This manuscript reviews two decades of projects funded by the Kirkhouse Trust (KT), a charity registered in the UK. KT was established to improve the productivity of legume crops important in African countries and in India. KT’s requirements for support are: 1) the research must be done by national scientists in their home institution, either a publicly funded agricultural research institute or a university; 2) the projects need to include a molecular biology component, which to date has mostly comprised the use of molecular markers for the selection of one or more target traits in a crop improvement programme; 3) the projects funded are included in consortia, to foster the creation of scientific communities and the sharing of knowledge and breeding resources. This account relates to the key achievements and challenges, reflects on the lessons learned and outlines future research priorities.

Objectives: The purpose of this study is to determine the association between umbilical venous blood flow (UVBF) to placental pulsatility index (PPI) ratio and gestational age (GA) in women undergoing prenatal assessments and adverse pregnancy outcome (APO) screening Methods: Between January and December 2022, sonographic examinations were conducted to assess the fetal umbilical cord insertion site in singleton fetuses, and hemodynamic indices of the umbilical artery, umbilical vein, and uterine artery were computed. Through regression analysis, we derived the optimal regression equation to elucidate the UVBF/PPI ratio parameters based on GA. Results: Among 492 singleton fetuses between 21+0 and 40+6 weeks of gestation in the final study. The average fetal UVBF/PPI ratio was 180.45±119.32. Correlation analysis revealed a positive relationship between the UVBF/PPI ratio and GA(p = .000). Using regression analysis, the best-fit regression equation was the linear function model, which explains the value of UVBF/PPI ratio parameters based on GA. Lower UVBF/PPI ratio revealed a positive relationship in the low birth weight fetuses (p=0.021) and higher preterm delivery rate (p=0.034). Cerebroplacental ratio (CPR) showed a high correlation with the UVBF/PPI ratio (r=0.471, p=0.000). Conclusions: The findings of our analyses revealed that contribute to our understanding of fetal hemodynamics and highlight the potential of UVBF/PPI ratio as a predictive marker for adverse pregnancy outcomes, such as preterm birth, low birth weight, or potential fetal hypoxemia. It might be useful for prenatal counseling and clinical purposes.

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: Fine-needle aspiration cytology (FNAC) is widely used to diagnose and monitor thyroid nodules. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the standard for interpreting FNAC specimens. The risk of malignancy in Bethesda III nodules also known as Atypia of Undetermined Significance (AUS) varies significantly throughout several studies published worldwide. This retrospective study examines the risk of cancer in thyroid FNAC categorized as Bethesda III, as identified in the final histopathology of thyroidectomy specimens at a single endocrine surgery center. Methods: This retrospective cohort analysis included 1038 consecutive patients who underwent elective thyroid surgery with complete follow up data between January 2020 and March 2024. Preoperative data on clinical and pathological characteristics have been collected. The final histopathology report from the thyroidectomy specimen was compared to the results of the preoperative FNAC on nodules that were judged to be Bethesda category III. Statistical methods were performed using SPSS version 29. Results: A total of 670 ultrasound-guided FNACs (64.5%) performed during the study period were included in the final analysis. The study population was predominantly female, represented by 79.6% of patients with a mean age of 42.5 (SD 12.1), while 20.4% were male and significantly older with mean age 45.13 years (p = 0.02). The FNAC inadequacy rate was 5.1%, which was associated with a high risk of malignancy (6 out of 34, 17.6%). Out of the total sample size of 170 patients classified as group III, 57 were found to have malignancies in final surgical histopathology, representing 33.5% of the cases within this category. The secondary gender-related outcome analysis showed that female patients classified under the Bethesda II category had a significantly higher risk of malignancy, with a rate of 21.2%, compared to males who had a malignancy rate of 3.4% in the same Bethesda category (p = 0.001, chi square test). However, female had more better prognostic non-invasive tumors than male (p = 0.02, chi square test). Conclusion: The study's results indicate that Bethesda categories II and III are associated with a higher risk of malignancy in comparison to the reports of the first and third editions of the TBSRTC, particularly for female patients classified under category II.

The undoped and tungsten (W)-doped vanadium dioxide (VO₂) thin films were prepared by electron beam evaporation associated with ion-beam assisted deposition (IAD). The influence of different W-doped contents (3%-5%) on the optical, electrical, structural, and thermos-mechanical properties of VO₂ thin films was investigated experimentally. Spectral transmittance results showed that with the increase of W-doped contents, the transmittance in the visible light range (400-750 nm) decreases from 60.2% to 53.9%, and the transmittance in the infrared wavelength range (2.5 μm to 5.5 μm) drops from 55.8% to 15.4%. As the W-doped content increases, the residual stress in the VO₂ thin film decreases from -0.276 GPa to -0.238 GPa, but the surface roughness increases. For temperature-dependent spectroscopic measurements, heating the VO2 thin films from 30°C to 100°C showed the most significant change in transmittance for the 5% W-doped VO₂ thin film. When the heating temperature exceeds 55°C, the optical transmittance drops significantly, and the visible light transmittance drops by about 11%. Finally, X-ray Diffraction (XRD) and scanning electron microscope (SEM) were used to evaluate the microstructure characteristics of VO₂ thin films.

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

This is a single tertiary center in southwest Romania, population-based, study. We retrospectively compared data obtained in two periods: January 2008 - December 2013 and January 2018 - De-cember 2023, respectively. The global incidence of transposition of great arteries (TGA) - the ter-minated cases added to the ones resulting in live-born pregnancies, remained almost constant. The live-born incidence of TGA decreased (0.34% to 0.013%). The prenatal detection rate increased slightly (71.42% to 87.5%). The median gestational age at the diagnosis decreased, from 29.3 ges-tational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The proportion of terminated pregnancies significantly increased (14.28% to 75%, p = 0.019).

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.

Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers: (1) Background: It is important to get a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will inform the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences, based on trustable information.; (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized findings; (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed the identification of current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers.

Cognitive impairment is a condition which affects aging patient populations and is becoming more prevalent as the geriatric population expands. It is categorized by the extent of cognitive decline, memory loss, functional abilities, and the capability to perform daily tasks. Based on the degree of impairment, it is classified as mild cognitive impairment or dementia. Considering the debilitating nature of cognitive decline and its impact on quality of life, prevention is key. In addition, given the gradual progression of the underlying causes of cognitive decline, early diagnosis and appropriate management has the potential to offer clinical advantages and better patient outcomes. Management options discussed vary from pharmaceutical regimens to neurosurgical interventions, with differing outcomes based on etiology of cognitive impairment.

The penetrability and directivity of ultrasound in different media is of interest in engineering and medical applications (imaging, nondestructive testing, sonochemistry, among others). The nonlinearity of a liquid can be used in the parametric antenna framework to generate low-frequency components with particular features from several ultrasonic signals at the source. Bubbly liquids are dispersive liquids in which a small amount of tiny gas bubbles leads to the increase of the nonlinear parameter of the media over certain frequency ranges. Parametric antenna applied to this huge nonlinear media gives rise to low-frequency components with relatively small intensity at the source. The evolution of a low-frequency component (difference-frequency component obtained from two primary signals) during its propagation in a bubbly liquid is somehow unknown. It is thus interesting to analyse its characteristics to establish whether this component can benefit from the quality of its own frequency and from the primary frequencies in terms of directivity and penetrability into the medium. It must be noted that no such study in bubbly liquids exists in the litterature, but only for homogeneous media. To this end, several numerical models developed previously are used here to analyse the difference-frequency component obtained from a parametric antenna emitting from two ultrasonic signals at the source in one and two-dimensional domains. These models allow us to observe the behavior of this frequency component. An angle that measures the directivity of a beam is also defined. Our results show a point hardly found in the literature: the high directivity and the huge penetrability of the secondary beam associated to the difference-frequency component into the bubbly liquid, compared to the same frequency signal excited directly from the source in the bubbly liquid and to the parametric acoustic array in homogeneous fluids.

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

Today, there are commercially available high-performance electric wheelchairs, capa-ble of responding to strong limitations. However, despite these advancements, there is a significant portion of the population with severe disabilities who cannot access this mobility solution due to safety reasons. Indeed, either due to motor issues preventing reliable control of the wheelchair's commands, or associated visual or cognitive pathologies, the use of an electric wheelchair by these individuals would put them at risk and could also constitute a danger to those around them. This is why our research team is working on the development of augmented wheelchairs that allow a greater autonomy. We are mainly developing a system compatible with all electric wheel-chairs on the market, capable of making them anti-collision and anti-fall on uneven ground (sidewalks, stairs, etc.). In this article, we present our solution regarding the anti-collision function, in particular the sensors used to do this, as well as the strategy. We will focus on the shortcomings and weaknesses of various types of sensors and demonstrate how, by combining them in a certain way, we can develop a collision avoidance device capable of managing the diversity of everyday life situations. The two types of sensors that will be combined here are an in-house developed special near infrared sensor from the laboratory and a commercially available ultrasonic sensor. We will present the internal operation of the sensors, their limitations, experimental tests involving integration with the wheelchair, and the structure of the complete device.

The German health authorities' guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence from additional hardware. The study examines the effectiveness of manual disinfection methods, specifically the cleaning process, addressing concerns raised by the Robert Koch Institute regarding the lack of validation for wipe disinfection of semi-critical devices. The EQUINOS colored wipe disinfection kit identified wetting gaps in all cleanings across four probes tested. The results indicate significant challenges in ensuring complete surface wetting, particularly in complex body parts such as clip-on areas and shapes for additional biopsy attachments, suggesting that manual methods alone may not adequately mitigate the risk of infection transmission (p value .001). The study concludes that while manual disinfection methods are a viable alternative to automated reprocessing, there is a critical need for enhanced training and potentially the development of more effective manual disinfection techniques or colored wipes to ensure patient safety and compliance with healthcare hygiene standards.

Sperm capacitation involves biochemical and physiological changes that enable sperm to fertilize the oocyte. It can be induced in vitro under controlled conditions that simulate the environment of the oviduct. While extensively studied in mammals, its approach in lizards remains absent. Understanding the mechanisms that facilitate reproduction is essential for advancing the implementation of assisted reproductive technologies in this group. Fifteen males of Sceloporus torquatus were collected during the early stage of the reproductive season. The sperm were isolated from the seminal plasma and then diluted up to a volume of 150 μl using BWW medium to incubate with 5% CO2 at 30 °C for a maximum duration of 3 hours. A fraction was retrieved hourly for ongoing sperm assessment. We found that total motility is maintained up to 2 hours post-incubation, after which it decreased. However, sperm viability remained constant. From that moment on, we observed a transition to a deeper and less symmetrical flagellar bending in many spermatozoa. The chlortetracycline assay indicated a reduction in the percentage of sperm showing the F pattern and an increase in those exhibiting the capacitated (B) and reactive (RA) patterns, accompanied by an elevation in the percentage of damaged acrosomes as revealed by the lectin binding assay. In mammals, these changes are often associated with sperm capacitation. These observations support the notion that this process may also occur in saurian.

