Bewegungstherapie und körperliche Aktivität bei Patienten mit Herzinsuffizienz

Praxis ◽  
2018 ◽  
Vol 107 (17-18) ◽  
pp. 951-958 ◽  
Author(s):  
Matthias Wilhelm
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Körperliche Aktivität ◽  
Phase Iii

Zusammenfassung. Herzinsuffizienz ist ein klinisches Syndrom mit unterschiedlichen Ätiologien und Phänotypen. Die überwachte Bewegungstherapie und individuelle körperliche Aktivität ist bei allen Formen eine Klasse-IA-Empfehlung in aktuellen Leitlinien. Eine Bewegungstherapie kann unmittelbar nach Stabilisierung einer akuten Herzinsuffizienz im Spital begonnen werden (Phase I). Sie kann nach Entlassung in einem stationären oder ambulanten Präventions- und Rehabilitationsprogramm fortgesetzt werden (Phase II). Typische Elemente sind Ausdauer-, Kraft- und Atemtraining. Die Kosten werden von der Krankenversicherung für drei bis sechs Monate übernommen. In erfahrenen Zentren können auch Patienten mit implantierten Defibrillatoren oder linksventrikulären Unterstützungssystemen trainieren. Wichtiges Ziel der Phase II ist neben muskulärer Rekonditionierung auch die Steigerung der Gesundheitskompetenz, um die Langzeit-Adhärenz bezüglich körperlicher Aktivität zu verbessern. In Phase III bieten Herzgruppen Unterstützung.

scholarly journals AB0332 IMMUNOSUPPRESSIVE AND IMMONOMODULATING AGENTS IN RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW OF CLINICAL TRIALS AND THEIR CURRENT DEVELOPMENT STAGE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1464.1-1465
Author(s):  
J. Blaess ◽  
J. Walther ◽  
J. E. Gottenberg ◽  
J. Sibilia ◽  
L. Arnaud ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
B Cells ◽  
Phase I ◽  
Phase Ii ◽  
Clinical Development ◽  
Phase Iii ◽  
Jak Inhibitors ◽  
Exclusion Criteria ◽  
Immunomodulating Drugs

Background:Rheumatoid arthritis (RA) is the most frequent chronic inflammatory diseases with an incidence of 0.5% to 1%. Therapeutic arsenal of RA has continuously expanded in recent years with the recent therapeutic progress with the arrival of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), biological (bDMARDs) and targeted synthetic (tsDMARDs), JAK inhibitors. However, there are still some unmet needs for patients who do not achieve remission and who continue to worsen despite treatments. Of note, only approximately 40% of patients are ACR70 responders, in most randomized controlled trials. For these patients, finding new therapeutic avenues is challenging.Objectives:The objective of our study was to analyze the whole pipeline of immunosuppressive and immunomodulating drugs evaluated in RA and describe their mechanisms of action and stage of clinical development.Methods:We conducted a systematic review of all drug therapies in clinical development in RA in 17 databases of international clinical trials. Inclusion criterion: study from one of the databases using the keywords “Rheumatoid arthritis” (search date: June 1, 2019). Exclusion criteria: non-drug trials, trials not related to RA or duplicates. We also excluded dietary regimen or supplementations, cellular therapies, NSAIDs, glucorticoids or their derivatives and non-immunosuppressive or non-immunomodulating drugs. For each csDMARD, bDMARD and tsDMARD, we considered the study at the most advanced stage. For bDMARDs, we did not take into account biosimilars.Results:The research identified 4652 trials, of which 242 for 243 molecules met the inclusion and exclusion criteria. The developed molecules belong to csDMARDs (n=21), bDMARDs (n=117), tsDMARDs (n=105).Among the 21 csDMARDs molecules: 8 (38%) has been withdrawn, 4 (19%) are already labelled in RA (hydroxychloroquine, leflunomide, methotrexate and sulfasalazine) and 9 (43%) are in development: 1 (11%) is in phase I/II, 5 (56%) in phase II, 3 (33%) in phase IV.Among the 117 bDMARDs molecules: 69 (59%) has been withdrawn, 9 (8%) are labeled in RA (abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, sarilumab, tocilizumab) and 39 (33%) are in development: 9 (23%) in phase I, 3 (8%) in phase I/II, 21 (54%) in phase II, 5 (12%) are in phase III, 1 (3%) in phase IV. bDMARDs currently under development target B cells (n=4), T cells (n=2), T/B cells costimulation (n=2),TNF alpha (n=2), Interleukine 1 or his receptor (n=3), Interleukine 6 or his receptor (n=7), Interleukine 17 (n=4), Interleukine 23 (n=1), GM-CSF (n=1), other cytokines or chemokines (n=5), integrins or adhesion proteins (n=3), interferon receptor (n=1) and various other targets (n=4).Among the 105 tsDMARDs molecules: 64 (61%) has been withdrawn, 6 (6%) JAK inhibitors, have just been or will probably soon be labelled (baricitinib, filgotinib, peficitinib, tofacitinib and upadacitinib), 35 (33%) are in development: 8 (24%) in phase I, 26 (74%) in phase II, 1 (3%) in phase III and. tsDMARDs currently under development target tyrosine kinase (n=12), janus kinase (JAK) (n=3), sphingosine phostate (n=3), PI3K pathway (n=1), phosphodiesterase-4 (n=3) B cells signaling pathways (n=3) and various other targets (n=10).Conclusion:A total of 242 therapeutic trials involving 243 molecules have been or are being evaluated in RA. This development does not always lead to new treatments since 141 (58%) have already been withdrawn. Hopefully, some of the currently evaluated drugs will contribute to improve the therapeutic management of RA patients, requiring a greater personalization of therapeutic strategies, both in the choice of molecules and their place in therapeutic sequences.Disclosure of Interests:Julien Blaess: None declared, Julia Walther: None declared, Jacques-Eric Gottenberg Grant/research support from: BMS, Pfizer, Consultant of: BMS, Sanofi-Genzyme, UCB, Speakers bureau: Abbvie, Eli Lilly and Co., Roche, Sanofi-Genzyme, UCB, Jean Sibilia: None declared, Laurent Arnaud: None declared, Renaud FELTEN: None declared

