Safety and efficacy of the OdonAssist inflatable device for assisted vaginal birth: the BESANCON ASSIST study.

BACKGROUND: The first feasibility study of the OdonAssist inflatable device for use in clinically indicated assisted vaginal birth reported a success rate of 48% with no significant safety concerns. Additional studies exploring the device performance in other clinical settings are warranted before definitive conclusions can be drawn about its safety and efficacy in current practice. OBJECTIVE: This study aimed to investigate the safety and efficacy of the OdonAssist before conducting a randomized controlled trial. STUDY DESIGN: This was an open-label, nonrandomized study of 104 women with a clinically indicated assisted vaginal birth using the OdonAssist at the Besancon University Hospital, France. Data, including those of a nested cohort group of women who had an assisted vaginal birth using vacuum or spatulas because a trained OdonAssist device operator was not available at the time of delivery, were collected. The primary outcome measure was the proportion of successful assisted vaginal births using the OdonAssist. Neonatal outcome data were reviewed at days 1 and 28, and maternal outcomes were investigated up to day 90. RESULTS: Between December 2019 and May 2021, 2191 pregnant women were approached, and 83% (1636/1973) of them consented to participate in the study. Among them, 10.7% (176/1636) required an assisted vaginal birth owing to a vertex presentation at +1 and below. The OdonAssist was used in 59% of births (104/176), and 41.1% (72/176) of the participants were included in the nested cohort group. The rate of successful assisted vaginal births using the OdonAssist was 88.5% (92/104). No emergency cesarean deliveries were performed in the OdonAssist group. There were no serious adverse maternal or neonatal reactions related to the use of the device. The rate of third- and fourth-degree perineal tears with the OdonAssist was 3.8% (4/104). The maternal perception ratings of the birth experience with the OdonAssist (collected on days 1, 7, and 28 using a 15-point scale) were high. In addition, the operators reported a positive perception of the device, with ease of use across the different steps of the procedure. One single technique was used for all vertex fetal head positions. CONCLUSION: The OdonAssist is a safe and effective alternative to other current devices for assisted vaginal births. The high acceptance rate (83%) among pregnant women and the high rate of successful assisted vaginal births using the OdonAssist confirm the feasibility of a future randomized controlled trial.

Ultrasonography for the Diagnosis and Follow-Up of Extramammary Paget Disease (EMPD): A Review.

Extramammary Paget disease (EMPD) is a rare skin tumor that manifests as poorly delimited lesions located mainly in genital area. Prognosis correlates with thickness and dermal invasion. The gold standard for diagnosis is the histopathological study of a biopsy. However, this technique is invasive and only shows a small area of the tumor. A good correlation has been reported between ultrasounds (US) and histopathologic finding. Moreover, a US examination has the advantages of wide availability, noninvasiveness, low cost, ease of use, and real-time scanning. We review the ultrasound signs described for this disease.

Influence of serum uric acid on bone and fracture risk in postmenopausal women.

AIMS: Uric acid has been associated with several metabolic conditions, including bone diseases. Our objective here was to consider the relationship between serum uric acid levels and various bone parameters (bone mineral density, ultrasonographic parameters, vitamin D, PTH and serum calcium), as well as the prevalence and risk of fragility fracture. METHODS: An observational and cross-sectional study carried out on 679 postmenopausal women, classified into 3 groups according to their serum uric acid levels, in whom bone densitometry, calcaneus ultrasounds, PTH, vitamin D and serum calcium analysis were done. Bone fractures were collected through the clinical history and lateral spinal X-ray. RESULTS: Higher uric acid levels were found in women with older age, high BMI, diabetes, and high blood pressure. Higher levels of PTH and serum calcium were also observed, but did not effect on vitamin D. Serum uric acid was positively related to densitometric and ultrasonic parameters and negatively associated with vertebral fractures. CONCLUSIONS: In the population of postmenopausal women studied, sUA levels were correlated with BMD, BUA, and QUI-Stiffness, and this correlation was independent of age and BMI. In addition, sUA was associated with a decrease in vertebral fractures. These results imply a beneficial influence of sUA on bone metabolism, with both a quantitative and qualitative positive effect, reflected in the lower prevalence of vertebral fractures.

