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The cellular adhesion receptor αvβ6-integrin is highly expressed in many cancers, e.g., pancreatic, lung, head-and-neck, cervical, bladder, and esophageal carcinoma. Multimerization of αvβ6-integrin-specific RGD peptides increases the target affinity and retention but affects biodistribution and pharmacokinetics. Amide formation of the terminal carboxylic acid moieties of the square-symmetrical bifunctional chelator DOTPI with 3-azidopropylamine yields derivatives with 4, 3, and 2 terminal azides and zero, 1, and 2 remaining carboxylic acids, respectively, whereby formation of the 2-cis-isomer is preferred according to NMR investigation of the Eu(III)-complexes. Cu(II)-catalyzed alkyne–azide cycloaddition (CuAAC) of the alkyne-functionalized αvβ6-integrin binding peptide cyclo[YRGDLAYp(NMe)K(pent-4-ynoic amide)] (Tyr2) yields the respective di-, tri-, and tetrameric conjugates for Lu-177-labeling. In mice bearing αvβ6-integrin-expressing xenografts of H2009 (human lung adenocarcinoma) cells, the Lu-177-labeled trimer’s tumor-to-blood ratio of 112 exceeds that of the tetramer (10.4) and the dimer (54). Co-infusion of gelofusine (succinylated gelatin) reduces the renal uptake of the trimer by 89%, resulting in a 10-fold better tumor-to-kidney ratio, while no improvement of that ratio is observed with arginine/lysine, para-aminohippuric acid (PAH), and hydroxyethyl starch (HES) coinfusions. Since the Lu-177-labeled Tyr2-trimer outperforms the dimer and the tetramer, such trimers are considered the best lead structures for the ongoing development of αvβ6-integrin targeted anticancer theranostics.

Dr. Dabbs: Your March/April Guncrank Diaries hit a nerve in a good way. I'm a physician, and deal with my share of big-city trauma and 'people being mean to each [...]

To determine whether biological sex affects oncological outcome after extended pelvic lymph node dissection, radical cystectomy, and urinary diversion for muscle-invasive bladder cancer, and to identify risk factors impacting outcome.

Zusammenfassung: Hintergrund: Bei der Einrichtung des Traumanetzwerks im Großraum Nürnberg stellte sich die Frage nach einem präklinischen System zur Verbesserung der Schnittstelle Rettungsdienst bzw. Notarzt und Schockraum. In einer Arbeitsgruppe bestehend aus den Lehrrettungsassistenten von Arbeiter-Samariter-Bund, Bayrischem Roten Kreuz, Johanniter-Unfall-Hilfe, Malteser Hilfsdienst, Vertretern der Notarztgruppen und Ärzten aus dem Krankenhaus Rummelsberg entstand ein Schulungskonzept für das präklinische Traumamanagement. Material und Methoden: Zunächst erfolgte eine ausführliche Recherche in der internationalen Literatur zum präklinischen Traumamanagement, sowie ein Studium der amerikanischen Schulungskonzepte (ITLS®, PHTLS®). Danach wurde die Versorgungsrealität vor Ort kritisch evaluiert und das deutsche System mit den amerikanischen Konzepten verglichen. Ergebnisse: Es entstand ein zweitägiges Konzept mit 6 Sequenzen (Einsatzstelle und Kinetik, Untersuchungsablauf Trauma, Pathologien, Versorgungsablauf, Praxisausbildung und Evaluation). Die Abläufe im Konzept werden standardisiert und unterliegen der ATLS-Logik. In diesen Abläufen wurde der Einbindung und Stellung des Notarztes in Deutschland besondere Beachtung geschenkt, sowie die Kompetenzen des Rettungsdienstpersonals definiert. Schlussfolgerung: Durch die Teamarbeit aller Beteiligten wurde die Akzeptanz erhöht und eine Umsetzung deutlich erleichtert. Das Konzept steht allen Hilfsorganisationen offen, um ihre Mitarbeiter darin zu unterrichten. Durch ein qualifiziertes präklinisches System, welches nahtlos mit den hospitalen Versorgungskonzepten (ATLS®) arbeitet, könnte eine Verbesserung der Versorgung von Traumapatienten durch Integration von Notarzt und Rettungsdienst erreicht werden.

