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EPOS2020 is the 4th and most recent version of the European Position Paper on Rhinosinusitis and Nasal Polyps which was first published in 2005. It aims to provide the most up to date scientifically robust information on the topic published in the literature which has been critically analysed by an international group of clinicians drawn from all disciplines dealing with these problems together with patients. The guidelines offer evidence-based recommendations and care pathways for acute and chronic rhinosinusitis in both adults and children. Management of these diseases from the patients' perspective is an important part of EPOS2020. Not only is this included in the main document but, for the first time, we have produced a separate supplement dedicated to and in collaboration with patients, EPOS4Patients, which aims to provide information in an accessible format, to answer frequently asked questions about these diseases and their treatment options as well as including useful patient resources and websites. It has never been more important for patients to be actively involved in their care. Being well informed helps you to make the best decisions together with your doctor.

EPOS2020 is the 4th and most recent version of the European Position Paper on Rhinosinusitis and Nasal Polyps which was first published in 2005. It aims to provide the most up to date scientifically robust information on the topic published in the literature which has been critically analysed by an international group of clinicians drawn from all disciplines dealing with these problems together with patients. The guidelines offer evidence-based recommendations and care pathways for acute and chronic rhinosinusitis in both adults and children. Management of these diseases from the patients' perspective is an important part of EPOS2020. Not only is this included in the main document but, for the first time, we have produced a separate supplement dedicated to and in collaboration with patients, EPOS4Patients, which aims to provide information in an accessible format, to answer frequently asked questions about these diseases and their treatment options as well as including useful patient resources and websites. It has never been more important for patients to be actively involved in their care. Being well informed helps you to make the best decisions together with your doctor.

EPOS2020 is the 4th and most recent version of the European Position Paper on Rhinosinusitis and Nasal Polyps which was first published in 2005. It aims to provide the most up to date scientifically robust information on the topic published in the literature which has been critically analysed by an international group of clinicians drawn from all disciplines dealing with these problems together with patients. The guidelines offer evidence-based recommendations and care pathways for acute and chronic rhinosinusitis in both adults and children. Management of these diseases from the patients' perspective is an important part of EPOS2020. Not only is this included in the main document but, for the first time, we have produced a separate supplement dedicated to and in collaboration with patients, EPOS4Patients, which aims to provide information in an accessible format, to answer frequently asked questions about these diseases and their treatment options as well as including useful patient resources and websites. It has never been more important for patients to be actively involved in their care. Being well informed helps you to make the best decisions together with your doctor.

EPOS2020 is the 4th and most recent version of the European Position Paper on Rhinosinusitis and Nasal Polyps which was first published in 2005. It aims to provide the most up to date scientifically robust information on the topic published in the literature which has been critically analysed by an international group of clinicians drawn from all disciplines dealing with these problems together with patients. The guidelines offer evidence-based recommendations and care pathways for acute and chronic rhinosinusitis in both adults and children. Management of these diseases from the patients' perspective is an important part of EPOS2020. Not only is this included in the main document but, for the first time, we have produced a separate supplement dedicated to and in collaboration with patients, EPOS4Patients, which aims to provide information in an accessible format, to answer frequently asked questions about these diseases and their treatment options as well as including useful patient resources and websites. It has never been more important for patients to be actively involved in their care. Being well informed helps you to make the best decisions together with your doctor.

Dutch society makes use of a variety of goods and services provided by ecosystems – generally referred to as ecosystem services. A visible record of the status and trends in ecosystem services can help government and industry to incorporate the interests of nature and the environment in the Netherlands into decisionmaking processes. The results show that although Dutch ecosystems make a valuable contribution towards the need for the sustainable provision of goods and services, they do not satisfy the entire demand. Moreover, over the past 20 years the demand for most ecosystem services has risen faster than the supply., De Nederlandse samenleving gebruikt verschillende goederen en diensten die ecosystemen leveren – de zogeheten ecosysteemdiensten. Het zichtbaar maken van de toestand en trends van ecosysteemdiensten in Nederland kan helpen bij de oordeelsvorming en besluitvorming van natuur in Nederland door de overheid en het bedrijfsleven. Resultaten laten zien dat, alhoewel Nederlandse ecosystemen een belangrijke bijdrage leveren aan de behoefte aan een duurzame voorziening van goederen en diensten, ze niet voorzien in de totale vraag. Bovendien geldt dat voor de meerderheid van de ecosysteemdiensten de vraag ernaar sneller toeneemt dan het aanbod in de afgelopen twintig jaar.

