Prediction of neurologic outcome after out-of-hospital cardiac arrest: An interpretable approach with machine learning.

Out-of-hospital cardiac arrest (OHCA) is a critical condition with low survival rates. In patients with a return of spontaneous circulation, brain injury is a leading cause of death. In this study, we propose an interpretable machine learning approach for predicting neurologic outcome after OHCA, using information available at the time of hospital admission. METHODS: The study population were 55 615 OHCA cases registered in the Swedish Cardiopulmonary Resuscitation Registry between 2010 and 2020. The dataset was split to training and validation sets (for model development) and test set (for evaluation of the final model). We used an XGBoost algorithm with stratified, repeated 10-fold cross-validation along with Optuna framework for hyperparameters tuning. The final model was trained on 10 features selected based on the importance scores and evaluated on the test set in terms of discrimination, calibration and bias-variance tradeoff. We used SHapley Additive exPlanations to address the 'black-box' model and align with eXplainable artificial intelligence. RESULTS: The final model achieved: area under the receiver operating characteristic value 0.964 (95% confidence interval (CI) [0.960-0.968]), sensitivity 0.606 (95% CI [0.573-0.634]), specificity 0.975 (95% CI [0.972-0.978]), positive predictive value (PPV) 0.664 (95% CI [0.625-0.696]), negative predictive value (NPV) 0.969 (95% CI [0.966-0.972]), macro F1 0.803 (95% CI [0.788-0.816]), and showed a very good calibration. SHAP features with the highest impact on the model's output were:'ROSC on arrival to hospital', 'Initial rhythm asystole' and 'Conscious on arrival to hospital'. CONCLUSIONS: The XGBoost machine learning model with 10 features available at the time of hospital admission showed good performance for predicting neurologic outcome after OHCA, with no apparent signs of overfitting.

The Recyclability of Fire-Retarded Biobased Polyamide 11 (PA11) Composites Reinforced with Basalt Fibers (BFs): The Influence of Reprocessing on Structure, Properties, and Fire Behavior.

The growing requirements regarding the safety of using polymers and their composites are related to the emergence of more effective, sustainable, and hazardous-limited fire retardants (FRs). Significant amounts of FRs are usually required to effectively affect a polymer's burning behavior, while the knowledge of their recycling potential is still insufficient. At the same time, concerns are related not only to the reduced effectiveness of flame retardancy but also, above all, to the potential deterioration of mechanical properties caused by the degradation of temperature-affected additives under processing conditions. This study describes the impact of the four-time reprocessing of bio-based polyamide 11 (PA11) modified with an intumescent flame-retardant (IFR) system composed of ammonium polyphosphate (APP), melamine cyanurate (MC), and pentaerythritol (PER) and its composites containing additional short basalt fibers (BFs). Composites manufactured via twin-screw extrusion were subjected to four reprocessing cycles using injection molding. A comprehensive analysis of their structural, mechanical, and fire behavior changes in each cycle was conducted. The obtained results confirmed the safety of using the proposed fire-retarded polyamide and its composites while reprocessing under the recommended process parameters without the risk of significant changes in the structure. The partial increase in flammability of reprocessed PA-based materials caused mainly by polymer degradation has been described.

Clinical and echocardiographic characterization of patients hospitalized for severe tricuspid valve regurgitation: a single tertiary-care center experience with 2-year follow-up.

INTRODUCTION: Tricuspid regurgitation (TR) is a common acquired valvular heart disease. Recently, new transcatheter treatment options for severe TR have emerged that could change management of this condition, which warrants better characterization of this specific patient group. OBJECTIVES: The aim of the study was to describe the clinical and echocardiographic characteristics of patients with severe TR and to evaluate their short- and mid­term prognosis. PATIENTS AND METHODS: This retrospective, observational, single­center study enrolled consecutive patients with severe TR hospitalized between January 2016 and September 2021 in the Department of Cardiology, Medical University of Warsaw, Poland. The severity of heart failure (HF) was evaluated using the New York Heart Association classification. Echocardiographic assessment was performed by an experienced sonographer. EuroSCORE II and TRI­SCORE models were computed for each patient, and 12- and 24­month clinical outcomes were reported. RESULTS: The study comprised 172 patients (93 women [54.1%]) at a mean (SD) age of 76.4 (10.5) years. The most common comorbidities included: atrial fibrillation (84.9%), hypertension (68%), chronic kidney disease (54.1%), coronary artery disease (45.3%), and diabetes mellitus (30.9%). The median (interquartile range) EuroSCORE II and TRI­SCORE values were 4.68% (2.88%-8.05%) and 14% (5%-34%), respectively. The median follow­up was 24 (8.5-41) months. The overall mortality was 29.7% at 1 year and 47.3% at 2 years. TR grade, tricuspid annular plane systolic excursion (TAPSE) above 17 mm, TAPSE to systolic pulmonary artery pressure ratio below 0.26, and increased right atrial area were significant factors associated with mortality. CONCLUSIONS: Patients presenting with severe TR are characterized by a large comorbidity burden and poor prognosis, despite intensive HF management.

