The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
This article explores the challenges local youth workers face at the intersection of providing social care and detecting violent extremism. Extremism and other radical ideologies are often assumed to be a harbinger of terrorism. Even though both are still a rare phenomenon among adolescents, European states have become highly concerned with being alert to early signs of radicalisation processes. As a result, youth workers as well as other local professionals have been confronted with the task of detecting these early signs. However, despite training and increased knowledge, the question remains whether youth workers are sufficiently equipped to assess potential risks in youth who show no concrete plans for criminal action. In these cases, prevention targets ideas rather than violent behaviour. This article details qualitative results of a case study among Dutch youth workers and suggests that no clear framework exists for detection of radicalisation processes into (violent) extremism. This has two main causes. Firstly, the concepts of radicalisation and (violent) extremism are in practice difficult to distinguish. Secondly, the youth worker's judgement often relies more on individual perceptions rather than evidence-based criteria to identify potential ‘risky’ persons. This situation may lead to undesired side effects such as executive arbitrariness, prejudice or stigmatisation.
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Agricultural/horticultural products account for 9% of Dutch gross domestic product. Yearly expansion of production involves major challenges concerning labour costs and plant health control. For growers, one of the most urgent problems is pest detection, as pests cause up to 10% harvest loss, while the use of chemicals is increasingly prohibited. For consumers, food safety is increasingly important. A potential solution for both challenges is frequent and automated pest monitoring. Although technological developments such as propeller-based drones and robotic arms are in full swing, these are not suitable for vertical horticulture (e.g. tomatoes, cucumbers). A better solution for less labour intensive pest detection in vertical crop horticulture, is a bio-inspired FW-MAV: Flapping Wings Micro Aerial Vehicle. Within this project we will develop tiny FW-MAVs inspired by insect agility, with high manoeuvrability for close plant inspection, even through leaves without damage. This project focusses on technical design, testing and prototyping of FW-MAV and on autonomous flight through vertically growing crops in greenhouses. The three biggest technical challenges for FW-MAV development are: 1) size, lower flight speed and hovering; 2) Flight time; and 3) Energy efficiency. The greenhouse environment and pest detection functionality pose additional challenges such as autonomous flight, high manoeuvrability, vertical take-off/landing, payload of sensors and other equipment. All of this is a multidisciplinary challenge requiring cross-domain collaboration between several partners, such as growers, biologists, entomologists and engineers with expertise in robotics, mechanics, aerodynamics, electronics, etc. In this project a co-creation based collaboration is established with all stakeholders involved, integrating technical and biological aspects.
This proposal envisions a solution for organizations and their employees to keep each other resilient and healthy.We aim for proactive detection of stress at an early stage, so it can facilitate a safe and collaborative dialogue between employers and employees at a time that they are both still able to see their co-dependency and mutual interests, while acknowledging the possible tension of conflicting interests. A sorrow shared is a sorrow halved.We use an Impact Plan Approach in which a Theory of Change (the DESTRESS Strategy) directs research activities that identify problems and causse, determine the required change to overcome them, and adjust the DESTRESS strategy to make improvements that are necessary to invoke that change. Subsequently, the DESTRESS strategy will be translated into the DESTRESS solution, for which a strategy for implementation and evaluation will be devised.
Pre-eclampsia (PE) is a common and severe pregnancy complication and is associated with substantial perinatal morbidity and mortality in mothers and infants. The disease is often characterized by a non-specific presentation which makes it challenging for physician to diagnose PE during regular pregnancy check-ups. To date, there are no diagnostic tests on the market for detection of PE early in pregnancy (first trimester). In this project, we will develop a platform to sensitively analyse calcium-binding proteins (CBPs) which will unlock the full potential of CBPs as predictive PE markers. The technology will also be applicable for other diseases (e.g., dementia and cancer) where CBPs are also known to play a key role in disease pathophysiology. We will develop with phage display antibodies that can recognize calcium binding to specific motifs in proteins. To this end we will synthesize peptide motifs with and without calcium to select antibodies that are specific for calcium bound proteins. These antibodies will be validated for their clinical use. For this goal we will use serum samples from the Improved studie (EU subsidised study) to determine if we can recognize pre-eclampsia in a very early stage. This knowledge can lead to a better treatment of pregnant women suffering from this disease and also will probably increase the well-being for the baby born and the development further in life.
