How are children and young people engaged in research on paediatric obesity and which issues do they report?:A scoping review

The importance of engaging children and adolescents in research is increasingly acknowledged. The aim of this scoping review is to explore how children and young people have been engaged in research on paediatric obesity and which issues they have reported, in order to highlight areas that require further inquiry or action by researchers and health care professionals. There were 13 papers eligible for this review. Methods used included in-depth interviews, structured or semi-structured interviews, and focus groups, as well as more creative qualitative research methods. Half of the studies included young people with their parents; parents were always present when the interviewees were young children. Personal and sensitive themes, such as bullying, a desire to “fit in”, strong negative emotions about oneself (e.g., low self-esteem, low self-efficacy), and not feeling supported by family, peers, and professionals, were more often shared if parents were not present. An additional issue, wanting to be independent versus being under parental control was found in studies with adolescents. Engaging children and adolescents in multiple phases of research on paediatric obesity is beneficial in allowing better insight into their perspectives and providing recommendations that are more in line with their personal needs and life circumstances; such studies are still scarce in this field, however

Double-heterostructure cavities: from theory to design

We derive a frequency-domain-based approach for radiation (FAR) from double-heterostructure cavity (DHC) modes. We use this to compute the quality factors and radiation patterns of DHC modes. The semi-analytic nature of our method enables us to provide a general relationship between the radiation pattern of the cavity and its geometry. We use this to provide general designs for ultrahigh quality factor DHCs with radiation patterns that are engineered to emit vertically

Asymptotic behaviour of a semilinear elliptic system with a large exponent

Consider the problem \begin{eqnarray*} -\Delta u &=& v^{\frac 2{N-2}},\quad v>0\quad {in}\quad \Omega, -\Delta v &=& u^{p},\:\:\:\quad u>0\quad {in}\quad \Omega, u&=&v\:\:=\:\:0 \quad {on}\quad \partial \Omega, \end{eqnarray*} where $\Omega$ is a bounded convex domain in $\R^N,$ $N>2,$ with smooth boundary $\partial \Omega.$ We study the asymptotic behaviour of the least energy solutions of this system as $p\to \infty.$ We show that the solution remain bounded for $p$ large and have one or two peaks away form the boundary. When one peak occurs we characterize its location.Comment: 16 pages, submmited for publicatio

Metabolomics-Based Screening of Inborn Errors of Metabolism: Enhancing Clinical Application with a Robust Computational Pipeline

Contains fulltext : 238438.pdf (Publisher’s version ) (Open Access

Appropriate medication use in Dutch terminal care:study protocol of a multicentre stepped-wedge cluster randomized controlled trial (the AMUSE study)

Background: Polypharmacy is common among patients with a limited life expectancy, even shortly before death. This is partly inevitable, because these patients often have multiple symptoms which need to be alleviated. However, the use of potentially inappropriate medications (PIMs) in these patients is also common. Although patients and relatives are often willing to deprescribe medication, physicians are sometimes reluctant due to the lack of evidence on appropriate medication management for patients in the last phase of life. The aim of the AMUSE study is to investigate whether the use of CDSS-OPTIMED, a software program that gives weekly personalized medication recommendations to attending physicians of patients with a limited life expectancy, improves patients’ quality of life. Methods: A multicentre stepped-wedge cluster randomized controlled trial will be conducted among patients with a life expectancy of three months or less. The stepped-wedge cluster design, where the clusters are the different study sites, involves sequential crossover of clusters from control to intervention until all clusters are exposed. In total, seven sites (4 hospitals, 2 general practices and 1 hospice from the Netherlands) will participate in this study. During the control period, patients will receive ‘care as usual’. During the intervention period, CDSS-OPTIMED will be activated. CDSS-OPTIMED is a validated software program that analyses the use of medication based on a specific set of clinical rules for patients with a limited life expectancy. The software program will provide the attending physicians with weekly personalized medication recommendations. The primary outcome of this study is patients’ quality of life two weeks after baseline assessment as measured by the EORTC QLQ-C15-PAL questionnaire, quality of life question.Discussion: This will be the first study investigating the effect of weekly personalized medication recommendations to attending physicians on the quality of life of patients with a limited life expectancy. We hypothesize that the CDSS-OPTIMED intervention could lead to improved quality of life in patients with a life expectancy of three months or less. Trial registration: This trial is registered at ClinicalTrials.gov (NCT05351281, Registration Date: April 11, 2022).</p

