bluuebunny/crossref_metadata_2025_split huggingface dataset:
C78. Prosthetic valve thrombosis in uncontrolled internormalized ratio ended up with disaster on prosthetic valve surgary : a barrier of anticoagulant management in rural area
Authors: Hustiar M , Nadia  , Heriansyah T , Purnawarman A 
Published: April 2022

Abstract

Background
Mechanical prosthetic valve thrombosis (PVT) is a life-threatening complication that requires immediate intervention. With current prosthetic devices and aggressive prophylactic anticoagulation, the incidence of PVT remains low. It needs monitoring of international normalized ratio (INR), which is somewhat difficult to do in rural areas such as West Aceh due to geography. This report details the case of a woman with PVT who developed heart failure after a period of suboptimal anticoagulation.

Case Summary
We described a 51-year-old woman who had undergone coronary artery bypass graft and mitral valve replacement procedure in 2017. Her physical examination showed the decrease of the prosthetic click sound and lung congestion. From her blood examination, the INR was subtherapeutic. A thrombus was detected on the prosthetic mitral valve by transoesophageal echocardiography. She had history of uncontrolled INR because the patient do not routinely checked her blood to control the optimal dose of anticoagulant. The patient underwent reoperation for mechanical valve thrombosis but unfortunately in the end the patient died at the procedure.

Discussion
In patients undergoing mechanical heart valve replacement, time in therapeutic range of targeted INR should be ≥ 70 % otherwise it will increase in risk of thromboembolic events. However, in developing countries which have remote areas, repeated examination of the use of warfarin in obtaining the INR target is still a major challenge. Conversely, serious risks can occur if this is not achieved and might be ended up with disaster toward the patient.
C82. Rare electrocardiography findings of Wellen’s Type A evolving into Type B on late onset Myocardial Infarction: A Case Report
Authors: Achmad R M P , Madiastuti Septi , Nadia Ina , Widyantoro Bambang 
Published: April 2022

Abstract

Background
Wellens' Syndrome is a left anterior descending (LAD) coronary artery disease which first described in 1982 by de Zwaan et al. A byphasic T or deeply inverted T are the typical Wellen's electrocardiogram (ECG) changes which represent a critical stenosis. It may be presented without any typical symptoms, and normal or mildly elevated enzymes depends on its onset.

Case Summary
A 56-years-old male, admitted to ER with typical chest pain within 1 day. The first ECG showed byphasic T wave on V2 and V3, and an hour serial ECG showed a deeply inverted T wave on V2 and V3. Cardiac marker showed an elevated Troponin I levels of 1,590.6 ng/L. The patient was diagnosed with acute NSTEMI and underwent an early invasive strategy on the next day. Coronary angiography revealed total occlusion of the proximal LAD, and implantation of drug eluting stent was done accordingly. The patient remained symptoms-free after the procedure and discharged in stable condition.

Discussion
This patient suffering a left coronary total occlusion with no appearance of any ST-elevation on ECG. Therefore, a critical stenosis does not always came up with a typical ST-segment changes. Wellen’s type ECG showed how the T waves evolution would represent a critical stenosis. Early recognition of Wellen's typical ECG in this patient lead to early invasive strategy decision and later resulted a good outcome.
C84. Resistent Hypertension in Young Patient, what has Been Missed? A Case Report of Coartation of the Aorta
Authors: Hartoko A , Sulastomo H 
Published: April 2022

Abstract

Background
In children and adolescent patient the most common cause hypertension is secondary due to renal disease. There are other cause of secondary hypertension including Coartation of the Aorta (CoA). Early diagnosis and prompt treatment are important for CoA, if left untreated CoA can causes ventricular hypertrophy, premature coronary artery disease and eventually heart failure.

Case Illustration
A 17 Years old patient with history of hypertension since the age of 12. He was suspected secondary hypertension due to renal disease and referred to pediatric nephrologist. Laboratory examination and CT angiography renal artery showed normal result. He was treated with multiple antihypertensive drugs, but remains hypertensive despite of medical therapy for 5 years.
He was referred to our hospital due to resistant hypertension. At physical examination this patient revealed blood pressure at upper 150/90 and lower extremities 100/60. Echocardiography examination and CT angiography showed Left Ventricle Hypertrophic (LVH) with coartation aorta located distal to left subclavian artery. Thoracic Endovascular Repair (TEVAR) was performed to dilated the coartation in this patient. Post TEVAR procedure peak systolic gradient reduced from 51 mmHg to 4 mmHg.

