bluuebunny/crossref_metadata_2025 huggingface dataset:
Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States
Authors: Tenforde Mark W , Self Wesley H , Zhu Yuwei , Naioti Eric A , Gaglani Manjusha , Ginde Adit A , Jensen Kelly , Talbot H Keipp , Casey Jonathan D , Mohr Nicholas M , Zepeski Anne , McNeal Tresa , Ghamande Shekhar , Gibbs Kevin W , Files D Clark , Hager David N , Shehu Arber , Prekker Matthew E , Erickson Heidi L , Gong Michelle N , Mohamed Amira , Johnson Nicholas J , Srinivasan Vasisht , Steingrub Jay S , Peltan Ithan D , Brown Samuel M , Martin Emily T , Monto Arnold S , Khan Akram , Hough Catherine L , Busse Laurence W , Lohuis Caitlin ten , Duggal Abhijit , Wilson Jennifer G , Qadir Nida , Chang Steven Y , Mallow Christopher , Rivas Carolina , Babcock Hilary M , Kwon Jennie H , Exline Matthew C , Botros Mena M , Lauring Adam S , Shapiro Nathan I , Halasa Natasha , Chappell James D , Grijalva Carlos G , Rice Todd W , Jones Ian D , Stubblefield William B , Baughman Adrienne , Womack Kelsey N , Rhoads Jillian P , Lindsell Christopher J , Hart Kimberly W , Turbyfill Caitlin , Olson Samantha , Murray Nancy , Adams Katherine , Patel Manish M ,   for the Influenza and Other Viruses in the Acutely Ill (IVY) Network
Published: May 2022

Background

Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19–associated hospitalization.

Methods

Case-control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states 11 March–15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction–negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose 2) and continuous time modeled using restricted cubic splines.

Results

A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46–70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88–91) versus 82% (95% CI, 79–85) at ≥180 days (P < .001). VE declined for Pfizer-BioNTech (88% to 79%, P < .001) and Moderna (93% to 87%, P < .001) products, for younger adults (18–64 years) (91% to 87%, P = .005), and for adults ≥65 years of age (87% to 78%, P < .001). In models using restricted cubic splines, similar changes were observed.

Conclusions

In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19–associated hospitalization was largely sustained through 9 months.
Custodiol-N versus Custodiol: a prospective randomized double-blind multicentre phase III trial in patients undergoing elective coronary bypass surgery
Authors: Szabó Gábor , Brlecic Paige , Loganathan Sivakkanan , Wagner Florian , Rastan Ardawan , Doenst Torsten , Karck Matthias , Veres Gábor
Published: May 2022

OBJECTIVES

HTK-Solution (Custodiol) is a well-established cardioplegic and organ preservation solution. We currently developed a novel HTK-based solution, Custodiol-N, which includes iron chelators to reduce oxidative injury, as well as l-arginine, to improve endothelial function. In this first-in-human study, Custodiol-N was compared to Custodiol in patients undergoing elective coronary artery bypass surgery. The aim of this comparison was to evaluate the safety and ability of Custodiol-N to protect cardiac tissue.

METHODS

The study was designed as a prospective randomized double-blind non-inferiority trial. Primary end point was area under the curve (AUC) of creatine kinase muscle-brain (CK-MB) within the first 24 h after surgery. Secondary end points included peak CK-MB and troponin-T and AUC of troponin-T release, cardiac index, cumulative catecholamine dose, intensive care unit stay and mortality. All values in the abstract are given as mean ± SD, P < 0.05 was considered statistically significant.

RESULTS

Early termination of the trial was performed per protocol as the primary non-inferiority end-point was reached after inclusion of 101 patients. CK-MB AUC (878±549 vs 779±439 h U/l, non-inferiority P < 0.001, Custodiol vs Custodiol-N) and troponin-T AUC (12990±8347 vs 13498±6513 h pg/ml, noninferiority P < 0.001, Custodiol vs Custodiol-N) were similar in both groups. Although the trial was designed for non-inferiority, peak CK-MB (52±40 vs 42±28 U/l, superiority P < 0.03, Custodiol vs Custodiol-N) was significantly lower in the Custodiol-N group.

CONCLUSIONS

This study shows that Custodiol-N is safe and provides similar cardiac protection as the established HTK-Custodiol solution. Significantly reduced peak CK-MB levels in the Custodiol-N group in the full analysis set may implicate a beneficial effect on ischaemia/reperfusion injury in the setting of coronary bypass surgery.
Parsimonious risk model for predicting mortality after surgical lung biopsy for interstitial lung disease
Authors: Yun Jae Kwang , Lee Geun Dong , Kim Hyeong Ryul , Kim Yong-Hee , Kim Dong Kwan , Park Seung-Il , Choi Sehoon
Published: May 2022

OBJECTIVES

To develop a risk model for predicting postoperative mortality and morbidity in patients with interstitial lung disease undergoing surgical lung biopsy.

METHODS

From 2004 to 2019, patients who underwent surgical lung biopsy for interstitial lung disease were included in this study. Based on the findings of the multivariable analysis using preoperative clinical variables, a risk model for predicting postoperative mortality and morbidity was developed.

RESULTS

During the study period, 1177 patients were enrolled. Among them, morbidity and mortality occurred in 45 (3.8%) and 29 (2.5%) patients, respectively, which gradually declined over time from 8.9% in 2004–2005 to 0% in 2018–2019. In the final multivariable analysis, the dyspnoea grade, a forced vital capacity of ≤60%, preoperative oxygen therapy and preoperative intensive care unit stay were found to be the independent factors associated with both morbidity and mortality; smoking >40 pack-years was additionally identified as a factor related to mortality. Diffusing capacity of carbon monoxide ≤50%, which was a significant factor in the univariable analysis, became insignificant after adjustment for the forced vital capacity in the multivariable analysis. The risk scoring system based on this model showed a good discriminant ability for both morbidity [area under the receiver operating characteristic curve (95% confidence interval): 0.830 (0.726–0.932)] and mortality [0.887 (0.804–0.975)].

