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In this article, gain errors in current sensing for highly dynamic three-phase drives with three current sensor measurements are compensated without the aid of the machine plant model. As three current sensors are used, redundant information from the neutral current measurement is extracted by constructing its mathematical relation with the measured time-varying dq current. The proposed method compensates for non-symmetrical current sensor gain errors even in the presence of offset errors. A Recursive Sliding Window Least Square method is proposed to minimize the computation effort such that the method is suitable to be applied online. It does not incorporate a low-pass filter or averaging method based on electrical speed, making it suitable for highly dynamic applications. It is able to be applied in any three-phase AC machine, as the machine plant is not considered. Analysis, simulation and experimental results obtained from the hardware prototype by mimicking the actual application of high-precision mechatronics demonstrate the validity of the proposed method.

Introduction: The use of immune checkpoint inhibitors (ICIs) in cancer im-munotherapy has shown increased overall survival in a wide range of cancer types with the associated risk of developing severe immune-mediated adverse events, commonly involving the gastrointestinal tract. Aim: The aim of this position statement is to provide an updated practice advice to the gastroenterologists and oncologists on the diagnosis and management of ICI-induced gas-trointestinal toxicity. Methodology: The evidence reviewed in this paper includes a comprehensive search strategy of English language publications. Consensus was reached using a three-round modified Delphi methodology and approved by the members of the Belgian Inflammatory Bowel Disease Research and Development Group (BIRD), Belgian Society of Medical Oncology (BSMO), Belgian group of Digestive Oncology (BGDO), and Belgian Respiratory Society (BeRS). Conclusions: The management of ICI-induced colitis requires an early multidisciplinary ap-proach. A broad initial assessment is necessary (clinical presentation, laboratory markers, endoscopic and histologic examination) to confirm the diagnosis. Criteria for hospitalisation, management of ICIs, and initial endoscopic assessment are proposed. Even if corticosteroids are still considered the first-line therapy, biologics are recommended as an escalation therapy and as early treatment in patients with high-risk endoscopic findings. (c) 2023 Elsevier Ltd. All rights reserved.

Cancer enhances the risk of venous thromboembolism, but a hypercoagulant microenvironment also promotes cancer progression. Although anticoagulants have been suggested as a potential anticancer treatment, clinical studies on the effect of such modalities on cancer progression have not yet been successful for unknown reasons. In normal physiology, complex formation between the subendothelial-expressed tissue factor (TF) and the blood-borne liver-derived factor VII (FVII) results in induction of the extrinsic coagulation cascade and intracellular signaling via protease-activated receptors (PARs). In cancer, TF is overexpressed and linked to poor prognosis. Here, we report that increased levels of FVII are also observed in breast cancer specimens and are associated with tumor progression and metastasis to the liver. In breast cancer cell lines, tumor-expressed FVII drives changes reminiscent of epithelial-to-mesenchymal transition (EMT), tumor cell invasion, and expression of the prometastatic genes, SNAI2 and SOX9. In vivo, tumor-expressed FVII enhanced tumor growth and liver metastasis. Surprisingly, liver-derived FVII appeared to inhibit metastasis. Finally, tumor-expressed FVII-induced prometastatic gene expression independent of TF but required a functional endothelial protein C receptor, whereas recombinant activated FVII acting via the canonical TF:PAR2 pathway inhibited prometastatic gene expression. Here, we propose that tumor-expressed FVII and liver-derived FVII have opposing effects on EMT and metastasis.

The WG Digital & Computational Pathology, formerly called the WG IT (Computational) enjoyed an active presence at the 34th European Congress of Pathology (ECP) 2022 in Basel. Whether tackling the important question of “AI: useful or useless” in different disease entities, to a live demonstration of “AI in the wild” during the hugely popular Computational One-Day Symposium, or discussing critical aspects of quality management and ethics at the AI Taskforce meeting, the presence of digital and computational pathology could certainly be felt. Importantly, abstracts for poster sessions and oral free papers were abundant, highlighting the increasing relevance and interest of these topics for pathologists across Europe and beyond. Here, we give a short report on the activities connected to digital & computational pathology at the ECP.

