bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing hybrid ensemble feature selection strategies for transcriptomic biomarker discovery in complex diseases
Authors: Claude Elsa , Leclercq Mickaël , Thébault Patricia , Droit Arnaud , Uricaru Raluca
Published: July 2024

Biomedical research takes advantage of omic data, such as transcriptomics, to unravel the complexity of diseases. A conventional strategy identifies transcriptomic biomarkers characterized by expression patterns associated with a phenotype by relying on feature selection approaches. Hybrid ensemble feature selection (HEFS) has become increasingly popular as it ensures robustness of the selected features by performing data and functional perturbations. However, it remains difficult to make the best suited choices at each step when designing such approaches. We conducted an extensive analysis of four possible HEFS scenarios for the identification of Stage IV colorectal, Stage I kidney and lung and Stage III endometrial cancer biomarkers from transcriptomic data. These scenarios investigate the use of two types of feature reduction by filters (differentially expressed genes and variance) conjointly with two types of resampling strategies (repeated holdout by distribution-balanced stratified and random stratified) for downstream feature selection through an aggregation of thousands of wrapped machine learning models. Based on our results, we emphasize the advantages of using HEFS approaches to identify complex disease biomarkers, given their ability to produce generalizable and stable results to both data and functional perturbations. Finally, we highlight critical issues that need to be considered in the design of such strategies.
In vivo mouse models for adult brain tumors: Exploring tumorigenesis and advancing immunotherapy development
Authors: Figg John , Chen Dongjiang , Falceto Font Laura , Flores Catherine , Jin Dan
Published: July 2024

Brain tumors, particularly glioblastoma (GBM), are devastating and challenging to treat, with a low 5-year survival rate of only 6.6%. Mouse models are established to understand tumorigenesis and develop new therapeutic strategies. Large-scale genomic studies have facilitated the identification of genetic alterations driving human brain tumor development and progression. Genetically engineered mouse models (GEMMs) with clinically relevant genetic alterations are widely used to investigate tumor origin. Additionally, syngeneic implantation models, utilizing cell lines derived from GEMMs or other sources, are popular for their consistent and relatively short latency period, addressing various brain cancer research questions. In recent years, the success of immunotherapy in specific cancer types has led to a surge in cancer immunology-related research which specifically necessitates the utilization of immunocompetent mouse models. In this review, we provide a comprehensive summary of GEMMs and syngeneic mouse models for adult brain tumors, emphasizing key features such as model origin, genetic alteration background, oncogenic mechanisms, and immune-related characteristics. Our review serves as a valuable resource for the brain tumor research community, aiding in the selection of appropriate models to study cancer immunology.
Neuro-oncology access in Sub-Saharan Africa: A literature review of challenges and opportunities
Authors: Yevudza W Elorm , Buckman Vincent , Darko Kwadwo , Banson Mabel , Totimeh Teddy
Published: July 2024

Background

Ensuring equitable access to treatments and therapies in the constantly evolving field of neuro-oncology is an imperative global health issue. With its unique demographic, cultural, socioeconomic, and infrastructure characteristics, Sub-Saharan Africa faces distinct challenges. This literature review highlights specific barriers to neuro-oncology care in the region and explores potential opportunities for enhancing access.

Methods

Predetermined keyword searches were employed to screen titles and abstracts using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Inclusion criteria were studies published between January 1, 2003, and June 20, 2023, specifically addressing the capacity and challenges of neuro-oncology in the Sub-Saharan African region. The data sources queried were PubMed and Google Scholar. Systematic reviews and meta-analyses were deliberately excluded. All authors conducted independent screening and structured data extraction meticulously.

Results

Our paper identified multiple challenges that impede access to quality treatment for brain tumors. These include constrained resources, insufficient training of healthcare professionals, certain cultural beliefs, and a general lack of awareness about brain tumors, all contributing to delayed diagnosis and treatment. Furthermore, the lack of detailed data on the incidence and prevalence of primary central nervous system tumors impairs the accurate assessment of disease burden and precise identification of areas requiring improvement. However, we discovered that ongoing research, advocacy, enhanced training, mentorship, and collaborative efforts present valuable opportunities for substantial progress in neuro-oncology access.

Conclusions

While we provide a glimpse of the current state, we hope these results will help stimulate dialogue and catalyze initiatives to surmount highlighted obstacles and improve neuro-oncology outcomes across Sub-Saharan Africa.
Recognition of Online E-cigarette Marketing and E-cigarette-Related Attitudes and Behaviors Among Young Adults
Authors: Donaldson Scott I , Beard Trista A , Chen-Sankey Julia C , Ganz Ollie , Wackowski Olivia A , Allem Jon-Patrick
Published: July 2024

Introduction

Past research examining the relationship between exposure to online e-cigarette marketing and e-cigarette-related attitudes and behaviors has relied on unaided recall measures that may suffer from self-report bias. To date, few studies have presented participants with e-cigarette marketing stimuli and assessed recognition. This study examined the associations between recognition of online e-cigarette marketing stimuli and e-cigarette-related attitudes and behaviors among young adults in California.

Aims and Methods

A non-probability representative sample of young adults (ages 18–24; N = 1500) living in California completed an online survey assessing their recognition of online e-cigarette marketing stimuli, including image-based (ie, Instagram and email) and audiovisual (ie, YouTube and TikTok) promotions, and positive e-cigarette-related attitudes (eg, appeal of e-cigarettes) and behaviors (eg, e-cigarette use). Adjusted and weighted logistic regression analyses were used.

