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Abstract Anti-science movements brought more than public distrust in science. Perhaps even more worryingly, these movements are also associated with instances of harassment of—and violence against—scientists. However, virtually nothing is known about individuals likely to harass or harm scientists. Across two pre-registered studies (total N = 749), we investigated the role of worldviews (e.g., political ideology, conspiracy mentality, science cynicism), radicalization risk factors (relative deprivation and threat), and personality traits and how these relate to harassment of scientists (both attitudes and behavior). We found that science cynicism–the perception that scientists are incompetent and corrupt–drives approval of scientists’ harassment (attitudes), as well as harmful behavior (e.g., refusing to donate money, not signing a petition). Additionally, perceiving scientists as threatening, as well as dark personality traits (psychopathy and narcissism), contributed to approving scientists’ harassment. Overall, the present research takes a first step in identifying predictors of the willingness to harm scientists.

Abstract Background Many organizations are faced with growing numbers of employees who combine their jobs with informal caregiving responsibilities. To support working caregivers in maintaining a good balance between work, private life and informal care, a workplace participatory approach (PA) intervention was implemented in four Dutch organizations. This study’s aims were to evaluate the degree of PA implementation, contextual factors influencing implementation, and stakeholder experiences with the PA. Methods A mixed methods process evaluation was conducted alongside a randomized controlled trial among three stakeholder groups: caregiving employees, their supervisors, and trained occupational professionals who acted as PA process facilitators. The implementation frameworks of Steckler and Linnan (2002) and Carrol et al. (2007) were applied to evaluate recruitment, reach, dosage, fidelity and context, as well as stakeholders’ satisfaction, experiences and perceived intervention outcomes. Data were collected after PA implementation (4–7 months) using questionnaires, semi-structured interviews, checklists and research logs. Results Of the 57 caregivers in the intervention group, 48 participated in the stepwise intervention. Among them, 20 (42%) completed all seven steps of the PA, and 30 (63%) involved their supervisors. PA implementation and supervisor involvement varied based on personal factors (e.g. a need for balance-related improvements; preference to keep caregiving private), interpersonal factors (e.g. caregiver-supervisor relationship quality), and organizational factors (high work demands; a supportive workplace culture for caregivers). Caregivers, supervisors, and process facilitators reported positive experiences with the PA, finding it valuable for addressing informal caregiving, receiving support and working on balance-related changes in multiple life domains. Some caregivers, however, needed more than the standard 3 PA meetings to identify key issues and implement solutions. Conclusions Stakeholders found the PA helpful in addressing working caregivers’ work-life balance, but PA implementation can be further stimulated by creating a supportive organizational culture in which it is encouraged and safe to discuss informal care. Moreover, to better support working caregivers in the long term, the PA should be viewed as an ongoing and iterative process taking into account their evolving balance and circumstances. Trial registration Current Controlled Trials ISRCTN15363783 (Registration date 21 November 2022; Retrospectively registered).

OBJECTIVE: This study evaluated the effectiveness of the promotion of postural shift intervention using a dynamic seat cushion on the 6-month incidence of neck and low-back pain among high-risk office workers. METHODS: In a cluster-randomized controlled trial (RCT), 133 office workers were randomly assigned, at cluster level, to intervention (N=67) and control (N=66) groups. The intervention group received a dynamic seat cushion to encourage postural shifts during sitting, while the control group received a placebo seat pad. Primary outcomes were 6-month incidence of neck and low-back pain. Secondary outcomes included sitting discomfort, pain intensity, disability, and trunk muscle performance. Analyses utilized Cox proportional hazard models. RESULTS: During the 6-month period, 15% of participants in the intervention group developed neck pain and 10% developed low-back pain. For the control group, this was 65% and 59%, respectively. Hazard rate (HR) ratios, after adjusting for biopsychosocial factors, indicated a protective effect of the intervention for neck pain [HR_adj 0.19, 95% confidence interval (CI) 0.09–0.39, P

