Terms Of Impact Research Articles

The impact of an active-learning designed faculty development program: A students’ perspective of an Italian university

This study aims to understand the impact of a faculty development program emphasizing active learning (innovative teaching) attended by instructors of diverse disciplines at the University of Padova in Italy, which has had an 800-year history of using traditional approaches to teaching and learning. Using a community of practice theoretical framework, it recognized that the development of faculty learning communities provided a supportive medium for fostering innovative teaching. A multilevel research design involving surveys collected from 2019 to 2020 explored the program’s impact in terms of student satisfaction and program effectiveness. Findings showed varied levels of impact, among student examination attempts, pass rates and average grades. These findings, although involving one university, are organizationally and culturally emblematic of other Italian universities and have related implications when considering the implementation of innovative approaches to teaching via faculty development programs. This study also revealed challenges (faculty engagement) and limitations when measuring (e.g., satisfaction, exam attempts) the impact of active learning in relationship to learning outcomes.
 Received: 30 June 2022Accepted: 3 October 2023

Child sexual abuse (rape) in Anambra state: South Eastern Nigeria

Background: Child sexual abuse (CSA) which is an infringement of the child’s fundamental human right has assumed a public health importance due to increasing prevalence globally and Nigeria in particular. This problem not only possess immediate complications like unwanted pregnancy, sexually transmitted infections (STI) and others, but the long term impact on the child’s mental-health is enormous. This study is aimed at documenting the burden of this problem in Anambra state and interventions to mitigate it. Methods: This was a prospective study of all the children who presented to the Ntasi Sexual Assault Reference Center (SARC), Anambra State with history of sexual abuse from September 2019 to August 2020. Results: A total of 820 children were seen during the study period, 81 (9.8%) were diagnosed to have been sexually abused. There were 69 (85.3%) female and 12 (14.8%) male giving a female to male ratio of 5:1. The incidence of the abuse increased with increasing age of the subjects and peaks at those aged 11-15 years, 28 (34.6%). Sixty-nine (85.2%) were abused once while 12 (14.8%) were abused multiple times. Most of the abuse took place in the perpetrators home 47 (38.8%) followed by uncompleted building 14 (11.6%). Vaginal penetration 69 (85.2%) was the commonest form of sexual abuse seen followed by anal penetration 12 (14.8). Conclusions: Child sexual abuse remains a major public health problem with high rate of under-reporting. Heath education, free medical care to victims and government strong political will are needed in curbing this menace.

The impact of lockdowns or severe social restrictions during COVID-19 pandemic on glycaemic control of adults suffering with type 2 diabetes mellitus: a review

Glycemic control in diabetes has shown to improve insulin sensitivity and reduce both microvascular and microvascular complications in diabetes mellitus. In 2020, with the globe facing COVID-19 pandemic. The governments and authorities resorted to lockdowns to reduce the spread of infection. We aimed to find the impact of lockdowns during COVID-19 pandemic on glycaemic control of adults suffering with type 2 diabetes mellitus. (T2DM). We systematically searched 5 medical databases MEDLINE via PubMed, Embase, CINAHL, web of science and Cochrane library up to 16th November 2021 using key terms. Total of 24899 articles were identified by the search, of which 17571 articles were excluded for duplication, 7303 were excluded after screening for title and abstract, and further 16 articles excluded after full text review. We analyzed the final 9 observational studies fulfilling the criteria. The 2177 participants from final 9 observational studies, 5 studies showed worsening glycemic control during lockdown period, 2 reported improvement and 2 showed no significant change. We noticed that weight was correlating with glycated hemoglobin change. Studies with lockdown period >10weeks reported greater HbA1c deterioration and the farther HbA1c check done from start of lockdown, higher HbA1c values noticed. Glycemic control overall in type 2 diabetes has worsened due to lockdown measures which may be due to reduced physical activity, change in diet or psychosocial changes. There has also been increase in BMI (Body Mass Index) correlating with raise in HbA1c. More in-depth review is required into long term impact of lockdowns on diabetes.

An empirical study of 4P’s of marketing strategies of agrochemical companies in and around Pune city.

