Search Results (8,823)

Pain management in multiple trauma patients presents a complex clinical challenge due to competing priorities such as hemodynamic instability, polypharmacy, coagulopathy, and the urgency of life-saving interventions. In this context, peripheral nerve blocks (PNBs) are increasingly recognized as a valuable asset for their role in managing pain in patients with multiple traumatic injuries. By reducing reliance on systemic opioids, PNBs support effective pain control and facilitate early mobilization, aligning with enhanced recovery principles. This narrative review summarizes current evidence on the use of PNBs in the context of polytrauma, focusing on their analgesic efficacy, integration within multimodal analgesia protocols, and contribution to improved functional outcomes. Despite these advantages, clinical application is limited by specific concerns, including the potential to mask compartment syndrome, the risk of nerve injury or local anesthetic systemic toxicity (LAST), and logistical barriers in acute trauma settings. Emerging directions in the field include the refinement of ultrasound-guided PNB techniques, the expanded use of continuous catheter systems, and the incorporation of fascial plane blocks for anatomically complex or multisite trauma. Parallel efforts are focusing on the development of decision-making algorithms, improved risk stratification tools, and integration into multimodal analgesic pathways. There is also growing emphasis on standardized clinical protocols, simulation-based training, and patient education to enhance safety and consistency in practice. As evidence continues to evolve, the long-term impact of PNBs on functional recovery, quality of life, and healthcare utilization must be further explored. With thoughtful implementation, structured training, and institutional support, PNBs may evolve into a cornerstone of modern trauma analgesia. Full article

Background and Objectives: Ultrasound measurement of thyroid volume is not routinely performed in children without suspected thyroid disorders. However, pediatricians must be aware of the normal thyroid volume values in children in order to recognize and treat thyroid disorders in children on time. Therefore, this study aimed to explore factors that influence thyroid volume in children aged 4 to 18 years and to provide descriptive data on thyroid volume across this age range. Materials and Methods: This was a prospective, non-interventional cross-sectional study conducted on a population of children aged 4 to 18 years without confirmed thyroid disorders. We used validated formulas for calculating thyroid volume that integrate the linear dimensions of this organ, such as length, width, and depth, as well as the appropriate correction factor. The Spearman or Pearson correlation coefficient was calculated to assess the relationship between total thyroid volume and various continuous variables, while multiple linear regression analysis was used to evaluate the effect of potential predictors on the total thyroid volume. Results: The study included 100 children, predominantly girls (75.0%). Significant positive correlations with thyroid volume were found for age, height, weight, body mass index (BMI), body surface area, serum creatinine, birthweight, and number of comorbidities, while calcitonin was negatively correlated with children’s thyroid volume. We identified age, BMI, and serum creatinine as significant independent positive predictors of thyroid volume in children. Conclusions: Age, BMI, and serum creatinine emerged as significant independent positive predictors of thyroid volume and should be considered when interpreting pediatric thyroid ultrasound measurements. Full article

Background/Objectives: This is a retrospective review of 36 patients with electrodiagnostic (EDX) confirmation of carpal tunnel syndrome (CTS) and ultrasound (US) detection of marked median nerve enlargement (defined as a cross-sectional area [CSA] of 40 mm² or greater) at the wrist. Methods: We describe the clinical, electrodiagnostic (EDX), and US findings in these patients and discuss the pathophysiologic basis of a markedly enlarged median nerve. Results: The markedly enlarged median nerve was detected by US in a total of 39 hands (36 patients, with 3 bilateral). Of the 39 hands, thenar atrophy was observed in 15 (38.5%) hands, and pinprick loss in the median nerve distribution was noted in all hands. Moderately severe or severe median nerve entrapment at the carpal tunnel (CT) was confirmed by EDX studies in 21 (53.8%) and 16 (41.0%) hands, respectively. A total of 12 (30.8%) hands had no compound muscle action potentials (CMAPs) over the abductor pollicis brevis muscle, and sensory nerve action potentials (SNAPs) were not detected in 31 (79.5%) hands. The wrist CSA was between 40 and 44 mm² in 20 (51.3%) hands, between 45 and 49 mm² in 13 (33.3%) hands, and 50 mm² or greater in 6 (15.4%) hands. Conclusions: The implications of the markedly enlarged median nerve for surgical management of CTS are unknown, and future prospective studies are needed. Full article

