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Purpose: Shear wave elastography (SWE) provides a means for adding information about the mechanical properties of tissues to a diagnostic ultrasound examination. It is important to understand the physics and methods by which the measurements are made to aid interpretation of the results as they relate to disease processes., Methods: The components of how ultrasound is used to generate shear waves and make measurements of the induced motion are reviewed. The physics of shear wave propagation are briefly described for elastic and viscoelastic tissues. Additionally, shear wave propagation in homogeneous and inhomogeneous cases is addressed., Results: SWE technology has been implemented by many clinical vendors with different capabilities. Various quality metrics are used to define valid measurements based on aspects of the shear wave signals or wave velocity estimates., Conclusion: There are many uses for SWE in abdominal imaging, but it is important to understand how the measurements are performed to gauge their utility for diagnosis of different conditions. Continued efforts to make the technology robust in complex clinical situations are ongoing, but many applications actively benefit from added information about tissue mechanical properties for a more holistic view of the patient for diagnosis or assessment of prognosis and treatment management., Competing Interests: Declarations. Conflict of interest: Matthew W. Urban and Mayo Clinic have a financial interest in shear wave elastography technology. Jaydev Dave has no conflicts with respect to the content presented in this article. Jaydev Dave has received research support from Lantheus, General Electric Healthcare and Philips Healthcare, is a owner of Marichi Physics Consultants, LLC and provides consulting services to CurveBeam AI and Rayscan Inc., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Abstract: Sonazoid is a new ultrasound contrast agent with unique Kupffer phase imaging advantages and high mechanical index stability. This paper introduces the basic theories and advantages of Sonazoid ultrasound. Then, the application and latest advances of Sonazoid in the diagnosis and treatment of liver diseases are reviewed in detail. In addition, the advantages and disadvantages of Sonazoid ultrasound and its future directions are discussed. Sonazoid is expected to become an important tool for clinical ultrasound diagnosis and treatment., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: To evaluate the role of shear-wave dispersion slope for predicting renal allograft dysfunction., Methods: We retrospectively reviewed 128 kidney transplant recipients (median age, 55 years [interquartile range, 43-62 years]; male, 68) who underwent biopsy for allograft evaluation from November 2022 to February 2023. Cortex and renal sinus fat stiffness and shear-wave dispersion slope were obtained at shear-wave elastography (SWE). Cortex-to-sinus stiffness ratio (SR) and dispersion slope ratio (DSR)-related clinical and pathologic factors were evaluated using multivariable linear regression analysis. We conducted univariate and multivariate analyses for multiparametric ultrasound (US) parameters for identifying acute rejection and calculated the area under the receiver operating curve (AUC) values., Results: Of 128 patients, 31 (24.2%) demonstrated acute rejection. The SR value did not differ between patient groups (1.21 vs. 1.20, p = 0.47). Patients with acute rejection demonstrated a higher DSR than those without rejection (1.4 vs. 1.21, p < 0.01). Interstitial fibrosis and tubular atrophy grade (IFTA; coefficient, 0.11/grade; p = 0.04) and renal transplant and biopsy interval (coefficient, 0.00007/day; p = 0.03) were SR determinant factors, whereas only IFTA grade (coefficient, 0.10/grade; p = 0.01) for DSR. Multivariate analysis revealed mean resistive index (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.02-1.14, p = 0.01) and DSR value (OR 16.0, 95% CI 3.0-85.8, p = 0.001) as independent factors for predicting acute rejection. An AUC of 0.74 for detecting acute rejection was achieved by combining the resistive index and DSR value., Conclusion: Shear-wave dispersion slope obtained at SWE may help identify renal allograft dysfunction., Clinical Relevance Statement: Acute rejection in renal allografts is a major cause of allograft failure, but noninvasive diagnosis is a challenge. Shear-wave dispersion slope can identify acute rejection non-invasively., Key Points: • The interstitial fibrosis and tubular atrophy grade was a determinant factor for stiffness ratio and shear-wave dispersion slope ratio between cortex and renal sinus fat. • Shear-wave dispersion slope ratio between cortex and renal sinus fat could identify acute rejection in renal allografts. • A shear-wave dispersion slope has a potential to reduce unnecessary renal biopsy for evaluating renal allografts., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Objectives: The recognition of arterial phase hyperenhancement (APHE) and washout during the late phase is key for correct diagnosis of hepatocellular carcinoma (HCC) with contrast-enhanced ultrasound (CEUS). This meta-analysis was conducted to compare SonoVue®-enhanced and Sonazoid®-enhanced ultrasound in the assessment of HCC enhancement and diagnosis., Methods: Studies were included in the analysis if they reported data for HCC enhancement in the arterial phase and late phase for SonoVue® or in the arterial phase and Kupffer phase (KP) for Sonazoid®. Forty-two studies (7502 patients) with use of SonoVue® and 30 studies (2391 patients) with use of Sonazoid® were identified. In a pooled analysis, the comparison between SonoVue® and Sonazoid® CEUS was performed using chi-square test. An inverse variance weighted random-effect model was used to estimate proportion, sensitivity, and specificity along with 95% confidence interval (CI)., Results: In the meta-analysis, the proportion of HCC showing APHE with SonoVue®, 93% (95% CI 91-95%), was significantly higher than the proportion of HCC showing APHE with Sonazoid®, 77% (71-83%) (p < 0.0001); similarly, the proportion of HCC showing washout at late phase/KP was significantly higher with SonoVue®, 86% (83-89%), than with Sonazoid®, 76% (70-82%) (p < 0.0001). The sensitivity and specificity for the detection of APHE plus late-phase/KP washout detection in HCC were also higher with SonoVue® than with Sonazoid® (sensitivity 80% vs 52%; specificity 80% vs 73% in studies within unselected patient populations)., Conclusion: APHE and late washout in HCC are more frequently observed with SonoVue® than with Sonazoid®. This may affect the diagnostic performance of CEUS in the diagnosis of HCCs., Clinical Relevance Statement: Meta-analysis data show the presence of key enhancement features for diagnosis of hepatocellular carcinoma is different between ultrasound contrast agents, and arterial hyperenhancement and late washout are more frequently observed at contrast-enhanced ultrasound with SonoVue® than with Sonazoid®., Key Points: • Dynamic enhancement features are key for imaging-based diagnosis of HCC. • Arterial hyperenhancement and late washout are more often observed in HCCs using SonoVue®-enhanced US than with Sonazoid®. • The existing evidence for contrast-enhanced US may need to be considered being specific to the individual contrast agent., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Objective: Our aim was to predict these stages of hepatic fibrosis and necroinflammation using measurements from two-dimensional shear wave elastography (2D-SWE), transient elastography (Fibroscan, TE), and shear wave dispersion (SWD)., Materials and Methods: In this prospectively designed study, chronic liver patients with nonspecific etiology whose biopsy was performed for up to 1 week were included. Two-dimensional SWE, SWD, and TE measurements were performed. The METAVIR and F-ISHAK classification was used for histopathological evaluation., Results: Two-dimensional SWE and TE were considered significant for detecting hepatic fibrosis. In distinguishing ≥F2, for 2D-SWE, area under the receiver operating characteristics (AUROC) was 0.86 (confidence interval [CI], 0.75-0.96) for the cutoff value of 8.05 kPa ( P = 0.003); for TE, AUROC was 0.79 (CI, 0.65-0.94) for the cutoff value of 10.4 kPa ( P < 0.001). No significance was found for TE in distinguishing ≥F3 ( P = 0.132). However, for 2D-SWE, a cutoff value of 10.45 kPa ( P < 0.001), with AUROC = 0.87 (CI, 0.78-0.97) was determined for ≥F3. Shear wave dispersion was able to determine the presence of necroinflammation ( P = 0.016) and a cutoff value of 15.25 (meter/second)/kiloHertz ([m/s]/kHz) ( P = 0.006) and AUROC of 0.71 (CI, 0.57-0.85) were calculated for distinguishing ≥A2. In addition, a cutoff value of 17.25 (m/s)/kHz ( P = 0.023) and AUROC = 0.72 (CI, 0.51-0.93) were found to detect severe necroinflammation. The cutoff value for SWD was 15.25 (m/s)/kHz ( P = 0.013) for detecting ≥A2 in the reversible stage of fibrosis (F0, F1, and F2), and AUROC = 0.72 (CI, 0.56-0.88)., Conclusions: Two-dimensional SWE and TE measurements were significant in detecting the irreversible stage and the stage that should be treated in hepatic fibrosis noninvasively. Shear wave dispersion measurements were significant in detecting necroinflammation noninvasively., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

