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Dutch Abstract: De bijdrage gaat in op de wijzigingen die de laatste jaren zijn aangebracht aan het juridische kader waaraan de maatschap zonder rechtspersoonlijkheid onderworpen is. Het WVV heeft zijn invloed gehad op de maatschap, maar ook een aantal nieuwe regels op het vlak van de boekhouding, de inschrijvingsplicht in het KBO en de registratie van uiteindelijke begunstigden in het UBO-register hebben belangrijke gevolgen voor de maatschap. In het licht van al deze zaken wordt nagegaan of de flexibele BV een alternatief kan zijn voorde maatschap die specifiek gebruikt wordt bij familiale vermogensplanning. English Abstract: The contribution addresses the changes made in recent years to the legal framework to which the unincorporated partnership is subject. The WVV (new Belgian Code of Companies and Associations) has had its repercussions for the partnership, but also a number of new rules in the field of accounting, the obligation to register in the KBO and the registration of ultimate beneficial owners in the UBO register have important consequences for the partnership. In light of all these issues, it is being examined whether the flexible BV can be an alternative for the partnership that is specifically used in estate planning.

International audience; During isometric contractions, the net joint torque stability is modulated with the force production phases, i.e., increasing (IFP), holding (HFP), and decreasing force (DFP) phases. It was hypothesized that this modulation results from an altered cortical control of agonist and antagonist muscle activations. Eleven healthy participants performed 50 submaximal isometric ankle plantar flexion contractions. The force production phase effect (IFP, HFP and DFP) was assessed on the net joint torque stability, agonist and antagonist muscles activations, cortical activation, and corticomuscular coherence (CMC) with agonist and antagonist muscles. In comparison to HFP, the net joint torque stability, the agonist muscles activation and the CMC with agonist muscles were lower during IFP and even more during DFP. Antagonist muscle activations, cortical activations and CMC with antagonist muscles were higher during HFP than during IFP only. Increased CMC with agonist and antagonist muscles appeared to enhance the fine motor control. At a cortical level, agonist and antagonist muscle activations seemed to be controlled independently according to their muscle function and the phase of force production. Results revealed that CMC was an adequate measure to investigate the cortical regulation of agonist and antagonist muscle activations. This may have potential applications for patients with altered muscle activations.

Objectives In healthy adults, homologous muscle activations appear during bilateral contractions (BI) and can be induced during unilateral contractions (UNI) at high force level. After brain injury, involuntary homologous muscle activations during UNI can have neurological significance. Although homologous muscle activations are supposed to originate from commands sent by the motor cortices [1] , the common neural drive shared across homologous muscles remains unclear. The intermuscular coherence (IMC) between electromyographic (EMG) signals can highlight different neural strategies to control muscle activations [2] , [3] . The IMC ∼ 10 Hz is supposed to reflect subcortical strategies while IMC in higher frequency bands is supposed to reflect different cortical contributions. This study compared the IMC between homologous muscles according to contraction type. Methods Eleven right-footed subjects performed 3 maximal isometric UNI and BI ankle plantarflexion contractions. Right and left ankle torque and homologous triceps surae EMG signals were recorded. IMC magnitude between homologous EMG signals was calculated in α (5–12 Hz), β (13–30 Hz), γ (30–60 Hz) and γ+ (> 60 Hz) frequency bands during the 2 s where the net ankle torque was maximal. Right and left torques and IMC magnitudes were compared between UNI and BI. Results Right torque was not significantly different between conditions. Left torque was significantly different from baseline and between conditions. IMCα was significantly higher during UNI than BI. No significant differences in IMCβ and IMCγ between conditions were observed. IMCγ+ was significantly higher during BI than UNI. Conclusions Our results suggest different neural strategies to control muscle activations according to contraction type. During UNI, higher IMCα suggests subcortical structures involvement to inhibit unsolicited homologous muscle activations [3] . During BI, higher IMCγ+ may suggest an optimization of the neural drive shared across homologous muscles to reduce computational effort [2] , [3] . Similar investigations in people with brain injury may help understanding the underlying neurophysiological mechanisms of motor overflow.

