Coating Membranes for a Sorbent-Based Artificial Liver: Adsorption Characteristics

Techniques are described for the coating of sorbents to be used in an artificial liver support system based on mixed sorbent bed hemoperfusion. Activated charcoal has been coated with cellulose acetate (CA) by solvent evaporation. With Amberlite XAD-4, the Wurster technique was used for coating with CA. XAD-4 has also been coated with a synthetic polyelectrolyte with anticoagulant activity by adsorption and fixation by gamma radiation-induced crosslinking. Activated charcoal, XAD-4, and a cation exchange resin, all in powdered form, were encapsulated in agarose gel beads. Adsorption characteristics onto the sorbents are described. The results are in agreement with a theoretical model presented. In general, adsorption onto XAD-4 is limited by film diffusion. With activated charcoal, pore diffusion limitation is generally observed. Blood compatibility is improved by coatin

A Practical Attack on the MIFARE Classic

The MIFARE Classic is the most widely used contactless smart card in the market. Its design and implementation details are kept secret by its manufacturer. This paper studies the architecture of the card and the communication protocol between card and reader. Then it gives a practical, low-cost, attack that recovers secret information from the memory of the card. Due to a weakness in the pseudo-random generator, we are able to recover the keystream generated by the CRYPTO1 stream cipher. We exploit the malleability of the stream cipher to read all memory blocks of the first sector of the card. Moreover, we are able to read any sector of the memory of the card, provided that we know one memory block within this sector. Finally, and perhaps more damaging, the same holds for modifying memory blocks

Bestuurlijk gedogen en strafrechtelijk vervolgen

In de bijdrage Bestuurlijk gedogen en strafrechtelijk vervolgen wordt de samenhang tussen bestuurlijk gedogen en strafrechtelijk gedogen nader verkend. Het vertrekpunt is het bestuurlijk gedogen. Auteur zal een antwoord zoeken op de vraag inhoeverre die vorm van gedogen consequenties heeft voor de mogelijkheid van strafrechtelijk vervolgen. Bijdrage in de bundel Spectraal recht de bevoegdheidsuitoefening door de overheid als rechtsfeit / onder red. van E.C.H.J. van der Linden ... et al. ; met bijdr. van A.Q.C. Tak ... et al.. - Den Haag SDU, 1998. - 268 p. ill. ; 24 cm. - Juridische reeks / Universiteit Maastricht ; 1 ISBN 90-5409-164-9

Problems in Treating Experimentally Induced Acute Hepatic Failure by Hemoperfusion or Cross Circulation

Acute hepatic failure was induced in rats by galactosamine injection intraperitoneally (1 gm per kg). Twenty-four hours later rats were treated by hemoperfusion (HP) over encapsulated sorbents: cellulose acetate-coated charcoal, polyelectrolyte-coated XAD4, a combination of both, or cross circulation with a healthy donor. Compared with control treatment (prevention of hypoglycemia by glucose infusion), the survival rate was not improved by HP or cross circulation: controls 19% vs. treated animals 0 to 17%. Extension of duration or increased frequency of HP gave the same survival rates. Computer simulation based on zero-order introduction of a possible toxin into a two-compartment model shows that HP up to 5 hr per day is not able to clear the body effectively from the assumed toxin if its partition coefficient exceeds a value of 50

Evaluation of the First Year(s) of Physicians Collaboration on an Interdisciplinary Electronic Consultation Platform in the Netherlands:Mixed Methods Observational Study

BACKGROUND: Complexity of health problems and aging of the population create an ongoing burden on the health care system with the general practitioner (GP) being the gatekeeper in primary care. In GPs daily practice, collaboration with specialists and exchange of knowledge from the secondary care play a crucial role in this system. Communication between primary and secondary care has shortcomings for health care workers that want to practice sustainable patient-centered health care. Therefore, a new digital interactive platform was developed: Prisma. OBJECTIVE: This study aims to describe the development of a digital consultation platform (Prisma) to connect GPs with hospital specialists via the Siilo application and to evaluate the first year of use, including consultations, topic diversity, and number of participating physicians. METHODS: We conducted a mixed methods observational study, analyzing qualitative and quantitative data for cases posted on the platform between June 2018 and May 2020. Any GP can post questions to an interdisciplinary group of secondary care specialists, with the platform designed to facilitate discussion and knowledge exchange for all users. RESULTS: In total, 3674 cases were posted by 424 GPs across 16 specialisms. Most questions and answers concerned diagnosis, nonmedical treatment, and medication. Mean response time was 76 minutes (range 44-252). An average of 3 users engaged with each case (up to 7 specialists). Almost half of the internal medicine cases received responses from at least two specialisms in secondary care, contrasting with about one-fifth for dermatology. Of note, the growth in consultations was steepest for dermatology. CONCLUSIONS: Digital consultations offer the possibility for GPs to receive quick responses when seeking advice. The interdisciplinary approach of Prisma creates opportunities for digital patient-centered networking

