Ultrasound Parameters Research Articles

A personalized clinical assessment: multi-sensor approach for understanding musculoskeletal health in the frail population

BackgroundSarcopenia is a muscle disorder causing a progressive reduction of muscle mass and strength, but the mechanism of its manifestation is still partially unknown. The three main parameters to assess are: muscle strength, muscle volume or quality and low physical performance. There is not a definitive approach to assess the musculoskeletal condition of frail population and often the available tests to be performed in those clinical bedridden patients is reduced because of physical impairments. In this paper, we propose a novel instrumental multi-domain and non-invasive approach during a well-defined protocol of measurements for overcoming these limitations. A group of 28 bedridden elder people, subjected to surgery after hip fracture, was asked to perform voluntary isometric contractions at the 80% of their maximum voluntary contraction with the non-injured leg. The sensor employed before and/or during the exercise were: ultrasound to determine the muscle architecture (vastus lateralis); force acquisition with a load cell placed on the chair, giving an indication of the muscle strength; surface electromyography (EMG) for monitoring muscular electrical activity; time-domain (TD) near-infrared spectroscopy (NIRS) for evaluating muscle oxidative metabolism.ResultsA personalized “report card” for each subject was created. It includes: the force diagram (both instantaneous and cumulative, expected and measured); the EMG–force diagram for a comparison between EMG derived median frequency and measured force; two graphs related to the hemodynamic parameters for muscle oxidative metabolism evaluation, i.e., oxy-, deoxy-, total-hemoglobin and tissue oxygen saturation for the whole exercise period. A table with the absolute values of the previous hemodynamic parameters during the rest and the ultrasound related parameters are also included.ConclusionsIn this work, we present the union of protocols, multi-domain sensors and parameters for the evaluation of the musculoskeletal condition. The novelties are the use of sensors of different nature, i.e., force, electrical and optical, together with a new way to visualize and combine the results, by means of a concise, exhaustive and personalized medical report card for each patient. This assessment, totally non-invasive, is focused on a bedridden population, but can be extended to the monitoring of rehabilitation progresses or of the training of athletes.

Usefulness of Antigen Carbohydrate 125 and N-Terminal Pro-B-Type Natriuretic Peptide for Assessing Congestion in Chronic Heart Failure: Insights from the CARDIOREN Registry

Introduction: A comprehensive assessment of congestion, including circulating biomarkers, is recommended in patients with acute heart failure. The circulating biomarkers natriuretic peptides (NPs) and carbohydrate antigen-125 (CA125) could be useful for congestion assessment in ambulatory chronic heart failure (CHF), but there is only limited information about their applicability in this context. Therefore, this study aimed to examine the association of plasma CA125 and NP levels with clinical and ultrasound congestion parameters in CHF. Methods: This is a cross-sectional substudy of the Cardioren Spanish Registry, which enrolled 1,107 patients with CHF from 13 tertiary hospitals in Spain between October 2021 and February 2022. Through ambulatory visits, we performed a comprehensive assessment of congestion-related parameters, including clinical variables (orthopnea, peripheral edema, and jugular engorgement, represented by the composite congestion score [CCS]), echocardiography variables (lung B-lines and inferior vena cava [IVC] diameter), and circulating biomarkers (CA125 and NPs). The association of the NP and CA125 levels with the clinical and echocardiographic congestion parameters was examined by multiple linear and logistic regression analyses. Results: This substudy included 802 patients for whom all the biomarker parameters were available {median age, 74 (interquartile range [IQR], 63–81) years; 65% male}. The proportion of patients with left ventricular ejection fraction ≥50% and estimated glomerular filtration rate <60 was 34% and 58%, respectively. The median CCS was 0 (IQR: 0–1), with 45% of the sample exhibiting a median CCS of ≥1. The jugular engorgement, peripheral edema, and orthopnea rates were 32%, 21%, and 21%, respectively. A total of 35% of patients who underwent ultrasound examination showed lung B-lines, and the median IVC diameter was 16 mm. The median CA125 and NTproBNP levels were 14 U/mL (IQR: 9–28) and 1,382 pg/mL (IQR: 563–3,219), respectively. Multivariate analysis showed that higher CA125 levels were independently associated with higher odds of peripheral edema (p = 0.023) and lung B-lines (p < 0.001). Further, NTproBNP was positively associated with jugular engorgement (p < 0.001), orthopnea (p = 0.034), and enlarged IVC diameter (p = 0.031). Conclusions: Clinical signs of congestion are frequent in CHF. In the ambulatory setting, NTproBNP was associated with parameters linked to intravascular congestion such as orthopnea, jugular engorgement, and IVC diameter, whereas CA125 was associated with extravascular volume overload parameters (peripheral edema and lung B-lines).