Mechanical and Rheological Evaluation of Polyester-Based Composites Containing Biochar.

The use of biodegradable polymers as matrices in composites gives a wide range of applications, especially in niche areas. The assessment of the effect of the filler content on the change of mechanical properties makes it possible to optimize the composition for specific needs. Biochar was used as a filler in the studied composites with two different biodegradable blends as a matrix. Poly(1,4-butylene adipate-co-1,4-butylene terephthalate)/polylactide/biochar (PBAT/PLA/BC) and polylactide/poly[(R)-3-hydroxybutyrate-co-4-hydroxybutyrate]/biochar (PLA/P(3HB-co-4HB)/BC) composites with 0, 10, 15, 20 and 30 wt% of biochar underwent mechanical tests. The test results revealed a change in the properties of the composites related to the filler content. The results of the tensile test showed that increasing the biochar content increased the tensile modulus values by up to 100% for composites with 30 wt% of biochar, compared to unfilled matrices, and decreased the elongation associated with the breaking of PBAT/PLA and PLA/P(3HB-co-4HB) matrix composites. The elongation values at break of PBAT/PLA and PLA/(3HB-co-4HB) composites with 30 wt% biochar were reduced by 50% and 65%, respectively, compared to the unfilled matrices. PLA/P(3HB-co-4HB) matrix composites, in contrast to PBAT/PLA/BC, showed a decrease in tensile strength with the increases in filler content from 35.6 MPa for unfilled matrix to 27.1 MPa for PLA/P(3HB-co-4HB)/BC30 composites. An increase in filler content increased the brittleness of the composites regardless of the matrix used, as determined under the Charpy impact-test. This phenomenon was observed for all tested PLA/P(3HB-co-4HB) composites, for which the impact strength decreased from 4.47 kJ/m2 for the matrix to 1.61 kJ/m2 for the composite containing 30 wt% biochar. PBAT/PLA-based composites with 10 wt% of biochar showed slightly lower impact strength compared to the unfilled matrix, but composites with 30 wt% biochar showed 30% lower impact strength than PBAT/PLA. The complex viscosity value increased with increased filler content. For all composites tested on both polyester matrices, the viscosity decreased with increasing angular frequency.

Prediction of survival in out-of-hospital cardiac arrest: the updated Swedish cardiac arrest risk score (SCARS) model.

Aims: Out-of-hospital cardiac arrest (OHCA) is a major health concern worldwide. Although one-third of all patients achieve a return of spontaneous circulation and may undergo a difficult period in the intensive care unit, only 1 in 10 survive. This study aims to improve our previously developed machine learning model for early prognostication of survival in OHCA. Methods and results: We studied all cases registered in the Swedish Cardiopulmonary Resuscitation Registry during 2010 and 2020 (n = 55 615). We compared the predictive performance of extreme gradient boosting (XGB), light gradient boosting machine (LightGBM), logistic regression, CatBoost, random forest, and TabNet. For each framework, we developed models that optimized (i) a weighted F1 score to penalize models that yielded more false negatives and (ii) a precision-recall area under the curve (PR AUC). LightGBM assigned higher importance values to a larger set of variables, while XGB made predictions using fewer predictors. The area under the curve receiver operating characteristic (AUC ROC) scores for LightGBM were 0.958 (optimized for weighted F1) and 0.961 (optimized for a PR AUC), while for XGB, the scores were 0.958 and 0.960, respectively. The calibration plots showed a subtle underestimation of survival for LightGBM, contrasting with a mild overestimation for XGB models. In the crucial range of 0-10% likelihood of survival, the XGB model, optimized with the PR AUC, emerged as a clinically safe model. Conclusion: We improved our previous prediction model by creating a parsimonious model with an AUC ROC at 0.96, with excellent calibration and no apparent risk of underestimating survival in the critical probability range (0-10%). The model is available at www.gocares.se.

