Ultrasound Imaging Research Articles

CystNet: An AI driven model for PCOS detection using multilevel thresholding of ultrasound images

Polycystic Ovary Syndrome (PCOS) is a widespread endocrinological dysfunction impacting women of reproductive age, categorized by excess androgens and a variety of associated syndromes, consisting of acne, alopecia, and hirsutism. It involves the presence of multiple immature follicles in the ovaries, which can disrupt normal ovulation and lead to hormonal imbalances and associated health complications. Routine diagnostic methods rely on manual interpretation of ultrasound (US) images and clinical assessments, which are time-consuming and prone to errors. Therefore, implementing an automated system is essential for streamlining the diagnostic process and enhancing accuracy. By automatically analyzing follicle characteristics and other relevant features, this research aims to facilitate timely intervention and reduce the burden on healthcare professionals. The present study proposes an advanced automated system for detecting and classifying PCOS from ultrasound images. Leveraging Artificial Intelligence (AI) based techniques, the system examines affected and unaffected cases to enhance diagnostic accuracy. The pre-processing of input images incorporates techniques such as image resizing, normalization, augmentation, Watershed technique, multilevel thresholding, etc. approaches for precise image segmentation. Feature extraction is facilitated by the proposed CystNet technique, followed by PCOS classification utilizing both fully connected layers with 5-fold cross-validation and traditional machine learning classifiers. The performance of the model is rigorously evaluated using a comprehensive range of metrics, incorporating AUC score, accuracy, specificity, precision, F1-score, recall, and loss, along with a detailed confusion matrix analysis. The model demonstrated a commendable accuracy of \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$96.54\\%$$\\end{document} when utilizing a fully connected classification layer, as determined by a thorough 5-fold cross-validation process. Additionally, it has achieved an accuracy of \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$97.75\\%$$\\end{document} when employing an ensemble ML classifier. This proposed approach could be suggested for predicting PCOS or similar diseases using datasets that exhibit multimodal characteristics.

Effect of classical prolotherapy technique in knee osteoarthritis for a sample of Egyptian population: clinical and imaging study

BackgroundKnee osteoarthritis (KOA) is a progressive musculoskeletal disease that leads to physical impairment and disability. Several nonoperative therapeutic options have been proposed to reduce symptoms, improve physical function, and prevent disability. One of these therapeutic options is dextrose prolotherapy (DPT). The current study aimed to investigate the efficacy of DPT in the treatment of symptomatic KOA and to evaluate its potential proliferative role as assessed by musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI).ResultsSeventeen knees (21.25%) dropped out, leaving 63 knees in the final analysis (57 females and 6 males, aged 41–74 years) with KOA. At 24-week follow-up, the visual analogue scale and overall Western Ontario and McMaster Universities scores showed significant improvement (P < 0.001). Moreover, a highly significant increase in cartilage thickness with a decrease in effusion grade and meniscal extrusion was observed by MSUS (P < 0.001). By MRI, there was a statistically significant decrease in effusion grade (P = 0.013) and meniscal extrusion (P = 0.005) and a highly significant increase in cartilage thickness (P < 0.001). Logistic analysis showed that lower patients’ body mass index (BMI) at baseline was a significant predictor for clinical improvement following DPT.ConclusionDPT might be considered a relatively safe minimally invasive intervention for the treatment of KOA with high adherence and satisfaction. It may lead to significant clinical and structural improvement in patients with KOA. Furthermore, lower BMI is a predicting factor for better clinical response to DPT.Trial registrationThe study was registered prospectively in ClinicalTrials.gov: clinical trial registration number NCT04178304 on 21 November 2019, https://register.clinicaltrials.gov/XXX.

Benign and malignant breast lesions in children and adolescents - diagnostic and therapeutic approach.