Background: Moderate aortic stenosis (AS) often coexists with left ventricular (LV) systolic dysfunction and may affect survival through afterload mismatch. Because outcomes are ultimately driven by the condition of the LV, accurate assessment of LV performance is crucial to improve risk stratification. This study investigated the prognostic value of LV global longitudinal strain (GLS) in patients with moderate AS and reduced LV systolic dysfunction. Methods: Patients with moderate AS (aortic valve area 1.0-1.5 cm2) and reduced LV ejection fraction (EF) (= 11% (10% and 27%) (p < 0.001). On multivariable analysis, LVGLS as a continuous variable (HR 0.753; 95% CI 0.673-0.843; p < 0.001) and as a categorical variable (

Background & Aims: HEV genotype (gt) 3 infections are prevalent in high-income countries and display a wide spectrum of clinical presentations. Host - but not viral - factors are reported to be associated with worse clinical outcomes.Methods: Demographic, clinical, and biochemical data laboratory-confirmed HEV infections (by PCR and/or a combination of IgM and IgG serology) at the Belgian National Reference Centre between January 2010 and June 2018 were collected using stand-ardised case report forms. Genotyping was based on HEV open reading frame 2 sequences. Serum CXCL10 levels were measured by a magnetic bead-based assay. H&E staining was performed on liver biopsies.Results: A total of 274 HEV-infected individuals were included. Subtype assignment was possible for 179/218 viraemic cases, confirming gt3 as dominant with an almost equal representation of clades abchijklm and efg. An increased hospitalisation rate and higher peak serum levels of alanine aminotransferase, bilirubin, and alkaline phosphatase were found in clade efg-infected in-dividuals in univariate analyses. In multivariable analyses, clade efg infections remained more strongly associated with severe disease presentation than any of the previously identified host risk factors, being associated with a 2.1-fold higher risk of hos-pitalisation (95% CI 1.1-4.4, p = 0.034) and a 68.2% higher peak of bilirubin levels (95% CI 13.3-149.9, p = 0.010), independently of other factors included in the model. In addition, acute clade efg infections were characterised by higher serum CXCL10 levels (p = 0.0005) and a more pronounced liver necro-inflammatory activity (p = 0.022). Conclusions: In symptomatic HEV gt3 infections, clade efg is associated with a more severe disease presentation, higher serum CXCL10 levels, and liver necro-inflammatory activity, irrespective of known host risk factors.Clinical Trial Registration: The protocol was submitted to clinicaltrials.gov (NCT04670419).(c) 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. This study is a retrospective analysis of routinely collected data, within the Belgian National Reference Centre (NRC) programme funded by the National Institute for Health and Disability Insurance (RIZIV-INAMI, Belgium). TV is supported by a senior clinical investigator grant of the Research Foundation Flanders (FWO) (number 18B2821N, Belgium). JS and NH acknowledge funding from the European Research Council (ERC) Horizon 2020 research and innovation program (grant agreement 682540 — TransMID, European Union). The funding sources did not have any role in study design, in the collection, analysis, and interpretation of data, in the manuscript writing, or in the decision to submit the paper for publication. We thank Harry Dalton for helpful discussions on the national data collection and clinical outcome analysis and Christophe Conrad for his help in collecting patients data. The authors also especially thank all physicians from the following centres who participated in the study: Algemeen Ziekenhuis Alma, Eeklo; Algemeen Medisch Laboratorium, Antwerpen; Algemeen Stedelijk Ziekenhuis, Aalst; Algemeen Ziekenhuis Delta, Roeselare; Algemeen Ziekenhuis Delta, Torhout; Algemeen Ziekenhuis Nikolaas, Sint-Niklaas; Algemeen Ziekenhuis Sint-Elisabeth, Zottegem; Algemeen Ziekenhuis, Turnhout; Centre Hospitalier Universitaire Brugmann, Brussels; Centre Hospitalier de l’Ardenne, Libramont; Hôpital de Braine-l’Alleud-Waterloo, Braine-l’Alleud; Hôpital Delta, Brussels; Centre Hospitalier de Mouscron, Mouscron; Centre Hospitalier Régional Haute Senne, Soignies; Centre Hospitalier Epicura, Hornu; Centre Hospitalier Universitaire de Liège, Liège; Centre Hospitalier de la Wallonie Picarde, Tournai; Clinique CHC, Waremme; Grand Hôpital de Charleroi, Charleroi; Gasthuiszusters Antwerpen, Antwerpen; Hôpital Princesse Paola, Marche-en-Famenne; Hôpital Iris Sud, Brussels; Instituut voor Tropische Geneeskunde, Antwerpen; Hôpital de Jolimont, La Louvière; Centre Hospitalier de Jolimont, Lobbes; Centre Hospitalier de Jolimont, Nivelles; Centre Hospitalier de Jolimont, Tubize; Eurofins Labo Van Poucke, Kortrijk; Medisch Labo Medina, Dendermonde; Algemeen Ziekenhuis Maria Middelares, Gent; Ziekenhuis Netwerk Antwerpen Middelheim, Antwerpen; Cliniques Universitaires Saint-Luc, Brussels; Centre Hospitalier Universitaire UCL, Dinant; Centre Hospitalier Universitaire UCL, Namur; Centre Hospitalier Universitaire de MontGodinne, Yvoir; Clinique Saint-Luc, Bouge; Clinique Notre-Dame de Grâce, Gosselies; Sint-Andriesziekenhuis, Tielt; Algemeen Ziekenhuis West, Veurne; Algemeen Ziekenhuis Sint Blasius, Dendermonde; Algemeen Ziekenhuis SintJan, Brugge; Klinik Sankt-Joseph, Sankt-Vith; Algemeen Ziekenhuis SintLucas, Gent; Algemeen Ziekenhuis Sint-Maarten, Mechelen; Centre Hospitalier Universitaire Saint-Pierre, Brussels; Sint-Trudo Ziekenhuis, Sint-Truiden; Centre Hospitalier Universitaire Tivoli, La Louvière; Hôpital Erasme – Cliniques Universitaires de Bruxelles, Brussels; Universitair Ziekenhuis Antwerpen, Antwerpen; Universitair Ziekenhuis Gent, Gent; Cassiman David, Laleman Wim, Van Malenstein Hannah, Verslype Chris and Van der Merwe Schalk from Universitair Ziekenhuis Leuven, Leuven; Virga Jesse Ziekenhuis, Hasselt; Universitair Ziekenhuis Brussel, Brussels; Jan Yperman Ziekenhuis, Ieper.