STUDY QUESTION Does Day 3 embryo biopsy for pre-implantation genetic testing for monogenic (PGT-M) and structural chromosomal aberrations (PGT-SR) affect body composition and blood pressure readings of 6-year-old singletons? SUMMARY ANSWER This study of 87 PGT-M and PGT-SR conceived singletons showed no differences in anthropometric measurements and blood pressure readings in comparison with a matched cohort of peers born after ICSI without embryo biopsy. WHAT IS KNOWN ALREADY While neonatal outcomes after PGT conception have been found comparable to those after ICSI without embryo biopsy, only a few studies have reported outcomes after PGT at older ages. Moreover, embryo biopsy is also applied in couples who opt for PGT-M and PGT-SR and hence are not necessarily infertile. Health parameters and in particular body composition data in this group of children are lacking. STUDY DESIGN, SIZE, DURATION This single-centre matched-pair cohort study evaluated body composition of 6-year-old children born after fresh blastocyst embryo transfer with or without embryo biopsy performed at Day 3 for the purpose of PGT-M and PGT-SR. For each child born after embryo biopsy, a singleton born after transfer of a fresh ICSI embryo at the blastocyst stage and reaching the age of 6 years between May 2011 and June 2017 was matched as closely as possible for gender, age, maternal educational level and birth order. PARTICIPANTS/MATERIALS, SETTING, METHODS Anthropometry (weight, height, BMI, skinfold thickness, waist and mid-upper arm circumference) and blood pressure readings in a longitudinally followed cohort of 87 singletons conceived by PGT-M and PGT-SR and a pairwise matched sample of 87 children conceived by ICSI are described. Results are adjusted for current, neonatal and parental characteristics. MAIN RESULTS AND THE ROLE OF CHANCE From the 124 eligible PGT-M and PGT-SR families, 110 could be reached of whom 23 refused and 87 (87/110 = 79%) participated. All anthropometric measurements, including z-scores of BMI, waist and mid-upper arm circumference, were comparable between the PGT-M and PGT-SR (−0.23; 0.27; 0.17, respectively) and ICSI (−0.29; 0.11; 0.11, respectively) groups (all P > 0.05). Furthermore, indices of peripheral (triceps) and central (subscapular) adiposity derived from skinfold thickness were comparable (PGT-M and PGT-SR: 14.7 mm; 11.6 mm and ICSI: 15.5 mm; 11.5 mm) as well as the percentage total body fat mass derived from these (PGT-M and PGT-SR: 13.7% and ICSI: 13.9%) (all P > 0.05). Z-scores for blood pressure were also comparable between the PGT and ICSI groups (all P > 0.05). Results did not change when adjusted for neonatal (birthweight, birth order), current (age) and parental (smoking during pregnancy, parental BMI) characteristics. Hospitalization rate and surgical intervention rate were not different for PGT-M and PGT-SR children compared to matched peers born after ICSI. LIMITATIONS, REASONS FOR CAUTION Although our study describes the largest cohort of singletons born after embryo biopsy worldwide, we were only able to detect moderate differences in anthropometrics and blood pressure with our sample size. WIDER IMPLICATIONS OF THE FINDINGS Although Day 3 embryo biopsy followed by blastocyst transfer is not associated with adverse outcomes regarding anthropometry and blood pressure, future studies should focus on outcomes in children born after trophectoderm biopsy and/or transfer of warmed embryos after vitrification. STUDY FUNDING/COMPETING INTEREST(s) This study was supported by Methusalem grants and by grants from Wetenschappelijk Fonds Willy Gepts; all issued by the Vrije Universiteit Brussel (VUB). All co-authors, except M.B. declared no conflict of interest. M.B. has received consultancy fees from MSD, Serono Symposia and Merck. The Universitair Ziekenhuis Brussel (UZ Brussel) and the Centre for Medical Genetics have received several educational grants from IBSA, Ferring, Organon, Shering-Plough, Merck for establishing the database for follow-up research and organizing the data collection.

