72 research outputs found
Production of medium-chain fatty acids and higher alcohols by a synthetic co-culture grown on carbon monoxide or syngas
Synthesis gas, a mixture of CO, H2, and CO2, is a promising renewable feedstock for bio-based production of organic chemicals. Production of medium-chain fatty acids can be performed via chain elongation, utilizing acetate and ethanol as main substrates. Acetate and ethanol are main products of syngas fermentation by acetogens. Therefore, syngas can be indirectly used as a substrate for the chain elongation process.ERC Grant (Project 323009) and the Gravitation Grant (Project 024.002.002) of the Netherlands Ministry of Education, Culture and Science, and the Netherlands Science Foundation (NWO
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy versus palliative systemic chemotherapy in stomach cancer patients with peritoneal dissemination, the study protocol of a multicentre randomised controlled trial (PERISCOPE II)
Background: At present, palliative systemic chemotherapy is the standard treatment in the Netherlands for gastric
cancer patients with peritoneal dissemination. In contrast to lymphatic and haematogenous dissemination,
peritoneal dissemination may be regarded as locoregional spread of disease. Administering cytotoxic drugs directly
into the peritoneal cavity has an advantage over systemic chemotherapy since high concentrations can be
delivered directly into the peritoneal cavity with limited systemic toxicity. The combination of a radical gastrectomy
with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promising
results in patients with gastric cancer in Asia. However, the results obtained in Asian patients cannot be
extrapolated to Western patients.
The aim of this study is to compare the overall survival between patients with gastric cancer with limited peritoneal
dissemination and/or tumour positive peritoneal cytology treated with palliative systemic chemotherapy, and those
treated with gastrectomy, CRS and HIPEC after neoadjuvant systemic chemotherapy. Methods: In this multicentre randomised controlled two-armed phase III trial, 106 patients will be randomised (1:1)
between palliative systemic chemotherapy only (standard treatment) and gastrectomy, CRS and HIPEC
(experimental treatment) after 3–4 cycles of systemic chemotherapy.Patients with gastric cancer are eligible for
inclusion if (1) the primary cT3-cT4 gastric tumour including regional lymph nodes is considered to be resectable,
(2) limited peritoneal dissemination (Peritoneal Cancer Index < 7) and/or tumour positive peritoneal cytology are
confirmed by laparoscopy or laparotomy, and (3) systemic chemotherapy was given (prior to inclusion) without
disease progression.
Discussion: The PERISCOPE II study will determine whether gastric cancer patients with limited peritoneal
dissemination and/or tumour positive peritoneal cytology treated with systemic chemotherapy, gastrectomy, CRS
and HIPEC have a survival benefit over patients treated with palliative systemic chemotherapy only.
Trial registration: clinicaltrials.gov NCT03348150; registration date November 2017; first enrolment November 2017;
expected end date December 2022; trial status: Ongoing
The association of adverse life events and parental mental health with emotional and behavioral outcomes in young adults with autism spectrum disorder
People with autism spectrum disorder (ASD) are at increased risk of developing co-occurring mental health difficulties across the lifespan. Exposure to adverse life events and parental mental health difficulties are known risk factors for developing a range of mental health difficulties. This study investigates the association of adverse life events, parental stress and mental health with emotional and behavioral problems in young adults with ASD. One hundred and fifteen young adults with ASD derived from a population-based longitudinal study were assessed at three time-points (12-, 16-, and 23-year) on questionnaire measures of emotional and behavioral problems. Parent-reported exposure to adverse life events and parental stress/mental health were measured at age 23. We used structural equation modeling to investigate the stability of emotional and behavioral problems over time, and the association between adverse life events and parental stress and mental health and emotional and behavioral outcomes at 23-year. Our results indicate that exposure to adverse life events was significantly associated with increased emotional and behavioral problems in young adults with ASD, while controlling for symptoms in childhood and adolescence. Higher reported parental stress and mental health difficulties were associated with a higher frequency of behavioral, but not emotional problems, and did not mediate the impact of adverse life events. These results suggest that child and adolescent emotional and behavioral problems, exposure to life events and parent stress and mental health are independently associated, to differing degrees, with emotional or behavioral outcomes in early adulthood. Lay Summary: People with autism experience high rates of mental health difficulties throughout childhood and into adult life. Adverse life events and parental stress and mental health may contribute to poor mental health in adulthood. We used data at three time points (12-, 16-, and 23-year) to understand how these factors relate to symptoms at 23-year. We found that emotional and behavioral problems in childhood, adverse life events and parent mental health were all associated with increased emotional and behavioral problems in adulthood