scholarly journals Unconventional Anticancer Agents: A Systematic Review of Clinical Trials

2006 ◽  
Vol 24 (1) ◽  
pp. 136-140 ◽  
Author(s):  
Andrew J. Vickers ◽  
Joyce Kuo ◽  
Barrie R. Cassileth
Keyword(s):  
Clinical Trials ◽  
Phase I ◽  
Cancer Patients ◽  
Phase Ii ◽  
Dose Finding ◽  
Phase Iii ◽  
High Dose ◽  
Free Text ◽  
Phase Ii Trials ◽  
Off Label

Purpose A substantial number of cancer patients turn to treatments other than those recommended by mainstream oncologists in an effort to sustain tumor remission or halt the spread of cancer. These unconventional approaches include botanicals, high-dose nutritional supplementation, off-label pharmaceuticals, and animal products. The objective of this study was to review systematically the methodologies applied in clinical trials of unconventional treatments specifically for cancer. Methods MEDLINE 1966 to 2005 was searched using approximately 200 different medical subject heading terms (eg, alternative medicine) and free text words (eg, laetrile). We sought prospective clinical trials of unconventional treatments in cancer patients, excluding studies with only symptom control or nonclinical (eg, immune) end points. Trial data were extracted by two reviewers using a standardized protocol. Results We identified 14,735 articles, of which 214, describing 198 different clinical trials, were included. Twenty trials were phase I, three were phase I and II, 70 were phase II, and 105 were phase III. Approximately half of the trials investigated fungal products, 20% investigated other botanicals, 10% investigated vitamins and supplements, and 10% investigated off-label pharmaceuticals. Only eight of the phase I trials were dose-finding trials, and a mere 20% of phase II trials reported a statistical design. Of the 27 different agents tested in phase III, only one agent had a prior dose-finding trial, and only for three agents was the definitive study initiated after the publication of phase II data. Conclusion Unconventional cancer treatments have not been subject to appropriate early-phase trial development. Future research on unconventional therapies should involve dose-finding and phase II studies to determine the suitability of definitive trials.

