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Abstract As plastic pollution exists in aquatic ecosystems globally, monitoring its abundance and distribution has become crucial for understanding transport pathways, sources, sinks, and impacts. Riverbanks are accumulation zones for plastic, but the selection of monitoring methods is constrained by research goals, available resources, and site-specific conditions. This diversity in approaches has led to disparate datasets, highlighting the need for standardized monitoring protocols. Here, we study the spatial distribution of plastic at the riverbank scale, quantify the uncertainty of existing riverbank methods, and provide recommendations for improved monitoring based on the balance between uncertainty loss and increase in effort. We measured riverbank plastic abundance at eight Dutch riverbanks, categorizing the items using 108 item categories (River-OSPAR). For every riverbank, an area of 100 by 25 meters was subdivided into five-by-five-meter squares, resulting in 100 individual monitored sub-areas. We found riverbank plastic exhibited high spatial variability, with deposition patterns ranging from parallel to the waterline to clustered, random, or uniform (Moran’s I between -0.050 and 0.301). Individual measurements from diverse sampling protocols are 5-49 times less accurate than estimates derived from extensive sampling, highlighting the diminishing impact of specific methods with increased data collection. Lastly, our findings suggest that increasing the sampling area quickly reaches diminishing returns in terms of accuracy. Reducing the sampled area by 80% only increases the uncertainty in estimating the true plastic density by 20%. While standardized protocols are essential for data comparability, a rigid, uniform sampling approach may be less efficient and resource-intensive than a flexible (step-wise) strategy that adapts to local conditions. By demonstrating that extensive sampling can mitigate the differences between unique sampling protocols, this study promotes a shift towards flexible and efficient riverbank plastic monitoring, ultimately accelerating global efforts to combat plastic pollution.

Latent growth curve modeling was used to investigate the longitudinal link between attachment, effortful control (EC), and maladaptive development during middle childhood. In a community sample, children (Time 1: n = 157; M[subscript age] = 10.91) and their mothers were examined three times over a two-year period. Attachment was operationalized at a more strategic (self-reported trust in maternal support) and more automatic level (secure base script knowledge). Mothers reported about children's EC and maladjustment. Secure attachment was associated with higher EC, but EC development was only linked with baseline self-reported trust. Also, EC indirectly linked baseline self-reported trust with change in externalizing and internalizing problems over time. In addition, self-reported trust was indirectly linked with change in externalizing problems over time through EC development. EC, and, less robustly, EC development were linked with attachment and change in emotional and behavioral problems.

Increasing mental health issues, such as emotional problems, pose a threat for the academic performance of undergraduate students. We propose a route connecting emotional problems and academic performance through executive functioning skills (EFS). Despite the abundance of research on the topic of EFS, there is a significant gap in understanding this route, specifically among a population of undergraduate students. The aim of this study was to examine whether EFS mediated the association between emotional problems and academic performance among undergraduate students. Cross-sectional data (n = 2,531) was used from a survey among Dutch undergraduate students from a large variety of faculties at a university of applied sciences. We assessed emotional problems using the Depression Anxiety Stress Scale-21, five EFS (cognitive inhibition, task initiation, sustained attention, planning, time management), and academic performance (study delay; yes/no). Mediation analyses were performed, using the Hayes PROCESS macro, adjusted for gender. We found that cognitive inhibition, task initiation, sustained attention, planning, and time management mediated the association between emotional problems and academic performance. Regarding separate EFS, no large differences were found. The data suggests that improving all EFS in undergraduates experiencing emotional problems could be a fruitful strategy for preventing academic delays.

Abstract During the July 2021 European floods approximately eight million empty dairy packaging (buttertubs) were flushed from a dairy processing facility in Belgium into the Vesdre river. Some were transported further downstream, into the Ourthe river and eventually the Meuse river. There are many unknowns when it comes to plastic transport in rivers, especially in response to floods. We therefore used this incident as an unique opportunity to study these buttertubs as a tracer for plastic transport dynamics in a riverine environment in response to an extreme flood event. Normally, it is unknown when and where individual plastic items found on riverbanks entered the environment. In this case, however, the ID stamps on the buttertups allowed for them to be traced back to the flooding of the factory. We studied the transport and deposition of these buttertubs in the Dutch Meuse over 2 years following the flood. We also collected buttertubs at different points in time to investigate their fragmentation and mass loss. Within 3 weeks of the flood, the buttertubs were transported up to 328 km from the spilling location. Overall, the majority (78%) of buttertubs we found within the first 3 weeks were deposited within less than 100 km of the point of emission. Over the following 2 years, the mean transport distance of the found buttertubs moved downstream from 100 km in July/August 2021, to 153 km in July 2023. The buttertubs average transport velocity decreased from 11.7 km/d within the first 3 weeks, to 0.2 km/d by July 2023. Based on the 89 buttertubs we collected and analyzed in detail over the 2 years, we did not find a significant mass loss. Of all 89 buttertubs found, 47 showed cracks and only 12 appeared to have pieces missing. This study shows that even during extreme flood events, the majority of spilled plastic litter is retained within a limited distance after being emitted into the river. The findings of this study can be utilized to improve plastic transport modelling, and overall better understand plastic transport in the freshwater environment.