Benign and malignant breast lesions in children and adolescents are rare compared to adults. Most tumors are benign. Malignant breast lesions are extremely rare. Fibroadenomas are the most common, accounting for 95% of all lesions. Diagnosis is based on history and physical examination of the breast and armpit. Imaging studies include ultrasound, mammography, and magnetic resonance imaging. Ultrasound is the most commonly used imaging test. Other tests are used in cases of diagnostic doubt. Core needle biopsy should be considered for appropriate diagnostic management. Excisional biopsy should be considered for complex clinical conditions and imaging studies. Except in doubtful situations in children and adolescent girls, a conservative approach and observation of the lesions along with periodic ultrasound examination initially every 6-12 months is advisable. Management of malignant breast lesions in children typically involves a multidisciplinary team consisting of pediatric oncologists, surgeons, radiation oncologists, pathologists, and other specialists and depends on the clinical condition of the patient. An important aspect is the experience of the clinician and radiologist in the treatment of breast lesions, as well as increasing patient and family awareness of possible breast lesions and self-examination. This review aims to provide a scoping overview of the available literature on benign and malignant lesions of the breast in pediatric and adolescent populations to assist physicians and surgeons in making decisions regarding the appropriate diagnosis and management of pediatric breast disease.

Associations between inflammatory markers and carotid plaques in CKD: mediating effects of eGFR–a cross-sectional study

BackgroundChronic kidney disease (CKD) is a significant public health concern associated with a high prevalence of carotid plaques, which are indicators of atherosclerosis and predictors of adverse cardiovascular outcomes. Inflammation is a hallmark of CKD, contributing to both renal dysfunction and cardiovascular complications. This study aims to investigate the association between inflammatory markers—systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), aggregate inflammatory status index (AISI), monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to high-density lipoprotein cholesterol ratio (NHR), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR)—and carotid plaques in CKD patients, and to explore the potential mediating role of estimated glomerular filtration rate (eGFR) in this relationship.MethodsA cross-sectional analysis was conducted on patients admitted to the Division of Nephrology between January 2023 and June 2023. The primary endpoint was the presence of carotid plaques assessed using ultrasound imaging. Multivariable logistic regression models were used to examine the associations between inflammatory markers and carotid plaques, and trend tests were performed to evaluate the trending association of carotid plaques risk and inflammatory markers in tertiles. Restricted cubic spline (RCS) analysis was used to assess potential non-linear relationships, and subgroup analyses were conducted to examine consistency across different strata. Mediation analysis was performed to explore the role of eGFR.ResultsOf the 609 participants, 387 were included in the final analysis after applying exclusion criteria. Elevated levels of LnSIRI (OR = 1.87, 95% CI = 1.25–2.80), LnSII (OR = 1.67, 95% CI = 1.09–2.56), LnAISI (OR = 1.70, 95% CI = 1.22–2.37), LnMHR (OR = 1.94, 95% CI = 1.15–3.26), LnNHR (OR = 1.82, 95% CI = 1.10–3.02), and LnMLR (OR = 2.26, 95% CI = 1.18–4.34) were significantly associated with the presence of carotid plaques. There were significant trends for increasing tertiles of SIRI, AISI, MHR and NHR. RCS analysis showed no significant non-linear associations. Subgroup analyses indicated similar associations across most strata. eGFR partially mediated these relationships, with proportions mediated ranging from 14.7 to 17.5%.ConclusionsInflammatory markers are significantly associated with carotid plaques in CKD patients, with eGFR playing a partial mediating role. These findings highlighted the importance of managing inflammation and maintaining renal function to mitigate the risk of atherosclerosis in CKD patients.Trial registrationNot applicable.

Endometriosis, a novel treatment ahead?

Endometriosis is an estrogen-dependent condition that can lead to significant morbidity, including chronic pelvic pain, multiple surgeries, and infertility. Recent discoveries regarding its genetics, the potential influence of environmental factors and the immune system, along with intrinsic abnormalities in the endometrium of affected women and the secretions from endometriotic lesions, have provided new insights into the disease's pathogenesis. These findings form the basis for developing new treatments aimed at managing disease-related pain and infertility. It was possible to observe a case of remission of symptoms and complete disappearance of lesions on ultrasound images after anthroposophic treatment. Certainly, more cases need to be followed up in the long term to verify whether there has been a real cure for the disease. Case: Brazilian woman in the reproductive period with endometriosis presented remission of symptoms with disappearance of the lesions after anthroposophic treatment

Novel Bioreactor Design for Non-invasive Longitudinal Monitoring of Tissue-Engineered Heart Valves in 7T MRI and Ultrasound.

