bluuebunny/crossref_metadata_2025_split huggingface dataset:
C70. Performing Percutaneous Coronary Intervention in Dextrocardia: A Case Report
Authors: Syafar R H , Khairat M , Syukri M 
Published: April 2022

Abstract

Background
Dextrocardia is defined as the heart location in the right hemithorax with the apex pointing inferiorly and to the right. Performing percutaneous coronary intervention (PCI) in patient with dextrocardia can be difficult and requires some modification.

Case Summary
A 55-years old male with chest pain 3 hours before admission, apex in right side, a chest X-ray confirm the heart in the right hemithorax, electrocardiogram (ECG) was consistent with dextrocardia and showed inferior ST-segment elevation myocardial infarction (STEMI). We performed primary PCI with femoral access. During coronary angiography, it was a challenge to engage the diagnostic catheter to both of ostium right and left coronary artery. Coronary angiography showed total occlusion in the proximal of right coronary artery (RCA). We inversed the engagement technique and radiological angles for RCA from the left anterior oblique 35º to the right anterior oblique 30º and finally revascularization could be done easier.

Discussion
Performing PCI in patient with dextrocardia can be challenging. Inversion the engagement technique and radiological angles and views will give an advantage to the operator for imaging and doing intervention. Using image reversal technology is also help to get the image like a normal position.
C83. Recurrent Syncope in Isolated Right Ventricular Non-Compaction Cardiomyopathy: A Case Report
Authors: Chandra S , Lukito A A , Hutabarat H , Fernandes R A P 
Published: April 2022

Abstract
Isolated right ventricular non-compaction cardiomyopathy (iRVNC) is a rare disease, and often under diagnosed. The patients might come with right heart failure, ventricular arrhythmias and systemic embolism. A 64 –yo female presented with episodes of recurrent syncope. There is thickened trabecular on apical right ventricular (RV), moderate tricuspid regurgitation and moderate probability of pulmonary hypertension on echocardiography. Furthermore, cardiac MRI on this patient confirned hypertrabeculated and dilatation of RV, spongiform appearance of the RV apical, non-compacted (NC) thickness of the RV was 23.5 mm at the apical level with compacted thickness (C) of 2 mm (NC to C ratio 11,7), hypertrophic moderator band, and dilatation RA and global hypokinetic and decreased function of RV. Hence, the diagnosis was an isolated right ventricular non-compaction cardiomyopathy, without LV involvement. The medication given including sildenafil, nebivolol, spironolactone, digoxin and edoxaban. Lesson learned from this case, syncope might be one of iRVNC symptoms. Multiple modalities could be needed for diagnostic confirmation for patients with syncope. Echocardiography as a diagnostic tool is useful to find prominent trabeculations and when NC/C ratio &gt;2. If the echocardiographic findings were inconclusive, cardiac MRI was could be performed for better discrimination between compact and non-compact inner and outer layers of myocardium with NC/C ratio &gt; 2,3.
C85. Right heart failure due to chronic thromboembolic pulmonary hypertension in systemic lupus erythematosus patient: a case report
Authors: Saputra B M I , Darma K S S 
Published: April 2022

Abstract

Background
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with varying clinical manifestations and high risk of thrombosis. Chronic Thromboembolic Pulmonary Hypertension (CTEPH) as late complication of acute pulmonary embolic sometimes occured in SLE patients and in advanced condition it can manifest as right heart failure.

Case Summary
A female, 29 years old with complaints of bilateral ankle oedema and bloated stomach, as well as dyspneu on effort occurred progressively since approximately 4 months. These complaints were also accompanied by hair loss and redness on both cheeks. Physical examination revealed increased jugular venous pressure, systolic murmur in left lower sternal border, ascites, hepatomegaly, and bilateral ankle oedema. Echocardiography revealed dilated right atrium and right ventricle (RV), decreased RV systolic function, severe tricuspid regurgitation, and distended inferior vena cava. Computed tomography (CT) pulmonary angiography showed filling defect in the left pulmonary artery. Lab examination showed an increase in D-dimer, ANA titer &gt;1: 1000, and lupus anticoagulant ratio 1.59. Diuretics therapy, anticoagulant, corticosteroid, and immunosuppressant were given to this patient. Right heart function was improved following the treatment.

