Structural Game Characteristics and Problematic Gaming:Introduction of the Risk Characteristics Checklist for Games (RCCG)

Introduction: The current state of research suggests that personal, environmental, and product-related risk factors contribute to the development and maintenance of gaming disorder. Concerning game related risk factors, evidence points to certain game features contributing to the overall risk of gaming disorder, as for example reward features, social features, and monetization features. However, no standardized instrument is available to capture risk enhancing game characteristics. Methods: Based on theoretical considerations and stepwise conducted qualitative analyses of in-game content, risk-enhancing game features were identified and specified. Furthermore, a pilot study was conducted comprising N = 4,468 students (M[Age] = 14.54 years, SD = 1.37 years). Game features of the preferred games of the students were analyzed regarding their predictive value of gaming disorder. Results: Data suggests that two features are associated most strongly with gaming disorder: 1) mandatory social interactions (β = .20), and 2) number of reward categories (β = .12). Based on these findings and further updates, the RCCG was refined and finalized. Conclusions: With the RCCG, a structured instrument to capture, describe, and evaluate risk enhancing structural characteristics of video games is available. The RCCG enables a general risk assessment of games as well as recommended age-classifications based on certain structural features unsuitable for specific age groups

Longitudinal magnon in the tetrahedral spin system Cu2Te2O5Br2 near quantum criticality

We present a comprehensive study of the coupled tetrahedra-compound Cu2Te2O5Br2 by theory and experiments in external magnetic fields. We report the observation of a longitudinal magnon in Raman scattering in the ordered state close to quantum criticality. We show that the excited tetrahedral-singlet sets the energy scale for the magnetic ordering temperature T_N. This energy is determined experimentally. The ordering temperature T_N has an inverse-log dependence on the coupling parameters near quantum criticality

Methicillin-Resistant Staphylococcus aureus in Meat Products, the Netherlands

A new methicillin-resistant Staphylococcus aureus (MRSA) clone related to pig and cattle farming was detected in the Netherlands. We investigated the extent of S. aureus presence in meat and found 36 S. aureus strains in 79 samples. Two strains were MRSA; 1 was multilocus sequence type 398, the clone related to farming

Student Success at the University of Pretoria, 2009-2019: A Systemic, Intentional and Data-Informed Strategy

Preface: In essence, the publication provides an exposé of the evolution of an increasingly complex and comprehensive student success strategy developed by a South African university (viz the University of Pretoria). The problem facing the University in 2009 was common across the higher education sector in South Africa: the phenomenon of student success. This publication is a case study or series of case studies of how the University of Pretoria intentionally integrated its student support and development programmes between 2009 and 2019, and how it innovated and improved the holistic programme over the decade. The outcome was a gradual increase in the student success rate as measured by both module pass percentage (defined as the number of students who passed v the number who enrolled for the module) and minimum time to completion of individual cohorts (‘cohort’ defined as a group of first-time entering students followed through to graduation). The chapter reflects on contextualised approaches to student success initiatives that are similar to those found at other institutions, nationally and internationally. Using case studies shows how initiatives develop over time within a unique context, as well as challenges and successes. This publication has both a descriptive and exploratory approach in its case studies. Existing but siloed initiatives within the University were uncovered, interrogated, improved and integrated into a broader programme between 2009 and 2019. The cases might provide some insights into the phenomenon of student success that other South African institutions could contextualise

Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative

Background: The increasing sub-classification of cancer patients due to more detailed molecular classification of tumors, and limitations of current trial designs, require innovative research designs. We present the design, governance and current standing of three comprehensive nationwide cohorts including pancreatic, esophageal/gastric, and colorectal cancer patients (NCT02070146). Multidisciplinary collection of clinical data, tumor tissue, blood samples, and patient-reported outcome (PRO) measures with a nationwide coverage, provides the infrastructure for future and novel trial designs and facilitates research to improve outcomes of gastrointestinal cancer patients. Material and methods: All patients aged ≥18 years with pancreatic, esophageal/gastric or colorectal cancer are eligible. Patients provide informed consent for: (1) reuse of clinical data; (2) biobanking of primary tumor tissue; (3) collection of blood samples; (4) to be informed about relevant newly identified genomic aberrations; (5) collection of longitudinal PROs; and (6) to receive information on new interventional studies and possible participation in cohort multiple randomized controlled trials (cmRCT) in the future. Results: In 2015, clinical data of 21,758 newly diagnosed patients were collected in the Netherlands Cancer Registry. Additional clinical data on the surgical procedures were registered in surgical audits for 13,845 patients. Within the first two years, tumor tissue and blood samples were obtained from 1507 patients; during this period, 1180 patients were included in the PRO registry. Response rate for PROs was 90%. The consent rate to receive information on new interventional studies and possible participation in cmRCTs in the future was >85%. The number of hospitals participating in the cohorts is steadily increasing. Conclusion: A comprehensive nationwide multidisciplinary gastrointestinal cancer cohort is feasible and surpasses the limitations of classical study designs. With this initiative, novel and innovative studies can be performed in an efficient, safe, and comprehensive setting

Penumbral Rescue by normobaric O = O administration in patients with ischemic stroke and target mismatch proFile (PROOF): Study protocol of a phase IIb trial.

Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs. PROOF investigates the use of normobaric oxygen (NBO) therapy within 6 h of symptom onset/notice for brain-protective bridging until endovascular revascularization of acute intracranial anterior-circulation occlusion. Randomized (1:1), standard treatment-controlled, open-label, blinded endpoint, multicenter adaptive phase IIb trial. Primary outcome is ischemic core growth (mL) from baseline to 24 h (intention-to-treat analysis). Secondary efficacy outcomes include change in NIHSS from baseline to 24 h, mRS at 90 days, cognitive and emotional function, and quality of life. Safety outcomes include mortality, intracranial hemorrhage, and respiratory failure. Exploratory analyses of imaging and blood biomarkers will be conducted. Using an adaptive design with interim analysis at 80 patients per arm, up to 456 participants (228 per arm) would be needed for 80% power (one-sided alpha 0.05) to detect a mean reduction of ischemic core growth by 6.68 mL, assuming 21.4 mL standard deviation. By enrolling endovascular thrombectomy candidates in an early time window, the trial replicates insights from preclinical studies in which NBO showed beneficial effects, namely early initiation of near 100% inspired oxygen during short temporary ischemia. Primary outcome assessment at 24 h on follow-up imaging reduces variability due to withdrawal of care and early clinical confounders such as delayed extubation and aspiration pneumonia. ClinicalTrials.gov: NCT03500939; EudraCT: 2017-001355-31

Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative

Background: The increasing sub-classification of cancer patients due to more detailed molecular classification of tumors, and limitations of current trial designs, require innovative research designs. We present the design, governance and current standing of three comprehensive nationwide cohorts including pancreatic, esophageal/gastric, and colorectal cancer patients (NCT02070146). Multidisciplinary collection of clinical data, tumor tissue, blood samples, and patient-reported outcome (PRO) measures with a nationwide coverage, provides the infrastructure for future and novel trial designs and facilitates research to improve outcomes of gastrointestinal cancer patients. Material and methods: All patients aged ≥18 years with pancreatic, esophageal/gastric or colorectal cancer are eligible. Patients provide informed consent for: (1) reuse of clinical data; (2) biobanking of primary tumor tissue; (3) collection of blood samples; (4) to be informed about relevant newly identified genomic aberrations; (5) collection of longitudinal PROs; and (6) to receive information on new interventional studies and possible participation in cohort multiple randomized controlled trials (cmRCT) in the future. Results: In 2015, clinical data of 21,758 newly diagnosed patients were collected in the Netherlands Cancer Registry. Additional clinical data on the surgical procedures were registered in surgical audits for 13,845 patients. Within the first two years, tumor tissue and blood samples were obtained from 1507 patients; during this period, 1180 patients were included in the PRO registry. Response rate for PROs was 90%. The consent rate to receive information on new interventional studies and possible participation in cmRCTs in the future was >85%. The number of hospitals participating in the cohorts is steadily increasing. Conclusion: A comprehensive nationwide multidisciplinary gastrointestinal cancer cohort is feasible and surpasses the limitations of classical study designs. With this initiative, novel and innovative studies can be performed in an efficient, safe, and comprehensive setting

Is the 23-valent pneumococcal polysaccharide vaccine useful in preventing community-acquired pneumonia?

