Peak Enhancement Research Articles

Brain activation patterns in the executive function of children and adolescents after an exercise intervention

This study explored brain activation patterns in the executive function of children and adolescents following an exercise intervention. After computer retrieval of relevant studies, we independently screened the studies, extracted data, and assessed the quality. We used Ginger ALE 2.3 software to conduct activation likelihood estimation, then we discussed and calculated the activation cluster and activation probability of the brain regions of children and adolescents who completed an exercise intervention. After the exercise intervention, children and adolescents achieved five peak activation enhancement points (total volume = 2,070 mm3) and six peak activation reduction points (total volume = 1,352 mm3) in the process of completing executive function tasks. The results indicate that the improvement in executive function caused by an exercise intervention is the result of synergetic changes in multiple brain regions with increased and decreased activation.

Efficacy and safety of coronary computed tomography angiography in diagnosing coronary lesions in children.

Identification of paediatric coronary artery abnormalities is challenging. We studied whether coronary artery CT angiography can be performed safely and reliably in children. Retrospective analysis of consecutive coronary CT angiography scans was performed for image quality and estimated radiation dose. Both factors were assessed for correlation with electrocardiographic-gating technique that was protocoled on a case-by-case basis, radiation exposure parameters, image noise artefact parameters, heart rate, and heart rate variability. Sixty scans were evaluated, of which 96.5% were diagnostic for main left and right coronaries and 91.3% were considered diagnostic for complete coronary arteries. Subjective image quality correlated significantly with lower heart rate, increasing patient age, and higher signal-to-noise ratio. Estimated radiation dose only correlated significantly with choice of electrocardiographic-gating technique with median doses as follows: 2.42 mSv for electrocardiographic-gating triggered high-pitch spiral technique, 5.37 mSv for prospectively triggered axial sequential technique, 3.92 mSv for retrospectively gated technique, and 5.64 mSv for studies which required multiple runs. Two scans were excluded for injection failure and one for protocol outside the study scope. Five non-diagnostic cases were attributed to breathing motion, scanning prior to peak contrast enhancement, or scan acquisition during the incorrect portion of the R-R interval. Diagnostic-quality coronary CT angiography can be performed reliably with a low estimated radiation exposure by tailoring each scan protocol to the patient's body habitus and heart rate. We propose coronary CT angiography is a safe and effective diagnostic modality for coronary artery abnormalities in children.

A Ratiometric Fluorescence Biosensor for Detection of Alkaline Phosphatase Via an Advanced Chemometric Model.

In this paper, a ratiometric fluorescence biosensor was introduced for alkaline phosphatase (ALP) detection based on 2-aminopurine (2-Amp) and thioflavin T (ThT)-G-quadruplex system. We designed a special DNA (5'-AGGGTTAGGGTTAGGGTTAGGGAAA/i2-Amp/AAAA-PO4-3', AP) modified with a phosphate moiety at the 3'-end, G-quadruplex at the 5'-end, and a fluorophore (2-Amp) in the middle. In the absence of ALP, the G-rich AP strand could be prone to fold into G-quadruplex structures in the presence of K+. Then, ThT combined with G-quandruplex, resulting in the enhancement of fluorescence emission peak at 485 nm. However, ALP-mediated hydrolysis of the 3'-phosphoryl end promoted the cleavage of AP by the exonuclease I (Exo I), releasing 2-Amp which displayed a strong fluorescence emission peak at 365 nm. Moreover, the quantitative fluorescence model (QFM) was derived for the analysis of the fluorescence measurements obtained by the proposed ratiometric fluorescent biosensor. With the aid of the advanced model, the proposed ratiometric fluorescent biosensor possessed satisfactory results for the detection of ALP in the human serum samples, with accuracy comparable to that of the reference method-the commercial ALP assay kit. Under the optimized experimental conditions, this method exhibited good selectivity and higher sensitivity, and the detection limit was found to be as low as 0.017 U/L. Therefore, it is reasonable to expect that the method had a great potential to detect ALP quantitatively in clinical diagnosis.

Pancreatic Ductal Adenocarcinoma: The Characteristics of Contrast-Enhanced Ultrasound Are Correlated with the Hypoxic Microenvironment.

