bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-Objective Robust Planning Tools
Authors: Zatarain Salazar Jazmin , Castelletti Andrea , Giuliani Matteo
Published: April 2022

Shared water resource systems spark a number of conflicts related to their multi sectorial, regional, and intergenerational use. They are also vulnerable to a myriad of uncertainties stemming from changes in the hydrology, population demands, and climate change. Planning and management under these conditions are extremely challenging. Fortunately, our capability to approach these problems has evolved dramatically over the last few decades. Increased computational power enables the testing of multiple hypotheses and expedites the results across a range of planning alternatives. Advances in flexible multi-objective optimization tools facilitate the analyses of many competing interests. Further, major shifts in the way uncertainties are treated allow analysts to characterize candidate planning alternatives by their ability to fail or succeed instead of relying on fallible predictions. Embracing the fact that there are indeterminate uncertainties whose probabilistic descriptions are unknown, and acknowledging relationships whose actions and outcomes are not well-characterized in planning problems, have improved our ability to perform diligent analysis. Multi-objective robust planning of water systems emerged in response to the need to support planning and management decisions that are better prepared for unforeseen future conditions and that can be adapted to changes in assumptions. A suite of robustness frameworks has emerged to address planning and management problems in conditions of deep uncertainty. That is, events not readily identified or that we know so little about that their likelihood of occurrence cannot be described. Lingering differences remain within existing frameworks. These differences are manifested in the way in which alternative plans are specified, the views about how the future will unfold, and how the fitness of candidate planning strategies is assessed. Differences in the experimental design can yield diverging conclusions about the robustness and vulnerabilities of a system. Nonetheless, the means to ask a suite of questions and perform a more ambitious analysis is available in the early 21st century. Future challenges will entail untangling different conceptions about uncertainty, defining what aspects of the system are important and to whom, and how these values and assumptions will change over time.
Identifying the critical states of complex diseases by the dynamic change of multivariate distribution
Authors: Peng Hao , Zhong Jiayuan , Chen Pei , Liu Rui
Published: April 2022

The dynamics of complex diseases are not always smooth; they are occasionally abrupt, i.e. there is a critical state transition or tipping point at which the disease undergoes a sudden qualitative shift. There are generally a few significant differences in the critical state in terms of gene expressions or other static measurements, which may lead to the failure of traditional differential expression-based biomarkers to identify such a tipping point. In this study, we propose a computational method, the direct interaction network-based divergence, to detect the critical state of complex diseases by exploiting the dynamic changes in multivariable distributions inferred from observable samples and local biomolecular direct interaction networks. Such a method is model-free and applicable to both bulk and single-cell expression data. Our approach was validated by successfully identifying the tipping point just before the occurrence of a critical transition for both a simulated data set and seven real data sets, including those from The Cancer Genome Atlas and two single-cell RNA-sequencing data sets of cell differentiation. Functional and pathway enrichment analyses also validated the computational results from the perspectives of both molecules and networks.
A3D database: structure-based predictions of protein aggregation for the human proteome
Authors: Badaczewska-Dawid Aleksandra E , Garcia-Pardo Javier , Kuriata Aleksander , Pujols Jordi , Ventura Salvador , Kmiecik Sebastian
Published: April 2022

Protein aggregation is associated with many human disorders and constitutes a major bottleneck for producing therapeutic proteins. Our knowledge of the human protein structures repertoire has dramatically increased with the recent development of the AlphaFold (AF) deep-learning method. This structural information can be used to understand better protein aggregation properties and the rational design of protein solubility. This article uses the Aggrescan3D (A3D) tool to compute the structure-based aggregation predictions for the human proteome and make the predictions available in a database form. In the A3D database, we analyze the AF-predicted human protein structures (for over 20.5 thousand unique Uniprot IDs) in terms of their aggregation properties using the A3D tool. Each entry of the A3D database provides a detailed analysis of the structure-based aggregation propensity computed with A3D. The A3D database implements simple but useful graphical tools for visualizing and interpreting protein structure datasets. It also enables testing the influence of user-selected mutations on protein solubility and stability, all integrated into a user-friendly interface.

Availability and implementation

A3D database is freely available at: http://biocomp.chem.uw.edu.pl/A3D2/hproteome. The data underlying this article are available in the article and in its online supplementary material.

Supplementary information

Supplementary data are available at Bioinformatics online.
GMHCC: high-throughput analysis of biomolecular data using graph-based multiple hierarchical consensus clustering
Authors: Lu Yifu , Yu Zhuohan , Wang Yunhe , Ma Zhiqiang , Wong Ka-Chun , Li Xiangtao
Published: April 2022

Motivation

Thanks to the development of high-throughput sequencing technologies, massive amounts of various biomolecular data have been accumulated to revolutionize the study of genomics and molecular biology. One of the main challenges in analyzing this biomolecular data is to cluster their subtypes into subpopulations to facilitate subsequent downstream analysis. Recently, many clustering methods have been developed to address the biomolecular data. However, the computational methods often suffer from many limitations such as high dimensionality, data heterogeneity and noise.

