Magnetic resonance imaging enables the noninvasive mapping of both anatomical white matter connectivity and dynamic patterns of neural activity in the human brain. We examine the relationship between the structural properties of white matter streamlines (structural connectivity) and the functional properties of correlations in neural activity (functional connectivity) within 84 healthy human subjects both at rest and during the performance of attention-and memory-demanding tasks. We show that structural properties, including the length, number, and spatial location of white matter streamlines, are indicative of and can be inferred from the strength of resting-state and task-based functional correlations between brain regions. These results, which are both representative of the entire set of subjects and consistently observed within individual subjects, uncover robust links between structural and functional connectivity in the human brain.uman cognitive function is supported by large-scale interactions between different regions of the brain. The anatomical scaffolding that mediates these interactions can be described by a structural connectome that maps the spatial layout of white matter (1). Structural connectivity (SC), defined by the physical properties of these direct anatomical connections, supports the relay of electrical signals between brain regions. Neurophysiological events can similarly be described by a functional connectome that maps coordinated changes in neuronal activity, field potentials, blood flow, or energy consumption (2). Functional connectivity (FC), defined by temporal correlations in such neurophysiological events, reflects the resting-state and task-dependent strengths of correlated activity in different brain regions (3-5). The estimation of structural and functional connectivity from different experimental techniques raises two complementary questions about the quantitative relationships between structural and functional connectomes: (i) to what extent can the resting-state and task-dependent strengths of functional correlations between brain regions be inferred from structural connectomes, and (ii) to what extent can the physical properties of anatomical connections be inferred from functional connectomes?Connectomes, whether examined at the neural or systems level, are networks whose structural properties, such as the length and number of connections, can differentially impact functional properties, such as local or global correlations in temporal dynamics. Whereas the length and density of anatomical connections are thought to impact functional processes such as information segregation and integration (6, 7), the extent to which such relationships are robustly observed in the human brain is not well understood. Previous studies have been limited in scope to specific anatomical connections and brain regions, small sample sizes, and resting-state neural activity (8-13) and have consequently left several fundamental questions unanswered. How do variations in structural features, such a...

Brain structural abnormalities and neurocognitive dysfunction have been observed in individuals with fetal alcohol spectrum disorders (FASDs). Little is known about how white matter integrity is related to these functional and morphological deficits. We used a combination of diffusion tensor and T1-weighted magnetic resonance imaging to evaluate white matter integrity in individuals with FASDs and related these findings to neurocognitive deficits. Seventeen children and adolescents with FASDs were compared with 19 typically developing age-and gender-matched controls. Lower fractional anisotropy (FA) was observed in individuals with FASDs relative to controls in the right lateral temporal lobe and bilaterally in the lateral aspects of the splenium of the corpus callosum. White matter density was also lower in some, but not all regions in which FA was lower. FA abnormalities were confirmed to be in areas of white matter in post hoc region of interest analyses, further supporting that less myelin or disorganized fiber tracts are associated with heavy prenatal alcohol exposure. Significant correlations between performance on a test of visuomotor integration and FA in bilateral splenium, but not temporal regions were observed within the FASD group. Correlations between the visuomotor task and FA within the splenium were not significant within the control group, and were not significant for measures of reading ability. This suggests that this region of white matter is particularly susceptible to damage from prenatal alcohol exposure and that disruption of splenial fibers in this group is associated with poorer visuomotor integration.

BACKGROUND:The COVID-19 pandemic resulted in a statewide stay-at-home (SAH) order in California beginning March 19, 2020, forcing large-scale behavioral changes and taking an emotional and economic toll. The effects of SAH orders on the trauma population remain unknown. We hypothesized an increase in rates of penetrating trauma, gunshot wounds, suicide attempts, and domestic violence in the Southern California trauma population after the SAH order. METHODS:A multicenter retrospective analysis of all trauma patients presenting to 11 American College of Surgeons levels I and II trauma centers spanning seven counties in California was performed. Demographic data, injury characteristics, clinical data, and outcomes were collected. Patients were divided into three groups based on injury date: before SAH from

An ability to flexibly shift a decision criterion can be advantageous. For example, a known change in the base rate of targets and distractors on a recognition memory test will lead optimal decision makers to shift their criterion accordingly. In the present study, 95 individuals participated in two recognition memory tests that included periodic changes in the base rate probability that the test stimulus had been presented during the study session. The results reveal a wide variability in the tendency to shift decision criterion in response to this probability information, with some appropriately shifting and others not shifting at all. However, participants were highly reliable in their tendency to shift criterion across tests. The goal of the present study was to explain what factors account for these individual differences. To accomplish this, over 50 variables were assessed for each individual (e.g., personality, cognitive style, state of mind). Using a regression model that incorporated different sets of factors, over 50% of the variance was accounted for. The results of the analysis describe the total, direct, and mediating effects on criterion shifting from factors that include memory strength, strategy, and inherent characteristics such as a fun-seeking personality, a negative affect, and military rank. The results are discussed with respect to understanding why participants rarely chose an optimal decision-making strategy and provide greater insight into the underlying mechanisms of recognition memory.

