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1
Taser, Ahmet Emre, Kerim Guney, and Erhan Kurt. "Circular Antenna Array Synthesis Using Multiverse Optimizer." International Journal of Antennas and Propagation 2020 (August 24, 2020): 1–10. http://dx.doi.org/10.1155/2020/3149826.
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Antenna array synthesis is one of the most popular topics in the electromagnetic field. Since achieving a desired antenna radiation pattern is a mathematical problem, in the literature, there are various optimization algorithms applied to the synthesis process of different kinds of antenna arrays. In this study, Multiverse Optimizer (MVO) and modified MVO (MMVO) are used to perform circular antenna array (CAA) synthesis. During the exploration, exploitation, and local search phases of calculation, MVO uses three concepts in cosmology; white hole, black hole, and wormhole. Convergence capability of this nature-inspired algorithm is employed for finding optimum amplitude and position values of CAA elements in order to achieve an array pattern with low maximum sidelobe level (MSL) and minimum circumference. The performance of MVO and MMVO was tested on five design examples of pattern synthesis, and the obtained results were compared with ten different algorithms. The simulation results show that MVO and MMVO provide low MSLs with small circumferences.
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Ryabov, V. V., S. V. Popov, E. V. Vyshlov, M. Sirotina, N. V. Naryzhnaya, A. V. Mukhomedzyanov, I. A. Derkachev, et al. "Reperfusion cardiac injury. The role of microvascular obstruction." Siberian Journal of Clinical and Experimental Medicine 38, no. 2 (July 3, 2023): 14–22. http://dx.doi.org/10.29001/2073-8552-2023-39-2-14-22.
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Microvascular obstruction (MVO) of coronary arteries increases the mortality rate and major adverse cardiac events in patients with acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI). According to preliminary data platelets, inflammation, Ca2+ overload, neuropeptide Y, and endothelin-1 could be involved in the pathogenesis of MVO. Many questions related to the pathogenesis of MVO remain unanswered. The role of endothelial cell damage in the formation of MVO in patients with AMI and PCI is unknown. It is unclear whether nitric oxide (NO) production reduces or decreases sensitivity of smooth muscle cells of coronary arteries to NO in patients with MVO. It was obtained only indirect evidence on the involvement of inflammation in the development of MVO. The role of ROS in the pathogenesis of MVO is not studied. The role of necroptosis and pyroptosis in the pathogenesis of MVO in patients with AMI and PCI is also not studied.The significance of thromboxane A, vasopressin, angiotensin II, and prostacyclin in the formation of MVO is unknown before. It was not obtained conclusive evidence on the involvement of coronary artery spasm in the development of MVO. Correlation analysis of the neuropeptide Y, endothelin-1 levels and the MVO size in patients with AMI and PCI was not performed. It is not clear whether endogenous adrenaline exacerbates MVO or, conversely, prevents MVO.
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Song, Qi, Yourui Huang, Wenhao Lai, Tao Han, Shanyong XU, and Xue Rong. "Multi-membrane search algorithm." PLOS ONE 16, no. 12 (December 6, 2021): e0260512. http://dx.doi.org/10.1371/journal.pone.0260512.
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This research proposes a new multi-membrane search algorithm (MSA) based on cell biological behavior. Cell secretion protein behavior and cell division and fusion strategy are the main inspirations for the algorithm. In order to verify the performance of the algorithm, we used 19 benchmark functions to compare the MSA test results with MVO, GWO, MFO and ALO. The number of iterations of each algorithm on each benchmark function is 100, the population number is 10, and the running is repeated 50 times, and the average and standard deviation of the results are recorded. Tests show that the MSA is competitive in unimodal benchmark functions and multi-modal benchmark functions, and the results in composite benchmark functions are all superior to MVO, MFO, ALO, and GWO algorithms. This paper also uses MSA to solve two classic engineering problems: welded beam design and pressure vessel design. The result of welded beam design is 1.7252, and the result of pressure vessel design is 5887.7052, which is better than other comparison algorithms. Statistical experiments show that MSA is a high-performance algorithm that is competitive in unimodal and multimodal functions, and its performance in compound functions is significantly better than MVO, MFO, ALO, and GWO algorithms.
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Schauten, M. B. J., Aloy Soppe, and Jurjen Soppe. "Maatschappelijk verantwoord ondernemen (MVO) en reputatie." Maandblad Voor Accountancy en Bedrijfseconomie 84, no. 7/8 (July 1, 2010): 395–404. http://dx.doi.org/10.5117/mab.84.20868.
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In dit artikel introduceren wij een maatstaf waarmee de reputatie voor maatschappelijk verantwoord ondernemen (MVO-R) kan worden gemeten. Met behulp van deze maatstaf wordt vervolgens voor 2447 ondernemingen uit 29 landen de MVO-Reputatie bepaald. De data die gebruikt zijn om de MVO-R-scores te berekenen, bestaan uit MVO-scores van internationale rating agency’s, die per onderneming betrekking hebben op circa 177 aspecten van MVO. Uit het empirisch onderzoek blijkt dat: i) ondernemingen gemiddeld genomen meer dan voldoen aan de MVO-verwachtingen die geschapen zijn door de ondernemingen zelf; ii) er in Europa het hoogst wordt gescoord op MVO-Reputatie, met Groot Brittannië en Finland als leiders; iii) dat de utilitysector het best scoort en dat ‘gezondheidszorg’ en ‘financiële instellingen’ het slechtst scoren op MVO-Reputatie.
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Huang, Yinhao, Dazhou Lei, Ziwei Chen, and Biao Xu. "Factors associated with microvascular occlusion in patients with ST elevation myocardial infarction after primary percutaneous coronary intervention." Journal of International Medical Research 49, no. 6 (June 2021): 030006052110244. http://dx.doi.org/10.1177/03000605211024490.
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Objective This study aimed to determine predictors of microvascular occlusion (MVO) in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (pPCI). Methods This retrospective, observational study consecutively included 113 patients with STEMI undergoing pPCI. Cardiac magnetic resonance imaging was used to determine the presence of MVO in these patients. Biomarkers in serum were routinely tested 1 day after pPCI. Multivariable logistic regression analysis was used to evaluate significant predictors of occurrence of MVO. Results There were 62 patients in the MVO group and 51 patients in the non-MVO group. C-reactive protein (CRP), thrombomodulin, lymphatic vessel endothelial hyaluronan receptor-1, syndecan-1, and troponin T (TnT) levels after the procedure were significantly higher in the MVO group than in the non-MVO group. CRP (hazard ratio [HR]=1.036), TnT (HR=1.316), and syndecan-1 (HR=1.986) levels were independently associated with MVO in patients with acute myocardial infarction after pPCI. Conclusions Levels of CRP, TnT, and syndecan-1 can be used as serum biomarkers for MVO in patients with STEMI receiving pPCI.
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Wu, Han, Ran Li, Kun Wang, Dan Mu, Jian-Zhou Chen, Xuan Wei, Xue Bao, Zhong-Hai Wei, Jun Xie, and Biao Xu. "Predictive Value of Fasting Blood Glucose for Microvascular Obstruction in Nondiabetic Patients with ST-Segment Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention." Cardiology Research and Practice 2020 (September 26, 2020): 1–7. http://dx.doi.org/10.1155/2020/8429218.
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Background. The relationship between fasting blood glucose (FBG) and microvascular obstruction (MVO) after primary percutaneous coronary intervention (PCI) remains unclear in nondiabetic patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to determine the predictive value of FBG in MVO in nondiabetic STEMI patients. Methods. A total of 108 nondiabetic STEMI patients undergoing primary PCI were enrolled in this study. The patients were classified into either the MVO group or non-MVO group based on cardiac magnetic resonance imaging (CMR). Results. FBG in the MVO group was higher than in the non-MVO group. Univariate analysis showed that FBG, peak high-sensitive troponin T (TnT), pre-PCI thrombolysis in myocardial infarction (pre-PCI TIMI) flow, left ventricular ejection fraction (LVEF), infarction size, left ventricular end-diastolic diameter (LVEDd), left ventricular end-diastolic volume (LVEDV), and global longitudinal strain (GLS) were likely predictive factors of MVO. After adjustment for other parameters, FBG, peak TnT, LVEF, and LVEDV remained independent predictors for MVO. Conclusion. FBG was independently associated with MVO in nondiabetic STEMI patients.
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Hu, Hongping, Yangyang Li, Yanping Bai, Juping Zhang, and Maoxing Liu. "The Improved Antlion Optimizer and Artificial Neural Network for Chinese Influenza Prediction." Complexity 2019 (August 5, 2019): 1–12. http://dx.doi.org/10.1155/2019/1480392.
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The antlion optimizer (ALO) is a new swarm-based metaheuristic algorithm for optimization, which mimics the hunting mechanism of antlions in nature. Aiming at the shortcoming that ALO has unbalanced exploration and development capability for some complex optimization problems, inspired by the particle swarm optimization (PSO), the updated position of antlions in elitism operator of ALO is improved, and thus the improved ALO (IALO) is obtained. The proposed IALO is compared against sine cosine algorithm (SCA), PSO, Moth-flame optimization algorithm (MFO), multi-verse optimizer (MVO), and ALO by performing on 23 classic benchmark functions. The experimental results show that the proposed IALO outperforms SCA, PSO, MFO, MVO, and ALO according to the average values and the convergence speeds. And the proposed IALO is tested to optimize the parameters of BP neural network for predicting the Chinese influenza and the predicted model is built, written as IALO-BPNN, which is against the models: BPNN, SCA-BPNN, PSO-BPNN, MFO-BPNN, MVO-BPNN, and ALO-BPNN. It is shown that the predicted model IALO-BPNN has smaller errors than other six predicted models, which illustrates that the IALO has potentiality to optimize the weights and basis of BP neural network for predicting the Chinese influenza effectively. Therefore, the proposed IALO is an effective and efficient algorithm suitable for optimization problems.
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Vyshlov, E. V., Ya A. Alexeeva, W. Yu Ussov, O. V. Mochula, and V. V. Ryabov. "Phenomena of microvascular myocardial injury in patients with primary ST-segment elevation myocardial infarction: Prevalence and association with clinical characteristics." Siberian Journal of Clinical and Experimental Medicine 37, no. 1 (April 7, 2022): 36–46. http://dx.doi.org/10.29001/2073-8552-2021-36-4-36-46.
