О состоянии и проблемах автоматизации Фундаментальной библиотеки Академии наук Республики Узбекистан

Dit rapport heeft tot doel bijzondere aandacht te vragen van de Nederlandse regering, in het bijzonder de Minister van Buitenlandse Zaken, voor de praktijken van arrestatie, verhoor, detentie en berechting van Palestijnse kinderen door de Israëlische militaire autoriteiten op de Westelijke Jordaanoever. Hiermee beoogt het rapport de Minister ertoe aan te zetten om, in diens betrekkingen met de Israëlische and Palestijnse autoriteiten, en waar mogelijk in Europese Unie-verband, te bevorderen dat arrestatie, verhoor, detentie en ebrechting van Palestijnse kinderen door de Israëlische militaire autoriteiten uitsluitend plaats vindt in overeenstemming met de internationaal erkende rechten van het kind en de daarbij behorende standaarden

The influence of entrance constriction on hydrodynamics and intertidal morphology within estuarine basins

We investigate the influence of basin entrance constriction on current velocities, tidal asymmetry, bed shear stresses and intertidal morphology by using a numerical model developed in Delft3D. Hypsometric curves created for six sub-estuaries within Tauranga Harbour indicate a possible link between intertidal hypsometry and entrance constriction. Model results for both spring- and neap tidal cycles show that a constricted subestuary with a deep entrance channel is associated with low current velocities and bed shear stresses in the centre of the basin– conditions favourable for sediment deposition. These constricted geometries are shown to be characterized by convex intertidal equilibrium profiles. Unconstricted sub-estuary model results display an even distribution of relatively high current velocities and bed shear stresses resulting in potential for erosion throughout the estuary. The unconstricted basins in our study are mainly associated with concave intertidal equilibrium profiles. Flood dominance increases from the entrance further into the estuary for both constricted and unconstricted conditions

Food Literacy Is Associated With Adherence to a Mediterranean-Style Diet in Kidney Transplant Recipients

Objectives Adherence to a Mediterranean-style diet is associated with improved health outcomes in kidney transplant recipients (KTR). However, poor dietary habits, including excessive sodium intake, are common in KTR, indicating difficulties with incorporating a healthy diet into daily life. Food literacy is identified as potential facilitator of a healthy diet, but the precise relationship between food literacy and dietary intake in KTR has not been investigated. This study examined food literacy levels in KTR and its association with adherence to a Mediterranean-style diet and sodium intake. Methods This cross-sectional study is part of the TransplantLines Cohort and Biobank Study. Food literacy was measured with the Self-Perceived Food Literacy (SPFL) questionnaire. Dietary intake assessment with food frequency questionnaires was used to calculate the Mediterranean Diet Score. Sodium intake was based on the 24-hour urinary sodium excretion rate. Associations of SPFL with Mediterranean Diet Score and sodium intake were assessed with univariable and multivariable linear regression analyses. Results In total, 148 KTR (age 56 [48-66]; 56% male) completed the SPFL questionnaire with a mean SPFL score of 3.63 ± 0.44. Higher SPFL was associated with a higher Mediterranean Diet Score in KTR (β = 1.51, 95% confidence interval 0.88-2.12, P ≤ .001). Although KTR with higher food literacy tended to have a lower sodium intake than those with lower food literacy (P = .08), the association of food literacy with sodium intake was not significant in a multivariable regression analysis (β = 0.52 per 10 mmol/24-hour increment, 95% confidence interval −1.79 to 2.83, P = .66). Conclusions Higher levels of food literacy are associated with better adherence to a Mediterranean-style diet in KTR. No association between food literacy and sodium intake was found. Further studies are needed to determine if interventions on improving food literacy contribute to a healthier diet and better long-term outcomes in KTR

The effect of physician training and patient education on the discussion of care decisions at the internal medicine outpatient clinic

