Prevalence of frailty according to the Hospital Frailty Risk Score and related factors in older patients with acute coronary syndromes in Vietnam.

OBJECTIVES: (1) To investigate the prevalence of frailty defined by the Hospital Frailty Risk Score (HFRS), a new scale for assessing frailty, in older patients with acute coronary syndrome (ACS); (2) To identify associations between frailty and the prescriptions of cardiovascular medications, percutaneous coronary intervention (PCI) and in-hospital adverse outcomes. METHODS: An observational study was conducted in patients aged older than 60 years with ACS at Thong Nhat Hospital from August to December 2022. The Hospital Frailty Risk Score is retrospectively calculated for all participants based on ICD-10 codes, and those with HFRS scores ≥5 were defined as frail. Logistic regression models were applied to examine the relationship between frailty and the study outcomes. RESULTS: There were 511 participants in the study. The median age was 72.7, 60% were male and 29% were frail. Frailty was associated with lower odds of beta-blocker use at admission (OR .49 95% CI .25-.94), treatment with PCI during hospitalisation (OR .48, 95% CI .30-.75), but did not show an association with prescriptions of cardiovascular drugs at discharge. Frailty was significantly associated with increased odds of adverse outcomes, including major bleeding (OR 4.07, 95% CI1.73-9.54), hospital-acquired pneumonia (OR 2.55, 95% CI 1.20-5.42), all-cause in-hospital mortality (OR 3.14, 95% CI 1.37-7.20) and non-cardiovascular in-hospital mortality (OR 10.73, 95% CI 1.93-59.55). CONCLUSIONS: The HFRS was an effective tool for stratifying frailty and predicting adverse health outcomes in older patients with ACS. Further research is needed to compare the HFRS with other frailty assessment tools in this population.

Fried Frailty Phenotype in Elderly Patients with Chronic Coronary Syndrome: Prevalence, Associated Factors, and Impact on Hospitalization.

Purpose: To investigate the prevalence and factors associated with frailty and impact of frailty on hospitalization due to any cause in elderly patients with chronic coronary syndrome (CCS). Patients and Methods: We conducted a study wherein we assessed frailty using Fried frailty phenotype for outpatients aged ≥60 years with CCS. Logistic regression analysis was performed to assess the factors associated with frailty. Frailty was adjusted for demographic and geriatric variables and comorbidities to assess its impact on hospitalization. Results: Overall, 420 patients (median age 70 years [interquartile range, 65-77]; men, 74.5%) who completed the 3-month follow-up period were analyzed. Coronary revascularization for > 1 year was the most common clinical scenario for CCS (59.8%; n = 251). The prevalence of non-frail, pre-frail, and frail patients were 22.4% (n = 94), 49.7% (n = 209), and 27.9% (n = 117), respectively. In the adjusted model, three factors associated with frailty were age ≥ 75 years (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.39-3.75, P = 0.001), limitations in instrumental activity of daily living (OR 3.89, 95% CI 2.33-6.48, P < 0.001), and heart failure (OR 2.30, 95% CI 1.32-4.02, P = 0.003). The overall 3-month hospitalization rate was higher in frail patients than in non-frail patients (23.9% vs 13.5%, P = 0.012). Frailty was associated with hospitalization (OR 1.85, 95% CI 1.04-3.30, P = 0.037) but in a weak strength of association (r = 0.126). Conclusion: The prevalence of frailty was 27.9% in the elderly patients with CCS. Age ≥ 75 years, limitations in functional status, and heart failure were associated with increased odds of frailty. Frailty was a predictor of 3-month all-cause hospitalization in these patients.

Another new species of Dibamus Dumril & Bibron, 1839 (Squamata: Dibamidae) from Nui Chua National Park, Ninh Thuan Province, Vietnam.

A new species of dibamid lizard, Dibamus deimontis sp. nov., is described based on eight specimens collected from the highlands of Nui Chua Mountain within Nui Chua National Park, Ninh Thuan Province, southern Vietnam. Dibamus deimontis sp. nov. co-occurs with the recently described Dibamus tropcentr, but is recorded at higher elevations (670700 m a.s.l. vs. 200280 m a.s.l.), and in a different habitat and microhabitats than the previous species. Our study represents the first report on the near sympatric occurrence of two Dibamus species. The new species can be distinguished from other congeners by the following combination of characters: rostral, labial and nasal sutures incomplete; two to three postoculars; three to five scales on the posterior edge of infralabial; 2225 midbody scale rows; 193225 ventral scales; 4755 subcaudal scales; 115 presacral and 27 tail vertebrae (in a single male specimen examined); and maximum snout-vent length 136.2 mm. We suggest this species should be considered as Vulnerable (VU) following the IUCNs Red List categories. Our study brings the number of species in the genus Dibamus to 26; Dibamus deimontis sp. nov. is the eighth species of Dibamus recorded in Vietnam, and underlines the importance of the country as a local center of reptilian diversity in Southeast Asia.

