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Purpose: Despite its clinical benefits, intraoperative navigation is currently used only in approximately 20% of total hip arthroplasties (THA) partly due to the high cost of the systems and time-consuming preoperative preparation. By providing a simpler and less expensive alternative, the use of intraoperative navigation is likely to increase among surgeons. In this study, we sought to validate the accuracy and utility of Fluoro HIP, a newly developed cup angle measurement software that runs on iOS devices. Methods: Twenty-seven patients who underwent primary total hip arthroplasty between June and September 2022 were included in the study. All patients underwent surgery in the supine position. Inclination and anteversion angles were determined using Fluoro HIP software based on the fluoroscopic images captured during surgery. Navigation errors were calculated by comparing with the values obtained from postoperative CT images. Results: The inclination and anteversion angles measured were 38.7 ​± ​3.9 and 15.0 ​± ​3.1°, respectively. The absolute value errors were 2.7 ​± ​1.9 and 3.0 ​± ​2.1° for the inclination and anteversion, respectively. Although Fluoro HIP software-based system may not be as precise as the conventional CT-based or portable navigation systems, the intraoperative evaluation of the cup angles by this system was considered to have acceptable accuracy and reproducibility for most THA cases performed in the supine position. Most importantly, our system requires no preoperative preparation and is significantly less expensive than other types of navigation systems currently in use. Conclusion: The Fluoro HIP software-based system is a highly cost-effective and affordable alternative to the conventional navigation systems.

A citric acid was added to the electrolyte as an capping agent to effectively enhance the reflectance of the Ag deposition-based electrochromic (EC) cells. The electrochemical properties of EC electrolytes containing different concentrations of citric acid were compared and the surface morphology of Ag deposited in these electrolytes were also analyzed. The redox potential of Ag+/Ag was not changed in the presence of citric acid, but the rate of consumption of Ag+ in the deposition was significantly affected by the citric acid especially in case of high concentration. As adding citric acid, the increasing of reflectance of Ag deposits in total wavelength region is increased, typical at the [Silver nitrate] : [Citric acid] is 1 : 2, the reflectance in the wavelength range (400–580 nm) is increased more, it is leading to specular mirror appearance. The mechanism for enhancement of the reflectance was discussed in terms of surface morphology of the Ag deposits and deposition behavior of the Ag nanoparticle.

Background/Purpose: Differential diagnosis of isolated immunoglobin (Ig)G4-related sclerosing cholangitis (IgG4-SC) and cholangiocarcinoma is challenging. We aimed to clarify the role of endoscopic retrograde cholangiography (ERCP)-related procedures in the differential diagnosis of isolated IgG4-SC and perihilar cholangiocarcinoma (PHCC). Methods: Seven patients with hilar-type isolated IgG4-SC diagnosed at Hiroshima University Hospital and sixty-five patients with surgically resected invasive PHCC were enrolled, and the diagnostic yields of intraductal ultrasonography (IDUS), peroral cholangioscopy (POCS), and pathological examinations were determined. Results: In six of seven (86%) patients with isolated IgG4-SC, the stricture was in the perihilar bile duct. IDUS showed that symmetrical wall thickening (40% vs. 5%, p = 0.04), homogeneous internal echo (80% vs. 5%, p < 0.001), and smooth outer margins (80% vs. 6%, p < 0.001) were more frequent in isolated IgG4-SC than in PHCC. POCS showed a smooth mucosal surface more frequent in isolated IgG4-SC (75% vs. 7%, p = 0.006). Only one patient had two pathological findings characteristic of IgG4-SC. The sensitivity for diagnosing PHCC was 81% using two or more combined sampling methods. Conclusions: Pathological examinations have limitations in the differential diagnosis of isolated-IgG4-SC and PHCC, and a diagnostic strategy that combines multiple ERCP-related procedures, including IDUS and POCS, is recommended.

