General–purpose automatic speech recognition (ASR) systems have improved their quality and are being used for pronunciation assessment. However, the assessment of isolated short utterances, as words in minimal pairs for segmental approaches, remains an important challenge, even more for non-native speakers. In this work, we compare the performance of our own tailored ASR system (kASR) with the one of Google ASR (gASR) for the assessment of Spanish minimal pair words produced by 33 native Japanese speakers in a computer-assisted pronunciation training (CAPT) scenario. Participants of a pre/post-test training experiment spanning four weeks were split into three groups: experimental, in-classroom, and placebo. Experimental group used the CAPT tool described in the paper, which we specially designed for autonomous pronunciation training. Statistically significant improvement for experimental and in-classroom groups is revealed, and moderate correlation values between gASR and kASR results were obtained, beside strong correlations between the post-test scores of both ASR systems with the CAPT application scores found at the final stages of application use. These results suggest that both ASR alternatives are valid for assessing minimal pairs in CAPT tools, in the current configuration. Discussion on possible ways to improve our system and possibilities for future research are included.

This review article is focused on the analysis of the state of the art of sensors for guided 9 ultrasonic waves for the detection and localization of impacts, therefore of interest for the structural 10 health monitoring (SHM). The recent developments in sensor technologies are then reported and 11 discussed through the many references in recent scientific literature. The physical phenomena re-12 lated to impact event and the main physical quantities are then introduced to discuss their im-13 portance in the development of the hardware and software components for SHM systems. An im-14 portant aspect of the article is the description of the different ultrasonic sensor technologies cur-15 rently present in the literature and what advantages and disadvantages they could bring, in relation 16 to the various phenomena investigated. In this context, the analysis of the front-end electronics is 17 deepened, the type of data transmission both in terms of wired and wireless technology and in terms 18 of online and offline signal processing. The integration aspects of sensors for the creation of net-19 works with autonomous nodes with the possibility of powering through energy harvesting devices 20 and the embedded processing capacity is also studied. Finally, the emerging sector of processing 21 techniques using deep learning and artificial intelligence concludes the review by indicating the 22 potential for the detection and autonomous characterization of the impacts.

Nanometer-curved surfaces are abundant in biological systems as well as in nano-sized technologies. Properly functionalized polymer-grafted nanoparticles (PGNs) adhere to surfaces with different geometries and curvatures. This work explores some of the energetic and mechanical characteristics of the adhesion of PGNs to surfaces with positive, negative and zero curvatures using Coarse-Grained Molecular Dynamics (CGMD) simulations. Our calculated free energies of binding of the PGN to the curved and flat surfaces as a function of separation distance show that curvature of the surfaces critically impacts the adhesion strength. We find that the flat surface is the most adhesive, and the concave surface is the least adhesive surface. This somewhat counterintuitive finding suggests that while a bare nanoparticle is more likely to adhere to a positively curved surface than a flat surface, grafting polymer chains to the nanoparticle surface inverts this behavior. Moreover, we studied the rheological behavior of PGN upon separation from the flat and curved surfaces under external pulling force. The results presented herein can be exploited in drug delivery and self-assembly applications.

Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairments, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive-compulsive, post-traumatic, and substance use disorder; and shows transdiagnostic potential for EDs, particularly among clinical non-responders. As such, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value, yet are limited to case series and reports on anorexia nervosa. Further empirical work is thus needed to explore ketamine efficacy across ED subgroups; establish safety profiles and optimize dosing; and develop theory-driven, targeted treatment strategies at the individual patient level.

High Brassicaceae consumption reduces the risk of developing several cancer types, probably due to their glucosinolate amount. Extracts from Sinapis nigra L. and Sinapis alba L. have been obtained from leaves and seeds under different conditions using ethanol/water mixtures because well accepted by food industry. The EtOH/H2O 8:2 mixture gives better yields in glucosinolate amounts from grinded seeds, mainly sinalbin in S. alba and sinigrin in S. nigra. The highest antiproliferative activity in both non-tumour and tumour cell lines was induced by S. alba seeds extract. To evaluate whether Sinapis spp effect was only due to glucosinolate content or it was influenced by the extracts’ complexity, cells were treated with extracts or glucosinolates, in the presence of myrosinase. Pure sinigrin did not modify cell proliferation, while pure sinalbin was less effective than the extract. The addition of myrosinase increased the antiproliferative effects of the S. nigra extract and sinigrin. Antiproliferative activity was correlated to MAPKs modulation, which was cell and extract-dependent. Cell-cycle analysis evidenced a proapoptotic effect of S. alba on both tumour cell lines and of S. nigra only on HCT 116. Both extracts showed good antimicrobial activity in disc diffusion tests and on ready-to-eat fresh salad. These results underline the potential effects of Sinapis spp in chemoprevention and food preservation.

Ultrasonic measurements are used in civil engineering for structural health monitoring of concrete infrastructures. The late portion of the ultrasonic wavefield, the coda, is sensitive to small changes in the elastic moduli of the material. Coda Wave Interferometry (CWI) correlates these small changes in the coda with the wavefield recorded in intact, or unperturbed, concrete specimen to reveal the amount of velocity change that occurred. CWI has the potential to detect localised damages and global velocity reductions alike. In this study, the sensitivity of CWI to different types of concrete mesostructures and their damage levels is investigated numerically. Realistic numerical concrete models of concrete specimen are generated and damage evolution is simulated using the discrete element method. In the virtual concrete lab, the simulated ultrasonic wavefield is propagated from one transducer using a realistic source signal and recorded at a second transducer. Different damage scenarios reveal a different slope in the decorrelation of waveforms with the observed reduction in velocities in the material. Finally, the impact and possible generalizations of the findings are discussed and recommendations are given for a potential application of CWI in concrete at structural scale.

Access to broadband communications in different parts of the world has become a priority for some governments and regulatory authorities around the world in recent years. Building new digital roads and pursuing a connected society includes looking for easier access to the Internet. In general, not all the areas where people congregate are fully covered, especially in rural zones, thus restricting access to data communications and bringing inequality. In the present review article, we have comprehensively surveyed the use of three platforms to deliver broadband services to such remote and low-income areas are proposed: Unmanned Aerial Vehicles (UAV), Altitude Platforms (APS), and Low-Earth Orbit (LEO) satellites. These novel strategies support the connected and accessible world hypothesis. Hence UAVs are considered a noteworthy solution since their efficient maneuverability can aboard the rural coverage issues or not-spots.

Silybum marianum (L.) Gaertn. (aka milk thistle) constitute the almost exclusive source of silymarin, a mixture of different flavonolignans, and is thus considered as a unique model for their extraction. The present research deals with ultrasound-assisted extraction (UAE) of S. marianum flavonolignans and their quantification using LC system. The optimal conditions for UAE were: aqueous EtOH 54.5% (v/v) as solvent, applying an ultrasound frequency of 36.6 kHz during an extraction time of 60 min at 45°C with a liquid to solid ratio of 25:1 ml/g DW. Following optimization, the extraction method was validated according to international standards of the association of analytical communities (AOAC) in order to ensure its precision and accuracy for the quantitation of the individual silymarin components. The efficiency of UAE was compared with maceration protocol of the same duration. The optimized and validated conditions allowed highest extraction yields of flavonolignans in comparison to maceration. The antioxidant capacity of the extracts was confirmed by the CUPRAC assays and inhibition of advanced glycation end products. The skin anti-aging action was also confirmed toward the strong in vitro inhibition capacity of the obtained extract against collagenase and elastase enzymes. The procedure presented here allows a green efficient extraction and quantification of the main flavonolignans from the fruits of S. marianum with attractive antioxidant and anti-aging activities for future cosmetic applications.

Background: Elucidation of epigenetic mechanisms correlating with neuropathic pain in humans is crucial for the prevention and treatment of this treatment-resistant pain state. In the present study, associations between neuropathic pain characteristics and DNA methylation of the transient receptor potential ankyrin 1(TRPA1) gene were evaluated in chronic pain patients and preoperative patients. Methods: Pain and psychological states were prospectively assessed in patients who suffered chronic pain or were scheduled for thoracic surgery. Neuropathic characteristics were assessed using the Douleur Neuropathique 4 (DN4) questionnaire. DNA methylation levels of the CpG island in the TRPA1 gene were examined using whole blood. Results: Forty-eight adult patients were enrolled in this study. Increases in DNA methylation rates at CpG -51 showed positive correlations with increases in the DN4 score both in preoperative and chronic pain patients. Combined methylation rates at CpG -51 also significantly increased together with increase in DN4 scores. Conclusions: Neuropathic pain characteristics are likely associated with methylation rates at the promoter region of the TRPA1 gene in human peripheral blood.

We demonstrate hybrid integration of a lithium niobate microring resonator with a silicon nitride waveguide in the vertical configuration to achieve efficient light coupling. The microring resonator is fabricated on a lithium niobate on insulator (LNOI) substrate using photolithography assisted chemo-mechanical etching (PLACE). A fused silica cladding layer is deposited on the LNOI ring resonator. The silicon nitride waveguide is further produced on the fused silica cladding layer by first fabricating a trench in the fused silica using focused ion beam (FIB) etching for facilitating the evanescent coupling, followed by formation of the silicon nitride waveguide on the bottom of the trench. The FIB etching ensures the required high positioning accuracy between the waveguide and the ring resonator. We achieve Q-factors as high as 1.4*10^7 with the vertically integrated device.

