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To Scenes Through Screens? A Study of The Offline Club Digital Detox Community
No full textAs daily life, social relations, and labour increasingly unfold through digital media, users seek to regulate their digital engagement by adopting dumbphones, uninstalling applications, or participating in “digital detox.” In high-connectivity contexts such as the Netherlands, digital disengagement has gained traction among middle-class citizens and expatriate professionals. This article examines how digital disconnection is commodified, socially valorised, and collectively experienced through a case study of The Offline Club (TOC), a Netherlands-based initiative offering curated digital detox events. Drawing on a netnographic approach, we analysed 35 posts on TOC’s Instagram page, conducted participant observation at two events, and carried out nine semi-structured interviews with attendees. We argue that TOC constructs digital disconnection as a curated, temporary practice that unfolds within urban contexts where the role of digital technologies becomes increasingly ambiguous. While TOC markets disconnection as resistance to digital saturation, its own reliance on social media and platform infrastructure for outreach and legitimacy reveals a paradox of disconnection-through-connection. Our findings demonstrate how such initiatives both respond to and reproduce platform logics, simultaneously cultivating community while inadvertently reinforcing cycles of commodified digital non-use. From a digital humanist perspective, we critique the limitations of initiatives like TOC that offer symptomatic relief without addressing the structural conditions of digital dependency. While participants may temporarily reclaim attention and presence, the broader socio-technical systems that underpin digital overload remain unchallenged, raising critical questions about the efficacy and politics of commercialised digital detox movements
Medication-related Emergency Department Visits
No full textMedicines may cause adverse drug reactions or can be used incorrectly, potentially resulting in patient harm. Such harm is referred to as adverse drug events (ADEs). ADEs are a major cause of emergency department (ED) visits and hospital admissions.The first aim of this thesis was to study how often ADEs lead to medication-related ED visits without subsequent hospital admission, to what extent these medication-related ED visits are preventable, and whether they are recognised by ED physicians. The second aim was to determine whether patients remember medication changes made during an ED visit, and whether these changes are documented in the medical records of healthcare providers, such as general practitioners and community pharmacists. Third, the thesis evaluated the effect and costs of medication reviews in patients who are hospitalised due to an ADE. In addition, it was assessed whether medication reviews are more effective in a specific group of patients, namely those admitted because of medication-related trauma.Research conducted in two hospitals showed that 17% of ED visits without hospital admission were caused by an ADE, of which more than one third were preventable. In almost two thirds of patients, the ADE was not recognised by the ED physician. Most patients recalled medication changes made during the ED visit; however, these changes were not always documented in the medical records of general practitioners and community pharmacists. Medication reviews in hospitalised patients with an ADE more frequently resulted in medication changes and led to net cost savings compared with standard care. No evidence was found that medication reviews were more effective in the group of patients with medication-related trauma
Diverse perceptions of ecosystem (dis)services in a Himalayan protected area
No full textProtected areas are essential for balancing biodiversity conservation with the delivery of ecosystem services. However, despite extensive research on the economic valuation of these services, understanding local people's perceptions, particularly of ecosystem services and disservices, remains limited. Therefore, we assessed local perceptions and their socio-demographic determinants in Langtang National Park, a protected area in Nepal's Himalayan region. Ecosystem services and disservices were identified through a stakeholder consultation workshop. We conducted semi-structured interviews with 105 respondents. Both quantitative and qualitative analyses combined Fisher's exact test with Monte Carlo simulation (10,000 replicates), Cramer's V, and content analysis. The most highly regarded ecosystem services include drinking water (96 % of respondents), species and habitat conservation (92 %), air quality maintenance (91 %), protecting the environment for future generations (89 %), and water quality maintenance (89 %). The common ecosystem disservices include crop raiding by wildlife (93 %), allergies (58 %), and barriers to development and construction (48 %). Education and occupation are significantly associated with perceptions of ecosystem services, including carbon sequestration, air regulation, tourism, and research. Although ecosystem services are perceived to operate from local to global scales, disservices are mainly experienced at the local level. This emphasizes developing localized solutions in both national and international biodiversity conservation policies and practices, including indicators for ecosystem disservices.</p
Phylogenomic insights into the taxonomy and evolutionary relationships of penduline tits (Remiz spp.)
