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Acoustic holographic lenses, also known as acoustic holograms, can change the phase of a transmitted wavefront in order to shape and construct complex ultrasound pressure fields, often for focusing the acoustic energy on a target region. These lenses have been proposed for transcranial focused ultrasound (tFUS) to create diffraction-limited focal zones that target specific brain regions while compensating for skull aberration. Holograms are currently designed using time-reversal approaches in full-wave time-domain numerical simulations. Such simulations need time-consuming computations, which severely limits the adoption of iterative optimization strategies. In the time-reversal method, the number and distribution of virtual sources can significantly influence the final sound field. Because of the computational constraints, predicting these effects and determining the optimal arrangement is challenging. This study introduces an efficient method for designing acoustic holograms using a volumetric holographic technique to generate focused fields inside the skull. The proposed method combines a modified mixed-domain method for ultrasonic propagation with a gradient descent iterative optimization algorithm. The findings are further validated in underwater experiments with a realistic 3D-printed skull phantom. This approach enables substantially faster holographic computation than previously reported techniques. The iterative process uses explicitly defined loss functions to bias the ultrasound field's optimization parameters to specific desired characteristics, such as axial resolution, transversal resolution, coverage, and focal region uniformity, while eliminating the uncertainty associated with virtual sources in time-reversal techniques. The proposed techniques enable more rapid hologram computation and more flexibility in tailoring ultrasound fields for specific therapeutic requirements. [ABSTRACT FROM AUTHOR]

We perform large-scale atomistic simulations of a system containing 12 × 106 atoms, comprising an oxygen gas-filled bubble immersed in water, to understand the stability and cavitation induced by ultrasound. First, we propose a method to construct a bubble/water system. For a given bubble radius, the pressure inside the bubble is estimated using the Young–Laplace equation. Then, this pressure is used as a reference for a constant temperature, constant pressure simulation of an oxygen system, enabling us to extract a sphere of oxygen gas and place it into a cavity within an equilibrated water box. This ensures that the Young–Laplace equation is satisfied and the bubble is stable in water. Second, this stable bubble is used for ultrasound-induced cavitation simulations. We demonstrate that under weak ultrasound excitation, the bubble undergoes stable cavitation, revealing various fluid velocity patterns, including the first-order velocity field and microstreaming. These fluid patterns emerge around the bubble on a nanometer scale within a few nanoseconds, a phenomenon challenging to observe experimentally. With stronger ultrasound intensities, the bubble expands significantly and then collapses violently. The gas core of the collapsed bubble, measuring 3–4 nm, exhibits starfish shapes with temperatures around 1500 K and pressures around 6000 bar. The simulation results are compared with those from Rayleigh–Plesset equation modeling, showing good agreement. Our simulations provide insights into the stability and cavitation of nanosized bubbles. [ABSTRACT FROM AUTHOR]

Acoustic holography (AH) is a technique with significant potential in realms, such as biomedicine, industry, and augmented reality. The implementation of acoustic holograms can be realized by a passive approach or active ones. Although the passive approach (by a 3D printer) can achieve high-quality acoustic field generation, it is constrained by high manufacturing costs and static field control. On the contrary, the active approach with a phased transducer array (PTA) as the latest technique stands out since it supports dynamic, flexible, and reconfigurable acoustic field generation. However, current PTA-based AH techniques face the drawback of inferior acoustic field fineness due to the Spatial Bandwidth Product (SBP) limit of PTA, which hinders the application of PTA in precise tasks, such as neural electrodes and microfluidics control. To address this issue, we propose a super-resolution acoustic holography (SRAH) method inspired by the concept of super-resolution in ultrasonic imaging and computer vision, by which we can generate acoustic fields reaching the physical diffraction limit of acoustic waves regardless SBP of PTA. In other words, this method enables high-SBP acoustic field generation with low-SBP PTA. The method is based on self-supervised learning, integrating a generative adversarial network and a physical model of acoustic wave propagation, specifically the linear accumulation method. Both simulation and experimental results demonstrate that the proposed method can generate high-fidelity acoustic fields suitable for intricate tasks with low-SBP PTA. Moreover, the performance of the algorithm improves as the target SBP increases. Therefore, the proposed SRAH method shows great potential for applications requiring elaborate manipulation. [ABSTRACT FROM AUTHOR]

Optical image stabilization (OIS) systems maintain the three-dimensional focal position of a lens through mechanical actuation systems. This paper examines an optical lens for OIS that utilizes ultrasound vibration to alter the focal position, not only in the depth direction but also in the radial direction. The lens has a simple structure with no mechanical moving parts and consists of an ultrasound transducer divided into four pieces, a glass disk, and a transparent viscoelastic gel film that functions as a lens. The acoustic radiation force generated by the resonant flexural vibration of the glass disk can alter the surface profile of the gel film, allowing for a variable-focus function. The concave and convex lenses can be interchanged using two resonant vibration modes: the standing-wave mode, in which the vibration loop appears at the center, and the traveling-wave mode, in which the vibration node appears at the center. The positions of ultrasound vibrations on the lens can be controlled in a two-dimensional plane by adjusting the driving amplitudes of each channel, thereby achieving focus control in the radial direction. The focusing characteristics of the lens are evaluated through ray-tracing simulation. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to investigate the effects of the level of contraction during isometric shoulder abduction at different abduction angles on muscle thickness and stiffness of the shoulder girdle in asymptomatic individuals. Design: Measurement properties study. Setting: Biomechanics and motion analysis lab. Participants: Twenty individuals volunteered to participate in this study. Main Outcome Measure: The subjects were tested for morphological and mechanical properties, expressed by thickness and stiffness of the supraspinatus tendon and muscle, and upper trapezius muscle. Moreover, acromiohumeral distance was also evaluated using B-mode ultrasound and shear-wave elastography. Intervention: The thickness and stiffness of the supraspinatus and upper trapezius muscle were assessed at 3 angles of abduction (0°, 60°, and 90°) and 3 levels of contraction (0%, 10%, and 20% of the maximal voluntary isometric contraction) using ultrasonography with shear-wave imaging. Moreover, the acromiohumeral distance was measured to establish the occupation ratio during passive movement. Results: The supraspinatus and upper trapezius muscle thickness and stiffness were significantly greater at 60° shoulder abduction compared with 0°, and 90° compared with 60°, as well as significantly greater at 20% maximal voluntary isometric contraction compared with 0% and 10% maximal voluntary isometric contraction. Thickness and stiffness were significantly greater in the supraspinatus compared with the upper trapezius muscle at all 3 angles of shoulder abduction for all 3 level of contractions. The acromiohumeral distance decreased significantly from 0° to 60° and from 60° to 90°. Conclusion: Morphological and mechanical properties of the supraspinatus and upper trapezius muscles depended on the relative level of muscle contraction and the angle of shoulder abduction. [ABSTRACT FROM AUTHOR]

The generation of acoustic vortex beams has garnered significant research interest in recent years due to their diverse applications, including acoustic communication, particle manipulation, and biomedical ultrasound. However, incorporating more vortices and expanding the capacity of these beams and related devices in three dimensions remain challenging. In this study, we propose a phase-constrained iterative angular spectrum method for fabricating a 3D-printed holographic lens capable of reconstructing multi-vortex acoustic beams within a 3D volume. To evaluate the performance of the proposed lens, we conduct tests using both numerical simulations and practical underwater measurements. Furthermore, we demonstrate the transfer of acoustic angular momentum to two absorbent acoustic objects, achieving rotation of these objects with the performance influenced by vortices at target positions. The results indicate that the proposed method can generate multiple acoustic vortex beams within a 3D volume. This capability enhances the effectiveness and versatility of various applications, such as the manipulation of three-dimensional objects and high-density information transmission. [ABSTRACT FROM AUTHOR]