Results

A total of 79.0% (n = 1185) of young adults, including 78.1% (n = 310/397) of participants under 21 years old, recognized online e-cigarette marketing. Participants who reported recognition of stimuli, compared with those who did not, had greater odds of reporting appeal of e-cigarettes (AOR = 2.26, 95% CI = 1.65 to 3.09) and e-cigarette purchase intentions (AOR = 1.66, 95% CI = 1.13 to 2.43) among all participants, and susceptibility to use e-cigarettes among never users (AOR = 2.29, 95% CI = 1.59 to 3.29).

Conclusions

Young adults in California recognized audiovisual and image-based online e-cigarette marketing. Such recognition may lead to positive e-cigarette-related attitudes and behavioral intentions, especially among never users. Future research should examine the causal relationships between the associations found in this study. Findings may inform the development and evaluation of psychometrically valid measures of online e-cigarette marketing exposures.

Implications

Recognition of online e-cigarette marketing stimuli was associated with greater odds of reporting the appeal and benefits of e-cigarettes, purchase intentions, and lifetime e-cigarette use among all participants, and susceptibility to use e-cigarettes among never users. These findings may motivate the development and evaluation of psychometrically valid measures of online e-cigarette marketing exposures.
Association Between Coronary Artery Disease and Herpes Zoster: A Cohort Study in Taiwan
Authors: Lai Shih-Wei , Kuo Yu-Hung , Liao Kuan-Fu
Published: July 2024

Background

Coronary artery disease (CAD) and herpes zoster represent significant health burdens, and their potential interrelationships remain understudied. This cohort study aimed to address the existing knowledge gap by systematically exploring whether people with CAD are at increased risk for developing herpes zoster.

Methods

Using the 2006–2015 claims data of the National Health Insurance Program in Taiwan, we identified participants aged ≥20 years with a new diagnosis of CAD as the CAD group. We selected sex- and age-matched participants without CAD as the non-CAD group. The incidence rate of herpes zoster at the end of follow-up was calculated. A multivariable Cox proportional hazards regression model was used to measure the hazard ratio and 95% CI for herpes zoster associated with covariables.

Results

The overall incidence rate of herpes zoster was 1.14-fold greater in the CAD group as compared with the non-CAD group (6.52 vs 5.74 per 1000 person-years; 95% CI, 1.08–1.20). After controlling for covariables, the adjusted hazard ratio of herpes zoster was 1.21 (95% CI, 1.14–1.27) for the CAD group as compared with the non-CAD group.

Conclusions

This cohort study provides valuable insights into the potential association between CAD and the risk of developing herpes zoster. The findings may have implications for preventive strategies of herpes zoster in people with CAD. Further research and collaboration with diverse groups will be critical to validate and extend our findings.
Chimeric Antigen Receptor T-Cell Postinfusion Fever: Infection Profile, Clinical Parameters, and Biomarkers Trends to Assist Antibiotic Stewardship
Authors: Peyrony Olivier , Garcia-Pouton Nicole , Chumbita Mariana , Teijon-Lumbreras Christian , Aiello Tommaso Francesco , Monzó-Gallo Patricia , Gallardo-Pizarro Antonio , Ortiz-Maldonado Valentín , Martinez-Cibrian Núria , Delgado Julio , Fernandez de Larrea Carlos , Mensa Josep , Puerta-Alcalde Pedro , Soriano Alex , Garcia-Vidal Carolina
Published: July 2024

Background

This study aimed to describe documented infections associated with postinfusion fever after CAR T-cell therapy and to evaluate daily changes in vital signs, laboratory results, and the National Early Warning Score (NEWS) in patients with and without confirmed bacterial infections following fever onset, with the objective of assisting in antibiotic stewardship.

Methods

This was a retrospective, observational study including all consecutive adult patients who received CAR T-cell therapy. Documented infection in the first fever episode after infusion, and clinical and analytic trend comparison of patients with bacterial documented infections and those without documented infections, are described.

Results

Among 152 patients treated with CAR T-cell therapy, 87 (57.2%) had fever within 30 days of infusion, with a median time from infusion to fever of 3 (interquartile range, 2–5) days. Of these 87 patients, 82 (94.3%) received broad-spectrum antibiotics. Infection was documented in 9 (10.3%) patients and only 4 (4.6%) had bacterial infections. Clinical signs and biomarkers were similar in patients with bacterial documented infection and in those without documented infection at fever onset. Fever, tachycardia, and high C-reactive protein levels remained high during the first 3 days after CAR T-cell infusion, even when no infection was documented.

Conclusions

Fever is a common symptom following CAR T-cell infusion and is largely treated with broad-spectrum antibiotics. However, confirmed bacterial documented infections after the first fever post–CAR T-cell infusion are very unusual. Because clinical parameters and biomarkers are not useful for identifying infectious fever, other methods should be assessed to ensure the proper use of antibiotics.
Disparities in Physical Therapy Outcomes Based on Race and Ethnicity: A Scoping Review
Authors: Patel Rupal M , Prusynski Rachel A , Williams-York Bernadette , Matthews Ndidiamaka D , VanHoose Lisa
Published: July 2024

Objective

This scoping review synthesizes and summarizes the evidence on racial and ethnic disparities in outcomes after physical therapist treatment.

Methods

Four databases from 2001 through 2021 were searched for articles reporting physical therapy outcomes across racial and ethnic groups. The Arksey and O’Malley methodological framework was adapted for this scoping review. Two reviewers screened the abstracts, and 5 reviewers screened full texts for inclusion. Five reviewers extracted information including study design, diagnoses, setting, outcomes reported, the domains the outcomes measured, and racial and ethnic groups included. To identify disparities, summarized differences in outcomes (better, worse, no difference) for each racial and ethnic group compared to White patients were calculated.

