US Measurements Research Articles

Assessment of Reliability, Agreement, and Accuracy of Masseter Muscle Ultrasound Thickness Measurement Using a New Standardized Protocol.

There is no validated method of assessing masseter muscle thickness (MMT) by ultrasound imaging (US). However, this is important to ensure study and measurement quality of MMT by US in future studies, as MMT differs depending on the examined area. Thus, this study's aim was to present a new standardized method for assessing the MMT by US and to evaluate the reliability, consistency, and accuracy of its measurements. We also compared the results of MMT measurements obtained by US and computer tomography (CT). The study included nine healthy adults. The US and CT scans were collected in a supine rest position with the mandible in relaxed position. US measurements were determined according to a new standardized protocol (with precise probe location). The MMT measured by CT and US over a seven-day interval showed excellent intra-rater reliability. The mean MMT measured by CT was 12.1 mm (1.74) on the right side and 11.9 mm (1.61) on the left side. The mean MMT measured by US was 12.7 mm (2.00) on the right side and 11.5 mm (1.37) on the left side. The mean percent error in MMT measurement between CT and US was below 6%. A strong linear relationship was found between the CT and US measurements of the MMT on both body sides (p < 0.001, r ≥ 0.93). The proposed method of MMT measurement using US demonstrated excellent reliability, yielding results similar to those obtained from CT images. We recommend the use of this standardization protocol in further studies where precise assessment of MMT by US is expected.

Feasibility of capturing vessel expansion with 4D-CTA: Phantom study to determine reproducibility, spatial and temporal resolution.

Dynamic Computed Tomography Angiography (4D CTA) has the potential of providing insight into the biomechanical properties of the vessel wall, by capturing motion of the vessel wall. For vascular pathologies, like intracranial aneurysms, this could potentially refine diagnosis, prognosis, and treatment decision-making. The objective of this research is to determine the feasibility of a 4D CTA scanner for accurately measuring harmonic diameter changes in an in-vitro simulated vessel. A silicon tube was exposed to a simulated heartbeat. Simulated heart rates between 40 and 100 beats-per-minute (bpm) were tested and the flow amplitude was varied, resulting in various changes of tube diameter. A 320-detector row CT system with ECG-gating captured three consecutive cycles of expansion. Image registration was used to calculate the diameter change. A vascular echography set-up was used as a reference, using a 9MHz linear array transducer. The reproducibility of 4D CTA was represented by the Pearson correlation (r) between the three consecutive diameter change patterns, captured by 4D CTA. The peak value similarity (pvs) was calculated between the 4D CTA and US measurements for increasing frequencies and was chosen as a measure of temporal resolution. Spatial resolution was represented by the Sum of the Relative Percentual Difference (SRPD) between 4D CTA and US diameter change patterns for increasing amplitudes. The reproducibility of 4D CTA measurements was good (r ≥ 0.9) if the diameter change was larger than 0.3mm, moderate (0.7 ≤ r<0.9) if the diameter change was between 0.1 and 0.3mm, and low (r<0.7) if the diameter change was smaller than 0.1mm. Regarding the temporal resolution, the amplitude of 4D CTA was similar to the US measurements (pvs ≥ 90%) for the frequencies of 40 and 50bpm. Frequencies between 60 and 80bpm result in a moderate similarity (70% ≤ pvs<90%). A low similarity (pvs<70%) is observed for 90 and 100bpm. Regarding the spatial resolution, diameter changes above 0.30mm result in SRPDs consistently below 50%. In a phantom setting, 4D CTA can be used to reliably capture reproducible tube diameter changes exceeding 0.30mm. Low pulsation frequencies (40 or 50bpm) provide an accurate measurement of the maximum tube diameter change.

