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Background: Patients diagnosed with radioiodine refractory (RAI-R) thyroid carcinoma (TC) have a significantly worse prognosis than patients with radiosensitive TC. These refractory malignancies are often dedifferentiated, hindering the effectiveness of iodine-based imaging. Additionally, the role of metabolic imaging using [18F]FDG PET/CT is also limited in these cases, making adequate staging of RAI-R TC challenging. Recent case series have shown promising results regarding the role of the prostate-specific membrane antigen (PSMA) in TC. In this study we explored the value of [18F]AlF-PSMA-11 PET/CT in RAI-R TC. Methods: In this phase II study, lesions detected on [18F]AlF-PSMA-11 PET were compared to findings from [18F]FDG PET/CT. Additionally, the serologic soluble prostate-specific membrane antigen (sPSMA) was measured using ELISA. PSMA-expression on tumor tissue in any available resection specimens was analysed with an immunostainer. Results: Eight patients were included, with a total of 39 identified lesions based on PET imaging. [18F]AlF-PSMA-11 PET identified 30 of 39 lesions, and [18F]FDG PET identified 33 lesions, leading to a detection rate of 76.9% and 84.6%, respectively. Interestingly, while nine lesions were solely visualized on [18F]FDG, six were uniquely seen on [18F]AlF-PSMA-11 PET. While sPSMA was immeasurable in all female patients, no correlation was found between sPSMA in male patients and disease-related factors. In five out of eight patients immunohistology showed PSMA expression on the primary tumor. Conclusions: Although not all lesions could be visualized, [18F]PSMA-11 PET identified multiple lesions imperceptible on [18F]FDG PET. These results display the potential additional diagnostic role of PSMA-targeted imaging in patients with RAI-R TC. Trial registration number No. EudraCT 2021-000456-19. [ABSTRACT FROM AUTHOR]

AbstractWhen students enter university, they become increasingly accountable for their own learning. Feedback and self-reflection processes are an important part of this. Therefore, the primary aim of this mixed methods study is to contribute to the understanding of how feedback literacy and self-reflection can be measured, interact, and support each other in the learning process. The study uses reflective logs, self-reflection course grades, the Feedback Orientation Scale, and the Self-Reflection and Insight Scale to follow-up on engineering students during their first year at university. In general, a positive relation is observed between feedback literacy and self-reflection, as well as growth during the first year at university, as evidenced through students’ reflective logs. These findings support earlier research and echo the call to promote reflection about feedback to enhance student feedback literacy. As these observations were not supported by the measurement scales, it is suggested that if the goal is to assess actual engagement rather than students’ intentions, the scales should be used with caution. [ABSTRACT FROM AUTHOR]

Aim: Anal fistula is one of the most common anal diseases, affecting between 1 and 3 per 10 000 people per year. Symptoms have a potentially severe effect on a patient's quality of life. Surgery is the mainstay of treatment, aiming to cure the fistula and preserve anal sphincter function. Rectal advancement flap (RAF) is currently the gold standard treatment but has recurrence rates varying between 20% and 50% and might lead to disturbance of continence. The aim of the trial described in this work is to discover if the minimally invasive fistula tract laser closure (FiLaC™) technique could achieve higher healing rates and a better functional outcome than RAF. Method: We will perform a randomized prospective multicentre noninferiority study of the treatment of high trans‐sphincteric perianal fistulas, comparing FiLaC™ with RAF in terms of fistula healing, recurrence rate, functional outcome and quality of life. Primary and secondary fistula healing will be evaluated at 26 and 52 weeks' follow‐up. Quality of life will be evaluated using the SF‐36 questionnaire, the Faecal Incontinence Quality of Life Scale questionnaire and the Vaizey score at 3, 6, 12 and 26 weeks postoperatively. Conclusion: High trans‐sphincteric fistulas have a potentially severe effect on a patient's quality of life. Classical treatment with RAF is a time‐consuming invasive procedure. The LATFIA trial aims to compare FiLaC™ with the gold standard treatment with RAF. In case of noninferiority, FiLaC™ treatment could be standardized as a first line treatment for high trans‐sphincteric fistulas. Better conservation of the patient's anal sphincter function could possibly be obtained. Likewise, we will report on the postoperative quality of life when applying these two techniques. [ABSTRACT FROM AUTHOR]

To investigate the differences in outcome of CRT with three-weekly cisplatin (100mg/m2, cis100) versus weekly (40mg/m2, cis40) cisplatin in the treatment of locally advanced (LA) HNSCC in a real-world setting. A retrospective chart review in a tertiary care facility in Ghent, Belgium, including all patients with LA HNSCC treated with concurrent cisplatin-based CRT, whether adjuvant or definite, from 2011-2022. Patients were treated with intensity-modulated radiotherapy (IMRT) or volumetric-arc radiotherapy (VMAT) using simultaneous integrated boost. Definite treatment comprised 32x2.16 Gy to the primary tumor and involved lymph nodes, and 56 Gy to elective neck nodes. Adjuvant treatment comprised 32x2.16 Gy (after R1 or R2 resection or ENE) or 33x2Gy on tumor bed and 56 Gy on elective neck nodes. Patients who underwent neoadjuvant chemotherapy, had other histologic subtypes or who received prior irradiation for HNSCC were excluded. The primary outcomes were disease-free survival (DFS) and overall survival (OS). Secondary outcomes were 3-month locoregional control (LRC) measured as first response evaluation, treatment completion and grade 3-5 toxicity according to the CTCAE v5.0. Survival analyses were performed via the Kaplan-Meier method using the log-rank test. Independent outcomes were assessed at the 0.05 significance level. 220 patients were included (162 cis40, 58 cis100). Median duration of follow-up was 66 months. Patient characterstics and outcomes are summarized in Table 1. Median OS and DFS were numerically longer in the cis100 group, although this difference was not statistically significant (mOS 83.6m vs 64.7m, p=0.316; mDFS NR vs 50.3m, p=0.125). First response evaluation showed no significant differences between the two groups (see table 1). Less patients completeted the full dose of prescribed radiotherapy in the cis40 group (93% vs 100%, p=0.07) although this was not significant. Mean cumulative dose of cisplatin was similar between groups. Toxicity analysis showed higher rates of ototoxicity (29 vs 7%, p<0.001) and gr 3-4 acute kidney failure (15.6vs 4.9%, p<0.05) and in the cis100 group, although this did not translate into increased chronic kidney impairment in the cis100 group. We observed more hematologic toxicity in the cis40 group (see table 1). [Display omitted] [Display omitted] [Display omitted] In this retrospective single-centre study, high dose cisplatin was associated with a trend to improved survival outcomes compared to weekly cisplatin. We observed an increase in Gr 3-4 acute kidney injury and ototoxicity in the cis-100 group, and more hematotoxicity in the cis40 group. [ABSTRACT FROM AUTHOR]

Echo intensity determined by muscle ultrasound has been proposed as an efficient method for the assessment of muscle quality. The influence of changing ultrasound parameter settings on echo intensity values was assessed using a standardized approach. In this repeated measures cross-sectional study, sixteen repeated scans of rectus femoris, gracilis, and rectus abdominis were taken in 21 middle-aged persons with a portable Mindray M7 premium ultrasound machine equipped with a linear 5.0–10.0 MHz transducer. The settings of three parameters were fixed: gain, depth, and frequency. The settings of the following adjustable parameters were changed over their entire range: dynamic range, gray map, line density, persistence, and IClear. Repeated measures analyses were performed to evaluate the effect of changing the settings on echo intensity values. In all three muscles, dynamic range, gray map, and IClear correlated significantly (rrm-values ranging between −0.86 and 0.45) with echo intensity. In all three muscles, the echo intensity values differed significantly across the dynamic range (p < 0.013), gray map (p < 0.003), and IClear (p < 0.003). In middle-aged subjects, echo intensity values of lower limb and trunk muscles are significantly related to ultrasound parameters and significantly differ across their respective setting range. For the assessment of muscle quality through ultrasound, it is suggested to fix parameter settings within their midrange in order to minimize the effect of setting-dependent factors on EI values. [ABSTRACT FROM AUTHOR]

