756 research outputs found
Neo-Atlantis: Dutch Responses to Five Meter Sea Level Rise
What would happen to the Netherlands if, in 2030, the sea level starts to rise and eventually, after 100 years, a sea level of five meters above current level would be reached? Two socio-economic scenarios are developed from a literature review and by interviews with researchers and practicionersin the domains of social sciences, economics, civil engineering, and land use planning. One scenario describes what would happen in a future characterised by a trend towards further globalisation, marketisation and high economic growth, while the other scenario happens in a future under opposite trends. Under both scenarios, the Southwest and Northwest of the Netherlands – already now below seal level - would be abandoned because of sea level rise. Although most experts believe that geomorphology and current engineering skills allow to largely maintain the territorial integrity of the Netherlands, there are some reasons to assume that this is not likely to happen. Social processes that precede important political decisions – such as the growth of the belief in the reality of SLR and the framing of such decision in a proper political context (policy window) – evolve slowly. Although a flood disaster would speed up decision-making, the general expectation is that decisions would come too late in view of the rate of SLR and the possible pace of construction of works.Extreme sea level rise, The Netherlands, flood defences
Time-Series Intervention Analysis Using ITSACORR: Fatal Flaws
The ITSACORR method (Crosbie, 1993, 1995) is evaluated for the analysis of two-phase interrupted time-series designs. It is shown that each component of the ITSACORR framework (including the structural model, the design matrix, the autocorrelation estimator, the ultimate parameter estimation scheme, and the inferential method) contains fatal flaws
Nucleation and crystallization process of silicon using Stillinger-Weber potential
We study the homogeneous nucleation process in Stillinger-Weber silicon in
the NVT ensemble. A clear first-order transition from the liquid to crystal
phase is observed thermodynamically with kinetic and structural evidence of the
transformation. At 0.75 T_m, the critical cluster size is about 175 atoms. The
lifetime distribution of clusters as a function of the maximum size their reach
follows an inverse gaussian distribution as was predicted recently from the
classical theory of nucleation (CNT). However, while there is a qualitative
agreement with the CNT, the free energy curve obtained from the simulations
differs significantly from the theoretical predictions, suggesting that the
low-density liquid phase found recently could play a role in the nucleation
process.Comment: 21 page
Efficient routing on complex networks
In this letter, we propose a new routing strategy to improve the
transportation efficiency on complex networks. Instead of using the routing
strategy for shortest path, we give a generalized routing algorithm to find the
so-called {\it efficient path}, which considers the possible congestion in the
nodes along actual paths. Since the nodes with largest degree are very
susceptible to traffic congestion, an effective way to improve traffic and
control congestion, as our new strategy, can be as redistributing traffic load
in central nodes to other non-central nodes. Simulation results indicate that
the network capability in processing traffic is improved more than 10 times by
optimizing the efficient path, which is in good agreement with the analysis.Comment: 4 pages, 4 figure
High exposures to bioactivated cyclophosphamide are related to the occurrence of veno-occlusive disease of the liver following high-dose chemotherapy
We investigated whether the occurrence of veno-occlusive disease of the liver (VOD) may be associated with individual variations in the pharmacokinetics of high-dose cyclophosphamide. Patients received single or multiple courses of cyclophosphamide (1000 or 1500 mg m−2 day−1), thiotepa (80 or 120 mg m−2 day−1) and carboplatin (265–400 mg m−2 day−1) (CTC) for 4 consecutive days. The area under the plasma concentration–time curves (AUCs) were calculated for cyclophosphamide and its activated metabolites 4-hydroxycyclophosphamide and phosphoramide mustard based on multiple blood samples. Possible relationships between the AUCs and the occurrence of VOD were studied. A total of 59 patients (115 courses) were included. Four patients experienced VOD after a second CTC course. The first-course AUC of 4-hydroxycyclophosphamide (P=0.003) but not of phosphoramide mustard (P=0.101) appeared to be predictive of the occurrence of VOD after multiple courses. High exposures to bioactivated cyclophosphamide may lead to increased organ toxicity
Bosutinib in Resistant and Intolerant Pediatric Patients With Chronic Phase Chronic Myeloid Leukemia: Results From the Phase I Part of Study ITCC054/COG AAML1921
Pediatric patients; Intolerant; Chronic myeloid leukemiaPacientes pediátricos; Intolerantes; Leucemia mieloide crónicaPacients pediàtrics; Intolerants; Leucèmia mieloide crònicaPurpose
Bosutinib is approved for adults with chronic myeloid leukemia (CML): 400 mg once daily in newly diagnosed (ND); 500 mg once daily in resistant/intolerant (R/I) patients. Bosutinib has a different tolerability profile than other tyrosine kinase inhibitors (TKIs) and potentially less impact on growth (preclinical data). The primary objective of this first-in-child trial was to determine the recommended phase II dose (RP2D) for pediatric R/I and ND patients.
