bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal variation of hospital-acquired bloodstream infections: A national cohort study
Authors: Blot Koen , Hammami Naïma , Blot Stijn , Vogelaers Dirk , Lambert Marie-Laurence
Published: May 2021

Background:

Hospital-acquired bloodstream infections (HABSIs) cause increased morbidity, mortality, and hospital costs that are partially preventable. HABSI seasonality has been described for gram-negative bacteria but has not been stratified per infection origin.

Objective:

To assess seasonality among all types of HABSIs and their associations with climate.

Methods:

Hospitals performing surveillance for at least 1 full calendar year between 2000 and 2014 were included. Mixed-effects negative binomial regression analysis calculated the peak-to-low monthly ratio as an adjusted HABSI incidence rate ratio (IRR) with 95% confidence intervals (CIs). Another regression model examined associations between HABSI rates and climate variables. These analyses were stratified by microorganism and infectious origin.

Results:

The study population included 104 hospitals comprising 44,111 HABSIs. Regression analysis identified an incidence rate ratio (IRR) peak in August for gram-negative HABSIs (IRR, 1.59; 95% CI, 1.49–1.71), CLABSIs (IRR, 1.49; 95% CI, 1.30–1.70), and urinary tract HABSI (IRR, 1.52; 95% CI, 1.34–1.74). The gram-negative incidence increased by 13.1% (95% CI, 9.9%–16.4%) for every 5°C increase in temperature. Seasonality was most present among E. coli, K. pneumoniae, E. cloacae, and the nonfermenters. Gram-positive and pulmonary HABSIs did not demonstrate seasonal variation.

Conclusions:

Seasonality with summer spikes occurred among gram-negative bacteria, CLABSIs, and urinary tract HABSIs. Higher ambient temperature was associated with gram-negative HABSI rates. The preventable causative factors for seasonality, such as the nurse-to-patient ratio, indoor room temperature or device-utilization, need to be examined to assess areas for improving patient safety.
Mind the gap: A tale of two curriculum fallacies
Authors: Graves Kathleen
Published: May 2021

Throughout my professional life, I have been interested in the relationship between teachers and curriculum. As someone who has taught languages, educated teachers, and developed curriculum and materials, I have been puzzled by the separation of curriculum and teaching. In the US, this separation is encapsulated in the phrase ‘curriculum and instruction’, where they are seen as separate domains of research and responsibility (Doyle, 1992; Kaplan & Owings, 2015). Indeed, as a teacher educator, I would often hear the refrain from teachers, ‘I know how to plan a good lesson, but I'm not sure what the big picture is. How do the lessons fit together as a whole?’ I interpreted this to mean that they did not have a sense of the overall curricular structure and aims for their students’ learning. As a materials and curriculum developer, I saw my responsibility as providing a map for teachers that would show how the parts added up to a sensible whole.
Seasonal Variation of Methane Microseepage in the Dawanqi Oilfield (China): A Possible Climatic Control
Authors: Zhao Yujia , Wang Guojian , Etiope Giuseppe , Wang Yong , Zhu Zhenzhen , Wang Chunhui , Chen Xufeng , Tang Junhong
Published: May 2021

Natural gas microseepage in petroleum‐bearing sedimentary basins is an important complement to geophysical methods in oil‐gas exploration and a natural source of methane (CH4) for the atmosphere. Microseepage, typically occurring in correspondence with petroleum fields throughout the world, is generally lower in summer, due to temperature‐driven methanotrophic consumption, and higher in winter. The global estimates of microseepage methane emission have, however, relatively high uncertainties because of limited amounts of flux data, leading to poor knowledge of the spatial distribution and temporal variability of the gas emission factors. We studied the seasonal variation of microseepage flux to the atmosphere from a petroleum field in China (the Dawanqi oilfield), through methane flux measurements performed in summer 2014, winter 2015, and summer 2019. Winter data refer to frozen soil conditions, with snow cover and ice thickness in the soil exceeding 60 cm. Gas concentration (CH4, CO2, C2+ alkanes) and stable C isotopic composition of CH4 and CO2 in shallow (4 m deep) boreholes confirmed the existence of thermogenic gas seepage. Methane microseepage is higher in summer and lower or nil in winter. This seasonal trend is opposite to what was observed in areas where winter soil is not or poorly frozen. Our data suggest that seasonal microseepage variation may not be univocal worldwide, being strongly dependent on the presence of ice and snow cover in winter. The regional increase of temperature due to climate change, already demonstrated for the Tarim Basin over the last 50 years, could, in the future, reduce winter ice and enhance annual methane emission to the atmosphere.
Novel vocalizations are understood across cultures
Authors: Ćwiek Aleksandra , Fuchs Susanne , Draxler Christoph , Asu Eva Liina , Dediu Dan , Hiovain Katri , Kawahara Shigeto , Koutalidis Sofia , Krifka Manfred , Lippus Pärtel , Lupyan Gary , Oh Grace E. , Paul Jing , Petrone Caterina , Ridouane Rachid , Reiter Sabine , Schümchen Nathalie , Szalontai Ádám , Ünal-Logacev Özlem , Zeller Jochen , Winter Bodo , Perlman Marcus
Published: May 2021