Results

In our study, we develop a novel Graph-based Multiple Hierarchical Consensus Clustering (GMHCC) method with an unsupervised graph-based feature ranking (FR) and a graph-based linking method to explore the multiple hierarchical information of the underlying partitions of the consensus clustering for multiple types of biomolecular data. Indeed, we first propose to use a graph-based unsupervised FR model to measure each feature by building a graph over pairwise features and then providing each feature with a rank. Subsequently, to maintain the diversity and robustness of basic partitions (BPs), we propose multiple diverse feature subsets to generate several BPs and then explore the hierarchical structures of the multiple BPs by refining the global consensus function. Finally, we develop a new graph-based linking method, which explicitly considers the relationships between clusters to generate the final partition. Experiments on multiple types of biomolecular data including 35 cancer gene expression datasets and eight single-cell RNA-seq datasets validate the effectiveness of our method over several state-of-the-art consensus clustering approaches. Furthermore, differential gene analysis, gene ontology enrichment analysis and KEGG pathway analysis are conducted, providing novel insights into cell developmental lineages and characterization mechanisms.

Availability and implementation

The source code is available at GitHub: https://github.com/yifuLu/GMHCC. The software and the supporting data can be downloaded from: https://figshare.com/articles/software/GMHCC/17111291.

Supplementary information

Supplementary data are available at Bioinformatics online.
Social Workers Dealing with Ethical Dilemmas in the Course of Their Professional Work: The Greek Experience
Authors: Chatzifotiou Sevaste , Papouli Eleni
Published: April 2022

Globally, ethical dilemmas are a relatively neglected topic in social work research, despite their obvious importance to ethical professional practice. This study aims to contribute to the existing literature by exploring ethical dilemmas and related issues faced by social workers in Greece. For our purposes, we created an online survey questionnaire via Survey Monkey software and distributed it nationwide to all social workers, asking those who had more than two years of work experience at any kind of service providing agency to complete it. A total of 835 questionnaires were returned and used for data analysis (response rate 11.13 per cent). The study highlights the diversity of ethical dilemmas encountered by social workers in their professional practice, as well as revealing the different strategies, tools and mechanisms used in dealing with them. Further, it shows the urgent need for developing appropriate ethics support activities and training programmes for social workers, as a crucial part of their ongoing professional education and development. Such ethics initiatives are required to remain ethically competent throughout their working life.
Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents in Israel
Authors: Prunas Ottavia , Weinberger Daniel M , Pitzer Virginia E , Gazit Sivan , Patalon Tal
Published: April 2022

Background

The short-term effectiveness of a 2-dose regimen of the BioNTech/Pfizer BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, however, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months.

Methods

Leveraging the database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where 2 outcomes were evaluated: documented SARS-CoV-2 infection (regardless of symptoms) and symptomatic infection (COVID-19). Cases were defined as individuals aged 12–16 with a positive polymerase chain reaction (PCR) test occurring between 15 June and 8 December 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously.

Results

We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% (95% confidence interval [CI]: 84–86%) and 90% (95% CI: 89–91%) effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19), respectively. However, in line with findings for adults, waning effectiveness was evident. Long-term protection was reduced to 73% (95% CI: 68–77%) against infection and 79% (95% CI: 73–83%) against COVID-19 3–5 months after the second dose and waned to 53% (95% CI: 46–60%) against infection and 66% (95% CI: 59–72%) against COVID-19 after 5 months.

Conclusions

Although vaccine-induced protection against both infection and COVID-19 continues over time in adolescents, the protection wanes with time since vaccination, starting 3 months after inoculation and continuing for more than 5 months.
The Effect of Macrolides on Mortality in Bacteremic Pneumococcal Pneumonia: A Retrospective, Nationwide Cohort Study, Israel, 2009–2017
Authors: Chowers Michal , Gerassy-Vainberg Shiran , Cohen-Poradosu Ronit , Wiener-Well Yonit , Bishara Jihad , Maor Yasmin , Zimhony Oren , Chazan Bibiana , Gottesman Bat-sheva , Dagan Ron , Regev-Yochay Gili ,   IAIPD research group, Cohen-Poradosu Ronit , Brosh Tal , Weinberger Miriam , Rogozin Evgeny , Bishara Jihad , Hershman Mirit , Tziba Yevgenia , Strahilevitz Jacob , Istomin Valery , Chazan Bibiana , Stein Michal , Maor Yasmin , Weber Gabriel , Cohen Regev , Katzir Michal , Chowers Michal , Schindler Yehudit , Glikman Daniel , Reisenberg Klaris , Oren Ilana , Ghanem-Zoubi Nasrin , Rahav Galia , Weider Anat , Wiener-Well Yonit , Dagan Ron , Regev-Yochay Gili
Published: April 2022

Background

Previous cohort studies of pneumonia patients reported lower mortality with advanced macrolides. Our aim was to characterize antibiotic treatment patterns and assess the role of quinolones or macrolides in empirical therapy.

Materials

An historical cohort, 1 July 2009 to 30 June 2017, included, through active surveillance, all culture-confirmed bacteremic pneumococcal pneumonia (BPP) among adults in Israel. Cases without information on antibiotic treatment were excluded. Logistic regression analysis was used to assess independent predictors of in-hospital mortality.