Assessing Fetal Circulatory Changes in Gestational Diabetes via Aortic Isthmus Doppler

Background: Gestational diabetes mellitus (GDM) is a common complication during pregnancy that can negatively impact fetal heart function and structure. This study aimed to investigate the hemodynamic characteristics of the fetal aortic isthmus in patients with GDM using Doppler ultrasound parameters. Methods:This was a cross-sectional observational study including 47 pregnant patients with GDM and 47 healthy pregnant patients as controls. Fetal biometric measurements and umbilical artery Doppler values were obtained. Aortic isthmus Doppler was used to measure systolic and diastolic flow velocity time integrals (S and D), peak systolic velocity (PSV), and systolic nadir (Ns) to calculate the isthmus flow index (IFI) = (S + D)/S and isthmus systolic index (ISI) = Ns/PSV. A generalized additive model was used to analyze the relationship between IFI, ISI and gestational age. Results: Compared to controls, the GDM group had significantly lower D (2.39 cm vs. 2.76 cm), Ns (11.48 cm/s vs. 14.06 cm/s), IFI (1.24 vs. 1.27) and ISI (0.14 vs. 0.16). Curve fitting showed IFI was lower in the GDM group for most gestational weeks and decreased with advancing weeks, while ISI remained constantly lower and decreased linearly. Conclusions: Fetal aortic isthmus Doppler parameters IFI and ISI were altered in GDM pregnancies, suggesting earlier changes in aortic arch hemodynamics compared to the umbilical artery. Combining IFI and ISI may provide more comprehensive assessment of fetal circulatory changes in GDM. These findings could enhance our understanding of the pathophysiologic impacts of maternal diabetes.

Spectral Ultrasound Combined With Clinical Pathological Parameters in Prediction of Axillary Lymph Node Metastasis in Breast Cancer.

To explore the clinical value of the nomogram based on spectral Doppler ultrasound combined with clinical pathological parameter in predicting axillary lymph node metastasis in breast cancer. We prospectively gathered clinicopathologic and ultrasonic data from 240 patients confirmed breast cancer. The risk factors of axillary lymph node metastasis were analyzed by univariate and multivariate logistic regression, and the prediction model was established. The model calibration, predictive ability, and diagnostic efficiency in the training set and the testing set were analyzed by receiver operating characteristic curve and calibration curve analysis, respectively. Univariate analysis showed that lymph node metastasis was related with tumor size, Ki-67, axillary ultrasound, ultrasound spectral quantitative parameter, internal echo, and calcification (P < .05). Multivariate logistic regression analysis showed that the Ki-67, axillary ultrasound, quantitative parameter (the mean of the mid-band fit in tumor and posterior tumor) were independent risk factors of axillary lymph node metastasis (P < .05). The models developed using Ki-67, axillary ultrasound, and quantitative parameters for predicting axillary lymph node metastasis demonstrated an area under the receiver operating characteristic curve of 0.83. Additionally, the prediction model exhibited outstanding predictability for axillary lymph node metastasis, as evidenced by a Harrell C-index of 0.83 (95% confidence interval 0.73-0.93). Axillary ultrasound combined with Ki-67 and spectral ultrasound parameters has the potential to predict axillary lymph node metastasis in breast cancer, which is superior to axillary ultrasound alone.

Quantitative and qualitative analysis of contrast-enhanced ultrasound for differentiating benign and malignant superficial enlarged lymph nodes.

