100 research outputs found

    Mechanische onkruidbestrijding in de gewasrijen

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    De resultaten van vijf jaar onderzoek naar de mechanische onkruidbestrijding in gewas rijen staan op een rij. De werkgroep Technische Aspecten bij het Grondbewerkingsonderzoek evalueerde de resultaten en trok conclusies voor de praktijk. Deze zijn in dit artikel in het kort weergegege

    Clinical prediction models for mortality in patients with covid-19: external validation and individual participant data meta-analysis

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    OBJECTIVE: To externally validate various prognostic models and scoring rules for predicting short term mortality in patients admitted to hospital for covid-19. DESIGN: Two stage individual participant data meta-analysis. SETTING: Secondary and tertiary care. PARTICIPANTS: 46 914 patients across 18 countries, admitted to a hospital with polymerase chain reaction confirmed covid-19 from November 2019 to April 2021. DATA SOURCES: Multiple (clustered) cohorts in Brazil, Belgium, China, Czech Republic, Egypt, France, Iran, Israel, Italy, Mexico, Netherlands, Portugal, Russia, Saudi Arabia, Spain, Sweden, United Kingdom, and United States previously identified by a living systematic review of covid-19 prediction models published in The BMJ, and through PROSPERO, reference checking, and expert knowledge. MODEL SELECTION AND ELIGIBILITY CRITERIA: Prognostic models identified by the living systematic review and through contacting experts. A priori models were excluded that had a high risk of bias in the participant domain of PROBAST (prediction model study risk of bias assessment tool) or for which the applicability was deemed poor. METHODS: Eight prognostic models with diverse predictors were identified and validated. A two stage individual participant data meta-analysis was performed of the estimated model concordance (C) statistic, calibration slope, calibration-in-the-large, and observed to expected ratio (O:E) across the included clusters. MAIN OUTCOME MEASURES: 30 day mortality or in-hospital mortality. RESULTS: Datasets included 27 clusters from 18 different countries and contained data on 46 914patients. The pooled estimates ranged from 0.67 to 0.80 (C statistic), 0.22 to 1.22 (calibration slope), and 0.18 to 2.59 (O:E ratio) and were prone to substantial between study heterogeneity. The 4C Mortality Score by Knight et al (pooled C statistic 0.80, 95% confidence interval 0.75 to 0.84, 95% prediction interval 0.72 to 0.86) and clinical model by Wang et al (0.77, 0.73 to 0.80, 0.63 to 0.87) had the highest discriminative ability. On average, 29% fewer deaths were observed than predicted by the 4C Mortality Score (pooled O:E 0.71, 95% confidence interval 0.45 to 1.11, 95% prediction interval 0.21 to 2.39), 35% fewer than predicted by the Wang clinical model (0.65, 0.52 to 0.82, 0.23 to 1.89), and 4% fewer than predicted by Xie et al's model (0.96, 0.59 to 1.55, 0.21 to 4.28). CONCLUSION: The prognostic value of the included models varied greatly between the data sources. Although the Knight 4C Mortality Score and Wang clinical model appeared most promising, recalibration (intercept and slope updates) is needed before implementation in routine care

    Effects of lay support for pregnant women with social risk factors on infant development and maternal psychological health at 12 months postpartum

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    Background The ELSIPS (Evaluation of Lay Support in Pregnant Women with Social Risk) RCT showed that lay support for women with social risk had a positive effect on maternal mental health and mother-infant bonding. This exploratory study examined whether these observed benefits would impact infant development at 1 year. Methods A sub-sample of women whose infants were under one year who had participated in the ELSIPS RCT which randomised women to receive either standard care or the services of a Pregnancy Outreach Worker (POW), and who were contactable, were eligible to participate in the follow up. At home visits, the Bayley Scales of Infant Development (3rd Edition) and standardised measures of depression, self efficacy, mind-mindedness and bonding were completed. Results 486 women were eligible for follow up, of whom 154 agreed to participate. 61/273 were successfully followed up in the standard maternity care arm and 51/213 in the POW arm. Women who completed follow up were less depressed and had higher selfefficacy scores at 8–12 weeks postpartum than those who did not complete follow up. There were no significant differences in maternal outcomes, infant cognitive development, receptive communication, expressive communication, fine motor development or social/emotional functioning between groups at 12 month follow up. Infants of mothers who received the POW intervention had significantly better gross motor development than infants whose mothers received standard care (p<0.03)

    Maternal common mental disorders and infant development in Ethiopia : the P-MaMiE Birth Cohort