Results

A total of 2016 patients with BPP were identified. The median age was 67.2 years (interquartile range [IQR] 53.2–80.6); 55.1% were men. Lobar pneumonia was present in 1440 (71.4%), multi-lobar in 576 (28.6%). Median length of stay was 6 days (IQR 4–11). A total of 1921 cases (95.3%) received empiric antibiotics with anti-pneumococcal coverage: ceftriaxone, in 1267 (62.8%). Coverage for atypical bacteria was given to 1159 (57.5%), 64% of these, with macrolides. A total of 372 (18.5%) required mechanical ventilation, and 397 (19.7%) died. Independent predictors of mortality were age (odds ratio [OR] 1.051, 95% confidence interval [CI] 1.039, 1.063), being at high-risk for pneumococcal disease (OR 2.040, 95% CI 1.351, 3.083), multi-lobar pneumonia (OR 2.356, 95% CI 1.741, 3.189). Female sex and macrolide therapy were predictors of survival: (OR 0.702, 95% CI .516, .955; and OR 0.554, 95% CI .394, .779, respectively). Either azithromycin or roxithromycin treatment for as short as two days was predictor of survival. Quinolone therapy had no effect.

Conclusions

Empirical therapy with macrolides reduced odds for mortality by 45%. This effect was evident with azithromycin and with roxithromycin. The effect did not require a full course of therapy.
Impact of Vaccination and Early Monoclonal Antibody Therapy on Coronavirus Disease 2019 Outcomes in Organ Transplant Recipients During the Omicron Wave
Authors: Solera Javier T , Árbol Berta G , Alshahrani Abdullah , Bahinskaya Ilona , Marks Nikki , Humar Atul , Kumar Deepali
Published: April 2022

Background

Solid organ transplant (SOT) recipients are at high risk for complications from coronavirus disease 2019 (COVID-19) and vaccine breakthrough infections are common. We determined the effectiveness of ≥3 doses of mRNA vaccine and early monoclonal antibody therapy in reducing disease severity against the Omicron (B.1.1.529) variant.

Methods

Prospective cohort study of consecutive SOT recipients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection referred to our transplant center who were followed for at least 30 days. The primary outcome was supplemental oxygen requirement. Effectiveness of sotrovimab and ≥3 vaccine doses was estimated using adjusted risk ratios (RR).

Results

Three hundred adult organ transplant recipients were included. Seventy-one patients (24.1%) were hospitalized, 44 (14.9%) required supplemental oxygen, 19 (6.5%) were admitted to the intensive care unit (ICU), 15 (5.1%) required mechanical ventilation (MV), and 13 (4.4%) died. On multivariate analysis, age and multiple comorbidities were risk factors for oxygen requirement. Both receipt of ≥3 vaccine doses prior to SARS-CoV-2 infection and receipt of sotrovimab in the first 7 days of symptom onset was associated with a reduction in the need for supplemental oxygen (RR 0.30 [95% confidence interval {CI}: .17 to .54] and RR 0.24 (95% CI: .1 to .59), respectively]. For sotrovimab, the number needed to treat (NNT) to prevent one patient requiring oxygen was 6.64 (95% CI: 4.56–13.66). Both sotrovimab use and having received ≥3 vaccine doses were also associated with a shorter hospitalization length of stay.

Conclusions

In a cohort of SOT recipients with Omicron variant COVID-19 infection, prior receipt of ≥3 mRNA vaccine doses and early monoclonal antibody therapy were independently associated with significantly reduced disease severity.
OR12. Augmentation of endothelial progenitor cell proliferation in stable coronary artery disease subjects using human umbilical cord blood-mesenchymal stem cell-derived secretome in hyperglycemia condition
Authors: Hidayat D F O , Oktaviono Y H , Lefi A
Published: April 2022

Background and Aims

The number of endothelial progenitor cells (EPC) was decreased in stable coronary artery disease (SCAD) and diabetic patients. Human umbilical cord blood-mesenchymal stem cell-derived secretome (secretome) has the potential to improve the proliferation of EPC. This study aims to figure out the effect of the secretome on EPC proliferation of SCAD patients and hyperglycemia conditions.

Method and Results

EPC’s were isolated from peripheral blood samples and cultured for three days in the Stemline II medium. Cultured EPC’s were incubated with various concentrations of secretome (2%, 10%, and 20%). The other groups were treated with high glucose (25 mmol/L), a combination of secretome and high glucose, vascular endothelial growth factors-only (positive group), and the basal medium only (negative group). MTT cell proliferation assay kit was used to evaluate the EPC’s proliferation at 72 hours after reagent addition. The absorbance of MTT was measured in optical density (OD). The 20% secretome group was significantly higher than the positive control group (1.59 vs. 1.43; p < 0.001). EPC proliferation in the secretome group is dose-dependent manner. EPC’s proliferation of the high glucose group was significantly lower than the negative control group (0.65 vs. 0.89; p < 0.001). EPCs proliferation OD was significantly higher between a combination of 20% secretome and high glucose than the secretome-only group (1.78 vs. 1.59; p < 0.001).

Conclusion

The secretome enhances the EPC proliferation of SCAD patients, even in a high glucose condition. The secretome is a new potential substance to modulate the EPC proliferation of SCAD patients.
OR20. Correlation between diabetes mellitus and significant in-stent restenosis in patient underwent coronary angiography evaluation
Authors: Putera N M , Pintaningrum Y , Habib P
Published: April 2022

Aims

Percutaneous Coronary Intervention (PCI) is a non-surgical invasive intervention with or without stenting performed on coronary heart disease (CHD) patient to improve blood flow of narrowed coronary arteries. One of the complication after PCI is in-stent restenosis (ISR), which is the narrowing of stented segment of coronary artery. Diabetes Mellitus (DM), is characterized by hyperglycemia, has long been known to increase the risk of CHD by 2-4 fold. Condition of hyperglycemia in diabetes has affects on the progression of neointimal hyperplasia (NIH) that progress to ISR. As the number of CHD patients with diabetes mellitus (DM) is expected to increase, so is the risk of ISR incidence in CHD patients with diabetes mellitus (DM) who undergo PCI.

