bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on low-carbon supply chain decision-making under different incentive models
Authors: Peng XinXin , Tao YuHong , Wang ChunMei , Zhong Zhen
Published: May 2022

Considering the low-carbon supply chain led by one manufacturer and followed by one retailer, market demand is influenced by the investment of low-carbon product promotion and the degree of emission reduction. Stackelberg game theory is used to construct the game models with no-incentive model and three incentive models, respectively. The equilibrium solutions of the degree of low-carbon products promotion, the degree of low-carbon products emission reduction, the market demand, the cost-sharing ratio of the manufacturer to the retailer’s low-carbon products promotion, the degree of government’s incentive to the manufacturer’s low-carbon products, as well as the manufacturer’s and retailer’s profit are obtained in the four models. Finally, with the results, we provide some policy suggestions for the management and practice of a low-carbon supply chain.
Elite-Public Gaps in Attitudes to Nuclear Weapons: New Evidence from a Survey of German Citizens and Parliamentarians
Authors: Smetana Michal , Onderco Michal
Published: May 2022

A recent surge in survey-based scholarship has shed new light on public attitudes toward nuclear weapons. Yet, we still know little about how these public attitudes differ from those of political elites. To address this gap, we conducted an original survey on a large representative sample of German citizens and on a unique elite sample of German parliamentarians. In the survey, we asked the respondents about their views on different aspects of NATO's nuclear sharing practice. We found support for several hypotheses concerning nuclear use, extended deterrence, withdrawal of forward-deployed weapons, and the feasibility of global nuclear disarmament. As such, we provide systematic empirical evidence that there are, indeed, important gaps in public and elite attitudes toward nuclear weapons. Our findings underscore the argument that scholars should survey both political elites and the general public to obtain a comprehensive picture of attitudes toward pertinent questions in our field.
Behavioral Influence
Authors: Chambers Christopher P , Cuhadaroglu Tugce , Masatlioglu Yusufcan
Published: May 2022

In the context of stochastic choice, we introduce an individual decision model that admits a cardinal notion of peer influence. The model presumes that individual choice is not only determined by idiosyncratic evaluations of alternatives but also by the influence of the observed behavior of others. We establish that the equilibrium defined by the model is unique, stable, and falsifiable. Moreover, the underlying preferences and influence parameters as well as the structure of the underlying network are uniquely identified from, arguably, limited data. The baseline model includes two individuals with conformity motives. Generalizations to multi-individual settings and negative interactions are also introduced and analyzed.
Magnetically driven accretion disc winds: the role of gas thermodynamics and comparison to ultra-fast outflows
Authors: Wang Weixiao , Bu De-Fu , Yuan Feng
Published: May 2022

Winds are commonly observed in luminous active galactic nuclei. A plausible model of those winds is magnetohydrodynamic (MHD) disc winds. In the case of disc winds from a thin accretion disc, isothermal or adiabatic assumption is usually adopted in such MHD models. In this work, we perform two-dimensional MHD simulations implementing different thermal treatments (isothermal, adiabatic, and radiative) to study their effects on winds from a thin accretion disc. We find that both the isothermal model and the adiabatic model overestimate the temperature, underestimate the power of disc winds, and cannot predict the local structure of the winds, compared to the results obtained by solving the energy equation with radiative cooling and heating. Based on the model with radiative cooling and heating, the ionization parameter, the column density, and the velocity of the disc winds have been compared to the observed ultra-fast outflows (UFOs). We find that in our simulations the UFOs can only be produced inside hundreds of Schwarzschild radius. At much larger radii, no UFOs are found. Thus, the pure MHD winds cannot interpret all the observed UFOs.
Thermal radiative cooling of carbon cluster cations CN+, N = 9, 11, 12, 17–27
Authors: Iida Shimpei , Hu Wei , Zhang Rui , Ferrari Piero , Masuhara Kei , Tanuma Hajime , Shiromaru Haruo , Azuma Toshiyuki , Hansen Klavs
Published: May 2022

The radiative cooling rates of C$_N^+$ clusters (N = 9, 11, 12, 17–27) have been measured in the ultrahigh vacuum of an electrostatic storage ring to values on the order of 104 s−1. The rates were measured as a competing channel to unimolecular decay, and the rate constants pertain to the excitation energies where these two channels compete. Such high values can only be explained as photon emission from thermally excited electronic states, a mechanism that has also been seen in polycyclic aromatic hydrocarbon cations. The high rates have a very strong stabilizing effect on the clusters and the underlying mechanism gives a high energy conversion efficiency, with the potential to reach high quantum efficiencies in the emission process. The competing decay of unimolecular fragmentation defines upper limits for photon energies that can be down-converted to lower energy photons. Including previously measured cluster sizes provides the limits for all clusters C$_N^+$, N = 8–27, of values that vary from 10 to 14.5 eV, with a general increase with size. Clusters absorbing photons of energies below these limits cool down efficiently by emission of photons via electronic transitions and their fragmentation is strongly reduced, increasing their survival in HI regions.
Variable thermal energy injection from magnetar spin-down as a possible cause of stripped-envelope supernova light-curve bumps
Authors: Moriya Takashi J , Murase Kohta , Kashiyama Kazumi , Blinnikov Sergei I
Published: May 2022

