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Verwildering of ‘rewilding’ als strategie voor natuurbescherming wint aan populariteit. Het bevorderen van natuurlijke processen staat centraal. Wat dat oplevert aan biodiversiteit blijft vaak beperkt tot grote zoogdieren en vogels, zelden komen ongewervelden in beeld. Door ongewervelden te koppelen aan natuurlijke processen kan monitoring ervan inzicht bieden in het succes van verwildering.

Prostate cancer patients with an enlarged prostate and/or excessive pubic arch interference (PAI) are generally considered non-eligible for high-dose-rate (HDR) brachytherapy (BT). Steerable needles have been developed to make these patients eligible again. This study aims to validate the dosimetric impact and performance of steerable needles within the conventional clinical setting. HDR BT treatment plans were generated, needle implantations were performed in a prostate phantom, with prostate volume > 55 cm3 and excessive PAI of 10 mm, and pre- and post-implant dosimetry were compared considering the dosimetric constraints: prostate V100 > 95 % (13.50 Gy), urethra D0.1cm3 < 115 % (15.53 Gy) and rectum D1cm3 < 75 % (10.13 Gy). The inclusion of steerable needles resulted in a notable enhancement of the dose distribution and prostate V100 compared to treatment plans exclusively employing rigid needles to address PAI. Furthermore, the steerable needle plan demonstrated better agreement between pre- and post-implant dosimetry (prostate V100: 96.24 % vs. 93.74 %) compared to the rigid needle plans (79.13 % vs. 72.86 % and 87.70 % vs. 81.76 %), with no major changes in the clinical workflow and no changes in the clinical set-up. The steerable needle approach allows for more flexibility in needle positioning, ensuring a highly conformal dose distribution, and hence, HDR BT is a feasible treatment option again for prostate cancer patients with an enlarged prostate and/or excessive PAI.

RIVM rapport:De Nederlandse overheid biedt de bevolking onderzoeken aan om ziekten vroegtijdig op te sporen, en zo beter te kunnen behandelen. Het gaat om bevolkingsonderzoeken naar verschillende vormen van kanker en de screenings van ongeboren en pasgeboren kinderen op bepaalde ziekten. Allerlei ontwikkelingen hebben invloed op het aanbod van deze onderzoeken in de toekomst: de vergrijzing, economische en technologische ontwikkelingen en maatschappelijke opvattingen. Het is alleen onzeker hoe deze ontwikkelingen zullen verlopen. De overheid wil inzicht krijgen in de mogelijke ontwikkelingen om beter voorbereid te zijn op de toekomst van screening en vroege opsporing. Het RIVM heeft daarom de belangrijkste ontwikkelingen op een rij gezet. Dit kan VWS(Ministerie van Volksgezondheid, Welzijn en Sport ) helpen om een visie te vormen over de toekomst van screening en vroege opsporing en keuzes te maken over mogelijke acties. Een voorbeeld is het groeiende tekort aan personeel en de druk die dit zal leggen op de uitvoering van bevolkingsonderzoeken naar kanker. Dit betekent dat misschien op een andere manier zal worden bepaald wie een uitnodiging voor een screening krijgt en op welk moment. Nu zijn leeftijd en geslacht daar de basis voor, maar in de toekomst kunnen ook andere kenmerken mee gaan spelen. Zo zouden mensen met een kleine kans op kanker minder vaak gescreend kunnen worden, en blijft het aanbod voor mensen met een hoog risico behouden. Technologische vernieuwing op het gebied van screening en vroege opsporing gaan snel. Mogelijk kan de techniek helpen om ze in de toekomst in een andere, eenvoudigere vorm aan te bieden. Denk aan een bloedtest voor de bevolkingsonderzoeken naar kanker. Maar nieuwe vormen van screening en vroege opsporing roepen ook vragen op over het beheer van persoonlijke gegevens en de rol van de overheid. Bedrijven zullen vaker dan nu gezondheidsonderzoeken aanbieden. De vraag is hoe de overheid zich daartoe gaat verhouden. Bovendien denkt niet iedereen

Basiskwaliteit Natuur is de set van condities (abiotiek, inrichting en beheer) die algemene soorten nodig hebben om algemeen te blijven of worden. Zonder deze condities zullen de algemene soorten achteruitgaan. Basiskwaliteit Natuur richt met name zich op het landelijk en stedelijk gebied, waar natuur niet de primaire functie is. Het doel van dit kennisdocument is om eenduidigheid te scheppen over de basisprincipes van BKN, de beschikbare kennis over BKN in kaart te brengen en de kennishiaten te identificeren. Het kennisdocument biedt dus een basis om verder te bouwen aan de ontwikkeling van BKN en dient als eerste aanzet om ermee aan de slag te gaan. De doelgroep van dit kennisdocument is professionals die werken met BKN, zoals bijvoorbeeld ministeries, gemeenten, waterschappen, provincies, adviesbureaus, agrarische natuurverenigingen en natuurorganisaties.

Het gebied bestaat uit de deelgebieden Weerterbos, Ringselven en Kruispeel (Habitatrichtlijngebied) en de Hugterheide en de Weerter- en Budelerbergen (Vogelrichtlijngebied). 1. De Ecologische Autoriteit is van oordeel dat de NDA onvoldoende inzicht geeft in samenhang tussen bodem, water en de natuurdoelen van het gebied. Ook de problemen door verdroging, stikstofdepositie en vervuiling van grond- en oppervlaktewater zijn niet voldoende in beeld. Dit inzicht moet verbeterd worden. 2. Door te weinig gegevens is het onvoldoende mogelijk te beoordelen of er sinds de aanmelding (T0) verslechtering heeft plaatsgevonden. Op basis van de NDA en het veldbezoek concludeert de Ecologische Autoriteit dat het halen van de doelen niet kan worden gegarandeerd. Om verslechtering verder uit te sluiten moeten (aanvullende) maatregelen getroffen worden. 3. De maatregelen voor natuurherstel zijn onvoldoende uitgewerkt. Ze missen vooral een kwantitatieve onderbouwing. Ook zijn mogelijk effectieve maatregelen niet in beeld omdat er niet voldoende systeeminzicht is.

