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Debate exists regarding predictive value of brain MRI for long-term neurodevelopmental outcome (NDO) in infants with severe unconjugated hyperbilirubinemia (above exchange transfusion levels). To investigate whether MRI findings among (pre-)term infants with severe unconjugated hyperbilirubinemia can predict NDO at ≥ 12 months and determine optimal timing for MRI. PubMed and Embase. Last update: June 14, 2024. Studies in which (pre-)term infants with severe unconjugated hyperbilirubinemia who underwent an MRI before 24 months and had a reported NDO at ≥ 12 months were included. Patient characteristics, MRI and NDO details were extracted. The search yielded 732 studies, of which 22 were included. Individual patient information was obtained for 120 infants (MRI-timing: early (≤6 weeks) n = 75, late (>6 weeks) n = 19, unknown n = 26). Positive predictive value (PPV) of abnormal MRI in the total group for impaired NDO was high (77.5 %). The PPV of late compared to early MRI was much higher, 92.3 % versus 71.7 %. Negative predictive value of normal MRI for normal NDO in the total group was low (29.0 %) and again higher in late compared to early MRI, 50.0 % versus 27.3 %. Quantitative synthesis of results was impossible due to large heterogeneity in study designs. Furthermore, selection bias towards patients with impaired outcome might have influenced our results. Brain MRI can serve as prognostic tool for NDO in infants with severe unconjugated hyperbilirubinemia, both in early and late stages, but each timing has inherent constraints. Further prospective studies are necessary. • This systematic review uniquely evaluates the predictive value of brain MRI for neurodevelopmental outcomes in neonates with severe unconjugated hyperbilirubinemia (above exchange transfusion levels). • Late MRIs (conducted >6 weeks postnatally) demonstrate a significantly higher predictive value for impaired neurodevelopmental outcomes compared to early MRIs (conducted ≤6 weeks postnatally). • The high percentages in reported studies (75.8 %) of infants with adverse neurological outcomes after severe unconjugated hyperbilirubinemia suggest selection bias, may also be due to the wide NDO range and are not fully representative of the broader patient population. • There is a notable lack of large, prospective studies assessing the predictive value of MRI in neonatal severe unconjugated hyperbilirubinemia. [ABSTRACT FROM AUTHOR]

No previous study has investigated fatigue in older patients with Inflammatory Bowel Disease (IBD). To describe the prevalence of fatigue in older patients and compare it to the prevalence in younger patients with IBD, and to determine factors associated with fatigue. A prospective, multicenter cohort study, including older- (≥ 65 years) and younger patients with IBD (18–64 years). A geriatric assessment was performed in older patients to measure deficits in geriatric assessment (DiG). Fatigue was defined by one item from the short Inflammatory Bowel Disease Questionnaire. Active disease was defined as the presence of clinical or biochemical disease activity. Fatigue prevalence in the 405 older patients varied between 45.4% (71/155) in active disease to 23.6% (60/250) in remission. Fatigue prevalence in 155 younger patients was 59.5% (47/79) and 57.4% (89/155), respectively. Female sex, clinical disease activity, use of immunomodulators and presence of DiG were associated with fatigue in older patients with IBD. Fatigue prevalence is lower in older patients with IBD compared to younger patients with IBD, but increases when active disease is present. Clinicians should be aware that fatigue is a relevant symptom in older patients with IBD, as it is associated with DiG. [ABSTRACT FROM AUTHOR]

The crosstalk of joint pathology with local lymph nodes in osteoarthritis (OA) is poorly understood. We characterized the change in T cells in lymph nodes following load-induced OA and established the association of the presence and migration of T cells to the onset and progression of OA. We used an in vivo model of OA to induce mechanical load-induced joint damage. After cyclic tibial compression of mice, we analyzed lymph nodes for T cells using flow cytometry and joint pathology using histology and microcomputed tomography. The role of T-cell migration and the presence of T-cell type was examined using T-cell receptor (TCR)α−/− mice and an immunomodulatory drug, Sphingosine-1-phosphate (S1P) receptor inhibitor-treated mice, respectively. We demonstrated a significant increase in T-cell populations in local lymph nodes in response to joint injury in 10, 16, and 26-week-old mice, and as a function of load duration, 1, 2, and 6 weeks. T-cell expression of inflammatory cytokine markers increased in the local lymph nodes and was associated with load-induced OA progression in the mouse knee. Joint loading in TCRα−/− mice reduced both cartilage degeneration (Osteoarthritis Research Society International (OARSI) scores: TCRα 0.568, 0.981-0.329 confidence interval (CI); wild type (WT) 1.328, 2.353-0.749 CI) and osteophyte formation. Inhibition of T-cell egress from lymph nodes attenuated load-induced cartilage degradation (OARSI scores: Fingolimod: 0.509, 1.821-0.142 CI; Saline 1.210, 1.932-0.758 CI) and decreased localization of T cells in the synovium. These results establish the association of lymph node-resident T cells in joint damage and suggest that the S1P receptor modulators and T-cell immunotherapies could be used to treat OA. [ABSTRACT FROM AUTHOR]

We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life). A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2–3 moderate deficits and 4–5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed. Somatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284–3.743; P =.004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936–5.825; P <.001). Deficits in geriatric assessment independently associate with lower health-related quality of life. Deficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies. [Display omitted] [ABSTRACT FROM AUTHOR]

Family members of patients treated with Extracorporeal Membrane Oxygenation (ECMO) during an Intensive Care Unit (ICU) stay are at risk of developing symptoms of anxiety, depression and Post-Traumatic Stress Disorder (PTSD). Coping strategies used by family members may play an important role in the severity of some of these symptoms. The primary aim of this study was to describe coping strategies used by family members of ECMO-treated patients during ICU admission and recovery period. The secondary aim was to explore the course of the symptoms anxiety, depression, PTSD, and Health Related Quality Of Life (HRQOL) over time. In this single-center prospective longitudinal study, validated questionnaires were used to measure coping strategies, symptoms of anxiety, depression and PTSD, and HRQOL in family members of ECMO-treated patients directly after the start of ECMO and at one and six months after the start of ECMO. Family members (n = 26) mainly used problem-focused coping strategies. Symptoms of anxiety appeared to be most present during treatment but decreased over time, as did symptoms of depression and PTSD. HRQOL was severely affected, especially in the mental domain, and did not improve over time. In family members of ECMO-treated patients, problem-focused coping mechanisms were most prominent. Psychological functioning was impaired on admission but improved over time, although a mild reaction to stress remained. [ABSTRACT FROM AUTHOR]

