bluuebunny/crossref_metadata_2025 huggingface dataset:
Catalytic Gaussian thermal operations
Authors: Yadin Benjamin , Jee Hyejung H , Sparaciari Carlo , Adesso Gerardo , Serafini Alessio
Published: July 2022

We examine the problem of state transformations in the framework of Gaussian thermal resource theory in the presence of catalysts. To this end, we introduce an expedient parametrisation of covariance matrices in terms of principal mode temperatures and asymmetries, and consider both weak and strong catalytic scenarios. We show that strong catalysts (where final correlations with the system are forbidden) are useless for the single mode case, in that they do not expand the set of states reachable from a given initial state through Gaussian thermal operations. We then go on to prove that weak catalysts (where final correlations with the system are allowed) are instead capable of reaching more final system states, and determine exact conditions for state transformations of a single mode in their presence. Next, we derive necessary conditions for Gaussian thermal state transformations holding for any number of modes, for strong catalysts and approximate transformations, and for weak catalysts with and without the addition of a thermal bath. We discuss the implications of these results for devices operating with Gaussian elements.
Estimating the spectral density of unstable scars
Authors: Lippolis D
Published: July 2022

In quantum chaos, the spectral statistics generally follows the predictions of random matrix theory (RMT). A notable exception is given by scar states, that enhance probability density around unstable periodic orbits of the classical system, therefore causing significant deviations of the spectral density from RMT expectations. In this work, the problem is considered of both RMT-ruled and scarred chaotic systems coupled to an opening. In particular, predictions are derived for the spectral density of a chaotic Hamiltonian scattering into a single- or multiple channels. The results are tested on paradigmatic quantum chaotic maps on a torus. The present report develops the intuitions previously sketched in Lippolis (2019 EuroPhys. Lett. 126 10003).
Differences in stream responsiveness between a tropical montane cloud forest and a tropical lowland rainforest
Authors: Nainar A , Kuraji K , Cleophas F , Justine V T , Maidin N , Kamlun K U , Bidin K , Majuakim L , Hassan R , Mahali M
Published: July 2022

Tropical Montane Cloud Forests (TMCF) have unique hydrology considering their high moisture, steep headwater terrain, shallow soils, frequent precipitation, and the presence of horizontal precipitation. While the hydrology of Tropical Lowland Rainforests (TLRF) has been given due attention, TMCF in Malaysia have been less explored. This study compares stream responsiveness and peak flow dynamics between TLRF (substation Inobong, 5.33 ha) and TMCF (substation Alab, 8.53 ha) in Crocker Range, Sabah, Malaysia. Streams in both study site were instrumented with water level sensors and dataloggers, and meteorological stations that records data at 10-minute intervals. Two hydrograph metrices namely T
res (time taken from start of precipitation to hydrograph initiation) and T
peak (time taken from start of hydrograph response to peak discharge) were assessed via a combination of the Mann-Whitney test and ANCOVA. TMCF took a longer time to achieve peak water level (mean T
peak=143 mins) compared to TLRF (mean T
peak=118 mins). Average rainfall intensity (P
i) was negatively correlated with T
peak. T
res was higher in TMCF (mean=141 mins) than in TLRF (mean=51 mins) and was not affected by P or P
i. Understanding such hydrological dynamics in TMCF is important for better headwater resource management and for flood prevention.
Estimating soil organic carbon at Takasago UNIMAS Educational Forest for forest rehabilitation
Authors: Wasli M E , Laujang N N C , Meekiong K , Nahrawi H , Shabdin Z , Elias H , Mohd Raffi M A , Sidi M
Published: July 2022

Soil Organic Carbon (SOC) has long been known as an indicator of soil health. This study aims to estimate the amount of SOC at Takasago-UNIMAS Educational Forest, a post-construction site, for forest rehabilitation. Since 2018, rehabilitation approaches have been conducted in the UNIMAS campus to restore these land areas via enrichment planting. The estimation of SOC was conducted at three sites; Secondary Forest (SF), Enrichment Planting site (2018) (EP18) and Enrichment Planting site (2019) (EP19). In each study plot, soil samples from different depths were collected for further analysis. Our findings showed that the soils in SF portray the highest amount of Total Carbon and Nitrogen, suggesting that this site may not have been considerably affected due to the past land use. Moreover, the estimation of SOC in all sites indicated that SF shows the highest mean at 2007.0 g/m2 at the soil depth of 0-30cm, followed by EP18 and EP19. From the estimation, it can be concluded that although the period of establishment in EP18 and EP19 may have contributed to the lower SOC as compared to SF, the SOC estimation from this study could be a value-added option in determining the state of soil recovery and, possibly, the effectiveness of enrichment planting for forest rehabilitation.
Rapid assessment of insect diversity (Ext.), Kalabakan, Sabah
Authors: Razy J , Momin B , John L Y , Chung A Y C
Published: July 2022

