bluuebunny/crossref_metadata_2025 huggingface dataset:
C50. Obstructive hypertrophic cardiomyopathy in young adult man: a case report
Authors: Sinaga A , Ardini T W , Lubis A C , Hasan H
Published: April 2022

Background

Hypertrophic obstructive cardiomyopathy (obstructive HCM) is an autosomal dominant congenital disease characterized by obstruction of the left ventricular outflow tract with asymmetric septal hypertrophy. Obstructive HCM is predispose to the appearance of malignant ventricular arrhythmias, leading to syncope or sudden death.

Case Description

A 25-years-old male patient came to the hospital with chief complaint intolerance activity and previous syncope, without history of sudden cardiac death in his family member. ECG showed sinus rhytm with left axis deviation and left ventricular hypertrophy. Chest x ray showed cardiomegaly. The echocardiography showed asymmetric septal hypertrophy (septal/posterior wall thickness ratio 1.31), left atrium dilatation (LAVi 94.2 mL/m2), SAM and mild mitral regurgitation, mild aortic regurgitation, hyperdynamic ejection fraction (79%) with lower longitudinal strain values in basal and mid ventricular septal segment, grade I diastolic dysfunction, resting LVOT gradient 19.53 mmHg , provoked LVOT gradient 47.31 mmHg.

Discussion

Non-invasive treatment was given due to LVOT gradient below 50 mmHg. The patient prescribed diltiazem 100mg once daily and recommended clinical evaluation follow-up every year or any worsening of symptoms. The other family member suggested for familial screening echocardiography.
C51. Impending Rupture in Acute Type A Aortic Dissection : Case Report
Authors: Santoso Anita Surya , Sargowo Djanggan , Kurnianingsih Novi
Published: April 2022

Background

Acute aortic dissection is a life threatening condition that remains a challenge to diagnose and treat. 67% patients was presented with Acute type A aortic dissection (ATAAD) and often accompanied with some complications.

Case Summary

A 40-year-old male with risk factor hypertension was presented with sudden sharp tearing-like chest pain and radiating to the back 3 hours before admission. He had transient decrease of consciousness and waken up spontaneously. He was compos mentis, with normal JVP, normal heart sound, no pulsus deficit, hypotension, cold acral and oliguria. He got fluid rehydration and the BP was stabilized. Haemoglobin was normal with increase D-Dimer. The ECG was normal and chest radiography revealed cardiomegaly and widening mediastinum. From eyeballing echocardiogram showed moderate pericardial effusion without right atrial and right ventricle collapse. A CT scan angiography was performed and revealed an Aortic Dissection Stanford A Debakey I.

Discussion

The development of an evidence-based strategy to rule out aortic dissection in patients presenting chest pain would be useful to diagnose patients with chest pain. Rapid diagnosis of dissection is most likely when CT is a part of the diagnostic testing. Hypotension and shock occurred in > 25% of patients with type ATAAD and in this patient was associated transient loss of consciousness. This patient was in impending rupture condition. The definitive treatment for this patient was emergency aortic repair surgery. We was succeded to stabilize the patient then referred to a cardiothoracic surgeon in 24 hours later.
C56. Isolated Right Ventricular Non-Compaction Cardiomyopathy (IRVNC) in Adolescence: A Case Report
Authors: Fernandes R , Lukito A A , Chandra S , Hutabarat H
Published: April 2022

Background

Non-compaction ventricular myocardium (NCVM) is a rare genetic cause of cardiomyopathy which mostly affects the left ventricle. A limited case of IRVNC was reported which render a limited knowledge for clinician.

Case Summary

A 16-y.o male presented to our emergency unit with recurrent syncope, chest discomfort, palpitation which exaggerated by strenuous exercise. There was no familial history of sudden death. On admission, BP of 102/64 mmHg and bradycardia of 49 bpm were remarkable. Electrocardiography revealed sinus arrhythmia, 49 bpm with early repolarization on precordial leads and LVH. Laboratory tests were in normal limits. Echocardiography revealed hyper-trabeculated RV with no LV-dysfunction. CMR was performed and showed normal LV dimension and function. Right atrium and RV were dilated with RV-dysfunction. RV trabeculae were indicative for IRVNC (NC/C ratio of 4.3). Holter ECG monitoring was done and remarkable for sinus arrhythmia without sinus pause nor ventricular arrhythmia.

Anticoagulant was given for embolic prevention in the non-compacted area. ACEi, β-blockers, and diuretic were not given due to hypotension, bradycardia and no signs of congestion. The patient showed clinical improvement and discharged after 5 days of hospitalization.

