Adenosine in Interventional Cardiology: Physiopathologic and Pharmacologic Effects in Coronary Artery Disease.

This review article focuses on the role of adenosine in coronary artery disease (CAD) diagnosis and treatment. Adenosine, an endogenous purine nucleoside, plays crucial roles in cardiovascular physiology and pathology. Its release and effects, mediated by specific receptors, influence vasomotor function, blood pressure regulation, heart rate, and platelet activity. Adenosine therapeutic effects include treatment of the no-reflow phenomenon and paroxysmal supraventricular tachycardia. The production of adenosine involves complex cellular pathways, with extracellular and intracellular synthesis mechanisms. Adenosine's rapid metabolism underscores its short half-life and physiological turnover. Furthermore, adenosine's involvement in side effects of antiplatelet therapy, particularly ticagrelor and cangrelor, highlights its clinical significance. Moreover, adenosine serves as a valuable tool in CAD diagnosis, aiding stress testing modalities and guiding intracoronary physiological assessments. Its use in assessing epicardial stenosis and microvascular dysfunction is pivotal for treatment decisions. Overall, understanding adenosine's mechanisms and clinical implications is essential for optimizing CAD management strategies, encompassing both therapeutic interventions and diagnostic approaches.

A GIS-MCDM-based road network planning for tourism development and management in Arasbaran forest, Iran.

It is very important for managers to plan a road network that meets all the requirements for tourism development and management. The aim of this study was to evaluate and modify an existing road network for tourism purposes in the Arasbaran protected area. First, the map layers of effective criteria were prepared in GIS and were standardized by a fuzzy logic approach and finally combined considering their relative importance weights obtained through pair-wise comparison technique. A suitability map was then acquired. After that, 14 different scenarios of road network were designed to access the recreational area using PEGGER extension in ArcView. Then, they were evaluated in terms of technical, environmental, and socio-economic criteria to achieve the optimal-designed road network. Moreover, the existing road network was modified according to the optimal-designed road scenario. Finally, a modified version of the existing road network was proposed for tourism development and management in the Arasbaran region. Regarding the results, the slope criterion with a value of 0.289 was identified as the most important factor in providing a suitability map for road planning. The seventh scenario, with a road density of 3.34 m ha-1 and accessibility (hard) of 64.68%, was chosen as the optimal option to modify the existing road network due to the best performances in terms of minimum costs and environmental impacts on the basis of the highest value per unit length (72.26). According to the assessments and chi-square test comparison, the optimal-designed road network and the proposed road network were identified as better alternatives compared to the existing road. Based on this work, it can be concluded that the combination of GIS-MCDM approaches can properly assist in tourism planning and management.

Double coronary artery occlusion presenting as inferior ST segment elevation myocardial infarction and Wellens syndrome type A: a case report.

Background: ST elevation myocardial infarctions are usually a consequence of the occlusion of a single coronary artery, but in 2.5% of the cases, two or more culprit lesions are found. Simultaneous coronary artery occlusion is a potentially life-threatening condition that leads to cardiogenic shock or ventricular arrhythmias. Case summary: We presented the case of a 74-year-old man presenting with chest pain and ST segment elevation (STE) in inferior leads and evidence of alternating STE in anterior leads in a pattern like Wellens syndrome type A in subsequent electrocardiogram (ECGs). Emergency coronary angiography (CA) revealed thrombotic occlusion of the proximal right coronary artery (RCA) and sub-occlusion of mid left anterior descending artery (LAD). During the CA, he became haemodynamically unstable requiring intravenous inotropes and vasopressors, and he underwent primary percutaneous coronary intervention of both RCA and LAD culprit lesions. His subsequent hospital stay was uneventful, and he was discharged 5 days later. Discussion: ST elevation myocardial infarction with more than one culprit coronary artery is a rare but at high risk of haemodynamic decompensation. The causes of occlusion of multiple coronary arteries may be several: coronary embolism, coronary ectasia, simultaneous plaque disruption, coronary vasospasm, hypercoagulability states, smoking, and illicit drug abuse. The presumed mechanism behind the presented case may be a combination of release of pro-thrombotic cytokines due to the thrombotic occlusion of the first coronary and low output state secondary to myocardial dysfunction leading to impaired flow in a severe stenotic coronary artery with subsequent thrombosis.

Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve Replacement.

