Category: Blood

Centenarians, once considered rare, have become commonplace. Indeed, they are the fastest-growing demographic group of the world’s population, with numbers roughly doubling every ten years since the 1970s. How long humans can live, and what determines a long and healthy life, have been of interest for as long as we know. Plato and Aristotle discussed and wrote about the ageing process over 2,300 years ago. Advertisement The pursuit of understanding the secrets behind exceptional longevity isn’t easy, however. It involves unravelling the complex interplay of genetic predisposition and lifestyle factors and how they interact throughout a person’s life. Now our recent study, published in GeroScience, has unveiled some common biomarkers, including levels of cholesterol and glucose, in people who live past 90. Nonagenarians and centenarians have long been of intense interest to scientists as they may help us understand how to live longer, and perhaps also how to age in better health. So far, studies of centenarians have often been small scale and focused on a selected group, for example, excluding centenarians who live in care homes. Huge dataset Ours is the largest study comparing biomarker profiles measured throughout life among exceptionally long-lived people and their shorter-lived peers to date. We compared the biomarker profiles of people who went on to live past the age of 100, and their shorter-lived peers, and investigated the link between the profiles and the chance of becoming a centenarian. Advertisement Our research included data from 44,000 Swedes who underwent health assessments at ages 64-99 – they were a sample of the so-called Amoris cohort. These participants were then followed through Swedish register data for up to 35 years. Of these people, 1,224, or 2.7%, lived to be 100 years old. The vast majority (85%) of the centenarians were female. Twelve blood-based biomarkers related to inflammation, metabolism, liver and kidney function, as well as potential malnutrition and anaemia, were included. All of these have been associated with ageing or mortality in previous studies. The biomarker related to inflammation was uric acid – a waste product in the body caused by the digestion of certain foods. We also looked at markers linked to metabolic status and function including total cholesterol and glucose, and ones related to liver function, such as alanine aminotransferase (Alat), aspartate aminotransferase (Asat), albumin, gamma-glutamyl transferase (GGT), alkaline phosphatase (Alp) and lactate dehydrogenase (LD). We also looked at creatinine, which is linked to kidney function, and iron and total iron-binding capacity (TIBC), which is linked to anaemia. Finally, we also investigated albumin, a biomarker associated with nutrition. Findings We found that, on the whole, those who made it to their hundredth birthday tended to have lower levels of glucose, creatinine and uric acid from their sixties onwards. Although the median values didn’t differ significantly between centenarians and non-centenarians for most biomarkers, centenarians seldom displayed extremely high or low values. For example, very few of the centenarians had a glucose level above 6.5 earlier in life, or a creatinine level above 125. Villagrande Strisaili in the Ogliastra Province of Sardinia, Italy, has the world’s highest population of centenarian men. Sabino Parente/Shutterstock For many of the biomarkers, both centenarians and non-centenarians had values outside of the range considered normal in clinical guidelines. This is probably because these guidelines are set based on a younger and healthier population. When exploring which biomarkers were linked to the likelihood of reaching 100, we found that all but two (alat and albumin) of the 12 biomarkers showed a connection to the likelihood of turning 100. This was even after accounting for age, sex and disease burden. Advertisement The people in the lowest out of five groups for levels of total cholesterol and iron had a lower chance of reaching 100 years as compared to those with higher levels. Meanwhile, people with higher levels of glucose, creatinine, uric acid and markers for liver function also decreased the chance of becoming a centenarian. In absolute terms, the differences were rather small for some of the biomarkers, while for others the differences were somewhat more substantial. For uric acid, for instance, the absolute difference was 2.5 percentage points. This means that people in the group with the lowest uric acid had a 4% chance of turning 100 while in the group with the highest uric acid levels only 1.5% made it to age 100. Even if the differences we discovered were overall rather small, they suggest a potential link between metabolic health, nutrition and exceptional longevity. Advertisement The study, however, does not allow any conclusions about which lifestyle factors or genes are responsible for the biomarker values. However, it is reasonable to think that factors such as nutrition and alcohol intake play a role. Keeping track of your kidney and liver values, as well as glucose and uric acid as you get older, is probably not a bad idea. That said, chance probably plays a role at some point in reaching an exceptional age. But the fact that differences in biomarkers could be observed a long time before death suggests that genes and lifestyle may also play a role. Karin Modig, Associate Professor, Epidemiology, Karolinska Institutet This article is republished from The Conversation under a Creative Commons license. Read the original article.

