bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrodynamic evolution of Sgr A East: the imprint of a supernova remnant in the Galactic Centre
Authors: Zhang Mengfei , Li Zhiyuan , Hua Ziqian , Morris Mark R
Published: April 2023

We perform three-dimensional numerical simulations to study the hydrodynamic evolution of Sgr A East, the only known supernova remnant (SNR) in the centre of our Galaxy, to infer its debated progenitor supernova (SN) type and its potential impact on the Galactic Centre environment. Three sets of simulations are performed, each of which represents a certain type of SN explosion (SN Iax, SN Ia, or core-collapse SN) expanding against a nuclear outflow of hot gas driven by massive stars, whose thermodynamical properties have been well established by previous work and fixed in the simulations. All three simulations can simultaneously roughly reproduce the extent of Sgr A East and the position and morphology of an arc-shaped thermal X-ray feature, known as the ‘ridge’. Confirming previous work, our simulations show that the ridge is the manifestation of a strong collision between the expanding SN ejecta and the nuclear outflow. The simulation of the core-collapse SN, with an assumed explosion energy of 5 × 1050 erg and an ejecta mass of 10 M⊙, can well match the X-ray flux of the ridge, whereas the simulations of the SN Iax and SN Ia explosions underpredict its X-ray emission, due to a smaller ejecta mass. All three simulations constrain the age of Sgr A East to be ≲1500 yr and predict that the ridge should fade out over the next few hundred years. We address the implications of these results for our understanding of the Galactic Centre environment.
Systematic errors in the maximum-likelihood regression of Poisson count data: introducing the overdispersed χ2 distribution
Authors: Bonamente Massimiliano
Published: April 2023

This paper presents a new method to estimate systematic errors in the maximum-likelihood regression of count data. The method is applicable in particular to X-ray spectra in situations where the Poisson log-likelihood, or the Cash goodness-of-fit statistic, indicate a poor fit that is attributable to overdispersion of the data. Overdispersion in Poisson data is treated as an intrinsic model variance that can be estimated from the best-fit model, using the maximum-likelihood Cmin statistic. The paper also studies the effects of such systematic errors on the ΔC likelihood-ratio statistic, which can be used to test for the presence of a nested model component in the regression of Poisson count data. The paper introduces an overdispersed χ2 distribution that results from the convolution of a χ2 distribution that models the usual ΔC statistic, and a zero-mean Gaussian that models the overdispersion in the data. This is proposed as the distribution of choice for the ΔC statistic in the presence of systematic errors. The methods presented in this paper are applied to XMM–Newton data of the quasar 1ES 1553+113 that were used to detect absorption lines from an intervening warm-hot intergalactic medium (WHIM). This case study illustrates how systematic errors can be estimated from the data, and their effect on the detection of a nested component, such as an absorption line, with the ΔC statistic.
Cerebral oxygenation during exercise deteriorates with advancing chronic kidney disease
Authors: Theodorakopoulou Marieta P , Dipla Konstantina , Zafeiridis Andreas , Faitatzidou Danai , Koutlas Aggelos , Doumas Michael , Papagianni Aikaterini , Sarafidis Pantelis
Published: April 2023

Background

Cognitive impairment and exercise intolerance are common in chronic kidney disease (CKD). Cerebral perfusion and oxygenation play a major role in both cognitive function and exercise execution. This study aimed to examine cerebral oxygenation during a mild physical stress in patients at different CKD stages and controls without CKD.

Methods

Ninety participants (18 per CKD stage 2, 3a, 3b and 4 and 18 controls) underwent a 3-min intermittent handgrip exercise at 35% of their maximal voluntary contraction. During exercise, cerebral oxygenation [oxyhaemoglobin (O2Hb), deoxyhaemoglobin (HHb) and total haemoglobin (tHb)] was assessed by near-infrared spectroscopy. Indices of microvascular (muscle hyperaemic response) and macrovascular function (carotid intima-media thickness and pulse wave velocity (PWV)) and cognitive and physical activity status were also evaluated.

Results

No differences in age, sex and body mass index were detected among groups. The mini-mental state examination score was significantly reduced with advancing CKD stages (controls: 29.2 ± 1.2, stage 2: 28.7 ± 1.0, stage 3a: 27.8 ± 1.9, stage 3b: 28.0 ± 1.8, stage 4: 27.6 ± 1.5; P = .019). Similar trends were observed for physical activity levels and handgrip strength. The average response in cerebral oxygenation (O2Hb) during exercise was lower with advancing CKD stages (controls: 2.50 ± 1.54, stage 2: 1.30 ± 1.05, stage 3a: 1.24 ± 0.93, stage 3b: 1.11 ± 0.89, stage 4: 0.97 ± 0.80 μmol/l; P < .001). The average tHb response (index of regional blood volume) showed a similar decreasing trend (P = .003); no differences in HHb among groups were detected. In univariate linear analysis, older age, lower estimated glomerular filtration rate (eGFR), Hb, microvascular hyperaemic response and increased PWV were associated with poor O2Hb response during exercise. In the multiple model, eGFR was the only parameter independently associated with the O2Hb response.

