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2022 ◽  
Vol 14 (2) ◽  
pp. 908
Author(s):  
Elyakim Ben-Hakoun ◽  
Eddy Van De Voorde ◽  
Yoram Shiftan

Located in the Middle East, Haifa Port serves both local and international trade interests (from Asia, Europe, America, Africa, etc.). Due to its strategic location, the port is part of the Belt and Road initiative. This research investigates Haifa Port’s emissions contribution to the existing daily emission inventory level in the area. This research is based on a developed full bottom-up model framework that looks at the single vessel daily voyage through its port call stages. The main data sources for vessel movements used in this research are the Israel Navy’s movements log and the Israel Administration of Shipping and Ports’ (ASP) operational vessel movements and cargo log. The Fuel Consumption (FC) data and Sulfur Content (SC) levels are based on official Israel ASP survey data. The observation years in this research are 2010–2018, with a focus on the Ocean-Going Vessel (OGV) type only. The results show that the vessel fleet calling at Israel ports mainly comprises vessels that have a lower engine tier grade (i.e., Tier 0 and 1), which is considered a heavy contributor to nitrogen oxide (NOx) pollution. The study recommends an additional cost charged (selective tariff) to reflect the external social cost linked to the single vessel air pollution combined with supportive technological infrastructure and economic incentive tools (e.g., electric subsidy) to attract or influence vessel owners to assign vessels equipped with new engine tier grades for calls at Israeli ports.


2022 ◽  
Vol 8 ◽  
Author(s):  
Juha H. Vähätalo ◽  
Lauri T. A. Holmström ◽  
Katri Pylkäs ◽  
Sini Skarp ◽  
Katja Porvari ◽  
...  

Objective: Cardiac hypertrophy with varying degrees of myocardial fibrosis is commonly associated with coronary artery disease (CAD) related sudden cardiac death (SCD), especially in young victims among whom patterns of coronary artery lesions do not entirely appear to explain the cause of SCD. Our aim was to study the genetic background of hypertrophy, with or without fibrosis, among ischemic SCD victims with single vessel CAD.Methods: The study population was derived from the Fingesture study, consisting of all autopsy-verified SCDs in Northern Finland between the years 1998 and 2017 (n = 5,869). We carried out targeted next-generation sequencing using a panel of 174 genes associated with myocardial structure and ion channel function in 95 ischemic-SCD victims (mean age 63.6 ± 10.3 years; 88.4% males) with single-vessel CAD in the absence of previously diagnosed CAD and cardiac hypertrophy with or without myocardial fibrosis at autopsy.Results: A total of 42 rare variants were detected in 43 subjects (45.3% of the study subjects). Five variants in eight subjects (8.4%) were classified as pathogenic or likely pathogenic. We observed 37 variants of uncertain significance in 39 subjects (40.6%). Variants were detected in myocardial structure protein coding genes, associated with arrhythmogenic right ventricular, dilated, hypertrophic and left ventricular non-compaction cardiomyopathies. Also, variants were detected in ryanodine receptor 2 (RYR2), a gene associated with both cardiomyopathies and catecholaminergic polymorphic ventricular tachycardias.Conclusions: Rare variants associated with cardiomyopathies, in the absence of anatomic evidence of the specific inherited cardiomyopathies, were common findings among CAD-related SCD victims with single vessel disease and myocardial hypertrophy found at autopsies, suggesting that these variants may modulate the risk for fatal arrhythmias and SCD in ischemic disease.


Author(s):  
Bhavneet Singh ◽  
Rekha Gupta ◽  
Sreenivas Reddy

AbstractThe occurrence of super-dominant “single coronary artery” is an extremely rare and seldom reported phenomenon. The heart is dependent on a single vessel which makes its occlusion, if present, catastrophic. Here, the authors present an extremely rare combination of superdominant right coronary artery coexisting with absent left coronary artery and left circumflex artery with abnormal origin of left anterior descending artery from right coronary sinus. Precise morphological and physiological knowledge and evaluation of these anomalies is a must for opting the best available therapeutic modality and better prognosis.


2021 ◽  
Author(s):  
xiaoke xie ◽  
Xuanting Liu ◽  
Yiwen Chen ◽  
Jiazhu Zhu ◽  
Yongxian Xu ◽  
...  

