Optimized breath analysis:customized analytical methods and enhanced workflow for broader detection of VOCs

IntroductionBreath Volatile organic compounds (VOCs) are promising biomarkers for clinical purposes due to their unique properties. Translation of VOC biomarkers into the clinic depends on identification and validation: a challenge requiring collaboration, well-established protocols, and cross-comparison of data. Previously, we developed a breath collection and analysis method, resulting in 148 breath-borne VOCs identified.ObjectivesTo develop a complementary analytical method for the detection and identification of additional VOCs from breath. To develop and implement upgrades to the methodology for identifying features determined to be "on-breath" by comparing breath samples against paired background samples applying three metrics: standard deviation, paired t-test, and receiver-operating-characteristic (ROC) curve.MethodsA thermal desorption (TD)-gas chromatography (GC)-mass spectrometry (MS)-based analytical method utilizing a PEG phase GC column was developed for the detection of biologically relevant VOCs. The multi-step VOC identification methodology was upgraded through several developments: candidate VOC grouping schema, ion abundance correlation based spectral library creation approach, hybrid alkane-FAMES retention indexing, relative retention time matching, along with additional quality checks. In combination, these updates enable highly accurate identification of breath-borne VOCs, both on spectral and retention axes.ResultsA total of 621 features were statistically determined as on-breath by at least one metric (standard deviation, paired t-test, or ROC). A total of 38 on-breath VOCs were able to be confidently identified from comparison to chemical standards.ConclusionThe total confirmed on-breath VOCs is now 186. We present an updated methodology for high-confidence VOC identification, and a new set of VOCs commonly found on-breath

An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives

BackgroundMany countries are improving medical education in teaching hospitals through more focus on internal quality assurance, for example by creating new stakeholders like hospital-wide education committees. Adequate oversight is thought essential to ensure the quality of medical education. How teaching hospitals distribute roles and responsibilities for quality control across educational stakeholders to organize this oversight is rarely investigated. This study aims to answer the following exploratory question: Who are the primary stakeholders involved in educational governance, and what are their roles in safeguarding educational quality in teaching hospitals?MethodsWe conducted an exploratory qualitative study of educational governance structures in all teaching hospitals in the Netherlands with at least three training programs. We carried out document analysis of recent governance codes, documents drafted by Dutch teaching hospitals to describe their methods of internal governance for the national accreditor, and analyzed the data using a thematic analysis approach through the lens of organizational theories of Mintzberg and Freidson.ResultsThe study identified key stakeholders in quality management of medical education in all teaching hospitals of the Netherlands. An overview of their roles and responsibilities is given and a stakeholder map is drafted. Teaching hospitals gave the hospital-wide education committee three different roles: an advisory role, a quality controller role and a conflict mediation role.DiscussionHospitals have set up the assignment of decision-making power in different ways, creating different variants of hospital-wide education committees and potentially causing them to be less effective at quality management. Whether these different roles affect the quality management of medical education in practice requires practice-oriented research. The study reveals remarkable ambiguity regarding the assignment and exercise of decision-making power between actors. This study contributes to the literature by identifying key actors and their roles in the quality management of postgraduate medical education, providing a foundation for follow-up research

The role of psychological comfort with service robot reminders:a dyadic field study

PurposeThis study aims to propose a service robot option to address shortages of human frontline employees (FLEs) in long-term care (LTC) service settings. With a field study, the authors investigate the effect of psychological comfort with robot reminders of LTC residents and human FLEs on acceptance and attentive engagement, ultimately resulting in effort and willingness to interact with the service robot. The outcomes provide valuable insights into human-robot interaction in the LTC sector.Design/methodology/approachThe 45 residents and 49 human FLEs who participated in the field study completed a survey measuring various perceptual variables after deploying a service robot.FindingsBoth the residents' sample and the FLE sample demonstrate that psychological comfort with robot reminders increases robot acceptance. This increased acceptance evokes greater attentive engagement, ultimately leading to a higher willingness to exert effort to interact with the service robots.Research limitations/implicationsThis study highlights service robots with well-received reminder functions and the ability to prompt efforts by both residents and employees during their implementation at LTC services. The findings suggest further research avenues for designing service robots that can be effectively integrated.Originality/valueThis study leverages a service robot in a field study involving LTC residents and human FLEs rather than hypothetical scenarios, which is rather limited in current studies. The findings are both timely and relevant, considering the gradual implementation of service robots into LTC services

Still Lost in the Mall:False Memories Happen and That's What Matters

For more than 25 years, psychologists have explored how people can develop rich false memories. Murphy et al. (2023) replicated the original “lost in the mall” study (Loftus and Pickrell 1995), demonstrating that 35% of participants developed false beliefs or memories. Andrews and Brewin (in press) reanalyzed Murphy et al.'s data, concluding that participants who developed false memories reported 25% of the suggested details and 50% of their reports were potentially real memories. Based on this, Andrews and Brewin posited that only 4% of Murphy et al.'s participants developed false memories. We take issue with Andrews and Brewin's conclusions. Given human memory is reconstructive, we should expect participants' reports to contain remnants of accurate memories, self or schematic knowledge, or speculation. Moreover, even low false memory rates can be practically important. What matters is that suggestive influences can lead to substantial memory distortions and even plant new events that had not occurred

A Syndemic Clustering of Adversities on Suicide Risk among YMSM Living with HIV in Bangkok:A Causal Latent Class Analysis