Results

Of 1511 abstracts screened, 65 met inclusion criteria, 57 of which were observational designs. All 65 articles included non-Hispanic White patients as the reference group. A majority of the physical therapy outcomes reported by race were for Black patients and/or Hispanic or Latino patients, whereas outcomes for Asian, American Indian, Alaskan Native, and/or Native Hawaiians or Pacific Islander patients were reported infrequently. Most articles reported disparities in health outcomes for patients in the inpatient rehabilitation setting (n = 48) and for adults (n = 59) with neurologic diagnoses (n = 36). Compared to White patients, worse outcomes were reported more frequently for all marginalized racial and ethnic groups after physical therapy, with the exception of marginalized groups having the same or better outcomes for successful post-rehabilitation community discharge.

Conclusion

Gaps remain in understanding outcome disparities beyond older adult and neurologic populations as well as for musculoskeletal diagnoses frequently treated by physical therapists.

Impact

The presence of racial and ethnic disparities in physical therapy outcomes should motivate physical therapists to understand the mechanisms underlying disparities and focus on social and structural drivers of health inequity in their clinical decision-making.
Schizophrenia-Like Deficits and Impaired Glutamate/Gamma-aminobutyric acid Homeostasis in Zfp804a Conditional Knockout Mice
Authors: Zhang Qiao-xia , Wu Shan-shan , Wang Peng-jie , Zhang Rui , Valenzuela Robert K , Shang Shan-shan , Wan Ting , Ma Jie
Published: July 2024

Background and Hypothesis

Zinc finger protein 804A (ZNF804A) was the first genome-wide associated susceptibility gene for schizophrenia (SCZ) and played an essential role in the pathophysiology of SCZ by influencing neurodevelopment regulation, neurite outgrowth, synaptic plasticity, and RNA translational control; however, the exact molecular mechanism remains unclear.

Study Design

A nervous-system-specific Zfp804a (ZNF804A murine gene) conditional knockout (cKO) mouse model was generated using clustered regularly interspaced short palindromic repeat/Cas9 technology and the Cre/loxP method.

Results

Multiple and complex SCZ-like behaviors, such as anxiety, depression, and impaired cognition, were observed in Zfp804a cKO mice. Molecular biological methods and targeted metabolomics assay validated that Zfp804a cKO mice displayed altered SATB2 (a cortical superficial neuron marker) expression in the cortex; aberrant NeuN, cleaved caspase 3, and DLG4 (markers of mature neurons, apoptosis, and postsynapse, respectively) expressions in the hippocampus and a loss of glutamate (Glu)/γ-aminobutyric acid (GABA) homeostasis with abnormal GAD67 (Gad1) expression in the hippocampus. Clozapine partly ameliorated some SCZ-like behaviors, reversed the disequilibrium of the Glu/GABA ratio, and recovered the expression of GAD67 in cKO mice.

Conclusions

Zfp804a cKO mice reproducing SCZ-like pathological and behavioral phenotypes were successfully developed. A novel mechanism was determined in which Zfp804a caused Glu/GABA imbalance and reduced GAD67 expression, which was partly recovered by clozapine treatment. These findings underscore the role of altered gene expression in understanding the pathogenesis of SCZ and provide a reliable SCZ model for future therapeutic interventions and biomarker discovery.
Cross-cultural adaptation and psychometric validation of the Female Sexual Function Index-6 (FSFI-6) Bangla version
Authors: Johra Refat Uz , Ahsan Mohammad Shamsul , Sarkar Ahsan Aziz
Published: July 2024

Background

The 6-item Female Sexual Function Index (FSFI-6) is the shortened version of the widely used 19-item FSFI-19, designed for efficient screening of female sexual dysfunction in outpatient settings. However, this shorter FSFI-6 tool has not yet been validated for use in Bangladesh.

Aim

The purpose of this study was to culturally adapt and validate the FSFI-6 in Bangla.

Methods

The FSFI-6 was translated into Bangla using standard adaptation protocols. We interviewed 100 married, sexually active women aged 18 years and over from the outpatient and psychiatric sex clinic of a psychiatry department. Of these women, 50 were clinically diagnosed with sexual disorders based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, criteria. After obtaining written informed consent, participants completed a semi-structured questionnaire to provide sociodemographic information and the Bangla-adapted version of the FSFI-6. We assessed reliability and construct validity using the Statistical Package for Social Sciences, version 25, along with Classical and Bayesian Instrument Development software.

Outcome

Study outcomes were internal consistency, factor structure, and sensitivity and specificity.

Results

The study involved 100 participants with a mean ± SD age of 30 ± 5.4 years, ranging from 18 to 48 years. The majority of respondents (54.34%) reported issues related to sexual desire. The overall mean score on the Bangla-adapted FSFI-6 was 18.4 ± 5.4. Reliability analysis showed a high internal consistency, with a Cronbach’s alpha of 0.887 indicating robust reliability. Both inter-item correlations and item-total correlations were within the acceptable range. A cutoff value of 19 for the FSFI-6 demonstrated high discriminative power, effectively distinguishing between individuals with sexual disorders and those without sexual disorders or with other psychiatric conditions. The sensitivity at this cutoff was 96%, with a specificity of 100%.

Clinical Implications

The FSFI-6 Bangla version can be used to screen patients for female sexual dysfunction in an outpatient setting.