Linguistic communication requires speakers to mutually agree on the meanings of words, but how does such a system first get off the ground? One solution is to rely on iconic gestures: visual signs whose form directly resembles or otherwise cues their meaning without any previously established correspondence. However, it is debated whether vocalizations could have played a similar role. We report the first extensive cross-cultural study investigating whether people from diverse linguistic backgrounds can understand novel vocalizations for a range of meanings. In two comprehension experiments, we tested whether vocalizations produced by English speakers could be understood by listeners from 28 languages from 12 language families. Listeners from each language were more accurate than chance at guessing the intended referent of the vocalizations for each of the meanings tested. Our findings challenge the often-cited idea that vocalizations have limited potential for iconic representation, demonstrating that in the absence of words people can use vocalizations to communicate a variety of meanings.
C646 inhibits G2/M cell cycle-related proteins and potentiates anti-tumor effects in pancreatic cancer
Authors: Ono Hiroaki , Kato Tomotaka , Murase Yoshiki , Nakamura Yutaro , Ishikawa Yoshiya , Watanabe Shuichi , Akahoshi Keiichi , Ogura Toshiro , Ogawa Kosuke , Ban Daisuke , Kudo Atsushi , Akiyama Yoshimitsu , Tanaka Shinji , Ito Hiromichi , Tanabe Minoru
Published: May 2021

The activity of histone acetyltransferases (HATs) plays a central role in an epigenetic modification in cooperation with HDACs (histone deacetyl transferases). It is likely that malfunction of this enzymatic machinery controlling epigenetic modification is relevant to carcinogenesis and tumor progression. However, in pancreatic cancer, the clinical relevance of HAT activity and histone acetylation has remained unclear. We identified that H3 acetylation was expressed in all pancreatic cancer patients, indicating that H3 acetylation may be essential in pancreatic cancer cells. We also found that the HAT inhibitor C646 augmented anti-tumor effects in vitro by inhibiting cell proliferation and cell cycle progression concomitantly with suppression of acetylated H3K9 and H3K27 expression. C646 or p300 and CBP (CREB-binding protein)-specific siRNA treatment inhibited the transcription of the G2/M cell cycle regulatory proteins cyclin B1 and CDK1 (cyclin-dependent kinase 1). C646 treatment also inhibited tumor growth in vivo in a xenograft mouse model. C646 could be an effective therapeutic agent for pancreatic cancer. The epigenetic status of pancreatic cancers based on their level of histone H3 acetylation may influence patient survival. Epigenetic stratification according to H3K27 acetylation could be useful for predicting disease prognosis as well as the therapeutic efficacy of C646 in pancreatic cancer.
Molecular docking analysis and evaluation of the antibacterial and antioxidant activities of the constituents of Ocimum cufodontii
Authors: Aliye Muhdin , Dekebo Aman , Tesso Hailemichael , Abdo Teshome , Eswaramoorthy Rajalakshmanan , Melaku Yadessa
Published: May 2021

Ocimum cufodontii((Lanza) A.J.Paton) has been traditionally used in Ethiopia against bacteria.The extracts of the leaves and roots ofO. cufodontiiafter silica gel column chromatography furnished compounds1–5, compounds3and4are new natural products. The oil from the hydro-distillation of the leaves, after analyzed with GC–MS, has led to the identification ofβ-caryophyllene as a principal component, suggesting the essential oil as medicine and spices to enhance the taste of food. The constituents ofO. cufodontiiwere assessed for their antibacterial activity againstE. coli, K. pneumonia, S. typhymuriumandS. aureus.The best activity was displayed againstS. aureusby the hexane extract of the roots, compound4, and the essential oil with an inhibition zone of 17, 15, and 19 mm, respectively. Molecular docking analysis revealed that compound1has better docking efficiency and forms hydrophobic interactions with five amino acids (ARG192, PHE196, GLU185, GLU193, and LYS189). This suggests that the compounds may act as potential inhibitors of DNA gyrase. The constituents were also assessed for their antioxidant activities using DPPH, ferric thicyanate and ferric reducing power assay. The hexane extracts of the roots inhibited the DPPH radical and peroxide formation by 90.5 and 83%, respectively, suggesting the potential of the extract as an antioxidant. Furthermore, the hexane extract of the roots ofO. cufodontiiexhibited the maximum reducing power compared with the EtOAc and methanol extracts. Hence, the activity displayed herein indicated as the plant has great potential as a remedy for diseases caused by bacteria and radicals.
Prediction of daily and cumulative cases for COVID-19 infection based on reproductive number (R0) in Karnataka: a data-driven analytics
Authors: Suresh Kuralayanapalya Puttahonnappa , Patil Sharanagouda S. , Thyagaraju Bharath Prasad Cholanayakanahalli , Ramkrishnappa Srikantha Gowda , Hemadri Divakar , Chandrashekara S.
Published: May 2021