This study investigated the clustering of psychosocial adversities and their synergistic effect with depression on suicidality in a 12-month prospective cohort (N = 214) of YMSM living with HIV in Bangkok, Thailand. Latent class analysis identified subgroups with distinct combinations of adversities, including bullying, intimate partner violence, substance use, HIV stigma, low social support, histories of sex work, and below-income status. Significant interactive synergism were found as hypothesized, supporting a syndemic effect with qualitatively increasing levels of adversities on suicidality (score range: 3-17) over the 12 months. The interaction between moderate adversity clustering and depression (βow = 2.50, 95% CI: 1.12-3.88) and high adversity clustering and depression (βow = 3.61, 95% CI: 1.12-6.09) indicated that the impact of depression on suicidality was modified by pre-existing adversities. The findings suggest that, while a multi-component intervention addressing psychosocial problems is ideal, effective depression treatment alone could significantly reduce suicidality among YMSM living with HIV.</p

Beyond the records:Data quality and COVID-19 vaccination progress in low- and middle-income countries

Using phone surveys and administrative data in 36 LMICs, we find survey-based COVID-19 vaccine coverage to systematically exceed administrative figures by 47% on average. This discrepancy is strongest in Sub-Saharan Africa, raising questions about the role of data quality for our understanding of vaccination progress. We isolate the effect of sampling and measurement errors on the estimated vaccination rate in six survey experiments conducted in five Sub-Saharan African countries. Accounting for respondent selection effects reduces misalignment between data sources by 42% on average. Proxy reports miss some vaccinations, but other error sources including strategic misreporting, panel conditioning, or survey mode effects do not affect survey estimates. After adjusting for errors in the survey data, a substantial average gap of 9 percentage points remains with the official figures and seems to relate to flaws in administrative records that we document using data covering all 134 LMICs worldwide. Our results provide novel evidence on the size and sources of measurement error in modern data sources that have seen a surge in use by development economists. Our error-corrected estimates imply that vaccination progress may have been quicker than what African countries were credited for in the public discourse

Assessing the potential of transorbital and supraorbital approaches for stereotactic surgery:an anatomical feasibility study

AIM: The Transorbital and supraorbital minimally invasive approaches have been defined to reach intraorbital structures, adjacent sinuses, skull base, and other intracranial targets in this region. These approaches reduce the possible cosmetic and brain retraction-related morbidities caused by traditional transcranial approaches. Although these pathways are being studied endoscopically, a stereotactic approach has not been defined. The Kocher`s point and its surroundings, which are traditional entry points used in stereotactic surgery create compelling trajectories, carry a potentially higher complication risk for subventricular psychosurgical and hypothalamic targets. Herein, we aimed to evaluate the supraorbital and transorbital approaches as alternative entry sites and trajectories targeting the nucleus accumbens (NAc), subcallosal cingulate gyrus (SCG), and lateral hypothalamic area (LHA), in cadavers and surgical planning station. MATERIAL AND METHODS: The three-dimensional relationship of the identified trajectories within the anterior and middle cranial fossae as well as the stereotactically targeted NAc, SCG, and LHA, were demonstrated through dissection studies conducted in cadavers. To validate the accuracy of the measurements from the cadaver, trajectory planning was replicated using radiological imaging of patients without a space-occupying lesion who underwent gamma knife surgery. These measurements were compared with those from cadavers. RESULTS: The transorbital and supraorbital trajectories did not pass through the lateral ventricles and they can be used for subventricular targets. Additionally, the NAc and LHA can be targeted simultaneously. These trajectories pass along a broader anatomical area within the NAc due to the anatomical orientation of the nucleus. CONCLUSION: These findings suggest that these entry points may offer new opportunities for stimulating different targets in the prefrontal cortex and may serve as an approach for future clinical use

Cell Mechanisms of Post-Mortem Excitability of Skeletal Muscle

The excitability of skeletal muscle is a less-known post-mortem supravital phenomenon in human bodies, and it can be used to estimate the post-mortem interval. We conducted a field study in the Netherlands to investigate the applicability of muscle excitability (SMR) by mechanical stimulation for estimating the post-mortem interval in daily forensic practice. Knowledge concerning the post-mortem cell mechanisms accounting for the post-mortem excitability of skeletal muscle is lacking. Cell mechanisms are the specific intracellular and biochemical processes responsible for post-mortem muscle excitability. We have studied the theoretical backgrounds of the cell mechanisms that might be responsible for post-mortem muscle excitability, by performing literature research via the databank PubMed. Based on the current available literature, in our opinion the intracellular changes in muscle cells that are responsible for SMR resemble the intracellular processes responsible for muscle fatigue due to energy exhaustion in the living. We hypothesize two pathways, depending on the level of energy in the muscle cell, that could be responsible for post-mortem muscle excitability by mechanical stimulation

Huwelijk en geregistreerd partnerschap in het IPR

Huwelijk en geregistreerd partnerschap in het IPR geeft een volledig en actueel overzicht van het Nederlandse IPR voor het huwelijk en het geregistreerd partnerschap. Recente Europese ontwikkelingen en ontwikkelingen in wetgeving en rechtspraak zijn in het boek verwerkt. Bovendien is niet alleen de IPR-regelgeving beschreven, maar ook de uitvoeringsregelgeving die geldt voor gemeenteambtenaren belast met de registratie van huwelijken en geregistreerde partnerschappen in de registers van de burgerlijke stand en de Basisregistratie Personen