Accumulated data show the utility of diagnostic multi-organ point-of-care ultrasound (PoCUS) in the assessment of patients admitted to an internal medicine ward. Assess whether multi-organ PoCUS (lung, cardiac, and abdomen) provides relevant diagnostic and/or therapeutic information in patients admitted for any reason to an internal medicine ward. Prospective, observational, and single-center study, at a secondary hospital. Multi-organ PoCUS was performed during the first 24 hours of admission. The sonographer had access to the patients’ medical history, physical examination, and basic complementary tests performed in the ED (laboratory, X-ray, electrocardiogram). We considered a relevant ultrasound finding if it implied a significant diagnostic and/or therapeutic change. In the second semester of 2019, 310 patients were enrolled (48.7% men, mean age 70.5 years). Relevant ultrasound findings were detected in 86 patients (27.7%) and in 60 (19.3%) triggered a therapeutic change. These findings were associated with older age (Mantel-Haenszel 2 = 25.6; p< .001) and higher degree of dependency (Mantel Haenszel 2 = 5.7; p = .017). Multi-organ PoCUS provides relevant diagnostic information, complementing traditional physical exam, and facilitates therapy adjustment, regardless of the cause of admission. Multi-organ PoCUS to be useful need to be systematically integrated into the decision-making process in internal medicine.

Abstract Purpose: This study aims to evaluate the potential of multimodal ultrasound techniques in improving the visibility of liver lesions that are indistinct under conventional ultrasound. Specifically, we will explore the application of fusion imaging, contrast-enhanced ultrasound (CEUS), and high-frequency ultrasound in enhancing the visibility of liver masses. These techniques will be utilized to assist in visualizing liver lesions and to accurately localize them for the purpose of performing percutaneous tissue biopsy. Lastly, we will compare the biopsy results with the final diagnosis to assess whether multimodal techniques can enhance the success rate of percutaneous biopsy for liver masses that are not clearly visible under conventional ultrasound. Furthermore, the potential impact of these techniques on the development of personalized treatment strategies for patients was also discussed. Materials and Results: A retrospective analysis was conducted on 144 patients with liver masses who underwent conventional ultrasound examinations at our hospital from October 2018 to January 2024. These patients had poor visibility on conventional ultrasound, but the tumor location was visible on abdominal computerized tomography (CT) or magnetic resonance imaging (MRI) scans. We excluded 71 patients who did not undergo percutaneous liver tumor biopsy and 8 patients who remained non-visualized under multimodal ultrasound. Finally, 95 patients met the inclusion criteria and their clinical and radiological data were selected for analysis. Computerized tomography or magnetic resonance imaging-ultrasound (CT/MR-US) fusion imaging was performed in 55 patients, CEUS was conducted in 95 patients, and high-frequency ultrasound examination was performed in 21 patients. The visibility of the lesions using these three techniques was evaluated, and the consistency between the biopsy pathology and the final diagnosis was analyzed. Results: In the study, a total of 39 cases were identified as solitary liver lesions, 34 cases as multiple lesions, and an additional 23 cases as diffuse hepatocellular carcinoma. Among them, there were 13 cases (13.7%) of lesions located in the left lobe, 73 cases (76.8%) in the right lobe, and 9 cases (9.4%) at the junction of the left and right lobes. The average maximum diameter of the lesions was 2.7 cm (ranging from 0.7 cm to 10.0 cm). The detection rates of lesions using CT/MR-US fusion imaging, contrast-enhanced ultrasound (CEUS), and high-frequency ultrasound examination were 49.1%, 96.8%, and 76.2%, respectively. All patients in the entire cohort underwent percutaneous ultrasound-guided biopsy after confirming the target location of the lesions, including 9 patients underwent percutaneous microwave ablation. No severe complications were observed. The accuracy rate of the biopsies was 91.6%, and the positive concordance rate was 91.1%. The biopsy pathology included 39 cases of hepatocellular carcinoma (HCC), 16 cases of intrahepatic cholangiocarcinoma (ICC), 22 cases of metastatic adenocarcinoma, 3 cases of hepatic adenoma (HA), 1 case of vascular sarcoma, and 1 case of mixed HCC-ICC. Among the 13 patients with negative pathology findings after biopsy, 8 cases were considered false negatives (based on follow-up laboratory tests and imaging results consistent with malignant tumor characteristics), resulting in a false negative rate of 8.9%. Conclusions: The application of multimodal ultrasound technology can significantly improve the success rate of liver lesion biopsies that are difficult to visualize using conventional ultrasound. Furthermore, it will facilitate the guidance of microwave ablation therapy for lesions using multimodal ultrasound imaging, enabling collaborative precision treatment planning for patients with clinical physicians.

The design is described of a readily useable technology for routine paddock-scale soil porosity estimation. The method is non-contact (proximal) and typically from sensors mounted on a small farm vehicle around 1 m above the soil surface. Challenges arise from the need to have a compact low-power rigid structure and to allow for pasture cover and surface roughness. The high-frequency regime for acoustic reflections from a porous material is a function of the porosity , the tortuosity , and the angle of incidence . There is no dependence on frequency, so measurements must be conducted at two or more angles of incidence in order to obtain two or more equations in the unknown soil properties and . A system requiring a single transmitter/receiver pair to be moved from one angle to another is not viable for rapid sampling. Therefore, the design includes at least two transmitter/reflector pairs placed at identical distances from the ground so that they would respond identically to power reflected from a perfectly reflecting surface. A single 25 kHz frequency is a compromise which allows for the frequency-dependent signal loss from a natural rough agricultural soil surface. Multiple-transmitter and multiple-microphone arrays are described which give a good signal to noise ratio while maintaining a compact system design. The resulting arrays have a diameter of 100 mm. Pulsed ultrasound is used so that the reflected sound can be separated from sound travelling directly through the air horizontally from transmitter to receiver. The average porosity estimated for soil samples in the laboratory and in the field is found to be within around 0.04 of the porosity measured independently. This level of variation is consistent with uncertainties in setting the angle of incidence, although assumptions made in modelling the interaction of ultrasound with the rough surface no doubt also contribute.

Despite the many advantages of lung ultrasound (LUS) in the diagnosis and management of patients with dyspnea, adoption among hospitalists has been slow. We performed semi-structured interviews of hospitalists from 4 diverse health systems in the US to understand determinants of adoption within a range of clinical settings. We used the Diffusion of Innovation Theory to guide a framework analysis of the data. Of 27 hospitalists invited, we performed in-terviews of 22 from 4 hospitals of diverse types. Median years post-residency of interviewees was 10.5 [IQR:5-15]. Four main themes emerged: 1) There are important clinical advantages to LUS despite operator dependence, 2) LUS enhances patient and clinician experience, 3) Investment of clinician time to learn and perform LUS is a barrier to adoption but yields improved efficiency for the health system and 4) Mandated training and use may be necessary to achieve broad adoption as monetary incentives are less effective. Despite perceived benefits of LUS for patients, clinicians and health systems, an important barrier to broad LUS adoption is the experience of time scarcity by hospitalists. Future implementation strategies should focus on changes to the clinical environment that address clinician barriers to learning and adoption of new skills.

Background: Ultrasonography (US) represents the gold standard imaging method for the assessment of testicular lesions (TL). The gray-scale (GSUS) and color-Doppler (CDUS) ultrasound examination allow sonographers to investigate size, margins, echotexture and vascular features of TL, with the effort to differentiate benign from malignant lesions. Recently, the use of contrast-enhanced US (CEUS) and sonoelastography (SE) led to further improvements in the differential diagnosis of TL. Although GSUS and CDUS are often sufficient to suggest the benign or malignant nature of TL, CEUS can be decisive in the differential diagnosis of unclear findings, while SE can help to strengthen the diagnosis. The contemporary combination of GSUS, CDUS, CEUS and SE led to a new diagnostic paradigm named multiparametric US (mp-US), able to provide a more detailed characterization of TL than the single techniques alone. This narrative and pictorial review is aimed to describe the mp-US appearance of several TL. Methods: An extensive Medline search was performed identifying studies in the English language focusing on mp-US evaluation of TL. Results: a practical mp-US “identity card” and iconographic characterization of several benign and malignant TL is provided herein. Conclusions: the mp-US characterization of TL reported herein can be useful in daily clinical practice.

Abstract: Background. The newer wireless portable scanners seem to permit a quicker bedside ultrasound (US) assessment, shortening the transfer times of the portable US unit and without the hindering of connection cables. However, no substantial evidence is currently available regarding of the clinical effectiveness of such new generation devices. Objective. The aim of the current study was to evaluate the efficacy of a wireless US system with respect to a high-end US unit in a cohort of consecutive respiratory patients. Materials and Methods. This prospective observational study included a total of 72 respiratory patients admitted in the department of Internal Medicine. The US examination were independently performed by two experienced blinded examiners with a high-end Esaote MyLab-Twice scanner and a wireless double-head linear and convex probe OTE-L/C501CD. The findings resulting from the high-end US assessment and the wireless US examination were then compared each other. All the patients had a confirmation chest CT scan. Results. The high-end US machine identified 64 positive cases for pleuro-pulmonary alterations, in comparison to which the wireless US unit resulted in 13 false negative results. The respective overall sensitivity and specificity for the portable wireless US unit were of 79.69% and 100.00%, respectively. The resolution of the portable wireless US device was judged as good in 22 (31%) cases, affected by minor diagnostic limitations in 26 (36%) cases and affected by major diagnostic limitations in 24 (33%). The main diagnostic strength of the wireless probe was in the detection of pleural effusion (sensitivity 100%). The diagnostic sensitivity of the wireless probe in assessing abnormalities of the pleural line (67%), pulmonary subpleural consolidations (65%), pleural lesions (33%) and pericardial effusion (0%) was reduced. Conclusions. The newer wireless US probes may have clinical roles for the detection and management of pleural effusion when used by experienced examiners. However, sensitivity in detecting other pleuro-pulmonary pathologies is not comparable to high-end ultrasound machines.

Magnetomotive ultrasound (MMUS) is a promising imaging modality for detecting magnetic nanoparticles. In MMUS, an external oscillating magnetic field induces motion of the injected magnetic nanoparticles within tissue, and phase-based tracking algorithms are used to detect the motion. However, the subwavelength scale of theses displacements (often a few micrometers) makes direct visualization on conventional ultrasound B-mode images impossible. In this work, we adapt the Eulerian motion magnification technique to create a novel ultrasound display mode for identifying the nanoparticle locations, eliminating the need for displacement tracking algorithms. Phantom and in-vivo experiments demonstrate that our technique successfully magnifies magnetomotion and the associated shear wave propagation in ultrasound B-mode imaging and pinpoints the nanoparticle vibration source, even in low-concentration scenarios. Additionally, motion magnification magnified the displacement of nanoparticles, having the potential to improve the localization accuracy of displacement tracking algorithms in MMUS.

Tissue Doppler Imaging (TDI) is a non-invasive, echocardiographic imaging technique that measures myocardial motion velocity throughout the cardiac cycle using Doppler principles. While conventional Doppler techniques assess blood flow velocity by sensing high-frequency, low amplitude signals from small, fast-moving blood cells, TDI uses the same Doppler principles to instead measure high-amplitude, lower-velocity signals of myocardial tissue. Methods A literature review was conducted to survey and review studies investigating the limitations, strengths, physical principles, novel methods, applications in diseased states, and prognostic capabilities of TDI. These articles were further screened for inclusion, and those deemed ineligible or irrelevant to the scope of the review were discarded. In total, 19 studies were included in the qualitative synthesis. Results TDI is shown to be an effective method for detailed quantification of cardiac function. It provides an early means of diagnosing cardiac dysfunction and is a valid prognostic indicator for various forms of heart disease. TDI's versatility and precision allows clinicians to predict the clinical course of disease, leading to early intervention and the selection of targeted care management plans for many cardiac pathologies. Despite imaging limitations like angle dependence and incapacity for passive and active motion differentiation, further investigation continues to reveal novel TDI methodologies that advance the scope of this imaging technique.

The internationals guidelines about food intolerances, allergy and immunity provide for rigorous steps in which ultrasonography is not provided. However there is evidence in literature about an ancillar role of ultrasonography in these conditions. In this report we analyze the main pathologies with allergic or immune pathogenesis

Late onset Pompe disease is a recessive lysosomal storage disease. Clinical features include skeletal muscles deficiency and diaphragm weakness. Clinical management relies on supportive treatment and mechanical ventilation in patents with chronic respiratory failure. M mode ultrasound and tissue Doppler imaging can be used to assess and to follow up diaphragm function.

Ultrasound imaging is a vital imaging tool in musculoskeletal medicine, with the number of publications on ultrasound-guided surgery increasing in recent years. However, ultrasound imaging has drawbacks, such as operator dependency and image obscurity. Artificial Intelligence (AI) and Deep Learning (DL), a subset of AI, can address these issues. DL methods, including segmentation, detection, and localization of target tissues and medical instruments, potentially allow physicians and surgeons to perform ultrasound-guided procedures more accurately and efficiently. This review summarizes recent advances in ultrasound-guided procedures for musculoskeletal diseases and provides a comprehensive overview of the utilization of AI/DL in ultrasound for musculoskeletal medicine, particularly focusing on ultrasound-guided surgery.

Ultrasound A-scan is an important tool for quantitative assessment of ocular lesions. However, its usability is limited by difficulty to accurately localize the ultrasound probe to a lesion of interest. In this study, a transparent LiNbO3 single crystal ultrasound transducer was fabricated, and integrated with a widefield fundus camera to guide the ultrasound local position. The novel fundus camera guided ultrasound probe was validated for in vivo measurement of rat eyes. Anterior and posterior segments of the rat eye could be unambiguously differentiated with the fundus photography guided ultrasound measurement. A model eye was also used to verify the clinical potential of the prototype device.

