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Item does not contain fulltext, BACKGROUND: It is unknown whether differences in clot structure and resolution contribute to the reported risk differences of recurrent venous thromboembolism (VTE) between men and women. PATIENTS/METHODS: We used data from the EINSTEIN-PE study, a randomized, multicenter, non-inferiority study in which patients 18 years and older with acute symptomatic pulmonary embolism (PE) were randomized to rivaroxaban or enoxaparin followed by a vitamin K antagonist. PE was diagnosed by computed tomography pulmonary angiography scan or high-probability ventilation/perfusion scintigraphy. Three weeks after randomization a follow-up scan was performed. An independent adjudication committee assessed the degree of vascular obstruction. RESULTS AND CONCLUSIONS: A total of 371 participants including 174 (46.9%) women and 197 (53.0%) men were included in the present analysis. At 3 weeks, there was no difference between men and women in complete clot resolution: 39.6% and 40.2%, respectively. The absolute reduction in pulmonary vascular obstruction at week 3 was also similar: 12.9% (95% confidence interval [CI]: 11.6-14.2) in men and 12.1% (95% CI: 10.4-13.7) in women, corresponding to a resolution ratio of 0.29 (95% CI: 0.24-0.33) and 0.35 (95% CI: 0.28-0.42), respectively. No differences in clot resolution were observed between men and women diagnosed with acute PE at 3 weeks after start of anticoagulant therapy. These findings suggest that the reported higher rate of VTE recurrence in men cannot be explained by decreased clot resolution.

Contains fulltext : 231629.pdf (Publisher’s version ) (Open Access)

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Contains fulltext : 235752.pdf (Publisher’s version ) (Open Access), Background First-pass reperfusion (FPR) is associated with favorable outcome after endovascular treatment. It is unknown whether this effect is independent of patient characteristics and whether FPR has better outcomes compared with excellent reperfusion (Expanded Thrombolysis in Cerebral Infarction [eTICI] 2C-3) after multiple-passes reperfusion. We aimed to evaluate the association between FPR and outcome with adjustment for patient, imaging, and treatment characteristics to single out the contribution of FPR. Methods and Results FPR was defined as eTICI 2C-3 after 1 pass. Multivariable regression models were used to investigate characteristics associated with FPR and to investigate the effect of FPR on outcomes. We included 2686 patients of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry. Factors associated with FPR were as follows: history of hyperlipidemia (adjusted odds ratio [OR], 1.05; 95% CI, 1.01-1.10), middle cerebral artery versus intracranial carotid artery occlusion (adjusted OR, 1.11; 95% CI, 1.06-1.16), and aspiration versus stent thrombectomy (adjusted OR, 1.07; 95% CI, 1.03-1.11). Interventionist experience increased the likelihood of FPR (adjusted OR, 1.03 per 50 patients previously treated; 95% CI, 1.01-1.06). Adjusted for patient, imaging, and treatment characteristics, FPR remained associated with a better 24-hour National Institutes of Health Stroke Scale (NIHSS) score (-37%; 95% CI, -43% to -31%) and a better modified Rankin Scale (mRS) score at 3 months (adjusted common OR, 2.16; 95% CI, 1.83-2.54) compared with no FPR (multiple-passes reperfusion+no excellent reperfusion), and compared with multiple-passes reperfusion alone (24-hour NIHSS score, (-23%; 95% CI, -31% to -14%), and mRS score (adjusted common OR, 1.45; 95% CI, 1.19-1.78)). Conclusions FPR compared with multiple-passes reperfusion is associated with favorable outcome, independently of patient, i

Contains fulltext : 226920.pdf (Publisher’s version ) (Open Access), Due to the traumatic events they may have experienced, refugee youth are vulnerable to mental health problems. Social Circus is a psycho-social intervention that aims to enhance resilience by promoting self-esteem, interpersonal trust and social support through classes in circus arts. To explore these effects on refugee youth, a qualitative study was conducted in south-east Turkey. Semi-structured interviews and participative observations revealed that circus classes offered participants structure and a new purpose in life. Participating youth became more active, while impulsive behaviour decreased. Experiencing success through visible progress and holding the positively valued position of a circus artist seemed to contribute to the children's self-esteem. In addition, the mental and physical support received during circus classes could increase interpersonal trust. By creating opportunities for social interaction and building relationships, Social Circus may also promote social support. This study provides preliminary evidence that Social Circus may enhance resilience in refugee youth.

