Day :
Keynote Forum
Khatijah Lim Abdullah
University of Southampton UK
Keynote: Clinical decision-making styles and critical thinking skills among general care nurses in Malaysia
Time : 9.45-10.30
Biography:
Khatijah Lim Abdullah has completed her Doctorate from the University of Southampton UK. She is currently a Professor in Nursing in University of Malaya, Malaysia and Vice President for Qualitative Research Association Malaysia. She has published more than 50 papers in reputed journals and is presently the Chief Editor for Malaysian Journal of Qualitative Research.
Abstract:
The aim of this study is to assess the relationships between critical thinking skills and types of clinical decision-making among general care nurses in Malaysia. This quantitative descriptive correlational study was conducted in nine public hospitals from Peninsular Malaysia. Five hundred and forty nine nurses recruited via multistage cluster sampling, completed the demographic data questionnaire, Health science reasoning test (HSRT) and 24-item Nursing Decision-making instrument (24-NDM). The results of the study show that nurses’ average HSRT score was 13.8±3.4 which meant the majority of them failed to manifest critical thinking skills. In addition, the results show that 65.2% of the nurses studied were more inclined in making quasi-rational decisions, with 24.6% inclined towards analytical-systematic decisions, whereas only 10.2% displayed intuitive-interpretive decisions (
=268, df=2, p<0.001). With multinomial logistic regression, only education qualification is significantly associated with the nurses’ critical thinking score, whereas years of working experience and education qualification significantly predicted types of clinical decision nurses made (p<0.001). Finally, there is significant positive relationship between critical thinking skills and clinical decision-making, which accentuates the positive results yielded from previous studies. This finding provides further evidence that critical thinking and clinical decision-making are both interrelated. Since clinical decision-making cannot be easily taught in nursing curricula, cultivating critical thinking among nursing students perhaps is the right remedy for producing future nurses who can make effective clinical decisions
- Heart Disease and Failure,Diabetes, Obesity & Stroke,Pediatric Cardiology
Location: singapore
Session Introduction
Veena Dhawan
Postgraduate Institute of Medical Education and Research, India
Title: Aberrant DNA methylation of M1-macrophage genes in coronary artery disease
Biography:
Veena Dhawan has completed her PhD from PGIMER and did Post-doctoral Research at Minneapolis USA and Post-graduate Institute of Medical Education and Research, Chandigarh, India. At present, she is working as a Professor in the Department of Experimental Medicine and Biotechnology at PGIMER a National Institute of repute. She has published around 90 papers in reputed journals and written around seven book chapters.
Abstract:
Macrophage heterogeneity within atherosclerotic lesions has attracted much interest owing to the importance of balance between M1 and M2 population. Though, it remains unknown how macrophage heterogeneity is regulated. Moreover, the regulation of macrophage polarization and activation also involve DNA methylation. However, it remains unknown which genes are directly regulated by DNA methylation. The aim of the study was to assess the gene-specific promoter DNA methylation status of M1/ M2 macrophage polarization markers STAT1, STAT6, MHC2, IL12b, iNOS, JAK1, JAK2 and SOCS5 in peripheral blood mononuclear cells of CAD patients. A casecontrol study was performed with 25 CAD patients and 25 controls to investigate the gene-specific promoter DNA methylation status using MS-HRM analysis. Our data indicates that there was a clear-cut difference in the pattern of gene-specific promoter DNA methylation of above mentioned genes in CAD patients as compared to controls. A consistent hypomethylated pattern was observed for most of the samples including both CAD patients and controls, which was heterogeneous DNA methylation as evident by their melting profiles. A significant difference was observed between the mean percentage methylation of STAT1, IL12b, MHC2, iNOS, JAK1 and JAK2 in CAD patients and control subjects. Our data showed that MS-HRM assay is a rapid and inexpensive method for qualitatively investigation and identification of aberrant gene-specific promoter DNA methylation changes in CAD. Since, monocytes and macrophages play a significant role in atherosclerosis, we propose that epigenetic markers including gene-specific promoter DNA methylation based on monocyte/macrophage might aid as diagnostic markers or drug targets for clinical application. Therefore, skewing the M1/M2 balance towards a more preferable phenotype through DNA methylation-related interventions may offer novel possibilities for atherosclerotic disease management.
Veena Dhawan
Postgraduate Institute of Medical Education and Research, India
Title: Aberrant DNA methylation of M1-macrophage genes in coronary artery disease
Biography:
Veena Dhawan has completed her PhD from PGIMER and did Post-doctoral Research at Minneapolis USA and Post-graduate Institute of Medical Education and Research, Chandigarh, India. At present, she is working as a Professor in the Department of Experimental Medicine and Biotechnology at PGIMER a National Institute of repute. She has published around 90 papers in reputed journals and written around seven book chapters.
