Displaying publications 21 - 40 of 170 in total

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  1. Memon MS, Yunus N, Razak AA
    Int J Prosthodont, 2001 May-Jun;14(3):214-8.
    PMID: 11484567
    PURPOSE: The impact strength and the flexural properties of denture base materials are of importance in predicting their clinical performance upon sudden loading. This study compares the impact and transverse strengths and the flexural modulus of three denture base polymers.
    MATERIALS AND METHODS: The investigation included a relatively new microwave-polymerized polyurethane-based denture material processed by an injection-molding technique, a conventional microwave-polymerized denture material, and a heat-polymerized compression-molded poly(methyl methacrylate) (PMMA) denture material. Impact strength was determined using a Charpy-type impact tester. The transverse strength and the flexural modulus were assessed with a three-point bending test. The results were subjected to statistical analysis using a one-way analysis of variance and the Scheffé test for comparison.
    RESULTS: The impact strength of the microwave-polymerized injection-molded polymer was 6.3 kl/m2, while its flexural strength was 66.2 MPa. These values were lower than those shown by the two compression-molded PMMA-based polymers. The differences were statistically significant. The flexural modulus of the new denture material was 2,832 MPa, which was higher than the conventional heat-polymerized polymer but was comparable to the other microwave-polymerized PMMA-based polymer. The difference in the flexural modulus was statistically significant.
    CONCLUSION: In terms of the impact and flexural strengths, the new microwave-polymerized, injection-molded, polyurethane-based polymer offered no advantage over the existing heat- and microwave-polymerized PMMA-based denture base polymers. However, it has a rigidity comparable to that of the microwave-polymerized PMMA polymer.
    Matched MeSH terms: Stress, Mechanical
  2. Abdul Wahab AH, Mohamad Azmi NA, Abdul Kadir MR, Md Saad AP
    Int J Artif Organs, 2022 Feb;45(2):200-206.
    PMID: 33645338 DOI: 10.1177/0391398821999391
    Glenoid conformity is one of the important aspects that could contribute to implant stability. However, the optimal conformity is still being debated among the researchers. Therefore, this study aims to analyze the stress distribution of the implant and cement in three types of conformity (conform, non-conform, and hybrid) in three load conditions (central, anterior, and posterior). Glenoid implant and cement were reconstructed using Solidwork software and a 3D model of scapula bone was done using MIMICS software. Constant load, 750 N, was applied at the central, anterior, and posterior region of the glenoid implant which represents average load for daily living activities for elder people, including, walking with a stick and standing up from a chair. The results showed that, during center load, an implant with dual conformity (hybrid) showed the best (Max Stress-3.93 MPa) and well-distributed stress as compared to other conformity (Non-conform-7.21 MPa, Conform-9.38 MPa). While, during eccentric load (anterior and posterior), high stress was located at the anterior and posterior region with respect to the load applied. Cement stress for non-conform and hybrid implant recorded less than 5 MPa, which indicates it had a very low risk to have cement microcracks, whilst, conform implant was exposed to microcrack of the cement. In conclusion, hybrid conformity showed a promising result that could compromise between conform and non-conform implant. However, further enhancement is required for hybrid implants when dealing with eccentric load (anterior and posterior).
    Matched MeSH terms: Stress, Mechanical
  3. Al-Fakih EA, Abu Osman NA, Mahmad Adikan FR
    Sensors (Basel), 2016 Jul 20;16(7).
    PMID: 27447646 DOI: 10.3390/s16071119
    The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket.
    Matched MeSH terms: Stress, Mechanical
  4. Najib N, Bachok N, Arifin NM, Ishak A
    Sci Rep, 2014;4:4178.
    PMID: 24569547 DOI: 10.1038/srep04178
    This paper is about the stagnation point flow and mass transfer with chemical reaction past a stretching/shrinking cylinder. The governing partial differential equations in cylindrical form are transformed into ordinary differential equations by a similarity transformation. The transformed equations are solved numerically using a shooting method. Results for the skin friction coefficient, Schmidt number, velocity profiles as well as concentration profiles are presented for different values of the governing parameters. Effects of the curvature parameter, stretching/shrinking parameter and Schmidt number on the flow and mass transfer characteristics are examined. The study indicates that dual solutions exist for the shrinking cylinder but for the stretching cylinder, the solution is unique. It is observed that the surface shear stress and the mass transfer rate at the surface increase as the curvature parameter increases.
