Improve Blood Flow Research Articles

Pleiotropic Effects of Resveratrol on Aging-Related Cardiovascular Diseases-What Can We Learn from Research in Dogs?

Resveratrol (RES) is a polyphenol with natural anti-inflammatory and antioxidant properties. It is found in abundance in plants, i.e., grapes and mulberry fruit. In addition, synthetic forms of RES exist. Since the discovery of its specific biological properties, RES has emerged as a candidate substance not only with modeling effects on the immune response but also as an important factor in preventing the onset and progression of cardiovascular disease (CVD). Previous research provided strong evidence of the effects of RES on platelets, mitochondria, cardiomyocytes, and vascular endothelial function. In addition, RES positively affects the coagulation system and vasodilatory function and improves blood flow. Not only in humans but also in veterinary medicine, cardiovascular diseases have one of the highest incidence rates. Canine and human species co-evolved and share recent evolutionary selection processes, and interestingly, numerous pathologies of companion dogs have a human counterpart. Knowledge of the impact of RES on the cardiovascular system of dogs is becoming clearer in the literature. Dogs have long been recognized as valuable animal models for the study of various human diseases as they share many physiological and genetic similarities with humans. In this review, we aim to shed light on the pleiotropic effects of resveratrol on cardiovascular health in dogs as a translational model for human cardiovascular diseases.

Non-Pharmacological Exercise Randomized Controlled Trials in Alzheimer's Disease.

This narrative review aimed to summarize evidence on responses to exercise in pre-clinical Alzheimer's disease (AD) and on how long-term exercise programs work to improve neuropsychiatric symptoms and cognitive performance. We conducted a narrative review of the body of research on the benefits of long-term exercise programs in improving cognitive performance and reducing neuropsychiatric scores in patients with AD. Long-term exercise therapy appears to improve blood flow, increase hippocampal volume, and promote neurogenesis in patients with AD. Higher levels of physical activity are associated with a lower chance of developing the disease, and most prospective studies have shown that physical inactivity is one of the most prevalent modifiable risk factors for the development of AD. Exercise appears to be beneficial in improving cognitive function, a neuropsychiatric symptom of AD. Exercise has been shown to have fewer side effects, such as non-pharmacological effects and better adherence than medication. In this review, experts provided a snapshot and authoritative summary of evidence for non-pharmacological exercise in patients with AD based on the best synthesis efforts, identified the main knowledge gaps and relevant barriers, and provided directions for future research. Furthermore, experts in randomized trial designs provided practical details and recommendations for researchers working in this area, underscoring the importance of relevant topics.

Investigation of Far Infrared Emission and UV Protection Properties of Polypropylene Composites Embedded with Candlenut-Derived Biochar for Health Textiles.

Far infrared radiation (FIR) within the wavelength range of 4-14 μm can offer human health benefits, such as improving blood flow. Therefore, additives that emit far infrared radiation have the potential to be incorporated into polymer/fabric matrices to develop textiles that could promote health. In this study, biochar derived from candlenuts and pyrolyzed with activated carbon (AC) was incorporated into polypropylene (PP) films and investigated for its potential as a health-promoting textile additive. The properties of biochar were compared with other far infrared (FIR) emitting additives such as hematite, Indian red ochre, and graphene. The addition of biochar increased FIR emissivity to 0.90, which is 9% higher than that of pristine PP. Additionally, biochar enhanced UV and near-infrared (NIR) blocking capabilities, achieving an ultra-protection factor (UPF) of 91.41 and NIR shielding of 95.85%. Incorporating 2 wt% biochar resulted in a 3.3-fold higher temperature increase compared to pristine PP after 30 s of exposure to an FIR source, demonstrating improved heat retention. Furthermore, the ability to achieve the lowest thermal effusivity among other additives supports the potential use of biochar-incorporated fabric as a warming material in cold climates. The tensile properties of PP films with biochar were superior to those with other additives, potentially contributing to a longer product lifespan. Additionally, samples with red ochre exhibited the highest FIR emissivity, while samples with hematite showed the highest capacity for UV shielding.