Conclusions

Brain activation during a mild physical task appears to decrease with advancing CKD as suggested by the smaller increase in cerebral oxygenation. This may contribute to impaired cognitive function and reduced exercise tolerance with advancing CKD.
Enhanced dominance of soil moisture stress on vegetation growth in Eurasian drylands
Authors: Zhang Yu , Zhang Yangjian , Lian Xu , Zheng Zhoutao , Zhao Guang , Zhang Tao , Xu Minjie , Huang Ke , Chen Ning , Li Ji , Piao Shilong
Published: April 2023

Despite the mounting attention being paid to vegetation growth and their driving forces for water-limited ecosystems, the relative contributions of atmospheric and soil moisture dryness stress on vegetation growth are an ongoing debate. Here we comprehensively compare the impacts of high vapor pressure deficit (VPD) and low soil water content (SWC) on vegetation growth in Eurasian drylands during 1982–2014. The analysis indicates a gradual decoupling between atmospheric dryness and soil dryness over this period, as the former has expanded faster than the latter. Moreover, the VPD–SWC relation and VPD–greenness relation are both non-linear, while the SWC–greenness relation is near-linear. The loosened coupling between VPD and SWC, the non-linear correlations among VPD–SWC-greenness and the expanded area extent in which SWC acts as the dominant stress factor all provide compelling evidence that SWC is a more influential stressor than VPD on vegetation growth in Eurasian drylands. In addition, a set of 11 Earth system models projected a continuously growing constraint of SWC stress on vegetation growth towards 2100. Our results are vital to dryland ecosystems management and drought mitigation in Eurasia.
Effect of xanthophyll-rich food and supplement intake on visual outcomes in healthy adults and those with eye disease: a systematic review, meta-analysis, and meta-regression of randomized controlled trials
Authors: Hu Weili , Shankar Pavitra , Yao Yuanhang , Su Xinyi , Kim Jung Eun
Published: April 2023

Context

Xanthophyll intake is known to improve eye health; however, its benefits on visual outcomes have not been systematically studied, particularly in a population with eye diseases.

Objective

A systematic review, meta-analysis, and meta-regression were conducted to investigate the effect of xanthophyll intake on visual outcomes, and further subgroup analysis was performed on the basis of eye disease status.

Data Sources

The PubMed, Scopus, Embase, CINAHL, Cochrane, and Web of Science databases were searched, and relevant randomized controlled trials were identified.

Data Extraction

For systematic review, meta-analysis, and meta-regression, 43, 25, and 21 articles were selected, respectively.

Data Analysis

Xanthophyll intake enhanced macular pigment optical density (MPOD) for both heterochromatic flicker photometry (weighted mean difference [WMD], 0.05; 95% confidence interval [CI], 0.03–0.07) and autofluorescence imaging (WMD, 0.08; 95%CI, 0.05–0.11) measurements and decreased photostress recovery time (WMD, –2.35; 95%CI, –4.49 to –0.20). While enhancement in visual acuity logarithm of the minimum angle of resolution was observed in response to the xanthophyll-rich food and supplement intake only for patients with eye disease (WMD, –0.04; 95%CI, –0.07 to –0.01). Meta-regression showed a positive correlation between change in MPOD (heterochromatic flicker photometry) and the corresponding change in serum lutein levels (regression coefficient = 0.068; P = 0.00).

Conclusion

Intake of xanthophyll-rich food or supplements can improve eye health. Additional improvement in visual acuity was observed in patients with eye disease. A positive association between MPOD and serum lutein level, while absent with dietary xanthophyll intake, suggests the importance of bioavailability when examining the effect of xanthophyll on eye health.

Systematic Review Registration

PROSPERO registration no. CRD42021295337.
Three-Year Outcomes Following Permissive Cardiotoxicity in Patients on Trastuzumab
Authors: Zhou Shijie , Cirne Filipe , Chow Justin , Zereshkian Arman , Bordeleau Louise , Dhesy-Thind Sukhbinder , Ellis Peter M , Mukherjee Som D , Aghel Nazanin , Leong Darryl P
Published: April 2023

Introduction

Cardiotoxicity, manifest by reduced left ventricular ejection fraction (LVEF), is the most common reason for the premature discontinuation of trastuzumab. While permissive cardiotoxicity (where mild cardiotoxicity is accepted to enable ongoing trastuzumab) has been shown feasible, the longer-term outcomes are unknown. We aimed to study the intermediate-term clinical outcomes of patients who underwent permissive cardiotoxicity.

Materials and Methods

We performed a retrospective cohort study of patients referred to the cardio-oncology service at McMaster University from 2016 to 2021 for LV dysfunction following trastuzumab administration.

Results

Fifty-one patients underwent permissive cardiotoxicity. The median (25th-75th percentile) follow-up time from cardiotoxicity onset was 3 years (1.3-4 years). Forty-seven (92%) patients completed trastuzumab; 3 (6%) developed severe LV dysfunction or clinical heart failure (HF) while on trastuzumab and prematurely discontinued therapy. One discontinued trastuzumab by patient choice. At final follow-up after therapy completion, 7 (14%) patients still had mild cardiotoxicity, including 2 who had clinical heart failure and stopped trastuzumab early. Among those with recovered LV function, 50% had normalized LVEF or GLS by 6 and 3 months, respectively, after initial cardiotoxicity. There was no difference in characteristics between those who did or did not recover their LV function.