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Aim. The aim of this study was to evaluate the prevalence of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH), their combination, and relationship to the clinical and anamnestic characteristics in patients with primary STEMI after coronary reperfusion.Material and Methods. A single-center observational cohort study comprised a total of 60 patients with primary STEMI and successful coronary reperfusion within 12 hours of the onset of symptoms. All patients were studied using a contrast-enhanced cardiac magnetic resonance imaging (CE-MRI) at day 2 after STEMI. The study protocol was registered on ClinicalTrials.gov (Identifier: NCT03677466).Results. The total occurrence rate of MVO and IMH phenomena was 68.3% including MVO only in 17% of patients, IMH only in 15% of cases, combination of MVO and IMH in 36% cases, and without a microvascular myocardial injury in 32% of cases. The patients with MVO only and combination of MVO and IMH experienced a longer time of ischemia versus patients without these conditions: 205 (140–227) and 193 (95–400) versus 130 (91–160) min (p = 0.049). On the contrary, the time of myocardial ischemia did not differ between patients with IMH only (113 min) and patients without it. Then, patients were assigned to the group of pharmaco-invasive strategy of coronary reperfusion (PIS) (n = 39) and the group of primary percutaneous intervention (PPCI) (n = 21). The incidence of MVO only and IMH only was equal in PIS and PPCI groups: 17.9% versus 14.2% and 12.8% versus 19.1% in PIS and PPCI groups, respectively. The tendency to a decrease in the incidence of combined MVO and IMH was observed in PIS group compared to PPCI group: 30.8% versus 47.6% (p = 0.09).Conclusion. The combination of MVO and IMH phenomena in patients with primary STEMI after coronary reperfusion developed more often than each of these phenomena separately. The development of MVO only and combination of MVO and IMH was associated with a longer duration of myocardial ischemia. A total frequency of combination of MVO and IMH phenomena in patients with primary STEMI after coronary reperfusion was as high as 68.3%. Combination of these phenomena developed more frequently than each of them separately: 36% versus 17% (MVO only) and 15% (IMH only). No difference was observed in the duration of myocardial ischemia between the groups with MVO only and without it. The thrombolysis did not increase the occurrence of IMH in PIS group compared with PPCI group. There was a tendency to a decrease in the incidence of combination of MVO and IMH in PIS group compared to PPCI group: 30.8 versus 47.6% (р = 0.09).
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Gusc, Joanna, and Derk-Jan Haverkamp. "Naar prestatie-indicatoren voor maatschappelijk verantwoord ondernemen (MVO) in due diligence reviews." Maandblad Voor Accountancy en Bedrijfseconomie 84, no. 9 (September 1, 2010): 438–46. http://dx.doi.org/10.5117/mab.84.21890.
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Ondanks het groeiende belang van maatschappelijk verantwoord ondernemen (MVO), volstaan bedrijven vaak met de naleving van extern opgelegde (wettelijke) eisen. Er ontbreekt een instrument voor de vertaling van MVO naar bedrijfsprocessen, zoals risicoanalyses. Dit artikel bekijkt MVO vanuit het perspectief van de ‘due diligence review’. Een due diligence review richt zich op het in kaart brengen van bedrijfsrisico’s. Hierbij ontbreekt het echter nog aan goede indicatoren om de bedrijfsrisico’s op MVO-gebied te meten. In het methodisch ontwerpproces worden de vier perspectieven van de Balanced Scorecard (BSC) toegepast om op systematische wijze MVO-prestatie-indicatoren te ontwikkelen voor due diligence reviews.
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Bhimani, Kevin, Aniruddha Singh Lakhnot, Shyam Sharma, Mukul Sharma, Reena A. Panchal, Varad Mahajani, and Nikhil Koratkar. "Molybdenum Vanadium Oxides as Intercalation Hosts for Chloroaluminate Anions." Batteries 9, no. 2 (January 29, 2023): 92. http://dx.doi.org/10.3390/batteries9020092.
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Driven by the cost and scarcity of Lithium resources, it is imperative to explore alternative battery chemistries such as those based on Aluminum (Al). One of the key challenges associated with the development of Al-ion batteries is the limited choice of cathode materials. In this work, we explore an open-tunnel framework-based oxide (Mo3VOx) as a cathode in an Al-ion battery. The orthorhombic phase of molybdenum vanadium oxide (o-MVO) has been tested previously in Al-ion batteries but has shown poor coulombic efficiency and rapid capacity fade. Our results for o-MVO are consistent with the literature. However, when we explored the trigonal polymorph of MVO (t-MVO), we observe stable cycling performance with much improved coulombic efficiency. At a charge–discharge rate of ~0.4C, a specific capacity of ~190 mAh g−1 was obtained, and at a higher rate of 1C, a specific capacity of ~116 mAh g−1 was achieved. We show that differences in synthesis conditions of t-MVO and o-MVO result in significantly higher residual moisture in o-MVO, which can explain its poor reversibility and coulombic efficiency due to undesirable water interactions with the ionic liquid electrolyte. We also highlight the working mechanism of MVO || AlCl3–[BMIm]Cl || Al to be different than reported previously.
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Alekseeva, Ya V., E. V. Vyshlov, E. N. Pavlyukova, V. Yu Ussov, V. A. Markov, and V. V. Ryabov. "Impact of microvascular injury various types on function of left ventricular in patients with primary myocardial infarction with ST segment elevation." Kardiologiia 61, no. 5 (May 31, 2021): 23–31. http://dx.doi.org/10.18087/cardio.2021.5.n1500.
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Aim. To analyze the long-term effect of microvascular injury various types on the structural and functional parameters of the left ventricle assessed by echocardiography in patients with primary ST-segment elevation myocardial infarction (STEMI).Materials and methods. The study included 60 patients with primary STEMI admitted within the first 12 hours after the onset of disease who underwent stenting of the infarct-associated coronary artery. Each patient included in the study underwent CMR imaging on the second day post-STEMI. MVO and IMH were assessed using late gadolinium enhancement and T2-weighted CMR imaging. Subsequently, all patients underwent the standard echocardiographic protocol on the 7th day and 3 months after MI. Results. We divided all patients into 4 groups: the 1st group didn’t have any phenomena of IMH and MVO, the 2nd group had only MVO, patients of the 3rd group had only IMH and in the 4th group there was a combination of MVO and IMH. LV ejection fraction was significantly lower in patients with combination of MVO and IMH, if compared to those without it. Correlation analysis showed a moderate inverse correlation between the MVO area and LV contractile function: the larger the area, the lower the LVEF (R=-0,60; p=0,000002).Conclusions. The combination of IMH and MVO is a predictor of a reduction in LVEF and an increase of volumetric measurements within 3 months after MI. In comparison with patients without microvascular injury isolated MVO is associated with lower LVEF. The size of MVO is directly correlated with the LV contractile function decrease. Isolated IMH was not associated with deterioration of left ventricular function.
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Sever, Ozkan, Akin Cakir, and Fatih Horozoglu. "A comparison of the effect of intravitreal dexamethasone implant on macular and branch retinal vein occlusion. A real life experience." European Journal of Ophthalmology 30, no. 5 (June 12, 2020): 1106–11. http://dx.doi.org/10.1177/1120672120934982.
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Purpose: This study aimed to compare the effects of intravitreal dexamethasone (IVDx) implants on branch retinal vein occlusions (BRVOs) and macular vein occlusions (MVOs). Methods: Seventeen consecutive patients with MVO and 18 patients with BRVO, whose foveal thicknesses were greater than 300 µm, were recruited for this study. BRVO and MVO patients were diagnosed by means of fundus fluorescein angiography. Patients were treatment-naive. Initially, each patient in both the BRVO and MVO groups received an IVDx implant, and then a pro re nata IVDx regimen was initiated. Primary outcomes included VA gain, intraocular pressure (IOP) changes, macular ischemia, central macular thickness, retinal neovascularization, and number of IVDx injections. Follow-up time was 12 months. Results: The MVO group initially had significantly lower central macular thickness and a lower percentage of macular ischemia and systemic hypertension than those in the BRVO group ( p = 0.001, 0.045, and 0.010, respectively). There was a statistically significant VA gain in both groups ( p < 0.001), but the VA gain of the MVO group was greater than that of the BRVO group ( p < 0.001). The mean total number of IVDx injections administered throughout the study period was significantly lower in the MVO group than in the BRVO group (1.3 ± 0.4 vs 2.0 ± 0.0; p = 0.001). Discussion: MVO and BRVO have different disease characteristics, and IVDx implants were more effective on the visual gain in patients with MVO than that of patients with BRVO who had higher numbers of IVDx injections.
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Fracassi, Francesco, Giampaolo Niccoli, Vincenzo Vetrugno, Michele Cauteruccio, Antonino Buffon, Ilaria Gatto, Igor Giarretta, Paolo Tondi, Roberto Pola, and Filippo Crea. "The 9p21 Rs 1333040 polymorphism is associated with coronary microvascular obstruction in ST-segment elevation myocardial infarction treated by primary angioplasty." European Heart Journal: Acute Cardiovascular Care 8, no. 8 (October 6, 2017): 703–7. http://dx.doi.org/10.1177/2048872617735808.
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Background: Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI. Methods: We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI. The Rs1333040 polymorphism was evaluated by polymerase chain reaction-restriction fragment length polymorphism using restriction endonucleases (Bsml). Two expert operators unaware of the patients’ identity performed the angiographic analysis; collaterals were assessed applying Rentrop’s classification. Angiographic MVO was defined as a post-pPCI Thrombolysis In Myocardial Infarction (TIMI)<3 or TIMI 3 with myocardial blush grade 0 or 1, whereas electrocardiographic MVO was defined as ST segment resolution <70% one hour after pPCI. Results: Among our 133 STEMI patients (mean age 63 ± 11 years, men 72%), 35 (26%) and 53 (40%) respectively experienced angiographic or electrocardiographic MVO. Angiographic and electrocardiographic MVO were different among the three variants ( p= 0.03 and p=0.02 respectively). In particular, T/T genotype was associated with a higher incidence of both angiographic and electrocardiographic MVO compared with C/C genotype ( p=0.04 and p=0.03 respectively). Moreover, Rentrop score <2 detection rate differed among the three genotypes ( p=0.03). In particular T/T genotype was associated with a higher incidence of a Rentrop score <2 as compared with C/C genotype ( p= 0.02). Conclusion: Rs1333040 polymorphism genetic variants portend different MVO incidence. In particular, T/T genotype is related to angiographic and electrocardiographic MVO and to worse collaterals towards the culprit artery.