International audience; Lors de contractions musculaires bilatérales (CB) ou unilatérales (CU), la production de force dépend de la contribution des muscles agonistes et antagonistes au moment de force développé. Dans le cas de CB, il est supposé que des commandes nerveuses communes, d’origine corticale, sont envoyées de manière bilatérale aux muscles homologues de manière à améliorer l’efficacité de la contraction musculaire (Boonstra et al., 2015). Dans cette situation, les commandes communes contrôlant les activations musculaires antagonistes restent encore méconnues. Ces commandes communes peuvent être estimées à partir de la cohérence intermusculaire (CIM), i.e., la corrélation fréquentielle entre les activités électromyographiques (EMG), autour de 40 Hz lors de contractions musculaires à niveau de force maximal. Le but de cette étude était d’évaluer les modulations de la CIM entre les muscles homologues en fonction du type de contraction et de la fonction des muscles. Il était attendu que la synchronisation des activations des muscles homologues entraine une CIM plus élevée en CB. D’autre part, les commandes indépendantes permettant un contrôle plus spécifique des muscles antagonistes pourraient différer selon les conditions et entrainer des CIM différentes selon la fonction des muscles. 11 sujets droitiers (25±5 ans) ont réalisé 3 CU droites, 3 CU gauches et 3 CB isométriques en flexion dorsale de cheville à intensité maximale. Le moment de force produit autour des chevilles droite et gauche et l’EMG des muscles tibiaux antérieurs, gastrocnémiens médiaux et latéraux, et soléaires, droits et gauches ont été mesurés. La CIM a été calculée entre l’activité EMG des muscles homologues, séparément pour les muscles agonistes et antagonistes, dans la bande de fréquence 30-60Hz pour les 2s où le moment de force produit était maximal. Une ANOVA à mesures répétées TYPE (CU droit, CU gauche, CB) x MUSCLE (agonistes, antagonistes) a révélé un effet TYPE (p

Dans un contexte de changements globaux, il est primordial de comprendre les cycles du Carbone (C) et de l’Azote (N) dans les agrosystèmes. Dans les écosystèmes prairiaux (puits de C et faible lixiviation), une synchronisation entre l’offre du sol et la demande de la plante en N semble exister. Cette synchronisation repose sur différents processus microbiens, tel que le « rhizosphere priming effect » (RPE), défini comme l’accélération de la minéralisation des matières organiques du sol (MOS) induite par la plante. L’influence de la disponibilité en CO2 (400 et 700 ppm) sous prairie d’une part, et en N (40 et 200 kg N/ha) à travers trois modes de gestion : (i) prairie, (ii) blé conventionnel, et (iii) blé sur couverture permanente de prairie d’autre part, a été étudiée. Un dispositif de marquage continu au 13CO2 a permis de distinguer la respiration du sol de celle des plantes dans les mésocosmes. L’augmentation de la disponibilité en CO2 de l’atmosphère a permis une hausse significative de la biomasse végétale totale, de l’appareil racinaire, donc de la demande en N et de l’offre du sol via l’augmentation du RPE. En outre, l’augmentation de la biomasse, en prairie et association blé-prairie sous fertilisation forte, a appauvri le sol en N et conduit à une hausse du RPE. Ces résultats préliminaires valident l’existence d’une synchronisation entre l’offre du sol et la demande de la plante en N. En revanche, le remaniement récent du sol prairial riche en N ne permet pas d’observer une influence nette du mode de gestion sur cette synchronisation. Cependant, l’association blé-prairie suggère une meilleure synchronisation sol-plante, notamment par la réduction significative du potentiel de lixiviation. Finalement, la poursuite du dispositif à plus long terme semble essentielle afin d’observer l’évolution de cette synchronisation au travers des divers modes de gestion., In the framework of global changes, it is crucial to better comprehend the carbon (C) and nitrogen (N) cycles involved in agrosystems. Within grassland ecosystems (C sink and low N lixiviation), there seems to be a synchronization between plant N-demand and soil N-offer. This synchronization relies on different microbial processes, such as the “rhizosphere priming effect” (RPE), which is defined as an enhancement of mineralization of soil organic matter (SOM) induced by plants. The influence of CO2 availability (400 and 700 ppm) in grassland on one hand, and N availability (40 et 200 kg N/ha) through three land-uses (i) grassland, (ii) wheat cropping, (iii) wheat on permanent grassland cover on the other hand, have been studied. A continuous 13CO2 labeling device permitted to distinguish soil respiration from plant respiration in the mesocosms. The rising CO2 availability enabled a significant increase of total plant biomass, root systems, N-demand and thereafter of soil offer via a stronger RPE. Besides, the increased plant biomass in grassland and mixed cropping, under a high N-fertilization, led to soil-N depletion and higher RPE. These preliminary results validate the existence of synchronization between plant N-demand and soil N-offer. However, the recent disturbance of the N-rich grassland soil, did not allow the clear observation of land-uses impact on this synchronization. Mixed cropping suggests better soil-plant synchronization, particularly thanks to the significant reduction of the lixiviation potential. Finally, a long-term follow-up appears essential in order to observe how this synchronization evolves, from one land-use to another.

