Higher education reform: getting the incentives right

This study is a joint effort by the Netherlands Bureau for Economic Policy Analysis (CPB) and the Center for Higher Education Policy Studies. It analyses a number of `best practices¿ where the design of financial incentives working on the system level of higher education is concerned. In Chapter 1, an overview of some of the characteristics of the Dutch higher education sector is presented. Chapter 2 is a refresher on the economics of higher education. Chapter 3 is about the Australian Higher Education Contribution Scheme (HECS). Chapter 4 is about tuition fees and admission policies in US universities. Chapter 5 looks at the funding of Danish universities through the so-called taximeter-model, that links funding to student performance. Chapter 6 deals with research funding in the UK university system, where research assessments exercises underlie the funding decisions. In Chapter 7 we study the impact of university-industry ties on academic research by examining the US policies on increasing knowledge transfer between universities and the private sector. Finally, Chapter 8 presents food for thought for Dutch policymakers: what lessons can be learned from our international comparison

Spontaneous Ratchet Effect in a Granular Gas

The spontaneous clustering of a vibrofluidized granular gas is employed to generate directed transport in two different compartmentalized systems: a "granular fountain" in which the transport takes the form of convection rolls, and a "granular ratchet" with a spontaneous particle current perpendicular to the direction of energy input. In both instances, transport is not due to any system-intrinsic anisotropy, but arises as a spontaneous collective symmetry breaking effect of many interacting granular particles. The experimental and numerical results are quantitatively accounted for within a flux model.Comment: 4 pages, 5 figures; Fig. 4 has been reduced in size and qualit

Eradication of Resistant and Susceptible Aerobic Gram-Negative Bacteria From the Digestive Tract in Critically Ill Patients; an Observational Cohort Study

BACKGROUND: Selective Decontamination of the Digestive tract (SDD) aims to prevent nosocomial infections, by eradication of potentially pathogenic micro-organisms from the digestive tract. OBJECTIVES: To estimate the rate of and the time to eradication of resistant vs. susceptible facultative aerobic gram-negative bacteria (AGNB) in patients treated with SDD. METHODS: This observational and retrospective study included patients admitted to the ICU between January 2001 and August 2017. Patients were included when treated with SDD (tobramycin, polymyxin B, and amphotericin B) and colonized in the upper or lower gastro-intestinal (GI) tract with at least one AGNB present on admission. Decontamination was determined after the first negative set of cultures (rectal and throat). An additional analysis was performed of two consecutive negative cultures. RESULTS: Of the 281 susceptible AGNB in the throat and 1,087 in the rectum on admission, 97.9 and 93.7%, respectively, of these microorganisms were successfully eradicated. In the upper GI-tract no differences in eradication rates were found between susceptible and resistant microorganisms. However, the median duration until eradication was significantly longer for aminoglycosides resistant vs. susceptible microorganisms (5 vs. 4 days, p < 0.01). In the lower GI-tract, differences in eradication rates between susceptible and resistant microorganisms were found for cephalosporins (90.0 vs. 95.6%), aminoglycosides (84.4 vs. 95.5%) and ciprofloxacin (90.0 vs. 95.2%). Differences in median duration until eradication between susceptible and resistant microorganisms were found for aminoglycosides and ciprofloxacin (both 5 days vs. 6 days, p = 0.001). Decontamination defined as two negative cultures was achieved in a lower rate (77–98% for the upper GI tract and 64–77% for the lower GI tract) and a median of 1 day later. CONCLUSION: The vast majority of both susceptible and resistant microorganisms are effectively eradicated from the upper and lower GI tract. In the lower GI tract decontamination rates of susceptible microorganisms are significantly higher and achieved in a shorter time period compared to resistant strains

Cancer and heart disease:associations and relations

Emerging evidence supports that cancer incidence is increased in patients with cardiovascular (CV) disease and heart failure (HF), and patients with HF frequently die from cancer. Recently, data have been generated showing that circulating factors in relation to HF promote tumour growth and development in murine models, providing proof that a causal relationship exists between both diseases. Several common pathophysiological mechanisms linking HF to cancer exist, and include inflammation, neuro-hormonal activation, oxidative stress and a dysfunctional immune system. These shared mechanisms, in combination with risk factors, in concert may explain why patients with HF are prone to develop cancer. Investigating the new insights linking HF with cancer is rapidly becoming an exciting new field of research, and we herein review the most recent data. Besides insights in mechanisms, we call for clinical awareness, that is essential to optimize treatment strategies of patients having developed cancer with a history of HF. Finally, ongoing and future trials should strive for comprehensive phenotyping of both CV and cancer end points, to allow optimal usefulness of data, and to better describe and understand common characteristics of these two lethal diseases

Keanekaragaman Potensi Regenerasi Vegetasi pada Hutan Rawa Gambut: Studi Kasus di Kawasan Hutan Dengan Tujuan Khusus (KHDTK) Tumbang Nusa, Kalimantan Tengah

