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• Automating wildlife monitoring with wireless 4G cameras and end-to-end data streams. • Remote monitoring of sensor performance, API handling and automated task management. • Deep learning for automated identification of focal species and human detection. • Total cost saving of >40 % through automation, AI and less regular site visits. • Enabling technologies allow scaling-up of a cost-efficient biodiversity monitoring. Modern approaches with advanced technology can automate and expand the extent and resolution of biodiversity monitoring. We present the development of an innovative system for automated wildlife monitoring in a coastal Natura 2000 nature reserve of the Netherlands with 65 wireless 4G wildlife cameras which are deployed autonomously in the field with 12 V/2A solar panels, i.e. without the need to replace batteries or manually retrieve SD cards. The cameras transmit images automatically (through a mobile network) to a sensor portal, which contains a PostgreSQL database and functionalities for automated task scheduling and data management, allowing scientists and site managers via a web interface to view images and remotely monitor sensor performance (e.g. number of uploaded files, battery status and SD card storage of cameras). The camera trap sampling design combines a grid-based sampling stratified by major habitats with the camera placement along a traditional monitoring route, and with an experimental set-up inside and outside large herbivore exclosures. This provides opportunities for studying the distribution, habitat use, activity, phenology, population structure and community composition of wildlife species and allows comparison of traditional with novel monitoring approaches. Images are transferred via application programming interfaces to external services for automated species identification and long-term data storage. A deep learning model for species identification was tested and showed promising results for identifying focal species. Furthermore, a detailed cost analysis revealed that establishment costs of the automated system are higher but the annual operating costs much lower than those for traditional camera trapping, resulting in the automated system being >40 % more cost-efficient. The developed end-to-end data pipeline demonstrates that continuous monitoring with automated wildlife camera networks is feasible and cost-efficient, with multiple benefits for extending the current monitoring methods. The system can be applied in open habitats of other nature reserves with mobile network coverage. [ABSTRACT FROM AUTHOR]

Postoperative pancreatic fistula remains the leading cause of significant morbidity after pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Preoperative chemoradiotherapy has been described to reduce the risk of postoperative pancreatic fistula, but randomized trials on neoadjuvant treatment in pancreatic ductal adenocarcinoma focus increasingly on preoperative chemotherapy rather than preoperative chemoradiotherapy. This study aimed to investigate the impact of preoperative chemotherapy and preoperative chemoradiotherapy on postoperative pancreatic fistula and other pancreatic-specific surgery related complications on a nationwide level. All patients after pancreatoduodenectomy for pancreatic ductal adenocarcinoma were included in the mandatory nationwide prospective Dutch Pancreatic Cancer Audit (2014–2020). Baseline and treatment characteristics were compared between immediate surgery, preoperative chemotherapy, and preoperative chemoradiotherapy. The relationship between preoperative chemotherapy, chemoradiotherapy, and clinically relevant postoperative pancreatic fistula (International Study Group of Pancreatic Surgery grade B/C) was investigated using multivariable logistic regression analyses. Overall, 2,019 patients after pancreatoduodenectomy for pancreatic ductal adenocarcinoma were included, of whom 1,678 underwent immediate surgery (83.1%), 192 (9.5%) received preoperative chemotherapy, and 149 (7.4%) received preoperative chemoradiotherapy. Postoperative pancreatic fistula occurred in 8.3% of patients after immediate surgery, 4.2% after preoperative chemotherapy, and 2.0% after preoperative chemoradiotherapy (P =.004). In multivariable analysis, the use of preoperative chemoradiotherapy was associated with reduced risk of postoperative pancreatic fistula (odds ratio, 0.21; 95% confidence interval, 0.03–0.69; P =.033) compared with immediate surgery, whereas preoperative chemotherapy was not (odds ratio, 0.59; 95% confidence interval, 0.25–1.25; P =.199). Intraoperatively hard, or fibrotic pancreatic texture was most frequently observed after preoperative chemoradiotherapy (53% immediate surgery, 62% preoperative chemotherapy, 77% preoperative chemoradiotherapy, P <.001). This nationwide analysis demonstrated that in patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma, only preoperative chemoradiotherapy, but not preoperative chemotherapy, was associated with a reduced risk of postoperative pancreatic fistula. [Display omitted] [ABSTRACT FROM AUTHOR]