Purpose: To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood. Method: Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48–70 MHz vascular ultrasound, and accelerometery. Results: Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (β = −6.6; 95% confidence interval, −12.5 to −0.7) and positively associated with left ventricular mass (β = 6.8; 1.4–12.3), radial intima-media thickness (β = 11.4; 5.4–17.5), brachial intima-media thickness (β = 8.0; 2.0–14.0), and femoral intima-media thickness (β = 1.3; 0.2–2.3). MVPA was inversely associated with body fat percentage (β = −3.4; −6.6 to −0.2), diastolic blood pressure (β = −0.05; −0.8 to −0.1), and femoral (β = −18.1; −32.4 to −0.8) and radial (β = −13.4; −24.0 to −2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations. Conclusions: In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood. [ABSTRACT FROM AUTHOR]

Cavitation in supercooled water has been induced by the short ultrasound pulses of an ultrasonic horn driven at 20 kHz. The cavitation during the ultrasonic pulses and occasionally the crystallization events thereafter have been imaged by a high-speed camera. The probability of ice crystallization in dependence on the pulse duration and temperature showed a high chance for the water to remain liquid if sufficiently short bursts of moderate acoustic power were applied. This regime has been used for the assessment of sonoluminescence (SL) from the generated cavitation bubbles in the supercooled liquid state. To this end, light emitting events were summed up over a number of ultrasonic pulses by an image intensifier. SL appeared mostly directly under the tip of the ultrasonic horn and sometimes also a few millimeters below the tip. The intensity of SL events showed a slight rise for a decrease in temperature, i.e., for an increase in supercooling. This behavior is in accord with the SL dependence on temperature above the freezing point and might be attributed to a further lowering of vapor pressure. An increase in the bubble collapse peak temperature for increased supercooling is calculated on the basis of spherical bubble model calculations, which supports the findings. The simulations predict further that the peak temperature will fall off again beyond a certain supercooling level. [ABSTRACT FROM AUTHOR]

The present work is dedicated to an experimental and theoretical study of an innovative underwater ultrasound source. The source works using a technique in which a pulsed power generator using the impedance mismatch of a long high-voltage coaxial cable generates a train of voltage impulses with a very high pulse repetition frequency of the order of a few MHz. Applying this train of voltage impulses to a pair of underwater electrodes generates a streamer-initiated breakdown of water and, subsequently, a plasma column connecting the electrodes over a very large inter-electrode gap of 55 mm. The interaction of the long plasma column thus formed with the surrounding water produces a rapidly expanding vapor bubble, an "instrument" producing a strong pressure wave with an overall energy efficiency of 24%, an order of magnitude higher than most underwater pressure sources reported in the literature. [ABSTRACT FROM AUTHOR]

Background: Local high-frequency percussive (HFP) massage has recently found widespread application in physical therapy. Although HFP massage reportedly improves range of motion (ROM), the mechanism underlying its action has not yet been proven. This study aimed to clarify whether a 5-minute percussive massage regimen affects muscular or connective tissues, such as the deep fascia and deep intermuscular fascia and the change in joint ROM. Method: The study sample was calculated using G*Power analysis program, and this study enrolled 15 healthy men who underwent 5-minute HFP massage to the medial gastrocnemius muscle. Shear-wave elastography was used to measure tissue stiffness in the deep fascia, muscle, and deep intermuscular fascia through shear-wave velocity as well as the ROM of the volunteers' ankle joint dorsiflexion before and after the HFP massage. A value of P < .05 was used to declare statistical significance, and post hoc was used to calculate the effect size using G*Power. Results: Shear-wave velocity revealed a significant change in the deep fascia (P = .003; shear-wave velocity: -0.7 m/s) and significant increase in ROM of ankle dorsiflexion (P = .002; increase in ROM: 3.0°) after 5 minutes of HFP massage. However, the muscle and deep intermuscular fascia did not exhibit any significant changes. Conclusions: HFP massage for 5 minutes modified the stiffness of the deep fascia and concurrently improved the ankle joint-dorsiflexion ROM. This method can be used as an intervention to decrease stiffness of the deep fascia and increase the ROM efficiently. [ABSTRACT FROM AUTHOR]

Context: Piriformis syndrome is often associated with muscle spasms and shortening of the piriformis muscle (PM). Physical therapy, including static stretching of the PM, is one of the treatments for this syndrome. However, the effective stretching position ofthe PM is unclear in vivo. This study aimed to determine the effective stretching positions of the PM using ultrasonic shear wave elastography. Design: Observational study. Methods: Twenty-one healthy young men (22.7 [2.41 y) participated in this study. The shear elastic modulus of the PM was measured at 12 stretching positions using shear wave elastography. Three of the 12 positions were tested with maximum internal rotation at 0°, 20°, or 40° hip adduction in 90° hip flexion. Nine of the 12 positions were tested with maximum external rotation at positions combined with 3 hip-flexion angles (70°, 90°, and 110°) and 3 hip-adduction angles (0°, 20°, and 40°). Results.' The shear elastic modulus of the PM was significantly higher in the order of 40°, 20°, and 0° of adduction and higher in external rotation than in internal rotation. The shear elastic modulus of the PM was significantly greater in combined 110° hip flexion and 40° adduction with maximum external rotation than in all other positions. Conclusion.- This study revealed that the position in which the PM was most stretched was maximum external rotation with 110° hip ftexion and 40° hip adduction. [ABSTRACT FROM AUTHOR]

Focused ultrasound has experimentally been found to enhance the diffusion of nanoparticles; our aim with this work is to study this effect closer using both experiments and non-equilibrium molecular dynamics. Measurements from single particle tracking of 40 nm polystyrene nanoparticles in an agarose hydrogel with and without focused ultrasound are presented and compared with a previous experimental study using 100 nm polystyrene nanoparticles. In both cases, we observed an increase in the mean square displacement during focused ultrasound treatment. We developed a coarse-grained non-equilibrium molecular dynamics model with an implicit solvent to investigate the increase in the mean square displacement and its frequency and amplitude dependencies. This model consists of polymer fibers and two sizes of nanoparticles, and the effect of the focused ultrasound was modeled as an external oscillating force field. A comparison between the simulation and experimental results shows similar mean square displacement trends, suggesting that the particle velocity is a significant contributor to the observed ultrasound-enhanced mean square displacement. The resulting diffusion coefficients from the model are compared to the diffusion equation for a two-time continuous time random walk. The model is found to have the same frequency dependency. At lower particle velocity amplitude values, the model has a quadratic relation with the particle velocity amplitude as described by the two-time continuous time random walk derived diffusion equation, but at higher amplitudes, the model deviates, and its diffusion coefficient reaches the non-hindered diffusion coefficient. This observation suggests that at higher ultrasound intensities in hydrogels, the non-hindered diffusion coefficient can be used. [ABSTRACT FROM AUTHOR]

