Low Pulse Research Articles

Efficacy and safety of low-intensity pulsed ultrasound (LIPUS) combined with tadalafil in the treatment of severe erectile dysfunction: a retrospective cohort study.

Low-intensity pulsed ultrasound (LIPUS) is an effective and safe treatment for mild to moderate erectile dysfunction (ED). This study aimed to investigate the efficacy and safety of combining LIPUS with tadalafil in treating severe ED. The data from 27 patients treated with LIPUS alone (group A) and 21 patients treated with a combination of LIPUS and daily 10 mg tadalafil (group B) were retrospectively analyzed. The LIPUS regimen consisted of twice-weekly treatments for 4 consecutive weeks. The treatment was considered effective if the change in International Index of Erectile Function-Erectile Function Domain (IIEF-EF) score after treatment was greater than or equal to the minimal clinically important difference (MCID) (the MCID for severe ED is 7 points). The effectiveness, IIEF-EF score, erectile hardness score (EHS), peak systolic velocity (PSV), end diastolic velocity (EDV), and adverse events were evaluated before treatment, 4 weeks after treatment, and 12 weeks after treatment. Compared to pre-treatment, both groups showed significant improvement in IIEF-EF score and EHS at 4 and 12 weeks after treatment (P<0.001), with no statistically significant difference between the two time points (P>0.05). The effective rate did not significantly differ between group A (9/27, 33.3%) and group B (10/21, 47.62%) at 4 weeks or between group A (9/27, 33.3%) and group B (12/21, 57.14%) at 12 weeks after treatment (P=0.32, P=0.10). However, in patients without comorbidities, the effective rate of group B (12/18, 66.67%) was higher than that of group A (9/25, 36.00%) at 12 weeks after treatment (P=0.047). After LIPUS treatment, the PSV level significantly increased and the EDV level significantly decreased compared with before treatment (P<0.05). No adverse events were reported. The study suggests that LIPUS has a therapeutic effect on severe ED patients, especially those without comorbidities. It may have a synergistic or overlapping effect with phosphodiesterase type 5 inhibitors (PDE5Is) on severe ED patients without comorbidities.

Therapeutic effects of LIPUS on the elasticity of injured tendons: animal experiment

Abstract This paper aims to explore the efficacy and duration of low-intensity pulsed ultrasound (LIPUS) treatment in improving the elastic properties of injured tendons through animal experiments. 48 healthy 3-month-old New Zealand white rabbits (weight 2.5-3.0 kg) were randomly divided into the Control group (n = 9) and model group (n = 39). The rabbits in the model group were injected with 0.2ml PGE2 mixed solution (concentration: 500 ng/0.2ml) into the Achilles tendon 2cm above the calcaneus, once a week, for 4 weeks, to build the Achilles tendon injury model. The Control group was injected with the same volume of PBS solution. Three rabbits were randomly selected from the Control and model groups for model validation, the model group was randomly divided into the Model (n = 6) and LIPUS (n = 30) groups. Then the LIPUS was randomly divided into the LIPUS1 (n = 6), LIPUS4 (n = 6), LIPUS7 (n = 6), LIPUS14 (n = 6), and LIPUS28 (n = 6) subgroups. Following interventions on days 1, 4, 7, 14, and 28, tendon elasticity was assessed by shear wave elastography (SWE). The elastic modulus of the Model, LIPUS1, and LIPUS4 groups exhibited a significant decrease compared to the Control group during the early stages of treatment. With prolonged treatment duration, the elastic modulus of LIPUS groups gradually increased. By day 7, no statistically significant difference in elastic modulus existed between the LIPUS7 and Control groups, indicating that LIPUS treatment had successfully restored the Achilles tendon’s elasticity to a healthy state. In summary, LIPUS therapy demonstrates the potential to effectively ameliorate the elastic properties of injured Achilles tendons.

