VU University Medical Center Amsterdam (Dutch: VU Medisch Centrum or VUmc) is the university hospital affiliated with the Vrije Universiteit Amsterdam. It is rated as one of the best academic medical centers in the country in terms of patient care and research. It is located next to Amsterdam's A10 ringway in the southwestern part of the city, next to the campus of the Vrije Universiteit and close to Schiphol airport. On 30 October 2015, researchers at the VUmc Cancer Center Amsterdam reported developing a blood test that, from a single drop of blood, can diagnose cancer with a probability of 97%, and about 6-8% probability of a false diagnosis, in healthy patients. Also since October 2015 the VUmc got the first MRIdian system in Europe, currently the most advanced radiation therapy system to treat tumors, because the system has a built-in MRI scanner to aim the radiation optimally.
The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.
Measurable residual disease (MRD) monitoring has become a critical component in the management of acute myeloid leukemia (AML), to inform prognosis, guide therapy, and serve as a key endpoint in clinical trials. The 2025 update of the MRD guideline provides a comprehensive and refined framework for MRD assessment, aligned with the ELN 2022 genetic risk classification. Developed by members of the ELN-DAVID consortium, the guidelines incorporate expert consensus determined through a two-stage Delphi round. They address the clinical implementation of MRD methodologies, technical considerations, integration into clinical trials, and future directions. Importantly, MRD recommendations are tailored to individual prognostic and genetic subgroups. A new qualitative MRD response category, designated as optimal, warning, or high risk of treatment failure, has been introduced to facilitate contextual interpretation of the MRD burden and its clinical relevance. Notably, ultrahigh-sensitivity (UHS) NGS-based MRD assessment is now recommended for FLT3-ITD-mutated AML following intensive chemotherapy and prior to allogeneic hematopoietic cell transplantation. A total of 56 recommendations were formulated, with 53 achieving a high level of consensus (≥90%). These updated guidelines represent a major step forward toward harmonizing MRD assessments in AML and enhancing its clinical utility across diverse treatment settings.
Analysis of signals defined on complex topologies modeled by graphs is a topic of increasing interest. Signal decomposition plays a crucial role in the representation and processing of such information, in particular, to process graph signals based on notions of scale (e.g., coarse to fine). The graph spectrum is more irregular than for conventional domains; i.e., it is influenced by graph topology, and, therefore, assumptions about spectral representations of graph signals are not easy to make. Here, we propose a tight frame design that is adapted to the graph Laplacian spectral content of given classes of graph signals. The design is based on using the ensemble energy spectral density, a notion of spectral content of given signal sets that we determine either directly using the graph Fourier transform or indirectly through a polynomial-based approximation scheme. The approximation scheme has the benefit that (i) it does not require eigendecomposition of the Laplacian matrix making the method feasible for large graphs, and (ii) it leads to a smooth estimate of the spectral content. A prototype system of spectral kernels each capturing an equal amount of energy is initially defined and subsequently warped using the signal set's ensemble energy spectral density such that the resulting subbands each capture an equal amount of ensemble energy. This approach accounts at the same time for graph topology and signal features, and it provides a meaningful interpretation of subbands in terms of coarse-to-fine representations. We also show how more simplified designs of signal-adapted decomposition of graph signals can be adopted based on ensemble energy estimates. We show the application of proposed methods on the Minnesota road graph and three different designs of brain graphs derived from neuroimaging data.
AIMS:Female underrepresentation in clinical trials of acute coronary syndromes (ACS) may hinder the assessment of sex-based differences in the outcomes of long-term pharmacological therapy. The presence of these differences and their potential association with female representation in clinical trials remain unclear. METHODS AND RESULTS:A systematic search of Embase, Medline Ovid, and Cochrane Central was conducted through 1 July 2025, in accordance with the reporting standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible randomized controlled trials (RCTs) compared long-term pharmacological therapy for ACS with placebo or standard care, included ≥1-year follow-up, and reported a clinical event as the primary outcome. Sex differences in treatment effects were analysed using a random-effects meta-analysis, while meta-regression was used to assess the association between the proportion of females in each trial and these differences. The main outcome was the sex difference in the relative effect measure (REM; mostly a hazard ratio) for the primary efficacy endpoint. Among 102 RCTs, female representation ranged from 10 to 52%. Forty-eight trials provided sex-stratified data. Pooled analysis showed no evidence of sex-related differences in efficacy: the mean difference in the log of the REM of males minus females was 0.00 (95% confidence interval, -0.05-0.05; P = 0.98; heterogeneity I² = 0%). Meta-regression indicated no relationship between female trial participation and sex-specific treatment effects. CONCLUSION:In RCTs of long-term pharmacological therapy after ACS, treatment efficacy was comparable between sexes, irrespective of sex distribution. These findings support current guidelines recommending equivalent long-term pharmacological strategies for secondary prevention in both sexes.
There is a gap between the evaluation of injury prevention programmes in controlled trials and their use in real-world practice, and implementation research seeks to bridge this gap by supporting programme uptake beyond research settings. This study explored implementation processes and influencing factors during and after effectiveness trials of injury prevention programmes, and examined strategies used for scale-up following trials. Using a mixed methodologies design, corresponding authors of published injury prevention trials were contacted and invited to complete a survey on implementation activities conducted during their trial and, where applicable, during scale-up. A subsample of respondents also participated in semi-structured interviews. In total, 107 injury prevention studies were identified, of which 39 authors completed the survey and nine took part in interviews. Implementation strategies applied during trials were often underreported in published studies but were identified through the survey, with common strategies including in-person training, staff education, and the provision of supportive materials. Only approximately one-third of the studies resulted in scale-up beyond the trial context. Survey responses and interview data highlighted several facilitators and barriers relevant to both trial implementation and scale-up, such as programme context, coach and athlete motivation, and organisational support. Other factors were phase-specific: trial implementation benefited from structured programme development and close researcher involvement, whereas scale-up was more strongly influenced by limited resources and external momentum, such as public events. These findings suggest that to enhance implementation and scale-up of injury prevention programmes, implementation factors should be considered throughout both the development and evaluation phases. Systematic reporting and assessment of facilitators and barriers during trials and broader scale-up initiatives, along with transparent descriptions of implementation strategies used in effectiveness studies, are essential to improve the translation of research findings into practice.