Throughout October, we are observing the first annual Emily Adkins Blood Clot Awareness Month in honor of our daughter Emily, who died Oct. 21, 2022, from an undiagnosed blood clot. Even as it marks a sad occasion, the observance serves as a time to celebrate recent advancements toward preventing and detecting blood clots. It’s also an opportunity to create awareness about the potential fatality of blood clots and ways to prevent them, such as the Caprini Risk Score. Since Emily’s passing, my wife Janet, my son Douglas and I have been gratified to see significant changes resulting from our advocacy efforts. In June, Florida Gov. Ron DeSantis signed the Emily Adkins Prevention Act requiring the establishment of a policy workgroup to understand the impact of blood clots and enhance their detection. Although four months later we are still waiting for the state surgeon general to appoint a chair for the policy workgroup, this legislation is a necessary step forward for effective blood clot prevention efforts. In addition to the legislation, we have seen great advancements in mechanical thrombectomy ― a blood clot removal procedure using less invasive endovascular devices — and breakthroughs from Rapid AI that uses artificial intelligence to detect and treat blood clots. With about 3 in 4 Florida residents having at least one medical experience that puts them at greater risk of a blood clot or pulmonary embolism, this work couldn’t be more important. Emily Adkins Blood Clot Awareness Month is an important part of educating Americans on the prevalence of blood clots. Everyone should work with their medical providers to establish a blood clot prevention plan and calculate their Caprini Risk Score. Our goal is to honor the lives of those lost to blood clots and continue advocating for treatments and advancements that will prevent families from suffering this preventable pain and heartache. Doug Adkins, CEO, Emily’s Promise, Jacksonville You may not believe, but you can still love Herb Gartner’s Oct. 8 letter made a logical argument for why he personally does not believe in God. It has been said that the only true religion is the one set out in the Book of Leviticus, with all others being manmade. Christianity has morphed into a religion, but started out as a faith, meaning a personal belief — not an organized institution. In response to an earlier column from a rabbi on the Jewish High Holidays, Mr. Gartner asked how does one rationally and logically square the horrible death of 6 million Jews in Nazi Germany with a benevolent God who hears prayers? The crown of creation, mankind being made higher than all other living creatures, has the unique characteristic of demonstrating free will, and that includes accepting its consequences. In Jewish history there were the patriarchs, judges, kings and prophets that lead to the concept of a redeemer and savior ― a messiah. In a broken world, bad things happen to good people and evil temporarily triumphs from time to time. Through it all we are called to do justice, show mercy and care for the widow, orphan or stranger in our midst. Some events and relationships will smother one’s hope and resiliency. Others, in spite of such adversity, will rise above. Tomorrow the sun will rise at its appointed time; one person dies, another is born. The complexity of all that is life, within our bodies and in the universe, bears witness to what modern science is only beginning to reveal to our understanding. I cannot see gravity, but I believe in it because I experience it (knowingly and unknowingly) all the time. To borrow from Christian scripture, “So now faith, hope and love abide; these three, but the greatest is love.” Rob Richardson, Jacksonville Beach Kudos to Furyk & Friends, Timuquana club In the three years of the PGA Champions Constellation Furyk & Friends at Timuquana Country Club in Jacksonville, I can say with confidence that I have the best time watching golf in person. There is no other golf venue where you can watch action on seven different holes from one place, the 58 Club. This event has put Jacksonville on the map as a golf destination in October. This year’s event was threatened when four greens, a part of the practice facility and several TVs were damaged by vandalism early on Thursday, Oct. 5. Within 16 hours, the team at Timuquana, in collaboration with TPC Sawgrass, MacCurrach Golf Construction Inc., the PGA and others had the course repaired and ready for competition on Friday morning. Arriving on Friday morning to our viewing stand you could see the outstanding repair work done on the greens, especially the 17th, which was right in