Reconnecting the University to the Region of Twente : Findings from the RUNIN-Design Lab Think Tank

The RUNIN project's Design Lab Think Tank took place on 28th June 2018. Its aim was to discuss the topic of universities' engagement with society, specifically in their region. It used a world café format that brought together regional stakeholders to discuss how the University of Twente (UT) can incorporate societal questions in its core activities and, through this, create regional benefits. This report provides a description of the event, a summation of the initiatives proposed and an analysis of the discussion that was prompted by the sub-questions around the subject of universities' societal engagement

Omega-3 Fatty Acids and Vitamin D in Cardiology

Dietary modification and supplementation play an increasingly important role in the conservative treatment of cardiovascular disease. Current interest has focused on n-3 polyunsaturated fatty acids (PUFA) and vitamin D. Clinical trial results on this subject are contradictory in many aspects. Several studies indicate that n-3 PUFA consumption improves vascular and cardiac hemodynamics, triglycerides, and possibly endothelial function, autonomic control, inflammation, thrombosis, and arrhythmia. Experimental studies show effects on membrane structure and associated functions, ion channel properties, genetic regulation, and production of anti-inflammatory mediators. Clinical trials evaluating a possible reduction in cardiovascular disease by n-3 PUFA have shown different results. Supplementation of vitamin D is common regarding prevention and treatment of osteoporosis. But vitamin D also seems to have several effects on the cardiovascular system. Vitamin D deficiency appears to be related to an increase in parathyroid hormone levels and can predispose to essential hypertension and left ventricular hypertrophy, increased insulin resistance, and eventually to atherosclerosis and adverse cardiovascular events. Randomized prospective clinical trials are needed to determine whether vitamin D and omega-3 FA supplementation therapy should be recommended as a routine therapy for primary or secondary prevention of cardiovascular disease

Automatic Detection of Building Displacements Through Unsupervised Learning From InSAR Data

We introduce an unsupervised learning method that aims to identify building anomalies using Interferometric Synthetic Aperture Radar (InSAR) time-series data. Specifically, we leverage data obtained from the European Ground Motion Service to develop our proposed approach, which employs a long short-term memory autoencoder model and a reconstruction loss function based on a soft variant of the dynamic time warping, namely “soft-DTW”. We deliberately utilize this loss function for its ability to compare time-series that are not aligned in time, unlike the other conventional reconstruction losses that do not account for time shifts. Moreover, we enhance the performance of anomaly detection by smoothing inputs with a Hann window and defining the learning objective to reconstruct the time order of randomly permuted input series. Our experimental findings, based on persistent scatterer data from Rome, Italy, reveal that our method outperforms several unsupervised machine learning and deep learning methods in detecting various types of building displacement, such as trend, noise, and step anomalies. Additionally, quantitative and qualitative evaluations validate the efficacy of our approach in identifying potentially anomalous buildings. Thus, our method offers a promising solution for detecting anomalies in PS-InSAR time-series, which could have substantial implications in the fields of urban monitoring and infrastructure management

Multiple Myeloma Treatment in Real-world Clinical Practice : Results of a Prospective, Multinational, Noninterventional Study

Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: M.M. has received personal fees from Janssen, Celgene, Amgen, Bristol-Myers Squibb, Sanofi, Novartis, and Takeda and grants from Janssen and Sanofi during the conduct of the study. E.T. has received grants from Janssen and personal fees from Janssen and Takeda during the conduct of the study, and grants from Amgen, Celgene/Genesis, personal fees from Amgen, Celgene/Genesis, Bristol-Myers Squibb, Novartis, and Glaxo-Smith Kline outside the submitted work. M.V.M. has received personal fees from Janssen, Celgene, Amgen, and Takeda outside the submitted work. M.C. reports honoraria from Janssen, outside the submitted work. M. B. reports grants from Janssen Cilag during the conduct of the study. M.D. has received honoraria for participation on advisory boards for Janssen, Celgene, Takeda, Amgen, and Novartis. H.S. has received honoraria from Janssen-Cilag, Celgene, Amgen, Bristol-Myers Squibb, Novartis, and Takeda outside the submitted work. V.P. reports personal fees from Janssen during the conduct of the study and grants, personal fees, and nonfinancial support from Amgen, grants and personal fees from Sanofi, and personal fees from Takeda outside the submitted work. W.W. has received personal fees and grants from Amgen, Celgene, Novartis, Roche, Takeda, Gilead, and Janssen and nonfinancial support from Roche outside the submitted work. J.S. reports grants and nonfinancial support from Janssen Pharmaceutical during the conduct of the study. V.L. reports funding from Janssen Global Services LLC during the conduct of the study and study support from Janssen-Cilag and Pharmion outside the submitted work. A.P. reports employment and shareholding of Janssen (Johnson & Johnson) during the conduct of the study. C.C. reports employment at Janssen-Cilag during the conduct of the study. C.F. reports employment at Janssen Research and Development during the conduct of the study. F.T.B. reports employment at Janssen-Cilag during the conduct of the study. The remaining authors have stated that they have no conflicts of interest. Publisher Copyright: © 2018 The AuthorsMultiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.publishersversionPeer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis

Correction: vol 7, 13205, 2016, doi:10.1038/ncomms13205Rheumatoid arthritis (RA) affects millions world-wide. While anti-TNF treatment is widely used to reduce disease progression, treatment fails in Bone-third of patients. No biomarker currently exists that identifies non-responders before treatment. A rigorous community-based assessment of the utility of SNP data for predicting anti-TNF treatment efficacy in RA patients was performed in the context of a DREAM Challenge (http://www.synapse.org/RA_Challenge). An open challenge framework enabled the comparative evaluation of predictions developed by 73 research groups using the most comprehensive available data and covering a wide range of state-of-the-art modelling methodologies. Despite a significant genetic heritability estimate of treatment non-response trait (h(2) = 0.18, P value = 0.02), no significant genetic contribution to prediction accuracy is observed. Results formally confirm the expectations of the rheumatology community that SNP information does not significantly improve predictive performance relative to standard clinical traits, thereby justifying a refocusing of future efforts on collection of other data.Peer reviewe

Relationship between epicardial fat tissue thickness and CRP and neutrophil-lymphocyte ratio in metabolic syndrome patients over 65 years

Objective: There are no data evaluating the association of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) with epicardial fat tissue thickness (EFTT) in elderly metabolic syndrome (MS) patients. In this study, we aimed to investigate the relationship of EFTT with CRP and NLR in patients with MS over 65 years. Methods: A cross-sectional study was performed. Fifty patients (patient group) with MS and 25 subjects (control group) without MS were allocated in the study. All parameters were compared in patient and control groups. The correlations between NLR, CRP, and EFTT were evaluated. Results: White blood cell and neutrophil levels were higher in MS group (p=0.020 and p=0.019, respectively). Both transverse and longitudinal EFTT were increased in MS patients (p<0.001). There was a significant correlation between the EFTT and NLR but not with CRP in the MS group (r=0.4, p=0.003). Conclusion: Our study showed that both longitudinal and transverse EFTT are associated with NLR in patients older than 65 years with MS. In geriatric MS patients, higher NLR level may be an indicator of increased visceral fat around the myocardium

A simplified neutrosophic multiplicative set-based TODIM using water-filling algorithm for the determination of weights

KOSEOGLU, ALI/0000-0002-2131-7141; Sahin, Ridvan/0000-0001-7434-4269WOS: 000504579500001Due to the technological developments around the world, the amount of information that researchers work on increases continuously. This information density contains incomplete and uncertain data that cannot be fully expressed with crisp numbers. Fuzzy sets, intuitionistic fuzzy sets, and neutrosophic sets are useful tools to manage such information, but these concepts use a symmetrical and uniform scale to express data, whereas real-life problems contain nonsymmetrical and non-uniform information. Intuitionistic multiplicative sets (IMSs) are effective tools for dealing with these real-life problems. However, IMSs cannot handle real-life problems completely because indeterminate information depends on membership and non-membership information of IMSs, which is a restriction for decision makers and also for decision problems. To overcome this limitation, this paper generalizes the IMSs by using simplified neutrosophic set and introduces a novel approach that is called simplified neutrosophic multiplicative sets (SNMSs). Firstly, we define SNMS, show their set-based operations, and then give a description of simplified neutrosophic multiplicative numbers (SNMNs). Based on SNMNs, we develop two simplified neutrosophic multiplicative aggregation operators on SNMNs that are called simplified neutrosophic multiplicative weighted arithmetic average operator and simplified neutrosophic multiplicative weighted geometric average operator. Furthermore, we define some simplified neutrosophic multiplicative distance measures. Finally, using a model based on water-filling algorithm for determining criteria weights, we give a numerical example to demonstrate the effectiveness of the introduced concept with the proposed simplified neutrosophic multiplicative simplified neutrosophic multiplicative-TODIM method

Characteristics of recurrent emergency department visits within 72 hours of visits for the same or related complaints

We aimed to investigate the characteristics of recurrent emergency department visits within 72 hours for the same or related complaints. Recurrent visits were defined as any repeated visits to the emergency department within the first 72 hours of discharge after the first admission with the same or similar complaints. The study population included patients revisiting the emergency department within 72 hours after the first visit. Recurrent visit files were screened from the Hospital Information Management System, and data were compared between the first and second visits. Of the 83,578 patients included, 1,952 (2.3%) fulfilled the inclusion criteria. Thus, the revisit rate was 2.3%. Emergency Department triage scores showed no significant differences between the visits, but 2 patients with triage scores of 4 in the first visit subsequently had triage score of 1 in the recurrent visits. In addition, the presence of comorbidities was found to be significantly associated with revisit and hospitalization. Measuring and evaluating the causes of revisits to the emergency department allow assessment of hospital quality. We believe that to reduce the revisit rate, prolonged emergency room observation is necessary, particularly for patients with comorbidities and those presenting complaints related to the cardiovascular system, oncology, and respiratory system. Further, morbidity and mortality rates will consequently decrease. [Med-Science 2016; 5(4.000): 937-40