Telemedicine can be used to monitor determinants and outcomes of patients with chronic diseases, possibly increasing the quality and value of care. Telemedicine was found to reduce outpatient visits and hospital admissions for patients with inflammatory bowel diseases (IBD). We performed a full economic evaluation of telemedicine interventions in patients with IBD, comparing the cost-utility of telemedicine vs standard care. We performed a randomized trial of 909 patients with IBD at 2 academic and 2 non-academic hospitals in The Netherlands. Patients were randomly assigned to groups that received telemedicine (myIBDcoach; n = 465) or standard outpatient care (n = 444) and followed for 12 months. Costs were measured from a societal perspective. Direct healthcare costs were based on actual resource use. Indirect costs comprised self-reported hours sick leave from work, intervention costs (annual license fee of €40 per patient [$45]), and utility costs (assessed using EQ5D). Cost-utility and uncertainty were estimated using the non-parametric bootstrapping method. Telemedicine resulted in lower mean annual costs of €547/patient [$612] (95% CI, €1029–2143 [$1150-2393]; mean costs of €9481 [$10,587] for standard care and €8924 [$9965] for telemedicine) without changing quality adjusted life years. At the Dutch threshold of €80,000 [$89,335] per quality adjusted life year, the intervention had increased incremental cost-effectiveness over standard care in 83% of replications and an incremental net monetary benefit of €707/patient [$790] (95% CI, €1241–2544 [$1386-2841]). Telemedicine with myIBDcoach is cost saving and has a high probability of being cost effective for patients with IBD. This self-management tool enables continuous registration of quality indicators and (patient-reported) outcomes and might help reorganize IBD care toward value-based healthcare. ClinicalTrials.gov no: NCT02173002. [ABSTRACT FROM AUTHOR]

Objective: Mechanical loading and joint health have a unique relationship in osteoarthritis (OA) onset and progression. Although high load levels adversely affect cartilage health, exercise that involves low to moderate load levels can alleviate OA symptoms. We sought to isolate the beneficial effects of mechanical loading using controlled in vivo cyclic tibial compression. We hypothesized that low-level cyclic compression would attenuate post-traumatic OA symptoms induced by destabilization of the medial meniscus (DMM).Methods: 10-week-old C57Bl/6J male mice underwent DMM surgery (n = 51). After a 5-day post-operative recovery period, we applied daily cyclic tibial compression to the operated limbs at low (1.0N or 2.0N) or moderate (4.5N) magnitudes for 2 or 6 weeks. At the completion of loading, we compared cartilage and peri-articular bone features of mice that underwent DMM and loading to mice that only underwent DMM.Results: Compared to DMM alone, low-level cyclic compression for 6 weeks attenuated DMM-induced cartilage degradation (OARSI score, P = 0.008, 95% confidence interval (CI): 0.093 to 0.949). Low-level loading attenuated DMM-induced osteophyte formation after 2 weeks (osteophyte size, P = 0.033, 95% CI: 3.27-114.45 μm), and moderate loading attenuated subchondral bone sclerosis after 6 weeks (tissue mineral density (TMD), P = 0.011, 95% CI: 6.32-70.60 mg HA/ccm) compared to limbs that only underwent DMM. Finally, loading had subtle beneficial effects on cartilage cellularity and aggrecanase activity after DMM.Conclusion: Low-level cyclic compression is beneficial to joint health after an injury. Therefore, the progression of early OA may be attenuated by applying well controlled, low-level loading shortly following joint trauma. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) patients are at risk of an impaired nutritional status. The impact thereof on the IBD relapse risk is clinically relevant, though sparsely investigated. The aim was to explore the association between an impaired nutritional status risk and the occurrence of disease flares in IBD outpatients participating in a longitudinal telemedicine study. IBD outpatients were recruited from the myIBDcoach study cohort, with one year clinical follow-up. Through myIBDcoach, a telemedicine tool, patients reported on disease activity and risk of impaired nutritional status (i.e. Short Nutritional Assessment Questionnaire >1 and/or BMI < 18.5 kg/m2) every one to three months. Data was analysed by generalized estimating equation modelling. In total, 417 patients were included. During follow-up, 49 patients (11.8%) flared after initial clinical remission and 53 patients (12.7%) showed an increased risk of impaired nutritional status. The risk of impaired nutritional status was associated with flare occurrence (OR 2.61 (95% CI 1.02–6.69)). The risk of an impaired nutritional status was associated with subsequent flares in IBD outpatients. This emphasizes the importance of monitoring disease activity in IBD patients at risk of impaired nutritional status. [ABSTRACT FROM AUTHOR]

Precision oncology is being driven by rapid advances in novel diagnostics and therapeutic interventions, with treatments targeted to the needs of individual patients on the basis of genetic, biomarker, phenotypic, or psychosocial characteristics that distinguish a given patient from other patients with similar clinical presentations. Inherent in the theranostics paradigm is the assumption that diagnostic test results can precisely determine whether an individual is likely to benefit from a specific treatment. As part and integral in the current era of precision oncology, theranostics in the context of nuclear medicine aims to identify the appropriate molecular targets in neoplasms (diagnostic tool), so that the optimal ligands and radionuclides (therapeutic tool) with favorable labeling chemistry can be selected for personalized management of a specific disease, taking into consideration the specific patient, and subsequently monitor treatment response. Over the past two decades, the use of gallium-68 labeled peptides for somatostatin receptor (SSTR)-targeted PET/CT (or PET/MRI) imaging followed by lutetium-177 and yttrium-90 labeled SSTR-agonist for peptide receptor radionuclide therapy has demonstrated remarkable success in the management of neuroendocrine neoplasms, and paved the way to other indications of theranostics. Rapid advances are being made in the development of other peptide-based radiopharmaceuticals, small molecular-weight ligands and with newer radioisotopes with more favorable kinetics, potentially useful for theranostics strategies for the clinical application. The present review features the Bad Berka experience with first-in-human studies of new radiopharmaceuticals, for example, prostate-specific membrane antigen ligand, gastrin-releasing peptide receptor, neurotensin receptor 1 ligand, novel SSTR-targeting peptides and nonpeptide, and bone-seeking radiopharmaceuticals. Also new radioisotopes, for example, actinium (225Ac), copper (64Cu), scandium (44Sc), and terbium (152Tb/161Tb) will be discussed briefly demonstrating the development from basic science to precision oncology in the clinical setting. [ABSTRACT FROM AUTHOR]