De grote parelmoervlinder is in Nederland een ernstig bedreigde dagvlinder. Gelderland herbergt op de Veluwe meer dan de helft van de Nederlandse populatie. Sinds 2017 is de soort sterk in aantal achteruit gegaan. Om deze kenmerkende soort van heischrale omgeving te behouden is onderzoek verricht naar de habitatkwaliteit en zijn de recente vindplaatsen op hun kwaliteiten beoordeeld. Op basis daarvan is geadviseerd over maatregelen voor herstel.

De grote parelmoervlinder is in Nederland een ernstig bedreigde dagvlinder. Het is een kenmerkende soort van een schrale, dus stikstofarme omgeving. Gelderland herbergt op de Veluwe meer dan de helft van de Nederlandse populatie. Sinds 2017 is de soort sterk in aantal achteruitgegaan. De problemen en kansen voor herstel zijn onlangs nader onderzocht.

In recent years Dutch dairy farms faced changes in weather conditions with longer periods of drought and heatwaves. The aim of this study was to gain more insight into the effects of extreme weather events on dairy farms in the region ‘de Achterhoek’ in the Netherlands and to identify promising adaptation options. To this end, a questionnaire was implemented on 165 dairy farms and existing farm data were collected from these farms for the period 2016-2021. Results showed that crop yields and feeding values were significantly lower in the years 2018, 2019 and 2020. Environmental performance decreased in this period, and the number of farmers irrigating grass and maize fields increased. Respondents reported other effects of drought and heatwaves, such as reduced roughage stocks, increased labor, and heat stress of cows. Respondents already implemented many adaptation measures on their farms, and considered various other measures to be promising adaptation options., De Nederlandse melkveehouderij heeft in de afgelopen jaren te maken gehad met langdurigere perioden van droogte en hitte. Het doel van deze studie was om meer inzicht te krijgen effecten hiervan op melkveebedrijven in de Achterhoek en om perspectiefvolle adaptatiemaatregelen in beeld te brengen. Hiertoe hebben 165 melkveehouders een enquête ingevuld en zijn KringloopWijzer gegevens verzameld voor de periode 2016 t/m 2021. Resultaten laten lagere gewasopbrengsten en voederwaardes zien voor 2018, 2019 en 2020, alsook verminderde milieuprestaties en een toename in hittestress bij koeien. Ook zijn er andere effecten van droogte en hitte op de bedrijfsvoering, zoals een toename in beregening, meer arbeid en een vermindering van de ruwvoervoorraad. Respondenten gaven dat er al veel adaptatiemaatregelen worden getroffen op bedrijven, en men ziet perspectief in diverse andere maatregelen zoals het telen van andere gewassen of rassen, beter bodembeheer en maatregelen om hittestress te beperken.

Basiskwaliteit Natuur is de set van condities (abiotiek, inrichting en beheer) die algemene soorten nodig hebben om algemeen te blijven of worden. Zonder deze condities zullen de algemene soorten achteruitgaan. Basiskwaliteit Natuur richt met name zich op het landelijk en stedelijk gebied, waar natuur niet de primaire functie is. Het doel van dit kennisdocument is om eenduidigheid te scheppen over de basisprincipes van BKN, de beschikbare kennis over BKN in kaart te brengen en de kennishiaten te identificeren. Het kennisdocument biedt dus een basis om verder te bouwen aan de ontwikkeling van BKN en dient als eerste aanzet om ermee aan de slag te gaan. De doelgroep van dit kennisdocument is professionals die werken met BKN, zoals bijvoorbeeld ministeries, gemeenten, waterschappen, provincies, adviesbureaus, agrarische natuurverenigingen en natuurorganisaties.

We report on a detailed spatial and spectral analysis of the large-scale X-ray emission from the merging cluster Cygnus A. We use 2.2 Ms Chandra and 40 ks XMM-Newton archival datasets to determine the thermodynamic properties of the intracluster gas in the merger region between the two sub-clusters in the system. These profiles exhibit temperature enhancements that imply significant heating along the merger axis. Possible sources for this heating include the shock from the ongoing merger, past activity of the powerful AGN in the core, or a combination of both. To distinguish between these scenarios, we compare the observed X-ray properties of Cygnus A with simple, spherical cluster models. These models are constructed using azimuthally averaged density and temperature profiles determined from the undisturbed regions of the cluster and folded through MARX to produce simulated Chandra observations. The thermodynamic properties in the merger region from these simulated X-ray observations were used as a baseline for comparison with the actual observations. We identify two distinct components in the temperature structure along the merger axis, a smooth, large-scale temperature excess we attribute to the ongoing merger, and a series of peaks where the temperatures are enhanced by 0.5-2.5 keV. If these peaks are attributable to the central AGN, the location and strength of these features imply that Cygnus A has been active for the past 300 Myr injecting a total of $\sim$10$^{62}$ erg into the merger region. This corresponds to $\sim$10% of the energy deposited by the merger shock., Comment: Accepted for publication in MNRAS