Previous studies suggested that trauma-focused cognitive behavior therapy (TF-CBT) is effective in reducing symptoms of post-traumatic stress disorder (PTSD) and depression in children and adolescents. However, the effects of app-assisted TF-CBT-based interventions in psychiatric clinics compared to treatment-as-usual (TAU) are under-explored. The purpose of this study was to reveal the added value of the app-assisted TF-CBT-based intervention as an add-on to TAU. The digitalized measures of the Child and Adolescent Trauma Screen (CATS), The Adolescent Dissociative Experience Scale (A-DES), Short Moods and Feelings Questionnaire (SMFQ), PTSD Checklist (PCL-5), and Children's Post-Traumatic Cognitions Inventory (CPTCI) were applied at baseline and post-treatment. The app-assisted TF-CBT-based group participants started with higher levels of negative alterations in cognition and mood compared to TAU participants but at post-treatment, no significant differences were observed between the app-assisted TF-CBT and TAU groups. Within the app-assisted TF-CBT group, post-treatment scores were significantly lower in post-traumatic stress symptoms, intrusion symptoms, alterations in arousal and reactivity, overall post-traumatic cognitions, and belief in being "a fragile person in a scary world”. Within the TAU group, post-treatment scores were notably lower just in dissociation and intrusion symptoms. The study suggests that app-assisted TF-CBT-based intervention can be effective in addressing specific trauma-related symptoms. The findings imply the necessity for screening for traumatic experiences, incorporating trauma-informed care, implementation of TF-CBT into treatment protocols, utilization of app-assisted interventions, tailoring interventions to individual needs, and comprehensive assessment and monitoring of treatment progress.

Lower limb exoskeletons have the potential to reduce the prevalence of work-related musculoskeletal disorders; however, they often lack user-oriented control strategies. Human-in-the-loop (HITL) controls can adapt an exoskeleton’s assistance in real-time, to optimize the user-exoskeleton interaction. This study presents a HITL control for a knee exoskeleton to minimize the users’ physical effort, a parameter innovatively evaluated by their interaction torque with the exoskeleton (a muscular effort indicator) and metabolic cost. This work innovates by estimating the user’s metabolic cost within the HITL control through a machine-learning model. The regression model was able to estimate the metabolic cost, in real-time, with a root-mean-squared error of 0.66 W/kg and a mean absolute percentage error of 26%, making faster (10s) and less noisy estimations than a respirometer (K5, Cosmed) device. The HITL reduced the user’s metabolic cost and interaction torque by 7.3% and 32.3%, respectively, when compared to a zero-torque control. The developed HITL control surpassed both a non-exoskeleton and a zero-torque condition regarding the user’s physical effort, even for a simple task such as slow walking. Furthermore, the user-specific control enabled a lower metabolic cost than the non-user-specific assistance. This proof-of-concept demonstrated the potential for HITL controls in assisted working.

Conclusions: Our findings suggest that the NMS-E represents a valuable preoperative diagnostic tool for endometriosis, effectively correlating with the disease's severity and surgical outcomes. Incorporating the NMS-E into clinical practice could significantly enhance the management of endometriosis by addressing current diagnostic limitations and guiding surgical planning.

Rice blast and brown planthopper (BPH) are two of the most destructive diseases and pests in rice (Oryza sativa L.) production in China. The development of multi-resistant varieties is widely recognized as the most efficient and environmentally friendly approach to controlling crop diseases and pests. Functional molecular markers (FMMs) have been developed from functional variants in the genic region associated with trait variation, greatly enhancing the efficiency of identifying and pyramiding valuable genes in crop breeding. In this study, two FMMs and a multiplex PCR amplification system were developed for two major broad-spectrum BPH resistance genes, Bph6 and Bph9. By assistance of FMMs in multi-resistant rice restorer line development pipeline, two lines (Huahui7713 and Huahui3006) with blast and BPH resistance were developed by pyramiding three resistance genes Pigm, Bph6 and Bph9. Huahui7713 and Huahui3006 as male lines, two new hybrid rice varieties (WeiLiangYou7713 and Xuanliangyou3006) were certificated and commercial released in China. WeiLiangYou7713 and Xuanliangyou3006 showed improved blast and BPH resistance, and no penalty on yield and grain-quality. Annual promotion area of WeiLiangYou7713 has exceeded 53.3 thousand hectares, indicating its widespread adoption and success in the market. Huahui7713 and Huahui3006 could have great potential for utilization in blast and BPH resistance rice breeding.

Introduction Blunt carotid injuries (BCI) in pediatric trauma are quite rare. Due to the low number of cases, only a few reports and studies have been conducted on this topic. This review will discuss how frequent BCI/ BCVI on pediatric patients after blunt trauma is, what routine diagnostics look like, if a CT/ CTA scan on pediatric patients after blunt trauma is always necessary and if there are any negative health effects? Methods This literature review includes reviews, systematic reviews, case reports and original studies in english language between 1999 and 2020 that have dealt with pediatric blunt trauma and the diagnostics of BCI and BCVI. Furthermore, publications on the risk of radiation exposure on children were included in the study. For literature research, Medline (PubMed) and the Cochrane library were used. Results Pediatric BCI/ BCVI, shows an overall incidence between 0.03 – 0.5% of confirmed BCI/ BCVI cases due to pediatric blunt trauma. 1.1 – 3.5% of pediatric blunt trauma patients underwent CTA to detect BCI. Only 0.17 – 1.2% of all CTA scans shows a positive diagnosis for BCI. In children, the median volume CT dose index on a non-contrast head CT is 33 milligray, a computed tomography angiography needs at least 138 mGy. A cumulative doses of about 50 mGy almost triples the risk of leukemia, and doses of about 60 mGy triples the risk of brain cancer. Discussion Knowing that a BCI could have extensive neurologic consequences for children, it is necessary to evaluate routine pediatric diagnostics after blunt trauma. Computed tomography scans (CT) and computed tomography angiography (CTA) are mostly used in routine BCI diagnostics. However, since radiation exposure in children should be as low as reasonably achievable, it should be asked if other diagnostic methods could be used to identify risk groups. Trauma guidelines and clinical scores like the McGovern score are reflect established BCI screening options, as well as using duplex ultrasound.

Heart failure (HF) affects about 60 million people worldwide, making it one of the chronic conditions with the greatest health and economic impact. The primary objective was to assess the efficacy of lung ultrasound (LUS) in the management of HF in order to intervene early and reduce the rate of hospital readmissions. A systematic search was conducted on PubMed, Embase, Google Scholar, Web of Science, and Scopus, including clinical trials, meta-analysis, systematic reviews, and original articles from 2019/1/1-2023/12/31, about LUS for the assessment of HF, on an outpatient basis, for HF diagnosis or/and decompensation. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 873 articles were identified of which 33 articles were selected: [n=19] focused on prognostic assessment of HF, [n=11] centred on multimodal diagnostic assessments, and [n=2] addressing therapeutic guidance for HF diagnosis. LUS exhibits advantages in the detection of sub-clinical congestion linked to prognostic significance in re-admission and mortality during out-patient follow-up, after hospital discharge, and in complex scenarios as the patients' homes or institutional long-term care facilities. However, there are considerable uncertainties in their interpretation and monitoring changes due to its lack of standardization. The need for an updated international consensus on the use of LUS seems obvious.

Currently, conventional spark-ignition engines face challenges in meeting the ever-growing demands of customers and increasingly stringent regulations regarding pollutant emissions. A combination of innovative strategies and carbon-neutral fuels is deemed necessary in order to further reduce fuel consumption and minimize engine emissions. The present work aims to assess the performance of combustion strategies using low-carbon content fuel, such as methanol M100, ignited by a plasma-assisted igniter (PAI) under ultra-lean conditions. The experimental campaign is conducted on a single-cylinder research engine at different engine speeds and low loads, moving up to the engine lean stable limits. To determine the benefits brought by the proposed strategy, referred to as M100-PAI, the obtained outcomes are compared with the ones obtained using market gasoline E5 ignited by the PAI system and conventional spark. The synergy between M100 (methanol) and Plasma Assisted Ignition (PAI) in internal combustion engines yielded notable benefits. This combination significantly improved combustion stability if compared to the other combinations tested, by extending the lean stable limit to λ=2.0, reducing cycle-to-cycle variability, and facilitating faster flame front acceleration, resulting in enhanced homogeneity. These enhancements, obtained with the combination M100-PAI, contributed to higher fuel efficiency showing a 10% efficiency gain over the combination E5-gasoline spark ignition.

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.

Chemical process control relies on a tightly controlled, narrow range of margins for critical variables, ensuring process stability and safeguarding equipment from potential accidents. The availability of historical process data is limited to a specific setpoint of operation. This challenge raises issues for process monitoring in predicting and adjusting to deviations outside of the range of operational parameters. Therefore, this paper proposes simulation-assisted deep transfer learning for predicting and optimizing the final purity and production capacity of the glycerin purification process. The proposed network is trained by the simulation domain to generate a base feature extractor, which is then fine-tuned using few-shot learning techniques on the target learner to extend the working domain of the model beyond the historical practice. The result shows that the proposed model improved prediction performance by 99% in predicting water content and 79.72% in glycerin prediction over the conventional deep learning model. Additionally, the implementation of the proposed model identified the production and product quality improvement for enhancing the glycerin purification process.

Although ovarian cystic teratoma is the most common ovarian tumor, complications are quite rare. However, it is important to be recognized by the radiologist in order to avoid inaccurately diagnosing them as malignant lesions. This case report describes a 61-year-old postmenopausal woman, who presented to the emergency room with abdominal pain following a minor blunt abdominal trauma. In this context, a CT scan was performed, which showed the presence of round, hypodense masses randomly distributed in the peritoneum, with coexisting ascites in moderate amount; ovarian carcinoma with peritoneal carcinomatosis was suspected. The patient was hospitalized and an MRI of the abdomen and pelvis was recommended for a more detailed lesion characterization. Following this examination, the patient was diagnosed with mature cystic ovarian teratoma complicated by rupture. Surgery was performed, and the outcome was favorable. The cases of ruptured cystic teratomas are rare, and to our knowledge, this is the first occurrence described in literature. Special attention must be paid when confronting with such a case in medical practice, since it can easily misdiagnosed as peritoneal carcinomatosis

Abstract: Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VL) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VL have been repeatedly studied in both normal and difficult airways. The superiority of VL then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) has been noticed two dec-ades ago. Since then, sporadic clinical experiences of use have appeared in literature. In this re-view article, we presented our vast use experiences of the styletubation (more than 55,000 pa-tients since 2016). We found this technique is swift (the time to intubate: from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satis-faction and fast learning curve for the novice trainees) in both normal and difficult airway sce-narios. We therefore propose styletubation technique can be feasibly applied as universal rou-tine use for tracheal intubation.

