bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of Lipochitooligosaccharide Binding to a LysM-RLK for Nodulation in Medicago truncatula
Authors: Cullimore Julie , Fliegmann Judith , Gasciolli Virginie , Gibelin-Viala Chrystel , Carles Noémie , Luu Thi-Bich , Girardin Ariane , Cumener Marie , Maillet Fabienne , Pradeau Stéphanie , Fort Sébastien , Bono Jean-Jacques , Gough Clare , Lefebvre Benoit
Published: April 2023

Lysin motif receptor–like kinases (LysM-RLKs) are involved in the perception of chitooligosaccharides (COs) and related lipochitooligosaccharides (LCOs) in plants. Expansion and divergence of the gene family during evolution have led to various roles in symbiosis and defense. By studying proteins of the LYR-IA subclass of LysM-RLKs of the Poaceae, we show here that they are high-affinity LCO-binding proteins with a lower affinity for COs, consistent with a role in LCO perception to establish arbuscular mycorrhiza (AM). In Papilionoid legumes, whole-genome duplication has resulted in two LYR-IA paralogs, MtLYR1 and MtNFP in Medicago truncatula, with MtNFP playing an essential role in root nodule symbiosis with nitrogen-fixing rhizobia. We show that MtLYR1 has retained the ancestral LCO-binding characteristic and is dispensable for AM. Domain swapping between the three LysMs of MtNFP and MtLYR1 and mutagenesis in MtLYR1 suggest that the MtLYR1 LCO-binding site is on the second LysM and that divergence in MtNFP led to better nodulation, but surprisingly with decreased LCO binding. These results suggest that divergence of the LCO-binding site has been important for the evolution of a role of MtNFP in nodulation with rhizobia.
The Peroxisomal β-Oxidative Pathway and Benzyl Alcohol O-Benzoyltransferase HSR201 Cooperatively Contribute to the Biosynthesis of Salicylic Acid
Authors: Kotera Yu , Komori Hirotomo , Tasaki Kosuke , Takagi Kumiko , Imano Sayaka , Katou Shinpei
Published: April 2023

The phytohormone salicylic acid (SA) regulates plant defense responses against pathogens. Previous studies have suggested that SA is mainly produced from trans-cinnamic acid (CA) in tobacco, but the underlying mechanisms remain largely unknown. SA synthesis is activated by wounding in tobacco plants in which the expression of WIPK and SIPK, two stress-related mitogen-activated protein kinases, is suppressed. Using this phenomenon, we previously revealed that HSR201 encoding benzyl alcohol O-benzoyltransferase is required for pathogen signal–induced SA synthesis. In this study, we further analyzed the transcriptomes of wounded WIPK-/SIPK-suppressed plants and found that the expression of NtCNL, NtCHD and NtKAT1, homologous to cinnamate-coenzyme A (CoA) ligase (CNL), cinnamoyl-CoA hydratase/dehydrogenase (CHD) and 3-ketoacyl-CoA thiolase (KAT), respectively, is associated with SA biosynthesis. CNL, CHD and KAT constitute a β-oxidative pathway in the peroxisomes and produce benzoyl-CoA, a precursor of benzenoid compounds in petunia flowers. Subcellular localization analysis showed that NtCNL, NtCHD and NtKAT1 localize in the peroxisomes. Recombinant NtCNL catalyzed the formation of CoA esters of CA, whereas recombinant NtCHD and NtKAT1 proteins converted cinnamoyl-CoA to benzoyl-CoA, a substrate of HSR201. Virus-induced gene silencing of any one of NtCNL, NtCHD and NtKAT1 homologs compromised SA accumulation induced by a pathogen-derived elicitor in Nicotiana benthamiana leaves. Transient overexpression of NtCNL in N. benthamiana leaves resulted in SA accumulation, which was enhanced by co-expression of HSR201, although overexpression of HSR201 alone did not cause SA accumulation. These results suggested that the peroxisomal β-oxidative pathway and HSR201 cooperatively contribute to SA biosynthesis in tobacco and N. benthamiana.
JA-Regulated AaGSW1–AaYABBY5/AaWRKY9 Complex Regulates Artemisinin Biosynthesis in Artemisia annua
Authors: Kayani Sadaf-Ilyas , Yanan Ma , Fu Xueqing , Shen Qian , Li Yongpeng , Rahman Saeed-ur , Peng Bowen , Huang Liu , Tang Kexuan
Published: April 2023