    Matched MeSH terms: Stress, Mechanical
  5. Shimoda K, Nishimura A, Sunggip C, Ito T, Nishiyama K, Kato Y, et al.
    Sci Rep, 2020 08 18;10(1):13926.
    PMID: 32811872 DOI: 10.1038/s41598-020-70956-5
    Cardiac tissue remodeling caused by hemodynamic overload is a major clinical outcome of heart failure. Uridine-responsive purinergic P2Y6 receptor (P2Y6R) contributes to the progression of cardiovascular remodeling in rodents, but it is not known whether inhibition of P2Y6R prevents or promotes heart failure. We demonstrate that inhibition of P2Y6R promotes pressure overload-induced sudden death and heart failure in mice. In neonatal cardiomyocytes, knockdown of P2Y6R significantly attenuated hypertrophic growth and cell death caused by hypotonic stimulation, indicating the involvement of P2Y6R in mechanical stress-induced myocardial dysfunction. Unexpectedly, compared with wild-type mice, deletion of P2Y6R promoted pressure overload-induced sudden death, as well as cardiac remodeling and dysfunction. Mice with cardiomyocyte-specific overexpression of P2Y6R also exhibited cardiac dysfunction and severe fibrosis. In contrast, P2Y6R deletion had little impact on oxidative stress-mediated cardiac dysfunction induced by doxorubicin treatment. These findings provide overwhelming evidence that systemic inhibition of P2Y6R exacerbates pressure overload-induced heart failure in mice, although P2Y6R in cardiomyocytes contributes to the progression of cardiac fibrosis.
    Matched MeSH terms: Stress, Mechanical
  6. Aman S, Khan I, Ismail Z, Salleh MZ, Al-Mdallal QM
    Sci Rep, 2017 05 26;7(1):2445.
    PMID: 28550289 DOI: 10.1038/s41598-017-01358-3
    This article investigates heat transfer enhancement in free convection flow of Maxwell nanofluids with carbon nanotubes (CNTs) over a vertically static plate with constant wall temperature. Two kinds of CNTs i.e. single walls carbon nanotubes (SWCNTs) and multiple walls carbon nanotubes (MWCNTs) are suspended in four different types of base liquids (Kerosene oil, Engine oil, water and ethylene glycol). Kerosene oil-based nanofluids are given a special consideration due to their higher thermal conductivities, unique properties and applications. The problem is modelled in terms of PDE's with initial and boundary conditions. Some relevant non-dimensional variables are inserted in order to transmute the governing problem into dimensionless form. The resulting problem is solved via Laplace transform technique and exact solutions for velocity, shear stress and temperature are acquired. These solutions are significantly controlled by the variations of parameters including the relaxation time, Prandtl number, Grashof number and nanoparticles volume fraction. Velocity and temperature increases with elevation in Grashof number while Shear stress minimizes with increasing Maxwell parameter. A comparison between SWCNTs and MWCNTs in each case is made. Moreover, a graph showing the comparison amongst four different types of nanofluids for both CNTs is also plotted.
    Matched MeSH terms: Stress, Mechanical
  7. Khan I, Shah NA, Dennis LC
    Sci Rep, 2017 03 15;7:40147.
    PMID: 28294186 DOI: 10.1038/srep40147
    This scientific report investigates the heat transfer analysis in mixed convection flow of Maxwell fluid over an oscillating vertical plate with constant wall temperature. The problem is modelled in terms of coupled partial differential equations with initial and boundary conditions. Some suitable non-dimensional variables are introduced in order to transform the governing problem into dimensionless form. The resulting problem is solved via Laplace transform method and exact solutions for velocity, shear stress and temperature are obtained. These solutions are greatly influenced with the variation of embedded parameters which include the Prandtl number and Grashof number for various times. In the absence of free convection, the corresponding solutions representing the mechanical part of velocity reduced to the well known solutions in the literature. The total velocity is presented as a sum of both cosine and sine velocities. The unsteady velocity in each case is arranged in the form of transient and post transient parts. It is found that the post transient parts are independent of time. The solutions corresponding to Newtonian fluids are recovered as a special case and comparison between Newtonian fluid and Maxwell fluid is shown graphically.