Discussions

Recently, there has been no specific criteria and cut off for IRNVC. Earlier studies mentioned that ILVNC criteria could be used for diagnosing IRNVC, as we used in our case. In the future, it’s necessary to determine new cut off points dedicated for IRVNC. Furthermore, close follow-up is needed as complications such as arrhythmia, embolic events and heart failure might occurred.
C63. Myocardial bridging on coronary angiography: an innocent bystander or a culprit in myocardial infarction?
Authors: Reeiner M , Aryadana W , Sutanegara B A P D , Artha I M J R
Published: April 2022

Myocardial bridging is one of the nonatherosclerotic causes of coronary artery disease and is characterized by muscles overlying the intramyocardial course of a major epicardial coronary artery segment, leading to systolic compression. This condition is usually benign but can be associated with unstable angina, myocardial infarction, and death. We report herein a myocardial infarction associated with a subtotal systolic narrowing of the LAD by a myocardial bridge. A 57-year-old-man with chronic heart failure caused by myocardial bridging post-non-ST elevation myocardial infarction and hypertensive heart disease. The electrocardiography showed sinus rhythm, echocardiography shows normal left and right ventricular function, regional wall motion abnormality, grade I diastolic dysfunction and “milking effect” was observed in the mid-segment of the left anterior descending coronary artery on the coronary angiogram. Schwarz type C is categorized in this case, β-blockers and calcium channel blockers remain the mainstay of treatment and relieve hemodynamic disorders caused by myocardial bridging by decreasing heart rate, increasing the period of diastolic coronary filling, and decreasing coronary artery contractility and compression. Other diagnostic modalities needed if symptoms persist despite optimal medical therapy and myotomy, coronary artery bypass graft, or stent implantation can be considered in these patients. At the six-month follow-up visit, the patient had no acute coronary syndrome event, but chest pain and heart failure were felt occasionally.
C65. Pace and Ablate as an Alternative Approach for Rate Control Strategy in Patient with Atrial Fibrillation
Authors: Hazzy Fandy , Rizal Ardian
Published: April 2022

Background

AF patient with refractory to optimal medical therapy for rate or rhythm control, atrioventricular (AV) nodal ablation with permanent pacemaker (PPM) implantation is an effective strategy for symptomatic relief. Maintenance of controlled ventricular rate helps to avoid frequent exacerbations of CHF and tachycardia-mediated cardiomyopathy, and is also associated with improved quality of life.

Case Summary

Female 66-year-old suffered from Heart Failure exacerbations caused by paroxysmal AF with rapid ventricular response (RVR) with underlying hypertensive cardiovascular disease. Rhythm control strategy with drip Amiodarone induce sinus bradycardia with unstable hemodynamic, when drugs was stopped then AF RVR reappeared, we tried to rate control strategy with Digoxin but, she experienced same condition as before. She underwent a pragmatical technique AV nodal ablation with cardiac pacing for rate control and she had drastic improvement of symptoms within the next 24 h. Complete AV block was achieved after application of 2 radiofrequency energies over the anatomic AV node. A permanent pacemaker (PPM) was programmed to VVIR at the rate of 70 bpm.

Discussion

Conventional medical therapies, including beta-blockers, non-dihydropyridine calcium channel blockers, digoxin, and anti-arrhythmic drugs, may fail to control the ventricular rate. Atrioventricular junction ablation and pacing (AVJAP) can be applied for patients whom medication is inadequate or associated with side effects (Recommendation IIA). According to our case, AVJAP is possible but an attractive choice for some elderly patients who are not compliant with treatment or associated with dangerous side effect for patients.
C69. Percutaneous Balloon Pulmonary Valvuloplasty for Critical Pulmonary Stenosis Baby as A Challenging Management in Resource-Limited Hospital: A Case Report
Authors: Sitio M , Santoso A S , Iskandar  , Widasmara S , Koentartiwi D , Yogibuana V , Martini H
Published: April 2022

Background

Severe or critical right ventricular outflow tract obstructions are life-threatening conditions. Percutaneous balloon pulmonary valvuloplasty is the preferred therapy for pulmonary valve stenosis.

Case Summary

A-50-day-old cyanotic baby girl, weighing 4.4 kg, was admitted to hospital with a bluish appearance insidiously progressing over the preceding 2 weeks. Transthoracic echocardiogram (TTE) revealed critical pulmonary valvular stenosis with pulmonary valve annulus diameter 7 mm, severe tricuspid regurgitation (TR), restrictive intraatrial mixing physiology, and an almost spontaneously closed Patent Ductus Arteriosus. The patient underwent percutaneous balloon pulmonary valvuloplasty (BPV). The available balloon, Tyshak mini balloon 9.0 mm x 20 mm, failed to across stenotic lession. It was replaced with coronary balloon 2 mm x 10 mm and inflated several times with a maximum pressure of 10 mmHg within 10 seconds. After the valve was adequately opened, the coronary balloon was replaced by previous Tyshak mini balloon. It was inflated once with pressure of 3 mmHg for 5 seconds. Successful dilatation is indicated by the disappearance of the waist around the balloon under cineangiography. RV-PA gradient decreased from 67 mmHg to 38 mmHg, a 43% reduction. After the procedure, the patient was no longer cyanotic. TTE after BPV demonstrated no pulmonary stenosis, TR TVG decreased from 100 mmHg to 20 mmHg, and no pulmonary regurgitation.

Discussion

Our successful results suggest that percutaneous balloon pulmonary valvuloplasty is a potential and safe intervention for babies with critical Pulmonal Stenosis that was conducted in resource-limited hospital.
C74. Post covid-19 cardiomyopathy in an adolescent patient: a case report
Authors: Pujowaskito P , Tartila T S , Tafriend N A , Jannah F D K
Published: April 2022

Background

Myocardial injury caused by viral myocarditis may occur during COVID-19 infections. This condition may lead to cardiomyopathy as the chronic sequela. We report a case of an adolescent COVID-19 survivor without underlying heart disease presented with dilated cardiomyopathy. 

