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Towards a Quantum Theory
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314397.pdf (Publisher’s version ) (Open Access
Quality of Life Among Patients With Locally Advanced Pancreatic Cancer: A Prospective Nationwide Multicenter Study.
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317616.pdf (Publisher’s version ) (Open Access)BACKGROUND: Health care providers of patients with cancer should discuss the impact of treatment, such as multiagent chemotherapy and surgery, on quality of life (QoL). However, in the era of shared decision-making, data on QoL in locally advanced pancreatic cancer (LAPC) remain scarce. METHODS: We performed a prospective multicenter study involving patients with LAPC across 13 Dutch centers. These patients were included in both the LAPC registry and the Dutch Pancreatic Cancer Project (PACAP; ClinicalTrials.gov identifier: NCT03513705). The study evaluated QoL over time and assessed the impact of treatment. The primary outcome was global health status (GHS) based on the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Secondary outcomes included functioning and symptom scores from the EORTC QLQ-C30 and the EORTC QLQ Pancreatic Cancer Module (QLQ-PAN26). Outcomes were measured at diagnosis and at 3-month intervals up to 12 months. Outcomes were compared over time and between groups, with both statistical and clinical significance (Δ ≥10 points) evaluated. RESULTS: A total of 170 patients completed at least one QoL-questionnaire. Most patients (n=152; 89%) received tumor-directed treatment, including 116 (68%) who received chemotherapy (± radiotherapy) alone and 36 (21%) who underwent chemotherapy (± radiotherapy) followed by resection; 18 (11%) patients received best supportive care (BSC). At baseline, GHS was highest among patients who received chemotherapy + resection (mean [SD], 70 [16]) compared with those receiving chemotherapy alone (mean [SD], 64 [20]) and BSC (mean [SD], 48 [21]) (P=.001). The overall mean [SD] GHS at baseline was 63 [20] and remained stable over time (P=.27), including in patients receiving tumor-directed treatment (P=.57). One-third of the QoL subscales (9/28) showed statistically and clinically significant changes over time. Improvements were observed in appetite loss, pancreatic pain, and hepatic symptoms, although patients reported increased diarrhea, flatulence, altered bowel habits, and financial difficulties. Over time, patients reported reduced fear of future health, but a decline in health care satisfaction. CONCLUSIONS: This multicenter study demonstrated that general QoL remained stable during the first year in patients with LAPC, 89% of whom received tumor-directed treatment. Certain symptoms worsened and deserve greater attention from health care providers. These findings can guide shared decision-making and improve symptom management
Towards better outcomes of revision total knee arthroplasty
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317869.pdf (Publisher’s version ) (Open Access)Radboud University, 16 april 2025Promotor : Schreurs, B.W. Co-promotores : Hannink, G.J., Smulders, K.196 p
The association between maternal immune activation and brain structure and function in human offspring: a systematic review
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318116.pdf (Publisher’s version ) (Open Access)Maternal immune activation (MIA) during pregnancy, as a result of infectious or inflammatory stimuli, has gained increasing attention for its potential role in adverse child neurodevelopment, with studies focusing on associations in children born preterm. This systematic review summarizes research on the link between several types of prenatal MIA and subsequent child structural and/or functional brain development outcomes. We identified 111 neuroimaging studies in five MIA areas: inflammatory biomarkers (n = 13), chorioamnionitis (n = 18), other types of infections (n = 18), human immunodeficiency virus (HIV) (n = 42), and Zika virus (n = 20). Overall, there was large heterogeneity in the type of MIA exposure examined and in study methodology. Most studies had a prospective single cohort design and mainly focused on potential effects on the brain up to one year after birth. The median sample size was 53 participants. Severe infections, i.e., HIV and Zika virus, were associated with various types of cerebral lesions (e.g., microcephaly, atrophy, or periventricular leukomalacia) that were consistently identified across studies. For less severe infections and chronic inflammation, findings were generally inconsistent and mostly included deviations in white matter structure/function. Current findings have been mainly observed in the infants' brain, presenting an opportunity for future studies to investigate whether these associations persist throughout development. Additionally, the inconsistent findings, encompassing both regions of interest and null results, call into question whether prenatal exposure to less severe infections and chronic inflammation exerts a small effect or no effect on child brain development
Becoming a mathematician
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316158.pdf (Publisher’s version ) (Open Access
Embracing variability in the search for biological mechanisms of psychiatric illness
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315163.pdf (Publisher’s version ) (Open Access)Despite decades of research, we lack objective diagnostic or prognostic biomarkers of mental health problems. A key reason for this limited progress is a reliance on the traditional case-control paradigm, which assumes that each disorder has a single cause that can be uncovered by comparing average phenotypic values of patient and control samples. Here, we discuss the problematic assumptions on which this paradigm is based and highlight recent efforts that seek to characterize, rather than minimize, the inherent clinical and biological variability that underpins psychiatric populations. Embracing such variability is necessary to understand pathophysiological mechanisms and develop more targeted and effective treatments
Electrophysiological correlates of visual memory search
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307068.pdf (Publisher’s version ) (Open Access)In everyday life, we frequently engage in 'hybrid' visual and memory search, where we look for multiple items stored in memory (e.g., a mental shopping list) in our visual environment. Across three experiments, we used event-related potentials to better understand the contributions of visual working memory (VWM) and long-term memory (LTM) during the memory search component of hybrid search. Experiments 1 and 2 demonstrated that the FN400 - an index of LTM recognition - and the CDA - an index of VWM load - increased with memory set size (target load), suggesting that both VWM and LTM are involved in memory search, even when target load exceeds capacity limitations of VWM. In Experiment 3, we used these electrophysiological indices to test how categorical similarity of targets and distractors affects memory search. The CDA and FN400 were modulated by memory set size only if items resembled targets. This suggests that dissimilar distractor items can be rejected before eliciting a memory search. Together, our findings demonstrate the interplay of VWM and LTM processes during memory search for multiple targets.23 p
Post-treatment duration of positivity for standard and ultra-sensitive Plasmodium falciparum antigen-based rapid diagnostic tests, a cohort study from a low-endemic setting in Namibia.
