Search Results (34)

Purpose: This study investigates the test–retest reliability of maximal voluntary contraction (MVC) and integrated object positioning during bimanual box lifting tasks in children with unilateral spastic cerebral palsy (USCP), using the Activities of Daily Living Test and Training Device (ADL-TTD). Materials and Methods: Utilizing an explorative cross-sectional design, the study recruited 47 children with USCP. The ADL-TTD, equipped with an Inertial Measurement Unit (IMU) for precise object positioning, measured MVC, and object position in 3D space in a cross-sectional measurement containing two measurements in a fixed time period. Results: The findings demonstrated good test–retest reliability for MVC, with an ICC_agreement of 0.95 for the mean MVC value. Additionally, good reliability was observed for object positioning in different directions measured with an IMU, with ICC_agreement ranging from 0.82 to 0.86 degrees. Regarding the standard error of measurement (SEM), the SEM_agreement for the mean MVC value was 5.94 kg, while the SEM_agreement for object positioning was 1.48, 5.39, and 3.43 degrees, respectively. Conclusions: These results indicate that the ADL-TTD demonstrates good test–retest reliability for both MVC and object positioning, making it a valuable tool for analyzing this population in cross-sectional research by providing reliable measures of task-oriented strength and object manipulation. However, the relatively high SEM_agreement, particularly in MVC, suggests that caution is needed when using this tool for repeated testing over time. This pioneering approach could significantly contribute to tailored assessment and training for children with USCP, highlighting the importance of integrating task-specific strength and positional accuracy into therapeutic interventions. Full article

Background/objectives: Negative symptoms in schizophrenia spectrum disorders are related to impaired social functioning and lower quality of life, making accurate assessment important. To date, most tools for assessing negative symptoms are observational, which can be influenced by the raters’ experience and opinion. Self-rating scales, like the Self-Evaluation of Negative Symptoms (SNS), could complement observer ratings by adding information from the patient’s perspective. Here, we aim to evaluate the psychometric properties of the Dutch translation of the SNS and the relationship between the SNS and functional outcomes. Methods: The SNS was added to the Pharmacotherapy Monitoring Outcome Survey (PHAMOUS)-protocol for adults with a DSM-5 classification of a disorder in the psychosis spectrum. Internal consistency was assessed by Cronbach’s alpha. Confirmatory factor analysis (CFA) was used to evaluate the construct validity of the five subscales of the SNS. Correlational analyses were performed between the SNS and the Positive and Negative Syndrome Scale (PANSS), the Health of Nation Outcomes Scales (HoNOS), the Global Assessment of Functioning (GAF), Functional Remission tool (FR) and the Manchester Short Assessment of Quality of Life (ManSA). Results: A total of 247 patients participated in this study. Internal consistency was good (α = 0.87). CFA confirmed the five-factor structure of the SNS. The SNS was significantly correlated (all p < 0.001) with the PANSS positive (r = 0.31), PANSS negative (r = 0.33), HoNOS (r = 0.37), FR (r = 0.27) and the ManSA (r = −0.40). Conclusions: The Dutch SNS shows good psychometric properties and is related to functional outcomes and quality of life. The SNS can be valuable in complementing current observational-based instruments, and future research may investigate whether the SNS can be used as a standalone measurement tool for the assessment of negative symptoms. Full article

Influenza D virus (IDV) is a newly emerged zoonotic virus increasingly reported worldwide. Cattle are considered the main reservoir of IDV, although it was first isolated from pigs. IDV infects multiple animal species and contributes to the bovine respiratory disease complex (BRDC). To date, there has been no report on the presence and frequency of IDV among cattle herds in Pakistan. In this study, we collected nasal swabs from cattle and performed virological surveillance of IDV via qRT-PCR. Among 376 swab samples, IDV was detected in 9 samples (2.4%). Four dairy cattle farms were positive for IDV; two IDV-positive samples (two/nine, 22.2%) belonged to asymptomatic cattle, while seven IDV-positive samples (seven/nine, 77.8%) were from cattle showing respiratory clinical signs, including two with a recent history of abortion and mastitis. Partial sequences of the hemagglutinin–esterase-fusion gene of IDV were obtained from nine qRT-PCR-positive samples. Notably, all IDV strains in this study clustered within the D/OK lineages in phylogenetic analysis. A 98.8–99.6% genetic identity to its European and US counterparts indicates that the IDVs are closely related. The D/OK lineage of IDV was previously unreported in Pakistan. This is the first report of IDV in Pakistan. We confirmed that IDV is circulating among cattle herds in Pakistan. This study underscores the importance of virological surveillance to monitor the ecology of IDV for better animal and public health. The continued spread of IDV and its adaptation to various hosts necessitate further epidemiological studies. Full article