Role of Ultrasound in Evaluation of Median and Ulnar Nerves in Rheumatoid Arthritis Patients in Correlation with Nerve Conduction Studies

Abstract Background Rheumatoid arthritis (RA) is a systemic inflammatory disease of unknown etiology characterized by the involvement of the joints. RA is also associated with vasculopathy, peripheral, autonomic, and entrapment neuropathy. The presence of peripheral neuropathy contributes significantly to the functional limitation in rheumatoid arthritis patients. Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and consists of the compression of the median nerve as it courses through the carpal tunnel followed by the cubital tunnel syndrome which is the most common site for entrapment for the ulnar nerve. Aim of the Work to evaluate the role of ultrasound in evaluation of median and ulnar nerves in rheumatoid arthritis patients in correlation with nerve conduction studies. Patients and Methods to elucidate this aim, 25patients diagnosed with RA, diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for diagnosis of RA. And 25 healthy control subjects (matched for age and body mass index) were enrolled. Results this study was carried on 25 patients, 9 (34.7%) of whom were females, and 17 (68%) were males. The mean age of the studied group was (38.96±6.24 years old). The mean disease duration was 7 ±1.13 years; the mean disease activity index was 4.28 ±0.15. All the studied cases suffer from needle sensation, 24 (96) had numbness and 17(68) had burning sensation. All the studied cases in patient group had distal weakness and negative sensory testing (light touch, pinprick, temperature and vibration). As regarding to extra-articular manifestations, the most common was dry mouth and dry eye in all the studied cases followed by itchy skin in 13(52) patient, then joints aches and subcutaneous nodules in 2(8) patient and purpura was seen in only a case. Conclusion US has the advantage of early detection of median and ulnar nerves neuropathy and can assess the morphology of median and ulnar nerves and its surroundings. US measurements of median and ulnar nerves have a comparable diagnostic value as a non- invasive and an alternative modality for the evaluation of carpal tunnel syndrome and cubital tunnel syndrome.

Sonography in the diagnosis of peri-implant bone defects: An invitro study on native human mandibles.

The aim of this study on native human cadavers was to compare clinical, sonographic, and radiological measurements of fenestrations, dehiscences, and 3-wall bone defects on implants. The examination was carried out on five human mandibles. After the insertion of 27 implants, dehiscences (n = 14), fenestrations (n = 7) and 3-wall bone defects (n = 6) were prepared in a standardized manner. The direct measurement of the bone defects was carried out with a periodontal probe and the radiological examination was carried out using digital volume tomography (DVT). The ultrasound examination (US) was performed using a clinical 24-MHz US imaging probe. Means and standard deviations of the direct, US, and DVT measurements were calculated. Measurements were statistically compared using the Pearson correlation coefficient and Bland-Altman analysis. Bone defects were on average 3.22 ± 1.58 mm per direct measurement, 2.90 ± 1.47 mm using US, and 2.99 ± 1.52 mm per DVT assessment. Pairwise correlations of these measurements were R = .94 (p < .0001) between direct and US, R = .95 (p < .0001) between DVT and US, and R = .96 (p < .0001) between direct and DVT. The mean differences of the measurements (and 95% CI) between direct and US was 0.41 (-0.47 to 1.29), US and DVT 0.33 (-0.30 to 0.97), and direct and DVT 0.28 (-0.50 to 1.07). All peri-implant bone defects could be identified and sonographically measured. US measurements showed a strong correlation with direct and DVT measurements. The sonographic measurement accuracy was highest for dehiscences, followed by fenestrations and 3-wall bone defects.

Percutaneous ultrasound-guided cryoablation for early-stage primary breast cancer: a follow-up study in Japan

BackgroundUltrasound-guided percutaneous cryoablation (PCA) for early-stage breast cancer (ESBC) can be performed under local anesthesia in an outpatient clinic. This study continues a pilot stage to examine local control, safety, patient quality of life (QoL), satisfaction and cosmetic outcomes of cryoablation for ESBC.MethodsPCA was performed under local anesthesia for patients with primary ESBC, followed by radiation and endocrine therapies. Oncologic outcomes were examined by imaging (mammography, ultrasound, MRI) at baseline and 1, 6, 12, 24, 36, and 60 months post-cryoablation. EQ-VAS, EQ-5D-5L, subjective satisfaction and Moiré topography were used to measure health-related QoL outcomes.ResultsEighteen patients, mean aged 59.0 ± 9.0 years, mean tumor size 9.8 ± 2.3 mm, ER + , PR + (17/18), HER2-, Ki67 < 20% (15/18), underwent PCA and were followed for a mean of 44.3 months. No serious adverse events were reported, and no patients had local recurrence or distant metastasis in the 5-year follow-up. Cosmetic outcomes, satisfaction level, and QoL all improved post-cryoablation. Five-year average reduction rates of the cryolesion long, short, and depth diameters, on US, were 61.3%, 42.3%, and 22.8%, respectively, compared to the 86.2% volume reduction rate on MRI. The correlation coefficient between MRI and US measurement criteria was highest for the long diameter. During follow-up, calcification of the treated area was observed in 13/18 cases.ConclusionCryoablation for ESBC is an effective and safe procedure with excellent cosmetic outcomes and improved QoL. This study contributes to the growing evidence supporting cryoablation as a potential standard treatment for ESBC, given compliance to pre-defined patient selection criteria.