Artemisinin, a sesquiterpene lactone obtained from Artemisia annua, is an essential therapeutic against malaria. YABBY family transcription factor AaYABBY5 is an activator of AaCYP71AV1 (cytochrome P450–dependent hydroxylase) and AaDBR2 (double-bond reductase 2); however, the protein–protein interactions of AaYABBY5, as well as the mechanism of its regulation, have not yet been elucidated. AaWRKY9 protein is a positive regulator of artemisinin biosynthesis that activates AaGSW1 (glandular trichome–specific WRKY1) and AaDBR2 (double-bond reductase 2). In this study, YABBY–WRKY interactions are revealed to indirectly regulate artemisinin production. AaYABBY5 significantly increased the activity of the luciferase (LUC) gene fused to the promoter of AaGSW1. Toward the molecular basis of this regulation, AaYABBY5 interaction with AaWRKY9 protein was found. The combined effectors AaYABBY5 + AaWRKY9 showed synergistic effects toward the activities of AaGSW1 and AaDBR2 promoters, respectively. In AaYABBY5 overexpression plants, the expression of GSW1 was found to be significantly increased when compared to that of AaYABBY5 antisense or control plants. In addition, AaGSW1 was identified as an upstream activator of AaYABBY5. Further, it was found that AaJAZ8, a transcriptional repressor of jasmonate signaling, interacted with AaYABBY5 and attenuated its activity. Co-expression of AaYABBY5 and anti-AaJAZ8 in A. annua increased the activity of AaYABBY5 toward artemisinin biosynthesis. This current study provides the first indication of the molecular basis of regulation of artemisinin biosynthesis through YABBY–WRKY interactions, which are regulated through AaJAZ8. This knowledge presents AaYABBY5 overexpression plants as a powerful genetic resource for artemisinin biosynthesis.
Impact of the microbiome on mosquito-borne diseases
Authors: Shi Huicheng , Yu Xi , Cheng Gong
Published: April 2023

Mosquito-borne diseases present a significant threat to human health, with the possibility of outbreaks of new mosquito-borne diseases always looming. Unfortunately, current measures to combat these diseases such as vaccines and drugs are often either unavailable or ineffective. However, recent studies on microbiomes may reveal promising strategies to fight these diseases. In this review, we examine recent advances in our understanding of the effects of both the mosquito and vertebrate microbiomes on mosquito-borne diseases. We argue that the mosquito microbiome can have direct and indirect impacts on the transmission of these diseases, with mosquito symbiotic microorganisms, particularly Wolbachia bacteria, showing potential for controlling mosquito-borne diseases. Moreover, the skin microbiome of vertebrates plays a significant role in mosquito preferences, while the gut microbiome has an impact on the progression of mosquito-borne diseases in humans. As researchers continue to explore the role of microbiomes in mosquito-borne diseases, we highlight some promising future directions for this field. Ultimately, a better understanding of the interplay between mosquitoes, their hosts, pathogens, and the microbiomes of mosquitoes and hosts may hold the key to preventing and controlling mosquito-borne diseases.
State Incarceration Policy in the U.S. Federal System: Assessing Recent Approaches to Reducing Incarceration Rates
Authors: Davis Brandon R
Published: April 2023

Although scholarship analyzing U.S. incarceration policy generally focuses on the federal government and federal criminal justice laws, state and local governments are principally responsible for the criminal justice strategy and tactics utilized within their jurisdictions, and that determines the size of state correctional populations. The overwhelming majority of the total U.S. prison population is under the jurisdiction of state correctional authorities. Since 2010, forty-six states have reduced their prison populations, but the efficacy of these reforms and interventions has varied considerably. Utilizing a series of case studies, I analyze a range of state approaches to reducing the prison population and consider the effectiveness of these policies. The most effective approaches have focused on reducing prison admissions, creating or expanding early release opportunities, and decreasing readmission of conditional release violators.
Development and Validation of the Negative Symptom Inventory-Psychosis Risk
Authors: Strauss Gregory P , Walker Elaine F , Pelletier-Baldelli Andrea , Carter Nathan T , Ellman Lauren M , Schiffman Jason , Luther Lauren , James Sydney H , Berglund Alysia M , Gupta Tina , Ristanovic Ivanka , Mittal Vijay A
Published: April 2023

Background and Hypotheses

Early identification and prevention of psychosis is limited by the availability of tools designed to assess negative symptoms in those at clinical high-risk for psychosis (CHR). To address this critical need, a multi-site study was established to develop and validate a clinical rating scale designed specifically for individuals at CHR: The Negative Symptom Inventory-Psychosis Risk (NSI-PR).

Study Design

The measure was developed according to guidelines recommended by the NIMH Consensus Conference on Negative Symptoms using a transparent, iterative, and data-driven process. A 16-item version of the NSI-PR was designed to have an overly inclusive set of items and lengthier interview to support the ultimate intention of creating a new briefer measure. Psychometric properties of the 16-item NSI-PR were evaluated in a sample of 218 CHR participants.

Study Results

Item-level analyses indicated that men had higher scores than women. Reliability analyses supported internal consistency, inter-rater agreement, and temporal stability. Associations with measures of negative symptoms and functioning supported convergent validity. Small correlations with positive, disorganized, and general symptoms supported discriminant validity. Structural analyses indicated a 5-factor structure (anhedonia, avolition, asociality, alogia, and blunted affect). Item response theory identified items for removal and indicated that the anchor range could be reduced. Factor loadings, item-level correlations, item-total correlations, and skew further supported removal of certain items.