Strengths and Limitations

The internal consistency of this study, indicated by a Cronbach’s alpha of 0.887, was robust. The instrument is time efficient, user friendly, and well suited for outpatient settings. However, the sampling technique utilized was nonrandomized, confined to a single institution, and did not incorporate assessments for concurrent validity or test–retest reliability.

Conclusion

The FSFI-6 Bangla version showed good reliability and validity in this study, supporting its usability as a valuable tool for screening sexual dysfunction in female.
Deletion of Dux ameliorates muscular dystrophy in mdx mice by attenuating oxidative stress via Nrf2
Authors: Sun Siyuan , Zhai Wen , Zhang Ruixue , Cai Na
Published: July 2024

DUX4 has been widely reported in facioscapulohumeral muscular dystrophy, but its role in Duchenne muscular dystrophy (DMD) is unclear. Dux is the mouse paralog of DUX4. In Dux−/− mdx mice, forelimb grip strength test and treadmill test were performed, and extensor digitorum longus (EDL) contraction properties were measured to assess skeletal muscle function. Pathological changes in mice were determined by serum CK and LDH levels and muscle Masson staining. Inflammatory factors, oxidative stress, and mitochondrial function indicators were detected using kits. Primary muscle satellite cells were isolated, and the antioxidant molecule Nrf2 was detected. MTT assay and Edu assay were used to evaluate proliferation and TUNEL assay for cell death. The results show that the deletion of Dux enhanced forelimb grip strength and EDL contractility, prolonged running time and distance in mdx mice. Deleting Dux also attenuated muscle fibrosis, inflammation, oxidative stress, and mitochondrial dysfunction in mdx mice. Furthermore, Dux deficiency promoted proliferation and survival of muscle satellite cells by increasing Nrf2 levels in mdx mice.
3. The Determinants of Detrimental Changes in Pulse Pressure During Hemodyalisis Treatment in Maintenance Hemodialysis Patients
Authors: Damayanti Ratna , Kuswadi Iri , Prasanto R Heru , Puspitasari Metalia , Wardhani Yulia , Pratama Danny
Published: July 2024

Background: Studies have shown that large decreases or rises of pulse pressure during hemodialysis associated with cardiovaskular event, all-cause and cardiovascular mortality.

Objective: Thus we studied about the determinants of detrimental changes in pulse pressure (ΔPP) during hemodialysis.

Method: This is a prospective, observational, cross-sectional study in which patients undergoing maintenance hemodialysis for ≥ 6 months in dr. Sardjito Hospital, Yogyakarta were enrolled in April 2023. Mann-whitney, independent-t, chi-square, fisher exact tests and logistic regression analyses were used to compare the difference and association between group 1 (ΔPP>5 mmhg or ΔPP less than -25 mmhg) and group 2 (ΔPP -25 to 5 mmhg) with the determinants of detrimental changes in pulse pressure during hemodialysis.

Result: There were 136 patients in our study, of which 75(55.1%) were male. The mean age was 52(18-87) years. The most common comorbid was hypertension, 85(62.5%). The mean hemodialysis vintage of patients was 3.93(0.5-27.6) years. From test analysis we found significant difference between group in post-dialysis systolic blood pressure (SBP)(p=0.002), pre-dialysis diastolic blood pressure (DBP) (p=0.012), post-dialysis DBP (p=0.041), ultrafiltration (p=0.046), post-dialysis PP (p=0.016), pre-dialysis mean-arterial-pressure (MAP) (p= 0.011), post-dialysis MAP (p=0.001), and alfa blocker treatment (p=0.033). Multivariat logistic regression analysis show significant association between groups 1 with ultrafiltration (p=0.033; OR=1) and pre-dialysis DBP (p=0.035; OR=1.153).

Conclusion: Our study demonstrates that group with detrimental changes in pulse pressure during hemodialysis were found to have higher post-dialysis DBP, post-dialysis SBP, post-dialysis PP, pre-dialysis MAP, post-dialysis MAP, alfa blocker treatment, ultrafiltration and pre-dialysis DBP.
7. Correlation between Blood Pressure and Body Mass Index, in Patients Undergoing Chronic Haemodialysis in Dr Sardjito Hospital, Yogyakarta
Authors: Muslikhah Zaenab , Kuswadi Iri
Published: July 2024

Background: Hypertension is a common complication of chronic kidney disease (CKD) and persists among most patients with End Stage Renal Disease (ESRD) on maintenance haemodialysis (HD). Hypertension in the haemodialysis patient population is multifactorial. Using various definitions of hypertension, the prevalence of hypertension in haemodialysis patients is estimated to be about 75%. In the general population, obesity is positively correlated with hypertension. On the haemodialysis patients, there was hypothesis of “reverse epidemiology” in the relationship between body mass index (BMI) and blood pressure (BP) of haemodialysis patients, that high BMI may be not completely related to hypertension.

Objective: The aim of this study is to evaluate the relationship between blood pressure and BMI in HD patients and dialysis adequacy

Method: This is prospective, observational, cross-sectional study in which patients undergoing maintenance haemodialysis ≥ three months in dr Sardjito Hospital, Yogyakarta, were enrolled in April 2023. The Mann Whitney test and one way Annova analysis was done to study the correlation between BMI and BP.