Conclusions

Among patients exposed to permissive trastuzumab cardiotoxicity for HER2-positive breast cancer, 6% were unable to complete planned trastuzumab due to severe LV dysfunction or clinical HF. Although most patients recover their LV function after trastuzumab discontinuation or completion, 14% still have persistent cardiotoxicity by 3-year follow-up.
Hierarchical regulatory module GENOMES UNCOUPLED1-GOLDEN2-LIKE1/2-WRKY18/40 modulates salicylic acid signaling
Authors: Lee Keun Pyo , Li Mengping , Li Mengshuang , Liu Kaiwei , Medina-Puche Laura , Qi Shan , Cui Chaojun , Lozano-Duran Rosa , Kim Chanhong
Published: April 2023

Chloroplast-to-nucleus retrograde signaling (RS) pathways are critical in modulating plant development and stress adaptation. Among chloroplast proteins mediating RS pathways, GENOMES UNCOUPLED1 (GUN1) represses the transcription of the nuclear transcription factors GOLDEN2-LIKE1 (GLK1) and GLK2 that positively regulate chloroplast biogenesis. Given the extensive exploration of the function of GUN1 in biogenic RS carried out in previous years, our understanding of its role in plant stress responses remains scarce. Here, we revealed that GUN1 contributes to the expression of salicylic acid (SA)-responsive genes (SARGs) through transcriptional repression of GLK1/2 in Arabidopsis (Arabidopsis thaliana). Loss of GUN1 significantly compromised the SA responsiveness in plants, concomitant with the upregulation of GLK1/2 transcripts. In contrast, knockout of GLK1/2 potentiated the expression of SARGs and led to enhanced stress responses. Chromatin immunoprecipitation, coupled with quantitative PCR and related reverse genetic approaches, unveiled that in gun1, GLK1/2 might modulate SA-triggered stress responses by stimulating the expression of WRKY18 and WRKY40, transcriptional repressors of SARGs. In summary, we demonstrate that a hierarchical regulatory module, consisting of GUN1-GLK1/2-WRKY18/40, modulates SA signaling, opening a research avenue regarding a latent GUN1 function in plant–environment interactions.
DELAYED GREENING 409 encodes a dual-localized pentatricopeptide repeat protein required for chloroplast and mitochondrial development
Authors: Wang Huiying , Liu Jing , Zhao Wei , Terzaghi William , Deng Linbin , Liu Hongfang , Zheng Qiwei , Fan Shihang , Hua Wei , Zheng Ming
Published: April 2023

In ﬂowering plants, hundreds of RNA editing events occur in the chloroplasts and mitochondria during posttranscriptional processes. Although several pentatricopeptide repeat (PPR) proteins have been shown to form the editosome core, the precise interactions between the different editing factors are still obscure. Here, we isolated an Arabidopsis (Arabidopsis thaliana) PPR protein, designated DELAYED GREENING 409 (DG409), that was dually targeted to chloroplasts and mitochondria. This protein consists of 409 amino acids with 7 PPR motifs but lacks a C-terminal E, E+, or DYW domain. A mild dg409 knockdown mutant displays a sickly phenotype. In this mutant, the young leaves are pale green and turn green at maturity, and the development of chloroplasts and mitochondria is severely disrupted. Complete loss of DG409 function results in defective embryos. Transcriptomic analysis of the dg409 knockdown plants showed some editing defects in genes from both organelles, including CASEINOLYTIC PROTEASE P (clpP)-559, RNA POLYMERASE SUBUNIT ALPHA (rpoA)-200, ACETYL-COA CARBOXYLASE CARBOXYL TRANSFERASE SUBUNIT BETA (accD)-1568, NADH DEHYDROGENASE SUBUNIT 7 (nad7)-1505, and RIBOSOMAL PROTEIN S3 (rps3)-1344. RNA immunoprecipitation showed that DG409 was associated with the targeted transcripts in vivo. Interaction assays revealed that DG409 directly interacted with 2 DYW-type PPR proteins (EARLY CHLOROPLAST BIOGENESIS2 [AtECB2] and DYW DOMAIN PROTEIN2 [DYW2]) and 3 multiple organellar RNA editing factors (MORF2, MORF8, and MORF9). These results indicate that DG409 is involved in RNA editing via protein complexes and is therefore essential for chloroplast and mitochondrial development.
Complex Patterns of Diversification in the Gray Zone of Speciation: Model-Based Approaches Applied to Patagonian Liolaemid Lizards (Squamata: Liolaemus kingii clade)
Authors: Sánchez Kevin I , Diaz Huesa Emilce G , Breitman María F , Avila Luciano J , Sites Jack W , Morando Mariana
Published: April 2023

