Hepatic Steatosis and Thyroid Function Tests in Overweight and Obese Children

Objectives. Associations between thyroid function and nonalcoholic fatty liver disease (NAFLD) are unknown in childhood. Thus, the aim of the present study was to investigate in 402 consecutive overweight/obese children the association between thyroid function tests and hepatic steatosis as well as metabolic variables. Methods. Hepatic steatosis was diagnosed by ultrasound after exclusion of infectious and metabolic disorders. Fasting serum samples were taken for determination of thyroid function (TSH, FT4, and FT3), along with alanine aminotransferase (ALT), lipid profile, glucose, insulin, and insulin resistance (IR). Results. Eighty-eight children (21.9%) had TSH above the normal range (>4.0 mIU/L). FT3 and FT4 were within the reference intervals in all subjects. Elevated TSH was associated with increased odds of having hepatic steatosis (OR 2.10 (95% CI, 1.22–3.60)), hepatic steatosis with elevated ALT (2.42 (95% CI, 1.29–4.51)), hypertriglyceridemia, elevated total cholesterol, and IR as well as metabolic syndrome (considered as a single clinical entity), after adjustment for age, gender, pubertal status, and body mass index-SD score (or waist circumference). Conclusions. In overweight/obese children, elevated TSH concentration is a significant predictor of hepatic steatosis and lipid and glucose dysmetabolism, independently of the degree of total and visceral obesity

Estimating a mean-path from a set of 2-d curves

To perform many common industrial robotic tasks, e.g. deburring a work-piece, in small and medium size companies where a model of the work-piece may not be available, building a geometrical model of how to perform the task from a data set of human demonstrations is highly demanded. In many cases, however, the human demonstrations may be sub-optimal and noisy solutions to the problem of performing a task. For example, an expert may not completely remove the burrs that result in deburring residuals on the work-piece. Hence, we present an iterative algorithm to estimate a noise-free geometrical model of a work-piece from a given dataset of profiles with deburring residuals. In a case study, we compare the profiles obtained with the proposed method, nonlinear principal component analysis and Gaussian mixture model/Gaussian mixture regression. The comparison illustrates the effectiveness of the proposed method, in terms of accuracy, to compute a noise-free profile model of a task

Hunt–Crossley model based force control for minimally invasive robotic surgery

International audienceIn Minimally Invasive Surgery (MIS) the continuously increasing use of robotic devices allows surgical operations to be conducted more precisely and more efficiently. Safe and accurate interaction between robot instruments and living tissue is an important issue for both successful operation and patient safety. Human tissue, which is generally viscoelastic, nonlinear and anisotropic, is often described as purely elastic for its simplicity in contact force control design and online computation. However, the elastic model cannot reproduce the complex properties of a real tissue. Based on in vitro animal tissue relaxation tests, we identify the Hunt-Crossley viscoelastic model as the most realistic one to describe the soft tissue's mechanical behavior among several candidate models. A force control method based on Hunt-Crossley model is developed following the state feedback design technique with a Kalman filter based active observer (AOB). Both simulation and experimental studies were carried out to verify the performance of developed force controller, comparing with other linear viscoelastic and elastic model based force controllers. The studies and comparisons show that the Hunt-Crossley model based force controller ensures comparable rise time in transient response as the controller based on Kelvin-Boltzmann model which is reported as the most accurate description for robot-tissue interaction in recent literature, but it causes much less overshoot and remains stable for tasks with faster response time requirements

Use of the Gore Tigris Vascular Stent in Advanced Femoropopliteal Peripheral Arterial Disease