Result: There was a total 114 patients in our study which 62 (54,4%) were male and 52 (45,6%) were female. Mean age was 53(15-87), the most common comorbidity is hypertension. Mean BMI was 23.48±4.36, the mean dialysis vintage was 38.4 (3-33.07) months. There was significant correlation between blood pressure and BMI (p= 0,040), and no significant correlation between BP and dialysis adequation (p= 0,622)

Conclusion: There was significant correlation between blood pressure and BMI (p=0,048)
8. Clinical Characteristics of a Dry Body Weight Patients with Intradialytic Hypertension
Authors: Tanod Darryl Virgiawan , Palar Stella , Hasiholan Marbun Maruhum Bonar
Published: July 2024

Background: Intradialytic hypertension (IDH) is associated with poor outcomes. In terms of its pathophysiology, extracellular fluid overload is a crucial determinant. However, patients with dry body weight still experience repeated events in IDH. The study aims to present the clinical characteristics of patients with dry body weight IDH in our dialysis center.

Objective: Out of 167 hemodialysis (HD) patients, 20 patients (11.97%) had IDH with dry body weight. We collected the following clinical characteristics: gender, age, Kt/V, vascular access, HD duration, urine output, serum sodium, HD frequency, etiology of ESRD, antihypertensive drugs, dry weight, ESA injection, ultrafiltration (UF), dialysis vintage, BMI, and IDWG.

Method: Quantitative descriptive method

Result: Patients with IDH were more likely to be female (13, 65%); have an age range of 61-70 years (7, 35%); have Kt/V ≤ 1.8 (15, 75%); use AVF vascular access (14, 70%); have an HD duration of 4.5 hours (16, 80%); have a urine output of 10-500 ml/24 hours (10, 50%); have a serum sodium level of 136-145 meq/L (17, 85%); receive HD twice a week (20, 100%); have hypertension as the etiology of ESRD (10, 50%); take >3 combination antihypertensive drugs (9, 45%); receive post-HD ESA injection (16, 80%); have a UF rate of 1000-1500 (8, 40%); have a dialysis vintage of 1-5 years (10, 50%); and have an IDWG of ± 1.35 kg.

Conclusion: The most prominent clinical characteristics of patients with dry body weight IDH are being female, having Kt/V ≤1.8, and hypertension as the etiology of ESRD.
14. Socio-Demographics, Chronic Disease, Sleep Disturbances, and Visuospatial Impairment among Indonesian Older Persons: A Large Population-Based Study
Authors: Felisia Cindy , Winona Patricia , Handajani Yvonne Suzy , Turana Yuda
Published: July 2024

Background: Chronic diseases, especially hypertension, dyslipidemia, stroke, as well as sleep impairment, were found as the risk factors of cognitive impairment. However some studies showed conflicting results between some of those factors and cognitive function in older persons.

Objective: This study aims to investigate the association between socio-demographic factors (age, gender, education level, residential area), chronic diseases (hypertension, stroke, and dyslipidemia), and sleep quality, with the occurrence of visuospatial impairment among Indonesian older persons.

Method: This research conducted a cross-sectional study including 3,288 participants aged 60 years and older, utilizing data from the Indonesian Family Life Survey-5 (IFLS-5). The analysis performed using the Chi-Square test and multivariate logistic regression.

Result: This study showed 29.7% of older persons in Indonesia experienced visuospatial impairment. The findings from the multivariate analysis demonstrated a statistically significant association between age, gender, education level, residential area, stroke, dyslipidemia, insomnia, and visuospatial impairment (p below 0.05). Subjects with dyslipidemia exhibited normal visuospatial function (OR = 0.666; 95% CI 0.470-0.944). However, this study showed hypertension was not associated with visuospatial impairment. Among socio-demographic factors, this study found that education level had the highest effect on visuospatial function (OR = 2.816; 95% CI 3.065-4.752). Moreover, among chronic diseases, stroke was identified as the most significant risk factor for visuospatial impairment (OR = 1.652; 95% CI 1.015-2.688).

Conclusion: This study reinforces the two significant factors that affect visuospatial function, the educational level and stroke history. These findings emphasized the importance of managing chronic conditions as the essential preserving cognitive health strategy among the older population.
21. Scoping Review on the Long-Term Usage of Amlodipine and its Impact on Dementia Risk
Authors: Tahir Fadila Natasya , Rahmawati Riana , Sari Fery Luvita
Published: July 2024

Background: Hypertension is a known risk factor for dementia, particularly vascular dementia and Alzheimer’s. To achieve the target blood pressure, hypertensive patients require long-term treatment with antihypertensive medications. The most widely used type of dihydropyridine calcium channel blockers (CCBs) in Indonesia is amlodipine.

Objective: This review aims to summarize existing evidence on the long-term use of amlodipine and its association with a decreased risk of dementia.

Methods: Articles were gathered through searches on Pubmed, Sciencedirect, Spingerlink, Portal Garuda, and Google Scholar, covering the period from 2011 to 2021. Both Indonesian and English keywords were employed, and the article selection process adhered to PRISMA-ScR guidelines.

Results: Over a decade, four systematic reviews (including two meta-analyses) and thirteen original articles investigated the impact of long-term CCB usage on dementia risk. The analysis involved a total of 714,047 hypertensive patients across 13 original articles. Of these, 46.1% were from European countries, 30.7% from America, and 23% from Asia. The most-referenced article, an RCT study involving 3,417 participants, was cited 201 times. Among CCB studies, one reported a significant reduction in dementia risk associated with long-term amlodipine use (at least 2.5 years).