Music perception in foetuses has been explored under different theoretical paradigms such as habituation, categorical perception, sound preferences and recall. This study investigated the temporal dimension of music perception through the habituation and sensitization paradigm. Foetuses of 41 pregnant women, mean gestational age of 34.7 weeks (±2.4), were observed during ultrasound exams. Foetuses’ reaction to two different tempos (Allegro vs Adagio) and sources (internal vs external) of music stimuli was registered by heart rate variability (HR) and motor response according to the Assessment of Preterm Infants Behaviour scale (APIB) by its factors of movement (MOV) and organization (ORG). A folkloric lullaby, sung and played live with a stringed instrument by a musician, was presented in three stages that were compared to baseline: 1) slow tempo (Adagio), 2) fast tempo (Allegro); and 3) now sung by mother at slow tempo (Adagio). Exploratory analyses showed that all factors increased from baseline to first stage. HR and ORG varied significantly among stages, with HR being the strongest factor. MOV merely detected change from baseline to first stage. ORG decreased for Allegro but increased for maternal Adagio, while HR decreased to near baseline values. ANOVA-repeated measures with gestational age as covariate showed that all measures were sensitive to first music presentation (Adagio), although only HR and ORG differed among stages. Considering estimated marginal means, adjusted for gestational age, HR presented a sensitization pattern throughout stages, but ORG kept habituating to external source and increased to maternal Adagio, suggesting foetal discrimination by sound source. We conclude that foetuses showed different behavioural and physiological responses to external versus internal sound source and musical tempo. The combined use of a behavioural scale (APIB) and HR in foetuses proved to be a valid multidimensional instrument.

The COVID-19 pandemic has affected millions of people globally, with respiratory organs being strongly affected in individuals with comorbidities. Medical imaging-based diagnosis and prognosis have become increasingly popular in clinical settings to detect COVID-19 lung infections. Among various medical imaging modalities, ultrasound stands out as low-cost, mobile, and radiation-safe imaging technology. In this comprehensive review, we focus on ultrasound-based AI studies for COVID-19 detection that use public or private lung ultrasound datasets. We surveyed articles that used publicly available lung ultrasound datasets for COVID-19 and reviewed publicly available datasets and organize ultrasound-based AI studies per dataset. We analyzed and tabulated studies in several dimensions, such as data preprocessing, AI models, cross-validation, and evaluation criteria. In total, we reviewed 42 articles, where 28 articles used public datasets, and the rest used private data. Our findings suggest that ultrasound-based AI studies for the detection of COVID-19 have great potential for clinical use, especially for children and pregnant women. Our review also provides a useful summary for future researchers and clinicians who may be interested in the field.

Background: Ultrasonography’s usefulness in endometrial cancer (EC) diagnosis consists of its staging and predictive roles. Ultrasound-measured tumor-free distance from the tumor to the uterine serosa (uTFD) is a promising marker for this variable. The aim of the study was to determine the usefulness of this biomarker in locoregional staging, and thus in the prediction of lymph node metastasis (LNM). Methods: We conducted a single-institutional, prospective study on 116 consecutive patients with EC who underwent 2D transvaginal ultrasound examination. The uTFD marker was compared with the depth of ultrasound-measured myometrial invasion (uMI). Univariate and multivariate logit models were evaluated to assess the predictive power of the uTFD and uMI in regard to LNM. The reference standard was a final histopathology result. Survival was assessed by the Kaplan-Meyer method. Results: LNM was found in 17% of the patients (20/116). In the univariate analysis, uMI and uTFD were significant predictors of LNM. Accuracy was 70.7%, and NPV was 92.68% (OR 4.746, 95% CI 1.710-13.174) for uMI (p = 0.002), and 63.8%, and 89.02% (OR 0.842, 95% CI 0.736 – 0.963), respectively, for uTFD (p = 0.01). The cut-off value for uTFD in the prediction of LNM was 5.2 mm. The absence of LNM was associated more with biomarker values uMI <1/2 and uTFD >=5.2 mm than with the presence of metastases with uMI >1/2 and uTFD values <5.2 mm. In the multivariate analysis, the accuracy of the uMI-uTFD model was 74%, and NPV was 90.24% (p = NS). Neither uMI nor uTFD are surrogates for overall and recurrence-free survivals in endometrial cancer. Conclusions: Both uMI and uTFD, either alone or in combination, are valuable tools for gaining additional preoperative information on expected lymph node status. Negative lymph nodes status is better described by ultrasound biomarkers than a positive status. It is easier to use uTFD measurement as a biomarker of EC invasion than uMI, and the former still maintains a similar predictive value for lymph node metastases to the latter at diagnosis.

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

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

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

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

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

HTTP/2 video streaming has caught a lot of attentions in the development of multimedia technologies over the last few years. In HTTP/2, the server push mechanism allows the server to deliver more video segments to the client within a single request in order to deal with the requests explosion problem. As a result, recent research efforts have been focusing on utilizing such a feature to enhance the streaming experience while reducing the request-related overhead. However, current works only optimize the performance of a single client, without necessary concerns of possible influences on other clients in the same network. When multiple streaming clients compete for a shared bandwidth in HTTP/1.1, they are likely to suffer from unfairness, which is defined as the inequality in their bitrate selections. For HTTP/1.1, existing works have proven that the network-assisted solutions are effective in solving the unfairness problem. However, the feasibility of utilizing such an approach for the HTTP/2 server push has not been investigated. Therefore, in this paper, a novel proxy-based framework is proposed to overcome the unfairness problem in adaptive streaming over HTTP/2 with the server push. Experimental results confirm the outperformance of the proposed framework in ensuring the fairness, assisting the clients to avoid rebuffering events and lower bitrate degradation amplitude, while maintaining the mechanism of the server push feature.

Animal-assisted interventions (AAI) are a unique class of complementary medical treatments that can improve a patient’s quality of life, both physically and psychologically. Part I of this two-paper systematic literature review series focused on the study methods and quantitative results of researchers in this field. We continue this in-depth review here in Part II by discussing the common theories associated with AAI in the context of cancer. Of all the factors at work in human-animal interactions, researchers explicitly cite compatible animal personality, physical touch, physical movement, distraction/entertainment, and increased human interaction as the mechanisms responsible for the positive clinical outcomes observed in AAI. In various combinations, these mechanisms group under broader theoretical frameworks that attempt to fully explain the AAI context as it relates to cancer care. The social support hypothesis and the conception of a human-animal bond are the most referenced overarching frameworks. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are also referenced. We briefly consider other relevant theories commonly noted in the human-animal interactions literature that have the potential to clarify aspects of cancer-related AAI. We also discuss the neurobiological transduction mechanisms needed to connect theoretical frameworks and their mechanisms directly to the observed clinical outcomes. To advance the field, researchers should consider overarching theories with testable hypotheses when designing studies, and use consistent terminology when reporting results. This review lays a foundation for progress towards a unified theoretical framework and for effective treatment of the whole cancer patient.

Difficult-to-cut materials are being increasingly used in many industries because of their superior properties, including high corrosion resistance, heat resistance and specific strength. However, these same properties make the materials difficult to machine using conventional machining techniques. Laser-assisted milling (LAM) is one of the effective methods for machining difficult-to-cut materials. In laser-assisted milling machining occur after the workpiece is locally preheated using a laser heat source. Laser assisted machining has been studied by many researchers on flat workpiece or micro end-milling. However, there is no research on the curved shape using laser assisted milling. This study investigated the use of laser assisted milling to machine a three-dimensional curved shape workpiece based on NURBS. A machining experiment was performed on Inconel 718 using different tool paths (ramping, contouring) under various machining conditions. Finite elements analysis was conducted to determine the depth of cut. Cutting force, specific cutting energy and surface roughness characteristics were measured, analyzed and compared for conventional and LAM machining. LAM significantly improved these machining characteristics, compared to conventional machining. There results can be applied to the laser-assisted machining of various three-dimensional shapes.

The efficiency of producing embryos using in vitro technologies in livestock species rarely exceeds the 30 to 40% threshold, indicating that the proportion of oocytes that fail to develop after in vitro fertilization and culture is considerably large. Considering that the intrinsic quality of the oocyte is one of the main factors affecting blastocyst yield, the precise identification of non-invasive cellular or molecular markers that predict oocyte competence is of major interest to research and practical applications. The aim of this review was to explore the current literature on different non-invasive markers associated with oocyte quality in the bovine model. Apart from some controversial findings, the presence of cycle-related structures in ovaries, a follicle size between 6 and 10 mm, large number of surrounding cumulus cells, slightly expanded investment without dark areas, large oocyte diameter (>120 microns), dark cytoplasm, and the presence of a round and smooth first polar body have been associated to better competence. In addition, the combination of oocyte and zygote selection by BCB test and spindle imaging have the potential to further optimize the identification of oocytes with better developmental competence for in vitro-derived technologies in livestock species.

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results; therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.

Medical research has suggested that the anterior-posterior (AP)-diameter of the inferior vena cava (IVC) and its associated temporal variation as imaged by bedside ultrasound is useful in guiding fluid resuscitation of the critically-ill patients. This paper develops semi-automatic active ellipse and rectangle algorithms for measurement and tracking of the AP-diameter. The proposed algorithms are compared with an expert manual measurement and the previous work based on active circle model. It is shown that regardless of the shape of the IVC, the rectangle model always outperforms the two other models and performs very close to manual measurement.

Background and Objectives: Acute Heart Failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying the pulmonary hypertension (PH) in patients admitted due to AHF, predict the evolution of the disease during hospitalization and identify areas of improvement in the care of patients with AHF. Materials and Methods: Patients were evaluated with a standard exam of lung ultrasound, echocardiography, inferior vena cava (IVC) and femoral, renal, hepatic, portal venous Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation – SD 13,4). Seven patients (23.3%) had a renal function worsening. Regarding ultrasound findings, venous excess ultrasonography score (VExUS) score was calculated at admission and at discharge, surprisingly remaining unchanged or even worsened in most of them (21 patients, 70.0%). The area under the curve for the Lung Score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (p &lt;0.001), hepatic vein Doppler (p &lt;0.001), portal vein Doppler (p = 0.030), intra-renal vein Doppler (p = 0.025) and VExUS score (p = 0.023), remaining similar the femoral vein Doppler (p = 0.177) and IVC (p = 0.132). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VExUS score, should be further studied in different populations before expanding its use in AHF patients.

