bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated Step-Up Gain DC-DC Converter Featuring Switched Capacitor and Regenerative Boost Configuration for Enhanced Solar PV Applications
Authors: Devi Tellapati Anuradha , Nagi Reddy B. , R Lavanya , Roshan Rakesh , S Saravanan , Ambaliya Raju
Published: July 2024

The innovative elevated step-up gain DC-DC converter with switched capacitor and regenerative Boost configuration is a pivotal advancement in solar photovoltaic (PV) energy conversion. With a focus on enhancing solar PV applications, this converter efficiently elevates the low-voltage DC output of solar panels, addressing the challenge of low-voltage outputs inherent in solar panels. This breakthrough technology facilitates energy storage, off-grid power supply, and grid integration, contributing to a sustainable solution for optimizing solar power consumption. The converter's regenerative qualities promise to revolutionize solar PV applications, increasing sustainability and efficiency. Its main feature, a significant increase in step-up gain, ensures the effective conversion of low-voltage DC output from solar panels to higher levels, crucial for diverse applications in solar PV systems. This transformative technology plays a vital role in creating a more environmentally and energy-resilient world.
Sustainable Approaches for Recycling Lithium-ion Battery Materials
Authors: Gera Rajat , Bhardwaj Nitin , Mishr Neeti , Kaushik Vaibhav , Kalele Girish , Hima Bindu O.S.D. , Sharma Priyanka
Published: July 2024

In recent years, nanomaterials have gained attention as potential tools for tissue engineering, providing adaptable platforms for long-term medical treatment. In this research, we detailed the physicochemical characteristics of a range of nanoparticles—quantum dots, gold, silver, and iron oxide— that are crucial for their use in tissue engineering. While gold nanoparticles were 20 nm in size, 30 m^2/g in surface area, and had a positive zeta potential of +20 mV, silver nanoparticles were 15 nm in size, 25 m^2/g in surface area, and had a negative zeta potential of -15 mV. The size, surface area, and zeta potential of iron oxide nanoparticles were 30 nm, 40 m^2/g, and +10 mV, respectively. In contrast, the lowest size and zeta potential of quantum dots were 10 nm and +30 mV, respectively. It was also noted that mechanical strength, pore size, and porosity are important scaffold qualities that regulate cellular activity and tissue regeneration. Collagen scaffolds had a lower mechanical strength of 15 MPa, a larger porosity of 90%, and a smaller pore size of 50 µm, in contrast to poly(lactic-co-glycolic acid) (PLGA) scaffolds that had 100 µm pores, 80% porosity, and 20 MPa mechanical strength, respectively. In comparison to chitosan scaffolds, which had the biggest pore size of 120 µm, porosity of 75%, and mechanical strength of 25 MPa, gelatin scaffolds had a moderate hole size of 75 µm, an 85% porosity, and an intermediate mechanical strength of 18 MPa. In addition, testing cell viability and proliferation on scaffolds that included nanomaterials revealed that these materials may influence cellular behavior; for example, gold nanoparticles exhibited a cell vitality of 95% and a cell proliferation that was much higher than control. Finally, the regulated and sustained release kinetics seen in drug release profiles from drug delivery systems based on nanomaterials demonstrate their promise for improving therapeutic results. In conclusion, the research highlights the importance of nanomaterials in developing long-term healthcare solutions and explains their many uses in tissue engineering.
A Novel Technology for Smart shopping trolley system
Authors: Chiranjivi M. , Durga Rao A. , Chiranjeevi Rao B. , Nikhil Raj R. , Hukesh S.
Published: July 2024

First off, humans now enjoy a higher standard of living thanks to contemporary technology. But shopping has become a world unto itself in the modern day. With its cutting-edge technology, the “Smart Shopping Trolley Using RFID and ZigBee” seeks to completely transform the shopping experience. With Radio-Frequency Identification (RFID), ZigBee communication, and a Hc-05 Bluetooth module, this cutting-edge cart makes shopping easy and productive. Customers may easily add items with RFID tags to the cart thanks to RFID technology. There is no longer a need for human scanning or checkout lines because the system automatically recognizes and records the items [9]-[10]. The ZigBee communication system monitors the items in customers’ carts as they navigate the store and syncs with their mobile phone via a Bluetooth module into the app called Serial Bluetooth terminal which guarantee precise billing.
Energy Conservation Opportunities and its Techniques in Net Zero Energy Buildings
Authors: Rao Kambhampati Venkata Govardhan , Sai Kalyani Thalanki Venkata , Anuradha Devi Tellapati , Kiran Kumar Malligunta , Anusha Kunduru , Bikku Thulasi
Published: July 2024

The electrical energy is very necessary to address all household needs and commercial needs. This energy is used all over the world for almost all purposes. It is diminished day by day as fossil fuels are used for energy production. As natural resources are limited and getting exhausted, there is every need to conserve energy. It even involves in rising up pollution and increasing the global temperature by emitting greenhouse gases. It shows severe impact of climate. This paper explains the term energy conservation, methods to conserve energy, use of energy efficient devices and also how energy efficient devices are chosen for various purposes. This paper even focuses on net zero energy buildings and explains a methodology for arranging lights and blind control for windows in net zero buildings to conserve energy.
Analyzing the Outdoor Performance of Different Types of PV Module Technologies
Authors: Kumar Balachandran Praveen , Vijay Kumar Chintala Venkata , B Prudhvi Naidu , M Thanmayi , Sunil Katta
Published: July 2024

