Mediamusic (E-Journal)
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Adalimumab and infliximab survival in patients with hidradenitis suppurativa:a daily practice cohort study
No full textBackground: Biologics are often required for the treatment of hidradenitis suppurativa (HS). However, data on the drug survival of biologics in daily practice are currently lacking.Objectives: To assess the drug survival of antitumour necrosis factor biologics in a daily practice cohort of patients with HS and to identify predictors for drug survival.Methods: A retrospective multicentre study was performed in two academic dermatology centres in the Netherlands. Adult patients with HS using biologics between 2008 and 2020 were included. Drug survival was analysed with Kaplan-Meier survival curves and predictors of survival with univariate Cox regression analysis.Results: The overall drug survival of adalimumab (n = 104) at 12 and 24 months was 56 center dot 3% and 30 center dot 5%, respectively, which was predominantly determined by infectiveness. Older age (P = 0 center dot 02) and longer disease duration (P < 0 center dot 01) were associated with longer survival time. For infliximab (n = 44), overall drug survival was 58 center dot 3% and 48 center dot 6% at 12 and 24 months, respectively, and was predominantly determined by infectiveness and side-effects. Surgery during treatment was associated with a longer survival time (P = 0 center dot 01).Conclusions: Survival rates were comparable for adalimumab and infliximab at 12 months, and were mainly determined by ineffectiveness. Age, disease duration (adalimumab) and surgery (infliximab) are predictors for longer survival.</p
The Matrix Reloaded:Reconstructing the Boundaries of (International) Law and Politics
No full textInterdisciplinary scholarship at the intersection of international law (IL) and International Relations (IR) has illuminated the roles of politics in law, of law in politics, and of the shifting boundary between the two in various areas of international affairs. The boundary itself, however, has proven resilient. While critical approaches investigating the politics of international law have come to insist on the lasting significance of legality proper, IR approaches to legalization have returned to politics.Although the apparent limits to challenging the boundary between legality and politics are not new, we suggest that they are intimately related to another great divide, i.e., that between the state and the international. Together, these two crosscutting lines have shaped the possibilities and constraints of articulating substantive positions ‘in’ (international) law and politics at least since the Interwar period. Reading these distinctions as intertwined ‘nested oppositions’, this article reconstructs the stylized but paradigmatic debates between Max Weber and Hans Kelsen over the nature of the state and between Hans Morgenthau and Hersch Lauterpacht over the nature of the international.We further illustrate how the same conceptual oppositions still enable and constrain current debates in IL and IR, discussing as examples the creation of states and the justiciability of international crimes. Crossing and contesting the boundaries ultimately reaffirms them as the matrix in which conflicts over states and the international are articulated as legal and political
'The medicine is not for sale':Practices of traditional healers in snakebite envenoming in Ghana
No full textBACKGROUND: Snakebite envenoming is a medical emergency which is common in many tropical lower- and middle-income countries. Traditional healers are frequently consulted as primary care-givers for snakebite victims in distress. Traditional healers therefore present a valuable source of information about how snakebite is perceived and handled at the community level, an understanding of which is critical to improve and extend snakebite-related healthcare.METHOD: The study was approached from the interpretive paradigm with phenomenology as a methodology. Semi-structured interviews were conducted with 19 traditional healers who treat snakebite patients in two rural settings in Ghana. From the Ashanti and Upper West regions respectively, 11 and 8 healers were purposively sampled. Interview data was coded, collated and analysed thematically using ATLAS.ti 8 software. Demographic statistics were analysed using IBM SPSS Statistics version 26.FINDINGS: Snakebite was reportedly a frequent occurrence, perceived as dangerous and often deadly by healers. Healers felt optimistic in establishing a diagnosis of snakebite using a multitude of methods, ranging from herbal applications to spiritual consultations. They were equally confident about their therapies; encompassing the administration of plant and animal-based concoctions and manipulations of bite wounds. Traditional healers were consulted for both physical and spiritual manifestations of snakebite or after insufficient pain control and lack of antivenom at hospitals; referrals by healers to hospitals were primarily done to receive antivenom and care for wound complications. Most healers welcomed opportunities to engage more productively with hospitals and clinical staff.CONCLUSIONS: The fact that traditional healers did sometimes refer victims to hospitals indicates that improvement of antivenom stocks, pain management and wound care can potentially improve health seeking at hospitals. Our results emphasize the need to explore future avenues for communication and collaboration with traditional healers to improve health seeking behaviour and the delivery of much-needed healthcare to snakebite victims.</p