Abstract Background Neck and low back pain are prevalent issues among office workers due to prolonged sitting, necessitating effective interventions. Dynamic seat cushion, designed to promote postural shifts, have emerged as promising solutions to address this concern. This study aims to evaluate the effectiveness of a dynamic seat cushion on recovery and recurrence of neck and/or low back pain in office workers. Methods This study used 6-month follow-up data of a randomized controlled trial, involving 66 office workers who reported neck and/or low back pain during the trial. At baseline, participants were cluster-randomized into an intervention group, which received a dynamic seat cushion designed to encourage postural shifts, or a control group, which received a placebo seat pad. Health outcomes included recovery duration and recurrence of pain. Analyses utilized log rank test and Cox proportional hazard models. Results The recovery rate from neck and/or low back pain was 100% for the intervention group, and 86% for the control group. The median recovery duration of participants who reported pain during the 6-month period was 1 month in the intervention group and 3 months in the control group. The intervention group had a higher probability of recovery compared to the control group (HRadj 4.35, 95% CI 1.87–10.11; p

Abstract Ptychographic extreme ultraviolet (EUV) diffractive imaging has emerged as a promising candidate for the next generationmetrology solutions in the semiconductor industry, as it can image wafer samples in reflection geometry at the nanoscale. This technique has surged attention recently, owing to the significant progress in high-harmonic generation (HHG) EUV sources and advancements in both hardware and software for computation. In this study, a novel algorithm is introduced and tested, which enables wavelength-multiplexed reconstruction that enhances the measurement throughput and introduces data diversity, allowing the accurate characterisation of sample structures. To tackle the inherent instabilities of the HHG source, a modal approach was adopted, which represents the cross-density function of the illumination by a series of mutually incoherent and independent spatial modes. The proposed algorithm was implemented on a mainstream machine learning platform, which leverages automatic differentiation to manage the drastic growth in model complexity and expedites the computation using GPU acceleration. By optimising over 200 million parameters, we demonstrate the algorithm's capacity to accommodate experimental uncertainties and achieve a resolution approaching the diffraction limit in reflection geometry. The reconstruction of wafer samples with 20-nm high patterned gold structures on a silicon substrate highlights our ability to handle complex physical interrelations involving a multitude of parameters. These results establish ptychography as an efficient and accurate metrology tool.