Harnwegsinfektionen zeichnen sich durch ein breites klinisches Erscheinungsbild aus und reichen von der unkomplizierten Zystitis bis hin zum septischen Schock. 9–31 % aller Septikämien haben einen urogenitalen Fokus und werden als Urosepsis bezeichnet. Die Urosepsis tritt häufig im Zusammenhang mit gesundheitssystemassoziierten Infektionen auf. Einen wesentlichen Risikofaktor stellt die obstruktive Uropathie (z. B. Urolithiasis, Tumoren, Strikturen etc.) dar. Schwere und Verlauf der Urosepsis sind neben der Pathogenität des Erregers von der Art und dem Ausmaß der individuellen Immunantwort abhängig. Die Therapie gliedert sich in eine kausale (antimikrobielle Therapie und Fokussanierung), supportive (hämodynamische und pulmonale Stabilisierung) und adjunktive (Glukokortikoid- und Insulin-Therapie) Therapie und sollte ohne Zeitverzug initiiert werden. Dem demographischen Wandel geschuldet ist zukünftig mit einer weiteren Zunahme der Uroseptikämien zu rechnen, weswegen jeder Urologe mit der zielgerichteten Diagnostik und effektiven Therapie vertraut sein sollte.

May 27, 2022 | State Legislatures News | Print NCSL involvement: Stangl is the staff vice chair of the Redistricting and Elections Standing Committee Years of legislative service: 11 The [...]

Using nationally representative data, we determined the likelihood of adverse pathology at radical prostatectomy (RP) to better inform case selection for partial gland ablation (PGA).

Cognitive neuroscience studies in humans have enabled decades of impactful discoveries but have primarily been limited to recording the brain activity of immobile participants in a laboratory setting. In recent years, advances in neuroimaging technologies have enabled recordings of human brain activity to be obtained during freely moving behaviours in the real world. Here, we propose that these mobile neuroimaging methods can provide unique insights into the neural mechanisms of human cognition and contribute to the development of novel treatments for neurological and psychiatric disorders. We further discuss the challenges associated with studying naturalistic human behaviours in complex real-world settings as well as strategies for overcoming them. We conclude that mobile neuroimaging methods have the potential to bring about a new era of cognitive neuroscience in which neural mechanisms can be studied with increased ecological validity and with the ability to address questions about natural behaviour and cognitive processes in humans engaged in dynamic real-world experiences.

Introduction In the formulation of problems related to the use of substances and proposed state-based solutions, concepts play a central part. As Edman (2012) pointed out in a recent issue [...], Concepts play a central part in the formulation of problems and proposed solutions to the use of substances. This article reports the initial results from a cross European historical study, carried out to a common methodology, of the language of addiction and policy responses in two key periods, 1860-1930 and the 1950s and 1960s. It concludes that the language of addiction was varied and nonstandard in the first period. The Anglo-American model of inebriety did not apply across Europe but there was a common focus on theories of heredity and national degeneration. After World War II, there was a more homogenous language but still distinct national differences in emphasis and national interests and policy responses to different substances. More research will be needed to deepen understanding of the conditions under which these changes took place and the social and policy appeal of disease theories. Keywords addiction, concepts, policy, history, alcohol and other drugs, tobacco

Der Beitrag bietet einen Einblick über mögliche technische Diskriminierung durch Fachsoftware im Bereich der Arbeitssuche. Dazu wird nach einer kurzen technischen Einführung konkret an den Softwarelösungen „ALLEGRO“ der Bundesagentur für Arbeit in Deutschland und dem Arbeitsmarktchancen-Assistenzsystem des Arbeitsmarktservice in Österreich aufgezeigt, ob und inwieweit diese Softwarelösungen auf technischen Mechanismen beruhen, die Diskriminierung von Arbeitssuchenden (re)produzieren. Nach einer zusammenfassenden Schlussfolgerung werden schließlich Vorschläge für erste Schritte der persönlichen Auseinandersetzung von Sozialarbeiter_innen mit diesen Mechanismen gegeben.