Discussion
The increased risk of thrombosis in this case is related to several factors, including: antiphospholipid antibodies, inflammation and disease activity. CTEPH is formed as a result of poor resolution of the thrombus in the pulmonary arteries, resulting in fibrosis of residual thrombotic material that can impede blood flow. Increased intrapulmonary pressure due to pulmonary vascular obstruction causes RV remodeling and dysfunction.
C86. Secondary Prophylaxis For Rheumatic Heart Disease During The Pandemic Era: A Case Report
Authors: Ramadhan G F , Supriadi E 
Published: April 2022

Abstract

Background
Rheumatic heart disease (RHD) is heart diseases results from recurrent episodes of acute rheumatic fever (ARF). It often occurs in developing countries and its pathogenesis is not clearly understood. RHD can be controlled with prophylaxis that requires patients to visit healthcare facility regularly. However, the current pandemic condition is a challenge for patients to receive routine treatment and evaluation.

Case Summary
A 17-years-old girl comes to emergency room with complaints of shortness of breath with mark limitation of physical activity 3 days prior to admission. The patient also complaint with joint pain and leg swelling. She was diagnosed Rheumatic Heart Disease and received prophylactic penicillin injections every month. However, since the pandemic, She do vice versa. In physical examination was found pansystolic murmur on aortic valve and bilateral lower extremity edema. Echocardiography showed moderate mitral regurgitation and mild aortic regurgitation. This patient was hospitalized and treated with benzathine penicillin G, prednisone, aspirin, furosemide and captopril.

Discussion
Management of ARF includes eradication cause of infection, treat complications, and secondary prevention. Administration of secondary prophylaxis is useful for reduce new bacterial strains that can cause recurrent acute or chronic attacks. First line of secondary prophylaxis for ARF is intramuscular benzathine penicillin G that given per month. In this current pandemic conditions, patients are expected to continue prophylaxis therapy and follow up the disease with using pandemic health protocols.
C94. The characteristics and outcome of pediatric patients with congenital heart disease (CHD) infected by coronavirus disease 2019 (COVID-19) between march 2020 to february 2021 at sanglah hospital: a case series of 12 patients
Authors: Ambara G S , Gunawijaya E , Yantie N P V K 
Published: April 2022

Abstract

Background
Coronavirus disease 2019 (COVID-19) has a complex connection to cardiovascular system. COVID-19 infection has been proven to cause significant dysfunction in lung, heart, and endothelial cells. Therefore, patients with complex congenital heart lesions have a high risk of developing severe complications and worse outcomes. This paper aims to determine the characteristics and outcome of pediatric congenital heart disease (CHD) patients infected by COVID-19 at Sanglah hospital.

Case Summary
Within the period of March 2020 to February 2021, there were 12 cases of pediatric CHD accompanied by COVID-19 infection, which consists of 8 females and 4 males within the age of 6 days to 18 years. Based upon symptomatic CHD classification, there were 4 cyanotic CHD cases and 1 acyanotic case, respiratory problems were reported in all 5 cases. These are pneumonia in 4 cases and respiratory distress caused by hyaline membrane disease (HMD) in 1 case. 2 cases require mechanical ventilation. The outcome of all inpatient cases were favorable.

Discussion
To date, there are only few scientific evidence detailing how COVID-19 affects CHD. We were unable to calculate the correlation analysis since the population sample was too small. The most severe cases that requires mechanical ventilation had comorbidities in the form of malnutrition and down syndrome. From the perspective of pathophysiology, one of the most important factor determining outcome was the severity of CHD itself. Other contributing factors were COVID-19’s destructive effect on heart tissue and co-infection by other microorganism.
C96. The First Percutaneous Transvenous Mitral Commissurotomy guided by Three Dimensional Transesophageal Echocardiography in Haji Adam Malik General Hospital Medan
Authors: Indra R K , Lubis A C , Ardini T W , Hasan H 
Published: April 2022

Abstract

Background
Percutaneous Transvenous Mitral Commissurotomy (PTMC) has become the treatment of choice for patients with mitral stenosis. PTMC guided by three-dimensional Transesophageal Echocardiography (3D-TEE) promise of greater safety and efficacy.

