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Creating and contesting the message:The lifecycle of EU migration information campaigns from Europe to Senegal
No full textImplementation support structure for the Dutch Health Promoting School program:a multiple case study
No full textSupport structures are available to schools worldwide for the implementation of Health Promoting School (HPS) programs. To get more insight in these structures, this multiple case study aimed to map variation in levels of support within eight Public Health Service (PHS) regions in the Netherlands and associations with contextual factors. Designed together with a Community of Practice, the study included two rounds of semistructured group interviews (N = 1-4 employees; +/- 3.5 hours per case) and document analysis. Data were collected on eight indicators of the level of support (e.g. intensity and reach) and 24 contextual factors relating to Healthy School Advisers, PHSs, stakeholder collaboration, and the wider context. Scores were assigned for all indicators and factors per region, and patterns were examined. Results showed large variation in the level of support across cases, mainly in intensity of provided support, integration in the PHS, and reach in terms of percentage of certified HPS schools. Some aspects such as advisers' context sensitivity scored low in all cases. Key contextual factors were related to the PHS: its policy, internal support, capacity, and (structural) budget. Other important factors related to collaboration with regional stakeholders: coordination, division of responsibilities, and communication structure. Structural budget and strategic stakeholder coordination could be improved in all cases. In conclusion, there is much room for improvement toward sufficient and higher quality HPS implementation support for all schools in the Netherlands. To strengthen support, it is important to establish commitment of the PHS organization, strong coordination between stakeholders, and strong national positioning of the HPS program. These conclusions might also apply to other countries
Psychological side effects of antipsychotic medication after remission from first-episode psychosis:a HAMLETT ecological momentary assessment study
No full textBackground. Evidence on psychological side effects (PSEs) of antipsychotic medication after remission from first-episode psychosis (FEP), and their momentary impact on daily life, is limited. This study examined how Dopamine-2 (D-2) affinity and antipsychotic dosage relate to momentary PSEs. Methods. This ecological momentary assessment (EMA) study included baseline data from 56 participants in the ongoing Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment (HAMLETT) trial. Momentary mental states indicative of reduced affect intensity, stability, and variability, as well as avolition and mental fatigue, were assessed 10x/day for eight days (N = 3,005 data points). Since these PSEs may result from D-2-receptor actions, antipsychotics were classified by receptor affinity and mechanism of action. Multilevel mixed-effects regression models examined serial cross-sectional associations between D-2 affinity or dosage and concurrent PSEs, both overall and separately for mornings, daytimes, and evenings. Results. Higher antipsychotic dosages were associated with reduced affect variability (Beta [B] = -1.40 [95% confidence interval [CI]: -2.52; -0.29]) and decreased positive affect stability (B = 0.23 [95% CI: 0.04; 0.42]) and intensity (B = -1.11 [95% CI: -1.97; -0.24]). The latter was also associated with the use of high-affinity D-2 antagonists versus partial D-2 agonists (B = 12.98 [95% CI: 2.43; 23.53]) and versus low-affinity D-2 antagonists (B = 10.04 [95% CI: 0.59; 19.49]). Other PSEs were not associated with D-2 affinity/dosage. Results were relatively consistent across daytimes. Conclusions. Higher antipsychotic dosage and high-affinity D-2 antagonists were associated with decreased positive affect after remission from FEP, which may partly drive the frequently reported blunting of emotional experience
Development of a paediatric asthma shared decision-making tool:intervention design and evaluation
No full textBackground : Asthma is the most common chronic disease in children, yet adherence to treatment remains poor due to barriers in communication and self-management. Shared decision-making (SDM) can improve adherence, but no decision aid currently exists for paediatric asthma. This gap limits children's engagement in treatment decisions, highlighting the need for a tailored patient decision aid. The aim was to develop a decision aid to support SDM between children with asthma, their parents, and healthcare providers (HCPs), followed by an evaluation of its acceptability and usability. Methods : A user-centred, iterative co-design approach was used, involving children aged 6-18 years with physician-diagnosed asthma, their parents, and healthcare providers (including paediatricians, asthma nurses, and general practitioners). An initial needs assessment identified key challenges in asthma-related decision-making. These insights informed eight structured co-creation sessions focusing on identifying decision points, exploring preferences, and shaping content and format of the decision aid. Usability and acceptability were tested with end-users, and the final version was independently reviewed against the IPDAS checklist by two researchers to assess quality and completeness. Results : A needs assessment (n = 37) with HCPs, patients, and caregivers identified substantial information gaps, with many patients