With its subsidy retention fund, the city of Ghent targets homeowners, who live in a dwelling of bad quality and do not have the resources to renovate or move out. Being in this no-choice situation, they are locked-in homeowners. Through this innovative policy instrument, Ghent aims to improve the quality of its housing stock targeting households who may not take up other renovation-encouraging instruments. To reach the households who would otherwise not be able to renovate, important efforts in outreaching and offering technical and social guidance accompany the renovation subsidy. Guidance activities substantially increase the cost of the instrument, but in reaching the households living in bad-quality houses, it has the potential to create major benefits not only technically but also socially as housing quality is related to well-being. Generally, the identification of a causal relationship is difficult as well-being and its mediators are complex matters. This case offered a unique opportunity to collect information from the beneficiaries on a range of well-being domains both before the renovation of their dwelling and after the renovation. Even though the research was restricted to short-term effects, the results suggest that improvements in different domains of well-being can be linked to the improvement of housing quality. These improvements in well-being in Ghent show that (local) government spending in housing renovation of locked-in homeowners can be an instrument to achieve social progress. [ABSTRACT FROM AUTHOR]

Purpose: The impact of perineal descent (PD) on functional outcome and quality of life after ventral mesh rectopexy (VMR) is unknown. The purpose of this study was to analyze the effect of PD on the functional outcome and quality of life (QOL) after VMR. Methods: A retrospective analysis was performed on fifty-five patients who underwent robotic VMR between 2018 and 2021. Pre and postoperative data along with radiological studies were gathered from a prospectively maintained database. The Cleveland Clinic Constipation score (CCCS), the Rome IV criteria and the 36-Item Short-Form Health Survey (SF-36), were used to measure functional results and QOL. Results: All 55 patients (mean age 57.8 years) were female. Most patients had radiological findings of severe PD (n = 31) as opposed to mild/moderate PD (n = 24). CCCS significantly improved at 3 months and 1 year post-VMR (mean difference = -4.4 and -5.4 respectively, p < 0.001) with no significant difference between the two groups. The percentage of functional constipation Rome IV criteria only showed an improved outcome at 3 months for severe PD and at 1 year for mild/moderate PD (difference = -58.1% and -54.2% respectively, p < 0.05). Only the SF-36 subscale bodily pain significantly improved in the mild/moderate PD group (mean difference = 16.7, p = 0.002) 3 months post-VMR which subsided after one year (mean difference = 5.5, p = 0.068). Conclusion: Severe PD may impact the functional outcome of constipation without an evident effect on QOL after VMR. The results, however, remain inconclusive and further research is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Isolated recurrence in remnants of the seminal vesicles (SV) after treatment of primary prostate cancer (PCa) has become a more frequent entity with the widespread use of more sensitive next-generation imaging modalities. Salvage vesiculectomy is hypothesized to be a worthwhile management option in these patients. The primary goal of this study is to describe the surgical technique of this new treatment option. Secondary outcomes are peri- and post-operative complications and early oncological outcomes. Methods: Retrospective multicenter study, including 108 patients with solitary recurrence in the SV treated between January 2009 and June 2022, was performed. Patients with local recurrences outside the SVs or with metastatic disease were excluded. Both SVs were resected using a robot-assisted or an open approach. In selected cases, a concomitant lymphadenectomy was performed. Results: Overall, 31 patients (29%) reported complications, all but one grade 1 to 3 on the Clavien–Dindo Scale. A median PSA decrease of 2.07 ng/ml (IQR: 0.80–4.33, p < 0.001), translating into a median PSA reduction of 92% (IQR: 59–98%) was observed. At a median follow-up of 14 months, freedom from secondary treatment was 54%. Lymphadenectomy had a significant influence on PSA reduction (p = 0.018). Conclusion: Salvage vesiculectomy for PCa recurrence limited to the SV is a safe procedure with excellent PSA response and is a potential curative treatment in a subset of patients. A concomitant lymphadenectomy can best be performed in all patients that did not underwent one at primary treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study is to systematically review the literature about available devices facilitating perineal support during defecation in patients with obstructive defecation syndrome (ODS) and posterior pelvic organ prolapse (POP). Methods: We searched for the terms "defecat/ion or ODS" and" pessar/ies or device/aid/tool/perineal/perianal/prolapse and support" in MEDLINE, PubMed and Web of Science. Data abstraction was performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis) guidelines. A two-stage inclusion was performed, selecting first on title and abstract and secondly the full text. For variables with sufficient data, a meta-analysis was performed using a random-effects model. Other variables were descriptively reported. Results: Ten studies out of 1332 were included for systematic review. The devices could be categorized into three groups: pessaries (n = 8), vaginal stent (n = 1) and external support device (n = 1). Methodology and data reporting is heterogeneous. Meta-analysis could be performed for the Colorectal-Anal Distress Inventory (CRADI-8) and Impact Questionnaire (CRAI-Q-7) in three pessary studies which showed a significant mean change. Significant improvement of stool evacuation was seen in two other pessary studies. The vaginal stent significantly decreases ODS. Subjective perception of constipation improved significantly using the posterior perineal support device. Conclusion: All reviewed devices seem to improve ODS in patients with POP. There are no data on their efficacy with regard to perineal descent-associated ODS. There is a lack of comparative studies between devices. Studies are difficult to compare due to different inclusion criteria and evaluation tools. [ABSTRACT FROM AUTHOR]

• Maxwell's equations, the Lorenz gauge, and the Dirac equation are discretized on new and existing space-time stencils. • The stability condition of the minimally-coupled Dirac equation is derived. • A novel, multiphysics finite-difference time-domain method for the fully-coupled Maxwell-Dirac equations is proposed. • The advocated method is verified by performing an accuracy test, as well as a comparison with an existing solver. • Two physical systems show the conservation of probability and energy, and the applicability of the method. The recent development of nanoelectronic devices that incorporate Dirac materials has highly increased the need for adequate simulation and modelling tools. This paper introduces an accurate, multiphysics finite-difference time-domain method to solve the pertinent Maxwell-Dirac equations. The stability criterion for the Dirac equation with electromagnetic fields is derived, which reduces to the Courant-Friedrichs-Lewy condition in the absence of electromagnetic fields. Validation examples show the second-order accuracy of the novel fully coupled Maxwell-Dirac scheme and illustrate that total norm and energy are caonserved within a relative error of order 10 − 4. The method is applied to a ZrTe 5 waveguide and it is found that even at low field strengths, the charge carriers can be accelerated to 80% of the Fermi velocity. Furthermore, the flexibility of the advocated method allows for the seamless integration into existing computational electromagnetics frameworks and the possible extension to higher-order schemes. [ABSTRACT FROM AUTHOR]

First-year university students are confronted with a different culture of feedback than they were used to in secondary education. Since the emphasis at university is mainly on independent learning, students need to fulfil the role of a self-regulated learner and need to develop feedback literacy to make use of the multitude of feedback opportunities. In this study, reflective logs were used to capture first-year engineering students' most impactful feedback experiences. It was demonstrated that reflective logs are a valuable instrument to provide insight into students' feedback literacy. Moreover, a significant association between the reflection level and the presence of the different feedback literacy characteristics was found. Although most of the students acknowledge the basic understandings of feedback, only about half of the reflective logs point to a more advanced use of feedback opportunities. The lack of some specific characteristics suggest that students behold a teacher-centred view of feedback. Therefore, it is important to explicitly introduce them to the contemporary learner-centred definitions of feedback so that they can recognise the variety of feedback opportunities. The study further endorses that developing reflective skills can be an important precursor to feedback literacy. [ABSTRACT FROM AUTHOR]

Measuring muscle quantity and quality is very important because the loss of muscle quantity and quality is associated with several adverse effects specifically in older people. Ultrasound is a method widely used to measure muscle quantity and quality. One problem with ultrasound is its limited field of view, which makes it impossible to measure the muscle quantity and quality of certain muscles. In this study, we aimed to evaluate the intra- and inter-rater reliability of extended-field-of-view (EFOV) ultrasound for the measurement of muscle quantity and quality in nine muscles of the limbs and trunk. Two examiners took two ultrasound EFOV images with a linear probe from each of the muscle sites. The intraclass correlation coefficient (ICC) was used, and the standard error of measurement and coefficient of variation were calculated. Intra-rater reliability was good to excellent (ICC = 0.2–1.00) for all muscle measurements. The inter-rater reliability for most of the muscle measurements was good to excellent (ICC = 0.82–0.98). Inter-rater reliability was moderate (0.58–0.72) for some muscle quantity measurements of the tibialis anterior, gastrocnemius, rectus femoris, biceps femoris and triceps brachii muscles. Muscle quantity and quality can be measured reliably using EFOV US. [ABSTRACT FROM AUTHOR]

