It is suggested that older patients waiting for an elective surgical procedure have a poor nutritional status and low physical activity level. It is unknown if this hypothesis is true and if these conditions improve after a medical procedure. We aimed to determine the trajectory of both conditions before and after transcatheter aortic valve implantation (TAVI). Included patients (n = 112, age 81 ± 5 years, 58% male) received three home visits (preprocedural, one and six months postprocedural). Nutritional status was determined with the mini nutritional assessment-short form (MNA-SF) and physical activity using an ankle-worn monitor (Stepwatch). The median MNA-SF score was 13 (11-14), and 27% of the patients were at risk of malnutrition before the procedure. Physical activity was 6273 ± 3007 steps/day, and 69% of the patients did not meet the physical activity guidelines (>7100 steps/day). We observed that nutritional status and physical activity did not significantly change after the procedure (β 0.02 [95% CI -0.03, 0.07] points/months on the MNA-SF and β 16 [95% CI -47, 79] steps/month, respectively). To conclude, many preprocedural TAVI patients should improve their nutritional status or activity level. Both conditions do not improve naturally after a cardiac procedure.
This paper introduces the Internet-of-Things (IoT) and describes its evolution from a concept proposed by Kevin Ashton in 1999 through its public emergence in 2005 in a United Nations ITU report entitled “The Internet of Things”, to the present day where IoT devices are available as off-the-shelf products from major manufacturers. Using a systematic study of public literature, the paper presents a five-phase categorisation of the development of the Internet-of-Things from its beginnings to the present day. Four mini case studies are included to illustrate some of the issues involved. Finally, the paper discusses some of the big issues facing future developers and marketers of Internet-of-Things based products ranging from artificial intelligence (AI) through to customer privacy and acceptance finishing with an optimistic assessment of the future of the Internet-of-Things.