Objectives During and after the completion of a motor task, an event-related desynchronization (ERD) and synchronization (ERS) – i.e., a decrease and increase of the 13–31 Hz spectral magnitude–are respectively recorded over the motor cortex (M1). The ERD is supposed to reflect M1 involvement to perform the motor task [1] , [2] while the ERS is supposed to reflect an active “top-down” cortical inhibition of the motor command [1] , [3] . Studies revealed that ERD/S are modulated with the force level [1] . However, it remains to know whether ERD/S are related to the task performance, reflecting force control. We investigated the relationship between the ERD/S and the accuracy and variability of the force production. Methods Eleven healthy participants performed 50 × 10-s isometric right plantar flexion contractions at 20% of their maximal torque. The ankle torque and the M1 EEG activity were recorded. After appropriate preprocessing, the absolute and variable errors (AE/VE) of the ankle torque, respectively reflecting accuracy and variability of the motor task and the ERD were computed during the holding force phase. The ERS was computed 1-s after the end of the contraction. All data were normally distributed. Pearson correlations between ERD/S and AE/VE were computed. Results No significant correlation was found between the ERD and VE (r2 = 0.11; P = 0.75) nor between the ERD and AE (r2 = 0.56; P = 0.07). The ERS significantly increased as the VE increased (r2 = 0.8; P Conclusion These results suggest that the ERD is not linked with fine motor control modulating accuracy and variability of force. However, the significant ERS-VE relationship suggests that the more variable is the force produced, the more M1 is deactivated, probably reflecting an increased inhibition of the motor command.

Introduction: The effect of in vitro fertilization (IVF) on neurodevelopmental outcome is unclear. Probably, IVF does not affect traditional measures of neurological development in infancy, but little is known on long-term effects. Recently a new video-based instrument to evaluate neuromotor development was developed. The Infant Motor Profile (IMP) evaluates neuromotor condition in infants in terms of the quality of spontaneous motor behaviour. The IMP does not only assess traditional neuromotor domains, such as performance, symmetry and movement fluency, but also two novel domains: variation and variability. Movement variation denotes the size of the child's movement repertoire. Previous studies demonstrated that reduced movement variation is associated with early lesions of the periventricular white matter and - more generally - reflects the integrety of cortical connectivity. In addition, reduced variation during infancy is associated with neurodevelopmental disorders in later life and reduced intelligence at school age. Variability denotes the child's ability to select from the repertoire of movements the strategy that suits the situation best. In this prospective, assessor-blinded cohort study, we address the question whether ovarian hyperstimulation and/or the in vitro procedure affect movement variation during infancy. Material and Methods: Singletons born following IVF with conventional controlled ovarian hyperstimulation (COH-IVF, n = 68), following IVF in a modified natural cycle (MNC-IVF, n = 57) and following natural conception born to subfertile couples (Sub-NC, n = 90) were assessed with the IMP at 4, 10 and 18 months. The assessment resulted in a total IMP score and 5 domain scores: variation (i.e. the size of movement repertoire), variability (i.e. the ability to select motor strategies), symmetry, fluency and performance. Primary outcome was the domain score variation. Outcome variables were analyzed with a mixed effects model. Results: The mixed model indicated an overall effect of treatment on variation (p Conclusions: The preliminary data suggest that ovarian hyperstimulation may be associated with reduced movement variation in infancy. These findings stress the need to carefully monitor neurodevelopment in IVF offspring.

Objective The major objective of this study was to determine whether the embryo biopsy procedure might cause growth restriction or affect health outcome of children. Study design Auxological data and physical findings were compared at birth and age 2 for 102 children (70 singletons and 32 twins) born after PGD/PGS and 102 matched children born after intracytoplasmic sperm injection (ICSI) in a prospective study . Results No statistically significant differences regarding weight, height and head circumference standard deviation scores (SDS) at birth and at age two years were observed. At two years of age the mean BMI SDS tended to be lower in PGD/PGS children ( p = 0.058). PGD/PGS babies had been more often breastfed ( p = 0.013), but mostly during a shorter time. The prevalence of major as well as minor congenital anomalies, hospital admissions and surgical interventions was similar. Conclusion Children born after embryo biopsy applied in PGD/PGS present similar prenatal and postnatal growth and health outcome in the first two years of life compared to ICSI children. Up till now, PGD and PGS appear not to be associated with a higher risk for health problems.