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Simple Summary: Recent advances in breast imaging focus on refining diagnostic tools to improve early cancer detection and patient care. This study introduces a novel use of plane-wave ultrasound technology, specifically the Viscosity Plane-wave UltraSound (ViPLUS) module, to evaluate breast glandular tissue. The research aimed to establish normal viscosity values in healthy women, investigate correlations with breast density, menstrual cycle phases, and menopausal status, and explore its potential role in identifying breast cancer risks. The findings could pave the way for personalized breast screening protocols and may lead to significant improvements in diagnostic accuracy, particularly for women with dense breast tissue. Background/Objectives: This study pioneers the application of the ViPLUS module, utilizing plane-wave ultrasound to measure breast tissue viscosity and elasticity. The primary goal was to establish normal reference values for viscosity in healthy women. Secondary objectives included exploring correlations between breast tissue viscosity and breast density categories, hormonal influences, and menstrual cycle phases. Methods: A prospective study was conducted on 245 asymptomatic women. Viscosity and elasticity measurements were obtained using the ViPLUS module, ensuring high reliability with stringent quality control measures. Data were statistically analyzed to evaluate correlations and group differences. Results: The median viscosity value for normal breast parenchyma was 1.7 Pa.s, with no significant variations based on breast density, menopausal status, or menstrual cycle phase. A strong correlation (rho = 0.866, p < 0.001) was observed between elasticity and viscosity values. Conclusions: The findings suggest that breast viscosity is consistent across diverse physiological states, indicating its potential as an independent diagnostic marker. This parameter could be pivotal in future breast cancer screening strategies, especially for younger women and those with dense breasts. [ABSTRACT FROM AUTHOR]

To investigate the changes in liver stiffness and immune-inflammatory markers associated with obesity and the degree of hepatic steatosis in obese children and adolescents. A total of 76 obese children and adolescents aged 6–18 years, with body mass index percentiles >95th, were included in the study. Patients with metabolic syndrome, diabetes mellitus, and chronic liver disease were excluded. A control group of 44 patients of healthy and normal-weight children was included. Laboratory values from the past month were analyzed using patient records. Shear wave elastography and ultrasound examinations were performed on a single device by the same experienced radiologist. The systemic immune-inflammation index and pan-immune inflammation values were significantly higher in obese patients with hepatic steatosis compared to obese patients without hepatic steatosis (p <0.001). Liver stiffness values were significantly higher in steatotic patients compared to nonsteatotic patients (p <0.001). A significant difference was observed between hepatic steatosis grades in terms of immune-inflammation index and pan-immune inflammation value values (p <0.001). There was a strong, positive, statistically significant correlation between liver stiffness and immune-inflammation index and pan-immune inflammation value (p <0.05). Immune-inflammatory biomarkers and shear wave elastography may provide valuable insights into the diagnosis and follow-up of inflammation and fibrosis in the evaluation of hepatic steatosis in obese children and adolescents. [ABSTRACT FROM AUTHOR]

Alcohol-related liver disease (ALD) is a major cause of global morbidity and mortality, progressing from steatosis to cirrhosis and hepatocellular carcinoma. While liver biopsy remains the gold standard for identifying liver disease, non-invasive methods like shear wave dispersion (SWD) elastography offer promising alternatives. This scoping review evaluates SWD's potential in the study of ALD, comparing it to metabolic dysfunction-associated steatotic liver disease (MASLD). SWD measures changes in shear wave speed in relation to liver viscosity and necroinflammation. Studies in MASLD suggest that SWD effectively correlates with fibrosis and inflammation stages, but its application in ALD remains underexplored. Both ALD and MASLD show similar inflammatory and fibrotic pathways, despite having different etiologies and histological features. This review emphasizes the necessity to identify ALD-specific SWD reference values and verify SWD's ability to improve diagnosis and disease progression. Prospective studies comparing SWD findings with histological benchmarks in ALD are essential for establishing its clinical utility. Incorporating SWD into clinical practice could revolutionize the non-invasive evaluation of ALD, offering a safer, cost-effective, and repeatable diagnostic tool. [ABSTRACT FROM AUTHOR]

Background and Aims: Pancreaticobiliary maljunction (PBMJ) has a long common channel (CC) that causes pancreaticobiliary reflux (PBR), which has been implicated in gallstones, cholangiocarcinoma, and pancreatitis. By contrast, PBR has occurred in cases with normal and longer CCs than normal but shorter than PBMJ. This pathophysiology has been primarily reported in adults and rarely in children. We sometimes observe this pathophysiology in children with pancreatitis and cholelithiasis. Herein, we report the clinical figures on the diagnosis of children with PBR in normal and relatively long CCs. Patients and Methods: This study included seven children who complained of refractory pancreatitis and cholelithiasis diagnosed with PBR in normal and relatively long CCs at our institution from August 2018 to September 2024. We measured the lengths of their CCs and sphincter of Oddi muscles via endoscopic retrograde cholangiopancreatography (ERCP) and cholangiography. In addition, amylase and lipase levels in bile juice were measured. Results: All seven children demonstrated elevated amylase and lipase levels in bile juice obtained from gallbladder drainage and/or the common bile duct. ERCP and cholangiography indicated 2.2–5.5-mm lengths of CCs in their cases, which are normal lengths in two cases and relatively longer (0.3–1.1 mm: mean 0.6 mm) than the normal upper limit of CC in children in five cases, with their CCs shorter than the sphincters of Oddi. All children underwent extrahepatic bile duct resection and bilio–jejunal anastomosis, demonstrating no clinical symptom recurrence postoperatively. Conclusions: Some children with cholelithiasis and pancreatitis exhibit normal and relatively long CCs, causing PBR and inducing gastrointestinal diseases. Careful investigation by ERCP and cholangiography focused on the CC length, and pancreatic enzyme level assessments in bile juice are useful for diagnosing PBR in children with cholelithiasis and refractory pancreatitis. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the clinical application value of ultrasound viscoelastic imaging in noninvasive quantitative assessment of chronic kidney disease (CKD). A total of 332 patients with CKD and 190 healthy adults as a control group were prospectively enrolled. Before kidney biopsy, ultrasound viscoelastic imaging was performed to measure the mean stiffness value (Emean), mean viscosity coefficient (Vmean), and mean dispersion coefficient (Dmean) of the renal. CKD patients were divided into three groups based on estimated glomerular filtration rate. The differences in clinic, pathology, ultrasound image parameters between the control and patient groups, or among different CKD groups were compared. The correlation between viscoelastic parameters and pathology were analyzed. Emean, Vmean, and Dmean in the control group were less than the CKD group (p < 0.05). In the identification of CKD from control groups, the area under curve of Vmean, Dmean, Emean, and combining the three parameters is 0.90, 0.79, 0.69, 0.91, respectively. Dmean and Vmean were increased with the decline of renal function (p < 0.05). Vmean and Dmean were positively correlated with white blood cell, urea, serum creatinine, and uric acid (p < 0.05). Vmean is positively correlated with interstitial fibrosis and inflammatory cell infiltration grades (p < 0.001). Ultrasound viscoelastic imaging has advantages in noninvasive quantitative identification and evaluating renal function of CKD. Emean > 6.61 kPa, Vmean > 1.86 Pa·s, or Dmean > 7.51 m/s/kHz may suggest renal dysfunction. Combining Vmean, Dmean, and Emean can improve the efficiency of identifying CKD. [ABSTRACT FROM AUTHOR]

