Objectives Patients who underwent corrective surgery for tetralogy of Fallot (TOF) have increased long-term risk of cardiovascular morbidity and mortality. Yet, limited information is available on how to evaluate the risk in this population. Therefore, the aim of this study was to investigate the prognostic value of aerobic exercise capacity, along with other related parameters, at medium-term follow-up in adult patients with tetralogy of Fallot. Methods and results Between 2000 and 2003, 92 adults (age 26.2 ± 7.8 years; 63 male) with corrected TOF or TOF-type morphology underwent a cardiopulmonary exercise test (CPET) until exhaustion and echocardiography. During a mean follow-up of 7.3 ± 1.2 years (range 0.9 to 9.3 years), 2 patients died and 26 patients required at least 1 cardiac-related intervention at a mean age of 28.9 ± 7.9 years. Event-free survival tended to be higher in patients with the classical type of TOF (P = 0.061). At multivariate Cox analysis, age at CPET [hazard ratio (HR): 1.13, P = 0.006], age at correction (HR: 0.82, P = 0.037), right ventricular (RV) function (HR: 4.94, P = 0.001), QRS duration (HR: 1.02, P = 0.007), percentage of predicted peak oxygen uptake (peak VO2%) (HR: 0.96, P = 0.029) and ventilatory effi ciency slope (VE/VCO2 slope) (HR: 1.13, P = 0.021) were signifi cantly related to the incidence of death/cardiac-related intervention during medium follow-up. Conclusions Early corrective surgery and a well-preserved RV are associated with a better outcome in adults with corrected TOF. Furthermore, CPET provides important prognostic information; peak VO2% and VE/VCO2 slope are independent predictors for event-free survival in patients with corrected TOF.
Paper presented at Diversity of Journalisms. ECREA Journalism Studies Section and 26th International Conference of Communication (CICOM) The launch of more than 300 free daily newspapers worldwide during the last 15 years defies the idea that newspaper markets are impossible to penetrate. Although a third of papers closed down in the last ten years, newspaper circulation in most countries with free newspapers is actually higher than before their entry. Readership analysis of free newspapers shows that these papers have a younger audience than paid newspapers, contradicting the notion that young people don’t read newspapers anymore.
OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases.DESIGN: Prospective cohort study.SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366).MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%).MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer.RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50.CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.
Various companies in diagnostic testing struggle with the same “valley of death” challenge. In order to further develop their sensing application, they rely on the technological readiness of easy and reproducible read-out systems. Photonic chips can be very sensitive sensors and can be made application-specific when coated with a properly chosen bio-functionalized layer. Here the challenge lies in the optical coupling of the active components (light source and detector) to the (disposable) photonic sensor chip. For the technology to be commercially viable, the price of the disposable photonic sensor chip should be as low as possible. The coupling of light from the source to the photonic sensor chip and back to the detectors requires a positioning accuracy of less than 1 micrometer, which is a tremendous challenge. In this research proposal, we want to investigate which of the six degrees of freedom (three translational and three rotational) are the most crucial when aligning photonic sensor chips with the external active components. Knowing these degrees of freedom and their respective range we can develop and test an automated alignment tool which can realize photonic sensor chip alignment reproducibly and fully autonomously. The consortium with expertise and contributions in the value chain of photonics interfacing, system and mechanical engineering will investigate a two-step solution. This solution comprises a passive pre-alignment step (a mechanical stop determines the position), followed by an active alignment step (an algorithm moves the source to the optimal position with respect to the chip). The results will be integrated into a demonstrator that performs an automated procedure that aligns a passive photonic chip with a terminal that contains the active components. The demonstrator is successful if adequate optical coupling of the passive photonic chip with the external active components is realized fully automatically, without the need of operator intervention.
Due to the existing pressure for a more rational use of the water, many public managers and industries have to re-think/adapt their processes towards a more circular approach. Such pressure is even more critical in the Rio Doce region, Minas Gerais, due to the large environmental accident occurred in 2015. Cenibra (pulp mill) is an example of such industries due to the fact that it is situated in the river basin and that it has a water demanding process. The current proposal is meant as an academic and engineering study to propose possible solutions to decrease the total water consumption of the mill and, thus, decrease the total stress on the Rio Doce basin. The work will be divided in three working packages, namely: (i) evaluation (modelling) of the mill process and water balance (ii) application and operation of a pilot scale wastewater treatment plant (iii) analysis of the impacts caused by the improvement of the process. The second work package will also be conducted (in parallel) with a lab scale setup in The Netherlands to allow fast adjustments and broaden evaluation of the setup/process performance. The actions will focus on reducing the mill total water consumption in 20%.
To reach the European Green Deal by 2050, the target for the road transport sector is set at 30% less CO2 emissions by 2030. Given the fact that heavy-duty commercial vehicles throughout Europe are driven nowadays almost exclusively on fossil fuels it is obvious that transition towards reduced emission targets needs to happen seamlessly by hybridization of the existing fleet, with a continuously increasing share of Zero Emission vehicle units. At present, trailing units such as semitrailers do not possess any form of powertrain, being a missed opportunity. By introduction of electrically driven axles into these units the fuel consumption as well as amount of emissions may be reduced substantially while part of the propulsion forces is being supplied on emission-free basis. Furthermore, the electrification of trailing units enables partial recuperation of kinetic energy while braking. Nevertheless, a number of challenges still exist preventing swift integration of these vehicles to daily operation. One of the dominating ones is the intelligent control of the e-axle so it delivers right amount of propulsion/braking power at the right time without receiving detailed information from the towing vehicle (such as e.g. driver control, engine speed, engine torque, or brake pressure, …etc.). This is required mainly to ensure interoperability of e-Trailers in the fleets, which is a must in the logistics nowadays. Therefore the main mission of CHANGE is to generate a chain of knowledge in developing and implementing data driven AI-based applications enabling SMEs of the Dutch trailer industry to contribute to seamless energetic transition towards zero emission road freight transport. In specific, CHANGE will employ e-Trailers (trailers with electrically driven axle(s) enabling energy recuperation) connected to conventional hauling units as well as trailers for high volume and extreme payload as focal platforms (demonstrators) for deployment of these applications.
