AbstractIn the context of the EU Chemicals Strategy for Sustainability Towards a Toxic-free Environment, and in the aim to facilitate Safe-and-Sustainable-by-Design (SSbD) development of new materials and products, the EU-funded project HARMLESS builds a Decision Support System (DSS) to support innovators in SSbD assessments of products at early design stages. The HARMLESS DSS is fine-tuned to enable Advanced Materials (AdMa) screening, using a combination of New Approach Methodologies (NAMs) and guided by Integrated Approaches to Testing and Assessment (IATAs). Three online tools for SSbD screenings are developed and tested on case study materials, namely: Advanced Materials Earliest Assessment (AMEA), Warning flags, design Advice, Screening Priorities (WASP) and Alternative SSbD Inspector (ASDI). The following case studies are assessed: Oxide-perovskites for automotive catalysts, imogolites for agricultural solutions, aerogel mats for facade insulation and colloidal silica for paint formulations. The case study materials are provided by both large and small enterprises, they represent diverse industry sectors and different stages in the value chain. Results show the DSS ability to guide innovators in developing SSbD AdMa, by facilitating the assessment of most SSbD dimensions and visualizing the results in a comprehensive, yet detailed way, enabling their own balancing of SSbD benefits and trade-offs.

Title : A case of choledocholithiasis 10 years post cholecystectomy, a rare case report-Matthew Mufuridza Vengesai 1 Amrit Pokhrel1 , Dr Senanayake Prematilake 1, Dr Peter Braude 11- Department of Internal Medicine, Manning Base Hospital, Taree, Australia.

Understanding how medicinal plants adapt to environmental changes is critical for optimizing their growth, yield, and pharmacological quality. This study investigates the adaptive mechanisms of Schisandra sphenanthera following ecological migration from Luanchuan (LC) to Tongdao (TD), focusing on the interplay between metabolic reprogramming, microbial community dynamics, and transcriptional regulation. Utilizing an integrative multi-omics approach—combining metabolomics (HPLC-MS), transcriptomics (RNA-seq), and metagenomics—we identified 2,627 metabolites, 57,061 unigenes, and significant shifts in microbial community structures. Notably, the accumulation of lignans (e.g., Schisandrin A, B, C) and triterpenoids (e.g., hydroxymexicanoic acid, ganoderic acid) significantly increased in TD, while flavonoid compounds (e.g., apigenin, daidzein) decreased, indicating a resource allocation trade-off consistent with the ”energy allocation hypothesis.” Concurrently, rhizosphere microbial communities shifted from Alphaproteobacteria dominance in LC to Actinobacteria prevalence in TD, with implications for nitrogen fixation and pathogen suppression. Transcriptomic analyses revealed extensive reprogramming, with upregulation of key genes ( PAL, 4CL, SQS) linked to secondary metabolism, and Weighted Gene Co-expression Network Analysis (WGCNA) highlighted MAPK signaling pathways mediating plant-microbe interactions. These findings elucidate a complex regulatory network where environmental stress triggers microbial community restructuring, transcriptional reprogramming, and secondary metabolism remodeling, ultimately facilitating ecological adaptation.

Objective: This study aimed to quantify the interplay between socioeconomic and ethnic inequalities in preterm birth rates using routinely collected maternity data in England from 2018-2021. Design: A retrospective cohort study using electronic health data. Setting: English hospitals. Sample: 1,537,595 livebirths. All women aged 13-55 with a singleton livebirth (April 2018-March 2021) at 24-42 weeks were included. Methods: Multivariate Poisson regression was used to estimate rate of preterm birth in each ethnic and deprivation group. A post-hoc calculation identified the rate of preterm birth for each ethnic group at each level of deprivation. Main Outcome Measures: Preterm birth (livebirth less than 37 weeks). Results: The rate of preterm birth was 6·30% (95%CI:6·22-6·37) in women living in the most deprived areas, compared to a rate of 5·05% (95%CI:4·96-5·14) among women in the least deprived areas. White women had a preterm birth rate of 5·74% (95%CI:5·70-5·78). Whereas South Asian and Black women had higher rates of preterm birth at 6·09% (95%CI:5·98-6·21) and 5·89% (95%CI:5·70-6·09) respectively. Deprivation attenuated the rate of preterm birth across all ethnicity groups. In areas of high deprivation, preterm birth rates were similar across ethnicity groups. In the least deprived areas, South Asian and Black women had higher rates of preterm birth. Conclusion: Deprivation and ethnicity remain key drivers of inequalities in preterm birth. Prevention strategies need to address socioenvironmental and structural determinants of preterm birth in areas of high deprivation and minority ethnicity groups.