The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis.The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.

This EAACI position paper aims at providing a state-of-the-art overview on nonallergic rhinitis (NAR). A significant number of patients suffering from persistent rhinitis are defined as nonallergic noninfectious rhinitis (NANIR) patients, often denominated in short as having NAR. NAR is defined as a symptomatic inflammation of the nasal mucosa with the presence of a minimum of two nasal symptoms such as nasal obstruction, rhinorrhea, sneezing, and/or itchy nose, without clinical evidence of endonasal infection and without systemic signs of sensitization to inhalant allergens. Symptoms of NAR may have a wide range of severity and be either continuously present and/or induced by exposure to unspecific triggers, also called nasal hyperresponsiveness (NHR). NHR represents a clinical feature of both AR and NAR patients. NAR involves different subgroups: drug-induced rhinitis, (nonallergic) occupational rhinitis, hormonal rhinitis (including pregnancy rhinitis), gustatory rhinitis, senile rhinitis, and idiopathic rhinitis (IR). NAR should be distinguished from those rhinitis patients with an allergic reaction confined to the nasal mucosa, also called entopy or local allergic rhinitis (LAR). We here provide an overview of the current consensus on phenotypes of NAR, recommendations for diagnosis, a treatment algorithm, and defining the unmet needs in this neglected area of research.

The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis.The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.

This EAACI position paper aims at providing a state-of-the-art overview on nonallergic rhinitis (NAR). A significant number of patients suffering from persistent rhinitis are defined as nonallergic noninfectious rhinitis (NANIR) patients, often denominated in short as having NAR. NAR is defined as a symptomatic inflammation of the nasal mucosa with the presence of a minimum of two nasal symptoms such as nasal obstruction, rhinorrhea, sneezing, and/or itchy nose, without clinical evidence of endonasal infection and without systemic signs of sensitization to inhalant allergens. Symptoms of NAR may have a wide range of severity and be either continuously present and/or induced by exposure to unspecific triggers, also called nasal hyperresponsiveness (NHR). NHR represents a clinical feature of both AR and NAR patients. NAR involves different subgroups: drug-induced rhinitis, (nonallergic) occupational rhinitis, hormonal rhinitis (including pregnancy rhinitis), gustatory rhinitis, senile rhinitis, and idiopathic rhinitis (IR). NAR should be distinguished from those rhinitis patients with an allergic reaction confined to the nasal mucosa, also called entopy or local allergic rhinitis (LAR). We here provide an overview of the current consensus on phenotypes of NAR, recommendations for diagnosis, a treatment algorithm, and defining the unmet needs in this neglected area of research.

This study presents FABM-PCLake, a complete redesign of the PCLake aquatic ecosystem model, which we implemented into the Framework for Aquatic Biogeochemical Models (FABM). In contrast to the original model, which was designed for temperate, fully mixed freshwater lakes, the new FABM-PCLake represents an integrated aquatic ecosystem model that enables simulations of hydrodynamics and biogeochemical processes for zero dimensional, one-dimensional as well as three-dimensional heterogeneous environments. FABM-PCLake describes interactions between multiple trophic levels, including piscivorous, zooplanktivorous and benthivorous fish, zooplankton, zoobenthos, three groups of phytoplankton and rooted macrophytes. The model also accounts for oxygen dynamics and nutrient cycling for nitrogen, phosphorus and silicon, both within the pelagic and benthic domains. FABM-PCLake includes a two-way communication between the biogeochemical processes and the physics, where some biogeochemical state variables (e.g., phytoplankton) influence light attenuation and thereby the spatial and temporal distributions of light and heat. At the same time, the physical environment, including water currents, light and temperature influence a wide range of biogeochemical processes. The model enables studies on ecosystem dynamics in physically heterogeneous environments (e.g., stratifying water bodies, and water bodies with horizontal gradient in physical and biogeochemical properties), and through FABM also enables data assimilation and multi-model ensemble simulations. Examples of relevant model applications include climate change impact studies and environmental impact assessment scenarios for lakes and reservoirs worldwide.

