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The Cape Bounty Arctic Watershed Observatory (CBAWO), Melville Island, Nunavut (74°55′N, 109°34′W) was established in 2003 to examine Arctic ecosystem processes that would be impacted by climate warming and permafrost degradation. This paper provides a synthesis of how remote sensing has contributed to biogeophysical modelling and monitoring at the CBAWO from 2003 to 2023. Given the location and isolated nature of the CBAWO in the Canadian High Arctic, remote sensing data and derivatives have been instrumental for studies examining ecosystem structure and function at local and landscape scales. In combination with field measurements, remote sensing data facilitated mapping and modelling of vegetation types, % vegetation cover and aboveground phytomass, soil moisture, carbon exchange rates, and permafrost degradation and disturbance. It has been demonstrated that even in an environment with limited vegetation cover and phytomass, spectral vegetation indices (e.g., the normalized difference vegetation index) are able to model various biogeophysical variables. These applications are feasible for research sites such as the CBAWO using high spatial resolution remote sensing data across the visible, infrared, and microwave regions of the electromagnetic spectrum. Furthermore, as the satellite record continues to expand, we will gain a greater understanding of the impacts arising from the expected continued warming at northern latitudes. Although the logistics for research in the Arctic remain challenging, today's technologies (e.g., high spatial resolution satellite remote sensing, automated in situ sensors and data loggers, and wireless communication systems) can support a host of scientific endeavours in the Arctic (and other remote sites) through modelling and monitoring of biogeophysical variables and Earth surface processes with limited but critical field campaigns. The research synthesized here for the CBAWO highlights the essential role of remote sensing of terrestrial ecosystems in the Canadian Arctic.

Objectives: Distal radius malunion can result in pain and functional complaints. One of the functional problems that can affect daily life is impaired forearm rotation. The primary aim of this study was to investigate the effect of corrective osteotomy for distal radius malunion on forearm rotation at 12 months after surgery. We secondarily studied the effect on grip strength, radiological measurements, and patient-reported outcome measurements (PROMs). Patients and methods: This cohort study analysed prospectively collected data of adult patients with symptomatic distal radius malunion. All patients underwent corrective osteotomy for malunion and were followed for 1 year. We measured forearm rotation (pronation and supination) and grip strength and analysed radiographs. PROMs consisted of the Patient-Rated Hand/Wrist Evaluation (PRWHE) questionnaire, Visual Analogue Scale for pain, and satisfaction with hand function. Results: Preoperative total forearm rotation was 112° (SD: 34°), of which supination of 49° (SD: 25°) was more impaired than pronation of 63° (SD: 17°). Twelve months after surgery, an unpaired Student's t-test showed a significant improvement of total forearm rotation to 142° (SD: 17°) (p

Abstract Background The ability to communicate is a prerequisite for participation in today’s society. To measure participation in adults with communication disorders, the Communicative Participation Item Bank (CPIB) was developed in 2006. Since then, several new PROMs have been developed to measure communication and the impact of communication disorders on participation. Moreover, the CPIB items do not all appear to be relevant to certain populations with communication problems and context of communicative participation is changing rapidly, given the increased use of digital communication forms. The purpose of this study was to identify new PROMs developed since 2006 that aim to measure (aspects of) communication, in order to select items that are suitable for expanding the Communicative Participation Item Bank to make the item bank more widely applicable (e.g., to the hearing-impaired population) and tailored to the current societal context. Methods Medline and Embase were used to search for PROMs that aim to measure (aspects of) communication. Each new PROM as well as the CPIB, was evaluated to determine to what extent it contains items that measure communicative participation and to what extent these items capture all communicative participation domains by linking each item to the ICF Activities and Participation domains. Results This study identified 31 new PROMs, containing 391 items that were labelled as measuring communicative participation. The majority of the 391 items measure aspects of ICF Activities and Participation domain ‘communication’, followed by the domain ‘interpersonal interactions and relationships’. The other ICF Activity and Participation domains were less often addressed. Analysis of the CPIB showed that items do not cover all domains of participation as defined in the ICF, such as the ‘major life areas’ domain. Conclusions We found a potential pool of 391 items measuring communicative participation that could be considered for extending the CPIB. We found items in domains that are already present in the CPIB, but also items that relate to new domains, such as an item on talking with customers or clients for the ‘major life areas’ domain. Inclusion of new items in other domains would benefit the comprehensiveness of the item bank.