Method and Results

A retrospective cross-sectional study was conducted using medical records of CHD patients who underwent coronary angiography evaluation between January 2018 and March 2020 at Catheterization Laboratory, Regional General Hospital of West Nusa Tenggara. Significant ISR was defined as diameter of stenosis ≥50% at coronary angiography evaluation. Total subjects were 66 subjects, with 33 DM subjects and 33 non-DM subjects, and ISR was found in 12 and 10 subjects respectively. There was no significant difference on the incidence of ISR between the DM and non-DM groups.

Conclusion

There was no correlation between DM and ISR, and there was no significant difference in the incidence of ISR between the DM and non-DM group in CHD subjects underwent coronary angiography evaluation.
OR21. Correlation between monocyte count and severity of coronary artery in patient with coronary arterial disease quantification using syntax score system hospitalized in nusa tenggara barat hospital
Authors: Humaera N N , Pintaningrum Y , Irawati D
Published: April 2022

Aims

Currently cardiovascular disease has become the first cause of non-communicable diseases death globally. It is predicted that the mortality rate will increase reaching up to 23.3 million in 2030. This study aims to investigate the correlation between monocyte count and severity of CAD quantification using Syntax Score.

Methods and Result

An observational cross-sectional study was conducted among CAD patients admitted in Nusa Tenggara Barat Hospital. The research data was documented from the medical and cathlab records of patients diagnosed with CAD during the period of December 2018 - October 2019 hospitalized in Nusa Tenggara Barat Hospital. Syntax score was calculated by Syntax Score 1 calculator. Statistical analysis were performed using SPSS 26.0 with Pearson correlation test. Sixty-five patients data was analysed. Majority of the subjects were men (80%) and 73.8% aged less than 65 years old. Approximately 69.2% exhibited low category syntax score and 76.9% had high monocyte level. Statistical analysis using Pearson correlation test finds p value 0.081 and r value is 0.218.

Conclusion

No correlation between Syntax Score with monocyte count was observed.
OR24. Creation and validation of 3D-printing based fluoroscopic coronary angiography simulator’s prototype as a learning media
Authors: Mawaris K , Gharini P P R , Anggrahini D W
Published: April 2022

Background and Aims

Obtaining a good projections of coronary angiogram (CA) and interpreting them is a complex ability for cardiology residents to learn. We aimed to create and validate a simple learning media protoype which can simulate fluoroscopic coronary angiography (FCA) phenomenon in a concrete way as well as being realistic, radiation-free, portable, and cost-effective.

Methods and Results

We used “Research & Development” steps. FCA simulator consisted of CT-scan derived transparent heart and opaque coronary mannequin, visible light and white screen in a minimized “C-arm” system, and video circuits. After interviewing anatomist (n = 1) and instrumentational engineer (n = 1), we obtained validation from FCA practitioners: cardiology interventionists (n = 3), cardiology interventional fellows (n = 2), and interventional radiographers (n = 3) by using a rating scale questionaire. Prototype was rated as very eligible (90%). Each aspect: relevance to curriculum (94%); educational value (92%); efficiency (88%); accuracy (90%); aesthetic (80%); durability (83%); safety (95%); portability (91%); cost (97%) were also rated as very eligible. Simulated images of right coronary artery were rated as very similar by all FCA practitioners, while left coronary artery’s (LCA) were rated as quite to very similar.

Conclusion

We successfully created a prototype of 3D-printing based FCA simulator. The simulator was able to demonstrate a concrete and visible phenomenon of CA, as well as radiation-free, portable, and cost-effective. The simulated images were realistic, however, improvement was needed for LCA. The protoype is very eligible for diagnostic CA learning media and ready to be field tested.
OR30. Effect of hyponatremia in heart failure patients at discharge on 30-day readmission rate: a single-centre study
Authors: Wibowo P G , Nathania M , Hasanah D Y , Soerarso R
Published: April 2022

Background and Aims

Hyponatremia is often observed in patients with heart failure. The proposed pathophysiology of hyponatremia in heart failure is due to increase of arginine vasopressin activity that elevates renal water reabsorption, thereby diluting sodium content in plasma. Hyponatremia has been identified as a factor that worsens heart failure patients' prognosis, including cardiovascular morbidity and mortality. Thus, this study was conducted to investigate the impact of hyponatremia in heart failure patients on rehospitalisation within thirty days.

Methods and Results

This is a single-centre prospective cohort study. A total of 205 acute decompensated heart failure patients admitted to National Cardiovascular Center Harapan Kita from July 2018 to March 2019 were included into the study. The study population was then divided into two groups based on predischarge sodium level. In this study, hyponatremia was defined as serum sodium level less than 135 mEq/l. Among the study population, 58 patients (28.3%) had hyponatremia at discharge. The data was analyzed using chi-square test. There were 19 patients who were readmitted within 30 days and 52.9% of them had hyponatremia at discharge. The effect of hyponatremic status at discharge to 30-day readmission rate was statistically significant (p = 0.03, OR = 3.19 95%CI 1.22-8.33).

