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Magnetically actuated glaucoma drainage devicefor regulating intraocular pressure afterimplantation

Microsystems & Nanoengineering 2023年第4期9卷 91-105页

作者： Inês C.F.Pereira Ralph J.S.van Mechelen hans M.Wyss Leonard Pinchuk Henny J.M.Beckers Jaap M.J.den Toonder Microsystems Department of Mechanical EngineeringEindhoven University of Technology5600MB EindhovenThe Netherlands Institute for Complex Molecular Systems(ICMS) Eindhoven University of Technology5600MB EindhovenThe Netherlands University Eye Clinic Maastricht Maastricht University Medical Centre+(MUMC+)6202AZ MaastrichtThe Netherlands InnFocus Inc.a Santen CompanyMiamiFlorida 33186USA Ophthalmic Biophysics Center Bascom Palmer Eye InstituteUniversity of Miami Miller School of MedicineMiamiFlorida 33136USA

The key risk factor for glaucoma is increased intraocular pressure (IOP). Glaucoma drainage devices implanted in theeye can reduce IOP and thus stop disease progression. However, most devices currently used in clinical practice arepassive and do not allow for postsurgical IOP control, which may result in serious complications such as hypotony (i.e.,excessively low IOP). To enable noninvasive IOP control, we demonstrate a novel, miniature glaucoma implant that willenable the repeated adjustment of the hydrodynamic resistance after implantation. This is achieved by integrating amagnetic microvalve containing a micropencil-shaped plug that is moved using an external magnet, thereby openingor closing fluidic channels. The microplug is made from biocompatible poly(styrene-block-isobutylene-block-styrene)(SIBS) containing iron microparticles. The complete implant consists of an SIBS drainage tube and a housing elementcontaining the microvalve and fabricated with hot embossing using femtosecond laser-machined glass molds. Usingin vitro and ex vivo microfluidic experiments, we demonstrate that when the microvalve is closed, it can providesufficient hydrodynamic resistance to overcome hypotony. Valve function is repeatable and stable over time. Due to itssmall size, our implant is a promising, safe, easy-to-implant, minimally invasive glaucoma surgery device.

关键词： enable implantation overcome

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Cross-Validation, Shrinkage and Variable Selection in Linear Regression Revisited

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Open Journal of Statistics 2013年第2期3卷 79-102页

作者： hans C. van Houwelingen Willi Sauerbrei Department of Medical Statistics and Bioinformatics Leiden University Medical Center Leiden The Netherlands Institut fuer Medizinische Biometrie und Medizinische Informatik Universitaetsklinikum Freiburg Freiburg Germany

In deriving a regression model analysts often have to use variable selection, despite of problems introduced by data- dependent model building. Resampling approaches are proposed to handle some of the critical issues. In order to assess and compare several strategies, we will conduct a simulation study with 15 predictors and a complex correlation structure in the linear regression model. Using sample sizes of 100 and 400 and estimates of the residual variance corresponding to R2 of 0.50 and 0.71, we consider 4 scenarios with varying amount of information. We also consider two examples with 24 and 13 predictors, respectively. We will discuss the value of cross-validation, shrinkage and backward elimination (BE) with varying significance level. We will assess whether 2-step approaches using global or parameterwise shrinkage (PWSF) can improve selected models and will compare results to models derived with the LASSO procedure. Beside of MSE we will use model sparsity and further criteria for model assessment. The amount of information in the data has an influence on the selected models and the comparison of the procedures. None of the approaches was best in all scenarios. The performance of backward elimination with a suitably chosen significance level was not worse compared to the LASSO and BE models selected were much sparser, an important advantage for interpretation and transportability. Compared to global shrinkage, PWSF had better performance. Provided that the amount of information is not too small, we conclude that BE followed by PWSF is a suitable approach when variable selection is a key part of data analysis.

关键词： Cross-Validation LASSO Shrinkage Simulation Study Variable Selection

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A Credit System to Solve Agricultural Nitrogen Pollution

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The Innovation 2021年第1期2卷 1-2页

作者： Baojing Gu hans J.M.van Grinsven Shu KeeLam Oene Oenema Mark A.Sutton Arvin Mosier Deli Chen College of Environmental and Resource Sciences Zhejiang UniversityHangzhou 310058PR China Policy Simulation Laboratory Zhejiang University310058 HangzhouChina Netherlands Environmental Assessment Agency(PBL) Postbus 30314The Netherlands School of Agriculture and Food The University of MelbourneMelbourneVIC 3010 Australia Wageningen University&Research P.O.Box 476700 AAWageningenThe Netherlands NERC Centre for Ecology&Hydrology Bush EstatePenicuikEH260QBUK