Case Summary

A 16-year-old male patient was referred to Cardiology Outpatient Clinic, Indonesian Army Central Hospital Gatot Soebroto. The patient presented with a chief complaint of fatigue and just recovered from mild to moderate COVID-19 one month before the visit. There was no prior history of heart disease. Physical examination was within normal limit, but laboratory findings showed highly elevated NT-proBNP (7705 pg/mL) and D-dimer (1850 ng/mL). ECG revealed normal sinus rhythm with poor R wave progression. Echocardiography detected all chamber dilatation, eccentric left ventricular hypertrophy, global hypokinetic, moderate mitral regurgitation, and reduced ejection fraction (22%). The patient was diagnosed with new-onset dilated cardiomyopathy as a COVID-19 sequela and we initiated treatment with ARB (candesartan), beta-blocker (bisoprolol), diuretics (furosemide and spironolactone), rivaroxaban, and trimetazidine. During a follow-up visit three months later, the patient’s recovery was stable.

Discussion

 The occurrence of new-onset cardiomyopathy in our previously healthy young patient highlights the possible mechanism of COVID-19 as a single cause of myocardial injury without underlying heart disease. Comprehensive evaluation and optimal treatment should be taken during hospitalization and post-discharge period to prevent further complications. Additional examinations such as cardiac magnetic resonance and endomyocardial biopsy should be done to provide definitive confirmation.
C78. Prosthetic valve thrombosis in uncontrolled internormalized ratio ended up with disaster on prosthetic valve surgary : a barrier of anticoagulant management in rural area
Authors: Hustiar M , Nadia  , Heriansyah T , Purnawarman A
Published: April 2022

Background

Mechanical prosthetic valve thrombosis (PVT) is a life-threatening complication that requires immediate intervention. With current prosthetic devices and aggressive prophylactic anticoagulation, the incidence of PVT remains low. It needs monitoring of international normalized ratio (INR), which is somewhat difficult to do in rural areas such as West Aceh due to geography. This report details the case of a woman with PVT who developed heart failure after a period of suboptimal anticoagulation.

Case Summary

We described a 51-year-old woman who had undergone coronary artery bypass graft and mitral valve replacement procedure in 2017. Her physical examination showed the decrease of the prosthetic click sound and lung congestion. From her blood examination, the INR was subtherapeutic. A thrombus was detected on the prosthetic mitral valve by transoesophageal echocardiography. She had history of uncontrolled INR because the patient do not routinely checked her blood to control the optimal dose of anticoagulant. The patient underwent reoperation for mechanical valve thrombosis but unfortunately in the end the patient died at the procedure.

Discussion

In patients undergoing mechanical heart valve replacement, time in therapeutic range of targeted INR should be ≥ 70 % otherwise it will increase in risk of thromboembolic events. However, in developing countries which have remote areas, repeated examination of the use of warfarin in obtaining the INR target is still a major challenge. Conversely, serious risks can occur if this is not achieved and might be ended up with disaster toward the patient.
C82. Rare electrocardiography findings of Wellen’s Type A evolving into Type B on late onset Myocardial Infarction: A Case Report
Authors: Achmad R M P , Madiastuti Septi , Nadia Ina , Widyantoro Bambang
Published: April 2022

Background

Wellens' Syndrome is a left anterior descending (LAD) coronary artery disease which first described in 1982 by de Zwaan et al. A byphasic T or deeply inverted T are the typical Wellen's electrocardiogram (ECG) changes which represent a critical stenosis. It may be presented without any typical symptoms, and normal or mildly elevated enzymes depends on its onset.

Case Summary

A 56-years-old male, admitted to ER with typical chest pain within 1 day. The first ECG showed byphasic T wave on V2 and V3, and an hour serial ECG showed a deeply inverted T wave on V2 and V3. Cardiac marker showed an elevated Troponin I levels of 1,590.6 ng/L. The patient was diagnosed with acute NSTEMI and underwent an early invasive strategy on the next day. Coronary angiography revealed total occlusion of the proximal LAD, and implantation of drug eluting stent was done accordingly. The patient remained symptoms-free after the procedure and discharged in stable condition.

Discussion

This patient suffering a left coronary total occlusion with no appearance of any ST-elevation on ECG. Therefore, a critical stenosis does not always came up with a typical ST-segment changes. Wellen’s type ECG showed how the T waves evolution would represent a critical stenosis. Early recognition of Wellen's typical ECG in this patient lead to early invasive strategy decision and later resulted a good outcome.
C84. Resistent Hypertension in Young Patient, what has Been Missed? A Case Report of Coartation of the Aorta
Authors: Hartoko A , Sulastomo H
Published: April 2022

Background

In children and adolescent patient the most common cause hypertension is secondary due to renal disease. There are other cause of secondary hypertension including Coartation of the Aorta (CoA). Early diagnosis and prompt treatment are important for CoA, if left untreated CoA can causes ventricular hypertrophy, premature coronary artery disease and eventually heart failure.

Case Illustration

A 17 Years old patient with history of hypertension since the age of 12. He was suspected secondary hypertension due to renal disease and referred to pediatric nephrologist. Laboratory examination and CT angiography renal artery showed normal result. He was treated with multiple antihypertensive drugs, but remains hypertensive despite of medical therapy for 5 years.

