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Personalization of eHealth systems is a promising technique for improving patients’ adherence. This paper explores the possibility of personalisation based on the patients’ medical health situation and on their health literacy. The study is set within the context of a self-management support system (SMSS) for renal transplant patients. A SMSS is designed with layering, nudging, emphaticizing, and focusing principles. It has two communication styles: (1) a guided style that provided more interpretation support and addressed emotional needs; and (2) a factual style that showed only measurement history, medical information, and recommendations. To evaluate the design, 49 renal transplant patients with three different experience levels participated in a lab study, in which they used the system in imaginary scenarios to deal with three medical health situations (alright, mild concern, and concern). A 96% understanding and 87% adherence rate was observed, with a significant interaction effect on adherence between patient group and health situation. Furthermore, compared to recently transplanted patients, not recently transplanted patients were relatively more positive towards the factual than the guided communication style in the “alright” condition. Furthermore, additional medical information was searched more often in health situations that causes mild concern and a majority of patients did not change the communication style to their preferred styles. By attuning the communication style to patient’s experience and medical health situation according to the applied principles and acquired insights, SMSSs are expected to be better used.

Background Self-management support systems (SMSS) have been proposed for renal transplant patients to increase their autonomy and reduce the number of hospital visits. For the design and implementation of such systems, it is important to understand factors influencing patients’ acceptance of a SMSS. This paper aims to identify these key factors. Methods From literature, possible factors and related questionnaire items were identified. Afterwards, focus groups with experts and patients were conducted to adapt the items to the application domain. To investigate acceptance of a SMSS and the influencing factors, fifty renal transplant patients answered the questionnaire before and after using the SMSS for 4 months. Results All the questionnaire constructs had a satisfactory or higher level of reliability. After using the SMSS for 4 months, trust and performance expectancy could explain part of the variation in behavioural intention of using the SMSS, but not beyond the explanation given by patients’ affect towards the system, which accounted for 26% of the variance. Conclusions We anticipate that in future caregivers implementing a SMSS will benefit from taking steps to improve patients’ affect as this was found to correlate with patients use intention. Trial registration The study was registered in ToetsingOnline, a registry held by the Dutch Central Committee on Research Involving Human Subjects. The registration number is NL33387.058.11 , and the date of registration is 31st July 2012.

The high frequency of outpatient visits after kidney transplantation is burdensome to both the recovering patient and health care capacity. Self-monitoring kidney function offers a promising strategy to reduce the number of these outpatient visits. The objective of this study was to investigate whether it is safe to rely on patients' self-measurements of creatinine and blood pressure, using data from a self-management randomized controlled trial. For self-monitoring creatinine, each participant received a StatSensor Xpress-i Creatinine Meter and related test material. For self-monitoring blood pressure, each participant received a Microlife WatchBP Home, an oscillometric device for blood pressure self-measurement on the upper arm. Both devices had a memory function and the option to download stored values to a computer. During the first year post transplantation, 54 patients registered their self-measured creatinine values in a Web-based Self-Management Support System (SMSS) which provided automatic feedback on the registered values (eg, seek contact with hospital). Values registered in the SMSS were compared with those logged automatically in the creatinine device to study reliability of registered data. Adherence to measurement frequency was determined by comparing the number of requested with the number of performed measurements. To study adherence to provided feedback, SMSS-logged feedback and information from the electronic hospital files were analyzed. Level of adherence was highest during months 2-4 post transplantation with over 90% (42/47) of patients performing at least 75% of the requested measurements. Overall, 87.00% (3448/3963) of all registered creatinine values were entered correctly, although values were often registered several days later. If (the number of) measured and registered values deviated, the mean of registered creatinine values was significantly lower than what was measured, suggesting active selection of lower creatinine values. Adherence to SMSS feedback ranged from 53% (14/24) to 85% (33/39), depending on the specific feedback. Patients' tendency to postpone registration and to select lower creatinine values for registration and the suboptimal adherence to the feedback provided by the SMSS might challenge safety. This should be well considered when designing self-monitoring care systems, for example by ensuring that self-measured data are transferred automatically to an SMSS.