Toward a theranostic device for gliomas.

BACKGROUND: In the surgical management of glioblastoma, a highly aggressive and incurable type of brain cancer, identification and treatment of residual tissue is the most common site of disease recurrence. Monitoring and localized treatment are achieved with engineered microbubbles (MBs) by combining ultrasound and fluorescence imaging with actively targeted temozolomide (TMZ) delivery. METHODS: The MBs were conjugated with a near-infrared fluorescence probe CF790, cyclic pentapeptide bearing the RGD sequence and a carboxyl-temozolomide, TMZA. The efficiency of adhesion to HUVEC cells was assessed in vitro in realistic physiological conditions of shear rate and vascular dimensions. Cytotoxicity of TMZA-loaded MBs on U87 MG cells and IC50 were assessed by MTT tests. RESULTS: We report on the design of injectable poly(vinyl alcohol) echogenic MBs designed as a platform with active targeting ability to tumor tissues, by tethering on the surface a ligand having the tripeptide sequence, RGD. The biorecognition of RGD-MBs onto HUVEC cells is quantitatively proved. Efficient NIR emission from the CF790-decorated MBs was successfully detected. The conjugation on the MBs surface of a specific drug as TMZ is achieved. The pharmacological activity of the coupled-to-surface drug is preserved by controlling the reaction conditions. CONCLUSIONS: We present an improved formulation of PVA-MBs to achieve a multifunctional device with adhesion ability, cytotoxicity on glioblastoma cells and supporting imaging.

Breast Ultrasound Images Augmentation and Segmentation Using GAN with Identity Block and Modified U-Net 3.

One of the most prevalent diseases affecting women in recent years is breast cancer. Early breast cancer detection can help in the treatment, lower the infection risk, and worsen the results. This paper presents a hybrid approach for augmentation and segmenting breast cancer. The framework contains two main stages: augmentation and segmentation of ultrasound images. The augmentation of the ultrasounds is applied using generative adversarial networks (GAN) with nonlinear identity block, label smoothing, and a new loss function. The segmentation of the ultrasounds applied a modified U-Net 3+. The hybrid approach achieves efficient results in the segmentation and augmentation steps compared with the other available methods for the same task. The modified version of the GAN with the nonlinear identity block overcomes different types of modified GAN in the ultrasound augmentation process, such as speckle GAN, UltraGAN, and deep convolutional GAN. The modified U-Net 3+ also overcomes the different architectures of U-Nets in the segmentation process. The GAN with nonlinear identity blocks achieved an inception score of 14.32 and a Fréchet inception distance of 41.86 in the augmenting process. The GAN with identity achieves a smaller value in Fréchet inception distance (FID) and a bigger value in inception score; these results prove the model's efficiency compared with other versions of GAN in the augmentation process. The modified U-Net 3+ architecture achieved a Dice Score of 95.49% and an Accuracy of 95.67%.

Effects of Low-Intensity Pulsed Ultrasound-Induced Blood-Brain Barrier Opening in P301S Mice Modeling Alzheimer's Disease Tauopathies.