Low-intensity pulsed ultrasound ameliorates insulin resistance in type 2 diabetes mice via promoting glucagon-like peptide-1 release

Abstract Glucagon-like peptide-1 (GLP-1) is a hormone secreted by intestinal L-cells. It regulates glucose levels by boosting insulin secretion, inhibiting glucagon release, and preventing β-cell death. GLP-1 is increasingly used in managing type 2 diabetes mellitus (T2DM). This study assessed the effectiveness of low-intensity pulsed ultrasound (LIPUS), a non-pharmacological intervention, in enhancing insulin resistance in diabetic mice by stimulating GLP-1 release. T2DM was induced in C57BL/6J mice through a high-fat diet and streptozotocin injection. Mice were divided into Control, T2D-sham and T2D-LIPUS groups. The T2D-LIPUS group received LIPUS treatment with a frequency of 1MHz, intensity of 120mW/cm2, and duty cycle of 20%for 20 minutes/day, 5 days/week for 4 weeks. Glucose tolerance and insulin resistance were measured through tests. Pancreatic histology and GLP-1 expression in serum were evaluated. Results showed that T2DM increased insulin resistance, but LIPUS treatment alleviated it. GLP-1 levels significantly increased in the T2D-LIPUS group compared to the T2D-sham group, approaching the control group’s level. LIPUS also reduced apoptosis of islet β cells. These findings suggest that LIPUS stimulation of the intestine can enhance islet β-cell activity through GLP-1 regulation of the gut-pancreas axis, mitigating insulin resistance in T2DM.

An integrated dual-frequency IVUS system with interleaved sampling and parallel signal processing based on FPGA

Abstract Due to the lack of high voltage and low frequency pulse transmission channels, commercial high frequency IVUS imaging system cannot meet the hardware requirements of ultrasound angiography. Therefore, it is of great research significance to develop a dual-frequency IVUS rotary imaging system with high integration, high sampling rate and sampling accuracy. In this work, an integrated dual-frequency IVUS system with interleaved sampling and parallel signal processing based on FPGA was developed. The central frequency of low-frequency channel is up to 10MHz, and the peak voltage range is 80-200V. The central frequency of the high-frequency channel is up to 60MHz, and the voltage peak-to-peak range is 40-80V. The acquisition channel is 500MHz and 12bit, which is realized by interleaved sampling of two ADC. The motor controlled ultrasonic transducer acquires 400-800 lines per turn, and eventually form a 360-degree IVUS hybrid imaging successfully.

Abstract 13: Vascular Chemerin, Particularly from PVAT, contributes to Norepinephrine and Serotonin-Induced Vasoconstriction and Vascular Stiffness in a Sex-Dependent Manner

The adipokine chemerin has been implicated in healthy blood pressure maintenance and adiposity-associated hypertension, evidenced by falls in mean arterial pressure after administration of an antisense oligonucleotide against chemerin in Dahl SS rats. Circulating levels of chemerin are positively associated, in humans, with hypertension and aortic stiffening—a blood pressure-independent risk factor of cardiovascular disease. While chemerin’s role in blood pressure is observed in whole animals, mechanisms of chemerin’s influence on vascular health and disease remain unknown. Chemerin causes direct vasoconstriction through its main receptor Chemerin1 and indirect vasoconstriction by amplifying electrical field stimulation-induced contraction. We identified chemerin production at the vasculature—the blood vessel and its perivascular adipose tissue (PVAT)—and are working to discover the mechanistic role of vascular chemerin in blood vessel function and disease. Using RNAScope®, QPCR, isometric contractility, western blot, and in vivo imaging, we test the hypothesis that vascular chemerin increases arterial contractility through Chemerin1 and plays a role in aortic stiffening. RNAScope® probes detected CMKLR1 expression in the tunica media and PVAT of the thoracic aorta. QPCR revealed Rarres2 expression was higher in the PVAT, and CMKLR1 expression was higher in the media. Chemerin1 antagonism via the selective inhibitor CCX832 (1μM) significantly reduced maximal contraction to both norepinephrine (NE) and serotonin (5-HT) (see figure), but not angiotensin II, in the male rat +PVAT groups. This supports that PVAT-derived chemerin plays a role in sympathetic stimulation of the vasculature. Interestingly, in females, this change in contractile response to NE and 5-HT was not observed. Western blot showed that females express significantly lower levels of chemerin protein in PVAT, suggesting PVAT as the primary source of active chemerin. Finally, male, but not female, genetic chemerin knockout Dahl SS rats have lower aortic arch pulse wave velocity than wild types (M WT: 3.7 ± .7 M KO: 1.4 ± .3 F WT: 2.6 ± .5, F KO: 1.5 ± .3 m/s, N=4-6/group), highlighting a role of chemerin in aortic stiffening. Thus, chemerin, sourced by the PVAT, plays a significant role in vascular contractility and aortic stiffening in males. Future work will determine if chemerin’s influence is amplified in adiposity-associated hypertension, where chemerin levels are elevated in both sexes.