A study performed in a large sexually transmitted infection clinic in Antwerp, Belgium, demonstrated that automated rapid plasma reagin testing on the AIX1000 system shows a similar performance to the manually performed Macro-Vue RPR Card Test, except for a negative deviation for high-titer samples. Background: Manually performed nontreponemal assays, such as rapid plasma reagin (RPR), are labor intensive and time consuming. Recently, commercial automated RPR assays gained attention. The aim of this study was to compare the qualitative and quantitative performance of the AIX1000 (RPR-A; Gold Standard Diagnostics) to a manual RPR test (RPR-M; Becton Dickinson Macrovue) within a high-prevalence setting. Methods: A retrospective panel of 223 samples was selected for comparison between RPR-A and RPR-M, including 24 samples from patients with known syphilis stages and 57 samples from 11 patients in follow-up. In addition, 127 samples obtained during routine syphilis diagnosis with RPR-M were analyzed prospectively with AIX1000. Results: Overall qualitative concordance (percent agreement) between both assays was 92.0% in the retrospective and 89.0% in the prospective panel. Of 32 discordances, 28 were explained by a treated syphilis infection still positive in one assay and already negative in the other. One sample was false positive with RPR-A, 1 infection remained undetected by RPR-M, and 2 remained undetected by RPR-A. A hook effect was apparent on the AIX1000 at RPR-A titers from 1:32 onward; however, no infections were missed. Accepting a ±1 titer difference, quantitative concordance between both assays reached 73.1% and 98.4% for the retrospective and prospective panels, respectively, with an upper limit of reactivity for RPR-A at 1:256. Conclusions: The AIX1000 showed a similar performance to Macrovue RPR with the exception of a negative deviation for high-titer samples. Within the reverse algorithm used in our high-prevalence setting, AIX1000's main advantage is automation. [ABSTRACT FROM AUTHOR]

The informal transport sector has various ambivalent characteristics and often a negative connotation since it commonly operates unauthorized and illicitly and is not part of the official transport sector. However, the informal sector provides a mix of legitimate transport offerings as well as important complementary services. The paper focuses on these 'new mobilities' and aims to understand informal transportation systems not only as a service coverage in specific areas lacking formal transit, but also as an activity that arises as a popular form of struggle and a covert and unorganized form of resistance against the political power embedded in dominant transportation systems. Through an empirical study conducted in the region of Urabá in Colombia the paper explores how the dominant agricultural industries in the region are causing huge challenges related to the overlap of transportation scales, congestion and risks of accidents in urban areas, affecting urban development, and how injustices of the existing public transport services and insufficient road infrastructures trigger the production of informal transportation. The paper mobilizes the theory of 'everyday forms of resistance', which draws attention to certain common behaviour and activities of subaltern groups as tactics to survive and undermine repressive domination. As such, this paper questions through its case study to what extent the informal transportation actions in Urabá are in a way challenging oppression and can be called an everyday form of resistance. [ABSTRACT FROM AUTHOR]

The focus of this study is the implications of structural transformation for gender equality, specifically equal pay, in Sub-Saharan Africa. While structural transformation affects key development outcomes, including growth, poverty, and access to decent work, its effect on the gender pay gap is not clear ex-ante. Evidence on the gender pay gap in sub-Saharan Africa is limited, and often excludes rural areas and informal (self-)employment. This paper provides evidence on the extent and drivers of the gender pay gap in non-farm wage- and self-employment activities across three countries at different stages of structural transformation (Malawi, Tanzania and Nigeria). The analysis leverages nationally-representative survey data and decomposition methods, and is conducted separately among individuals residing in rural versus urban areas in each country. The results show that women earn 40 to 46 percent less than men in urban areas, which is substantially less than in high-income countries. The gender pay gap in rural areas ranges from (a statistically insignificant) 12 percent in Tanzania to 77 percent in Nigeria. In all rural areas, a major share of the gender pay gap (81 percent in Malawi, 83 percent in Tanzania and 70 percent in Nigeria) is explained by differences in workers' characteristics, including education, occupation and sector. This suggests that if rural men and women had similar characteristics, most of the gender pay gap would disappear. Country-differences are larger across urban areas, where differences in characteristics account for only 32 percent of the pay gap in Tanzania, 50 percent in Malawi and 81 percent in Nigeria. Our detailed decomposition results suggest that structural transformation does not consistently help bridge the gender pay gap. Gender-sensitive policies are required to ensure equal pay for men and women. [ABSTRACT FROM AUTHOR]

Congenital Stationary Night Blindness (CSNB) constitutes a group of non-progressive retinal disorders characterized by disturbances in scotopic vision and/or by a delay in adaptation to darkness, as well as by low visual acuity, myopia, nystagmus, and strabismus. Color vision and fundus appearance tend to be normal. To date, several CACNA1F gene variants have been linked to a CSNB phenotype but only few reports have focused on the optic nerve in this disease. Twelve patients underwent standard ophthalmological and genetic evaluation including spectral domain optical coherence tomography (SD-OCT), full-field electroretinography (ffERG), kinetic perimetry, fundus photography, magnetic resonance imaging (MRI), and next-generation sequencing (NGS). Bilateral thinning of the peripapillary nerve fiber layer (pRNFL) and the ganglion cell complex (GCC) supported involvement of the optic nerves. MRI, when available, was assessed for gross intracranial optic pathway abnormalities. All patients were shown to carry pathogenic variants in the CACNA1F gene, and all showed signs of optic nerve involvement. All patients showed a certain degree of myopic refractive error. Low average pRNFL thickness was evident in all patients. In three of them, pRNFL thickness was evaluated longitudinally and was proven to be stable over time. MRI imaging was unremarkable in all cases. Our data support the hypothesis that CACNA1F could be related to early-onset or congenital optic nerve involvement without any signs of a progressive optic neuropathy. Even though additional data from larger cohorts and longer follow-up periods are needed to further support and confirm our findings, there is a clear significance to our findings in the preparation for future CACNA1F gene therapy trials. [ABSTRACT FROM AUTHOR]

Abstract Aiming to offer persons with disabilities more opportunities to live independently and more inclusively, Flanders radically revised its subsidies for care and care infrastructure for persons with disabilities. Since 2017, subsidies for care are no longer allocated to care providers, but directly to the person with disabilities as a Personal Care Budget (PCB). In 2018, up-front bricks-and-mortar subsidies for care infrastructure were replaced with subsidies granted upon effective use of the accommodation and varying with the user’s specific needs. The results of surveys of PCB holders, licensed care providers and social housing providers suggest that on average receiving a PCB stimulated persons with disabilities to move, had a positive impact on housing quality outcomes for those who moved, and triggered changes in the provision of housing. On the other hand, housing costs for users increased and the positive effects on housing choice may be hampered by issues of housing supply. Effects differed according to the context and characteristics of the persons involved. Apart from these findings on the effects of more demand-driven subsidies, the study provides insight into the cross-policy effects of subsidies and therefore stresses the need for a more transversal approach in policy-making and research. [ABSTRACT FROM AUTHOR]

Recent research has increasingly been studying the long-lasting effects of secondary education structures and processes on higher education (HE) outcomes. While the influence of socioeconomic composition on higher education enrolment is established, the underlying mechanisms remain unclear. We posit that the composition effect partially runs through the educational expectations of the students' peers at school. By considering shared post-secondary expectations among students within a school – or, peer expectation culture – we transcend the dominant individual approach to expectations. Additionally, we go beyond the supposed positive (i.e. normative) effects of peers on HE enrolment, by considering the negative effects of having ambitious peers on HE enrolment resulting from comparative group processes. Logistic multilevel analyses of longitudinal data (2013–2019) from 1250 students across 30 Flemish high schools showed that socio-economic status (SES) composition effects on HE outcomes were mediated by expectation culture. Students attending schools with high expectation cultures were more likely to attend HE in general, and to attend university over other HE institutes compared to students in schools with low expectation cultures. The results suggest normative effects of peers on both outcomes, while comparative processes were only found for the choice of institution. This study underscores the long-term consequences of both individual and school-level expectations in secondary education and calls for including comparative reference group effects in studies on educational decision-making. [ABSTRACT FROM AUTHOR]