Conclusions

These findings support the psychometric properties of the NSI-PR and guided the creation of a new 11-item NSI-PR that will be validated in the next phase of this multi-site scale development project.
Roles of lower-side leaf trichomes in diffusion resistance and gas-exchange characteristics across environmental gradients inMetrosideros polymorpha
Authors: Amada Gaku , Yoshiko Kosugi , Kitayama Kanehiro , Onoda Yusuke
Published: April 2023

Leaf trichomes on the lower leaf surface are common in many plant species, especially those grown under dry and/or low-temperature conditions; however, their adaptive significance remains unclear. Lower-side leaf trichomes can directly decrease gas fluxes through increased gas-diffusion resistance but can indirectly increase gas fluxes through increased leaf temperature owing to increased heat-diffusion resistance. We examined whether the combined direct and indirect effects of trichome resistance increase photosynthetic rates and water-use efficiency (WUE) using Metrosideros polymorpha Gaud., which varies widely in the masses of lower-side non-glandular leaf trichomes across various environments on the Hawaiian Islands. We employed both field surveys, including ecophysiological measurements at five elevation sites, and simulation analyses to predict the gas-exchange rates of leaves with various trichome-layer thicknesses across a wide range of environmental conditions. Field surveys showed that the trichome-layer thickness was the largest at the coldest and driest site and the thinnest at the wettest site. Field surveys, experimental manipulations and simulation analyses demonstrated that leaf trichomes significantly increased leaf temperature owing to the increased heat resistance. Simulation analyses showed that the effect of leaf trichomes on heat resistance was much larger than that on gas-flux resistance. Leaf trichomes can increase daily photosynthesis only in cold dry areas by increasing the leaf temperature. However, the increased leaf temperature with leaf trichomes resulted in a consistent decrease in the daily WUE at all elevation sites. The magnitudes of trichome effects on gas-exchange rates were associated with the temperature difference across the elevational gradient, the strong light intensity in Hawaii, the leaf-size variation and the conservative stomatal behavior of M. polymorpha as well as the trichome-layer thickness. In summary, the lower-side leaf trichomes in M. polymorpha can be beneficial for carbon assimilation in low-temperature environments but not for water conservation in most environments in terms of diffusion resistance.
Highly cited tropical medicine articles in the Web of Science from 1991 to 2020: A bibliometric analysis
Authors: Monge-Nájera Julián , Ho Yuh-Shan
Published: April 2023

Background

An adequate response to health needs to include the identification of research patterns about the large number of people living in the tropics and subjected to tropical diseases. Studies have shown that research does not always match the real needs of those populations, and that citation reflects mostly the amount of money behind particular publications. Here we test the hypothesis that research from richer institutions is published in better-indexed journals, and thus has greater citation rates.

Methods

The data in this study were extracted from the Science Citation Index Expanded database; the 2020 journal Impact Factor (IF2020) was updated to 30 June 2021. We considered places, subjects, institutions and journals.

Results

We identified 1041 highly cited articles with ≥100 citations in the category of tropical medicine. About a decade is needed for an article to reach peak citation. Only two COVID-19–related articles were highly cited in the last 3 y. The most cited articles were published by the journals Memorias Do Instituto Oswaldo Cruz (Brazil), Acta Tropica (Switzerland) and PLoS Neglected Tropical Diseases (USA). The USA dominated five of the six publication indicators. International collaboration articles had more citations than single-country articles. The UK, South Africa and Switzerland had high citation rates, as did the London School of Hygiene and Tropical Medicine in the UK, the Centers for Disease Control and Prevention in the USA and the WHO in Switzerland.

Conclusions

About 10 y of accumulated citations is needed to achieve ≥100 citations as highly cited articles in the Web of Science category of tropical medicine. Six publication and citation indicators, including authors’ publication potential and characteristics evaluated by Y-index, indicate that the currently available indexing system places tropical researchers at a disadvantage against their colleagues in temperate countries, and suggest that, to progress towards better control of tropical diseases, international collaboration should increase, and other tropical countries should follow the example of Brazil, which provides significant financing to its scientific community.
From components to communities: bringing network science to clustering for molecular epidemiology
Authors: Liu Molly , Chato Connor , Poon Art F Y
Published: April 2023

Defining clusters of epidemiologically related infections is a common problem in the surveillance of infectious disease. A popular method for generating clusters is pairwise distance clustering, which assigns pairs of sequences to the same cluster if their genetic distance falls below some threshold. The result is often represented as a network or graph of nodes. A connected component is a set of interconnected nodes in a graph that are not connected to any other node. The prevailing approach to pairwise clustering is to map clusters to the connected components of the graph on a one-to-one basis. We propose that this definition of clusters is unnecessarily rigid. For instance, the connected components can collapse into one cluster by the addition of a single sequence that bridges nodes in the respective components. Moreover, the distance thresholds typically used for viruses like HIV-1 tend to exclude a large proportion of new sequences, making it difficult to train models for predicting cluster growth. These issues may be resolved by revisiting how we define clusters from genetic distances. Community detection is a promising class of clustering methods from the field of network science. A community is a set of nodes that are more densely inter-connected relative to the number of their connections to external nodes. Thus, a connected component may be partitioned into two or more communities. Here we describe community detection methods in the context of genetic clustering for epidemiology, demonstrate how a popular method (Markov clustering) enables us to resolve variation in transmission rates within a giant connected component of HIV-1 sequences, and identify current challenges and directions for further work.
Phylogenomic Insights on the Xanthomonas translucens Complex, and Development of a TaqMan Real-Time Assay for Specific Detection of pv. translucens on Barley
Authors: Tambong James T. , Xu Renlin , Fleitas Maria Constanza , Wang Lipu , Hubbard Keith , Kutcher Randy
Published: April 2023