The Sungai Tiagau Forest Reserve is a Class 1 Protection Forest Reserve under jurisdiction of Serudong District Forestry Office of Sabah Forestry Department. This reserve is located in south eastern Sabah, covering an area of 7,010 ha. This study was aimed to document the insect fauna of Sg. Tiagau Forest Reserve (Ext.), as well as to investigate the threats affecting insect diversity. Nocturnal insect diversity was assessed through light-trapping from 7:00 p.m. until 9:00 p.m. for three consecutive nights while diurnal insects were documented through sweep nets and forceps. A mean 58 species of nocturnal insects was recorded from a one-square-metre of the light-trapping cloth within three different sites, with an average of 74 individuals. The mean Shannon Index was 3.84 while Simpson Index was 111.26 and Fisher Alpha Index was 178.48. When making a comparison with other forest reserves in Sabah, this reserve shows moderately low in terms of insect diversity but moderate in terms of species richness. Eight Bornean endemic species were recorded during the survey and that will be provide significant information to enhance the conservation of Sg. Tiagau Forest Reserve (Ext.) and serve as a baseline information for future research. From the insects recorded, they can be used to promote nature tourism by highlighting Bornean endemic and interesting species, such as the iconic butterfly, Rajah Brooke Birdwing. There are a few threats and issues that may affect insect diversity, including forest fire, changes in land-use and encroachment. A cooperation between Sabah Forestry Department with relevant agencies could help in addressing the discussed issues. This first-hand information on insects of the reserve can be included in the formulation plan of a sustainable forest management system as stipulated in HCVRN.
Rehabilitation of degraded forest area using dipterocarp species in Merlimau Forest Reserve, Melaka
Authors: Farah Shahanim M M , Nurcahaya Khairany M A , Zahirah M T
Published: July 2022

The rehabilitation of degraded sites is now recognized as major issue globally. One of the means in rehabilitating degraded areas is through replanting. In this study, a variety of dipterocarp species were planted in a 1.5 hectare degraded forest area in Merlimau Forest Reserve, Melaka. The main objective of this study is to rehabilitate degraded site with commercial timber species. Combinations of slow-release fertilizer and organic fertilizers as well as big planting hole were applied as a part of the improved planting technique. In order to sustain the flora biodiversity of the site, line clearing for planting was adopted. Suitable species were matched to the topography of the site to increase the survival and growth. Growth and survival of saplings planted were monitored and data obtained were analyzed using SPSS program. After 62 months of planting, the survival rate recorded was very high which was 78% in average with Merawan siput jantan exhibiting the highest increment in both height and diameter throughout planting measurements.
Sustainable Forest Management contribution to food security: A stakeholders’ perspectives in Sabah, Malaysia
Authors: Lintangah W J , Atin V , Ibrahim A L , Yahya H , Johnlee E B , Martin R A , John G
Published: July 2022

Implementing Sustainable Forest Management (SFM) policy has contributed to conserving and protecting the forests to remain relevant for future generations. This study determines stakeholders’ viewpoint on the relationship between the implementation of SFM and food security in Sabah. The study was conducted by distributing online questionnaires through the SurveyMonkey platform using convenience sampling methods. Most of the respondents agreed that the forestry sector is still relevant to the development and generation of the economy and revenue to the state of Sabah. Apart from nature-based tourism, wood-based manufacturing, furniture industry, and agroforestry practices, other potential economic-generation segments are indigenous forest food productions, such as wild honey, fruits, vegetables, and game animals. The forestry sector could contribute to food security for Sabah by advancing the current practices and the use of local resources of forest foods. Other prospects are integrating natural and plantation forest management programs with the generation of forest food resources. Factors that could foster the forestry sector’s contribution to food security, among others, are research and innovation, education, involvement of local communities, and the role of government policy on forestry and food security in Sabah.
Bornean Pygmy Elephant habitat usage of natural salt licks in Segaliud Lokan Forest Reserve
Authors: Sompud J , Adams A Z , Hiew S E , Maid M , Kodoh J , Mohd Sani S , Goh C , Jonalius M , Baba M
Published: July 2022

Bornean pygmy elephant (Elephas maximus borneensis) is crucial in the forests ecosystem as it plays a vital role as a forest engineer. As such, it is crucial to conduct more research to contribute to the conservation of this species. This study examined the pygmy elephant usage of natural salt lick in Segaliud Lokan Forest Reserve (SLFR), also known as FMU19B. Salt lick is vital to maintain wildlife health. This study investigated the elephant’s visitation frequency and examined its activity pattern in the natural salt lick area. A camera trap survey was conducted from November 2019 till August 2020. Four natural salt licks (C50SL, C56SL, C59SL and C60SL), and three non-salt licks (C50NSL, C56NSL, and C59&C60NSL) was selected. The data were analysed using descriptive and statistical analysis. The results show a higher visitation frequency at the salt lick area than the non-salt lick area (p<0.01). The salt lick at C59 was the most frequently visited by the elephant. The activity pattern displayed by the Bornean pygmy elephant shows a higher degree of nocturnal activity (73.3%). This information is essential for the timber concession forest managers to design the conservation work for the species in balancing with the timber extraction activity.
The potential of timber-agroforestry to meet Sarawak’s forestry demand
Authors: Ngu A , Bahar N H A
Published: July 2022