Alzheimer's disease (AD) is the leading cause of dementia. No treatments have led to clinically meaningful impacts. A major obstacle for peripherally administered therapeutics targeting the central nervous system is related to the blood-brain barrier (BBB). Ultrasounds associated with microbubbles have been shown to transiently and safely open the BBB. In AD mouse models, the sole BBB opening with no adjunct drugs may be sufficient to reduce lesions and mitigate cognitive decline. However, these therapeutic effects are for now mainly assessed in preclinical mouse models of amyloidosis and remain less documented in tau lesions. The aim of the present study was therefore to evaluate the effects of repeated BBB opening using low-intensity pulsed ultrasounds (LIPU) in tau transgenic P301S mice with two main readouts: tau-positive lesions and microglial cells. Our results show that LIPU-induced BBB opening does not decrease tau pathology and may even potentiate the accumulation of pathological tau in selected brain regions. In addition, LIPU-BBB opening in P301S mice strongly reduced microglia densities in brain parenchyma, suggesting an anti-inflammatory action. These results provide a baseline for future studies using LIPU-BBB opening, such as adjunct drug therapies, in animal models and in AD patients.

Cavitation-Effect-Based Treatments and Extractions for Superior Fruit and Milk Valorisation.

Ultrasound generates cavities in liquids with high-energy behaviour due to large pressure variations, leading to (bio)chemical effects and material modification. Numerous cavity-based treatments in food processes have been reported, but the transition from research to industrial applications is hampered by specific engineering factors, such as the combination of several ultrasound sources, more powerful wave generators or tank geometry. The challenges and development of cavity-based treatments developed for the food industry are reviewed with examples limited to two representative raw materials (fruit and milk) with significantly different properties. Both active compound extraction and food processing techniques based on ultrasound are taken into consideration.

Recent Developments in Sonochemical Synthesis of Nanoporous Materials.

Ultrasounds are commonly used in medical imaging, solution homogenization, navigation, and ranging, but they are also a great energy source for chemical reactions. Sonochemistry uses ultrasounds and thus realizes one of the basic concepts of green chemistry, i.e., energy savings. Moreover, reduced reaction time, mostly using water as a solvent, and better product yields are among the many factors that make ultrasound-induced reactions greener than those performed under conventional conditions. Sonochemistry has been successfully implemented for the preparation of various materials; this review covers sonochemically synthesized nanoporous materials. For instance, sonochemical-assisted methods afforded ordered mesoporous silicas, spherical mesoporous silicas, periodic mesoporous organosilicas, various metal oxides, biomass-derived activated carbons, carbon nanotubes, diverse metal-organic frameworks, and covalent organic frameworks. Among these materials, highly porous samples have also been prepared, such as garlic peel-derived activated carbon with an apparent specific surface area of 3887 m2/g and MOF-177 with an SSA of 4898 m2/g. Additionally, many of them have been examined for practical usage in gas adsorption, water treatment, catalysis, and energy storage-related applications, yielding satisfactory results.

Green Synthesis of Aromatic Nitrogen-Containing Heterocycles by Catalytic and Non-Traditional Activation Methods.

Recent advances in the environmentally benign synthesis of aromatic N-heterocycles are reviewed, focusing primarily on the application of catalytic methods and non-traditional activation. This account features two main parts: the preparation of single ring N-heterocycles, and their condensed analogs. Both groups include compounds with one, two and more N-atoms. Due to the large number of protocols, this account focuses on providing representative examples to feature the available methods.

Study and optimization of oil-in-water emulsions formulated by low- and high-frequency ultrasounds.

OBJECTIVE: A combined treatment using both low-frequency (20 kHz) and high-frequency ultrasounds (1.63 MHz) is a promising new process to stabilize emulsions with minimalist formulation. In order to optimize process parameters, a Doehlert experimental design was performed with oil-in-water emulsions, presently used for cosmetic products, composed of water, caprylic/capric triglycerides and oleic acid. METHODS: Effects of treatment time, oil content and oleic acid content were studied on emulsion properties (droplet size, polydispersity index, ζ-potential and yield of oil incorporation) and on emulsion stability after a 28-day storage (creaming index, Turbiscan stability index (TSI) and oil release). RESULTS: From experimental data, a model was established that allowed to study effects of each parameter and their interactions on emulsion formation and stability. Oleic acid content had a great impact on emulsion formation: It reduced droplet size, PDI and ζ-potential and increased yield of oil incorporation. However, a critical value could be highlighted, beyond which oleic acid effects reversed. Treatment time had an important beneficial effect on emulsion stability as it decreased creaming index, TSI and oil release after 28 days of storage. Oil content had a negative effect on emulsion formation and on emulsion stability. However, treatment time and oil content often had a beneficial synergistic effect. CONCLUSION: The optimized conditions for emulsion processing were obtained through a desirability approach. They were experimentally validated.