Atomic-scale understanding of microstructural evolution in electrochemical additive manufacturing of metallic nickel

Atomic-level manufacturing is fundamentally concerned with the precise removal, addition, and migration of material at the atomic and close-to-atomic scale (ACS). Tip-based electrochemical deposition, a quintessential ACS electrochemical additive manufacturing technique, offers promising prospects for achieving bottom-up fabrication of metallic micro/nano structures. However, the complex physicochemical reactions involved in electrodes lead to a limited understanding of the mechanisms underlying atomic electrodeposition and structural evolution. For the first time, this study proposes electric double-layer controlled electrochemical kinetics and investigates the effect of direct current (DC) and pulse current (PC) on nickel atomic electrodeposition using molecular dynamics (MD) simulations. The findings reveal that compared to DC electrodeposition, PC electrodeposition results in more orderly deposition morphology, improved surface smoothness, reduced dislocation density, and lower crystal distortion, with these effects being particularly pronounced under low pulse duty ratio conditions. In addition, the pulse frequency significantly influences the morphology and structure of the deposit. The high pulse frequency yields smoother surfaces with local protrusions, while the low frequency favors the formation of orderly and dense structures excepting slightly increased roughness. This study provides critical insights into understanding the microscopic mechanisms of atomic-scale electrodeposition processes and achieving atomically controlled tip-based electrochemical additive manufacturing of micro/nanodevices.

A highly survivable X‐band low noise amplifier based on GaN HEMT technology and impact of pulse width on recovery time

AbstractGaN high electron mobility transistor (HEMT)‐based low noise amplifiers (LNAs) are an integral part of microwave receiver systems to enhance signal‐to‐noise ratio (SNR). The noise of LNA itself becomes critical for systems requiring high SNR, such as imaging and satellite communication systems. This paper discusses the design of a three‐stage LNA operating at the X‐band in the frequency range of 8.0–12.0 GHz. The amplifier's design and small signal, noise, and linearity characterizations are discussed. Stagewise analysis for gain, noise figure (NF), and matching network losses at the design stage results in achieving promising results. The proposed LNA provides a gain of 23.2 dB with dB gain ripple. Its NF is below 1.5 dB, output power at 1 dB gain compression is 16.4 dBm, and third‐order intercept point is 24.7 dBm at 10 GHz. LNA's survivability is validated to input stress as high as 42 dBm. This LNA is the best reported NF and survivability combination in the 8.0–12.0‐GHz frequency range. The reverse recovery time of LNA is measured under two different pulse conditions, and it has been shown that LNA has better recovery times for lower pulse width signals. This LNA finds its applications in radars and satellite communication systems.

Effects of laser non-uniform shock peening on the microstructure and fatigue performance of SUS 304 stainless steel welded joints

Residual tensile stresses and microstructural heterogeneity in welded joints are primary factors that degrade fatigue performance. As an effective post-weld strengthening method, Laser Shock Peening (LSP) can address these issues. Given the personalized demands of different regions, this paper proposes a Laser Non-Uniform Shock Peening (LNUSP) technique. This approach involves applying high pulse energy to the weld zone (WZ) and heat-affected zone (HAZ), and low pulse energy to the base material (BM) to achieve a more uniform residual compressive stress distribution and refined microstructure, thereby improving overall performance and service life. Results indicate that LSP transforms residual tensile stresses on the weld surface into compressive stresses. Compared to original samples, uniformly LSP-treated samples, and locally LSP-treated samples, LNUSP-treated samples exhibit more uniform residual stress and hardness distribution. LSP significantly increases surface hardness, with LNUSP-treated samples achieving a maximum hardness of 308.3 HV. Additionally, LSP induces martensitic transformation in the BM and WZ areas, alters grain orientation, and promotes dislocation movement, resulting in dislocation tangling, dislocation networks, and twin structures, which refine grain size. Consequently, LSP markedly improves joint fatigue performance, delaying fatigue crack propagation. The fatigue life of LNUSP-treated samples is increased by 25.41 % compared to original samples, reaching levels comparable to high-energy large-area impacts. This enhancement is attributed to the uniform residual stress and refined grain structure.