Conclusion: Numerous studies highlight the potential of long-term CCB use, particularly dihydropyridines, in lowering the risk of dementia. However, research specifically on amlodipine remains limited. Considering the widespread use of amlodipine in Indonesia, further investigation is crucial to elucidate its impact on reducing the risk of dementia.
25. Simple Steps, Substantial Results: A Meta-Analysis of Pilates at Reducing Blood Pressure in Hypertensive Patients
Authors: Milla Clonia , Tazkira Bellinda Zalzabillah , Firdaus Salma , Welliam Yongki , Susilo Hendri
Published: July 2024

Background: Hypertension, affecting 1.28 billion people globally, remains a significant challenge. While diverse treatment options exist, including medications and lifestyle modifications, achieving consistent adherence, particularly among sedentary individuals, presents a significant hurdle. Limited adherence to traditional exercise regimens necessitates exploring alternative approaches, one of which being Pilates, an indoor isometric exercise program.

Objective: This study aimed to evaluate Pilates efficacy for lowering blood pressure (BP) in hypertensive patients.

Method: A systematic literature search was conducted on PubMed, Science Direct, Web of Science, and DOAJ in January 2024 according to PRISMA 2020 guidelines. Original studies on Pilates in hypertensive patients, presenting systolic BP (SBP) and diastolic BP (DBP) as their primary outcomes, were selected for analysis. Heart rate (HR) and mean arterial pressure (MAP) were stated as secondary outcomes. Meta-analysis was performed using R software 4.3.1 using a random-effect model.

Result: Out of 387 preliminary studies, a systematic literature search identified 7 eligible studies involving 227 participants. Overall, Pilates was found to significantly reduce both SBP (SMD=−2.10 mmHg [95% CI: −4.14 to −0.05, p=0.046]; I2=94.2%, p<0.01) and DBP (SMD=−2.25 mmHg [95% CI: −3.82 to −0.67, p=0.012]; I2=93.7%, p<0.01). Subgroup analysis revealed that despite differences in study design (RCT vs. crossover trials) and duration of intervention (8, 12, and 16 weeks), no significant differences were found.

Conclusion: In conclusion, Pilates significantly reduced SBP and DBP, suggesting its potential as a non-pharmacological adjunctive treatment for hypertension. However, larger and longer-term studies are needed to confirm the long-term efficacy and safety of Pilates for managing hypertension.
33. Functional Study of ELMO-1 Genetic Variant in Diabetes Mellitus Type II and Diabetic Nephropathy
Authors: Elfiani E , Puspasari A , Harahap H , Amanda N , Suhaimi N , Ali Z , Effendi I , Slamet S , Abdillah N , Yuniarti R , Akbar K , Wangsa S , Mulia D
Published: July 2024

Introduction: Engulfment and Cell Motility (ELMO-1) genetic variation was strong candidate of genetic risk for diabetic nephropathy (DN). Several previous study reported genetic variation in intron of ELMO-1 gene as DN risk factor but the study reported genetic variation in promoter of this gene still limited. Genetic variation in promoter of gene promises as diseases risk factor, that may correlate with the functional of genetic variant, whereas difference genotype has difference protein level.

Aims: This study was functional genetic variant study which revealed functional of three ELMO-1 genetic variation in promoter. The difference of protein ELMO-1 protein level between genotype was investigated.

Methods: Study design was cross sectional. Totally 74 patients with DM type II which full filled study criteria was participated, as much 43 patients have DN. We investigated 3 genetic variation in ELMO-1 promoter with Sanger sequencing. The genetic variants were ELMO-1 rs1882071 G/T, rs13242914 C/T, rs13242348 A/G. Blood ELMO-1 was measure with Enzyme-linked Immunosorbent Assay (ELISA).

Result: Subject who suffered DM type II with GG genotype of rs1882071 has higher mean ELMO-1 blood level than GT and TT genotype (p value 0.735). Subject with TT genotype of rs13242914 has higher mean ELMO-1 blood level than CT and CC genotype (p value 0.511). Subject with GG genotype of rs13242348 has higher mean ELMO-1 blood level than AG and AA genotype (p value 0.634). Similar trends also shown in subject who suffered diabetic nephropathy as renal complication of DM type II with p value (0.846; 0.230; 0.847) respectively for rs1882071 G/T, rs13242914 C/T, rs13242348 A/G.

Conclusion: Blood protein ELMO-1 level was difference between genotype in subject who suffered DM type II or with DN complication. None of them was statistically significant, it may cause by other genetic variation or other factor that may influence blood ELMO-1 level.
37. Ambulatory Blood Pressure in Resistant Hypertension Treated with Renal Denervation, Does it Work?: a Systematic Review
Authors: Kusala Effendi Vico Virya , Revaldo  , Sabran M. Z. , Rubismo K. Y. , Lee J. V. , Zebua A. , Jhoputri C. F. , Lee J. B. , Kurniawan A.
Published: July 2024

Background: Hypertension is a worldwide condition that occurs in a fourth of the world’s population and it is still rising, posing a threat to public health, with two-thirds living in low- to middle-income countries. One of the procedural treatments to treat resistant hypertension is renal denervation. However, the efficacy of renal denervation with resistant hypertension is not known and needs further investigations.

Objective: The purpose of this study was to find out the efficacy of renal denervation in patients with resistant hypertension.

Method: This review was conducted on 10-15 December 2023. Two independent researchers systematically extracted data from several databases, such as PubMed Central (PMC), Science Direct, and PUBMED by using MeSH terminology of keywords renal denervation, hypertension, and safety. The extracted studies were then analyzed and selected according to our inclusion criteria such as studies in the last 5 years, cohort studies, and case-control studies. We excluded systematic reviews, meta-analyses, case series, case reports, studies on pregnant women, children, and animals. Research quality was assessed using Newcastle-Ottawa (NOS).