CONCLUSIONS

We developed a scoring system for predicting the risk of morbidity and mortality, which could help determine surgical candidates for lung biopsy among patients with interstitial lung disease.
Evolution and functional diversification of R2R3-MYB transcription factors in plants
Authors: Wu Yun , Wen Jing , Xia Yiping , Zhang Liangsheng , Du Hai
Published: May 2022

R2R3-MYB genes (R2R3-MYBs) form one of the largest transcription factor gene families in the plant kingdom, with substantial structural and functional diversity. However, the evolutionary processes leading to this amazing functional diversity have not yet been clearly established. Recently developed genomic and classical molecular technologies have provided detailed insights into the evolutionary relationships and functions of plant R2R3-MYBs. Here, we review recent genome-level and functional analyses of plant R2R3-MYBs, with an emphasis on their evolution and functional diversification. In land plants, this gene family underwent a large expansion by whole genome duplications and small-scale duplications. Along with this population explosion, a series of functionally conserved or lineage-specific subfamilies/groups arose with roles in three major plant-specific biological processes: development and cell differentiation, specialized metabolism, and biotic and abiotic stresses. The rapid expansion and functional diversification of plant R2R3-MYBs are highly consistent with the increasing complexity of angiosperms. In particular, recently derived R2R3-MYBs with three highly homologous intron patterns (a, b, and c) are disproportionately related to specialized metabolism and have become the predominant subfamilies in land plant genomes. The evolution of plant R2R3-MYBs is an active area of research, and further studies are expected to improve our understanding of the evolution and functional diversification of this gene family.
TCMPG: an integrative database for traditional Chinese medicine plant genomes
Authors: Meng Fanbo , Tang Qiang , Chu Tianzhe , Li Xianhai , Lin Yue , Song Xiaoming , Chen Wei
Published: May 2022

Because of their great therapeutic and economic value, medicinal plants have attracted increasing scientific attention. With the rapid development of high-throughput sequencing technology, the genomes of many medicinal plants have been sequenced. Storing and analyzing the increasing volume of genomic data has become an urgent task. To solve this challenge, we have proposed the Traditional Chinese Medicine Plant Genome database (TCMPG, http://cbcb.cdutcm.edu.cn/TCMPG/), an integrative database for storing the scattered genomes of medicinal plants. TCMPG currently includes 160 medicinal plants, 195 corresponding genomes, and 255 herbal medicines. Detailed information on plant species, genomes, and herbal medicines is also integrated into TCMPG. Popular genomic analysis tools are embedded in TCMPG to facilitate the systematic analysis of medicinal plants. These include BLAST for identifying orthologs from different plants, SSR Finder for identifying simple sequence repeats, JBrowse for browsing genomes, Synteny Viewer for displaying syntenic blocks between two genomes, and HmmSearch for identifying protein domains. TCMPG will be continuously updated by integrating new data and tools for comparative and functional genomic analysis.
DgbZIP3 interacts with DgbZIP2 to increase the expression ofDgPODfor cold stress tolerance in chrysanthemum
Authors: Bai Huiru , Liao Xiaoqin , Li Xin , Wang Bei , Luo Yunchen , Yang Xiaohan , Tian Yuchen , Zhang Lei , Zhang Fan , Pan Yuanzhi , Jiang Beibei , Jia Yin , Liu Qinglin
Published: May 2022

The bZIP transcription factor plays a very important role in abiotic stresses, e.g. drought, salt, and low-temperature stress, but the mechanism of action at low temperature is still unclear. In this study, overexpression of DgbZIP3 led to increased tolerance of chrysanthemum (Chrysanthemum morifolium Ramat.) to cold stress, whereas antisense suppression of DgbZIP3 resulted in decreased tolerance. Electrophoretic mobility shift assay (EMSA), chromatin immunoprecipitation (ChIP), luciferase complementary imaging analysis (LCI), and dual-luciferase reporter gene detection (DLA) experiments indicated that DgbZIP3 directly bound to the promoter of DgPOD and activated its expression. DgbZIP2 was identified as a DgbZIP3-interacting protein using yeast two-hybrid, co-immunoprecipitation, LCI, and bimolecular fluorescence complementation assays. Overexpression of DgbZIP2 led to increased tolerance of chrysanthemum to cold stress, whereas antisense suppression of DgbZIP2 resulted in decreased tolerance. A ChIP–qPCR experiment showed that DgbZIP2 was highly enriched in the promoter of DgPOD, while DLA, EMSA, and LCI experiments further showed that DgbZIP2 could not directly regulate the expression of DgPOD. The above results show that DgbZIP3 interacts with DgbZIP2 to regulate the expression of DgPOD to promote an increase in peroxidase activity, thereby regulating the balance of reactive oxygen species and improving the tolerance of chrysanthemum to low-temperature stress.
Improved ginseng production under continuous cropping through soil health reinforcement and rhizosphere microbial manipulation with biochar: a field study ofPanax ginsengfrom Northeast China
Authors: Liu Cheng , Xia Rong , Tang Man , Chen Xue , Zhong Bin , Liu Xiaoyu , Bian Rongjun , Yang Li , Zheng Jufeng , Cheng Kun , Zhang Xuhui , Drosos Marios , Li Lianqing , Shan Shengdao , Joseph Stephen , Pan Genxing
Published: May 2022