Abstract Vascular occlusion leading to brain dysfunctions is usually considered evoking microglia-induced inflammation response. However, it remains unclear how microglia interact with blood vessels in the development of vascular occlusion-related brain disorders. Here, we illuminate long-term spatiotemporal dynamics of microglia and their activation pattern during single vessel occlusion and recanalization. The results show that microglia display remarkable response characteristics in different phases, including acute reaction, rapid diffusion, transition and chronic effect. Microglial cell body represents a unique filament-shape migration and has slower motility compared to the immediate reaction of processes to occlusion. We capture single microglia with few processes moves out of the cluster and redistributes territory with increasing ramified processes. Microglial cluster resolves gradually until microglial number and morphology become stabilized. Therefore, our study offers a comprehensive analysis of spatiotemporal dynamics of microglia to both vessel occlusion and recanalization. Microglial phase-specific response suggests the morphological feature-oriented phased intervention would be an attractive option for vascular occlusion-related diseases treatments.


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2289
Author(s):  
Przemysław Dyrla ◽  
Arkadiusz Lubas ◽  
Jerzy Gil ◽  
Marek Saracyn ◽  
Maciej Gonciarz

Dynamic tissue perfusion measurement (DTPM) and single vessel flow measurement (SVFM) were assessed in differentiating inflammatory and malignant lesions of the pancreas. Sixty-nine patients (age 62.0 ± 14.7; 33 Female and 36 Men; 40 with malignant and 29 with inflammatory lesions) in whom during the endoscopic ultrasound (EUS) of focal pancreatic lesions it was possible to adequately evaluate the flow in the color Doppler, and then perform a biopsy, were qualified for the study. The assessed DTPM parameters flow velocity (TFV), perfusion intensity (TPI), and resistive index (TRI) as well as the following SVFM parameters: flow velocity (FV), volume flow (VolF), and resistive index (RI) differed significantly between the malignant and inflammatory lesions (p < 0.005). TFV and TPI have slightly better discriminatory properties than the corresponding FV and VolF parameters (p < 0.10). Considering the Doppler parameters usually evaluated in a given method, the TPI = 0.009 cm/s (sensitivity 79%, specificity 92%, AUC 0.899, p < 0.001) was significantly better (p = 0.014) in differentiating between inflammatory and malignant pancreatic lesions in comparison to FV = 2.526 cm/s (sensitivity 79%, specificity 70%, AUC 0.731, p < 0.001). Tissue perfusion has better discriminatory properties in the differentiation of solid pancreatic lesions than the Doppler blood flow examination in the single vessel within the tumor.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Ying Li ◽  
Li Li ◽  
Kun Wang ◽  
Pengtao Wu ◽  
Yijie Cui

Objective. The aim of this study was at investigating the risk stratification and prognostic value of hypersensitive troponin T (hs-TnT) combined with matrix metalloproteinase 2 (MMP-2) in patients with acute coronary syndrome (ACS). Methods. 80 patients with coronary syndrome admitted to our hospital from January 2019 to January 2020 and 40 healthy people (control group) in the same period were selected. According to different types of diseases, the patients were divided into an acute group ( n = 40 ) and stable group ( n = 40 ). Besides, they all were monitored by the hs-TnT value, serum MMP-2, and coronary angiography at admission and the comparative analysis was carried out. The patients in both groups were followed up for 30 days, and the incidence of adverse cardiovascular events in the patients during this period was recorded. Results. Compared with those in the control group, the MMP-2 and hs-TnT levels in the acute group and the stable group were significantly higher and the MMP-2 and hs-TnT levels in the acute group were significantly higher than those in the stable group, with statistically significant differences ( P < 0.05 ). The 30-day follow-up results showed that the incidence of adverse cardiovascular events in the acute group was significantly higher than that in the stable group, with statistically significant differences ( P < 0.05 ). The hs-TnT and MMP-2 levels in the acute myocardial infarction (AMI) group were significantly higher than those in the unstable angina pectoris (UAP) group, with statistically significant differences ( P < 0.01 ). The hs-TnT and MMP-2 levels in the non-single-vessel group were significantly higher than those in the single-vessel group, with statistically significant differences ( P < 0.01 ). Conclusion. The hs-TnT and MMP-2 high expression levels are closely associated with myocardial injury, and they can effectively predict the severity of patients’ disease. In addition, the hs-TnT and MMP-2 elevated levels can be considered as an important index to judge the short-term treatment efficacy and the risk stratification of early ACS, playing an important role in clinical treatment and rehabilitation in the later stage.


