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>Les cancers thyroïdiens sont souvent diagnostiqués lors de l'exploration d'un nodule thyroïdien. Ils se développent aux dépens des cellules folliculaires et sont majoritairement différenciés (papillaire ou vésiculaire) et de bon pronostic, plus rarement peu différenciés et exceptionnellement anaplasiques de pronostic sombre. Les carcinomes médullaires se développent aux dépens des cellules C et s'intègrent dans 25 % des cas à une NEM2 associée à une mutation du proto-oncogène RET. Le bilan thyroïdien est souvent normal. Le diagnostic repose sur l'échographie, qui caractérisera le ou les nodules thyroïdiens à ponctionner ainsi que les adénopathies cervicales. L'examen cyto-histologique établit le diagnostic et la classification de la tumeur déterminant traitement et suivi. On réalisera une thyroïdectomie totale ou partielle, associée ou non à un curage ganglionnaire. L'hypothyroïdie est quasi constante en post-opératoire et justifie une supplémentation à vie par L-thyroxine. Pour les cancers différenciés, une posologie freinatrice associée à un traitement adjuvant par irathérapie (131I) est indiquée dans les formes à haut risque de récidive. La surveillance biologique repose sur la thyroglobuline sérique, indétectable en l'absence de récidive. Pour les carcinomes médullaires, le suivi biologique repose sur la calcitonine, indétectable en l'absence de persistance ou de récidive, et sur l'antigène carcino-embryonaire (ACE) sériques. La recherche d'une mutation du gène RET doit être systématique. Thyroid cancers are often diagnosed during the exploration of a thyroid nodule. They are developed at the expense of follicular cells mainly differentiated of papillary or vesicular types and associated with a good prognosis, more rarely of oncocytic type and exceptionally of anaplastic type, associated with a poor prognosis. Medullary thyroid carcinomas are developed at the expense of C cells and are part of a MEN 2, associated with a proto-oncogene RET mutation in 25% of cases. Thyroid function is generally conserved. Diagnosis is based on ultrasound, which will characterize the thyroid nodule(s) and the cervical adenopathies to be punctured. The cyto-histological examination establishes the definitive diagnosis and the classification of the tumor determining the management and follow-up. A total or partial thyroidectomy is performed, possibly associated with lymph node removal. Hypothyroidism is quasi-systematic after surgery requiring a supplementation by L-thyroxine. In thyroid differentiated carcinomas, a high L-thyroxine dosage to suppress TSH and an adjuvant iratherapy (1131) are recommended in the forms with high risk of recurrence. Biological follow-up relies on serum thyroglobulin, indetectable in the absence of relapse. In the case of medullary carcinoma, biological follow-up relies on serum calcitonin, indetectable in the absence of persistence or recurrence and carcinoembryonic antigen (CEA). The search for a RET mutation is always recommended. [ABSTRACT FROM AUTHOR]

In traditional cardiac ultrasound diagnostics, the process of planning scanning paths and adjusting the ultrasound window relies solely on the experience and intuition of the physician, a method that not only affects the efficiency and quality of cardiac imaging but also increases the workload for physicians. To overcome these challenges, this study introduces a robotic system designed for autonomous cardiac ultrasound scanning, with the goal of advancing both the degree of automation and the quality of imaging in cardiac ultrasound examinations. The system achieves autonomous functionality through two key stages: initially, in the autonomous path planning stage, it utilizes a camera posture adjustment method based on the human body's central region and its planar normal vectors to achieve automatic adjustment of the camera's positioning angle; precise segmentation of the human body point cloud is accomplished through efficient point cloud processing techniques, and precise localization of the region of interest (ROI) based on keypoints of the human body. Furthermore, by applying isometric path slicing and B-spline curve fitting techniques, it independently plans the scanning path and the initial position of the probe. Subsequently, in the autonomous scanning stage, an innovative servo control strategy based on cardiac image edge correction is introduced to optimize the quality of the cardiac ultrasound window, integrating position compensation through admittance control to enhance the stability of autonomous cardiac ultrasound imaging, thereby obtaining a detailed view of the heart's structure and function. A series of experimental validations on human and cardiac models have assessed the system's effectiveness and precision in the correction of camera pose, planning of scanning paths, and control of cardiac ultrasound imaging quality, demonstrating its significant potential for clinical ultrasound scanning applications. [ABSTRACT FROM AUTHOR]

Purpose: Ultrasound is widely used to diagnose disease and guide surgery because it is versatile, inexpensive and radiation-free. However, image acquisition is dependent on the operation of a professional sonographer, which is a difficult skill to learn for a wider range of non-sonographers. Methods: We propose a prior knowledge-based visual navigation method to obtain three important standard ultrasound views of the heart, based on the sonographer's skill learning and augmented reality prompts. The key information about the probe movement was captured using vision-based tracking and normalisation methods on 14 volunteers, based on a professional sonographer's practice. An augmented reality-based navigation method was then proposed to guide operators with no ultrasound experience to find standard views of the heart in a second set of three volunteers. Results: Through quantitative analysis and qualitative scoring, the results showed that the proposed method can effectively guide non-sonographers to obtain standard views with diagnostic value. Conclusion: It is believed that the method proposed in this paper has clear application value in primary care, and expansion of the data will allow the accuracy of the navigation to be further improved. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to develop an experimental model for the study of intra-articular knee movements depending on the function of the knee joint and involved muscle groups under isometric stretching conditions with different loads. The experimental procedure included an ultrasound examination of a knee joint after isometric stretching in healthy men (n = 32). The changes (in millimeters) in the distances between the femur and tibia were measured using an ultrasound sonographer at three stages. The first stage was performed on ten (n = 10) healthy men in five different sitting and upright positions. In the second and third experimental model stages, lower limbs loading was applied to 22 participants. Our hypothesis, which was confirmed, was that as a result of increased loads on the participant's back, an intra-articular decrease in the femur–tibia cartilage surface distance would be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model of the mechanical effects during the deformation of knee joint bone cartilage and it can also help outline some future tasks: increasing loading weights, enlarging participant groups, performing comparisons of men and women, and performing comparisons of healthy and pathological individuals. [ABSTRACT FROM AUTHOR]

Purpose: a comparative analysis of biometric parameters of the optic nerve obtained by different diagnostic ultrasound sensors.Material and methods. We examined 20 healthy volunteers with emmetropia aged 20 to 40 years (40 eyes), average age 30.5 ± 5.4 years, who had no complaints or ophthalmic pathologies. Ultrasound scanning was performed on a multifunctional Voluson E8 (GE) scanner (11–18 MHz linear sensor), ophthalmic ultrasound device Ellex Eyecubed (a conventional 10 MHz transducer) and an ophthalmic scanner Absolu «Quantel Medical» (a 20 MHz transducer). All examinations were carried out by one operator who used the same scanning technique and measured the optic nerve sheath diameter (ONSD) and optic nerve diameter (OND) without sheaths in both eyes. Six consequent measurements of the ONSD and the OND parameters were performed to ascertain the reproducibility of the examinations and evaluate the variation coefficient.Results. The analysis revealed no statistically significant differences in the ONSD and in the OND obtained with 11–18 MHz, 10 MHz and 20 MHz transducers in the B-mode (р > 0.05). The minimum variation coefficient of the optic nerve thickness parameters was registered using a high-frequency 20 MHz transducer on the ophthalmic scanner. The biometry obtained with a high frequency 20 MHz transducer could be considered as the most reproducible.Conclusion. A high frequency 20 MHz transducer can be recommended for optimal visualization and precise evaluation of biometric parameters of the retrobulbar part of the optic nerve. Transducers of multifunctional scanners with the frequency range from 11 to 20 MHz can be used for measurements of the optic nerve sheath diameter.

