Non-healing wounds represent a substantial medical burden with few effective treatments available. To address this challenge, we developed a novel epidermal wound healing model using suction... Show moreNon-healing wounds represent a substantial medical burden with few effective treatments available. To address this challenge, we developed a novel epidermal wound healing model using suction blisters in healthy volunteers. This model allowed for the comprehensive assessment of wound healing dynamics and the evaluation of INM-755, a topical cream containing cannabinol, as a potential therapeutic agent. Two clinical studies were conducted: an observational study and an interventional study. In both studies, healthy volunteers underwent a suction blister procedure on their lower back, creating open epidermal wounds. Wound healing parameters were assessed using advanced imaging systems. Skin barrier function and perfusion were evaluated through trans epidermal water loss (TEWL) and dynamic optical coherence tomography (D-OCT), respectively. The observational study demonstrated the successful and reproducible Induction of blisters and the removal of epidermal sheet, enabling quantifiable measurements of wound healing parameters over time. Re-epithelialization was observed, revealing recovery of skin barrier function and perfusion. In the interventional study, differences of treatments over time were quantified using the above-described techniques. Despite differences from disease-specific blistering, our developed model provides a valuable platform for studying wound healing mechanisms and assessing novel therapeutic interventions. The sensitivity to treatment effects demonstrated in our study underscores the potential utility of this model in early-phase clinical drug development programs targeting wound healing disorders. Show less
Background: Left ventricular apical pacing (LVAP) is considered to preserve left ventricular (LV) systolic function in both patients with and without congenital heart disease. However, sporadic... Show moreBackground: Left ventricular apical pacing (LVAP) is considered to preserve left ventricular (LV) systolic function in both patients with and without congenital heart disease. However, sporadic LVAP-associated cardiac dysfunction in children with complex structural heart disease was recently reported. We present the case of a 2.5-year-old child with complex congenital heart disease and LVAP-induced cardiomyopathy. Case summary: Corrective surgery for double outlet right ventricle, subpulmonary ventricular septal defect, and transposition of the great arteries was done at the age of 1.5 months. Late complete atrioventricular block occurred, necessitating VVI pacemaker insertion with LV apical epicardial leads. He presented with heart failure and dilated cardiomyopathy 1.5 years after pacemaker insertion and required persistent circulatory support with intravenous inotropes. Speckle tracking echocardiography identified an important LV apical to basal dyssynchrony. After excluding any coronary artery involvement, cardiac resynchronization therapy was performed. Speckle tracking echocardiography guided lead placement resulted in improved LV contraction synchrony. Cardiac function recovered progressively in combination with oral heart failure medication and is almost normal at 10-month follow-up. Discussion: Right ventricular pacing is a well-known cause of pacing-induced cardiomyopathy. The LV apex and LV free wall are thought to be most optimal locations for ventricular pacing in children. However, LVAP can also be the cause of a pacing-induced cardiomyopathy and decreased systolic LV function in children with complex congenital heart disease due to lack of LV contraction synchrony. Cardiac resynchronization therapy can reverse this LV dysfunction and remodelling. Show less
Shen, H.X.; Chen, C.; Yan, S.J.; Hallensleben, C.; Kleij, R. van der; Li, M.Y.; ... ; Zhou, Y. 2024
Background Digital health plays a vital role in healthcare services. Governments in many countries, including China, are increasingly advocating for the appropriate use of digital technologies to... Show moreBackground Digital health plays a vital role in healthcare services. Governments in many countries, including China, are increasingly advocating for the appropriate use of digital technologies to address significant health system challenges. It is crucial to incorporate digital health education into the curriculum for future nurses to adapt to the changes in the digital medical system. This study aimed to evaluate the impact of an online Digital Health and Informatics Course in China on the knowledge and comprehension of key digital health and informatics topics, self-assessment of nursing informatics competencies, and satisfaction among undergraduate nursing students. The findings of this study provide recommendations for the design and implementation of future digital health education. Methods This study employed a one-group, quasi-experimental mixed-methods design with pre- and postassessments. The participants received digital health and informatics education through six three-hour online sessions in six interactive days, with online self-learning materials in between. An online