Osteosarcoma is a challenging disease requiring multidisciplinary management in expert centers for optimal outcome. There are no current international protocols or guidelines specific for pediatric and adolescent osteosarcoma. The European Standard Clinical Practice (ESCP) project is a collaboration between ERN PaedCan and SIOP Europe’s Clinical Trial Groups to develop approved clinical recommendations reflecting current best practice. This manuscript is a summary of the full ESCP guideline for patients with osteosarcoma. The manuscript provides evidence graded recommendations for diagnosis, staging, management, response evaluation and follow-up. The methodology as defined in the standard operating procedures of the European Society for Medical Oncology (ESMO) was applied. Experts of the Fight OsteoSarcoma Through European Research (FOSTER) consortium contributed. In summary, the ESCP provides guidance on low-grade, but has a focus on high-grade osteosarcoma. In high-grade osteosarcoma the outcomes of most recent trials for clinical subgroups (e.g., metastatic vs. non-metastatic, resectable vs. non-resectable) are discussed, for treatment-naïve as well as for recurrent/refractory disease. An overview of current evidence also highlights the need for further therapeutic development as patients with primary metastatic or recurrent/refractory high-grade osteosarcoma still have a poor prognosis. Intensified collaborative research is identified as a prerequisite to increase survival and to limit long-term toxicities.

The increasing CO2 emissions from e-commerce deliveries present a pressing environmental concern. If half of all consumers decided to have their online order delivered to a pick-up point instead of at home, this could vastly reduce CO2 emissions of e-commerce. This study investigated (a) whether nudging could help consumers shift towards pick-up point delivery as a more sustainable choice, and (b) which type of nudging would be most effective. An RCT was conducted with a representative sample of the Dutch population (N = 1213). In an online store setting, participants selected a product and completed the check-out process – selecting between more and less sustainable delivery options. Their selection had real consequences as the gift would be delivered with the selected delivery method. Four different nudging conditions were contrasted: a default nudge, in which the most sustainable option (i.e., delivery to pick-up point) was selected automatically, and three decision-information nudges, in which CO2 emissions for the delivery options was displayed. The decision-information nudges varied in complexity, from high complexity (emissions in grams of CO2 for each delivery option) to medium (percentage of CO2 reduction for the most sustainable option) and low complexity (a green leaf next to the most sustainable option). Relative to control, the default nudge was the most effective at steering participants towards the most sustainable delivery choice, followed by the medium- and low-informational nudging conditions. In addition, instead of steering them towards the most sustainable delivery option, the high-informational nudge appeared to steer participants away from the two most polluting delivery options – thereby potentially saving more greenhouse gas emissions (GHG) than the other conditions. In sum, this study provides substantial evidence for the use of behavioral strategies in quest towards more sustainable online consumption.

The Frontline and Relapsed Rhabdomyosarcoma (FaR-RMS) clinical trial is an overarching, multinational study for children and adults with rhabdomyosarcoma (RMS). The trial, developed by the European Soft Tissue Sarcoma Study Group (EpSSG), incorporates multiple different research questions within a multistage design with a focus on (i) novel regimens for poor prognostic subgroups, (ii) optimal duration of maintenance chemotherapy, and (iii) optimal use of radiotherapy for local control and widespread metastatic disease. Additional sub-studies focusing on biological risk stratification, use of imaging modalities, including [18F]FDG PET-CT and diffusion-weighted MRI imaging (DWI) as prognostic markers, and impact of therapy on quality of life are described. This paper forms part of a Special Issue on rhabdomyosarcoma and outlines the study background, rationale for randomisations and sub-studies, design, and plans for utilisation and dissemination of results.

