Search Results (70)

Background/Objectives: The clinical application of CAD/CAM restorative materials continues to evolve due to increasing demand for aesthetic, durable, and minimally invasive indirect restorations. Hybrid nanoceramics, such as Grandio disc (VOCO GmbH, Cuxhaven, Germany), are increasingly used in indirect restorative dentistry due to their favourable combination of mechanical strength, polishability, wear resistance, and bonding potential. One challenge associated with adhesive protocols for CAD/CAM materials lies in achieving durable bonds with resin cements. Extensive post-polymerization during fabrication reduces the number of unreacted monomers available for chemical interaction, thereby limiting the effectiveness of traditional adhesive strategies and necessitating specific surface conditioning approaches. This study aimed to evaluate, in a preliminary, non-inferential manner, the influence of several combined conditioning protocols on surface micromorphology, elemental composition, and descriptive SBS trends of a CAD/CAM hybrid nanoceramic. This work was designed as a preliminary pilot feasibility study. Due to the limited number of specimens (two discs per protocol, each providing two independent enamel bonding measurements), all bond strength outcomes were interpreted descriptively, without inferential statistical testing. This in vitro study investigated the effects of various surface conditioning protocols on the adhesive performance of CAD/CAM hybrid nanoceramics (Grandio disc, VOCO GmbH, Cuxhaven, Germany) to dental enamel. Hydrofluoric acid (HF) etching was performed to improve adhesion to indirect resin-based materials using two commercially available gels: 9.5% Porcelain Etchant (Bisco, Inc., Schaumburg, IL, USA) and 4.5% IPS Ceramic Etching Gel (Ivoclar Vivadent, Schaan, Liechtenstein), in combination with airborne-particle abrasion (APA), silanization, and universal adhesive application. HF may selectively dissolve the inorganic phase, while APA increases surface texture and micromechanical retention. However, existing literature reports inconsistent results regarding the optimal conditioning method for hybrid composites and nanoceramics, and the relationship between micromorphology, elemental surface changes, and adhesion remains insufficiently clarified. Methods: A total of ten composite specimens were subjected to five conditioning protocols combining airborne-particle abrasion with varying hydrofluoric acid (HF) concentrations and etching times. Bonding was performed using a dual-cure resin cement (BiFix QM) and evaluated by shear bond strength (SBS) testing. Surface morphology was examined through environmental scanning electron microscopy (ESEM), and elemental composition was analyzed via energy-dispersive X-ray spectroscopy (EDS). Results: indicated that dual treatment with HF and sandblasting showed descriptively higher SBS, with values ranging from 5.01 to 6.14 MPa, compared to 1.85 MPa in the sandblasting-only group. ESEM revealed that higher HF concentrations (10%) created more porous and irregular surfaces, while EDS indicated an increased fluorine presence trend and silicon reduction, indicating deeper chemical activation. However, extending HF exposure beyond 20 s did not further improve bonding, suggesting the importance of protocol optimization. Conclusions: The preliminary observations suggest a synergistic effect of mechanical and chemical conditioning on hybrid ceramic adhesion, but values should be interpreted qualitatively due to the pilot nature of the study. Manufacturer-recommended air abrasion alone may provide limited adhesion under high-stress conditions, although this requires confirmation in studies with larger sample sizes and ageing simulations. Future studies should address long-term durability and extend the comparison to other hybrid CAD/CAM materials and to other etching protocols. Full article

Background and Objectives: Type 2 diabetes mellitus (T2DM) substantially increases the risk of heart failure (HF) and worsens its prognosis. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), initially developed for glycemic control, have shown important cardiovascular benefits. This systematic review and meta-analysis evaluated the effects of SGLT2i on HF hospitalizations, cardiovascular (CV) death, and renal outcomes, as well as their safety profile, in patients with T2DM and established HF. Materials and Methods: Following PRISMA 2020 guidelines, we systematically searched PubMed, the Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing SGLT2i with placebo in adults with T2DM and HF. Data on HF hospitalizations, CV death, other clinical outcomes, and adverse events were extracted. Risk of bias was assessed using the Cochrane RoB2 tool, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using RevMan 5.4.1. Results: Ten RCTs including more than 21,000 participants met the inclusion criteria. Most were large, international, double-blind trials with overall low risk of bias. SGLT2i reduced the composite of worsening HF or CV death by about 21% (pooled HR 0.79, 95% CI 0.69–0.89), mainly driven by a consistent reduction in HF hospitalizations across trials. Effects on CV death alone were directionally favorable but not uniformly significant. Furthermore, SGLT2i were associated with beneficial effects on cardiac function and patient-reported health status and showed consistent renoprotective effects. The safety profile was favorable, with a small increase in genital infections and no excess of hypoglycemia or other serious adverse events. Conclusions: In patients with T2DM and HF, SGLT2i meaningfully reduce HF events and provide additional renal benefits with good tolerability. Our findings consolidate and update the current evidence by focusing specifically on RCTs enrolling patients with both T2DM and established HF across the spectrum of ejection fraction, thereby reinforcing the role of SGLT2i as a key component of guideline-directed therapy in this high-risk population. Full article