The insulating nature and complex redox reaction of elemental sulfur mandates their encapsulation inside an electronic conductor such as carbon. We discuss here a sulfur/microporous carbon aerogel (S/CA) composite as an efficient, low-cost, high-performance cathode for rechargeable lithium-sulfur (Li/S) battery. The S/CA cathode with varying ratios of sulfur:CA is prepared using pressure induced melt diffusion technique. Of the four different ratios, (sulfur:CA= 70:30) exhibited the best performance. The Li/S cell with (sulfur:CA= 70:30) cathode shows a first discharge capacity of 1308 mAhg -1 at a current rate C/10 and the cell is stable up to 300 cycles with a discharge capacity ≈750 mAhg -1. This composition also exhibits good rate capability over the current density range (0.1-2)C. Post cycling UV-Visible absorbance spectroscopy is carried out to ascertain the dissolution of lithium polysulfides in various S/CA cathodes. UV-Visible results confirm that among the various sulfur:CA compositions, the one with the (sulfur:CA= 70:30) has the optimum retention of polysulfides leading to a superior Li/S battery performance.

Planktonic Foraminifera (PF) shells are ubiquitous archives used as proxies in paleoceanography, and play a crucial role in paleoclimate reconstruction. Planktonic Foraminifera species are sensitive to both abiotic and biotic environmental parameters, and have experienced habitat shifts in response to ocean warming since the post-industrial era. In comparison to the seminal works from the 1950s to the 1970s, we reevaluate the ecological niche of planktonic Foraminifera in the modern ocean. Here, we present the most comprehensive update of their modern global ecological niches, vertical habitat distribution and thermal tolerance using the FORCIS database, which includes all available water-column sourced data over the last century. Our analysis of modern planktonic Foraminifera global distribution patterns, over the 1970-2018 interval, reveals the highest diversity in the tropical and subtropical oceans. Planktonic Foraminifera have consistently maintained a depth preference within the upper 100 m of the ocean, likely due to dependence on light and food availability. Spanning temperatures from-2°C to more than 32°C highlights the remarkable thermal tolerance and/or adaptability of PF to a wide range of temperatures. In addition, species that were once restricted to lower latitudes in the early post-industrial era (pre-1970) have been observed at higher latitudes over the past 50 years. Since the 1970s, small to medium-sized species have increased in abundance across all latitudes, from tropical to polar oceans, a trend particularly evident in the extensive data from the eastern North Atlantic. The analyses of the FORCIS database updates the evolving biogeography of modern PF, and advances our understanding of their ecology, providing revised benchmarks for paleoceanographic interpretations and the ecology of modern planktonic calcifiers.

The reproductive cycle of plants features a crucial transition between diploid sporophytic and haploid gametophytic generations. In garlic ( Allium sativum L .), a lack of gametophyte fertility poses significant challenges for breeding. This study conducted a comprehensive comparative transcriptomic analysis across three developmental stages of garlic floral buds from three genotypes with varied fertility profiles to unravel the genetic underpinnings of gametophyte development. Through differential expression analysis and weighted gene co-expression network analysis (WGCNA), we identified key pathways and genes influencing gametophyte fertility. Our analysis revealed significant enrichment in pathways related to lipid metabolism, amino acid biosynthesis, nucleic acid metabolism, and ribosome biogenesis, which are pivotal for gametophyte vitality and development. Furthermore, we identified the AsAMS gene as a key regulator of gametophyte fertility, that may orchestrat tapetal development and microspore formation by modulating the expression of genes involved in lipid biosynthesis and transport, thereby playing a crucial role in pollen viability. The first functional validation using virus-induced gene silencing (VIGS) in garlic further substantiated the role of AsAMS, which demonstrated its critical impact on pollen viability and morphological integrity of reproductive structures. Taken together, these findings not only deepen our understanding of the genetic mechanisms underlying gametophyte development in garlic but also shed light on potential genetic interventions to overcome fertility barriers. By delineating the pathways and key regulators such as AsAMS, this study opens new avenues for enhancing reproductive efficiency in garlic.

