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BackgroundFrailty is common in patients with heart failure (HF) and is associated with poor clinical outcomes, including recurrent hospitalisations, functional decline, long-term care need and death. Frailty is a dynamic condition; individuals can fluctuate between different severity states. The pattern in which frailty status changes over time and its relation to clinical outcomes in patients with HF is poorly understood.ObjectivesTo describe the frailty trajectory of ambulatory patients with HF and explore how subsequent and recurrent hospitalisations during follow up impact on the frailty trajectory.MethodsWe prospectively recruited consecutive patients between August and September 2021, who have attended our rapid access HF clinic with suspected HF and followed them until February 2022. We performed in-depth analysis on a subgroup of patients with confirmed HF with ≥ 1 hospital admission during the follow up period to understand their frailty trajectory. Frailty status was determined using the Clinical frailty scale (CFS): CFS 3 = non-frail; CFS 4 = pre-frail; CFS ≥5 = frail. We studied how the baseline frailty status change after each hospital admission, considering the length of stay and cause of admission.Results83 patients were assessed at our rapid access HF clinic and 67 (80%) patients had confirmed HF. During a median follow up of 498 days, 27 (40%) HF patients had ≥1 hospital admission and 12 (18%) had recurrent (>1) hospital admissions. Of HF patients with ≥1 hospital admission, 51% were male, median (Range) age was 74(51-93) years; median (Range) NTproBNP was 1300 (100-16659) ng/L; 63% had HFpEF (LVEF>50%)]. 6 (22%) patients were non-frail (CFS 3); 10 (37%) were pre-frail (CFS 4) and 11 (41%) were frail (CFS ≥5) at baseline.Patients who were frail at baseline were more likely to experience worsening frailty status with subsequent hospital admissions, when compared to those who were non-frail or pre-frail at baseline (78% in CFS 5 vs 30% in CFS 4 vs 33% in CFS3, p=0.05) (Figure 1).The frailty trajectory of individual patients in relation to each hospital admission was shown in Figure 2. Apart from baseline frailty status, the frailty trajectory also varied according the number and cause of hospital admissions. Patients with recurrent admissions were more likely to experience worsening frailty status over time irrespective of their baseline frailty status. Falls (30%) and infections (38%) were the most common causes of hospital admissions corresponding to a worsening frailty status. The length of stay had no impact on frailty trajectory.ConclusionWorsening frailty status at baseline and recurrent hospital admissions with falls and infection were associated with worsening frailty trajectory over time in ambulatory patients with HF. Frailty is a dynamic state and should be evaluated at regular intervals, to identify patients at risk of deterioration in a timely fashion.Abstract 135 Figure 1Bar chart showing the proportion of patients with improved, stable or worsening frailty status after hospital admission, stratified according to baseline frailty statusAbstract 135 Figure 2Frailty trajectory of individual patients in relation to each hospital admission, stratified according to baseline frailty statusConflict of InterestNo Conflict of Interest

Here, we report a facile route to the synthesizing of a new donor-acceptor complex, L3, using 4-{[(anthracen-9-yl)meth-yl] amino}-benzoic acid, L2, as donor moiety with anthraquinone as an acceptor moiety. The formation of donor-acceptor complex L3 was facilitated via H-bonding and characterized by single-crystal X-ray diffraction. The X-ray diffraction results confirmed the synthesized donor-acceptor complex L3 crystal belongs to the triclinic system possessing the P-1 space group. The complex L3 was also characterized by other spectral techniques, viz., FTIR and UV absorption spectroscopy, which confirmed the formation of new bonds between donor L2 moiety and acceptor anthraquinone molecule. The crystallinity and thermal stability of the newly synthesized complex L3 was confirmed by powdered XRD and TGA analysis and theoretical studies; Hirshfeld surface analysis was performed to define the type of interactions occurring in the complex L3. Interestingly, theoretical results were successfully corroborated with experimental results of FTIR and UV absorption. The density functional theory (DFT) calculations were employed for HOMO to LUMO; the energy gap (∆E) was calculated to be 3.6463 eV. The complex L3 was employed as a photocatalyst for the degradation of MB dye and was found to be quite efficient. The results showed MB dye degraded about 90% in 200 min and followed the pseudo-first-order kinetic with rate constant k = 0.0111 min and R = 0.9596. Additionally, molecular docking reveals that the lowest binding energy was -10.8 Kcal/mol which indicates that the L3 complex may be further studied for its biological applications.