To estimate the reproductive number (R0) of the coronavirus in the present scenario and to predict the incidence of daily and probable cumulative cases, by 20 August, 2020 for Karnataka state in India. The model used serial interval with a gamma distribution and applied ‘early R’ to estimate the R0 and ‘projections’ package in R program. This was performed to mimic the probable cumulative epidemic trajectories and predict future daily incidence by fitting the data to existing daily incidence and the estimated R0 by a model based on the assumption that daily incidence follows Poisson distribution. The maximum-likelihood (ML) value of R0 was 2.242 for COVID-19 outbreak, as on June 2020. The median with 95% CI of R0 values was 2.242 (1.50–3.00) estimated by bootstrap resampling method. The expected number of new cases for the next 60 days would progressively increase, and the estimated cumulative cases would reach 27,238 (26,008–28,467) at the end of 60th day in the future. But, if R0 value was doubled the estimated total number of cumulative cases would increase up to 432,411 (400,929–463,893) and if, R0 increase by 50%, the cases would increase up to 86,386 (80,910–91,861). The probable outbreak size and future daily cumulative incidence are largely dependent on the change in R0 values. Hence, it is vital to expedite the hospital provisions, medical facility enhancement work, and number of random tests for COVID-19 at a very rapid pace to prepare the state for exponential growth in next 2 months.
Effect of a bioconverted product of Lotus corniculatus seed on the axillary microbiome and body odor
Authors: Kim Min-Ji , Tagele Setu Bazie , Jo HyungWoo , Kim Min-Chul , Jung YeonGyun , Park Yeong-Jun , So Jai-Hyun , Kim Hae Jin , Kim Ho Jin , Lee Dong-Geol , Kang Seunghyun , Shin Jae-Ho
Published: May 2021

The skin microbiome, especially the axillary microbiome, consists of odor-causing bacteria that decompose odorless sweat into malodor compounds, which contributes to the formation of body odor. Plant-derived products are a cheap source of bioactive compounds that are common ingredients in cosmetics. Microbial bioconversion of natural products is an ecofriendly and economical method for production of new or improved biologically active compounds. Therefore, in this study, we tested the potential of aLactobacillus acidophilusKNU-02-mediated bioconverted product (BLC) ofLotus corniculatusseed to reduce axillary malodor and its effect on the associated axillary microbiota. A chemical profile analysis revealed that benzoic acid was the most abundant chemical compound in BLC, which increased following bioconversion. Moreover, BLC treatment was found to reduce the intensity of axillary malodor. We tested the axillary microbiome of 18 study participants, divided equally into BLC and placebo groups, and revealed through 16S rRNA gene sequencing thatStaphylococcus,Corynebacterium,andAnaerococcuswere the dominant taxa, and some of these taxa were significantly associated with axillary malodor. After one week of BLC treatment, the abundance ofCorynebacteriumandAnaerococcus, which are associated with well-known odor-related genes that produce volatile fatty acids, had significantly reduced. Likewise, the identified odor-related genes decreased after the application of BLC. BLC treatment enhanced the richness and network density of the axillary microbial community. The placebo group, on the other hand, showed no difference in the microbial richness, odor associated taxa, and predicted functional genes after a week. The results demonstrated that BLC has the potential to reduce the axillary malodor and the associated odor-causing bacteria, which makes BLC a viable deodorant material in cosmetic products.
Greatly enhanced breakdown strength and energy density in ultraviolet‐irradiated polypropylene
Authors: Chen Jiayu , Li Bao‐Wen , Sun Yi , Zhang Pengxiang , Shen Zhonghui , Zhang Xin , Nan Ce‐Wen , Zhang Shujun
Published: May 2021

Polymer dielectrics have drawn great attentions for applications in advanced electronic devices and power grids because of their high breakdown strength, low dielectric loss, and excellent flexibility. However, the low energy density in polymer dielectric capacitors will hinder the continuous miniaturization of electrical systems. In this work, ultraviolet irradiation is demonstrated to greatly enhance the breakdown strength and energy density of polypropylene. Dramatically improved breakdown strength of 867 MV/m and discharged energy density of 8.0 J/cm3, together with the high energy efficiency of >90%, were simultaneously achieved in polypropylene after ultraviolet irradiation. Our research shows that proper ultraviolet irradiation can effectively improve the energy density of polypropylene without sacrificing its high charge‐discharge efficiency, being potential for applications in power electronics and pulse electric systems.
Dynamic Cascading Failure Model for Blackout Risk Assessment of Power System With Renewable Energy
Authors: Wang Leibao , Hu Bo , Xie Kaigui
Published: May 2021

To assess the blackout risk of power system with high penetration of renewable, the existing cascading failure models need to be improved for capturing the dynamics and relays of renewable generation. In this paper, a dynamic model of cascading failure considering the utility-scale and distributed renewable energy is proposed. With the solution of dynamic equations for power system, the logics of relays are simulated for components such as transmission lines, conventional generators and renewable generations. The failure interactions among sources, networks, and loads are analyzed more comprehensively. In the proposed model, to capture the impact of renewable energy on the system dynamics, the dynamic equations for the utility-scale renewables are constructed with the second generic generation model of WECC (Western Electricity Coordinating Council), and the interactions among distributed renewables and the transmission system are considered in the amount of net load at buses. And to capture the tolerance of renewables for disturbances, the simulation logic is constructed for the voltage relays and frequency relays of utility-scale renewables and the anti-islanding relay of distributed renewables. The presented model is verified on the IEEE 39-bus system. The results show that renewable energy has a significant influence on the cascading failure risk.
Research status and Prospect of integrated energy system collaborative control based on energy Internet
Authors: Ye Peng , Qu Keming , Sun Feng , Zhang Mingli , Zhang Na
Published: May 2021

As the only way to build the energy Internet, the key and difficult point of integrated energy system is to plan it reasonably and efficiently. This paper analyzes and summarizes the basic strategy, key technologies, control difficulties and influencing factors of integrated energy system control, summarizes the existing problems at home and abroad, and summarizes the content framework and control model of general integrated energy system control covering the source, network, load and storage links in a comprehensive way based on the latest research progress. According to the latest research progress, the paper analyzes the current control schemes, and concludes the development trend of the current integrated energy system collaborative control, makes a reasonable outlook on the future, and provides a way of thinking for people to study the integrated energy system in the future.
Research on Supply Chain Governance Strategy: game value analysis based on Incomplete Contract Theory
Authors: Wang Luyao
Published: May 2021