Purpose – Most papers and books on conducting literature reviews primarily emphasize achieving technical quality, ensuring reproducibility and validating results. Notwithstanding the need for technical excellence, there is also a need for relevance. The purpose of this study is to address that need and offer practical and constructive suggestions for enhancing the meaningful contribution of a literature review, thereby increasing its impact and relevance for publication. Design/methodology/approach – In this conceptual paper, the authors explore strategies to enhance the relevance and contribution of a literature review. By clarifying the needs of diverse audiences and the principles of generating new insights, the authors provide a broad range of options without being prescriptive. Recognizing that every literature review is unique, this paper contrasts various approaches to offer flexible and adaptable guidance. Findings – Literature reviews can be enjoyable to read and write, offering a wide range of substantial contributions that meet the expectations of readers and journal editors. This paper offers practical suggestions for prospective authors to make their reviews more relevant, invaluable and engaging, and summarizes these suggestions in a comprehensive checklist. Research limitations/implications – The paper is not exhaustive but rather complements prevalent literature review methodologies. Originality/value – Existing literature offers limited guidance on enhancing a review’s contribution to science, academic inquiry and society. This paper fills that gap by providing both academic considerations and practical recommendations, drawing on the author’s extensive experience in reviewing and conducting literature reviews. Claves para mejorar el impacto de las revisiones de literatura: directrices para realizar contribuciones significativas Objetivo – La mayoría de los artículos y libros sobre la realización de revisiones de literatura enfatizan principalmente la obtención de calidad técnica, asegurando la reproducibilidad y validando resultados. A pesar de la necesidad de excelencia técnica, también existe la necesidad de la relevancia. El presente artículo aborda esa necesidad y tiene como objetivo ofrecer sugerencias prácticas y constructivas para mejorar la contribución significativa de una revisión de literatura, aumentando así su impacto y relevancia para su publicación. Diseño/metodología/enfoque – En este artículo conceptual, los autores exploran estrategias para mejorar la relevancia y la contribución de una revisión de literatura. Al clarificar las necesidades de audiencias diversas y los principios para generar nuevos conocimientos, los autores proporcionan una amplia gama de opciones sin ser prescriptivos. Reconociendo que cada revisión de literatura es única, este artículo contrasta varios enfoques para ofrecer orientación flexible y adaptable. Resultados – Las revisiones de literatura pueden ser placenteras de leer y escribir, ofreciendo una amplia gama de contribuciones sustanciales que satisfacen las expectativas de los lectores y editores de revistas. Este artículo ofrece sugerencias prácticas para que los autores potenciales hagan que sus revisiones sean más relevantes, valiosas y atractivas, y resume estas sugerencias en una lista de verificación integral. Originalidad – La literatura existente ofrece una orientación limitada sobre cómo mejorar la contribución de una revisión a la ciencia, la investigación académica y la sociedad. Este artículo cubre ese vacío proporcionando consideraciones académicas y recomendaciones prácticas, basadas en la extensa experiencia de los autores en la revisión y realización de revisiones de literatura. Limitaciones/implicaciones de la investigación – El artículo no es exhaustivo, sino que complementa las metodologías prevalentes de revisión de literatura. 提升文献综述影响力：提出有意义贡献的指南 目的 – 大多数关于如何进行文献综述的文章和书籍主要强调实现技术质量、确保可重复性和验证结果。尽管技术卓越性至关重要, 但同样需要注重相关性。本文正是为了满足这一需求, 旨在提供实用且建设性的建议, 以增强文献综述的有意义贡献, 从而增加其发表的影响力和相关性。 设计/方法论/途径 – 在这篇概念性文章中, 作者探讨了增强文献综述相关性和贡献的策略。通过阐明多样化受众的需求和生成新见解的原则, 作者提供了广泛的选项, 而不是一味地指示。认识到每篇文献综述都是独一无二的, 本文对比了各种方法, 以提供灵活和适应性的指导。 研究结果 – 文献综述可以既有趣味性又富有实质性贡献, 满足读者和期刊编辑的期望。本文为潜在作者提供了实用的建议, 使他们的综述更具相关性、不可或缺且引人入胜, 并将这些建议总结在一个全面的清单中。 独创性 – 现有文献对如何增强综述对科学、学术研究和社会的贡献提供的指导有限。本文通过结合学术考虑和实际建议, 弥补了这一空白, 基于作者在审阅和进行文献综述方面的丰富经验, 提供了独特的见解。 研究限制/启示 – 该文章并非详尽无遗, 而是对现有文献综述方法的补充。

Water availability explains a large part of the spatial and temporal yield variability of ware potato in the Netherlands. Climate change is projected to lead to greater variability in water availability. Therefore, an accurate simulation of crop yield as a function of water availability is of high importance. Many crop models can simulate water-limited potato yields, but as detailed experimental data on drought and oxygen stress are scarce, models are often not well calibrated and evaluated. We set up a large experiment and an on-farm observational trial to calibrate and evaluate the simulation of water-limited yield of different potato cultivars across the Netherlands. In addition, we investigated the required model complexity to accurately simulate water-limited potato yields. The crop growth model WOFOST was used for simulations either as a single model or coupled with SWAP. Yields were simulated applying either only drought stress or by including both drought and oxygen stress. We employed two methods for simulating oxygen stress in SWAP-WOFOST. The calibration improved accuracy of simulated water-limited yields as demonstrated in our model evaluation. Both on sandy and clayey soils, water-limited yields were best simulated using SWAP-WOFOST while simulating oxygen stress using a process-based method in combination with a rooting density that decreases linearly with rooting depth. On sandy soils, the bottom boundary condition of free drainage was applicable. On clayey soils measured groundwater levels (or soil water pressure heads when measurements are not available) should be used as bottom boundary condition. On sandy soils both WOFOST and SWAP-WOFOST may be used, as results were similar. On clayey soils, WOFOST is less suitable, as it cannot simulate capillary rise. SWAP-WOFOST however has many options and parameters, which can result in large differences in results. Hence, a careful model set up and evaluation is required for each application.

