Deep brain stimulation (DBS) of the nucleus accumbens (NAc) has proven to be an effective treatment for therapy refractory obsessive-compulsive disorder. Clinical observations show that anxiety ...symptoms decrease rapidly following DBS. As in clinical studies different regions are targeted, it is of principal interest to understand which brain area is responsible for the anxiolytic effect and whether high-frequency stimulation of different areas differentially affect unconditioned (innate) and conditioned (learned) anxiety. In this study, we examined the effect of stimulation in five brain areas in rats (NAc core and shell, bed nucleus of the stria terminalis (BNST), internal capsule (IC) and the ventral medial caudate nucleus (CAU)). The elevated plus maze was used to test the effect of stimulation on unconditioned anxiety, the Vogel conflict test for conditioned anxiety, and an activity test for general locomotor behaviour. We found different anxiolytic effects of stimulation in the five target areas. Stimulation of the CAU decreased both conditioned and unconditioned anxiety, while stimulation of the IC uniquely reduced conditioned anxiety. Remarkably, neither the accumbens nor the BNST stimulation affected conditioned or unconditioned anxiety. Locomotor activity increased with NAc core stimulation but decreased with the BNST. These findings suggest that (1) DBS may have a differential effect on unconditioned and conditioned anxiety depending on the stimulation area, and that (2) stimulation of the IC exclusively reduces conditioned anxiety. This suggests that the anxiolytic effects of DBS seen in OCD patients may not be induced by stimulation of the NAc, but rather by the IC.
IntroductionDistal radius fractures are among the most prevalent traumatic injuries worldwide. These injuries are associated with high healthcare-related and socioeconomic costs, mainly resulting ...from loss of productivity. To optimise recovery and return to work, wrist exercises are recommended. However, adherence to standard exercise regimens is low. Serious games provide a treatment platform for standardised postoperative care, uniting meaningful recovery with entertainment. Also, mobile serious games, for example, smartphone or tablet applications, are able to send practice reminders believed to improve self-efficacy.Methods and analysisTo test the effectiveness of a mobile serious game for distal radius fracture rehabilitation compared with standard care, a multicentre, randomised controlled clinical trial was designed. Primary outcome will be the Patient-Rated Wrist Evaluation (PRWE) score after 6 weeks of treatment. Secondary outcomes are range of motion, grip strength, pain scores, and self-reported treatment adherence after 2, 6 and 12 weeks of treatment.Adult patients with any type of closed distal radius fracture are included directly after non-operative or operative fracture treatment. Patients are recruited in the outpatient clinics of four teaching hospitals. The intended sample size is 92 patients, based on the minimal clinically important difference of the PRWE score at 6 weeks, using a superiority model.Patients are randomised between using the wearable-controlled mobile serious game ReValidate! (intervention group) and standard care consisting of unsupervised exercises and a referral for physiotherapy or exercise therapy upon request or recommendation by the treating clinician (control group).Ethics and disseminationThe protocol has been approved by the Medical Ethical Review Board of the Amsterdam University Medical Centres, location Academic Medical Centre in Amsterdam, the Netherlands. Results will be made available to involved healthcare providers, funders, and to the general public including patients via peer-reviewed academic journals and international conferences.Trial registration numberDutch Trial Registry (NTR), NL6140, protocol V.2.
Highlights • Hands are a prominent vector for the transfer of one’s own self DNA and other non-self DNA. • DNA transferred indirectly via handshake was observed on surfaces contacted after 15 min. • ...Delays in deposition decreased the detectability of the transferred contribution. • Shedding ability and activities performed affected the persistence of non-self DNA
ABSTRACT
The objective of this thought leadership article is to create a systems view of drug shortages based on the perceptions of practitioners and policymakers. We develop a comprehensive ...framework describing what stakeholders are currently doing when faced with drug shortages and show the outcomes of their actions. In a review of practitioner literature and public reports published from 2010 to 2020, we identify cause‐and‐effect relationships related to generic drug shortages in six high‐income European countries (Belgium, France, the Netherlands, Norway, Sweden, and the UK) in normal times. By combining and connecting data from these different sources, we develop a systems view of the current state. Though several of the associations covered in the systems view are well known, putting them all together and considering their interrelationships is what is offered by this research. Based on this systems view, we derive three basic solution archetypes for drug shortages: (1) let the market handle it; (2) search for alternatives; and (3) bend the rules. The interactions between these archetypes generate causal ambiguity making it harder to understand and solve the problem as the side effects of solutions can be missed. We show how the interaction of archetypes can compromise intended behavior or escalate unintended behavior. However, our systems view allows us to suggest higher‐level solution archetypes that overrule such side effects. The basic and higher‐order solution archetypes can provide baselines for research and support the development of future interventions.
