bluuebunny/crossref_metadata_2025 huggingface dataset:
FAKTOR-FAKTOR YANG MEMPENGARUHI KUNJUNGAN IMUNISASI PADA MASA PANDEMI COVID-19 DI KAMPUNG CIBUNGBULANG DAN KAMPUNG LEUWEUNGKOLOT
Authors: . Irmalasari , Khodijah Parinduri Siti , Chotimah Indira
Published: February 2022

Imunisasi merupakan upaya pencegahan yang telah berhasil menurunkan morbiditas (angka kesakitan) dan mortalitas (angka kematian) penyakit infeksi pada bayi dan anak. Pada masa pandemi COVID-19 diberbagai daerah jadwal imunisasi mengalami penundaan sehingga menyebabkan cakupan Imunisasi pada bulan Januari sampai April 2020 yang dibandingkan dengan 2019 pada kurun waktu yang sama menunjukan penurunan mulai dari 0.5%. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi kunjungan imunisasi pada masa pandemi COVID-19. Jenis penelitian ini adalah kuantitatif dengan menggunakan desain cross sectional, jumlah sampel pada penelitian ini yaitu sebanyak 102 orang yang merupakan ibu yang memiliki bayi usia dari (0-2 tahun), pengambilan sampel menggunakan teknik propotional sample, instrument yang digunakan berupa kuesioner, analisis data menggunakan uji chi-square, hasil penelitian ini menunjukan bahwa adanya pengaruh antara kategori pengetahuan (p-value = 0,027), sikap (p-value = 0,002), serta tidak ada pengaruh antara peran petugas kesehatan (p-value = 0,062), dan akses (p-value = 1,000) dengan kunjungan imunisasi pada masa pandemi COVID-19. Bagi Puskesmas disarankan Membuat iklan layanan petunjuk teknis pelayanan imunisasi pada masa pandemi COVID-19, bagi peran petugas kesehatan Melakukan promosi kesehatan ke dasa-desa mengenai pentingnya imunisasi pada masa pandemi COVID-19 dan penerapan protokol kesehatan dengan cara 5M, bagi mahasiswa Diharapkan dapat mengembangkan penelitian yang serupa dengan variabel dan jumlah sampel yang berbeda.
Like, comment, and share the university experience: exploring the narratives present in Ontario universities' Instagram profiles
Authors: Padillo Aimee Jeanne
Published: February 2022

The main objective of this study was to explore the visual content and discourse present in three Ontario universities’ Instagram profiles, particularly their profiles dedicated to student recruitment and admissions. The study looked at the Instagram content published by top-three high application volume universities: McMaster University (macadmit), Ryerson University (whyryerson), and University of Toronto (futureuoft). The data collected was composed of photos, videos, and captions from all three universities from September 1, 2020 to December 31, 2020 inclusive. The results showed that visual assets highlighting the institution, portraits of students, and event/advertisements were the most occurring types of Instagram content. In addition, there was a high use of event/advertisement style in the accompanying captions. When the visual assets and captions were juxtaposed against each other, there was a high incongruence between the pairing which can be laborious for readers who will need to consolidate the visual and text information.
Match me if you can: self-presentation and dating applications
Authors: Soll Hunter
Published: February 2022

The purpose of this research paper, which is a pilot project, is to understand how different dating applications facilitate the process of impression-management, and if different applications lead to different modes of impression-management. Research suggests that dating apps can serve multiple purposes, among which casual sex and participating in hookup culture is only one (Anzani et. al, 2018; Timmermans & Courtois, 2018; Lebfevre, 2018; Castro & Barrada, 2020). Tinder and JSwipe are two popular dating applications, and they will be used as platforms to study alongside impression-management theory to explore how eligible single males incorporate techniques from this theory to emphasize different attributes to potential romantic partners. Findings from this MRP suggest that individuals stress non-physical attributes to potential matches, regardless of the application that is being used. However, this research paper was a pilot project, and therefore cannot confirm or dismiss any assumptions. This study points in various directions that might be fertile ground for further research on this topic, to confirm these findings.
Airtightness of Nepalese Residential Buildings
Authors: Chaulagain Nischal , Baral Bivek , Davidsson Henrik , Burke Stephen
Published: February 2022

Experimental field measurements regarding airtightness following the fan pressurisation method were done on 25 typical residential buildings at different locations in Nepal. The field measurement data were classified according to building type and building age. The mean air permeability (Q50 ) for the studied buildings was 6.9 l/s·m2 and the mean air change rate was 55.5 air changes per hour at 50 Pa. The maximum air leakage rate (Q50 ) was 28.4 l/s·m2 for brick masonry in mud mortar type and the minimum recorded was 1.7 l/s·m2 for brick masonry in cement mortar type building. Brick masonry in mud mortar-type buildings was found to be leakier regardless of the building age, and brick masonry in cement mortar-type buildings was comparatively more airtight. Leakage locations identified through visual inspection included the spacing between the door frame and operable door area, horizontal window slider, joint areas of window frame and wall, wood plank-based wall structure, roof joint areas and holes in the wall. This research is the first of its kind in Nepal to assess the airtightness of buildings, and the outcome of this research is one of the key parameters to evaluate the thermal performance of Nepalese buildings scientifically.
La espondilitis anquilosante, causas y diagnóstico. Una revisión sistemática
Authors: Cañar Lascano Geovanny German , Sper Sempértegui Alberto , Fernández Villarroel Juan Gonzalo
Published: February 2022

