bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation and mitigation strategies for impacts and efforts of climate change in Indonesia
Authors: Twidyawati A , Nurbani  , Prasetyo W B , Manurung S E , Pebriadi A M
Published: July 2021

Global warming has become an important issue at this time, where this phenomenon is caused by an increase in the concentration of Greenhouse Gases (GHGs). Climate change is believed to have a negative impact on various aspects of life and the development sector, especially the agricultural sector, and it is feared that it will bring new problems to the sustainability of agricultural production, especially food crops. Rice fields are one the main anthropogenic source of nitrous oxide (N2O) gas, which contributes to global warming. Impact of climate change requires an active effort to anticipate it through mitigation and adaptation strategies. Therefore, the government of Indonesia has taken several steps to cope with anticipated greater losses, among others, through mitigation and adaptation programs. Mitigation measures in the agricultural sector is done through several activities, among others: the development of low-emission rice, ZA fertilizer use as nitrogen source, the development of rice cultivation technology without processing, the development of organic agriculture, green energy development and the development of intermittent irrigation technology. While adaptation measures in this program include: adjustment of time and cropping patterns, use of resistant varieties of drought, submergence, and salinity; rain harvesting technology development, and irrigation technology. This paper attempt to highlight the position agricultural sector in climate change, either as an emitter, sink or impact prone sectors climate change.
Sustainable bioindustrial agriculture: concept, implementation, and its potential for bioenergy production
Authors: Harnowo D , Yunus A , Susanto G W A , Prayogo Y , Sriwahyuningsih  , Harsono A , Mejaya I M J
Published: July 2021

This study is aimed to explain the concept of Sustainable Bioindustrial Agriculture (SBA), its implementation in Indonesia, and the potential of SBA for bioenergy production, as well as for reducing Green Hause Gas (GHG) emission. The results of the study. SBA is an agricultural system which principally manages and optimally utilizes all biological resources, including biomass and agricultural organic waste, for the welfare of the community in an ecosystem in harmony with the principles of reduce, reuse, and recycle. Crop-Livestock Integration System (CLIS) is very important component of SBA. The implementation of SBA in Indonesia has not yet been fully meet the target. There is a big potential for the development of SBA in the country, including for the production of bioenergy, especially biogas. The production of biogas within such system is very potential for reducing the impact of climate change i.e. through reducing GHG emission.
Legacy of ideas of the Javanese Community in the cultivation of medicinal plants in anticipation of climate change in Indonesia
Authors: Wibowo A , Setyawati A , Masyithoh G , Rahayu E S
Published: July 2021

Climate change is an unavoidable consequence of global warming, which is believed will have a broad impact on numerous aspects of life, especially for mountain communities. Changes in rainfall patterns, increased frequency of extreme climate events, along rising air temperatures and sea levels are some of the serious issues faced by the global community. Mountain communities have their local wisdom for dealing with climate change. The huge impact of climate change requires an active effort to anticipate the widespread effects using mitigation and adaptation strategies. This research investigates the legacy of ideas of the Javanese mountain community in anticipating climate change. The research method is qualitative and uses an explorative approach to examine how the legacy of ideas of the Javanese community, combined with local potential, is used as a strategy for anticipating climate change. The research results show that the cultivation of medicinal plants based on ancestral heritage is used as an anticipation strategy for dealing with uncertainties in climate and weather. Since ancient times, mountain communities have believed that the cultivation of medicinal plants in mountain regions offers an alternative source of subsistence if other food and vegetable crops fail to thrive. Medicinal plants are not only consumed by the local community but can also be sold since they are believed to have a relatively stable price and a clear consumer market. They can be consumed by all segments of the community, for stamina, to treat diseases, and also for beauty, and to promote domestic harmony.
The strategic role of civil society organisations in handling climate change: A case of Riau in Indonesia
Authors: Samnuzulsari T , Kristanti D , Susanto H , Yudiatmaja W E , Yunanto M K , Meilinda S D , Akbar D
Published: July 2021

Although many local civil society organisations (CSOs) involve in reducing the impact of climate change, the issue has been reported by a limited study. This paper addresses the gap by investigating the role of local CSOs in helping to anticipate the effect of climate change. This study looked into the case of Riau because it has many CSOs concerned with environmental problems. The objectives of this research are to classify the environmental CSOs in Riau and analyze their contribution to climate change resilience. Using a qualitative approach, the data were collected by using interviews on a series of participants, including CSO’s activists, government officials, academicians, and community leaders. We reveal that local CSOs can be classified as conservation, advocation, empowerment, and conflict resolution. Along with their own and government programs, the CSOs have been contributed to tackling climate change by ensuring forest and peatland preservation. The theoretical and practical contributions of the study are elaborated.
Economic analysis of application two agroforestry combinations in the sloping lands
Authors: Karmini  , Karyati
Published: July 2021

