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Background Surgical repair of tetralogy of Fallot (ToF) depends on the anatomical variations of the heart defect. A group of patients with a hypoplastic pulmonary valve annulus required a transannular patch. This study aimed to evaluate the early and late outcomes of ToF repair with a transannular Contegra® monocuspid patch in a single center. Methods A retrospective review of medical records was conducted. This study included 224 children with a median age of 13 months who underwent ToF repair with a Contegra® transannular patch in over 20 years of observation. The primary outcomes were hospital mortality and need for early reoperations. The secondary outcomes were late death and event-free survival. Results The hospital mortality in our group was 3.1%, whereas two patients required early reoperation. Three patients were excluded from the study because follow-up data were not available. In the remaining group of patients (212 patients), the median follow-up was 116 (range, 1-206) months. One patient died because of sudden cardiac arrest at home six months after surgery. Event-free survival was observed in 181 patients (85.4%), whereas the remaining 30 patients (14.1%) required graft replacement. The median time to reoperation was 99 (range, 4-183) months. Conclusions Although surgical treatment of ToF has been performed for more than 60 years worldwide, the optimal approach in children with a hypoplastic pulmonary valve annulus remains debatable. Among options, the Contegra® monocuspid patch can be effectively used in transannular repair of ToF with good long-term results.

This paper presents Vesta, a digital health platform composed of a smart home in a box for data collection and a machine learning based analytic system for deriving health indicators using activity recognition, sleep analysis and indoor localization. This system has been deployed in the homes of 40 patients undergoing a heart valve intervention in the United Kingdom (UK) as part of the EurValve project, measuring patients health and well-being before and after their operation. In this work a cohort of 20 patients are analyzed, and 2 patients are analyzed in detail as example case studies. A quantitative evaluation of the platform is provided using patient collected data, as well as a comparison using standardized Patient Reported Outcome Measures (PROMs) which are commonly used in hospitals, and a custom survey. It is shown how the ubiquitous in-home Vesta platform can increase clinical confidence in self-reported patient feedback. Demonstrating its suitability for digital health studies, Vesta provides deeper insight into the health, well-being and recovery of patients within their home.

Continuous overnight vital signs monitoring would be ideal for patients suffering from epilepsy, where life-threatening hypoxemias can occur during sleep. However, the existing physiological monitoring systems suffer from limitations in terms of usability factors and/or limited information of the signals being acquired. The body location of the monitoring system is a crucial consideration, seldom addressed by the wider community. This article presents a proof-of-concept, neck-worn photoplethysmography system, which was developed and tested to assess the feasibility of the neck as a monitoring site for longitudinal sensing of cardiac and respiratory responses during sleep. The novel system was compared against a gold-standard commercial multichannel cardiorespiratory polysomnography (PSG) system during oxygen desaturation cycles, to assess its ability to measure heart rate, respiratory rate (RR), and peripheral blood oxygen saturation (SpO 2 ) on 15 participants. The findings for heart rate showed a marginal mean error of 0.47 beats/min with limits of agreement (LOA) at 95% confidence between −3.17 and 4 bpm. RR comparisons had an overall mean error of 0.43 breaths/min, with LOA at 95% confidence between −2.73 and 3.3 bpm. Lastly, the system accurately outputs SpO 2 with an overall root-mean-square error of 1.44% between 90 and 100% SpO 2 using a custom calibration method. Moreover, it was observed that the neck made it possible for the system to detect desaturation events on an average 12.6 s prior to the PSG system, which used a peripheral finger-based PPG system. Ultimately, this proof-of-concept study illustrates the viability of neck-based sensing for minimally invasive monitoring of cardiac and respiratory vitals during sleep.

One of the main shortcomings of received signal strength-based indoor localisation techniques is the labour and time cost involved in acquiring labelled `ground-truth' training data. This training data is often obtained through fingerprinting, which involves visiting all prescribed locations to capture sensor observations throughout the environment. In this work, the authors present a helmet for localisation optimisation (H4LO): a low-cost robotic system designed to cut down on said labour by utilising an off-the-shelf light detection and ranging device. This system allows for simultaneous localisation and mapping, providing the human user with accurate pose estimation and a corresponding map of the environment. The high-resolution location estimation can then be used to train a positioning model, where received signal strength data is acquired from a human-worn wearable device. The method is evaluated using live measurements, recorded within a residential property. They compare the groundtruth location labels generated automatically by the H4LO system with a camera-based fingerprinting technique from previous work. They find that the system remains comparable in performance to the less efficient camera-based method, whilst removing the need for time-consuming labour associated with registering the user's location.