The production of ginseng, an important Chinese medicine crop, has been increasingly challenged by soil degradation and pathogenic disease under continuous cropping in Northeast China. In a field experiment, an Alfisol garden continuously cropped with Chinese ginseng (Panax ginseng C. A. Meyer) was treated with soil amendment at 20 t ha−1 with maize (MB) and wood (WB) biochar, respectively, compared to conventional manure compost (MC). Two years after the amendment, the rooted topsoil and ginseng plants were sampled. The changes in soil fertility and health, particularly in the soil microbial community and root disease incidence, and in ginseng growth and quality were portrayed using soil physico-chemical assays, biochemical assays of extracellular enzyme activities and gene sequencing assays as well as ginsenoside assays. Topsoil fertility was improved by 23% and 39%, ginseng root biomass increased by 25% and 27%, and root quality improved by 6% and 18% with WB and MB, respectively, compared to MC. In the ginseng rhizosphere, fungal abundance increased by 96% and 384%, with a significant and insignificant increase in bacterial abundance, respectively, under WB and MB. Specifically, the abundance of Fusarium spp. was significantly reduced by 19–35%, while that of Burkholderia spp. increased by folds under biochar amendments over MC. Relevantly, there was a significant decrease in the abundance proportion of pathotrophic fungi but a great increase in that of arbuscular mycorrhizal fungi, along with an enhanced microbial community network complexity, especially fungal community complexity, under biochar amendments. Thus, biochar, particularly from maize residue, could promote ginseng quality production while enhancing soil health and ecological services, including carbon sequestration, in continuously cropped fields.
Regulatory interaction of BcWRKY33A and BcHSFA4A promotes salt tolerance in non-heading Chinese cabbage [Brassica campestris (syn. Brassica rapa) ssp. chinensis]
Authors: Wang Huiyu , Li Zhubo , Ren Haibo , Zhang Changwei , Xiao Dong , Li Ying , Hou Xilin , Liu Tongkun
Published: May 2022

Salinity is a universal environmental stress that causes yield reduction in plants. WRKY33, which has been extensively studied in plant defense against necrotrophic pathogens, has recently been found to be important in salt-responsive pathways. However, the underlying molecular mechanisms controlling the involvement of WRKY33 in salt tolerance have not been fully characterized. Here, we explored the function of BcWRKY33A in non-heading Chinese cabbage (NHCC). Under salt stress, BcWRKY33A expression is significantly induced in roots. As a nuclear protein, BcWRKY33A has strong transcriptional activation activity. Overexpression of BcWRKY33A confers salt tolerance in Arabidopsis, whereas silencing of BcWRKY33A causes salt sensitivity in NHCC. Furthermore, BcHSFA4A, a protein that interacts with BcWRKY33A, could directly bind to the HSE motif within the promoters of BcZAT12 and BcHSP17.6A, which are involved in the plant response to salt stress. Finally, we found that BcWRKY33A could enhance the transcriptional activity of BcHSFA4A and affect its downstream genes (e.g. BcZAT12 and BcHSP17.6A), and co-overexpression of BcWRKY33A and BcHSFA4A could promote the expression of salt-related genes, suggesting that the regulatory interaction between BcWRKY33A and BcHSFA4A improves salt tolerance in plants. Overall, our results provide insight into the molecular framework of the BcWRKY33A-BcHSFA4A signaling pathway, which also aids in our understanding of the molecular mechanism of salt tolerance in plants.
Lessons From a Museum's Cabinet: DNA Barcoding and Collections-Based Life Stage Associations Reveals a Hidden Diversity in the Puerto Rican Bank Paedomorphic Lycidae (Coleoptera: Elateroidea: Leptolycini)
Authors: Ferreira Vinicius S , Ivie Michael A
Published: May 2022

The Leptolycini are a group of Lycidae endemic to the West Indies. Leptolycini adult females have been hypothesized to be extreme paedomorphic (i.e., larviform), however, females and larvae of the group are currently unknown. Here we provide the first association of adult male and immature life stages from the Puerto Rico using DNA barcoding, also collections-based associations and descriptions of immature Leptolycini and the first description of a paedomorphic female from the Virgin Islands. To carry out these life-stage associations we prepared an in-depth review of the Leptolycini fauna of the Puerto Rican bank (Puerto Rico and Virgin Islands). Several new taxa and taxonomic arrangements are proposed: Cessator crypticusnew species, Cessator tortolensisnew species, Cessator obrienorumnew species; Dracolycus chupacabranew genus and species, Dracolycus marshallinew species; Leptolycus falsoheterocornisnew species, and Leptolycus viensisnew species. Nanolycus gnomus Kazantsev is moved to Cessator gnomus (Kazantsev) new combination, rendering Nanolycus Kazantsev a new junior synonym of Cessator Kazantsev. The subgenus Baholycus Bocak is a new junior synonym of Leptolycus Leng and Mutchler. Leptolycus heterocornis var. flavicollis Leng and Mutchler is elevated to Leptolycus flavicollis Leng and Mutchler new status; Leptolycus (Leptolycus) albicauda Kazantsev is a new junior synonym of Leptolycus flavicollis Leng and Mutchler. An updated key to the adults and immature forms of Leptolycini from the Puerto Rican bank and a discussion on the importance of scientific collections in biodiversity studies is also provided.
High-z Sudoku: a diagnostic tool for identifying robust (sub)mm redshifts
Authors: Bakx Tom J L C , Dannerbauer Helmut
Published: May 2022