Contains fulltext : 291524.pdf (Publisher’s version ) (Open Access) For intradermal (ID) immunisation, novel needle-based delivery systems have been proposed as a better alternative to the Mantoux method. However, the penetration depth of needles in the human skin and its effect on immune cells residing in the different layers of the skin has not been analyzed. A novel and user-friendly silicon microinjection needle (Bella-mu(TM)) has been developed, which allows for a perpendicular injection due to its short needle length (1.4-1.8 mm) and ultrashort bevel. We aimed to characterize the performance of this microinjection needle in the context of the delivery of a particle-based outer membrane vesicle (OMV) vaccine using an ex vivo human skin explant model. We compared the needles of 1.4 and 1.8 mm with the conventional Mantoux method to investigate the depth of vaccine injection and the capacity of the skin antigen-presenting cell (APC) to phagocytose the OMVs. The 1.4 mm needle deposited the antigen closer to the epidermis than the 1.8 mm needle or the Mantoux method. Consequently, activation of epidermal Langerhans cells was significantly higher as determined by dendrite shortening. We found that five different subsets of dermal APCs are able to phagocytose the OMV vaccine, irrespective of the device or injection method. ID delivery using the 1.4 mm needle of a OMV-based vaccine allowed epidermal and dermal APC targeting, with superior activation of Langerhans cells. This study indicates that the use of a microinjection needle improves the delivery of vaccines in the human skin.