ABSTRACT: Solid particle number emissions have been regulated in a wide range of automotive fields. Its technical regulations require annual calibration of a particle number counting system because a standard like span gas with a known particle number concentration does not exist. However, the calibration does not fully ensure the validity of the measurements during the annual usage interval. This paper proposes a methodology of on-site checks of the particle number counting system with a particle generator so that its measurement values can be validated during the interval of the calibration.

We have shown that the flow velocity of Shirase Glacier can be estimated by applying the offset tracking method to the amplitude images derived from the phased array type L-band synthetic aperture radar type-2 (PALSAR-2) onboard the Advanced Land Observing Satellite-2. Although the offset tracking is widely used, the method is sometimes not applicable effectively and the reason is not always clear. Here, we consider a possibility of ionospheric contamination and show the validation results of the estimated flow velocity applied the offset tracking method to the PALSAR-2 data, based on in-situ measurement of the flow velocity from the GNSS receiver on the autonomous phase-sensitive radio echo sounder simultaneously with the PALSAR-2 observation. As a result, the ionospheric contamination can yield a spurious error of ±0.2 km a−1. After statistically removing the erroneous pairs, the RMSE was 0.049 km a−1 derived from the flow velocity error between the in-situ measurement results and estimated from satellite, and the estimated flow velocity obtained using PALSAR-2 data is proved to be in good agreement with the ground truth. Obtained spatial and temporal variations reveal signature of glacier dynamics, which prove the efficacy of the offset tracking method. The obtained ice-flow velocity increases rapidly from the upstream region to the coast, but its velocity is roughly constant over a region, 10-km long about the grounding line (GL), then gradually tends to increase again downstream from the GL. This trend has continued largely unchanged over24 years since 1996.

In order to investigate the difference of SPN emission from G-DI vehicles, which is caused by sampling locations, ninety-six tests were conducted at three vehicle benches with each two particle counters; the one was deployed at a CVS tunnel in compliance with UNECE Regulation 83 whereas the other was equipped at tailpipe with a pitot-type exhaust flow meter considered as a practice for RDE frontloading developments. As a result, the differences of all tests were within ± 30 %. This was attributed to internal particle processes as well as misalignment of signals between particle number concentration and exhaust flow rate.

The Shirase Glacier, one of the fastest-flowing outlet glaciers in East Antarctica, flows into a bay that is usually covered by landfast sea ice. Although the presence of landfast ice is considered to stabilize glacier tongue, quantitative assessments are insufficient. We investigated the spatiotemporal variations in the flow velocities of both the glacier tongue and the surrounding landfast ice using a correlation method with ALOS-2/PALSAR-2 images, before and after a landfast-ice collapse in April 2017. After the collapse, the glacier tongue flow accelerated by 8–15% (0.20–0.38 km a−1). After reestablishment of landfast ice, the flow velocity of the landfast ice in contact with the glacier terminus is 20%–90% of the flow velocity of the glacier terminus The estimates of interactive changes in the motions of both glacier ice and sea ice can be used to quantify the buttress effect, which is a key factor affecting the mass budget of Antarctic outlet glaciers.

Clinical decision-making regarding treatments based on personal characteristics leads to effective health improvements. Here, the authors introduce a modeling framework to evaluate the actionability of treatment pathways.

Functional ceramic coatings have been investigated for several decades to mitigate tritium permeation through structural materials in a fusion reactor blanket. For the establishment of a liquid blanket system, the coatings require not only tritium permeation reduction but also the tolerance to irradiation damage induced by neutrons and corrosion by liquid tritium breeders. In this study, deuterium permeation measurements under exposure to liquid lithium–lead were performed for a heavy-ion-irradiated zirconium oxide coating sample to elucidate the synergy of irradiation and corrosion on hydrogen isotope permeation. The irradiated coating decreased the deuterium permeation flux under lithium–lead exposure by more than two orders of magnitude in comparison with the unirradiated one. Each activation energy of permeation and diffusion of the coating sample was larger than that of the unirradiated one at around 450 °C and decreased to the level of the unirradiated one at 600 °C. The results indicated that the voids formed by ion irradiation aggregated in grain boundaries of the coating, resulting in an increase in the energy barrier of diffusion at low temperatures and then a decrease due to the defect recovery at high temperatures. Besides, a corrosion product layer formed on the coating during lithium–lead exposure increased the energy barrier of solution. The synergy of irradiation and corrosion on permeation was developed at lower temperatures before the defect recovery.