BACKGROUND AND OBJECTIVES: In patients with severe aortic stenosis (AS), left ventricular systolic dysfunction is one of the main predictors of adverse events after surgical aortic valve replacement (SAVR). However, more patients undergo surgery earlier, often with preserved systolic function. In these cases, global longitudinal strain (GLS) has been proposed as a marker of ventricular remodeling post-surgery. This study aims to evaluate GLS variation in patients undergoing SAVR and explore differences across the diastolic dysfunction classes. METHODS: From June 2020 to March 2023, patients with AS and preserved ejection fraction (EF) requiring SAVR were enrolled. Echocardiographic evaluations were conducted preoperatively, seven days post-surgery, and twelve months after surgery. Patients were divided into two groups based on the severity of diastolic dysfunction: Group A (grade I) and Group B (grades II-III). RESULTS: The final analysis included 108 patients (mean age 71.3 ± 7.2 years). Twenty-two patients (20.4%) also underwent coronary artery bypass grafting (CABG). The preoperative EF averaged 61.6 ± 6.03%, with no significant differences between groups. Preoperative GLS was 16 ± 4.3%, decreasing to 12.8 ± 3.4% postoperatively (p < 0.0001). GLS was comparable between the groups preoperatively (p = 0.185) and postoperatively (0.854). After twelve months, GLS improved in both groups (Group A: 17.7 ± 3.4%, Group B: 15.7 ± 3.2%, p < 0.0001), but only Group A showed significant improvement from preoperative values (p = 0.018). SAVR improved GLS regardless of CABG intervention. CONCLUSIONS: SAVR in patients with preserved LVEF results in an early reduction in GLS, regardless of diastolic dysfunction. After twelve months, GLS improved significantly, with significant recovery only in patients with mild dysfunction.

Fire up Biosensor Technology to Assess the Vitality of Trees after Wildfires.

The development of tools to quickly identify the fate of damaged trees after a stress event such as a wildfire is of great importance. In this context, an innovative approach to assess irreversible physiological damage in trees could help to support the planning of management decisions for disturbed sites to restore biodiversity, protect the environment and understand the adaptations of ecosystem functionality. The vitality of trees can be estimated by several physiological indicators, such as cambium activity and the amount of starch and soluble sugars, while the accumulation of ethanol in the cambial cells and phloem is considered an alarm sign of cell death. However, their determination requires time-consuming laboratory protocols, making the approach impractical in the field. Biosensors hold considerable promise for substantially advancing this field. The general objective of this review is to define a system for quantifying the plant vitality in forest areas exposed to fire. This review describes recent electrochemical biosensors that can detect plant molecules, focusing on biosensors for glucose, fructose, and ethanol as indicators of tree vitality.

Contrast-Induced Acute Kidney Injury in Patients with Heart Failure on Sodium-Glucose Cotransporter-2 Inhibitors Undergoing Radiocontrast Agent Invasive Procedures: A Propensity-Matched Analysis.

(1) Background: This single-center retrospective study aimed to evaluate whether sodium-glucose cotransporter-2 inhibitors (SGLT2-i) therapy may have a nephroprotective effect to prevent contrast-induced acute kidney injury (CI-AKI) in patients with heart failure (HF) undergoing iodinated contrast medium (ICM) invasive procedures. (2) Methods: The population was stratified into SGLT2-i users and SGLT2-i non-users according to the chronic treatment with gliflozins. The primary endpoint was CI-AKI incidence during hospitalization. Secondary endpoints were all-cause mortality and the need for continuous renal replacement therapy (CRRT). (3) Results: In total, 86 patients on SGLT2-i and 179 patients not on SGLT2-i were enrolled. The incidence of CI-AKI in the gliflozin group was lower than in the non-user group (9.3 vs. 27.3%, p < 0.001), and these results were confirmed after propensity matching analysis. Multivariable logistic regression showed that only SGLT2-i treatment was an independent preventive factor for CI-AKI (OR: 0.41, 95% CI: 0.16-0.90, p = 0.045). The need for CRRT was reported only in five patients in the non-SGLT2-i-user group compared to zero patients in the gliflozin group (p = 0.05). (4) Conclusions: SGLT2-i therapy was associated with a lower risk of CI-AKI in patients with HF undergoing ICM invasive procedures.

Photoswitchable metal coordinating tweezers operated by light-harvesting dendrimers.

A dendrimer bearing two cyclam units linked by an azobenzene moiety, and luminescent naphthalene units at the periphery performs three different functions (light-harvesting, photoisomerization and coordination of metal ions) which can cooperate or interfere depending on the nature of the metal ion. It is thus an example of light controlled molecular tweezers in which Zn(II) coordination allows 100% efficient photosensitization of azobenzene switching, while Cu(II) shuts down azobenzene isomerization.