In this study we detangled the evolutionary history of the Patagonian lizard clade Liolaemus kingii, coupling dense geographic sampling and novel computational analytical approaches. We analyzed nuclear and mitochondrial data (restriction site-associated DNA sequencing and cytochrome b) to hypothesize and evaluate species limits, phylogenetic relationships, and demographic histories. We complemented these analyses with posterior predictive simulations to assess the fit of the genomic data to the multispecies coalescent model. We also employed a novel approach to time-calibrate a phylogenetic network. Our results show several instances of mito-nuclear discordance and consistent support for a reticulated history, supporting the view that the complex evolutionary history of the kingii clade is characterized by extensive gene flow and rapid diversification events. We discuss our findings in the contexts of the “gray zone” of speciation, phylogeographic patterns in the Patagonian region, and taxonomic outcomes. [Model adequacy; multispecies coalescent; multispecies network coalescent; phylogenomics; species delimitation.]
Effect of Host-Switching on the Ecological and Evolutionary Patterns of Parasites
Authors: D’Bastiani Elvira , Princepe Débora , Marquitti Flavia M D , Boeger Walter A , Campião Karla M , Araujo Sabrina B L
Published: April 2023

Speciation via host-switching is a macroevolutionary process that emerges from a microevolutionary dynamic where individual parasites switch hosts, establish a new association, and reduce reproductive contact with the original parasite lineage. Phylogenetic distance and geographic distribution of the hosts have been shown to be determinants of the capacity and opportunity of the parasite to change hosts. Although speciation via host-switching has been reported in many host-parasite systems, its dynamic on the individual, population and community levels is poorly understood. Here we propose a theoretical model to simulate parasite evolution considering host-switching events on the microevolutionary scale, taking into account the macroevolutionary history of the hosts, to evaluate how host-switching can affect ecological and evolutionary patterns of parasites in empirical communities at regional and local scales. In the model, parasite individuals can switch hosts under variable intensity and have their evolution driven by mutation and genetic drift. Mating is sexual and only individuals that are sufficiently similar can produce offspring. We assumed that parasite evolution occurs at the same evolutionary time scale as their hosts, and that the intensity of host-switching decreases as the host species differentiate. Ecological and evolutionary patterns were characterized by the turnover of parasite species among host species, and parasite evolutionary tree imbalance respectively. We found a range of host-switching intensity that reproduces ecological and evolutionary patterns observed in empirical communities. Our results showed that turnover decreased as host-switching intensity increased, with low variation among the model replications. On the other hand, tree imbalance showed wide variation and non-monotonic tendency. We concluded that tree imbalance was sensitive to stochastic events, whereas turnover may be a good indicator of host-switching. We found that local communities corresponded to higher host-switching intensity when compared to regional communities, highlighting that spatial scale is a limitation for host-switching. [Dispersal of parasites, opportunity and capacity of interaction, phylogenetic conservatism, and community structure.]
Consilience Across Multiple, Independent Genomic Data Sets Reveals Species in a Complex with Limited Phenotypic Variation
Authors: Wootton Lara M , Forest Félix , Verboom G Anthony
Published: April 2023

Species delimitation in the genomic era has focused predominantly on the application of multiple analytical methodologies to a single massive parallel sequencing (MPS) data set, rather than leveraging the unique but complementary insights provided by different classes of MPS data. In this study, we demonstrate how the use of two independent MPS data sets, a sequence capture data set and a single-nucleotide polymorphism (SNP) data set generated via genotyping-by-sequencing, enables the resolution of species in three complexes belonging to the grass genus Ehrharta, whose strong population structure and subtle morphological variation limit the effectiveness of traditional species delimitation approaches. Sequence capture data are used to construct a comprehensive phylogenetic tree of Ehrharta and to resolve population relationships within the focal clades, while SNP data are used to detect patterns of gene pool sharing across populations, using a novel approach that visualizes multiple values of K. Given that the two genomic data sets are independent, the strong congruence in the clusters they resolve provides powerful ratification of species boundaries in all three complexes studied. Our approach is also able to resolve a number of single-population species and a probable hybrid species, both of which would be difficult to detect and characterize using a single MPS data set. Overall, the data reveal the existence of 11 and five species in the E. setacea and E. rehmannii complexes, with the E. ramosa complex requiring further sampling before species limits are finalized. Despite phenotypic differentiation being generally subtle, true crypsis is limited to just a few species pairs and triplets. We conclude that, in the absence of strong morphological differentiation, the use of multiple, independent genomic data sets is necessary in order to provide the cross-data set corroboration that is foundational to an integrative taxonomic approach. [Species delimitation; genotyping-by-sequencing; population structure; integrative taxonomy; cryptic species; Ehrharta (Poaceae).]
Hybridization and Transgressive Evolution Generate Diversity in an Adaptive Radiation ofAnolisLizards
Authors: Wogan Guinevere O U , Yuan Michael L , Mahler D Luke , Wang Ian J
Published: April 2023