The reemergence and spread of Xanthomonas translucens, the causal agent of bacterial leaf streak in cereal crops and wilt in turfgrass and forage species, is a concern to growers in the United States and Canada. The pathogen is seedborne and listed as an A2 quarantine organism by EPPO, making it a major constraint to international trade and exchange of germplasm. The pathovar concept of the X. translucens group is confusing due to overlapping of plant host ranges and specificity. Here, comparative genomics, phylogenomics, and 81 up-to-date bacterial core gene set (ubcg2) were used to assign the pathovars of X. translucens into three genetically and taxonomically distinct clusters. The study also showed that whole genome-based digital DNA–DNA hybridization unambiguously can differentiate the pvs. translucens and undulosa. Orthologous gene and proteome matrix analyses suggest that the cluster consisting of graminis, poae, arrhenatheri, phlei, and phleipratensis is very divergent. Whole-genome data were exploited to develop the first pathovar-specific TaqMan real-time PCR tool for detection of pv. translucens on barley. Specificity of the TaqMan assay was validated using 62 Xanthomonas and non- Xanthomonas strains as well as growth chamber-inoculated and naturally infected barley leaves. Sensitivity levels of 0.1 pg (purified DNA) and 23 CFUs per reaction (direct culture) compared favorably with other previously reported real-time PCR assays. The phylogenomics data reported here suggest that the clusters could constitute novel taxonomic units or new species. Finally, the pathovar-specific diagnostic tool will have significant benefits to growers and facilitate international exchange of barley germplasm and trade.
8. Efficacy of Renal Denervation on Office Blood Pressure in Resistant Hypertension: a Systematic Review
Authors: Sabran M.Z. , Rubismo K.Y. , Lee J.V. , Zebua A. , Jhoputri C.F. , Lee J.B. , Kurniawan A.
Published: April 2023

Hypertension almost occurs in about a quarter of the world's population and is still increasing, causing a burden in public health. Renal denervation is one of the strategies to treat resistant hypertension. However, studies on the efficacy of renal denervation in patients with resistant hypertension are still limited and not well known. The purpose of this study was to find out the efficacy of renal denervation in patients with resistant hypertension by office blood pressure measurement. This review was conducted on 10–17 December 2022. 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). From 5 cohort studies (1605 subjects from various countries), all of them showed renal denervation resulted in better and sustained office blood pressure control on long-term follow up; All studies have proven good quality based on NOS. In conclusion, renal denervation showed efficacy by sustained blood pressure reducing effect in patients with resistant hypertension. However, further study is needed to confirm these findings.
10. Correlation Between Nutritional Status and Waist Circumference with Incidence of Hypertension in The Elderly at Prof. dr. R.D. Kandou Hospital
Authors: Kumalasari Y. , Palar S. , Sugeng C. , Umboh O.
Published: April 2023

Background: Hypertension is the main risk factors of cardiovascular diseases that cause mortality. One of the risk factors of hypertension is obesity. Changes in the prevalence value of hypertension occur as a result of the aging process and life style changes such as unhealthy diet, excessive weight.

Objective: This study aimed to determine the correlation between nutritional status and waist circumference with the incidence of hypertension in the elderly who were admitted in the internal medicine wards at Prof. dr. R.D. Kandou Hospital.

Method: This study was observational analytic with cross-sectional design. The sample in this study were patients who were admitted in the internal medicine wards at Prof. dr. R.D. Kandou Hospital on August until December 2022 as many as 105 respondents. The sampling techniques is simple random sampling. Data were collected from medical record and direct measurement of waist circumference of participants.

Results: This study showed that of 105 respondents, 68 males (64.8%) and 37 females (35.2%), range from 60 to 92 years old, there were 70 respondents found with hypertension (66.67%). The majority of hypertension was suffered by respondents with overweight nutritional status (44.28%), and waist circumference with the central obesity category (57.14%). Correlation found between incidence of hypertension in the elderly with nutritional status (p = <0.001; OR = 5.2) and waist circumference (p = <0.001; OR = 5.33).

Conclusions: Nutritional status and waist circumference are significantly associated with the incidence of hypertension in the elderly.
14. Effect of Doing Yoga for 1 Month to Systolic and Diastolic Blood Pressure: A System Overview and Meta Analysis
Authors: Pintaningrum Yusra , Dewi Made Kartika
Published: April 2023

Background: The World Health Organization (WHO) has identified high blood pressure as one of the most important causes of morbidity and premature mortality in both developed and developing countries. Stress is one of the predisposing factors for hypertension. Hypertension is a major risk factor for death and ranks 3rd as a cause of disability. Yoga reduces cortisol levels so that stress is reduced so that it is expected to reduce blood pressure.

Objective: Researchers compared the differences in mean systolic and diastolic blood pressure between groups that did yoga and those who didn’t do yoga

Method: Researchers included all study that compared blood pressure between the yoga group and the non-yoga group after 1 month. The collected data were combined and analyzed with the Review Manager 5.3 software.

Result: The researcher conducted a random effect analysis model with high heterogeneity (I2 = 80%; Chi2 = 20.32) and (I2 = 92%; Chi2 = 50.56). Researchers found that the mean combined systolic difference between doing yoga for 1 month and not doing yoga was -3.32 (p = 0.02; 95% CI: -6.09 – -0.55) and diastolic of -3.13 (p = 0.07; 95% CI: -6.50 – 0.23).

Conclusion: In this meta-analysis, researchers found that doing yoga for 1 month lowered systolic blood pressure.
16. Obesity is a Major Cause of Hypertension in the Elderly in Indonesia
Authors: Sulaiman Natashya Marvelia , Handajani Yvonne Suzy , Turana Yuda
Published: April 2023

Background: Hypertension is the leading cause of premature death in the world. The prevalence of hypertension in the elderly in Indonesia was 55,2–69,5% and will increase with advancing age.

