Thalassemia Associated Pulmonary Hypertension

Cardiac disease is the main cause of death in both forms of thalassemia; thalassemia major (TM) and thalassemia intermedia (TI). Pulmonary hypertension (PH) is one of the cardiopulmonary morbidities with high mortality that, if not treated, may trigger right-sided heart failure and premature death. PH is defined as a mean pulmonary artery pressure of ≥25 mmHg at rest or ≥30 mmHg during exercise. The prevalence of PH is known to be higher in TI than in TM. Moreover, the pathophysiology of PH in thalassemia appears to be sophisticated and complex. Risk factors for occurrence of PH consists of non-transfusion dependent thalassemia (NTDT), sub-optimally transfused transfusion dependent thalassemia (TDT), splenectomy, thrombocytosis, anemia, NRBC ≥ 300 × 106, iron accumulation, history of thrombosis and older age. Other parameters which aggravate the risk of PH include hemolysis, oxidative stress, hypoxemia, alteration of erythrocyte membrane, decline of nitric oxide biological availability, arginine abnormal regulation and arginase excess. The screening method for PH is Doppler echocardiography but the gold standard for detection of PH is right heart catheterization (RHC). Current medical therapeutic options in PH comprise hydroxyurea, L- Carnitine, sildenafil, calcium channel antagonists, endothelin 1-receptor blockers and prostacyclin agonists. The only curative surgical method for the refractory and severe cases of PH is pulmonary endarterectomy. In this article, the etiology, pathophysiology, diagnostic methods and novel therapies of thalassemia associated PH are discussed.

High altitude accumulation and preserved climate information in the western Pamir, observations from the Fedchenko Glacier accumulation basin

The accumulation region of Fedchenko Glacier represents an extensive snow reservoir in the Pamir Mountains feeding the longest glacier in Central Asia. Observed elevation changes indicate a continuous ice loss in the ablation region of Fedchenko Glacier since 1928, while the mass balance of the accumulation region is largely unknown. In this study, we show that accumulation varies considerably in the main accumulation basin, with accumulation rates up to 2400 mm w.e. a−1 in the West, decreasing to <1000 mm w.e. a−1 in the center, although the elevation difference is <200 m. The combination of snow/firn samples and ground-penetrating radar profiles suggests that this accumulation pattern is persistent during the recent past. The recent accumulation history is reconstructed from internal radar reflectors using a firn densification model and shows strong interannual variations, but near constant mean values since 2002. Modeling of trajectories, based on accumulation and glacier geometry, results in an estimate of the depth/age relation close to the main divide. This region provides one of the most suitable locations for retrieving climate information with temporal high resolution for the last millennium, with a potential to cover most of the Holocene in less detail.

A 2700-year annual timescale and accumulation history for an ice core from Roosevelt Island, West Antarctica

We present a 2700-year annually resolved chronology and snow accumulation history for the Roosevelt Island Climate Evolution (RICE) ice core, Ross Ice Shelf, West Antarctica. The core adds information on past accumulation changes in an otherwise poorly constrained sector of Antarctica. The timescale was constructed by identifying annual cycles in high-resolution impurity records, and it constitutes the top part of the Roosevelt Island Ice Core Chronology 2017 (RICE17). Validation by volcanic and methane matching to the WD2014 chronology from the WAIS Divide ice core shows that the two timescales are in excellent agreement. In a companion paper, gas matching to WAIS Divide is used to extend the timescale for the deeper part of the core in which annual layers cannot be identified. Based on the annually resolved timescale, we produced a record of past snow accumulation at Roosevelt Island. The accumulation history shows that Roosevelt Island experienced slightly increasing accumulation rates between 700 BCE and 1300 CE, with an average accumulation of 0.25±0.02 m water equivalent (w.e.) per year. Since 1300 CE, trends in the accumulation rate have been consistently negative, with an acceleration in the rate of decline after the mid-17th century. The current accumulation rate at Roosevelt Island is 0.210±0.002 m w.e. yr−1 (average since 1965 CE, ±2σ), and it is rapidly declining with a trend corresponding to 0.8 mm yr−2. The decline observed since the mid-1960s is 8 times faster than the long-term decreasing trend taking place over the previous centuries, with decadal mean accumulation rates consistently being below average. Previous research has shown a strong link between Roosevelt Island accumulation rates and the location and intensity of the Amundsen Sea Low, which has a significant impact on regional sea-ice extent. The decrease in accumulation rates at Roosevelt Island may therefore be explained in terms of a recent strengthening of the ASL and the expansion of sea ice in the eastern Ross Sea. The start of the rapid decrease in RICE accumulation rates observed in 1965 CE may thus mark the onset of significant increases in regional sea-ice extent.

Tourism Initiated Changes on the Sustainability of Historical Texture: Yeni Cuma Mosque Trabzon

Since the first periods of humanity, the reflections of emerging cultures have created the living texture and architecture. The continuing accumulations from older periods transfer a history by layering at certain environments. While these environments which appear as the evidence of development and advancement present the artifacts of previous generations; they create a common language by creating a link between past, today and present. The necessity for protection and transfer of architecture which is the physical reflection of this accumulation, history and culture continuing through ages to the future generations is a clear fact. Preventing the disappearance of historical buildings which show the difference of a geography, country or city from others and create its identity is an important issue for sustainable architecture. When sustainability unites with history and tourism, it can achieve the protection, development and transfer of natural and cultural resources from one generation to the other. For this reason, in the scope of this study, Camii Cedid/St Eugenios Church (Yeni Cuma Mosque) transformed into a mosque after the conquest of the city of Trabzon, which has an important historical texture within its geography, will be examined in terms of the sustainable development it created in the region and the changes it went through