Background/Objectives: Complex emotions in daily life often arise as mixtures of basic emotions, but most emotion-recognition systems still target a small set of discrete states and rely on contact-based sensing. This study aimed (1) to examine whether four compound emotions—Positive Surprise, Negative Surprise, Positive Sadness, and Negative Sadness—defined by valence direction within basic emotion categories can be differentiated using heart rate variability (HRV), and (2) to evaluate the feasibility of a camera-based contactless system (Deep Health Vision System, DHVS) by comparing it with a reference chest-strap device (Polar H10). Methods: Ten healthy adults viewed video clips designed to induce the four complex emotions. HRV was recorded simultaneously using Polar H10 and a webcam-based rPPG implementation of DHVS. Two-minute baseline and during-stimulus segments were extracted, and change rates of standard HRV indices were computed. After each stimulus, participants reported Valence, Arousal, Dominance, and proportional basic-emotion composition. Statistical analyses examined within-condition HRV changes, associations between HRV and self-reports, differences across emotion/valence conditions, and concordance between DHVS and Polar H10. Results: Self-reports confirmed distinct affective profiles for the four compound emotions. Positive and Negative Surprise were associated with heart rate reduction, while Positive Sadness showed reduced total power; Negative Sadness yielded heterogeneous but nonsignificant HRV changes. Specific HRV indices demonstrated condition-dependent correlations with Valence, Arousal, and Dominance. LF/HF changes were more sensitive to emotion category (Surprise vs. Sadness), whereas total power changes were more sensitive to valence (positive vs. negative). DHVS partially reproduced Polar H10 HRV patterns, with clearer concordance under positive-valence conditions. Conclusions: HRV captures distinct autonomic signatures of complex emotions defined by valence direction and shows meaningful links with subjective affective evaluations. LF/HF and total power provide complementary information on emotion category and valence-related autonomic reactivity, supporting indicator-specific modeling strategies. DHVS shows preliminary feasibility as a contactless HRV sensing platform for complex emotion recognition, warranting further validation with larger samples and more robust rPPG processing. Full article

Background/Objectives: Heart Failure (HF) remains a leading cause of hospitalization and mortality worldwide, representing a significant burden on patients and healthcare systems. Despite advances in pharmacological and device-based therapies, readmission rates remain high and traditional monitoring approaches often fail to detect early physiological deterioration. This review examines the clinical utility and implementation challenges of remote hemodynamic monitoring in HF, highlighting its role in improving patient outcomes and guiding precision care. Method: A comprehensive narrative review was conducted using PubMed, Scopus, and Web of Science databases to identify peer-reviewed English-language studies published in the past ten years. Results: Monitoring hemodynamic status is essential for preventing HF readmissions, as elevated filling pressures often precede symptoms. Previous studies suggest that traditional methods may be less effective in detecting early changes, which could contribute to delays in initiating treatment. Remote monitoring offers continuous, individualized assessment and has shown potential to reduce hospitalizations, though its effectiveness varies across populations and settings. Telemonitoring primarily targets patients at higher risk of hospitalization, such as those classified as New York Heart Association(NYHA) class III and individuals with comorbidities that exacerbate HF. Remote hemodynamic monitoring presents notable clinical advantages, although its widespread adoption faces several challenges (i.e., the invasiveness of some monitoring systems; limited patient adherence due to technical complexity or cognitive and physical barriers; difficulties associated with comorbidities; variability in the efficacy of monitoring strategies across populations; difficulties faced by healthcare teams in managing and interpreting large volumes of real-time data; cost-effectiveness issues related to devices and infrastructure costs). Addressing these limitations will be essential to fully understanding the potential of remote monitoring in HF care. Conclusions: Remote hemodynamic monitoring enables early detection of physiological deterioration in HF, allowing timely interventions that reduce hospitalizations and improve outcomes. Emerging evidence suggests that, in contrast to traditional approaches, this method has the potential to support more personalized, data-driven care. Integrating biopsychosocial, gender, and intersectional perspectives further aligns this strategy with precision medicine, enhancing its effectiveness and equity in clinical practice. Despite promising recent advances, further research is essential to broaden the scientific evidence base and to enhance support for clinical decision-making. Full article