front of us. The repairs were done with meticulous precision, keeping the repairs level and the grain of the repaired pieces matching the existing grain of the green. The ultimate acknowledgment of the hard work to repair the greens came with the first group to play the 17th on Friday. Scott Parel, the second player to shoot, knocked down a hole in one to the extreme delight of the crowd. People from New Jersey, Mississippi, Alabama, Michigan, Georgia, Pennsylvania and other states complimented the achievement of maintaining the integrity of a great golfing event. Everyone looks forward to coming back next year. The city of Jacksonville should present formal recognition to all those who worked hard to preserve the integrity of this golf event — and maintain Jacksonville as the home of a premier golf destination. Charles Jaskiewicz, Ormond Beach Two-state solution only way to peace The incredible violence occurring in Israel and Gaza is abhorrent and tragic — but it was decidedly predictable. While Israel certainly has a right to exist and defend itself, it does not have the right to oppress and dehumanize an entire population for decades. Israel is undeniably a strategic ally in the Middle East and at present, at least a nominal democracy. But its far-right Likud party, which dominates the Knesset, has moved increasingly

The horror classic Dracula is coming to the stage at the Palace Theatre in London, Ont., later this month — and in an effort to promote the play and the need for blood donors, the cast gave blood. The cast and crew from the London Community Players and Odesa Company visited Canadian Blood Services donor centre on Friday. “It seems like a natural fit to have the production of Dracula donate blood,” said Scott Smalley, the co-director of the production. “Perhaps it’s not a natural fit because Dracula usually extracts the blood for himself, but today we’re here to give to others.” Ben Kennes, who is playing the role of the Count in the film, also rolled up his sleeve at the clinic. “This is quite the interesting situation Dracula’s in, giving blood instead of taking it, but it’s always for a good cause,” he said. London’s Palace Theatre hosts a Dracula blood drive 17 hours ago Duration 0:37 Featured VideoActors Ben Kennes and Amy Dickson perform a scene from Dracula at the Canada Blood Service donor centre on Oct. 13, 2023. Kennes, who is playing Dracula in the production, also gave blood. Written in 1924, this will be the first stage production of Dracula in London since the Grand Theatre run it nearly 30 years ago. Along with the technical challenges ahead of them, the production team is leaning into the original themes of horror. “With our production, we’re gonna try to make it spookier and darker. Even if it’s a story that everybody knows, we still want to give people those jump scares and get them into the Halloween spirit,” Kennes said. Dracula is playing at the Palace Theatre from Oct. 27 to Nov. 5. The cast of the Palace Theatre’s upcoming performance of Dracula after donating blood at the Canadian Blood Services donor centre. From left to right: Amy Dickson, Daniel Jewlal, Ben Kennes and Dan Curtis. (Mike Lacasse/CBC News) Blood donations needed The cast’s visit to the blood donor clinic on Wharncliffe Road also highlighted the need for blood donations in the London area. Nearly 800 donors are needed to keep inventory levels topped up in the city, according to Canadian Blood Services. “We need blood,” said Elaine Keller, the community development manager for Canadian Blood Services. “There are so many people across the country and we can’t get that blood without donors. It’s a critical part of everyday medical care and there’s no substitute.” To book an appointment to give, visit the blood services website. Ben Kennes, in costume as Dracula, waits to finish donating blood at the Canadian Blood Services donor clinic in London, Ont. (Mike Lacasse/CBC News)

Share on PinterestThe secret to longevity may lie in the levels of certain blood biomarkers. Rob and Julia Campbell/Stocksy The secret as to why some people live to 100 whereas others do not may be hidden in the metabolic profiles of centenarians and is established earlier in life. A new study found that people who lived to 100 tended to have lower — but not extremely lower — measurements of creatinine, glucose, and uric acid. The researchers also discovered that the metabolic profiles of centenarians were already established decades before their 100th year. A new study has investigated what may be unique about people who live to be 100 years old and beyond. The study’s authors were looking for differences