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Al-qaness, Mohammed A. A., Mohamed Abd Elaziz, Ahmed A. Ewees, and Xiaohui Cui. "A Modified Adaptive Neuro-Fuzzy Inference System Using Multi-Verse Optimizer Algorithm for Oil Consumption Forecasting." Electronics 8, no. 10 (September 21, 2019): 1071. http://dx.doi.org/10.3390/electronics8101071.
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Oil is the primary source of energy, therefore, oil consumption forecasting is essential for the necessary economic and social plans. This paper presents an alternative time series prediction method for oil consumption based on a modified Adaptive Neuro-Fuzzy Inference System (ANFIS) model using the Multi-verse Optimizer algorithm (MVO). MVO is applied to find the optimal parameters of the ANFIS. Then, the hybrid method, namely MVO-ANFIS, is employed to forecast oil consumption. To evaluate the performance of the MVO-ANFIS model, a dataset of two different countries was used and compared with several forecasting models. The evaluation results show the superiority of the MVO-ANFIS model over other models. Moreover, the proposed method constitutes an accurate tool that effectively improved the solution of time series prediction problems.
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Aurigemma, Cristina, Giancarla Scalone, Fabrizio Tomai, Luca Altamura, Giovanni De Persio, Alessandra Stazi, Filippo Crea, and Gaetano A. Lanza. "Persistent enhanced platelet activation in patients with acute myocardial infarction and coronary microvascular obstruction: clinical implications." Thrombosis and Haemostasis 111, no. 01 (2014): 122–30. http://dx.doi.org/10.1160/th13-02-0166.
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SummaryAbout 30% of patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing recanalisation of the infarct-related coronary artery do not achieve valid myocardial reperfusion (no-reflow phenomenon or coronary microvascular obstruction [MVO]). The mechanisms of MVO are incompletely understood. In this study we investigated the role platelet activation in the pathogenesis of coronary MVO in STEMI patients. We enrolled 48 STEMI patients (age 56.2 ± 11 years; 31 men), treated by primary percutaneous coronary intervention (PCI) followed by double anti-platelet treatment, and 20 control patients with stable coronary artery disease (CAD) on single antiplatelet treatment (age 57.5 ± 6 years, 12 men). STEMI patients were divided into two groups: 35 patients with complete myocardial reperfusion (MR) and 13 patients with coronary MVO despite successful PCI. Platelet activation was assessed on admission and at one-month follow-up by measuring platelet receptor expression and monocyteplatelet aggregates (MPAs). Platelet receptor expression, platelet receptor conformational change for fibrinogen binding availability and MPA formation were increased in STEMI patients with MVO compared to both STEMI patients with MR and stable CAD patients, both on admission and at one-month follow-up (p<0.05 for all). Among STEMI patients, platelet activation is greater in those who display coronary MVO, compared to those with MR, after successful PCI, both on admission and one month after STEMI, suggesting that enhanced platelet activation might be involved in the pathogenesis of MVO. The persistence of enhanced platelet activation despite double classical anti-platelet therapy suggests that new anti-platelet strategies should be considered in patients with coronary MVO.
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van der Weg, Kirian, Wichert J. Kuijt, Sebastiaan CAM Bekkers, Jan GP Tijssen, Cynthia L. Green, Miguel E. Lemmert, Mitchell W. Krucoff, and Anton PM Gorgels. "Reperfusion ventricular arrhythmia bursts identify larger infarct size in spite of optimal epicardial and microvascular reperfusion using cardiac magnetic resonance imaging." European Heart Journal: Acute Cardiovascular Care 7, no. 3 (March 27, 2017): 246–56. http://dx.doi.org/10.1177/2048872617690887.
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Aims: Ventricular arrhythmia (VA) bursts following recanalisation in acute ST-elevation myocardial infarction (STEMI) are related to larger infarct size (IS). Inadequate microvascular reperfusion, as determined by microvascular obstruction (MVO) using cardiac magnetic resonance imaging (CMR), is also known to be associated with larger IS. This study aimed to test the hypothesis that VA bursts identify larger infarct size in spite of optimal microvascular reperfusion. Methods: All 65 STEMI patients from the Maastricht ST elevation (MAST) study with brisk epicardial flow (TIMI 3), complete ST recovery post-percutaneous coronary intervention and early CMR were included. Using 24-hour Holter registrations from the time of admission, VA bursts were identified against subject-specific Holter background VA rates using a statistical outlier method. MVO and final IS were determined using delayed enhancement CMR. Results: MVO was present in 37/65 (57%) of patients. IS was significantly smaller in the group without MVO (median 9.4% vs. 20.5%; p < 0.001). IS in the group with MVO did not differ depending on VA burst ( n = 28/37; median 20.8% vs. 19.7%; p = 0.64). However, in the group without MVO, VA burst was associated with significantly larger IS ( n = 17/28; median 10.5% vs. 4.1%; p = 0.037). In multivariable analyses, VA burst as well as anterior infarct location remained independent predictors of larger infarct size. Conclusion: In the presence of suboptimal reperfusion with MVO by CMR, VA burst does not further define MI size. However, with optimal TIMI 3 reperfusion and optimal microvascular perfusion (i.e. no MVO), VA burst is associated with larger IS, indicating that VA burst is a marker of additional cell death.
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Maas, Karen. "Maatschappelijke prestaties van organisaties: van outputmeting naar impactmeting." Maandblad Voor Accountancy en Bedrijfseconomie 85, no. 11 (November 1, 2011): 563–72. http://dx.doi.org/10.5117/mab.85.12870.
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In de afgelopen decennia is Maatschappelijk Verantwoord Ondernemen (MVO) een steeds belangrijker concept geworden. Bedrijven worden, direct of indirect, aangesproken om verantwoording af te leggen over hun MVO-activiteiten en de resultaten ervan. Ook bestuurders vragen hun managers steeds vaker om de impact van hun MVO-activiteiten inzichtelijk te maken. Inzicht in de impact van MVO helpt managers bij het maken van strategische beslissingen. Hoewel er veel methoden voor het meten van effecten beschikbaar zijn maakt de diversiteit van methoden het moeilijk voor managers om een geschikte meetmethode te selecteren. Een indeling van de methoden op basis van een aantal kenmerken vereenvoudigt dit selectieproces. Empirisch onderzoek onder 272 bedrijven uit de Dow Jones Sustainability World Index (DJSI World) onderzoekt of bedrijven die actief zijn op het gebied van MVO zich bezighouden met impactmeten. Specifiek wordt gekeken naar het meten van impact van uitgaven aan filantropische doelen. De resultaten tonen aan dat impact in de periode 2005 – 2009 steeds vaker gemeten wordt en ook op meerdere dimensies.
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Huet, Fabien, Mariama Akodad, Nils Kuster, Hélène Kovacsik, Florence Leclercq, Anne-Marie Dupuy, Richard Gervasoni, et al. "An hs-TNT Second Peak Associated with High CRP at Day 2 Appears as Potential Biomarkers of Micro-Vascular Occlusion on Magnetic Resonance Imaging after Reperfused ST-Segment Elevation Myocardial Infarction." Cardiology 140, no. 4 (2018): 227–36. http://dx.doi.org/10.1159/000490881.
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Introduction: Micro-vascular occlusion (MVO) in a myocardial infarction (MI) is associated with an increased risk of heart failure and mortality. Hs-T-troponin has a double peak kinetic after MI. The aim was to determine if this kinetic was correlated to MVO evaluated by cardiac magnetic resonance imaging (MRI) after MI. Methods: This is a monocentric retrospective study. Inclusion criteria were hospitalization for MI, Thrombolysis In Myocardial Infarction flow 0 at coronary angiography, reperfusion within 12 h from the onset of chest pain, cardiac MRI within the first month, and a 5-days’ biological follow-up with at least hs-T-Troponin and C-reactive protein (CRP). Statistics were performed using the R software. Results: Ninety-eight patients were included. Fifty-three patients (54.1%) had MVO at MRI. The existence of MVO was associated with a trend of more kissing procedure during primary percutaneous coronary intervention (p = 0.06), a significantly more frequent second peak of troponin (p = 0.048), a significantly higher CRP level (p < 0.0001) and a longer time to balloon (p = 0.01). The association of CRP level above 40 mg/L at day 2 and the observation of a second peak of troponin were associated to 95% of MVO in ST-segment elevation MI patients. By contrast, in the absence of these 2 criteria, MVO was absent in 78% of the cases. This score was associated with a higher rate of hospitalisation at 2 years. Conclusion: A biological score integrating hs-TNT second peak and CRP might help to predict MVO and predict outcomes after reperfused MI in our population.
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Aschenbach, William G., Gregory L. Brower, Robert J. Talmadge, John L. Dobson, and L. Bruce Gladden. "Effect of a myocardial volume overload on lactate transport in skeletal muscle sarcolemmal vesicles." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 281, no. 1 (July 1, 2001): R176—R186. http://dx.doi.org/10.1152/ajpregu.2001.281.1.r176.
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This study sought to determine the effect of a myocardial volume overload (MVO) on sarcolemmal (SL) lactate (La−) transport and the aerobic profile of skeletal muscle. SL vesicles were obtained from female rats 10 wk after either a MVO was induced by creation of an infrarenal fistula ( n = 10), or sham surgeries were performed ( n = 11). Influx of 14C-labeled L(+)-La− was measured at various unlabeled La− concentrations under zero- trans conditions. La− transport kinetics were determined using a Michaelis-Menten equation with an added linear component to discriminate between carrier-mediated and diffusional transport. Although heart and lung weights were significantly increased ( P < 0.0001) in the MVO group, left ventricular function was only modestly altered ( P < 0.05). A significant reduction in type I myosin heavy chain (MHC) in the soleus and a strong trend ( P = 0.06) for a reduced type IIx MHC in the plantaris were observed in MVO rats, but no differences in citrate synthase activity or monocarboxylate transporter proteins (MCT)-1 expression were noted in any muscle. Carrier-mediated La− influx into SL vesicles was similar between sham and MVO ( K m = 12 ± 1 and 18 ± 3 mM; apparent Vmax = 772 ± 99 and 827 ± 80 nmol · mg−1 · min−1, respectively). Total influx at 100 mM was lower in MVO, and this was due to a 30% reduction in membrane diffusion. In conclusion, a 10-wk MVO did not alter MCT-mediated La− transport or protein expression but was associated with modest changes in myofibrillar proteins and impaired SL diffusive properties.