Abstract Since the COVID-19 pandemic, the interest in RNA-lipid nanoparticle (LNP) based drug products has increased drastically. While one RNA-LNP drug product, Onpattro, was already on the market in 2018, high volume manufacturing was only initiated end of 2020 with the approval of the mRNA-LNP vaccines, Comirnaty and Spikevax. As such, deep product knowledge for RNA-LNPs is continuously increasing. In this article the effect of large-scale mixing and lab-scale shaking on mRNA-LNP drug product quality characteristics is investigated. It is shown that mixing and shaking can have a profound impact on both LNP size distribution and mRNA encapsulation, suggesting a direct correlation between both quality characteristics, and further supported by a proposed underlying mechanism. An in-depth investigation of different drug product (DP) presentations reveals a consistent effect of headspace volume and LNP content on the shaking stress sensitivity. Results reported in this study are of utter importance for both small- and large-scale manufacturers but also for care givers and patients using these products.

Abstract Background Mental health literacy (MHL) is crucial for early recognition of and coping with mental health problems, and for the use and acceptance of mental health services, leading to better health outcomes, especially in adolescence. The prevalence of mental health problems among adolescents is seen as a major public health concern and MHL is an important factor in facilitating positive mental health outcomes. However, the availability of valid measurement instruments for assessing the multifaceted nature of MHL is limited, hindering the ability to make meaningful comparisons across studies. The Knowledge and Attitudes to Mental Health Scales (KAMHS) is a promising comprehensive instrument for measuring adolescents’ mental health literacy but its psychometric properties have not been explored in any other contexts than the Welsh. The aim of this study was to translate the KAMHS into Dutch, adapt it in this context, and evaluate its psychometric properties. Methods We performed a cross-sectional study with Dutch adolescents between the ages 11–16. We translated the KAHMS and assessed its content validity using cognitive interviewing with n = 16 adolescents. Next, n = 406 adolescents were asked to fill in the translated KAMHS-NL and reference scales, on mental health (SDQ and WHO-5), resilience (BRS), and mental health help-seeking behaviors. We assessed construct validity based on a priori hypotheses regarding convergent and divergent correlations between subscales of KAMHS-NL and the reference scales. Finally, we assessed structural validity via confirmatory factor analysis and exploratory structural equation modeling. Results The KAMHS-NL showed good content validity and satisfactory construct validity. In total, 28 of the 48 hypotheses regarding convergent and divergent correlations between the KAMHS and reference scales were confirmed. Contrary to our expectations, weak, but significant associations were found between MHL and resilience. The KAMHS showed an acceptable to good internal consistency (McDonald’s omega ranging from 0.62 to 0.84). Finally, we could generally confirm the postulated structure of the KAMHS-NL in the Dutch sample with a 5-factor solution (RMSEA = 0.033; CFI = 0.96). Conclusions The Dutch version of the KAMHS is a valid measure for detecting differences in MHL levels in adolescents. The KAMHS is a promising instrument for assessing MHL in adolescents in a multifaceted manner in other countries which may facilitate rigorous global MHL research. The instrument therefore deserves further validation research in other settings and comparisons across various cultural contexts.

Automated vehicles (AVs) may require the implementation of an external human-machine interface (eHMI) to communicate their intentions to human-driven vehicles. The optimal placement of the eHMI, either on the AV itself or as part of the road infrastructure, remains undetermined. The current driving simulator study investigated the effect of eHMI positioning on human driving behavior, during the approach and execution of right turns at T-intersections. Forty-three participants drove under three conditions: absence of eHMI, eHMI on the AV (eHMIv), and eHMI integrated into the infrastructure (eHMIi). Participants encountered AVs that either yielded or did not yield to their vehicles. The results regarding the placement of the eHMI showed that both concepts are advantageous, but for different reasons. eHMIv was appreciated because implicit and explicit communication are congruent, although the AV must first be visually identified to respond to it. eHMIi was appreciated because a familiar cue is always at a known location in the environment; as a result, participants braked earlier for the intersection and came less close to the AV (which can be interpreted as a safety advantage or efficiency disadvantage). Although there are limitations to a driving simulator study like this, this research provides important insights into the fundamental question of how information placement affects drivers’ visual attention demands and driving behavior, topics that are important in view of the development of future cities.

