Search Results (639)

Marfan syndrome (MFS) is characterized by progressive aortic aneurysm formation resulting from mutations in the fibrillin-1 (Fbn1) gene. Although the thoracic aorta is the primary site of pathology, accumulating evidence indicates that vascular dysfunction in MFS extends beyond the aorta to involve multiple arterial beds. Statins have been shown to attenuate aneurysm progression in experimental models of MFS; however, their effects on systemic vascular remodeling and arterial stiffness outside the aorta remain poorly characterized. In this study, we investigated the impact of chronic atorvastatin therapy on vascular structure and hemodynamic function across multiple vascular beds in the Fbn1^C1041G/+^ mouse model of MFS. Male and female control and MFS mice received drinking water with or without atorvastatin (1 g/kg/day) from 4 weeks to 6 months of age, enabling the effects of atorvastatin to be assessed in both healthy and MFS arteries. High-frequency ultrasound imaging was used to assess vascular parameters in the aorta, left common carotid artery (LCCA), and posterior cerebral artery (PCA). Atorvastatin treatment significantly attenuated aortic root dilation in both male and female MFS mice and reduced aortic pulse wave velocity (PWV), indicating improved arterial compliance. In the carotid circulation, atorvastatin significantly reduced LCCA wall thickness and carotid PWV, although carotid wall strain did not improve. Atorvastatin raised both systolic and diastolic blood pressure in male and female MFS mice relative to untreated MFS animals, reaching levels not significantly different from untreated controls in both sexes, while having little effect in healthy controls apart from a rise in female diastolic pressure. In the posterior cerebral artery, peak systolic velocity, a hemodynamic index rather than a direct measure of perfusion, showed similarly sex-dependent changes, increasing in female MFS mice but decreasing further in males after atorvastatin. Collectively, these findings demonstrate that atorvastatin exerts systemic but heterogeneous vascular effects in MFS, improving arterial stiffness and structural remodeling across multiple arterial beds while producing sex-specific hemodynamic responses that warrant further investigation. Full article

The pine wood nematode Bursaphelenchus xylophilus (Nickle, 1970) is one of the most damaging pests affecting coniferous forests, prompting the European Union to adopt strict measures to limit its spread. In sawmills, wood is typically heat-treated following the International Standard for Phytosanitary Measures No. 15 (ISPM 15, 2019), which recommends heat treatment or fumigation with methyl bromide or sulfuryl fluoride for wood packaging materials including pallets, crates, and dunnage. To investigate safer and more cost-effective alternatives, this study uses ultrasound technology as a potential control method. Ultrasound, defined as high-frequency sound waves beyond human hearing, generates acoustic cavitation capable of damaging biological tissues. Nematodes were exposed to ultrasound both in vitro and within artificially inoculated green wood blocks (50 × 50 × 50 mm). In vitro tests showed significant reductions in viability at the measured time points (15, 30, 45 min), with complete mortality observed at 45 min. In wood blocks, nematode numbers declined progressively across the measured intervals, with linear regression providing a model-based estimate of complete elimination before approx. 80 min, although this was not experimentally verified. These results demonstrate that the use of ultrasound at 40 kHz reduces nematode survival under both laboratory conditions and wood matrix conditions. Full article

