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In recent years, managed honey bee colonies have been suffering from an increasing number of biotic and abiotic stressors, resulting in numerous losses of colonies worldwide. A pan-European study, EPILOBEE, estimated the colony loss in Belgium to be 32.4% in 2012 and 14.8% in 2013. In the current study, absolute viral loads of four known honey bee viruses (DWV-A, DWV-B, AmFV, and BMLV) and three novel putative honey bee viruses (Apis orthomyxovirus 1, apthili virus, and apparli virus) were determined in 300 Flemish honey bee samples, and associations with winter survival were determined. This revealed that, in addition to the known influence of DWV-A and DWV-B on colony health, one of the newly described viruses (apthili virus) shows a strong yearly difference and is also associated with winter survival. Furthermore, all scrutinized viruses revealed significant spatial clustering patterns, implying that despite the limited surface area of Flanders, local virus transmission is paramount. The vast majority of samples were positive for at least one of the seven investigated viruses, and up to 20% of samples were positive for at least one of the three novel viruses. One of those three, Apis orthomyxovirus 1, was shown to be a genuine honey bee-infecting virus, able to infect all developmental stages of the honey bee, as well as the Varroa destructor mite. These results shed light on the most prevalent viruses in Belgium and their roles in the winter survival of honey bee colonies., Importance: The western honey bee ( Apis mellifera ) is a highly effective pollinator of flowering plants, including many crops, which gives honey bees an outstanding importance both ecologically and economically. Alarmingly high annual loss rates of managed honey bee colonies are a growing concern for beekeepers and scientists and have prompted a significant research effort toward bee health. Several detrimental factors have been identified, such as varroa mite infestation and disease from various bacterial and viral agents, but annual differences are often not elucidated. In this study, we utilize the viral metagenomic survey of the EPILOBEE project, a European research program for bee health, to elaborate on the most abundant bee viruses of Flanders. We complement the existing metagenomic data with absolute viral loads and their spatial and temporal distributions. Furthermore, we identify Apis orthomyxovirus 1 as a potentially emerging pathogen, as we find evidence for its active replication honey bees., Competing Interests: The authors declare no conflict of interest.

In 2019, a joint eight-variant model was published in which eight single nucleotide polymorphisms (SNPs) in seven Apis mellifera genes were associated with Varroa destructor drone brood resistance (DBR, i.e. mite non-reproduction in drone brood). As this model was derived from only one Darwinian Black Bee Box colony, it could not directly be applied on a population-overarching scale in the northern part of Belgium (Flanders), where beekeepers prefer the carnica subspecies. To determine whether these eight SNPs remained associated with the DBR trait on a Flemish colony-broad scope, we performed population-wide modelling through sampling of various A. mellifera carnica colonies, DBR scoring of Varroa-infested drone brood and variant genotyping. Novel eight-variant modelling was performed and the classification performance of the eight SNPs was evaluated. Besides, we built a reduced three-variant model retaining only three genetic variants and found that this model classified 76% of the phenotyped drones correctly. To examine the spread of beneficial alleles and predict the DBR probability distribution in Flanders, we determined the allelic frequencies of the three variants in 292 A. mellifera carnica queens. As such, this research reveals prospects of marker-assisted selection for Varroa drone brood resistance in honeybees., (© 2024. The Author(s).)

Objectives: Falls in elderly patients treated in general hospitals have already been the focus of several studies. Research within psychiatric settings, however, remains limited, despite the fact that this population has a number of characteristics that could increase the fall risk. The aim of this retrospective study was to estimate the prevalence of falling in patients with a psychiatric hospital setting., Methods: A retrospective descriptive chart review of falls registered in the period July 1, 2013 until June 30, 2019 in a Belgian University Psychiatric Hospital was conducted. Data were collected from the "patient related incident report and management system" (PiMS) of the hospital. All registered falls of all hospitalized patients were included in the study., Results: During the 6-year study period an incidence of 4.4 falls per 1,000 patient days was found. Only 0.5% of the falls resulted in severe injury and none of these falls were fatal. Eighty percent of falls involved a patient over the age of 65. Only 25.0% of the elderly patients suffered physical consequences, while injuries were present in 31.4% of adults and 68.2% of young patients. The two most common causes of a fall were the health status (63.3%) and the behavior (55.1%) of the patient., Conclusion: The estimated prevalence of falls in our study was generally in line with the rates found in literature on falls in psychiatric settings. Falls in psychiatric settings occur both in younger and older patients, suggesting that all age categories deserve sufficient attention in fall prevention policies. However, more research is necessary to improve fall prevention policies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 de Smet, Carpels, Creten, De Pauw, Van Eldere, Desplenter and De Hert.)