This literature review summarizes the evidence on the prevalence, determinants, clinical and economic consequences of nonadherence with immunosuppressive drugs in renal transplant patients. A literature search yielded 38 articles measuring nonadherence by self-report, collateral report, assay, refill prescriptions or electronic monitoring. The weighted mean prevalence of self-reported nonadherence was 28%. Nonadherence is associated with poor clinical outcomes, contributing to 20% of late acute rejection episodes and 16% of the graft losses (weighted means). In addition, nonadherence results in lower lifetime costs because of shorter survival, yet also in a lower number of quality adjusted life years. Consistent determinants of nonadherence were younger age, social isolation, and cognitions (e.g. low self-efficacy, certain health beliefs). Determinants concerning the health care system/team seem to be under-investigated. Because the evidence summarized in this review is based on older immunosuppressive regimens, further research should focus on prevalence, determinants and consequences of nonadherence with newer immunosuppressive regimens.

BACKGROUND Evidence on prevalence and correlates of pretransplant medication nonadherence (MNA) is limited. The present study explored self-reported prevalence and correlates of MNA before heart, liver, and lung transplantation. METHODS This cross-sectional descriptive study included 174 patients: 69 lung, 33 heart, and 72 liver transplant candidates. MNA was assessed by self-report using the following question: "During the past 14 days, how often did you not take your medication?" Patients scoring once or higher on a five-point rating scale were considered to be nonadherent. Correlates of MNA explored were demographics, anxiety and depression (Hospital Anxiety and Depression Inventory), personality traits (NEO Personality Inventory-Revised), perceived health status (Euro-QOL), and social support (Social Support Questionnaire). RESULTS Prevalence of pretransplant MNA was 16.7% and was comparable among the three groups. After correction for multiple comparisons (i.e., P=0.01), higher educational level (P=0.006) was related to MNA. Less severe depression (P=0.069), lower scores on the personality trait conscientiousness (P=0.021), and less received social support (P=0.062) tended to be related to MNA. Multiple logistic regression revealed that higher educational level (P=0.008), lower received social support (P=0.013), and lower conscientiousness (P=0.023) were independent predictors of pretransplant MNA. CONCLUSIONS Several correlates of MNA allow identification of patients at risk for pretransplant MNA.