Result: From 10 cohort studies (2753 subjects from various countries), 9 of them showed renal denervation reduced blood pressure based on ambulatory monitoring. One of the studies showed the blood pressure lowering effect able to reach up to 3 years; All studies have proven good quality based on NOS.

Conclusion: In conclusion, renal denervation showed efficacy by significantly reducing the blood pressure in patients with resistant hypertension. However, further study is needed to confirm these findings.
38. Triglyceride-Glucose Index Associated with Multivessel Artery Coronary Disease (MVCD) Incidents in Patients with Coronary Artery Disease (CAD) at Sultan Agung Islamic Hospital in Semarang
Authors: Alfaruq Umar , Abduh Saugi
Published: July 2024

Background: Coronary artery disease (CAD) patients with multivessel coronary artery disease (MVCD) have higher incidence of major adverse cardiovascular events (MACEs) than patients with single vessel coronary artery disease (SVCD). The triglyceride-glucose index (TyG) is a marker of insulin resistance (IR) which has been linked to cardiovascular diseases. However, evidence on the effect of TyG index on the incidence of multivessel coronary artery disease (MVCD) in coronary artery disease (CAD) is still limited.

Objective: This study aims to investigate the association between the TyG index and the incidence of MVCD in CAD patients at Sultan Agung Islamic Hospital.

Method: Total of 198 subjects suffering from CAD at Sultan Agung Islamic Hospital Semarang for the period March 2022 to December 2023 were divided into 2 groups, the first group being the MVCD group if the stenosis was ≥ 50% in at least two blood vessels main coronary artery and the second group is the non-multivessel coronary artery disease (non-MVCD) if the stenosis is ≥ 50% in one main coronary artery. This research is an analytical observational study with a cross sectional design. Multivariate test was carried out with a logistic regression test.

Result: The study showed that the higher the TyG index value (p=0.000; PR = 4.117; 95% CI = 2.284-7.424) significantly increased the risk of MVCD in CAD patients.

Conclusion: An increase in the TyG index is closely related to the risk of MVCD in CAD patients. This study revealed that the TyG index can be a predictor of the severity in CAD patients.
40. NT-Pro-BNP levels are not significantly affected by left atrial appendage occlusion (LAAO), a systematic review and meta-analysis
Authors: Sebastian M , Deantri F , Sianipar LM , Krisna AI
Published: July 2024

Background: Left atrial appendage occlusion (LAAO) is a procedure used to occlude or close the left atrial appendage (LAA), a part of the left atrium that is associated with thrombus formation in patients with atrial fibrillation. However, LAA is involved in the neurohumoral homeostasis that may be affected by this procedure.

Objectives: This study aims to evaluate the changes of NT-pro-BNP to see the neurohormonal effects caused by LAAO.

Methods: We searched the online databases PubMed (Search conducted on December 2023), ScienceDirect (Search conducted on December 2023), and Cochrane Library (Search conducted on December 2023) for studies of atrial fibrillation patients that underwent left atrial appendage occlusion which measures NT-Pro-BNP levels as an outcome. All samples that were included are patients with a prior diagnosis of atrial fibrillation indicated for LAAO due to contraindications to standard anticoagulation regimens. Baseline demographic data, as well as NT-pro-BNP concentration pre and post-LAAO, are extracted for this study. The primary outcome of this study is the absolute mean difference across NT-Pro-BNP levels obtained before the procedure and during the initial follow-up visit for each of the studies included in this analysis with a 95% confidence interval.

Results: To compare NT-Pro-BNP changes after LAAO, we analyzed 7 studies comparing the changes of NT-Pro-BNP during follow-up from established baseline levels. Using a random-effects model, and Hedges’s method, the pooled NT-Pro-BNP changes in this study are statistically not significant, with an absolute mean difference in NT-Pro-BNP concentration of -27.486 pg/dl (95%CI -81.723;26.750, p=0.32). Begg’s test for publication bias was conducted and showed this study had a low risk of publication bias (z=-0.90, p=0.548).

Conclusion: This study is among one of the first to quantitatively pool studies of NT-Pro-BNP changes after LAAO. In this study, NT-Pro-BNP changes are not statistically significant. Further high-quality studies are required to validate this result.
43. A Brewing Thyroid Storm: Secondary Hypertension due to Thyrotoxicosis Diagnostic Approach in Limited Setting
Authors: Oetama S , Andryan DP , Lilyasari O
Published: July 2024

Background: Secondary hypertension is relatively uncommon with a 10% incidence rate.

Objective: To describe a case of secondary hypertension caused by metabolic disorder.

Case Illustration: A 28-year-old man came to the emergency department of Pupuk Kaltim Hospital with dyspnea on effort since three days before admission. He had persistent hypertension uncontrolled with triple antihypertensive drugs since four years ago. BP was 169/103 mmHg, heart rate 135-145 bpm, temperature 37.9° C. He had alopecia areata, exophthalmos, icteric, bilateral rales, systolic murmur at lower sternal border, and bilateral pitting edema. ECG showed AFib with Ashman phenomenon. CXR revealed cardiomegaly and flattened cardiac waist. LVEF is preserved with concentric LVH and LA dilatation. Abdominal sonogram revealed congestive hepatopathy. fT4 was increased while TSH was reduced. H2FPEF score estimated 38.7% probability of HFpEF. Burch Wartofsky score was 60 (thyroid storm). He was assessed with thyroid heart disease. Medication included intravenous furosemide and digoxin, warfarin, hydrochlorothiazide, ramipril, spironolactone, propranolol, and methimazole. Blood pressure successfully managed with five antihypertensive agents.