Increasing amounts of nitrogen fertilizer have been used in agriculture during the last decades to boost food production for the increasing global human *** marked increase in reactive nitrogen use has also contributed to severe nitrogen pollution and multiple impacts on human and ecosystems'health.1 Nitrogen is an important precursor to air pollution(e.g.,fine particulate matter,near-surface ozone),water pollution(algal blooms,nitrate contamination),biodiversity loss(nitrogen deposition and eutrophication),soil acidification(ammonium fertilizer use),and global warming(nitrous oxide).2 Agricultural nitrogen pollution has decreased in some high-income countries,such as those in the European Union(EU),during the last decades,but the remaining nitrogen pollution still causes serious *** societal cost of nitrogen pollution by agriculture in the EU has been estimated to range from V35 to V230 billion per year and this cost appears to be greater than the farm profits from nitrogen fertilizer use,which range from V20 to V80 billion per year.3 Socioeconomic trade-offs between farmers and society need to be introduced to decrease nitrogen pollution.

关键词： pollution cost income

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Penetration of the Stiffener Web to Deck Plate Weld in Orthotropic Plated Bridge Decks

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Journal of Civil Engineering and Architecture 2013年第3期7卷 261-272页

作者： hans De Backer Amelie Outtier Philippe van Bogaert Department of Civil Engineering Ghent University Ghent B-9052 Belgium

This paper reports the results of experimental research the longitudinal stiffeners in an orthotropic plated bridge deck on concerning the connection between the deck plate and the web of a microscopic scale. An important number of test specimens of a weld are studied with the help of a video microscope, to detect the efficiency of the root of the weld. The second part of the paper is concerned with parametric analysis of the lack of weld penetration by using accurate finite element modelling. The results demonstrate that the weld quality often required can not always be assured, which surely has important consequence on the stresses in the weld and the fatigue resistance.

关键词： Weld penetration orthotropic plated bridge deck stiffener web to deck plate weld.

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Systolic and Diastolic Strain Measurements Show Left Ventricular Dysfunction in Women with Turner Syndrome

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Congenital Heart Disease 2021年第4期16卷 357-368页

作者： Allard T.van den Hoven Sultan Yilmazer Lidia R.Bons Roderick W.Jvan Grootel L.W.Geenen An M.van Berendoncks Anthonie L.Duijnhouwer hans-Marc J.Siebelink Jolien W.Roos-Hesselink Annemien E.van den Bosch Department of Congenital Cardiology Erasmus MCRotterdamNetherlands Department of Cardiology Radboud University Medical CenterNijmegenNetherlands Department of Cardiology Leiden University Medical CenterRotterdamNetherlands

Aim:This study aimed to describe the systolic left ventricular global longitudinal strain(LvGLS)and left ventricular peak early diastolic strain rate(Sre)in adult women with Turner syndrome(TS)and to determine its relationship with exercise capacity and clinical ***:In this cross-sectional cohort study,consecutively included adult TS women underwent an electrocardiogram,transthoracic echocardiogram(TTE)and cardiopulmonary exercise test(CPET)on the same *** and Sre were measured using 2D speckle tracking analysis(STE)and compared with age-matched healthy female ***:Ninety-four adult women(age 36±13 years)with TS and 32 healthy age-matched female controls were *** with TS had a significantly impaired/reduced systolic LvGLS(–17.82±2.98%vs.–21.80±1.85%,p0.001),compared to healthy female ***,TS women had reduced diastolic function as measured by conventional echocardiographic parameters:A higher A-wave(p<0.001),lower E/A-ratio(p=0.001),longer deceleration time(p=0.006),and a higher E/E’-ratio(p<0.001).Women with TS also had a significantly reduced maximal workload(p=0.033),reduced oxygen uptake(p<0.001)and a reduced maximal heart rate(p<0.001)during *** linear regression analysis revealed that Age,karyotype and QT-duration were significantly associated with Sre,but not with LvGLS,in the TS ***:Systolic and diastolic strain and exercise capacity were significantly reduced in TS women compared to healthy *** correlation between strain itself and exercise capacity could be demonstrated,but correlations with conventional TTE parameters and baseline characteristics were found.

关键词： Turnersyndrome speckletracking echocardiography strain exercise capacity

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Emerging pollutants in the environment:A challenge for water resource management

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International Soil and Water Conservation Research 2015年第1期3卷 57-65页

作者： Violette Geissen hans Mol Erwin Klumpp Günter Umlauf Marti Nadal Martine van der Ploeg Sjoerd E.A.T.M.van de Zee Coen J.Ritsema Soil Physics and Land Management Group Wageningen University6708PB WageningenThe Netherlands Rikilt WageningenThe Netherlands Agrosphere Forschungszentrum JülichJülichGermany Joint Research Center IspraItaly Laboratory of Toxicology and Environmental Health IISPVUniversitat Rovira i VirgiliReusSpain

