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For estimating herbage intake during grazing, the traditional sward cutting technique was compared in grazing experiments in 2002 and 2003 with the recently developed n-alkanes technique and with the net energy method. The first method estimates herbage intake by the difference between the herbage mass before and after grazing and the regrowth between the 2 points in time. The second technique estimates herbage intake by the ratio of a dosed even-chain synthetic n-alkane (C32) and a naturally occurring odd-chain n-alkane (C31 or C33) in the herbage and feces. The third technique calculated the intake from the animal's energy requirements for milk production and maintenance. The sward cutting technique estimated herbage intake with the highest coefficient of variation and had different results in the 2 experimental years. The n-alkanes method yielded less variable results, whereas the net energy method gave the least variable results. In 2002, the estimates of the alkane ratio C32:C33 were best related with estimations of the net energy method. In 2003, the estimates of the alkane ratio C32:C31 were best related. The estimate based on the alkane ratio C32:C33 had a lower coefficient of variation than the one based on the alkane ratio C32:C31. Therefore, the C32:C33 alkane method was considered to be a better direct estimator for herbage intake by grazing lactating dairy cows. [ABSTRACT FROM AUTHOR]

The concentrations of magnesium, sodium, chlorine, aluminum, and calcium in pooled human dental calculus dried to constant weight at 105 C were determined by instrumental neutron activation analysis. Their mean concentrations were 0.50 ± 0.04%, 0.37±0.03%, 0.09 ± 0.01%, 96.08 ± 14.63 ppm, and 28.04 ± 1.70%, respectively. [ABSTRACT FROM AUTHOR]

The sample to be analysed, and a standard of known composition, were irradiated simultaneously in the poolside facility of a nuclear reactor for 130 hours in a thermal neutron flux of approximately 2 × 1013 n.cm-2. sec-1, and the induced radioactivity compared after a cooling period of four weeks. The investigation was done with a high resolution Ge(Li) detector coupled to a fully transistorized 4000 channel analyser. The concentration of five elements, namely Sb, Ag, Zn, Co and Fe, was determined in human dental calculus by instrumental activation analysis and found to be 0,68 ppm, 0,18 ppm, 174 ppm, 0,08 ppm and 54 ppm respectively. [ABSTRACT FROM AUTHOR]

We report a study of the optimization of power conversion efficiency in hybrid solar cells based on nanostructured titanium dioxide and a poly[2-(2-ethylhexyloxy)-5-methoxy-1,4-phenylenevinylene] (MEH-PPV) based conjugated polymer. Charge collection efficiency is enhanced by introducing a poly(ethylenedioxythiophene)/polystyrene sulphonate (PEDOT) layer (under the gold electrode) as the hole collector. Device performance is maximized for a device with a net active layer thickness of 100 nm. The optimized device has peak external quantum efficiencies ≈40% at the polymer’s maximum absorption wavelength and yield short circuit current density >=2 mA cm-2 for air mass (AM) 1.5 conditions (100 mW cm-2, 1 sun). The AM 1.5 open circuit voltage for this device is 0.64 V and the fill factor is 0.43, resulting in an overall power conversion efficiency of 0.58%. [ABSTRACT FROM AUTHOR]

The effects of 4 diploid perennial ryegrass cultivars that differed in water-soluble carbohydrate (WSC) concentrations on milk yield and nitrogen (N) utilization in dairy cows were evaluated in a 2-yr grazing experiment. Twelve lactating dairy cows were assigned to 1 cultivar for a 2-wk period in a 4 x 4 Latin square design with 3 replicates. Each year, the experiment lasted 8 wk. Swards were in a vegetative stage throughout the experiment. Herbage constituents were determined, and DM intake was estimated with the n-alkane technique. Nitrogen utilization was calculated as N excreted in milk divided by N intake, assuming a zero N retention. Two cultivars had consistently higher WSC concentrations and slightly lower neutral detergent fiber concentrations than the other 2 cultivars. The ranking of the cultivars in chemical composition traits in both years was rather consistent. Cows grazing the cultivar with the lowest concentration of WSC had the lowest herbage DM intake, N intake, milk yield, and milk N yield in 2002, but with a similar difference in WSC concentration, no differences among cultivars were found in 2003. In both years, milk urea N concentration was slightly higher for cows grazing the cultivar with the lowest WSC concentration, although it was significant only in 2003. Nitrogen utilization (N milk:N intake, g/g) varied between 0.241 and 0.246 in 2002 and between 0.190 and 0.209 in 2003, and in both years there was no effect of cultivar. At relatively high N concentrations in grass and only small differences among cultivars in neutral detergent fiber concentrations, cultivars with an elevated WSC concentration did not increase N utilization in grazing dairy cows. [ABSTRACT FROM AUTHOR]