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Fague, Jeremy, and Caio Almeida. "Robust optimization of time series momentum portfolios." Brazilian Review of Finance 19, no. 1 (March 6, 2021): 52–69. http://dx.doi.org/10.12660/rbfin.v19n1.2021.82045.
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Mean-Variance Optimization (MVO) is well-known to be extremely sensitive to slight differences in the expected returns and covariances: if these measures change day to day, MVO can specify very different portfolios. Making wholesale changes in portfolio composition can cause the incremental gains to be negated by trading costs. We present a method for regularizing portfolio turnover by using the ℓ1 penalty, with the amount of penalization informed by recent historical data. We find that this method dramatically reduces turnover, while preserving the efficiency of mean-variance optimization in terms of risk-adjusted return. Factoring in reasonable estimates of transaction costs, the turnover-regularized MVO portfolio substantially outperforms a leverage-constrained MVO approach, in terms of risk-adjusted return.
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K.Dhal, P., and K. Ramash Kumar. "A Novel Hybrid Particle Swarm- Multiverse Optimization based Voltage Stability Improvement in IEEE 57 Bus System." International Journal of Engineering & Technology 7, no. 2.24 (April 25, 2018): 381. http://dx.doi.org/10.14419/ijet.v7i2.24.12089.
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The major role of power system is voltage stability. It is required to plan properly and smooth operation and control. It presents a new approach of voltage stability improvement in IEEE 57 bus system using hybrid algorithm. The hybrid algorithm (PSO-MVO) is combination of PSO which is used for exploitation and MVO used for exploration. It is used in an uncertain environment. The FACTS device as STATCOM is connected in IEEE 57 test system to check for event of voltage stability improvement through power system analysis tool (PSAT) software. Once the ability of system goes through sudden loading, its stability gets affected. It desires compensation to boost voltage from disturbances. The varied operative condition while not used STATCOM in the system, used with STATCOM tuned by PSO-MVO algorithm are measured judge the performance of the projected system. The hybrid PSO-MVO technique is implemented in this paper to solve the proposed problem. The simulation results are obtained by PSAT software for 57 IEEE bus systems. The hybrid algorithm validates its effectiveness compare to individual PSO and MVO algorithm.
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Coelho-Lima, Jose, Ashfaq Mohammed, Suzanne Cormack, Samuel Jones, Adnan Ali, Pedram Panahi, Matt Barter, et al. "Kinetics Analysis of Circulating MicroRNAs Unveils Markers of Failed Myocardial Reperfusion." Clinical Chemistry 66, no. 1 (December 30, 2019): 247–56. http://dx.doi.org/10.1373/clinchem.2019.308353.
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Abstract BACKGROUND Failed myocardial reperfusion occurs in approximately 50% of patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). It manifests as microvascular obstruction (MVO) on cardiac magnetic resonance (CMR) imaging. Although prognostically important, MVO is not routinely screened for. Our aim was to investigate the kinetics of circulating short noncoding ribonucleic acids [microRNAs (miRNAs)] following PPCI and their association with MVO in STEMI patients. METHODS Screening of 2083 miRNAs in plasma from STEMI patients with (n = 6) and without (n = 6) MVO was performed by next-generation sequencing. Two candidate miRNAs were selected and quantified at 13 time points within 3 h postreperfusion in 20 STEMI patients by reverse transcription and quantitative PCR. Subsequently, these 2 miRNAs were measured in a “validation” STEMI cohort (n = 50) that had CMR imaging performed at baseline and 3 months post-PPCI to evaluate their association with MVO. RESULTS miR-1 and miR-133b were rapidly released following PPCI in a monophasic or biphasic pattern. Both miRNAs were enriched in circulating microparticles. A second miR-1 peak (90–180 min postreperfusion) seemed to be associated with a higher index of microvascular resistance. In addition, miR-1 and miR-133b levels at 90 min post-PPCI were approximately 3-fold (P = 0.001) and 4.4-fold (P = 0.008) higher in patients with MVO, respectively. Finally, miR-1 was significantly increased in a subgroup of patients with worse left ventricular (LV) functional recovery 3 months post-PPCI. CONCLUSIONS miR-1 and miR-133b levels increase within 3 h of PPCI. They are positively associated with MVO and worse LV functional recovery post-PPCI.
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Kumar, Mekalathur B. Hemanth, Saravanan Balasubramaniyan, Sanjeevikumar Padmanaban, and Jens Bo Holm-Nielsen. "Wind Energy Potential Assessment by Weibull Parameter Estimation Using Multiverse Optimization Method: A Case Study of Tirumala Region in India." Energies 12, no. 11 (June 5, 2019): 2158. http://dx.doi.org/10.3390/en12112158.
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In this paper the multiverse optimization (MVO) was used for estimating Weibull parameters. These parameters were further used to analyze the wind data available at a particular location in the Tirumala region in India. An effort had been made to study the wind potential in this region (13°41′30.4″ N 79°21′34.4″ E) using the Weibull parameters. The wind data had been measured at this site for a period of six years from January 2012 to December 2017. The analysis was performed at two different hub heights of 10 m and 65 m. The frequency distribution of wind speed, wind direction and mean wind speeds were calculated for this region. To compare the performance of the MVO, gray wolf optimizer (GWO), moth flame optimization (MFO), particle swarm optimization (PSO) and other numerical methods were considered. From this study, the performance had been analyzed and the best results were obtained by using the MVO with an error less than one. Along with the Weibull frequency distribution for the selected region, wind direction and wind speed were also provided. From the analysis, wind speed from 2 m/s to 10 m/s was present in sector 260–280° and wind from 0–4 m/s were present in sector 170–180° of the Tirumala region in India.
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Ndrepepa, Gjin, and Adnan Kastrati. "Coronary No-Reflow after Primary Percutaneous Coronary Intervention—Current Knowledge on Pathophysiology, Diagnosis, Clinical Impact and Therapy." Journal of Clinical Medicine 12, no. 17 (August 27, 2023): 5592. http://dx.doi.org/10.3390/jcm12175592.
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Coronary no-reflow (CNR) is a frequent phenomenon that develops in patients with ST-segment elevation myocardial infarction (STEMI) following reperfusion therapy. CNR is highly dynamic, develops gradually (over hours) and persists for days to weeks after reperfusion. Microvascular obstruction (MVO) developing as a consequence of myocardial ischemia, distal embolization and reperfusion-related injury is the main pathophysiological mechanism of CNR. The frequency of CNR or MVO after primary PCI differs widely depending on the sensitivity of the tools used for diagnosis and timing of examination. Coronary angiography is readily available and most convenient to diagnose CNR but it is highly conservative and underestimates the true frequency of CNR. Cardiac magnetic resonance (CMR) imaging is the most sensitive method to diagnose MVO and CNR that provides information on the presence, localization and extent of MVO. CMR imaging detects intramyocardial hemorrhage and accurately estimates the infarct size. MVO and CNR markedly negate the benefits of reperfusion therapy and contribute to poor clinical outcomes including adverse remodeling of left ventricle, worsening or new congestive heart failure and reduced survival. Despite extensive research and the use of therapies that target almost all known pathophysiological mechanisms of CNR, no therapy has been found that prevents or reverses CNR and provides consistent clinical benefit in patients with STEMI undergoing reperfusion. Currently, the prevention or alleviation of MVO and CNR remain unmet goals in the therapy of STEMI that continue to be under intense research.
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Iancu, Adrian, Dan Rafiroiu, and Ioana Dregoesc. "Thrombus Aspiration, from “Heart to Soul”." Journal Of Cardiovascular Emergencies 2, no. 2 (June 1, 2016): 57–62. http://dx.doi.org/10.1515/jce-2016-0009.
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Abstract Microvascular obstruction (MVO) is one of the most frequent complications encountered during primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. The embolization of thrombotic material seems to be the leading cause of MVO, and many clinical trials have demonstrated that thrombus aspiration (TA) may be a useful means of preventing this phenomenon. Continuous advancements in technology have contributed to the development of various devices for thrombus aspiration. However, a review of the literature indicates that there is disagreement regarding the role of TA in the prevention and treatment of MVO. TA is increasingly used in the treatment of acute stroke in patients who are admitted to the hospital within eight hours from the onset of symptoms. This review presents the current knowledge regarding the role of TA in the prevention of MVO.
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Hu, Hongping, Yan Ao, Huichao Yan, Yanping Bai, and Na Shi. "Signal Denoising Based on Wavelet Threshold Denoising and Optimized Variational Mode Decomposition." Journal of Sensors 2021 (July 12, 2021): 1–23. http://dx.doi.org/10.1155/2021/5599096.
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To eliminate the noise from the signals received by MEMS vector hydrophone, a joint algorithm is proposed in this paper based on wavelet threshold (WT) denoising, variational mode decomposition (VMD) optimized by a hybrid algorithm of Multiverse Optimizer (MVO) and Particle Swarm Optimization (PSO), and correlation coefficient (CC) judgment to perform the signal denoising of MEMS vector hydrophone, named as MVO-PSO-VMD-CC-WT, whose fitness function is the root mean square error (RMSE) and whose individual is the parameters of VMD. For every individual, the original signal is decomposed by VMD into pure components, noisy components, and noise components in terms of CC judgment, where the pure components are directly retained, the noisy components are denoised by WT denoising, and the noise components are discarded, and then, the denoised noisy components and the pure components are reconstructed to be the denoised signal of the original signal. Then, the obtained optimal individual is utilized to perform the signal denoising by MVO-PSO-VMD-CC-WT by the use of the above repeated signal processing. Two simulated experimental results show that the MVO-PSO-VMD-CC-WT algorithm which has the highest signal-to-noise ratio and the least RMSE is superior to the other compared algorithms. And the proposed MVO-PSO-VMD-CC-WT algorithm is effectively applied to perform the signal denoising of the actual lake experiments. Therefore, the proposed MVO-PSO-VMD-CC-WT is suitable for the signal denoising and can be applied into the actual experiments in signal processing.