No full textPenduline tits (genus Remiz) are small passerines distributed across Europe, Central and East Asia, and North Africa, renowned for their elaborate nests and unusually diverse mating systems. However, the taxonomy and evolutionary relationships within this genus have remained contentious due to overlapping breeding distributions and extensive hybridization. Using broad-range geographic sampling and whole-genome sequencing, here we report the phylogenetic relationships within this genus. Our results from maximum likelihood trees, species trees, population structure, and PCA analyses consistently identify four distinct, well-supported monophyletic clades. Based on these robust results, we support dividing Remiz into four species: the Eurasian Penduline Tit (R. pendulinus), Black-headed Penduline Tit (R. macronyx), White-crowned Penduline Tit (R. coronatus), and Chinese Penduline Tit (R. consobrinus). Among these species, R. consobrinus diverged earlier from other species, followed by R. coronatus , and then, R. pendulinus and R. macronyx . R. pendulinus and R. macronyx showed shallow genetic differentiation with recent divergence (∼87,000 years ago) and ongoing gene flow. Our findings demonstrate the effectiveness of phylogenomic approaches in resolving taxonomic ambiguities and provide a robust evolutionary framework for tracing the diversification of life history traits, particularly nest structures and mating systems, across the genus.</p
Directly Measuring the Connectivity between Isoenergetic Light-Harvesting Antennas in Plant Photosystem II at Physiological Temperature
No full textThe plant photosystem II (PSII) supercomplex features a relatively “flat” energy landscape in the excitonic energy transfer (EET) network between the light-harvesting antenna and core subunits. The resulting intersubunit EET proceeds predominantly between isoenergetic excitonic states. Visualizing these EET dynamics is difficult due to the heavy spectral overlaps between the components, particularly at physiological temperature. We employ polarization-resolved two-dimensional electronic spectroscopy to measure and compare the anisotropy kinetics between the LHCII-CP29-CP24 complex and some of its constituents. Using the orientational differences between the subunits, together with the EET time scales estimated from energy transfer theory and phenomenological kinetic modeling, we identify the contribution of intra- and intersubunit EET processes to the observed anisotropy decay components. The results suggest that EET rates between the antenna subunits are not homogeneous and can be sensitive to the interprotein arrangement. The approach provides an effective method for studying EET in large multichromophoric systems.</p
BiNet:A Deep Encoder-Decoder Network for Binarizing Degraded Ancient Manuscripts
No full textHandwritten document image binarization is a semantic segmentation process that differentiates ink pixels from background pixels of the surface material. It is an essential step toward several handwriting analysis tasks, including character recognition, writer identification, and estimating the development of script styles. The binarization task is challenging due to the vast diversity of writing styles among people, writing surfaces, and inks used. It is even more complex for ancient historical manuscripts due to the aging and degradation of these documents over time. One such manuscript collection is the famous Dead Sea Scrolls (DSS), which poses extreme challenges for the existing binarization techniques. This article presents a novel binarization pipeline for DSS images using deep encoder-decoder networks. Although the artificial neural network presented here is primarily designed to binarize the DSS images, it can also be used on many other manuscript collections. Additionally, transfer learning demonstrates the network’s versatility for a wide range of handwritten documents, making it a unique, multi-purpose tool for binarization. Qualitative results and several quantitative comparisons using historical manuscripts and datasets from handwritten document image binarization competitions (H-DIBCO and DIBCO) exhibit the system’s robustness and effectiveness. The best-performing network architecture proposed here, BiNet, derived from the U-Net encoder-decoder, outperforms existing methods by achieving an F-score of 86.7% (±9.4) on fused images created using multi-spectral photos of the DSS collection.</p
Evolution of neuroimaging features in children with acute flaccid myelitis compared to other forms of childhood myelitis
No full textBackground: Acute flaccid myelitis (AFM) is characterized by acute onset of flaccid limb weakness, MRI abnormalities in the spinal cord grey matter and CSF pleocytosis often associated with enterovirus infections. MOG-associated diseases (MOGAD) can manifest with similar neuroradilogical features.Objective: To analyze MRI findings in patients with AFM at baseline and follow-up in comparison to other forms of childhood transverse myelitis such as MOGAD.Patients and methods: Children from 11 European centers who fulfilled the clinical criteria of AFM were included. Brain and spinal MRI was performed at various stages of the disease course. MRI scans were evaluated using a previously established scoring table and compared with MRI scans of a recently published cohort of children with different forms of transverse myelitis including MOGAD.Results: We included 15 patients (8 females, 7 males, age range: 9 months-9,11 years). In 10/15 patients enterovirus was detected in respiratory/rectal specimens. At first presentation 13/15 patients presented with a longitudinal extensive transverse myelitis like involvement. Cervical grey matter was involved in almost all children. Axial involvement either manifested as grey matter alone or a mixture of white matter and grey matter hyperintensity in T2. Nerve root enhancement was found in 2/15 and leptomeningeal enhancement in 1/15 patients. 