La espondilitis anquilosante es una artritis que se caracteriza por presentar inflamación crónica y las articulaciones se van degenerando, que afecta en gran proporción la columna vertebral y la articulación sacro ilíaca, esta enfermedad es más común que se presente en hombre que en mujeres, alrededor de los 20 a 30 años, afectado la calidad de vida de los individuos, y generando malestar y limitación de su movilidad. El objetivo de esta investigación es describir las causas y el diagnóstico de la espondilitis anquilosante a través de una revisión sistemática. Como conclusión se menciona que, es evidente que existe una gran variedad de afecciones que pueden estar asociadas con la EA, sin embargo, se observa la coincidencia que una de las principales consecuencias que genera esta enfermedad es el deterioro de la calidad de vida de los individuos que padecen esta y otras enfermedades durante su vida, y que repercuten en el comportamiento psicológico de los mismos. Es importante destacar que se debe seguir realizando análisis y estudios genéticos y de casos de pacientes con esta patología que permita determinar de forma más clara las causas que generan esta enfermedad y la prevalencia de la misma en los individuos, así como poder determinar posibles nuevos tratamientos que permitan mejorar en gran medida los síntomas, como el dolor, la inflamación y la rigidez para que las personas con esta enfermedad puedan realizar sus actividades sin depender de la ayuda de otras personas.
Previsão do preço do café arábica: uma aplicação de redes neurais CNN-BLSTM
Authors: Santos José Airton Azevedo dos
Published: February 2022

Este trabalho propõe a utilização da rede neural CNN-BLSTM como ferramenta de previsão do preço do café arábica. A base de dados disponibilizada pelo CEPEA (Centro de Estudos Avançados em Economia Aplicada) apresenta uma série histórica, do preço do café arábica, no período entre janeiro de 1997 e dezembro de 2021. Modelos de previsão baseados em redes neurais LSTM, BLSTM, CNN e CNN-BLSTM foram implementados, na linguagem Python, utilizando o framework Keras. Resultados obtidos, dos quatro modelos, foram comparados por meio das métricas MAE, RMSE e MAPE. Verificou-se, para um horizonte de 6 meses, que o modelo CNN-BLSTM apresentou melhor desempenho.
Comercialização e utilização de agrotóxicos no município de Crisópolis-BA
Authors: Souza Jaciara Pinheiro de , Porto Murilo de Jesus , Credidio Graziella Cecilio , Teles André Lacerda Braga
Published: February 2022

A expansão da produção agrícola e pecuária no Brasil levou a intensificação da utilização de produtos agrotóxicos, fato preocupante diante dos efeitos negativos desses produtos sobre o meio ambiente e saúde humana. A Bahia é um dos principais estados consumidores de agrotóxicos e trabalhos prévios no município baiano de Crisópolis-BA demonstraram ampla utilização desses produtos por sua população. Considerando o potencial lesivo dos agrotóxicos, fica evidente a importância de investigações referentes à sua comercialização para identificação de eventuais problemas e planejamento de ações corretivas. Nesse âmbito, a presente pesquisa teve o objetivo de investigar variáveis relacionadas à comercialização de agrotóxicos no município de Crisópolis-BA no ano de 2021. Dessa forma, informações foram levantadas junto aos estabelecimentos de comercialização de agrotóxicos do município por meio de observações e aplicação de questionários aos proprietários e funcionários dos estabelecimentos. Os dados foram analisados utilizando estatística descritiva e inferencial. Os resultados demonstraram maior tendência de vendas para os produtos com o princípio ativo 2,4-D + picloram. Esses dados sugerem grande demanda e manipulação desses produtos pela população, o que é motivo de preocupação considerando seu potencial toxicológico (classes toxicológicas I). Além disso, verificou-se a preponderante falta de conhecimento por parte dos vendedores acerca do uso seguro dos agrotóxicos. Dado preocupante posto que a ausência da informação sobre o seu manejo correto implica um maior risco de exposição, podendo contribuir para intoxicação do trabalhador rural por esses produtos.
Tecnologias Assistivas e Digitais na Educação Especial: o que foi possível realizar em tempos de pandemia da Covid-19
Authors: Freitas Thayane Nascimento , Macêdo Rosane Ferreira , Sousa Rogério Leal de , Ibiapina Fausneto Alves , Jesus Ivone das Dores de , Sena Lilían de Sousa , Serra Ilka Márcia Ribeiro de Souza
Published: February 2022

O referido artigo apresenta uma abordagem a respeito das tecnologias assistivas e digitais na educação especial: o que foi possível realizar em tempos de pandemia da Covid-19. Tem como objetivo identificar quais as tecnologias assistivas e digitais foram utilizadas pelos docentes no ensino remoto aos estudantes público-alvo da educação especial em duas escolas da rede pública municipal de Teresina e, uma em Picos-PI, durante a pandemia da Covid-19. Para o desenvolvimento da pesquisa, se fez inicialmente uma pesquisa de campo de cunho exploratório, a partir de uma abordagem qualitativa. Para coleta de dados utilizamos entrevistas semiestruturadas, optamos nesta pesquisa, pelo tipo descritiva, como complemento, utilizou-se o método indutivo com o propósito de melhor expor o objeto de estudo aqui apresentado. Como possíveis resultados observamos que a utilização das tecnologias assistivas e digitais ainda não ocorrem de forma efetiva nas práticas pedagógicas durante o ensino remoto aos estudantes com deficiência, deixando-os em uma inclusão mascarada, ou seja, excluídos. Assim, acredita-se que a formação continuada dos docentes sobre as tecnologias digitais e assistivas faz-se necessária para favorecer inclusão nas práticas pedagógicas no ensino remoto, bem como a interlocução ente os professores da sala regular e do atendimento educacional especializado, com intuito de viabilizar um trabalho colaborativo que favoreça a participação efetiva desses estudantes público-alvo da educação especial.
Constitutional Compliance Solution to Law Testing Rulings in the Constitutional Court
Authors: Sulistyowati Tri , Ridho Ali , Nasef M Imam
Published: February 2022