We present methods to (i) graphically identify robust redshifts using emission lines in the (sub)mm regime, (ii) evaluate the capabilities of different (sub)mm practices for measuring spectroscopic redshifts, and (iii) optimize future (sub)mm observations towards increasing the fraction of robust redshifts. Using this publicly available code (https://github.com/tjlcbakx/redshift-search-graphs), we discuss scenarios where robust redshifts can be identified using both single- and multiple-line detections, as well as scenarios where the redshift remains ambiguous, even after the detection of multiple lines. Using the redshift distribution of (sub)mm samples, we quantify the efficiencies of various practices for measuring spectroscopic redshifts, including interferometers, as well as existing and future instruments specifically designed for redshift searches. Finally, we provide a method to optimize the observation strategy for future (sub)mm spectroscopic redshift searches with the Atacama Large Millimetre/submillimetre Array, where 2 mm proves indispensable for robust redshifts in the $\mathit{ z}$ = 2−4 region.
Starfall: a heavy rain of stars in ‘turning on’ AGN
Authors: McKernan B , Ford K E S , Cantiello M , Graham M , Jermyn A S , Leigh N W C , Ryu T , Stern D
Published: May 2022

As active galactic nuclei (AGN) ‘turn on’, some stars end up embedded in accretion discs around supermassive black holes (SMBHs) on retrograde orbits. Such stars experience strong headwinds, aerodynamic drag, ablation, and orbital evolution on short time-scales. The loss of orbital angular momentum in the first ∼0.1 Myr of an AGN leads to a heavy rain of stars (‘starfall’) into the inner disc and on to the SMBH. A large AGN loss cone (θAGN, lc) can result from binary scatterings in the inner disc and yield tidal disruption events (TDEs). Signatures of starfall include optical/UV flares that rise in luminosity over time, particularly in the inner disc. If the SMBH mass is $M_{\rm SMBH} \gtrsim 10^{8}\, \mathrm{M}_{\odot }$, flares truncate abruptly and the star is swallowed. If $M_{\rm SMBH}\lt 10^{8}\, \mathrm{M}_{\odot }$, and if the infalling orbit lies within θAGN, lc, the flare is followed by a TDE that can be prograde or retrograde relative to the AGN inner disc. Retrograde AGN TDEs are overluminous and short-lived as in-plane ejecta collide with the inner disc and a lower AGN state follows. Prograde AGN TDEs add angular momentum to inner disc gas and so start off looking like regular TDEs but are followed by an AGN high state. Searches for such flare signatures test models of AGN ‘turn on’, SMBH mass, as well as disc properties and the embedded population.
Characteristics and evolution of Be-type high-mass X-ray binaries as potential ultraluminous X-ray sources
Authors: Karino Shigeyuki
Published: May 2022

Some ultraluminous X-ray sources (ULXs) exhibit X-ray pulses, and their central sources are thought to be neutron stars. It has also been suggested that some are transient sources with Be-type donors. In this study, we use the mass accretion model of a Be-type high-mass X-ray binary (BeHMXB) to estimate the conditions under which a giant X-ray burst caused by a BeHMXB exceeds the Eddington luminosity. Moreover, we investigate the duration for which BeHMXBs can be observed as transient ULXs with bursts above the Eddington luminosity during binary evolutions. The results indicate that BeHMXBs could be ULXs for a typical duration of approximately 1 Myr. Comparisons with nearby observed BeHMXBs indicate that many binary systems have the potential to become ULXs during their evolution. Particularly, a BeHMXB system tends to become a ULX when the Be donor has a dense deccretion disc aligned with the orbital plane. Because BeHMXBs are very common objects and a significant number of them can become ULXs, we conclude that a reasonable fraction of the observed ULXs could consist of evolved BeHMXBs.
Lineage-specific insertions in T-box riboswitches modulate antibiotic binding and action
Authors: Giarimoglou Nikoleta , Kouvela Adamantia , Patsi Ioanna , Zhang Jinwei , Stamatopoulou Vassiliki , Stathopoulos Constantinos
Published: May 2022

T-box riboswitches (T-boxes) are essential RNA regulatory elements with a remarkable structural diversity, especially among bacterial pathogens. In staphylococci, all glyS T-boxes synchronize glycine supply during synthesis of nascent polypeptides and cell wall formation and are characterized by a conserved and unique insertion in their antiterminator/terminator domain, termed stem Sa. Interestingly, in Staphylococcus aureus the stem Sa can accommodate binding of specific antibiotics, which in turn induce robust and diverse effects on T-box-mediated transcription. In the present study, domain swap mutagenesis and probing analysis were performed to decipher the role of stem Sa. Deletion of stem Sa significantly reduces both the S. aureus glyS T-box-mediated transcription readthrough levels and the ability to discriminate among tRNAGly isoacceptors, both in vitro and in vivo. Moreover, the deletion inverted the previously reported stimulatory effects of specific antibiotics. Interestingly, stem Sa insertion in the terminator/antiterminator domain of Geobacillus kaustophilus glyS T-box, which lacks this domain, resulted in elevated transcription in the presence of tigecycline and facilitated discrimination among proteinogenic and nonproteinogenic tRNAGly isoacceptors. Overall, stem Sa represents a lineage-specific structural feature required for efficient staphylococcal glyS T-box-mediated transcription and it could serve as a species-selective druggable target through its ability to modulate antibiotic binding.
Controllable Majorana vortex states in iron-based superconducting nanowires
Authors: Li Chuang , Luo Xun-Jiang , Chen Li , Liu Dong E , Zhang Fu-Chun , Liu Xin
Published: May 2022