He was referred to our hospital due to resistant hypertension. At physical examination this patient revealed blood pressure at upper 150/90 and lower extremities 100/60. Echocardiography examination and CT angiography showed Left Ventricle Hypertrophic (LVH) with coartation aorta located distal to left subclavian artery. Thoracic Endovascular Repair (TEVAR) was performed to dilated the coartation in this patient. Post TEVAR procedure peak systolic gradient reduced from 51 mmHg to 4 mmHg.

Discussion

CoA are one of the causes of secondary hypertension. Uncommonly resistant hypertension can occur in CoA. Early diagnosis and prompt treatment are important for CoA. In this patient the CoA already caused LVH, and if left untreated it can lead more severe complication such as heart failure, and premature coronary artery disease and death.
C97. The Important Role of Manual Aspiration through Guiding Catheter after Percutaneous Mechanical Thrombectomy (Angiojet) in Patient with Subacute Limb Ischemia due to Essential Thrombocytosis
Authors: A Ramadhani , H Hariawan , MT Ismail , VY Anggraeni
Published: April 2022

Background

Essential thrombocytosis (ET) is a myeloproliferative neoplasm characterized by increased platelet counts and excessive large and morphologically mature megakaryocytes in the bone marrow. ET may be complicated by thrombotic events, mostly in small and medium vessel. However there are limited evidence to guide management, particularly in cases with acute tissue ischemia. Understanding the basic pathophysiology concept of thrombosis in patient with ET is vital in choosing the right modality for revascularization.

Case Summary

A 73-year-old female with history of essential thrombocytosis presenting with severe debilitating pain on her right lower extremity. Physical examination showed decreased peripheral oxygen saturation. Dupplex Ultrasound revealed total thrombus at femoral artery dextra and no flow at popliteal artery, anterior and posterior tibial artery. We decided to perform revascularization with percutaneous mechanical thrombectomy (Angiojet). Arteriography evaluation still showing abundant number of thrombus. We continued with manual aspiration using guiding catheter and showing a remarkable result with normal blood flow down to the distal part with minimal residual thrombus.

Discussion

Histopatbological evaluations of arterial thrombi in ET revealed platelet-rich clots with abundant von Willebrand factor (VWF) and very little fibrin. Hence tllrombolysis agent used in CDT will not effective. Large thrombus which can not be lysed by fibrinolytic should be evacuated by a larger hole catheter aspiration
Controllability of switched Hilfer neutral fractional dynamic systems with impulses
Authors: Kumar Vipin , Kostić Marko , Tridane Abdessamad , Debbouche Amar
Published: April 2022

The aim of this work is to investigate the controllability of a class of switched Hilfer neutral fractional systems with non-instantaneous impulses in the finite-dimensional spaces. We construct a new class of control function that controls the system at the final time of the time-interval and controls the system at each of the impulsive points i.e. we give the so-called total controllability results. Also, we extend these results to the corresponding integro-system. We mainly use the fixed point theorem, Laplace transformation, Mittag-Leffler function, Gramian type matrices and fractional calculus to establish these results. In the end, we provide a simulated example to verify the obtained analytical results.
‘I'm usually being my own doctor’: women's experiences of managing polycystic ovary syndrome in Canada
Authors: Ismayilova Miya , Yaya Sanni
Published: April 2022

Background

Polycystic ovary syndrome (PCOS) is a complex, chronic condition characterized by anovulation, polycystic ovarian morphology and hyperandrogenism that requires lifelong management. To reduce the risk of comorbidity and to manage symptoms, lifestyle management and pharmaceuticals such as oral contraceptives are the most common forms of treatment and should be tailored to the individual patient. The literature to date has shown PCOS patients to experience widespread dissatisfaction with the amount and quality of information they receive from providers, along with lower levels of trust in physicians. Little is known about the lived experiences of women managing PCOS in Canada, across age groups.

Methods

In-depth remote interviews explored women's lived experiences managing PCOS and the barriers and facilitators they encountered in their management journeys. Data were analyzed using thematic analysis and interpretive description methodology.

Results

Twenty-five in-depth, telephone interviews conducted with participants (aged 18–63 y) across Canada revealed participants lacking sufficient information and guidance from physicians, especially in primary care. Areas in need of more guidance included lifestyle management and mental health. Lack of empathy and weight bias among physicians were also perceived by participants. Older participants received little guidance on treatment options postmenopause. Loss of trust and withdrawal from seeking medical care were prominent themes, along with greater self-reliance on self-management, including self-educating and self-experimenting with treatments.

Conclusions

Most women in this study were frustrated with the level of involvement and information provision from their doctors. Key recommendations are identified for the provision of care to younger and older patients with PCOS. Improved education for physicians may be needed to improve the quality of healthcare provision for PCOS.
Global and regional burden and quality of care of non-rheumatic valvular heart diseases: a systematic analysis of Global Burden of Disease 1990–2017
Authors: Nejad Mehrabi , Ahmadi Naser , Mohammadi Esmaeil , Shabani Mahya , Sherafati Alborz , Aryannejad Armin , Rezaei Negar , Ghanbari Ali , Yoosefi Moein , Aminorroaya Arya , Shabani Mahsima , Rezaei Nazila , Salavati Tina , Larijani Bagher , Naderimagham Shohreh , Farzadfar Farshad
Published: April 2022

Background

With an increase in the incidence and prevalence of non-rheumatic valvular heart diseases (NRVHDs), having a proper understanding of the disease current status in terms of quality of care and healthcare access can considerably affect further planning for the healthcare system.

