Although neuroimaging is essential for prompt and proper management of traumatic brain injury (TBI), there is a regrettable and acute lack of robust methods for the visualization and assessment of TBI pathophysiology, especially for of the purpose of improving clinical outcome metrics. Until now, the application of automatic segmentation algorithms to TBI in a clinical setting has remained an elusive goal because existing methods have, for the most part, been insufficiently robust to faithfully capture TBI-related changes in brain anatomy. This article introduces and illustrates the combined use of multimodal TBI segmentation and time point comparison using 3D Slicer, a widely-used software environment whose TBI data processing solutions are openly available. For three representative TBI cases, semi-automatic tissue classification and 3D model generation are performed to perform intra-patient time point comparison of TBI using multimodal volumetrics and clinical atrophy measures. Identification and quantitative assessment of extra-and intra-cortical bleeding, lesions, edema, and diffuse axonal injury are demonstrated. The proposed tools allow cross-correlation of multimodal metrics from structural imaging (e.g., structural volume, atrophy measurements) with clinical outcome variables and other potential factors predictive of recovery. In addition, the workflows described are suitable for TBI clinical practice and patient monitoring, particularly for assessing damage extent and for the measurement of neuroanatomical change over time. With knowledge of general location, extent, and degree of change, such metrics can be associated with clinical measures and subsequently used to suggest viable treatment options.

The thalamus plays a crucial role in sensorimotor, cognitive, and attentional circuit functions. Disruptions in thalamic connectivity are believed to underlie the symptoms of multiple sclerosis (MS). Therefore, assessing thalamocortical structural connectivity (SC) and functional connectivity (FC) may provide new insights into the mechanism of intrinsic functional plasticity in a large-scale neural network. We used resting-state FC measurement and diffusion tensor imaging probabilistic tractography to study the functional and structural integrity of the thalamocortical system in patients with relapsing-remitting MS (RRMS) and matched healthy controls. In the thalamocortical connections of RRMS patients, we found lesion load-related regional FC in the right temporal pole, which reflected compensatory hyperconnectivity related to lesion-related demyelination. We also found significant correlations between increased diffusivity and slowed cognitive processing (PASAT) or the impact of fatigue (MFIS-5), as well as between connective fiber loss and disease duration. Taken together, the evidence from SC and FC analysis of the thalamocortical system suggests that minimally disabled RRMS patients exhibit a dissociated SC–FC pattern and limited regional functional plasticity to compensate for the chronic demyelination-related loss of long-distance SC. These results also provide further evidence supporting the notion that MS is a disorder of anatomical disconnection.

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Background: Exercise therapy is commonly prescribed by primary care physicians (PCPs) in the management of chronic musculoskeletal (MSK) pain. Aims: We evaluated the clinical effectiveness of a supervised neuromuscular (NM) exercise program in older people with chronic MSK pain. Design: A 12-week, two-arm randomized controlled trial comparing 6 weeks supervised NM exercise versus waiting list control. Setting: We enrolled 72 participants with chronic MSK pain in a primary care clinic. Methods: Participants were randomly allocated (block size of 12) in 1:1 ratio to the NM (N=36) and control group (N=36). Data were collected at baseline, 6 and 12 weeks. The primary outcome was the Brief Pain Inventory (BPI) score at 6 weeks (post-intervention). Secondary outcomes included the Pain Self-Efficacy Questionnaire (PSEQ), Short form of Health Survey (SF-12), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scores, and functional measurement using the Timed-Up-and-Go test and handgrip strength. Results: Compared with the control group at 6 weeks, the NM group demonstrated a significantly greater improvement in the BPI-severity pain (between-group difference -1.27, 95% CI = -2.08 to -0.45, P = 0.002) and PSEQ (between-group difference 6.50, 95% CI = 2.022 to 10.77, P = 0.003). Participants who complied to the protocol also demonstrated statistical significant improvement in the SF-12-physical score and PHQ-9 score. Conclusion and implications: NM exercise has the potential of reducing pain, improving self-efficacy, physical function and mood in older people with chronic MSK pain. It can be an option to PCPs in exercise prescriptions.

