A modified arthroscopic en masse suture bridge repair is effective for delaminated rotator cuff tears.

PURPOSE: This study aimed to clarify the characteristics of delaminated rotator cuff tears (RCTs) and evaluate the clinical outcomes of a modified arthroscopic en masse suture bridge repair for delaminated RCTs. METHODS: Patients with full-thickness RCTs, who underwent arthroscopic suture bridge repair with a minimum 2-year follow-up, were retrospectively reviewed. Patients were categorized into two groups based on the presence of delamination. Delaminated RCTs were treated using a modified en masse suture bridge technique, while nondelaminated RCTs received a conventional suture bridge technique. Preoperative and postoperative Constant scores and American Shoulder and Elbow Surgeons (ASES) scores were determined to evaluate clinical outcomes. Postoperative magnetic resonance imaging (MRI) was carried out to identify the integrity and retear of the repaired rotator cuff. RESULTS: A total of 172 patients were included in our study cohort, in which 67 (39%) delaminated RCTs were confirmed intraoperatively. The prevalence of delamination was significantly higher in large tears (53/102, 52%) compared to medium tears (14/70, 20%) (p < 0.001). No significant differences in age (n.s.) or gender (n.s.) were observed between the two groups. Both groups showed significant improvements in Constant and ASES scores postoperatively (both p < 0.001), with no significant differences between the groups (n.s.). The retear rates were 2/67 (3.0%) in the delamination group and 3/105 (2.9%) in the nondelamination group, showing no significant difference (n.s.). CONCLUSIONS: The modified arthroscopic en masse suture bridge technique was effective for repairing delaminated RCTs, yielding favourable clinical outcomes comparable to those of nondelaminated tears. LEVEL OF EVIDENCE: Level IV.

A Thermodynamic Study on Information Power in Communication Systems.

Modern information theory pioneered by Shannon provides the mathematical foundation of information transmission and compression. However, the physical (and especially the energetic) nature of the information has been elusive. While the processing of information incurs inevitable energy dissipation, it is possible for communication systems to harness information to perform useful work. In this article, we prove that the thermodynamic cost (that is, the entropy production of the communication system) is at least equal to the information transmitted. Based on this result, a model of a communication heat engine is proposed, which can extract work from the heat bath by utilizing the transmission of information. The communication heat engine integrates the manipulation of both energy and information so that both information and power may be transmitted in parallel. The information transmission rate and the information power of the communication heat engine are derived from a pure thermodynamics argument. We find that the information power of the communication heat engine can be increased by increasing the number of communication channels, but the absolute energy efficiency of the heat engine first increases and then decreases after the number of channels of the system exceeds a threshold. The proposed model and definitions provide a new way to think of a classical communication system from a thermodynamic perspective.

Proton Relay for the Rate Enhancement of Electrochemical Hydrogen Reactions at Heterogeneous Interfaces.

Proton transfer is critically important to many electrocatalytic reactions, and directed proton delivery could open new avenues for the design of electrocatalysts. However, although this approach has been successful in molecular electrocatalysis, proton transfer has not received the same attention in heterogeneous electrocatalyst design. Here, we report that a metal oxide proton relay can be built within heterogeneous electrocatalyst architectures and improves the kinetics of electrochemical hydrogen evolution and oxidation reactions. The volcano-type relationship between activity enhancement and pKa of amine additives confirms this improvement; we observe maximum rate enhancement when the pKa of a proton relay matches the pH of the electrolyte solution. Density-functional-theory-based reactivity studies reveal a decreased proton transfer energy barrier with a metal oxide proton relay. These findings demonstrate the possibility of controlling the proton delivery and enhancing the reaction kinetics by tuning the chemical properties and structures at heterogeneous interfaces.

Exosomes produced from 3D cultures of umbilical cord mesenchymal stem cells in a hollow-fiber bioreactor show improved osteochondral regeneration activity.