A hypoxic microenvironment is associated with an increased risk of metastasis, treatment resistance and poor prognosis of pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify contrast-enhanced ultrasound (CEUS) characteristics that could predict the hypoxic microenvironment of PDAC. A total of 102 patients with surgically resected PDAC who underwent CEUS were included. CEUS qualitative and quantitative characteristics were analyzed. The expression of hypoxia-inducible factor-1α (HIF-1) and glucose transporter-1 (GLUT1) were demonstrated by immunohistochemistry. The associations between CEUS characteristics and the HIF-1α and GLUT1 expression of PDACs were evaluated. We found that HIF-1α-high PDACs and GLUT1-high PDACs had a larger tumor size and were more prone to lymph node metastasis. There was a significant positive linear correlation between the expression of HIF-1α and GLUT1. CEUS qualitative characteristics including completeness of enhancement and peak enhancement degree (PED) were related to the expression of HIF-1α and GLUT1. A logistic regression analysis showed that tumor size, lymph node metastasis, incomplete enhancement and iso-enhancement of PED were independent predictors for HIF-1α-high PDACs and GLUT1-high PDACs. As for quantitative characteristics, HIF-1α-high PDACs and GLUT1-high PDACs showed higher peak enhancement (PE) and wash-in rate (WIR). CEUS can effectively reflect the hypoxia microenvironment of PDAC, which may become a noninvasive imaging biomarker for prognosis prediction and individualized treatment.

Quantitative analysis of pre-treatment dynamic contrast-enhanced ultrasound for assessing the response of colorectal liver metastases to chemotherapy plus targeted therapy: a dual-institutional study.

To investigate the clinical value of pre-treatment quantitative contrast-enhanced ultrasound (CEUS) in assessing the response of colorectal liver metastases (CRLM) to chemotherapy plus targeted therapy. This study retrospectively enrolled 50 CRLM patients from the Zhongshan Hospital, Fudan University as the training cohort and 14 patients from Shanghai Tenth People's Hospital as the testing cohort. Patients underwent the CEUS examination before receiving chemotherapy (CAPOX, FOLFOX, FOLFIRI, or FOLFOXIRI) plus targeted therapy (Bevacizumab or Cetuximab). The therapy response was determined according to Response Evaluation Criteria in Solid Tumors version 1.1 based on pre-treatment CT and 3-month follow-up CT after therapy. Dynamic analysis was performed by VueBox® software. Time-intensity curves with quantitative perfusion parameters were obtained. In the training cohort, univariable and multivariable logistic regression analyses were used to develop the predictive model of therapy response. The predictive performance of the developed model was validated in the testing cohort. After the logistic regression analyses, the peak enhancement (PE) (odds ratio = 1.640; 95% confidence intervals [CI] 1.022-2.633) and time to peak (TTP) (odds ratio = 0.495; 95% CI 0.246-0.996) were determined as independent predictive factors. PE and TTP generated from VueBox® were not affected by ultrasound instruments and contrast agent dosage in therapy response evaluation (P > 0.05). The logistic regression model achieved satisfactory prediction performance (area under the curve: 0.923 in the training cohort and 0.854 in the testing cohort). CEUS with dynamic quantitative perfusion analysis, which presents high consistency, has potential practical value in predicting the response of CRLM to chemotherapy plus targeted therapy.

Experimental and Analytical Studies on Low-Cost Glass-Fiber-Reinforced-Polymer-Composite-Strengthened Reinforced Concrete Beams: A Comparison with Carbon/Sisal Fiber-Reinforced Polymers.

This study presents an experimental framework with seventeen beams to investigate the impact of loading type, configuration, and through-bolt anchorage on LC-GFRP (Low-Cost Glass-Fiber-Reinforced Polymer) confinement performance. Beams underwent three-point and four-point bending, with LC-GFRP applied in various ways, including U-shaped, side-bonded, and fully wrapped, with and without anchors. The performance of LC-GFRP was compared to CFRP (Carbon-Fiber-Reinforced Polymer) and sisal wraps. LC-GFRP in side-bonded and U-shaped configurations without anchors under three-point bending showed no shear failure, while those under four-point bending without anchors experienced shear failure. With anchors, U-shaped configurations successfully prevented shear failure. The side-bonded, U-shaped, and U-shaped configurations along the full span with anchors demonstrated peak capacity enhancements of 72.11%, 43.66%, and 68.39% higher improvements than the corresponding configurations without anchors, respectively. Wrapping all sides of the beam with LC-GFRP or CFRP prevented shear failure without additional anchors, with complete wrapping being the most efficient method. When anchors were used, significant capacity enhancements were observed. Existing shear strength prediction models were evaluated, highlighting the need for more tailored expressions for LC-GFRP confinement, especially for non-U-shaped configurations.