OBJECTIF: Un traitement combiné utilisant à la fois des ultrasons à basse fréquence(20 kHz) et à haute fréquence (1,63 MHz) est un nouveau procédé prometteur pour stabiliser les émulsions avec une formulation minimaliste. Afin d'optimiser les paramètres du procédé, un plan d'expériences de Doehlert a été réalisé avec des émulsions huile-dans- eau, actuellement utilisées pour des produits cosmétiques, composées d'eau, de triglycérides capryliques/capriques et d'acide oléique. METHODES: Les effets du temps de traitement, de la teneur en huile et de la teneur en acide oléique ont été étudiés sur les propriétés des émulsions (taille des gouttelettes, indice de polydispersité, potentiel-ζ et rendement d'incorporation de l'huile) et sur la stabilité des émulsions après un stockage de 28 jours (indice de crémage, indice de stabilité au Turbiscan (TSI) et relargage de l'huile). RESULTATS: A partir des données expérimentales, un modèle a été établi et a permis d'étudier les effets de chaque paramètre et leurs interactions sur la formation et la stabilité des émulsions. La teneur en acide oléique a eu un impact important sur la formation des émulsions : elle a réduit la taille des gouttelettes, le PDI et le potentiel-ζ, et a augmenté le rendement d'incorporation de l'huile. Cependant, une valeur critique a pu être mise en évidence, au-delà de laquelle les effets de l'acide oléique s'inversent. Le temps de traitement a eu un effet bénéfique important sur la stabilité des émulsions car il a diminué l'indice de crémage, le TSI et le relargage d'huile après 28 jours de stockage. La teneur en huile a eu un effet négatif sur la formation des émulsions et sur leur stabilité. Cependant, le temps de traitement et la teneur en huile ont souvent eu un effet synergique bénéfique. CONCLUSION: Les conditions optimisées pour le traitement des émulsions ont été obtenues par une approche de désirabilité. Elles ont été validées expérimentalement.

Ultrasound-assisted extraction of oil from hempseed (Cannabis sativa L.): Part 2.

BACKGROUND: Oilseed-matrix consolidation is a crucial factor when talking about oil expression because, as the cake consolidates, the coefficient of permeability inevitably decreases. Thus, any treatment that extensively ruptures cell walls reduces rigidity and hardness of the oilseed press-cake, while improving the oil expression. Such process intensification was investigated in the present study through the introduction of the ultrasound (US) technology. Screw pressing of Cannabis sativa L. seeds was operated using a pilot scale equipment set at three different pressures (low, medium and high) to understand the correlation with the ultrasound effectiveness. Samples of non-exhausted press-cakes were tested for objective instrumental indices of compressibility and oil expression yields prior and after the US treatment. RESULTS: US led to a drag resistance reduction within press-cakes, improving oil flowability through a decrease in the material cohesiveness and adhesiveness. Consistently, sonication favoured oil extraction yields and oil antioxidant capacities, which increased with respect to the untreated samples, respectively equal to +19.2% and + 29.4% for the press-cake screwed at low pressure, to +21.8% and + 49.3% at medium pressure, and to +15.4% and + 0.5% at high pressure. Overall, US highest effectiveness was accounted for samples screwed at medium pressure. CONCLUSION: Press-cake compressibility can be well described by macroscopic texture parameters; indeed, their decrease is linked to higher oil expression efficiencies. Sonication can help boosting oil extraction yields reducing drag resistance within the mechanical screwing equipment. These outcomes offer good potentials for US application in the hempseed technology and, more extensively, in the oil seed industry. © 2022 Society of Chemical Industry.