Reliability of ultrasonography to measure cervical multifidus, semispinalis cervicis and longus colli muscles dimensions in patients with unilateral cervical disc herniation: An observational cross-sectional test-retest study

BackgroundUltrasonography (US) has been suggested to assess the morphology and function of cervical muscles; but little is known about the reliability of the US measures in patients with cervical disc herniation (CDH). The purpose of this study was to evaluate within-day inter and intra-rater and between-day intra-rater reliability of US to measure dimensions of deep cervical muscles in patients with unilateral CDH. MethodsThirty patients with unilateral CDH participated. Anterior-posterior and lateral dimension of longus colli (LC), multifidus (MF) and semispinalis cervicis (SC) were measured using B-mode ultrasound. The measurements were repeated by rater A 1 h (for within-day reliability) and one week (for between-day reliability) later. For inter-rater reliability, rater B performed all muscles measurements like rater A. ResultsWithin-day reliability measurement for all muscles was good to excellent with IntraClass Correlation Coefficients (ICC) ranging from 0.82 to 0.96, standard error of measurement (SEM) from 0.18 to 0.46 and minimal detectable changes (MDC) from 0.43 to 1.09. Between-day reliability was good for all muscle dimensions with ICC ranging from 0.75 to 0.89, SEM from 0.30 to 0.64 and MDC from 0.71 to 1.52. Inter-rater reliability was also good with ICC ranging from 0.75 to 0.89, SEM from 0.34 to 0.65 and MDC from 0.81 to 1.55. ConclusionsUS was demonstrated to have high within-day inter and intra-rater and between-day intra-rater reliability to measure muscles dimensions in patients with unilateral CDH. It can be used to assess deep cervical muscles or to monitor the effects of interventions.

Common bile duct diameter reference values in patients with gallstone disease across various age-gender groups

Objective. Our goal was to establish common bile duct (CBD) diameter reference levels for abdominal ultrasound and percutaneous transhepatic cholecysto-cholangiography (PTCC) measurements with relevance to age and gender across the cohort of patients with underlying gallbladder disease excluding any intra- or extrahepatic bile ducts lesions.Materials and methods. 251 symptomatic patients with gallbladder disease and no signs of choledocholithiasis or biliary obstruction presenting to Liver and Pancreas Surgery Department, Sklifosovsky Research Institute for Emergency Medicine from January 2019 to June 2023 were reviewed. All the selected subjects underwent transabdominal ultrasound examination of hepato-biliary zone and PTCC. Common bile duct diameter, if not obscured, was measured at its widest visible portion by means of electronic calipers. The relationship between CBD size, age and gender was examined by nonparametric tests across stratified groups.Results. Mean sonographic CBD diameter was as high as 4.99 ± 1.17 mm with no evidence of correlation with age or gender. Mean cholecysto-cholangiography CBD diameter made up 6.49 ± 1.52 mm and reflected a considerable increase with age only: patients under 60 had CBD diameter significantly narrower, then those over 60. Basing upon the 95-percentile, we derived upper reference limit of 6.0 mm for US measurements without age and sex association, and for PTCC measurements regarding distinct age groups (8.0 mm in subjects &lt; 60 years and 9.0 mm in subjects ≥ 60 years). Diameter of common bile duct was substantially higher on cholangiograms versus sonograms.Conclusion. Present study displayed notable common bile duct diameter discrepancies not only between ultrasound and cholangiography measurements, but also throughout age-dependent groups on cholangiograms. We imply those variations to be taken in consideration in case of contrasting various radiological evaluations of common bile duct, and in case of ruling out the diagnosis of choledocholithiasis or bile flow abnormality.

The accuracy of the ultrasound measured transverse cricoid diameter and the epiphyseal transverse diameter of the distal radius in predicting the pediatric endotracheal tube size.