To reveal the non-Abelian braiding statistics of Majorana zero modes (MZMs), it is crucial to design a Majorana platform, in which MZMs can be easily manipulated in a broad topological nontrivial parameter space. This is also an essential step to confirm their existence. In this study, we propose an iron-based superconducting nanowire system with Majorana vortex states to satisfy desirable conditions. This system has a radius-induced topological phase transition, giving a lower bound for the nanowire radius. In the topological phase, the iron-based superconducting nanowires have only one pair of MZMs over a wide range of radii, chemical potential and external magnetic fields. The wave function of MZMs has a sizable distribution at the side edge of the nanowires. This property enables the control of the interaction of MZMs in neighboring vortex nanowires and paves the way for Majorana fusion and braiding.
Preventing symptomatic vitamin D deficiency and rickets among Indigenous infants and children in Canada
Authors: Irvine James , Ward Leanne M
Published: May 2022

Vitamin D deficiency (VitDD) rickets and other manifestations of severe VitDD, such as cardiomyopathy and hypocalcemic seizures, continue to be diagnosed in Canada. Breastfed Indigenous infants, particularly those living in northern communities, are disproportionately impacted, although formula-fed infants are not exempt in cases where the mother’s vitamin D status is critically low. This statement deals with the prevention of rickets and hypocalcemia due to VitDD for Indigenous children, and revises an earlier document from the Canadian Paediatric Society. An assessment of the risk for VitDD is recommended for each maternal-infant dyad because of the link between maternal and infant VitDD. Along with supports for enhanced adherence, additional VitD supplementation is recommended for prenatal women and infants deemed at high risk and, in certain situations, intermittent higher dose supplementation may be required. Food insecurity can also contribute to rickets, so advocacy is required to prevent VitDD rickets in Indigenous children.
1 NEUROPEPTIDEY LEVELS EFFECT ON BLOOD PRESSURE IN CHRONIC KIDNEY DISEASE PATIENTS WITH HYPERTENSION
Authors: Muzasti Riri Andri , Wendy  , Loesnihari Ricke
Published: May 2022

Background: Impaired kidney function in Chronic Kidney Disease (CKD) results in increase sympathetic nerve activation, therefore CKD patients often experience hypertension (Ht). Increased sympathetic nerve tone is mediated by increment of sympathetic neurotransmitter which is Neuropeptide Y (NPY).

Objective: this study aims to identify Neuropeptide (NPY) levels effect on blood pressure (BP) in CKD patients with hypertension and compare with healthy population.

Methods: This case-control study involved 43 CKD patients with regular hemodialysis, 20 non-dialysis CKD stage 1-5 patients and 25 healthy controls. NPY levels were checked by enzyme-linked immunosorbent assay (ELISA). It said to be significant if p value < 0.05.

Results: This study shows that NPY levels have a significant effect on BP. Patients with Ht grade II had higher NPY levels (885.80 ng/L) than Ht grade I (423.18 ng/L) or controlled Ht (464.06 ng/L) (p=0.024), but it was higher in controlled (937.56 ng/L) than CKD patients (617.14 ng/L) (p=0.06).

Conclusions:> NPY levels affect BP. It seem displays a bidirectional effect in cardiovascular tissue, acting as a cardio-depressant and a cardio-stressor.; lowers BP in healthy populations but increases BP in CKD patients. Further research is needed to prove bidirectional effect of NPY levels and control other factors that influence BP, such as adherence to Ht medication, inflammation, and ages so that the results of this study can represent a large population.
3 WHY THEY DON'T TAKE THE PILL: A QUALITATIVE STUDY OF ANTIHYPERTENSIVE MEDICATION NONAHDERENCE IN EAST BORNEO PRIMARY HEALTH CARE
Authors: Widianto L. , Susilowati I. , Bakhtiar R. , Fitriani E.
Published: May 2022

Background: Adherence to antihypertensive medication is one of the key drivers of optimal blood pressure control. We found nonadherence to antihypertensive medication in some patients in the Sempaja Primary Health Care.

Objective: To determine the factors that influence the patient's nonadherence to antihypertensive medication.

Method: Qualitative study with in-depth interview method. Inclusion criteria are aged >18 year old, diagnosed with hypertension for at least 1 year, nonadherence to antihypertensive medication based on medical record and MMAS-8 (Morisky 8—Item Medication Adherence Questionnaire). In-depth interview was recorded, transcribed, reflected, and identified by triangulation method.

Result: We have 9 subjects (67% female, 33% male), age range of 35-35 years (22.2%), 46-55 years (33.3%), >55 years (44.4%). Educational state were elementary school (44.4%), junior high school (11.1%), senior high school (44.4%). All subjects were covered by national health insurance. All subjects had blood pressure >140/90 mmhg. The pattern of antihypertensive prescribed were single oral antihypertensive (33%) and combination oral antihypertensive (67%). The identified factors are patient factors (lack of knowledge, unaware attitude, negative stigma toward primary health care), drug factors (side effect and alternative local herbal alternative), environmental factors (busy to work, wrong information from family and neighbors), healthcare system factors (difficulty in transportation, unfriendly services, low quality of education and counseling, limited drug options).

Conclusion: Many factors lead to antihypertensive medication nonadherence in primary health care. We need to systematically identify the causes, optimize education and counseling, optimize prolanis program, treated hypertension with an individual approach, and invite community leaders to participate in solving existing problem.
6 CHARACTERISTICS OF HYPERTENSION IN OUTPATIENT SARI DHARMA CLINIC DENPASAR BALI
Authors: Dewi Dewa Ayu Rina Wiana , Nugraha Ida Bagus Aditya
Published: May 2022

Background: Prevalence of hypertension (HT) in outpatient clinic remains high and increasing overtime, especially in Asian. The mortality higher among those people, hence hypertension is a leading cause of many morbidities such as type 2 diabetes mellitus, cardiovascular event, and end stage renal disease.

