Qarakhanids on the Edge of the Bukhara Oasis: Archaeobotany of Medieval Paykend

The urban center of Paykend was an exchange node just off the main corridor of the Silk Road in the Bukhara Oasis on the edge of the hyperarid Kyzyl–Kum Desert. The city was occupied from the end of 4 century B.C.E. to the mid–12 century C.E.; our study focuses on the Qarakhanid period (C.E. 999 – 1211), the last imperial phase of urban occupation at Paykend before its abandonment. In this study, we present the results of an analysis of archaeobotanical remains recovered from a multifunction rabat, which appears to have comprised a domicile, military structure, center of commerce, and/or a caravanserai, a roadside inn for travelers. We shed light on how people adapted a productive economy to the local ecological constraints. By adding these data to the limited Qarakhanid archaeobotany from across Central Asia, we provide the first glimpses into cultivation, commerce, and consumption at a Silk Road trading town along the King’s Road, the central artery of ancient Eurasia.

Impact of the COVID-19 Pandemic on Ophthalmic Practice. Historical Aspects and Clinical Examples

This article presents data on clinical ophthalmological manifestations of COVID-19 described in the literature, clinical examples that we met in pandemic conditions, COVID-19 including early and late manifestations, as well as references to studies conducted decades ago and aimed to evaluate the effects of coronavirus infection on the visual organ. The purpose of the most studies was to study the effect of COVID-19 on the visual organ indicate that the most common ophthalmological manifestation of this disease is conjunctivitis, which occurs in 3–10 % of cases. Our observations showed that patients with COVID-19, when applying for an appointment with an ophthalmologist after 1–3 months, make complaints about the feeling of dryness, discomfort in the eyes, itching and redness of the eyelids. These complains arose immediately after the illness and persisted during the above terms. This phenomenon can be explained by the fact that any inflammatory process occurring on the eye surface disrupts the process of lacrimation and leads to the emergence of dry eye syndrome. It is necessary to pay close attention to complaints from the visual organ not only in patients with COVID-19 in the early stages of the disease, but also in the coming months after stopping the acute pathological process. As studies have shown, coronavirus can involve the posterior segment of the eye in the pathological process, since this virus has a retinotropic effect. This hypothesis can be confirmed by the reports of several authors who studied with optical coherence tomography (OCT) the state of the retina 11–33 days after the onset of symptoms in patients with COVID-19. OCT data indicate the presence of hyperreflexive zones at the level of the ganglion cell layer and the plexiform layer, the severity of these zones being greater in the papillomacular bundle region. In addition, cases of thromboembolic complications affecting the vascular system of the eye are described. Considering the fact that in the development of thromboembolism of the central artery and retinal vein, therapy is as effective as possible in the first hours from the beginning of this pathological process development, close attention should be paid to patients’ complaints to visual impairment occurred against the background of coronavirus infection. The data presented in this article open up a range of possibilities for conducting new scientific research that will help to preserve the vision and health of our patients as effectively as possible.

VASCULAR ANATOMY OF GREATER OMENTUM IN MIDDLE AGE ADULTS

The variability of artery and vein topography of greater omenta from 20 corpses of middle age adults was investigated by applying the anatomical and morphometric methods. The right and left gastroepiploic arteries supply the greater omentum with blood. In 80% of the cases studied these arteries form the superior arterial arch, in 15% of the cases they are not connected, and in 5% of the cases they form anastomosis through the right and left lateral branches, thus, forming the middle arterial arch of the greater omentum. In 10% of the cases, the left gastroepiploic artery is located in the thick of the posterior plate of the greater omentum. The right gastroepiploic artery branches into central, right medial, intermediate and lateral arteries and in 10% left additional artery. The right gastroepiploic artery and vein are longer in men (16.95 ± 5.5 cm) that in women (15.77 ± 2.9 cm). The outer diameter of these vessels is larger in women: 0.24 ± 0.03 cm of arteries and 0.27 ± 0.03 cm of veins. The central artery is the longest and widest of all omental branches. The area of the central artery is more preferred for flaps in quadrangular and triangular shapes of the greater omentum. The branches of the right gastroepiploic artery supply blood to the right half of the greater omentum and reach the lower edge of its free part. The left half of the greater omentum is supplied by the branches of the left gastroepiploic artery, namely by the left medial, intermediate and lateral arteries, which do not reach the lower edge of the free part of the omentum. In 10% of the cases, the superior left part of the omentum is additionally supplied with blood by the splenic artery. On such case of blood vessels presence, it can serve as a source for obtaining a flap. One vein accompanies the artery of the same name. All the veins of the omentum have a larger diameter than the arteries. In 15% of the cases greater omentum is quadrangular, in 25% of the cases is triangular and in 60% it is of irregular shape with two or more parts. In the one-part omentum, the left and right parts have the same blood supply. At the two-part structure, the right half is in more favourable condition in terms of the blood supply that enables to recommend its usage in transplantation surgery.

Abstract P057: The Association Of Diabetes Duration With Central Artery Stiffness And Its 5-year Change Among Older Adults: The Atherosclerosis Risk In Communities Study (ARIC).