Purpose: Does 15-minute consult using Motivational Interviewing (MI) have a positive effect on (1) time until return to work (RTW) and relapse after work resumption for patients who have been work disabled for longer than 3 months, and (2) can psychological variables (i.e., work-related motivation, work-related psychological needs, quality of life and work ability) explain these results?Methods: 265 patients were included in a pilot randomized controlled trial, parallel and single blind, with an allocation ratio of 1:1 comparing the consult with MI with the consult as usual group (CAU). There was a 12-month follow up on actual RTW and relapse for both groups. The psychological outcomes were work-related motivation (MAWS), work-related psychological needs (BPNSFS), quality of life (EQ5D5L)) and work ability (WAI). Measurement of these indicators took place at baseline, 1 week after the intervention and 3 months after the intervention.Results: Patients in the MI group showed faster RTW and had a lower chance of relapse compared to those in the CAU condition. No significant differences were found between MI and CAU for the psychological outcomes.Conclusions: Based on our results, there is some evidence that counseling including MI helps work-disabled patients to RTW faster and experience less relapse. However, much remains unknown about the underlying psychological mechanisms explaining this effect. Suggestions are made for the full RCT. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Women with a symptomatic rectocele may undergo different trajectories depending on the specialty consulted. This survey aims to evaluate potential differences between colorectal surgeons and gynecologists concerning the management of a rectocele. Methods: A web-based survey was sent to abdominal surgeons (CS group) and gynecologists (G group) asking about their perceived definition, diagnostic workup, multidisciplinary discussion (MDT) and surgical treatment of rectoceles. The answers of both groups were analyzed with the chi-square test or Fisher's exact test at p < 0.050. Results: A rectocele was defined as a prolapse of the posterior vaginal wall by 78% of the G and 41% of the CS group. All gynecologists and 49% of the CS group evaluated a rectocele clinically in dorsal decubitus, with 91% of gynecologists using a speculum and 65% using the Pelvic Organ Prolapse-Quantification (POP-Q) scoring system, compared to < 1/3 of colorectal surgeons. A digital rectal examination was performed by 90% of the CS group and 57% of the G group. A transvaginal ultrasound was only used by the G group, while anal manometry was opted for by the CS group (65%) and minimally by the G group (14%). In the G group, a posterior repair was the preferred surgical technique (78%), whereas 63% of the CS group preferred a rectopexy. Multidisciplinary discussions (MDT) were mostly organized ad hoc. Conclusions: An availability bias is seen in different aspects of rectocele evaluation and treatment. Colorectal surgeons and gynecologists are acting based on their training and experience. Motivation for pelvic floor MDT starts with creating awareness of the availability bias. [ABSTRACT FROM AUTHOR]

Historical land cover (LC) maps are an essential instrument for studying long-term spatio-temporal changes of the landscape. However, manual labelling on low-quality monochromatic historical orthophotos for semantic segmentation (pixel-level classification) is particularly challenging and time consuming. Therefore, this paper proposes a methodology for the automated extraction of very-high-resolution (VHR) multi-class LC maps from historical orthophotos under the absence of target-specific ground truth annotations. The methodology builds on recent evolutions in deep learning, leveraging domain adaptation and transfer learning. First, an unpaired image-to-image (I2I) translation between a source domain (recent RGB image of high quality, annotations available) and the target domain (historical monochromatic image of low quality, no annotations available) is learned using a conditional generative adversarial network (GAN). Second, a state-of-the-art fully convolutional network (FCN) for semantic segmentation is pre-trained on a large annotated RGB earth observation (EO) dataset that is converted to the target domain using the I2I function. Third, the FCN is fine-tuned using self-annotated data on a recent RGB orthophoto of the study area under consideration, after conversion using again the I2I function. The methodology is tested on a new custom dataset: the 'Sagalassos historical land cover dataset', which consists of three historical monochromatic orthophotos (1971, 1981, 1992) and one recent RGB orthophoto (2015) of VHR (0.3–0.84 m GSD) all capturing the same greater area around Sagalassos archaeological site (Turkey), and corresponding manually created annotations (2.7 km² per orthophoto) distinguishing 14 different LC classes. Furthermore, a comprehensive overview of open-source annotated EO datasets for multiclass semantic segmentation is provided, based on which an appropriate pretraining dataset can be selected. Results indicate that the proposed methodology is effective, increasing the mean intersection over union by 27.2% when using domain adaptation, and by 13.0% when using domain pretraining, and that transferring weights from a model pretrained on a dataset closer to the target domain is preferred. [ABSTRACT FROM AUTHOR]

In this work, an important step is taken towards the bioavailability improvement of poorly water-soluble drugs, such as flubendazole (Flu), posing a challenge in the current development of many novel oral-administrable therapeutics. Solvent electrospinning of a solution of the drug and poly (2-ethyl-2-oxazoline) (PEtOx) is demonstrated to be a viable strategy to produce stable nanofibrous amorphous solid dispersions (ASDs) with ultrahigh drug-loadings (up to 55 wt% Flu) and long-term stability (at least one year). Importantly, at such high drug loadings, the concentration of the polymer in the electrospinning solution has to be lowered below the concentration where it can be spun in absence of the drug as the interactions between the polymer and the drug result in increased solution viscosity. A combination of experimental analysis and molecular dynamics simulations revealed that this formulation strategy provides strong, dominant and highly stable hydrogen bonds between the polymer and the drug, which is crucial to obtain the high drug-loadings and to preserve the long-term amorphous character of the ASDs upon storage. In vitro drug release studies confirm the remarkable potential of this electrospinning formulation strategy by significantly increased drug solubility values and dissolution rates (respectively tripled and quadrupled compared to the crystalline drug), even after storing the formulation for one year. [Display omitted] • High drug loadings are achieved by lowering the polymer concentration below spinning concentrations of pure PEtOx • Molecular modeling of realistic ASDs reveal kinetic entrapment of drug molecules • Strong, dominant and highly stable Flu-PEtOx hydrogen bonds are experimentally and computationally revealed to be present • ASDs are proven to be stable for at least one year, demonstrating long-term stability • Significant increase of in vitro drug solubility values and dissolution rates is obtained [ABSTRACT FROM AUTHOR]

Dynamic forces generated by human locomotion, including walking, jumping and running, can lead to excessive vibrations of slender structures and result in severe vibration serviceability issues. This has led to the development of load and prediction models. For running, however, the existing load models are limited to single person load models calibrated on a rigid surface. The aim of this study is to address this gap by exploring the influence of low-frequency vertical vibrations on the running motion, known as active human–structure interaction. A measurement campaign was conducted using a transportable measurement setup that was placed on both a rigid and a vibrating surface. The results demonstrate the presence of active human–structure interaction during running on a vertical vibrating surface. Key findings include changes of the peak contact forces influenced by the relative phase and frequency difference between the runner and the structure. • Treadmill running tests were conducted on a rigid and vertical vibrating surface. • A method to analyze the running gait on a vibrating surface is proposed. • No active guidance of the pacing rate is observed. • The frequency difference between runner and structure determines the contact force. • An influence range of active human–structure interaction for running is determined. [ABSTRACT FROM AUTHOR]

The article focuses on the discovery of a hybrid Leishmania parasite in Costa Rica, which shares genetic similarities with hybrids found in Panama. Topics include the genetic analysis of the hybrid, its triploid nature, and the identification of L. braziliensis and L. guyanensis as the parent strains.

The article presents a study which established long-term cell viability for bioprinted Arabidopsis and soybean cells. Topics discussed include demonstration of the maintenance of three-dimensional (3D) bioprinted Arabidopsis root cells, applicability of 3D bioprinting toward plant cell regeneration, and identity maintenance of 3D bioprinting root cells.

The roofscape plays a vital role in the support of sustainable urban planning and development. However, availability of detailed and up-to-date information on the level of individual roof-part topology remains a bottleneck for reliable assessment of its present status and future potential. Motivated by the need for automation, the current state-of-the-art focuses on applying deep learning techniques for roof-plane segmentation from light-detection-and-ranging (LiDAR) point clouds, but fails to deliver on criteria such as scalability, spatial predictive continuity, and vectorization for use in geographic information systems (GISs). Therefore, this paper proposes a fully automated end-to-end workflow capable of extracting large-scale continuous polygon maps of roof-part instances from ultra-high-resolution (UHR) aerial imagery. In summary, the workflow consists of three main steps: (1) use a multitask fully convolutional network (FCN) to infer semantic roof-part edges and objects, (2) extract distinct closed shapes given the edges and objects, and (3) vectorize to obtain roof-part polygons. The methodology is trained and tested on a challenging dataset comprising of UHR aerial RGB orthoimagery (0.03 m GSD) and LiDAR-derived digital elevation models (DEMs) (0.25 m GSD) of three Belgian urban areas (including the famous touristic city of Bruges). We argue that UHR optical imagery may provide a competing alternative for this task over classically used LiDAR data, and investigate the added value of combining these two data sources. Further, we conduct an ablation study to optimize various components of the workflow, reaching a final panoptic quality of 54.8% (segmentation quality = 87.7%, recognition quality = 62.6%). In combination with human validation, our methodology can provide automated support for the efficient and detailed mapping of roofscapes. [ABSTRACT FROM AUTHOR]