01 december 2021, Contains fulltext : 246130.pdf (Publisher’s version ) (Open Access), BACKGROUND: Randomised controlled trials with perfusion selection have shown benefit of endovascular treatment (EVT) for ischaemic stroke between 6 and 24 hours after symptom onset or time last seen well. However, outcomes after EVT in these late window patients without perfusion imaging are largely unknown. We assessed their characteristics and outcomes in routine clinical practice. METHODS: The Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, multicentre study in the Netherlands, included patients with an anterior circulation occlusion who underwent EVT between 2014 and 2017. CT perfusion was no standard imaging modality. We used adjusted ordinal logistic regression analysis to compare patients treated within versus beyond 6.5 hours after propensity score matching on age, prestroke modified Rankin Scale (mRS), National Institutes of Health Stroke Scale, Alberta Stroke Programme Early CT Score (ASPECTS), collateral status, location of occlusion and treatment with intravenous thrombolysis. Outcomes included 3-month mRS score, functional independence (defined as mRS 0-2), and death. RESULTS: Of 3264 patients who underwent EVT, 106 (3.2%) were treated beyond 6.5 hours (median 8.5, IQR 6.9-10.6), of whom 93 (87.7%) had unknown time of stroke onset. CT perfusion was not performed in 87/106 (80.2%) late window patients. Late window patients were younger (mean 67 vs 70 years, p<0.04) and had slightly lower ASPECTS (median 8 vs 9, p<0.01), but better collateral status (collateral score 2-3: 68.3% vs 57.7%, p=0.03). No differences were observed in proportions of functional independence (43.3% vs 40.5%, p=0.57) or death (24.0% vs 28.9%, p=0.28). After matching, outcomes remained similar (adjusted common OR for 1 point improvement in mRS 1.04, 95% CI 0.56 to 1.93). CONCLUSIONS: Without the use of CT perfusion selection criteria, EVT in the 6.5-24-hour time window was not associated with poore

Contains fulltext : 245712.pdf (Publisher’s version ) (Open Access), BACKGROUND: Pulmonary embolism (PE) is a potentially fatal disease, but data on the incidence of fatal PE in cancer patients are scant. OBJECTIVE: We sought to estimate the proportion of cancer patients with PE at autopsy. METHODS: For this retrospective cohort study, all autopsy reports of cancer patients were retrieved from PALGA: Dutch Pathology Registry and used for data extraction. The primary outcome was PE at time of autopsy, defined as any clot obstructing a pulmonary artery. The secondary outcome was venous thromboembolism, defined as the composite of thrombotic PE, deep vein thrombosis, splanchnic vein thrombosis, or internal jugular vein thrombosis. RESULTS: A total of 9571 cancer patients were included. In 1191 (12.4%; 95% confidence interval [CI], 11.8-13.1) patients, one or more PE events were observed at autopsy, of whom 1074 (90.2%) had a thrombotic embolism, 168 (14.1%) a tumor embolism, 9 (0.8%) a septic embolism, 7 (0.6%) a fat tissue embolism, and 3 (0.3%) a bone marrow embolism. Among patients with PE for whom the cause of death was specified in the autopsy report, death was considered PE-related in 642 patients (66.7%), which was 6.7% of the total study population. Venous thromboembolism was observed in 1223 (12.8%; 95% CI, 12.1-13.5) patients. CONCLUSION: The proportion of PE in cancer patients at autopsy is substantial. Although the study population is not representative for the total cancer population, it suggests that PE is an important disease complication in cancer patients.