A new siderophore, serratiochelin D (1), was isolated from a soil-derived, non-pigmented strain of Serratia marcescens along with two previously reported siderophores, serratiochelins A and B. Siderophores were obtained after cultivating the bacterium in an iron-deficient medium, and the chemical structures were elucidated based on HPLC-UV, mass spectrometry, and extensive 1D and 2D NMR spectral analyses. The iron-chelating, growth-promoting, and cytotoxic activities were evaluated using standard methods. Serratiochelin D (1) demonstrated xenosiderophoric activity by promoting the growth of Staphylococcus aureus , Acinetobacter baumannii , and Mycobacterium tuberculosis in iron-limited media and thus has the potential to be developed into a sideromycin against pathogens in these genera and other MDR bacteria. [Display omitted] • Sideromycins are an efficient tool against microbial resistance. • A new siderophore, serratiochelin D, is reported in this study. • Chemical structures were confirmed by extensive spectroscopic analyses. • Isolated compounds were tested for growth promoting and cytotoxic activities. [ABSTRACT FROM AUTHOR]

– This population-based study aimed to investigate incidence, risk factors, treatment, and survival of synchronous peritoneal metastases (PM) of hepatobiliary origin. – All Dutch patients diagnosed with hepatobiliary cancer between 2009 and 2018 were selected. Factors associated with PM were identified with logistic regression analyses. Treatments for patients with PM were categorized into local therapy, systemic therapy, and best supportive care (BSC). Overall survival (OS) was investigated using log-rank test. – In total, 12 649 patients were diagnosed with hepatobiliary cancer of whom 8% (n = 1066) were diagnosed with synchronous PM (12% [n = 882/6519] in biliary tract cancer [BTC] vs. 4% [n = 184/5248] in hepatocellular carcinoma [HCC]). Factors that were positively associated with PM were the female sex (OR 1.18, 95% CI 1.03–1.35), BTC (OR 2.93, 95% CI 2.46–3.50), diagnosis in more recent years (2013–2015: OR 1.42, 95% CI 1.20–1.68; 2016–2018: OR 1.48, 95% CI 1.26–1.75), T3/T4 stage (OR 1.84, 95% CI 1.55–2.18), N1/N2 stage (OR 1.31, 95% CI 1.12–1.53) and other synchronous systemic metastases (OR 1.85, 95% CI 1.62–2.12). Of all PM patients, 723 (68%) received BSC only. Median OS was 2.7 months (IQR 0.9–8.2) in PM patients. – Synchronous PM were found in 8% of all hepatobiliary cancer patients and occurred more often in BTC than in HCC. Most patients with PM received BSC only. Given the high incidence and dismal prognosis of PM patients, extended research in hepatobiliary PM is needed to achieve better outcome in these patients. [ABSTRACT FROM AUTHOR]

Due to the centralization of pancreatic surgery, patients with suspected pancreatic cancer may undergo diagnostic workup in both a non-pancreatic centre and a pancreatic centre, i.e. multicentre workup. This retrospective study assessed whether multicentre diagnostic workup is associated with repeated diagnostics, delayed time-to-diagnosis, delayed time-to-treatment, survival and whether variation existed among pancreatic cancer networks. This nationwide study included all patients diagnosed with non-metastatic pancreatic ductal adenocarcinoma (PDAC) in 2015, registered by the Netherlands Cancer Registry. A delayed time-to-diagnosis was defined as ≥3 weeks from initial hospital visit to final diagnosis. A delayed time-to-treatment was defined as ≥6 weeks from the first hospital visit to start of first tumour treatment. Multilevel logistic regression analyses and survival analyses were performed. In total, 931 patients with non-metastatic PDAC were included. Overall, 175 patients (19%) underwent a multicentre diagnostic workup, which was significantly associated with repeated diagnostic investigations (OR = 6.31, 95% CI 4.13–9.64, P < 0.0001), a delayed time-to-diagnosis (OR = 2.66 95% CI 1.74–4.06, P < 0.001), and a delayed time-to-treatment (OR = 1.93 95% CI 1.12–3.31, P = 0.02), but not with decreased survival (HR = 1.09 95% CI 0.83–1.44; P = 0.532). Variation in outcomes per network was observed, especially for time-to-treatment, though the ICC was not statistically significant (P = 0.065). Multicentre diagnostic workup for patients with PDAC is associated with repeated diagnostic investigations, a delayed time-to-diagnosis and delayed time-to-treatment compared to patients with monocentre workup. To reduce costs and improve treatment times, efforts should be made to improve network coordination, for example via network care pathways. [ABSTRACT FROM AUTHOR]