The development of cardiovascular implants is abundant, yet their clinical adoption remains a significant challenge in the treatment of valvular diseases. Tissue-engineered heart valves (TEHV) have emerged as a promising solution due to their remodeling capabilities, which have been extensively studied in recent years. However, ensuring reproducible production and clinical translation of TEHV requires robust longitudinal monitoring methods.Cardiovascular magnetic resonance imaging (MRI) is a non-invasive, radiation-free technique providing detailed valvular imaging and functional assessment. To facilitate this, we designed a state-of-the-art metal-free bioreactor enabling dynamic MRI and ultrasound imaging. Our compact bioreactor, tailored to fit a 72mm bore 7T MRI coil, features an integrated backflow design ensuring MRI compatibility. A pneumatic drive system operates the bioreactor, minimizing potential MRI interference. The bioreactor was digitally designed and constructed using polymethyl methacrylate, utilizing only polyether ether ketone screws for secure fastening. Our biohybrid TEHV incorporates a non-degradable polyethylene terephthalate textile scaffold with fibrin matrix hydrogel and human arterial smooth muscle cells.As a result, the bioreactor was successfully proven to be MRI compatible, with no blooming artifacts detected. The dynamic movement of the TEHVs was observed using gated MRI motion artifact compensation and ultrasound imaging techniques. In addition, the conditioning of TEHVs in the bioreactor enhanced ECM production. Immunohistology demonstrated abundant collagen, α-smooth muscle actin, and a monolayer of endothelial cells throughout the valve cusp. Our innovative methodology provides a physiologically relevant environment for TEHV conditioning and development, enabling accurate monitoring and assessment of functionality, thus accelerating clinical acceptance.

Phrenic Nerve Sonography Alterations in Patients with ALS: Insight with Clinical and Neurophysiological Findings

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder, and although the diagnosis is primarily based on clinical criteria, ENMG, as the “gold standard”, does not always show detectable changes. Therefore, our study suggests that alterations in echogenicity and heterogeneity of the phrenic nerve (PN) may serve as potential additional diagnostic tools for ALS. Methods: Our study included 32 patients in the ALS group and 64 individuals in the control group. Each participant underwent an interview and completed questionnaires to collect clinical and demographic data, including age, gender, height, body mass index (BMI), hip and waist circumference, duration of illness, ALS-FRS-R score, comorbidities, and medication use. Ultrasound examinations of the PN were performed by two authors using a high-resolution “Philips EPIQ 7” ultrasound machine equipped with a linear 4–18 MHz transducer. The ALS group participants underwent PN sonography and conduction examinations, arterial blood gas (ABG) analysis, respiratory function tests (RFT), and electroneuromyography (ENMG). Results: The study demonstrated that the phrenic nerve is significantly smaller on both sides in patients with ALS compared to the control group (p &lt; 0.01). Changes in the homogeneity and echogenicity of the PN were also observed on both sides. On the right side, 43.8% of the nerves showed heterogeneity, 40.6% were isoechoic, and 21.9% were hyperechoic. On the left side, 59.4% of the nerves exhibited heterogeneity, 34.4% were isoechoic, and 28.1% were hyperechoic. Moreover, sonography on both sides showed significant correlation with ALS-FRS-R, COMPASS-31, and ENMG results. Conclusions: Our study highlights the importance of phrenic nerve ultrasound as a promising supplementary diagnostic tool for ALS. The significant differences in phrenic nerve size, echogenicity, and homogeneity between patients with ALS and the control group demonstrate that ultrasound imaging can detect morphological changes in the phrenic nerve. Incorporating phrenic nerve ultrasound into routine diagnostic protocols could improve early detection, enhance disease monitoring, and offer a more comprehensive understanding of the neurodegenerative processes in ALS.

Impact of contraction intensity and ankle joint angle on calf muscle fascicle length and pennation angle during isometric and dynamic contractions

During muscle contraction, not only are the fascicles shortening but also the pennation angle changes, which leads to a faster contraction of the muscle than of its fascicles. This phenomenon is called muscle gearing, and it has a direct influence on the force output of the muscle. There are few studies showing pennation angle changes during isometric and concentric contractions for different contraction intensities and muscle lengths. Therefore, the aim was to determine these influences over a wide range of contraction intensities and ankle joint angles for human triceps surae. Additionally, the influence of contraction intensity and ankle joint angle on muscle gearing was evaluated. Ten sport students performed concentric and isometric contractions with intensities between 0 and 90% of the maximum voluntary contraction and ankle joint angles from 50° to 120°. During these contractions, the m. gastrocnemius medialis and lateralis and the m. soleus were recorded via ultrasound imaging. A nonlinear relationship between fascicle length and pennation angle was discovered, which can be described with a quadratic fit for each of the muscles during isometric contraction. A nearly identical relationship was detected during dynamic contraction. The muscle gearing increased almost linearly with contraction intensity and ankle joint angle.

