62 research outputs found
Supplemental material for Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure
No full textSupplemental material for Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure by Ines Frederix, Lien Vanderlinden, Anne-Sophie Verboven, Maria Welten, Donna Wouters, Gilles De Keulenaer, Bavo Ector, Ivan Elegeert, Pierre Troisfontaines, Caroline Weytjens, Wilfried Mullens and Paul Dendale in Journal of Telemedicine and Telecare</p
Effect of a telemonitoring‐facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA‐HF 1 (TElemonitoring in the MAnagement of Heart Failure) study
No full textAims Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow-up of patients through a telemonitoring-facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate.
Methods and results One hunderd and sixty CHF patients [mean age 76 ± 10 years, 104 males, mean left ventricular ejection fraction (LVEF) 35 ± 15%] were block randomized by sealed envelopes and assigned to 6 months of intense follow-up facilitated by telemonitoring (TM) or usual care (UC). The TM group measured body weight, blood pressure, and heart rate on a daily basis with electronic devices that transferred the data automatically to an online database. Email alerts were sent to the GP and heart failure clinic to intervene when pre-defined limits were exceeded. All-cause mortality was significantly lower in the TM group as compared with the UC group (5% vs. 17.5%, P = 0.01). The total number of follow-up days lost to hospitalization, dialysis, or death was significantly lower in the TM group as compared with the UC group (13 vs. 30 days, P = 0.02). The number of hospitalizations for heart failure per patient showed a trend (0.24 vs. 0.42 hospitalizations/patient, P = 0.06) in favour of TM.
Conclusion Telemonitoring-facilitated collaboration between GPs and a heart failure clinic reduces mortality and number of days lost to hospitalization, death, or dialysis in CHF patients. These findings need confirmation in a large trial
Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure
No full textAbstract: Aims The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up. Methods Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t(0)); 142 CHF patients (65% male; age: 76 +/- 10 years; EF: 36 +/- 15%) were alive and entered the follow-up study (time point: t(1)) with a final evaluation at 79 months (time point: t(2)). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t(1) -t(2)). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs. Results Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group (p = 0.04). Healthcare costs did not differ significantly between the TM (euro 9140 +/- 10580) and UC group (euro 12495 +/- 22433) (p = 0.87). Discussion An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL: )
Assessing historical church tower asymmetry using point cloud spatial expansion
No full textChurch towers are key cultural heritage. In theory, towers are vertical, while facade elements are symmetrically positioned around the tower axis. However, during service of a structure, building and lifetime conditions cause deviations, with associated risks. Laser scanning point clouds can be used to assess the structural state but a universal approach was missing. The proposed algorithm first estimates the tower inclination, and tests which multi-axis representation best represents the course of the tower. Next, point cloud spatial expansion recovers relative distances and deviations of facade elements. The resulting procedure was applied to assess two Dutch medieval towers including the Old Church in Delft and the St. Bavo Church in Haarlem, respectively. As results of analysis, significant asymmetry was found with a 1.4° deviation of the multi-modal axis of the St. Bavo Church tower together with variations of 0.1%–1.5% for facade slopes, while 0.1°–3.1° radial deviations were found in the position of the turrets of the Old Church tower.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Optical and Laser Remote Sensin
Acute myocardial infarction due to spontaneous postpartum multi-vessel coronary artery dissection
No full textAbstractSpontaneous coronary artery dissection is a rare cause of myocardial infarction in young, otherwise healthy people. We present a case report of a 37-year-old woman, without cardiovascular risk factors, who survived a major acute myocardial infarction due to multi-vessel spontaneous coronary artery dissection which was complicated by cardiogenic shock in the third week postpartum. She fully recovered with medical therapy in combination with angioplasty.<Learning objective: Acute myocardial infarction (AMI) during pregnancy and postpartum is a rare but often catastrophic event and spontaneous coronary artery dissection is the most frequent cause of AMI in this population. Because of the high mortality rate, it is important to recognize this entity in the early stage of presentation. Coronary angiography remains the golden standard and should be performed without hesitation in unstable patients.
