Daily ingestion of alginate reduces energy intake in free-living subjects

Sodium alginate is a seaweed-derived fibre that has previously been shown to moderate appetite in models of acute feeding. The mechanisms underlying this effect may include slowed gastric clearance and attenuated uptake from the small intestine. In order to assess whether alginate could be effective as a means of appetite control in free-living adults, 68 males and females (BMI range: 18.50-32.81 kgl M-2) completed this randomised, controlled two-way crossover intervention to compare the effects of 7 day daily ingestion of a strong-gelling sodium alginate formulation against a control. A sodium alginate with a high-guluronate content was chosen because, upon ingestion, it forms a strong gel in the presence of calcium ions. Daily preprandial ingestion of the sodium alginate formulation produced a significant 134.8 kcal (7%) reduction in mean daily energy intake. This reduced energy intake was underwritten by significant reductions in mean daily carbohydrate, sugar, fat, saturated fat and protein intakes. The absence of any significant interaction effects between the main effect of preload type and those of gender, BMI classification and/or timing of preload delivery indicates the efficacy of this treatment for individuals in different settings. These findings suggest a possible role for a strong-gelling sodium alginate formulation in the future management of overweight and obesity. (C) 2008 Elsevier Ltd. All rights reserved

Repeated cervical length measurements for the verification of short cervical length

Research into fetal development and medicin

Etravirine pharmacokinetics in HIV-infected pregnant women

__Background__ The study goal was to describe etravirine pharmacokinetics during pregnancy and postpartum in HIV-infected women. __Methods__ IMPAACT P1026s and PANNA are on-going, non-randomized, open-label, parallel-group, multi-center phase-IV prospective studies in HIV-infected pregnant women. Intensive steady-state 12-h pharmacokinetic profiles were performed from 2nd trimester through postpartum. Etravirine was measured at two labs using validated ultra performance liquid chromatography (detection limits: 0.020 and 0.026 mcg/mL). __Results__ Fifteen women took etravirine 200 mg twice-daily. Etravirine AUC0-12 was higher in the 3rd trimester compared to paired postpartum data by 34% (median 8.3 vs. 5.3 mcg*h/mL, p = 0.068). Etravirine apparent oral clearance was significantly lower in the 3rd trimester of pregnancy compared to paired postpartum data by 52% (median 24 vs. 38 L/h, p = 0.025). The median ratio of cord blood to maternal plasma concentration at delivery was 0.52 (range: 0.19-4.25) and no perinatal transmission occurred. __Conclusion__ Etravirine apparent oral clearance is reduced and exposure increased during the third trimester of pregnancy. Based on prior dose-ranging and safety data, no dose adjustment is necessary for maternal health but the effects of etravirine in utero are unknown. Maternal health and infant outcomes should be closely monitored until further infant safety data are available. __Clinical Trial registration:__ The IMPAACT protocol P1026s and PANNA study are registered at ClinicalTrials.gov under NCT00042289 and NCT00825929

Colorectal liver metastases: Surgery versus thermal ablation (COLLISION) - a phase III single-blind prospective randomized controlled trial

Background: Radiofrequency ablation (RFA) and microwave ablation (MWA) are widely accepted techniques to eliminate small unresectable colorectal liver metastases (CRLM). Although previous studies labelled thermal ablation inferior to surgical resection, the apparent selection bias when comparing patients with unresectable disease to surgical candidates, the superior safety profile, and the competitive overall survival results for the more recent reports mandate the setup of a randomized controlled trial. The objective of the COLLISION trial is to prove non-inferiority of thermal ablation compared to hepatic resection in patients with at least one resectable and ablatable CRLM and no extrahepatic disease. Methods: In this two-arm, single-blind multi-center phase-III clinical trial, six hundred and eighteen patients with at least one CRLM (≤3cm) will be included to undergo either surgical resection or thermal ablation of appointed target lesion(s) (≤3cm). Primary endpoint is OS (overall survival, intention-to-treat analysis). Main secondary endpoints are overall disease-free survival (DFS), time to progression (TTP), time to local progression (TTLP), primary and assisted technique efficacy (PTE, ATE), procedural morbidity and mortality, length of hospital stay, assessment of pain and quality of life (QoL), cost-effectiveness ratio (ICER) and quality-adjusted life years (QALY). Discussion: If thermal ablation proves to be non-inferior in treating lesions ≤3cm, a switch in treatment-method may lead to a reduction of the post-procedural morbidity and mortality, length of hospital stay and incremental costs without compromising oncological outcome for patients with CRLM. Trial registration:NCT03088150 , January 11th 2017

