bluuebunny/crossref_metadata_2025 huggingface dataset:
34. BLOOD PRESSURE CONTROL AMONG HYPERTENSIVE PATIENTS IN SANGLAH GENERAL HOSPITAL DURING COVID-19 PANDEMIC
Authors: Kamardi Stanly , Jagannatha Gusti Ngurah Prana , Pradnyana I Wayan Agus Surya , Yasmin AA Ayu Dwi Adelia
Published: May 2021

Background:

The COVID-19 pandemic presents a challenge to control patients with chronic disease and conditions, because many people have postponed regular visit for chronic health condition such as hypertension. To make things worse, hypertension is the most important comorbidities and predictor of poor outcomes from COVID-19. Blood pressure control become more crucial to be top priority during this pandemic and beyond.

Objective:

The aim of this study is to determine the blood pressure control status among hypertensive patient in outpatient settings during the pandemic, as compared to before the pandemic of COVID-19.

Methods:

This retrospective, comparative cross-sectional study included 108 medical records of patients with hypertension diagnosis in outpatient cardiology clinic, at Sanglah General Hospital in January 2021. The data obtained were blood pressure during pandemic in January 2021, compared to blood pressure in the same patient before the pandemic (before March 2020).

Result:

The proportion of controlled hypertension before pandemic era was 49.1%, and has decreased during the pandemic to 39.8% (p value = 0.123). Wilcoxon signed rank test showed that there was increased systolic blood pressure level between before pandemic compared to during pandemic of COVID-19 (p value = 0.041).

Conclusion:

The optimal management of hypertension become a very important issue during pandemic of COVID-19, since patients with this pre-existing condition could experience severe complications when infected with SARS-CoV-2. The alternatives to hospital and community-based care, such as mobile phone consultation or telemedicine can be developed by the multidiscipline collaboration to increase control status of hypertension.
39. PROGNOSTIC VALUE OF SYSTOLIC BLOOD PRESSURE IN HOSPITALIZED CHRONIC HEART FAILURE PATIENTS IN DR. SARDJITO HOSPITAL
Authors: Adhyatma Amri , Kusumastuti Dyah Adhi , Bagaswoto Hendry Purnasidha , Mumpuni Hasanah
Published: May 2021

Background:

Heart failure (HF) is a clinical syndrome due to various underlying diseases with high morbidity and mortality. Hypertension is one of the major risk factor leading to heart failure. Intriguingly, some studies showed that higher systolic blood pressure (SBP) in HF patient is associated with better outcome in survival.

Objective:

We aimed to investigate the association of SBP and in-hospital mortality of chronic heart failure (CHF) patients.

Method:

Hospitalized CHF patients were retrospectively collected from Dr. Sardjito Hospital CHF Registry between March 2019 and October 2020. Shock diagnosis at admission was excluded. Blood pressure at admission, demographic characteristic and echocardiography were analyzed. Systolic blood pressure was grouped into SBP < 110 mmHg and SBP ≥ 110 mmHg. In-hospital mortality was the primary endpoint in this study. Bivariate and multivariate analyses were performed.

Result:

A total of 345 patients were included where 10 patients experienced in-hospital mortality. The mean SBP was 121 ± 25 mmHg and diastolic blood pressure was 71 ± 14 mmHg. Hypertension was found in 137 (39.8%) patients whereas ischemic heart disease (IHD) 161 (46.8%) was the leading cause of HF. We found that the SBP < 110 mmHg group was associated with increased in-hospital mortality compared to the SBP ≥ 110 mmHg group (6.7% versus 0.9%) P = 0.004; non-adjusted RR 7.36 (95% CI 1.59–34.13). Logistic regression analyzing age (≥70 y.o.), obesity, diabetes mellitus, sex, LVEF < 50% and IHD resulted in adjusted OR 6.42 (95% CI 1.29–31.85) with P = 0.023.

Conclusion:

Low blood pressure (SBP < 110 mmHg) was associated with poor outcome in CHF patients.
48. BLOOD PRESSURE ON ADMISSION CHARACTERISTIC IN PATIENT WITH ACUTE CORONARY SYNDROME
Authors: Adam Mochamad Faisal , Harlyjoy Bambang Widyantoro Beta Canina , Juzar Dafsah A
Published: May 2021

Background:

Blood pressure had been a valuable diagnostic tool in cardiovascular disease, such as acute coronary syndrome (ACS). Nevertheless, ample studies have shown that blood pressure in ACS patients had a J-curve prognosis and known as a predictor of myocardial damage. High blood pressure is believed as a sign of larger size of viable myocytes that could still compensate the extent of injury happening during ACS.

Objective:

To compare the blood pressure on admission characteristic in patients presenting with acute coronary syndrome at National Cardiovascular Center Harapan Kita (NCCHK).

Methods:

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

Results:

This study included 1383 patients, with median age of 59: 27–94, 78.1% male patients, and 70.4% had history of hypertension. ST-segment elevation myocardial infarction (STEMI) happened in 34.3% of the patient. From our analysis, it showed that patients presenting with STEMI had lower systolic blood pressure (SBP) compared to those with the diagnosis of Non-ST segment elevation myocardial infarction (NSTEMI) or unstable angina pectoris (UAP) (124: 60–255 vs 131: 63–255 vs 136: 71–236, p = 0.000). In the subset of patients with prior hypertension, SBP in STEMI patients remained lowest compared to NSTEMI and UAP patients (132: 60–255 vs 137: 63–255 vs 142: 71: 236, p = 0.000).