Hydrogeological Characterization Based on Long Term Groundwater Pressure Monitoring

2010 ◽  
Author(s):  
Shuji Daimaru ◽  
Ryuji Takeuchi ◽  
Masaki Takeda ◽  
Masayuki Ishibashi
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Large Scale ◽  
Pumping Test ◽  
Phase Iii ◽  
Pressure Monitoring ◽  
Energy Agency ◽  
Hydrogeological Characteristics ◽  
Under Construction

The Mizunami Underground Research Laboratory (MIU) is now under construction by the Japan Atomic Energy Agency in the Tono area of central Japan. The MIU project is being implemented in three overlapping Phases: Surface-based Investigation (Phase I), Construction (Phase II) and Operation (Phase III). The changes of groundwater pressure due to shaft excavation can be considered analogous to a large-scale pumping test. Therefore, there is the possibility that the site scale groundwater field (several km square) can be approximated by the long-term groundwater pressure monitoring data from Phase II. Based on the monitoring observations, hydrogeological characteristics were estimated using the s-log(t/r2) plot based on the Cooper-Jacob straight line method. Results of the s-log(t/r2) plots are as follows. The groundwater flow field around the MIU construction site is separated into domains by an impermeable fault. In other words, the fault is a hydraulic barrier. Hydraulic conductivity calculated from s-log(t/r2) plots are in the order of 1.0E−7(m/s). The above results from the long term monitoring during Phase II are a verification of the hydrogeological characteristics determined in the Phase I investigations.

Phase I Trial of Escalating-Dose Irinotecan Given Weekly With Cisplatin and Concurrent Radiotherapy in Locally Advanced Esophageal Cancer

2003 ◽  
Vol 21 (15) ◽  
pp. 2926-2932 ◽  
Author(s):  
David H. Ilson ◽  
Manjit Bains ◽  
David P. Kelsen ◽  
Eileen O’Reilly ◽  
Martin Karpeh ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Phase I ◽  
Induction Chemotherapy ◽  
Phase Ii ◽  
Phase I Trial ◽  
Locally Advanced ◽  
Phase Iii ◽  
Concurrent Radiotherapy ◽  
Minimal Toxicity ◽  
Grade 3

Purpose: To identify the maximum-tolerated dose and dose-limiting toxicity (DLT) of weekly irinotecan combined with cisplatin and radiation in esophageal cancer. Patients and Methods: Nineteen patients with clinical stage II to III esophageal squamous cell or adenocarcinoma were treated on this phase I trial. Induction chemotherapy with weekly cisplatin 30 mg/m2 and irinotecan 65 mg/m2 was administered for four treatments during weeks 1 to 5. Radiotherapy was delivered weeks 8 to 13 in 1.8-Gy daily fractions to a dose of 50.4 Gy. Cisplatin 30 mg/m2 and escalating-dose irinotecan (40, 50, 65, and 80 mg/m2) were administered on days 1, 8, 22, and 29 of radiotherapy. DLT was defined as a 2-week delay in radiotherapy for grade 3 to 4 toxicity. Results: Minimal toxicity was observed during chemoradiotherapy, with no grade 3 or 4 esophagitis, diarrhea, or stomatitis. DLT caused by myelosuppression was seen in two of six patients treated at the 80-mg/m2 dose level, thus irinotecan 65 mg/m2 was defined as the recommended phase II dose. Dysphagia improved or resolved after induction chemotherapy in 13 (81%) of 16 patients who reported dysphagia before therapy. Only one patient (5%) required a feeding tube. Six complete responses (32%) were observed, including four pathologic complete responses in 15 patients selected to undergo surgery (27%). Conclusion: Cisplatin, irinotecan, and concurrent radiotherapy can be administered on a convenient schedule with relatively minimal toxicity and an acceptable rate of complete response in esophageal cancer. Further phase II evaluation of this regimen is ongoing. A phase III comparison to fluorouracil or taxane-containing chemoradiotherapy should be considered.

scholarly journals Etude par resonance magnetique des mouvements moléculaires dans l'acrylonitrile solide

1973 ◽  
Vol 51 (23) ◽  
pp. 3889-3900 ◽  
Author(s):  
Buu Ban ◽  
C. CHACHATY
Keyword(s):  
Phase Transitions ◽  
Phase I ◽  
Phase Ii ◽  
Phase Iii ◽  
Solid Matrix ◽  
Peroxy Radicals ◽  
Γ Irradiation ◽  
Rotational Oscillation ◽  
Résonance Magnétique ◽  
Oxygen Addition