The degraded lands on sloping lands can be rehabilitated by implementing the two agroforestry systems of Falcataria moluccana (sengon)–Arachis hypogaea (groundnut) and Anthocephalus cadamba (jabon)–Glycine max (soybean). The aims of this research were to estimate the production cost, revenue, and profit of two agroforestry systems of sengon – groundnut and jabon – soybean, analyze their financial feasibility, and and select one of two agroforestry systems for the rehabilitation of the sloping lands. This research calculated the production cost, revenue, profit, Net Present Value (NPV), Benefit Cost Ratio (Net B/C Ratio), and Internal Rate of Returns (IRR). The application of agroforestry system of sengon–groundnut needs production cost and produces revenue and profit also has the NPV and Net B/C Ratio values bigger rather than that of jabon-soybean. Two agroforestry systems of sengon-groundnut and jabon-soybean are feasible to be implemented for rehabilitation the degraded lands on sloping lands. From an economic perspective, the application of the agroforestry system of sengon-groundnut is better compared with that of jabon-soybean to rehabilitate the degraded lands on the sloping lands, and this recommendation is further supported by the hydro-orological and silvicultural aspects.
A feasibility study on cultivating shallots (Allium ascalonicum L) in Selo District, Boyolali Regency, Indonesia
Authors: Suswadi  , Prasetyowati K , Kartikasari R D , Prasetyo A
Published: July 2021

The success of agricultural enterprises is closely related to various factors, including climate change that cannot be controlled by humans. Climate greatly affects the risk of horticultural production, one of which is shallot. The purpose of this study was to determine the income, profits of farmers, and the feasibility of cultivating shallot plants in the highlands of Selo, Boyolali. This research was conducted in Senden Village, Selo District, Boyolali Regency. The basic method used in this research is descriptive. Methods of data collection using questionnaires and observations. The results of the research showed that the total cost was Rp. 7,754,932.53, the revenue is Rp. 14,566,666.67, and the income is Rp. 8,064,783.3. The result showed that the shifting of seeds during the high intensity of rainfall in Selo District, Boyolali Regency was feasible to be developed. The findings also showed that there are simple ways of shallot cultivation to respond to climate change. Most costs are spent on buying shallot seeds. To reduce the cost of production facilities, farmers are expected to be able to make their shallot seeds so that profits can be maximized.
Hunger climate vulnerability index (HCVI) and macroeconomic indicators downstream of Bengawan Solo Watershed
Authors: Suryanto  , Utomowati R , Gravitiani E , Rosalia A C T
Published: July 2021

This studi aims to investigate: 1) the level of Hunger Climate Vulnerability Index (HCVI)) among the regencies, 2) correlation between macroeconomic indicator and Hunger Climate indicators such as economic growth and poverty, and 3) mapping of comparison of HCVI in Watershed of Bengawan Solo covering Bojonegoro, Tuban, Lamongan and Gresik. Topographically, downstream of Bengawan Solo Watershed is the area most prone to flooding. If the threat of climate change becomes more apparent where potential shifts and rainfall intensity will increase the risk of flooding especially in the agricultural sector. The method used in this research by using the score of HCVI, correlation analysis, and geographic information system (GIS). The HCVI represents the level of people’s vulnerability as the impact of disasters (i.e., floods) attacked their region. The third tool is - GIS; this tool is used to mapping the result of the HCVI and correlation among the HCVI, economic growth, and poverty index. The results showed the highest score of the HCVI score respectively obtained by Tuban Districts Bojonegoro, Lamongan, and Gresik. For the grade of HCVI, Tuban Districts and Bojonegoro Districts are categorized into high, Lamongan Districts are moderate, and Gresik Districts are the lowest. Indicators of macroeconomics, such as poverty index supported the HCVI score. Meanwhile the macro-economic indicators especially economic growth do not represent the HCVI score.
Urban farmer communities empowerment through the climate village program in Sleman, Yogyakarta
Authors: Sumbodo B T , Sardi  , Raharjo S , Prasetyanto H , Ika S R
Published: July 2021

The conversion of agricultural land for residential and commercial use is a severe problem faced by the Sleman District Government. As an urban area where the need for farm products is getting higher, Sleman, on the contrary, is suffering from the availability of agricultural land. Utilization of homestead land optimally is one way to maintain foodstuffs’ availability in downsizing groundwater resources due to climate change and green land conversion. This study explains urban farmer community empowerment through the Climate Village Education in Pendowoharjo Village, Sleman. The empowerment was done under the triple helix model framework, consisting of Janabadra University, village government, the village-owned company called Bumdes Amarta, and an urban farmer community, namely the Tanjung Lestari Women Farmers Group. Activities in the climate village program are the design of rainwater harvesting equipment called IPAH (Rainwater Harvesting Installation), infiltration wells and dead-end channels called rorak, training, and mentoring to use IPAH as well as training in viticulture and hydroponic systems, and optimization of households waste management system, the core business of Bumdes. Indicators of the success and sustainability of the climate village program are the increased number of IPAH facilities, infiltration wells, and rorak; the increased number of residents harvesting and utilizing rainwater, the increased number of female farmer group members who actively use their yards for vegetable cultivation with viticulture and hydroponic system, as well as the increased income of Bumdes from household waste management business.
Real-Time Context of Tobacco Marketing Exposure and Community Vulnerability—An Ecological Momentary Assessment Among Young Adults
Authors: Chen-Sankey Julia C , van de Venne Judy , Westneat Susan , Rahman Basmah , Folger Shanell , Anesetti-Rothermel Andrew , Debnam Charles , Ribisl Kurt M , Cohn Amy , Rose Shyanika W
Published: July 2021

Background

Exposure to tobacco product marketing increases tobacco use among young adults, especially those from vulnerable communities (VCs).