Objective

In this study, we aimed to evaluate and compare the quality and equity of care concerning NRVHDs in terms of gender and sociodemographic index (SDI) using a newly proposed index.

Methods

We obtained the primary measures (e.g. incidence) from the Global Burden of Disease (GBD) data about NRVHD from 1990 to 2017 to calculate the subsequent secondary indices (e.g. mortality-to-incidence ratio) with close association to quality of care. Then, using principal component analysis (PCA), quality of care index (QCI) was calculated as a novel index from the secondary indices, rescaled to 0–100. QCI was calculated for all age groups and both genders, globally, regionally and nationally between 1990 and 2017.

Results

Globally, the QCI for NRVHDs in 2017 was 87.3, and it appears that gender inequity was unremarkable (gender disparity ratio = 1.00, female QCI: 90.2, male QCI: 89.7) in 2017 similar to the past three decades. Among WHO world regions, the Western Pacific Region and Eastern Mediterranean Region showed the highest (90.1) and lowest (74.0) QCI scores. Regarding SDI, the high-middle-SDI quintile with a QCI of 89.4 and the low-SDI quintile with a QCI of 77.8 were the two extremes of healthcare quality in 2017.

Conclusion

Although global status regarding the NRVHD’s quality of care is acceptable, higher attention is required for lower SDI countries.
I've Got a Feeling: Leaders, Summits, and Reassurance
Authors: Kydd Andrew H
Published: April 2022

Students of international summit diplomacy argue that personal, face-to-face interaction between national leaders is an important factor in building trust between states. The generation of personal impressions is held to be a nonrational process driven by instinct, psychology, or the structure of the brain. However, actors may still respond to these impressions rationally. I present a model of how leaders should respond to their impressions at summits. Some implications are that attending summits may be reassuring if they are costly and trustworthy types can get good impressions of each other and then cooperate, but that mistaken impressions can also form that can lead to exploitation of trustworthy types by untrustworthy types. I illustrate the model with reference to the summits in Singapore and Hanoi between US President Donald Trump and North Korean leader Kim Jong-un.
Arabidopsis alkaline ceramidase ACER functions in defense against insect herbivory
Authors: Huang Li-Qun , Li Ping-Ping , Yin Jian , Li Yong-Kang , Chen Ding-Kang , Bao He-Nan , Fan Rui-Yuan , Liu Hao-Zhuo , Yao Nan
Published: April 2022

Plant sphingolipids are important membrane components and bioactive molecules in development and defense responses. However, the function of sphingolipids in plant defense, especially against herbivores, is not fully understood. Here, we report that Spodoptera exigua feeding affects sphingolipid metabolism in Arabidopsis, resulting in increased levels of sphingoid long-chain bases, ceramides, and hydroxyceramides. Insect-induced ceramide and hydroxyceramide accumulation is dependent on the jasmonate signaling pathway. Loss of the Arabidopsis alkaline ceramidase ACER increases ceramides and decreases long-chain base levels in plants; in this work, we found that loss of ACER enhances plant resistance to S. exigua and improves response to mechanical wounding. Moreover, acer-1 mutants exhibited more severe root-growth inhibition and higher anthocyanin accumulation than wild-type plants in response to methyl jasmonate treatment, indicating that loss of ACER increases sensitivity to jasmonate and that ACER functions in jasmonate-mediated root growth and secondary metabolism. Transcript levels of ACER were also negatively regulated by jasmonates, and this process involves the transcription factor MYC2. Thus, our findings reveal that ACER is involved in mediating jasmonate-related plant growth and defense and that jasmonates function in regulating the expression of ACER.
Two years of optical and NIR observations of the superluminous supernova UID 30901 discovered by the UltraVISTA SN survey
Authors: Hueichapan E D , Contreras C , Cartier R , Lira P , Sanchez-Saez P , Milvang-Jensen B , Fynbo J P U , Anderson J P , Hamuy M
Published: April 2022

We present deep optical and near-infrared photometry of UID 30901, a superluminous supernova (SLSN) discovered during the UltraVISTA survey. The observations were obtained with VIRCAM (YJHKs) mounted on the VISTA telescope, DECam (griz) on the Blanco telescope, and SUBARU Hyper Suprime-Cam (HSC; grizy). These multiband observations comprise +700 d making UID 30901 one of the best photometrically followed SLSNe to date. The host galaxy of UID 30901 is detected in a deep HST F814W image with an AB magnitude of 27.3 ± 0.2. While no spectra exist for the SN or its host galaxy, we perform our analysis assuming z = 0.37, based on the photometric redshift of a possible host galaxy found at a projected distance of 7 kpc. Fitting a blackbody to the observations, the radius, temperature, and bolometric light curve are computed. We find a maximum bolometric luminosity of 5.4 ± 0.34 × 1043 erg s−1. A flattening in the light curve beyond 600 d is observed and several possible causes are discussed. We find the observations to clearly favour an SLSN type I, and plausible power sources such as the radioactive decay of 56Ni and the spin-down of a magnetar are compared to the data. We find that the magnetar model yields a good fit to the observations with the following parameters: a magnetic field B = 1.4 ± 0.3 × 1014 G, spin period of P = 6.0 ± 0.1 ms, and ejecta mass $M_{\mathrm{ ej}} = 11.9^{+4.8}_{-6.4} \,\mathrm{ M}_{\odot }$.
Epigenetic regulation of epithelial to mesenchymal transition: a trophoblast perspective
Authors: Choudhury Jaganmoy , Pandey Deepak , Chaturvedi Pradeep Kumar , Gupta Surabhi
Published: April 2022