and parents unaware of treatment options or potential side effects. HCPs emphasised the potential value of a decision aid in improving information delivery and encouraging SDM. In eight co-creation sessions, a multidisciplinary group (n = 18) collaborated to develop and refine two complementary decision aids. Feedback highlighted improved clarity, age-appropriate design, and relevance for real-life consultations. In the final phases, both decision aids were tested for acceptability and usability, showing high user satisfaction with minor revisions made (n = 32). A quality assessment was conducted by two independent reviewers. Both tools met all 12 IPDAS criteria. These results confirm their quality and suitability for implementation in practice. Conclusion : The decision aids were well received by patients, parents and HCPs and met IPDAS criteria. They address critical unmet needs in paediatric asthma care by supporting informed decision-making. These tools have the potential to improve the quality of clinical consultations and promote more patient-centred care in the treatment of childhood asthma. Clinical trial number : Not applicable
An AI-powered data curation and publishing virtual assistant:usability and explainability/causability of, and patient interest in the first-generation prototype
No full textIntroduction Ensuring high quality and reusability of personal health data is costly and time-consuming. An AI-powered virtual assistant for health data curation and publishing could support patients to ensure harmonization and data quality enhancement, which improves interoperability and reusability. This formative evaluation study aimed to assess the usability of the first-generation (G1) prototype developed during the AI-powered data curation and publishing virtual assistant (AIDAVA) Horizon Europe project.Methods In this formative evaluation study, we planned to recruit 45 patients with breast cancer and 45 patients with cardiovascular disease from three European countries. An intuitive front-end, supported by AI and non-AI data curation tools, is being developed across two generations. G1 was based on existing curation tools and early prototypes of tools being developed. Patients were tasked with ingesting and curating their personal health data, creating a personal health knowledge graph that represented their integrated, high-quality medical records. Usability of G1 was assessed using the system usability scale. The subjective importance of the explainability/causability of G1, the perceived fulfillment of these needs by G1, and interest in AIDAVA-like technology were explored using study-specific questionnaires.Results A total of 83 patients were recruited; 70 patients completed the study, of whom 19 were unable to successfully curate their health data due to configuration issues when deploying the curation tools. Patients rated G1 as marginally acceptable on the system usability scale (59.1 +/- 19.7/100) and moderately positive for explainability/causability (3.3-3.8/5), and were moderately positive to positive regarding their interest in AIDAVA-like technology (3.4-4.4/5).Discussion Despite its marginal acceptability, G1 shows potential in automating data curation into a personal health knowledge graph, but it has not reached full maturity yet. G1 deployed very early prototypes of tools planned for the second-generation (G2) prototype, which may have contributed to the lower usability and explainability/causability scores. Conversely, patient interest in AIDAVA-like technology seems quite high at this stage of development, likely due to the promising potential of data curation and data publication technology. Improvements in the library of data curation and publishing tools are planned for G2 and are necessary to fully realize the value of the AIDAVA solution
Urban Policymakers' Perspectives on the Equity Impacts and Risks of Local Energy and Mobility Decarbonisation Policies:A Case Study of Dutch Cities
No full textDecarbonisation of urban energy and transportation systems has become a priority for cities worldwide, with policies primarily aiming to promote rooftop solar electricity generation and a shift to private electric vehicles (EVs). However, these policies may also increase inequalities in access to affordable, low-carbon mobility and the associated benefits. While academic literature shows increasing awareness of these equity impacts and risks, the extent to which this applies to policy practice remains unclear. We therefore conducted a case study of seven Dutch cities, analysing local policy documents and conducting interviews with policymakers. The study provided insight into the current policy landscape and revealed a general sensitivity among interviewed policymakers to possible equity impacts of the current decarbonisation policies. Only a few measures to address these impacts are currently in place, but policymakers have proposed a range of novel and more inclusive measures, which can be tested for their impacts and scaling potential in real-life experiments. Another priority for future research is exploring the potential of shared electric mobility to provide equitable access to low-carbon transportation
Comment on Iasella et al. Close Follow-Up of Patients with Neurofibromatosis Type 1 Reduces the Incidence of Malignant Peripheral Nerve Sheath Tumour. <i>Cancers</i> 2025, <i>17</i>, 1306
No full textThe Effect of Far Infrared Treatment on Changes in Biomarkers in the Arteriovenous Fistula