Objective: To examine the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) with Sonazoid (Sonazoid-CEUS) for endometrial lesions. Methods: In this prospective and multicenter study, data were collected from 84 patients with endometrial lesions from 11 hospitals in China. All the patients received a conventional US and Sonazoid-CEUS examination. The lesion characteristics based on US and Sonazoid-CEUS imaging were collected from the case report forms. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined using histopathologic diagnosis as the gold standard. Results: Of the 79 patients included, 29 were diagnosed with benign lesions and 50 with endometrial carcinoma (EC). The accuracy, sensitivity, specificity, PPV, and NPV for Sonazoid-CEUS and US at differentiating EC from benign endometrial lesions were 82.2%, 94%, 62.1%, 81.0%, and 85.7%, and 79.7%, 96%, 51.7%, 92.3%, and 88.2%, respectively, with no significant differences observed for any of the values. For Sonazoid-CEUS, the best delineators of EC versus benign lesions were early enhancement and hyperenhancement (74% vs 53.3%, P = 0.029, 68% vs 45%, P < 0.001), and lesion size enlargement (76% vs 48%, P = 0.001). Despite finding no significant difference in the enhancement patterns (P =.367), a faster wash-in pattern with the contrast agent entering before the surrounding myometrium was more common in the EC vs benign cases (92% vs 48.3%). Conclusions: Sonazoid-CEUS has higher accuracy, specificity, and comparable sensitivity for differentiating EC from benign endometrial lesions compared with conventional US. It provides complementary hemodynamics information reflective of tissue vascularization, which may improve the overall diagnostic efficiency. [ABSTRACT FROM AUTHOR]

Oxygen isotopes in stream water can serve as natural tracers of watershed dynamics. Freshwater pearl mussels provide δ18Owater estimates that overcome temporal and spatial limitations of instrumental records. The reliability of shell‐based δ18Owater reconstructions depends on understanding which shell layer biomineralizes closer to oxygen isotopic equilibrium with ambient water. To determine this, both the (outer) prismatic and (inner) nacreous sublayers of the outer shell layer were sampled. Over 2500 isotope values were obtained from shells collected from the Our River (Luxembourg) and from mussels cultured in tanks at constant temperature and monitored δ18Owater. Calculated δ18Owater from the prismatic portion was in excellent agreement with monitored δ18Owater, while δ18Oshell of the nacreous portion was systematically offset by +0.43‰, overestimating δ18Owater by +0.53‰. Although shell portions were formed simultaneously from the same extrapallial fluid, they underwent different fractionation mechanisms, presumably due to differences in carbonic anhydrase activity catalyzing mineralization processes. [ABSTRACT FROM AUTHOR]

Background: It is unknown how shear wave dispersion (SWD) is displayed in pediatric liver transplant recipients and not fully elucidated how ultrasound shear wave elastography (2D-SWE) display within this cohort, which is important to determine to improve noninvasive surveillance of these patients. The study aimed to compare SWE and SWD values with histopathology in pediatric liver recipients., Methods: Forty-eight pediatric liver recipients were examined with SWE in conjunction with an elective liver biopsy (clinically without complication). Additionally, SWD values were measured in 21 children. SWE and SWD values were compared to histologically determined fibrosis graded as none-to-mild (F0-1) and moderate-to-severe (F2-4), and inflammation graded as low (grade 0-1) and high (grade 2-4)., Results: Two children were excluded due to SWE IQR/median > 30% kPa. The mean age across 46 included patients was 10.9 years (range 1.4-18). The number of patients and median (range) SWE value (kPa) for each stage of fibrosis were: F0-1 [n = 23; 5.8 (3.2-16.1)], F2 [n = 22; 6.0 (4.5-25.9)], F3 [n = 1; 33.3], and F4 [n = 0]. Significantly higher SWE values and greater variability were registered in F2-4 vs. F0-1 (p = .05). Grade of fibrosis correlated weakly to SWE values (r = .3; p = .05), but not to SWD values (r = .2; p = .27). In patients with low-grade inflammation, median SWD was 13.7 m/s KHz (10.7-17.6). Only one patient had high-grade inflammation., Conclusions: Uncomplicated transplanted liver grafts in a small pediatric cohort revealed slightly increased SWE and SWD values compared to previously reported values in healthy children. This likely reflect both the fibrotic and inflammatory elements in the grafts; however, other confounders impacting the liver's viscoelastic properties are also probable factors., (© 2023 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.)

Objectives: The aim of this study was to develop a predictive model based on Sonazoid contrast-enhanced ultrasound (SCEUS) and clinical features to discriminate poorly differentiated hepatocellular carcinoma (P-HCC) from intrahepatic cholangiocarcinoma (ICC)., Patients and Method: Forty-one ICC and forty-nine P-HCC patients were enrolled in this study. The CEUS LI-RADS category was assigned according to CEUS LI-RADS version 2017. Based on SCEUS and clinical features, a predicated model was established. Multivariate logistic regression analysis and LASSO logistic regression were used to identify the most valuable features, 400 times repeated 3-fold cross-validation was performed on the nomogram model and the model performance was determined by its discrimination, calibration, and clinical usefulness., Results: Multivariate logistic regression and LASSO logistic regression indicated that age (> 51 y), viral hepatitis (No), AFP level (≤  20 µg/L), washout time (≤  45 s), and enhancement level in the Kupffer phase (Defect) were valuable predictors related to ICC. The area under the receiver operating characteristic (AUC) of the nomogram was 0.930 (95% CI: 0.856-0.973), much higher than the subjective assessment by the sonographers and CEUS LI-RADS categories. The calibration curve showed that the predicted incidence was more consistent with the actual incidence of ICC, and 400 times repeated 3-fold cross-validation revealed good discrimination with a mean AUC of 0.851. Decision curve analysis showed that the nomogram could increase the net benefit for patients., Conclusions: The nomogram based on SCEUS and clinical features can effectively differentiate P-HCC from ICC., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Non-hypervascular hypointense nodules (NHHNs) can transform into hypervascular hepatocellular carcinoma (HCC) during the long-term follow-up. However, the risk factors for NHHN hypervascular transformation in chronic hepatitis B virus (HBV)-infected populations are unknown. This study assessed the predictive value of gadoxetic acid-enhanced magnetic resonance imaging (MRI) for HCC development in patients with chronic HBV infection. Methods: A total of 86 patients with HBV infection who underwent gadoxetic acid-enhanced MRI at the First Affiliated Hospital of Sun Yat-sen University between January 2011 and July 2019 and were followed up for 2 years were retrospectively reviewed. Imaging features, including cirrhosis, steatosis, and NHHNs, were collected. Radiomics features were extracted from the entire liver. The HCC development predictive models were built based on each patient's clinical data, MRI features, and radiomic features. We then collected the qualitative and quantitative features of each NHHN and investigated the risk factors of hypervascular transformation. Results: Thirteen patients developed HCC within two years. The risk factors for HCC development in patients with chronic HBV infection included older age, cirrhosis, and NHHNs. The MRI, radiomics, and integrated models developed all had an area under the curve (AUC) above 0.8. The potential risk factors for hypervascular transformation of NHHNs were the diameter of the NHHN (OR = 1.69, 95% CI:1.23, 2.32, P = 0.001) and the signal intensity (SI) ratio of the NHHN to the liver in the hepatobiliary phase (HBP SI ratio*10, OR = 0.36, 95% CI:0.11, 0.85, P = 0.044). The AUC of the hypervascular transformation model was 0.846 (95% CI:0.719, 0.972). Conclusion: In chronic HBV infection population, patients with older age, cirrhosis and NHHNs are more likely to develop HCC within two years. Models based on these factors or radiomic features can effectively predict HCC development. The diameter of the NHHNs and the signal intensity ratio of NHHN to the liver in the hepatobiliary phase are potential risk factors for the hypervascular transformation of NHHNs. [ABSTRACT FROM AUTHOR]