The shortage of obstetricians and gynecologists is increasing in developed countries; therefore, there is a need to improve prenatal care procedures. To automate fetal ultrasound (US) imaging, this paper presents a deep neural network (DNN) model that generates US scan motions for a robot. Additionally, the robot can adapt to the abdominal surface even if the abdominal shape is not precisely known. The latent space of the DNN model is designed to represent the abdominal-shape information. The DNN model can predict the proper trajectory by mapping the height and width of the abdomen to the latent space. Moreover, the robot can detect any deviations from the correct trajectory and return to the right position. For validation, we performed a US scan using the proposed model on tissue-mimicked phantoms that were not used for training. Subsequently, we evaluated the number of dots that were wiped off by the robot from the phantom surface. Overall, the number of dots removed accounted for 91.7% of the total dots. The results demonstrated the feasibility of using the DNN model for motion generation. Hence, the proposed system has the potential to automate fetal US scans according to the individual differences in the abdominal shape. [ABSTRACT FROM AUTHOR]

The development of a new generation of minimally invasive surgery is mainly reflected in robot-assisted diagnosis and treatment methods and their clinical applications. It is a clinical concern for robot-assisted surgery to use a multi-joint robotic arm performing human ultrasound scanning or ultrasound-guided percutaneous puncture. Among them, the motion control of the robotic arm, and the guiding and contact scanning processes of the ultrasonic (US-) probe determine the diagnosis effect, as well as the accuracy and safety of puncture surgery. To address these challenges, this study developed an intelligent robot-assisted system integrating autonomous US inspection and needle positioning, which has relation to several intelligent algorithms such as adaptive flexible control of the robot arm, autonomous US-scanning, and real-time attitude adjustment of the puncture needle. To improve the cooperativity of the spatial operation of the robot end-effector, we propose an adaptive flexible control algorithm that allows the operator to control the robot arm flexibly with low damping. To achieve the stability and uniformity of contact detection and imaging, we introduced a self-scanning method of US-probe based on reinforcement learning and built a software model of variable stiffness based on MuJoco to verify the constant force and velocity required by the end mechanism. We conducted a fixed trajectory scanning experiment at a scanning speed of 0.06 m/s. The force curve generally converges towards the desired contact force of 10 N, with minor oscillations around this value. For surgical process monitoring, we adopted the puncture needle detection algorithm based on Unet++ to acquire the position and attitude information of the puncture needle in real time. In short, we proposed and verified an adaptive control method and learning strategy by using an UR robotic arm equipped with a US-probe and puncture needle, and we improved the intelligence of the US-guided puncture robot. [ABSTRACT FROM AUTHOR]

Abstract Background Fetal skeletal dysplasia is a diverse group of degenerative diseases of bone and cartilage disorders that can lead to movement disorder and even death. This study aims to evaluate the diagnostic yield of sonographic examination and genetic testing for fetal skeletal dysplasia. Methods From September 2015 to April 2021, the study investigated 24 cases with suspected short-limb fetuses, which were obtained from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. To identify the causative gene, multiple approaches (including karyotype analysis, copy number variations and whole exome sequencing) were performed on these fetuses. And further segregation analysis of the candidate variant was performed in parents by using Sanger sequencing. Results ① Out of 24 cases, likely pathogenic variants in FGFR3, FBN2, COL1A2, CUL7 and DYNC2H1 were detected in 6 cases; pathogenic variants in FGFR3, IMPAD1 and GORAB were identified in other 6 cases; and variants in WNT1, FBN1, OBSL1, COL1A1, DYNC2H1 and NEK1, known as Variant of Undetermined Significance, were found in 4 cases. There were no variants detected in the rest 8 cases by the whole exome sequencing. ② Of 24 cases, 12 (50%) were found to carry variants (pathogenic or likely pathogenic) in seven genes with 12 variants. Four fetuses (16.7%) had variants of uncertain significance. Conclusion Genetic testing combining with ultrasound scanning enhances the accurate diagnosis of fatal skeletal dysplasia in utero, and then provides appropriate genetic counseling.

Yoshihiro Fukumoto,1,2 Masashi Taniguchi,2 Tetsuya Hirono,2 Masahide Yagi,2 Momoko Yamagata,1,2 Ryusuke Nakai,3 Yosuke Yamada,4 Misaka Kimura,5 Noriaki Ichihashi2 1Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan; 2Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; 3Kyoto University Institute for the Future of Human Society, Kyoto, Japan; 4National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan; 5Institute for Active Health, Kyoto University of Advanced Science, Kameoka, JapanCorrespondence: Yoshihiro Fukumoto, Faculty of Rehabilitation, Kansai Medical University, 18– 89 Uyamahigashicho, Hirakata City, Osaka, 573-1136, Japan, Tel +81-72-856-2307, Fax +81-72-856-2150, Email fukumoty@hirakata.kmu.ac.jpPurpose: This study aimed to investigate the association of muscle thickness (MT) and echo intensity (EI) obtained at different regions along the muscle length with muscle volume (MV), intramuscular adipose tissue (IntraMAT), and muscle strength of the quadriceps femoris (QF).Patients and Methods: A total of 135 community-dwelling adults (64 men and 71 women) participated in the study. Ultrasound scanning of the rectus femoris (RF) and vastus intermedius (VI) was performed at three locations (from mid- to distal thigh). The MT of the RF and VI and EI of the RF were measured. MRI-derived MV, IntraMAT, and muscle strength of the QF were measured.Results: The correlation between RF-MT and RF-MV weakened as scanning approached the distal thigh, and the difference between the coefficients for the scanning locations was significant for women. However, the correlation of VI-MT with VI-MV and that of the combined MT of RF and VI with the MV of the whole QF and muscle strength were comparable among the scanning locations for both sexes. The correlation of RF-EI with the IntraMAT of the RF and the whole QF and muscle strength was also comparable among the scanning locations for both sexes.Conclusion: The results of this study suggest that ultrasound measurements at the distal thigh can predict MV, IntraMAT, and muscle strength of the QF to the same degree as those at the mid-thigh.Keywords: ultrasound scanning, rectus femoris, thigh, muscle strength, MRI

Background: Fetal skeletal dysplasia is a diverse group of degenerative diseases of bone and cartilage disorders that can lead to movement disorder and even death. This study aims to evaluate the diagnostic yield of sonographic examination and genetic testing for fetal skeletal dysplasia. Methods: From September 2015 to April 2021, the study investigated 24 cases with suspected short-limb fetuses, which were obtained from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. To identify the causative gene, multiple approaches (including karyotype analysis, copy number variations and whole exome sequencing) were performed on these fetuses. And further segregation analysis of the candidate variant was performed in parents by using Sanger sequencing. Results: ① Out of 24 cases, likely pathogenic variants in FGFR3, FBN2, COL1A2, CUL7 and DYNC2H1 were detected in 6 cases; pathogenic variants in FGFR3, IMPAD1 and GORAB were identified in other 6 cases; and variants in WNT1, FBN1, OBSL1, COL1A1, DYNC2H1 and NEK1, known as Variant of Undetermined Significance, were found in 4 cases. There were no variants detected in the rest 8 cases by the whole exome sequencing. ② Of 24 cases, 12 (50%) were found to carry variants (pathogenic or likely pathogenic) in seven genes with 12 variants. Four fetuses (16.7%) had variants of uncertain significance. Conclusion: Genetic testing combining with ultrasound scanning enhances the accurate diagnosis of fatal skeletal dysplasia in utero, and then provides appropriate genetic counseling. [ABSTRACT FROM AUTHOR]

BACKGROUND: The steadily increasing number of people with obesity requires the development of simple and accurate methodological approaches to assess the absolute and relative amount of body fat mass. The body adiposity index (BAI) is one of the indices proposed to assess the body fat percentage. However, the comparison analysis of common methods, i.e., of bio-electrical impedance analysis and ultrasound scanning, and BAI was not performed for the Russian population.AIM: Comparison analysis of the body fat percentage estimates by bio-electrical impedance analysis, ultrasound scanning, and body adiposity index in the group of adult male and females.MATERIALS AND METHODS: An examination of healthy males and females from Moscow was conducted. Height, weight, waist and hip circumferences were measured. The body fat percentage was obtained by bio-electrical impedance analysis — BIA (ABC-02 Medas), ultrasound scanning — US (BodyMetrixTM, IntelaMetrix), and body adiposity index.RESULTS: 263 females and 134 males aged 18 to 73 years participated in the study. Correlation coefficients between BAI values and the body fat percentage obtained by BIA and US were 0.749 and 0.763 (p