Overheden, natuurorganisaties en bedrijven werken samen aan betere natuur in de Eems-Dollard. In het Programmaplan Eems-Dollard 2050 2021-2026 staan de strategieën en projecten. Deze derde jaarrapportage geeft de nieuwste inzichten in de problematiek van de Eems-Dollard aan de hand van langjarige meetreeksen en onderzoeken en de voortgang van projecten en pilots.

In het programma Eems-Dollard 2050 werken overheden, natuur- en milieuorganisaties en bedrijven samen om de natuur te herstellen. In de 1e tranche van het programma (2016-2020) zijn verschillende projecten en onderzoeken opgestart. Het programma is volop in uitvoering en er is veel geleerd. Dit nieuwe programmaplan geeft op basis van deze ervaringen de aanpak voor de 2e tranche (2021-2026).

Objective: the role of the survival of motor neuron (SMN) gene in amyotrophic lateral sclerosis (ALS) is unclear, with several conflicting reports. A decisive result on this topic is needed, given that treatment options are available now for SMN deficiency. Methods: in this largest multicenter case control study to evaluate the effect of SMN1 and SMN2 copy numbers in ALS, we used whole genome sequencing data from Project MinE data freeze 2. SMN copy numbers of 6,375 patients with ALS and 2,412 controls were called from whole genome sequencing data, and the reliability of the calls was tested with multiplex ligation-dependent probe amplification data. Results: the copy number distribution of SMN1 and SMN2 between cases and controls did not show any statistical differences (binomial multivariate logistic regression SMN1 p = 0.54 and SMN2 p = 0.49). In addition, the copy number of SMN did not associate with patient survival (Royston-Parmar; SMN1 p = 0.78 and SMN2 p = 0.23) or age at onset (Royston-Parmar; SMN1 p = 0.75 and SMN2 p = 0.63). Interpretation: in our well-powered study, there was no association of SMN1 or SMN2 copy numbers with the risk of ALS or ALS disease severity. This suggests that changing SMN protein levels in the physiological range may not modify ALS disease course. This is an important finding in the light of emerging therapies targeted at SMN deficiencies., European Union (EU); Horizon 2020; European Research Council (ERC); Research and Innovation Programme; EScORIAL; IWT; FWO-Vlaanderen; United Kingdom Medical Research Council; Neurodegenerative Disease Research (JPND); Netherlands; ZONMW; BRAIN-MEND; NIH/NINDS; Italian Ministry of Health; Fondazione Regionale per la Ricerca Biomedica Regione Lombardia; Science Foundation Ireland; ALS Liga Belgie; National Lottery of Belgium; KU Leuven Opening the Future Fund; E. von Behring Chair for Neuromuscular and Neurodegenerative Disorders; ALS Foundation Netherlands; PPP Allowance; Motor Neurone Disease Association; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre; Fondazione Italiana di Ricerca per la SLA - AriSLA; Exomefals; Novals; ALS Association; E-RARE JTC Project Repetomics

Contains fulltext : 220779.pdf (publisher's version ) (Open Access), BACKGROUND: Microspheres loaded with radioactive (166)Ho ((166)Ho-MS) are novel particles for radioembolisation and intratumoural treatment. Because of the limited penetration of beta radiation, quantitative imaging of microsphere distribution is crucial for optimal intratumoural treatment. Computed tomography (CT) may provide high-resolution and fast imaging of the distribution of these microspheres, with lower costs and widespread availability in comparison with current standard single-photon emission tomography (SPECT) and magnetic resonance imaging. This phantom study investigated the feasibility of CT quantification of (166)Ho-MS. METHODS: CT quantification was performed on a phantom with various concentrations of HoCl and Ho-MS to investigate the CT sensitivity and calibrate the CT recovery. (166)Ho-MS were injected into ex vivo tissues, in VX-2 cancer-bearing rabbits, and in patients with head-neck cancer, to demonstrate sensitivity and clinical visibility. The amount of Ho-MS was determined by CT scanning, using a density-based threshold method and compared with a validated (166)Ho SPECT quantification method. RESULTS: In the phantom, a near perfect linearity (least squares R(2) > 0.99) between HU values and concentration of (166)Ho was found. Ex vivo tissue experiments showed an excellent correlation (r = 0.99, p < 0.01) between the dose calibrator, SPECT, and CT imaging. CT recovery was on average 86.4% ex vivo, 76.0% in rabbits, and 99.1% in humans. CONCLUSION: This study showed that CT-based quantification of Ho microspheres is feasible and is a high-resolution alternative to SPECT-based determination of their local distribution.