Ethnopharmacological relevance: Glaucocalyxin B (GLB) is known for its anti-inflammatory properties, including alleviating neuroinflammation and treating inflammatory bone injuries. However, its effects on inflammation-induced damage in diabetic cardiomyopathy (DCM) have not been adequately studied. Aim of the study: This study aims to investigate the effects of GLB on inflammatory injury in DCM and to explore its mechanisms in reducing myocardial inflammatory injury. Materials and methods: We utilized network pharmacology analysis, a diabetic rat model (the experimental period lasts for 8 weeks), and H9c2 rat cardiomyocyte experiments to assess the potential of GLB to alleviate DCM-induced inflammatory damage, while also investigating the related anti-inflammatory mechanisms of GLB. Results: Network pharmacology analysis of GLB revealed its involvement in regulating myocardial cell proliferation and the DCM process, as well as its association with inflammation, apoptosis, and oxidative damage. Further in vivo and in vitro studies demonstrated that the application of GLB significantly reduced the levels of oxidative stress markers, such as ROS and MDA, at both tissue and cellular levels. Additionally, GLB also reduced cardiomyocyte apoptosis caused by high glucose levels by enhancing the BCL2/BAX ratio. Signal pathway analysis indicates that the use of GLB inhibits the activation of the NF-κB/NLRP3 pathway. Conclusion: Overall, the findings suggest that GLB effectively mitigates oxidative stress and inflammatory damage associated with DCM. The protective effects of GLB are linked to its modulation of the NF-κB/NLRP3 signaling pathway.

Aims: The study aimed to elucidate the population pharmacokinetics of ciprofol in surgical pediatric patients and to establish a validated dosing regimen for this demographic. Methods: In this study, 27 healthy Chinese children aged 1 to 9, scheduled for elective urologic surgery, received a 0.6 mg/kg bolus of ciprofol over 30 seconds. Thirteen arterial blood samples were collected from each child for analysis. A population pharmacokinetic analysis using nonlinear mixed-effects modeling was conducted with intensive sampling data, and safety assessments were performed throughout the trial. Results: Ciprofol’s pharmacokinetics were best described by a three-compartment model, with key parameters estimated as follows: clearance (CL) at 0.0313 L/min/kg, central compartment volume (V1) at 0.506 L/kg, and peripheral volumes V2 and V3 at 0.225 L/kg and 1.34 L/kg, respectively. Intercompartmental clearances were CL2 at 0.0278 L/min/kg and CL3 at 0.0199 L/min/kg. Including blood urea nitrogen (BUN) as a covariate for V1 improved the model statistically, but its effect on ciprofol exposure was minimal and not clinically significant. Age and weight had no impact on ciprofol’s pharmacokinetics. The study also reported that ciprofol was well-tolerated, with no hemodynamic adverse events. Conclusions: In pediatric patients, both CL and V1 of ciprofol are higher per kilogram than in adults, necessitating a higher induction dose. A 0.6 mg/kg dose in children aged 1 to 9 is expected to provide similar exposure without adverse effects.

A document by Paolo Marra-Biggs. Click on the document to view its contents.

Variations of residual stress fields in a fatigue test specimen and/or across specimens influence the plasticity-induced crack closure process as well as the out-of-plane constraint factor. Therefore, these variations can contribute significantly to the scatter of fatigue properties obtained on specimens without stress relief, especially at low stress intensity factor range. To address this problem, a new compliance-based method is developed for correcting fatigue crack growth data in the presence of a residual stress fields of variable magnitude. It is based on the theoretical modelling of the propagation of an edge crack in an elasto-plastic material subjected to cyclic loading of a constant amplitude. The method is demonstrated for compact tension super duplex stainless steel (SDSS) specimens fabricated using wire-arc additive manufacturing (WAAM) and tested without post-fabrication heat treatment. It can be applied for both the evaluation of residual stress fields in fatigue specimens and obtaining the intrinsic fatigue properties of materials.

Using a RAD sequencing approach to investigate the taxonomic classification of Tridacninae giant clams (genera: Hippopus and Tridacna) and address the phylogenetic discordance within the current literature. Population Size and Structure: Focusing in American Sāmoa, we conducted a comprehensive array of surveys on SCUBA, to assess current population stocks and identifying local hotspots for restoration purposes. Population Genetics: Using T. maxima samples, we are analyzing population genetics to identify source-sink populations and measure interisland connectivity.

