Fabrication Strategies for Bioceramic Scaffolds in Bone Tissue Engineering with Generative Design Applications.

The aim of this study is to provide an overview of the current state-of-the-art in the fabrication of bioceramic scaffolds for bone tissue engineering, with an emphasis on the use of three-dimensional (3D) technologies coupled with generative design principles. The field of modern medicine has witnessed remarkable advancements and continuous innovation in recent decades, driven by a relentless desire to improve patient outcomes and quality of life. Central to this progress is the field of tissue engineering, which holds immense promise for regenerative medicine applications. Scaffolds are integral to tissue engineering and serve as 3D frameworks that support cell attachment, proliferation, and differentiation. A wide array of materials has been explored for the fabrication of scaffolds, including bioceramics (i.e., hydroxyapatite, beta-tricalcium phosphate, bioglasses) and bioceramic-polymer composites, each offering unique properties and functionalities tailored to specific applications. Several fabrication methods, such as thermal-induced phase separation, electrospinning, freeze-drying, gas foaming, particle leaching/solvent casting, fused deposition modeling, 3D printing, stereolithography and selective laser sintering, will be introduced and thoroughly analyzed and discussed from the point of view of their unique characteristics, which have proven invaluable for obtaining bioceramic scaffolds. Moreover, by highlighting the important role of generative design in scaffold optimization, this review seeks to pave the way for the development of innovative strategies and personalized solutions to address significant gaps in the current literature, mainly related to complex bone defects in bone tissue engineering.

Online in-class vs. out-of-class flipped learning models in English as foreign language writing classes.

Flipped learning models are considered as important elements of English as a foreign language (EFL) writing courses in order to advance the EFL learners' writing skills. Significantly, studies examining the efficacy of in-class and out-of-class writing models in flipped classroom settings when teaching online EFL writing courses are still of focus in the Turkish Cypriot context. This investigation aimed to examine the most efficient flipped learning model among the in-class vs. out-of-class writing models for the purpose of helping instructors to advance their EFL learners' writing achievement in an online writing setting. In addition, this study sorted to reveal the EFL learners' perceptions toward learning writing through in-class and out-of-class flipped learning writing models. A mixed methods research design was applied to achieve the aforementioned aims. Twenty-eight EFL learners studying at a private university's English Language Teaching department constituted the participants of this study. As the findings pointed out, the EFL learners in group A who wrote their essays in-class outperformed those in group B, who wrote their essays out-of-class. Moreover, it was found that the majority of the participants had more positive perceptions toward the in-class flipped classroom writing model. This study highlights that, better learner performances are achieved when the learners write during the class session online with the support of the instructor when implementing a flipped classroom model to teach EFL writing.

Geometric morphometric study of anterior branches of external carotid artery and carotid bifurcation by 3D-CT angiography.

PURPOSE: The aim of our study was to determine the variations of the anterior branches of the external carotid artery (ECA) and investigate the morphometric and geometric features of the anterior branches of the ECA and carotid bifurcation (CB). METHODS: A total of 563 ECAs were included from 288 patients in the study. Classification and exit angles of anterior branches of ECA and determination of vertebral levels of CB and anterior branches were performed. RESULTS: The anterior branch variants of the ECA were observed in 8 different subgroups. The most common variations were type Ia 42.3% (n = 120) on the right and type Ib 40.9% (n = 114) on the left. When looking at the vertebral levels, CB was detected at C4 level in 32.9% of total ECAs (n = 185), STA was at C4 level in 33.4% of total ECAs (n = 188), LA was at C3 level in 50.1% of total ECAs (n = 282), and FA was at C2 level in 37.3% of total ECAs. The mean CB angle in all cases was 59.93° ± 16.04. In the anterior branches of the ECA in cases belonging to the Type I group, the widest angle belonged to FA (R = 116.88 ± 27.04°, L = 110.32° ± 25.94). CONCLUSION: In conclusion, a new classification of the variations of the anterior branches of the ECA was made on the basis of the CTA images to gain more practicality in surgical procedures. This study revealed for the first time the angular and level relationship between CB and ECA anterior branches.

Critical Thinking for Writing Using Facebook Under COVID-19 Lockdown: A Course Model for English Literature Students.