Radboud University, 17 december 2020, Promotor : Hagoort, P. Co-promotor : Schoffelen, J.M., Contains fulltext : 227394.pdf (publisher's version ) (Open Access), The brain is capable of responding to the environment dynamically and thus producing the appropriate behavior. This happens for example by changing the physical connections in the brain, but on a short time scale especially by tuning the relevant brain areas to each other through brain waves. I investigated how brain waves affect local brain activity and how this changes behavior. I did this by letting volunteers do computer tasks while recording brain activity with an MEG device. For example, they had to respond to a changing image. I showed how the strength of the characteristic brain signal of that image depends on the presence of fast brain waves. If the presence of fast brain waves was high in the visual brain area, the characteristic brain signal was stronger and people reacted faster to it. This shows that fast brain waves are related to the efficiency of the brain process.

Contains fulltext : 229327.pdf (Publisher’s version ) (Open Access), A change in our current approach toward drug development is required to improve the likelihood of finding effective treatment for patients with amyotrophic lateral sclerosis (ALS). The aim of the Treatment Research Initiative to Cure ALS (TRICALS) is to extend the collective effort with industry and consolidate drug development paths. TRICALS has begun a series of meetings on how to best move the field forward collaboratively, thereby addressing five major topics in ALS clinical trials: (1) preclinical research, (2) biomarker development, (3) eligibility criteria, (4) efficacy endpoints and (5) innovative trial design. There is an appetite for ongoing discussions of these major topics in clinical trials between representatives from academia, patient advocacy groups, industry partners and funding bodies. Industry is open to fundamentally change drug development for ALS and shorten the time to effective therapy for patients by implementing promising innovations in biomarker development, trial design, and patient selection. There is however, a pressing need from all stakeholders for regulatory discussions and amendments of current guidelines to successfully adopt innovation in future clinical development lines.

Contains fulltext : 226123.pdf (publisher's version ) (Open Access), Background: Early identification of patients with mental health problems in need of highly specialised care could enhance the timely provision of appropriate care and improve the clinical and cost-effectiveness of treatment strategies. Recent research on the development and psychometric evaluation of diagnosis-specific decision-support algorithms suggested that the treatment allocation of patients to highly specialised mental healthcare settings may be guided by a core set of transdiagnostic patient factors. Aims: To develop and psychometrically evaluate a transdiagnostic decision tool to facilitate the uniform assessment of highly specialised mental healthcare need in heterogeneous patient groups. Method: The Transdiagnostic Decision Tool was developed based on an analysis of transdiagnostic items of earlier developed diagnosis-specific decision tools. The Transdiagnostic Decision Tool was psychometrically evaluated in 505 patients with a somatic symptom disorder or post-traumatic stress disorder. Feasibility, interrater reliability, convergent validity and criterion validity were assessed. In order to evaluate convergent validity, the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and the ICEpop CAPability measure for Adults (ICECAP-A) were administered. Results: The six-item clinician-administered Transdiagnostic Decision Tool demonstrated excellent feasibility and acceptable interrater reliability. Spearman's rank correlations between the Transdiagnostic Decision Tool and ICECAP-A (-0.335), EQ-5D-5L index (-0.386) and EQ-5D-visual analogue scale (-0.348) supported convergent validity. The area under the curve was 0.81 and a cut-off value of ≥3 was found to represent the optimal cut-off value. Conclusions: The Transdiagnostic Decision Tool demonstrated solid psychometric properties and showed promise as a measure for the early detection of patients in need of highly specialised mental healthcare.

