100 research outputs found

    Mammoeten in de Vlietwijk!

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    FdA – Publicaties niet-programma gebonde

    Virtual Neanderthals : a study in agent-based modelling Late Pleistocene hominins in western Europe

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    This study presents an agent-based simulation model exploring the patterns of presence and absence of Late Pleistocene Neanderthals in western Europe. HomininSpace implements a parameterized generic demographic and social model of hominin dispersal while avoiding parameter value biases and explicitly modelled handicaps. Models are simulated through time within a high-resolution environment where reconstructed temperatures and precipitation levels influence the carrying capacity of the landscape. Model parameter values are assigned and varied automatically while optimizing the match with Neanderthal archaeology using a Genetic Algorithm (GA) inspired by the processes of natural selection. The system is able to traverse the huge parameter space that is created by the complete set of all possible parameter value combinations to find those values that will result in a simulation that matches well with archaeological data in the form of radiometrically obtained presence data. Human Origin

    Gastrointestinal Stromal Tumor in Pregnancy: A Case Report

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    Background. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract and are diagnosed relatively seldom in pregnancy. Case. We describe a remarkable clinical course and long-term outcome, now nine years after first diagnosis, of a massive and metastatic, with a high malignancy grade GIST case, found in and treated from the first trimester of pregnancy onwards. Conclusion. GIST occurring during pregnancy is extremely rare. However, early diagnosis is important for optimal management. The recent better understanding of oncogenesis, the use of immunohistochemistry for differential diagnosis of GISTs, and the use of imatinib mesylate as the treatment of first choice are—as shown in this case—important for care of pregnant women with this type of malignancy

    Happisburgh I. GIS data sets.

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    This internal report from the faculty of Archaeology of the University of Leiden provides an overview of excavations done between 2004 and 2012 at the coastal area referred to as Happisburgh I at the east Anglian coast. Here several excavations have produced archaeological and biological material relevant to early hominin occupation on the British coastal area.Human Origin

    Early pregnancy biomarker discovery study for spontaneous preterm birth

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    (1) Objective: discover new candidate biomarkers for spontaneous preterm birth in early pregnancy samples. When fully clinically validated, early pregnancy biomarkers for sPTB give the possibility to intervene or monitor high-risk pregnancies more intensively through, as example, pelvic exams, ultrasound or sonographic cervical length surveillance. (2) Study design: Early pregnancy serum samples of eight spontaneous extreme and very preterm birth cases (&lt;32 weeks of gestational age) without any symptoms of preeclampsia and fetal growth restriction and eight uncomplicated pregnancies were analyzed by liquid chromatography mass spectrometry (LC-MS). Thirteen proteins, which were differentially expressed according to the LC-MS data, were subsequently selected for confirmation by enzyme-linked immunosorbent assay (ELISA). (3) Results: Differential expression of four candidate biomarkers was confirmed by ELISA with decreased early pregnancy levels of gelsolin and fibulin-1 and increased levels of c-reactive protein and complement C5 in the preterm birth group. (4) Conclusions: The confirmed candidate biomarkers are all to some extent related to inflammatory pathways and/or the complement system. This supports the hypothesis that both play a role in extreme and very preterm birth without any symptoms of preeclampsia and fetal growth restriction. The predictive value of complement C5, c-reactive protein, fibulin-1 and gelsolin should, therefore, be validated in another cohort with early pregnancy samples.</p

    Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation

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    Introduction: Magnesium sulfate (MgSO4) is frequently administered for maternal and fetal neuroprotection in preeclampsia (PE) and imminent preterm birth, respectively. Objective: To assess whether MgSO4 affects neonatal cerebral oxygenation, blood flow, and cerebral autoregulation (CAR) during the first postnatal days independently from PE. Methods: 148 neonates 0.5) was determined. Linear mixed models were applied. Results: MgSO4 exposure was recorded in 77 neonates. Twenty-nine neonates were born following PE. MgSO4 independently lowered cFTOE (B: -0.026, 95% CI: -0.050 to 0.002, p < 0.05) but did not affect PSV and RI. PE was associated with a lower cFTOE (B: -0.041, 95% CI: -0.067 to -0.015, p < 0.05) and a tendency towards both lower PSV (B: -4.285, 95% CI: -9.067 to 0.497, p < 0.1) and more impaired CAR (B: 4.042, 95% CI: -0.028 to 8.112, p < 0.1), which seemed to be strongly mediated by fetal brain sparing. MgSO4 did not alter CAR. Conclusions: In contrast to fetal brain sparing in PE, MgSO4 seems to lower cFTOE by lowering cerebral oxygen demands in preterm neonates without affecting the cerebrovasculature

    Cost-effectiveness analysis of a first-trimester screening test for preterm preeclampsia in the Netherlands

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    Objectives: The risk of preterm preeclampsia (PT PE) can significantly be reduced by starting acetylsalicylic acid ≤ 16 weeks of gestational age. First trimester predictive models based on maternal risk factors to effectively start this therapy lacked sufficient power, but recent studies showed that these models can be improved by including test results of biochemical and/or -physical markers. To investigate whether testing a biochemical marker in the first trimester is cost-effective in the Netherlands, a cost-effectiveness analysis was performed in this study. Study design: The outcome of this study was expressed as an incremental cost-effectiveness ratio (ICER) with as effect prevented PT PE cases. To evaluate the impact of each model parameter and to determine model uncertainties, both univariate and probabilistic sensitivity analyses were performed. Results: When compared to the baseline strategy, the test strategy is estimated to save almost 4 million euros per year on a national scale and at the same time this would prevent an additional 228 PT PE cases. The sensitivity analyses showed that the major drivers of the result are the costs to monitor a high-risk pregnancy and the specificity and that most of the model simulations were in the southeast quadrant: cost saving and more prevented complications. Conclusions: This study showed that a first-trimester test strategy to screen for PT PE in the first trimester is potentially cost-effective in the Dutch healthcare setting. The fact that the specificity is a major driver of the ICER indicates the importance for a (new) screening model to correctly classify low-risk pregnancies.</p

    Healthy and preeclamptic pregnancies show differences in Guanylate-Binding Protein-1 plasma levels

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    The large interferon-inducible anti-angiogenic pro-inflammatory GTPase Guanylate Binding Protein-1 (GBP-1) is produced and secreted by activated endothelial cells and is highly induced by inflammatory cytokines and inhibited by angiogenic growth factors. During pregnancy a generalized mild inflammatory response is observed. During preeclampsia this generalized inflammatory response is even further activated and activation of the endothelium occurs. We hypothesized that GBP-1 is increased in healthy pregnancy and will be even further increased during preeclampsia. In the first experiment, plasma and placentas were collected from healthy and preeclamptic pregnancies. Plasma was also collected from non-pregnant women. For the second experiment longitudinal blood samples from women with a healthy or preeclamptic pregnancy were collected from the end of the first trimester until birth and one sample postpartum. The plasma GBP-1 levels were measured by ELISA and GBP-1 mRNA and protein levels in the placenta were tested by qPCR and immunohistochemistry. During pregnancy higher plasma concentrations of GBP-1 compared with non-pregnant women were observed. Surprisingly, during preeclampsia, plasma GBP-1 levels were lower than in control pregnancies and similar to the level of non-pregnant controls. Placental GBP-1 mRNA levels were not different between healthy and preeclamptic pregnancies and GBP-1 protein was virtually undetectable in the trophoblast by immunohistochemistry in placental tissue. Evaluation of longitudinal samples showed that plasma GBP-1 concentrations increased towards the end of pregnancy in healthy pregnancies, but not in preeclampsia. In line with our hypothesis, we found higher GBP-1 plasma levels during healthy pregnancy. However, plasma GBP-1 did not further increase during preeclampsia, but was stable. Further studies are needed to evaluate why GBP-1 does not increase during preeclampsia
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