Study question Do full term singletons born after preimplantation genetic diagnosis (PGD) differ in their psychosocial functioning from children born after intracytoplasmic sperm injection (ICSI) and spontaneous conceived controls (SC)? Summary answer The psychosocial maturation process of 5-6-year-old PGD children is comparable between the three conception groups (PGD, ICSI and SC). What is already known In general, a lot of research has been published regarding follow-up of children born after artificial reproductive technologies (ART), which mainly is reassuring. But the ART population itself is marked by broad diversity [IVF, ICSI, gamete donation, preimplantation genetic screening (PGS) or PGD] which complicates comparisons. Some literature concerning the socio-emotional development of PGD/PGS children is available and it suggests a normal maturation process. However, the complex reality of PGD families (e.g. safety of the technique and psychological burden of genetic histories) asks for an exclusive PGD sample with matched control groups and a multi-informant approach. Study design, size, duration Between April 2011 and May 2013, the psychosocial wellbeing of preschoolers and their families born after PGD was assessed in a prospective case-controlled, matched follow-up study, with a multi-informant approach. Participants/materials, setting, methods A group of 47 PGD, 50 ICSI and 55 SC 5-6-year-old children participated in a follow-up study performed at the Centre for Medical Genetics of the Universitair Ziekenhuis Brussel (UZ Brussel). Assessments took place in the hospital and in kindergartens. Children performed the Bene-Anthony family relations test (FRT), yielding their perceptions upon family relationships. Parents and teachers completed the child behaviour checklist (CBCL) and Caregiver Teacher Report Form (C-/TRF), respectively. Parental and family functioning were measured by the NEO-FFi, the parenting stress index (PSI), the Greenberger Work-Parenting Investment Questionnaire and the Marlowe-Crowne Social Desirability Scale (MCSDS). Statistical analysis was performed by using analysis of covariance (ANCOVA). Main results and the role of chance No differences were detected between the psychosocial development of PGD children and the control groups. Parents did not differ in reporting problem behaviour and they were stricter than teachers. Concerning family functioning the ART parents scored comparable with each other. PGD and ICSI mothers were emotionally more stable [NEO-FFi Neuroticism/emotionality: P = 0.013, η(2) = 0.066; 95% confidence interval (CI) 95% (0.003;0.148)]. They experienced less parental stress in general [PSI, Total stress: P = 0.001, η(2) = 0.102, 95% CI (0.02;0.192)] and on different sublevels opposed to their SC counterparts. Yet ART mothers presented higher ratings on the NEO-FFi Conscientiousness [P = 0.011, η(2) = 0.064; 95% CI (0.003;0.144)] indicating a higher feeling of competence and goal directedness. Mediation analysis confirmed: PGD and ICSI mothers who experienced less family stress were emotionally more stable. A power analysis indicated that a sample with 152 children is sufficient to detect a medium size effect with 80% power using ANCOVA. Limitations, reasons for caution The current sample comprised only Dutch speaking Caucasians, hence conclusions should be drawn cautiously. Future research should include larger groups, prematures, multiples and children from different cultural backgrounds. Wider implications of the findings This current research is the first to compare PGD preschoolers with matched controls. Concerns about the behavioural effects on the offspring should not inhibit the use of PGD. Furthermore, our findings suggest that on the long run ART procedures might enhance personal resources of women to cope with family stress. These findings are reassuring for women who might feel insecure and anxious during their ART trajectory. Study funding/competing interests This research project gained funding from the OZR (a grant by the Research group of the Vrije Universiteit Brussel), the FWO (Fonds Wetenschappelijk Onderzoek) and the Wetenschappelijk Fonds Willy Gepts. The UZ Brussel and the Centre of Medical Genetics received funding from pharmaceutical firms for data collection. UZ Brussel and the Centre for Medical Genetics have received many educational grants for organizing the data collection, from IBSA, Ferring, Organon, Shering-Plough, Merck and Merck Belgium. M.B. has received consultancy and speaker's fees from Organon, Serono Symposia and Merck. The other authors have no competing interests. Trial registration number not applicable.

Study question Do preschool preimplantation genetic diagnosis (PGD) children differ in their cognitive and psychomotor development from children born after ICSI and spontaneous conception (SC)? Summary answer The cognitive development of PGD pre-schoolers was comparable to children born after ICSI and SC but motor development differed between ICSI and SC groups. Study design, size duration The cognitive abilities and motor skills of 5- to 6-year-old singletons born after PGD (n = 47) were assessed in comparison with 49 ICSI and 48 SC children in a prospective, case-controlled, matched follow-up study between April 2011 and May 2013. Participants/materials, setting, methods PGD singletons, ICSI and SC children of preschool age were examined with the Wechsler Preschool and Primary Scale of Intelligence (WPSSI-III-NL) and the Movement ABC (M ABC). The WPSSI-III-NL revealed scores for Full IQ, Verbal IQ and Performance IQ. The M ABC yields a total score and comprising scores for measurements of balance, dexterity and ball skills. Since embryo biopsy is the only technical difference between the PGD and ICSI procedures, ICSI children were included as controls. These children were part of a Dutch-speaking cohort of children conceived after assisted reproduction technology (ART) at the Universitair Ziekenhuis Brussel (UZ Brussel) who received longitudinal follow-up. The SC children acted as a second control group similar to the fertile PGD sample and in contrast to the ICSI group. The SC group was recruited through announcements in a variety of media. The children were matched for age, gender, birth order and educational level of the mother. The assessments carried out for the ART groups were blinded whenever possible. The data were analysed using analysis of covariance (ANCOVA) and partial eta squared (η(2)), which was used as a measurement of effect size. Main results and the role of chance The overall cognitive development of PGD singletons did not differ from controls [P = 0.647, η(2) = 0.006; 95% confidence interval (CI) (0, 0.043)]. The partial IQ scores for Verbal and Performance intelligence revealed similar results. Analysis of motor development based on the total score as well as subscales did indicate a significant difference between the three conception groups [P = 0.033, η(2) = 0.050, 95% CI (0, 0.124)]. Post hoc analysis indicated that the significant difference was situated between performances of ICSI and SC children. Balance capacities [P = 0.004, η(2) = 0.079, 95% CI (0.025, 0.163)] and its post hoc analysis yielded equivalent results. Motor capacities of PGD singletons, however, did not differ from any of the two other conception groups. Limitations, reasons for caution Given that we only assessed Caucasian singletons born after PGD, caution is required when drawing more general inferences from our results. The small sample size may be a limitation. A priori power analysis, however, revealed that at least 52 children per group were needed to detect a medium effect and 80% power using ANCOVA. Originally our sample met this threshold but we had to exclude six cases in order to remove outliers and due to missing data. Wider implications of the findings Long-term follow-up of children born after embryo biopsy, in this case for PGD, is needed to confirm that the development of these children remains comparable to ICSI and SC children. Our findings do support the safety of the PGD technique and will reassure patients with hereditary genetic diseases regarding the health of their future offspring conceived with PGD. Study funding/competing interests Funding for this study was obtained from the OZR (Research group of the Vrije Universiteit Brussel), the FWO (Fonds Wetenschappelijk Onderzoek) and the Wetenschappelijk Fonds Willy Gepts. The UZ Brussel and the Centre of Medical Genetics received funding from pharmaceutical firms for data collection. UZ Brussel and the Centre for Medical Genetics have received many educational grants for organizing the data collection, from IBSA, Ferring, Organon, Shering-Plough, Merck and Merck Belgium. M.B. has received consultancy and speaker's fees from Organon, Serono Symposia and Merck.

