Process Mining on National Health Care Data for the Discovery of Patient Journeys of Older Adults.

Objective: Understanding the longitudinal patterns of health care utilization among older adults is crucial for designing effective patient journeys and enhancing care coordination across settings. This study aims to uncover the most common patient journeys of older adults.

Design: This explorative study used process mining techniques to analyze national health care data from 2017 to 2019, focusing on patient care journeys of older adults (aged ≥65 years) in the Netherlands.

Team Size and Composition in Home Healthcare: Quantitative Insights and Six Model-Based Principles.

The aim of this constructive study was to develop model-based principles to provide guidance to managers and policy makers when making decisions about team size and composition in the context of home healthcare. Six model-based principles were developed based on extensive data analysis and in close interaction with practice. In particular, the principles involve insights in capacity planning, travel time, available effective capacity, contract types, and team manageability.

Avoiding Hospital Admissions and Delayed Transfers of Care by Improved Access to Intermediate Care: A Simulation Study.

Objective: The current waiting times for intermediate care in the Netherlands prohibit timely access, leading to unwanted and costly hospital admissions. We propose alternative policies for improvement of intermediate care and estimate the effects on the waiting times, hospitalization, and the number of patient replacements.

Design: Simulation study.

[On the specific treatment of asthenic states: focus on sulbutiamine].

In this article, we try to present the available data regarding the pharmacokinetics and pharmacodynamics of sulbutiamine (Enerion), the mechanisms of its anti-asthenic action. Then we analyze and summarize the available evidence base considering the efficacy and safety of Enerion for the treatment of asthenic syndromes. Then we compare Enerion with some other drugs.

Rethinking the immunotherapy numbers game.

Immunotherapies are a major breakthrough in oncology, yielding unprecedented response rates for some cancers. Especially in combination with conventional treatments or targeted agents, immunotherapeutics offer invaluable tools to improve outcomes for many patients. However, why not all patients have a favorable response remains unclear.

Reduced Waiting Times by Preference-Based Allocation of Patients to Nursing Homes.

Objectives: The long waiting times for nursing homes can be reduced by applying advanced waiting-line management. In this article, we implement a preference-based allocation model for older adults to nursing homes, evaluate the performance in a simulation setting for 2 case studies, and discuss the implementation in practice.

Design: Simulation study.

A three-step framework for capacity planning in a nursing home context.

This paper presents a three-step conceptual framework that can be used to structure the care-related capacity planning process in a nursing home context. The proposed framework provides a sound practical vehicle to organise client-centred care without overstretching available capacity. Within this framework, an MILP for shift scheduling and a Genetic Algorithm (GA) for task-scheduling are proposed.

Cariprazine's Potential in Improving Social Dysfunction in Patients With Schizophrenia: A Perspective.

Social dysfunction is one of the most debilitating aspects of schizophrenia. Treatment of this complex phenomenon, constituted by negative, cognitive, and affective symptoms, has been difficult with the available pharmacological agents, hence it represents an unmet medical need. Cariprazine, a novel, third-generation antipsychotic with a unique mechanism of action has been proven to sufficiently alleviate negative, cognitive, and affective symptoms of schizophrenia.

Mathematical modeling of radiotherapy and its impact on tumor interactions with the immune system.

Radiotherapy is a primary therapeutic modality widely utilized with curative intent. Traditionally tumor response was hypothesized to be due to high levels of cell death induced by irreparable DNA damage. However, the immunomodulatory aspect of radiation is now widely accepted.

Modeling COVID-19 hospital admissions and occupancy in the Netherlands.

We describe the models we built for predicting hospital admissions and bed occupancy of COVID-19 patients in the Netherlands. These models were used to make short-term decisions about transfers of patients between regions and for long-term policy making. For forecasting admissions we developed a new technique using linear programming.

Optimal patient protocols in regional acute stroke care.

In acute stroke care two proven reperfusion treatments exist: (1) a blood thinner and (2) an interventional procedure. The interventional procedure can only be given in a stroke centre with specialized facilities. Rapid initiation of either is key to improving the functional outcome (often emphasized by the common phrase in acute stroke care "time=brain").

