Biological effects of combinations of structurally diverse human milk oligosaccharides.

Human milk oligosaccharides (HMOs) are a diverse group of structures and an abundant bioactive component of breastmilk that contribute to infant health and development. Preclinical studies indicate roles for HMOs in shaping the infant gut microbiota, inhibiting pathogens, modulating the immune system, and influencing cognitive development. In the past decade, several industrially produced HMOs have become available to fortify infant formula.

Stability of the Glycated Amino Acid 6-(2-Formyl-5-hydroxymethyl-1-pyrrolyl)-l-norleucine (Pyrraline) During Oxidation.

Food proteins may be modified during processing and storage through reactions with reducing sugars (Maillard reaction, glycation) or by reactive oxygen species (protein oxidation). Little is known about particular reactions at the interface of glycation and oxidation. In the present study, the glycated amino acid pyrraline (6-(2-formyl-5-hydroxymethyl-1-pyrrolyl)-l-norleucine) and the proteinogenic amino acids tyrosine and tryptophan were subjected to different types of oxidation.

An Alternative Treatment Option for Blauth III B Thumb Hypoplasia-Thumb Stabilization with Iliac Crest Bone Graft and Intermetacarpal Arthrodesis.

Thumb hypoplasia modified Blauth III B is usually treated by pollicization or, less commonly, by toe transfer. Both procedures always result in the resection of a body part, but with good cosmesis and acceptable function. We describe an intermetacarpal I/II arthrodesis with autologous bone graft augmentation to lengthen and stabilize the loose thumb.

MetaTransformer: deep metagenomic sequencing read classification using self-attention models.

Deep learning has emerged as a paradigm that revolutionizes numerous domains of scientific research. Transformers have been utilized in language modeling outperforming previous approaches. Therefore, the utilization of deep learning as a tool for analyzing the genomic sequences is promising, yielding convincing results in fields such as motif identification and variant calling.

Effectiveness of Meaning-Centered Coaching on the Job of Oncology Nurses on Spiritual Care Competences: A Participatory Action Research Approach.

Background: Nurses' competences in providing spiritual care can increase quality of care for and quality of life of patients with cancer and job satisfaction but are often suboptimal. Training to improve this mostly takes place off-site, although implementation in daily care practice is key.

Objectives: The aims of this study were to implement a meaning-centered coaching on the job intervention and to measure its effects on oncology nurses' spiritual care competences and job satisfaction, and factors influencing this.

RabbitQCPlus 2.0: More efficient and versatile quality control for sequencing data.

Assessing the quality of sequencing data plays a crucial role in downstream data analysis. However, existing tools often achieve sub-optimal efficiency, especially when dealing with compressed files or performing complicated quality control operations such as over-representation analysis and error correction. We present RabbitQCPlus, an ultra-efficient quality control tool for modern multi-core systems.

Role-Perceptions of Dutch Spiritual Caregivers in Implementing Multidisciplinary Spiritual Care: A National Survey.

Background: During the course of their disease, patients are, apart from suffering physical discomfort, also confronted with psychological, social, and spiritual challenges. However, healthcare professionals often lack the knowledge and skills to address the spiritual dimension and are in need of support for taking this responsibility. Spiritual caregivers are experts in spiritual care, but their contribution to the integration of this care by other healthcare professionals is largely unknown.

An AI-Powered Clinical Decision Support System to Predict Flares in Rheumatoid Arthritis: A Pilot Study.

Treat-to-target (T2T) is a main therapeutic strategy in rheumatology; however, patients and rheumatologists currently have little support in making the best treatment decision. Clinical decision support systems (CDSSs) could offer this support. The aim of this study was to investigate the accuracy, effectiveness, usability, and acceptance of such a CDSS-Rheuma Care Manager (RCM)-including an artificial intelligence (AI)-powered flare risk prediction tool to support the management of rheumatoid arthritis (RA).