This study presents FABM-PCLake, a complete redesign of the PCLake aquatic ecosystem model, which we implemented into the Framework for Aquatic Biogeochemical Models (FABM). In contrast to the original model, which was designed for temperate, fully mixed freshwater lakes, the new FABM-PCLake represents an integrated aquatic ecosystem model that enables simulations of hydrodynamics and biogeochemical processes for zero dimensional, one-dimensional as well as three-dimensional heterogeneous environments. FABM-PCLake describes interactions between multiple trophic levels, including piscivorous, zooplanktivorous and benthivorous fish, zooplankton, zoobenthos, three groups of phytoplankton and rooted macrophytes. The model also accounts for oxygen dynamics and nutrient cycling for nitrogen, phosphorus and silicon, both within the pelagic and benthic domains. FABM-PCLake includes a two-way communication between the biogeochemical processes and the physics, where some biogeochemical state variables (e.g., phytoplankton) influence light attenuation and thereby the spatial and temporal distributions of light and heat. At the same time, the physical environment, including water currents, light and temperature influence a wide range of biogeochemical processes. The model enables studies on ecosystem dynamics in physically heterogeneous environments (e.g., stratifying water bodies, and water bodies with horizontal gradient in physical and biogeochemical properties), and through FABM also enables data assimilation and multi-model ensemble simulations. Examples of relevant model applications include climate change impact studies and environmental impact assessment scenarios for lakes and reservoirs worldwide.

Here, we present a community perspective on how to explore, exploit and evolve the diversity in aquatic ecosystem models. These models play an important role in understanding the functioning of aquatic ecosystems, filling in observation gaps and developing effective strategies for water quality management. In this spirit, numerous models have been developed since the 1970s. We set off to explore model diversity by making an inventory among 42 aquatic ecosystem modellers, by categorizing the resulting set of models and by analysing them for diversity. We then focus on how to exploit model diversity by comparing and combining different aspects of existing models. Finally, we discuss how model diversity came about in the past and could evolve in the future. Throughout our study, we use analogies from biodiversity research to analyse and interpret model diversity. We recommend to make models publicly available through open-source policies, to standardize documentation and technical implementation of models, and to compare models through ensemble modelling and interdisciplinary approaches. We end with our perspective on how the field of aquatic ecosystem modelling might develop in the next 5–10 years. To strive for clarity and to improve readability for non-modellers, we include a glossary.

Here, we present a community perspective on how to explore, exploit and evolve the diversity in aquatic ecosystem models. These models play an important role in understanding the functioning of aquatic ecosystems, filling in observation gaps and developing effective strategies for water quality management. In this spirit, numerous models have been developed since the 1970s. We set off to explore model diversity by making an inventory among 42 aquatic ecosystem modellers, by categorizing the resulting set of models and by analysing them for diversity. We then focus on how to exploit model diversity by comparing and combining different aspects of existing models. Finally, we discuss how model diversity came about in the past and could evolve in the future. Throughout our study, we use analogies from biodiversity research to analyse and interpret model diversity. We recommend to make models publicly available through open-source policies, to standardize documentation and technical implementation of models, and to compare models through ensemble modelling and interdisciplinary approaches. We end with our perspective on how the field of aquatic ecosystem modelling might develop in the next 5–10 years. To strive for clarity and to improve readability for non-modellers, we include a glossary.

Simulation modelling in ecology is a field that is becoming increasingly compartmentalized. Here we propose a Database Approach To Modelling (DATM) to create unity in dynamical ecosystem modelling with differential equations. In this approach the storage of ecological knowledge is independent of the language and platform in which the model will be run. To create an instance of the model, the information in the database is translated and augmented with the language and platform specifics. This process is automated so that a new instance can be created each time the database is updated. We describe the approach using the simple LotkaeVolterra model and the complex ecosystem model for shallow lakes PCLake, which we automatically implement in the frameworks OSIRIS, GRIND for MATLAB, ACSL, R, DUFLOW and DELWAQ. A clear advantage of working in a database is the overview it provides. The simplicity of the approach only adds to its elegance.

