OBJECTIVE: Patients diagnosed with advanced larynx cancer face a decisional process in which they can choose between radiotherapy, chemoradiotherapy, or a total laryngectomy with adjuvant radiotherapy. Clinicians do not always agree on the best clinical treatment, making the decisional process for patients a complex problem.METHODS: Guided by the International Patient Decision Aid (PDA) Standards, we followed three developmental phases for which we held semi-structured in-depth interviews with patients and physicians, thinking-out-loud sessions, and a study-specific questionnaire. Audio-recorded interviews were verbatim transcribed, thematically coded, and analyzed. Phase 1 consisted of an evaluation of the decisional needs and the regular counseling process; phase 2 tested the comprehensibility and usability of the PDA; and phase 3 beta tested the feasibility of the PDA.RESULTS: Patients and doctors agreed on the need for development of a PDA. Major revisions were conducted after phase 1 to improve the readability and replace the majority of text with video animations. Patients and physicians considered the PDA to be a major improvement to the current counseling process.CONCLUSION: This study describes the development of a comprehensible and easy-to-use online patient decision aid for advanced larynx cancer, which was found satisfactory by patients and physicians (available on www.treatmentchoice.info). The outcome of the interviews underscores the need for better patient counseling. The feasibility and satisfaction among newly diagnosed patients as well as doctors will need to be proven. To this end, we started a multicenter trial evaluating the PDA in clinical practice (ClinicalTrials.gov Identifier: NCT03292341).LEVEL OF EVIDENCE: NA Laryngoscope, 129:2733-2739, 2019.
MULTIFILE
During times of high activity by predators and competitors, herbivores may be forced to forage in patches of low‐quality food. However, the relative importance in determining where and what herbivores forage still remains unclear, especially for small‐ and intermediate‐sized herbivores. Our objective was to test the relative importance of predator and competitor activity, and forage quality and quantity on the proportion of time spent in a vegetation type and the proportion of time spent foraging by the intermediate‐sized herbivore European hare (Lepus europaeus). We studied red fox (Vulpes vulpes) as a predator species and European rabbit (Oryctolagus cuniculus) as a competitor. We investigated the time spent at a location and foraging time of hare using GPS with accelerometers. Forage quality and quantity were analyzed based on hand‐plucked samples of a selection of the locally most important plant species in the diet of hare. Predator activity and competitor activity were investigated using a network of camera traps. Hares spent a higher proportion of time in vegetation types that contained a higher percentage of fibers (i.e., NDF). Besides, hares spent a higher proportion of time in vegetation types that contained relatively low food quantity and quality of forage (i.e., high percentage of fibers) during days that foxes (Vulpes vulpes) were more active. Also during days that rabbits (Oryctolagus cuniculus) were more active, hares spent a higher proportion of time foraging in vegetation types that contained a relatively low quality of forage. Although predation risk affected space use and foraging behavior, and competition affected foraging behavior, our study shows that food quality and quantity more strongly affected space use and foraging behavior than predation risk or competition. It seems that we need to reconsider the relative importance of the landscape of food in a world of fear and competition.
MULTIFILE
Spatial variation in habitat riskiness has a major influence on the predator–prey space race. However, the outcome of this race can be modulated if prey shares enemies with fellow prey (i.e., another prey species). Sharing of natural enemies may result in apparent competition, and its implications for prey space use remain poorly studied. Our objective was to test how prey species spend time among habitats that differ in riskiness, and how shared predation modulates the space use by prey species. We studied a one‐predator, two‐prey system in a coastal dune landscape in the Netherlands with the European hare (Lepus europaeus) and European rabbit (Oryctolagus cuniculus) as sympatric prey species and red fox (Vulpes vulpes) as their main predator. The fine‐scale space use by each species was quantified using camera traps. We quantified residence time as an index of space use. Hares and rabbits spent time differently among habitats that differ in riskiness. Space use by predators and habitat riskiness affected space use by hares more strongly than space use by rabbits. Residence time of hare was shorter in habitats in which the predator was efficient in searching or capturing prey species. However, hares spent more time in edge habitat when foxes were present, even though foxes are considered ambush predators. Shared predation affected the predator–prey space race for hares positively, and more strongly than the predator–prey space race for rabbits, which were not affected. Shared predation reversed the predator–prey space race between foxes and hares, whereas shared predation possibly also released a negative association and promoted a positive association between our two sympatric prey species. Habitat riskiness, species presence, and prey species’ escape mode and foraging mode (i.e., central‐place vs. noncentral‐place forager) affected the prey space race under shared predation.