Background: Central artery stiffness is a predictor of cardiovascular risk and mortality among individuals with diabetes. Few studies examined whether the duration of diabetes relates to arterial stiffening and its rate of progression. Objective: To examine the association of diabetes duration from midlife to older adulthood with arterial stiffness and its 5-year change. Methods: Diabetes (defined by fasting glycemia level >126 mg/dl or use of glucose lowering agents or self-reported) was ascertained at visit 1 (1988-1990), on repeated examinations and on telephone follow-up calls of 2,155 ARIC cohort members (58% women, 20% black, mean age 74 years), as well as time since ascertainment of diabetes. Carotid femoral pulse wave velocity (cfPWV), a measure of central artery stiffness, was obtained at cohort visits 5 (2011-13) and 6 or 7 (2016-19). Associations of duration of diabetes with visit 5 cfPWV and the 5-year cfPWV change from visit 5 to visit 6 or 7 were evaluated by multivariable linear regression adjusted for demographic factors. Results: Among study participants with diabetes ascertained from midlife to older adulthood (n=639 (29%)), the mean cfPWV at visit 5 was 78.6, 95%CI (52.9, 104.4) cm/s greater than those without diabetes. Over a mean of 4.9 (SD 3) years of follow-up, cfPWV increased by a median 137 cm/s. The 5-year change in cfPWV was 40.5, 95%CI (12.3, 68.8) cm/s greater among those with diabetes, as compared to those without diabetes. The mean diabetes duration was 8.1(SD 6.8) years for participants with diabetes. After adjusting for demographic factors, we observed a positive association of diabetes duration with the 5-year change in cfPWV in older adulthood (Figure). Conclusion: Duration of diabetes was associated with a greater rate of progression of central arterial stiffness in older adults.

Abstract P215: Association Of Lung Function In Mid-life With Central Artery Stiffness Later In Life, The Atherosclerosis Risk In Communities Study

Introduction: Poor lung function and aortic stiffness often co-occur, but causal and temporal relationships are equivocal. Investigating relationships between mid-life lung function and arterial stiffness later in life may highlight modifiable targets to slow arterial aging. Objective: Assess whether lung function in mid-life is associated with central artery stiffness later in life, and whether this relationship is modified by baseline smoking status, hypertension, or diabetes. Methods: We included 3,529 ARIC cohort participants (60% women; 22% Black; mean baseline age 51.4 (SD: 4.9)) who attended visits 1 (1987-1989) and 5 (2011-2013). Spirometry included forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) of high-quality grades. Central artery stiffness (carotid-femoral pulse wave velocity (cfPWV)) was measured at visit 5. Associations of mid-life lung function with later-life central artery stiffness (cfPWV>75 th percentile) were evaluated by multivariable Poisson and logistic regressions adjusted for covariates. Sensitivity analyses excluded participants with chronic obstructive pulmonary disease identified from surveillance of hospitalizations occurring in follow up (N=109). Results: Mean FEV1 at visit 1 was 3.04 L (SD: 0.73) and FVC was 3.99 L (SD: 0.96). Lung function varied by thoracic height. Visits 1 and 5 were a mean of 23.8 years apart, and mean cfPWV at visit 5 was 1167 cm/s (SD: 379). Lung function at visit 1 was inversely associated with adjusted prevalence and odds of later cfPWV>75 th percentile among those present at visit 5 (Table). Stratum-specific estimates suggested modification by baseline smoking status, hypertension, and diabetes, but were not nominally statistically different. Sensitivity analyses did not alter inferences. Conclusion: Lung function at mid-life is inversely associated with central artery stiffness in later life. Whether change in mid-life pulmonary function is associated with arterial stiffness later in life warrants further examination.

Relationship Between Central Artery Stiffness, Brain Arterial Dilation, and White Matter Hyperintensities in Older Adults: The ARIC Study

Objective: Nonatherosclerotic outward remodeling of the large intracranial arteries may facilitate propagation of excessive aortic pulsatile energy into the cerebral microcirculation and has been associated with adverse cognitive outcomes. We sought to determine the relationship between central artery stiffness, brain arterial diameters, and white matter hyperintensity (WMH) volume in the general population of older adults. Approach and Results: We examined data from 1275 stroke-free participants of the ARIC (Atherosclerosis Risk in Communities) study (59% female, 30% Black, mean age 77 years) who underwent carotid-femoral pulse wave velocity (cf-PWV) testing and brain magnetic resonance imaging. A cf-PWV >12 m/s was considered elevated. Relationships between WMH and arterial diameters at the M1A1 segment of the middle and anterior cerebral arteries (whichever larger) were analyzed in the absence of artery-specific plaque, adjusting for intracranial volume and potential confounders. The average cf-PWV was 11.7 m/s and WMH volume was 11.2 cm 3 . Each 0.5 mm increment in M1A1 diameter was associated with 24% greater WMH volume in participants with elevated cf-PWV (exponentiated β=1.24 [95% CI, 1.12–1.36]), compared with a 10% greater WMH volume in participants without elevated cf-PWV (exponentiated β=1.10 [95% CI, 1.01–1.19]), P value for interaction=0.04. Conclusions: In this examination of older adults from the general population, larger, plaque-free arterial diameters in the middle cerebral circulation were associated with greater WMH volume, particularly among participants with elevated central artery stiffness. Strategies to reduce central artery stiffness may mitigate the association between cerebrovascular outward remodeling and microvascular damage.