Interspecific hybridization may act as a major force contributing to the evolution of biodiversity. Although generally thought to reduce or constrain divergence between 2 species, hybridization can, paradoxically, promote divergence by increasing genetic variation or providing novel combinations of alleles that selection can act upon to move lineages toward new adaptive peaks. Hybridization may, then, play a key role in adaptive radiation by allowing lineages to diversify into new ecological space. Here, we test for signatures of historical hybridization in the Anolis lizards of Puerto Rico and evaluate 2 hypotheses for the role of hybridization in facilitating adaptive radiation—the hybrid swarm origins hypothesis and the syngameon hypothesis. Using whole genome sequences from all 10 species of Puerto Rican anoles, we calculated D and f-statistics (from ABBA-BABA tests) to test for introgression across the radiation and employed multispecies network coalescent methods to reconstruct phylogenetic networks that allow for hybridization. We then analyzed morphological data for these species to test for patterns consistent with transgressive evolution, a phenomenon in which the trait of a hybrid lineage is found outside of the range of its 2 parents. Our analyses uncovered strong evidence for introgression at multiple stages of the radiation, including support for an ancient hybrid origin of a clade comprising half of the extant Puerto Rican anole species. Moreover, we detected significant signals of transgressive evolution for 2 ecologically important traits, head length and toepad width, the latter of which has been described as a key innovation in Anolis. [Adaptive radiation; introgression; multispecies network coalescent; phenotypic evolution; phylogenetic network; reticulation; syngameon; transgressive segregation.]
Effect of Copper Sulfate Pentahydrate and Cultivar Resistance on Reducing Bacterial Leaf Streak in Hard Red Spring Wheat in North Dakota
Authors: Lux LeAnn , Halvorson Jessica , Hansen Bryan , Meyer Scott , Shi Gongjun , Liu Zhaohui , Friskop Andrew
Published: April 2023

Bacterial leaf streak (BLS) is one of the most significant foliar diseases affecting hard red spring wheat (HRSW) production in North Dakota. The most effective management tool for BLS is the use of host resistance; however, the adoption and availability of resistant cultivars is limited for HRSW producers. This has led to questions pertaining to the use of copper-based products to suppress BLS severity in HRSW production. Four field experiments were conducted from 2020 to 2022 in North Dakota to evaluate the efficacy of copper sulfate pentahydrate (CSP) applied at the flag leaf stage on reducing BLS severity and protecting HRSW yield and test weight. Experiments were conducted in a randomized complete block design with a split-plot arrangement with four replications. Three treatments served as the main plots (noninoculated, inoculated, and inoculated + CSP applied at flag leaf). Five HRSW cultivars varying in host resistance served as subplots. A high level of disease occurred across all experiments. A combined analysis suggested that the use of CSP did not provide adequate BLS suppression and did not protect HRSW yield or test weight regardless of HRSW susceptibility. The lowest mean yield loss was associated with the moderately resistant cultivar Boost (9%), and the highest was associated with the susceptible cultivar SY Rockford (19%). Variability in yield loss values among cultivars suggests that more research is needed to strengthen our understanding of BLS in HRSW.
A Brief Evaluation of a Copper Resistance Mobile Genetic Island in the Bacterial Leaf Spot Pathogen Xanthomonas euvesicatoria pv. perforans
Authors: Bibi Shaheen , Weis Kylie , Kaur Amandeep , Bhandari Rishi , Goss Erica , Jones Jeffrey B. , Potnis Neha
Published: April 2023

Due to the continuous use of copper containing bactericides without effective alternative bactericides, copper resistance has become more prevalent in plant pathogens, including Xanthomonas euvesicatoria pv. perforans (formerly Xanthomonas perforans), a predominant cause of bacterial leaf spot disease of tomato and pepper in the Southeastern United States. Previously, reports of copper resistance have been associated with a large conjugative plasmid. However, we have characterized a copper resistance genomic island located within the chromosome of multiple X. euvesicatoria pv. perforans strains. The island is distinct from a previously described chromosomally encoded copper resistance island in X. vesicatoria strain XVP26. Computational analysis revealed the genomic island to contain multiple genes associated with genetic mobility, including both phage-related genes and transposase. Among copper-tolerant strains of X. euvesicatoria pv. perforans isolated from Florida, the majority of strains were found to have the copper resistance chromosomally encoded rather than plasmid borne. Our results suggest that this copper resistance island may have two modes of horizontal gene transfer and that chromosomally encoded copper resistance genes may provide a fitness advantage over plasmid-borne resistance.
3. Association Between Blood Pressure Variability (BPV) and Heart Failure in Elderly Hypertensive Patients: A Systematic Review
Authors: Husen Auliya , Safitri Aulia
Published: April 2023

Background: Blood pressure variability (BPV) may be one of many factors that can increase the risk of cardiovascular events. However, its relationship with heart failure in elderly hypertensive patients are still less clear. Due to current situations, the implications of BPV on heart failure have been ignored, with limited application in clinical practice.

Objective: To investigate the association between BPV and heart failure in elderly hypertensive patients.

Method: We conducted trial and observational studies between 2018 – 2022 through PubMed and Cochrane systematically. The keywords used were “blood pressure variability”, “systolic blood pressure variability” and “heart failure”. The studies included elderly hypertensive patients (age >60 years old). Primary end-point was the occurrence of heart failure. PRISMA guidelines 2020 were used for review writing.

Result: Two studies with total 17.232 patients were included in this review. The subjects of these two studies were elderly hypertensive patient without any prior cardiovascular events. The characteristic of subject in these two studies were similar, with mean age of one study was and BMI while the mean age of the other one was and BMI. These all two studies showed that the high BPV increasing cardiovascular events, including hospitalization and death from heart failure.

