Abdominal adipose tissue and type 2 diabetic kidney disease: adipose radiology assessment, impact, and mechanisms.

Diabetic kidney disease (DKD) is a significant healthcare burden worldwide that substantially increases the risk of kidney failure and cardiovascular events. To reduce the prevalence of DKD, extensive research is being conducted to determine the risk factors and consequently implement early interventions. Patients with type 2 diabetes mellitus (T2DM) are more likely to be obese. Abdominal adiposity is associated with a greater risk of kidney damage than general obesity. Abdominal adipose tissue can be divided into different fat depots according to the location and function, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), perirenal adipose tissue (PAT), and renal sinus adipose tissue (RSAT), which can be accurately measured by radiology techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI). Abdominal fat depots may affect the development of DKD through different mechanisms, and radiologic abdominal adipose characteristics may serve as imaging indicators of DKD risk. This review will first describe the CT/MRI-based assessment of abdominal adipose depots and subsequently describe the current studies on abdominal adipose tissue and DKD development, as well as the underlying mechanisms in patients of T2DM with DKD.

Magnetocardiography-based coronary artery disease severity assessment and localization using spatiotemporal features.

Objective.This study aimed to develop an automatic and accurate method for severity assessment and localization of coronary artery disease (CAD) based on an optically pumped magnetometer magnetocardiography (MCG) system.Approach.We proposed spatiotemporal features based on the MCG one-dimensional signals, including amplitude, correlation, local binary pattern, and shape features. To estimate the severity of CAD, we classified the stenosis as absence or mild, moderate, or severe cases and extracted a subset of features suitable for assessment. To localize CAD, we classified CAD groups according to the location of the stenosis, including the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA), and separately extracted a subset of features suitable for determining the three CAD locations.Main results.For CAD severity assessment, a support vector machine (SVM) achieved the best result, with an accuracy of 75.1%, precision of 73.9%, sensitivity of 67.0%, specificity of 88.8%, F1-score of 69.8%, and area under the curve of 0.876. The highest accuracy and corresponding model for determining locations LAD, LCX, and RCA were 94.3% for the SVM, 84.4% for a discriminant analysis model, and 84.9% for the discriminant analysis model.Significance. The developed method enables the implementation of an automated system for severity assessment and localization of CAD. The amplitude and correlation features were key factors for severity assessment and localization. The proposed machine learning method can provide clinicians with an automatic and accurate diagnostic tool for interpreting MCG data related to CAD, possibly promoting clinical acceptance.

Assessment of functional and structural brain abnormalities with resting-state functional MRI in patients with vestibular neuronitis.

BACKGROUND: Vestibular neuritis (VN) is a disorder manifesting as acute, isolated, spontaneous vertigo. There are few comprehensive studies on the changes in related functional and structural brain regions. PURPOSE: To evaluate alterations in spontaneous neural activity, functional connectivity (FC), and gray matter volume (GMV) in patients with VN. MATERIAL AND METHODS: A total of 24 patients with VN and 22 age- and sex-matched healthy controls underwent resting-state functional magnetic resonance imaging (rs-fMRI) and three-dimensional T1-weighted anatomical imaging. We calculated the amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo), and degree centrality (DC) to discern local brain abnormalities. The most abnormal brain region was selected as the region of interest (ROI) for FC analysis based on ALFF and ReHo values after Bonferroni correction. Voxel-based morphometry (VBM) was used to assess differences in GMV. RESULTS: Patients with VN, compared to healthy controls, showed increased ALFF (P < 0.001), ReHo values (P = 0.002, <0.001), and DC (P = 0.013) in the left lingual gyrus and right postcentral gyrus. FC analysis demonstrated enhanced connectivity between the left lingual gyrus and the left superior frontal gyrus, and decreased connectivity with the right insula gyrus, right and left supramarginal gyrus (P = 0.012, 0.004, <0.001, 0.014). In addition, GMV was reduced in the bilateral caudate (P = 0.022, 0.014). CONCLUSIONS: Patients with VN exhibit abnormal spontaneous neural activity and changes in ALFF, ReHo, DC, GMV, and FC. Understanding these functional and structural brain abnormalities may elucidate the underlying mechanisms of VN.

Revealing spatiotemporal travel demand and community structure characteristics with taxi trip data: A case study of New York City.

