Government 2.0: key challenges to its realization

Government 2.0 is often presented as a means to reinforce the relation between state and citizens in an information age. The promise of Government 2.0 is impressive but its potential has not or hardly been realized yet in practice. This paper uses insights from various disciplines to understand Government 2.0 as an institutional transformation. It focuses on three key issues ‑ leadership in government, incentives for citizens and mutual trust ‑ and our analysis shows that Government 2.0 efforts are too often guided by overly optimistic and simplified ideas about these issues. Our discussion suggests that there are no easy, one‑size‑fits‑all ways to address challenges of leadership, citizen incentives and trust: a contextual approach and hard work is needed to tackle these challenges. Realizing Government 2.0 means looking beyond the technology and understanding its potential in a specific situation

Increased PXR and Suppressed T-Cell Signaling Are Associated With Malignant Degeneration of Barrett's Esophagus

Background and Aims: Barrett's esophagus (BE) is the precursor lesion for esophageal adenocarcinoma (EAC). To detect EAC in early stage, patients with BE undergo endoscopic surveillance. Surveillance cohorts largely consist of nondysplastic BE (NDBE) patients with a low annual progression risk (&lt;0.5%). Predictive biomarkers for malignant progression of NDBE could improve efficacy of surveillance. Biomarker research has mostly focused on aberrant protein expression on BE epithelial cells. Moreover, insight in cell signaling driving malignant transformation is unknown. This study uses a data-driven approach to analyze tumor-stroma interaction in NDBE which progressed to high-grade dysplasia or EAC. Methods: In this case-control study, we performed RNA sequencing analysis on index NDBE biopsies from 6 patients who, during long-term follow-up, progressed and 7 who did not progress to high-grade dysplasia/EAC. For control samples, squamous and duodenum tissues from BE patients were analyzed. For validation, we used quantitative PCR. Results: Significant differences in BE transcriptomic profiles between progressors and nonprogressors were found by principal component and differential expression analyses. Ingenuity pathway analysis indicated that 8 cell signaling pathways were significantly upregulated in the progressors, and 14 pathways were significantly downregulated. The most interesting finding was the upregulation of the xenobiotic metabolism pregnane X receptor signaling pathway in the progressor cohort, while of the downregulated pathways in progressors, several were related to the immune system. Conclusion: These novel transcriptomic insights are fundamental for developing (chemo-)preventive therapies. These could be therapies, which protect against toxins, including biles, responsible for pregnane X receptor activation or which enhance protective immune mechanisms. The identified RNA markers are promising biomarkers for improving risk stratification in surveillance programs.</p

Biogenic Carbon Fraction of Biogas and Natural Gas Fuel Mixtures Determined with 14C

This study investigates the accuracy of the radiocarbon-based calculation of the biogenic carbon fraction for different biogas and biofossil gas mixtures. The focus is on the uncertainty in the C-14 reference values for 100% biogenic carbon and on the C-13-based isotope fractionation correction of the measured C-14 values. The separately (AMS) measured CO2 and CH4 fractions of 8 different biogas samples showed C-14 values between 102% and 116% (pMC). The delta C-13 values of these samples varied between -6% and +31% for the CO2 fraction and between -28% and -62% for the CH4 fraction. The uncertainty in calculated biogenic carbon fractions due to uncertainty in the C-14 reference values depends on the available information about the origin of the used biogenic materials. It varies between +/- 0.5% and +/- 3.5% (absolute) depending on the type of biogas. A method is proposed to minimize this uncertainty for different groups of biogases. The calculated biogenic carbon fraction deviates up to +/- 2.5% for biofossil gas mixtures, if the applied isotope fractionation correction is based on the delta C-13 value of the mixed biofossil sample instead of the biogenic delta C-13 value. Combination of both error sources shows that the uncertainty in the calculated biogenic carbon fraction varies between +/- 0.7% and +/- 4.5%, depending on the type of biogas in the sample

Temporal associations between salivary cortisol and emotions in clinically depressed individuals and matched controls:A dynamic time warp analysis