High-frequency ultrasound-assisted activation of peracetic acid (PAA) was investigated as a tunable advanced oxidation process for the removal of organic pollutants from water. Sunset Yellow FCF (SSY), a representative anionic azo dye, was used as a probe contaminant in a 425 kHz sonoreactor to clarify the roles of PAA speciation, acoustic cavitation, dissolved gases, oxidant dose, acoustic power, and initial pH. UV spectroscopic analysis showed that PAA exhibits pH-dependent far-UV absorbance associated with acid-base speciation and peroxide equilibria, while ultrasonication promoted simultaneous PAA activation and H₂O₂ accumulation. Compared with PAA alone and ultrasound alone, the combined US/PAA process markedly enhanced SSY decolorization. Under natural conditions, 5 mg/L SSY and 5 mM PAA were completely decolorized within 210 min, with an initial rate of 0.116 mg/L·min, compared with 0.078 and 0.0086 mg/L·min for ultrasound and PAA alone, respectively. The corresponding synergy ratio and synergy index were 1.5 and 1.34. The process exhibited tunable reaction-pathway control, with two favorable pH windows: a strongly acidic region, where interfacial HO^•-driven sonochemistry and PAA stability are favored, and a mildly alkaline region, where PAA deprotonation promotes peracetate-driven acyl/peroxyl radical-chain propagation. Oxygen saturation improved performance, whereas CO₂ suppressed cavitation-driven activation. Increasing PAA concentration and acoustic power enhanced removal up to practical limits, beyond which radical scavenging and diminishing sonochemical returns became evident. Beyond demonstrating enhanced decolorization, this study distinguishes US/PAA from previously reported UV/PAA, transition-metal/PAA, and ultrasound-only systems by showing how 425 kHz cavitation converts PAA into a tunable hybrid HO^•/acyl–peroxyl radical network. The main contribution is a mechanistic operating map that links PAA speciation, sonochemical peroxide accumulation, dissolved gas chemistry, acoustic power, oxidant dose, and pH to pollutant-removal performance, thereby defining practical windows for sono-activated PAA treatment of anionic dyes and related recalcitrant contaminants. Full article

Colorectal cancer (CRC) remains the third most common malignancy worldwide and a leading cause of cancer mortality, largely driven by metastatic dissemination. Among metastatic routes, lymphatic spread is crucial to determine the prognosis and establish an adequate therapeutic strategy. Lymph node metastasis (LNM) defines stage III disease in the TNM classification, guiding adjuvant chemotherapy and surgical planning. However, nodal staging based on lymphadenectomy and histopathology is invasive, time-consuming, and may lead to overtreatment. Conventional imaging modalities, including computed tomography, magnetic resonance imaging, and endorectal ultrasound, show limited sensitivity and specificity for small or micro-metastatic nodes. Despite multimodal progress, no non-invasive technique reliably identifies malignant nodes in real time. PET–MRI, contrast-enhanced ultrasound, photoacoustic and fluorescence approaches, ICG mapping, and sentinel node biopsy improve detection but remain limited by specificity, cost, or availability. Extranodal extension (ENE) and tumor deposits (TDs) carry major prognostic value, reflecting aggressive biology and association with distant spread. Meanwhile, phylogenetic studies challenge linear dissemination models, indicating that some metastases arise directly from the primary tumor or TDs rather than LNMs. These data support refinement of staging and surgical strategies according to tumor biology rather than purely anatomical criteria. High-frequency quantitative ultrasound (HF-QUS) enables real-time, operator-independent, three-dimensional nodal assessment with reported sensitivity and specificity exceeding 85%. Combined with artificial intelligence and molecular profiling, it may support biologically informed staging, reduce unnecessary surgery, and foster precision oncology. Lymphatic dissemination in CRC offers a platform to merge tumor biology with technological innovation, where advanced imaging, molecular insight, and artificial intelligence may redefine nodal staging toward precision, non-invasive care. Full article

Background: Static (at-rest) and dynamic (expression-linked) wrinkles are complementary hallmarks of facial aging. While static wrinkles are widely studied, the objective quantification of dynamic wrinkles during active facial movement remains a novel and underexplored frontier. Quantifying both phenotypes under real-life product use requires objective, non-invasive endpoints alongside standardized clinical grading. Aim: This study aimed to evaluate the clinical and instrumental efficacy of a multi-active topical cream on static and dynamic wrinkles over 8 weeks of twice-a-day use. Methods: After a 2-week washout, we conducted a monocentric, open-label study on 62 Chinese women (25–55) who used the topical cream twice daily for 8 weeks (per-protocol n = 49; dynamic-wrinkle subset n = 41; dermatologist 0–9 grading at T0/Timm/W4/W8). The instrumental endpoints were PRIMOS-CR wrinkle morphometry (forehead, crow’s feet) and periocular high-frequency ultrasound (UC22). Dynamic wrinkles were assessed via high-speed smile imaging (max P10; mean P1–P10). Statistics comprised Wilcoxon’s tests for dermatologist-graded (ordinal) endpoints and repeated-measures ANOVA with Dunnett’s tests for continuous instrumental endpoints (α = 0.05). Results: Improvements were evident at Timm (periorbital elasticity −17.70%, global-face elasticity −15.23%, firmness −19.47%, smoothness −20.16%, radiance −25.75%; all p < 0.001). By Week 8, dermatologist-graded wrinkles generally decreased: crow’s feet −26.89%, under-eye −33.74%, glabellar −35.30%, forehead −34.69% (all p < 0.001). PRIMOS showed reductions in wrinkle area/length (forehead area −8.69%, length −12.05%; crow’s feet area −8.70%, length −16.03%; all p < 0.001). Ultrasound indicated increased periocular epidermal thickness (+26.57%) and density (+12.69%) (both p = 0.005). Dynamic-wrinkle grades improved during smiling (under-eye: max −12.64%, mean −15.74%; crow’s feet: max −15.97%, mean −16.89%; all p < 0.001), with reductions across P1–P10. Conclusions: In real-life, with twice-daily use, the multi-active cream demonstrated significant within-subject improvements in both static and dynamic (expression-linked) wrinkles, as supported by dermatologist grading, PRIMOS 3D wrinkle morphometry, and periocular high-frequency ultrasound. Full article