Identification of a micropeptide and multiple secondary cell genes that modulate <i>Drosophila</i> male reproductive success
No full textEven in well-characterized genomes, many transcripts are considered noncoding RNAs (ncRNAs) simply due to the absence of large open reading frames (ORFs). However, it is now becoming clear that many small ORFs (smORFs) produce peptides with important biological functions. In the process of characterizing the ribosome-bound transcriptome of an important cell type of the seminal fluid-producing accessory gland of Drosophila melanogaster, we detected an RNA, previously thought to be noncoding, called male-specific abdominal (msa). Notably, msa is nested in the HOX gene cluster of the Bithorax complex and is known to contain a micro-RNA within one of its introns. We find that this RNA encodes a "micropeptide" (9 or 20 amino acids, MSAmiP) that is expressed exclusively in the secondary cells of the male accessory gland, where it seems to accumulate in nuclei. Importantly, loss of function of this micropeptide causes defects in sperm competition. In addition to bringing insights into the biology of a rare cell type, this work underlines the importance of small peptides, a class of molecules that is now emerging as important actors in complex biological processes.</p
Supporting struggling students:Prevention and early intervention with Success for All
No full textIt was investigated whether the American program Success for All (SfA) could improve the reading outcomes and behavioral engagement of struggling students in the Netherlands. Earlier studies have shown that investment in prevention and early intervention pays off. In a systematic review, it was found that effective programs like SfA can even reduce the number of special education assignments. The aim of SfA is to ensure that all students experience success in learning. To achieve this, several evidence-based strategies are combined. Dutch and American teachers who were interviewed, valued the integrated approach to reading/language, the books, the cooperative learning activities and tutoring as effective features of SfA for struggling students. However, teachers also mentioned that they sometimes found it difficult to balance between the scriptedness of SfA and the need for flexibility in the support of struggling students. With regard to effects of SfA in the Netherlands, we found in the first cohort that first grade students at SfA-schools had significantly better reading comprehension skills than students at control schools. In the second cohort, no significant effect of SfA on reading comprehension was found. No significant effects of SfA on the other reading outcomes and behavioral engagement were found either. It is important to keep in mind that all studies were conducted during the first years of SfA in the Netherlands. The studies in this dissertation showed that there was room for improvement in the implementation of the program
Opinion Dynamics and Collective Risk Perception:An Agent-Based Model of Institutional and Media Communication About Disasters
No full textThe behavior of a heterogeneous population of individuals during an emergency, such as epidemics, natural disasters, terrorist attacks, is dynamic, emergent and complex. In this situation, reducing uncertainty about the event is crucial in order to identify and pursue the best possible course of action. People depend on experts, government sources, the media and fellow community members as potentially valid sources of information to reduce uncertainty, but their messages can be ambiguous, misleading or contradictory. Effective risk prevention depends on the way in which the population receives, elaborates and spread the message, and together these elements result in a collective perception of risk. The interaction between individuals' attitudes toward risk and institutions, the more or less alarmist way in which the information is reported and the role of the media can lead to risk perception that differs from the original message, as well as to contrasting opinions about risk within the same population. The aim of this study is to bridge a model of opinion dynamics with the issue of uncertainty and trust in the sources, in order to understand the determinants of collective risk assessment. Our results show that alarming information spreads more easily than reassuring one, and that the media plays a key role in this. Concerning the role of internal variables, our simulation results show that risk sensitiveness has more influence on the final opinion than trust towards the institutional message. Furthermore, the role of different network structures seemed to be negligible, even on two empirically calibrated network topologies, thus suggesting that knowing beforehand how much the public trusts their institutional representatives and how reactive they are to a certain risk might provide useful indications to design more effective communication strategies during crises