Background: Acute myeloid leukemia (AML) is a malignancy of the bone marrow with a median age at diagnosis of 70 years. AML is difficult to treat, especially in older patients, among whom outcomes have historically been poor. Over the last two decades, a greater understanding of the molecular mechanisms of the pathology has led to the development of new drugs and multiple updates to treatment guidelines. Methods: A population-based retrospective cohort study was conducted for all patients aged 60 and older who were newly diagnosed with AML (n = 370) as defined by the European Leukemia Net 2022 criteria in Friesland, a Dutch province, between 2005 and 2023. Results: In this cohort of patients with a median age of 73 years, complete bone marrow analysis to classify the AML according to ELN increased in time from 49% (2005–2011) to 86% (2022–2023). The rate of patients receiving antileukemic therapy increased over time (2005–2011: 19%; 2012–2016: 64%; 2017–2021: 75%; 2022–2023: 74%), mainly driven by the introduction of hypomethylating agents. Over these time periods, the use of intensive chemotherapy (13%, 27%, 27%, and 5%) and rates of stem cell transplantation (3%, 9%, 27%, and 14%) underwent similar development as more patients were deemed eligible for these interventions from 2012 onwards, but usage declined again after the introduction of venetoclax in 2022. The median overall survival was 3.7, 7.3, 8.0, and 9.4 months over the four time periods, respectively. Conclusions: Our study demonstrates how outcomes of patients with newly diagnosed AML aged 60 and older improved over the last two decades. Full article

Microbiota colonization and development in early life is impacted by various host intrinsic (genetic) factors, but also diet, lifestyle, as well as environmental and residential factors upon and after birth. To characterize the impact of maternal nutrition and environmental factors on vaginally born infant gut microbiota composition, we performed an observational study in five distinct geographical areas in Vietnam. Fecal samples of infants (around 39 days old) and fecal and breast milk samples of their mothers (around 28 years) were collected. The microbiota composition of all samples was analyzed by 16S rRNA gene Illumina sequencing and a bioinformatics workflow based on QIIME. In addition, various breast milk components were determined. Strong associations between the geographically determined maternal diet and breast milk composition as well as infant fecal microbiota were revealed. Most notable was the association of urban Ha Noi with relatively high abundances of taxa considered pathobionts, such as Klebsiella and Citrobacter, at the expense of Bifidobacterium. Breast milk composition was most distinct in rural Ha Long Bay, characterized by higher concentrations of, e.g., docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), selenium, and vitamin B12, while it was characterized by, e.g., iron, zinc, and α-linolenic acid (ALA) in Ha Noi. Breast milk iron levels were positively associated with infant fecal Klebsiella and negatively with Bifidobacterium, while the EPA and DHA levels were positively associated with Bifidobacterium. In conclusion, differences between five regions in Vietnam with respect to both maternal breast milk and infant gut microbiota composition were revealed, most likely in part due to maternal nutrition. Thus, there could be opportunities to beneficially steer infant microbiota development in a more desired (rural instead of urban) direction through the mother’s diet. Full article