Conclusion: This review found that in elderly patients, BPV is significantly associated with the occurrence of heart failure. Therefore, these findings may have important implications for optimizing blood pressure variability monitoring and treatment strategies in those elderly hypertensive patients.
4. Safety of Renal Denervation as Treatment for Resistant Hypertension: A Systematic Review
Authors: Rubismo K. Y. , Sabran M. Z. , Lee J. V. , Zebua A. , Jhoputri C. F. , Lee J. B. , Kurniawan A.
Published: April 2023

Hypertension is very common throughout the world's population, which many people are unaware of, but it is still rising in population and causing a major public health problem. One of the methods used in treating resistant hypertension is renal denervation. However, studies on its safety and vascular complications effects are still unknown. The purpose of this study was to find out the safety of renal denervation in patients with resistant hypertension. 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 4 cohort studies (166 subjects from various countries), 3 of them showed renal denervation has a favorable safety profile in gaining blood pressure control. The safety endpoint such as all-cause death and vascular complication were reached, but one study reported one patient with progression of renal artery stenosis and hypertensive urgency; 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.
5. Nocturnal Dipping Pattern in Hypertensive Patients as a Risk Factor for Cerebral Small Vessel Disease (CSVD): A Systematic Review and Meta-Analysis
Authors: Tiara Chyntia , Trifitriana Monica , Mulawarman Rido , Gandasari Hana Yuniko , Regina Marissa Sylvia
Published: April 2023

Background: Cerebral small vascular disease (CSVD) is one of the most prevalent cerebral vascular pathologies encountered by middle-aged and older people, which can be observed by magnetic resonance imaging (MRI). The most important modifiable risk factor for CSVD is hypertension. Abnormal circadian blood pressure (BP) variability has been reported to significantly damage hypertensive patients’ target organs. Moreover, in many studies, controlling sleep blood pressure has been shown to exert greater protection against stroke and cardiovascular events.

Objective: We aim to assess the nocturnal dipping pattern of blood pressure with the findings of cerebral small vessel disease.

Method: We performed a comprehensive search on topics that assess nocturnal blood pressure monitoring and cerebral small vessel disease findings through imaging from inception up until November 2022.

Result: There were a total of 2674 patients from 5 studies. The outcome of this study reported that reverse dipping and dipping BP patterns were significantly associated with the prevalence of CSVD. Meta-analysis showed that the reverse dipping BP pattern was associated with a higher risk for CSVD (OR 2.18 [1.80, 2.64], p = 0.64; I2: 0%, p < 0.00001), meanwhile dipping pattern had a lower risk for CSVD (OR 0.51 [0.42, 0.63], p = 0.04; I2: 59%, p < 0.00001). There was no association between the non-dipping pattern and CSVD (OR 0.92 [0.77, 1.10], p = 0.70; I2:0%, p = 0.35).

Conclusion: Nocturnal BP pattern and CSVD were shown to be associated, with the reverse dipping BP pattern having a higher risk and dipping having a lower risk.
9. Factors Affecting Medication Compliance in Elderly with Hypertension in 13 Provinces in Indonesia
Authors: Cynthia Nathalie , Suryakusuma Linda , Turana Yuda , Handajani Yvonne Suzy
Published: April 2023

Background: Currently we see an increase in life expectancy followed by an increase in the number of elderly with various health problems, one of them being hypertension. Moreover, not all patients can control this disease properly. The most difficult challenge is someone's adherence to taking medication. If this is not properly anticipated, it will lead to a decrease in the quality of life for the elderly in the future.

Objective: To determine the affecting factors of medication compliance in elderly with hypertension.

Method: This study was a cross-sectional study of 253 hypertensive elderly who had been diagnosed by a doctor and were taking antihypertensive medication using secondary data from the Indonesian Family Life Survey 2015. A person is said to be compliant with hypertension treatment if someone has taken the medicine prescribed by the doctor every week.

Result: There were 32.8% of respondents were not compliant with hypertension treatment. Multivariate analysis showed several significant factors (p-value <0,05) in determining medication adherence namely duration of hypertension, education about hypertension management, adherence to weight control, grade of hypertension and complications due to hypertension. The most influential independent factor was the elderly who did not receive education about hypertension management (p = 0.000; OR = 5.216).

Conclusion: This study found several factors in determining medication adherence in the elderly namely having a history of hypertension > 5 years, having grade 2 hypertension, receiving education on hypertension management, not controlling weight, and having complications.
21. Defining the Relationship Between Arm and Leg Blood Pressure Readings: A Systematic Review
Authors: Untari P. U. , Daindes T.
Published: April 2023

Background: The upper arm is the most common place to take measurements of blood pressure (BP). However, there are several circumstances in which this cannot be done. It is probable that it will be necessary to test the patient's BP in the leg.

Objective: To understand whether the differences of BP readings obtained in the arm and leg.

Method: The Preferred Reporting Items for Systematic Study and Meta-Analysis (PRISMA) 2020 standards were adhered to in order to ensure that this review was carried out correctly. The search for studies to be included in the systematic review was carried out from December, 30nd 2022 using the PubMed and SagePub databases by inputting the words: “blood pressure”, “leg” and “arm”

Result: After identifying 811 PubMed and 508 SagePub articles, the total article that met publishing time criteria (2012 and after) are 83 articles. After performing tittle screening, 17 articles were chosen. When final exclusion criteria were applied, we have 2 articles left. According to this study, the systolic BP in the legs is higher than in the arms, while the diastolic BP in the legs is lower. This difference has been considered to lie somewhere in the range of 10–40 mmHg.