One of the current constitutional issues in Indonesia is the non-compliance of the decision to immediately follow up the decision of the Constitutional Court, which is final. This paper aims to analyze forms of non-compliance with the decision of the Constitutional Court and create a model that is expected to be a solution to the problem. This type of research is juridical normative by using secondary data processed by editing and systematization techniques.  The results showed the form of non-compliance of the decision of the Constitutional Court by the addresat of the decision is manifested in 3 (three) forms, namely normative, praxis, and normative and praxis forms. There are three proposed state-regulation solutions, namely judicial deferral by limiting the time of action, re-affirmation of judicial restraint, collaborative action, and collective awareness between state institutions.
Guarantee Of Worker Rights During The Covid 19 Pandemic
Authors: Agustanti Rosalia Dika , Wahyuningsih Yuliana Yuli , - Satino
Published: February 2022

This research discusses the rights of workers / laborers during the COVID-19 pandemic and what if the employers do not meet these rights. Problem which is more in-depth about the employment that emerged during this pandemic, namely the occurrence of massive layoffs. The research was conducted using the Normative Juridical method. By applying the Statute Approach, Conceptual Approach, and Case Approach, the results show that employers have not been able to fulfill workers / labor rights during the COVID-19 pandemic. There are companies that have not implemented the clean lifestyle and occupational health standards K3 protection such as masks, hand sanitizer and personal protective equipment. Prevention and handling policies are still not optimal, the principle of maintaining social distancing has not been implemented optimally, there are still many workers who are jostling for work when they come to work, not to mention during the trip to work in public transportation.  This situation makes them vulnerable to infection. However, they still have to go to work because of the risk of losing their income. Efforts that can be made if wages are not paid are to take the route or methods as regulated in Law Number 2 of 2004 concerning Settlement of Industrial Relations Disputes. The basis of a dispute between a worker/ laborer and an entrepreneur is a dispute over rights.
Dynamics of Village Head Election Arrangements
Authors: Wantu Fence M , Tome Abdul Hamid
Published: February 2022

This study aims to analyze the arrangement of village head elections from the beginning of independence until now. The method used in this study is the normative legal research method regarding primary and secondary legal materials. The legal materials obtained are then analyzed descriptively. The results showed that the arrangement of the selection of village heads has its dynamics in line with the development of the politics of the law of the state that occurs. The existing legal, political conditions influence determining the conditions for the candidates of village heads. Although it has been regulated for a long time, it turns out that all existing laws and regulations have not made arrangements related to the provisions of the supervisory mechanism and the mechanism of resolving disputes for the selection of village heads. Regulation of the Minister of Home Affairs on the Selection of Village Heads attaches supervisory duties to the regional election committee. However, it does not make arrangements for how the surveillance process should be conducted.On the one hand, in the regulation, it is expressly mentioned the existence of supervisors in the implementation of village head elections. Nevertheless, it did not specify who the superintendent was. Similarly, the settlement of disputes for the selection of village heads is left entirely to the Regent /Mayor to do so. Granting authority to the head of the region can undermine the democratic process built by the village through the selection of village heads.
DETERMINASI KEBIJAKAN DIVIDEN PADA PERUSAHAAN LQ45 YANG TERDAFTAR DI BURSA EFEK INDONESIA
Authors: Sabtohadi Joko , Nurfadillah Mursidah , Anitra Ver
Published: February 2022

Penelitian ini bertujuan untuk menganalisis faktor yang mempengaruhi kebijakan dividen pada perusahaan LQ 45 yang Listing di Bursa Efek Indonesia. Jenis penelitian yang di gunakan adalah jenis penelitian kuantitatif  dengan menggunakan Metode porpusive sampling untuk menentukan sampel. Penelitian ini menggunakan 45 perusahaan LQ45 sebagai populasi dan terdapat 24 sampel perusahaan LQ45 yang terdaftar di BEI periode 2016-2019. Data ini diolah dengan menggunakan aplikasi SPSS dan metode analisis dalam penelitian ini menggunakan Regresi Linier Berganda. Hasil analisis menunjukkan bahwa secara simultan semua variabel bebas berpengaruh terhadap kebijakn dividen, namun secara parsial hanya profitabilitas yang berpengaruh signifikan
ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI PENYERAPAN TENAGA KERJA PADA SEKTOR PERHOTELAN DI PROVINSI MALUKU DENGAN MENGGUNAKAN METODE REGRESI DATA PANEL
Authors: Matdoan Muhammad Yahya , Talakua Mozart W
Published: February 2022

