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Several filamentary discharges can be applied to a combustible mixture, which can then ignite. The energy density of this discharge is a vital parameter, as it directly influences the local temperature rise and radical production. The goal of this article is to investigate how a previous discharge affects the energy density of a second discharge. To investigate the pulse-to-pulse coupling of filamentary discharges a one-dimensional numerical model is developed. In the developed model, the compressible Navier-Stokes equations are coupled to a plasma model. The plasma model is used to estimate the local energy density, while the compressible Navier-Stokes equations model the reactive flow. As a first step, skeletal air plasma chemistry is used, which includes fast gas heating, slow gas heating and the rapid generation of radicals. The skeletal plasma chemistry is combined with a detailed hydrogen combustion mechanism. Simulations in both air and hydrogen/air are conducted at several discharge energies and pressures. From the analysis of these results, we conclude that the main mechanism of pulse-to-pulse coupling is the reduction in molar density due to temperature rise.

Purpose: We compared hemodynamic parameters between subjects with marked, intermediate and minimal cardioinhibition during vasovagal syncope.Methods: The study included subjects with a decrease in heart rate while experiencing a complete vasovagal syncope during tilt-table testing. The subjects were classified as having marked, intermediate or minimal cardioinhibition, based on tertile values of the decrease in heart rate. Hemodynamic parameters between these groups were compared before tilt in the supine position, shortly after tilt and during cardioinhibition. Results:A total of 149 subjects with a median age of 43 (interquartile range 24–60) years were included in the study. Among the three groups with different levels of cardioinhibition, the highest heart rate was observed in subjects with marked cardioinhibition both before and shortly after tilt and at the start of cardioinhibition. The heart rate decrease in these subjects was both larger and faster compared to subjects with minimal and intermediate cardioinhibition. Conclusion: Subjects with marked cardioinhibition have both a larger and faster decrease in heart rate compared to subjects with intermediate and minimal cardioinhibition, as early as from the start of cardioinhibition. Marked cardioinhibition is related to differences in hemodynamic profiles already present well before the start of cardioinhibition.

Sown field margins can improve the conservation of biodiversity in rural areas and can contribute to the aesthetics of rural landscapes, thereby potentially increasing public support for agri-environmental measures. However, these two functions do not necessarily coincide. This raises the question whether field margins that are appreciated for their contribution to landscape aesthetics also deliver on the conservation of biodiversity. We conducted choice experiments with different groups of citizens and collected biodiversity data in the Netherlands, to investigate if the number of colors and vegetation cover in field margins increased respondents’ appreciation for them, and how these visual cues correlated with taxonomic diversity and abundance of plants and invertebrates in those field margins. Using manipulated photos, we also assessed whether the presence of colorful field margins in a range of different rural landscapes increased respondents’ appreciation of those landscapes. Respondents preferred colorful margins with high vegetation cover and showed a preference for green rural landscapes with colorful field margins. The presence of colorful field margins increased landscape aesthetics most in the least appreciated landscapes. The number of colors correlated positively with the diversity of sown and spontaneous plant species, and overall invertebrate abundance and abundance of predatory invertebrates, but was not related to invertebrate diversity. Our results show for the first time that colorful field margins support both public appreciation and diversity of plants and abundance of ground-dwelling invertebrates, with potential advantages to farmers in terms of natural pest control, at least in intensively used agricultural landscapes. However, management practices to maintain a high number of colors over time may be detrimental for invertebrate diversity. To optimize the different functions, we recommend that field margin layouts should consist of a perennia

Science plays a crucial role in identifying transformative change trajectories that are positive for biodiversity and human well-being. The concept of transformative change for biodiversity is receiving increased attention both within the political as well as in the scientific arena, but what transformative change entails still remains scientifically unclear. In this paper we report on a research priority exercise undertaken at the 2022 Alternet conference in which conference participants within each session were asked to jointly propose research gaps relevant to transformative change. Thirteen research priorities are identified, emphasising the need to learn from doing through transdisciplinary participatory action research, involving multiple disciplines including social sciences and building on existing research on, for example, nature-based solutions, OneHealth and climate change. The identified research priorities were later analysed under the umbrella of transformative change principles as a proxy for science to act as a lever to realise transformative change for biodiversity. Mobilising scientific research, interdisciplinarity and co-construction with stakeholders and decision-makers is a necessary step forward to make transformative progress in developing the biodiversity research agenda. In this respect, transformative action by the scientific community to develop the research agenda in an all-inclusive participatory process can be seen as a lever of transformative change for biodiversity. Such an all-inclusive participatory process for the development of a long-term biodiversity research agenda is in accordance with building on an integrated and whole-of-society approach as included in the EU Biodiversity Strategy’s aims and priorities around enabling transformative change.