Background: With roughly 45,000 adult patients each year, distal radius fractures are one of the most common fractures in the emergency department. Approximately 60% of all these fractures are displaced and require surgery. The current guidelines advise to perform closed reduction of these fractures awaiting surgery, as it may lead to post-reduction pain relief and release tension of the surrounding neurovascular structures. Recent studies have shown that successful reduction does not warrant conservative treatment, while patients find it painful or even traumatizing. The aim of this study is to determine whether closed reduction can be safely abandoned in these patients. Methods: In this multicenter randomized clinical trial, we will randomize between closed reduction followed by plaster casting and only plaster casting. Patients aged 18 to 75 years, presenting at the emergency department with a displaced distal radial fracture and requiring surgery according to the attending surgeon, are eligible for inclusion. Primary outcome is pain assessed with daily VAS scores from the visit to the emergency department until surgery. Secondary outcomes are function assessed by PRWHE, length of stay at the emergency department, length of surgery, return to work, patient satisfaction, and complications. A total of 134 patients will be included in this study with follow-up of 1 year.Discussion: If our study shows that patients who did not receive closed reduction experience no significant drawbacks, we might be able to reorganize the initial care for distal radial fractures in the emergency department. If surgery is warranted, the patient can be sent home with a plaster cast to await the call for admission, decreasing the time spend in the emergency room drastically. Trial registration: This trial was registered on January 27, 2023.

QC 20231108

Suspended Particulate Matter (SPM) plays an important role in controlling water quality, particularly in turbid estuaries. SPM may be impacted by changes in weather and climate, including potential changes in the frequency or intensity of extremes. Yet, the linkages between extreme events in wind and river discharge, and particularly the role these have on local dynamics and spatial patterns of estuarine SPM are, to date, largely unknown. This study investigates the effects that wind and river discharge have on SPM in a turbid estuary. It uses atmospherically corrected remotely sensed reflectances from Landsat-5, -7, and -8. From these data, we establish a 37-year-long time series, from 1984 to 2020, of satellite-derived SPM for the Scheldt Estuary. SPM was estimated using an algorithm applied to the near-infrared band and subsequently compared to in situ SPM data. Additionally, a time series of river discharge and wind speed were used to assess the frequency and severity of extreme events of wind speed and river discharge. In general, statistically significant but weak relationships between SPM and river discharge and between SPM and wind speed were observed. SPM correlated with river discharge and wind in large parts of the estuary, indicating the important role of these drivers in the entire estuarine system. Our study demonstrates how synoptic satellite snapshots can be combined with in situ time series of drivers, such as river discharge and wind, to capture where these drivers relate to (and likely affect) SPM within an estuary. However, our study demonstrates an inability to capture SPM during windstorms both from in situ and satellite data. We discuss the challenges and limitations of assessing the effects of extreme events from satellite and in situ SPM. We recommend the deployment of complementary moored turbidimeters for continuous observations at two strategic locations, as indicated by our spatial study, to improve the ability to capture the effects of

Brachytherapy (BT) is a safe and effective technique to treat prostate cancer that has not spread outside the prostate gland (localised prostate cancer). Nonetheless, in current clinical practice hazards can arise in positioning the BT needles in the prostate for the purpose of irradiation. Intermediate structures can block access to the prostate and needle-tissue interactions can result in unexpected deflection of the needle inserted. These situations are undesirable because they lead to insufficient radiation of the prostate, potentially reducing treatment outcomes or resulting in patients being excluded from this treatment. Various techniques have been proposed in the literature to mitigate these hazards, of which actively steerable needles are considered very promising. However, manufacturing and cleaning such designs is often complex, while the low rigidity of the needles limits control and increases the risk of buckling when penetrating stiffer tissues such as the prostate. These factors have made implementation in BT protocols challenging....., Medical Instruments & Bio-Inspired Technology

Hoe zorgen we voor meer biodiversiteit op het boerenland? Daarvoor is het nodig dat boeren gemotiveerd zijn om eraan te werken. Maar ook moeten er mensen zijn die met hun waarnemingen en tellingen de ontwikkelingen kunnen volgen. Burgerwetenschap is daarbij onmisbaar. Een nieuw artikel zet de ervaringen met verschillende benaderingen op een rij.

De provincie Limburg heeft een natuurdoelanalyse (NDA) opgesteld voor het Natura 2000-gebied Kunderberg, gelegen in de Zuid-Limburgse gemeenten Voerendaal en Simpelveld op de flank van het Plateau van Ubachsberg. Het wordt gekenmerkt door kalkgesteente, soortenrijke kalkgraslanden met veel orchideeën, kalkbossen, struweelrijke graften, holle wegen en oud eiken-haagbeukenbos. De NDA moet duidelijk maken of de bestaande en geplande maatregelen voldoende zijn voor het halen van de doelen voor het in stand houden van de beschermde natuur, of dat aanvullende maatregelen nodig zijn. In de Kunderberg is (verdere) verslechtering van de natuur niet uit te sluiten. De doelen voor verbetering en uitbreiding van habitats in de Kunderberg moeten concreet worden gemaakt. Om (verdere) verslechtering tegen te gaan en het bereiken van de doelen niet uit beeld te brengen moeten snel maatregelen getroffen worden. Met name gericht op vermindering inspoeling van meststoffen, reductie stikstofdepositie, connectiviteit en toereikend beheer.

De provincie Limburg heeft een natuurdoelanalyse (NDA) opgesteld voor het Natura 2000-gebied Noorbeemden en Hoogbos. De NDA moet duidelijk maken of de bestaande en geplande maatregelen voldoende zijn voor het halen van de doelen voor het in stand houden van de beschermde natuur, of dat aanvullende maatregelen nodig zijn. De gebieden liggen in Zuid-Limburg hebben een totale omvang van 55,5 hectare en lopen over in een Vlaams Natura 2000-gebied. In Noorbeemden en Hoogbos heeft de natuur te lijden onder met name verdroging, vermesting van het grondwater en stikstofdepositie. In het natuurgebied is (verdere) verslechtering niet uit te sluiten. De doelen voor het gebied moeten nog concreter worden gemaakt en ook mist informatie over het vliegend hert (keversoort). Om (verdere) verslechtering tegen te gaan moeten snel maatregelen worden getroffen.