The increasing adoption of digital technologies in the agriculture sector has significantly contributed to optimizing on-farm routines, especially in data-driven decision-making. This study aimed to develop an application to determine the slaughter point of lambs by predicting subcutaneous fat thickness (SFT) using pre-slaughter parameters such as body weight (BW), body condition score (BCS), and skinfold measurements at the brisket (BST), lumbar (LST), and tail base (TST), obtained using an adipometer. A total of 45 Pantaneiros lambs were evaluated, finished in feedlot, and slaughtered at different body weights. Each pre-slaughter weight class showed a distinct carcass pattern when all parameters were included in the model. Exploratory analysis revealed statistical significance for all variables (p < 0.001). BW and LST were selected to construct the predictive equation (R² = 55.44%). The regression equations were integrated into the developed application, allowing for in-field estimation of SFT based on simple measurements. Compared to conventional techniques such as ultrasound or visual scoring, this tool offers advantages in portability, objectivity, and immediate decision-making support. In conclusion, combining accessible technologies (e.g., adipometer) with traditional variables (e.g., body weight), represents an effective alternative for production systems aimed at optimizing and enhancing the value of lamb carcasses. Full article

Starch particles (SPs) were extracted from underutilized wild yam (Dioscorea remotiflora) tubers using two methods: (1) acid hydrolysis (AH) alone and (2) acid hydrolysis assisted by ultrasound (AH-US). The SPs were chemically modified through esterification (using acetic anhydride [AA] and lauroyl chloride [LC]) and crosslinking (with citric acid [CA] and sodium hexametaphosphate [SHMP]). They were subsequently characterized by their yield, amylose content, and structural and physical properties. The yield of particles was 17.5–19.7%, and the residual amylose content was 2.8–3.2%. Particle sizes ranged from 0.46 to 0.55 µm, which exhibited mono-modal and bi-modal distributions for AH and AH-US treatments, respectively. Following chemical modification, yield notably increased, especially with substitution by LC (33.6–36.5%) and CA (32.6–38.7%). Modified SPs exhibited bi-modal particle distributions with micro- and nanoparticles and variable peak intensities depending on the chemical compound used. Unmodified SPs displayed irregular morphologies, showing disruptions (AH) or aggregation (AH-US). Chemical substitutions altered morphologies, leading to amorphous surfaces (CA: AH), clustering (LC), or fragmentation into smaller particles (SHMP) under AH-US treatment. FT-IR analysis indicated a decrease in hydroxyl groups’ peak area (A(-OH)), confirming the substitution of these groups in the starch structure. Crosslinking with CA resulted in the highest degree of substitution (AH: 0.43; AH-US: 0.44) and melting enthalpy (ΔH_f: 343.0 J/g for AH-US), revealing stronger interactions between SPs from both methods. These findings demonstrate that the extraction treatment of D. remotiflora SPs and the type of chemical modifier significantly influence the properties of SPs, underscoring their potential applications as natural biocarriers. Full article

Background/Objectives: Ultrasound imaging is widely employed to assess kidney health and diagnose renal diseases. Accurate segmentation of renal structures in ultrasound images plays a critical role in the diagnosis and treatment of related kidney diseases. However, challenges such as speckle noise and low contrast still hinder precise segmentation. Methods: In this work, we propose an encoder–decoder architecture, named MAT-UNet, which incorporates two distinct attention mechanisms to enhance segmentation accuracy. Specifically, the multi-convolution pixel-wise attention module utilizes the pixel-wise attention to enable the network to focus more effectively on important features at each stage. Furthermore, the triple-branch multi-head self-attention mechanism leverages the different convolution layers to obtain diverse receptive fields, capture global contextual information, compensate for the local receptive field limitations of convolution operations, and boost the segmentation performance. We evaluate the segmentation performance of the proposed MAT-UNet using the Open Kidney US Data Set (OKUD). Results: For renal capsule segmentation, MAT-UNet achieves a Dice Similarity Coefficient (DSC) of 93.83%, a 95% Hausdorff Distance (HD95) of 32.02 mm, an Average Surface Distance (ASD) of 9.80 mm, and an Intersection over Union (IOU) of 88.74%. Additionally, MAT-UNet achieves a DSC of 84.34%, HD95 of 35.79 mm, ASD of 11.17 mm, and IOU of 74.26% for central echo complex segmentation; a DSC of 66.34%, HD95 of 82.54 mm, ASD of 19.52 mm, and IOU of 51.78% for renal medulla segmentation; and a DSC of 58.93%, HD95 of 107.02 mm, ASD of 21.69 mm, and IOU of 43.61% for renal cortex segmentation. Conclusions: The experimental results demonstrate that our proposed MAT-UNet achieves superior performance in multiple renal structure segmentation in ultrasound images. Full article