More than just a beer - Brewers' spent grain, spent hops, and spent yeast as potential functional fillers for polymer composites.

Beer is among the most popular beverages in the world, with the production distributed uniformly between the biggest continents, so the utilization of brewing by-products is essential on a global scale. Among their potential recipients, the plastics industry offers extensive range of potential products. Herein, the presented study investigated the application of currently underutilized solid brewing by-products (brewers' spent grain, spent hops, spent yeast) as fillers for highly-filled poly(ε-caprolactone)-based composites, providing the first direct connection between spent hops or spent yeast and the polymer composites. Comprehensive by-product characterization revealed differences in chemical composition. The elemental C:O ratio, protein content, and Trolox equivalent antioxidant capacity varied from 1.40 to 1.89, 12.9 to 32.4 wt%, and 2.41 to 10.24 mg/g, respectively, which was mirrored in the composites' structure and performance. Morphological analysis pointed to the composition-driven hydrophilicity gap limiting interfacial adhesion for high shares of brewers' spent grain and spent hops, due to high hydrophilicity induced by carbohydrate content. Phytochemicals and other components of applied by-products stimulated composites' oxidative resistance, shifting oxidation onset temperature from 261 °C for matrix over 360 °C for high spent yeast shares. Simultaneously, spent yeast also provided compatibilizing effects for poly(ε-caprolactone)-based composites, reducing complex viscosity compared to other fillers and indicating its highest affinity to poly(ε-caprolactone)due to the lowest hydrophilicity gap. The presented results indicate that the proper selection of brewing by-products and adjustment of their shares creates an exciting possibility of engineering composites' structure and performance, which can be transferred to other polymers differing with hydrophilicity.

An update on cardiovascular disorders in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a complex multifactorial etiology that develops as a result of autoimmune processes, leading to widespread inflammation and malfunction of multiple tissues and organs, and, as a consequence, triggers arterial hypertension, conduction disorders, valvular heart disease, pulmonary hypertension (PH), and venous thromboembolism events (VTE), contributing to increased mortality. Moreover, autoimmune abnormalities can accelerate atherogenesis and lead to many SLE manifestations, including coronary artery disease (CAD) and cerebrovascular events. The current review aimed to systematize existing data from the latest works and summarize published guidelines and recommendations. In particular, the prevalence of cardiovascular disorders in SLE patients, advances in diagnostics (including imaging methods and biomarker laboratory testing), the possible future direction of therapy, and the latest European Alliance of Associations for Rheumatology (EULAR) guidelines for optimal management of cardiovascular risk in SLE were overviewed.

The Influence of the Modification of Carbon Nanotubes on the Properties of Copper Matrix Sintered Materials.

This paper presents the results of research on the microstructure, mechanical, and tribological properties of Cu/0.5 wt.% MWCNT (multi-walled carbon nanotube) sintered composite materials produced by powder metallurgy. The purpose of this research was to investigate the impact of carbon nanotube modifications on the uniformity of their dispersion and the effectiveness of their bonding with the matrix. The MWCNTs were modified by chemical oxidation. Additionally, a modification of the ingredient mixing method utilizing ultrasonic frequencies was employed. The tests were carried out using scanning electron microscopy (SEM), transmission electron microscopy (TEM), Vickers hardness tests, static compression tests, and wear tests using the pin-on-disc method. Furthermore, mechanical properties and strain distribution analyses of the micro-specimens were conducted using the Micro-Fatigue System (MFS). The implemented modifications had a positive effect on the dispersion of MWCNTs in the copper matrix and on the mechanical and tribological properties of the sinters.

Fire-Retardant Flexible Foamed Polyurethane (PU)-Based Composites: Armed and Charmed Ground Tire Rubber (GTR) Particles.