Therapeutic antibodies targeting immune checkpoints have shown limited efficacy in clinical trials in glioblastoma (GBM) patients. Ultrasound-mediated blood-brain barrier opening (UMBO) using low-intensity pulsed ultrasound improved drug delivery to the brain. We explored the safety and the efficacy of UMBO plus immune checkpoint inhibitors in preclinical models of GBM. A Blood-brain barrier (BBB) opening was performed using a 1 MHz preclinical ultrasound system in combination with 10µl/g microbubbles. Brain penetration of immune checkpoint inhibitors was determined, and immune cell populations were evaluated using flow cytometry. The impact of repeated treatments on survival was determined. In syngeneic GL261-bearing immunocompetent mice, we showed that UMBO safely and repeatedly open the BBB. BBB opening was confirmed visually and microscopically using Evans’s blue dye and magnetic resonance imaging. UMBO plus anti-PDL-1 was associated with a significant improvement of the overall survival compared to anti-PD-L1 alone. Using mass spectroscopy, we showed that the penetration of therapeutic antibodies can be increased when delivered intravenously compared to non-sonicated brains. Furthermore, we observed an enhancement of activated microglia percentage when combined with anti-PD-L1. Here, we report that the combination of UMBO and anti-PD-L1 dramatically increases GL261-bearing mice's survival compared to their counterparts treated with anti-PD-L1 alone. Our study highlights the BBB as a limitation to overcome to increase the efficacy of anti-PD-L1 in GBM and supports clinical trials combining UMBO and in GBM patients.

Study evaluates the characteristics and clinical course of patients with iris cysts in the long term of follow-up (24-48 months). We analyzed retrospectively the medical records of 39 patients with iris cysts (27 female and 12 male). Age, visual acuity, intraocular pressure (IOP), slit-lamp evaluation, and ultrasound biomicroscopy images were assessed. The mean age at diagnosis was 40.6±17.48 years. 30 (76.9%) cysts were peripheral, 5 (12.8%) cysts located at the pupillary margin, 2 (5.1%) cysts were midzonal and 2 (5.1%) multichamber cysts extended from the periphery to the pupillary margin. 23 (59%) cysts were in the lower temporal quadrant, 11 (28.2%) cysts in the lower nasal quadrant, and 5 (12.8%) cysts in the upper nasal quadrant. Cyst size was positively correlated with the age of the patients (rs = 0.38, p = 0.003) and negatively correlated with visual acuity (rs = -0.42, p = 0.014). No cyst growth was documented. The only complication was an increase in IOP in 3 (7.7%) patients with multiple cysts. The anatomical location of cysts cannot differentiate them from solid tumors. The vast majority of cysts are asymptomatic, do not increase in size, and do not require treatment in long-term follow-up.

Fusarium wilt of banana is a devastating disease that has decimated banana production worldwide. Host resistance to Fusarium oxysporum f. sp. cubense (Foc), the causal agent of this disease, is genetically dissected in this study using two Musa acuminata ssp. malaccensis segregating populations segregating for Foc Tropical (TR4) and Subtropical (STR4) race 4 resistance. Marker loci and trait association using 11 SNP-based PCR markers allowed the candidate region to be delimited to a 12.9 cM genetic interval corresponding to a 959 kb region on Chromosome 3 of ‘DH-Pahang’ reference assembly v4. Within this region, there is a cluster of pattern recognition receptors, namely leucine rich repeat ectodomain containing receptor-like protein kinases, cysteine-rich cell wall associated protein kinases, and leaf rust 10 disease-resistance locus receptor-like proteins positioned in an interspersed arrangement. Their transcript levels were rapidly upregulated in the resistant but not in susceptible F2 progenies at the onset of infection. This suggests that one or several of these genes may control resistance at this locus. To confirm the segregation of single-gene resistance, we generated an inter-cross between the resistant parent ‘Ma850’ and a susceptible line ‘Ma848’, to show that the STR4 resistance co-segregated with marker ‘28820’ at this locus. Finally, an informative SNP marker 29730 allowed the locus specific resistance to be assessed in a collection of diploid and polyploid banana plants. Out of the 60 lines screened, 22 lines were predicted to carry resistance at this locus, including lines known to be TR4 resistant, such as ‘Pahang’, ‘SH-3362’, ‘SH-3217’, ‘Ma-ITC0250’, and ‘DH-Pahang/CIRAD 930’. Additional screening in the International Institute for Tropical Agriculture’s collection suggests that the dominant allele is common among in the elite ‘Matooke’ NARITA hybrids, as well as in other triploid or tetraploid hybrids derived from East African highland bananas. Fine-mapping and candidate gene identification will allow characterization of molecular mechanisms underlying TR4 resistance. The markers developed in this study can now aid the marker-assisted selection of TR4 resistance in breeding programs around the world.

(1) Background: Considering highly selected patients with ductal carcinoma in situ (DCIS), active surveillance is a valid alternative to surgery. Our study is aimed at showing the reliability of post-biopsy complete lesion removal, documented by mammogram, as additional criterion to select these patients. (2) Methods: 2173 Vacuum Assisted Breast Biopsies (VABB) documented as DCIS have been reviewed. Surgery has been performed in all cases. We retrospectively collected the reports of post-VABB complete lesion removal and the histological results of the biopsy and surgery. We calculated the rate of upgrade of DCIS identified on VABB upon excision for patients with post-biopsy complete lesion removal and for those showing residual lesion. (3) Results: We observed 2173 cases of DCIS: 408 classified as low grade; 1262 as intermediate grade; 503 as high grade. The overall upgrading rate to invasive carcinoma was 15.2% (330/2173). The upgrade rate was significantly lower (8.2%) when considering patients showing mammographically documented complete removal of the lesion. (4) Conclusion: The absence of mammographically documented residual lesion following VABB is associated to a lower upgrading rate of DCIS to invasive carcinoma on surgical excision and should be considered when deciding the proper management DCIS diagnosis.

Nymphaea lotus L. is the medicinal plant that has long been used as food, cosmetic and traditional medicines in Africa and Asia since the ancient time. Its flavonoids and other interesting phytochemical compounds from rhizome, leaf, and the whole flowers have been reported in the previous published researches. However, stamens, which are essential for reproductive functions, may also represent new alternative sources of potential antioxidant flavonoids as investigated in this study. The innovative green chemistry method i.e. ultrasound-assisted extraction (USAE) as well as macroporous resin (MPR) purification procedure were employed in this current research. The optimal ultrasound-assisted extraction condition is 90 % (v/v) aqEtOH with 34.65 khz ultrasonic frequency and 46 minutes of extraction time. Comparing with heat reflux extraction (HRE) conventional method, the significant gain of 1.35 total flavonoids content was obtained using optimized USAE conditions, jumping to 2.80 when this USAE associated with MPR purification. Not only in vitro cell free antioxidant activity of N. lotus stamen extracts, but also in cellulo antioxidant investigation using yeast model showed the same trend to indicate that the best antioxidant flavonoid can be found in USAE coupled with MPR purification. Moreover, the key antioxidant genes expression in yeast model such as SIR2 and SOD2 were also expressed at the highest level in yeast cell treated with the extract from USAE together with MPR purification. Consequently, it can be seen that the USAE combined with MPR purification can help to enhance the flavonoids antioxidant potential of the stamens extract from this medicinal species.

Almond (Prunus dulcis (Mill.) D.A.Webb) is one of the most important nut crops both in terms of area and production. Over the last decades, an important part of the beneficial actions for health associated with their consumption was attributed to the phenolic compounds, mainly accumulated in almond skin. Interestingly, after cold-pressed oil extraction, most of these antioxidant phenolic compounds are retained in a skin-enriched by-product, so-called almond cold-pressed oil residue. In Morocco, ranked fifth producer in the world, this production generates an important part of this valuable byproduct. In the present study, using a multivariate Box-Behnken design, an ultrasound-assisted extraction (USAE) method of phenolic compounds from Moroccan almond cold-pressed oil residue was developed and validated. Response surface methodology resulted in the optimal extraction conditions: the use of aqueous EtOH 53.0% (v/v) as green solvent, applying an US frequency of 27.0 kHz for an extraction duration of 29.4 min. The present USAE allowed substantial gains in terms of extraction efficiency compared to conventional heat reflux extraction. Applied to 3 different local Beldi genotypes growing at 3 different experimental sites, the optimal USAE conditions led to a total phenolic content of 13.86 mg/g dry weight (DW). HPLC analysis revealed that the main phenolic compounds from this valuable byproduct were: chlorogenic acid followed by protocatechuic acid, p-hydrobenzoic acid and p-coumaric acid. The accumulation of these phenolic compounds appeared to be more dependent on the genetic background than on the environmental impact here represented by the 3 experimental culture sites. Both in vitro cell free and cellular antioxidant assays were performed, and revealed the great potential of these extracts. In particular, correlation analysis evidenced the prominent roles of chlorogenic acid, protocatechuic acid and p-hydrobenzoic acid. To summarize, the USAE method presented here is a quick, green, simple and efficient validated USAE for the possible valorization of antioxidant phenolic compounds from Moroccan almond cold-Pressed oil residues, making it possible to generate extracts with attractive antioxidant activities for future nutraceutical and/or cosmetic applications.

In this research, low-fat dried Chinese sausage was formulated with mango peel pectin (MPP) extracted by microwave assisted extraction (MAE) (0%, 5%, 10% and 15% (w/w). The extractable yield of pectin attained from peel of Nam Dok Mai variety was achieved at 13.85% using 700-watt power. The extracted MPP were of high equivalent weight (1,485.78 mg/mol), degree esterification (77.19%) and methoxyl content (19.33%) with the structure of more porosity as compared to that of the conventional method. Spectrum scans by Fourier transform infrared spectrophotometer (FT-IR) advised that the extracted MPP gave the similar wave number profiles as the commercial pectin. Quality attributes of the Chinese sausages were accessed and compared with the control formula (CTRL). At higher concentrations of MPP, the product had positively increased colour intensity. The texture profile of the sausage illustrated that only the hardness value was comparable with the CTRL, while springiness, cohesiveness, gumminess and chewiness were statistically lower (p < 0.05). Furthermore, the sensory evaluation by experienced panellists (n=12) indicated that 5% MPP similarly represented overall acceptability with the CTRL. Consequently, MPP can be effectively applied at low level as fat replacement in Chinese sausage allowing colour improvement and product of healthier option.