The purpose of the extension project is to find out the practical applicability and performance of various solar module innovations in real outdoor conditions. By systematically measuring voltage and monitoring electricity production, the research aims to produce valuable research data that can inform and guide local and global stakeholders in the optimization and implementation of various solar energy innovations. The research focuses on the comparative analysis of three visible PV module types - monocrystalline, polycrystalline and amorphous silicon. The study focuses on collecting daily routine performance parameters of these modules to provide meaningful and actionable information. The project recognizes the importance of evaluating solar panel technologies in real outdoor environments, as performance in controlled laboratory environments may not accurately reflect real-world conditions. Therefore, the research uses a comprehensive methodology that combines rigorous data collection techniques with advanced monitoring systems. To ensure the reliability and validity of the findings, a large experimental setup will be established in an outdoor environment that promotes the collection of solar energy. Each type of PV module is strategically placed to receive optimal sunlight throughout the day, minimizing potential shading and obstructions. An advanced data acquisition system continuously measures and records the voltage readings of the modules. In addition, the system closely monitors power generation to capture performance fluctuations over time.
Solar wireless electric vehicle charging system
Authors: Suresh O.P. , Satyanarayana Salava V. , Hema Bindu P. , Anand K. , Srujith Kumar N. , Sujith V.
Published: July 2024

The automotive industry has undergone a transformation with the growing popularity of electrical vehicles, which provide an eco-friendlier and cleaner substitute for conventional fuel-powered cars. However, the scarcity of EV charging stations is impeding the widespread use of electric vehicles. This research offers a novel wireless EV charging technology that runs on solar energy as a solution to this problem, providing EV owners worldwide with affordable and environmentally friendly options. The wireless power transmission technology at the centre of the suggested system allows EVs to charge without the need for physical hookups. This technology improves user accessibility and safety while doing away with the need for cords. By using solar energy, one can lessen their reliance on traditional power sources increasing the cost- and environmentally-effectiveness of the charging. Comparing this strategy to the conventional plug-in EV charging techniques reveals a number of benefits. The system's ability to charge electric vehicles (EVs) while they are in motion further improves user convenience and reduces discharge time. Solar power offers a sustainable and renewable energy source, minimizing reliance on the power grid and environmental impact. Wireless charging also eliminates the need for physical connections, improving safety and convenience. The purpose of this study is to solve the shortcomings of the conventional electric vehicle systems and offer an innovative solution that will further the development of sustainable transportation. The combination of solar energy and wireless charging for electric vehicles not only promotes the use of sustainable energy. It also encourages the growth of an energy ecosystem that is more flexible and interconnected, paving the path for more environmentally friendly and effective city transport in the future.
Optimal Energy Management and Control Strategies for Electric Vehicles Considering Driving Conditions and Battery Degradation
Authors: Manoj Vasupalli , Guntreddi Venkataramana , Ramana Pilla , Vineela Rathan Bathula , Sasi Kowshik Mavuduru , Pravallika Sathapasthi
Published: July 2024

Electric vehicles (EVs) are crucial for reducing greenhouse gas emissions and promoting sustainable transportation. However, optimizing energy management in EVs is challenging due to the variability in driving conditions and the impact of battery degradation. This paper proposes an advanced energy management and control strategy that accounts for these factors, aiming to enhance both vehicle performance and battery longevity. We integrate real-time data on driving conditions with detailed battery degradation models to develop a comprehensive control framework. Our methodology employs a combination of rule-based and optimization-based algorithms to dynamically adjust energy usage, ensuring optimal performance under diverse driving scenarios. Our strategy significantly improves energy efficiency and mitigates battery degradation compared to conventional approaches. Specifically, findings show an increase in overall driving range and a reduction in battery wear. Additionally, a sensitivity analysis underscores the robustness of our approach across different driving conditions and battery states. This research offers critical insights for the development of next-generation EV energy management systems, promoting longer-lasting and more efficient electric vehicles. Future work will focus on real-world testing and further refinement of the control algorithms to ensure practical applicability and enhanced performance in varied driving environments.
Numerical Analysis of Solar Collector Absorber Tubes with C- shaped Roughness for Enhanced Heat Transfer
Authors: Agarwal Abhishek
Published: July 2024

Solar collector absorber tubes perform a significant function in solar power devices that concentrate the solar energy into a single cylindrical absorber tube. Characteristically, this type of tube is covered with a smooth surface. The purpose of this study is to simulate the convectional behaviour of these absorber tubes with the help of numerical calculation methods like Computational Fluid Dynamics (CFD). The collector tube CAD model has been made using the Creo design software and the ANSYS CFX software is used for the CFD simulations corresponding to the three mass_flow rates (0.005Kg/s, 0.010Kg/s, and 0.015Kg/s). The heat transfer is improved by tweaking the absorber tube with a C-shaped corrugated roughness profile. The choice of the Shear Stress Transport turbulence (SSTT) model for analysis is justified by its capability to accurately predict both laminar and turbulent flows, which is why it is considered to be suitable for the absorber tube with a cross-sectional shape. Findings demonstrated that the use of C-shaped artificial roughness led to a substantial rise in convective heat transfer, for 6.016% of the thermal conductivity was taken into account. The SST turbulence model verifies its efficacy by predicting the fluid flow patterns across the absorber tubes. This study forms the basis for developing new mechanical efficiency metrics for solar collector absorber tubes, which is significant for solar energy technology development.
Green Synthesis of Nano catalysts for Sustainable Petrochemical Refining
Authors: Singla Tara , Bisht Deepa , Taneja Madhur , Bhatnagar Sanjay , K Hemalatha , Talukdar Soumita
Published: July 2024