Conclusion:

Subjects with STEMI, considered as those with the most extensive myocardial damage, have lowest SBP on admission compared to ACS patients without ST segment elevation even in the subset population with prior hypertension.
54. COMPARATION OF D-DIMER LEVELS IN HYPERTENSIVE AND NON-HYPERTENSIVE ADULT COVID-19 PATIENTS
Authors: Andina Tantika , Tampubolon Daulat JPM
Published: May 2021

Background:

Coagulopathy is an important clinical feature of Coronavirus Disease 2019 (COVID-2019) associated with severe conditions, making D-dimer useful as a prognostic tool to predict severity and mortality of COVID-19. Hypertension also caused elevated D-dimer levels.

Objective:

This study aims to compare D-dimer levels in hypertensive and non-hypertensive COVID-19 patients.

Methods:

Cross-sectional study was conducted on 96 adult COVID-19 patients admitted between October 2020 and January 2021. Patients with diabetes mellitus, pregnancy/postpartum and malignancy were excluded. D-dimer levels were compared using independent T-test or Mann-Whitney test. Age, sex and severity of COVID-19 were adjusted using subgroup analysis.

Result:

96 COVID-19 patients who were mostly (56.8%) males with 57 subjects (71.25%) younger than 60 years old were included in the analysis. 48 (50%) subjects were hypertensive. Median D-dimer levels of hypertensive and non-hypertensive COVID-19 patients were 1,021.0 (154.0–10,000) and 503.5 (204.0–2,798.0) respectively. The difference between median D-dimer levels of hypertensive and non-hypertensive was significant (p = 0.004). The difference, however, was only found in subjects younger than 60 years old and those with mild symptoms, indicating that age and severity may contribute to D-dimer level.

Conclusion:

D-dimer level was significantly higher in hypertensive COVID-19 patients compared to non-hypertensive patients. Age and disease severity also affect D-dimer levels in COVID-19 patients
59. DIFFERENCES IN EJECTION FRACTION BASED ON LEFT VENTRICULAR GEOMETRIC PATTERN IN HYPERTENSIVE PATIENTS
Authors: Azzuhdi Muhammad Zakiy , Fernando Harben , Maulana Giovanno R , Yanni Mefri
Published: May 2021

Background:

Left ventricular (LV) geometric patterns and LV ejection fraction (LVEF) have a strong prognostic value in hypertensive patients. However, the differences in EF among various abnormal LV geometric pattern types, including Concentric Remodelling (CR), Concentric Hypertrophy (CH), and Eccentric Hypertrophy (EH), in hypertensive patients is still less studied.

Objective:

To evaluate the differences in LVEF among various types of abnormal LV geometric patterns in hypertensive patients with reduced EF (<50%).

Methods:

We collected data from clinical echocardiographic database of patients at DR. M. Djamil Hospital, Padang, in 2019. The inclusion criteria included hypertension, LVH, and LVEF < 50%. Subjects were divided into three groups based on LV geometric patterns, i.e. CR, CH, and EH groups. Statistical analysis was performed by STATA.

Results:

In this study, 54 hypertensive patients (41 males, 13 females) with mean age of 61.33 ± 13.43 years were included. We found that in hypertensive patients with reduced EF, CH was the most common abnormal LV geometric pattern (50%), followed by EH (44.4%), and CR (5.56%). There was a significant difference in EF among the three groups (p = 0.03), with EH had the lowest EF (35.63 ± 8.79%), followed by CH (41.30 ± 5.44%) and CR (44.67 ± 6.66%).

Conclusions:

Our study demonstrated that LV eccentric hypertrophy has the lowest ejection fraction compared to the other two of abnormal LV geometric pattern in hypertensive patients with reduced ejection fraction. Thus, we suggested that the prognosis of hypertensive patients is potentially worsened by LV eccentric hypertrophy condition.
61. LEFT VENTRICULAR GEOMETRY PATTERN OF HYPERTENSION PATIENTS WHO UNDERTAKING ECHOCARDIOGRAPHY AT AL-IHSAN HOSPITAL BANDUNG ON 2018-2019
Authors: Wulandari Putri , Tiksnadi Badai Bhatara , Djajakusumah Tony S. , Akbar Mohammad Rizki
Published: May 2021

Background:

Hypertension can induce changes in structures and functions of the heart as the Hypertension Mediated Organ Damage (HMOD). The most common subclinical symptoms of HMOD are Left Ventricular Hypertrophy (LVH), which is one of the Left Ventricular (LV) geometry. LV Geometry has prognostic significance.

Objective:

To describe LV geometry pattern of hypertension patients who undertaking echocardiography at Al-Ihsan Hospital Bandung.

Method:

This is a descriptive, cross-sectional study using medical record and the echocardiography result from January 2008–December 2019. Hypertension was defined as patient diagnosed with a code I10 (essential hypertension), I11 (hypertensive heart disease) based on ICD X, and/or patients with a history of hypertension. The exclusion criteria were samples with incomplete data of medical records and echocardiography results. The LV geometry was determined by re-calculation of relative wall thickness (RWT) and left ventricular mass index (LVMI).

Result:

There were 123 of 6247 hypertension patients, female (66.7%), age 60 ± 12 years, obesity (49.6%), CAD (24.4%), DM II (27.6%), rEF (23.6%), VHD (30.1%). LV geometry patterns were concentric LVH (49 pts/40%), eccentric LVH (41 pts/33%), normal geometry (22 pts/18%), and concentric remodeling (11 pts/9%). Concentric LVH tends to occur in women, age >65 years, and obese patients. Eccentric LVH tends to occur in patients with comorbid CAD, VHD, rEF, and DM II. Concentric remodeling and normal geometry are never dominant as the most pattern of geometry in hypertension patients.