Exploring Frailty in the Intersection of Cardiovascular Disease and Cancer in Older People.

Advances in cardiovascular therapies and cancer treatments have resulted in longer patient survival. The coexistence of cancer and cardiovascular disease has been recognized as a complex clinical scenario. In addition to cardiovascular disease, older people with cancer are at greater risk of experiencing multimorbidity and geriatric syndromes, such as frailty. In older people, the concurrent presence of cancer and cardiovascular disease increases the risk of mortality, and the presence of frailty can exacerbate their conditions and hinder treatment effectiveness. Given the significant intersection among frailty, cardiovascular disease, and cancer in older people, this paper aims to provide an overview of the current research in this field and identifies gaps in the research to understand the burden and impact of frailty in these populations. While many studies have examined the prevalence and impact of frailty on adverse outcomes in patients with cancer or cardiovascular disease, evidence of frailty in individuals with both conditions is lacking. There is no universally accepted definition of frailty, which leads to inconsistencies in identifying and measuring frailty in older adults with cardiovascular disease and cancer. The frailty index seems to be a preferred frailty definition in studies of patients with cancer, while the frailty phenotype seems to be more commonly used in cardiovascular research. However, differences in how the frailty index was categorized and in how patients were classified as 'frail' depending on the cut points may have a negative effect on understanding the impact of frailty in the studied populations. This makes it challenging to compare findings across different studies and limits our understanding of the prevalence and impact of frailty in these populations. Addressing these research gaps will contribute to our understanding of the burden of frailty in older people with cardiovascular disease and cancer, and improve clinical care protocols in this vulnerable population.

Hiding on jagged karst pinnacles: A new microendemic genus and species of a limestone-dwelling agamid lizard (Squamata: Agamidae: Draconinae) from Khammouan Province, Laos.

We describe a unique new species and genus of agamid lizard from the karstic massifs of Khammouan Province, central Laos. Laodracon carsticola Gen. et sp. nov. is an elusive medium-sized lizard (maximum snout-vent length 101 mm) specifically adapted to life on limestone rocks and pinnacles. To assess the phylogenetic position of the new genus amongst other agamids, we generated DNA sequences from two mitochondrial gene fragments (16S rRNA and ND2) and three nuclear loci ( BDNF, RAG1 and c-mos), with a final alignment comprising 7 418 base pairs for 64 agamid species. Phylogenetic analyses unambiguously place the new genus in the mainland Asia subfamily Draconinae, where it forms a clade sister to the genus Diploderma from East Asia and the northern part of Southeast Asia. Morphologically, the new genus is distinguished from all other genera in Draconinae by possessing a notably swollen tail base with enlarged scales on its dorsal and ventral surfaces. Our work provides further evidence that limestone regions of Indochina represent unique "arks of biodiversity" and harbor numerous relict lineages. To date, Laodracon carsticola Gen. et sp. nov. is known from only two adult male specimens and its distribution seems to be restricted to a narrow limestone massif on the border of Khammouan and Bolikhamxai provinces of Laos. Additional studies are required to understand its life history, distribution, and conservation status.

Safe and effective profile of the VSTENT bioresorbable polymer sirolimus-eluting stent in the treatment of patients with de novo coronary artery lesions: a prospective, cohort, multicenter study.