A Qualitative and Quantitative Study to Evaluate the Effectiveness and Safety of Magnetic Stimulation in Women with Urinary Incontinence Symptoms and Pelvic Floor Disorders.

Background and objectives: Involuntary loss of urine owed to dysfunction of the detrusor muscle or muscles of the pelvic floor is known as urinary incontinence (UI). In this study, ultrasound monitoring was employed for the first time to measure the usefulness and safety of electromagnetic stimulation for women with Stress or Urge UI. Materials and Methods: A total of 62 women were enrolled, with a mean age of 55.1 (±14.5); 60% of them were menopausal and presented with urinary incontinence (UI). Eight validated questionnaires were used to evaluate Stress UI, prolapse, overactive bladder urge, faecal incontinence, and quality of life, and the whole study population was tested with ultrasounds at the beginning and at the end of the treatment cycle. The device used was a non-invasive electromagnetic therapeutic system composed of a main unit and an adjustable chair applicator shaped for deep pelvic floor area stimulation. Results: Ultrasound measurements and validated questionnaires revealed a consistent and statistically significant (p < 0.01) improvement of the mean scores when pre- and post-treatment data were considered. Conclusions: Study results showed that the proposed treatment strategy led to a significant improvement in Pelvic Floor Muscle (PFM) tone and strength in patients with UI and pelvic floor disorders, without discomfort or side effects. The demonstration was qualitatively carried out with validated questionnaires and quantitatively with ultrasounds exams. Thus, the "chair" device we used represents valuable and effective support that could be widely employed in the gynaecological field for patients affected by different pathologies.

Ultrasound and nanomaterial: an efficient pair to fight cancer.

Ultrasounds are often used in cancer treatment protocols, e.g. to collect tumor tissues in the right location using ultrasound-guided biopsy, to image the region of the tumor using more affordable and easier to use apparatus than MRI and CT, or to ablate tumor tissues using HIFU. The efficacy of these methods can be further improved by combining them with various nano-systems, thus enabling: (i) a better resolution of ultrasound imaging, allowing for example the visualization of angiogenic blood vessels, (ii) the specific tumor targeting of anti-tumor chemotherapeutic drugs or gases attached to or encapsulated in nano-systems and released in a controlled manner in the tumor under ultrasound application, (iii) tumor treatment at tumor site using more moderate heating temperatures than with HIFU. Furthermore, some nano-systems display adjustable sizes, i.e. nanobubbles can grow into micro-bubbles. Such dual size is advantageous since it enables gathering within the same unit the targeting properties of nano bubbles via EPR effect and the enhanced ultrasound contrasting properties of micro bubbles. Interestingly, the way in which nano-systems act against a tumor could in principle also be adjusted by accurately selecting the nano-system among a large choice and by tuning the values of the ultrasound parameters, which can lead, due to their mechanical nature, to specific effects such as cavitation that are usually not observed with purely electromagnetic waves and can potentially help destroying the tumor. This review highlights the clinical potential of these combined treatments that can improve the benefit/risk ratio of current cancer treatments.

Renal complications and quality of life in postsurgical hypoparathyroidism: a case-control study.