Objective: This study aimed to determine the relationship between obesity and other risk factors with hypertension in the elderly in Indonesia.

Methods: This research is a cross-sectional study with 4389 elderly aged over 60 years included in this study using secondary data analysis IFLS-5. Hypertension is defined as someone diagnosed with hypertension by a healthcare professional. Chi-Square test and multivariate logistic regression were used for analysis.

Results: The characteristic of respondents were mostly aged 60–74 years (87,5%), female (51%), and education level of <9 years (85,4%). The prevalence of hypertension was 27,5%. Most of the respondents did not have smoking behavior (55,3%), light to moderate physical activity (62,4%), poor sleep quality (83,4%), poor food security status (95,5%), and did not obese (72,5%). Multivariate analysis showed that BMI, sex, sleep quality, and level of education had a significant association with hypertension (p < 0,05). The dominant risk factor of hypertension was obesity (p = 0,000; OR = 1,759).

Conclusion: A significant relationship was found between obesity, female, poor sleep quality, and education level of <9 years with hypertension. Obesity was found as a dominant risk factor associated with hypertension.
19. Visit-to-visit Systolic Blood Pressure Variability Independent of Mean Systolic Blood Pressure is Associated with Various Cardiovascular Events and Mortality: A Systematic Review and Meta-analysis
Authors: Saputra P.B.T. , Lamara A.D. , Saputra M.E. , Pasahari D. , Wardani F. A. , Lituhayu P. K. , Theno A. F. , Regina A. , Azmi Y. , Al Farabi M.J. , Oktaviono Y.H.
Published: April 2023

Background: The association between visit-to-visit systolic blood pressure variability (SBPV) and cardiovascular outcomes after being adjusted with mean systolic blood pressure (SBP) is questionable.

Objective: To systematically review studies quantifying the associations of visit-to-visit SBPV adjusted to mean SBP with cardiovascular outcomes.

Method: A systematic search in PubMed, Scopus, and Science Direct was conducted on 27 November 2022. We included studies evaluating the association of various SBPV parameters with cardiovascular outcomes. Only clinical trials and cohort studies were included. We included all patients with available data on visit-to-visit SBPV and cardiovascular outcomes. Hemodialysis patients were excluded due to inter-hemodialysis BPV. Different parameters of SBPV (standard deviation, coefficient of variation, variation in mean) were extracted and analyzed as standardized hazard ratios, a log-hazard ratio for each unit of SBPV divided by its standard deviation. Generic inverse variance using random effect meta-analysis was performed to estimate pooled standardized hazard ratio. The QUIPS tool for prognostic study was used for risk of bias assessment.

Result: A total of 9,944,254 subjects from 43 studies (21 trials and 22 cohorts) were included in meta-analysis. Increased visit-to-visit SBPV was associated with a risk of all-cause mortality (HR 1.21, CI95%[1.16–1.25]), cardiovascular mortality (HR 1.1, CI95%[1.07–1.14]) cardiovascular events (HR 1.1, CI95%[1.07–1.13]), myocardial infarction (HR1.13, CI95%[1.07–1.19]) and stroke (HR 1.22, CI95%[1.16–1.29]). After sensitivity analysis for studies adjusted to mean SBP, SBPV is still significantly associated with all mentioned cardiovascular outcomes.

Conclusion: Systolic blood pressure variability, independent of mean SBP, is associated with all-cause mortality, cardiovascular death, cardiovascular events, myocardial infarction, and stroke.

PROSPERO registration number CRD42023389113
22. The Effect of DASH Diet on Blood Pressure and Metabolic Profile in Hypertensive Patients: A Systematic Review and Meta-Analysis
Authors: Alifah Khusnun , Damayanti Ynes Aulia Eka , Rahmani Aulia
Published: April 2023

Background: Hypertension contributes to the increased risk of adverse cardiovascular events and leads to higher morbidity and mortality. Life style modification, including diet, is the recommended initial intervention strategy to reduce blood pressure and affect the metabolic profile as a risk factor of hypertension. One of the recommended dietary interventions is Dietary Approach to Stop Hypertension (DASH).

Objective: This review aims to systematically review and analyze the studies on the effect of DASH Diet on blood pressure and metabolic profile in hypertensive patients

Methods: All the literature were systematically searched by PubMed using PICO analyses (Population: hypertensive patients, Intervention: DASH diet, Comparison: usual care, Outcome: blood pressure and metabolic profile) and obtained 119 studies. Based on the predetermined inclusion and exclusion criteria, there are six studies included in this analysis. Statistical analysis was performed using Review Manager 5.4.

Results: A total of three randomized controlled trials (RCTs) were reviewed comparing the effects of DASH and usual or control diet on blood pressure. Systolic blood pressure was significantly reduced in DASH group than control group (mean difference -3.89 [-5.02, -2.75]; P < 0.00001; I2 = 0%, P-heterogenicity = 0.45). Diastolic blood pressure was significantly reduced in DASH group than control group (mean difference -2.19 [-3.04, -1.33]; P < 0.00001; I2 = 37%, P-heterogenicity = 0.21). We reviewed three RCTs comparing uric acid levels. One study found uric acid levels were significantly reduced in the DASH group than control group.

