bluuebunny/crossref_metadata_2025_split huggingface dataset:
P109 The Influence of Sex on Cuff Blood Pressure Accuracy
Authors: Stoneman Elif , Picone Dean , Schultz Martin , Armstrong Matthew , Bos Willem , Dwyer Nathan , Lacy Peter , Laugesen Esben , Omboni Stefano , Pucci Giacomo , Roberts-Thomson Philip , Stouffer George , Takazawa Kenji , Weber Thomas , Westerhof Berend , Sharman James 
Published: March 2020

Abstract
Background
Cuff blood pressure (BP) is intended to approximate central aortic BP and accuracy is paramount. Sex differences in BP physiology could influence the accuracy of cuff BP as an estimate of invasive aortic BP, but this has not been explored in-depth and was the aim of this study.

Methods
Cuff and invasive aortic BP were measured in 1701 subjects (31.9% female, aged 63 ± 12) during coronary angiography from the INvaSive blood PressurE ConsorTium (INSPECT) database. Cuff accuracy was defined as cuff–invasive BP. In a sub-sample (n = 376, 27% female, aged 63 ± 11), invasive brachial BP was recorded to assess systolic (SBP) amplification (invasive brachial–aortic SBP).

Results
Invasive aortic SBP was higher in females compared with males (mean [95% CI]: 141.8 mmHg [137.1, 146.3] versus 132.9 mmHg [129.4, 136.4], p < 0.001). Cuff SBP significantly underestimated invasive aortic SBP in females compared with males (−3.1 mmHg [−5.9, −0.2] versus 1.4 mmHg [−1.1, 4.0], p < 0.001 for difference). Sex differences remained after adjustment for age and height. In the sub-sample, aortic-to-brachial SBP-amplification was lower in females (7.1 mmHg [3.3, 10.8] versus 10.2 mmHg [5.1, 15.4], p = 0.0070). Sex, SBP-amplification, height and age were associated with cuff BP inaccuracy, but only SBP-amplification and age remained associated in multivariable analysis (p < 0.05).

Conclusion
Females have greater propensity towards cuff BP inaccuracy through underestimation of aortic SBP. Both age and the magnitude of aortic-to-brachial SBP-amplification are related to cuff BP inaccuracy, which provide greater understanding of sex differences in BP physiology and may help improve the accuracy of cuff BP methods.
P110 Impact of Cardiac Pre-load on Arterial Stiffness in Patient with Essential Hypertension
Authors: Faconti Luca , McNally Ryan , Farukh Bushra , Chowienczyk Phil 
Published: March 2020

Abstract
Background
Effects of afterload and blood pressure (BP) on pulse wave velocity (PWV) have been investigated using vasoactive drugs but effects of cardiac pre-load have not previously been studied.

Methods
Transient mechanical reduction of cardiac pre-load (lower limb venous occlusion, LVO) and expansion of cardiac pre-load (intravenous infusion of 2 litres of saline solution, SST) were performed in patients with hypertension. BP, carotid-femoral PWV (Sphygmocor, AtCor Medical, Asutralia), cardiac stroke volume (SV) and total peripheral resistance (TPR) derived by transthoracic echocardiography were recorded during LVO and SST. Peak flow velocity in superior vena cava (SVCx) was used to asses change in pre-load.

Results
35 subjects were studied. SVCx decreased during LVO (n = 20) by mean (95% confidence-intervals) 7.6 (2.8–11.6) cm/s and increased during SST (n = 15) by 7.1 (−0.3–14.6) cm/s. LVO produced a small but significant reduction in mean arterial BP (MAP) of 1.5 (0.0–3.1) mmHg and SV of 6.7 (2.2–11.3) mL; while TPR and PWV increased by 236.9 (51.7–422.1) dynes-sec/cm5 and 0.7 (0.3–1.1) m/s respectively. SST produced a decrease of MAP of 4.3 (0.4–8.0) mmHg while SV increased by 4.8 (0.7–9.1) mL. TPR and PWV were reduced by 255.7 (15.4–490.5) dynes-sec/cm5 and 0.7 (0.1–1.0) m/s, respectively. All p < 0.05.

