Using analytic morphomics to describe body composition associated with post‐kidney transplantation diabetes mellitus

BackgroundBetter risk assessment tools are needed to predict post‐transplantation diabetes mellitus (PTDM). Using analytic morphomic measurements from computed tomography (CT) scans, we aimed to identify specific measures of body composition associated with PTDM.MethodsWe retrospectively reviewed 99 non‐diabetic kidney transplant recipients who received pre‐transplant CT scans at a single institution between 1/2005 and 5/2014. Analytic morphomic techniques were used to measure abdominal adiposity, abdominal size, and psoas muscle area and density, standardized by gender. We measured the associations of these morphomic factors with PTDM.ResultsOne‐year incidence of PTDM was 18%. The morphomic factors significantly associated with PTDM included visceral fat area (OR=1.84 per standard deviation increase, P=.020), body depth (OR=1.79, P=.035), and total body area (OR=1.67, P=.049). Clinical factors significantly associated with PTDM included African American race (OR=3.01, P=.044), hypertension (OR=2.97, P=.041), and dialysis vintage (OR=1.24 per year on dialysis, P=.048). Body mass index was not associated with PTDM (OR=1.05, P=.188). On multivariate modeling, visceral fat area was an independent predictor of PTDM (OR=1.91, P=.035).ConclusionsAnalytic morphomics can identify pre‐transplant measurements of body composition that are predictive of PTDM in kidney transplant recipients. Pre‐transplant imaging contains a wealth of underutilized data that may inform PTDM prevention strategies.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138207/1/ctr13040.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138207/2/ctr13040_am.pd

Imaging Inter-Edge State Scattering Centers in the Quantum Hall Regime

We use an atomic force microscope tip as a local gate to study the scattering between edge channels in a 2D electron gas in the quantum Hall regime. The scattering is dominated by individual, microscopic scattering centers, which we directly image here for the first time. The tip voltage dependence of the scattering indicates that tunneling occurs through weak links and localized states.Comment: 4 pages, 5 figure

The impact of intraoperative fluid management during laparoscopic donor nephrectomy on donor and recipient outcomes

BackgroundIntraoperative fluid management during laparoscopic donor nephrectomy (LDN) may have a significant effect on donor and recipient outcomes. We sought to quantify variability in fluid management and investigate its impact on donor and recipient outcomes.MethodsA retrospective review of patients who underwent LDN from July 2011 to January 2016 with paired kidney recipients at a single center was performed. Patients were divided into tertiles of intraoperative fluid management (standard, high, and aggressive). Donor and recipient demographics, intraoperative data, and postoperative outcomes were analyzed.ResultsOverall, 413 paired kidney donors and recipients were identified. Intraoperative fluid management (mL/h) was highly variable with no correlation to donor weight (kg) (R = 0.017). The aggressive fluid management group had significantly lower recipient creatinine levels on postoperative day 1. However, no significant differences were noted in creatinine levels out to 6 months between groups. No significant differences were noted in recipient postoperative complications, graft loss, and death. There was a significant increase (P < 0.01) in the number of total donor complications in the aggressive fluid management group.ConclusionsAggressive fluid management during LDN does not improve recipient outcomes and may worsen donor outcomes compared to standard fluid management.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149691/1/ctr13542_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149691/2/ctr13542.pd

Scanned Potential Microscopy of Edge and Bulk Currents in the Quantum Hall Regime

Using an atomic force microscope as a local voltmeter, we measure the Hall voltage profile in a 2D electron gas in the quantum Hall (QH) regime. We observe a linear profile in the bulk of the sample in the transition regions between QH plateaus and a distinctly nonlinear profile on the plateaus. In addition, localized voltage drops are observed at the sample edges in the transition regions. We interpret these results in terms of theories of edge and bulk currents in the QH regime.Comment: 4 pages, 5 figure

Combining biomarkers for prognostic modelling of Parkinson's disease

BACKGROUND: Patients with Parkinson's disease (PD) have variable rates of progression. More accurate prediction of progression could improve selection for clinical trials. Although some variance in clinical progression can be predicted by age at onset and phenotype, we hypothesise that this can be further improved by blood biomarkers. OBJECTIVE: To determine if blood biomarkers (serum neurofilament light (NfL) and genetic status (glucocerebrosidase, GBA and apolipoprotein E (APOE))) are useful in addition to clinical measures for prognostic modelling in PD. METHODS: We evaluated the relationship between serum NfL and baseline and longitudinal clinical measures as well as patients' genetic (GBA and APOE) status. We classified patients as having a favourable or an unfavourable outcome based on a previously validated model, and explored how blood biomarkers compared with clinical variables in distinguishing prognostic phenotypes . RESULTS: 291 patients were assessed in this study. Baseline serum NfL was associated with baseline cognitive status. Nfl predicted a shorter time to dementia, postural instability and death (dementia-HR 2.64; postural instability-HR 1.32; mortality-HR 1.89) whereas APOEe4 status was associated with progression to dementia (dementia-HR 3.12, 95% CI 1.63 to 6.00). NfL levels and genetic variables predicted unfavourable progression to a similar extent as clinical predictors. The combination of clinical, NfL and genetic data produced a stronger prediction of unfavourable outcomes compared with age and gender (area under the curve: 0.74-age/gender vs 0.84-ALL p=0.0103). CONCLUSIONS: Clinical trials of disease-modifying therapies might usefully stratify patients using clinical, genetic and NfL status at the time of recruitment