Discussion
CoA are one of the causes of secondary hypertension. Uncommonly resistant hypertension can occur in CoA. Early diagnosis and prompt treatment are important for CoA. In this patient the CoA already caused LVH, and if left untreated it can lead more severe complication such as heart failure, and premature coronary artery disease and death.
C97. The Important Role of Manual Aspiration through Guiding Catheter after Percutaneous Mechanical Thrombectomy (Angiojet) in Patient with Subacute Limb Ischemia due to Essential Thrombocytosis
Authors: A Ramadhani , H Hariawan , MT Ismail , VY Anggraeni 
Published: April 2022

Abstract

Background
Essential thrombocytosis (ET) is a myeloproliferative neoplasm characterized by increased platelet counts and excessive large and morphologically mature megakaryocytes in the bone marrow. ET may be complicated by thrombotic events, mostly in small and medium vessel. However there are limited evidence to guide management, particularly in cases with acute tissue ischemia. Understanding the basic pathophysiology concept of thrombosis in patient with ET is vital in choosing the right modality for revascularization.

Case Summary
A 73-year-old female with history of essential thrombocytosis presenting with severe debilitating pain on her right lower extremity. Physical examination showed decreased peripheral oxygen saturation. Dupplex Ultrasound revealed total thrombus at femoral artery dextra and no flow at popliteal artery, anterior and posterior tibial artery. We decided to perform revascularization with percutaneous mechanical thrombectomy (Angiojet). Arteriography evaluation still showing abundant number of thrombus. We continued with manual aspiration using guiding catheter and showing a remarkable result with normal blood flow down to the distal part with minimal residual thrombus.

Discussion
Histopatbological evaluations of arterial thrombi in ET revealed platelet-rich clots with abundant von Willebrand factor (VWF) and very little fibrin. Hence tllrombolysis agent used in CDT will not effective. Large thrombus which can not be lysed by fibrinolytic should be evacuated by a larger hole catheter aspiration
Controllability of switched Hilfer neutral fractional dynamic systems with impulses
Authors: Kumar Vipin , Kostić Marko , Tridane Abdessamad , Debbouche Amar 
Published: April 2022

AbstractThe aim of this work is to investigate the controllability of a class of switched Hilfer neutral fractional systems with non-instantaneous impulses in the finite-dimensional spaces. We construct a new class of control function that controls the system at the final time of the time-interval and controls the system at each of the impulsive points i.e. we give the so-called total controllability results. Also, we extend these results to the corresponding integro-system. We mainly use the fixed point theorem, Laplace transformation, Mittag-Leffler function, Gramian type matrices and fractional calculus to establish these results. In the end, we provide a simulated example to verify the obtained analytical results.
‘I'm usually being my own doctor’: women's experiences of managing polycystic ovary syndrome in Canada
Authors: Ismayilova Miya , Yaya Sanni 
Published: April 2022

Abstract

Background
Polycystic ovary syndrome (PCOS) is a complex, chronic condition characterized by anovulation, polycystic ovarian morphology and hyperandrogenism that requires lifelong management. To reduce the risk of comorbidity and to manage symptoms, lifestyle management and pharmaceuticals such as oral contraceptives are the most common forms of treatment and should be tailored to the individual patient. The literature to date has shown PCOS patients to experience widespread dissatisfaction with the amount and quality of information they receive from providers, along with lower levels of trust in physicians. Little is known about the lived experiences of women managing PCOS in Canada, across age groups.

Methods
In-depth remote interviews explored women's lived experiences managing PCOS and the barriers and facilitators they encountered in their management journeys. Data were analyzed using thematic analysis and interpretive description methodology.

Results
Twenty-five in-depth, telephone interviews conducted with participants (aged 18–63 y) across Canada revealed participants lacking sufficient information and guidance from physicians, especially in primary care. Areas in need of more guidance included lifestyle management and mental health. Lack of empathy and weight bias among physicians were also perceived by participants. Older participants received little guidance on treatment options postmenopause. Loss of trust and withdrawal from seeking medical care were prominent themes, along with greater self-reliance on self-management, including self-educating and self-experimenting with treatments.