Ocean thermal energy conversion (OTEC) is a solution for environmental and climate change issues in the tropics. The OTEC potential in Malaysia using ocean conditions and bathymetry data has been previously studied and demonstrated. Following this, it is vital to perform a basic performance analysis of a 10 MW Rankine Cycle OTEC plant using the Malaysian ocean conditions. In this paper, the results of heat and mass balance will be reported for a 10 MW Rankine cycle OTEC plant which uses heat exchangers of plate-type and anhydrous ammonia as its working fluid. The value of a minimum objective function (γ) is derived by total heat surface area (AT) divided by the net power (PN). γ decreases when the inlet temperature difference (inlet temperature of warm seawater (TWSWI)—inlet temperature of cold seawater (TCSWI)) increases. PN is clarified to be approximately 70–80% of the PG (gross power) using Malaysian ocean conditions.

Composted green waste is a recycled material which can be produced locally, adding value to the environmental credentials of a green roof system. As the organic component of green roof growing media, composted green waste can contribute positively to the physical requirements as well as improve environmental performance. In addition it can contain nutrients for plant growth and survival. These will not typically be provided by an inert inorganic substrate and will help establish vegetation. This study is aimed to investigate the performance of bio compost as soil media in extensive green roof with respect to different composition. Runoff were tested for total suspended solids (TS), turbidity, chemical oxygen demand (COD), pH, and color measurements. The results showed that 50% of bio compost in soil media has the best performance in term of plant growth and runoff quality.

Water hyacinth (WH) is notorious for causing severe environmental degradation and being an economic burden to manage. However, it offers substantial prospects if exploited, especially by rural communities. High temperatures, eutrophic conditions and other environmental factors promote the proliferation of the plant in regions where it has been introduced. Regarded as among the world’s worst invasive weeds, WH is nearly impossible to control and eradicate without an integrated approach and community participation. The effectiveness of control methods varies, yet sustained community involvement determines the long-term success of these methods. Reproducing rapidly, WH has the resource capacity to support a unique microeconomic ecosystem, incentivising WH control by generating sustainable income. The WH ecology, the socioeconomic impacts of its invasion and its various applications are reviewed, and revenue generation and cost-saving options are highlighted. A circular microeconomic model is proposed by integrating WH valorisation into the general limitations of a rural community. Empowering locals with opportunities and enticing them with potential economic gains can be a nudge towards a pro-environment behavioural change in managing WH. This would aid in upgrading local livelihoods and could foster resilience within the community in tackling both environmental problems and economic setbacks through the management of WH invasions.

Hepatitis B reactivation (HBVr) in cancer patients is a well-established complication due to chemotherapy-induced immunosuppression. Studies have reported HBVr associated with immunosuppressive medications, such as rituximab, methotrexate, and high dose steroids. There are different risks for different types of chemotherapy with rituximab carrying one of the highest risks for hepatitis B reactivation. Tyrosine kinase inhibitors (TKIs) are the standard of care in patients with chronic myeloid leukemia (CML). The risk of HBVr in chronic myeloid leukemia has been reported in many studies, but to this date, there are no clear guidelines or recommendations regarding screening and monitoring of HBV in CML patients receiving TKIs. We conducted this review to identify the risk of HBVr in patients with CML who are treated with tyrosine kinase inhibitors. We recommend testing for HBV status in patients who are to be treated with TKIs and to consider giving prophylaxis in those who are positive for HBsAg at baseline. More studies are needed to assess the risk of reactivation in patients with Hepatitis B core antibody positive receiving TKIs. Currently, monitoring such patients for reactivation may be the best strategy.

