An explainable machine learning-based probabilistic framework for the design of scaffolds in bone tissue engineering.

Recently, 3D-printed biodegradable scaffolds have shown great potential for bone repair in critical-size fractures. The differentiation of the cells on a scaffold is impacted among other factors by the surface deformation of the scaffold due to mechanical loading and the wall shear stresses imposed by the interstitial fluid flow. These factors are in turn significantly affected by the material properties, the geometry of the scaffold, as well as the loading and flow conditions.

Revisiting Cardiovascular Benefits of Blood Pressure Reduction in Primary and Secondary Prevention: Focus on Targets and Residual Risk-A Systematic Review and Meta-Analysis.

Background: Previous meta-analyses resurrected the debated statement "the lower, the better" following blood pressure (BP)-lowering treatment. We investigated the benefits of BP-lowering treatment at different BP targets by prevention category.

Methods: The meta-analysis protocol was registered at the International Prospective Register of Systematic Reviews (CRD42022379249).

When anticoagulation management in atrial fibrillation becomes difficult: Focus on chronic kidney disease, coagulation disorders, and cancer.

Anticoagulation therapy (AT) is fundamental in atrial fibrillation (AF) treatment but poses challenges in implementation, especially in AF populations with elevated thromboembolic and bleeding risks. Current guidelines emphasize the need to estimate and balance thrombosis and bleeding risks for all potential candidates of antithrombotic therapy. However, administering oral AT raises concerns in specific populations, such as those with chronic kidney disease (CKD), coagulation disorders, and cancer due to lack of robust data.

One-year outcomes following a hypertensive urgency or emergency.

There are scarce data on the comparative prognosis between patients with hypertensive emergencies (HE), urgencies (HU), and those without HU or HE (HP). Our study aimed to compare cardiovascular (CV) outcomes of HE, HU, and HP during a 12-month follow-up period. The population consisted of 353 consecutive patients presenting with HE or HU in a third-care emergency department and subsequently referred to our hypertension center for follow-up.

DASH vs. Mediterranean diet on a salt restriction background in adults with high normal blood pressure or grade 1 hypertension: A randomized controlled trial.

Background & Aims: Non-pharmacological measures are recommended as the first-line treatment for individuals with high-normal blood pressure (BP) or mild hypertension. Studies directly comparing the BP effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on a salt restriction background are currently lacking.

Sex-related cardiovascular prognosis in patients with hypertensive emergencies: a 12-month study.

Current evidence on the prognosis of patients with a hypertensive crisis and predisposing factors is limited. We registered the clinical phenotype of patients with HC admitted to the emergency department, while those with a hypertensive emergency (HE) were hospitalized. One-year outcomes, i.

Net clinical benefit of DOACs vs. usual anticoagulation treatment in venous thromboembolism and active cancer: systematic review and meta-analysis.

Patients with active cancer are at high risk of recurrent venous thromboembolism (VTE). Usual treatment includes low molecular weight heparin (LMWH), while vitamin K antagonists (VKAs) have also been used as substitutes for LMWH. Direct oral anticoagulants (DOACs) are considered a beneficial alternative to the usual treatment but are accompanied by an increased rate of bleeding compared to LMWH.

Chronic Thoracic Aortic Dissection: How to Treat, When to Intervene.

Thoracic aortic dissection (AD) is associated with increased morbidity and mortality. Acute aortic syndrome is the first presentation of the disease in most cases. While acute AD management follows concrete guidelines because of its urgent and life-threatening nature, chronic AD is usually overlooked, although it concerns a wide spectrum of patients surviving an acute event.

Fatty liver index and cardiovascular outcomes in never-treated hypertensive patients: a prospective cohort.

The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing rapidly worldwide, affecting 25-30% of the population. Fatty liver index (FLI) is a validated marker of NAFLD and can be used as a screening tool for hepatic steatosis. The purpose of the study was to evaluate the relationship between FLI and the risk of major cardiovascular events in never treated hypertensive patients.

Common surgical masks and unattended blood pressure changes in treated hypertensive patients.

Although the effect of face masks on preventing airborne transmission of SARS-CoV-2 is well studied, no study has evaluated their effect on blood pressure (BP). Therefore, we investigated the effect of surgical masks on BP in 265 treated hypertensive patients. Following the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa.

Renal outcomes associated with glucose-lowering agents: Systematic review and meta-analysis of randomized outcome trials.

Although the clinical questions of the recent glucose-lowering trials are principally oriented towards preventing macrovascular events, an updated review regarding renal outcome prevention is lacking. We assessed the impact of different antihyperglycemic classes on kidney damage progression. A systematic review and meta-analysis was performed by searching PubMed, Cochrane Collaboration Library, Medline, and previous overviews through June 2021 (any language) for earlier and contemporary glucose-lowering trials, including patients with, but not limited to, type 2 diabetes mellitus vs.

BEM evaluation of surface octahedral strains and internal strain gradients in 3D-printed scaffolds used for bone tissue regeneration.

Most of the mechnoregulatory computational models appearing so far in tissue engineering for bone healing predictions, utilize as regulators for cell differentiation mainly the octahedral volume strains and the interstitial fluid velocity calculated at any point of the fractured bone area and controlled by empirical constants concerning these two parameters. Other stimuli like the electrical and chemical signaling of bone constituents are covered by those two regulatory fields. It is apparent that the application of the same mechnoregulatory computational models for bone healing predictions in scaffold-aided regeneration is questionable since the material of a scaffold disturbs the signaling pathways developed in the environment of bone fracture.