Inadequate fire resistance of polymers raises questions about their advanced applications. Flexible polyurethane (PU) foams have myriad applications but inherently suffer from very high flammability. Because of the dependency of the ultimate properties (mechanical and damping performance) of PU foams on their cellular structure, reinforcement of PU with additives brings about further concerns. Though they are highly flammable and known for their environmental consequences, rubber wastes are desired from a circularity standpoint, which can also improve the mechanical properties of PU foams. In this work, melamine cyanurate (MC), melamine polyphosphate (MPP), and ammonium polyphosphate (APP) are used as well-known flame retardants (FRs) to develop highly fire-retardant ground tire rubber (GTR) particles for flexible PU foams. Analysis of the burning behavior of the resulting PU/GTR composites revealed that the armed GTR particles endowed PU with reduced flammability expressed by over 30% increase in limiting oxygen index, 50% drop in peak heat release rate, as well as reduced smoke generation. The Flame Retardancy Index (FRI) was used to classify and label PU/GTR composites such that the amount of GTR was found to be more important than that of FR type. The wide range of FRI (0.94-7.56), taking Poor to Good performance labels, was indicative of the sensitivity of flame retardancy to the hybridization of FR with GTR components, a feature of practicality. The results are promising for fire protection requirements in buildings; however, the flammability reduction was achieved at the expense of mechanical and thermal insulation performance.

Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy.

Objective: Platelets are strongly associated with cardiovascular events due to their role in thrombotic processes. Reticulated platelets have higher prothrombotic potential. The aim of the study was to evaluate the effectiveness of immature platelet fraction (IPF) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS). Methods: This prospective, observational study enrolled patients with ACS treated with dual antiplatelet therapy comprising acetylsalicylic acid and clopidogrel or ticagrelor. The primary outcome was a composite endpoint defined as major adverse cardiovascular events (MACE): all-cause death, myocardial infarction (MI), ischemic stroke, or unplanned revascularization. IPF was determined using flow cytometry in the first 24 h of hospitalization. MACE were evaluated by 2 physicians based on electronic databases and source documentation including discharge letters received from patients upon telephone contact. Results: Overall, there were 140 ACS patients (mean age 65.1 ± 11.7, 37 females [26.4%]) included in this study. Of them, 22.9% had diabetes mellitus, 69.3% hyperlipidemia, 25% had a history of MI. The median IPF values were 2.85 [1.8-4.2] %. Clinical follow-up (median time: 57 months [interquartile range 55-59 months]) was available for 130 patients (92.9%). MACE occurred in 27 patients (20.8%). There were higher rates of MACE at higher IPF tertiles (3rd vs 1st tertile: HR = 5.341 95% CI: 1.546-18.454, P = .008). Cox regression analyses showed that IPF level was independently associated with MACE. Time-dependent receiver-operating characteristic curve analysis revealed area under the curve of 0.656 for 5-year outcome with an IPF cutoff point of 3.45% being 63.0% sensitive and 65.0% specific for MACE. Conclusions: The study showed IPF may be an independent predictor of long-term mortality and MACE (ClinicalTrials.gov number, NCT06177587).

Management of ground tire rubber waste by incorporation into polyurethane-based composite foams.

Rapid economic growth implicated the developing multiple industry sectors, including the automotive branch, increasing waste generation since recycling and utilization methods have not been established simultaneously. A very severe threat is the generation of enormous amounts of post-consumer tires considered burdensome waste, e.g., due to the substantial emissions of volatile organic compounds (VOCs). Therefore, it is essential to develop novel, environmentally friendly methods for their utilization, which would hinder their environmental impacts. One of the most promising approaches is shredding, resulting in the generation of ground tire rubber (GTR), which can be introduced into polymeric materials as filler. The presented work is related to the thermomechanical treatment of GTR in a twin-screw extruder with zinc borate, whose incorporation is aimed to enhance shear forces within the extruder barrel. Modified GTR was introduced into flexible polyurethane (PU) foams, and the impact of modification parameters on the cellular structure, static and dynamic mechanical performance, thermal stability, as well as thermal insulation, and acoustic properties was investigated. Emissions of VOCs from applied fillers and prepared composites were monitored and evaluated. Depending on the treatment parameters, beneficial changes in foams' cellular structure were noted, which enhanced their thermal insulation performance, mechanical strength, and thermal stability. It was proven that the proposed method of GTR thermomechanical treatment assisted by zinc borate particles might benefit the performance of flexible PU foamed composites and hinder VOC emissions, which could broaden the application range of GTR and provide novel ways for its efficient utilization.