THE COMPARATIVE STUDY OF THE EFFECT OF LOW-INTENSITY BROADBAND AND LOW-INTENSITY PULSED ULTRASOUND ON B16 MELANOMA CELLS IN VITRO

Aim. To evaluate the effect of low-intensity broadband ultrasound (UMUS) and low-intensity pulsed ultrasound (LIPUS) on B16 melanoma cells in vitro. Methods. The research was conducted on B16 melanoma cells under two modes of low-intensity ultrasonic sounding of cells, for which an SDG 2082 X Siglent generator (USA) with an ultrasonic emitter diameter of 20 mm was used; with a frequency for UMUS of 1-7 MHz, intensity of 30 mW/cm, pulse duration of 50 μs, and for LIPUS with a frequency of 1.5 MHz, intensity of 30 mW/cm, pulse duration of 200 μs. Both modes of cell sounding were carried out with threefold irradiation, once a day after which the distribution of cells by cycle phases, the level of apoptosis and proliferative activity was determined by the method of ductal cytofluorimetry. Results. Under the influence of UMUS ultrasonic sounding, the inhibition of the proliferation of melanoma cells by 1.6 times (P&lt;0.05), a 2-fold decrease in the content of aneuploid cells, compared to the control, was found, however, cytostatic and proapoptotic effects were not recorded. Under the influence of LIPUS sounding, an anti-proliferative effect, an increase in the content of dead and apoptotic cells and a decrease in the DI-index compared to the corresponding control were found. Conclusions. Under the action of low-intensity broadband ultrasound (UMUS) and low-intensity pulsed ultrasound (LIPUS), a cytotoxic/cytostatic and pro-apoptotic effect and a decrease in the content of the aneuploid cell population were revealed.

The signal quality improvement of laser-induced breakdown spectroscopy due to the microwave plasma torch modulation

BackgroundLaser-induced breakdown spectroscopy (LIBS) is a versatile analytical technique for element determination in solids, liquids, and gases. However, LIBS suffers from low detection sensitivity and high relative standard deviation (RSD), restricting its large-scale applications. the process of a physical sampling can, in some cases, compromise the mechanical strength of the component under examination. It should be considered that too large laser energy is bound to cause damage to samples which cannot be tolerated in the process of safe production in the nuclear industry. It is necessary to find a method to obtain high elemental signal intensity in low energy laser. ResultsHere, we present a novel approach by integrating microwave plasma torch (MPT) with LIBS, referred to as MPT-LIBS, which effectively addresses the limitations associated with traditional LIBS. The MPT-LIBS technique is evaluated using Cu samples with a low laser pulse energy of 0.55 mJ. A remarkable enhancement factor of over 70 for Cu I 521.82 nm line is demonstrated, while that of Cu I 324.75 nm and 327.40 nm lines exceeding two orders of magnitude. Furthermore, the RSDs of all Cu spectral lines are reduced, especially for Cu I 521.82 nm, which is decreased from 11.48 % to 1.36 %. This indicates a significant improvement in signal stability. Characterization of the tested samples using con-focal microscopy reveals that the ablation area of MPT-LIBS is only 1.36 times of that of LIBS. The limit of detection of Cu I 324.75 nm line is reduced from 52.8 ppk to 319 ppm. Significance and noveltyThis study not only offers valuable guidance for improving signal stability and the limit of detection in LIBS, but also demonstrates minimal sample damage due to its low ablation amount. Consequently, the proposed methodology has the potential to significantly advance LIBS technology, expanding its applicability in industrial applications.