Optical and mechanical properties of multilayer coatings depend on the selected layer materials and the deposition technology; therefore, knowledge of the performances of thin films is essential. In the present work, titanium dioxide (TiO2) and silicon dioxide (SiO2) thin films have been prepared by plasma ion-assisted deposition (PIAD). The optical, structural, and mechanical properties of thin films have been investigated using spectrometer/ellipsometer, X-ray diffraction (XRD), atomic force microscopy (AFM), and laser interferometer. The results show that TiO2 film fabricated by PIAD induces a high refractive index, wide optical band gap, amorphous structure, smooth surface, and tensile stress. In the case of SiO2 film, high bias voltage leads to dense structure and compressive stress. As an application, a three-wavelength high reflectance at 632.8, 808, and 1550nm is optimized and deposited. The dependence of total stress in the multilayer on the substrate temperature is studied as well. In conclusion, it is demonstrated that PIAD is an effective method for the preparation of ultralow stress TiO2/SiO2 multilayer films. The achieved stress is as low as 1.4Mpa. The result could provide guidance to the stress optimization of most optical components without prefiguring, backside coating, and post-deposition treatments.

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

In order to solve the problem of measuring the distance and position between the flanges of two pipelines on the seabed, a measuring device for pulling rope in seawater was designed. Aiming at the sealing problem of the key equipment that is the rotating shaft of the rope winch, this paper used the principle of the magnetic coupling to transfer the driving moment, and adopted the method of converting the dynamic seal into the static seal structure to realize the reliable sealing of the motor. Through the experiment of measuring two pipelines with underwater rope pulling device, it was verified that the measuring accuracy of the device meets the design requirements, and the feasibility of the application of magnetic coupling technology in winch is also verified.

In the recent years, Cannabis and hemp-based products have become increasingly popular for various applications ranging from recreational use, edibles, beverages to health care products and medicines. The rapid detection and differentiation of phytocannabinoids is, therefore, essential to assess the potency, therapeutic and nutritional values of cannabis cultivars. Here, we implemented the SpiderMass technology for the in vivo detection of cannabidiol acid (CBDA) and tetrahydrocannabinol acid (THCA) and other endogenous organic plant compounds to access distribution gradients within the plants and differentiate cultivars. The SpiderMass system is composed of an IR- laser handheld microsampling probe connected to the mass spectrometer through a transfer tube. The analysis was performed in situ on different plant organs from freshly cultivated Cannabis plants in only a few seconds. SpiderMass analysis easily discriminated the two acid phytocannabinoid isomers by MS/MS and the built statistical models differentiated between four Cannabis cultivars. Different abundancies of acid phytocannabinoids were also found along the plant as well as between different cultivars. All together, these results introduce the direct analysis by SpiderMass as a compelling analytical alternative for forensic and hemp industrial analysis.

Systemic sclerosis is an autoimmune disease characterized by organ fibrosis and vasculopathy. Almost all patients suffer from Raynaud’s phenomenon (RP). Currently, several imaging techniques are available; nailfold video capillaroscopy (NVC) is the most widely available, but flow quantification is not possible with NVC. Novel imaging techniques are of interest in this population. We performed a single-center feasibility study using Micro Vascular Imaging (MVI) as a novel imaging technique for flow quantification of small fingertip vessels. We compared a group of 20 healthy controls (HCs) with 20 Systemic Sclerosis (SSc) patients. In HCs, flow measurements assessed with MVI were statistically significantly higher in individual fingers and combined for all fingers (p&lt;0.0001). As a cut-off value to discriminate HCs from SSc, a peak systolic (PS) flow velocity of &lt;6.9 cm/s and an end-diastolic (ED) flow velocity of &lt;2.68 cm/s was determined. Test characteristics for PS flow velocity showed moderate sensitivity (0.69, 95% CI 0.58-0.78) but high specificity (0.88, 95% CI 0.79-0.93). Similar test characteristics for ED flow velocity were obtained. The optimal cut-off point was estimated at &lt;2.68 cm/s, sensitivity was moderate (0.65, 95% CI 0.53-0.75), specificity was 0.80 (95% CI 0.70-0.87). Here, we present the first study on the use of MVI to assess blood flow in the fingertips with high specificity in SSc patients. Future studies need to investigate correlations with the risk for organ complications, such as digital ulcers or pulmonary arterial hypertension.

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

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

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.

This study aimed on evaluating the potential diagnostic value of a novel, sonographic, B-Flow Imaging (BFI)-based sign (“flashlight sign”, FLS) for the detection of wall-adherent, floating arterial structures (WAFAS). The FLS, characterized by a fast moving, very bright, intraluminal signal was detected in 28 patients with WAFAS. We divided this cohort into three subgroups, depending on the affected vascular segments: (1) peripheral arteries (n = 10), (2) native abdominal aorta (n = 8), and (3) abdominal aorta after endovascular aortic repair (EVAR; n = 10). Clinical characteristics were analyzed and BFI-findings were compared with contrast enhanced ultrasound (CEUS) and computed tomography angiography (CTA). Seven patients (25%) suffered from arterial embolism downstream to the FLS (EVAR, n = 4; native abdominal aorta, n = 1; peripheral arteries, n = 2). WAFAS of the abdominal aorta (native or after EVAR), as indicated by the FLS, were visible by CEUS and CTA in 60% and 93.3%, respectively. Based on the so far largest cohort of patients with WAFAS, we propose a clinically useful, BFI-based sonographic sign for detection of these so far underrated arterial pathologies in the abdominal aorta and the peripheral arteries.

Background. Shoulder in CrossFit should have a balance between mobility and stability. Glenohumeral internal rotation deficit and posterior shoulder stiffness are risk factors for overhead shoulder injury. Objective. To determine the effectiveness of instrument assisted soft tissue mobilization and horizontal adduction stretch in CrossFit practitioners’ shoulders. Methods: Twenty-one regular CrossFitters were allocated to experimental (stretching with isometric contraction and instrument assisted soft tissue mobilization) or control group (instrument assisted soft tissue mobilization). Each session lasted 5 minutes, 2 days a week, over a period of 4 weeks. Shoulder internal rotation and horizontal adduction (digital inclinometer), and posterior shoulder stretch perception (Park scale) were evaluated. Shapiro-Wilk test was used to analyze the distribution of the sample. Parametric student's t-test was used to obtain the intragroup differences. The inter- and intra-rater differences were calculated using a repeated measures ANOVA. Results. Changes were found in the experimental group following intervention (p < 0.05), and when comparing baseline and follow-up assessments (p < .05) in all variables. Significant differences were found in the control group following intervention (p < 0.05), in right horizontal adduction and left internal rotation. When comparing perception of internal rotation and horizontal adduction in both groups in the three assessments significant differences were found. Conclusions. Instrument assisted soft tissue mobilization can improve shoulder horizontal adduction and internal rotation. An instrument-assisted soft tissue mobilization technique yields the same results alone as those achieved in combination with post-isometric stretch with shoulder adduction.

Background Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery. Objectives The aims of this review are (1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, (2) to assess the clinical feasibility of the existing virtual planning approaches, and (3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods. Methods A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation. Results 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 minutes in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD:-0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous. Conclusions Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.

Deep sky observation is a fascinating activity, but it requires favourable conditions in order to be fully appreciated. Complex equipment, light pollution around urban areas, lack of contextual information often prevents newcomers from making the most of their observations, restricting the field to a niche expert audience. In this paper, we show how combining the usage of smart telescopes with eXplainable Artificial Intelligence makes the practice of astronomy even more accessible and educative, and how it has been applied during outreach sessions In Luxembourg Greater Region.

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

Model-based image reconstruction has brought improvements in terms of contrast and spatial resolution to imaging applications such as magnetic resonance imaging and emission computed tomography. However, their use for pulse-echo techniques like ultrasound imaging is limited by the fact that model-based algorithms assume a finite grid of possible locations of scatterers in a medium -- which does not reflect the continuous nature of real world objects and creates a problem known as off-grid deviation. To cope with this problem, we present a method of dictionary expansion and constrained reconstruction that approximates the continuous manifold of all possible scatterer locations within a region of interest. The expanded dictionary is created using a highly coherent sampling of the region of interest, followed by a rank reduction procedure based on a truncated singular value decomposition. We develop a greedy algorithm, based on the Orthogonal Matching Pursuit (OMP), that uses a correlation-based non-convex constraint set that allows for the division of the region of interest into cells of any size. To evaluate the performance of the method, we present results of 2-dimensional ultrasound image reconstructions with simulated data in a nondestructive testing application. Our method succeeds in the reconstructions of sparse images from noisy measurements, providing higher accuracy than previous approaches based on regular discrete models.

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

The primary considerations while producing rice (Oryza sativa L.) include improving its nutritional quality and production. To tackle widespread hunger globally, better nutritional, high-yielding rice cultivars need to be developed. The conventional ways are to increase the production of rice and add balanced nutrients in the daily diet to fulfill the need of yield and nutrient quality. This article focuses on nutritional strategies for rice and illustrates the availability of omics technologies. Current advancements providing many methodologies and approaches for exploring genetic resources and for understanding the molecular mechanisms involved in trait formation have been highlighted. Studying the genetic influences of various characteristics has been proven to expedite crop breeding processes. In this perspective, genome-wide association research, genome selection (GS), and QTL mapping are all genetic analysis that helps in increasing the nutritional content of rice. Implementation of several omic techniques are effective approaches to enhance and regulate the nutritional quality of rice cultivars. Advancements in different types of omics including genomics and pangenomics, transcriptomics, metabolomics, nutrigenomics, and proteomics are also relevant to rice development initiatives. This review article compiles genes, locus, mutants and all omic approaches for rice enhancement. This knowledge will be very useful for now and for the future regarding rice studies.