Purpose: To prospectively evaluate the safety and efficacy of using the Tigris vascular stent (Gore, Flagstaff, Arizona) alone or in combination with the Viabahn stent (Gore) for revascularizing femoropopliteal Trans-Atlantic Intersociety Consensus (TASC) type B–D lesions with varying degrees of calcification. Materials and Methods: Patients with Rutherford stage ≥ 3 and TASC type ≥ B were included in the study. From January 2015 to April 2017, 31 segments in 31 patients (21 men, ovarall mean age 73.3 ± 9.2 years) were treated. The breakdown by TASC type and Rutherford stage were TASC B (n = 12), C (n = 6), and D (n = 13), and Rutherford 3 (n = 28) and 4 (n = 3). The lesions were located in the common femoral artery (n = 1), superficial femoral artery (SFA; n = 20), distal SFA to P1 (n = 3), popliteal P1 (n = 1), popliteal P1–3 (n = 3), popliteal P2–3 (n = 2), and 1 femoropopliteal bypass. There were 18 occlusions (58.1%) and 13 stenoses (41.9%). The mean diseased segment length was 15.5 ± 9.9 cm with 80.6% of moderate/severe calcification. The follow-up consisted of color Doppler ultrasound and clinical assessment at 1, 3, 6, 9, 12, and 15 months. Results: Technical success was 100%. There were no periprocedural or postprocedural complications. The mean stented lesion length was 17.2 ± 10.5 cm with a mean follow-up of 13.1 ± 6.9 months. Primary patency rates at 6, 9, 12, and 15 months were, respectively, 100% (24/31 patients), 90.5% (21/31 patients), 88.9% (20/31 patients), and 80% (15/31 patients). The median postprocedural Rutherford stage was 1. Three occlusions occurred at 7, 9, and 14 months, leading to a target lesion revascularization of 9.7% and a secondary patency of 100% at 15 months. Logistic analysis results demonstrated that lesion length (P =.003) was associated with reocclusion. Amputation-free survival at 15 months was 100%. Intrastent restenosis was observed in four cases (12.9%) but none were associated with worsening of symptoms. No stent fractures were observed. Conclusions: The Tigris stent used alone or in combination with a Viabahn stent for femoropopliteal TASC B–D lesions demonstrated acceptable 12-month primary patency with a low reintervention rate

Assessing cognitive impairment in SLE: examining relationships between resting glucose metabolism and anti-NMDAR antibodies with navigational performance.

Objective: Resting Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) brain imaging and neuropsychological testing were used to investigate the usefulness of a spatial navigation task (SNT) as a performance benchmark for cognitive impairment related to anti-N-methyl D-aspartate (anti-NMDA) receptor antibodies (DNRAb) in SLE. Methods: Neuropsychological assessments, including a desktop 3-D virtual SNT, were performed on 19 SLE participants and 9 healthy control (HC) subjects. SLE participants had stable disease activity and medication doses and no history of neuropsychiatric illness or current use of mind-altering medications. Resting FDG-PET scans were obtained on all SLE participants and compared with a historical set from 25 age-matched and sex-matched HCs. Serum DNRAb titres were measured by ELISA. Results: 11/19 (58%) of SLE participants failed to complete the SNT (SNT-) compared with 2/9 (22%) of HCs. Compared with 7/9 (78%) in HCs, only 2/9 (22%; p=0.037) of SLE participants with high serum DNRAb titres completed the SNT, in contrast to 6/10 (60%; p=0.810) in SLE participants with low DNRAb titres. Voxel-wise comparison of FDG-PET scans between the 8 SLE participants successfully completing the SNT task (SNT+) and the 11 SNT- SLE participants revealed increased metabolism in the SNT+ participants (p Conclusions: SNT performance is associated with serum DNRAb titres and resting glucose metabolism in the anterior putamen/caudate and frontal cortex, suggesting compensatory neural recruitment in SNT-associated regions is necessary for successful completion of the task. The SNT therefore has potential for use as a marker for SLE-mediated cognitive impairment

Mutant p53 induces Golgi tubulo-vesiculation driving a prometastatic secretome

TP53 missense mutations leading to the expression of mutant p53 oncoproteins are frequent driver events during tumorigenesis. p53 mutants promote tumor growth, metastasis and chemoresistance by affecting fundamental cellular pathways and functions. Here, we demonstrate that p53 mutants modify structure and function of the Golgi apparatus, culminating in the increased release of a pro-malignant secretome by tumor cells and primary fibroblasts from patients with Li-Fraumeni cancer predisposition syndrome. Mechanistically, interacting with the hypoxia responsive factor HIF1\u3b1, mutant p53 induces the expression of miR-30d, which in turn causes tubulo-vesiculation of the Golgi apparatus, leading to enhanced vesicular trafficking and secretion. The mut-p53/HIF1\u3b1/miR-30d axis potentiates the release of soluble factors and the deposition and remodeling of the ECM, affecting mechano-signaling and stromal cells activation within the tumor microenvironment, thereby enhancing tumor growth and metastatic colonization