Colour duplex sonography of temporal arteries before decision for biopsy: a prospective study in 55 patients with suspected giant cell arteritis

Although a temporal artery biopsy is the gold standard for the diagnosis of giant cell arteritis (GCA), there is considerable evidence that characteristic signs demonstrated by colour duplex sonography (CDS) of the temporal arteries may be of diagnostic importance. We aimed to test the hypothesis that CDS can replace biopsy in the algorithm for the approach to diagnose GCA. Bilateral CDS was performed in consecutive patients older than 50 years with clinically suspected GCA, as well as in 15 age- and gender-matched control subjects with diabetes mellitus and/or stroke and 15 healthy subjects, to assess flow parameters and the possible presence of a dark halo around the arterial lumen. Unilateral temporal artery biopsy was then performed in patients with suspected GCA, which was directed to a particular arterial segment in case a halo was detected in CDS. Final diagnoses, after completion of a 3-month follow-up in 55 patients, included GCA (n = 22), polymyalgia rheumatica (n = 12), polyarteritis nodosa, Wegener's, and Adamantiades-Behçet's diseases (n = 3), and neoplastic (n = 8) and infectious diseases (n = 10). A dark halo of variable size (0.7–2.0 mm) around the vessel lumen was evident at baseline CDS in 21 patients (in 12 and 9 uni- or bilaterally, respectively) but in none of the controls. The presence of unilateral halo alone yielded 82% sensitivity and 91% specificity for GCA, whereas the specificity reached 100% when halos were found bilaterally. Blood-flow abnormal parameters (temporal artery diameter, peak systolic blood-flow velocities, stenoses, occlusions) were common in GCA and non-GCA patients, as well as in healthy and atherosclerotic disease-control, elderly subjects. At follow-up CDS examinations performed at 2 and 4 weeks after initiation of corticosteroid treatment for GCA, halos disappeared in all 18 patients (9 and 9, respectively). We conclude that CDS, an inexpensive, non-invasive, and easy-to-perform method, allows a directional biopsy that has an increased probability to confirm the clinical diagnosis. Biopsy is not necessary in a substantial proportion of patients in whom bilateral halo signs can be found by CDS

Differential Effects of Two Isoenergetic Meals Rich in Saturated or Monounsaturated Fat on Endothelial Function in Subjects With Type 2 Diabetes

OBJECTIVE—To examine the acute effects of consumption of monounsaturated (MUFAs) and saturated fatty acids (SAFAs) on endothelial function in subjects with type 2 diabetes

Differential Effects of Two Isoenergetic Meals Rich in Saturated or Monounsaturated Fat on Endothelial Function in Subjects With Type 2 Diabetes

OBJECTIVE—To examine the acute effects of consumption of monounsaturated (MUFAs) and saturated fatty acids (SAFAs) on endothelial function in subjects with type 2 diabetes

Hydrogen as an energy carrier : A literature study on mass transportation

In the current Master's Thesis, the use of hydrogen as a fuel in transportation, the state of hydrogen in the European Union as well as the rest of the European countries' future for adopting hydrogen in the mass transportation sector, were researched. Initially, the thesis provides an overview of hydrogen classification, production methods, storage methods, and transportation methods. Furthermore, it discusses the environmental impact of hydrogen production and use, assesses the technology readiness level, the cost of hydrogen technologies and their environmental footprint. Finally, it examines the energy use, the environmental footprint, reviews the policies and regulations governing the use of hydrogen of the transportation sector in Europe.The method used is literature review and found that hydrogen has some potential to decarbonize the transportation sector in Europe after 2035. However, there are multiple challenges that need to be addressed, such as the high cost of hydrogen production and the lack of infrastructure for hydrogen refueling. Steps to address these challenges are being taken, such as investing in research and development of hydrogen technologies and providing financial incentives for the deployment of hydrogen infrastructure.The electrolysis of water using renewable energy sources was found to be the least efficient and most expensive production technique, but this is expected to change in the future. In the meantime, programs have been launched in Europe to increase hydrogen adoption in the transport sector, through measures such as the development of new gas stations and pipeline networks. Since there is currently no regulatory framework specifically for hydrogen, it is governed by regulations that apply to hazardous liquids and gases or alternative fuels.However, further research and development is needed to make hydrogen more cost-competitive and to build the necessary infrastructure. With the right policies and investments, hydrogen can play a major role in decarbonizing the transportation sector in the EU

