On the Neutral Gas Content and Environment of NGC 3109 and the Antlia Dwarf Galaxy

As part of a continuing survey of nearby galaxies, we have mapped the neutral gas content of the low surface brightness, Magellanic-type galaxy NGC 3109 --- and its environment, including the Antlia dwarf galaxy --- at unprecedented velocity resolution and brightness sensitivity. The HI mass of NGC 3109 is measured to be (3.8 +/- 0.5) x 10^8 Msun. A substantial warp in the disk of NGC 3109 is detected in the HI emission image in the form of an extended low surface brightness feature. We report a positive detection in HI of the nearby Antlia dwarf galaxy, and measure its total neutral gas mass to be (6.8 +/- 1.4) x 10^5 Msun. We show the warp in NGC 3109 to lie at exactly the same radial velocity as the gas in the Antlia dwarf galaxy and speculate that Antlia disturbed the disk of NGC 3109 during a mild encounter ~1 Gyr in the past. HI data for a further eight galaxies detected in the background are presented.Comment: Accepted for publication in A

Construction and validation of a patient- and user-friendly nursing home version of the Geriatric Depression Scale.

Objective To construct a patient- and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. Methods The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n¼410), the Mini Mental State Examination (n¼410) and a diagnostic interview (SCAN; n¼333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, items that were identified as unsuitable were removed using the data of the Assess project (n¼77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specitivity, area under ROC and positive and negative predictive values), the newly constructed shortened GDS was validated in the AGED data set (n¼333), using DSM-IV diagnosis for depression as measured by the SCAN as ‘gold standard’. Results The eight-item GDS that resulted from stage 1 showed good internal consistency in both the Assess data set (a¼0.86) and the AGED dataset (a¼0.80). In the AGED dataset, high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. Conclusion The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population

Characterization of immune response to neurofilament light in experimental autoimmune encephalomyelitis

PMCID: PMC3856490This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.PMCID: PMC385649

Transition strategies for metropolitan food clusters

Metropolitan food clusters entail the development of a new agri logistic system and promises to produce gains for people, planet, and profit. Establishing a transition towards system innovations like metropolitan food clusters needs strategies to overcome the challenges actors face, because transitions are complex processes which are difficult to manage. To define major challenges and strategies to cope with them a literature study into transition, complexity, and learning theories was conducted. The findings where used in analyzing the case study Greenpark, which is located in an emerging economy. In this article it is concluded that system innovations like metropolitan food clusters need the establishment of niches in which they can foster in an environment based on trust and learning and in which a management style is used which manages order and disorder, aims for innovation, and provides room for self organization. When scaling up to the regime level the challenge arises how to push through existing practices and rules and in this context, the support of an influential actor network is essential. This means connections are necessary between the innovation process inside a niche and people and organizations outside the niche with executive power and involving potential executers of metropolitan food clusters in the design process is a suited way of doing this. The challenge however is to understand and prevent the innovative potential of the niche from weakening because of a management style that is based on hierarchy and control

Influence of dialysate temperature on creatinine peritoneal clearance in peritoneal dialysis patients: a randomized trial

Background: Patients on continuous ambulatory peritoneal dialysis (PD) are encouraged to warm dialysate to 37 \ub0C before peritoneal infusion; main international PD guidelines do not provide specific recommendation, and patients generally warm dialysate batches partially or do not warm them at all. Warming of dialysate is a time-consuming procedure, not free from potential risks (i.e. degradation of glucose), and should be justified by a clear clinical benefit. Methods: We designed a single blind randomized controlled trial where 18 stable PD patients were randomized to receive a peritoneal equilibration test either with dialysate at a controlled temperature of 37 \ub0C (intervention group) or with dialysate warmed with conventional methods (control group). Primary end-point was a higher peritoneal creatinine clearance in patients in the intervention group. Results: Patients in the intervention group did not show a significantly higher peritoneal creatinine clearance when compared to the control group (6.38 \ub1 0.52 ml/min vs 5.65 \ub1 0.37 ml/min, p = 0.2682). Similar results were obtained for urea peritoneal clearance, mass transfer area coefficient of creatinine and urea. There were no significant differences in total abdominal discomfort questionnaire score, blood pressure and body temperature between the two groups. Conclusions: Using peritoneal dialysate at different temperatures without causing significant side effects to patients appears feasible. We report a lack of benefit of warming peritoneal dialysate to 37 \ub0C on peritoneal clearances; future PD guidelines should not reinforce this recommendation. Trial registration: NCT04302649, ClinicalTrials.gov; date of registration 10/3/2020 (retrospectively registered)

Randomized phase III KEYNOTE-045 trial of pembrolizumab versus paclitaxel, docetaxel, or vinflunine in recurrent advanced urothelial cancer: results of >2 years of follow-up.

BackgroundNovel second-line treatments are needed for patients with advanced urothelial cancer (UC). Interim analysis of the phase III KEYNOTE-045 study showed a superior overall survival (OS) benefit of pembrolizumab, a programmed death 1 inhibitor, versus chemotherapy in patients with advanced UC that progressed on platinum-based chemotherapy. Here we report the long-term safety and efficacy outcomes of KEYNOTE-045.Patients and methodsAdult patients with histologically/cytologically confirmed UC whose disease progressed after first-line, platinum-containing chemotherapy were enrolled. Patients were randomly assigned 1 : 1 to receive pembrolizumab [200 mg every 3 weeks (Q3W)] or investigator's choice of paclitaxel (175 mg/m2 Q3W), docetaxel (75 mg/m2 Q3W), or vinflunine (320 mg/m2 Q3W). Primary end points were OS and progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) by blinded independent central radiology review (BICR). A key secondary end point was objective response rate per RECIST v1.1 by BICR.ResultsA total of 542 patients were enrolled (pembrolizumab, n = 270; chemotherapy, n = 272). Median follow-up as of 26 October 2017 was 27.7 months. Median 1- and 2-year OS rates were higher with pembrolizumab (44.2% and 26.9%, respectively) than chemotherapy (29.8% and 14.3%, respectively). PFS rates did not differ between treatment arms; however, 1- and 2-year PFS rates were higher with pembrolizumab. The objective response rate was also higher with pembrolizumab (21.1% versus 11.0%). Median duration of response to pembrolizumab was not reached (range 1.6+ to 30.0+ months) versus chemotherapy (4.4 months; range 1.4+ to 29.9+ months). Pembrolizumab had lower rates of any grade (62.0% versus 90.6%) and grade ≥3 (16.5% versus 50.2%) treatment-related adverse events than chemotherapy.ConclusionsLong-term results (>2 years' follow-up) were consistent with those of previously reported analyses, demonstrating continued clinical benefit of pembrolizumab over chemotherapy for efficacy and safety for treatment of locally advanced/metastatic, platinum-refractory UC.Trial registrationClinicalTrials.gov: NCT02256436