In recent times, machine learning being an exciting area, has attracted a lot of studies for its ability to foresee complex chemical and biological properties of chemical compounds used in drug design. This article proposes a machine-learning based quantitative structure-property relationship(QSPR) model for benzenoid hydrocarbons and their physical properties through eigenvalues-based graphical indices. Benzenoid hydrocarbons play a crucial role in drug design and pharmaceutical chemistry due to their stability, aromaticity, and ability to participate in various biological interactions. To validate the results, machine learning technique is applied to predict the properties using various graphical indices. Further, to rank the best hydrocarbon MCDM technique namely SAW is adopted. From the analysis, it is obvious that the best predictive graphical index is Laplacian energy for the property polarizability and the best hydrocarbon is Dibenzo[a,h]pyrene.

The pollen morphology of 13 Euphorbiaceae species and one Phyllanthaceae species native to forest fragments of Cerrado was investigated to contribute to expanding the morphological knowledge and characterizing species for the conservation of degraded areas. The pollen grains were acetolyzed, measured, and photographed using light microscopy (LM). To obtain more details of exine ornamentation, non-acetolyzed pollen grains of some species were observed using scanning electron microscopy (SEM). The qualitative data were described, a pollen key was presented, and descriptive and multivariate statistics analyzed the quantitative data. The pollen grains of Euphorbiaceae differ in polarity, size, amb, shape, number, and type of apertures (inaperturate, 3-colporate, 4-porate, or pantoporate), type of endoapertures (circular, lalongate, lolongate or endocingulate) and exine ornamentation (psilate, microreticulate, reticulate, or with Croton-pattern). Phyllanthus acuminatus Vahl. (Phyllanthaceae) presents pollen grains in monads, isopolar, medium, circular amb, oblate spheroidal, 3-diploporate, and exine pilate. The number and type of apertures, the morphology of the endoapertures, and the ornamentation of the exine were the essential data for distinguishing the studied species, in addition to the diameter measurements and the variations in the thickness of the exine layers being quantitative characters that characterize the analyzed taxa.

Breast cancer remains a leading cause of mortality among women, driving the need for more accurate diagnostic tools. To address this, a smart ruthenium (Ru)-catalyzed bioorthogonal activation chemiluminescent (BAC) probe has been developed for long-lasting non-invasive in vivo imaging. Although chemiluminescence imaging offers ultrahigh sensitivity without background autofluorescence, its application in breast cancer is limited by poor selectivity in complex tumor environments, slow activation kinetics and insufficient resolution. The BAC probe overcomes these challenges via a smart “Ru-locked” mechanism, achieving light-independent, thiol-triggered activation in complex tumor microenvironment. This mechanism enables rapid activation (1 min), prolonged half-life ( t 1/2 = 18.5 h), and high sensitivity (LOD = 87 nM) across a broad emission range (400-800 nm), while enhancing selectivity for thiol-containing metabolites, particularly H 2S. The probe exhibits low toxicity in vitro and efficiently activates chemiluminescence within the tumor microenvironment in vivo, enabling precise imaging for tumor localization and image-guided surgery. Additionally, the phenoxy-adamantyl-1,2-dioxetane luminophores are developed via an efficient synthetic route, which reduces the synthesis from seven steps to two, lowering production costs (300- to 400-fold) and increasing yields from 40% to 95%. This study introduces a smart Ru-locked BAC probe for real-time, non-invasive monitoring of thiol-related homeostasis in breast cancer, with promising application in clinical diagnostic and therapeutic potential.

As Large Language Models (LLMs) continue to evolve, their black-box nature poses significant challenges in terms of interpretability, trust, and accountability. Explainable Artificial Intelligence (XAI) emerges as a crucial approach to making these models more transparent by providing insights into their decision-making processes. This paper explores the significance of XAI techniques in enhancing the interpretability of LLMs, examining key methodologies, such as attention visualization, feature attribution, and surrogate modeling. Additionally, we discuss the implications of transparent AI systems in critical domains, addressing ethical concerns, bias mitigation, and regulatory compliance. By unveiling the black box, we aim to bridge the gap between high-performance AI and human-understandable explanations, fostering more reliable and accountable AI systems.