Hybrid microparticles based on an iron core and amphiphilic shell have been prepared to respond simultaneously to external (magnetic and ultrasounds field) and internal (pH) stimuli for delivery of the anticancer drug doxorubicin. The microparticles have been prepared in three main steps; including surface modification of the iron core followed by conjugation with the amphiphilic chitosan and drug loading. The particles demonstrate spherical shape and dimension in the range 1-3 m with tunable surface charge by changing the pH of surrounding environment. The microparticles demonstrate good stability in simulated physiological solutions and able to allocate up to 400 g of drug per mg of bare carrier. The response to ultrasound and the changes in the shell structure when exposed to different pH allows to control the doxorubicin release. In vitro cytotoxicity tests performed on fibloblast NIH/3T3 demonstrate a reduction in the cell viability when doxorubicin was administrated by microparticles compared to the free formulation; in particular when ultrasound were applied. The bare microparticles demonstrate cytocompatibility and hemocompatibility up to 50g/mL and 60 g/mL, respectively.

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.

Recent digital transformations have significantly impacted the current society, economy, and culture. This includes adoption of rapidly emerging technologies, such as artificial intelligence (AI), immersive technology (e.g., virtual, augmented, mixed and extended reality (VR/AR/MR/XR)), cloud services, and internet of things, in our day-to-day life. `Metaverse’ has emerged as a technology that incorporates many of these transforming technologies to deliver personalised immersive experience related to specific application areas. A potential major beneficiary of Metaverse is the educational ecosystem, where highly immersive learning experiences can be delivered to students, catering to their personal learning needs and train them on life skills such as empathy, ethical qualities, and communication skills. The present-day Metaverse allows physical engagement, enabling users to utilise limb movements to interact with the presented materials. However, ethical concerns and technical limitations impede the widespread implementation of the Metaverse in the real-world. This paper provides a comprehensive survey of the existing literature covering the architecture, type and components of Metaverse, followed by practical aspects of metaverse implementation. The paper is concluded by discussing on the open challenges and issues along with their mitigation strategies and future research directions after the detailed usecase of Metaverse in Education.

Juvenile idiopathic arthritis (JIA) is a disease with unknown causes within all forms of arthritis in children under 16 years of age. The diagnosis is made when another joint pathology is excluded. Difficulties in early and differential diagnosis lead to the rapid disability of patients and an unfavourable life prognosis. Therefore, timely diagnosis is necessary to prevent irreversible damage to the joints and preserve their function. Due to the widespread use of new technologies, modern multimodal imaging has gained recognition, which includes X-ray, ultrasound, and MRI. The combination of methods plays a key role in confirming the diagnosis, monitoring disease activity, prognosis during the course, and outcome in children with JIA. Each method has its own advantages and disadvantages. The introduction of the method of passive microwave radiometry (MWR), in combination with other imaging methods, makes it possible to expand the possibilities of screening the disease in the preclinical and early clinical phases.

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

Smart Living, an increasingly prominent concept, entails incorporating sophisticated technologies in homes and urban environments to elevate the quality of life for citizens. A critical success factor for Smart Living services and applications, from energy management to healthcare and transportation, is the efficacy of human action recognition (HAR). HAR, rooted in computer vision, seeks to identify human actions and activities using visual data and various sensor modalities. This paper extensively reviews the literature on HAR in Smart Living services and applications, amalgamating key contributions and challenges while providing insights into future research directions. The review delves into the essential aspects of Smart Living, the state of the art in HAR, and the potential societal implications of this technology. Moreover, the paper meticulously examines the primary application sectors in Smart Living that stand to gain from HAR, such as smart homes, smart healthcare, and smart cities. By underscoring the significance of the four dimensions of Context Awareness, Data Availability, Personalization, and Privacy in HAR, this paper serves as a valuable resource for researchers and practitioners striving to advance Smart Living services and applications.

Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a "diagnosis of exclusion". The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. The goal of the study was to assess the condition of the tissues in the female urethra in UPS, by using transvaginal ultrasound (TVUS) and cross-polarization optical tomography (CP OCT). TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. When studied with CP OCT it was shown that with UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. This paper showed that the introduction of new technology — CP OCT — in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

Background: The liver is involved in disseminated tuberculosis in more than 80% of the cases while primary liver involvement is rare, representing < 1% of all cases. Hepatic tuberculosis (TB) can be treated by conventional anti-TB therapy, however, diagnosing this disease still remains a challenge. The diagnosis might be particularly difficult in patients with a single liver lesion that could be misdiagnosed as a tumor or other focal liver lesions. While computed tomography and magnetic resonance imaging findings have been described, there is a paucity of literature on contrast-enhanced ultrasound (CEUS) features of hepatic TB. Case Summary: herein, we describe a case of a patient with tuberculous lymphadenopathy and chronic HCV-related liver disease who developed a single macronodular hepatic TB lesion. Due to the finding of a hepatocellular carcinoma (HCC) highly suggestive CEUS pattern, specifically a LR5 category according to the Liver Imaging Reporting and Data System (LI-RADS), and a good response to antitubercular therapy, a non-invasive diagnosis of HCC was made, and the patient underwent liver resection. We also review the published literature on imaging features of hepatic TB and discuss the diagnostic challenge represented by hepatic TB when occurs as a single focal liver lesion. Conclusions: this report shows for the first time that CEUS pattern of hepatic TB might be misinterpreted as HCC and specific imaging features are lacking. Personal history and epidemiological data are mandatory in interpreting CEUS findings of a focal liver lesion even when the imaging pattern is highly suggestive of HCC.

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.

Background: Myometrial invasion (MI) is a parameter currently used in transvaginal ultrasound (TVS) in endometrial cancer (EC) to determine local staging, however, without molecular diagnostics, it is insufficient for selection of high-risk cases, i.e., those with a high risk of lymph node metastases (LNM). Methods: One hundred sixteen consecutive EC patients, who had received 2D transvaginal ultrasound examinations in their preoperative workup and final histopathology results as a reference standard, were included in this prospective study. Univariate and multivariate logistic models of analyzed TVS biomarkers (tumor [T] size, T area [AREA], T volume [SPE-VOL], MI, T-free distance to serosa [TFD], endo-myometrial irregularity, [EMIR], cervical stromal involvement, CSI) were evaluated to assess the relative accuracy of the possible LNM predictors. To avoid a potential bias in assuming linear relations between LNM and continuous predictors, spline functions were applied. Calculations were made in R with the use of libraries splines, glmulti, and pROC. Results: LNM was found in 20 out of 116 (17%) patients. In univariate analysis, only uMI, EMIR, uCSI and uTFD were significant predictors of LNM. Accuracy was 0.707 (AUC 0.684, 95% CI 0.568-0.801) for uMI (p<0.01), 0.672 (AUC 0.664, 95% CI 0.547-0.781) for EMIR (p<0.01), 0.776 (AUC 0.647, 95% CI 0.529-0.765) for uCSI (p<0.01), and 0.638 (AUC 0.683, 95% CI 0.563-0.803) for uTFD (p<0.05). The cut-off value for uTFD was 5.2 mm. However, AREA and VOL revealed significant relation by non-linear analysis as well. Among all possible multivariate models, the one comprising interactions of splines of uTFD with uMI and splines of SPE-VOL with uCSI showed most usefulness. Accuracy was 0.802 (AUC 0.791, 95% CI 0.673-0.91) Conclusions: A combination of uTFD for patients with uMI>50%, and SPE-VOL for patients with uCSI, allows for the most accurate prediction of LNM in EC, rather than uMI alone.

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

Background: The Micro Hand S robot is the first domestically produced surgical robot that has entered clinical use in China, and this is the first report of its application in colon cancer.Objective: This study aimed to validate the safety and efficacy of the domestically produced Chinese minimally invasive Micro Hand S surgical robot system in complex surgery, such as robotic complete mesocolic excision (R-CME).Methods: From March 2018 to December 2018, 30 patients with right hemicolon cancer underwent R-CME with the Micro Hand S robot system. The operative findings, morbidities, oncological findings and unique characteristics were summarizedwere analyzed.Result: 12 patients with right hemicolon cancer and 18 patients with sigmoid colon cancer underwent RCME with the Micro Hand S robot system. During the study period, the median operative duration was 209 (range, 180-255) min, and the median estimated blood loss volume was 35 (range, 25-75) ml. The median number of lymph nodes harvested was 42 (21-77), and the median postoperative hospital stay was 5 (range, 4-7) days. According to the Clavien-Dindo classification, there were no severe complications except for 7 cases of grade I complications and 5 cases of grade II complications. The conversion rate for all operations was 0%. There were no cases of 30-day readmission or 30-day mortality. Conclusion: Clinical application of domestically produced Chinese minimally invasive surgical robot system “Micro Hand S ” in selected colon cancer patients is technically feasible and safe.

Smart living, a concept that has gained increasing attention in recent years, revolves around integrating advanced technologies in homes and cities to enhance the quality of life for citizens. Sensing and human action recognition are crucial aspects of this concept. Smart living applications span various domains, such as energy consumption, healthcare, transportation, and education, which greatly benefit from effective human action recognition. This field, originating from computer vision, seeks to recognize human actions and activities using not only visual data but also many other sensor modalities. This paper comprehensively reviews the literature on human action recognition in smart living environments, synthesizing the main contributions, challenges, and future research directions. This review selects five key domains: Sensing Technology, Multimodality, Real-time Processing, Interoperability, and Resource-Constrained Processing, as they encompass the critical aspects required for successfully deploying human action recognition in smart living. These domains highlight the essential role that sensing and human action recognition play in successfully developing and implementing smart living solutions. This paper serves as a valuable resource for researchers and practitioners seeking to explore further and advance the field of human action recognition in smart living.