In everyday pediatric anesthesia practice, clinicians frequently exchange an already inserted endotracheal tube because of a leak or resistance causing significant morbidity. We investigated the accuracy of two ultrasound measurements; the transverse cricoid diameter and epiphyseal diameter of the distal radius in the prediction of endotracheal tube size that best fits in children compared to age-based formulas. One hundred children (1-6 years) who underwent elective surgery with endotracheal tube whether cuffed (n = 50) or uncuffed (n = 50) were enrolled. The primary endpoint was the agreement between the reference tube size for which its outer diameter was selected based on transverse cricoid diameter and the final best-fit-ETT. The Correlation and Bland Altman agreement tests were conducted between best-fit-ETT outer diameter and ultrasound-measured outer diameter, and between best-fit-ETT inner diameter and inner diameter calculated by age-based formulas. The agreement rate between transverse cricoid diameter-based endotracheal tube size and best-fit-ETT size was 88% in cuffed group compared to 90% in uncuffed group. A significant positive correlation was reported between the outer diameter of best-fit-ETT and the outer diameter measured by the two ultrasound methods. A lower degree of positive correlation was reported between the inner diameter of best-fit-ETT, and the inner diameter calculated by age-based formulas. Bland Altman's analysis showed agreement between best-fit-ETT outer diameter and epiphyseal diameter of the distal radius in both groups and with transverse cricoid diameter in the cuffed group, with no agreement with age-based formulas in either group. Both transverse cricoid diameter and epiphyseal diameter of the distal radius are reliable predictors of the size of best-fit-ETT pediatric endotracheal tube compared to age-based formulas. To save time and effort, we recommend the US measurement of the epiphyseal diameter of distal radius in the preoperative visit and documenting the predicted tube size with the preoperative assessments.

Establishment of Reference Intervals for Caudal Vena Cava-to-Aorta Ratio Measured Ultrasonographically in Healthy Nonsedated Dogs

The ultrasonographic assessment of the caudal vena cava-to-aorta ratio (CVC:Ao) appears to be a promising method for early recognition of alterations of intravascular volume status in veterinary medicine. The primary objective of this study was to establish the reference intervals of the CVC:Ao ratio with ultrasound in nonsedated healthy dogs. Secondary objectives were to determine the influence of the respiratory cycle and to evaluate correlations between ultrasonographic measurements, signalment and physical exam findings. Ultrasonographic measurements of Ao and CVC diameters were successfully obtained for all sixty dogs included. No evidence of a difference was observed between the measurements of Ao and CVC diameters, and CVC:Ao ratio between inspiration and expiration (P = .373, P = .318, and P = .537, respectively). The reference interval for CVC:Ao ratio (95% CI), generated from US measurements performed at any moment of the respiratory cycle was defined as 0.93 (0.91-0.95) −1.32 (1.30-1.34). The CVC:Ao ratio was significantly negatively correlated with age (r = −0.341, P = .008) and positively correlated with respiratory rate (r = 0.423, P < .001), but not with heart rate (P = .573) or arterial systolic blood pressure (P = .166). A low inter- and intraoperator variability in repeated measurements was observed for each operator and between operators. The ultrasonographic measurement of the CVC:Ao ratio appears as a simple method with low inter- and intraoperator variability using the ultrasonographic protocol described in the current study. With the reference interval established in the present study in healthy nonsedated dogs, further studies should evaluate the utility of this simple method in assessing and monitoring volume status in hypo- and hypervolemic dogs.

Patient Safety Culture Analysis in Dental Hospital Using Dental Office Survey on Patient Safety Culture Questionnaire: A Cross-cultural Adaptation and Validation Study.