P-396 Family functioning and psychological well-being of 5- to 6-yearold singletons born after preimplantation genetic diagnosis; a prospective case-controlled matched study C.Winter1, F. van Acker2, M. Bonduelle1, S. Desmyttere1, J. Nekkebroeck1 1UZ Brussel, Centre for Medical Genetics, Brussels, Belgium 2Open Universiteit Heerlen, Faculty of Psychology, Heerlen, The Netherlands Study question: As preimplantation genetic diagnosis (PGD) is applied to families who might have suffered traumatic family histories, questions remain about the psychological development of their offspring. We investigated if PGD preschoolers differ in their social-emotional development from children born after intracytoplasmic sperm injection (ICSI) and spontaneous conception (SC). Summary answer: The psychological development of PGD children was not different from those of children born after ICSI and SC, nor in the perceptions of the children themselves neither by the reports of their parents. The amount of parental stress concerning family life is more prominent by SC mothers than PGD/ICSI families. What is known already: Literature about the broad psychological development of children at preschool age born after PGD is scarce. One study showed that, at toddler age PGD/PGS (preimplantation genetic screening) mothers reported less behavioral problems. Two other studies found that PGD/PGS parents experienced lower stress levels in comparison to controls. As PGD patients have a different indication than PGS couples, long term follow-up of their children is needed. Study design, size, duration: Between April 2011 and May 2013, the psychological development of 47 5- to 6-year-old PGD singletons was assessed in a prospective case-controlled matched follow-up study. ICSI and SC children were matched according to age, gender, educational level of mother and birth order. ART group assessments were mostly blinded. Participants/materials, setting, methods: 47 PGD singletons, 50 ICSI and 55 SC children were examined with the family relations test (FRT) measuring the perceptions of family interactions of the children themselves. PGD/ICSI children were tested in the UZ Brussel. Both parents completed the Child Behavior Checklist (CBCL) and the Parenting Stress Index (PSI). Main results and the role of chance: No group differences were detected concerning children's positive, negative and global perceptions on their mothers and fathers using the FRT. Fathers of the three groups did not differ significantly in their stress experience (PSI/NOSI) as opposed to mothers (p = .004; ?2 = .086). Post hoc Tukey tests (p = .001) confirmed that mothers of SC children (M = 313.37, SD = 10.16) reported significantly more stress than PGD (M = 265.31, SD = 10.32) and ICSI mothers (M = 275.71, SD = 9.98). The CBCL data did not reveal any group differences regarding behavioral problems. Limitations, reason for caution: Given the fact that we assessed a relatively small group of Caucasian Dutch speaking PGD singletons our data might not be generalizable. These are the first data of a broad evaluation of PGD preschoolers and their families; it will be interesting to report on the whole data set. Wider implications of the findings: Our results confirm those of the few other studies. PGD families do not seem to differ in their daily interactions/perceptions from SC or ICSI families. Furthermore our findings suggest that at preschool age PGD mothers are rather more relaxed than SC mothers. On the long term, when PGD parents might develop their own diseases or deteriorations, it might be useful to comprehend how these families interact and how they perceive each other. Study funding/competing interest(s): Funding by University(ies), Funding by hospital/clinic(s), Funding by national/international organization(s), Funding by commercial/corporate company(ies), This study was funded by the Onderzoeksraad (OZR) of the Vrije Universiteit Brussel and the FWO (Fonds Wetenschappelijk Onderzoek) and Wetenschappelijk Fonds Willy Gepts. The UZ Brussel and the Centre for Medical Genetics have received many educational grants for organizing the data collection from IBSA, Ferring, Organon, Shering-Plough, Merck, Merck Belgium. M. Bonduelle has received consultancy and speaker's fees from Organon, Serono Symposia, Merck. Trial registration number: No clinical trial.