Long COVID and its cardiovascular consequences: What is known?

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused high morbidity and mortality and has been a source of substantial challenges for healthcare systems globally. Despite a full recovery, a significant proportion of patients demonstrate a broad spectrum of cardiovascular, pulmonary and neurological symptoms that are believed to be caused by long-term tissue damage and pathological inflammation, which play a vital role in disease development. Microvascular dysfunction also causes significant health problems. This review aimed to critically appraise the current data on the long-term cardiovascular sequelae of coronavirus disease 2019 (COVID-19), with a primary focus on cardiovascular symptoms such as chest pain, fatigue, palpitations, and breathlessness, and more significant disease entities including myocarditis, pericarditis and postural tachycardia syndrome. Potential risk factors identified in recent studies that contribute towards the development of long COVID are also included alongside a summary of recent advances in diagnostics and putative treatment options.

High-frequency, high-intensity transcutaneous electrical nerve stimulation compared with opioids for pain relief after gynecological surgery: a systematic review and meta-analysis.

OBJECTIVES: Opioids are important for postoperative analgesia but their use can be associated with numerous side effects. Transcutaneous electrical nerve stimulation (TENS) has been used for acute pain treatment and has dose-dependent analgesic effects, and therefore presents an alternative to intravenous (iv) opioids for postoperative pain relief. The aim of this meta-analysis was to compare high-frequency, high-intensity (HFHI or intense) TENS to iv opioids with regard to postoperative pain intensity, recovery time in the Post Anesthesia Care Unit (PACU) and opioid consumption after elective gynecological surgery. METHODS: We searched Medline, Embase, Web of Science, Cochrane, Amed and Cinahl for RCTs and quasi-experimental studies (2010-2022), and WHO and ClinicalTrials.gov for ongoing/unpublished studies. Meta-analysis and subsequent Trial Sequential Analysis (TSA) was performed for all stated outcomes. Quality of evidence was assessed according to GRADE. RESULTS: Only three RCTs met the inclusion criteria (362 participants). The surgical procedures involved surgical abortion, gynecologic laparoscopy and hysteroscopy. The applied TENS frequency was 80 Hz and intensity 40-60 mA. There was no difference in pain intensity according to Visual Analogue Scale (VAS) at discharge from PACU between the TENS and opioid group (MD VAS -0.15, 95 % CI -0.38 to 0.09) (moderate level of evidence). Time in PACU was significantly shorter in the TENS group (MD -15.2, 95 % -22.75 to -7.67), and this finding was manifested by TSA (high-level of evidence). Opioid consumption in PACU was lower in the TENS group (MD Morphine equivalents per patient mg -3.42, 95 % -4.67 to -2.17) (high-level of evidence). CONCLUSIONS: There was no detectable difference in postoperative pain relief between HFHI TENS and iv opioids after gynecological surgery. Moreover, HFHI TENS decreases recovery time and opioid consumption in PACU. HFHI TENS may be considered an opioid-sparing alternative for postoperative pain relief after gynecological surgery. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021231048.

Compatibility of Sustainable Mater-Bi/poly(ε-caprolactone)/cellulose Biocomposites as a Function of Filler Modification.

Despite their popularity and multiplicity of applications, wood-polymer composites (WPCs) still have to overcome particular issues related to their processing and properties. The main aspect is the compatibility with plant-based materials which affects the overall performance of the material. It can be enhanced by strengthening the interfacial adhesion resulting from physical and/or chemical interactions between the matrix and filler, which requires introducing a compatibilizer or a proper modification of one or both phases. Herein, the impact of cellulose filler modifications with varying contents (1-10 wt%) of hexamethylene diisocyanate (HDI) on the compatibility of Mater-Bi/poly(ε-caprolactone) (PCL)-based biocomposites was evaluated. An analysis of surface wettability revealed that the filler modification reduced the hydrophilicity gap between phases, suggesting compatibility enhancement. It was later confirmed via microscopic observation (scanning electron microscopy (SEM) and atomic force microscopy (AFM)), which pointed to the finer dispersion of modified particles and enhanced quality of the interface. The rheological analysis confirmed increased system homogeneity by the reduction in complex viscosity. In contrast, thermogravimetric analysis (TGA) indicated the efficient modification of filler and the presence of the chemical interactions at the interface by the shift of thermal decomposition onset and the changes in the degradation course.