MULTIFILE
Alle auto's, windmolens en o.a. houten kozijnen hebben één ding gemeen. Ze moeten gecoat worden om het materiaal te beschermen. Alleen al in Nederland wordt ruim 1 miljard euro omzet gerealiseerd met coatings. Er is dringend behoefte aan verduurzaming en innovatie. Aan het einde van de levensduur wordt de coating meestal verbrand, dit leidt tot meer CO2 omdat coatings veelal van fossiele grondstoffen zijn gemaakt. Het maken van een biobased coating is daarom essentieel. Echter, één belangrijk ingrediënt mist, de aromaat. Het zijn de aromaten die de coating glanzend, krasvast en uv-bestendig maken. De coatingindustrie heeft geprobeerd het fossiele ingrediënt ftaalzuuranhydride (PA) in de hars te vervangen, maar er is tot op heden geen goede oplossing gevonden. Relement ontwikkelde als eerste bedrijf wereldwijd een bio-aromaat, te weten biobased 3-methylftaalzuuranhydride (bio-MPA). Een showmodel van een coating gebaseerd op bio-MPA ontbreekt en dat is precies wat samen met Fontys Hogeschool onderzocht gaat worden in dit KIEM Go-Chem project. Het doel van het project Alchemist is om een biobased alkyd coating showmodel te realiseren gebaseerd op bio-MPA i.p.v. fossiel PA. De eigenschappen van de coating worden getest en vergeleken met een alkyd coating gebaseerd op fossiel PA. Er worden betere eigenschappen verwacht door het vervangen van PA door MPA.
Coatings zijn overal: denk aan o.a. auto’s, windmolens en houten kozijnen. Alleen al in Nederland wordt ruim 1 miljard euro omzet gerealiseerd met coatings. Er is echter een probleem: aan het einde van de levensduur wordt de coating meestal verbrand, omdat recycling erg moeilijk is. Het maken van een biobased coating is daarom essentieel om de CO2-voetprint te verlagen. Echter, één belangrijk ingrediënt mist, de aromaat. Het zijn de aromaten die de coating belangrijke eigenschappen geven zoals glans en krasvastheid. Relement ontwikkelde als eerste bedrijf wereldwijd een bio-aromaat, te weten biobased 3-methylftaalzuuranhydride (bio MPA) wat een vervanger kan zijn voor het fossiel ftaalzuuranhydride (PA). Het doel van dit Kiem GoChem project Alchimist is om het effect van bio MPA t.o.v. fossiel PA op de performance van een alkydcoating beter te begrijpen.
100 woorden Ava is een medisch home device die je gebruikt in combinatie met een app op je telefoon vóórdat je naar de huisarts gaat. Ava spreekt, maakt gebruik van Big Data en het internet en zal in staat zijn om onze hartslag, pupilreflex, huidintensiteit en zuurstofgehalte in onze longen te meten. Door elke dag een gezondheidscheck te doen met Ava, hou je meer grip op je gezondheid en wordt de gezondheidszorg efficiënter. De kans op een misdiagnose wordt minimaal en ziekte kan voorkomen worden. De metingen en informatie wordt toegankelijk gemaakt en je blijft zelf beheerder van je eigen medische data.