Remodeling of the aortoiliac anatomy is a challenge to the long-term performance of stent grafts for endovascular aneurysm repair. Changes in vessel diameter and length can result in loss of seal at attachment sites, limb disunion, or kinking, with the development of high-pressure endoleaks, migration, or limb occlusion. The aim of this study was to assess the durability and conformability of the ultralow-profile INCRAFT AAA endograft (Cordis Corporation, Milpitas, Calif) during 5-year follow-up. From 2010 to 2011, there were 60 patients (median age, 74 years; range, 60-94 years) with intact abdominal aortic aneurysms who were enrolled in the INNOVATION trial to evaluate the safety, effectiveness, and durability of the INCRAFT AAA device. Clinical and technical success was assessed with protocol-specified, monitored follow-up clinic visits and core laboratory-assessed computed tomography (CT) at 1 month, 6 months, and 12 months after implantation and annually through 5 years thereafter. Diameter and angulation changes at the proximal aortic neck and diameter changes at the iliac attachment zones were measured in addition to the standard CT assessments. Significant aortoiliac remodeling was observed throughout long-term follow-up after endovascular aneurysm repair. Proximal aortic neck diameter 15 mm below the lowest main renal artery increased from 23.5 ± 2.5 mm at 1 month to 27.3 ± 2.8 mm at 5 years (P =.002). Neck dilation >5 mm was observed in 8 of 38 patients with 5-year CT studies (21%). The aortic neck straightened, with angulation decreasing from 34 ± 14 degrees preoperatively to 31 ± 11 degrees at 1 month (P <.001) and to 20 ± 12 degrees at 5 years (P =.018). Straightening of the neck was most prominent in patients who presented with a high degree of preoperative angulation (r = 0.61; P <.001). Between 1 month and 5 years, iliac attachment zone diameter increased from 13.5 ± 1.9 mm to 15.0 ± 2.4 mm on the right (P =.002) and from 13.9 ± 2.3 mm to 16.8 ± 2.7 mm on the left (P <.001). During 5 years, 9 of 72 (13%) iliac arteries enlarged >5 mm. There was a significant relationship between main body oversizing and aortic neck enlargement (r = 0.42; P =.009). No similar association was observed between iliac limb oversizing and iliac dilation over time (r = 0.10 and P =.549, right side; r = 0.14 and P =.400, left side). There were no aneurysm-related deaths in the series. There were two type IA endoleaks, both of which were present on the 1-month CT scan and associated with challenging aortic neck anatomy. No patient experienced endograft migration or rupture through 5 years. Type IB endoleaks occurred in two patients, both accompanied by iliac artery dilation and loss of seal. Stent fracture occurred in two struts of the bare transrenal stent of one patient, without loss of fixation or seal. One patient experienced graft limb occlusion and was observed without intervention. There were three patients (5%) with aneurysm sac enlargement (>5 mm) through 5 years, each of whom had type II endoleak. Significant aortoiliac remodeling occurs after endograft implantation, including proximal aortic neck dilation, straightening of the neck, and iliac artery enlargement. The ultralow-profile INCRAFT device adapted well to these changes, with acceptably low 5-year rates of device-related endoleaks, endograft migration, and limb occlusion. [ABSTRACT FROM AUTHOR]

Objective: Metabolic syndrome is characterized by obesity, hyperglycemia, hypertension, insulin resistance, and dyslipidemia. Metabolic syndrome is associated with osteoarthritis (OA), but it is unclear if the association is attributable to increased mechanical loading on joints caused by obesity or other aspects of metabolic syndrome. Here we examined the effects of altered metabolism, obesity, and the gut microbiome on load-induced OA.Design: Cartilage damage was induced through cyclic compressive loading in four groups of adult male mice: Toll-like receptor-5 deficient (TLR5KO) mice that develop metabolic syndrome due to alterations in the gut microbiome, TLR5KO mice submitted to chronic antibiotics to prevent metabolic syndrome (TLR5KOΔMicrobiota), C57BL/6J mice fed a high fat diet to cause obesity (HFD), and untreated C57BL/6J mice (WT). Loading was applied for 2 weeks (n = 10-11/group) or 6 weeks (n = 10-11/group).Results: After 2 weeks of loading, cartilage damage (OARSI score) was not different among groups. After 6 weeks of loading, HFD mice had increased load-induced cartilage damage, while TLR5KO mice had cartilage damage comparable to WT mice. TLR5KOΔMicrobiota mice had less cartilage damage than other groups. HFD mice had elevated serum inflammatory markers. Each group had a distinct gut microbiome composition.Conclusions: Severe obesity increased load-induced cartilage damage, while milder changes in adiposity/metabolic syndrome seen in TLR5KO mice did not. Furthermore, the effects of systemic inflammation/obesity on cartilage damage depend on the duration of mechanical loading. Lastly, reduced cartilage damage in the TLR5KOΔMicrobiota mice suggests that the gut microbiome may influence cartilage pathology. [ABSTRACT FROM AUTHOR]

Abstract Experiencing and observing social exclusion and inclusion, as well as prosocial behavior, are important aspects of social relationships in childhood. However, it is currently unknown to what extent these processes and their neural correlates differ in heritability. We investigated influences of genetics and environment on experiencing social exclusion and compensating for social exclusion of others with the Prosocial Cyberball Game using fMRI in a twin sample (aged 7–9; N = 500). Neuroimaging analyses (N = 283) revealed that experiencing possible self-exclusion resulted in activity in inferior frontal gyrus and medial prefrontal cortex, which was influenced by genetics and unique environment. Experiencing self-inclusion was associated with activity in anterior cingulate cortex, insula and striatum, but this was not significantly explained by genetics or shared environment. We found that children show prosocial compensating behavior when observing social exclusion. Prosocial compensating behavior was associated with activity in posterior cingulate cortex/precuneus, and showed unique environmental effects or measurement error at both behavioral and neural level. Together, these findings show that in children neural activation for experiencing possible self-exclusion and self-inclusion, and for displaying prosocial compensating behavior, is accounted for by unique environmental factors and measurement error, with a small genetic effect on possible self-exclusion. [ABSTRACT FROM AUTHOR]

Abstract Marine and coastal ecosystems are among the largest contributors to the Earth's productivity. Experimental studies have shown negative impacts of microplastics on individual algae or zooplankton organisms. Consequently, primary and secondary productivity may be negatively affected as well. In this study we attempted to estimate the impacts on productivity at ecosystem level based on reported laboratory findings with a modelling approach, using our biogeochemical model for the North Sea (Delft3D-GEM). Although the model predicted that microplastics do not affect the total primary or secondary production of the North Sea as a whole, the spatial patterns of secondary production were altered, showing local changes of ±10%. However, relevant field data on microplastics are scarce, and strong assumptions were required to include the plastic concentrations and their impacts under field conditions into the model. These assumptions reveal the main knowledge gaps that have to be resolved to improve the first estimate above. Graphical abstract Unlabelled Image Highlights • Modelling the impact of microplastics on marine productivity requires strong assumptions. • The model predicts that microplastics do not affect the total production in the North Sea. • Yet, spatial patterns of secondary production are altered, showing local changes of ±10%. • Large knowledge gaps exist concerning plastic concentrations and impacts in the field. [ABSTRACT FROM AUTHOR]

