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Returning to Work Is Associated With Higher Quality of Life: A LIMB-Q Analysis in Patients With Limb-Threatening Injuries.
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317624.pdf (Publisher’s version ) (Open Access)OBJECTIVES: To identify clinical, demographic, and patient-reported outcomes associated with return to work after lower extremity traumatic injury requiring amputation or limb salvage. DESIGN: Cross-sectional study. SETTING: Multicenter across 25 countries. PATIENT SELECTION CRITERIA: Working patients who sustained lower extremity trauma requiring soft-tissue reconstruction or amputation. OUTCOME MEASURES AND COMPARISONS: The main outcome measurements were LIMB-Q scores. Regression analyses were performed to evaluate associations between functional and quality-of-life outcomes by return-to-work status. RESULTS: Responses were received from 258 participants with 66% being male participants (n = 173) and a mean age of 40 years old (IQR: 19-78). Of respondents that worked before injury, 67% (n = 173) returned to work after a mean 16 months (SD 39). Divorced or widowed status [ P = 0.006; OR 0.107 (95% CI 0.022-0.531)], bilateral injuries [ P = 0.004; OR 0.093 (95% CI 0.019-0.471)], and having a manual labor job [ P = 0.002; OR 0.191 (95% CI 0.027-0.395)] were negatively associated with return to work. Increased time since injury [ P = 0.036, OR 1.08 (95% CI 1.02-1.16)] and higher educational status [ P = 0.024; OR 5.12 (95% CI 1.24-21.0)] were positively associated with return-to-work status. Reconstruction or amputation was not associated with return to work [ P = 0.087, OR (95% CI 0.190-1.11)]. LIMB-Q Function ( P = 0.033; 95% CI [-11.3 to -0.49]) and LIMB-Q Life Impact ( P = 0.008; 95% CI [-13.5 to -2.01]) scores were significantly increased in patients that returned to work after injury. CONCLUSIONS: Patients who returned to work after lower extremity injury reported higher levels of function and overall return to normalcy in their lives. Returning to work may improve quality of life in patients following lower extremity trauma. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence
Towards equitable healthcare for people with intellectual disabilities: the role of specialized medical ID expertise. Context, content, and perspectives
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313554.pdf (Publisher’s version ) (Open Access)Radboud University, 23 januari 2025Promotores : Leusink, G.L., Naaldenberg, J. Co-promotores : Bakker-van Gijssel, E.J., Pelle, T.194 p
In-situ analysis of methane plasmas with mid-infrared supercontinuum-based Fourier-transform spectroscopy
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314305.pdf (Publisher’s version ) (Open Access
Climate change as a catalyst for economic inequality: The failure of workplace learning in the global south
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317527.pdf (Publisher’s version ) (Open Access)4 p
Een wikken en wegen tussen de zorg- en onthoudingsplicht van de overheid
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316908.pdf (Publisher’s version ) (Open Access
Fluoxetine exerts anti-proliferative effect in human epidermal keratinocytes.
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315925.pdf (Publisher’s version ) (Open Access)We have recently shown that fluoxetine (FX) suppressed polyinosinic-polycytidylic acid-induced inflammatory response and endothelin release in human epidermal keratinocytes, via the indirect inhibition of the phosphoinositide 3-kinase (PI3K)-pathway. Because PI3K-signaling is a positive regulator of the proliferation, in the current, highly focused follow-up study, we assessed the effects of FX (14 µM) on the proliferation and differentiation of human epidermal keratinocytes. We found that FX exerted anti-proliferative actions in 2D cultures (HaCaT and primary human epidermal keratinocytes [NHEKs]; 48- and 72-h; CyQUANT-assay) as well as in 3D reconstructed epidermal equivalents (48-h; Ki-67 immunohistochemistry). Importantly, FX did not influence epidermal thickness (hematoxylin-eosin staining), and it did not have a major impact on the differentiation-associated alteration of the gene expression pattern (24-h treatments; RNA-Seq). Moreover, neither keratin (K)-1, nor K10 expression was altered by FX in NHEKs (RT-qPCR) or in 3D epidermal equivalents (semi-quantitative immunohistomorphometry). FX did not influence differentiation-induced up-regulation of occludin (RT-qPCR; NHEKs), and did not alter differentiation-associated barrier forming capacity of epidermal keratinocytes (electrical impedance; Lucifer Yellow penetration assay). Our data indicate that, besides the previously reported combined anti-inflammatory and putative anti-pruritic effects, FX may also suppress proliferation of human epidermal keratinocytes without impairing their differentiation and barrier-forming capacity
Pancreatic Cancer Networks in Transition: Evaluation of Network Care, Patient Experiences, and Future Directions