The herbicide fluridone (1-methyl-3-phenyl-5-[3-trifluoromethyl (phenyl)]-4(1H)-pyridone) interferes with carotenoid biosynthesis in plants by inhibiting the conversion of phytoene to phytofluene. Fluridone also indirectly inhibits the biosynthesis of abscisic acid and strigolactones, and therefore, our study indirectly addresses the effect of reduced ABA on the roots and leaf buds development in stem cuttings of Salix babylonica L. 'Tortuosa'. The stem cuttings were kept in distilled water (control) or in a solution of fluridone (10 mg/L) in natural greenhouse light and temperature conditions. During the experiments, morphological observations were carried out on developing roots and leaf buds, as well as their appearance and growth. After three weeks of continuous treatments, adventitious roots and leaf buds were collected and analysed. Identification and analysis of anthocyanins were carried out using micro-HPLC-MS/MS-TOF, while HPLC-MS/MS was used to analyse phenolic acids, flavonoids and salicinoids. The fluridone applied significantly inhibited root growth, but the number or density of roots was higher compared to the control. Contents of salicortin and salicin were several dozen times higher in leaf buds than in roots of willow. Fluridone increased the content of salicortin in roots and leaf buds and declined the level of salicin in buds. Fluridone also declined the content of most anthocyanins in roots but enhanced their content in buds, especially cyanidin glucoside, cyanidin galactoside and cyanidin rutinoside. Besides, fluridone markedly decreased the level of chlorophylls and carotenoids in the leaf buds. The results indicate that applied fluridone solution reduced root growth, caused bleaching of leaf buds, and markedly affected the content of secondary metabolites in the adventitious roots and leaf buds of S. babylonica stem cuttings. The paper presents and discusses in detail the significance of fluridone's effects on physiological processes and secondary metabolism. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to compare the diagnostic performance of washout-parametric imaging (WOPI) with that of conventional contrast-enhanced ultrasound (cCEUS) in differentiating focal liver lesions (FLLs). Methods: A total of 181 FLLs were imaged with contrast-enhanced ultrasound using Sonazoid, and the recordings were captured for 10 minutes in a prospective setting. WOPI was constructed from three images, depicting the arterial phase (peak enhancement), the early portal venous phase (1-minute post-injection), and the vasculo-Kupffer phase (5 or 10 minutes post-injection). The intensity variations in these images were color-coded and superimposed to produce a single image representing the washout timing across the lesions. From the 181 FLLs, 30 hepatocellular carcinomas (HCCs), 30 non-HCC malignancies, and 30 benign lesions were randomly selected for an observer study. Both techniques (cCEUS and WOPI) were evaluated by four off-site readers. They classified each lesion as benign or malignant using a continuous rating scale, with the endpoints representing "definitely benign" and "definitely malignant." The diagnostic performance of cCEUS and WOPI was compared using the area under the receiver operating characteristic curve (AUC) with the DeLong test. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Results: The difference in average AUC values between WOPI and cCEUS was 0.0062 (95% confidence interval, -0.0161 to 0.0285), indicating no significant difference between techniques. The interobserver agreement was higher for WOPI (ICC, 0.77) than cCEUS (ICC, 0.67). Conclusion: The diagnostic performance of WOPI is comparable to that of cCEUS in differentiating FLLs, with superior interobserver agreement. [ABSTRACT FROM AUTHOR]

Background and Objectives: To evaluate the value of the postvascular phase of contrast-enhanced ultrasound (CEUS) in differentiating between benign and metastatic lymph nodes (LNs) in patients with breast cancer (BC). Materials and Methods: This study retrospectively analyzed 96 suspicious LNs in the lymphatic drainage area of the breast from 90 patients with BC. All LNs were assessed by conventional ultrasound (US) and CEUS following intravenous Sonazoid injection. All LNs underwent puncture biopsy, and pathological results were obtained. The correlations between US and CEUS indicators of LNs and LN metastasis (LNM) were analyzed. Results: Of the 96 LNs, 66 were metastatic. Overall, 80.00% (24/30) of the benign LNs exhibited relative hyper-enhancement in the postvascular phase, whereas 96.97% (64/66) of the metastatic LNs exhibited relative hypo-enhancement (p < 0.001). This CEUS finding was highly predictive of metastasis, with a sensitivity of 96.97%, specificity of 80.00%, positive predictive value of 91.43%, negative predictive value of 92.31%, and accuracy of 91.67%. The mean postvascular phase intensity (MPI) was significantly lower for malignant (median MPI, 12 dB) than for benign (median MPI, 75 dB) LNs. The postvascular phase was more sensitive, specific, and accurate than conventional US or the vascular phase of CEUS for the diagnosis of LNM, with an area under the curve of 0.95 (95% confidence interval: 0.89–0.99). Conclusions: Qualitative and quantitative indicators of the postvascular phase of CEUS provide a reliable diagnostic approach to differentiate benign and metastatic LNs in patients with BC. [ABSTRACT FROM AUTHOR]

Background: The use of two-dimensional (2D) ultrasound for guiding radiofrequency ablation (RFA) of benign thyroid nodules presents limitations, including the inability to monitor the entire treatment volume and operator dependency in electrode positioning. We compared three-dimensional (3D)-guided RFA using a matrix ultrasound transducer with conventional 2D-ultrasound guidance in an anthropomorphic thyroid nodule phantom incorporated additionally with temperature-sensitive albumin. Methods: Twenty-four phantoms with 48 nodules were constructed and ablated by an experienced radiologist using either 2D- or 3D-ultrasound guidance. Postablation T2-weighted magnetic resonance imaging scans were acquired to determine the final ablation temperature distribution in the phantoms. These were used to analyze ablation parameters, such as the nodule ablation percentage. Further, additional procedure parameters, such as dominant/non-dominant hand use, were recorded. Results: Nonsignificant trends towards lower ablated volumes for both within (74.4 ± 9.1% (median ± interquartile range) versus 78.8 ± 11.8%) and outside of the nodule (0.35 ± 0.18 mL versus 0.45 ± 0.46 mL), along with lower variances in performance, were noted for the 3D-guided ablation. For the total ablation percentage, 2D-guided dominant hand ablation performed better than 2D-guided non-dominant hand ablation (81.0% versus 73.2%, p = 0.045), while there was no significant effect in the hand comparison for 3D-guided ablation. Conclusion: 3D-ultrasound-guided RFA showed no significantly different results compared to 2D guidance, while 3D ultrasound showed a reduced variance in RFA. A significant reduction in operator-ablating hand dependence was observed when using 3D guidance. Further research into the use of 3D ultrasound for RFA is warranted. Relevance statement: Using 3D ultrasound for thyroid nodule RFA could improve the clinical outcome. A platform that creates 3D data could be used for thyroid diagnosis, therapy planning, and navigational tools. Key Points: Twenty-four in-house-developed thyroid nodule phantoms with 48 nodules were constructed. RFA was performed under 2D- or 3D-ultrasound guidance. 3D- and 2D ultrasound-guided RFAs showed comparable performance. Real-time dual-plane imaging may offer an improved overview of the ablation zone and aid electrode positioning. Dominant and non-dominant hand 3D-ultrasound-guided RFA outcomes were comparable. [ABSTRACT FROM AUTHOR]

