Introduction Radical cystectomy (RC) is the standard treatment for patients with non-metastatic muscle-invasive bladder cancer, as well as for patients with therapy refractory high-risk non-muscle invasive bladder cancer. However, 50–65% of patients undergoing RC experience perioperative complications. The risk, severity and impact of these complications is associated with a patient’s preoperative cardiorespiratory fitness, nutritional and smoking status and presence of anxiety and depression. There is emerging evidence supporting multimodal prehabilitation as a strategy to reduce the risk of complications and improve functional recovery after major cancer surgery. However, for bladder cancer the evidence is still limited. The aim of this study is to investigate the superiority of a multimodal prehabilitation programme versus standard-of-care in terms of reducing perioperative complications in patients with bladder cancer undergoing RC.Methods and analysis This multicentre, open label, prospective, randomised controlled trial, will include 154 patients with bladder cancer undergoing RC. Patients are recruited from eight hospitals in The Netherlands and will be randomly (1:1) allocated to the intervention group receiving a structured multimodal prehabilitation programme of approximately 3–6 weeks, or to the control group receiving standard-of-care. The primary outcome is the proportion of patients who develop one or more grade ≥2 complications (according to the Clavien-Dindo classification) within 90 days of surgery. Secondary outcomes include cardiorespiratory fitness, length of hospital stay, health-related quality of life, tumour tissue biomarkers of hypoxia, immune cell infiltration and cost-effectiveness. Data collection will take place at baseline, before surgery and 4 and 12 weeks after surgery.Ethics and dissemination Ethical approval for this study was granted by the Medical Ethics Committee NedMec (Amsterdam, The Netherlands) under reference number 22–595/NL78792.031.22. Results of the study will be published in international peer-reviewed journals.Trial registration number NCT05480735.
Background Conventional medical management, while essential, cannot address all multifaceted consequences of Parkinson’s disease (PD). This pilot study explores the potential of a co-designed creative arts therapy on health-related quality of life, well-being, and pertinent non-motor symptoms.
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Background: Emergency department utilization has increased tremendously over the past years, which is accompanied by an increased necessity for emergency medicine research to support clinical practice. Important sources of evidence are systematic reviews (SRs) and meta-analyses (MAs), but these can only be informative provided their quality is sufficiently high, which can only be assessed if reporting is adequate. The purpose of this study was to assess the quality of reporting of SRs and MAs in emergency medicine using the PRISMA statement. Methods: The top five emergency medicine related journals were selected using the 5-year impact factor of the ISI Web of Knowledge of 2015. All SRs and MAs published in these journals between 2015 and 2016 were extracted and assessed independently by two reviewers on compliance with each item of the PRISMA statement. Results: The included reviews (n = 112) reported a mean of 18 ± 4 items of the PRISMA statement adequately. Reviews mentioning PRISMA adherence did not show better reporting than review without mention of adherence (mean 18.6 (SE 0.4) vs. mean 17.8 (SE 0.5); p = 0.214). Reviews published in journals recommending or requiring adherence to a reporting guideline showed better quality of reporting than journals without such instructions (mean 19.2 (SE 0.4) vs. mean 17.2 (SE 0.5); p = 0.001). Conclusion: There is room for improvement of the quality of reporting of SRs and MAs within the emergency medicine literature. Therefore, authors should use a reporting guideline such as the PRISMA statement. Active journal implementation, by requiring PRISMA endorsement, enhances quality of reporting.
In de recente open brief van de creatieve industrie aan de informateur worden overheden opgeroepen samen met onderzoekers en de praktijk te experimenteren om hun digitale transformatie te laten slagen. Deze KIEM-aanvraag voorziet in deze behoefte. Het project heeft als doel in co-creatie met praktijkpartners voor de gemeenten Utrecht en Overbetuwe een data-gedreven segmentatiemodel en bijbehorend communicatie- en participatie-instrument te ontwikkelen die deze gemeenten in staat stelt om innovatie op het gebied van burger- en buurtparticipatie aan te jagen. Dit gebeurt in living labs, waarbij hogescholen en praktijkpartners samen experimenteren met nieuwe vormen van vraaggestuurde (digitale) communicatie. Centraal in het experimenteren staan 14 (concept) ‘betrokkenheidsprofielen’, die in de living labs (1) getoetst worden, en (2) waarvoor een concretiseringsslag gemaakt wordt richting strategische en tactische communicatie. In ieder living lab zullen enkele profielen centraal staan. De onderzoekspartners in het consortium, dat naast de gemeenten Utrecht en Overbetuwe bestaat uit de Hogeschool van Arnhem en Nijmegen, de Hogeschool Utrecht en Citisens (onderdeel van Necker van Naem, een onderzoek- en adviesbureau in de publieke sector), hebben de gezamenlijke ambitie na deze KIEM-aanvraag een vervolgaanvraag in te dienen, met meer Nederlandse gemeenten. In deze nieuwe aanvraag zullen andere (concept) betrokkenheidsprofielen getoetst en geconcretiseerd worden, met als uiteindelijke doel het data-gedreven segmentatiemodel voor de 14 profielen volledig te valideren. Beoogde uitkomsten van het project, dat een looptijd heeft van 1 jaar, zijn (1) het eerder genoemde communicatie- en participatie-instrument voor beide participerende gemeenten, (2) een blogserie, en (3) een openbare afsluitende bijeenkomst waarin de resultaten van het onderzoek en een doorkijk naar de toekomst gedeeld zullen worden.
In Gelderland at industriepark Kleefsewaard, a prominent knowledge hub for hydrogen technology has been developed, featuring key industry players and research groups contributing to innovative and cost-effective hydrogen technologies. However, the region faces a challenge in the lack of available test equipment for hydrogen innovations. In Anion Exchange Membrane (AEM) technology, a route to follow is to create hydrogen more efficiently with stacks that can operate under high pressure (50 bar – 200 bar). This results in compact hydrogen storage. Research must be done to understand crossover effects which become more apparent at these high pressure conditions. The overall goal is to design a Balanced of Plant (BOP) system, incorporating Process Flow Diagram (PFD) and Piping & Instrumentation Diagram (P&ID) elements, alongside hydrogen purification systems and gas-liquid separators, for a test setup operating AEM stacks at 200 bar. De Nooij Stainless contributes by designing and fabricating a gas liquid separator, addressing challenges such as compatibility, elevated temperatures, and hydrogen safety. ON2Quest collaborates in supporting the design of a hydrogen purification system and the Balance of Plant (BoP), ensuring flexibility for testing future stacks and hydrogen purification components. HyET E-Trol specializes in high pressure (up to 200 bar) AEM electrolyser stacks and is responsible for providing problem statements and engineering challenges related to the (Balanced of Plant) BoP of AEM systems, and contributes in solving them. Subsequent projects will feature test sequences centered on other stacks, allowing for testing stacks from other companies. The resulting framework will provide a foundation for ongoing advancements, with contributions from each partner playing a crucial role in achieving the project's goals.