Many forest communities in Sarawak, and globally, practise some form of smallholder management system including agroforestry. Yet, agroforestry practitioners predominantly focus on non-timber crops as the major source of income while the timber output remains underutilized and understudied. Smallholder timber agroforestry systems, therefore, have huge potential to equitably meet the increasing demand for both timber and food while reducing the pressure on natural forests. We investigate the readiness of agroforestry smallholders in Sarawak to supply timber commercially, and the opportunities and challenges they face. Semi-structured interviews were conducted with Sarawak forestry stakeholders including agroforestry farmers, timber industry actors, civil society organizations, academia, and government agencies. Descriptive statistics are used to analyse the data. Our results demonstrate that smallholders in Sarawak lack technical silvicultural and horticultural knowledge and formal timber market access, despite majority smallholders expressing interest in timber production. The underutilization of smallholder timber is linked with conservation and protection objectives. Legal constraints, limited capacity building and lack of market information were cited as major barriers for smallholders. Key recommendations to lower barriers for smallholder participation include provision of resources and an enabling legal framework that harmonizes agriculture and forestry demands while being inclusive of smallholders’ perspectives and realities.
Effect of NPK and silicon fertilizer on growth, flowering, and nectar of Turnera ulmifolia L.
Authors: Sidi M , Omar D , Nahrawi H , Elias H , Wasli H
Published: July 2022

Turnera ulmifolia L. is a beneficial plant mostly planted in the oil palm plantation as it is easily adapting to a variety of environmental conditions, mainly to conserve beneficial insects. Nevertheless, the planted plants were left without proper maintenance and less study was conducted on biological control agent conservation. Thus, this study aimed to examine the effect of NPK, silicon fertilizer and their combination on the growth and development of T. ulmifolia. Treatments including T0 Control (No fertilization application), T1 (0.2 g NPK), T2 (0.2 g NPK+3.9 g silicon), T3 (0.2 g NPK+4.9 g silicon), T4 (3.9 g silicon) and T5 (4.9 g silicon) were applied 20 days after transplanting at monthly interval for three months. Results revealed the greatest height and number of branches were observed in T1. Overall, the chlorophyll content ranged between 27.92 to 31.18 SPAD values. All treatments gave the same effect on morphometric measurements on the first 30 days of observation. After 60 days, the greatest value for broad tube width and length was observed in T4 which differs significantly from other treatments. The application of fertilizer in T1, T2 and T3 showed 10-20% promotive effects over the control in the amount of nectar produced per flower. For all three observation periods, a similar trend was recorded for the total sugar concentration in flowers, where the mean total sugar content was between 1.37 and 1.61 mg per flower.
Mapping pre and post earthquake land cover change in Melangkap, Kota Belud Sabah using multi-temporal satellite Landsat 8/OLI and Sentinel 2 Imagery
Authors: Kamlun U K , Miuse C F , Puma D D , Mahali M , Wong W , Phua M-H
Published: July 2022

Earthquakes in mountainous belt can trigger major disturbance to the landscape impound a large amount of debris exported largely to the streams and forming landslide. During the 5th of June 2015, an earthquake of 5.9 Richter scale hit the heart of Mount Kinabalu, Sabah. The tremors caused the surrounding area to be affected largely to the population that is located near the river stream site. This study maps the land cover in Kota Belud following the earthquake that occurred in 2015 using Landsat 8 Operational Land Imagery (year 2014) and Sentinel-2 Multispectral Imagery data (2020). It was reported as one of the locations that severely impacted by the earthquake. Maximum likelihood algorithm was used to generate the map of land cover change of Kota Belud year 2014 and year 2020. Nine (9) classes of land cover were identified in the study area consisting of primary forest, secondary forest, shrubland, paddy, rubber plantation, bare rock, bare soil, built up, and river. The result obtained shows the most affected area is the river area, Sungai Panataran, that flow through Melangkap from Mount Kinabalu. Other land cover type also shows changes but mostly due to deforestation and agricultural activities. In conclusion, mapping the Kota Belud area using remote sensing and geographical information system (GIS) is useful for monitoring the landscape change of the site due to the vulnerability to natural disaster such as flood and earthquake.
Suitability for salt-lick tourism: A preliminary assessment on the natural salt-licks at Segaliud-Lokan Forest Reserve, Sandakan, Sabah
Authors: Lim W S , Mojiol A R , Yip P M , Goh C , Liau P , Liaw Y C , John S V
Published: July 2022

The natural salt-licks are visited by various species of terrestrial mammals, hence ideal for mammal watching, although the suitability for salt-lick tourism is influenced by other factors. Preliminary research was conducted on the suitability of four natural salt-licks for mammal watching in Segaliud-Lokan Forest Reserve (SLFR), Sabah. The camera trapping survey and field assessment were conducted for eight months, and then the assessment criteria applied in this study included the lick accessibility, detection frequency, species richness, viewable activity sighting probability, reliability and visibility on the terrestrial mammals, at a given lick. A total of 12 different mammal species were recorded, where Sambar Deer, Bearded Pig, Banteng, and Bornean Orang-utan were determined as the main visitor species of this study. Among the four selected salt-licks, the rating score of SL50A (Score=1.71) was significantly lower than those of SL50B, SL56 and SL59 (Score=2.57 respectively, χ2
2
=6.794, p=0.042), hence highlighting that SL50A was not suitable for conducting mammal watching activity, unlike the other three natural licks at SLFR. The assessment on the compatibility between the supply (mammalian physical availability) and demand (highly anticipated species) was excluded from this research, therefore emphasizing the need to fill up this particular research gap in the future.
Biodegradable chitosan coating for wood protection
Authors: Andok A , Jesuet M S G
Published: July 2022

