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Mitral valve prolapse (MVP) is the most frequent valvulopathy with a prevalence of 1.2%-2.4% in general population and it is characterized by a benign course. Although it can be associated with some complications, ventricular arrhythmias (VA) and sudden cardiac death (SCD) as ultimate expressions, are the most worrying. The estimated risk of SCD in MVP is between 0.2% and 1.9% per year including both MVP patients with left ventricular (LV) dysfunction due to severe MR and MVP patients without significant MR. The latter ones constitute a particular phenotype called "malignant MVP" characterized by bileaflet myxomatous prolapse, ECG repolarization abnormalities and complex VAs (c-VAs) with polymorphic/right bundle branch block morphology (RBBB) and LV fibrosis of the papillary muscles (PMs) and inferobasal wall secondary to mechanical stretching visualized as late gadolinium enhancement (LGE) areas by cardiac magnetic resonance (CMR). In MVP, the first diagnostic approach is transthoracic echocardiography (TTE) that defines the presence of mitral annular disjunction (MAD) which seems to be associated with "arrhythmic MVP" (AMVP). From an ECG point of view, AMVP is characterized by frequent premature ventricular contractions (PVCs) arising from one or both PMs, fascicular tissue, and outflow tract, as well as by T-wave inversion in the inferolateral leads. The aim of the present paper is to describe TTE red flags that could identify MVP patients at high risk to develop complex arrhythmias as supported by the corresponding findings of LGE-CMR and anatomy studies. TTE could be a co-partner in phenotyping high-risk arrhythmic MVP patients.

Early detection and treatment of cancer have led to a noticeable reduction in both mortality and morbidity. However, chemotherapy and radiotherapy could exert cardiovascular (CV) side effects, impacting survival and quality of life, independent of the oncologic prognosis. In this regard, a high clinical index of suspicion is required by the multidisciplinary care team in order to trigger specific laboratory tests (namely natriuretic peptides and high-sensitivity cardiac troponin) and appropriate imaging techniques (transthoracic echocardiography along with cardiac magnetic resonance, cardiac computed tomography, and nuclear testing (if clinically indicated)), leading to timely diagnosis. In the near future, we do expect a more tailored approach to patient care within the respective community along with the widespread implementation of digital health tools.

Disaster is a state of serious disruptions in the functionality of any society or county Disasters pose serious economic or environmental impacts that surpass the capacity of the affected country or society to compete with the use of their assets Recently, Pakistan significantly prone to health disasters due to COVID-19 among developing South Asian countries The long-term impact of health disasters and other natural hazards put additional pressure mostly on the government's economic policy It forces the government to follow a constructive approach like a disaster relief-based approach rather than a conventional mitigation management formation to reduce the impact of disaster risk This study elaborates on the main issues associated with disaster preparedness as well as recovery of the economy and businesses of the country For Scientific risk performance analysis, open-source data from the National Institute of Disaster Management (NDMA) has been utilized to study the current situation of COVID-19 in Pakistan Results show Pakistan has been facing a highly vulnerable situation as more than three hundred and fifty thousand confirmed cases have been reported Poor health and technical management facilities have been exposed against COVID-19 as Pakistan has a low heath budget because of its declining GDP growth rate in the world This research will help in disaster preparedness and the development of a disaster risk management framework while designing strategies to deal with such pandemics in the future © 2021 The Author(s)

Eco-friendly waste utilization helps in the development of sustainable infrastructures. Recently, researchers have focused on the production of road infrastructures using the circular economy concept of human safety. The objective of this study is to investigate and explore the utilization of optimum polymer waste content for the development of polymer-modified asphalt mixtures using response surface methodology (RSM). RSM based on Box–Behnken design (BBD) was employed to optimize experimental design and included three factors: X1, polymer type; X2, polymer contents; and X3, testing day. The optimized responses determined by the RSM were as follows: MS of 42.98 kN, MF of 5.08 mm, and MQ of 8.66 kN/mm, indicating a favorable and consistent precision in comparison with experimental values. Moreover, the Marshall characteristics of samples prepared with PE were quite improved compared to PET. In conclusion, the incorporation of such polymer wastes in road construction is a sustainable and cost-effective way of improving their engineering properties. This study will help in the development of sustainable road infrastructures supporting human safety and environmentally friendly practices.

Mitral valve prolapse (MVP) is the most common valvular disease with a prevalence of 2%. It has generally a benign course; however, recent findings suggested an association between MVP and complex arrhythmias and eventually cardiac arrest and for this reason, it is also called arrhythmogenic MVP. Subjects who experience this complication are in general young women, with thickened mitral leaflets or bileaflet prolapse not necessarily associated with severe mitral regurgitation (MR). The nature of the relation between MVP and cardiac arrest is not clearly understood. Actually, the challenging task is to find the cluster of prognostic factors including T-wave inversion, polymorphic premature ventricular contractions, bileaflet prolapse, MR severity, but most importantly, those parameters of hypercontractility, mitral annulus disjunction (MAD), and myocardial fibrosis using a multimodality approach. Transthoracic echocardiography is the first-line imaging modality for the diagnosis of MVP, but also for detecting MAD and hypercontractility, followed by cardiac magnetic resonance for tissue characterization and detection of myocardial and papillary muscle fibrosis, using either late gadolinium enhancement (at the basal segment of the inferolateral wall and papillary muscles) (macro-fibrosis), or diffuse fibrosis by T1 mapping (native and post contrast T1). Moreover, there are also preliminary data on positron emission tomography utilizing 18F-fluorodeoxyglucose as a tool for providing evidence of early myocardial inflammation. The objective of this review article is to provide the clinician with an overview and a practical clinical approach to MVP for risk stratification and treatment guidance.