This study evaluated the effect of ultrasonic pulse-assisted extraction on the yield and antioxidant activity of essential oils from grapefruit (Citrus paradisi) by-products using hydrodistillation and Soxhlet solvent extraction (hexane, acetone, ethanol). Ultrasound was applied at 40% amplitude for 20 min before extraction. Results showed that ultrasound significantly increased extraction yield with hexane (from 2.6 ± 0.58% to 7.6 ± 1.5%) and acetone (from 8.6 ± 0.96% to 12 ± 1.4%), while ultrasound-assisted hydrodistillation nearly doubled the yield (from 0.7 ± 0.03% to 1.5 ± 0.49%). In contrast, ultrasound decreased yield with ethanol by 3%. Antioxidant activity measured by TEAC assay was highest in acetone extracts without ultrasound (13,366.5 ± 7.66 mmol TE/g) and ethanol extracts (12,606.8 ± 0.51 mmol TE/g). However, ultrasound combined with ethanol increased DPPH scavenging activity from 1073.5 ± 1.07 µg/mL to 4933.3 ± 0.71 µg/mL and maintained high flavonoid content (9.41 ± 0.15 mg/mL) and phenolics (5.33 ± 0.09 mg/mL). Ultrasound-assisted hydrodistillation also enhanced antioxidant capacity, with DPPH values rising from 51.82 ± 5.56 µg/mL to 2413.03 ± 3.17 µg/mL. These findings demonstrate that ultrasound effectively enhances essential oil extraction and antioxidant activity depending on the solvent used, underscoring the potential of this clean technology for valorizing citrus by-products. Full article

Background/Objectives: Scars are formed from trauma to the dermis and more specifically during the wound-healing phase. Skin needling is a technique used in scar therapy which stimulates the skin to regenerate. The aim of this study was to objectively and subjectively evaluate the degree of scar reduction after skin needling treatments based on visible changes using specialized measuring devices—ultrasound, Courage & Khazaka, and standardized questionnaires. Methods: Six patients were enrolled. Participants were given a series of three skin needling treatments. Before and after the treatment, the participants were examined for selected skin parameters with the help of specialized measuring devices such as Courage & Khazaka and skin ultrasound. Skin firmness and elasticity and MEP and HEP skin echogenicity were taken into account. Each patient completed POSAS questionnaires on satisfaction, pain, and adverse effects. Results: Based on the results of the POSAS questionnaire, a significant improvement in patients’ scar evaluation was observed after the treatment. Patients reported the most noticeable improvements in parameters such as color (p = 0.035), stiffness (p = 0.009), thickness (p = 0.041), and irregularity (0.007). An improvement in scar elasticity was observed in all subjects after treatment. Conclusions: Skin needling treatment combined with the skin needling technique and post-treatment skincare is an effective method of scar therapy, and the risk of side effects or complications after a series of treatments is low. Full article

Background/Objectives: Accurate diagnosis of thyroid cancer is critical but challenging due to overlapping ultrasound (US) features of benign and malignant nodules. This study aimed to evaluate the diagnostic performance of non-invasive and minimally invasive US techniques, including B-mode US, shear wave elastography (SWE), color Doppler, superb microvascular imaging (SMI), and TI-RADS, in patients with suspected thyroid lesions and to assess their reliability and cost effectiveness compared with fine needle aspiration (FNA) biopsy. Methods: A prospective, single-center study (October 2023–February 2025) enrolled 300 patients with suspected thyroid cancer at a Spanish tertiary hospital. Of these, 296 patients with confirmed diagnoses underwent B-mode US, SWE, Doppler, SMI, and TI-RADS scoring, followed by US-guided FNA and Bethesda System cytopathology. Lasso-penalized logistic regression and a bootstrap analysis (1000 replicates) were used to develop diagnostic models. A utility function was used to balance diagnostic reliability and cost. Results: Thyroid cancer was diagnosed in 25 patients (8.3%). Elastography combined with SMI achieved the highest diagnostic performance (Youden index: 0.69; NPV: 97.4%; PPV: 69.1%), outperforming Doppler-only models. Intranodular vascularization was a significant risk factor, while peripheral vascularization was protective. The utility function showed that, when prioritizing cost, elastography plus SMI was cost effective (α < 0.716) compared with FNA. Conclusions: Elastography plus SMI offers a reliable, cost-effective diagnostic rule for thyroid cancer. The utility function aids clinicians in balancing reliability and cost. SMI and generalizability need to be validated in higher prevalence settings. Full article