PURPOSE: Conventional therapy (calcium and activated vitamin D) does not restore calcium homeostasis in patients with chronic hypoparathyroidism (HypoPT) and is associated with renal complications and reduced quality of life (QoL). The aim of this study was to evaluate in a case-control, cross-sectional study, the rate of renal complications and QoL in two sex- and age-matched cohort of patients with differentiated thyroid cancer with (n = 89) and without (n = 89) chronic post-operative HypoPT (PoHypoPT) and their relationship with the biochemical control of the disease. METHODS: Serum and urinary parameters, renal ultrasound and QoL were assessed by SF-36 and WHO-5 questionnaires. RESULTS: Forty-three (48.3%) PoHypoPT patients reported symptoms of hypocalcemia. Twenty-six (29.2%) patients were at target for all 6 parameters, 46 (51.6%) for 5. The most frequently unmet targets were gender-specific 24-h urinary calcium (44.9%) and serum calcium (37.1%). Serum phosphate, magnesium and 25(OH)D were in the normal range in > 90% of patients. Renal calcifications were found in 26 (29.2%) patients, with no correlation with 24-h urinary calcium. eGFR did not differ between patients and controls. Conversely, patients had a significant higher rate of renal calcifications and a lower SF-36, but not WHO-5, scores. SF-36 scores did not differ between PoHypoPT patients who were, or not, hypocalcemic. CONCLUSIONS: Our study shows that the rate of renal calcifications was higher in patients with PoHypoPT than in those without. This finding, together with the reduced QoL and the presence of hypocalcemic symptoms in about half patients, underscores that the treatment of chronic HypoPT with conventional therapy is suboptimal.

Renal Resistive Index: Not Only for Kidney Clinics.

Renal Resistive Index (RRI) is a measurement of the resistance of the renal blood flow. A value higher than 0.70 is a marker of increased resistance and is correlated with kidney injury and its severity. Additionally, it may be associated with the mortality rate in the post-surgery population. In COVID-19 subjects, we found that high RRI has been associated with high levels of serum C-reactive protein, a marker of systemic inflammatory reaction syndrome. Finally, we propose RRI not only as a marker of kidney injury, but also as a tool to evaluate the course of critical illness.

Modified FMCW Scheme for Improved Ultrasonic Positioning and Ranging of Unmanned Ground Vehicles at Distances < 50 mm

Unmanned ground vehicles (UGVs) find extensive use in various applications, including that within industrial environments. Efforts have been made to develop cheap, portable, and light-ranging/positioning systems to accurately locate their absolute/relative position and to automatically avoid potential obstacles and/or collisions with other drones. To this aim, a promising solution is the use of ultrasonic systems, which can be set up on UGVs and can potentially output a precise reconstruction of the drone's surroundings. In this framework, a so-called frequency-modulated continuous wave (FMCW) scheme is widely employed as a distance estimator. However, this technique suffers from low repeatability and accuracy at ranges of less than 50 mm when used in combination with low-resource hardware and commercial narrowband transducers, which is a distance range of the utmost importance to avoid potential collisions and/or imaging UGV surroundings. We hereby propose a modified FMCW-based scheme using an ad hoc time-shift of the reference signal. This was shown to improve performance at ranges below 50 mm while leaving the signal unaltered at greater distances. The capabilities of the modified FMCW were evaluated numerically and experimentally. A dramatic enhancement in performance was found for the proposed FMCW with respect to its standard counterpart, which is very close to that of the correlation approach. This work paves the way for the future use of FMCWs in applications requiring high precision.

Compact Interrogation System of Fiber Bragg Grating Sensors Based on Multiheterodyne Dispersion Interferometry for Dynamic Strain Measurements.

Dual-comb multiheterodyne spectroscopy is a well-established technology for the highly sensitive real-time detection and measurement of the optical spectra of samples, including gases and fiber sensors. However, a common drawback of dual-comb spectroscopy is the need for a broadband amplitude-resolved absorption or reflection measurement, which increases the complexity of the dual comb and requires the precise calibration of the optical detection. In the present study, we present an alternative dispersion-based approach applied to fiber Bragg grating sensors in which the dual comb is compacted by a single dual-drive-unit optical modulator, and the fiber sensor is part of a dispersion interferometer. The incident dual comb samples a few points in the spectrum that are sensitive to Bragg wavelength changes through the optical phase. The spectra reading is improved due to the external interferometer and is desensitized to changes in the amplitude of the comb tones. The narrow-band detection of the fiber sensor dispersion changes that we demonstrate enables the compact, cost-effective, high-resolution multiheterodyne interrogation of high-throughput interferometric fiber sensors. These characteristics open its application both to the detection of fast phenomena, such as ultrasound, and to the precise measurement at high speed of chemical-/biological-sensing samples. The results with a low-reflectivity fiber Bragg grating show the detection of dynamic strain in the range of 215 nε with a 30 dB signal to noise ratio and up to 130 kHz (ultrasonic range).