Long-term Prognosis of Patellar Tendinopathy (Jumper’s Knee) in Young, Elite Volleyball Players: Tendon Changes 11 Years After Baseline

Background: The long-term prognosis of jumper's knee and whether structural changes in the patellar tendon persist is unknown. Purpose: To investigate whether limitations in knee function and structural changes persisted beyond the athletic career of young elite volleyball players. Study Design: Cohort study; Level of evidence, 2. Methods: Volleyball players (mean ± SD age, 18 ± 0.8 years) enrolled in 2006-2011 in a prospective cohort study were invited in 2020-2022 to a follow-up study. Participants rated their knee function with the Victorian Institute of Sport Assessment–Patellar Tendon (VISA-P) score (baseline and follow-up) and the International Knee Documentation Committee (IKDC) score (follow-up) and reported if jumper's knee had influenced their decision to retire from sport. Tendon thickness and structural changes were assessed with ultrasound (baseline) and magnetic resonance imaging (MRI) (follow-up) of both patellar tendons. Results: We included 138 of 143 former athletes (97%) 11.4 ± 1.6 years after their baseline examination. At baseline, 37 persons (52 knees) had developed jumper's knee. At follow-up, participants reported lower knee function scores in knees diagnosed with jumper's knee at baseline than healthy knees (VISA-P scores: jumper's knee, 81 [95% CI, 70-92]; healthy, 90 [95% CI, 86-94]; P < .001; IKDC scores: jumper's knee, 82 [95% CI, 75-89]; healthy, 92 [95% CI, 91-95]; P < .001). Jumper's knee problems directly caused 7 of the 37 athletes (19%) with jumper's knee at baseline to retire from competitive volleyball. Of the 138 players included, 97 (70%) completed a bilateral MRI examination (194 knees). At follow-up, 38 of the 54 abnormal tendons (70%) had no structural changes (P < .001 vs baseline) while 22 of the 140 normal tendons (16%) had developed structural changes. Clinical symptoms were not correlated with tendon structure at follow-up (VISA-P scores for normal tendons: 85 [95% CI, 73-87]; abnormal: 89 [95% CI, 85-92]; P = .48). Conclusion: Jumper’s knee is not a self-limiting condition; volleyball players who had developed jumper's knee during adolescence reported persistent reductions in knee function 11 years later, leading one-fifth to retire from competitive volleyball. Although approximately 70% of tendons with structural changes at baseline were normal at follow-up, there was no clear relationship between structure and function.

Interobserver Reproducibility of Ultrasound Attenuation Imaging Technology in Liver Fat Quantification.

This study aims to investigate the interobserver variability in the quantitative assessment of liver fat content using ultrasound attenuation imaging technology (USAT). This prospective, single-center study included 96 adult patients who were either diagnosed with or suspected of having metabolic dysfunction-associated steatotic liver disease. Independent observers, blinded to each other's assessments, evaluated hepatic steatosis visually and through USAT measurements. Separate measurements were taken at five intercostal and subcostal sites, and the median values of these measurements were recorded. The correlation between USAT measurements and visual steatosis grades was examined using Spearman's correlation test. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to evaluate the interobserver variability of USAT measurements. Interobserver agreement for USAT measurements was excellent for the intercostal examination and good for the subcostal examination (p < 0.001). Body mass index did not significantly affect the level of interobserver agreement. Interobserver variability in Bland-Altman plots of USAT measurements was within the 95% limits of agreement. USAT measurements correlated very strongly with the visual degree of hepatic steatosis, both intercostal and subcostal (p < 0.001). USAT measurements were also significantly different between different visual degrees of hepatic steatosis (p < 0.001). In the assessment of hepatic steatosis, USAT measurements obtained from the intercostal space showed excellent agreement in terms of interobserver reproducibility.