De provincie Limburg heeft een natuurdoelanalyse (NDA) opgesteld voor het Natura 2000-gebied Savelsbos - een relatief smalle langgerekte bosstrook van 360 hectare met eiken-haagbeukenbos, kalkrijk parelgras-beukenbos en gierstgras-beukenbos op de rand van het Maasterras. De NDA moet duidelijk maken of de bestaande en geplande maatregelen voldoende zijn voor het halen van de doelen voor het in stand houden van de beschermde natuur, of dat aanvullende maatregelen nodig zijn. In het Savelsbos is (verdere) verslechtering van de natuur niet uit te sluiten. Het gebied staat onder druk door onder andere stikstofdepositie en bemesting door run-off vanuit naastgelegen landbouwgronden. De doelen voor verbetering en uitbreiding van habitats in het Savelsbos moeten concreet worden gemaakt. Ook is niet gekeken naar de doelstellingen en de impact van de maatregelen voor het vliegend hert (keversoort). Om (verdere) verslechtering tegen te gaan en het bereiken van de doelen moeten snel maatregelen getroffen worden. Met name gericht om de vermesting vanuit run-off en stikstofdepositie te verminderen.

Twee van de meest algemene dagvlinders zijn klein koolwitje en klein geaderd witje. Ze komen verspreid door het hele land voor en lijken vergelijkbare eisen te stellen aan hun omgeving. Klein koolwitje zien we wel wat meer in landbouwgebieden en klein geaderd witje in een wat natuurlijker omgeving. In Zweden heeft men nu de eisen van de soorten onderzocht, vooral met het oog op klimaatverandering.

Het Nationaal Programma Landelijk Gebied (NPLG) adresseert beleidsdoelen voor stikstof, klimaat, water en natuur, die integraal en gebiedsgericht zullen worden opgepakt en uitgewerkt. Daarbij is een overzicht gewenst van mogelijke maatregelen die op landbouwbedrijven genomen kunnen worden, tezamen met een beoordeling van effecten op de beoogde doelen en in hoeverre er bij afzonderlijke maatregelen sprake kan zijn van afwenteling naar andere thema’s of beleidsdoelen. Vanuit een dertigtal beschikbare onderzoeksrapporten zijn alle genoemde milieumaatregelen per bedrijfsonderdeel bij elkaar gezet voor akkerbouw- en melkveebedrijven. Vervolgens zijn voor groepen maatregelen de effecten op de milieudoelen beschreven en mogelijke interacties. Zowel voor akkerbouw- als melkveebedrijven komt een veelheid aan maatregelen naar voren, waaruit passende keuzes gemaakt kunnen worden, rekening houdend met verschillen in bedrijfsstructuur, fysieke omstandigheden en ligging ten opzichte van kwetsbare natuurgebieden.

Conformity of tumour volumes and dose plans in prostate brachytherapy (BT) can be constrained by unwanted needle deflections, needle access restrictions and visualisation limitations. This work validates the feasibility of teleoperated robotic control of an active steerable needle using magnetic resonance (MR) for guidance. With this system, perturbations can be counteracted and critical structures can be circumvented to access currently inaccessible areas. The system comprises of (1) a novel steerable needle, (2) the minimally invasive robotics in an MR environment (MIRIAM) system, and (3) the daVinci Research Kit (dVRK). MR scans provide visual feedback to the operator controlling the dVRK. Needle steering is performed along curved trajectories to avoid the urethra towards targets (representing tumour tissue) in a prostate phantom with a targeting error of 1.2 ± 1.0 mm. This work shows the potential clinical applicability of active needle steering for prostate BT with a teleoperated robotic system in an MR environment.

Conformity of tumour volumes and dose plans in prostate brachytherapy (BT) can be constrained by unwanted needle deflections, needle access restrictions and visualisation limitations. This work validates the feasibility of teleoperated robotic control of an active steerable needle using magnetic resonance (MR) for guidance. With this system, perturbations can be counteracted and critical structures can be circumvented to access currently inaccessible areas. The system comprises of (1) a novel steerable needle, (2) the minimally invasive robotics in an MR environment (MIRIAM) system, and (3) the daVinci Research Kit (dVRK). MR scans provide visual feedback to the operator controlling the dVRK. Needle steering is performed along curved trajectories to avoid the urethra towards targets (representing tumour tissue) in a prostate phantom with a targeting error of 1.2 ± 1.0 mm. This work shows the potential clinical applicability of active needle steering for prostate BT with a teleoperated robotic system in an MR environment., Medical Instruments & Bio-Inspired Technology

Over the past decades, significant efforts have been made to understand the nature, dynamics and evolution of volcanic systems. In parallel, the continuous demographic expansion and extensive urbanization of volcanic areas have increased the exposure of our society to these natural phenomena. This increases the need to improve our capacities to accurately assess projected volcanic hazards and their potential socioeconomic and environmental impact, and Antarctica and the sub-Antarctic islands are no exception. More than a hundred volcanoes have been identified in Antarctica, some of which are entirely buried beneath the ice sheet and others as submarine volcanoes. Of these, at least eight large (basal diameters > c. 20-30 km) volcanoes are known to be active and pose a considerable threat to scientific and ever-increasing tourism activities being carried out in the region. Despite the scientific and socioeconomic interest, many aspects of the past volcanic activity and magmatic processes in Antarctica, and current volcanic hazards and risks, remain unknown. Moreover, many of Antarctica's volcanoes preserve a remarkable history of the eruptive environment, from which multiple parameters of past configurations of the Antarctic ice sheet (AIS) can be deduced. Given the critical role that the AIS plays in regulating Earth's climate, Antarctica's volcanoes therefore can be regarded as the ground truth for current models of past climates derived from modelling and studies of marine sediments. Here, we provide a succinct overview of the evolution of volcanism and magmatism in Antarctica and the sub-Antarctic region over the past 200 million years. Then, we briefly review the current state of knowledge of the most crucial aspects regarding Antarctica's volcanic and magmatic processes, and the contributions volcanic studies have made to our understanding of ice sheet history and evolution, geothermal heat flow, as well as present-day and future volcanic hazard and risk. A pri