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317407.pdf (Publisher’s version ) (Open Access)BACKGROUND: The standard malaria rapid diagnostic test (RDT) and newer ultra-sensitive RDT (uRDT) target Plasmodium falciparum histidine rich protein-2 (HRP2), which persists post-treatment. The duration of test positivity has not previously been studied in a low transmission setting. METHODS: We conducted a longitudinal cohort study in a low transmission setting in Namibia. RDT-positive individuals identified through passive and active case detection were treated and followed weekly for testing by RDT and uRDT, HRP2 quantification, quantitative PCR (qPCR) of parasitemia, and quantitative reverse transcriptase PCR (RT-PCR) of gametocytemia, until RDT and uRDT were negative for two consecutive weeks. Determinants of persistent positivity were identified using Cox proportional hazards models. FINDINGS: Among 137 participants with complete follow-up and no evidence of resurgence during follow-up, median duration of positivity was 42 days (range: 3-98 range) for RDT, compared to 67 days (range 12-105) for uRDT. In a sub-analysis of those with laboratory data before treatment (n = 60), drug resistance did not explain persistent positivity. Younger age (<15 years versus ≥15 years: aHR: 1.85, 95% CI 1.04-3.30, and 1.67, 95% CI 0.96-2.89, for RDT and uRDT, respectively), higher initial parasite density (highest versus lowest tertile: aHR 0.11, 95% CI 0.04-0.32 and 0.19, 95% CI 0.07-0.48 for RDT and uRDT, respectively), and persistent parasitemia (≥7 days versus reference of <7 days, aHR 0.39, 95% CI 0.20-0.76, and 0.40, 95% CI 0.21-0.76 for RDT and uRDT, respectively) were associated with longer duration of positivity. INTERPRETATION: Duration of RDT/uRDT positivity was more than double compared to reports from higher endemic settings, potentially due to lower population immunity to clear parasite DNA and antigen. Prolonged duration of positivity compromises their use to detect current infection, but increased detection of recent infection can facilitate surveillance and inform elimination efforts. FUNDING: The project was funded by the Bill and Melinda Gates Foundation (A128488 and INV1135840), Horchow Family Fund (5300375400), and Chan Zuckerberg Biohub.01 januari 202
Predictive processing: Shedding light on the computational processes underlying motivated behavior
No full textItem does not contain fulltextIntegrating the predictive processing framework into our understanding of motivation offers promising avenues for theoretical development, while shedding light on the computational processes underlying motivated behavior. Here we decompose expected free energy into intrinsic value (i.e., epistemic affordance) and extrinsic value (i.e., instrumental affordance) to provide insights into how individuals adapt to and interact with their environment.2 p
Evaluating patient participation in VBHC
No full textItem does not contain fulltextWe conducted a multi-center mixed-methods study between February 2022 and January 2023 in a consortium of seven Dutch hospitals (Santeon hospitals) that collaborate in implementing VBHC by actively measuring, benchmarking, and improving value of care for fifteen medical conditions. Multidisciplinary Value improvment (VI) teams per medical condition have been set up in each of the seven hospitals, with a few exceptions when the hospital does not provide care for that condition. These VI teams consist of healthcare professionals, project leaders, managers, and data-analysts who work together to achieve value improvements. A questionnaire on patient participation (the public and patient engagement evaluation tool) was tailored to the study’s context, completed by value improvment team members (n=147 from 76 different VI teams). In addition, 30 semi-structured interviews were held with VI team members, and analyzed through thematic analysis. Data is archived at St. Antonius Hospital and not available due to privacy restrictions. Aggregated questionnaire data is available as appendix to the published open acces article