We report the worldwide experience of surgical pulmonary artery banding (PAB) treatment of end-stage left ventricular dilated cardiomyopathy (LV-DCM) with preserved right ventricular function. Pediatric LV-DCM is a leading cause of cardiac death,1,2 especially if the left ventricular end-diastolic diameter exceeds a z score of +5.3 Heart transplantation (HTx) is the only viable life-saving option, but is limited by donor availability and an unpredictable long-term survival. PAB was introduced on the following hypotheses4: (1) geometric rearrangement of LV dimension is achieved by reestablishing the interventricular septal position with gradual restoration of LV ejection fraction; (2) cardiac improvement with potential for regeneration reciprocal to the patient’s age5 is promoted by PAB-induced right ventricular hypertrophy. Fifteen centers of 11 countries from America, Asia, and Europe introduced PAB in an effort to diminish the need for LV assist device support and HTx, and especially to enable functional recovery. The Figure shows the flowchart of 70 patients who received PAB between March 2006 and 2017. Nine patients (mean age 159±101days) underwent PAB placement after complex open-chest procedures including: mitral valve repair (n=4); mitral valve replacement (n=1), anomalous left coronary artery arising from the pulmonary artery repair (n=1), epicardial pacemaker placement (n=1), fenestrated atrial septal defect closure (n=1), and repair of a left-sided partial anomalous pulmonary venous return (n=1). All but the latter patient recovered following a mean …

This repository offers smart-home wearable accelerometer and Radio Signal Strength Indicator (RSSI) data acquired : 1) with low-cost hardware; 2) with high-resolution location annotations; 3) from four UK homes. The data are intended to evaluate RSSI-based indoor localisation methods with activity measurements provided from a user-worn wearable device. A wrist worn accelerometer records activity signatures which are relayed to a number of receiving Access Points (AP) placed throughout the building. Upon reception of a packet, each AP measures the RSSI of the received radio signal and timestamps the accelerometer measurements. Location labels are recorded automatically using a small camera which registers fiducial floor tags as the participant carries out their normal routines in a natural way. Approximately 14 h of annotated wearable measurements are provided. A scripted fingerprint measurement is provided along with several unscripted natural living recordings, where the participant carried out a number of daily household activities which are annotated, where possible, throughout. Codes are provided to access the data and to replicate the ground-truthing procedure. Machine-accessible metadata file describing the reported data (ISA-Tab format)

OBJECTIVES Our goal was to evaluate the early and late results of the surgical management of congenital supravalvular aortic stenosis (SVAS). METHODS We performed a retrospective, multicentre study using data from the European Congenital Heart Surgeons Association. Exclusion criteria were age >18 years, operation before 1990 and redo supravalvular aortic stenosis operations. Multivariate Cox regression analysis was performed to detect independent predictors of adverse events. RESULTS Of a total of 301 patients (male/female = 194/107; median age 3.9 years, range 13 days-17.9 years), 17.6% had a prior surgical or interventional procedure. Pulmonary artery stenosis was present in 41.5% and coronary anomalies in 13.6%. The operation consisted of a single patch repair in 36.7%, a pantaloon-shaped patch in 36.7%, a 3-patch technique in 14.3% and other techniques in 11.7%. Postoperative complications occurred in 14.9%, and the early mortality rate was 5%. At a median follow-up of 13 years (interquartile range 3.5-7.8; follow-up completed 79.1%), there were 10 late deaths (4.2%). A surgical reoperation or an interventional cardiology procedure occurred in 12.6% and 7.2%, respectively. No significant differences in outcomes between the techniques were found. Age at repair

I assume, perhaps in a quite old fashioned manner, that the production of knowledge requires a collective autonomy of organised producers. Autonomy does not mean sovereignty, in fact is presupposes multiple “external” and “internal” social relations or deals that only permit relative and limited independence of the entity that after Bourdieu we usually refer to as a field. The autonomy in question not only has some dishonourable genealogy but also requires constant reproduction of exclusion, hierarchy and in general all scholastic backup. Yet this autonomy is still to be defended against the powers far more more malign. I want to argue that nomadic quasi-institutions could and probably would have a function on maintaining this autonomy of the presupposed field . Even if this is not at all their purpose it may in fact be a good thing.