The injection of electron cyclotron (EC) waves fulfills a number of important tasks in nuclear fusion devices for which detailed knowledge of the spatial power deposition profile is critical. This deposition profile is commonly determined using forward models such as beam or ray tracing. Recent numerical and experimental studies have shown that small-angle scattering of the EC beam as it passes through the turbulent plasma edge can cause significant broadening of the effective deposition profile, leading to considerable underestimation of the deposition width by forward methods. However, traditional inverse methods to determine the deposition profile from measurements overestimate the deposition profile width due to transport broadening. In this work, we implement three novel methods to resolve the EC power deposition profile from measurements that counteract transport broadening by simultaneously resolving transport and power deposition. We validate their assumptions and compare the results from these methods to the traditional break-in-slope method as well as to the TORAY ray-tracing code in a set of DIII-D discharges spanning five different confinement modes. We show that the four different inverse methods, novel and established, paint a consistent picture of deposition broadening. Specifically, we show that the measured power deposition profile is between 1.6 and 3.6 times wider than the TORAY profiles. Moreover, we show the considerable consequences that this level of broadening can have for ITER.

BACKGROUND Short-term neck pain after posterior cervical foraminotomy (posterior surgery) compared with anterior cervical discectomy with fusion (anterior surgery) treating cervical radiculopathy has only been assessed once, retrospectively, to our knowledge. The aim of this study was to prospectively evaluate the course of neck pain for 6 weeks after both treatments. METHODS This is a secondary analysis of the multicenter Foraminotomy ACDF Cost-Effectiveness Trial (FACET), conducted from January 2016 to May 2020. Of 389 patients who had single-level, 1-sided cervical radiculopathy and were screened for eligibility, 265 were randomly assigned to undergo posterior surgery (n = 132) or anterior surgery (n = 133). The primary outcome of the present analysis was neck pain, assessed weekly for 6 weeks using the visual analog scale (VAS), on a scale of 0 to 100. The secondary outcomes were arm pain, neck disability, work ability, quality of life, treatment satisfaction, motor and sensory changes, and hospital length of stay. Data were analyzed with mixed model analysis in intention-to-treat samples using 2-sided 95% confidence intervals (CIs). RESULTS In the first postoperative week, the mean VAS for neck pain was 56.2 mm (95% CI, 51.7 to 60.8 mm) after posterior surgery and 46.7 mm (95% CI, 42.2 to 51.2 mm) after anterior surgery. The mean between-group difference was 9.5 mm (95% CI, 3.3 to 15.7 mm), which gradually decreased to 2.3 mm (95% CI, -3.6 to 8.1 mm) at postoperative week 6. As of postoperative week 5, there was no significant difference between groups. Responder analyses confirmed this result. Secondary outcomes showed small differences between groups. CONCLUSIONS Insight into the course of neck pain during the first 6 weeks after posterior compared with anterior surgery is provided. Despite initially more neck pain after posterior surgery, patients swiftly improved and, as of postoperative week 5, results similar to those after anterior surgery were observed.

CONTEXT As elsewhere in Western Europe, large scale intensive agriculture dominates the landscape of the Netherlands. Grassland for dairy production occupies more than a quarter of its land surface. The high production intensity on conventionally farmed grassland leads to poor habitat quality, resulting in sharp declines in bird and insect numbers. Nature-inclusive agriculture (NIA) comprises innovations in farm management, technology and resource use that have the potential to address farmland biodiversity decline, but few Dutch farmers implement these. OBJECTIVE We aim to analyze the adoption of NIA practices in the Dutch dairy sector. Specifically, we study the influence of the dominant agri-food regime on the innovation system for NIA. METHODS Innovation Systems Analysis was performed to identify the various structural barriers which hinder adoption. Our study used a multi-method design in which data on NIA in the Dutch dairy sector was collected via a literature study, four workshops and a focus group discussion. RESULTS AND CONCLUSIONS We identified five key blocking mechanisms that hinder adoption of nature-inclusive agriculture in the Dutch dairy sector: (1) insufficient economic incentives for farmers, (2) limited action perspective of many dairy farmers in the Netherlands, (3) lack of a concrete and shared vision for NIA, (4) lack of NIA-specific and integral knowledge and (5) regime resistance, which moreover is connected to each of the previous blocking mechanisms. Our analysis shows that one of the empirical novelties of this paper is that these blocking mechanisms are strongly interlinked in the Dutch dairy sector, thereby perpetuating a situation of lock-in. We conclude that in order to accelerate adoption of nature-inclusive farming practices, problems need to be addressed in conjunction with one another, and therefore holistic approaches are key. A second important conclusion is that in order to foster growth of the innovation system around NIA, the

This work investigates kinetics and transport of CO2 microwave plasmas through simulation results from a 1D radial fluid model and experiments. Simulation results are validated against spatially resolved measurements of neutral species mole fractions, gas temperature, electron number density and temperature obtained by means of Thomson and Raman scattering diagnostics, yielding good agreement. As such, the model is used to complement experiments and assess the main chemical reactions, mass and energy transport in diffuse and contracted plasma regimes. From model results, it is found that, as pressure is raised, the inhomogeneous gas heating induces significant gradients in neutral and charged species mole fractions profiles. Moreover, the transition from diffuse to contracted plasma is accompanied by a change in the dominant charged species, which favours electron–ion recombination over dissociative attachment. Associative ionization rates increase in the plasma core from diffuse to contracted regime. These processes contribute to the increase in the peak electron number density with pressure, that determines radial plasma contraction.

BackgroundCranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage.MethodsPatients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time from hemorrhage to first treatment, rebleed, or last follow-up. Rebleeding in the first 2 weeks and first year were compared using incidence rate ratio and difference.ResultsOf 1077 patients, 250 met the inclusion criteria and had 95 cumulative person-years natural history follow-up. The overall annualized rebleed rate was 7.3% (95% CI, 3.2-14.5). The incidence rate of rebleeding in the first 2 weeks was 0.0011 per person-day; an early rebleed risk of 1.6% in the first 14 days (95% CI, 0.3-5.1). For the remainder of the first year, the incidence rate was 0.00015 per person-day; a rebleed rate of 5.3% (CI, 1.7-12.4) over 1 year. The incidence rate ratio was 7.3 (95% CI, 1.4-37.7; P, 0.026).ConclusionsThe risk of rebleeding of a dural arteriovenous fistula with cortical venous drainage presenting with hemorrhage is increased in the first 2 weeks justifying early treatment. However, the magnitude of this increase may be considerably lower than previously thought. Treatment within 5 days was associated with a low rate of rebleeding and appears an appropriate timeframe.

Background: The risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased in postmenopausal women compared with men of similar age, suggesting a role for sex hormones. We aimed to explore whether sex hormones, and age at menarche/menopause have a causal effect on aSAH risk by conducting a 2-sample MR study (Mendelian randomization). Methods: We obtained sex-specific genetic instruments for serum estradiol, bioavailable testosterone (BioT), SHBG (sex hormone-binding globulin), and age at menarche/menopause from genome-wide association studies. The associated sex-specific aSAH risk was estimated with inverse-variance weighted MR analyses with various statistical sensitivity analyses. Multivariable and cluster MR analyses were performed for BioT and SHBG to account for a genetic and phenotypic correlation between the 2 exposures. The clusters represented (1) single-nucleotide polymorphisms primarily increasing SHBG, with secondary decreasing effects on BioT, and (2) single-nucleotide polymorphisms affecting BioT without affecting SHBG. Results: Univariable MR analyses showed an 18% increased aSAH risk among women per 1-SD increase in genetically determined SHBG levels (odds ratio, 1.18 [95% CI, 1.05–1.34]; P=0.007). Suggestive evidence was identified for a 27% decreased risk of aSAH among women per 1-SD increase in BioT (odds ratio, 0.73 [95% CI, 0.55–0.95]; P=0.02). The latter association disappeared in cluster analysis when only using SHBG-independent variants. MR analyses with variants from the cluster with primary SHBG effects and secondary (opposite) BioT-effects yielded a statistically significant association (odds ratio, 1.21 [95% CI, 1.05–1.40]; P=0.008). No other causal associations were identified. Conclusions: Genetic predisposition to elevated serum levels of SHBG, with secondary lower serum BioT levels, is associated with an increased aSAH risk among women, suggesting that SHBG and BioT causally elevate aSAH risk. Further studies are required to eluci

Background: The risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased in postmenopausal women compared with men of similar age, suggesting a role for sex hormones. We aimed to explore whether sex hormones, and age at menarche/menopause have a causal effect on aSAH risk by conducting a 2-sample MR study (Mendelian randomization). Methods: We obtained sex-specific genetic instruments for serum estradiol, bioavailable testosterone (BioT), SHBG (sex hormone-binding globulin), and age at menarche/menopause from genome-wide association studies. The associated sex-specific aSAH risk was estimated with inverse-variance weighted MR analyses with various statistical sensitivity analyses. Multivariable and cluster MR analyses were performed for BioT and SHBG to account for a genetic and phenotypic correlation between the 2 exposures. The clusters represented (1) single-nucleotide polymorphisms primarily increasing SHBG, with secondary decreasing effects on BioT, and (2) single-nucleotide polymorphisms affecting BioT without affecting SHBG. Results: Univariable MR analyses showed an 18% increased aSAH risk among women per 1-SD increase in genetically determined SHBG levels (odds ratio, 1.18 [95% CI, 1.05–1.34]; P=0.007). Suggestive evidence was identified for a 27% decreased risk of aSAH among women per 1-SD increase in BioT (odds ratio, 0.73 [95% CI, 0.55–0.95]; P=0.02). The latter association disappeared in cluster analysis when only using SHBG-independent variants. MR analyses with variants from the cluster with primary SHBG effects and secondary (opposite) BioT-effects yielded a statistically significant association (odds ratio, 1.21 [95% CI, 1.05–1.40]; P=0.008). No other causal associations were identified. Conclusions: Genetic predisposition to elevated serum levels of SHBG, with secondary lower serum BioT levels, is associated with an increased aSAH risk among women, suggesting that SHBG and BioT causally elevate aSAH risk. Further studies are required to eluci