Dynamic contrast-enhanced ultrasonography with sonazoid predicts microvascular invasion in early-stage hepatocellular carcinoma.

Microvascular invasion (MVI) is an independent risk factor for the early recurrence and poor survival of hepatocellular carcinoma (HCC). This study aims to investigate the potential clinical value of dynamic contrast-enhanced ultrasound (DCE-ultrasound)-Sonazoid in pre-operatively assessing MVI in HCC. This single centre prospective study included 140 patients with histopathologically confirmed single HCC lesions. Patients were classified according to the post-operative pathological information presence of MVI: MVI+ group (n = 32) and MVI- group (n = 108). All patients underwent DCE-ultrasound within 1 week before surgery. The quantitative perfusion parameters of HCC lesions, margins of HCC lesions, and distal liver parenchyma were obtained and analyzed. Clinicopathological (serum alpha-fetoprotein, Des-gamma-carboxyprothrombin, and pathological grade) and grayscale imaging features (tumor size) were significantly different between the MVI+ and MVI- groups (p < 0.05). Further quantitative analysis showed that when comparing the MVI+ and MVI- groups, half-decrease time and wash-out rate of HCC lesions and peak enhancement in the arterial phase of difference between the margin area of HCC and distal liver parenchyma were significantly different (p = 0.045, p = 0.035, and p = 0.023, respectively). Combining the above three quantitative parameters, the accuracy, sensitivity, specificity, positive-predictive value, and negative-predictive value were 69.3% (97/140), 37.8% (17/45), 84.3% (80/95), 53.1% (17/32), 74.1% (80/108), respectively. DCE-ultrasound with quantitative perfusion analysis has the potential to predict MVI in HCC lesions. DCE-ultrasound with quantitative perfusion analysis has the potential to predict MVI in HCC lesions.

Qualitative and quantitative features of deep endometriosis in contrast-enhanced ultrasound: An initial experience and literature review.

This research aims to present the findings of contrast-enhanced ultrasound (CEUS) in a series of patients with proven deep endometriosis (DE) and provide an updated literature review. Between January 2018 and October 2022, seven patients with DE lesions had their imaging and medical records retrospectively reviewed. Clinical data, recorded images of a standardized conventional B-mode ultrasound, and Sonovue® CEUS were interpreted by two blinded, independent, experienced radiologists in consensus. The enhanced characteristics of the DE lesion on CEUS were also assessed using VueBox® software quantitatively. DE lesion appeared as irregular hypoechoic or heterogeneous on conventional ultrasound with dotted blood flow signal on color Doppler. Six of seven DE lesions showed heterogeneous hypo-enhancement in arterial phases. All the lesions showed a heterogeneous washout rapidly that began in the late arterial phase. In quantified analysis, the mean relative peak enhancement compared with adjacent tissue was 0.47±0.25. Our findings and literature review suggested that CEUS could be a feasible and promising non-invasive modality for diagnosing DE.

Contrast-enhanced ultrasonography of the thyroid gland in healthy dogs, hypothyroid dogs and dogs with non-thyroidal illness

Diagnosis of canine hypothyroidism remains challenging, as non-thyroidal illness (NTI)-syndrome and medical treatment can influence thyroid hormone concentrations. Conventional ultrasound may give additional hints, however high interobserver variability has been described. Contrast-enhanced ultrasound (CEUS) allows detection of changes in tissue perfusion. The purpose of the present study was to assess the possible diagnostic value of CEUS regarding diagnosis of hypothyroidism. CEUS of the thyroid gland was performed in 52 healthy dogs, 16 hypothyroid dogs, and 20 NTI patients. The following perfusion parameters were calculated: Thyroid/carotid artery (TG/CA) ratios for peak enhancement (PE) and area under the curve (AUC), time to peak (TTP) and wash-in and wash-out rates (WiR, WoR) of the thyroid gland. Impact of sedation on perfusion parameters was investigated in 8 calm healthy dogs which were examined before and after sedation using midazolam and butorphanol. Significantly higher median TG/CA ratios for PE were detected for the left and right thyroid lobe in dogs with hypothyroidism (0.97/0.96) compared to healthy dogs (0.85/0.85) and dogs with NTI (0.84/0.84). AUCs were also significantly increased in hypothyroid dogs when compared to other groups. Dogs with NTI showed significantly lower WiR and WoR compared to other groups. Values for TTP were not significantly different between groups. Sedation had only impact on results of TTP which was significantly prolonged in sedated dogs. In conclusion, CEUS of the thyroid gland can provide an additional tool for diagnosis of hypothyroidism in dogs and support its differentiation from NTI. Sedation has limited impact on CEUS results.