Animal and clinical studies have shown that mesenchymal stem cells (MSCs) play an important role in cartilage repair. The therapeutic effect of mesenchymal stem cells based therapies has been increasingly demonstrated to exosome-mediated paracrine secretion. Here, we investigated the cellular processes and mechanism of exosomes produced by conventional 2D culture (2D-Exos) and exosomes produced from 3D culture (3D-Exos) of umbilical MSCs (U-MSCs) in a hollow-fiber bioreactor for the treatment of cartilage repair. We found that the yield of 3D-Exos was 7.5-fold higher than that of 2D-Exos. The in vitro experiments indicated that both 2D-Exos and 3D-Exos can stimulate chondrocyte proliferation, migration, and matrix synthesis, and inhibit apoptosis, with 3D-Exos exerting a stronger effect than 2D-Exos. This effect was partly attributed to the activation of transforming growth factor beta 1 and Smad2/3 signaling. The injection of 2D-Exos and 3D-Exos showed enhanced gross appearance and attenuated cartilage defect; however, 3D-Exos showed a superior therapeutic effect than 2D-Exos. In summary, our study provides novel insights into the chondroprotective effects of exosomes produced from 3D culture of U-MSCs in a hollow-fiber bioreactor. Because of its promising biological function and high yield, 3D-Exos may become a promising therapeutic method for the treatment of cartilage defects.

Music for reducing the anxiety and pain of patients undergoing a biopsy: A meta-analysis.

AIM: This study aimed to evaluate the efficacy of music therapy for reducing the anxiety and pain of patients who underwent a biopsy. BACKGROUND: Music can affect human anxiety and pain by triggering a neuroendocrine effect. Clinical study results indicated that music can influence the anxiety and pain caused by invasive procedures. There is no effective solution for anxiety and pain arising from a biopsy. Although researchers in this field have different views, music still holds promise in reducing the anxiety and pain in patients undergoing the biopsy. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Systematic searches were conducted in PubMed, Embase, Medline and Cochrane databases for studies reported in the English language. The review period covered 2000 - December 2016. The outcome measure of interest was anxiety and pain. METHODS: This review followed Cochrane methods. Studies were selected according to the PICOS framework. The methodological quality of studies was assessed with the Cochrane risk of bias tool. A systematic review of effectiveness was conducted by using GRADE approach. RESULTS: Nine randomized controlled trials with a total of 326 participants in the music intervention group and 323 controls met the inclusion criteria. Music had a tendency towards decreasing systolic blood pressure before the biopsy, State-Trait Anxiety Inventory scores after the biopsy, diastolic blood pressure after the biopsy and heart rate after the biopsy. Similarly, music also tended to be more effective for controlling pain after the biopsy. There was moderate quality evidence for the outcome: State-Trait Anxiety Inventory scores after the biopsy; and low- or very low-quality evidence for other outcomes. CONCLUSION: Music can be used for patients before and during the biopsy procedure. This approach may be performed by nurses to promote the recovery of patients after the biopsy.

Characteristics of the gut microbiota and serum metabolites in postmenopausal women with reduced bone mineral density.

Introduction: Emerging evidence suggests that the gut microbiota is closely associated with bone homeostasis. However, little is known about the relationships among the bone mineral density (BMD) index, bone turnover markers, and the gut microbiota and its metabolites in postmenopausal women. Methods: In this study, to understand gut microbiota signatures and serum metabolite changes in postmenopausal women with reduced BMD, postmenopausal individuals with normal or reduced BMD were recruited and divided into normal and OS groups. Feces and serum samples were collected for 16S rRNA gene sequencing, liquid chromatography coupled with mass spectrometry (LC-MS)-based metabolomics and integrated analysis. Results: The results demonstrated that bacterial richness and diversity were greater in the OS group than in the normal group. Additionally, distinguishing bacteria were found among the two groups and were closely associated with the BMD index and bone turnover markers. Metabolomic analysis revealed that the expression of serum metabolites, such as etiocholanolone, testosterone sulfate, and indole-3-pyruvic acid, and the corresponding signaling pathways, especially those involved in tryptophan metabolism, fatty acid degradation and steroid hormone biosynthesis, also changed significantly. Correlation analysis revealed positive associations between normal group-enriched Bacteroides abundance and normal group-enriched etiocholanolone and testosterone sulfate abundances; in particular, Bacteroides correlated positively with BMD. Importantly, the tryptophan-indole metabolism pathway was uniquely metabolized by the gut bacteria-derived tnaA gene, the predicted abundance of which was significantly greater in the normal group than in the control group, and the abundance of Bacteroides was strongly correlated with the tnaA gene. Discussion: Our results indicated a clear difference in the gut microbiota and serum metabolites of postmenopausal women. Specifically altered bacteria and derived metabolites were closely associated with the BMD index and bone turnover markers, indicating the potential of the gut microbiota and serum metabolites as modifiable factors and therapeutic targets for preventing osteoporosis.