Abstract Background Socioeconomic inequalities in colorectal cancer (CRC) survival are well recognised. The aim of this study was to describe the impact of socioeconomic deprivation on survival in patients with synchronous CRC liver-limited metastases, and to investigate if any survival inequalities are explained by differences in liver resection rates. Methods Patients in the National Bowel Cancer Audit diagnosed with CRC between 2010 and 2016 in the English National Health Service were included. Linked Hospital Episode Statistics data were used to identify the presence of liver metastases and whether a liver resection had been performed. Multivariable random-effects logistic regression was used to estimate the odds ratio (OR) of liver resection by Index of Multiple Deprivation (IMD) quintile. Cox-proportional hazards model was used to compare 3-year survival. Results 13,656 patients were included, of whom 2213 (16.2%) underwent liver resection. Patients in the least deprived IMD quintile were more likely to undergo liver resection than those in the most deprived quintile (adjusted OR 1.42, 95% confidence interval (CI) 1.18–1.70). Patients in the least deprived quintile had better 3-year survival (least deprived vs. most deprived quintile, 22.3% vs. 17.4%; adjusted hazard ratio (HR) 1.20, 1.11–1.30). Adjusting for liver resection attenuated, but did not remove, this effect. There was no difference in survival between IMD quintile when restricted to patients who underwent liver resection (adjusted HR 0.97, 0.76–1.23). Conclusions Deprived CRC patients with synchronous liver-limited metastases have worse survival than more affluent patients. Lower rates of liver resection in more deprived patients is a contributory factor. [ABSTRACT FROM AUTHOR]

Currently, the routine use of radiographs for uncomplicated ankle fractures represents good clinical practice. However, radiographs are associated with waiting time, radiation exposure, and costs. Studies have suggested that radiographs seldom alter the treatment strategy if no clinical indication for the imaging study was present. The objective of the present study was to evaluate the effect of routine radiographs on the treatment strategy during the follow-up period of ankle fractures. All patients aged ≥18 years, who had visited 1 of the participating clinics with an eligible ankle fracture in 2012 and with complete follow-up data were included. The data were retrospectively analyzed. The sociodemographic and clinical characteristics and the number of, and indications for, the radiographs taken were collected from the medical records of the participating clinics. We assessed the changes in treatment strategy according to the radiographic findings. In 528 patients with an ankle fracture, 1174 radiographs were performed during the follow-up period. Of these radiographs, 936 (79.7%) were considered routine. Of the routine radiographs taken during the follow-up period, only 11 (1.2 %) resulted in changes to the treatment strategy. Although it is common practice to take radiographs routinely during the follow-up period for ankle fractures, the results from the present study suggest that routine radiographs seldom alter the treatment strategy. This limited clinical relevance should be weighed against the health care costs and radiation exposure associated with the use of routine radiographs. For a definitive recommendation, however, the results of our study should be confirmed by a prospective trial, which we are currently conducting. [ABSTRACT FROM AUTHOR]

Idle brownfields in urban settings are potential resources that could be put to productive use, meeting the goals of urban intensification, helping to curb urban sprawl on the periphery and benefiting communities living around sites. Various decision support tools exist in order to evaluate redevelopment scenarios. Spatial decision support systems have recently been developed to aid in evaluating the implications of the physical attributes of redevelopment scenarios, with a limited focus on the proximity of essential amenities to the local community. The application of proximity analysis in this context supports stakeholders in determining which social amenities are furthest from the local community and the extent to which including such amenities on-site would benefit the local community. A geographic information system based proximity analysis approach is presented specifically for this purpose. The distribution of walking distances for local households is compared to scenarios in which specific social amenities are included on-site. The approach is demonstrated using an abandoned brownfield case study in the Flemish region of Belgium. The local community would benefit most from having a doctor and pharmacy on-site in terms reduced walking distance. The inclusion of other amenities on-site such as employment, schools, green space, meeting places and shops also shortens walking distances for the local community but to a limited extent in comparison to a doctor and a pharmacy. ‘Walking distance’ is an indicator that is easily understood by stakeholders and the approach lays the foundation for more detailed analyses that would include frequency of visits. [ABSTRACT FROM AUTHOR]

The Flemish region in Belgium is characterised by a high and ever-growing proportion of settlement area. Moreover, the historical growth pattern has resulted in fragmented urban development causing societal and environmental problems such as strong competition for space by multiple sectors and traffic congestion. The Flemish government has incorporated in its Spatial Policy Plan the goal to reduce land take to zero by 2040 and to guide future urban development according to the Transit-Oriented Development (TOD) planning model. One of the principles of the plan is to concentrate urban development (to house the growing population and employment) at locations with good access to public transport and public and private services. Moreover, accessibility should be reached by means of active modes of transportation (e.g. walking, cycling). This paper offers a method to assist spatial planners that operate at a regional scale level by operationalizing these TOD-principles through mapping the urban development potential area-wide at high resolution. The proposed method builds upon the 'node-place model' put forward by Bertolini (1999). The method is applied to assess the urban development potential of locations in Flanders at a full-scale (i.e. for every location in Flanders, not only in areas around train stations). The method can be used to support policy makers operating at various levels (regional – local) to identify and prioritise locations that qualify for expansion, densification or reduction of the built-up area. • TOD principles are translated in an area-wide urban development map. • Urban development map based on accessibility of public transport and services. • Full-scale mapping of Bertolini's node-place model for regional spatial planners. • High resolution maps facilitate identifying local 'hotspots' for urban development. [ABSTRACT FROM AUTHOR]