Background: The drug-eluting stent was a significant stride forward in the development of enhanced therapeutic therapy for coronary intervention, with three generations of increased advancement. VSTENT is a newly developed stent manufactured in Vietnam that aims to provide coronary artery patients with a safe, effective, and cost-efficient option. The purpose of this trial was to determine the efficacy and safety of a new bioresorbable polymer sirolimus-eluting stent called VSTENT. Methods: This is a prospective, cohort, multicenter research in 5 centers of Vietnam. A prespecified subgroup received intravascular ultrasound (IVUS) or optical coherence tomography (OCT) imaging. We determined procedure success and complications during index hospitalization. We monitored all participants for a year. Six-month and 12-month rates of major cardiovascular events were reported. All patients had coronary angiography after 6 months to detect late lumen loss (LLL). Prespecified patients also had IVUS or OCT performed. Results: The rate of device success was 100% (95% CI: 98.3-100%; P<0.001). Major cardiovascular events were 4.7% (95% CI: 1.9-9.4%; P<0.001). The LLL over quantitative coronary angiography (QCA) was 0.08±0.19 mm (95% CI: 0.05-0.10; P<0.001) in the in-stent segment and 0.07±0.31 mm (95% CI: 0.03-0.11; P=0.002) in 5 mm within the two ends of the stent segment. The LLL recorded by IVUS and OCT at 6 months was 0.12±0.35 mm (95% CI: 0.01-0.22; P=0.028) and 0.15±0.24 mm (95% CI: 0.02-0.28; P=0.024), respectively. Conclusions: This study's device success rates were perfect. IVUS and OCT findings on LLL were favorable at 6-month follow-up. One-year follow-up showed low in-stent restenosis (ISR) and target lesion revascularization (TLR) rates, reflecting few significant cardiovascular events. VSTENT's safety and efficacy make it a promising percutaneous intervention option in developing nations.

COVID-19 infection and decline in outdoor activities associated with depression in older adults: A multicenter study in Vietnam.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has caused a serious global communicable disease burden. Although COVID-19 and its policy responses have significantly influenced older adults, the impact of COVID-19 on depression in the older population is not fully understood. We aimed to investigate whether a history of COVID-19 infection and a decline in outdoor activities during the COVID-19 pandemic were associated with depression among older adults in Vietnam. METHODS: This multicenter cross-sectional study was conducted on 1,004 outpatients (aged ≥60 years; mean age 70.8 ± 7.3 years; men, 33.0%) visiting three hospitals for a comprehensive geriatric assessment between November 2021 and July 2022. Depression over the past week was evaluated using the 15-item Geriatric Depression Scale. History of COVID-19 infection and decline in outdoor activities were included as binary variables. We adjusted these two factors with sociodemographic and geriatric variables and comorbidities using a logistic regression analysis in separate models. RESULTS: A total of 156 participants (15.5%) experienced depression. The proportion of mild, moderate, and severe depressive symptoms was 14.1%, 44.9%, and 41.0%, respectively. In the multivariate model, decline in outdoor activities (odds ratio [OR] 17.2, 95% confidence interval [CI] 9.15-32.2, p <0.001) and history of COVID-19 infection (OR 2.22, 95% CI 1.28-3.84, p = 0.004) were associated with depression. Additionally, we found that age ≥ 75 years, female sex, being underweight, limitations in functional status, poor sleep quality, and stroke were associated with depression. Of the associated factors, decline in outdoor activities had a moderate strength of association with depression (r = 0.419), while each of the remaining factors had a weak strength of association. CONCLUSIONS: COVID-19 had a direct and indirect impact on depression in older adults, reflecting an association between both a history of COVID-19 infection and a decline in outdoor activities during the COVID-19 pandemic and depression in the older population.

A new green pitviper of the Trimeresurus albolabris complex (Reptilia, Serpentes, Viperidae) from central and southern Myanmar.

In the frame of our investigations on the systematics of the complex of species of Trimeresurus albolabris, we came across specimens from Myanmar variously referred to as Trimeresurus albolabris Gray, 1842 or T. septentrionalis Kramer, 1977 in the literature. We describe a new species of green pitviper of the genus Trimeresurus Lacpde, 1804 from central and southern Myanmar based on molecular analyses drawn from previously published phylogenies and new morphological data. This new species, Trimeresurus uetzi sp. nov., is broadly similar to both Trimeresurus albolabris and T. septentrionalis, but it differs from these latter species by a series of morphological characters such as presence of white pre- and postocular streaks in male, iris copper in male or green gold in female, more ventral plates, and a much shorter hemipenis. We compare this new species with Trimeresurus albolabris as currently defined and other species of this complex. We also emphasize the need for additional integrated studies on Trimeresurus albolabris sensu lato populations distributed in southern Indochina and Sundaland.

A new species of the genus Dibamus Dumril & Bibron, 1839 (Squamata: Dibamidae) from the driest and hottest place of Vietnam.