We conducted a longitudinal process study of one firm's failed attempt to develop a new product. Our extensive data analysis suggests that teams in complex dynamic environments characterized by ...delays are subject to multiple "information filters" that blur their perception of actual project performance. Consequently, teams do not realize their projects are in trouble and repeatedly fall into a "decision trap" in which they stretch current project stages at the expense of future stages. This slowly and gradually reduces the likelihood of project success. However, because of the information filters, teams fail to notice what is happening until it is too late.
Testing for COVID‐19 is a key intervention that supports tracking and isolation to prevent further infections. However, diagnostic tests are a scarce and finite resource, so abundance in one country ...can quickly lead to shortages in others, creating a competitive landscape. Countries experience peaks in infections at different times, meaning that the need for diagnostic tests also peaks at different moments. This phase lag implies opportunities for a more collaborative approach, although countries might also worry about the risks of future shortages if they help others by reallocating their excess inventory of diagnostic tests. This article features a simulation model that connects three subsystems: COVID‐19 transmission, the diagnostic test supply chain, and public policy interventions aimed at flattening the infection curve. This integrated system approach clarifies that, for public policies, there is a time to be risk‐averse and a time for risk‐taking, reflecting the different phases of the pandemic (contagion vs. recovery) and the dominant dynamic behavior that occurs in these phases (reinforcing vs. balancing). In the contagion phase, policymakers cannot afford to reject extra diagnostic tests and should take what they can get, in line with a competitive mindset. In the recovery phase, policymakers can afford to give away excess inventory to other countries in need (one‐sided collaboration). When a country switches between taking and giving, in a form of two‐sided collaboration, it can flatten the curve, not only for itself but also for others.
Conquering cocoa VAN OORSCHOT, N
Dairy Industries International,
06/2000, Letnik:
65, Številka:
6
Magazine Article, Trade Publication Article
Cocoa powder enhances ice cream products in many different ways, but the production of chocolate ice cream is not as simple as it looks. Oorschot discusses the advantages of using cocoa among ice ...cream manufacturers to meet the consumers' preferences and expectations.
DNA decontamination of fingerprint brushes Szkuta, Bianca; Oorschot, Roland A.H. van; Ballantyne, Kaye N
Forensic science international,
08/2017, Letnik:
277
Journal Article
Recenzirano
Highlights • Fingerprint brushes are vectors for the transfer of DNA between surfaces. • The biological nature of the material being transferred influenced detectability. • DNA was detected on the ...bristles of new unused squirrel hair brushes. • Squirrel hair brushes were effectively cleaned with solutions of hypochlorite and Virkon. • Fiberglass bristles became matted when wet and could not be cleaned effectively
Australia was one of the earliest regions outside Africa to be colonized by fully modern humans, with archaeological evidence for human presence by 47,000 years ago (47 kya) widely accepted 1, 2. ...However, the extent of subsequent human entry before the European colonial age is less clear. The dingo reached Australia about 4 kya, indirectly implying human contact, which some have linked to changes in language and stone tool technology to suggest substantial cultural changes at the same time 3. Genetic data of two kinds have been proposed to support gene flow from the Indian subcontinent to Australia at this time, as well: first, signs of South Asian admixture in Aboriginal Australian genomes have been reported on the basis of genome-wide SNP data 4; and second, a Y chromosome lineage designated haplogroup C∗, present in both India and Australia, was estimated to have a most recent common ancestor around 5 kya and to have entered Australia from India 5. Here, we sequence 13 Aboriginal Australian Y chromosomes to re-investigate their divergence times from Y chromosomes in other continents, including a comparison of Aboriginal Australian and South Asian haplogroup C chromosomes. We find divergence times dating back to ∼50 kya, thus excluding the Y chromosome as providing evidence for recent gene flow from India into Australia.
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•We have sequenced 13 Aboriginal Australian Y chromosomes•These diverged from Y chromosomes in other continents around 50,000 years ago•They diverged from Papua New Guinean Y chromosomes soon after this•We find no evidence for Holocene male gene flow to Australia from South Asia
Bergström et al. show that Aboriginal Australian Y chromosomes diverged from Eurasian, including South Asian, Y chromosomes ∼50,000 years ago. This is around the time that Australia was first populated and thus disproves the previous hypothesis of prehistoric Y chromosome gene flow from India ∼5,000 years ago.
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