Study on the Effects of Low-Intensity Pulsed Ultrasound and Iron Ions for Proliferation and Differentiation of Osteoblasts

ObjectiveThis study involved the proliferation and differentiation of osteoblasts treated with low-intensity pulsed ultrasound (LIPUS) and iron (Fe3+) ions, respectively. The biological effects of LIPUS and Fe3+ ions on the proliferation and differentiation of osteoblasts were also evaluated. MethodsMC3T3-E1 cells were seeded in six-well plates with the medium, which contained different concentrations of Fe3+ (0, 100, 200, 300, 400, 500, 600 and 700 μg L-1, respectively). LIPUS treatment was directed at the bottom of the plate for 20 min at an intensity of 80 mW cm-2 every day. ResultsViability results showed that a dose of 400 μg L-1 Fe3+ ions had the best effect at promoting osteogenic proliferation in cell culture. The results of alkaline phosphatase staining and mineralization indicated that the differentiation of osteoblasts was promoted by LIPUS and Fe3+ ions. Fluorescence staining results showed that the number of cell nuclei in the LIPUS, Fe3+ and LIPUS-Fe groups increased by 37.20%, 55.81% and 89.76%, respectively. Migration data indicated that migration and proliferation rates were increased by LIPUS and Fe3+, and the results of protein expression indicated that LIPUS and Fe3+ may increase the expression of Wnt, β-catenin, and Runx2, hence promoting normal bone regeneration and development. ConclusionThe combination of LIPUS (1.5 MHz, 80 mW cm-2) and Fe3+ accelerates the proliferation and differentiation of osteoblasts significantly compared with single-factor treatment (stimulated by LIPUS and Fe3+ ions, respectively). This study could establish a foundation for LIPUS-responsive biomaterials in the repair and regeneration of bone tissues.

Pulse Pressure and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation: An Extracorporeal Life Support Organization Registry Analysis.

Low pulse pressure (PP) in venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is a marker of cardiac dysfunction and has been associated with acute brain injury (ABI) as continuous-flow centrifugal pump may lead to endothelial dysregulation. We retrospectively analyzed adults (≥18 years) receiving "peripheral" VA-ECMO for cardiogenic shock in the Extracorporeal Life Support Organization Registry (January 2018-July 2023). Acute brain injury (our primary outcome) included central nervous system (CNS) ischemia, intracranial hemorrhage, brain death, and seizures. Multivariable logistic regressions were performed to examine whether PP ≤10 mm Hg was associated with ABI. Of 9,807 peripheral VA-ECMO patients (median age = 57.4 years, 67% = male), 8,294 (85%) had PP >10 mm Hg versus 1,513 (15%) had PP ≤10 mm Hg. Patients with PP ≤10 mm Hg experienced ABI more frequently versus PP >10 mm Hg (15% versus 11%, p < 0.001). After adjustment, PP ≤10 mm Hg was independently associated with ABI (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI] = 1.06-1.48, p = 0.01). Central nervous system ischemia and brain death were more common in patients with PP ≤10 versus PP >10 mm Hg (8% versus 6%, p = 0.008; 3% versus 1%, p < 0.001). Pulse pressure ≤10 mm Hg was associated with CNS ischemia (aOR = 1.26, 95% CI = 1.02-1.56, p = 0.03) but not intracranial hemorrhage (aOR = 1.14, 95% CI = 0.85-1.54, p = 0.38). Early low PP (≤10 mm Hg) at 24 hours of ECMO support was associated with ABI, particularly CNS ischemia, in peripheral VA-ECMO patients.

Effect of low-intensity pulsed ultrasound on postoperative rehabilitation of rotator cuff tears: Protocol for a systematic review and meta-analysis.