Case Summary
We report a 29-year-old woman who came to our outpatient clinic with shortness of breath as a chief complaint for the past three months. ECG depicted sinus rhythm. Transthoracic Echocardiography (TTE) and 3D-TEE showed severe mitral stenosis with MVA planimetry: 0.8 cm2, MV mean PG 12 mmHg, MV PHT 403 ms, Wilkins score was 4 and no thrombus was found. Therefore, we decided to do PTMC. We successfully done the antegrade transseptal puncture by fluoroscopy guided by two-dimensional (2D) TEE . Then, we used Inoue-balloon catheter No. 24 to dilate the mitral valve. Afterthat, we did 3D-TEE evaluation of the mitral valve area and it showed a significant improvement, with MVA 3D planimetry: 2.0 cm2 and MV mean PG: 4 mmHg and we found moderate mitral regurgitation (MR VC 0.4 cm, MR PISA: 0.3 cm), so we decided to end the procedure.

Discussion
In this case, the PTMC procedure was carried with 2D and 3D-TEE guiding, where process run more easily because interventionist can ensure the targeted site during transeptal puncture, navigation to the mitral valve and post inflation inspection. 3D-TEE guiding can also directly ensure the success of PTMC in real time by evaluating the MVA planimetry (pre and post PTMC) and the mitral regurgitation.
C98. The Role of Echocardiography as a Diagnostic Modality in Pulmonary Embolism in Intensive Care
Authors: Alaydrus S Q , Munirwan H 
Published: April 2022

Abstract

Background
Pulmonary embolism (PE) is the third most frequent cause of death in the world. In epidemiological studies, annual incidence rates for PE range from 39-115 per 100 000 population. Acute PE interferes with both circulation and gas exchange. Right ventricular (RV) failure due to acute pressure overload is considered the primary cause of death in severe PE.

Case Summary
A 70-year-old female patient presents to the emergency room of RSUDZA with complaints of typical chest pain that has been experienced since 3.5 hours before admission. In the emergency department, patients with obesity status with a general condition are weak and agitated. Physical examination found within normal limits. From laboratory test, there were leukocytosis and increasing of D-Dimer. From ECG we found McGinn White Sign. Based on echocardiography, we found RV/LV basal ratio &gt; 1 accompanied by Mc Connel sign and decreased right ventricular systolic function.

Discussion
Echocardiography is one of diagnostic modalities that is very useful for making a diagnosis, where the use of echocardiography is more accessible than computer tomography (CT) as the gold standard. In this case, by using echocardiography especially in intensive rooms, the diagnosis of pulmonary embolism can be established faster in high risk patients. The prognosis of pulmonary embolism is very dependent on the speed at which the diagnosis is made.
C101. Toxoplasmic Myocarditis in Immunocompetent Patient: A Rare Case Report
Authors: Suryawan Willy , Siswanto Bambang Budi , Kurniawan Agnes 
Published: April 2022

Abstract

Background
Toxoplasmosis is the most frequent protozoan infection among human. Primary acquired infections in immuno-competent hosts are usually asymptomatic or may cause only slight, self-resolving and not pathognomonic symptoms. Although often considered as benign, acute infections in young healthy adults can lead to heart inﬂammation, including acute myocarditis.

Case Illustration
A 28-year-old man was admitted to the hospital with a chief complaint of flu-like illness with intermittent fever and sharp chest pain. His physical examination was unremarkable. The electrocardiography showed no significant ST-T changes. His laboratory investigations gave the following results: elevated level of HsTrop T (571 ng/L; reference: &lt;4 ng/dL), SGOT (112 U/L; reference: &lt;41 U/L), SGOT (114 U/L; reference: &lt;41 U/L). The echocardiography showed lateral pericardial thickening with preserved left ventricular function. He underwent cardiac MRI (cMRI). The cMRI showed myocardial edema without ischemic scar. The serological test is positive for recent Toxoplasma infection. Therefore, the patient was diagnosed with acute toxoplasmic myocarditis and subsequently treated with corticosteroid, ACE-I, beta blocker, and a combination of pyrimethamine and clindamycin. His symptoms was improved.