Posterior acoustic shadowing is a key diagnostic feature in ultrasound imaging of calcified lesions, such as gallbladder and kidney stones. However, conventional assessment relies primarily on qualitative interpretation, and its underlying structural characteristics remain insufficiently quantified. This study aimed to quantitatively characterize posterior acoustic shadows using wavelet-based texture analysis and to investigate their diagnostic relevance across different expert-defined shadow confidence groups. Ultrasound B-mode images were analyzed from gallbladder stone and kidney stone datasets. Regions of interest (ROIs) were extracted from gallbladder and kidney stone images across three shadow confidence levels (50–60%, 60–80%, and >80%), and multi-scale wavelet features were computed. The results demonstrated a substantial reduction in high-frequency components with increasing attenuation. Total detail energy decreased by approximately 80% in the gallbladder group and 55–60% in the kidney group from low to high shadow confidence levels. Similarly, normalized ratios (E_{detail/approx} and E_detail/total showed consistent decreases, with inter-group differences of approximately 2.3–2.5-fold at 50–60%, which converged to negligible levels (<2.4% difference) at >80%. These findings suggest that wavelet-based energy distributions may provide acoustically interpretable quantitative descriptors of posterior shadow formation in ultrasound stone imaging. Full article

Background: Cutaneous squamous cell carcinoma (cSCC) is commonly regarded as a sporadic malignancy primarily driven by ultraviolet exposure. However, the occurrence of multiple, aggressive tumors at a relatively young age suggests the presence of underlying genetic susceptibility. The role of germline variants affecting extracellular matrix organization, pigmentation pathways, and tumor metabolism in aggressive cSCC remains incompletely understood. Case Presentation: We describe a 53-year-old patient with a long-standing history of multiple aggressive cutaneous squamous cell carcinomas involving the scalp and facial regions, characterized by recurrent and multifocal disease. A comprehensive diagnostic approach was undertaken, including histopathological examination, fluorescence confocal microscopy, high-frequency cutaneous ultrasound, and genetic analysis using whole-exome sequencing (WES). Results: Histopathology confirmed high-risk features consistent with aggressive cSCC. Cutaneous ultrasound and fluorescence confocal microscopy provided complementary, non-invasive insights into tumor depth, architecture, and invasive patterns. Whole-exome sequencing identified a heterozygous truncating variant in COL6A3 (NM_004369.4:c.5645C>A, p.Ser1882Ter), classified as likely pathogenic according to ACMG criteria. Additionally, two heterozygous variants of uncertain significance were detected in TYR (NM_000372.5:c.1569C>A, p.Ser523Arg) and FH (NM_000143.4:c.1237-5_1237-4insTCTCCCTCCCTC). Although individually inconclusive, the combined germline genetic background may have contributed to the patient’s aggressive and multifocal cutaneous phenotype. Discussion: This case report supports a potential role of extracellular matrix remodeling, pigmentation-related susceptibility, and metabolic dysregulation in cutaneous carcinogenesis and tumor aggressiveness. This case illustrates how integrating WES with advanced non-invasive imaging techniques can enhance the understanding of biologically aggressive cSCC. Conclusions: This report highlights a unique case of multifocal aggressive cSCC characterized by a distinct germline genetic profile identified by WES and multimodal imaging assessment. Comprehensive molecular and imaging evaluation may be beneficial in selected patients with atypical or aggressive cutaneous squamous cell carcinoma, with implications for personalized surveillance and management. Full article