There are potential opportunistic risks in the partnerships of enterprises in different industries. Asymmetric information, incomplete decision-making and Human bounded rationality are factors for the formation of opportunistic risks, and adopting external governance is a feasible way to defuse the risks. Supply chain governance is a new type of governance which is different from enterprise governance. Its scope of governance is wider than enterprise governance. It is the performance of environmental evolution and organizational innovation. Based on the incomplete contract, this paper analyzes the game between the supplier and the manufacturer. It is found that in the process of the game, the cooperation benefits of both parties are the largest and the distribution of benefits is the fairest. Therefore, combined with the theory of supply chain governance, this paper hopes to maximize the value of supply chain by optimizing the supply chain governance strategy under the condition of incomplete contract.
Prevalence of Pregnancy-Induced Hypertension and Its High-Risk Factors among the Antenatal Women
Authors: John Sony , Vanitha M. , Babu Athira , Sushma Priya , Regina Ashihrii Eloni , Frank Reena Wilma
Published: May 2021

Objective A hypertensive disorder during pregnancy seriously endangers the safety of the fetus and women during pregnancy. This study was conducted to estimate the prevalence of pregnancy-induced hypertension (PIH) and its risk factors among antenatal women. The aim of this study was to find the prevalence of PIH and risk factors for PIH among antenatal women in a selected hospital in Mangaluru.

Methods A descriptive study was performed. The study used the total sample size of 400 pregnant women attending the obstetrics and gynecology outpatient department according to the inclusion and exclusion criteria in a tertiary care hospital in Karnataka. The data was collected with a self-reported checklist. Data were entered and analyzed by using SPSS 23.

Results The prevalence of PIH was 10.75% that is 43 antenatal women out of 400. In this study, 34.88% had a family history of PIH, 23% had a previous history of PIH, 16% had a history of gestational diabetes, and 20.93% had a history of thyroid problems. The most important risk factors found for PIH in the present study are the previous history of PIH (adjusted odds ratio [OR] = 1.276, 95% confidence interval [CI: 0.125–11.836), family history of hypertension (adjusted OR=1.930, 95% CI: 1.130–3.296), and thyroid problems (adjusted OR=1.904, CI: 0.786–4.611).

Conclusion PIH is a common medical disorder associated with pregnancy. We noted that PIH is more prevalent in those who had it in their previous pregnancy. PIH is associated with multiple complications in the mother and the baby and particularly preterm delivery. The timely intervention of regular antenatal checkups, nutrition, health education, etc., can reduce the severity of PIH.
Glossing in the Linguistic Survey of India
Authors: Lahaussois Aimée
Published: May 2021

In this article, I explore glossing practices in the period surrounding the publication of the Linguistic
Survey of India (LSI), the large-scale survey of languages spoken on the Indian subcontinent at the turn of the 20th
century, under the stewardship of George Abraham Grierson (1851–1941).

After a brief discussion of the reasons that the LSI constitutes a useful corpus for studying glossing practices,
I provide a detailed examination of the glossing practices used in the text specimens which accompany language descriptions in the
LSI. I then contrast these practices with glossing in materials produced both prior to and subsequent to the LSI, in order to
place the glossing practices established by Grierson within a historical context, thereby contributing a description of one step
in the history of glossing of descriptive linguistic materials.
4. HYPERTENSION RISK ASSOCIATION TO CORONARY HEART DISEASES IN OBESITY PATIENTS AT PUBLIC HOSPITALS OF THE CHRISTIAN UNIVERSITY OF INDONESIA FOR THE YEAR 2019
Authors: Suling Frits R.W.
Published: May 2021

Background:

Modern developments have influenced various fields. Especially changes in lifestyle to diet. Modern lifestyle and diet are starting to appear to increase the risk of cardiovascular disease, one of which is coronary heart disease. According to the World Health Organization (WHO), in 2012 Coronary Heart Disease (CHD) is one of the most common cardiovascular diseases and is a cause of death globally with a high enough figure, scoring 7.4 million and increasing every day. In Indonesia, the prevalence of CHD cases is quite high for cardiovascular disease, amounting to 1.5% in 2013. According to age groups, CHD occurs mostly in age groups. 65-74 years (3.6%) age group 75 years and over (3.2%), age group 55-64 years (2.1%) and age group 35-44 years (1.3%). Obesity is one of the risk factors in the increased incidence of CHD. According to Jean Vaguen, there is a close relationship between differences in body morphology or distribution of body fat with health problems related to obesity risk factors. Obesity caused by excessive fat accumulation. Heart and Blood Vessel Disease which is caused by the accumulation of fat in the central part of the body. Another risk factor is hypertension. Hypertension can cause atherosclerosis in the coronary blood vessels in various ways, affecting the force of blood flow, coronary artery endothelial function, permeability of blood vessel walls, adhesiveness of platelets, and remodeling of blood vessels

Objective:

To study the association of hypertension risk factors in patients with coronary heart disease and obesity at the Hospital of the Faculty of Medicine, Christian University of Indonesia, Jakarta.