Synergistic effect of Hypoxic Conditioning and Cell-Tethering Colloidal Gels enhanced Productivity of MSC Paracrine Factors and Accelerated Vessel Regeneration.

Microporous hydrogels have been widely used for delivering therapeutic cells. However, several critical issues, such as the lack of control over the harsh environment they are subjected to under pathological conditions and rapid egression of cells from the hydrogels, have produced limited therapeutic outcomes. To address these critical challenges, cell-tethering and hypoxic conditioning colloidal hydrogels containing mesenchymal stem cells (MSCs) are introduced to increase the productivity of paracrine factors locally and in a long-term manner. Cell-tethering colloidal hydrogels that are composed of tyramine-conjugated gelatin prevent cells from egressing through on-cell oxidative phenolic crosslinks while providing mechanical stimulation and interconnected microporous networks to allow for host-implant interactions. Oxygenating microparticlesencapsulated in tyramine-conjugated colloidal microgels continuously generated oxygen for 2 weeks with rapid diffusion, resulting in maintaining a mild hypoxic condition while MSCs consumed oxygen under severe hypoxia. Synergistically, local retention of MSCs within the mild hypoxic-conditioned and mechanically robust colloidal hydrogels significantly increased the secretion of various angiogenic cytokines and chemokines. The oxygenating colloidal hydrogels induced anti-inflammatory responses, reduced cellular apoptosis, and promoted numerous large blood vessels in vivo. Finally, mice injected with the MSC-tethered oxygenating colloidal hydrogels significantly improved blood flow restoration and muscle regeneration in a hindlimb ischemia (HLI) model.

THE EFFECT OF SELF-ACUPRESSURE ON REDUCING BLOOD PRESSURE, HEADACHE AND SLEEP QUALITY DISORDERS IN HYPERTENSIVE PATIENTS

Hypertension is still a major health problem in Indonesia. Various efforts to overcome the problem of hypertension have been made, both pharmacological and non-pharmacological treatments. A therapy based on the patient's habits or culture will certainly be easier to implement and obey by. Therefore, this study aims to analyze the effect of self-acupressure on blood pressure, headache, and sleep quality of hypertensive patients. The research method used is a quasi-experiment, single-group pre-post-test design. The sample in this study were hypertensive patients who fit the inclusion and exclusion criteria at Wonokerto Health Centre, Pekalongan Regency. The data analysis used was univariate and bivariate analysis. Bivariate analysis used paired group t-test technique. The results showed that there was an effect of self-acupressure in reducing systolic blood pressure (p-value: 0.004), headache pain scale (p-value: 0.001), and decreased sleep quality disorder score (p value: 0.000). Massaging at acupressure points has the effect of improving blood flow, stimulating endorphin hormones and providing a relaxing effect so that it can reduce blood pressure, headache pain scale and sleep quality disturbance scores. Recommendations for future research are to add a control group and/or compare it with other independent complementary therapy techniques.

EFFECT OF PHYSIOTHERAPY ON THE IMPLANTATION POTENTIAL OF THIN ENDOMETRIUM

The article is dedicated to the urgent problem of infertility associated with thin endometrium. The mechanisms of action of various physiotherapeutic methods on the endometrium, such as magnetotherapy, laser therapy, ultrasound therapy, and electrical stimulation, are discussed. The beneficial effects of physiotherapy are described in detail, including improved blood flow, reduced inflammation, and stimulation of tissue regeneration. The results of clinical trials confirming the effectiveness of physiotherapy in increasing the thickness and improving the structure of the endometrium are presented. The article also includes indications and contraindications for the use of physiotherapy and emphasizes the importance of an individualized approach to treatment.

Cranio-Orbital Approach and Decompression of the Optic Nerves: A 2-Stage, 4-by-4-Step Approach to Improve Vision in Sellar and Parasellar Lesions.