A new species of the genus Dibamus Dumril & Bibron, 1839 is described based on seven specimens collected from Nui Chua National Park, Ninh Thuan Province, southern Vietnam, the hottest and driest place of the country. Dibamus tropcentr sp. nov. is superficially similar to Dibamus smithi Greer, 1985, but can be distinguished from the latter by: the presence of a rudimentary labial suture; by larger number of subcaudal scales; by comparatively longer tail; by generally larger number of midbody scale rows; by having the interparietal scale not enlarged, subequal to the nuchal scale; by having frontal and frontonasal scales subequal in size as compared to almost twice larger frontal scale in D. smithi; by having three scales posterior to interparietal; by having the medial scale posterior to mental not enlarged; by having three to four scales on the posteromedial edge of infralabials; and by having supralabial scale larger than ocular scale. We suggest the new species should be considered as Vulnerable (VU) following the IUCNs Red List categories. The new species occurs in dry maritime mixed low evergreen forests at elevations of 200280 m a.s.l. and was recorded in association with termite species Globitermes sulphureus (Haviland). Our study brings the total number of species of the genus Dibamus to 25; this is the seventh species of the genus recorded from Vietnam.

Frailty and Associated Factors among the Elderly in Vietnam: A Cross-Sectional Study.

BACKGROUND: Frailty syndrome is common among older people and can lead to various adverse consequences such as falls, cognitive decline, disability, dependent living, increased mortality, excessive drug use, and prolonged hospital stays. OBJECTIVES: This research determined the prevalence of frailty and associated factors among older adults in Vietnam. METHODS: A cross-sectional study was conducted on 584 older adults across five Ho Chi Minh City wards from November 2020 to January 2021. Based on the modified Fried frailty scale, the participants were divided into three categories: robust, pre-frail, and frail. A chi-square test (or Fisher's test) examined the relationship between frailty categories and other variables. Multivariable logistic regression used variates with a cut-off of p ≤ 0.05 in the univariate analysis. RESULTS: The prevalence rates of frailty and pre-frailty were 19% and 64%, respectively. The most common frailty component was weak grip strength (63.9%), followed by slowness (36.1%), weight loss (21.6%), low physical activity (19.5%), and exhaustion (18.5%). In addition, the prevalence of frailty was significantly associated with age, BMI levels, living alone, and sarcopenia. CONCLUSION: The community's prevalence of frailty among older adults is high. Frailty can lead to many adverse consequences for the elderly. As there were some modifiable factors associated with frailty, it should be assessed in older people through community-based healthcare programs for early diagnosis and management.

Sex Difference in Control of Low-Density Lipoprotein Cholesterol in Older Patients after Acute Coronary Syndrome.

Objective. The main aim of this study is to examine the achievement of low-density lipoprotein cholesterol (LDL-C) targets in older patients after acute coronary syndrome (ACS), and the secondary aim is to examine sex difference in LDL-C target achievement. Methods. Patients aged ≥60 years with ACS admitted to a tertiary hospital in Vietnam were recruited from December 2019 to August 2020. LDL-C target achievement was defined as having an LDL-C goal of <1.8 mmol/L. Multivariate logistic regression was applied to investigate the predictive factors for LDL-C target achievement. Results. A total of 232 participants were included in this study (mean age 75.5 years, 40.1% were women). Participants had an average of three chronic conditions other than coronary heart disease. All participants were prescribed statin monotherapy at discharge (59.5% on high-intensity statins). After 3 months, 218 (94.0%) of the participants were on statin monotherapy, 14 (6.0%) were on statin combined with ezetimibe. The proportion of participants that achieved LDL-C target after 3 months was 56.5% (40.9% in women and 66.9% in men, p < 0.001). On univariate logistic regression, women were less likely to achieve their LDL-C target compared to men (unadjusted OR 0.34, 95% CI 0.20−0.59). This association was still significant in the adjusted model (adjusted OR 0.43, 95% CI 0.24−0.78). Other factors that were significantly associated with LDL-C target achievement included age, smoking, sedentary lifestyle, LDL-C level on admission, history of using statin before admission, and high-intensity statin prescribed at discharge. Conclusions. Our study found that nearly a half of older patients with ACS did not achieve their LDL-C target after 3 months, and suboptimal control of LDL-C was more common in women.

An integrative taxonomic revision of slug-eating snakes (Squamata: Pareidae: Pareineae) reveals unprecedented diversity in Indochina.