This paper presents a novel sensor for the detection and characterization of regions of air turbulence that would be of use to improve UAV stability in bad weather. It consists of a combined Schlieren imager and a Radar Acoustic Sounding System (RASS) to produce dual modality “images” of air movement within the measurement volume. The ultrasound modulated Schlieren imager consists of a strobed point light source, parabolic mirror, light-block and camera which are controlled by two laptops. It provides a fine scale projection of the acoustic pulse modulated air turbulence through the measurement volume. The narrow beam 40 kHz/ 17 GHz RASS produces spectra based on Bragg enhanced Doppler radar reflections from the acoustic pulse as it travels. Tests using artificially generated air vortices showed some disruption of the Schlieren image and of the RASS spectrogram. This should allow the higher resolution Schlieren images to identify the turbulence mechanisms that are disrupting the RASS spectra.

Inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), defines as an idiopathic, chronic, relapsing, inflammatory disease affecting the gastrointestinal tract and leading to chronic damage. Endoscopy with biopsies is considered the gold standard for IBD diagnosis, whereas magnetic resonance (MRI) for CD extension and complication assess-ment. However, the latter are invasive procedures; thus, the need for a reliable, accessible and noninvasive way to perform IBD diagnosis and monitoring in the tight control era, like intestinal ultrasound (IUS) is. Compared to endoscopy and MRI, IUS has shown reliable diagnostic accuracy in assessing CD and UC severity and extension. Performing IUS in a point-of-care setting (POCIUS) can guide the clinician in driving the diagnostic and therapeutic pathway, thus accel-erating clinical decisions. POCIUS performed with pocket devices can represent the future of physical examination in outpatient or inpatient examination. Accordingly, we performed a liter-ature review about the application of IUS in CD and UC diagnosis. Furthermore, we explored the technical aspects of this imaging technique and its application in a point-of-care setting.

The purpose of this review is to present the current role of ultrasound-based techniques in the diagnostic pathway of prostate cancer (PCa). With overdiagnosis and overtreatment of a clinically insignificant PCa over the past years, multiparametric magnetic resonance imaging (mpMRI) became recommended for every patient suspected of PCa before performing a biopsy. It enabled targeted sampling of the suspicious prostate regions, improving the accuracy of the traditional systematic biopsy. However, mpMRI is associated with high costs, relatively low availability, long and separate procedure or exposure to the contrast agent. The novel ultrasound modalities such as shear wave elastography (SWE), contrast-enhanced ultrasound (CEUS) or high frequency micro-ultrasound (MicroUS) may be capable of maintaining the performance of mpMRI without its limitations. Moreover, the real-time lesion visualization during biopsy would significantly simplify the diagnostic process. Another value of these new techniques is the ability to enhance the performance of mpMRI by creating the image fusion of multiple modalities. Such models might be further analyzed by artificial intelligence to mark the regions of interest for investigators and help to decide about the biopsy indications. The dynamic development and promising results of new ultrasound-based techniques should encourage researchers to thoroughly study their utilization in prostate imaging.

Low-complexity ultrasound systems are increasingly desired for wearable point-of-care ultra-sound and massive-channel ultrasound for 3-D matrix imaging. However, the system complexity is closely associated with the imaging capabilities, remaining as a challenge. To resolve this limitation, this study revisits the general structures of analog and digital beamformers and in-troduces a hybrid approach to implement efficient ultrasound systems. The suggested hybrid beamforming takes two stages, where the first analog stage partially beamforms M-channel RF signals to N sum-out data (M-to-N beamforming), and the second digital stage beamforms N partial sums to single final beamformed data (N-to-1 beamforming). Our approach was systematically designed and implemented, which was demonstrated with a customized 64-channel 1-D phased array using a tissue mimicking phantom. The demonstrated results indicate that the analog-digital hybrid beamforming can be applied to any kind of arrays for sophisticated 3-D imaging and tiny wearable ultrasound applications.

Endoscopic ultrasound (EUS) and intraductal ultrasound (IDUS) play very important roles in the field of biliary tract disease. Because of their excellent spatial resolution, the detection of small lesions and T-staging of tumors have become possible. Additionally, contrast-enhanced EUS and the new imaging technique of detective flow imaging are reported to be useful for differential diagnosis. Furthermore, EUS-guided tissue acquisition is used not only for pathological diagnosis, but also to collect tissue samples for cancer genome profiling. Although percutaneous transhepatic biliary drainage (PTBD) was traditionally performed in cases where endoscopic retrograde cholangiopancreatography is not feasible, treatments using EUS have recently become increasingly common, and EUS-guided biliary drainage was recently suggested to be superior to PTBD in terms of a higher success rate, less adverse events, and lower reintervention rate. This review provides an overview of diagnosis and treatment utilizing the features and techniques of EUS and IDUS.

Accurate prostate volume estimation is crucial for effective prostate disease management. Ultrasound (US) imaging, particularly transrectal ultrasound, offers a cost-effective and rapid assessment. However, US images often suffer from artifacts and poor contrast, making prostate volume estimation challenging. This review explores recent advancements in deep learning (DL) techniques for automatic prostate segmentation in US images as a primary step for prostate volume estimation. We examine various DL architectures, including traditional U-Net modifications and innovative designs incorporating residual connections, multi-directional image data, and attention mechanisms. Additionally, we discuss pre-processing methods to enhance image quality, the integration of shape information, and strategies to improve the consistency and robustness of DL models. The effectiveness of these techniques is evaluated through metrics such as Dice Similarity Coefficient, Jaccard Index, and Hausdorff Distance. The review highlights the potential of DL in improving prostate volume estimation accuracy and reducing clinical workload, while also identifying areas for future research to enhance model performance and generalizability.

Prenatal diagnosis of clubfoot traditionally relied on two-dimensional ultrasonography. To enhance diagnosis and predict postnatal outcomes, we examined the parameters that differentiate pathological clubfoot using three-dimensional ultrasonography. In our retrospective study, we examined the findings of prenatal ultrasound and the postnatal outcomes of pregnancies with suspected congenital clubfoot between 2018 and 2021. Based on the three-dimensional perspective, we measured the angles of varus, equinus, calcaneopedal block and forefoot adduction and compared the sonographic variables between the postnatal treated and non-treated groups. We evaluated 31 pregnancies (47 feet) with suspected clubfoot using three-dimensional ultrasonography. After delivery, a total of 37 feet (78.7%) underwent treatment involving serial casting only or additional Achilles tenotomy. The treated group showed significantly greater hindfoot varus deviation (60.5° vs. 46.6°, p=0.026) and calcaneopedal block deviation (65.6° vs. 26.6°, p <0.05) compared to the non-treated group. The calcaneopedal block had an area under the curve of 0.98 with a diagnostic threshold of 46.2 degrees (sensitivity of 97%, specificity of 90%, positive predictive value of 97%, and negative predictive value of 90%). During prenatal evaluation of clubfoot using three-dimensional ultrasonography, the calcaneopedal block deviation has the potential to predict postnatal treatment.

Lung ultrasound (LUS) allows the detection of a series of manifestations of COVID-19 such as B lines and consolidations. The objective of this work was to study the inter-rater reliability (IRR) when detecting signs associated with COVID-19 in the LUS, as well as the impact of performing the test in the longitudinal or transverse orientation. 33 physicians with advanced experience in LUS, independently evaluated ultrasound videos previously acquired with the ULTRACOV system of 20 patients with confirmed COVID-19. In each patient, 24 videos of 3 seconds were acquired (using 12 positions with the probe in longitudinal and transverse orientations). Physicians had no information about the patients or other previous evaluations. The score assigned to each acquisition followed the convention applied in previous studies. A substantial IRR was found in the cases of normal LUS (κ = 0.74), only a fair IRR for the presence of individual B lines (κ = 0.36) and for confluent B lines occupying <50% (κ = 0.26), and a moderate IRR in consolidations and B-lines >50% (κ = 0.50). No statistically significant differences between the longitudinal and transverse scans were found. The IRR in LUS of COVID-19 patients may benefit from more standardization of the clinical protocols.

The migration of gallstones from the gallbladder into the gastrointestinal tract has been recognized for over 100 years. The most common way gallstone reaches the digestive tract is through a fistula between the gallbladder and the duodenum. Large stones become impacted in the duodenum and result in gastric outlet obstruction (Bouveret's syndrome). In this report, we present a 81-years old patient with the cholecystoduodenal fistula, which was diagnosed by ultrasound and computed tomography and effectively surgically managed. Even Bouveret syndrome is rare, with a timely diagnosis followed with an appropriate treatment maybe we could decrease morbidity and mortality rates of this complication.

Background The falsification of food products is a practice that has always been with mankind. Initially, it stemmed from the need to satisfy basic needs, and then from the desire for profit, at the expense of the health and sometimes the lives of consumers. Today, food safety issues are becoming a priority in consumers' daily lives. It is estimated that one in four food products is falsified. Man has lost the ability to naturally identify healthy food. He has therefore begun to prioritise the speed and ease of its preparation at the expense, often of health. The techniques currently available for detecting falsification are inaccessible to the ordinary consumer. The technique proposed by the authors is the beginning of a publicly available method for detecting falsification. Scope and approach Currently, instrumental or sensory methods are used to assess the authenticity, and therefore identification, of foods. The former are expensive and time-consuming and the latter are unobjective. The authors proposed a method using ultrasound with parameters that are neutral to the material to be tested. The technique allows results to be obtained in times measured in microseconds without destroying the material under test, saving costs. Three differently weighted groups of beers were used for the study. These were industrial, regional and domestic beers. Main findings and conclusions The results of the study indicate that the ultrasonic method is useful for the non-destructive identification of industrial and regional beers, which are produced using different technologies and differ in composition. The method analysed was not suitable for separating homebrew beers from other types of beer.

(1) Background: adnexal masses during pregnancy detection are increased due to the use of first trimester screening and to advanced maternal age. Although the low risk of malignancy, other risks are associated: torsion, rupture or labour obstruction. Correct diagnosis and management are fundamental to guarantee both maternal and fetal safety. Adnexal masses may be troublesome to classify during pregnancy due to the increase in the uterus volume and to pregnancy-related hormonal changes. Management should be based on ultrasound examination to provide the best treatment. (2) Methods: the aim was to describe the ultrasound features of ovarian masses detected during pregnancy. We evaluated patient’s management, perinatal outcomes and follow-up. (3) Results: our study demonstrated that the management should be guided by an accurate ultrasound examination performed by an expert operator according to standardized techniques. Secondly, our results confirm the data present in the literature: the masses are most frequently benign, ultrasound follow-up is the best management strategy and obstetric outcome is not considerably affected. (4) Conclusions: the management of patients with ovarian masses detected during pregnancy should be based on ultrasound examination and a centralization in referral centers for ovarian masses should be considered.

The hawthorn fruit, a member of the Rosaceae family, is a medicinal plant with numerous therapeutic properties. It exhibits a wide range of variants, with Crataegus tanacetifolia being Turkey's most widely recognized species. The hawthorn fruit has various biological activities, including anti-inflammatory, antibacterial, antioxidant, immune-modulating, and anti-carcinogenic properties. Vinegar was produced from the hawthorn fruit and the techniques of pasteurization and ultrasound were employed to enhance the antioxidant capabilities and extend the shelf life. A total of 56 mature Wistar-Albino rats were allocated into seven groups and administered hawthorn fruit vinegar via oral gavage on a daily basis. The experimental groups were classified as pasteurized (HVP) and ultrasound (HVU) treated, with two different dosage levels (0.5 and 1 mg/kg), and a control group consisting of regular vinegar. The SOD, MDA, and CAT antioxidant levels were measured using the ELISA method in plasma and liver tissue samples. The total cholesterol, triglyceride, HDL, LDL, AST, and ALT values were quantified in commercially available kits. The levels of SOD and CAT in the plasma and liver were found to be significantly higher in the HVU1 group. In a manner akin to those mentioned, the HVU1 cohort exhibited the highest HDL value. The levels of LDL were comparably low in both the thermal pasteurized and ultrasound treatment groups. This finding agrees with HDL levels and is statistically significant (p≤0.05). There were significant expressions of both CAT and SOD in HVU groups in liver tissues immunohistochemically. The possible therapeutic effects of hawthorn vinegar may boost its antioxidant capabilities and contribute to an overall improvement in quality of life.

Objectives- We prospectively analyzed children with acute chest pain and clinical suspicion of pneumothorax (PNX) evaluated at the pediatric Emergency Department. Methods- After clinical examination and before Chest X-Ray, children underwent LUS to evaluate the presence of PNX. We enrolled 70 children, 13 (18,57%) received a final diagnosis of PNX. Results- In all 13 (100%) patients LUS showed the “bar-code sign”, the absence of lung sliding and the absence of B lines while in 12 (92,3%) there was the lung point, giving a diagnosis of PNX. All cases had PNX features on CXR. The “bar-code sign”, the absence of lung sliding and the absence of B lines had a sensitivity of 100% and a specificity of 100%. The “bar-code sign” had a positive predictive value of 100% and a negative predictive value of 100% for the detection of PNX. Conclusions- LUS is highly accurate in detecting or excluding pneumothorax in children with acute chest pain evaluated in the pediatric emergency department.

The popularity of handheld devices for point-of-care ultrasound (POCUS) has increased in recent years due to their portability and cost-effectiveness. However, POCUS has the drawback of lower imaging quality compared to conventional ultrasound, because of hardware limitations. Improving the quality of POCUS through post-image processing would therefore be beneficial, with deep learning approaches showing promise in this regard. This review investigates the state-of-the-art progress of image enhancement using deep learning suitable for POCUS applications. A systematic search was conducted from January 2024 to February 2024 on PubMed and Scopus. From the 457 articles that were found, the full text was retrieved for 69 articles. From this selection, 15 articles were identified addressing multiple quality enhancement aspects. A disparity in the baseline performance of the low-quality input images was seen across these studies, ranging between 8.65–29.24 dB for the Peak Signal-to-Noise Ratio (PSNR) and 0.03-0.71 for the Structural Similarity Index Measure (SSIM). In six studies, where both PSNR and the SSIM metrics were reported for the baseline and the generated images a mean difference of 6.60 (SD ± 2.99) and 0.28 (SD ± 0.15) was observed for the PSNR and SSIM, respectively. The reported performances demonstrate the potential of deep-learning-based image enhancement for POCUS. However, variability in the extent of performance gain across datasets and articles was notable, and the heterogeneity across articles makes quantifying the exact improvements challenging.