Contains fulltext : 221730.pdf (publisher's version ) (Open Access)

Contains fulltext : 229543.pdf (Publisher’s version ) (Closed access), OBJECTIVE: To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms. SUMMARY OF BACKGROUND DATA: Many centers are currently screening surgical patients for COVID-19 using either chest CT, RT-PCR or both, due to the risk for worsened surgical outcomes and nosocomial spread. The optimal design and yield of such a strategy are currently unknown. METHODS: This multicenter study included consecutive adult patients without COVID-19 symptoms who underwent preoperative screening using chest CT and RT-PCR before elective or emergency surgery under general anesthesia. RESULTS: A total of 2093 patients without COVID-19 symptoms were included in 14 participating centers; 1224 were screened by CT and RT-PCR and 869 by chest CT only. The positive yield of screening using a combination of chest CT and RT-PCR was 1.5% [95% confidence interval (CI): 0.8-2.1]. Individual yields were 0.7% (95% CI: 0.2-1.1) for chest CT and 1.1% (95% CI: 0.6-1.7) for RT-PCR; the incremental yield of chest CT was 0.4%. In relation to COVID-19 community prevalence, up to approximately 6% positive RT-PCR was found for a daily hospital admission rate >1.5 per 100,000 inhabitants, and around 1.0% for lower prevalence. CONCLUSIONS: One in every 100 patients without COVID-19 symptoms tested positive for SARS-CoV-2 with RT-PCR; this yield increased in conjunction with community prevalence. The added value of chest CT was limited. Preoperative screening allowed us to take adequate precautions for SARS-CoV-2 positive patients in a surgical population, whereas negative patients needed only routine procedures.

15 december 2020, Contains fulltext : 228492.pdf (publisher's version ) (Open Access), Sustained attention has long been thought to benefit perception in a continuous fashion, but recent evidence suggests that it affects perception in a discrete, rhythmic way. Periodic fluctuations in behavioral performance over time, and modulations of behavioral performance by the phase of spontaneous oscillatory brain activity point to an attentional sampling rate in the theta or alpha frequency range. We investigated whether such discrete sampling by attention is reflected in periodic fluctuations in the decodability of visual stimulus orientation from magnetoencephalographic (MEG) brain signals. In this exploratory study, human subjects attended one of the two grating stimuli, while MEG was being recorded. We assessed the strength of the visual representation of the attended stimulus using a support vector machine (SVM) to decode the orientation of the grating (clockwise vs. counterclockwise) from the MEG signal. We tested whether decoder performance depended on the theta/alpha phase of local brain activity. While the phase of ongoing activity in the visual cortex did not modulate decoding performance, theta/alpha phase of activity in the frontal eye fields and parietal cortex, contralateral to the attended stimulus did modulate decoding performance. These findings suggest that phasic modulations of visual stimulus representations in the brain are caused by frequency-specific top-down activity in the frontoparietal attention network, though the behavioral relevance of these effects could not be established.