Purpose

This study examined real-time tobacco marketing exposure among young adults from vulnerable and non-vulnerable communities using Ecological Momentary Assessment (EMA).

Methods

This study used EMA data to assess context (e.g., location and activity) of tobacco marketing exposure using four text-messaging surveys per day over 2 weeks. Young adult non-current tobacco users living in Washington, D.C. (n = 146; ages 18–24) recorded 5,285 surveys, including 20 participants (13.2%) from VCs with high proportions of lower income and racial/ethnic minorities, and high smoking rates. Unadjusted and adjusted multilevel logistic regressions were used to assess the associations between exposure to any and flavored tobacco marketing, VC residence, and real-time context.

Results

Fifty-nine participants (40.4%) reported at least one tobacco marketing exposure and recorded 94 exposure moments. In adjusted models, odds of exposure were higher among VC residents (AOR = 2.6, 95% CI = 1.2–5.4), in the presence of anyone using tobacco versus no use (AOR = 4.0, 95% CI = 2.4–6.7), at store/retail (AOR = 17.0, 95% CI = 6.4–44.8), or outside/in transit (AOR = 4.1, 95% CI = 2.1–7.8) versus at home. VC residence (AOR = 7.2, 95% CI = 2.3–22.2) was the strongest predictor of flavored tobacco marketing exposure among all covariates examined.

Conclusions

Young adults are predominantly exposed to tobacco marketing in their daily lives through retail advertisements. Young adults from VCs are at increased risks of seeing any tobacco and especially flavored tobacco marketing. Policies that curtail tobacco retailer density and advertisement displays may reduce overall and differential tobacco marketing exposure.
DeepMotifSyn: a deep learning approach to synthesize heterodimeric DNA motifs
Authors: Lin Jiecong , Huang Lei , Chen Xingjian , Zhang Shixiong , Wong Ka-Chun
Published: July 2021

The cooperativity of transcription factors (TFs) is a widespread phenomenon in the gene regulation system. However, the interaction patterns between TF binding motifs remain elusive. The recent high-throughput assays, CAP-SELEX, have identified over 600 composite DNA sites (i.e. heterodimeric motifs) bound by cooperative TF pairs. However, there are over 25 000 inferentially effective heterodimeric TFs in the human cells. It is not practically feasible to validate all heterodimeric motifs due to cost and labor. We introduce DeepMotifSyn, a deep learning-based tool for synthesizing heterodimeric motifs from monomeric motif pairs. Specifically, DeepMotifSyn is composed of heterodimeric motif generator and evaluator. The generator is a U-Net-based neural network that can synthesize heterodimeric motifs from aligned motif pairs. The evaluator is a machine learning-based model that can score the generated heterodimeric motif candidates based on the motif sequence features. Systematic evaluations on CAP-SELEX data illustrate that DeepMotifSyn significantly outperforms the current state-of-the-art predictors. In addition, DeepMotifSyn can synthesize multiple heterodimeric motifs with different orientation and spacing settings. Such a feature can address the shortcomings of previous models. We believe DeepMotifSyn is a more practical and reliable model than current predictors on heterodimeric motif synthesis. Contact:kc.w@cityu.edu.hk
Repeated dietary shifts in elapid snakes (Squamata: Elapidae) revealed by ancestral state reconstruction
Authors: Maritz Bryan , Barends Jody M , Mohamed Riaaz , Maritz Robin A , Alexander Graham J
Published: July 2021

Identifying the traits of ancestral organisms can reveal patterns and drivers of organismal diversification. Unfortunately, reconstructing complex multistate traits (such as diet) remains challenging. Adopting a ‘reconstruct, then aggregate’ approach in a maximum likelihood framework, we reconstructed ancestral diets for 298 species of elapid snakes. We tested whether different prey types were correlated with one another, tested for one-way contingency between prey type pairs, and examined the relationship between snake body size and dietary composition. We demonstrate that the evolution of diet was characterized by niche conservation punctuated by repeated dietary shifts. The ancestor of elapids most likely fed on reptiles and possibly amphibians, with deviations from this ancestral diet occurring repeatedly due to shifts into marine environments and changes in body size. Moreover, we demonstrate important patterns of prey use, including one-way dependency—most obviously the inclusion of eggs being dependent on a diet that already included the producers of those eggs. Despite imperfect dietary data, our approach produced a robust overview of dietary evolution. Given the paucity of natural history information for many organisms, our approach has the potential to increase the number of lineages to which ancestral state reconstructions of multistate traits can be robustly applied.
Functional Specialization of the Medial Temporal Lobes in Human Recognition Memory: Dissociating Effects of Hippocampal versus Parahippocampal Damage
Authors: Argyropoulos Georgios P D , Dell’Acqua Carola , Butler Emily , Loane Clare , Roca-Fernandez Adriana , Almozel Azhaar , Drummond Nikolas , Lage-Martinez Carmen , Cooper Elisa , Henson Richard N , Butler Christopher R
Published: July 2021