Method:

This type of research is an observational study. This study only made observations to patients and did not provide any treatment to patients. The research design used was cross sectional. Research Location: General Hospital of Christian University of Indonesia, Time of study: April to June 2020 The target population in this study were patients with coronary heart disease, both outpatient and inpatient. The sample selection used purposive sampling method.

Conclusion:

There is a significant relationship between hypertension, hypercholesterolemia, and diabetes on CHD in obese patients at the General Hospital of the Christian University of Indonesia, Jakarta for the period 2019.
5. THE ADDITION OF SEHAT, AN ADAPTATION OF DASH DIET, IN ONGOING REGIMENT OF CAPTOPRIL IN A HYPERTENSION PATIENT AT PRIMARY HEALTHCARE SETTING: AN EXPERIMENTAL STUDY
Authors: Setiabudi PA , Ramadhani FR , Kautsarani I , Syabani HS
Published: May 2021

Background:

Hypertension still becomes a menacing worldwide problem. Ninety percent of people over 55 years will develop hypertension. DASH (Dietary Approaches to Stop Hypertension) diet proven to have substantial blood pressure (BP)-lowering action. Captopril is one of the first-line hypertension treatments in Indonesia since it was accessible and affordable. We conducted SEHAT (Seleksi Gaya Hidup Anti Hipertensi), a more adapted hypertension intervention program based on the DASH diet.

Objective:

Here we are going to report the results of adding SEHAT in an ongoing regiment of captopril in a hypertension patient in a primary healthcare setting.

Method:

: We conducted SEHAT counseling in the monthly “PROLANIS” in Sutojayan Primary Health Care. 14 patients with essential hypertension divided into 2 groups: 7 patients accustomed to SEHAT and received 3 × 25 mg Captopril, while 7 others with only captopril consumption as a control group. We measured the difference value of systolic, diastolic, and Mean Arterial Pressure (MAP) pre and post 4-weeks intervention. Statistical analysis was done using an independent t-test.

Result:

Based on mmHg measurement, there were a greater reduction of systolic blood pressure (−11.43 vs 1.71; p = 0.259), diastolic blood pressure (−4.29 vs −2.57; p = 0.833), and MAP (−1.14 vs −6.86; p = 0.517) between SEHAT and control group respectively.

Conclusion:

SEHAT has the potency to become a promising antihypertension program in primary health care. As there was no significant result, further studies need to be carried out with a greater sample to strengthen its efficacy.
9. HYPERTENSION WITH COVID 19 INFECTION AT THE HOSPITAL OF THE CHRISTIAN UNIVERSITY OF INDONESIA, JAKARTA PERIOD MAY TO OCTOBER 2020
Authors: Suling Frits Reinier Wantian , Raspati Zega A , Rantung Nolly Octavianes Habel , Chandramin  , Puspitasari Febtusia
Published: May 2021

Background:

This study discussed patients with covid infection 19 who were admitted to Indonesian Christian university hospital with comorbid hypertension. On December 31, 2019, China reported a case of mysterious pneumonia with no known cause. Within 3 days, the number of patients with these cases was 44 patients and continues to increase until now there are thousands of cases. Initially epidemiological data showed 66% of patients were related or exposed to a seafood market or live market in Wuhan, Hubei Province, China. (2019-nCoV) .2 On February 11, 2020, the World Health Organization named the new virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and the name of the disease as Coronavirus Disease 2019 (COVID-19).

Hypertension is one of the most common comorbids in Covid-19 patients. Hypertension is also widely available in Covid-19 patients who experience ARDS. It is currently unclear whether uncontrolled hypertension is a risk factor for contracting Covid-19, but controlling blood pressure is still considered important to reduce the burden of disease. SARS-CoV-2, the virus that causes Covid-19, binds to ACE2 in the lungs to enter cells, resulting in the use of angiotensin converting enzymes (ACE inhibitors) and angiotensin receptor blockers (ARBs), 2 classes of drugs that are frequently used in controlling hypertension, questionable benefit or harm.

Objective:

Studying patients with covid 19 and their accompanying comorbids who were treated at the Hospital of the Faculty of Medicine of the Indonesian Christian University, Jakarta.

Method:

This type of research is observational research. This study only observed patients. Study design of all treated patients with COVID-19. Research Location: General Hospital of the Christian University of Indonesia, Research Time: May to October 2020.

Result:

It showed 50 people entered the inclusion criteria, hypertension with the most covid 19, 26 people (52%), type 2 diabetes mellitus with covid 19, 22 people (44%), CKD on hemodialysis with covid 19, 4 people (8%), CKD Non HD with covid 19, 3 people (6%). There were 2 patients with heart failure with covid 19 (4%), 2 people with hyperthyroidism with covid 19 (4%). Meanwhile, the ages of 61–70 years (40%) have a lot of Covid 19 in the period that date.

Conclusion:

Covid 19 patients with comorbid hypertension and type 2 diabetes mellitus were mostly found with ages between 61-70 years.
15. BODY MASS INDEX AND HYPERTENSION IN INDONESIAN HAJJ PILGRIMS
Authors: Utami Eka , Ardiana Meity
Published: May 2021

Background:

Indonesia has the largest number of yearly hajj pilgrim around the world. Most of those pilgrims are elderly obese with comorbidity such as hypertension.

Objective:

The aim of this study is to determine correlation between body mass index and hypertension among East Java's pilgrims in 2017 to 2019.

Method:

This study is observational analytic as in cross sectional analysis from East Java pilgrims data between 2017 to 2019. Data was collected by trained hajj health worker and then analyzed by spearman rank correlation test. Body mass index was classified by World Health Organization (WHO) while hypertension by Joint National Committee (JNC) 8.