Podeu consultar el llibre complet a: http://hdl.handle.net/2445/32393Although bacteremic pneumococcal pneumonia is the most severe form of pneumonia, non-bacteremic forms are much more frequent. Laboratory methods for the diagnosis of nonbacteremic pneumococcal pneumonia have a low sensitivity and specificity, and therefore all-cause pneumonia has been proposed as a suitable outcome to evaluate vaccination effectiveness. This work reviews the epidemiology of community-acquired pneumonia (CAP) and evaluates the effectiveness of the 3-valent pneumococcal polysaccharide vaccine (PPV-23) in preventing CAP requiring hospitalization in people aged ≥65 years. We performed a case-control study in patients aged ≥65 years admitted through the emergency department who presented with clinical signs and symptoms compatible with pneumonia. We included 489 cases and 1,467 controls and it was obtained a vaccine efectiveness of 23.6 (0.9-41.0). Our results suggest that PPV-23 vaccination is effective and reduces hospital admissions due to pneumonia in the elderly, strengthening the rationale for vaccination programmes in this age group

[The effectiveness of disease management in diabetes: a meta-analysis]

Item does not contain fulltextOBJECTIVE: Systematic evaluation of the effectiveness of innovative care concepts for diabetes, taking into account heterogeneity of study results. DESIGN: Systematic review, meta-analysis and meta-regression analysis. METHOD: Medline, CINAHL and PsycINFO were searched for reviews and empirical studies into adult patients with diabetes in whom interventions were used that consisted of a minimum of 2 components from the Chronic Care Model. In the meta-analysis, a random-effects model was used to pool results on HbA1c and systolic blood pressure. Meta-regression analysis was used to examine the extent to which 3 differences in study design - (a) methodological quality, (b) length of follow-up, and (c) number of intervention components - could explain the heterogeneity in effect measures. RESULTS: The reviews (n = 15) generally reported modest improvements in glycaemic control. The empirical studies (n = 56) differed greatly in the direction and magnitude of measured effects on HbA1c (mean: -5 mmol/mol; 95% CI: -7- -3.5) and systolic blood pressure (mean: -2.8 mmHg; 95% CI: -4.7- -0.95). Variation in methodological quality between the studies could not explain this. Short-term studies (/= 1 year), but this difference was not significant. The variation in the number of intervention components explained 8-12% of the heterogeneity in effects of diabetes care innovations. CONCLUSION: Diabetes care interventions that include more than 2 components have the most positive effects on clinical outcomes. Considering the connection between length of follow-up and results as well as the fact that the targets of these innovations focus primarily on the future, the impact of such interventions should be measured in the long term

Hydroxyapatite does not improve the outcome of a bipolar hemiarthroplasty.

In a one-surgeon study the clinical and radiographic results of 30 cementless bipolar hip prostheses in 24 patients younger than 55 years were evaluated. Eleven noncoated prostheses (Noncoated Group) and 19 hydroxyapatite-coated prostheses (Hydroxyapatite Group) were compared after a mean followup of 10.4 years. The Harris hip score increased from a preoperative average of 41 points to 76 points at final followup (Noncoated Group, 70 points; Hydroxyapatite Group, 80 points). Thigh or groin pain was present in 15 patients (16 hips) (Noncoated Group, 55%; Hydroxyapatite Group, 53%). Radiographically, subsidence was the major problem at the noncoated prostheses (Noncoated Group, 91%; Hydroxyapatite Group, 5%), whereas osteolysis mainly was seen at the hydroxyapatite-coated prostheses (Noncoated Group, 18%; Hydroxyapatite Group, 89%). The obtained aseptic revision rate of 27% (Noncoated Group, 27%; Hydroxyapatite Group, 26%) is too high to use this implant in young patients. The large amounts of polyethylene wear debris generated by the bipolar system play an important role in this limited success. In the initially well-fixed hydroxyapatite-coated prostheses the sealing effect of a hydroxyapatite coating creates high concentrations of polyethylene in the limited joint space, resulting in massive proximal femoral osteolysis. Consequently, a hydroxyapatite coating introduces a new failure mechanism. Therefore, hydroxyapatite does not improve the outcome of a cementless bipolar hemiarthroplasty in the long-term