Syringaresinol attenuates osteoarthritis via regulating the NF-κB pathway.

Osteoarthritis (OA) is a now regarded as a worldwide whole joint disease with synovial inflammation, cartilage degeneration, and subchondral sclerosis. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used drugs for OA treatment which only relieve the symptoms and restrain the progression of OA. However, various severe adverse effects often occur in patients with long-term NSAIDs use, which heavily burdens the healthcare system and impacts the quality of life. Therefore, it is much imperative to identify alternative drugs with increased efficacy. Syringaresinol (Syr), a naturally occurring phytochemical which belonging to the lignan group of polyphenols, shows anti-tumor and anti-oxidant activities, which to benefit human health. Studies has shown Syr can regulate the inflammatory response by modulating the secretion and expression level of cytokines IL-6, IL-8, and tumor necrosis factor (TNF)-α. it also shows the inhibitory effect on NF-κB pathway in mouse cells. In the present study, we aimed to demonstrate the anti-inflammatory effects of Syr in OA. In vitro Syr treatment in IL-1ß-activated mouse chondrocytes significantly restrained the expression of NO, PGE2, IL-6, TNF-α, INOS, COX-2 and MMP-13. Moreover, it considerably ameliorated the degradation of aggrecan and collagen II. Furthermore, the phosphorylation of the NF-kB signaling pathway was significantly suppressed by Syr. Moreover, in vivo, the cartilage degeneration was attenuated and the increased Osteoarthritis Research Society International (OARSI) scores were reversed in the DMM + Syr group, comprared to those in the DMM group. In sum, our study demonstrated that Syr can attenuate the inflammation in vitro and further verified its effect on OA in vivo. Thus, Syr might be a potent therapeautic alternative for OA treatment.

The umbilical cord mesenchymal stem cell-derived exosomal lncRNA H19 improves osteochondral activity through miR-29b-3p/FoxO3 axis.

BACKGROUND: Our previous study revealed that the exosomal lncRNA H19 derived from umbilical cord mesenchymal stem cells (UMSCs) plays a pivotal role in osteochondral regeneration. In this study, we investigated whether the exosomal lncRNA H19 could act as a competing endogenous RNA (ceRNA) to potentiate osteochondral activity in chondrocytes. METHODS: Dual-luciferase reporter assay, RNA pull-down, RNA immunoprecipitation (RIP), and fluorescence in situ hybridization (FISH) were carried to verify the interaction between miR-29b-3p and both lncRNA H19 and the target mRNA FoxO3. Chondrocytes were treated with UMSC-derived exosomes, which highly expressing lncRNA H19 expression, followed by apoptosis, migration, senescence, and matrix secretion assessments. An in vivo SD rat cartilage defect model was carried out to explore the role and mechanism of lncRNA H19/miR-29b-3p. RESULTS: UMSCs were successfully identified, and exosomes were successfully extracted. Exosomes exhibited the ability to transfer lncRNA H19 to chondrocytes. Mechanistically, exosomal lncRNA H19 potentiated osteochondral activity by acting as a competing endogenous sponge of miR-29b-3p, and miR-29b-3p directly targeted FoxO3. Intra-articular injection of exosomes overexpressing lncRNA H19 could promote sustained cartilage repair; however, this effect could be undermined by miR-29b-3p agomir. CONCLUSIONS: Our study revealed a significant role in the development of strategies against cartilage defects for UMSC-derived exosomes that overexpress lncRNA H19. Exosomal H19 was found to promote chondrocyte migration, matrix secretion, apoptosis suppression, as well as senescence suppression, both in vitro and in vivo. The specific mechanism lies in the fact that exosomal H19 acts as a ceRNA against miR-29b-3p to upregulate FoxO3 in chondrocytes.

Exosomes derived from umbilical cord mesenchymal stem cells in mechanical environment show improved osteochondral activity via upregulation of LncRNA H19.