Conclusion:

The LV geometry of hypertension patients majority have experienced LVH with the most pattern is concentric LVH.
62. RESISTIVE INDEX OF INTERNAL CAROTID ARTERY AND COMMON CAROTID ARTERY IN PATIENTS WITH CEREBRAL SMALL VASCULAR DISEASE
Authors: Rinjani Ansi , Mesiano Taufik , Andini Putri Widya , Yugo Mohammad Reynalzi , Yunus Reyhan Eddy , Kurniawan Mohammad , Hidayat Rakhmad , Rasyid Al , Harris Salim
Published: May 2021

Background/Objective:

Cerebroarterial pulsatility has been reported to be significantly increased in patients with cerebral small vessel disease (CSVD). Resistive index (RI) is a parameter of pulsatility and describes resistance of the vascular wall. This study aims to describe RI of internal carotid artery (ICA) and common carotid artery (CCA) in CSVD.

Methods:

This retrospective study evaluated the registry in Neurosonology Lab, between January and June of 2020. Patients were categorized into CSVD and non CSVD diagnosed using brain scan or MRI. CSVD markers such as lacune, microbleeds, perivascular space, and fazekas class are evaluated from MRI. RI of ICA and CCA were measured using Carotid Doppler Ultrasound. Uni- and bivariate analysis were done to evaluate the mean difference.

Result:

There were 79 subjects with a median age of 60 (49–66) years, comprising 54.4% with CSVD. RI in CSVD was not significantly higher than non CSVD and tended to be lower. RI of patients with CSVD markers such as lacune (ICA 0.69 ± 0.9, CCA 0.77 ± 0.08), microbleeds (ICA 0.68 ± 0.06, CCA 0.72 ± 0.08), perivascular space > 11 (ICA 0.80 ± 0.17, CCA 0.77 ± 0.05) and fazekas ≥2 (ICA 0.69 (0.09), CCA 0.76 (0.08)) tended to be higher than normal population.

Conclusions:

This study did not find a significantly higher RI in CSVD compared to non-CSVD, but RI of ICA and CCA in CSVD patient has a tendency to be higher than normal population. Further studies with larger sample sizes are needed to determine role of RI.
63. AMELIORATION OF CARDIAC HYPERTROPHY BIOMARKERS BY DECAFFEINATED LIGHT ROASTED GREEN COFFEE EXTRACT IN METABOLIC SYNDROME RAT MODEL
Authors: Nugroho Dwi Adi , Lukitasari Mifetika , Kholis Mukhammad Nur , Wahyuni Nila Aisyah , Rohman Mohammad Saifur
Published: May 2021

Background:

Metabolic syndrome is associated with increased prevalence of cardiac hypertrophy. The effect of coffee consumption on cardiovascular outcome is still controversial due to its caffeine content.

Objective:

This study aimed to investigate the effect of light roasted decaffeinated green coffee extract (GCE) on amelioration of cardiac hypertrophy biomarkers in metabolic syndrome rat model

Methods:

Twenty five metabolic syndrome rat model were divided into GCE 100, 200, 250 group, normal control (NC) and metabolic syndrome (MS) group. Rats in the GCE groups were treated once daily with green coffee extract at a dose of 100, 200, and 250 mg/bw.t respectively. The extract was given for 9 weeks through oral gavage. The metabolic syndrome parameters were measured every two weeks by colorimetric method. Blood pressure was determined by tail cuff blood pressure recorder. Angiotensin 2 level was analysed by ELISA method. Cardiac TNFα, IL6, NFKβ, RAC1 and BNP gene expression was analysed by RT-PCR methods.

Results:

The metabolic syndrome parameters were significantly in all GCE groups after administration of green coffee extract for 9 weeks. The lowest angiotensin 2 level were observed in GCE 250 group compared to that of MS and GCE 100 and 200 group. The cardiac TNFα, IL6, NFKβ, RAC1 and BNP gene expression were significantly lower in all GCE group (p < 0.000) compared to that of MS group. However, in GCE 100 group the expression of those genes was the lowest among all GCE groups.

Conclusion:

This study suggested that the administration of GCE 100 mg/bw.t ameliorated angiotensin 2 level and cardiac hypertrophy biomarker in metabolic syndrome rat model.
72. MYOCARDIAL FIBROSIS IN HYPERTENSIVE PATIENTS: A NOVEL TARGET IMAGING BIOMARKER
Authors: Damaiati NE , Atmadikoesoemah CA , Elen  , Kasim M
Published: May 2021

Background:

Myocardial fibrosis is essential in pathological basis of many cardiovascular diseases. Cardiac magnetic resonance (CMR) using T1 mapping serves to identify interstitial fibrosis in many cases, one of which is hypertension. It is suggested that T1 mapping in hypertensive patients compared to other cardiovascular risk factors share similar values that is strongly linked to cardiovascular morbidity including increased ischemic burden, decreased systolic function, and cardiovascular death.

Objective:

To identify the extend of myocardial fibrosis in hypertensive patients compared to other cardiovascular risk factors.

Methods:

The study was conducted in Department of Cardiology and Vascular Medicine Universitas Indonesia/National Cardiovascular Center Harapan Kita. Analysis was performed on data extracted from cardiac magnetic resonance examinations on all hypertensive patients consulted to the imaging division in January-December 2018. A total of 120 subjects underwent scanning on a 1.5-Tesla Philips Achieva scanner. At rest, mid LV native T1 map was acquired using the Look-Locker methods.