2021 ◽  
Author(s):  
Masahiro Fukuda ◽  
Toshio Suda ◽  
Takayoshi Matsumura ◽  
Hajime Hirase

Significance: Photothrombosis is a widely used model of ischemic stroke in rodent experiments. In the photothromboris model, the photosensitizer Rose Bengal is systemically introduced to the blood stream and activated by green light to induce aggregation of platelets that eventually cause vessel occlusion. Since the activation of Rose Bengal is a one-photon phenomenon and the molecules in the illuminated area (light path) are subject to excitation, targeting of thrombosis is unspecific especially in the depth dimension. We have developed a photothrombosis protocol that can target a single vessel in the cortical parenchyma by two-photon excitation. Aim: We aim to induce a thrombotic stroke in the cortical parenchyma by two-photon activation of Rose Bengal so that we confine photothrombosis within a vessel of a target depth. Approach: FITC-dextran is injected into the blood stream to visualize the cerebral blood flow in anesthetized adult mice with a cranial window. After a target vessel is chosen by two-photon imaging (950 nm), Rose Bengal is injected into the blood stream. The scanning wavelength is changed to 720 nm and photothrombosis was induced by scanning the target vessel. Results: Two-photon depth-targeted single vessel photothrombosis was achieved with a success rate of 84.9+/-1.7% within 80 s. Attempts without Rose Bengal (i.e., only with FITC) did not result in photothrombosis at the excitation wavelength of 720 nm. Conclusions: We described a protocol that achieves depth-targeted single vessel photothrombosis by two-photon excitation. Simultaneous imaging of blood flow in the targeted vessel using FITC dextran enabled the confirmation of vessel occlusion and prevention of excess irradiation that possibly induces unintended photodamage.


2021 ◽  
Vol 8 ◽  
Author(s):  
Adam Hartley ◽  
Matthew Shun-Shin ◽  
Mikhail Caga-Anan ◽  
Christopher Rajkumar ◽  
Alexandra N. Nowbar ◽  
...  

Aim: Malondialdehyde-modified low-density lipoprotein (MDA-LDL) forms a significant component of oxidised LDL. The effects of exercise on levels of MDA-LDL and anti-MDA-LDL antibodies are not well-understood. Furthermore, it is not known whether these can be modified in patients with coronary artery disease by percutaneous coronary intervention (PCI).Methods: The Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina (ORBITA) trial was the first blinded, multi-centre randomised trial of PCI vs. placebo procedure for angina relief. Serum samples were available at four time-points: pre-randomisation pre- (P1) and post- (P2) exercise and post-randomisation (6-weeks following the PCI or placebo procedure), pre- (P3) and post- (P4) exercise. ELISAs were performed using laboratory-developed assays for MDA-LDL (adjusted for Apolipoprotein B) and anti-MDA-LDL antibodies.Results: One hundred ninety-six of the 200 patients (age 66.1 [SD 8.99] years, 28% female) with severe single vessel coronary artery disease suitable for PCI enrolled in the ORBITA trial had blood available for analysis. With exercise at pre-randomisation (P2–P1) there was no significant change in adjusted MDA-LDL (−0.001, 95% CI −0.004 to 0.001; p = 0.287); however, IgG and IgM anti-MDA-LDL significantly declined (−0.022, 95% CI −0.029 to −0.014, p &lt; 0.0001; −0.016, 95% CI −0.024 to −0.008, p = 0.0002, respectively). PCI did not have a significant impact on either the pre-exercise values (P3 controlling for P1) of MDA-LDL (p = 0.102), IgG (p = 0.444) or IgM anti-MDA-LDL (p = 0.909). Nor did PCI impact the exercise induced changes in these markers (P4 controlling for P1, P2, and P3) for MDA-LDL (p = 0.605), IgG (p = 0.725) or IgM anti-MDA-LDL (p = 0.171). Pre-randomisation ischaemia on stress echo did not impact these interactions.Conclusions: Exercise results in an acute reduction in anti-oxLDL antibodies in patients with severe single vessel coronary disease, possibly indicating an induction in homoeostatic clearance via the innate immune system. However, PCI did not ameliorate this effect.