Discussion
We reported a case of an acute toxoplasmic myocarditis in an immunocompetent young man. This case demonstrates the importance of determining the etiology of myocarditis in order to start an appropriate therapy and prevent possible sequeale.
An artificial coculture fermentation system for industrial propanol production
Authors: Hocq Rémi , Sauer Michael 
Published: April 2022

Abstract
Converting plant biomass into biofuels and biochemicals via microbial fermentation has received considerable attention in the quest for finding renewable energies and materials. Most approaches have so far relied on cultivating a single microbial strain, tailored for a specific purpose. However, this contrasts to how nature works, where microbial communities rather than single species perform all tasks. In artificial coculture systems, metabolic synergies are rationally designed by carefully selecting and simultaneously growing different microbes, taking advantage of the broader metabolic space offered by the use of multiple organisms. 1-propanol and 2-propanol, as biofuels and precursors for propylene, are interesting target molecules to valorize plant biomass. Some solventogenic Clostridia can naturally produce 2-propanol in the so-called Isopropanol–Butanol–Ethanol (IBE) fermentation, by coupling 2-propanol synthesis to acetate and butyrate reduction into ethanol and 1-butanol. In this work, we hypothesized propanoate would be converted into 1-propanol by the IBE metabolism, while driving at the same time 2-propanol synthesis. We first verified this hypothesis and chose two propionic acid bacteria (PAB) strains as propanoate producers. While consecutive PAB and IBE fermentations only resulted in low propanol titers, coculturing Propionibacterium freudenreichii and Clostridium beijerinckii at various inoculation ratios yielded much higher solvent concentrations, with as much as 21 g/l of solvents (58% increase compared to C. beijerinckii monoculture) and 12 g/l of propanol (98% increase). Taken together, our results underline how artificial cocultures can be used to foster metabolic synergies, increasing fermentative performances and orienting the carbon flow towards a desired product.
An interolog-based barley interactome as an integration framework for immune signaling
Authors: Velásquez-Zapata Valeria , Elmore James Mitch , Fuerst Gregory , Wise Roger P 
Published: April 2022

AbstractThe barley MLA nucleotide-binding leucine-rich-repeat (NLR) receptor and its orthologs confer recognition specificity to many fungal diseases, including powdery mildew, stem-, and stripe rust. We used interolog inference to construct a barley protein interactome (Hordeum vulgare predicted interactome, HvInt) comprising 66,133 edges and 7,181 nodes, as a foundation to explore signaling networks associated with MLA. HvInt was compared with the experimentally validated Arabidopsis interactome of 11,253 proteins and 73,960 interactions, verifying that the 2 networks share scale-free properties, including a power-law distribution and small-world network. Then, by successive layering of defense-specific “omics” datasets, HvInt was customized to model cellular response to powdery mildew infection. Integration of HvInt with expression quantitative trait loci (eQTL) enabled us to infer disease modules and responses associated with fungal penetration and haustorial development. Next, using HvInt and infection–time–course RNA sequencing of immune signaling mutants, we assembled resistant and susceptible subnetworks. The resulting differentially coexpressed (resistant – susceptible) interactome is essential to barley immunity, facilitates the flow of signaling pathways and is linked to mildew resistance locus a (Mla) through trans eQTL associations. Lastly, we anchored HvInt with new and previously identified interactors of the MLA coiled coli + nucleotide-binding domains and extended these to additional MLA alleles, orthologs, and NLR outgroups to predict receptor localization and conservation of signaling response. These results link genomic, transcriptomic, and physical interactions during MLA-specified immunity.
Effect of High-Intensity Power Training on Cognitive Function in Older Adults With Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Study
Authors: Zhao Ren Ru , Mavros Yorgi , Meiklejohn Jacinda , Anderberg Kylie A , Singh Nalin , Kay Shelley , Baker Michael K , Wang Yi , Climstein Mike , O’Sullivan Anthony , De Vos Nathan , Baune Bernhard T , Blair Steven N , Simar David , Fiatarone Singh Maria A 
Published: April 2022