This study examined the anatomical features of Anacardiaceae from Malaysia. A total of 31 species from 13 genera of the family Anacardiaceae in Malaysia were obtained from Kepong Xylarium (KEPw), Forest Research Institute Malaysia. The genera in Anacardiaceae were distinguished based on anatomical features. The diagnostic anatomical features that were used to separate the genera are scalariform perforations plates present in Campnosperma, larger rays in Pentaspadon and Spondias, and radial canals in some genera. Mineral inclusion, i.e., crystals and silica also could be diagnostic features to distinguish the genera in Malaysian Anacardiaceae; silica was observed in Gluta, Parishia, and Swintonia. Anatomical features could be used as indicators to the other wood properties and lead to potential usage of timber in Anacardiaceae. However, the presence of druses in individual Toxicodendron succedaneum indicated its adaptation to the local microclimatic conditions.

Purpose This paper aims to develop 3D-printed customized padding to increase pressure at the zero pressure region. This padding is specifically intended for facial areas with complex contours in pressure therapy treatment of hypertrophic scars. Design/methodology/approach To carry out this study, a full-face head garment was fabricated by a local occupational therapist, and pressure measurements were conducted to establish the pressure exerted by this head garment and to determine the zero pressure region. Furthermore, an additional manufacturing method was used to construct customized padding, and pressure measurements were performed to measure the pressure exerted after application of this customized padding. Findings The results reveal that 3D-printed customized padding can increase pressure at the zero pressure region, which occurs on complex contour surfaces with a spatial gap because of non-contact of the head garment and facial surfaces. Practical implications This paper suggests that an additive manufacturing method using 3D printing is capable of producing accurate, functional and low-cost medical parts for rehabilitation. Moreover, the 3D-printed padding fabricated by additive manufacturing assists in generating optimal pressure, which is necessary for effective pressure therapy. Originality/value Digital design using 3D scanning, computer-aided design and 3D printing is capable of designing and producing properly fitting, customized padding that functions to increase pressure from zero to an acceptable pressure range required for pressure therapy.

Hybrid Ocean Thermal Energy Conversion (H‐OTEC) systems are characterized by the adoption of both open‐loop and closed‐loop Rankine cycles. In the closed‐loop configuration, a working fluid such as ammonia is evaporated in a heat exchanger, utilizing the heat from water vapor generated in a vacuum chamber by warm surface seawater introduction. The vapor is then expanded through a turbogenerator to produce electricity before being condensed in a cold‐water heat exchanger using cold water. In Malaysia, significant advancements are being made in the technology for seawater suction systems, particularly for applications in fish breeding, farming, desalination plants, and power generation. The operation of an H‐OTEC Experimental system at UPM I‐AQUAS, Port Dickson, Malaysia depends on surface seawater for turbine operation, necessitating the installation of a piping system spanning 336 m from the H‐OTEC facility to the suction location. Challenges associated with seawater intake systems include pump cavitation due to high suction head, pipe contamination by organisms such as barnacles and algae, pump placement, strainer size, and pipe diameter intake. The primary objective of this study is to provide valuable insights, conduct field testing, and gather necessary data for the development of the first‐of‐its‐kind surface seawater piping system for H‐OTEC in the Asian region. This objective was accomplished through the installation of a centrifugal pump unit with a flow rate of 40 m3/h (600 L/min), the laying of 106 mm inner diameter parallel pipes, installation of strainers, and a booster pump connected to a 125 A HDPE pipe. The collected data provides the necessary input in establishing the layout design and location selection of the seawater intake pipe, introduce a novel helical crossflow self‐cleaning suction screen water intake system, facilitate weight structure design, and enable pump sizing and suction pump analysis.

Malaysia’s heritage structures are facing challenges due to rapid local development and societal challenges that threaten their cultural and artistic values. Improving conservation approaches in this context is an urgent and crucial task. The application of geo-information technologies in laser scanning, photogrammetry, and geographic information systems (GISs) has significantly improved these conservation approaches. In this study, we fused drone images and range data from a laser scanner to construct a high-resolution three-dimensional GIS city model for one traditional Malay settlement located in Malaysia. The results showed that fusing photogrammetry and laser scanning can effectively capture the architectural uniqueness of Malay buildings, including specific façade geometries on walls, roofs, and motifs. The findings show that the development of various geoinformation approaches can assist with the conservation of Malay city heritage in this region.