Abstract:
Macrophage heterogeneity within atherosclerotic lesions has attracted much interest owing to the importance of balance between M1 and M2 population. Though, it remains unknown how macrophage heterogeneity is regulated. Moreover, the regulation of macrophage polarization and activation also involve DNA methylation. However, it remains unknown which genes are directly regulated by DNA methylation. The aim of the study was to assess the gene-specific promoter DNA methylation status of M1/ M2 macrophage polarization markers STAT1, STAT6, MHC2, IL12b, iNOS, JAK1, JAK2 and SOCS5 in peripheral blood mononuclear cells of CAD patients. A casecontrol study was performed with 25 CAD patients and 25 controls to investigate the gene-specific promoter DNA methylation status using MS-HRM analysis. Our data indicates that there was a clear-cut difference in the pattern of gene-specific promoter DNA methylation of above mentioned genes in CAD patients as compared to controls. A consistent hypomethylated pattern was observed for most of the samples including both CAD patients and controls, which was heterogeneous DNA methylation as evident by their melting profiles. A significant difference was observed between the mean percentage methylation of STAT1, IL12b, MHC2, iNOS, JAK1 and JAK2 in CAD patients and control subjects. Our data showed that MS-HRM assay is a rapid and inexpensive method for qualitatively investigation and identification of aberrant gene-specific promoter DNA methylation changes in CAD. Since, monocytes and macrophages play a significant role in atherosclerosis, we propose that epigenetic markers including gene-specific promoter DNA methylation based on monocyte/macrophage might aid as diagnostic markers or drug targets for clinical application. Therefore, skewing the M1/M2 balance towards a more preferable phenotype through DNA methylation-related interventions may offer novel possibilities for atherosclerotic disease management.
Cindy Rodrigues Cleto
Newcastle University, UK
Title: Defective cilia in endocardial derived cells; A cause for congenital heart defects?
Biography:
Cindy Rodrigues Cleto is a sixth year Medical Student at the University of Liverpool, UK. She has completed her MReS in Cardiovascular Science at the University of Newcastle where she carried out this research.
Abstract:
Introduction: Primary cilia on endocardial cells could prove to be a cause of congenital heart defects. Endocardial cells mainly contribute to the outflow tract (OFT) and atrioventricular (AV) endocardial cushion; later developing into the four heart valves. Knocking out IFT88 creates abnormal primary cilia and in turn causes cardiac malformations.
Aims: The aims of this study were to establish the spatiotemporal expression of primary cilia on endocardial derived cells; and by using an IFT88 mouse model, to discover if defecting to the primary cilia in endocardial derived cells causes an abnormal cardiac phenotype?
Methods: For the spatiotemporal expression of primary cilia, Tie2Cre positive mouse embryos of age’s e10.5-e12.5 were stained with anti-green fluorescent protein and acetylated tubulin to show the endothelial cells and primary cilia respectively. For the IFT88 mouse model, three mutants were collects at e15.5; two were hematoxylin and eosin stained to look at histology and one was stained with acetylated tubulin to show any defect in the primary cilia.
Results: The spatiotemporal expression of primary cilia mainly highlighted that there is an abundance of cilia in the OFT and AV endocardial cushions at e10.5 and e11.5 but this significantly drops by e12.5. The IFT88 mouse model showed that knocking out IFT88 significantly decreases the number of primary cilia in mutants, causing cardiac malformations including atrio-ventricular septal defects and dysplastic mitral and tricuspid valves.
Conclusion: Primary cilia are present in the endocardial derived cells at earlier time points. Knocking out IFT88 does produce defective cilia that lead to cardiac malformations.
Flavio Burgarella
Heart Friends Around The World, Italy
Title: Heart friends around the world get heart better
Biography:
Flavio Burgarella is a Cardiologist and Physiatrist, Head of the Cardiac Rehabilitation Center of San Pellegrino Terme, in the province of Bergamo, Italy. He is registered with the National Associations of Journalists. He is the Founder and Executive Director of Heart Friends Around The Word, (www.hfatw.org) international association, affiliated with the World Heart Federation, whose aim is to promote the prevention and rehabilitation of cardiovascular diseases in developing nations. He is the Founder and Chairman of Burgarella Quantum Healing (BQH) (www.quantummind.eu ) with the aim to promote the helping relationship between Science and Consciousness. He is an Honorary Member of the Russian Federation of Cardiology and the Cuban Atherosclerosis Society. He got for his activity the Sodalem Honoris Causa by the Society of MD of the Slovak Republic. He has published several books on health education and five books of poetry. He organized several campaigns to promote health through physical activity, including three jogging tour of Italy in relay. He is enrolled at the Science and Consciousness Group of the Faculty of Psychology of the University of Padua and collaborates with Egocreanet at the Incubator of the University of Florence (Italy)
Abstract:
