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The effect of automated audit and feedback on data completeness in the electronic health record of the general physician: protocol for a cluster randomized controlled trial.

Trials 2021 May 4;22(1):325. Epub 2021 May 4.

Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33 blok J, 3000, Leuven, Belgium.

Background: The electronic health record (EHR) of the general physician (GP) is an important tool that can be used to assess and improve the quality of healthcare. However, there are some problems when (re) using the data gathered in the EHR for quality assessments. One problem is the lack of data completeness in the EHR. Read More

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Magnetic Fluid Hyperthermia as Treatment Option for Pancreatic Cancer Cells and Pancreatic Cancer Organoids.

Int J Nanomedicine 2021 23;16:2965-2981. Epub 2021 Apr 23.

Department of General, Visceral and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany.

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is a cancer with a meager prognosis due to its chemotherapy resistance. A new treatment method may be magnetic fluid hyperthermia (MFH). Magnetoliposomes (ML), consisting of superparamagnetic iron oxide nanoparticles (SPION) stabilized with a phospholipid-bilayer, are exposed to an alternating magnetic field (AMF) to generate heat. Read More

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Synthetic single cell RNA sequencing data from small pilot studies using deep generative models.

Sci Rep 2021 Apr 30;11(1):9403. Epub 2021 Apr 30.

Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, 79104, Freiburg, Germany.

Deep generative models, such as variational autoencoders (VAEs) or deep Boltzmann machines (DBMs), can generate an arbitrary number of synthetic observations after being trained on an initial set of samples. This has mainly been investigated for imaging data but could also be useful for single-cell transcriptomics (scRNA-seq). A small pilot study could be used for planning a full-scale experiment by investigating planned analysis strategies on synthetic data with different sample sizes. Read More

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Biomarkers of Radiotherapy-Induced Immunogenic Cell Death.

Cells 2021 Apr 17;10(4). Epub 2021 Apr 17.

Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. 616, 6200 MD Maastricht, The Netherlands.

Radiation therapy (RT) can induce an immunogenic variant of regulated cell death that can initiate clinically relevant tumor-targeting immune responses. Immunogenic cell death (ICD) is accompanied by the exposure and release of damage-associated molecular patterns (DAMPs), chemokine release, and stimulation of type I interferon (IFN-I) responses. In recent years, intensive research has unraveled major mechanistic aspects of RT-induced ICD and has resulted in the identification of immunogenic factors that are released by irradiated tumor cells. Read More

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Loss of enteric neuronal Ndrg4 promotes colorectal cancer via increased release of Nid1 and Fbln2.

EMBO Rep 2021 Apr 23:e51913. Epub 2021 Apr 23.

Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.

The N-Myc Downstream-Regulated Gene 4 (NDRG4), a prominent biomarker for colorectal cancer (CRC), is specifically expressed by enteric neurons. Considering that nerves are important members of the tumor microenvironment, we here establish different Ndrg4 knockout (Ndrg4 ) CRC models and an indirect co-culture of primary enteric nervous system (ENS) cells and intestinal organoids to identify whether the ENS, via NDRG4, affects intestinal tumorigenesis. Linking immunostainings and gastrointestinal motility (GI) assays, we show that the absence of Ndrg4 does not trigger any functional or morphological GI abnormalities. Read More

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Outcomes in Octogenarians and the Effect of Comorbidities After Intact Abdominal Aortic Aneurysm Repair in the Netherlands: A Nationwide Cohort Study.

Eur J Vasc Endovasc Surg 2021 Apr 16. Epub 2021 Apr 16.

Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands.

Objective: Age is an independent risk factor for mortality after both elective open surgical repair (OSR) and endovascular aneurysm repair (EVAR). As a result of an ageing population, and the less invasive nature of EVAR, the number of patients over 80 years (octogenarians) being treated is increasing. The mortality and morbidity following aneurysm surgery are increased for octogenarians. Read More

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Deep Mixture Generative Autoencoders.

IEEE Trans Neural Netw Learn Syst 2021 Apr 19;PP. Epub 2021 Apr 19.

Variational autoencoders (VAEs) are one of the most popular unsupervised generative models that rely on learning latent representations of data. In this article, we extend the classical concept of Gaussian mixtures into the deep variational framework by proposing a mixture of VAEs (MVAE). Each component in the MVAE model is implemented by a variational encoder and has an associated subdecoder. Read More

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Identification of DNA methylation markers for early detection of CRC indicates a role for nervous system-related genes in CRC.

Clin Epigenetics 2021 Apr 15;13(1):80. Epub 2021 Apr 15.

Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.