Multimodality OCT, IVUS and FFR evaluation of coronary intermediate grade lesions in women vs. men.

Background: The pathophysiology of atherosclerotic plaque formation and its vulnerability seem to differ between genders due to contrasting risk profiles and sex hormones, however this process is still insufficiently understood. The aim of the study was to compare the differences between sexes regarding the optical coherence tomography (OCT), intravascular ultrasound (IVUS) and fractional flow reserve (FFR)-derived coronary plaque indices. Methods: In this single-center multimodality imaging study patients with intermediate grade coronary stenoses identified in coronary angiogram (CAG) were evaluated using OCT, IVUS and FFR. Stenoses were considered significant when the FFR value was ≤0.8. Minimal lumen area (MLA), was analyzed by OCT in addition to plaque stratification into fibrotic, calcific, lipidic and thin-cap fibroatheroma (TCFA). IVUS was used for evaluation of lumen-, plaque- and vessel volume, as well as plaque burden. Results: A total of 112 patients (88 men and 24 women) with chronic coronary syndromes (CCS), who underwent CAG were enrolled. No significant differences in baseline characteristics were present between the study groups. The mean FFR was 0.76 (0.73-0.86) in women and 0.78 ± 0.12 in men (p = 0.695). OCT evaluation showed a higher prevalence of calcific plaques among women than men p = 0.002 whereas lipid plaques were more frequent in men (p = 0.04). No significant differences regarding minimal lumen diameter and minimal lumen area were found between the sexes. In IVUS analysis women presented with significantly smaller vessel area, plaque area, plaque volume, vessel volume (11.1 ± 3.3 mm2 vs. 15.0 ± 4.6 mm2 p = 0.001, 6.04 ± 1.7 mm2 vs. 9.24 ± 2.89 mm2 p < 0.001, 59.8 ± 35.2 mm3 vs. 96.3 (52.5-159.1) mm3 p = 0.005, 106.9 ± 59.8 mm3 vs. 153.3 (103-253.4) mm3 p = 0.015 respectively). At MLA site plaque burden was significantly greater for men than women (61.50 ± 7.7% vs. 55.5 ± 8.0% p = 0.005). Survival did not differ significantly between women and men (94.6 ± 41.9 months and 103.51 ± 36.7 months respectively; p = 0.187). Conclusion: The presented study did not demonstrate significant differences in FFR values between women and men, yet a higher prevalence of calcific plaques by OCT and lower plaque burden at the MLA site by IVUS was found in women vs. men.

Influence of Inorganic Additives on the Surface Characteristics, Hardness, Friction and Wear Behavior of Polyethylene Matrix Composites.

The aim of this research was to analyze the effect of inorganic additives on the tribological properties of the high-density polyethylene (HDPE) matrix composite surface. Titanium (Ti) and hexagonal boron nitride (hBN) were added in different mass fractions. The samples were produced by pressing a pre-prepared mixture of granules. The composite samples with the following mass fractions of additives were fabricated: 5% hBN, 10% hBN, 28% Ti-2% hBN, 23% Ti-7% hBN, and 20% Ti-10% hBN. An even distribution of individual additives' concentrations was confirmed. Observations of morphology, surface topography, hardness, and tribological measurements were conducted using reciprocating motion tests with the "pin-on-flat" and rotational tests with the "pin-on-disc" configuration. Subsequently, microscopic observations and measurements of the wear track profile were carried out. Additionally, geometry parameters of the contacting elastic body were calculated for various counter-samples. It was found that the Shore D hardness of samples containing Ti and hBN increased with the Ti content, while the coefficient of friction (COF) value decreased. The addition of hBN alone did not significantly affect the hardness, regardless of the ratio, while the COF increased with the increasing hBN content. The COF value doubled with the addition of 10% hBN (COF = 0.22), whereas the addition of 90% Ti-10% hBN resulted in a decrease in the COF value, to COF = 0.83. The highest hardness value was obtained for the sample containing 28% Ti-2% hBN (66.5), while the lowest was for the sample containing 10% hBN (63.2). The wear track analysis, including its height and width caused by deformation, was detected using a focal differentiation microscope and scanning electron microscopy. Additionally, EDS maps were generated to determine the wear characteristics of the composite.