This study explores sustainable methods for recycling lithium-ion battery (LIB) materials, with the goal of tackling the issues of resource depletion and environmental pollution linked to LIB production and end-of-life management. An analysis of the composition shows that graphite (30%), nickel (20%), lithium (15%), and cobalt (10%) are the main components of LIBs. This emphasizes the economic potential of recycling methods to reclaim these valuable materials. Recovery efficiency assessments show different levels of success, with graphite having the highest recovery efficiency at 95%, followed by lithium at 90%, aluminum at 90%, and cobalt at 85%. The analysis of energy consumption highlights the disassembly and electrolysis steps as the ones that require the most energy. This emphasizes the need to optimize recycling processes in order to reduce environmental impact and improve sustainability. The analysis of costs highlights the significant expenses related to disassembly and electrolysis, underscoring the importance of implementing cost-effective approaches to enhance the economic feasibility of lithium-ion battery recycling. This study offers important insights into the feasibility and implications of sustainable LIB recycling approaches. It emphasizes opportunities for resource recovery, energy efficiency improvements, and cost optimization to support the transition towards a circular economy and a greener future.
Point mutations at specific sites of the nsp12–nsp8 interface dramatically affect the RNA polymerization activity of SARS-CoV-2
Authors: Ferrer-Orta Cristina , Vázquez-Monteagudo Sergi , Ferrero Diego S. , Martínez-González Brenda , Perales Celia , Domingo Esteban , Verdaguer Nuria
Published: July 2024

In a recent characterization of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variability present in 30 diagnostic samples from patients of the first COVID-19 pandemic wave, 41 amino acid substitutions were documented in the RNA-dependent RNA polymerase (RdRp) nsp12. Eight substitutions were selected in this work to determine whether they had an impact on the RdRp activity of the SARS-CoV-2 nsp12–nsp8–nsp7 replication complex. Three of these substitutions were found around the polymerase central cavity, in the template entry channel (D499G and M668V), and within the motif B (V560A), and they showed polymerization rates similar to the wild type RdRp. The remaining five mutations (P323L, L372F, L372P, V373A, and L527H) were placed near the nsp12–nsp8
F
contact surface; residues L372, V373, and L527 participated in a large hydrophobic cluster involving contacts between two helices in the nsp12 fingers and the long α-helix of nsp8
F
. The presence of any of these five amino acid substitutions resulted in important alterations in the RNA polymerization activity. Comparative primer elongation assays showed different behavior depending on the hydrophobicity of their side chains. The substitution of L by the bulkier F side chain at position 372 slightly promoted RdRp activity. However, this activity was dramatically reduced with the L372P, and L527H mutations, and to a lesser extent with V373A, all of which weaken the hydrophobic interactions within the cluster. Additional mutations, specifically designed to disrupt the nsp12–nsp8
F
interactions (nsp12-V330S, nsp12-V341S, and nsp8-R111A/D112A), also resulted in an impaired RdRp activity, further illustrating the importance of this contact interface in the regulation of RNA synthesis.
Germline
BARD1
variants predispose to mesothelioma by impairing DNA repair and calcium signaling
Authors: Novelli Flavia , Yoshikawa Yoshie , Vitto Veronica Angela Maria , Modesti Lorenzo , Minaai Michael , Pastorino Sandra , Emi Mitsuru , Kim Jin-Hee , Kricek Franz , Bai Fang , Onuchic José N. , Bononi Angela , Suarez Joelle S. , Tanji Mika , Favaron Cristina , Zolondick Alicia A. , Xu Ronghui , Takanishi Yasutaka , Wang Zhanwei , Sakamoto Greg , Gaudino Giovanni , Grzymski Joseph , Grosso Federica , Schrump David S. , Pass Harvey I. , Atanesyan Lilit , Smout Jan , Savola Suvi , Sarin Kavita Y. , Abolhassani Hassan , Hammarström Lennart , Pan-Hammarström Qiang , Giorgi Carlotta , Pinton Paolo , Yang Haining , Carbone Michele
Published: July 2024

We report that ~1.8% of all mesothelioma patients and 4.9% of those younger than 55, carry rare germline variants of the BRCA1 associated RING domain 1 (
BARD1)
gene that were predicted to be damaging by computational analyses. We conducted functional assays, essential for accurate interpretation of missense variants, in primary fibroblasts that we established in tissue culture from a patient carrying the heterozygous
BARD1
V523A
mutation. We found that these cells had genomic instability, reduced DNA repair, and impaired apoptosis. Investigating the underlying signaling pathways, we found that BARD1 forms a trimeric protein complex with p53 and SERCA2 that regulates calcium signaling and apoptosis. We validated these findings in
BARD1
-silenced primary human mesothelial cells exposed to asbestos. Our study elucidated mechanisms of
BARD1
activity and revealed that heterozygous germline
BARD1
mutations favor the development of mesothelioma and increase the susceptibility to asbestos carcinogenesis. These mesotheliomas are significantly less aggressive compared to mesotheliomas in asbestos workers.
Lived Religious Practice and Tourism Perceptions of Southern Buddhist Monks in an Ethnic Tourism Community in Xishuangbanna, China
Authors: Li Yu
Published: July 2024

The Dai Garden, situated in Menghan Town of Xishuangbanna, Yunnan Province, China, is an ethnic tourist destination operated by the local company of Jinghong city investment and development. This case study was created to illustrate the complexity of Buddhist tourism. It outlines how the tour guides utilize cultural differences to stigmatize Southern Buddhist monks and addresses the negative tourism perceptions of Southern Buddhist monks in tourism in China, which leads to social and cultural unsustainability in religious tourism. It also reveals the challenges of business, primarily in marketing and management. This study should serve as a reference for other religious tourism businesses seeking to attain a higher level of social/cultural sustainability.