Rotator cuff tears are a common shoulder injury that significantly impacts patients' daily lives and work abilities. Although surgical treatment methods for rotator cuff tears have been continuously improved with advances in medical technology, postoperative rehabilitation remains challenging. Therefore, finding effective rehabilitation treatments is crucial for improving patient prognosis and enhancing quality of life. This study will aim to systematically evaluate the impact of low-intensity pulsed ultrasound (LIPUS) on postoperative rehabilitation of rotator cuff tears, comprehensively assessing the efficacy and safety of LIPUS in postoperative recovery. This protocol will search multiple databases including PubMed/MEDLINE, Embase, Cochrane Library, CNKI, Scopus, and Web of Science to identify randomized controlled trials related to LIPUS for postoperative rehabilitation of rotator cuff tears. The search will encompass literature published from the inception of the databases up to April 2024. Methodological quality assessment and data extraction will be conducted using the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. Meta-analysis will be performed on appropriate studies using either random-effects or fixed-effects models, and subgroup analyses will be conducted to explore potential heterogeneity. Studies meeting the inclusion criteria will be included in the analysis. All analyses will be performed using Stata version 16.0. The incidence of rotator cuff tear rates will be assessed by imaging techniques such as MRI or ultrasound. Pain intensity will be scored using standardized pain assessment scales, such as the Visual Analog Scale (VAS). Improved range of motion (ROM) in shoulder flexion, abduction, and rotation. Functional outcomes will be evaluated using effective measures such as Constant-Murley scores (CMS) and shoulder joint scores by American Shoulder and Elbow Surgeons (ASES). Adverse events associated with LIPUS therapy, including skin irritation, increased pain, or any other complications. Subgroup analysis will also be carried out if possible. Following the meta-analysis, we will assess the overall effect of LIPUS on postoperative rehabilitation of rotator cuff tears, and further explore its impact on aspects such as pain relief, functional improvement, and postoperative complications. It is anticipated that this study will provide comprehensive evidence regarding the role of LIPUS in postoperative rehabilitation of rotator cuff tears, guiding clinical practice and future research. The resultant manuscript will be submitted for publication in a peer-reviewed journal. CRD42024530798.

Recent Advances in Basic Studies of Low-Intensity Pulsed Ultrasound in Periodontal Tissue Regeneration: A Systematic Review.

Approximately half of the adult population is suffering from periodontal disease, and conventional periodontal treatment strategies can only slow the progression of the disease. As a kind of tissue engineering, periodontal regeneration brings hope for the treatment of periodontal disease. Low-intensity pulsed ultrasound (LIPUS) is a form of ultrasound with a frequency of 1-3MHz and a much lower intensity (< 1W/cm2) than traditional ultrasound energy and output. LIPUS has been adopted for a variety of therapeutic purposes due to its bioeffects such as thermal, mechanical, and cavitation effects, which induce intracellular biochemical effects and lead to tissue repair and regeneration ultimately. In this systematic review, we summarize the basic research of LIPUS in the treatment of periodontal disease in periodontal disease animal models and the influence of LIPUS on the biological behavior (including promoting osteogenic differentiation of stem cells and inhibiting inflammatory response) and potential mechanism of periodontal ligament stem cells (PDLSCs), hoping to provide new ideas for the treatment of periodontal disease. We believe that LIPUS can be used as an auxiliary strategy in the treatment of periodontal disease and play an exciting and positive role in periodontal regeneration.

Pilot Study of Personalized Transcranial Magnetic Stimulation with Spectral Electroencephalogram Analyses for Assessing and Treating Persons with Autism.

Autism spectrum condition (ASC) is a neurodevelopmental condition that is only partly responsive to prevailing interventions. ASC manifests core challenges in social skills, communication, and sensory function and by repetitive stereotyped behaviors, along with imbalances in the brain's excitatory (E) and inhibitory (I) signaling. Repetitive transcranial magnetic stimulation (rTMS) has shown promise in ASC and may be a useful addition to applied behavioral analysis (ABA), a gold-standard psychotherapeutic intervention. We report an open-label clinical pilot (initial) study in which ABA-treated ASC persons (n = 123) received our personalized rTMS protocol (PrTMS). PrTMS uses low TMS pulse intensities and continuously updates multiple cortical stimulation locales and stimulation frequencies based on the spectral EEG and psychometrics. No adverse effects developed, and 44% of subjects had ASC scale scores reduced to below diagnostic cutoffs. Importantly, in PrTMS responders, the spectral EEG regression flattened, implying a more balanced E/I ratio. Moreover, with older participants, alpha peak frequency increased, a positive correlate of non-verbal cognition. PrTMS may be an effective ASC intervention, offering improved cognitive function and overall symptomatology. This warrants further research into PrTMS mechanisms and specific types of subjects who may benefit, along with validation of the present results and exploration of broader clinical applicability.

