Structure function interface with sequential shortening of basal and apical components of the myocardial band

Objective: To mechanically test the intact cardiac structure to determine the sequence of contraction within the myocardial mass to try to explain ejection and suction. Methods: In 24 pigs (30–85 kg), segment shortening at the site of sonomicrometer crystals was continuously recorded. The ECG evaluated rhythm, and Millar pressure transducers measured intraventricular pressure and dP/dt. Results: Study of segment shortening defined a sequence of contraction within the myocardial mass, starting at the free wall of the right ventricle and on the endocardial side of the antero-septal wall of the left. Crystal location defined underlying contractile trajectory; transverse in right ventricle followed by basal posterior left ventricle, and from the endocardial anterior wall to the posterior apical segment and finally to the epicardial side of the anterior wall. Mean shortening fraction averaged 18±3%, with endocardial exceeding epicardial shortening by 5±1%. Epicardial segment crystal displacement followed endocardial shortening by 82±23 ms in the anterior wall, and finished 92±33 ms after endocardial shortening stopped, time frame that matches the interval of fast drop of ventricular pressure and the start of suction. Conclusions: Crystal shortening fraction sequence followed the rope-like myocardial band model to contradict traditional thinking, with two starting points of excitation–contraction, the right anterior free wall of the right ventricle, and the endocardial side of the anterior wall. Active suction may be due to active shortening of the epicardial fibers of the anterior wall, because relaxation was not detected when both mitral and aortic valves were closed during the interval previously termed ‘isovolumetric relaxation’.     

The therapeutic effect of cerium oxide nanoparticle on ischaemia/reperfusion injury in rat testis

Testicular torsion is a dangerous urogenital disorder which is caused by twisting of spermatic cord, and unless immediate treatments happen at a proper time, oxidative stress, occurred during ischaemia reperfusion, finally leads to irreversible disintegration of testicular tissue. One of the first preventive lines is to administrate antioxidant factors. In the present study, we investigate the therapeutic effect of cerium oxide nanoparticle on the injury. We divided 45 rats into nine groups, subjected eight groups to testicular torsion–detorsion, injected different doses of cerium oxide nanoparticle into the peritoneum of six groups and analysed all the groups regarding spermatogenetic indices including sperm count, sperm viability and Johnson mean. Our results showed that cerium oxide nanoparticle can alleviate oxidative stress in testis, and this alleviation promotes the reproductive indices as the concentration of cerium oxide nanoparticles increases. The catalase-mimetic and superoxide dismutase-mimetic activities of cerium oxide nanoparticle are the most probable theories to explain the antioxidant effect of the nanoparticle.     

Does the Use of a Tourniquet Influence Outcomes in Total Knee Arthroplasty: A Randomized Controlled Trial

BackgroundIntraoperative tourniquet use in total knee arthroplasty (TKA) is a common practice which may improve visualization of the surgical field and reduce blood loss. However, the safety and efficacy associated with tourniquet use continues to be a subject of debate among orthopedic surgeons. The primary purpose of this study is to evaluate the effects of tourniquet use on pain and opioid consumption after TKA.MethodsThis is a multicenter randomized controlled trial among patients undergoing TKA. Patients were preoperatively randomized to undergo TKA with or without the use of an intraoperative tourniquet. Frequency distributions, means, and standard deviations were used to describe baseline patient demographics (age, gender, race, body mass index, smoking status), length of stay, surgical factors, visual analog scale pain scores, and opioid consumption in morphine milligram equivalents.ResultsA total of 327 patients were included in this study, with 166 patients undergoing TKA without a tourniquet and 161 patients with a tourniquet. A statistically significant difference was found in surgical time (97.87 vs 92.98 minutes; P = .05), whereas none was found for length of stay (1.73 vs 1.70 days; P = .87), postop visual analog scale pain scores (1.73 vs 1.70; P = .87), inpatient opioid consumption (19.84 vs 19.27 morphine milligram equivalents; P = .74), or outpatient opioid consumption between the tourniquet-less and tourniquet cohorts, respectively. There were no readmissions in either cohort during the 90-day episode of care.ConclusionUtilization of a tourniquet during TKA has minimal impact on postoperative pain scores and opioid consumption when compared with patients who underwent TKA without a tourniquet.     

ASO Visual Abstract: Chemotherapy After Diagnosis of Malignant Bowel Obstruction is Associated with Greater Survival for Medicare Patients with Advanced Malignancy

Annals of Surgical Oncology -     

Microstructural Evolution during Accelerated Tensile Creep Test of ZK60/SiCp Composite after KoBo Extrusion

In the current study, the creep properties of magnesium alloy reinforced with SiC particles were investigated. For this purpose, ZK60/SiCp composite was produced by the stir casting method following the KoBo extrusion and precipitation hardening processes. The creep tests were performed at 150 °C under 10–110 MPa. The results showed that the stress exponent (n) and the average true activation energy (Q) was changed at high stresses, was found with increasing stress, the creep mechanism changing from grain boundary sliding to dislocation climb. The results of microstructure characterization after the creep test showed that at low stresses, the dynamic recrystallization resulting from twinning induced the GBS mechanism. However, at high stresses, with increasing diffusion rates, conditions are provided for dynamic precipitation and the dislocation climb of the dominant creep mechanism. Examination of the fracture surfaces and the surrounding areas showed that the cavity nucleation in the ternary boundary and surrounding precipitation was the main cause of damage. The evaluation of the samples texture after creep showed that the unreinforced alloy showed a moderately strong fiber texture along the angle of ϕ₁ = 0–90°, which was tilted about Φ = 10°. A new strong texture component was observed at (90°, 5°, 0°) for the composite sample, which crept due to minor splitting of the basal pole by ~5° toward RD.     

An Improved Optimization Model to Predict the MOR of Glulam Prepared by UF-Oxidized Starch Adhesive: A Hybrid Artificial Neural Network-Modified Genetic Algorithm Optimization Approach

The purpose of the present article is to study the bending strength of glulam prepared by plane tree (Platanus Orientalis-L) wood layers adhered by UF resin with different formaldehyde to urea molar ratios containing the modified starch adhesive with different NaOCl concentrations. Artificial neural network (ANN) as a modern tool was used to predict this response, too. The multilayer perceptron (MLP) models were used to predict the modulus of rapture (MOR) and the statistics, including the determination coefficient (R²), root mean square error (RMSE), and mean absolute percentage error (MAPE) were used to validate the prediction. Combining the ANN and the genetic algorithm by using the multiple objective and nonlinear constraint functions, the optimum point was determined based on the experimental and estimated data, respectively. The characterization analysis, performed by FTIR and XRD, was used to describe the effect of the inputs on the output. The results indicated that the statistics obtained show excellent MOR predictions by the feed-forward neural network using Levenberg–Marquardt algorithms. The comparison of the optimal output of the actual values obtained by the genetic algorithm resulting from the multi-objective function and the optimal output of the values estimated by the nonlinear constraint function indicates a minimum difference between both functions.