This study investigated the influence of several covariates on the time and sequence of deciduous dentition emergence in puppies. Data were obtained in a longitudinal study, with some cross‐sectional observations, of 1001 puppies of 53 dog breeds. A parametric proportional hazards survival model was used to estimate median emergence time and evaluate the effect of the covariates. No significant differences were found between the left and right sides of a puppy's dentition, but differences were statistically significant for the earlier appearance of maxillary incisors and canines and later appearance of maxillary premolars compared with their mandibular counterparts. The tendency for delayed onset and completion of emergence in female compared to male puppies was statistically but not clinically significant. The differences between puppies of breeds of different size or skull type were both statistically and clinically significant, with small and brachycephalic breeds showing later emergence times, longer clinical eruption times and more individual variation. Per quadrant, regardless of dog breed, canines or incisors were usually the first teeth to emerge and fully erupt, followed by premolars in the order Pd3 > 4 > 2. The maxillary canines and incisors usually emerged earlier than mandibular canines. Age estimation standards for breed size groups are presented based on the number of emerged teeth per quadrant. To assess whether a puppy has reached the legally required minimum age of 8 weeks to leave the litter, the best predictive capability using the data from this study is obtained when assessing the emergence status of the deciduous third premolars. [ABSTRACT FROM AUTHOR]

This paper presents a practical and pedagogical model of socially innovative planning based on four dialectical relations between actors, institutions and planning instruments that frame, constitute and position planning actions. The paper illustrates and evaluates this model by analysing four spatial planning studios that took place during the authors’ six-year long engagement in a heavily contested urban renewal project in the city of Antwerp, Belgium. The paper shows how a frame for critical inquiry helped to address changes in the studio and project realities. by understanding, experiencing and responding to the ethical and socio-environmental consequences of spatial planning practice. [ABSTRACT FROM AUTHOR]

Women are often found to be in inferior jobs with lower wages and lower job quality, but to report higher job satisfaction. This gender-job satisfaction paradox is documented for high-income countries and is explained by gender inequality in job quality and expectations. In this paper we document this paradox for a developing country. We explore the complex relationship between gender, job quality and job satisfaction among agro-industry workers in Senegal, using primary data from a comprehensive worker survey. We use a multiple mediation model to disentangle direct and indirect pathways through which gender relates to job satisfaction. We find that women's job satisfaction is higher, despite earning lower wages, receiving fewer nonwage benefits, being more in casual employment, and working fewer hours than men. Moreover, job satisfaction varies more strongly with gender than with worker education, wages or other job quality characteristics. We find that gender inequality in job quality mitigates the positive relationship between gender and job satisfaction, with wage and nonwage benefits as major mediating variables. Our findings imply opposing direct and indirect gender effects on job satisfaction, and bring some nuance in the debate on how reducing gender inequality in job quality may affect women's job satisfaction. [ABSTRACT FROM AUTHOR]

Motivation may predict return to work (RTW), yet the measurement of motivation needs more scientific evidence. We adopt a dimensional approach, based on the self-determination theory (SDT), distinguishing between amotivation, controlled and autonomous motivation. We seek to explore the presence of these dimensions in sick-disabled patients, and are interested in associations with quality of life, depression, patient's predictions of RTW, and health care provider estimations of patient's motivation. A cross-sectional study in 336 patients was conducted. Motivation was assessed using the Motivation at Work Scale (MAWS) and examined in relation to patient outcomes, patient's prediction of RTW, and health care provider estimations of patients' motivation. A cluster analysis was performed, and differential associations between motivational profiles were explored. Cluster analysis revealed four profiles. Highly controlled profiles were most prevalent, reported poorer mental quality of life, and expected a longer time before RTW, regardless of the level of autonomous motivation. Interestingly, the health care provider's estimation was not related to controlled motivation. Our results show that SDT may help to differentiate people with a work disability regarding their motivation to RTW. Most notably, the devastating consequences of controlled motivation are discussed, and clinical implications are provided. Assessing the different dimensions of motivation in the context of RTW will be a significant advance as the self-report measures appear to be viable tools. Controlled motivation, which indicates that people are motivated to RTW but only because they "have to", has negative consequences yet a high prevalence and should therefore be addressed by the practitioner. Practitioners should keep in mind that employees are motivated by several motives at the same time, with some being more beneficial than others. Controlled motivation can be converted into autonomous (i.e., good quality) motivation by supporting autonomy of the patient, by supporting their relationships with colleagues, managers, and health care providers and by supporting their feeling of competence in the RTW process. [ABSTRACT FROM AUTHOR]

Purpose: Gyrate atrophy of the choroid and retina (GACR) is an autosomal recessive inherited metabolic disorder (IMD) characterised by progressive retinal degeneration, leading to severe visual impairment. The rapid developments in ophthalmic genetic therapies warrant knowledge on clinical phenotype of eligible diseases such as GACR to define future therapeutic parameters in clinical trials.Retrospective chart analysis was performed in nineteen patients. Data were analysed using IBM SPSS Statistics version 28.0.1.1.Nineteen patients were included with a mean age of 32.6 years (range 8–58). Mean age at onset of ophthalmic symptoms was 7.9 years (range 3–16). Median logMAR of visual acuity at inclusion was 0.26 (range -0.18–3.00). Mean age at cataract surgery was 28.8 years (n = 11 patients). Mean spherical equivalent of the refractive error was -8.96 (range -20.87 to -2.25). Cystoid maculopathy was present in 68% of patients, with a loss of integrity of the foveal ellipsoid zone (EZ) in 24/38 eyes. Of the 14 patients treated with dietary protein restriction, the four patients who started the diet before age 10 showed most benefit.This study demonstrates the severe ophthalmic disease course associated with GACR, as well as possible benefit of early dietary treatment. In addition to visual loss, patients experience severe myopia, early-onset cataract, and CME. There is a loss of foveal EZ integrity at a young age, emphasising the need for early diagnosis enabling current and future therapeutic interventions.Methods: Gyrate atrophy of the choroid and retina (GACR) is an autosomal recessive inherited metabolic disorder (IMD) characterised by progressive retinal degeneration, leading to severe visual impairment. The rapid developments in ophthalmic genetic therapies warrant knowledge on clinical phenotype of eligible diseases such as GACR to define future therapeutic parameters in clinical trials.Retrospective chart analysis was performed in nineteen patients. Data were analysed using IBM SPSS Statistics version 28.0.1.1.Nineteen patients were included with a mean age of 32.6 years (range 8–58). Mean age at onset of ophthalmic symptoms was 7.9 years (range 3–16). Median logMAR of visual acuity at inclusion was 0.26 (range -0.18–3.00). Mean age at cataract surgery was 28.8 years (n = 11 patients). Mean spherical equivalent of the refractive error was -8.96 (range -20.87 to -2.25). Cystoid maculopathy was present in 68% of patients, with a loss of integrity of the foveal ellipsoid zone (EZ) in 24/38 eyes. Of the 14 patients treated with dietary protein restriction, the four patients who started the diet before age 10 showed most benefit.This study demonstrates the severe ophthalmic disease course associated with GACR, as well as possible benefit of early dietary treatment. In addition to visual loss, patients experience severe myopia, early-onset cataract, and CME. There is a loss of foveal EZ integrity at a young age, emphasising the need for early diagnosis enabling current and future therapeutic interventions.Results: Gyrate atrophy of the choroid and retina (GACR) is an autosomal recessive inherited metabolic disorder (IMD) characterised by progressive retinal degeneration, leading to severe visual impairment. The rapid developments in ophthalmic genetic therapies warrant knowledge on clinical phenotype of eligible diseases such as GACR to define future therapeutic parameters in clinical trials.Retrospective chart analysis was performed in nineteen patients. Data were analysed using IBM SPSS Statistics version 28.0.1.1.Nineteen patients were included with a mean age of 32.6 years (range 8–58). Mean age at onset of ophthalmic symptoms was 7.9 years (range 3–16). Median logMAR of visual acuity at inclusion was 0.26 (range -0.18–3.00). Mean age at cataract surgery was 28.8 years (n = 11 patients). Mean spherical equivalent of the refractive error was -8.96 (range -20.87 to -2.25). Cystoid maculopathy was present in 68% of patients, with a loss of integrity of the foveal ellipsoid zone (EZ) in 24/38 eyes. Of the 14 patients treated with dietary protein restriction, the four patients who started the diet before age 10 showed most benefit.This study demonstrates the severe ophthalmic disease course associated with GACR, as well as possible benefit of early dietary treatment. In addition to visual loss, patients experience severe myopia, early-onset cataract, and CME. There is a loss of foveal EZ integrity at a young age, emphasising the need for early diagnosis enabling current and future therapeutic interventions.Conclusion: Gyrate atrophy of the choroid and retina (GACR) is an autosomal recessive inherited metabolic disorder (IMD) characterised by progressive retinal degeneration, leading to severe visual impairment. The rapid developments in ophthalmic genetic therapies warrant knowledge on clinical phenotype of eligible diseases such as GACR to define future therapeutic parameters in clinical trials.Retrospective chart analysis was performed in nineteen patients. Data were analysed using IBM SPSS Statistics version 28.0.1.1.Nineteen patients were included with a mean age of 32.6 years (range 8–58). Mean age at onset of ophthalmic symptoms was 7.9 years (range 3–16). Median logMAR of visual acuity at inclusion was 0.26 (range -0.18–3.00). Mean age at cataract surgery was 28.8 years (n = 11 patients). Mean spherical equivalent of the refractive error was -8.96 (range -20.87 to -2.25). Cystoid maculopathy was present in 68% of patients, with a loss of integrity of the foveal ellipsoid zone (EZ) in 24/38 eyes. Of the 14 patients treated with dietary protein restriction, the four patients who started the diet before age 10 showed most benefit.This study demonstrates the severe ophthalmic disease course associated with GACR, as well as possible benefit of early dietary treatment. In addition to visual loss, patients experience severe myopia, early-onset cataract, and CME. There is a loss of foveal EZ integrity at a young age, emphasising the need for early diagnosis enabling current and future therapeutic interventions. [ABSTRACT FROM AUTHOR]