Keywords: pelvic ultrasound, follicle number per ovary, FNPO, ovarian volume, PCOM, upper normal limits, referral population

For 80 years high-intensity focused ultrasound (HIFU) has been a significant area for medical research. It is a non-invasive procedure which causes cell death in a highly localised area at a defined distance from the transducer. Since 2000, the clinical indications have broadened considerable as the technology has improved. This review looks back at the history of HIFU and the current clinical indications.

Recent technological advances, including capsule endoscopy (CE) and balloon-assisted endoscopy (BAE), have revealed that small intestinal disease is more common than previously thought. CE has advantages including, high diagnostic yield, discom-fort-free, outpatient basis, and physiological images. BAE enabled endoscopic diagnosis and treatment in the deep small bowel. Computed tomography (CT) enterography with negative oral contrast can evaluate masses, wall thickening, and narrowing of the small intestine. In addition, Enhanced CT can detect abnormalities outside the gastrointestinal tract that endoscopy cannot evalu-ate. Each modality has its advantages and disadvantages, and a good combination of multiple modalities leads to an accurate diagnosis. As a first-line modality, three-phase enhanced CT is preferred. If CT shows a mass, stenosis, or wall thickening, a BAE should be selected. If there are no abnormal findings on CT and no obstructive symptoms, CE should be selected. If there are sig-nificant findings in the CE, determine the indication for BAE and its insertion route based on these findings. Early diagnosis of small intestinal tumors is essential for favorable outcomes. For early diagnosis, the possibility of small bowel lesions should be considered in patients with unexplained symptoms and signs after examination of the upper and lower gastro-intestinal tract.

People working in the field of Animal-Assisted Interventions (AAI) often state that they perceive animal welfare as a matter of paramount importance, nevertheless most of scientific literature focuses on the effectiveness of interventions from the user's perspective. Before focusing on animals’ management and welfare during the interaction with users, it would be important to ensure animal welfare during their “ordinary lives”. This article reports information and considerations about the management of donkeys involved in AAI in Northern Italy. Six facilities with several years of experience in Donkey-Assisted Interventions were visited for the purpose of an initial data collection regarding the management of donkeys involved in AAI. A general lack of knowledge regarding the nutritional needs of the donkey and a heterogeneity of practices in the field of its preventive medicine have been identified; the study also highlighted a need for efforts to create a more stimulating and enriched environment for animals involved in AAI. Some possible areas for improvement in the management of donkeys involved in AAI have been highlighted. Further studies are necessary to provide a more comprehensive picture of the welfare of donkeys involved in this context.

Lavander distillation leads to huge quantities of solid waste produced yearly. This waste is usually discarded resulting in serious environmental issues. However, it still contains residual essential oil and other bioactive compounds. This research reports on the development and comparison of optimized solid-liquid separation methods, i.e. microwave (MAE) and ultrasound assisted extraction (UAE) of phenolic compounds from lavender distillation waste. Optimal pretreatment conditions, such as waste moisture content and particle size were also determined. The extracts were spray or freeze-dried and the resulting powders were characterized for their physicochemical properties. The majority of the original phenolic compounds in lavender were found in the leachate fraction after distillation (61%), while 43% in the solid waste. Drying of the solid waste before extraction affected the process efficiency. UAE led to higher phenolic content and antioxidant properties compared to MAE. Drying (spray or freeze) the extracts did not significantly affect their phenolic content, while the use of maltodextrin as a drying agent improved the drying process yield especially in the freeze-drying method. It is concluded that valorization of lavender distillation wastes can be achieved via an integrated process consisting of a green extraction method and a consequent drying process that result in a stable bioactive powder.

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 paper introduces an innovative nanotechnology-based approach that provides a pathway to enhance the energy release efficiency of nanoenergetic materials (nEMs) by harnessing self-synchronized collective atomic vibrations and phonon wave resonance within the transition domains between nanocomponents, without altering the material composition. The key innovation involves incorporating finely-tuned 2D-ordered linear-chain carbon-based multilayer nano-enhanced interfaces as programmable nanodevices into the transition domains using advanced multistage processing and assembly techniques. These programmable nanodevices enable precise control over self-synchronized collective atomic vibrations and phonon wave propagation, leading to synergistic effects. To activate and optimize these effects, a combination of various methods is employed, including energy-driven initiation of allotropic phase transformations, surface acoustic wave-assisted micro/nano-manipulation, heteroatom doping, directed self-assembly using high-frequency electromagnetic fields, and data-driven inverse design approaches. By leveraging a data-driven inverse design strategy and uncovering hidden structure-property relationships, we maximize energy release efficiency using the carbon nano-materials genome approach derived from multifactorial neural network-based predictive models. This approach not only unlocks new functionalities in nEMs but also improves environmental performance and safety levels. By pioneering transformative pathways for nEMs through harnessing phonon wave resonance in low-dimensional nanocarbon transition interfaces, this research brings significant advancements in the field.

Primary spontaneous pneumothorax (PSP) is a pleural disease that abruptly affects healthy adolescents and young adults, representing a common thoracic disorder in this age group. This study aimed to investigate the necessity of preoperative chest tube insertion in patients with PSP and to re-evaluate current clinical treatment approaches. A retrospective review of medical records was conducted for children and young adults aged 14–30 years, diagnosed with PSP and who underwent Video-assisted thoracoscopic surgery (VATS) between January 2016 and December 2022 at Wonju Severance Christian Hospital. Patients were retrospectively divided into two groups based on their initial treatment: chest tube insertion and non-chest tube insertion. Clinical data including demographics, treatment details, and outcomes were collected and compared. Total 128 cases of PSP were included in the study. The total length of hospital stay was significantly shorter in the non-chest tube group (p=0.000), which was attributed to the omission of pre-operative chest tube insertions. No significant differences were observed between the two groups in terms of postoperative complications or recurrence rates. In cases of young patients with PSP, omitting pre-operative chest tube insertion may be a viable option if the patient is scheduled for VATS.

Following the European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) joint guide-lines (2018) for the management of patients with cervical cancer, treatment decisions should be guided by modern imaging techniques. After five years (2023), an update of the ES-GO-ESTRO-ESP recommendations was performed furtherly confirming this statement. Trans-vaginal/transrectal ultrasound (TRS/TVS) or pelvic magnetic resonance (MRI) enables tumour delineation and precise assessment of its local extent, including the evaluation of the depth of infiltration in the bladder- or rectal wall. Additionally, both techniques have very high specificity to confirm the presence of metastatic pelvic lymph nodes but fail to exclude them due to insuffi-cient sensitivity to detect small-volume metastases, as any other currently available imaging modality. In early-stage disease (T1a to T2a1, except T1b3) with negative lymph nodes on TVS/TRS or MRI, surgicopathological staging should be performed. In all other situations, con-trast-enhanced computed tomography (CECT) or 18F-fluorodeoxyglucose positron emission tomography in combination with CT (PET-CT) are recommended to assess extrapelvic spread. The aim of this paper is to review the evidence supporting the implementation of diagnostic imaging with a focus on ultrasound at primary diagnostic workup of cervical cancer.

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.

Keywords: renal replacement therapy. Point-of-Care Ultrasound; intensive care; acute kidney injury; nephrologist.Point of care ultrasonography (POCUS) is gaining heightened significance in critical care settings as it allows for quick decision making at the bedside. While computerized to-mography is still considered the standard imaging modality for many diseases, the risks and delays associated with transferring a critically ill patient out of the Intensive Care Unit (ICU) have prompted physicians to explore alternative tools. Ultrasound guidance has increased safety of invasive procedures in the ICU, such as the placement of vascular catheters and drainage of collections. Ultrasonography is now seen as an extension of the clinical examination, providing quick answers for rapidly deteriorating patients in the ICU. The field of nephrology is increasingly acknowledging the value of diagnostic Point-of-Care Ultrasound (POCUS). By employing multi-organ POCUS, nephrologists can address specific queries arising during the diagnosis and treatment of patients with acute kidney injury. This approach aids in ruling out hydronephrosis and offering immediate information on hemodynamics, thereby consolidating patient data and facilitating the development of personalized treatment strategies.

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.

"Enhancing the Efficiency of Natural Gas Liquid (NGL) Extraction and Fractionation Trains: An Integrated Approach of Simulation Analysis, Advanced Modifications, and Technological Advancements. Through comprehensive research, innovative solutions such as the heat pump aided distillation (HPAD) system and self-heat recuperation technology (SHRT) have been developed to significantly reduce the energy consumption associated with conventional distillation systems. To identify a practical system for NGL fractionation trains, this study extensively examined and compared various HPAD and SHRT options to retrofit a single column. The objective was to find the most suitable and efficient solution for the fractionation process of natural gas liquids (NGLs). The retrofit options analyzed in this study encompassed a range of techniques, including vapor compression (VC), mechanical vapor re-compression (MVR), thermal vapor re-compression (TVR), bottom flashing (BF), side heat exchanger (SHE), intermediate heating and cooling (IHC), self-heat recuperative (SHR), and modified self-heat recuperative (MSHR) distillation. These methods were carefully examined to determine their suitability and effectiveness in improving the performance of NGL fractionation trains In this study, a depropanizer column, typically employed in conventional NGL plants, was selected as a case study. The simulation software Aspen HYSYS V7.3 was employed to model and analyze eight retrofit designs based on predefined criteria. The simulation data was carefully evaluated to identify the most efficient design for minimizing energy consumption. Among the retrofit options, the mechanical vapor re-compression (MVR) technique demonstrated the most significant energy cost reduction, with a remarkable 68.11 percent improvement compared to the base case conventional column. These findings highlight the potential of MVR as an effective solution for lowering energy costs in NGL fractionation trainsFollowing the MVR retrofit option, the study found that vapor compression (VC) achieved a considerable energy cost reduction of 66.65 percent, closely followed by modified self-heat recuperative (MSHR) at 64.02 percent, bottom flashing (BF) at 62.88 percent, self-heat recuperative (SHR) at 55.85 percent, side heat exchanger (SHE) at 54.23 percent, intermediate heating and cooling (IHC) at 39.54 percent, and thermal vapor re-compression (TVR) also at 39.54 percent. These findings highlight the significant potential for energy savings offered by these retrofit options, with VC being the most popular choice, closely followed by MSHR, BF, SHR, SHE, IHC, and TVR.