Conclusion: This study suggests a careful interpretation of BP as different location of measurement may significantly cause different results. Also, the opposite correlation in systolic & diastolic between arm & leg measurement make it more complicated than usual & simple conventional BP interpretation.
30. Knowledge and Medication Compliance In patients with Hypertension at Posbindu in Seroja Health Care Working Area
Authors: Maulida Syifa Nur , Luthfiah Hasna , Dewi Anggieta Kumala
Published: April 2023

Background: The global prevalence of hypertension is 22% of the total world population and Indonesia found 34.1% population with hypertension at the age of > 18 years. Based on the proportion of history of taking medication, 32.3% did not take medication regularly, and 13.3% did not take antihypertensive medication. Compliance with hypertension treatment is important because hypertension is an incurable disease and treatment can affect the patient's recovery and complications. Objective: This study aims to determine the relationship between Patient Knowledge and medication compliance for hypertension Patients at Posbindu in Seroja Health Care Working Area. Bekasi. Method: A total of 90 residents were enrolled from Posbindu in the Seroja Health Care Working Area stratified with purposive sampling for a month. A face-to-face questionnaire survey was conducted by trained investigators. Result: This study shows that the patient percentages with good knowledge are 67.8%, 12,2% with sufficient knowledge, and 20% with poor knowledge of hypertension. 62.2% of respondents were not obedient to having hypertension medication. The Chi-Square test shows the value of probability p value 0.001 (p 0.001, r = 0.374). Conclusion: There is a significant relationship between the level of knowledge and medication compliance in hypertensive patients at Posbindu in the Seroja Health Care Working Area.
31. Evaluation of Hypertension Patient's Adherence to Treatment in Primary Healthcare Settings Across Multiple Centers in Indonesia
Authors: Izzati Nabila , Saputri Faradila Budi , Rizky Farizal , Saputra Mahendra Eko
Published: April 2023

Background: Hypertension is a significant public health concern as it can lead to cardiovascular and cerebrovascular diseases. Many hypertension patients are unaware of their condition and do not take any medication. Riskesdas 2018 stated that the prevalence of hypertension in ages >18 years old is 34,1%, 8,8% being diagnosed, 13,3% not taking medication, and 32,3% in poor compliance. Multiple factors contribute to poor compliance with long-term antihypertensive therapy. This study examines hypertensive therapy compliance in primary care and its major determinants.

Method: We gather the data of patients with hypertension using the Electronic Medical Record in the Primary Healthcare Center (Puskesmas). We also included the National Health Insurance system data to determine when the patient went to Puskesmas from November 2021 to October 2022. The patient's gender and other comorbid conditions become the independent variable. The dependent variable is patient compliance which is associated with the number of patient visits in 1 year.

Result: We Gather 44,293 data from patients visiting 5 Puskesmas. These are 1,493 unique patients diagnosed with hypertension. Only 493 male patients from 1,493 patients (33%) went to the Puskesmas for treatment. However, there was no difference in compliance between male and female patients (p = 0.136). Hypertensive patients with comorbid (diabetes) amounted to 225 out of 1,790 patients (13%). The independent t-test showed that patients with comorbidities were more likely to routinely control (p = 0.000).

Conclusion: Compliance from hypertensive patients is often neglected. Gender and comorbidities are essential for planning appropriate public interventions to increase patient compliance.
55. The Duration of Hypertension does not Affect Left Atrial Volume Index and Left Ventricular Mass Index in Hypertensive patients at Regional Referral Hospital
Authors: Mushlih Abdullah , Tiksnadi Badai Bhatara , Martanto Erwan , Putra Agastya Prabhaswara , Undarsa Alberta Claudia
Published: April 2023

Background: Increased left atrial size and volume and left ventricular hypertrophy can be used as prognostic indicators of cardiovascular morbidity and mortality. Enlargement of left atrium and hypertrophied of LV are already known associated with several factors, but many of them studied in mild-hypertension case in primary/secondary health care. The objective of this study was to evaluate the effect of hypertension duration on Left Atrial Volume Index (LAVi) and Left Ventricular Mass Index (LVMi) in hypertensive patient at Regional Referral Hospital.

Methods: Data from hypertension registry at Dr Hasan Sadikin General Hospital, Bandung, from March to December 2022 were collected. Patients with reduced left ventricular systolic function, moderate to severe valvular heart disease, professional athlete, pregnancy, congenital heart disease, pulmonary arterial hypertension were excluded. Patients’ hypertension duration, gender, age, echocardiographic measurement was collected. Linear regression analysis was conducted to evaluate effects of hypertension duration on LAVi and LVMi from echocardiographic evaluation.