A central debate in the systems neuroscience of memory concerns whether different medial temporal lobe (MTL) structures support different processes in recognition memory. Using two recognition memory paradigms, we tested a rare patient (MH) with a perirhinal lesion that appeared to spare the hippocampus. Consistent with a similar previous case, MH showed impaired familiarity and preserved recollection. When compared with patients with hippocampal lesions appearing to spare perirhinal cortex, MH showed greater impairment on familiarity and less on recollection. Nevertheless, the hippocampal patients also showed impaired familiarity compared with healthy controls. However, when replacing this traditional categorization of patients with analyses relating memory performance to continuous measures of damage across patients, hippocampal volume uniquely predicted recollection, whereas parahippocampal, rather than perirhinal, volume uniquely predicted familiarity. We consider whether the familiarity impairment in MH and our patients with hippocampal lesions arises from “subthreshold” damage to parahippocampal cortex (PHC). Our data provide the most compelling neuropsychological support yet for dual-process models of recognition memory, whereby recollection and familiarity depend on different MTL structures, and may support a role for PHC in familiarity. Our study highlights the value of supplementing single-case studies with examinations of continuous brain–behavior relationships across larger patient groups.
Higher Comorbidity Burden Predicts Worsening Neurocognitive Trajectories in People with Human Immunodeficiency Virus
Authors: Ellis Ronald J , Paolillo Emily , Saloner Rowan , Heaton Robert K
Published: July 2021

Background

Age-related comorbidities accumulate faster in people with HIV (PWH) than in those without HIV. We evaluated whether a validated multimorbidity scale, the Charlson index, predicted neurocognitive trajectories in PWH.

Methods

Scaled scores of a comprehensive neuropsychological battery were averaged across all visits. Multilevel modeling examined between- and within-person predictors of global neurocognition. At the between-person level, averaged Charlson scores were examined as a predictor of neurocognitive change rate, covarying for HIV disease characteristics. Within-persons, visit-specific Charlson index was used to predict fluctuations in global neurocognition at the same and next visit, covarying for disease measures.

Results

Participants were 1195 PWH (mean baseline age: 43.0; SD: 9.7 years) followed for a mean of 7.1 years (range: 0.5–20.5). At the between-person level, more rapid neurocognitive worsening correlated with higher (worse) average Charlson scores (standardized β: −0.062; SE: 0.015; P = .001) and lower CD4 nadir (standardized β: 0.055; SE: 0.021; P = .011), but not viral suppression or average CD4+ lymphocytes (P > .05). At the within-person level, poorer visit-specific neurocognition was related to worse concurrent, but not preceding, Charlson scores (standardized β: −0.046; SE: 0.015; P = .003), detectable HIV viral load (standardized β: 0.018; SE: 0.006; P = .001), and higher CD4+ (standardized β: 0.043; SE: 0.009; P < .001).

Conclusions

The impact of comorbidities on neurocognitive decline exceeded that of HIV disease factors. Although correlative, the temporal relationships suggested that treatment of comorbidities might improve neurocognitive prognosis for PWH.
The significance of an outpatient multidisciplinary educational consultation to atrial fibrillation patients before electrical cardioversion
Authors: Von Hirsch A , Flendalen C , Kvernstrom B , Bru E , Morken IM
Published: July 2021

Funding Acknowledgements

none

Background

Atrial fibrillation (AF) patients may have many concerns related to their disease and to the electrical cardioversion (ECV) procedure. An outpatient multidisciplinary educational consultation before ECV may reduce their concerns.

Aims

This study aimed to investigate perceived support from healthcare professionals and symptoms of anxiety, depression among AF patients receiving multidisciplinary educational consultation before ECV, compared to patients receiving usual care.

Methods

Patients with persistent AF (n = 217) invited to undergo ECV at an AF outpatient clinic were non-randomly divided in two groups based on the need for an updated echo description: 1) multidisciplinary educational consultation before ECV (n = 115), and 2) usual care from a municipality physician before ECV (n =102). Both groups completed validated questionnaires on symptoms of anxiety and depression and perceived support from healthcare professionals.

Results

Analysis of covariance (ANCOVA) revealed that patients receiving multidisciplinary educational consultation perceived higher constructive support from healthcare professionals (Mean [M] = 3.06 ± 0.79 vs 2.52 ± 0.98; Effect size [ES] = 0.66; p < 0.000), as well as lesser non-constructive support from healthcare professionals (M = 1.19 ± 0.90 vs 1.53 ± 0.87; ES 0.40; p = 0.003), compared to patients receiving usual care. The analyses were controlled for gender, age and history of ECV. In this group the patients had also lesser symptoms of anxiety (M= 4.17 ± 4.11 vs 5.40 ± 4.00; ES = 0.28; p = 0.042), and depression (M = 3.35 ± 3.06 vs 4.77 ± 3.81; ES = 0.38; p = 0.005).