Plant viral diseases cause great losses in agricultural production. Virus cross-protection is a strategy in which a mild virus is employed to shield plants against subsequent infections by severe viral strains. However, this approach is restricted to protection against the same viruses. In this study, we observed that pre-inoculation with apple geminivirus (AGV) reduced the accumulation of secondarily infected heterologous viruses, such as cucumber mosaic virus, potato virus X, and tobacco mosaic virus in Nicotiana benthamiana, tomato, and pepper plants. Transcriptional expression analysis showed that autophagy-related genes were transcriptionally up-regulated upon AGV inoculation at an early stage of infection. Accordingly, autophagic activity was observed to be elevated following AGV infection. Interestingly, AGV accumulation was reduced in autophagy-deficient plants, suggesting that autophagy activation promotes AGV infection in the plant. Moreover, pre-inoculation with AGV provided cross-protection against infection with a phytopathogenic bacterium (Pseudomonas syringae) and fungus (Botrytis cinerea) in Nicotiana species. In summary, our study showed that AGV, an asymptomatic virus, could protect plants against severe viral, fungal, and bacterial diseases to some extent through the activation of autophagy pathways, highlighting its potential as a biocontrol agent for managing a wide range of plant crop diseases in the field. [ABSTRACT FROM AUTHOR]

The most important role of footwear is to ensure safe, functional walking, and foot protection. For the proper functionality of not only the work shoes, the anti-slip behavior of the shoe under various conditions and environments plays an important role in the prevention of slips, trips, falls, and consequent injuries. This article is intended to review the current understanding of the frictional mechanisms between shoe outsoles and various counterfaces that impact the evaluation of outsole slipperiness. Current research focuses on the mechanisms driving outsole friction on different ground surfaces or the definition and description of parameters that influence outsole friction. Subsequently, the review discusses the effect of various surface contaminants on footwear friction. Lastly, challenges and outlooks in the field of footwear outsoles are briefly mentioned. [ABSTRACT FROM AUTHOR]

Background/Objectives: Algorithms for quantifying liver fat content based on the ultrasound attenuation coefficient (AC) are currently available; however, little is known about whether their accuracy increases by applying quality criteria such as the interquartile range-to-median ratio (IQR/M) or whether the median or average AC value should be used. Methods: AC measurements were performed with the Aplio i800 ultrasound system using the attenuation imaging (ATI) algorithm (Canon Medical Systems, Otawara, Tochigi, Japan). Magnetic resonance imaging proton density fat fraction (MRI-PDFF) was the reference standard. The diagnostic performance of the AC median value of 5 measurements (AC-M) was compared to that of AC average value (AC-A) of 5 or 3 acquisitions and different levels of IQR/M for median values or standard deviation/average (SD/A) for average values were also analyzed. Concordance between AC-5M, AC-5A, and AC3A was evaluated with concordance correlation coefficient (CCC). Results: A total of 182 individuals (94 females; mean age, 51.2y [SD: 15]) were evaluated. A total of 77 (42.3%) individuals had S0 steatosis (MRI-PDFF < 6%), 75 (41.2%) S1 (MRI-PDFF 6–17%), 10 (5.5%) S2 (MRI-PDFF 17.1–22%), and 20 (11%) S3 (MRI-PDFF ≥ 22.1%). Concordance of AC-5A and AC-3A with AC-5M was excellent (CCC: 0.99 and 0.96, respectively). The correlation with MRI-PDFF was almost perfect. Diagnostic accuracy of AC-5M, AC-5A, and AC3A was not significantly affected by different levels of IQR/M or SD/A. Conclusions: The accuracy of AC in quantifying liver fat content was not affected by reducing the number of acquisitions (from five to three), by using the mean instead of the median, or by reducing the IQR/M or SD/A to ≤5%. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) is a major cause of chronic liver disease, in which liver stiffness increases. Liver stiffness measurements (LSM) are therefore essential in diagnosing liver diseases and predicting disease development. The study objective was to perform a comprehensive prospective assessment of the liver before, after and 4 years after treatment for HCV, including an assessment of the long-term outcome of fibrosis, steatosis and inflammation. Methods and findings: Patients eligible for HCV treatment were included prospectively in 2018 (n = 47). Liver stiffness was measured using transient elastography and 2D shear-wave elastography (SWE). Blood tests, B-mode ultrasound (US) and SWE, were performed before, after (end of treatment [EOT]), 3 months after (EOT3) and 4 years after treatment (4Y). At the final visit, we added attenuation imaging and shear-wave dispersion slope (SWDS) measurements to assess steatosis and inflammation. Three months after treatment, the sustained virologic response rate was 93%. The median liver stiffness for baseline, EOT, EOT3 and 4Y was 8.1, 5.9, 5.6 and 6.3 kPa, respectively. There was a significant reduction in liver stiffness from baseline to EOT, and from EOT to EOT3. After 4 years, the mean attenuation coefficient (AC) was 0.58 dB/cm/MHz, and the mean SWDS value was 14.3 (m/s)/kHz. Conclusion: The treatment for HCV was highly effective. Measurements of liver stiffness decreased significantly after treatment and remained low after 4 years. AC measurements indicated low levels of liver steatosis. Shear-wave dispersion values indicated inflammation of the liver, but the clinical implication is undetermined and should be explored in larger studies. Clinicaltrials.gov: NCT03434470 Abbreviations: AC: attenuation coefficient; APRI: aspartate aminotransferase to platelet ratio index; ATI: attenuation imaging; cACLD: compensated advanced chronic liver disease; CAP: controlled attenuation parameter; FIB-4: Fibrosis-4 Index for liver fibrosis; HCC: hepatocellular carcinoma; LSM: liver stiffness measurement; NAFLD: non-alcoholic fatty liver disease; NASH: non-alcoholic steatohepatitis; SWDS: shear-wave dispersion slope; SWE: shear-wave elastography; US: ultrasound [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the use of liver stiffness (LS) and dispersion slope (DS) in classifying patients with chronic hepatitis B (CHB) by the necessity of antiviral treatment. Methods: A retrospective review examined 249 patients with CHB (male:female, 107:142; mean age, 53±14 years) between April 2018 and March 2022. Patients for whom treatment was indicated, termed group 1, exhibited either serum alanine transaminase (ALT) and aspartate aminotransferase levels not exceeding five times the upper limit of normal and LS >13 kPa, or hepatitis B virus DNA >2,000 IU/mL and ALT >40 IU/L. The remaining patients comprised group 2 (treatment not required). In subgroup analysis, patients with LS <13 kPa were further examined. Results: Overall, group 1 exhibited significantly higher LS (12.64±6.76 vs. 6.31±1.67 kPa, P<0.001) and DS (15.52±4.95 vs. 11.04±1.93 [m/s]/kHz, P<0.001) than group 2. In subgroup analysis, group 1 also demonstrated significantly higher values (LS: 8.05±2.12 vs 6.31±1.67 kPa, P<0.001, DS: 13.06±2.75 vs. 11.04±1.93 [m/s]/kHz, P<0.001). The areas under the curve (AUCs) for LS and DS in identifying group1 were 0.855 (95% confidence interval [CI], 0.80 to 0.90; P<0.001) and 0.810 (95% CI, 0.75 to 0.86; P<0.001), respectively. In subgroup analysis, the AUCs for LS and DS in identifying group 1 were 0.751 (95% CI, 0.69 to 0.81; P<0.001) and 0.711 (95% CI, 0.64 to 0.77; P<0.001), respectively. For identifying group 1, the AUCs for LS and DS did not differ significantly (P>0.05). Conclusion: LS and DS assist in classifying patients with CHB by their need for antiviral treatment. [ABSTRACT FROM AUTHOR]