Background: Cerebral palsy (CP) is a neurodevelopmental disorder caused by a brain injury resulting in poor coordination and motor control deficits, which is one of the most common physical disabilities in children. CP brings a heavy burden on families and society and becomes a significant public health issue. In recent years, hydrotherapy, and transcranial direct current stimulation (tDCS) as a physical therapy for CP is developing rapidly. When hydrotherapy and tDCS are used to treat separately, it has positive therapeutic effect in children with CP. The development of new therapies in combination with physical rehabilitation approaches is critical to optimize functional outcomes. tDCS has attracted interest in this context, because of significant functional improvements have been demonstrated in individuals with brain injuries after a short period of cerebral stimulation. Since the onset of this work, tDCS has been used in combination with constraint-induced therapy, virtual reality therapy to potentiate the treatment effect. Up to now, there are no studies on the effect of a combined application of hydrotherapy and tDCS in children with CP. We will conduct a 2-arm parallel clinical trial to investigate the effect of a combined application of tDCS and hydrotherapy. Methods and analysis: This study is an outcome assessor and data analyst-blinded, randomized, controlled superiority trial during the period from October 2021 to December 2023. CP patients meeting the inclusion criteria will be allocated in a 1:1 ratio into the treatment group (hydrotherapy plus tDCS), or the control group (treatment as usual). All participants will receive 30 sessions of treatment over 10 weeks. The primary outcomes will be the difference in the Gross Motor Function Assessment and Pediatric Balance Scale during rest and activity. The secondary outcomes will be the difference in adverse effects between the control and treatment groups. Conclusions: This study aims to estimate the efficacy of a combined application of tDCS and hydrotherapy in patients with CP. Trial Registration: This study protocol was registered in Chinese ClinicalTrials.gov, ID: ChiCTR2100047946.

In bioarchaeology, cranial trauma studies generally have focused on the frequency in the population to explore violence within or between society. They focus less on further discussion of the consequences and interactions of the injured individual with the surrounding. In this study, macroscopic observation and computed tomography scans (endocast reconstruction) were used to explore a special cranium in the Sampula site of northwest China. The model of bioarchaeology of care (BoC) was used to further analyse the individual's disability experience, related health care and the broader social meaning of caring behaviour. The results showed that the individual numbered Sampula I M2:103 was an adult male who suffered severe antemortem cranial trauma that led to brain injury. Short‐term health care involving wound treatment and nutritional support, as well as long‐term assistance in social and rehabilitation, was available in the Sampula Iron Age society. Although there were limitations to the analysis, the individual's ability to survive in the Iron Age was a testament to those who cared for him, as well as the level of care and medicinal knowledge in this society. The BoC allowed for a more human‐centred approach to understanding the lives of those in the past, and its application can provide more insight into past societies, cultures, groups and individual identity.

In many scenarios, we need to find the most likely program that meets a specification under a local context, where the local context can be an incomplete program, a partial specification, natural language description, and so on. We call such a problem program estimation . In this article, we propose a framework, LingLong Synthesis Framework (L2S) , to address this problem. Compared with existing work, our work is novel in the following aspects. (1) We propose a theory of expansion rules to describe how to decompose a program into choices. (2) We propose an approach based on abstract interpretation to efficiently prune off the program sub-space that does not satisfy the specification. (3) We prove that the probability of a program is the product of the probabilities of choosing expansion rules, regardless of the choosing order. (4) We reduce the program estimation problem to a pathfinding problem, enabling existing pathfinding algorithms to solve this problem. L2S has been applied to program generation and program repair. In this article, we report our instantiation of this framework for synthesizing conditional expressions (L2S-Cond) and repairing conditional statements (L2S-Hanabi). The experiments on L2S-Cond show that each option enabled by L2S, including the expansion rules, the pruning technique, and the use of different pathfinding algorithms, plays a major role in the performance of the approach. The default configuration of L2S-Cond correctly predicts nearly 60% of the conditional expressions in the top 5 candidates. Moreover, we evaluate L2S-Hanabi on 272 bugs from two real-world Java defects benchmarks, namely Defects4J and Bugs.jar. L2S-Hanabi correctly fixes 32 bugs with a high precision of 84%. In terms of repairing conditional statement bugs, L2S-Hanabi significantly outperforms all existing approaches in both precision and recall.

Automated program repair is an emerging technology that seeks to automatically rectify program errors and vulnerabilities. Repair techniques are driven by a correctness criterion that is often in the form of a test suite. Such test-based repair may produce overfitting patches, where the patches produced fail on tests outside the test suite driving the repair. In this work, we present a repair method that fixes program vulnerabilities without the need for a voluminous test suite. Given a vulnerability as evidenced by an exploit, the technique extracts a constraint representing the vulnerability with the help of sanitizers. The extracted constraint serves as a proof obligation that our synthesized patch should satisfy. The proof obligation is met by propagating the extracted constraint to locations that are deemed to be “suitable” fix locations. An implementation of our approach (E xtract F ix ) on top of the KLEE symbolic execution engine shows its efficacy in fixing a wide range of vulnerabilities taken from the ManyBugs benchmark, real-world CVEs and Google’s OSS-Fuzz framework. We believe that our work presents a way forward for the overfitting problem in program repair by generalizing observable hazards/vulnerabilities (as constraint) from a single failing test or exploit.