Context: Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. Design: Cross-sectional study. Methods: The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. Results: Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC >.78 for the pectoralis musculature) and excellent (ICC >.94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, −22.8 to 252.5 kPa for the dominant arm [P =.039]). Mean pectoralis major and minor stiffness differences were not significant (P >.214). Conclusions: Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected. [ABSTRACT FROM AUTHOR]

Numerical simulations of the evolution of mobile and immobile dislocations in ceramics under applied pressure in dry pressing at a relatively low temperature are performed in order to study the possibility of production of all-dislocation-ceramics of solid electrolytes, which are expected to have extremely high ionic conductivity without dendrite formation because the diameter of a dislocation pipe is considerably larger than the distance between neighboring dislocations. The present numerical simulations are only for the densification process by plastic deformation of grains under high pressure under the assumption that the compaction of particles by their rearrangement is completed beforehand. By the plastic deformation, new dislocations are generated inside the grains. The required total dislocation density of about 1017 m−2 seems to be achievable under some conditions of dry pressing according to the present numerical simulations. Very short ultrasound irradiation at the beginning of the dry pressing sometimes considerably increases the dislocation density, while for other cases, it even considerably decreases the dislocation density due to enhanced annihilation of mobile dislocations by ultrasound. [ABSTRACT FROM AUTHOR]

A muscle's architecture, defined as the geometric arrangement of its fibers with respect to its mechanical line of action, impacts its abilities to produce force and shorten or lengthen under load. Ultrasound and other noninvasive imaging methods have contributed significantly to our understanding of these structure–function relationships. The goal of this work was to develop a MATLAB toolbox for tracking and mathematically representing muscle architecture at the fascicle scale, based on brightness-mode ultrasound imaging data. The MuscleUS_Toolbox allows user-performed segmentation of a region of interest and automated modeling of local fascicle orientation; calculation of streamlines between aponeuroses of origin and insertion; and quantification of fascicle length, pennation angle, and curvature. A method is described for optimizing the fascicle orientation modeling process, and the capabilities of the toolbox for quantifying and visualizing fascicle architecture are illustrated in the human tibialis anterior muscle. The toolbox is freely available. [ABSTRACT FROM AUTHOR]

An all-optical photoinduced lensing method is used to excite and monitor acoustic waves in liquids. Following optical absorption, the laser pulse induces a localized temperature gradient that launches pressure waves in the excited region at the nanosecond time scale. This generates a lens-like optical element in the sample. A probe laser beam senses the refractive index change due to the acoustic and thermal effects. Piezo-optic and thermo-optic coefficients govern how the refractive index of a material changes in response to mechanical stress and temperature variations, respectively. These effects are connected to the physical properties of the liquids and can be accessed by theoretically describing the intensity signal. A complete set of physical properties of ten liquids are quantitatively described in this work. These effects find applications in a wide range of fields, from optical communication, ultrasonic imaging, and sensing to adaptive optics and fundamental research. [ABSTRACT FROM AUTHOR]

Antibubbles are liquid droplets encapsulated by a gas film that have recently been explored for on-demand ultrasound-triggered drug release. However, their ultrasound imaging capabilities are limited by their stiff shells stabilized with silica nanoparticles. Here, we develop polymeric antibubbles that generate greater ultrasound contrast than silica-based antibubbles, while showing better stability than conventional polymeric microbubbles. [ABSTRACT FROM AUTHOR]

Background: To determine the utility of contrast-enhanced voiding urography (CeVUS) in the treatment of vesicoureteral reflux (VUR) through ureterovesical reimplantation in children. Methods: A total of 159 children with recurrent urinary tract infections were selected for CeVUS and voiding cystourethrography (VCUG) from December 2018 to December 2020, among whom 78 patients were eventually diagnosed with VUR. Overall, 60 pyelo-ureteric units (PUUs) were operated according to surgical indications. Accordingly, we determined the general clinical characteristics of all children, obtained two-dimensional ultrasound images, assessed the reflux status of children using the contrast-enhanced technique, and compared the obtained results via CeVUS and VCUG. Both imaging modalities were reperformed at 6, 12, and 18 months after surgery to evaluate postoperative outcomes. In particular, we assessed the consistency of the evaluation and calculated the diagnostic efficacy of CeVUS for different levels of reflux at different time points. Results: CeVUS showed considerable efficacy in the diagnosis of children with VUR. Notably, the diagnostic results of both CeVUS and VCUG achieved high agreement, with a kappa value of 0.966 (P < 0.001). The results of our follow-up at different stages and evaluation of postoperative efficacy revealed that CeVUS possessed substantial diagnostic efficacy and good consistency with VCUG. Conclusion: CeVUS is an accurate and safe examination, with considerable clinical significance for diagnosing VUR in children, determining the treatment approach, conducting follow-up during treatment, and evaluating subsequent treatment outcomes. [ABSTRACT FROM AUTHOR]

Background Lateral ankle sprain (LAS) is a common injury with incidence rates reported at 7.2 per 1000 person-years. Physical examination strategies provide limited information to guide rehabilitation that can maximize clinical outcomes. Early and accurate diagnostic information using ultrasound imaging enables individualized care and the ability to monitor healing along with its response to activity and rehabilitation. Purpose The purpose of this study was to describe and observe the outcomes associated with Point of Care Ultrasound (POCUS) guided early management of acute and sub-acute lateral ankle sprains. Study Design Case series Methods Individuals with a LAS within the prior 28 days underwent a clinical evaluation to include a POCUS exam to assess ligamentous integrity. Objective and POCUS findings were integrated to classify each LAS into one of four categories. Each grade of ankle sprain corresponded to levels of bracing for the protection of injured structures with each patient receiving physical therapy care based on rehabilitation guidelines. Participants completed the Foot and Ankle Ability Measure (FAAM) activities of daily living and Sports subscale, the Foot and Ankle Outcome Score (FAOS), Patient Reported Outcomes Measurement Information Systems Global Health, Tampa Scale of Kinesiophobia (TSK-11), Cumberland Ankle Instability Tool (CAIT), and the Numeric Pain Rating Scale as well as the Ankle Lunge Test and Figure 8 measurements at baseline, 4 weeks, 8 weeks and 12 weeks post enrollment. The FAAM Sport subscale, all FAOS subscales, and the TSK-11 were also collected at 24 weeks while the CAIT was collected at baseline and 24 weeks. Results Fourteen participants were enrolled with 11 participants completing all data collection. FAAM Sport scores significantly improved at 4, 8, 12 and 24 weeks. All components of the FAOS significantly increased except for Sport scores at four weeks and Quality of Life scores at four and eight weeks. Conclusion POCUS guided early management and ligamentous protection of LASs resulted in significant short and long-term improvement in function and return to sporting activity. This case series highlights the feasibility of using ultrasound imaging to assess the severity of ligamentous injury and align bracing strategies for ligamentous protection. The observations from this case series suggest that functional bracing strategies focused on ligamentous protection to promote healing and reduce re-injury rates does not delay improvement in functional outcomes. Level of Evidence Level IV, Case Series [ABSTRACT FROM AUTHOR]