Immune thrombocytopenia (ITP) is an autoimmune blood disorder characterised by isolated severe thrombocytopenia. Arterial thrombotic events, such as acute ischaemic stroke (AIS), are rare complications. A 56-year-old woman with chronic ITP on eltrombopag and dexamethasone therapy presented to the emergency department due to AIS in the vertebrobasilar territory, and lower abdominal pain. The computed tomography (CT) scan of the head was unremarkable, whereas CT angiography revealed left vertebral artery occlusion. As the platelet count was sufficient, intravenous thrombolysis (IVT) was initiated. However, after 15 min, an anaphylactic reaction occurred, which was appropriately solved. Although the IVT was prematurely stopped, the NIHSS score improved from 7 to 2, and the follow-up head CT scan remained unremarkable. CT angiography of the thoracoabdominal aorta revealed multiple thrombi in the infrarenal aorta, inferior mesenteric artery (IMA), and left renal artery. The abdominal pain subsided after IVT, but recurred within 24 h. Repeated CT angiography showed ischaemia of the descending colon, with persistent IMA occlusion. After the hemicolectomy condition stabilised. Discrete left-sided ataxia and impaired sensation were the only neurological sequelae. We found two articles reporting only three patients with ITP who suffered AIS and were treated with IVT. A favourable outcome was observed in two cases, while one patient suffered an intracranial haemorrhage (ICH) and died. A review of AIS cases with undefined thrombocytopenia treated with IVT reported ICH in up to 6.8% of patients. Our case suggests that IVT for AIS may be effective in patients with ITP. Further data are needed to better clarify this issue. Full article

Previous studies on dose-escalated radiotherapy in head and neck cancer have shown mixed results, and it is not established which patients would benefit from dose escalation. Further, while dose escalation does not appear to increase late toxicity, this needs to be confirmed with longer follow-up. In this study, we analysed treatment outcome and toxicity in 215 patients with oropharyngeal cancer treated with dose-escalated radiotherapy (>72 Gy, EQD2, α/β = 10 Gy, boost by brachytherapy or simultaneous integrated boost) and a matched cohort of 215 patients treated with standard dose external-beam radiotherapy (68 Gy) between 2011 and 2018 at our institution. The 5-year overall survival (OS) was 77.8% (72.4–83.6) and 73.7% (67.8–80.1) in the dose-escalated and standard dose group, respectively (p = 0.24). Median follow-up was 78.1 (49.2–98.4) and 60.2 (38.9–89.4) months in the dose-escalated and standard dose groups, respectively. Grade ≥3 osteoradionecrosis (ORN) and late dysphagia were more common in the dose-escalated group compared to the standard dose group, with 19 (8.8%) vs. 4 (1.9%) patients developing grade ≥3 ORN (p = 0.001), and 39 (18.1%) vs. 21 (9.8%) patients developing grade ≥3 dysphagia (p = 0.01). No predictive factors to help select patients for dose-escalated radiotherapy were found. However, the remarkably good OS in the dose-escalated cohort, despite a predominance of advanced tumour stages, encourages further attempts to identify such factors. Full article

The leading cause of death for patients with HPV associated squamous cell carcinoma of the head and neck (SCCHN) after treatment with chemoradiotherapy (CRT) nowadays is peripheral metastasis. This study investigated whether induction chemotherapy (IC) could improve progression free survival (PFS) and impact on relapse pattern after CRT. Methods: Eligible patients in this multicenter, randomized, controlled, phase 2 trial had p16-positive locoregionally advanced SCCHN. Patients were randomized in a 1:1 ratio to either RT with cetuximab (arm B) versus the same regimen preceded by two cycles of taxotere/cisplatin/5-FU (arm A). The RT dose was escalated to 74.8 Gy for large volume primary tumors. Eligibility criteria included patients of 18–75 years, an ECOG performance status 0–1, and adequate organ functions. Results: From January 2011 to February 2016, 152 patients, all with oropharyngeal tumors were enrolled, 77 in arm A and 75 in arm B. Two patients, one in each group, withdrew their consent after randomization, leaving 150 patients for the ITT analysis. PFS at 2 years was 84.2% (95% CI 76.4–92.8) in arm A and 78.4% (95% CI 69.5–88.3) in arm B (HR 1.39, 95% CI 0.69–2.79, p = 0.40). At the time of analysis, there were 26 disease failures, 9 in arm A and 17 in arm B. In arm A, 3 patients had local, 2 regional, and 4 distant relapses as first sites of recurrence, and in arm B, 4, 4, and 9 relapses in corresponding sites. Eight out of 26 patients with disease progression had salvage therapy and 7 were alive NED (no evidence of disease), at 2 years. Locoregional control was 96% in arm A and 97.3% in arm B and OS 93% and 90.5%, respectively. Local failure as first site of recurrence was low, in 4.6% of patients and was similar for T1/T2 and T3/T4 tumors (n.s). Nevertheless, out of 7 patients with primary local failures, 4 were treated with the escalated RT dose. Toxicity was low and similar in the treatment arms. There was one fatal event in arm A where the combined effects of the drugs used in chemotherapy and cetuximab could not be ruled out. Conclusions: PFS, locoregional control and toxicity did not differ between the two arms, OS was high, and there were few local relapses. In arm B, more than twice as many patients had distant metastasis as the first site of relapse compared to arm A. The response to IC was found to define 29% of patients in arm A who did not have a tumor relapse during follow-up. An escalated dose of 74.8 Gy could mitigate the negative impact of large tumor volume but for some patients, even this intensified treatment was insufficient. Full article