The purpose of this study is to look into the impact of marketing mix (MM) factors (product, price, place or distribution, and promotion) on boosting product promotion effectiveness and their involvement in reducing difficulties inside the company. The primary goals of this paper are to explore the theoretical aspects of MM, to provide some viewpoints for researchers, and to provide some instructions for the marketing department of agrochemical Company’s innovations. To measure the impact of promotion on the marketing of its product, the researchers used the main related academic resources from university libraries and the internet, and they designed and distributed questionnaires to a random sample of agrochemical companies for customers and employees.
 The following are the key conclusions of this paper:
 
 The promotion has a very high impact in terms of increasing product sales.
 Product distribution can have a favourable impact on consumer satisfaction.
 The company's promotion approach has a very positive impact on growing product sales.
 
 According to the researchers, the company should increase the level of promotion in its activities and departments, and expanding sales points is critical, thus the company's distribution policies should be improved.

Bibliometric Study of Papers Published During 2007 to 2021

The study examines the change in pattern of impact factor and SCImago Journal Ranking (SJR) of the journal under study from 2008 to 2021 besides examining the pattern of growth of the number of papers. The study identified the most prolific actors (authors, institutions, and countries), besides examining their citation impact in terms of citation per paper & relative citation impact. The pattern of citation and highly cited papers have also been identified. Based on the analysis of data it is observed that the number of articles published was highest and almost equal in the years 2013, 2016, and 2017. Using the methodology of the complete count of records, it is observed that 56 countries contributed 2,939 articles. China followed by the USA published the highest number of papers. The value of CPP was highest for Universidad de Granada (Spain) and Leiden University (the Netherlands). Among the authors, Nees Jan van Eck and Ludo Waltman of the Leiden University had the highest CPP. Only a minuscule number of published articles remained uncited. Article authored by Aria, M. and Cuccurullo, C. published in issue 11(4), 2017, 959-975 of the journal received the highest number of citations. The pattern of authorship indicates that during the first ten years, more papers were single and two-authored while during 2017-2021 more number of papers were multi-authored.

Osteoporosis in Asthma and COPD.

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are principally lifestyle related chronic inflammatory airway disease. They are globally associated with various systemic comorbidities and mortality. Osteoporosis is the common associated metabolic bone disease with respiratory disturbances, which affect the prognosis and increase mortality and morbidity in the patients. Apart from OSTEOPOROSIS, exhaustive attention has been paid towards other associated systemic comorbidities like cardiovascular diseases, cerebrovascular diseases, metabolic syndrome, malnutrition, skeletal muscle dysfunction (sarcopenia), anxiety, depression and so on (Iheanacho et al. in Int J Chronic Obstr Pulm Dis 15:439-460, 2020; Singh et al. in Eur Respir J 53:1900164, 2019). Osteoporosis is a significant extrapulmonary manifestation in asthma and COPD, which are grossly neglected and inadequately treated. The comorbidities have significant impact in terms of morbidity, mortality and economic burden in asthma and COPD patients, hence management of asthma and COPD should comprise thorough management, as this will also have an impact on the outcome of these patients. Various risk factors such as smoking, systemic inflammation, vitamin deficiency, and the use of oral or inhaled corticosteroid are responsible for osteoporosis in patients with asthma and COPD. The presence of osteoporosis in patients with asthma and COPD is invariably asymptomatic unless complicated by fragility fractures, therefore, it is necessary to explore the pathogenesis of osteoporosis in asthma and COPD and special attention is to be paid for early recognition of patients at high risk for osteoporosis in these patients. This chapter is focussed on osteoporosis as an extrapulmonary manifestation of asthma and COPD with an emphasis on the pathogenesis, risk factor, potential mechanism of osteoporosis, diagnosis, and prevention with passing reference to treatment as well in asthma and COPD patients.

Voltage profile analysis at planning and operational stages with allowable PV hosting capacity

AbstractHigh level of photovoltaic (PV) integration into the distribution network (DN) may have a negative impact in terms of voltage variations across the limits. As such thorough analysis is required to ensure voltage within limits, mainly at feeder‐end buses. In this study, the PV integration problem is addressed in a more comprehensive way, considering the unbalance DN, impedance characteristic, and interaction of load against available PV output. The approach applies to both the planning and operational stage in the assessment of allowable PV hosting capacity (HC). In the planning stage, the local impedance index is computed at constant load and power factor conditions. The entire network is partitioned into areas and the most suitable area for PV integration is determined, which can allow maximum PV integration, without/minimum voltage violations. In the operation stage for allowable PV hosting capacity, further voltage analysis is performed, wherein peakness of PV output and load conditions do not match each other. Towards, voltage regulation via PV inverter, the power factor profile is adjusted as a function of PV output. The study is demonstrated for transient solar radiation, with emphasis on maintaining the voltage at feeder‐end buses. The simulation is carried out on interfacing GridPV in MATLAB and OpenDSS toolbox. The proposed scheme for allowable HC and further voltage regulation in the network using PV inverter is also compared with those approaches, applying optimised and centralised placement of PVs.