IntroductionWound closure with triclosan-coated sutures (TCS) appears to reduce the risk of surgical site infection (SSI). Because there is a strong association between postoperative SSI and the development of acute abdominal wall dehiscence (AWD) after laparotomy, we hypothesized that the use of TCS for wound closure after laparotomy may also reduce the risk of AWD.MethodsThe MEDLINE, Embase, and CENTRAL databases were searched from their inception to 01 November 2022. Randomized trials that compared the use of TCS with identical but uncoated sutures for fascial closure were eligible if they could provide individual participant data (IPD) on AWD. From these trials, we only included in the analysis those subjects who underwent open abdominal surgery. The primary outcome was the incidence of AWD within 30 days postoperatively, requiring emergency reoperation. The certainty of evidence was assessed using the GRADE methodology (PROSPERO: CRD42019121173.ResultsWe identified twelve eligible trials. Eight studies shared IPD. The incidence of AWD within 30 days after surgery was 27/1,565 (1.7%) in the TCS group vs. 40/1,430 (2.8%) in the control group (Relative Risk: 0.70 [95% confidence interval (CI) 0.44–1.11, I2 = 0%, τ2 = 0.00]). The certainty of evidence was moderate after downgrading for imprecision. The incidence of incisional SSI was 163/1,576 (10.3%) vs. 198/1,439 (13.8%), RR 0.80 (95% CI 0.67–0.97).ConclusionWe found no conclusive evidence to support the use of triclosan-coated sutures for the prevention of acute abdominal wall dehiscence after laparotomy. In these selected studies, a significant reduction in incisional SSI was observed.

Background/Objectives: The redirection or reshaping of the acetabulum might be warranted to attain a concentric and stable hip in children with developmental dysplasia of the hip (DDH). The aim of this study is to assess the late clinical and radiological results, and to determine the number of patients requiring secondary surgery or a total hip arthroplasty at a long-term follow-up. Methods: Our institution performed 99 Salter osteotomies on 76 patients without underlying neuromuscular conditions over a 21-year period, from 1981 to 2002. These procedures were carried out by three different surgeons. Patients underwent a comprehensive evaluation at the review visit, including a physical examination, clinical assessments using the Harris hip score (HHS), Oxford score (OHS) and Visual Analogue Scale (VAS) pain score, as well as pelvic radiographs. Results: At a median follow-up of 22 years, total hip arthroplasty was performed in 6 out of 77 hips (8%). Patients who underwent a Salter osteotomy with an open reduction had a higher rate of avascular necrosis (AVN) of the femoral head compared to those who only underwent a Salter pelvic osteotomy (p < 0.001). There were statistically significant differences in the group with and without AVN in terms of HHS (p = 0.006, 95%CI 0.003 to 0.006), OHS (p = 0.016, 95%CI 0.012 to 0.017), a modified OHS (p = 0.018, 95% CI 0.012 to 0.016), a VAS score in activity (p = 0.046, 95%CI 0.042 to 0.050) and VAS score satisfaction (p = 0.005, 95%CI 0.003 to 0.006). Conclusions: The rate of THA was 8% at a mean of follow-up of 22 years. Secondary results suggest that AVN occurs more frequently when a Salter osteotomy is combined with an open reduction. The occurrence of AVN is associated with significantly lower clinical outcome scores and patient satisfaction, as well as significantly higher pain scores. In the absence of AVN, good clinical results can be expected at long-term follow-up.