Non-invasive, environmental monitoring is being successfully utilised to improve health care outcomes for patients while allowing them to more safely and comfortably live in their homes instead of health care facilities. This promises to reduce costs and ease the health care burden for many countries globally. However, these systems are still in early stages of research and only highly skilled researchers and engineers can successfully deploy them. The difficulty in deploying these systems prevents their mass use and potential cost savings motivating research interest in smart homes in a box (SHiB). In this paper we present the EurValve Activity Monitoring Kit, a minimalist activity monitoring system that can be deployed in a home by the patient and still obtain valuable lifestyle and activity level information for medical clinicians. We describe the design of the system and how it is being used in the H2020 EurValve Project. The initial results show that the system is easily deployed and yet still effective for non-invasive sensing for activity classification and localisation.

BACKGROUND: We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. METHODS: Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). RESULTS: Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). CONCLUSIONS: Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required. info:eu-repo/semantics/publishedVersion

It can be tempting to think about smart homes like one thinks about smart cities. On the surface, smart homes and smart cities comprise coherent systems enabled by similar sensing and interactive technologies. It can also be argued that both are broadly underpinned by shared goals of sustainable development, inclusive user engagement and improved service delivery. However, the home possesses unique characteristics that must be considered in order to develop effective smart home systems that are adopted in the real world [37].

Dire que Jean-Francois Lyotard est un penseur incontournable releve d’une banalite. Nous sommes d'habitude (et cela sans doute est une habitude moderne) tentes de chercher un secret derriere une telle biographie intellectuelle et creatrice. Il n’est justement plus possible de penser un evenement theorique et une production intellectuelle comme Œuvre, qui plus est d’un « grand homme », parce que les deux presupposent une version miniaturisee de la narration teleologique que J-F. Lyotard a auss...

To say that Jean-Francois Lyotard is a thinker to be reckoned with would be tantamount to stating the obvious. We are usually—and this is probably a modern habit—tempted to look for secrets lurking behind this kind of intellectual and creative biography. Put more finely, it is no longer possible--and rightly so--to conceive of a theoretical event and an intellectual output as Œuvre, and, what is more, that of a “great man”, because the two presuppose a miniaturized version of the teleological...

L'idée de fonder la critique comme un type particulier de réflexion et de connaissance sembla pendant longtemps inséparable du projet de l'émancipation. Certes, cette idée est, de manière générale, introduite par Kant mais c'est avec Marx qu'elle trouve véritablement sa place dans le champ du social et du politique. Le statut de la « critique de l'économie politique » est en lui-même une chose tout à la fois fascinante et problématique dans divers marxismes, même si Marx l'a lui-même peu théo...

The biodegradable polymer drug-eluting stents have been proposed as an alternative to durable polymer DES, theoretically improving vessel healing and reducing the need for prolonged double anti platelet therapy (DAPT), however clinical significance of this technology is under debate. Therefore, we sought to compare the clinical outcomes of two Paclitaxel eluting stents (PES) containing different polymer-based eluting matrices.In this multicenter registry of 392 consecutive patients who underwent PCI between June 2006 and September 2008, we included patients with stable angina or NSTE-ACS displaying at least one significant lesion (50% diameter stenosis) in native coronary arteries.Biodegradable polymer PES (BP-PES, LUC Chopin(2) , Balton, Poland) was implanted in 206 patients, whereas durable polymer PES (DP-PES, Taxus, Boston Scientific, USA) was implanted in 186 patients. There were no significant differences in baseline characteristics between groups with the exception of increased diabetes and number of lesions for BP-PES. In risk-unadjusted analysis at 1-year follow-up, there were no significant differences in TLR (BP-PES: 8.4% vs.6%; P = 0.36), TVR (BP-PES: 11.1% vs.8.4%; P = 0.36) and incidence of stent thromboses (BP-PES: 2.15% vs.3.4%; P = 0.42) between groups. There was also no difference in MACCE between groups (17.6% vs. 14.4%, P = 0.49). The mean dual antiplatelet therapy (DAPT) compliance at 1 year was 77% for BP-PES versus 92% for DP-PES (P = 0.03). Kaplan-Meier analysis showed a significantly higher long-term stroke free survival in BP-PES (P = 0.04). After adjustment, this was sustained with an additional tendency toward higher MI free survival for BP-PES (P = 0.059).In this observational analysis, BP-PES were comparable to DP-PES, with regard to incidence of repeated revascularizations, stent thromboses and MACCE despite earlier DAPT discontinuation.

Chaque révolte populaire vise la récupération de l’espace commun. Et il ne s’agit pas en premier lieu de « l’espace public » conçu comme un lieu privilégié du pouvoir légitime dans ses nombreuses mutations comme l’espace politique, l’espace culturel ou encore l’espace économique. Bien au contraire, tandis que les rebelles contestent et rejettent le bien-fondé des «espaces publics » – parfois jusqu’à demander leur anéantissement, ils veulent plutôt récupérer l’espace commun. Le premier milieu ...