Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease

Introduction Dual-tasking (DT) while walking is common in daily life and can affect both gait and cognitive performance depending on age, attention prioritization, task complexity and medical condition. The aim of the present study was to investigate the effects of DT on cognitive DT cost (DTC) (i) in a dataset including participants of different age groups, with different neurological disorders and chronic low-back pain (cLBP) (ii) at different levels of cognitive task complexity, and (iii) in the context of a setting relevant to daily life, such as combined straight walking and turning. Materials and methods Ninety-one participants including healthy younger and older participants and patients with Parkinson's disease, Multiple Sclerosis, Stroke and cLBP performed a simple reaction time (SRT) task and three numerical Stroop tasks under the conditions congruent (StC), neutral (StN) and incongruent (StI). The tasks were performed both standing (single task, ST) and walking (DT), and DTC was calculated. Mixed ANOVAs were used to determine the effect of group and task complexity on cognitive DTC. Results A longer response time in DT than in ST was observed during SRT. However, the response time was shorter in DT during StI. DTC decreased with increasing complexity of the cognitive task. There was no significant effect of age and group on cognitive DTC. Conclusion Our results suggest that regardless of age and disease group, simple cognitive tasks show the largest and most stable cognitive effects during DT. This may be relevant to the design of future observational studies, clinical trials and for clinical routine

On Beneficial Vehicle-to-Grid (V2G) Services

A number of studies have investigated the possibility of extending Electric Vehicle (EV) Lithium-ion battery life by deliberately choosing to store the battery at a low to moderate state of charge. Recently, there has been considerable interest shown in the scheme of a deliberate discharge and subsequent recharge of a battery to yield an overall reduction in battery degradation whilst carrying out Vehicle-to-Grid (V2G) services (so-called `beneficial V2G'). This paper presents an investigation of the conditions permitting successful operation of this method by examining incremental time variation of the relevant parameters for two types of cells from results of the same physical size and chemistry, and similar capacity. These two types of cells are found in this present analysis to offer differing degrees of suitability for beneficial V2G

Pharmacokinetics and pharmacodynamics of carboplatin administered in a high-dose combination regimen with thiotepa, cyclophosphamide and peripheral stem cell support.

The aim of this pharmacokinetic/pharmacodynamic study was to define the relationships of the carboplatin exposure with the toxicity in patients treated with high dose carboplatin (400 mg m-2 day-1), cyclophosphamide (1500 mg m-2 day-1) and thiotepa (120 mg m-2 day-1) for four consecutive days, followed by peripheral stem cell transplantation. Exposure to carboplatin was studied in 200 treatment days by measuring the area under the carboplatin plasma ultrafiltrate (pUF) concentration vs time curve (AUC). The AUC was obtained by using a previously validated limited sampling model. A total of 31 patients was studied who received one, two or three courses of this high-dose chemotherapy regimen. The unbound, plasma ultrafiltrate carboplatin was almost completely cleared from the body before each next treatment day in a course; the day-to-day AUC variation was 3.3%. The mean cumulative AUC over 4 days was 19.6 (range 14.1-27.2) mg ml-1 min-1. In 97 treatment days the carboplatin dose was calculated using the Calvert formula with the creatinine clearance as the measure for the glomerular filtration rate (GFR). For these courses, the inter-patient variability in pharmacokinetics was significantly reduced from 21% to 15% (P = 0.007) in comparison with the schemes where it was given as a fixed dose of 400 mg m-2. There were no relationships found between toxicity and the AUC of carboplatin, which may be due to the influence of overlapping toxicities of cyclophosphamide and thiotepa. However, the ototoxicity was strongly related to the cumulative carboplatin AUC. This toxicity was dose limiting for carboplatin in this schedule. It appeared that the carboplatin pharmacokinetics in these regimens were similar to those reported at conventional dosages. To reduce the inter-patient variation, the carboplatin dose can be calculated using the Calvert-formula with the creatinine clearance as the measure for the GFR

An Indwelling Urethral Catheter Knotted Around a Double-J Ureteral Stent: An Unusual Complication after Kidney Transplantation

Urethral catheterization is a common procedure with a relatively low complication rate. Knotting of an indwelling urethral catheter is a very rare complication, and there are only a few case reports on knotted catheters, most of them concerning children. We report an especially rare case where a urethral catheter formed a knot around a double-J ureteral stent after a kidney transplantation. We will discuss the various risk factors for knotting of a catheter and the methods to untangle a knot

Predicting outcome of internet-based treatment for depressive symptoms.

In this study we explored predictors and moderators of response to Internet-based cognitive behavioral therapy (CBT) and Internet-based problem-solving therapy (PST) for depressive symptoms. The sample consisted of 263 participants with moderate to severe depressive symptoms. Of those, 88 were randomized to CBT, 88 to PST and 87 to a waiting list control condition. Outcomes were improvement and clinically significant change in depressive symptoms after 8 weeks. Higher baseline depression and higher education predicted improvement, while higher education, less avoidance behavior and decreased rational problem-solving skills predicted clinically significant change across all groups. No variables were found that differentially predicted outcome between Internet-based CBT and Internet-based PST. More research is needed with sufficient power to investigate predictors and moderators of response to reveal for whom Internet-based therapy is best suited. © 2013 Copyright Society for Psychotherapy Research