Conclusions: DASH diet is effective as an initial intervention in reducing blood pressure and metabolic profile, especially uric acid.
25. Hypertension as the Main Comorbidity Diseases in Covid-19 Patients with Diabetes Mellitus: A Single Centre in North Sumatera, Indonesia
Authors: Muzasti R.A. , Situmorang M.
Published: April 2023

Background: The outbreak of coronavirus disease 2019 (COVID-19) is the leading worldwide healthcare problem. Clinical observations have shown that patients with acute respiratory syndrome coronavirus 2 infection admitted to the hospital were more often those with diabetes mellitus (DM) or hypertension, and a meta-analysis confirmed these findings. Studies of co-morbidities associated with an unfavorable outcome pointed to hypertension and DM as the main comorbid disease along with cardiovascular disease, and chronic obstructive lung disease.

Objective: to investigate the clinical characteristics, comorbidities, presenting symptoms, laboratory results, and outcomes

Method: All patients aged 18 years or older, who were admitted to Universitas Sumatera Utara Hospital for COVID-19 and confirmed with DM, during June 2020 - December 2021 were included in this retrospective study. The discharge summary, states whether the patient is recovered or dead at the end of the hospital stay.

Result: This study was conducted on 141 inpatients, admitted to hospital for COVID-19. Of a total of 90 patients who were confirmed with DM (63.8%), only 37 patients fulfilling the inclusion and exclusion criteria with comorbidities of hypertension (35·1%), cardiovascular disease (10·8%), chronic kidney disease (8·1%), chronic obstructive lung disease (7·1%), and without comorbidities other than DM (13.5%). Mean age was 60.7 (±11.11) years; 54.1% of the patients were male. The most common symptoms were cough (70.3%). Diarrhea was uncommon (8.1%). 35.1% of these patients died.

Conclusion: The most frequent comorbidities in this study of COVID-19 patients with DM are hypertension
29. Measures of Arterial Stiffness and Subclinical Large Vessel Atherosclerosis After Preeclampsia: A Pooled Study-Level Meta-Analysis
Authors: Labi N. Toding , Rampengan D. , Rampengan S.
Published: April 2023

Background: Preeclampsia has been suggested as the risk of subsequent cardiovascular disease, specifically sustained vascular dysfunction after delivery. Several vascular imaging modalities have been studied in the post-partum period. However, it remains unclear whether some degree of vascular dysfunction in form of increasing arterial stiffness and large vessel atherosclerosis persists in women after preeclampsia.

Objective: This study aims to summarize evidence of increasing arterial stiffness and subclinical large vessel atherosclerosis after preeclampsia.

Methods: A search for eligible studies was conducted until April 2022 on PubMed, ScienceDirect, Cochrane Library databases. Included studies were observational, with the preeclampsia as the main exposure, assessed at least 3 months post-partum. Arterial stifness and subclinical large vessel atherosclerosis are measured by augmentation index (AIx), carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT) respectively. Review Manager (RevMan) 5.4 was utilized to compute mean differences (MD) and confidence intervals (CI).

Results: We identified 22 studies that involve 1,954 patients. There was evidence of increasing arterial stiffness in women after preeclampsia compared with women with normal pregnancy when measured by AIx [MD 6.52% (95% CI 2.76, 10.28; p = 0.0007; I2 = 0.81)] and cfPWV [MD 0.64 m/s (95% CI 0.17, 1.11; p = 0.007; I2 = 0.81)]. Subclinical large vessel atherosclerosis via cIMT were more frequent in women after preeclampsia [MD 0.02 mm (95% CI 0.01, 0.04; p = 0.0007; I2 = 0.48)].

Conclusion: Pooled data from studies evaluating vascular imaging suggest that some vascular dysfunction in form of increasing arterial stiffness and subclinical large vessel atherosclerosis persists after preeclampsia as compared with women with prior normal pregnancy.
34. Efficacy and Safety of Sacubitril Valsartan in Managing Hypertension Compared with Angiotensin Receptor Blockers: A Systematic Review and Meta-analysis
Authors: Sukmadja Daniel , Prawara Ananta Siddhi , Prasiddha Kaka Citta , Tarigan Tinanda
Published: April 2023

Background: Sacubitril/Valsartan has shown promising result in the management of heart failure with reduced ejection fraction patients. However, it also withhold the potential as antihypertensive agent. Thus, its effectiveness in reducing high blood pressure (BP) compared with Angiotensin Receptor Blockers (ARBs) needs to be determined.

Objective: This study aimed to compare the efficacy and safety of Sacubitril/Valsartan and ARBs in managing hypertension patients.

Methods: We searched for the studies from Pubmed, Proquest, Google Scholar and Cochrane Library databases which compare the BP reduction effect of Sacubitril/Valsartan and ARBs. The main outcomes were mean office and ambulatory BP reduction. The safety profile was determined by the incidence of adverse events (AEs).