Scanning acoustic microscopy is a useful non-destructive imaging technique for semiconductor inspection, providing acoustic contrast without physical sectioning. However, the selection of an ultrasound transducer for high-quality imaging is not determined by the operating center frequency alone. The focusing condition, represented by the F-number, also plays a critical role in determining the lateral resolution. In this study, the combined effects of the center frequency and F-number on lateral resolution were investigated using wafer-based test samples. Focused ultrasound transducers with different center frequencies were used to image a striped resolution target for quantitative lateral resolution analysis. In addition, a custom-fabricated silicon wafer containing void-mimicking patterns was also imaged for qualitative evaluation. The results show that a higher frequency does not necessarily guarantee better lateral resolution. In fact, a lower-frequency transducer with tighter focusing showed greater image quality compared to a higher-frequency transducer with a larger F-number. These findings indicate that both frequency and F-number should be jointly considered when selecting ultrasound transducers for semiconductor inspection. This wafer-based evaluation provides practical guidance for optimizing imaging conditions in scanning acoustic microscopy, according to target feature size and inspection requirements. Full article

Background: Acne vulgaris affects up to 80% of individuals aged 11–30 years and frequently results in permanent scarring with significant psychosocial impact. This prospective single-arm case series evaluated the safety and high-frequency ultrasound-assessed morphological changes in a combined protocol integrating subcision, PEGDE-crosslinked hyaluronic acid supplemented with calcium hydroxyapatite (CaHA), and fractional 1470 nm diode laser therapy in patients with facial atrophic acne scars. Methods: Twenty patients (aged 18–42 years, Fitzpatrick phototypes I–II) with moderate-to-severe atrophic acne scars underwent subcision of fibrotic adhesions using a 22G cannula combined with a single subcutaneous injection of 2 mL PEGDE-crosslinked hyaluronic acid with CaHA microparticles on day 0, followed by two sessions of fractional 1470 nm diode laser therapy on days 7 and 28. Scar depth and diameter were assessed using high-frequency ultrasound (48 MHz) at baseline and on days 28, 49, 77, and 139. Results: All participants completed the protocol without serious adverse events. High-frequency ultrasound demonstrated progressive reductions in mean scar depth (from 0.35 to 0.05 mm; −86%) and scar diameter (from 4.27 to 1.06 mm; −75%) by day 139, with reductions continuing beyond the active treatment phase. In linear mixed-effects models accounting for within-patient clustering of the two lesions assessed per participant, the reductions in both depth and diameter were statistically significant at every follow-up timepoint relative to baseline (all p < 0.001). These ultrasound findings were not corroborated by a control group, blinded assessment, validated clinical grading, or patient-reported outcomes. Conclusions: In this single-arm case series, the combined subcision, PEGDE-crosslinked HA–CaHA filler, and fractional 1470 nm diode laser protocol was well tolerated and associated with progressive, sustained reductions in high-frequency ultrasound-measured scar depth and diameter. As an uncontrolled, unblinded study without validated clinical grading or patient-reported outcomes, these findings are preliminary and require confirmation in larger, controlled trials. Full article

