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Contains fulltext : 305683.pdf (Publisher’s version ) (Open Access)

01 februari 2023, Item does not contain fulltext, Transgender women may opt for genital gender-affirming surgery (gGAS), which comprises bilateral orchiectomy, gender-affirming vulvoplasty, or vaginoplasty. Vaginoplasty is chosen most frequently in this population, penile inversion vaginoplasty being the surgical gold standard. In selected cases, skin graft vaginoplasty, intestinal vaginoplasty, or peritoneal vaginoplasty may be indicated. In this article, we discuss the various types of gGAS for transgender women, (contra)-indications, intraoperative considerations, techniques, surgical outcomes, and postoperative patient-reported outcomes.

Dit essay is een pleidooi voor de landschapsecologie. Landschapsecologie is essentieel voor alle ruimtelijke uitdagingen en transities waar we voor staan. De internationale context van het werkveld is belangrijk, voor de gezamenlijke aanpak van uitdagingen, maar ook voor co-creëren van kennis en inzichten. Het tijdschrift Landschap heeft altijd een belangrijke rol in deze ontwikkeling gehad, maar naast Landschap en de Werkgemeenschap Landschapsecologisch Onderzoek (WLO) speelt ook de internationale landschapsecologische vereniging IALE een rol.

Individual activity is related to the health, welfare and performance of broilers. In previous work using a radio frequency identification system, we were able to collect individual activity data over time, and activity was found to be heritable. The aim of the current study was to estimate genetic parameters for activity while taking into account the effect of age. Therefore, two repeated measurement models were fitted. The model with an intercept and slope for genetic and permanent environmental effect, and a heterogeneous residual variance, yielded the best goodness-of-fit. First results showed that daily heritability varied between 7 and 30%. The heritability was lowest at the start and at the end of the production life. This study shows potential for selection on activity in broilers. Furthermore, this study shows that activity patterns (in time) can be changed, as both the intercept and slope of activity are heritable.

Animal behaviour is complex and comparing average levels of behavioural activities is sometimes insufficient to pick up on behavioural differences between (groups of) animals. Entropy, a measure of the randomness or regularity of time series, might help us to describe aspects of behaviour better. In this study, we determined daily entropy in individual broiler activity levels over time, based on a time series of observed activity per 15 minutes across a day, to assess individual variation and consistency in entropy of activity. Activity data for calculation of entropy were available for 79 broilers for a maximum of 21 days. We observed individual variation in entropy between broilers, but the level of entropy was not very consistent across days. The individual variation in entropy indicates potential for future research to look into whether and how entropy differences relate to other traits in broilers.

Fast-growing broilers are relatively inactive and this is thought to be a result of selection for high growth rates. This reduced activity level is considered a major cause of leg weakness and associated leg health problems. Increased activity, especially early in life, is suggested to have positive effects on leg health, but the relationship between early activity and growth is unclear. A clearer understanding of the relationship between activity early in life and body weight gain could help determine how selecting on increased early activity could affect body weight gain in broilers. Here, a radio frequency identification (RFID) tracking system was implemented to record daily individual broiler activity throughout life, in 5 production rounds. As mean activity levels alone do not capture the variation in activity over time, multiple (dynamic) descriptors of activity were determined based on the individual birds’ daily distances moved, focusing on the period from 0 to 15 days old. The mean, skewness, root mean square error (RMSE), autocorrelation, and entropy of (deviations in) activity were determined at the individual level, as well as the average daily gain (ADG). Relationships between activity descriptors and ADG were determined for 318 birds. Both when combining the data from the different production rounds and when taking production round and start weight into account, a negative relationship between ADG and RMSE was observed, indicating that birds that were more variable in their activity levels had a lower ADG. However, the activity descriptors, in combination with recording round and start weight, explained only a small part (8%) of the variation in ADG. Therefore, it is recommended for future research to also record other factors affecting ADG (e.g., type of feed provided and feed intake) and to model growth curves. Overall, this study suggests that increasing early activity does not necessarily negatively affect body weight gain. This could contribute to

The Job Shop Problem is a well-studied scheduling problem which is proven to be NP-Hard. The Job Shop Problem consists of a set of jobs and a set of machines. For each job, one activity has to be processed on each machine and the order in which the activities have to be executed is predetermined for each job. The goal is to choose an ordering of activities for each machine such that the makespan is minimized. Approximation methods seem to work quite well at finding good solutions fast, but exact methods have trouble finding optima, especially for the bigger instances. In this thesis, we look at two exact methods for the Job Shop Problem, Branch-and-bound and Constraint Programming, and we test whether combining these two techniques reduces the amount of time needed to solve instances of the Job Shop Problem. To efficiently do this, we created new branching structures which make use of Constraint Programming in their choice of the next branch and then propagate the consequences of these choices. We found that adding Constraint Programming to a Branch-and-bound algorithm improves its efficiently by a lot, but calculating lower bounds in each node of a Constraint Programming algorithm has little effect and in some cases it even slows down the algorithm. A possible reason for this result is that both the edge-finding Constraint Propagation technique and the preemptive one-machine relaxation make use of the Jackson Preemptive Schedule in their calculations. Since the latter is used in cutting of branches of the search tree, it is possible that it is dominated by the Constraint Propagation techniques.