Luminosity evolution of some stripped-envelope supernovae such as Type I superluminous supernovae is difficult to explain by the canonical 56Ni nuclear decay heating. A popular alternative heating source is rapid spin-down of strongly magnetized rapidly rotating neutron stars (magnetars). Recent observations have indicated that Type I superluminous supernovae often have bumpy light curves with multiple luminosity peaks. The cause of bumpy light curves is unknown. In this study, we investigate the possibility that the light-curve bumps are caused by variations of the thermal energy injection from magnetar spin-down. We find that a temporal increase in the thermal energy injection can lead to multiple luminosity peaks. The multiple luminosity peaks caused by the variable thermal energy injection is found to be accompanied by significant increase in photospheric temperature, and photospheric radii are not significantly changed. We show that the bumpy light curves of SN 2015bn and SN 2019stc can be reproduced by temporarily increasing magnetar spin-down energy input by a factor of 2–3 for 5–20 d. However, not all the light-curve bumps are accompanied by the clear photospheric temperature increase as predicted by our synthetic models. In particular, the secondary light-curve bump of SN 2019stc is accompanied by a temporal increase in photospheric radii rather than temperature, which is not seen in our synthetic models. We therefore conclude that not all the light-curve bumps observed in luminous supernovae are caused by the variable thermal energy injection from magnetar spin-down and some bumps are likely caused by a different mechanism.
Inert Pepper aptamer-mediated endogenous mRNA recognition and imaging in living cells
Authors: Wang Qi , Xiao Feng , Su Haomiao , Liu Hui , Xu Jinglei , Tang Heng , Qin Shanshan , Fang Zhentian , Lu Ziang , Wu Jian , Weng Xiaocheng , Zhou Xiang
Published: May 2022

The development of RNA aptamers/fluorophores system is highly desirable for understanding the dynamic molecular biology of RNAs in vivo. Peppers-based imaging systems have been reported and applied for mRNA imaging in living cells. However, the need to insert corresponding RNA aptamer sequences into target RNAs and relatively low fluorescence signal limit its application in endogenous mRNA imaging. Herein, we remolded the original Pepper aptamer and developed a tandem array of inert Pepper (iPepper) fluorescence turn-on system. iPepper allows for efficient and selective imaging of diverse endogenous mRNA species in live cells with minimal agitation of the target mRNAs. We believe iPepper would significantly expand the applications of the aptamer/fluorophore system in endogenous mRNA imaging, and it has the potential to become a powerful tool for real-time studies in living cells and biological processing.
CalFitter 2.0: Leveraging the power of singular value decomposition to analyse protein thermostability
Authors: Kunka Antonin , Lacko David , Stourac Jan , Damborsky Jiri , Prokop Zbynek , Mazurenko Stanislav
Published: May 2022

The importance of the quantitative description of protein unfolding and aggregation for the rational design of stability or understanding the molecular basis of protein misfolding diseases is well established. Protein thermostability is typically assessed by calorimetric or spectroscopic techniques that monitor different complementary signals during unfolding. The CalFitter webserver has already proved integral to deriving invaluable energy parameters by global data analysis. Here, we introduce CalFitter 2.0, which newly incorporates singular value decomposition (SVD) of multi-wavelength spectral datasets into the global fitting pipeline. Processed time- or temperature-evolved SVD components can now be fitted together with other experimental data types. Moreover, deconvoluted basis spectra provide spectral fingerprints of relevant macrostates populated during unfolding, which greatly enriches the information gains of the CalFitter output. The SVD analysis is fully automated in a highly interactive module, providing access to the results to users without any prior knowledge of the underlying mathematics. Additionally, a novel data uploading wizard has been implemented to facilitate rapid and easy uploading of multiple datasets. Together, the newly introduced changes significantly improve the user experience, making this software a unique, robust, and interactive platform for the analysis of protein thermal denaturation data. The webserver is freely accessible at https://loschmidt.chemi.muni.cz/calfitter.
La prévention de la carence en vitamine D symptomatique et du rachitisme chez les nourrissons et les enfants autochtones du Canada
Authors: Irvine James , Ward Leanne M
Published: May 2022

Le rachitisme par carence en vitamine D et les autres manifestations d’une carence grave, comme la myocardiopathie et les convulsions hypocalcémiques, sont encore diagnostiqués au Canada. Les nourrissons autochtones allaités, notamment ceux qui habitent dans des communautés du Nord, sont démesurément touchés, même si ceux qui reçoivent des préparations commerciales n’en sont pas exemptés lorsque le taux sérique de vitamine D de la mère est extrêmement bas. Le présent document de principes, qui se veut une révision d’un document déjà publié par la Société canadienne de pédiatrie, porte sur la prévention du rachitisme et de l’hypocalcémie causés par la carence en vitamine D chez les enfants autochtones. Il est recommandé d’évaluer le risque d’une telle carence chez chaque dyade mère-nourrisson, en raison du lien entre sa présence chez la mère et chez le nourrisson. En plus de proposer des mesures de soutien pour favoriser une meilleure adhésion à la prise de vitamines supplémentaires, il est préconisé de prescrire un ajout de suppléments aux femmes pendant la période prénatale et aux nouveau-nés en cas d’exposition à un risque marqué, sans compter que des doses plus élevées intermittentes de suppléments peuvent être nécessaires dans certains cas. L’insécurité alimentaire peut également contribuer au rachitisme, et c’est pourquoi des revendications s’imposent pour éviter la carence en vitamine D chez les enfants autochtones.
Comparison of drug retention of TNF inhibitors, other biologics and JAK inhibitors in RA patients who discontinued JAK inhibitor therapy
Authors: Amstad Andrea , Papagiannoulis Eleftherios , Scherer Almut , Rubbert-Roth Andrea , Finckh Axel , Mueller Ruediger , Dudler Jean , Möller Burkhard , Villiger Peter M , Schulz Martin M P , Kyburz Diego
Published: May 2022

Objectives

JAK Inhibitors (JAKi) are recommended DMARDs for patients with moderate-to-severe RA who failed first-line therapy with methotrexate. There is a lack of data allowing an evidence-based choice of subsequent DMARD therapy for patients who had discontinued JAKi treatment. We aimed to compare the effectiveness of TNF inhibitor (TNFi) therapy vs JAKi vs other mode of action (OMA) biologic DMARD (bDMARD) in RA patients who were previously treated with a JAKi.