The European COST Sub-Urban Action (TU1206) has had the fundamental aim of closing the knowledge gap between subsurface experts and potential users of subsurface knowledge - urban decision- makers, practitioners and researchers. The Action assembled a network involving >30 countries, 23 actively participating cities, researchers, practitioners and urban decision-makers, and brought together the fragmented research and good practice across Europe in sustainable urban sub-surface use. Development of national exemplars has been encouraged, and good practice identified to inspire others, using a lighthouse-follower approach to cascade knowledge and good practice across Europe and further afield. Experts from both sides of the knowledge gap were brought together to assess and synthesise the state-of-the-art in lighthouse cities with respect to urban sub-surface knowledge, understanding, and use of that knowledge. This was achieved in 19 City Studies, with findings encapsulated in an over-view report “Out of Sight - Out of Mind”. Expert sub-groups then identified good practice in subsurface data and knowledge locally, nationally, and Europe-wide. These are highlighted in the synthesis report “Opening up the subsurface for the cities of tomorrow”, and expanded on in seven topic review reports. These also identified key gaps in knowledge, and its use. A new concept, GEOCIM is proposed for City Quarter to Conurbation scales, combining subsurface and above-ground models. These enable: a.) holistic urban planning; b.) identifying subsurface opportunities; and c.) saving costs by reducing uncertainty in ground conditions. Finally, the Action’s reports and outputs were integrated within an online toolbox, and will be further outlined in the Final Report of the Action, to be made available on the Action’s website. The Sub-Urban Toolbox promotes and disseminates the good practice, and decision-support tools: a.) to help better inform and empower city decision- and policy-makers about the sub-surface and the vital importance of its early-stage consideration; and b.) accelerate uptake amongst sub-surface experts of sub-surface modelling workflows. Users with different backgrounds and needs, require different access to, and appropriate translations of, the Sub-Urban Toolbox. Therefore different entry points are provided for sub-surface technical experts, and urban planners, and decision- and policy-makers. As the critical mass of city decision- and policy-makers that is better aware of the sub-surface and its sustainable use expands, the potential for higher level policy consideration of the subsurface grows, and a wider range of impacts will become achievable. [ABSTRACT FROM AUTHOR]

Objective: Animal models recapitulating post-traumatic osteoarthritis (OA) suggest that subchondral bone (SCB) properties and remodeling may play major roles in disease initiation and progression. Thus, we investigated the role of SCB properties and its effects on load-induced OA progression by applying a tibial loading model on two distinct mouse strains treated with alendronate (ALN).Design: Cyclic compression was applied to the left tibia of 26-week-old male C57Bl/6 (B6, low bone mass) and FVB (high bone mass) mice. Mice were treated with ALN (26 μg/kg/day) or vehicle (VEH) for loading durations of 1, 2, or 6 weeks. Changes in articular cartilage and subchondral and epiphyseal cancellous bone were analyzed using histology and microcomputed tomography.Results: FVB mice exhibited thicker cartilage, a thicker SCB plate, and higher epiphyseal cancellous bone mass and tissue mineral density than B6 mice. Loading induced cartilage pathology, osteophyte formation, and SCB changes; however, lower initial SCB mass and stiffness in B6 mice did not attenuate load-induced OA severity compared to FVB mice. By contrast, FVB mice exhibited less cartilage damage, and slower-growing and less mature osteophytes. In B6 mice, inhibiting bone remodeling via ALN treatment exacerbated cartilage pathology after 6 weeks of loading, while in FVB mice, inhibiting bone remodeling protected limbs from load-induced cartilage loss.Conclusions: Intrinsically lower SCB properties were not associated with attenuated load-induced cartilage loss. However, inhibiting bone remodeling produced differential patterns of OA pathology in animals with low compared to high SCB properties, indicating that these factors do influence load-induced OA progression. [ABSTRACT FROM AUTHOR]

The aim of this study is to develop standard statistical methods and software for the analysis of beach litter data. The optimal ensemble of statistical methods comprises the Mann-Kendall trend test, the Theil-Sen slope estimation, the Wilcoxon step trend test and basic descriptive statistics. The application of Litter Analyst, a tailor-made software for analysing the results of beach litter surveys, to OSPAR beach litter data from seven beaches bordering on the south-eastern North Sea, revealed 23 significant trends in the abundances of beach litter types for the period 2009–2014. Litter Analyst revealed a large variation in the abundance of litter types between beaches. To reduce the effects of spatial variation, trend analysis of beach litter data can most effectively be performed at the beach or national level. Spatial aggregation of beach litter data within a region is possible, but resulted in a considerable reduction in the number of significant trends. [ABSTRACT FROM AUTHOR]

Wheat occupies a principal place in the diet of humans globally, contributing more to our daily calorie and protein intake than any other crop. For this reason, preventing weed induced yield losses in wheat has high significance for world food sustainability. Herbicides and tillage play an important role in weed control, but their use has often unacceptable consequences for humans and the wider environment. Additionally, the range of herbicides effective on key weeds is dwindling due to the evolution of herbicide resistance. Elevating crop competitiveness against weeds, through a combination of wheat breeding and innovative planting design (planting density, row spacing and orientation), has strong potential to reduce weed-induced yield losses in wheat. The last decade of research has provided a solid foundation for the breeding of weed suppressive wheat cultivars, and continued research in this area should be a focus for the future. In the interim, there is cause for optimism that weeds can be effectively suppressed using existing wheat varieties, through careful cultivar selection and choice of planting design. Further research is required to define the nature of relationships between cultivar traits and competitive planting strategies, across diverse weed flora in multiple countries, sites and seasons. Investment in such innovation promises to produce benefits, not only in terms of sustained wheat yields, but also in terms of human and ecosystem health, through ameliorating chemical and sediment contamination, soil degradation, and CO 2 pollution. [ABSTRACT FROM AUTHOR]

Being accepted or rejected by peers is highly salient for developing social relations in childhood. We investigated the behavioral and neural correlates of social feedback and subsequent aggression in 7–10-year-old children, using the Social Network Aggression Task (SNAT). Participants viewed pictures of peers that gave positive, neutral or negative feedback to the participant’s profile. Next, participants could blast a loud noise towards the peer, as an index of aggression. We included three groups ( N = 19, N = 28 and N = 27) and combined the results meta-analytically. Negative social feedback resulted in the most behavioral aggression, with large combined effect-sizes. Whole brain condition effects for each separate sample failed to show robust effects, possibly due to the small samples. Exploratory analyses over the combined test and replication samples confirmed heightened activation in the medial prefrontal cortex (mPFC) after negative social feedback. Moreover, meta-analyses of activity in predefined regions of interest showed that negative social feedback resulted in more neural activation in the amygdala, anterior insula and the mPFC/anterior cingulate cortex. Together, the results show that social motivation is already highly salient in middle childhood, and indicate that the SNAT is a valid paradigm for assessing the neural and behavioral correlates of social evaluation in children. [ABSTRACT FROM AUTHOR]

Nodular regenerative hyperplasia (NRH) is a poorly understood liver condition, which is increasingly recognized in thiopurine-treated patients with inflammatory bowel disease (IBD).1 It is difficult to establish an optimal approach to NRH patients, because its manifestations are highly variable (from asymptomatic to symptoms of noncirrhotic portal hypertension [NCPH]) and the prognosis is unknown.2 The aim of this study was to identify NRH cases in IBD patients treated with azathioprine, mercaptopurine, and/or thioguanine, and to describe its clinical course. [ABSTRACT FROM AUTHOR]