This paper investigates the use of contactless power ultrasonic excitation to decrease the electrical impedance of the weld in laser welding. The literature extensively documents the impact of em-ploying contact power ultrasonic excitation on the microstructure morphology and refinement of grain in the weld. This study involves characterizing an industrial High Power Ultrasound Transducer (HPUT) by determining the optimal distance and angle for contactless excitation of the fusion zone in the weld, aiming to achieve the maximum amplitude. Subsequently, the transducer is integrated into the laser welding system, resulting in the creation of an ultrasonic-assisted welding system. To find the improvement due to the contactless vibration assistance, the welding area was char-acterised by an impedance ohmmeter device. The results indicate an approximately 6 % im-provement in the welding quality in terms of the impedance value, an important parameter for battery pack welding. In response to the issue of overheating in the industrial transducer during prolonged welding operations, an alternative transducer was proposed to overcome this challenge. Further investigations are carried out by the alternative transducer to find the effect of different wave types, namely, shear and compressional waves, on the welding quality. The contact vibration can excite the plate approximately 50 times higher in acceleration amplitude than contactless ex-citation. Nevertheless, enhancements of 10% and 6% are observed in the impedance value when utilising compressional and shear waves, respectively, as compared to the results obtained with contactless vibration.

This study describes the efficient synthesis of five dinitrochalcones (DNCH) using an ultrasonic bath as an unconventional method to improve reaction yields and reduce reaction times. The Claisen-Schmidt condensation of nitroacetophenones and nitrobenzaldehydes was carried out in a cyclohexane-methanol solvent system under ultrasonic irradiation, achieving yields between 56% and 92%. The application of ultrasound not only accelerated the reaction but also improved the overall efficiency compared to conventional methods such as magnetic stirring. Characterization of the synthesized compounds was performed by NMR spectroscopy, confirming the consistency of their structures. Thus, it is confirmed that obtaining DNCH with a nitro group in ortho provide by ultrasonic irradiation is an energetically efficient and environmentally friendly alternative.

Background: Objective quantitative texture characteristics may be helpful in salivary glandular tumor differential diagnosis. This study uses machine learning (ML) to explore and validate the performance of ultrasound (US) texture features in diagnosing salivary glandular tumors. Material and methods: 122 patients with salivary glandular tumors, including 71 benign and 51 malignant tumors, are enrolled. A representative brightness mode US pictures are selected for further Gray Level Co-occurrence Matrix (GLCM) texture analysis. We use t-test to test the significance and use receiver operating characteristic curve method to fund optimal cut-point for these significant features. After splitting 80% data into training set and 20% data into testing set, we use five machine learning models k-nearest Neighbors (kNN), Naïve Bayes, Logistic regression, Artificial Neural Networks (ANN) and supportive vector machine (SVM) to explore and validate the performance of US GLCM texture features in diagnosing salivary glandular tumors. Results: This study includes 49 female and 73 male patients, with a mean age of 53 years old, ranging from 21 to 93. We find that six GLCM texture features (contrast, inverse difference movement, entropy, dissimilarity, inverse difference and difference entropy) are significantly different between benign from malignant tumors (p<0.05). On ML, the overall accuracy rates are 74.3% (95%CI: 59.8-88.8%), 94.3% (86.6-100%), 72% (54-89%), 84% (69.5-97.3%) and 73.5% (58.7-88.4%) for kNN, Naïve Bayes, Logistic regression, one node ANN and SVM, respectively. Conclusion: US texture analysis with ML has potential as an objective and valuable tool for assessment of salivary gland tumors.

Ultrasound (US) scans of the inferior vena cava (IVC) provide useful information on the volume status of a patient. However, their investigation is user-dependent and prone to measurement errors. An important technical problem is the objective difficulty in studying a very compliant blood vessel like IVC, which makes large respirophasic movements and shows a complicated three dimensional geometry. Using bi-dimensional (2D) B-mode views either in long or short axis has improved the characterization of IVC dynamics compared to a measurement along a single direction (M-mode). However, specific movements of the IVC can challenge also the information provided by these 2D sections. Thus, these two orthogonal views, provided by an US system in X-plane, are here integrated by an innovative method. It is tested on simulated videos of the IVC performing complicated movements, that are compensated by the new method, overcoming the biased measurements provided by 2D scans. The method is then applied on example experimental data.

The increasing attendance of paediatric emergency departments becomes a serious health issue. To reduce an elevated burden of medical errors, inevitably caused by high level of stress exerted on emergency physicians, we propose potential areas for improvement in regular paediatric emergency departments. In effort to guarantee demanded quality of care to all incoming patients, the workflow in paediatric emergency departments should be sufficiently optimized. The key component remains implementing one of the validated paediatric triage systems upon patient's arrival at emergency department and fast-tracking patients with low level of risk according to the triage system. To ensure the patient's safety, emergency physicians should follow issued guidelines. Cognitive aids, such as well-designed checklists, posters or flow charts, generally improve physicians' adherence to guidelines and should be therefore available in every paediatric emergency department. To sharpen diagnostic accuracy, the use of ultrasound in paediatric emergency department, according to ultrasound protocols, should be targeted to answer specific clinical questions. Combining all mentioned improvements might reduce number of errors linked with overcrowding. The review serves not only as a blueprint for modernizing paediatric emergency departments, but also as a bin of useful literature which can be suitable in the paediatric emergency field.

Ultrasound is a well-known tool to produce thermal and non-thermal effects on cells and tissues. These effects require a correct application of ultrasound in terms of localization and acoustic energy delivered. This article describes a new device that combines ultrasound and Dry Needling treatments. The ultrasound transducer can rotate in 3D space mechanically to align itself in the direction of the needle. The transducer electronically focuses the acoustic pressure automatically on the needle tip and its surroundings. A computer, using graphical interface software, controls the angulation of the array and the focus position.

Cardiomyopathy is the leading cause of morbidity and mortality among all complications of type 2 diabetes (T2D) and obese patients. Diabetic cardiomyopathy (DC) is characterized by changes in cardiac morphology with declines in both systolic and diastolic functions. No rodent models fully captured phenotypes of DC. The ZDSD rat, a new generation of T2D rat model with intact leptin signaling features with slow onset of diabetes and obesity, which closely mimics the development of the disease in patients. Age-matched male ZDSD and SD rats were monitored for blood pressure, glucose and cardiac function using echocardiography. Animals were also challenged with 1 mg/kg dobutamine for the assessment of cardiac reserve. ZDSD rats developed hypertension from age of 18 weeks with blood pressure significantly higher than controls. At resting state, ZDSD rats showed biphasic changes in left ventricular posterior wall thickness and cavity volume. Concomitantly, both ejection fraction (EF) and transmitral E/A ratio of LV declined at 34 weeks old. Upon treatment with dobutamine, ZDSD lost cardiac contractility. Therefore, ZDSD rats may serve as a suitable preclinical model to study potential therapeutic approaches to treat cardiomyopathy with presence of metabolic syndromes.

We used an ultrasensitive, broadband optomechanical ultrasound sensor to study the acoustic signals produced by pressurized nitrogen escaping from a variety of small syringes. Harmonically related jet tones extending into the MHz region were observed for a certain range of flow (i.e., Reynolds number), in qualitative agreement with historical studies on gas jets emitted from pipes/orifices of much larger dimensions. For higher turbulent flow rates, we observed broadband ultrasonic emission in the ~ 0 – 5 MHz range, likely limited on the upper end by attenuation in air. These observations are made possible by the broadband, ultrasensitive response (for air-coupled ultrasound) of our optomechanical devices. Aside from their theoretical interest, our results could have practical implications for the non-contact monitoring and detection of early-stage leaks in pressured fluid systems.

Imaging of the ocular vasculature can provide new insights into the pathophysiology of ocular diseases. This study proposes a novel high-frequency super-resolution ultrasound localization microscopy (SRULM) technique and evaluates its ability to measure in vivo perfusion changes in the rat eye at elevated intraocular pressure (IOP). A 38.4 MHz center frequency linear array transducer on a VisualSonics Vevo F2 imaging platform was used to collect high frame rate (1 kHz) radiofrequency data of the posterior rat eye following systemic microbubble contrast injection. Following clutter and spatiotemporal non-local means filtering, individual microbubbles were localized and tracked. The microbubble tracks were accumulated over 10,000 frames to generate vascular images quantifying perfusion velocity and direction. Experiments were performed using physiologic relevant controlled flow states for algorithm validation and subsequently performed in vivo on the rat eye at 10 mm Hg IOP increments from 10 to 60 mm Hg. The posterior vasculature of the rat eye, including the ophthalmic artery, long posterior ciliary arteries and their branches, central retinal artery and retinal arterioles and venules were successfully visualized, and velocities quantified at each IOP level. Significant reductions in arterial flow were measured as IOP was elevated. High-frequency SRULM can be used to visualize and quantify perfusion velocity of the rat eye in both the retrobulbar and intraocular vasculature simultaneously. The ability to detect ocular perfusion changes throughout the depth of the eye may help elucidate the role ischemia has in the pathophysiology of ocular diseases such as glaucoma.

This study addresses the challenge of dispersing disinfectant liquids for sanitizing people, indoor spaces, vehicles, and outdoor areas. Fine aerosol sprays with a large surface area of particles are considered the most promising solution for such tasks. The study identifies shortcomings in current spraying methods and highlights the potential of ultrasonic liquid atomization for improving disinfection processes. Innovative specialized ultrasonic atomizers are introduced, capable of producing aerosols with the required droplet size and efficiency from disinfectant liquids of varying viscosities, including those containing silver nanoparticles.

Rehabilitation from musculoskeletal injuries focuses on reestablishing and monitoring muscle activation patterns to accurately produce force. The aim of this study is to explore the use of a novel low-powered wearable distributed Simultaneous Musculoskeletal Assessment with Real-Time Ultrasound (SMART-US) device to predict force during an isometric squat task. Participants (N=5) performed maximum isometric squats under two medical imaging techniques; clinical musculoskeletal motion mode (m-mode) ultrasound on the dominant vastus lateralis and SMART-US sensors placed on the rectus femoris, vastus lateralis, medial hamstring, and vastus medialis. Ultrasound features were extracted, and a linear ridge regression model was used to predict ground reaction force. The performance of ultrasound features to predict measured force was tested using either the Clinical M-mode, SMART-US sensors on the vastus lateralis (SMART-US: VL), rectus femoris (SMART-US: RF), medial hamstring (SMART-US: MH), and vastus medialis (SMART-US: VMO) or utilized all four SMART-US sensors (Distributed SMART-US). Model training showed that the Clinical M-mode and the Distributed SMART-US model were both significantly different from the SMART-US: VL, SMART-US: MH, SMART-US:RF, and SMART-US:VMO models (p<0.05). Model validation showed that the Distributed SMART-US model had an R² of 0.80 ±0.04 and was significantly different from SMART-US: VL but not from the Clinical M-mode model. In conclusion, a novel wearable distributed SMART-US system can predict ground reaction force using machine learning, demonstrating the feasibility of wearable ultrasound imaging for ground reaction force estimation.

Background: clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by the application of long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid healing of the tendon after surgery has been documented, but the aspect regarding tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescent previously treated for clubfoot have been described in the literature. Since rupture is a rare event in this age group a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon, in patients treated for clubfoot, between patients treated with casting alone and the ones who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: 22 asymptomatic patients, (34 feet) median age 12 years, previously treated for clubfoot, were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: a greater thickness and structural alterations with presence of hypoechoic areas of the operated tendons compared to those treated with plaster alone were observed (p value: 0.0498 and

Lignocellulosic biomass, an abundant and renewable resource, serves as a crucial raw material for the production of biofuels, biochemicals, and various value-added products. This paper aims to develop and optimize a mild alkaline treatment of sawdust assisted by ultrasound, along with enzymatic hydrolysis of the pretreated material. The sonochemical pretreatment with alkali emerged as the optimal approach to enhance the susceptibility of cellulose to subsequent enzymatic hydrolysis, thereby increasing the yield of reducing sugars. A comparative study was performed using various ultrasonic applicators (horn and bath) and conventional assisted alkaline pretreatment. The ultrasonic assisted pretreatment revealed a higher delignification as 68% (horn) and 57% (bath) comparing with conventional pretreatment. Processes were optimized using a statistical analysis based on a 23 factorial design. The ratio between sawdust and alkanine solution (RSL = 0.5–1.5 g/100 mL), US amplitude (A = 20–60%), and working temperature (t = 30–50 °C) were selected as process factors. The optimal operating conditions to maximize the reducing sugar yield (138.15 mg GE /gsubstrate) were found as following: solid/liquid ratio RSL,opt = 1.25 g/100 mL, US amplitude Aopt = 60%, and and pretreatment temperature topt = 50 °C. The overall outcomes clearly confirmed the intensification of delignification by ultrasound assisted alkaline pretreatment

Endobronchial Ultrasound has been widely used in the lymph node staging of lung tumors and the diagnosis of mediastinal diseases. In the last decades this procedure has evolved in several technical aspects, with new tools available to optimize the tissue sampling and to increase the diagnostic yield, like elastography, different types of needles and, most recently, miniforceps and cryobiopsy. Then, also the indications for EBUS have extended beyond the thoracic boundaries to sample lesions of the liver, left adrenal gland and retroperitoneal lymph nodes via the gastroesophageal tract. In this review we will analyze the actual indication of EBUS, even the more unusual, to underline the multiple use of EBUS in clinical practise.