This study presents the feasibility of estimating the ice thickness of the Shirase Glacier using the synthetic aperture interferometric radar altimeter (SIRAL) on board the CryoSat-2 and the interannual variation of the ice thickness of the Shirase Glacier in 2011–2020. The SIRAL data were converted to ice thickness by assuming hydrostatic equilibrium, and the results showed that the ice thickness decreased from the grounding line to the terminus of the glacier. Furthermore, the ice thickness decreased 30 km downstream from the grounding line of the glacier in 2012 and 2017, and decreased 55 km and 60 km downstream from the grounding line of the glacier at other times, which was attributed to the discharge of landfast ice and the retreat of the glacier terminus. When the flow of glacial ice can be reasonably approximated as an incompressible fluid, and the law of conservation of mass can be applied to the ice stream, the multiple of the velocity and the underlying ice thickness under a constant ice density can be shown to correspond to the equation of continuity. Consequently, this study revealed that the ice thickness decreases with accelerating flow velocity, which is coincident with past outflow events.

An optimum operation of a gasoline particulate filter (GPF) for a gasoline direct injection vehicle in terms of its performance of pressure drop, soot loading, and filtration efficiency becomes inevitable to fulfill upcoming emission regulations. This paper proposes a methodology to characterize the GPF performance for validation of simulation models for more precise operation strategies along with future legislative requirements. The feasibility was examined through experiments of miniature GPF samples using a synthetic particle generator. Firstly, permeability of the GPF walls was estimated to be 6.9 ± 1.5 × 10−13 m2 by a flow resistance descriptor model, which was in good agreement with its pore structure. Secondly, photoacoustic sensor systems indicated soot accumulation inside the GPFs in real time thanks to linear correlations between sensor signals and soot mass concentrations in exhaust. Thirdly, particle number counting systems compliant with respective regulatory technical requirements exhibited time-resolved filtration efficiencies of the GPFs in conjunction with solid particle number emissions whose diameter was larger than 10 nm and 23 nm. The filtration efficiencies at a clean state of the GPF were 0.78 and 0.77, respectively. The slight difference could be explained by Brownian diffusion and interception for particle filtration.

Particulate matter and – recently – particle number emissions from direct injection gasoline engines have already been regulated. The measurement techniques are well established for moderate temperature (23 ± 5 °C) but not for low temperature (e.g. -7 °C). Such an extended environmental condition has been enforced under real driving conditions but not yet for the laboratory testing. During development processes of engines and emission control systems, the testing at low temperature is of interest. This paper focuses on various challenges that need to be addressed for the developments with respect to engine calibrations and particle measurements under the extended environmental conditions.

Particle number exhaust emissions from diesel – and recently – from gasoline direct injection engines have already been regulated for particle sizes larger than 23 nm. However, interests have been extended to different applications and also to particles smaller than 23 nm. The UNECE Particle Measurement Programme (PMP) group is currently evaluating the feasibility to measure the sub-23 nm particle emissions by modifying the existing methodology. This paper focuses on the associated challenges of particle number measurement instruments in terms of sampling and diluting the emissions as well as of counting the sub-23 nm particles.

This study investigated the effect of exogenously administered polyphenolic antioxidant, α-glycosyl isoquercitrin (AGIQ), on neural function in rats following dietary exposure at 0.5% from gestational day 6 to postnatal day 77, in comparison with nonpolyphenolic α-lipoic acid (ALA) at 0.2%. AGIQ-exposed offspring revealed enhanced fear extinction learning at the 3rd trial and transcript upregulation of Fos and Kif21b in the hippocampal dentate gyrus and Grin2d in the amygdala. AGIQ also increased the number of FOS-immunoreactive (+) hippocampal granule cells. While ALA showed fear extinction learning-related transcript expression changes, it changed neither fear extinction learning nor FOS+ cell numbers. The increases of FOS+ cells and Grin2d transcripts by AGIQ suggested an association with increase of synaptic plasticity, leading to enhancement of fear extinction learning. AGIQ may also upregulate KIF21B, a recently identified memory-rewriting molecule. The present study findings suggest a possible therapeutic use of AGIQ in mitigating some stress disorders.