Analysis of Magnetic Resonance Imaging Perfusion Parameters for the Identification of Spinal Metastatic Tumors with Rich Blood Supply

To determine the reliability of dynamic magnetic resonance imaging (MRI) perfusion parameters for the evaluation of blood supply to spinal metastatic tumors. A total of 36 patients with spinal metastasis who underwent dynamic contrast-enhanced magnetic resonance spinal perfusion imaging at Tianjin Hospital from December 2018 to December 2020 were reviewed. Subsequently, the patients underwent corresponding preoperative examination using digital subtraction angiography of the spine at the hospital and were divided into 2 groups accordingly. Differences in dynamic MRI perfusion parameters between the 2 groups were analyzed. There were statistically significant differences between the 2 groups in the quantitative dynamic contrast-enhanced MRI perfusion parameters vascular permeability and plasma volume, as well as semi-quantitative peak enhancement and blood flow ratio parameters. Dynamic MRI perfusion may distinguish spinal metastatic lesions with rich blood supply from those with poor blood supply and may help clinicians identify patients that can benefit from invasive spinal angiography and preoperative embolization. This technique may also provide guidance on decision taking for surgery basing on dynamic MRI perfusion parameters.

The changes in molecular interaction and conformation of lysozyme mediated by ionic liquids

Using Ionic liquids（ILs）to regulate protein crystallization has attracted great attention, but the mechanism of ILs mediating crystallization is still unclear. Herein, we chose 1-butyl-3-methylimidazolium chloride ([C4mim]Cl) and 1,3-dimethylimidazolium iodide ([C1mim]I) as additives to mediate lysozyme crystallization, and use situ Raman to track the conformational changes of lysozyme in solution. Meanwhile, molecular simulation was used to explore the binding between ILs and lysozyme molecules. The results demonstrated that the addition of ILs produced new characteristic peaks in Raman spectra, suggesting some changes to occur in solution structure. The changes of peaks at 1340 cm−1 and 1359 cm−1, and the enhancement of peak at 1450 cm−1 indicated the unfolding of lysozyme molecules. The quantitative analysis of amide Ⅰ band showed that the addition of ILs increased the β-sheet content in secondary structures. Molecular docking showed that [C4mim]Cl and [C1mim]I could both bind to the active site of lysozyme molecules, and the binding energy were −3.1 kcal/mol and −4.5 kcal/mol, respectively. Molecular dynamics results showed that [C4mim]Cl could stably bind to lysozyme molecules, while [C1mim]I left the active site after several ns, which means that [C4mim]Cl brought about stronger impact on interaction of lysozyme molecules than [C1mim]I in solution.

A novel quantitative approach to evaluate femoral head perfusion by contrast-enhanced ultrasound: A pilot study in infants with developmental dysplasia of the hip.

Avascular necrosis (AVN) is a major morbidity that can occur after surgical reduction of a hip with developmental dysplasia. Early detection of changes in femoral head perfusion during surgery may help detect a hip at risk for AVN and guide intraoperative management. Contrast-enhanced ultrasound (CEUS) can be employed for visualization of femoral head perfusion. In this study we evaluate a quantitative CEUS technique to assess femoral head perfusion pre- and post-surgical reduction. CEUS images were obtained following a bolus injection of an ultrasound contrast agent, prior to and again following surgical reduction and casting. An image processing technique called delta projection was used to quantify hip perfusion, measuring peak enhancement (PE) and perfusion index (PI). We analyzed CEUS images of the hips of eight patients, including seven females, whose ages ranged from 4 months to 1 year. In five hips, perfusion increased following surgery, with a mean pre-surgery PE of 6.7 ±2.5(± SE) and PI of 10.5 ±6.3; and a post-reduction PE of 13.1±6.1 (p=0.07) and PI of 14.2 ±6.2 (p=0.008). The change in contrast visualization was observed to be greater within the central aspect of the cartilaginous femoral epiphysis. The proposed technique can quantify pre- and post-surgical perfusion changes on CEUS images in patients with developmental dysplasia. This quantitative technique may provide a more objective and accurate assessment of changes in femoral head perfusion that may have the potential to be indicative of the risk of developing AVN.