GridPix structures combine the high resolution of a pixel readout chip with a Micromegas as gas amplification stage. This detector has shown excellent performance before with the Timepix ASIC, but has been improved by using the successor ASIC, the Timepix3. This new version of the GridPix detectors has been used in test beams at the ELSA accelerator at Bonn, where 2.5 GeV electrons are available for tracking studies. It could be demonstrated that the spatial resolution in both transverse and longitudinal direction follows the diffusion function. Structures made of four GridPixes have been designed and constructed to cover larger areas. Also these devices called quads have been successfully tested with the electron beam giving similarly good results as the single GridPix detector.

The iVitality online research platform has been developed to gain insight into the relationship between early risk factors (ie, poorly controlled hypertension, physical or mental inactivity) and onset and possibly prevention of dementia. iVitality consists of a website, a smartphone application, and sensors that can monitor these indicators at home. Before iVitality can be implemented, it should fit the needs and preferences of users, ie, offspring of patients with dementia. This study aimed to explore users' motivation to participate in home-based health monitoring research, to formulate requirements based on users' preferences to optimize iVitality, and to test usability of the smartphone application of iVitality. We recruited 13 participants (aged 42-64 years, 85% female), who were offspring of patients with dementia. A user-centered methodology consisting of four iterative phases was used. Three semistructured interviews provided insight into motivation and acceptance of using iVitality (phase 1). A focus group with six participants elaborated on expectations and preferences regarding iVitality (phase 2). Findings from phase 1 and 2 were triangulated by two semistructured interviews (phase 3). Four participants assessed the usability of the smartphone application (phase 4) using a think aloud procedure and a questionnaire measuring ease and efficiency of use (scale 1-7; higher scores indicated better usability). All participants were highly motivated to contribute to dementia research. However, the frequency of home-based health monitoring should not be too high. Participants preferred to receive feedback about their measurements and information regarding the relationship between these measurements and dementia. Despite minor technical errors, iVitality was considered easy and efficient to use (mean score 5.50, standard deviation 1.71). Offspring of patients with dementia are motivated to contribute to home-based monitoring research by using iVitality and are able to use the smartphone application. The formulated requirements will be embedded to optimize iVitality.

After a kidney transplantation, patients have to visit the hospital often to monitor for early signs of graft rejection. Self-monitoring of creatinine in addition to blood pressure at home could alleviate the burden of frequent outpatient visits, but only if patients are willing to self-monitor and if they adhere to the self-monitoring measurement regimen. A prospective pilot study was conducted to assess patients' experiences and satisfaction. For 3 months after transplantation, 30 patients registered self-measured creatinine and blood pressure values in an online record to which their physician had access to. Patients completed a questionnaire at baseline and follow-up to assess satisfaction, attitude, self-efficacy regarding self-monitoring, worries, and physician support. Adherence was studied by comparing the number of registered with the number of requested measurements. Patients were highly motivated to self-monitor kidney function, and reported high levels of general satisfaction. Level of satisfaction was positively related to perceived support from physicians (P<0.01), level of self-efficacy (P<0.01), and amount of trust in the accuracy of the creatinine meter (P<0.01). The use of both the creatinine and blood pressure meter was considered pleasant and useful, despite the level of trust in the accuracy of the creatinine device being relatively low. Trust in the accuracy of the creatinine device appeared to be related to level of variation in subsequent measurement results, with more variation being related to lower levels of trust. Protocol adherence was generally very high, although the range of adherence levels was large and increased over time. Patients' high levels of satisfaction suggest that at-home monitoring of creatinine and blood pressure after transplantation offers a promising strategy. Important prerequisites for safe implementation in transplant care seem to be support from physicians and patients' confidence in both their own self-monitoring skills and the accuracy of the devices used.