Deep eutectic solvent-assisted fabrication of bioinspired 3D carbon-calcium phosphate scaffolds for bone tissue engineering.

Tissue engineering is a burgeoning field focused on repairing damaged tissues through the combination of bodily cells with highly porous scaffold biomaterials, which serve as templates for tissue regeneration, thus facilitating the growth of new tissue. Carbon materials, constituting an emerging class of superior materials, are currently experiencing remarkable scientific and technological advancements. Consequently, the development of novel 3D carbon-based composite materials has become significant for biomedicine. There is an urgent need for the development of hybrids that will combine the unique bioactivity of ceramics with the performance of carbonaceous materials. Considering these requirements, herein, we propose a straightforward method of producing a 3D carbon-based scaffold that resembles the structural features of spongin, even on the nanometric level of their hierarchical organization. The modification of spongin with calcium phosphate was achieved in a deep eutectic solvent (choline chloride : urea, 1 : 2). The holistic characterization of the scaffolds confirms their remarkable structural features (i.e., porosity, connectivity), along with the biocompatibility of α-tricalcium phosphate (α-TCP), rendering them a promising candidate for stem cell-based tissue-engineering. Culturing human bone marrow mesenchymal stem cells (hMSC) on the surface of the biomimetic scaffold further verifies its growth-facilitating properties, promoting the differentiation of these cells in the osteogenesis direction. ALP activity was significantly higher in osteogenic medium compared to proliferation, indicating the differentiation of hMSC towards osteoblasts. However, no significant difference between C and C-αTCP in the same medium type was observed.

Intravascular Imaging versus Physiological Assessment versus Biomechanics-Which Is a Better Guide for Coronary Revascularization.

Today, coronary artery disease (CAD) continues to be a prominent cause of death worldwide. A reliable assessment of coronary stenosis represents a prerequisite for the appropriate management of CAD. Nevertheless, there are still major challenges pertaining to some limitations of current imaging and functional diagnostic modalities. The present review summarizes the current data on invasive functional and intracoronary imaging assessment using optical coherence tomography (OCT), and intravascular ultrasound (IVUS). Amongst the functional parameters-on top of fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR)-we point to novel angiography-based measures such as quantitative flow ratio (QFR), vessel fractional flow reserve (vFFR), angiography-derived fractional flow reserve (FFRangio), and computed tomography-derived flow fractional reserve (FFR-CT), as well as hybrid approaches focusing on optical flow ratio (OFR), computational fluid dynamics and attempts to quantify the forces exaggerated by blood on the coronary plaque and vessel wall.

Is aspiration an effective acute stroke treatment in older adults?

Introduction: Clinical outcomes after interventional stroke treatment rely on several factors, with older age being associated with poorer results, which are mainly attributed to patient's comorbidities and medications. The delivery of an aspiration catheter could be hindered by carotid tortuosity, which is more prevalent in elderly patients with increasing age. In this study, we aimed to compare the clinical and angiographic outcomes of a direct aspiration first-pass technique in interventional stroke treatment for elderly patients compared with younger patients. Materials and methods: A total of 162 patients (92 women and 70 men, aged between 35 and 94 years +/- 12.4 years) were included in this study. Patients who were treated in a comprehensive stroke center due to a large-vessel occlusion stroke using aspiration as the first-choice treatment were included in this study. To evaluate carotid arteries, the tortuosity index (TI) was calculated for each segment of each carotid pathway. Results: Age correlated significantly with the presence of carotid tortuosity (R = 0.408, p = 0.000), extracranial length ratio (R = 0.487, p = 0.000), and overall length ratio (R = 0.467, p = 0.000). No significant associations were found with coiling, kinking, or intracranial length ratio. Successful aspiration-based recanalization rate decreased with increasing age, and the differences between the age subgroups were not statistically significant. A comparison of the extreme subgroups, i.e., <60 years old vs. ≥80 years old, did not yield a statistically significant change (p = 0.068). Conclusion: Successful aspiration-based recanalization rate decreased with increasing age; however, these differences were not significant. Clinical outcomes did not significantly differ with regard to carotid tortuosity, regardless of the time of assessment. Neither intracranial nor extracranial tortuosity was significantly associated with reperfusion-related complications in either of the age subgroups.