    Matched MeSH terms: Stress, Mechanical
  8. Bayat M, Alarifi IM, Khalili AA, El-Bagory TMAA, Nguyen HM, Asadi A
    Sci Rep, 2019 Oct 25;9(1):15317.
    PMID: 31653877 DOI: 10.1038/s41598-019-51450-z
    A thermo-elastic contact problem of functionally graded materials (FGMs) rotating brake disk with different pure brake pad areas under temperature dependent material properties is solved by Finite Element Method (FEM). The properties of brake disk change gradually from metal to ceramic by power-law distribution along the radial direction from the inner to the outer surface. Areas of the pure pad are changing while the vertical force is constant. The ratio of brake pad thickness to FGMs brake disk thickness is assumed 0.66. Two sources of thermal loads are considered: (1) Heat generation between the pad and brake disk due to contact friction, and (2) External thermal load due to a constant temperature at inner and outer surfaces. Mechanical responses of FGMs disk are compared with several pad contact areas. The results for temperature-dependent and temperature-independent material properties are investigated and presented. The results show that the absolute value of the shear stress in temperature-dependent material can be greater than that for temperature-independent material. The radial stress for some specific grading index (n = 1.5) is compressive near the inner surface for double contact while it is tensile for a single contact. It is concluded that the radial strain for some specific value of grading index (n = 1) is lower than other FGMs and pure double side contact brake disks.
    Matched MeSH terms: Stress, Mechanical
  9. Teo YX, Chan YS, Gouwanda D, Gopalai AA, Nurzaman SG, Thannirmalai S
    Sci Rep, 2021 07 22;11(1):15020.
    PMID: 34294775 DOI: 10.1038/s41598-021-94268-4
    Although global demand for palm oil has been increasing, most activities in the oil palm plantations still rely heavily on manual labour, which includes fresh fruit bunch (FFB) harvesting and loose fruit (LF) collection. As a result, harvesters and/or collectors face ergonomic risks resulting in musculoskeletal disorder (MSD) due to awkward, extreme and repetitive posture during their daily work routines. Traditionally, indirect approaches were adopted to assess these risks using a survey or manual visual observations. In this study, a direct measurement approach was performed using Inertial Measurement Units, and surface Electromyography sensors. The instruments were attached to different body parts of the plantation workers to quantify their muscle activities and assess the ergonomics risks during FFB harvesting and LF collection. The results revealed that the workers generally displayed poor and discomfort posture in both activities. Biceps, multifidus and longissimus muscles were found to be heavily used during FFB harvesting. Longissimus, iliocostalis, and multifidus muscles were the most used muscles during LF collection. These findings can be beneficial in the design of various assistive tools which could improve workers' posture, reduce the risk of injury and MSD, and potentially improve their overall productivity and quality of life.
    Matched MeSH terms: Stress, Mechanical
  10. Gangoda SVS, Avadhanam B, Jufri NF, Sohn EH, Butlin M, Gupta V, et al.
    Sci Rep, 2018 01 26;8(1):1689.
    PMID: 29374229 DOI: 10.1038/s41598-018-20117-6
    Amyloid β (Aβ) deposition is a hallmark of Alzheimer's disease (AD). Vascular modifications, including altered brain endothelial cell function and structural viability of the blood-brain barrier due to vascular pulsatility, are implicated in AD pathology. Pulsatility of phenomena in the cerebral vasculature are often not considered in in vitro models of the blood-brain barrier. We demonstrate, for the first time, that pulsatile stretch of brain vascular endothelial cells modulates amyloid precursor protein (APP) expression and the APP processing enzyme, β-secretase 1, eventuating increased-Aβ generation and secretion. Concurrent modulation of intercellular adhesion molecule 1 and endothelial nitric oxide synthase (eNOS) signaling (expression and phosphorylation of eNOS) in response to pulsatile stretch indicates parallel activation of endothelial inflammatory pathways. These findings mechanistically support vascular pulsatility contributing towards cerebral Aβ levels.