Conclusion
Modulation of cardiac pre-load affect PWV beyond the effects on afterload and BP. The reciprocal changes of BP, PWV, SV and TPR could be explained by a role of the autonomic nervous system in the regulation of vascular tone in response to change of pre-load.
P111 Arterial Stiffness and Unattended and Attended BP Values
Authors: Paini Anna , Aggiusti Carlo , Bertacchini Fabio , Stassaldi Deborah , Capellini Sara , Rosei Enrico Agabiti , Muiesan Maria Lorenza , Salvetti Massimo 
Published: March 2020

AbstractMeasurement of “unattended” blood pressure (BP) may reduce or eliminate the “white coat effect”. Despite the possible advantages of this approach for BP measurement, only few studies analysed the relationship between unattended BP and cardiovascular events or with hypertension mediated organ damage (HMOD). The aim of our study was to evaluate the relationship between “attended” or “unattended” BP values and carotid-femoral pulse wave velocity (PWV) in 285 subjects undergoing a visit and assessment of arterial stiffness at an ESH Excellence Centre. Unattended BP (measured with the patient alone in the room, with an oscillometric device programmed to perform 3 BP measurements, at 1 minute intervals, after 5 minutes) and attended BP were measured with the same device, on the same day of the measurement of PWV, in random order.
Results
Mean age was 63 ± 13 years, mean BMI 26 ± 4, 47% were female, 76% had hypertension (55% treated). Systolic unattended BP was lower as compared to attended SBP (124.4 ± 14.3 vs 130.9 ± 16.1 mmHg). PWV was similarly correlated with attended and unattended SBP values (r = 0.428 and r = 0.404, p < 0.0001, respectively). No difference for the prediction of increased arterial stiffness was observed at receiver operator curves (ROC) analysis: attended SBP area under the curve (AUC) 0.665, 95% CI 0.607–0.720 vs unattended SBP: AUC 0.651, 95% CI 0.593–0.706, p for the comparison = ns).

Conclusion
Attended and unattended BP values are similarly correlated with PWV, the gold standard measure of arterial stiffness. These findings may provide further information on the clinical value of unattended BP.
P114 “Stifflammation” is an Essential Cause of Cardiovascular Hospitalizations in Hypertensives
Authors: Christopoulou Georgia , Vlachopoulos Charalambos , Korogiannis Lambros , Terentes-Printzios Dimitrios , Sigala Evangelia , Koutagiar Iosif , Gardikioti Vasiliki , Tousoulis Dimitrios 
Published: March 2020

Abstract
Purpose/Background/Objectives
Hypertension is associated with increased cardiovascular risk, inflammation and arterial stiffness. We sought to investigate the role of inflammation and arterial stiffness in the prognosis of cardiovascular hospitalization in hypertensives patients over an extensive follow-up.

Methods
One hundred and seventy-three patients (mean age 52.5 ± 13.2 years, 57% males) untreated hypertensives at baseline without cardiovascular disease, were included in the study. Arterial stiffness was assessed with carotid-femoral pulse wave velocity (PWV). High-sensitivity C-reactive protein (hsCRP) was measured in venous blood samples.

Results
During 13.6 ± 0.4 years of follow-up, forty-four patients (25.4%) patients were admitted in hospital due to cardiovascular causes. In multivariable logistic regression analysis, only higher hsCRP (Odds Ratio [OR] = 3.34, 95% Confidence intervals [CI]: 1.22–9.51, p = 0.020) and increased PWV (OR = 1.48, 95% Confidence intervals [CI]: 1.03–2.12, p = 0.036) were associated with higher risk of cardiovascular hospitalizations, which was independent of age, gender, systolic blood pressure, left ventricular mass index and presence of diabetes. In further analysis, receiver operating characteristic (ROC) curves were generated to evaluate the ability of hsCRP and PWV to discriminate subjects with cardiovascular hospitalization. The area under the curve (AUC) and 95% CIs of the ROC curves were AUC = 0.69 (95% CI: 0.59–0.78, p < 0.001) for hsCRP and AUC = 0.74 (95% CI: 0.65–0.83, p < 0.001) for PWV (Figure 1).