Despite advances in cranial base techniques, surgery of the sellar and parasellar regions remains challenging because of complex neurovascular relationships. Lesions within this region frequently present with progressive visual deterioration caused by distortion and compression of the optic chiasm and nerves. In addition to the direct mass effect from mechanical forces acting on the optic apparatus, these lesions alter blood supply and reduce vascular perfusion, prompting surgical treatment to remove the lesion, alleviate compression, and improve blood flow to the optic nerve. We sought to describe a 2-stage, 4-by-4-step approach, broken down and described as a "four-by-four" technique for optic apparatus decompression and a wide approach to different sellar and parasellar lesions. We describe the operative nuances and key anatomic points in the microsurgical removal of sellar and parasellar lesions. The technique is illustrated with examples of different cases with pre- and follow-up MRI imaging and a brief overview of visual outcomes. The described technique has been demonstrated in various lesions in 5 patients. Patients presented with bilateral visual loss in 4 (80.0%) cases and with unilateral visual loss in 1 (20.0%) case. Improvement in visual function was noted in all cases, confirmed with visual acuity and visual field testing. The transcranial approach ("from above") remains an important surgical option for patients with excellent exposure and visualization of the sellar and parasellar regions. It permits early access to the optic canal for careful microsurgical decompression and relaxation of the optic nerve to preserve and improve its microvascularization and ultimately vision. The authors augmented the 2-stage, 4-by-4-step technique of decompression with elaborate illustrations of diverse sellar and parasellar lesions to demonstrate the versatility of this approach.

Predicting and Validating the Mechanism of Action of the Enema Formula in Treating Colorectal Cancer by Using Network Pharmacology, GEO, and TCGA Databases

Background: The GCF, created by Professor Liu Shenlin, an esteemed expert in traditional Chinese medicine, is rooted in principles to improve blood flow, relieve blood congestion, clear heat, and detoxify the body. Developed as an empirical formula, it holds significance in CRC treatment. Objective: This study aimed to predict and confirm the active elements, possible targets, and molecular mechanisms against colorectal cancer (CRC) in the GCF enema formula. Methods: Using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), we screened active elements and drug targets. Colorectal cancer (CRC)-related targets were collected from the Online Mendelian Inheritance in Man (OMIM) database, Disease Gene Network (DisGeNET) database, and Therapeutic Target Database (TTD). The overlap between action targets of all active elements and CRC-related targets was determined to find common targets. A Protein-Protein Interaction (PPI) network of common targets was built using the String database, and Cytoscape software was used for visual analysis to identify core targets. Simultaneously, the common targets were analyzed using the Metascape database for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Additionally, core targets and active elements were tested using Discovery Studio 2019 for molecular docking. Furthermore, the expression differences and prognostic impacts of core targets were examined across various cancer databases. Results: Screening revealed 90 active elements and 251 drug targets in the GCF. There were 6113 disease targets, with 113 common targets between CRC and the GCF. Core targets identified through PPI analysis included AKT1, STAT3, MYC, SRC, EGFR, and IL6. KEGG enrichment analysis uncovered 101 relevant pathways related to these targets. Molecular docking experiments confirmed favorable interactions between core targets and multiple active elements in the GCF. Additionally, examination of the Human Protein Atlas (HPA) database highlighted differential expression of core targets MYC and EGFR in normal colorectal tissue compared to CRC tissue. Conclusion: The GCF, comprising a combination of three drugs, appears to counteract CRC by influencing core targets, such as AKT1, STAT3, MYC, SRC, EGFR, and IL6. This process involves regulating multiple cancer-related signaling pathways, notably the PI3K-AKT pathway.

Effect of extracorporeal shock wave therapy on the microbial community in burn scars: retrospective case-control study.