Simulation modelling in ecology is a field that is becoming increasingly compartmentalized. Here we propose a Database Approach To Modelling (DATM) to create unity in dynamical ecosystem modelling with differential equations. In this approach the storage of ecological knowledge is independent of the language and platform in which the model will be run. To create an instance of the model, the information in the database is translated and augmented with the language and platform specifics. This process is automated so that a new instance can be created each time the database is updated. We describe the approach using the simple LotkaeVolterra model and the complex ecosystem model for shallow lakes PCLake, which we automatically implement in the frameworks OSIRIS, GRIND for MATLAB, ACSL, R, DUFLOW and DELWAQ. A clear advantage of working in a database is the overview it provides. The simplicity of the approach only adds to its elegance.

Sulfaat is een belangrijke stof in sloten in veenweidegebieden. Het wordt in de zuurstofloze waterbodem door micro-organismen omgezet in sulfide, dat zich bindt aan ijzer. Daardoor komt fosfaat vrij, wat slecht is voor de ecologische kwaliteit van het slootwater. De gedachte was altijd dat de inlaat van gebiedsvreemd water in de polders de grootste bron van sulfaat is. De laatste jaren is duidelijk geworden dat het sulfaat vooral afkomstig is uit de veenweidebodem zelf. In de Krimpenerwaard gaat het om 75%. Het inlaatwater blijkt de sulfaatconcentraties in de gemiddelde veensloot zelfs omlaag te brengen!

Vanaf 1996 is de Wet op de Waterkering van kracht die voor gebieden met een primaire waterkering een bepaald beschermingsniveau voorschrijft. Voor de Maas betekent dit dat de dijken een beschermingsniveau van 1250 jaar moeten garanderen met uitzondering van sommige dijken in de Getijmaas die een beschermingsniveau van 2000 jaar hebben. Maximale waterstanden die het opgelegde beschermingsniveau garanderen worden ook wel toetspeilen genoemd. Deze toetspeilen worden bepaald met behulp van een maatgevende afvoergolf. Voor de bedijkte Maas is dit een afvoergolf met een gemiddelde kans van voorkomen van eens in de 1250 jaar. De maatgevende afvoergolf wordt geconstrueerd uit een aantal historische hoogwaters gemeten te Borgharen vanaf 1911. De maatgevende afvoergolf wordt vanaf Borgharen doorgerekend met het 2-D stromingsmodel WAQUA om de toetspeilen te bepalen. Volgens de Wet op de Waterkering moeten de toetspeilen elke 5 jaar opnieuw bepaald worden. In het rapport wordt de methodiek waarmee de toetspeilen worden verkregen beoordeeld, waarbij er vooral wordt ingegaan op de betrouwbaarheid van de verkregen toetspeilen d.m.v. het uitvoeren van een gevoeligheidsanalyse. Allereerst is de opschalingsmethodiek onderzocht waarmee de maatgevende afvoergolf bepaald wordt. De opschaling, die deel uitmaakt van de methodiek, roept een aantal vragen op aangezien het uitgaat van een standaard verhouding tussen de maatgevende afvoer en de piekafvoer. De maximale waterstanden van naar de maatgevende afvoer opgeschaalde historische hoogwaters kunnen flinke afwijkingen hebben t.o.v. de toetspeilen. Ongeveer de helft van de opgeschaalde hoogwaters veroorzaakt hogere maximale waterstanden en de andere helft lagere maximale waterstanden dan de toetspeilen. Er is onderzoek gedaan naar de mogelijkheid om met schematisatie een beter verband te vinden, maar dit bleek op niks uit te lopen. Samenvattend kleven er een hoop onzekerheden aan het voorspellen van waterstanden bij extreem hoge afvoeren v