Chitosan coating is a biopolymer-based coat made out of modified chitin that is usually derived from shellfish. The general development of the chitosan coating was to provide adequate, albeit impermanent, lamination of food products for protection during long transportation. With the idea for a pro tempore coating, this study focused on the production of a transient coating made from cockle shells-derived chitin, for the temporary protection coating for pre-machinated wood instead. Due to its solubility in organic acids, the purpose of the coating primarily focused on the protection of pre-machined wood that is high in moisture content and susceptible to damages, in which will allow the easy removal of said coating whenever necessary. The process started with the extraction of chitin from the cockle shells through the demineralization, deproteinization, and deacetylation steps before integrating it with starch and glycerol to produce the biodegradable coating. The aim of this study was to determine the effect of the different deacetylation time (30, 60, and 90 minutes) on the physical and chemical properties of the coating. The physical properties observed includes the water absorption, drying time, various temperature resistance, and viscosity, meanwhile the chemical properties were observed based on its infrared spectra identification and pH value. Based on the results, the samples with the longest deacetylation time of 90 minutes displayed the best physical properties with a lower water absorption, shorter drying time, lower pH value, and best resistance towards the various temperature cycles, as compared to the other samples. This evidently shows the importance of the deacetylation process, as well as a sufficient hydrolysis prolongation in producing a desirable chitosan coating quality.
Multi-parameter optimization (grey relational analysis) and modeling of a cellulosic plant/glass fiber hybrid reinforced polymer composite (PxGyEz) for offshore pressure vessels development
Authors: Samuel Bassey Okon , Sumaila Malachy , Dan-Asabe Bashar
Published: July 2022

The aim of this research is to produce more environmentally friendly materials for offshore applications. Due to their high water absorption, cellulosic fibers are known to be hydrophilic, making composites reinforced with them perform poorly and unreliable in humid settings. Previous research has focused on the development of natural fiber-based composite materials, but none has focused on the optimization of these cellulosic-based fiber-reinforced composites for offshore applications where weight, water absorption, and strength are important considerations. This paper presents the optimization of the composite material PxGyEz(withx, y, andzrepresenting the volume fraction of pineapple leaf fiber (PALF) (P), the volume fraction of glass fiber (G), and fiber length respectively in an epoxy matrix) using the grey relational analysis for offshore pressure vessels. The material at 10% PALF, 15% glass fiber, and 15 mm fiber length, which is, P10G15E15was the optimum, having a grey relational grade of 0.716. Also, statistical analysis showed that the treated PALF fibers contributed 45.73% to the water absorption properties of the PxGyEzcomposites as compared to the 0.3% contribution of glass fiber to the grey relational grade and a 9.5% contribution of fiber length. Also, there was an improvement in the grey relational grade by 73.61%. SEM and Fourier-transform infrared spectroscopy (FTIR) analysis showed microstructural and chemical formations that explained the water absorption behavior of the optimized hybrid composite. Also, regression analysis was carried out and an equation was developed for the prediction of grey relational grades at different combinations of PxGyEz. A thick pressure vessel developed with the optimized material was simulated and results showed operational reliability with its yield starting at 30.01 MPa, which is 44.98% higher than the 20.7 MPa limit by the ASME X Class I cylinders.
Racial privilege as a function of White supremacy and contextual advantages for Asian Americans
Authors: Oh David C , Eguchi Shinsuke
Published: July 2022

This article uses the discursive construction of “Asian privilege” as a vehicle to think through what constitutes racial privilege. For racial privilege to exist three conditions are required: (1) structural control; (2) racial invisibility to hide power; and (3) direct benefits of a structural racist system. For Asian Americans, the accrued “benefits” in some areas of social life, what we call contextual advantages are indirect, based on the shape-shifting of White supremacy, not Asian American self-determination. This is not, however, to excuse or deny some Asian Americans’ cooperation with White supremacy, settler colonialism, and U.S. empire, but to note that hegemonic usefulness to White supremacy is not equivalent to racial privilege.
Immunopathology of the optic nerve in multiple sclerosis
Authors: Fernández Blanco Laura , Marzin Manuel , Leistra Alida , van der Valk Paul , Nutma Erik , Amor Sandra
Published: July 2022