Measuring relatives' perceptions of end-of-life communication with physicians in five countries: a psychometric analysis.

Unlabelled: (FPPFC) was developed to assess quality of physician-family end-of-life communication in nursing homes. However, its validity has been tested only in the USA and the Netherlands. The aim of this paper is to evaluate the FPPFC construct validity and its reliability, as well as the psychometric characteristics of the items comprising the scale.

Identifying, exploring and integrating the spiritual dimension in proactive care planning: A mixed methods evaluation of a communication training intervention for multidisciplinary palliative care teams.

Background: Patients receiving palliative care value attention given to their spiritual needs. However, these needs often remain unexplored as healthcare professionals lack the skills to identify and explore them and to integrate this information into care plans.

Aim: To evaluate the effects of an interactive communication training intervention for palliative care teams in order to identify and explore the spiritual dimension and integrate it in patients' care plans.

The GP's perceived role and use of language concerning the existential dimension of palliative patients: a Dutch interview study.

Background: Palliative patients have to cope with their disease and impending death. Knowing what this means for a patient is crucial for person-centred care. Although guidelines state it is a GP core task to explore existential issues of palliative patients, this is not standard practice.

Titanium wear from magnetically controlled growing rods (MCGRs) for the treatment of spinal deformities in children.

Magnetically controlled growing rods (MCGRs) are an effective treatment method for early-onset scoliosis (EOS). In recent years, increasing titanium wear was observed in tissue adjacent to implants and in blood samples of these patients. This study aims to investigate the potential correlation between amount of metal loss and titanium levels in blood during MCGR treatment as well as influencing factors for metal wear.

Comparison of the photocatalytic activity of novel hybrid photocatalysts based on phthalocyanines, subphthalocyanines and porphyrins immobilized onto nanoporous gold.

A series of different singlet oxygen photosensitizers was immobilized onto nanoporous gold powder with a mean pore size of 40 nm copper catalyzed azide-alkyne cycloaddition. The attachment of phthalocyanine and porphyrin derivatives was performed on the peripheral substituent of the macrocycle, whereas the subphthalocyanine derivatives were attached the axial substituent with respect to the macrocyclic ring system. All obtained hybrid systems were studied in the photooxidation of 2,5-diphenylfuran as a chemical singlet oxygen quencher and showed increased photocatalytic activity compared to the same amount of the corresponding photosensitizer in solution due to photoinduced interactions of the plasmon resonance of the nanostructured gold support and the attached photosensitizer.

Oncologist responses to advanced cancer patients' lived illness experiences and effects: an applied conversation analysis study.

Background: An advanced cancer patient's life is often disturbed by fear of cancer recurrence, cancer progress, approaching suffering, and fear of dying. Consequently, the role of the medical oncologist is not only to provide best quality anti-cancer treatment, but also to address the impact of disease and treatment on a patient's life, the lived illness experience. We aimed to gain insights into whether and how medical oncologists working at an outpatient clinic identify and explore lived illness experiences raised by patients with advanced cancer, and how this influences patients' responses.

GG DSM 33156 effects on pathogen defence in the upper respiratory tract: a randomised, double-blind, placebo-controlled paediatric trial.

Acute upper respiratory tract infections (URTIs) are caused by numerous viruses and bacteria. URTIs can be a cause of morbidity and are among the most common reasons for visiting healthcare practitioners and prescribing antibiotics to children in addition to causing absenteeism from school and work. Oral intake of GG DSM 33156 has shown beneficial health effects in several clinical trials, primarily relating to immune function and gastrointestinal health in children and adults.

Making complex decisions in uncertain times: experiences of Dutch GPs as gatekeepers regarding hospital referrals during COVID-19-a qualitative study.