In many clinical situations, it is critical to exclude or identify abnormally lymph nodes (LNs). The nature of superficial abnormally LNs is closely related to the stage, treatment, and prognosis of the disease. Ultrasound (US) is an important method for examining superficial LNs due to its cheap and safe characteristics. However, it is still difficult to determine the nature of some LNs with overlapping benign and malignant features in images. Contrast-enhanced ultrasound (CEUS) can be used to evaluate the microperfusion status of tissues in real time, and it can improve diagnostic accuracy to a certain extent. Therefore, in this study, we will analyze the correlation between CEUS quantitative parameters and benign and malignant superficial abnormally LNs, to evaluate the efficacy and value of CEUS in distinguishing benign and malignant superficial LNs. This study retrospectively analyzed 120 patients of abnormal LNs who underwent US and CEUS at the China-Japan Union Hospital of Jilin University from December 2020 to August 2023. All 120 cases of abnormal LNs underwent US-guided coarse needle biopsy, and accurate pathological results were obtained, along with complete US and CEUS images. According to the pathological results, LNs were divided into benign and malignant groups, and the qualitative and quantitative parameters of US and CEUS between the two groups were analyzed. The cutoff value is determined by the receiver operating characteristic (ROC) curve of the subjects, and sensitivity, specificity, and accuracy are applied to evaluate the ability of the cutoff value to distinguish between the two groups. There were a total of 120 LNs, including 36 in the benign group and 84 in the malignant group. The results showed that malignant LNs were usually characterized by the disappearance of lymphatic hilum, round ness index (L/T) <2, irregular morphology, and the manifestation of uneven perfusion (P<0.05). The differences in the quantitative parameters peak enhancement (PE), rise time (RT), time to peak (TTP), wash-in rate (WIR), and wash-out rate (WOR) were statistically significant (P<0.05). The result showed that RT and TTP in the malignant LNs were higher than those in the benign LNs, while the PE, WIR, and WOR were lower. A comparison of the ∆ values showed that the differences in ∆PE, ∆WIR, and ∆fall time (FT) were statistically significant (P<0.05), Among them, the ∆PE and ∆WIR of malignant LNs were higher than those of benign LNs, while the ∆FT was lower than that of benign LNs. Quantitative analysis of CEUS features is valuable in the diagnosis of benign and malignant LNs, and US combined with CEUS helps to improve the accuracy of identifying the nature of LNs.

CNN applied to ultrasonic guided wave spectrum image classification

Abstract Osteoporosis is a worldwide problem associated with an increasing number of fragility fractures. Currently, the standard for identifying patients at risk of fragility fracture is through Dual X-ray Absorptiometry (DXA). Different altenatives have been proposed, such as magnetic resonance imaging (MRI), three-dimensional X-rays, ultrasound or algorithms providing scores from clinical data. Among ultrasonic techniques, Bi-Directional Axial Transmission (BDAT) has been used to classify patients with or without fragility fractures, initially using ”classical” ultrasound parameters, such as velocities and latter using Support Vector Machine and automatic features, with performances close to the gold standard DXA. The aim of this study was to investigate the use of Convolutional Neural Networks (CNN) applied to patient classification using ultrasonic guided wave spectrum images, using a previous database of post menopausal women with or without fragility fractures. Two networks will be tested, a reference one, ResNet, successfully applied in classification and diagnosis in medical images, and a tailored one, denoted BDAT-Net, which hyperparameters will be optimized through a grid approach. The obtained accuracy, using BDAT-Net and clinical data (age, body mass index, cortisone intake) was found equal to 0.66 [0.64-0.69] comparable with the one obtained with DXA and significantly better than the one obtained with ResNet. These encouraging results open the door to the use of robust ultrasonic devices for fracture risk assessment, in particular in countries where DXA is not widely available.

A Preliminary Study Using High‐Frequency Ultrasound to Evaluate Vulvar Skin With Lichenoid Vulvar Dermatoses

ABSTRACTBackgroundLichenoid vulvar dermatoses (LVD) are inflammatory diseases primarily affecting the vulva and anus. This study aims to evaluate the skin changes in patients with LVD using high‐frequency ultrasound.MethodsForty‐five patients with LVD, who attended Henan Provincial People's Hospital from November 2021 to March 2024, were selected. According to the pathological conclusions, patients were divided into two groups: the vulvar lichen sclerosus (VLS) group (n = 24) and the vulvar lichen simplex chronicus (VLSC) group (n = 21). Thirty age‐ and BMI‐matched healthy women were selected as the control group. We assessed the epidermal thickness, subepidermal low echogenic band (SLEB) thickness, dermal thickness, and vascular index (VI) among the three groups. Receiver operating characteristic curve (ROC) analysis was performed to determine the diagnostic efficacy of these ultrasound parameters for LVD. Binary logistic regression was used to investigate risk factors influencing LVD pathology in VLS patients.ResultsEpidermal thickness, SLEB thickness, dermal thickness, and VI were increased in the VLS and VLSC groups compared to the control group (p &lt; 0.05). There were no statistically significant differences in ultrasound parameters between the VLS and VLSC groups (p &gt; 0.05). The ROC curves showed that the area under the curve (AUC) value for the dermis (AUC = 0.882) was the largest for VLS, and VI (AUC = 0.917), it was the largest for VLSC. Binary logistic regression indicated that having an allergic disease was a risk factor for VLS between VLS and VLSC groups (OR = 6.797, p = 0.028).ConclusionHigh‐frequency ultrasound can detect thickening of the skin and increasing VI in patients with LVD, which can be helpful in the evaluation and management of LVD.