Advances in technologies that can record and stimulate deep brain activity in humans have led to impactful discoveries within the field of neuroscience and contributed to the development of novel therapies for neurological and psychiatric disorders. Further progress, however, has been hindered by device limitations in that recording of single-neuron activity during freely moving behaviors in humans has not been possible. Additionally, implantable neurostimulation devices, currently approved for human use, have limited stimulation programmability and restricted full-duplex bidirectional capability. In this study, we developed a wearable bidirectional closed-loop neuromodulation system (Neuro-stack) and used it to record single-neuron and local field potential activity during stationary and ambulatory behavior in humans. Together with a highly flexible and customizable stimulation capability, the Neuro-stack provides an opportunity to investigate the neurophysiological basis of disease, develop improved responsive neuromodulation therapies, explore brain function during naturalistic behaviors in humans and, consequently, bridge decades of neuroscientific findings across species.

Personal-computer-based software receivers have found broad use as R&D toots for testing new signal processing algorithms, for analyzing received GNSS signals, and for integrating various sensors with GNSS. Software receivers [...]

There are two main approaches used in the selection of stocks in actively managed equity portfolios. One is the traditional approach based on fundamental analysis, where managers research and analyze [...]

Art-based research methods can enable young people to generate data that provide insights into their lives. We assessed the feasibility, value, and limitations of collages as a participatory research method to understand the experiences of young women living with HIV. Individual collages were created in participatory workshops, firstly in 2015 and secondly in 2017, by a cohort of young women living with HIV in Lusaka, Zambia. Collages were analyzed visually and thematically and compared to other qualitative methods. Participants engaged readily with making collages and expressed how the collages represented themselves. The collages conveyed aspirations, resilience, optimism, and identities beyond HIV. Other data generation methods focused more on challenges associated with HIV. The second collages demonstrated more complex portrayals of participants’ life and developmental transitions. Collages provided a feasible, effective, and therapeutic method of empowering young women living with HIV to tell their own stories and express their full selves.

Hintergrund: Die Marginalvene (MV) ist eine angeborene, vorwiegend venöse Gefäßmalformation, die auf einer fehlenden Rückbildung des embryonalen Venensystems an den unteren Extremitäten beruht. Sie geht mit einer Vielzahl an Komplikationen einher. Bisher werden in der Literatur keine einheitlichen Therapieregime beschrieben. Fragestellung: Welche Behandlungsstrategien und Ergebnisse gibt es bei Patienten mit MV? Material und Methoden: Im Zeitraum 01.01.2008 bis 31.12.2020 wurden alle am Universitätsklinikum Augsburg behandelten Patienten mit Marginalvene retrospektiv aufgearbeitet. Ergebnisse: Das mediane Alter zum Diagnosezeitpunkt lag bei 14,8 Jahren (3–42 Jahre). 12/16 Patienten hatten eine Beinlängendifferenz. 75 % der Patienten (12/16) hatten bereits zur Diagnosestellung MV eine chronisch-venöse Insuffizienz (CVI). Im untersuchten Kollektiv wurden 62,5 % (10/16) der Patienten zum Zeitpunkt der Diagnosestellung mittels Kompression konservativ behandelt. Bei weiteren 31,3 % (5/16) der Patienten erfolgte primär eine offen-chirurgische Entfernung der MV und bei 1/16 Patienten wurde die MV primär mittels endovenöser Lasertherapie (EVLT) verschlossen; 15/16 Patienten wurden sekundär therapiert. 2,6 ± 2,4 (MW ± SD) Sekundärprozeduren wurden pro Patient im Follow up durchgeführt. Das mittlere Follow-up lag bei 8,1 Jahren. Diskussion: Zur Prävention/Vermeidung einer Progression einer CVI und Thrombembolieprophylaxe sollte nach Diagnosestellung die MV zeitnah verschlossen/entfernt werden. Die Anwendung chirurgisch-konventioneller Techniken zur Entfernung der MV scheint gegenüber der Behandlung mit minimal-invasiven Prozeduren hinsichtlich der Anzahl der erforderlichen Sekundäreingriffe von Vorteil.

Objective: In an era of highly active antiretroviral therapies, the authors needed to confirm previous findings showing that stress and depression have an impact on HIV disease progression. The goal of the current study was to examine the effects of lifetime trauma, recent stressful events, and depression on all cause and AIDS-related mortality among HIV infected men and women. The authors hypothesized that these psychosocial variables would predict significantly faster HIV-specific and all-cause mortality. Method: The authors consecutively sampled HIV-infected men and women who received care at one of eight infectious diseases clinics in five Southeastern states. The sample included 490 patients who were followed by interview for 27 months and followed with their medical records for up to 41 months. Results: There were 29 deaths; 16 were AIDS-related. More lifetime trauma and antigenic marker on helper/inducer T cells (CD4) Conclusions: Further research is needed to determine if interventions to address trauma and depression can modify these detrimental effects on HIV.