Conclusion

The findings indicate that a multidisciplinary educational consultation before ECV improves the patient’s perception of constructive support from healthcare professionals and reduce their symptoms of anxiety and depression.
Frequency of venous thromboembolism risk factors in hospitalized patients with pulmonary embolism in routine Russian practice
Authors: Nikulina NN , Terekhovskaya YUV , Iakushin SS
Published: July 2021

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Ryazan State Medical University

Despite advances in the diagnosis and treatment of Pulmonary Embolism (PE), it remains one of the most common causes of death among cardiovascular diseases.

Purpose. To study the prevalence of the Venous Thromboembolism (VTE) risk factors (RFs) among patients with PE in the typical Regional Vascular Centers in Russia.

Materials and Methods. The study was conducted within the framework of the Russian SIRENA Register. А retro- and prospective analysis of the clinical cases (n = 107, median age 63 (52-74) years, 39.3% of men) of PE treated at the Regional Vascular Centers from 01 May 2018 to 31 May 2019 (13 months) was performed.

Results. It was revealed that 72.9% of patients had multiple RFs. The average number of strong RFs per PE patient is 1.1, moderate RFs – also 1.1, weak RFs - 2.4. Strong (± moderate and weak) RFs were registered in 26.2% of patients. The most common strong RFs is a history of VTE (22.4% of the PE cohort). Moderate (± low) RFs were observed in 31.8% of PE cases. The most common moderate RFs is malignant neoplasms (17.8%, n = 19; 7 out of 19 had metastases, 5 out of 19 received chemotherapy). In the 40.2% of patients, only weak RFs were identified. The most prevalent were arterial hypertension (70.1%), old age (59.8%) and obesity (46.7%). As a result, 6.5% of PE patients did not have any RFs, and 67.3% of PE patients did not have reversible RFs.

Сonclusion. A high frequency and multiple character of VTE RFs were registered in PE patients in routine clinical practice. The greatest frequency is common cardiovascular RFs, which allows to consider VTE as part of the cardiovascular continuum. In a small number of  PE patients, no known VTE RFs were detected, which determines the need to study other possible conditions that contribute to the PE development. Two-thirds of patients do not have reversible VTE RFs, which leads to the need for active anticoagulant prevention of PE in these patients.
Cardiac involvement in patients with coronavirus pneumonia
Authors: Germanova O , Tereshina O
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background. New COVID-19 disease is well known by its primary damage of respiratory system. However, it is also possible to involve other organs and systems.

Purpose. To determine the cardiac involvement in patients with COVID-19 pneumonia.

Materials and methods. We performed echocardiography with speckle tracking in 48 patients. All of them had serologically verified COVID-19 pneumonia with lung involvement 5-60% on CT. None of them were treated by antimalarial drugs. 28 of them were men and 20 women, mean age - 45 ± 4,4 years old. We performed echocardiography in 1 month period from onset of the disease.

Results. Most of the patients (30 patients) had enlargement of right heart chambers. Despite of right ventricle enlargement, in none of the patients had reduced right ventricle function (TAPSE 22 ± 2 mm, right ventricle strain -21,2 ± 1,5%). The mean systolic pulmonary artery pressure was slightly elevated (38 ± 2 mm Hg).

Left ventricle was enlarged in 9 patients (with mean end diastolic volume 82 ± 5 ml/m2). In 25 of them, the ejection fraction was decreased (44 ± 4%). In all patients with COVID-19 pneumonia, the changes in circumferential and longitudinal strain were observed. Both parameters were decreased. The mean value of circumferential strain was -16,3 ± 1,9%. The longitudinal strain parameter was -14,2 ± 1,4%. 25 patients had enlargement of left atrium (>40ml/m2) and the reservoir strain of left atrium was decreased (-23,3 ± 1,5%)  in 29 of them.

After 2 months from the onset of the disease, we noticed the normalization of echocardiography data in all patients.

Nevertheless, we observed cardiac structural and functional changes in all patients, troponins levels were increased only in 12 patients.

Conclusion. We observed cardiac involvement in different degree in all of patients with COVID-19 pneumonia. Changes characterized by atriums and ventricles enlargement, and left ventricle contractile dysfunction.  Due to the fact that only part of the patients with COVID-19 with cardiac changes had elevated troponins, we believe that the mechanism of these pathological changes need further research.
Relationship of myocardial fibrosis markers with glomerular filtration rate in patients with arterial hypertension
Authors: Sharafutdinova R , Ruzov VI , Razin VA , Gimaev RH , Nizamova LT
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background. Renal damage in arterial hypertension is considered among the typical damage variants of target organs such as heart, blood vessels and brain. One of the complications of arterial hypertension is nephrosclerosis. Developing quite gradually, arterial hypertension kidney damage goes unnoticed for a long time because clinically it does not cause the patient any discomfort. The most accessible and objective way to assess renal function is to calculate glomerular filtration rate (GFR). Tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) is a protein that is a natural inhibitor of metalloproteinases and forms complexes with matrix metalloproteinase-1 and other metalloproteinases, irreversibly inhibiting their activity. Many studies have demonstrated that TIMP-1 can be considered a serum marker of myocardial and vascular fibrosis

Aim of the study. To assess the relationship between GFR and plasma TIMP-1 concentration in patients with arterial hypertension.