Conclusion
Our study shows the independent complimentary prognostic role of inflammation and arterial stiffness in the prognosis of hypertensives even in studies with extensive follow-up.
P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management?
Authors: Kirkham Fran , Nuredini GN , Saunders A , Drazich Erin , Bunting Eva , Rankin Philip , Ali K , Okorie M , Rajkumar Chakravarthi 
Published: March 2020

Abstract
Objective
International guidelines advocate conservative management of post-stroke white coat hypertension. The aims of this study were to investigate; i) does WCH/E result in increased stroke risk? and ii) is WCH/E associated with surrogate markers of cardiovascular risk?

Methods
The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of transient ischaemic attack (TIA) or lacunar stroke in the preceding 14 days. Patients were grouped by BP phenotypes. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension, n = 25 sustained hypertension). Thirty-two patients with normal BP (clinic BP <140/90 mmHg and day-time ABPM <135/85 mmHg), and 30 patients with WCH/E (clinic BP >140/90 mmHg and day-time ABPM <135/85 mmHg) were recruited. Other surrogate markers measured were; Central aortic BP (SphygoCor, AtCor Medical), QKD100−60 interval and nocturnal dipping status (Diasys Integra II, Novocor).

Results
Compared to the normotensive cohort, patients with WCH/E were older, had a higher body mass index (BMI) and a larger proportion of patients were on anti-hypertensive medication. Both central systolic (145 ± 13 vs 118 ± 8, p < 0.001) and diastolic BP (82 ± 8 vs 76 ± 7, p = 0.004) were higher in WCH/E. The WCH/E cohort also had more lacunar strokes (p = 0.039) (Table 1).

Conclusion
In this population of post-stroke patients, WCH/E was associated with higher prevalence of lacunar stroke. These individuals also had higher central pressures despite more patients being on anti-hypertensive treatment, suggesting that post-stroke WCH/E should be managed more aggressively.

Table 1

Normotension (N = 32)
WCH/E (N = 30)
Significance

Male, n (%)
21 (66)
22 (73)
0.511

Age (years)
69.9 ± 11.5
75.7 ± 9 3
0.033

BMI (kg/m2)
25 ± 4
28 ± 4
0.014

Anti-hypertensive use, n (%)
19 (59)
23 (77)
0.146

Clinic SBP (mmHg)
125 ± 9
155 ± 13
<0.001

Clinic DBP (mmHg)
75 ± 7
81 ± 8
0.003

Daytime systolic ABPM (mmHg)
114 ± 10
121 ± 10
0.007

Daytime diastolic ABPM (mmHg)
73 ± 7
72 ± 7
0.586

Central SBP (mmHg)
118 ± 8
145 ± 13
<0.001

Central DBP (mmHg)
76 ± 7
82 ± 8
0.004

QKD100−60 interval (msec)
208 ± 18
197 ± 26
0.114

Non-dipper, n (%)
16 (57)
14 (50)
0.592

Stroke type

TIA, n (%)
25 (78)
16 (53)
0.039

Lacunar, n (%)
7 (22)
14 (47)

Data expressed as mean ± standard deviation or number (percentage). Significance determined by t-test. Chi-squared used for: anti-hypertensive use, male gender, dipping status and stroke type.
P117 Case Report of a Patient with Extreme Reverse Dipping Phenomenon Decades After Kidney Transplantation
Authors: Batta Dóra , Kőrösi Beáta , Nemcsik-Bencze Zsófia , Nemcsik János 
Published: March 2020