3-D Visualization of Atlantic salmon skin through Ultrasound and Photoacoustic Microscopy.

Three-dimensional photoacoustic imaging (PAM) has emerged as a promising technique for non-invasive label-free visualization and characterization of biological tissues with high spatial resolution and functional contrast. The application of PAM and ultrasound as a microscopy technique of study for Atlantic salmon skin is presented here. A custom ultrasound and photoacoustic experimental setup was used for conducting this experiment with a sample preparation method where the salmon skin is embedded in agarose and lifted from the bottom of the petridish. The results of C-scan, B-scan, and overlayed images of ultrasound and photoacoustic are presented. The results are then analyzed for understanding the pigment map and its relation to salmon behavior to external stimuli. The photoacoustic images are compared with the optical images and analyzed further. A custom colormap and alpha map is designed and the matrices responsible for PAM and ultrasound are inserted together to overlay the ultrasound image and PAM image on top of each other. In this study, we propose an approach that combines scanning acoustic microscopy (SAM) images with PAM images for providing a comprehensive understanding of the salmon skin tissue. Overlaying acoustic and photoacoustic images enabled unique visualization of tissue morphology, with respect to identification of structural features in the context of their pigment distribution.

Enhancing Ischemic Stroke Evaluation by a Model-Based Photoacoustic Tomography Algorithm.

Ischemic stroke (IS) is characterized by the sudden interruption of blood supply to the brain, resulting in neurological impairments and even mortality. Photoacoustic computed tomography (PACT) integrates the high contrast of optical imaging and the penetration of ultrasound imaging, enabling non-invasive IS evaluation. However, the image reconstruction quality significantly affects the oxyhemoglobin saturation (sO2) estimation. This study investigates a model-based with total variation minimized by augmented Lagrangian and alternating direction (MB-TVAL3) approach and compared it with the widely used back-projection (BP) and delay-and-sum (DAS) algorithms. Both simulations and invivo experiments are conducted to validate the performance of the MB-TVAL3 algorithm, showing a higher sO2 estimation accuracy and sensitivity in detecting infarct area compared to BP and DAS. The findings of this study emphasize the impact of acoustic inverse problem on the accuracy of sO2 estimation and the proposed approach offers valuable support for IS evaluation and cerebrovascular diagnosis.

Ultrasound imaging velocimetry in a dense two-phase swirling flow

Ultrasound imaging velocimetry in a dense two-phase swirling flow

Congenital Pulmonary Airway Malformation Type II and Challenge in the decision-making process in developing countries-a case report

Congenital Pulmonary Airway Malformation (CPAM) is a congenital lung disease that can be present from prenatal to childhood. The overall incidence of CPAM is reported to be 1 in 10,000 to 1 in 35,000 births, making it the most common type of congenital lung lesion. This malformation results from the interruption of lung development during various stages of embryogenesis. This case report aims to illustrate the disease through ultrasound imaging, emphasize its characteristics, and discuss parental counseling and decision-making regarding the continuation of pregnancy. It is important to highlight the limitations of prenatal diagnostic precision in developing countries and the need for additional diagnostic tools to improve parental decision-making options.

Ultrasound protein-copolymer microbubble library engineering through poly(vinylpyrrolidone-co-acrylic acid) structure

HypothesisWhile albumin-coated microbubbles are routine contrast agents for ultrasound imaging, their short duration of contrast enhancement limits their use, yet can be improved by incorporating protein-copolymer hybrids into microbubble shells. The incorporation of N-vinyl-2-pyrrolidone and acrylic acid copolymer (P(VP–AA)) has been shown to enhance the performance of bovine serum albumin (BSA)-coated microbubbles. However, the impact of the copolymer structural properties on key microbubble characteristics (i.e., concentration, mean diameter and acoustic response) remains poorly understood. Therefore, we hypothesize that the copolymer structure affects its capacity to form micelle-like nanoaggregates, protein-copolymer hybrids, and microbubble shells, ultimately influencing the physicochemical and acoustic properties of the microbubbles. ExperimentsHere we evaluate the production and performance of BSA@P(VP–AA) microbubbles synthesized using a series of P(VP–AA) copolymers with –C8H17 and –C18H37 end groups and molecular weight cutoffs between 3.5 and 15 kDa. Both simulation and experimental data demonstrate that interactions between BSA and the copolymers significantly influence the performance of the resulting microbubbles across the library of 60 formulations. FindingsThe introduction of –C8H17 terminated copolymers into microbubble shells resulted in up to 200-fold higher concentration, 7-fold greater acoustic response, and 5-fold longer ultrasound contrast enhancement compared to plain BSA microbubbles. The enhanced acoustic performance was sustained during in vivo cardiac ultrasound imaging, without altering liver accumulation after copolymer introduction. These findings underscore how optimizing copolymer structure (specifically the terminal end group and molecular weight) can tailor the formation and performance of protein-copolymer-coated microbubbles, offering valuable insights for designing ultrasound contrast agents.