Methods

RA patients who discontinued JAKi treatment within the Swiss RA registry SCQM were included for this observational prospective cohort study. The primary outcome was drug retention for either TNFi, OMA bDMARD or JAKi. The hazard ratio for treatment discontinuation was calculated adjusting for potential confounders. A descriptive analysis of the reasons for discontinuation was performed.

Results

Four hundred treatment courses of JAKi were included, with a subsequent switch to either JAKi, TNFi or OMA bDMARD. The crude overall drug retention was higher in patients switching to another JAKi as compared with TNFi and comparable to OMA. A significant difference of JAKi vs TNFi persisted after adjusting for potential confounders.

Conclusion

In a real-world population of RA patients who discontinued treatment with a JAKi, switching to another JAKi resulted in a higher drug retention than switching to a TNFi. A switch to a second JAKi seems an effective therapeutic option.
A Quarter Century of Mortgage Risk
Authors: Davis Morris A , Larson William D , Oliner Stephen D , Smith Benjamin R
Published: May 2022

This article provides a comprehensive history of default risk for newly originated home mortgages in the USA over the past quarter century. The loan-level source data include the entire guarantee book for Fannie Mae and Freddie Mac. We track many loan characteristics and produce a summary measure of risk. Among our many results, we show that mortgage risk had already risen in the 1990s, planting seeds of the financial crisis well before the actual event. Our results also cast doubt on explanations of the crisis that focus on borrowers with low credit scores. The aggregate series are available for download at https://www.fhfa.gov/papers/wp1902.aspx.
Interaction of replacing corn silage with soyhulls as a roughage source with or without 3% added wheat straw in the diet: impacts on intake, digestibility, and ruminal fermentation in steers fed high-concentrate diets
Authors: Neville Bryan W , Pickinpaugh Wayde J , Mittleider Lea J , Moore Rebecca L , Swanson Kendall C , Caton Joel S
Published: May 2022

Six ruminally cannulated steers [475.0 ± 49.6 kg initial body weight (BW)] were used in a 6 × 3 incomplete Latin square design (six treatments and three periods), to evaluate the impacts replacing of corn silage with pelleted soyhulls as roughage in high-concentrate finishing diets containing 30% modified distillers grains with solubles. Treatments were based on increasing dietary inclusion of soyhulls and consisted of: (1) Control (0), roughage supplied by dietary inclusion of 20% corn silage [dry matter (DM) basis]; (2) 50% replacement of corn silage with soyhulls (50); (3) 100% replacement of corn silage with soyhulls (100), and the same three treatments repeated with 3% added wheat straw (DM basis) replacing corn in the diet (0S, 50S, and 100S, respectively). Absolute dry matter intake (DMI; kg/d basis) tended to decrease both linearly and quadratically (P ≤ 0.09) and proportional DMI (% of BW) decreased linearly (P = 0.04) with increasing soyhull inclusion but was not affected by the addition of straw in the diet (P = 0.68). Total tract digestibility of organic matter and crude protein were not affected by soyhull inclusion or added straw (P ≥ 0.32). Ruminal pH did not differ (P = 0.65) with increasing soyhull inclusion but increased with the addition of straw (P < 0.01; 5.9 vs. 6.1 for no straw and straw, respectively). Molar proportions of acetate and butyrate decreased while propionate increased with increased soyhull inclusion (P ≤ 0.03; linearly and quadratically, respectively). Ruminal fluid kinetics were unaffected by either rate of replacement of corn silage with soyhulls or wheat straw inclusion (P ≥ 0.13). Decreases in DMI observed in this study would likely decrease finishing cattle performance and underscores the need for additional research before recommending this practice to cattle feeders.
4 ANTIHYPERTENSIVE EFFECT OF NIGELLA SATIVA (HABBATUS SAUDA) SUPPLEMENTATION IN POPULATION WITH CARDIOMETABOLIC RISK FACTORS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Ulfiarakhma Dela , Mulawarman Rido , Trifitriana Monica , Mulawarman  , Tondas Alexander Edo
Published: May 2022

Background:
Nigella sativa or Habbatus Sauda is known to have beneficial effect to reduce blood pressure and other cardiovascular markers. But antihypertensive effect of N. sativa in hypertensive population remains controversial.

Objective: We aim to assess the latest evidence of antihypertensive effect of N. sativa in patients with cardiometabolic risk factors.

Method: A systematic review and meta-analysis was conducted according to the PRISMA statement. We systematically searched relevant studies in Pubmed, Cochrane, and Scopus from the date of inception until January 2022. Outcomes of interest were reduction of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate.

Results: A total of 974 patients from 13 randomized controlled trials were included. Mean duration of treatment was 7.15 weeks. Pooled analysis showed that N. sativa supplementation significantly reduce both SBP (MD -3.93 [-5.72, -2.14], p<0.0001; I2: 39%, p=0.07) and DBP (MD -3.26 [-4.76, -1.75], p<0.0001; I2: 54%, p=0.01) compared to placebo group. Subgroup analysis showed that BP was reduced significantly in both hypertensive and non-hypertensive group, although non-hypertensive group had greater SBP and DBP reduction. NS powder showed greater SBP reduction compared to NS oil (MD -5.22 vs -2.77). Heart rate was also significantly reduced in NS group (MD -2.25 [-2.25, -0.54], p<0.001; I2: 0%, p=0.86).