in body function prior to extreme old age that might expand our understanding of aging and longevity. This makes it the first piece of research to compare blood biomarkers measured at earlier stages of life for people who eventually lived to be centenarians against others who did not. Their findings indicate that centenarians, by and large, were likely to have lower levels of glucose, creatinine, and uric acid than other people. The median differences between centenarians and others were small, and centenarians rarely had values at either the low or high end of the healthy ranges, tending to remain in the middle ranges of measurement. The researchers also found that eventual centenarians had settled into a metabolic profile by age 65, 35 years before reaching the century mark. The study is published in GeroScience. Due to improved life expectancies globally, older adults, including people living past the age of 100, are the fastest-growing age group. In 2015, there were nearly half a million centenarians alive, and it is predicted that by 2050 there will be 3.7 million people worldwide who are older than 100. The study’s authors analyzed data from over 44,000 Swedes enrolled in the population-based AMORIS (Apolipoprotein MOrtality RISk) cohort. They then measured the participants’ biomarkers between 1985 and 1996, and followed these until 2020. The researchers looked at 12 blood biomarkers of metabolic status and function. These included total cholesterol and glucose, as well as alanine aminotransferase (Alat), aspartate aminotransferase (Asat), albumin, gamma-glutamyl transferase (GGT), alkaline phosphatase (Alp), and lactate dehydrogenase (LD), which are related to liver health. They also tracked creatinine, a marker of kidney status, as well as iron-binding capacity (TIBC) and iron, which measure anemia. They assessed nutrition via a measurement of albumin. The authors concluded that values for nearly all the biomarkers were distinctive in centenarians, except for alanine aminotransferase and albumin. Dr. Mireille Serlie, professor of endocrinology at Yale, who was not involved in the study, told Medical News Today that creatinine “is dependent on renal [kidney] function and muscle mass.” “The lower creatinine in this age group (mean age at first biomarker testing in centenarians was 79.6 years) is compatible with higher renal function,” she said. Looking for lifestyle clues in centenarians’ biomarkers is a speculative game. However, Dr. Serlie noted that “Lifestyle is associated with renal function through salt intake, hypertension, obesity, hyperglycemia, cardiac function, etc.” ”So, higher renal function in this group could be a readout for a better overall lifestyle and diet. This is also true for glucose,” said Dr. Serlie. Slightly lower uric acid levels suggest that centenarians did not have issues with kidney stones, kidney disease, or gout. However, having too low a level of uric acid is problematic in its own right, which may lead to neurological problems. The study reflects the multiple possible implications of different biomarker measurements. Dr. Serlie explained by example, citing iron, TIBC, and albumin, which may say something about nutrition. “Taking levels of iron, TIBC, and albumin as markers for nutritional state might be less suitable because they can be influenced by inflammation or chronic illness. A lower albumin does not necessarily signal malnutrition. And iron levels can be low during illness. This is then also not reflective of a nutritional deficiency, per se,” she said. People whose metabolic profiles and blood readings were more extreme were least likely to reach 100. This includes people who had the lowest levels of total cholesterol and iron, as well as those with the highest levels of glucose, creatinine, uric acid, and liver-function biomarkers. While the biomarker profiles of centenarians were very similar, the researchers found that there are two clusters of centenarians. They differed in biomarkers apart from the ones that distinguished them from non-centenarians: total cholesterol, albumin, and TBIC. “These biomarkers are all related to nutrition,” said the study’s first author, Dr. Shunsuke Murata. “One group were more similar to non-centenarians, and we named it ‘higher nutrition.’ The other group had somewhat more favorable levels, and we named it ‘lower but enough nutrition.’” “We can only speculate on what is behind the difference, for example, caloric restriction,” he noted. “When we stress that centenarians overall experienced more compressed values, we mean that they more seldom displayed extreme values of the biomarkers. For example, almost none of the centenarians had a glucose above seven earlier in life, while such extreme values were more common in non-centenarians,” Dr. Murata explained. Perhaps this affected non-centenarians’ relative lack of longevity, he said. “It is difficult to say if the absence of extreme values point towards lifestyle. But the findings of overall more favorable values for centenarians, and the fact that these markers are related to diet and lifestyle, it is possible — or perhaps even likely — that such factors have an impact. What we cannot know is to what extent genetic factors interact with this.”— Dr. Shunsuke Murata The fact, however, that centenarians’ biomarker profiles are in place so much earlier in life may provide a clue. “This speaks against chance only, or genetic only, as factors for reaching exceptional age,” hypothesized Dr. Murata. “To fully answer the question of why, we would need more information, ideally about genetics, lifestyle factors, and biomarkers within the same cohort of people,” he added. Meanwhile, other

Babar says he would have bowled first, had he won the toss, names an unchanged lineup; Shubman Gill back for India. Pakistan are 102-2 against India after 19 overs in their World Cup 2023 fixture in Ahmedabad after being invited to bat first. Situation right now India, on their own turf, and carrying an unblemished record against Pakistan in the 50-over World Cup are the overwhelming favourites. Even the experts from the Pakistan side, including Wasim Akram and Shoaib Malik, have acknowledged that. To pull an upset, this would require a Fakhar Zaman in the Champions Trophy final type performance for the ages. Pakistan’s innings 17th over Shardul Thakur is hit for a boundary on the first delivery of the over, with Babar just standing still and pushing the ball down the ground straight. Two singles also follow later in the over. 16th over Five singles off of Jadeja in the 16th over of the innings. Babar and Rizwan happy to simply rotate the strike for now — especially against the tricky spin of Jadeja. 15th over A very good over from Pandya is marred after Rizwan flicks him in front of square for a boundary on the last delivery. 14th over Jadeja is brought into the attack as India look to take advantage of the spinning track. Rizwan earns a massive reprieve as Jadeja traps him in front of the wickets and is given out, only for a review to overturn the decision. Just a run off Jadeja’s first. 13th over Imam departs on the second delivery of Pandya’s third over after the southpaw went to attack a wide delivery, only to edge it back to the keeper. A simple catch for KL Rahul knocks the second wicket down for Pakistan. Wicketkeeper Rizwan now comes to the crease. A boundary and a single ends the thirteenth over for Pakistan with the score at 74 for the loss of two wickets. 12th over Kuldeep is brought in to end Siraj’s spell. A decent over from the spinner is ruined by a tickle down the fine leg as Pakistan collect 8 runs from it. 11th over Babar pulls Pandya twice to collect 11 runs from Pandya’s second over. Two short deliveries easily put away by the skipper to bring Pakistan’s score at 60 at the end of the 11th over. 10th over Imam and Babar are looking to settle things down after the surprise Abdullah wicket. A single from Siraj’s fifth ends the power play for Pakistan with 49 on the board. 9th over Seven runs from Hardik Pandya’s first over as he replaces Bumrah in the attack. A boundary down the fine leg and three singles bring Pakistan’s total to 48 for the loss of one wicket. Captain Babar Azam is now at the crease. 8th over Siraj dismisses Shafique on the last delivery of his fourth over. The ball comes back in sharply, keeps low and traps Abdullah in front of the wickets. He departs for 20. 7th over Abdullah steps out on Bumrah’s second delivery and dispatches him for a boundary towards long on. Imam also flicks him down the leg side for a boundary on the last over with 9 runs coming off it. 6th over While Bumrah has stifled the Pakistan openers from one end, runs keep on coming off of Siraj as a double and three singles result in five runs from the sixth over. 5th over Another good over from Bumrah with the pacer bowling six dots to end a maiden for India. Imam tried to cut him towards point but good fielding from Ravindra Jadeja — arguably the best fielder in the Indian side — prevented a certain boundary. 4th over Abdullah frees up his arms on the first delivery from Siraj and dispatches him for a boundary through the covers. Both the openers look good early on, with the pitch offering little to nothing to the pacers. A pair of singles and a boundary means six runs for Pakistan in the fourth. 