2021 ◽  
Vol 12 (10) ◽  
pp. 39-46
Author(s):  
Subhasish Singh ◽  
Rashmita Pradhan

Background: In order to facilitate diagnosis and timely intervention, it is essential to understand the presentation pattern of cardiac symptoms, and distribution of risk factors in women with Coronary Artery Disease (CAD). However, limited data is available regarding the salient features of CAD in women like distribution of risk factors and anatomical extent. Aims and Objective: The purpose of the present study was to determine the clinical and risk factor profile of women admitted with CAD and to analyze their angiographic findings in relation to the clinical presentation and risk factors in a tertiary care referral center of eastern India. Materials and Methods: In this study we prospectively analysed risk factors and angiographic patterns of 140 consecutive female patients who underwent coronary angiography for suspected CAD over a period of 2 years. Results: CAD most commonly affected females of age group >60yrs with higher incidence among postmenopausal as compared to premenopausal women. Unstable angina was the commonest presentation among patients with normal coronaries as well as obstructive CAD.A substantial percentage of women presenting with anginal pain were angiographically normal. Hypertension was the most common associated risk factor followed by diabetes, elevated total cholesterol, high LDL & low HDL. Most common coronary angiography finding was single vessel disease. On analysis, diabetes mellitus, elevated cholesterol, elevated LDL & triglycerides were most commonly associated with triple vessel disease. Conclusion: The incidence of CAD in females increased with age. Single vessel disease was the commonest presentation with Left Anterior Descending Artery, the most frequently involved vessel.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Mohamed Ali ◽  
Ahmed Mohamed Onsy ◽  
Mostafa Mohamed Abdelmonaem ◽  
Ahmed Ahmed Khashaba

Abstract Background Recent studies have suggested that fat disposition in epicardial tissue may be a predictor of the severity of coronary artery disease (CAD). Epicardial adipose tissue (EAT) is defined as the adipose tissue located between the outer wall of the myocardium and the visceral layer of pericardium, surrounding the heart and the coronary vessels. EAT is closely related to the adventitia of the coronary arteries without a barrier that may directly influence the development and progression of atherosclerosis and CAD through pro-inflammatory mediators. Objective The aim of the work is to investigate the relation between epicardial fat volume (EFV) [assessed by multidetector computed tomography (MDCT)] and severity of CAD. Methods This cross sectional study was conducted on 40 patients referred for MDCT coronary angiography to assess their complaint. EFV was quantified during non-contrast phase and severity of CAD was assessed by segment involvement score (SIS) and segment stenosis score (SSS) during contrast phase at Nasr City Police Hospital in the period between August 2018 and April 2019. Results The 40 consecutive subjects consisted of 30 males (75%) and 10 females (25%) with mean age 56 ±10.27 years. Risk factors of atherosclerosis were analyzed among the studied population as followed; the BMI ranged between 24 and 30.9 kg/m2, hypertensive patients were 77.5%, diabetic patients were 55% and smokers were 67.5%. The laboratory finding of the studied group revealed that the serum LDL.C ranged between 70 and 218 mg/dl (Mean±SD =163.88±43.37, Median= 183.5). The serum HDL.C ranged between 30 and 62 mg/dl (Mean±SD = 41.45±9.87, Median= 37). The serum total cholesterol ranged between 136 and 280 mg/dl (Mean±SD = 214.35± 35.51, Median= 224). The serum triglycerides ranged between 110 and 215 mg/dl (Mean±SD = 164.13±27.38, Median= 173).The serum creatinine ranged between 0.8 and 1.8 mg/dl (Mean±SD = 1.12±0.19, Median= 1.1). 17.5% of the studied patients had normal coronaries while 37.5% had single vessel disease and 45% had multi-vessel disease. There was a significant relationship between EFV and CAC score (p = 0.011, r = 0.397), a highly significant relationship between EFV and SSS score (p = 0.001, r = 0.518) and significant relationship between EFV & SIS score (P = 0.003, r = 0.459). Patients with normal coronary arteries were noted to have a lower EFV value than those with coronary lesions (highly significant relationship, p = 0.004) either single vessel disease or multi-vessel disease. There is no significant difference between the effects of EFV on number of diseased coronaries either single vessel disease or multi-vessel disease. Conclusion EFV increased in patients with both significant coronary artery stenosis or coronary calcification. EFV is considered an independent risk factor for CAD.


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