Advance directives in dementia care: perspectives of people with Alzheimer's disease, elderly care physicians and relatives

Hertogh, C.M.P.M. [Promotor]Eefsting, J.A. [Promotor]Droes, R.M. [Copromotor

Restraint interventions in people with moderate to profound intellectual disabilities:Perspectives of support staff and family members

Background: Due to incompatibilities in communication, it is key that family members and support staff can take the perspective of people with moderate to profound intellectual disabilities (ID) whilst putting aside their own perspectives. Method: Ten vignettes describing types of restraint interventions (RIs) were presented to 20 unique pairs of support staff and family members related to individuals with moderate to profound ID. Results: In taking their own perspective, more than half of the support staff and family members perceived all RIs as involuntary and severe. In contrast, when asked to put themselves in the position of the client/family member, only three RIs were considered involuntary by a majority of support staff and family members. Conclusions: These results indicate that support staff and family members can take into account the perspective of people with moderate to profound ID in the evaluation and consideration of involuntary care

Functional environmental genomics of a municipal landfill soil.

We investigated the toxicity of soil samples derived from a former municipal landfill site in the South of the Netherlands, where a bioremediation project is running aiming at reusing the site for recreation. Both an organic soil extract and the original soil sample was investigated using the ISO standardised Folsomia soil ecotoxicological testing and gene expression analysis. The 28 day survival/reproduction test revealed that the ecologically more relevant original soil sample was more toxic than the organic soil extract. Microarray analysis showed that the more toxic soil samples induced gene regulatory changes in twice as less genes compared to the soil extract. Consequently gene regulatory changes were highly dependent on sample type, and were to a lesser extent caused by exposure level. An important biological process shared among the two sample types was the detoxification pathway for xenobiotics (biotransformation I, II and III) suggesting a link between compound type and observed adverse effects. Finally, we were able to retrieve a selected group of genes that show highly significant dose-dependent gene expression and thus were tightly linked with adverse effects on reproduction. Expression of four cytochrome P450 genes showed highest correlation values with reproduction, and maybe promising genetic markers for soil quality. However, a more elaborate set of environmental soil samples is needed to validate the correlation between gene expression induction and adverse phenotypic effects

Functional Requirements for Assistive Technology for People with Cognitive Impairments and Dementia

The amount of technological aids on the market to support people in their everyday functioning is increasing. For example mobile telephone, electronic diary, skyping and domotics. Many of these aids are too complicated to operate for people with cognitive impairments, like dementia. For technology to be practicable and useful for them, it will have to meet certain requirements. This paper addresses the needs and impairments of people with dementia, and the functional requirements for assistive technology for people with dementia. © 2012 Springer-Verlag

Systematic review: non-endoscopic surveillance for colorectal neoplasia in individuals with Lynch syndrome

Background: Individuals with Lynch syndrome are at high risk for colorectal cancer (CRC). Regular colonoscopies have proven to decrease CRC incidence and mortality. However, colonoscopy is burdensome and interval CRCs still occur. Hence, an accurate, less-invasive screening method that guides the timing of colonoscopy would be of important value.Aim: To outline the performance of non-endoscopic screening modalities for Lynch-associated CRC and adenomas.Methods: Systematic literature search in MEDLINE and EMBASE to identify studies investigating imaging techniques and biomarkers for detection of CRC and adenomas in Lynch syndrome. The QUADAS-2 tool was used for the quality assessment of included studies.Results: Seven of 1332 screened articles fulfilled the inclusion criteria. Two studies evaluated either CT colonography or MR colonography; both techniques were unable to detect CRC and (advanced) adenomas <10 mm. The other five studies evaluated plasma methylated-SEPTIN9, faecal immunochemical test (FIT), faecal tumour DNA markers (BAT-26, hMLH1, p53, D9S171, APC, D9S162, IFNA and DCC) and faecal microbiome as screening modalities. Sensitivity for CRC varied from 33% (BAT-26) to 70% (methylated-SEPTIN9) to 91% (hMLH1). High specificity (94-100%) for CRC and/or adenomas was observed for methylated-SEPTIN9, FIT and BAT-26. Desulfovibrio was enriched in the stool of patients having adenomas. However, all these studies were characterised by small populations, high/unclear risk of bias and/or low prevalence of adenomas.Conclusions: Imaging techniques are unsuitable for colon surveillance in Lynch syndrome, whereas biomarkers are understudied. Having outlined biomarker research in Lynch-associated and sporadic CRC/adenomas, we believe that these non-invasive markers may hold potential (whether or not combined) for this population. As they could be of great value, (pre-)clinical studies in this field should be prioritised.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Strongly correlated hopping and many-body bound states