Conclusion

Hyponatremia in heart failure patients at discharge is associated with increased risk of 30-day readmission.
OR32. Efficacy and Safety of Therapeutic Versus Prophylactic Dose of Anticoagulation in Hospitalized Patients with Severe COVID-19 Pneumonia and Coagulopathy: An Open-Label, Randomized Controlled Trial
Authors: Adrian L H , Hutomo S A , Negari A D S
Published: April 2022

Background and Aims

The use of therapeutic anticoagulation to improve outcomes in COVID-19-associated coagulopathy remains unclear. We aimed to compare the efficacy and safety of therapeutic versus standard prophylactic anticoagulation in this population.

Methods and Results

This was a single-center, open-label, two-arms, randomized controlled study conducted from 1st April to 15th July 2021. Two-hundred fifty severe COVID-19 patients with coagulopathy were randomly assigned (1:1 ratio) to receive either prophylactic anticoagulation (subcutaneous unfractionated heparin/UFH 5000IU b.i.d or fondaparinux 2.5mg o.d) or therapeutic anticoagulation (weight-adjusted dose UFH or fondaparinux). Anticoagulation was administered until hospital discharge or at the treating physician’s discretion. All patients received international COVID-19 guideline-driven therapy throughout the study. Baseline characteristics were not significantly different (p > 0.05) between both arms, except for the D-dimer and CRP level at admission (p = 0.04; p = 0.001; respectively). During a 30-day follow-up, therapeutic arm revealed significant higher need for NIV/invasive MV (41.3% vs. 29%, p = 0.02), higher progression to ARDS (34.1% vs. 16.1%, p = 0.001), and increased 30-day all-cause mortality (58.7% vs. 15.3%, p < 0.001) as compared with prophylactic arm. There was no significant difference between both arms in the incidence of acute MI (20% vs. 13.6%, p = 0.07), VTE (4.8% vs. 0.8%, p = 0.09), arterial thromboembolism (3.2% vs. 0%, p = 0.29) and overall bleeding (17.6% vs. 6.4%, p = 0.18) at 30-days.

Conclusion

Therapeutic anticoagulation was considered safe and effective in preventing thromboembolic events, but not in the need for NIV/invasive MV, progression to ARDS and 30-day all-cause mortality in hospitalized patients with severe COVID-19 and coagulopathy.
OR35. Exercise Effect on Global Myocardial Function Score in Patients with Refractory Angina Undergoing Extracorporeal Shockwave Myocardial Revascularization (ESMR): A Study focusing on Speckle Tracking and Exercise Stress Echocardiography
Authors: Tantawi P , Pratama A P , Maulana C A
Published: April 2022

Aims

Refractory angina pectoris (RAP) is defined as the occurrence of frequent angina attacks uncontrolled by optimal drug therapy. Extracorporeal shockwave myocardial revascularization (ESMR) is one of the alternative therapies that can be performed to treat RAP. Stress echocardiography is necessary to determine the inducible myocardial segments. To date, study evaluating the effect of exercise on myocardial function using WMSI and GLS was still limited. The aim of this study was to show the effect of exercise on global myocardial function evaluated using GLS and WMSI from echocardiography.

Methods and Results

This is a cross sectional and single center study of 9 Refractory Angina Pectoris patients underwent stress echocardiography from April - June 2021 in Mohammad Hoesin General Hospital, Palembang. Pre and post exercise WMSI and GLS were obtained and analyzed using McNemar non-parametric test. There were no significant differences between both pre and post GLS (p = 0.500) and WMSI (p = 0.250) through exercise stress echocardiography.

Conclusion

Our study showed no significant difference of global myocardial function evaluated by GLS and WMSI, pre and post exercise. Segmental myocardial function analysis seems to be more potential as useful assessment for RAP undergoing ESMR procedure.
OR39. High Level of Non-High-Density Lipoprotein Cholesterol Was Associated with Severe Coronary Artery Stenosis in Chronic Coronary Syndrome Patients at Sanglah General Hospital
Authors: Gunarsa M , Aryadana W , Artha J R
Published: April 2022

Aims

(1)To prove the association between non-HDL cholesterol level and severity of coronary artery lesions in chronic coronary syndrome (CCS) patients who undergo coronary angiography (2) Determine optimal cutoff value for non-HDL, LDL and TG cholesterol levels that were associated with severe coronary artery lesions in CCS patients.

Methods and Results

This is an analytic observational study using consecutive sampling technique that was conducted from June to November 2020. The relationship between non-HDL cholesterol and degree of coronary stenosis was assessed using Chi-square test. Of the subjects that were included, 90.3% (65/72) are men, mean age of 59.43 ± 8.9 years. Non HDL-C (cut off 104.5 mg/dL), has area under curve 0.846, sensitivity 80% and specificity 78.1%, (p < 0.001). Bivariate analysis showed that high non-HDL cholesterol was related to the degree of severe coronary stenosis (prevalence ratio of 3.385; CI95% 1.819-6.296, p < 0.001). Multivariate logistic regression analysis showed high non-HDL cholesterol is an independent predictor of severe coronary artery stenosis in CCS patients (OR of 25.8; 95% CI 6,46-103; p < 0.001). Sub-analysis based on lipid fraction showed that high non-HDL cholesterol (> 104.5 mg / dL) had better AUC (0.846), sensitivity (80%) and specificity (78.1%) compared to high LDL (LDL >81 mg/dL with AUC 0.793, p < 0.001/ Se 70%/ Sp 68.8%) and high TG (TG > 132.5 mg/dL with AUC 0.623, p = 0.111/ Se 57.5% / Sp 53.1%).

