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Background: A prediction tool was developed and internally validated to aid the diagnosis of Cushing's syndrome in dogs attending UK primary‐care practices. External validation is an important part of model validation to assess model performance when used in different populations. Objectives: To assess the original prediction model's transportability, applicability, and diagnostic performance in a secondary‐care practice in the Netherlands. Animals: Two hundred thirty client‐owned dogs. Methods: Retrospective observational study. Medical records of dogs under investigation of Cushing's syndrome between 2011 and 2020 were reviewed. Dogs diagnosed with Cushing's syndrome by the attending internists and fulfilling ALIVE criteria were defined as cases, others as non‐cases. All dogs were scored using the aforementioned prediction tool. Dog characteristics and predictor‐outcome effects in development and validation data sets were compared to assess model transportability. Calibration and discrimination were examined to assess model performance. Results: Eighty of 230 dogs were defined as cases. Significant differences in dog characteristics were found between UK primary‐care and Dutch secondary‐care populations. Not all predictors from the original model were confirmed to be significant predictors in the validation sample. The model systematically overestimated the probability of having Cushing's syndrome (a = −1.10, P <.001). Calibration slope was 1.35 and discrimination proved excellent (area under the receiver operating curve = 0.83). Conclusions and Clinical Importance: The prediction model had moderate transportability, excellent discriminatory ability, and overall overestimated probability of having Cushing's syndrome. This study confirms its utility, though emphasizes that ongoing validation efforts of disease prediction tools are a worthwhile effort. [ABSTRACT FROM AUTHOR]

Four derivatives of 2'‐hydoxychalcone were synthesized through Claisen‐Schmidt condensation by combining 2'‐hydroxyacetophenone and four different benzaldehyde derivatives (o‐vanillin, salicylaldehyde, p‐anisaldehyde, and benzaldehyde) in the presence of a base. The reactions took place in an ionic liquid, 1‐dodecyl‐3‐methylimidazolium bromide ([DDMIm]Br), and were facilitated by microwave irradiation. The reactions were completed within 10 to 15 minutes, yielding products with chemical yields ranging from 52.64 % to 83.42 %. The structures of the synthesized products were confirmed using 1H NMR and 13C NMR spectroscopy. Additionally, antimicrobial activity tests demonstrated the effectiveness of specific derivatives against Staphylococcus aureus and Escherichia coli, underscoring the importance of hydroxy and methoxy groups on the aromatic ring in inhibiting microbial growth. These findings provide valuable knowledge for developing chalcone derivatives with improved properties and potential applications in drug discovery. Furthermore, the synthesized products′ reactivity was analyzed using Frontier Molecular Orbital (FMO) and their reactivity site was mapped using Molecular Electrostatic Potential (MEP). Lastly, molecular docking analysis was attempted to explain antibacterial activities from all products. Nonetheless, the molecular docking simulations conducted in this study were inadequate to fully account for the antimicrobial activity observed in all the products. [ABSTRACT FROM AUTHOR]

Summary: Little is known about the long‐term health‐related quality of life (HRQoL) and persistence of symptoms among patients with indolent non‐Hodgkin lymphoma (iNHL). This large population‐based longitudinal study therefore investigated the long‐term HRQoL and persistence of symptoms and identified associated sociodemographic, clinical and psychological factors. Patients diagnosed between 1999 and 2014 and four or more months after diagnosis were invited to participate in a longitudinal survey. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. The EORTC QLQ‐C30 and CLL‐16 were completed by 669 patients (74% response rate). Patients completed on average four questionnaires. Primary treatment was active surveillance (52%), systemic therapy (31%) or radiotherapy (13%). Respectively, 36% reported persistent fatigue, 33% persistent neuropathy and 25% persistent role‐functioning impairment. This was 2–3 times higher than in the age‐ and sex‐matched normative population. Up to 10 years after diagnosis, scores remained relatively stable without clinically relevant changes. Comorbidities, psychological distress, shorter time since diagnosis, systemic therapy, younger age, education level and having no partner were associated with worse outcomes (all ps < 0.05). Up to a third of patients with iNHL experience long‐term persistent symptoms which do not improve over time. Early recognition of symptoms will help in providing tailored supportive care for those in need. [ABSTRACT FROM AUTHOR]

Dehydration of calcium silicate hydrates, the primary binding phase of cement paste, contributes significantly to the degradation of cementitious materials at high temperatures. Kinetics of the dehydration process is usually parameterized as the product of the classic Arrhenius equation and a kinetic expression, calibrating the influence of the temperature and the reaction degree, respectively. By means of the Exp‐function approximation, an improved kinetic expression is proposed and the differential equation is solved by utilizing the Mean‐value Theorem for integrals. The established dehydration model is validated by comparing with independent experimental measurements, concerning different heating regime and molar ratios of calcium‐to‐silicon. Both the temperature history and the calcium‐to‐silicon molar ratios influence the kinetics and the final status of the dehydration process. The established model provides access to further investigation of the microstructural evolution of heated concrete, containing supplementary cementitious materials. [ABSTRACT FROM AUTHOR]

Summary: Studies on the conditional life expectancy of patients with chronic myeloid leukaemia (CML) are lacking. Using data from the Netherlands Cancer Registry, we examined the life expectancy of patients with CML in the Netherlands diagnosed during 1989–2018. As of the early 2010s, the life expectancy of patients with CML who survived several years after diagnosis came narrowly close to the general population's life expectancy, regardless of age. This finding can essentially be ascribed to the introduction and broader application of tyrosine kinase inhibitors (TKIs) and provide optimism to patients with CML who can look forward to a near‐normal life expectancy in a modern TKI era. [ABSTRACT FROM AUTHOR]