Silver deposition-based electrochromic (EC) device enabled various optical states by using either the electrodeposition of silver thin films or silver nanoparticles on an indium tin oxide electrode. These optical states, including chromatic colors such as cyan, magenta, yellow, and green, are based on absorption by the localized surface plasmon resonance of silver nanoparticles. However, an ideal counter-reaction material that does not affect the color representation by silver nanoparticles and does not dissolve the deposited silver has not been reported. To achieve both color retention and chromatic color representation, MnO2 was utilized as the counter electrode material. The EC properties of the novel device with the MnO2 counter electrode were investigated in terms of charge density and its ability to change color. The novel EC device achieved both representations of chromatic color and retained its color without power supply.

Candidate compounds for new thermoelectric and superconducting materials, which have narrow band gap and flat bands near band edges, were exhaustively searched by the high-throughput first-principles calculation from an inorganic materials database named AtomWork. We focused on PbBi2Te4 which has the similar electronic band structure and the same crystal structure with those of a pressure-induced superconductor SnBi2Se4 explored by the same data-driven approach. The PbBi2Te4 was successfully synthesized as single crystals using a melt and slow cooling method. The core level X-ray photoelectron spectroscopy analysis revealed Pb2+, Bi3+ and Te2- valence states in PbBi2Te4. The thermoelectric properties of the PbBi2Te4 sample were measured at ambient pressure and the electrical resistance was also evaluated under high pressure using a diamond anvil cell with boron-doped diamond electrodes. The resistance decreased with increasing of the pressure, and pressure-induced superconducting transitions were discovered at 2.5 K under 10 GPa. The maximum superconducting transition temperature increased up to 8.4 K at 21.7 GPa. The data-driven approach shows promising power to accelerate the discovery of new thermoelectric and superconducting materials.

Cryptographic hash functions play an essential role in various aspects of cryptography, such as message authentication codes, pseudorandom number generation, digital signatures, and so on. Thus, the security of their hardware implementations is an important research topic. Hao et al. proposed an algebraic fault analysis (AFA) for the SHA-256 compression function in 2014. They showed that one could recover the whole of an unknown input of the SHA-256 compression function by injecting 65 faults and analyzing the outputs under normal and fault injection conditions. They also presented an almost universal forgery attack on HMAC-SHA-256 using this result. In our work, we conducted computer experiments for various fault-injection conditions in the AFA for the SHA-256 compression function. As a result, we found that one can recover the whole of an unknown input of the SHA-256 compression function by injecting an average of only 18 faults on average. We also conducted an AFA for the SHACAL-2 block cipher and an AFA for the SHA-256 compression function, enabling almost universal forgery of the chopMD-MAC function.

Abstract Electrochemiluminescence (ECL) refers to light emission induced by an electrochemical redox reaction. The stability, emission response, and light intensity of the ECL device are known to be improved by using an alternating current (AC) voltage. In this paper, an AC-driven ECL device is fabricated with DNA/Ru(bpy)3 2+ hybrid film-modified electrode. The Ru(bpy)3 2+ complex exhibits significant electrochemical reactivity in the DNA/Ru(bpy)3 2+ hybrid film prepared by electrochemical adsorption. The hybrid film contains unique micrometre-scale aggregates of Ru(bpy)3 2+ in DNA matrix. The physicochemical properties of the hybrid film and its AC-driven ECL characteristics in the electrochemical device are studied. Orange-coloured ECL is observed to be emitted from only the aggregated structures in the hybrid film at the high AC frequency of 10 kHz, which corresponds to a response time shorter than 100 μs.