quiz and focus group discussions pre- and post the course were designed to evaluate the knowledge and comprehension of key digital health and informatics topics. Also, a validated Chinese version of the Self-assessment of Nursing Informatics Competencies Scale was conducted pre- and post-course to assess self-assessment of nursing informatics competencies. Additionally, all students were invited to participate in an online survey with a performance-focused course evaluation form as well as focus group discussions to gather their feedback on the learning experience and their evaluations of the course. Results A total of 24 undergraduate nursing students were enrolled in the course. All students completed all sessions of this course, resulting in an attendance rate of 100%. Additionally, all students completed both pre- and postassessments. In terms of the knowledge and comprehension of key digital health and informatics topics, scores of the quiz on knowledge assessment improved from the pre-test [mean pretest score: 78.33 (SD 6.005)] to the posttest [mean post-test score: 83.17 (SD 4.86)] upon completion of the course (P<0.001). Also, students acknowledged that the course enhanced their knowledge and comprehension of informatics and digital health, the benefits of (nursing) informatics in clinical practice, and the role of health care professionals in informatics and digital health. In terms of self-assessment of nursing informatics competencies, scores on nursing informatics attitudes demonstrated significant improvement (P<0.001). Furthermore, students reported high satisfaction with various aspects of this course, including the opportunity to explore broad horizons in informatics for future careers, engaging in group discussions, and analyzing case studies on the use of informatics and digital health in clinical practice. Conclusions This Online Digital Health and Informatics education effectively improved undergraduate nursing students’ knowledge and comprehension of the key digital health and informatics topics, nursing informatics attitudes in the self-assessment of nursing informatics competency with high levels of satisfaction. In order to ensure that future education in digital health and informatics for nursing students is in line with the technological advancements in clinical settings, it is necessary to foster collaboration between medical school training and clinical practice. This collaboration should involve the use of clinical examples to illustrate advanced digital health applications and the inclusion of practical exercises on the use of digital health technology in clinical settings. Show less
Synthetic supramolecular polymers and hydrogels in water are emerging as promising biomaterials due to their modularity and intrinsic dynamics. Here, we introduce temperature sensitivity into the... Show moreSynthetic supramolecular polymers and hydrogels in water are emerging as promising biomaterials due to their modularity and intrinsic dynamics. Here, we introduce temperature sensitivity into the nonfunctionalized benzene-1,3,5-tricarboxamide (BTA-EG4) supramolecular system by incorporating a poly(N-isopropylacrylamide)-functionalized (BTA-PNIPAM) moiety, enabling 3D cell encapsulation applications. The viscous and structural properties in the solution state as well as the mechanical and dynamic features in the gel state of BTA-PNIPAM/BTA-EG4 mixtures were investigated and modulated. In the dilute state (c ∼μM), BTA-PNIPAM acted as a chain capper below the cloud point temperature (Tcp = 24 °C) but served as a cross-linker above Tcp. At higher concentrations (c ∼mM), weak or stiff hydrogels were obtained, depending on the BTA-PNIPAM/BTA-EG4 ratio. The mixture with the highest BTA-PNIPAM ratio was ∼100 times stiffer and ∼10 times less dynamic than BTA-EG4 hydrogel. Facile cell encapsulation in 3D was realized by leveraging the temperature-sensitive sol-gel transition, opening opportunities for utilizing this hydrogel as an extracellular matrix mimic. Show less
Central Asia is highly vulnerable to the impacts of climate change. There is, however, a lack of research on how local businesses, political elites and the general public perceive the need for... Show moreCentral Asia is highly vulnerable to the impacts of climate change. There is, however, a lack of research on how local businesses, political elites and the general public perceive the need for comprehensive greening initiatives to address its consequences. To account for the material and ideational factors influencing clean energy transition in Central Asian petrostates, I offer an alternative analytic framework that I call ‘contrasting adaptation’. I argue that the energy transition has resulted in two contradictory responses at multiple levels of political governance: a formal response that is broadly supportive of new ‘green’ identities and policies, and an informal response that seeks to delay plans to decarbonize local business models and continues to prioritize ‘old’ oil and gas activities through new transnational networks. Drawing on a model of actor interactions at different levels of climate governance, I examine ‘contrasting adaptation’ – its constituent policies and discourse – to provide a better theorized framework for understanding climate politics in Central Asia. I use comparative analysis of the climate policies of Kazakhstan and Uzbekistan, the two Central Asian petrostates that pledged to carbon neutrality, informed by documentary and textual sources, and discourse analysis. Show less