Conclusion: This meta-analysis suggests short-term treatment with N. sativa is associated with significant reduction of SBP, DBP, and heart rate in hypertensive and non-hypertensive patients with cardiometabolic risk factors. Future trials are needed to strengthen the evidence of long-term antihypertensive effect of N. sativa.
10 A NOVEL PEPTIDE ELABELA IS ASSOCIATED WITH HYPERTENSION-RELATED SUBCLINICAL ATHEROSCLEROSIS
Authors: Hendrianus  , Adiarto Suko , Prakoso Radityo , Firdaus Isman , Indriani Suci , Rudiktyo Estu , Widyantoro Bambang , Taofan Taofan , Ambari Ade Meidian , Sukmawan Renan
Published: May 2022

Background: Elabela is a newly identified peptide which, alongside apelin, acts as an endogenous ligand that activates the angiotensin receptor-like 1 receptor (APJ). Previous clinical studies have shown the association of elabela with hypertension, but information about the role of elabela in hypertension-related atherosclerosis is scarce.

Objectives: To determine the association between plasma elabela peptide levels and subclinical atherosclerosis in the hypertensive population.

Methods: A total of 104 subjects with hypertension were included in a cross-sectional study. Plasma elabela levels were measured using enzyme-linked immunosorbent assay (ELISA) by extracting the peptide following the manufacturer's instructions. The subclinical atherosclerosis parameter was assessed by measuring the carotid intima-media thickness (IMT) using ultrasound.

Results: Compared to stage 1, elabela levels decreased in stage 2 of the hypertension group (0.14 [0.09, 0.23] ng/ml vs. 0.23 [0.13, 0.45] ng/ml; P = 0.000), and in the group with increased carotid IMT compared to normal IMT (0.15 [0.10, 0.23] ng/ml vs. 0.24 [0.13, 0.38] ng/ml; P = 0.005). Additionally, a linear correlation analysis showed that elabela had a significant negative correlation with systolic blood pressure (r = -0.340, P = 0.000) and carotid IMT (r = -0.213; P = 0.030). In multivariate analysis, decreased elabela levels (cut-off 0.155 ng/ml) were associated with the higher cardiovascular risk group in this study (OR 5.0, 95% CI 1.8-13.5, P < 0.001).

Conclusion: This study is the first to demonstrate the association of circulating elabela with carotid IMT in hypertensive patients, implicating that elabela is involved in the pathogenesis of hypertension-related subclinical atherosclerosis. Reduced elabela levels were also associated with increased cardiovascular risk.
17 EFFECTS OF WHOLE-BODY VIBRATION TRAINING ON BLOOD PRESSURE IN POSTMENOPAUSAL WOMEN WITH HYPERTENSION: A SYSTEMATIC REVIEW
Authors: Suhaima Isma Zahira , Ardiantara Sabda , Rudiatmoko Diar Riyanti
Published: May 2022

Background: Menopause is considered an important determinant of hypertension in women, with 41% of postmenopausal women are hypertensive. Increased blood pressure (BP) in postmenopausal women can be caused by arterial stiffness, renin-angiotensin system activation, endothelial dysfunction, lack of estrogens, sympathetic activation, anxiety, and depression. Hence, they should be given special treatment, such as exercise therapy, to improve the quality of their hypertensive therapy. Whole-body vibration training (WBVT) is a resistance training known for its ability to improve arterial stiffness. However, its ability to decrease BP is still controversial.

Objective: This study aims to identify the effects of WBVT on blood pressure in postmenopausal women with hypertension.

Method: A systematic literature search was performed using particular keywords with medical subheading (MeSH) terms on three journal databases, including Pubmed, Proquest, and Cochrane. The search results were screened and assessed using inclusion and exclusion criteria, double article, and full text availability by three independent authors. The quality of the randomized control trial (RCT) was evaluated using the Jadad scale.

Result: Four Randomized controlled trials (RCTs) consisting of 114 total patients were eligible to fulfil the criteria. All studies showed that WBVT significantly decreased systolic (10-12 mmHg) and diastolic (5-6 mmHg) BP compared with the control group. One study also showed a reduction of mean arterial pressure (9 mmHg).

Conclusion: WBVT might be beneficial as an adjuvant therapy to reduce blood pressure in postmenopausal women with hypertension, but further research that includes more subjects is needed to confirm this result.
18 COMPARISON SIDE EFFECTS OF ALISKIREN VS RAMIPRIL IN PATIENTS WITH HYPERTENSION: A META-ANALYSIS
Authors: Pratama I Ketut Suarthaputra , Nurjanah Alya Tanti , Humaera Nada Nafisha , Pintaningrum Yusra
Published: May 2022

Background: Hypertension is a health problem that is a challenge worldwide. Several treatments are currently being developed to treat hypertension, namely by giving Renin Inhibitor (RI) and Angiotensin-Converting Enzyme Inhibitor (ACE-I) drugs. The examples of each drug class are Aliskiren (RI) and Ramipril (ACE-I). The controversy over which drug Aliskiren from the RI group and Ramipril from the ACE-I group is still ongoing and needs to be resolved.

Aims: This meta-analysis was conducted to compare the side effects experienced by patients treated with Aliskiren and Ramipril to reduce blood pressure.