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    Background: Chronicity and severity of early exposure to maternal common mental disorders (CMD) has been associated with poorer infant development in high-income countries. In low- and middle-income countries (LAMICs), perinatal CMD is inconsistently associated with infant development, but the impact of severity and persistence has not been examined. Methods: A nested population-based cohort of 258 pregnant women was identified from the Perinatal Maternal Mental Disorder in Ethiopia (P-MaMiE) study, and 194 (75.2%) were successfully followed up until the infants were 12 months of age. Maternal CMD was measured in pregnancy and at two and 12 months postnatal using the WHO Self-Reporting Questionnaire, validated for use in this setting. Infant outcomes were evaluated using the Bayley Scales of Infant Development. Results: Antenatal maternal CMD symptoms were associated with poorer infant motor development ( β ^ -0.20; 95% CI: -0.37 to -0.03), but this became non-significant after adjusting for confounders. Postnatal CMD symptoms were not associated with any domain of infant development. There was evidence of a dose-response relationship between the number of time-points at which the mother had high levels of CMD symptoms (SRQ ≥ 6) and impaired infant motor development ( β ^ = -0.80; 95%CI -2.24, 0.65 for ante- or postnatal CMD only, β ^ = -4.19; 95%CI -8.60, 0.21 for ante- and postnatal CMD, compared to no CMD; test-for-trend χ213.08(1), p < 0.001). Although this association became non-significant in the fully adjusted model, the β ^ coefficients were unchanged indicating that the relationship was not confounded. In multivariable analyses, lower socio-economic status and lower infant weight-for-age were associated with significantly lower scores on both motor and cognitive developmental scales. Maternal experience of physical violence was significantly associated with impaired cognitive development. Conclusions: The study supports the hypothesis that it is the accumulation of risk exposures across time rather than early exposure to maternal CMD per se that is more likely to affect child development. Further investigation of the impact of chronicity of maternal CMD upon child development in LAMICs is indicated. In the Ethiopian setting, poverty, interpersonal violence and infant undernutrition should be targets for interventions to reduce the loss of child developmental potential.Peer Reviewe

    Iliocaval venous obstruction, cardiac preload reserve, and exercise limitation

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    Cardiac output during exercise increases by as much as five-fold in the untrained man, and by as much as eight-fold in the elite athlete. Increasing venous return is a critical but much overlooked component of the physiological response to exercise. Cardiac disorders such as constrictive pericarditis, restrictive cardiomyopathy and pulmonary hypertension are recognised to impair preload and cause exercise limitation, however the effects of peripheral venous obstruction on cardiac function have not been well described. This manuscript will discuss how obstruction of the iliocaval venous outflow can lead to impairment in exercise tolerance; how such obstructions may be diagnosed, the potential implications of chronic obstructions on sympathetic nervous system activation, and relevance of venous compression syndromes in heart failure with preserved ejection fraction

    Functionality of thermally hydrogen-passivated interfaces of oxidized crystalline arrays of Si nanowires on (100)Si

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    Electron spin resonance studies have been performed on arrays of single-crystalline Si nanowires (NWs), 375 nm long and of top diameter of about 5 nm, fabricated on (100)Si by top-down etching and final thinning by thermal oxidation in dry O2/N2 at 1150 C1150\ ^{\circ}\text{C} . The SiO2/SiNW interfaces, showing a density of inherent electrically detrimental Pb0 (Si3Si)P_{b0}\ (\text{Si}_{3}\equiv{}\text{Si}^{\bullet}) defects substantially exceeding that of standard technological (100)Si/SiO2, are of inferior electrical quality. An extensive study of the passivation kinetics in H2 and forming gas ambient reveals that, even under optimized conditions, the defect system cannot be inactivated to device grade (at best, 40×40\times improvement in H2), due to the excessive interface stress as exposed by the enhanced spread in activation energy for hydrogen passivation kinetics. The data reveal the inability, of intrinsic nature, to sufficiently suppress Pb0P_{b0} defects, preventing to reach device-grade functioning of solar cells using single-crystalline NW arrays on (100)Si in the current state of manufacturing

    Advies robuuste verbinding Nieuwe Hollandse Waterlinie

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    In opdracht van de Dienst Landelijk Gebied is het ontwerp voor een robuuste ecologische verbinding tussen de Biesbosch en Loevestein / Munnikenland getoetst. Onderzocht is of de geplande verbinding aan de ontwerprichtlijnen voor robuuste verbindingen voldoet en met welke aanpassingen het functioneren van de verbindingszone eventueel zou kunnen worden verbeterd. Tevens is onderzocht of de inrichting van de robuuste verbinding aansluit bij of conflicteert met de wensen voor landschapsinrichting vanuit het herstelplan Nieuwe Hollandse Waterlinie

    Advies robuuste verbinding Nieuwe Hollandse Waterlinie

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    In opdracht van de Dienst Landelijk Gebied is het ontwerp voor een robuuste ecologische verbinding tussen de Biesbosch en Loevestein / Munnikenland getoetst. Onderzocht is of de geplande verbinding aan de ontwerprichtlijnen voor robuuste verbindingen voldoet en met welke aanpassingen het functioneren van de verbindingszone eventueel zou kunnen worden verbeterd. Tevens is onderzocht of de inrichting van de robuuste verbinding aansluit bij of conflicteert met de wensen voor landschapsinrichting vanuit het herstelplan Nieuwe Hollandse Waterlinie
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