Purpose: Colonoscopy and the fecal immunochemical test (FIT) are currently the most widely used screening modalities for colorectal cancer (CRC), however, both with their own limitations. Here we aim to identify and validate stool-based DNA methylation markers for the early detection of CRC and investigate the biological pathways prone to DNA methylation.

Methods: DNA methylation marker discovery was performed using The Cancer Genome Atlas (TCGA) colon adenocarcinoma data set consisting of normal and primary colon adenocarcinoma tissue. Read More

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A Heart Rate Monitoring App (FibriCheck) for Atrial Fibrillation in General Practice: Pilot Usability Study.

JMIR Form Res 2021 Apr 7;5(4):e24461. Epub 2021 Apr 7.

Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.

Background: Atrial fibrillation (AF) is a major risk factor for stroke. The current opportunistic screening procedure consists of pulse palpation and an electrocardiogram when an irregular rhythm is found. Smartphone apps that measure heart rhythm could be useful in increasing the detection of AF in a primary care setting. Read More

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Fast and optimal algorithm for case-control matching using registry data: application on the antibiotics use of colorectal cancer patients.

BMC Med Res Methodol 2021 Apr 2;21(1):62. Epub 2021 Apr 2.

Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, J building, 3000, Leuven, Belgium.

Background: In case-control studies most algorithms allow the controls to be sampled several times, which is not always optimal. If many controls are available and adjustment for several covariates is necessary, matching without replacement might increase statistical efficiency. Comparing similar units when having observational data is of utter importance, since confounding and selection bias is present. Read More

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Learning Subject-Generalized Topographical EEG Embeddings Using Deep Variational Autoencoders and Domain-Adversarial Regularization.

Sensors (Basel) 2021 Mar 4;21(5). Epub 2021 Mar 4.

Institute of Scientific and Industrial Research, Osaka University, Ibaraki, Osaka 567-0047, Japan.

Two of the biggest challenges in building models for detecting emotions from electroencephalography (EEG) devices are the relatively small amount of labeled samples and the strong variability of signal feature distributions between different subjects. In this study, we propose a context-generalized model that tackles the data constraints and subject variability simultaneously using a deep neural network architecture optimized for normally distributed subject-independent feature embeddings. Variational autoencoders (VAEs) at the input level allow the lower feature layers of the model to be trained on both labeled and unlabeled samples, maximizing the use of the limited data resources. Read More

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Cellular immune phenotypes and worsening scores of frailty-associated parameters over an 18-month period in the very old.

J Gerontol A Biol Sci Med Sci 2021 Mar 29. Epub 2021 Mar 29.

Department of Immunology, University of Tübingen, Tübingen, Germany.

Frailty has been related to inflammaging and certain immune parameters. In previous analyses of participants >80 years of age in the longitudinal BELFRAIL cohort study the main focus was on T-cell phenotypes and the association with CMV-serostatus and survival, finding that a CD4:CD8 ratio >5 was associated with frailty, impaired activities of daily living (ADL), and mortality (but only in women). Here, we phenotyped peripheral blood immune cells via multicolor flow cytometry and correlated these with the dynamics of changes in ADL, geriatric depression score, mini-mental state examination, and short physical performance battery from baseline values over 18 months´ follow-up. Read More

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VAEs: Fixing Sample Generation for Regularized VAEs.

Comput Vis ACCV 2020 Nov-Dec;12625:643-660. Epub 2021 Feb 25.

Scientific Computing and Imaging Institute, School of Computing, University of Utah, Salt Lake City, UT, USA.

Unsupervised representation learning via generative modeling is a staple to many computer vision applications in the absence of labeled data. Variational Autoencoders (VAEs) are powerful generative models that learn representations useful for data generation. However, due to inherent challenges in the training objective, VAEs fail to learn useful representations amenable for downstream tasks. Read More

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February 2021

Medication strategies in first episode psychosis patients: A survey among psychiatrists.

Early Interv Psychiatry 2021 Mar 22. Epub 2021 Mar 22.

Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.

Aim: There is an ongoing debate regarding the optimal timing of discontinuation of antipsychotic drugs for patients with first episode psychosis. Although most guidelines recommend maintenance therapy for at least 1 or 2 years after reaching remission, study results indicate that early discontinuation may be beneficial for at least a subsample of patients. To date, little is known about which medication strategies are applied in patients recovering from a first psychotic episode. Read More

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Clinical outcomes and risk factors for mortality from ventilator-associated events: A registry-based cohort study among 30,830 intensive care unit patients.

Infect Control Hosp Epidemiol 2021 Mar 11:1-8. Epub 2021 Mar 11.