Human schistosomiasis is one of neglected tropical diseases that remain highly prevalent in sub-Saharan Africa (SSA). Human schistosomiasis is mainly caused by two species, Schistosoma haematobium and S. mansoni, leading to urogenital and intestinal schistosomiasis, respectively. The World Health Organization (WHO) recommends mass drug administration (MDA) with praziquantel as the primary method of global intervention. Currently, MDA with praziquantel covers over half of the target population in endemic SSA countries. However, an accurate diagnosis is crucial for monitoring and evaluating the effectiveness of MDA. The standard diagnosis of both urogenital and intestinal schistosomiasis relies on the microscopic identification of eggs. However, the diagnostic sensitivity of this approach is low, especially for light or ultra-light infections. This is because Schistosoma eggs are laid inside of the venous plexus of the urinary bladder or mesenteric vein, where the adult flukes live. Approximately half of the eggs circulate in the blood vessels or are packed in neighboring tissues, while the remaining half are expelled into the lumen of the urinary bladder or intestine intermittently when the blood vessels are ruptured. In the field setting, the accuracy of any diagnostic method is critical for proper management of the intervention. The present article reviews the recent prevalence of urogenital schistosomiasis in SSA and highlights the practical limitations of diagnostic methods such as urine microscopy, urine reagent strips, molecular diagnosis, and ultrasound scanning in the field setting. Despite continuous global efforts to eliminate schistosomiasis over the past 20 years, many areas still remain endemic in SSA. No single diagnostic approach achieves acceptable sensitivity and specificity in the field setting. Therefore, any field survey should employ a combination of these methods based on the purpose of the study to accurately monitor and evaluate urogenital schistosomiasis. Based on diagnostic values and a cost–benefit analysis, a urine reagent strip test can replace urine microscopy in the field setting. The WHO criteria by ultrasound diagnosis should be updated including the echogenic snow sign and contour distortion. [ABSTRACT FROM AUTHOR]

Reproducibility of body fat (BF) and fat-free mass (FFM) measurements obtained by two indirect methods (bioimpedance analysis (BIA) and ultrasound scanning (US)) was performed in a group of young adults. To evaluate reproducibility, the repeated body composition measurements obtained using an ABC-02 Medas bioimpedance analyzer and BodyMetrixTM ultrasound scanner were carried out in the group of adult men and women. The study indicates the reliability of both individual and group estimates, as well as high reproducibility of measurements obtained with BIA and US. Strong positive significant correlations were found between the body composition measurements obtained with an ABC-02 Medas and BodyMetrixTM, as well as between repeated measurements of each of the devices. The analysis carried out for the ABC-02 Medas and BodyMetrixTM devices indicates good reproducibility of BF and FFM measurements in young men and women. The highest reproducibility was shown for the results of FFM measurements. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to develop an experimental model for the study of intra-articular knee movements depending on the function of the knee joint and involved muscle groups under isometric stretching conditions with different loads. The experimental procedure included an ultrasound examination of a knee joint after isometric stretching in healthy men (n = 32). The changes (in millimeters) in the distances between the femur and tibia were measured using an ultrasound sonographer at three stages. The first stage was performed on ten (n = 10) healthy men in five different sitting and upright positions. In the second and third experimental model stages, lower limbs loading was applied to 22 participants. Our hypothesis, which was confirmed, was that as a result of increased loads on the participant’s back, an intra-articular decrease in the femur–tibia cartilage surface distance would be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model of the mechanical effects during the deformation of knee joint bone cartilage and it can also help outline some future tasks: increasing loading weights, enlarging participant groups, performing comparisons of men and women, and performing comparisons of healthy and pathological individuals.

Ultrasound scanning (USS) technique has been routinely used in performance testing of meat animals, such as swine and beef cattle. This study is to evaluate USS application in organic lamb production, selection, and the accuracy of carcass traits and market value prediction. Ewes (n = 60) were bred, pregnancy diagnosed at 40 d post-mating, and their suckling lambs were assigned to two groups, a non-creep feeding (control) and creep feeding (treatment) group. Each group was balanced with sexes and litter size when allocated into groups at 30-d of age. All lambs had unrestricted suckled their dams during pasture grazing or grazing with creep feeding supplementation until weaning. There were 28 control and 32 treatment group lambs presented at weaning 90 d of age. Lambs were continued to graze as two groups on fescue-based pasture or grazing with creep feeding supplementation till marketing at 120 d. Weaning body weight (BW), average daily gain (ADG), and post-weaning growth weight were significantly (P < 0.05) greater than control 24.0 kg, 226 g/d, and 28.0 kg for treatment group compared with control group at 21.3 kg, 196 g/d, and 25.3 kg, respectively. However, AGD was not significantly increased during the post-weaning creep supplementary feeding period. The ultrasound scanned carcass traits increase in creep feeding over control lambs at weaning and post-weaning measurements (Figure 1). The average ultrasound scanned back fat depth, loineye muscle depth, muscle width, and loineye muscle area were 2.2 mm, 17.9 mm, 45.6 mm and 5.8 cm² at weaning age of 90 d; and 2.6 mm, 20.9 mm, 48.0 mm, and 7.0 cm² at 120 d, respectively. The correlative associations (Table 1) between carcass traits and lamb BW, such as loineye muscle depth (LED), loineye muscle width (LEW), loineye muscle depth (LED) and loineye muscle area (LEA), and LEA were significantly improved (P < 0.05) with increased BW. However, there was no difference in these traits due to treatment except backfat depth, which was significantly higher for treatment and females. Creep supplementary feeding lambs during pre-weaning has increased ADG and weaning weight; therefore, will enhance market values of organically raised lambs. The results indicate that USS technique is worthy of application in meat lamb selection, post-weaning performance and market premium prediction. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to establish a reliable method for producing 3D reconstruction of sonographic callus. Methods: A cohort of ten closed tibial shaft fractures managed with intramedullary nailing underwent ultrasound scanning at two, six, and 12 weeks post-surgery. Ultrasound capture was performed using infrared tracking technology to map each image to a 3D lattice. Using echo intensity, semi-automated mapping was performed to produce an anatomical 3D representation of the fracture site. Two reviewers independently performed 3D reconstructions and kappa coefficient was used to determine agreement. A further validation study was undertaken with ten reviewers to estimate the clinical application of this imaging technique using the intraclass correlation coefficient (ICC). Results: Nine of the ten patients achieved union at six months. At six weeks, seven patients had bridging callus of ≥ one cortex on the 3D reconstruction and when present all achieved union. Compared to six-week radiographs, no bridging callus was present in any patient. Of the three patients lacking sonographic bridging callus, one went onto a nonunion (77.8% sensitive and 100% specific to predict union). At 12 weeks, nine patients had bridging callus at ≥ one cortex on 3D reconstruction (100%-sensitive and 100%-specific to predict union). Presence of sonographic bridging callus on 3D reconstruction demonstrated excellent reviewer agreement on ICC at 0.87 (95% confidence interval 0.74 to 0.96). Conclusion: 3D fracture reconstruction can be created using multiple ultrasound images in order to evaluate the presence of bridging callus. This imaging modality has the potential to enhance the usability and accuracy of identification of early fracture healing. Cite this article: Bone Joint Res 2021;10(12):759–766.

Abstract Background Women with abdominal pain and bloating frequently have their Ca-125 levels investigated for suspected ovarian cancer and this has led to a significant increase in referrals to the ovarian cancer service. We have conducted this study to help improve the efficiency in which these patients are investigated and to improve future pathways within the referral service. Methods This was a retrospective observational outcome study. Data were collected from electronic documents of patients’ referrals, assessments, and clinical correspondences over 48 months. The study was conducted in a secondary gynaecology cancer centre with direct referrals from primary care. The pelvic mass clinic was set up to include a consultation and an ultrasound scan with support available for patients if required. All patients included were referred directly from primary care for suspected ovarian cancer with Ca-125 result over a period of 2 years. Results 286 were referred from primary care according to the NICE guidelines of ‘2-week wait for ovarian cancer’. Only 223 patients who had a Ca-125 result reported at the time of their referral were included in the analysis. Out of the 223 patients, 126 patients were discharged with or without a repeat Ca-125 after the initial assessment. 18 patients were diagnosed with cancer following the referral, but only 12 of them had a primary ovarian malignancy. The malignancy rate in women under 50 years of age was 22% (4/18) and 78% (14/18) in women aged 50 or above. Conclusion One-stop focused gynaecology ultrasound clinics where clinicians may assess patients and perform ultrasound scans for suspected cancer, may be better for managing this patient population due to improved efficiencies in waiting times, same day diagnosis and a reduction in waiting times to first appointment. Secondly, the majority of the patients with Ca-125 of more than 35 U/mL, who were referred through this pathway, did not have cancer. This review queries the future value of using Ca-125 as the basis for referrals from primary care for suspected ovarian malignancy. Further studies are required to assess whether a higher Ca-125 cut off may be used as the basis of referrals for premenopausal women.