To describe the long-term functioning of patients who survived a COVID-19-related admission to the intensive care unit and their family members, in the physical, social, mental and spiritual domain. A single-centre, prospective cohort study with a mixed-methods design. The intensive care unit of the University Medical Center Groningen in the Netherlands. To study functioning 12 months after intensive care discharge several measurements were used, including a standardised list of physical problems, the Clinical Frailty Scale, the Medical Outcomes Study Short-Form General Health Survey, the McMaster Family Assessment Device, the Hospital Anxiety and Depression Scale, and the Spiritual Needs Questionnaire, as well as open questions and interviews with survivors and their family members. A total of 56 survivors (77%) returned the 12-month questionnaire, whose median age was 62 (inter-quartile range [IQR]: 55.0–68.0). Moreover, 67 family members (66%) returned the 12-month questionnaire, whose median age was 58 (IQR: 43–66). At least one physical problem was reported by 93% of the survivors, with 22% reporting changes in their work-status. Both survivors (84%) and their family members (85%) reported at least one spiritual need. The need to feel connected with family was the strongest. The main theme was 'returning to normal' in the interviews with survivors and 'if the patient is well, I am well' in the interviews with family members. One year after discharge, both COVID-19 intensive care survivors and their family members positively evaluate their health-status. Survivors experience physical impairments, and their family members' well-being is strongly impacted by the health of the survivor. [ABSTRACT FROM AUTHOR]

The growing demand for renewable energy stimulates the exploration of new materials and methods for clean energy, a process which is boosted by nanoscience and emerging nanotechnologies. Recently a high efficiency and high power density energy conversion mechanism was demonstrated through the use of jetted charged microdroplets, which fully relies on the net charges stored in the electrical double layer within a hundred nanometers of the water/gas interface, and then delivered at a metal target for converting kinetic energy to electrical energy. The method is fundamentally different from the traditional electrokinetic conversion and electrostatic generators, termed as ballistic energy conversion. It has a great potential in further applications due to the ultra-simple device design and the use of water, avoiding the challenges of new materials inventions. However, thorough theory is still lacking for both a quantitative description and an optimization of this system. Here we model and experimentally characterize the physical properties of the ballistic energy conversion system. Our model predicts the optimal working conditions of the energy harvesting including initial velocity and jet size, as well as the key performance factors including efficiency, generated target voltage, and power density. The results show that by using maximally charged droplets, an appropriate size and initial velocity of microjet, the system efficiency can be over 90%, at a generated voltage below 1 kV and a power density of at least 100 W/m 2 . The combination of high efficiency, huge power density, simplicity and compactness makes the ballistic energy conversion generator a promising device for green energy conversion. [ABSTRACT FROM AUTHOR]

Objective Complex local crosstalk amongst endocrine cells within the islet ensures tight coordination of their endocrine output. This is illustrated by the recent demonstration that the negative feedback control by delta cells within pancreatic islets determines the homeostatic set-point for plasma glucose during mouse postnatal development. However, the close association of islet endocrine cells that facilitates paracrine crosstalk also complicates the distinction between effects mediated directly on beta cells from indirect effects mediated via local intermediates, such as somatostatin from delta cells. Methods To resolve this problem, we generated reporter mice that allow collection of pure pancreatic delta cells along with alpha and beta cells from the same islets and generated comprehensive transcriptomes for each islet endocrine cell type. These transcriptomes afford an unparalleled view of the receptors expressed by delta, alpha and beta cells, and allow the prediction of which signal targets which endocrine cell type with great accuracy. Results From these transcriptomes, we discovered that the ghrelin receptor is expressed exclusively by delta cells within the islet, which was confirmed by fluorescent in situ hybridization and qPCR. Indeed, ghrelin increases intracellular calcium in delta cells in intact mouse islets, measured by GCaMP6 and robustly potentiates glucose-stimulated somatostatin secretion on mouse and human islets in both static and perfusion assays. In contrast, des-acyl-ghrelin at the same dose had no effect on somatostatin secretion and did not block the actions of ghrelin. Conclusions These results offer a straightforward explanation for the well-known insulinostatic actions of ghrelin. Rather than engaging beta cells directly, ghrelin engages delta cells to promote local inhibitory feedback that attenuates insulin release. These findings illustrate the power of our approach to resolve some of the long-standing conundrums with regard to the rich feedback that occurs within the islet that is integral to islet physiology and therefore highly relevant to diabetes. [ABSTRACT FROM AUTHOR]

Background The stentless Freedom Solo aortic bioprosthesis is implanted supraannularly using one running suture line in the sinuses of Valsalva. We report our 9-year experience with this bioprosthesis. Methods From April 2005 to July 2014, 350 consecutive patients at our institution underwent aortic valve replacement with the Freedom Solo bioprosthesis. Follow-up and echocardiographic data were collected retrospectively from referring cardiology centers. Results The mean age was 76 ± 6 years, 48% were male, and 46% underwent a concomitant procedure. Median EuroSCORE II was 3.0 (interquartile range, 1.9 to 4.9). Operative mortality was 5.1% for all procedures and 2.1% for isolated aortic valve replacement. The 1-, 5-, and 9-year overall survival was 92%, 74%, and 47%, respectively. At 6 years, freedom from structural valve deterioration and freedom from aortic valve reoperation were 98% and 96%, respectively. Prosthetic valve endocarditis occurred at a rate of 0.8% per patient-year. Permanent pacemaker implantation was necessary in 2.3% (n = 8), and moderate and severe prosthesis–patient mismatch occurred in 30 patients overall (9.6%). Postoperative maximum and mean valvular gradients were 17 mm Hg and 10 mm Hg, respectively, and remained stable during follow-up. Conclusions Aortic valve replacement with the Freedom Solo is safe and has a low rate of permanent pacemaker implantations and prosthesis–patient mismatch. Survival is comparable to that with other aortic bioprostheses, and structural valve deterioration and aortic valve reoperation are infrequent during midterm follow-up. Hemodynamic performance is excellent, with low valvular gradients that remain stable during follow-up. [ABSTRACT FROM AUTHOR]

