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Aims: To assess physicians' adherence to guideline-recommended medications for the treatment of chronic heart failure (CHF) with reduced ejection fraction.Methods and Results: QUALIFY is an international prospective observational longitudinal survey of 7092 CHF outpatients recruited 1-15 months after hospitalization for heart failure from September 2013 to December 2014 in 547 centres in 36 countries. We constructed a five-class guideline adherence score for angiotensin converting enzyme inhibitors (ACEIs), beta-blockers, angiotensin receptor blockers (ARBs), mineralocorticoid receptor antagonists, and ivabradine. The adherence score was good in 67%, moderate in 25%, and poor in 8% of patients. Adherence was lower in women than men but there were differences in age (65.7 ± 12.5 years women vs. 62.2 ± 12.4 years men, P < 0.001) and the proportion of women at ≥50% target dose of beta-blockers was lower in those >67 years (median) (11% vs. 16.2%, P = 0.005). Geographic variations were observed with lower adherence scores in Central/Eastern European countries. The proportion of patients at target dose and ≥50% of target dose was low (27.9% and 63.3% for ACEIs, 14.8% and 51.8% for beta-blockers, 6.9% and 39.5% for ARBs, and 6.9% and 39.5% for ivabradine, respectively). It was also lower in patients most recently hospitalized (<6  vs. ≥6 months) except for beta-blockers.Conclusion: This international survey shows that adherence to guideline-recommended medications is relatively satisfactory but the dosage of recommended CHF medications is usually suboptimal. Action plans aimed at improving adherence to guidelines are required. [ABSTRACT FROM AUTHOR]

A total of 359 soil samples collected from five continents (Africa, Asia, Australia, Europe and South America) were investigated for the presence/absence of soil ciliate species. Merging records by species identity, we have compiled a master data list (species by sample matrix). In the list, a total of 964 soil ciliate species (644 described and 320 undescribed) are recorded. The species distributions within the 359 samples and across the five continents are examined. The frequency distribution of the species over samples is used for global diversity estimation. A statistical ACE (abundance-based coverage estimation) model which links observed data to unseen species is applied to assess regional and global soil ciliate species richness. The model, whose reliability was tested by its power to predict the number of new species in additional samples from Africa, may resolve the controversial issue on global species diversity of soil ciliates. Although an accurate point estimate is not feasible due to severe undersampling, the statistical model enables us to obtain a minimum regional diversity and global species diversity. A consistent finding over all five continents is that at least half of the species diversity is still undiscovered. Our model also yields a global soil ciliate diversity of at least 1900 species, that is, doubles the number of currently known species, and thus diversity is relatively high. This is consistent with the finding of Foissner, who used a probability-based method. Soil ciliate distributions between continent pairs are analyzed by adjusted abundance-based similarity/overlap indices. These new indices account for the effect of unseen species and also reduce the bias generated by undersampling. The adjusted abundance-based Jaccard (or Sørensen) index shows that there is about 30% (18% for Sørensen) dis-similarity between any two continents, supporting the moderate endemicity model. The results are discussed with respect to protist species distribution, that is, whether they are cosmopolitan or of restricted distribution. [ABSTRACT FROM AUTHOR]