Letter to the editor, "Validation and clinical value of the MANAGE-PD tool:A clinician-reported tool to identify Parkinson's disease patients inadequately controlled on oral medications"

The MANAGE-PD tool may help general neurologists in deciding whether a patient with advanced Parkinson's disease should be referred for an advanced therapy. Although the development and clinical validation of MANAGE-PD would appear to serve an important need, we urge the reader to be aware of several methodological concerns.</p

The risk of colectomy and colorectal cancer after appendectomy in patients with ulcerative colitis:a systematic review and meta-analysis

Background: Appendectomy decreases the risk of developing ulcerative colitis [UC], and is suggested to have a beneficial effect on the clinical course of established UC. However, recent studies showed no significantly decreased colectomy rate, and moreover an apparently increased risk of colorectal cancer [CRC]. We aimed to investigate the suggested correlation in a meta-analysis and to analyse possible confounding factors. Methods: A systematic review and meta-analysis were performed using MEDLINE, EMBASE, and the Cochrane Library. Data from studies describing the influence of appendectomy on colectomy and CRC were extracted from published reports. Exclusion criteria were patients aged <18 years, non-UC, and animal studies. Results: From 891 studies, 13 studies evaluating 73 323 UC patients [appendectomy n = 2859] were included. All studies, except one, were rated as poor quality. Overall, colectomy rate in appendectomised and non-appendectomised patients was not significantly different (odds ratio [OR] 1.25, 95% confidence interval [CI] 0.88-1.77, I2 = 53%). The proportion of colectomies undertaken for CRC or high-grade dysplasia [HGD] was significantly higher after appendectomy [OR 2.85, 95% CI 1.40-5.78, I2 = 32%], with 50% of the colectomies indicated for CRC/HGD compared with 9.4% in non-appendectomised patients. Possible additional confounding factors were a longer UC disease duration, less medication use, and a higher prevalence of primary sclerosing cholangitis [PSC] in appendectomised patients. Conclusions: Appendectomy in established UC is associated with apparently higher rates of subsequent CRC/HGD, but this appears to be due to inequalities in at-risk exposure between groups, presumably secondary to positive clinical effects of appendectomy on disease symptoms. This finding emphasises the importance of regular endoscopic surveillance in this patient group

Commitment, Learning, and Alliance Performance: A Formal Analysis Using an Agent-Based Network Formation Model

Current theoretical arguments highlight a dilemma faced by actors who either adopt a weak or strong commitment strategy for managing their alliances and partnerships. Actors who pursue a weak commitment strategy|i.e. immediately abandon current partners when a more pro table alternative is presented|are more likely to identify the most rewarding alliances. On the other hand, actors who enact a strong commitment approach are more likely to take advantage of whatever opportunities can be found in existing partnerships. Using agent-based modeling, we show that actors who adopt a moderate commitment strategy overcome this dilemma and outperform actors who adopt either weak or strong commitment approaches. We also show that avoiding this dilemma rests on experiencing a related tradeo : moderately-committed actors sacri ce short-term performance for the superior knowledge and information that allows them to eventually do better

The impact of bead milling on the thermodynamics and kinetics of the structural phase transition of VO2 particulate materials and their potential for use in thermochromic glazing

The thermodynamics and kinetics of the structural phase transition from monoclinic VO2 (M) to rutile VO2 (R) and vice versa were studied for particulate materials obtained by bead milling of VO2 (M) powder. Using wet bead milling, we decreased the particle size of VO2 (M) powder from ∼1 μm to 129 nm. With progressive milling, the switching enthalpy decreased from 47 J g−1 to 29 J g−1 due to a loss of crystallinity. The switching kinetics were studied using Friedman's differential isoconversional method. The activation energy |Eα| decreases with increasing difference between the actual temperature of the material and its switching temperature (T0). Furthermore, |Eα| decreases with progressive milling, and kinetic asymmetry is induced. For milled particulate materials, |Eα| is lower for the switch from VO2 (R) to VO2 (M) than for the opposite switch. For hydrothermally synthesized nanoparticles, |Eα| is in the same order of magnitude, albeit with inverse switching asymmetry. Latter may result from different defects that are introduced during both preparation techniques. Applying layers of milled particulate material to glass sheets yielded thermochromic coatings with luminous transmission of 40.7% and solar modulation of 8.3%. This demonstrates that milled VO2 particles have potential for use in energy efficient thermochromic windows

Clinical statistical analysis plan for the ACCURE trial:the effect of appendectomy on the clinical course of ulcerative colitis, a randomised international multicentre trial

Background: The primary treatment of ulcerative colitis (UC) is medical therapy using a standard step-up approach. An appendectomy might modulate the clinical course of UC, decreasing the incidence of relapses and reducing need for medication. The objective of the ACCURE trial is to assess the efficacy of laparoscopic appendectomy in addition to standard medical treatment in maintaining remission in UC patients. This article presents the statistical analysis plan to evaluate the outcomes of the ACCURE trial. Design and methods: The ACCURE trial was designed as a multicentre, randomised controlled trial. UC patients with a new diagnosis or a disease relapse within the past 12 months, treated with 5-ASA, corticosteroids, or immunomodulators until complete clinical and endoscopic remission (defined as total Mayo score &lt; 3 with endoscopic subscore of 0 or 1), were counselled for inclusion. Also, patients previously treated with biologicals who had a washout period of at least 3 months were considered for inclusion. Patients were randomised (1:1) to laparoscopic appendectomy plus maintenance treatment or a control group (maintenance therapy only). The primary outcome is the 1-year UC relapse rate (defined as a total Mayo-score ≥ 5 with endoscopic subscore of 2 or 3, or clinically as an exacerbation of symptoms and rectal bleeding or FCP &gt; 150 or intensified medical therapy other than 5-ASA therapy). Secondary outcomes include number of relapses per patient, time to first relapse, disease activity, number of colectomies, medication usage, and health-related quality of life. Discussion: The ACCURE trial will provide comprehensive evidence whether adding an appendectomy to maintenance treatment is superior to maintenance treatment only in maintaining remission in UC patients. Trial registration: Dutch Trial Register (NTR) NTR2883. Registered May 3, 2011. ISRCTN, ISRCTN60945764. Registered August 12, 2019

The clinical relevance of an inflamed appendix in Crohn's disease.