Slug-eating snakes of the subfamily Pareinae are an insufficiently studied group of snakes specialized in feeding on terrestrial mollusks. Currently Pareinae encompass three genera with 34 species distributed across the Oriental biogeographic region. Despite the recent significant progress in understanding of Pareinae diversity, the subfamily remains taxonomically challenging. Here we present an updated phylogeny of the subfamily with a comprehensive taxon sampling including 30 currently recognized Pareinae species and several previously unknown candidate species and lineages. Phylogenetic analyses of mtDNA and nuDNA data supported the monophyly of the three genera Asthenodipsas, Aplopeltura, and Pareas. Within both Asthenodipsas and Pareas our analyses recovered deep differentiation with each genus being represented by two morphologically diagnosable clades, which we treat as subgenera. We further apply an integrative taxonomic approach, including analyses of molecular and morphological data, along with examination of available type materials, to address the longstanding taxonomic questions of the subgenus Pareas, and reveal the high level of hidden diversity of these snakes in Indochina. We restrict the distribution of P. carinatus to southern Southeast Asia, and recognize two subspecies within it, including one new subspecies proposed for the populations from Thailand and Myanmar. We further revalidate P. berdmorei, synonymize P. menglaensis with P. berdmorei, and recognize three subspecies within this taxon, including the new subspecies erected for the populations from Laos and Vietnam. Furthermore, we describe two new species of Pareas from Vietnam: one belonging to the P. carinatus group from southern Vietnam, and a new member of the P. nuchalis group from the central Vietnam. We provide new data on P. temporalis, and report on a significant range extension for P. nuchalis. Our phylogeny, along with molecular clock and ancestral area analyses, reveal a complex diversification pattern of Pareinae involving a high degree of sympatry of widespread and endemic species. Our analyses support the "upstream" colonization hypothesis and, thus, the Pareinae appears to have originated in Sundaland during the middle Eocene and then colonized mainland Asia in early Oligocene. Sundaland and Eastern Indochina appear to have played the key roles as the centers of Pareinae diversification. Our results reveal that both vicariance and dispersal are responsible for current distribution patterns of Pareinae, with tectonic movements, orogeny and paleoclimatic shifts being the probable drivers of diversification. Our study brings the total number of Pareidae species to 41 and further highlights the importance of comprehensive taxonomic revisions not only for the better understanding of biodiversity and its evolution, but also for the elaboration of adequate conservation actions.

First national record of Quasipaaverrucospinosa (Bourret, 1937) (Amphibia: Anura: Dicroglossidae) from Thailand with further comment on its taxonomic status.

BACKGROUND: Spiny Frog Quasipaa is a genus of frogs that belongs to a relatively poorly known group. Most of the species distribution has been recorded in China; however, a few incidences of identification have occurred in the eastern part of Indochina. To date, only one species (Quasipaafasciculispina) of Quasipaa has been recorded from Chanthaburi and Trat Provinces in south-eastern Thailand. NEW INFORMATION: Based on recent fieldwork conducted in northern Thailand, we report a new record of Quasipaaverrucospinosa from Doi Phu Kha National Park, Nan Province at an altitude of 900-1000 m a.s.l. Our study has demonstrated that populations of this species are paraphyletic and has revealed deep genetic differences. Therefore, it is recommended that a comprehensive study be undertaken to clarify the taxonomic and geographic distribution of this species for its suitable protection and conservation.

First records of the fanged frogs Limnonectes bannaensis Ye, Fei & Jiang, 2007 and L. utara Matsui, Belabut & Ahmad, 2014 (Amphibia: Anura: Dicroglossidae) in Thailand.

BACKGROUND: The taxonomic status of the Thai populations belonging to the Limnonectes kuhlii species complex is controversial, due to phenotypic similarity in the cryptic species complex. Recently, some studies on this group in Thailand have discovered four new species: L. taylori, L. megastomias, L. jarujini and L. isanensis. Even so, the diversity of this group is still incomplete. NEW INFORMATION: Based on an integrative approach encompassing genetic and morphological analyses, we conclude that the Limnonectes populations from Nan Province (northern) and Yala Province (southern) of Thailand are conspecific with L. bannaensis Ye, Fei & Jiang, 2007 and L. utara Matsui, Belabut & Ahmad, 2014, respectively. These are the first records of these species in Thailand. Our study highlights the importance of using DNA sequence data in combination with morphological data to accurately document species identity and diversity. This is especially important for morphologically cryptic species complexes and sympatrically occurring congeners.

First national record of Gracixalus quangi Rowley, Dau, Nguyen, Cao & Nguyen, 2011 and G. yunnanensis Yu, Li, Wang, Rao, Wu &Yang, 2019 (Amphibia: Anura: Rhacophoridae) from Thailand.