The effects of 8 diploid perennial ryegrass (Lolium perenne L.) cultivars on dry matter (DM) intake, DM digestibility, and milk yield (MY) of dairy cows were evaluated in the summer of 2000 and 2001. Each summer, herbage was harvested daily and stall-fed to 12 dairy cows during six 2-wk periods. Six cultivars were fed in 3 periods (1, 3, and 5) according to a double 3 x 3 Latin square design. In the other periods (2, 4, and 6), 2 cultivars were fed in a repeated measurement design. Herbage mass and leaf blades in the sward canopy varied among cultivars, but differences were not consistent between years. The largest differences in herbage composition were found in water-soluble carbohydrate content, followed by crude protein content. only small differences were found in the neutral detergent fiber (NDF) content. A higher water-soluble carbohydrate content was found in 2 cultivars in both years, whereas ranking of cultivars in crude protein and NDF content was not consistent with years. Dry matter intake and MY were not affected by cultivar. In both years, DM digestiblity was high (>77%), with very small differences among cultivars in 2000 (<0.5%) and larger differences in 2001 (up to 4%). This was associated with a delayed heading date in 2001, resulting in larger differences in leaf blades and NDF content among cultivars. It may be concluded that the 8 cultivars used in our experiments do not provide grass breeders with encouraging evidence to include selection criteria for an increased DM intake, DM digestibility, and MY in their grass breeding schemes. [ABSTRACT FROM AUTHOR]

In the middle of the worldwide COVID-19 crisis, the whole of Europe was alarmed about a possible side effect of the AstraZeneca vaccine against COVID-19. Consequently, the use of this AstraZeneca vaccine was temporarily suspended in many European nations including the Netherlands. In this article, we chronologically describe the decisions that were made about the use of this vaccine in the Netherlands and we discuss the risk-benefit ratios of these actions as well as possible non-medical reasons that may explain why these actions were taken.