How can new energy development reduce CO2 emissions: Empirical evidence of inverted U-shaped relationship in China.

This article is based on the statistical yearbook data of 30 provinces, municipalities and autonomous regions in China (excluding Hong Kong, Macao, Taiwan, and Tibet Autonomous Region) from 2000 to 2017, a total of 18 years of statistical yearbook data was used to conduct in-depth research on the reduction of CO2 emissions from the development of new energy in the region. First, it is proposed that the regional new energy development has a significant negative effect on CO2 emissions. Meanwhile, this impact has a significant time lag effect, and the development of new energy cannot be quickly and effectively applied in the short term to replace traditional fossil energy in the dynamic model. Therefore, there is a significant positive impact in the short term, but the significant negative effect of new energy development on CO2 emission can be shown in the long run. Secondly, the new energy development has a significant non-linear impact on CO2 emissions, showing an inverted U-shaped relationship, which confirms the existence of the Environmental Kuznets Curve (EKC) of CO2 emissions based on new energy development. Finally, in order to alleviate the continuous impact of national economic development on CO2 emissions, the DID model is used to prove that the level of technological innovation has a significant moderating effect on the CO2 emission reduction effect of new energy development, which confirms theoretically the importance of technological innovation in accelerating new energy substitution and improving energy efficiency.

Exact solutions of perturbed stochastic NLSE with generalized anti-cubic law nonlinearity and multiplicative white noise

The paper retrieves the perturbed stochastic nonlinear Schrödinger equation in magneto-optic waveguides with generalized anti-cubic law nonlinearity and multiplicative noise in the Itô sense. Exact solutions are obtained with the aid of the trial equation method and the complete discriminant system for a polynomial. Compared to previous solutions, this method has achieved a broader and more comprehensive set of exact solutions. The obtained exact solutions help explain light propagation, nonlinear effects, the impact of noise on the system, and various physical processes occurring within waveguides. Some graphical simulations have been provided to demonstrate the dynamical behavior of the solutions and the impact of noise term in Itô sense.

Государственное регулирование и дерегулирование: право и экономика в современной России

Introduction. The legal aspects of state regulation of economic relations are of high relevance for the Russian Federation due to the development of modern crisis situations. At present, it is necessary to study the general parameters of the interaction between law and economics, on the basis of which it is possible to develop specific recommendations for improving Russian legislation. Empirical analysis. The author presents general factors that have a serious (in the long term) impact on the Russian economy: gradual decarbonization; the emergence of the concept of sustainable development, establishing a link between GDP growth (gross domestic product) and concern for future generations; universal digitalization affecting all spheres of public life. Methods and concepts. The confrontation between the two global currents of libertarianism and Keynesianism has a serious impact on the limits of state intervention in economic relations. At the same time, the gradual convergence leads to the development of such concepts as the social market economy and libertarian paternalism, each of them involving a transition to indirect influence and taking into account social factors in creating a competitive environment. The absence of a direct consolidation of the foundations of the economic system in the Constitution of Russia implies the development of synthetic principles that need further constitutionalization. Theoretical analysis. In the Russian Federation, the further strengthening of the direct role of the state in the country’s economy has institutional grounds – a large bureaucratic apparatus and a significant public sector in the economic system. At the same time, legal support for various forms of deregulation (self-regulation, co-regulation, quasi-regulation, etc.) has been formed. The declared "regulatory guillotine", in isolation from the general directions of administrative reform, is unlikely to have a significant long-term effect. Results. The process of deconcentration of power (with deregulation being one of the aspects) in the Russian Federation cannot be considered complete. Deregulation is not the only form of deconcentration and reduction of the administrative burden on businesses.