The beauty of chemistry in the words of writers and in the hands of scientists.

Chemistry is a central science because all the processes that sustain life are based on chemical reactions, and all things that we use in everyday life are natural or artificial chemical compounds. Chemistry is also a fantastic world populated by an unbelievable number of nanometric objects called molecules, the smallest entities that have distinct shapes, sizes, and properties. Molecules are the words of matter. Indeed, most of the other sciences have been permeated by the concepts of chemistry and the language of molecules. Like words, molecules contain specific pieces of information that are revealed when they interact with one another or when they are stimulated by photons or electrons. In the hands of chemists, molecules, particularly when they are suitably combined or assembled to create supramolecular systems, can play a variety of functions, even more complex and more clever than those invented by nature. The wonderful world of chemistry has inspired scientists not only to prepare new molecules or investigate new chemical processes, but also to create masterpieces. Some nice stories based on chemical concepts (1) show that there cannot be borders on the Earth, (2) underline that there is a tight connection among all forms of matter, and (3) emphasize the irreplaceable role of sunlight.

Anion sensing in aqueous media by photo-active transition-metal bipyridyl rotaxanes.

A chloride anion templation methodology is utilized in the construction of novel transition-metal rhenium(I) and ruthenium(II) bipyridyl appended [2]rotaxanes. (1)H NMR spectroscopic titrations reveal the ability of the rotaxanes to selectively bind chloride over the more basic oxoanions, with the ruthenium(II) bipyridyl appended rotaxane strongly binding chloride in 30% water. Photophysical investigations demonstrate the ability of the rotaxanes to sense anions in aqueous media, with chloride being selectively complexed, in general agreement with NMR spectroscopy determined anion binding data.

Easy separation of Δ and Λ isomers of highly luminescent [Ir(III)]-cyclometalated complexes based on chiral phenol-oxazoline ancillary ligands.

A new class of neutral cyclometalated iridium(III) complexes with enantiomerically pure C(1)-symmetric phenol-oxazolines (3a,b) have been synthetized in high yields and fully characterized. Resolution of the corresponding Δ(R) and Λ(R) or Δ(S) and Λ(S) isomers was easily achieved by conventional flash chromatography. The corresponding Δ and Λ helicities have been confirmed by CD spectroscopy and X-ray crystallography. Regarding the absorption and luminescence properties with unpolarized light, no significant difference between Δ and Λ isomers has been observed. A strong blue luminescence is observed for deaerated solutions of complexes 5a and 5b in CH(3)CN.

Evaluation of phototoxicity of dendritic porphyrin-based phosphorescent oxygen probes: an in vitro study.

Biological oxygen measurements by phosphorescence quenching make use of exogenous phosphorescent probes, which are introduced directly into the medium of interest (e.g. blood or interstitial fluid) where they serve as molecular sensors for oxygen. The byproduct of the quenching reaction is singlet oxygen, a highly reactive species capable of damaging biological tissue. Consequently, potential probe phototoxicity is a concern for biological applications. Herein, we compared the ability of polyethyleneglycol (PEG)-coated Pd tetrabenzoporphyrin (PdTBP)-based dendritic nanoprobes of three successive generations to sensitize singlet oxygen. It was found that the size of the dendrimer has practically no effect on the singlet oxygen sensitization efficiency in spite of the strong attenuation of the triplet quenching rate with an increase in the dendrimer generation. This unexpected result is due to the fact that the lifetime of the PdTBP triplet state in the absence of oxygen increases with dendritic generation, thus compensating for the concomitant decrease in the rate of quenching. Nevertheless, in spite of their ability to sensitize singlet oxygen, the phosphorescent probes were found to be non-phototoxic when compared with the commonly used photodynamic drug Photofrin in a standard cell-survival assay. The lack of phototoxicity is presumably due to the inability of PEGylated probes to associate with cell surfaces and/or penetrate cellular membranes. In contrast, conventional photosensitizers bind to cell components and act by generating singlet oxygen inside or in the immediate vicinity of cellular organelles. Therefore, PEGylated dendritic probes are safe to use for tissue oxygen measurements as long as the light doses are less than or equal to those commonly employed in photodynamic therapy.

Sustainable Forest Operations (SFO): A new paradigm in a changing world and climate.