Conclusions
Most women in this study were frustrated with the level of involvement and information provision from their doctors. Key recommendations are identified for the provision of care to younger and older patients with PCOS. Improved education for physicians may be needed to improve the quality of healthcare provision for PCOS.
Global and regional burden and quality of care of non-rheumatic valvular heart diseases: a systematic analysis of Global Burden of Disease 1990–2017
Authors: Nejad Mehrabi , Ahmadi Naser , Mohammadi Esmaeil , Shabani Mahya , Sherafati Alborz , Aryannejad Armin , Rezaei Negar , Ghanbari Ali , Yoosefi Moein , Aminorroaya Arya , Shabani Mahsima , Rezaei Nazila , Salavati Tina , Larijani Bagher , Naderimagham Shohreh , Farzadfar Farshad 
Published: April 2022

Abstract

Background
With an increase in the incidence and prevalence of non-rheumatic valvular heart diseases (NRVHDs), having a proper understanding of the disease current status in terms of quality of care and healthcare access can considerably affect further planning for the healthcare system.

Objective
In this study, we aimed to evaluate and compare the quality and equity of care concerning NRVHDs in terms of gender and sociodemographic index (SDI) using a newly proposed index.

Methods
We obtained the primary measures (e.g. incidence) from the Global Burden of Disease (GBD) data about NRVHD from 1990 to 2017 to calculate the subsequent secondary indices (e.g. mortality-to-incidence ratio) with close association to quality of care. Then, using principal component analysis (PCA), quality of care index (QCI) was calculated as a novel index from the secondary indices, rescaled to 0–100. QCI was calculated for all age groups and both genders, globally, regionally and nationally between 1990 and 2017.

Results
Globally, the QCI for NRVHDs in 2017 was 87.3, and it appears that gender inequity was unremarkable (gender disparity ratio = 1.00, female QCI: 90.2, male QCI: 89.7) in 2017 similar to the past three decades. Among WHO world regions, the Western Pacific Region and Eastern Mediterranean Region showed the highest (90.1) and lowest (74.0) QCI scores. Regarding SDI, the high-middle-SDI quintile with a QCI of 89.4 and the low-SDI quintile with a QCI of 77.8 were the two extremes of healthcare quality in 2017.

Conclusion
Although global status regarding the NRVHD’s quality of care is acceptable, higher attention is required for lower SDI countries.
I've Got a Feeling: Leaders, Summits, and Reassurance
Authors: Kydd Andrew H 
Published: April 2022

Abstract
Students of international summit diplomacy argue that personal, face-to-face interaction between national leaders is an important factor in building trust between states. The generation of personal impressions is held to be a nonrational process driven by instinct, psychology, or the structure of the brain. However, actors may still respond to these impressions rationally. I present a model of how leaders should respond to their impressions at summits. Some implications are that attending summits may be reassuring if they are costly and trustworthy types can get good impressions of each other and then cooperate, but that mistaken impressions can also form that can lead to exploitation of trustworthy types by untrustworthy types. I illustrate the model with reference to the summits in Singapore and Hanoi between US President Donald Trump and North Korean leader Kim Jong-un.
Arabidopsis alkaline ceramidase ACER functions in defense against insect herbivory
Authors: Huang Li-Qun , Li Ping-Ping , Yin Jian , Li Yong-Kang , Chen Ding-Kang , Bao He-Nan , Fan Rui-Yuan , Liu Hao-Zhuo , Yao Nan 
Published: April 2022

Abstract
Plant sphingolipids are important membrane components and bioactive molecules in development and defense responses. However, the function of sphingolipids in plant defense, especially against herbivores, is not fully understood. Here, we report that Spodoptera exigua feeding affects sphingolipid metabolism in Arabidopsis, resulting in increased levels of sphingoid long-chain bases, ceramides, and hydroxyceramides. Insect-induced ceramide and hydroxyceramide accumulation is dependent on the jasmonate signaling pathway. Loss of the Arabidopsis alkaline ceramidase ACER increases ceramides and decreases long-chain base levels in plants; in this work, we found that loss of ACER enhances plant resistance to S. exigua and improves response to mechanical wounding. Moreover, acer-1 mutants exhibited more severe root-growth inhibition and higher anthocyanin accumulation than wild-type plants in response to methyl jasmonate treatment, indicating that loss of ACER increases sensitivity to jasmonate and that ACER functions in jasmonate-mediated root growth and secondary metabolism. Transcript levels of ACER were also negatively regulated by jasmonates, and this process involves the transcription factor MYC2. Thus, our findings reveal that ACER is involved in mediating jasmonate-related plant growth and defense and that jasmonates function in regulating the expression of ACER.
Two years of optical and NIR observations of the superluminous supernova UID 30901 discovered by the UltraVISTA SN survey
Authors: Hueichapan E D , Contreras C , Cartier R , Lira P , Sanchez-Saez P , Milvang-Jensen B , Fynbo J P U , Anderson J P , Hamuy M 
Published: April 2022