Osteoarthritis of the hand (HOA) is one of the most common musculoskeletal diseases affecting health. Osteophytes, documented by imaging procedures are often used as diagnostic criteria. The gold standard is the radiographic image, however, more sensitive and saver methods such as ultrasound are gaining in importance. We investigated the prevalence, grade and pattern of osteophytes by high resolution ultrasound investigation (US) in a population-based cross-sectional study. Factory workers were recruited at work. 26 finger joints of each participant were examined with US with grading the occurrence of osteophytes in a semiquantitative score ranging 0-3, increasing scores indicated larger osteophytes. 427 participants (mean age 53.5 years, range. 20-79 years) were investigated, resulting in 11,000 scored joints. At least one osteophyte was found in 4,546/11,000 (41.3%) joints or 426/427 (99.8%) participants but grade 2 or 3 osteophytes were seen in only 553 (5.0%) joints. The number of os-teophyte sum score increased with age (0.18/year of age increase, p<0.001). Distal interphalange-al joints (DIP) were predominantly affected with 61%, followed by proximal interphalangeal joints (PIP) with 48%, carpometacarpal joint 1 (CMC1) with 39% and metacarpophalangeal joints (MCP) with 16%. In conclusion, US is a feasible screening tool for osteophytes and HOA. Grade 1 osteophytes are a common finding in the working population when assessed by ultrasound and their prevalence is increasing with age. Prevalence of grade 2 or 3 osteophytes is less common and reflects clini-cal presence of HOA. Follow up investigations are necessary to recognize the predictive rele-vance of early osteophytes.

Identified by the eponym “Edwards’ Syndrome,” trisomy 18 (T18) represents the second most common autosomal trisomy after T21. The pathophysiology underlying the extra chromosome 18 is a nondisjunction error, mainly linked with the advanced maternal age. More frequent in female fetuses, the syndrome portends high mortality, reaching a rate of 80% of miscarriages or stillbirths. The three-step evaluation includes first trimester screening for fetal aneuploidy using a combination of maternal age, fetal nuchal translucency thickness, fetal heart rate and maternal serum free ß-hCG and PAPP-A; followed by the research for fragments of fetal DNA in maternal blood; and, finally, invasive techniques leave to the established diagnosis. Starting with the first trimester scan, selected ultrasound findings should be investigated to define not only the impact of the genetic problem on the fetus, but also to address the prenatal counselling. Previous series underline that T18 is not uniformly lethal. An active dialogue on the choices in the management of infants with T18 has emerged, sustained by the transition from the comfort care to the intervention attitude. Survival rates for individuals with supposedly fatal conditions have increased. In this novel scenario, an ad hoc counselling is pivotal. To support it, a comparative analysis by pictorial assays between ultrasound and autopsy findings could be beneficial. We provide an illustrative tool from a clinical case managed in early second trimester, with the purpose to strive a balanced approach in the hard choice faced by couples of fetuses with T18.

The current Covid-19 pandemic has hugely disrupted the delivery of routine and established medical care. Patients can develop a wide range of clinical signs and symptoms from a cough and fever to severe respiratory failure. There is an ongoing argument on a concise investigative pathway to ensure the safety of all healthcare workers. The stethoscope can help with any clinical respiratory assessment but the risk of cross infection is high. Computer tomography should not be routinely performed. There is a potential place for lung ultrasound but outcomes are not yet determined.

Speckle noise reduction is an important area of research in the field of ultrasound image processing. Several algorithms for speckle noise characterization and analysis have been recently proposed in the area. Synthetic ultrasound images can play a key role in noise evaluation methods as they can be used to generate a variety of speckle noise models under different interpolation and sampling schemes, and can also provide valuable ground truth data for estimating the accuracy of the chosen methods. However, not much work has been done in the area of modelling synthetic ultrasound images, and in simulating speckle noise generation to get images that are as close as possible to real ultrasound images. An important aspect of simulated synthetic ultrasound images is the requirement for extensive quality assessment for ensuring that they have the texture characteristics and gray-tone features of real images. This paper presents texture feature analysis of synthetic ultrasound images using local binary patterns (LBP) and demonstrates the usefulness of a set of LBP features for image quality assessment. Experimental results presented in the paper clearly show how these features could provide an accurate quality metric that correlates very well with subjective evaluations performed by clinical experts.

The superharmonic imaging of tissue has the potential for high spatial and contrast resolutions, compared to the fundamental and second harmonic imaging. For this technique, the spectral bandwidth of an ultrasound transducer is divided for transmission of ultrasound and reception of its superharmonics (i.e., higher than the second harmonic). Due to the spectral division for the transmission and reception, transmitted ultrasound energy is not sufficient to induce superharmonics in media without using contrast agents, and it is difficult that a transducer has a -6-dB fractional bandwidth of higher than 100%. For the superharmonic imaging of tissue, thus, multi-frequency array transducers are the best choice if available; transmit and receive elements are separate and have different center frequencies. However, the construction of a multi-frequency transducer for intravascular ultrasound (IVUS) imaging is particularly demanding because of its small size of less than 1 mm. Here, we report a recently developed dual-element focused IVUS transducer for the third harmonic imaging of tissue, which consists of a 35-MHz element for ultrasound transmission and a 105-MHz element for third harmonic reception. For high quality third harmonic imaging, both elements were fabricated to have the same focus at 2.5 mm. The results of tissue mimicking phantom tests demonstrated that the third harmonic images produced by the developed transducer had higher spatial resolution and deeper imaging depth than the fundamental images.

Abstract INTRODUCTION: The objective of this study is to assess the diagnostic accuracy, reliability, and efficacy of elastosonography in the diagnosis of cesarean scar pregnancy. To this end, the present study will compare the elastosonography findings in patients with cesarean scar pregnancy with those obtained through definitive diagnostic methods and investigate the diagnostic potential of elastosonography. MATERIAL AND METHOD: This prospective cohort study was conducted at Mardin Training and Research Hospital between October 2023 and January 2024. Patients with a cesarean scar pregnancy between six and twelve weeks of gestation were evaluated. The stiffness and elasticity of the scar tissue were assessed using elastosonography, and the diagnostic accuracy of this method was evaluated by comparing the results with those obtained through definitive diagnostic procedures. RESULTS: In this study, the demographic and clinical characteristics of 61 patients with cesarean scar pregnancy (CSP) were analyzed. The mean age of the patients was 32 years, the mean gestational age was 8.4 weeks, the mean BMI was 27.2, the mean parity was 1.9, and the mean number of previous cesarean sections was 1.3. While the elasticity of the scar tissue decreased with increasing gestational week, no significant correlation was found between age, BMI, parity, and number of previous cesarean sections and elastosonography findings. The gestational sac strain ratio, myometrial shear wave velocity, and scar stiffness, as measured by elastosonography, were found to be significant in the diagnosis of CSP. Conversely, the beta-hCG and fetal heart rate parameters did not contribute significantly to the diagnosis. CONCLUSION: In conclusion, the results of this study indicate that elastosonography has the potential to serve as a diagnostic tool for the identification of pregnancies in cases of cesarean section scar. The findings indicate that elastosonographic parameters, including the gestational sac tension ratio, myometrium shear wave velocity, and scar stiffness, may prove useful in diagnosing pregnancy in a cesarean scar. Further research is required to ascertain the full clinical utility of this technique. However, this study provides valuable information on the diagnostic accuracy and reliability of elastosonography in the evaluation of pregnancy in a cesarean scar.

Hydrogen is a clean-burning fuel with water as its only by-product, yet its widespread adoption is hampered by logistical challenges. Liquid organic hydrogen carriers, such as alcohols from sustainable sources, can be converted to hydrogen through aqueous phase reforming (APR), a promising technology that bypasses the energy-intensive vaporization of feedstocks. However, the hydrothermal conditions of APR pose significant challenges to catalyst stability, which is crucial for its industrial deployment. This review focuses on the stability of catalysts in APR, particularly in sustaining hydrogen production over extended durations or multiple reaction cycles. Additionally, we explore the potential of ultrasound-assisted APR, where sonolysis enables hydrogen production without external heating. Although the technological readiness of ultrasound-assisted APR currently trails behind thermal APR, the development of catalysts optimized for ultrasound use may unlock new possibilities in the efficient hydrogen production from alcohols.

(1) Background: LUS has emerged as a simple, rapid and non-invasive method for the dynamic assessment of pulmonary congestion, a major prognostic factor and a therapeutic target in AHF. (2) Methods: In the single-center prospective observational study, 42 patients hospitalized for AHF in the post-emergency polyvalent medicine department of CHU Grenoble were successively included between May 2021 and July 2022. Clinical examination, LUS and electrolyte panel results were collected daily. Vital status was assessed 30 days after the last LUS. The primary endpoint was the evolution of the number of B-lines according to the dose of diuretic administered ; (3) Results: We performed 188 LUS. Our patients were elderly (85.8 [SD 8.1]) and comorbid. The median number of B-lines decreased from 17 at admission to 7 in the middle of the hospital stay, then stagnated until discharge. Simultaneously, the median dose of diuretics, initially stable at a maximum of 40 mg/d IV, decreased to 20mg/d IV by the end of hospital stay. Patients with CKD had a higher mean number of B-lines at entry (24.2 [SD 11.6]) compared to those without CKD (8.2 [SD 8.8]). However, the evolution of B-lines number was independent of creatinine levels. 30-day all-causes mortality was significantly related to the number of B-lines at discharge (15.2 [SD 10.1] in deceased patients versus 3.9 [SD 5.4] in living patients, p

Considering the age of the dogs, it was expected that elderly animals would have stiffer thyroids than adults. The aim of this study was to evaluate the thyroid glands of healthy dogs using 2D shear wave elastography in order to establish qualitative and quantitative parameters of tissue stiffness in dogs of different age groups. The B-mode ultrasound and elastography findings were correlated with the weight and sex of the patients, allowing a reference range to be established for different groups of dogs. 31 dogs of different breeds, sexes and sizes were evaluated. Animals with clinical signs or ultrasound findings indicative of endocrine disease or thyroid lesions were not included in the study. Using QelaXtoTM 2D software, shear wave velocity data in m/s and color elastograms were evaluated and calculated. A healthy thyroid has a blue color elastogram, indicative of low stiffness, and there was no distinction between adult and elderly dogs, genders or sizes. The reference range for the shear wave velocity of thyroid tissue assessed by 2D shear wave elastography can be between 1.6 and 2.0 m/s with a variation of ±0.889 in adult and elderly dogs.

Background: According to EWGSOP2, the diagnosis of sarcopenia is confirmed when in addition to low muscle strength, low muscle quantity or quality is present. Echo intensity (EI) determined by muscle ultrasound (US) has been proposed as an efficient method for the assessment of muscle quality. The effect of changing various US parameter settings on EI remains unclear. Therefore, the aim of this study was to assess the differences between EI values obtained by adjusting parameter settings over their entire range in a sample of middle-aged healthy subjects. Methods: Thirty-two repeated US scans of rectus femoris (RF) and rectus abdominis (RA) muscles were taken in eight men and three women with a portable Mindray M7 premium US machine, working in an Extended field-of-view, B-Mode setup, equipped with a linear 5.0-10.0 MHz transducer. The following US parameters and settings were fixed: gain 60dB, depth 6.5cm, and frequency 10 MHz. Readily adjustable parameters were dynamic range (DR), gray map (GM), line density, persistence, and IClear. A default setting DR65 was chosen as the reference setting. For each of the parameters, the settings of one single parameter of interest was changed over its entire range following a standardized protocol. The EI values were calculated using the open-source software ImageJ. Repeated measures analyses were performed to evaluate the effect of parameter settings on EI. Linear interpolation was used to determine non-significant ranges across a given parameter. Results: For the RF muscle, the EI values were significantly different across DR (p<0.001), GM (p<0.001), and IClear (p<0.001). Post hoc analysis confirmed the differences within these three settings. Echo intensity values within the range of DR55 to DR80 were not significantly different. For the RA muscle, the EI values were significantly different across DR (p=0.004) and GM (p=0.030). Post hoc pairwise comparisons revealed no significant difference with the default setting, except for DR150 (p=0.042). Conclusion: We showed that EI values differ across the DR and GM range, especially in the RF. We suggest using a DR setting within its midrange to minimize the effect of machine setting-dependent factors on EI values. These findings reconfirm the need for standardization of ultrasound echo intensity settings when applied for diagnostic purposes of muscle quality.

This study aims to explore the applicability of an innovative cervical tactile ultrasound approach for predicting spontaneous preterm birth (sPTB). Eligible participants were women with low-risk singleton pregnancies in their second trimester, enrolled in this prospective observational study. A Cervix Monitor (CM) device was designed with a vaginal probe comprising four tactile sensors and a single ultrasound transducer operating at 5 MHz. The probe enabled the application of controllable pressure to the external cervical surface, facilitating the acquisition of stress-strain data from both anterior and posterior cervical sectors. These data were used to calculate cervical elasticity, as a stress-to-strain ratio. CM examination data were analyzed for 127 women at 24 - 28 gestational weeks. PTB was observed in 6.3% (8 out of 127) of the cases. The preterm group exhibited a lower average cervical stress-to-strain ratio (elasticity) of 0.70±0.26 kPa/mm compared to the term group's 1.63±0.65 kPa/mm, with a significant p-value of 1.1×10-4. Diagnostic accuracy for predicting spontaneous preterm birth based solely on cervical elasticity data was found to be 95.0% (95% CI, 88.5–100.0). These findings suggest that measuring cervical elasticity with the designed tactile ultrasound probe could potentially predict spontaneous preterm birth in a cost-effective manner.