Conclusion

High non-HDL cholesterol is independently associated with severe coronary stenosis in CCS patients, while having better association to severe coronary artery stenosis. Optimal cut off point for non-HDL-C, LDL-C and TG were 104.5 mg/dL, 81 mg/dL and 132.5 mg/dL.
OR52. Prolonged QRS duration as an independent predictor of extended in-hospital length of stay in congestive heart failure patients in the rural hospital
Authors: Sukmadja D , Hartoko B
Published: April 2022

Aims

This study was conducted to determine whether prolonged QRS duration in electrocardiography (ECG) measurement could be used as a predictor for extended in-hospital length of stay (LOS) in congestive heart failure (CHF) patients.

Methods and Results

We obtained data of 147 patients who were diagnosed with CHF for January 2019-December 2020 from medical records. Patients who were referred and not survived were excluded. Predictor analysis was performed using bivariate chi-square test and multivariate logistic regression. The median age of all patients was 56.0 ± 12.26 years, with predominantly male patients (66.7%). There were 13.3% cases with prolonged QRS duration (≥120 ms) and 45.9% cases with extended LOS (>6 days). Bivariate chi-square test showed significant correlation between prolonged QRS duration and extended LOS in CHF patients (OR: 0.28, 95% CI: 0.09 to 0.82, p: 0.016). Multivariate logistic regression demonstrated that prolonged QRS duration was significantly associated with extended LOS in CHF patients (OR: 4.56, 95% CI: 1.46 to 13.96, p: 0.009).

Conclusion

Prolonged QRS duration was found to be an independent predictor of extended in-hospital length of stay in congestive heart failure patients, particularly in the rural area setting in which resources are limited.
OR55. Risk Factor For Mortality Of Patients Waiting For Elective Coronary Artery Bypass Graft Surgery
Authors: Perdana A , Sobirin M A , Nugroho Suhartono M A
Published: April 2022

Background and Aims

Insufficient capacity for cardiac surgery results in extensive waiting time of patients requiring coronary artery bypass grafting (CABG). Previous studies have reported a consequence of an increased risk of mortality while waiting for CABG. Identification of mortality rates and risk factors for mortality is important in patients waiting for CABG.

Methods and results

This retrospective cohort study was done on patients awaiting for elective CABG in dr. Kariadi General Hospital from January 2018 to December 2020. Identification of risk factors that associated with mortality was done on patients who were waiting CABG using logistic regression methods. There were 162 patients fulfilling the criteria, with a mean waiting time for an operation of 9.8 months. While waiting for CABG surgery, 32 (19.7%) patients died of any cause. Independent risk factors for death while waiting for CABG included : left ventricular ejection fraction < 45% (OR 4.75; 95% CI 1.76-12.78; p = 0.002), left main disease (OR 4.12; 95% CI 1.50-11.27; p = 0.006), serum creatinin > 1.5 mg/dl (OR 3.71; 95% CI 1.41-9.74; p = 0.008), and number of coronary artery disease risk factor > 3 (OR 3.34; 95% CI 1.24-8.99; p = 0.017).

Conclusions

Long waiting lists for CABG is associated with high mortality rate which is influenced by left ventricular ejection fraction < 45%, left main disease, serum creatinin > 1.5 mg/dl, and number of coronary artery disease risk factor > 3.
OR67. The Effects of Electric Cigarette Smoke and Conventional Cigarette Smoke Exposure on the Increase of Atherogenic Marker: Leptin Receptor (mRNA-ObR) and Aortic Calcification in Mice
Authors: Putri N L P D A , Wiryawan N , Aryadana W , Widiana I G R , Arijana I G K N , Dewangga I M S Y
Published: April 2022

Aims

The effect of e-cigarettes on atherosclerosis is still a matter of debate. One method that can be used as atherogenic process marker is the expression of Leptin receptors (mRNA-ObR) and aortic calcification. The aim of this study was to compare Leptin receptors (mRNA-ObR) expression and aortic calcification in mice exposed to conventional cigarettes and e-cigarettes.

Methods and Results

Thirty samples of mice were randomly divided into control group, conventional cigarette exposure group, and e-cigarette exposure group. After 2 months of treatment using a modified smoking chamber, a surgical procedure was performed to remove aortic tissue. This procedure was followed by histopathological examination to discover aortic calcification, and RT-PCR examination to see the expression of mRNA-ObR. The results of post hoc analysis showed that control group and conventional cigarette exposure group had differences in mRNA-ObR expression and aortic calcification [0.030 (0.090-0.046) fg/µl vs 0.332 (0.990-0.537) fg/µl, p = 0.000, in mRNA ObR; and 0.130 ± 0.719% vs 1.678 ± 0.696%, p = 0.000, in aortic calcification], as well as control group and e-cigarette exposure group [0.030 (0.090-0.046) fg/µl vs 0.376 (0.218-0.464) fg/µl, p = 0.000, in mRNA ObR and 0.130±0.719% vs 1.493±0.496%, p = 0.000, in aortic calcification]. Meanwhile, the group with e-cigarette exposure and group with conventional cigarette exposure didn’t show any differences [0.376 (0.218-0.464) fg/µl vs 0.332 (0.990-0.537) fg/µl, p = 0.568, in mRNA ObR and 1.493 ± 0.496% vs 1.678 ± 0.696%, p = 0.889, in aortic calcification].