The VExUS score and mortality in patients with Acute Kidney Injury: findings from a multidisciplinary prospective study.

The utility of the venous excess ultrasound (VExUS) score in predicting mortality remains uncertain in acute kidneyinjury (AKI) patients. This was a post-hoc study involving 246 AKI patients presenting to a tertiarycare emergency department. Venous ultrasound assessments were conducted to determine the VExUS score. Cox regressionanalysis was used to identify predictors of 6-month mortality. The study found no significant association between theVExUS score and 6-month mortality in AKI patients in the regression analyses. However, in the subgroup analyses, VExUSgrades 2-3 were associated with lower survival rates in the cardiorenal subgroup (HR: 3.98 [95% CI: 1.33-11.93]), and in AKIgrade 1 (HR: 4.07 [95% CI: 1.74-9.49]). This association was not present in other AKI subgroups. The predictors of mortalityincluded higher age (OR: 1.024; 95% CI 1.005-1.043), malignancy (OR: 2.186; 95% CI 1.408-3.392), lower systolic bloodpressure (OR: 0.990; 95% CI 0.982-0.998), elevated pulse (OR: 1.013; 95% CI 1.005-1.022), and higher lactate levels (OR:1.210; 95% CI 1.097-1.334). The VExUS score did not predict 6-month mortality in the general cohort of AKIpatients in the emergency department. However, VExUS grades 2-3 were associated with lower survival rates in the cardiorenalsubgroup and patients with AKI grade 1.

Coarctation of aorta presenting as systemic hypertension in a young adult: A case report

A 33-year-old male who was under investigation for young onset hypertension for nine years had weak lower limb pulse and radio femoral delay on examination. Transthoracic echocardiogram revealed a bicuspid aortic valve, and a CT aortogram detected coarctation of the aorta at the junction of the aortic arch and descending thoracic aorta.Coarctation of the aorta is a rare secondary cause of hypertension in young. Symptoms of presentation may vary depending on the site and severity of coarctation. But the commonest presentation is hypertension in the upper extremity of the body. It could be associated with structural heart disease; the commonest is the bicuspid aortic valve. Treatment options for coarctation of the aorta include balloon angioplasty and surgical repair. Lifelong follow-up is needed in both treatment modalities, even after successful correction.

Machine learning classification of permeable conducting spheres in air and seawater using electromagnetic pulses

Abstract This paper presents machine learning classification on simulated data of permeable conducting spheres in air and seawater irradiated by low frequency electromagnetic pulses. Classification accuracy greater than 90% was achieved. The simulated data were generated using an analytical model of a magnetic dipole in air and seawater placed 1.5–3.5 m above the center of the sphere in 50 cm increments. The spheres had radii of 40 cm and 50 cm and were of permeable materials, such as steel, and non-permeable materials, such as aluminum. A series RL circuit was analytically modeled as the transmitter coil, and an RLC circuit as the receiver coil. Additive white Gaussian noise was added to the simulated data to test the robustness of the machine learning algorithms to noise. Multiple machine learning algorithms were used for classification including a perceptron and multiclass logistic regression, which are linear models, and a neural network, 1D convolutional neural network (CNN), and 2D CNN, which are nonlinear models. Feature maps are plotted for the CNNs and provide explainability of the salient parts of the time signature and spectrogram data used for classification. The pulses investigated, which expand the literature, include a two-sided decaying exponential, Heaviside step-off, triangular, Gaussian, rectangular, modulated Gaussian, raised cosine, and rectangular down-chirp. Propagation effects, including dispersion and frequency dependent attenuation, are encapsulated by the analytical model, which was verified using finite element modeling. The results in this paper show that machine learning methods are a viable alternative to inversion of electromagnetic induction (EMI) data for metallic sphere classification, with the advantage of real-time classification without the use of a physics-based model. The nonlinear machine learning algorithms used in this work were able to accurately classify metallic spheres in seawater even with significant pulse distortion caused by dispersion and frequency dependent attenuation. This paper presents the first effort towards the use of machine learning to classify metallic objects in seawater based on EMI sensing.