Patients and Methods
In the phase I part of this international, open-label trial (ClinicalTrials.gov identifier: NCT04258943), children age 1-18 years with R/I (per European LeukemiaNet 2013) Ph+ CML were enrolled using a 6 + 4 design, testing 300, 350, and 400 mg/m2 once daily with food. The RP2D was the dose resulting in 0/6 or 1/10 dose-limiting toxicities (DLTs) during the first cycle and achieving adult target AUC levels for the respective indication. As ND participants were only enrolled in phase II, the ND RP2D was selected based on data from R/I patients.
Results
Thirty patients were enrolled; 27 were evaluable for DLT: six at 300 mg/m2, 11 at 350 mg/m2 (one DLT), and 10 at 400 mg/m2 (one DLT). The mean AUCs at 300 mg/m2, 350 mg/m2, and 400 mg/m2 were 2.20 μg h/mL, 2.52 μg h/mL, and 2.66 μg h/mL, respectively. The most common adverse event was diarrhea (93%; ≥grade 3: 11%). Seven patients stopped because of intolerance and eight because of insufficient response. Complete cytogenetic and major molecular response to bosutinib appeared comparable with other published phase I/II trials with second-generation TKIs in children.
Conclusion
Bosutinib was safe and effective. The pediatric RP2D was 400 mg/m2 once daily (max 600 mg/d) with food in R/I patients and 300 mg/m2 once daily (max 500 mg/d) with food in ND patients, which achieved targeted exposures as per adult experience.Sponsorship for the study was provided by Erasmus MC/Sophia Children's Hospital, Department of Pediatrics, Rotterdam, the Netherlands
Comparing static and dynamic emotion recognition tests:Performance of healthy participants
Facial expressions have a communicatory function and the ability to read them is a prerequisite for understanding feelings and thoughts of other individuals. Impairments in recognition of facial emotional expressions are frequently found in patients with neurological conditions (e.g. stroke, traumatic brain injury, frontotemporal dementia). Hence, a standard neuropsychological assessment should include measurement of emotion recognition. However, there is debate regarding which tests are most suitable. The current study evaluates and compares three different emotion recognition tests. 84 healthy participants were included and assessed with three tests, in varying order: a. Ekman 60 Faces Test (FEEST) b. Emotion Recognition Task (ERT) c. Emotion Evaluation Test (EET). The tests differ in type of stimuli from static photographs (FEEST) to more dynamic stimuli in the form of morphed photographs (ERT) to videos (EET). Comparing performances on the three tests, the lowest total scores (67.3% correct answers) were found for the ERT. Significant, but moderate correlations were found between the total scores of the three tests, but nearly all correlations between the same emotions across different tests were not significant. Furthermore, we found cross-over effects of the FEEST and EET to the ERT; participants attained higher total scores on the ERT when another emotion recognition test had been administered beforehand. Moreover, the ERT proved to be sensitive to the effects of age and education. The present findings indicate that despite some overlap, each emotion recognition test measures a unique part of the construct. The ERT seemed to be the most difficult test: performances were lowest and influenced by differences in age and education and it was the only test that showed a learning effect after practice with other tests. This highlights the importance of appropriate norms
Emotion Recognition and Traffic-Related Risk-Taking Behavior in Patients with Neurodegenerative Diseases