The aim of this paper is to explore the effectiveness of critical thinking for improving the writing skill of undergraduate Arab students who study English Literature at Saudi universities under lockdown circumstances due to the COVID-19 pandemic. At the same time, it explores the impact of implementing Facebook as an online Constructivist tool to improve this skill. A general overview of the status of English language education in Saudi Arabia is briefly presented to shed light on the ongoing English language challenges in learning writing for undergraduate students in the English language and literature departments, which got more manifested due to the current status of education mode with the emergence of the pandemic. Two-group posttest-only randomized experiment was employed to evaluate the effectiveness of the proposed model, using the infusion and constructivism approaches. A total of 40 students enrolled in a literature course at a private university in Saudi Arabia participated in the experiment. The treatment was conducted through utilizing Facebook. The results demonstrated that students' improvement in English writing was due to the combination of the infusion of a set of critical skills and the constructivist teaching and learning mode.

Structural, biocompatibility, and antibacterial properties of Ge-DLC nanocomposite for biomedical applications.

Integrative production of new nanocomposites has been used to enhance favorable features of biomaterials for unlocking ultimate potential of different molecules. In the present study, advantageous properties of diamond like carbons (DLC) and germanium (Ge) like greater biocompatibility and antibacterial attributes were aimed to combined into a thin film. For this purpose, 400 nm DLC-Ge nanocomposite was coated on the borosilicate glasses via the magnetron sputtering and surface characteristics was analyzed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and The Raman spectrum. Biocompatibility analysis were performed by 3-(4,5-Dimethylthiazol-2-yl) (MTT) cell viability assay and Hoechst 33258 fluorescent staining genotoxicity assessments on the human fibroblast cell line (HDFa). Finally, antibacterial properties of DLC-Ge nanocomposite coatings were investigated by Pseudomonas aeruginosa (ATCC 27853) and Staphylococcus aureus (ATCC 25923) bacterial attachment analysis. As a result of magnetron sputtering coating, nearly 400 nm thick DLC-Ge nanocomposite film showed a smooth, a non-porous, and a dense characteristic. Cell viability analysis showed that Ge-DLC coatings permits %95 cell surface growth of fibroblast cells. Also, there were no significant difference in aspect of nuclear abnormalities compared to the (-) control which showed nonmutagenic features of the thin film. Finally, antibacterial attachment analysis put forth that Ge-DLC coatings inhibits bacterial adhesion as %40 and %25 rates for P. aeruginosa and S. aureus bacterial strains, respectively. From these results, DLC-Ge nanocomposites could be proposed as a potential new biomaterial for various biomedical applications.

Undescribed polyether ionophores from Streptomyces cacaoi and their antibacterial and antiproliferative activities.

Polyether ionophores represent a large group of naturally occurring compounds mainly produced by Streptomyces species. With previously proven varieties of bioactivity including antibacterial, antifungal, antiparasitic, antiviral and anti-tumor effects, the discovery of undescribed polyethers leading to development of efficient therapeutics has become important. As part of our research on polyether-rich Streptomyces cacaoi, we previously performed modification studies on fermentation conditions to induce synthesis of specialized metabolites. Here, we report four undescribed and nine known polyether compounds from S. cacaoi grown in optimized conditions. Antimicrobial activity assays revealed that four compounds, including the undescribed (6), showed strong inhibitory effects over both Bacillus subtilis and methicillin-resistant Staphylococcus aureus (MRSA) growth. Additionally, K41-A and its C15-demethoxy derivative exhibited significant cytotoxicity. These results signified that selectivity of C15-demethoxy K41-A towards cancer cells was higher than K41-A, which prompted us to conduct mechanistic experiments. These studies showed that this uninvestigated compound acts as a multitarget compound by inhibiting autophagic flux, inducing reactive oxygen species formation, abolishing proteasome activity, and stimulating ER stress. Consequently, the optimized fermentation conditions of S. cacaoi led to the isolation of undescribed and known polyethers displaying promising activities.

Tribological, biocompatibility, and antibiofilm properties of tungsten-germanium coating using magnetron sputtering.