Study Design: Preclinical experimental study. Objective: To develop an intraoperative ultrasound-assisted imaging device, which could be placed at the surgical site through an endoscopic working channel and which could help surgeons recognition of different tissue types during endoscopic spinal surgery (ESS). Summary of Background Data: ESS remains a challenging task for spinal surgeons. Great prof iciency and experience are needed to perform procedures such as intervertebral discectomy and neural decompression within a narrow channel. The limited surgical view poses a risk of damaging important structures, such as nerve roots. Methods: We constructed a spinal endoscopic ultrasound system, using a 4-mm custom ultrasound probe, which can be easily inserted through the ESS working channel, allowing up to 10 mm depth detection. This system was applied to ovine lumbar spine samples to obtain ultrasound images. Subsequently, we proposed a 2-stage classification algorithm, based on a pretrained DenseNet architecture for automated tissue recognition. The recognition algorithm was evaluated for accuracy and consistency. Results: The probe can be easily used in the ESS working channel and produces clear and characteristic ultrasound images. We collected 367 images for training and testing of the recognition algorithm, including images of the spinal cord, nucleus pulposus, adipose tissue, bone, annulus fibrosis, and nerve roots. The algorithm achieved over 90% accuracy in recognizing all types of tissues with a Kappa value of 0.875. The recognition times were under 0.1 s using the current configuration. Conclusion: Our system was able to be used in existing ESS working channels and identify at-risk spinal structures in vitro. The trained algorithms could identify 6 intraspinal tissue types accurately and quickly. The concept and innovative application of intraoperative ultrasound in ESS may shorten the learning curve of ESS and improve surgical efficiency and safety. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Results Conclusions This study sought to assess the capabilities of large language models (LLMs) in identifying clinically significant metabolic dysfunction‐associated steatotic liver disease (MASLD).We included individuals from NHANES 2017–2018. The validity and reliability of MASLD diagnosis by GPT‐3.5 and GPT‐4 were quantitatively examined and compared with those of the Fatty Liver Index (FLI) and United States FLI (USFLI). A receiver operating characteristic curve was conducted to assess the accuracy of MASLD diagnosis via different scoring systems. Additionally, GPT‐4V's potential in clinical diagnosis using ultrasound images from MASLD patients was evaluated to provide assessments of LLM capabilities in both textual and visual data interpretation.GPT‐4 demonstrated comparable performance in MASLD diagnosis to FLI and USFLI with the AUROC values of .831 (95% CI .796–.867), .817 (95% CI .797–.837) and .827 (95% CI .807–.848), respectively. GPT‐4 exhibited a trend of enhanced accuracy, clinical relevance and efficiency compared to GPT‐3.5 based on clinician evaluation. Additionally, Pearson's r values between GPT‐4 and FLI, as well as USFLI, were .718 and .695, respectively, indicating robust and moderate correlations. Moreover, GPT‐4V showed potential in understanding characteristics from hepatic ultrasound imaging but exhibited limited interpretive accuracy in diagnosing MASLD compared to skilled radiologists.GPT‐4 achieved performance comparable to traditional risk scores in diagnosing MASLD and exhibited improved convenience, versatility and the capacity to offer user‐friendly outputs. The integration of GPT‐4V highlights the capacities of LLMs in handling both textual and visual medical data, reinforcing their expansive utility in healthcare practice. [ABSTRACT FROM AUTHOR]

Introduction Adductor-related groin pain involves an injury to the common aponeurosis connecting the rectus abdominus and adductor longus to the pubis. It commonly occurs in sports that require cutting and pivoting and can result in significant loss of playing time. Platelet-Rich Plasma (PRP) is often indicated for treatment of musculoskeletal disorders and may represent an alternative treatment for patients with adductor-related groin pain. The purpose of this case report is to describe the non-surgical management of adductor-related groin pain in a competitive soccer player with a with an ultrasound (US)-guided PRP injection and physical therapy management. Case Description A 17-year-old male competitive soccer player with right-sided adductor-related groin pain was treated with an US-guided PRP and a multi-phased physical therapy regimen based on tissue healing and individual patient/criteria progression. The patient completed 12 physical therapy sessions over six weeks post PRP injection. Outcomes At the end of treatment, clinically meaningful improvements were observed in pain intensity, passive range of motion, strength (handheld dynamometry, Biodex), functional tests, psychosocial (OSPRO-YF) and patient-reported outcomes (HAGOS, LEFS). The subject returned to sport at six weeks post injection without limitation and at three months follow up, the subject reported that he had returned to 95% of his previous level of play. Discussion This case report may offer support for PRP as an alternative treatment in the management of adductor-related groin pain. Incorporation of PRP as an adjunct to physical therapy led to improvements on all outcomes that surpassed the clinical significance change criteria. [ABSTRACT FROM AUTHOR]

The quasi-static properties of micro-architected (meta)materials have been extensively studied over the past decade, but their dynamic responses, especially in acoustic metamaterials with engineered wave propagation behavior, represent a new frontier. However, challenges in miniaturizing and characterizing acoustic metamaterials in high-frequency (megahertz) regimes have hindered progress toward experimentally implementing ultrasonic-wave control. Here, we present an inertia design framework based on positioning microspheres to tune responses of 3D microscale metamaterials. We demonstrate tunable quasi-static stiffness by up to 75% and dynamic longitudinal-wave velocities by up to 25% while maintaining identical material density. Using noncontact laser-based dynamic experiments of tunable elastodynamic properties and numerical demonstrations of spatio-temporal ultrasound wave propagation, we explore the tunable static and elastodynamic property relation. This design framework expands the quasi-static and dynamic metamaterial property space through simple geometric changes, enabling facile design and fabrication of metamaterials for applications in medical ultrasound and analog computing. [ABSTRACT FROM AUTHOR]

Nowadays, composite materials have become prevalent across various sectors, particularly finding usage in large-scale applications such as spaceships, automobiles, and aircrafts. The accurate detection of the defects in these materials is crucial, yet traditional methods often rely on human inspection, which is susceptible to errors. Recent advancements in machine learning have enabled defect detection using ultrasonic non-destructive testing methods. This paper introduces a new dataset named UNDT, which is obtained from the scans of 60 different composite materials, generating a total of 1150 images depicting both defective and non-defective areas. Several transfer learning methods are applied on the newly introduced UNDT dataset as well as the publicly available USimgAIST ultrasonic dataset. Comparative performance assessments illustrate the significance of utilising the transfer learning approach for defect classification on ultrasonic inspection images. Furthermore, the research emphasises the substantial benefits of employing these transfer learning methods. Notably, the DenseNet121 and VGG19 models achieve the highest accuracy rates, with 98.8% and 98.6% on the UNDT and USimgAIST datasets, respectively. [ABSTRACT FROM AUTHOR]

The recent development of microacoustic metagratings opens up promising possibilities for manipulating acoustic wavefronts passively, particularly in applications such as flat acoustic lenses and ultra-high frequency ultrasound imaging. The emergence of two-photon polymerization has made it feasible to precisely manufacture microscopic structures, as required when metagratings are scaled to MHz frequencies in airborne ultrasound. Nevertheless, the downsizing process presents another hurdle as the increased thermoviscous effects result in substantial losses that must be considered during the design phase. In this study, we propose two designs for microacoustic metagratings that refract a normally incident wave towards –35 ° at 2 MHz, consisting of single-body and two-body meta-atoms. The designs are created by employing shape optimization techniques that incorporate the linearized Navier–Stokes equations in every iteration starting from a neutral geometry. This ensures that the evolution of geometric key features responsible for anomalous refraction fully accounts for thermoviscous effects, as would be the case during evolution in nature where the full set of physics is always active. Subsequently, we experimentally evaluate the effectiveness of these metagratings by employing a capacitive micromachined ultrasonic transducer as the sound source and an optical microphone as the detector, covering a frequency range from 1.8 to 2.2 MHz. Our findings confirm the single-body geometry reported in the literature and show an alternative geometry for two-body design, showcasing the successful utilization of two-photon polymerization for manufacturing microscopic acoustic metamaterials. [ABSTRACT FROM AUTHOR]

