Species-environment relationship in marine soft-bottom communities: regression modeling and the implications of scale

A literature study was performed aiming to explore the relation between the spatial scale of marine benthic surveys and the observed goodness-of-fit of regression models relating animal abundance to the environment. A further objective was to tabulate the abiotic factors and processes that predominantly explain the variation in abundance and to examine whether or not the type of important factors differ in relation to the scale of the study. Single studies in which benthos-environment regression models were applied at different spatial scales and which would have allowed a within-study comparison of the goodness-of-fit in relation to scale, were not found. The paucity of studies that reported quantitative information and, if they did so, the use of a variety of incomparable statistical models resulted in very few observations and a lack of statistical power of the (between-study) relation between scale and goodness-of-fit. Most studies confirmed the importance of sediment characteristics and elevation (in case of intertidal areas) or water depth (in case of subtidal areas) in determining the benthos. Further studies on the importance of the spatial scale of marine benthos-environment surveys should be based on a unified analytical approach, which can only be realized if original data are available

Management of asthma in primary care

Asthma is a common non-communicable respiratory disease. In this thesis we analysed three different management strategies for adult patients with asthma in primary care. In the first, we targeted the currently recommended aim of __Controlled asthma__, which means patients experience hardly any symptoms. The second targeted __Partly Controlled asthma__, which allowed some symptoms. The third additionally used a FeNO-measurement to assess current control. Aiming for Partly Controlled asthma significantly reduced medication usage compared to Controlled asthma, while exacerbation-rate, quality of life and asthma control were similar. FeNO-guided Controlled asthma also significantly reduced medication usage compared to Controlled asthma and additionally significantly improved asthma control compared to Partly Controlled asthma. Aiming for FeNO-guided Controlled asthma is therefore the optimal strategy. In this thesis we also analysed daily measurements of symptoms and peak-flow, which are recorded in Written Asthma Action Plans, or in apps. Hereby we were able to predict future asthma exacerbations several days in advance with reasonable accuracy. Finally, we compared an online assessment of asthma control by a questionnaire with the results of the same questionnaire assessed by a practice nurse. We showed that asthma control is perceived as better when interacting with a caregiver than by online self-assessment.Zon-MW LongfondsUBL - phd migration 201

MyAirCoach: The use of home-monitoring and mHealth systems to predict deterioration in asthma control and the occurrence of asthma exacerbations; Study protocol of an observational study

© Published by the BMJ Publishing Group Limited. Introduction Asthma is a variable lung condition whereby patients experience periods of controlled and uncontrolled asthma symptoms. Patients who experience prolonged periods of uncontrolled asthma have a higher incidence of exacerbations and increased morbidity and mortality rates. The ability to determine and to predict levels of asthma control and the occurrence of exacerbations is crucial in asthma management. Therefore, we aimed to determine to what extent physiological, behavioural and environmental data, obtained by mobile healthcare (mHealth) and home-monitoring sensors, as well as patient characteristics, can be used to predict episodes of uncontrolled asthma and the onset of asthma exacerbations. Methods and analysis In an 1-year observational study, patients will be provided with mHealth and home-monitoring systems to record daily measurements for the first-month (phase I) and weekly measurements during a follow-up period of 11 months (phase II). Our study population consists of 150 patients, aged ≥18 years, with a clinician's diagnosis of asthma, currently on controller medication, with uncontrolled asthma and/or minimally one exacerbation in the past 12 months. They will be enrolled over three participating centres, including Leiden, London and Manchester. Our main outcomes are the association between physiological, behavioural and environmental data and (1) the loss of asthma control and (2) the occurrence of asthma exacerbations. Ethics This study was approved by the Medical Ethics Committee of the Leiden University Medical Center in the Netherlands and by the NHS ethics service in the UK. Trial registration number NCT02774772

Lamivudine Treatment for Chronic Hepatitis B

The hepatitis B virus (HBV) is one of the smallest human viruses known and belongs to the family of Hepadnaviridae; it was the first human hepatitis virus that could be characterized. Before the discovery of the virus two types of transmission of infectious hepatitis were distinguished on the basis of epidemiological observations: the classical hepatitis (type A) was transmitted by the faecal-oral route, while type B was transmitted parentally.' In 1963, B8 Blumberg discovered a previously unknown antigen in the blood of an Australian aboriginal (Australia antigen) and within a few years this was found to be related to the parentally transmitted type B hepatitis.' In the early seventies the virus was seen by electron microscopy3 and the genome was found to be a small, circular DNA that was partially double-stranded (figure I). The nucleotide sequence of the virus contains only 3200 nucleotides (3.2 kb) and revealed 4 overlapping genes for the production of seven viral proteins

ERS International congress, Madrid, 2019: Highlights from the General Pneumology Assembly

This article contains highlights and a selection of the scientific advances from the European Respiratory Society's General Pneumology Assembly that were presented at the 2019 European Respiratory Society International Congress in Madrid, Spain. The most relevant topics from the different groups will be discussed, covering a wide range of areas including rehabilitation and chronic care, general practice and primary care and M-health and E-health. In this review, the newest research and actual data as well as award-winning abstracts and highlight sessions will be discussed

p53 and P-glycoprotein are often co-expressed and are associated with poor prognosis in breast cancer.

Expression of both P-glycoprotein (P-gp) and mutant p53 have recently been reported to be associated with poor prognosis of breast cancer. The expression of P-gp is associated in vitro and in vivo with cross-resistance to several anti-cancer drugs. p53 plays a regulatory role in apoptosis, and mutant p53 has been suggested to be involved in drug resistance. Interestingly, in vitro experiments have shown that mutant p53 can activate the promoter of the MDR1 gene, which encodes P-gp. We investigated whether p53 and P-gp are simultaneously expressed in primary breast cancer cells and analysed the impact of the co-expression on patients prognosis. Immunohistochemistry was used to investigate P-gp expression (JSB-1, C219) and nuclear p53 accumulation (DO-7) in 20 operable chemotherapy untreated and 30 locally advanced breast cancers undergoing neoadjuvant chemotherapy with doxorubicin and cyclophosphamide. Double immunostaining showed that P-gp expression and nuclear p53 accumulation often occur concomitantly in the same tumour cells. A correlation between p53 and P-gp expression was found in all 50 breast cancers (P = 0.003; Fisher's exact test). P-gp expression, nuclear p53 accumulation, and co-expression of p53 and P-gp were more frequently observed in locally advanced breast cancers than in operable breast cancers (P = 0.0004, P = 0.048; P = 0.002 respectively. Fisher's exact test). Co-expression of p53 and P-gp was the strongest prognostic factor for shorter survival by multivariate analysis (P = 0.004) in the group of locally advanced breast cancers (univariate analysis: P = 0.0007). Only 3 out of 13 samples sequentially taken before and after chemotherapy displayed a change in P-gp or p53 staining. In conclusion, nuclear p53 accumulation is often associated with P-gp expression in primary breast cancer, and simultaneous expression of p53 and P-gp is associated with shorter survival in locally advanced breast cancer patients. Co-expression of P-gp and mutant p53 belong to a series of molecular events resulting in a more aggressive phenotype, drug resistance and poor prognosis