Antibacterial effect of ultrasound combined with Litsea cubeba essential oil nanoemulsion on Salmonella Typhimurium in kiwifruit juice

This study investigated the antibacterial effect of ultrasound (US) combined with Litsea cubeba essential oil nanoemulsion (LEON) on Salmonella Typhimurium in kiwifruit juice and effect on the quality and sensory properties of kiwifruit juice. In this study, LEON prepared by ultrasonic emulsification method had a good particle size distribution and high stability. The US+LEON treatment significantly (P < 0.05) improved antibacterial efficacy, compared to the control, and would not destroy the nutritional components containing ascorbic acid, flavonoids, total phenol and total soluble solids. Meanwhile, US+LEON treatment enhanced 2, 2-diphenyl-1-picrylhydrazyl (DPPH), 2, 2′-azino-bis-(3-ethylbenzothiazoline-6 sulfonic acid) (ABTS) radical scavenging capacity and ferric ion reducing antioxidant power (FRAP). In terms of sensory properties, US and LEON had a significant (P < 0.05) effect on the odor and overall morphology of kiwifruit juice. The enhance of antibacterial efficacy and the retention of nutrients by combined treatments shows that US+LEON is a promising antibacterial method that will provide new ideas for the processing and safety of fruit juices, and the US parameters and LEON concentration should be adjusted to reduce the effect on food sensory properties in future studies.

Pediatric Cranial Ultrasound Revisited: A Comprehensive Review.

Cranial ultrasound (CUS) is an indispensable tool in the evaluation of intracranial pathology in premature and term neonates and older infants. Familiarity with standard cranial ultrasound techniques and parameters, normal anatomy, and commonly encountered abnormalities is crucial for providing appropriate care for these patients. This review provides a comprehensive overview of cranial ultrasound in clinical practice.

Establishment of a prediction model of pulmonary artery hypertension in patients with hyperthyroidism.

This study aims to assess the tricuspid annular plane systolic excursion (TAPSE)/PASP ratio as a potential indicator for predicting the probability of developing pulmonary arterial hypertension (PAH) in hyperthyroidism patients. A nomogram model will be developed based on our findings, as well as the receiver operating characteristic (ROC) curve. The study involved 166 hyperthyroid patients treated at Yijishan Hospital, and the period covered August 2021 to August 2022. Patients were divided into two groups according to pulmonary artery systolic pressure ≥35 mmHg. Univariate and multivariate logistic analyses were performed on the two groups' demographic and laboratory data to identify potential diagnostic markers. These parameters were evaluated using ROC curves to determine their precision in forecasting PAH. The findings were validated by plotting a calibration curve based on a line chart model. In the study, eventually, 80 patients were enrolled: 30 in the PAH group and 50 in the No PAH group. Multipleistic regression analysis predicted the occurrence risk of developing PAH. When paired with other conventional echocardiographic parameters (such as TAPSE, MPI, and SV) and serological markers (such as FT3 and FT4), the developed model demonstrated outstanding predictive performance with an area under the ROC curve of 0.985, a Youden index of 0.971, a sensitivity of 100%, and a specificity of 97.1%. The nomogram model constructed by combining the TAPSE/PASP ratio with FT3 and FT4 serum markers, as well as conventional ultrasound parameters SV and MPI in hyperthyroidism patients, demonstrates robust discriminatory ability and consistency.

P.312: Impact of delayed graft function on doppler ultrasound parameters in the early period after kidney transplantation.

P.312: Impact of delayed graft function on doppler ultrasound parameters in the early period after kidney transplantation.

Mitigating Doxorubicin-Induced Cardiotoxicity through Quercetin Intervention: An Experimental Study in Rats.