Abstract: The use of IVF and related procedures has offered opportunities for couples to conceive who otherwise would remain childless. This technology is often viewed as the only option but is very expensive and not highly effective. ln an effort to improve access to care, governments are attempting to provide funding. In Ireland for example the Health Service Executive (HSE) has recently made IVF funding available through Regional Fertility Hubs. for couples who qualify. However, this policy has threatened a less invasive approach available in Ireland that can help many couples before IVF is employed. We propose that a newly emerging “medical treatment process” called Restorative Reproductive Medicine (RRM), combined with methods or apps that track biomarkers of the menstrual cycle as a prerequisite option for appropriate patients. To illustrate the effectiveness, we compared live birth rates from an established Irish RRM clinic that uses the ChartNeo app to HFEA (Human Fertilization and Embryology Authority) data, both from 2019. RRM treatment had a live birth rate of 40.4% compared to 24.4% per treatment cycle for IVF (P>0.0001). RRM twin pregnancy rate was 2.5% compared to 7% for IVF. RRM babies were usually full term and normal birth weight. Therefore, RRM is less expensive, less invasive, and more effective than IVF for most patients. This merits further evaluation and support by the HSE and other global authorities guiding health policy.

Background Robotic-assisted thoracic surgery (RATS) has become the standard procedure for treating lung malignancy, offering numerous advantages over traditional methods. However, the minimally invasive nature of RATS presents unique challenges, notably a limited field of view and reduced tactile feedback for the surgeon. These limitations can significantly impact the surgeon's ability to navigate complex anatomical structures during surgery. To address these challenges, we recognized the need for enhanced preoperative familiarization with each patient’s specific anatomy. In response, we developed an innovative virtual reality (VR) surgical navigation system, utilizing head-mounted displays (HMDs), designed to provide surgeons with a more comprehensive and interactive understanding of the patient's anatomy before the actual surgery. This VR system aims to extend the surgeon's capabilities in both preoperative sumilation and intraoperative navigation, potentially mitigating the inherent limitations of RATS. Methods Three-dimensional (3D) volumized data, meticulously extracted from preoperative computed tomography (CT) scans, were seamlessly integrated into the Perspectus VR Education software. These data were then displayed on an HMD, facilitating an interactive 3D reconstruction of pulmonary structures. This reconstruction allowed for each structure to be visualized individually, enabling detailed preoperative resection simulations tailored to each patient's unique anatomy. During RATS, these specific 3D reconstructed images were made accessible within the surgeon's console through the TilePro™ multi-display input, providing real-time, intraoperative guidance. Results During the preoperative simulations, the 3D anatomic structure of the pulmonary vessels, as well as the spatial relationship between the lesion and adjacent tissues, were successfully visualized. This enhanced visualization enabled surgeons to thoroughly evaluate a patient's anatomy, significantly improving the safety and accuracy of the subsequent procedure. The integration of VR software with the HMD provided surgeons with a true 3D interaction with real patient data. This setup not only offered a unique perspective through the surgical console but also allowed for easy manipulation of the data on a mobile laptop, thereby enhancing the overall surgical planning process. Conclusions VR simulation using HMDs offers a viewing experience akin to that of a robotic 3D viewer, potentially providing an innovative avenue for surgeons to develop specific robotic surgical skills without the need for practicing on live patients. This technology, when integrated with routine imaging modalities, can significantly enhance preoperative planning. Such integration not only contributes to the safety but also improves the accuracy of anatomical resections. Our findings suggest that VR simulation with HMDs is particularly effective in assisting surgeons to accurately identify lesion locations in RATS, thereby optimizing surgical outcomes.

Keywords: oligozoospermia; male infertility; epididymis; scrotal exploration; scrotal ultrasound; partial epididymal obstruction

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.

During the last decades, a growing number of studies have shown that infections during pregnancy have an important impact on both pregnant women and their fetuses. Our goal was to identify newborns from pregnancies with SARS-CoV-2 infection and to investigate the extension of neonatal complications using cardiac, abdominal and cerebral ultrasonography, hearing testing and indirect ophthalmoscopy. By contrast, neonates whose mothers were vaccinated against COVID-19 during pregnancy and those from pathology-free pregnancies have been examined. A total of 458 newborns were included, over a period of 10 months, divided into 3 groups, COVID-19 group, vaccine group and control group. Although 6 cardiac malformations were found in the COVID-19 group, no correlation was made compared to the vaccine and control group (p=0.07). Grade 1 intraventricular hemorrhage and hypoxic ischemic encephalopathy were the most prevalent among neonates from mothers with SARS-CoV-2 infection (p=0.002 and p&lt;0.001, respectively). The kidney anomaly found to be most frequent in this group was grade 1 unilateral hydronephrosis (p&lt;0.001). COVID-19 disease during the gestational period had no effect on the auditory or visual function. Despite the fact that our observations are relevant, further studies investigating the effects of SARS-CoV-2 infection during pregnancy and the neonatal outcomes are necessary.

Amid the deepening imbalance in the supply and demand of allogeneic organs, xenotransplanta-tion can be a practical alternative because it makes an unlimited supply of organs possible. How-ever, to perform xenotransplantation on patients, the source animals to be used must be free from infectious agents. This requires breeding of animals using assisted reproductive techniques, such as somatic cell nuclear transfer, embryo transfer, and cesarean-section, without colostrum de-rived in designated pathogen-free (DPF) facilities. Most infectious agents can be removed from animals produced by these methods, but several viruses known to pass through the placenta are not easy to remove, even with these methods. Therefore, in this review, we look at the characteris-tics of several viruses known to cross the placenta and determine how they can be detected. This review is intended to help maintain DPF facilities by preventing animals infected with the virus from entering DPF facilities and to help select pigs suitable for xenotransplantation.

Candidiasis is one of the global public health problems. In fluconazole resistant Candida spp. (FRCS), mutations in ergosterol biosynthesis gene 11 (ERG 11) have been commonly found. This study aimed to determine the profile of FRCS isolates and to detect mutations in part of ERG 11 gene in fluconazole resistant Candida albicans (FRCA) isolates. Study was conducted on 150 isolates of FRCS obtained from patients admitted in a tertiary care hospital, South India from September 2019 to December 2021. Candida spp. was identified by MALDI-TOF MS and fluconazole resistance was detected by VITEK 2 system. Following which a part of the ERG 11 gene of the FRCA isolates were amplified, purified, sequenced and a phylogenetic tree was constructed. Out of the 150 FRCS, the most common FRCS was C. auris followed by C. glabrata, C. krusei, C. parapsilosis, C. albicans, C. tropicalis and C. guilliermondii. Sequencing of amplicons detected a single missense mutation and 44 silent mutations. We opined that fluconazole resistance in FRCA isolates may be due to mecha-nisms other than the studied one in our region. Phylogenetic analysis of amplified sequences of 12 FRCA isolates observed three clusters and all 12 sequences showed relatedness to Malaysian 2019 isolates.

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.

Ultrasound (US) has become a widely used imaging modality in clinical practice, characterized by its rapidly evolving technology, advantages, and unique challenges such as low imaging quality and high variability. There is a critical need to develop advanced automatic US image analysis methods to enhance diagnostic accuracy and objectivity. Vision transformer, a recent innovation in machine learning, has demonstrated significant potential in various research fields, including general image analysis and computer vision, due to its capacity to process large datasets and learn complex patterns. Its suitability for automatic US image analysis tasks, such as classification, detection, and segmentation, has been recognized. This review provides an introduction to vision transformer and discusses its applications in specific US image analysis tasks, while also addressing the open challenges and potential future trends in its application in medical US image analysis. Vision transformer has shown promise in enhancing the accuracy and efficiency of ultrasound image analysis and is expected to play an increasingly important role in the diagnosis and treatment of medical conditions using ultrasound imaging as technology progresses.

The retrospective noninterventional study investigated the kinetic energy of video images of 18 fertilized eggs (7 were normal and 11 were abnormal) recorded by a time-lapse device leading up to the beginning of the first cleavage. The norm values of cytoplasmic particles were measured by the optical flow method. Three phases profile for normal cases were found regarding the kinetic energy that were 2.199×10⁻²⁴±2.076×10⁻²⁴, 2.369×10⁻²⁴±1.255×10⁻²⁴, and 1.078×10⁻²⁴±4.720×10⁻²⁵ (J) for the phases 1, 2, and 3, respectively. In phase 2, the energies were 2.369 × 10⁻²⁴ ± 1.255 × 10⁻²⁴ and 4.694 × 10⁻²⁴ ± 2.996 × 10⁻²⁴ (J) (mean ± SD, P = 0.0372), and the time required was 8.114 ± 2.937 and 6.018 ± 5.685 (H) (P = 0.0413) for the normal and abnormal cases, respectively. The kinetic energy change was considered a condition for applying the free energy principle that states that, for any self-organized system to be in equilibrium in its environment, it must minimize its informational free energy. The kinetic energy while interpreting it in terms of the free energy principle suggesting clinical usefulness would further our understanding of the phenomenon of fertilized egg development with respect to the birth of human life.

Alginate, a biopolymer promising in food, biomedical, pharmaceutical, and electronic materials industries, is characterized by its biodegradability, biocompatibility, low toxicity, and gel-forming properties. It is most abundantly found in brown algae. However, conventional dilute acid and alkali extraction methods face limitations in commercialization due to their long processing time, low throughput, and high solvent requirements. In this study, a microwave-assisted extraction (MAE) process for sodium alginate was designed to improve extraction efficiency. Solid/liquid ratio, extraction temperature, and extraction solvent concentration were major variables affecting sodium alginate extraction from Undaria pinnatifida(sea mustard). They were then statistically optimized using response surface methodology. Under optimal conditions (13.27 g/L, 91.86 ℃, 2.51 %(w/v), and 15 min), the yield was 38.41 %, which was 93.43 % of the theoretical content of sodium alginate in Undaria pinnatifida. Our work has confirmed the productivity and industrial feasibility of efficient extraction of sodium alginate from marine biomass, and we hope that it will serve as an encouraging case for the application of biopolymers as one of the desirable options for alternative petrochemicals to construct a sustainable society.