Optic neuritis, a primary clinical manifestation commonly observed in multiple sclerosis (MS), is a major factor leading to permanent loss of vision. Despite decreased vision (optic neuritis), diplopia, and nystagmus, the immunopathology of the optic nerve in MS is unclear. Here, we have characterized the optic nerve pathology in a large cohort of MS cases (n = 154), focusing on the immune responses in a sub-cohort of MS (n = 30) and control (n = 6) cases. Immunohistochemistry was used to characterize the myeloid (HLA-DR, CD68, Iba1, TMEM119, and P2RY12) and adaptive immune cells (CD4, CD8, and CD138) in the parenchyma, perivascular spaces, and meninges in optic nerve tissues from MS and control cases. Of the 154 MS cases, 122 (79%) reported visual problems; of which, 99 (81%) optic nerves showed evidence of damage. Of the 31 cases with no visual disturbances, 19 (61%) showed evidence of pathology. A pattern of myeloid cell activity and demyelination in the optic nerve was similar to white matter lesions in the brain and spinal cord. In the optic nerves, adaptive immune cells were more abundant in the meninges close to active and chronic active lesions, and significantly higher compared with the parenchyma. Similar to brain tissues in this Dutch cohort, B-cell follicles in the meninges were absent. Our study reveals that optic nerve pathology is a frequent event in MS and may occur in the absence of clinical symptoms.
Referral rate of chronic kidney disease patients to a nephrologist in the Region of Southern Denmark: results from KidDiCo
Authors: Kampmann Jan Dominik , Heaf James Goya , Mogensen Christian Backer , Mickley Hans , Wolff Donna Lykke , Brandt Frans
Published: July 2022

Background

Data on the referral rate of chronic kidney disease (CKD) patients to specialists are sparse. Investigating referral rates and characterizing patients with kidney disease not followed by a nephrologist are relevant for future measures in order to optimize public health and guideline implementation.

Methods

Data were extracted from the Kidney Disease Cohort of Southern Denmark (KidDiCo). Referral rates for all incident CKD patients below 60 mL/min/1.73 m² and referral rates according to the KDIGO guidelines based on glomerular filtration rates below 30 mL/min/1.73 m² were calculated. Information on contact with one of the nephrologist outpatient clinics in the Region of Southern Denmark was collected from the Danish National Patient Registry. The individual follow-up time for nephrology contact was 12 months. Additional data were accessed via the respective national databases. CKD patients on dialysis and kidney transplanted patients were excluded.

Results

A total of 3% of patients with an eGFR <60 mL/min/1.73 m²–16% of patients with an eGFR <30 mL/min/1.73 m² and 35% of patients with an eGFR <15 mL/min/1.73 m² were in contact with a nephrologist in the outpatient settings. Younger age, male sex, diabetes, hypertension, higher education and proximity to a nephrology outpatient clinic increased the chance of nephrology follow-up.

Conclusion

Only a small fraction of CKD patients are followed by a nephrologist. More studies should be performed in order to find out which patients will profit the most from renal referral and how to optimize the collaboration between nephrologists and general practitioners.
BNT162b2 vaccine effectiveness in chronic kidney disease patients—an observational study
Authors: Bielopolski Dana , Libresco Gilad , Barda Noam , Dagan Noa , Steinmetz Tali , Yahav Dafna , Charytan David M , Balicer Ran D , Rozen-Zvi Benaya
Published: July 2022

Background

Chronic kidney disease (CKD) is a risk factor for severe coronavirus disease 2019 (COVID-19). We aimed to evaluate the real-life effectiveness of the BNT162b2 messenger RNA vaccine for a range of outcomes in patients with CKD compared with matched controls.

Methods

Data from Israel's largest healthcare organization were retrospectively used. Vaccinated CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2] and maintenance dialysis patients were matched to vaccinated controls without CKD (eGFR ≥60 ml/min/1.73 m2) according to demographic and clinical characteristics. Study outcomes included documented infection with severe acute respiratory syndrome coronavirus 2, symptomatic infection, COVID-19-related hospitalization, severe disease and death. Vaccine effectiveness was estimated as the risk ratio (RR) at days 7–28 following the second vaccine dose, using the Kaplan–Meier estimator. Effectiveness measures were also evaluated separately for various stages of CKD.

Results

There were 67 861 CKD patients not treated with dialysis, 2606 hemodialysis (HD) patients and 70 467 matched controls. The risk of severe disease {RR 1.84 [95% confidence interval (CI) 0.95–2.67]} and death [RR 2.00 (95% CI 0.99–5.20)] was increased in nondialysis CKD patients compared with controls without CKD following vaccination. For the subgroup of patients with eGFR <30 ml/min/1.73 m2, the risk of severe disease and death was increased compared with controls [RR 6.42 (95% CI 1.85–17.51) and RR 8.81 (95% CI 1.63–13.81), respectively]. The risks for all study outcomes were increased in HD patients compared with controls.

Conclusion

Two doses of the BNT162b2 vaccine were found to be less efficient for patients with eGFR <30 ml/min/1.73 m2. Risk in HD patients is increased for all outcomes. These results suggest prioritizing patients with eGFR <30 ml/min/1.73 m2 for booster shots, pre- and post-exposure prophylaxis and early COVID-19 therapy.
Therapeutic adherence of patients with Heart Failure
Authors: Catarino P A U L A , Vaz A L E X A N , Paiva SÍLVIA
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

Heart Failure (HF) is one of the main priorities among chronic diseases, causing great economic, social and individual impact. Despite of improvement in pharmacological treatments, there is a possibility of therapeutic education improvement.

Low adherence to the therapeutic regimen is a serious public health problem. Education for the understanding of HF and the development of skills for self-care are considered keys to improve adherence, avoid decompensation crises and maintain the clinical stability of patients.