The culture of safety and patient safety management in dental practice lags compared with medical practice. Hospitals strive to pursue quality and safety of healthcare services, with evidence of patient safety incidents in medical practice demonstrating the importance of promoting a safety culture. Measuring patient safety culture is a necessary first step to improving safety culture in clinical settings. As a hospital, dental hospital should improve the quality and culture of patient safety. Thus, our objective was to conduct a cross-cultural adaptation of a US measure of dental office patient safety culture for use in Indonesian dental hospitals. A cross-sectional study was conducted on 200 respondents at a dental hospital in Java, Indonesia. The first stage includes cultural adaptation and translation, followed by developing a questionnaire that was tested through expert agreement and analysis of validity and reliability using Spearman, Cronbach correlation coefficients, and correlation coefficients between classes. The Dental Office Survey on Patient Safety Culture consists of 58 items and 10 dimensions (overall perceptions of patient safety and quality, organizational learning, teamwork, staff training, work pressure and pace, management support for patient safety, office processes and standardization, communication about errors, communication openness, and patient care tracking/follow-up). A total of 200 respondents with a response rate of 61.5% and 77 invalid responses due to incomplete filling, so 123 respondents were analyzed. The validity test results on 38 question items from 10 dimensions, with a sign of 0.05%, 35 items are declared valid. The Indonesian version of the Dental Office Survey on Patient Safety Culture shows good validity and good reliability and has the potential to be used to evaluate patient safety culture in dental hospitals in Indonesia.

Measuring Chinese climate uncertainty

We develop indices of Twitter-based Chinese Climate Uncertainty (TC-CU) and Climate Policy Uncertainty (TC-CPU) from 2010 to onward. Our indices spike with climate change-related presidential announcements, UN climate change conferences, climate change-related flood deaths, warning about melting glaciers in China’s Qilian mountains, and rising climate concerns regarding bitcoin mining, among many others. We find that TC-CPU can predict future US climate uncertainty and attention measures while US measures do not predict Chinese climate change measures. Moreover, TC-CU (TC-CPU) negatively predicts equity returns of small (value) firms. Finally, we find a decline in CO2 emissions in response to shocks to TC-CU.

Evaluating the Adipose Tissue Depth as a Predictor Factor for Gestational Diabetes in Later Pregnancy-A Systematic Review.

The increasing prevalence of gestational diabetes mellitus (GDM) requires non-invasive and precise techniques for evaluating the predisposing risk factors such as visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). According to PRISMA, we developed a systematic review and searched after "visceral adipose tissue AND gestational diabetes" and identified 221 articles on the MEDLINE and Word of Science databases. After assessing them for inclusion criteria and two researchers screened them, 11 relevant articles were included. Although evidence is conflicting, more studies favor using US-determined VAT in GDM prediction. VAT may be more valuable than body mass index or SAT in predicting GDM. VAT can represent an additive factor to the prediction tool of the risk of developing GDM when used in conjunction with other anthropometric or biological parameters or maternal risk factors. US measurements are heterogeneous given different evaluation techniques, cut-off values and inter-operator variation. A significant limitation is the lack of a gold standard to identify GDM confidently. Pregnant women may benefit from early monitoring and preventive care if classified as high risk for GDM early in the gestational period. US-measured VAT during the first trimester of pregnancy seems a valuable and inexpensive screening approach to predict GDM development later in pregnancy, either by itself or if used in conjunction with other clinical and biological parameters.

Instrumentation improvements for NGV aerodynamic characterization at high Mach numbers

One of the most important new engine concepts is the Geared turbofan. In these engines a gear box allows the decoupling between fan and turbine rotational speeds. As a consequence, the separate aerodynamic optimization of both components becomes possible leading to an increase in engine bypass ratios, higher propulsive efficiency and lower specific fuel consumption. The multi-stage intermediate pressure turbine (IPT) is one of the key parts of the thermodynamic cycle in geared turbofan architectures. During the characterization of a LPT NGV row, it is important to have detailed pressure losses measurements as accurate as possible. Because of the aerodynamic differences with conventional low pressure turbines (LPT), this becomes mandatory when the NGV is designed for an IPT. The main error sources are related to circumferential anisotropy, to repeatability of US and DS measurements, to effects of instrumentation in 2D losses and to static pressure measurement in the probe environment.

The impact of the US-China trade war on China's vehicle and vehicle chip industry

On 22 March 2018, US President Donald Trump signed a presidential memorandum on the 301- investigation, which will impose 25% tariff on specific Chinese goods. The trade war between China and the US officially started and during this time, several US measures influence China's vehicle industry and vehicle chip industry. This paper selects the China auto industry indexes, China Auto chip indexes and US dollar exchange rates from 6 months before the trade war to 24 January 2020.This paper uses VAR and ARMA-GARCH models to model and analyses the data, to study how the Chinese vehicle industry and vehicle chip industry have been affected by the US-China trade war, and to predict the future development of the Chinese vehicle industry and vehicle chip industry. This paper also suggests that in the current chip war between China and the United States, China can strengthen its technological development, strengthen trade exchanges with technological powers, and enhance exchanges with the United States to gain benefits.