Adjuvant Hepatic Arterial Infusion Pump Chemotherapy After Resection of Colorectal Liver Metastases: Results of a Safety and Feasibility Study in The Netherlands
Background: The 10-year overall survival with adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after resection of colorectal liver metastases (CRLMs) was 61% in clinical trials from Memorial Sloan Kettering Cancer Center. A pilot study was performed to evaluate the safety and feasibility of adjuvant HAIP chemotherapy in patients with resectable CRLMs. Study Design: A phase II study was performed in two centers in The Netherlands. Patients with resectable CRLM without extrahepatic disease were eligible. All patients underwent complete resection and/or ablation of CRLMs and pump implantation. Safety was determined by the 90-day HAIP-related postoperative complications from the day of pump placement (Clavien–Dindo classification, grade III or higher) and feasibility by the successful administration of the first cycle of HAIP chemotherapy. Results: A total of 20 patients, with a median age of 57 years (interquartile range [IQR] 51–64) were included. Grade III or higher HAIP-related postoperative complications were found in two patients (10%), both of whom had a reoperation (without laparotomy) to replace a pump with a slow flow rate or to reposition a flipped pump. No arterial bleeding, arterial dissection, arterial thrombosis, extrahepatic perfusion, pump pocket hematoma, or pump pocket infections were found within 90 days after surgery. After a median of 43 days (IQR 29–52) following surgery, all patients received the first dose of HAIP chemotherapy, which was completed un
Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research.
BACKGROUND: 'Treatment burden', defined as both the workload and impact of treatment regimens on function and well-being, has been associated with poor adherence and unfavourable outcomes. Previous research focused on treatment workload but our understanding of treatment impact is limited. This research aimed to systematically review qualitative research to identify: 1) what are the treatment generated disruptions experienced by patients across all chronic conditions and treatments? 2) what strategies do patients employ to minimise these treatment generated disruptions? METHODS AND FINDINGS: The search strategy centred on: treatment burden and qualitative methods. Medline, CINAHL, Embase, and PsychINFO were searched electronically from inception to Dec 2013. No language limitations were set. Teams of two reviewers independently conducted paper screening, data extraction, and data analysis. Data were analysed using framework synthesis informed by Cumulative Complexity Model. Eleven papers reporting data from 294 patients, across a range of conditions, age groups and nationalities were included. Treatment burdens were experienced as a series of disruptions: biographical disruptions involved loss of freedom and independence, restriction of meaningful activities, negative emotions and stigma; relational disruptions included strained family and social relationships and feeling isolated; and, biological disruptions involved physical side-effects. Patients employed "adaptive treatment work" and "rationalised non-adherence" to minimise treatment disruptions. Rationalised non-adherence was sanctioned by health professionals at end of life; at other times it was a "secret-act" which generated feelings of guilt and impacted on family and clinical relationships. CONCLUSIONS: Treatments generate negative emotions and physical side effects, strain relationships and affect identity. Patients minimise these disruptions through additional adaptive work and/or by non-adherence. This affects physical outcomes and care relationships. There is a need for clinicians to engage with patients in honest conversations about treatment disruptions and the 'adhere-ability' of recommended regimens. Patient-centred practice requires management plans which optimise outcomes and minimise disruptions
A comparative study of non-parametric models for identification of linear-time invariant systems
A comparative study of methods used for identification of Linear-Time-Invariant (LTI) systems based on Non-parametric model (step, impulse, sine and frequency responses) and Parametric model (autoregressive external inputs) was conducted. A series of experiments conducted on a laboratory heating system showed that the step and impulse responses were good identification methods but only limited to first order process. The frequency response using the sine response was good for estimating the gain and phase shift of system in frequency doma-in, but was time consuming. However, the frequency response method using random binary signals was good for unpredicted white noise characteristics and considered the best method for non-parametric system identifica-tion. The autoregressive external input (ARX) model was very useful for system identification, but on applicati-on, few input parameters gave poor model fit, while many parameters led to complex modeling. The analyses were based on Matlab software package Release 14. Journal of Applied Science and Technology Vol. 13 (1 & 2) 2008: pp. 20-2
Upgrading dilute ethanol from syngas fermentation to n-caproate with reactor microbiomes
High n-caprylate productivities and specificities from dilute ethanol and acetate: chain elongation with microbiomes to upgrade products from syngas fermentation
Chain Elongation with Reactor Microbiomes: Open-Culture Biotechnology To Produce Biochemicals
Expression of the Human Dp 71 (Apo-Dystrophin-1 ) Gene from a 760-kb DMD-YAC Transferred to Mouse Cells
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