In this study, borosilicate glass and 316 L stainless steel were coated with germanium (Ge) and tungsten (W) metals using the Magnetron Sputtering System. Surface structural, mechanical, and tribological properties of uncoated and coated samples were examined using SEM, X-ray diffraction (XRD), energy-dispersive spectroscopy, and tribometer. The XRD results showed that WGe2 chemical compound observed in (110) crystalline phase and exhibited a dense structure. According to the tribological analyses, the adhesion strength of the coated deposition on 316 L was obtained 32.8 N, and the mean coefficient of friction was around 0.3. Biocompatibility studies of coated metallic biomaterials were analyzed on fibroblast cell culture (Primary Dermal Fibroblast; Normal, Human, Adult (HDFa)) in vitro. Hoescht 33258 fluorescent staining was performed to investigate the cellular density and chromosomal abnormalities of the HDFa cell line on the borosilicate glasses coated with germanium-tungsten (W-Ge). Cell viabilities of HDFa cell line on each surface (W-Ge coated borosilicate glass, uncoated borosilicate glass, and cell culture plate surface) were analyzed by using (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cytotoxicity assay. The antibiofilm activity of W-Ge coated borosilicate glass showed a significant reduction effect on Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) adherence compared to control groups. In the light of findings, tungsten and germanium, which are some of the most common industrial materials, were investigated as biocompatible and antimicrobial surface coatings and recommended as bio-implant materials for the first time.

Design of EM-artifact-free earphone based on the photoacoustic effect.

Electromagnetic interactions between conventional earphones and the electroencephalography (EEG) electrodes used for analyzing brain waves give rise to efficiency problems in neurophysiological studies of auditory perception. Currently used speakers and headphones are electromagnetic devices based on strong magnets. In spite of intensive use of such systems, there has been no effective way to eliminate the electromagnetic artifacts produced by such audio transmitting devices to date. The ability for transferring audible sounds without the use of electromagnetic devices that can affect the EEG signal would open up many innovative possibilities in Audio Technologies. Audible sound transfer over long distances is possible by the photoacoustic effect. In such studies, the modulated optical signal can be converted into an audible signal arising from the absorption of the light energy of relevant molecules. In this study, we propose an earphone based on the photoacoustic effect, and calculated the dB SPL (Sound Pressure Level) values for a spherical cell filled with olive pomace. By the use of the method of Diebold and Westervelt, we theoretically calculated the sound pressure levels for our cell and determined a 60 dB SPL at a sound frequency of 1000 Hz for our preliminary earphone design.

A novel approach recommendation for hazard analysis.

Hazard evaluation generally defines the ranking of hazards in the work environment and ignores the interaction of hazards. This article aims to overcome this drawback using a fuzzy cognitive map (FCM) approach to analyze the interaction of hazards related to sheathing tasks in a construction firm. The FCM approach can be insufficient for hazard evaluation over the long term due to certain budget and time restrictions allocated by the firm. When the firm allocates more time and budget for a process, the firm must limit the allocated time and budget for the other processes. This article aims to overcome this problem so linear programming is used to optimize the goal and resources of the firm. The article contributes to hazard evaluation of sheathing tasks in a construction firm considering the interaction of the hazards and the capacity of the firm.

Hazard analysis using a Bayesian network and linear programming.

In order to make a system safer, it is necessary to determine which hazard should be removed by considering the interactions of all hazards in the process. In this study, the influence of the hazards related to iron works in a construction firm is examined by Bayesian network approach. If only the most important hazard is identified and removed from the work environment, it may be erroneous to comment on the levels of the remaining hazards. A Bayesian network is proposed to remove this problem. If there is more time and budget than planned for a process, these capacities will have to be reduced in other processes. Linear programming is proposed to remove this problem. A strong decision support system has been established by combining a Bayesian network and linear programming. A construction firm application has been demonstrated using the proposed method.

Impact of UV-C radiation on growth of micro and macro algae in irrigation systems.

Sustainability of irrigation systems is crucially important for both economical and efficient usage of natural water sources. Irrigation system efficiency could be negatively affected by some natural flora such as micro (Arthrospira maxima) and macro (Cladophora sp.) algae. In this study, efficiency of UV-C radiation, which has been proven effectiveness in demolishing of bacteria and microbes in medicine, for micro and macro algae. Our study was performed under laboratory conditions and was carried out in two main phases. In the first phase, spectral absorbance curves were established for micro and macro algae, the greatest absorbance value was determined in UV region (300 nm to 450 nm). In the second phase, to analyze the growth of algae species depending on UV-C illumination, micro algae within three different basins with the same cross-sectional area and different water depths (D1:12.5 cm, D2:25 cm, D3:45cm) were exposed to UV-C radiation for different durations (2, 4, 6, 8 and 16 s). The maximum inhibition on the growth rate of A. maxima was observed in 16 s UV-C radiation treatment groups of D1 and D2 basins. Since Cladophora sp. macro algae are aquatic weeds floating over the water surface, they were exposed to UV-C radiation similar to micro algae only in D1 basin. The greatest reduction rate in biomass values of Cladophora sp. was observed in 16 s UV-C exposed groups. The experimental findings showed that UV-C radiation could be used to reduce growth of micro and macro algae. It was concluded based on present findings that UV-C radiation could reliably be used for efficient water use in open or closed irrigation systems.