Hydrogen as an energy carrier : A literature study on mass transportation

In the current Master's Thesis, the use of hydrogen as a fuel in transportation, the state of hydrogen in the European Union as well as the rest of the European countries' future for adopting hydrogen in the mass transportation sector, were researched. Initially, the thesis provides an overview of hydrogen classification, production methods, storage methods, and transportation methods. Furthermore, it discusses the environmental impact of hydrogen production and use, assesses the technology readiness level, the cost of hydrogen technologies and their environmental footprint. Finally, it examines the energy use, the environmental footprint, reviews the policies and regulations governing the use of hydrogen of the transportation sector in Europe.The method used is literature review and found that hydrogen has some potential to decarbonize the transportation sector in Europe after 2035. However, there are multiple challenges that need to be addressed, such as the high cost of hydrogen production and the lack of infrastructure for hydrogen refueling. Steps to address these challenges are being taken, such as investing in research and development of hydrogen technologies and providing financial incentives for the deployment of hydrogen infrastructure.The electrolysis of water using renewable energy sources was found to be the least efficient and most expensive production technique, but this is expected to change in the future. In the meantime, programs have been launched in Europe to increase hydrogen adoption in the transport sector, through measures such as the development of new gas stations and pipeline networks. Since there is currently no regulatory framework specifically for hydrogen, it is governed by regulations that apply to hazardous liquids and gases or alternative fuels.However, further research and development is needed to make hydrogen more cost-competitive and to build the necessary infrastructure. With the right policies and investments, hydrogen can play a major role in decarbonizing the transportation sector in the EU

Lead users' ideas on core features to support physical activity in rheumatoid arthritis : a first step in the development of an internet service using participatory design

Background: Despite the growing evidence of the benefits of physical activity (PA) in individuals with rheumatoid arthritis (RA), the majority is not physically active enough. An innovative strategy is to engage lead users in the development of PA interventions provided over the internet. The aim was to explore lead users' ideas and prioritization of core features in a future internet service targeting adoption and maintenance of healthy PA in people with RA. Methods: Six focus group interviews were performed with a purposively selected sample of 26 individuals with RA. Data were analyzed with qualitative content analysis and quantification of participants' prioritization of most important content. Results: Six categories were identified as core features for a future internet service: up-to-date and evidence-based information and instructions, self-regulation tools, social interaction, personalized set-up, attractive design and content, and access to the internet service. The categories represented four themes, or core aspects, important to consider in the design of the future service: (1) content, (2) customized options, (3) user interface and (4) access and implementation. Conclusions: This is, to the best of our knowledge, the first study involving people with RA in the development of an internet service to support the adoption and maintenance of PA. Participants helped identifying core features and aspects important to consider and further explore during the next phase of development. We hypothesize that involvement of lead users will make transfer from theory to service more adequate and user-friendly and therefore will be an effective mean to facilitate PA behavior change

Lead users' ideas on core features to support physical activity in rheumatoid arthritis : a first step in the development of an internet service using participatory design

Background: Despite the growing evidence of the benefits of physical activity (PA) in individuals with rheumatoid arthritis (RA), the majority is not physically active enough. An innovative strategy is to engage lead users in the development of PA interventions provided over the internet. The aim was to explore lead users' ideas and prioritization of core features in a future internet service targeting adoption and maintenance of healthy PA in people with RA. Methods: Six focus group interviews were performed with a purposively selected sample of 26 individuals with RA. Data were analyzed with qualitative content analysis and quantification of participants' prioritization of most important content. Results: Six categories were identified as core features for a future internet service: up-to-date and evidence-based information and instructions, self-regulation tools, social interaction, personalized set-up, attractive design and content, and access to the internet service. The categories represented four themes, or core aspects, important to consider in the design of the future service: (1) content, (2) customized options, (3) user interface and (4) access and implementation. Conclusions: This is, to the best of our knowledge, the first study involving people with RA in the development of an internet service to support the adoption and maintenance of PA. Participants helped identifying core features and aspects important to consider and further explore during the next phase of development. We hypothesize that involvement of lead users will make transfer from theory to service more adequate and user-friendly and therefore will be an effective mean to facilitate PA behavior change