Background: Plantar fasciitis (PF) is a common disorder without objective parameters for disease severity. Purpose: To investigate whether structural changes in the plantar fascia and heel fat pad determined by ultrasound scanning with or without contrast are related to outcome measures in patients with symptomatic PF and to investigate whether there is an association between changes in US findings and improvement in pain and function. Methods: All patients (n = 90) in a randomized controlled trial treated with training and/or glucocorticosteroid injection were assessed for morning pain, function pain, Foot Function Index (FFI), and ultrasound measured thickness of the fascia and heel fat pad at entry and after 6 months. Thirty patients were included in a longitudinal study that assessed pain, function, and microvascular volume (MV) by contrast‐enhanced ultrasound at entry and after 5 months of treatment. Results: None of the ultrasound parameters at the initial examination were related to clinical outcomes at 5–6 months. Changes in US measured thickness of the fascia but not the fat pad correlated with improvement in all outcome measures at 6 months (FFI: r = 0.30, p = 0.005, morning pain: r = 0.21, p = 0.046, function pain: r = 0.28, p = 0.007). MV did not change despite significant improvement in symptoms. Conclusion: Changes in ultrasound measured fascia thickness are associated with clinical improvement in PF patients. [ABSTRACT FROM AUTHOR]

Breast ultrasound utilizes various scanning techniques to acquire optimal images for diagnostic evaluation. During interventional procedures, such as ultrasound-guided biopsies or preoperative localizations, knowledgeable and purposeful scanning adjustments are critical for successfully identifying the targeted mass or biopsy marker or clip. While most ultrasound scanning parameters are similar across different vendors, detailed descriptions specifically addressing the scanning parameters-often referred to as "knobology"- for breast ultrasound is at best limited in the literature. This review highlights ten key operator-controlled adjustments (including transducer selection, beam focusing, power, depth, gain and time gain compensation, harmonic imaging, spatial compounding, dynamic range, beam steering, and color Doppler) that significantly influence image quality in breast ultrasound. Each adjustment is accompanied by an "In practice" section providing examples and practical tips on implementation. The last topic discusses color Doppler which is generally used in breast ultrasound for evaluating the vascularity of a finding. Color Doppler, or more specifically, color Doppler twinkling, can be leveraged as a technique to detect certain breast biopsy markers that are challenging to detect by conventional B-mode ultrasound. While the cause of color Doppler twinkling is still under active investigation, twinkling is a clinically well-known, compelling ultrasound feature typically described with kidney stones. A step-by-step guide on how to use color Doppler twinkling to detect these markers is provided., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tbcr.amegroups.org/article/view/10.21037/tbcr-24-30/coif). C.U.L. serves as an unpaid editorial board member of Translational Breast Cancer Research from October 2023 to September 2025. C.U.L. and M.W.U. are co-PIs on a National Institute of Biomedical Imaging and Bioengineering (NIBIB) grant (R01 EB033008) to the Mayo Clinic and on an internal Mayo Clinic Discovery Translation Program award. Patents are pending for non-metallic ultrasound detectable markers as well as Doppler ultrasound twinkling technologies. G.K.H. was supported by NIBIB grant (R01 EB033008) to the Mayo Clinic and by an internal Mayo Clinic Discovery Translation Program award. The other authors have no other conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

BACKGROUND: Use of timely antenatal care has been identified as key to facilitating healthy pregnancies worldwide. Although considerable investment has been made to enhance maternal health services in Nepal, approximately one-third of women do not attend antenatal care until after the first trimester (late). These women miss out on the benefits of screening and interventions that are most effective in the first trimester. OBJECTIVE: This study aimed to identify the missed opportunities of women who do not attend antenatal care in the first trimester, and to explore some of the factors underlying late attendance and consider potential solutions for minimizing these missed opportunities in the future. STUDY DESIGN: This study was conducted in 3 hospitals in Nepal. Focus groups (n=18) with a total of 48 postnatal women and 49 staff members, and 10 individual interviews with stakeholders were conducted. Purposive sampling facilitated the obtainment of a full range of maternity experiences, staff categories, and stakeholder positions. Data were qualitative and analyzed using a thematic approach. RESULTS: Limited awareness among women of the importance of early antenatal care was reported as a key factor behind attendance only after the first trimester. The family and community were described as significant influencers in women's decision-making regarding the timing of antenatal care. The benefits of early ultrasound scanning and effective supplementation in pregnancy were the major missed opportunities. Increasing awareness, reducing cost, and enhancing interprofessional collaboration were suggested as potential methods for improving timely initiation of antenatal care. CONCLUSION: Limited awareness continues to drive late attendance to antenatal care after the first trimester. Investment in services in the first trimester and community health education campaigns are needed to improve this issue and enhance maternal and neonatal outcomes.

The aim. To assess the hemodynamic parameters of the hepatic and visceral blood flow in patients with compensated and decompensated liver cirrhosis. Materials and methods. 290 patients with liver cirrhosis were examined: 206 had gastrointestinal bleeding, 84 had diuretic-resistant ascites. Ultrasonic scanning, Doppler sonography, esophagogastroduodenoscopy, angiography, radioisotope scintigraphy were performed to assess blood flow in the portal, splenic and superior mesenteric veins and in the hepatic, splenic and superior mesenteric arteries. Results. Change in the hepatic microcirculatory blood flow in the natural course of liver cirrhosis was characterized by decreased portal and increased arterial blood flow, “arterialization” of hepatic blood flow based on scintigraphy. Decompensation of the disease was associated with progressive reduction in both portal and arterial hepatic blood flow, which were correlated with the severity of functional liver disorders regardless of the complication nature. The portal blood flow in the natural course of liver cirrhosis was characterized by 3.5–4.5 times increased volume of visceral blood. Decompensation of the disease was accompanied by a decrease in blood flow in the portal vein as compared to the splenic and superior mesenteric veins by 1.8–2.2 and 1.5–2.7 times, respectively. Arterial blood flow in the natural course of liver cirrhosis was characterized by a relatively increased hepatic arterial flow. The ultrasound criterion of hepatic blood flow “arterialization” was an increase in hepatic-splenic arterial index, which can be used as a sign to differentiate between different forms of portal hypertension. Decompensation of the disease was characterized by an average of 8.2 % decreased arterial blood flow in the hepatic artery compared to the splenic artery in dynamics. Prognostically unfavorable signs were the progression of splenomegaly degree, the increase in the portal vein diameter with the decreased velocity characterizing the increase in congestive index by 2.4–2.6 times, the decrease in the hepatic artery diameter and velocity in it over time.Conclusions. The hepatic and visceral blood flow characteristics should be considered when choosing method of conservative, surgical or minimally invasive treatment of liver cirrhosis complications. Based on the hepatic hemodynamic characteristics, the mismatch between portal perfusion (reduced) and visceral blood flow (increased) is the essence of portal hypertension in liver cirrhosis. Accordingly, the criterion of treatment effectiveness in decompensated liver cirrhosis should be improved portal liver perfusion and (or) reduced volume of visceral blood flow.

Differences in the way health care delivery across countries may have important impacts on health outcomes and can result in inequalities. A questionnaire survey of members of national societies through EBCOG and EAPM was carried out in 2021. A total of 53 responses were received from 26 countries. Most countries reported that routine antenatal care is primarily delivered by medical staff, involving obstetric specialists or family doctors mostly in government-run facilities. Women from minority groups are able to access antenatal care easily in most countries. Less than 10% of women did not attend antenatal care throughout the pregnancy. Most booking for antenatal care takes place in the first trimester and the number of visits range from 6 to 10 depending on parity. Most countries provide routine ultrasound with 2-3 reported scans performed by specifically trained health care professionals. Facilities for prenatal screening/diagnosis of malformations in both low- and high-risk cases varied across Europe. While antenatal care is relatively standardized throughout Europe, important differences still exist in care delivery and accessibility to care. Antenatal preventive strategies appear to be variably available throughout Europe. [ABSTRACT FROM AUTHOR]

Background: Women with abdominal pain and bloating frequently have their Ca-125 levels investigated for suspected ovarian cancer and this has led to a significant increase in referrals to the ovarian cancer service. We have conducted this study to help improve the efficiency in which these patients are investigated and to improve future pathways within the referral service.Methods: This was a retrospective observational outcome study. Data were collected from electronic documents of patients' referrals, assessments, and clinical correspondences over 48 months. The study was conducted in a secondary gynaecology cancer centre with direct referrals from primary care. The pelvic mass clinic was set up to include a consultation and an ultrasound scan with support available for patients if required. All patients included were referred directly from primary care for suspected ovarian cancer with Ca-125 result over a period of 2 years.Results: 286 were referred from primary care according to the NICE guidelines of '2-week wait for ovarian cancer'. Only 223 patients who had a Ca-125 result reported at the time of their referral were included in the analysis. Out of the 223 patients, 126 patients were discharged with or without a repeat Ca-125 after the initial assessment. 18 patients were diagnosed with cancer following the referral, but only 12 of them had a primary ovarian malignancy. The malignancy rate in women under 50 years of age was 22% (4/18) and 78% (14/18) in women aged 50 or above.Conclusion: One-stop focused gynaecology ultrasound clinics where clinicians may assess patients and perform ultrasound scans for suspected cancer, may be better for managing this patient population due to improved efficiencies in waiting times, same day diagnosis and a reduction in waiting times to first appointment. Secondly, the majority of the patients with Ca-125 of more than 35 U/mL, who were referred through this pathway, did not have cancer. This review queries the future value of using Ca-125 as the basis for referrals from primary care for suspected ovarian malignancy. Further studies are required to assess whether a higher Ca-125 cut off may be used as the basis of referrals for premenopausal women. [ABSTRACT FROM AUTHOR]