Triest Plein - Monumentality, Representation, and Democracy
No full textThe Caritas Psychiatric Center (PC Caritas) in Melle, Belgium, is a clinic campus consisting of about a dozen buildings embedded into a park. Sint Jozef, named after the priest Petrus Jozef Triest from Gent, Belgium, is one of the remaining villas built in 1908 and centrally located on the campus. It was initially used as a treatment center for so-called “hysterical women” and has experienced multiple changes of functions over time. Like other buildings on the campus, it was considered not to meet today’s requirements anymore and therefore decided to be demolished. Thanks to the research collective BAVO, the demolition was halted midway, and competition to start a second life of the ruin was initiated. The experimental concept presented by architecten de vylder vinck taillieu was chosen and developed further together with multiple participants, including doctors and clinic staff, patients and visitors, and others. The project was then renamed Kanunnik Petrus Jozef Triest Plein, in short Triest Plein (Triest Square).AR1A061Architecture, Urbanism and Building Science
Monitoring Deformations Of A Wooden Church Tower By Laser Scanning
No full textChurches are part of heritage structures that take an important role in Europe ́s cultural identity. As such, these structures must be protected to prevent catastrophic collapse and any damage must be reported timely to establish planning to maintenance and restoration. This can be achievable when the churches are monitored periodically with regular intervals. However, this monitoring strategy has not been available in most of the Europe’s churches for a number of reasons, complexity of the structures and limited budget are just two of them. Laser scanning has been widely used in capturing rich three-dimensional (3D) topographic data of visible surfaces of a structure with high accuracy. This paper presents a methodology to determine the shape and possible deviation from verticality of the church’s tower for monitoring deformation using a terrestrial laser scanner. The 500-year old wooden tower of St. Bavo Church in Haarlem, Netherlands is selected as a case study. First, point clouds of the tower captured from different views are registered into the same coordinate system. Second, a RANSAC method is employed to extract point clouds of a whole façades of the tower. Next, a point and surface-based method is proposed to compute the deformation of the surface from its data points. The results indicate that there is slightly different deformation between the tower facades in the same story and in neighbour stories. Moreover, the maximum total relative deformation at Story 7 of the tower by 0.63m.Optical and Laser Remote SensingBio-based Structures & Material
The Current State of the St. BavoChurch Tower: A Verification Study and Structural Analysis of the Wooden Tower of the St. Bavo Church in Haarlem,The Netherlands
No full textThe structural reliability of the wooden tower of the Grote of St. BavoChurch in Haarlem has been assessed with the regular methods. In addition to the regular methods, some modern technologies have been used in the structural analysis. The mechanical properties of the timber have been determined with longitudinal vibration tests and visual grading. The inclination of the tower has been determined with a terrestrial laser scanner and the entire has been modeled and verified with a Finite Element Model. Conclusions are based on the results of the Finite Element Model, which takes the determined mechanical properties and inclination in consideration.Civil Engineering | Structural Engineering | Steel and Timber Constructio
The story of the Sanatorium, Baarn, designed by H.P. Berlage & T. Sanders
No full textThis study investigates the evolving role of the health and wellness centre Sanatorium Baarn, designed by H.P. Berlage and T. Sanders, through the lens of changing public perception over time. The inquiry is grounded in the central question: 'To what extent has the public reception of the health and wellness centre Sanatorium Baarn, designed by H.P Berlage and Theo Sanders, evolved over time and which factors within and outside the design process have influenced this interpretation and evaluation?'The Sanatorium, envisioned by H.P. Berlage and T. Sanders, aimed to rival European health centres ('Kur') and establish itself within Baarn's community. Surprisingly, it exceeded expectations, becoming a haven for both the rich and ill. Initially embraced, the Sanatorium's architectural intricacies were cherished by the community. Its significance persisted, endorsed by figures like Sergio Polano. However, a gradual transformation unfolded. Neglect, complexities in ownership, wartime disruptions, and post-war decline marred its splendour. Despite rehabilitation, guest numbers dwindled due to factors like car-free days, necessitating closure. Evolving fire safety standards posed further challenges.Amid these changes, public perception endured, keeping it a cherished symbol. Post-war shifts made it political, transitioning into a facility for war victims (BAVO) and Indonesian repatriates. An arson attempt damaged the structure's integrity, but hope remained for revival. After an auction, the building teetered on a second chance, poised for restoration. The city council, eager to preserve it, oversaw demolition and transformation. Yet, challenges arose with the new design by Van den Broek and Bakema. Municipal decisions and communal functions significantly influenced its trajectory. Ultimately, interventions altered its status, reflecting architectural resilience amidst historical shifts.AR2A011Architectural History ThesisArchitecture, Urbanism and Building Science
Unifocal Right-Sided Ablation Treatment for Neurally Mediated Syncope and Functional Sinus Node Dysfunction Under Computed Tomographic Guidance.
No full textBACKGROUND: Biatrial, extensive, and complex ablation strategies have been published for the treatment of neurally mediated syncope, sinus node dysfunction, and functional atrioventricular block. We have developed a less extensive and more specific approach compared with previously published cardioneuroablation strategies, called cardioneuromodulation. It is based on tailored vagolysis of the sinoatrial node through partial ablation of the anterior right-ganglionated plexus, preferentially through a right-sided approach. METHODS: Patients with syncope were enrolled between December 2016 and December 2017. They were assigned to group A if they had a positive head-up tilt test and to group B if they presented with a pause ≥3 seconds. The area to target during cardio-neuromodulation was designed offline on a computed tomographic scan. Slow heart rates and pauses were compared during 24-hour rhythm registration at baseline, at 1-month follow-up, and 6-month follow-up. Syncope burden was assessed before the procedure and at 3- and 6-month follow-up. RESULTS: Twenty patients underwent cardio-neuromodulation through a right-sided approach (12 in group A, 8 in group B). The first application of radiofrequency energy led to a P-P interval shortening >120 ms in all 20 patients. After a mean±SD ablation time of 7±4 minutes and mean ablated surface area of 11±6 mm2 , the P-P interval shortened by 219±160 ms (P<0.001). The number of beats <50/min during 24-hour rhythm registration was reduced by a median of 100% at 6-month follow-up (P<0.001). Syncope burden was reduced by 95% at 6-month follow-up (P<0.001). CONCLUSIONS: These data indicate that cardio-neuromodulation, through a right-sided and computed tomographic–guided procedure, is safe, fast, and highly reproducible in preventing inappropriate functional sinus bradycardia and syncope recurrence
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