Introduction – Molecular tests can contribute to improve the preoperative diagnosis of thyroid nodules. Tests available are expensive and not adapted to different population. Aim – This study aimed to compare the cyto-histological genetic profile, and to evaluate the reliability of molecular tests on Ultrasound-guided Fine Needle Aspiration Cytology (US-FNAC) in accurately diagnosing differentiated thyroid carcinomas (DTCs) and predicting biologic behavior of papillary thyroid carcinomas (PTCs). Material and methods – The series included 259 patients with paired cyto-histological samples totalizing 518 samples. The genetic alterations were analyzed by PCR/Sanger sequencing. The association with clinicopathologic features was evaluated in PTCs. Results/Discussion – From the 259 patients included, histologies were 50 (19.3%) benign controls and 209 (80.7%) DTCs cases, from which 182 were PTCs; cytologies were 5.8% non-diagnostic, 18.2% benign, 39% indeterminate and 37.1% malignant. In histology, indeterminate nodules (n=101) were 22.8% benign and 77.2% malignant. Mutation frequencies in cytology and histology specimens were, respectively, TERTp: 3.7% vs. 7.9%; BRAF: 19.5% vs. 25.1%; RAS: 11% vs. 17.5%. The overall cyto-histological agreement of the genetic mutations was 94.9%, Cohen’s k=0.67, and in indeterminate nodules 95.7%, k=0.64. The identified mutations exhibited a discriminative ability in diagnosing DTC with a specificity of 100% for TERTp and BRAF, and of 94% for RAS, albeit with low sensitivity. TERTp and BRAF mutations were associated with aggressive clinicopathological features and tumor progression in PTCs (p<0.001). The obtained good cyto-histological agreement suggests that molecular analysis in US-FNAC may anticipate the genetic profile and the behavior of thyroid tumors, confirming malignancy and contributing to refer patients towards surgery.

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.

We are introducing a highly efficient 48-channel ultrasound beamforming system ideal for ultrasound endoscopy applications. The system includes a transmitter and a receiver, which allow for low-area, high-resolution imaging acquisition. The transmitter uses a charge redistribution HV (high voltage) scheme to generate three-level pulses that actuate the transducer, implemented with the standard CMOS process for optimal cost and power savings. Meanwhile, the receiver features a sub-array structure and a delay generator that reduces area usage. To achieve high-resolution ultrasound imaging acquisition with low computational power, we developed the Shift Coherence Factor (SCF) algorithm, which is hardware-friendly. This approach delivers a lateral resolution over 20% better than the conventional delay and sum (DAS) algorithm, with a contrast ratio of over 30 dB. The system was implemented in a 180 nm standard CMOS process with an area of 24.98 mm2, power consumption of 8.23 mW per channel, achieving a delay resolution of 8.33 ns, and a low-area implementation of 0.52 mm2 per channel. The system offers high-quality imaging acquisition with minimal additional area and power consumption, which has great potential for 3D imaging or catheterized ultrasound systems.

The present study focuses on the development and optimization of a highly efficient unique hybrid technique — membrane-assisted gas absorption (MAGA) in designing the separation unit, which provides the improvement in mass-transfer of a target component during the natural gas processing in terms of sweetening stage. A novel design of membrane-assisted gas absorption cell is used to enhance the ratio between absorbent amount and membrane surface available for permeation. The performance tests were implemented on example of two gas mixtures separation: one is model ternary gas mixture and the second is quasi real natural gas, which includes number of hydrocarbons, nitrogen, acid impurities and xenon. For both cases, the MAGA unit demonstrated high acid gases removal efficiency, and high recovery of hydrocarbons. The ultimate efficiency of studied system was up to 96 and 61 % of removed acid gases with hydrocarbons losses up to 1 % at highest productivity. In this way, the residual sum of acid gases content may be lowered to 1 vol.% using the heat-free hybrid membrane-assisted gas absorption unit maintaining suitable recovery rate of methane, ethane, propane and n-butane. Nevertheless, the overall efficiency of the process may be enhanced using the specific absorption agents with aqueous amino alcohol solutions.

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.

Currently the bimatoprost implant (DURYSTA) is approved for a single administration secondary to concern for progressive corneal endothelial cell (CEC) loss with intracameral administration. In order to better understand the cause of CEC loss and other adverse events (AEs) with intracameral administration, multimodal imaging of the implant utilizing optical coherence topography (OCT), robotic ultrasound and bio microscopy video recording was utilized. Inherently the anterior chamber is a non-confined space. In certain examples the implant assumed a round and spotted structure as it picked up iris pigment as it migrated around the anterior chamber. Accordingly, we explored delivery of the implant in the middle segment behind the iris and in front of the pseudophakic lens. We then evaluated the suitability of various imaging modalities to assess the implant in this location. For middle segment administration, the ArcScan Insight 100 robotic ultrasound provided resolution and repeatability sufficient to monitor the implant behind the iris. This preliminary study hypothesizes that DURYSTA migration in the anterior chamber is the main source of AEs. Through use of a confined location, the middle segment, the implant is unlikely to migrate and cause CEC loss while also delivering drug closer to its site of action, the ciliary body. Further efforts are underway to understand the suitability of the middle segment for serial DURYSTA administration to maximize intraocular pressure lowering while minimizing AEs.

Gastric outlet obstruction (GOO) poses a common and challenging clinical scenario, characterized by mechanical blockage in the pylorus, distal stomach, or duodenum, resulting in symptoms such as nausea, vomiting, abdominal pain, and early satiety. Its diverse etiology encompasses both benign and malignant disorders. The spectrum of current treatment modalities extends from conservative approaches to more invasive interventions, incorporating procedures like surgical gastroenterostomy (SGE), self-expandable metallic stents (SEMS) placement, and the advanced technique of endoscopic ultrasound-guided gastroenterostomy (EUS-GE). While surgery is favored for longer life expectancy, stents are preferred in malignant gastric outlet stenosis. The novel EUS-GE technique, employing a lumen-apposing self-expandable metal stent (LAMS), combines the immediate efficacy of stents with the enduring benefits of gastroenterostomy. Despite its promising outcomes, EUS-GE is a technically demanding procedure requiring specialized expertise and facilities.

The black hole (BH) phenomenon is an intraluminal restenotic lesion. It was identified by intravascular ultrasound (IVUS) and optical coherence tomography (OCT) after intracoronary brachytherapy and drug-eluting stent implantation. Despite the similarity in the mode of action of brachytherapy and drug-eluting stent implantation, the BH phenomenon appears to be uncommon after drug-eluting stent implantation. Specifically, the BH phenomenon is better identified by OCT than by IVUS. Herein, we present a case of in-stent restenosis with suspected BH phenomenon on IVUS confirmed by OCT.

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.

Drones have been used in a variety of scenarios such as atmospheric monitoring, fire rescue, agricultural irrigation, etc., in which accurate environmental perception is of crucial importance for both decision-making and control. Among the drone sensors, the RGB camera is indispensable for capturing rich visual information for vehicle navigation but encounters a grand challenge in high-dynamic-range scenes that occur frequently in real applications. Specifically, the recorded frames suffer from under-exposure and over-exposure simultaneously and degenerate the successive vision tasks. To solve the problem, we take object tracking as an example and leverage the superior response of event cameras over a large intensity range to propose an event-assisted object tracking algorithm that can achieve reliable tracking under large intensity variations. Specifically, we propose to pursue feature matching from dense event signals, and based on which to (i) design a UNet-based image enhancement algorithm to balance the RGB intensity with the help of neighboring frames in the time domain, and then (ii) construct a dual-input tracking model to track the moving objects from intensity balanced RGB video and event sequence. The proposed approach is comprehensively validated in both simulation and real experiments.

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.

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.

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 &lt;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.

Infertility affects millions worldwide, posing a significant global health challenge. The proteomic analysis of follicular fluid provides a comprehensive view of the complex molecular landscape within ovarian follicles, offering valuable information on the factors influencing oocyte development and on the overall reproductive health. The follicular fluid is derived from the plasma and contains various proteins that can have different roles in oocyte health and infertility and this fluid is a critical microenvironment for the developing oocytes as well. Using HPLC/MS method we investigated the protein composition of the follicular fluid and after classification we did relative quantification of the identified proteins in the pregnant (P) and non-pregnant (NP) groups. Based on the protein-protein interaction analysis ALB and ApoA1 was found to be hub proteins and the quantitative comparison of the P and NP groups resulted significantly lower concentration of ApoA1 and HDL-cholesterol in the P group. As both molecules are involved in the cholesterol transport, we also investigated their role in the development of oocytes and in the prediction of fertility.

Globally, between 10% and 15% of couples experience infertility. Given the high demand for Assisted Reproductive Techniques (ART), there is growing interest in exploring modifiable factors influencing their outcomes. In this context, the objective of this review was to investigate the impact of adherence to the Mediterranean Diet (MD), recognized for its benefits in reproductive health, on ART outcomes. Methodology: A systematic review was conducted following the PRISMA methodology. International databases were consulted, selecting studies published between 2010 and 2023, in English and Spanish, involving patients aged 18-55, and examining intermediate and/or clinical outcomes of ART. Systematic reviews, meta-analyses, and animal studies were excluded. Results: Of the 9 included articles, 5 found statistically significant associations between adherence to the MD and positive outcomes in ART, such as a higher number and quality of embryos, clinical and biochemical pregnancy, and live births. However, other studies found no such associations. Conclusions: There is a potential association between adherence to the MD and ART outcomes. The evidence is very limited, necessitating further investigation.

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.

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.

The issue of optimising the initial stand density (ISD) of tree plantations has high practical importance. The objective of this study was to nondestructively evaluate the influence of the initial stand density of Scots pine plantations located in the European part of the Russian Federation on wood basic density (BD), moisture content (MC), ultrasound velocity (UV), latewood content, and drilling resistance (DR). 45-year-old trees with stand densities of 500, 1000, 3000, 5000, and 10000 trees/ha were tested by a 5-cm-long core sample for gravimetric MCGM and BD, by PULSAR-2.2 for UV along the height (UVH) and through the tree trunk diameter (UVD), by the IML-RESI PD-400 tool for DR, and by GANN HT 85T for MC based on the electrical resistance method (MCERM). A significant influence of ISD was found on DBH, UVD, MCGM, and MCERM. ISD had no significant impact on BD, UVH, and DR. The wood BD ranged from 356 to 578 kg/m-3, with a mean value of 434±3.3 kg/m-3, and was restricted by the soil and environmental factors. DBH and 70% MCERM were good indicators of tree vitality. Linear correlations between DBH and MCERM (R2=0.67), DBH and MCGM (R2=0.74), DR and BD (R2=0.71), and the two-factor model MCGM=f(DBH, BD), (R2=0.76) were found.

