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β-Cell Mass in Individuals With and Without Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass
No full textPostbariatric hypoglycemia (PBH) is a serious complication of Roux-en-Y gastric bypass (RYGB), characterized by severe hypoglycemia that may lead to loss of consciousness and seizures. The exact mechanism of PBH is poorly understood. One potential mechanism is β-cell expansion. To this end, we investigated β-cell mass in individuals with and without PBH after RYGB using [68Ga]Ga-NODAGA-exendin-4 positron emission tomography/computed tomography imaging (PET/CT). Individuals with PBH (n = 10) and without PBH (n = 9) after RYGB were included. PET/CT imaging was performed after infusion with 102.2 ± 6.9 MBq of the [68Ga]Ga-NODAGA-exendin-4 tracer to quantify pancreatic β-cell mass. The two groups did not differ with respect to sex, age, BMI, and total body weight loss after RYGB. Time between RYGB and inclusion was longer for individuals with PBH compared with those without. β-Cell mass did not differ between the groups. Individuals with PBH had a smaller pancreas than those without. β-Cell mass correlated neither with body weight parameters nor with metabolic parameters. Our data indicating that β-cell mass does not differ between individuals with and without PBH after RYGB argue against expansion of β-cell mass to explain PBH. ARTICLE HIGHLIGHTS: The exact mechanism of postbariatric hypoglycemia (PBH) is unclear, but β-cell mass expansion is hypothesized to play a role. We used [68Ga]Ga-NODAGA-exendin-4 positron emission tomography/computed tomography (PET/CT) to determine β-cell mass in individuals with and without PBH after Roux-en-Y gastric bypass surgery. β-Cell mass did not differ between individuals with and without PBH. Pancreas volume was lower in individuals with PBH compared with those without PBH. Our data argue against β-cell mass expansion to explain PBH after Roux-en-Y gastric bypass. Further study is required to understand PBH.</p
Does luteal phase support in MOH-IUI treatment improve cumulative live birth rates in couples with unexplained subfertility? Study protocol of the LUMO study:A centre, randomised, double-blind, controlled trial with cost-effectiveness analysis
No full textIntroduction Couples diagnosed with unexplained subfertility are advised to start mild ovarian hyperstimulation and intrauterine insemination (MOH-IUI) as a primary treatment. Natural feedback mechanisms and hormone release are affected by artificially stimulated cycles and induced ovulation. Additional luteal support could positively affect progesterone patterns in the luteal phase. The LUMO study evaluates whether the addition of exogenous progesterone in the luteal phase following MOH-IUI treatment cycle will improve pregnancy and live birth rates. Methods and analysis A multicentre randomised, double-blind, controlled trial will be conducted in Dutch fertility clinics, academic and non-academic hospitals. There are two treatment arms: group A progesterone luteal phase support; group B placebo, without crossover. All initiated MOH-IUI cycles within 6 months after randomisation are included (study period). Participants will start study medication, applying a daily dosage of 2dd 300 mg progesterone (Utrogestan) or 2dd 300 mg placebo in vaginal capsules on the second day after the IUI procedure. Treatment is continued until the onset of menstruation, a negative pregnancy test (IUI+14 days), a miscarriage or until 7 weeks of gestation in case of a viable pregnancy. Follow-up ends at 12 months after the end of study period (18 months after study randomisation). The primary outcome is cumulative pregnancy rate, achieved within 6 months after randomisation, leading to live birth. A total of 1008 patients (504 patients in each group) will be included. Ethics and dissemination The study was approved by the Central Committee on Research Involving Human Subjects on 30 January 2023. All participating sites have the approval of the local Board of Directors to participate in the LUMO study. An informed consent form will be signed by all participants. Study results will be presented at (inter)national conferences and published in peer-reviewed journals. It is expected that the results of this trial will be used to draft national guidelines on this issue
Erratum to ‘Perspective:Vegan Diets for Older Adults? A Perspective On the Potential Impact On Muscle Mass and Strength’ Advances in Nutrition 13 (2022) 712-725 (Advances in Nutrition (2022) 13(3) (712–725), (S2161831322000229))
No full textThe publisher regrets that all X's belonging to reference 86 in table 1, shifted a column to the left. As a consequence, the first five X's at reference 86 were placed under ‘O’ and the last one under ‘V’ in the first published version. Instead, the first five X's belonging to that reference should have been placed under ‘N’ and the last one under ‘O’. The correct table is published below. The publisher would like to apologise for any inconvenience caused
Embracing the Future of Medical Education With Large Language Model–Based Virtual Patients:Scoping Review