Cigarette smoking causes hypomethylation of the gene Aryl Hydrocarbon Receptor Repressor (AHRR), which regulates detoxification and oxidative stress-responses. We investigated whether AHRR DNA methylation is related to chronic obstructive pulmonary disease (COPD) and studied its function in airway epithelial cells (AECs). The association with COPD was assessed in blood from never and current smokers with/without COPD, and in AECs from ex-smoking non-COPD controls and GOLD stage II-IV COPD patients cultured with/without cigarette smoke extract (CSE). The effect of CRISPR/Cas9-induced AHRR knockout on proliferation, CSE-induced mitochondrial membrane potential and apoptosis/necrosis in human bronchial epithelial 16HBE cells was studied. In blood, DNA methylation of AHRR at cg05575921 and cg21161138 was lower in smoking COPD subjects than smoking controls. In vitro, AHRR DNA methylation at these CpG-sites was lower in COPD-derived than control-derived AECs only upon CSE exposure. Upon AHRR knockout, we found a lower proliferation rate at baseline, stronger CSE-induced decrease in mitochondrial membrane potential, and higher CSE-induced late apoptosis/necroptosis. Together, our results show lower DNA methylation of AHRR upon smoking in COPD patients compared to non-COPD controls. Our data suggest that higher airway epithelial AHRR expression may lead to impaired cigarette smoke-induced mitochondrial dysfunction and apoptosis/necroptosis, potentially promoting unprogrammed/immunogenic cell death.

BACKGROUND: The prevalence of age-associated diseases, such as chronic obstructive pulmonary disease (COPD), is increasing as the average life expectancy increases around the world. We previously identified a gene signature for ageing in the human lung which included genes involved in apical and tight junction assembly, suggesting a role for airway epithelial barrier dysfunction with ageing. AIM: To investigate the association between genes involved in epithelial barrier function and age both in silico and in vitro in the airway epithelium. METHODS: We curated a gene signature of 274 genes for epithelial barrier function and tested the association with age in two independent cohorts of bronchial brushings from healthy individuals with no respiratory disease, using linear regression analysis (FDR < 0.05). Protein-protein interactions were identified using STRING©. The barrier function of primary bronchial epithelial cells at air-liquid interface and CRISPR-Cas9-induced knock-down of target genes in human bronchial 16HBE14o-cells was assessed using Trans epithelial resistance (TER) measurement and Electric cell-surface impedance sensing (ECIS) respectively. RESULTS: In bronchial brushings, we found 55 genes involved in barrier function to be significantly associated with age (FDR < 0.05). EPCAM was most significantly associated with increasing age and TRPV4 with decreasing age. Protein interaction analysis identified CDH1, that was negatively associated with higher age, as potential key regulator of age-related epithelial barrier function changes. In vitro, barrier function was lower in bronchial epithelial cells from subjects > 45 years of age and significantly reduced in CDH1-deficient 16HBE14o-cells. CONCLUSION: The significant association between genes involved in epithelial barrier function and age, supported by functional studies in vitro, suggest a role for epithelial barrier dysfunction in age-related airway disease.

BACKGROUND: The prevalence of age-associated diseases, such as chronic obstructive pulmonary disease (COPD), is increasing as the average life expectancy increases around the world. We previously identified a gene signature for ageing in the human lung which included genes involved in apical and tight junction assembly, suggesting a role for airway epithelial barrier dysfunction with ageing. AIM: To investigate the association between genes involved in epithelial barrier function and age both in silico and in vitro in the airway epithelium. METHODS: We curated a gene signature of 274 genes for epithelial barrier function and tested the association with age in two independent cohorts of bronchial brushings from healthy individuals with no respiratory disease, using linear regression analysis (FDR < 0.05). Protein-protein interactions were identified using STRING©. The barrier function of primary bronchial epithelial cells at air-liquid interface and CRISPR-Cas9-induced knock-down of target genes in human bronchial 16HBE14o-cells was assessed using Trans epithelial resistance (TER) measurement and Electric cell-surface impedance sensing (ECIS) respectively. RESULTS: In bronchial brushings, we found 55 genes involved in barrier function to be significantly associated with age (FDR < 0.05). EPCAM was most significantly associated with increasing age and TRPV4 with decreasing age. Protein interaction analysis identified CDH1, that was negatively associated with higher age, as potential key regulator of age-related epithelial barrier function changes. In vitro, barrier function was lower in bronchial epithelial cells from subjects > 45 years of age and significantly reduced in CDH1-deficient 16HBE14o-cells. CONCLUSION: The significant association between genes involved in epithelial barrier function and age, supported by functional studies in vitro, suggest a role for epithelial barrier dysfunction in age-related airway disease.