Vanaf 1996 is de Wet op de Waterkering van kracht die voor gebieden met een primaire waterkering een bepaald beschermingsniveau voorschrijft. Voor de Maas betekent dit dat de dijken een beschermingsniveau van 1250 jaar moeten garanderen met uitzondering van sommige dijken in de Getijmaas die een beschermingsniveau van 2000 jaar hebben. Maximale waterstanden die het opgelegde beschermingsniveau garanderen worden ook wel toetspeilen genoemd. Deze toetspeilen worden bepaald met behulp van een maatgevende afvoergolf. Voor de bedijkte Maas is dit een afvoergolf met een gemiddelde kans van voorkomen van eens in de 1250 jaar. De maatgevende afvoergolf wordt geconstrueerd uit een aantal historische hoogwaters gemeten te Borgharen vanaf 1911. De maatgevende afvoergolf wordt vanaf Borgharen doorgerekend met het 2-D stromingsmodel WAQUA om de toetspeilen te bepalen. Volgens de Wet op de Waterkering moeten de toetspeilen elke 5 jaar opnieuw bepaald worden. In het rapport wordt de methodiek waarmee de toetspeilen worden verkregen beoordeeld, waarbij er vooral wordt ingegaan op de betrouwbaarheid van de verkregen toetspeilen d.m.v. het uitvoeren van een gevoeligheidsanalyse. Allereerst is de opschalingsmethodiek onderzocht waarmee de maatgevende afvoergolf bepaald wordt. De opschaling, die deel uitmaakt van de methodiek, roept een aantal vragen op aangezien het uitgaat van een standaard verhouding tussen de maatgevende afvoer en de piekafvoer. De maximale waterstanden van naar de maatgevende afvoer opgeschaalde historische hoogwaters kunnen flinke afwijkingen hebben t.o.v. de toetspeilen. Ongeveer de helft van de opgeschaalde hoogwaters veroorzaakt hogere maximale waterstanden en de andere helft lagere maximale waterstanden dan de toetspeilen. Er is onderzoek gedaan naar de mogelijkheid om met schematisatie een beter verband te vinden, maar dit bleek op niks uit te lopen. Samenvattend kleven er een hoop onzekerheden aan het voorspellen van waterstanden bij extreem hoge afvoeren v

info:eu-repo/semantics/published

The multiexponential behavior of the decay curves obtained in vitro by a Carr-Purcell-Meiboom-Gill (CPMG) sequence from spleens and kidneys of mice is analyzed. The mice were inoculated with the acute lymphocytic P388 leukemic cells and treated with the anticancer drug cis-diamminedichloroplatinum(II), cis-Pt. Kidneys and spleens of control animals display four relaxation components. The two longest ones were assigned, in the kidneys, in decreasing order of their relaxation time value, to intracellular and extracellular water, respectively. In spleens, the reversed assignment resulted. The two shortest ones are assigned to different tightly bound hydration water compartments, the fastest relaxing one being more greatly influenced by the unobservable crystalline water. No significant systemic effect on the intra- and extracellular water relaxation times could be observed in the kidneys under P388 leukemia inoculation, despite an apparent increase in the intracellular water content. In contrast, drug administration results in the apparent decrease in or even disappearance of the extracellular water component, with an increase in both relaxation time and apparent fraction of the intracellular water. These effects correlate well with changes in the usual nephrotoxicity parameters and are explained in terms of the well-known cell damage in kidneys under cis-platinum administration. A systemic effect under P388 leukemia disease is observed for the spleen, resulting again in the disappearance of the extracellular water component. The latter is related to splenomegaly due to invasion of the organ by leukemic cells during disease development., Journal Article, Research Support, Non-U.S. Gov't, SCOPUS: ar.j, FLWNA, info:eu-repo/semantics/published

The multiexponential behavior of the decay curves obtained in vitro by a Carr-Purcell-Meiboom-Gill (CPMG) sequence from spleens and kidneys of mice is analyzed. The mice were inoculated with the acute lymphocytic P388 leukemic cells and treated with the anticancer drug cis-diamminedichloroplatinum(II), cis-Pt. Kidneys and spleens of control animals display four relaxation components. The two longest ones were assigned, in the kidneys, in decreasing order of their relaxation time value, to intracellular and extracellular water, respectively. In spleens, the reversed assignment resulted. The two shortest ones are assigned to different tightly bound hydration water compartments, the fastest relaxing one being more greatly influenced by the unobservable crystalline water. No significant systemic effect on the intra- and extracellular water relaxation times could be observed in the kidneys under P388 leukemia inoculation, despite an apparent increase in the intracellular water content. In contrast, drug administration results in the apparent decrease in or even disappearance of the extracellular water component, with an increase in both relaxation time and apparent fraction of the intracellular water. These effects correlate well with changes in the usual nephrotoxicity parameters and are explained in terms of the well-known cell damage in kidneys under cis-platinum administration. A systemic effect under P388 leukemia disease is observed for the spleen, resulting again in the disappearance of the extracellular water component. The latter is related to splenomegaly due to invasion of the organ by leukemic cells during disease development., Journal Article, Research Support, Non-U.S. Gov't, SCOPUS: ar.j, FLWNA, info:eu-repo/semantics/published

info:eu-repo/semantics/published