Impact of digital interdisciplinary consultation on secondary care referrals by general practitioners:a protocol for a stepped-wedge cluster randomised controlled trial

INTRODUCTION: Optimal collaboration between general practice and hospital care is crucial to maintain affordable and sustainable access to healthcare for the entire population. General practitioners (GPs) are the gatekeepers to specialist care and patients will visit hospitals mostly only after referral. However, a substantial part of these referrals may be inappropriate, as communication between GPs and medical specialists can be challenging and referring patients may be the most obvious action for a GP to perform.A new digital platform (Prisma) connects GPs and specialists in interdisciplinary groups and facilitates asynchronous, accessible and fast teleconsultation within the group. No previous research has been done to evaluate the impact of this new platform on the referral rates to the hospital. METHODS AND ANALYSIS: A stepped-wedge randomised controlled trial (RCT) will be performed in Zwolle region in the Netherlands to analyse the effect of introduction of the platform on rate of inappropriate referrals to orthopaedic surgery. In four steps, GPs in the region will be given access to the platform. GPs will be part of the control condition until randomisation to the intervention. According to our sample size calculation, we need to include 18 practices with 1008 patients presenting with hip and knee symptoms. Routine care data of hospital registrations will be analysed to calculate the rate of inappropriate referrals (primary outcome). Secondary outcome are costs, primary and secondary care workload, posted cases and user satisfaction. Alongside this quantitative analysis, we will evaluate patient experience, facilitators and barriers for use of the platform. ETHICS AND DISSEMINATION: The medical ethics review board of University Medical Center Groningen (UMCG), the Netherlands (METc-number: 2021/288) has confirmed that the Medical Research Involving Human Subjects Act (WMO) does not apply to the process evaluation because the study does not involve randomisation of patients or different medical treatments (letter number: M21.275351). TRIAL REGISTRATION NUMBER: NL9704

Genetic parameters of colostrum and calf serum antibodies in Swedish dairy cattle

BackgroundA sufficient IgG content in the colostrum is essential for the newborn calf, as it provides passive immunity which substantially affects the probability of survival during rearing. Failure of passive transfer (FPT) occurs when a calf does not absorb enough antibodies from the colostrum and is defined by an IgG concentration in calf serum lower than 10 g/L. Apart from delayed access to colostrum, FPT can be due to a low production of IgG in the mother or poor IgG absorption by the calf. The aim of this study was to estimate the genetic background of antibody levels and indicator traits for antibodies in the colostrum and calf serum, and their correlation with milk production.ResultsColostrum data were available for 1340 dairy cows with at least one calving and calf serum data were available for 886 calves from these cows. Indicator traits for antibody concentrations were estimated using refractometry (a digital Brix refractometer for colostrum and an optical refractometer for serum), and enzyme-linked immunosorbent assays (ELISA) were used to determine the levels of total IgG and natural antibodies (NAb) of various antibody isotypes in the colostrum and calf serum. Colostrum traits had heritabilities ranging from 0.16 to 0.31 with repeatabilities ranging from 0.21 to 0.55. Brix percentages had positive genetic correlations with all colostrum antibody traits including total IgG (0.68). Calf serum antibody concentrations had heritabilities ranging from 0.25 to 0.59, with a significant maternal effect accounting for 17 to 27% of the variance. When later in life calves produced their first lactation, the lactation average somatic cell score was found to be negatively correlated with NAb levels in calf serum.Conclusions​​​​​​​Our results suggest that antibody levels in the colostrum and calf serum can be increased by means of selection

Psychological factors associated with changes in physical activity in Dutch people with type 2 diabetes under societal lockdown:A cross-sectional study

AIMS: To investigate changes in physical activity (PA) and psychological factors during societal lockdown in people with type 2 diabetes. METHODS: A cross‐sectional study among Dutch adults with type 2 diabetes. Data were collected using online questionnaires. A multivariate multinomial logistic regression was performed with change in PA during societal lockdown as outcome and perceived change in stress, anxiety, perceived risk for COVID‐19 infection, emotional well‐being and former PA status as determinants. RESULTS: Five hundred and sixty seven respondents filled out the questionnaire, 536 were included in the final analysis: mean age of 65.9 ± 7.9 years; mean diabetes duration 13.3 ± 8 years; 54% men; 47% reported no change in PA, 27% became less active and 26% became more active during societal lockdown. Participants who were more likely to become less active were participants who experienced more stress (OR: 2.27; 95% CI 1.25–4.13) or less stress (OR: 2.20; 95% CI 1.03–4.71). Participants who were more likely to become more active were participants who experienced more stress (OR: 2.31; 95% CI 1.25, 4.26). Participants with higher emotional well‐being (OR: 0.98; 95% CI 0.97, 0.99) were less likely to become less active than to report no change in PA. CONCLUSIONS: Changes in PA in people with type 2 diabetes during societal lockdown are associated with changes in psychological factors such as perceived stress and emotional well‐being. People with diabetes and their caregivers should be aware of these possible changes