Purpose

Evaluate the therapeutic adherence of patients with HF

Methods

Was developed a quantitative, cross-sectional, descriptive and correlational study. A questionnaire that incorporates translated scale Heart Failure Compliance Questionnaire (HFCQ) and EQ-5D-3L. Sampling was consecutive non-probability of 43 patients followed in outpatient visit and hospitalized in the ward at a university hospital.

Results

Globally, adherence was 65,7% (±8,5%), patients who obtain an overall score of 75% or more are considered "adherent". Thus, we can consider that these patients have low rates of therapeutic adherence.

The worst adherence score was physical exercise (54.5%). Most of these patients were unwell when performing daily activities, justified by respiratory discomfort, intolerance to physical activity and palpitations when performing any activity that required a little more physical effort.

The diet (weight, amount of liquids, and salt intake) also has a low adherence rate (60.8%). The studies report an adherence to instructions on weight monitoring of 12%-75% and control of fluid intake of 23%, and a non-adherence to sodium restriction of 50%-88%, corroborating the results obtained.

With the best adherence was smoking (78.1% ±21.3%), and it is in this domain that the greatest range of adherence is found. This is followed by health maintenance (69.8%) and medication (68.9%).

Conclusion(s)

Patients are more aware of adherence to medication and the importance of appointments than they are of diet or physical exercise. More targeted studies are needed in the search for new non-drug therapies knowing that such treatments are simple and low cost.
Nurse and general practioner-led up-titration strategy: a real world experience in a heart failure unit in colombia
Authors: Rodriguez A , Gonzalez-Robledo G , Buitrago G , Gonzalez V
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Despite improvement of heart failure (HF) prescription rates, doses prescribed in clinical practice are lower than those achieved in randomized clinical trials. Nurse-led up-titration strategy has been widely used in Europe with promising results. Nevertheless, there is no evidence of this approach in Latin America.

Methods

A prospective cohort study was conducted in 50 patients with reduced ejection fraction to evaluate efficacy and safety of nurse and general practioner(GP)-led up-titration protocol, based on problem solving from the European Society of Cardiology HF guidelines. Patients were admitted in our HF unit from January 2017 to December 2019. After discharge our clinical pathway provides 3 types of visits : Cardiologist visits, educational visits and titration visits with GP and registered nurse. Along intervention the registered nurse lead flexible diuretic titration and structured phone monitoring calls.

Results

Baseline characteristics are showed in Table 1. Mean age was 72.5 years, 50% of patients were women, 66% had ischemic cardiomiopathy, mean N-terminal pro-B-type natiuretic peptide was 3285pg/dl, and 58% of patients were NYHA class III. At 97 days with an average of 4 up-titration visits disease-modifying drugs titration was completed. At the beginning 98% of patients had Beta Blockers (BB) , 98% had Mineralocorticoid Receptor Antagonist (MRA), and all of them had Angiotensin Converting Enzyme Inhibitors, angiotensin receptor blockers or Angiotensin Receptor Neprilysin Inhibitor (ARNI). According to the guidelines Angiotensin Converting Enzyme Inhibitors and angiotensin receptor blockers were replaced by ARNI in symptomatic patients. At the end of titration, BB target dose was achieved for 44% of patients, intermediate dose for 46% and final low dose for only 10% of patients. Ivabradine was added for 22% of patients. MRA intermediate and high doses were achieved for 82,5% of patients. Target dose of ARNI was achieved for 62% of patients, intermediate dose for 22% and only 20% of patients remained in starting dose. On average ARNI target dose was completed at 56 days. According to our protocol three patients stopped MRA due to hyperkalemia and symptomatic hypotension was the main cause for stopping up-titration. There was a relationship between patient´s caregiver and higher doses of ARNI( p=0.624) and BB (p=0.421).

Conclusion

A nurse and GP directed up-titration protocol is an encouraging strategy in HF units to achieve the recommended doses of disease-modifying drugs according to the guidelines.
Psychometric Validation of the Spanish Version of the Caregiver Contribution to Self-Care of Heart Failure Index ( CC-SCHFI)
Authors: Juarez-Vela R , Vellone E , Durante A , De Maria M , Di Nitto M , Gea-Caballero V A , Santolalla-Arnedo I , Benavent-Cervera J V , Rubio-Gracia J , Antonio-Oriola R
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) is a theoretically driven instrument to measure the extent to which caregivers support Heart Failure ( HF) patients to perform self-care. The CC-SCHFI measures caregivers' contribution to the self-care maintenance and self-care management and caregiver confidence in contributing to heart failure patients, self-care. To date, the CC-SCHFI was never tested in Spanish speaking populations.

Purpose

To translate the CC-SCHFI from English into Spanish and to test its psychometric characteristics.

Method

CC-SCHFI translation and back-translation was performed according to the Beaton el al. Methodology. Data from a cross-sectional study conducted in an outpatient clinic in Spain were used for the analysis. Psychometric analysis was performed with Exploratory factor analysis (EFA) with oblique rotation. Cronbach’s alpha coefficient was used to test CC-SCHFI reliability.