BACKGROUND: Exosomes derived from stem cells have been demonstrated to be good candidates for the treatment of osteochondral injury. Our previous studies have demonstrated that mechanical stimulation could be crucial for the secretion of exosomes derived from umbilical cord mesenchymal stem cells (U-MSCs). Therefore, we explore whether mechanical stimulation caused by a rotary cell culture system (RCCS) has a beneficial effect on exosome yield and biological function. METHODS: U-MSCs were subjected to an RCCS at different rotational speeds and exosomes were characterised by transmission electron microscopy, nanoparticle tracking analysis and western blotting. small-interfering RNAs of Rab27a (siRNA-Rab27a) was used to reduce exosome production. Quantitative real-time PCR (qRT-PCR) was used to detect the expression of mechanically sensitive long non-coding RNA H19 (LncRNA H19). The effects of exosomes on chondrocyte proliferation were examined using cell counting kit-8 (CCK-8), toluidine blue staining and a series of related genes. Annexin V-FITC and PI (V-FITC/PI) flow cytometry was used to detect the effect of exosomes on the inhibition of chondrocyte apoptosis. Macroscopic evaluation, MRI quantification and immunohistochemical staining were conducted to investigate the in vivo effects of exosomal LncRNA H19 through SD rat cartilage defect models. RESULTS: RCCS significantly promoted exosome production at 36 rpm/min within 196 h. Mechanical stimulation was able to increase the expression level of exosomes. The exosomal LncRNA H19 was found to promote chondrocyte proliferation and matrix synthesis and inhibit apoptosis in vitro. Chondral regeneration activity was lost in LncRNA H19-defective exosomes. The injection of exosomal LncRNA H19 in vivo resulted in improved macroscopic assessment, MRI quantification and histological analysis. Moreover, exosomal LncRNA H19 was able to relieve pain levels during the early stages of cartilage repair in an animal experiment. CONCLUSION: Our findings confirmed that mechanical stimulation can enhance exosome yield as well as biological function for the repair of cartilage defects. The underlying mechanism may be related to the high expression of LncRNA H19 in exosomes. The translational potential of this article: This study provides a theoretical support of optimizing exosome production. It advances the yield of mesenchymal stem cell exosome and facilitate the clinical application to repair of osteochondral damage.

Reversible ketone hydrogenation and dehydrogenation for aqueous organic redox flow batteries.

Aqueous redox flow batteries with organic active materials offer an environmentally benign, tunable, and safe route to large-scale energy storage. Development has been limited to a small palette of organics that are aqueous soluble and tend to display the necessary redox reversibility within the water stability window. We show how molecular engineering of fluorenone enables the alcohol electro-oxidation needed for reversible ketone hydrogenation and dehydrogenation at room temperature without the use of a catalyst. Flow batteries based on these fluorenone derivative anolytes operate efficiently and exhibit stable long-term cycling at ambient and mildly increased temperatures in a nondemanding environment. These results expand the palette to include reversible ketone to alcohol conversion but also suggest the potential for identifying other atypical organic redox couple candidates.

Primary tumours of the calcaneus.

The calcaneus is a rare location for the occurrence and development of primary tumour types. Clinicians are unfamiliar with calcaneal tumour types, which may result in a delay in diagnosis or a missed diagnosis, resulting in unnecessary morbidity and amputation. Heel pain and localized swelling of the ankle are the most common symptoms. X-ray is the first choice for a tentative diagnosis of a calcaneal tumour. The final diagnosis depends on a histological examination. The treatment of calcaneal tumour types varies depending on the Enneking system. The majority of patients with benign tumours heal, except for a few with a palindromia. For malignant tumours, the prognosis is comparatively poor, resulting in disability and a high rate of metastasis. This review describes the spectrum of calcaneal tumour types and specifically illustrates the epidemiology, symptomatology, imagology, histopathology and treatment options that may facilitate diagnosis and improve prognosis.

Pharmacological Properties of the Medical Maggot: A Novel Therapy Overview.

In the last decade, maggot has been hailed as the miraculous "medicinal maggot" for its diverse properties, including antimicrobial, antibiofilm, anti-inflammatory, and wound healing activities. The fact that maggots show so many beneficial properties has increased the interest in these tiny larvae dramatically. Whilst there is relatively abundant clinical evidence to demonstrate the success of maggots as debridement agents, not so much emphasis has been placed on the basic science evidence, which was a combination of physical and biochemical actions. This review differs from those earlier works in that it is undertaken to provide an update of the latest scientific basis published on maggot, particularly active ingredients within maggot excretions/secretions (ES). Further investigations should focus on the isolation, identification, recombination, transgenosis, and mass production of the beneficial molecules within maggots.