Background: The risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased in postmenopausal women compared with men of similar age, suggesting a role for sex hormones. We aimed to explore whether sex hormones, and age at menarche/menopause have a causal effect on aSAH risk by conducting a 2-sample MR study (Mendelian randomization). Methods: We obtained sex-specific genetic instruments for serum estradiol, bioavailable testosterone (BioT), SHBG (sex hormone-binding globulin), and age at menarche/menopause from genome-wide association studies. The associated sex-specific aSAH risk was estimated with inverse-variance weighted MR analyses with various statistical sensitivity analyses. Multivariable and cluster MR analyses were performed for BioT and SHBG to account for a genetic and phenotypic correlation between the 2 exposures. The clusters represented (1) single-nucleotide polymorphisms primarily increasing SHBG, with secondary decreasing effects on BioT, and (2) single-nucleotide polymorphisms affecting BioT without affecting SHBG. Results: Univariable MR analyses showed an 18% increased aSAH risk among women per 1-SD increase in genetically determined SHBG levels (odds ratio, 1.18 [95% CI, 1.05–1.34]; P=0.007). Suggestive evidence was identified for a 27% decreased risk of aSAH among women per 1-SD increase in BioT (odds ratio, 0.73 [95% CI, 0.55–0.95]; P=0.02). The latter association disappeared in cluster analysis when only using SHBG-independent variants. MR analyses with variants from the cluster with primary SHBG effects and secondary (opposite) BioT-effects yielded a statistically significant association (odds ratio, 1.21 [95% CI, 1.05–1.40]; P=0.008). No other causal associations were identified. Conclusions: Genetic predisposition to elevated serum levels of SHBG, with secondary lower serum BioT levels, is associated with an increased aSAH risk among women, suggesting that SHBG and BioT causally elevate aSAH risk. Further studies are required to eluci

BackgroundCranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage.MethodsPatients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time from hemorrhage to first treatment, rebleed, or last follow-up. Rebleeding in the first 2 weeks and first year were compared using incidence rate ratio and difference.ResultsOf 1077 patients, 250 met the inclusion criteria and had 95 cumulative person-years natural history follow-up. The overall annualized rebleed rate was 7.3% (95% CI, 3.2-14.5). The incidence rate of rebleeding in the first 2 weeks was 0.0011 per person-day; an early rebleed risk of 1.6% in the first 14 days (95% CI, 0.3-5.1). For the remainder of the first year, the incidence rate was 0.00015 per person-day; a rebleed rate of 5.3% (CI, 1.7-12.4) over 1 year. The incidence rate ratio was 7.3 (95% CI, 1.4-37.7; P, 0.026).ConclusionsThe risk of rebleeding of a dural arteriovenous fistula with cortical venous drainage presenting with hemorrhage is increased in the first 2 weeks justifying early treatment. However, the magnitude of this increase may be considerably lower than previously thought. Treatment within 5 days was associated with a low rate of rebleeding and appears an appropriate timeframe.

Background: The risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased in postmenopausal women compared with men of similar age, suggesting a role for sex hormones. We aimed to explore whether sex hormones, and age at menarche/menopause have a causal effect on aSAH risk by conducting a 2-sample MR study (Mendelian randomization). Methods: We obtained sex-specific genetic instruments for serum estradiol, bioavailable testosterone (BioT), SHBG (sex hormone-binding globulin), and age at menarche/menopause from genome-wide association studies. The associated sex-specific aSAH risk was estimated with inverse-variance weighted MR analyses with various statistical sensitivity analyses. Multivariable and cluster MR analyses were performed for BioT and SHBG to account for a genetic and phenotypic correlation between the 2 exposures. The clusters represented (1) single-nucleotide polymorphisms primarily increasing SHBG, with secondary decreasing effects on BioT, and (2) single-nucleotide polymorphisms affecting BioT without affecting SHBG. Results: Univariable MR analyses showed an 18% increased aSAH risk among women per 1-SD increase in genetically determined SHBG levels (odds ratio, 1.18 [95% CI, 1.05–1.34]; P=0.007). Suggestive evidence was identified for a 27% decreased risk of aSAH among women per 1-SD increase in BioT (odds ratio, 0.73 [95% CI, 0.55–0.95]; P=0.02). The latter association disappeared in cluster analysis when only using SHBG-independent variants. MR analyses with variants from the cluster with primary SHBG effects and secondary (opposite) BioT-effects yielded a statistically significant association (odds ratio, 1.21 [95% CI, 1.05–1.40]; P=0.008). No other causal associations were identified. Conclusions: Genetic predisposition to elevated serum levels of SHBG, with secondary lower serum BioT levels, is associated with an increased aSAH risk among women, suggesting that SHBG and BioT causally elevate aSAH risk. Further studies are required to eluci