Information

© The Author 2024
A Cusco Journey into Cultural Heritage, Adventure, and Gastronomy
Authors: Santos Eleonora
Published: July 2024

This case study delves into the motivations driving tourists to visit Cusco, exploring strategic approaches and diverse offerings that attract visitors to this historic city. It provides a roadmap for sustainable growth and prosperity while offering stakeholders valuable insights into tourist’s motivations. Focused on the city’s rich heritage and global tourism significance, the study emphasizes cultural immersion, adventure experiences, and sustainable practices. Utilizing qualitative research, the findings reveal the unique motivations of Cusco’s visitors. Despite challenges, growth opportunities highlight targeted marketing, heritage preservation, and community engagement. The study’s implications advocate for continued efforts in sustainable tourism management, stakeholder collaboration, and the preservation of Cusco’s cultural and natural assets. These insights can guide stakeholders towards sustainable growth, social harmony, and environmental conservation, contributing to enduring prosperity for this iconic destination.

Information

© The Author 2024
6. Survey of Erectile Dysfunction Based on Erection Hardness Score (EHS) in Chronic Kidney Disease Patients with Comorbid of Hypertension that Routinely Hemodialyzed in Saiful Anwar General Hospital, Malang, East Java, Indonesia
Authors: Widiaputro Dandi Prasetianto , Suwito Heru , Gunawan Atma
Published: July 2024

Background: Sexual function disturbance is common among chronic kidney disease patients. Both conditions have the same risk factor such as vascular abnormalities and comorbid conditions such as hypertension. The estimated prevalence of erectile dysfunction reaches 87,5% in stage 5 chronic kidney disease patients. Erection hardness is component of erectile function that can be easily measured by EHS. Nevertheless, sexual dysfunction remains under-recognized which is indicated by lack of data about this condition in Indonesia, especially in Malang

Objective: Assess erectile dysfunction using EHS questionnaire in CKD patients with comorbid of hypertension that routinely hemodialyzed in Saiful Anwar General Hospital Malang.

Method: This is descriptive cross-sectional study conducted between May - July 2021 using EHS questionnaire in Indonesian language. The inclusion criteria were CKD patients that routinely hemodialyzed at Saiful Anwar General Hospital. This study excluded non-sexually active patients and history of erectile dysfunction before CKD. An EHS score of ≤3 indicates erectile dysfunction.

Result: total of 120 men with mean age 50.5 years participated in this survey. 83 patients (69%) had comorbid of hypertension, and 37 patients (31%) didn’t have comorbid of hypertension. Erectile dysfunction based on EHS ≤3 in CKD patients with comorbid of hypertension was higher than non-Hypertension patients (89% vs 86% patients). EHS score 1 and 3 was higher in comorbid of hypertension group than non-hypertension group (16% vs 13%; 39% vs 37%).

Conclusion: Erectile dysfunction with EHS score ≤3 in CKD patients with comorbid of hypertension was higher than in CKD patients without comorbid of hypertension.
11. Treatment Profiles of Hypertensive Patients at a Private Hospital in Cirebon
Authors: Hikmayani A. A. , Rachmawan Y. P.
Published: July 2024

Background: Hypertension is one of the most widely prevalent cardiovascular disorders in the world, affecting 1.28 billion adults, of whom two-thirds live in low- and middle-income countries.

Objectives: To assess the distribution of hypertensive patients receiving monotherapy, dual combination, and triple combination antihypertensive medication and its comorbidities.

Methods: This descriptive analytic study was conducted from November 2022 to November 2023. This study included adult hypertensive patients (age ≥18 years) treated with one or more antihypertensive medications. The hospital information system was used to obtain demographic and clinical data. A total of 147 patients’ data were analyzed.

Results: This study shows 42.2% of hypertensive patients are treated with triple combination drugs, 41.5% are receiving four combination drugs, and 4.1% are on five antihypertension drugs. Only 2.7% are receiving monotherapy, and 9.5% of patients are receiving dual combination drugs. The most commonly used triple combination drugs (35.5%) are angiotensin receptor blocker (ARB), dihydropyridine-calcium channel blocker (DHP-CCB), and beta blocker (BB). BB is one of the most used antihypertension drugs (86.4%), beside DHP-CCB (87%). Most patients receiving triple combination drugs are women (85.5%), in the age group between 55 and 64 years old (46.8%), and 69.3% have coronary artery disease (CAD) as the most prevalent comorbidity.