AbstractA patient with the complaint of moderately elevated blood pressure came to our office. Important data in his history was kidney transplantation in 1985, due to glomerulonephritis and since that time he was in regular nephrology care. He also had chronic lumboischialgia, chronic hypertension and stage 3b chronic kidney disease. He was included into our screening program, in which arterial stiffness and central hemodynamics were also registered with Mobil-O-Graph. Besides moderately elevated office blood pressure (143/102 mmHg, heart rate: 68/min), in ABPM extreme reverse dipping phenomenon (24 h average: 140/93 mmHg; daytime average: 130/86 mmHg; night-time average: 175/114 mmHg) was found, which was unknown until that time. The blood pressure elevation appeared immediately in supine position. Antihypertensive medications were modified. Ultrasound of the transplanted kidney did not confirm compression of the renal artery; on ECHO left ventricular hypertrophy was found. Neuropathy test described autonomic neuropathy. After the modification of antihypertensive medications, the extreme reverse dipping phenomenon was attenuated, but still present. Benfotiamine + Pyridoxine (200/200 mg daily) was started by a rheumatologist, because of chronic back pain. After a year of their administration in an ABPM control the neuroprotective medication was ineffective for the recovery of the extreme reverse dipping phenomenon, but 19 months following the initiation, the supine hypertension phenomenon was further attenuated. In conclusions, in patients decades after kidney transplantation autonomic neuropathy can lead to supine hypertension and extreme reverse dipping phenomenon on ABPM, which can be influenced with the modification of antihypertensive medications and probably with neuroprotective agents.
P126 Characterization of Skin Temperature Changes in Response to Photobiostimulation Using Thermal Imaging: A Thermo-Anatomical Correlation
Authors: Hoffer Oshrit , Rabin Neta , Gavish Lilach , Halak Moshe , Haim Ortal , Shayovitz Yuval , Shkilevich Simon , Gavish Benjamin , Zimmer Yair , Ovadia-Blechman Zehava 
Published: March 2020

Abstract
Background and Objective
Infrared Thermal Imaging (ITI) is a noninvasive method to measure skin temperature (ST). The latter is determined by the microcirculatory blood flow and ambient temperature. Photobiostimulation has been shown to increase blood flow. The objective was to characterize the spatial and temporal changes in ST, in response to photobiostimulation using ITI.

Methods
A randomized-controlled clinical study with 20 healthy subjects (30 ± 8 years old, 10:10 male:female). Subjects were irradiated with either red (630 nm, 55 mW/cm2) or near-infrared (830 nm, 70 mW/cm2) light-emitting diodes for 5 minutes [min] over the wrist area. Thermal images of the hands were captured every minute before, during, and 20 min after irradiation. The ST change from baseline (ΔST) of each of five anatomical regions (wrist, palm center, arch [surrounding vascular arches], proximal phalanx, distal phalanx) was measured. Subjects who responded to photobiostimulation (ΔST ≥ 0.5°C) were included in this analysis. Mean measurement changes were modeled by ΔST = A * (1−exp[−time/tau]), to which non-linear regression was applied with the adjustable parameters of amplitude(A) and characteristic rise time (tau).

Results
Photobiostimulation caused ST increase that initiated during irradiation, reached a plateau during follow-up, and fitted the model by R > 0.9 for all regions. Following the anatomical path of the blood supply, from the wrist to the distal phalanx, the ΔST amplitude(A) increased while tau decreased: Mean ± SE for wrist ⇒ center ⇒ arch ⇒ proximal phalanx ⇒ distal phalanx: A = 1.03 ± 0.08 ⇒ 1.7 ± 0.03 ⇒ 2.1 ± 0.03 ⇒ 3.0 ± 0.05 ⇒ 3.4 ± 0.05, and tau = 7.9 ± 1.7 ⇒ 6.2 ± 0.4 ⇒ 5.7 ± 0.3 ⇒ 5.6 ± 0.3 ⇒ 4.3 ± 0.3, respectively.