Major determinants of Bitcoin price: Application of a vector error correction model

Research in recent years has shown that Bitcoin is a virtual asset that is used as a medium of exchange and investment tool other than shares and bonds, the development of the digital era has opened up opportunities for Bitcoin to be chosen as part of an investor’s portfolio. The focus of this study is to examine the impact of nine key determinants on Bitcoin price. The data used in the study are daily data starting from January 1, 2018 to January 1, 2022. The main data source is taken from Investing.com, and the estimation method applied is the Vector Error Correction Model (VECM). The main finding shows that Bitcoin Volume impacts Bitcoin Price negatively, which is in line with the demand theory. Another finding is related to the substitute effect of Ethereum Volume, Litecoin Volume, and Gold Volume, each of which influences Bitcoin Price positively, suggesting that these three commodities are substitutes to Bitcoin. In contrast, whereas Oil Volume has an insignificant effect on Bitcoin price in the short term, it has a negative significant impact in the long term. In addition, LQ45 stock index Volume influences Bitcoin Price positively in the short term, suggesting that LQ45 stock index and Bitcoin substitute for each other. Moreover, Google Trends impacts Bitcoin price positively in the long term. In terms of the income effect, either the Indonesian GDP or US GDP has a strong positive effect on Bitcoin price in both the short and long term.

Gastronomic Sustainable Tourism and Social Change in World Heritage Sites. The Enhancement of the Local Agroecological Products in the Chinampas of Xochimilco (Mexico City)

In the Xochimilco area, within the urban perimeter of Mexico City, a unique ancestral agri-food production system persists: the chinampa system, also called chinampería. The chinampa agri-food production is a World Heritage inscribed by UNESCO and contributes to the sustainability of both the peri-urban wetland and the city. In addition, the Xochimilco area is also one of the most important domestic tourist destinations in Mexico City. The current situation of Xochimilco struggles between two core economic activities: agriculture and tourism. Although both activities contribute significantly to the development of the area, both have been noted as systematically damaging the local environment. However, emerging agriculture practices through agroecological production seem to have a positive impact in terms of better tourism praxis where the gastronomy of chinampero product plays a pivotal role. In this article, we will analyze the role of tourism in the area as a massive distorting and contaminant activity, but also from the positive perception and the possibilities of gastronomic tourism as a new responsible modality of tourism linked to sustainability and the mise en valeur of the chinampa agroecological products.

Airlines' network analysis on an air-rail multimodal system

This article explores the potential impact of short-haul flight bans in Spain. We build the rail and flight network for the Spanish peninsula, merging openly available ADS-B-based data, for the reconstruction of air schedules and aircraft rotations, and rail operator data, for the modelling of the rail network. We then simulate a ban that would remove flights having a suitable train replacement, \ie representing a trip shorter than a threshold that we vary continuously up to 15-h. We study the impact in terms of 1) air route reduction, 2) aircraft utilisation and fleet downsizing for airlines, 3) airport infrastructure relief and rail network requirements, 4) CO2 emissions, and 5) possible itineraries and travel times for passengers. We find that a threshold of 3 hours (banning all flights with a direct rail alternative faster than three hours) presents some notable advantages in emissions while keeping the aircraft utilisation rate at an adequate level. Interestingly, the passengers would then experience an increase in their itinerary options, with only a moderate increase in their total travelling times.

The Impact on the Brazilian Economy of the Olympic Games in Rio De Janeiro in 2016

Purpose: To analyze the impacts of the 2016 Olympic Games on the Brazilian economy, considering three distinct dimensions: economic, social and sporting to identify current gaps/benefits. Theoretical framework: The event, hosted in Rio de Janeiro, had a unique opportunity to examine the effects that a global mega sporting event can have on a developing country (Rocha, 2017; Cabral, 2016; Agência IBGE, 2023). However, there is still a lot to investigate and understand about the real impact on the daily lives of Brazilians resulting from the games. Design/methodology/approach: The research used the Brazilian statistical institute, which reveals data at the time of the Olympic games and currently to understand a trend that occurred in this time horizon from 2016 to 2023. In addition, another instrument was used, a questionnaire, which allowed the collection of very specific elements about the impact that the Olympic Games had on the city of Rio de Janeiro in 2016 at a social, economic, and sporting level, from the perspective of those surveyed. Findings: They made it possible to perceive the positive impulse in the economy through investments, the development of infrastructures, the creation of jobs and the boosting of tourism. Regarding the social, environmental, and sporting sphere, it can be noted that the main results indicate an international projection and positive impact in the long term, although many aspects deserve the attention of the State to improve the quality and living conditions of people and Rio de Janeiro in a broad sense. Research, Practical & Social implications: We suggest that other study instruments be used and as a sample the ministry of sport, which did not provide any response to this study, so it could be a future contribution to obtain a superior perception compared to that currently obtained in this study with the Brazilian people. Originality/value: The results indicate that the number of abandoned sports facilities is high (a description of them was made). The lack of environmental control has been a highlight since the games took place. Finally, there is no prospect of interest from the government or other responsible entities in providing improvements to the facilities, equipment, and other legacies of the games, as well as allowing access to the public.