Materials and Methods. 144 patients (87 men, 67 women) with arterial hypertension with preserved systolic function were examined, mean age was 52.45 ± 4.81 years, duration of AH was 4.82 ± 2.63 years. Calculation of GFR was carried out using the MDRD formula. Tissue matrix metalloproteinase-1 inhibitor concentrations were measured with DSL kit (USA). The reference values were 92-116 ng/ml. The patients were divided into 3 groups depending on GFR: group 1 - GFR over 90 ml/min/1.73m2 (n = 59), group 2 - GFR 60-90 ml/min/1.73m2 (n = 63), group 3 - GFR under 60 ml/min/1.73m2 (n = 22).

Results. The highest level of TIMP-1 (481.9 ± 106.4 ng/ml) was found in Group 3 patients (GFR <60 ml/min/1.73m2). The level of TIMP-1 in Group 3 was statistically significantly higher than in patients of Group 1 (p < 0.0001) and Group 2 (p < 0.0001). In group 2 (GFR 60-90 ml/min/1.73m2) the level of TIMP-1 (330.5 ± 108.3 ng/ml) was higher than in group 1 (297.6 ± 104.9 ng/ml), but the difference was not statistically significant (p = 0.091). The correlation analysis revealed a negative association of plasma TIMP-1 level and GFR in patients with arterial hypertension, i.e. the higher TIMP-1, the lower glomerular filtration rate (r=-0.37, p = 0.0001).

Conclusions. The increased concentration of TIMP-1 in the blood of patients with arterial hypertension is evidence of increasing fibrosis in the heart and vessels, leading to the emergence and progression of renal dysfunction.
Spontaneous platelet aggregation in patients with chronic heart failure with arterial hypertension
Authors: Sharafutdinova R , Ruzov VI , Razin VA , Gimaev RH , Nizamova LT
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Aim of study. To study spontaneous platelet aggregation in patients with arterial hypertension with different functional classes (FC) of CHF with preserved systolic function not taking antiplatelet therapy.

Material and Methods

51 patients with AH with different types of CHF, mean age 55.4 ± 5.9 years, with preserved left ventricular systolic function according to ECHO-CS were studied. The patients were divided into 4 groups depending on FC of CHF: Group 1 - 0 FC of CHF (n = 11), Group 2 - 1 FC of CHF (n = 13), Group 3 - 2 FC of CHF (n = 14), and Group 4 - 3 FC of CHF (n = 13). Spontaneous platelet aggregation was determined on a KFK-2MP photoelectrocolorimeter (Russia).

Results. During the study, the spontaneous platelet aggregation was 1.08 ± 0.31 in patients with CHF class 0 (1 gr), and 1.22 ± 0.25 in patients with CHF class 1, with no statistical difference in comparison with 1 gr (p = 0.233). In group 3 (2FC CHF), spontaneous platelet aggregation was 1.33 ± 0.27, with a statistically significant difference with spontaneous platelet aggregation in patients with type 0 (p = 0.042), but with group 2 (1FC CHF), no statistically significant difference was found (p = 0.281). Spontaneous platelet aggregation in group 4 (3FC CHF) was 1,62 + 0,32, with statistically significant difference in comparison with all groups, so with group 1 - p < 0,001, with group 2 - p = 0,016 and with group 3 - p = 0,017.

Conclusion. Patients with arterial hypertension with preserved systolic function showed an increase in spontaneous platelet aggregation with increasing functional class of CHF, and the most significant increase in platelet aggregation was seen in patients with class 3 CHF.
The feasibility and acceptability of a virtual six-week psychoeducational intervention for carers of patients with heart failure
Authors: Cassidy L , Hill L , Fitzsimons D
Published: July 2021

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Northern Ireland Chest Heart and Stroke Queen"s University Belfast

Background

Globally, the number of individuals living with heart failure (HF) is increasing, with many living with additional comorbidities and complex health needs. Carers play an invaluable role in helping the patient with self-care at home, taking on the key responsibility for tasks critical in the management and monitoring of HF symptoms. As a result, carers can frequently experience poor quality of life attributed to this caring role, whilst simultaneously managing health problems of their own. Evidence has shown that many of these carers have unmet educational, social and emotional needs, that require urgent support and information.

Purpose

To assess the feasibility and acceptability of a six-week psychoeducational intervention tailored towards carers of patients with HF.

Methods

  The psychoeducational intervention was co-produced with involvement of carers, HF professionals and researchers. It was delivered over six weeks, with four support group sessions and an information booklet tailored specifically to the needs of carers. Carers were identified by the clinical HF team or through social media, with informed consent obtained before inclusion. Due to COVID-19 regulations, the support group sessions were delivered virtually via a secure online app (Zoom). Each session involved a member of the interdisciplinary research team and covered topics including: 1. Understanding HF, 2. Personal wellbeing, 3. Communication and Support, and 4. Practical skills to help manage HF. Validated questionnaires (SF-12, HADS,ZBI,PSS,MSPSS,CPS) measuring carer related outcomes were completed at baseline, at 6 weeks and 3 months post intervention. Qualitative data from focus group post-intervention explored the acceptability of the intervention. Data was analysed using SPSS (version 27) and NVivo (version 11).

