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A key aspect when investigating the use of recycled plastics in bitumen relates considerably to the issues relating to occupational, health and safety for humans and the environment from a fuming and emissions perspective. This research investigates laboratory-generated fumes in the forms of volatile organic compounds (VOCs), and polycyclic aromatic hydrocarbons (PAHs) generated from producing polymer modified bitumen using five different types of recycled plastics. A comparative analysis of recycled plastic modified bitumen fumes was conducted based on a series of optimized parameters, including working temperatures (160 °C, 180 °C and 200 °C) and polymer contents (1%, 2%, 4% and 6% by weight of bitumen) against neat bitumen and polymer-modified bitumen. selleck products Forty-eight volatile organic compounds (VOCs) and sixteen polycyclic aromatic hydrocarbons (PAHs) were quantified using gas chromatography-mass spectrometry (GC-MS). The results from the comparative analysis revealed that the incorporation of recycled plastics could reduce overall emissions from both VOCs and PAHs perspectives. The reduction in emissions can be attributed to the enhancement in thermal stability of the bitumen blend when recycled plastics are added. The reduction rate is heavily dependent on the type and source of recycled plastics used in the blending process. Furthermore, a specific compound concentration analysis of the top-four weighted compounds emitted reveals that the total concentration of emissions can be deceiving as specific compounds can spike when adding recycled plastics in bitumen despite a reduction trend for the overall concentration.Monitoring the fuel consumption gap between official and real-world measurements is of great interest to policy makers and researchers. This study explores how sampling methods (simple random, stratified and quota sampling) can be used to supplement and validate the monitoring. Three user datasets were utilised to simulate the fuel consumption gap of the 11.6-15.5 million vehicles registered annually in the European Union (2018-2020). Results suggest that a simple random sample of 16,240 vehicles is sufficient to estimate accurately the fleets' average fuel consumption gap. Stratified sampling can reduce the sample size to less than 4,500 vehicles. To estimate accurately the fuel consumption gap of each manufacturer, the sample size increases to approximately 17,200 vehicles. The increase in sales of plug-in hybrid vehicles in 2020 led to an increase of the average fuel consumption gap by 8% and its standard deviation (variability) by 20%. This higher variability resulted in a more than double sample size, compared to previous years. It was also found that the introduction of the Worldwide Harmonized Light vehicles Test Procedure (WLTP) reduced the average gap by 20-24%. This study highlights the viability of a sampling scheme to estimate the fuel consumption gap by monitoring less than 0.05% of the fleet. Moreover the study draws attention to the need for further analysis and understanding of the real-world use and fuel consumption of plug-in hybrid vehicles.East Asian countries experience severe air pollution owing to their rapid development and urbanization induced by substantial economic activities. South Korea and China are among the most polluted East Asian countries with high mass concentrations of PM2.5. Although the occurrence of transboundary air pollution among neighboring countries has been recognized for a long time, studies involving simultaneous ground-based PM2.5 monitoring and source apportionment in South Korea and China have not been conducted to date. This study performed simultaneous daily ground-based monitoring of PM2.5 in Seoul and Beijing from January to December 2019. The mass concentrations of PM2.5 and its major chemical components were analyzed simultaneously during 2019. Positive matrix factorization (PMF) as well as dispersion normalized PMF (DN-PMF) were utilized for the source apportionment of ambient PM2.5 at the two sites. 23 h average ventilation coefficients were applied for daily PM2.5 chemical constituents' data. Nine sources were identified at both sites. While secondary nitrate, secondary sulfate, mobile, oil combustion, biomass burning, soil, and aged sea salt were commonly found at both sites, industry/coal combustion and incinerator were identified only at Seoul and incinerator/industry and coal combustion were identified only at Beijing. Reduction of the meteorological influences were found in DN-PMF compare to C-PMF but the effects of DN on mobile source were reduced by averaging over the 23 h sampling period. The DN-PMF results showed that Secondary nitrate (Seoul 25.5%; Beijing 31.7%) and secondary sulfate (Seoul 20.5%; Beijing 17.6%) were most dominant contributors to PM2.5 at both sites. Decreasing secondary sulfate contributions and increasing secondary nitrate contributions were observed at both sites.Persistent Organic Pollutants (POPs) have become immensely prevalent in the environment as a result of their unique chemical properties (persistent, semi-volatile and bioaccumulative nature). Their occurrence in the soil, water and subsequently in food has become a matter of concern. With food being one of the major sources of exposure, the detrimental impact of these chemicals on the gut microbiome is inevitable. The gut microbiome is considered as an important integrant for human health. It participates in various physiological, biochemical and immunological activities; thus, affects the metabolism and physiology of the host. A myriad of studies have corroborated an association between POP-induced gut microbial dysbiosis and prevalence of disorders. For instance, ingestion of polychlorinated biphenyls, polybrominated diphenyl ethers or organochlorine pesticides influenced bile acid metabolism via alteration of bile salt hydrolase activity of Lactobacillus, Clostridium or Bacteroides genus. At the same time, some chemicals such as DDE have the potential to elevate Proteobacteria and Firmicutes/Bacteriodetes ratio influencing their metabolic activity leading to enhanced short-chain fatty acid synthesis, ensuing obesity or a pre-diabetic state. This review highlights the impact of POPs exposure on the gut microbiota composition and metabolic activity, along with an account of its corresponding consequences on the host physiology. The critical role of gut microbiota in impeding the POPs excretion out of the body resulting in their prolonged exposure and consequently, enhanced degree of toxicity is also emphasized.
Administration of intracoronary (IC) adenosine allows an easily feasible, inexpensive, and more rapid alternative method for fractional flow reserve (FFR). It is common practice in many centers worldwide. Nicardipine is a strong coronary vasodilator but its efficacy and safety for assessing FFR is not established. The purpose of present study was to compare the efficacy and safety of IC nicardipine and adenosine for assessing FFR.