Results:

Overall, the majority of participants were male (73%) with mean age of 57.22 ± 10.01 years and mean body mass index of 25.75 ± 4.40. The number of subjects with diabetes mellitus, dyslipidemia, and smokers were 40%, 50%, and 22% respectively. There is no difference between T1 value of patients who were hypertensive with no other cardiovascular risk factors (n = 19, mean T1 1253.63 ± 347.48) and hypertensive patients carrying other risk factors (n = 34, mean T1 1250.66 ± 365.42), p = 0.75. In addition, both groups showed no difference in terms of left ventricular systolic function with mean ejection fraction (EF) of 48.6% in those with hypertension alone and EF of 45.4% in hypertensive patients with other additional risk factors (p = 0.48).

Conclusion:

Hypertension alone had similar extent of myocardial fibrosis to those with any other additional cardiovascular risk factors. Since extent of myocardial fibrosis is strongly linked to cardiovascular death, this finding should be brought into more careful investigation in the future.
75. MORE FREQUENT REHOSPITALIZATION IN HEART FAILURE PATIENTS WITH HYPERTENSION
Authors: Widasmara Seprian , Aziz Indra Jabbar , Rohman Mohammad Saifur
Published: May 2021

Introduction:

Heart Failure (HF) is the most common heart disease in the world and is increasing in prevalence. Despite the significant advances in therapies and prevention, mortality and morbidity are still high, poor quality of life and recurrent rehospitalization. Therefore, HF health expenditures are also considerable. Hypertension was the most common risk factor for CHF. However, no obvious data regarding recurrent rehospitalization in heart failure patients with hypertension in Indonesia

Objective:

The study aimed to compare recurrent rehospitalization of patients with heart failure with hypertension and without hypertension

Method:

We completed a descriptive analytic from heart failure registry of Dr Saiful Anwar Hospital. Baseline characteristic, hypertension treatment, length of stay, hospital mortality, recurrent rehospitalization and others data also analyze to compare between hypertension and non-hypertension patients.

Result:

A total of 1163 patients were included in this study. 28.5% of admitted HF patients suffered from hypertension. Interestingly, 27.9% of sample has been recorded as history of recurrent re-hospitalization. There was no significant difference in length of stay between heart failure patients with hypertension and without hypertension (mean = 6.68 ± 4.51; p = 0.453). However, the proportion of patient with hypertension experienced more frequent rehospitalization as compare non hypertension HF patient.

Conclusion:

HF patients with hypertension experienced more frequent hospitalization in this study
Applied Rapid Qualitative Analysis to Develop a Contextually Appropriate Intervention and Increase the Likelihood of Uptake
Authors: Lewinski Allison A. , Crowley Matthew J. , Miller Christopher , Bosworth Hayden B. , Jackson George L. , Steinhauser Karen , White-Clark Courtney , McCant Felicia , Zullig Leah L.
Published: May 2021

Background:

Rapid approaches to collecting and analyzing qualitative interview data can accelerate discovery timelines and intervention development while maintaining scientific rigor. We describe the application of these methods to a program designed to improve care coordination between the Veterans Health Administration (VHA) and community providers.

Methods:

Care coordination between VHA and community providers can be challenging in rural areas. The Telehealth-based Coordination of Non-VHA Care (TECNO Care) intervention was designed to improve care coordination among VHA and community providers. To ensure contextually appropriate implementation of TECNO Care, we conducted preimplementation interviews with veterans, VHA administrators, and VHA and community providers involved in community care. Using both a rapid approach and qualitative analysis, an interviewer and 1–2 note-taker(s) conducted interviews.

Results:

Over 5 months, 18 stakeholders were interviewed and we analyzed these data to identify how best to deliver TECNO Care. Responses relevant to improving care coordination include health system characteristics; target population; metrics and outcomes; challenges with the current system; and core components. Veterans who frequently visit VHA or community providers and are referred for additional services are at risk for poor outcomes and may benefit from additional care coordination. Using these data, we designed TECNO Care to include information on VHA services and processes, assist in the timely completion of referrals, and facilitate record sharing.

Conclusion:

Rapid qualitative analysis can inform near real-time intervention development and ensure relevant content creation while setting the stage for stakeholder buy-in. Rigorous and timely analyses support the delivery of contextually appropriate, efficient, high-value patient care.
Modified Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging of the Prostate: Comparison With Reduced Field-of-View Imaging and Single Shot Echo-Planar Imaging
Authors: Lee Eun Ji , Hwang Jiyoung , Chang Yun-Woo , Hong Seong Sook , Oh Eunsun , Nam Bo Da , Sung Jae Kon , Thomas Benkert
Published: May 2021

Objective

The objective of this study was to compare the image quality and apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) with modified reduced field of view (FOV) based on 2-dimensional (2D)-selective radiofrequency excitations by tilting the excitation plane in prostate with reduced FOV using parallel-transmit-accelerated 2D-selective radiofrequency excitation and single-shot echo planar imaging (ssEPI).

Methods

Fifty patients who underwent multiparametric magnetic resonance imaging including 3 DWIs were included. Two observers independently performed qualitative image analyses using 5-point scale. Apparent diffusion coefficient measurements were performed for quantitative analysis.

Results

Modified reduced FOV provided the highest qualitative scores for all categories compared with reduced FOV and ssEPI (P < 0.000). Both reduced FOV DWIs showed higher ADC values compared with ssEPI (P < 0.001); however, the ADC ratios between the lesion and peripheral zone were not significantly different (all P > 0.05).