The effectiveness of extracorporeal shock wave therapy (ESWT) has been demonstrated in various medical fields, including burn medicine. It promotes wound healing, improves blood flow, and modulates the inflammatory responses. The recovery speed and outcomes of skin diseases are influenced by the skin microbiome; however, studies examining the effects of specific treatments on the skin microbiome are lacking. This study investigated the impact of ESWT on the skin microbiome of burn patients, focusing on the microbial diversity and community structure within burn scars. In the retrospective case-control study, nineteen patients with burn scars were treated with ESWT, and changes in their skin microbiome were evaluated. ESWT was administered weekly for three months, and samples were collected from the ESWT-treated burn scars and untreated normal skin. Blood chemistry, and pain and itching scores were evaluated during sample collection. The collected samples were then subjected to 16S rRNA sequencing. Microbial community analysis was conducted using the QIIME2 and R packages. After ESWT, changes in alpha diversity indices were observed in burn scars. Faith phylogenetic diversity (P<0.05) and observed features (P<0.01) increased, whereas the evenness index decreased (P<0.01); no marked changes were noted in untreated skin. Beta diversity analysis showed stable microbial community structures in both the treated and untreated areas. A considerable increase in Micrococcus and Staphylococcus abundance was observed. Network analysis revealed a more open microbial network structure after ESWT, indicating adaptive changes in the microbial community. ESWT enhances microbial diversity and modifies microbial community structure in burn scars, promoting a more balanced and functionally supportive microbiome. ESWT aids in scar remodeling and positively influences skin microbiome dynamics, contributing to improved skin health and recovery.

Is Really Birth Ball Sitting Effective on Labour Outcomes Among Prim Mothers?

Birthing ball exercises are one of the non-pharmacological methods for speeding the start of labour. Exercises with birth balls have the potential to reduce discomfort by relaxing muscles and improving blood flow to the uterus. This study aimed to determine the effectiveness of birth ball use on labour outcomes among primi mothers at a selected hospital in Salem. A quantitative research approach with a quasi-experimental post-test control group design was used. The sample size was 60; each 30 in the experimental group and control group were selected by using the non-probability purposive sampling technique. Written consent was obtained from the samples. A modified partograph was used to assess the labour outcomes. Both birth balls utilised in this study were found to affect labour outcomes. There were statistically positive correlations between the birth ball exercise effects on the progress of labour in terms of decreasing labour pain (z = 4.910 at p level of P&lt;0.001), the highest effect on cervical dilatation (z =2.856 at p level of P&lt;0.001), promoting normal modes of delivery (z = 4.538 at p level of P&lt;0.001), and reducing the perineal tear (z = 3.693 at p level of P&lt;0.001) in the experimental group group, while the control group showed less progress with highly statistically significant differences. Moreover, the control group expressed a higher pain score and perineal tear. This study revealed that the birth ball sitting helps to reduce the indensity of labour pain, promote cervical dilatation, and promote normal delivery.

Evaluation of Preoperative Low-flow Areas in STA-MCA Bypass Surgery Using Vascular Fusion Map Image.

The superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery requires an anastomosis of the STA to an MCA with diminished blood flow. However, identifying the precise location of the MCA with reduced flow preoperatively is challenging as it often remains nonvisualized. To address this issue, we developed a novel technique, the area target bypass (ATB) method, to infer the location of the responsible vessel for low-flow areas. The cornerstone of the ATB method lies in the utilization of the vascular fusion map (VFM). The VFM integrates 3D perfusion and 3D vascular images, enabling simultaneous evaluation of cerebral surface vessels and regions with reduced blood flow. This study aimed to assess the efficacy of the STA-MCA bypass surgery adopting the ATB method. Between August 2022 and March 2023, we conducted eight STA-MCA bypass surgeries using the ATB method. For each case, the VFM was generated using the MTT and DLY parameters, and blood flow improvement was evaluated based on the VFM score, determined by an average score from seven experts. In all cases, the target vessel was identified either preoperatively or during craniotomy, with postoperative patency of the STA-MCA bypass confirmed. Out of the eight cases, seven demonstrated improved blood flow with a VFM score exceeding 1. No complications were reported. The introduction of the ATB method has proven its potential in accurately pinpointing optimal anastomosis sites.