The University of Northern Kuzbass Agglomeration: Campus as a Strategic Bet

The article presents the concept of university campus of Northern Kuzbass agglomeration, emerging in Kuzbass in the context of the region’s transition on the path of sustainable development. The work provides an overview of successful practices in universities’ achieving significant local impact in terms of effective organization of the campus space. The peculiarities of the Russian context of universities’ turning to regions are noted. A hypothesis is formulated about the reasonableness of the regional university betting on development of campus infrastructure, which is supposed to initiate and support new formats of activities and practices as well as internal institutional changes. On the example of creating a world-level campus in Kemerovo there are shown possible changes in the university model, which allow to solve regional problems of supporting agglomerative development. The paper might be of interest as a case study when designing campus infrastructure development in the regions of Russia.

Effectiveness of transitional-care heart failure programmes in multimorbid patiens: a population-based study with longitudinal real-world data in 77,554 patients

Abstract Background High comorbidity burden has a negative impact in terms of outcomes and medical resource use despite access to integrated care in universal health-care systems in patients with heart failure (HF). Whether the breach in outcomes determined by comorbidity burden can be mitigated by intensive HF management in integrated care programs is not known. Purpose To analyse the effectiveness across morbidity groups on health outcomes of integrated care before and after a pragmatic implementation of an intensive transitional care nurse-based HF management program in a healthcare area of 209,255 inhabitants. Methods We included all individuals discharged alive in Catalonia with HF as the primary diagnosis between 2015 and 2019. Morbidity and clinical complexity were evaluated using the Adjusted Morbidity Group (GMA) index. The GMA is an instrument developed and validated in Catalonia for grouping morbidity that identifies populations with multimorbidity and higher use of healthcare resources and has been shown better discrimination power than Charlson’s Index. For this study we classified patients into 3 morbidity groups: low or intermediate risk GMA, high risk GMA and very high-risk GMA. To evaluate the efficacy of the programme according to GMA strata, we compared outcomes between HF patients of the implementation area and HF patients of the remaining healthcare areas of Catalonia stratified in morbidity groups according to levels of GMA and across implementation periods (years 2015-2016 (pre-implementation), 2017 (transition) and 2018-2019 (consolidation). Results We included 77,554 patients: 3,396 exposed to the implementation area and 74,158 exposed to the rest of healthcare areas. 13,981 had a low or intermediate risk GMA 32,138 high risk and 31,435 very high risk. During the period of the study, 55,886 patients (72.1%) experienced at least one major adverse event. As shown in Table 1, multivariate adjusted Cox proportional hazards models stratified according to GMA groups showed that implementation of the program resulted in an improvement of all studied outcomes in the consolidation period compared to the pre-implementation period across all risk-group according to GMA. As shown in Figure 1, the implementation of the program resulted in a significant reduction of the risk adverse events compared to the rest of Catalonia during the consolidation period (left column) and this improvement was observed across all morbidity-group strata (Figure 1, central and right columns). Interestingly, the size effect of the improvement was particularly noticeable in patients in the high-risk and very high-risk group strata. Conclusions Transitional-care nurse-based HF programmes improve clinical outcomes in patients with HF and are effective regardless the comorbidity burden of patients. Individuals with a very high comorbidity index obtain even a greater reduction of readmissions when exposed to those programs than less comorbid patients.