Contains fulltext : 220762.pdf (Publisher’s version ) (Open Access), BACKGROUND: Dysphagia and dysarthria are frequently described in pediatric neuromuscular diseases (pNMD). The consequences can be substantial: failure to thrive, malnutrition, aspiration pneumonia, or communication problems. Early detection and identification of risk factors and etiology support preventing complications and morbidity, including impact on quality of life. Information about the prevalence of dysphagia and dysarthria in pNMD is scarce. OBJECTIVE: To describe the pooled prevalence of dysphagia and dysarthria in pNMD in the Netherlands. In addition, we describe the prevalence of dysphagia and dysarthria each, and the prevalence of chewing (oral) and swallowing problems per diagnostic group, based on their anatomic origin. METHODS: Data were collected from 295 children (mean age 11;0 years, range 2;6-18;0) with pNMD in 12 hospitals and rehabilitation centers in the Netherlands. A speech language therapist established whether dysphagia and dysarthria were present or not. RESULTS: In almost all the 14 diagnostic groups of pNMD, dysphagia and dysarthria were present. Pooled overall prevalence of dysphagia and dysarthria was 47.2% and 31.5%, respectively. Of 114 children with dysphagia, 90.0% had chewing problems, 43.0% showed swallowing problems and 33.3% showed both chewing and swallowing problems. CONCLUSIONS: The overall pooled prevalence of dysphagia and dysarthria was high in the population of pNMD. It can be argued that periodic monitoring of dysphagia and dysarthria and early referral to a speech language therapist should be a necessity from the start of the diagnosis in the whole pNMD population.

Contains fulltext : 219439.pdf (Publisher’s version ) (Open Access), PURPOSE: One-third of patients with RAS wild-type mCRC do not benefit from anti-EGFR monoclonal antibodies. This might be a result of variable pharmacokinetics and insufficient tumor targeting. We evaluated cetuximab tumor accumulation on [(89)Zr]Zr-cetuximab PET/CT as a potential predictive biomarker and determinant for an escalating dosing strategy. PATIENTS AND METHODS: PET/CT imaging of [(89)Zr]Zr-cetuximab (37 MBq/10 mg) after a therapeutic pre-dose (500 mg/m(2)

Contains fulltext : 229597.pdf (publisher's version ) (Open Access), Background: Improved imaging techniques have increased the incidence of subsegmental pulmonary embolism (ssPE). Indirect evidence is suggesting that ssPE may represent a more benign presentation of venous thromboembolism not necessarily requiring anticoagulant treatment. However, correctly diagnosing ssPE is challenging with reported low interobserver agreement, partly due to the lack of widely accepted diagnostic criteria. Objectives: We sought to derive uniform diagnostic criteria for ssPE, guided by expert consensus. Methods: Based on an extensive literature review and expert opinion of a Delphi steering committee, two surveys including statements regarding diagnostic criteria and management options for ssPE were established. These surveys were conducted electronically among two panels, respectively: expert thoracic radiologists and clinical venous thromboembolism specialists. The Delphi method was used to achieve consensus after multiple survey rounds. Consensus was defined as a level of agreement >70%. Results: Twenty-nine of 40 invited radiologists (73%) and 40 of 51 clinicians (78%) participated. Following two survey rounds by the expert radiologists, consensus was achieved on 15 of 16 statements, including on the established diagnostic criteria for ssPE (96% agreement): a contrast defect in a subsegmental artery, that is, the first arterial branch division of any segmental artery independent of artery diameter, visible in at least two subsequent axial slices, using a computed tomography scanner with a desired maximum collimator width of

Contains fulltext : 229147.pdf (Publisher’s version ) (Closed access), BACKGROUND: Approximately 15% of saphenous vein grafts (SVGs) occlude during the first year after coronary artery bypass graft surgery (CABG) despite aspirin use. The POPular CABG trial (The Effect of Ticagrelor on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting Surgery) investigated whether ticagrelor added to standard aspirin improves SVG patency at 1 year after CABG. METHODS: In this investigator-initiated, randomized, double-blind, placebo-controlled, multicenter trial, patients with ≥1 SVGs were randomly assigned (1:1) after CABG to ticagrelor or placebo added to standard aspirin (80 mg or 100 mg). The primary outcome was SVG occlusion at 1 year, assessed with coronary computed tomography angiography, in all patients that had primary outcome imaging available. A generalized estimating equation model was used to perform the primary analysis per SVG. The secondary outcome was 1-year SVG failure, which was a composite of SVG occlusion, SVG revascularization, myocardial infarction in myocardial territory supplied by a SVG, or sudden death. RESULTS: Among 499 randomly assigned patients, the mean age was 67.9±8.3 years, 87.1% were male, the indication for CABG was acute coronary syndrome in 31.3%, and 95.2% of procedures used cardiopulmonary bypass. Primary outcome imaging was available in 220 patients in the ticagrelor group and 223 patients in the placebo group. The SVG occlusion rate in the ticagrelor group was 10.5% (51 of 484 SVGs) versus 9.1% in the placebo group (43 of 470 SVGs), odds ratio, 1.29 [95% CI, 0.73-2.30]; P=0.38. SVG failure occurred in 35 (14.2%) patients in the ticagrelor group versus 29 (11.6%) patients in the placebo group (odds ratio, 1.22 [95% CI, 0.72-2.05]). CONCLUSIONS: In this randomized, placebo-controlled trial, the addition of ticagrelor to standard aspirin did not reduce SVG occlusion at 1 year after CABG. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02352402.