Doxorubicin (DOX) is an effective anticancer drug, but its use is limited by dose-dependent heart toxicity. Quercetin is a natural antioxidant frequently studied for its beneficial properties. Moreover, a wide range of dietary supplements are available for human use. This in vivo study aimed to explore the potential cardioprotective effects of quercetin in chronic DOX treatment. A total of 32 Wistar rats were randomly divided into four groups: control, DOX, DOX/Q-50, and DOX/Q-100, treated with saline, 2.5 mg/kg body-weight DOX, 2.5 mg/kg body-weight DOX + 50 mg quercetin, and 2.5 mg/kg body-weight DOX + 100 mg quercetin, respectively, for two weeks. Rats were monitored using cardiac ultrasound (US) and markers for cardiac injury. Oxidative damage and ultrastructural changes in the heart were investigated. Chronic DOX treatment led to a decline in cardiac function and elevated values of NT pro-BNP, troponin I, and CK-MB. Quercetin treatment slightly improved certain US parameters, and normalized serum NT pro-BNP levels. Furthermore, DOX-induced SOD1 depletion with consequent Nrf2 activation and DNA damage as shown by an increase in γH2AX and 8HOdG. Quercetin treatment alleviated these alterations. Oral administration of quercetin alleviated serum markers associated with DOX-induced cardiotoxicity. Furthermore, it exhibited a favorable impact on the cardiac US parameters. This suggests that quercetin may have potential cardioprotective properties.

Comprehensive evaluation of fetal renal ultrasound parameters for fetal growth restriction

ObjectiveThis study aims to investigate variances in renal ultrasound parameters between fetuses experiencing fetal growth restriction (FGR) and those with normal intrauterine development, with the intent to offer actionable insights for clinical management. MethodForty-five pregnant women diagnosed with FGR between 28 and 36 weeks of gestation, who underwent examination at Wenzhou People's Hospital from September 2021 to June 2023, constituted the FGR group. Concurrently, 65 pregnant women with normal intrauterine development at matching gestational weeks formed the control group. Renal ultrasound parameters, encompassing renal artery peak systolic velocity (PSV), end diastolic velocity (EDV), time averaged maximum velocity (TAMX), resistive indices (S/D, PI, RI), ratios of renal volume to gestational age (RV/WEEK) and estimated fetal weight (RV/EFW), vascular indices (VI, FI, VFI), were compared between the two groups. All parameters represented the mean values of bilateral kidneys. ResultIn the FGR group, fetal renal artery PSV (37.71 ± 9.93 cm/s), EDV (6.19 ± 1.50 cm/s), TAMX (15.10 ± 3.83 cm/s), RV/WEEK (0.45 ± 0.12), RV/EFW (7.53 ± 3.24), VI (22.19 ± 15.00), and VFI (5.53 ± 3.63) were significantly lower compared to the control group (PSV: 47.11 ± 11.24 cm/s, EDV: 7.13 ± 2.00 cm/s, TAMX: 17.85 ± 3.85 cm/s, RV/WEEK: 0.66 ± 0.19, RV/EFW:9.20 ± 3.17, VI: 28.67 ± 14.72, VFI: 7.40 ± 3.68). Conversely, fetal renal artery resistive indices (S/D: 9.09 ± 2.58, PI: 2.71 ± 0.56, RI: 0.92 ± 0.04) in the FGR group were notably higher than those in the control group (S/D: 6.22 ± 1.93, PI: 2.20 ± 0.73, RI: 0.87 ± 0.04), with statistical significance (P < 0.05). No significant difference was found in renal FI between the FGR group (26.78 ± 6.59) and the control group (26.89 ± 5.82) (P > 0.05). Receiver operating characteristic (ROC) curve analysis revealed higher diagnostic efficacy for RV/WEEK and RI among individual indicators, while combined parameter application yielded the highest diagnostic efficiency. ConclusionUtilizing a comprehensive evaluation of fetal kidney ultrasound parameters with multiple indices facilitates early screening and diagnosis of FGR fetuses, thereby aiding clinical decision-making and enhancing newborn birth outcomes.