Laparoscopic donor nephrectomy (LDN) is the current gold standard in kidney donation. Mini-incision open donor nephrectomy (MINI) techniques have been used extensively but have become less popular. The aim of the present study was to compare the results and safety of a non-muscle-splitting MINI technique with the current gold standard of LDN. A single center retrospective cohort study of all living donor nephrectomies between 2011 and 2019 was used for the study. The primary outcome of this study was short term (

Coastal flooding is driven by the combination of (high) tide and storm surge, the latter being caused by strong winds and low pressure in tropical and extratropical cyclones. The combination of storm surge and the astronomical tide is defined as the storm tide. To gain an understanding of the threat posed by coastal flooding and to identify areas that are especially at risk, now and in the future, it is crucial to accurately model coastal inundation. Most models used to simulate the coastal inundation scale follow a simple planar approach, referred to as bathtub models. The main limitations of this type of models are that they implicitly assume an infinite flood duration, and they do not capture relevant physical processes. In this study we develop a method to generate hydrographs called HGRAPHER, and we provide a global dataset of storm tide hydrographs based on time series of storm surges and tides derived from the Global Tide and Surge Model (GTSM) forced with the ERA5 reanalysis wind and pressure fields. These hydrographs represent the typical shape of an extreme storm tide at a certain location along the global coastline. We test the sensitivity of the HGRAPHER method with respect to two main assumptions that determine the shape of the hydrograph, namely the surge event sampling threshold and coincidence in the time of the surge and tide maxima. The hydrograph dataset can be used to move away from planar inundation modelling techniques towards dynamic inundation modelling techniques across different spatial scales.

Zebrafish hearts can regenerate by replacing damaged tissue with new cardiomyocytes. Although the steps leading up to the proliferation of surviving cardiomyocytes have been extensively studied, little is known about the mechanisms that control proliferation and redifferentiation to a mature state. We found that the cardiac dyad, a structure that regulates calcium handling and excitation-contraction coupling, played a key role in the redifferentiation process. A component of the cardiac dyad called leucine-rich repeat–containing 10 (Lrrc10) acted as a negative regulator of proliferation, prevented cardiomegaly, and induced redifferentiation. We found that its function was conserved in mammalian cardiomyocytes. This study highlights the importance of the underlying mechanisms required for heart regeneration and their application to the generation of fully functional cardiomyocytes.

This paper presents a comprehensive description of the serial verb construction (henceforth SVC) in Tujia. It shows that serial verbs or verb phrases in Tujia are linked by the particle lie 55. lie 55 does not contribute any semantic content to the construction, but only functions as a linking particle. lie 55 is not used for any other purpose in any other structure. SVCs in Tujia can be classified into two types: non-symmetric and symmetric, depending on argument sharing. Symmetric SVCs can be further divided into three types according to how the arguments of the verb are shared: those which share both agents and patients, those which share only agents and those which do not share any arguments. SVCs in Tujia can be used to indicate various types of semantic relations: most frequently this involves sequentiality, but also action-result, cause-effect, and action-purpose. The use of a linking particle in SVCs is rarely reported in the existing literature, so that the present research contributes to the general typology of SVCs.

Intent sensing is a growing field within medical device control, with major potential applications for assistive devices, such as prosthetics. As many sensors as possible should be utilised to maximise accuracy. The availability of sensors may change over time due to changing surroundings or activities, sensors failing, and electrode contact being lost. The sensor network should be dynamic and modular in nature, continuing to function even when some sensors are unavailable. The management of sensor unavailability may help to reduce the need for device maintenance, particularly in developing nations with limited availability of these services. An algorithm is proposed to classify intent using networked sensors in real time. Data are gathered using human participants wearing four surface electromyography sensors and performing a pseudo-random sequence of grasps. The relationship between time offset and prediction accuracy is investigated, with the algorithm predicting future intent actions up to half a second in advance. Sensor dropout is simulated by randomly replacing sensor readings with recorded noise. The new algorithm is compared to existing algorithms and shown to be more accurate in situations of sensor dropout, with the difference increasing as more sensors become unavailable. This suggests that when reductions in sensing capabilities are likely to occur over time, the modular method is more appropriate for control.