Objective: The purposes of this study is to determine the characteristics among HT patient in outpatient Sari Dharma Clinic Denpasar Bali

Method: We performed cross-sectional study with all HT patients >18 years old. The data were collected from medical record since August 2021-Januari 2022. The diagnosis was made based on NKF-KDOQI 2021 if blood pressure > 140/90.

Result: 114 patients were included. We found 47 (41,2%) were male and 67 were female (58,8%), 63 (55,3%) were obese and 51 (44,7%) normal. About 54 sample (47,4%) take 1 tablet and 60 (52,6%) sample take combination anti-hypertensive drug. Approximately 62,3% patients have HT with comorbidity and 37,7% without comorbidity. The mean of age was 54.86 years old and mean arterial blood pressure was 102,29 mmHg, the mean of systolic blood pressure was 141.36 mmHg and diastolic blood pressure was 82.75 mmHg.

Conclusion: In summary, this study showed that patient with hypertension tends to have comorbidities. Female was the most likely to have hypertension. The majority of patient used combination anti-hypertensive agents. This study may be use as primary data for analytical studies about correlation of HT and some of risk factor.
11 NEWLY-DIAGNOSED HYPERTENSION DURING ADMISSION FOR COVID-19 CARE AND ITS SUBSEQUENT EFFECT ON OUTCOME OF TREATMENT: A PROSPECTIVE COHORT STUDY
Authors: Sholehuddin M.A. , Firmansya M.A.R. , Ilahi N.H.R. , Wahyuni K. , Kurniati  , Lutfiyah A. , Ilahi W.K.
Published: May 2022

Background: Recent evidences shown that majority of hypertension case in Indonesia were unrecognized, undiagnosed, and left untreated. Hypertension is among the most prevalent comorbidity of COVID-19 infection and being associated with poor outcome following standard treatment. This study aimed to describe newly-diagnosed hypertension among COVID-19 subject and its outcome following treatment

Material & Methods: This cohort study enroll subject admitted to Gelora Joko Samudro Centre for COVID-19 Care, confirmed by Nucleic Acid Amplification Test (NAAT) for COVID-19, with no or mild symptom. Newly-diagnosed hypertension was confirmed by manual blood pressure examination as required by JNC VII criteria for hypertension, without previous history of hypertension. Non-hypertensive COVID-19 subject was enrolled as paired control group.

Results: Among 62 subjects admitted with hypertension as presenting comorbidities, 20 subjects (32.26%) were newly-diagnosed. They were predominantly male, with average age of 47.2±9.65 years old. Newly-diagnosed hypertension group has significant longer day of admission (p 0.001) compared to the control group (Mean difference 5.5 95%CI 2.48-8.41). Newly-diagnosed hypertension group also has significant duration of viral shedding (p<0.001) compared to the control group (Mean difference 6.6 95%CI 3.68-9.52). At the end of treatment the newly-diagnosed hypertension group has significant reduced proportion of subject achieving negative conversion (p 0.002) compared to the control group (HR 0.3, 95%CI 0.12-0.63).

Conclusion: Newly-diagnosed hypertension were quite prevalent in COVID-19 care, and had been associated with longer day of admission, longer duration of viral shedding and lower rate of negative conversion at the end of treatment compared with control group.
21 SYSTOLIC BLOOD PRESSURE VARIABILITY AS PREDICTOR OF ADVERSE OUTCOMES IN PATIENTS UNDERWENT MYOCARDIAL REVASCULARIZATION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Anantawikrama W. P. , Handayani R. , Ransun T. , Candrasatria R. M. , Iustitia S. P.
Published: May 2022

Background: Coronary Arterial Disease (CAD) has large morbidity and mortality burden, becoming the leading cause of death worldwide. High Systolic Blood Pressure (SBP) Variability has been associated with increased cardiovascular disease risk. However, the evidence of its impact on myocardial revascularization outcome is still lacking.

Objective: This study aimed to investigate the SBP variability prognostic value in patients who received myocardial revascularization.

Method: Literature search was conducted on PubMed, EMBASE, Cochrane Library, Google Scholar, and ProQuest. The outcomes were all-cause mortality and major adverse cardiovascular events (MACEs).

Result: Five cohort studies involving a total of 11,214 patients received myocardial revascularization were included, of which three studies reported data in Percutaneous Coronary Intervention (PCI) and two studies analyze the outcome on Coronary Arterial Bypass Grafting (CABG). On pooled analysis of PCI group, elevated SBP variability significantly associated with higher all-cause mortality (Hazard ratio [HR] 1.63; 95% confidence interval [CI] 1.34—1.98; p < 0.0001; I2 = 0%) and increased MACEs (Hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.19—1.62; p < 0.0001; I2 = 12%). On pooled analysis of CABG group, increased SBP variability have non-significant association with higher mortality (Hazard ratio [HR] 1.29; 95% confidence interval [CI] 0.85—1.94; p <=0.24; I2 = 85%)

Conclusion: Increased SBP variability was significantly associated with higher all-cause mortality and MACEs in patients undergoing PCI, but its association is insignificant to all-cause mortality in patients who received CABG.
25 HYPERTENSION AND MORTALITY PREDICTOR WITHIN 10 DAYS AMONG END-STAGE RENAL DISEASE WITH COVID-19 INFECTION
Authors: Perdhana Langgeng , Chasani Shofa , Udji Sofro Muchlis Achsan
Published: May 2022

Background: Hypertension is a common condition found in hemodialysis patients. Hypertension increases the risk of cardiocerebrovascular events among patients with End- Stage Renal Disease (ESRD). On another hand, ESRD plays a role as a predictor factor of severe Covid-19 infection. The mortality rate among hemodialysis patients is higher than in the general population. There are limited studies that determine the role of hypertension as a predictor factor of mortality among ESRD patients with Covid-19 infection.