The Asian longhorned beetle, Anoplophora glabripennis (Coleoptera: Cerambycidae: Lamiinae), is a serious pest of over 43 species of hardwood trees in North America, China and Europe. The development of an effective lure and trap for monitoring A. glabripennis has been hindered by the fact that mate finding involves a rather complex series of behaviors and responses to several chemical (and visual), cues. Adults (female-biased) locate a tree via host kairomones. Research has demonstrated that female contact pheromone components are precursors that undergo abiotic oxidation to yield attractive volatile components. Males also produce a pheromone to attract other adults nearby before the final step of recognition by males to the female-produced trail and contact pheromones. Our research aimed to identify new female-produced components from ozone and UV-treated A. glabripennis body washes and test them for behavioral activity using laboratory and field assays. The ozone and UV treatment of virgin female extract yielded sixteen aldehydes, nine of which were found in trace amounts. All sixteen aldehydes elicited antennal responses (GC-EAD) in both males and females, although responses were clearer and more distinct with standards of hexanal, heptanal, octanal, nonanal, decanal, undecanal and dodecanal. Olfactometer assays showed that males were highly attracted to a blend of these seven aldehydes. Females did not show any attraction to the blend in olfactometer assays. Despite low population levels during field tests in 2018 in China, traps containing the aldehyde blend detected A. glabripennis on a weekly basis over 6 weeks and caught significantly more adults (mainly males) than control ‘flight intercept panel’ traps. Field tests in China in 2019 that used the aldehyde blend along with a three-component host blend lure also caught significantly more males (nearly 5×) than blank control traps.

This paper highlights the evolution and impact of the SWAP model (Soil – Water – Atmosphere – Plant), which was initiated by R.A. Feddes and colleagues fifty years ago, in 1974. Since then, the SWAP model has played a crucial role in the advancement of agrohydrology. This paper highlights some major advances that have been made, especially focussing on the last fifteen years. The domain of the SWAP model deals with the simulation of the soil water balance in both unsaturated and saturated conditions. The model solves the Richards equation using the water retention and hydraulic conductivity functions as described by the Van Genuchten – Mualem equations. Bimodal extensions of the Van Genuchten - Mualem relationships have been implemented, as well as modifications near saturation and addressing hysteresis. An important sink term in the Richards equation is root water uptake. Crop development plays an important role in a robust simulation of root water uptake. That is why a link has been made with the dynamic crop growth model WOFOST. Instead of using a prescribed crop development, a distinction between potential and actual crop development is calculated by reducing the potential photosynthesis as a result of water or oxygen stress. Since the early days of SWAP, empirical and macroscopic concepts have been used to simulate root water uptake. Recently two process-based concepts of root water uptake and oxygen stress have also been implemented. Another important sink-source term in the Richards equation is the interaction with artificial drains. In SWAP, drainage can be simulated by either using prescribed or simulated drain heads and simulation of controlled drainage with subirrigation is possible. Finally, we briefly elaborate on three studies using SWAP: water stresses in agriculture in the Netherlands, regional water productivity in China, and controlled drainage with subirrigation. We finish discussing promising developments for the near future.