Conclusions

The modified reduced FOV DWI showed better overall image quality, differentiability of anatomic regions, and lesion conspicuity with fewer artifacts compared with DWI with reduced FOV and ssEPI.
Initial Experience With Diffusion-Weighted Magnetic Resonance Imaging for the Evaluation of Endometrial Fibrosis
Authors: Feng Yongjing , Jiang Peipei , Hu Qing , Sun Shuangshuang , He Jian , Chen Weibo , Zhou Nan , Hu Yali , Zhou Zhengyang
Published: May 2021

Objective

This study aimed to determine the feasibility of diffusion-weighted imaging for detecting endometrial fibrosis in patients with intrauterine injury.

Methods

This prospective study included 34 patients with endometrial fibrosis and 34 healthy controls. All participants underwent T2-weighted and diffusion-weighted magnetic resonance imaging with b values of 0 and 1000 s/mm2 during the periovulatory phase with a dominant follicle. The endometrial apparent diffusion coefficient (ADC) and uterine anatomical parameters (endometrial thickness [EMT], length of the uterine cavity [LUC], and junctional zone thickness [JZT]) were measured and compared. Performance of the uterine endometrial ADC and anatomical parameters in diagnosing endometrial fibrosis was evaluated.

Results

Patients with endometrial fibrosis showed a lower endometrial ADC, lower EMT, shorter LUC, and higher JZT than did healthy controls (all, P < 0.001). Endometrial ADC value and uterine anatomical parameters showed good performance in diagnosing endometrial fibrosis, with the areas under the receiver operating characteristic curves of 0.976, 0.870, 0.883, and 0.864, respectively. The area under the curve of ADC was significantly higher than those of EMT (z = 1.973, P = 0.0485), LUC (z = 2.059, P = 0.0395), and JZT (z = 2.484, P = 0.0130). Intraobserver and interobserver agreements of endometrial ADC value measurements were excellent for both patients (intraclass correlation coefficient = 0.987 and 0.983, respectively) and healthy women (intraclass correlation coefficient = 0.986 and 0.989, respectively).

Conclusions

Our preliminary results suggest that diffusion-weighted imaging has the potential to be a noninvasive imaging tool for the quantitative assessment of endometrial fibrosis.
Supratentorial Extraventricular Ependymomas: Imaging Features and the Added Value of Apparent Diffusion Coefficient
Authors: Wang Xiaoshuang , Han Fang , Lv Yi , Gao Jiahao , Du Zunguo , Zhang Jiawen
Published: May 2021

Objective

To improve the understanding and the diagnosis of intracranial ependymal tumors.

Methods

The clinical, radiological and prognostic features of 48 supratentorial extraventricular ependymomas and 74 intraventricular ependymomas were summarized and compared.

Results

Supratentorial extraventricular ependymomas, most often located in the frontal lobe (33.3%) and classified as grade III (75.0%), had relatively large eccentric cysts (3.07 ± 2.03 cm), significant enhancement (84.8%), low apparent diffusion coefficient (ADC) values, and associated with higher mortality (41.3%). The majority of intraventricular lesions occurred in the fourth ventricle (86.5%) and classified as grade II (78.4%), had relatively small and multiple cystic changes (1.04 ± 0.87 cm), slight or moderate enhancement (76.9%), high ADC values and associated with lower mortality (20.7%). There were few significant differences between grade II and grade III tumors in these 2 groups, respectively. Young age, high grade and low ADC values are worse prognostic indicators for patients with supratentorial extraventricular ependymomas, but not for those with intraventricular ependymomas.

Conclusions

Conventional radiological features, combined with clinical manifestations and quantitative information provided by diffusion-weighted imaging, may not only enhance the diagnosis and assist in determining prognosis but also provide a better pathophysiological understanding of intracranial ependymal tumors.
MRI Changes of the Symphysis Pubis in Patients With Axial Spondyloarthritis and Association With Clinical Factors
Authors: Yan Junrong , Qiao Pengyan , Meng Jingwen , Qian Lixia
Published: May 2021

Objective

This study aimed to evaluate the magnetic resonance imaging (MRI) changes of the symphysis pubis in patients with axial spondyloarthritis (ax-SpA) and to assess its association with clinical factors.

Methods

A retrospective analysis of 172 patients with ax-SpA was performed to assess the presence of active inflammatory and structural changes of the symphysis pubis on MRI scans, and their association with clinical factors and the SPARCC (Spondyloarthritis Research Consortium of Canada) scoring of the sacroiliac joint were evaluated.

Results

The proportions of active inflammation and structural changes of the symphysis pubis were 69/172 (40.1%) and 54/172 (31.4%), respectively. When comparing the active inflammation and no-active inflammation symphysis pubis groups, the former had higher level C-reactive protein, higher erythrocyte sedimentation rate, and younger median age of patients. Moreover, no significant correlation was noted between the active inflammation of the symphysis pubis and SPARCC score of the sacroiliac joint. When comparing the normal and abnormal symphysis pubis groups, the latter had longer symptom duration.

Conclusions

The MRI changes of the symphysis pubis were seen in 55.2% of the patients with ax-SpA and were associated with C-reactive protein, erythrocyte sedimentation rate, and symptom duration.
Dual-Energy Computed Tomography Virtual Noncalcium Technique in Diagnosing Osteoporosis: Correlation With Quantitative Computed Tomography
Authors: Liu Zhenghua , Zhang Yuting , Liu Zhou , Kong Jiangtao , Huang Dageng , Zhang Xiaoyue , Jiang Yonghong
Published: May 2021

Objective

The aim of this study was to evaluate dual-energy computed tomography (CT) virtual noncalcium (VNCa) technique as a means of quantifying osteoporosis.