Background: The risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased in postmenopausal women compared with men of similar age, suggesting a role for sex hormones. We aimed to explore whether sex hormones, and age at menarche/menopause have a causal effect on aSAH risk by conducting a 2-sample MR study (Mendelian randomization). Methods: We obtained sex-specific genetic instruments for serum estradiol, bioavailable testosterone (BioT), SHBG (sex hormone-binding globulin), and age at menarche/menopause from genome-wide association studies. The associated sex-specific aSAH risk was estimated with inverse-variance weighted MR analyses with various statistical sensitivity analyses. Multivariable and cluster MR analyses were performed for BioT and SHBG to account for a genetic and phenotypic correlation between the 2 exposures. The clusters represented (1) single-nucleotide polymorphisms primarily increasing SHBG, with secondary decreasing effects on BioT, and (2) single-nucleotide polymorphisms affecting BioT without affecting SHBG. Results: Univariable MR analyses showed an 18% increased aSAH risk among women per 1-SD increase in genetically determined SHBG levels (odds ratio, 1.18 [95% CI, 1.05–1.34]; P=0.007). Suggestive evidence was identified for a 27% decreased risk of aSAH among women per 1-SD increase in BioT (odds ratio, 0.73 [95% CI, 0.55–0.95]; P=0.02). The latter association disappeared in cluster analysis when only using SHBG-independent variants. MR analyses with variants from the cluster with primary SHBG effects and secondary (opposite) BioT-effects yielded a statistically significant association (odds ratio, 1.21 [95% CI, 1.05–1.40]; P=0.008). No other causal associations were identified. Conclusions: Genetic predisposition to elevated serum levels of SHBG, with secondary lower serum BioT levels, is associated with an increased aSAH risk among women, suggesting that SHBG and BioT causally elevate aSAH risk. Further studies are required to eluci

This work investigates kinetics and transport of CO2 microwave plasmas through simulation results from a 1D radial fluid model and experiments. Simulation results are validated against spatially resolved measurements of neutral species mole fractions, gas temperature, electron number density and temperature obtained by means of Thomson and Raman scattering diagnostics, yielding good agreement. As such, the model is used to complement experiments and assess the main chemical reactions, mass and energy transport in diffuse and contracted plasma regimes. From model results, it is found that, as pressure is raised, the inhomogeneous gas heating induces significant gradients in neutral and charged species mole fractions profiles. Moreover, the transition from diffuse to contracted plasma is accompanied by a change in the dominant charged species, which favours electron–ion recombination over dissociative attachment. Associative ionization rates increase in the plasma core from diffuse to contracted regime. These processes contribute to the increase in the peak electron number density with pressure, that determines radial plasma contraction.

The role of anisotropic scattering in rotational collisions of electrons with CO molecules is investigated numerically with Monte Carlo (MC) simulations and with calculations using the Lisbon KInetics two-term Boltzmann solver (LoKI-B). The study adopts integral cross sections taken from the IST-Lisbon database of LXCat or extracted from Biagi's code Magboltz v11.10. Different angular scattering models for rotational collisions are implemented and compared in MC simulations, and a novel anisotropic scattering model is derived from the dipole-Born differential cross sections, to describe the strongly forward-peaked nature of rotational collisions. This model is also implemented in LoKI-B, to describe the anisotropic inelastic/superelastic scattering in dipole rotational collisions, using coherent expressions for the corresponding integral and momentum transfer cross sections. The comparison between MC and LoKI-B results shows that the calculation of swarm parameters is more influenced by the choice of the angular scattering model than the adoption of the two-term approximation, yielding deviations up to 50% in the reduced mobility for different angular distributions. The consequences in the swarm derivation of cross sections are also discussed. Finally, it is shown that inclusion of electric-quadrupole interactions, usually neglected in electron swarm studies, can improve the agreement between numerical results and measurements.

An expert committee was formed to reach consensus on the use of tilt table testing (TTT) in the diagnosis of disorders that may cause transient loss of consciousness (TLOC) and to outline when other provocative cardiovascular autonomic tests are needed. While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous events. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to the performance of (1) additional provocation tests, such as the active standing test, carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO2 or neuro-endocrine tests; and (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.

An expert committee was formed to reach consensus on the use of Tilt Table Testing (TTT) in the diagnosis of disorders that may cause transient loss of consciousness (TLOC) and to outline when other provocative cardiovascular autonomic tests are needed. While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous ones. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to perform (1) additional provocation tests, such as the active standing test carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO2 or neuro-endocrine tests; (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.

Accurate simulations of the behavior of RF waves in hot, magnetized fusion plasmas have traditionally been computationally demanding due to the integro-differential character of the hot plasma wave equation. In this work a method is described that allows the integral in the hot-plasma wave equation to be rewritten as a set of differential operators by fitting a polynomial through the dielectric tensor components. This approach is applied to a one-dimensional simulation with typical profiles and plasma parameters for the JET fusion reactor. The accuracy and computational time are compared with an all-orders model and a truncated Finite Larmor Radius model. It is shown that the proposed method can be used to achieve accuracies previously only obtained with extremely heavy all-orders models like the two-dimensional AORSA code, but at significantly reduced computational costs. The MATLAB code that has been developed in this work is available under the GPLv3 licence.