Background: Standardized screening for subthalamic deep brain stimulation (STN DBS) in Parkinson’s disease (PD) patients is crucial to determine eligibility, but its utility to predict postoperative outcomes in eligible patients is inconclusive. It is unknown whether wearable data can contribute to this aim. Objective: To evaluate the utility of universal components incorporated in the DBS screening, complemented by a wearable sensor, to predict motor outcomes and Quality of life (QoL) one year after STN DBS surgery. Methods: Consecutive patients were included in the OPTIMIST cohort study from two DBS centers. Standardized assessments included a preoperative Levodopa Challenge Test (LCT), and questionnaires on QoL and non-motor symptoms including cognition, psychiatric symptoms, impulsiveness, autonomic symptoms, and sleeping problems. Moreover, an ambulatory wearable sensor (Parkinson Kinetigraph (PKG)) was used. Postoperative assessments were similar and also included a Stimulation Challenge Test to determine DBS effects on motor function. Results: Eighty-three patients were included (median (interquartile range) age 63 (56–68) years, 36% female). Med-OFF (Stim-OFF) motor severity deteriorated indicating disease progression, but patients significantly improved in terms of Med-ON (Stim-ON) motor function, motor fluctuations, QoL, and most non-motor domains. Motor outcomes were not predicted by preoperative tests, including covariates of either LCT or PKG. Postoperative QoL was predicted by better preoperative QoL, lower age, and more preoperative impulsiveness scores in multivariate models. Conclusion: Data from the DBS screening including wearable data do not predict postoperative motor outcome at one year. Post-DBS QoL appears primarily driven by non-motor symptoms, rather than by motor improvement.

Item does not contain fulltext Stromal vascular fraction (SVF) is the primary isolate obtained after enzymatic digestion of adipose tissue that contains various cell types. Its successful application for cell-based construct preparation in an intra-operative setting for clinical bone augmentation and regeneration has been previously reported. However, the performance of SVF-based constructs compared with traditional ex vivo expanded adipose tissue-derived mesenchymal stromal cells (ATMSCs) remains unclear and direct comparative analyses are scarce. Consequently, we here aimed at comparing the in vitro osteogenic differentiation capacity of donor-matched SVF versus ATMSCs as well as their osteoinductive capacity. Human adipose tissue from nine different donors was used to isolate SVF, which was further purified via plastic-adherence to obtain donor-matched ATMSCs. Both cell populations were immunophenotypically characterized for mesenchymal stromal cell, endothelial, and hematopoietic markers after isolation and immunocytochemical staining was used to identify different cell types during prolonged cell culture. Based on normalization using plastic-adherence fraction determination, SVF and ATMSCs were seeded and cultured in osteogenic differentiation medium for 28 days. Further, SVF and ATMSCs were seeded onto devitalized bovine bone granules and subcutaneously implanted into nude mice. After 42 days of implantation, granules were retrieved, histologically processed, and stained with hematoxylin and eosin (HE) to assess ectopic bone formation. The ATMSCs were shown to be a homogenous cell population during cell culture, whereas SVF cultures consisted of multiple cell types. All donor-matched comparisons showed either accelerated or stronger mineralization for SVF cultures in vitro. However, neither SVF nor ATMSCs loaded on devitalized bone granules induced ectopic bone formation on subcutaneous implantation, as opposed to control granules loaded with bone morphogenetic protein-2 (BMP-2), which triggered ectopic bone formation with 100% incidence. Despite the observed lack of osteoinduction, our findings provide important in vitro evidence on the osteogenic superiority of intra-operatively available SVF as compared with donor-matched ATMSCs. Consequently, further studies should focus on optimizing the efficacy of these cell populations for implementation in orthotopic bone fracture or defect treatment.