Epigenetic changes alter the expression of genes at both pre- and post-transcriptional levels without changing their DNA sequence. Accumulating evidence suggests that such changes can modify cellular behavior and characteristics required during development and in response to various extracellular stimuli. Trophoblast cells develop from the outermost trophectoderm layer of the blastocyst and undergo many phenotypic changes as the placenta develops. One such phenotypic change is differentiation of the epithelial natured cytotrophoblasts into the mesenchymal natured extravillous trophoblasts. The extravillous trophoblasts are primarily responsible for invading into the maternal decidua and thus establishing connection with the maternal spiral arteries. Any dysregulation of this process can have adverse effects on the pregnancy outcome. Hence, tight regulation of this epithelial–mesenchymal transition (EMT) is critical for successful pregnancy. This review summarizes the recent research on the epigenetic regulation of the EMT occurring in the trophoblast cells during placental development. The functional significance of chemical modifications of DNA and histone, which regulate transcription, as well as non-coding RNAs, which control gene expression post-transcriptionally, is discussed in relation to trophoblast biology.
God, God’s Perfections, and the Good: Some Preliminary Insights from the Catholic-Hindu Encounter
Authors: S. J. Francis X Clooney
Published: April 2022

There are good reasons for envisioning a global discourse about God, premised necessarily agreed upon perfections considered to be by definition proper to God, and for thinking through the implications of our understanding of God for morality. Philosophically, it makes sense to hold that claims about omnipotence, omniscience, and other superlative perfections are indeed maximal, and define “God” wherever the terminology of divine persons is taken up. Religiously too, it makes sense to assert that a deity possessed of perfections is not just the deity of one’s own tribe or religion, but also the deity of the whole world, whether acknowledged as such or not. This essay delves into the larger set of rich complexities by three moves. First, I look into a single extended historical case of the extension of the discourse about God beyond the Christian West, the discourse on God proffered by Western Jesuit missionaries in India from the sixteenth to twentieth centuries. Second, I place next to that Jesuit learning the instance of a famed Hindu theologian’s discourse on God, God’s perfections, and their moral implications. Third, I briefly step back and assess the dangers and fruitful prospects inherent in thinking about God and morality in an interreligious context.
Survival, symptoms and hospitalization of older patients with advanced chronic kidney disease managed without dialysis
Authors: Chou Angela , Li Chenlei , Farshid Sanjay , Hoffman Anna , Brown Mark
Published: April 2022

Background

Shared decision-making (SDM) is important when considering whether an older patient with advanced chronic kidney disease (CKD) should be managed with dialysis or conservative kidney management (CKM). Physicians may find these conversations difficult because of the relative paucity of data on patients managed without dialysis.

Methods

This prospective observational study was conducted in a unit supported by a multidisciplinary Kidney Supportive Care (KSC) programme, in a cohort of 510 patients (280 CKM and 230 dialysis) ≥65 years of age with CKD stages 4 and 5. Survival was evaluated using logistic regression and Cox proportional hazards models. Linear mixed models were utilized to assess symptoms over time.

Results

CKM patients were older (mean 84 versus 74 years; P < .001) and almost 2-fold more likely to have three or more comorbidities (P < .001). The median survival of CKM patients was lower compared with dialysis from all time points: 14 months [interquartile range (IQR) 6–32] versus 53 (IQR 28–103) from decision of treatment modality or dialysis start date (P < .001); 15 months (IQR 7–34) versus 64 (IQR 30–103) from the time the estimated glomerular filtration rate (eGFR) was ≤15 mL/min/1.73 m2 (P < .001); and 8 months (IQR 3–18) versus 49 (19–101) from eGFR ≤10 mL/min/1.73 m2. A total of 59% of CKM patients reported an improvement in symptoms by their third KSC clinic visit (P < .001). The rate of unplanned hospitalization was 2-fold higher in the dialysis cohort.

Conclusions

CKM patients survive a median of 14 months from the time of modality choice and have a lower rate of hospitalization than dialysis patients. Although the symptom burden in advanced CKD is high, most elderly CKM patients managed through an integrated KSC programme and can achieve improvement in their symptoms over time. These data might help with SDM.
Attentional Bias in Non–Smoking Electronic Cigarette Users: An Eye-Tracking Study
Authors: Fitzpatrick Chelsea L , Kim Hyoun S , Sears Christopher R , McGrath Daniel S
Published: April 2022

Introduction

This study examined attentional bias (AB) to e-cigarette cues among a sample of non–smoking daily e-cigarette users (n = 27), non–smoking occasional e-cigarette users (n = 32), and control participants (n = 61) who did not smoke or use e-cigarettes. The possibility that e-cigarette users develop a transference of cues to traditional cigarettes was also examined.