Udder health of dairy cows is related to their productivity and welfare. The period from dry-off to calving and early lactation is crucial. Ultrasonography is a useful and practical tool for the examination of the mammary parenchyma and blood flow. This observational study investigated the relationship between udder echotexture features, blood flow volume (BFVol) in the milk vein, milk somatic cell count (SCC) and daily milk yield (DMY) from late lactation, throughout dry period and consecutive early lactation. Seventeen repeated measurements were performed on 21 Holstein cows. The udder parenchyma was examined with B-mode ultrasonography. Udder echotexture was studied using 15 features: Numerical Pixel Value (NPV), Pixel Standard Deviation (PSD), Skewness, Excess, Contrast, Homogeneity, Correlation, Entropy, Run Percentage, Long Run Emphasis, Grey Value Distribution, Runlength Distribution, Gradient Mean Value, Gradient Variance and Percentage of Non-zero Gradients. Blood flow in the milk vein was examined with spectral Doppler. Linear mixed effects models were employed to investigate relationships between BFVol, udder echotexture features, SCC and DMY, throughout the study period. Our models showed that a 1-kg increase in DMY was associated with a significant increase of 0.25 L/min in the expected BFVol, and that a 1,000,000-cells/mL increase in SCC was associated with a significant BFVol decrease of 0.49 L/min, keeping all other variables constant. Multivariable models showed significant associations between DMY and NPV, PSD and Long Run Emphasis, and between SCC and NPV, PSD, Gradient Mean Value, Homogeneity, Gradient Variance and Entropy. In conclusion, udder echotexture and BFVol in the milk vein are related to SCC and milk yield. Ultrasonography can be used for the comprehensive assessment of udder health in the direction of precision dairy farming.

Falls, highly common in the constantly increasing global aging population, can have a variety of negative effects on their health, well-being, and quality of life, including restricting their capabilities to conduct Activities of Daily Living (ADLs), which are crucial for one’s sustenance. Timely assistance during falls is highly necessary, which involves tracking the indoor location of the elderly during their diverse navigational patterns associated with ADLs to detect the precise location of a fall. With the decreasing caregiver population on a global scale, it is important that the future of intelligent living environments can detect falls during ADL.s while being able to track the indoor location of the elderly in the real world. Prior works in these fields have several limitations, such as – the lack of functionalities to detect both falls and indoor locations, high cost of implementation, complicated design, the requirement of multiple hardware components for deployment, and the necessity to develop new hardware for implementation, which make the wide-scale deployment of such technologies challenging. To address these challenges, this work proposes a cost-effective and simplistic design paradigm for an Ambient Assisted Living system that can capture multimodal components of user behaviors during ADLs that are necessary for performing fall detection and indoor localization in a simultaneous manner in the real world. Proof of concept results from real-world experiments are presented to uphold the effective working of the system. The findings from two comparison studies with prior works in this field are also presented to uphold the novelty of this work. The first comparison study shows how the proposed system outperforms prior works in the areas of indoor localization and fall detection in terms of the effectiveness of its software design and hardware design. The second comparison study shows that the cost for the development of this system is the least as compared to prior works in these fields, which involved real-world development of the underlining systems, thereby upholding its cost-effective nature.

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

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.

It is already well known that infants and children infected with COVID-19 develop mild to mod-erate forms of the disease, with fever and oropharyngeal congestion being the most common symptoms. Nevertheless, there are cases in which the patients accuse respiratory symptoms. These cases need lung evaluation, which can be done using lung ultrasound (LUS), because it is a non-irradiating and repeatable imaging technique. 19 children with COVID-19 pneumonia were eval-uated using LUS. The LUS score (LUSS) for each patient varied between 1 to 8 points from a max-imum of 36 points. The arithmetic mean was 4.47 ± 2.36 (S.D), while 95% CI for the Arithmetic mean was 3.33 to 5.61. The lung changes were correlated with their biomarkers, specifically in-flammatory markers. The correlation between LUSS and LDH, D-dimers and IL-6 was a strong positive one with r=0.66 (p=0.01, 95% CI 0.147 to 0.896) between the LUSS and LDH level at symptomatic infants and children (with cough present) and r=0.66 (p=0.01, 95% CI 0.140 to 0.895) between LUSS and D-dimers level at symptomatic infants and children (with cough pre-sent). The results suggest that LUS could be a good imaging technique that can be used both in ini-tial evaluation of children with respiratory diseases, and, also in their follow-up, correlated with symptoms and biomarkers.

A novel approach based on response surface methodology (RSM) was developed to predict and apply the best extraction conditions for the isolation of various-type polyphenolic antioxidants from the dried flower buds of Magnolia x soulangeana Soul.-Bod. var. ‘Lennei’ (Magnoliaceae). As a method of choice, ultrasound-assisted extraction was used and the optimized extraction parameters (temperature, time of extraction, the composition of aqueous-ethanolic extractants and solvent to solid ratio) have been determined using a central composite design factorial analysis, followed by appropriate spectrophotometric methods (with Folin–Ciocalteu and 2,2-diphenyl-1-picrylhydrazyl reagents) to determine the antioxidant and antiradical potential of extracts, respectively. The use of 66.8% (V/V) ethanol, as the extraction solvent during the 55.2 min extraction protocol, and the ratio of extractant volume to herbal substance of 46.8 mL/g gave the highest total yield of bioactive antioxidant phenolics in the extract obtained. For this herbal preparation, qualitative and quantitative analysis was performed using combined chromatographic (LC), spectroscopic (PDA) and tandem mass spectrometric (ESI-QTOF–MS/MS) techniques. A detailed phytochemical profiling, conducted for the first time, documented substantial amounts of polyphenolic antioxidants, especially phenylethanoids and flavonoids in the flower buds of M. soulangeana ‘Lennei’. Their average total content exceeded 30.3 and 36.5 mg/g dry weight, respectively.

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

Dog Assisted Therapy is hypothesized to lower stress in children with Autism Spectrum Disorder (ASD) and children with Down Syndrome (DS), which may be visible on a physiological level. In this study, we measured Heart Rate Variability (HRV) and salivary cortisol of 20 children with DS or ASD at the beginning and end of 6 weekly sessions of Dog-Assisted Therapy. We found a decrease of cortisol levels during single sessions, but no overall effect after 6 sessions (6 weeks). The effect of Dog Assisted Therapy on the increase of HRV could not be confirmed. This study is one of the first to use physiological measurements to test the effects of DAT.

Foliar fungal diseases in tomatoes include early blight (Alternaria linariae), Septoria leaf spot (Septoria lycopersici), and late blight (Phytophthora infestans) which is oomycetes. These are one of the significant production constraints in tomatoes. We describe the etiology, host range, distribution, symptoms, and disease cycle to understand the biology followed by management practices emphasizing the resistance breeding approach for these diseases. In crop improvement efforts, we provide an analytical review, including conventional and molecular methods for improving this disease resistance. Modern breeding tools, including genomics, genetic transformation, and genome editing, can be used to improve these traits. There is a good possibility of using these tools in the future to improve these traits.

Equine-assisted services (EAS) are being increasingly used as complementary interventions for military veterans who have experienced trauma. However, there is limited evidence of benefit for this population and almost no literature describing desired potential outcomes and possible mechanisms of action. The aim of this article is to address these gaps by reviewing the extant literature of animal-assisted interventions in general, and equine-assisted services in particular, with the goal of providing guidance for future investigations in the field. Currently, the field is in the early stage of scientific development, but published results are promising. Interventions that enhance treatment compliance and/or outcomes could benefit this population. Preliminary results, reviewed herein, indicate that EAS interventions might benefit the military veteran population by enhancing treatment engagement and therapeutic alliance, as well as contributing to symptom reduction and resulting in various transdiagnostic benefits. It is recommended that future studies include exploration of potential beneficial outcomes discussed herein as well as investigate suggested mechanisms of action.

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.

Background: Instrument-assisted soft tissue mobilization (IASTM) is thought to alter fluid dynamics in human soft tissue. The aim of this study was to investigate the influence of IASTM on the thoracolumbar fascia (TLF) on the water content of the lumbar myofascial tissue. Methods: 21 healthy volunteers were treated with IASTM. Before and after the procedure and 5 and 10 minutes later, lumbar bioimpedance was measured by bioimpedance analysis (BIA) and TLF stiffness by indentometry. Tissue temperature was recorded at the measurement time points using an infrared thermometer. Results: Bioimpedance increased significantly from 58.3 to 60.4 Ω (p < 0.001) at 10-minute follow-up after the treatment. Temperature increased significantly from 36.3 to 36.6° Celsius from 5 to 10 minutes after treatment (p = 0.029), while lumbar myofascial stiffness did not change significantly (p = 0.84). Conclusions: After the IASTM intervention, there was a significant increase in bioimpedance, likely due to a decrease in water content in myofascial lumbar tissue. Further studies in a randomized control trial design are needed to extrapolate the results in healthy subjects to a symptomatic population as well and to confirm the reliability of BIA in myofascial tissue.

The objective of this study was to assess the impact of different inoculation technologies on the aerobic biological semi-decomposition process of bokashi-type biofertilizer formulations. We examined their effects on the chemical and biological quality of the product, as well as their influence on the agronomic and nutritional characteristics of red-beet and cabbage crops in the field. The highest yields of field-grown beet crops were obtained from seedlings produced using the following treatments: bokashi biofertilizer + biodynamic preparations 502-507 BPB (62.6 Mg ha-1), bokashi + Chamomilla 12CH (60.2 Mg ha-1), and bokashi + Carbo vegetabilis 12 CH (56.3 Mg ha-1). These results corresponded to an increase of 60.9%, 54.7%, and 44.7%, respectively, compared to the yield of the control treatment (38.9 Mg ha-1). The increase in productivity of cabbage plants was higher in the treatment bokashi + Calcarea carbônica 12 CH (35.8 Mg ha-1), being 148.6% higher than the control (14.4 Mg ha-1).The content of moisture, carbon, nitrogen, C/N ratio, and pH H2O in the majority of the evaluated formulations, comply with the standards outlined in IN Nº 61, 2020, by Ministry of Agriculture, Fisheries and Supply, qualifying them as class "A" solid organic compound fertilizers.