Anxiety is an increasingly prevalent mental disorder, causing widespread hardship and interfering with society's economic progression. Standard treatments include various talk therapies with poor prognoses or drug interventions with complex side effects, both introducing unnecessary burdens to patients. To remedy this, non-invasive ultrasound stimulation to the vagus nerve is a novel, low-cost treatment that is showing promise. Although vagus nerve stimulation is already approved for epilepsy and other conditions, it requires regular maintenance. In contrast, studies using non-invasive ultrasound stimulation have shown preliminary positive results in affecting vagal activity with minimal drawbacks. This review covers a variety of studies investigating the effects of ultrasound stimulation on the vagus nerve. With rising levels of anxiety with each generation, there is a pressing need for more innovative and diverse treatments with fewer costs and more benefits. [ABSTRACT FROM AUTHOR]

Background: Alterations in the bacteria, such as the periodontal bacteria, might be considered potential risk factors for nonalcoholic fatty liver disease (NAFLD). Most studies analyzing this association have focused mainly on a specific periodontal bacteria (Porphyromonas gingivalis) and have involved relatively small study populations (tens or hundreds of individuals). To address this gap, a sizable, nationally representative adult population was utilized to investigate the association between the incidence of NAFLD and high serum IgG antibodies for 19 periodontal bacteria. Methods: To explore this association, data from the Third National Health and Nutrition Examination Survey (NHANES III)—which provides a cross-sectional representation of the noninstitutionalized U.S. population, encompassing 33,994 individuals—were analyzed. Participants aged 40 years and above with data on NAFLD—determined by the gold standard of ultrasound examination (USON)—as well as comprehensive records of serum IgG antibodies against periodontal bacteria, were included, resulting in a final analysis subset of 6,330 individuals. Results: Using a cluster analysis based on the Socransky classification scheme for oral microorganisms, antibody titers for the 19 bacteria were grouped into four clusters—Red-Green, Orange-Blue, Yellow-Orange, and Orange-Red. When these clusters, as well as individual antibody relationships with NAFLD, were examined, the adjusted odds ratios (ORs) ranged from 0.958 [95% confidence interval (CI): 0.916, 1.003] to 1.021 [95% CI: 0.987, 1.055]. This indicated that no statistically significant associations were found (P > 0.05), underscoring the absence of a meaningful link. Conclusions: In summary, it was discovered that there is currently no evidence to correlate serum antibodies to periodontal pathogens with NAFLD in the nationally representative NHANES III. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

High dose-rate brachytherapy presents a promising therapeutic avenue for prostate cancer management, involving the temporary implantation of catheters which deliver radioactive sources to the cancerous site. However, as catheters puncture and penetrate the prostate, tissue deformation is evident which may affect the accuracy and efficiency of the treatment. In this work, a data-driven in silico modelling procedure is proposed to simulate brachytherapy while accounting for prostate biomechanics. Comprehensive magnetic resonance and transrectal ultrasound images acquired prior, during and post brachytherapy are employed for model personalisation, while the therapeutic procedure is simulated via sequential insertion of multiple catheters in the prostate gland. The medical imaging data are also employed for model evaluation, thus, demonstrating the potential of the proposed in silico procedure to be utilised pre- and intra-operatively in the clinical setting. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound imaging has become a crucial tool in medical diagnostics, offering real-time visualization of internal organs and tissues. However, challenges such as low contrast, high noise levels, and variability in image quality hinder accurate interpretation. To enhance the diagnostic accuracy and support treatment decisions, precise segmentation of organs and lesions in ultrasound image is essential. Recently, several deep learning methods, including convolutional neural networks (CNNs) and Transformers, have reached significant milestones in medical image segmentation. Nonetheless, there remains a pressing need for methods capable of seamlessly integrating global context with local fine-grained information, particularly in addressing the unique challenges posed by ultrasound images. Methods: In this paper, to address these issues, we propose DDTransUNet, a hybrid network combining Transformer and CNN, with a dual-branch encoder and dual attention mechanism for ultrasound image segmentation. DDTransUNet adopts a Swin Transformer branch and a CNN branch to extract global context and local fine-grained information. The dual attention comprising Global Spatial Attention (GSA) and Global Channel Attention (GCA) modules to capture long-range visual dependencies. A novel Cross Attention Fusion (CAF) module effectively fuses feature maps from both branches using cross-attention. Results: Experiments on three ultrasound image datasets demonstrate that DDTransUNet outperforms previous methods. In the TN3K dataset, DDTransUNet achieves IoU, Dice, HD95 and ACC metrics of 73.82%, 82.31%, 16.98 mm, and 96.94%, respectively. In the BUS-BRA dataset, DDTransUNet achieves 80.75%, 88.23%, 8.12 mm, and 98.00%. In the CAMUS dataset, DDTransUNet achieves 82.51%, 90.33%, 2.82 mm, and 96.87%. Discussion: These results indicate that our method can provide valuable diagnostic assistance to clinical practitioners. [ABSTRACT FROM AUTHOR]

The skull has long been an obstacle for transcranial ultrasound therapy and neuromodulation, leading to waveform distortion and focal points misalignment. In this work, we propose a dual-focus transcranial ultrasound focusing method for ex vivo human skulls to bridge this barrier, which is demonstrated by using a 2 MHz single-element transducer placed outside the occipital bone, coupled to a 3D-printed acoustic holographic lens. The experimental results show that the proposed method allows for achieving high-precision single- and dual-focus ultrasound focusing through human skulls with the maximum target registration error less than one wavelength in water. The in-target ratio spans a range from 72% to 92%, with an average of 80.7%, while the out-of-target ratio varies from 0% to 43.9%, with an average of 18.3%. Additionally, the focal spots are substantially free of the skull-induced distortion, closely matching the ideal ones, and maintain a clearly identifiable circular focus shape. The method opens up a route toward the subsequent applications in clinical research and may enable to implement transcranial ultrasound therapy and neuromodulation. [ABSTRACT FROM AUTHOR]

Background: Intracerebral hemorrhage (ICH) is a common neurosurgical emergency with high morbidity and mortality. The trans-sylvian microsurgical evacuation of ICH in the basal ganglia is a classic but technically challenging approach. Method: We describe a novel technique using handheld portable ultrasound to guide trans-sylvian, trans-insular evacuation of basal ganglia hematomas, allowing for rapid identification, precise evacuation, and post-evacuation assessment from a small Sylvian fissure opening. Conclusion: Intraoperative portable ultrasonography is a rapid, simple, and inexpensive technique that provides real-time visualization of ICH and key cortical structures, minimizing potential damage during exposure and exploration. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Methods Results Conclusion Microfocused ultrasound with visualization (MFU‐V) is widely used in aesthetic medicine for skin tightening and rejuvenation. However, its role in regenerative aesthetics and its precise mechanism of action are not fully understood.This narrative review aims to contextualize and articulate the mechanism of action of MFU‐V, evaluate its role in regenerative aesthetics, and assess its effectiveness based on existing clinical, histological, and skin‐mechanical studies.A comprehensive literature search was performed to collect and analyze studies on MFU's biological mechanisms, clinical outcomes, and impact on extracellular matrix (ECM) regeneration. The review integrates findings from clinical trials, histological analyses, and biomechanical assessments to provide a cohesive understanding of MFU‐V's role in aesthetic medicine.MFU‐V emits focused ultrasound energy that penetrates multiple skin layers and the superficial musculoaponeurotic system, creating localized thermal coagulation points. These points initiate biological responses that recruit fibroblasts and stimulate the production of new collagen and elastin fibers. Enhanced ECM protein synthesis leads to significant improvements in skin biomechanics and quality, reducing skin laxity and enhancing appearance. Clinical studies support these findings, showing improvements in skin firmness and texture following MFU‐V treatment.Through analyzing the underlying biological mechanisms and the observable clinical outcomes, this narrative review sets the stage for a comprehensive understanding of the mechanism of action and role of MFU‐V in regenerative aesthetics. [ABSTRACT FROM AUTHOR]

Endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) is a widely used procedure in interventional pulmonology, known for its diagnostic accuracy and low complication rates. We report a rare complication of EBUS-TBNA involving the damage of the TBNA needle during sampling of a mediastinal lymph node, resulting in an impacted needle spring in the airway. Despite its rarity, awareness of such potential issues is crucial for all practitioners performing EBUS-TBNA to ensure patient safety and optimal outcomes. [ABSTRACT FROM AUTHOR]

Background: Regional anesthesia (RA) can improve patient outcomes and reduce perioperative complications including deaths. Despite its benefits, RA is less utilised in low-resource settings. The purpose of this study was to assess practice and challenges related to RA in Amhara Regional Hospitals, Northwest-Ethiopia. Methods: A web- based survey was distributed among 360 anesthetists working in Amhara Regional Hospitals, Northwest-Ethiopia from November 15 - January 30, 2023. An English, semi-structure, self-administered questionnaire was disseminated by email and telegram following ethical clearance. The survey included questions about the use of RA, socio-demographic characteristics of anesthetist, types of practiced regional blocks, and barriers to perform RA. All volunteer respondents who filled online questionnaire during study period were included. The data were coded and analyzed using statistical package for social Sciences (SPSS) software-version 20. Both inferential and descriptive statistics were used to describe the results. Results: The overall response rate was 63.3% (223 out of 360 completed surveys). A total of 132 respondents (36.7%) did not provide a response, and 5 respondents (1.4%) submitted incomplete) surveys. The most frequently self-reported barriers to performing peripheral nerve blocks were a lack of equipment (regional procedure kit including block needle, ultrasound, nerve stimulator, or epidural set) 185 (82.9%), lack of knowledge 171(76.7%), lack of practical skills 112 (50.2%), and lack of drugs/medication 50 (22.4%). Conclusions: The principal findings indicate that all respondents perform spinal anaesthesia, while the practice of peripheral RA varies. Reported barriers to performing RA are related to knowledge and training, as well as a lack of equipment (there aren't enough regional procedure kits available that include an epidural set, block needle, nerve stimulator, and ultrasound). A more stringent approach with specific requirements, distinguishing between neuraxial and peripheral blocks, enhance training opportunities for peripheral nerve blocks are required in Ethiopia. [ABSTRACT FROM AUTHOR]

ABSTRACT A standardized methodology for the ultrasound evaluation of the pelvic sidewall has not been proposed to date. Herein, a collaborative group of gynecologists and gynecological oncologists with extensive ultrasound experience presents a systematic methodology for the ultrasonographic evaluation of structures within the pelvic sidewall. Five categories of anatomical structures are described (muscles, vessels, lymph nodes, nerves and ureters). A step‐by‐step transvaginal ultrasound (or, when this is not feasible, transrectal ultrasound) approach is outlined for the evaluation of each anatomical landmark within these categories. Accurate assessment of the pelvic sidewall using a standardized approach improves the detection and diagnosis of non‐gynecological pathologies that may mimic gynecological tumors, reducing the risk of unnecessary and even harmful intervention. Furthermore, it plays an important role in completing the staging of malignant gynecological conditions. Transvaginal or transrectal ultrasound therefore represents a viable alternative to magnetic resonance imaging in the preoperative evaluation of lesions affecting the pelvic sidewall, if performed by an expert sonographer. A series of videoclips showing normal and abnormal findings within each respective category illustrates how establishing a universally applicable approach for evaluating this crucial region will be helpful for assessing both benign and malignant conditions affecting the pelvic sidewall. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Nipple adenoma (NA) is a rare benign lesion of the lactiferous ducts, often mistaken for malignancy due to its diverse clinical and imaging presentations. We report the case of a 34-year-old female presenting with persistent bloody discharge and nipple erosion, for which multimodal ultrasound evaluation was pivotal in the differential diagnosis. Ultrasonography revealed a hypoechoic, well-defined nodule in the left nipple, with significant blood flow and a fast-in-fast-out contrast enhancement pattern, indicative of NA. Despite the presentation mimicking malignant processes, the benign nature of the lesion was confirmed postoperatively via histology and immunohistochemistry. This case underscores the value of a comprehensive ultrasound approach in diagnosing NA, emphasizing its ability to distinguish it from malignant lesions, and thus infer an appropriate treatment course. Maintaining a high index of suspicion coupled with tailored ultrasound techniques is recommended for accurate NA diagnosis, which remains a challenging yet critical task to avoid unnecessary aggressive interventions. [ABSTRACT FROM AUTHOR]

Background: Analysis of ultrasound radio frequency (RF) signals allows for the determination of the index of reflectivity (IR), which is a new measure that is dependent on tissue properties. Previous work has shown differences in the IR of the carotid artery wall with long-duration spaceflight; therefore, it was hypothesized that liver tissue would also show differences in this measure with spaceflight. Methods: The RF signal of a liver tissue region of interest (ROI) was displayed and processed along six different lines covering a surface of approximately 2 cm × 2 cm. The IR was calculated as the energy backscattered by the liver ROI divided by the total energy returned to the ultrasound probe. Results: Seven astronauts were investigated preflight, inflight on day 150, and postflight 4 days and 6 months after rerunning to Earth. Compared to preflight (63% ± 18%), the liver tissue ROI IR was significantly lower on flight day 150 (46% ± 14%; p = 0.027) and 4 days postflight (46% ± 19%; p = 0.025). At 6 months postflight, the IR returned to preflight values (59% ± 13%; p = 0.919). Conclusion: The significant decrease in the coefficient of reflectivity inflight and 4 days postflight indicates an alteration in the liver tissue that reduces the reflection of ultrasound waves. This change in tissue properties could either be due to the addition of particles that do not reflect ultrasound waves or structural or cellular changes that alter the reflectivity of the tissue. [ABSTRACT FROM AUTHOR]

The management of adenomyosis has undergone significant evolution, moving from traditional surgical interventions like hysterectomy to more conservative methods aimed at preserving fertility. Essential roles have been played by uterine-sparing surgeries and uterine artery embolization. Despite these advancements, there is a growing interest in less invasive alternatives. This review delves into the potential of high-intensity focused ultrasound (HIFU). HIFU employs focused ultrasound waves for precise ablation of adenomyotic lesions. The review conducts a thorough analysis of HIFU principles, safety, efficacy, and its possible synergies with other therapies. HIFU seems to be effective for adenomyosis treatment, demonstrating a favorable adverse effect profile and suitability for fertility preservation. Combining HIFU with hormonal treatment appears to enhance long-term symptom control, presenting a promising and comprehensive approach for managing adenomyosis. The goal of this article is to develop a comprehensive understanding of HIFU's role in contemporary adenomyosis management and to explore areas requiring further research. [ABSTRACT FROM AUTHOR]