Cigarette smoking causes hypomethylation of the gene Aryl Hydrocarbon Receptor Repressor (AHRR), which regulates detoxification and oxidative stress-responses. We investigated whether AHRR DNA methylation is related to chronic obstructive pulmonary disease (COPD) and studied its function in airway epithelial cells (AECs). The association with COPD was assessed in blood from never and current smokers with/without COPD, and in AECs from ex-smoking non-COPD controls and GOLD stage II-IV COPD patients cultured with/without cigarette smoke extract (CSE). The effect of CRISPR/Cas9-induced AHRR knockout on proliferation, CSE-induced mitochondrial membrane potential and apoptosis/necrosis in human bronchial epithelial 16HBE cells was studied. In blood, DNA methylation of AHRR at cg05575921 and cg21161138 was lower in smoking COPD subjects than smoking controls. In vitro, AHRR DNA methylation at these CpG-sites was lower in COPD-derived than control-derived AECs only upon CSE exposure. Upon AHRR knockout, we found a lower proliferation rate at baseline, stronger CSE-induced decrease in mitochondrial membrane potential, and higher CSE-induced late apoptosis/necroptosis. Together, our results show lower DNA methylation of AHRR upon smoking in COPD patients compared to non-COPD controls. Our data suggest that higher airway epithelial AHRR expression may lead to impaired cigarette smoke-induced mitochondrial dysfunction and apoptosis/necroptosis, potentially promoting unprogrammed/immunogenic cell death.

Vergrassing belemmert een soortenrijke heidefauna, want vooral op droge heide hebben veel soorten een lage vegetatie met open plekken nodig. Begrazing kan hiervoor zorgen, maar andere heidesoorten zijn juist kwetsbaar voor te veel begrazing. Een beheerexperiment op Brabantse heideterreinen laat zien dat intensiveren of juist extensiveren van de begrazing heel effectief kan zijn.

OBJECTIVES: A systematic review was conducted with the aims of identifying sectors mentioned in the public health emergency preparedness and response (PHEPR) literature and mapping the involvement of those sectors in the seven PHEPR cycle domains. SETTING: A detailed search strategy was conducted in Embase and Scopus, covering the period between 1 January 2005 and 1 January 2020. METHODS: Published articles focusing on preparedness for and/or response to public health emergencies of multiple origins on the European continent were included. The frequency with which predetermined sectors were mentioned when describing collaboration during the preparedness and response cycle was determined. RESULTS: The results show that description of the involvement of sectors in PHEPR in general and collaboration during PHEPR is predominantly confined to a limited number of sectors, namely 'Governmental institutions', 'Human health industry', 'Experts' and 'Civil Society'. Description is also limited to only three domains of the PHEPR cycle, namely 'Risk and crisis management', 'Pre-event preparations and governance' and 'Surveillance'. CONCLUSIONS: Optimal preparedness and response require predefined collaboration with a broader scope of partners than currently seems to be the case based on this literature review. We recommend considering these outcomes when planning multisectoral collaboration during preparedness and response, as well as the need to further operationalise the term 'multisectoral collaboration' during PHEPRs. PROSPERO REGISTRATION NUMBER: PROSPERO with registration number 176 331.

Dit rapport richt zich op het bepalen van de Basiskwaliteit ván Natuur aan de hand van een praktisch hanteerbare set soorten. Het biedt daartoe een soortenlijst vanuit verschillende soortgroepen. Voorts wordt een perspectief geschetst voor de toepassing van deze soortenlijsten voor het ontwikkelen van benchmarks voor Basiskwaliteit Natuur (BKN) die in de praktijk kunnen worden gebruikt om de kwaliteit van het landschap aan de soorten af te lezen.

Steerable instruments allow for precise access to deeply-seated targets while sparing sensitive tissues and avoiding anatomical structures. In this study we present a novel omnidirectional steerable instrument for prostate high-dose-rate (HDR) brachytherapy (BT). The instrument utilizes a needle with internal compliant mechanism, which enables distal tip steering through proximal instrument bending while retaining high axial and flexural rigidity. Finite element analysis evaluated the design and the prototype was validated in experiments involving tissue simulants and ex-vivo bovine tissue. Ultrasound (US) images were used to provide visualization and shape-reconstruction of the instrument during the insertions. In the experiments lateral tip steering up to 20 mm was found. Manually controlled active needle tip steering in inhomogeneous tissue simulants and ex-vivo tissue resulted in mean targeting errors of 1.4 mm and 2 mm in 3D position, respectively. The experiments show that steering response of the instrument is history-independent. The results indicate that the endpoint accuracy of the steerable instrument is similar to that of the conventional rigid HDR BT needle while adding the ability to steer along curved paths. Due to the design of the steerable needle sufficient axial and flexural rigidity is preserved to enable puncturing and path control within various heterogeneous tissues. The developed instrument has the potential to overcome problems currently unavoidable with conventional instruments, such as pubic arch interference in HDR BT, without major changes to the clinical workflow., Medical Instruments & Bio-Inspired Technology

Microbrachytherapy with radioactive holmium-166 (166Ho) microspheres (MS) has the potential to be an effective treatment method for brain malignancies. Direct intratumoural delivery of 166Ho-MS and dose coverage of the whole tumour are crucial requirements. However, currently no dedicated instruments for controlled intratumoural delivery exist. This study presents an administration device that facilitates this novel magnetic resonance imaging (MRI) -guided intervention. The bioceramic alumina oxide cannula creates a straight channel for a superelastic nitinol precurved stylet to control spatial deposition of Ho-MS. End-point accuracy of the stylet was measured during insertions in phantoms. Imaging tests were performed in a 3 Tesla MRI-scanner to quantify instrument-induced artefacts. Additionally, the feasibility of non-radioactive holmium-165 (165Ho)-MS delivery with the administration device was evaluated in a brain tumour simulant. Absolute stylet tip error was 0.88 ± 0.61 mm, instrument distortion in MRI depended on needle material and orientation and dose delivery of 165Ho-MS in a brain tumour phantom was possible. This study shows that the administration device can accurately place the stylet for injection of Ho-MS and that visualization can be performed with MRI., Medical Instruments & Bio-Inspired Technology