Background and aimsSolid tumors account for about 30% of all pediatric cancers. The diagnosis is typically based on histological and molecular analysis of a primary tumor biopsy. Liquid biopsies carry several advantages over conventional tissue biopsy. However, their use for genomic analysis and response monitoring of pediatric solid tumors is still in experimental stages and mostly performed retrospectively without direct impact on patient management. In this case series we discuss six clinical cases of children with a solid tumor for whom a liquid biopsy assay was performed and demonstrate the potential of liquid biopsy for future clinical decision making.MethodsWe performed quantitative real-time PCR (RT-qPCR), droplet digital PCR (ddPCR) or reduced representation bisulphite sequencing of cell-free DNA (cfRRBS) on liquid biopsies collected from six pediatric patients with a solid tumor treated between 2017 and 2023 at the Princess Máxima Center for Pediatric Oncology in the Netherlands. Results were used to aid in clinical decision making by contribution to establish a diagnosis, by prognostication and response to therapy monitoring.ResultsIn three patients cfRRBS helped to establish the diagnosis of a rhabdomyosarcoma, an Ewing sarcoma and a neuroblastoma (case 1-3). In two patients, liquid biopsies were used for prognostication, by MYCN ddPCR in a patient with neuroblastoma and by RT-qPCR testing rhabdomyosarcoma-specific mRNA in bone marrow of a patient with a rhabdomyosarcoma (case 4 and 5). In case 6, mRNA testing demonstrated disease progression and assisted clinical decision making.ConclusionThis case series illustrates the value of liquid biopsy. We further demonstrate and recommend the use of liquid biopsies to be used in conjunction with conventional methods for the determination of metastatic status, prognostication and monitoring of treatment response in patients with pediatric solid tumors.

Key points Strategies for segmenting sarcoma tumors vary widely throughout literature. Details of the segmentation strategy are often not reported. Including necrotic or cystic areas in the segmentation affects diffusion measurements. Varying the slice of a single-slice segmentation can drastically impact diffusion measurements.

Because of decreasing severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) incidence rates in the Netherlands at the time, the government of the Netherlands lifted most restrictions on June 26, [...]

IntroductionMild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients.MethodsThis qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support.ResultsThis resulted in the intervention “Routes to Recovery,” which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan.DiscussionRoutes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.

We report a severe acute respiratory syndrome coronavirus 2 superspreading event in the Netherlands after distancing rules were lifted in nightclubs, despite requiring a negative test or vaccination. This occurrence illustrates the potential for rapid dissemination of variants in largely unvaccinated populations under such conditions. We detected subsequent community transmission of this strain.

Background and objectives Large shares of pregnant Muslims worldwide observe the Ramadan fast. Previous research showed that Ramadan during pregnancy is associated with adverse offspring health outcomes lasting throughout the life-course. Evidence on effects on birth outcomes is inconclusive, however, and previous research did not consider the role of dietary composition and sleep patterns during Ramadan. This study systematically documents maternal lifestyle during Ramadan and assesses if diet and sleep adaptations to Ramadan, independent of and in addition to maternal fasting, are associated with neonatal health outcomes. Methods This study reports a survey of 326 Muslims who delivered their baby in Mainz, Germany, linked to maternal & infant hospital records. Participants reported on fasting, dietary composition and sleep schedules while pregnant during Ramadan. Results Fasting during pregnancy was associated with reduced birthweight, in particular for fasting during the first trimester (-352ˑ92g, 95% CI: -537ˑ38; -168ˑ46). Neither dietary composition nor altered sleep were directly associated with birthweight. However, dietary composition during Ramadan outside of fasting hours seems to moderate the fasting-birthweight association, which disappeared for women switching to high-fat diets. Conclusions The finding that dietary intake during Ramadan potentially moderates the fasting-birthweight association is of high relevance to pregnant Muslims who wish to fast and their healthcare professionals, since dietary choices outside of fasting hours are often relatively easily modifiable. This is the first study to include information on maternal diet and sleep during Ramadan, and additional research is needed to assess the roles of specific (macro)nutrients and food groups.

Remote sensing is revolutionizing the way we study forests, and recent technological advances mean we are now able - for the first time - to identify and measure the crown dimensions of individual trees from airborne imagery. Yet to make full use of these data for quantifying forest carbon stocks and dynamics, a new generation of allometric tools which have tree height and crown size at their centre are needed. Here, we compile a global database of 108753 trees for which stem diameter, height and crown diameter have all been measured, including 2395 trees harvested to measure aboveground biomass. Using this database, we develop general allometric models for estimating both the diameter and aboveground biomass of trees from attributes which can be remotely sensed - specifically height and crown diameter. We show that tree height and crown diameter jointly quantify the aboveground biomass of individual trees and find that a single equation predicts stem diameter from these two variables across the world's forests. These new allometric models provide an intuitive way of integrating remote sensing imagery into large-scale forest monitoring programmes and will be of key importance for parameterizing the next generation of dynamic vegetation models.