No full textBackground: In recent years, large language models (LLMs) have experienced rapid development. LLM-based virtual patients have begun to gain attention, offering new opportunities for simulations in medical education. Objective: This study aims to systematically analyze the current applications, research trends, and challenges of LLM-based virtual patients in medical education and to explore potential future directions for development. Methods: This study adheres to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Five databases (Web of Science Core Collection, PubMed, IEEE Xplore, Embase, and Scopus) were searched from January 1, 2018, to June 24, 2025, to identify studies related to the application of LLM-based virtual patients in medical education. A comprehensive analysis of LLM-based virtual patients from research design to application and evaluation was conducted. Results: A total of 28 studies were included in this scoping review. Analysis revealed that 92.9% (26/28) of the studies were published in the past 2 years, indicating that LLM-based virtual patient research is still in its early stages. The research primarily focuses on medical training and spans a wide range of medical disciplines. When using LLMs, advanced technologies such as social robots, virtual reality, and mixed reality are used to present LLM-based virtual patients. Combining these technologies with various supplementary tools enhances the realism of LLM-based virtual patients and improves user interaction. The evaluation of LLM-based virtual patients mainly emphasizes user experience. However, evaluation methods lack standardization, and only 13% (3/23) of studies used validated tools in assessing LLM-based virtual patients, while only 21.7% (5/23) of studies objectively measured learning outcomes facilitated by LLM-based virtual patients. All included studies expressed a positive attitude toward LLM-based virtual patients; however, they overlook privacy and security considerations in practical applications. Conclusions: LLM-based virtual patients hold significant innovation potential in medical education and are still in the early stages of development. They are primarily applied in medical training and show promise in communication skills training, although they cannot replace real-world interactions. Moreover, the heterogeneity of research designs, the absence of nonverbal cues in interactions, and concerns regarding privacy and security limit their broader implementation. Future research should focus on improving the reliability, realism, safety, and scientific efficacy of LLM-based virtual patients
Why study design matters:evaluating bias and generalizability in contrast-enhanced mammography research
No full textTouché: lichamelijk onderzoek als integriteitsinbreuk onder Wvggz
No full textAls patiënt een inwendig onderzoek moeten ondergaan, is bijzonder ingrijpend. Het overkwam de patiënte in deze uitspraak, terwijl ze was opgenomen onder de machtiging tot voortzetting van een crisismaatregel. Ze was wilsbekwaam in haar verzet tegen opname, maar zou levensgevaarlijk zijn voor zichzelf. Ze zei haar polsen met een scheermesje door te snijden. Om zelfbeschadiging te voorkomen doorzocht de verpleging haar kamer en kleding, zonder het mesje aan te treffen. De volgende morgen werd ze tot lichamelijk vaginaal onderzoek gedwongen. De klachtencommissie verklaarde de klacht hierover niet-ontvankelijk. De rechtbank Amsterdam verklaarde de klacht gegrond onder afwijzing van schadevergoeding. Deze uitspraak is om meerdere redenen relevant, allereerst vanwege het verschil tussen onderzoek aan en in het lichaam, zowel aan de orde bij de Wvggz als in het strafrecht. Mijns inziens bood geen enkele bepaling een goede basis voor het onderzoek bij deze patiënte
Unraveling the Regimes of Synthetic Data Metrics:Expectations, Ethics, and Politics
No full textSynthetic data - artificially produced data used for various data science tasks - have become the subject of intense scholarly interest, engendering both hope and hype in fields like machine learning (ML) and data privacy. In this commentary, we shed light on a little-studied facet of the emerging synthetic data landscape: their evaluation through the use of different quality measures, such as privacy, utility, and fidelity metrics. While these may seem highly technical, this commentary argues that evaluation metrics are inextricably linked to the expectations, ethics and politics of synthetic data. Situating synthetic data metrics within longer histories of data measurement in big data and ML discourses, we unfold a conceptualization of synthetic data metrics as metrological regimes which highlights the multifaceted ways in which they are implicitly and explicitly political. We put this concept to use by providing a three-fold preliminary analysis of metrics for the evaluation of synthetic tabular data: first, we outline the current constitution of synthetic data’s metrological regimes around utility, privacy, and fidelity metrics; second, we highlight the performativity of these metrological regimes; that is, how they overshadow other crucial measures and enact quantifications of essentially contested concepts; and third, we emphasize the fragility of synthetic data’s metrological regimes by pointing to the eruption of specific negotiations regarding which privacy metrics (not) to use for synthetic data evaluation. By foregrounding how metrics shape the expectations, ethics, and politics of synthetic data, this commentary underlines the need for their critical study
Ostalgie: nostalgia as identity politics
No full textThe chapter offers a theoretical framework for analysing communist nostalgia and introduces Ostalgie as a form of nostalgic identity politics that finds one of its main expressions in cultural productions. It uses the East German rock band ‘Silly’ as a case study to demonstrate how music can form a focal point around which listeners individually and collectively negotiate a continued sense of East German identity after reunification