Phase transitions and molecular motions in solid acrylonitrile and its deuterated homologue CH2=CDCN, have been studied between 100 and 191 °K (m.p.) by wide line n.m.r. and by T1 relaxation time measurements. Phase I (164 °K < T < 191 °K) is trapped and becomes metastable by quick cooling of acrylonitrile at 77 °K. It changes into the phase II, stable between 113 °K and 164 °K by a long duration annealing at 155–160 °K. The phase II → phase III transition occurs at 113 °K. It may be assumed that phase III, stable below this temperature, is rigid at T < 105 °K. Phase II may be characterized by a rotational oscillation of molecules around an axis defined by the N atom and the middle of the vinyl double bond. In phase I, acrylonitrile molecules undergo a binary reorientation motion around this axis with an activation energy of 4.2 kcal mol−1. The motion of peroxy radicals, trapped in acrylonitrile has been also studied by e.s.r. These radicals were produced by oxygen addition to free radicals previously formed by γ irradiation of acrylonitrile at 77 °K. The g anisotropy variation with temperature, shows no discontinuities at phase transitions, the activation of reorientation of peroxy radicals being 0.65 kcal mol−1. This result suggests that we are dealing in fact with macroradicals, the internal rotation of which is only observable in a solid matrix.

Offline Well Abandonment SIMOPs: An 81 Well Phase I & II Case Study Enabling ABEX Reduction in South East Asia

2021 ◽  
Author(s):  
Steven A. Canny ◽  
Jane Amarin ◽  
Verapich Pinprayong ◽  
Chumpae Sratongroy ◽  
Pancharat Pitchayang ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Business Performance ◽  
Net Present Value ◽  
Balance Sheet ◽  
Pressure Control ◽  
Phase Iii ◽  
Well Abandonment ◽  
The Cost

Abstract In the decommissioning phase of oilfield facility lifecycles, focus pivots from positive net present value to executing the care and preservation, then decommissioning in the safest and most environmentally sensitive manor, and at the lowest total cost of ownership. Asset Retirement Obligation (ARO) is a long-term liability carried on the balance sheet, as a provision for the cost to return a wellsite to pre-exploration condition. The reduction of abandonment and decommissioning expenditure (ABEX) in executing compliant operations is a key business performance factor, and critical in executing higher volumes of wells earlier than planned. In doing so maximizing value to company shareholders, residents, industries and government level stakeholders. In the case study, an offline pre-abandonment and Phase I primary reservoir isolation project is presented, which seeks to maximize net project efficiency via offline wellbore intervention, executing the primary reservoir isolation of the wellbore via rigless techniques. This approach contributed to ABEX reductions by up to 40% per well vs the planned approval for expenditure (AFE) provisions taken for the operations. The project execution structure utilized offline intervention and Phase I primary reservoir isolation of 81 wellbores, across 5 wellhead platforms and 47 days continuous operations. Operations were part of a simultaneous operation (SIMOPS) project, as an offline work front located on the wellhead platform (WHP) weather deck. A second work front for Phase II and Phase III well abandonment operations, is executed concurrently, from the jack-up rig cantilever above the WHP. Live well operations are conducted concurrently by both work fronts, through the Christmas Tree (XT) and pressure control equipment in Phase I, and through the drilling riser and blowout preventor for Phase II and Phase III, to maximize productivity when the rig is on location. The scope of operations included wellhead qualification, wellbore access and preparation, well kill, injectivity testing, various wellbore preparation and cement placement techniques, pressure testing and lubrication of the wellbore. The operator's system engineering, design of operations and planning agility are key to its success. Acute focus was given to the batching of operations and delivery of these in a phased approach to increase productivity and maintain high service delivery through repetition of tasks. The project successfully executed Incident Free Operations (IFO) with 100% productive time and facilitated combined project performance, which delivered wells up to 44% ahead of the planned AFE. To enable this, over 4.19 million feet of slickline was run, conveying 428 bottom hole assemblies (BHAs), preparing the wellbores to isolate 804 primary reservoirs, and 2 intermediate reservoirs.

scholarly journals Pelagic community production and carbon-nutrient stoichiometry under variable ocean acidification in an Arctic fjord

2013 ◽  
Vol 10 (7) ◽  
pp. 4847-4859 ◽  
Author(s):  
A. Silyakova ◽  
R. G. J. Bellerby ◽  
K. G. Schulz ◽  
J. Czerny ◽  
T. Tanaka ◽  
...  
Keyword(s):  
Phase I ◽  
Ocean Acidification ◽  
Phase Ii ◽  
Inorganic Carbon ◽  
Phytoplankton Community ◽  
P Uptake ◽  
Phase Iii ◽  
Cumulative Change ◽  
Carbon Concentrations ◽  
Community Production