Self-Compacting Concrete (SCC) is a unique kind of concrete that tends to consolidate in terms of its weight. In this study, the prime target is to investigate the durability properties of SCC developed using eco-friendly economical waste binding materials as partial replacement to costly cement. This circular economy concept will not only help in the development of green concrete but will also help to improve the climatic condition by reducing the use and production of cement. An economical design methodology has been applied to produce environmentally friendly construction material. This research focuses on the application of Alum Sludge (AS) and Brick Dust (BD) in Self-Compacting Concrete (SCC). Both materials are waste materials containing binding properties. Performance of SCC developed using these two materials was tested considering mechanical properties of concrete using the destructive testing technique. Results showed that BD and AS can be utilized for up to 12% and 9% of replacement of cement, respectively, to achieve equal or higher compressive, tensile, and flexural strength. The application of BD and AS has demonstrated a subsequent improvement of SCC’s mechanical properties, i.e., compressive, tensile, and flexural strength. This study will help the production of composite green materials with the help of eco-friendly and economical waste materials for sustainable infrastructure development.

Polymer composites have been identified as the most innovative and selective materials known in the 21st century. Presently, polymer concrete composites (PCC) made from industrial or agricultural waste are becoming more popular as the demand for high-strength concrete for various applications is increasing. Polymer concrete composites not only provide high strength properties but also provide specific characteristics, such as high durability, decreased drying shrinkage, reduced permeability, and chemical or heat resistance. This paper provides a detailed review of the utilization of polymer composites in the construction industry based on the circular economy model. This paper provides an updated and detailed report on the effects of polymer composites in concrete as supplementary cementitious materials and a comprehensive analysis of the existing literature on their utilization and the production of polymer composites. A detailed review of a variety of polymers, their qualities, performance, and classification, and various polymer composite production methods is given to select the best polymer composite materials for specific applications. PCCs have become a promising alternative for the reuse of waste materials due to their exceptional performance. Based on the findings of the studies evaluated, it can be concluded that more research is needed to provide a foundation for a regulatory structure for the acceptance of polymer composites.

Numerous environmental issues arise as a result of a linear economy strategy: reserves become scarce and end up in landfills and as greenhouse gases. Utilizing waste as a resource or shifting towards a circular economy are among the effective strategies for addressing these issues. To track this shift, appropriate measures that concentrate on sustainable development while taking practical contexts into consideration are required. In this paper, we utilize plastic wastes as a replacement for bitumen for reuse aiming at a circular economy. The use of plastic waste materials, i.e., plastic bottles (PET) and gas pipes (PE) in asphalt materials as a bitumen modifier was studied through series of experimental lab test methods. Marshall samples were prepared using a conventional Marshall method containing five different percentages (0%, 5%, 10%, 15%, and 20%) of plastic content by total weight of bitumen. Samples were tested after 1 and 30 days and the result shows that the stability of plastic-modified asphalt concrete was increased after 30 days, while still meeting standard criteria with plastic contents up to 20%. Moreover, the addition of waste plastic in road construction is a very effective strategy for reusing plastic waste, which also provides economic and social benefits for a sustainable approach to road pavements.

The behaviour of asphalt concrete mixtures is difficult to understand due to its complex nature under different loading conditions and environmental factors. For prediction, there is a need to find mathematical relations between multiple inputs and outputs using a simple and precise way. Recently, artificial neural networks (ANNs) has been widely used to study the mechanical parameters of asphalt concrete materials and its applications in civil engineering fields. This study presents the application of ANNs method for prediction of Marshall stability of asphalt concrete developed with two different types of aggregates based on mineralogy under four different testing temperatures ranging between 25 °C and 60 °C. The ANNs model established with six input variables including temperature, aggregate type, ultrasonic pulse velocity–time and space volume, unit volume of dry air, and saturated surface dry weight. The proposed model developed using six neurons in hidden layer for the prediction of experimental data. The feasibility of the proposed model checked in terms of root mean square error (RMSE) and coefficient of determination (R2). The R2 values found within range during both training (0.909–0.999) and validation phase (0.886–0.997) depending on estimated parameters. Moreover, the influence of different aggregate type has been investigated under varying temperatures conditions using the proposed ANNs method. The proposed model has shown the potential to understand the mechanical behaviour of sustainable asphalt concretes accurately under various temperature conditions.