Impact of age in the effectiveness of the implementation of a transitional-care heart failure program: a population-based analysis with real-world data in 77,554 patients

Abstract Background Old age has a negative impact in terms of outcomes and medical resource use in patients with heart failure (HF). The efficacy of HF management programs has been widely proved, however the influence of age in the effectiveness of HF programs is still unknown. Purpose To analyze the effect of age on health outcomes before and after a pragmatic implementation of an intensive transitional care nurse-based HF management program integrating hospital and primary care and resources for patients with HF at a high risk of events in a health-care area of 209,255 inhabitants. Methods For the purposes of this study, we included all individuals consecutively admitted to hospital with at least one ICD-9-CM code for HF as the primary diagnosis and discharged alive in Catalonia between January, the 1st, 2015 and December, the 31st of 2019. We considered 3 distinct periods of implementation of the HF program: pre-implementation (2015-2016), transition (2017) and consolidation (2018-2019). To evaluate the efficacy of the program according to age strata, we compared outcomes between HF patients of the implementation area and HF patients of the remaining healthcare areas of Catalonia across implementation periods and stratified according to age strata. Results We included 77,554 patients in the study: 3,396 in the implementation area (HUB-Delta area) and 74,158 in the rest of Catalonia. According to age, patients were classified as, 15-74 years age-group (19.624, 25.3%), 75-84 years age-group (28.054, 36.1%) and >84 years age-group (29.876, 38.5%). In the implementation area, all-cause death, clinically related hospitalizations and HF readmissions were significantly improved in the consolidation period compared to the pre-implementation period in all age-groups (Table 1). As shown in Figure 1, left column, the implementation of the program resulted in a significant improvement in all outcomes evaluated for the whole HF population of the HUB-Delta area compared to the rest of Catalonia. The improvement was consistent across all age groups (Figure 1, middle and right columns) in the consolidation period for all outcomes evaluated. However, in patients >84 years old, the size effect of improvement in patients of the HUB-Delta area tended to be attenuated when compared to the benchmark. Conclusions The risk of mortality, clinically related hospitalizations and HF hospitalizations in recently discharged patients with HF has an independent association with age. The implementation of an intensive transitional care nurse-based HF management program improves clinical outcomes across age strata. Remarkably these improvements are also seen in very old patients above 84 years old.Figure 1Table 1

Characterization and prognostic impact of ischemic etiology in heart failure with reduced left ventricular ejection fraction

Abstract Introduction and objectives Ischemic heart disease is the cause of 50-60% of cases of heart failure with reduced left ventricular ejection fraction (HF-rEF). The impact of ischemic etiology on left ventricular ejection fraction (LVEF) improvement and prognosis remains unclear. Our main objective was to analyze the differential clinical profile between ischemic and non-ischemic etiology, as well as its medium-to-long term prognosis. Methods Prospective study of a cohort of patients with HF-rEF in real clinical practice. A comparative analysis was performed between patients with HF-rEF of non-ischemic etiology (Group 1) and ischemic etiology (Group 2). Clinical, analytical, echocardiographic and therapeutic variables were analyzed, and the medium-to-long term impact in terms of mortality and hospital readmissions for HF was evaluated. Results 409 patients were analyzed. 276 patients (67.5%) had non-ischemic etiology and 133 patients (32.5%) had ischemic etiology. Group 2 was older (65.8±13.3vs70.8±10.3;p<0.001), more men (68.1%vs86.5%;p<0.001), higher prevalence of arterial hypertension (62.3%vs76.7%;p = 0.004), diabetes mellitus (38.8%vs67.7%; p<0.001), dyslipemia (52.4%vs82.7%;p<0.001), chronic kidney disease (34.4%vs56.4%;p<0.001), anemia (24.3%vs47.4%;p<0.001) and vascular comorbidity (25.7%vs54.9%;p<0.001) and lower prevalence of atrial fibrillation (56.2%vs44.4%;p = 0.025). In Group 2 there was a lower proportion of de novo HF (60.1%vs45.1%;p = 0.004) with longer HF evolution time (24.4±48.8vs61.5±89.3; p<0.001), a lower proportion of patients improving LVEF at follow-up (51.6%vs21.1%;p<0.001) and a higher baseline NTproBNP concentration [4463(IQR 1976-10431)vs5746(IQR 2336.5-13789);p = 0.039]. Regarding baseline treatment, in Group 1 there was a higher prescription of mineralocorticoid receptor antagonists (78.3%vs63.9%;p = 0.002) and less ICD implantation (6.5vs14.3%;p = 0.01), with no differences in the rest of the treatment. With a mean follow-up of 60 months, Group 2 had a higher readmission rate (39%vs50.3%;p<0.01) and higher HF mortality (26.8%vs41%;p<0.01), with differences from early stages. Conclusions Patients with HF-rEF of ischemic etiology associate a greater number of comorbidities, a lower percentage of de novo HF, longer time of HF evolution, lower percentage of LVEF improvement and higher baseline NTproBNP.