Conclusion

There were no differences in Leptin receptor (mRNA-ObR) expression and aortic calcification in conventional cigarettes and e-cigarettes exposure groups.
OR73. The Relationship Between Echocardiographic Parameters and Chronotropic Incompetence in Patients with Cardiovascular Disease at Sanglah General Hospital, Bali
Authors: Jagannatha G N P , Pradnyana I W A S , Kamardi S , Yasmin A A A D A
Published: April 2022

Background and Aims

Patients with cardiovascular disease commonly have chronotropic incompetence which may be associated with cardiac remodelling and increased LV filling pressure. This study aimed to determine the association between echocardiography findings and chronotropic incompetence (CI) among patients with cardiovascular disease.

Method and Results

This was a cross-sectional study that included 136 medical records of patients with cardiovascular disease underwent treadmill stress test (TST) and echocardiography examination at outpatient cardiology clinic, Sanglah General Hospital from 2018 until 2020. Chronotropic incompetence was defined as maximum heart rate that can’t reach 85% age-predicted maximum heart rate. Data was analyzed using SPSS version 21. Mann-Whitney U test was used to evaluate the association between echocardiography findings such as ejection fraction (EF), left ventricular internal dimension end-diastolic (LVIDd), LVIDd index (LVIDdi), left ventricular mass, E/E’ ratio, left atrial volume index (LAVI) and CI. Among 136 subjects of this study, the mean age was 54.7 years, 71.3% were male and 37.5% were obese. Patients with CI were found to had lower LVIDd (42.8+0.89 vs 45.2+0.72, p = 0.029), lower LVIDi (24.6+0.37 vs 25.5+ 0.31, p = 0.025), higher left ventricular mass (175.6+3.27 vs 125.1+2.63, p < 0.001), higher E/E’ ratio (17.3+0.29 vs 13+0.35, p < 0.001), and higher LAVI (47+1.98 vs 31.6+1.09, p < 0.001) compared with patients without CI.

Conclusion

Patients with cardiovascular disease commonly have chronotropic incompetence that could be detected by TST examination, which may be partly predicted by echocardiographic parameters that are associated with cardiac remodelling and increased LV filling pressure.
OR74. The relationship between hypertension and homocysteine level in patients with peripheral arterial disease in mataram city
Authors: Rialdi M A , Yanna I , Herpan S H , Catarina B
Published: April 2022

Aims

Peripheral arterial disease (PAD) is a disorder or narrowing of the peripheral arteries, especially in the lower extremities due to atherosclerosis. Hyperhomocysteinemia is an independent factor in the formation of atherosclerosis. Hypertension is associated with hyperhomocysteinemia and the incidence of atherosclerosis. Data regarding plasma homocysteine levels in PAP patients with hypertension are limited. Therefore, this study aimed to investigate the comparation between hypertension and plasma homocysteine levels in PAD patients in Mataram City.

Method and Result

This research is a cross sectional study conducted at Siti Hajar Islamic Hospital Mataram City. The number of samples in this study was 42 samples. The study sample was a PAP subject with hypertension and an ankle brachial index (ABI) score of < 0.90. The results of this study were homocysteine levels in PAP patients with hypertension and PAP patients with non-hypertension. Analyze data using unpaired T test. Forty-two PAP patients participated in the study, with 32 samples (76.1%) female and average age 56.07 years. The average level of homocysteine in PAP patients with hypertension (6.13±0.56 μmol/L) was significantly higher than homocysteine levels in PAP patients with non-hypertension (5.18±1.14 μmol/L) (p = 0.002). Gender, age, DM history and ABI score are not associated with PAP and hypertension.

Conclusion

There were significant differences between average homocysteine levels in the PAP subject group with hypertension and non-hypertension.
OR79. Validation of EuroSCORE II, Ambler score and Harapan Kita Score as Predictor of In Hospital Mortality in Patients Underwent Heart Valve Surgery
Authors: Asmuni M , Soesanto A M , Kurniawati Y , Zahara R , Dwiputra B , Rossimarina V
Published: April 2022

Aims

Preoperative risk prediction models have important role in heart valve surgery management. Changing in patient characteristics and surgical facilities over time, might affect the predicting value of those scoring system. This study aimed to compare the validation of EuroSCORE II, Ambler score and Harapan Kita score in predicting in hospital mortality at patients underwent heart valve surgery

Methods

Cohort restrospective study was performed at 416 patients who underwent heart valve surgery from November 2018 to December 2019. Data was taken from the medical records by consecutive sampling method. The calibration and discrimination value of EuroSCORE II, Ambler score and Harapan Kita score were obtained.