The increased use of electrothermal ice protection systems (ETIPSs) in various industries (manned and unmanned aviation, energy production) requires improvements to de-icing efficiency, ice shedding predictability, and energy consumption. To achieve these, a coupled numerical and experimental investigation of ETIPS’s ice removal (ice shedding) mechanism is presented in this paper. Idealized ETIPS de-icing experiments performed in the icing wind tunnel of the von Karman Institute show several ice shedding mechanisms. A one-dimensional phase change solver developed for ice melting simulations highlights the water layer thickness influence over the ice shedding process. Coupled numerical–experimental results are employed to develop an idealized ice shedding model. The model is validated in realistic de-icing experiments in a second experimental campaign in the icing wind tunnel of the LeClerc Icing Research Laboratory.

Hypothesis: Characterizing the microstructure of an ice/surface interface and its effect on the icephobic behavior of surfaces remains a significant challenge. Introducing X-ray Computed Tomography (XCT) can provide unprecedented insights into the internal (porosity) and interfacial structures, i.e. wetting regime, between (super)hydrophobic surfaces and ice by visualizing these optically inaccessible regions. Experiments: Frozen droplets with controlled volume were deposited on top of metallic and polymeric substrates with different levels of wettability. Different modes of XCT (3D and 4D) were utilized to obtain information on the internal and interfacial structure of the ice/surface system. The results were supplemented by conventional surface analysis techniques, including optical profilometry and contact angle measurements. Findings: Using XCT on ice/surface systems, the 3D and 4D (imaging with temporal resolution) structural information can be visualized. From these datasets, qualitative and quantitative results were obtained, not only for characterizing the interface but also for analyzing the entire droplet/surface system, e.g., measurement of porosity size, shape, and location. These results highlight the potential of XCT in the characterization of both droplets and substrates and proves that the technique can aid to develop hydrophobic surfaces for use as icephobic materials.

Objective: Skater's cramp is a movement disorder in speed skaters. We investigated whether affected skaters matched the disease profile of task-specific dystonia, specifically whether there was evidence of maladaptive muscle activity occurring simultaneously with aberrant movements (jerking). We further examined different skating intensities, positing no change would be more indicative of task-specific dystonia. Methods: We analyzed video, kinematic and muscle activity in 14 affected skaters. We measured the angular velocity and electromyographic activity of normalized speed skating strokes using one dimensional statistical non-parametric mapping. Skaters were matched with comparably skilled controls, and filled out a bespoke clinical questionnaire. Results: Skaters’ impacted leg showed over-activation in the peroneus longus, tibialis anterior and gastrocnemius that coincided with higher foot movement compared to their healthy leg and controls. This pattern persisted regardless of skating intensity. Clinical features indicated it was task-specific and painless with common trigger factors including stress, equipment change, and falling. Conclusions: We showed aberrant muscular and kinematic activity in a movement disorder in speed skaters indicative of task-specific dystonia. Significance: Understanding skater's cramp as a task-specific dystonia could reduce the damage that misdiagnosis and unsuccessful invasive operations have caused. Our quantitative method has value in testing future treatment efficacy.

Introduction: Endoscopic detection of early neoplasia in Barrett's esophagus is difficult. Computer Aided Detection (CADe) systems may assist in neoplasia detection. The aim of this study was to report the first steps in the development of a CADe system for Barrett's neoplasia and to evaluate its performance when compared with endoscopists. Methods: This CADe system was developed by a consortium, consisting of the Amsterdam University Medical Center, Eindhoven University of Technology, and 15 international hospitals. After pretraining, the system was trained and validated using 1.713 neoplastic (564 patients) and 2.707 non-dysplastic Barrett's esophagus (NDBE; 665 patients) images. Neoplastic lesions were delineated by 14 experts. The performance of the CADe system was tested on three independent test sets. Test set 1 (50 neoplastic and 150 NDBE images) contained subtle neoplastic lesions representing challenging cases and was benchmarked by 52 general endoscopists. Test set 2 (50 neoplastic and 50 NDBE images) contained a heterogeneous case-mix of neoplastic lesions, representing distribution in clinical practice. Test set 3 (50 neoplastic and 150 NDBE images) contained prospectively collected imagery. The main outcome was correct classification of the images in terms of sensitivity. Results: The sensitivity of the CADe system on test set 1 was 84%. For general endoscopists, sensitivity was 63%, corresponding to a neoplasia miss-rate of one-third of neoplastic lesions and a potential relative increase in neoplasia detection of 33% for CADe-assisted detection. The sensitivity of the CADe system on test sets 2 and 3 was 100% and 88%, respectively. The specificity of the CADe system varied for the three test sets between 64% and 66%. Conclusion: This study describes the first steps towards the establishment of an unprecedented data infrastructure for using machine learning to improve the endoscopic detection of Barrett's neoplasia. The CADe system detected neoplasia reliably and outperformed a large group of endoscopists in terms of sensitivity.