Regulation of angiogenesis by signal sequence-derived peptides.

The neuropilin-like, Discoidin, CUB and LCCL domain containing 2 (DCBLD2) is a transmembrane protein with an unusually long signal sequence (SS) composed of N-terminal (N) and C-terminal (C) subdomains, separated by a transition (tra) subdomain. DCBLD2 interacts with VEGFR-2 and regulates VEGF-induced endothelial cell signaling, proliferation and migration, as well as angiogenesis. The exact mechanisms by which DCBLD2 interacts with VEGFR2 to modulate VEGF signaling remain unclear. Searching for VEGFR2 interacting DCBLD2 domains, we generated various constructs containing different DCBLD2 domain combinations and conducted co-immunoprecipitation and signaling studies in HEK 293T and endothelial cells. Several peptides were synthesized based on the identified domain, and their effect on VEGF signaling was assessed in vitro in cell culture and in vivo using matrigel plug and corneal micropocket assays. The effect of the lead peptide was further evaluated using a murine hindlimb ischemia model. DCBLD2 SS interacted with VEGFR2 and promoted VEGF signaling. SS was not cleaved in the mature DCBLD2 and its hydrophobic transmembrane 'traC' segment, but not the 'N' subdomain, was involved in DCBLD2-VEGFR2 interaction. The smallest unit in DCBLD2 SS that interacts with VEGFR2 was the L5VL5 sequence. Even after the central valine was removed, the L10 sequence mimicked the DCBLD2 SS traC's effect on VEGF-signaling, while shorter or longer poly-leucine sequences were less effective. Finally, a synthetic traC peptide enhanced VEGF signaling in vitro, promoted VEGF-induced angiogenesis in vivo, and improved blood flow recovery following hindlimb ischemia. DCBLD2 SS along with its derivative peptides can promote VEGFR2 signaling and angiogenesis. Synthetic peptides based on DCBLD2 SS hold promise as therapeutic agents for regulating angiogenesis. Importantly these findings refine the traditional view of signal sequences as mere targeting elements, revealing a role in cellular signaling. This opens new avenues for research and therapeutic strategies.

Implementation Trendelenburg Position In Septic Shock Patients In The Intensive Care Unit : A Case Report

Introduction: Shock is a clinical syndrome that occurs due to hemodynamic and metabolic disorders characterized by failure of the circulatory system to maintain adequate perfusion to the body's vital organs. Objective: This study aimed to describe the implementation of the Trendelenburg position intervention in patients with septic shock in the intensive care unit. Method: Researchers used the case report method to explain the implementation of the Trendelenburg position intervention in shock management. Result: In this study, the Trendenburg position can increase perfusion in patients with septic shock at the beginning of the maneuver but it does not last long. This position helps increase the perfusion of vital organs by improving blood flow to the brain and other organs in the patient. Recommendation: This study concludes that the Trendelenburg position has a positive effect on patients with septic shock if combined with other interventions and pharmacological support. Keywords: Intensive Care Unit, Shock, Trendelenburg

Evaluation of novel balloon pulmonary angioplasty using intravascular ultrasound for total occlusion lesions and blood flow in the postprocedural phase after initially unsuccessful procedures.

