BACKGROUND: A significant number of older patients planned for transcatheter aortic valve implantation (TAVI) experience a decline in physical functioning and death, despite a successful procedure.OBJECTIVE: To systematically review the literature on the association of preprocedural muscle strength and physical performance with functional decline or long-term mortality after TAVI.METHODS: We followed the PRISMA guidelines and pre-registered this review at PROSPERO (CRD42020208032). A systematic search was conducted in MEDLINE and EMBASE from inception to 10 December 2021. Studies reporting on the association of preprocedural muscle strength or physical performance with functional decline or long-term (>6 months) mortality after the TAVI procedure were included. For outcomes reported by three or more studies, a meta-analysis was performed.RESULTS: In total, two studies reporting on functional decline and 29 studies reporting on mortality were included. The association with functional decline was inconclusive. For mortality, meta-analysis showed that low handgrip strength (hazard ratio (HR) 1.80 [95% confidence interval (CI): 1.22-2.63]), lower distance on the 6-minute walk test (HR 1.15 [95% CI: 1.09-1.21] per 50 m decrease), low performance on the timed up and go test (>20 s) (HR 2.77 [95% CI: 1.79-4.30]) and slow gait speed (<0.83 m/s) (HR 2.24 [95% CI: 1.32-3.81]) were associated with higher long-term mortality.CONCLUSIONS: Low muscle strength and physical performance are associated with higher mortality after TAVI, while the association with functional decline stays inconclusive. Future research should focus on interventions to increase muscle strength and physical performance in older cardiac patients.
Physical activity is crucial in human life, whether in everyday activities or elite sports. It is important to maintain or improve physical performance, which depends on various factors such as the amount of physical activity, the capability, and the capacity of the individual. In daily life, it is significant to be physically active to maintain good health, intense exercise is not necessary, as simple daily activities contribute enough. In sports, it is essential to balance capacity, workload, and recovery to prevent performance decline or injury.With the introduction of wearable technology, it has become easier to monitor and analyse physical activity and performance data in daily life and sports. However, extracting personalised insights and predictions from the vast and complex data available is still a challenge.The study identified four main problems in data analytics related to physical activity and performance: limited personalised prediction due to data constraints, vast data complexity, need for sensitive performance measures, overly simplified models, and missing influential variables. We proposed end investigated potential solutions for each issue. These solutions involve leveraging personalised data from wearables, combining sensitive performance measures with various machine learning algorithms, incorporating causal modelling, and addressing the absence of influential variables in the data.Personalised data, machine learning, sensitive performance measures, advanced statistics, and causal modelling can help bridge the data analytics gap in understanding physical activity and performance. The research findings pave the way for more informed interventions and provide a foundation for future studies to further reduce this gap.
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End-stage kidney disease patients treated with conventional hemodialysis (CHD) are known to have impaired physical performance and protein-energy wasting (PEW). Nocturnal hemodialysis (NHD) was shown to improve clinical outcomes, but the evidence is limited on physical performance and PEW. We investigate whether NHD improves physical performance and PEW. This prospective, multicenter, non-randomized cohort study compared patients who changed from CHD (2-4 times/week 3-5 h) to NHD (2-3 times/week 7-8 h), with patients who continued CHD. The primary outcome was physical performance at 3, 6 and 12 months, assessed with the short physical performance battery (SPPB). Secondary outcomes were a 6-minute walk test (6MWT), physical activity monitor, handgrip muscle strength, KDQOL-SF physical component score (PCS) and LAPAQ physical activity questionnaire. PEW was assessed with a dietary record, dual-energy X-ray absorptiometry, bioelectrical impedance spectroscopy and subjective global assessment (SGA). Linear mixed models were used to analyze the differences between groups. This study included 33 patients on CHD and 32 who converted to NHD (mean age 55 ± 15.3). No significant difference was found in the SPPB after 1-year of NHD compared to CHD (+0.24, [95% confidence interval -0.51 to 0.99], p = 0.53). Scores of 6MWT, PCS and SGA improved (+54.3 [95%CI 7.78 to 100.8], p = 0.02; +5.61 [-0.51 to 10.7], p = 0.03; +0.71 [0.36 to 1.05], p &lt; 0.001; resp.) in NHD patients, no changes were found in other parameters. We conclude that NHD patients did not experience an improved SPPB score compared to CHD patients; they did obtain an improved walking distance and self-reported PCS as well as SGA after 1-year of NHD, which might be related to the younger age of these patients.