The hemodynamics of adrenal veins with four-dimensional computed tomography using quantitative time-density curve: a study based on aldosteronism patients

Present study quantitatively analyzed adrenal venous flow using four-dimensional computed tomography (4D CT). We reviewed 4D CT images of 55 patients [mean age, 52 years ± 11 (standard deviation); 23 females] who underwent adrenal venous sampling between August 2017 and February 2021. Time–density curves were referred for the adrenal venous enhancement. The clinical factors affecting hemodynamics were assessed using uni- and multivariate linear regression analyses. The right and left adrenal veins (RAV and LAV, respectively) were visualized in all cases. Mean peak enhancement values in RAV and LAV were 247 ± 67 and 292 ± 70 Hounsfield units (P < 0.01), and were reached at 44.43 ± 6.86 and 45.39 ± 7.53 s (P < 0.01), respectively. The body mass index (BMI), plasma renin activity and potassium were significant factors influencing the peak enhancement of RAV blood flow [standardized regression coefficients, − 0.327 (P = 0.017), − 0.346 (P = 0.013), 0.426 (P = 0.016), respectively]. A linear relationship between sex and the time-to-peak was observed for RAV [standardized regression coefficient, 0.348 (P = 0.046)]. RAV had a lower contrast effect than LAV and reached its peak faster. BMI, plasma renin activity, and potassium were associated with flow density in RAV. Sex independently influenced the time-to-peak.

A Novel Wave Energy Equivalence Based Lumping Block Method for Efficiently Predicting the Fatigue Damage of Mooring Lines

The lumping block equivalent method (LBEM) is widely used to reduce the computational effort in the fatigue damage assessment of offshore structures, and the wave parameters of the representative sea states (RSSs) resulting from LBEM are of vital importance for the accurate prediction of offshore structures’ fatigue damage. In this study, a novel wave energy equivalence (WEE)-based LBEM is proposed to determine the wave parameters of the RSS accurately. The novelty of the proposed method is that a compact relationship between the input wave energy component and mooring lines’ fatigue damage is derived, and the modified statistical relationships between the wave parameters and spectral moments are provided by incorporating the effects of the peak enhancement factor of the input wave spectrum, the number of original sea states (OSSs) and the equivalence bandwidth of the OSSs. Based on the compact relationship, the wave energy component of the RSS can be determined from the wave energy component of the OSSs for each wave frequency from the viewpoint of the fatigue damage equivalence criterion. The wave energy distribution of the RSS can be accurately characterized with the wave energy distribution of the OSSs, and the spectral moments of the RSS can be calculated by its energy distribution directly, without any approximation. Moreover, the wave parameters of the RSS can be determined from the modified statistical relationships easily. The effectiveness of the proposed WEE LBEM is numerically investigated with a moored semi-submersible platform. Results show that the proposed WEE LBEM is robust, efficient and accurate within engineering expectations, and it outperforms the conventional LBEMs both in accuracy and robustness.

Early prediction of pathologic complete response of breast cancer after neoadjuvant chemotherapy using longitudinal ultrafast dynamic contrast-enhanced MRI