Background and Clinical Significance: Hyaluronic acid fillers are currently the most widely used materials in aesthetic medicine and represent one of the most frequently performed minimally invasive procedures worldwide. Vascular occlusion is the most severe complication associated with this type if filler injections due to the risk of tissue necrosis and permanent sequelae. Early recognition and precise identification of the affected vascular territory are essential to prevent irreversible damage. Case Presentation: his report describes a case of infraorbital artery occlusion with retrograde extension to the anterior superior alveolar artery and associated gingival ischemia, highlighting the role of high-frequency ultrasound in diagnosis and management. A 60-year-old woman developed vascular occlusion following supraperiosteal HA injection in the medial cheek. Clinical findings included livedo reticularis in the infraorbital and nasal regions, along with ipsilateral gingival anesthesia and mucosal ischemia. High-frequency ultrasound was used to assess the extent and mechanism of vascular involvement. A targeted treatment approach was implemented using low-dose hyaluronidase (100 IU/mL), with 200 IU administered in the infraorbital region and an additional 100 IU delivered under ultrasound guidance to the affected alveolar branch. Ultrasound examination revealed extrinsic compression of the infraorbital artery and secondary occlusion of the anterior superior alveolar artery consistent with retrograde embolization. Following image-guided administration of hyaluronidase, complete reperfusion was achieved, with resolution of both cutaneous and gingival ischemia and no functional or aesthetic sequelae. Conclusions: High-frequency ultrasound provides critical diagnostic information in vascular complications after HA filler injection, allowing for accurate identification of the mechanism and extent of vascular involvement. Ultrasound-guided low-dose hyaluronidase may represent an effective and safe strategy to restore perfusion while minimizing unnecessary enzyme exposure and associated adverse effects. Full article

Functional properties of caseins play a crucial role in the dairy industry, so it is important to develop methods to improve their functionality. The aim of this study is to investigate the combined effect of high-intensity ultrasound (HIUS) treatment and calcium chelation on functional properties of casein micelles. For this purpose, micellar casein concentrate (MCC) was prepared with a concentration of 3% (w/w) casein. Then, 0 and 10 mM of Disodium hydrogen phosphate was added. HIUS was performed at a frequency of 20 kHz, power intensity of 550 W/cm², and an amplitude of 100% for 0, 5, 10, 15, and 20 min at 25 °C. Factorial design was employed to investigate the effect of ultrasound time (UST) and disodium phosphate (DSP) on foam capacity (FC), emulsion activity index (EAI), gelation time (GT), G′ at 480 min of oscillation time (G′₄₈₀), slope of complex viscosity, and linear viscoelastic region (LVR). At 0 mM of DSP, increasing UST from 0 to 15 min decreased GT from 114.39 ± 3.20 to 83.52 ± 1.61 min, and it extended LVR from 40.36 ± 0.12 to 41.27 ± 0.27% of the applied strain. In addition, applying HIUS for 15 min increased the elasticity and firmness of MCC gel networks at 0 mM of DSP. G′₄₈₀ was not influenced by UST, but it was reduced by DSP from 108.40 ± 3.29 to 15.78 ± 1.58 Pa. Increasing both UST and DSP significantly increased FC from 110.00 ± 13.23 to 163.33 ± 11.55% and foam stability (FS) in all treatments. FS reached its maximum (doubled) after 10 min of UST at 0 mM of DSP. However, EAI and emulsion stability index (ESI) decreased with increasing both UST and DSP. HIUS treatment combined with calcium chelation might highlight a new approach to improve foaming properties. However, regardless of calcium chelation, HIUS treatment is a promising technology to improve the gelling properties of casein micelles. Full article

The paper proposes a Digital Twin (DTw) framework, constructing a circuit model replicating the pulse transmission and reception processes for devices with high sensitivity to noises, such as wearable ultrasound transducers. The model is suitable to train supervised AI algorithms denoising the noisy ultrasound signal received. The DTw combines the circuit simulations with the AI data processing by training the model with the cleaned pulsed signals and by correcting the noises modeled by ‘white-noise’ voltage generators. Specifically, the voltage outputs of the circuit simulations are used to train the AI models and to test noisy signals for reconstruction. The DTw model is based on the transmission line theory combined with the perturbation impedance approach, supporting human body tissue discrimination based on noises. Two open-source tools are used for the DTw construction, the LTSpice and the Orange Mining tool, which are used for the circuit simulation and for the AI data processing, respectively. The theoretical work proves that the methodology is able to reconstruct correctly, with a good performance in the time domain and the frequency domain, noisy voltage signals, by addressing the analysis on cancer detection by combining circuit, AI and Monte Carlo approaches. Full article