Net clinical benefit of a reduced dose of DOACs in non-valvular atrial fibrillation: A meta-analysis of randomized trials.

Background: In standard dosing, direct Oral Anticoagulants (DOACs) are used as an alternative to warfarin to prevent ischemic stroke and systemic embolism in non-valvular Atrial Fibrillation (AF). However, randomized comprehensive evidence considering the efficacy and safety of the low-dose DOACs in the same setting is still lacking. Toward this end, we conducted a meta-analysis of randomized trials to estimate the risk/benefit ratio, in terms of net clinical benefit, by comparing a reduced dose of DOACs and warfarin.

Isolated diastolic vs. systolic hypertension phenotypes and outcomes: prospective cohort of newly diagnosed individuals with hypertension.

Aims: To evaluate whether different hypertension phenotypes, namely, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and systolic/diastolic hypertension (SDH) have a differential outcome effect by clinic and ambulatory blood pressure (BP) measurements.

Methods: We prospectively evaluated in 569 never-treated patients with sustained hypertension (age 52.6 ± 11.

Gradient 3D Printed PLA Scaffolds on Biomedical Titanium: Mechanical Evaluation and Biocompatibility.

The goal of the present investigation was to find a solution to crucial engineering aspects related to the elaboration of multi-layered tissue-biomimicking composites. 3D printing technology was used to manufacture single-layered and gradient multi-layered 3D porous scaffolds made of poly-lactic acid (PLA). The scaffolds manufacturing process was optimized after adjusting key printing parameters.

Talonavicular Dislocation-What Lies Beneath?

Background: The talonavicular joint is a rare site of dislocation. Its etiology varies and can be the result of either acute trauma or a chronic degenerative process that most commonly occurs in patients with rheumatoid arthritis or Charcot arthropathy. Our aim is to highlight the relationship between the underlying pathology of talonavicular dislocations and the final outcome in the case of operative management.

Effect of ultrasound on bone fracture healing: A computational mechanobioregulatory model.

Bone healing process is a complicated phenomenon regulated by biochemical and mechanical signals. Experimental studies have shown that ultrasound (US) accelerates bone ossification and has a multiple influence on cell differentiation and angiogenesis. In a recent work of the authors, a bioregulatory model for providing bone-healing predictions was addressed, taking into account for the first time the salutary effect of US on the involved angiogenesis.

Effect of ultrasound on bone fracture healing: A computational bioregulatory model.

Bone healing is a complex biological procedure in which several cellular actions, directed by biochemical and mechanical signals, take place. Experimental studies have shown that ultrasound accelerates bone ossification and has a multiple influence on angiogenesis. In this study a mathematical model predicting bone healing under the presence of ultrasound is demonstrated.

Evaluation of ultrasonic scattering for different cortical bone porosities and excitation frequencies: A numerical study.

Quantitative ultrasound is a promising and relative recent method for the assessment of bone. In this work, the interaction of ultrasound with the porosity of cortical bone is investigated for different frequencies. Emphasis is given on the study of complex scattering effects induced by the propagation of an ultrasonic wave in osseous tissues.

Numerical evaluation of the backward propagating acoustic field in healing long bones.

The propagation of ultrasound in healing long bones induces complex scattering phenomena due to the interaction of an ultrasonic wave with the composite nature of callus and osseous tissues. This work presents numerical simulations of ultrasonic propagation in healing long bones using the boundary element method aiming to provide insight into the complex scattering mechanisms and better comprehend the state of bone regeneration. Numerical models of healing long bones are established based on scanning acoustic microscopy images from successive postoperative weeks considering the effect of the nonhomogeneous callus structure.

Concrete wave dispersion interpretation through Mindlin's strain gradient elastic theory.

Classical elastic wave features like pulse velocity and attenuation have been used for decades for concrete condition characterization. Relatively recently the effect of frequency has been studied showing no doubt over the dispersive behavior of the material. Despite the experimental evidence, there is no unified theory to model the material and explain this phase velocity change at frequencies below 200 kHz.

Non-linear dynamic modeling of glucose in type 1 diabetes with kernel adaptive filters.

We propose a non-linear recursive solution to the problem of short-term prediction of glucose in type 1 diabetes. The Fixed Budget Quantized Kernel Least Mean Square (QKLMS-FB) algorithm is employed to construct a univariate model of subcutaneous glucose concentration, which: (i) handles nonlinearities by transforming the input space into a high-dimensional Reproducing Kernel Hilbert Space and, (ii) finds a sparse solution by retaining a representative subset of the training input vectors. The dataset comes from the continuous multi-day recordings of 15 type 1 patients in free-living conditions.

Boundary element simulation of ultrasonic backscattering during the fracture healing process.

Competent fracture healing monitoring and treatment requires an extensive knowledge of bone biology and microstructure. The use of non-invasive and non-radiating means for the monitoring of the bone healing process has gained significant interest in recent years. Ultrasound is considered as a modality which can contribute to the assessment of bone status during the healing process, as well as, enhance the rate of the tissues' ossification.