AbstractWe sought to determine the effects of 12 months of power training on cognition, and whether improvements in body composition, muscle strength, and/or aerobic capacity (VO2peak) were associated with improvements in cognition in older adults with type 2 diabetes (T2D). Participants with T2D were randomized to power training or low-intensity sham exercise control condition, 3 days per week for 12 months. Cognitive outcomes included memory, attention/speed, executive function, and global cognition. Other relevant outcomes included VO2peak, strength, and whole body and regional body composition. One hundred and three adults with T2D (mean age 67.9 years; standard deviation [SD] 5.9; 50.5% women) were enrolled and analyzed. Unexpectedly, there was a nearly significant improvement in global cognition (p = .05) in the sham group relative to power training, although both groups improved over time (p &lt; .01). There were significant interactions between group allocation and body composition or muscle strength in the models predicting cognitive changes. Therefore, after stratifying by group allocation, improvements in immediate memory were associated with increases in relative skeletal muscle mass (r = 0.38, p = .03), reductions in relative body fat (r = −0.40, p = .02), and increases in knee extension strength were directly related to changes in executive function (r = −0.41, p = .02) within the power training group. None of these relationships were present in the sham group (p &gt; .05). Although power training did not significantly improve cognition compared to low-intensity exercise control, improvements in cognitive function in older adults were associated with hypothesized improvements in body composition and strength after power training.
Coping mechanisms and burnout among checkpoint soldiers in the IDF: a salutogenic perspective
Authors: Atias Dor , Machluf-Biton Maayan , Lior Yotam , Ohayon Ofir , Antonovsky Avishai 
Published: April 2022

Summary
While many military positions are characterized by rigorous routines and long-hour shifts, some positions also require the practice of sensitivity and empathy alongside diligence and attention. Prolonged exposure to such conditions may promote emotional exhaustion, depersonalization and diminished self-accomplishment perception, all part of work-related burnout which may affect soldiers’ ability to practice their duty. The service in the Israel Defense Forces (IDF) checkpoint unit is an example of such conditions due to the soldiers’ constant interaction with civilian population. In this questionnaire-based cross-sectional study which included 404 responders from the IDF checkpoint battalions, we examined the effects of demographical, situational and personal variables on soldiers’ burnout. A hierarchical multivariate linear regression (R2 = 0.47) identified sense of coherence, the core concept in the salutogenic model of health, as the most prominent protective factor, followed by service motivation and perceived well-being (WB). Taken together, the results revealed several factors associated with military work-related burnout. These findings can serve as a base for burnout prevention programs, which may potentially improve not only the soldiers’ WB but also the interfaces between military and civilian populations.
Transfer of Anolis Locomotor Behavior Across Environments and Species
Authors: Foster Kathleen Lois , Selvitella Alessandro Maria 
Published: April 2022

Abstract
Arboreal animals must learn to modulate their movements to overcome the challenges posed by the complexity of their heterogeneous environment, reduce performance failure, and survive. Anolis lizards are remarkable in the apparent ease with which they conquer this heterogeneity, demonstrating an impressive ability to modulate their locomotor behavior to maintain stable locomotion on widely disparate surfaces. Significant progress has been made towards understanding the impact of substrate structure on the behavioral plasticity of arboreal species, but it is unclear whether the same strategies employed to shift between substrates in one context can be employed to shift between those same substrates in a new context. Is the kinematic shift between broad and narrow perches achieved in a similar way on different inclines? Do all species within an ecomorph make similar adjustments? Here, we analyze the limb movements of two trunk-crown Anolis ecomorphs, Anolis carolinensis and Anolis evermanni, running on 6 different surfaces (3 inclinations × 2 perch diameters), from the perspective of Transfer Learning. Transfer learning is that field of machine learning which aims at exploiting the knowledge gained from one task to improve generalization about another, related task. In our setting, we use transfer learning to show that the strategies employed to improve locomotor stability on narrow perches are transferred across environments with different inclines. Further, behaviors used on vertical inclines are shared, and thus transfer well, across perch diameters whereas the relationship between horizontal and intermediate inclines change on different perch diameters, leading to lower transfer learning of shallow inclines across perch diameters. Interestingly, the best incline for transfer of behavior differs between limbs: forelimb models learn best from the vertical incline and hind limb models learn best from horizontal and intermediate inclines. Finally, our results suggest both that subtle differences exist in how A. carolinensis and A. evermanni adjust their behaviors in typical trunk-crown environments and that they may have converged on similar strategies for modulating forelimb behavior on vertical surfaces and hind limb behavior on shallow surfaces. The transfer of behavior is analogous to phenotypic plasticity, which likely plays a key role in the rapid adaptive evolution characteristic of Anolis lizards. This work is an example of how modern statistical methodology can provide an interesting perspective on new biological questions, such as on the role and nuances of behavioral plasticity and the key behaviors that help shape the versatility and rapid evolution of Anolis lizards.