No full textIntroduction: Far infrared radiation may improve arteriovenous fistula maturation and patency rates in patients on hemodialysis (HD). The mechanism is proposed to involve anti-inflammatory and vasodilatory effects in the arteriovenous fistula. This study examined the impact of far infrared radiation on plasma changes and dialysate excretion of biomarkers of endothelial dysfunction, inflammation, and vasodilation in the arteriovenous fistula during a single HD. Methods: The study was a randomized, controlled, single-blinded study involving 44 participants on HD with an arteriovenous fistula. Participants were randomized to far infrared radiation or no far infrared radiation (control). Blood samples and dialysate water were drawn before, during, and after 4 h of HD. The change and elimination of biomarkers of endothelial dysfunction, inflammation, and vasodilation was explored in blood and dialysate water, respectively. Changes in plasma levels from the start to the end of HD and the area under the curve for the biomarker concentration were compared between groups by ANCOVA. Results: There was no difference in the change of biomarkers of endothelial dysfunction, inflammation, and vasodilation between the two groups after and during 4 h of HD. There was a minimal excretion of the biomarkers in the dialysate water. Regardless of the treatment group, 4 h of HD caused a significant decrease in tumor necrosis factor-alpha (-1.30 [-1.70; -1.03] pg/mL, p < 0.001), monocyte chemoattractant protein-1 (-32.50 [-50.50; -8.25] pg/mL, p < 0.001), nitrite and nitrate (-20.00 [-27.75; -14.00] mu mol/L, p < 0.001) as well as asymmetric dimethylarginine (-0.24 [-0.28; -0.18] <mu>mol/L, p < 0.001). Conclusion: Overall, the study is not supportive of a beneficial effect of far infrared radiation on the arteriovenous fistula on biomarkers of endothelial dysfunction, inflammation, or vasodilation during one HD treatment. (c) 2025 S. Karger AG, Base
Renal cell carcinoma detection:a systematic review in diagnostic urinary biomarkers
No full textBackgroundRenal cell carcinoma (RCC) accounts for 90% of all renal neoplasms and is often incidentally detected through unrelated imaging procedures. Differentiating between benign and malignant renal masses remains challenging using imaging alone. Urinary biomarkers may aid in this distinction, yet none are currently implemented in the clinic. Moreover, a comprehensive overview of urinary diagnostic biomarkers for RCC is lacking. Therefore, we aimed to systematically review and summarize existing literature on potential urinary biomarkers with diagnostic properties for RCC.MethodsPubMed, Scopus and Web of Science were used for the identification of eligible studies evaluating urinary biomarkers in adults with sporadic RCC which reported diagnostic properties compared to controls groups. Standardized data extraction was performed. Risk of bias of was assessed by using a modified STROBE 22-items checklist for observational studies.ResultsIn total 136 articles were identified through database search, four via a previous review and 19 through cross-referencing. After screening, 46 articles were included, identifying 105 individual biomarkers: metabolites (n = 40), proteins (n = 29), miRNAs (n = 12), DNA methylation markers (n = 13) and others (n = 11). Additionally, 29 multi-biomarker panels were described. Promising diagnostic markers (AUC >= 0.80) included dysregulated energy metabolism markers, proteins AQP1 and PLIN2, and miRNAs; miR-122-5p, miR-15a and miR-30c, however validation is severely lacking.ConclusionsVarious urinary biomarkers for RCC show promising diagnostic potential. The diagnostic ability of multi-biomarker panels often exceeded those of individual markers. However, individual markers and panels require external validation before clinical implementation.Trial registrationThis systematic review was registered on PROSPERO (CRD42023474582), and was designed and written based on the PRISMA guidelines
Implications of inflammation and sex in lower extremity arterial disease
No full textBackground: Lower extremity arterial disease (LEAD) affects over 200 million people globally and is largely driven by chronic vascular inflammation. However, the complex interplay between inflammatory pathways, their prognostic value and potential sex-specific differences remains insufficiently understood. Methods and Results: Literature indicates that elevated inflammatory markers—such as (high-sensitivity) C-reactive protein, fibrinogen, D-dimer, interleukin-6, α-defensins and soluble adhesion molecules as well as newly arising parameters such as neutrophil counts and markers of clonal haematopoiesis—may predict both the onset and progression of LEAD, from declining ankle–brachial indices and impaired walking performance to higher rates of amputation, cardiovascular events and mortality. Moreover, women with LEAD frequently present at older ages with more advanced disease, exhibit distinct lesion patterns and greater functional impairment, and often have higher baseline CRP levels than men, although the strength of association between inflammatory markers and adverse outcomes may be attenuated in women. However, it remains unclear how inflammatory markers can guide (sex) specific patient stratification in LEAD or which markers provide the most clinical utility in general. Conclusion: Together, these findings underscore the need for comprehensive inflammatory profiling in LEAD risk stratification and highlight the importance of joining sex-specific analyses, new (bio)markers and machine learning to integrate clinical, genomic, proteomic and functional data into future studies to inform patient-tailored prevention and treatment strategies.</p