With increasing penetration rates of driver assistance systems in road vehicles, powerful sensing and processing solutions enable further automation of on-road as well as off-road vehicles. In this maturing environment, SMEs are stepping in and education needs to align with this trend. By the input of student teams, HAN developed a first prototype robot platform to test automated vehicle technology in dynamic road scenarios that include VRUs (Vulnerable Road Users). These robot platforms can make complex manoeuvres while carrying dummies of typical VRUs, such as pedestrians and bicyclists. This is used to test the ability of automated vehicles to detect VRUs in realistic traffic scenarios and exhibit safe behaviour in environments that include VRUs, on public roads as well as in restricted areas. Commercially available VRU-robot platforms are conforming to standards, making them inflexible with respect to VRU-dummy design, and pricewise they are far out of reach for SMEs, education and research. CORDS-VTS aims to create a first, open version of an integrated solution to physically emulate traffic scenarios including VRUs. While analysing desired applications and scenarios, the consortium partners will define prioritized requirements (e.g. robot platform performance, dummy types and behaviour, desired software functionality, etc.). Multiple robots and dummies will be created and practically integrated and demonstrated in a multi-VRU scenario. The aim is to create a flexible, upgradeable solution, published fully in open source: The hardware (robot platform and dummies) will be published as well-documented DIY (do-it-yourself) projects and the accompanying software will be published as open-source projects. With the CORDS-VTS solution, SME companies, researchers and educators can test vehicle automation technology at a reachable price point and with the necessary flexibility, enabling higher innovation rates.
The ENCHANT project aims to clarify the differences between circular Calcium Carbonate (CCC) and grounded Calcium Carbonate (GCC), in order to expand the applications of the circular alternative CCC in the paint and coating industry. CCC is produced by pyrolysis from paper waste in an innovative process developed by the company Alucha Works B.V., and it can be applied again as filler or binder in consumer products (e.g. plastics, rubbers, paints and coatings) in a cost-effective manner. Products containing CCC have a higher content of circular resources, which minimizes their carbon footprint, and reduces the exploitation of primary resources. Performances of CCC in oil-based paints, however, is not optimal, due to a larger oil adsorption as compared to GCC. A physical and chemical characterization of CCC and GCC samples, including competitive oil-water adsorption measurements, would help Alucha to formulate a solution to match the properties of CCC and GCC, either adjusting the recycling process or applying a surface modification treatment to CCC. This would enable Alucha to expand the market for CCC, making oil-based formulation products more circular.
The RAAK Pro MARS4Earth project focuses on the question of whether it is possible to develop a prototype of a modular and autonomous aerial manipulator (drone + robot arm) that can physically interact with a realistic outdoor environment, and what possibilities this creates to several application domains. In essence, the aerial manipulator acts as "arms and hands in the air", which can be used for both active interaction (maintenance of offshore windturbine) and passive interaction (selective plant treatment and firefighting). The modular aerial manipulator consists of four basic building blocks: • Mission-specific interaction module(s); • Intelligent surface exploration; • Adaptive interaction control algorithm(s); • Advanced on-board perception and decision module(s). In the meantime the first version of the aforementioned modular building blocks have been designed and realized by various consortium partners. However, due to the various measure of the COVID 19, consortium partners and researchers were not able to carry out the integration of various modules to realize the complete system. Moreover, it was not possible to conduct thorough tests in the operational environment to evaluate the performance of the first prototype. This is a crucial step tp realize the aerial manipulator with the envisaged modularity and performance. In this RAAK Impulse project, we will conduct integration of the first versions of the modules developed by the various consortium partners. Moreover, we will conduct thorough test in Emshave and Twente safety campus to investigate the functionality and performance of the developed integrated prototype. With this Impulse, we will be able to make up for the delay caused by the COVID -19 measures and conclude the project by realizing the original objectives of the MARS4Earth project.