An enormous interest in the development of efficient protocols for cellulose extraction has been demonstrated in the last years, however, they were usually based on non-sustainable chemical and thermal approaches. In this work we describe a new and more sustainable method for cellulose extraction from eucalyptus and pine tree wood waste products exclusively performed using microwave-assisted radiation. The methodology includes 3 main steps: i) alkaline treatment; ii) bleaching I, using H2O2; and iii) bleaching II, an acidic treatment. Samples obtained in each step were characterized by Fourier-transform Infrared (FTIR) spectroscopy, powder X-ray diffraction (PXRD), thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The results were compared with those of starting materials, with the commercially available microcrystalline cellulose and with an industrial paper pulp. Results confirmed that for both type of wood wastes, cellulose was retained during the extractions procedures and that the removal of hemicellulose was achieved at the last step as seen by the FTIR spectra and TGA curves. The developed protocol is innovative since it constitutes an easy and quick approach to extract cellulose, from eucalyptus and pine tree wood waste using mild chemical and thermal conditions, microwave irradiation, and environmentally friendly purification steps. This approach offers the possibility of a future scale-up study to potentially apply the develop protocol to the extraction of cellulose in an industrial scale.

Wild strawberry (Fragaria vesca L.) leaves possess diverse antioxidant properties, mainly due to the different classes of phenolics. In this study, microwave-assisted extraction (MAE) and accelerated solvent extraction (ASE) of wild strawberry phenolics were carried out to understand the impact of extraction temperature, extraction time and solvent-to-sample ratio (SSR) on the quantitative and qualitative properties of the obtained extracts. The highest total phenolic content (8027 mg GA/100 g DW), as well the highest DPPH• antiradical activity (903 mol TE/g DW) was obtained with ASE at 150 °C, static time 5 min and SSR of 40:1; while the highest ABTS•+ antiradical activity (681 mol TE/g DW,) and FRAP (2389 mol TE/g DW) was obtained with MAE after 5 min at 80 °C and a SSR of 40:1. The correlation analysis showed that phenolics largely contributed to the antioxidant properties of the studied MAE extracts, while correlation was not found in ASE extracts. A total of 54 different phenolics were identified by UPLC/MS-MS in MAE and ASE extracts obtained at optimal extraction conditions. MAE extract was shown to have a higher content of phenolic acids (40%), but lower content of proanthocyanidins (88%), flavonols (29%), flavan-3-ols (50%) and flavones (39%) than ASE extract.

The article is devoted to the study of ultrasonic agglomeration of PM2.5 in uniform and non-uniform ultrasonic fields. The possibility of increasing the efficiency of ultrasonic agglomeration by initiating acoustic streams in a resonant non-uniform ultrasonic field is shown. A non-uniform ultrasonic field with zones of high and low sound pressure levels formed using a bending-oscillating disk transmitter made it possible to initiate acoustic vortex-type streaming that promote the movement of particles into the nodal areas of a standing wave and between them. The efficiency of ultrasonic treatment was determined indirectly by the degree of inertial trapping of agglomerates. It has been established that the impact of an non-uniform ultrasonic field in comparison with the impact of a uniform ultrasonic field makes it possible to increase the efficiency of inertial capture of agglomerates PM2.5 from 89% to 95%, PM1.5 from 85% to 92%, PM0.5 from 76% to 85%. The results obtained made it possible to propose a design for an agglomeration chamber, which allows for a multiple increase in the productivity of ultrasonic processing of a gas-dispersed flow.

Particle-mediated elasticity/viscoelasticity imaging has potential to expand the elasticity imaging field, as it can provide accurate and local tissue elastic properties as well as density, Poisson’s ratio, and viscosity. Here, we investigated elasticity imaging based on the use of small particles located within the tissue and at the tissue interface exposed to a static and dynamic external load. First, we discuss elasticity/viscoelasticity imaging methods based on the use of particles (bubbles and rigid spheres) located within the tissue. Elasticity/viscoelasticity imaging techniques based on the use of particles (bubbles, rigid and soft spheres) located at the tissue interface are then presented. Based on new advances, we updated some of the models for the responses of the particles located within the tissue and at the tissue interface available in the literature. Finally, we compared the mathematical models for the particles located within the tissue and at the tissue interface and evaluated the elasticity/viscoelasticity imaging methods based on the use of small particles. Therefore, instead of the use of the term elasticity imaging, we suggest the use of the term viscoelasticity imaging.

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 feasibility of recovering bioactive antioxidants from Phyllantus emblica leaves using ethanol -water mixture (0 – 100%) and heat-assisted extraction technology (HAE-T) was investigated in this present study. To this effect, the process parameter of operating temperature (OT: 30 -50 oC), solid -to-liquid ratio (S:L: 1:20 - 1:60 g/mL) and extraction time (ET: 45 - 180 min) were investigated on the extract total phenolic content (TPC, mg GAE/g d.w), yield (EY, %) and antioxidant activity (μM AAE/g d.w) by employing the Box-Behnken experimental design (BBD) available in response surface methodology (RSM). Multi-objective process optimization using the desirability function algorithm to determine set of process variables that simultaneously optimize process responses of TPC, EY and AA was also investigated. The recovery process was thereafter modeled with BBD-RSM and multi gene genetic programming (MGGP) algorithm and model reliability assessment via Monte Carlo simulation were conducted for the best performing set of models for predicting TPC, EY and AA values. The HPLC characterization of the recovered extract was carried out to ascertain the phenolic compound constituents of the Phyllantus emblica leaf extract. The 50% ethanol solution was found to be the best for the optimal extraction of antioxidants from Phyllantus emblica leaves. The HAE-T was suitable for recovering bioactive extract from Phyllantus emblica leaves and investigated process parameters have impacts on the recovery process. The process parameters that simultaneously gave the optimum EY of 21.6565%, TPC of 67.116 mg GAE/g and AA of 3.68583 µM AAE/g were OT of 41.61 oC, S:L of 1:60 g/mL and ET of 180 min. The HPLC extract profiling revealed that the bioactive constituents present in the recovered extract were betulinic acid, gallic acid, chlorogenic acid, caffeic acid, ellagic acid, and ferulic acid. Both the developed BBD-RSM and evolved MGGP-based models predicted the observed process response of TPC, EY and AA satisfactorily with BBD-RSM models marginally better in their predictions. The reliability results showed that the BBD-RSM models predicted TPC, EY and AA values with high certainty of 99.985%, 97.569% and 98.661%, respectively.

Objectives: Chylothorax is a relatively rare condition of lymphatic fluid accumulation in the thoracic cavity due to a leakage from the thoracic duct or its tributaries. Patients present with dyspnea, malnutrition, and immunosuppression. Treatment can be conservative or surgical, depending on etiology and clinical course. The optimal management algorithm for chylothorax is still controversial. Methods: This is a retrospective study of all patients with chylothorax treated at our Department of Thoracic Surgery during the 10-year period. Results: A total of 14 patients were identified for the study. Nine patients had chylothorax after lung or esophageal cancer surgery. Four patients had chylothorax in advanced lymphoma. One patient had chylothorax after blunt chest trauma. A conservative approach was initiated in most patients (92%), including pleural drainage, nil per mouth, total parenteral nutrition, and somatostatin 0.1 mg bid subcutaneously. Surgical treatment was indicated in patients with thoracic drain production >800 mL per day beyond the fifth day of treatment and those with blunt thoracic trauma. Two patients had thoracic duct ligation via right-sided thoracotomy, and five patients had video-assisted thoracoscopic thoracic duct ligation with the immediate arrest of chylous leakage. Conclusion: Chylothorax should be treated conservatively initially. Surgical treatment should not be delayed in case of failure beyond the fifth day. In our series of patients, a video-assisted thoracoscopic approach for thoracic duct ligation proved to be minimally invasive, highly efficient, and well tolerated by patients and, therefore, should be the preferable route of surgical treatment.

Phytochemicals from Hedera helix L. lead to extracts with good biological properties which are beneficial to human health and can be used to protect plants against different diseases. The aim of this research was to find the most suitable extraction method and the most favorable parameters for different bioactive compounds extraction from ivy leaves. Different extraction methods, namely microwave assisted extraction (MAE), ultrasound assisted extraction (UAE), and conventional heating extraction (CHE), were used. The most suitable method for saponins extraction is MAE with an extraction efficiency of 58%, while for carbohydrates and polyphenols the best results were achieved by UAE with an extraction efficiency of 61.7% and 63.5%, respectively. The antioxidant activity (AA) of the extracts was also determined. The highest AA was obtained by UAE (368.98±9.01 µmol TR/gDM). Better results were achieved at 50 °C for 10 min of extraction, using 80% ethanol in water as solvent. In order to evaluate their in vitro cytotoxicity, the extracts richest in bioactive compounds were tested on NCTC fibroblasts. Their influence on the DNA content of RAW 264.7 murine macrophages was also tested. Until 200 µg/mL, the extracts obtained by UAE and MAE were cytocompatible with NCTC fibroblasts at 48 h of treatment.

Ureteral stricture (US) following ureteroscopic lithotripsy (URSL) has emerged as a serious issue due to the widespread use of laser technology. The management of complex US is challenging. This prospective study evaluated the efficacy of robot-assisted uretero-ureterostomy (RAUU) in addressing US following URSL, and analyzed the pathology of transected ureteral tissues to identify the risk factors for US during URSL. Fourteen patients, with a mean age of 49.8 years, were included in this study. The mean stricture length on radiography was 22.66 ± 7.38 mm. Nine (64.2%) patients had experienced failure with previous interventions, including eight patients who underwent endoscopic incision plus balloon dilation. At an average follow-up of 12.8 months, the overall success rates were 92.9% both clinically and radiographically, without major complications. Pathological findings revealed microcalcifications in 57.1% patients and loss of ureteral mucosa in 28.6% patients. In conclusion, this technique of RAUU via end-to-end anastomosis exhibits promise as a viable option for US following URSL in appropriately selected patients, despite serious pathological changes of the ureter. Migration to the site of ureteral perforation may be the most serious factor contributing to the development of US.

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.