A significant number of emerging pollutants(EPs)resulting from point and diffuse pollution is present in the aquatic *** are chemicals that are not commonly monitored but have the potential to enter the environment and cause adverse ecological and human health *** to the NORMAN network,at least 700 substances categorized into 20 classes,have been identified in the European aquatic *** light of their potential impact action is urgently *** this study,we present a concept that shows the current state of art and challenges for monitoring programs,fate and risk assessment tools and requirements for policies with respect to emerging pollutants as a base for sustainable water resource ***,methods for sampling and analysis are not harmonized,being typically focused on certain EP *** a number of known highly hazardous EPs detection limits are too high to allow proper risk *** other EPs such as microplastics method development is in its *** ultra-sensitive instrumental techniques should be used for quantitative determination of prioritized EPs in water,suspended matter,soil and *** on EPs'and their metabolites'properties that determine their fate in the environment are often not *** surveys on water quality often use different parameters for water quality assessment and often do not include EPs.A harmonized monitoring of surface and groundwater is not yet achieved and urgently *** component integrated into models assessing the fate of EPs in a multi compartment environmental approach are missing and must be *** main goal of risk assessment is the overall protection of ecological communities in the aquatic environment and human *** methods for assessing the cumulative risks from combined exposures to several stressors,including mixtures of EPs in a multi-scale approach are required.A combination of regulations and management meas

关键词： Emerging pollutants Water resource management Monitoring Risk assessment Water policies

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Estimated impact of introduction of new diagnostic criteria for gestational diabetes mellitus

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World Journal of Diabetes 2021年第6期12卷 868-882页

作者： Leon de Wit Anna B Zijlmans Doortje Rademaker Christiana A Naaktgeboren J hans DeVries Arie Franx Rebecca C Painter Bas B van Rijn Department of Obstetrics and Gynaecology University Medical Center UtrechtUtrecht 3584 EANetherlands Department of Obstetrics and Gynaecology Gelderse Vallei HospitalEde 6716 RPNetherlands Department of Obstetrics and Gynaecology Amsterdam University Medical Centers-Location AMCAmsterdam 1105 AZNetherlands Department of Obstetrics and Gynaecology Amsterdam University Medical Centers–Location AMCAmsterdam 1105 AZNetherlands Department of Endocrinology Amsterdam University Medical Centers–Location AMCAmsterdam 1105 AZNetherlands Department of Obstetrics and Fetal Medicine Erasmus MC Sophia Children HospitalRotterdam 3015 GDNetherlands

BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly *** To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy *** We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically *** were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both *** compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy *** Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly *** to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean *** infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<*** excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to *** Applying the WHO 2013 criteria would result in a substantial increase in GDM *** diagnosed women are at increased risk for pregnancy adverse *** risk,however,seems to be lower than those identified by the

关键词： Diagnostic criteria Gestational diabetes Glucose tolerance test Incidence Pregnancy outcome

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Current status and perspectives of immune-based therapiesfor hepatocellular carcinoma

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World Journal of Gastroenterology 2016年第1期22卷 253-261页

作者： Maridi Aerts DaphnéBenteyn hans van Vlierberghe Kris Thielemans Hendrik Reynaert Department of Gastroenterology and Hepatology 1090 BrusselsBelgium Vrije Universiteit Brussel(VUB) Department of Immunology1090 BrusselsBelgium UZ Gent Department of Gastroenterology and HepatologyDe Pinte laan9000 GhentBelgium

Hepatocellular carcinoma(HCC)is a frequent cancer with a high *** early stage cancer there are potentially curative treatments including local ablation,resection and liver ***,for more advanced stage disease,there is no optimal treatment *** in the case of a"curative"treatment,recurrence or development of a new cancer in the precancerous liver is ***,there is an urgent need for novel and effective(adjuvant)therapies to treat HCC and to prevent recurrence after local treatment in patients with *** unique immune response in the liver favors tolerance,which remains a genuine challenge for conventional immunotherapy in patients with ***,even in this"immunotolerant"organ,spontaneous immune responses against tumor antigens have been detected,although they are insufficient to achieve significant tumor *** ablation therapy leads to immunogenic tumor cell death by inducing the release of massive amounts of antigens,which enhances spontaneous immune *** immune therapies such as dendritic cell vaccination and immune checkpoint inhibition are under *** for cancer has made huge progress in the last few years and clinical trials examining the use of immunotherapy to treat hepatocellular carcinoma have shown some *** this review,we discuss the current status of and offer some perspectives on immunotherapy for hepatocellular carcinoma,which could change disease progression in the near future.