Background/Objectives: Beetroot supplementation is a rich source of inorganic nitrate and has been proposed to enhance nitric oxide bioavailability and support cardiovascular recovery after exercise. This study aimed to evaluate the effects of beetroot supplementation on post-exercise cardiovascular and autonomic recovery in postmenopausal women. Methods: A systematic review and meta-analysis were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Searches were performed in PubMed, Scopus, and Web of Science databases from inception to July 2025. Ten trials involving postmenopausal women were included. Outcomes assessed included cardiovascular measures (blood pressure and vascular function), autonomic parameters derived from heart rate variability (HRV)—specifically the root mean square of successive differences (RMSSD), the standard deviation of normal-to-normal intervals (SDNN), and high-frequency power (HF)—as well as physical performance (peak oxygen uptake [VO_2peak or VO_2max] and functional fitness tests). Four independent reviewers extracted data, assessed risk of bias, and evaluated the certainty of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Results: Pooled analyses from two trials (n = 54) revealed a statistically significant improvement in RMSSD with beetroot supplementation (mean difference: 6.68 ms; 95% CI: 0.86 to 12.50; p = 0.02), suggesting enhanced parasympathetic reactivation after exercise. No significant effects were detected for HF (mean difference: 61.75 ms²; 95% CI: −70.92 to 194.43; p = 0.36) or SDNN (mean difference: 6.20 ms; 95% CI: −9.69 to 22.09; p = 0.44). Substantial to considerable heterogeneity was identified across outcomes (I² = 73–86%). Certainty of evidence was rated moderate for RMSSD, low for SDNN, and very low for HF. Conclusions: Beetroot supplementation may enhance post-exercise autonomic recovery in postmenopausal women, primarily through improvements in RMSSD. However, further trials with standardized protocols, larger samples, and longer intervention durations are required to clarify its impact on broader HRV domains, cardiovascular function, and clinical outcomes. Full article

Background: Transthyretin cardiac amyloidosis (ATTR-CM) is an infiltrative cardiomyopathy that frequently progresses to symptomatic heart failure (HF), often with mildly reduced or reduced ejection fraction (EF). Standard therapies are limited in NYHA III–IV, and Tafamidis is approved only for the early stages. Cardiac contractility modulation (CCM) therapy has shown promise in HF with reduced EF, but its role in ATTR-CM remains unexplored. Methods: This multicentric, prospective pilot study evaluated the safety and efficacy of CCM therapy in ten patients (n = 10) with ATTR-CM, EF between 25 and 45%, and NYHA class III–IV symptoms refractory to optimal medical therapy. All patients underwent implantation of the Optimizer CCM system and were followed for at least 12 months. The primary endpoint was the incidence of worsening heart failure (WHF); secondary endpoints included changes in EF, NYHA class, 6-minute walk test (6MWT), and quality of life metrics. Results: In this cohort (n = 10), CCM therapy significantly reduced WHF episodes (from 0.18 ± 0.09 to 0.025 ± 0.08 hospitalizations/patient-year, p < 0.001) and improved NYHA class and 6MWT (p < 0.001). EF increased by an average of 4.8 ± 6.1%, and 6MWT improved by 31.3 ± 53.3%. Importantly, all patients became eligible for Tafamidis after CCM therapy due to improved functional status. Conclusion: This pilot study suggests that CCM therapy is a feasible and potentially effective option for ATTR-CM patients with advanced HF who are not candidates for existing disease-modifying treatments. These findings support the rationale for larger studies, including the ongoing AMY-CCM registry (NCT05167799), to validate CCM’s therapeutic role in this population. Full article