All differentiated root cells derive from stem cells spatially organized within the stem cell niche (SCN), a microenvironment located within the root tip. Here, we compiled recent advances in the understanding of how the SCN drives the establishment and maintenance of cell types. The quiescent center (QC) is widely recognized as the primary driver of cell fate determination, but it is recently considered a convergence center of multiple signals. Cell identity of the cortex endodermis initials is mainly driven by the regulatory feedback loops between transcription factors (TFs), acting as mobile signals between neighboring cells, including the QC. As exemplified in the vascular initials, the precise spatial expression of these regulatory TFs is connected with a dynamic hormonal interplay. Thus, stem cell maintenance and cell differentiation are regulated by a plethora of signals forming a complex, multilevel regulatory network. Integrating the transcriptional and post-translational regulations, protein–protein interactions, and mobile signals into models will be fundamental for the comprehensive understanding of SCN maintenance and differentiation. [ABSTRACT FROM AUTHOR]

Age estimation in adult dogs can be performed by the radiographic measurement of the tooth pulp cavity, but the technique has hardly been described. In this study, the application of measuring pulp/tooth width ratios (P/T ratios) of the maxillary canine teeth was investigated. Pulp and tooth widths were measured at two locations on 166 maxillary canine teeth of the heads of 84 dog cadavers, using digital extraoral lateral oblique open mouth radiographs. The dogs belonged to different breeds and sexes and had a known age between 194 and 1907 days (approximately 6 months ‐ 5 years). Both at the cemento‐enamel junction (CE) and the half‐height of the tooth, a comparable non‐linear regression with age was demonstrated. Measuring at the CE location was less hindered by wear or superimposition. No statistically significant difference according to sex and breed size and no clinically significant difference according to skull type was found. The highest predictable capacity was found in the youngest dogs until the age of 448 days, of which 84.4% of the canine teeth had a P/T ratio above 0.39. Our results demonstrate that measuring P/T ratios of canine teeth can be used in practice to assign dogs to age categories, with the highest accuracy in young adult dogs. [ABSTRACT FROM AUTHOR]

The continuation of work that undermines employee well-being necessitates an investigation into the antecedents of work design. Therefore, we examined how autonomy supportive and controlling leadership--as defined in self-determination theory (SDT)--relate to employees' job resources, job demands, and well-being. Using a cross-sectional (N = 501) and a daily diary study (N = 123), we found that autonomy supportive leadership relates to employees' work engagement via job resources both at the between- and within-person levels. However, only the cross-sectional study evidenced a relationship between autonomy supportive leadership and exhaustion via job resources. Controlling leadership related to exhaustion via job demands at the between-person level in both studies but not at the within-person level. Alongside implications for the literature on SDT, work design theory, the leadership literature, and workplace re-enchantment, we advance concomitant insights to practitioners. [ABSTRACT FROM AUTHOR]

Several hypotheses have been proposed to explain the initial steps in the domestication process of the wolf. We discuss the human-initiated model in which wolf pups were brought to camp sites by male hunters and cared for by nursing women. A good relation between the more sociable and playful pups and the women and their children likely formed affiliative bonds and led to the survival of such pups into maturity. Some of these animals could have reproduced and delivered at least one litter. A selection on the behaviour of subsequent generations could ultimately have led to Palaeolithic dogs. [ABSTRACT FROM AUTHOR]

In times of social distancing, we need to adapt some of our research methods. Methodologies in field research can be partly replaced by a combination of online methods, which will often include online interviews. Technologically, there are few limitations to conducting interviews online, but there are side effects to digital mediation: privacy related concerns, technology hiccups, and physical distance may be barriers to disclosure for the interviewee. A survey among master students who had conducted interviews online confirmed these negative effects on the flow of interviews. Barriers to disclosure may be overcome by introducing familiarity and role-sharing. We tested the methodology of duo interviews via online video-calling tool Skype. In duo interviews, two respondents who know each other, interview each other in absence of a researcher. This explorative study investigated the effects of digital mediation on the flow of interviews and possible mitigation by familiarity between interviewer and interviewee. The qualitative study's respondents were mostly experienced interviewers who knew each other well and were also experienced in using online video-calling tools, which reduced the influence of variation in technical and interviewing skills. The focus of the study was on finding conditions for the use of the familiarity strategy in online interviews. While familiarity between interview participants was reported to positively affect disclosure, the use of this method is limited to specific interview purposes. An unexpected finding was that the absent researcher was, in fact, present in the interview due to the element of video-recording. We list recommendations and conditions for conducting duo interviews over online video-calling tools, as well as limitations. [ABSTRACT FROM AUTHOR]

In the quest for 3,3‐dichloro‐β‐lactam building blocks, the serendipitous formation of 2,2‐dichloro‐N‐(chloromethyl)acetamides was observed. This peculiar reactivity was investigated in detail, both experimentally and computationally by means of Density Functional Theory (DFT) calculations. 2,2‐Dichloro‐N‐(chloromethyl)acetamides were thus shown to be formed experimentally through reaction of 2,2‐dichloroacetyl chloride with glyceraldehyde‐derived imines, i. e. (2,2‐dimethyl‐1,3‐dioxolan‐4‐yl)methanimines, bearing aromatic N‐substituents, in the presence as well as in the absence of a base. Deployment of aliphatic imines, however, resulted in complex reaction mixtures, pointing to the importance of a stabilizing aromatic substituent at nitrogen. The DFT results indicate that the substituents can alter the governing equilibria on the one hand and intrinsic barrier heights for the different routes on the other hand, showing that these are controlling the reaction outcome. Furthermore, the 2,2‐dichloro‐N‐(chloromethyl)acetamides proved to be rather unstable in solution and thus difficult to isolate. Nonetheless, their molecular structure was confirmed by means of NMR analysis of several purified analogs and X‐ray study of a 4‐methoxyphenyl derivative. [ABSTRACT FROM AUTHOR]

The impact of surgeon and hospital volume on outcomes after radical prostatectomy (RP) for localised prostate cancer (PCa) remains unknown. To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa. Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. All comparative studies for nonmetastatic PCa patients treated with RP published between January 1990 and May 2020 were included. For inclusion, studies had to compare hospital or surgeon volume, defined as caseload per unit time. Main outcomes included oncological (including prostate-specific antigen persistence, positive surgical margin [PSM], biochemical recurrence, local and distant recurrence, and cancer-specific and overall survival) and nononcological (perioperative complications including need for blood transfusion, conversion to open procedure and within 90-d death, and continence and erectile function) outcomes. Risk of bias (RoB) and confounding assessments were undertaken. Both a narrative and a quantitative synthesis were planned if the data allowed. Sixty retrospective comparative studies were included. Generally, increasing surgeon and hospital volumes were associated with lower rates of mortality, PSM, adjuvant or salvage therapies, and perioperative complications. Combining group size cut-offs as used in the included studies, the median threshold for hospital volume at which outcomes start to diverge is 86 (interquartile range [IQR] 35–100) cases per year. In addition, above this threshold, the higher the caseload, the better the outcomes, especially for PSM. RoB and confounding were high for most domains. Higher surgeon and hospital volumes for RP are associated with lower rates of PSMs, adjuvant or salvage therapies, and perioperative complications. This association becomes apparent from a caseload of >86 (IQR 35–100) per year and may further improve hereafter. Both high- and low-volume centres should measure their outcomes, make them publicly available, and improve their quality of care if needed. We reviewed the literature to determine whether the number of prostate cancer operations (radical prostatectomy) performed in a hospital affects the outcomes of surgery. We found that, overall, hospitals with a higher number of operations per year have better outcomes in terms of cancer recurrence and complications during or after hospitalisation. However, it must be noted that surgeons working in hospitals with lower annual operations can still achieve similar or even better outcomes. Therefore, making hospital's outcome data publicly available should be promoted internationally, so that patients can make an informed decision where they want to be treated. Higher surgeon and hospital volumes for radical prostatectomy are associated with lower rates of positive surgical margins, adjuvant or salvage therapies, and perioperative complications. Centres performing radical prostatectomy surgeries should make their outcomes publicly available for benchmarking purposes. [ABSTRACT FROM AUTHOR]