One hundred and fifty-nine patients with a total of 193 vessels undergoing clinically indicated FFR assessment of intermediate coronary stenoses were included. For the initial assessment of FFR, hyperemia was induced by an IC adenosine. After a washout period of 3min, FFR was reassessed using 200 μg of IC nicardipine.

Hyperemic efficacy among two different stimuli was compared. The mean FFR with IC adenosine was 0.83±0.09 and that with an IC nicardipine was 0.84±0.09. The median FFR with an IC adenosine was 0.83 (0.78-0.91) and that with an IC nicardipine was 0.85 (0.79-0.91) (p-value 0.246). Both FFR values showed an excellent correlation (R
=0.982, p<0.001). Nicardipine produced fewer changes in heart rate, less chest pain and less flushing than adenosine. Transient atrioventricular block occurred in 29 patients with IC adenosine and none with IC nicardipine.

IC bolus injection of nicardipine could be introduced as a safe and practical alternative method of inducing hyperemia during FFR measurements. Compared to IC adenosine, IC nicardipine has a similar hyperemic efficacy and excellent side-effect profile.
IC bolus injection of nicardipine could be introduced as a safe and practical alternative method of inducing hyperemia during FFR measurements. Compared to IC adenosine, IC nicardipine has a similar hyperemic efficacy and excellent side-effect profile.
Sudden cardiac death (SCD) causes high mortality and substantial societal burdens for healthcare systems (HSs). The risk of SCD is significantly increased in patients with reduced left ventricular ejection fraction after myocardial infarction (MI). Current guidelines recommend re-evaluation of cardioverter-defibrillator implantation 40days post-MI, earliest. Medical therapy alone does not provide sufficient protection against SCD, especially in the first month post-MI, and needs time. Consequently, there is a gap in care of high-risk patients upon hospital discharge. The wearable cardioverter defibrillator (WCD) is a proven safe, effective therapy, which temporarily protects from SCD. Little information on WCD cost-effectiveness exists. We conducted this research to demonstrate the medical need of the device in the post-MI setting defining WCD cost-effectiveness.

Based on a randomized clinical trials (RCTs) and Italian and international data, we developed a Markov-model comparing costs, patient survival, and quality-of-life, and calculated the Incremental Cost-Effectiveness Ratio (ICER) of a WCD vs. current standard of care in post-MI patients. The rather conservative base case analysis - based on the RCT intention-to-treat results - produced an ICER of €47,709 per Quality Adjusted Life Year (QALY) gained, which is far lower than the accepted threshold of €60,000 in the Italian National HS. The ICER per Life Year (LY) gained was €38,276.

WCD utilization in post-MI patients is clinically beneficial and cost-effective. While improving guideline directed patient care, the WCD can also contribute to a more efficient use of resources in the Italian HS, and potentially other HSs as well.
WCD utilization in post-MI patients is clinically beneficial and cost-effective. While improving guideline directed patient care, the WCD can also contribute to a more efficient use of resources in the Italian HS, and potentially other HSs as well.
Cardiac sarcoidosis (CS) is an important cause of mortality in patients with sarcoidosis. The aim of this retrospective cohort study was to characterize the prevalence, incidence, clinical features and outcomes of CS in the southern region of New Zealand.

45 patients were identified 23 fulfilling international classification criteria, 9 fulfilling physician consensus criteria, and 13 classified as possible CS. As of June 2021, 26 patients were living and domiciled in the Canterbury district; estimated point prevalence was 4.43 cases per 100,000 people. The average annual incidence was 0.24 cases per 100,000 people between 2016 and 2020. We estimated a 5.14% frequency of CS in patients with sarcoidosis. Median age at presentation was 56years (range 31-72). Common presentations included heart failure, heart block and life threatening ventricular and supraventricular arrhythmias. Electrocardiogram abnormalities were found in 93.3% and cardiac MRI was often relied upon by physicians for diagnosis. The 10-year survival was 94% (95% CI 78-99%).
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