PurposeThe purpose of this study was to evaluate the temporal trends of ultrafast dynamic contrast-enhanced (DCE)-MRI during neoadjuvant chemotherapy (NAC) and to investigate whether the changes in DCE-MRI parameters could early predict pathologic complete response (pCR) of breast cancer. Materials and methodsThis longitudinal study prospectively recruited consecutive participants with breast cancer who underwent ultrafast DCE-MRI examinations before treatment and after two, four, and six NAC cycles between February 2021 and February 2022. Five ultrafast DCE-MRI parameters (maximum slope [MS], time-to-peak [TTP], time-to-enhancement [TTE], peak enhancement intensity [PEI], and initial area under the curve in 60 s [iAUC]) and tumor size were measured at each timepoint. The changes in parameters between each pair of adjacent timepoints were additionally measured and compared between the pCR and non-pCR groups. Longitudinal data were analyzed using generalized estimating equations. The performance for predicting pCR was assessed using area under the receiver operating characteristic curve (AUC). ResultsSixty-seven women (mean age, 50 ± 8 [standard deviation] years; age range: 25–69 years) were included, 19 of whom achieved pCR. MS, PEI, iAUC, and tumor size decreased, while TTP increased during NAC (all P < 0.001). The AUC (0.92; 95% confidence interval [CI]: 0.83–0.97) of the model incorporating ultrafast DCE-MRI parameter change values (from timepoints 1 to 2) and clinicopathologic characteristics was greater than that of the clinical model (AUC, 0.79; 95% CI: 0.68–0.88) and ultrafast DCE-MRI parameter model at timepoint 2 when combined with clinicopathologic characteristics (AUC, 0.82; 95% CI: 0.71–0.90) (P = 0.01 and 0.02). ConclusionEarly changes in ultrafast DCE-MRI parameters after NAC combined with clinicopathologic characteristics could serve as predictive markers of pCR of breast cancer.

Effects of exercise and cold-water exposure on microvascular muscle perfusion.

Microvascular blood flow (MBF) and its intramuscular regulation are of importance for physiological responsiveness and adaptation. The quantifiable in-vivo monitoring of MBF after cycling or systemic cold-water exposure may reveal new insights into capillary regulatory mechanisms. This study aimed to assess the role of exercise and cold therapy on MBF by using contrast-enhanced ultrasound (CEUS). Twenty healthy athletes were recruited and randomly assigned to an intervention (IG) or a control group (CG). MBF was quantified in superficial (rectus femoris, RF) and deep muscle layers (vastus intermedius, VI). Representative perfusion parameters (peak enhancement (PE) and wash-in area under the curve (WiAUC)) were measured after a standardized measurement protocol for both groups at resting conditions (t0) and after cycling (20 min., 70% Watt max, t1) for both groups, after cold-water immersion exposure for IG (15 min., 12°C) or after precisely 15 minutes of rest for CG (t2) and for both groups after 60 minutes of follow-up (t3). At t1, MBF in VI increased significantly compared to resting conditions in both groups in VI (p= 0.02). After the cold-water exposure (t2), there were no statistically significant changes in perfusion parameters as well as after 60 minutes of follow-up (t3) (p = 0.14). Cycling leads to an upregulation of MBF. However, cold exposure does not change the MBF. The implementation of CEUS during different physiological demands may provide deeper insight into intramuscular perfusion regulation and regenerative processes.

Impact of Double Time Delays on Regime Shift and Stochastic Resonance for a Species Population System Driven by Colored Correlated Multiplicative and Additive Noises

In this paper, the characteristics for the state transition between the boom state and the extinction one, varius stochastic resonance (SR) phenomena for a species population system induced by double time delays and colored cross-correlated Gaussian noises are investigated. The control of the species population system has an important effect on ecological balance and the development of human living environment. By means of the numerical calculation of the mean extinction time and the stationary probability density function (SPDF), we can figure out some fact: both external and internal noises, the noise correlation strength and its correlation time, one time delay can all reduce the ecological stability and shorten the survival time of the system; while the other time delay can enhance significantly the biological stability and postpone the extinction of the population. For the mean extinction time (MET) of the species population, it is found that noise correlation strength, time delay, the noise correlation time can all reduce the peak value of the MET, which leads to the reduction of the life cycle. Inversely, the other time delay will not change the maximum of the MET, and induce the peak value to shift to the left. With respect to the SNR, it is discovered that in the noise correlation strength and its correlation time, one-time delay mainly plays a prominent role in inhibiting the SR effect. On the contrary, the multiplicative noise can result in the enhancement of the resonant peak. In particular, the other time delay and the additive noise can stimulate the SR effect for the SNR during the initial period. However, the further increase of them will bring about the reduction of the resonant phenomenon.

Residual current under the combined effect of carrier envelope phase and chirp: phase shift and peak enhancement.