Salmonella enterica serovar Typhimurium strain ATCC14028s is commercially available from multiple national type culture collections, and has been widely used since 1960 for quality control of growth media and experiments on fitness ("laboratory evolution"). ATCC14028s has been implicated in multiple cross-contaminations in the laboratory, and has also caused multiple laboratory infections and one known attempt at bioterrorism. According to hierarchical clustering of 3002 core gene sequences, ATCC14028s belongs to HierCC cluster HC20_373 in which most internal branch lengths are only one to three SNPs long. Many natural Typhimurium isolates from humans, domesticated animals and the environment also belong to HC20_373, and their core genomes are almost indistinguishable from those of laboratory strains. These natural isolates have infected humans in Ireland and Taiwan for decades, and are common in the British Isles as well as the Americas. The isolation history of some of the natural isolates confirms the conclusion that they do not represent recent contamination by the laboratory strain, and 10% carry plasmids or bacteriophages which have been acquired in nature by HGT from unrelated bacteria. We propose that ATCC14028s has repeatedly escaped from the laboratory environment into nature via laboratory accidents or infections, but the escaped micro-lineages have only a limited life span. As a result, there is a genetic gap separating HC20_373 from its closest natural relatives due to a divergence between them in the late 19th century followed by repeated extinction events of escaped HC20_373. Author summary: Clades of closely related bacteria exist in nature. Individual isolates from such clades are often distinguishable by genomic sequencing because genomic sequence differences can be acquired over a few years due to neutral drift and natural selection. The evolution of laboratory strains is often largely frozen, physically due to storage conditions and genetically due to long periods of storage. Thus, laboratory strains can normally be readily distinguished from natural isolates because they show much less diversity. However, laboratory strain ATCC14028s shows modest levels of sequence diversity because it has been shipped around the world to multiple laboratories and is routinely used for analyses of laboratory evolution. Closely related natural isolates also exist, but their genetic diversity is not dramatically greater at the core genome level. Indeed, many scientists doubt that such isolates are natural, and interpret them as undetected contamination by the laboratory strain. We present data indicating that ATCC14028s has repeatedly escaped from the laboratory through inadvertent contamination of the environment, infection of technical staff and deliberate bioterrorism. The escapees survive in nature long enough that some acquire mobile genomic elements by horizontal gene transfer, but eventually they go extinct. As a result, even extensive global databases of natural isolates lack closely related isolates whose ancestors diverged from ATCC14028s within the last 100 years. [ABSTRACT FROM AUTHOR]

In times of social distancing, we need to adapt some of our research methods. Methodologies in field research can be partly replaced by a combination of online methods, which will often include online interviews. Technologically, there are few limitations to conducting interviews online, but there are side effects to digital mediation: privacy related concerns, technology hiccups, and physical distance may be barriers to disclosure for the interviewee. A survey among master students who had conducted interviews online confirmed these negative effects on the flow of interviews. Barriers to disclosure may be overcome by introducing familiarity and role-sharing. We tested the methodology of duo interviews via online video-calling tool Skype. In duo interviews, two respondents who know each other, interview each other in absence of a researcher. This explorative study investigated the effects of digital mediation on the flow of interviews and possible mitigation by familiarity between interviewer and interviewee. The qualitative study's respondents were mostly experienced interviewers who knew each other well and were also experienced in using online video-calling tools, which reduced the influence of variation in technical and interviewing skills. The focus of the study was on finding conditions for the use of the familiarity strategy in online interviews. While familiarity between interview participants was reported to positively affect disclosure, the use of this method is limited to specific interview purposes. An unexpected finding was that the absent researcher was, in fact, present in the interview due to the element of video-recording. We list recommendations and conditions for conducting duo interviews over online video-calling tools, as well as limitations. [ABSTRACT FROM AUTHOR]

[Display omitted] • First observed truely catalytic reductive coupling reaction of imines and iminium ions. • Stability of intermediate imine/iminium ion is critical. • Hydrogen is used for the regeneration of the catalyst. • Catalytic reductive coupling is proven for several different substrates. The first heterogeneously catalyzed process for the reductive coupling of imines and iminium ions is reported using precious metal catalysts in combination with hydrogen gas as the terminal reductant. The optimized method in terms of catalyst composition and reaction conditions allowed to produce aromatic vicinal diamines without the use of stoichiometric amounts of zero or low valent metals, which is currently the preferred method. The most important mechanistic features of the reaction were unraveled by a combined experimental and computational approach. The developed methodology is very efficient for the coupling of aromatic iminium ions with yields up to 88% while imines give only low to moderate yields. [ABSTRACT FROM AUTHOR]

Numerous Aspergillus fumigatus (Af) airborne spores are inhaled daily by humans and animals due to their ubiquitous presence. The interaction between the spores and the respiratory epithelium, as well as its impact on the epithelial barrier function, remains largely unknown. The epithelial barrier protects the respiratory epithelium against viral infections. However, it can be compromised by environmental contaminants such as pollen, thereby increasing susceptibility to respiratory viral infections, including alphaherpesvirus equine herpesvirus type 1 (EHV-1). To determine whether Af spores disrupt the epithelial integrity and enhance susceptibility to viral infections, equine respiratory mucosal ex vivo explants were pretreated with Af spore diffusate, followed by EHV-1 inoculation. Spore proteases were characterized by zymography and identified using mass spectrometry-based proteomics. Proteases of the serine protease, metalloprotease, and aspartic protease groups were identified. Morphological analysis of hematoxylin-eosin (HE)-stained sections of the explants revealed that Af spores induced the desquamation of epithelial cells and a significant increase in intercellular space at high and low concentrations, respectively. The increase in intercellular space in the epithelium caused by Af spore proteases correlated with an increase in EHV-1 infection. Together, our findings demonstrate that Af spore proteases disrupt epithelial integrity, potentially leading to increased viral infection of the respiratory epithelium. [ABSTRACT FROM AUTHOR]

In this article, a family of interleaved high-step-down dc–dc converters is proposed integrating the valley-fill switched capacitor structure and a double-series capacitor Buck converter. This integration generates three converters, which will be extensively explored herein via theoretical and experimental analysis. A complete theoretical analysis of the structures is presented in order to mathematically explain the physical operation of the proposed topologies. A design procedure is presented for the following specifications: 300 V/12 V input to output voltage, 100 W of power and a switching frequency of 100 kHz, and the results obtained are compared to state-of-the-art dc–dc converters that enable similar high-step-down operation. [ABSTRACT FROM AUTHOR]