Result:

There was a total of 105.988 data was collected in which 392 data are invalid due to inappropriate value. Almost half (45.47%) of the pilgrims were normal body mass index yet only 4871 (4.6%) of the pilgrims were underweight. There were 38.403 (36.36%) pilgrims categorized as overweight while 14.301 (13.54%) were obese. However, only 54.120 (1.7%) had normal systolic blood pressure. Further, alarmingly, 31.096 (29.44%) were in pre hypertension stage. There were only 13.757 (13.02%) and 6623 (6.2%) pilgrims categorized having grade one and two hypertension respectively. From the spearmen test analysis result, there was a significant correlation between body mass index and hypertension (p = 0.000, r = 1).

Conclusion:

In sum, there was a strong linear significant relationship between body mass index and systolic blood pressure.
42. INTRADIALYTIC HYPERTENSION AND SIX MONTH – ALL CAUSE MORTALITY IN HEMODIALYSIS PATIENTS
Authors: Perdhana Langgeng , Chasani Shofa
Published: May 2021

Background:

Hemodialysis is safe and beneficial for CRF patient. However, there are several complications during hemodialysis process including intradialytic hypertension (IDH). IDH has been associated with poor outcomes in hemodialysis patients. But only a few studies have investigated the relationship of IDH with mortality in patients undergoing hemodialysis.

Objective:

This study aims to determine the relationship between IDH and 6 month-all cause mortality in hemodialysis patients.

Method:

The cohort design study was carried out in October 2019 to March 2020 at the Hemodialysis Unit of Roemani Muhammadiyah Hospital Semarang. The dependent variable was IDH that defined as rise in Mean Arterial Pressure (MAP) >15 mmHg within or immediately post dialysis. The mortality was investigated over 6 months after the baseline measurements.

Result:

Among 85 respondents, it was found that 22 (25.9%) respondents categorized into IDH group and 63 (74.1%) categorized into non IDH group. The respondents consisted of 54 (63.5%) males and 31 (36.5%) females. The mean delta MAP in the IDH and non IDH group was (mean ± standard error, 22.6 ± 7.9 vs −5 ± 12.3). From the Kaplan Meier survival curve described that non IDH group had higher survival rate than the IDH group (96.8% vs 77.3%, p = 0.004). From Cox regression study we found a significant relationship between IDH and 6-month all cause mortality in hemodialysis patients (p = 0.018; Hazard ratio: 7.305).

Conclusion:

There was a significant relationship between IDH and 6 month – all cause mortality in hemodialysis patients.
45. BLOOD PRESSURE ON ADMISSION IN PATIENTS WITH ACUTE CORONARY SYNDROME COMPLICATED BY ACUTE RESPIRATORY FAILURE
Authors: Sain Azlan , Widyantoro Bambang , Harlyjoy Beta Canina , Juzar Dafsah Arifa
Published: May 2021

Background:

Patient with Acute Coronary Syndrome (ACS) can present with varying degrees of hemodynamic compromise, fluid overload and end-organ hypoperfusion. In addition, these patients typically have high filling pressures, biventricular failure and secondary pulmonary hypertension resulting in decreased gas exchange and increased work of breathing, contributing to acute respiratory failure (ARF). Blood pressure is an easily obtainable diagnostic tool. Ample studies had shown the role of BP on admission as a prognostic instrument in ACS patient.

Objective:

To observe the relationship of BP on admission and ARF as ACS complication at National Cardiovascular Centre Harapan Kita (NCCHK)

Methods:

We collected medical record data of acute coronary syndrome patients in NCCHK from January to December 2020.

Results:

1.383 samples were obtained. ARF occurs in 4.2% of our patients. Systolic Blood Pressure (SBP) in patient with respiratory failure was higher (130: 60–255 mmHg) compared with patient without respiratory failure (116: 61–255 mmHg, p = 0.001). Diastolic Blood Pressure (DBP) was also higher in patient with ARF (77: 30–218 vs 70: 38–130 mmHg, p = 0.001). Further analysis with chi-square test showed that patient with hypertension on admission was associated with ARF (p = 0.035) with odds ratio 1.8, 95% CI of 1.036 to 3.383 (p = 0.038).

Conclusion:

ACS patients complicated by ARF have higher blood pressure (SBP and DBP) on admission than in ACS patients without respiratory failure
47. PULSE PRESSURE ON ADMISSION AND SHORT-TERM OUTCOME IN ST-SEGMENTS ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PERCUTANEOUS INTERVENTION
Authors: Suryawan Willy , Danny Siska Suridanda , Harlyjoy Beta Canina , Sain Azlan , Widyantoro Bambang
Published: May 2021

Background:

In patients with ST-segment elevation myocardial infarction (STEMI), blood pressure (BP) variables are easily obtainable prognostic tools. Recently, pulse pressure (PP) has been identified as a more powerful prognostic predictor of cardiovascular events compared to systolic blood pressure (SBP) or diastolic blood pressure (DBP) in selected populations.

Objective:

To observe the relationship of BP variables on admission and short-term outcomes in STEMI patients undergoing PCI at National Cardiovascular Center Harapan Kita (NCCHK).

Methods:

We collected medical record data of STEMI patients undergoing primary PCI in NCCHK from January to December 2020.

