CT Quantitation and Prediction of the Risk of Type 2 Diabetes Mellitus in Non-Obese Patients with Pancreatic Fatty Infiltration.

Purpose: To examine the risk of type 2 diabetes mellitus in non-obese patients with pancreatic fatty infiltration through abdominal computed tomography (CT) quantitation. Patients and Methods: We carried out a retrospective analysis of abdominal CT and inpatient medical records of 238 inpatients from July 2019 to April 2021. The patients were divided into a normal non-obese group (BMI < 25, n = 135) and diabetic non-obese group (BMI < 25, n = 103). Abdominal CT-related parameters included body width; mean CT values of the pancreas, liver, and spleen; difference between pancreas and spleen CT values (P-S); pancreas-to-spleen attenuation ratio (P/S); and liver-to-spleen attenuation ratio (L/S). Logistic regression was used to estimate the risk factors for comorbid diabetes in a non-obese population. Results: The P-values of the pancreas CT value, P-S, P/S, body width, and L/S were all <0.05 and correlated to comorbid diabetes in non-obese patients. Worsening pancreatic fatty infiltration increased the risk of developing diabetes. Using a P/S of 1.0 as reference, every successive decrease in this ratio by 0.1 increases patient risk by 3.981, 4.452, 6.037, and 12.937 times. Conclusion: The risk of developing type 2 diabetes mellitus in non-obese patients increases with the degree of pancreatic fatty infiltration as assessed by CT.

Octopus-inspired sensorized soft arm for environmental interaction.

Octopuses can whip their soft arms with a characteristic "bend propagation" motion to capture prey with sensitive suckers. This relatively simple strategy provides models for robotic grasping, controllable with a small number of inputs, and a highly deformable arm with sensing capabilities. Here, we implemented an electronics-integrated soft octopus arm (E-SOAM) capable of reaching, sensing, grasping, and interacting in a large domain. On the basis of the biological bend propagation of octopuses, E-SOAM uses a bending-elongation propagation model to move, reach, and grasp in a simple but efficient way. E-SOAM's distal part plays the role of a gripper and can process bending, suction, and temperature sensory information under highly deformed working states by integrating a stretchable, liquid-metal-based electronic circuit that can withstand uniaxial stretching of 710% and biaxial stretching of 270% to autonomously perform tasks in a confined environment. By combining this sensorized distal part with a soft arm, the E-SOAM can perform a reaching-grasping-withdrawing motion across a range up to 1.5 times its original arm length, similar to the biological counterpart. Through a wearable finger glove that produces suction sensations, a human can use just one finger to remotely and interactively control the robot's in-plane and out-of-plane reaching and grasping both in air and underwater. E-SOAM's results not only contribute to our understanding of the function of the motion of an octopus arm but also provide design insights into creating stretchable electronics-integrated bioinspired autonomous systems that can interact with humans and their environments.

An automatic fresh rib fracture detection and positioning system using deep learning.

OBJECTIVE: To evaluate the performance and robustness of a deep learning-based automatic fresh rib fracture detection and positioning system (FRF-DPS). METHODS: CT scans of 18,172 participants admitted to eight hospitals from June 2009 to March 2019 were retrospectively collected. Patients were divided into development set (14,241), multicenter internal test set (1612), and external test set (2319). In internal test set, sensitivity, false positives (FPs) and specificity were used to assess fresh rib fracture detection performance at the lesion- and examination-levels. In external test set, the performance of detecting fresh rib fractures by radiologist and FRF-DPS were evaluated at lesion, rib, and examination levels. Additionally, the accuracy of FRF-DPS in rib positioning was investigated by the ground-truth labeling. RESULTS: In multicenter internal test set, FRF-DPS showed excellent performance at the lesion- (sensitivity: 0.933 [95%CI, 0.916-0.949], FPs: 0.50 [95%CI, 0.397-0.583]) and examination-level. In external test set, the sensitivity and FPs at the lesion-level of FRF-DPS (0.909 [95%CI, 0.883-0.926], p < 0.001; 0.379 [95%CI, 0.303-0.422], p = 0.001) were better than the radiologist (0.789 [95%CI, 0.766-0.807]; 0.496 [95%CI, 0.383-0.571]), so were the rib- and patient-levels. In subgroup analysis of CT parameters, FRF-DPS were robust (0.894-0.927). Finally, FRF-DPS(0.997 [95%CI, 0.992-1.000], p < 0.001) is more accurate than radiologist (0.981 [95%CI, 0.969-0.996]) in rib positioning and takes 20 times less time. CONCLUSION: FRF-DPS achieved high detection rate of fresh rib fractures with low FP values, and precise positioning of ribs, thus can be used in clinical practice to improve the detection rate and work efficiency. ADVANCES IN KNOWLEDGE: We developed the FRF-DPS system which can detect fresh rib fractures and rib position, and evaluated by a large amount of multicenter data.