(1) Background: Patella and achilles tendon injuries have become increasingly prevalent due to an increasingly active population. These injuries can cause significant dysfunction which is especially true for elite athletes. Standard B-Mode ultrasound has been useful in the diagnosis of these injuries, however, only to a limited extent. Shear wave elastography (SWE) can aid in evaluation by objectively measuring tissue stiffness. Prior studies have proven shear wave values can be used to evaluate tendon tissue noting differences in healthy versus pathologic tendons. One main limitation remains a lack of normative data for specific tendon tissues which we aim to address in this study; (2) Methods: A cross-sectional study of healthy volunteers aged 18-65 without lower extremity injury was evaluated using A Samsung RS85 Prestige ultrasound machine with a 14L-2 MHz transducer. Shear wave values were collected in a standardized manner for the patellar tendon at one location, as well as the achilles tendon at the midportion and insertional areas; (3) Results: Data for 54 healthy adult patellar and achilles tendons was collected bilaterally. The mean SWE average of the patellar tendon (P1-P3) for all subjects was 96.3 +/- 10.9 kPA. A higher BMI was correlated with a decrease in patella tendon kPA and the mean PT1 was higher for males compared to females (adjusted mean 96.4 kPA for males and 88.5 kPA for females, mean difference = 7.9 kPA; P = 0.009). The mean SWE average of the insertional Achilles (AT1-AT3) for all subjects was 101.7 +/-16.2 kPA and for the midportion achilles (MTP1-MTP5) was 145.6 +/- 18.8 kPA. There was a decrease in kPA for insertional Achilles measurements in those with a higher BMI, but this did not reach statistical significance (p=.12); (4) Conclusion: This study provides normative SWE values for the patella and achilles tendon using the Samsung RS85. These values can be used for comparison to pathological tissue by means of the same examination protocol to better understand tendon degeneration. Further studies are warranted as to how SWE can be applied to the diagnosis of tendinopathy, partial and full-thickness tears, and response to treatment.

The 22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal microdeletion disorder caused by hemizygous microdeletion of the long arm of chromosome 22. It is now known to have a heterogenous presentation that includes multiple additional congenital anomalies and later-onset conditions, such as gastrointestinal and renal abnormalities, autoimmune disease, variable cognitive delays, behavioral phenotypes and psychiatric illness. The purpose of our paper is to present the case of a fetus diagnosed with a rare and complex cardiac malformation (interrupted aortic arch (IAA) type B, large malalignment-type ventricular septal defect (VSD), pulmonary valve dysplasia, aberrant right subclavian artery (ARSA). The result of the genetic testing revealed 22q11.2 deletion and after genetic counselling the patient decided to continue the pregnancy. She was regularly followed until delivery which took place in Germany so that neonatal cardiac surgery could be performed in an experienced center for cardiac malformations. We emphasize on the ultrasound aspects regarding the cardiac anomaly and specific features of 22q11.2DS in a continuous manner from diagnosis until delivery.

Introduction and Objective: Caudal block has been used in children for many years and is considered the gold standard for multimodal analgesia in the pediatric age group. Caudal block belongs to the category of central neuraxial blocks, which can provide both visceral and somatic analgesia. With the introduction of ultrasound into the clinical practice of anaesthesia, the caudal block is now performed under USG guidance. In our study, we aimed to compare the efficacy of a single caudal block in postoperative acute pain management, the need for additional analgesics, the incidence of side effects, the timing of initial analgesic administration, and the need for rescue analgesic administration (paracetamol 10 mg/kg) in circumcision surgery. Materials and Methods: 120 patients undergoing circumcision surgery were divided into 3 groups. The caudal block was performed in all cases under USG guidance. Only the caudal block was applied for cases in the Caudal group (Group C). The Caudal + paracetamol group (Group CP) received paracetamol 10 mg/kg intravenously (i.v.) and the caudal block. Patients in the Caudal + meperidine group (Group CM) received 1 mg/kg meperidine intravenously. The caudal block was performed in each case with a 0.5 ml/kg volume of 0.125% bupivacaine. Results: As a result of our study, it was found that the least postoperative pain occurred in 12.50% of the CM group (p=0.011). Significant results were obtained when weight and age variables were analyzed according to the groups (p-values p=0.011 and p=0.003, respectively). Significant differences were found between the input pulse values, 5-minute pulse values, 15-minute pulse values, and input SpO2 values (p values p < 0.001, p < 0.001, p=0.011, p=0.037, respectively). Only Wong-Baker pain scores at the 24th hour differed significantly from the periods measured after the groups (p < 0.001). There was no significant difference between the FLACC and Wong-Baker pain scores in the other periods. There was no difference between the groups regarding the time when postoperative analgesics were administered and the total amount of analgesics administered (rescue analgesic 10 mg/kg oral paracetamol) (p=0.408, p=0.238). Conclusion: Caudal block can be safely applied during circumcision. Ultrasound guidance increases the chances of success and reduces the complication rate. Caudal block can be safely used in pediatric surgery since it does not cause serious complications, has low postoperative pain scores, and reduces the number of postoperative analgesics.

Background: Globally, about 3.5 billion people are affected by intestinal parasitic infections (IPIs). This study aimed to investigate the effects of IPIs on intestinal wall thickness and its potential association with hypertension in different genders. Methods: A total of 108 subjects, including 83 consecutive patients with symptomatic and laboratory-confirmed IPIs (male = 48; female = 35) and 25 healthy controls (male = 10; female = 15), were recruited. B-mode ultrasound grayscale and color images of the duodenum and colon were obtained with and without water contrast. Results: Patients with IPIs had a tendency towards greater duodenal wall thickness (DUOTHICK = 0.88 ± 0.73 cm) compared to controls (0.595 ± 0.089 cm), p = 0.056. Patients with IPIs also had significantly greater ascending colon wall thickness (ASCTHICK = 1.076 ± 0.29 cm) and descending colon wall thickness (DSCTHICK = 1.175 ± 0.366 cm) compared to controls (ASCTHICK = 0.6015 ± 0.1607 cm, DSCTHICK = 0.6223 ± 0.135 cm), p < 0.05. Men over 50 years had greater DSCTHICK (1.25 ± 0.434 cm) than post-menopausal women (0.986 ± 0.389 cm), p < 0.05. DSCTHICK significantly predicted diastolic blood pressure (β = -0.295, p < .05) and blood sodium level (β = -0.300, p < .05). Conclusion: We demonstrated the effects of IPIs on the intestinal microbiome causing intestinal wall cytoskeletal dysfunction, which led to the development of a "leaky gut syndrome."

Background: Endoscopic Ultrasound (EUS) is widely used for the diagnosis of bilio-pancreatic and gastrointestinal (GI) tract diseases, for the evaluation of subepithelial lesions, and for sampling of lymph nodes and solid masses lo-cated next to the GI tract. The role of Artificial Intelligence in healthcare in growing. This review aimed to provide an overview of the current state of AI in EUS from imaging to pathological diagnosis and training. Methods: AI algorithms can assist in lesion detection and characterization in EUS by analysing EUS images and identifying suspicious areas that may require further clinical evaluation or biopsy sampling. Deep learning tech-niques, such as convolutional neural networks (CNNs), have shown great potential for tumour identification and subepithelial lesion (SEL) evaluation by extracting important features from EUS images and using them to classify or segment the images. Results: AI models with new features can increase the accuracy of diagnoses, provide faster diagnoses, identify subtle differences in disease presentation that may be missed by human eyes, and provide more information and in-sights into disease pathology. Conclusions: The integration of AI in EUS images and biopsies has the potential to improve the diagnostic accura-cy, leading to better patient outcomes and to a reduction of repeated procedures in case of non-diagnostic biopsies.

This paper develops the study of the effect of powerful ultrasound on the laser breakdown of liquids and a comparative study of the possibilities of acoustic and optical diagnostics of breakdown. The method of laser-induced breakdown spectroscopy (LIBS) for elemental analysis of liquids, along with high efficiency, continues to be less sensitive compared to traditional chemical methods. The paper develops a method of using additional ultrasound irradiation of the laser breakdown area in order to increase the efficiency of LIBS. Using the developed technique, spectral lines of chemical elements such as potassium, manganese, sodium, calcium, etc. were obtained for the first time depending on the frequency and power of ultrasound. It is shown that a sharp increase in the intensity of spectral lines of elements in water during laser breakdown is observed in the field of high-power ultrasound. It indicates an increase in the sensitivity of the combined method of ultrasonic LIBS. Along with the optical spectrum, the spectral and energy characteristics of acoustic emission were studied. An automated complex for hydrophysical and spectral studies is described, which was tested in the Sea of Japan during the voyage No. 81 of the research vessel RV "Professor Gagarinsky" in August 2022.

In recent years, lung ultrasound (LUS) has been increasingly used for the diagnosis of respiratory diseases in both adult and pediatric patients. However, asthma is a field in which the use of LUS is not yet well defined or is in development. In the following case series, we describe clinical, laboratory, radiological results as well as detailed lung ultrasound findings of 6 children with asthma: some of them with acute asthma attack and with inadequately controlled allergic asthma or childhood asthma; others with acute asthma and allergic or infantile asthma adequately controlled by preventive therapy. Finally we describe the clinical, laboratory and imaging parameters of a child with severe allergic asthma in the absence of exacerbation. In these cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up. It also showed different ultrasound features depending on the severity of the individual asthma based on the type of asthmatic phenotype and control of it.

Ultrasound has become widely used as a mean to measure the rectus femoris muscle in the acute and chronic phase of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, we created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for training of various health care providers in vitro and vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.

Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection have become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also evaluate the grade of malignancy. Pooling the data of the studies which compared the PNENs grading between EUS-FNA samples and surgical specimen, the concordance rate was 77.5% (κ-statistic: 0.65, 95% confidence interval = 0.59 - 0.71, P< 0.01). EUS is a particularly important modality for the treatment of PNENs.

Amyloidosis is due to deposition of an excessive amount of protein in many parenchymal tissues, including myocardium. The onset of cardiac Amyloidosis (CA) is an inauspicious prognostic factor, that can lead to sudden death. We retrospectively analyzed 135 patients with systemic amyloidosis, admitted to our ward between 1981 and 2019. Among them, 54 patients (46.30% F / 53.70% M, age 63.95±12.82 years) presented CA at baseline. In 53 patients, there was associated with multiorgan involvement, while in one there was primary myocardial deposition. As control group, we enrolled 81 patients (49.30% F / 50.70% M, aged 58.33±15.65) who did not meet the criteria for CA. In 44/54 of patients CA was associated with AL, 5/54 with AA, 3/54 of patients with ATTR, in 1/54 AL was related to hemodialysis and 1/54 to Gel-Amyloidosis. The most common AL type was IgG (28/44); less frequent forms were either IgA (7/40) or IgD (2/40), while seven patients had a λ free light chain form. The 32 AL with complete Ig were 31 λ-chain and just one k-chain. CA patients presented normal BP (SBP 118.0±8.4 mmHg; DBP 73.8±4.9 mmHg), while those with nCA had increased proteinuria (p=0.02). TnI and NT-proBNP were significantly increased compared to nCA (p= 0.031 and p=0.047, respectively). In CA patients we found an increased LDH compared to nCA (p=0.0011). CA patients were also found to have an increased interventricular septum thickness compared to nCA (p=0.002), a decreased Ejection Fraction % (p=0.0018) and Doppler velocity E/e’ ratio (p=0.0095). Moreover, CA patients were seen to have an enhanced right atrium area (p=0.0179), right ventricle basal diameter (p= 0.0112) and wall thickness (p=0.0471) as compared to nCA, as well as an increased inferior cava vein diameter (p=0.0495). TAPSE was the method chosen to evaluate systolic function of the right heart. In CA subjects very poor TAPSE levels were found compared to nCA patients (p=0.0495). Additionally, we found a significant positive correlation between TAPSE and lymphocyte count (r=0.47; p=0.031) as well as Gamma globulins (r=0.43, p=0.033), Monoclonal component (r=0.72; p=0.047) and IgG values (r=0.62, p=0.018). On the contrary, a significant negative correlation with LDH (r=-0.57, p=0.005), IVS (r=-0.51, p=0.008) and diastolic function evaluated as E/e’ (r=-0.60, p=0.003) were verified. CA patients had very poor survival compared to controls (30 vs. 66 months in CA vs nCA, respectively, P=0.15). Mean survival of CA individuals was worse also when stratified according to NT-proBNP levels, using 2500 pg/mL as class boundary (174 vs. 5.5 months, for patients with lower vs higher values than the median, respectively p=0.013). In much the same way, decreased right heart systolic function was correlated with a worse prognosis (18.0 months median survival, not reached in subjects with lower values than 18mm, p=0.0186). Finally, our data highlight the potential prognostic and predictive value of right heart alterations characterizing amyloidosis, as a novel clinical parameter correlated to increased LDH and immunoglobulins levels. Overall, we confirm the clinical relevance of cardiac involvement and propose that right heart evaluation may be considered as a new marker for clinical risk stratification in patients with amyloidosis.

Zinc oxide is one of the most important semiconductor metal oxides and one of the most promising n-type materials, but its practical use is limited because of both its high thermal conductivity and its low electrical conductivity. Numerous studies have shown that doping with metals in ZnO structures leads to the modification of the band gap energy. In this work, Al-doped ZnO, Ni-doped ZnO, and undoped ZnO nanocrystalline powders were prepared by sol-gel method coupled with ultrasound irradiation. The doping concentration in ZnO was 1.0 at.% of Al and Ni. Influence of Al³⁺ and Ni²⁺ ions in the ZnO network are explored in this paper. X-ray Diffraction (XRD), Raman Spectroscopy, Nitrogen Adsorption (BET method), X-Ray Fluorescence (XRF) and Field Emission Scanning Electron Microscopy (FESEM) analyses demonstrated the incorporation of metal ions (aluminum and nickel) into the ZnO wurtzite structure. The crystallite size of the sample was decreased from 24.5 nm (ZnO) to 22.0 nm (ZnO-Al) and 21 nm (ZnO-Ni).