Appropriate medication use in Dutch terminal care:study protocol of a multicentre stepped-wedge cluster randomized controlled trial (the AMUSE study)

Background: Polypharmacy is common among patients with a limited life expectancy, even shortly before death. This is partly inevitable, because these patients often have multiple symptoms which need to be alleviated. However, the use of potentially inappropriate medications (PIMs) in these patients is also common. Although patients and relatives are often willing to deprescribe medication, physicians are sometimes reluctant due to the lack of evidence on appropriate medication management for patients in the last phase of life. The aim of the AMUSE study is to investigate whether the use of CDSS-OPTIMED, a software program that gives weekly personalized medication recommendations to attending physicians of patients with a limited life expectancy, improves patients’ quality of life. Methods: A multicentre stepped-wedge cluster randomized controlled trial will be conducted among patients with a life expectancy of three months or less. The stepped-wedge cluster design, where the clusters are the different study sites, involves sequential crossover of clusters from control to intervention until all clusters are exposed. In total, seven sites (4 hospitals, 2 general practices and 1 hospice from the Netherlands) will participate in this study. During the control period, patients will receive ‘care as usual’. During the intervention period, CDSS-OPTIMED will be activated. CDSS-OPTIMED is a validated software program that analyses the use of medication based on a specific set of clinical rules for patients with a limited life expectancy. The software program will provide the attending physicians with weekly personalized medication recommendations. The primary outcome of this study is patients’ quality of life two weeks after baseline assessment as measured by the EORTC QLQ-C15-PAL questionnaire, quality of life question.Discussion: This will be the first study investigating the effect of weekly personalized medication recommendations to attending physicians on the quality of life of patients with a limited life expectancy. We hypothesize that the CDSS-OPTIMED intervention could lead to improved quality of life in patients with a life expectancy of three months or less. Trial registration: This trial is registered at ClinicalTrials.gov (NCT05351281, Registration Date: April 11, 2022).</p

Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light

BACKGROUND: Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve remaining problems of SLN mapping in colorectal cancer. METHODS: The FLARE imaging system was used for real-time identification of SLNs after injection of the NIR lymphatic tracer HSA800 in the colon and rectum of (n = 4) pigs. A total of 32 SLN mappings were performed in vivo and ex vivo after oncologic resection using an identical injection technique. Guided by these results, SLN mappings were performed in ex vivo tissue specimens of 24 consecutive colorectal cancer patients undergoing resection. RESULTS: Lymph flow could be followed in real-time from the injection site to the SLN using NIR fluorescence. In pigs, the SLN was identified in 32 of 32 (100%) of SLN mappings under both in vivo and ex vivo conditions. Clinically, SLNs were identified in all patients (n = 24) using the ex vivo strategy within 5 min after injection of fluorescent tracer. Also, 9 patients showed lymph node involvement (N1 disease). In 1 patient, a 3-mm mesenteric metastasis was found adjacent to a tumor-negative SLN. CONCLUSIONS: The current pilot study shows proof of principle that ex vivo NIR fluorescence-guided SLN mapping can provide high-sensitivity, rapid, and accurate identification of SLNs in colon and rectum. This creates an experimental platform to test optimized, non-FDA-approved NIR fluorescent lymphatic tracers in a clinical setting.Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

Verslag van de 159e zomerbijeenkomst te Den Hoorn

Tijdens de 159e zomervergadering van de NEV, die plaatsvond op Texel van 4 tot 6 juni 2004, zijn 1117 taxa van veertien insectenordes waargenomen. Hoewel ook dit keer wat aantal soorten betreft, kevers de boventoon voerden zijn er geen nieuwe keversoorten voor de provincie Noord-Holland gevonden. Met soortenlijst en lijst van vindplaatse