    Matched MeSH terms: Stress, Mechanical
  11. Teasdale JE, Hazell GG, Peachey AM, Sala-Newby GB, Hindmarch CC, McKay TR, et al.
    Sci Rep, 2017 Jan 06;7:39945.
    PMID: 28059114 DOI: 10.1038/srep39945
    Endothelial dysfunction caused by the combined action of disturbed flow, inflammatory mediators and oxidants derived from cigarette smoke is known to promote coronary atherosclerosis and increase the likelihood of myocardial infarctions and strokes. Conversely, laminar flow protects against endothelial dysfunction, at least in the initial phases of atherogenesis. We studied the effects of TNFα and cigarette smoke extract on human coronary artery endothelial cells under oscillatory, normal laminar and elevated laminar shear stress for a period of 72 hours. We found, firstly, that laminar flow fails to overcome the inflammatory effects of TNFα under these conditions but that cigarette smoke induces an anti-oxidant response that appears to reduce endothelial inflammation. Elevated laminar flow, TNFα and cigarette smoke extract synergise to induce expression of the transcriptional regulator activating transcription factor 3 (ATF3), which we show by adenovirus driven overexpression, decreases inflammatory gene expression independently of activation of nuclear factor-κB. Our results illustrate the importance of studying endothelial dysfunction in vitro over prolonged periods. They also identify ATF3 as an important protective factor against endothelial dysfunction. Modulation of ATF3 expression may represent a novel approach to modulate proinflammatory gene expression and open new therapeutic avenues to treat proinflammatory diseases.
    Matched MeSH terms: Stress, Mechanical
  12. Honjo M, Yamagishi R, Igarashi N, Ku CY, Kurano M, Yatomi Y, et al.
    Sci Rep, 2021 01 12;11(1):747.
    PMID: 33436915 DOI: 10.1038/s41598-020-80736-w
    To evaluate the effect of postoperative corticosteroids on surgical outcome and autotaxin (ATX) levels after microhook ab interno trabeculotomy combined with cataract surgery (μLOT-CS), prospective, consecutive non-randomized case series comparing outcomes of 30 eyes with primary open angle glaucoma was performed. The aqueous ATX, intraocular pressure (IOP) and glaucoma medications were monitored for 3 months postoperatively. An in-vivo mouse μLOT model was generated. In vitro, ATX and fibrotic changes induced by dexamethasone (Dex) treatment following scratch (S) in cultured human trabecular meshwork (hTM) cells were assessed by immunofluorescence, immunoenzymatic assay, and RT-qPCR. Postoperative ATX at 1 week and the number of antiglaucoma medications at 3 months were significantly lower in non-steroid group, and steroid use was the only variable significantly associated with postoperative medications at 3 months in multiregression analyses. In vitro, ATX activity was significantly upregulated in the Dex + S group, and αSMA was significantly upregulated in the Dex and Dex + S groups. Fibronectin and COL1A1 were significantly upregulated in the S group. μLOT-CS decreased IOP and medications in the overall cohort, and non-use of postoperative steroids resulted in a smaller number of postoperative medications. Limiting postoperative steroids in μLOT may minimize IOP elevation and postoperative fibrosis.
    Matched MeSH terms: Stress, Mechanical
  13. Asiri A, Saidin S, Sani MH, Al-Ashwal RH
    Sci Rep, 2021 Mar 11;11(1):5634.