There is a lack of comprehensive reports on nutrient deficiencies and dietary intake among various age groups of children in China. The objective of this review is to provide an overview of the nutrient status, intake, and diet adequacy of Chinese children (0–18 years old). PubMed and Scopus were searched for literature published between January 2010 and July 2022. A systematic review approach with a quality assessment was performed to analyze 2986 identified articles in English and Chinese. Eighty-three articles were included in the analysis. In younger children, anemia and iron and Vitamin A deficiencies remain severe public health problems, despite high Vitamin A and adequate iron intake. In older children, a high prevalence of selenium; Vitamin A and D deficiencies; and inadequate intakes of Vitamins A, D, B, C, selenium, and calcium were reported. Intakes of dairy, soybeans, fruits, and vegetables were below recommended levels. High intakes of iodine, total and saturated fat, and sodium and low dietary diversity scores were also reported. As nutritional concerns vary with age and region, future nutrition interventions should be tailored accordingly. Full article

Extracting meaningful attributes of radar scatterers from SAR images, PAZ in our case, facilitates a better understanding of SAR data and physical interpretation of deformation processes. The attribute categories and attribute extraction method are not yet thoroughly investigated. Therefore, this study recognizes three attribute categories: geometric, physical, and land-use attributes, and aims to design a new scheme to extract these attributes of every coherent radar scatterer. Specifically, we propose to obtain geometric information and its dynamics over time of the radar scatterers using time series InSAR (interferometric SAR) techniques, with SAR images in HH and VV separately. As all InSAR observations are relative in time and space, we convert the radar scatterers in HH and VV to a common reference system by applying a spatial reference alignment method. Regarding the physical attributes of the radar scatterers, we first employ a Random Forest classification method to categorize scatterers in terms of scattering mechanisms (including surface, low-, high-volume, and double bounce scattering), and then assign the scattering mechanism to every radar scatterer. We propose using a land-use product (i.e., TOP10NL data for our case) to create reliable labeled samples for training and validation. In addition, the radar scatterers can inherit land-use attributes from the TOP10NL data. We demonstrate this new scheme with 30 Spanish PAZ SAR images in HH and VV acquired between 2019 and 2021, covering an area in the province of Friesland, the Netherlands, and analyze the extracted attributes for data and deformation interpretation. Full article

Adenoid cystic carcinoma (AdCC), a rare heterogenous disease, presents diagnostic, prognostic, and therapeutic challenges. To obtain more knowledge, we conducted a retrospective study on a cohort of 155 patients diagnosed in 2000–2022 with AdCC of the head and neck in Stockholm and investigated several clinical parameters in correlation to treatment and prognosis in the 142/155 patients treated with curative intent. The strongest favourable prognostic factors were early disease stage (stage I and II) as compared to late disease (stage III and IV) and major salivary gland subsite as compared to other subsites, with the best prognosis in the parotid gland, irrespective of the stage of the disease. Notably, in contrast to some studies, a significant correlation to survival was not found for perineural invasion or radical surgery. However, similar to others, we confirmed that other common prognostic factors, e.g., smoking, age, and gender, did not correlate to survival and should not be used for prognostication of AdCC of the head and neck. To conclude, in AdCC early disease stage, major salivary gland subsite and multimodal treatment were the strongest favourable prognostic factors, while this was not the case for age, gender and smoking nor perineural invasion and radical surgery. Full article