Depression can be understood as a complex dynamic system where depressive symptoms interact with one another. Cortisol is suggested to play a major role in the pathophysiology of depression, but knowledge on the temporal interplay between cortisol and depressive symptoms is scarce. We aimed to analyze the temporal connectivity between salivary cortisol and momentary affective states in depressed individuals and controls. Thirty pair-matched depressed and non-depressed participants completed questionnaires on momentary positive (PA) and negative (NA) affect and collected saliva three times a day for 30 days. The association between cortisol and affect was analyzed by dynamic time warp (DTW) analyses. These analyses involved lag-1 backward to lag-1 forward undirected analyses and lag-0 and lag-1 forward directed analyses. Large inter- and intra-individual variability in the networks were found. At the group level, with undirected analysis PA and NA were connected in the networks in depressed individuals and in controls. Directed analyses indicated that increases in cortisol preceded specific NA items in controls, but tended to follow upon specific affect items increase in depressed individuals. To conclude, at group level, changes in cortisol levels in individuals diagnosed with a depression may be a result of changes in affect, rather than a cause.</p

SERIES:eHealth in primary care. Part 4: Addressing the challenges of implementation

Background The implementation of eHealth applications in primary care remains challenging. Enhancing knowledge and awareness of implementation determinants is critical to build evidence-based implementation strategies and optimise uptake and sustainability. Objectives We consider how evidence-based implementation strategies can be built to support eHealth implementation. Discussion What implementation strategies to consider depends on (potential) barriers and facilitators to eHealth implementation in a given situation. Therefore, we first discuss key barriers and facilitators following the five domains of the Consolidated Framework for Implementation Research (CFIR). Cost is identified as a critical barrier to eHealth implementation. Privacy, security problems, and a lack of recognised standards for eHealth applications also hinder implementation. Engagement of key stakeholders in the implementation process, planning the implementation of the intervention, and the availability of training and support are important facilitators. To support care professionals and researchers, we provide a stepwise approach to develop and apply evidence-based implementation strategies for eHealth in primary care. It includes the following steps: (1) specify the eHealth application, (2) define problem, (3) specify desired implementation behaviour, and (4) choose and (5) evaluate the implementation strategy. To improve the fit of the implementation strategy with the setting, the stepwise approach considers the phase of the implementation process and the specific context. Conclusion Applying an approach, as provided here, may help to improve the implementation of eHealth applications in primary care.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Balans na drie jaar COVID-19: grootste vertraging leergroei voor rekenen-wiskunde, spelling en begrijpend lezen schommelen

Hoewel de wereldwijde COVID-19 crisis achter de rug lijkt, zijn de gevolgen op de leerontwikkeling van leerlingen nog steeds zichtbaar. Tijdens de COVID-19 periode werden scholen en leerlingen meer dan eens geconfronteerd met schoolsluitingen, afstandsonderwijs en lesuitval. Welke consequenties heeftdit gehad voor de leergroei van Nederlandse leerlingen? We maken de balans op na drie jaar COVID-19. In deze factsheet kijken we naar de landelijke cijfers voor de Cito-vaardigheidsscores van leerlingen in de volgende drie domeinen: begrijpend lezen, spelling en rekenen-wiskunde. Deze factsheet gaat alleenover leerlingen die bij de start van COVID-19 in de onderbouw zaten (in groep 3, 4 en 5), omdat we hier kijken naar de leergroei over een periode van drie jaar. Deze leerlingen zitten nu dus in de bovenbouw

Na drie jaar COVID-19 blijft ongelijkheid in leervertraging afnemen

Hoewel de wereldwijde COVID-19 crisis achter de rug lijkt, zijn de gevolgen op de leerontwikkeling van leerlingen nog steeds zichtbaar. Tijdens de COVID-19 periode werden scholen en leerlingen meer dan eens geconfronteerd met schoolsluitingen, afstandsonderwijs en lesuitval. Welke consequenties heeftdit gehad voor de leergroei van Nederlandse leerlingen, en de verschillen tussen leerlingen naar opleidingsniveau van de ouders? We maken de balans op na drie jaar COVID-19. In deze factsheet kijken we naar de landelijke cijfers voor de Cito-vaardigheidsscores van leerlingen in de volgende drie domeinen: begrijpend lezen, spelling en rekenen-wiskunde. Deze factsheet gaat alleen over leerlingen die bij de start van COVID-19 in de onderbouw zaten (in groep 3, 4 en 5), omdatwe hier kijken naar de leergroei over een periode van drie jaar. Deze leerlingen zitten nu dus in de bovenbouw