This study investigated the anti-obesity effects of a homogenized, viscous vegetable (VV) mixture prepared from mucilaginous vegetables, with a focus on modulating hepatic lipid metabolism and gut microbiota composition in mice fed with a high-fat (HF) diet. The VV mixture was formulated by blending freeze-dried powders of ten mucilaginous vegetables, classified as moderately thick using a line-spread test and extremely thick according to the IDDSI framework in a 1:9 ratio (VV mixture: water, w/w). Six-week-old male C57BL/6 mice were fed control or HF diets, with or without 10% VV mixture for 8 weeks (n = 7 per group). The HF diet induced significant weight gain, adipose tissue accumulation, hepatic steatosis, and inflammation. The HF diet also significantly reduced hepatic ACO1, CPT1 mRNA expression, and α-diversity with distinct fecal microbiota profiles. On the other hand, VV mixture supplementation reduced serum TC, LDL-C levels and NAFLD scores. VV mixture supplementation also increased hepatic ACO1 and CPT1 mRNA expression, enhanced α-diversity, and enriched SCFA-producing bacteria, particularly the Lachnospiraceae NK4A136 group. In conclusion, the VV mixture attenuated HF diet-induced obesity, possibly through its high viscosity–mediated effects on hepatic fatty acid oxidation and gut microbiota modulation. Full article

Background: Heart failure (HF) is frequently associated with skeletal muscle wasting, reduced functional capacity, and malnutrition. High-protein diets offer a promising nutritional intervention to improve these outcomes in individuals with HF. Objective: This systematic review evaluated randomized controlled trials of high-protein dietary interventions in HF populations, with emphasis on intervention characteristics, quantitative benefits, and risk of bias. Methods: We conducted a comprehensive search in PubMed, MEDLINE, Embase, and Cochrane CENTRAL from inception to June 2025. Eligible studies enrolled adults (≥18 years) with HF, implemented high-protein regimens (≥1.1 g/kg/day or ~25–30% of energy), and reported on functional capacity, body composition, muscle strength, clinical outcomes, or biochemical markers. Two reviewers independently screened, extracted data, and assessed bias (Cochrane RoB 2). Heterogeneity in dosing, duration, and outcomes precluded meta-analysis; we therefore provide a narrative synthesis. Results: Ten trials (nine randomized controlled trials, one pilot) involving 1080 patients (median n = 38; range 21–652) were included. High-protein interventions yielded mean improvements in six-minute walk distance of +32 ± 14 m, lean body mass gain of +1.6 ± 0.9 kg, and 9 ± 4% enhancement in quality-of-life scores; muscle strength effects varied from −2% to +11%. Two studies reported an 18% reduction in HF readmissions (p < 0.05). The risk-of-bias assessment identified two low-risk, three moderate-risk, and one high-risk study. Key limitations include small sample sizes, varied protein dosing (1.1–1.5 g/kg/day), short follow-up (2–6 months), and outcome heterogeneity. Conclusions: High-protein dietary strategies appear to confer modest, clinically relevant gains in functional capacity, nutritional status, and HF readmission risk. Larger, well-powered trials with standardized dosing and longer follow-up are necessary to establish optimal protein targets, long-term efficacy, and safety. Full article

The transient operation of pump turbines generates significant flow-induced instabilities, prompting a comprehensive numerical investigation using the SST $k-\omega$ turbulence model to examine these instability effects throughout the complete operating range in turbine mode. This study specifically analyzes the evolutionary mechanisms of unsteady flow dynamics under ten characteristic off-design conditions while simultaneously characterizing the pressure fluctuation behavior within the vaneless space (VS). The results demonstrate that under both low-speed conditions and near-zero-discharge conditions, the VS and its adjacent flow domains exhibit pronounced flow instabilities with highly turbulent flow structures, while the pressure fluctuation amplitudes remain relatively small due to insufficient rotational speed or flow rate. Across the entire turbine operating range, the blade passing frequency (BPF) dominates the VS pressure fluctuation spectrum. Significant variations are observed in both low-frequency components (LFCs) and high-frequency, low-amplitude components (HF-LACs) with changing operating conditions. The HF-LACs exhibit relatively stable amplitudes but demonstrate significant variation in the frequency spectrum distribution across different operating conditions, with notably broader frequency dispersion under runaway conditions and adjacent operating points. The LFCs demonstrate significantly higher spectral density and amplitude magnitudes under high-speed, low-discharge operating conditions while exhibiting markedly reduced occurrence and diminished amplitudes in the low-speed, high-flow regime. This systematic investigation provides fundamental insights into the flow physics governing pump-turbine performance under off-design conditions while offering practical implications for optimizing transient operational control methodologies in hydroelectric energy storage systems. Full article