Technological imaginaries can shape how consumers view technologies, what technologies are researched, and what technologies eventually get produced. While technological imaginaries can encompass both utopian and dystopian visions of the future, generally these imaginaries tend to lean towards utopian visions – which can lead to blind spots for possible dangers. Cyberpunk-genre stories, with their highly detailed, highly critical and exclusively dystopian visions of the future, can serve to sobering and informative tool for technological imaginaries, helping us to envision what moral and ethical problems future technological developments have in store for us so that we can pre-emptively start formulating answers to those problems. To illustrate an example of how cyberpunk can influence technological imaginaries in a meaningfully informative and possibly educational way, two quintessential cyberpunk-genre videogames were analyzed for key themes in their narratives, after which these disseminated themes were formulated into the technological imaginaries the games propose. The result is that cyberpunk-genre stories in particular offer a compelling counter-balance to utopian technological imaginaries, introducing a degree of skepticism and critique into our technological imaginaries related to human augmentation technologies in particular.

Religion and marketing are more alike than one might expect: both aim to make others see the truth that they see. Since the foundation of the Dutch Protestant Church (PKN), the church congregation has focused on missionary work (evangelising), but decreased in members despite it. This thesis investigates the missionary work of the PKN and discusses to what extent the PKN can be regarded as a ‘faith brand’. By looking at the PKN website, reports the PKN has published and taking interviews, the research shows how the PKN conducts missionary work. These data are analysed using Mara Einstein’s concept of ‘faith branding’. The relation between the concepts of ‘marketing’, ‘faith branding’, ‘evangelising’ and ‘missionary work’ are explored and then clarified by discussing three examples of faith brands in the US. The emphasis lays on creating an understanding of how of the PKN as an overarching organisation creates a brand image and how three local churches feel about that. The thesis argues that there seems to be a difference between the identity of the overarching organisation and the way the local churches identify themselves as represented by the churches interviewed.

Deze scriptie analyseert de percepties van Nederlandse diplomaten op de Nederlandse ambassades in Algiers en Parijs ten tijde van de Algerijnse onafhankelijkheidsoorlog. De nadruk in dit onderzoek ligt op de percepties van Nederlandse diplomaten op ras, antikoloniaal geweld en moderniteit. Tevens draagt dit onderzoek bij aan de bestaande literatuur over Nederlands buitenlandbeleid. Uit dit onderzoek blijkt dat de Nederlandse diplomaten geweld van non-state actoren zwaarder veroordeelden en beïnvloed werden door het proces van othering – gestart door de Fransen tijdens de Algerijnse onafhankelijkheidsoorlog - van de Algerijnen.