Periprosthetic shoulder infection (PSI) remains a devastating complication after reverse shoulder arthroplasty (RSA). Currently, scientific data related to the management of PSI are limited, and the optimal strategy and related clinical outcomes remain unclear. Guidelines from the Infectious Diseases Society of America for the management of periprosthetic joint infection are mainly based on data from patients after hip and knee arthroplasty. The aim of this study was to evaluate whether these guidelines are also valid for patients with PSI after RSA. In addition, the functional outcome according to the surgical intervention was assessed. An RSA database was retrospectively reviewed to identify infections after primary and revision RSAs, diagnosed between 2004 and 2018. Data collected included age, sex, indication for RSA, causative pathogen, surgical and antimicrobial treatment, functional outcome, and recurrence. Thirty-six patients with a PSI were identified. Surgical treatment was subdivided into débridement and implant retention (DAIR) (n = 6, 17%); 1-stage revision (n = 1, 3%); 2-stage revision (n = 16, 44%); multiple-stage revision (>2 stages) (n = 7, 19%); definitive spacer implantation (n = 2, 6%); and resection arthroplasty (n = 4, 11%). The most common causative pathogens were Staphylococcus epidermidis (n = 11, 31%) and Cutibacterium acnes (n = 9, 25%). Recurrence was diagnosed in 4 patients (11%), all of whom were initially treated with a DAIR approach. The median follow-up period was 36 months (range, 24-132 months). PSI is typically caused by low-virulence pathogens, which often are diagnosed with a delay, resulting in chronic infection at the time of surgery. Our results indicate that treatment of patients with chronic PSI with DAIR has a high recurrence rate. In addition, implant exchange (ie, 1- and 2-stage exchange) does not compromise the functional result as compared with implant retention. Thus, patients with chronic PSI should be treated with implant exchange. Future research should further clarify which surgical strategy (ie, 1-stage vs. 2-stage exchange) has a better outcome overall. [ABSTRACT FROM AUTHOR]

Sensorimotor control can be disturbed because of pain and trauma. There is scarce comprehension about which component of the sensorimotor system would benefit the most from treatment in distal radius fracture (DRF). The purpose of this study was to determine whether the sensorimotor control of subjects with a history of DRF impaired compared with healthy subjects. If so, which component of the sensorimotor system is most affected. Nine healthy participants and 11 participants with a DRF history executed posture and reproduction tasks in interaction with a robotic wrist manipulator. A posture task with force perturbations assess sensorimotor control. Position and force reproduction tasks assessed sensory feedback. Electromyography recorded the muscle activity to study the motor part of the sensorimotor system. Cross-sectional case-control. The results showed that the motor responses to the perturbations during the posture task did not differ significantly, whereas the position reproduction did significantly differ between the 2 groups. Moreover, participants with a DRF history did not adapt to the changed dynamics of the environment during the posture task, whereas the controls did. The results of this study imply that processing of sensory position feedback is impaired in people with a DRF history while sensorimotor control during a posture task is unaffected. A possible explanation for these results is that different neural networks are involved during reproduction and posture tasks. A history of DRF is related to disturbed processing of sensory feedback of the sensorimotor system, especially the Joint Position Sense, which leads to an impairment in detecting a changed environment and adapting to it. Impaired Joint Position Sense and thereby the inability to adapt adequately to a changing environment should be taken into account during the rehabilitation of patients with DRF. • Sensory position feedback in the wrist joint is disturbed in people with a history of DRF. • This influences the adaptation to changed environmental dynamics during position tasks. • Treatment of DRF should also focus on sensorimotor control exercises of the wrist. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer. Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in 11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses. In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8–61.5 months), 58% (95% CI 48–66), and 49% (95% CI 40–57), respectively. Three- and five-year risk of recurrence were respectively 40% (95% CI 31–48), and 45% (95% CI 36–54). Three- and five-year risk of LRR were 26% (95% CI 19–33), and 30% (95% CI 22–38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached). In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years. • Five-year risk of recurrence after CRT for proximal esophageal cancer was 45%. • Most recurrences were locoregional and mainly in the primary involved tumor field. • Surgery or radiotherapy was performed in 75% of patients with a local recurrence. • Salvage surgery of isolated locoregional recurrence resulted in favorable outcome. • The recurrence pattern suggests that follow-up may be shortened to three years. [ABSTRACT FROM AUTHOR]

