73 research outputs found

    Competing Claims on Natural Resources: What Role for Science?

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    Competing claims on natural resources become increasingly acute, with the poor being most vulnerable to adverse outcomes of such competition. A major challenge for science and policy is to progress from facilitating univocal use to guiding stakeholders in dealing with potentially conflicting uses of natural resources. The development of novel, more equitable, management options that reduce rural poverty is key to achieving sustainable use of natural resources and the resolution of conflicts over them. Here, we describe an interdisciplinary and interactive approach for: (i) the understanding of competing claims and stakeholder objectives; (ii) the identification of alternative resource use options, and (iii) the scientific support to negotiation processes between stakeholders. Central to the outlined approach is a shifted perspective on the role of scientific knowledge in society. Understanding scientific knowledge as entering societal arenas and as fundamentally negotiated, the role of the scientist becomes a more modest one, a contributor to ongoing negotiation processes among stakeholders. Scientists can, therefore, not merely describe and explain resource-use dynamics and competing claims, but in doing so, they should actively contribute to negotiation processes between stakeholders operating at different scales (local, national, regional, and global). Together with stakeholders, they explore alternatives that can contribute to more sustainable and equitable use of natural resources and, where possible, design new technical options and institutional arrangements

    Flow cytometric immunobead assay for fast and easy detection of PML-RARA fusion proteins for the diagnosis of acute promyelocytic leukemia

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    The PML-RARA fusion protein is found in approximately 97% of patients with acute promyelocytic leukemia (APL). APL can be associated with life-threatening bleeding complications when undiagnosed and not treated expeditiously. The PML-RARA fusion protein arrests maturation of myeloid cells at the promyelocytic stage, leading to the accumulation of neoplastic promyelocytes. Complete remission can be obtained by treatment with all-trans-retinoic acid (ATRA) in combination with chemotherapy. Diagnosis of APL is based on the detection of t(15;17) by karyotyping, fluorescence in situ hybridization or PCR. These techniques are laborious and demand specialized laboratories. We developed a fast (performed within 4-5 h) and sensitive (detection of at least 10% malignant cells in normal background) flow cytometric immunobead assay for the detection of PML-RARA fusion proteins in cell lysates using a bead-bound anti-RARA capture antibody and a phycoerythrin-conjugated anti-PML detection antibody. Testing of 163 newly diagnosed patients (including 46 APL cases) with the PML-RARA immunobead assay showed full concordance with the PML-RARA PCR results. As the applied antibodies recognize outer domains of the fusion protein, the assay appeared to work independently of the PML gene break point region. Importantly, the assay can be used in parallel with routine immunophenotyping for fast and easy diagnosis of APL

    Comparison of outcome and characteristics between 6343 COVID-19 patients and 2256 other community-acquired viral pneumonia patients admitted to Dutch ICUs

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    Purpose: Describe the differences in characteristics and outcomes between COVID-19 and other viral pneumonia patients admitted to Dutch ICUs. Materials and methods: Data from the National-Intensive-Care-Evaluation-registry of COVID-19 patients admitted between February 15th and January 1th 2021 and other viral pneumonia patients admitted between January 1st 2017 and January 1st 2020 were used. Patients' characteristics, the unadjusted, and adjusted in-hospital mortality were compared. Results: 6343 COVID-19 and 2256 other viral pneumonia patients from 79 ICUs were included. The COVID-19 patients included more male (71.3 vs 49.8%), had a higher Body-Mass-Index (28.1 vs 25.5), less comorbidities (42.2 vs 72.7%), and a prolonged hospital length of stay (19 vs 9 days). The COVID-19 patients had a significantly higher crude in-hospital mortality rate (Odds ratio (OR) = 1.80), after adjustment for patient characteristics and ICU occupancy rate the OR was respectively 3.62 and 3.58. Conclusion: Higher mortality among COVID-19 patients could not be explained by patient characteristics and higher ICU occupancy rates, indicating that COVID-19 is more severe compared to other viral pneumonia. Our findings confirm earlier warnings of a high need of ICU capacity and high mortality rates among relatively healthy COVID-19 patients as this may lead to a higher mental workload for the staff. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/)

    Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

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    Scientific Assessment and Innovation in Neurosurgical Treatment Strategie
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