An Oral Care Program (OCP) was implemented in home care nursing teams in a northern province of the Netherlands to improve the oral health and hygiene of older people who make use of formal home care in 2018–2019. The aim of the current study was to evaluate the experiences of the stakeholders involved (older people, home-care nurses and dental hygienists) and to report the experienced impact of OCP, with a qualitative approach. Three dental hygienists, nine home care nurses, and eight older people were interviewed with semi-structured interviews, which were audio recorded, transcribed and analyzed using thematic analysis. The codes derived were grouped into nine main themes. OCP was experienced as mostly positive by all stakeholders involved. The educational part lead to more awareness towards oral care, but should be repeated regularly. Personalized oral care plans for older people were experienced positively, however, obtaining oral care behavior changes appeared to be difficult. Collaboration between dental hygienists and home care nurses lead to a positive experience from both sides The method and intensity of collaboration varied between the teams. To provide better access to oral health care for older people in the community, a long term collaboration between home care nursing teams and dental care professionals in their working area should be established. Full article

Introduction: A risk factor for the failure of surgical debridement in patients with early periprosthetic joint infections (PJI) is the presence of multidrug-resistant microorganisms. Staphylococcus epidermidis is one of the most isolated microorganisms in PJI and is associated with emerging resistance patterns. We aimed to assess the antibiotic resistance patterns of S. epidermidis in early PJIs treated with surgical debridement and correlate them to clinical outcomes. Material and Methods: A retrospective multicentre observational study was conducted to evaluate patients with an early PJI (within 3 months after the index arthroplasty) by S. epidermidis with at least two positive intraoperative cultures. Clinical failure was defined as the need for additional surgical intervention or antibiotic suppressive therapy to control the infection. Results: A total of 157 patients were included. The highest rate of resistance was observed for methicillin in 82% and ciprofloxacin in 65% of the cases. Both were associated with a higher rate of clinical failure (41.2% vs. 12.5% (p 0.048) and 47.3% vs. 14.3% (p 0.015)), respectively. Furthermore, 70% of the cases had reduced susceptibility to vancomycin (MIC ≥ 2), which showed a trend towards a higher failure rate (39.6% vs. 19.0%, NS). Only 7% of the cases were rifampin-resistant. Only the resistance to fluoroquinolones was an independent risk factor for clinical failure in the multivariate analysis (OR 5.45, 95% CI 1.67–17.83). Conclusion: S. epidermidis PJIs show a high rate of resistance. Resistance to fluoroquinolones is associated with clinical failure. Alternative prophylactic antibiotic regimens and optimising treatment strategies are needed to improve clinical outcomes. Full article

Myocardial infarction is the most common cause of death worldwide. An understanding of the alterations in protein pathways is needed in order to develop strategies that minimize myocardial damage. To identify the protein signature of cardiac ischemia/reperfusion (I/R) injury in rats, we combined, for the first time, protein matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) and label-free proteomics on the same tissue section placed on a conductive slide. Wistar rats were subjected to I/R surgery and sacrificed after 24 h. Protein MALDI-MSI data revealed ischemia specific regions, and distinct profiles for the infarct core and border. Firstly, the infarct core, compared to histologically unaffected tissue, showed a significant downregulation of cardiac biomarkers, while an upregulation was seen for coagulation and immune response proteins. Interestingly, within the infarct tissue, alterations in the cytoskeleton reorganization and inflammation were found. This work demonstrates that a single tissue section can be used for protein-based spatial-omics, combining MALDI-MSI and label-free proteomics. Our workflow offers a new methodology to investigate the mechanisms of cardiac I/R injury at the protein level for new strategies to minimize damage after MI. Full article

In the course of the twentieth century, the glorified image of Viking Age Scandinavia exerted an increasing attraction on intellectuals and nation builders in remote parts of Europe, especially those which self-identified as peripheral, marginalized, and ‘northern’. In the Dutch province of Friesland, the cultivation of a Frisian national identity went hand in hand with an antagonizing process of self-contrastation vis-à-vis the urbanized heartland in the west of the country. Fueled by these anti-Holland sentiments, the adoption of Nordic identity models could serve to create alternative narrative molds in which to cast the Frisian past. In this article, I will chart this process of cultural “nordification” from its initial phase in the writings of Frisian Scandinavophiles to contemporary remediations of Frisian history in popular culture and public discourses. In this context, special attention will be paid to the reception history of the pagan King Redbad (d. 719) and his modern transformation from ‘God’s enemy’ to beloved national icon. Full article