Discussion: Renovascular hypertension is unlikely (absence of paraumbilical bruit and normal renal function). It is difficult to obtain plasma renin and aldosterone level but his electrolyte profile (no sodium retention and potassium excretion) is unsuitable for primary hyperaldosteronism. Aortic coarctation is unlikely (absence of differential hypertension and rib notching). No clinical signs of hypercortisolism are found. Pheochromocytoma is unlikely (no suprarenal tumor via abdominal ultrasound). Obstructive sleep apnea is eliminated as well (no history of excessive snoring, no hypercarbia).

Conclusion: Clinical suspicion for secondary hypertension is necessary to ensure therapeutic precision.
45. Morbidity of Hemodialisis Patients: Focus on the Incident Rate of Cataract Surgery and Anemia with Blood Transfusion at OKU Timur Hospital
Authors: Mulia Deddy Primadona , Irawan Rico , Kartika Herleni , Wangsa Syahpri Putra , Akbar Kgs. M. Yusuf Arief , Trikandiani Ida , Ariyanti Firda , Sugihartono  , Permana Adhi , Effendi Ian , Ali Zulkhair , Suhaimi Novadian , Slamet Suprapti , Makky Chairil , Rachman Edy Nur , Elfiani  , Pratama Novandra Abdillah , Yuniarti Rery Tri Ferry
Published: July 2024

Introduction: Hemodialysis (HD) is a modality of renal replacement therapy (RRT) in patients with end-stage chronic Renal disease (ESRD). The most common etiologies of Chronic Kidney Disease (PGK) are hypertension and Diabetes Mellitus which can affect patient morbidity and mortality. The continuous hemodialysis process can also affect the body’s metabolism, such as disrupting erythropoietin production and disrupting the composition of the aqueous humor and eye structure, resulting in visual impairment. This can be seen from the incidence of cataract surgery and the frequency of blood transfusions in HD patients.

Method: This research is a descriptive analysis with a cross sectional design to determine the relationship between several variables assessed on the incidence of morbidity in hemodialysis patients. There were 55 hemodialysis patients grouped based on age, gender, history of disease, duration of HD, number of cataract surgery patients, and frequency of blood transfusions. Data was taken from medical records from June 2022 to October 2023. Data were analyzed using the Chi Square and Fisher Exact statistical tests.

Results: The average age of study respondents was 53.8 ± 8.7, gender male and female 27 (49.1%) and 28 (50.9%), duration of HD 34.4 ± 13.2. The etiology was hypertension 32 (58.2%), DM 16 (29.1%), and others 7 (12.7). Several variables were assessed for the morbidity of cataract surgery and anemia (hb<8.0) respectively, namely gender (p=0.503 & p=0.729), patient age (p=0.384 & p=0.680), cause of CKD (p=0.074 & p= 0.153), and duration of hemodialysis (p=0.891 & p=0.260). From several variable factors assessed, a p value >0.05 was obtained.

Discussion: Anemia is one of the complications and morbidities of HD patients which has an impact on the patient’s quality of life. The pathophysiology of this anemia is varied, namely decreased erythropoietin production due to kidney damage, iron deficiency due to repeated phlebotomy and blood retention in the dialyzer, shortened erythrocyte lifespan, severe hyperparathyroidism, inflammation and infection, aluminum toxicity, folic acid deficiency, hypothyroidism, and hemoglobinopathy. Meanwhile, ocular morbidity can be caused by several factors, namely causes of CKD such as hypertension or diabetes, metabolic disorders, uremia and anemia, and the hemodialysis process itself causes corneal and conjunctival calcification.

Conclusion: There is no statistical relationship between gender, patient age, duration of HD, and causes of CKD on the incidence of morbidity in routine hemodialysis patients in the form of cataracts and anemia.
46. Using The ASCVD Score to Estimate Severity of Atherosclerotic Occlusion
Authors: Prasada Muh Adytia , Abduh M. Saugi
Published: July 2024

Background: The ASCVD (Atherosclerotic Cardiovascular Disease) risk score, developed by the American College of Cardiology, predicts the risk of cardiovascular problems over the next 10 years. The Gensini score is a useful tool for evaluating the severity of coronary artery occlusion. However, the correlation between the ASCVD score and stenosis severity in patients with CAD has not been investigated.

Objective: This study aims to determine the correlation between the ASCVD Score and the degree of stenosis based on the Gensini Score (GS) in patients with coronary artery disease who underwent coronary angiography.

Method: This observational cross-sectional study enrolled patients who underwent coronary angiography for ST-elevation myocardial infarction, NSTEMI, unstable angina pectoris, or chest pain at Sultan Agung Islamic Hospital Semarang from January 2020 to December 2021. The patients were assessed using the ASCVD score and divided into two groups according to the Gensini score: mild-moderate (Gensini Score <38 points) and severe (Gensini Score >38 points). Data were analyzed using spearman and multivariate logistic regression analysis to determine the dominant risk factors.

Result: Among 151 patients, 52 had severe stenosis scores. Patients with a high ASCVD score had the highest GS. Regression analysis of risk factors showed the best association of GS with gender (p=0.000) and Diabetes Mellitus (p=0.019).

Connsclusion: The present study indicates that the ASCVD score correlates with the severity of stenosis and is related to the cardiovascular risk factors of diabetes and gender.