Using a knowledge elicitation method to specify the business model of a human factors organization

Concept Mapping was used to structure knowledge elicitation interviews with a group of human factors specialists whose goal was to describe the business model of their Department. This novel use of cognitive task analysis to describe the business model of a human factors organization resulted in a number of Concept Maps on topics such as Department strengths and weaknesses, strategic plans and partnerships, and ambitions and goals. This work might be seen as a prototype for how other human factors organizations might brainstorm their activities, progress, and goals

Drugs of abuse and tranquilizers in Dutch surface waters, drinking water and wastewater: Results of screening monitoring 2009

In the surface waters of the rivers Rhine and Meuse, twelve drugs that are listed in the Dutch Opium act were detected at low concentrations. They are from the groups amphetamines, tranquilizers (barbiturates and benzodiazepines) opiates and cocaine. During drinking water production, most compounds are removed or concentrations are substantially lowered. In finished drinking water, three barbiturates were still detected in very low concentrations (up to 12 ng/L). The amounts are below health based provisional drinking water limits. Ongoing monitoring of the presence of these compounds in water and possible long-term effects on human health are a point of interest. It is recommended to investigate possible ecotoxicological effects. These findings are the results of a RIVM investigation performed under the authority of the VROM-Inspectorate of the Dutch Ministry of Infrastructure and the Environment. This investigation was carried out in cooperation with KWR Watercycle Research Institute and the Research Institute for Pesticides and Water of the University Jaume I (Spain). A total of 65 water samples were analysed for 37 different drugs of abuse and metabolites. In addition to surface waters and drinking water, sewage waters were also analysed. The compounds can be detected due to the increased sensitivity of analytical methods nowadays available. However, drugs have probably been present in the aquatic environment since they have been used by humans. Substantial fractions of the total load of drugs in the Rhine and Meuse rivers enter the Netherlands from abroad. There is also a contribution through effluents from sewage water treatment plants in the Netherlands. The concentrations found in Dutch sewage water are in the same range as concentrations found in other Western European countries. Based on the measured concentrations, cocaine consumption in some Dutch cities could be estimated and compared

Evaluatie van de nota Duurzame gewasbescherming : deelrapport Voedselveiligheid

Het percentage groente- en fruitmonsters waarop in Nederland te veel resten van gewasbeschermingsmiddelen zijn aangetroffen, is tussen 2003 en 2010 met 70% gedaald. Daarnaast is de absolute hoeveelheid resten van gewasbeschermingsmiddelen op dit type voedsel verminderd. De meeste producten waarop resten zijn aangetroffen, zijn afkomstig uit het buitenland. Verder is de voedselveiligheid sinds 2003 verbeterd. Dit blijkt uit een evaluatie van het beleidsdoel voor voedselveiligheid, zoals geformuleerd in de nota Duurzame gewasbescherming van het ministerie van Landbouw, Natuur en Voedselkwaliteit (nu Economische Zaken, Landbouw en Innovatie). Het doel hiervan is het aantal overschrijdingen met 50% te verminderen

Evaluatie van de nota Duurzame gewasbescherming : deelrapport Voedselveiligheid

Het percentage groente- en fruitmonsters waarop in Nederland te veel resten van gewasbeschermingsmiddelen zijn aangetroffen, is tussen 2003 en 2010 met 70% gedaald. Daarnaast is de absolute hoeveelheid resten van gewasbeschermingsmiddelen op dit type voedsel verminderd. De meeste producten waarop resten zijn aangetroffen, zijn afkomstig uit het buitenland. Verder is de voedselveiligheid sinds 2003 verbeterd. Dit blijkt uit een evaluatie van het beleidsdoel voor voedselveiligheid, zoals geformuleerd in de nota Duurzame gewasbescherming van het ministerie van Landbouw, Natuur en Voedselkwaliteit (nu Economische Zaken, Landbouw en Innovatie). Het doel hiervan is het aantal overschrijdingen met 50% te verminderen