ChatGPT, a state-of-the-art AI model created by OpenAI, is renowned for its ability to produce text responses that closely mimic human communication. Recently, it has broadened its scope to encompass multimodal interactions, rendering it particularly advantageous for medical applications. In this paper, we explore into the potential of ChatGPT in the realm of Ultrasound (US) imaging, Our investigation encompasses a series of case studies and examples, each tailored to demonstrate ChatGPT’s application in various aspects of US imaging. These include emphasizing its capacity for intricate analyses, including grayscale texture examination and perfusion metrics in contrast-enhanced ultrasound (CEUS). Moreover, its involvement in real-time imaging guidance, its role in streamlining workflow efficiencies, and its utility in the simplification of medical report generation to facilitate better patient communication. The case studies, while successful, unveil certain limitations and challenges, prominently featuring concerns regarding privacy and technical constraints. Despite these challenges, the evidence gathered from our examples indicates that ChatGPT's innovative features and its ability to operate across multiple modes significantly enhance the efficiency of quantitative image analysis in US imaging. By improving diagnostic precision and potentially elevating patient care outcomes, ChatGPT marks a significant stride forward in healthcare technology, though it necessitates careful consideration of its associated ethical and technical challenges.

Summary Introduction: The psoas muscle index (PMI) and the skeletal mass index (SMI), as determined by computed tomography (CT), are the reference methods for assessing muscle mass. An alternative method is to measure the area of the rectus femoris muscle using ultrasonography (US).Objective : The objective of this study is twofold: firstly, to assess whether ultrasound imaging of the rectus femoris has an adequate correlation with psoas muscle index (PMI) and skeletal mass index (SMI) measurements obtained from computed tomography (CT) scans of oncosurgical patients at the L3 level; and secondly, to establish a cut-off point for diagnosing low muscle mass using this ultrasound technique. Material and methods: A retrospective cross-sectional observational study was carried out on oncosurgical patients referred to the nutrition consultation of the General University Hospital of Castellón over a four-year period. Malnutrition was diagnosed according to the GLIM criteria, muscle mass was assessed by ultrasound using a Mindray device, and skeletal muscle index (SMI) and appendicular skeletal muscle mass (PMI) were measured by computed tomography at the third lumbar vertebra (L3). Patients lacking a CT scan or with a CT scan performed more than one month after the ultrasound examination were excluded. Results: The study cohort comprised 43 patients (31 males), with a mean age of 64.7 ± 6.72 years, a mean BMI of 23.7 ± 4.31 kg/m², and a mortality rate of 25.6%. Most of the evaluations were conducted post-surgically (65.1%), with a notable prevalence of radical cystectomy and hepatic surgery. A total of 53 ultrasound evaluations were conducted, with an average area of 2.96 cm² [2.47-4.2] and adipose tissue of 0.55 cm [0.1-0.99] *. Additionally, computed tomography (CT) scans were performed to assess skeletal muscle mass (SMM) using the SMI/height method, yielding an average area of 38.4 cm² [31.6- 54.7)The median values for the variables were as follows: 272 [207-390] HU,PMI area of 4.31 m² [3.71-5.94] * and 86 [69-103] * HU density in PMI. All data were expressed as median and interquartile range. The Pearson correlation coefficients between US and SMI/height, SMI/height and PMI/height, and US and PMI/height were 0.70, 0.750, and 0.548, respectively. All these coefficients were statistically significant (p < 0.001). Following the established criteria for low muscle mass for SMI (1) and PMI (2), a ROC curve analysis was conducted on US, with a cutoff point for low muscle mass of 3.6 cm² , AUC 0.770 with 70% and specificity 100%.Respect PMI , the cut-off was 3.29 cm 2 and the area under the curve was 0.609, with a sensitivity of 42.55% and a specificity of 100%. Conclusions: The results of this study indicate that there is a significant correlation between SMI, PMI, and the area in cm² measured by US in the rectus femoris according to the protocol of García-Almeida et al. (3). The positive correlation between ultrasound and computed tomography (CT) imaging in our sample, which yielded comparable results to those reported by (4), suggests that ultrasonography may serve as a viable alternative to CT for the detection of low muscle mass. This study is the first to establish a cutoff point for ultrasonography in comparison to SMI and PMI. Further studies are required, utilising a semi-automatic method to circumvent measurement bias and encompassing a larger patient cohort, in order to detect cutoff points pre- and post-surgery for cystectomy and hepatic surgery, as well as cutoff points by sex.

The Digital electronics collaborative enhanced learning (DECEL) project has recently developed an international collaborative education course. Its main objective is to enhance the digital electronics skills of international students by working on a complex, multidisciplinary applied problem using a mixed digital architecture. We have developed a logic level synthesis and dedicated software layers on the Red Pitaya FPGA platform. The diversity of digital concepts to be implemented, from hardware description language (HDL) to high-level languages such as Python or Matlab, forced the students to work together and rapidly improve their skills. Their motivation was fueled by the curiosity of controlling an ultrasound probe to obtain ultrasound signatures. This particular physics, little known to the students, was an additional source of curiosity. The goal of forming an image in a liquid medium was an additional motivating factor for them. The students reported that they learned a lot from the experiment. Thus, the technical parts and pedagogical results are documented in this work for reproducibility.

Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and con-sequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study is to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evalua-tion of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aim to demonstrate how MUS of RFT correlates better with the quality of life (Qol) in this population, likely because it enables the detection of regional quadriceps muscle sarcopenia, in comparison to the other mentioned methods. Methods: This is a prospective pilot study including 77 subjects (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA and RFT was measured by MUS. Moreover, Homeostasis Model Assessment of Insulin Resintance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was as-sessed using the Moorehead-Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p=0.001). Firstly, we observed positive correlation pre-surgery between HOMA and: RFT (r=0.27, p=0.02), iFFM (r=0.36, p=0.001), AMI (r=0.31, p=0.01) and dynamometer (r=0.26, p=0.02). In addition, we found correlation between RFT and iFFM (pre-surgical: r=0.31, p=0.01; post-surgical: r=0.25, p=0.05) and between RFT and lower extremities AMI post-surgical (r=0.27, p=0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p=0.001), but not with dynamometer (p=0.94). Finally, a tendency to a positive correlation between QoL question-naire and RFT post-surgery (r=0.23, p=0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS for the evaluation of SO and the follow-up after BS of these patients. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.

Whey protein was pretreated with multi-frequency ultrasound in mono, dual, and tri-frequency modes. The effect of multi-frequency ultrasound pretreatment on the hardness, chemical forces, and microstructure of acid-induced whey protein gel was investigated. Whey protein gels pretreated with dual and tri-frequency ultrasound showed higher hardness (p3.35 mm) in those samples were resisted to gastric digestion. Moreover, the tri-frequency ultrasound pretreatment of whey protein gel released the least free amino group during gastric digestion. In contrast, whey protein gel with the mono-frequency ultrasound pretreatment released the highest amount of free amino acid group during intestinal digestion. Findings from this study suggested that gel hardness and network density could modulate the digestion behaviors of protein gels.

: Shear-wave elastography (SWE) has become popular in clinical practice for many diseases.However, there are not adequate research for spleen-related diseases.This study aimed to investigate the potential of quantitative values obtained through SWE in evaluating spleen pathologies in the pediatric population and to demonstrate its perfomance to differentiate splenomegaly-related diseases.Research group retrospectively included children with pathological diagnoses related to spleen from November 2016 to April 2021 and they were categorized three groups as portal hypertension (PH), benign lymphoid hyperplasia (BLH), malignant infiltration (MI).Spleen sizes and parenchymal stiffness were also calculated for each group.Subsequently, mean spleen stiffness in each compared with normal values within the same age group.In total 2781 children (1379 children for study group, 1402 children for control group) were enrolled to the study.The highest stiffness were observed in the PH group, which is statistically higher than others (p&lt;0.05). Although the mean spleen stiffness in the group with BLH was higher than the control and MI group, the difference was not statistically significant (p=0.08).The mean stiffness in the group with MI was significantly lower than both the control group (p=0.005) and PH (p=0.01).In conclusion, using SWE in the differential diagnosis of etiologies causing splenomegaly, could make important contribution.

This study evaluated the hip joints of the giant anteater (Myrmecophaga tridactyla) through imaging and macroscopic analyses and proposed a surgical approach for arthrotomy procedures in this species. The study used four samples fixed in 10% formaldehyde and six thawed carcasses. Radiographic and ultrasound examinations and anatomical dissection allowed the proposal of a surgical approach for the hip joint. The radiographic evaluation occurred with frog-legged ventrodorsal and lateral projections, and the ultrasound enabled joint soft tissue assessment. The articular elements represented similar characteristics to other domestic species. Some anatomical particularities of muscle groups were the intermuscular septum between the tensor fasciae latae and superficial gluteus muscles at the level of the greater trochanter of the femur, which provides lateral access to the femoral head and neck more conservatively. In conclusion, the anatomical particularities of radiographic positioning, the clinical applications of joint ultrasound, and the arrangement of muscle groups must be considered when evaluating and surgically accessing the hip joint of the giant anteater.

This study explores the use of remote ultrasound vibration to enhance welding strength. It examines the effects of 20 kHz, and 40 kHz High Power Ultrasound Transducers (HPUT) in contact and contactless modes during ultrasonic assistance laser welding. Employing shear tests and microscopy for assessment, the research evaluates ultrasound's impact on welding strength and identifies the optimal transducer. Theoretical and numerical analyses investigate vibration transmission into the welding area, particularly examining the vibration distribution and cavitation initiation within the molten pool area. Results indicate that ultrasound-assisted welding increases pull test performance, including the resistance force and strain, and improves microscopic structural integrity. Numerical simulations suggest that narrow-band vibration intensifies pressure in specific welding zones. Contactless ultrasound application also shows enhanced welding quality, offering a promising alternative to current methods. This work contributes to electric car technology by suggesting improvements in welding techniques for power battery systems.

Background: Interstitial lung disease (ILD) is a frequent complication in systemic sclerosis (SSc). So, an increased awareness of this complication is a real need in the clinical setting, because it may affect the prognosis of patients. In particular, an accurate strategy is desirable in order to detect ILD in its stages. So, we investigate the validity of ultrasound (US) in detecting subclinical ILD in SSc, and to determine its potential in disease progression. Methods: 133 patients without respiratory symptoms and 133 healthy controls were included. Borg scale, Rodnan skin score (RSS), pulmonary auscultation, chest radiographs and respiratory function tests (RFT) were performed. An expert rheumatologist performed the lung US. High-resolution CT (HRCT) was also performed. After the baseline assessment, the patients were followed every 3 months for 12 months. Results: A total of 79 of 133 patients (59.4%) showed US signs of ILD in contrast to healthy controls (4.8%) (p=0.0001). The clinical and laboratory variables associated with ILD were anti-centromere antibodies (p=0.005) and RSS (p=0.004). A positive correlation was demonstrated between the US and HRCT findings (p=0.001). Sensitivity and specificity of US in detecting ILD was 91.2% and 88.6% respectively. A good inter-observer reliability was observed (k = 0.72). In the follow-up, a total of 30 patients out of 79 (37.9%) who demonstrated US signs of ILD at baseline, showed changes in the ILD score by US. Conclusions: US showed a high prevalence of subclinical ILD in SSc patients. It demonstrated to be a valid, reliable and feasible tool to detect ILD in SSc and to monitoring the disease progression.

Cervical cancer remains a major public health problem. Despite the screening programs, cervical cancer is the second most commonly diagnosed cancer. Most of the cases occur in less developed countries, and it is the third leading cause of cancer death among females. In 2000–2007, the five-year relative survival rate for European women diagnosed with cervical cancer was 62%.[1] Standard treatment for locally advanced cervical cancer reveals external beam radiotherapy (EBRT) with concurrent chemotherapy followed by image-guided adaptive brachytherapy (IGABT) boost [2, 3]. In the last years, the Gynaecological (GYN) working group composed of Group Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) has developed new recommendations for the treatment of cervical cancer based on IGABT. The treatment plan includes 3-dimensional (3D) imaging based on magnetic resonance imaging (MRI) or computed tomography (CT), adaptive to the target volume and organ at risk [4–6]. The brachytherapy insertion is made under anaesthesia. At the time of the application insertion, the ultrasound is used to guide the dilatation of the uterine canal and assess the depth of the uterine cavity. In this paper, we review the data available in international literature about the use of ultrasound (US) in brachytherapy treatment of cervical cancer.

The purpose of the present study was to develop an experimental model for studying of the intra-articular knee movements depending on the work of the knee joint and applied muscle groups in isometric stretching conditions with different tens. The experimental procedure includes ultrasound examination of a knee joint after isometric stretching of healthy men (n=32). The changes in millimeters of the distances between the femur and tibia were measured with ultrasound sonographer at three stages. The first stage was performed on ten (n=10) healthy men at five different sitting and upright positions. In the second and third experimental model stages the lower limbs loading was on 22 participants. Our hypothesis which was confirmed, was that as a result of increasing extraloads on the participants back (2, 5, 10, 15, 17, 20 kg), a intra-articular decrease in the femur-tibia cartilage surface distance wiil be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model for the mechanical effects during deformation of the knee joint bone cartilage, as well as to outlines the some future tasks: increasing loading weights; enlarge participant groups; comparison men and women; healthy and pathology comparison.

The aim of this literature review was to present the novel imaging modalities elastography and contrast-enhanced ultrasonography. We provided an overview of the concepts and applications of each technique for the investigation of neoplastic and metastatic tumors in dogs and cats. Studies with elastography are based on the elasticity and deformation of the evaluated tissue. The information obtained from the different types of elastography can aid in the detection and differentiation of malignant and benign structures. Descriptions of elastographic studies in several organs and tissue in veterinary medicine reported that, in general, malignant tumors tend to be more rigid, and, therefore, less deformable than benign lesions or in comparison to the healthy parenchyma. Contrast-enhanced ultrasonography is based on the intravenous injection of contrast media constituted by microbubbles. This imaging modality can be performed in non-sedated animals and provides information on the tissue perfusion, allowing the investigation of macro- and micro-circulation. Studies with different organs and tissues were performed in dogs and cats and revealed a tendency of malignant tumors to present faster transit of the contrast media (time to wash-in, peak and wash-out). These advanced techniques can be associated with other imaging modalities, aiding important information to the well-established exams of B-mode and Doppler ultrasonography. They can be used as screening tests, potentially representing an alternative to the invasive sampling methods required for cytological and histopathological analysis.