Background: Dysphagia services have only recently been formalised within Chinese health services. There has been no comprehensive evaluation of all aspects of dysphagia services practice in China. Aims: To provide a profile for the dysphagia practice in China by assessing various facets of dysphagia services. Methods and Procedures: This is a survey study carried out from December 2022 to May 2023 online in China. One hundred fifty‐nine respondents comprising doctors, nurses or therapists involved in the field of dysphagia rehabilitation completed a questionnaire via Sojump. The questionnaire included dichotomous (e.g., yes/no) and multiple‐choice questions related to participants' general information and their provision of dysphagia management services. Results were analysed descriptively and the differences among different levels of hospitals were analysed. Outcomes and Results: Approximately two‐thirds of hospitals (67.9%) started dysphagia services within the last 5 years. A significant difference in the initiation of dysphagia rehabilitation was observed across different hospital levels (χ2 = 32.70;p < 0.001). Routine dysphagia screening was a standard practice in most hospitals (71.7%), with the most frequently employed screening method being the water swallow test (95.6%). Clinical swallowing evaluation emerged as the preferred initial assessment method (80.5%) and the most utilised assessment method (91.8%). Video fluoroscopic swallow study and flexible endoscopic evaluation swallowing were used by 22.7% and 12.6% of respondents. A significant difference was observed in the choice of assessment methods across hospitals of different levels (χ2 = 43.397; p < 0.001). The majority of respondents (53.5%) primarily employed rehabilitation as the main intervention method (76%–100%). Most respondents indicated that they would reevaluate patients after treatment (74.8%) and reported routine follow‐up with patients (60.4%). Conclusions and Implications: Despite the relatively recent development of dysphagia management in China, the practice patterns uncovered in this study are broadly consistent with Chinese guidelines and consensus. However, the use of instrumental assessments remains low, resulting in a lack of objective evaluation of patient conditions and outcomes. There is a need for policy and resource support in the field of dysphagia rehabilitation in China. WHAT THIS PAPER ADDS: What is already known on this subject: Assessment and treatment methods for dysphagia are various across different patients, medical facilities and settings. There has been no comprehensive evaluation of all aspects of dysphagia rehabilitation practice in China. What this study adds to existing knowledge: The study assessed various facets of dysphagia rehabilitation in China through an online survey. We found that the relatively recent development of dysphagia management in China, but the practice patterns uncovered in this study are broadly consistent with Chinese guidelines and consensus. Variations in practice patterns between hospitals of different levels may be attributed to resource constraints and patient needs. Besides, while rehabilitation exercises are the primary intervention method for dysphagia in China, the assessment largely centres on clinical swallowing evaluation. The use of instrumental assessments remains low, resulting in a lack of objective evaluation of patient conditions and outcomes. What are the clinical implications of this work?: The study assessed various facets of dysphagia rehabilitation in China, and the results indicate that the use of instrumental assessments needs to be improved and there is a need for policy and resource support in the field of dysphagia rehabilitation in China. [ABSTRACT FROM AUTHOR]

Objectives: People with HIV are at increased risk for metabolic dysfunction‐associated steatohepatitis (MASH). Although sex differences are documented in the general population, their role in the context of HIV is less understood. Methods: This was a multicentre cohort study including people with HIV without viral hepatitis coinfection. A FibroScan‐AST (FAST) score >0.35 was used to diagnose MASH with significant liver fibrosis (stage F2–F4). We investigated sex‐based differences in MASH trends as a function of age using a segmented linear mixed‐effects model. Random effects accounted for clustering by the four sites. Adjusted models included ethnicity, diabetes, hypertension, and detectable HIV viral load. Results: We included 1472 people with HIV (25% women). At baseline, the prevalence of MASH with fibrosis by FAST score was lower in women than in men (4.8% vs. 9.2%, p = 0.008). Based on the adjusted model, male sex (+0.034; p = 0.04), age per year (+0.003; p = 0.05), detectable HIV viral load (+0.034; p = 0.02), and hypertension (+0.03; p = 0.01) were positively associated with MASH with fibrosis. Although men exhibited generally higher FAST scores, FAST scores increased in women during the critical biological age of presumed perimenopause to menopause (between 40 and 50 years), reaching levels similar to those in men by the age of 55 years. Conclusion: Despite women with HIV having a lower prevalence of MASH with fibrosis than men, they exhibit an acceleration in FAST score increase around the perimenopausal age. Future studies should target adequate consideration of sex differences in clinical investigation of metabolic dysfunction‐associated steatotic liver disease to fill current gaps and implement precision medicine for people with HIV. [ABSTRACT FROM AUTHOR]

To assess the best method for measuring the fetal pancreas, provide nomograms and evaluate the effect of GDM on it. A total of 271 singleton fetuses (17–36 weeks) were included in this study. Measurements of pancreatic parameters established reference ranges. Repeatability and consistency analyzed. GDM impact on fetal pancreatic growth assessed. Measurements of fetal pancreatic parameters fell within the 95 % confidence interval when performed by the same or different physicians. Pancreatic midline longitudinal axis demonstrated the best intraclass correlation coefficients (ICC) and follow by the pancreatic circumference. The successful display rate and measured parameters of the integral fetal pancreas achieved 90.3 %. Pancreatic midline longitudinal axis and circumference increased with gestational age, with significant differences observed among fetuses at different gestational ages (F=2060 and F=2264, p<0.05). Pancreatic midline longitudinal axis and circumference in normal fetuses from 17 to 36 weeks of gestation were positively correlated with gestational age and abdominal circumference. Poorly controlled GDM fetuses exhibited significantly larger pancreatic midline longitudinal axis and circumference compared to the normal group fetuses (Z-values were −3.82 and −3.77, both p<0.01), while no significant differences were found between well-controlled GDM group fetuses and normal group fetuses (Z-values were −0.59 and −0.042, both p>0.05). Ultrasound method using anatomical landmarks to measure the fetal pancreatic midline longitudinal axis and circumference is reliable. Pancreatic measurements increase with gestational age. Poorly controlled gestational diabetes can lead to enlargement of the fetal pancreas. [ABSTRACT FROM AUTHOR]

Introduction: To determine the frequency of superior cluneal nerve entrapment (SCN‐E) in patients who applied to our outpatient clinic with low back pain. Methods: Two hundred patients with mechanical low back pain persisting more than 3 months were included in our study. All patients were evaluated with detailed clinical history and physical examination. Ultrasound‐guided diagnostic injection was performed in patients who had tenderness on the posterior iliac crest and whose main complaint emerged by pressing on this point. Patients with 70% or greater pain relief 1 h after the injection were considered as SCN‐E. The frequency and clinical features of SCN‐E were determined and compared with other mechanical low back pain. Results: The mean age of the patients included in our study was 48.56 ± 14.11 years, with 138 female and 62 male patients. The diagnostic injection was performed on 31 patients and considered positive in 24 of them. The frequency of SCN‐E was determined as 12%. The Hip‐Knee Flexion Test was determined to be more specific for SCN‐E than other causes of low back pain, the sensitivity and specificity of the test were 41.67% and 88.64% (p = 0.001; p < 0.01). In addition, all demographic and clinical features in patients diagnosed with SCN‐E were found to be similar to other mechanical low back pain cases. Conclusions: In patients with chronic low back pain, SCN‐E is not a rare cause and is often overlooked. Increasing the awareness and experience of physicians on SCN‐E will prevent patients from being exposed to unnecessary surgical or non‐surgical treatments. [ABSTRACT FROM AUTHOR]