La0.8Sr0.2MnO3-Based Perovskite Nanoparticles with the A-Site Deficiency as High Performance Bifunctional Oxygen Catalyst in Alkaline Solution.

Perovskite (La0.8Sr0.2)1-xMn1-xIrxO3 (x = 0 (LSM) and 0.05 (LSMI)) nanoparticles with particle size of 20-50 nm are prepared by the polymer-assisted chemical solution method and demonstrated as high performance bifunctional oxygen catalyst in alkaline solution. As compared with LSM, LSMI with the A-site deficiency and the B-site iridium (Ir)-doping has a larger lattice, lower valence state of transition metal, and weaker metal-OH bonding; therefore, it increases the concentration of oxygen vacancy and enhances both oxygen evolution reaction (OER) and oxygen reduction reaction (ORR). LSMI exhibits superior ORR performance with only 30 mV onset potential difference from the commercial Pt/C catalyst and significant enhancement in electrocatalytic activity in the OER process, resulting in the best oxygen electrode material among all the reported perovskite oxides. LSMI also exhibits high durability for both ORR (only 18 mV negative shift for the half-wave potential compared with the initial ORR) and OER process with 10% decay. The electrochemical results indicate that the A-site deficiency and Ir-doping in perovskite oxides could be promising catalysts for the applications in fuel cells, metal-air batteries, and solar fuel synthesis.

Nanoscale Engineering of Heterostructured Anode Materials for Boosting Lithium-Ion Storage.

Rechargeable lithium-ion batteries (LIBs), as one of the most important electrochemical energy-storage devices, currently provide the dominant power source for a range of devices, including portable electronic devices and electric vehicles, due to their high energy and power densities. The interest in exploring new electrode materials for LIBs has been drastically increasing due to the surging demands for clean energy. However, the challenging issues essential to the development of electrode materials are their low lithium capacity, poor rate ability, and low cycling stability, which strongly limit their practical applications. Recent remarkable advances in material science and nanotechnology enable rational design of heterostructured nanomaterials with optimized composition and fine nanostructure, providing new opportunities for enhancing electrochemical performance. Here, the progress as to how to design new types of heterostructured anode materials for enhancing LIBs is reviewed, in the terms of capacity, rate ability, and cycling stability: i) carbon-nanomaterials-supported heterostructured anode materials; ii) conducting-polymer-coated electrode materials; iii) inorganic transition-metal compounds with core@shell structures; and iv) combined strategies to novel heterostructures. By applying different strategies, nanoscale heterostructured anode materials with reduced size, large surfaces area, enhanced electronic conductivity, structural stability, and fast electron and ion transport, are explored for boosting LIBs in terms of high capacity, long cycling lifespan, and high rate durability. Finally, the challenges and perspectives of future materials design for high-performance LIB anodes are considered. The strategies discussed here not only provide promising electrode materials for energy storage, but also offer opportunities in being extended for making a variety of novel heterostructured nanomaterials for practical renewable energy applications.

Recent advances in nanostructured Nb-based oxides for electrochemical energy storage.

For the past five years, nanostructured niobium-based oxides have emerged as one of the most prominent materials for batteries, supercapacitors, and fuel cell technologies, for instance, TiNb2O7 as an anode for lithium-ion batteries (LIBs), Nb2O5 as an electrode for supercapacitors (SCs), and niobium-based oxides as chemically stable electrochemical supports for fuel cells. Their high potential window can prevent the formation of lithium dendrites, and their rich redox chemistry (Nb(5+)/Nb(4+), Nb(4+)/Nb(3+)) makes them very promising electrode materials. Their unique chemical stability under acid conditions is favorable for practical fuel-cell operation. In this review, we summarized recent progress made concerning the use of niobium-based oxides as electrodes for batteries (LIBs, sodium-ion batteries (SIBs), and vanadium redox flow batteries (VRBs)), SCs, and fuel cell applications. Moreover, crystal structures, charge storage mechanisms in different crystal structures, and electrochemical performances in terms of the specific capacitance/capacity, rate capability, and cycling stability of niobium-based oxides are discussed. Insights into the future research and development of niobium-based oxide compounds for next-generation electrochemical devices are also presented. We believe that this review will be beneficial for research scientists and graduate students who are searching for promising electrode materials for batteries, SCs, and fuel cells.