Attempts to use computers to aid in the detection of breast malignancies date back more than 20 years. Despite significant interest and investment, this has historically led to minimal or no significant improvement in performance and outcomes with traditional computer aided detection. However, recent advances in artificial intelligence and machine learning are now starting to deliver on the promise of improved performance. There are at present more than 20 FDA approved AI applications for breast imaging, but adoption and utilization are widely variable and overall low. Breast imaging is unique and has aspects that create both opportunities and challenges for AI development and implementation. Breast cancer screening programs worldwide rely on screening mammography to reduce the morbidity and mortality of breast cancer and many of the most exciting research and available AI applications focus on cancer detection for mammography. There are however multiple additional potential applications for AI in breast imaging including decision support, risk assessment, breast density quantitation, workflow and triage, quality evaluation, response to neoadjuvant chemotherapy assessment, and image enhancement. In this review the current status, availability, and future directions of investigation of these applications are discussed, as well as the opportunities and barriers to more widespread utilization.

This review article is aimed at exploring the possibility of developing an integrated approach in the management of the different needs of endometrial cancer (EC) patients seeking to become pregnant. Life preservation of the woman, health preservation of the baby, a precocious and – as much as possible – minimally invasive characterization of the health and fertility parameters of the patient, together with the concerns regarding the obstetric, neonatal, and adult health risks of the children conceived via assisted reproduction techniques (ART) are all essential aspects of the problem to be taken into consideration, yet the possibility to harmonize such needs through a concerted integrated approach is still highly challenging. This article aims to illustrate the main features of EC and how it affects the normal physiology of pre-menopausal women. Then, we focus on the prospect for a miR-based, molecular evaluation of patient health status, including both EC early diagnosis and staging and, similarly, the receptivity of the woman, discussing the possible evaluation of both aspects using a single specific panel of circulating miR in the patient, thus allowing a relatively fast, non-invasive way to perform such testing with a significantly reduced margin of error. Finally, the ethical and legal/regulatory complexities arising from such innovative techniques require not only a risk-benefit analysis; respect for patient autonomy and equitable health care access allocation are fundamental issues as well.

Considering the controversial benefits of video-assisted thoracoscopic surgery (VATS), we intended to evaluate the impact of surgical approach on cardiac function after lung resection using myocardial work analysis. Echocardiographic data of 45 patients (25 thoracotomy vs. 20 VATS) were retrospectively analyzed. All patients underwent transthoracic echocardiography (TTE) 2 weeks before and after surgery, including two-dimensional speckle tracking and tissue doppler imaging. No notable changes in left ventricular (LV) function, assessed mainly using the LV global longitudinal strain (GLS), global myocardial work index (GMWI), and global work efficiency (GWE), were observed. Right ventricular (RV) TTE values, including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), and RV free-wall GLS (RVFWGLS), indicated greater RV function impairment in the thoracotomy group than in the VATS group [TAPSE (mm): 17.90 ± 3.80 vs. 20.60 ± 3.50, p &lt; 0.018; TASV (cm/s): 12.40 ± 2.90 vs. 14.60 ± 2.50, p &lt; 0.010; RVFWGLS (%): −11.50 ± 8.50 vs. −17.50 ± 9.70, p &lt; 0.033), respectively]. Unlike RV function, LV function remained preserved after lung resection. The thoracotomy group exhibited greater RV function impairment than did the VATS group. Further studies should evaluate the long-term impact of surgical approach on cardiac function.

Marker-assisted selection (MAS) and genomic selection (GS) have been used to select individuals with desirable traits. MAS used a few markers associated with a specific trait to select individuals with desirable traits, which are determined after a Genome-wide association studies (GWAS). On the contrary, GS uses a large number of markers distributed across the genome to predict the genomic breeding values for a further selection of the individuals. In general, MAS has shown a high prediction accuracy but is not suitable for traits that are controlled for multiple genes, and has another constraint, it is required the phenotypic data; on the contrary, GS has not shown the highest prediction accuracy as MAS but it takes into account the effect of multiple genes controlling a target trait and it can be used without phenotypic data. Including GWAS-selected markers in GS can enhance the reduced prediction accuracy that GS shows in comparison with MAS. Thus, the objective of this study was to compare the prediction accuracy of MAS, and some models of genomic prediction (gBLUP, gBLUP including GWAs-selected markers, and some Bayesian models such as Bayes A, Bayes B, Bayes LASSO and Bayesian Ridge Regression) with GWAS-selected markers incorporated in gBLUP in order to confirm if the incorporation of GWAS in GS increases the prediction accuracy of GS. As a model for this study, it was used data from Sorghum which has shown population structure, to evaluate if the incorporation of GWAs-selected markers into GS improves prediciton accuracy. It was used a sample of 6000 SNPs out of the 265.487 reported in the study conducted by Morris et al (2013), and also it was considered some parameters that affect the efficiency of the selection such as the size of the training population, the heritability, and the number of QTNs. The GWAS-selected SNPs were identified after using the model BLINK. The results showed that the incorporation of GWAS-selected markers enhanced the performance of the genomic selection with similar prediction accuracy as MAS, the number of QTNs and size of the training population affected the accuracy, with higher accuracy with a bigger size of the training population and with a lower number of QTNs, but it seems that the heritability does not have any impact in the model where GWAS-selected SNPs were included in gBLUP.

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

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

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.

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

Ovarian tissue cryopreservation (OTC) or testicular tissue cryopreservation (TTC) are effective and often the only options for fertility preservation in female or male patients due to oncological, medical, or social aspects. While TTC and resumption of spermatogenesis, either in vivo or in vitro, has still be considered an experimental approach in humans, OTC and autotransplantation has been applied increasingly to preserve fertility with more than 200 live births worldwide. However, the cryopreservation of reproductive cells followed by the resumption of gametogenesis, either in vivo or in vitro, may interfere with sensitive and highly regulated cellular processes. In particular, the epigenetic profile, which includes not just reversible modifications of the DNA itself but also post-translational histone modifications, small non-coding RNAs, gene expression and availability, and storage of related proteins or transcripts, have to be considered in this context. Due to complex reprogramming and maintenance mechanisms of the epigenome in germ cells, growing embryos, and offspring, OTC and TTC are carried out at very critical moments early in the life cycle. Given this background, the safety of OTC and TTC taking into account the epigenetic profile has to be clarified. Cryopreservation of mature germ cells (including Metaphase II oocytes and mature spermatozoa collected via ejaculation or more invasively after testicular biopsy) or embryos has been used successfully for many years in Medically Assisted Reproduction (MAR). However, tissue freezing followed by in vitro or in vivo gametogenesis has become more attractive in the past, while few human studies have analysed the epigenetic effects, with most data deriving from animal studies. In this review, we highlight the potential influence of the cryopreservation of immature germ cells and subsequent in vivo or in vitro growth and differentiation on the epigenetic profile in humans and animals.

Excitation of the acoustic field leading to the Blaha effect affects the plasticity of the material significantly in ultrasonic vibration-assisted forming. In a micro-forming field, the effects are more significant in the deformation in surface of materials [1]-[3], in which reduction of the surface roughness based on the increasing of plastic deformation of surface asperity was effective [4]. On the other hand, the effect on deformation behavior of the bulk region indicted reduction in the yield stress of materials, and not only acoustic effect [5], but also impact effect is found to generate a large amount of dislocation and produce plastic deformation [6][7]. However, the effect on the bulk is more significant as that on the surface. Differences in the effect on the surface and the bulk are not clarified. In this study, the mechanism of the deformation in the surface of the material with ultrasonic vibration assistance is investigated and compared with that in the bulk. Forging tests using a newly developed ultrasonic vibrator were carried out on pure Cu foils with various process conditions. The longitudinal vibration frequency of the ultrasonic transducer is 60∓2kHz, and the vibration amplitude is in an adjustable range of 0~10μm. Forging test was carried out at different initial stress, specimen size and amplitude. The difference in acoustic softening and impact effects on the surface and the bulk was discussed.

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.

Ultrasound based haptic feedback is a potential technology for human-computer interaction (HCI) with the advantages of low cost, low power consumption and controlled force. In this paper, the phase optimization for multipoint haptic feedback based on ultrasound array is investigated and the corresponding experimental verification is provided. A mathematical model of acoustic pressure is established for the ultrasound array and then a phase optimization model for an ultrasound transducer is constructed. We propose a pseudo-inverse (PINV) algorithm to accurately determine the phase contribution of each transducer in the ultrasound array. By controlling the phase difference of the ultrasound array, the multipoint focusing forces are formed leading to various shapes such as geometries and letters that can be visualized. Because the unconstrained PINV solution results in unequal amplitudes for each transducer, a weighted amplitude iterative optimization is deployed to further optimize the phase solution, by which the uniform amplitude distributions of each transducer are obtained. For the purpose of experimental verifications, a platform of ultrasound haptic feedback consisting of a Field Programmable Gate Array (FPGA), an electrical circuit and an ultrasound transducer array is prototyped. The haptic performances of single point, multiple points and dynamic trajectory were verified by controlling the ultrasound force exerted on the liquid surface. The experimental results demonstrate that the proposed phase optimization model and theoretical results are effective and feasible, and the acoustic pressure distribution is consistent with the simulation results.

Advancement in biotechnology and genomics research have promoted access to DNA markers and their use in breeding programs. Genome-wide association study (GWAS), Genomic selection (GS) and Marker-Assisted Selection (MAS) are some of the applications of DNA markers in plant breeding. Researchers have suggested combining these individual applications for better selection accuracies. This study examines the potential advantages of incorporating GWAS-results into MAS and GS as well as the validity of the different methods for combining these approaches. From this study, it was concluded that number of QTNs have greater effects on prediction accuracies compared to heritability estimates. Also, the increase in prediction accuracy from the invalid method of incorporating GWAS results into GS and MAS model is similar to results recorded with using the valid approach. However, greater difference may be observed in another scenario which can lead to spurious results when used to make breeding decisions.