It has been argued that the Internet presents numerous new opportunities for crime, including homicide. So far, empirical scholarly research in this domain is rather limited. In order to discover how perpetrators have used the Internet in the homicides they have committed, we conducted an international newspaper search (2006–2017). Based on this analysis, we identify five distinct types of Internet use in homicides, namely Internet as an encyclopedia, Internet as a platform, Internet as a trigger, Internet as a market place, and Internet as a meeting place. Our findings indicate that these types do not significantly differ from key characteristics of homicides in general to the degree that they constitute unique forms of homicide. Rather, Internet-related homicides constitute a replication, or facilitation of already existing forms of homicide assisted through new technological means. • 48 Newspaper articles were uncovered reflecting a relationship between Internet and homicide; • Six categories were identified, reflecting the use of Internet in homicides; • Categories include Internet as a(n (1) podium; (2) encyclopedia; (3) hunting ground; (4)means to acquire weapons; (5)trigger; (6) organization tool. • Whilst the Internet has had an impact on each of these homicides, its impact has not been transformative in nature. [ABSTRACT FROM AUTHOR]

Objective: To examine implementation and patients' and providers' participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.Methods: Our DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates.Results: Implementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients' login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18-56) and was highest for questions concerning patients' perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1-10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers' treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use.Conclusion: We implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool.Practice Implications: Requirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support. [ABSTRACT FROM AUTHOR]

A collimated source of 241Am was scanned over the endcap of a 21 year old coaxial HPGe-detector that had spent about 75% of its life at room temperature (and the remaining time at 77 K). The detector response was recorded and used as a measure of the relative thickness of the top deadlayer. This thickness was not homogeneous and was thicker near to the outer surface of the crystal compared to the centre, which could be a result of increased diffusion of Li atoms during times the detector was kept at room temperature. The results were compared with two newer HPGe-detectors that proved to have homogeneous top deadlayers. • The top deadlayer of three HPGe-detectors were investigated. • One detector had been kept at room temperature for about 15 years. • The top deadlayer of this detector exhibited a heterogeneous structure. • The strange structure is presumably due to diffusion of Li-atoms. [ABSTRACT FROM AUTHOR]

Background: Fatty liver is the leading cause of chronic liver diseases and increases the risk of cardiovascular disease. Besides alcohol consumption, energy-containing nonalcoholic beverages may contribute to liver fat accumulation.Objective: We aimed to study the consumption of alcoholic and nonalcoholic beverages and their mutual replacement in relation to hepatic triglyceride content (HTGC) in middle-aged men and women.Methods: In this cross-sectional analysis, HTGC was assessed by proton magnetic resonance spectroscopy. Habitual consumption of alcoholic and nonalcoholic beverages was assessed using a validated food-frequency questionnaire. All beverages were converted to standard servings and to percentage of total energy intake (En%). We performed linear regression to examine the association of alcoholic and nonalcoholic beverages with HTGC, adjusted for age, sex, smoking, education, ethnicity, physical activity, total energy intake, and total body fat. We studied replacement of alcoholic beverages with nonalcoholic beverages per 1 serving/d and per 5 En%/d.Results: After exclusion of individuals with missing values, 1966 participants (47% men) were analyzed, with a mean ± SD age of 55 ± 6 y, BMI of 26 ± 4 kg/m2, and HTGC of 5.7% ± 7.9%. Each extra alcoholic serving per day was associated with more liver fat (1.09 times; 95% CI: 1.05, 1.12). Replacing 5 En% of alcoholic beverages with milk was associated with less liver fat (0.89 times; 95% CI: 0.81, 0.98), whereas replacement with 5 En% of sugar-sweetened beverages was associated with liver fat to an extent similar to alcoholic beverages (1.00 times; 95% CI: 0.91, 1.09).Conclusion: In a population-based cohort, consumption of each extra daily alcoholic beverage was associated with more liver fat. In isocaloric replacement of alcoholic beverages, milk was associated with less liver fat, whereas sugar-sweetened beverages were equally associated with liver fat. This suggests that intake of alcohol and sugars may contribute to liver fat accumulation. This trial was registered at clinicaltrials.gov as NCT03410316. [ABSTRACT FROM AUTHOR]

This paper describes the drone-borne dosimetry performed in two separate case studies. Two drone measurements were performed using a reference dose-rate detector measuring the ambient dose equivalent rate. A first flight was used to obtain reference measurements using a cesium-137 point source and flying at multiple speeds and different heights. A second flight was performed above the D1 radium storage of Umicore in Olen, Belgium. The main goal of this flight was to perform a scanning pattern over the area to create a dose-rate map. After the flights, we used historic measurements and a dose-rate model verified by Monte Carlo simulations using Penelope (2018) to verify the dose-rates measurements performed by the drone. Finally, we used the findings from both flights to provide recommendations regarding drone measurements using dose-rate detectors. • Dose-rate detector time constants should be kept at a minimum. • Flight altitude should be as low as safely possible. • Flight speeds should be as low as battery capacity permits. [ABSTRACT FROM AUTHOR]