Idiopathic normal-pressure hydrocephalus remains difficult to treat. Controversy exists as to whether or not shunting can really improve cognitive functions and whether quantified intracranial pressure monitoring (ICP-Mo) can predict postoperative improvement rates. Several studies have drawn attention to the lack of a prospective study concerning the surgical outcome of this condition. We have performed such a study on idiopathic normal-pressure hydrocephalus patients shunted on the basis of ICP-Mo when "high" waves (amplitude > 9 mm Hg) were present. Twenty-three patients underwent surgery. The preoperative and postoperative clinical states were assessed by a quantitative procedure blind to the ICP-Mo results. A clear postshunting improvement was seen in 96% of the patients at 1 year with a statistically significant correlation between high wave relative frequency and the grade of improvement (P < 0.05). At the same time, 66.6% of shunted patients showed a significant improvement in cognitive functions. Complications of shunting were successfully managed without residual deficits in this series. We recommend the use of quantitative ICP-Mo as a criterion for surgery and to predict the improvement grade.

introduction: Since the vitrification technique is increasedly used and controlled outcome studies are still scarce, it is important to collect follow-up data on children conceived with this method in order to evaluate the potential toxicity of the cryoprotectants to the embryo and future child. The major objective of this study was to determine if the vitrification procedure might affect health outcome of children at birth. The applied vitrification technique was the same in all conceptions (VIT). A control group of children born after intracytoplasmic sperm injection (ICSI) with fresh embryo transfer on day 5 was included in order to determine whether potential differences in children's outcome could be exclusively attributed to the vitrification procedure. Material and Methods: A prospective longitudinal follow-up study on medical outcome of all children born after vitrification and after ICSI at the Centre for Reproductive Medicine of the UZ Brussel has been undertaken since March 2008. Data on pregnancy and birth were obtained through written questionnaires. The children were examined and checked for possible major anomalies at 2 months of age by trained clinical geneticists. Malformations were classified according to criteria previously defined in our centre. A major malformation causes functional impairment and/or requires surgical correction. Mean term, birthweight, major malformations, perinatal death rate and the number of neonatal hospitalizations were compared for both groups. Statistical analysis included the Student's t test and the Fisher's exact test for comparing continuous and categorical variables, respectively. Results: Between March 2008 and November 2010, 6301 embryos were vitrified on day 5 in 2080 ICSI cycles. Of these, 2180 embryos were thawed in 1380 cycles. 325 women presented positive HCG values resulting in 91 still ongoing pregnancies and 99 liveborn children. Medical outcome of these 99 children (84 singletons, 12 twins and 3 triplets) born after VIT were compared with 402 children (305 singletons, 91 twins and 6 triplets) conceived after intracytoplasmic sperm injection (ICSI) in our centre between March 2008 and November 2010. Mean birth weight ± standard deviation reached 3396 ± 737 g in VIT singletons and 3241 ± 624 g in ICSI singletons. Mean birth weight for VIT singletons was 155 g higher compared to ICSI singletons (p = 0.057). Correcting birth weight data for sex and gestational age through standard deviation scores showed a slight but statistically significant difference between VIT and ICSI singletons (p = 0.047). Mean standard deviation score ± standard deviation for the weight at birth was -0.03 ± 1.62 in VIT singletons and -0.40 ± 1.45 in ICSI singletons. No statistically significant differences regarding mean term, prematurity (term

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