Accessibility improvement for pedestrians has received increasing attention in planning. However, pedestrian space is more likely to be designed only for individual streets to secure minimum easiness of walking, and little attention has been paid to developing a street network for pedestrians to walk around multiple destinations on a neighbourhood scale. There is also a lack of empirical analysis of how much pedestrian accessibility would vary depending on the characteristics of streets on routes to specific destinations. This paper is aimed at examining the spatial relationship between pedestrian flows by street type and various street characteristics around multiple destinations in a city centre. First, a literature review summarises what street characteristics should be considered in accessibility analysis for pedestrians. Then, a pedestrian flow model is developed in a way that measures accessibility with street characteristics of origins, destinations, and routes on multi-scales from on-street ones to neighbourhood-scale ones. A multiple regression model is made using data from the West End area in London, in which street characteristics are taken for routes from each street segment to nearby stations and attractions. As a result, this analysis found that the route characteristics to a single nearest station and attraction can account for pedestrian flows well, but route characteristics to multiple nearby stations and attractions do not improve the model fit. These results are more prominent for pedestrianised streets. Their implication may be that these destinations are currently not linked well for pedestrians, and pedestrianisation is required to contribute more to the linkage.

Organic nonvolatile transistor memory with synthetic polypeptide derivatives as dielectric was fabricated by a solution process. When only poly (γ-benzyl-l-glutamate) (PBLG) was used as dielectric, the device did not show obvious hysteresis in transfer curves. However, PBLG blended with PMMA led to a remarkable increase in memory window up to 20 V. The device performance was observed to remarkably depend on the blend ratio. This study suggests the crystal structure and the molecular alignment significantly affect the electrical performance in transistor-type memory devices, thereby provides an alternative to prepare nonvolatile memory with polymer dielectrics.

The aim of this study was to evaluate the effects of the mitogen-activated protein kinase (MAPK) pathway inhibitors SB203580, CMPD-1, SB239063, SP600125, and FR180204 on the activity of P-glycoprotein (P-gp) and to assess whether the MAPK pathway affects P-gp directly. Changes in the fluorescence of residual rhodamine 123, a marker of P-gp activity, in the apical region of Caco-2 cells were measured in the presence of MAPK pathway inhibitors using time-lapse confocal laser scanning microscopy at 0, 10, 20, 30, and 60 min. Significant differences were observed between the fluorescence levels of control cells and cells treated with SB203580 for 20, 30, or 60 min. However, no significant change was observed in the residual rhodamine 123 fluorescence of cells treated with CMPD-1, SB239063, SP600125, or FR180204. Among the p38-MAPK pathway inhibitors investigated, CMPD-1 and SB239063 showed no detectable effect on the activity of P-gp. Further, JNK 1, 2, 3-MAPK pathway (SP600125) and ERK1/2 pathway (FR180204) inhibitors did not affect P-gp activity. However, SB203580 enhanced the transfer of rhodamine 123 across the apical cell membrane. Thus, SB203580 activated P-gp, although not through the p38-MAPK pathway. Importantly, the MAPK pathway did not affect P-gp activity shortly after treatment.

Cordyceps sinensis, a fungus that parasitizes on the larva of Lepidoptera, has been used as a valued traditional Chinese medicine. We investigated the effects of water extracts of Cordyceps sinensis (WECS), and particularly focused on its anticancer and antimetastatic actions. Based on in vitro studies, we report that WECS showed an anticancer action, and this action was antagonized by an adenosine A3 receptor antagonist. Moreover, this anticancer action of WECS was promoted by an adenosine deaminase inhibitor. These results suggest that one of the components of WECS with an anticancer action might be an adenosine or its derivatives. Therefore, we focused on cordycepin (3′-deoxyadenosine) as one of the active ingredients of WECS. According to our experiments, cordycepin showed an anticancer effect through the stimulation of adenosine A3 receptor, followed by glycogen synthase kinase (GSK)-3β activation and cyclin D1 suppression. Cordycepin also showed an antimetastatic action through inhibiting platelet aggregation induced by cancer cells and suppressing the invasiveness of cancer cells via inhibiting the activity of matrix metalloproteinase (MMP)-2 and MMP-9, and accelerating the secretion of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 from cancer cells. In conclusion, cordycepin, an active component of WECS, might be a candidate anticancer and antimetastatic agent.

