Effect of antithrombotic stewardship on the efficacy and safety of antithrombotic therapy during and after hospitalization

Background Although the benefits of antithrombotic drugs are indisputable to reduce thrombotic events, they carry a high risk of compromising patient safety. No previous studies investigated the implementation and (cost-) effectiveness of a hospital-based multidisciplinary antithrombotic team on bleeding and thrombotic outcomes. The primary aim of this study was to compare the proportion of patients with a composite end point consisting of one or more bleeding episodes or one or more thrombotic event from hospitalization until three months after hospitalization. Methods and findings A prospective, multicenter before-after intervention study was conducted in two Dutch hospitals. Adult patients hospitalized between October 2015 and December 2017 treated with anticoagulant therapy were included. The primary aim was to estimate the proportion of patients with a composite end point consisting of one or more bleeding episodes or one or more thrombotic event from hospitalization until three months after hospitalization. The intervention was the implementation of a multidisciplinary antithrombotic team focusing on education, medication reviews by pharmacists, implementing of local anticoagulant therapy guidelines based on national guidelines, patient counselling and medication reconciliation at admission and discharge. The primary endpoint was analysed using segmented linear regression. We obtained data for 1,886 patients: 941 patients were included in the usual care period and 945 patients in the intervention period. The S-team study showed that implementation of a multidisciplinary antithrombotic team over time significantly reduced the composite end point consisting of one or more bleeding episodes or one or more thrombotic event from hospitalization until three months after hospitalization in patients using anticoagulant drugs (-1.83% (-2.58% to -1.08%) per 2 month period). Conclusions This study shows that implementation of a multidisciplinary antithrombotic team over time significantly reduces the composite end point consisting of one or more bleeding episodes or one or more thrombotic event from hospitalization until three months after hospitalization in patients using anticoagulant drugs

Die gebruik van deskundigestelsels vir netwerkbestuur : 'n hulpmiddel vir intydse foutdiagnose van rekenaarnetwerke

Tesis (M. Ing.) -- Universiteit van Stellenbosch, 1993.Een kopie mikrofiche.Full text to be digitised and attached to bibliographic record

Introduction: risk and uncertainty in the early modern world

This article introduces the various articles in this forum. It first sets the scene by showing why the maritime sector forms an excellent case study to investigate risk and uncertainty in the premodern world. Second, it problematises from a historical perspective both Frank Knight's and Douglass North's approaches to risk and uncertainty, arguing that notwithstanding the lack of data, premodern commerce could properly assess both risk and uncertainty. Third, it introduces the various articles in the forum.</p

Coda: risk and uncertainty in the past and present

This is the final version. Available on open access from SAGE Publications via the DOI in this recordThis coda takes stock of the articles in the forum and subsequently draws some lessons from the articles on the question of how to deal with risk and uncertainty in the present. It argues that looking at how risk and uncertainty were perceived and dealt with in the early modern world allows one to envisage new solutions to deal with the major problems facing human society today, such as climate change.European Research Council (ERC)Economic Historical AssociationEconomic History SocietyInstitute for Historical Researc

Action Classification using the Average of Pose Changes

This article briefly discusses some of our ongoing work on the problem of human action recognition. We evaluate a simple and intuitive technique, based on the changes in human pose, against publicly available behaviour datasets. We achieve results comparable to many other state of the art techniques, while also being much simpler and potentially faster. 1.1. Problem Statement 1

Left ventricular segmentation from MRI datasets with edge modelling conditional random fields

Publication of this article was funded by the Stellenbosch University Open Access Fund.The original publication is available at http://www.biomedcentral.com/bmcmedimagingBackground: This paper considers automatic segmentation of the left cardiac ventricle in short axis magnetic resonance images. Various aspects, such as the presence of papillary muscles near the endocardium border, makes simple threshold based segmentation difficult. Methods: The endo- and epicardium are modelled as two series of radii which are inter-related using features describing shape and motion. Image features are derived from edge information from human annotated images. The features are combined within a discriminatively trained Conditional Random Field (CRF). Loopy belief propagation is used to infer segmentations when an unsegmented video sequence is given. Powell’s method is applied to find CRF parameters by minimizing the difference between ground truth annotations and the inferred contours. We also describe how the endocardium centre points are calculated from a single human-provided centre point in the first frame, through minimization of frame alignment error. Results: We present and analyse the results of segmentation. The algorithm exhibits robustness against inclusion of the papillary muscles by integrating shape and motion information. Possible future improvements are identified. Conclusions: The presented model integrates shape and motion information to segment the inner and outer contours in the presence of papillary muscles. On the Sunnybrook dataset we find an average Dice metric of 0.91 ± 0.02 and 0.93 ± 0.02 for the inner and outer segmentations, respectively. Particularly problematic are patients with hypertrophy where the blood pool disappears from view at end-systole.Stellenbosch UniversityPublishers' versio