Background: All pregnancies are at a risk of producing congenital malformations, though only some of them are at a greater risk. Congenital anomalies its problem in which abnormalities of structure, function or body metabolism resulting in physical or mental disability or it may be fatal. Objective: This study aimed for early detection of major fetal anomalies to improve fetal and maternal outcome. Patients and methods: This cross-sectional study that include 422 pregnant females was carried out at the Ultrasound Unit and Obstetrics & Gynecology Department, Faculty of Medicine, Zagazig University during the period from December 2018 to July 2019. Results: Ultrasonography can identify at least 35-50% of major fetal malformations with a specificity of 90-100%. Though other methods of screening like biochemical markers and karyotyping are available, ultrasonography has the advantage of being non- invasive, safe, fast, accurate and reproducible with real time display, causing no discomfort to the patient at any time of gestation. Conclusions: The Prevalence of congenital fetal malformations (CFMF) among the study participants using ultrasonography scanning was 3.6%. The most prevalent anomalies were Hydrops fetalis and CVS anomalies. Therefore screening for congenital anomalies in obstetric sonography is an important component of primary healthcare for maternal and child health. [ABSTRACT FROM AUTHOR]

Purpose: The three-dimensional (3D) ultrasound (US) imaging realized by continuous scanning of a region is of great value for medical diagnosis and robot-assisted needle insertion. During scanning, the contact force and posture between the probe and skin of the patient are crucial factors that determine the quality of US imaging. We propose a robotic system for automatic scanning of curved surfaces with a stable contact force and vertical contact posture (the probe is parallel to the normal of the surface at the contact point). Methods: A 6-DOF robotic arm is used to hold and drive a two-dimensional (2D) US probe to complete automatic scanning. Further, a path-planning strategy is proposed to generate the scan path covering the selected area automatically. We also developed a novel force-measuring device based on optical waveguides to measure the distributed contact force and contact posture. Based on the measured force and posture, the robotic arm automatically adjusts the position and orientation of the probe and maintains a stable contact force and vertical contact posture at each scan point. Results: The novel force-measuring device is easy to fabricate, integrates with the probe and has the capacity of measuring the force distributed on the contact surface and estimating the contact posture. The experimental results of automatic scanning of a US phantom and parts of the human body demonstrate that the proposed system performs well in automatically scanning curved surfaces, maintaining a stable contact force and vertical contact posture and producing a good quality 3D US volume. Conclusion: An automatic US scanning robotic system with an optical waveguide-based force-measuring device was developed and tested successfully. Experimental results demonstrated the feasibility of the proposed system to scan the human body. [ABSTRACT FROM AUTHOR]

During an ultrasound (US) scan, the sonographer is in close contact with the patient, which puts them at risk of COVID-19 transmission. In this paper, we propose a robot-assisted system that automatically scans tissue, increasing sonographer/patient distance and decreasing contact duration between them. This method is developed as a quick response to the COVID-19 pandemic. It considers the preferences of the sonographers in terms of how US scanning is done and can be trained quickly for different applications. Our proposed system automatically scans the tissue using a dexterous robot arm that holds US probe. The system assesses the quality of the acquired US images in real-time. This US image feedback will be used to automatically adjust the US probe contact force based on the quality of the image frame. The quality assessment algorithm is based on three US image features: correlation, compression and noise characteristics. These US image features are input to the SVM classifier, and the robot arm will adjust the US scanning force based on the SVM output. The proposed system enables the sonographer to maintain a distance from the patient because the sonographer does not have to be holding the probe and pressing against the patient's body for any prolonged time. The SVM was trained using bovine and porcine biological tissue, the system was then tested experimentally on plastisol phantom tissue. The result of the experiments shows us that our proposed quality assessment algorithm successfully maintains US image quality and is fast enough for use in a robotic control loop.

It is now well recognized that unacceptable inequalities in maternity care that exist due to a woman's ethnicity, socio-economic deprivation, age, residential social status within a country can have adverse effects on the outcomes of their pregnancies. Perceived attitudes can lead to dismissal of concerns, breakdown of trust and can affect interactions with maternity services. Women from black and Asian ethnicity are at 2-4 times higher risk of maternal mortality. Similarly women with underlying mental health issues and those with undocumented status are also at higher risk of adverse outcomes during pregnancy and within the first postnatal year. There is need for research, to understand why these different practices exist and how we can more effectively understand and overcome the barriers and factors which can lead to inequality in access to uniform standard of care. Covid-19 pandemic created challenges for the provision of maternity services. Each country responded by their own creative and pragmatic solutions. It is important that individualized care based on a woman's individual social and medical needs must remain a priority to improve maternity care. It is proposed that EU funding should be made available to set up large scale European wide research to inform future policies. [ABSTRACT FROM AUTHOR]

In traditional cardiac ultrasound diagnostics, the process of planning scanning paths and adjusting the ultrasound window relies solely on the experience and intuition of the physician, a method that not only affects the efficiency and quality of cardiac imaging but also increases the workload for physicians. To overcome these challenges, this study introduces a robotic system designed for autonomous cardiac ultrasound scanning, with the goal of advancing both the degree of automation and the quality of imaging in cardiac ultrasound examinations. The system achieves autonomous functionality through two key stages: initially, in the autonomous path planning stage, it utilizes a camera posture adjustment method based on the human body's central region and its planar normal vectors to achieve automatic adjustment of the camera's positioning angle; precise segmentation of the human body point cloud is accomplished through efficient point cloud processing techniques, and precise localization of the region of interest (ROI) based on keypoints of the human body. Furthermore, by applying isometric path slicing and B-spline curve fitting techniques, it independently plans the scanning path and the initial position of the probe. Subsequently, in the autonomous scanning stage, an innovative servo control strategy based on cardiac image edge correction is introduced to optimize the quality of the cardiac ultrasound window, integrating position compensation through admittance control to enhance the stability of autonomous cardiac ultrasound imaging, thereby obtaining a detailed view of the heart's structure and function. A series of experimental validations on human and cardiac models have assessed the system's effectiveness and precision in the correction of camera pose, planning of scanning paths, and control of cardiac ultrasound imaging quality, demonstrating its significant potential for clinical ultrasound scanning applications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tang, Wang, Luo, Jiang, Nian, Qi, Sang and Gan.)

Objective This study was conducted to estimate the genetic parameters and breeding values of breast meat related traits of Pekin ducks. Selection response was also determined by using ultrasound breast muscle thickness (BMT) measurements in combination with bosom breadth (BB) and keel length (KL) values. Methods The traits analyzed were breast meat weight (BMW), body weight (BW), breast meat percentage (BMP) and the three parameters of breast meat (BB, KL, and BMT). These measurements were derived from studying 15,781 Pekin ducks selected from 10 generations based on breast meat weight. Genetic parameters and breeding value were estimated for the analysis of the breeding process. Results Estimated heritability of BMW and BMP were moderate (0.23 and 0.16, respectively), and heritability of BW was high (0.48). Other traits such as BB, KL, and BMT indicated moderate heritability ranging between 0.11 and 0.28. Significant phenotypic correlations of BMW with BW and BMP were discovered (p