Impact of climate change on low-flows in the river Meuse

In this study observed precipitation, temperature, and discharge records from the Meuse basin for the period 1911-2003 are analysed. The primary aim is to establish which meteorological conditions generate (critical) low-flows of the Meuse. This is achieved by examining the relationships between observed seasonal precipitation and temperature anomalies, and low-flow indices. Secondly, the possible impact of climate change on the (joint) occurrence of these low-flow generating meteorological conditions is addressed. This is based on the outcomes of recently reported RCM climate simulations for Europe given a scenario with increased atmospheric greenhouse-gas concentrations. The observed record (1911-2003) hints at the importance of multi-seasonal droughts in the generation of critical low-flows of the river Meuse. The RCM simulations point to a future with wetter winters and drier summers in Northwest Europe. No increase in the likelihood of multi-seasonal droughts is simulated. However, the RCM scenario runs produce multi-seasonal precipitation and temperature anomalies that are out of the range of the observed record for the period 1911-2003. The impact of climate change on low-flows has also been simulated with a hydrological model. This simulation indicates that climate change will lead to a decrease in the average discharge of the Meuse during the low-flow season. However, the model has difficulties to simulate critical low-flow conditions of the Meuse

Evaluating Comprehensibility of 157 Patient-Reported Outcome Measures (PROMs) in the Nationwide Dutch Outcome-Based Healthcare Program:More Attention for Comprehensibility of PROMs is Needed

IntroductionPatient-reported outcomes measures (PROMs) are increasingly prevalent in healthcare and used for shared decision-making and healthcare quality evaluation. However, the extent to which patients with varying health literacy levels can complete PROMs is often overlooked. This may lead to biased aggregated data and patients being excluded from studies or other PROM collection initiatives. This cross-sectional study evaluates the comprehensibility of 157 well-known and widely used PROM scales using a comprehensibility checklist.MethodsPairs of two independent raters scored 157 PROM scales designed for adults included in the 35 sets of outcome information developed as part of the Dutch Outcome-Based Healthcare Program. The PROM scales were scored on the eight comprehensibility domains of the Pharos Checklist for Questionnaires in Healthcare (PCQH). Interrater agreement of domain ratings was assessed using Intraclass Correlation Coefficients or Cohen's kappa. Subsequently, final ratings were established through discussion and used to evaluate the domain-specific comprehensibility rating for each PROM scale.ResultsComprehensibility of a large number of PROM scales (n = 157), which cover a wide range of diseases and conditions across Dutch medical specialist care, was assessed. While most PROM scales were written at an accessible language level, with minimal use of medical terms, instruction clarity, number of questions, and response options emerged as significant issues, affecting a substantial proportion of PROM scales. Interrater agreement was high for most domains of the PCQH.ConclusionThis study highlights the need for greater attention to the comprehensibility of PROMs to ensure their accessibility to all patients, including those with low health literacy. The PCQH can be a valuable tool in PROM development in addition to qualitative methods and in selection processes enabling comparison of comprehensibility between PROMs. However, the PCQH needs further development and validation for these purposes. Enhancing the comprehensibility of PROMs is essential for their effective incorporation in healthcare evaluation and decision-making processes

A family history of breast cancer will not predict female early onset breast cancer in a population-based setting

ABSTRACT: BACKGROUND: An increased risk of breast cancer for relatives of breast cancer patients has been demonstrated in many studies, and having a relative diagnosed with breast cancer at an early age is an indication for breast cancer screening. This indication has been derived from estimates based on data from cancer-prone families or from BRCA1/2 mutation families, and might be biased because BRCA1/2 mutations explain only a small proportion of the familial clustering of breast cancer. The aim of the current study was to determine the predictive value of a family history of cancer with regard to early onset of female breast cancer in a population based setting. METHODS: An unselected sample of 1,987 women with and without breast cancer was studied with regard to the age of diagnosis of breast cancer. RESULTS: The risk of early-onset breast cancer was increased when there were: (1) at least 2 cases of female breast cancer in first-degree relatives (yes/no; HR at age 30: 3.09; 95% CI: 128-7.44), (2) at least 2 cases of female breast cancer in first or second-degree relatives under the age of 50 (yes/no; HR at age 30: 3.36; 95% CI: 1.12-10.08), (3) at least 1 case of female breast cancer under the age of 40 in a first- or second-degree relative (yes/no; HR at age 30: 2.06; 95% CI: 0.83-5.12) and (4) any case of bilateral breast cancer (yes/no; HR at age 30: 3.47; 95%: 1.33-9.05). The positive predictive value of having 2 or more of these characteristics was 13% for breast cancer before the age of 70, 11% for breast cancer before the age of 50, and 1% for breast cancer before the age of 30. CONCLUSION: Applying family history related criteria in an unselected population could result in the screening of many women who will not develop breast cancer at an early age

Monitoring catches in the pulse fishery

Dit rapport geeft informatie over de vangstsamenstelling van de Nederlandse pulsvisserij op platvis. Traditioneel wordt er in de Nederlandse platvisvisserij voornamelijk met de conventionele boomkor gevist. De afgelopen jaren heeft er een geleidelijke en gedeeltelijke overgang plaatsgevonden naar de pulsvisserij, waarbij de wekkerkettingen zijn vervangen door elektrodes. De Nederlandse demersale vissers zijn positief over het pulstuig, voornamelijk door lagere oliekosten en goede tong vangsten. In de zuidelijke Noordzee is sinds 2007 per lidstaat een ontheffing voor 5 procent van de boomkorvloot. Dat wil zeggen dat 5% van de boomkorvloot met het pulstuig mag vissen. In 2011 is bij de toekenning van de vergunningen door de EU de voorwaarde gesteld dat er meer informatie zou worden verzameld over de effecten van de pulsvisserij. Dit rapport beschrijft de onderzoeksactiviteiten die zijn uitgevoerd om aan deze voorwaarde van de EU te voldoen