Infrastructural design, transport and mobility policies are strong instruments for interpreting historical urban and regional transformation processes. The paper addresses the intercausalities between both of them. To do so, it briefly sketches debates on the causalities of transport infrastructure and urbanisation and the theory of technological politics, drawing attention to the relationship between transport infrastructure and politics, and how infrastructures and their techno-political frames include means of power and authority. From there, the paper moves to the debate on the relationship between social justice and transport, showing how transport systems embody social processes and social (in)injustice. The history of agrarian extractivism in the region of Urabá in Colombia serves as a case study. The paper shows how existing transport networks of the region of Urabá have supported the expansion of agrarian extractivist industries and more specifically the production of transport (in)justice. It explores the development of the infrastructural network, transport systems and urbanisation of this region from the early 1900s onwards. Results show how the actual agrarian extractivist industries of the region are causing huge challenges related to the overlapping of transport scales, congestion and risks of accidents in urban areas, and how actual transport dynamics in the region are affecting urban development, generating a high segregation characterised by uneven distributions of public services and transport infrastructures. The paper reveals that the existing transport developments in the region of Urabá have no support for local development and are mainly thought for the efficiency of agrarian extractivist industries over local economic development. Agrarian extractivism has been a consistent factor in the economic, political and social spheres, and since colonial times the appropriation of natural resources and the dispossession of territories has been omnipresent. This paper explores the historical role of transport in agrarian extractivism, the long-term impact of the prolongation of old mechanisms, and the interrelations of the latter with current urbanisation and development. It concludes that infrastructural developments in this region have supported agrarian extractivist industries, first in colonial times, but also more recently, showing the deep embeddedness of the relation between mobility and urbanity in the (agrarian extractivist) development history of this region. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence has shown benefits of spinal manipulations in patients with patellofemoral pain syndrome (PFPS). There is scarcity regarding medium term effects of spinal manual therapy on outcome measures in PFPS patients. Therefore, the aim of the present study was to compare the effectiveness of local exercise therapy and spinal manual therapy for knee pain, function and maximum voluntary peak force (MVPF) velocity of the quadriceps in PFPS patients.Methods: Forty-three patients with PFPS were randomly assigned to a local exercise or spinal manual therapy group. The local exercise group received six sessions (one session per week) of supervised training of the knee-and hip muscles with mobilization of the patellofemoral joint. The spinal manual therapy group received six interventions (one intervention per week) of high velocity low thrust manipulations at the thoracolumbar region, sacroiliac joint, and/or hip. All patients were also asked to do home exercises. Maximum, minimum and current pain were measured using the visual analogue scale. Function was assessed with the anterior knee pain scale (AKPS) and MPFV was recorded using a Biodex System 3 dynamometer. Patients were assessed before intervention, after 6 weeks of intervention and after 6 weeks of follow-up. Between-group differences at assessments were analysed by way of analysis of covariance with Bonferroni correction.Results: Pain and functionality improved more following spinal manipulative therapy than local exercise therapy. After 6 weeks of intervention the between-group difference (local versus spinal) for maximal pain was 23.4 mm [95% CI: 9.3, 37.6; effect size (ES): 1.04] and - 12.4 [95% CI: - 20.2, - 4.7; ES: 1.00] for the AKPS. At 6 weeks of follow-up the between-group difference for maximal pain was 18.7 mm [95% CI: 1.4, 36.0; ES: 0.68] and - 11.5 [95% CI: - 19.9, - 3.3; ES: - 0.87] for the AKPS.Conclusions: This study suggests that spinal manual therapy is more effective than local exercise therapy in improving pain and function in patients with PFPS in the medium term. We suggest for future research to investigate whether combining local exercise therapy and spinal manual therapy is more effective than either single intervention on its own. This clinical trial study was approved by the Medical Ethics Committee METC Z under registration number NL57207.096. and registered retrospectively in ClinicalTrials.gov PRS with registration ID number NCT04748692 on the 10th of February 2021. [ABSTRACT FROM AUTHOR]

Only few biomarkers have been evaluated for their prognostic value following radical prostatectomy. We explored if tissue N-glycosylation shows prognostic properties for biochemical recurrence (BCR)-free survival. Tissue N-glycosylation profile was determined from 82 prostate cancer (PCa) patients and prognostic features were compared to clinical and biochemical parameters for BCR-free survival. Majority presented with Gleason score 3 + 4 (41%), extensive local disease (62%) and without pelvic lymph nodes invasion (83%). Several parameters (low T stage, low Gleason score, low EAU risk groups for BCR, absence of positive surgical margins, high ratio of fucosylated triantennary structures on total of multiantennary structures [3AFc/MA], low ratio of fucosylated biantennary with core-branched N-acetylglucosamine on total of biantennary structures, and high ratio of triantennary structures on total of multiantennary structures) proved to have a univariate beneficial effect on BCR-free survival. Multivariate analysis proved positive surgical margins and 3AFc/MA to be independent prognosticators. Tissue N-glycans are a powerful prognostic tool and can be an asset in PCa as the ratio of 3AFc/MA is independently associated with BCR-free survival. This could be of clinical use in guiding patients following radical prostatectomy, e.g. referral to adjuvant radiotherapy. Further elaboration of this biomarker is warranted. [ABSTRACT FROM AUTHOR]

This study considers displacement occurring around the Jakarta flood mitigation projects between 2015–17 and explores the emergence of social innovation by affected kampung communities along the Ciliwung River. A framework combining theories on domicide and social innovation is developed to scrutinize two main case studies, Bukit Duri and Kampung Tongkol, revealing their connection to the city's urban development trajectory as well as the continuous struggle over adequate housing for low‐income groups. The study questions official plans, policies and responses towards flood‐induced displacement and resettlement planning. It also brings social innovation into the debate to unpack how displacement became a key moment for transformative change. The paper argues that, although urban eviction is related to globalization, outcomes are not foreclosed. Predominant urban mechanisms are contested, shaped, and transformed by local communities. [ABSTRACT FROM AUTHOR]

Common rust, caused by Puccinia sorghi, is a widespread and destructive disease of maize. The Rp1‐D gene confers resistance to the P. sorghi IN2 isolate, mediating a hypersensitive cell death response (HR). To identify differentially expressed genes (DEGs) and metabolites associated with the compatible (susceptible) interaction and with Rp1‐D‐mediated resistance in maize, we performed transcriptomics and targeted metabolome analyses of P. sorghi IN2‐infected leaves from the near‐isogenic lines H95 and H95:Rp1‐D, which differed for the presence of Rp1‐D. We observed up‐regulation of genes involved in the defence response and secondary metabolism, including the phenylpropanoid, flavonoid, and terpenoid pathways. Metabolome analyses confirmed that intermediates from several transcriptionally up‐regulated pathways accumulated during the defence response. We identified a common response in H95:Rp1‐D and H95 with an additional H95:Rp1‐D‐specific resistance response observed at early time points at both transcriptional and metabolic levels. To better understand the mechanisms underlying Rp1‐D‐mediated resistance, we inferred gene regulatory networks occurring in response to P. sorghi infection. A number of transcription factors including WRKY53, BHLH124, NKD1, BZIP84, and MYB100 were identified as potentially important signalling hubs in the resistance‐specific response. Overall, this study provides a novel and multifaceted understanding of the maize susceptible and resistance‐specific responses to P. sorghi. [ABSTRACT FROM AUTHOR]

Introduction: The use of fluoroscopy during percutaneous nephrolithotomy (PCNL) may lead to an overestimation of stone-free rates. The objective of this study is to demonstrate the feasibility of intraoperative CT-guided PCNL compared with standard of care (SoC) PCNL. Patients and Methods: A prospective feasibility study (20 patients undergoing PCNL with an intraoperative CT scan between June 2017 and February 2020) and a retrospective study of a historical cohort (20 consecutive patients undergoing SoC PCNL between September 2015 and September 2016) were conducted. All procedures were performed by an expert endourologist in a tertiary referral hospital. Follow-up was performed at 6 weeks postoperatively. The primary goal is to investigate the practicality and potential benefits and harms of intraoperative CT scanning during PCNL. Secondary outcomes are a stone-free rate after the 6-week follow-up, perioperative radiation exposure, the need for postoperative imaging, and peri- and postoperative complications. Statistical significance was considered at p < 0.05. Results: The initial stone-free rate in the CT scan group was 65% (n = 13). In 25% (n = 5) of patients, residual stone fragments were removed after the perioperative CT scan. In the SoC group, 85% (n = 17) of patients were thought to be stone free perioperatively. At the 6-week follow-up, 80% (n = 16) in the CT scan group vs 50% in the SoC group (n = 10) were found to be stone free. Radiation exposure, perioperatively, was higher in the CT scan group. Complications were comparable between groups. Limitations of the study are the nonrandomized design of the study and nonstandardized follow-up imaging. Conclusions: Intraoperative CT scanning during PCNL is feasible and gives a better estimate of any remaining stone fragments compared with fluoroscopy only. [ABSTRACT FROM AUTHOR]

To counter man-at-the-end attacks such as reverse engineering and tampering, software is often protected with techniques that require support modules to be linked into the application. It is well known, however, that attackers can exploit the modular nature of applications and their protections to speed up the identification and comprehension process of the relevant code, the assets, and the applied protections. To counter that exploitation of modularity at different levels of granularity, the boundaries between the modules in the program need to be obfuscated. We propose to do so by combining three cross-boundary protection techniques that thwart the disassembly process and in particular the reconstruction of functions: code layout randomization, interprocedurally coupled opaque predicates, and code factoring with intraprocedural control flow idioms. By means of an experimental evaluation on realistic use cases and state-of-the-art tools, we demonstrate our technique's potency and resilience to advanced attacks. All relevant code is publicly available online. [ABSTRACT FROM AUTHOR]