    PMID: 33707606 DOI: 10.1038/s41598-021-85149-x
    In this study, single, mix, multilayer Polyvinyl alcohol (PVA) electrospun nanofibers with epidermal growth factor (EGF) and fibroblast growth factor (FGF) were fabricated and characterized as a biological wound dressing scaffolds. The biological activities of the synthesized scaffolds have been verified by in vitro and in vivo studies. The chemical composition finding showed that the identified functional units within the produced nanofibers (O-H and N-H bonds) are attributed to both growth factors (GFs) in the PVA nanofiber membranes. Electrospun nanofibers' morphological features showed long protrusion and smooth morphology without beads and sprayed with an average range of 198-286 nm fiber diameter. The fiber diameters decrement and the improvement in wettability and surface roughness were recorded after GFs incorporated within the PVA Nanofibers, which indicated potential good adoption as biological dressing scaffolds due to the identified mechanical properties (Young's modulus) in between 18 and 20 MPa. The MTT assay indicated that the growth factor release from the PVA nanofibers has stimulated cell proliferation and promoted cell viability. In the cell attachment study, the GFs incorporated PVA nanofibers stimulated cell proliferation and adhered better than the PVA control sample and presented no cytotoxic effect. The in vivo studies showed that compared to the control and single PVA-GFs nanofiber, the mix and multilayer scaffolds gave a much more wound reduction at day 7 with better wound repair at day 14-21, which indicated to enhancing tissue regeneration, thus, could be a projected as a suitable burn wound dressing scaffold.
    Matched MeSH terms: Stress, Mechanical
  14. Mehmood OU, Norzie Mustapha, Sharidan Shafie, Hayat T
    Sains Malaysiana, 2014;43:1109-1118.
    This research looks at the effects of partial slip on heat and mass transfer of peristaltic transport. The magnetohydrodynamic (MHD) flow of viscous fluid in a porous asymmetric channel has been considered. The exact solutions for the stream function, longitudinal pressure gradient, longitudinal velocity, shear stress, temperature and concentration fields are derived by adopting long wavelength and small Reynolds number approximations. The results showed that peristaltic pumping and trapping are reduced with increasing velocity slip parameter. Furthermore, temperature increases with increasing thermal slip parameter. Moreover, the concentration profile decreases with increasing porosity parameter, Schmidt number and concentration slip parameter. Comparisons with published results are found to be in good agreement.
    Matched MeSH terms: Stress, Mechanical
  15. Yazariah M. Yatim, Brian R. Duffy, Stephen K. Wilson
    Sains Malaysiana, 2013;42:975-980.
    We investigate unsteady flow of a thin film of Newtonian fluid around a symmetric slender dry patch moving with constant velocity on an inclined planar substrate, the flow being driven by a prescribed constant shear stress at the free surface of the film (which would be of uniform thickness in the absence of the dry patch). We obtain a novel unsteady travelling-wave similarity solution which predicts that the dry patch has a parabolic shape and that the film thickness increases monotonically away from the dry patch.
    Matched MeSH terms: Stress, Mechanical
  16. Abu Osman NA, Gholizadeh H, Eshraghi A, Wan Abas WAB
    Prosthet Orthot Int, 2017 Oct;41(5):476-483.
    PMID: 28946824 DOI: 10.1177/0309364616670396
    OBJECTIVES: This study aimed to evaluate and compare a newly designed suspension system with a common suspension in the market.

    STUDY DESIGN: Prospective study.

    METHODS: Looped liners with hook fastener and Iceross Dermo Liner with pin/lock system were mechanically tested using a tensile testing machine in terms of system safety. A total of 10 transtibial amputees participated in this study and were asked to use these two different suspension systems. The pistoning was measured between the liner and socket through a photographic method. Three static axial loading conditions were implemented, namely, 30, 60, and 90 N. Furthermore, subjective feedback was obtained.

    RESULTS: Tensile test results showed that both systems could safely tolerate the load applied to the prosthesis during ambulation. Clinical evaluation confirmed extremely low pistoning in both systems (i.e. less than 0.4 cm after adding 90 N traction load to the prosthesis). Subjective feedback also showed satisfaction with both systems. However, less traction at the end of the residual limb was reported while looped liner was used.

    CONCLUSION: The looped liner with hook fastener is safe and a good alternative for individuals with transtibial amputation as this system could solve some problems with the current systems. Clinical relevance The looped liner and hook fastener were shown to be good alternative suspension for people with lower limb amputation especially those who have difficulty to use and align the pin/lock systems. This system could safely tolerate centrifugal forces applied to the prosthesis during normal and fast walking.

    Matched MeSH terms: Stress, Mechanical
  17. Bajuri MN, Kadir MR, Amin IM, Ochsner A
    Proc Inst Mech Eng H, 2012 Jul;226(7):510-20.