The hotel sector is one of the sectors that has made a major contribution to employment and economic development in Maluku Province. The more the population, the more difficult it is to find work. The purpose of this study is to analyze the effect of the variable number of accommodation, number of occupancy, number of available beds and minimum wage of employees on labor absorption in the hotel sector in Maluku Province. One method that can be used to solve this problem is the Panel Data Regression method. Panel data regression is a combination of time series data and cross section data. This method can be used to determine the relationship between two or more variables that are quantitative in nature, so that one variable can be predicted from the other variables. The Panel Data Regression model used in this study is the Fixed Effect Model (FEM) with the results obtained, namely that there are three variables that affect labor absorption in the hotel sector in Maluku Province, namely the number of accommodation, the number of occupancy and the minimum wage of employees. Meanwhile, the number of available beds has no effect on labor absorption in the hotel sector in Maluku Province.
Nanomedicine of Plant Origin for the Treatment of Metabolic Disorders
Authors: Hu Fang , Sun Dong-Sheng , Wang Kai-Li , Shang Dan-Ying
Published: February 2022

Metabolic disorders are major clinical challenges of health that are progressing globally. A concurrence of metabolic disorders such as obesity, insulin resistance, atherogenic dyslipidemia, and systematic hypertension leads to metabolic syndrome. Over the past years, the metabolic syndrome leads to a five- and two-fold rise in diabetes mellitus type II and cardiovascular diseases. Natural products specifically plant extracts have insulin-sensitizing, anti-inflammatory, and antioxidant properties and are also considered as an alternative option due to few adverse effects. Nanotechnology is one of the promising strategies, which improves the effectiveness of treatment and limits side effects. This review mainly focuses on plant extract-based nanosystems in the management of the metabolic syndrome. Numerous nano-drug delivery systems, i.e., liposomes, hydrogel nanocomposites, nanoemulsions, micelles, solid lipid, and core–shell nanoparticles, have been designed using plant extracts. It has been found that most of the nano-formulations successfully reduced oxidative stress, insulin resistance, chronic inflammation, and lipid profile inin vitroandin vivostudies as plant extracts interfere with the pathways of metabolic syndrome. Thus, these novel plant-based nanosystems could act as a promising candidate for clinical applications.
Cell-Penetrating Botulinum Neurotoxin Type A With Improved Cellular Uptake and Therapeutic Index
Authors: Wei Xuan , Li Lu , Wu Yiwen , Liu Jia
Published: February 2022

Botulinum neurotoxin serotype A (BoNTA) is widely used for treating neuromuscular disorders. Despite of the various marketed products, BoNTA is known to have small therapeutic index ranging from 5 to 15. In the present study, we designed and characterized engineered BoNTA proteins with fusion of cell-penetrating peptides (CPPs). We have shown that CPPs, particularly a recently reported zinc finger protein could improve the cellular uptake and intramuscular therapeutic index of BoNTA. Our study has shed the light on developing next-generation neuromuscular modulators using CPP fusion.
Resilient and Self-Healing Hyaluronic Acid/Chitosan Hydrogel With Ion Conductivity, Low Water Loss, and Freeze-Tolerance for Flexible and Wearable Strain Sensor
Authors: Hu Yunping , Liu Nannan , Chen Kai , Liu Mingxiang , Wang Feng , Liu Pei , Zhang Yiyuan , Zhang Tao , Xiao Xiufeng
Published: February 2022

Conductive hydrogel is a vital candidate for the fabrication of flexible and wearable electric sensors due to its good designability and biocompatibility. These well-designed conductive hydrogel–based flexible strain sensors show great potential in human motion monitoring, artificial skin, brain computer interface (BCI), and so on. However, easy drying and freezing of conductive hydrogels with high water content greatly limited their further application. Herein, we proposed a natural polymer-based conductive hydrogel with excellent mechanical property, low water loss, and freeze-tolerance. The main hydrogel network was formed by the Schiff base reaction between the hydrazide-grafted hyaluronic acid and the oxidized chitosan, and the added KCl worked as the conductive filler. The reversible crosslinking in the prepared hydrogel resulted in its resilience and self-healing feature. At the same time, the synthetic effect of KCl and glycerol endowed our hydrogel with outstanding anti-freezing property, while glycerol also endowed this hydrogel with anti-drying property. When this hydrogel was assembled as a flexible strain sensor, it showed good sensitivity (GF = 2.64), durability, and stability even under cold condition (−37°C).
Microneedle-Mediated Transdermal Delivery of Drug-Carrying Nanoparticles
Authors: Jiang Xue , Zhao Huanhuan , Li Wei
Published: February 2022

Drug-carrying nanoparticles have obtained great attention for disease treatments due to the fact that they can improve drug solubility, provide drug protection and prolong release duration, thus enhancing drug bioavailability and increasing therapeutic efficacy. Although nanoparticles containing drugs can be administered via different routes such as oral, intravenous and ocular, transdermal delivery of nanoparticles mediated by microneedles has attracted considerable interest due to the capability of circumventing enzymatic degradation caused by gastrointestinal track, and increasing patient compliance by reducing pain associated with hypodermic injection. In this review, we first introduce four types of nanoparticles that were used for drug delivery, and then summarize strategies that have been employed to facilitate delivery of drug-loaded nanoparticles via microneedles. Finally, we give a conclusion and provide our perspectives on the potential clinical translation of microneedle-facilitated nanoparticles delivery.
Oligodendroglia Generated From Adult Rat Adipose Tissue by Direct Cell Conversion
Authors: Vellosillo Lara , Pascual-Guerra Jorge , Muñoz Maria Paz , Rodríguez-Navarro José Antonio , González-Nieto Daniel , Barrio Luis Carlos , Lobo Maria del Val Toledo , Paíno Carlos Luis
Published: February 2022