Objectives : Neurodegenerative diseases (NDDs), such as Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies, and Huntington's disease, inevitably lead to impairments in higher-order cognitive functions, including the perception of emotional cues and decision-making behavior. Such impairments are likely to cause risky daily life behavior, for instance, in traffic. Impaired recognition of emotional expressions, such as fear, is considered a marker of impaired experience of emotions. Lower fear experience can, in turn, be related to risk-taking behavior. The aim of our study was to investigate whether impaired emotion recognition in patients with NDD is indeed related to unsafe decision-making in risky everyday life situations, which has not been investigated yet. Methods: Fifty-one patients with an NDD were included. Emotion recognition was measured with the Facial Expressions of Emotions: Stimuli and Test (FEEST). Risk-taking behavior was measured with driving simulator scenarios and the Action Selection Test (AST). Data from matched healthy controls were used: FEEST (n = 182), AST (n = 36), and driving simulator (n = 18). Results: Compared to healthy controls, patients showed significantly worse emotion recognition, particularly of anger, disgust, fear, and sadness. Furthermore, patients took significantly more risks in the driving simulator rides and the AST. Only poor recognition of fear was related to a higher amount of risky decisions in situations involving a direct danger. Conclusions: To determine whether patients with an NDD are still fit to drive, it is crucial to assess their ability to make safe decisions. Measuring emotion recognition may be a valuable contribution to this judgment
Crystallization of a supercooled liquid and of a glass - Ising model approach
Using Monte Carlo simulations we study crystallization in the
three-dimensional Ising model with four-spin interaction. We monitor the
morphology of crystals which grow after placing crystallization seeds in a
supercooled liquid. Defects in such crystals constitute an intricate and very
stable network which separate various domains by tensionless domain walls. We
also show that the crystallization which occurs during the continuous heating
of the glassy phase takes place at a heating-rate dependent temperature.Comment: 7 page
Reducing pain in children with cancer at home:a feasibility study of the KLIK pain monitor app
Purpose This study assessed adherence to, feasibility of, and barriers and facilitators of implementation of an app developed to monitor and follow-up with pain in children with cancer at home. Methods Children (8-18 years) receiving cancer treatment (all diagnoses) or their parents (of children aged 0-7 years) used the KLIK Pain Monitor app for 3 weeks. Pain was assessed twice daily using an 11-point numeric rating scale (NRS-11) (ranging from 0 to 10). Healthcare professionals (HCP's) from the hospital's Pediatric Pain Service were instructed to follow-up with clinically significant pain scores (>= 4) within 120 min (scores 4-6) or 30 min (scores 7-10). Adherence, feasibility, and implementation outcomes were assessed using questionnaires, app log data, and interviews. Results Twenty-seven children (M age = 7.3 years, 51.8% male) and six HCP's participated. Sixty-three percent (N = 17) of families used the app on a daily basis during three weeks, and 18.5% (N = 5) reported pain scores twice daily during that time (family adherence). Twelve out of 27 children (44.4%) reported a clinically significant pain score at least once. In 70% (14/20) of clinically significant pain scores, HCP's followed-up with families within the set timeframe (HCP adherence). Outcomes reveal feasibility for the majority of app functions (i.e., positive evaluation by >= 70% families/HCP's), and non-feasible aspects could be resolved. Identified barriers and facilitators were used to improve future implementation efforts. Conclusion Use of the KLIK Pain Monitor app seems feasible. Future research will determine its effectiveness in reducing pain in children with cancer at home
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