We study a system in which the quantum dynamics of electrons depend on the particle density in their neighborhood. For any on-site repulsive interaction, we show that the exact two-body and three-body ground states are bound states. We also discuss the finite density case in a mean-field framework and we show that the system can undergo an unusual transition from an effective attractive interaction to a repulsive one, when varying the electron density.Comment: 6 pages, 6 EPS figures, minor modifications and references adde

Laminar burning velocities and Markstein numbers for pure hydrogen and methane/hydrogen/air mixtures at elevated pressures

Spherically expanding flame propagations have been employed to measure flame speeds for H2/CH4/air mixtures over a wide range of H2 fractions (30 %, 50 %, 70 and 100 % hydrogen by volume), at initial temperatures of 303 K and 360 K, and pressures of 0.1, 0.5 and 1.0 MPa. The equivalence ratio (ϕ) was varied from 0.5 to 2.5 for pure hydrogen and from 0.8 to 1.2 for methane/hydrogen mixtures. Experimental laminar burning velocities and Markstein numbers for methane/hydrogen/air mixtures at high pressures, which are crucial for gas turbine applications, are very rare in the literature. Moreover, simulations using three recent chemical kinetic mechanisms (Konnov-2018 detailed reaction, Aramco-2.0-2016 and San Diego Methane detailed mechanism (version 20161214)) were compared against the experimentally derived laminar burning velocities. The maximum laminar burning velocity for 30 % and 50 % H2 occurs at ϕ = 1.1. However, it shifts to ϕ = 1.2 for 70 % H2 and to ϕ = 1.7 for a pure H2 flame. The laminar burning velocities increased with hydrogen fraction and temperature, and decreased with pressure. Unexpected behaviour was recorded for pure H2 flames at low temperature and ϕ = 1.5, 1.7 wherein ul did not decrease when the pressure increased from 0.1 to 0.5 MPa. Although, the measurement uncertainty is large at these conditions, the flame structure analysis showed a minimum decline in the mass fractions of the active species (H, O, and OH) with the rise in the initial pressure. Markstein length (Lb) and Markstein number (Mab and Masr) varied non-monotonically with hydrogen volume fraction, pressure and temperature. There was generally good agreement between simulations and experimentally derived laminar burning velocities, however, for experiments of rich-pure hydrogen at high initial pressures, the level of agreement decreased but remained within the limits of experimental uncertainty

Subtle, CXCR3-dependent, chemotaxis of cytotoxic cells within infected tissues allows efficient target localization

Toxicolog

Increased aortic stiffness and blood pressure in non-classic Pompe disease

Vascular abnormalities and glycogen accumulation in vascular smooth muscle fibres have been described in Pompe disease. Using carotid-femoral pulse wave velocity (cfPWV), the gold standard methodology for determining aortic stiffness, we studied whether aortic stiffness is increased in patients with Pompe disease. Eighty-four adult Pompe patients and 179 age- and gender-matched volunteers participated in this cross-sectional case-controlled study. Intima media thickness and the distensibility of the right common carotid artery were measured using a Duplex scanner. Aortic augmentation index, central pulse pressure, aortic reflexion time and cfPWV were assessed using the SphygmoCor® system. CfPWV was higher in patients than in volunteers (8.8 versus 7.4 m/s, p < 0.001). This difference was still present after adjustment for age, gender, mean arterial blood pressure (MAP), heart rate and diabetes mellitus (p = 0.001), and was shown by subgroup analysis to apply to the 40-59 years age group (p = 0.004) and 60+ years age group (p = 0.01), but not to younger age groups (p = 0.99)

The synthesis of cyclophellitol-aziridine and its configurational and functional isomers

Medical Biochemistr