Background. Myopia, leading to visual function impairment, is one of the most topical issues in eye pathology. Although myopia is a common disease, its pathogenesis has a set of questions unstudied, which is why it is crucial to develop an axial myopia model on animals, a clinical picture of which is maximally similar to human and makes it possible to study both pathogenesis and treatment of myopia. So, the purpose of the present paper was to study certain parameters of the visual organ when modelling form deprivation myopia in rats under different light conditions. Material and Methods. Group 1 (10 animals) consisted of intact rats. Group 2 (15 animals) consisted of the rats, both eyelids of which were sutured to induce form deprivation myopia. Group 3 (15 animals) were rats with eyelids sutured to induce form deprivation myopia which, unlike Group 2 rats, were kept under poor light conditions for 14 days. Within the same period, animals of Groups 1 and 2 were kept under natural light conditions. Once a 14-day period expired, sutures were taken out from the eyelids. After suture removal, all the animals were performed ultrasound scanning, tonometry (Maklakov applanation tonometer, a 2 g and 4 mm plunger) to measure intraocular pressure, and pachymetry (Handy Pachymetr SP–100) to measure corneal thickness. At two weeks after removal of sutures from the eyelids, the animals were sacrificed under general anesthesia and the eyeballs were enucleated. Objective criterion for myopia development was elongation of anterior-posterior dimension (APD) of the eyeball which was measured using ultrasound scanning (in vivo) and a digital sliding caliper (Topex) with 0.02 mm accuracy (post mortem). Data obtained were processed using the non-parametric Kruskall-Wallis and Mann-Whitney tests using a software program (Statistica 5.5). Results. Our data on changes in visual organ parameters (intraocular pressure, corneal thickness, anterior-posterior dimension of the eyeball) in young rats when modelling form deprivation myopia under different light conditions showed more rapid progression of myopia when lighting was poor. Thus, the changes in the parameters involved in myopization were significantly more pronounced in the rats with an axial myopia model induced under poor light conditions as compared to those in experimental myopia under natural lighting (IOP was higher by 15.0%; APD was longer by 5.0%). Conclusions. Form deprivation myopia which is induced by eyelid suture in two-week-old rats in the period of eyeball growth under poor light conditions can be recommended for studying structural and functional characteristics of progressive myopia and developing pathogenetically-oriented treatment methods for the disease.

Purpose: Biomechanical simulation of anatomical deformations caused by ultrasound probe pressure is of outstanding importance for several applications, from the testing of robotic acquisition systems to multi-modal image fusion and development of ultrasound training platforms. Different approaches can be exploited for modelling the probe–tissue interaction, each achieving different trade-offs among accuracy, computation time and stability. Methods: We assess the performances of different strategies based on the finite element method for modelling the interaction between the rigid probe and soft tissues. Probe–tissue contact is modelled using (i) penalty forces, (ii) constraint forces, and (iii) by prescribing the displacement of the mesh surface nodes. These methods are tested in the challenging context of ultrasound scanning of the breast, an organ undergoing large nonlinear deformations during the procedure. Results: The obtained results are evaluated against those of a non-physically based method. While all methods achieve similar accuracy, performance in terms of stability and speed shows high variability, especially for those methods modelling the contacts explicitly. Overall, prescribing surface displacements is the approach with best performances, but it requires prior knowledge of the contact area and probe trajectory. Conclusions: In this work, we present different strategies for modelling probe–tissue interaction, each able to achieve different compromises among accuracy, speed and stability. The choice of the preferred approach highly depends on the requirements of the specific clinical application. Since the presented methodologies can be applied to describe general tool–tissue interactions, this work can be seen as a reference for researchers seeking the most appropriate strategy to model anatomical deformation induced by the interaction with medical tools. [ABSTRACT FROM AUTHOR]

Skeletal muscle mass deficiency and quality degradation constitute sarcopenia for elderly people. Sarcopenia can result in musculoskeletal damage and accompany various metabolic problems, which make early sarcopenia diagnosis important. Various modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), have been developed for screening sarcopenia. Recently, ultrasound scanning was suggested for screening sarcopenia because of its safety, usability, and cost effectiveness. However, there has been no standardized assessment methodology for screening sarcopenia with ultrasound scanning. Therefore, prior to this study, we developed a four-degrees-of-freedom (DOF) sarcopenia detection system using an RGB-D camera and an ultrasound probe to automatically scan the human thigh without operator dependency. However, due to the eye-to-hand approach with the RGB-D camera, the system has limited usability for clinical trials. Therefore, in this study we modified the system such that it became eye-in-hand by attaching the RGB-D camera to the upper part of the system with an enhanced arc fitting algorithm. The modified system and enhanced algorithm were verified by an in-vitro test with bean curd-gelatin phantom. The results showed that the thickness of bean curd in the gelatin phantom was maintained at approximately 12.7 ± 0.35 mm over the 71.5∘ scanning range with 2.49 ± 0.15 N radial force at various thickness measuring points.

The purpose of the present study was to develop an experimental model for the study of intra-articular knee movements depending on the function of the knee joint and involved muscle groups under isometric stretching conditions with different loads. The experimental procedure included an ultrasound examination of a knee joint after isometric stretching in healthy men ( n = 32). The changes (in millimeters) in the distances between the femur and tibia were measured using an ultrasound sonographer at three stages. The first stage was performed on ten ( n = 10) healthy men in five different sitting and upright positions. In the second and third experimental model stages, lower limbs loading was applied to 22 participants. Our hypothesis, which was confirmed, was that as a result of increased loads on the participant's back, an intra-articular decrease in the femur-tibia cartilage surface distance would be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model of the mechanical effects during the deformation of knee joint bone cartilage and it can also help outline some future tasks: increasing loading weights, enlarging participant groups, performing comparisons of men and women, and performing comparisons of healthy and pathological individuals.

Purpose: Ultrasound is widely used to diagnose disease and guide surgery because it is versatile, inexpensive and radiation-free. However, image acquisition is dependent on the operation of a professional sonographer, which is a difficult skill to learn for a wider range of non-sonographers., Methods: We propose a prior knowledge-based visual navigation method to obtain three important standard ultrasound views of the heart, based on the sonographer's skill learning and augmented reality prompts. The key information about the probe movement was captured using vision-based tracking and normalisation methods on 14 volunteers, based on a professional sonographer's practice. An augmented reality-based navigation method was then proposed to guide operators with no ultrasound experience to find standard views of the heart in a second set of three volunteers., Results: Through quantitative analysis and qualitative scoring, the results showed that the proposed method can effectively guide non-sonographers to obtain standard views with diagnostic value., Conclusion: It is believed that the method proposed in this paper has clear application value in primary care, and expansion of the data will allow the accuracy of the navigation to be further improved., Competing Interests: Conflict of interestThe authors have no relevant financial or non-financial interests to disclose., (© Korean Society of Medical and Biological Engineering 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Considered the most common congenital testicular abnormality of companion animals and a predisposition factor to the development of testicular neoplasia, cryptorchidism is defined as the non-descent of one or both testes to their normal anatomical location. Data on the occurrence of cryptorchidism in Brazil are scarce. The purpose of this work was to verify the occurrence of cryptorchidism in dogs of different sizes and breeds.Materials and Methods: Cryptorchidism identification was carried out by ultrasound scanning, from November, 1994 to March, 2007, at the Centre for Veterinarian Diagnosis and Support (Centro de Apoio e Diagnóstico Veterinário - CAD), in Rio de Janeiro. 4924 male dogs of different breeds were examined, revealing 403 (8.2%) cryptorchidism.Results: In this study, occurrence took place more often on the right testicle (59.5%), more frequently displaying inguinal localisation (59.5%) and unilateral occurrence (70%). Regarding bilateral presentation, the symmetrical form was the most common (86.8%). Cryptorchidism was more common in the inguinal region of dog of small sized breeds and in the abdominal region in dogs of medium- and large-sized breeds.Conclusions: Ultrasound scan proved a valuable diagnosis tool for cryptorchid testes, giving precise localisation and parenchymal changes thus leading to a safe clinical treatment. [ABSTRACT FROM AUTHOR]

This study tested for association between Toxoplasma gondii and pregnancy and abortion to investigate sub-optimal reproduction in farmed red deer (Cervus elaphus). Sera from a sub-sample (n = 2304) of pregnant and non-pregnant hinds in early gestation at first pregnancy scan (scan 1) and approximately at the end of second trimester at second pregnancy scan (scan 2) were tested for T. gondii antibodies using a validated ELISA. Foetuses and/or uteri from pregnant, non-pregnant, and aborting hinds at scan 1, scan 2, or weaning were tested for T. gondii DNA by nested PCR. At scan 1, 31.1% of 861 rising two-year-old (R2) and 28.3% of 357 mixed-aged (MA, ≥ 2 years) hinds were sero-positive. There was no association between scan 1 serology and non-pregnancy at animal (R2, p = 0.05 and MA, p = 0.43) or herd level (R2, p = 0.37). Toxoplasma gondii DNA was detected in 3/18 placenta and 4/18 foetal brains from aborting R2 hinds and 15/157 R2 and 3/21 MA uteri from non-pregnant hinds at scan 1. At scan 2, sero-prevalence was higher (odds ratio = 1.6, 95% CI = 1.04–2.48) in aborted (34.3% of 268) than in non-aborted (23.5% of 446) R2 hinds (p = 0.03) and 7.9% of abortions between scans were attributable to T. gondii exposure. Within-herd sero-prevalence at scan 2 was positively associated with daily abortion rate in R2 herds with aborted hinds (p < 0.001) but not in MA herds (p = 0.07). Toxoplasma gondii DNA was detected in 27/169 uteri, 2/20 cotyledons, and 1/5 foetal brains from aborted hinds at scan 2 and in uteri from 5/33 hinds not rearing a calf to weaning. Toxoplasma gondii RFLP genotyping of five loci revealed a unique type I/III genotype pattern, TgRDNZ1, in a foetal brain sample, not been previously reported in deer. These findings provide serological and molecular evidence that T. gondii infection is associated with abortion in red deer, possibly in all three trimesters. [ABSTRACT FROM AUTHOR]