Department of Infection Control, West China Hospital of Sichuan University, Chengdu, China.

Objective: To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.

Design: A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.

Setting: The study was conducted using data from 5 adult ICUs of a referral hospital. Read More

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Short-Acting Sedative-Analgesic Drugs Protect Against Development of Ventilator-Associated Events in Children: Secondary Analysis of the EUVAE Study.

Respir Care 2021 May 9;66(5):798-805. Epub 2021 Mar 9.

CRIPS, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.

Background: The U.S. Centers for Disease Control and Prevention proposed a shift in its surveillance paradigm from ventilator-associated pneumonia to ventilator-associated events (VAE) to broaden the focus of prevention and achieve a greater impact on outcomes. Read More

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Estimating Baseline Incidence of Conditions Potentially Associated with Vaccine Adverse Events: a Call for Surveillance System Using the Korean National Health Insurance Claims Data.

J Korean Med Sci 2021 Mar 8;36(9):e67. Epub 2021 Mar 8.

Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Background: Vaccines against coronavirus disease 2019 (COVID-19) are raising concerns about vaccine safety, particularly in the context of large-scale immunization. To address public concerns, we measured the baseline incidence rates of major conditions potentially related to vaccine-related adverse events (VAEs). We aimed to provide a basis for evaluating VAEs and verifying causality. Read More

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Quantification of Retinal Vessel Myogenic Constriction in Response to Blood Pressure Peaks: Implications for Flicker Light-Induced Dilatation.

Front Physiol 2021 18;12:608985. Epub 2021 Feb 18.

Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.

Background/aims: Flicker-light induced retinal vessel dilatation (FID), a marker of microvascular endothelial function, has been shown to be blunted in sedentary cardiovascular risk patients (SR) as well as healthy physically active individuals (HA). This study aimed to quantify the retinal myogenic response to blood pressure (BP) peaks and its effects on consecutive FID for differentiation of microvascular health.

Methods: Ten HA and eleven SR with a previously established restriction of arteriolar FID (aFID) (<2. Read More

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February 2021

Treatment of murine partial thickness scald injuries with multipotent adult progenitor cells decreases inflammation and promotes angiogenesis leading to improved burn injury repair.

Wound Repair Regen 2021 Mar 2. Epub 2021 Mar 2.

Future Industries Institute, University of South Australia, Adelaide, South Australia, Australia.

Stem cells have been shown to have potential as a new therapy for burns and promote wound healing through decreasing inflammation and increasing angiogenesis. Multipotent adult progenitor cells (MAPC® cells) are a subpopulation of bone marrow-derived stem cells with outstanding self-renewal and differentiation capacity. MAPC cells also secrete a wide range of cytokines which can affect cellular activities. Read More

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Cardiologists' perceptions on multidisciplinary collaboration in heart failure care - a qualitative study.

BMC Health Serv Res 2021 Feb 23;21(1):170. Epub 2021 Feb 23.

Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, Blok J, Bus 7001, 3000, Leuven, Belgium.

Background: Cardiologists play a key role in multidisciplinary care by guiding heart failure (HF) management in the hospital and in the community. Regional implementation of multidisciplinary health care interventions depends on how they perceive collaboration with other health care disciplines, yet research on this topic is limited. This study aimed to explore the views and opinions of cardiologists on multidisciplinary collaboration in HF care. Read More

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February 2021

The impact of trophic and immunomodulatory factors on oligodendrocyte maturation: Potential treatments for encephalopathy of prematurity.

Glia 2021 Jun 30;69(6):1311-1340. Epub 2020 Nov 30.

Department for Developmental Origins of Disease, University Medical Center Utrecht Brain Center and Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.

Encephalopathy of prematurity (EoP) is a major cause of morbidity in preterm neonates, causing neurodevelopmental adversities that can lead to lifelong impairments. Preterm birth-related insults, such as cerebral oxygen fluctuations and perinatal inflammation, are believed to negatively impact brain development, leading to a range of brain abnormalities. Diffuse white matter injury is a major hallmark of EoP and characterized by widespread hypomyelination, the result of disturbances in oligodendrocyte lineage development. Read More

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Visualizing population structure with variational autoencoders.

G3 (Bethesda) 2021 Jan;11(1)

Department of Biology, University of Oregon Institute of Ecology and Evolution, Eugene, Oregon, 97403.