Results

 Nine participants consented to participate, six of which were recruited from heart failure clinics, and three volunteered in response to social media advertisements. Two participants, due to personal health reasons, withdrew consent and did not attend the support group sessions. All carers were female, mean age 61 years, four spouses and three adult children. Preliminary qualitative findings show carers recalled information and advice included in the intervention as useful and easy to understand. With the intervention being described as, "a dimension that doesn’t already exist". The majority of participants (n = 5) preferred the convenience and flexibility of the online approach to the intervention, however some participants (n = 2) felt that they would have benefitted more from an in-person approach. A second  support group is currently underway. 

Conclusions

Preliminary results are promising and indicate that carers responded well to an online psychoeducational intervention.
The biomedical, socioeconomic and demographic predictors of heart failure readmissions
Authors: Choi ESC , Wiseman T , Gordon CG , Betihavas V
Published: July 2021

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): Sydney Local Health District

Introduction

Heart failure hospitalisations and readmissions pose a significant clinical and economic burden internationally. Current studies support a range of biomedical and sociodemographic factors as predictors of HF readmissions; however, there are a paucity of studies synthesising the research on this topic. 

Purpose

The purpose of this systematic review was to identify biomedical, socioeconomic and demographic predictors of heart failure-related readmissions in adults with heart failure.

Methods

Electronic databases (Medline, Embase and Scopus) were searched using a structured search strategy. The particular risk factors of interest were left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) function class, brain natriuretic peptide (BNP), heart rate, blood pressure, employment status, income, age, sex, ethnicity, indigenous status, marital status, and socioeconomic indexes for areas (SEIFA) scores. After the removal of duplicates, the article selection process was conducted by two independent authors according to an inclusion and exclusion criteria. The articles were first filtered by title and abstract against the inclusion and exclusion criteria. The remaining articles were then assessed by reviewing the studies in full text. The relevant Critical Appraisal Skills Programme (CASP) tools were then used to appraise the final articles included for review.

Results

In total 1,516 papers were retrieved from the search. Of the 1,516 papers, 666 were from Medline, 567 were from CINAHL, 282 were from Embase, and one paper was from an independent search. After the removal of duplicates, 1296 papers were filtered according to title and abstract and 1183 papers were excluded from this process. 95 papers were assessed by reading them in full and of the 95 papers, 77 were excluded. This resulted in eighteen studies being included for review. Unemployment was the only socioeconomic factor predictive of HF readmissions (HR = 1.09; 95%CI= 1.05-1.14; p = 0.03) and SEIFA scores did not predict HF readmissions in adults with HF (p > 0.05). Indigenous status was a risk factor of HF readmissions according to one study (p < 0.05). Age or sex did not affect the risk of HF readmissions in adults with HF (p > 0.05). NYHA function class, BNP levels, and heart rate predicted HF readmissions in the population of interest. LVEF and blood pressure were non-significant predictors of HF readmissions (p > 0.05).

Conclusions

Current HF guidelines have a strong biomedical focus in the management of HF patients. This review however, shows there are sociodemographic factors that are predictive of HF readmissions in addition to the biomedical predictors that have been more extensively studied. Future studies should examine their combined effect on readmission risk and the early interventions to prevent readmissions.
Psychological stress and its correlates in Chinese patients with acute coronary syndrome
Authors: Zou H , Chair SY , Cao X
Published: July 2021

Funding Acknowledgements

None.

Background

Psychological stress is associated with high incidence of coronary heart disease and increases the risk of mortality and poor health status. Although a few studies have investigated psychological stress in this population, this problem is usually unrecognized and untreated in most Chinese patients with acute coronary syndrome. There is insufficient information regarding the features of psychological stress and associated factors among this population.

Purpose

This study aimed to assess the level of psychological stress and to identify its correlates in Chinese patients with acute coronary syndrome.

Methods

Patients aged over 18 years and with acute coronary syndrome were invited to participate in a cross-sectional survey in two tertiary public hospitals in China, from June to July 2019. A total of 332 patients completed measures of sociodemographic and clinical characteristics, psychological stress (10-item Perceived Stress Scale), and illness perception (Brief Illness Perceptions Questionnaire). Independent sample t-tests, bivariate correlations, and multivariable linear regression were performed to analyze potential correlates, including age, gender, education level, employment status, income, episode of illness, revascularization procedure, comorbidities, body mass index, blood pressure, blood glucose, blood lipids, and illness perception.

Results

The average patient age was 62.2 years, 67.5% were male, and 54.2% had less than high school education. The mean score for psychological stress was 21.30 ± 3.99 and 66.9% of patients had high psychological stress (score ≥ 20). Multivariable regression analysis showed that being overweight/obesity versus normal weight (body mass index:  ≥ 24 kg/m2 versus < 24 kg/m2) was associated with lower psychological stress (β =  -0.134, p = 0.007). Having a high level of fasting blood glucose (≥ 6.1 mmol/L) versus normal fasting blood glucose (< 6.1 mmol/L) was associated with high psychological stress (β = 0.123, p = 0.017). Additionally, negative cognitive illness perception (β = 0.190, p = 0.01), negative emotional illness perception (β = 0.290, p < 0.001), and poor illness understanding (β = 0.118, p = 0.032) were associated with high psychological stress.