An expert committee was formed to reach consensus on the use of tilt table testing (TTT) in the diagnosis of disorders that may cause transient loss of consciousness (TLOC) and to outline when other provocative cardiovascular autonomic tests are needed. While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous events. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to the performance of (1) additional provocation tests, such as the active standing test, carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO2 or neuro-endocrine tests; and (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.

An expert committee was formed to reach consensus on the use of Tilt Table Testing (TTT) in the diagnosis of disorders that may cause transient loss of consciousness (TLOC) and to outline when other provocative cardiovascular autonomic tests are needed. While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous ones. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to perform (1) additional provocation tests, such as the active standing test carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO2 or neuro-endocrine tests; (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.

The role of anisotropic scattering in rotational collisions of electrons with CO molecules is investigated numerically with Monte Carlo (MC) simulations and with calculations using the Lisbon KInetics two-term Boltzmann solver (LoKI-B). The study adopts integral cross sections taken from the IST-Lisbon database of LXCat or extracted from Biagi's code Magboltz v11.10. Different angular scattering models for rotational collisions are implemented and compared in MC simulations, and a novel anisotropic scattering model is derived from the dipole-Born differential cross sections, to describe the strongly forward-peaked nature of rotational collisions. This model is also implemented in LoKI-B, to describe the anisotropic inelastic/superelastic scattering in dipole rotational collisions, using coherent expressions for the corresponding integral and momentum transfer cross sections. The comparison between MC and LoKI-B results shows that the calculation of swarm parameters is more influenced by the choice of the angular scattering model than the adoption of the two-term approximation, yielding deviations up to 50% in the reduced mobility for different angular distributions. The consequences in the swarm derivation of cross sections are also discussed. Finally, it is shown that inclusion of electric-quadrupole interactions, usually neglected in electron swarm studies, can improve the agreement between numerical results and measurements.

Accurate simulations of the behavior of RF waves in hot, magnetized fusion plasmas have traditionally been computationally demanding due to the integro-differential character of the hot plasma wave equation. In this work a method is described that allows the integral in the hot-plasma wave equation to be rewritten as a set of differential operators by fitting a polynomial through the dielectric tensor components. This approach is applied to a one-dimensional simulation with typical profiles and plasma parameters for the JET fusion reactor. The accuracy and computational time are compared with an all-orders model and a truncated Finite Larmor Radius model. It is shown that the proposed method can be used to achieve accuracies previously only obtained with extremely heavy all-orders models like the two-dimensional AORSA code, but at significantly reduced computational costs. The MATLAB code that has been developed in this work is available under the GPLv3 licence.

The end of the first working program of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) provided an opportunity to draw lessons from its work. This perspective paper captures insights from ecosystem services (ES) researchers and practitioners, largely drawing from the Europeancontext (referred to herein as ES community ), on this key science policy interface. We synthesize reflections from a workshop on how (i) IPBES can engage the ES community; (ii) the ES community can engage with IPBES; and (iii) individual scientists can contribute. We note that IPBES constitutes a great advancement towards multidisciplinarity and inclusivity in ES research and practice. Key reflections for IPBES are that funding and visibility at ES research events could be improved, the contribution and selection processes could be more transparent, and communication with experts improved. Key reflections for the ES community include a need to improvepolicy-relevance by integrating more social scientists, researchers from developing countries, early-career scientists and policy-makers. Key reflections directed towards individual scientists include contributing (pro)actively to science policy inter-face initiatives such as IPBES and increasing transdisciplinary research. These reflections intend to contribute to the awareness of challenges and opportunities for institutions, groups and individuals working on ES. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor and Francis Group.

BACKGROUND: An increasing number of children are suffering from brain damage-related visual processing dysfunctions (VPD). There is currently a lack of evidence-based intervention methods that can be used early in development. We developed a visual intervention protocol suitable from 1 year of age. The protocol is structured, comprehensive and individually adaptive, and is paired with quantitative outcome assessments. Our aim is to investigate the effectiveness of this first visual intervention program for young children with (a risk of) VPD. METHODS: This is a single-blind, placebo-controlled trial that is embedded within standard clinical care. The study population consists of 100 children born very or extremely preterm (< 30 weeks) at 1 year of corrected age (CA), of whom 50% are expected to have VPD. First, children undergo a visual screening at 1 year CA. If they are classified as being at risk of VPD, they are referred to standard care, which involves an ophthalmic and visual function assessment and a (newly developed) visual intervention program. This program consists of a general protocol (standardized and similar for all children) and a supplement protocol (adapted to the specific needs of the child). Children are randomly allocated to an intervention group (starting upon inclusion at 1 year CA) or a control group (postponed: starting at 2 years CA). The control group will receive a placebo treatment. The effectiveness of early visual intervention will be examined with follow-up visual and neurocognitive assessments after 1 year (upon completion of the direct intervention) and after 2 years (upon completion of the postponed intervention). DISCUSSION: Through this randomized controlled trial we will establish the effectiveness of a new and early