ABSTRACT
We present deep optical and near-infrared photometry of UID 30901, a superluminous supernova (SLSN) discovered during the UltraVISTA survey. The observations were obtained with VIRCAM (YJHKs) mounted on the VISTA telescope, DECam (griz) on the Blanco telescope, and SUBARU Hyper Suprime-Cam (HSC; grizy). These multiband observations comprise +700 d making UID 30901 one of the best photometrically followed SLSNe to date. The host galaxy of UID 30901 is detected in a deep HST F814W image with an AB magnitude of 27.3 ± 0.2. While no spectra exist for the SN or its host galaxy, we perform our analysis assuming z = 0.37, based on the photometric redshift of a possible host galaxy found at a projected distance of 7 kpc. Fitting a blackbody to the observations, the radius, temperature, and bolometric light curve are computed. We find a maximum bolometric luminosity of 5.4 ± 0.34 × 1043 erg s−1. A flattening in the light curve beyond 600 d is observed and several possible causes are discussed. We find the observations to clearly favour an SLSN type I, and plausible power sources such as the radioactive decay of 56Ni and the spin-down of a magnetar are compared to the data. We find that the magnetar model yields a good fit to the observations with the following parameters: a magnetic field B = 1.4 ± 0.3 × 1014 G, spin period of P = 6.0 ± 0.1 ms, and ejecta mass $M_{\mathrm{ ej}} = 11.9^{+4.8}_{-6.4} \,\mathrm{ M}_{\odot }$.
Epigenetic regulation of epithelial to mesenchymal transition: a trophoblast perspective
Authors: Choudhury Jaganmoy , Pandey Deepak , Chaturvedi Pradeep Kumar , Gupta Surabhi 
Published: April 2022

Abstract
Epigenetic changes alter the expression of genes at both pre- and post-transcriptional levels without changing their DNA sequence. Accumulating evidence suggests that such changes can modify cellular behavior and characteristics required during development and in response to various extracellular stimuli. Trophoblast cells develop from the outermost trophectoderm layer of the blastocyst and undergo many phenotypic changes as the placenta develops. One such phenotypic change is differentiation of the epithelial natured cytotrophoblasts into the mesenchymal natured extravillous trophoblasts. The extravillous trophoblasts are primarily responsible for invading into the maternal decidua and thus establishing connection with the maternal spiral arteries. Any dysregulation of this process can have adverse effects on the pregnancy outcome. Hence, tight regulation of this epithelial–mesenchymal transition (EMT) is critical for successful pregnancy. This review summarizes the recent research on the epigenetic regulation of the EMT occurring in the trophoblast cells during placental development. The functional significance of chemical modifications of DNA and histone, which regulate transcription, as well as non-coding RNAs, which control gene expression post-transcriptionally, is discussed in relation to trophoblast biology.
God, God’s Perfections, and the Good: Some Preliminary Insights from the Catholic-Hindu Encounter
Authors: S. J. Francis X Clooney 
Published: April 2022

Abstract
There are good reasons for envisioning a global discourse about God, premised necessarily agreed upon perfections considered to be by definition proper to God, and for thinking through the implications of our understanding of God for morality. Philosophically, it makes sense to hold that claims about omnipotence, omniscience, and other superlative perfections are indeed maximal, and define “God” wherever the terminology of divine persons is taken up. Religiously too, it makes sense to assert that a deity possessed of perfections is not just the deity of one’s own tribe or religion, but also the deity of the whole world, whether acknowledged as such or not. This essay delves into the larger set of rich complexities by three moves. First, I look into a single extended historical case of the extension of the discourse about God beyond the Christian West, the discourse on God proffered by Western Jesuit missionaries in India from the sixteenth to twentieth centuries. Second, I place next to that Jesuit learning the instance of a famed Hindu theologian’s discourse on God, God’s perfections, and their moral implications. Third, I briefly step back and assess the dangers and fruitful prospects inherent in thinking about God and morality in an interreligious context.
Survival, symptoms and hospitalization of older patients with advanced chronic kidney disease managed without dialysis
Authors: Chou Angela , Li Chenlei , Farshid Sanjay , Hoffman Anna , Brown Mark 
Published: April 2022