Abstract Background Infection with SARS-CoV-2 in high-risk groups such as kidney transplant and dialysis patients is shown to be associated with a more serious course of the disease. Four years after the start of the COVID-19 pandemic, crucial knowledge on the immune responses in these patient groups is still lacking. Therefore, this study aimed at investigating the humoral immune response after a SARS-CoV-2 infection compared to vaccination as well as the evolution of immunoglobulins over time. Methods Kidney transplant recipients, patients on haemodialysis or on peritoneal dialysis and healthy controls were included in this longitudinal multicenter study. SARS-CoV-2 anti-RBD, anti-NP and anti-S1S2 immunoglobulin G (IgG) and A (IgA) as well as the neutralizing antibody capacity were measured. Results Kidney transplant recipients had a significantly better humoral response to SARS-CoV-2 after infection (86.4%) than after a two-dose mRNA vaccination (55.8%) while seroconversion was comparable in patients on haemodialysis after infection (95.8%) versus vaccination (89.4%). In individuals without prior COVID-19, the IgG levels after vaccination were significantly lower in kidney transplant recipients when compared to all other groups. However, the IgA titres remained the highest in this patient group at each time point, both after infection and vaccination. A history COVID-19 was associated with higher antibody levels after double-dose vaccination in all patient categories and, while decreasing, titres remained high six months after double-dose vaccination. Conclusion Kidney transplant recipients had a more robust humoral response to SARS-CoV-2 following infection compared to a two-dose mRNA vaccination, while patients on haemodialysis exhibited comparable seroconversion rates. Notably, individuals with prior COVID-19 exhibited higher IgG levels in response to vaccination. Hybrid immunity is thus the best possible defence against severe COVID-19 disease and seems also to hold up for these populations. Next, it is not clear whether the higher IgA levels in the kidney transplant recipients is beneficial for neutralizing SARS-CoV-2 or if it is a sign of disease severity.

Background The applicability of quantitative flow ratio (QFR), a nonhyperemic, invasive coronary angiography‐derived computation of fractional flow reserve (FFR), has not been studied in coronary artery bypass grafts. We sought to explore the correlation and diagnostic agreement between QFR and FFR in saphenous vein grafts (SVGs). Methods and Results A total of 129 prospectively included patients (mean age 73±8 years, 84% male) with prior coronary artery bypass grafting underwent invasive coronary angiography and pressure‐derived functional assessment in 150 nonoccluded SVGs. QFR dedicated angiography images of the SVGs were acquired and used for offline QFR computation. The diagnostic performance of QFR was compared with 2‐dimensional quantitative coronary angiography, using FFR as a reference. A threshold of ≤0.80 was used to define functional significance. QFR was successfully computed in 140 (93%) SVGs. We found a significant correlation between QFR and FFR (r=0.72, P

Background: After 3 months of anticoagulation for venous thromboembolism (VTE), the decision needs to be made whether to stop anticoagulation or extend treatment indefinitely. The VTE-PREDICT calculator can be used to estimate individual risks of VTE recurrence and bleeding to guide this decision. Objectives: To evaluate the impact of predicted individual risks of recurrence and bleeding on clinicians’ decisions on anticoagulation duration and to assess usefulness of the VTE-PREDICT calculator. Methods: A randomized controlled trial and within-subject study was conducted among clinicians treating VTE patients. The clinicians were asked to complete an online survey containing 6 fictional case vignettes. Group A proposed anticoagulant duration for each case without additional information first and subsequently after seeing calculator-predicted risks (within-subject analysis). Group B was directly provided with calculator risks and proposed treatment duration for each case vignette (for comparison with group A results in a randomized controlled trial analysis). Then, group B received questions on usefulness and credibility of the calculator. Results: Forty-five clinicians were assigned to group A and 48 to B. Overall, group A did not propose different anticoagulation durations than group B. However, individual clinicians in group A changed proposed duration in 35% of the cases after seeing the calculator risks. The calculator was considered useful and credible by most clinicians. Conclusion: Overall, use of the VTE-PREDICT calculator did not affect proposed anticoagulation duration. However, individual clinicians frequently changed their proposed duration after using the calculator, especially for patients with high bleeding risk.