Results: 5114 adult patients with hypertension from 10 RCTs were included. Sacubitril/Valsartan provided significant mean reduction of office systolic BP (mean difference: –4.66; 95%CI: –5.13 to –4.20; p < 0.001), office diastolic BP (mean difference: –3.23; 95%CI: –3.54 to –2.92; p < 0.001), ambulatory systolic BP (mean difference: –3.42; 95%CI: –5.13 to –1.17; p < 0.001), and ambulatory diastolic BP compared with ARBs (mean difference: –1.50; 95%CI: –2.15 to –0.85; p < 0.001). There was no significant difference in the incidence of AEs between the two groups (RR: 1.04; 95%CI: 0.95 to 1.14; p = 0.35). The BP reduction and incidence of AEs were consistent in the subgroup analysis (Olmesartan and Valsartan treatment group), except in comparison with Olmesartan treatment group for ambulatory systolic BP parameter (mean difference: –2.62; 95% CI: –5.30 to 0.07; p: 0.06).

Conclusion: Sacubitril/Valsartan is more potent in reducing BP to ARBs, with similar safety profile.
37. Hyperuricemia and The Risk of Hypertension: A Systematic Review and Meta-Analysis
Authors: Halomoan Reynaldo , Christopher Jonathan
Published: April 2023

Background: Hypertension is the leading cardiovascular problem and is still a global health burden. The incidence of hypertension is related to several risk factors, and hyperuricemia might be linked to the increased risk of hypertension.

Objective: The aim of this study is to discuss the association of hyperuricemia and the risk of hypertension.

Method: Systematic literatures search was conducted from PubMed, ScienceDirect, and PLOS One to find relevant Studies from 2010 to 2023. Random-effect model was used to analyze. Confidence Interval (CI) of 95% were reported. I2 test was used to assess the heterogeneity across studies. Meta-analysis was performed using RevMan 5.3.

Result: Four studies were selected and 4807 participants were included in this study. From our analysis, hyperuricemia was associated with the increased risk of hypertension (RR 1.42 [1.25, 1.62], p < 0.00001, I2: 58%). Our analysis showed insignificant heterogeneity

Conclusion: Hyperuricemia was associated with the risk of hypertension. Management of hyperuricemia is important in reducing the risk of developing hypertension
38. Thiazide-Like or Thiazide-Type Diuretics for Hypertension? A Systematic Review and Meta-Analysis Comparing the Cardiovascular Events
Authors: Yusuf Muhammad , Leonita Ivena , Waranugraha Yoga
Published: April 2023

Background: Despite current local and global guidelines favoring thiazide-like diuretics (TLD), thiazide-type diuretics (TTD) are still more commonly prescribed for hypertension. Whether one treatment reduced cardiovascular event (CVE) risk compared to the other is still questionable.

Objective: This meta-analysis aimed to prove the superiority of TLD over TTD.

Method: The potential articles from PubMed, Cochrane, ScienceDirect, ResearchGate, and ProQuest were identified through January 2023. Studies comparing CVE outcomes between TLD and TTD treatment in hypertensive patients were included. The risk of bias was assessed using Cochrane RoB 2.0 for randomized trials and ROBINS-I for cohort studies. The pooled effect was measured by the fixed or random effect model and showed in risk ratio (RR) and the corresponding 95% confidence interval (CI).

Result: In the beginning, 416 articles were identified from electronic scientific databases. After a detailed screening process, one randomized trial and four cohort studies were included. A total of 792,814 hypertensive patients who received TLD (59,386) or TTD (733,428) were involved in the analysis. The overall risk of bias is low in all studies. Pooled quantitative analysis from three studies showed similar RR of myocardial infarction (0.78 [0.55, 1.11]), heart failure (0.87 [0.67, 1.14], stroke (0.92 [0.78, 1.07]), or composite of CVEs (0.89 [0.72, 1.10]) between the two groups. Publication bias was not found.

Conclusion: Patients who received TLD did not have a lower risk of CVE than patients who received TTD.
40. Nocturnal Hypertension and Dipping Pattern in Acute Stroke Patients
Authors: Jeremia Ivan , Tiksnadi Amanda , Kurniawan Mohammad , Tunjungsari Dyah
Published: April 2023

Background: In acute stroke patients, there is a well-known disruption of blood pressure patterns. The relationship between nocturnal hypertension as well as dipping patterns in acute stroke patients with neurological outcomes and recurrent stroke events is still being studied to create optimal blood pressure management.Until now, publications about blood pressure patterns in acute stroke patients are still limited.

Objective: This article aims to describe events of nocturnal hypertension and dipping pattern in acute stroke patients.

Method: We took secondary data from the use of an ambulatory blood pressure monitoring (ABPM) device for 24 hours that had been performed on acute stroke patients in the stroke unit dr. Cipto Mangunkusumo Hospital from October – December 2022. From the use of ABPM, the subject's blood pressure was grouped based on the dipping profile and the incidence of nocturnal hypertension.

Result: A total of 9 subjects were included in the study, with median age 62 (49–75) years old, 66.7% had an ischemic stroke, and 33.3% hemorrhagic. Nocturnal hypertension was found in 77.8% among subjects who was meassured at onset #5 days, whereas in patients who were meassured at onset >5 days, all had nocturnal hypertension. Nocturnal hypertension events did not occur in subjects without comorbid hypertension. Of all nine subjects, abnormal dipping patterns was found in 6 (66.7%) subjects (non-dipper 2 (22.2%), reverse dipper 3 (33.3%), and extreme dipper 1 (11.1%)).