    PMID: 22913098 DOI: 10.1177/0954411912445846
    The wrist is the most complex joint for virtual three-dimensional simulations, and the complexity is even more pronounced when dealing with skeletal disorders of the joint such, as rheumatoid arthritis (RA). In order to analyse the biomechanical difference between healthy and diseased joints, three-dimensional models of these two wrist conditions were developed from computed tomography images. These images consist of eight carpal bones, five metacarpal bones, the distal radius and ulna. The cartilages were developed based on the shape of the available articulations and ligaments were simulated via mechanical links. The RA model was developed accurately by simulating all ten common criteria of the disease related to the wrist. Results from the finite element (FE) analyses showed that the RA model produced three times higher contact pressure at the articulations compared to the healthy model. Normal physiological load transfer also changed from predominantly through the radial side to an increased load transfer approximately 5% towards the ulnar. Based on an extensive literature search, this is the first ever reported work that simulates the pathological conditions of the rheumatoid arthritis of the wrist joint.
    Matched MeSH terms: Stress, Mechanical
  18. Chandramathi S, Suresh K, Sivanandam S, Kuppusamy UR
    PLoS One, 2014;9(5):e94567.
    PMID: 24788756 DOI: 10.1371/journal.pone.0094567
    Stress alters the oxidant-antioxidant state and immune cell responses which disrupts its function to combat infection. Blastocystis hominis, a common intestinal protozoan has been reported to be opportunistic in immunocompromised patients namely cancer. B. hominis infectivity in other altered immune system conditions especially stress is unknown. We aimed to demonstrate the stress effects towards the susceptibility and pathogenicity of B. hominis infection.
    Matched MeSH terms: Stress, Mechanical
  19. Khan A, Khan I, Ali F, Ulhaq S, Shafie S
    PLoS One, 2014;9(3):e90280.
    PMID: 24621775 DOI: 10.1371/journal.pone.0090280
    This study investigates the effects of an arbitrary wall shear stress on unsteady magnetohydrodynamic (MHD) flow of a Newtonian fluid with conjugate effects of heat and mass transfer. The fluid is considered in a porous medium over a vertical plate with ramped temperature. The influence of thermal radiation in the energy equations is also considered. The coupled partial differential equations governing the flow are solved by using the Laplace transform technique. Exact solutions for velocity and temperature in case of both ramped and constant wall temperature as well as for concentration are obtained. It is found that velocity solutions are more general and can produce a huge number of exact solutions correlative to various fluid motions. Graphical results are provided for various embedded flow parameters and discussed in details.
    Matched MeSH terms: Stress, Mechanical*
  20. Chan BT, Abu Osman NA, Lim E, Chee KH, Abdul Aziz YF, Abed AA, et al.
    PLoS One, 2013;8(6):e67097.
    PMID: 23825628 DOI: 10.1371/journal.pone.0067097
    Dilated cardiomyopathy (DCM) is the most common myocardial disease. It not only leads to systolic dysfunction but also diastolic deficiency. We sought to investigate the effect of idiopathic and ischemic DCM on the intraventricular fluid dynamics and myocardial wall mechanics using a 2D axisymmetrical fluid structure interaction model. In addition, we also studied the individual effect of parameters related to DCM, i.e. peak E-wave velocity, end systolic volume, wall compliance and sphericity index on several important fluid dynamics and myocardial wall mechanics variables during ventricular filling. Intraventricular fluid dynamics and myocardial wall deformation are significantly impaired under DCM conditions, being demonstrated by low vortex intensity, low flow propagation velocity, low intraventricular pressure difference (IVPD) and strain rates, and high-end diastolic pressure and wall stress. Our sensitivity analysis results showed that flow propagation velocity substantially decreases with an increase in wall stiffness, and is relatively independent of preload at low-peak E-wave velocity. Early IVPD is mainly affected by the rate of change of the early filling velocity and end systolic volume which changes the ventriculo:annular ratio. Regional strain rate, on the other hand, is significantly correlated with regional stiffness, and therefore forms a useful indicator for myocardial regional ischemia. The sensitivity analysis results enhance our understanding of the mechanisms leading to clinically observable changes in patients with DCM.
    Matched MeSH terms: Stress, Mechanical
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