The anatomical connectivity of the human brain supports diverse patterns of correlated neural activity that are thought to underlie cognitive function. In a manner sensitive to underlying structural brain architecture, we examine the extent to which such patterns of correlated activity systematically vary across cognitive states. Anatomical white matter connectivity is compared with functional correlations in neural activity measured via blood oxygen level dependent (BOLD) signals. Functional connectivity is separately measured at rest, during an attention task, and during a memory task. We assess these structural and functional measures within previously-identified resting-state functional networks, denoted task-positive and task-negative networks, that have been independently shown to be strongly anticorrelated at rest but also involve regions of the brain that routinely increase and decrease in activity during task-driven processes. We find that the density of anatomical connections within and between task-positive and task-negative networks is differentially related to strong, task-dependent correlations in neural activity. The space mapped out by the observed structure-function relationships is used to define a quantitative measure of separation between resting, attention, and memory states. We find that the degree of separation between states is related to both general measures of behavioral performance and relative differences in task-specific measures of attention versus memory performance. These findings suggest that the observed separation between cognitive states reflects underlying organizational principles of human brain structure and function.

100 thumbs with primary osteoarthrosis of the joints of the trapezium were treated by trapeziectomy and a FCR sling arthroplasty to reconstruct a first intermetacarpal ligament by the method described by Burton and Pellegrini (1986). Pain at rest remained in five. Some pain at or after exertion persisted in 46, and 49 became completely pain-free. 88 were satisfied with the procedure and there was a significant increase in pinch strength and in the ability to perform activities of daily life. It has become our preferred procedure for treating osteoarthrosis of the basal joint of the thumb.

Purpose The COVID-19 pandemic resulted in increased penetrating trauma and decreased length of stay (LOS) amongst the adult trauma population, findings important for resource allocation. Studies regarding the pediatric trauma population are sparse and mostly single-center. This multicenter study examined pediatric trauma patients, hypothesizing increased penetrating trauma and decreased LOS after the 3/19/2020 stay-at-home (SAH) orders. Methods A multicenter retrospective analysis of trauma patients ≤ 17 years old presenting to 11 centers in California was performed. Demographic data, injury characteristics, and outcomes were collected. Patients were divided into three groups based on injury date: 3/19/2019–6/30/2019 (CONTROL), 1/1/2020–3/18/2020 (PRE), 3/19/2020–6/30/2020 (POST). POST was compared to PRE and CONTROL in separate analyses. Results 1677 patients were identified across all time periods (CONTROL: 631, PRE: 479, POST: 567). POST penetrating trauma rates were not significantly different compared to both PRE (11.3 vs. 9.0%, p = 0.219) and CONTROL (11.3 vs. 8.2%, p = 0.075), respectively. POST had a shorter mean LOS compared to PRE (2.4 vs. 3.3 days, p = 0.002) and CONTROL (2.4 vs. 3.4 days, p = 0.002). POST was also not significantly different than either group regarding intensive care unit (ICU) LOS, ventilator days, and mortality (all p > 0.05). Conclusions This multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS.

Purpose There is mounting evidence that surgical patients with COVID-19 have higher morbidity and mortality than patients without COVID-19. Infection is prevalent amongst the trauma population, but any effect of COVID-19 on trauma patients is unknown. We aimed to evaluate the effect of COVID-19 on a trauma population, hypothesizing increased mortality and pulmonary complications for COVID-19-positive (COVID) trauma patients compared to propensity-matched COVID-19-negative (non-COVID) patients. Methods A retrospective analysis of trauma patients presenting to 11 Level-I and II trauma centers in California between 1/1/2019–6/30/2019 and 1/1/2020–6/30/2020 was performed. A 1:2 propensity score model was used to match COVID to non-COVID trauma patients using age, blunt/penetrating mechanism, injury severity score, Glasgow Coma Scale score, systolic blood pressure, respiratory rate, and heart rate. Outcomes were compared between the two groups. Results A total of 20,448 trauma patients were identified during the study period. 53 COVID trauma patients were matched with 106 non-COVID trauma patients. COVID patients had higher rates of mortality (9.4% vs 1.9%, p = 0.029) and pneumonia (7.5% vs. 0.0%, p = 0.011), as well as a longer mean length of stay (LOS) (7.47 vs 3.28 days, p < 0.001) and intensive care unit LOS (1.40 vs 0.80 days, p = 0.008), compared to non-COVID patients. Conclusion This multicenter retrospective study found increased rates of mortality and pneumonia, as well as a longer LOS, for COVID trauma patients compared to a propensity-matched cohort of non-COVID patients. Further studies are warranted to validate these findings and to elucidate the underlying pathways responsible for higher mortality in COVID trauma patients.