Methods: The search for published scientific articles was carried out systematically using the Preferred Reporting, Items for Systematic Review, and Meta-Analysis (PRISMA) method. The search was conducted using the Pubmed and Cochrane library databases published from 2005 to December 2021 regarding the comparison of side effects of giving Aliskiren with Ramipril in hypertensive patients

Results: We found systematically all randomized trials whose effects were compared presenting Aliskiren with Ramipril in hypertensive patients. Five studies were included with a total of 3,381 patients randomized. Aliskiren therapy had more dominant side effects than Ramipril therapy. The side effects of Aliskiren were dizziness (OR 0.97, 95% CI 0.70-1.34; P=0.57; I2=0%), headache (OR 1.02, 95% CI 0.79-1.33; P= 0, 28; I2=21%) and cough (OR 0.30, 95% CI 0.21-0.42; P=0.37; I2=7%). Meanwhile, the side effects of ramipril were diarrhea (OR 1.08, 95% CI 0.53-2.20; P=0.10; I2=51%) and nasopharyngitis (OR 1.13, 95% CI 0, 78-1.63; P=0.80; I2=0%)

Conclusions: Aliskiren and Ramipril therapy both gave therapeutic effects in the form of dizziness, headache, cough, diarrhea, and nasopharyngitis. Some of the more dominant side effects found in patients receiving Aliskiren therapy were dizziness, headache, and cough. Meanwhile, diarrhea and nasopharyngitis were more frequently found in patients receiving Ramipril therapy.
22 SERUM URIC ACID LEVEL AS A POTENTIAL BIOCHEMICAL MARKER IN DETERMINING THE SEVERITY AND DURATION OF HYPERTENSION: A PROSPECTIVE OBSERVATIONAL ANALYTIC STUDY
Authors: Pratama Y. , Ramadhan M.R. , Sohan V.G. , Rahadiyan T.
Published: May 2022

Background: Recent studies demonstrated that uric acid levels are associated with hypertension, these suggest that unexplained hyperuricemia could be a risk marker in patients with hypertension.

Objective: Aims of this study was to determine the role of uric acid as potential biomarker in relation to essential hypertension.

Method: This study was an observational analytic study design. 150 subjects were studied, divided into 2 groups, the first group was 100 essential hypertension patients without comorbid factors, and control group included 50 healthy subjects. Subject's age group 30-60 years. All the subject's blood pressure was measured using mercury sphygmomanometer on 3 different occasions, then serum uric acid was measured by taking blood sample and sent to the laboratory for analysis with uricase/PAP method. The data were analyzed to assess the significant correlation and difference in means of the studied variables between two different groups.

Result: The mean level of serum uric acid is significantly higher in hypertension group compared to control group (6.2 ± 1.8 vs 5.4 ± 1.4, p-value 0.016). Serum uric acid based on the duration of hypertension showed the difference compared to control group (<5 years: 5.8 ± 1.4 vs 35 years: 7.0 ± 2.4, p-value 0.004). There is relationship between hypertension and uric acid level (153.8 ± 10.1 vs 118.3 ± 9.0, p-value 0.07; 93.7 ± 7.8 vs 75.9 ± 6.3, p-value 0.03)

Conclusion: Serum uric acid can be considered as a potential biomarker in determining the severity and duration of hypertension.
23 CAROTID ARTERY ULTRASOUND PROFILE AND COGNITIVE IMPAIRMENT IN CORONARY ARTERY DISEASE
Authors: Nabilah Rizqi Amanda , Mesiano Taufik , Ramli Yetty , Hidayat Rakhmad , Kurniawan Mohammad , Rasyid Al , Harris Salim
Published: May 2022

Background: Coronary artery disease is a common cardiovascular disease caused by atherosclerotic plaque accumulation in epicardial arteries. Atherosclerotic plaque, along with hypoperfusion and oxidative stress may cause cerebral dysfunction that leads to cognitive impairment. This study will further assess the correlation between cardiac function, carotid artery profile, and thus their impact on cognitive impairment.

Methods: A cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital, Jakarta between January 2020-June 2021. Inclusion criteria were coronary artery disease; exclusion criteria were history of stroke, brain injury, tumour, or infection. All subjects underwent carotid/transcranial doppler ultrasound and cognitive function examination (MOCA-Ina and MMSE) by certified neurologists. Normal ejection fraction defined as LVEF ≥55%, normal MOCA-Ina as score 26 and above, and normal MMSE as score 25 and above.

Results: Twenty-nine subjects were enrolled in this study. Twenty-four (82.75%) subjects suffered from cognitive impairment where 19 (65.5%) subjects have abnormal MOCA-Ina or MMSE or both and 5 subjects (17.2%) subjects have abnormalities in at least one cognitive function domain. Memory function was the most common domain affected (79.17%), followed by executive function (58.3%), visuospatial (29.17%), attention (8.3%) and language (8.3%). However, the carotid artery ultrasound profile was within normal limits.

Conclusion: Cognitive impairment is common disabling comorbidity found in coronary artery disease with memory function as the most frequent domain affected; although carotid artery profile was normal. Therefore, patients with coronary artery disease should be advised to undergo cognitive function screening and carotid ultrasound, especially those with lower ejection fractions.
24 IS POOR ADHERENCE TO HYPERTENSIVE TREATMENT ASSOCIATED WITH THE RISK OF OBSTRUCTIVE SLEEP APNEA IN LONG TERM DIALYSIS PATIENTS?
Authors: Putri Anandita , Lubis Afrilia Rosada , Muzasti Riri Andri
Published: May 2022

Background: Obstructive Sleep Apnea (OSA) is one of the causes of secondary hypertension. Vast majority of secondary hypertensive patients have uncontrolled blood pressure due to poor adherence to treatment. However, the association between adherence to hypertensive treatment and the risk of OSA in long term dialysis patients remains unclear.

Objective: This study aimed to investigate the association between adherence to hypertensive treatment and the risk of OSA in long term dialysis patients.

Method: A cross-sectional study was conducted on eighty-nine hypertensive patients at the Rasyida Kidney Hospital, Medan, North Sumatera. Adherence to hypertensive treatment was measured using the Morisky Medication Adherence Scale (MMAS) questionnaire while the risk of OSA was assessed utilizing the STOP-Bang questionnaire (a tool used to help diagnose OSA). Patients' age, gender, history of smoking, and body mass index (BMI) were also analyzed as possible associated factors. The Chi-Square test and multivariate analysis were used to analyze the association between study variables.