The bioactive compounds in burdock (Arctium lappa L.) roots, including chlorogenic acid (CGA) and cynarin, are valuable for use in nutraceutical foods. The ultrasound-assisted extraction of bioactive substances from dried burdock root powder (DBR) was investigated with 95% ethanol to reduce the impact of polysaccharide inulin on the extraction of free CGA and cynarin. The ethanolic extraction of CGA and cynarin was evaluated under ultrasound (300 W) at 40 kHz (U40) and 120 kHz (U120) with shaking at 120 rpm (S120) for comparison. Using a 1/30 (g/mL-solvent) solid-to-liquid ratio at 30 °C in 120 min, amounts of CGA and cynarin with U40 were as high as 818.74 μg/g-DBR and 173.68 μg/g-DBR, respectively, being much higher than those with U120 and S120. Total phenolic content, total flavonoid content, and antioxidant activity of the extract using U40 were significantly better than using U120 and S120. For U40 and U120, CGA increased with a decreasing solid-to-liquid ratio, while cynarin showed a decrease with a decreasing solid-to-liquid ratio using U120. Moreover, no observable degradations of free CGA and cynarin in ethanol were detected. By combining ultrasound and ethanol, the extracts with high-content CGA and cynarin from burdock roots were effectively achieved for use in health foods. [ABSTRACT FROM AUTHOR]

Background/Objectives: Obstetric ultrasound is one of the most commonly used imaging modalities during pregnancy to detect any fetal abnormalities. The aim of this systematic review was to appraise all available scientific literature and summarize current evidence regarding the safety of fetal ultrasound by using the thermal index (TI) and mechanical index (MI). Methods: We applied the PRISMA guidelines in order to prepare the review, and a 2-step process was performed in order to evaluate the available literature and decide which studies to be included. A thorough search of the Medline, Scopus, and Google Scholar databases was performed. Randomized and non-randomized studies were considered for review. The MI and TI were available in ultrasound machines after 1993; thus, studies before that year would not provide data on these two indexes. Results: A total of 21 studies were included in this review, including prospective, retrospective, cross-sectional, and survey-type studies. A common theme of the majority of the studies is the increased acoustic output available to the machines with time and the limited awareness of where the MI/TI indexes are from the operators. Conclusions: This review indicates that, while obstetric ultrasound is predominantly safe, there is a need for operators to consistently observe MI/TI indexes and adhere to the ALARA principle to minimize potential risks. [ABSTRACT FROM AUTHOR]

We describe an autopsied case of amyotrophic lateral sclerosis, wherein fasciculations were detected by muscle ultrasonography in the early stage. The myotome areas with fasciculations corresponded to areas of severe pathological lesions. Our results demonstrated that these fasciculations indicate excitability and severity of affected lower motor neurons and significantly contribute to diagnosis. [ABSTRACT FROM AUTHOR]

Lithium-ion batteries (LIBs) are widely used in electric vehicles and energy storage systems, making accurate state transition monitoring a key research topic. This paper presents a characterization method for large-format LIBs based on phased-array ultrasonic technology (PAUT). A finite element model of a large-format aluminum shell lithium-ion battery is developed on the basis of ultrasonic wave propagation in multilayer porous media. Simulations and comparative analyses of phased array ultrasonic imaging are conducted for various operating conditions and abnormal gas generation. A 40 Ah ternary lithium battery (NCMB) is tested at a 0.5C charge-discharge rate, with the state of charge (SOC) and ultrasonic data extracted. The relationship between ultrasonic signals and phased array images is established through simulation and experimental comparisons. To estimate the SOC, a fully connected neural network (FCNN) model is designed and trained, achieving an error of less than 4%. Additionally, phased array imaging, which is conducted every 5 s during overcharging and overdischarging, reveals that gas bubbles form at 0.9 V and increase significantly at 0.2 V. This research provides a new method for battery state characterization. [ABSTRACT FROM AUTHOR]

Germinal matrix hemorrhage (GMH) is a critical condition affecting premature infants, commonly diagnosed through cranial ultrasound imaging. This study presents an advanced deep learning approach for automated GMH grading using the YOLOv8 model. By analyzing a dataset of 586 infants, we classified ultrasound images into five distinct categories: Normal, Grade 1, Grade 2, Grade 3, and Grade 4. Utilizing transfer learning and data augmentation techniques, the YOLOv8 model achieved exceptional performance, with a mean average precision (mAP50) of 0.979 and a mAP50-95 of 0.724. These results indicate that the YOLOv8 model can significantly enhance the accuracy and efficiency of GMH diagnosis, providing a valuable tool to support radiologists in clinical settings. [ABSTRACT FROM AUTHOR]

This study evaluates the performance of the MaskFormer model for segmenting and classifying breast lesions using ultrasound images, addressing ultrasound's limitations. Ultrasound used for breast cancer detection faces challenges like low image contrast and difficulty in the detection of small or multiple lesions, further complicated by variability based on operator skill. Initial experiments with U-Net and other CNN-based models revealed constraints, such as early plateauing in model loss, which indicated suboptimal learning and performance. In contrast, MaskFormer demonstrated continuous improvement, achieving higher precision in breast lesion segmentation and significantly reducing both false positives and false negatives. Comparative analysis showed MaskFormer's superior performance, with the highest precision and recall rates for malignant lesions and an overall mean average precision (mAP) of 0.943. The model's ability to detect a diverse range of breast lesions, including those potentially missed by the human eye, especially by less experienced practitioners, underscores its potential. These findings suggest that integrating AI models like MaskFormer could greatly enhance ultrasound performance for breast cancer detection, providing reliable, operator-independent image analysis and potentially improving patient outcomes on a global scale. [ABSTRACT FROM AUTHOR]

Normal neuronal cell differentiation and migration is critical to brain formation, is rapidly occurring as the fetal brain develops, and peaks at the time of the routine ultrasound anatomic survey. Abnormalities in cortical migration can signify an underlying genetic abnormality or other fetal injury that can have a profound impact on future development. Although cortical migration peaks at 20–22 weeks, cortical migration abnormalities are rarely diagnosed at the time of the anatomic survey. We describe three cases of fetal cortical abnormalities in which prenatal ultrasound imaging was instrumental to making a prompt and accurate diagnosis in the mid-trimester and for guiding clinical counseling. [ABSTRACT FROM AUTHOR]

Pulmonary aspiration in the perioperative period carries the risk of significant morbidity and mortality. As such, guidelines have been developed with the hopes of minimizing this risk by recommending fasting from solids and liquids over a specified amount of time. Point-of-care ultrasound has altered the landscape of perioperative medicine; specifically, gastric ultrasound plays a pivotal role in perioperative assessment. Further, the advent of glucagon-like-peptide-1 receptor agonists, the widespread use of cannabis, and Enhanced Recovery program carbohydrate beverage presents new challenges when attempting to standardize fasting guidelines. This review synthesizes the literature surrounding perioperative fasting guidelines specifically with regard to the use of point-of-care ultrasound in assessing for gastric contents and minimizing the risk of aspiration. [ABSTRACT FROM AUTHOR]