Results: A total of 94 patient's was studied with median age: 60.5 (22–75) years old and male: 50%. The median duration of hypertension was 5 (0.08–44) years. The median value of LAVi was 20.9 (10.1–56.4) ml/m2, The median LVMi was 124.65 (52.9–281.8) g/m2. There was no significant association between duration of hypertension and LAVi, R2 = .009, P = .482, F = .370, CI (19.389, 24.456). There was no significant association between duration of hypertension and LVMi: R2 = .006, P = .446, F .58, CI (120.06, 138.72)

Conclusion: Hypertension duration doesn’t significantly affect Left Atrial Volume Index and Left Ventricular Mass Index in Hypertensive patients at Regional Referral Hospital.
57. Effect of Sodium-Glucose Cotransporter-2 Inhibitor on Blood Pressure in Patient with Type 2 Diabetes Mellitus with Renal Impairment: a Systematic Review
Authors: Lee J.B. , Sabran M.Z. , Rubismo K.Y. , Zebua A. , Jhoputri C.F. , Lee J.V.
Published: April 2023

Hypertension is a common comorbidity in patients with Type 2 Diabetes Mellitus (T2DM). One of the new anti-diabetic classes is (SGLT2) inhibitor which is still widely tested in clinical trials for indications beyond T2DM. However, the effect of SGLT2 inhibitors on blood pressure in T2DM patients with renal impairment is still not well known. This study wants to find out the effect of SGLT2 inhibitors on blood pressure in patients with T2DM and renal impairment. This study was conducted on 1–7 January 2023. Two independent researchers systematically extracted data from several databases, such as PubMed Central (PMC), Science Direct, and PUBMED by using MeSH terminology of keywords SGLT2 inhibitor and blood pressure. The extracted studies were then analyzed and selected according to our inclusion criteria such as studies in the last 5 years, diabetic patients with renal impairment, 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 3 cohort studies (2173 subjects from various countries), all of them showed SGLT2 inhibitors had significantly lowered systolic blood pressure and also improved the blood pressure profile in the population; All studies have proven good quality based on NOS. In conclusion, SGLT2 inhibitors had a blood pressure-lowering effect in T2DM patients with renal impairment. However, further study is needed to confirm these findings.
Evaluation of Knowledge, Attitudes, and Practice in an Online Faculty Development Course for Anesthesia Educators in East Africa
Authors: Kejela Edosa , Tesfaye Gosa , Getachew Adane , Rose Elizabeth S. , Winful Taiye , Eyayu Zemene , Martin Marie H. , Sileshi Bantayehu
Published: April 2023

Introduction:

Faculty in low-resourced communities often have limited training on teaching and learning. An innovative, online, 13-week course using a flipped classroom model was developed for junior faculty anesthesiologists at teaching hospitals in East Africa and piloted in Ethiopia and Tanzania.

Methods:

Quantitative and qualitative data were collected and analyzed to evaluate potential change in participants' knowledge, skills, and attitudes as well as the feasibility of e-learning in the region.

Results:

Analysis of data revealed that top areas of change in participants' knowledge were in the flipped classroom approach (increased by 79%), effective mentoring practices (67%), and elements of effective course goals and objectives (58%). Leading areas of change in skills were in developing goals and objectives (72%), using case-based learning (67%), and engaging learners through PowerPoint (64%). Change in attitudes was largest in the areas of effective mentoring and strong leadership (27%), using course and lecture learning objectives (26%), and student-centered learning theory (26%). Qualitative data revealed that participants were satisfied with the course; found the structure, presentations, and delivery methods to be effective; and appreciated the flexibility of being online but experienced challenges, particularly in connectivity.

Discussion:

This evaluation demonstrated the efficacy of using e-learning in East Africa and highlights the innovation of online faculty development in a region where it has not been done before. By using participants as future instructors, this course is scalable in the region and worldwide, and it can help address limited access to training by providing a critical mass of trainers competent in teaching, mentoring, and leading.
The immediate effects of lavender-based essential oil inhalation on subsequent polysomnography in people with poor sleep quality
Authors: Yang Chun-Pai , Yang Cheng-Chia , Tsai I-Ju , Lin Tsung-Hsing , Chiou Ya-Ling , Wang Hsiao-Fen , Chang Ching-Mao , Yih Kuang-Hway
Published: April 2023

Background:

Although aromatherapy is considered an adjuvant therapy to promote sleep quality, few objective sleep testing instruments can confirm the effects of aromatherapy on sleep physiology. The purpose of this study was to confirm and compare the immediate effects of a single lavender essential oil (SLEO) group to a complex lavender essential oil (CLEO) group by objective polysomnography (PSG) recordings.

Methods:

Participants were randomly divided into the SLEO group and CLEO group in this single-blind trial to explore the sleep effect of essential oil aroma. All the participants completed the sleep-related questionnaires and underwent two consecutive nights of PSG recordings, who had one night without aromatherapy and one night with one of the two aromas randomly assigned to them.

Results:

Total of 53 participants were recruited for this study, 25 participants were in the SLEO group, and 28 were in the CLEO group. Baseline characteristics and sleep-related questionnaires were similar in both groups. Both SLEO and CLEO extended the total sleep time (TST) (Δ = 43.42 and 23.75 minutes, respectively) and sleep period time (SPT) (Δ = 38.86 and 24.07 minutes, respectively). The SLEO group further improved sleep efficiency and increased the amounts of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep and decreased spontaneous arousals. However, there was no significant difference in PSG parameters between the SLEO and CLEO groups.

Conclusion:

Both SLEO and CLEO extended TST and SPT, with no significant differences between these two groups. These results warrant practical applications and merit future studies (Clinical trial registration: ClinicalTrials.gov: NCT03933553).