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Mohammed, Soheb Anwar, Muhammad Wahab Amjad, Xucai Chen, Maria F. Acosta, Dillion Hanrahan, Emmanuelle J. Meuillet, Evan C. Unger, and John J. Pacella. "Sonoreperfusion with fibrin-targeted phase shift microbubbles for the treatment of microvascular obstruction." Journal of the Acoustical Society of America 153, no. 3_supplement (March 1, 2023): A141. http://dx.doi.org/10.1121/10.0018436.
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More than 1 million Americans yearly have a new or recurrent acute myocardial infarction (AMI). Although the mortality rate from AMI has decreased in recent years, post-MI congestive heart failure is increasing due to microvascular obstruction (MVO), ultimately limiting myocardial salvage. We aim to address this unmet need by devising an image-guided therapy called sonoreperfusion (SRP) to resolve MVO by ultrasound-targeted microbubble cavitation (UTMC). In this study, we hypothesized that fibrin-targeted phase shift microbubbles (FTPSMBs; ∼200 nm) (Microvascular Therapeutics, Inc) would improve SRP efficacy compared to fibrin-targeted microbubbles (FTMBs; 1–3 μm) to treat MVO owing to the smaller size and more efficient microthrombi penetration. A rat hindlimb model of MVO was created by directly injecting freshly prepared porcine microthrombi into the left femoral artery under contrast-enhanced ultrasound imaging (CEUS) guidance, and treated with UTMC (1 MHz, 1.5 MPa, 5 ms pulse duration, 5-sec pulse interval) with concomitant administration of FTPSMBs/FTMBs (3 mL/hr). The treatment effect was accessed with CEUS. UTMC with FTPSMBs caused more rapid and complete reperfusion of rat hindlimb following MVO compared with FTMB, likely owing to their small size and more effective thrombus penetration. Studies to explore the underlying molecular mechanisms associated with SRP treatments are underway.
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Pacella, John J. "Microvascular no reflow in acute MI—Mechanistic studies of sonoreperfusion." Journal of the Acoustical Society of America 153, no. 3_supplement (March 1, 2023): A136. http://dx.doi.org/10.1121/10.0018418.
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Congestive heart failure (CHF) following acute myocardial infarction (AMI) is on the rise. Microvascular obstruction (MVO) is the single most important contributor to post-AMI CHF; it occurs in up to 80% of patients with AMI and is associated with worse outcomes. To address this unmet need, we have been developing ultrasound targeted microbubble cavitation (UTMC) to achieve “sonoreperfusion” (SRP) for MVO. During SRP, US is applied to intravenously administered MBs as they transit the coronary microcirculation, which causes MBs to oscillate and generate shear stress. We have previously shown that SRP therapy restores perfusion during MVO through direct mechanical “chiseling” effects of MBs on microthrombi. However, MVO is more than just physical obstruction from microemboli; it is characterized by a milieu of inflammation and oxidative stress, a state of imbalance between the formation of damaging reactive oxygen species (ROS) and antioxidant defenses. One such defense is nitric oxide (NO), which has multi-level therapeutic potential for MVO. We have demonstrated that UTMC releases NO from endothelial cells through mechanotransduction, and that NO is a major contributor to the efficacy of SRP. We are now actively pursuing strategies to optimize SRP, not only through mechanical mechanisms but also by addressing oxidative stress.
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Amjad, Muhammad Wahab, Soheb Anwar Mohammed, Marco Fazzari, Xucai Chen, Bruce Freeman, Terry Matsunaga, and John J. Pacella. "Cardioprotective efficacy of ultrasound-targeted nitrofatty acid microbubbles in rat myocardial ischemia-reperfusion injury model." Journal of the Acoustical Society of America 153, no. 3_supplement (March 1, 2023): A102. http://dx.doi.org/10.1121/10.0018308.
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Over 1 million Americans suffer from acute myocardial infarction (AMI) annually. Although mortality from AMI has decreased, post-AMI congestive heart failure is increasing due to microvascular obstruction (MVO). MVO comprises mechanical obstruction, along with oxidate stress and inflammation. Currently available treatments for MVO are not consistently effective. Hence, we have been developing ultrasound (US)-targeted microbubble cavitation (UTMC) as a potential treatment for MVO. Nitro-fatty acids (NFA) are pleiotropic signaling molecules with broad anti-inflammatory actions, potentially beneficial for the treatment of MVO. NFA are amphipathic thus can seamlessly integrate into the phospholipid shell of MBs. Thus, we have constructed microbubbles with NFA (NFABs) to treat ischemia-reperfusion injury (IRI) with UTMC in the rat myocardial model. Left anterior descending (LAD) coronary artery was ligated for 30 min, allowing for IRI. After 15 min of reperfusion, UTMC + NFABs therapy was administered. Echocardiography measurements were recorded at baseline, during ligation and post-treatment. Left ventricular fractional shortening (%) was calculated and NFA concentration in cardiac tissue was determined. UTMC with NFABs exhibited promising efficacy in improving fractional shortening post IRI, and in targeted myocardial delivery of NFA. Studies assessing ejection fraction, myocardial area at risk, histopathology, inflammatory burden, oxidative stress and cytoprotective biomarkers are underway.
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Vatambeti, Rajasekhar, and P. K. Dhal. "Congestion Control and Optimal Size of a Photovoltaic Device Using Multiverse Optimization Technique." Mathematical Modelling of Engineering Problems 8, no. 4 (August 31, 2021): 566–74. http://dx.doi.org/10.18280/mmep.080409.
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Congestion management plays an important role in the operation, control, and safety of the grid. This paper proposes the multiverse optimization (MVO) algorithm for the congestion management of the IEEE 30 bus system, aiming to identify line congestion, and eliminate it at the minimum congestion price (i.e., the minimum loss). The continuation power flow (CPF) mechanism is adopted to analyze the voltage stability and maximum load capacity of the grid. The MVO algorithm helps to boost the voltage with a photovoltaic (PV) device, whenever the grid became unstable. The optimal position of the device is found through six iterations, and the fitness function is found capable of maximizing loading parameters, while minimizing power loss. The new approach is evaluated under different operating conditions, namely, in the presence of an MVO-tuned PV grid, and in the absence of a PV grid. The results show that the MVO-tuned PV grid performed much better than the grid without a PV.
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CHIANG, LUNG-YIH, PAVEL D. NASELSKY, and PETER COLES. "COSMIC COVARIANCE AND THE LOW QUADRUPOLE ANISOTROPY IN THE WMAP DATA." Modern Physics Letters A 23, no. 17n20 (June 28, 2008): 1489–97. http://dx.doi.org/10.1142/s0217732308027874.
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Low quadrupole power in the cosmic microwave background (CMB) temperature anisotropies has been a puzzle since WMAP data release. In this talk I will demonstrate that the minimum variance optimization (MVO), a methodology used by many authors including the WMAP science team to separate the CMB from foreground contamination, serves not only to extract the CMB, but to subtract the “cosmic covariance”, an intrinsic correlation between the CMB and the foregrounds. Such subtraction induces low variance in the signal via MVO, which in turn propagates into the multipoles, causing a quadrupole deficit with more than 90% CL. As we do not know the CMB and the foregrounds a priori, and their correlation is subtracted by the MVO in any case, there is therefore an unknown error in the quadrupole power even before the cosmic variance interpretation. We combine the MVO and Monte Carlo simulations, assuming CMB is a Gaussian random field, and the estimated quadrupole power falls in [308.13, 401.97] μ K 2 (at 1 − σ level).
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Bochaton, Thomas, Jules Lassus, Alexandre Paccalet, François Derimay, Gilles Rioufol, Cyril Prieur, Eric Bonnefoy-Cudraz, et al. "Association of myocardial hemorrhage and persistent microvascular obstruction with circulating inflammatory biomarkers in STEMI patients." PLOS ONE 16, no. 1 (January 28, 2021): e0245684. http://dx.doi.org/10.1371/journal.pone.0245684.
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Introduction Myocardial hemorrhage (IMH) and persistent microvascular obstruction (MVO) are associated with impaired myocardial recovery and adverse clinical outcomes in STEMI patients. However, their relationship with circulating inflammatory biomarkers is unclear in human patients. Methods and results Twenty consecutive patients referred for primary percutaneous coronary intervention of first STEMI were included in a prospective study. Blood sampling was performed at admission, 4, 12, 24, 48 hours, 7 and 30 days after reperfusion for inflammatory biomarker (C reactive protein, fibrinogen, interleukin-6 (IL-6) and neutrophils count) assessment. At seven days, cardiovascular magnetic resonance (CMR) was performed for infarct size, MVO and IMH assessment. Median infarct size was 24.6% Interquartile range (IQR) [12.0–43.5] of LV mass and edema was 13.2% IQR [7.7–36.1] of LV mass. IL-6 reached a peak at H24 (5.6 pg/mL interquartile range (IQR) [2.5–17.5]), CRP at H48 (11.7 mg/L IQR [7.1–69.2]), fibrinogen one week after admission (4.4 g/L IQR [3.8–6.7]) and neutrophils at H12 (9.0 G/L IQR [6.5–12.7]). MVO was present in 11 patients (55% of the study population) and hemorrhage in 7 patients (35%). Patients with IMH had significantly higher IL-6, CRP, fibrinogen, and neutrophils levels compared to patients without IMH. Patients with persistent MVO had significantly higher CRP, fibrinogen and neutrophils level compared to patients without MVO, but identical IL-6 kinetics. Conclusion In human patients with acute myocardial infarction, intramyocardial hemorrhage appears to have a stronger relationship with inflammatory biomarker release compared to persistent MVO. Attenuating myocardial hemorrhage may be a novel target in future adjunctive STEMI treatments.