3rd over The openers are wary and watchful against Bumrah who has a habit of picking early wickets in the power play. Just a single from the third ball brings Pakistan’s score at 17 for the loss of no wickets. 2nd over Siraj was sent to the covers three times in his first over. Two gorgeous boundaries and tickle down the fine leg got Imam off to a great start. All runs from boundaries for Pakistan so far. Siraj ends his first with Pakistan at 16 for no loss. 1st over A nervy start for opener Abdullah Shafique as Jasprit Bumrah bowled five dot deliveries before he was flicked for a boundary on the last delivery. There does not seem to be early swing available for the bowlers, something the Indian skipper was interested in. Line-ups Pakistan captain Babar Azam said had he won the toss, he would have bowled first before proceeding to name an unchanged lineup. India make one change, with Shubman Gill replacing Ishan Kishan. Pakistan: 1 Abdullah Shafique, 2 Imam-ul-Haq, 3 Babar Azam (capt), 4 Mohammad Rizwan (wk), 5 Saud Shakeel, 6 Iftikhar Ahmed, 7 Shadab Khan, 8 Mohammad Nawaz, 9 Hasan Ali, 10 Shaheen Afridi, 11 Haris Rauf India: 1 Rohit Sharma (capt), 2 Shubman Gill, 3 Virat Kohli, 4 Shreyas Iyer, 5 KL Rahul (wk), 6 Hardik Pandya, 7 Ravindra Jadeja, 8 Shardul Thakur, 9 Kuldeep Yadav, 10 Jasprit Bumrah, 11 Mohammed Siraj Pakistan’s unenviable record against India in ODI World Cup Two-time champions India have a perfect 7-0 record against Pakistan in the 50-overs World Cup and are also the top-ranked ODI team, who have won both their games in the tournament so far. But Pakistan also have two wins from two at the World Cup after seeing off the Netherlands and Sri Lanka, and Babar is approaching the tournament’s most-anticipated clash at the Narendra Modi Stadium, the world’s largest cricket venue, with a complete disregard for the past. “I don’t think

NASHVILLE, Tenn. (WSMV) – A man is dead after a shooting in North Nashville on Thursday night. Metro Nashville Police said 44-year-old Terran Frazier was shot twice and ran up to homes along Phillips Street and 14th Avenue North trying to get help as he was bleeding out. Danielle was home alone when she heard Frazier breathing heavily on her front porch and then he started banging on her door. Her dog started barking and she thought the man was trying to break into her house. Instead of looking out the peephole, she called 911 and hid inside her home. “Scared and worried, and just not really knowing what was going on,” Danielle said. “Being alone, I just really didn’t want to be by the door in case it wasn’t someone who was hurt, and it was someone trying to break into the house. I had two thoughts. If this person is hurt, they need help. If they are not hurt and are trying to break in, I need help.” After about five minutes of knocking, Danielle said it went quiet and police showed up a short time later. When she opened the door, she found a giant pool of blood on her porch and across her door. “It just broke my heart opening the door and seeing the handprints and just not being able to help,” Danielle said. “Feeling guilty for not being able to help in the moment.” Officers found Frazier a short distance away collapsed on the sidewalk in front of another house. He was taken to the hospital where he died. READ MORE: Police identify victim in fatal North Nashville shooting Sean Heggem had just gotten into town on a weekend trip from California with his wife and friends after the shooting happened. Their rideshare driver pulled up to their vacation rental along Phillips Street when they saw what they thought was a homeless man stumbling down the road. Heggem said Frazier came over to their car and started banging on the window asking for help. They quickly noticed he was shot and called 911 too. “Kind of shocking to see that,” Heggem said. “Having another human being affectively bleeding out. You show up and it’s like, It’s a heck of a welcoming to Nashville.’” There was a trail of blood down the sidewalk in front of their vacation rental. Police blocked off the entire area and searched for evidence. Danielle hired a cleaning crew to take care of the blood that covered her front porch as she tried to figure out why Frazier spent so much time at her house. She thinks he came there because it was very close to where the shooting happened. “I don’t know if it’s because we leave the porch light on or because the house is yellow,” Danielle said. Metro Nashville Police said detectives are working active leads searching for who shot Frazier. Copyright 2023 WSMV. All rights reserved.