Conclusion: From this research, there is a high incidence of nocturnal hypertension and abnormal dipping pattern in acute stroke patients.
42. Atrial Fibrillation and Hypertension in Prolanis Community in Bandung City: A Quantitative-Descriptive Study
Authors: Wijayanti S. , Fitriyani A.W. , Qolbi H.H , Fajarulhuda M. , Maulana A.R.
Published: April 2023

Background: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia which often is asymptomatic and undiagnosed. One of the risk factors for atrial fibrillation include high blood pressure. Hypertension itself, based on International Society of Hypertension 2020 is defined when systolic blood pressure $140mmHg and/or diastolic blood pressure $90mmHg. In Indonesia, we have PROLANIS (Program Pengelolaan Penyakit Kronis), a program which is held by Ministry of Health in Indonesia to manage chronic disease such as hypertension.

Objective: This descriptive study is aimed to identify the prevalence of atrial fibrillation in hypertensive patient among PROLANIS community in Bandung City.

Method: We performed prospective screening using a six-leads FDA approved ECG mobile in twenty-one primary care among PROLANIS community during March-October 2022.

Result: We collected 692 data from PROLANIS community in twenty-one primary care in Bandung City. AF in normotensive patient was 2.7% (n = 10), AF in stage 1 hypertension was 4.37% (n = 10) and AF in stage 2 hypertension was 4.5% (n = 4).

Conclusion: Hypertension and AF often coexist. Patient with hypertension have 1.7-fold higher risk of developing AF than normotensive individual. Hypertension may induce early and progressive changes in left atrium anatomy and function, which may promote AF through a variety of electrophysiological mechanism. We found studies which conducted by the same method (using mobile electrocardiogram), AF was found 8.1% in hypertensive patient. The diagnosis of atrial fibrillation from the tools warrants further cardiological evaluation but it could be helpful in patients at cardiovascular risk for better prevention.
49. The Differences of Clinical Characteristics between Coronary Artery Disease Patients with and without Hypertension
Authors: Prabhaswara Agastya , Tiksnadi Badai Bhatara , Ikhsani Rizkania
Published: April 2023

Background: Hypertension may appear concomitantly and share the same pathophysiology with other comorbidities of coronary artery disease (CAD), which may indicate a relation between the two. This study aims to compare the differences between CAD patients with and without hypertension.

Methods: This retrospective study includes subjects from the CAD registry in Dr. Hasan Sadikin General Hospital Bandung, from March-September 2022. Hypertension was defined as blood pressure $140/90 mmHg, known history of hypertension, or routinely consumed hypertension medication. Salt intake, history of smoking, low physical activity, body mass index (BMI), heart failure (HF), stroke, type-2 diabetes mellitus (T2DM), chronic kidney disease (CKD), obstructive sleep apnea (OSA), dyslipidemia, and chronic obstructive pulmonary disease (COPD) were compared between CAD patients with and without hypertension.

Results: From 173 subjects included in this study, 124 (71.7%) subjects had hypertension, consist of 66.7% of male population and 93.8% of female population. The mean age in CAD patients with hypertension were higher than without hypertension (59.8 ± 8.3 vs 56.4 ± 8.8 years). There was no significant difference (p-value >0.05) regarding salt intake, history of smoking, low physical activity, BMI, diabetes, CKD, OSA, dyslipidemia, and COPD. Significant difference was found with age, female, HF, and stroke (p-value < 0.05). Multivariate analysis showed that hypertension was only independently associated with age [OR 1.04 (1–1.08, p-value 0.045)], female [OR 6.97 (1.57–30.86 p-value 0.01)], and HF [OR 3.5 (1.01–12.82, p-value 0.048)].

Conclusion: CAD patients with hypertension was higher in female, older population, and those who have heart failure compared to CAD patients without hypertension.
50. Effectiveness of Renal Denervation in Patients with Resistant Hypertension: An Umbrella and Mapping Review
Authors: Lamara A.D. , Wardani F.A. , Al Farabi M.J. , Pasahari D. , Saputra M.E. , Lituhayu P.K. , Theno A.F. , Regina A. , Saputra P.B.T. , Azmi Y. , Oktaviono Y.H.
Published: April 2023

Background: Resistant hypertension is a condition when blood pressure remains high despite the routine consumption of three antihypertensive agents, including diuretics. Due to the unwanted side effects of antihypertensive agents, non-pharmacology therapy such as renal denervation can be chosen as alternative management, even though this modality still remain controversial. This umbrella review appraises published meta-analyses of observational, controlled trial, and randomized controlled trial (RCT) for the efficacy of renal denervation in hypertension.

Objective: The aim of this umbrella review is to provide an overview of the efficacy of controversial renal denervation as an alternative management in the case of resistant hypertension.

Method: Eight databases were searched was the beginning of 2012 to the 15th of January 2023. Thirteen meta-analyses were included. Non-English languages, wrong study type, wrong population, and wrong study outcomes were excluded.

Result: Eight of thirteen meta-analyses showed significant benefits of renal denervation in reducing blood pressure. Furthermore, one of which showed that the efficacy of renal denervation is better than pharmacological therapy in lowering the blood pressure in resistant hypertension. No significant benefit of renal denervation was found in any other meta-analyses, nonetheless, it was safe to use.

Conclusion: Despite various results from multiple meta-analyses, this umbrella review reveals that renal denervation is beneficial in lowering the blood pressure in resistant hypertension. Further research using long-term follow-up and big-scale subjects is needed to confirm this result.