Intestinal ultrasound for follow-up after 24 weeks of biological therapy in inflammatory bowel disease patients: an Egyptian center experience during the COVID-19 pandemic

BackgroundInflammatory bowel disease is a chronic inflammatory condition of the gut. It has two major subtypes Crohn’s disease and ulcerative colitis. The follow-up consists of radiologic, molecular, endoscopic, and histological assessments. Intestinal ultrasound (IUS) is a noninvasive measure that provides future hope in guiding the management of IBD patients. This study is to assess the effectiveness of IUS in IBD patients’ follow-up in our tertiary center during the pandemic. This is a prospective observational study during the COVID-19 pandemic. We used IUS to assess activity of IBD at baseline and at 6-month follow-up of patients on maintenance biological therapy using the following parameters: bowel haustrations, stratification, bowel wall thickness (BWT), Doppler sign (Limberg classification), presence of lymph nodes, or fibrofatty infiltration, echogenicity of the bowel, and presence of fistulae or abscesses. We compared the IUS with other radiologic parameters, histologic, and endoscopic scores at baseline before therapy, while we compared IUS with clinical scores and laboratory parameters before and after 24 weeks of biological treatment.ResultsThe cohort included 50 known IBD patients from June 2021 to January 2022. The laboratory studies showed a significant improvement in the hemoglobin indices, CRP, and fecal calprotectin from baseline and after 24 weeks. BWT, lumen diameter, lymph node presence, inflammatory signs, and Doppler activity signs were the most significant parameters in detecting improvement. However, there was no significant correlation between fecal calprotectin levels and ultrasound parameters. There was a positive correlation between MR and CT enterography, endoscopic parameters, and IUS parameters at baseline.ConclusionsIUS is an effective tool for follow-up of IBD patients especially during the pandemic periods.

An ultrasound multiparametric method to quantify liver fat using magnetic resonance as standard reference.

There is an unmet need for a reliable and reproducible non-invasive measure of fatty liver content (FLC) for monitoring steatotic liver disease in clinical practice. Sonographic FLC assessment is qualitative and operator-dependent, and the dynamic quantification range of algorithms based on a single ultrasound (US) parameter is unsatisfactory. This study aims to develop and validate a new multiparametric algorithm based on B-mode images to quantify FLC using Magnetic Resonance (MR) values as standard reference. Patients with elevated liver enzymes and/or bright liver at US (N = 195) underwent FLC evaluation by MR and by US. Five US-derived quantitative features [attenuation rate(AR), hepatic renal-ratio(HR), diaphragm visualization(DV), hepatic-portal-vein-ratio(HPV), portal-vein-wall(PVW)] were combined by mixed linear/exponential regression in a multiparametric model (Steatoscore2.0). One hundred and thirty-four subjects were used for training and 61 for independent validations; score-computation underwent an inter-operator reproducibility analysis. The model is based on a mixed linear/exponential combination of 3 US parameters (AR, HR, DV), modelled by 2 equations according to AR values. The computation of FLC by Steatoscore2.0 (mean ± std, 7.91% ± 8.69) and MR (mean ± std, 8.10% ± 10.31) is highly correlated with a low root mean square error in both training/validation cohorts, respectively (R = 0.92/0.86 and RMSE = 5.15/4.62, p < .001). Steatoscore2.0 identified patients with MR-FLC≥5%/≥10% with sensitivity = 93.2%/89.4%, specificity = 86.1%/95.8%, AUROC = 0.958/0.975, respectively and correlated with MR (R = 0.92) significantly (p < .001) better than CAP (R = 0.73). Multiparametric Steatoscore2.0 measures FLC providing values highly comparable with MR. It is reliable, inexpensive, easy to use with any US equipment and qualifies to be tested in larger, prospective studies as new tool for the non-invasive screening and monitoring of FLC.

Analysis of ultrasound coronary parameters and blood red cell distribution width and N-terminal pro-brain natriuretic peptide concentrations following coronary lesions in children with Kawasaki disease.