Results:

Three hundred and forty-four samples were obtained. No in-hospital mortality was found in our population. The median length-of-stay was 5: 3–47 days. In-hospital cardiac arrest rate was 2.9% (10 patients), with rate of rehospitalization of 11.3% (39 patients). In patients experiencing in-hospital cardiac arrest, the SBP was lower (115.40 ± 22.27 vs 126.94 ± 24.48, p = 0.169), DBP was higher (81.50: 56–92 vs 76: 28–128, p = 0.746), and lower PP (34.50: 20–63 vs 48: 6–119, p = 0.020). Further analysis with chi-square test showed that PP < 40 mmHg is associated with in-hospital cardiac arrest (p = 0.023).

Conclusion:

Pulse pressure on admission is associated with in-hospital cardiac arrest in STEMI patients undergoing PCI.
Seatbelts Save Lives, and Spines, in Motor Vehicle Accidents
Authors: Sarwahi Vishal , Atlas Aaron M. , Galina Jesse , Satin Alexander , Dowling Thomas J. , Hasan Sayyida , Amaral Terry D. , Lo Yungtai , Christopherson Nathan , Prince Jose
Published: May 2021

Study Design.

Database study.

Objective.

The purpose of this study was to use a large, nationwide database to determine prevalence of pediatric spine fractures in the United States, associated injuries, mechanisms of injury (MOI), use of safety devices, and mortality rates.

Summary of Background Data.

Spinal fractures account for 1% to 2% of pediatric injuries. However, they are associated with significant comorbidities and complications. Motor vehicle accidents (MVAs) are most responsible for increased incidence observed.

Methods.

Retrospective review of National Trauma Data Bank between 2009 and 2014 (analysis in 2019) for all vertebral fractures in patients under 18 years of age. Subanalysis included those in MVAs where protective device use data were available. Patient demographics, MOI, geographical and anatomical region of injury, concomitant musculoskeletal/organ injury, protective device usage, hospital length of stay, surgical procedures, and mortality were all analyzed.

Results.

A total of 34,563 patients with 45,430 fractured vertebrae included. Median age was 15 years. Most fractures (63.1%) occurred in patients aged 15 to 17 years, most frequent MOI was MVA (66.8%), and most common geographic location was the South (38%). Males sustained more spine fractures than females, overall (58.4% vs. 41.6%; P < 0.001) and in MVAs (54.4% vs. 45.6%; P < 0.001). Those in MVAs wearing seatbelts had lower odds of cranial (29.6% vs. 70.4%; odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.82–0.89; P < 0.001) and thoracic (30.1% vs. 69.9%; OR = 0.88, 95% CI: 0.84–0.91; P < 0.001) organ injury, multivertebral (30% vs. 70%; OR = 0.78, 95% CI: 0.73–0.83; P < 0.001) and concomitant nonvertebral fractures (30.9% vs. 69.1%; OR = 0.89, 95% CI:0.73–0.83; P < 0.001), and 21% lower odds of mortality (29.3% vs. 70.7%; OR = 0.79, 95% CI: 0.66–0.94; P = 0.009). Over 70% of drivers were not restrained during MVA, with majority of seatbelt violations incurred by males, ages 15 to 17, in the South.

Conclusion.

Over 60% of pediatric spinal fractures occur in children aged 15 to 17 years, coinciding with the beginning of legal driving. MVA is the most common cause and has significant association with morbidity/mortality. Nearly two- thirds pediatric spinal fractures sustained in MVAs occurred without seatbelts. Absence of seatbelts associated with >20% greater odds of mortality. Ensuring new drivers wear protective devices can greatly reduce morbidity/ mortality associated with MVA.

Level of Evidence: 3
The Chimeric Scapulodorsal Vascularized Latissimus Dorsi Nerve Flap for Immediate Reconstruction of Total Parotidectomy Defects With Facial Nerve Sacrifice
Authors: Li Sean S. , Mangialardi Maria L. , Nguyen Quyen T. , Orosco Ryan K. , Honart Jean F. , Qassemyar Quentin , Kolb Frederic J.
Published: May 2021

Background

Total parotidectomy with facial nerve sacrifice creates 2 challenging reconstructive problems: restoration of facial contour and facial nerve rehabilitation. Strong evidence suggesting that vascularized nerve grafts are superior to nonvascularized nerve grafts motivated our team to develop a chimeric scapulodorsal flap combining the usual harvestable local tissues with the vascularized latissimus dorsi motor nerve (SD-LDVxN). We present our experiences developing a new program at University of California, San Diego, highlighting our first case here, and present preliminary retrospective results focusing on the functional outcomes of facial nerve reanimation.

Materials and Methods

The first case performed in the United States was a 57-year-old woman with stage IVA left parotid adenoid cystic carcinoma and House-Brackmann grade 6 facial palsy. She underwent total parotidectomy with facial nerve sacrifice and a free chimeric SD-LDVxN flap reconstruction. She had an unremarkable postoperative course, and 3- and 6-month follow-up functional results are reported. Preliminary functional results from our total series of 25 patients were reported.

Results

At her 3-month follow-up, she was a House-Brackmann 5 with a static eFACE score of 37, dynamic eFACE score of 31, and smile eFACE score of 48. At her 6-month follow-up, she was a House-Brackmann 5 with a static eFACE score of 50, dynamic eFACE score of 27, and smile eFACE score of 53. Preliminary results from our total series of 25 patients with an average of 5 years of follow-up were a House-Brackmann 2.5 and eFACE scores of 83.1 for static facial symmetry, 67.5 for dynamic facial symmetry, and 77.7 for smile score. Twenty of the 25 patients had postoperative radiotherapy. No local tumor recurrence had been reported. The average reinnervation time was 9 months and ranged from 3 to 15 months.