AUTHOR'S NOTE: Many thanks to Ronald Knibbe, Jacek Moskalewicz, and Robin Room, who commented on confused first versions of this paper and stimulated an extensive change. They are not responsible [...], Policy on illegal drugs has been from the beginning also policy on foreigners. But there are periods when the linkage becomes stronger and its profile more distinct. The integration of Europe seems to be a period stimulating a change in the character of the linkage because of the increase of 'national uncertainty.' The Austrian case is the focus of this paper: it is investigated since the arrival of the 'international drug wave.' The investigation is based on the analysis of the special police reports on drug offenses published since 1975, on interviews with other drug professionals, and on studies of immigration and attitudes toward immigrants. A main conclusion is that the intensification of the linkage reflects increasing major social conflicts. KEY WORDS: Drug policy, drug policy and foreigners, the drug situation of foreigners, police records on drug offenses, local and foreign drug offenders.

Purpose: Retail organizations that consider a service ecosystems view of sustainability focused on transformation have the potential to contribute to the wellbeing of individuals, business and society. The purpose of this paper is to explore the transformative nature of sustainable retail fashion organizations and their impact on wellbeing within a sustainable retail service ecosystem. Design/methodology/approach: A qualitative in-depth case study research design was implemented using four sustainable fashion brands. Data were collected from multiple sources including secondary data from company websites and publicly available reports and interviews with founders and/or high-ranking managers within the organization. Findings: Three overarching themes critical to transformation in sustainable retail service ecosystems were identified: (1) embedded core purpose or ethos, (2) relevance of fit and (3) breadth and depth of message. Corresponding wellbeing elements were found within the three themes – community and society wellbeing, environmental wellbeing, business strategy wellbeing, consumer wellbeing, leadership wellbeing, employee wellbeing, stakeholder and value chain wellbeing and brand wellbeing. Research limitations/implications: Future research offers an important opportunity to further explore the relationships between sustainability, TSR and wellbeing in other service contexts. Originality/value: The paper contributes to transformative service research literature by conceptualizing a sustainable retail service wellbeing ecosystem framework.

ABSTRACTAccording to one widely accepted view, our actions and emotions ought to be proportional to the degree of value present in their objects. Against this proportionality principle, Pettigrove sketches a view according to which the value of some virtuous actions and attitudes derives from the characteristic way of being of the agent herself, and not from any other goods that agent appreciates, pursues, or promotes. Granting Pettigrove’s rejection of the proportionality principle, I raise some questions for his replacement account. I suggest that it is not just the characteristic way of being of an agent who loves and forgives virtuously that explains the goodness of their love and forgiveness, but also the role such virtues play in making possible valuable relationships that are partially constitutive of human flourishing.

This paper concerns the history and structure of the so-called self-help groups of alcoholics in Austria. These self-help groups have roots other than AA. And they not only have other [...], Non-AA self-help groups are common in Austria. They owe much to professionals and tend to be aligned with professional alcoholism treatment services. Alcoholics Anonymous groups are more aligned with general medical and psychiatric services and tend to attract alcoholics who have not been successfully treated by specialized alcoholism services.

Transcathetertherapy has expanded the treatment options for patients with heart valve disease. Interventional therapy for aortic, mitral, and pulmonic valve disease is well established; however, catheter-based approaches to tricuspid regurgitation (TR) are still in early stages of development. For some of the interventional concepts to TR, including the edge-to-edge-repair, transcatheter annuloplasty, the tricuspid spacer, and caval valves, procedural feasibility and favorable early clinical outcome have been demonstrated in small compassionate case series. This article reviews the pathophysiological background and current evidence for caval valve implantation and examines the potential role of this approach for the treatment of severe TR.