Sievers, Eva; Spierenburg, M.J.; Jhagroe, S.S.; Oudenhoven, A.P. E van 2024
Rapid global change threatens to outstrip global efforts to establish sustainable stewardship of social-ecological systems (SES). Place-based research can enhance effectiveness of global... Show moreRapid global change threatens to outstrip global efforts to establish sustainable stewardship of social-ecological systems (SES). Place-based research can enhance effectiveness of global sustainability policies and actions by providing contextualized knowledge underpinning bottom-up solutions. However, the use and transfer of place-based knowledge remains a major challenge. In this study, we analyze place-based knowledge transfer in a local-to-global and knowledge-to-action context. We aim to provide insights on when, how, and why place-based research can inform decision-making at the global scale, and lead to action towards more sustainable and just futures. Our iterative and exploratory methodology involved alternating rounds of literature reviews and interviews with interdisciplinary researchers. We identify four key steps (place-based knowledge production, knowledge synthesis, knowledge use at the global scale, and knowledge revision and lessons learned) and five facilitative factors (bridging organizations, knowledge brokers, boundary organizations, institutionalized knowledge governance and polycentric governance systems), which provide a comprehensive understanding of place-based knowledge transfer. Our conceptual framework provides suggestions on how to set up place-based knowledge transfer to be more effective, complete, and inclusive. Furthermore, our study discusses two major structural challenges that currently inhibit place-based knowledge transfer, and shows ways forward for science and policy to overcome these. We argue that place-based knowledge transfer can be an effective means to undo dominant power relations and the epistemic status quo, and enable a shift from short-termism in science and policy towards more long-term SES goals. Therefore, it is seminal to open up the predominant value system to more diverse knowledge systems, signifying a shift away from global decision-making that is guided by neoliberal capitalist principles and over-emphasizes short-term and individual gains. Finally, it is crucial to prioritize learning over knowing to exploit the long-term value of place-based knowledge transfer. Show less
Through a series of questions and responses, in this dialogue-based article we aim to stimulate reflection on indirect translation within the audiovisual translation community, offering... Show moreThrough a series of questions and responses, in this dialogue-based article we aim to stimulate reflection on indirect translation within the audiovisual translation community, offering perspectives on this practice. We start by delving into the historical roots of indirect translation in the industry, questioning how far back such practices extend. Then we shift the focus to the challenges translators face in indirect translation workflows, to the potential contributions of research to the ongoing debates surrounding indirect translation, as well as to how indirect translation and machine translation intersect. Finally, looking to the future, we examine potential developments in indirect translation workflows and consider how educational programs can adapt to meet the changing demands of the industry. Show less
This article explores the current and future technological pathways of RFID components and quantifies their environmental impacts through life cycle assessment (LCA), and also covering the critical... Show moreThis article explores the current and future technological pathways of RFID components and quantifies their environmental impacts through life cycle assessment (LCA), and also covering the critical materials and energy use of tags, readers, and backend servers. We assess RFID-enabled lithium-ion battery supply chains with different cathode chemistries – lithium nickel cobalt aluminum oxide (NCA), nickel cobalt manganese oxide (NCM) as case applications. The results indicate that miniaturization and novel antenna materials can reduce the current environmental impacts of tags and readers by 60 % and 4 %, respectively. Direct energy consumption and antennas are the main contributors for tags, while microcontrollers and transceivers are the main contributors for readers. Furthermore, the overall environmental improvements of RFID system outweigh their additional environmental impacts. The use of RFID systems in optimizing battery supply process gives higher reductions in climate change and abiotic resource depletion impacts than switching to low-carbon battery chemistries (i.e. using NCM instead of NCA). Show less