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Local ablation for hepatocellular carcinoma, a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the first-line treatment for early-stage hepatocellular carcinoma. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-Guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients. [ABSTRACT FROM AUTHOR]

Study Design: Longitudinal study. Objectives: Intravoxel incoherent motion (IVIM), a magnetic resonance imaging (MRI) scanning technique that applies diffusion-weighted imaging (DWI), is effective for the quantitative assessment of malignant tumors of the vertebral bone. We hypothesized that IVIM parameters of vertebral bodies are associated with the prognosis of osteoporotic vertebral fracture (OVF). We aimed to explore the relationships between IVIM parameters for vertebral collapse and non-union after OVF and calculate the cut-off values of these parameters for vertebral collapse and non-union. Methods: A total of 150 patients with acute OVF (150 women; mean age: 79.1 ± 7.4 years) were included and treated conservatively with bracing. MRI was performed at the time of injury. IVIM parameters, such as apparent diffusion coefficient (ADC), molecular diffusion coefficient (D), and perfusion-related diffusion (D*) were recorded. The patients were classified into 3 groups: low-collapse (height loss of ≤50%), high-collapse (height loss of >50%), and non-union. We compared ADC, D, and D* among the low-collapse, high-collapse, and non-union groups and performed a receiver operating characteristic (ROC) curve analysis to determine the boundary values of the high-collapse and non-union groups. Results: The low-collapse, high-collapse, and non-union groups had no significant differences in ADC and D. However, D* differed significantly among the 3 groups. ROC analysis revealed cut-off values of 19.0 × 10-3 mm2/s and 12.3 × 10-3 mm2/s for the high-collapse and non-union groups, respectively. Conclusions: D* is a significant prognostic indicator for high-collapse and non-union groups with OVF. This suggests that D* should be considered when assessing OVF. [ABSTRACT FROM AUTHOR]

Introduction: The interaction between the heart and spleen plays a crucial role among cardiac and multiple organ networks, particularly in heart failure (HF). Ultrasound shear wave imaging is a non-invasive technology capable of quantifying tissue quality, but its significance in the spleen in patients with HF is poorly understood., Methods and Results: This prospective observational study enrolled hospitalized 232 patients with HF undergoing abdominal ultrasonography. We used shear wave elastography (SWE) to assess spleen tissue elasticity and shear wave dispersion (SWD) to assess spleen tissue viscosity. Clinical, echocardiography, right heart catheterization, and outcome data were collected. Spleen SWE was negatively correlated with right ventricular fractional area change (R =  - 0.180, P = 0.039), but not with right-sided pressure or congestion indices. When patients were divided into three groups based on tertile values of splenic parameters, Kaplan-Meier analysis demonstrated that patients with the highest spleen SWE and SWD had lower event-free survival rates from cardiac deaths and decompensated HF over a median 494-days follow-up period (P < 0.0001 and P < 0.0001, respectively). In a multivariable Cox proportional hazard model, both spleen SWE and SWD were independently associated with increased risks of adverse cardiac events (hazard ratio, 4.974 and 1.384; P = 0.003 and P < 0.0001). Mechanistically, we evaluated mRNA expressions of CD36, a monocyte/macrophage-associated molecule, in peripheral leukocytes, and found that enhanced spleen stiffness was associated with the upregulation of CD36 expressions., Conclusion: Share wave imaging of the spleen is useful for stratifying the prognosis of HF patients and may suggest a role of the cardio-splenic axis in HF pathogenies., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Purpose: Hepatobiliary phase (HBP) hypointense nodules without arterial phase hyperenhancement (APHE) on gadoxetic acid-enhanced MRI (GA-MRI) may be nonmalignant cirrhosis-associated nodules or hepatocellular carcinomas (HCCs). We aimed to characterize HBP hypointense nodules without APHE on GA-MRI by performing contrast-enhanced ultrasound using perfluorobutane (PFB-CEUS)., Methods: In this prospective, single-center study, participants at high-risk of HCC having HBP hypointense nodules without APHE at GA-MRI were enrolled. All participants underwent PFB-CEUS; if APHE and late, mild washout or washout in the Kupffer phase were present, the diagnosis of HCC was established according to the v2022 Korean guidelines. The reference standard consisted of histopathology or imaging. The sensitivity, specificity, and positive/negative predictive values of PFB-CEUS for detecting HCC were calculated. Associations between clinical/imaging features and the diagnosis of HCC were evaluated with logistic regression analyses., Results: In total, 67 participants (age, 67.0 years ± 8.4; 56 men) with 67 HBP hypointense nodules without APHE (median size, 1.5 cm [range, 1.0-3.0 cm]) were included. The prevalence of HCC was 11.9% (8/67). The sensitivity, specificity, and positive and negative predictive values of PFB-CEUS for detecting HCC were 12.5%(1/8), 96.6%(57/59), 33.3%(1/3) and 89.1%(57/64), respectively. Mild-moderate T2 hyperintensity on GA-MRI (odds ratio, 5.756; P = 0.042) and washout in the Kupffer phase on PFB-CEUS (odds ratio, 5.828; P = 0.048) were independently associated with HCC., Conclusion: Among HBP hypointense nodules without APHE, PFB-CEUS was specific for detecting HCC, which had a low prevalence. Mild-moderate T2 hyperintensity on GA-MRI and washout in the Kupffer phase on PFB-CEUS may be useful to detect HCC in those nodules., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Thermochemical recycling of plastics in the presence of catalysts is often employed to facilitate the degradation of polymers. The choice of the catalyst is polymer-oriented, while its selection becomes more difficult in the case of polymeric blends. The present investigation studies the catalytic pyrolysis of polymers abundant in waste electric and electronic equipment (WEEE), including poly(acrylonitrile-butadiene-styrene) (ABS), high-impact polystyrene (HIPS) and poly(bisphenol-A carbonate) (PC), along with their blends with polypropylene (PP) and poly(vinyl chloride) (PVC). The aim is to study the kinetic mechanism and estimate the catalysts' effect on the activation energy of the degradation. The chosen catalysts were Fe2O3 for ABS, Al-MCM-41 for HIPS, Al2O3 for PC, CaO for Blend A (comprising ABS, HIPS, PC and PP) and silicalite for Blend B (comprising ABS, HIPS, PC, PP and PVC). Thermogravimetric experiments were performed in a N2 atmosphere at several heating rates. Information on the degradation mechanism (degradation steps, initial and final degradation temperature, etc.) was attained. It was found that for pure (co)polymers, the catalytic degradation occurred in one-step, whereas in the case of the blends, two steps were required. For the estimation of the activation energy of those degradations, isoconversional kinetic models (integral and differential) were employed. In all cases, the catalysts used were efficient in reducing the estimated Eα, compared to the values of Eα obtained from conventional pyrolysis. [ABSTRACT FROM AUTHOR]

Background and Aim: This is a cross‐sectional observational study conducted on living liver donors focusing on "long‐term remnant liver health" specifically looking at steatosis, inflammation, and fibrosis using multiparametric ultra sonological evaluation and noninvasive blood tests. Methods: Multiparametric ultrasound evaluation included assessment of shear wave elastography (fibrosis), sound speed plane wave ultrasound, attenuation plane wave ultrasound (steatosis), and viscosity plane wave ultrasound (inflammation). Blood test based APRI and FIB‐4 were calculated. Liver biopsy was performed if noninvasive evaluation pointed toward clinically relevant fibro progression (F4). Results: Out of 36 donors, significant fibrosis (>F2) was found in 11 donors (30.5%), seven donors (19.4%) had severe fibrosis (>F3), and two donors had shear wave elastography values suggestive of cirrhosis(F4). Of these two, one donor was extensively evaluated and was found to have biopsy proven cirrhosis with endoscopic evidence of portal hypertension. The prevalence of fatty liver disease in our study group was 50%. Conclusion: We report the first liver donor cohort with fibroprogression and cirrhosis occurring in the remnant liver. Our donor cohort with a significant proportion having steatosis and fibroprogression underscores the importance of regular follow‐up of liver donors and evaluation of remnant liver. [ABSTRACT FROM AUTHOR]