Summary: Contemporary diagnosed WM patients, compared to the general population, continue to experience excess mortality regardless of having survived up to 15 years post‐diagnosis. This gradual increase in excess mortality might result from the incurable nature of this disease characterized by multiple relapses throughout the disease course with limited efficacious treatment options in the released/refractory setting. [ABSTRACT FROM AUTHOR]

Summary: It is unclear how treatment advances impacted the population‐level survival of patients with lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia (LPL/WM). Therefore, we assessed trends in first‐line therapy and relative survival (RS) among patients with LPL/WM diagnosed in the Netherlands between 1989 and 2018 (N = 6232; median age, 70 years; 61% males) using data from the nationwide Netherlands Cancer Registry. Patients were grouped into three age groups (<65, 66–75 and >75 years) and four calendar periods. Overall, treatment with anti‐neoplastic agents within 1 year post‐diagnosis gradually decreased over time, following a broader application of an initial watch‐and‐wait approach. Approximately 40% of patients received anti‐neoplastic therapy during 2011–2018. Furthermore, use of chemotherapy alone decreased over time, following an increased application of chemoimmunotherapy. Detailed data among 1596 patients diagnosed during 2014–2018 revealed that dexamethasone‐rituximab‐cyclophosphamide was the most frequently applied regimen; its use increased from 14% to 39% between 2014 and 2018. The 5‐year RS increased significantly over time, particularly since the introduction of rituximab in the early–mid 2000s. The 5‐year RS during 1989–1995 was 75%, 65%, and 46% across the age groups compared to 93%, 85%, and 79% during 2011–2018. However, the survival improvement was less pronounced after 2011. Collectively, the impressive survival improvement may be accounted for by broader application of rituximab‐containing therapy. The lack of survival improvement in the post‐rituximab era warrants studies across multiple lines of therapy to further improve survival in LPL/WM. [ABSTRACT FROM AUTHOR]

Aim: To address alarm fatigue, a new alarm management system which ensures a quicker delivery of alarms together with waveform information on nurses' handheld devices was implemented and settings optimised. The effects of this clinical implementation on alarm rates and nurses' responsiveness were measured in an 18-bed single family rooms neonatal intensive care unit (NICU).Methods: The technical implementation of the alarm management system was followed by clinical workflow optimisation. Alarms and vital parameters from October 2017 to December 2019 were analysed. Measures included monitoring alarms, nurses' response to alarms and time spent by patients in different saturation ranges. A survey among nurses was performed to evaluate changes in alarm rate and use of protocols.Results: A significant reduction of monitoring alarms per patient days was detected after the optimisation phase (in particular for SpO2 ≤ 80%, P < .001). More time was spent by infants within the optimal peripheral oxygen saturation range (88% < SpO2 < 95%, P < .001). Results from the surveys showed that false alarms are less likely to cause an inappropriate response after the optimisation phase.Conclusion: The implementation of an alarm management solution and an optimisation programme can safely reduce the alarm burden inside of the NICU environment. [ABSTRACT FROM AUTHOR]

Survival continues to increase in chronic lymphocytic leukaemia: a population-based analysis among 20 468 patients diagnosed in the Netherlands between 1989 and 2016 Keywords: chronic lymphocytic leukaemia; survival; cancer epidemiology; population-based; registry EN chronic lymphocytic leukaemia survival cancer epidemiology population-based registry 574 577 4 04/30/20 20200501 NES 200501 Chronic lymphocytic leukaemia (CLL) is the most frequently diagnosed and prevalent form of leukaemia among adults in Western countries (Brenner I et al. i , [2]; Kristinsson I et al. i , [6]; Van den Broek I et al. i , [9]). Relative survival (RS) is the overall survival (OS) in the patient cohort divided by the expected OS of an equivalent group from the general population, matched to the patient group by age, sex, and period (Dickman & Adami, [3]). Furthermore, the incidence of CLL might be overestimated, because most patients diagnosed with Rai stage 0 or I before 2008 can be reclassified into monoclonal B-cell leukaemia according to the most recent diagnostic criteria (Hallek I et al. i , [5]). [Extracted from the article]

Objectives: Assessment of "real‐world" treatment strategies and outcome in Dutch polycythemia vera (PV) patients. Methods: Retrospective chart review in 150 patients with PV (WHO 2008 diagnostic criteria) from 10 major non‐academic hospitals in the Netherlands. Results: Patients (median age 64 years, 49% male) frequently had cardiovascular risk factors (56%) and prior vascular events (31%). About 70% of patients were high‐risk, based on ELN criteria. However, the majority of patients were treated with phlebotomies alone (55%). Cytoreduction with hydroxyurea (HU) was received by 44% as part of their initial therapy, with or without phlebotomies. The time to achieve the 45% hematocrit target was shortest in patients treated with phlebotomies with or without HU (125 ± 99 and 197 ± 249 days, respectively) compared to patients treated with only HU (232 ± 216 days). Leukocyte and platelet levels were lower in HU‐treated patients, and ELN response targets were more often reached. During the median follow‐up period of 4.1 years, 14 patients (9%) suffered a thrombotic vascular event. Conclusions: In Dutch clinical practice, there is major clinical variation in treatment strategies for PV. Phlebotomizing patients shorten the time to achieve hematocrit control, while HU better controls platelet and leukocyte levels. The thrombotic vascular event rate remains clinically significant. [ABSTRACT FROM AUTHOR]

The article discusses the creation of a national program for Hodgkin lymphoma (HL) survivorship care in the Netherlands as of August 2019. Topics covered include the steps in screening of late adverse events like cardiovascular disease, thyroid dysfunction, and reduced fertility, the development of guidelines for the most frequent ones, and the flow of data from and to various sources and their use. Also noted are the BETER clinics' coordination with the patients' general practitioners (GP).