Contains fulltext : 220749.pdf (Publisher’s version ) (Closed access), Background and Purpose- Collateral circulation status at baseline is associated with functional outcome after ischemic stroke and effect of endovascular treatment. We aimed to identify clinical and imaging determinants that are associated with collateral grade on baseline computed tomography angiography in patients with acute ischemic stroke due to an anterior circulation large vessel occlusion. Methods- Patients included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands; n=500) and MR CLEAN Registry (n=1488) were studied. Collateral status on baseline computed tomography angiography was scored from 0 (absent) to 3 (good). Multivariable ordinal logistic regression analyses were used to test the association of selected determinants with collateral status. Results- In total, 1988 patients were analyzed. Distribution of the collateral status was as follows: absent (7%, n=123), poor (32%, n=596), moderate (39%, n=735), and good (23%, n=422). Associations for a poor collateral status in a multivariable model existed for age (adjusted common odds ratio, 0.92 per 10 years [95% CI, 0.886-0.98]), male (adjusted common odds ratio, 0.64 [95% CI, 0.53-0.76]), blood glucose level (adjusted common odds ratio, 0.97 [95% CI, 0.95-1.00]), and occlusion of the intracranial segment of the internal carotid artery with occlusion of the terminus (adjusted common odds ratio 0.50 [95% CI, 0.41-0.61]). In contrast to previous studies, we did not find an association between cardiovascular risk factors and collateral status. Conclusions- Older age, male sex, high glucose levels, and intracranial internal carotid artery with occlusion of the terminus occlusions are associated with poor computed tomography angiography collateral grades in patients with acute ischemic stroke eligible for endovascular treatment.

Contains fulltext : 221897.pdf (publisher's version ) (Open Access), Rhythmic brain activity may reflect a functional mechanism that facilitates cortical processing and dynamic interareal interactions and thereby give rise to complex behavior. Using magnetoencephalography (MEG), we investigated rhythmic brain activity in a brain-wide network and their relation to behavior, while human subjects executed a variant of the Simon task, a simple stimulus-response task with well-studied behavioral effects. We hypothesized that the faster reaction times (RT) on stimulus-response congruent versus incongruent trials are associated with oscillatory power changes, reflecting a change in local cortical activation. Additionally, we hypothesized that the faster reaction times for trials following instances with the same stimulus-response contingency (the so-called Gratton effect) is related to contingency-induced changes in the state of the network, as measured by differences in local spectral power and interareal phase coherence. This would be achieved by temporarily upregulating the connectivity strength between behaviorally relevant network nodes. We identified regions-of-interest that differed in local synchrony during the response phase of the Simon task. Within this network, spectral power in none of the nodes in either of the studied frequencies was significantly different in the pre-cue window of the subsequent trial. Nor was there a significant difference in coherence between the task-relevant nodes that could explain the superior behavioral performance after compatible consecutive trials.

In 2013 staan Rijkswaterstaat (RWS) en de natuurorganisaties met de koppen tegen elkaar. De natuurorganisaties zien de vaargeulverruiming Eemshaven-Noordzee als de zoveelste aantasting van het Eems-estuarium, terwijl zij, samen met wetenschappers, al jaren aangegeven dat ‘de Eems-Dollard ziek is’ en er geïnvesteerd moet worden in natuurherstel. RWS betoogt dat de vaargeulverruiming op zich geen wezenlijke invloed heeft op de natuur. Uiteindelijk besluiten de natuurorganisaties geen bezwaar te maken tegen de vaargeulverruiming, onder voorwaarde dat er snel natuurherstel zal plaatsvinden. De basis hiervoor wordt gelegd in 2014, in de samenwerkingsovereenkomst Ecologie en Economie in Balans (E&E), die door rijk, regionale overheden, bedrijfsleven en natuurorganisaties, in totaal zeven partijen, wordt ondertekend (Stuurgroep E&E, 2014).

Overheden, natuurorganisaties en bedrijven werken samen aan betere natuur in de Eems-Dollard. De ambitie, de onderzoeken en de projecten staan in het Meerjarig adaptief programma Eems-Dollard 2050. Deze rapportage gaat over de voortgang van het programma in 2019.

Dit Engelse ras bij uitstek is ontstaan toen pluimveetentoonstellingen in opkomst waren.