Aims/Background Kawasaki disease is an acute inflammatory condition primarily affecting the young children. It can lead to coronary artery abnormalities, which can worsen the prognosis. Early diagnosis of coronary disease is crucial for the effective treatment and the prognosis evaluation. To explore the clinical significance of ultrasound examination characteristics, peripheral blood red cell distribution width, and changes in N-terminal pro-brain natriuretic peptide levels for the early detect coronary artery abnormality in children with Kawasaki disease. Methods The case-control study was conducted. 85 Kawasaki disease patients diagnosed in our hospital from January 2020 to December 2023 were selected as the Kawasaki disease group. 100 healthy children who received physical examination in the Department of Child Healthcare during the same period were selected as control group. The cardiac ultrasound indicators, erythrocyte sedimentation rate, C-reactive protein, white blood cell, neutrophil percentage, platelet count, D-dimer, red cell distribution width, N-terminal pro-brain natriuretic peptide of two groups were compared. The Kawasaki disease group was further divided into the coronary artery lesion group and the non-coronary artery lesion group based on whether coronary artery lesions occurred in the Kawasaki disease patients. The differences of above indicators were compared. Results The left main coronary artery, left anterior descending branch, and right coronary artery Z-scores of the Kawasaki disease group were all higher than those of the control group (p < 0.05). There was no significant difference in left ventricular ejection fraction between Kawasaki disease group and control group (p > 0.05). The erythrocyte sedimentation rate, C-reactive protein, neutrophil percentage, platelet count, D-dimer, red cell distribution width, and N-terminal pro-brain natriuretic peptide of Kawasaki disease group were all higher than those of control group (p < 0.05). The left main coronary artery, left anterior descending branch, and right coronary artery Z-scores of Kawasaki disease patients with coronary artery lesions were all higher than those of Kawasaki disease patients without coronary artery lesions (p < 0.05). The left ventricular ejection fraction of Kawasaki disease patients with coronary artery lesions was lower than that of Kawasaki disease patients without coronary artery lesions (p < 0.05). The erythrocyte sedimentation rate, C-reactive protein, white blood cell, neutrophil percentage, platelet count, D-dimer, red cell distribution width, and N-terminal pro-brain natriuretic peptide of Kawasaki disease patients with coronary artery lesions were all higher than those of Kawasaki disease patients without coronary artery lesions, and the differences were statistically significant (p < 0.05). After treatment, the left main coronary artery, left anterior descending branch, and right coronary artery Z-scores of Kawasaki disease patients with coronary artery lesions significantly decreased (p < 0.05), and the left ventricular ejection fraction significantly increased (p < 0.05). The erythrocyte sedimentation rate, C-reactive protein, white blood cell, neutrophil percentage, platelet count, D-dimer, red cell distribution width, and N-terminal pro-brain natriuretic peptide of Kawasaki disease patients with or without coronary artery lesions significantly decreased after treatment compared with before treatment in the same group (p < 0.05). Conclusion Kawasaki disease patients with coronary artery lesions exhibit significantly increased coronary artery vessel diameter, as well as elevated red cell distribution width and N-terminal pro-brain natriuretic peptide concentration. The combined use of ultrasound combined with red cell distribution width and N-terminal pro-brain natriuretic peptide examination can assist in determining whether Kawasaki disease patients have coronary artery lesions and assessing the clinical treatment effect.

Ultrasound-mediated spatial and temporal control of engineered cells in vivo

Remote regulation of cells in deep tissue remains a significant challenge. Low-intensity pulsed ultrasound offers promise for in vivo therapies due to its non-invasive nature and precise control. This study uses pulsed ultrasound to control calcium influx in mammalian cells and engineers a therapeutic cellular device responsive to acoustic stimulation in deep tissue without overexpressing calcium channels or gas vesicles. Pulsed ultrasound parameters are established to induce calcium influx in HEK293 cells. Additionally, cells are engineered to express a designed calcium-responsive transcription factor controlling the expression of a selected therapeutic gene, constituting a therapeutic cellular device. The engineered sonogenetic system’s functionality is demonstrated in vivo in mice, where an implanted anti-inflammatory cytokine-producing cellular device effectively alleviates acute colitis, as shown by improved colonic morphology and histopathology. This approach provides a powerful tool for precise, localized control of engineered cells in deep tissue, showcasing its potential for targeted therapeutic delivery.

Enhanced oil recovery in tight reservoirs by ultrasonic-assisted CO2 flooding: Experimental study and molecular dynamics simulation