ABSTRACT

Background
Shared decision-making (SDM) is important when considering whether an older patient with advanced chronic kidney disease (CKD) should be managed with dialysis or conservative kidney management (CKM). Physicians may find these conversations difficult because of the relative paucity of data on patients managed without dialysis.

Methods
This prospective observational study was conducted in a unit supported by a multidisciplinary Kidney Supportive Care (KSC) programme, in a cohort of 510 patients (280 CKM and 230 dialysis) ≥65 years of age with CKD stages 4 and 5. Survival was evaluated using logistic regression and Cox proportional hazards models. Linear mixed models were utilized to assess symptoms over time.

Results
CKM patients were older (mean 84 versus 74 years; P &lt; .001) and almost 2-fold more likely to have three or more comorbidities (P &lt; .001). The median survival of CKM patients was lower compared with dialysis from all time points: 14 months [interquartile range (IQR) 6–32] versus 53 (IQR 28–103) from decision of treatment modality or dialysis start date (P &lt; .001); 15 months (IQR 7–34) versus 64 (IQR 30–103) from the time the estimated glomerular filtration rate (eGFR) was ≤15 mL/min/1.73 m2 (P &lt; .001); and 8 months (IQR 3–18) versus 49 (19–101) from eGFR ≤10 mL/min/1.73 m2. A total of 59% of CKM patients reported an improvement in symptoms by their third KSC clinic visit (P &lt; .001). The rate of unplanned hospitalization was 2-fold higher in the dialysis cohort.

Conclusions
CKM patients survive a median of 14 months from the time of modality choice and have a lower rate of hospitalization than dialysis patients. Although the symptom burden in advanced CKD is high, most elderly CKM patients managed through an integrated KSC programme and can achieve improvement in their symptoms over time. These data might help with SDM.
Attentional Bias in Non–Smoking Electronic Cigarette Users: An Eye-Tracking Study
Authors: Fitzpatrick Chelsea L , Kim Hyoun S , Sears Christopher R , McGrath Daniel S 
Published: April 2022

Abstract

Introduction
This study examined attentional bias (AB) to e-cigarette cues among a sample of non–smoking daily e-cigarette users (n = 27), non–smoking occasional e-cigarette users (n = 32), and control participants (n = 61) who did not smoke or use e-cigarettes. The possibility that e-cigarette users develop a transference of cues to traditional cigarettes was also examined.

Methods
AB was assessed using a free-viewing eye-gaze tracking methodology, in which participants viewed 180 pairs of images for 4 seconds (e-cigarette and neutral image, e-cigarette and smoking image, smoking and neutral image).

Results
Daily and occasional e-cigarette users attended to pairs of e-cigarette and neutral images equally, whereas non–users attended to neutral images significantly more than e-cigarette images. All three groups attended to e-cigarette images significantly more than smoking images, with significantly larger biases for e-cigarette users. There were no between-group differences in attention to pairs of smoking and neutral images. A moderation analysis indicated that for occasional users but not daily users, years of vaping reduced the bias toward neutral images over smoking images.

Conclusions
Taken together, the results indicate that the e-cigarette users exhibit heightened attention to e-cigarettes relative to non–users, which may have implications as to how they react to e-cigarette cues in real-world settings. AB for e-cigarettes did not transfer to traditional cigarette cues, which indicates that further research is required to identify the mechanisms involved in the migration of e-cigarettes to traditional cigarettes.

Implications
This study is the first attempt to examine attentional biases for e-cigarette cues among non–smoking current e-cigarette users using eye-gaze tracking. The results contribute to the growing literature on the correlates of problematic e-cigarette use and indicate that daily and occasional e-cigarette use is associated with attentional biases for e-cigarettes. The existence of attentional biases in e-cigarette users may help to explain the high rate of failure to quit e-cigarettes and provides support for the utility of attentional bias modification in the treatment of problematic e-cigarette use.