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Prognostic implications of renal function trajectories in heart failure management
No full textIntroduction: The interaction between the heart and kidneys, known as cardiorenal syndrome, means that worsening renal function (WRF) in heart failure can lead to a vicious cycle, where declining renal function further impairs cardiac performance. Monitoring and managing WRF in heart failure is crucial, as it is associated with poorer prognosis, increased hospitalization rates, and higher mortality.
Purpose: This study is to compare baseline characteristics, treatment regimens, and clinical outcomes in HF patients with WRF versus those with stable or improved renal function at first visit to HF clinic.
Methods: This retrospective cohort study involved 343 HF patients with HFrEF across 10 hospitals from January 2021 to June 2023. WRF is defined by increase in serum creatinine at first HF clinic visit by ≥26.5 μmol/L from baseline or an increase of ≥25% from baseline values. Patients were categorized into WRF (n = 49, 14.3%) and stable/improved renal function (n = 294, 85.7%). Comparative analysis included demographics, comorbidities, medication use, ejection fraction [EF], NYHA class and clinical outcomes (HF hospitalization, mortality, and composite outcomes).
Results: Patients with WRF were slightly older (58.8 ± 14.9 years) than those with stable/improved function (56.5 ± 13.6 years, p = 0.280). Comorbidities such as hypertension (77.6% vs. 65.2%, p = 0.089) and dyslipidaemia (65.3% vs. 51.7%, p = 0.077) were more prevalent in the WRF group. At first visit, renin-angiotensin-aldosterone system inhibitors (RAAS) use was lower in the WRF group (68.8% vs. 84.4%, p = 0.009) but higher beta-blocker use (97.9% vs. 90.1%, p = 0.077). Mineralocorticoid receptor antagonists (MRA), sodium-glucose cotransporter-2 (SGLT2) inhibitor and frusemide use were comparable in both groups. There was no difference with HF medications prescription at 3 months. The WRF group showed significant EF improvement (24.3 ± 4.6% to 41.8 ± 9.7%, p = 0.019), whereas the stable/improved group had a non-significant change (26.5 ± 8.0% to 33.7 ± 12.7%, p = 0.315). The WRF group had a higher composite outcome rate at 3 months (22.9% vs. 7.6%, p < 0.001), HF hospitalization at 3 months (16.3% vs. 5.8%, p = 0.02) and mortality at 3 months (8.5% vs. 2.2%, p = 0.037).
Conclusion: HF patients with WRF experienced greater EF improvement but higher hospitalization and adverse outcomes. Close monitoring and optimizing renal function are vital in HF management to improve patient outcomes
Introduction: The Future of Work Models, Work Dynamics and Workplace Technology in Asia
No full textThe future of work is one of the most pressing topics of the twenty-first century, with technological advancements, shifting social dynamics, and changing economic landscapes driving fundamental transformations in workplaces across the globe. However, the trajectory of work in Asia is distinct, shaped by unique cultural, economic, and demographic factors that set the region apart from the rest of the world. The rapid advancement of information technology, increasing awareness of mental well-being, environmental, social and governance (ESG) principles, and femininity of work culture all have impacted the work models, work dynamics, and the work environment. Various work models emerged, causing workplace dynamics to be more accommodative, and we saw an influx of new workplace technology being deployed to support the changes in the work models. This chapter aims to provide an overview of this book, covering these aspects of the work landscape based on literature and attempts to project the future of work in Asia. This knowledge is essential to equip policymakers, business leaders, and employees with essential perspectives on adapting to evolving dynamics and fostering a more inclusive, resilient, and sustainable future of work in Asia
Centrifuge modelling of complex infrastructure-seabed interaction in the touchdown zone using fibre optic sensing
No full textA key challenge when designing risers and cables is to quantify the level of fatigue in the seabed touchdown zone, where cable/riser overbending and complex soil-structure-fluid interaction occur. In this study, soil-structure interaction was investigated in a geotechnical centrifuge using three-dimensional actuation to model the behaviour of a riser section instrumented with state-of-the-art fibre-optic sensors. Reconstituted natural carbonate silty sand was used to model the seabed. The acquisition of high-resolution data enables interpretation of the distribution of stress and contact force along the model riser under actively controlled (and realistic) heave, surge, and sway motions; as well as quantifying the resulting pitch and yaw rotations. The findings not only contribute to formulating new design approaches for risers used in the conventional energy sector, but also advance understanding relevant to the burgeoning offshore renewables sector by informing dynamic power cable design
Competitive Advantage Management of Madrasah In the Artificial Intelligence Era
No full textMadrasah Aliyah Negeri (MAN) 3 Jombang is one of the high-performing and competitive madrasahs, having been awarded the Research and Skills Madrasah, with a large number
of students from pesantren Bahrul Ulum Tambakberas Jombang. This study aims to describe how it plans, implements, and evaluates its competitive advantages. The study uses a descriptive qualitative approach. Data were collected through interviews, observations, and documentation. The
data obtained were analysed using thematic analysis. Triangulation and member check are used to enhance trustworthiness. The findings show that MAN 3 Jombang initiated competitive advantage planning through brainstorming, becoming a character-based madrasah, a healthy madrasah, and an Adiwiyata madrasah. This planning involved establishing key strategies, internalising Islamic values, holding work meetings, and setting goals based on the vision, mission, objectives, and strategy. The
implementation was carried out by forming working groups, centres for excellence and innovation, extracurricular activities, digitalising services, offering excellent classes and programs, tahfidz, hybrid curriculum, habituation, providing role models, domestic and international partnerships, establishing internal quality assurance, and madrasah culture. Evaluation conducted through academic supervision, Madrasah Self-Evaluation, performance assessment, and product evaluation. This study