Ultrafine Nb2O5 Nanocrystal Coating on Reduced Graphene Oxide as Anode Material for High Performance Sodium Ion Battery.

Ultrafine niobium oxide nanocrystals/reduced graphene oxide (Nb2O5 NCs/rGO) was demonstrated as a promising anode material for sodium ion battery with high rate performance and high cycle durability. Nb2O5 NCs/rGO was synthesized by controllable hydrolysis of niobium ethoxide and followed by heat treatment at 450 °C in flowing forming gas. Transmission electron microscopy images showed that Nb2O5 NCs with average particle size of 3 nm were uniformly deposited on rGO sheets and voids among Nb2O5 NCs existed. The architecture of ultrafine Nb2O5 NCs anchored on a highly conductive rGO network can not only enhance charge transfer and buffer the volume change during sodiation/desodiation process but also provide more active surface area for sodium ion storage, resulting in superior rate and cycle performance. Ex situ XPS analysis revealed that the sodium ion storage mechanism in Nb2O5 could be accompanied by Nb(5+)/Nb(4+) redox reaction and the ultrafine Nb2O5 NCs provide more surface area to accomplish the redox reaction.

The performance and mechanism of modified activated carbon air cathode by non-stoichiometric nano Fe3O4 in the microbial fuel cell.

Cathodic catalyst is one of the key materials in microbial fuel cell (MFC). The addition of non-stoichiometric nano Fe3O4 in activated carbon (NSFe3O4/AC) air cathode was beneficial to boosting the charge transfer of the cathode accompanying with the enhancement of power performance in MFC. The air cathode modified by NSFe3O4 (5%, Wt%) increased the maximum power density by 83.3% from 780 mW/m(2) to 1430 mW/m(2) compared with bare air cathode. The modified cathodes showed enhanced electrochemical properties and appeared the maximum exchange current density of 18.71×10(-4) A/cm(2) for oxygen reduction reaction. The mechanism of oxygen reduction for the NSFe3O4/AC catalyst was a 4-electron pathway. The oxygen vacancy of the NSFe3O4 played a crucial role in electrochemical catalytic activity. The great catalytic performance made NSFe3O4 have a promising outlook applied in MFC.

Titanium Oxynitride Nanoparticles Anchored on Carbon Nanotubes as Energy Storage Materials.

Sub-8 nm titanium oxynitride (TiON) nanoparticles were uniformly formed on the surface of carbon nanotubes (CNTs) by annealing amorphous TiO2 (a-TiO2) conformally coated CNTs (CNTs/a-TiO2) at 600 °C in ammonia gas. The novel CNTs/TiON nanocomposite was systematically characterized by X-ray diffraction (XRD), high-resolution transmission electron microscopy imaging (HRTEM), scanning transmission electron microscopy-energy dispersive spectroscopy (STEM-EDX), and X-ray photoelectron spectroscopy (XPS). The results show that Ti, O, and N are homogeneously distributed in TiON nanoparticles. The specific capacitance of CNTs/TiON exhibits 187 F g(-1) at a current density of 0.5 A g(-1), which is much higher than that of CNTs (33.4 F g(-1)) and CNTs/TiO2 (83.4 F g(-1)) obtained by annealing CNTs/a-TiO2 at 450 °C in nitrogen gas. CNTs/TiON also exhibits enhanced cycle durability, which enables it to be considered as a promising candidate for supercapacitors.

Unsupervised reconstruction of a three-dimensional left ventricular strain from parallel tagged cardiac images.

A new algorithm, called the Unsupervised Tag ExTraction and Heart strain(E) Reconstruction (UNTETHER) algorithm, is presented for quantifying three-dimensional (3D) myocardial strain in tagged cardiac MR images. Five human volunteers and five postinfarct patients were imaged. 3D strains measured by UNTETHER and a user-supervised technique were compared. Each study was analyzed in 49 +/- 8 min with UNTETHER, compared to approximately 4 hr with the user-supervised technique. For pooled human data, the correlation coefficient between the two methods for circumferential shortening (E(cc)) was r = 0.91 at the mid-wall (P < 0.0005). UNTETHER is capable of measuring wall motion abnormalities resulting from coronary artery disease, and has the potential to overcome the main limitations (time and user-supervision requirements) to routine clinical use of tagged cardiac MRI.