Abstract Anomalous aortic origin of the coronary artery (AAOCA) is a rare disease associated with sudden cardiac death, usually related to physical effort in young people. Clinical routine tests fail to assess the ischemic risk, calling for novel diagnostic approaches. To this aim, some recent studies propose to assess the coronary blood flow (CBF) in AAOCA by computational simulations but they are limited by the use of data from literature retrieved from normal subjects. To overcome this limitation and obtain a reliable assessment of CBF, we developed a fully patient-specific lumped parameter model based on clinical imaging and in-vivo data retrieved during invasive coronary functional assessment of subjects with AAOCA. In such a way, we can estimate the CBF replicating the two hemodynamic conditions in-vivo analyzed. The model can mimic the effective coronary behavior with high accuracy and could be a valuable tool to quantify CBF in AAOCA. It represents the first step required to move toward a future clinical application with the aim of improving patient care. The study was registered at Clinicaltrial.gov with (ID: NCT05159791, date 2021-12-16). Introduction Anomalous aortic origin of the coronary artery (AAOCA) is a rare congenital disease with several anatomical variants, such as the origin from the opposite sinus of Valsalva1. In some cases, an intramural tract may also be present in the most proximal zone, whereby part of the coronary artery (CA) is enclosed within the aortic wall2. Although AAOCA is often asymptomatic3, it is related to sudden cardiac death (SCD) or ischemic events, usually associated with high-intensity physical activity, especially in young athletes4,5. Risk estimation based on pre-operative tests is critical to AAOCA diagnosis and management because traditional clinical exams, such as stress tests, usually fail to recognize adverse events related to ischemia and SCD6. Moreover, the mechanisms linking the anatomical abnormality with the risk of SCD are still unclear. In this context, computational simulations have contributed to clarifying some mechanical and physiological aspects linked to ischemia since they can simulate extreme stress conditions, which are not traditionally evaluated in diagnostic tests. Previous biomechanical studies using structural finite element analysis7 have shown a limited expansion of the anomalous CA under increasing pressure, particularly within the intramural tract8. Furthermore, 3D computational fluid dynamics (CFD)9,10,11, and 3D fluid-structure interaction (FSI) simulations12,13,14were performed to assess coronary blood flow (CBF) and coronary perfusion in AAOCA. However, it is worth noting that these hemodynamic investigations were based on the analytically computed coronary resistance based on physiological hypotheses for healthy subjects, probably poorly reliable in AAOCA patients. In addition, the results were not validated due to the lack of in-vivo CBF measurements. Finally, the available patient-specific simulations deal with a small cohort of patients, not attaining general conclusions for the AAOCA population. Therefore we aimed to develop a patient-specific lumped-parameter model (LPM) fed by anatomical, hemodynamic, and functional data retrieved from AAOCA patients that could accurately estimate CBF at two different conditions. We validate the model accuracy in replicating in-vivo conditions by comparing the results with in-vivo measurements. Methods This study was approved by the IRCCS Policlinico San Raffaele ethical committee (record number 19/int/2021, approved 09/06/2021). All patients enrolled in the study at IRCCS Policlinico San Donato gave written informed consent. All methods were carried out in accordance with relevant guidelines and regulations. In particular, the present work includes data retrieved from 19 AAOCA patients, recruited for the NECESSARY study (GR-2019-12369116, Italian Ministry of Health) between November 2021 and May 2023 (ClinicalTrials.gov Identifier: NCT05159791). The study population consists of patients with AAOCA, subjects with other congenital cardiac abnormalities or contraindications to performing the required diagnostic tests were excluded. All patients recruited did not present atherosclerotic plaque and calcification or diagnosis of severe stenosis. The study involved the collection of clinical data and coronary anomaly classification. Details regarding the acquisition, post-processing, and use of such data are described in the following sections, and a schematic representation is also shown in Fig. 1. Figure 1 Schematic representation of the lumped-parameter model and input data used to calibrate it. On the top, IVUS registration was illustrated in the yellow rectangle: a slice was selected to extract the geometrical measurements related to the more proximal tract (OSTIUM) of a right CA. In the green rectangle, the points selected along the centerline of the 3D model of the aortic root were shown; they were used to measure aortic geometrical parameters. The 3D model was reconstructed through the segmentation of CT. In the middle, signals recorded during the coronary functional assessment were shown in the blue rectangle. For both rest and hyperemic conditions CBF (Q) and CA resistance (R) were assessed. Aortic pressure wave signal was used to extract patient values to rescale both aortic and left ventricular pressure waves taken from literature14. On the bottom, the purple rectangle enclosed a schematic representation of the lumped-parameter model. Each arterial