Conclusion
Using ITI, a thermo-anatomical association in response to photobiostimulation was established. Thermal imaging may be used for quantitative characterization of blood re-distribution in response to vasoactive interventions with potential for vascular diagnostics.
P130 Cardiac Resynchronization Therapy Improves Early Ventricular Contraction and Reduces Time to Onset of Relaxation
Authors: Gu Haotian , Claridge Simon , Rinaldi Aldo , Chowienczyk Phil 
Published: March 2020

Abstract
Background
Haemodynamic effects of Cardiac Resynchronisation Therapy (CRT) may be mediated by an improvement in early systolic function, as well as by improvements in overall systolic function. We examined whether CRT improves early ventricular contraction as measured by first-phase ejection fraction (EF1) and time to onset of ventricular relaxation (TOR).

Methods
EF1 was defined as the fraction of LV volume ejected from the start of systole to the time of the first systolic peak (T1) on the carotid pressure waveform. Time-varying ejection phase myocardial wall stress (MWS) was calculated from echocardiographic imaging of left ventricular volumes and left ventricular pressure was obtained by carotid tonometry during systole calibrated from peripheral mean and diastolic blood pressure. TOR was defined as time to peak MWS over ejection time.

Results
25 patients (aged 72.8 ± 8.5 years) with heart failure and severely reduced EF (30.2 ± 7.0%) were studied before and immediately after CRT implantation. There was no difference in mean arterial pressure, central systolic pressure and augmentation pressure after CRT implantation. There was significant improvement in overall ejection fraction (pre: 30.2 ± 6.7% vs post: 35.9 ± 8.1%, p = 0.002) and EF1 (pre: 10.9 ± 3.4% vs post: 13.7 ± 4.7%, p = 0.010). TOR reduced significantly (pre: 48.0 ± 14.3% vs post: 40.0 ± 10.7%, p = 0.0012). The change in EF1 was negatively associated with change in TOR (β = −0.586, p = 0.003). This relationship persisted after adjustment for age, gender, baseline MAP and baseline EF1 (β = −0.452, p = 0.007).

Conclusion
In patients with heart failure, an improvement of early ejection is associated with reduction in TOR immediately after CRT implantation.
P154 Effect of Vitamin D Deficiency on Insulin Induced Vasodilatation and Receptor Expression in Rat Model of Polycystic Ovary Syndrome
Authors: Bányai Bálint , Rita Benko , Róbert Tarszabó , Krisztina Lajtai , Mária Horváth Eszter , Szabolcs Várbíró 
Published: March 2020

AbstractIn polycystic ovary syndrome (PCOS) hyperandrogenism and metabolic dysfunction increase cardiovascular risk. Vitamin D3 deficiency is a common comorbidity in PCOS. Our aim was to examine the alterations of insulin-induced vasodilation and receptor expression in rat aorta in a PCOS model.
Methods
Female Wistar rats were treated as follows: 1. vitamin D supplemented group (D+T−); 2. vitamin D deficient (D−T−), 3. vitamin D supplemented with transdermal testosterone application (D+T+) and 4. vitamin D deficient with transdermal testosterone (D−T+). Wire myograph was used for testing insulin relaxation of aorta rings in physiological salt solution and under NOS inhibition. Insulin (IR) and vitamin D receptor (VDR) density was examined by immunohistochemistry.

Results
Insulin-induced vasodilatation of the aorta rings were significantly lower in both vitamin deficient compared to the vitamin supplemented groups (p < 0.05). NOS inhibition significantly reduce the relaxation. Aorta endothelial IR expression was significantly higher in the vitamin D deficient group, meanwhile in the testosterone-treated groups (D+T+; D−T+) the expression was significantly lower (Area%: D+: 0.830 ± 0.10; D+T+: 0.298 ± 0.06; D−: 1.364 ± 0.12; D−T+: 0.354 ± 0.15, p < 0.05 in D− & D+T+ & D−T+ vs D+. p < 0.01 D+T+ & D−T+ vs D−). VDR density was significantly higher in the vitamin D deficient groups in comparison to the supplemented groups (Area% VDR: D+: 41.56 ± 5.58 vs D−: 60.63 ± 5.23) Testosterone treatment have not any effect on VDR expression.