Results

Caregivers had a mean age of 60,5 and the majority was female (85%) Data from 220 caregivers were analyzed. From EFA, using the principal axis factoring method, we extracted two factors in self-care maintenance subscale ("treatment adherence behaviors" and "symptom control and maintenance behaviors" factors) and self-care monitoring subscale ("Illness behaviors" and "Prevention behaviors" factors) and one factor for self-efficacy subscale. The Cronbach’s alpha coefficient was = 0.838)
Influence of diet with low glycemic index on anthropometric parameters in patients with atherosclerotic coronary artery disease
Authors: Payziev D D , Alyavi B A , Uzokov J , Orziev D Z
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Diet with low glycemic index (DLGI) has been demonstrated favorable effect on several biochemical indexes. Purpose of the study was to evaluate the diet with low glycemic index on anthropometric parameters such as on body mass index (BMI), waist circumference (WC) and hip circumference (HC), waist to hip ratio (WHR) in patients with atherosclerotic coronary artery disease (ACAD).

Material and Methods

160 patients with confirmed ACAD, aged 38-76 years old (mean age 58.2±12.0 years; male=48%) entered as three months dietary intervention either with DLGI (n=80) or routine diet (RD, n=80) together with standard therapy from 2016 to 2019. BMI, WC, HC, WHR were checked at baseline and in three months of the intervention. All statistical analysis were performed by STATA software.

Results

DLGI showed favorable effect on BMI (from 29.8±8.12 to 91 kg/m2 in Group 1 vs. from 30.2±9.30 to 28.8±8.7 kg/m2 in Group 2, P<0.05), WC (from 100.6±18.5 cm to 91.6±16.8 cm vs. from 98.9±19.2 cm to 95.6±18.1 cm, p<0.05), HC (from 95.8±20.2 cm to 87.4±18.4 cm vs. from 97.0±19.8 cm to 96.2±19.5 cm) and WHR (from 1.1±0.9 cm to 0.9±0.8 cm vs. from 1.0±0.9 cm to 0.98±0.78 cm) than routine diet. Even though, BMI, WC, HC and WHR decreased in both groups from baseline, there were only statistically significant changes in Group 1 compared to Group 2. When we separately analyzed gender differences men tended to be more likely to be influenced by diet with low glycemic index (P>0.05) than women in terms of WC, HC and WHR however there were not observed significantly changes in BMI by gender.

Conclusion

DLGI showed superiority to reduce BMI, WC, HC and WHR patients with confirmed ACAD. Men had a tendency to be affected by WC, HC and WHR in DLGI intervention. Further studies are required with large amount of patients to clarify.
Pushing to keep going, scared: a qualitative study exploring why transcatheter aortic valve implantation to treat aortic stenosis is a highly acceptable intervention to patients and carers.
Authors: Straiton N , Gallagher R , Gullick J
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Contemporary options to treat severe, symptomatic aortic stenosis (AS) include transcatheter and surgical approaches (TAVI and SAVR). Evidence continues to accumulate for minimally invasive TAVI to be used to treat AS for expanding patient groups, however patients experiences are seldom investigated.

Purpose

The aim of this study was to explore patients and carers perspectives of the acceptability of TAVI as a treatment option for AS, in the context of their values, attitudes, and the burden and effectiveness of intervention, to better guide expectations and management of recovery.

Methods

Older patients (n=18) and their carers (n= 8) were interviewed 4-6 months post TAVI. Data was themed deductively by applying the theoretical framework of acceptability (1) as an analytic lens, followed by inductive analysis to identify any further emergent themes.

Results

The mean age of patient participants was 85 ± 5 years and 33% were women. Patients experiences of severe AS symptoms (e.g., breathlessness and fatigue) resulted in growing emotions of ‘struggling and pushing to keep to going’ in their daily lives, a few thought they were ‘nearly gone’ and expressed feelings of being scared. Debilitating AS symptoms, and a challenge to the values of this older patient group were the major influencing factors informing high prospective acceptability of the TAVI. Patients and their carers perceived the TAVI procedure to be a ‘good operation’ because of a short hospital stay and minimal disruption to their lives. Low burden resulted in high levels of concurrent acceptability of TAVI. Most patients experienced gradual symptom relief and being able to ‘get back to normal’, be independent and reconnect with valued pastimes, leading to high retrospective acceptability of the intervention for both patients and carers.

Conclusion

Patients and carers perceive TAVI to have high prospective, concurrent, and retrospective acceptability as improved symptoms restored mental wellbeing, the procedure was uncomplicated and operative burden was low, and most patients regained functional capacity and a return to their normal lives. The need to assess acceptability of interventions, such as TAVI, from the perspectives of patients and carers is increasingly becoming important in health care, not only better support patients and carers but to inform effective implementation and sustainability of treatment modalities.
Physical activity and technology usage performed by patients with coronary artery disease: a gender approach
Authors: Munoz Gomez E , Moreno-Segura N , Sentandreu-Mano T , Deka P , Klompstra L , Pathak D , Sempere-Rubio N , Orihuela L , Mont J , Cruz M , Westas M , Marques-Sule E
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Recent studies show that cardiac telerehabilitation, including exercise and lifestyle modification, is effective in reducing cardiovascular risk factors in patients with coronary artery disease (CAD). Thus, physical activity and technology usage of patients with CAD are important key points in order to create technology-based cardiac rehabilitation programs to improve physical patients´ condition and reduce cardiovascular risk.