Abstract. Net community production (NCP) and carbon to nutrient uptake ratios were studied during a large-scale mesocosm experiment on ocean acidification in Kongsfjorden, western Svalbard, during June–July 2010. Nutrient depleted fjord water with natural plankton assemblages, enclosed in nine mesocosms of ~ 50 m3 in volume, was exposed to pCO2 levels ranging initially from 185 to 1420 μatm. NCP estimations are the cumulative change in dissolved inorganic carbon concentrations after accounting for gas exchange and total alkalinity variations. Stoichiometric coupling between inorganic carbon and nutrient net uptake is shown as a ratio of NCP to a cumulative change in inorganic nutrients. Phytoplankton growth was stimulated by nutrient addition half way through the experiment and three distinct peaks in chlorophyll a concentration were observed during the experiment. Accordingly, the experiment was divided in three phases. Cumulative NCP was similar in all mesocosms over the duration of the experiment. However, in phases I and II, NCP was higher and in phase III lower at elevated pCO2. Due to relatively low inorganic nutrient concentration in phase I, C : N and C : P uptake ratios were calculated only for the period after nutrient addition (phase II and phase III). For the total post-nutrient period (phase II + phase III) ratios were close to Redfield, however they were lower in phase II and higher in phase III. Variability of NCP, C : N and C : P uptake ratios in different phases reflects the effect of increasing CO2 on phytoplankton community composition and succession. The phytoplankton community was composed predominantly of haptophytes in phase I, prasinophytes, dinoflagellates, and cryptophytes in phase II, and haptophytes, prasinophytes, dinoflagellates and chlorophytes in phase III (Schulz et al., 2013). Increasing ambient inorganic carbon concentrations have also been shown to promote primary production and carbon assimilation. For this study, it is clear that the pelagic ecosystem response to increasing CO2 is more complex than that represented in previous work, e.g. Bellerby et al. (2008). Carbon and nutrient uptake representation in models should, where possible, be more focused on individual plankton functional types as applying a single stoichiometry to a biogeochemical model with regard to the effect of increasing pCO2 may not always be optimal. The phase variability in NCP and stoichiometry may be better understood if CO2 sensitivities of the plankton's functional type biogeochemical uptake kinetics and trophic interactions are better constrained.

scholarly journals Influence of YEA-SACC 1026 Probiotic on Some Production and Consumption Indices in Chicken Broilers

2017 ◽  
Vol 74 (1) ◽  
pp. 37
Author(s):  
Ionel TOADER ◽  
Aurel SARA ◽  
Mihai BENTEA ◽  
Marius CIOLTEA
Keyword(s):  
Body Weight ◽  
Phase I ◽  
Phase Ii ◽  
Average Daily Gain ◽  
Phase Iii ◽  
Production And Consumption ◽  
Daily Gain ◽  
Average Body ◽  
Average Body Weight

The researches followed the effects of powderYEA-SACC 1026 probiotic on some production and consumption indices in chicken broilers. The researches were effected on 75 meat chickens of Ross-308 hybrid, which were grouped in three lots of 25 capita/lot during 42 days. In the lot L1(E), for 42 days, in the mixed fodder was added YEA-SACC 1026 probiotic in proportion of 0.1% in breeding phase I (1-14 days), of 0.1% in phase II (15-35 days) and 0.1% in phase III (36-42 days). In the lot L2(E), for 42 days, in the mixed fodder was added YEA-SACC 1026 probiotic in proportion of 0.25% in breeding phase I (1-14 days), of 0.25% in phase II (15-35 days) and 0.25% in phase III (36-42 days). The chickens of all lots were weighted at the beginning of experiment and after that weekly being calculated the average body weight, average daily gain, fodder intake and fodder conversion index. The use of y YEA-SACC 1026 probiotic in lot L1(E) determined an increase of body weight with 16.26%, of average daily gain with 15.55% and the fodder conversion index was reduced with 29.16% given to Control Lot L(M). On the second place was situated the lot L2(E), in witch was administered 0.25% of YEA-SACC 1026 probiotic, with an increase of body weight of 8.32%, of average daily gain with 7.54% and the fodder conversion index was reduced with 21.78% given to Control Lot L(M). These superior results, registered in meat chickens from lot L1(E) YEA-SACC 1026 probiotic 0.1% and lot L2(E) YEA-SACC 1026 probiotic 0.25%, confirm the favourable influence of this probiotic on chicken broilers’ performances.