Background Benzodiazepines are commonly prescribed medications approved for and used in the treatment of anxiolytic and sleep disorders, as well as for seizures, and alcohol withdrawal. However, benzodiazepines are also controlled substances (schedule IV in Canada) because of their potential for abuse and personal harms, which are especially prevalent among older people. It is therefore important to understand how benzodiazepines are being prescribed, and the prevalence of off-label benzodiazepine prescribing, of which very little is known due to challenges in documenting treatment indication. Methods Data from the MOXXI (Medical Office of the XXIst century) electronic health record system in Quebec Canada was used, where specifying the treatment indication for each prescription is required, to estimate the prevalence of off-label prescribing and indications for off-label use of benzodiazepines. Each drug indication was retrospectively classified as either on-label or off-label according to the Health Canada drug database. Off-label prescriptions were further classified as having class evidence supporting their prescription if another benzodiazepine had been approved for the indication by Health Canada. Results There were 20,125 (17.0%) adult patients prescribed benzodiazepines out of the 118,227 patients enrolled in the MOXXI system. The patients were predominantly female (65.6%), and tended to be older with an average age of 60.14 years (standard deviation = 15.68) at the time of the first benzodiazepine prescription. A total of 101,583 unique prescriptions were written for 14 different benzodiazepines to these patients. An approximately equal number of benzodiazepines were prescribed on and off-label (49.3% on-label, 49.2% off-label), with clonazepam having the highest prevalence of off-label prescription (99.5%). Most off-label prescription indications were classified as having class evidence (95.2%). The most common off-label indication was insomnia; 31.6% of all off-label benzodiazepine prescriptions were for insomnia. Conclusions We found that benzodiazepines were frequently prescribed in the province of Quebec and were prescribed off-label approximately half of the time. When prescribed off-label we found that the majority of these prescriptions were for indications that were approved for at least one benzodiazepine. These findings indicate the importance of reminding physicians on the important differences between benzodiazepines that can substantially impact patient outcomes, particularly in older people.

Antiphospholipid syndrome (APS) is well known for its association with arterial and venous thrombosis. Intracardiac thrombosis -more often involving right atrium- although rare, could be a serious manifestation of the disease, complicating its course. We describe a 49-year-old man with known history of APS and multiple myocardial infarction episodes and episodes of venous and arterial thrombosis, who presented with worsening dyspnea. Further evaluations revealed the presence of a mobile mass in the right ventricular outflow tract (RVOT) in favor of thrombosis. The patient was medically managed with aggressive anticoagulation and the RVOT mass underwent regression on follow-up imaging investigations.

Audio stimuli have been used to support awareness of mind wandering and mindfulness during meditation. Binaural beats, an auditory illusion, have attracted significant research interest due to their psychological impacts, including aiding meditation. However, binaural beats have demonstrated inconsistent impacts on user experiences and neural responses during meditation, with this relationship still not fully explored. In this paper, we examine the effect of binaural beats on EEG signals with respect to user experience. The results show that binaural beats increased the occurrence of theta-alpha dominant frequency ratio in the range 1.3-1.8, and this correlates with reduced mind wandering. User mindfulness was also identified to have a positive correlation with cross-frequency coupling. These findings can help researchers evaluate the suitability of binaural beats for meditation and give further insight into how binaural beats function in the brain.

With the escalating global prevalence of obesity, understanding eating behavior is an imperative focus of research. Emerging evidence underscores the central role of dopamine and its receptors in normal and pathological regulation of food intake. Investigations have confirmed the stimulatory effect of selective activation of D4 dopamine receptors within the paraventricular nucleus of the hypothalamus on food intake. This leads to the hypothesis that perturbations in hypothalamic dopaminergic signaling pathways that regulate energy homeostasis may potentially underlie the propensity for obesity-related excess caloric consumption via a D4 Receptor-mediated mechanism. This study aims to elucidate the effects of central administration of the D4 receptor antagonist, L-745,870, on regulating food intake, satiety, and locomotor activity. Here, we investigated the impact of intra-paraventricular blockade of D4 receptors on standard food consumption, behavioral satiety sequence, and locomotor activity in male Wistar rats. Our results indicate that injection of L-745,870 at doses of 0.1 and 1 µg induces a significant reduction in standard food intake within sixty minutes of administration. At a dose of 0.1 µg, L-745,870 accelerated the onset of postprandial satiety without a significant effect on locomotor activity. Together, our results highlight the central role of D4 receptors in the modulation of feeding behavior and satiety and provide a potential avenue for using this compound for the development of pharmacological interventions for obesity. The demonstrated efficacy of L-745,870 in reducing food intake supports its potential therapeutic utility in the broader context of obesity management.