Obtaining oligodendroglial cells from dispensable tissues would be of great interest for autologous or immunocompatible cell replacement therapy in demyelinating diseases, as well as for studying myelin-related pathologies or testing therapeutic approaches in culture. We evaluated the feasibility of generating oligodendrocyte precursor cells (OPCs) from adult rat adipose tissue by expressing genes encoding transcription factors involved in oligodendroglial development. Adipose-derived mesenchymal cells were lentivirally transduced with tetracycline-inducible Sox10, Olig2, Zfp536, and/or Nkx6.1 transgenes. Immunostaining with the OPC-specific O4 monoclonal antibody was used to mark oligodendroglial induction. O4- and myelin-associated glycoprotein (MAG)-positive cells emerged after 3 weeks when using the Sox10 + Olig2 + Zfp536 combination, followed in the ensuing weeks by GFAP-, O1 antigen-, p75NTR (low-affinity NGF receptor)-, and myelin proteins-positive cells. The O4+ cell population progressively expanded, eventually constituting more than 70% of cells in culture by 5 months. Sox10 transgene expression was essential for generating O4+ cells but was insufficient for inducing a full oligodendroglial phenotype. Converted cells required continuous transgene expression to maintain their glial phenotype. Some vestigial characteristics of mesenchymal cells were maintained after conversion. Growth factor withdrawal and triiodothyronine (T3) supplementation generated mature oligodendroglial phenotypes, while FBS supplementation produced GFAP+- and p75NTR+-rich cultures. Converted cells also showed functional characteristics of neural-derived OPCs, such as the expression of AMPA, NMDA, kainate, and dopaminergic receptors, as well as similar metabolic responses to differentiation-inducing drugs. When co-cultured with rat dorsal root ganglion neurons, the converted cells differentiated and ensheathed multiple axons. We propose that functional oligodendroglia can be efficiently generated from adult rat mesenchymal cells by direct phenotypic conversion.
Using Environmental DNA to Detect Whales and Dolphins in the New York Bight
Authors: Alter S. Elizabeth , King Carissa D. , Chou Emily , Chin Sam Chew , Rekdahl Melinda , Rosenbaum Howard C.
Published: February 2022

Determining how cetaceans and other threatened marine animals use coastal habitats is critical to the effective conservation of these species. Environmental DNA (eDNA) is an emerging tool that can potentially be used to detect cetaceans over broad spatial and temporal scales. In particular, eDNA may present a useful complementary method for monitoring their presence during visual surveys in nearshore areas, and for co-detecting prey. In conjunction with ongoing visual surveys, we tested the ability of eDNA metabarcoding to detect the presence and identity of cetaceans in the New York Bight (NYB), and to identify fish species (potential prey) present in the area. In almost all cases in which humpback whales and dolphins were visually observed, DNA from these species was also detected in water samples. To assess eDNA degradation over time, we took samples in the same location 15 and 30 min after a sighting in seven instances, and found that eDNA often, but not always, dropped to low levels after 30 min. Atlantic menhaden were detected in all samples and comprised the majority of fish sequences in most samples, in agreement with observations of large aggregations of this important prey species in the NYB. While additional data are needed to better understand how factors such as behavior and oceanographic conditions contribute to the longevity of eDNA signals, these results add to a growing body of work indicating that eDNA is a promising tool to complement visual and acoustic surveys of marine megafauna.
Pediatric Cardiologist's View on Centralization of Pediatric Cardiology Services: A Questionnaire Survey
Authors: Tamimi Omar R. , AlGonaid Omer A. , AlMashham Yahya H. , Almashham Abdulrahman Y.
Published: February 2022

The population of the Kingdom of Saudi Arabia (KSA) exceeding 35 million people and in the presence of a non-structured increase in the number of pediatric cardiac centers, we expect to face some concerns like dilution of the service where the volume will be less than the acceptable standards, the increase in mortality and morbidity, and failure to obtain personalized medicine at a reasonable cost. Therefore, we built up this survey questionnaire about those concerns and collected the opinion of expert medical staff in Saudi Arabia who are working in the field of pediatric cardiology. Seventy percent of the responders vs. 25% recommend the centralization of the PCS as the solution for the above concerns, and 94% recommend sticking to the globally accepted criteria when issuing the license of the centers providing PCS including the volume of patients in each center, and minimum multidisciplinary facilities in terms of resources, services, and personnel.
Clinical Outcomes Associated With His-Purkinje System Pacing vs. Biventricular Pacing, in Cardiac Resynchronization Therapy: A Meta-Analysis
Authors: Gui Yang , Ye Lifang , Wu Liuyang , Mai Haohui , Yan Qiqi , Wang Lihong
Published: February 2022

Aims

His-Purkinje system pacing has recently emerged as an alternative to biventricular pacing (BIVP) in cardiac resynchronization therapy (CRT). The aim of this study was to conduct a meta-analysis comparing the clinical outcomes associated with His-Purkinje system pacing (HPSP) vs. BIVP in patients with heart failure. There is also a comparison of clinical outcomes of His-bundle pacing (HBP) and left bundle branch pacing (LBBP) in the His-Purkinje system.

Methods

We searched the Cochrane Library, Embase, and PubMed, for studies published between January 2010 and October 2021 that compared the clinical outcomes associated with HPSP vs. BIVP and HBP vs. LBBP in HPSP in patients who underwent CRT. The pacing threshold, R-wave amplitudes, QRS duration, New York Heart Association functional (NYHA), left ventricular ejection fraction (LVEF), and LV end-diastolic diameter (LVEDD) of heart failure, at follow-up, were extracted and summarized for meta-analysis.