Introduction: Diffusion-weighted imaging (DWI) as part of multiparametric magnetic resonance imaging (mpMRI) is an important sequence for the detection of prostate cancer (PCa). The objective of this retrospective analysis was to evaluate changes in apparent diffusion coefficient (ADC) measurements in biopsy-proven PCa undergoing TULSA-PRO (MR-guided transurethral ultrasound ablation of the prostate) at 3.0 T after 1, 3, and 6–12 months posttreatment. Methods: Nineteen patients underwent follow-up examinations after 1, 3, and 6–12 months including mpMRI at 3.0 T and urological-clinical examinations with quantitative analysis of ADCs. Results: In PCa, a significant increase of ADC values after 6–12 months was measured after TULSA-PRO treatment by 29.1% (pre-TULSA: 0.79 ± 0.16 × 10−3 mm2/s, 6–12 months: 1.02 ± 0.35 × 10−3 mm2/s), while the corresponding value in the reference tissue decreased by 48.5% (pre-TULSA: 1.20 ± 0.15 × 10−3 mm2/s, 6–12 months: 0.91 ± 0.29 × 10−3 mm2/s). The mean ADC values in the early follow-up groups at 1 and 3 months did not change significantly. Conclusion: DWI with ADC as part of mpMRI can serve as a biomarker to dynamically monitor the follow-up after TULSA after 6–12 months. For early posttreatment progression, it is not suitable due to too many confounding variables.

Visual feedback normally helps guide movements to their goal. When moving one’s hand, such guidance has to deal with a sensorimotor delay of about 100 ms. When moving a cursor, it also has to deal with a delay of tens of milliseconds that arises between the hand moving the mouse and the cursor moving on the screen. Moreover, the cursor is presented at a certain rate, so only positions corresponding with the position of the mouse at certain moments are presented. How does the additional delay and the rate at which cursor positions are updated influence how well the cursor can be guided to the goal? We asked participants to move a cursor to consecutive targets as quickly as they could. They did so for various additional delays and presentation rates. It took longer for the mouse to reach the target when the additional delay was longer. It also took longer when a lower presentation rate was achieved by not presenting the cursor all the time. The fraction of the time during which the cursor was present was more important than the rate at which the cursor’s position was updated. We conclude that the way human arm movements are guided benefits from continuous access to recent visual feedback.

The emotional experience of a visit to a concentration camp memorial is high in intensity and wide in diversity. Clustering of this emotional experience has led to a better understanding of the valence of emotions. It is not known how these emotion clusters affect the meaning derived from the experience and how this affects visit intention. This study addressed this gap in research and explored the potential relations between emotion clusters and meaning in the context of an expected visit to a concentration camp memorial. This study finds that the emotion cluster Sympathy is the only cluster to have a significant and large positive direct effect on Meaning and a significant, but small, positive indirect effect on Visit Intention. The Misery cluster is the only cluster that has a significant but small negative direct effect on Visit Intention. The Positivity cluster has no effects on Meaning and Visit Intention. In the discussion, we address the role of empathy, and theoretical implications are framed in Terror Management Theory. Managerial implications include a discussion on the use of promotion to trigger empathy.