Conclusion: Most hypertensive patients are receiving triple combination drugs as their daily antihypertension therapy, with BB being one of the most used antihypertension drugs. Most of these patients have CAD as a comorbidity. The most frequently used drugs are in accordance with the recent hypertension guidelines.
13. A Bioinformatics Study Using Network Pharmacology to Examine the Pharmacological Mechanisms of Amlodipine and Lercanidipine in Hypertension releted Chronic Kidney Disease
Authors: Akhmad Noval , Ardian Rizal , Adhika Prastya
Published: July 2024

Background: Lercanidipine antihypertensive efficacy is comparable to that of Amlodipine, and it is associated with a markedly lower incidence of vasodilation-related side effects, particularly pedal edema. Lercanidipine appears to protect the kidneys. To investigate the mechanisms of Lecarnidipine and Amlodipine in HT related CKD. We used a network pharmacology technique to do network analysis and target prediction.

Objective: To performed target prediction and network analysis by a network pharmacology method Amlodipine and Lercanidipine

Method: We looked through databases and studies to choose Lercanidipine and Amlodipine targets in HT status with CKD. Cytoscape was used to build the “Drug-Target” and “Drug-Target-Disease” networks. The STRING database was used to assess the protein-protein interaction (PPI). Biological functions of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were examined utilizing the ShinyGO 0.80 program for analysis.

Result: Amlodipine and HT status with CKD had 86 effective objectives, while Lercanidipine and HT status with CKD had 96 effective targets. 36 coretargets including SRC, GSK3B, ABCB1 MTOR, and MDM2, were obtained by further screening. The treatment of HT with CKD was expected to be facilitated by the Calcium signaling pathway, Neuroactive ligand-receptor interaction, Chemical carcinogenesis-receptor activation in Amlodipine, and Neuroactive ligand-receptor interaction, Pathways in cancer, Calcium signaling pathway in Lercanidipine.

Conclusion: Based on pharmacological networks, our study provided a comprehensive and systematic understanding of the potential processes by which Lercanidipine differs from Amlodipine. For more research on the pharmacological mechanism in the treatment of HT with CKD, the major targets and pathways will offer fresh perspectives.
18. The Prevalence and Risk Factors of Hypertension Among Adolescents in Southeast Asian Countries: A Systematic Review and Meta Analysis
Authors: Andrianto  , Albab Chabib Fachry , Saputri Ovin Nada
Published: July 2024

Introduction: Hypertension is a complex disease with many contributing factors. The prevalence of hypertension in Southeast Asian countries (SEA) has shown a significant upward trend over the last two decades on a global scale especially in adolescents. Pooled data on its burden among SEA adolescents have not yet been synthesized.

Objective: The objective of this study was to determine the prevalence of hypertension and to identify its risk factors among the adolescents in SEA.

Method: A systematic search was conducted through PubMed, ScienceDirect, and Cochrane Library selecting observational studies until January 2024. Meta-analysis was conducted using Review Manager 5.4.

Result: There were 12 included studies with total 15,967 patients with prehypertension and hypertension. Meta analysis showed that the overall pooled prevalence estimate of hypertension among adolescents in SEA was 12.37% [95% CI (8.43, 16.32), p<0.00001]. Among this, 11.39% [95% CI (5.71, 17.07), p<0.00001] of hypertension was reported in Indonesia, 16.95% [95% CI (-0.05, 33.95), p=0.05], in Malaysia, and 71.66% in other contries. Overall pooled prevalence estimate of prehypertension was 14.64% [95% CI (12.40, 16.87), p<0.00001]. Among this, 17.53% [95% CI (12.51, 22.5), p<0.00001] of prehypertension was reported in Indonesia, 13.21% [95% CI (8, 18.42), p<0.00001] in Malaysia, and 69,26% in other contries. The common risk factors that we found were female, ethnicity, smoking, alcohol, dyslipidemia, body mass index, physical activity, and psycosocial stress.

Conclusion: Our findings reveal about 1 in 10 adolescents in SEA are hypertensive. This study encourages urgent primary and secondary prevention activities and have implications for policy and intervention development among policymakers.
22. A Systematic Review and Meta-Analysis of the Correlation between Hypertension and Frailty and the Effect on the Prognosis for Illness in Older Individuals: Is it a disastrous condition to get older?
Authors: Zunardi Lutfi Hafiz , Anjarwani Setyasih , Prasetya Indra , Pratiwi Bunga Bella
Published: July 2024

Background: Low blood pressure (BP) in fragile elderly people may be linked to worse health outcomes, and hypertension treatment is controversial. Chronological age does not accurately reflect hypertension patients’ health. Frailty and biological age are linked, and its measurement helps clinicians address health status heterogeneity.

Objective: To figure out the fact that frailty is a predictor of adverse medical consequences among people with hypertension, we performed a meta-analysis.

Method: After searching in electronic scientific databases and following the PRISMA guidelines for interventional trials, all hypertension frailty and clinical outcomes from cross-sectional and longitudinal studies were included. For frailty outcomes, Review Manager 5.4.1 pooled HRs, ORs, and 95% CIs to analyze the implications.

Result: The meta-analysis comprised 34372 hypertensive individuals from eight study. The HR for mortality associated with frailty was 1.28 (95% CI: 1.2-1.38). 1.24 (95% CI: 1.22-1.27) was the aggregate HR for injurious falls associated with frailty. 1.79 HR (95% CI: 1.65-1.93); hospitalization due to frailty.