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Niccoli, Giampaolo, Rocco A. Montone, Borja Ibanez, Holger Thiele, Filippo Crea, Gerd Heusch, Heerajnarain Bulluck, et al. "Optimized Treatment of ST-Elevation Myocardial Infarction." Circulation Research 125, no. 2 (July 5, 2019): 245–58. http://dx.doi.org/10.1161/circresaha.119.315344.
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Primary percutaneous coronary intervention is nowadays the preferred reperfusion strategy for patients with acute ST-segment–elevation myocardial infarction, aiming at restoring epicardial infarct-related artery patency and achieving microvascular reperfusion as early as possible, thus limiting the extent of irreversibly injured myocardium. Yet, in a sizeable proportion of patients, primary percutaneous coronary intervention does not achieve effective myocardial reperfusion due to the occurrence of coronary microvascular obstruction (MVO). The amount of infarcted myocardium, the so-called infarct size, has long been known to be an independent predictor for major adverse cardiovascular events and adverse left ventricular remodeling after myocardial infarction. Previous cardioprotection studies were mainly aimed at protecting cardiomyocytes and reducing infarct size. However, several clinical and preclinical studies have reported that the presence and extent of MVO represent another important independent predictor of adverse left ventricular remodeling, and recent evidences support the notion that MVO may be more predictive of major adverse cardiovascular events than infarct size itself. Although timely and complete reperfusion is the most effective way of limiting myocardial injury and subsequent ventricular remodeling, the translation of effective therapeutic strategies into improved clinical outcomes has been largely disappointing. Of importance, despite the presence of a large number of studies focused on infarct size, only few cardioprotection studies addressed MVO as a therapeutic target. In this review, we provide a detailed summary of MVO including underlying causes, diagnostic techniques, and current therapeutic approaches. Furthermore, we discuss the hypothesis that simultaneously addressing infarct size and MVO may help to translate cardioprotective strategies into improved clinical outcome following ST-segment–elevation myocardial infarction.
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Boersma, Margreet. "De duurzame controller neemt leiding in een transitie naar maatschappelijk verantwoord ondernemen." Maandblad Voor Accountancy en Bedrijfseconomie 89, no. 5 (May 8, 2015): 181–87. http://dx.doi.org/10.5117/mab.89.31298.
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Steeds meer dringt het besef door dat er geen andere weg meer is dan duurzaam ondernemen. Organisaties die dit inzien streven naar meer dan alleen financiële winstmaximalisatie: er moet ook winst worden gecreëerd voor de mens, samenleving en milieu. Als de MVO-ambities meer zijn dan window-dressing, dan moet die winst hard aantoonbaar zijn. Dat kan alleen als duurzaamheid wordt verankerd in de strategische kaders en vast onderdeel is van de planning & controlcyclus. Daarmee ligt MVO op het bord van de controller. In deze bijdrage wordt geschetst welke instrumenten de controller kan gebruiken om het leiderschap in MVO op zich te nemen.
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Yang, Fen, Hossein Moayedi, and Amir Mosavi. "Predicting the Degree of Dissolved Oxygen Using Three Types of Multi-Layer Perceptron-Based Artificial Neural Networks." Sustainability 13, no. 17 (September 3, 2021): 9898. http://dx.doi.org/10.3390/su13179898.
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Predicting the level of dissolved oxygen (DO) is an important issue ensuring the sustainability of the inhabitants of a river. A prediction model can predict the DO level using a historical dataset with regard to water temperature, pH, and specific conductance for a given river. The model can be built using sophisticated computational procedures such as multi-layer perceptron-based artificial neural networks. Different types of networks can be constructed for this purpose. In this study, the authors constructed three networks, namely, multi-verse optimizer (MVO), black hole algorithm (BHA), and shuffled complex evolution (SCE). The networks were trained using the datasets collected from the Klamath River Station, Oregon, USA, for the period 2015–2018. We found that the trained networks could predict the DO level of 2019. We also found that both BHA- and SCE-based networks could predict the level of DO using a relatively simple configuration compared to that of MVO. From the viewpoints of absolute errors and Pearson’s correlation coefficient, MVO- and SCE-based networks performed better than BHA-based networks. In synopsis, the authors recommend MVO- and MLP-based artificial neural networks for predicting the DO level of a river.
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Amezquita, Lucio, Oscar Castillo, Jose Soria, and Prometeo Cortes-Antonio. "New Variants of the Multi-Verse Optimizer Algorithm Adapting Chaos Theory in Benchmark Optimization." Symmetry 15, no. 7 (June 27, 2023): 1319. http://dx.doi.org/10.3390/sym15071319.
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In this work, we present multiple variations of the Multi-verse Optimizer Algorithm (MVO) using chaotic maps, using it in the formation of new solutions. In these new variations of the MVO algorithm, which we call the Fuzzy-Chaotic Multi-verse Optimizer (FCMVO), we use multiple chaotic maps used in the literature to substitute some of the parameters for which the original algorithm used a random value in the formation of new universes or solutions. To implement chaos theory on these new variants, we also use Fuzzy Logic for dynamic parameter adaptation; the first tests are performed only using chaotic maps, and then we merge the use of Fuzzy Logic in each of these cases to analyze the improvement over the Fuzzy MVO. Subsequently, we use only the best-performing chaos maps in a new set of variants for the same cases; after these results, we observe the behavior of the algorithm in different cases. The objective of this study is to compare whether there is a significant improvement over the MVO algorithm using some of the best-performing chaotic maps in conjunction with Fuzzy Logic in benchmark mathematical functions prior to moving on to other case studies.
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Gosling, Rebecca C., Gareth Williams, Abdulaziz Al Baraikan, Samer Alabed, Eylem Levelt, Amrit Chowdhary, Peter P. Swoboda, et al. "Quantifying Myocardial Blood Flow and Resistance Using 4D-Flow Cardiac Magnetic Resonance Imaging." Cardiology Research and Practice 2023 (February 2, 2023): 1–7. http://dx.doi.org/10.1155/2023/3875924.
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Background. Ischaemia with nonobstructive coronary arteries is most commonly caused by coronary microvascular dysfunction but remains difficult to diagnose without invasive testing. Myocardial blood flow (MBF) can be quantified noninvasively on stress perfusion cardiac magnetic resonance (CMR) or positron emission tomography but neither is routinely used in clinical practice due to practical and technical constraints. Quantification of coronary sinus (CS) flow may represent a simpler method for CMR MBF quantification. 4D flow CMR offers comprehensive intracardiac and transvalvular flow quantification. However, it is feasibility to quantify MBF remains unknown. Methods. Patients with acute myocardial infarction (MI) and healthy volunteers underwent CMR. The CS contours were traced from the 2-chamber view. A reformatted phase contrast plane was generated through the CS, and flow was quantified using 4D flow CMR over the cardiac cycle and normalised for myocardial mass. MBF and resistance (MyoR) was determined in ten healthy volunteers, ten patients with myocardial infarction (MI) without microvascular obstruction (MVO), and ten with known MVO. Results. MBF was quantified in all 30 subjects. MBF was highest in healthy controls (123.8 ± 48.4 mL/min), significantly lower in those with MI (85.7 ± 30.5 mL/min), and even lower in those with MI and MVO (67.9 ± 29.2 mL/min/) ( P < 0.01 for both differences). Compared with healthy controls, MyoR was higher in those with MI and even higher in those with MI and MVO (0.79 (±0.35) versus 1.10 (±0.50) versus 1.50 (±0.69), P = 0.02 ). Conclusions. MBF and MyoR can be quantified from 4D flow CMR. Resting MBF was reduced in patients with MI and MVO.
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Li, Shengmao, Yu Huang, Lin Liu, Fan Zhang, Hui Ao, and Yingping Luo. "Mechanism of Magnolia Volatile Oil in the Treatment of Acute Pancreatitis Based on GC-MS, Network Pharmacology, and Molecular Docking." Evidence-Based Complementary and Alternative Medicine 2023 (February 7, 2023): 1–15. http://dx.doi.org/10.1155/2023/3503888.
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Objective. Magnoliae officinalis cortex (MOC) is one of the most frequently used traditional Chinese medicine (TCM) for the treatment of acute pancreatitis (AP). Magnolia volatile oil (MVO) is considered to be one of the main active ingredients in MOC for AP treatment. However, the underlying mechanism of MVO in AP therapy is unknown. Methods. An integrated strategy of gas chromatography-mass spectrum (GC-MS), network pharmacology, and molecular docking simulation was employed to predict underlying mechanism of MVO in AP treatment. First, the compounds of MVO were identified by GC-MS, and the targets of the identified characteristic compounds were collected from several databases, as well as AP-related targets. Next, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were carried out to obtain the mechanism. Moreover, the binding activity between core therapeutic targets and their corresponding compounds was evaluated by molecular docking simulation. Results. GC-MS results showed a total of 35 compounds that appeared in at least 18 out of 20 chromatograms were considered as characteristic compounds of MVO, and 33 compounds of those were identified. Network analysis demonstrated that 33 compounds regulated 142 AP-related targets. Of those, 8 compounds (α-eudesmol, γ-eudesmol, (−)-terpinen-4-ol, terpineol, hinesol, linalool, borneol, and β-eudesmol) and 8 targets (TNF, IL-1β, PPARγ, PPARα, PTGS2, NCOA1, CNR1, and ESR1) have a close relationship with AP treatment and were recognized as the key active compounds and the core therapeutic targets, respectively. The 142 targets were involved in both inflammation and calcium overload-related biological pathways, such as neuroactive ligand-receptor interaction, estrogen, MAPK, and calcium signaling pathway. Moreover, molecular docking simulation indicated that the 8 core therapeutic targets strongly interacted with their corresponding compounds. Conclusions. In summary, the present study elucidated that the efficacy of MVO in AP treatment might be attributed to anti-inflammation and inhibition of calcium overload through multicomponents and multitargets.
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Wang, Xiaoyu, Dongkun Luo, Jianye Liu, Wenhuan Wang, and Guixin Jie. "Prediction of Natural Gas Consumption in Different Regions of China Using a Hybrid MVO-NNGBM Model." Mathematical Problems in Engineering 2017 (2017): 1–10. http://dx.doi.org/10.1155/2017/6045708.