Purpose

The aim of this study was to compare the physical activity and the technological usage of women and men with CAD.

Methods

A cross-sectional study in patients with CAD was performed. Sociodemographic data, physical activity (measured with the International Physical Activity Questionnaire, IPAQ) and the technology usage (measured with the Technology use subscale of the Technology Usage Questionnaire) were collected. Descriptive and inferential analyzes were performed to explore the differences between men and women with CAD.

Results

A total of 70 participants were included (84.28% men, mean age=59±8.54 years). Regarding the IPAQ, men significantly reported higher walking time (99.31±95.22 METS vs. 33.28±37.42 METS, p=0.001, respectively) and higher total physical activity (4164.91±4164.91 METS vs. 1390.68±1609.05 METS, p<0.001, respectively) than women. In relation to technology usage, the entire sample used a mobile phone, whilst there were no significant gender differences in the functions/applications used (phone calls, text messages, camera, receive videos/photos, internet searches, apps, instant messages, social media, games) (p=0.068). Although the majority of the participants (85.71%) had regular access to internet, men used their phone more frequently than women (81.10% vs. 37.50%, p=0.005, respectively). Comparison by gender showed no significant differences in the type of device used for internet searches (computer, tablet, mobile phone) (p=0.169), familiarization with technology-based physical activity games (p=0.801), use of heart rate monitors (p=0.193), preference to monitor heart rate when exercising (p=0.664), nor use of other devices to monitor physical activity (pedometer, etc.) (p=0.193).

Conclusion

Based on the results obtained, we conclude that men with CAD were more physical active and used the Internet more often than women, whilst there were no differences by gender in the rest of variables. Assessment of physical activity and technology usage should be implemented in patients with CAD, in order to adapt and improve the design of technology-based telerehabilitation programs
Body Mass Index and its relation to patients with Acute Myocardial Infarction
Authors: Alsalim W , Alqahtani S , Omeish O , Momin H , Ghulam E , Vriz O , Kinsara A
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Objective

Obesity is frequently encountered in patients with acute coronary syndrome, but whether it is the cause of a detrimental effect on Troponin after acute coronary syndrome remains an area of research. We investigated the effects of the body mass index (BMI) in post-myocardial infarction (MI) patients, and see the difference in troponin and other parameters between normal and over-weight patients.

Design

A retrospective cohort study.

Place

Ministry of National Guard health affair, Jeddah, Saudi Arabia

Duration of the study

One year from January 2019-January 2020

Methodology

Data were extracted from the electronic medical files of patients hospitalized due to acute ST-elevation MI to examine the association between BMI and MI. The patients (n=63) were categorized in BMI groups (kg/m2) using the baseline measurements, to assess the independent factors associated with a patient with a high BMI who had a MI.

Results

In total, 61 post-MI patients with a mean age of 56.9 ± 11.2 years were included in the study. The average BMI was 28.5 ± 6.5 kg/m2. Just more than a third (37.4%, n=23) were in the normal BMI category, 19 (31.2%) overweight, and 19 (31.2%) obese/morbid obesity. The left ventricle mass was 93.74 ± 32.69 gram and LVEF 44.02% ± 10.02. There was a significant difference in the mean level of troponin and mean heart rate between the BMI groups (normal vs. overweight groups). A fair correlation between BMI and LV mass was noted. No statistically significant relation could be linked to high body mass with total cholesterol, LDL, or AST/ALT.

Conclusions

In this pilot study, the group with a high BMI had a statistically significant lower troponin level and higher mean heart rate. Such data need to be considered when assessing a patient’s risk. In addition, obese persons with a MI had a higher LV mass
implementing modified same-day discharge protocol
Authors: Abdelmalak M , Ibrahim W , Shawki S , Omar O , Omar O
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

To accomplish overcapacity and bed lacks same-day discharge post percutaneous coronary intervention (PCI) has appeared as a key to improve resource consumption. Also, to focus on evaluating the length of hospital stay (LOS) post PCI’s patients and how to decrease the LOS or same day discharge .

Aim

A quality improvement project that aimed for implementing new modified Same Day Discharge (SDD) protocol post- Percutaneous Coronary Intervention (PCI) in purpose to decreasing the patient LOS, resources utilization, improving patient satisfactions, manage overcrowded, bed shortages, and bed-flow efficiency.

Methods

After modifying the protocol to fit with the new cardiac care setting.

Orientation for staff nurses about SDD protocol.

Statistical results compared to determine the impact of the new modified SDD protocol regarding the LOS. (Figure B)

Patients who fit the criteria will be discharge on the same day post PCI. (Figure C)

Results & Data Analysis

During Sep. 2020, the total patients were 196 (PCI 64 Patients ) compared to 165 (PCI 26 Patients) on Sep. 2021.

PCI patients who met the SDD criteria and did not discharge were 48% on Sep. 2020 compared to 19% on Sep. 2021.

As showing on the data there is significant impact of the SDD modified protocol, there are 29% increased on the patient discharge.

Recommendation

Continuous using of these criteria.

Link the patient LOS to the data to assess how the SDD Impact and to support the result.

Conclusion

SDD protocol for post PCI patient in carefully selected patients that improve the patient discharge process.