The effective implementation of sustainable forest management depends largely on carrying out forest operations in a sustainable manner. Climate change, as well as the increasing demand for forest products, requires a re-thinking of forest operations in terms of sustainability. In this context, it is important to understand the major driving factors for the future development of forest operations that promote economic, environmental and social well-being. The main objective of this paper is to identify important issues concerning forest operations and to propose a new paradigm towards sustainability in a changing climate, work and environmental conditions. Previously developed concepts of forest operations are reviewed, and a newly developed concept - Sustainable Forest Operations (SFO), is presented. Five key performance areas to ensure the sustainability of forest operations include: (i) environment; (ii) ergonomics; (iii) economics; (iv) quality optimization of products and production; and (v) people and society. Practical field examples are presented to demonstrate how these five interconnected principles are relevant to achieving sustainability, namely profit and wood quality maximization, ecological benefits, climate change mitigation, carbon sequestration, and forest workers' health and safety. The new concept of SFO provides integrated perspectives and approaches to effectively address ongoing and foreseeable challenges the global forest communities face, while balancing forest operations performance across economic, environmental and social sustainability. In this new concept, we emphasize the role of wood as a renewable and environmentally friendly material, and forest workers' safety and utilization efficiency and waste management as additional key elements of sustainability.

Forest operations in coppice: Environmental assessment of two different logging methods.

Wood is a renewable resource and it actively contributes to enhance energy production under a sustainable perspective. However, harvesting, transport and use of wood imply several consequences and impacts on environment. There are different ways for managing forests dedicated to wood production and a sustainable approach is fundamental to preserve the resource. In this context, Life Cycle Assessment (LCA) is a useful tool for estimating the environmental impacts related to renewable resources. Traditional coppice is a common approach for forest management in several areas, including southern Europe and, specifically, Italy, Spain and the Balkans. Due to different terrain conditions, different types of forest operations are considered for wood extraction from coppices, where the main product is firewood used in domestic heating. The aim of this work was to compare the main common systems for firewood production in two different terrain conditions ('flat/low steep' and 'steep/very steep' terrains), in a representative environment for Mediterranean area, located in central Italy, by means of LCA. Seven different impact categories were evaluated in a cradle-to-gate perspective taking into account all the operations carried out from the trees felling to the firewood storage at factory. Results showed that the extraction phase was the most important in terms of environmental burdens in firewood production and the use of heavy and high-power machines negatively influenced the emissions compared with manual operations. Finally, considering the general low-inputs involved in wood production in coppice, the transport of workers by car to the work site resulted on consistent contributions into environmental burdens. An additional analysis about the modifications of CH4 and N2O exchanges between soil and atmosphere, due to soil compaction in the extraction phase, was made and based on bibliographic information. Results showed a sensible difference between disturbed and undisturbed soil.

A diagnostic protocol to identify water buffaloes (Bubalus bubalis) vaccinated with Brucella abortus strain RB51 vaccine.

The use of live vaccine strain RB51 for vaccination of domestic water buffaloes (Bubalus bubalis) at risk of infection with Brucella abortus is permitted notwithstanding the plans for the eradication and only under strict veterinary control. The antibodies induced by RB51 vaccination are not detectable using conventional diagnostic techniques; therefore, it is necessary to have a specific diagnostic tool able to discriminate vaccinated from unvaccinated animals. The combination of a complement fixation test (CFT) with specific RB51 antigen (RB51-CFT) and a brucellin skin test has been demonstrated to be a reliable diagnostic system to identify single cattle (Bos taurus) vaccinated with RB51. So far, no data are available in the international scientific literature regarding the use of this test association in water buffalo. For this reason the suitability of this test combination has been evaluated in a water buffalo herd. One hundred twenty-seven animals farmed in a herd of Salerno province (Campania, Southern Italy), in the context of a presumptive unauthorized use of RB51 vaccine were chosen for this study. All tested animals resulted negative to Rose Bengal test (RBT) and complement fixation test (CFT) used for the detection of specific antibodies against Brucella field strains. Seventy-one animals (56%) developed RB51 antigen-specific CFT (RB51-CFT) antibodies against RB51 vaccine in a first sampling, while 104 animals (82%) gave positive result to a second serum sampling conducted 11 days after the intradermal inoculation of the RB51 brucellin. One hundred and seven animals (84%) showed a positive reaction to the RB51-CFT in at least 1 sampling, while 111 animals (87%) resulted positive to the RB51 brucellin skin test. Thus, analysing the results of the 3 testing in parallel, 119 animals (94%) were positive to at least 1 of the performed tests. The results suggest that the use in parallel of the RB51 brucellin skin test with RB51-CFT may represent a reliable diagnostic system to identify water buffaloes vaccinated with RB51 vaccine.