Avocado (Persea americana), originally from Mesoamerica, has emerged as a focus of intense scientific and industrial interest due to its unique combination of nutritional richness, bioactive potential, and technological versatility. Its pulp, widely consumed across the globe, is notably abundant in monounsaturated fatty acids, especially oleic acid, which can comprise over two-thirds of its lipid content. In addition, it provides significant levels of dietary fiber, fat-soluble vitamins such as A, D, E and K, carotenoids, tocopherols, and phytosterols like β-sitosterol. These constituents are consistently associated with antioxidant, anti-inflammatory, glycemic regulatory, and cardioprotective effects, supported by a growing body of experimental and clinical evidence. This review offers a comprehensive and critical synthesis of the chemical composition and functional properties of avocado, with particular emphasis on its lipid profile, phenolic compounds, and phytosterols. It also explores recent advances in environmentally sustainable extraction techniques, including ultrasound-assisted and microwave-assisted processes, as well as the application of natural deep eutectic solvents. These technologies have demonstrated improved efficiency in recovering bioactives while aligning with the principles of green chemistry. The use of avocado-derived ingredients in nanostructured delivery systems and their incorporation into functional foods, cosmetics, and health-promoting formulations is discussed in detail. Additionally, the potential of native cultivars and the application of precision nutrition strategies are identified as promising avenues for future innovation. Taken together, the findings underscore the avocado’s relevance as a high-value matrix for sustainable development. Future research should focus on optimizing extraction protocols, clarifying pharmacokinetic behavior, and ensuring long-term safety in diverse applications. Full article

The growing demand for food and the environmental impact of conventional agriculture have prompted the search for sustainable alternatives. Phycocyanin (PC) and total phenolic compounds (TPC) extracted from Spirulina platensis have shown potential for the biological control of phytopathogens. The extraction method directly influences the yield and stability of these compounds. This study aimed to establish an efficient extraction protocol for PC and TPC and to evaluate their antimicrobial efficacy in vitro against Colletotrichum orchidearum, Fusarium nirenbergiae, and Alternaria sp. isolated from hydroponically grown lettuce. The phytopathogens were identified based on phylogenetic analyses using sequences from the ITS, EF1-α, GAPDH, and RPB2 gene regions. This is the first report of C. orchidearum in hydroponic lettuce culture in Brazil, expanding its known host range. Extracts were obtained using hydroalcoholic solvents and phosphate buffer (PB), combined with ultrasound-assisted extraction (bath and probe). The extracts were tested for in vitro antifungal activity. Data were analyzed by ANOVA (p < 0.05), followed by Tukey’s test. The combination of the PB and ultrasound probe resulted in the highest PC (95.6 mg·g⁻¹ biomass) and TPC (21.9 mg GAE·g⁻¹) yields, using 10% (w/v) biomass. After UV sterilization, the extract retained its PC and TPC content. The extract inhibited C. orchidearum by up to 53.52% after three days and F. nirenbergiae by 54.17% on the first day. However, it promoted the growth of Alternaria sp. These findings indicate that S. platensis extracts are a promising alternative for the biological control of C. orchidearum and F. nirenbergiae in hydroponic systems. Full article

Background: Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler (TCD) ultrasound parameters, cognitive performance, and depressive symptoms in older adults with mild cognitive impairment (MCI) and LLD. Importantly, we evaluated the integrative value of TCD-derived indices alongside MRI-confirmed white matter lesions (WMLs) and standardized neurocognitive and affective assessments. Methods: In this cross-sectional study, 96 older adults were enrolled including 78 cognitively unimpaired individuals and 18 with MCI. All participants underwent structured clinical, neuropsychological, and imaging evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), MRI-based Fazekas scoring of WMLs, and TCD ultrasonography of the middle cerebral artery. Hemodynamic variables included mean blood flow velocity (MBFV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI). Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of MCI. Results: Participants with MCI showed significantly lower MBFV and EDV, and higher PI and RI (p < 0.05 for all) compared with cognitively unimpaired participants. In multivariate analysis, lower MBFV (OR = 0.64, p = 0.02) and EDV (OR = 0.70, p = 0.03), and higher PI (OR = 3.2, p < 0.01) and RI (OR = 1.9, p < 0.01) remained independently associated with MCI. ROC analysis revealed excellent discriminative performance for RI (AUC = 0.919) and MBFV (AUC = 0.879). Furthermore, PI correlated positively with depressive symptom severity, while RI was inversely related to the GDS-15 scores. Conclusions: Our findings underscore the diagnostic utility of TCD-derived hemodynamic parameters—particularly RI and MBFV—in identifying early vascular contributions to cognitive and affective dysfunction in older adults. The integration of TCD with MRI-confirmed WML assessment and standardized cognitive/mood measures represents a novel and clinically practical multi-modal approach for neurovascular profiling in aging populations. Full article