Outcomes of balloon pulmonary angioplasty (BPA) using intravascular ultrasound (IVUS) with a rounded tip to cross a total occlusion lesion in chronic thromboembolic pulmonary hypertension without passing a conventional guidewire remain unclear. Even in initially unsuccessful cases of total occlusion lesions, improved blood flow may be observed in the postprocedural phase as a result of breaking the thrombosis cap surface. The aim of the study was to verify the initial success of BPA with a new technique using IVUS for total occlusion lesions and to evaluate peripheral blood flow in the postprocedural phase in initially unsuccessful cases. Initial success rate and associated factors were evaluated in 50 total occlusion lesions by attempted IVUS passage using a new technique without a preceding guidewire from August 2016 to February 2024. Peripheral blood flow improvement in the postprocedural phase among initially unsuccessful cases was investigated via subsequent angiographic examination or during follow-up. The success rate was 54%, and the sole determinant of success was the angle of the lesion. Peripheral perfusion improved in 15 of 23 initially unsuccessful cases in the postprocedural phase. Even in the unsuccessful cases, significant improvement in peripheral perfusion occurred in the postprocedural phase in the patients undergoing dilatation with the balloon advanced partway into the total occlusion lesion to confirm intravascular location of the balloon (P = .0257). BPA treatment of total occlusion lesions may improve perfusion in the postprocedural phase even following an initially unsuccessful treatment. Maximizing use of IVUS may provide an adjunctive role in BPA of total occlusion lesions.

The functional impact on donor vessel following transcatheter closure of coronary artery fistulas-a retrospective study using QFR analysis.

The impact of transcatheter closure of coronary artery fistula (CAF) and residual shunt after occlusion on improving blood flow in the donor vessel remains uncertain. To evaluate the functional impact on the donor vessel following CAFs closure using QFR (Quantitative Flow Ratio) analysis. A total of 46 patients with 48 CAFs who underwent transcatheter closure at Shanghai Chest Hospital and Shuguang Hospital between March 2015 and August 2023 were included in the review. The clinical, angiographic details, and QFR data were subjected to analysis. The size of the fistulae was defined according to the ratio between the diameters of the fistulae and the largest diameter of the coronary vessel not feeding the coronary fistula. Among 48 CAFs, the average diameter of the fistulae ostium was 3.19 ± 1.04 mm, while the mean diameter of the donor vessel segment following fistulae was 3.45 ± 1.01 mm. The mean QFR value of the donor vessels with medium CAFs was found to be significantly lower than those with small CAFs (0.93 ± 0.10 vs. 0.98 ± 0.03; p < 0.05). Furthermore, the mean QFR value of donor vessels with medium CAFs was observed to be significantly improved after occlusion (0.99 ± 0.01 vs. 0.93 ± 0.10; p = 0.01). However, there was no statistical difference in the mean QFR value of donor vessels with small CAFs before and after occlusion (0.98 ± 0.03 vs. 0.98 ± 0.02; p > 0.05). Moreover, the changes in QFR were more pronounced in donor vessels with medium CAFs compared to those with small CAFs after occlusion (0.06 ± 0.10 vs. 0.005 ± 0.012; p = 0.01). There is no statistical difference in the mean QFR variation and QFR variation rate between donor vessels with CAFs that occurred residual shunt and those without residual shunt after occlusion (p > 0.05). The presence of medium CAFs has a significant impact on the blood flow of the donor vessel, as compared to small CAFs, and may benefit from occlusion. A small residual shunt has no significant impact on the effectiveness of CAFs occlusion in enhancing donor blood flow.

Effects of Panax notoginseng saponins on alleviating low shear induced endothelial inflammation and thrombosis via Piezo1 signalling