Objectives: This study describes the initiation of the Dutch Lung Cancer Audit for Lung Oncology (DLCA-L) and reports the first results of three years of clinical auditing., Methods: The initiation, dataset, and data quality of the DLCA-L are described. For the analyses, all patients registered from 2017 to 2019 were included. Descriptive statistics were used to assess the first outcomes of the DLCA-L, including results from quality indicators, patient- and tumor characteristics, and the real-world use of immunotherapy., Results: The DLCA-L was initiated after the surgery and radiotherapy audit for lung cancer. In total, 33.788 NSCLC patients and 4.293 SCLC patients were registered in the DLCA-L from 2017 to 2019. Seventy-three (97 %) Dutch hospitals participated in the DLCA-L in 2019. The registry became nation-wide in 2020. The data quality improved over the years, with complete cases in 90 % of the NSCLC patients. In total, 15 quality indicators were established based on DLCA-L data to improve processes and clinical outcomes. An example of these quality indicators was brain imaging at diagnosis of stage III NSCLC patients, which increased from 80 % in 2017 to 90 % in 2019 and hospital variation was reduced. The DLCA-L provided data on immunotherapy use in stage IV NSCLC (n = 4.415) patients. These patients had a median age of 67 years and 11 % of the patients had an ECOG PS ≥ 2. The number of patients treated with immunotherapy in different hospitals varied between 2 patients to 163 patients per hospital., Conclusion: The DLCA-L has become a valuable and complete data source with national coverage in 2020. A high number of registered patients and limited missing data resulted in better insights into hospital processes and outcomes of lung cancer care. Quality indicators were, with success, used to establish improvements and minimize hospital variation. The DLCA-L also provides hospitals real-world information on the use of (systemic) therapies., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: Phase III studies of checkpoint inhibitors changed the therapeutic landscape for lung cancer. In 2015 the Dutch Society of Chest Physicians (NVALT) introduced a national immunotherapy registry for patients with lung cancer; quality standards for hospitals were implemented. At population level we studied clinical benefit in daily practice and in patients who are underrepresented in phase III trials., Materials and Methods: From the initial introduction of checkpoint inhibitors in the Netherlands patients were centrally registered. Educational programs and quality control were provided under supervision of NVALT. The largest immunotherapy providing hospitals were compared to hospitals who provided less checkpoint inhibitors as marker of experience. Patients characteristics, treatment and side effects, response rate and survival were studied., Results: A total of 2676 patients were registered, 2302 with follow up data were evaluated. Between October 2015 and December 2017 a gradual increase from 12 to 30 qualified hospitals showed no major toxicity differences. Toxicity led to a hospital admission rate of 9.1 with an average duration of 10.4 days. Overall tumor response was 21.8 % and median overall survival 12.6 months. Overall survival was not significantly different for patients aged ≥ 75 years, those having brain metastases or selected auto-immune diseases before start checkpoint inhibitors compared to younger patients or those without, respectively. Survival outcomes were worse in patients with PS 2+, non-smokers, and patients who received any palliative radiotherapy (HR 2.1, 95 % CI 1.7-2.7; 1.3, 95 % CI 1.0-1.6 and 1.2, 95 % CI 1.1-1.4, respectively)., Conclusions: Changes in the therapeutic landscape did not lead to major differences in quality of care between hospitals. Elderly patients, those with brain metastases or selected auto-immune disease underrepresented in clinical trials did not do worse on checkpoint inhibitors, except for those with PS 2 + ., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The objective of this phase II study was to document activity and toxicity of docetaxel and cisplatin as induction chemotherapy in patients with stage IIIA N2 non-small cell lung cancer (NSCLC) before definitive local treatment. Forty-six chemotherapy-nai ve patients (median age 60 years) were included. Treatment consisted of 3 cycles of docetaxel (85 mg/m2 on day 1), followed by cisplatin (40 mg/m2/day on days 1 and 2) every 21 days. Grade 3-4 leukopenia and neutropenia occurred in 45.7% and 65.2% of the patients, respectively. Among 8 cases of febrile neutropenia (17.4%), one (2.2%) resulted in early death. Common grade 3-4 non-haematological toxicities were nausea (17.4%) and vomiting (13%). Eighty-five percent of the patients received three courses; six stopped prematurely due to toxicity, one due to protocol violation. Response rate was the primary endpoint of this study. Considering eligible patients (n=40), 18 responses (1 complete and 17 partial responses) were observed (response rate 45%; 95% Confidence interval (CI): 29.3%-61.5%). In stage IIIA-N2 NSCLC patients, docetaxel-cisplatin could be administered and demonstrated manageable toxicity with modest efficacy.

Three studies using healthy volunteers (n = 271) investigated the effects of caffeine, carbohydrates and carbonation in functional "energy" drinks (EDs) with the aim of determining their benefit in every-day life. The results showed caffeine to be the main ED constituent responsible for the effects found, with possible minor, relatively weak effects of carbohydrates. EDs were found to improve and/or maintain mood and performance during fatiguing and cognitively demanding tasks relative to placebo. In terms of absolute values, EDs maintained levels of arousal compared to a deterioration in arousal where placebo was consumed. These effects were found in caffeine-deprived participants, and so may be largely due to "withdrawal reversal". There were only minor differences in the effects of water vs. "sensory-matched" placebo, supporting previous findings indicating that the type of placebo does not alter the conclusions drawn about the effects of the full ED. Finally, carbonation had various effects on mood, some of which were present immediately following consumption, others were consistent with slower absorption of caffeine (and possibly carbohydrates) from carbonated drinks.