359 research outputs found
Ontwikkelingen in de structuur van de landbouw in het noorden des lands
Een uitvoerig verslag van het onderzoek. De prognose en samenvatting hiervan zijn neergelegd in publikatie no. 2136. De bijlagen waarin in deze nota naar wordt verwezen, zijn afzonderlijk van de nota gebundeld
The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making
Purpose Decision-making and dexterity, features that become increasingly relevant in (robot-assisted) minimally invasive surgery, are considered key components in improving the surgical accuracy. Recently, DROP-IN gamma probes were introduced to facilitate radioguided robotic surgery. We now studied if robotic DROP-IN radioguidance can be further improved using tethered Click-On designs that integrate gamma detection onto the robotic instruments themselves. Methods Using computer-assisted drawing software, 3D printing and precision machining, we created a Click-On probe containing two press-fit connections and an additional grasping moiety for a ProGrasp instrument combined with fiducials that could be video tracked using the Firefly laparoscope. Using a dexterity phantom, the duration of the specific tasks and the path traveled could be compared between use of the Click-On or DROP-IN probe. To study the impact on surgical decision-making, we performed a blinded study, in porcine models, wherein surgeons had to identify a hidden Co-57-source using either palpation or Click-On radioguidance. Results When assembled onto a ProGrasp instrument, while preserving grasping function and rotational freedom, the fully functional prototype could be inserted through a 12-mm trocar. In dexterity assessments, the Click-On provided a 40% reduction in movements compared to the DROP-IN, which converted into a reduction in time, path length, and increase in straightness index. Radioguidance also improved decision-making; task-completion rate increased by 60%, procedural time was reduced, and movements became more focused. Conclusion The Click-On gamma probe provides a step toward full integration of radioguidance in minimal invasive surgery. The value of this concept was underlined by its impact on surgical dexterity and decision-making.Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas
Cost-effectiveness of continuous versus intermittent chemotherapy for patients with HER2-negative advanced breast cancer
Cost-effectiveness of continuous versus intermittent chemotherapy for patients with HER2-negative advanced breast cancer
What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey
Local authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (N=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services
Seeing the forest and the trees: a radio investigation of the ULIRG Mrk 273
Galaxy mergers have been observed to trigger nuclear activity by feeding gas to the central supermassive black hole. One such class of objects are Ultra Luminous InfraRed Galaxies (ULIRGs), which are mostly late stage major mergers of gas-rich galaxies. Recently, large-scale (∼100 kpc) radio continuum emission has been detected in a select number of ULIRGs, all of which also harbour powerful Active Galactic Nuclei (AGN). This hints at the presence of large-scale radio emission being evidence for nuclear activity. Exploring the origin of this radio emission and its link to nuclear activity requires high sensitivity multi-frequency data. We present such an analysis of the ULIRG Mrk 273. Using the International LOFAR telescope (ILT), we detected spectacular large-scale arcs in this system. This detection includes, for the first time, a giant ∼190 kpc arc in the north. We propose these arcs are fuelled by a low power radio AGN triggered by the merger. We also identified a bright ∼45 kpc radio ridge, which is likely related to the ionised gas nebula in that region. We combined this with high sensitivity data from APERture Tile In Focus (Apertif) and archival data from the Very Large Array (VLA) to explore the spectral properties. The ILT simultaneously allowed us to probe the nucleus at a resolution of ∼0.3″, where we detected three components, and, for the first time, diffuse emission around these components. Combining this with archival high frequency VLA images of the nucleus allowed us to detect absorption in one component, and a steep spectrum radio AGN in another. We then extrapolate from this case study to the importance of investigating the presence of radio emission in more ULIRGs and what it can tell us about the link between mergers and the presence of radio activity
A search for radio emission from double-neutron star merger GW190425 using Apertif
ContextDetection of the electromagnetic emission from coalescing binary neutron stars (BNS) is important for understanding the merger and afterglow. Aims. We present a search for a radio counterpart to the gravitational-wave (GW) source GW190425, a BNS merger, using Apertif on the Westerbork Synthesis Radio Telescope (WSRT). MethodsWe observed a field of high probability in the associated localisation region for three epochs at ΔT\ue2€., =\ue2€., 68, 90, 109 d post merger. We identified all sources that exhibit flux variations consistent with the expected afterglow emission of GW190425. We also looked for possible transients. These are sources that are only present in one epoch. In addition, we quantified our ability to search for radio afterglows in the fourth and future observing runs of the GW detector network using Monte Carlo simulations. ResultsWe found 25 afterglow candidates based on their variability. None of these could be associated with a possible host galaxy at the luminosity distance of GW190425. We also found 55 transient afterglow candidates that were only detected in one epoch. All of these candidates turned out to be image artefacts. In the fourth observing run, we predict that up to three afterglows will be detectable by Apertif. ConclusionsWhile we did not find a source related to the afterglow emission of GW190425, the search validates our methods for future searches of radio afterglows
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