The treatment of Dupuytren disease (DD) continues to evolve. New insights in risk factors for recurrence and new treatment modalities have changed the management strategies for DD over the past decades. However, several differences may remain between these insights and their clinical application. The current tendencies in management of Dupuytren disease, were investigated in a web-based survey. The survey was sent to all members of the Belgian Hand Group, the professional organisation of hand surgeons in Belgium. The participants indicated their preferred treatment for clinical cases and answered questions on the use and timing of splinting, physiotherapy, medication and adapting the management depending on fibrosis diathesis. These findings were compared to recommendations found in the literature. Forty out of 135 surveyed members of the Belgian Hand Group completed the survey and 7 responded incom- pletely, yielding a response rate of 35% for most questions. This is comparable to similar studies. There appeared to be still room for debate on surgical techniques for difficult cases. CCH use increased since reimbursement became available in Belgium, mainly due to satisfying clinical results for patient and surgeon. The survey demonstrated a wide variety in pre- and postoperative splinting protocols, but consensus existed with the literature on postoperative night-time application of orthoses for 7 to 12 weeks.

The strategy of reconnecting rivers with their floodplains currently gains popularity because it not only harnesses natural capacities of floodplains but also increases social co-benefits and biodiversity. In this paper, we present an example of a successfully implemented nature-based solution (NBS) in the Dijle valley in the centre of Belgium. The research objective is to retrospectively assess cost and benefit differences between a technical solution (storm basins) and an alternative NBS, here the restoration of the alluvial floodplain. The method is a comparative social cost-benefit analysis. The case study analysis reveals similar flood security, lower costs, more ecosystem services benefits and higher biodiversity values associated with the NBS option in comparison to the technical alternative. However, the business case for working with NBS depends substantially on the spatial and socio-ecological context. Chances for successful NBS implementation increase in conditions of sufficient space to retain flood water, when flood water is of sufficient quality, and when economic activity and housing in the floodplain is limited.

Honey bees (Apis mellifera) are susceptible to a wide range of pathogens, including a broad set of viruses. Recently, next-generation sequencing has expanded the list of viruses with, for instance, two strains of Lake Sinai Virus. Soon after its discovery in the USA, LSV was also discovered in other countries and in other hosts. In the present study, we assemble four almost complete LSV genomes, and show that there is remarkable sequence heterogeneity based on the Orf1, RNA-dependent RNA polymerase and capsid protein sequences in comparison to the previously identified LSV 1 and 2 strains. Phylogenetic analyses of LSV sequences obtained from single honey bee specimens further revealed that up to three distinctive clades could be present in a single bee. Such superinfections have not previously been identified for other honey bee viruses. In a search for the putative routes of LSV transmission, we were able to demonstrate the presence of LSV in pollen pellets and in Varroa destructor mites. However, negative-strand analyses demonstrated that the virus only actively replicates in honey bees and mason bees (Osmia cornuta) and not in Varroa mites., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: The Member States of European Union are encouraged to improve the general conditions for the production and marketing of apicultural products. In Belgium, programmes on the restocking of honey bee hives have run for many years. Overall, the success ratio of this queen breeding programme has been only around 50%. To tackle this low efficacy, we organized sanitary controls of the breeding queens in 2012 and 2014., Results: We found a high quantity of viruses, with more than 75% of the egg samples being infected with at least one virus. The most abundant viruses were Deformed Wing Virus and Sacbrood Virus (≥40%), although Lake Sinai Virus and Acute Bee Paralysis Virus were also occasionally detected (between 10-30%). In addition, Aphid Lethal Paralysis Virus strain Brookings, Black Queen Cell Virus, Chronic Bee Paralysis Virus and Varroa destructor Macula-like Virus occurred at very low prevalences (≤5%). Remarkably, we found Apis mellifera carnica bees to be less infected with Deformed Wing Virus than Buckfast bees (p < 0.01), and also found them to have a lower average total number of infecting viruses (p < 0.001). This is a significant finding, given that Deformed Wing Virus has earlier been shown to be a contributory factor to winter mortality and Colony Collapse Disorder. Moreover, negative-strand detection of Sacbrood Virus in eggs was demonstrated for the first time., Conclusions: High pathogen loads were observed in this sanitary control program. We documented for the first time vertical transmission of some viruses, as well as significant differences between two honey bee races in being affected by Deformed Wing Virus. Nevertheless, we could not demonstrate a correlation between the presence of viruses and queen breeding efficacies.