Background: General practitioners often act as gatekeeper, authorizing patients' access to hospital care. This gatekeeping role became even more important during the current COVID-19 crisis as uncertainties regarding COVID-19 made estimating the desirability of hospital referrals (for outpatient or inpatient hospitalization) complex, both for COVID and non-COVID suspected patients. This study explored Dutch general practitioners' experiences and ethical dilemmas faced in decision making about hospital referrals in times of the COVID-19 pandemic.

Genomic Stability and Phenotypic Characteristics of Industrially Produced Lacticaseibacillus rhamnosus GG in a Yogurt Matrix.

Lacticaseibacillus rhamnosus GG is a widely marketed probiotic with well-documented probiotic properties. Previously, deletion of the mucus-adhesive genes in dairy isolates was reported. In this study, we examined the genome preservation of industrially produced L.

The COVID-19 pandemic: A tipping point for advance care planning? Experiences of general practitioners.

Background: In 2020, the COVID-19 pandemic caused an acute risk of deterioration and dying for many, and an urgent need to start advance care planning.

Aim: To explore how general practitioners (GPs) experienced discussing values, goals and preferences with patients during COVID-19.

Design And Setting: Qualitative research in general practice.

Effects of an Integrated Palliative Care Pathway: More Proactive GPs, Well Timed, and Less Acute Care: A Clustered, Partially Controlled Before-After Study.

Objectives: This study presents the design of an integrated, proactive palliative care pathway covering the full care cycle and evaluates its effects using 3 types of outcomes: (1) physician-reported outcomes, (2) outcomes reported by family, and (3) (utilization of) health care outcomes.

Design: A clustered, partially controlled before-after study with a multidisciplinary integrated palliative care pathway as its main intervention.

Setting And Participants: after assessment in hospital departments of oncology, and geriatrics, and in 13 primary care facilities, terminally ill patients were proactively included into the pathway.

Decreased costs and retained QoL due to the 'PACE Steps to Success' intervention in LTCFs: cost-effectiveness analysis of a randomized controlled trial.

Background: The number of residents in long-term care facilities (LTCFs) in need of palliative care is growing in the Western world. Therefore, it is foreseen that significantly higher percentages of budgets will be spent on palliative care. However, cost-effectiveness analyses of palliative care interventions in these settings are lacking.

QALY-time: experts' view on the use of the quality-adjusted LIFE year in COST-effectiveness analysis in palliative care.

Background: The Quality-Adjusted Life Year (QALY) is internationally recognized as standard metric of health outcomes in cost-effectiveness analyses (CEAs) in healthcare. The ongoing debate concerning the appropriateness of its use for decision-making in palliative care has been recently mapped in a review. The aim was to report on and draw conclusions from two expert meetings that reflected on earlier mapped issues in order to reach consensus, and to advise on the QALY's future use in palliative care.

Impact of photosensitizer orientation on the distance dependent photocatalytic activity in zinc phthalocyanine-nanoporous gold hybrid systems.

Nanoporous gold powder was functionalized in a two-step approach by an azide terminated alkanethiol self-assembled monolayer (SAM) and a zinc(ii) phthalocyanine (ZnPc) derivative by copper catalyzed azide-alkyne cycloaddition (CuAAC). A series of different hybrid systems with systematic variation of the alkyl chain length on both positions, the alkanethiol SAM and the peripheral substituents of the ZnPc derivative, was prepared and studied in the photooxidation of diphenylisobenzofuran (DPBF). An enhancement by nearly one order of magnitude was observed for the photosensitized singlet oxygen (O) generation of the hybrid systems compared to the same amount of ZnPc in solution caused by the interaction of the npAu surface plasmon resonance and the excited state of the immobilized sensitizer.

Lactobacillus rhamnosus GG Genomic and Phenotypic Stability in an Industrial Production Process.

GG is one of the most widely marketed and studied probiotic strains. In GG, the gene cluster encodes pili, which are important for some of the probiotic properties of the strain. A previous study showed that the DNA sequence of the gene cluster was not present in some GG variants isolated from liquid dairy products.