BACKGROUND AND AIMS An appendectomy for appendiceal inflammation has been suggested to ameliorate the clinical course of patients with ulcerative colitis (UC). In contrast, for Crohn's disease (CD) an inverse association has been suggested with a higher incidence of CD and worse prognosis after appendectomy. The aim of this study was to analyse the clinical relevance of an inflamed appendix in CD patients undergoing ileocoecal resection (ICR). METHODS All consecutive patients undergoing primary ICR between 2007 and 2018 were considered for inclusion. Microscopic data of available appendiceal resection specimens (n=99) were revised by a dedicated IBD-pathologist and scored as inflamed or not inflamed. Eighteen patients had a previous appendectomy. Pathological findings were correlated with disease characteristics and recurrence rates (clinical, endoscopic and intervention-related). RESULTS In total, 117 patients were included: 77 (65.8%) females with a median age of 30 years [IQR 24 - 43] with a median follow up of 102 months [IQR 76-114]. Of patients without previous appendectomy (n=99), 39% had an inflamed appendix. No significant differences in disease characteristics (e.g. disease location, behaviour, time to surgery) or prognosis could be demonstrated between the two groups. In contrast, previous appendectomy (n=18) was associated with penetrating disease and numerically shorter disease duration at the time of resection. Furthermore, a trend was seen towards a stronger association with postoperative recurrence. CONCLUSION The current study could not confirm a different prognosis for CD patients with and without an inflamed appendix. In contrast, in patients with a previous appendectomy a trend was seen towards increased postoperative recurrence, which might be related to the higher incidence of penetrating disease

The history of Shtokman field development

Let's twist again! The first highly enantioselective asymmetric reaction in which a chiral reaction medium is the sole source of chirality is presented. The aza‐Baylis–Hillman reaction in an ionic liquid with a chiral anion, whose design is based on mechanistic insights, gave products with up to 84 % ee

Knowledge, health beliefs and attitudes towards dementia and dementia risk reduction among descendants of people with dementia:a qualitative study using focus group discussions

Abstract Background Individuals with a parental family history of dementia have an increased risk of developing dementia because they share their genes as well as their psychosocial behaviour. Due to this increased risk and their experience with dementia, they may be particularly eager to receive information regarding dementia risk reduction (DRR). This study evaluated the knowledge, beliefs and attitudes towards dementia and DRR among descendants of people with dementia. Method Using a semi-structured topic guide, three focus group discussions were conducted consisting of 12 female (80%) and 3 male (20%) descendants of people with dementia with a mean (± SD) age of 48.8 (± 12) years. Focus group discussions were audio recorded and transcribed. Each transcript was analysed thoroughly, and where appropriate, a code was generated and assigned by two researchers independently. Then, similar codes were grouped together and categorized into themes. Results The items in the topic guide could only be addressed after participants had been given the opportunity to share their experiences of having a parent with dementia. Participants were unaware or uncertain about the possibility of reducing the risk of developing dementia and therefore hesitant to assess their dementia risk without treatment options in sight. Moreover, participants indicated that their general practitioner only gave some information on heritability, not on DRR. Although participants identified a large number of modifiable risk factors as a group during the group discussions, they were eager to receive more information on dementia and DRR. In the end, participants adopted a more positive attitude towards a DRR programme and provided suggestions for the development of future DRR programmes. Conclusions Although the research aim was to evaluate the knowledge, beliefs and attitudes towards dementia and DRR, sharing experiences of having a parent with dementia seemed a prerequisite for considering participants’ own risk of developing dementia and participating in a DRR programme. Knowledge of dementia and DRR was limited. Due to unawareness of the possibility of reducing dementia risk, participants were hesitant about assessing their dementia risk. Group discussions positively changed the perception of dementia risk assessment and participants’ willingness to participate in a DRR programme

Recommendations in pre-registrations and internal review board proposals promote formal power analyses but do not increase sample size

In this preregistered study, we investigated whether the statistical power of a study is higher when researchers are asked to make a formal power analysis before collecting data. We compared the sample size descriptions from two sources: (i) a sample of pre-registrations created according to the guidelines for the Center for Open Science Preregistration Challenge (PCRs) and a sample of institutional review board (IRB) proposals from Tilburg School of Behavior and Social Sciences, which both include a recommendation to do a formal power analysis, and (ii) a sample of pre-registrations created according to the guidelines for Open Science Framework Standard Pre-Data Collection Registrations (SPRs) in which no guidance on sample size planning is given. We found that PCRs and IRBs (72%) more often included sample size decisions based on power analyses than the SPRs (45%). However, this did not result in larger planned sample sizes. The determined sample size of the PCRs and IRB proposals (Md = 90.50) was not higher than the determined sample size of the SPRs (Md = 126.00; W = 3389.5, p = 0.936). Typically, power analyses in the registrations were conducted with G*power, assuming a medium effect size, α = .05 and a power of .80. Only 20% of the power analyses contained enough information to fully reproduce the results and only 62% of these power analyses pertained to the main hypothesis test in the pre-registration. Therefore, we see ample room for improvements in the quality of the registrations and we offer several recommendations to do so