In situ adsorption of itaconic acid from fermentations of Ustilago cynodontis improves bioprocess efficiency.

Background: Reducing the costs of biorefinery processes is a crucial step in replacing petrochemical products by sustainable, biotechnological alternatives. Substrate costs and downstream processing present large potential for improvement of cost efficiency. The implementation of in situ adsorption as an energy-efficient product recovery method can reduce costs in both areas.

Holistic Approach to Process Design and Scale-Up for Itaconic Acid Production from Crude Substrates.

Bio-based bulk chemicals such as carboxylic acids continue to struggle to compete with their fossil counterparts on an economic basis. One possibility to improve the economic feasibility is the use of crude substrates in biorefineries. However, impurities in these substrates pose challenges in fermentation and purification, requiring interdisciplinary research.

Perceptions and Experiences of Nutrition Interventions in Individuals with Amyotrophic Lateral Sclerosis (ALS) and their Caregivers.

Nutrition concerns are prevalent in individuals with Amyotrophic Lateral Sclerosis (ALS). Despite the prevalence of nutrition concerns, few data are available on perceptions and experiences of nutrition interventions in individuals with ALS and their caregivers; this study aimed to collect this information. An online survey was developed and hosted on Survey Monkey.

What are essential elements of high-quality palliative care at home? An interview study among patients and relatives faced with advanced cancer.

Background: In the Netherlands, general practitioners (GPs) and community nurses play a central role in the palliative care for home-dwelling patients with advanced cancer and their relatives. To optimize the palliative care provision at home, it is important to have insight in the elements that patients and relatives consider essential for high-quality palliative care, and whether these essentials are present in the actual care they receive.

Methods: Qualitative semi-structured interviews were conducted with 13 patients with advanced cancer and 14 relatives.

Evidence on the effectiveness of health literacy interventions in the EU: a systematic review.

Background: In the last decade, the attention for health literacy has increased in the European Union. This is due to three main reasons. First, reviews have shown that inadequate health literacy is associated with worse health outcomes, higher health care use and expenditure.

Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

Background: In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects.

Percutaneous endoscopic gastrostomy under conscious sedation in patients with amyotrophic lateral sclerosis is safe: an observational study.

Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam).

Relatives' perceived quality of palliative care: comparisons between care settings in which patients die.

Background: Dying in the preferred setting is an indicator of good palliative care quality. Most people prefer to die at home. But does the quality of care as perceived by their relatives vary depending on the care setting that is the place of death? The aim is to compare (from the relatives perspective) whether there are perceived differences in the quality of palliative care between the settings in which people die.

Which patients die in their preferred place? A secondary analysis of questionnaire data from bereaved relatives.

Background: Previous studies on factors influencing the place of death have focused on cancer patients dying at home. However, home is not always the preferred place.

Aim: To provide insight into the extent to which patients with various diseases die in their preferred place and into factors associated with dying in the preferred place.

Differences in palliative care quality between patients with cancer, patients with organ failure and frail patients: A study based on measurements with the Consumer Quality Index Palliative Care for bereaved relatives.

Background: Palliative care is rooted in the care for incurably ill cancer patients. Yet today there is a recognised need for palliative care for patients with non-cancer conditions. However, the often unpredictable illness trajectories and the difficulty in predicting the imminence of death in people with non-cancer conditions may hamper the provision of high-quality palliative care.

Knowledge, use and attitude toward eHealth among patients with chronic lung diseases.

Background: Despite high expectations and numerous initiatives in the area of eHealth, implementation and use of eHealth applications on a national level is no common practice yet. There is no full understanding of patients' attitude on eHealth yet. Aim of this study is to gain insight into the level of knowledge and experiences with eHealth of people with chronic lung diseases.

Acute phase complications following traumatic spinal cord injury in Dutch level 1 trauma centres.

Objective: To assess the number and nature of complications during the acute phase following traumatic spinal cord injury and to explore the relationship between number of complications and length of hospital stay.

Design: Multi-centre prospective cohort study.

Patients: A total of 54 patients with traumatic spinal cord injury, referred to 3 level 1 trauma centres in The Netherlands.

The effect and process evaluations of the national quality improvement programme for palliative care: the study protocol.

Background: The nationwide integration of palliative care best practices into general care settings is challenging but important in improving the quality of palliative care. This is why the Dutch National Quality Improvement Programme for Palliative Care has recently been launched. This four-year programme consists of about 70 implementation trajectories of best practices.

Rat pancreatic beta cells and cytomegalovirus infection.

Objectives: Cytomegalovirus (CMV) infection has been suggested to accelerate beta-cell destruction and thereby to contribute to new-onset diabetes and failure of islet allografts in both humans and rodents. Surprisingly, direct CMV infection of beta cells has received only minor attention. Therefore, we investigated the susceptibility of rat beta cells for rat CMV (RCMV) infection and the direct effects on the regulation of immune cell-activating ligands.

On the assessment of adverse drug reactions from spontaneous reporting systems: the influence of under-reporting on odds ratios.

A well-known problem in spontaneous reporting systems (SRSs) for adverse drug reactions (ADRs) is under-reporting, that is, the problem that not all occurrences of ADRs are reported to the SRS. We look at the question of how to draw statistical conclusions from analyses of SRS data using reporting odds ratios. We will show that certain under-reporting problems play no role in assessing ADRs from SRSs: the results from the analyses turn out to be biased by some specific under-reporting problems, but not by others.

Evaluation plan for a cardiological multi-media workstation (I4C project).

The goal of the I4C project (Integration and Communication for the Continuity of Cardiac Care) is to build a multi-media workstation for cardiac care and to assess its impact in the clinical setting. This paper describes the technical evaluation plan for the prototype.

Relationship between impaired parasympathetic and sympathetic cardiovascular control in diabetes mellitus.

We have investigated the relationship between vagal and sympathetic lesions in 62 diabetic patients and compared the results with those from 37 healthy subjects. Vagal function was assessed by heart rate changes with forced breathing. Sympathetic control was measured by the heart rate and blood pressure changes after standing and the concomitant plasma catecholamine response.