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The accurate and reasonable prediction of natural gas consumption is significant for the government to formulate energy planning. To this end, we use the multiverse optimizer (MVO) algorithm to optimize the parameters of the Nash nonlinear grey Bernoulli model (NNGBM (1,1)) and propose a hybrid MVO-NNGBM model to predict the natural gas consumption in 30 regions of China. The results indicate that the prediction precision of the hybrid MVO-NNGBM model is better than that of other grey-based models. According to the forecast results, China’s natural gas consumption will grow rapidly over the next five years and reach 354.1 billion cubic meters (bcm) by 2020. Moreover, the spatial distribution of natural gas consumption will shift from being supply oriented towards being demand driven and will be mainly concentrated in coastal and developed provinces.
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Doolub, Gemina, and Erica Dall'Armellina. "Intracoronary Adenosine versus Intravenous Adenosine during Primary PCI for ST-Elevation Myocardial Infarction: Which One Offers Better Outcomes in terms of Microvascular Obstruction?" ISRN Cardiology 2013 (March 27, 2013): 1–8. http://dx.doi.org/10.1155/2013/248476.
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Aims. Previous studies have suggested that intravenous administration of adenosine improves myocardial reperfusion and reduces infarct size in ST-elevation myocardial infarction (STEMI) patients. Intracoronary administration of adenosine has shown conflicting results. Methods. In this retrospective, single-centre, blinded clinical study, we assessed whether selective intracoronary administration of adenosine distal to the occlusion site immediately before initial balloon inflation reduces microvascular obstruction (MVO) as assessed with cardiac magnetic resonance imaging (MRI). Using contrast-enhanced sequences, microvascular obstruction (MVO) was calculated. We found 81 patients presenting with STEMI within 12 h from symptom onset who were eligible for the study. In 80/81 (100%) patients receiving the study drug, MRI was performed on Day 1 after primary angioplasty. Results. The prevalence of MVO was reduced in the patients treated with intracoronary adenosine, (45%) compared to 85% of patients who were administered intravenous adenosine (). We found that the size of MVO in patients receiving intracoronary adenosine was significantly reduced compared to 0.91 g in the intravenous-treated group (). There was no statistically significant difference in TIMI flow and clinical outcomes after primary PCI. Conclusion. We found significant evidence that selective high-dose intracoronary administration of adenosine distal to the occlusion site of the culprit lesion in STEMI patients results in a decrease in microvascular obstruction.
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Alekseeva, Ya V., E. V. Vyshlov, O. V. Mochula, V. Yu Ussov, and V. V. Ryabov. "Effect of intramyocardial haemorrhage on structural and functional echocardiographic parameters of myocardium after ST-segment elevation myocardial infarction with." Russian Journal of Cardiology 25, no. 12 (December 30, 2020): 4032. http://dx.doi.org/10.15829/1560-4071-2020-4032.
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Aim. To analyze the effect of intramyocardial haemorrhage (IMH) on the structural and functional echocardiographic parameters of myocardium in patients with primary ST-segment elevation myocardial infarction (STEMI).Material and methods. The study included 60 patients with primary STEMI reperfused within 12 hours after symptom onset. On the second day after the event, all subjects underwent gadolinium-enhanced cardiac magnetic resonance imaging (MRI). IMH was visualized as T2-weighted hypointense areas. Subsequently, all patients underwent the standard echocardiography on the 7th day after MI.Results. IMH was revealed in 31 patients (51,6%). In 22 patients (70,9%), IMH was accompanied by microvascular obstruction (MVO). In the remaining 9 patients (29%), an isolated IMH phenomenon was visualized. Lower values of left ventricular ejection fraction (LVEF) and LV volume parameters were associated with a combination of MVO and IMH. At the same time, the indices of volumetric characteristics and LVEF in isolated IMH were the same as in the group without IMH and MVO. It was demonstrated that the IMH occupies 1% (1-3%) of the LV myocardium. Correlation analysis showed a moderate inverse correlation between the IMH area and LV contractile function: the larger the area, the lower the LVEF (R=-0,35; p=0,007).Conclusions. The analysis of the influence of different IMH phenotypes on the structural and functional echocardiographic parameters of myocardium in the short-term period after STEMI has shown that the combination of IMH with MVO and isolated IMH have different effects on LV contractile function. The combination of IMH with MVO is a predictor of a decrease in LVEF and increase of end-systolic volume (ESV), while an isolated IMH does not affect these parameters. Correlations between the IMH area and a decrease in LVEF, as well as an increase in ESV, have been demonstrated.
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Vella, C., L. Ferri, M. Ancona, B. Bellini, F. Russo, V. Romano, G. Ghizzoni, et al. "P14 CT SCAN DERIVED PARAMETERS PREDICT LEFT VENTRICLE OBSTRUCTION AFTER TAVI." European Heart Journal Supplements 25, Supplement_D (May 2023): D43. http://dx.doi.org/10.1093/eurheartjsupp/suad111.101.
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Abstract Introduction Mid Ventricular (MVO) and Left Ventricular Outflow Tract Obstruction (LVOTO) after Trans–catheter Aortic Valve Implantation (TAVI) have been previously described and are associated with adverse outcome. Pre–procedural identification of patient at risk of MVO and LVOTO after TAVI may help pre–operative risk stratification and patient selection and facilitate intra–operative management, finally improving clinical outcomes. This study aims to identify CT–scan and Echocardiographic predictors of Left Ventricular Obstruction (LVO), defined as the composite of MVO and LVOTO. Methods We retrospectively reviewed pre–operative CT scans and Trans–Thoracic Echocardiography of 349 patients treated with TAVI at our Centre between January 2019 and December 2021. Correlations between post–operative development of MVO and LVOTO and pre–operative Echocardiographic and CT scan measurements were tested. Results LVO occurred in 16.3% of patients after TAVI. At univariate analysis clinical factors associated to LVO were female gender (OR=2.2, p=0.006) and body surface area (OR=0.19, p=0.006); pre–procedural echocardiographic parameters identified were end–diastolic–diameter (OR=0.89, p<0.001) and left ventricular ejections fraction (OR=1.09, p<0.001), whereas pre–procedural CT scan measurements associated to LVO were intraventricular septum to leaflet coaptation length (SLCL; OR=0.87, p<0.001) and left ventricular systolic area (OR=0.9, p<0.001). After multivariate analysis, only left ventricular ejection fraction (OR=1.1, p<0.001) and the CT scan derived parameters SLCL (OR=0.9, p<0.001) and left ventricular area (OR=0.9; p<0.001) were able to predict LVO after TAVI. Conclusions Left ventricle obstruction (LVOTO + MVO) after TAVI can be predicted by CT scan derived parameters. Pre–procedural identification of patients at risk may help intraprocedural and postprocedural management, thus improving clinical outcomes.
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Shi, Huixian, Zijing Wang, Haiyi Zhou, Kaiyan Lin, Shuping Li, Xinnan Zheng, Zheng Shen, Jiaoliao Chen, Lei Zhang, and Yalei Zhang. "Using a Novel Algorithm Based on the Random Vector Functional Link Network and Multi-Verse Optimizer to Forecast Effluent Quality." Sustainability 14, no. 14 (July 7, 2022): 8314. http://dx.doi.org/10.3390/su14148314.
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The treatment of wastewater is a complicated biological reaction process. Reliable effluent prediction is critical in the scientific management of water treatment plants. This research proposes a soft sensor design strategy to address the issues above, Multi-Verse Optimizer (MVO)-based random vector functional link network (MVO-RVFL). The proposed approach is utilized to anticipate real-time effluent data obtained from the Benchmark Simulation Model 1 (BSM1). The results of the experiments demonstrate that the MVO methodology can successfully find the optimum input-hidden weights and hidden biases of the RVFL model while outperforming the original RVFL and other typical machine learning approaches in all types of influent datasets. In the situation of significant water quality variations, the use of the fusion process for model development was also investigated. The experimental results demonstrate that incorporating prior knowledge can effectively improve the model’s ability to cope with unexpected situations.
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Zajdel, Wojciech, Tomasz Miszalski-Jamka, Jarosław Zalewski, Jacek Legutko, Krzysztof Żmudka, and Elżbieta Paszek. "Cardiac Magnetic Resonance Shows Improved Outcomes in Patients with an ST-Segment Elevation Myocardial Infarction and a High Thrombus Burden Treated with Adjuvant Aspiration Thrombectomy." Journal of Clinical Medicine 11, no. 17 (August 25, 2022): 5000. http://dx.doi.org/10.3390/jcm11175000.
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There is a discrepancy between epicardial vessel patency and microcirculation perfusion in a third of patients treated with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Optimization with aspiration thrombectomy (AT) may reduce distal embolization and microvascular obstruction. The effect of AT in the treatment of STEMI is debatable. The purpose of this study was to use cardiac magnetic resonance (CMR) to determine whether AT influences microvascular obstruction (MVO), infarct size and left ventricular (LV) remodelling in STEMI patients. Sixty STEMI patients with a thrombus-occluded coronary artery were randomized in a 2:1 fashion to receive PCI proceeded by AT (AT + PCI group), or PCI only. MVO, myocardial infarct size and LV remodelling were assessed by CMR during the index hospitalization and 6 months thereafter. The majority of patients had a large thrombus burden (TIMI thrombus grade 5 in over 70% of patients). PCI and AT were effective in all cases. There were no periprocedural strokes. CMR showed that the addition of AT to standard PCI was associated with lesser MVO when indexed to the infarct size and larger infarct size reduction. There were less patients with left ventricle remodelling in the AT + PCI vs. the PCI only group. To conclude, in STEMI patients with a high thrombus burden, AT added to PCI is effective in reducing infarct size, MVO and LV remodelling.
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Pacella, John J. "Fibrin-targeted phase shift microbubbles outperform fibrin-targeted microbubbles for the treatment of microvascular obstruction." Journal of the Acoustical Society of America 152, no. 4 (October 2022): A115. http://dx.doi.org/10.1121/10.0015728.
