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Organic clay has low bearing capacity, low shear strength, sensitive to water content, and high compressibility. Therefore, the study about engineering properties improvement of organic clay is continuously in progress. In this research, bagasse ash (BA) and calcium carbide residue (CCR) were used as stabilizing agents to improve engineering properties of organic clay. Preliminary investigation was done to get the physical parameters, especially Atterberg limit of soil samples. To get the optimum water content (OMC), the original soil was compacted according to standard compaction test. The oven dried soil was mixed with 5, 10, 15, 20, 25 and 30% of binder and cured with 7,21,36 and 56 days curing period. Then, Atterberg limits, unconfined compression strength, and modulus of elasticity of treated soil were investigated. The plasticity index (PI) of stabilized soil decreases proportional to the binder quantity. However, after 10% binder, there was no significant improvement of PI of treated soil. With respect to curing period, PI of stabilized soil decreased, but the decrease of PI was almost constant from 36 to 56 days curing time. Unconfined compression strength (UCS) and modulus of elasticity of stabilized organic clay improve proportionally to both binder proportion and curing period. However, the improvement is not significant enough due to organic content in the organic clay.

Heart failure with preserved ejection fraction (HFpEF) is a growing healthcare burden worldwide and its prevalence is increasing. Diagnosing HFpEF is challenging and relies upon the presence of symptoms and/or signs of heart failure, preserved left ventricular systolic function, and evidence of diastolic dysfunction. Current diagnostic algorithms mainly rely on echocardiography (E/e’) and biomarkers (NT-proBNP). However, only a minority of patients with HFpEF are identified, and especially HFpEF patients at an early stage of the disease are easily missed. We propose to incorporate invasive stress testing, by means of right heart catheterisation at rest and during exercise, and accurate assessment of right ventricular function, by means of cardiac magnetic resonance imaging. These additions to the current diagnostic work-up will improve diagnostic sensitivity and accurate staging of HFpEF patients.

Research about chemically stabilized organic soil to improve shear strength has been done by many researchers. However, they have never undertaken the research about the the effect of water content on physical and chemical characteristics of stabilized organic soil. A set of experimental program performed in this research were chemical composition of organic soil (OS), calcium carbide residue (CCR), and bagasse ash (BA); also the physical characteristics of OS. The admixture (60% CCR + 40% BA) was added to the soil with proportion 5, 10, 15, 20, 25 and 30% with various water content, and the samples were cured in 7, 14, 21, and 36 days-curing time. Then, the experiment of physical properties of the stabilized soil was undertaken. The physical characteristics of the stabilized soil change with respect to the water content, quantity of admixture and the curing times. On the high water content, the changes of the physical properties are more significant compared to that on the lower water content. The unit weight, specific gravity, and the degree of acidity increase whereas void ratio and organic content decrease according to the proportion of the admixtures and curing time.

This study aims to measuring and revealing the role of innovation capacity and technology adoption towards product innovation performance in Micro Small Enterprises (MSEs) Food Industry. The research has applied analysis and clustering, regression and path analysis, by collecting data from a set of questionnaires to 76% of the total MSEs in food industry under the guidance of Research Unit for Natural Product Technology-Indonesia Institute of Sciences. The results demonstrated that innovation capacity variable has a significant effect which leads to a positive association with product innovation performance, as well as the existence of a significant indirect relationship through adoption technology as a mediator variable. Suggestions for conducting technology intervention in accordance with the results of regression test and clustering that are formed based on product characteristics and scale of business to improve food safety and product innovation performance are presented.

Background Currently, no specific treatment exists for heart failure with preserved ejection fraction (HFpEF). Left ventricular (LV) relaxation during diastole is a highly energy-demanding process, while energy homeostasis is known to be compromised in HFpEF. We hypothesise that trimetazidine – a fatty acid β‑oxidation inhibitor – improves LV diastolic function in HFpEF, by altering myocardial substrate use and improving the myocardial energy status. Objectives To assess whether trimetazidine improves LV diastolic function by improving myocardial energy metabolism in HFpEF. Methods The DoPING-HFpEF trial is a randomised, double-blind, placebo-controlled cross-over intervention trial comparing the efficacy of trimetazidine and placebo in 25 patients with stable HFpEF. The main inclusion criteria are: New York Heart Association functional class II to IV, LV ejection fraction ≥50%, and evidence of LV diastolic dysfunction. Patients are treated with one 20-mg trimetazidine tablet or placebo thrice daily (twice daily in the case of moderate renal dysfunction) for two periods of 3 months separated by a 2-week washout period. The primary endpoint is the change in pulmonary capillary wedge pressure during different intensities of exercise measured by right heart catheterisation. Our key secondary endpoint is the myocardial phosphocreatine (PCr)/ATP ratio measured by phosphorus-31 magnetic resonance spectroscopy and its relation to the primary endpoint. Exploratory endpoints are 6‑min walk distance, N -terminal pro-brain natriuretic peptide levels, and quality of life. Conclusion The DoPING-HFpEF is a phase-II trial that evaluates the effect of trimetazidine, a metabolic modulator, on diastolic function and myocardial energy status in HFpEF. [EU Clinical Trial Register: 2018-002170-52; NTR registration: NL7830]