As a sensitive and non‐invasive method for assessing changes in renal cortical blood perfusion in the elderly, contrast‐enhanced ultrasound (CEUS) can indirectly reflect changes in kidney filtration and reabsorption function, thus providing feasibility for early evaluation of renal function changes. However, significant differences exist among researchers in terms of operational methods, contrast agent selection, post‐data analysis, and many other aspects, leading to substantial heterogeneity in results. This hinders horizontal comparisons and greatly limits the clinical application of contrast‐enhanced ultrasound for evaluating renal cortical blood flow perfusion. Based on the latest domestic and overseas literature and discussions with clinical experts, this consensus provides recommended guidelines for the evaluation of renal cortical blood flow perfusion using contrast‐enhanced ultrasound. It is hoped that this consensus will promote a better understanding of CEUS among medical practitioners at all levels and standardize the examination of renal cortical blood flow perfusion with CEUS. [ABSTRACT FROM AUTHOR]

KANNO is a new human blood group that was recently discovered. The KANNO antigen shares the PRNP gene with the prion protein and the prion protein E219K polymorphism determines the presence or absence of the KANNO antigen and the development of anti-KANNO alloantibodies. These alloantibodies specifically react with prion proteins, which serve as substrates for conversion into pathological isoforms in some prion diseases and may serve as effective targets for resisting prion infection. These findings establish a potential link between the KANNO blood group and human prion disease via the prion protein E219K polymorphism. We reviewed the interesting correlation between the human PRNP gene's E219K polymorphism and the prion proteins it expresses, as well as human red blood cell antigens. Based on the immune serological principles of human blood cells, the prion protein E219K polymorphism may serve as a foundation for earlier molecular diagnosis and future drug development for prion diseases. [ABSTRACT FROM AUTHOR]

Introduction: Image-guided invasive procedures on the liver require a steep learning curve to acquire the necessary skills. The best and safest way to achieve these skills is through hands-on courses that include simulations and phantoms of different complications, without any risks for patients. There are many liver phantoms on the market made of various materials; however, there are few multimodal liver phantoms, and only two are cast in a 3D-printed mold. Methods: We created a virtual liver and 3D-printed mold by segmenting a CT scan. The InVesalius and Autodesk Fusion 360 software packages were used for segmentation and 3D modeling. Using this modular mold, we cast and tested silicone- and gelatin-based liver phantoms with tumor and vascular formations inside. We tested the gelatin liver phantoms for several procedures, including ultrasound diagnosis, elastography, fibroscan, ultrasound-guided biopsy, ultrasound-guided drainage, ultrasound-guided radio-frequency ablation, CT scan diagnosis, CT–ultrasound fusion, CT-guided biopsy, and MRI diagnosis. The phantoms were also used in hands-on ultrasound courses at four international congresses. Results: We evaluated the feedback of 33 doctors regarding their experiences in using and learning on liver phantoms to validate our model for training in ultrasound procedures. Conclusions: We validated our liver phantom solution, demonstrating its positive impact on the education of young doctors who can safely learn new procedures thus improving the outcomes of patients with different liver pathologies. [ABSTRACT FROM AUTHOR]

Porous materials have recently attracted significant attention in the aerospace and biomedical fields for addressing issues related to friction and wear. Porous materials are beneficial in applications where continuous lubrication is not feasible or for components that operate under extreme conditions, such as high speeds, elevated temperatures, and heavy loads. The pores can serve as reservoirs for liquid lubricants, which are gradually released during the operation of the components. The tribological properties of these materials depend on their porosity, the lubricants used, and any additional additives incorporated into the porous materials. This review article provides insight into common fabrication techniques for porous materials and examines their tribological performance for all three classes of materials—polymers, metals, and ceramics. Additionally, it discusses design criteria for porous self-lubricating materials by highlighting the critical properties of both the substrate and lubricants. [ABSTRACT FROM AUTHOR]

Background: Patients with liver pathology benefit from image-guided interventions. Training for interventional procedures is recommended to be performed on liver phantoms until a basic proficiency is reached. In the last 40 years, several attempts have been made to develop materials to mimic the imaging characteristics of the human liver in order to create liver phantoms. There is still a lack of accessible, reproducible and cost-effective soft liver phantoms for image-guided procedure training. Methods: Starting from a CT-scan DICOM file, we created a 3D-printed liver mold using InVesalius (Centro de Tecnologia da informação Renato Archer CTI, InVesalius 3 open-source software, Campinas, Brazil) for segmentation, Autodesk Fusion 360 with Netfabb (Autodesk software company, Fusion 360 2.0.19426 with Autodesk Netfabb Premium 2023.0 64-Bit Edition, San Francisco, CA, USA) for 3D modeling and Stratasys Fortus 380 mc 3D printer (Stratasys 3D printing company, Fortus 380 mc 3D printer, Minneapolis, MN, USA). Using the 3D-printed mold, we created 14 gelatin-based liver phantoms with 14 different recipes, using water, cast sugar and dehydrated gelatin, 32% fat bovine milk cream with intravenous lipid solution and technical alcohol in different amounts. We tested all these phantoms as well as ex vivo pig liver and human normal, fatty and cirrhotic liver by measuring the elasticity, shear wave speed, ultrasound attenuation, CT-scan density, MRI signal intensity and fracture force. We assessed the results of the testing performed, as well as the optical appearance on ultrasound, CT and MRI, in order to find the best recipe for gelatin-based phantoms for image-guided procedure training. Results: After the assessment of all phantom recipes, we selected as the best recipe for transparent phantoms one with 14 g of gelatin/100 mL water and for opaque phantom, the recipes with 25% cream. Conclusions: These liver gelatin-based phantom recipes are an inexpensive, reproducible and accessible alternative for training in image-guided and diagnostic procedures and will meet most requirements for valuable training. [ABSTRACT FROM AUTHOR]

In this study, we demonstrate the direct preparation of dihalo-γ-lactams featuring two distinct halogens from dichloroamides using a novel atom exchange radical cyclization (AERC) procedure. This method integrates the established atom transfer radical cyclization (ATRC) with halogen exchange in solution. The technique operates under mild conditions and requires small amounts of metallic copper, serving as both a supplemental activator and reducing agent. [ABSTRACT FROM AUTHOR]

Background and Aims: Transient elastography (TE), shear wave elastography, and/or magnetic resonance elastography (MRE), each providing liver stiffness measurement (LSM), are the most studied imaging-based noninvasive liver disease assessment (NILDA) techniques. To support the American Association for the Study of Liver Diseases guidelines on NILDA, we summarized the evidence on the accuracy of these LSM methods to stage liver fibrosis (F)., Approach and Results: A comprehensive search for studies assessing LSM by TE, shear wave elastography, or MRE for the identification of significant fibrosis (F2-4), advanced fibrosis (F3-4), or cirrhosis (F4), using histopathology as the standard of reference by liver disease etiology in adults or children from inception to April 2022 was performed. We excluded studies with <50 patients with a single disease entity and mixed liver disease etiologies (with the exception of HCV/HIV coinfection). Out of 9447 studies, 240 with 61,193 patients were included in this systematic review. In adults, sensitivities for the identification of F2-4 ranged from 51% to 95%, for F3-4 from 70% to 100%, and for F4 from 60% to 100% across all techniques/diseases, whereas specificities ranged from 36% to 100%, 74% to 100%, and 67% to 99%, respectively. The largest body of evidence available was for TE; MRE appeared to be the most accurate method. Imaging-based NILDA outperformed blood-based NILDA in most comparisons, particularly for the identification of F3-4/F4. In the pediatric population, imaging-based NILDA is likely as accurate as in adults., Conclusions: LSM from TE, shear wave elastography, and MRE shows acceptable to outstanding accuracy for the detection of liver fibrosis across various liver disease etiologies. Accuracy increased from F2-4 to F3-4 and was the highest for F4. Further research is needed to better standardize the use of imaging-based NILDA, particularly in pediatric liver diseases., (Copyright © 2024 American Association for the Study of Liver Diseases.)