The end of the first working program of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) provided an opportunity to draw lessons from its work. This perspective paper captures insights from ecosystem services (ES) researchers and practitioners, largely drawing from the Europeancontext (referred to herein as ES community ), on this key science policy interface. We synthesize reflections from a workshop on how (i) IPBES can engage the ES community; (ii) the ES community can engage with IPBES; and (iii) individual scientists can contribute. We note that IPBES constitutes a great advancement towards multidisciplinarity and inclusivity in ES research and practice. Key reflections for IPBES are that funding and visibility at ES research events could be improved, the contribution and selection processes could be more transparent, and communication with experts improved. Key reflections for the ES community include a need to improvepolicy-relevance by integrating more social scientists, researchers from developing countries, early-career scientists and policy-makers. Key reflections directed towards individual scientists include contributing (pro)actively to science policy inter-face initiatives such as IPBES and increasing transdisciplinary research. These reflections intend to contribute to the awareness of challenges and opportunities for institutions, groups and individuals working on ES. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor and Francis Group.

BackgroundBeta-based adaptive Deep Brain Stimulation (aDBS) is effective in Parkinson's disease (PD), when assessed in the immediate post-implantation phase. However, the potential benefits of aDBS in patients with electrodes chronically implanted, in whom changes due to the microlesion effect have disappeared, are yet to be assessed.MethodsTo determine the acute effectiveness and side-effect profile of aDBS in PD compared to conventional continuous DBS (cDBS) and no stimulation (NoStim), years after DBS implantation, 13 PD patients undergoing battery replacement were pseudo-randomised in a crossover fashion, into three conditions (NoStim, aDBS or cDBS), with a 2-min interval between them. Patient videos were blindly evaluated using a short version of the Unified Parkinson's Disease Rating Scale (subUPDRS), and the Speech Intelligibility Test (SIT).ResultsMean disease duration was 16 years, and the mean time since DBS-implantation was 6.9 years. subUPDRS scores (11 patients tested) were significantly lower both in aDBS (p=<.001), and cDBS (p = .001), when compared to NoStim. Bradykinesia subscores were significantly lower in aDBS (p = .002), and did not achieve significance during cDBS (p = .08), when compared to NoStim. Two patients demonstrated re-emerging tremor during aDBS. SIT scores of patients who presented stimulation-induced dysarthria significantly worsened in cDBS (p = .009), but not in aDBS (p = .407), when compared to NoStim. Overall, stimulation was applied 48.8% of the time during aDBS.ConclusionBeta-based aDBS is effective in PD patients with bradykinetic phenotypes, delivers less stimulation than cDBS, and potentially has a more favourable speech side-effect profile. Patients with prominent tremor may require a modified adaptive strategy.

The European Union (EU) 2020 Biodiversity strategy will soon come to an end and may not have been as successful as envisioned. In the current context of the global biodiversity crisis, the European Commission, the research community, and broader society cannot risk another, likely ineffective, attempt by the EU to halt biodiversity loss after 2020. Through the development of the EU post 2020 Biodiversity Strategy, the scientific community of the ALTER-Net and EKLIPSE networks saw a unique opportunity to make a difference for biodiversity in Europe by better involving scientists, policy makers, and society. We developed an innovative, transparent, and collaborative process—called the multiphased, iterative, and consultative elicitation of scientific expertise (MICESE) method. This process allowed us to produce a set of 12 key messages developed by scientists for the EU to prioritize in the development of the new post 2020 biodiversity strategy. These key messages were structured according to their systemic value, scale, and nature. We provide insights and analyses of the new MICESE method before reflecting on how to improve the future involvement of scientists in science–policy interfaces

The end of the first working program of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) provided an opportunity to draw lessons from its work. This perspective paper captures insights from ecosystem services (ES) researchers and practitioners, largely drawing from the Europeancontext (referred to herein as ‘ES community’), on this key science–policy interface. We synthesize reflections from a workshop on how (i) IPBES can engage the ES community; (ii) the ES community can engage with IPBES; and (iii) individual scientists can contribute. We note that IPBES constitutes a great advancement towards multidisciplinarity and inclusivity in ES research and practice. Key reflections for IPBES are that funding and visibility at ES research events could be improved, the contribution and selection processes could be more transparent, and communication with experts improved. Key reflections for the ES community include a need to improvepolicy-relevance by integrating more social scientists, researchers from developing countries, early-career scientists and policy-makers. Key reflections directed towards individual scientists include contributing (pro)actively to science–policy inter-face initiatives such as IPBES and increasing transdisciplinary research. These reflections intend to contribute to the awareness of challenges and opportunities for institutions, groups and individuals working on ES.