Application value of surgical navigation system based on deep learning and mixed reality for guiding puncture in percutaneous nephrolithotomy: a retrospective study.

This study was conducted to investigate the clinical value of a navigation system based on deep learning and mixed reality for the treatment of kidney stones with percutaneous nephrolithotomy (PNL), and to improve its theoretical basis for the treatment of kidney stones. The data of 136 patients with kidney stones from October 2021 to December 2023 were retrospectively analyzed. All patients underwent PNL, and were categorized into a control group (Group 1) and a surgical navigation group (Group 2) according to puncture positioning method. Preoperative computed tomography (CT) was performed in both groups. In group 1, procedures were performed under standard ultrasound guidance. PNL was performed with navigation system fused with ultrasound to guide percutaneous puncture in group 2. The baseline information and procedural characteristics of both groups were compared. PNL was successfully performed in both groups. No significant difference was found in the baseline date between the two groups. In group 2, real-time ultrasound images could be accurately matched with CT images with the aid of navigation system. The success rate of single puncture, puncture time, and decrease in hemoglobin were significantly improved in group 2 compared to group 1. (p < 0.05). The application of navigation system based on deep learning and mixed reality in PNL for kidney stones allows for real-time intraoperative navigation, with acceptable accuracy and safety. Most importantly, this technique is easily mastered, particularly by novice surgeons in the field of PNL.

Aerobic capacity of healthy young men associated with muscle oxygen extraction rate of the vastus lateralis muscle.

The determinants of aerobic capacity are oxygen delivery by the cardiopulmonary system and oxygen extraction by the skeletal muscles. However, the impact of the oxygen extraction capacity of the skeletal muscle is unclear. This study aimed to examine the associations between aerobic capacity; muscle strength, endurance, mass, and quality; and oxygen extraction capacity. Twenty-seven healthy young men (mean age, 20.7 ± 0.8 years; body mass index, 21.6 ± 3.2 kg m-2) were recruited. The following parameters were determined: peak work rate (WR) and oxygen uptake (V˙O2) corrected for body mass using the cardiopulmonary exercise testing; muscle strength and endurance using isokinetic muscle testing; muscle mass using bioelectrical impedance; muscle quality (muscle echo intensity) using an ultrasound imaging device, and muscle oxygen extraction rate (MOER) using near-infrared spectroscopy. Multiple regression analysis was performed using WR/kg peak and V˙O2/kg peak as dependent variables and each assessment index as an independent variable. Multiple regression analysis with WR/kg peak as the dependent variable resulted in the adoption of SMI (β = -0.41, P = 0.036), muscle echo intensity (β=-0.45, P = 0.012) and ΔMOER (β = 0.73, P < 0.001) as significantly associated factors. Multiple regression analysis with V˙O2/kg peak as the dependent variable resulted in ΔMOER (β = 0.65, P = 0.001) being adopted as a significantly associated factor. These findings suggest that muscle oxygen extraction rate is associated with aerobic capacity. MOER is a useful indicator because it is not affected by body mass.

Sleep restriction exacerbates cardiac dysfunction in diabetic mice by causing cardiomyocyte death and fibrosis through mitochondrial damage.