scholarly journals Toward Sustainable Development? A Bibliometric Analysis of PPP-Related Policies in China between 1980 and 2017

2018 ◽  
Vol 11 (1) ◽  
pp. 142 ◽  
Author(s):  
Cheng Chen ◽  
Dan Li ◽  
Caixia Man
Keyword(s):  
Sustainable Development ◽  
Phase I ◽  
Bibliometric Analysis ◽  
Phase Ii ◽  
Central Government ◽  
Phase Iii ◽  
Public Infrastructure ◽  
The Sustainable Development ◽  
The Public ◽  
Development Policies

This article aims to fill the void in the literature regarding the sustainable development of public–private partnerships (PPPs) by answering the following research questions: (1) Between 1980 and 2017, what were the PPP-related policy priorities in the three different historical phases of the Chinese national agenda that we have identified herein? (2) Have the PPP-related policies shown a pattern of moving toward sustainable development, and if so, to what extent? Against a criteria framework of evaluating how PPP-related policies could contribute to sustainable development, this article conducted a quantitative bibliometric analysis of 299 PPP-related policy documents issued by the Chinese central government between 1980 and 2017. By visualizing the networks of policy keywords and policy-issuing departments, this article identified the PPP-related policy priorities in the following three distinct historical phases: Phase I (1980–1997), the encouragement of foreign investment in the public infrastructure; Phase II (1998–2008), the encouragement of the marketization of the urban public utilities; and Phase III (2009–2017), the intensive institutionalization and extensive application of PPPs for solving the local debt problem. Corresponding to the abovementioned policy priorities, this article found that the pattern of PPP-related policies has shifted from the total absence of sustainable development policies in Phase I, to a few sustainable development policy attempts in Phase II, and finally, to a tendency toward policies favoring sustainable development in Phase III.

scholarly journals Improving newborn heart rate assessment using a simple visual timer

2020 ◽  
Vol 4 (1) ◽  
pp. e000638
Author(s):  
Caroline Henry ◽  
David E Morris ◽  
Sophie Coleman ◽  
Andrea Pereira ◽  
Christian Tamakloe ◽  
...  
Keyword(s):  
Heart Rate ◽  
Phase I ◽  
Phase Ii ◽  
Life Support ◽  
Phase Iii ◽  
Developmental Approach ◽  
Three Phase ◽  
Assessment Time ◽  
Potential Benefits ◽  
Improved Accuracy

ObjectiveNewborn resuscitation relies on accurate heart rate (HR) assessment, which, during auscultation, is prone to error. We investigated if a 6 s visual timer (VT) could improve HR assessment accuracy during newborn simulation.DesignProspective observational study of newborn healthcare professionals.SettingThree-phase developmental approach: phase I: HR auscultation during newborn simulation using a standard clock timer (CT) or the VT; phase II: repeat phase I after using a bespoke training app (NeoRate); phase III: following the Newborn Life Support course, participants assessed random HRs using the CT or VT.Main outcome measuresHR accuracy (within ±10 beats/min, correct HR category, i.e. <60, 60–100 and >100 beats/min), assessment time and error-free rates were compared.ResultsOverall, 1974 HR assessments were performed with participants more accurate using the VT for ±10 beats/min (70% CT vs 86% VT, p<0.001) and correct HR category (78% CT vs 84% VT, p<0.01). The VT improved accuracy across all three phases. Additionally, following app training in phase II, the HR accuracy of both the CT and VT improved. The VT resulted in faster HR assessment times of 11 s (IQR 9–13) compared with the CT at 15 s (IQR 9–23, p<0.001). Error-free scenarios increased from 24% using the CT to 57% using the VT (p<0.001), with a shorter assessment time (CT 116 s (IQR 65–156) vs VT 53 s (IQR 50–64), p<0.001).ConclusionUsing a VT to assess simulated newborn HR combined with a training app significantly improves accuracy and reduces assessment time compared with standard methods. Evaluation in the clinical setting is required to determine potential benefits.

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