Results

A total of 18 studies and 1517 patients were included in our analysis. After a follow-up period of 9.3 ± 5.4 months, the HPSP was found to be associated with shorter QRS duration in the CRT population compared to that in the BIVP (SMD, −1.17; 95% CI, −1.56 to −0.78; P < 0.00001; I2 = 74%). No statistical difference was verified between HBP and LBBP on QRS duration (SMD, 0.04; 95% CI, −0.32 to 0.40; P = 0.82; I2 = 84%). In the comparison of HPSP and BIVP, the LBBP subgroup showed improved LVEF (SMD, 0.67; 95% CI, 0.42–0.91; P < 0.00001; I2 = 0%), shorter LVEDD (SMD, 0.59; 95% CI, 0.93–0.26; P = 0.0005; I2 = 0%), and higher New York Heart Association functional class (SMD, −0.65; 95% CI, −0.86 to −0.43; P < 0.00001; I2 = 45%). In terms of pacing threshold and R-wave amplitude clinical outcomes, LBBP has a lower pacing threshold (SMD, 1.25; 95% CI, 1.12–1.39; P < 0.00001; I2 = 47%) and higher R-wave amplitude (MD, −7.88; 95% CI, −8.46 to −7.31; P < 0.00001; I2 = 8%) performance compared to HBP.

Conclusion

Our meta-analysis showed that the HPSP produced higher LVEF, shorter QRS duration, and higher NYHA functional class in the CRT population than the BIVP as observed on follow-up. LBBP has a lower pacing threshold and higher R-wave amplitude. HPSP may be a new and promising alternative to BIVP in the future.
Safety and Effectiveness Outcomes of a Novel Automated Titanium Suture Fastener Device Applied for Heart Valve Surgery in an Ovine Model
Authors: Li Bin , Bai Shanshan , Yue Guangxin , Zhu Jinyan , Zhang Min , Yang Baiqing , Luo Jiafei , Sun Yang , Zhang Leisheng , Wang Xin
Published: February 2022

Objective

This study was designed to evaluate the operability, effectiveness, and safety of the automated titanium suture fastener in a preclinical ovine model in comparison with manual tying in a mitral valve annuloplasty ring implantation surgery.

Methods

Eighteen adult Small-tailed Han sheep were prepared for the surgery of mitral valve annuloplasty ring implantation through lateral thoracotomy under cardiopulmonary bypass (CBP). A total of 12 stitches were performed to secure an annuloplasty ring, with 6 stitches done with the automated fastener and the other 6 by manual tying. The knotting time for the automated fastener or manual tying was recorded, respectively. The firmness of knots, mitral valve integrity, biocompatibility, thrombosis, local reactions, and other aspects were also compared at follow-up time (Days 30, 60, 90, and 180).

Results

Of the 18 sheep, 16 survived to the designated endpoints and were enrolled for further analysis. Compared with the control group, the knotting time was significantly reduced with the automated fastener (p < 0.01). All the annuloplasty rings were tightly secured by 6 fastener clips and 6 hand-made knots without any disengagement or displacement. All the mitral valves were intact without any defect, stenosis, prolapse, valve insufficiency, or perforation. Endothelialization was comparable between the two groups by Day 60. Small red thrombi formed at the thread end of the suture in both groups. No thrombus was found on the surface of the titanium clip. All the thrombi were within the acceptable range for the antithrombotic property. Thrombosis showed no significant difference by Day 60. No significant differences in the inflammatory response and pathological lesions were observed by Day 60. One case of diffuse renal infarction (area ratio = 20%) and 1 case of small focal renal infarction (area ratio < 5%) were caused by thromboembolism.

Conclusions

The automated fastener significantly shortened the procedure time of tying knots for the implantation of the annuloplasty ring in the ovine model, with comparable safety and effectiveness as manual tying.
Downregulation of PTEN Promotes Autophagy via Concurrent Reduction in Apoptosis in Cardiac Hypertrophy in PPAR α−/− Mice
Authors: Kumari Ritu , Ray Aleepta Guha , Mukherjee Dibyanti , Chander Vivek , Kar Dipak , Kumar Uppulapu Shravan , Bharadwaj P.V.P. Deepak , Banerjee Sanjay K. , Konar Aditya , Bandyopadhyay Arun
Published: February 2022