Relation of red cell distribution width with dipper and non-dipper hypertension.

Aim Red cell distribution width (RDW), an index of erythrocyte size, is associated with high risk for cardiovascular disease. Nondipping hypertension (HT) is lack of nocturnal fall in blood pressure(BP). The association between RDW and non-dipping BP in normotensive and hypertensive patients was investigated. Methods A total of 170 patients were categorized into 4 groups: Normotensive-Dipper (NT-D), Normotensive-Non-dipper (NTND), Hypertensive-Dipper (HT-D) and Hypertensive-Non-dipper(HT-ND). RDW and hs-CRP levels were measured. Results Hypertensive patients had higher RDW and hs-CRP levels(14.5 ± 0.87 vs.12.7 ± 0.66, p<0.001 for RDW; 0.99 ± 0.52 vs.0.63 ± 0.43, p<0.001 for hs-CRP). Besides, the RDW levels were higher in non-dippers (13.0 ± 0.63 vs.12.4 ± 0.55, p<0.001 for NT-ND and NT-D; 14.9 ± 0.78 vs.14.2 ± 0.82, p<0.001 for HT-ND and HT-D) Conclusion RDW is elevated in non-dipping BP both in normotensive and hypertensive subjects, which may be related with increased inflammatory state.

The spectroscopic (FT-IR, FT-Raman, dispersive Raman and NMR) study of ethyl-6-chloronicotinate molecule by combined density functional theory.

In this study, ethyl-6-chloronicotinate (E-6-ClN) molecule is recorded in the region 4000-400 cm(-1) and 3500-100 cm(-1) (FT-IR, FT-Raman and dispersive Raman, respectively) in the solid phase. ((1))H and ((13))C nuclear magnetic resonance (NMR) spectra are recorded in DMSO solution. The structural and spectroscopic data of the molecule are obtained for two possible isomers (S1 and S2) from DFT (B3LYP) with 6-311++G(d,p) basis set calculations. The geometry of the molecule is fully optimized, vibrational spectra are calculated and fundamental vibrations are assigned on the basis of the potential energy distribution (PED) of the vibrational modes. ((1))H and ((13))C NMR chemical shifts are calculated by using the gauge-invariant atomic orbital (GIAO) method. The electronic properties, such as excitation energies, oscillator strengths, wavelengths, HOMO and LUMO energies, are performed by time-dependent density functional theory (TD-DFT). Total and partial density of state and overlap population density of state diagrams analysis are presented for E-6-ClN molecule. Furthermore, frontier molecular orbitals (FMO), molecular electrostatic potential, and thermodynamic features are performed. In addition to these, reduced density gradient of the molecule is performed and discussed. As a conclusion, the calculated results are compared with the experimental spectra of the title compound. The results of the calculations are applied to simulate the vibrational spectra of the molecule, which show excellent agreement with the observed ones. The theoretical and tentative results will give us a detailed description of the structural and physicochemical properties of the molecule. Natural bond orbital analysis is done to have more information stability of the molecule arising from charge delocalization, and to reveal the information regarding charge transfer within the molecules.

The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study.