Lymphatic malformations (LMs) are rare congenital low-flow vascular anomalies that frequently involve the head and neck and may be managed with surgery, laser therapy, sclerotherapy, or multimodal approaches depending on lesion type, size, depth, and relationship with adjacent structures. Ultrasound-guided sclerotherapy with doxycycline is an established treatment option for macrocystic lesions, whereas the practical role of high-frequency superficial ultrasound as a technical adjunct has been less specifically discussed. We report the case of a 32-year-old man presenting with a painless left submandibular swelling of approximately two years’ duration. Magnetic resonance imaging showed a well-encapsulated cystic lesion measuring 56 × 35 mm in the left submandibular region, extending into the internal paralaryngeal space and causing mild compression of the laryngeal wall. Previous fine-needle aspiration cytology had not conclusively established the lymphatic nature of the lesion; therefore, an incisional biopsy was performed and confirmed a macrocystic LM. The patient underwent day-surgery intralesional doxycycline sclerotherapy under real-time high-frequency ultrasound guidance using an 18 MHz hockey-stick transducer. After aspiration of the main cystic compartment through a 25-gauge needle, 100 mg of doxycycline diluted to 10 mg/mL in normal saline was slowly injected under continuous visualization. The procedure was well tolerated under topical local anesthesia, without pain, complications, or adverse effects. A partial clinical reduction was observed after the first session; the treatment was repeated after three months, resulting in apparent complete clinical resolution at one-year follow-up; no post-treatment imaging was available to confirm radiological resolution. This case highlights the potential technical value of high-frequency superficial ultrasonography, particularly for needle positioning, improved delineation of superficial locules, and real-time monitoring of sclerosant distribution. Full article

Sierra Leone faces persistently high neonatal and maternal mortality rates, driven largely by delayed recognition and treatment of newborn respiratory distress and postpartum hemorrhage. In this protocol, we describe the planned implementation of a bundle of maternal and newborn clinical practices over a 36-month period across nine public health facilities in the Greater Freetown area and Bo District to address these critical gaps. The service delivery improvements include the World Health Organization (WHO) Essential Newborn Care Course (ENCC) Parts 1 and 2; Vayu bubble continuous positive airway pressure (bCPAP) and oxygen blenders for respiratory support; the WHO Postpartum Hemorrhage package; and obstetric risk stratification using point-of-care ultrasound (POCUS) and complementary diagnostics for maternal care improvement. We anticipate that this bundle of evidence-based clinical tools and training, reinforced by mentorship, structured checklists, and low-dose high-frequency (LDHF) practice, will significantly reduce perinatal and maternal mortality and morbidity. The bundle will be evaluated using a Hybrid Type 1 effectiveness-implementation design, utilizing routine health information system data, supplemented by project registers, skills assessments, and observations. By aligning with the Ministry of Health’s Child Survival Action Plan, the aim of this project protocol is to provide a sustainable and scalable model for reducing preventable maternal and newborn deaths in resource-constrained settings. Full article

Background/Objectives: The aim of this study was to develop and validate a high-frequency ultrasound radiomics-based model for quantitative assessment of metacarpophalangeal (MCP) joint cartilage damage in early rheumatoid arthritis (RA). Methods: 656 MCP joints from 99 early RA patients and 65 healthy controls were prospectively enrolled and graded according to the Outcome Measures in Rheumatology (OMERACT) system. After radiomics feature extraction, five machine learning classifiers were evaluated. Radiomics, clinical, and combined models were constructed and assessed. Radiomics scores were compared among healthy grade 0 joints, early RA grade 0 joints stratified into two risk subgroups, and RA grade ≥ 1 joints. SHapley Additive exPlanations (SHAP) analysis was used for interpretation. Results: Eight stable radiomics features were selected. Among classifiers, support vector machine achieved the highest cross-validated performance and was selected as the final radiomics classifier (validation AUC = 0.804). The combined model, integrating radiomics features with age, disease duration, and Disease Activity Score in 28 joints, achieved the best diagnostic performance (AUC = 0.855), significantly outperforming both the radiomics and clinical models. Among OMERACT grade 0 joints, the high-risk subgroup demonstrated elevated radiomics-derived scores. SHAP analysis identified original_shape2D_PerimeterSurfaceRatio as the strongest contributor. Conclusions: High-frequency ultrasound radiomics combined with clinical features demonstrated strong performance in detecting MCP joint cartilage damage in early RA and may provide a quantitative extension to conventional semiquantitative assessment. Full article