Ethnopharmacological relevancePanax notoginseng saponins (PNS) are the major effective components of Panax notoginseng (burk) F.H.Chen which is one of the classic promoting blood circulation herbs in traditional Chinese medicine. PNS is widely used in China for the treatment of cerebral ischemic stroke. Pathological low shear stress is a causal factor in endothelial inflammation and thrombosis. However, the mechanism of PNS against low shear related endothelial inflammation is still unclear. Aim to the studyThis study aims to investigate the effects of PNS against endothelial inflammation induced by low shear stress and to explore the underlying mechanical and biological mechanisms. Materials and methodsMouse model of carotid partial ligation for inducing low endothelial shear stress was established, the pharmacodynamic effect and mechanism of PNS against endothelial inflammation induced by low shear stress through Piezo1 were explored. Yoda1-evoked Piezo1 activation and expression in human umbilical vein endothelial cells (HUVECs) were determined at static condition. Microfluidic channel systems were used to apply shear stress on HUVECs and Piezo1 siRNA HUVECs to determine PECAM-1, p-YAP and VCAM-1 expression. And platelet rich plasma (PRP) was introduced to low shear treated endothelial cells surface to observe the adhesion and activation by fluorescence imaging and flowcytometry. ResultsPNS attenuated endothelial inflammation and improved blood flow in a reasonable dose response pattern in carotid partial ligation mouse model by influencing Piezo1 and PECAM-1 expression, while suppressing yes-associated protein (YAP) nuclear translocation. We found Piezo1 sensed abnormal shear stress and transduced these mechanical signals by different pathways in HUVECs, and PNS relieved endothelial inflammation induced by low shear stress through Piezo1. We also found Piezo1 signalling has interaction with PECAM-1 under low shear stress, which were involved in platelets adhesion to endothelial cells. Low shear stress increased YAP nuclear translocation and increased VCAM-1 expression in HUVECs which might activate platelets. PNS inhibited low shear induced Piezo1 and PECAM-1 expression and YAP nuclear translocation in HUVECs, furthermore inhibited platelet adhesion and activation on dysfunctional endothelial cells induced by low shear stress. ConclusionPNS ameliorated endothelial inflammation and thrombosis induced by low shear stress through modulation of the Piezo1 channel, PECAM-1 expression, and YAP nuclear translocation. PNS might serve as a potential therapeutic candidate for ameliorating endothelial inflammation induced by abnormal blood shear stress.

Machine learning based analysis of entropy production and wall shear stress in blood flow through stenosed artery

The building up of cholesterol and various substances on the inner boundary of arterial walls forms a plaque (stenosis), which results in the narrowing of walls of arteries, and this exerts additional stress on the walls. Shear stress at the wall of arteries may cause the formation of plaque, plaque growth, and expansive arterial remodeling, and it may also result in an increased risk of plaque rupture. The purpose of this research work is to use machine learning approaches to analyze the wall shear stress and entropy generation through irreversible processes of blood flow in a porous stenosed artery within the context of magnetohydrodynamic consideration. As a way of illustrating blood’s non-Newtonian behavior, the Casson fluid model is used. A blood flow model in the context of mild stenosis has been developed, and it has subsequently been computationally addressed using an explicit finite difference method. The velocity, temperature, entropy generation, Bejan number, and wall shear stress are visualized for different values of pertinent variables. The result reflects the increased velocity in the stenosed region. A hybrid machine learning method using artificial neural network and particle swarm optimization is implemented to optimize the entropy generation and wall shear stress. The network is trained using Stochastic gradient–descent training procedure as well as Levenberg–Marquardt training procedure, and the outcomes of both training procedures are compared. Using this machine learning process, the minimum entropy production has been found for specific values of the Hartmann number, dimensionless temperature difference, and pulsatile component of pressure gradient. This machine learning-based optimization approach enhances the ability to forecast quantitative changes in affecting parameters, which will contribute to minimized damage to the arterial wall, improved blood flow efficiency and the delivery of necessary components to tissues.

Comparison of the effect of telephone follow-up with social network follow-up program on self-efficacy and depression in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial

IntroductionCoronary artery bypass graft (CABG) surgery is a common procedure to improve blood flow to the heart muscles, but patients often face challenges during the recovery period. Self-efficacy and depression play crucial roles in patient outcomes. Telephone follow-up and social network follow-up have been introduced as interventions to enhance self-efficacy. This study aims to compare the effectiveness of telephone follow-up and social network follow-up on self-efficacy and depression in CABG patients. MethodThe study is a single-blinded, randomized controlled trial conducted at Shahid Rajaee Heart Hospital in Tehran, Iran. The sample size was determined to be 99 patients who met the inclusion criteria. Data were collected using a demographic questionnaire, Sullivan's cardiac self-efficacy questionnaire, and the Beck Depression Inventory (BDI). Participants were assigned to three groups: control, telephone follow-up, and WhatsApp follow-up using randomization. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). ResultsThe results revealed significant improvements in self-efficacy and reductions in depression scores for both the telephone and WhatsApp follow-up groups compared to the control group following the intervention (p < 0.001). Additionally, the mean self-efficacy score was higher and the mean depression score was lower in the WhatsApp follow-up group than in the telephone follow-up group after the intervention (p < 0.001). DiscussionThe findings provide valuable insights for healthcare professionals in choosing appropriate interventions to enhance patients' self-efficacy levels and improve mental health outcomes. Both telephone follow-up and social network follow-up interventions have their own advantages and can be effective in supporting patients' recovery after CABG surgery.

