Integration of data from remote monitoring systems and programmers into the hospital electronic health record system based on international standards

Remote follow-up of implanted ICDs may offer a solution to the problem of overcrowded outpatient clinics. All major device companies have developed a remote follow-up solution. Data obtained from the remote follow-up systems are stored in a central database system, operated and owned by the device company and accessible for the physician or technician. However, the problem now arises that part of the patient’s clinical information is stored in the local electronic health record (EHR) system in the hospital, while another part is only available in the remote monitoring database. This may potentially result in patient safety issues. Ideally all information should become available in the EHR system. IHE (Integrating the Healthcare Enterprise) is an initiative to improve the way computer systems in healthcare share information. To address the requirement of integrating remote monitoring data in the local EHR, the IHE Implantable Device Cardiac Observation (IDCO) profile has been developed. In our hospital, we have implemented the IHE IDCO profile to import data from the remote databases from two device vendors into the departmental Cardiology Information System. Data are exchanged via an HL7/XML communication protocol, as defined in the IHE IDCO profile

Highly crystallized as-grown smooth and superconducting MgB2 films by molecular-beam epitaxy

We have investigated the growth of superconductive thin films of magnesium diboride (MgB2) by molecular-beam epitaxy. A Si(111) substrate with a seed layer of MgO was used for the growth of these films by varying parameters such as the growth temperature, Mg:B flux ratio and deposition rate as well as the background pressure. It was found that highly crystallized films could already form at 250 °C; however, only in a narrow window of growth parameters. The highest critical temperature of 35.2 K with a sharp transition (TC of 0.5 K) was observed for films grown at 300 °C. Using a capping layer of MgO proved to be highly beneficial for the preservation and the smoothness of these films. Together with the fact that MgO proved to be a good seed layer for thin films of MgB2 makes it an ideal candidate for growing all epitaxial MgB2 Josephson junctions. ©2002 American Institute of Physics

NANO-IMPRINT TECHNOLOGY COMBINED WITH ROUGH TCO MORPHOLOGY AS DOUBLE TEXTURED LIGHT-TRAPPING SUPERSTRATE FOR THIN FILM SOLAR CELLS

Two types of nano-imprinted 2D grating textures were tested on their light trapping performance for thin film Si tandem solar cells in combination with various TCO’s. The combination with rough TCO layers like LPCVD ZnO leads to double textured superstrates that exhibit at least a similar light trapping capability as the state-of-the-art reference while using thinner TCO layers. Further optimization in combination with nano-imprinted AR textures on the air/glass interface has the potential for >13% devices with thin TCO and absorber layers

Recurrence of ventricular arrhythmias in ischaemic secondary prevention implantable cardioverter defibrillator recipients: long-term follow-up of the Leiden out-of-hospital cardiac arrest study (LOHCAT)

Aims to assess the long-term rate of mortality and the recurrence of potentially life-threatening ventricular arrhythmias in secondary prevention implantable cardioverter defibrillator (ICD) patients and to construct a model for baseline risk stratification.Methods and resultsSince 1996, all patients with ischaemic heart disease, receiving ICD therapy for secondary prevention of sudden death, were included in the current study. Patients were evaluated at implantation and during long-term follow-up. A total of 456 patients were included in the analysis and followed for 54 ± 35 months. During follow-up, 100 (22) patients died and ICD therapy was noted in 216 (47) patients, of which 138 (30) for fast, potentially life-threatening ventricular arrhythmia. Multivariate analysis revealed a history of atrial fibrillation or flutter (AF), ventricular tachycardia as presenting arrhythmia, and wide QRS and poor left ventricular ejection fraction as independent predictors of life-threatening ventricular arrhythmias. The strongest predictor was AF with a hazard ratio of 2.1 (95 confidence interval 1.3-3.2). On the basis of the available clinical data, it was not possible to identify a group which exhibited no risk on recurrence of potentially life-threatening ventricular arrhythmias.ConclusionIschaemic secondary prevention ICD recipients exhibit a high recurrence rate of potentially life-threatening ventricular arrhythmias. Factors that increase risk can be identified but, even with these factors, it was not possible to distinguish a recurrence-free group

Fertility preservation in female classic galactosemia patients

Almost every female classic galactosemia patient develops primary ovarian insufficiency (POI) as a diet-independent complication of the disease. This is a major concern for patients and their parents, and physicians are often asked about possible options to preserve fertility. Unfortunately, there are no recommendations on fertility preservation in this group. The unique pathophysiology of classic galactosemia with a severely reduced follicle pool at an early age requires an adjusted approach. In this article recommendations for physicians based on current knowledge concerning galactosemia and fertility preservation are made. Fertility preservation is only likely to be successful in very young prepubertal patients. In this group, cryopreservation of ovarian tissue is currently the only available technique. However, this technique is not ready for clinical application, it is considered experimental and reduces the ovarian reserve. Fertility preservation at an early age also raises ethical questions that should be taken into account. In addition, spontaneous conception despite POI is well described in classic galactosemia. The uncertainty surrounding fertility preservation and the significant chance of spontaneous pregnancy warrant counseling towards conservative application of these techniques. We propose that fertility preservation should only be offered with appropriate institutional research ethics approval to classic galactosemia girls at a young prepubertal age