BACKGROUND: The highly conserved Grainyhead-like (Grhl) family of transcription factors play critical roles in the development of the neural tube and craniofacial skeleton. In particular, deletion of family member Grainyhead-like 2 (Grhl2) leads to mid-gestational embryonic lethality, maxillary clefting, abdominoschisis, and both cranial and caudal neural tube closure defects. These highly pleiotropic and systemic defects suggest that Grhl2 plays numerous critical developmental roles to ensure correct morphogenesis and patterning. RESULTS: Here, using four separate Cre-lox conditional deletion models, as well as one genetic epistasis approach (Grhl2+/- ;Edn1+/- double heterozygous mice) we have investigated tissue-specific roles of Grhl2 in embryonic development, with a particular focus on the craniofacial skeleton. We find that loss of Grhl2 in the pharyngeal epithelium (using the ShhCre driver) leads to low-penetrance micrognathia, whereas deletion of Grhl2 within the ectoderm of the pharynx (NestinCre ) leads to small, albeit significant, differences in the proximal-distal elongation of both the maxilla and mandible. Loss of Grhl2 in endoderm (Sox17-2aiCre ) resulted in noticeable lung defects and a single instance of secondary palatal clefting, although formation of other endoderm-derived organs such as the stomach, bladder and intestines was not affected. Lastly, deletion of Grhl2 in cells of the neural crest (Wnt1Cre ) did not lead to any discernible defects in craniofacial development, and similarly, our epistasis approach did not detect any phenotypic consequences of loss of a single allele of both Grhl2 and Edn1. CONCLUSION: Taken together, our study identifies a pharyngeal-epithelium intrinsic, non-cell-autonomous role for Grhl2 in the patterning and formation of the craniofacial skeleton, as well as an endoderm-specific role for Grhl2 in the formation and establishment of the mammalian lung.

Steerable instruments allow for precise access to deeply-seated targets while sparing sensitive tissues and avoiding anatomical structures. In this study we present a novel omnidirectional steerable instrument for prostate high-dose-rate (HDR) brachytherapy (BT). The instrument utilizes a needle with internal compliant mechanism, which enables distal tip steering through proximal instrument bending while retaining high axial and flexural rigidity. Finite element analysis evaluated the design and the prototype was validated in experiments involving tissue simulants and ex-vivo bovine tissue. Ultrasound (US) images were used to provide visualization and shape-reconstruction of the instrument during the insertions. In the experiments lateral tip steering up to 20 mm was found. Manually controlled active needle tip steering in inhomogeneous tissue simulants and ex-vivo tissue resulted in mean targeting errors of 1.4 mm and 2 mm in 3D position, respectively. The experiments show that steering response of the instrument is history-independent. The results indicate that the endpoint accuracy of the steerable instrument is similar to that of the conventional rigid HDR BT needle while adding the ability to steer along curved paths. Due to the design of the steerable needle sufficient axial and flexural rigidity is preserved to enable puncturing and path control within various heterogeneous tissues. The developed instrument has the potential to overcome problems currently unavoidable with conventional instruments, such as pubic arch interference in HDR BT, without major changes to the clinical workflow., Medical Instruments & Bio-Inspired Technology

Microbrachytherapy with radioactive holmium-166 (166Ho) microspheres (MS) has the potential to be an effective treatment method for brain malignancies. Direct intratumoural delivery of 166Ho-MS and dose coverage of the whole tumour are crucial requirements. However, currently no dedicated instruments for controlled intratumoural delivery exist. This study presents an administration device that facilitates this novel magnetic resonance imaging (MRI) -guided intervention. The bioceramic alumina oxide cannula creates a straight channel for a superelastic nitinol precurved stylet to control spatial deposition of Ho-MS. End-point accuracy of the stylet was measured during insertions in phantoms. Imaging tests were performed in a 3 Tesla MRI-scanner to quantify instrument-induced artefacts. Additionally, the feasibility of non-radioactive holmium-165 (165Ho)-MS delivery with the administration device was evaluated in a brain tumour simulant. Absolute stylet tip error was 0.88 ± 0.61 mm, instrument distortion in MRI depended on needle material and orientation and dose delivery of 165Ho-MS in a brain tumour phantom was possible. This study shows that the administration device can accurately place the stylet for injection of Ho-MS and that visualization can be performed with MRI., Medical Instruments & Bio-Inspired Technology

Bij de uitvoering van maatregelen voor natuurherstel overheerst van oudsher een systeembenadering, waarin de invloed van de abiotische condities op de vegetatie centraal staat. Dat heeft voor zeldzame plantensoorten aantoonbaar succes gehad. Voor de bedreigde fauna is de aandacht weliswaar sterk toegenomen, maar blijft het herstel vaak nog achter. De vraag is of systeemherstel in grote natuurgebieden weer geschikt leefgebied heeft opgeleverd voor de terugkeer van verdwenen diersoorten. Via OBN-onderzoek is dit uitgezocht voor vijf bedreigde insectensoorten.

The discharging of cattle manure into the environment by dairy farmers in West Java, Indonesia, is causing environmental pollution and social issues. The objective of this study was to explore effects of increased utilization of cattle manure and good agricultural practices (GAP) on GHG emissions from the dairy and horticultural sector in Lembang Sub- District in West Java. Environmental consequences of various scenarios to avoid discharging of cattle manure were explored, including different manure processing methods, utilization of manure in either the dairy sector or the horticultural sector, and different levels of GAP in horticulture. Results showed that, compared to discharging, utilizing cattle manure on land for forage production and in horticulture lead to reduced GHG emissions, but only when cattle manure replaced currently used fertilizers. In a similar vein, results showed that implementing good agricultural practices (GAP) in horticultural production led to significant reduction of GHG emissions from the dairy and horticultural sectors in Lembang Sub-District.