Background and study aims Epiphrenic diverticula are rare and mainly occur in patients with underlying esophageal motility disorders. The current standard treatment is surgical diverticulectomy often combined by myotomy and is associated with significant adverse event (AE) rates. The aim of this study was to examine the efficacy and safety of peroral endoscopic myotomy in reducing esophageal symptoms in patients with esophageal diverticula. Patients and methods We performed a retrospective cohort study including patients with an esophageal diverticulum who underwent POEM between October 2014 and December 2022. After informed consent, data were extracted from medical records and patients completed a survey by telephone. The primary outcome was treatment success, defined as Eckardt score below 4 with a minimal reduction of 2 points. Results Seventeen patients (mean age 71 years, 41.2 % female) were included. Achalasia was confirmed in 13 patients (13 /17, 76.5 %), Jackhammer esophagus in two patients (2 /17, 11.8 %), diffuse esophageal spasm in one patient (1 /17, 5.9 %) and in one patient no esophageal motility disorder was found (1 /17, 5.9 %). Treatment success was 68.8 % and only one patient (6.3 %) underwent retreatment (pneumatic dilatation). Median Eckardt scores decreased from 7 to 1 after POEM (p Conclusions POEM is effective and safe to treat patients with esophageal diverticula and an underlying esophageal motility disorder.

Noisy human activities at sea are changing the acoustic environment, which has been shown to affect marine mammals and fishes. Invertebrates, such as bivalves, have so far received limited attention despite their important role in the marine ecosystem. Several studies have examined the impact of sound on anti-predator behavior using simulated predators, but studies using live predators are scarce. In the current study, we examined the separate and combined effects of boat sound playback and predator cues of shore crabs (Carcinus maenas) on the behavior of mussels (Mytilus spp.). We examined the behavior of the mussels using a valve gape monitor and scored the behavior from the crabs in one of two types of predator test conditions from video footage to control for effects from potential, sound-induced variation in crab behavior. We found that mussels closed their valve gape during boat noise and with a crab in their tank, but also that the stimulus combination did not add up to an even smaller valve gape. The sound treatment did not affect the stimulus crabs, but the behavior of the crabs did affect the valve gape of the mussels. Future research is needed to examine whether these results stand in situ and whether valve closure due to sound has fitness consequences for mussels. The effects on the well-being of individual mussels from anthropogenic noise may be relevant for population dynamics in the context of pressure from other stressors, their role as an ecosystem engineer, and in the context of aquaculture.

AimsSpinopelvic characteristics influence the hip’s biomechanical behaviour. However, to date there is little knowledge defining what ‘normal’ spinopelvic characteristics are. This study aims to determine how static spinopelvic characteristics change with age and ethnicity among asymptomatic, healthy individuals.MethodsThis systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify English studies, including ≥ 18-year-old participants, without evidence of hip or spine pathology or a history of previous surgery or interventional treatment, documenting lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). From a total of 2,543 articles retrieved after the initial database search, 61 articles were eventually selected for data extraction.ResultsWhen all ethnicities were combined the mean values for LL, SS, PT, and PI were: 47.4° (SD 11.0°), 35.8° (SD 7.8°), 14.0° (SD 7.2°), and 48.8° (SD 10°), respectively. LL, SS, and PT had statistically significant (p < 0.001) changes per decade at: −1.5° (SD 0.3°), −1.3° (SD 0.3°), and 1.4° (SD 0.1°). Asian populations had the largest age-dependent change in LL, SS, and PT compared to any other ethnicity per decade at: −1.3° (SD 0.3°) to −0.5° (SD 1.3°), –1.2° (SD 0.2°) to −0.3° (SD 0.3°), and 1.7° (SD 0.2°) versus 1.1° (SD 0.1°), respectively.ConclusionAgeing alters the orientation between the spine and pelvis, causing LL, SS, and PT to modify their orientations in a compensatory mechanism to maintain sagittal alignment for balance when standing. Asian populations have the largest degree of age-dependent change to their spinopelvic parameters compared to any other ethnicity, likely due to their lower PI.Cite this article: Bone Joint Res 2023;12(4):231–244.