关键词： Hepatocellular carcinoma Immunotherapy Dendritic cells Dendritic cell vaccination Therapy

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Empowerment according to Persons with Severe Mental Illness: Development of the Netherlands Empowerment List and Its Psychometric Properties

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Open Journal of Psychiatry 2017年第1期7卷 18-30页

作者： Wilma Boevink hans Kroon Philippe Delespaul Jim van Os Trimbos Institute Department of Reintegration Utrecht The Netherlands Department of Psychiatry and Psychology School of Mental Health and Neuroscience EURON Maastricht University Medical Centre Maastricht The Netherlands King’s College London King’s Health Partners Department of Psychosis Studies Institute of Psychiatry London UK

Objectives. It is unclear whether and to what extent purportedly empowering practices in mental health care, like rehabilitation programs, recovery-supporting mental health care environments and peer-run services, contribute to the process of empowerment. Several American empowerment questionnaires have been developed in recent years, facilitating the measurement of empowerment outcomes. Given likely major transatlantic cultural differences in a value-sensitive concept such as empowerment, this article describes the development of the Netherlands Empowerment List (NEL) and its psychometric properties. Methods. Patients in Dutch mental health services provided meaning to the empowerment concept from which the NEL was derived. Based on 531 completed questionnaires, analyses in agreement with COSMIN criteria examined aspects of internal consistency, content validity, structural validity, convergent validity, discriminant validity, reproducibility and responsiveness of the NEL. Results. The NEL is a 40-item self-report questionnaire with six subscales: Social support, Professional help, Connectedness, Confidence and purpose, Self-management and Caring community. Internal consistency (Cronbach’s alpha = 0.94), aspects of validity, reproducibility (intraclass correlation = 0.79) and responsiveness were good. Correlation with existing scales was the highest for the Mental Health Confidence Scale (r = 0.78) and the lowest for the Boston Empowerment Scale (r = 0.61). Conclusion. The NEL appears to be a suitable instrument to capture the dimension of empowerment in European mental health settings.

关键词： Empowerment Psychotic Disorder Recovery

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Clinical outcomes of patients with duodenal adenocarcinoma and intestinal-type papilla of Vater adenocarcinoma

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World Journal of Gastrointestinal Oncology 2020年第3期12卷 347-357页

作者： Laura L Meijer Marin Strijker Jacob K de Bakker Jurgen GJ Toennaer Barbara M Zonderhuis hans J van der Vliet Hanneke Wilmink Joanne Verheij Freek Daams Olivier R Busch Nicole CT van Grieken Marc G Besselink Geert Kazemier Department of Surgery Cancer Center AmsterdamAmsterdam UMCVU University AmsterdamAmsterdamNoord-Holland 1081HVThe Netherlands Department of Surgery Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamAmsterdamNoord-Holland 1105AZThe Netherlands Department of Medical Oncology Cancer Center AmsterdamAmsterdam UMCVU University AmsterdamAmsterdamNoord-Holland 1081HVThe Netherlands Department of Medical Oncology Cancer Center AmsterdamAmsterdam UMCUniversity of Amsterdam AmsterdamNoord-Holland 1105AZThe Netherlands Department of Pathology Cancer Center AmsterdamAmsterdam UMCUniversity of Amsterdam AmsterdamNoord-Holland 1105AZThe Netherlands Department of Pathology Cancer Center AmsterdamAmsterdam UMCVU University Amsterdam Noord-Holland 1081HVThe Netherlands

BACKGROUND Duodenal adenocarcinoma(DA)and intestinal-type papilla of Vater adenocarcinoma(it-PVA)are rare malignancies of the gastrointestinal *** therapeutic options are translated nowadays from treatment strategies for patients with colorectal cancer due to histopathological *** To retrospectively investigate the clinical outcome of patients with DA and *** All patients with DA and it-PVA diagnosed between 2000 and 2017 were included at two academic centers in the *** patients with histopathologically-confirmed DA or it-PVA were eligible for *** outcome was compared between DA and it-PVA per disease *** the subgroup of stage IV disease,survival after local treatment of oligometastases was compared with systemic therapy or supportive *** In total,155 patients with DA and it-PVA were *** with it-PVA more often presented with stage I disease,while DA was more often diagnosed at stage IV(P<0.001).Of all patients,79%were treated with curative *** median survival was 39 mo,and no difference in survival was found for patients with DA and it-PVA after stratification for disease ***(23%)of 31 patients with synchronous stage IV disease underwent resection of the primary tumor,combined with local treatment of *** treatment of metastases was associated with an overall survival of 37 mo,compared to 14 and 6 mo for systemic therapy and supportive care,*** Survival of patients with DA and it-PVA is comparable per disease *** results suggest a potential benefit for local treatment strategies in selected patients with oligometastases,although additional prospective studies are needed.

关键词： Duodenal adenocarcinoma Papilla of Vater adenocarcinoma Clinical outcomes Local treatment Metastases Survival

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