Urban traffic demand distribution is dynamic in both space and time. A thorough analysis of individuals' travel patterns can effectively reflect the dynamics of a city. This study aims to develop an analytical framework to explore the spatiotemporal traffic demand and the characteristics of the community structure shaped by travel, which is analyzed empirically in New York City. It uses spatial statistics and graph-based approaches to quantify travel behaviors and generate previously unobtainable insights. Specifically, people primarily travel for commuting on weekdays and entertainment on weekends. On weekdays, people tend to arrive in the financial and commercial areas in the morning, and the functions of zones arrived in the evening are more diversified. While on weekends, people are more likely to arrive at parks and department stores during the daytime and theaters at night. These hotspots show positive spatial autocorrelation at a significance level of p = 0.001. In addition, the travel flow at different peak times form relatively stable community structures, we find interesting phenomena through the complex network theory: 1) Every community has a very small number of taxi zones (TZs) with a large number of passengers, and the weighted degree of TZs in the community follows power-law distribution; 2) As the importance of TZs increases, their interaction intensity within the community gradually increases, or increases and then decreases. In other words, the formation of a community is determined by the key TZs with numerous traffic demands, but these TZs may have limited connection with the community in which they are located. The proposed analytical framework and results provide practical insights for urban and transportation planning.

Three-port approach vs standard laparoscopic radical cystectomy with an ileal conduit: a single-centre retrospective study.

BACKGROUND: This study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit. METHODS: Eighty-four patients, who were diagnosed with high-risk non-muscle-invasive and muscle-invasive bladder carcinoma and underwent LRC with an ileal conduit between January 2018 and April 2020, were retrospectively evaluated. Thirty and fifty-four patients respectively underwent the three-port approach and five-port LRC. Clinical characteristics, pathological data, perioperative outcomes, and follow-up data were analysed. RESULTS: There were no differences in perioperatively surgical outcome, including pathology type, prostate adenocarcinoma incidence, tumour staging, and postoperative creatinine levels between the two groups. The operative time (271.3 ± 24.03 vs. 279.57 ± 48.47 min, P = 0.299), estimated blood loss (65 vs. 90 mL, P = 0.352), time to passage of flatus (8 vs. 10 days, P = 0.084), and duration of hospitalisation post-surgery (11 vs. 12 days, P = 0.922) were no clear difference between both groups. Compared with the five-port group, the three-port LRC group was related to lower inpatient costs (12 453 vs. 14 134 $, P = 0.021). Our follow-up results indicated that the rate of postoperative complications, 90-day mortality, and the oncological outcome did not show meaningful differences between these two groups. CONCLUSIONS: Three-port LRC with an ileal conduit is technically safe and feasible for the treatment of bladder cancer. On comparing the three-port LRC with the five-port LRC, our technique does not increase the rate of short-term and long-term complications and tumour recurrence, but the treatment costs of the former were reduced.

Relative Computed Tomography (CT) Enhancement Value for the Assessment of Microvascular Architecture in Renal Cell Carcinoma.

BACKGROUND To investigate the correlation between the relative computed tomography (CT) enhancement value and the microvascular architecture in different pathologic subtypes of renal cell carcinoma (RCC). MATERIAL AND METHODS This retrospective study included 55 patients with pathologically confirmed RCC. Immunohistochemistry for CD34 was performed for all surgical specimens. Microvascular architecture parameters (density, area, diameter, and perimeter) for the microvessels and the microvessels with lumen were determined. The CT scan was performed during arterial phase or venous phase. The correlation of parameters on CT and tumor angiogenesis was investigated. RESULTS Density of microvessels showed a positive correlation with CT values of tumors, ratios of tumor to cortex, and differences of tumor and medulla, but no correlation with CT value ratio of tumor to aorta or tumor to medulla. CT parameters were positively correlated with microvascular parameters. However, no CT parameter differences between hypo-vascular clear cell RCC and papillary RCC was observed. Strikingly, the density and area of the microvessels were significantly higher in hypo-vascular clear cell RCC than that in papillary RCC, while the density of the microvessels with lumen in the cyst-present RCC was significantly higher than that in the cyst-absent RCC. The values (especially those of microvessels with lumen) of area density, diameter, and perimeter were higher in the capsule-absent RCC than in the capsule-present RCC. CONCLUSIONS The relative CT enhancement value of RCC was associated with vascular architecture parameters including density, area, and perimeter. Quantitative and semi-quantitative parameters on enhanced CT may shed some light on tumor vasculature and function as indicators of the biological behavior of RCC.