Background and Aim: Infection or bleeding after transrectal prostate biopsy remains a concern of both patients and urologists. We explored the risk of association of certain co-morbidities with both complications.Patients and Methods: Using the Taiwan National Health Insurance Research Database, we identified patients undergoing prostate biopsy from 2000 to 2013. We used logistic multivariable regression to search for associations between post-biopsy hospitalization and the two co-morbidities within a year after biopsy.Results: Among 3,601 prostate biopsies, 100 infections (3.77%) and 52 (1.44%) bleeding-related emergency room visits and hospitalizations were recorded within 30 days after biopsy. The group having the biopsy as an inpatient exhibited older age (p < 0.0001) and a higher percentage of having diabetes mellitus (p = 0.015) than patients without either complication. The logistic multivariable regression analysis showed that urinary retention, freedom from diabetes, and performance as an outpatient procedure were independent risk factors for infection-related hospitalization (odds ratios 1.81, 1.96, and 1.72; p values 0.031, 0.037, and 0.010, respectively).Conclusion: Patients with a recent history of urinary retention have a higher probability of infection-related hospitalization after prostate biopsy. [ABSTRACT FROM AUTHOR]

Cholesterol is essential in the brain from the earliest stages of embryonic development. Disruption of cholesterol synthesis pathways that leads to cholesterol deficiency underlies a few syndromes, including desmosterolosis and Smith–Lemli–Opitz syndrome. In both syndromes, brain anomalies can occur. The LSS gene encodes lanosterol synthase (LSS), an important enzyme in the cholesterol biosynthesis pathway. Biallelic pathogenic variants in this gene cause alopecia–intellectual disability type 4 syndrome (APMR4, MIM 618840), a rare autosomal recessive disorder. Here, we describe two new LSS variants (c.1016C > T; p. Ser339Leu and c.1522G > C; p. Gly508Arg) found in a compound heterozygous fetus diagnosed prenatally with brain abnormalities by ultrasound scanning. Two of his siblings from the same parents also harbored these variants. Both siblings had alopecia, mild intellectual disability, autism spectrum disorder, and cataracts. To the best of our knowledge, this case represents the first prenatal diagnosis of APMR4 first suspected by ultrasound. In addition, the phenotypic features of the siblings are extensive compared with those described in previous reports and include abnormal corpus callosum, cataracts, alopecia, and developmental delay. • Lanosterol synthase variants causing APMR identified due to fetal brain anomalies. • This case is the first prenatal diagnosis of APMR, first suspected by ultrasound. • Fetal genetic testing can help unravel an undiagnosed familial genetic history. [ABSTRACT FROM AUTHOR]

Sarcopenia is defined as muscle mass and strength loss with aging. As places, such as South Korea, Japan, and Europe have entered an aged society, sarcopenia is attracting global attention with elderly health. However, only few developed devices can quantify sarcopenia diagnosis modalities. Thus, the authors developed a sarcopenia detection system with 4 degrees of freedom to scan the human thigh with ultrasound probe and determine whether he/she has sarcopenia by inspecting the length of muscle thickness in the thigh by ultrasound image. To accurately measure the muscle thickness, the ultrasound probe attached to the sarcopenia detection system, must be moved angularly along the convex surface of the thigh with predefined pressure maintained. Therefore, the authors proposed an angular thigh scanning method for the aforementioned reason. The method first curve-fits the angular surface of the subject’s thigh with piecewise arcs using D information from a fixed RGB-D camera. Then, it incorporates a Jacobian-based ultrasound probe moving method to move the ultrasound probe along the curve-fitted arc and maintains radial interface force between the probe and the surface by force feedback control. The proposed method was validated by in-vitro test with a human thigh mimicked ham-gelatin phantom. The result showed the ham tissue thickness was maintained within approximately 26.01 ± 1.0 mm during 82° scanning with a 2.5 N radial force setting and the radial force between probe and surface of the phantom was maintained within 2.50 ± 0.1 N.

Impact fatigue caused by rain droplets, also called rain erosion, is a severe problem for wind turbine blades and aircraft. In this work, an assessment of impact fatigue on a glass fibre reinforced polymer laminate with a gelcoat is presented and the damage mechanisms are investigated. A single point impact fatigue tester is developed to generate impact fatigue damage and SN data. Rubber balls are repeatedly impacted on a single location of the coated laminate. Each impact induces transient stresses in the coated laminate. After repeated impacts, these stresses generate cracks, leading to the removal of the coating and damage to the laminate. High-resolution digital imaging is used to determine the incubation time until the onset of coating damage, and generate an SN curve. An acoustic emission sensor placed at the back of the laminate monitors changes in acoustic response as damage develops in the coated laminate. The subsurface cracks are studied and mapped by 3D X-ray computed tomography. A finite element method model of the impact shows the impact stresses in the coating and the laminate. The stresses seen in the model are compared to cracks found by 3D tomography. The damage is also evaluated by ultrasonic scanning. [ABSTRACT FROM AUTHOR]

This essay presents the early days of human cytogenetics, from the late 1950s until the mid 1970s, as a historical series of images. I propose a chronology moving from photographs of bodies to chromosome sets, to be joined by ultrasound images, which provided a return to bodies, by then focused on the unborn. Images carried ontological significance and, as I will argue, are principal characters in the history of human cytogenetics. Inspired by the historiography of heredity and genetics, studies on visual cultures, the conceptualization of circulation, and the sociology of pregnancy, I suggest that cytogenetics, through its focus on pregnancy, pregnant women, and their offspring, found strategic living materials that stabilized human chromosome studies as a biomedical, post-eugenics practice. The historicity of each path displays a wide circulation of objects, tools, and methods that condensed on images that shared in the centuries-old visual expertise that medicine and botany had manufactured. [ABSTRACT FROM AUTHOR]

Objectives: In a single blinded randomized controlled study, we investigated the effect of stabilization exercise on lumbar multifidus muscle thickness in patients with non-specific chronic low back pain. Low Back Pain is highly prevalent and results in considerable level of disability. Many causes have been associated with weakness or injury of the soft tissues in the lumbar area. Methods: A total of 122 individuals (44 males, 78 females) with non-specific chronic low back pain participated in this study. They were assigned to four different groups. Group 1 received stabilization exercise only. In addition to stabilization exercise, groups 2 and 3 received Transcutaneous Electrical Nerve Stimulation and massage therapy respectively and group 4 was the control group who received drug therapy only. Participants went through this protocol twice weekly for 8 consecutive weeks. Measurement of muscle thickness using Ultrasound scanning machine was done at baseline and end of 8th week. Analysis of variance was used to determine significant difference at P

Aim: US scanning has been defined as the urologist’s stethoscope. These recommendations have been drawn up with the aim of ensuring minimum standards of excellence for ultrasound imaging in urological and andrological practice. A series of essential recommendations are made, to be followed during ultrasound investigations in kidney, prostate, bladder, scrotal and penile diseases. Methods: Members of the Imaging Working Group of the Italian Society of Urology (SIU) in collaboration with the Italian Society of Ultrasound in Urology, Andrology and Nephrology (SIEUN) identified expert Urologists, Andrologists, Nephrologists and Radiologists. The recommendations are based on review of the literature, previously published recommendations, books and the opinions of the experts. The final document was reviewed by national experts, including members of the Italian Society of Radiology. Results: Recommendations are listed in 5 chapters, focused on: kidney, bladder, prostate and seminal vesicles, scrotum and testis, penis, including penile echo-doppler. In each chapter clear definitions are made of: indications, technological standards of the devices, the method of performance of the investigation. The findings to be reported are described and discussed, and examples of final reports for each organ are included. In the tables, the ultrasound features of the principal male uro-genital diseases are summarized. Diagnostic accuracy and second level investigations are considered. Conclusions: Ultrasound is an integral part of the diagnosis and follow-up of diseases of the urinary system and male genitals in patients of all ages, in both the hospital and outpatient setting. These recommendations are dedicated to enhancing communication and evidence-based medicine in an inter- and multi-disciplinary approach. The ability to perform and interpret ultrasound imaging correctly has become an integral part of clinical practice in uro-andrology, but intra and inter-observer variability is a well known limitation. These recommendations will help to improve reliability and reproducibility in uro-andrological ultrasound scanning.