Results: Multivariate analysis showed that older age (>50 years old) and higher BMI (>25 kg/m2) were significantly associated with high risk of OSA (OR=6.449; 95% CI= 2.246-18.520; p=0.001 and OR=6.130; 95% CI= 2.105-17.849; p=0.001, respectively). In contrary, we found no significant association between adherence to hypertensive treatment and the risk of OSA (p=0.679).

Conclusion: No association between adherence to hypertensive treatment and the risk of OSA was found in long term dialysis patients. However, being older and having higher BMI were significantly associated with higher risk of OSA in long term dialysis patients.
30 EFFECT OF HIGH-DOSE VITAMIN D ON HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Halomoan R.
Published: May 2022

Background: Vitamin D deficiency has been linked with the risk of developing hypertension. Every 16 ng/mL decrease in vitamin D increase the risk of hypertension by 16%. Studies of standard vitamin D supplementation have not provided beneficial effect in lowering blood pressure in patients with hypertension. This study aims to determine the effect of high dose vitamin D supplementation in lowering blood pressure in hypertensive patient compared to placebo.

Method: Systematic literatures search was conducted through online databases including PubMed and the Cochrane Library to find relevant randomized controlled trials (RCTs) from January 2010 to December 2021. Random-effect model was used to pool the weighted mean difference (WMD) of blood pressure across studies. Confidence Interval (CI) of 95% were reported. I2 test was used to assess the heterogeneity across studies. Meta-analysis was performed using RevMan 5.3.

Result: Four RCTs involving 1100 participants were included. On pooled analysis, high dose vitamin D supplementation did not show significant reduction in systolic blood pressure compared to placebo (WMD, 0.37; 95% CI, - 1.34 to 2.09; p= 0.67). Similar finding was also found in the association of high dose vitamin D supplementation and diastolic blood pressure (WMD, 0.32;95% CI, - 0.80 to 1.45; p= 0.57).

Conclusion: High dose vitamin D supplementation does not lower systolic and diastolic blood pressure in hypertensive patients
35 PROFILE OF HYPERTENSION IN YOUNG ADULT PATIENT IN MALANG CITY, INDONESIA
Authors: Sari D.I. , Fadlan M.R. , Sitio M. , Pramudya A.A. , Prakosa A.G.
Published: May 2022

Background and aims: Hypertension is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, but 46% of adults with hypertension are unaware that they have the condition. This study intended to provide and present data as an insight for appropriate management of hypertension in young adult.

Materials and methods: A cross-sectional study was conducted at the Islamic senior high school in Malang City. A total 678 young adult between the ages of 15 until 30 years old were reviewed. Data collected from questionnaire, include demographic, clnical, investigation and causes of hypertension.

Results: From a total 678 young adult, 110 have increased blood pressure whereas 56% were females. Out of 110 hypertensive young adults reviewed, 21% had a secondary cause and 79% had essential hypertension. The young adult with hypertension evidently had a family history of hypertension in a first degree relative (73%), mostly was a current or previous smokers (32%) and 0.1% admitted to prior use of metamphetamines. Comorbidities present were diabetes in 6% patients, metabolic syndrome in 12%, and obesity in 24%. Most patients had essential hypertension with a strong family history. High risk behavior, including smoking and illicit drug use, and obesity were identified as contributing factors.

Conclusions: Hypertension is oftenly found among young adult in Malang that needs more concern in managing hypertension comprehensively. These results suggest a targeted approach to the investigation of young hypertensives for secondary causes, and significant opportunities for lifestyle intervention.
37 FRUITS AND VEGETABLES INTAKE AND RISK OF HYPERTENSION: A META-ANALYSIS OF PROSPECTIVE COHORT STUDIES
Authors: Kamilia Ismini Aufa , Pintaningrum Yusra
Published: May 2022

Background: The association between fruit and vegetables (FVs) intake and hypertension risk remains controversial. Many studies have indicated that consumption of vegetables and fruits are positively associated with blood pressure.

Objective: To evaluate the impact of intake fruits and or vegetables and the risk of developing hypertension.

Methods: Prospective cohort studies were performed through PubMed. There were three studies included with total 146,647 participants were included.

Result: There was statistically significant between fruits intake and risk of hypertension (RR 0.87, 95% CI 0.83 to 0.91, p=0.00001), vegetables intake and risk of hypertension (RR 1.08, 95% CI 0.99 to 1.18, p=0.08).

Conclusion: There were statistically significant between fruits and vegetables intake and risk of hypertension. These findings support recommendation to increase the consumption of fruit and vegetables to prevent the risk of developing hypertension.
40 IMPACT OF BETA-BLOCKER ON OUTCOME AORTIC STENOSIS: A META-ANALYSIS
Authors: Ramdani Baiq Hanida Aolia , Pintaningrum Yusra
Published: May 2022

Background: Aortic stenosis (AS) is one of the most common valvular heart diseases. On 78% of patients with aortic stenosis have comorbid hypertension. Until now guideline treatment of a patient with hypertension in aortic stenosis is still controversial. Beta-blocker is an antihypertensive drug that has no known good or bad risk in aortic stenosis.

Objective: To evaluate the impact of beta-blocker as a treatment for hypertension in patients with aortic stenosis

Methods: A randomized control trial and other studies comparing outcomes of patient aortic stenosis using beta-blocker were performed through PubMed and Cochrane. The primary outcome was a risk for all-cause mortality. Risk ratios (RRs) were calculated using a random-effect model with a corresponding 95% confidence interval.