Ultrasonic sensors are inexpensive and can take measurements with high accuracy, even with simple hardware configurations, so they are used in various fields. When multiple ultrasonic sensors exist in the measurement space, crosstalk occurs due to other nodes, which causes measurement errors. Crosstalk includes not only receiving homogeneous signals from other nodes, but also overlap by other signals, and interference by heterogeneous signals. This paper proposes a method that uses frequency sweep keying modulation to be robust against overlap and a faster region-based convolutional neural networks (R-CNN)-based demodulator to reduce the interference caused by heterogeneous signals. The demodulator works by training faster R-CNN with the spectrograms of various received signals and classifying the received signals using a faster R-CNN. Experiments implementing an ultrasonic crosstalk environment showed that compared to on-off keying (OOK), phase-shift keying (PSK), and frequency-shift keying (FSK), the proposed method can implement CDMA even with shorter codes, and is robust against overlap. Compared to correlation-based frequency sweep keying, the time-of-flight error was reduced by approximately 75%. While existing demodulators did not consider heterogeneous signals, the proposed method ignored approximately 99% of the OOK and PSK signals, and approximately 79% of the FSK signals. The proposed method performs better than the existing methods and is expected to be used in various applications.

Spray technology is widely used in various industries, including medicine, food production, mechanical engineering, and nanopowder manufacturing. Achieving high dispersion and a narrow particle size distribution is crucial for many applications. Ultrasonic spraying is commonly used to achieve this. On other hand, hydraulic nozzles provide high atomization performance. Combining these two technologies promises to offer significant benefits, but the complex processes that occur simultaneously in such a device require careful study. This work proposes a fundamental design for an acoustic-hydraulic nozzle and investigates the physical processes when a liquid is sprayed using this nozzle, both theoretically and experimentally. The study identifies the critical modes of spraying and confirms that the simultaneous use of ultrasound and hydraulic pressure can produce a fine spray (droplet size less than 50 μm) with high productivity (5-10 ml/s). This approach has significant potential for modern industries and technologies.

Background: The purpose of this study was to compare the immediate and long-term complications that are associated with the utilized techniques for the insertion of indwelling central venous catheters, that is the open surgical technique, the ultrasound-guided technique and the transcutaneous technique based on external anatomical landmarks in the right internal jugular vein, to a pediatric population. Methods: This was a prospective randomized trial based on a pediatric patient population, under 16 years of age, of a tertiary pediatric-oncological hospital. Procedure was performed by a medical team with varying experience regarding the percutaneous and open insertion methods. We studied the outcome of our procedure, based on the immediate and delayed complication rate, as well as the needed time in order to complete the procedure and mean duration of line use. Results: The patients that were inserted in our protocol were divided into three subgroups, based on the selected technique for the insertion of the central venous catheter. A total number of 88 insertions (25.4%) (out of 346) were based on the technique that was using external anatomical landmarks, 121 insertions were based on the ultrasound-guided transcutaneous technique (34,9%), whereas in 137 cases (39.5%) the open surgical technique was preferred. All cases that were related to catheter re-insertion were excluded from our study. We performed a statistical analysis regarding the catheter dwell time between the three subgroups of patients and no significant difference was recorded. Moreover, the development of thrombosis was investigated, and we mentioned that the higher percentage of this complication was related with the transcutaneous external landmark and open surgical technique. Also, the incidence of infection was taken into consideration, which manifested an increased incidence when the transcutaneous technique based on external landmarks was used. Conclusions: Ultrasound guided percutaneous insertion was considered to be a safe and effective technique for the insertion of central venous catheters. Our study also demonstrated a decrease in operating times, when performed by operators with increasing expertise, increased preservation of the diameter of the venous lumen, and no increase in complication rates when the ultrasound-guided technique was selected.

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.

The aim of this study was to evaluate the clinical and radiographic outcomes of the All-on-4 technique in fully edentulous maxilla using R2GATE software for flapless, computer-guided surgery and immediate loading. Ten adult patients with fully edentulous maxilla, aged between 35 and 60 years, were included in the study between April 2021 and April 2022. The surgical procedure was performed under local anesthesia and followed the All-on-4 approach with immediate loading of implants using a screw-retained provisional acrylic resin prosthesis on the same day. Final prosthesis was delivered four months after the surgery. Clinical and radiographic outcomes were evaluated at four- and twelve-months post-operation. The study reported a 95% implant survival rate using the All-on-4 technique. The mean marginal bone level was recorded at 0.35 mm and 0.66 mm during the 4 and 12-month follow-up periods, respectively. Fixed provisional prosthesis fracture, abutment, and prosthesis screw loosening were the most frequent mechanical complications reported. Within the limitations of this study, the use of computer-guided surgery in the All-on-4 technique seemed to be a promising treatment option with high implant survival rates that may help reduce post-surgical discomfort and mechanical complications in the rehabilitation of the edentulous maxilla.

This study examined the impact of Vibration-Assisted Drilling (VAD) on hole quality and residual stress in Ti-6Al-4V ELI material. Ti-6Al-4V ELI possesses excellent mechanical properties but presents challenges in machining, including chip evacuation, burr formation, and elevated cutting temperatures. VAD, particularly Low-Frequency Vibration-Assisted Drilling (LF-VAD), has been explored as a potential solution to address these issues. The research com-pares LF-VAD with conventional drilling (CD) under various cutting and cooling conditions. LF-VAD exhibits higher maximum cutting forces under specific conditions, which result in accel-erated tool wear. However, it also demonstrates lower RMS (Root Mean Square) forces com-pared to CD, offering better control over chip formation, reduced burr formation, and improved surface roughness within the hole. Furthermore, LF-VAD generates greater compressive residual stresses on the hole's inner surface compared to CD, suggesting enhanced fatigue performance. These findings indicate that LF-VAD holds promise for improving hole quality, fatigue life, and overall component durability in Ti-6Al-4V machining applications.

This study deals with the computational analysis of the kinetic processes of a microbial electrolysis cell assisted-anaerobic digestion (MEC-AD) treating raw-waste activated sludge (WAS), comparatively with a conventional AD, as well as the effect of the Organic Loading Rate (OLR) on the system’s performance. The aim was to derive a single kinetic and mathematical model for the study of the MEC-AD, using the ADM1 framework, which can be utilized to extract the effect of an applied potential on the kinetics of AD. The experimental data were obtained from the long-term, continuous operation of two identical reactors (an AD and a MEC-AD), which were operated at different OLRs (1.1, 1.7 and 2.9 gCOD/(L*d)). The results showed that the MEC-AD yielded improved biomass yields, substrate consumption kinetics and 1st order disintegration kinetics, with a predominant contribution to disintegration of complex particulates, comparatively with the AD. Moreover, it enabled operation at higher OLRs (achieving the highest divergence from the AD at the OLR of 4.14 gCOD/(L*d)), therefore accelerating sludge treatment, as well as an improved performance at an increased solids retention time (SRT). These findings can serve as a quantitative guide for the effects of the operating parameters on the raw-WAS-fed MEC-AD performance.

(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.

(1) Background: the popularity of rabbits has increased during the last decades and became the third common companion animals in EU. Their participation in animal assisted interventions (AAI) is growing. It is highly important to ensure the well-being of the animals in AAI. Whereas the needs and the advantages of people involved in AAI are becoming more and more evident, the needs of animals are not clearly determined, it is required not to affect the animals negatively. Those animals who are used for AAI purpose need toneed to be transported regulrarly; (2) Methods: the rabbits stress – caused by transportation – were measured by non-invasive faecaesl cortisol metabolite (FCM) analysis. 18 animals were involved in the study and experienced a 30 minutes transportation every second day duringfor two weeks (total 6 times) while 128 samples were collected; (3) Results: rabbits –could handle the transportation procedure by the first and second time but subsequently the stress hormone metabolites in faeces samples increased significantly regardless of the offered treatments (hay, carrot and apple) during the carriage. (4) Conclusions: those owners who use rabbits for Animal Assisted Intervention purpose need to take into account that transportation itself is a stressful experience for the animals.

Surgical navigation has evolved as a vital tool in maxillofacial surgery, offering precise and patient-specific data. This study explores the clinical applications and accuracy of intraoperative tool tracking in maxillofacial surgery. The research includes 37 patients with various pathologies who underwent surgery assisted by a surgical navigation system using tracked instruments. The study showcases two representative cases: one involving coronoid hyperplasia with mouth opening deficit and another addressing nose-orbital-ethmoidal-frontal ossifying fibroma resection. The results indicate that surgical navigation with tracked instruments provides high precision (<1.5 mm error), reduced surgical time, and less invasive approaches. The study highlights the potential for reproducible outcomes and increased safety, especially in complex cases. Despite some limitations, the synergy between surgical navigation and tracked instruments offers a promising approach in maxillofacial surgery, expanding its applications beyond current practices.

Infertility” is a condition defined by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his/her partner’. The authors have set out to succinctly investigate, explore and assess infertility treatments harnessing the potential of stem cells to effectively and safely treat infertility, in addition to the legal and regulatory complexities at the heart of stem cell research, with an overview of the legislative state of affairs in six major European countries. In couples who cannot benefit from assisted reproductive technologies (ART) to treat their infertility, stem cells-based approaches have been shown to be a highly promising approach. Nonetheless, lingering ethical and immunological uncertainties require more conclusive findings and data before such treatment avenues can become mainstream and applied large scale. The isolation of human embryonic stem cells (ESCs) is ethically controversial, since their collection involves the destruction of human embryonic tissue. Overall, stem cell research has resulted in important new breakthroughs in the treatment of infertility. The effort to untangle the complex web of ethical and legal issues associated with such therapeutic approaches will have to rely on evidence-based, broadly shared standards, guidelines and best practices to make sure that the procreative rights of patients can be effectively reconciled with the core values at the heart of medical ethics.

In neonatal equines, pathologies involving umbilical structures are an important cause of morbidity, and surgical removal of urachal remnants is a common procedure in clinical practice. Surgery involving the ventral abdominal wall can cause substantial pain, leading to complications and prolonged recovery. The objectives of this study were to describe a two-point bilateral ultrasound-guided rectus sheath block at the level of the umbilicus and to evaluate the extent of dye distribution in foal cadavers. Ten foal cadavers were included in the study, in which a bilateral two-point ultrasound-guided rectus sheath block was performed—one injection cranially and a second one caudally to the umbilicus. The injectate consisted of a mixture of iodinated contrast medium and blue dye at a volume of 0.25 mL kg-1 per injection point (total 1 mL kg-1). After the injection, computer tomography and subsequent dissection of the ventral abdominal wall were performed. The extension of the contrast medium, the number of stained nerves, and contamination of the abdominal cavity were evaluated. The cranio-caudal extension of the contrast ranged from 0.8 to 1.4 centimeters per milliliter of injectate. The most commonly stained ventral branches of spinal nerves were thoracic (Th) nerves 16, 17, and 18 (95%, 85%, and 80% of the nerves, respectively). Abdominal contamination was found in 4 animals. The results suggest that the block could provide periumbilical analgesia. Further studies with different volumes of injectate and living animals are warranted.