Background: Bicuspid aortic valve (BAV) is a common congenital heart defect. Patients with BAV are at risk for long-term complications such as valve stenosis and regurgitation. This study aimed to investigate sex differences in blood and imaging biomarkers and to describe the long-term prognostic value of blood and echocardiographic biomarkers. Methods: Patients were included from 2 prospective observational cohort studies; they underwent venous blood sampling and transthoracic echocardiography including speckle tracking. Analyzed blood biomarkers were red-cell distribution width (RDW), creatinine, C-reactive protein (CRP), troponin T, N-terminal pro B-type natriuretic peptide (NT-proBNP), and transforming growth factor-beta (TGF-β). Sex differences were analyzed at baseline. Associations between biomarkers and arrhythmia-free and intervention-free survival were determined by Cox regression, adjusted for age and sex. Results: A total of 182 patients with BAV were included: median age 34; interquartile range [IQR]: 23-46 years; 55.5% male. CRP, NT-proBNP, and RDW were higher in women, whereas creatinine, troponin T and TGF-β were higher among men. After a median follow-up time of 6.9 (IQR: 6.5-9.9) years, arrhythmia-free and intervention-free survival was, 81.0% and 73.1%, respectively. NT-proBNP was associated with both arrhythmia-free and intervention-free survival (hazard ratio [HR], 1.94, P = 0.005 and HR, 2.06, P = 0.002, respectively). On echocardiography higher left atrial (LA) size, left ventricular end-diastolic diameter (LVEDD), left ventricular (LV) mass index and E/e’ ratio were associated with lower arrhythmia-free survival, whereas higher LA size, LV mass index, aortic valve peak velocity, and aortic regurgitation were associated with lower intervention-free survival. Conclusions: Differences were observed in blood biomarkers between men and women with BAV. Besides LV systolic parameters, diastolic LV function and NT-proBNP should have a more prominent role as prognostic markers in clinical care. Résumé: Contexte: La bicuspide valvulaire aortique (BVA) est une anomalie cardiaque congénitale fréquente. Les patients atteints d’une BVA présentent des risques de complications à long terme, comme la sténose valvulaire ou la régurgitation valvulaire. Cette étude visait 1) à évaluer les différences entre les sexes en ce qui concerne les biomarqueurs sanguins et les biomarqueurs à l’imagerie; et 2) à décrire la valeur pronostique à long terme des biomarqueurs sanguins et échocardiographiques. Méthodologie: Des patients de 2 études de cohortes observationnelles prospectives ont été inclus dans l’analyse. Des échantillons de sang veineux ont été prélevés, et des échocardiographies transthoraciques, y compris le suivi des marqueurs acoustiques, ont été effectuées. Les biomarqueurs sanguins analysés étaient les suivants : indice de distribution des globules rouges (IDR), créatinine, protéine C-réactive (CRP), troponine T, propeptide natriurétique de type B N-terminal (NT-proBNP) et facteur de croissance transformant β (TGF-β). Les différences entre les sexes ont été analysées au départ. Les liens entre les biomarqueurs et la survie sans arythmie et sans intervention ont été déterminés par la régression de Cox, avec correction en fonction de l’âge et du sexe. Résultats: Cent quatre-vingt-deux patients présentant une BVA étaient inclus (âge médian de 34 [écart interquartile : 23-46] ans, 55,5 % hommes). La CRP, la NT-proBNP et l’IDR étaient plus élevées chez les femmes, alors que la créatinine, la troponine T et le TGF-β étaient plus élevés chez les hommes. Après une période de suivi médiane de 6,9 (écart interquartile : 6,5-9,9) ans, les taux de survie sans arythmie et sans intervention étaient respectivement de 81,0 % et de 73,1 %. La NT-proBNP a été associée à la survie sans arythmie (rapport des risques instantanés [RRI] : 1,94, p = 0,005) et à la survie sans intervention (RRI : 2,06, p = 0,002). À l’échocardiographie, des valeurs élevées pour la taille de l’oreillette gauche, le diamètre télédiastolique du ventricule gauche (VG), l’indice de masse du VG et le rapport E/e’ étaient associées à un faible taux de survie sans arythmie, alors que des valeurs élevées pour la taille de l’oreillette gauche, l’indice de masse du VG, la vitesse maximale aortique et la régurgitation aortique étaient associées à un faible taux de survie sans intervention. Conclusions: Les biomarqueurs sanguins variaient en fonction du sexe des personnes présentant une BVA. Outre les paramètres systoliques du VG, la fonction VG diastolique et la NT-proBNP devraient être davantage utilisées comme marqueurs pronostiques en soins cliniques.