We examined heart rate (HR) and heart rate variability (HRV) in young and middle-aged men after a period of detraining that immediately followed the completion of an exercise training program. Eight young (27.8 ± 3.8 years) and ten middle-aged (41.9 ± 3.8 years) men were randomly assigned to complete an 8-week exercise training program that included either aerobic (young: n = 3; middle-aged: n = 2), resistance (young: n = 3; middle-aged: n = 3), or combined (aerobic/resistance) (young: n = 2; middle-aged: n = 5) exercise. Thereafter, participants ceased all planned exercise training activities during an 8-week detraining period. Resting HR and HRV were assessed at baseline, after exercise training, and after detraining. An analysis of mean differences between age groups at each time-point revealed a significantly higher standard deviation of normal RR intervals (SDNN), square root of the mean of squared differences between successive RR intervals (RMSSD), high-frequency (HF) band (0.15–0.40 Hz), and cardiac vagal index (CVI) in young participants when compared to middle-aged participants at baseline (p ≤ 0.019) and after detraining (p ≤ 0.045), but not after the 8-week exercise training intervention (p ≥ 0.057). Additionally, in middle-aged participants, we observed a significant negative association between the percent change in HRV indices (RMSSD, HF, and CVI) and systolic blood pressure in response to detraining (p < 0.05). In conclusion, young participants had higher levels of HRV indices at baseline, reflecting greater cardiac vagal modulation when compared to middle-aged participants. We showed that these age-related differences in HRV are diminished following exercise training but are reestablished following 8 weeks of detraining. Given that age-related attenuations in HRV may reflect changes in cardiovascular health, it is important to further investigate the relationships between HRV, exercise training and detraining, aging, and the risk of poor health outcomes. Full article

Background: Previous studies have indicated that transcutaneous electrical nerve stimulation (TENS) is highly effective in improving the treatment of neuropathy and achieving maximum recovery in the shortest time. However, its effectiveness in the early stages of the disease has not been studied, and no comparative analysis has been conducted between different modalities of TENS. Materials and Methods: This study included 82 patients with acute and subacute fibular tunnel (FT) syndrome lasting no more than 15 days. Patients were randomized into the following four groups depending on the modality of TENS used: sham TENS (20 patients), HF TENS (20 patients), LF TENS (21 patients), and a combined HF/LF TENS group (21 patients). Before treatment, immediately after treatment, and 3 months after the end of treatment patients were examined to determine the severity of hypoesthesia, motor deficit, and gait disturbance. Results: The reduction in hypoesthesia averaged after HF TENS, LF TENS, and sham TENS was 50.7% (p ≤ 0.01), 37.8 (p ≤ 0.01), and 11.4% (p > 0.05), respectively. The regression of motor deficit and gate disorders reached 61% after LF TENS (p ≤ 0.01), 6% after HF TENS (p > 0.05), and 6% (p > 0.05) after sham TENS. The combination of HF and LF TENS resulted in a 54.8% (p ≤ 0.01) reduction in hypoesthesia and 61.3% (p ≤ 0.01) regression of motor deficit, with a superior 30% (p ≤ 0.05) improvement in quality of life compared to separate use of HF and LF TENS. Conclusions: Early use of TENS in the treatment of FT syndrome turned out to be highly effective compared to sham TENS in reducing hypoesthesia, motor deficit, and gait disturbance. The analgesic effect and sensory recovery were higher after HF TENS. Motor and gait disturbances were reduced only after LF TENS, with evidence of prolonged regenerative and protective effect for at least 3 months after the end of treatment. The combination of HF TENS and LF TENS increases the therapeutic range of TENS with the achievement of the maximum positive effect of HF TENS and LF TENS after treatment and during the long-term period, which leads to a more pronounced improvement in the quality of life of patients with this pathology. Full article

Background/Objectives: Atherosclerotic cardiovascular diseases (ASCVDs) remain the leading cause of morbimortality worldwide. The objectives of this study were to update the prevalence rates of ASCVDs and to evaluate their relationship with cardiovascular–kidney–metabolic (CKM) disorders. Methods: This cross-sectional observational study included 6588 adults selected through a simple random population-based sample from the Health Service database of the Madrid Region (Spain). Adjusted prevalence rates were calculated by the direct method, according to Spanish population data from the National Institute of Statistics. The relationships of CKM disorders with coronary heart disease (CHD), stroke, peripheral arterial disease (PAD), and ASCVD were assessed by bivariate and multivariate analyses. Results: The age- and sex-adjusted prevalence rates among overall adults with CHD, stroke, PAD, and ASCVD were 3.8%, 3.0%, 1.8%, and 7.3%, respectively, and they reached 5.6%, 4.4%, 2.6%, and 10.8%, respectively, among people aged 40 years and older. The prevalence rates were higher in men than women aged over 40 years for CHD and ASCVD, between 50 and 69 years for stroke, and aged over 60 years for PAD. The mean ages of women and men with ASCVD were 74.9 and 70.2 years, respectively. Hypertension, heart failure (HF), hypercholesterolaemia, diabetes, low eGFR, atrial fibrillation (AF), prediabetes, and low HDL-c were independently associated with ASCVD, highlighting hypertension and HF for all of them, in addition to hypercholesterolaemia for CHD and stroke, and specifically, AF for stroke. Conclusions: More than one in ten people aged over 40 suffer from CHD, stroke, or PAD. Hypertension, HF, hypercholesterolaemia, diabetes, and low eGFR are the major CKM disorders associated with ASCVD. Full article