Conclusion
Vitamin-D deficiency causes impaired insulin induced vasodilation. Increased IR density could not compensate altered insulin-induced relaxation.
Influence of Work Environment Noise to Productivity of Employee Performance of Sidoarjo District
Authors: Cahyani Agustina Astri 
Published: March 2020

Employees of the Sidoarjo Regency Health Office have a great responsibility in developing and improving health, especially in Sidoarjo Regency but the location of the Sidoarjo Regency Health Office is less strategic because it is located in the center of the traffic crowd which has an impact on employee performance. This study aims to analyze the noise of the work environment on the productivity of the performance of the employees of the Sidoarjo Regency Health Office.
This research was observational analytic type. The sampling technique in this study used total sampling, as many as 30 people. The instruments of this research were questionnaire and sound level meter.
Data analysis techniques include editing, coding, data entry, and conducting univariate and bivariate analysis techniques.The results of this study are: the majority of Sidoarjo Health Office employees experience high noise with an average noise intensity of 71.01 dBA; most employees of the Sidoarjo Health Office (56.7%) had good work productivity; and there is an influence of environmental noise on employee performance productivity Sidoarjo Health Office with a pvalue of 0.020 <0.05.
To improve employee productivity, employees of the Sidoarjo Health Office are expected to submit noise complaints to the leaders of the Sidoarjo Health Office so that they can be addressed immediately and arrange sitting positions while working away from sources of noise and the Health Office is expected to be able to monitor the noise levels of the workspace of employees and immediately make efforts to reduce employee room noise.
Peer Counseling : Upaya Dalam Meminimalisir Masalah Remaja
Authors: Ridhani Akhmad Rizkhi , Abidarda Yulizar 
Published: March 2020

ABSTRAK Masa kian berubah dari tahun ke tahun, seiring perubahan tersebut tentunya banyak fenomena yang kita lihat dan rasakan, tak terkecuali fenomena masalah yang terjadi di remaja, khususnya di Indonesia. Masa remaja merupakan masa dimana seseorang mulai tumbuh dari masa kanak-kanak menuju masa penemuan jati diri, dimana pada saat-saat seperti itulah biasanya para remaja akan bertingkah sembarangan tanpa memikirkan akibat apa yang akan terjadi dari perbuatannya tersebut. Sering kali dengan kelakuan sembarangannya itu para remaja mendapatkan masalah yang tidak ringan. Maka oleh sebab itu perlu dicanangkan program peer-counseling bagi remaja sehingga mereka dapat mengungapkan masalahnya dengan memanfaatkan teman sejawat. Hubungan sebaya memiliki peranan yang kuat dalam kehidupan remaja, hubungan sebaya ini menimbulkan suatu hubungan saling percaya antar teman sebaya. Hubungan ini dapat menimbulkan suatu perilaku dimana remaja lebih percaya terhadap teman sebaya daripada dengan orang tua, sehingga pembentukan dan pelatihan konselor sebaya dapat menjadi suatu pilihan yang tepat dalam upaya membentengi anak atau remaja dari pengaruh negatif lingkungan sekitarnya.Kata Kunci: masalah remaja; peer counseling. ABSTRACTThe period has changed from year to year, as these changes certainly have many phenomena that we see and feel, including the phenomenon of problems that occur in adolescents, especially in Indonesia. Adolescence is a period where a person begins to grow from childhood to the time of discovery of identity, where at times like that usually the teenagers will act carelessly without thinking about the consequences of what will happen from these actions. Often with careless behavior, teenagers get problems that are not light. Therefore, it is necessary to launch a peer-counseling program for adolescents so that they can express their problems by using colleagues. Peer relationships have a strong role in adolescent life, this peer relationship creates a trusting relationship between peers. This relationship can lead to a behavior where adolescents are more trusting of peers than with parents, so the formation and training of peer counselors can be an appropriate choice in an effort to fortify children or adolescents from the negative influences of the surrounding environment.Keywords: peer counseling; youth problems.