Effect of low-intensity pulsed ultrasound on the mineralization of force-treated cementoblasts and orthodontically induced inflammatory root resorption via the Lamin A/C-Yes associated protein axis.

Orthodontic treatment commonly results in orthodontically induced inflammatory root resorption (OIIRR). This condition arises from excessive orthodontic force, which triggerslocal inflammatory responses and impedes cementoblasts' mineralization capacity. Low-intensity pulsed ultrasound (LIPUS) shows potential in reducing OIIRR. However, the precise mechanisms through which LIPUS reduces OIIRR remain unclear. This study aimed to explore the effects and mechanisms of LIPUS on the mineralization of force-treated cementoblasts and its impact on OIIRR. We established a rat OIIRR model and locally administered LIPUS stimulation for 7 and 14 days. We analyzed root resorption volume, osteoclast differentiation, and the expression of osteocalcin and yes-associated protein 1 (YAP1) using micro-computed tomography (micro-CT), hematoxylin and eosin, tartrate-resistant acid phosphatase, immunofluorescence and immunohistochemistry staining. Invitro, we applied compressive force and LIPUS to the immortalized mouse cementoblasts (OCCM30). We assessed mineralization using alkaline phosphatase (ALP) staining, alizarin red staining, real-time quantitative polymerase chain reaction, Western blotting and immunofluorescence staining. In rats, LIPUS reduced OIIRR, as evidenced by micro-CT analysis and histological staining. Invitro, LIPUS enhanced mineralization of force-treated OCCM30 cells, as indicated by ALP and alizarin red staining, upregulated mRNA expression of mineralization-related genes, and increased protein expression of mineralization markers. Mechanistically, LIPUS activated YAP1 signaling via the cytoskeleton-Lamin A/C pathway, supported by immunofluorescence and Western blot analysis. This study demonstrates that LIPUS promotes mineralization in force-treated cementoblasts and reduces OIIRR by activating YAP1 through the cytoskeletal-Lamin A/C signaling pathway. These findings provide fresh insights into how LIPUS benefits orthodontic treatment and suggest potential strategies for preventing and treating OIIRR.

F-actin microfilaments affect the LIPUS-promoted osteogenic differentiation of BMSCs through TRPM7.

The differentiation of bone marrow mesenchymal stem cells (BMSCs) toward osteogenesis can be induced by low-intensity pulsed ultrasound (LIPUS). However, themolecular mechanisms responsible for LIPUS stimulation areunclear. The possible molecular mechanisms by which LIPUS promotes osteogenic differentiation of BMSCs were investigated in this study. The quantification of alkaline phosphatase (ALP) activity, Alizarin Red S staining, ALP staining, and the establishment of a calvarial defect model were used to evaluate osteogenic effects. Immunofluorescence wasperformed to observe the expression of microfilaments and transient receptor potential melastatin 7 (TRPM7). The levels of F-actin/G-actin and osteogenesis-related proteins under LIPUS alone or LIPUS combined with cytoskeleton interfering drugs (Cytochalasin D [CytoD] or Jasplakinolide [JA]) were assayed by western blot. Quantitative real-time reverse transcription polymerase chain reaction was utilized to measure the expression of Trpm7 mRNA. Moreover, adenoviral Trpm7 knockdown wasverifiedusingwesternblot. The results demonstrated that LIPUS promoted bone formation in vivo. Under osteogenic induction in vitro, the osteogenesis of BMSCs induced by LIPUS was accompanied by the depolymerization and rearrangement of microfilaments and increased levels of TRPM7. By perturbing intracellular actin dynamics, CytoD enhanced the pro-osteogenicity of LIPUS and increased TRPM7 level, while JA inhibited the pro-osteogenicity of LIPUS and reduced TRPM7 level. Additionally, the knockdown of Trpm7 suppressed the osteogenic promotion of BMSCs induced by LIPUS. The transient depolymerization and rearrangement of the cytoskeleton microfilaments mediated by LIPUS can affect TRPM7 expression and subsequently promote the osteogenesis of BMSCs. This study provides further direction for exploring the molecular mechanism of LIPUS, as a mechanical stress, in facilitating the osteogenic differentiation of BMSCs.