Uretero-pelvic junction obstruction in children: Is vascular hitch an effective and safe solutions in very long term outcome? Report of 25 years follow-up

Vascular (VH) according to Hellstrom-Chapman technique is considered a safe and effective alternative approach to pure extrinsic Ureteropelvic Junction Obstruction (UPJO) with good results in short and medium term, but few data are available on long and verylong term outcomes. Our aim is to evaluate VH long and very-long term outcomes in patients treated in pediatric age focusing on relapse, development of hypertension and/or inferior polar kidney hypotrophy during puberty and adulthood. From 1990 to 2015 in our Department 76 children were treated by open or laparoscopic VH for pure extrinsic-UPJO. We were able to contact 54 of 76. 41 patients (25 males, 16 females) accepted to be studied. Mean follow- up time was 12.7 years (range 6-27 years); mean age at the assessment was 22.2 years. We excluded patients who were younger than 13 (if females) or 14 (if males) at the assessment (upper limits of physiological puberty onset). Patients were followed with US, MAG-3-scan and arterial blood pressure measurement. Collected data were compared with the preoperative ones by Student t-test. 95% of US images and MAG-3-scan reports were compatible with complete resolution of obstruction with good renal functionality. 87% of patients were completely healthy. We recorded 3 cases of hypertension (7%) not secondary to renovascular origin; 2 cases with recurrent flank pain (5%) with slightly dilated pelvis at the US and sub-obstructive pattern at MAG-3-scan with preserved renal function. Our experience confirms that VH, (open/laparoscopic) is a safe and effective procedure with good outcomes at very longterm follow-up. No patients at puberty and in adulthood required reoperation or presented polar hypotrophy and related vascular hypertension. VH is an alternative approach to pure extrinsic-UPJO. There were few data about long and very-long term outcomes in patients after this kind of surgery. We followed-up 41 patients confirming that VH (open/laparoscopic) is safe and effective with good long-term outcomes.

P351 Validation of anterior thigh ultrasound for screening of sarcopenia and elevated body fat in Inflammatory Bowel Disease

Abstract Background Sarcopenia (low muscle mass, strength and function) and visceral obesity are associated with adverse outcomes in inflammatory bowel disease (IBD). US measurement of thigh muscle thickness as a biomarker of muscle loss in IBD has not been validated to date. Our aim is to validate anterior thigh US for measurement of total muscle thickness (TMT) and fat thickness (FT) in IBD patients and to identify muscle thickness values associated with sarcopenia using bioelectrical impedance analysis (BIA). Methods A prospective study of muscle function and mass was carried out using handgrip strength testing, sit-to-stand test, B-mode US and bioelectrical impedance analysis (BIA) (SECA mBCA 525) in IBD patients attending outpatients in our centre. Sarcopenia was confirmed by ASM/H2. Stata was used for statistical analysis, p ≤ 0.05 denoted statistical significance. Results A total of 52 patients were included, 42% (n=22) were females with a mean age of 45.5 years. CD patients accounted for 75% (n=39). Mean BMI of females was 29.64 (SD 5.88) vs males 26.2 (SD 3.8), p=0.014. Sarcopenia was diagnosed in 16 patients (31%), 10/16 were female with a significantly lower TMT vs non-sarcopenic females (mean 3.56cm vs 4.32cm, p=0.05). ASM/H2 was lower in sarcopenic patients (mean 4.67 kg/h2 vs 8.97 kg/h2, p&amp;lt;0.001). Handgrip strength was lower in sarcopenic patients (mean 24.4 vs 32.1 kg, p=0.25), sit-to-stand did not differ significantly (mean 18.84 vs 13.13sec, p=0.027). Physical activity levels were insignificantly lower in the sarcopenia group (mean PAL 1.78 vs 1.85, p=0.089). TMT strongly correlated with ASM/H2 (r=0.385,p=0.005), skeletal muscle mass (mm) (r=0.368, p0.008), right leg MM (r=0.404, p0.003), handgrip strength (0.29, 0.035) and BMI (r=0.39, 0.005). FT strongly correlated with body fat (kg) (r=0.699, p&amp;lt;0.001), body fat % (r=0.76, p&amp;lt;0.001), body fat index (r=0.67, p&amp;lt;0.001), waist circumference (r=0.35,p0.01) and BMI (r=0.68, p&amp;lt;0.001). Of the sarcopenic patients, 62.5% had high body fat (n=10) which trended toward but did not reach statistical significance (p=0.08). Visceral fat was high overall with higher levels in men (3.6L vs 2.0L, p=0.009), it did not correlate with SF (r=-0.074, p=0.6). Finally, the intra-rater reliability for TMT and SF were both excellent (r=0.97, p&amp;lt;0.001 and 0.979 p&amp;lt;0.001 respectively). Conclusion Sarcopenia is prevalent in IBD patients. Anterior thigh US correlates with BIA and can be used as a screening tool for early loss of muscle mass in IBD patients in addition to screening for high visceral adiposity. The presence of increased visceral adiposity was high, which may have deleterious outcomes for CD patients, given its association with transmural inflammation and post-operative recurrence.