Abstract Background Perinatally chikungunya infected neonates have been reported to have high rates of post-infection neurologic sequelae, mainly cognitive problems. In older children and adults chikungunya does not appear to have sequelae, but data on postnatally infected infants are lacking. Methods We performed a prospective, non-controlled, observational study of infants infected before the age of 6 months with a severe chikungunya infection during the 2014–2015 epidemic in Curaçao, Dutch Antilles. Two years post-infection cognitive and motor - (BSID-III) and social emotional assessments (ITSEA) were performed. Results Of twenty-two infected infants, two died and two were lost to follow up. Eighteen children were seen at follow-up and included in the current study. Of these, 13 (72%) had abnormal scores on the BSID-III (cognitive/motor) or ITSEA. Conclusion In the first study aimed at postnatally infected infants, using an uncontrolled design, we observed a very high percentage of developmental problems. Further studies are needed to assess causality, however until these data are available preventive measure during outbreaks should also include young infants. Those that have been infected in early infancy should receive follow up.

The historical diffusion of SO2 control technology gives insights into the potential uptake of carbon capture and storage. Here the authors show that the global diffusion of flue gas desulfurization technology was very fast at times, especially for retrofit, and even after materiality, but strongly depended on regulation.

The ability to expand the use of predictive Airborne Laser Scanning (ALS)-derived Forest Resource Inventory (FRI) models to broader regional scales is crucial for supporting large scale sustainable forest management. This research examined the transferability of ALS-based FRI attributes between two forest estates located in the eastern and western boreal forest regions of Canada. The sites were structurally diverse due to a strong east-to-west gradient in climate conditions and disturbance regimes. We first examined the ALS–FRI attribute relationships between the sites. Second, we applied Ordinary Least Squares regressions and Random Forest, to predict four FRI attributes. Third, we tested if the inclusion of calibration data from the target location improved the performance of the transferred models. As the sites were located on opposing sides of a bioclimatic gradient, inclusion of target calibration data improved transferred model performance. However, attribute prediction accuracy varied with modeling approach, attribute, and site. The best transferability models fell within a ± 5% relative RMSE of the local predictive models but increased up to 10% in relative bias. These results have implications for forest researchers and managers on both the number, and location, of FRI plots when considering undertaking forest inventories over large disparate areas.

HM Kansen,1,2 TM Le,2 CSPM Uiterwaal,3 BE van Ewijk,4 WAF Balemans,5 DMW Gorissen,6 E de Vries,7 MF van Velzen,8 GHPR Slabbers,9 Y Meijer,1 AC Knulst,2 CK van der Ent,1 FC van Erp2 1Department of Pediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; 2Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands; 3Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; 4Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands; 5Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands; 6Department of Pediatrics, Deventer Hospital, Deventer, The Netherlands; 7Department of Pediatrics, Jeroen Bosch Academie (Research), Jeroen Bosch Hospital, ‘S Hertogenbosch, The Netherlands; 8Department of Pediatrics, Meander Medical Center, Amersfoort, The Netherlands; 9Department of Pediatrics, Bernhoven Hospital, Uden, The NetherlandsCorrespondence: HM KansenDepartment of Pediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Lundlaan 6, Utrecht 3508 AB, The NetherlandsTel +31 30 88 75 75 2 84Email h.m.kansen-2@umcutrecht.nlBackground: Uncontrolled asthma in children is still highly prevalent despite the availability of effective asthma treatment. We investigated 1) the prevalence of uncontrolled asthma among children referred for asthma and referred for atopic diseases other than asthma (ie food allergy, allergic rhinitis or atopic dermatitis) to secondary care; and 2) the predictors associated with uncontrolled asthma.Methods: All children (4 to 18 years) referred for asthma or atopic diseases other than asthma to 8 secondary care centers in The Netherlands were invited to an electronic portal (EP). The EP is a web-based application with several validated questionnaires including the ISAAC questionnaires and the Asthma Control Test (ACT). Children were eligible for inclusion in this study when their parents reported in the EP that their child had asthma diagnosed by a physician. The ACT was used to assess asthma control. Multiple predictors of asthma control (patient, asthma and atopic characteristics) were evaluated by univariable and multivariable logistic regression analyses.Results: We included 408 children: 259 children (63%) with asthma referred for asthma and 149 children (37%) with asthma referred for atopic diseases other than asthma. Thirty-nine percent of all children had uncontrolled asthma: 47% of the children referred for asthma and 26% of the children referred for atopic diseases other than asthma. Predictors associated with uncontrolled asthma were a family history of asthma (odds ratio [OR] 2.08; 95% confidence interval [95% CI] 1.34 to 3.24), and recurrent upper and lower respiratory tract infections in the past year (OR 2.40; 95% CI 1.52 to 3.81 and OR 2.00; 95% CI 1.25 to 3.23, respectively).Conclusion: Uncontrolled asthma is highly prevalent in children with asthma referred to secondary care, even if children are primarily referred for atopic diseases other than asthma. Thus, attention should be paid to asthma control in this population.Keywords: asthma, asthma control, atopic diseases, respiratory tract infections, prognosis

