Non‐ST‐Elevation Myocardial Infarction in the United States: Contemporary Trends in Incidence, Utilization of the Early Invasive Strategy, and In‐Hospital Outcomes

Background: There has been a paradigm shift in the definition of timing of early invasive strategy (EIS) for patients admitted with non‐ST‐elevation myocardial infarction (NSTEMI) in the last decade. Data on trends of EIS for NSTEMI and associated in‐hospital outcomes are limited. Our aim is to analyze temporal trends in the incidence, utilization of early invasive strategy, and in‐hospital outcomes of NSTEMI in the United States. Methods and Results: We analyzed the 2002–2011 Nationwide Inpatient Sample databases to identify all patients ≥40 years of age with the principal diagnosis of acute myocardial infarction (AMI) and NSTEMI. Logistic regression was used for overall, age‐, sex‐, and race/ethnicity‐stratified trend analysis. From 2002 to 2011, we identified 6 512 372 patients with AMI. Of these, 3 981 119 (61.1%) had NSTEMI. The proportion of patients with NSTEMI increased from 52.8% in 2002 to 68.6% in 2011 (adjusted odds ratio [OR; per year], 1.055; 95% confidence interval [CI], 1.054 to 1.056) in the overall cohort. Similar trends were observed in age‐, sex‐, and race/ethnicity‐stratified groups. From 2002 to 2011, utilization of EIS at day 0 increased from 14.9% to 21.8% (Ptrend<0.001) and utilization of EIS at day 0 or 1 increased from 27.8% to 41.4% (Ptrend<0.001). Risk‐adjusted in‐hospital mortality in the overall cohort decreased during the study period (adjusted OR [per year], 0.976; 95% CI, 0.974 to 0.978). Conclusions: There have been temporal increases in the proportion of NSTEMI and, consistent with guidelines, greater utilization of EIS. This has been accompanied by temporal decreases in in‐hospital mortality and length of stay

Application and Use of Social Analysis System2 (SAS2 ) in Nepal

Social Analysis System (SAS2) tools and techniques helped in generating scientific knowledge by applying it in 42 different cases in 12 different disciplines which includes community biodiversity management, preference analysis, community forestry management, social network analysis, access and benefit sharing mechanism and project monitoring. It further helped in providing policy level input in leasehold forestry and methodological input in seed release system. SAS project was successful in building the pool of human resources trained in application of SAS tools and techniques of 6 non-governmental organizations. Besides, more than 556 individuals of 35 community based organizations, farmers group, NGOs and INGOs including government officials received training on various SAS tools

Assessment of land use land cover dynamics and its impact on springs water in Ritung Khola Sub-Watershed, Myagdi district, Nepal

Land Use Land Cover (LULC) Change has emerged as a significant environmental issue and a worry for the sustainable use of natural resources. This study was performed to determine the rate in change of land cover and its significant impact on springs water in the Ritung Khola sub-watershed of Myagdi district, Nepal, between 2010 and 2020. This study analyzes LULC dynamics and it’s impact on springs water using satellite imageries (Landsat 5 TM and Landsat 8 OLI/TIRS) and focus group discussions with the inhabitants. We used Supervised Maximum Likelihood Classification algorithm to classify attributes of the LULC changes. The results demonstrated a significant change in LULC during those ten years (2010-2020). The area covered by agricultural land and human settlements significantly increased by 313.54% and 367.14%, respectively. On the contrary, barren land, water bodies and forest cover have been reduced by 37.52%, 13.16% and 5.26%, respectively. The number of active springs followed decreasing trend as many of them were completely displaced or dried due to erosions and frequent landslides. The findings from this study are expected to facilitate the planning process adopted to prevent springs under the threat of extension and mitigate the water scarcity problem