5/15 children had brainstem lesions. Follow-up MRI revealed residual T2 hyperintensities in 7/11 patients. Compared to patients with MOGAD AFM patients showed equally good resolution of MRI lesions overtime.Conclusion: Longitudinal spinal cord lesions mainly affecting the grey matter are characteristic of AFM whereas supratentorial lesions are less common. There is no significant difference between AFM and MOGAD concerning the resolution of lesions overtime.</p
Evaluating cost-effectiveness of RSV vaccination strategies for older adults in the Netherlands
No full textObjective: This study evaluates the cost-effectiveness of respiratory syncytial virus (RSV) vaccination for older adults in the Netherlands, aiming to identify the most effective vaccination strategy.Methods: A static decision tree cost-effectiveness model was developed to compare no vaccination with various RSV vaccination strategies for Dutch adults over six RSV seasons. Strategies included vaccinating adults aged ≥60, ≥75, and ≥75 combined with high-risk individuals aged 60–74. Each was assessed with two- and three-year intervals. The model incorporated health outcomes and costs associated with RSV disease and vaccination from a societal perspective, with a lifetime horizon. Recent incidence data were used, and vaccine effectiveness was based on efficacy from a meta-analysis for outpatient settings and real-world effectiveness data for inpatient settings. A probabilistic sensitivity analysis was conducted, using a €50,000 per quality-adjusted life year (QALY) willingness-to-pay threshold.Results: Vaccinating individuals aged ≥75 years and high-risk groups every three years could prevent approximately 19,000 general practitioner visits, 3300 hospitalizations (including 245 intensive care admissions), and 870 deaths in the first year. This strategy would avoid €29.5 million in healthcare costs and €6.3 million in productivity losses, gaining 2900 QALYs. It was cost-effective, with an average cost-effectiveness ratio (ACER) of €30,804/QALY. The most cost-effective strategy was vaccinating ≥75 year-olds every three years, with an incremental cost-effectiveness ratio (ICER) of 23,080/QALY compared to no vaccination. Vaccinating all ≥60-year-olds every three years resulted in the highest QALY gain, with an ACER of €39,918/QALY. Compared to the ≥75 and high-risk strategy, this approach had an ICER of €107,623/QALY, whereas the 75+ and high-risk strategy had an ICER of €61,987/QALY compared to the ≥75 strategy alone. Biennial strategies were associated with higher ACERs and were dominated in incremental comparisons.Conclusion: RSV vaccination for older adults in the Netherlands can be cost-effective, particularly when vaccinating every three years.</p
Safety and effectiveness of ATGAM-based immunosuppressive therapy in adult patients with aplastic anemia: an analysis from the Dutch Aplastic Anemia Register
No full textSpatially resolved polarization swings in the supermassive binary black hole candidate OJ 287 with first Event Horizon Telescope observations
No full textWe present the first Event Horizon Telescope 1.3 mm observations of the supermassive binary black hole candidate OJ 287. The observations achieved an unprecedented angular resolution of 18 μas and reveal significant structural and polarization variability over just five days, marking the shortest timescale on which such changes have been directly imaged in this source. The inner jet exhibits a twisted ridgeline structure, with features displaying apparent superluminal motions up to about 22 c. The linear polarization maps reveal three main polarized features whose electric-vector position angles (EVPAs) change substantially over the time span of our observations, including a component with a radial polarization consistent with being produced by a recollimation shock. Most notably, we directly resolved two innermost jet components whose EVPAs rotate in opposite directions. The faster component, moving at 2.4 ± 0.9 μas/day (17.4 ± 6.5 c), exhibits counterclockwise EVPA swings of roughly 3.7° per day, while the slower component, with a proper motion of 1.4 ± 0.3 μas/day (10.2 ± 2.2 c), rotates clockwise at approximately 2.5° per day. Previous studies inferred helical magnetic fields in AGN jets from time-resolved or integrated polarization variability but lacked the angular resolution to directly image this effect. Our results provide spatially resolved evidence that a helical magnetic field threads the jet’s collimation and acceleration zone, ruling out models based on the superposition of unresolved components. Our analysis suggests that propagating shocks interact with a Kelvin–Helmholtz plasma instability, illuminating different phases of the helical magnetic field and producing the observed polarization spatial and temporal variability. Moreover, our model naturally accounts for the more rapid polarization rotation observed in the faster moving component. Our model predicts even more rapid swings in polarization, which could be tested with future observations featuring a more densely sampled time coverage