Five-year safety and efficacy of leadless pacemakers in a Dutch cohort

BACKGROUND: Adequate real-world safety and efficacy of leadless pacemakers (LPs) have been demonstrated up to 3 years after implantation. Longer-term data are warranted to assess the net clinical benefit of leadless pacing.OBJECTIVE: The purpose of this study was to evaluate the long-term safety and efficacy of LP therapy in a real-world cohort.METHODS: In this retrospective cohort study, all consecutive patients with a first LP implantation from December 21, 2012, to December 13, 2016, in 6 Dutch high-volume centers were included. The primary safety endpoint was the rate of major procedure- or device-related complications (ie, requiring surgery) at 5-year follow-up. Analyses were performed with and without Nanostim battery advisory-related complications. The primary efficacy endpoint was the percentage of patients with a pacing capture threshold ≤2.0 V at implantation and without ≥1.5-V increase at the last follow-up visit.RESULTS: A total of 179 patients were included (mean age 79 ± 9 years), 93 (52%) with a Nanostim and 86 (48%) with a Micra VR LP. Mean follow-up duration was 44 ± 26 months. Forty-one major complications occurred, of which 7 were not advisory related. The 5-year major complication rate was 4% without advisory-related complications and 27% including advisory-related complications. No advisory-related major complications occurred a median 10 days (range 0-88 days) postimplantation. The pacing capture threshold was low in 163 of 167 patients (98%) and stable in 157 of 160 (98%).CONCLUSION: The long-term major complication rate without advisory-related complications was low with LPs. No complications occurred after the acute phase and no infections occurred, which may be a specific benefit of LPs. The performance was adequate with a stable pacing capture threshold.</p

‘Sell[ing] what hasn’t got a name’: An exploration of the different understandings and definitions of ‘community engagement’ work in the performing arts

Widely known to promote broader involvement in the processes which define the arts and culture (Webster, 1997), community engagement work in the performing arts — despite employing a set of commonly recognised norms — has tended to be conceptualised differently both historically and contemporarily. Drawing on ethnographic research — particularly semi-structured qualitative interview accounts of numerous British practitioners with a track record of work in the sector, the article explores these different conceptualisations. The article finds that it is the actual ‘work that matters’ and not what it is named, and that the diversity of understandings and definitions among sectoral practitioners is reflective of evolving thinking, values and practice, something that may be destabilising for better or worse

Forward K+ production in subthreshold pA collisions at 1.0 GeV

K+ meson production in pA (A = C, Cu, Au) collisions has been studied using the ANKE spectrometer at an internal target position of the COSY-Juelich accelerator. The complete momentum spectrum of kaons emitted at forward angles, theta < 12 degrees, has been measured for a beam energy of T(p)=1.0 GeV, far below the free NN threshold of 1.58 GeV. The spectrum does not follow a thermal distribution at low kaon momenta and the larger momenta reflect a high degree of collectivity in the target nucleus.Comment: 4 pages, 3 figure

Some Properties of R\'{e}nyi Entropy over Countably Infinite Alphabets

In this paper we study certain properties of R\'{e}nyi entropy functionals $H_\alpha(\mathcal{P})$ on the space of probability distributions over $\mathbb{Z}_+$. Primarily, continuity and convergence issues are addressed. Some properties shown parallel those known in the finite alphabet case, while others illustrate a quite different behaviour of R\'enyi entropy in the infinite case. In particular, it is shown that, for any distribution $\mathcal P$ and any $r\in[0,\infty]$, there exists a sequence of distributions $\mathcal{P}_n$ converging to $\mathcal{P}$ with respect to the total variation distance, such that $\lim_{n\to\infty}\lim_{\alpha\to{1+}} H_\alpha(\mathcal{P}_n) = \lim_{\alpha\to{1+}}\lim_{n\to\infty} H_\alpha(\mathcal{P}_n) + r$.Comment: 13 pages (single-column

Cryptographic Divergences: New Techniques and New Applications

In the recent years, some security proofs in cryptography have known significant improvements by replacing the statistical distance with alternative divergences. We continue this line of research, both at a theoretical and practical level. On the theory side, we propose a new cryptographic divergence with quirky properties. On the practical side, we propose new applications of alternative divergences: circuit-private FHE and prime number generators. More precisely, we provide the first formal security proof of the prime number generator PRIMEINC (Brandt and Damgård, CRYPTO 1992), and improve by an order of magnitude the efficiency of a prime number generator by Fouque and Tibouchi (ICALP 2014) and the washing machine technique by Ducas and Stehlé (EUROCRYPT 2016) for circuit-private FHE