Background: Decision‐making after local resection of T1 colorectal cancer (T1CRC) isoften complex and calls for optimal information provision as well as active patientinvolvement.Objective: The aim... Show moreBackground: Decision‐making after local resection of T1 colorectal cancer (T1CRC) isoften complex and calls for optimal information provision as well as active patientinvolvement.Objective: The aim was to evaluate the perceptions of patients with T1CRC oninformation provision and therapeutic decision‐making.Methods: This multicenter cross‐sectional study included patients who underwentendoscopic or local surgical resection as initial treatment. Information provision wasassessed using the EORTC QLQ‐INFO25 questionnaire. In patients with high‐riskT1CRC, we evaluated decisional involvement and satisfaction regarding thechoice as to whether to undergo additional treatment after local resection, and thelevel of decisional conflict using the Decisional Conflict Scale.Results: Ninety‐eight patients with T1CRC were included (72% response rate; 79/98 endoscopic and 19/98 local surgical resection; 45/98 high‐risk T1CRC). Mediantime since local resection was 28 months (IQR 18); none had developed recurrence.Unmet information needs were reported by 29 patients (30%; 18 low‐risk, 11 high‐risk), mostly on post‐treatment related topics (follow‐up visits, recovery time,recurrence prevention). After local resection, 24 of the 45 high‐risk patients (53%)underwent additional treatment, while others were subjected to surveillance.Higher‐educated patients were more often actively involved in decision‐making(93% vs. 43%, p = 0.002) and more frequently underwent additional treatment(79% vs. 40%, p = 0.02). Decisional conflict (p = 0.19) and satisfaction (p = 0.78)were comparable between higher‐ and lower‐educated high‐risk patients. Show less
Verdonschot R.G.; Wal, G.J. van der; Ashley, L.; Knudsen, B.; Grebmer zu Wolfsthurn, S. von; Schiller, N.O.; Hagoort, P. 2024
There is evidence from both behavior and brain activity that the way information is structured, through the use of focus, can up-regulate processing of focused constituents, likely to give... Show moreThere is evidence from both behavior and brain activity that the way information is structured, through the use of focus, can up-regulate processing of focused constituents, likely to give prominence to the relevant aspects of the input. This is hypothesized to be universal, regardless of the different ways in which languages encode focus. In order to test this universalist hypothesis, we need to go beyond the more familiar linguistic strategies for marking focus, such as by means of intonation or specific syntactic structures (e.g., it-clefts). Therefore, in this study, we examine Makhuwa-Enahara, a Bantu language spoken in northern Mozambique, which uniquely marks focus through verbal conjugation. The participants were presented with sentences that consisted of either a semantically anomalous constituent or a semantically nonanomalous constituent. Moreover, focus on this particular constituent could be either present or absent. We observed a consistent pattern: Focused information generated a more negative N400 response than the same information in nonfocus position. This demonstrates that regardless of how focus is marked, its consequence seems to result in an upregulation of processing of information that is in focus.Gravitation Grant 024.001.006 of the Language in Interaction Consortium from the Netherlands Organization for Scientific Research (NWO) Show less
As the world’s second most consumed resource, sand is being depleted at an alarming rate. China accounted for nearly half of the world’s sand consumption in 2012. Here we present a material flow... Show moreAs the world’s second most consumed resource, sand is being depleted at an alarming rate. China accounted for nearly half of the world’s sand consumption in 2012. Here we present a material flow analysis of sand from 1995 to 2020 that shows China’s overall sand supply surged by approximately 400% over the study period, yet the proportion of natural sand dropped from ~80% to ~21% due to the increasing use of manufactured sand. From 2010 to 2020, China’s natural sand supply nearly halved due to the strict policies on natural sand mining and the promotion of manufactured sand. This shift demonstrates a possibility for mitigating impacts on natural sand resources during industrialization and urbanization. Show less
In this chapter, we frame Pro-environmental behaviors (PEB) as a moral issue and describe the need to understand the development of environmental morality in young populations. We then specify... Show moreIn this chapter, we frame Pro-environmental behaviors (PEB) as a moral issue and describe the need to understand the development of environmental morality in young populations. We then specify factors associated with children’s and adolescents’ environmental morality and their relation with PEB, including young populations’ moral judgments of environmentally harmful actions, their sense of personal obligation to protect nature, and the role of moral environmental emotions. Next, we focus on developmental differences found in environmental morality. We end up by providing suggestions of how formative experiences, especially those organized in contact with nature, may instill a moral stance toward nature in youth. Show less