Objective: To determine the role of hypertension as a predictor factor of mortality within 10 days among ESRD patients with Covid-19 infection

Method: A cohort study was conducted from June 2020 to August 2021 at Roemani Muhammadiyah Hospital Semarang. The inclusion criteria were patients with ESRD, confirmed Covid-19, and treated in Covid-19 isolation ward of Roemani Muhammadiyah Semarang. Meanwhile, patients with incomplete data, and transferred to other hemodialysis units were excluded from this study. Collected data was then analyzed using Kaplan Meier and Cox Regression

Result: The prevalence of hypertension in this study is 88,2%. From Kaplan Meier analysis, survival within 10 days hypertension group is lower than non-hypertension group (61,2% VS 77,8%; p-value = 0,302). While, Cox Regression analysis showed that hypertension did not play a role as a predictor factor of mortality within 10 days among ESRD patients with Covid-19 infection (p=0,362, Hazard ratio= 2,058).

Conclusion: Hypertension did not play a role as a predictor factor of mortality within 10 days among ESRD patients with Covid-19 infection. Further research is needed.
27 ASSOCIATION BETWEEN VITAMIN D RECEPTOR GENE POLYMORPHISM AND ESSENTIAL HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Maulana M.Fajri Adda'i, R. , Widyantoro B.
Published: May 2022

Background and aim: Recent publications reported that the association between Vitamin D Receptor (VDR) gene polymorphism of Fokl (rs228570 or rs10735810) and essential hypertension (EH) remains controversial. Thus, we conducted this study to investigate the relationship between Fokl and EH.

Methods: Major medical databases (EMBASE, PUBMED, Science Direct, Cochrane, Springer, Scopus, ProQuest, and Lilacs) were systematically searched for observational studies evaluating the impact of Fokl polymorphism on EH, published until January 2022 with predefined protocol and without language restriction regarding PRISMA guideline. Analysis was performed in RevMan 5.3 (fixed and random-effects model through heterogeneity test) to provide pooled measures for odds ratio (OR) under Hardy-Weinberg Equilibrium based-on allele contrast, additive, dominant, and recessive genetic models.

Results: Eight observational studies enrolled comprising 3,762 cases and 4,445 controls. Under the allele model, Fokl polymorphism (f vs F) significantly increased the odds of having EH (OR=1.27; 95% confidence interval: 1.05—1.53). Fokl polymorphism was not significantly associated with EH under additive model (ff vs FF) with OR=0.94 (0.57—1.54), dominant model (Ff + ff vs FF) with OR=0.97 (0.8 — 1.16), and recessive model (FF + Ff vs ff) with OR=0.96 (0.59 — 1.56). However, subgroup analysis based on ethnicities, comprising Asian, European, American, and African, showed that only in African population, Fokl polymorphism was associated with reduced odds of EH under additive (OR=0.36; 0.17 — 0.74) and recessive model (OR=0.31; 0.14 — 0.7).

Conclusions: VDR gene polymorphism of Fokl was significantly associated with EH in a particular genetic model and could be affected by ethnicity. However, further studies are needed to make the robust evidence.
36 HYPERTENSION WITH NON-HEMORRHAGIC STROKE IN UNIVERSITAS KRISTEN INDONESIA GENERAL HOSPITAL
Authors: Suling F.R.W. , Tatriatmadja Z.A.R. , Florence E. , Rantung N.O.H. , Chandramin  , Puspitasari F.
Published: May 2022

Background: Hypertension is a significant public health problem. It is estimated that 1.13 billion people suffer from hypertension worldwide. In Indonesia, hypertension is the first rank of a non-communicable disease with the number of cases reaching 185,857 in 2018. One of the main complications of hypertension is stroke. Stroke is a common neurological disease that is in the form of focal and global neurological deficits. Stroke is divided into non-hemorrhagic (ischemic) and hemorrhagic.

Objectives: This study evaluates hypertensive patients with Non-Hemorrhagic Stroke at the Universitas Kristen Indonesia (UKI) General Hospital, Jakarta

Methods: The population was hypertensive patients with non-hemorrhagic stroke, both inpatient and outpatient at the UKI General Hospital Period 1 January - 31 March 2019. The research design used a descriptive qualitative cross-sectional with secondary data from medical records. Hypertension Criteria based on Joint National Committee VIII.

Results: In this study, 30 samples were obtained that met the inclusion criteria in the UKI general hospital from 1 January 2019 - 31 March 2019. The most stage 2 hypertension, 11 patients (36.7%), for the most age regardless of gender, age 56-65 years 14 patients (43.3 %), based on body mass index the most obesity type 1 as many as 16 patients (53.3%). The first time attack was on 23 patients (76.7 %). Most comorbid were 10 patients with diabetes (33.3%).

Concolusion: Stroke is one of the most common complications of hypertension in addition to coronary heart disease. For this reason, it is still necessary to carry out early prevention from health facilities, especially the first level so that the incidence of stroke does not increase.
39 CHARACTERISTICS AND MORTALITY IN HYPERTENSIVE COVID-19 PATIENTS AT A DISTRICT HOSPITAL IN NORTH JAKARTA: A CROSS-SECTIONAL STUDY
Authors: Andina Tantika , Sibarani Marcel H.R.
Published: May 2022

Background: The characteristics and clinical course of Coronavirus disease 2019 (COVID-19) patients treated in a district hospital, particularly those with comorbidities like hypertension, may differ from patients who were treated in a tertiary hospital. A better understanding of the characteristics and clinical courses of those patients is necessary to establish an optimal management strategy.

Objective: This study aims to describe the characteristics and to identify the predictors of mortality in hypertensive COVID-19 patients in a district hospital in North Jakarta.