Background: Care decision discussions are intended to align treatment with the patient’s wishes, goals and values. To overcome the numerous barriers to such discussions, physicians as well as patients need tailored support. We evaluate the effect of a physicians’ training and a conversation aid for patients about care decisions on patient and physician outcomes. Methods: At the internal medicine outpatient clinic of the University Medical Centre Utrecht, a 1:1 randomized, parallel-group study (patient conversation aid) was combined with a pre-post intervention (physicians’ training) design. Primary outcome was patient satisfaction, secondary outcomes were patient-doctor relationship, shared-decision-making, doctor preparedness and patient appreciation of the conversation aid. Results: Between October 2018 and February 2020 11 physicians (36% residents, 73% female) and 185 patients (median age 58 years (interquartile range (IQR) 50–68), 60% male) participated. Only 28% of the patients reported a care decision discussion during the consultation. We found no effect of the interventions on patient satisfaction (effect sizes -0.14 (95% confidence interval (CI) -0.56–0.27) for conversation aid; 0.04 (95% CI -0.40–0.48) for physician’s training), nor on the patient-doctor relationship or shared-decision-making. However, physicians felt more prepared to discuss care decisions after training (median 3 (IQR 1–4) vs 1 (IQR 0–3), p = 0.015). Patients assessed the conversation aid informative and gave an overall mark of median 7 (IQR 7–8). Conclusions: First steps towards fruitful discussions about care decisions were made: patients considered the conversation aid informative and physicians felt better prepared to discuss care decisions after training. The low number of care decision conversations patients reported shows exactly how important it is to focus on interventions that facilitate these discussions, for both the patient and physician. Further work needs to be done to establish the best way to empower patients and physicians. Trial registration: Dutch trial register, trial 6998 (NTR 7188), registered 04/05/2018, https://www.trialregister.nl/trial/6998

Clinical pharmacokinetics of antipsychotics in pediatric populations:a scoping review focusing on dosing regimen

Introduction:Achieving optimal clinical responses and minimizing side effects through precision dosing of antipsychotics in children and adolescents with psychiatric disorders remains a challenge. Identifying patient characteristics (covariates) that affect pharmacokinetics can inform more effective dosing strategies and ultimately improve patient outcomes. This review aims to provide greater insight into the impact of covariates on the clinical pharmacokinetics of antipsychotics in pediatric populations. Areas covered: A comprehensive literature search was conducted, and the main findings regarding the effects of the covariates on the pharmacokinetics of antipsychotics in children and adolescents are presented. Expert opinion: Our study highlights significant covariates, including age, sex, weight, CYP2D6 phenotype, co-medication, and smoking habits, which affect the pharmacokinetics of antipsychotics. However, the findings were generally limited by the small sample sizes of naturalistic, open-label, observational studies, and the homogeneous subgroups. Dosing based on weight and preemptive genotyping could prove beneficial for optimizing the dosing regimen in pediatric populations. Future research is needed to refine dosing recommendations and establish therapeutic reference ranges critical for precision dosing and Therapeutic Drug Monitoring (TDM). The integration of individual patient characteristics with TDM can further optimize the efficacy and safety of antipsychotics for each patient.</p

Effect of dupilumab on asthma and aeroallergen sensitization in pediatric atopic dermatitis patients: Results of the BioDay registry

Background: Atopic dermatitis (AD) is frequently associated with asthma and allergic rhinitis (AR). Dupilumab is an effective treatment for pediatric AD, although the effect on atopic comorbidities in pediatric AD patients is limited. Objective: To investigate the prevalence of asthma and AR in pediatric AD patients starting dupilumab treatment and to evaluate the effect of dupilumab on these comorbidities. Methods: This study included pediatric AD patients (aged 3–17 years) treated with dupilumab between 2019 and 2023. Patients were screened at baseline by a pulmonologist for the presence of asthma and AR. Screening included evaluation of medical history and current symptoms, spirometry (including Forced Expiratory Volume in 1 s (FEV1)), Fractional exhaled Nitric Oxide (FeNO), and measurement of aeroallergen-specific IgE levels. In patients diagnosed with comorbid asthma and/or AR, measurements were repeated at weeks 16 and 52. Spirometry measurements, FeNO, and aeroallergen-specific IgE levels during treatment were analyzed using a covariance pattern model. Results: Eighty-four patients were included. Asthma was diagnosed in 50 patients (59.5%) and AR in 72 patients (85.7%). Baseline FeNO levels were elevated in both patients with (29.0 ppb (95% CI 22.0–54.0)) and without asthma (26.0 ppb (95% CI 22.0–30.0)). During treatment, FeNO levels decreased (p <.001) and FEV1 scores increased (p <.001) in patients with asthma. In patients with asthma and/or AR, all aeroallergen-specific IgE levels decreased between 61.3% and 89.1% at 52 weeks of treatment. Conclusion: One year of dupilumab treatment, primarily indicated for AD, resulted in a significant improvement in comorbid asthma and a profound decrease in aeroallergen-specific IgE levels in patients with asthma and/or AR