Lung and Heart Diseases Are Better Predicted by Pack-Years than by Smoking Status or Duration of Smoking Cessation in HIV Patients.

BACKGROUND: The objective of this study was to assess the relationship of pack-years smoking and time since smoking cessation with risk of lung and heart disease. METHODS: We investigated the history of lung and heart disease in 903 HIV-infected patients who had undergone thoracic computed tomography (CT) imaging stratified by smoking history. Multimorbidity lung and heart disease (MLHD) was defined as the presence of ≥ 2 clinical or subclinical lung abnormalities and at least one heart abnormality. RESULTS: Among 903 patients, 23.7% had never smoked, 28.7% were former smokers and 47.6% were current smokers. Spirometry indicated chronic obstructive pulmonary disease in 11.4% of patients and MLHD was present in 53.6%. Age, male sex, greater pack-years smoking history and smoking cessation less than 5 years earlier vs. more than 10 years earlier (OR 2.59, 95% CI 1.27-5.29, p = 0.009) were independently associated with CT detected subclinical lung and heart disease. Pack-years smoking history was more strongly associated with MLHD than smoking status (p<0.001). CONCLUSIONS: MLHD is common even among HIV-infected patients who never smoked and pack- years smoking history is a stronger predictor than current smoking status of MLHD. A detailed pack-years smoking history should be routinely obtained and smoking cessation strategies implemented.

Effects of a three-year exposure to ambient ozone on biomass allocation in poplar using ethylenediurea.

We examined the effect of ambient ozone on visible foliar injury, growth and biomass in field-grown poplar cuttings of an Oxford clone sensitive to ozone (Populus maximoviczii Henry × berolinensis Dippel) irrigated with ethylenediurea (EDU) or water for three years. EDU is used as an ozone protectant for plants. Protective effects of EDU on ozone visible injury were found. As a result, poplar trees grown under EDU treatment increased leaves, lateral branches and root density in the third year, although no significant enhancement of stem height and diameter was found. Ambient ozone (AOT40, 24.6 ppm h; diurnal hourly average, 40.3 ppb) may finally reduce carbon gain by reducing the number of branches, and thus sites for leaf formation, in ozone-sensitive poplar trees under not-limiting conditions.

Relating safety, productivity and company type for motor-manual logging operations in the Italian Alps.

The study compared the performance of four different logging crews with respect to productivity, organization and safety. To this purpose, the authors developed a data collection method capable of providing a quantitative analysis of risk-taking behavior. Four crews were tested under the same working conditions, representative of close-to-nature alpine forestry. Motor-manual working methods were applied, since these methods are still prevalent in the specific study area, despite the growing popularity of mechanical processors. Crews from public companies showed a significantly lower frequency of risk-taking behavior. The best safety performance was offered by the only (public) crew that had been administered formal safety training. The study seems to deny the common prejudice that safety practice is inversely proportional to productivity. Instead, productivity is increased by introducing more efficient working methods and equipment. The quantitative analysis of risk-taking behavior developed in this study can be applied to a number of industrial fields besides forestry. Characterizing risk-taking behavior for a given case may eventually lead to the development of custom-made training programmes, which may address problem areas while avoiding that the message is weakened by the inclusion of redundant information. In the specific case of logging crews in the central Alps, the study suggests that current training courses may be weak on ergonomics, and advocates a staged training programme, focusing first on accident reduction and then expanding to the prevention of chronic illness.

Pig identification: comparison of results from injected transponders and electronic ear tags.

The aim of this study was to evaluate the results of two different electronic pig identification methods on various closed-cycle fattening farms in Brescia, Bergamo and Modena provinces and to consider the effect of slaughter procedures on ear tag retention. On-farm tests involved the intraperitoneal injection of a transponder into 527 piglets aged 20-30 days using a 5 cm steel needle, and the use of an electronic ear tag in 114 piglets of the same age range. The percentage of reading controls of intraperitoneal transponders varied from 96.8-100%, with recovery of 70% at the slaughterhouse. Retention of electronic ear tags on arrival at the slaughterhouse was 75.43%. Activities performed during the slaughter process resulted in the loss of 4.65% of the electronic ear tags present at the beginning of the slaughter cycle. To evaluate the effect of procedures conducted in the slaughterhouse on ear tag retention, various tests were conducted in an industrial slaughterhouse in Modena province, using a total of 199 ear tags of three different brands. The percentage of ear tags recovered after the slaughter process varied from 89% to 96%.