Item does not contain fulltext, BACKGROUND: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) are critical in determining subsequent treatment. Endoscopic full-thickness resection (eFTR) is a new treatment option for T1 CRC < 2 cm. We aimed to report clinical outcomes and short-term results. METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analyzed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk assessment, curative resection, adverse events, and short-term outcomes. RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection, and curative resection rates were 87.0 % (95 % confidence interval [CI] 82.7 %-90.3 %), 85.6 % (95 %CI 81.2 %-89.2 %), and 60.3 % (95 %CI 54.7 %-65.7 %). Curative resection rate was 23.7 % (95 %CI 15.9 %-33.6 %) for primary resection of T1 CRC and 60.8 % (95 %CI 50.4 %-70.4 %) after excluding deep submucosal invasion as a risk factor. Risk stratification was possible in 99.3 %. The severe adverse event rate was 2.2 %. Additional oncological surgery was performed in 49/320 (15.3 %), with residual cancer in 11/49 (22.4 %). Endoscopic follow-up was available in 200/242 (82.6 %), with a median of 4 months and residual cancer in 1 (0.5 %) following an incomplete resection. CONCLUSIONS: eFTR is relatively safe and effective for resection of small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

Contains fulltext : 253294.pdf (Publisher’s version ) (Open Access)

In dit informatieblad wordt de werking van bait sprays uitgelegd en staan tips voor hun toepassing voor de bestrijding van suzuki fruitvlieg in zachtfruit.

Contains fulltext : 244816.pdf (Publisher’s version ) (Open Access), BACKGROUND: Current treatment strategies have been designed to improve survival in locally advanced gastric cancer patients. Besides its impact on survival, treatment also affects health-related quality of life (HRQOL), but an overview of reported studies is currently lacking. The aim of this systematic review was therefore to determine the short- and long-term impact of chemotherapy, surgery, and (chemo)radiotherapy on HRQOL in locally advanced, non-metastatic gastric cancer patients. METHODS: A systematic review was performed including studies published between January 2000 and February 2021. We extracted studies published in Medline, Embase, and Scopus databases that assessed HRQOL in patients with locally advanced, non-metastatic gastric cancer treated with curative intent. Studies using non-validated HRQOL questionnaires were excluded. Short-term and long-term HRQOL were defined as HRQOL scores within and beyond 6 months after treatment, respectively. RESULTS: Initially, we identified 8705 articles (4037 of which were duplicates, i.e., 46%) and ultimately included 10 articles. Most studies reported that short-term HRQOL worsened in the follow-up period from 6 weeks to 3 months after surgery. However, recovery of HRQOL to preoperative levels occurred after 6 months. After completion of chemoradiotherapy, the same pattern was seen with worse HRQOL after treatment and a recovery of HRQOL after 6-12 months. CONCLUSIONS: In patients with locally advanced, non-metastatic gastric cancer, HRQOL deteriorated during the first 3 months after surgery and chemoradiotherapy. However, the long-term data showed a recovery of HRQOL after 6-12 months. To implement HRQOL in clinical decision making in current clinical practice, more research is needed.

Item does not contain fulltext, BACKGROUND: Esophagectomy is a technically challenging procedure, associated with significant morbidity. The introduction of minimally invasive esophagectomy (MIE) has reduced postoperative morbidity. OBJECTIVE: Although the short-term effect on complications is increasingly being recognized, the impact on long-term survival remains unclear. This study aims to investigate the association between postoperative complications following MIE and long-term survival. METHODS: Data were collected from the EsoBenchmark Collaborative composed by 13 high-volume, expert centers routinely performing MIE. Patients operated between June 1, 2011 and May 31, 2016 were included. Complications were graded using the Clavien-Dindo (CD) classification. To correct for short-term effects of postoperative complications on mortality, patients who died within 90 days postoperative were excluded. Primary endpoint was 5-year overall survival. RESULTS: A total of 915 patients were included with a mean follow-up time of 30.8 months (standard deviation 17.9). Complications occurred in 542 patients (59.2%) of which 50.2% had a CD grade ≥III complication [ie, (re)intervention, organ dysfunction, or death]. The incidence of anastomotic leakage (AL) was 135 of 915 patients (14.8%) of which 84 patients were classified as a CD grade ≥III. Multivariable analysis showed a significantly deteriorated long-term survival in all patients with AL [hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.25-2.24]. This inverse relation was most distinct when AL was scored as a CD grade ≥III (HR 1.83, 95% CI 1.30-2.58). For all other complications, no significant association with long-term survival was found. CONCLUSION: The occurrence and severity of AL, but not overall complications, after MIE negatively affect long-term survival of esophageal cancer patients.

