3D Dynamic Motion Planning for Robot-Assisted Cannula Flexible Needle Insertion into Soft Tissue

In robot-assisted needle-based medical procedures, insertion motion planning is a crucial aspect. 3D dynamic motion planning for a cannula flexible needle is challenging with regard to the nonholonomic motion of the needle tip, the presence of anatomic obstacles or sensitive organs in the needle path, as well as uncertainties due to the dynamic environment caused by the movements and deformations of the organs. The kinematics of the cannula flexible needle is calculated in this paper. Based on a rapid and robust static motion planning algorithm, referred to as greedy heuristic and reachability-guided rapidly-exploring random trees, a 3D dynamic motion planner is developed by using replanning. Aiming at the large detour problem, the convergence problem and the accuracy problem that replanning encounters, three novel strategies are proposed and integrated into the conventional replanning algorithm. Comparisons are made between algorithms with and without the strategies to verify their validity. Simulations showed that the proposed algorithm can overcome the above-noted problems to realize real-time replanning in a 3D dynamic environment, which is appropriate for intraoperative planning. © 2016 Author

Free Triiodothyronine Levels Are Associated with Diabetic Nephropathy in Euthyroid Patients with Type 2 Diabetes

Objective. To investigate the association of thyroid function and diabetic nephropathy (DN) in euthyroid patients with type 2 diabetes. Methods. A total of 421 patients were included in this cross-sectional study. The following parameters were assessed: anthropometric measurements, fast plasma glucose, serum creatinine, lipid profile, HbA1c, free triiodothyronine (FT3), free thyroxine, thyroid-stimulating hormone levels, and urinary albumin-to-creatinine ratio (UACR). Patients with UACR of ≥30 mg/g were defined as those suffering from DN. Results. Of the 421 patients, 203 (48.2%) suffered from DN, and no difference was found between males and females. The patients with DN yielded significantly lower FT3 levels than those without DN (P<0.01). The prevalence of DN showed a significantly decreasing trend across the three tertiles based on FT3 levels (59.6%, 46.4%, and 38.6%, P<0.01). After adjustment for gender and age, FT3 levels were found to correlate positively with estimated glomerular filtration rate (P=0.03) and negatively with UACR (P<0.01). Multiple linear regression analysis showed that FT3 level was independently associated with UACR (β=-0.18, t=-3.70, and P<0.01). Conclusion. Serum FT3 levels are inversely associated with DN in euthyroid patients with type 2 diabetes, independent of traditional risk factors

Interrelation between the lipid accumulation product index and diabetic kidney disease in patients with type 2 diabetes mellitus

ObjectiveThe purpose of this study was to determine the relation between the lipid accumulation product index (LAPI) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).MethodsHerein, 931 patients were enrolled and their data were collected. Then the interrelation between LAPI and DKD was assessed using multivariate logistic regression analyses (LRAs) and by a restricted cubic spline (RCS).ResultsIn total, 931 participants (352 females and 579 males) aged 55 years on average were included in the study. After adjusting for several confounders, the odds ratio for DKD was increased evidently in the third LAPI tertile compared with that in the first LAPI tertile. In addition, the RCS revealed a positive interrelation between LAPI and DKD. In the subgroup analyses, age, sex, hyperlipidemia, hypertension, and HbA1c did not significantly interact with LAPI.ConclusionsLAPI was higher in the DKD group than in the no-DKD group, and LAPI is positively linked with DKD, which may have potential value to diagnose DKD in clinical practice

Serum spexin differed in newly diagnosed type 2 diabetes patients according to body mass index and increased with the improvement of metabolic status

ObjectiveThe aim of this study was to explore serum spexin levels in newly diagnosed type 2 diabetes mellitus (T2DM) patients with different body mass indexes (BMIs) and to investigate the changes of spexin after improvement of metabolic indicators.MethodsA total of 323 newly diagnosed T2DM patients from national Metabolic Management Center (MMC) in Shanghai General Hospital were recruited. T2DM patients were categorized into three groups: diabetes with obesity group (DM-OB group, BMI≥28 kg/m2, n=89), diabetes with overweight group (DM-OV group, 24≤BMI&lt;28 kg/m2, n=161), and diabetes with normal weight group (DM-NW group, 18≤BMI&lt;24 kg/m2, n=73). In addition, 41 volunteers with normal glucose tolerance (NGT) were used as controls. Spexin and metabolic parameters were compared at baseline, and changes after MMC follow-up in 100 DM patients were investigated.ResultsIn the DM-OB group, the level of spexin was significantly lower than that in the DM-OV group and the DM-NW group (P &lt; 0.01). Spexin was significantly negatively related to body mass index (BMI, β=-0.214, P&lt;0.001), waist circumference (β=-0.249, P&lt;0.001), visceral fat area (VFA, β=-0.214, P&lt;0.001), and subcutaneous fat area (SFA, β=-0.265, P&lt;0.001) after adjustment for age and sex. Among all the metabolic indicators, the decline in BMI in the DM-OB group was the most obvious among those in the three groups (-3.7 ± 0.8 kg/m2 vs. -0.9 ± 0.3 kg/m2 vs. 0.7 ± 0.6 kg/m2, P&lt;0.01) after one year of MMC standardized management. The serum spexin level in the DM-OB group increased the most (1.00 ± 0.10 ng/mL vs. 0.49 ± 0.06 ng/mL in DM-OV group and 0.58 ± 0.09 ng/mL in DM-NW group, P &lt; 0.001).ConclusionsSerum spexin differed in newly diagnosed T2DM patients according to BMI and was lowest in the DM-OB group. With the improvement of metabolic indicators, especially the decline in BMI, serum spexin increased significantly after MMC management

Detection and attribution of hydrological changes in different climatic and geomorphic regions of China

Through large-scale hydrological simulation, understanding the impact of different climatic and geomorphic conditions on hydrological variables is valuable for water and land management. However, the related study is still a challenge due to strong environmental diversity in large scale region. The physically-based, national-scale hydrological model in China was developed and validated, which considered the spatial heterogeneity of climatic and geomorphic conditions. Using the model, hydrological differences during the period 1956–2020 in 21 representative basins located in nine climatic zones and four geomorphic regions were quantified. Results showed that: 1) mean annual precipitation was strongly positively correlated with mean actual evapotranspiration, and both increased gradually from north to south. Interestingly, as annual precipitation increases, precipitation tended to be more evenly distributed. In recent decades, the northern river basins have been warming and drying, while the Heihe River basin and the cold northeast regions were under climatic warming and wetting; 2) the spatial distribution of streamflow was consistent with precipitation, but their trends were different. In cold regions affected by frozen soil, the streamflow tended to increase. On the contrary, the basins located in the Warm Temperate Zone with intense human activities and fragile ecosystem had a significant decrease in natural streamflow. As for the streamflow components, the frozen soil and karst structures contributed to the increase of the baseflow index (BFI); 3) The streamflow increase or reduction in 86% of the basins was dominated by climate change, as the contribution rate varied from 51.4% to 95.7%. Affected by the Grain to Green Programme, the streamflow of the Weihe River basin reduced significantly while the BFI increased. However, the reduction of forest, grassland and wetland areas dominated streamflow increase in the Huaihe, and Hulan River basins, and the rates were 65.3% and 66.1%, respectively

Novel Role of NOX in Supporting Aerobic Glycolysis in Cancer Cells with Mitochondrial Dysfunction and as a Potential Target for Cancer Therapy

NAD(P)H oxidase plays a role in cancer metabolism by providing NAD+ to support increased glycolysis

Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimising Cardiovascular Outcomes in Patients with Type 2 Diabetes

The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium–glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease