Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19:an update from the Dutch Oncology COVID-19 Consortium

AIM OF THE STUDY: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were studied in patients with cancer and COVID-19. METHODS: The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID-19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account. RESULTS: Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life-prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome. CONCLUSION: There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic

QCD and strongly coupled gauge theories : challenges and perspectives

We highlight the progress, current status, and open challenges of QCD-driven physics, in theory and in experiment. We discuss how the strong interaction is intimately connected to a broad sweep of physical problems, in settings ranging from astrophysics and cosmology to strongly coupled, complex systems in particle and condensed-matter physics, as well as to searches for physics beyond the Standard Model. We also discuss how success in describing the strong interaction impacts other fields, and, in turn, how such subjects can impact studies of the strong interaction. In the course of the work we offer a perspective on the many research streams which flow into and out of QCD, as well as a vision for future developments.Peer reviewe

Exploring a Stakeholder Based Urban Densification and Greening Agenda for Rotterdam Inner City—Accelerating the Transition to a Liveable Low Carbon City

Work on a liveable low carbon city has often been approached in a technocratic way, not linking to other disciplines and urban practices at a large scale. This paper explores a stakeholder based urban agenda for a more liveable low carbon city by densifying and greening with the case study of Rotterdam inner city. Rotterdam presents a unique European case with a modernistic inner city. Like many North American cities, the inner city for a long time mainly served as a business or shopping district with few inhabitants and few synergetic links between flows, urban functions, and areas. In line with other cities, Rotterdam aims to reduce carbon emissions and provide a high quality of life. To address this, the hypothesis ‘densifying and greening leads to a more sustainable inner city’, was tested and applied with stakeholders using transition management combined with urban data, modelling, and design. With sustainability indicators, geographic information system (GIS) mapping, and urban models, a baseline study was completed and expected outcomes were described and, where possible, validated in reality. The outcomes confirmed the stated hypothesis and showed that linking design, GIS mapping, and city data to transition management proved successful

Mestvergisting als onderdeel van duurzame kringlopen

Het ministerie van LNV wil duidelijk hebben of mestvergisting bij kan dragen aan de klimaatdoelstellingen waar de landbouw aan moet voldoen. De vraag is of mestvergisting kan bijdragen aan de reductie van broeikasgas- en ammoniakemissie, wat het (lange termijn) effect is op de organische stofopbouw en of het toevoegen van extra organisch materiaal aan de mest in de mestvergister hierop van invloed is. In deze studie is gekeken naar verschillende scenario’s: rundveedrijfmest, varkensdrijfmest, beide mest typen 100% vergist en beide mest typen met covergist met organisch materiaal. Uit de literatuur komt naar voren dat er nog weinig (veld)onderzoek gedaan is naar het verschil in effect dat mestvergisting heeft op de emissies en opbouw van organische stof in de bodem. Toedieningstechniek, (weers)omstandigheden, viscositeit van de mest en bodemcondities bepalen of mestvergisten wel of niet bijdraagt aan emissiereductie. Het wel of niet meteen afvoeren van de mest naar de vergister blijkt volgens het gebruikte vergistingsmodel het meest te bepalen of vergisting bijdraagt aan de reductie van broeikasgas- en ammoniakemissie. Monovergisting met rundveedrijfmest blijk volgens het organische stof model substantieel meer bij de dragen aan de organische stof opbouw in de bodem dan de overige meststypen

Job shop scheduling by local search

We present a computational performance analysis of local search algorithms for job shop scheduling. The algorithms under investigation are iterative improvement, simulated annealing, threshold accepting and genetic local search. Our study shows that simulated annealing performs best in the sense that it finds better solutions than the other algorithms within the same amount of running time. Compared to more tailored algorithms, simulated annealing still finds the best results but only under the assumption that running time is of no concern

Exploring a Stakeholder Based Urban Densification and Greening Agenda for Rotterdam Inner City—Accelerating the Transition to a Liveable Low Carbon City

Work on a liveable low carbon city has often been approached in a technocratic way, not linking to other disciplines and urban practices at a large scale. This paper explores a stakeholder based urban agenda for a more liveable low carbon city by densifying and greening with the case study of Rotterdam inner city. Rotterdam presents a unique European case with a modernistic inner city. Like many North American cities, the inner city for a long time mainly served as a business or shopping district with few inhabitants and few synergetic links between flows, urban functions, and areas. In line with other cities, Rotterdam aims to reduce carbon emissions and provide a high quality of life. To address this, the hypothesis 'densifying and greening leads to a more sustainable inner city', was tested and applied with stakeholders using transition management combined with urban data, modelling, and design. With sustainability indicators, geographic information system (GIS) mapping, and urban models, a baseline study was completed and expected outcomes were described and, where possible, validated in reality. The outcomes confirmed the stated hypothesis and showed that linking design, GIS mapping, and city data to transition management proved successful.Landscape Architectur

Intussusception in Adults: Report of Four Cases and Review of the Literature

Intussusception in adults is a rare clinical entity. The individual surgeon will not often encounter this condition. A lead-point for adult intussusception exists in 90% of cases and is frequently malignant. We present four cases and discuss treatment and diagnostic modalities. A comprehensive review of the literature is given. All cases were treated by resection according to oncologic principles without previous reduction. Histological examination showed non-Hodgkin lymphoma, lipoma, clear cell sarcoma and adenocarcinoma as the lead-points