Methods

Dual-energy CT scans were obtained prospectively, targeting lumbar regions of 55 patients with chronic low back pain. A standard quantitative CT (QCT) phantom was positioned at the waist during each procedure, using proprietary software (QCT Pro; Mindways, Tex) to measure bone mineral density (BMD) in each vertebral body. Vendor dual-energy analytic software was altered with a specially modified configuration file to produce a “Virtual Non Calcium” or “VNCa” output, as such output variables were remapped to produce the following calcium values rather than iodine, yielding the following QCT parameters: CT value of calcium (originally “contrast media” [CM]), CT value of mixed energy imaging (regular CT value [rCT]), calcium density (originally “contrast agent density” [CaD]), and fat fraction (FF). Pearson test served to assess correlations between BMD and these parameters. Multiple linear regression analysis was applied to construct an equation for generating regressive BMD (rBMD) values. In gauging diagnostic accuracies, the criterion-standard BMD cutoff point (<80 mg/cm3) was adopted for QCT, whereas the rBMD threshold was defined by receiver operating characteristic curve.

Results

Contrast media, rCT, CaD, and FF values (reflecting CT value of calcium, regular CT value, calcium density, and fat fraction, respectively) significantly correlated with BMD (r values: 0.885, 0.947, 0.877, and 0.492, respectively; all P < 0.01). Contrast media, CaD, and FF showed independent associations with BMD; the regressive equation was formulated as follows: rBMD = 54.82 − 0.19 × CM + 20.03 × CaD − 1.24 × FF. The area under the curve of rBMD in diagnosing osteoporosis was 0.966 ± 0.009 (P < 0.01). At an rBMD threshold of less than 81.94 mg/cm3, sensitivity and specificity were 90.0% and 92.0%, respectively.

Conclusions

Dual-energy CT VNCa technique may constitute a valid alternative method for quantifying the mineral content and marrow fat composition of bone in diagnostic assessments of osteoporosis.
Determination of Cervical Lymph Nodes Metastasis and Extra Nodal Extension Status by Quantitative Assessment of Border Irregularity and Apparent Diffusion Coefficient in Patients With Tongue Squamous Cell Carcinoma
Authors: Yang Gongxin , Rao Min , Ren Jiliang , Yang Xing , Wang Jingbo , Wu Yingwei , Tao Xiaofeng
Published: May 2021

Objective

The objective of this study was to determine the diagnostic value of quantitative border irregularity assessment and apparent diffusion coefficient (ADC) in patients with squamous cell carcinoma of the tongue (SCCT).

Methods

Cervical lymph nodes (n = 192) from 63 patients with SCCT were examined preoperatively by magnetic resonance imaging, including routine head and neck sequences, dynamic contrast-enhanced magnetic resonance imaging, diffusion-weighted imaging, ADC, surface regularity (S
R), and visually assessed variables, and evaluated pathologically after surgery.

Results

Necrosis, lymphatic hilum, unclear margin, higher S
R, long to short axis ratio, and ADC were associated with metastasis in cervical lymph nodes (M-cLNs) and extranodal extension (ENE), and thickened nodal rim with ENE alone. Apparent diffusion coefficient, S
R, unclear margin, and visible necrosis were strongly associated with M-cLN, whereas S
R, unclear margin, and visible necrosis were associated with ENE status on logistic regression analysis.

Conclusions

Quantitative S
R and ADC data greatly improved diagnosis of M-cLNs and ENE, relative to visible variables alone in patients with SCCT.
Elastic waves in particulate glass-rubber mixtures
Authors: Taghizadeh Kianoosh , Steeb Holger , Luding Stefan , Magnanimo Vanessa
Published: May 2021

We investigate the propagation of waves in dense static granular packings made of soft and stiff particles subjected to hydrostatic stress. Physical experiments in a triaxial cell equipped with broadband piezoelectric wave transducers have been performed at ultrasound frequencies. The time of flight is measured in order to study the combined effect of applied stress and rubber content on the elastic properties of the mixtures. The bulk stiffness deduced from the wave speed is nonlinear and non-monotonic with the increasing percentage of rubber with a more prominent effect at higher pressures. Moreover, in the frequency domain, a spectral analysis gives insights on the transition from a glass- to a rubber-dominated regime and the influence of rubber particles on the energy dissipation. Mixtures with rubber content below 30% show enhanced damping properties, associated with slightly higher stiffness and lighter weight.
Small perturbations of elliptic problems with variable growth in RN
Authors: Ge Bin , Liu Hai-Cheng , Zhang Bei-Lei
Published: May 2021

In this paper, we study the existence of at least two non-trivial solutions for a class of
p
(
x
)-Laplacian equations with perturbation in the whole space. Using Ekeland’s variational principle and the mountain pass theorem, under appropriate assumptions, we prove the existence of two solutions for the equations.
Active thermal cloaking and mimicking
Authors: Cassier Maxence , DeGiovanni Trent , Guenneau Sébastien , Guevara Vasquez Fernando
Published: May 2021

We present an active cloaking method for the parabolic heat (and mass or light diffusion) equation that can hide both objects and sources. By active, we mean that it relies on designing monopole and dipole heat source distributions on the boundary of the region to be cloaked. The same technique can be used to make a source or an object look like a different one to an observer outside the cloaked region, from the perspective of thermal measurements. Our results assume a homogeneous isotropic bulk medium and require knowledge of the source to cloak or mimic, but are in most cases independent of the object to cloak.
The mechanics of brittle granular materials with coevolving grain size and shape
Authors: Buscarnera Giuseppe , Einav Itai
Published: May 2021