Although ecosystems comprise both biotic and abiotic structures and processes, the role of abiotic output receives less attention and is addressed inconsistently in ecosystem services (ES) classification systems. The authors explore the nature and position of abiotic ecosystem output from: 1) a theoretical perspective on ecosystems, ecosystems services and natural capital; 2) a practical perspective on applying the ES concept in environmental policy, spatial planning and ecosystem management. From a theoretical point of view, excluding abiotic flows in ES frameworks such as CICES is inconsistent with the principles of the ES concept. Consequently, abiotic flows with (high) societal relevance may in practice be neglected or selectively addressed; many of them are related to sediment and the subsurface part of ecosystems. This impedes the integration strength of the ES concept. Given the large contributions to the economy and the societal costs of non-sustainable use of abiotic flows, it also impedes holistic, consistent and transparent information provision to decision makers. The authors urge to include abiotic flows as inherent part in ecosystem services classification systems such as CICES. This makes the application of the ES concept more holistic and consistent and will optimize it's integration power for practical planning and decision making. [ABSTRACT FROM AUTHOR]

In patients with a small aortic root undergoing aortic valve replacement (AVR), the Freedom SOLO bioprosthesis may be the ideal prosthesis because of its stentless design and supra-annular implantation. This study investigated if the stentless Freedom SOLO has an advantage when compared with a stented bioprosthesis in patients with a small aortic root. From April 2005-July 2014, 269 consecutive patients underwent AVR with either a Freedom SOLO (n = 76) or Mitroflow (n = 193) bioprosthesis size 19mm or 21mm, respectively. This retrospective comparison study presents clinical and echocardiographic follow-up data. In results, operative outcome and survival were similar. At 7 years, cumulative incidence of aortic valve reoperation and structural valve deterioration favor the Freedom SOLO (0% vs 7.1%, P = 0.03 and 0% vs 4.5%, P = 0.08, respectively). Additionally, the postoperative peak and mean valvular gradients favor the Freedom SOLO (21 ± 9mmHg vs 32 ± 12mmHg and 12 ± 5mmHg vs 19 ± 8mmHg, both P = <0.001, respectively). During mid-term follow-up this hemodynamic advantage continued in favor of the Freedom SOLO. Also prosthesis-patient mismatch occurred less frequently in the Freedom SOLO (28% vs 52%, P = 0.001). There were no differences in prosthetic valve endocarditis, thromboembolic, or bleeding events. In conclusion, the stentless Freedom SOLO has several significant advantages for AVR in patients with a small aortic root in comparison with a stented Mitroflow bioprosthesis. The Freedom SOLO shows superior hemodynamic performance with significantly lower valvular gradients that remained stable during mid-term follow-up. Additionally, significantly fewer prosthesis-patient mismatch occurred and the Freedom SOLO showed superior durability. [ABSTRACT FROM AUTHOR]

Mindfulness-Based Childbirth and Parenting (MBCP) reduces mothers' anticipated fear of childbirth (FOC), nonurgent obstetric interventions during childbirth and may improve childbirth outcomes in women with high FOC (Veringa-Skiba et al, 2022). The aim of this study was to examine the short- and longer-term outcomes of MBCP on psychological well-being, pregnancy and birth experience, as compared to enhanced care-as-usual (ECAU), in pregnant women with high FOC and their partners. Participants were randomly assigned to MBCP or ECAU and completed questionnaires preintervention (T1), immediately after intervention (T2), two to four weeks after childbirth (T3) and 16-20 weeks after childbirth (T4). Both intention-to-treat and per-protocol analyses were conducted. The courses were provided by trained midwives. Participants included 141 pregnant women and 120 partners. MBCP comprised a nine-weekly three-hour session mindfulness group course for pregnant couples; ECAU consisted of two 90-minute individual couple consultation sessions. Measures of psychological well-being included measures like stress, depression, anxiety and fatigue. Measures of pregnancy and birth experience concerned experiencing uplifts during pregnancy, experienced fear of childbirth, labour pain and satisfaction with childbirth. No differences between MBCP and ECAU in the total group of birthing women were found. However, women with (at least an onset of) labour that participated in MBCP reported a better birth experience compared to ECAU at T3. Concerning the total partner group only one difference between MBCP and ECAU was found at T4; MBCP partners reported an increase in fatigue. However, in the partner risk group (i.e., partners with lower psychological well-being before intervention) partners experienced better psychological well-being at T2 and T3 after MBCP than ECAU. MBCP and ECAU demonstrate similar effects on psychological well-being, birth and pregnancy experience. However, MBCP appears superior to ECAU for labouring women in having a better childbirth experience and for partners at risk for psychological complaints in increasing their psychological well-being. MBCP only positively affects the childbirth experience of those who experience (onset of) natural birth. It might be advisable to include partners at risk for psychological complaints in the MBCP. [ABSTRACT FROM AUTHOR]

Animal models of osteoarthritis (OA) are essential tools for investigating the development of the disease on a more rapid timeline than human OA. Mice are particularly useful due to the plethora of genetically modified or inbred mouse strains available. The majority of available mouse models of OA use a joint injury or other acute insult to initiate joint degeneration, representing post-traumatic osteoarthritis (PTOA). However, no consensus exists on which injury methods are most translatable to human OA. Currently, surgical injury methods are most commonly used for studies of OA in mice; however, these methods may have confounding effects due to the surgical/invasive injury procedure itself, rather than the targeted joint injury. Non-invasive injury methods avoid this complication by mechanically inducing a joint injury externally, without breaking the skin or disrupting the joint. In this regard, non-invasive injury models may be crucial for investigating early adaptive processes initiated at the time of injury, and may be more representative of human OA in which injury is induced mechanically. A small number of non-invasive mouse models of PTOA have been described within the last few years, including intra-articular fracture of tibial subchondral bone, cyclic tibial compression loading of articular cartilage, and anterior cruciate ligament (ACL) rupture via tibial compression overload. This review describes the methods used to induce joint injury in each of these non-invasive models, and presents the findings of studies utilizing these models. Altogether, these non-invasive mouse models represent a unique and important spectrum of animal models for studying different aspects of PTOA. [ABSTRACT FROM AUTHOR]

This systematic review examined the clinical and hemodynamic performance of the stentless Freedom SOLO (Sorin Group, Milan, Italy) aortic bioprosthesis. The occurrence of postoperative thrombocytopenia was also analyzed. The Freedom SOLO is safe to use in everyday practice, with short cross-clamp times, and postoperative pacemaker implantation is notably lower. Valvular gradients are low and remain stable during short-term follow-up. Thrombocytopenia is more severe than in other aortic prostheses; however, this is without clinical consequences. Within a few years, the 15-year follow-up of this bioprosthesis will be known, which will be key to evaluating its long-term durability. [ABSTRACT FROM AUTHOR]

