245 research outputs found
Structural Characterisation by ESI-MS of Feruloylated Arabino-oligosaccharides Synthesised by Chemoenzymatic Esterification
The chemoenzymatic synthesis of feruloylated arabino-oligosaccharides has neen achieved, using a feruloyl esterase type C from Sporotrichum themophile (StFaeC). The structure of the feruloyl products was comfirmed by ESI-MS
Informal caregiving, a healthy decision? Determinants and health-related consequences of providing informal care
Better off at home? Effects of a nursing home admission on costs, hospitalizations and survival.
Aging-in-place policies substitute home care for nursing home admissions (NHA). They
appear to be a win-win by keeping public spending in check and being in line with personal
preferences, but have hitherto not been evaluated. We study the impact of NHA eligibility
using Dutch administrative data and exploiting variation between randomly assigned
assessors in their tendency to grant admission. The impact on mortality is zero, but with
considerable effect heterogeneity. Moreover, aging-in-place policies come at the cost of
increased curative care, especially hospital admissions, and do not reduce total healthcare
spending, suggesting they may not be a win-win after all
Learning curves for pediatric laparoscopy: how many operations are enough? The Amsterdam experience with laparoscopic pyloromyotomy
Few studies on the surgical outcomes of open (OP) versus laparoscopic pyloromyotomy (LP) in the treatment of hypertrophic pyloric stenosis have been published. The question arises as to how many laparoscopic procedures are required for a surgeon to pass the learning curve and which technique is best in terms of postoperative complications. This study aimed to evaluate and quantify the learning curve for the laparoscopic technique at the authors' center. A second goal of this study was to evaluate the pre- and postoperative data of OP versus LP for infantile hypertrophic pyloric stenosis. A retrospective analysis was performed for 229 patients with infantile hypertrophic pyloric stenosis. Between January 2002 and September 2008, 158 infants underwent OP and 71 infants had LP. The median operating time between the OP (33 min) and LP (40 min) groups was significantly different. The median hospital stay after surgery was 3 days for the OP patients and 2 days for the LP patients (p = 0.002). The postoperative complication rates were not significantly different between the OP (21.5%) and LP (21.1%) groups (p = 0.947). Complications were experienced by 31.5% of the first 35 LP patients. This rate decreased to 11.4% during the next 35 LP procedures (p = 0.041). Two perforations and three conversions occurred in the first LP group, compared with one perforation in the second LP group. The number of complications decreased significantly between the first and second groups of the LP patients, with the second group of LP patients quantifying the learning curve. Not only was the complication rate lower in the second LP group, but severe complications also were decreased. This indicates that the learning curve for LP in the current series involved 35 procedure
Erratum: The Herschel Bright Sources (HerBS): sample definition and SCUBA-2 observations
This is a correction to: Monthly Notices of the Royal Astronomical Society, Volume 473, Issue 2, January 2018, Pages 1751–1773, https://doi.org/10.1093/mnras/stx2267Instrumentatio
Influence of Calendar Period on the Association Between BMI and Coronary Heart Disease: A Meta-Analysis of 31 Cohorts
Objective: The association between obesity and coronary heart disease (CHD) may have changed over
time, for example due to improved pharmacological treatment of CHD risk factors. This meta-analysis of
31 prospective cohort studies explores the influence of calendar period on CHD risk associated with
body mass index (BMI).
Design and Methods: The relative risks (RRs) of CHD for a five-BMI-unit increment and BMI categories
were pooled by means of random effects models. Meta-regression analysis was used to examine the
influence of calendar period (>1985 v 1985) in univariate and multivariate analyses (including mean
population age as a covariate). Results: The age, sex, and smoking adjusted RR (95% confidence intervals) of CHD for a five-BMI-unit
increment was 1.28(1.22:1.34). For underweight, overweight and obesity, the RRs (compared to normal
weight) were 1.11(0.91:1.36), 1.31(1.22:1.41), and 1.78(1.55:2.04), respectively. The univariate analysis
indicated 31% (95%CI: 56:0) lower RR of CHD associated with a five-BMI-unit increment and a 51%
(95%CI: 78: 14)) lower RR associated with obesity in studies starting after 1985 (n ¼ 15 and 10,
respectively) compared to studies starting in or before 1985 (n ¼ 16 and 10). However, in the multivariate
analysis, only mean population age was independently associated with the RRs for a five-BMI-unit
increment and obesity ( 29(95%CI: 55: 5)) and 31(95%CI: 66:3), respectively) per 10-year
increment in mean age).
Conclusion: This study provides no consistent evidence for a difference in the association between BMI
and CHD by calendar period. The mean population age seems to be the most important factor that
modifies the association between the risk of CHD and BMI, in which the RR decreases with increasing
age
Evaluation of pulmonary arterial hypertension: invasive or noninvasive?
Vascular Biology and Interventio
A tool to balance benefit and harm when deciding about adjuvant therapy
Adjuvant therapy aims to prevent outgrowth of residual disease but can induce serious side effects. Weighing conflicting treatment effects and communicating this information with patients is not elementary. This study presents a scheme balancing benefit and harm of adjuvant therapy vs no adjuvant therapy. It is illustrated by the available evidence on adjuvant pelvic external beam radiotherapy (RT) for intermediate-risk stage I endometrial carcinoma patients. The scheme comprises five outcome possibilities of adjuvant therapy: patients who benefit from adjuvant therapy (some at the cost of complications) vs those who neither benefit nor contract complications, those who do not benefit but contract severe complications, or those who die. Using absolute risk differences, a fictive cohort of 1000 patients receiving adjuvant RT is categorised. Three large randomised clinical trials were included. Recurrences will be prevented by adjuvant RT in 60 patients, a majority of 908 patients will neither benefit nor suffer severe radiation-induced harm but 28 patients will suffer severe complications due to adjuvant RT and an expected four patients will die. This scheme readily summarises the different possible treatment outcomes and can be of practical value for clinicians and patients in decision making about adjuvant therapies
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