Osteogenic Differentiation Capacity of In Vitro Cultured Human Skeletal Muscle for Expedited Bone Tissue Engineering.

Expedited bone tissue engineering employs the biological stimuli to harness the intrinsic regenerative potential of skeletal muscle to trigger the reparative process in situ to improve or replace biological functions. When genetically modified with adenovirus mediated BMP2 gene transfer, muscle biopsies from animals have demonstrated success in regenerating bone within rat bony defects. However, it is uncertain whether the human adult skeletal muscle displays an osteogenic potential in vitro when a suitable biological trigger is applied. In present study, human skeletal muscle cultured in a standard osteogenic medium supplemented with dexamethasone demonstrated significant increase in alkaline phosphatase activity approximately 24-fold over control at 2-week time point. More interestingly, measurement of mRNA levels revealed the dramatic results for osteoblast transcripts of alkaline phosphatase, bone sialoproteins, transcription factor CBFA1, collagen type I, and osteocalcin. Calcified mineral deposits were demonstrated on superficial layers of muscle discs after an extended 8-week osteogenic induction. Taken together, these are the first data supporting human skeletal muscle tissue as a promising potential target for expedited bone regeneration, which of the technologies is a valuable method for tissue repair, being not only effective but also inexpensive and clinically expeditious.

Different preoperative approaches for acute lumber spinal fractures.

To compare the long and short term effectiveness of different preoperative approaches for lumber spinal fractures and finds a better surgical method for the disease. Follow up records of 144 patients received hyperbaric oxygen therapy or methylprednisolone infusion within 8 hours after the lubmer spinal injury were analyzed. Postoperative outcome immediately and 3, 6, 12, 36 months after the surgery were compared to evaluate the effectiveness two different approaches. The results indicated that there are no significant differences regarding age, sexual proportion, body mass index (BMI), visual analogue scale of pain (VAS) score as well as Frankel scores before the surgery, and significant differences VAS score as well as Frankel scores immediately after the surgery. In conclusion, hyperbaric oxygen therapy within 8 hours after the injury can be more effective than methylprednisolone infusion in patients with lumber spinal injury.

[Effects of uvulopalatopharyngoplasty surgery on subsequent continuous positive airway pressure in patients with obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: To determine the effect of uvulopalatopharyngoplasty (UPPP) therapy on post-surgery continuous positive airway pressure (CPAP) treatment during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to evaluate the use of Bi-level positive airway pressure (BiPAP) in whom CPAP therapy failed. METHODS: Thirty-four OSAHS patients after UPPP surgery were tested more than 3 months after the procedure. Among them 25 patients were treated with classical UPPP (cUPPP), in which all of the uvula and part of the soft palate were removed. Nine underwent modified UPPP (mUPPP), keeping part of the uvula. The control group consisted of 34 age, body mass index (BMI) and apnea hypopnea index (AHI) matched, newly diagnosed OSAHS patients without prior treatment. Four patients receiving both pre- and post-surgery tests were included in both groups. A manual titration of CPAP to determine the optimal CPAP pressure (oCPAP) and the highest CPAP pressure (hCPAP) the patient can tolerate was performed during both NREM and REM sleep in all 68 patients. RESULTS: 72% of the UPPP patients had less than 50% decrease in AHI, and 82% of the 34 patients still had AHI > 15 during post-operation PSG test. Hence, most of them needed further therapy. All of the untreated OSAHS patients could tolerate 17-20 cm H2O of CPAP during NREM and REM sleep. None had severe mouth air leak before an oCPAP was reached. In contrast, five in the surgery group failed to respond to CPAP treatment during both NREM and REM sleep, and one more during REM sleep. All of the nine patients who had a mUPPP could tolerate CPAP. One of the four tested both before and after surgery failed to respond to CPAP treatment after surgery during REM sleep and one during both NREM and REM sleep. However, the six patients failed to respond to CPAP treatment tolerated BiPAP therapy well. CONCLUSIONS: In a considerable number of patients with OSAHS, UPPP may compromise the applicability of nasal CPAP as a subsequent therapy, and BiPAP might be a treatment option for patients who could not tolerate CPAP treatment.