Imaging Features of Uncommon Entities That Manifest with Torsion.

Torsion is the twisting of an object along the axis, and various structures (organs and tumors) in the body can twist. Torsion causes initial lymphatic and venous outflow obstruction, leading to congestive edema, enlargement, venous hemorrhagic infarction, and surrounding edema. It can also cause subsequent arterial obstruction depending on the degree of torsion, leading to ischemia, infarction, necrosis, gangrene, and surrounding inflammation. Therefore, in several cases of torsion, immediate surgical intervention is required to improve blood flow and prevent serious complications. Clinical manifestations of torsion are often nonspecific and can affect individuals of varying ages and sex. Imaging plays an important role in the early diagnosis and management of torsion. Multiple imaging modalities, including US, radiography, CT, and MRI, are used to evaluate torsion, and each modality has its specific characteristics. The imaging findings reflect the pathophysiologic mechanism: a twisted pedicle (whirlpool sign), enlargement of the torsed structures, reduced blood flow, internal heterogeneity, and surrounding reactive changes. The whirlpool sign is a definitive characteristic of torsion. In some cases, despite poor internal enhancement, capsular enhancement is observed on contrast-enhanced CT and MR images and is considered to be associated with preserved capsular arterial flow or capsular neovascularization due to inflammation. Radiologists should be familiar with the pathophysiologic mechanisms, clinical characteristics, and imaging characteristics of torsion in various structures in the body. Since other articles about common organ torsions already exist, the authors of this article focus on the uncommon entities that manifest with torsion. ©RSNA, 2024.

Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor Improves the Vascular Function of Arteriovenous Fistula in Rats with Hyperglycemia.

Few evidence-based medications to improve the primary patency of arteriovenous fistulas in patients with diabetes who require hemodialysis are available. We investigated whether proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) could improve arteriovenous fistula function through pleiotropic effects in a rat model of hyperglycemia. Ex vivo effects of PCSK9i on the aorta of Sprague-Dawley (SD) rats were investigated using an organ bath system. For in vivo experiments, an abdominal aortocaval (AC) fistula was generated in SD rats (200-250 g) after inducing hyperglycemia through streptozotocin administration (80 mg/kg, intraperitoneal). Alirocumab (50 mg/kg/week, subcutaneous) was administered on the day of fistula surgery and day 7. Echocardiography, blood flow through the aorta-limb, vasomotor reactivity, and serum biochemistry were examined on D14. Furthermore, enzyme-linked immunosorbent assay and immunoblotting were performed. PCSK9i induced aorta relaxation ex vivo through a potassium channel-associated mechanism. PCSK9i significantly improved blood flow and preserved endothelial function without changes in cardiac function and serum lipid levels in rats with hyperglycemia. The levels of lectin-like oxidized low-density lipoprotein receptor-1, superoxide dismutase, cyclooxygenase-2, caspase-1, and interleukin-1β were significantly reduced in the treatment group. PCSK9i decreased the ratio of phosphorylated to total p38 mitogen-activated protein kinase and extracellular signal-regulated kinase in the aorta of rats with hyperglycemia. Short-term treatment with PCSK9i preserved endothelial function, induced vascular dilatation, and increased blood flow in the AC fistula of rats with hyperglycemia. The pleiotropic mechanisms were associated with the suppression of oxidative stress and tissue inflammation during hyperglycemia.