Result: Four studies with 2.398 patients were included. There were no significant differences between intervention beta-blocker or not for the risk of all-cause mortality (RR 0.82, 95% CI 0.53 to 1.28, p=0.38), and other outcome such us change of ejection fraction left ventricular (SMD 0.02, 95% CI -0.10 to 0.14, p=0.73) and left ventricular mass (SMD -0.03, 95% CI -0.15 to 0.09, p=0.62).

Conclusion: Intervention anti-hypertensive with beta-blocker not associated with outcome in patient with aortic stenosis.
46 ANGIOTENSIN-CONVERTING ENZYME INHIBITORS/ANGIOTENSIN RECEPTOR BLOCKER IMPROVES CLINICAL OUTCOMES IN COVID-19 PATIENTS: A META-ANALYSIS
Authors: Putra Bayushi Eka , Widyantoro Bambang , Maulana Rido , Putrinarita Agnes Dinar , Nugroho Bhayu Hanggadhi , Santoso Anwar
Published: May 2022

Objective: It is speculated that patients with pre-existing use of ACEi/ARB increase the infection risk and severity of COVID-19 pneumonia. Otherwise, the contrasting hypothesis stated that the use of ACEi/ARB might protect against virally induced lung and cardiac injury. We aimed to investigate association between pre-existing use of ACEi/ARB with the severity and mortality in patients with COVID-19 pneumonia.

Methods: We performed a comprehensive literature search from several databases in concordance to PRISMA algorithm. The population was COVID-19 pneumonia. Mortality was defined as in-hospital mortality; the severity of disease was categorized as severe versus non-severe based on the guidelines issued by National Health Commission of China on Diagnosis and Treatment of COVID-19. Population with pre-existing use of ACEi/ARB and without the use of ACEi/ARB were compared. The primary outcome was mortality, and the secondary outcomes were combined endpoint of mortality and severity.

Results: A total of 2,496 patients recruited from 8 eligible studies. This meta-analysis demonstrated that pre-existing use of ACEi/ARB is associated with a lower mortality (RR = 0.81, 95%CI 0.67 to 0.98, p = 0.03, I2 = 0%). There was no association solely with severity of disease. The use of ACEi/ARB is also associated with the combined endpoint of mortality and severity (RR = 0.87, 95%CI 0.76 to 0.99, p = 0.04, I2 = 32%).

Conclusion: The pre-existing use of ACEi or ARB is associated with lower mortality and the combined endpoint of severity and mortality in patients with COVID-19.
Urinary Bladder Matrix Grafting Versus Flap Coverage for Acute or Infected Wound Defects in Patients With Orthopaedic Trauma
Authors: Mundra Leela S. , Tucker Nicholas J. , Parry Joshua A.
Published: May 2022

Objectives:

Urinary bladder matrix (UBM) grafting of acute or infected wound defects has been reported to be successful in small case series. The purpose of this study was to compare the outcomes of UBM grafting with flap coverage.

Design:

This is a retrospective comparative study.

Setting:

Level-1 trauma center.

Patients:

Orthopaedic trauma patients with wound defects not amenable to primary closure or skin grafting.

Intervention:

Wound coverage with UBM grafting (n = 26) by orthopaedic trauma surgeons versus flap coverage (n = 26) by microvascular-trained plastic surgeons.

Main Outcome Measurements:

Primary wound coverage success, complications, returns to the operating room, hospital length of stay, and time to wound healing.

Results:

The UBM group was more likely to have an American Society of Anesthesiologist class ≥3 (58% vs. 23%, P = 0.02), a foot/ankle wound (77% vs. 12%, P < 0.001), an infected wound defect (81% vs. 50%, P = 0.03), and smaller defects (21 vs. 100 cm2, P = 0.02). UBM grafting resulted in a longer time to wound healing (6 vs. 2 months, P = 0.002) and a shorter hospital length of stay (2 vs. 14 days, P < 0.0001). UBM and flap groups had similarly high rates of failure of primary wound coverage (31% vs. 31%; P = 1.0), complications (46% vs. 62%, P = 0.4), and returns to the operating room (46% vs. 65%; P = 0.2). All 3 acute traumatic wounds undergoing UBM grafting concurrently with fracture fixation experienced graft failure and osteomyelitis.

Conclusion:

UBM grafting is an effective alternative to flap coverage for small traumatic or infected wounds but should be avoided in acute traumatic wounds undergoing fracture fixation.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Neutrophil Extracellular Traps and Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage
Authors: Witsch Jens , Spalart Valérie , Martinod Kimberly , Schneider Hauke , Oertel Joachim , Geisel Jürgen , Hendrix Philipp , Hemmer Sina
Published: May 2022

IMPORTANCE:

Myeloperoxidase (MPO)-DNA complexes, biomarkers of neutrophil extracellular traps (NETs), have been associated with arterial and venous thrombosis. Their role in aneurysmal subarachnoid hemorrhage (aSAH) is unknown.

OBJECTIVES:

To assess whether serum MPO-DNA complexes are present in patients with aSAH and whether they are associated with delayed cerebral ischemia (DCI).

DESIGN, SETTING, AND PARTICIPANTS:

Post-hoc analysis of a prospective, observational single-center study, with de novo serum biomarker measurements in consecutive patients with aSAH between July 2018 and September 2020, admitted to a tertiary care neuroscience ICU.

MAIN OUTCOMES AND MEASURES:

We analyzed serum obtained at admission and hospital day 4 for concentrations of MPO-DNA complexes. The primary outcome was DCI, defined as new infarction on brain CT. The secondary outcome was clinical vasospasm, a composite of clinical and transcranial Doppler parameters. We used Wilcoxon signed-rank-test to assess for differences between paired measures.