Conclusion: Frailty predicts death, hospitalization, and risky falls in hypertensive patients, according to this thorough research. Our findings show that hypertension patients may need frailty assessments in clinical settings. Our conclusion was based on a small number of studies, so more research is needed to confirm the role of frailty in predicting the likelihood of bad health outcomes in hypertensive patients and to learn more about how to predict frailty, the relationship between frailty models and correct medical conclusions, and the importance of the link between frailty and hypertension outcomes.
24. Decoding the Efficacy and Safety Profiles of Novel Antihypertensive Agents Targeting RAAS System: A Systematic Review and Meta-analysis of Clinical Trials
Authors: Homenta Rampengan Derren David Christian , Willyanto Sebastian Emmanuel , Amirah Shakira , Jowono Josh Nathaniel , Tjandra Kevin Christian , Ramadhan Roy Novri
Published: July 2024

Background: Dysregulation of the renin-angiotensin-aldosterone system (RAAS) often leads to hypertension, resulting in fatal cardiovascular and renal complications. Current RAAS-targeted therapies effectively slow the progression of established cardiorenal diseases but only provide a modest 20% reduction in the relative risk of cardiovascular disease compared to non-RAAS-targeted therapies. Recognizing these treatment limitations underscores the importance of developing safer and more efficacious anti-hypertensive agents.

Objective: This study aims to assess the efficacy and safety of novel therapies, including angiotensin receptor neprilysin inhibitor (ARNI), nonsteroidal mineralocorticoid receptor antagonist (NMRA), brain renin-angiotensin system (RAS) therapy, and RNA-based therapy.

Method: The study focused on assessing efficacy, measured by systolic and diastolic blood pressure (BP) control, and safety, evaluated through adverse event rates. Quality appraisal was done using RoB 2.0, while meta-analysis used RevMan 5.4

Result: A literature search across five databases resulted in the selection of 20 articles for analysis. Quality assessment categorized 14 studies as low-risk and six as high-risk of bias studies. In analyzing efficacy, ARNI and RNA-based therapy demonstrated superior BP control, whereas NMRA and brain RAS exhibited lower BP control compared to each control group. Regarding safety, NMRA and RNA-based therapy showed fewer adverse events, while ARNI and brain RAS revealed higher adverse events compared to each control group.

Conclusion: RNA-based therapy demonstrated superior efficacy and safety profile, hereby considered as the preferred drug among the four antihypertensive therapies explored in this study. This highlights its status as the optimal drug and underscores its promising potential for future research.

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32. Comparative Analysis of Intensive vs Standard Blood Pressure Targets on Mortality and Vascular Events in Hypertensive Patients with a History of Stroke: A Meta-Analysis Study
Authors: Majidan H. A. , Nursabur B. M. , Afiatin
Published: July 2024

Background: This study investigates the impact of intensive versus standard blood pressure control on mortality and vascular incidents in hypertensive patients with a history of stroke.

Objective: The aim is to compare these treatment approaches and understand their potential benefits and risks through a meta-analysis of existing studies.

Method: A comprehensive search was conducted across multiple databases, resulting in the inclusion of 11 Randomized Controlled Trial studies and 2 prospective cohort studies. The risk of bias was assessed using RoB 2 tools and the Newcastle-Ottawa Scale.

Result: Intensive blood pressure control showed a slightly higher risk of death and other vascular events compared to standard blood pressure control. Intensive blood pressure control has higher risk of death (OR: 1.11, 95% CI: 1.06 – 1.17, I2: 68%). It has a slightly lower risk of Death or Disability (OR: 0.95, 95% CI: 0.86 – 1.04, I2: 0%). It has a slightly higher risk of Hematoma Expansion (OR: 1.10, 95% CI: 1.01 – 1.19, I2: 72%). It has a slightly higher risk of recurrent stroke (OR: 1.04, 95% CI: 0.98 - 1.10, I2: 64%). It has a slightly higher risk of Neurological Detrioration (OR: 1.13, 95% CI: 1.05 - 1.21, I2: 3%). It has a lower risk of mRS score (OR: 0.86, 95% CI: 0.84 – 0.88, I2: 74%). It has a slightly lower risk of improvement mRS score (OR: 0.90, 95% CI: 0.87 – 0.93, I2: 0%). Most of the studies were conducted in multicentre regions and had large sample sizes, which signifies the external validity of this meta-analysis.

Conclusion: Intensive blood pressure targets may not be more beneficial than standard ones in reducing the risk of mortality and vascular events. Further studies are needed to validate these findings.
35. Efficacy and Safety of Valsartan Monotherapy or in Single-Pill Combination Compared to Other Anti-Hypertension Drugs: A Systematic Review
Authors: Tania Lim Stella , Huang Edeline , Kurniawan Andree
Published: July 2024

Background: Valsartan is one of the drugs that can be used as a first-line treatment for mild to moderate hypertension. It reduces blood pressure by inhibiting angiotensin II from causing the constriction of arterioles. However, potential side effects such as headache, dizziness, and cough may occur.

Objective: This systematic review aims to assess the safety and efficacy of Valsartan in single-pill combination or monotherapy compared to other anti-hypertensive drugs.

Method: Two researchers systematically extracted studies from PUBMED database using the keywords “valsartan”, “hypertension” and “efficacy” until 11 December 2023. Studies included were based on our inclusion criteria of studies in the last 5 years, clinical trials and randomised controlled trials. The JADAD scale was used to assess the quality of the studies.

Result: 7 studies, 6 of good and 1 with intermediate quality were included with 4222 patients aged 1 to 65 and older. From 3 of the included studies, single-pill combination of Valsartan with Sacubitril or Amlodipine has better efficacy than monotherapy of Valsartan or Olmesartan. However, 1 of the studies showed that single-pill combination with Amlodipine has the same efficacy as single-pill combination of Indapamide and Amlodipine. In 2 of 7 studies, monotherapy of Valsartan 160-mg has lower efficacy than monotherapy of Fimasartan 120-mg and Azilsartan medoxomil 80-mg. 1 study showed its efficacy in children. Only a few mild adverse events were reported in all studies.