CO2-enhanced oil recovery (CO2-EOR) has attracted great attention due to its dual effects of geological carbon storage and economic benefits, but the clay swelling, asphaltene deposition and gas channeling induced by CO2 still restrict its field application. The employment of chemical agents for the purpose of improving CO2-EOR performance is often limited by the heterogeneity of reservoirs and the potential for formation damage. Physical methods, such as ultrasonic-assisted CO2 flooding, appear to offer a promising alternative for CO2-EOR and geological sequestration. This study has conducted oil displacement experiments to investigate the EOR potential of ultrasonic-assisted CO2 flooding in tight reservoirs and clarify the effects of different ultrasound parameters. The ultrasonic waves with 20 kHz of acoustic frequency, 30 W/cm2 of sound intensity, 30 min of sonication time and moderate intermittent working mode can yield violent cavitation effects and avoid undesirable energy dissipation. Nearly a quarter of the saturated crude oil can be recovered from the tight core through ultrasonic-assisted CO2 flooding. It can be attributed to the composition alterations of crude oil and property changes of core matrix. Coupling with ultrasonic waves, CO2 would extract and vaporize crude oil more easily, which promotes oil swelling, lowers oil density and viscosity, decreases oil–gas interfacial tension and thus improves oil recovery. Besides, the ultrasound can help to mitigate the impact of CO2 adsorption-induced clay swelling on pore sizes through fluctuating pressure. And the strong hydrodynamic shear forces generated by mechanical vibration of ultrasound may also help to connect individual small pores and extend micro-fractures. These synergistic effects result in the transformation of micropores into mesopores and macropores. Furthermore, the wettability alteration of core samples implies that the ultrasonic-assisted CO2 flooding can induce the detachment of oil films from the rock surface. Finally, the results of molecular dynamics simulations indicate that the improvement in pressure inside the core sample resulting from ultrasonic cavitation facilitates the mixing of CO2 and oil, thereby weakening gas channeling and improving the displacement efficiency.

Risk stratification of postoperative atrial fibrillation in isolated off-pump coronary artery bypass grafting: focus on left atrial strain characteristics

Aim. To explore the potential of using left atrial strain parameters obtained through transthoracic speckle-tracking echocardiography for predicting new-onset postoperative atrial fibrillation (POAF) in patients undergoing off-pump coronary artery bypass grafting (CABG).Material and methods. The study included 111 patients with coronary artery disease referred for elective CABG. There were following exclusion criteria: recurrent or combined cardiac surgery, cerebral stroke, prior atrial tachyarrhythmia episodes, on-pump CABG, patients with NYHA class 4 heart failure. Patients included in the study underwent transthoracic speckle tracking echocardiography before surgery to assess the reservoir, conduit and contractile left atrial (LA) functions. After off-pump CABG, patients were prospectively observed until discharge from the hospital to record the primary end point — the first-time persistent POAF episode.Results. During follow-up, POAF was recorded in 11 patients (10%). The median endpoint registration was 4 days. The groups formed depending on the end point achievement were comparable in basic clinical and demographic characteristics and analyzed ultrasound parameters. In the majority of the patients studied, a decrease in LA function was detected. Disorders of the conduit (n=94, 85%) and reservoir functions (n=85) were dominant.Conclusion. The results obtained may indicate that there is no relationship between the LA myocardial strain parameters obtained during preoperative screening and the risk of POAF in patients with coronary artery disease who underwent off-pump CABG.

Effects of ultrasonic treatment on the structure and functional characteristics of myofibrillar proteins from black soldier fly

In the process of utilizing black soldier fly larvae (BSFL) lipids to develop biodiesel, many by-products will be produced, especially the underutilized protein components. These proteins can be recycled through appropriate treatment and technology, such as the preparation of feed, biofertilizers or other kinds of bio-products, so as to achieve the efficient use of resources and reduce the generation of waste. Myofibrillar protein (MP), as the most important component of protein, is highly susceptible to environmental influences, leading to oxidation and deterioration, which ultimately affects the overall performance of the protein and product quality. For it to be high-quality and fully exploited, in this study, black soldier fly myofibrillar protein (BMP) was extracted and primarily subjected to ultrasonic treatment to investigate the impact of varying ultrasonic powers (300, 500, 700, 900 W) on the structure and functional properties of BMP. The results indicated that as ultrasonic power increased, the sulfhydryl content and turbidity of BMP decreased, leading to a notable improvement in the stability of the protein emulsion system. SEM images corroborated the changes in the microstructure of BMP. Moreover, the enhancement of ultrasound power induced modifications in the intrinsic fluorescence spectra and FTIR spectra of BMP. Additionally, ultrasonic treatment resulted in an increase in carbonyl content and emulsifying activity of BMP, with both peaking at 500 W. It was noteworthy that BMP treated with ultrasound exhibited stronger digestibility compared to the untreated. In summary, 500 W was determined as the optimal ultrasound parameter for this study. Overall, ultrasound modification of insect MPs emerges as a dependable technique capable of altering the structure and functionality of BMP.