BACKGROUND: Red cell distribution width (RDW) is an indicator of erythrocyte in different size, and its prognostic value has been demonstrated in numerous cardiac and non-cardiac diseases. The purpose of this study was to evaluate the predictive value of RDW on the long- -term cardiovascular events in patients undergoing primary percutaneous coronary intervention (PCI). METHODS: Ninety-six consecutive patients (mean age 60.6 ± 12.5 years, 77.1% male) with ST-segment elevation myocardial infarction (STEMI), who were treated with primary PCI, were analyzed prospectively. Baseline RDW and high sensitive C-reactive protein (hs-CRP) were measured. The patients were followed up for major adverse cardiac events (MACE) for up to 48 months after discharge. RESULTS: There were 30 patients with long-term MACE (Group 1) and 66 patients without long-term MACE (Group 2). Age, admission RDW, hs-CRP and creatine kinase-MB levels, heart rate after PCI, previously used angiotensin converting enzyme inhibitor, left anterior descending artery lesion, and electrocardiographic no-reflow were higher in Group 1. Admission hemoglobin levels were lower in Group 1. An RDW level ≥ 13.85% measured on admission had 80% sensitivity and 64% specificity in predicting long-term MACE on receiver-operating characteristic curve analysis. In multivariate analyses, only admission RDW (HR 5.26, < 95% CI 1.71-16.10; p = 0.004) was an independent predictor of long-term MACE. CONCLUSIONS: A high baseline RDW value in patients with STEMI undergoing primary PCI is independently associated with increased risk for long term MACE.

Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study.

BACKGROUND: Psoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. OBJECTIVES: This study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. METHODS: The study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. RESULTS: Patients with psoriasis had significantly lower mean ± standard deviation (SD) 4C (17.1 ± 1.7 vs. 19.2 ± 2.3; P < 0.01), LAX (16.6 ± 1.5 vs. 19.5 ± 2.3; P < 0.01), and 2C (16.5 ± 1.5 vs. 19.4 ± 2.2; P < 0.01) peak longitudinal strain values compared with the control group. Moreover, mean ± SD LV global strain (16.6 ± 1.5 vs. 19.9 ± 2.1; P < 0.01) and strain rate (1.39 ± 0.30 vs. 1.51 ± 0.20; P < 0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (ß = 0.29, P = 0.04), duration of disease (ß = 0.35, P < 0.01), ejection fraction (EF) (ß = 0.38, P =0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E' ratio) (ß = 0.34, P =0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (ß = 0.36, P < 0.01), EF (ß = 0.32, P = 0.01), and E/E' ratio (ß = 0.35, P < 0.01). CONCLUSIONS: Using 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.

Thrombus aspiration in patients with ST elevation myocardial infarction: meta-analysis of 16 randomized trials.

OBJECTIVE: The mortality rate is high in some patients undergoing primary percutaneous coronary intervention (PPCI) because of ineffective epicardial and myocardial perfusion. The use of thrombus aspiration (TA) might be beneficial in this group but there is contradictory evidence in current trials. Therefore, using PRISMA statement, we performed a meta-analysis that compares PPCI+TA with PPCI alone. METHODS: Sixteen studies in which PPCI (n=5262) versus PPCI+TA (n=5256) were performed, were included in this meta-analysis. We calculated the risk ratio (RR) for epicardial and myocardial perfusion, such as the Thrombolysis In myocardial Infarction (TIMI) flow, myocardial blush grade (MBG) and stent thrombosis (ST) resolution (STR), and clinical outcomes, such as all-cause death, recurrent infarction (Re-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), stent thrombosis (ST), and stroke. RESULTS: Postprocedural TIMI-III flow frequency, postprocedural MBG II-III flow frequency, and postprocedural STR were significantly high in TA+PPCI compared with the PPCI alone group. However, neither all-cause mortality [6.6% vs. 7.4%, RR=0.903, 95% confidence interval (CI): 0.785-1.038, p=0.149] nor Re-MI (2.3% vs. 2.6%, RR=0.884, 95% CI: 0.693-1.127, p=0.319), TVR/TLR (8.2% vs. 8.0%, RR=1.028, 95% CI: 0.900-1.174, p=0.687), ST (0.93% vs. 0.90%, RR=1.029, 95% CI: 0.668-1.583, p=0.898), and stroke (0.5% vs. 0.5%, RR=1.073, 95% CI: 0.588-1.959, p=0.819) rates were comparable between the groups. CONCLUSION: This meta-analysis is the first updated analysis after publishing the 1-year result of the "Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction" trial, and it showed that TA did not reduce the rate of all-cause mortality, Re-MI, TVR/TLR, ST, and stroke.

Relation of fragmented QRS to tissue Doppler-derived parametersin patients with familial Mediterranean fever.