provides a practical contribution to Islamic education management, especially in madrasas and pesantrens, by applying competitive advantage management grounded in Islamic values to improve quality, achievement, performance, and image branding. This study offers a valuable practical
contribution to Islamic education management, particularly for madrasas within pesantren, by emphasising the implementation of competitive advantage management grounded in Islamic values to enhance quality, performance, achievements, and image branding
Bornean Orangutan Nest Classification using Image Enhancement with Convolutional Neural Network and Kernel Multi Support Vector Machine Classifier
No full textPreserving wildlife habitats is crucial in mitigating climate change. Species like orangutans and monkeys contribute to fruiting and planting in forests. The World Wide Fund Sabah Malaysia faces challenges in manually identifying and classifying orangutan nests for studying their behaviour and conserving their habitats. To address this, we propose automating the classification of captured images using machine learning algorithms. This research involves three key components: image processing, feature
extraction, and image classification. Our proposed image processing includes several steps, such as image pre-processing and enhancement techniques like local contrast
enhancement, sharpening, intensity adjustment, histogram equalization, and colour thresholding. We applied four different Convolutional Neural Networks (CNNs) to
extract and identify orangutan nests’ features. Subsequently, we utilize Support Vector Machine (SVM) for image classification. The results reveal that the Inception Residual Network Version 2 (ResNet-v2) achieves the best performance. This architecture is then combined with a kernel SVM to classify Bornean orangutan nests. Our approach
demonstrates impressive results, boasting an accuracy of 96.60%, an F1-score of 96.60%, a precision of 96.59%, and a recall of 96.58%. These metrics underscore the high accuracy and effectiveness of our proposed methodology for classifying Bornean orangutan nests. By reducing the need for extensive human intervention in image analysis, our method presents a valuable tool for conservationists and researchers committed to studying and safeguarding these endangered orangutans and their habitats. In future work, we aim to develop orangutan nest detector, contributing to
wildlife conservation research
An Overview of Mechanized Solutions for Oil Spill Treatment
No full textOil spills pose significant environmental hazards and require efficient and timely response measures for containment and cleanup. Mechanized solutions have proven to be instrumental in combating oil spills, offering effective containment, recovery, and treatment methods. This chapter provides an overview of various mechanized solutions used in the treatment of oil spills. We explore key technologies, equipment, and strategies employed in the response to oil spill incidents, emphasizing their effectiveness, limitations, and future prospects
Hidup terus optimis
No full textArtikel inspirasi ini membincangkan kepentingan sikap optimis sebagai kekuatan dalaman dalam menghadapi cabaran dan ketidakpastian kehidupan. Sikap optimis digambarkan sebagai pemangkin yang mendorong individu untuk terus berusaha meskipun berhadapan dengan kegagalan, kekecewaan dan tekanan emosi. Artikel ini menekankan bahawa kejayaan lazimnya terhasil daripada ketekunan, pemikiran positif dan daya tahan diri, bukannya ketiadaan halangan. Melalui pendekatan motivasi, perbincangan turut menyentuh pengalaman kegagalan dan kehilangan semangat yang sering dipengaruhi oleh pelbagai faktor dalaman dan luaran seperti tekanan akademik, kerjaya, keluarga serta persekitaran sosial. Artikel ini menggalakkan penerapan strategi daya tindak yang konstruktif, termasuk refleksi kendiri yang positif, penetapan matlamat yang realistik dan keupayaan menilai pengalaman negatif sebagai peluang pembelajaran. Secara keseluruhan, artikel ini menegaskan bahawa pembudayaan sikap optimis adalah penting bagi kesejahteraan emosi, perkembangan diri dan kejayaan jangka panjang, serta menyeru individu untuk bangkit daripada cabaran dengan keyakinan dan pemikiran yang lebih positif
Relationship between waist circumference and random blood glucose level in healthy young adults
No full textObesity has been strongly linked to metabolic diseases including type 2 diabetes mellitus (T2DM). The prevalence of obesity in young adults is increasing globally. Although body mass index (BMI) reflects general obesity, it fails to capture abdominal fat, a key predictor of insulin resistance and diabetic risk. Waist circumference (WC) is a simple anthropometric measurement for assessment of body composition and associated health risks, including T2DM. This study aimed to investigate the association
between WC and random blood glucose (RBG) level in healthy young adults
Cultural Symbolism and Sustainability of Orang Ulu Bead Craft in Bario, Sarawak
No full textThis paper explores the cultural symbolism, traditional knowledge, and sustainability challenges of bead-making among the Orang Ulu community in Bario, Sarawak. An in-depth
interview is conducted with an experienced bead artisan to document the meanings of bead colours and motifs, their traditional functions, and the factors threatening their continuity. Findings reveal that bead colours such as red, white, black, and yellow are imbued with symbolic values representing bravery, purity, ancestral connection, and prosperity. At the same time, motifs depict continuity and wealth. Beads are integral to ceremonial life, social status, and identity affirmation, yet face threats from declining youth participation, scarcity of materials, and competition from mass-produced alternatives. Duxbury et al. (2024) assert that safeguarding such cultural expressions is central to fostering community resilience and resisting the erosion of local identity in the face of globalisation. The study proposes preservation strategies including education-based interventions, modern design collaborations,
and community-led exhibitions. These strategies aim to safeguard bead-making as an essential component of intangible cultural heritage, contributing to cultural resilience and sustainable rural development