RESULTS:

Among 100 patients with spontaneous subarachnoid hemorrhage, mean age 59 years (sd ± 13 yr), 55% women, 78 had confirmed aSAH. Among these, 29 (37%) developed DCI. MPO-DNA complexes were detected in all samples. The median MPO-DNA level was 33 ng/mL (interquartile range [IQR], 18–43 ng/mL) at admission, and 22 ng/mL (IQR, 11–31 ng/mL) on day 4 (unpaired test; p = 0.015). We found a significant reduction in MPO-DNA levels from admission to day 4 in patients with DCI (paired test; p = 0.036) but not in those without DCI (p = 0.17). There was a similar reduction in MPO-DNA levels between admission and day 4 in patients with (p = 0.006) but not in those without clinical vasospasm (p = 0.47).

CONCLUSIONS AND RELEVANCE:

This is the first study to detect the NET biomarkers MPO-DNA complexes in peripheral serum of patients with aSAH and to associate them with DCI. A pronounced reduction in MPO-DNA levels might serve as an early marker of DCI. This diagnostic potential of MPO-DNA complexes and their role as potential therapeutic targets in aSAH should be explored further.
Conjunctival Histopathological Changes in Children With Vitamin D Deficiency
Authors: Aksoy Aydemir Gozde , Ilhan Cagri , Pehlıvanoglu Burcin , Aydemir Emre , Kiziltoprak Hasan , Bolu Semih
Published: May 2022

Purpose:

The aim of this study was to investigate tear function–associated clinical findings and conjunctival histopathological changes in children with vitamin D (Vit-D) deficiency.

Methods:

This study used a prospective case–control design. Group 1 (n=38) comprised pediatric patients with Vit-D deficiency, and group 2 (n=45) was the control group. Tear break-up times (TBUTs), Schirmer-1 test measurements, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (CIC) results of the groups were compared.

Results:

The participant demographic characteristics, including the mean age and the male-to-female ratio, were similar (P>0.05). The median TBUT and Schirmer-1 test measurement were 10 s (5–15) and 12 mm (6–19) in group 1 and 11 s (6–16) and 15 mm (8–21) in group 2 (P=0.004 and P=0.013, respectively). The median OSDI scores were 16 (10–20) in group 1 and 17 (10–21) in group 2 (P=0.092). According to the CIC, 25 samples in group 1 and 40 samples in group 2 were categorized as grade 0, 11 samples in group 1 and 5 samples in group 2 were categorized as grade 1, and 2 samples in group 1 and no sample in group 2 were categorized as grade 2 (P=0.027).

Conclusion:

Significant conjunctival histopathological changes occur in children with Vit-D deficiency, and these changes have effects on some tear function–associated clinical findings including the Schirmer-1 test and TBUT measurements.
Visual Outcomes of Patients With Peripheral Ulcerative Keratitis and the Effect of Immunosuppression—A 6-Year Experience in Queensland, Australia
Authors: Li Ye , McKelvie James , McLintock Cameron
Published: May 2022

Objective:

Peripheral ulcerative keratitis (PUK) can cause significant ocular morbidity and mortality. This study aimed to review the effects of systemic immunosuppression on visual outcomes.

Methods:

A state-wide, retrospective case series based in Queensland, Australia, was performed. A review of patients who presented with PUK to the major tertiary ophthalmology referral centers between January 2015 and January 2021 was undertaken. Parameters recorded included clinical features at presentation, investigations undertaken, treatment provided, visual outcomes, and mortality outcomes. The effect of immunomodulatory therapy on the change in vision from presentation to the most recent review was analyzed.

Results:

Twenty-two eyes of 26 patients with PUK (average age 69.81±14.54 years) were included and had a mean follow-up period of 577.73 days. Twelve patients (54.5%) had systemic autoimmune disease, one patient (4.5%) had positive syphilis serology, and nine patients (40.9%) had idiopathic PUK. Eighteen patients (81.8%) were treated with systemic steroids and 10 patients (45.5%) were treated with steroid-sparing immunomodulatory therapy. Average logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) at presentation and final follow-up were 0.63±0.65 and 0.64±0.82, respectively. Those who were treated with immunomodulatory therapy had a nonstatistically significant improvement in BCVA (−0.10±0.29 with vs. +0.10±0.35 without), and a similar trend was seen for doxycycline (−0.08±0.09 with vs. +0.22±0.49 without). Four of five perforations (80%) were surgically managed. Four patients (18.2%) were deceased.

Conclusions:

Peripheral ulcerative keratitis poses significant clinical challenges and requires intensive medical treatment, frequently involving systemic immunomodulatory therapy. Surgical treatment is required in a significant minority of cases. Ocular management alongside the use of doxycycline and immunomodulatory therapy in consultation with specialist physicians can optimize visual and systemic outcomes.
The Prevalence and Related Effects of HIV Drug-Resistant Strains Against Antiretroviral Therapy in China
Authors: Xing Hui , Ruan Yuhua , Liao Lingjie , Shao Yingming
Published: May 2022

Anti-human immunodeficiency virus (HIV) treatment resistance surveillance has been going on for nearly 18 years in China. In this paper, we review the prevalence in China of resistance to reverse transcriptase and protease inhibitors in the HIV-infected population receiving antiretroviral therapy (ART) and the population that stopped ART in recent years. Drug resistance is an important factor affecting the death of patients with acquired immune deficiency syndrome (AIDS). With the extension of the duration of ART and the expansion of the population receiving ART, especially the widespread promotion of preventive drugs before and after exposure, it is important to obtain insight into the prevalence and types of drug-resistant strains and their impact on the overall AIDS prevention and treatment effect.