Conclusion: In conclusion, Valsartan is well-tolerated in almost all age groups and exhibits greater efficacy in single-pill combinations. However, further studies are required to validate these findings.
56. Influence of Hypertension on β-amyloid Deposition and Alzheimer’s Disease Relationship in Older Adult Patients: A Systematic Review
Authors: Hailianto Evelyn Natalie , Embun Adeodatia Theodora Constantina , Sugiono Keshia Paramita , Jesslyn Olivia , Litelnoni Kirei Christabel , Sutanto Riona
Published: July 2024

Background: Hypertension has been associated with Alzheimer’s disease (AD) as well as vascular dementia. However, underlying neuropathological mechanisms of hypertension to AD remain poorly understood. Commonly used biomarkers for AD early detection are positron emission tomography (PET) which allows amyloid-beta (Aβ) plaques imaging. Therefore, we estimated the impact of hypertension on the presence and severity of Aβ deposition.

Objective: In this study, we assessed the relationships of hypertension with Aβ plaques deposition as AD pathology.

Method: Studies were extracted from ScienceDirect, PMC, and Pubmed using MesH terminology with “Amyloid-PET” and “Hypertension” keywords on 6 January 2024. The derived data were evaluated based on the inclusion and exclusion criteria. Included publications were either randomized controlled trials, clinical trials, cohorts, or observational studies from the past 5 years. Systematic reviews, meta-analyses, and animal studies were excluded from the study. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.

Result: After screening forty four studies, five cohorts and one observational study were included in this study with a total of 1423 participants. All studies showed good quality based on NOS. Studies suggest that higher amyloid-PET SUVr values was related to hypertension in older adult patients. Hypertension can lead to blood-brain barrier dysfunction and cerebral blood flow reduction followed by increased Aβ deposition. Elevated Aβ may increase risk for AD.

Conclusion: Hypertension is related to elevated Aβ deposition which increases risk for AD. Further research is needed to investigate possible confounders that may play a role in the association.
58. Association between Cognitive Dysfunction and Obstructive Sleep Apnea in Hypertensive Patients: Systematic Review
Authors: Embun Adeodatia Theodora Constantina , Hailianto Evelyn Natalie , Sugiono Keshia Paramita , Jesslyn Olivia , Litelnoni Kirei Christabel , Sutanto Riona
Published: July 2024

Background: Obstructive Sleep Apnea (OSA) is one of the well known disorders known to cause dysfunction in patients life. Thus, affecting the quality of lives of those patients. Several studies have also investigated several factors, such as, hypertension that might increase the risk of developing OSA and Cognitive Dysfunction (CD). We hypothesized that Hypertension can raise the risk of developing in patient (OSA) based on recent studies.

Objective: In this study we assessed the relation between increasing the risk of OSA and CD in hypertensive patients.

Methods: Studies were extracted from the ScienceDirect, PMC, and Pubmed using MesH terms with “Hypertension” and “Obstructive Sleep Apnea” and “Cognitive Dysfunction” keywords on 6 January 2024. Data were selected according to the inclusion and exclusion criteria. Included publications were either randomized controlled trials, clinical trials, cohorts, or observational studies from the past 5 years. Systematic reviews, meta-analyses, and animal studies were excluded from this study. Newcastle Ottawa Scale (NOS) was used to assess the quality of the studies.

Result: After screening Eighteen studies, one cohort and three cross-sectional studies were included with a total of 733 participants. All studies showed good quality based on NOS. Conclusions were drawn from comparing exposed groups and non-exposed groups. Our data confirm that hypertension appears to show higher risk of CD and OSA.

Conclusion: This study has found that patients with hypertension appears to show higher risk of CD and OSA. For available findings to be supported and confirmed, more research is required.
79. The Association between Psychological Stress and Primary Hypertension in Productive Communities Aged >40 years in Nainggolan District, Samosir Island: a Case-Control Study
Authors: Hutasoit J. I. , Sihombing E. P. R , Sijabat I. G. , Tamba A. B. , Siregar M. K. , Manurung R. D. , Hutabarat B. D.
Published: July 2024

Background: Hypertensive disease is still a serious problem that must be handled in everyday life because it is a disease that is a ‘silent killer’. Psychological stress is one of the risk factors for hypertension, therefore the earlier stress detection is carried out, the sooner hypertension can be prevented.

Objectives: The purpose of this study is to determine the relationship between psychological stress and the primary hypertension in productive communities aged >40 years in the Nainggolan District area for the 2021-2022 period.

Methods: This study was an observational analytical study with a case-control study design. The respondents in this study were productive communities aged >40 years in the working area of the Sirait Public Health Center with a total of 50 case groups and a control group of 50 respondents.

Results: There were 50 patients in the case group with an average age of 52.24 years and 50 patients in the control group with an average age of 47.30 years. In the case group there was 30% stress and in the control group there was 24%. In the study subjects, female gender (56%) was the majority. The chi square test showed no significant association between psychological stress and the incidence of ­primary hypertension (p value 0.652) with the magnitude of influence OR=0.737 (95% CI 0.353-1.789).