The autonomic nervous system (ANS) acts as a central regulator of socioemotional and physiological processes. Individual differences in ANS activity are associated with mental and physical health outcomes across the lifespan, stabilizing over the first 5 years of life. Thus, ANS activity has become a focus of developmental research. Current approaches to assessing ANS are often infeasible for deployment in large epidemiological studies and low resource settings, necessitating new approaches. The goal of the current study was to compare a “gold standard” system (BioRadio) to a new system (Mawi), which offers advantages of ease of use and automated scoring pipelines, in a sample of children in Malawi, an African country with one of the lowest per capita incomes in the world. Twenty-five children, aged 3 to 6 years, were assessed simultaneously with the two systems while participating in a standardized stressor protocol that included baseline, stressor, and recovery periods. Multiple ANS indicators outputted from each system were compared. Analyses assessed agreement in equivalent indices. Absolute heart rate scores were consistently higher from Mawi; consequently, other absolute scores were consistently higher or lower, depending on the index. After adjusting for index score mean differences between systems, agreement was good to excellent (ICC 0.75-0.97). There were no differences between systems in the detection of changes in ANS activity across the baseline, stressor, and recovery episodes of the protocol. The results provide initial evidence that the Mawi system produces data sufficiently similar to that of a gold standard to be considered valid. Thus, the Mawi system may be a feasible option for measuring ANS indicators, with particular utility under certain resource constraints. Future efforts to further validate the Mawi system should include testing in a variety of settings and contexts with larger sample sizes.

Background: Atopic dermatitis treatments that provide rapid and extensive itch relief and lesion clearance are inadequate. Methods: To compare the clinical effectiveness of tofacitinib combined with dupilumab and dupilumab monotherapy in adults with moderate-to-severe atopic dermatitis, a prospective, open-label, single-center, real-world study was performed between March 2021 and July 2022, lasting 18 weeks. Patients were treated with either tofacitinib plus dupilumab or dupilumab monotherapy for 12 weeks. Afterward, all patients received dupilumab only. Both clinician-oriented and patient-oriented scores were assessed at baseline (T0) and after 2 (T1), 6 (T2), 8 (T3), 12 (T4) and 18 (T5) weeks. Results: Twenty-seven patients received a combined regimen, and forty-seven received monotherapy. Reductions in IGA, EASI, SCORAD and BSA scores were significantly greater in the combined group at all time intervals, except for BSA from T5 to T0. However, there were no significant differences between the two groups in terms of changes in the POEM, ADCT, NRS, or DLQI score during these intervals. Conclusion: The combination of tofacitinib with dupilumab in the short-term is a potentially effective strategy for more rapid improvement of itch and AD lesions.

Purpose In heart failure, dyssynchrony is associated with accelerated cardiac remodeling and a worse prognosis. Both restored with resynchronization. We have previously developed a mouse model of dyssynchrony and resynchronization and here assess changes in protein expression within that model. Experimental design Mice were subjected to ischemia/reperfusion followed by pacemaker implantation. Three groups were defined: (i) sinus rhythm four weeks - synchronous heart failure (SynHF), (ii) right ventricular pacing (RVP) four weeks - dyssynchronous heart failure (DysHF) and (iii) RVP two weeks followed by two weeks sinus rhythm - resynchronized heart failure (ResynHF). Heart tissue was evaluated for protein content with mass spectrometry. Results A total of 3324 proteins were detected. The abundance of 589 proteins differed between DysHF and SynHF and 253 between DysHF and ResynHF. The changed proteins in the comparisons to DysHF overlapped to a great extent. Among the dysregulated proteins in DysHF were several immunoglobulin chains and extracellular matrix proteins. Conclusion Adding dyssynchrony to ischemic heart failure resulted in protein dysregulation, which was partly reversed with resynchronization. The dysregulation was characterized by an increased immune activity and skewing of the extracellular matrix proteins, which may be part of the remodeling process in DysHF.

A document by Kenneth Egwu. Click on the document to view its contents.