The influence of particle shape on the mechanics of sand is widely recognized, especially in mineral processing and geomechanics. However, most existing continuum theories for engineering applications do not encompass the morphology of the grains and its evolution during comminution. Similarly, the relatively few engineering models accounting for grain-scale processes tend to idealize particles as spheres, with their diameters considered as the primary and sole geometric descriptor. This paper inspires a new generation of constitutive laws for crushable granular continua with arbitrary, yet evolving, particle morphology. We explore the idea of introducing multiple grain shape descriptors into Continuum Breakage Mechanics (CBM), a theory originally designed to track changes in particle size distributions during confined comminution. We incorporate the influence of these descriptors on the elastic strain energy potential and treat them as dissipative state variables. In analogy with the original CBM, and in light of evidence from extreme fragmentation in nature, the evolution of the additional shape descriptors is postulated to converge towards an attractor. Comparisons with laboratory experiments, discrete element analyses and particle-scale fracture models illustrate the encouraging performance of the theory. The theory provides insights into the feedback among particle shape, compressive yielding and inelastic deformation in crushable granular continua. These results inspire new questions that should guide future research into crushable granular systems using particle-scale imaging and computations.
Ruga mechanics of soft-orifice closure under external pressure
Authors: Jin Hanxun , Landauer Alexander K. , Kim Kyung-Suk
Published: May 2021

Here, we report the closure resistance of a soft-material bilayer orifice increases against external pressure, along with ruga-phase evolution, in contrast to the conventional predictions of the matrix-free cylindrical-shell buckling pressure. Experiments demonstrate that the generic soft-material orifice creases in a threefold symmetry at a
limit-load
pressure of
p
/
μ
 ≈ 1.20, where
μ
is the shear modulus. Once the creasing initiates, the triple crease wings gradually grow as the pressure increases until the orifice completely closes at
p
/
μ
 ≈ 3.0. By contrast, a stiff-surface bilayer orifice initially wrinkles with a multifold symmetry mode and subsequently develops ruga-phase evolution, progressively reducing the orifice cross-sectional area as pressure increases. The buckling-initiation mode is determined by the layer's thickness and stiffness, and the pressure by two types of the layer's instability modes—the surface-layer-wrinkling mode for a compliant and the ring-buckling mode for a stiff layer. The ring-buckling mode tends to set the twofold symmetry for the entire post-buckling closure process, while the high-frequency surface-layer-wrinkling mode evolves with successive symmetry breaking to a final closure configuration of two- or threefold symmetry. Finally, we found that the threefold symmetry mode for the entire closure process provides the orifice's strongest closure resistance, and human saphenous veins remarkably follow this threefold symmetry ruga evolution pathway.
Do we automatically detect health- or general welfare-related issues? A framework
Authors: Stachowicz Joanna , Umstätter Christina
Published: May 2021

The early detection of health disorders is a central goal in livestock production. Thus, a great demand for technologies enabling the automated detection of such issues exists. However, despite decades of research, precision livestock farming (PLF) technologies with sufficient accuracy and ready for implementation on commercial farms are rare. A central factor impeding technological development is likely the use of non-specific indicators for various issues. On commercial farms, where animals are exposed to changing environmental conditions, where they undergo different internal states and, most importantly, where they can be challenged by more than one issue at a time, such an approach leads inevitably to errors. To improve the accuracy of PLF technologies, the presented framework proposes a categorization of the aim of detection of issues related to general welfare, disease and distress and defined disease. Each decision level provides a different degree of information and therefore requires indicators varying in specificity. Based on these considerations, it becomes apparent that while most technologies aim to detect a defined health issue, they facilitate only the identification of issues related to general welfare. To achieve detection of specific issues, new indicators such as rhythmicity patterns of behaviour or physiological processes should be examined.
Homebrew reagents for low cost RT-LAMP
Authors: Matute Tamara , Nuñez Isaac , Rivera Maira , Reyes Javiera , Blázquez-Sánchez Paula , Arce Aníbal , Brown Alexander J. , Gandini Chiara , Molloy Jennifer , Ramirez-Sarmiento César A. , Federici Fernán
Published: May 2021

RT-LAMP (reverse transcription - Loop-mediated isothermal amplification) has gained popularity for the detection of SARS-CoV-2. The high specificity, sensitivity, simple protocols and potential to deliver results without the use of expensive equipment has made it an attractive alternative to RT-PCR. However, the high cost per reaction, the centralized manufacturing of required reagents and their distribution under cold chain shipping limits RT-LAMP’s applicability in low-income settings. The preparation of assays using homebrew enzymes and buffers has emerged worldwide as a response to these limitations and potential shortages. Here, we describe the production of Moloney murine leukemia virus (M-MLV) Reverse Transcriptase and BstLF DNA polymerase for the local implementation of RT-LAMP reactions at low cost. These reagents compared favorably to commercial kits and optimum concentrations were defined in order to reduce time to threshold, increase ON/OFF range and minimize enzyme quantities per reaction. As a validation, we tested the performance of these reagents in the detection of SARS-CoV-2 from RNA extracted from clinical nasopharyngeal samples, obtaining high agreement between RT-LAMP and RT-PCR clinical results. The in-house preparation of these reactions results in an order of magnitude reduction in costs, and thus we provide protocols and DNA to enable the replication of these tests at other locations. These results contribute to the global effort of developing open and low cost diagnostics that enable technological autonomy and distributed capacities in viral surveillance.
No safe level of alcohol consumption for brain health: observational cohort study of 25,378 UK Biobank participants
Authors: Topiwala Anya , Ebmeier Klaus P. , Maullin-Sapey Thomas , Nichols Thomas E.
Published: May 2021

Objectives

To estimate the relationship between moderate alcohol consumption and brain health, determining the threshold intake for harm and identifying whether population subgroups are at differential risk.