Conclusions

The SD-LDVxN flap is a highly resourceful solution to reconstruct complex parotid defects, especially those that sacrifice the facial nerve. The vascularized nerve graft allows for primary facial reanimation. Nerve recovery may be superior to what could be expected with a conventional nerve graft.
Improved Genome Packaging Efficiency of AAV Vectors Using Rep Hybrids
Authors: Mietzsch Mario , Eddington Courtnee , Jose Ariana , Hsi Jane , Chipman Paul , Henley Tom , Choudhry Modassir , McKenna Robert , Agbandje-McKenna Mavis
Published: May 2021

Recombinant Adeno-associated viruses (rAAVs) are one of the most commonly used vectors for a variety of gene therapy applications. In the last two decades research focused primarily on the characterization and isolation of new cap genes resulting in hundreds of natural and engineered AAV capsid variants while the rep gene, the other major AAV open reading frame, has been less studied. This is due to the fact that the rep gene from AAV serotype 2 (AAV2) enables the ssDNA packaging of recombinant genomes into most AAV serotype and engineered capsids. However, a major byproduct of all vector productions is empty AAV capsids, lacking the encapsidated vector genome, especially for non-AAV2 vectors. Despite the packaging process being considered the rate-limiting step for rAAV production, none of the rep genes from the other AAV serotypes have been characterized for their packaging efficiency. Thus, in this study AAV2 rep was replaced with the rep gene of a select number of AAV serotypes. However, this led to a lowering of capsid protein expression, relative to the standard AAV2-rep system. In further experiments the 3’end of the AAV2 rep gene was reintroduced to promote increased capsid expression and a series of chimeras between the different AAV Rep proteins were generated and characterized for their vector genome packaging ability. The utilization of these novel Rep hybrids increased the percentage of genome containing (full) capsids ~2-4-fold for all of the non-AAV2 serotypes tested. Thus, these Rep chimeras could revolutionize rAAV production.

Importance

A major byproduct of all Adeno-associated virus (AAV) vector production systems are “empty” capsids, void of the desired therapeutic gene, and thus do not provide any curative benefit for the treatment of the targeted disease. In fact, empty capsids can potentially elicit additional immune responses in vivo gene therapies if not removed by additional purification steps. Thus, there is a need to increase the genome packaging efficiency and reduce the number of empty capsids from AAV biologics. The novel Rep hybrids from different AAV serotypes described in this study are capable of reducing the percentage of empty capsids in all tested AAV serotypes and improve overall yields of genome-containing AAV capsids at the same time. They can likely be integrated easily into existing AAV manufacturing protocols to optimize the production of the generated AAV gene therapy products.
Alternatives to mental health admissions for children and adolescents experiencing mental health crises: a systematic review of the literature
Authors: Clisu Denisa , Layther Imogen , Dover Deborah , Viner Russell M. , Read Tina , Cheesman David , Hodges Sally , Hudson Lee D
Published: May 2021

Background

Increasingly more children and young people (CYP) present in mental health crises, many being hospitalised due to concerns around illness severity and lack of community services. To release the burden of admission, we systematically reviewed the literature on the effects of proposed alternatives to CYP in crises.

Methods

Three databases (PsychInfo, PubMed and Web of Science) were searched for peer-reviewed papers in October 2020, with an updated search in May 2021.

Results

We identified 19 papers of interventions delivered in the emergency department, the home, outside of home but outside of clinics and in hospital clinics. The best evidence came from in-home interventions, in particular multisystemic therapy (MST), which proved to be promising alternatives by improving psychological outcomes and decreasing length of inpatient stay. The quality of included studies was low, with less than half being randomised controlled trials and only half of these at low risk of bias.

Conclusions

We could not recommend a particular intervention as an alternative to inpatient admission, however our review describes benefits across a range of types of inteventions that might be considered in multi-modal treatments. We also provide recommendations for future research, in particular the evaluation of new interventions as they emerge.
Detecting the ecological footprint of selection
Authors: Luiselli Juliette , Overcast Isaac , Rominger Andrew , Ruffley Megan , Morlon Hélène , Rosindell James
Published: May 2021

The structure of communities is influenced by many ecological and evolutionary processes, but the way this manifests in classic biodiversity patterns often remains unclear. Here, we aim to distinguish the ecological footprint of selection – through competition or environmental filtering – from that of neutral processes that are invariant to species identity. We build on existing Massive Eco-evolutionary Synthesis Simulations (MESS), which uses information from three biodiversity axes – species abundances, genetic diversity, and trait variation – to distinguish between mechanistic processes. In order to correctly detect and characterise competition, we add a new and more realistic form of competition that explicitly compares the traits of each pair of individuals. Our results are qualitatively different to those of previous work in which competition is based on the distance of each individual’s trait to the community mean. We find that our new form of competition is easier to identify in empirical data compared to the alternatives. This is especially true when trait data are available and used in the inference procedure. Our findings hint that signatures in empirical data previously attributed to neutrality may in fact be the result of pairwise-acting selective forces. We conclude that gathering more different types of data, together with more advanced mechanistic models and inference as done here, could be the key to unravelling the mechanisms of community assembly.