In this study, a Z-scheme Ho₂InSbO₇/Ag₃PO₄ (HAO) heterojunction photocatalyst was successfully fabricated for the first time by ultrasound-assisted solvothermal method. The structural features, compositional components and morphological characteristics of the synthesized materials were thoroughly characterized by a series of techniques, including X-ray diffraction, Fourier transform infrared spectroscopy, Raman spectrum, X-ray photoelectron spectroscopy, transmission electron microscopy, scanning electron microscopy and energy-dispersive X-ray spectroscopy. A comprehensive array of analytical techniques, including ultraviolet-visible diffuse reflectance absorption spectra, photoluminescence spectroscopy, time-resolved photoluminescence spectroscopy, photocurrent testing, electrochemical impedance spectroscopy, electron paramagnetic resonance, and ultraviolet photoelectron spectroscopy, was employed to systematically investigate the optical, chemical, and photoelectronic properties of the materials. Using oxytetracycline (OTC), a representative tetracycline antibiotic, as the target substrate, the photocatalytic activity of the HAO composite was assessed under visible light irradiation. Comparative analyses demonstrated that the photocatalytic degradation capability of the HAO composite surpassed those of its individual components. Notably, during the degradation process, the application of the HAO composite resulted in an impressive removal efficiency of 99.89% for OTC within a span of 95 min, along with a total organic carbon mineralization rate of 98.35%. This outstanding photocatalytic performance could be ascribed to the efficient Z-scheme electron-hole separation system occurring between Ho₂InSbO₇ and Ag₃PO₄. Moreover, the adaptability and stability of the HAO heterojunction were thoroughly validated. Through experiments involving the capture of reactive species and electron paramagnetic resonance analysis, the active species generated by HAO were identified as hydroxyl radicals (•OH), superoxide anions (•O₂⁻), and holes (h⁺). This identification provides valuable insights into the mechanisms and pathways associated with the photodegradation of OTC. In conclusion, this research not only elucidates the potential of HAO as an efficient Z-scheme heterojunction photocatalyst but also marks a significant contribution to the advancement of sustainable remediation strategies for OTC contamination. Full article

Non-invasive ultrasound diagnosis, combined with deep learning, is frequently used for detecting thyroid diseases. However, real-time detection on portable devices faces limitations due to constrained computational resources, and existing models often lack sufficient capability for small object detection of thyroid nodules. To address this, this paper proposes an improved lightweight small object detection network framework called LISA-YOLO, which enhances the lightweight multi-scale collaborative fusion algorithm. The proposed framework exploits the inherent symmetrical characteristics of ultrasound images and the symmetrical architecture of the detection network to better capture and represent features of thyroid nodules. Specifically, an improved depthwise separable convolution algorithm replaces traditional convolution to construct a lightweight network (DG-FNet). Through symmetrical cross-scale fusion operations via FPN, detection accuracy is maintained while reducing computational overhead. Additionally, an improved bidirectional feature network (IMS F-NET) fully integrates the semantic and detailed information of high- and low-level features symmetrically, enhancing the representation capability for multi-scale features and improving the accuracy of small object detection. Finally, a collaborative attention mechanism (SAF-NET) uses a dual-channel and spatial attention mechanism to adaptively calibrate channel and spatial weights in a symmetric manner, effectively suppressing background noise and enabling the model to focus on small target areas in thyroid ultrasound images. Extensive experiments on two image datasets demonstrate that the proposed method achieves improvements of 2.3% in F1 score, 4.5% in mAP, and 9.0% in FPS, while maintaining only 2.6 M parameters and reducing GFLOPs from 6.1 to 5.8. The proposed framework provides significant advancements in lightweight real-time detection and demonstrates the important role of symmetry in enhancing the performance of ultrasound-based thyroid diagnosis. Full article