Design

Observational cohort study. Alcohol consumption was determined at baseline assessment visit using touchscreen questionnaire (2016-10). Multi-modal MRI brain and cognitive testing were performed subsequently (2014-20). Clinical data was extracted from linked Hospital Episode Statistics.

Setting

UK Biobank study. Brain imaging was performed on identical scanners with identical protocols at three UK centres (2014-20).

Participants

25,378 participants (mean age 54.9±7.4 years).

Main outcome measures

Brain health as defined by structural and functional MRI brain measures.

Results

Alcohol consumption was negatively linearly associated with global brain grey matter volume (beta= -0.1, 95%CI= -0.11 to -0.09, p<2×10−16). The association with alcohol was stronger than other modifiable factor tested and robust to unobserved confounding. Widespread negative associations were observed with white matter microstructure (beta= -0.08, 95%CI= -0.09 to -0.06, p<2×10−16) and positive correlations with functional connectivity. Higher blood pressure and body mass index increased risk of alcohol-related harm (SBP*alcohol: beta= - 0.01, 95%CI = -0.02 to -0.004, p=0.005; BMI*alcohol: beta= -0.01, 95%CI = -0.02 to -0.002, p=0.02). Binging on alcohol had additive negative effects on brain structure on top of the absolute volume consumed (daily compared to never binging: beta= -0.19, 95%CI= -0.30 to -0.08, p<0.01). No evidence was found for differential effects of drinking wine, beer or spirits.

Conclusions

No safe dose of alcohol for the brain was found. Moderate consumption is associated with more widespread adverse effects on the brain than previously recognised. Individuals who binge drink or with high blood pressure and BMI may be more susceptible. Detrimental effects of drinking appear to be greater than other modifiable factors. Current ‘low risk’ drinking guidelines should be revisited to take account of brain effects.

Funding

AT is supported by a Wellcome Trust fellowship (216462/Z/19/Z). KPE is supported by the UK Medical Research Council (G1001354) and the European Commission (Horizon 2020 732592). This work was also supported by the Li Ka Shing Centre for Health Information and Discovery and NIH grant (TMS, TN: R01EB026859) and a Wellcome Trust award (TN: 100309/Z/12/Z).
A widely distributed genus of soil Acidobacteria genomically enriched in biosynthetic gene clusters
Authors: Crits-Christoph Alexander , Diamond Spencer , Al-Shayeb Basem , Valentin-Alvarado Luis , Banfield Jillian F.
Published: May 2021

Bacteria of the phylum Acidobacteria are one of the most abundant bacterial across soil ecosystems, yet they are represented by comparatively few sequenced genomes, leaving gaps in our understanding of their metabolic diversity. Recently, genomes of Acidobacteria species with unusually large repertoires of biosynthetic gene clusters (BGCs) were reconstructed from grassland soil metagenomes, but the degree to which these species are widespread is still unknown. To investigate this, we augmented a dataset of publicly available Acidobacteria genomes with 46 metagenome-assembled genomes recovered from permanently saturated organic-rich soils of a vernal (spring) pool ecosystem in Northern California. We recovered high quality genomes for three novel species from Candidatus Angelobacter (a proposed subdivision 1 Acidobacterial genus), a genus that is genomically enriched in genes for specialized metabolite biosynthesis. Acidobacteria were particularly abundant in the vernal pool sediments, and a Ca. Angelobacter species was the most abundant bacterial species detected in some samples. We identified numerous diverse biosynthetic gene clusters in these genomes, and also in additional genomes from other publicly available soil metagenomes for other related Ca. Angelobacter species. Metabolic analysis indicates that Ca. Angelobacter likely are aerobes that ferment organic carbon, with potential to contribute to carbon compound turnover in soils. Using metatranscriptomics, we identified in situ expression of specialized metabolic traits for two species from this genus. In conclusion, we expand genomic sampling of the uncultivated Ca. Angelobacter, and show that they represent common and sometimes highly abundant members of dry and saturated soil communities, with a high degree of capacity for synthesis of diverse specialized metabolites.
Retro Drug Design: From Target Properties to Molecular Structures
Authors: Wang Yuhong , Michael Sam , Huang Ruili , Zhao Jinghua , Recabo Katlin , Bougie Danielle , Shu Qiang , Shinn Paul , Sun Hongmao
Published: May 2021

To generate drug molecules of desired properties with computational methods is the holy grail in pharmaceutical research. Here we describe an AI strategy, retro drug design, or RDD, to generate novel small molecule drugs from scratch to meet predefined requirements, including but not limited to biological activity against a drug target, and optimal range of physicochemical and ADMET properties. Traditional predictive models were first trained over experimental data for the target properties, using an atom typing based molecular descriptor system, ATP. Monte Carlo sampling algorithm was then utilized to find the solutions in the ATP space defined by the target properties, and the deep learning model of Seq2Seq was employed to decode molecular structures from the solutions. To test feasibility of the algorithm, we challenged RDD to generate novel drugs that can activate μ opioid receptor (MOR) and penetrate blood brain barrier (BBB). Starting from vectors of random numbers, RDD generated 180,000 chemical structures, of which 78% were chemically valid. About 42,000 (31%) of the valid structures fell into the property space defined by MOR activity and BBB permeability. Out of the 42,000 structures, only 267 chemicals were commercially available, indicating a high extent of novelty of the AI-generated compounds. We purchased and assayed 96 compounds, and 25 of which were found to be MOR agonists. These compounds also have excellent BBB scores. The results presented in this paper illustrate that RDD has potential to revolutionize the current drug discovery process and create novel structures with multiple desired properties, including biological functions and ADMET properties. Availability of an AI-enabled fast track in drug discovery is essential to cope with emergent public health threat, such as pandemic of COVID-19.