Results

Observed in hospital mortality was 6.7%. EuroSCORE II, Ambler score and Harapan Kita score have good calibration (Hosmer-Lemeshow test p = 0.065, p = 0.233 and p = 0.314). The discriminative value of these three scores predicting in hospital mortality for EuroScore II AUC 0.763 (95% CI; 0.660-0.867), Ambler score AUC 0.748 (95% CI; 0.655-0.841) and Harapan Kita score AUC 0.694 (95% CI; 0.584-0.804)

Conclusion

EuroSCORE II, Ambler score and Harapan Kita score have fairly good validation. Those scoring system have good calibration with Harapan Kita score calibration relatively better than EuroSCORE and Ambler score, meanwhile Harapan Kita score has less discrimination value than EuroScore II and Ambler score.
M5. Effect of Macitentan on pulmonary vascular resistance index in patients with congenital heart disease-pulmonary arterial hypertension: a meta-analysis
Authors: Wijaya M P , Wijaya K M , Sutarmini S A N Y
Published: April 2022

Background and Aims

Macitentan is a novel dual endothelin receptor antagonist which proven effective as treatment in adults with pulmonary arterial hypertension.

Methods and Results

We performed a systematic search from inception until May 31, 2021, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines comparing PVRi baseline and after Macitentan 10mg and selected studies according to our pre-defined inclusion and exclusion criteria. Two reviewers extracted data into the predefined tables in the Microsoft Excel (Microsoft Corp., New Mexico, US) sheet. We used RevMan software to perform a meta-analysis and draw Forest plots. We used a random effects model to estimate risk ratios. A two-sided p-value of ≤ 0.05 was considered statistically significant. A total of three randomized control trials (RCTs) with 325 patients were included in our analysis. Macitentan 10mg a day showed moderately associated with lower PVRi compare with baseline value (SMD: -0.72) and statistically significant (p = 0.002; 95% CI=-1.18-(-0.25)).

Conclusion

Macitentan was developed by modifying the structure of Bosentan in order to increase the efficacy and safety. Macitentan has slower receptor dissociation kinetics and longer duration of action which allows once-daily dosing. The safety profile of Macitentan appears to be superior with respect to hepatic safety and edema than other therapy such as Bosentan and Ambrisentan, respectively. Macitentan is a promising drug to treat pulmonary hypertension which is well tolerated and associated with improvements.
M13. Stenting of right ventricular outflow tract as palliation for patient with right ventricular outflow tract obstruction with ventricular shunt physiology: a systematic review and meta-analysis
Authors: Ulfiarakhma D , Ardining H , Prakoso R
Published: April 2022

Aims

Right ventricular outflow tract (RVOT) stenting is emerging as an effective alternative to surgical palliation in selected patients. We aim to assess the outcome of RVOT stenting in patients suffered from RVOT obstruction with ventricular shunt physiology such as tetralogy of Fallot (ToF) and other type of lesions, also to compare its clinical outcomes with modified Blalock-Taussig shunt (mBTS) procedure.

Method and Results

A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We systematically searched the relevant studies from date of inception to June 2021. Outcomes of interest were pulmonary artery (PA) growth and oxygen saturation after palliation. Eleven retrospective studies (384 patients) were included for qualitative analysis, and four studies (193 patients) were eligible for meta-analysis. From our study, RVOT stenting can be accomplished safely and effectively in severe cyanosis or high risk patients with ToF physiology. Right PA z-score and oxygen saturation post RVOT stenting was significantly higher compared with post mBTS (MD 0.50; 95% CI 0.06 – 0.93, p = 0.03 and MD 3.46; 95% CI 1.42 – 5.49, p = 0.0009 respectively). Our analysis shows no significant difference of left PA z-score after palliation between two groups (MD -0.05; 95% CI -0.89 – 0.79, p = 0.90).

Conclusion

RVOT stenting effectively improves oxygen saturation and promotes proper pulmonary artery growth in patients with ToF physiology. The larger and randomized-controlled studies are required to better evaluate the efficacy of RVOT stenting and its superiority compared to mBTS.
M17. The usefulness of brain natriuretic peptide measurement in pediatric patients with cardiovascular disease: a systematic review and meta-analysis
Authors: Ardining H , Ulfiarakhma D , Prakoso R
Published: April 2022

Background and Aims

The use of brain natriuretic peptide (BNP), a common cardiac biomarker, has traditionally been limited to adult populations for heart failure assessment. In children, less is known about the diagnostic value of BNP. Emerging evidence suggests they might be useful in diagnosis of children with cardiovascular disease. We aim to evaluate the use of BNP in children with cardiovascular disease.

Methods and Results

We performed a systematic review of literatures on online databases for studies evaluating level of BNP in children with cardiovascular disease from inception to July 26, 2021. A total number of 8 studies comprising 1304 patients were included in the meta-analysis. All articles included in the meta-analysis had high quality according to the GRADE approach. From our analysis, higher BNP was found in patients with congenital heart disease (CHD) compared with healthy subjects (SMD 2.88 [0.21-5.56], p = 0.03; I2 99%). Higher BNP was also found in children with heart failure (HF) compared with patients without HF (SMD 1.21 [0.73-1.69], p < 0.0001; I2 0%), and higher in CHD patients with pulmonary hypertension (PH) compared with CHD patients without PH (SMD 1.76 [0.02-3.51], p = 0.05; I2 95%).

Conclusion

Significantly higher level of BNP was found in CHD patients, CHD-PH, and HF patients. Therefore, BNP measurement might be used for screening of CHD, PH in CHD populations and HF in pediatric populations. Further study is required to determine diagnostic accuracies and cut-offs within age groups.