Contains fulltext : 232404.pdf (Publisher’s version ) (Open Access), Background. To gain insight into the current state-of-the-art of shared decision making (SDM) during decisions related to pre and postoperative care process regarding primary total knee replacement (TKR). Methods. A scoping review was performed to synthesize existing scientific research regarding (1) decisional needs and preferences of patients preparing for, undergoing and recovering from TKR surgery, (2) the relation between TKR decision-support interventions and SDM elements (i.e., team talk, option talk, and decision talk), (3) the extent to which TKR decision-support interventions address patients' decisional needs and preferences. Results. 2526 articles were identified, of which 17 articles met the inclusion criteria. Of the 17 articles, ten had a qualitative study design and seven had a quantitative study design. All included articles focused on the decision whether to undergo TKR surgery or not. Ten articles (all qualitative) examined patients' decisional needs and preferences. From these, we identified four domains that affected the patients' decision to undergo TKR: (1) personal factors, (2) external factors, (3) information sources and (4) preferences towards outcome prediction. Seven studies (5) randomized controlled trials and 2 cohort studies) used quantitative analyses to probe the effect of decision aids on SDM and/or clinical outcomes. In general, existing decision aids did not appear to be tailored to patient needs and preferences, nor were the principles of SDM well-articulated in the design of decision aids. Conclusions. SDM in TKR care is understudied; existing research appears to be narrow in scope with limited relevance to established SDM principles and the decisional needs of patients undertaking TKR surgery.

Contains fulltext : 236985.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, OBJECTIVES: The reasons for tooth extraction are rarely recorded in epidemiological datasets. It poses a diagnostic challenge to determine if tooth loss is related to periodontal disease (TLPD). The present study aimed to assess the inter-tooth relationships based on the periodontal characteristics of existing teeth. METHODS: A cross-sectional dataset of 8,978 participants with complete periodontal examination (including probing pocket depth [PPD] and clinical attachment loss [CAL]) in the NHANES 2009-2014 was used in this study. Spearman rank correlation was applied to assess the inter-tooth correlations of PPD/CAL among 28 teeth after adjustment for relevant confounders. We further verify our findings in the Java Project on Periodontal Disease with TLPD information available (the number of TLPD = 12). RESULTS: Strong PPD/CAL correlations were observed in adjacent teeth (r for PPD = 0.652, r for CAL = 0.597; false discovery rate [FDR] <0.05) rather than those on non-adjacent teeth (r for PPD = 0.515, r for CAL = 0.476; FDR <0.05). The correlations increased among severe periodontitis cases (CAL ≥5 mm or PPD ≥6 mm). In line with this, we further observed that the teeth adjacent to the TLPD tooth had the most alveolar bone loss in the Java dataset. CONCLUSION: The periodontitis parameters (PPD/CAL) of adjacent teeth could be a potential indicator to estimate TLPD when actual reasons for tooth extraction are unknown. CLINICAL SIGNIFICANCE: Periodontally compromised teeth adjacent to a lost tooth may help estimate whether the loss could be related to periodontal disease when the actual extraction reasons are unknown.

Deze memo adresseert de vraag waar de kansen liggen om zeewier in te zetten voor de productie van nutritionele en functionele eiwitten, rekening houdend met de thans gangbare eiwitbronnen, de ontwikkelingen op het gebied van eiwitextractie en opkomende alternatieven eiwitten.

De uiterwaarden van de grote rivieren vertegenwoordigen een succesverhaal van natuurontwikkeling. Toch kunnen we voor veel kenmerkende diersoorten van het rivierecosysteem nog niet rekenen op duurzame populaties, zeker niet bij de te verwachten klimaatverandering. Het aanpassen van het landgebruik tot grote, aaneengesloten natuurgebieden (hotspots) langs de grote rivieren kan mogelijk aanzienlijke winst opleveren. Dit artikel verkent de bijdrage van vier van deze hotspots in 2050 voor een aantal riviergebonden gidssoorten met behulp van metapopulatiemodellering.