Dimensionality reduction is a common tool for visualization and inference of population structure from genotypes, but popular methods either return too many dimensions for easy plotting (PCA) or fail to preserve global geometry (t-SNE and UMAP). Here we explore the utility of variational autoencoders (VAEs)-generative machine learning models in which a pair of neural networks seek to first compress and then recreate the input data-for visualizing population genetic variation. VAEs incorporate nonlinear relationships, allow users to define the dimensionality of the latent space, and in our tests preserve global geometry better than t-SNE and UMAP. Read More

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January 2021

Construct validity of the Post-COVID-19 Functional Status Scale in adult subjects with COVID-19.

Health Qual Life Outcomes 2021 Feb 3;19(1):40. Epub 2021 Feb 3.

Department of Research and Development, CIRO+, PO Box 4080, 6080 AB, Horn, Haelen, The Netherlands.

Background: An increasing number of subjects are recovering from COVID-19, raising the need for tools to adequately assess the course of the disease and its impact on functional status. We aimed to assess the construct validity of the Post-COVID-19 Functional Status (PCFS) Scale among adult subjects with confirmed and presumed COVID-19.

Methods: Adult subjects with confirmed and presumed COVID-19, who were members of an online panel and two Facebook groups for subjects with COVID-19 with persistent symptoms, completed an online survey after the onset of infection-related symptoms. Read More

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February 2021

The epidemiology and clinical outcomes of ventilator-associated events among 20,769 mechanically ventilated patients at intensive care units: an observational study.

Crit Care 2021 02 2;25(1):44. Epub 2021 Feb 2.

Chinese Evidence-Based Medicine Center and CREAT Group, West China Hospital of Sichuan University, Chengdu, 610041, China.

Background: Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection (HAI) in intensive care units (ICUs). Ventilator-associated event (VAE), a more objective definition, has replaced traditional VAP surveillance and is now widely used in the USA. However, the adoption outside the USA is limited. Read More

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February 2021

COPD and pulmonary rehabilitation: new findings from Brazil.

J Bras Pneumol 2021 01 8;46(6):e20200596. Epub 2021 Jan 8.

. Department of Research and Development, Ciro, Horn, the Netherlands.

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January 2021

The Emerging Role of Nerves and Glia in Colorectal Cancer.

Cancers (Basel) 2021 Jan 5;13(1). Epub 2021 Jan 5.

Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands.

The role of the nervous system as a contributor in the tumor microenvironment has been recognized in different cancer types, including colorectal cancer (CRC). The gastrointestinal tract is a highly innervated organ system, which is not only innervated by the autonomic nervous system, but also contains an extensive nervous system of its own; the enteric nervous system (ENS). The ENS is important for gut function and homeostasis by regulating processes such as fluid absorption, blood flow, and gut motility. Read More

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January 2021

Molecular methods in diagnostics of post-BCG vaccine adverse events.

Cent Eur J Immunol 2020 27;45(2):130-135. Epub 2020 Jul 27.

Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland.

Introduction: Bacillus Calmette-Guérin (BCG) is the only tuberculosis vaccine available and although it has been routinely used for more than 80 years, its protective effect varies depending on the age and the form of tuberculosis. Due to the close analogy between the vaccine strain and other species of the Mycobacterium tuberculosis complex, molecular methods are recommended for differential diagnosis of post-BCG complications. The aim of the study was to assess usefulness of molecular methods in diagnosis of post-BCG vaccine adverse events (VAEs). Read More

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Subglottic suction frequency and adverse ventilator-associated events during critical illness.

Infect Control Hosp Epidemiol 2021 Jan 11:1-7. Epub 2021 Jan 11.

Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Objective: Tracheal intubation and mechanical ventilation provide essential support for patients with respiratory failure, but the course of mechanical ventilation may be complicated by adverse ventilator-associated events (VAEs), which may or may not be associated with infection. We sought to understand how the frequency of subglottic suction, an indicator of the quantity of sputum produced by ventilated patients, relates to the onset of all VAEs and infection-associated VAEs.

Design: We performed a case-crossover study including 87 patients with VAEs, and we evaluated 848 days in the pre-VAE period at risk for a VAE. Read More

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January 2021

Impact of primary care involvement and setting on multidisciplinary heart failure management: a systematic review and meta-analysis.

ESC Heart Fail 2021 Apr 6;8(2):802-818. Epub 2021 Jan 6.

Department of Public Health and Primary Care, KU Leuven (KUL), Kapucijnenvoer 33, Blok J Bus 7001, Leuven, 3000, Belgium.

Multidisciplinary disease management programmes (DMPs) are a cornerstone of modern guideline-recommended care for heart failure (HF). Few programmes are community initiated or involve primary care professionals, despite the importance of home-based care for HF. We compared the outcomes of different multidisciplinary HF DMPs in relation to their recruitment setting and involvement of primary care health professionals. Read More

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