Heart Friends Around The World (www.hfatw.org) Get Heart Better is a psycho - energetic - informational approach based on the brain heart consistency through breathing, awareness and BQH transformation. HFATW Get Heart Better uses the research of Heart Math (www.heartmath.com) and the scientific exploration of Quantum Mind (www.quantummind.eu) through the Burgarella Quantum Healing (BQH) method. HFATW Get Heart Better is a program that provides free training for cardiologists participating in the association and a training for health personnel who will take care of the management of the patient with myocardial infarction or operated to the heart in the first and second phase of cardiological rehabilitation. It is also useful in the clinical stability phase following a heart failure. It has been demonstrated its validity in the control of mental and emotional stress and in increasing, through the brain heart consistency, the heart rate variability, measurable and referable to the health of the heart. Once the consistency of the heart is obtained, it is possible to increase the resilience to the state of illness through awareness, mainly obtained through meditation on the present moment and the acceptance without judgment of cenesthetic, auditory perceptions and compulsive thoughts that may appear during practice. The part of scientific exploration related to Quantum Mind is based on the ability of operators to perceive the biofields with the second attention, to enter the state of awareness of non-awareness, such as the one existing in the space between two thoughts and to make the transformation on the basis of intention, an innovative process based on the ability to have experience of bringing the principles of quantum physics into clinical practice. With the appropriate training all the health workers involved in the first and second phase of rehabilitation can achieve the desired results. The foundation of the HFATW Get Heart Better program is based on heart-centered breathing while feelings of acceptance about appreciation, gratitude, compassion, and healing are felt. After a short time of practice, you automatically enter the "field of the heart" that can be appreciated, with the BQH perception, like an oscillatory movement, a cradle, consisting of two points at the antipodes, represented by the oscillation relative to the systolic and diastolic movement of the heart. The perception of this field leads to a slight altered state of consciousness, to the increase of HR Variability and to the heart - brain coherence. When we are aware of the field of the heart, we exploit the state of coherence present here, which corresponds to the coherence of the “unified field”. The field of the heart has a toric shape and represents a torsion field that has the property to propagate in space and to interfere with the material objects for the exchange of information. Thus, dwelling in the field of the heart dwells in a quantum field, in a reality with unlimited potential. This field also has morphogenetic characteristics, as it is located inside and around a morphic unit, at the heart, which organizes its characteristic structure and activity. The field of the heart with morphogenetic characteristics has its own intrinsic memory which, if taken up, can be useful in the morphogenesis process, in making its contribution to the regeneration of cardiac cells.
Yin Hua Zhang
Seoul National University, Republic of Korea
Title: S-Nitrosylation of transglutaminase 2 impairs fatty acid-stimulated contraction in hypertensive cardiomyocytes
Biography:
Yin Hua Zhang is a Cardiovascular Physiologist evaluating cardiac metabolism in health and diseased hearts. She has been working on nitric oxide and redox-regulation of myocardial contractility and cellular mechanisms. She is now focusing on obesity and hypertension and cardiovascular remodeling.
Abstract:
Transglutaminase 2 (TG2) is a calcium-dependent enzyme and in the cardiovascularsystem, TG2 has been reported to be involved in the development of cardiac hypertrophy, vessel remodeling, and age related vascular stiffness. Interestingly, TG2 is implicated in the regulation of muscle metabolism via modification of respiratory complexes and the ADP/ATP transporter in the mitochondria of myocardium. However, the role of TG2 in the heart during conditions of pressure overload in relation to fatty acid(FA) oxidation has not been investigated. Hence, we investigated the involvement of TG2 in cardiomyocytes contraction under FA supplementation. Using TG2 inhibitor and TG2-deficient mice, we demonstrated that FA-supplementation activated TG2 and increased ATP level and contractility of cardiac myocyte from normal heart. By contrast, in cardiac myocytes from angiotensin-II treated rats and mice, the effects of FA-supplementation on TG2 activity, ATP level and myocyte contraction were abolished. Furthermore, TG2 was inhibited by S-nitrosylation and its level increased in hypertensive myocytes. Treatment with inhibitor for neuronal nitric oxide synthase (nNOS) restored FA-induced increase of TG2 activity and myocyte contraction. Moreover, intracellular Ca2+ levels were increased by FA-supplementation in both normal and hypertensive myocytes, showing that S-nitrosylation of TG2 but not alteration of intracellular Ca2+ levels are responsible for contractile dysfunction. These results indicate that TG2 plays a critical role in the regulation of myocyte contractility by promoting FA metabolism and provide a novel target for preventing contractile dysfunction in heart with high work-load.
Sara.Abouradi
CASABLANCA University School of Medicine.
Title: Sex differences in de novo heart failure after stemi
Biography:
Sara Have completed my medical studies at the age of 24 years from CASABLANCA University School of Medicine. Now, Im an intern in cardiology unit at university hospital center ibn rochd of casablanca, I am a member in several voluntary medical associations.
Abstract:
Heart failure has different characteristics depending on the sex, In case of STEMI men and women have distinct cardiovascular responses to acute myocardial ischemia with a higher risk for women to develop acute heart failure,The main goal of this study is to determinate the relationships between gender and acute heart failure after STEMI in patients with no prior history of heart failure recorded at baseline.This is a retrospective, study including 210 patients who had been hospitalized in a cardiology intensive care unit for myocardial infarction from september 2017 to february 2019 , The main outcome measures were the incidence of Killip's class at hospital presentation and introhospital mortality rates.