segment was represented by the circuit highlighted in gray, aortic BCs were defined by the Windkessel circuit colored in orange, and the BC of the CAs were defined in the blue dashed rectangle. Full size image Clinical data acquisition Computed tomography (CT) scans were performed on a dual-source CT system (Somatom Flash; Siemens Medical Solutions, Forchheim, Germany). CT parameters were 0.6 mm slice thickness, 0.3 mm increment, kernel Bv38, and Admire with strength 2. For patients that had performed the CT in other centers (n(=)16), a maximum slice thickness of 0.6 mm was required. Cardiac magnetic resonance imaging (MRI) examinations were performed with a 1.5 T unit (Magnetom AERA, Siemens Medical Solutions, Forchheim, Germany) with 45 mT/m gradient power, using twelve channel surface phased-array coil placed over the thorax and with the patient in supine position. Image acquisition was gated by the electrocardiogram (ECG) signal and respiration control (breath-holding) to produce a CINE sequence throughout all the systole and diastole and to avoid cardiac and respiratory artifacts. An MRI study included a complete set of short-axis (from base to apex) CINE images, using an ECG-triggered steady-state free precession pulse sequence acquired with the following

GEORGETOWN, Ky. (LEX 18) — 10 years ago, when she was just four years old, Katie Eddington was involved in a lawn mowing accident. She underwent more than 20 surgeries following the accident and eventually lost her right leg. Now, she’s 14 and says, “I don’t remember too much about it, but it was like, really hard on my family obviously and that’s kinda how we’re so connected now and my aunt’s here and my nana’s here. So, it’s…it’s…it was a tough experience but we’re here now so.” On this tenth anniversary, Katie and her family wanted to do something different to mark the event that forever changed her life. Katie lost a lot of blood that day, so she wanted to host a blood drive with the Kentucky Blood Center that would help others in the way that she was helped. Katie says, “It’s literally something that I needed, but it’s also like literally one unit of blood is a life. So, we thought this was perfect.” There was a time when doctors didn’t think that Katie would walk again, but now she runs — marathons and track. Her mom, Samantha Eddington, explains that as a nurse, this journey has been difficult, but she’s proud of how far her daughter has come. She says, “You know, you know, but you’re still kind of in denial about it, until you just kind of see that this is what has to happen. So, her amputation was elective and that in and of itself was a challenge. But yeah I mean she’s done well.” Samantha is giving back her own blood. She says after her daughter’s accident, it was hard to accept help from others, but the community has shown up for her and her family all the way. “It just means a lot. It means that we did make a little bit of a difference and that people see that we tried really hard to make something positive out of it. So, it does, I see the people here,” says Samantha. Katie started running five months after her amputation. Along the way, she says people have shared how inspired they are. On this anniversary, she wants anyone struggling with any battle to know that they can make it too. “It was hard for me to get over the battles myself and I thought that I couldn’t relate to anybody. But by going to these competitions and stuff, it really showed me that I could get over it — and that’s all you kind of have to say is, ‘get over it’. Everybody is going through something,” says Katie.

MEMPHIS, Tenn. — Police say a woman was rushed into surgery Thursday after being stabbed multiple times by her boyfriend’s ex-girlfriend. Katie Jernigan was arrested and charged with attempted second-degree murder after her ex-boyfriend and his new girlfriend drove to the police station on Crump Avenue for help. The boyfriend said they drove to their home in the 700 block of Neptune Street after Jernigan called him and told him she was at his house and getting ready to slash his tires. Memphis man’s life taken in couple’s cross-country murder spree The boyfriend said when they arrived at the residence, Jernigan pulled up in her car and said she was going to kill both of them. He said Jernigan and his girlfriend began fighting, and Jerrigan started stabbing his girlfriend with a small knife. The boyfriend said he was also cut with the knife trying to break up the fight. The girlfriend was transported from the Crump Station to the Regional One Medical Center, where she underwent surgery. Hospital staff said the victim had two stab wounds to her upper and lower back and a laceration to her chest and forehead. Friday, the victim was listed in good condition at the hospital. One injured in Cordova shooting, sheriff’s office says Investigators said Jernigan admitted to waiting up the street for the couple to get home and getting into a physical fight with the new girlfriend. However, they said she told them she didn’t know what happened or how the blood got on her. Along with attempted second-degree murder, Jernigan is charged with two counts of aggravated assault. Jernigan is scheduled to be arraigned on Monday. Close Modal Suggest a Correction Suggest a Correction

Babies caked in blood, young bodies peppered with shrapnel… British surgeon Prof Ghassan Abu-Sittah flew to Gaza on Monday and has been operating night and day ever since By Jane Fryer Published: 17:00 EDT, 13 October 2023 | Updated: 17:48 EDT, 13 October 2023