BACKGROUND: Familial Mediterranean fever (FMF) may pose a risk for cardiovascular diseases due to continuous inflammatory status observed during the course of the disease. Recently, the presence of fragmented QRS (fQRS) has been recognized as a predictor of myocardial fibrosis. In this study, we aim to investigate the frequency of fQRS and its relation to Doppler-based indices. METHODS: This study consisted of 80 FMF patients and 30 healthy control subjects. fQRS pattern was defined as the presence of additional R waves or RSR', evidenced by notched R or S wave on electrocardiography (ECG). The patient and the control groups underwent conventional echocardiography and tissue Doppler echocardiography. RESULTS: There was no significant difference between groups regarding age (29 ± 12 vs 29 ± 15). FMF patients exhibited a statistically higher frequency of fQRS (% 56 vs % 13) (p < 0.01). E/Em ratio showed a statistically significant increase in the FMF group with fQRS (p < 0.0001), while the mean Em value was markedly lower (p < 0.0001). CONCLUSIONS: FMF patients displayed a statistically significant increase in frequency of fQRS. Doppler-derived diastolic index was statistically significantly impaired in FMF patients with fQRS as compared with the patients without fQRS. In conclusion, fQRS might be a new noninvasive marker for cardiac involvement in FMF patients.

Low bilirubin levels are associated with coronary slow flow phenomenon.

BACKGROUND AND AIM: Increasing evidence suggests an inverse relationship between bilirubin levels and cardiovascular disease. The present study evaluated the effect of bilirubin level on the slow coronary flow (SCF) phenomenon. METHODS: This study was cross-sectional and observational. We enrolled 222 consecutive patients who underwent coronary angiography for suspected ischaemic heart disease and were found to have normal or near-normal coronary arteries. Then, bilirubin levels were measured and coronary flow rate was assessed using the thrombolysis in myocardial infarction (TIMI) frame count. SCF was defined as a TIMI frame count > 27 frames. RESULTS: SCF was observed in at least one coronary vessel in 22 of the 222 subjects, indicating a prevalence of 10%. Serum bilirubin levels were significantly decreased in the SCF group. In multivariate logistic regression analysis, total bilirubin and diabetes mellitus were independent risk factors for SCF. Furthermore, after adjusting for age, sex, and cardiovascular disease risk factors, serum bilirubin level (B = -0.34, p < 0.001) was independently associated with TIMI frame count. CONCLUSIONS: These findings suggest that serum total bilirubin levels may be a useful marker for patients with the SCF phenomenon. We believe that further studies are needed to clarify the role of bilirubin in patients with SCF.

Effect of remote ischemic postconditioning on left ventricular mechanics.

BACKGROUND: Remote ischemic postconditioning (RIPC) decreases infarct size and prevents left ventricular (LV) remodeling in patients with myocardial infarction. However, there is no study that evaluates the effect of RIPC on LV mechanics assessed by speckle tracking echocardiography. Therefore, we aimed to test the effects of RIPC on LV deformation parameters such as strain, strain rate, rotation, and twist in healthy subjects. METHODS: The study group consisted of 22 healthy subjects. To test the effects of RIPC, 3 cycles of reperfusion followed by ischemia (each lasting 10 or 30 seconds) were applied immediately after 20 minutes of nondominant arm ischemia. Transthoracic echocardiography (TTE) was obtained at baseline and repeated 30 minutes after the completion of these cycles. In TTE images, apical 4-3-2 chamber longitudinal strain (LS)/strain rate, basal and apical circumferential strain/strain rate, and rotational parameters, such as basal rotation, apical rotation, and LV twist, were recorded. RESULTS: Apical 4-3-2 chamber LS and apical circumferential strain/strain rate measurements were comparable before and after RIPC, whereas basal circumferential strain was significantly decreased after RIPC (-23 ± 3.4 vs. -18.9 ± 6.9, P = 0.017). After RIPC, apical rotation was significantly increased (11.6 ± 3.7 vs. 16.7 ± 4.0, P < 0.001) and basal rotation was significantly decreased (-6.1 ± 2.1 vs. -4.7 ± 2.4, P = 0.03).Consequently, net LV twist was significantly increased (17.4 ± 4.5 vs. 21.7 ± 4.7). CONCLUSIONS: We proposed that RIPC affects the rotational mechanics of the heart rather than longitudinal mechanics. These results might give new insights into understanding the favorable effects of the post- conditioning.