Inquiring the impact of rural-urban migration, construction sector, and agriculture irrigated land on environmental degradation: insights from urbanized Asian countries.

The present study investigates the influence of rural-urban migration, construction sector share, and agriculture-irrigated land on environmental quality in urbanized Asian nations. For analysis, panel data from seven highly urbanized economies from 1996 to 2020 is utilized. The study employed an augmented mean group (AMG) estimator to find short and long-run results. The empirical discoveries depict that rural-urban migration increases energy demand in urbanized areas and significantly contributes to deteriorating environmental quality. The findings also reveal that the expansion of construction sectors is a significant source of high cement production, which also increases carbon emissions and environmental pollution by increasing the concentration of particulate matter in the atmosphere. The findings also exposed the role of agriculture-irrigated land, contributing to carbon emissions in urbanized Asian economies. The study also investigated the impact of the square term of irrigated agricultural land on environmental deterioration, revealing that adding agricultural land will further intensify environmental degradation by increasing carbon emissions in the atmosphere. A policy framework to reduce environmental damage in Asian economies caused by rural-to-urban migration, the building industry, and irrigated agricultural land was recommended based on the study's findings.

15-month follow-up of catheter ablation for atrial fibrillation in octogenarians

Abstract Background Catheter ablation for atrial fibrillation (AF) in octogenarians poses a challenge due to comorbidities, frailty, and suspected higher complication rates. Data regarding the outcome of catheter ablation in this population is scarce. Purpose Due to the projected increase of octogenarians presenting with AF in the future, we investigated the outcome of catheter ablation in this patient population. Methods We retrospectively analysed octogenarians with symptomatic AF undergoing catheter ablation in a single centre, including first and re-ablation procedures. Catheter ablation involved pulmonary vein isolation (PVI) using radiofrequency (RF), cryoballoon (CB) and pulsed field ablation (PFA) as energy sources and also atrial tachycardia (AT) ablation including linear lesions and/or ablation of complex fractionated atrial electrograms (CFAE). Follow-up (FU) was obtained to assess arrhythmia-free survival after a 90-day blanking period, recurrences after the blanking period, management of recurrences, rhythm at FU, use of antiarrhythmic drugs (AADs) and improvement in symptoms (EHRA symptom scale). Results A total of 126 patients (mean age 82.2 ± 1.9 years, paroxysmal AF n=48, persistent AF n=78, mean CHA2DS2-VASc-Score 4.2 ± 1.5) were included. 57.1% (n=72/126) underwent an index procedure {47.2% (n=34/72) RF PVI, 37.5% (n=27/72) CB PVI, 4.2% (n=3/72) PFA PVI and 11.1% (n=8/72) PVI + AT ablation}. 42.9% (n=54/126) received repeat procedures {20.4% (n=11/54) re-PVI, 42.6% (n=23/54) re-PVI + AT ablation, 37% (n=20/54) AT ablation}. FU of 108 patients after 15.4 ± 3.6 months revealed arrhythmia-free survival after the blanking period in 64.8% (n=70/108). Recurrence after the blanking period was seen in 35.2% (n=38/108). No significant difference in recurrences was shown between index and repeat procedures (32.3%, n=20/62 after index procedures and 36.7%, n=18/49 after repeat procedures, p =0.97). Management of recurrence involved repeat ablation (47%, n=18/38), AADs (16%, n=6/38), cardioversion (21%, n=8/38), pacemaker-implantation/AV-node ablation (5%, n=2/38) and pharmacological rate control (11%, n=4/38). At FU, 88.9% (n=96/108) of patients were in sinus rhythm with 21.3% (n=23/108) receiving AADs, 7.4% (n=8/108) were in AF, 0.9% (n=1/108) in AT and 2.8% (n=3/108) pacemaker-dependant. Symptoms were significantly improved at FU (mean EHRA score at FU= 1.2 ± 0.5, before ablation= 2.4 ± 0.5, p <0.0001). Conclusion Catheter ablation for AF in octogenarians is effective in maintaining sinus rhythm and controlling AF-related symptoms. Longer term success and impact on prognosis in this patient population is unknown and should be investigated further.