Air travel generates a substantial and growing share of global greenhouse gas emissions. Reduction efforts partly rely on estimates of emissions per passenger, which may be used for carbon budgets, offsets, or taxes. Aircraft emissions are typically allocated to individual passengers through space-based allocation dependent on seating arrangements by travel class. However, the operation of aircraft depends on profitability, which benefits from high fares from late bookings, often by business and high-income travellers. Fare-based allocation recognises the economic drivers of airline emissions by allocating the aircraft emissions proportionally to the paid airfares. In this article, we compare space-based passenger emissions, which differ only by class, with fare-based passenger emissions, which depend on the fare paid by the individual traveller. We extract space-based allocation factors from widely used emission calculators and derive fare-based allocation factors from airfares for domestic travel in the US. We find that the space-based allocation factors reflect the difference in average expenditure by travel class but not the difference in expenditure between travellers. With fare-based accounting, the most expensive economy trips have similar emissions to space-based premium trips, while less expensive premium trips have similar emissions to space-based economy trips. We find that a tax on fare-based instead of space-based emissions leads to a more evenly distributed impact on low-fare and high-fare travellers whilst achieving the same reduction in airline revenues. We conclude that fare-based emissions accounting better reflects the drivers of airline emissions and supports more equitable climate action.

Abstract Many biology-based precision drugs are available that neutralize aberrant molecular pathways in cancer. Molecular heterogeneity and the lack of reliable companion diagnostic biomarkers for many drugs makes targeted treatment of cancer inaccurate for many individuals. Identifying actionable hyperactive biological pathways in individual cancers may improve this situation. To achieve this we applied a novel targeted RNA next generation sequencing (t/RNA-NGS) technique to surgically obtained glioma tissues. The test combines mutation detection with analysis of biological pathway activities that are involved in tumour behavior in many cancer types (e.g. tyrosine kinase signaling, angiogenesis signaling, immune response, metabolism), via quantitative measurement of transcript levels and splice variants of hundreds of genes. We here present proof of concept that the technique, which uses molecular inversion probes, generates a histology-independent molecular diagnosis and identifies classifiers that are strongly associated with conventional histopathology diagnoses and even with patient prognosis. The test not only confirmed known glioma-associated molecular aberrations but also identified aberrant expression levels of actionable genes and mutations that have so far been considered not to be associated with glioma, opening up the possibility of drug repurposing for individual patients. Its cost-effectiveness makes t/RNA-NGS to an attractive instrument to aid oncologists in therapy decision making.

Background: The COVID-19 lockdown increases psychological problems in children and adolescents from the general population. Here we investigate the mental and social health during the COVID-19 lockdown in children and adolescents with pre-existing mental or somatic problems.Methods: We included participants (8–18 years) from a psychiatric (N = 249) and pediatric (N = 90) sample, and compared them to a general population sample (N = 844). Measures were assessed during the first lockdown (April-May 2020) in the Netherlands. Main outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS®) domains: Global Health, Peer Relationships, Anxiety, Depressive Symptoms, Anger, and Sleep-Related Impairment, as reported by children and youth. Additionally, socio-demographic variables, COVID-19-related questions, changes in atmosphere at home from a parent and child perspective, and children's experiences of lockdown regulations were reported by parents.Results: On all measures except Global Health, the pediatric sample reported least problems. The psychiatric sample reported significantly more problems than the general population sample on all measures except for Anxiety and Peer Relationships. Having a COVID-19 affected friend/relative and a COVID-19 related change in parental work situation negatively moderated outcome, but not in the samples with pre-existing problems. All parents reported significant decreases in atmosphere at home, as did children from the general population.Conclusion: We observed significant differences in mental and social health between three child and adolescent samples during the COVID-19 pandemic lockdown and identified COVID-19-related factors influencing mental and social health.