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Introduction: Mortality from AMI has decreased in recent years; however, microvascular obstruction (MVO) occurs frequently, ultimately limits myocardial salvage, is associated with rising post-AMI CHF, and has no definitive therapy. To address this urgent unmet need, we have developed an image-guided acute therapy, termed “sonoreperfusion” (SRP), that resolves MVO via ultrasound-targeted microbubble cavitation (UTMC). We previously used standard MBs with fibrin-targeting and demonstrated enhanced reperfusion compared to standard MBs with non-targeting. However, phase shift microbubbles are much smaller than standard MBs. Thus, we compared the SRP efficacies of fibrin-targeted phase shift microbubbles (FTPSMB) to standard size fibrin-targeted microbubbles (FTMBs). Methods: MVO of the rat hindlimb was created by injecting microthrombi into the left femoral artery under contrast-enhanced ultrasound (CEUS) guidance. DEFINITY® MBs were infused (2 ml/h) through the right external jugular vein for CEUS. Following 10 min of stable MVO, a transducer was positioned vertically above the hindlimb to deliver therapeutic US pulses during concomitant administration of FTMBs/FTPSMBs (3 ml/h). Results and conclusion: FTPSMB treatment resulted in a greater increase in the blood volume (dB) and flow rate (dB/sec) than FTMB after each 10-minute treatment session owing to their small size and more effective thrombus penetration. Studies to explore the underlying molecular mechanisms associated with SRP treatments are underway
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Rios-Navarro, Cesar, Victor Marcos-Garces, Antoni Bayes-Genis, Oliver Husser, Julio Nuñez, and Vicente Bodi. "Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR." Journal of Clinical Medicine 8, no. 11 (October 28, 2019): 1805. http://dx.doi.org/10.3390/jcm8111805.
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After a myocardial infarction (MI), despite the resolution of the coronary occlusion, the deterioration of myocardial perfusion persists in a considerable number of patients. This phenomenon is known as microvascular obstruction (MVO). Initially, the focus was placed on re-establishing blood flow in the epicardial artery. Then, the observation that MVO has profound negative structural and prognostic repercussions revived interest in microcirculation. In the near future, the availability of co-adjuvant therapies (beyond timely coronary reperfusion) aimed at preventing, minimizing, and repairing MVOs and finding convincing answers to questions regarding what, when, how, and where to administer these therapies will be of utmost importance. The objective of this work is to review the state-of-the-art concepts on pathophysiology, diagnostic methods, and structural and clinical implications of MVOs in patients with ST-segment elevation MIs. Based on this knowledge we discuss previously-tested and future opportunities for the prevention and repair of MVO.
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Terenicheva, M. A., R. M. Shakhnovich, O. V. Stukalova, D. V. Pevzner, G. K. Arutyunyan, A. Yu Demchenkova, I. N. Merkulova, and S. K. Ternovoy. "Correlations between clinical and laboratory findings and prognostically unfavorable CMR-based characteristics of acute ST-elevation myocardial infarction." Kardiologiia 61, no. 1 (February 11, 2021): 44–51. http://dx.doi.org/10.18087/cardio.2021.1.n1373.
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Aim To evaluate factors associated with unfavorable predictive characteristics of ST-segment elevation acute myocardial infarction (STEMI) as per data of magnetic resonance imaging (MRI).Material and methods The study included 52 patients with STEMI who underwent a primary percutaneous coronary intervention (pPCI). Contrast-enhanced cardiac MRI was performed for all patients on days 3-7. Delayed contrast-enhancement images were used for assessing infarct size, presence of microvascular obstruction (MVO) areas, and heterogeneity zones.Results Multifactorial analysis showed that independent predictors of MVO were type 2 diabetes mellitus (DM) (relative risk (RR) 1.9, confidence interval (CI): 1.1–3.26, р=0.012), increased levels of brain natriuretic peptide (BNP) (RR 2.04, CI: 1.39–2.99, р=0.004) and creatine kinase (CK) (RR 2.06, CI: 0.52–0.80, р=0.02), and infarct size (IS) (RR 2.81; CI: 1.38–5.72, р=0.0004). Construction of ROC curves provided the quantitative values of study indexes, at which the risk of MVO increased. For BNP, this value was ≥276 pg/ml (sensitivity, 95.7 %; specificity, 37.9 %); for CK ≥160 U/l (sensitivity, 74.1 %; specificity, 61.9 %); and for IS ≥18.8 % (sensitivity, 79.3 %; specificity, 69.6 %). Correlation analysis of risk factors for increased size of the heterogeneity zone showed significant correlations of the heterogeneity zone size with older age of patients (r=0.544, р<0.0001), higher concentrations of BNP (r=0.612, р<0.0001), CK (r=0.3, 95 % CI: 0.02–0.5, р=0.03), and C-reactive protein (CRP) (r=0.59, CI: 0.3–0.7, р=0.0001). Increased levels of CK (r=0.53, 95 % CI: 0.29–0.70, р=0.0001) and BNP (r=0.55, 95 % CI: 0.28–0.70, p=0.0003) significantly correlated with increased IS.Conclusion Risk of MVO formation as per MRI data increased in the presence of type 2 DM and IS ≥18.8 % (р<0.05). Formation of MVO in patients with STEMI was associated with increased levels of BNP ≥276 pg/ml and CK ≥160 U/l (р<0.05). Increased levels of BNP, CK, and CRP were associated with a larger size of heterogeneity zone according to data of the correlation analysis. A larger heterogeneity zone was more typical for older patients. Increased levels of CK and BNP were also associated with larger IS. The correlation analysis did not show any significant interactions between the size of heterogeneity zone, IS, and MVO size (р>0.05).
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Kamp-Roelands, A. E. M. "Ontwikkelingen in maatschappelijke verslaggeving." Maandblad Voor Accountancy en Bedrijfseconomie 77, no. 11 (November 1, 2003): 482–88. http://dx.doi.org/10.5117/mab.77.12758.
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Maatschappelijke verslaggeving laat in de praktijk een geleidelijke maar gestage groei zien. Hoewel wetgeving op dit terrein ontbreekt, zijn er voor bedrijven die een maatschappelijk verslag op willen stellen voldoende aanknopingspunten. In dit artikel wordt maatschappelijk verantwoord ondernemen (MVO) en met name de verslaggeving daarover besproken. Er wordt ingegaan op de ontwikkelingen in wet- en regelgeving en richtlijnen voor maatschappelijke verslaggeving en op de stand van zaken in de praktijk zowel met betrekking tot het rapporteren over MVO in het directieverslag als in afzonderlijke maatschappelijke verslaggeving.
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Bonfig, Nicole L., Chase R. Soukup, Ananya A. Shah, Susan Olet, Sarah J. Davidson, Christian W. Schmidt, Rose Peterson, Timothy D. Henry, and Jay H. Traverse. "Increasing Myocardial Edema Is Associated With Greater Microvascular Obstruction In ST-Segment Elevation Myocardial Infarction." American Journal of Physiology-Heart and Circulatory Physiology, September 9, 2022. http://dx.doi.org/10.1152/ajpheart.00347.2022.
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Microvascular obstruction (MVO) frequently develops after ST-elevation myocardial infarction (STEMI) and is associated with increased mortality and adverse left-ventricular remodeling. We hypothesized that increased extravascular compressive forces in the myocardium that arise from the development of myocardial edema as a consequence of ischemia-reperfusion injury would contribute to the development of MVO. We measured MVO, infarct size and left ventricular mass in STEMI patients (n=385) using cardiac MRI 2-3 days following successful percutaneous coronary intervention and stenting. MVO was found in 57% of STEMI patients. The average infarct size was 45 ± 29 grams. Patients with MVO had significantly greater infarct size and reduced LV function (p < 0.01) compared to patients without MVO. Patients with MVO had significantly greater LV mass than patients without MVO and there was a linear increase in MVO with increasing LV mass (p < 0.001). Myocardial edema by T2-weighted imaging increased with increasing LV mass and patients with MVO had significantly greater myocardial edema than patients without MVO (p < 0.01). Patients with MVO had significantly greater LVEDP than patients without MVO (p < 0.05). In a cohort of STEMI patients who underwent primary percutaneous intervention we observed that MVO increased linearly with increasing LV mass and was associated with increased myocardial edema and higher LVEDP. These observations support the concept that extravascular compressive forces in the left ventricle may increase with increasing ischemic injury and contribute to the development of MVO.
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Miyajima, K., Y. Shirai, F. Kin, T. Watanabe, M. Tatsuguchi, Y. Kawaguchi, and Y. Wakabayashi. "P52714D-flow cardiac magnetic resonance analysis of left ventricular blood flow dynamics in mid-ventricular obstructive hypertrophic cardiomyopathy." European Heart Journal 40, Supplement_1 (October 1, 2019). http://dx.doi.org/10.1093/eurheartj/ehz746.0242.
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Abstract Background Mid-ventricular obstructive hypertrophic cardiomyopathy (MVO-HCM) has different blood flow dynamics from other phenotypes, but there are few detailed data on blood flow dynamics in the left ventricle. Methods 4D-Flow MRI were performed at 1.5 T or 3 T with 9 MVO-HCM patients and 22 control patients (LVEF>50%, no wall motion abnormality). Myocardial infarction, severe valvular disease, HCM cases other than MVO were excluded. We calculated the cardiac function parameters and observed blood flow dynamics in the left ventricle using 4D-Flow MRI. Results LV mass was significantly higher in MVO-HCM group than in Control group (Control group; 73.3g vs MVO-HCM group; 109.5g, P=0.019). LVEF was higher in MVO-HCM group (Control group; 61.6% vs MVO-HCM group; 70.6%, P=0.026), but Stroke volume did not differ between the two groups (Control group; 68.8ml vs MVO-HCM group; 64.4ml, P=0.43).One or two vortices were observed in the left ventricle after opening the mitral valve. Two vortices were observed in 16 cases (72.7%) in the control group and 9 cases (100%) in the MVO-HCM group. Two vortices were formed on the anterior side and the posterior side. Blood flow pattern in which the vortex on the posterior side was formed to be the same size or larger than the vortex on the anterior side was observed only in the MVO-HCM group (Control group; 0% vs MVO-HCM group; 66.7%, P<0.001). Streamline of MVO-HCM & Control Conclusion Characteristic blood flow patterns in the left ventricle of the MVO-HCM were revealed by using 4D-MRI. We thought that blood flow collides with the left ventricle wall due to the marked hypertrophy in the mid-ventricle, and normal vortex ring can not be formed in the MVO-HCM cases.