We have previously reported that peroxynitrite is involved in dysfunction of nitric oxide (NO)-mediated vasorelaxation in SHR/NDmcr-cp rats (SHR-cp), which display typical symptoms of metabolic syndrome. This study investigated whether peroxynitrite is actually generated in the vascular wall with angiotensin II–induced NADPH-oxidase activation, thus contributing to the dysfunction. In isolated mesenteric arteries of male 18-week-old SHR-cp, relaxations in response to acetylcholine and sodium nitroprusside were impaired compared with that in Wistar-Kyoto rats. This impaired relaxation was not restored by treatment with apocynin, an NADPH-oxidase inhibitor. Protein expression of endothelial NO synthase increased while that of soluble guanylyl cyclase (sGC) decreased in the artery. We observed increased production of superoxide anions and peroxynitrite from the artery and their inhibition by apocynin, and also increased contents of nitrotyrosine, a biomarker of peroxynitrite, in mesenteric arteries and angiotensin II in aortas. Long-term (8 weeks) administration of telmisartan, an angiotensin II type 1–receptor antagonist, prevented the impaired vasorelaxation, decreased sGC expression and increased nitrotyrosine content in mesenteric arteries. These findings suggest that in the vascular wall of SHR-cp, peroxynitrite is continually produced by the reaction of NO with NADPH oxidase–derived superoxide via angiotensin II and gradually denatures sGC protein, leading to vasorelaxation dysfunction. Keywords:: peroxynitrite, angiotensin II, metabolic syndrome, NADPH oxidase, oxidative stress

Abstract.: Cigarette smoking is a major risk factor for cardiovascular disease. The induction of oxidative stress by smoking plays a key role in the progression of atherosclerosis. However, the underlying mechanisms are not fully understood. In the present study, we investigated whether long-term smoking can accelerate the progression of atherosclerosis and whether oxidative stress is implicated in its pathogenesis. Apolipoprotein E–deficient spontaneously hyperlipidemic mice, a model of atherosclerosis, were exposed to the gas-phase of smoke, from which tar and nicotine had been removed, for 15 min a day, 6 days a week, for 16 weeks. Exposure to cigarette smoke significantly increased the serum levels of oxidative stress markers such as thiobarbituric acid–reactive substances, oxidatively modified low-density lipoproteins, and 3-nitrotyrosine, but it did not affect serum cholesterol and triglyceride levels. Exposure to smoke also accelerated the accumulation of total cholesterol levels in the aorta that was accompanied by an increase in 3-nitrotyrosine levels of the atherosclerotic mice. These changes in the serum and aorta that progressed with exposure to smoke were prevented by vitamin E administration. Our data suggest that chronic cigarette smoking promotes and aggravates atherosclerosis and that the antioxidant vitamin E exerts an anti-atherogenic effect via reduction of oxidative stress. Keywords:: cigarette smoking, atherosclerosis, oxidative stress, apolipoprotein E–deficient spontaneously hyperlipidemic mice, vitamin E