Since the last decade, unusually high honey bee colony losses have been reported mainly in North-America and Europe. Here, we report on a comprehensive bee pathogen screening in Belgium covering 363 bee colonies that were screened for 18 known disease-causing pathogens and correlate their incidence in summer with subsequent winter mortality. Our analyses demonstrate that, in addition to Varroa destructor, the presence of the trypanosomatid parasite Crithidia mellificae and the microsporidian parasite Nosema ceranae in summer are also predictive markers of winter mortality, with a negative synergy being observed between the two in terms of their effects on colony mortality. Furthermore, we document the first occurrence of a parasitizing phorid fly in Europe, identify a new fourth strain of Lake Sinai Virus (LSV), and confirm the presence of other little reported pathogens such as Apicystis bombi, Aphid Lethal Paralysis Virus (ALPV), Spiroplasma apis, Spiroplasma melliferum and Varroa destructor Macula-like Virus (VdMLV). Finally, we provide evidence that ALPV and VdMLV replicate in honey bees and show that viruses of the LSV complex and Black Queen Cell Virus tend to non-randomly co-occur together. We also noticed a significant correlation between the number of pathogen species and colony losses. Overall, our results contribute significantly to our understanding of honey bee diseases and the likely causes of their current decline in Europe.

Dupuytren's disease has been the subject of numerous epidemiological surveys attempting to expand our knowledge on its origin and spread. In Flanders, although numerous studies on surgical outcome have been reported, information on prevalence of Dupuytren's disease is lacking. Therefore, Flanders' population in a non-hospital environment was studied by a clinical evaluation performed by a single hand specialist. Five different market places spread geographically in the 5 Flemish provinces of Belgium were visited to examine the hands of randomly chosen individuals over 50 years old visiting the market. In all, 500 people were examined; Dupuytren's disease was found to be present in 32% of the population. Nodules without finger contractures (stage 1) were seen in 24% of the population, in comparable proportions in males (28%) and females (20%). However, finger contractures (stage 2) were seen in 8%, significantly more often in males (11%) than in females (4%). The prevalence of stage 1 is somewhat lower in individuals over 80 years old. In men, the incidence of stage 2 was found to increase with age. These findings were compared with literature data on the prevalence of Dupuytren's disease in other countries and populations. It appears that, similar to northern Europe, Dupuytren's disease is also a common disease in Flanders.

Carpal tunnel syndrome (CTS) is rarely seen in children. A literature search in 1989 revealed 52 published cases. The authors review 163 additional cases that were published since that date. The majority of these cases were related with a genetic condition. The most common aetiology was lysosomal storage disease: mucopolysaccharidoses (MPS) in 95 and mucolipidoses (ML) in 22. In CTS secondary to MPS, clinical signs typical of adult CTS are rarely seen, and difficulty with fine motor tasks is the most frequent finding. CTS in MPS does not seem to be prevented by bone marrow transplantation, the usual treatment for the condition. CTS is probably due to a combination of excessive lysosomal storage in the connective tissue of the flexor retinaculum and a distorted anatomy because of underlying bone dysplasia. Mucolipidoses come next in the aetiology, with essentially similar symptoms. The authors found in the literature 11 cases of primary familial CTS, a condition which presents as an inheritable disorder of connective tissue mediated by an autosomal dominant gene; the symptoms may be more typical in some cases, but are more similar to MPS in others. A case with self-mutilation has been reported. Hereditary neuropathy with liability to pressure palsies (HNPP) is a rare autosomal dominant condition characterised by episodes of decreased sensation or palsies after slight traction or pressure on peripheral nerves; it may also give symptoms of CTS. Schwartz-Jampel syndrome (SJS), another genetic disorder with autosomal recessive skeletal dysplasia, is characterised by varying degrees of myotonia and chondrodysplasia; it has also been noted associated with CTS in a child. Melorrheostosis and Leri's syndrome have also been noted in children with CTS, as well as Déjerine-Sottas syndrome and Weill-Marchesani syndrome. Among non-genetic causes of CTS in children, idiopathic cases with children onset have been reported, usually but not always related with thickening of the transverse carpal ligament. Intensive sports practice has been reported as an aetiological factor in several cases of childhood CTS. Nerve territory oriented macrodactily, a benign localised form of gigantism, is another unusual cause of CTS in children, as are fibrolipomas of the median nerve or intraneural perineuroma or haemangioma of the median nerve. Acute cases have been reported in children with haemophilia, secondary to local bleeding. Another local cause is a musculotendinous malformation of the palmaris longus, the flexor digitorum superficialis, the flexor carpi radialis brevis (a supernumerary muscle), the first lumbricalis or the palmaris brevis. Isolated cases of childhood CTS have also been reported in Klippel-Trenaunay syndrome, in Poland's syndrome and in scleroderma. Finally, several cases have been noted following trauma, most often related with epiphysiolysis of the distal radius. Immediate reduction has cleared the problem in most cases, but exploration of the median nerve should be considered otherwise, and also in cases with delayed occurrence of symptoms. Overall 145 of the 163 reviewed cases have undergone open carpal tunnel release. Childhood CTS often has an unusual presentation, with modest complaints and children are often too young to communicate their problem. In CTS with specific aetiologies such as storage disease, the symptoms may be masked by the skeletal dysplasia and joint stiffness. Every child with even mild symptoms must be thoroughly examined and a family history must be taken. Children with storage disease may benefit from early clinical and electrophysiological screening before they develop obvious clinical signs.