Background and objective: Methylmalonic acidemia (MMA) and propionic acidemia (PA) are inborn errors of metabolism. While survival of MMA and PA patients has improved in recent decades, long-term outcome is still unsatisfactory. A protein restricted diet is the mainstay for treatment. Additional amino acid mixtures (AAM) can be prescribed if natural protein is insufficient. It is unknown if dietary treatment can have an impact on outcome. Design: We performed a nationwide retrospective cohort study and evaluated both longitudinal dietary treatment and clinical course of Dutch MMA and PA patients. Protein prescription was compared to the recommended daily allowances (RDA); the safe level of protein intake as provided by the World Health Organization. The association of longitudinal dietary treatment with long-term outcome was evaluated. Results: The cohort included 76 patients with a median retrospective follow-up period of 15 years (min–max: 0–48 years) and a total of 1063 patient years on a protein restricted diet. Natural protein prescription exceeded the RDA in 37% (470/1287) of all prescriptions and due to AAM prescription, the total protein prescription exceeded RDA in 84% (1070/1277). Higher protein prescriptions were associated with adverse outcomes in severely affected patients. In PA early onset patients a higher natural protein prescription was associated with more frequent AMD. In MMA vitamin B12 unresponsive patients, both a higher total protein prescription and AAM protein prescription were associated with more mitochondrial complications. A higher AAM protein prescription was associated with an increased frequency of cognitive impairment in the entire. Conclusion: Protein intake in excess of recommendations is frequent and is associated with poor outcome.

Background: This study evaluates whether a circumferential cast compared to a plaster splint leads to less fracture redisplacement in reduced extra-articular distal radius fractures (DRFs). Methods: This retrospective multicentre study was performed in four hospitals (two teaching hospitals and two academic hospitals). Adult patients with a displaced extra-articular DRF, treated with closed reduction, were included. Patients were included from a 5-year period (January 2012–January 2017). According to the hospital protocol, fractures were immobilized with a below elbow circumferential cast (CC) or a plaster splint (PS). The primary outcome concerned the difference in the occurrence of fracture redisplacement at one-week follow-up. Results: A total of 500 patients were included in this study (PS n = 184, CC n = 316). At one-week follow-up, fracture redisplacement occurred in 52 patients (17%) treated with a CC compared to 53 patients (29%) treated with a PS. This difference was statistically significant (p = 0.001). Conclusion: This study suggests that treatment of reduced DRFs with a circumferential cast might cause less fracture redisplacement at 1-week follow-up compared to treatment with a plaster splint. Level of Evidence Level III, Retrospective study.

BACKGROUND: Selecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging.METHODS: The study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI > 24) or explorative surgeries in patients with limited disease (PCI < 15). Secondary outcomes include correlations between surgical findings and MRI findings, cost-effectiveness, and quality of life (QOL) analysis.CONCLUSION: This randomized trial determines whether MRI can effectively replace surgical staging in patients with CRCPM considered for CRS-HIPEC.TRIAL REGISTRATION: Registered in the clinical trials registry of U.S. National Library of Medicine under NCT04231175 .

Klimaatverandering beïnvloedt wereldwijd de biodiversiteit en dwingt soorten in verspreiding mee te schuiven met de opwarming. In een artikel in Ecology Letters laat een internationaal onderzoeksteam zien dat versnippering van leefgebied door de mens voor vlinders bepaalt in welke mate ze hun verspreiding kunnen aanpassen en daarmee kunnen mee bewegen met klimaatverandering.

De provincie Overijssel gaat bij het aanpakken van overlast van eikenprocessierupsen sterker inzetten op het stimuleren van de natuurlijke vijanden van de rupsen. Daarom worden de komende week dertienhonderd koolmezennestkasten opgehangen.

De afgelopen decennia zijn de aantallen insecten afgenomen, en dat geldt ook voor veel soorten vlinders. We weten aan de hand van verspreidingsgegevens dat de meeste bestuivers zoals bijen en zweefvliegen achteruitgaan, maar hoe hard de populaties achteruitgaan kunnen we niet zeggen. Om dat te kunnen achterhalen, heb je langjarige gestandaardiseerde monitoring nodig, zoals het Meetnet Vlinders sinds 1990 de vinger aan de pols houdt van onze vlinderpopulaties. Aangezien vlinders ook bloemen bezoeken, zouden zij weleens de kanarie in de kolenmijn kunnen zijn.

Op 8 en 9 april organiseerde De Vlinderstichting voor de vijfde keer het symposium Future of Butterflies in Europe. Noodgedwongen was het een verkort online symposium, maar daardoor konden deelnemers uit meer landen dan ooit aanwezig zijn: 35 landen waren vertegenwoordigd. Het programma bracht een overzicht van actuele thema’s over vlinderbescherming, met veel bedreigingen maar ook nieuwe kansen.

In recent years, solution‐focused parenting support has been developed and implemented as a promising brief and strength‐based approach. Given the fundamental differences between solution‐focused and the historically more common problem‐focused parenting support and the complexity of transforming professional practice, an actual shift towards solution‐focused parenting support can be expected to be limited up to now. However, because research into the specific communication characteristics of professional parenting support is currently lacking, no conclusion can be drawn at present. Therefore, this study aims to explore the current problem‐ and solution‐focused characteristics of parenting support in the Dutch youth healthcare (YH). In total, 15 support sessions performed by 10 public health nurses were audio recorded and transcribed verbatim. A detailed qualitative content analysis of professional communication was conducted to identify problem‐ and solution‐focused factual, expressive, relational and appealing aspects of parenting support. Problem‐focused characteristics dominated all sessions of parenting support. This study is the first to thoroughly analyse the problem‐focused and solution‐focused communication characteristics of professional parenting support using a qualitative content analysis. Parenting support practice in the Dutch YH did not shift substantially to a solution‐focused approach. More effort is required to stimulate and facilitate this professional transformation.