We investigated the effects of P2-receptor agonists on cell size, intracellular calcium levels ([Ca2+]i), and permeation of FITC-labeled dextran (FD-4) as well as the relationship between these effects in human umbilical vein endothelial cells (HUVEC). FD-4 concentration, cell size, and [Ca2+]i were analyzed by HPLC with fluorescence, phase contrast microscopic imaging, and fluorescent confocal microscopic imaging, respectively. The P2Y1-receptor agonists 2-methylthio ATP (2meS-ATP) and ADP decreased cell size and increased [Ca2+]i in HUVEC. The P2Y2-receptor agonist UTP increased [Ca2+]i, but did not influence cell size. The P2X-receptor agonist α,β-methylene ATP did not induce either response. The decrease in size and increase in [Ca2+]i by 2meS-ATP were blocked by pyridoxalphosphate-6-azophenyl-2′,4′-disulphonic acid (PPADS, P2Y1-antagonist), thapsigargin (Ca2+-pump inhibitor), and U73122 (phospholipase C inhibitor). Furthermore, 2meS-ATP (P2Y1-receptor agonist) enhanced permeation of FD-4 through the endothelial cell monolayer. The 2meS-ATP-induced enhancement of the permeation was also prevented by PPADS, thapsigargin, and U73122. These results indicate that activation of P2Y receptors induces a decrease in cell size, an increase in [Ca2+]i, and may participate in facilitating macromolecular permeability in HUVEC. Keywords:: cell size, intracellular Ca2+, permeability, P2Y receptor, human umbilical vein endothelial cell

Prevention of cardiovascular disease (CVD) is an important therapeutic object of diabetes care. This study assessed whether an index based on plasma free amino acid (PFAA) profiles could predict the onset of CVD in diabetic patients. The baseline concentrations of 31 PFAAs were measured with high-performance liquid chromatography-electrospray ionization-mass spectrometry in 385 Japanese patients with type 2 diabetes registered in 2001 for our prospective observational follow-up study. During 10 years of follow-up, 63 patients developed cardiovascular composite endpoints (myocardial infarction, angina pectoris, worsening of heart failure and stroke). Using the PFAA profiles and clinical information, an index (CVD-AI) consisting of six amino acids to predict the onset of any endpoints was retrospectively constructed. CVD-AI levels were significantly higher in patients who did than did not develop CVD. The area under the receiver-operator characteristic curve of CVD-AI (0.72 [95% confidence interval (CI): 0.64-0.79]) showed equal or slightly better discriminatory capacity than urinary albumin excretion rate (0.69 [95% CI: 0.62-0.77]) on predicting endpoints. A multivariate Cox proportional hazards regression analysis showed that the high level of CVD-AI was identified as an independent risk factor for CVD (adjusted hazard ratio: 2.86 [95% CI: 1.57-5.19]). This predictive effect of CVD-AI was observed even in patients with normoalbuminuria, as well as those with albuminuria. In conclusion, these results suggest that CVD-AI based on PFAA profiles is useful for identifying diabetic patients at risk for CVD regardless of the degree of albuminuria, or for improving the discriminative capability by combining it with albuminuria.

Background: Although mutations in telomerase reverse transcriptase (TERT) promoter (TERTp) are the most common alterations in glioblastoma (GBM), predicting TERTp mutation status by preoperative imaging is difficult. We determined whether tumour-surrounding hyperintense lesions on fluid-attenuated inversion recovery (FLAIR) were superior to those of contrast-enhanced lesions (CELs) in assessing TERTp mutation status using magnetic resonance imaging (MRI). Methods: This retrospective study included 114 consecutive patients with primary isocitrate dehydrogenase (IDH)- wild-type GBM. The apparent diffusion coefficient (ADC) and volume of CELs and FLAIR hyperintense lesions (FHLs) were determined, and the correlation between MRI features and TERTp mutation status was analyzed. In a subset of cases, FHLs were histopathologically analyzed to determine the correlation between tumor cell density and ADC. Results: TERTp mutations were present in 77 (67.5%) patients. The minimum ADC of FHLs was significantly lower in the TERTp-mutant group than in the TERTp-wild-type group (mean, 958.9 × 10-3 and 1092.1 × 10-3 mm2/s, respectively, P < 0.01). However, other MRI features, such as CEL and FHL volumes, minimum ADC of CELs, and FHL/CEL ratio, were not significantly different between the two groups. Histopathologic analysis indicated high tumor cell density in FHLs with low ADC. Conclusion: The ADC of FHLs was significantly lower in IDH-wild-type GBM with TERTp mutations, suggesting that determining the ADC of FHLs on preoperative MRI might be helpful in predicting TERTp mutation status and surgical planning. [ABSTRACT FROM AUTHOR]