Methods

AB was assessed using a free-viewing eye-gaze tracking methodology, in which participants viewed 180 pairs of images for 4 seconds (e-cigarette and neutral image, e-cigarette and smoking image, smoking and neutral image).

Results

Daily and occasional e-cigarette users attended to pairs of e-cigarette and neutral images equally, whereas non–users attended to neutral images significantly more than e-cigarette images. All three groups attended to e-cigarette images significantly more than smoking images, with significantly larger biases for e-cigarette users. There were no between-group differences in attention to pairs of smoking and neutral images. A moderation analysis indicated that for occasional users but not daily users, years of vaping reduced the bias toward neutral images over smoking images.

Conclusions

Taken together, the results indicate that the e-cigarette users exhibit heightened attention to e-cigarettes relative to non–users, which may have implications as to how they react to e-cigarette cues in real-world settings. AB for e-cigarettes did not transfer to traditional cigarette cues, which indicates that further research is required to identify the mechanisms involved in the migration of e-cigarettes to traditional cigarettes.

Implications

This study is the first attempt to examine attentional biases for e-cigarette cues among non–smoking current e-cigarette users using eye-gaze tracking. The results contribute to the growing literature on the correlates of problematic e-cigarette use and indicate that daily and occasional e-cigarette use is associated with attentional biases for e-cigarettes. The existence of attentional biases in e-cigarette users may help to explain the high rate of failure to quit e-cigarettes and provides support for the utility of attentional bias modification in the treatment of problematic e-cigarette use.
Molecular mechanisms underlying leaf development, morphological diversification, and beyond
Authors: Nakayama Hokuto , Leichty Aaron R , Sinha Neelima R
Published: April 2022

Abstrvact

The basic mechanisms of leaf development have been revealed through a combination of genetics and intense analyses in select model species. The genetic basis for diversity in leaf morphology seen in nature is also being unraveled through recent advances in techniques and technologies related to genomics and transcriptomics, which have had a major impact on these comparative studies. However, this has led to the emergence of new unresolved questions about the mechanisms that generate the diversity of leaf form. Here, we provide a review of the current knowledge of the fundamental molecular genetic mechanisms underlying leaf development with an emphasis on natural variation and conserved gene regulatory networks involved in leaf development. Beyond that, we discuss open questions/enigmas in the area of leaf development, how recent technologies can best be deployed to generate a unified understanding of leaf diversity and its evolution, and what untapped fields lie ahead.
Feeding value of supplemental fat as a partial replacement for steam-flaked corn in diets for Holstein calves during the early growing phase
Authors: Plascencia Alejandro , Latack Brooke C , Carvalho Pedro H V , Zinn Richard A
Published: April 2022

In calf-fed Holstein steers, the early growing phase is characterized by very high relative dry matter intake (DMI) accompanied with lower-than-expected efficiency of energy utilization. Although fat is commonly supplemented in growing–finishing diets, the comparative feeding value has not been investigated during the initial receiving–growing period. Eighty-four Holstein calves (127.7 ± 2.1 kg body weight) were used to evaluate the effects of including 3.5% of supplemental yellow grease (YG) in the diet on characteristics of growth performance and dietary energy utilization of calves during the early growth phase. Morbidity and mortality were not affected by dietary treatments. Yellow grease supplementation did not affect DMI, but tended to increase average daily gain (4.6%; P = 0.07), and increased (P ≤ 0.03) gain efficiency (5.8%) and dietary net energy for maintenance (NEm) and gain (NEg) by 4.1% and 5.3%, respectively. Based on performance data, the estimated NE value of supplemental YG was 4.67 and 3.68 Mcal/kg for NEm and NEg, respectively. These values are consistent with current tabular values assigned for vegetable oils (4.75 and 3.51 Mcal/kg), but markedly less (16.6%) than NEm value assigned for YG (5.60 Mcal NEm/kg; NASEM, 2016. Nutrient requirements of beef cattle. 8th ed. Washington (DC): National Academy Press.).
What moves young people? Applying the risk perception attitude framework to physical activity behavior and cardiometabolic risk
Authors: Napolitano Melissa A , Tjaden Ashley Hogan , Bailey Caitlin P , DiPietro Loretta , Rimal Rajiv
Published: April 2022

Cardiometabolic disease risk factors, including metabolic syndrome and physical inactivity, are prevalent among young adults. However, few young adults are aware of their risk status. The risk perception attitude (RPA) framework was used to categorize participants (n = 456) enrolled in a three-arm randomized controlled weight management trial by their baseline values of cardiometabolic risk perceptions and physical activity self-efficacy. Trial recruitment occurred at two universities from 2015 to 2018 and participants were randomly assigned to one of three weight management interventions: Tailored, Targeted, Control. Cross-sectional and longitudinal analyses were conducted to examine associations between RPA category (i.e., Responsive, Indifferent, Avoidant, Proactive) and physical activity behavior. At baseline, the Responsive group had the highest amount of physical activity (mean [95% CI]: 379.2 [332.6 to 425.8] min/week), the Indifferent group had the lowest (296.7 [261.98 to 331.32] min/week), and the Avoidant/Proactive groups showed intermediate values. Over 6 months, there was a significant interaction between RPA group and intervention arm on change in physical activity adjusted for age, sex, race/ethnicity, baseline body mass index, and baseline moderate-to-vigorous physical activity (p = .017). Among Tailored intervention participants only, the Proactive participants were the only group to have an increase in physical activity (19.97 min/week) and the Indifferent participants had the most significant decrease in physical activity (127.62 min/week). Results suggest the importance of early screening for young adults to help raise awareness of cardiometabolic risk and ultimately support them in health promotion efforts.
Evaluating the use of e-assessment in a first-year pure mathematics module
Authors: Zegowitz Stefanie
Published: April 2022