Myofascial Pain Syndrome (MPS) is a prevalent chronic pain disorder characterized by myofascial trigger points (MTrPs). Current diagnosis relies on manual detection of MTrPs, which has low inter-rater reliability. This study aims to enhance diagnosis through machine learning (ML) and a combination of texture-features extracted from B-mode ultrasound (B-mode-US) images. Four texture-features were investigated: statistical-features, and their combination with Gabor, local binary (LBP), and SEGL, LBP + gray-level-co-occurrence-matrices + Edge for the classification of MTrPs on the B-mode-US images. B-mode-US images of trapezius muscles (n=90) were examined for MTrPs and healthy muscle. Three methods of LBP, SEGL, and Gabor were separately calculated for each B-mode-US image. Then, the statistical-features (e.g., entropy) were calculated over the B-mode-US images and those three methods. Seven Machine learning (ML) classifiers (e.g., neural network) with the calculated statistical-features were applied to discriminate MTrPs from healthy muscle. Additionally, traditional statistical analysis (i.e., ANOVA) was calculated between statistical-features within each method. The results indicated that the combination of statistical-features effectively discriminated between MTrPs and healthy muscles, based on traditional statistical analysis. However, ML classifiers struggled due to high variation and similar mean values among them. This discrepancy between them prompts further exploration of US texture-based automated ML for MTrPs diagnosis.

The decompensation trajectory check is a basic step to assess the clinical course and to plan future therapy in hospitalized patients with acute heart failure (ADHF). Due to the atypical presentation and clinical complexity, trajectory checks can be challenging in the oldest old patients with acute HF. Point of care ultrasound (POCUS) proved to be helpful in the clinical decision-making of patients with dyspnea, but no study has attempted to verify its effectiveness in predicting determinants of HF in-hospital worsening. In this single-center prospective study, we consecutively enrolled patients aged 75 or older hospitalized with acutely decompensated HF in a tertiary care hospital. All the patients underwent complete clinical examination, blood tests, and POCUS including Lung Ultrasound, Focused Cardiac Ultrasound, Pleural Effusion score (PEFs), and Inferior Vena Cava (IVC) assessment. Out of 184 patients hospitalized with ADHF enrolled in the study, sixty experienced HF in-hospital worsening. No differences were found among patients with HF worsening and controls in terms of age, gender, frailty, and left ventricular ejection fraction. By multivariable logistic analysis, total PEFs [aOR: 1.15 (CI95% 1.02– 1.33), p = 0.043], and IVC collapsibility [aOR: 0.90 (CI95% 0.83 – 0.95), p = 0.039] emerged as independent predictors of acute HF worsening after extensive adjustment for potential confounders.

This prospective study aimed to evaluate the ability of point-of-care Doppler ultrasound measurements of carotid-corrected flow time and changes in corrected carotid flow time (FTc) induced by volume expansion to predict fluid responsiveness in patients undergoing robot-assisted gynecological surgery in a modified head-down lithotomy position. FTc was measured using Doppler images of the common carotid artery before and after volume expansion. The stroke volume index at each time point was recorded using the MostCare instrument. Fluid responsiveness was defined as a stroke volume index ≥10% increase after volume expansion. Half (50%) of the 52 patients responded positively. The areas under the receiver operating characteristic curves measured to predict fluid responsiveness for the corrected carotid flow time and changes in the FTc were 0.82 [95% confidence interval:0.705–0.937; P &lt; 0.0001] and 0.67 (95% confidence interval:0.520–0.815; P &lt; 0.05), respectively. The optimal cut-off value for the FTc and the change in FTc were 356.5 ms and 19.5 ms, respectively. FTc is a more reliable predictor of fluid responsiveness than FTc induced by volume expansion in gynecological patients undergoing robot-assisted laparoscopic surgery in the modified head-down lithotomy position.

Breast cancer is the foremost common in women, and its early diagnosis will help treat and increase patients' survival. This review article aims to studies on recent findings of standard imaging techniques and their characteristics for breast cancer diagnosis and recent nanoparticles (NPs) which are used for breast cancer detection. Herein, The search was performed in the literature through scientific citation websites, including Google Scholar, PubMed, Scopus, and Web of Science until May 2023. A comprehensive study on different imaging modalities and NPs for breast cancer diagnosis is reviewed, and their successes, challenges, and limitations are discussed.

Background: We designed a prospective study of diagnostic accuracy which compared pelvic MRI and 3D-EAUS versus pelvic MRI alone in the preoperative evaluation and postoperative outcomes of patients with perianal fistulas. Methods: The sample size was 72 patients and was divided into two imaging groups. MRI alone was performed in the first group. Both MRI and 3D-EAUS were performed in a parallel fashion in the second group. Surgical exploration took place after two weeks and was the standard reference. Park’s classification, presence of a concomitant abscess or a secondary tract and location of the internal opening were recorded. All patients were re-evaluated for complete fistula healing and fecal incontinence six months postoperatively. All the collected data was subjected to statistical analysis. Results: Group MRI included 36 patients with 42 fistulas. Group MRI + 3D-EAUS included 36 patients with 46 fistulas. The adjusted sensitivity and negative predictive value were 1.00 for most fistula types in the group of combined imaging. The adjusted specificity improved on intersphincteric fistulas in the same group. The adjusted balanced accuracy improved on all fistula types, except for rectovaginal. The combination of imaging methods showed improved diagnostic accuracy only on the detection of a secondary tract. Healing rate at six months was 100%. Fecal incontinence at six months didn’t present a statistically significant difference between the two groups (Fisher's exact test p-value &gt; 0.9). Patients with complex perianal fistulas had a statistically significant higher probability to undergo a second surgery (x² test p-value=0.019). Conclusion: The combination of pelvic MRI and 3D-EAUS showed improved metrics of diagnostic accuracy and should be used in the preoperative evaluation of all patients with perianal fistulas, especially in those with complex type.

The COVID-19 pandemic has affected millions of people globally, with respiratory organs being strongly affected in individuals with comorbidities. Medical imaging-based diagnosis and prognosis have become increasingly popular in clinical settings for detecting COVID-19 lung infections. Among various medical imaging modalities, ultrasound stands out as a low-cost, mobile, and radiation-safe imaging technology. In this comprehensive review, we focus on AI-driven studies utilizing lung ultrasound (LUS) for COVID-19 detection and analysis. We provide a detailed overview of both publicly available and private LUS datasets and categorize the AI studies according to the dataset they used. Additionally, we systematically analyzed and tabulated the studies across various dimensions, including data preprocessing methods, AI models, cross-validation techniques, and evaluation metrics. In total, we reviewed 60 articles, 41 of which utilized public datasets, while the remaining employed private data. Our findings suggest that ultrasound-based AI studies for COVID-19 detection have great potential for clinical use, especially for children and pregnant women. Our review also provides a useful summary for future researchers and clinicians who may be interested in the field.

Ganoderic Acid (GA), a major bioactive compound isolated from an oriental medicinal mushroom, i.e. Ganoderma tsugae, has traditionally been found to have significant medicinal properties. As a result of GA's poor solubility in water, formulation poses several challenges. Additionally, the traditional method of administering it via alcohol always results in unfavorable patient side effects. In order to overcome these problems, Ganoderma Tsugae extracts obtained by ethanol extraction were encapsulated in nanodispersions by ultrasonic cavitation and solvent evaporation to maximise bioavailability. Resultant nanodispersions contained Ganoderic acid in a hydrophobic core with a mean particle size of no more than 200 nm and a very narrow particle distribution. An analysis of the interactions between the control variables and the process optimisation was conducted using the Response Surface Methodology (RSM). Based on the results of the experiment, it was found that the particle size of nanodispersions was influenced by the Hydrophilic-Lipophilic Balance (HLB) number and the evaporation temperature. Moreover, the physical stability of micellar systems is generally determined by the organic phase within them. Regarding formulation stability, the zeta average of the nanodispersions remained virtually unchanged in solutions with different pH levels and short-term storage (14 days) at room temperature. Overall, it has been demonstrated that Ganoderic acid nanodispersions can be efficiently generated by combining ultrasound cavitation and solvent evaporation.

The preparation of new materials based on starch for the development of biodegradable packaging is increasing, however, the poor properties of this biopolymer for this application causes an area of opportunities for the improvement of water vapour permeability (WVP), mechanical properties, thermal properties, hydrophilicity, water absorption, among others. Hence, starch has been combined with other polymers such as polyvinyl alcohol, which has shown an improvement in the mechanical properties of starch, also, the use of clays suggests that the properties of response to water can be improved. Therefore, in this work, the preparation and characterization of starch-PVA-nanoclay films prepared by solvent casting is reported. The results obtained suggest that the sonication of nanoclay is necessary to reach a good dispersion, which promotes a strong interaction among starch-PVA-nanoclay. In addition, the properties of WVP and mechanical properties of films improved with incorporation of nanoclay, the concentration of 0.5% w/v of nanoclay showed to be the best concentration due to concentrations of 1.0 and 1.5% w/v were poorer than 0.5% w/v. Accordingly, the successful incorporation of nanoclays into the matrix starch-PVA suggests that this material is a good candidate for use as packaging.

Coronavirus Disease 2019 (COVID-19) is the pandemic challenge of the last year. Cardiovascular involvement is one of the main characteristics of this disease. Due to endothelial damage, consequent phlogosis may increase a thrombosis risk. Cardiac injury may occur in different ways. However, an ischemic involvement of the cardiovascular system is rarely implied. In this regard, direct and indirect effects of COVID-19 are described. Nonetheless, the possible evaluation of the cardiovascular system may require different modalities. The cardiovascular evaluation may be different in emergency compared to critical care, requiring different tools for each setting. The aim of this review is to explore these modalities according to the different involvement of the cardiovascular system..

Abstract: Bacterial biofilms are highly resistant to antibiotics and have been implicated in the etiology of 60-80% of chronic microbial infections. We tested a novel combination of low intensity ultrasound and blue light against biofilm and planktonic bacteria. A laboratory prototype was built which produced both energies uniformly and coincidently from a single treatment head, impinging upon a 4.45 cm^2 target. To demonstrate proof of concept, Propionibacterium acnes biofilm was cultured on Millicell hanging inserts in 6-well plates. Hanging inserts with biofilm were treated in a custom exposure chamber designed to minimize unwanted ultrasound reflections. Coincident delivery of both energies demonstrated synergy over either alone, killing both stationary planktonic and biofilm cultures of P. acnes. Biofilm killing was dose dependent on exposure time (i.e. energy delivered). P. acnes biofilms were significantly reduced by the dual energy treatment (p<0.0001), with a >1 log10 reduction after a 5 min (9 J/cm^2) and >3 log10 reduction after a 30 min (54 J/cm^2) treatment (p<0.05). Mammalian cells were found unaffected by the treatment. Both the light and the ultrasound energies are at levels previously cleared by the FDA. Therefore, this combination treatment could be used as a safe, efficacious method to treat biofilm related syndromes.

Abstract We aim to describe the diagnosis and surgical management of urinary tract endometriosis (UTE). We detail current diagnostic tools including advanced transvaginal ultrasound, magnetic resonance imaging, and surgical diagnostic tools such as cystourethroscopy. While discussing surgical treatment options, we emphasize the importance of an interdisciplinary team, for complex cases that involve the urinary tract. While bladder DE is more straightforward in its surgical treatment, ureteral DE requires a high level of surgical skill. Specialists should be aware of the important entity of UTE due to the serious health implications for women. When UTE exists, it is important to work within a interdisciplinary radiological and surgical team.

We aimed to delineate cardiopulmonary interactions in acute bronchiolitis and to evaluate the capacity of a combined cardiopulmonary ultrasonography to predict the need for respiratory support. This was a prospective observational single-center study that includes infants < 12 month of age admitted to a hospital due to acute bronchiolitis. All the included patients under-went clinical, laboratory and cardiopulmonary ultrasonographic evaluation at the same time point within 24 hours of hospital admission. The existence of significant correlation between car-diac and respiratory parameters was the primary outcome. The association of different cardio-pulmonary variables with the need of respiratory support higher than O2, the length of stay hos-pitalization, the PICU stay, and the duration of respiratory support were a secondary outcome. We enrolled 112 infants (median age 1 (0.5-3) months; 62% males) hospitalized with acute bron-chiolitis. Increased values of the pulmonary variables (BROSJOD score, pCO2 and LUS) showed moderate correlations with NT-proBNP and all echocardiographic parameters indicative of pulmonary hypertension and myocardial dysfunction. Up to 36 (32%) infants required respira-tory support during the hospitalization. This group presented with higher lung ultrasound score (p<0.001), and increased values of Tei index (p<0.001) and pulmonary artery pressures (p<0.001). All the analyzed respiratory and cardiac variables showed moderate to strong correlations with the LOS hospitalization and the time of respiratory support. Lung ultrasound and echocardiog-raphy showed a moderate to strong predictive accuracy for the need of respiratory support in the ROC analysis, with AUC varying from 0.74 to 0.87. Conclusion: Those cases of bronchiolitis with a worse pulmonary status presented with a more impaired cardiac status. Cardiopulmonary ul-trasonography could be a good strategy to easily identify high-risk population for a complicated acute bronchiolitis hospitalization.