Conclusions

Patients with acute coronary syndrome experience high psychological stress that is significantly correlated with body mass index, fasting blood glucose, and illness perception. Health professionals should recognize this issue and interventions looking to relive psychological stress may benefit from targeting these correlates.
Transitioning a cardiovascular health and rehabilitation programme to a virtual platform during covid 19
Authors: Mcgaffin S , Taggart M , Smyth D , O"doherty D , Brown J , Teague S , Slevin C , Montgomery L , Coll M , Lindsay C , Crumley B , Gibson L , Elliott H , Hughes S , Connolly S
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

Our Hearts Our Minds

Purpose

Can a virtual cardiovascular prevention and rehabilitation programme be as effective as face-to-face programme.

Background

The Our Hearts Our Minds (OHOM) prevention and rehabilitation programme rapidly transitioned to a virtual platform in the covid era.  Here we compare if a virtual programme potentially could offer the same standard of the nursing intervention (education, smoking cessation, medical risk factor management and psychosocial health) as the previous face to face programme

Methods

Both the initial assessment (IA) and end of programme (EOP) assessments were conducted via telephone/video as per patient preference. The following measures were recorded at both time points (home blood pressure (BP) monitors were provided)

Smoking (self report) BP/Heart rate, Lipids/HbA1c (facilitated by phlebotomy hub), cardio protective drugs (doses, adherence), Hospital Anxiety and Depression score, EuroQoL

Nursing Intervention Smoking cessation counselling and pharmacotherapy where appropriate

Weekly meeting with cardiologist to optimise BP and lipid management and up titration cardio protective drugs

Bimonthly virtual coaching consultation for monitoring/goal resetting

Bimonthly group video education sessions

Results

From April to November 2020, of the 432 referrals received 400 were eligible with 377 accepting the offer of an IA (94% response rate). 262 have had an IA with the remaining 115 awaiting an assessment date.  Of the completed IA’s 257 were willing to attend the programme (98% uptake).  120 had been offered an end of programme assessment with 114 attending (96% of those offered). The results for the virtual programme were then compared to the same period one year previously when the programme was fully face to face and are outlined in the table below.

The comparison of results delivered via remote delivery are remarkably similar to those achieved in the previous year delivered via face to face.

Conclusion

Initial data has shown that virtual delivery of the nursing component of the OHOM prevention/rehabilitation programme was highly acceptable to patients and was as effective as that of the traditional face to face service.

Table 1 below exhibits the clinical and patient-reported outcomes.
Patophysiologic and gender differences regarding exercise responses in decompensated heart failure patients
Authors: Delgado BM , Froelicher ERIKA , Lopes IVO , Sousa LUIS , Novo ANDRÉ
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Heart Failure patients often present impairment on their functional capacity. Exercise training is the key component of cardiac rehabilitation and must be early implemented. Knowing the characteristics that lead a patient to be a good responder to an exercise intervention would be useful to identify the ones that could benefit from this same intervention.

Purpose

Identify the characteristics of good responses to an aerobic exercise training in decompensated heart failure (HF) patients and understand if there are gender differences. 

Methods

Cross sectional study with 76 inpatients who performed an aerobic exercise training program (AET). Functional capacity was evaluated at admission and discharge using three different tools: the London Chest of Activity of Daily Living (LCADL) scale, the Barthel Index (BI) and the 6-minute walking test (6MWT). Multivariate linear regression was performed by gender to understand which variables lead a patient to have better performance. Since it is known that men and women have different responses to exercise training, the results and analysis of the data collected were performed by gender.

Results

Seventy-six patients (52 men) were included. The mean age was 67 ± 10 years, 15.8% were New York Heart Association (NYHA) class IV and 76.3% had reduced ejection fraction. The major etiology of HF was ischemic disease (35.5%). Six predictive equations were obtained, one for each functional capacity (FC) tool divided by gender. NYHA class III patients do not differ from class IV in terms of FC at discharge. However, HFreduced ejection fraction patients presented higher 6MWT distance (309,6m vs 231m) and lower LCADL score (11 vs 15) compared to non-reduced. Gender analysis showed that women had an average of 4 days longer in-hospital stay and a considerable difference in the 6MWT. At admission women walked 15 meters less than man and at discharge 69 meters less, presenting also lower score at BI and higher at LCADL. However, only the discharge 6MWT distance presents a statistical significant difference (69 meters; p = 0.01). Traditionally women are more sedentary and present less fitness level than men. The linear regression model shows that gender is a independent variable that contributes to the change in the 6MWT - favouring men. 

Conclusions

The AET program appears to be more effective in younger patients, with low FC at admission and who are less impaired. Those with left systolic ventricular function apparently interfered with progression during the program. Gender influences the performance of patients undergoing exercise training. Men present higher FC at discharge but the predictive models are stronger for women. These results are consistent with the idea that gender plays an important role in determine the performance of patients in exercise training programs.