The end of the first working program of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) provided an opportunity to draw lessons from its work. This perspective paper captures insights from ecosystem services (ES) researchers and practitioners, largely drawing from the Europeancontext (referred to herein as ES community ), on this key science policy interface. We synthesize reflections from a workshop on how (i) IPBES can engage the ES community; (ii) the ES community can engage with IPBES; and (iii) individual scientists can contribute. We note that IPBES constitutes a great advancement towards multidisciplinarity and inclusivity in ES research and practice. Key reflections for IPBES are that funding and visibility at ES research events could be improved, the contribution and selection processes could be more transparent, and communication with experts improved. Key reflections for the ES community include a need to improvepolicy-relevance by integrating more social scientists, researchers from developing countries, early-career scientists and policy-makers. Key reflections directed towards individual scientists include contributing (pro)actively to science policy inter-face initiatives such as IPBES and increasing transdisciplinary research. These reflections intend to contribute to the awareness of challenges and opportunities for institutions, groups and individuals working on ES. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor and Francis Group.

Coastal ecosystems have been increasingly subjected to poor water quality. Remote sensing has been used to monitor water quality, but few studies have integrated remotely sensed data with compositional and/or abundance data of coral reef taxa. In the present study, fish biomass was assessed along the Jakarta Bay Thousand Island reef system and variation in the biomass of selected fish families related to substrate cover and remotely sensed data. Overall, fish biomass and the biomass of each of the families Acanthuridae, Apogonidae, Caesionidae, Chaetodontidae, Ephippidae, Pomacentridae, Labridae and the subfamily Scaridae were much higher mid- and offshore than inshore. Substrate cover and chlorophyll-a concentrations proved to be significant predictors of spatial variation in fish biomass, suggesting an important impact of reef degradation and eutrophication on reef fish abundance. Copyright © Marine Biological Association of the United Kingdom 2018

Although the Netherlands is one of the most densely populated countries in the world it has several interesting and sometimes internationally unique ecosystems associated with its position on a major European delta. Wet delta conditions and landscape dynamics have shaped the ecosystems of the lowlands while Dutch glaciation history has had significant impact on ecosystem development on the higher grounds. Today, most specific delta dynamics have disappeared due to human use and landscape alteration for flood protection, urbanisation and agriculture. Less than 12% of the Dutch land surface is more or less natural, and is mostly forested. No native forest survived in the Netherlands, current forests were all replanted for timber production or landscape restoration. Natural forests emerged where production forests were abandoned or by natural succession on open terrains. Most Dutch ecosystems and nature reserves are intensively managed because of external disturbances by other land use and to compensate for the lack of natural dynamics. Thanks to such conservation management and to improving environmental conditions in general, Dutch nature now shows the first signs of recovery after a long period of biodiversity loss.

Background Most older people wish to remain living at home as long as possible. Being able to perform daily activities and self-reliance are important conditions for older people to achieve this. Evidence regarding predictors of self-reliance in chronically ill older people receiving home-care is lacking. Aims The primary objective is to determine the predictors of self-reliance of patients with a chronic illness receiving home-care at six months follow-up. The secondary objective is to compare characteristics of patients with a chronic illness receiving home-care at six months follow-up, with those who are completely independent and do not receive home-care anymore. Methods A prognostic study with six months follow-up. Patient information regarding demographics, nursing diagnosis, amount of care, nurses and unplanned hospitalization were extracted from electronic patient files, used by a large long- term care organization in the east of the Netherlands. Multiple logistic regression analysis was performed to determine predictors of self-reliance. Results In total, data was collected from 216 patients, of which 127 patients were independent at six months follow-up. Four factors appear to predict self-reliance. Male (Odds Ratio (OR):1,411[95%Confidence Interval (CI):0,78-2,57]), number of actual nursing diagnosis (OR:0,80[95%CI:0,68-0,94]), problems in the psychosocial domain (OR:1,65[95%CI:0,89-3,05]) and problems in the physiological domain (OR:6,95[95%CI:1,54-31,23]) Conclusions The number of nursing diagnosis is the strongest predictor, reducing the chance of self-reliance after six months, followed by problems in the physiological and psychological domain. Being male seems to increase the chance of self-reliance. Recommendations More research is needed to understand which patient-characteristics, -problems and social circumstances influence self-reliance among older people with a chronic illness receiving home-care. Subsequently, interventions can be recommended

Supine hypertension commonly occurs in patients with neurogenic orthostatic hypotension due to autonomic failure. Supine hypertension promotes nocturnal sodium excretion and orthostatic hypotension, thus, interfering with quality of life. Perusal of the literature on essential hypertension and smaller scale investigations in autonomic failure patients also suggest that supine hypertension may predispose to cardiovascular and renal disease. These reasons provide a rationale for treating supine hypertension. Yet, treatment of supine hypertension, be it through nonpharmacological or pharmacological approaches, may exacerbate orthostatic hypotension when patients get up during the night. Fall-related complications may occur. More research is needed to define the magnitude of the deleterious effects of supine hypertension on cardiovascular, cerebrovascular, and renal morbidity and mortality. Integration of more precise cardiovascular risk assessment, efficacy, and safety data, and the prognosis of the underlying condition causing autonomic failure is required for individualized management recommendations.