Kotter's work, Leading Change, has been an outline for corporate change management initiatives since its publication in 1996. However, little research has been done on applying his 8-step model to change management in libraries. This article examines the suitability of Kotter's steps for use in a library setting and concludes that based on existing literature, it is an appropriate model for library leaders to follow as they implement change at the institution. [ABSTRACT FROM AUTHOR]

Background: Teleultrasound has gained significant traction in clinical practice in recent years. However, studies focusing on remote interventional ultrasound remain limited., Objectives: To evaluate the feasibility and accuracy of percutaneous puncture using a robot-assisted teleultrasound-guided interventional system (RTIS)., Materials and Methods: This study was approved by the institutional animal ethics committee and human research review board. Written informed consent was obtained from all patients. Two experienced interventional ultrasound physicians performed percutaneous punctures using both RTIS and conventional ultrasound guidance (CUG) in phantom and swine liver models, as well as in clinical settings. Puncture distance errors and operation durations were compared between the RTIS and CUG groups in the experimental models. For clinical applications, operation duration, success rates, and complications were recorded., Results: No significant differences were observed in puncture distance errors between the RTIS and CUG groups in the phantom study (2.85 ± 2.07 mm vs. 1.79 ± 1.93 mm; p = 0.158) or the swine liver study (3.28 ± 1.20 mm vs. 2.56 ± 0.98 mm; p = 0.148). However, puncture operation durations were significantly longer in the RTIS group compared to the CUG group across all scenarios: phantom study (50 ± 19 s vs. 19 ± 7 s; p < 0.001), swine liver study (106 ± 19 s vs. 61 ± 32 s; p = 0.001), and clinical application (200 ± 27.02 s vs. 104.8 ± 33.92 s; p < 0.001). All six patients in the RTIS group and ten patients in the CUG group successfully underwent percutaneous puncture without complications., Conclusion: The RTIS demonstrated safety and feasibility for percutaneous puncture, providing comparable accuracy to conventional methods., Clinical Relevance Statement: The RTIS offers a safe and effective solution for percutaneous puncture, with the potential to address the scarcity of medical resources in remote and underserved regions., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: To investigate whether a low-calorie, reduced-fat diet affects liver attenuation imaging (ATI) measurements., Methods: A total of 320 participants were enrolled in this prospective study. They were randomly assigned to four groups: a fasting group, a postprandial 0.5-hour examination group, a postprandial 2-hour examination group, and a postprandial 4-hour examination group. All participants first underwent liver ATI examination in a fasting state. Those in the postprandial groups then consumed a low-calorie, reduced-fat diet before undergoing a second ATI examination at 0.5 h, 2 h, or 4 h after the meal. The ATI values were compared among the groups. The differences between postprandial and fasting ATI values were also analyzed for the postprandial groups. Additionally, the consistency of the grading diagnosis of hepatic steatosis between the postprandial and fasting states was evaluated in the postprandial groups., Results: The ATI values for the 0.5 h postprandial group, 2 h postprandial group, and 4 h postprandial group were not significantly different from those of the fasting group (P = 0.576, 0.471, and 0.992, respectively). No significant differences were noted in the ATI values recorded during the postprandial and fasting states within each of the postprandial groups (P = 0.573, 0.076, and 0.805, respectively). The kappa values for diagnostic consistency between the postprandial and fasting states across the three divergent criteria were 0.833-0.951, 0.812-0.855, and 0.737-0.862, respectively., Conclusion: A low-calorie, reduced-fat diet does not significantly affect liver ATI measurements or the grading of hepatic steatosis. However, the lack of representation of older adults and populations with higher BMIs in this study may limit its generalizability, with the lack of external validation as a limitation. These issues should be tested and confirmed in further studies., Clinical Trial Number: (ChiCTR2200062314, August 2022)., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) imposes significant health care burdens. Early detection of advanced fibrosis and cirrhosis in MASLD is essential due to their unfavorable outcomes. This multilevel random-effects meta-analysis aimed to provide the best evidence for the diagnostic accuracy of 2-dimensional shear wave elastography in detecting liver fibrosis in biopsy-proven MASLD., Approach and Results: This study involves systematic search in PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS, and Cochrane Library electronic databases for full-text articles published in any language up to February 26, 2024. Included studies reported liver stiffness measurement by 2-dimensional shear wave elastography and used histological diagnosis as the gold standard. A linear mixed-effects multiple thresholds model was employed, and summary estimates for sensitivity, specificity (Sp), and summary area under the receiver operator characteristic curve were computed. Twenty observational studies (SuperSonic Imagine, General Electric Healthcare, and Canon Medical Systems) fulfilled the inclusion criteria, comprising 2223 participants with biopsy-proven MASLD. The prevalence of mild fibrosis (F1), significant fibrosis (F2), advanced fibrosis (F3), and cirrhosis (F4) was 30.0%, 18.5%, 17.9%, and 10.9%, respectively. The summary area under the receiver operator characteristic curve [95% CI] in detecting ≥F1, ≥F2, ≥F3, and F4 for all ultrasound machines considered together were 0.82 [0.16-0.98], 0.82 [0.76-0.88], 0.86 [0.77-0.93], and 0.89 [0.80-0.95], respectively. The optimal cutoff values were 6.432 kPa for ≥F1, 8.174 kPa for ≥F2, 9.418 kPa for ≥F3, and 11.548 kPa for F4, respectively., Conclusions: Our meta-analysis identified optimized cutoffs for fibrosis staging by 2-dimensional shear wave elastography in etiology-specific chronic liver diseases (MASLD), with excellent diagnostic performance, underscoring the potential for standardizing cutoff values., (Copyright © 2024 American Association for the Study of Liver Diseases.)

Objective: The purpose of this study was to improve our understanding of severe serine biosynthesis defects through a comprehensive description of prenatal, and postnatal manifestations and the mutational spectrum in a new cohort of 12 unrelated Egyptian Families., Methods: Detailed fetal ultrasound examination, postnatal assessment, and whole exome sequencing (WES) were performed in a cohort of 12 fetuses with suspected Neu-Laxova syndrome (NLS), the most severe expression of serine biosynthesis defects. Additionally, a comprehensive review of the literature was conducted by merging the data from all the molecularly-confirmed cases with ours to gain a better understanding of the clinical variability of NLS., Results: Novel clinical manifestations including intrauterine convulsions, hemivertebrae, natal teeth, holoprosencephaly, and rhombencephalosynapsis were observed. Molecular analysis identified 7 and 2 likely disease-causing variants in the PSAT1 and PHGDH genes, respectively. Four of them were novel, including the c.734G>A missense variant in PSAT1, which has been proposed to be a founder variant among Egyptians., Conclusion: The present cohort expands the spectrum of serine biosynthesis disorders. Moreover, it illuminates the role of prenatal exome sequencing in lethal conditions constituting the most severe end of already-known human diseases., (© 2024 John Wiley & Sons Ltd.)