The aim of this work was to determine the potential of using a pulsed electric field (PEF) and ultra-sound (US) apparatus to produce mitragynine extracts from Mitragyna speciosa dried leaves. Four modes of the device were tested: PEF, US, US + PEF, and PEF + US. The results were compared with extracts obtained using a conventional technique (maceration, as the control). Changes in the mitragynine content were determined with the liquid chromatography/mass spectrometry (LC-MS/MS) method. The LC-MS/MS analysis showed that the mitragynine contents from kratom extracts using four different modes were different. The highest extraction (106.63 ± 0.85 mg/L) of mitragynine was achieved by the PEF + US procedure, followed by US + PEF (97.27 ± 1.33 mg/L), with increased extraction efficiencies of 45.81 ± 0.59% and 33.00 ± 1.85%, respectively. Moreover, the total energy consumption under the combination technique was 25.0% lower than that with PEF assistance. Furthermore, scanning electron microscopy (SEM) and Fourier Transform Infrared Spectroscopy (FTIR) provided confirmatory evidence for the extraction of M. speciosa by the prototype. This study confirmed that PEF and US devices can be considered a green alternative method and may contribute to the application of agricultural products.

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.

Only cross-sectional studies have demonstrated muscle deficits in children with spastic cerebral palsy (SCP). The impact of functional impairments on altered muscle growth remains unclear. This prospective longitudinal study modelled the morphological muscle growth in 87 children with SCP (age range 6 months to 11 years, Gross Motor Function Classification System [GMFCS] level I/II/III=47/22/18). Repeated ultrasound assessments were performed during 2-year (y) follow-up with an interval of minimal 6 months. Three-dimensional freehand ultrasound was applied to assess medial gastrocnemius muscle volume (MV), mid-belly cross-sectional area (CSA) and muscle belly length (ML). Non-linear mixed models compared trajectories of (normalized) muscle growth between GMFCS-I versus GMFCS-II&amp;III. MV and CSA growth trajectories showed piecewise model with 2 breakpoints, with the highest growth before 2y and negative growth rates after 6-9y. Before 2y, children with GMFCS-II&amp;III already showed lower growth rates compared to GMFCS-I. From 2-9y, the growth rates did not differ between GMFCS-levels. After 9y, a more pronounced reduction in normalized CSA was observed in GMFCS-II&amp;III. Different trajectories in ML growth were shown between the GMFCS-level subgroups. These longitudinal trajectories could be used to monitor the SCP muscle pathology during childhood and to optimize treatment planning and goals aiming to stimulate muscle growth

The process of ultrasonic atomization involves a series of dynamic/topological deformations of free surface, though not always, of a bulk liquid (initially) below the air. This study focuses on such dynamic interfacial alterations realized by changing some acousto-related operating conditions, including ultrasound excitation frequency, acoustic strength or input power density, and the presence/absence of a “stabilizing” nozzle. High-speed, high-resolution imaging made it possible to qualitatively identify four representative transitions/demarcations: 1) the onset of a protrusion on otherwise flat free surface; 2) the appearance of undulation along the growing protuberance; 3) the triggering of emanating beads fountain out of this foundation-like region; and 4) the induction of droplets bursting and/or mist spreading. Quantitatively examined were the two-parameters specifications—on the degrees as well as induction—of the periodicity in the protrusion-surface and beads-fountain oscillations, detected over wider ranges of driving/excitation frequency (0.43–3.0 MHz) and input power density (0.5–10 W/cm2) applied to the ultrasound transducer of flat surface on which the nozzle was mounted or not. The resulting time sequence of images processed for the extended operating ranges, regarding the fountain structure pertaining in particular to recurring beads, confirms the wave-associated nature, i.e., their size “scalability” to the ultrasound wavelength, predictable from the traveling wave relationship. The thresholds in acoustic conditions for each of the four transition states of the fountain structure have been identified—notably, the onset of plausible “bifurcation” in the chain-beads diameter below a critical excitation frequency.

The accelerated pace with which new diagnostic possibilities are produced and the budget re-strictions of the healthcare sector require that the decision-making process of acquiring new technologies becomes systematic in nature. There are some methodologies such as the Health Technology Assessment (HTA) that encompasses technological domains, clinical effectiveness, patient safety, organizational and financial aspects, among others. However, these methods do not contemplate the learning curve (LC) which is a differential factor in operator-dependent technologies. An assessment model was conceived based on the assessment domains of the AdHopHTA project with the addition of LC. The model was validated and calibrated through System Dynamics (SD) and using as case study the assessment of Point-of-care Ultrasound (POCUS) equipment in dengue screening. The model helped identify the influence of the LC and patient demand on the income and costs for the healthcare system regarding dengue screening as well as the cost-benefit indicator. The control charts LC-CUSUM and CUSUM are graphic tools to intuitively assess the learning curve which can be used for real-time monitoring once students reach a certain skill level.

Background: The Micro Hand S robot is the first domestically produced surgical robot that has entered clinical use in China, and this is the first report of its application in colon cancer. Objective: This study aimed to validate the safety and efficacy of the domestically produced Chinese minimally invasive Micro Hand S surgical robot system in complex surgery, such as robotic complete mesocolic excision (R-CME). Methods: From March 2018 to December 2018, 30 patients with right hemicolon cancer underwent R-CME with the Micro Hand S robot system. The operative findings, morbidities, oncological findings and unique characteristics were summarizedwere analyzed. Result: 12 patients with right hemicolon cancer and 18 patients with sigmoid colon cancer underwent RCME with the Micro Hand S robot system. During the study period, the median operative duration was 209 (range, 180-255) min, and the median estimated blood loss volume was 35 (range, 25-75) ml. The median number of lymph nodes harvested was 42 (21-77), and the median postoperative hospital stay was 5 (range, 4-7) days. According to the Clavien-Dindo classification, there were no severe complications except for 7 cases of grade I complications and 5 cases of grade II complications. The conversion rate for all operations was 0%. There were no cases of 30-day readmission or 30-day mortality. Conclusion: Clinical application of domestically produced Chinese minimally invasive surgical robot system “Micro Hand S ” in selected colon cancer patients is technically feasible and safe.

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

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

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

Nowadays, the high demand for healthy foods and sustainable products, has led the food industry to explore innovative food technologies, such as fortification with bioactive compounds like antioxidants and polyphenols, that may be sourced from herbs or by-products. The aim of the present study was to explore the enrichment of refined olive oils with natural bioactive compounds such as the herbs rosemary (salvia rosmarinus), basil (ocimum basil), sage (salvia officinalis), lemon balm (melissa oficinallis), st. john’s wort (hypericum perforatum), pink savory (Thymbra satureja), dittany (origanum dictamnus), and by-products such as pomace from olives, olive leaves (olea europaea tree), orange peel (citrus sinensis), lemon peel (citrus limon), pomegranate peel (punica granatum) and mandarin peel (citrus reticulate). The fortification of the refined olive oils was performed with the use of different methodologies such as Conventional maceration (CM), Incubation shaking maceration (ISM), and Ultrasound assisted maceration (UAM). Their phenolic content and antioxidant capacity were measured with Folin–Ciocalteu assay and Ferric Reducing Antioxidant Power (FRAP) assay respectively. All methods demonstrated that different parameters such as time of maceration, temperature and sample concentration, play an important role in the fortification process of the refined olive oils. The predicyed bioavailability of the antioxidant and phenolic compounds in the fortified oils was determined with in vitro digestion and ranged from 4.84% to 53.11%. Furthermore, the refined olive oils fortified with pomace, basil, st. john's wort, and pomegranate peel presented the highest antioxidant and phenolic predicted bioavailability indices during the in vitro process compared to the control refined olive oil. Finally, fortification with natural herbs or by-products can be considered an innovative method for the improvement of the nutritional value of refined olive oils.

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

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI–TOF MS) is a commonly used technique for analyzing large biomolecules. However, the utilization of organic matrices limits the small-molecule analysis because of the interferences in the low-mass region and reproducibility issues. To overcome these limitations, a surface-assisted laser desorption/ionization (SALDI), which utilizes nanostructured metallic surfaces, has been developed. Herein, a novel approach for SALDI–MS was proposed using nanoengineered gold shell with nanogaps on the silica core (SiO2@Au NGS), which is an emerging material due to its excellent heat-generating capabilities. The gold shell thickness was controlled by adjusting the concentration of gold precursor for the growth of gold nanoparticles. SALDI-MS measurements were performed on a layer formed by drop-casting a mixture of SiO2@Au NGS and analytes. At the optimized process, the gold shell thickness was observed to be 17.2 nm, which showed the highest absorbance. The ion desorption efficiency was confirmed with a survival yield upon fragmentation. Based on the enhanced SALDI capability, SiO2@Au NGS was utilized to detect various small molecules including amino acids, sugars, and flavonoids. The limits of detection, reproducibility, and salt tolerance of SiO2@Au NGS demonstrate its potential as an effective and reliable SALDI material for small-molecule analyses.

Equine Assisted Activities (EAA) are considered a suitable innovative rehabilitative practice for children with neurodevelopmental disorders, including Autism Spectrum Disorder (ASD). While standardized scales have been previously used as a tool to evaluate the effects of EAA on different domains of functioning in ASD children, few studies have considered an ethological approach as a means to describe human-horse interactions in the context of ASD. In this study, we aimed to evaluate the behaviour of 19 children with ASD - in comparison with 19 typically developing children (TD) - during EAA sessions. We developed an ethogram from the video-recordings, to assess spatial relationships, social interactions and communicative behaviours displayed by the child towards the horse, as well as the occurrence of problem behaviours. Results indicate that children’s behaviours during EAA sessions are modulated by sex and age, while previous children’s experience with EAA appeared to improve interpersonal distance and horse handling. Results from this study highlight the importance of exploring children's behavioural response during animal-assisted activities through direct measurements. This may allow linking the quality/strength of the child-horse relationship to the benefits obtained by the child, particularly in the social/communicative domain, a core symptom of ASD.