In this paper we overview all analytical engineering solutions for corrosion problems in pressure vessels delivered over the past 60 years. We briefly detail strengths and weaknesses of existing approaches, thus demonstrating the need for novel uniform corrosion analysis methods for both current and new applications. To complement the review, we also present a new analytical model allowing to estimate the lifetime of pressured elastic vessels with mechanically assisted corrosion. Both internal/external pressure and internal/external corrosion are captured and dissolution driven corrosion is also considered. The readily implemented method improves existing analytical approaches and is shown to be effective for thin and thick shells, as well as various loading and corrosion intensity and geometrical conditions.

A complete model was developed to simulate the behavior of a circular clamped axisymmetric fluid-coupled Piezoelectric Micromachined Ultrasonic Transducer (PMUT). Combining Finite Difference and Boundary Element Matrix (FD-BEM), this model is based on the discretization of the partial differential equation used to translate the mechanical behavior of a PMUT. In the model, both the axial and the transverse displacements are preserved in the equation of motion and used to properly define the neutral line position. To introduce fluid coupling, a Green’s function dedicated to axisymmetric circular radiating sources is employed. The resolution of the behavioral equations is used to establish the equivalent electroacoustic circuit of a PMUT that preserves the average particular velocity, the mechanical power, and the acoustic power. Particular consideration is given to verifying the validity of certain assumptions that are usually made across various steps of previously reported analytical models. In this framework, the advantages of the membrane discretization performed in the FD-BEM model are highlighted through accurate simulations of the first vibration mode and especially the cutoff frequency that many other models do not predict. This high cutoff frequency corresponds to cases where the spatial average velocity of the plate is null and is of great importance for PMUT design because it defines the upper limit above which the device is considered to be mechanically blocked. These modeling results are compared with electrical and dynamic membrane displacement measurements of AlN-based PMUTs in air and fluid. This complete PMUT model using the FD-BEM approach is shown to be very efficient in terms of computation time and accuracy.

With the widespread Application of Virtual Reality (VR) in education, optimizing foreign language learning in VR has become a focal point of research. This paper introduces a comprehensive theoretical framework (VR-CCL) based on constructivism and cognitive load theory to enhance foreign language learning in VR. Through a literature review, we explore the applications of VR in education, foreign language learning theories, and prior works on technology-assisted language learning. We further detail the three main components of the VR-CCL framework and validate its effectiveness through two case studies: Duolingo VR and Rosetta Stone VR. Finally, we discuss the strengths and limitations of the framework and its implications for educators and developers.

Background: Ultrasonography in medicine allows real time “dynamic” assessment of structure where the procedure takes place. This feature and design could be more advantageous than radiological “static” view imaging. Thus, it is the convincing imaging tool for many structural cardiovascular and gastrointestinal interventions. Technically, the image resolution for Endosonography (EUS) is noticeably higher than that of transesophageal echocardiography (TOE). The benefits of investigating the cardiovascular structures using this high-resolution endoscope are unknown. Clinical applications: We present clinical applications of incidentally diagnosed cardiovascular structures, which demonstrated during routine gastrointestinal endosonographic procedures. These diagnoses could influence changes in management strategies. Discussion: The introduction of high resolution endosonography (EUS) in cardiology allows "panoramic" and “dynamic” real-time assessment of cardiovascular structures with an accurate definition of the variable cardiovascular anatomy. Using this advantage during routine gastrointestinal procedures allows for the early detection of asymptomatic cardiac pathologies and accompanying diseases, prevents double investigations for patients and operators, eliminates the risk of esophageal trauma, highlights interdisciplinary teamwork benefits, and could facilitate in the future the indications for cardiac-based structural procedures, which could influence management strategies with improved safety, efficacy, and economic outcomes. Conclusion: The introduction of endosonography (EUS) in cardiology provide high-resolution real-time assessments of cardiovascular anatomy. Thus, it can be used for early detections of variable cardiovascular pathologies during routine gastrointestinal procedures.

Background Ultrasonographic measurement of the optic nerve sheath diameter (ONSD) is helpful in the assessment of intracranial pressure. The aim of this study was to determine whether the Trendelenburg position during laparoscopic urological surgery changed the ONSD and whether changes correlated with postoperative complications. Methods In this prospective study, we measured ONSD before patients were placed in the Trendelenburg position. Then the Trendelenburg position was established by tilting the operating table to 20-25 degrees. After surgery, the patients were placed in a horizontal position, and the second measurement of ONSD was obtained. Results The study included 69 patients. The average preoperative ONSD in the right eye was 5.8 ± 0.7 mm and 5.8 ± 0.8 mm in the left eye. The average postoperative ONSD in the right eye was 6.6 ± 0.8 mm and 6.6 ± 0.7 mm in the left eye. The differences between postoperative and preoperative values in the right and left eyes were statistically significant (p <0.000001). ONSD increases above the norm did not correlate with the incidence of postoperative nausea (p = 0.94), delirium (p = 0.81), or the time to patient awakening (p = 0.29). Conclusion ONSD increased in patients who underwent surgical procedures performed in the Trendelenburg position, but the increase did not correlate with postoperative complications.

When analyzing user geospatial information through deep learning methods, it is typically necessary to annotate existing geospatial data. Currently, manual annotation methods are commonly employed, suffering from issues related to low efficiency and accuracy. This design is based on the TensorFlow deep learning framework and first realizes the BiLSTM+CRF+AGG deep learning model. Among the models, AGG is the aggregation layer, which is introduced to solve the problem of solid particle size equilibrium. Secondly, based on the characteristics of original data and professional data, an automatic labeling algorithm is proposed. The algorithm first preprocesses the acquired original data set and professional data set, The most valuable unlabeled data set which can make the training model converge quickly is selected from the original data set as the target data set. Sort the target data set based on preset rules and set annotation parameters for the sorted target data set. Based on the set annotation parameters, the corpus is synthesized and used as the annotation result. Thirdly, based on the active learning strategy, a manual annotation auxiliary scheme is proposed, and an Excel generation module that is convenient for manual annotation correction is designed and developed to further improve the efficiency and quality of annotation through iterative processing. The combination of the BiLSTM+CRF+AGG deep learning model and high-quality annotation can accurately identify non-standard, incomplete, or even incorrect geographical information entities. This annotation method has found successful practical application within the context of the research project and has been granted an invention patent.

We aimed to develop a non-linear regression model that could predict the fat fraction of the liver (USFF), similar to magnetic resonance imaging proton density fat fraction (MRI-PDFF), based on quantitative ultrasound (QUS) parameters. We measured and retrospectively collected the ultrasound attenuation coefficient (AC), backscatter-distribution coefficient (BSC-D), and liver stiffness (LS) using shear wave elastography (SWE) in 90 patients with clinically suspected non-alcoholic fatty liver disease (NAFLD) and 51 patients with clinically suspected metabolic-associated fatty liver disease (MAFLD). The MRI-PDFF was also measured in all patients within a month of the ultrasound scan. In the linear regression analysis, only AC and BSC-D showed a significant association with MRI-PDFF. Therefore, we developed prediction models using non-linear least-squares analysis to estimate MRI-PDFF based on the AC and BSC-D parameters. We fitted the models on the NAFLD dataset and evaluated their performance in 3-fold cross-validation repeated five times. We decided to use the model based on both parameters to estimate the ultrasound fat fraction (USFF). The correlation between USFF and MRI-PDFF was strong in NAFLD and very strong in MAFLD. According to a receiver operating characteristics (ROC) analysis, USFF could differentiate between <5% vs. ≥ 5% and < 10% vs. ≥ 10% MRI-PDFF steatosis with excellent, 0.97 and 0.91 area under the curve (AUC) accuracy in the NAFLD and with AUCs of 0.99 and 0.96 in the MAFLD groups. In conclusion, USFF calculated from QUS parameters is an accurate method to quantify liver fat fraction and to diagnose ≥ 5% and ≥ 10% steatosis in both NAFLD and MAFLD. Therefore, USFF can be an ideal non-invasive screening tool for patients with NAFLD and MAFLD risk factors.

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.

Cochlear implantation (CI) allows rehabilitation for patients with severe to profound hearing impairment. Although the use of a robotic assistant provides technical assistance to the surgeon, the assessment of the impact of its use on auditory outcomes remains uncertain. We aim to com-pare the hearing results of patients who underwent bilateral cochlear implantation, one side was performed with manual insertion and the other side with robot-assisted insertion. The electrode array intrascalar positioning and the surgery duration were also studied. This retrospective intra-individual study involved 10 patients who underwent bilateral cochlear implantation. The study included 2 infants and 8 adults. The unique composition of this cohort enabled us to utilize each patient as their own control. Regarding speech disyllabic recognition, pure tone average, ECAP, ratio of array translocation, basilar membrane rupture, percentage of translocated electrodes there was no difference between manual and robot-assisted CI groups. This study is the first to compare intra-individual hearing performance after cochlear implantation either manually or robot-assisted. The number of patients and the time delay between manual and robotic implantation may have led to a lack of power, but there was no apparent difference in hearing performance between manual and robotic implantation.

Determination of the fetal gender in the first trimester is important in twin pregnancy cases of familial X-linked genetic syndromes and helps determine chorionicity. We assessed and compared the accuracy of first-trimester ultrasound scans, and circulating cell-free fetal DNA (cffDNA) performed by non-invasive prenatal screening (NIPS) in determining fetal gender in the first trimester of twin pregnancies. For this purpose, we enrolled prospectively pregnant women with twin during the first trimester, gestational week (GA) 11-13. The fetal gender was determined using both ultrasound scans and cffDNA screening. Both results were compared to the newborn gender at delivery. A total of 113 women with twin pregnancies were enrolled. There was 100% sensitivity and specificity in Y chromosome detection using cffDNA. The accuracy of gender assignment using ultrasound in any first-trimester scans was 79.7%. Accuracy level increased from 54.2% in CRL 45-54 mm to 87.7% in CRL 55-67 mm and 91.5% in CRL 67-87 mm. Male fetuses had significantly higher chances of a gender assignment error compared to female fetuses, odds ratio = 23.57 (CI 7.356 - 75.66). This is the first study that compared the accuracy of gender determination in the first trimester by cffDNA and by ultrasound scanning in twin pregnancy. It was concluded that the cffDNA is highly sensitive and specific in determining the presence of the Y chromosome in twin pregnancies in the first trimester. Between CRL 67-87 mm, ultrasound scanning offers a highly accurate determination of fetal gender in twin pregnancies. Larger cohorts of multi-center studies are warranted.