The effect of haemodynamic monitoring of pulmonary artery pressure has predominantly been studied in the USA. There is a clear need for randomised trial data from patients treated with contemporary guideline-directed-medical-therapy with long-term follow-up in a different health-care system. MONITOR-HF was an open-label, randomised trial, done in 25 centres in the Netherlands. Eligible patients had chronic heart failure of New York Heart Association class III and a previous heart failure hospitalisation, irrespective of ejection fraction. Patients were randomly assigned (1:1) to haemodynamic monitoring (CardioMEMS-HF system, Abbott Laboratories, Abbott Park, IL, USA) or standard care. All patients were scheduled to be seen by their clinician at 3 months and 6 months, and every 6 months thereafter, up to 48 months. The primary endpoint was the mean difference in the Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary score at 12 months. All analyses were by intention-to-treat. This trial was prospectively registered under the clinical trial registration number NTR7673 (NL7430) on the International Clinical Trials Registry Platform. Between April 1, 2019, and Jan 14, 2022, we randomly assigned 348 patients to either the CardioMEMS-HF group (n=176 [51%]) or the control group (n=172 [49%]). The median age was 69 years (IQR 61–75) and median ejection fraction was 30% (23–40). The difference in mean change in KCCQ overall summary score at 12 months was 7·13 (95% CI 1·51–12·75; p=0·013) between groups (+7·05 in the CardioMEMS group, p=0·0014, and –0·08 in the standard care group, p=0·97). In the responder analysis, the odds ratio (OR) of an improvement of at least 5 points in KCCQ overall summary score was OR 1·69 (95% CI 1·01–2·83; p=0·046) and the OR of a deterioration of at least 5 points was 0·45 (0·26–0·77; p=0·0035) in the CardioMEMS-HF group compared with in the standard care group. The freedom of device-related or system-related complications and sensor failure were 97·7% and 98·8%, respectively. Haemodynamic monitoring substantially improved quality of life and reduced heart failure hospitalisations in patients with moderate-to-severe heart failure treated according to contemporary guidelines. These findings contribute to the aggregate evidence for this technology and might have implications for guideline recommendations and implementation of remote pulmonary artery pressure monitoring. The Dutch Ministry of Health, Health Care Institute (Zorginstituut), and Abbott Laboratories.

Background and aimsThe Heavy, Hypertensive, Atrial fibrillation, Pulmonary hypertension, Elder, Filling pressure (H2FPEF) score is a widely used diagnostic tool for heart failure with preserved ejection fraction (HFpEF). Angina symptoms are common in patients with HFpEF but are not included in the score. We aimed to determine whether incorporating angina into the H2FPEF score improves its diagnostic performance sex-specifically, given the well-known sex differences in both HFpEF and angina presentation.MethodsWe included 515 individuals from the UHFO-DM cohort with suspected HFpEF. Participants underwent standardised symptom collection, including angina using WHO questionnaires, and expert-panel adjudication of HFpEF. Following evaluation of H2FPEF, we assessed the association of angina with HFpEF independent of H2FPEF using logistic regression. By adding angina to H2FPEF, we developed a modified algorithm and evaluated it by the area under the receiver operating characteristic curve (AUC), calibration, reclassification and decision curve analysis. All analyses were stratified by sex. We also included another 751 individuals with suspected HFpEF from a Combination cohort of UHFO-COPD (n=136), STRETCH (n=331) and TREE (n=284) for regression analysis.ResultsIn the UHFO-DM cohort, HFpEF prevalence was 24%. Overall H2FPEF discrimination (AUC) was 0.72, with 0.69 in women and 0.74 in men. Angina was independently associated with HFpEF in women (OR 3.96, 95% CI 1.72 to 9.11, p=0.001) but not in men (1.90, 0.88 to 4.10, 0.102). Adding one point for angina in a modified H2FPEF score in women improved AUC from 0.69 to 0.71 (DeLong p=0.030), increased sensitivity (0.53 to 0.60) and negative predictive value (0.80 to 0.82) and yielded a continuous net reclassification improvement of 0.449, with preserved calibration and higher net clinical benefit on decision curves. No performance gain was observed with the same modification in men. In the Combination cohort, angina was also independently associated with HFpEF only in women (women, 2.13, 1.14 to 3.97, 0.018; men, 0.85, 0.44 to 1.66, 0.638).ConclusionsIn women with suspected HFpEF, the presence of angina provides diagnostic information independent of H2FPEF to uncover HFpEF. A simple sex-specific modification of H2FPEF, adding one point for angina in women, may slightly improve discrimination and rule-out performance in women.

Color images have more information and more storage space than gray images. The process of computing color images is also more complex compared to gray images. Nevertheless, human vision is more sensitive to color images compared to gray images, so color image processing is so important. Image watermarking is a method of copyright protection by embedding copyrights in the image. The embedding process can cause changes in the pixel value of the image, so it needs to be analyzed and measured the quality of watermarked images both visually or imperceptibility and watermark durability. In general, color images use the RGB color space model and color space conversion is not done when embedding watermarking. But several studies have suggested converting RGB color space to YCbCr color space for a specific purpose. This research proposes to analyze the robustness and imperceptibility performance in the R, G, B and Y color spaces in the CRT method. CRT is one of the methods of image watermarking in the spatial domain, where this method was previously also used as a cryptographic algorithm. So that the CRT method excels in durability and security watermarks. Based on the results of testing with the CRT method, the color space R has an advantage in the aspect of imperceptibility compared to other color spaces, the difference is very thin with the G and B color spaces, but when compared with the Y color space the difference reaches 3dB based on the PSNR calculation. But for testing the robustness of the color space Y is far superior compared to other color spaces even though extraction without attack, not all watermarks can be extracted perfectly.