Oesophageal balloon positioning by echocardiography to guide positive pressure ventilation.

Understanding the respiratory mechanics of ARDS patients is crucial to avoid ventilator-induced lung injury (VILI), and this is much more challenging if not only lung compliance is altered but the whole compliance of the respiratory system is abnormal, as in obese patients. We face this problem daily in the ICU, and to optimize ventilation, we estimate respiratory mechanics using an oesophageal balloon. The balloon position is crucial to assess reliable values. In the present technical note, we describe the use of echocardiography to confirm the correct position of this instrument.

High-Frequency Ultrasound of Facial Filler Materials in the Nasolabial Groove.

BACKGROUND: Various dermal fillers are often used for nasolabial groove filling. High-frequency ultrasonography might be a valuable tool for assessing facial filler materials. METHODS: The facial ultrasound images of plastic surgery hospital of the Chinese Academy of Medical Sciences from November 2014 to November 2021 were analyzed and judged. RESULTS: A total of 94 patients who underwent high-frequency ultrasound with a nasolabial groove filler were included in the study. Hyaluronic acid was detected in 35 cases, polyacrylamide in 34 cases, lipofilling in 10 cases, silicon oil in seven cases, calcium hydroxyapatite in six cases, and silicone implant in two cases. The ultrasonic performance of hyaluronic acid was divided into four types: aggregation, diffusion, mixed pattern, and associated infection; of polyacrylamide was divided into five types: aggregation and inclusion, aggregation and non-inclusion, diffusion, mixed pattern, and associated infection; and of lipofilling was divided into four types: aggregation, diffusion, fat liquefaction necrosis, and cystic change. Echo intensity, echo characteristics, boundary clarity, fluidity, and blood flow signals can be used as the basis for identifying filler materials. CONCLUSION: High-frequency ultrasound has an identification significance for the filling materials in the area of nasolabial groove. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Nanomaterials as Ultrasound Theragnostic Tools for Heart Disease Treatment/Diagnosis.

A variety of different nanomaterials (NMs) such as microbubbles (MBs), nanobubbles (NBs), nanodroplets (NDs), and silica hollow meso-structures have been tested as ultrasound contrast agents for the detection of heart diseases. The inner part of these NMs is made gaseous to yield an ultrasound contrast, which arises from the difference in acoustic impedance between the interior and exterior of such a structure. Furthermore, to specifically achieve a contrast in the diseased heart region (DHR), NMs can be designed to target this region in essentially three different ways (i.e., passively when NMs are small enough to diffuse through the holes of the vessels supplying the DHR, actively by being associated with a ligand that recognizes a receptor of the DHR, or magnetically by applying a magnetic field orientated in the direction of the DHR on a NM responding to such stimulus). The localization and resolution of ultrasound imaging can be further improved by applying ultrasounds in the DHR, by increasing the ultrasound frequency, or by using harmonic, sub-harmonic, or super-resolution imaging. Local imaging can be achieved with other non-gaseous NMs of metallic composition (i.e., essentially made of Au) by using photoacoustic imaging, thus widening the range of NMs usable for cardiac applications. These contrast agents may also have a therapeutic efficacy by carrying/activating/releasing a heart disease drug, by triggering ultrasound targeted microbubble destruction or enhanced cavitation in the DHR, for example, resulting in thrombolysis or helping to prevent heart transplant rejection.