Breast cancer is among the most prevalent cancers in Indonesia. One of the methods for early detection of breast cancer is utilizing ultrasound images to classify breast conditions into normal, benign tumors, or cancer. The advent of deep learning technology facilitates the image analysis process, such as the use of Transfer Learning Convolutional Neural Networks (CNNs). Generally, CNN models require large and balanced datasets to perform well in classification tasks. However, medical datasets like breast ultrasound images tend to be limited and imbalanced. The Wasserstein GAN (WGAN) is a generative data augmentation method capable of producing synthetic images by learning the pattern of the distribution of real image data. The implementation of the Wasserstein distance results in the training process of WGAN demonstrating stability from epochs 3000, 2500, and 3000 out of a total of 5000 epochs. The quality of the synthetic images improves with an increasing number of training iterations. By using WGAN, all of the evaluation metrics of each classifier are increasing, with the best accuracy score is achieved by VGG16 model with 83.33% accuracy.

In recent years, the chemo-photodynamic combinational therapy has become increasingly popular in treating breast cancer. However, the limited accumulation of nanodrugs into tumor (less than 1% of injected dose) extremely impacts therapeutic efficacy. Herein, the photosensitizer Chlorin e6 (Ce6) and the chemotherapeutic drug rhein (Rhe) were self-assembled to form a carrier-free nanodrug (RC NPs) with good stability and high drug loading rate. Ultrasound (US) irradiation was applied to increase the permeability of tumor blood vessels thus greatly enhance the drug accumulation of RC NPs in tumor tissues. After uptake by tumor cells, Ce6 could produce a sig-nificant amount of reactive oxygen species (ROS) when exposed to laser irradiation, while rhein could inhibit tumor cell proliferation and affect mitochondrial membrane potential, inducing tumor cell apoptosis through the mitochondria-dependent apoptosis pathway, thus effectively realizing the combined effect of PDT and chemotherapy. Taken together, RC NPs have an enhanced EPR effect when exposed to US irradiation and exhibit better tumor suppression, which provides new insights into chemo-photodynamic combination treatment for clinical breast cancer.

Introduction Sepsis-associated encephalopathy (SAE) is common in sepsis and is linked to high mortality and impaired neurologic outcome. Brain ultrasonography (US), including transcranial Doppler (TCD) and transcranial color-coded duplex sonography (TCCS), is a non-invasive tool for cerebral monitoring and might be useful in sepsis. The aims of this review are: 1) to explore whether brain perfusion is altered in sepsis, 2) to determine the role of brain US in guiding resuscitation, and 3) its ability to predict neurological outcomes in septic patients. Materials and methods This scoping review adhered to the PRISMA-ScR protocol and JBI methodology. A comprehensive literature search was conducted across MEDLINE, Scopus, and Web of Science. The review included studies on adults with sepsis or septic shock in the ICU. Randomised controlled trials, clinical trials, observational studies and systematic reviews were included. All the data related to the review's key questions were extracted and charted independently by two authors. Results 625 articles were screened, and 34 were ultimately included after application of exclusion criteria. 85% of the studies were observational 15% were systematic reviews with or without meta-analysis. The studies primarily focused on cerebral blood flow (CBF) alterations in sepsis, reporting variable results. Findings showed variable cerebral autoregulation (CAR) impairment, with higher incidence in the early stages of sepsis and associations with poor neurological outcomes. However, while alterations in CAR and CBF are common in septic patients, their impact on neurological outcomes and mortality is not clear. Regarding resuscitation, only a paucity of studies were found and no conclusions can be drawn. Conclusions The current body of evidence has a poor grade, but it is possible to say that brain US can identify cerebral perfusions alterations. Its usage during resuscitation is feasible and warrants further investigations. Use of brain US during resuscitation and for prediction of outcome is not currently supported by evidence. Further studies on brain perfusion, acquisition of 2D images of parenchyma (TCCS) and application of a multimodal brain monitoring might be useful in these contexts.

A review discusses recent research findings spanning the last two decades concerning ultrasonic technologies applicable to the oil, gas, and coal sectors. Various experiments conducted in laboratories have demonstrated the efficacy, cost-effectiveness, and environmental friendliness of ultrasound in recovering and processing oil, bitumen, coal, and oil shale. Ultrasound enhances formation permeability, coal gas permeability, and oil viscosity, particularly when delivered in short, powerful pulses at medium frequencies. Combining ultrasound with traditional recovery methods has shown promising results, boosting recovery efficiency by up to 100%. At the same time, ultrasonic treatment reduces the use of traditional reagents, thereby reducing environmental pollution. Moreover, ultrasound treatment shows potential in tasks such as separating oil-water emulsions, desulfurization, dewaxing oil, coal enrichment, and extracting valuable metals from metal-bearing shales through hydrometallurgical leaching. However, widespread industrial implementation of ultrasonic technology necessitates further field and mathematical research.

A thorough understanding of the type and severity of cataracts is crucial for accurately estimating the optimal phacoemulsification energy. In preceding research efforts, an innovative clinical prototype known as the Eye Scan Ultrasound System (ESUS) was developed to facilitate the automated characterization of cataracts. To evaluate the effectiveness of the prototype as a medical tool, extensive data must be collected from several patients with and without cataracts. However, obtaining an adequate number of patients and data for training and testing machine learning models is challenging. To overcome this limitation, the authors implemented a simulated prototype model of the ESUS system, to augment the data. The proposed model encompasses the electric-to-acoustic signal conversion in the ultrasonic transducer, the wave propagation through the eye, and the subsequent acoustic-to-electric signal conversion. Electrical modelling of the transducer was done using a two-port network and the wave propagation was modelled by using the k-Wave MATLAB toolbox. This holistic modelling approach enabled the generation of synthetic data augmentation, presenting great similarity with real data. The synthetic data can then be employed together with real data for the purpose of cataract classification.

This review provides an overview of eXplainable AI (XAI) methods for oncological ultrasound image analysis and compares their performance evaluations. A systematic search of Medline Embase and Scopus between March 25 and April 14 2024 identified 17 studies describing 14 XAI methods, including visualization, semantics, example-based, and hybrid functions. These methods primarily provided specific, local, and post-hoc explanations. Performance evaluations focused on AI model performance, with limited assessment of explainability impact. Standardized evaluations incorporating clinical end-users are generally lacking. Enhanced XAI transparency may facilitate AI integration into clinical workflows. Future research should develop real-time methodologies and standardized quantitative evaluative metrics.

Background: Intracavitary contrast-enhanced ultrasound is widely accepted as a highly informative, safe and easily reproducible technique for diagnosis, treatment and follow- up of different pathologies of the biliary tree. Methods: This article reports the combined conclusions of personal experience with pictorial examples and literature review of applications for CEUS in intracavitary biliary scenarios. Different methodologies, choices of equipment, indications for the procedure and expected complications were identified and described from the authors’ own experience as well as from a review of published studies with total of 208 patients for the period between 2009 and 2015. Results: Indications were biliary obstruction by various etiologies, including postoperative strictures, evaluation of the biliary tree of liver donors (n=12) and evaluation of localization of a drainage catheter. One of the studies found a statistically significant difference in the diagnostic accuracy of PTC and PUSC. Conclusion: Intracavitary CEUS brings all the positive features of US together with the virtues of contrast- enhanced imaging, proving comparable accuracy to the listed techniques for diagnostics of biliary tree diseases.

Deep eutectic solvents have emerged as a greener alternative and have attracted so much interest in the last two decades. This paper present alternative synthesis method to classical heating-stirring. The ultrasound method is one of the most promising syntheses DESs in terms of yield and energy. So, ultrasound synthesis method was studied to obtain hydrophobic (Aliquat 336: L-Menthol 3:7; Li-docaine: decanoic acid 1:2) and hydrophilic DESs based on Choline chloride and urea, ethylene glycol and oxalic acid. The physical characterization of DESs by comparison of FTIR spectra no show difference between DESs obtained by heating-stirring and ultrasound synthesis methods. The RMN spectra of the DESs obtained by heating-stirring revealed the DESs formation. Density and viscosity properties of DESs were evaluated. The density values are similar for both synthesis methods. However, lower viscosity values are obtained to the hydrophilic DESs prepared by ul-trasound methods.

This article aims to detect lung cavitations using lung ultrasound (LUS) in a cohort of patients with pulmonary tuberculosis (TB) and correlate the findings with chest computed tomography (CT) and chest x-ray (CXR) to obtain LUS diagnostic sensitivity. Patients with suspected TB were enrolled after being evaluated with CXR and chest CT. A blinded radiologist performed LUS within 3 days after the admission at the Infectious Diseases Department. Finally, 82 patients were enrolled in the study. BAL confirmed TB in 58/82 (71%). Chest CT showed pulmonary cavitations in 38/82 (43.6%; 32 TB patients and 6 non-TB ones), LUS in 15/82 (18.3%; 11 TB patients and 4 non-TB ones) and CXR in 27/82 (33%; 23 TB patients and 4 non-TB ones). Patients with multiple cavitations were 12 detected at CT and only 1 at LUS. LUS sensitivity was 39.5%, specificity 100%, PPV 100%, NPV 65.7%. CXR sensitivity was 68.4% and specificity 97.8%. No false positive cases were found. LUS sensitivity is rather low as many cavitated consolidations do not reach the pleural surface. Aerated cavitations could be detected with LUS with relative confidence, highlighting a thin air-crescent sign towards the pleural surface within a hypoechoic area of consolidation, easily distinguishable from dynamic or static air-bronchogram.

Catheter-based revascularization procedures developed as an alternative of systemic thrombolysis for patients at intermediate-high and high-risk pulmonary embolism. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow up. Secondary endpoints were short- and mid-term changes in echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate-high risk PE (86%), mostly female (57%), median age 66.5 years (IQR 56-74), and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036-7.7). RV echocardiographic parameters improved both at 24 hours and at follow up. In-hospital mortality was 3.9% (CI 95%, 1.08-9.74) while all-cause mortality was 11% (CI 95%, 5.4-19.2). Only 12% had bleeding complications, oh whom 4.9% were BARC 3. Preliminary results from USAT IH-PE registry showed low incidence of PH, improvement in RV function and a safe profile.

Femur length (FL) is a biometric measurement of ultrasound images used to identify the growth patterns and abnormalities of the foetus. Automatic segmentation of FL can improve the efficiency and convenience of inexperienced users. The femur region in a low-cost ultrasound image is a small area with low contrast intensity compared with the non-femur region. This study proposed a fully automated framework for segmenting and measuring the FL in a portable ultrasound image. We utilized statistical modeling, employing Gaussian mixture functions for thresholding to extract the femur area from the background. We also used the localizing region-based active contour method to segment the femur region accurately. We also proposed a refinement step in this framework to obtain a more accurate femur area in the ultrasound image. Because the length and position of the femur are the main factors affecting foetal biometric measurement accuracy, we not only evaluated segmentation results using region-based methods, such as sensitivity, specificity, and dice similarity. We also applied the FL measurement approach to evaluate the angle and length accuracy relative to the ground truth. In terms of region-based segmentation performance, the proposed method provided the best average performance with a sensitivity of 0.78, specificity of 0.87, and dice similarity of 0.81. For FL measurement performance, the proposed framework achieved an average angle accuracy of 0.99, distance accuracy of 0.88, and length accuracy of 0.93.

This paper presents the results of experiments on the study of a hydraulic fracture interaction with a preliminary created fracture that simulates a natural fracture. A distinctive feature of the conducted experiments is the ability to use an ultrasonic sounding to measure the fracture propagation and opening simultaneously with the fluid pore pressure measurements at the several points of the porous saturated sample. It allows to obtain the pressure distributions at various experiment stages and to establish a relation between the pore pressure distribution and the hydraulic fracture propagation and its interaction with macroscopic natural fracture. The possibilities of active ultrasonic monitoring have been expanded due to preliminary calibration experiments, which make it possible to estimate the fracture opening value by attenuation of ultrasonic pulses. The experiments show that the fracture propagation is limited by the natural fracture. This is caused by the hydraulic fracturing fluid leaks into the natural fracture, so both hydraulic fracture and natural fracture compose united hydraulic system.

Clinical management in neuro-oncology has changed to an integrative approach that incorporates molecular profile alongside histopathology and imaging findings. While the WHO guideline recommends genotyping of informative alterations as a routine clinical practice for central nervous system (CNS) tumors, acquisition of tumor tissue in the CNS is invasive and not always possible. Liquid biopsy is a non-invasive approach that provides the opportunity to capture the complex molecular heterogeneity of the whole tumor through detection of circulating tumor biomarkers in body fluids, such as blood or cerebrospinal fluid. Despite all the advantages, the low abundance of tumor-derived biomarkers, particularly in CNS tumors, as well as their short half-life has limited the application of liquid biopsy in clinical practice. Thus, it is crucial to identify factors that are associated with the presence of these biomarkers and explore possible strategies that can increase the shedding of these tumoral components into biological fluids. In this review, we first describe the clinical applications of liquid biopsy in CNS tumors including its roles in early detection of recurrence and monitoring of treatment response. We then discuss the utilization of imaging in identifying factors that affect the detection of circulating biomarkers as well as how image-guided interventions such as focused ultrasound can help enhance the presence of tumor biomarkers through blood-brain barrier disruption.

Pregnant women with diabetes often present impaired fetal growth, which is less common if maternal diabetes is well-controlled. However, developing strategies to estimate fetal body composition beyond fetal growth that could better predict metabolic complications later in life is essential. This study aimed to evaluate subcutaneous fat tissue (femur and humerus) in fetuses with normal growth among pregnant women with well-controlled diabetes using a reproducible 3D-ultrasound tool and offline TUI (Tomographic Ultrasound Imaging) analysis. Additionally, three artificial intelligence classifier models were trained and validated to assess the clinical utility of the fetal subcutaneous fat measurement. A significantly larger subcutaneous fat area was found in three-femur and two-humerus selected segments of fetuses from women with diabetes compared to the healthy pregnant control group. The full classifier model that includes subcutaneous fat measure, gestational age, fetal weight, fetal abdominal circumference, maternal body mass index, and fetal weight percentile as variables, showed the best performance, with a detection rate of 70%, considering a false positive rate of 10%, and a positive predictive value of 82%. These findings provide valuable insights into the impact of maternal diabetes on fetal subcutaneous fat tissue as a variable independent of fetal growth.