Hintergrund: Harnwegsinfektionen gehören weltweit zu den häufigsten bakteriellen Infektionskrankheiten, sowohl im ambulanten als auch stationären Setting. Fragestellung: Mit diesem Pilotprojekt soll primär die Frage beantwortet werden, welchen relativen Anteil der Antibiotikaeinsatz zur Therapie bakterieller Infektionen in einer universitären Urologie hat, um Antibiotic-Stewardship(ABS)-Programme besser implementieren zu können. Material und Methoden: Es handelt sich um ein epidemiologisches Pilotprojekt. Über einen Zeitraum von insgesamt drei Monaten wurde systematisch erhoben, wie viele Patientinnen und Patienten relativ im Verhältnis zur Gesamtanzahl der Patientinnen und Patienten eine Antibiotikagabe erhielten. Ergebnisse: Bei rund 40 % der urologischen Patientinnen und Patienten einer universitären Einrichtung wurde eine antimikrobielle Therapie bei bakterieller Harnwegsinfektion bzw. eine perioperative Antibiotikaprophylaxe zur Vermeidung bakterieller Komplikationen im Operationssaal eingesetzt. Insgesamt ist der Antibiotikaeinsatz im stationären Bereich am höchsten. Diskussion: Infektiologische Aspekte haben am Fachgebiet Urologie einen signifikanten Anteil. Dieses Wissen ist essentiell um ABS-Programme erfolgreich zu implementieren und der Resistenzentwicklung entgegen zu wirken. Detailliierte Folgeuntersuchungen sind notwendig, um die Antibiotikaverordnungspraxis in der Urologie genau zu verstehen und daraus gezielte ABS-Interventionen entwickeln zu können.

1. 'The law of July 19th of 1877, by which measures for the prevention of inebriety are taken. Effective for the kingdoms of Galicia and Lodomeria, inclusive of the Grand [...], Anticapitalist and xenophobic forces in Austrian Poland, a spirits-drinking area, pushed through the first law against inebriety in the Austrian empire in 1877, a time of economic crisis. Its main features were applied to Austria proper in 1922 legislation, adopted in somewhat parallel circumstances.

Acute rejection episodes often complicate clinical small bowel transplantation, which prompted us to investigate whether such episodes can be reversed and the intestinal graft salvaged. Inbred Lewis rats that received fully allogeneic Brown-Norway small bowel allografts were treated with eyelosporin A (10 mg/kg) for 5 days, and the drug was then discontinued. Clinical and histologic signs of acute rejection developed, and the animals were subsequently treated with FK 506 (2 mg/kg) on days 14, 16, and 18. Survival was significantly prolonged ( 201.7[+ or -]46.8 days) when compared with animals that were not administered FK 506 (16.5[+ or -]0.8 days) or allograft recipients that received no immunosuppressive therapy (10.8[+ or -]0.7 days). The histologic changes and functional impairment due to rejection that were observed prior to the start of the FK 506-therapy were reversed. However, biopsy specimens of all animals exhibited features of chronic rejection. This study provides evidence that acute rejection of intestinal allografts can be successfully treated with a short course of FK 506.

Mini-directional horizontal boring machines are particularly suited for installation of small diameter underground gas lines in suburban-and, to a certain extent, urban-areas because the equipment is compact and the trenchless [...]