Degradasi ekosistem hutan termasuk hutan rawa gambut umumnya diwakili oleh degradasi tutupan vegetasi. Degradasi hutan cenderung mengikuti gradien jarak dari tepi hutan menuju ke dalam hutan. Tujuan dari penelitian adalah untuk mengetahui keanekaragaman dan dominasi potensi regenerasi alami di hutan rawa gambut di Kalimantan Tengah. Anakan alam, guguran buah, dan biji yang tersimpan di lapisan tanah sebagai indikator potensi regenerasi alami diukur dari serangkaian plot terletak mengikuti gradien jarak. Hasil penelitian menunjukkan perbedaan potensi regenerasi alami mengikuti gradien jarak secara signifikan. Keragaman potensi regenerasi alami cenderung menurun mengikuti gradien gangguan, di mana yang terendah ditemukan di tepi hutan. Anakan alam di tepi didominasi oleh Combretocarpus rotundatus (Miq.) Danser sementara Litsea oppositifolia L.S. Gibbs mendominasi di bagian dalam. Guguran buah didominasi oleh Combretocarpus rotundatus di semua gradien jarak pada musim kemarau, sementara itu Palaquium sp. mendominasi gradien dalam hutan dan Combretocarpus rotundatus mendominasi gradien tepi hutan selama musim pancaroba. Hal ini menunjukkan bahwa musim memberi efek signifikan pada jumlah biji, jumlah spesies, dan keanekaragaman guguran buah, dan ketiga indikator potensi regenerasi ternyata lebih tinggi selama musim pancaroba. Biji di lapisan tanah didominasi oleh Tristaniopsis obovata (Benn.) Peter G. Wilson & J.T. Waterh di gradien dalam hutan dan Diospyros sp. di gradien tepi. Namun, biji di lapisan tanah di gradien tepi ini merupakan jenis yang menyusun pada gradien dalam hutan (50% indeks kesamaan). Hal ini menunjukkan bahwa penyebaran benih dari hutan sebagai sumber inokulum masih bisa mencapai tepi dan juga menunjukkan bagaimana kehadiran vegetasi di gradien tepi sebelum terjadi gangguan.Kata kunci: anakan alam; biji di lapisan tanah; gradien jarak; guguran buah; hutan rawa gambut Potential Diversity of Natural Regeneration in Peat Swamp Forest: A Case Study at Forest for Specific Purpose (KHDTK) Tumbang Nusa, Central KalimantanAbstractDegradation of forest ecosystem including peat swamp forest is generally represented by the degradation of its vegetation cover. Forest degradation tends to follow edge-to-interior distance gradient. This study aimed to determine the diversity and dominance of natural regeneration potential in peat swamp forest at Central Kalimantan. Seedling bank, seed rain, and seed soil bank as the indicators of natural regeneration potential were measured from series of plots located following the distance gradient. The results showed that the difference in natural regeneration potentials followed the distance gradient significantly. The diversity of natural regeneration potential tends to decrease following disturbance gradient, where the lowest was found near the edge. Seedling bank at the edge was dominated by Combretocarpus rotundatus (Miq.) Danser while Litsea oppositifolia L.S. Gibbs dominated at the interior. The seed rain was dominated by Combretocarpus rotundatus at all sites during dry season while during intermediate season, Palaquium sp. dominated the interior and Combretocarpus rotundatus near the edge. It was showed that climatic season gave significant effects on seed number, species number, and diversity of seed rain in which all the three regeneration indications were higher during intermediate season. The seed soil bank was dominated by Tristaniopsis obovata (Benn.) Peter G. Wilson & J.T. Waterh near to the interior and by Diospyros sp. at the edge. However, seed soil banks at the edge zone were dominated by species composing the interior forest (50% similarity index). This shows that the seed dispersal from forest as inoculum source can still reach the edge and also indicates existing vegetation at the edge prior to disturbance

Iron deficiency in heart failure:Mechanisms and pathophysiology

Iron is an essential micronutrient for a myriad of physiological processes in the body beyond erythropoiesis. Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF), with a prevalence reaching up to 59% even in non-anaemic patients. ID impairs exercise capacity, reduces the quality of life, increases hospitalisation rate and mortality risk regardless of anaemia. Intravenously correcting ID has emerged as a promising treatment in HF as it has been shown to alleviate symptoms, improve quality of life and exercise capacity and reduce hospitalisations. However, the pathophysiology of ID in HF remains poorly characterised. Recognition of ID in HF triggered more research with the aim to explain how correcting ID improves HF status as well as the underlying causes of ID in the first place. In the past few years, significant progress has been made in understanding iron homeostasis by characterising the role of the iron-regulating hormone hepcidin, the effects of ID on skeletal and cardiac myocytes, kidneys and the immune system. In this review, we summarise the current knowledge and recent advances in the pathophysiology of ID in heart failure, the deleterious systemic and cellular consequences of ID