Is livestock grazing a key factor for changing vegetation patterns in lime rich coastal dunes in the Netherlands?

In 1990, livestock grazing was introduced in Meijendel, a 1800 ha lime-rich coastal dune area, at a density of 0.06–0.07 LLU.ha-1.year−1 (1:12–18 ha) to counteract encroachment of tall grasses and shrubland on dune grassland and increase the bare sand area. Monitoring was based on four digital orthophotos (1975–1990–2001-2009) with a high spatial resolution (pixel size 25 × 25 cm). The changes were tested using Generalized Estimating Equations. Habitat changes occurred, but contradicting our hypothesis, there was no significant impact from the grazing on bare sand, grassland or shrubland within 11 and 19 years post livestock introduction. (1) After several decennia of decreasing bare sand, there was a significant increase between 2001 and 2009, irrespective of livestock presence. (2) The changes in grasslands and shrublands are independent of the livestock, but dependent on distance to the coast. (3) Bare sand and shrub cover determine the space left for the dune grasslands. It appears other factors than livestock grazing must have induced the changes. Changes in climate conditions and nitrogen load might have stimulated bare sand. An interaction with the end of Marram planting in 1990 cannot be concluded from available data. The disease-led reduction of rabbit grazing from the mid-1950s led to an expansion of the dominant shrub Hippophae rhamnoides. However, Hippophae shrubland typically regresses to grasslands on its collapse after 25–40 years. Tree species like Crataegus, Betula and Quercus will gradually dominate the landscape for far longer. Active removal of these indigenous species is necessary to prevent future loss of dune grasslands.</p

Impact of employee motivation on passenger satisfaction levels – A case study in the state of Karnataka (India)

Institute of Transport and Logistics Studies. Faculty of Economics and Business. The University of Sydne

Screening methods for neonatal hyperbilirubinemia:benefits, limitations, requirements, and novel developments

Severe neonatal hyperbilirubinemia (SNH) is a serious condition that occurs worldwide. Timely recognition with bilirubin determination is key in the management of SNH. Visual assessment of jaundice is unreliable. Fortunately, transcutaneous bilirubin measurement for screening newborn infants is routinely available in many hospitals and outpatient settings. Despite a few limitations, the use of transcutaneous devices facilitates early recognition and appropriate management of neonatal jaundice. Unfortunately, however, advanced and often costly screening modalities are not accessible to everyone, while there is an urgent need for inexpensive yet accurate instruments to assess total serum bilirubin (TSB). In the near future, novel icterometers, and in particular optical bilirubin estimates obtained with a smartphone camera and processed with a smartphone application (app), seem promising methods for screening for SNH. If proven reliable, these methods may empower outpatient health workers as well as parents at home to detect jaundice using a simple portable device. Successful implementation of ubiquitous bilirubin screening may contribute substantially to the reduction of the worldwide burden of SNH. The benefits of non-invasive bilirubin screening notwithstanding, any bilirubin determination obtained through non-invasive screening must be confirmed by a diagnostic method before treatment. ImpactKey message: Screening methods for neonatal hyperbilirubinemia facilitate early recognition and timely treatment of severe neonatal hyperbilirubinemia (SNH). Any bilirubin screening result obtained must be confirmed by a diagnostic method. What does this article add to the existing literature? Data on optical bilirubin estimation are summarized. Niche research strategies for prevention of SNH are presented. Impact: Transcutaneous screening for neonatal hyperbilirubinemia contributes to the prevention of SNH. A smartphone application with optical bilirubin estimation seems a promising low-cost screening method, especially in low-resource settings or at home.Afdeling Klinische Chemie en Laboratoriumgeneeskunde (AKCL

Diagnostic methods for neonatal hyperbilirubinemia:benefits, limitations, requirements, and novel developments

Invasive bilirubin measurements remain the gold standard for the diagnosis and treatment of infants with severe neonatal hyperbilirubinemia. The present paper describes different methods currently available to assess hyperbilirubinemia in newborn infants. Novel point-of-care bilirubin measurement methods, such as the BiliSpec and the Bilistick, would benefit many newborn infants, especially in low-income and middle-income countries where the access to costly multi-analyzer in vitro diagnostic instruments is limited. Total serum bilirubin test results should be accurate within permissible limits of measurement uncertainty to be fit for clinical purposes. This implies correct implementation of internationally endorsed reference measurement systems as well as participation in external quality assessment programs. Novel analytic methods may, apart from bilirubin, include the determination of bilirubin photoisomers and bilirubin oxidation products in blood and even in other biological matrices. ImpactKey message: Bilirubin measurements in blood remain the gold standard for diagnosis and treatment of severe neonatal hyperbilirubinemia (SNH). External quality assessment (EQA) plays an important role in revealing inaccuracies in diagnostic bilirubin measurements. What does this article add to the existing literature? We provide analytic performance data on total serum bilirubin (TSB) as measured during recent EQA surveys. We review novel diagnostic point-of-care (POC) bilirubin measurement methods and analytic methods for determining bilirubin levels in biological matrices other than blood. Impact: Manufacturers should make TSB test results traceable to the internationally endorsed total bilirubin reference measurement system and should ensure permissible limits of measurement uncertainty.Afdeling Klinische Chemie en Laboratoriumgeneeskunde (AKCL

