 3 weeks. At 6 weeks after bone graft, experimental sites were removed and analyzed for radiography, histology, and histomorphometry. Results. Micro-CT analysis showed a significant increase in new bone volume in the HBO-3 group, with or without bone graft. When bone grafting was performed, BV, BS, and BS/TV all significantly increased. Histomorphometric analysis showed significant increases in %NBA and %BVN in the HBO-1 and HBO-3 groups, regardless of bone graft. Conclusion. Hyperbaric oxygen therapy was effective for bone regeneration with only 1 week of treatment

North Korea: U.S. Relations, Nuclear Diplomacy, and Internal Situation

This report covers the overall U.S.-North Korea relationship, with an emphasis on nuclear diplomacy. Negotiations over North Korea's nuclear weapons program have occupied the past three U.S. administrations, even as some analysts anticipated a collapse of the isolated authoritarian regime. North Korea has been the recipient of over $1 billion in U.S. aid (though none since 2009) and the target of dozens of U.S. sanctions

The influence of contralateral circulation on computational fluid dynamics of intracranial arteries: simulated versus measured flow velocities

Abstract Background This study aimed to retrospectively evaluate the influence of contralateral anterior circulation on computational fluid dynamics (CFD) of intracranial arteries, by comparing the CFD values of flow velocities in unilateral anterior circulation with the measured values from phase-contrast magnetic resonance angiography (PC-MRA). Methods We analyzed 21 unilateral anterior circulation models without proximal stenosis from 15 patients who performed both time-of-flight MRA (TOF-MRA) and PC-MRA. CFD was performed with the inflow boundary condition of a pulsatile flow of the internal carotid artery (ICA) obtained from PC-MRA. The outflow boundary condition was given as atmospheric pressure. Simulated flow velocities of the middle cerebral artery (MCA) and anterior cerebral artery (ACA) from CFD were compared with the measured values from PC-MRA. Results The velocities of MCA were shown to be more accurately simulated on CFD than those of ACA (Spearman correlation coefficient 0.773 and 0.282, respectively). In four models with severe stenosis or occlusion of the contralateral ICA, the CFD values of ACA velocities were significantly lower (< 50%) than those measured with PC-MRA. ACA velocities were relatively accurately simulated in the models including similar diameters of both ACAs. Conclusion It may be necessary to consider the flow condition of the contralateral anterior circulation in CFD of intracranial arteries, especially in the ACA. Relevance statement Incorporating the flow conditions of the contralateral circulation is of clinical importance for an accurate prediction of a rupture risk in Acom aneurysms as the bidirectional flow and accurate velocity of both ACAs can significantly impact the CFD results. Key points • CFD simulations using unilateral vascular models were relatively accurate for MCA. • Contralateral ICA steno-occlusion resulted in an underestimation of CFD velocity in ACA. • Contralateral flow may need to be considered in CFD simulations of ACA. Graphical Abstrac