Conclusion: Psychological stress may not be the main cause of primary hypertension in Nainggolan District. It is worth further exploring the risk factors for primary hypertension, such as family history and other lifestyles.
Factors affecting adherence to recommendations on pre-operative cardiac testing
Authors: Stroda Alexandra , Sulot Tanja , Roth Sebastian , M’Pembele René , Mauermann Eckhard , Ionescu Daniela , Szczeklik Wojciech , De Hert Stefan , Filipovic Miodrag , Beck Schimmer Beatrice , Spadaro Savino , Matute Purificación , Turhan Sanem Cakar , van Waes Judith , Lagarto Filipa , Theodoraki Kassiani , Gupta Anil , Gillmann Hans-Jörg , Guzzetti Luca , Kotfis Katarzyna , Larmann Jan , Corneci Dan , Howell Simon J. , Lurati Buse Giovanna
Published: July 2024

BACKGROUND

Cardiac risk evaluation prior to noncardiac surgery is fundamental to tailor peri-operative management to patient's estimated risk. Data on the degree of adherence to guidelines in patients at cardiovascular risk in Europe and factors influencing adherence are underexplored.

OBJECTIVES

The aim of this analysis was to describe the degree of adherence to [2014 European Society of Cardiology (ESC)/European Society of Anaesthesiology (ESA) guidelines] recommendations on rest echocardiography [transthoracic echocardiography (TTE)] and to stress imaging prior to noncardiac surgery in a large European sample and to assess factors potentially affecting adherence.

DESIGN

Secondary analysis of a multicentre, international, prospective cohort study (MET-REPAIR).

SETTING

Twenty-five European centres of all levels of care that enrolled patients between 2017 and 2020.

PATIENTS

With elevated cardiovascular risk undergoing in-hospital elective, noncardiac surgery.

MAIN OUTCOME MEASURES

(Non)adherence to each pre-operative TTE and stress imaging recommendations classified as guideline-adherent, overuse and underuse. We performed descriptive analysis. To explore the impact of patients’ sex, age, geographical region, and hospital teaching status, we conducted multivariate multinominal regression analysis.

RESULTS

Out of 15 983 patients, 15 529 were analysed (61% men, mean age 72 ± 8 years). Overuse (conduction in spite of class III) and underuse (nonconduction in spite of class I recommendation) for pre-operative TTE amounted to 16.6% (2542/15 344) and 6.6% (1015/15 344), respectively. Stress imaging overuse and underuse amounted to 1.7% (241/14 202) and 0.4% (52/14 202) respectively. Male sex, some age categories and some geographical regions were significantly associated with TTE overuse. Male sex and some regions were also associated with TTE underuse. Age and regions were associated with overuse of stress imaging. Male sex, age, and some regions were associated with stress imaging underuse.

CONCLUSION

Adherence to pre-operative stress imaging recommendation was high. In contrast, adherence to TTE recommendations was moderate. Both patients’ and geographical factors affected adherence to joint ESC/ESA guidelines.

TRIAL REGISTRATION

NCT03016936.
Facility-level integration of hypertension and diabetes services with HIV treatment in sub-Saharan Africa: Evidence from Malawi, South Africa, and Zambia
Authors: Sande Linda , Benade Mariet , Tchereni Timothy , Kamanga Aniset , Ntjikelane Vinolia , Morgan Allison , Makwalu Taurai , Phiri Wyness , Lumano-Mulenga Priscilla , Haimbe Prudence , Shakwelele Hilda , Huber Amy , Pascoe Sophie , Maskew Mhairi , Scott Nancy , Rosen Sydney
Published: July 2024

Background

A growing number of people living with HIV (PLHIV) also have non-communicable diseases (NCDs). Shifting the health systems paradigm from vertical, parallel care to an integrated delivery model may facilitate better care-seeking and ultimately improve outcomes for people with a dual burden of HIV and NCDs. We describe the current state of integration of hypertension and diabetes care into HIV treatment in primary healthcare facilities in Malawi, South Africa and Zambia.

Methods

We administered structured interviews to HIV treatment providers in 41 primary healthcare facilities across the three countries to evaluate how NCD care is provided to PLHIV accessing antiretroviral therapy (ART). We defined integration as provision of all NCD services to PLHIV in the HIV clinic. The potential degree of integration in HIV clinics ranged from not integrated at all (no NCD services) to fully integrated (all NCD services). We also surveyed a sample of ART clients at the same facilities about their access to integrated HIV and non-HIV care.

Results

The degree of integration varied across the facilities and by country. All facilities (n=17) in South Africa reported being fully integrated for HIV care and hypertension and diabetes, and most providers in South Africa identified no barriers to integration. Integration was much less complete in Malawi and Zambia, with most facilities offering hypertension and diabetes screening/diagnosis and support but no treatment or disease monitoring services. Frequently cited barriers to integration in Malawi and Zambia were limited staff knowledge of integrated care provision and facility space constraints. Experience of ART clients experience with integrated services mirrored provider responses. Over 90% of survey participants in South Africa reported HIV and non-HIV visit and medication collection alignment, compared to fewer than half in Malawi and Zambia.

Conclusions

The level of integration of hypertension and diabetes care with HIV treatment varies widely across facilities and within districts in Malawi, South Africa, and Zambia, despite each country having national guidelines that promote integration. Interventions to increase integration must take into account differences among facilities at baseline. South Africa’s strategy for integrated chronic disease care has resulted in greater integration than have approaches in neighboring countries.