Ultra-thin corrugated metamaterial film as large-area transmission dynode

Large-area transmission dynodes were fabricated by depositing an ultra-thin continuous film on a silicon wafer with a 3-dimensional pattern. After removing the silicon, a corrugated membrane with enhanced mechanical properties was formed. Mechanical materials, such as this corrugated membrane, are engineered to improve its strength and robustness, which allows it to span a larger surface in comparison to flat membranes while the film thickness remains constant. The ultra-thin film consists of three layers (Al$_2$O$_3$ /TiN/Al$_2$O$_3$) and is deposited by atomic layer deposition (ALD). The encapsulated TiN layer provides in-plane conductivity, which is needed to sustain secondary electron emission. Two types of corrugated membranes were fabricated: a hexagonal honeycomb and an octagonal pattern. The latter was designed to match the square pitch of a CMOS pixel chip. The transmission secondary electron yield was determined with a collector-based method using a scanning electron microscope. The highest transmission electron yield was measured on a membrane with an octagonal pattern. A yield of 2.15 was achieved for 3.15 keV incident electrons for an Al$_2$O$_3$ /TiN/Al$_2$O$_3$ tri-layer film with layer thicknesses of 10/5/15 nm. The variation in yield across the surface of the corrugated membrane was determined by constructing a yield map. The active surface for transmission secondary electron emission is near 100%, i.e. a primary electron generates transmission secondary electrons regardless of the point of impact on the corrugated membrane

Performance of triage systems in emergency care: a systematic review and meta-analysis

Objective To assess and compare the performance of triage systems for identifying high and low-urgency patients in the emergency department (ED). Design Systematic review and meta-analysis. Data sources EMBASE, Medline OvidSP, Cochrane central, Web of science and CINAHL databases from 1980 to 2016 with the final update in December 2018. Eligibility criteria Studies that evaluated an emergency medical triage system, assessed validity using any reference standard as proxy for true patient urgency and were written in English. Studies conducted in low(er) income countries, based on case scenarios or involving less than 100 patients were excluded. Review methods Reviewers identified studies, extracted data and assessed the quality of the evidence independently and in duplicate. The Quality Assessment of studies of Diagnostic Accuracy included in Systematic Reviews -2 checklist was used to assess risk of bias. Raw data were extracted to create 2×2 tables and calculate sensitivity and specificity. ED patient volume and casemix severity of illness were investigated as determinants of triage systems’ performance. Results Sixty-six eligible studies evaluated 33 different triage systems. Comparisons were restricted to the three triage systems that had at least multiple evaluations using the same reference standard (Canadian Triage and Acuity Scale, Emergency Severity Index and Manchester Triage System). Overall, validity of each triage system to identify high and low-urgency patients was moderate to good, but performance was highly variable. In a subgroup analysis, no clear association was found between ED patient volume or casemix severity of illness and triage systems’ performance. Conclusions Established triage systems show a reasonable validity for the triage of patients at the ED, but performance varies considerably. Important research questions that remain are what determinants influence triage systems’ performance and how the performance of existing triage systems can be improved

Lack of genotype-phenotype correlation in basal cell nevus syndrome:A Dutch multicenter retrospective cohort study

Contains fulltext : 225468.pdf (Publisher’s version ) (Closed access

Low molecular weight protein tyrosine phosphatase (LMWPTP) upregulation mediates malignant potential in colorectal cancer

Phosphatases have long been regarded as tumor suppressors, however there is emerging evidence for a tumor initiating role for some phosphatases in several forms of cancer. Low Molecular Weight Protein Tyrosine Phosphatase (LMWPTP; acid phosphatase 1 [ACP1]) is an 18 kDa enzyme that influences the phosphorylation of signaling pathway mediators involved in cancer and is thus postulated to be a tumor-promoting enzyme, but neither unequivocal clinical evidence nor convincing mechanistic actions for a role of LMWPTP have been identified. In the present study, we show that LMWPTP expression is not only significantly increased in colorectal cancer (CRC), but also follows a step-wise increase in different levels of dysplasia. Chemical inhibition of LMWPTP significantly reduces CRC growth. Furthermore, downregulation of LMWPTP in CRC leads to a reduced migration ability in both 2D- and 3D-migration assays, and sensitizes tumor cells to the chemotherapeutic agent 5-FU. In conclusion, this study shows that LMWPTP is not only overexpressed in colorectal cancer, but it is correlated with the malignant potential of this cancer, suggesting that this phosphatase may act as a predictive biomaker of CRC stage and represents a rational novel target in the treatment of this disease.6108300831

Self-consistent Green's function approaches

We present the fundamental techniques and working equations of many-body Green's function theory for calculating ground state properties and the spectral strength. Green's function methods closely relate to other polynomial scaling approaches discussed in chapters 8 and 10. However, here we aim directly at a global view of the many-fermion structure. We derive the working equations for calculating many-body propagators, using both the Algebraic Diagrammatic Construction technique and the self-consistent formalism at finite temperature. Their implementation is discussed, as well as the inclusion of three-nucleon interactions. The self-consistency feature is essential to guarantee thermodynamic consistency. The pairing and neutron matter models introduced in previous chapters are solved and compared with the other methods in this book.Comment: 58 pages, 14 figures, Submitted to Lect. Notes Phys., "An advanced course in computational nuclear physics: Bridging the scales from quarks to neutron stars", M. Hjorth-Jensen, M. P. Lombardo, U. van Kolck, Editor