Heart failure (HF) is a major global health burden and a leading cause of morbidity and mortality. Nutritional status has emerged as an essential factor influencing outcomes in HF, with the Controlling Nutritional Status (CONUT) score gaining attention as a simple, objective marker derived from serum albumin, total cholesterol, and lymphocyte count. This meta-analysis evaluated the prognostic value of the CONUT score in predicting all-cause mortality in patients with acute and chronic heart failure. A systematic search was conducted in the PubMed, MEDLINE, Google Scholar, and Cochrane Library databases for the past ten years, using combinations of keywords such as “heart failure”, “CONUT score”, “malnutrition”, and “mortality”. Studies were included if they reported hazard ratios (HRs) for all-cause mortality in relation to CONUT score categories in adult HF populations. Eight eligible studies comprising 15,761 patients were included. Pooled analysis showed that higher CONUT scores were significantly associated with increased all-cause mortality (pooled HR = 1.47; 95% CI: 1.30–1.66). Despite substantial heterogeneity (I² = 80%), the direction of effect was consistent across studies. The CONUT score is a useful prognostic marker in acute and chronic heart failure patients. Further research should explore the effects of targeted nutritional interventions in high-risk HF patients identified by elevated CONUT scores and efforts to standardize malnutrition cut-offs in clinical practice. Full article

Background/Objectives: Heart failure (HF) poses a significant global health burden. In Spain, its prevalence rises annually, contributing significantly to cardiovascular-related hospitalizations and deaths. Through a broad and integrative perspective, the CARABELA-HF initiative seeks to improve the organization and delivery of HF care in Spain, addressing the key challenges identified across the care continuum. Methods: CARABELA-HF involved four phases: characterization of HF care models, validation of improvement areas, potential solutions and healthcare quality indicators, refinement of results from a regional perspective, and local dissemination and implementation. Ten pilot centers participated, and nine variables were identified to characterize operating HF care models. Results: Four HF care models were identified based on the degree of coordination between departments and resource availability. Structure, quality of care, and transformation indicators were used to evaluate these models, revealing improvement areas. Overall, this process identified solutions for generating a comprehensive and integrated HF care model, highlighting enhanced coordination, digital transformation, enhanced nursing roles, professional training and patients’ education, accredited HF care models, resource accessibility, and data-based evaluation. Conclusions: CARABELA-HF provides insights into current HF care models in Spain and identifies healthcare quality indicators for future improvement efforts. It strives to enhance patient outcomes, raise healthcare standards, and improve overall system efficiency through the promotion of a comprehensive and integrated HF care pathway. Full article

The original Glancing Angle Deposition (GLAD) technique was developed using the evaporation process, i.e., in high vacuum, with a nearly punctual source, and with the substrate aligned with the source axis. In this specific case, the substrate tilt angle can be assumed to be equal to the impinging incidence angle of evaporated atoms. With the sputtering process, the deposition pressure is higher, sources are larger, and substrates are not intrinsically aligned with the source. As a result, deviations from the growth models applied for evaporation are reported, and the substrate tilt angle is no longer relevant for describing the impinging atomic flux. To control the inclined nanostructure of metallic films, a relevant description of the atomic flux is required, applicable across all deposition configurations. In this work, transport simulation is used to determine the resultant incidence angle, a unique criterion relevant to each specific deposition condition. The different representations of the flux are described and discussed, and some typical examples of the resultant angles are presented. Ten elements are investigated: three hcp transition metals (Ti, Zr, and Hf), six bcc transition metals (V, Nb, Ta, Cr, Mo, and W), and one fcc post-transition metal (Al). Full article