Methods: A cross-sectional study was conducted on 192 hypertensive COVID-19 patients admitted between January and November 2021. Exclusion criteria were pregnancy and referral to another center. Demographic and clinical characteristics of the patients were obtained by reviewing medical records. Binary logistic regression analysis was performed to evaluate the associations between mortality and age, sex, comorbidities such as diabetes mellitus, heart disease, chronic kidney disease (CKD), cerebrovascular disease and pulmonary tuberculosis as well as C-reactive protein (CRP), D-dimer level at admission. The cut-off value of CRP and D-dimer level associated with mortality were determined using ROC analysis.

Results: Hypertensive COVID-19 patients were mostly male with an average age of 56.6 years (standard deviation 10.9). Mild, moderate, severe, and critical COVID-19 were found in 23.4%, 23.4%, 35.9%, and 17.2% of the patients, respectively. The majority of the participants (55.2%) had at least one comorbidity other than hypertension. The overall mortality rate was 15.1%. Heart disease (odds ratio 4.01, 95% CI 1.11 to 13.9; p = 0.029), CKD (OR 10.41, 95% CI 2.12 to 51.13; p = 0.004) and an elevated CRP level (OR 10.98, 95% CI 3.32 — 36.32; p < 0.001) were associated with a higher risk of mortality in hypertensive COVID-19 patients.

Conclusion: Hypertensive COVID-19 patients had a high frequency of comorbidities and similar clinical characteristics to those reported elsewhere. Hypertensive COVID-19 patients with heart disease, CKD, and elevated CRP levels were at higher risk of mortality and therefore may benefit from more aggressive therapy.
Can Laser-Assisted Indocyanine Green Angiography Be Used to Quantify Perfusion Changes During Staged Fixation of Pilon Fractures? A Pilot Study
Authors: Mitchell Brendon C. , Wall Pelle V. , Zak Taylor K. , Onodera Keenan M. , Gurusamy Pradyumna , Dwight Kathryn , Elsissy Joseph , Kent William T.
Published: May 2022

Objective:

To quantify soft tissue perfusion changes in pilon fractures during staged treatment using laser-assisted indocyanine green angiography (LA-ICGA).

Setting:

Level 1 trauma center.

Design:

Prospective cohort study.

Patients/Participants:

Twelve patients with 12 pilon fractures participated in the study. Seven patients had OTA/AO classification of 43-C3, 3 had 43-C2, and 2 had 43-B2.

Main Outcome Measures:

LA-ICGA was performed with the SPY fluorescence imaging platform. Analysis via ImageJ was used to generate a fractional area of perfusion (FAP) based on fluorescent intensity to objectively quantify soft tissue perfusion. Anterior, medial, and lateral measurements were performed at the time of initial external fixation (EF) application and then at the time of definitive fixation.

Results:

FAP within the region of interest was on average 64% medially, 61% laterally, and 62% anteriorly immediately before EF placement. Immediately before definitive open reduction internal fixation, fractional region of interest perfusion was on average 86% medially, 87% laterally, and 86% anteriorly. FAP increased on average 24% medially (P = 0.0004), 26% laterally (P = 0.001), and 19% anteriorly (P = 0.002) from the time of initial EF to the time of definitive open reduction and internal fixation.

Conclusions:

Quantitative improvement in soft tissue perfusion was identified through the course of staged surgical management in pilon fractures. LA-ICGA potentially may be used to determine appropriate timing for definitive surgical intervention based on the readiness of the soft tissue envelope. Ultimately, these findings may influence clinical outcomes with respect to choice of surgical approach, soft tissue management, surgical timing, and wound healing.

Level of Evidence:

Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Detection of Hemodynamic Status Using an Analytic Based on an Electrocardiogram Lead Waveform
Authors: Schmitzberger Florian F. , Hall Ashley E. , Hughes Morgan E. , Belle Ashwin , Benson Bryce , Ward Kevin R. , Bassin Benjamin S.
Published: May 2022

OBJECTIVES:

Delayed identification of hemodynamic deterioration remains a persistent issue for in-hospital patient care. Clinicians continue to rely on vital signs associated with tachycardia and hypotension to identify hemodynamically unstable patients. A novel, noninvasive technology, the Analytic for Hemodynamic Instability (AHI), uses only the continuous electrocardiogram (ECG) signal from a typical hospital multiparameter telemetry monitor to monitor hemodynamics. The intent of this study was to determine if AHI is able to predict hemodynamic instability without the need for continuous direct measurement of blood pressure.

DESIGN:

Retrospective cohort study.

SETTING:

Single quaternary care academic health system in Michigan.

PATIENTS:

Hospitalized adult patients between November 2019 and February 2020 undergoing continuous ECG and intra-arterial blood pressure monitoring in an intensive care setting.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

One million two hundred fifty-two thousand seven hundred forty-two 5-minute windows of the analytic output were analyzed from 597 consecutive adult patients. AHI outputs were compared with vital sign indications of hemodynamic instability (heart rate > 100 beats/min, systolic blood pressure < 90 mm Hg, and shock index of > 1) in the same window. The observed sensitivity and specificity of AHI were 96.9% and 79.0%, respectively, with an area under the curve (AUC) of 0.90 for heart rate and systolic blood pressure. For the shock index analysis, AHI’s sensitivity was 72.0% and specificity was 80.3% with an AUC of 0.81.

CONCLUSIONS:

The AHI-derived hemodynamic status appropriately detected the various gold standard indications of hemodynamic instability (hypotension, tachycardia and hypotension, and shock index > 1). AHI may provide continuous dynamic hemodynamic monitoring capabilities in patients who traditionally have intermittent static vital sign measurements.