Cardiac hypertrophy is characterized by an increase in the size of the cardiomyocytes which is initially triggered as an adaptive response but ultimately becomes maladaptive with chronic exposure to different hypertrophic stimuli. Prolonged cardiac hypertrophy is often associated with mitochondrial dysfunctions and cardiomyocyte cell death. Peroxisome proliferator activated receptor alpha (PPAR α), which is critical for mitochondrial biogenesis and fatty acid oxidation, is down regulated in hypertrophied cardiomyocytes. Yet, the role of PPAR α in cardiomyocyte death is largely unknown. To assess the role of PPAR α in chronic hypertrophy, isoproterenol, a β-adrenergic receptor agonist was administered in PPAR α knock out (PPAR α−/−) mice for 2 weeks and hypertrophy associated changes in cardiac tissues were observed. Echocardiographic analysis ensured the development of cardiac hypertrophy and compromised hemodynamics in PPAR α−/− mice. Proteomic analysis using high resolution mass spectrometer identified about 1,200 proteins enriched in heart tissue. Proteins were classified according to biological pathway and molecular functions. We observed an unexpected down regulation of apoptotic markers, Annexin V and p53 in hypertrophied heart tissue. Further validation revealed a significant down regulation of apoptosis regulator, PTEN, along with other apoptosis markers like p53, Caspase 9 and c-PARP. The autophagy markers Atg3, Atg5, Atg7, p62, Beclin1 and LC3 A/B were up regulated in PPAR α−/− mice indicating an increase in autophagy. Similar observations were made in a high cholesterol diet fed PPAR α−/−mice. The results were further validated in vitro using NRVMs and H9C2 cell line by blocking PPAR α that resulted in enhanced autophagosome formation upon hypertrophic stimulation. The results demonstrate that in the absence of PPAR α apoptotic pathway is inhibited while autophagy is enhanced. The data suggest that PPAR α signaling might act as a molecular switch between apoptosis and autophagy thereby playing a critical role in adaptive process in cardiac hypertrophy.
Association Between Arterial Stiffness and Blood Pressure Progression With Incident Hypertension: A Systematic Review and Meta-Analysis
Authors: Saz-Lara Alicia , Bruno Rosa María , Cavero-Redondo Iván , Álvarez-Bueno Celia , Notario-Pacheco Blanca , Martínez-Vizcaíno Vicente
Published: February 2022

Background

Arterial stiffness is an independent predictor of cardiovascular and all-cause mortality that is classically regarded as a consequence of arterial hypertension. However, a growing number of studies have shown that arterial stiffness is involved in the pathogenesis and prognosis of arterial hypertension. Thus, in this systematic review and meta-analysis, we aimed to assess whether arterial stiffness, as measured by pulse wave velocity, systolic blood pressure and diastolic blood pressure are associated with incident hypertension.

Methods

The Scopus, PubMed, Web of Science and Cochrane Library databases were searched from inception to March 30, 2021. The DerSimonian and Laird method was used to compute pooled relative risk estimates and their respective 95% confidence intervals of association between incident hypertension with pulse wave velocity, systolic blood pressure and diastolic blood pressure.

Results

Our findings provide a synthesis of the evidence supporting that the higher arterial stiffness (RR: 1.09; 95% CIs: 1.05, 1.12), systolic blood pressure (RR: 1.08; 95% CIs: 1.05, 1.10) and diastolic blood pressure (RR: 1.08; 95% CIs: 1.04, 1.12) are associated with incident hypertension in normotensive adult subjects, with similar independent predictive values. However, our results should be interpreted with caution because the meta-analyses performed showed considerable heterogeneity.

Conclusions

Our results showed that higher pulse wave velocity, systolic blood pressure and diastolic blood pressure are associated with incident hypertension. These findings are of clinical importance, supporting arterial stiffness as an additional tool for the prevention of arterial hypertension and being a fundamental component to reduce cardiovascular morbidity and mortality.

Systematic Review Registration

This study was registered in PROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=236435 (Registration number: CRD42021236435).
RAAS Inhibitor Prescription and Hyperkalemia Event in Patients With Chronic Kidney Disease: A Single-Center Retrospective Study
Authors: Riccio Eleonora , Capuano Ivana , Buonanno Pasquale , Andreucci Michele , Provenzano Michele , Amicone Maria , Rizzo Manuela , Pisani Antonio
Published: February 2022

Hyperkalemia is common in patients treated with renin–angiotensin–aldosterone system inhibitors (RAASis), and it represents the main cause of the large gap reported between guideline recommendations and real-world practice in chronic kidney disease (CKD). We conducted a CKD-population-based restrospective study to determine the prevalence of patients with CKD treated with RAASis, incidence of hyperkalemia in patients with CKD treated with RAASis, and proportion of patients with RAASi medication change after experiencing incident hyperkalemia. Among 809 patients with CKD analyzed, 556 (68.7%) were treated with RAASis, and RAASi prescription was greater in stages 2–4 of CKD. Hyperkalemia occurred in 9.2% of RAASi-treated patients, and the adjusted rate of hyperkalemia among patients with stage 4–5 CKD was 3-fold higher compared with patients with eGFR > 60 ml/min/1.73 m2. RAASi treatment was discontinued in 55.3% of the patients after hyperkalemia event (74.2% discontinued therapy, 3.2% received a reduced dose, and 22.6% reduced the number of RAASi drugs). This study shows that the incidence of hyperkalemia is frequently observed in patients with CKD patients with RAASis, and that rates increase with deteriorating levels of kidney function from stages 1 to 3. RAASi medication change following an episode of hyperkalemia occurred in almost half of the patients after experiencing hyperkalemia.
Assessment of the Causal Effects of Obstructive Sleep Apnea on Atrial Fibrillation: A Mendelian Randomization Study
Authors: Li Yalan , Leng Yiming , Tang Haibo , Deng Peizhi , Wang Jie , Yuan Hong , Miao Rujia , Mu Ping
Published: February 2022

Background

Obstructive sleep apnea (OSA) and atrial fibrillation (AF) are epidemiologically correlated, but the causal relationship between them remains elusive. We aimed to explore the causal relationships between OSA and AF.

Method

Using both the Finnish biobank and publicly available genome-wide association study data (GWAS), we conducted a two-sample Mendelian randomization (MR) analysis to estimate the causal effect of OSA on AF, both in the primary analysis and replicated analysis. The inverse variance weighted MR was selected as the main method. To further test the independent causal effect of OSA on AF, we also performed multivariable MR (MVMR), adjusting for body mass index (BMI), hypertension, and coronary artery disease (CAD), respectively.