The probability damage and fracture model for a composite material under impact loading is proposed, within this model, the damage parameters are regarded as the probability functions of strain, strain rate, and temperature with a preset probability density. FEM numerical strength computations for fiber-reinforced plates were carried out in the range of impact velocities up to 1200 m/s. The dynamics of energy absorption and plate damage levels with the impact velocity were analyzed. [ABSTRACT FROM AUTHOR]

Aims: A national screening programme has existed in the UK for the diagnosis of developmental dysplasia of the hip (DDH) since 1969. However, every aspect of screening and treatment remains controversial. Screening programmes throughout the world vary enormously, and in the UK there is significant variation in screening practice and treatment pathways. We report the results of an attempt by the British Society for Children's Orthopaedic Surgery (BSCOS) to identify a nationwide consensus for the management of DDH in order to unify treatment and suggest an approach for screening., Methods: A Delphi consensus study was performed among the membership of BSCOS. Statements were generated by a steering group regarding aspects of the management of DDH in children aged under three months, namely screening and surveillance (15 questions), the technique of ultrasound scanning (eight questions), the initiation of treatment (19 questions), care during treatment with a splint (ten questions), and on quality, governance, and research (eight questions). A two-round Delphi process was used and a consensus document was produced at the final meeting of the steering group., Results: A total of 60 statements were graded by 128 clinicians in the first round and 132 in the second round. Consensus was reached on 30 out of 60 statements in the first round and an additional 12 in the seond. This was summarized in a consensus statement and distilled into a flowchart to guide clinical practice., Conclusion: We identified agreement in an area of medicine that has a long history of controversy and varied practice. None of the areas of consensus are based on high-quality evidence. This document is thus a framework to guide clinical practice and on which high-quality clinical trials can be developed.Cite this article: Bone Joint J  2023;105-B(2):209-214.

Sounds in the audible range arising in mother's uterus during conventional ultrasound scanning were recorded noninvasively for the first time. It was found that their level is comparable with the level of spoken language. [ABSTRACT FROM AUTHOR]

Background Pregnancy-associated placental protein-A (PAPP-A) is a metalloprotease which circulates as an hetero-tetramer in maternal blood. Its maternal serum concentration in fetal trisomy 21 is decreased during the first trimester, so that PAPP-A is a useful screening biomarker. However, the regulation of PAPP-A placental secretion is unclear. We therefore investigated the secretion of PAPP-A in pregnancies complicated by fetal aneuploidies, both in vivo and in vitro. Methods Maternal serum collected between 10 WG and 33 WG during 7014 normal pregnancies and 96 pregnancies complicated by foetal trisomy 21, 18, and 13 were assayed for PAPP-A using the Immulite 2000xpi system®. The pregnancies were monitored using ultrasound scanning, fetal karyotyping and placental analysis. Villous cytotrophoblasts were isolated from normal and trisomic placenta and cultured to investigate PAPP-A secretion in vitro (n = 6). Results An increased nuchal translucency during the first trimester is a common feature of many chromosomal defect but each aneuploidy has its own syndromic pattern of abnormalities detectable at the prenatal ultrasound scanning and confirmed at the fetal examination thereafter. PAPP-A levels rise throughout normal pregnancy whereas in trisomy 21, PAPP-A levels were significantly decreased, but only during the first trimester. PAPP-A levels were decreased in trisomy 13 and sharply in trisomy 18, whatever the gestational age. In vitro, PAPP-A syncytial secretion was decreased in aneuploidy, and associated with decreased hCG secretion in Trisomy 21 and 18. These biochemical profiles did not appear to be linked to any specific histological lesions affecting the placenta. Conclusions These profiles may reflect different quantitative and qualitative placental dysfunctions in the context of these aneuploidies. [ABSTRACT FROM AUTHOR]

More than six billion tests for COVID-19 has been already performed in the world. The testing for SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) virus and corresponding human antibodies is essential not only for diagnostics and treatment of the infection by medical institutions, but also as a pre-requisite for major semi-normal economic and social activities such as international flights, off line work and study in offices, access to malls, sport and social events. Accuracy, sensitivity, specificity, time to results and cost per test are essential parameters of those tests and even minimal improvement in any of them may have noticeable impact on life in the many countries of the world. We described, analyzed and compared methods of COVID-19 detection, while representing their parameters in 22 tables. Also, we compared test performance of some FDA approved test kits with clinical performance of some non-FDA approved methods just described in scientific literature. RT-PCR still remains a golden standard in detection of the virus, but a pressing need for alternative less expensive, more rapid, point of care methods is evident. Those methods that may eventually get developed to satisfy this need are explained, discussed, quantitatively compared. The review has a bioanalytical chemistry prospective, but it may be interesting for a broader circle of readers who are interested in understanding and improvement of COVID-19 testing, helping eventually to leave COVID-19 pandemic in the past. [Display omitted] • RT-PCR is a golden standard for COVID-19 detection due to high sensitivity and accuracy. • Other detection methods can get faster time of analysis and lower cost than PCR-based. • FDA approved detection kits have advantage in accuracy vs published not yet approved methods. • Antibodies to virus are detected with ELISA, LFIA and CLIA, which may have an edge in sensitivity and specificity. • CT scan, X-ray scan, and lung ultrasound have comparable clinical accuracy about 93%. [ABSTRACT FROM AUTHOR]

Context: It is believed that 15°-25° head-down tilt position increases the internal jugular vein cross-sectional area (IJV CSA). The increase in IJV CSA before puncture reduces the risk of its perforation. This pattern was not observed in all patients. We assumed that the absence of respiratory-based IJV excursion is one of the criteria of head-down tilt position effectiveness. Aims: The aim of this study is to determine the head-down tilt angle, which ensures the absence of the respiratory-based IJV excursion. Subjects and Methods: Prospective study included twenty adult patients. The IJVs scanning was carried out in 1 min after placing the patients in a horizontal position on their back and in 1 min after placing them in the head-down tilt position at 5°, 10°, 15°, and 20° tilt angles. Results: We found that collapsibility index of <9% indicating the absence of respiratory-based IJV excursion was recorded in 25% of patients in the horizontal supine position. In this case, placing the patients in the Trendelenburg position for IJV catheterization may not be indicated. In 65% of the patients, the respiratory-based excursion was not observed at 10° head-down tilt position. Only 35% of the patients required 15° head-down tilt position. Conclusions: In clinical settings, the disappearance of respiratory-based vein excursion on the ultrasound scanner screen can be considered as criteria of the head-down tilt position effectiveness. [ABSTRACT FROM AUTHOR]

Background and Aim: Tattoo adverse reactions requiring diagnostic evaluation and treatment are becoming more common. The aim of this study was to assess tattoo reactions by 20-MHz ultrasonography referenced to histopathology as a comparative method. Materials and Methods: A total of 73 individuals with clinical adverse reactions in their tattoos were studied. Punch biopsies for reference histology were available from 58 patients. The Dermascan C® of Cortex Technology, Denmark, was employed. Total skin thickness and echo density of the echolucent band in the outer dermis were measured. Biopsy served for diagnosis and for determination of the level of cellular infiltration in the dermis. Results: In every tattoo reaction studied, the skin affected was found thicker compared with regional control of the same individual (mean difference 0.73 mm). A prominent echolucent band of mean thickness 0.89 mm was demonstrated, primarily located in the very outer dermis but propagating to deeper dermal layers parallel to increasing severity of reactions. The thickness of the echolucent band correlated with the thickness of cellular infiltration determined by microscopic examination, R = 0.6412 (P < 0.001). Special diagnoses such as granulomatous and pseudolymphomatous tattoo reactions showed no distinct characteristics by ultrasound, but mainly displayed themselves by their advanced inflammatory component. Discussion and Conclusion: It is demonstrated for the first time that ultrasound, with histopathology as the comparative method, can quantify the severity of tattoo reactions and noninvasively diagnose the depth of the inflammatory process in the dermis elicited by the microparticulate tattoo pigment, which itself is too minute to be imaged by ultrasound. Preoperative 20-MHz ultrasound scanning is introduced as a potentially useful method to guide therapeutic interventions by surgery and lasers. [ABSTRACT FROM AUTHOR]