Discovery of a Lead Brain-Penetrating Gonadotropin-Releasing Hormone Receptor Antagonist with Saturable Binding in Brain.

We report the synthesis, radiosynthesis and biological characterisation of two gonadotropin-releasing hormone receptor (GnRH-R) antagonists with nanomolar binding affinity. A small library of GnRH-R antagonists was synthesised in 20-67 % overall yield with the aim of identifying a high-affinity antagonist capable of crossing the blood-brain barrier. Binding affinity to rat GnRH-R was determined by autoradiography in competitive-binding studies against [ I]buserelin, and inhibition constants were calculated by using the Cheng-Prusoff equation.

The pre-separation of oxygen containing compounds in oxidised heavy paraffinic fractions and their identification by GC-MS with supersonic molecular beams.

The heavy petroleum fractions produced during refining processes need to be upgraded to useable products to increase their value. Hydrogenated heavy paraffinic fractions can be oxidised to produce high value products that contain a variety of oxygenates. These heavy oxygenated paraffinic fractions need to be characterised to enable the control of oxidation processes and to understand product properties.

Results on patient flow of implementing an Acute Medical Unit.

Background: There is an increased influx of patients needing admission. Introducing an acute medical unit (AMU) may increase the admission capacity without increasing the total number of beds.

Methods: Data collected during the first four years after implementation of an AMU in an academic tertiary care center in Amsterdam were analyzed.

Five-year clinical follow-up of the STENTYS self-apposing stent in complex coronary anatomy: a single-centre experience with report of specific angiographic indications.

Objectives: We sought to investigate angiographic indications for the use of the STENTYS technique and evaluated the long-term safety and clinical efficacy of the stent.

Background: Coronary lesions involving complex anatomy, including aneurysmatic, ectatic, or tapered vessel segments often carry a substantial risk of stent malapposition. The self-apposing stent technique may reduce the risk of stent malapposition and therefore improve clinical outcomes.

Keeping pace with the ebbs and flows in daily nursing home operations.

Nursing homes are challenged to develop staffing strategies that enable them to efficiently meet the healthcare demand of their residents. In this study, we investigate how demand for care and support fluctuates over time and during the course of a day, using demand data from three independent nursing home departments of a single Dutch nursing home. This demand data is used as input for an optimization model that provides optimal staffing patterns across the day.

Queues on a Dynamically Evolving Graph.

This paper considers a population process on a dynamically evolving graph, which can be alternatively interpreted as a queueing network. The queues are of infinite-server type, entailing that at each node all customers present are served in parallel. The links that connect the queues have the special feature that they are , in the sense that their status alternates between 'up' and 'down'.

Efficacy of the RADPAD Protection Drape in Reducing Operators' Radiation Exposure in the Catheterization Laboratory: A Sham-Controlled Randomized Trial.

Background: Interventional cardiologists are increasingly exposed to radiation-induced diseases like cataract and the stochastic risk of left-sided brain tumors. The RADPAD is a sterile, disposable, lead-free shield placed on the patient with the aim to minimize operator-received scatter radiation. The objective of the trial was to examine the RADPAD's efficacy in a real-world situation.

Analysis of oxidised heavy paraffininc products by high temperature comprehensive two-dimensional gas chromatography.

Heavy petroleum fractions are produced during crude and synthetic crude oil refining processes and they need to be upgraded to useable products to increase their market value. Usually these fractions are upgraded to fuel products by hydrocracking, hydroisomerization and hydrogenation processes. These fractions are also upgraded to other high value commercial products like lubricant oils and waxes by distillation, hydrogenation, and oxidation and/or blending.

Two-dimensional gas chromatography-online hydrogenation for improved characterization of petrochemical samples.

The Fischer-Tropsch (FT) process produces a variety of hydrocarbons over a wide carbon number range and during subsequent product workup a large variety of synthetic fuels and chemicals are produced. The complexity of the product slate obtained from this process is well documented and the high temperature FT (HT-FT) process products are spread over gas, oil and water phases. The characterization of these phases is very challenging even when using comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry (GC×GC-TOFMS).