Correlation between Body Composition and Inter-Examiner Errors for Assessing Lumbar Multifidus Muscle Size, Shape and Quality Metrics with Ultrasound Imaging.

Ultrasound imaging (US) is widely used in several healthcare disciplines (including physiotherapy) for assessing multiple muscle metrics such as muscle morphology and quality. Since measuring instruments are required to demonstrate their reliability, accuracy, sensitivity, and specificity prior to their use in clinical and research settings, identifying factors affecting their diagnostic accuracy is essential. Since previous studies analyzed the impact of sociodemographic but not body composition characteristics in US errors, this study aimed to assess whether body composition metrics are correlated with ultrasound measurement errors. B-mode images of the lumbar multifidus muscle at the fifth lumbar vertebral level (L5) were acquired and analyzed in 49 healthy volunteers by two examiners (one experienced and one novel). Cross-sectional area, muscle perimeter and mean echo intensity were calculated bilaterally. A multivariate correlation matrix was calculated for assessing the inter-examiner differences with body composition metrics. Results demonstrated excellent reliability (intraclass correlation coefficient, ICC > 0.9) for assessing the muscle cross-sectional area and perimeter, and good reliability for assessing the muscle shape and mean echo intensity (ICC > 0.7). Inter-examiner errors for estimating muscle size were correlated with participants' age (p value, p < 0.01), weight (p < 0.05), total and trunk lean mass (both, p < 0.01) and water volume (p < 0.05). Greater shape descriptors and mean brightness disagreements were correlated with older ages (p < 0.05) and total lean mass (p < 0.05). No correlations between age and body composition metrics were found (p > 0.05). This study found US to be a reliable tool for assessing muscle size, shape and mean brightness. Although aging showed no correlations with body composition changes in this sample, it was the main factor correlated with US measurement errors.

Association Between US Drug Price and Measures of Efficacy for Oncology Drugs Approved by the US Food and Drug Administration From 2015 to 2020

This cross-sectional study estimates all US Food and Drug Administration anticancer approvals in recent years and evaluates if an association exists between their cost and efficacy.

After the storm: how Hong Kong can hold on to its status as a global business hub in the Asia-Pacific

ABSTRACT Hong Kong went through turbulence and uncertainty when social unrest in 2019 became out of control, changing geopolitics triggered by US-China rivalries reshaped the entire business environment, and COVID-19 brought most economic activities to a standstill. Challenges came from all fronts, and at one point of time, observers expected a collapse of this global city. However, Hong Kong responded, as the six contributions in this special issue will show. The effects of the punitive US measures are two-sided. Also, Hong Kong has demonstrated institutional resilience in making strategic response adjustments. It holds on to its status as a highly ranked global financial centre and a business hub.

Geopolitics and Hong Kong as international financial centre: a dynamic IPE perspective

ABSTRACT This article examines the impact of US–China geopolitical tensions on Hong Kong as an IFC, and how Hong Kong is coping. Utilizing a dynamic IPE perspective, it details how Hong Kong officials, financial market actors and corporations have responded to the punitive US measures against Hong Kong and China in 2020 and 2021, measures that are tantamount to commercial and financial warfare on China and the city, but also that work against the interests of US corporates in Hong Kong. The analysis highlights Hong Kong’s competitive resiliency as an IFC, from 2019 to early-2022, and the sources of its resiliency.