The LHCb detector has undergone a major upgrade for LHC Run 3. This Upgrade I detector facilitates operation at higher luminosity and utilises full-detector information at the LHC collision rate, critically including the use of vertex information. A new vertex locator system, the VELO Upgrade, has been constructed. The core element of the new VELO are the double-sided pixelated hybrid silicon detector modules which operate in vacuum close to the LHC beam in a high radiation environment. The construction and quality assurance tests of these modules are described in this paper. The modules incorporate 200 \\mum thick, n-on-p silicon sensors bump-bonded to 130 \\nm technology ASICs. These are attached with high precision to a silicon microchannel substrate that uses evaporative CO\\(_2\\) cooling. The ASICs are controlled and read out with flexible printed circuits that are glued to the substrate and wire-bonded to the chips. The mechanical support of the module is given by a carbon fibre plate, two carbon fibre rods and an aluminium plate. The sensor attachment was achieved with an average precision of 21 \\(\\mathrm{\\mu m}\\), more than 99.5\\% of all pixels are fully functional, and a thermal figure of merit of 3 \\mathrm{Kcm^{2}W^{-1}}$ was achieved. The production of the modules was successfully completed in 2021, with the final assembly and installation completed in time for data taking in 2022.

Background/objectives: Preterm infants are at risk of iron deficiency (ID). In the Netherlands, preterm infants born after 32 weeks of gestational age (GA) do not receive iron supplementation on a routine basis. We hypothesized that dietary iron intake in these infants might not be sufficient to meet the high iron requirements during the first 6 months of life. Subjects/methods: In a prospective cohort study, we analyzed the prevalence and risk factors of ID in 143 infants born between 32+0 and 36+6 weeks GA who did not receive iron supplementation. Results: ID at the age of 4 and 6 months was present in 27 (18.9%) and 7 (4.9%) infants. Results of a multivariable logistic regression analysis showed that ID was associated with lower birth weight, a shorter duration of formula feeding, more weight gain in the first 6 months of life and lower ferritin concentrations at the age of 1 week. Conclusions: Preterm infants born after 32 weeks GA have an increased risk of ID compared with those born at term, supporting the need of iron supplementation. Our results suggests that measurement of ferritin at the age of 1 week might be useful to identify those infants at particular risk and could be used in populations without general supplementation programs. However, the efficacy and safety of individualized iron supplementation, based on ferritin concentrations at the age of 1 week, together with other predictors of ID, needs to be further investigated, preferably in a randomized controlled trial.

Background/Objectives: Late preterm infants (born ⩾32 weeks of gestation) are at risk for developing iron deficiency and iron deficiency anaemia, and this may lead to impaired neurodevelopment. In the Netherlands, there is no guideline for standardised iron supplementation in these infants. Individualised iron supplementation has been suggested (that is, treating those infants with the highest risk), but risk factors for deprived iron stores in this specific group of infants are not well documented. Subjects/Methods: In this prospective multi-centre study, we analysed the iron status at the postnatal age of 6 weeks of 68 infants born between 32 and 35 weeks of gestation in the Netherlands. Serum ferritin (SF) <70 μg/l in the absence of infection (C-reactive protein <5 mg/l) was defined as iron depletion and whenever in combination with a haemoglobin level <110 mg/dl as iron-depleted anaemia. Medical charts were reviewed to identify risk factors. Results: Iron depletion and iron-depleted anaemia were present in 38.2% and 30.9% of the infants, respectively. Infants with a birth weight <1830 g and a SF <155 μg/l in the first week of life had a 26.4 times higher risk to develop iron depletion (95% confidence interval 3.1–227.0, P =0.003). Multivariate regression analyses also showed that iron depletion was associated with a higher number of blood draws. Conclusions: Iron depletion is common in late preterm infants at the age of 6 weeks in a setting without standardised iron supplementation. One should consider early individualised iron supplementation for late preterm infants with a low birth weight (<1830 g), and a low SF in the first week of life (<155 μg/l), as they have a high risk to develop iron depletion.

The LHCb Outer Tracker is a gaseous detector covering an area of 5x6 m2 with 12 double layers of straw tubes. The detector with its services are described together with the commissioning and calibration procedures. Based on data of the first LHC running period from 2010 to 2012, the performance of the readout electronics and the single hit resolution and efficiency are presented. The efficiency to detect a hit in the central half of the straw is estimated to be 99.2%, and the position resolution is determined to be approximately 200 um. The Outer Tracker received a dose in the hottest region corresponding to 0.12 C/cm, and no signs of gain deterioration or other ageing effects are observed.