Diabetic cardiomyopathy (DCM) is a cardiovascular complication of diabetes mellitus with a poor prognosis and is the leading cause of death in diabetic patients. Sleep deficiency is not only recognized as an important risk factor for the development of type 2 DM, but is also associated with increased morbidity and mortality of cardiovascular disease. The underlying role and mechanisms of sleep restriction (SR) in DCM are far from clear. The KK/Upj-Ay mouse model of T2 DM was used as a study subject, and the small animal ultrasound imaging system was used to detect the function of the heart; immunopathological staining was used to clarify the histo-structural pathological alterations of the heart; and TUNEL staining, qPCR, transmission electron microscopy (TEM), and ELISA kits were used to detect apoptosis, oxidative stress, inflammation, and mitochondrial damage, and related molecular alterations. SR led to a significant increase in mortality, cardiac hypertrophy, necrosis, glycogen deposition and fibrosis further deteriorated in DM KK mice. SR increased cardiomyocyte death in KK mice through the Bax/Bcl2 pathway. In addition to this, SR not only exacerbated the inflammatory response, but also aggravated mitochondrial damage and promoted oxidative stress in KK mice through the PRDM16-PGC-1α pathway. Overall, SR exacerbates structural alterations and dysfunction through inflammation, oxidative stress, and apoptosis in DM KK mice, increasing the risk of death. Clinicians and diabetic patients are prompted to pay attention to sleep habits to avoid accelerating the transition of DCM to heart failure and inducing death due to poor sleep habits.

Dietary supplementation with rosemary essential oil improves genital characteristics, semen parameters and testosterone concentration in Barki rams

BackgroundMale reproductive performance is an essential part of sheep production; therefore, the use of natural antioxidants to improve sperm quality and maintain reproductive performance in males is very important. Hence, oral administration of rosemary essential oil (REO) was investigated to improve the fertility rate, including the ultrasonographic testes, epididymal tail and genital glands, as well as semen parameters and testosterone concentration. Sixty animals were splitted into two groups, each with 30 rams; the rosemary group (C + REO) received 2 mg/kg/bw and the control group (C-REO). Ultrasound images and blood samples were collected at 15, 30 and 45 days of the REO treatment.ResultsThe testis and epididymal tail ultrasonographic assessments demonstrated a significant enhancement in the C + REO group compared to the C-REO group. However, the rams in the C + REO group showed significant improvements in the pampini-form plexus, seminal vesicle, Cowper's and prostate genital glands compared to the C-REO group. The data showed that the sperm cell concentration (× 109/ml) and individual motility (%) were significantly improved in the C + REO group. Furthermore, ejaculate volume (ml) in the C + REO group was significantly higher than that in the C-REO group. While the animals treated with REO did not improve live spermatozoa (%), it reduced the abnormalities of spermatozoa (%) compared to the C-REO group. Also, the C + REO group significantly increased the testosterone concentration more than the C-REO group.ConclusionIt can be concluded that supplementation with 2 mg/kg/bw REO improves genital characteristics, semen parameters and testosterone concentration in Barki rams.

Bag of Feature-Based Ensemble Subspace KNN Classifier in Muscle Ultrasound Diagnosis of Diabetic Peripheral Neuropathy

Muscle ultrasound quantification is a valuable complementary diagnostic tool for diabetic peripheral neuropathy (DPN), enhancing physicians’ diagnostic capabilities. Quantitative assessment is generally regarded as more reliable and sensitive than visual evaluation, which often necessitates specialized expertise. This work develops a computer-aided diagnostic (CAD) system based on muscle ultrasound that integrates the bag of features (BOF) and an ensemble subspace k-nearest neighbor (KNN) algorithm for DPN detection. The BOF creates a histogram of visual word occurrences to represent the muscle ultrasound images and trains an ensemble classifier through cross-validation, determining optimal parameters to improve classification accuracy for the ensemble diagnosis system. The dataset includes ultrasound images of six muscles from 53 subjects, consisting of 27 control and 26 patient cases. An empirical analysis was conducted for each binary classifier based on muscle type to select the best vocabulary tree properties or K values for BOF. The result indicates that ensemble subspace KNN classification, based on the bag of features, achieved an accuracy of 97.23%. CAD systems can effectively diagnose muscle pathology, thereby addressing limitations and identifying issues in individuals with diabetes. This research underscores muscle ultrasound as a promising diagnostic tool to aid physicians in making accurate diagnoses, streamlining workflow, and uncovering muscle-related complications in DPN patients.