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317724.pdf (Publisher’s version ) (Open Access)Patients with pancreatic cancer may undergo diagnostic workup and treatment in multiple hospitals within a network. This dissertation examined aspects of this network care. There is considerable variation in the organization of care within the 15 pancreatic cancer networks in terms of size, number of surgeries, with only 40% having formal agreements. Undergoing diagnostic workup in multiple hospitals was associated with repeated diagnostics and delays in diagnosis and treatment. Network treatment, meaning surgery in hospital A and chemotherapy in hospital B, was not associated with delays in starting chemotherapy, incomplete chemotherapy, or worse survival. However, there was significant variation in chemotherapy outcomes across pancreatic cancer networks. A nationwide study showed that patients rated continuity of care as "sufficient," and that patients receiving multicenter care scored lower. Solutions are required to improve pancreatic cancer care, such as national network agreements and improved patient coordination.Radboud University, 16 april 2025Promotor : Laarhoven, C.J.H.M. van Co-promotor : Stommel, M.W.J.245 p
Resilient Membranized Coacervates Formed through Spontaneous Wrapping of Heat-Destabilized Lipid Bilayers around Coacervate Droplets
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317951.pdf (Publisher’s version ) (Open Access)11 p
Epigenetic mechanisms involved in the long-term proinflammatory effects of hyperuricemia
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316899.pdf (Publisher’s version ) (Open Access)Uric acid, a product of purine breakdown, plays important roles in the body and can contribute to health issues. Elevated urate levels in the bloodstream (hyperuricemia) are associated with gout, as well as cardiovascular and metabolic diseases. Beyond its role in crystal-induced inflammation, soluble urate is emerging as a modulator of immune responses. This thesis investigates whether soluble urate can prime innate immune cells, inducing epigenetic and transcriptional changes that promote inflammation. Findings show urate priming enhances IL-1β production while suppressing IL-1 receptor antagonist (anti-inflammatory) levels, effects associated with DNA methylation and histone modifications. SOCS3 (regulator of cytokine signaling) and type I interferon pathways were identified as key mediators of urate-induced inflammation. Examining cytokine production differences between sexes, reveals stronger inflammatory responses in male gout patients and enhanced in vitro cytokine production in females. The thesis concludes by discussing trained immunity as a mechanism linking soluble urate to persistent inflammation.Radboud University, 25 maart 2025Promotores : Joosten, L.A.B., Netea, M.G. Co-promotor : Crisan, T.O.255 p
Triangulated evidence provides no support for bidirectional causal pathways between diet/physical activity and depression/anxiety
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317129.pdf (Publisher’s version ) (Open Access)Background: Previous studies (various designs) present contradicting insights on the potential causal effects of diet/physical activity on depression/anxiety (and vice versa). To clarify this, we employed a triangulation framework including three methods with unique strengths/limitations/potential biases to examine possible bidirectional causal effects of diet/physical activity on depression/anxiety. Methods: Study 1: 3-wave longitudinal study (n = 9,276 Dutch University students). Using random intercept cross-lagged panel models to study temporal associations. Study 2: cross-sectional study (n = 341 monozygotic and n = 415 dizygotic Australian adult twin pairs). Using a co-twin control design to separate genetic/environmental confounding. Study 3: Mendelian randomization utilizing data (European ancestry) from genome-wide association studies (n varied between 17,310 and 447,401). Using genetic variants as instrumental variables to study causal inference. Results: Study 1 did not provide support for bidirectional causal effects between diet/physical activity and symptoms of depression/anxiety. Study 2 did provide support for causal effects between fruit/vegetable intake and symptoms of depression/anxiety, mixed support for causal effects between physical activity and symptoms of depression/anxiety, and no support for causal effects between sweet/savoury snack intake and symptoms of depression/anxiety. Study 3 provides support for a causal effect from increased fruit intake to the increased likelihood of anxiety. No support was found for other pathways. Adjusting the analyses including diet for physical activity (and vice versa) did not change the conclusions in any study. Conclusions: Triangulating the evidence across the studies did not provide compelling support for causal effects of diet/physical activity on depression/anxiety or vice versa.16 p