Results

In the primary analysis, OSA was significantly associated with the increased risk of AF (OR 1.21, 95% CI 1.11–1.32) and the replicated analysis showed consistent results (OR 1.17, 95% CI 1.05–1.30). Besides, there was no heterogeneity and horizontal pleiotropy observed both in the primary and replicated analysis. Further multivariable MR suggested that the causal relationships between OSA and AF exist independently of BMI and CAD. The MVMR result after the adjustment for hypertension is similar in magnitude and direction to the univariable MR. But it did not support a causal relationship between OSA and AF.

Conclusion

Our study found that genetically driven OSA causally promotes AF. This causal relationship sheds new light on taking effective measures to prevent and treat OSA to reduce the risk of AF.
The Effect of Endometrial Thickness on Pregnancy, Maternal, and Perinatal Outcomes of Women in Fresh Cycles After IVF/ICSI: A Systematic Review and Meta-Analysis
Authors: Liao Zhiqi , Liu Chang , Cai Lei , Shen Lin , Sui Cong , Zhang Hanwang , Qian Kun
Published: February 2022

Background

Thin endometrium on ovulation triggering day is associated with impaired pregnancy outcomes in women after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), but the role of thick endometrium on pregnancy outcomes remains controversial. Moreover, there has been insufficient evidence currently to analyze the influence of endometrial thickness (EMT) on obstetric complications and perinatal outcomes. Thus, we performed this meta-analysis to evaluate the effect of EMT on pregnancy, maternal, and perinatal outcomes in an enlarged sample size.

Methods

The databases Pubmed, Embase, Cochrane Libraries, and Web of Science were searched for English articles evaluating the correlation between EMT and pregnancy, maternal, or perinatal outcomes in women who underwent IVF/ICSI. We included studies that depicted a clear definition of outcomes and EMT grouping on ovulation triggering day. The EMT effect was analyzed in fresh cycle. Qualities of studies were assessed by the Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) and weighted mean difference (WMD) with 95% confidence intervals (CIs) were calculated for analyzing dichotomous and continuous outcomes respectively, under a fixed or random effect model.

Results

A total of 22 pieces of literature were included for the final meta-analysis. A decreased trend towards pregnancy outcomes was observed, such as live birth rate (LBR), clinical pregnancy rate (CPR), and implantation rate (IR) in the thin endometrium groups (EMT <7 mm). In contrast, thick endometrium (EMT >14 mm) had no effect on pregnancy outcomes compared to medium EMT groups (EMT 7–14 mm). Moreover, thin endometrium (EMT <7.5 mm) enhanced the incidence of hypertensive disorders of pregnancy (HDP) and small-for-gestational-age (SGA) infants, and decreased the birthweight (BW) of babies.

Conclusions

Our studies indicated that thin endometrium not only had detrimental effect on pregnancy outcomes, but also increased the risk of HDP in women and SGA of babies, or decreased BW of babies. The thick endometrium does not have an adverse effect on IVF outcomes. Therefore, patients need to be informed on possible obstetric complications and perinatal outcomes caused by thin endometrium and are encouraged to actively cooperate with perinatal care.

Systematic Review Registration

(https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=242637), identifier CRD42021242637.
Type 1 Diabetes Patients With Different Residual Beta-Cell Function but Similar Age, HBA1c, and Cardiorespiratory Fitness Have Differing Exercise-Induced Angiogenic Cell Mobilisation
Authors: Taylor Guy S. , Shaw Andy , Scragg Jadine H. , Smith Kieran , Campbell Matthew D. , McDonald Timothy J. , Shaw James A. , Ross Mark D. , West Daniel J.
Published: February 2022

Background

Many individuals with type 1 diabetes retain residual beta-cell function. Sustained endogenous insulin and C-peptide secretion is associated with reduced diabetes related complications, but underlying mechanisms remain unclear. Lower circulating numbers of endothelial and hematopoietic progenitor cells (EPCs and HPCs), and the inability to increase the count of these cells in response to exercise, are also associated with increased diabetes complications and cardiovascular disease. It is unknown whether residual beta-cell function influences HPCs and EPCs. Thus, this study examined the influence of residual beta-cell function in type 1 diabetes upon exercise-induced changes in haematopoietic (HPCs) and endothelial progenitor cells (EPCs).

Methods

Participants with undetectable stimulated C-peptide (n=11; Cpepund), 10 high C-peptide (Cpephigh; >200 pmol/L), and 11 non-diabetes controls took part in this observational exercise study, completing 45 minutes of intensive walking at 60% V˙O2peak. Clinically significant HPCs (CD34+) and EPCs (CD34+VEGFR2+) phenotypes for predicting future adverse cardiovascular outcomes, and subsequent cell surface expression of chemokine receptor 4 (CXCR4) and 7 (CXCR7), were enumerated at rest and immediately post-exercise by flow cytometry.

Results

Exercise increased HPCs and EPCs phenotypes similarly in the Cpephigh and control groups (+34-121% across phenotypes, p<0.04); but Cpepund group did not significantly increase from rest, even after controlling for diabetes duration. Strikingly, the post-exercise Cpepund counts were still lower than Cpephigh at rest.

Conclusions

Residual beta-cell function is associated with an intact exercise-induced HPCs and EPCs mobilisation. As key characteristics (age, fitness, HbA1c) were similar between groups, the mechanisms underpinning the absent mobilisation within those with negative C-peptide, and the vascular implications, require further investigation.