The hypothalamic-pituitary-adrenal (HPA) axis is a complicated, integrated physiological network that releases hormones that cause the adrenal cortex to secrete cortisol. Many studies have demonstrated hyperactivity of the HPA axis in some depressed patients. A technique to determine HPA activity involves the dexamethasone suppression test (DST), which measures the ability of dexamethasone to suppress the HPA axis for 24 hours. Excessive cortisol (hypercortisolism) is found in patients with Cushing's syndrome, a disorder which can include hypertension, depression, mania, and extreme confusion. To evaluate whether depressed patients with elevated post-DST serum cortisol levels (nonsuppressors) demonstrate any symptoms of Cushing's disease, 235 depressed inpatients (156 women and 79 men who were primarily Caucasian) were given the DST. Blood pressure (BP), admission weight, age and various factors influenced by HPA activity were assessed (e.g., serum glucose, sodium, and white blood cell count). DST status was found to be significantly related to BP: nonsuppressors averaged much higher systolic and diastolic pressure. Older age and heavier body weight were also related to hypertension. Almost twice as many nonsuppressors were hypertensive. DST results for the depressed patients were similar in nature but much milder than those for Cushing's patients. Cortisol levels were not significantly related to serum glucose, sodium, or potassium levels. However, a significant relationship was found between nonsuppressor status and low white blood cell count. Findings suggest that depressed nonsuppressors may be at risk for cardiovascular and immune-related disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Introduction:Low serum testosterone is related to increased mortality in male dialysis patients. An association of vitamin D status with serum androgen levels with concordant seasonal variation has been described, but it is undecided whether vitamin D supplementation improves testosterone levels. Methods:In a randomized, placebo-controlled, and double-blind manner, we investigated the effects of an oral vitamin D supplementation in healthy subjects and hemodialysis patients on testosterone levels. One hundred three healthy individuals received cholecalciferol 800 IE/day (n= 52) or placebo (n= 51) for 12 weeks. Thirty-three hemodialysis patients received cholecalciferol adapted to their serum levels following current guidelines (n= 15) or placebo (n= 18) for 12 weeks. Results:In healthy individuals, 25(OH)D3 levels rose significantly in the verum group (38.1 ± 13.7 vs. 72.5 ± 15.4 nmol/L, p< 0.001), whereas in the placebo group, levels dropped (37.7 ± 14.7 vs. 31.9 ± 13.1, p< 0.001). Testosterone levels did not change significantly (verum, males: 20.9 ± 6.6 vs. 20.5 ± 7.9 nmol/L, p= 0.6; verum, females: 0.9 ± 0.5 vs. 0.92 ± 0.5, p= 0.4; placebo, males: 18.5 ± 10.2 vs. 21.8 ± 16.5, p= 0.07, placebo, females: 1.6 ± 4.2 vs. 1.6 ± 4.9, p= 0.6). In dialysis patients, the mean cholecalciferol level was only 32.3 ± 17.8 nmol/L, with only 2% of the values being within the normal range. Cholecalciferol levels normalized in the verum group (29.4 ± 11.2 vs. 87.8 ± 22.3, p< 0.001), whereas levels dropped further in the placebo group (33.6 ± 16.6 vs. 24.6 ± 8.0 nmol/L, p< 0.001). Testosterone levels did not change significantly (verum, males: 8.0 ± 3.7 vs. 7.8 ± 3.8, p= 0.8; verum, females: 1.3 ± 1.0 vs. 1.2 ± 1.0 nmol/L, p= 0.5; placebo, males: 11.9 ± 5.0 vs. 11.6 ± 4.0 nmol/L, p= 0.6; placebo, females: 0.8 ± 0.5 vs. 0.7 ± 0.4 nmol/L, p= 0.8). Conclusion:Serum testosterone levels in hemodialysis patients and healthy individuals are independent from vitamin D status and cannot be significantly increased by cholecalciferol supplementation.

Although aggressive surgical treatment of metastatic disease is not usual, it has been reported that treatment of liver metastasis from colorectal cancer by liver resection (surgical removal of a portion of the liver) has a low mortality and a five-year survival rate ranging from 16 to 52 percent. To evaluate the usefulness of liver resection, a prospective study was undertaken of 1,221 patients treated over a 28-year period who had liver metastasis from colorectal cancer. There were 967 patients who underwent surgery for confirmation and staging of the progress of disease. Group 1, consisting of 921 patients (902 had non-resectable disease, and 19 could not be clearly classified), had 21 patients surviving at three years, and none at five years. The second group (62 patients) had resectable metastatic disease, but because a different treatment method had been chosen, the liver was not resected. In this group, median survival was 14.2 months (compared with 6.9 months for group 1); there were no survivors at five years. Group 3, consisting of 226 patients, had liver resection performed. Of this group, 43 had residual disease after resection, and survival was similar to that of group 2. Ten of the remaining 183 patients in group 3 who had potentially curative resection died after surgery. The remaining 173 patients in group 3 had survivals of 40 percent at five years and 27 percent at 10 years (25 patients alive at five years, and seven at 10 years.) There are 64 patients who have remained disease-free for up to 24 years. It is concluded that radical excision of liver metastasis in colorectal cancer can provide effective palliation (reduction of pain and discomfort), and in a small proportion of patients, a chance of cure. (Consumer Summary produced by Reliance Medical Information, Inc.)

The Telemedical Interventional Management in Heart Failure II (TIM-HF2) trial showed that, compared with usual care, a structured remote patient management (RPM) intervention done over 12-months reduced the percentage of days lost due to unplanned cardiovascular hospitalisations and all-cause death. The aim of the study was to evaluate whether this clinical benefit seen for the RPM group during the initial 12 month follow-up of the TIM-HF2 trial would be sustained 1 year after stopping the RPM intervention.