This study assessed the capability of Crangon crangon (L.), an ecologically and commercially important crustacean, of consuming plastics as an opportunistic feeder. We therefore determined the microplastic content of shrimp in shallow water habitats of the Channel area and Southern part of the North Sea. Synthetic fibers ranging from 200 μm up to 1000 μm size were detected in 63% of the assessed shrimp and an average value of 0.68 ± 0.55 microplastics/g w. w. (1.23 ± 0.99 microplastics/shrimp) was obtained for shrimp in the sampled area. The assessment revealed no spatial patterns in plastic ingestion, but temporal differences were reported. The microplastic uptake was significantly higher in October compared to March. The results suggest that microplastics >20 μm are not able to translocate into the tissues. [ABSTRACT FROM AUTHOR]

Objectives The majority of football injuries are caused by trauma to the lower extremities. Shinguards are considered an important measure in preventing lower leg impact abrasions, contusions and fractures. Given these benefits, Fédération Internationale de Football Association introduced the shinguard law in 1990, which made wearing shinguards during matches mandatory. This study evaluated the effect of the introduction of the shinguard law for amateur players in the Netherlands in the 1999/2000-football season on the incidence of lower leg injuries. Design Time trend analyses on injury data covering 25 years of continuous registration (1986–2010). Methods Data were retrieved from a system that records all emergency department treatments in a random, representative sample of Dutch hospitals. All injuries sustained in football by patients aged 6–65 years were included, except for injuries of the Achilles tendon and Weber fractures. Time trends were analysed with multiple regression analyses; a model was fitted consisting of multiple straight lines, each representing a 5-year period. Results Patients were predominantly males (92%) and treated for fractures (48%) or abrasions/contusions (52%) to the lower leg. The incidence of lower leg football injuries decreased significantly following the introduction of the shinguard law (1996–2000: −20%; 2001–2005: −25%), whereas the incidence of all other football injuries did not. This effect was more prominent at weekends/match days. No gender differences were found. Conclusions The results significantly show a preventive effect of the shinguard law underlining the relevance of rule changes as a preventive measure and wearing shinguards during both matches and training sessions. [ABSTRACT FROM AUTHOR]

Background & Aims Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies (interval CRC). Methods We collected data from 1273 patients with ulcerative colitis or Crohn's disease, enrolled in a surveillance program at 7 hospitals in The Netherlands, who underwent 4327 surveillance colonoscopies from January 1, 2000, through January 1, 2014. Patients were followed up from their first surveillance colonoscopy until the last surveillance colonoscopy, colectomy, or CRC. Factors that might have contributed to the occurrence of CRC were categorized as inadequate procedures (ie, inadequate bowel preparation), inadequate surveillance (CRC occurring outside the appropriate surveillance interval), or inadequate management of dysplasia (CRC diagnosed in the same colonic segment as a previous diagnosis of dysplasia). The remaining CRC cases were classified as true interval CRCs. Results CRC was diagnosed in 17 patients (1.3%), with an incidence of 2.5 per 1000 years of follow-up evaluation. Factors that might account for the occurrence of CRC were identified in 12 patients (70%). These were inadequate colonoscopies in 4 patients (24%), inadequate surveillance intervals in 9 patients (53%), and inadequate management of dysplasia in 2 patients (12%). The remaining 5 cases of CRC (30%) were classified as true interval CRCs. Conclusions In a retrospective analysis of patients with inflammatory bowel disease participating in a surveillance program, the incidence of CRC was only 1%, which supports the implementation of longer surveillance intervals. However, the fact that 30% of CRC cases were interval cancers indicates the need for variable surveillance intervals based on risk factors for CRC. [ABSTRACT FROM AUTHOR]

Practitioners and scientists dealing with urban water management call for a transition to adaptive regimes. Transition management theories claim that to induce transitions, new forms of research are necessary which cut across traditional disciplinary, organizational and sectoral boundaries. Are such current calls for collaboration reflected in a fundamental change in scientific practices at the international level? This paper explores whether we witness cross-boundary interactions in professional networks and changes in the knowledge production towards more collaborative patterns in urban water science. To this end, we investigate both the professional interaction network at an international congress and the development of scientific output over the last two decades, using social network and bibliometric techniques. The results suggest that the professional interactions indeed reflect the cross-boundary interactions needed for a transition. However, the emerging patterns in scientific output do not indicate an actual system level shift towards a new mode of knowledge production. [ABSTRACT FROM AUTHOR]

Summary Objective This study aimed to determine external and endonasal deformity, and satisfaction with nasal functioning and appearance, in Treacher Collins syndrome. Study design A cross-sectional cohort study was conducted. Methods Eleven adult patients with Treacher Collins syndrome were compared with 151 controls in terms of satisfaction with nasal functioning and appearance by means of the Nasal Appearance and Function Evaluation Questionnaire. In all patients with Treacher Collins syndrome, external nasal deformities were scored on standardized digital photographs of the nose as rated independently by three experienced physicians. Endonasal deformity was determined by standardized nasal endoscopy. Results The patients were relatively satisfied with the various esthetic nasal subunits. The most significant functional problems were snoring ( P = 0.001) and quality of phonation ( P = 0.003). The main external nasal deformities were the dorsal hump (73%), external deviation (≤55%), the bifid or bulbous nasal tip (55%), and columellar septal luxation (55%). In 82% of the patients, a septal deviation was found, often associated with spurs. Conclusion Satisfaction with esthetics of the nose was fair, but these patients suffer from the functional problems of snoring and impaired quality of phonation. A structured nasal ENT physical examination with nasal endoscopy might determine aspects requiring more attention during treatment. Septorhinoplasty can be performed at an adult age if there is a considerable esthetic wish of the patient and/or nasal obstruction combined with septal deviation. Attention should be paid to dorsal hump reduction, correction of the deviated external osseous framework, septoplasty, and correction of the nasal tip shape. Level of evidence : 2b [ABSTRACT FROM AUTHOR]

There is little anteroposterior growth of the midface in patients with syndromic craniosynostosis who are followed up over time without intervention. A Le Fort III with distraction osteogenesis can be done to correct this. This is a controlled way in which to achieve appreciable stable advancement of the midface without the need for bone grafting, but the vector of the movement is not always predictable. The purpose of this study was to evaluate the 3-dimensional effect of Le Fort III distraction osteogenesis with an external frame. Ten patients (aged 7–19 years) who had the procedure were included in the study. The le Fort III procedure and the placement of the external frame were followed by an activation period and then a 3-month retention period. Computed tomographic (CT) images taken before and after operation were converted and loaded into 3-dimensional image rendering software and compared with the aid of a paired sample t test and a colour-coded qualitative analysis. Comparison of the CT data before and after distraction indicated that the amount of midface advancement was significant. Le Fort III distraction osteogenesis is an effective way to advance the midface. However, the movement during osteogenesis is not always exactly in the intended direction, and a secondary operation is often necessary. Three-dimensional evaluation over a longer period of time is necessary. [ABSTRACT FROM AUTHOR]