BACKGROUND: The bushfrog genus Gracixalus Delorme, Dubois, Grosjean & Ohler, 2005 is found in southern and south-western China, Vietnam, Laos, Thailand and Myanmar. It is presently comprised of 17 species. In Thailand, only two species have been recorded, namely G. carinensis (Boulenger) and G. seesom (Massui, Khonsue, Panha & Eto). The latter of these two species is currently known to be endemic to the country. NEW INFORMATION: Based on recent field work conducted in 2019 in Doi Phu Kha National Park, Nan Province of northern Thailand, we are reporting two new records of the genus Gracixalus, G. quangi and G. yunnanensis, from Thailand, based on morphological and molecular evidence. In addition, this is the first study to report on the identification of a female specimen of G. yunnanensis. Furthermore, morphological data and natural history notes of the aforementioned species in Thailand have been provided, along with updated locations for the distribution of both species.

Training the Trainers in Microsurgery: A Success Story from Vietnam's Hanoi National Hospital of Odonto-stomatology.

BACKGROUND: Microsurgery is a highly specialized skill that requires advanced training. This is a recount of the 12-year development of Hanoi National Hospital of Odonto-Stomatology (NHOS) from a basic plastic surgery unit to a high-volume, subspecialized reconstructive center. METHODS: We present a 12-year retrospective account of the development of NHOS with a brief summary of microsurgical reconstructive outcomes. RESULTS: From 2008 to 2020, NHOS has performed 665 microsurgical flaps for reconstruction of various maxillomandibular defects. In the pioneering stage (2008-2011), without surgical microscopes, all five free flaps failed. After acquiring a microscope and mentoring from Hanoi's 108 Military Hospital, mandibular bone defect reconstruction with free fibula flaps had 85% success rate. In the growth stage (2012-2015), reconstruction advanced toward more complex defects requiring soft tissue, with a 98.7% success rate. The maturation stage (2016-2020) focused on refinement of reconstructive service to provide subspecialized care for malignant head and neck cancer patients with help from Taiwan's E-Da Hospital and Operation Smile's charity program. The charity mission trips were structured to facilitate good quality teaching rather than hit a quantitative goal of the number of surgeries done. And with a success rate of 99.4%, we have begun further education of the plastic surgery community in Vietnam. CONCLUSIONS: Our rapid 12-year maturation into a high-volume, subspecialized microsurgical center is the embodiment of the generous efforts of many international friends who invested their time and expertise. And we highly recommend charity mission trips to adopt the "training the trainers" concept to maximize lasting, local impact.

Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study.

OBJECTIVES: This study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge. DESIGN AND SETTINGS: A prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models. RESULTS: There were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01). CONCLUSIONS: In summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

A new species of Micryletta (Amphibia: Microhylidae) from southern Thailand.

We report on a new species, Micryletta dissimulans sp. nov., from the lowland forests of southern Thailand, which is described based on molecular and morphological evidence. The new species is characterized by a combination of the following characters: small body size (20.3-22.4 mm in males, 24.4-26.7 mm in females); slender body habitus; head longer than wide; snout rounded in dorsal and lateral view; eye length equal to snout length; tibiotarsal articulation reaching to tympanum; dorsal surface slightly granulated to shagreened; supratympanic fold indistinct, ventrally edged in black with large black spot behind eye; outer metatarsal tubercle absent; dorsum reddish-brown with merging irregular-shaped brown blotches edged in beige, no black spots on dorsum; body flanks brown with large black spots edged in whitish mottling, two large black blotches in axillary and inguinal areas on each side; lateral sides of head black, with white patches on lips absent, whitish mottling on tympanum and axillary region; ventral surface pinkish to bluish-gray, translucent, laterally with dark-brown marbled pattern, medially immaculate; throat in males dark-gray with sparse white mottling laterally; iris copper-orange. The new species is divergent from all other congeners in 16S rRNA gene sequences (5.0%-7.4%). To date, Micryletta dissimulans sp. nov. is only known from a single locality in Saba Yoi District, Songkhla Province, Thailand, at an elevation of 120 m a.s.l., but is also expected to occur in neighboring parts of Malaysia. We suggest Micryletta dissimulans sp. nov. be considered as a Data Deficient (DD) species following the IUCN's Red List categories (IUCN Standards and Petitions Committee, 2019).