This article presents the findings of a case study that introduced online quizzes as a form of assessment in pure mathematics. Rather than being designed as an assessment of learning, these quizzes were designed to be an assessment for learning; they aimed to academically support students in their transition from A-Level mathematics to university-level pure mathematics by providing an extrinsic motivation to engage them with their learning material early on and to emphasize the small details within proofs, such as defining notation, which are not necessarily emphasized by written homework assignments. The results obtained during the 2-year study using online quizzes show e-assessment to be a powerful complementary tool to traditional written homework assignments.
Have Paved Trails and Protected Bike Lanes Led to More Bicycling in Atlanta?: A Generalized Synthetic-Control Analysis
Authors: Garber Michael D. , Flanders W. Dana , Watkins Kari E. , Lobelo Felipe , Kramer Michael R. , McCullough Lauren E.
Published: April 2022

Background:

Bicycling is an important form of physical activity in populations. Research assessing the effect of infrastructure on bicycling with high-resolution smartphone data is emerging in several places, but it remains limited in low-bicycling US settings, including the Southeastern US. The Atlanta area has been expanding its bicycle infrastructure, including off-street paved trails such as the Atlanta BeltLine and some protected bike lanes.

Methods:

Using the generalized synthetic-control method, we estimated effects of five groups of off-street paved trails and protected bike lanes on bicycle ridership in their corresponding areas. To measure bicycling, we used 2 years (October 1, 2016 to September 30, 2018) of monthly Strava data in Atlanta’s urban core along with data from 15 on-the-ground counters to adjust for spatiotemporal variation in app use.

Results:

Considering all infrastructure as one joint intervention, an estimated 1.10 (95% confidence interval [CI]: 0.99, 1.18) times more bicycle–distance was ridden than would have been expected in the same areas had the infrastructure not been built, when defining treatment areas by the narrower of two definitions (defined in text). The Atlanta BeltLine Westside Trail and Proctor Creek Greenway had especially strong effect estimates, e.g., ratios of 1.45 (95% CI: 1.12, 1.86) and 1.55 (1.10, 2.14) under each treatment-area definition, respectively. We estimated that other infrastructure had weaker positive or no effects on bicycle–distance ridden.

Conclusions:

This study advances research on the topic because of its setting in the US Southeast, simultaneous assessment of several infrastructure groups, and data-driven approach to estimating effects. See video abstract at, http://links.lww.com/EDE/B936.
Local translation in primary afferents and its contribution to pain
Authors: Gale Jenna R. , Gedeon Jeremy Y. , Donnelly Christopher J. , Gold Michael S.
Published: April 2022

Chronic pain remains a significant problem due to its prevalence, impact, and limited therapeutic options. Progress in addressing chronic pain is dependent on a better understanding of underlying mechanisms. Although the available evidence suggests that changes within the central nervous system contribute to the initiation and maintenance of chronic pain, it also suggests that the primary afferent plays a critical role in all phases of the manifestation of chronic pain in most of those who suffer. Most notable among the changes in primary afferents is an increase in excitability or sensitization. A number of mechanisms have been identified that contribute to primary afferent sensitization with evidence for both increases in pronociceptive signaling molecules, such as voltage-gated sodium channels, and decreases in antinociceptive signaling molecules, such as voltage-dependent or calcium-dependent potassium channels. Furthermore, these changes in signaling molecules seem to reflect changes in gene expression as well as posttranslational processing. A mechanism of sensitization that has received far less attention, however, is the local or axonal translation of these signaling molecules. A growing body of evidence indicates that this process not only is dynamically regulated but also contributes to the initiation and maintenance of chronic pain. Here, we review the biology of local translation in primary afferents and its relevance to pain pathobiology.
Validation of the EDAN SA-10 ambulatory blood pressure monitor in general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard
Authors: Wang Bing , Liu Kui , Li Linyi , Yin Shimin , Ren Jie
Published: April 2022

Objective

To evaluate the accuracy of the EDAN SA-10 oscillometric upper-arm professional office ambulatory blood pressure (BP) monitor in general population according to the Association for the Advancement of Medical Instrumentation (AAMI)/European Society of Hypertension (ESH)/International Organization for Standardization (ISO) Universal Standard (ISO 81060-2:2018).

Methods

Subjects were recruited according to the AAMI/ESH/ISO Universal Standard using the same arm sequential BP measurement method. Four cuffs of the test device were used for arm circumference 16–21.5 cm (extra small), 20.5–28 cm (small), 27–35 cm (medium), and 34–43 cm (large).

Results

A total of 105 subjects were recruited, and 97 subjects were included in the final analysis. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was −0.59 ± 4.04/−1.79 ± 4.39 mmHg (systolic/diastolic). For criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 3.10/3.80 mmHg (systolic/diastolic).

Conclusion

The EDAN SA-10 upper-arm ambulatory BP monitor has passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in general population and can be recommended for clinical use.