We theoretically investigate the residual current of linearly polarized light incident on graphene under the combined effect of carrier envelope phase and chirp. Phase shift and peak residual current enhancement are significantly obtained. Phase shift is the natural result of introducing a linear chirp in the presence of carrier envelope phase. By comparing the residual current integrated along the kx direction for different chirp rates and carrier envelope phases, the enhancement can be observed from two regions, where multiphoton interference is involved. By increasing the chirp rate, the light-graphene interaction turns from a non-perturbative to a perturbative regime. Thus the results of the combined effect can help to find suitable parameters to study regime transition and control of electronic dynamics. We expect that this study contributes to the signal processing at optical frequencies and to the development of optoelectronic integrated device applications.

Quantitative analysis using intraoperative contrast-enhanced ultrasound in adult-type diffuse gliomas with isocitrate dehydrogenase mutations: association between hemodynamics and molecular features.

The relationship between contrast-enhanced ultrasound (CEUS) hemodynamics and the molecular biomarkers of adult-type diffuse gliomas, particularly isocitrate dehydrogenase (IDH), remains unclear. This study was conducted to provide a comprehensive description of the vascularization of adult-type diffuse gliomas using quantitative indicators. Additionally, it was designed to identify any variables with the potential to intraoperatively predict IDH mutation status. This prospective study enrolled patients with adult-type diffuse gliomas between November 2021 and September 2022. Intraoperative CEUS was performed, and CEUS videos were recorded for 90-second periods. Hemodynamic parameters, including the peak enhancement (PE) difference, were calculated based on the time-intensity curve of the region of interest. A differential analysis was performed on the CEUS parameters with respect to molecular biomarkers and grades. Receiver operating characteristic curves for various parameters were analyzed to evaluate the ability of those parameters to predict IDH mutation status. Sixty patients with adult-type diffuse gliomas were evaluated. All hemodynamic parameters, apart from rising time, demonstrated significant differences between IDH-mutant and IDH-wildtype adult-type diffuse gliomas. The PE difference emerged as the optimal indicator for differentiating between IDH-wildtype and IDH-mutant gliomas, with an area under the curve of 0.958 (95% confidence interval, 0.406 to 0.785). Additionally, the hemodynamic parameters revealed significant differences across both grades and types of adult-type diffuse gliomas. Hemodynamic parameters can be used intraoperatively to effectively distinguish between IDHwildtype and IDH-mutant adult-type diffuse gliomas. Additionally, quantitative CEUS equips neurosurgeons with dynamic perfusion information for various types and grades of adult-type diffuse gliomas.

Prediction of renal recovery following sepsis-associated acute kidney injury requiring renal replacement therapy using contrast-enhanced ultrasonography.

Microcirculatory dysfunction plays a critical role in sepsis-associated acute kidney injury (S-AKI) development; however, its impact on renal recovery remains uncertain. We investigated the association between cortical microcirculatory function assessed using contrast-enhanced ultrasonography (CEUS) and renal recovery after S-AKI needing renal replacement therapy (RRT). This retrospective study included 23 patients who underwent CEUS among those who underwent acute RRT for S-AKI. In addition, we acquired data from 17 healthy individuals and 18 patients with chronic kidney disease. Renal recovery was defined as sustained independence from RRT for at least 14 days. Of the CEUS-derived parameters, rise time, time to peak, and fall time were longer in patients with S-AKI than in healthy individuals (p = 0.045, 0.01, and 0.096, respectively). Fourteen patients (60.9%) with S-AKI receiving RRT experienced renal recovery; and these patients had higher values of peak enhancement, wash-in area under the curve (AUC), wash-in perfusion index, and washout AUC than those without recovery (p = 0.03, 0.01, 0.03, and 0.046, respectively). We evaluated the receiver operating characteristic curve and found that the peak enhancement, wash-in AUC, wash-in perfusion index, and wash-out AUC of CEUS derivatives estimated the probability of renal recovery after S-AKI requiring RRT (p = 0.03, 0.01, 0.03, and 0.04, respectively). CEUS-assessed cortical microvascular perfusion may predict renal recovery following S-AKI that requires RRT. Further studies are essential to validate the clinical utility of microcirculatory parameters obtained from CEUS to estimate renal outcomes in various etiologies and severities of kidney disease.