Abstract Multiple studies have investigated bibliometric features and uncategorized scholarly documents for the influential scholarly document prediction task. In this paper, we describe our work that attempts to go beyond bibliometric metadata to predict influential scholarly documents. Furthermore, this work also examines the influential scholarly document prediction task over categorized scholarly documents. We also introduce a new approach to enhance the document representation method with a domain-independent knowledge graph to find the influential scholarly document using categorized scholarly content. As the input collection, we use the WHO corpus with scholarly documents on the theme of COVID-19. This study examines different document representation methods for machine learning, including TF-IDF, BOW, and embedding-based language models (BERT). The TF-IDF document representation method works better than others. From various machine learning methods tested, logistic regression outperformed the other for scholarly document category classification, and the random forest algorithm obtained the best results for influential scholarly document prediction, with the help of a domain-independent knowledge graph, specifically DBpedia, to enhance the document representation method for predicting influential scholarly documents with categorical scholarly content. In this case, our study combines state-of-the-art machine learning methods with the BOW document representation method. We also enhance the BOW document representation with the direct type (RDF type) and unqualified relation from DBpedia. From this experiment, we did not find any impact of the enhanced document representation for the scholarly document category classification. We found an effect in the influential scholarly document prediction with categorical data.

The share of boys and men among detected victims of human trafficking is increasing globally, yet there is limited evidence on the specific experiences of these populations. The knowledge gap on mental health outcomes and support needs is particularly salient, which is problematic given the importance of psychological and emotional stabilisation in promoting recovery and avoiding re-victimisation. This systematic review reports on mental health outcomes identified in boys and young men who have experienced human trafficking. By describing the implications for services, the review seeks to identify challenges and opportunities in accessing and delivering mental health care and support to this population in post-trafficking settings. The review includes 31 papers published in English after 2000 and identified through database and grey literature searches. Despite significant limitations, such as a lack of gender-disaggregated results and imbalanced sample composition, which limit the possibility of extracting male-specific findings, the review highlights several mental health symptoms commonly described in the literature (e.g., depression, anxiety, PTSD, lack of self-esteem, lack of self-control). Regarding mental health care support, the review further identifies challenges specific to boys and young men (e.g., poor identification as trafficking victims) and challenges that disproportionately impact this population (e.g., confidentiality concerns; reluctance to seek help; trust issues).

Background: Discrepancies have been noted between the clinical and histologic diagnosis of vascular malformations. Objective: To evaluate the effectiveness of the International Society for Study of Vascular Anomalies (ISSVA) classification in diagnosing benign vascular anomalies based on clinical and (immuno) histologic parameters, focusing on lymphatic differentiation and vascular proliferation. Method: A retrospective study of 121 consecutive patients with benign skin and soft-tissue vascular anomalies located in the head and neck region (pyogenic granulomas and angioma senilis were excluded) by applying multiplex immunohistochemistry staining for lymph vessels (D2-40), endothelial blood vessels, and proliferating cells (Ki67). Clinical and histologic diagnosis was revised after the ISSVA classification. Results: Initially, 64 lesions were diagnosed as tumors and 57 as malformations. Revision diagnosis following the ISSVA classification revealed 27 tumors, 90 malformations (22.2% lymphatic), and 4 non-ISSVA. Immunostaining showed lymphatic differentiation in 24 (19.8%) of 121 cases, of which 20 were malformations. Proliferative activity (Ki67+) was found in 41 (33.8%) of 121 cases, of which 8 were arteriovenous malformations. Limitation: Quality and size of materials (biopsies vs resections) and clinical information. Conclusion: The diagnostic accuracy of combined histologic and clinical approaches for identifying vascular anomalies following the ISSVA classification can be substantially enhanced by incorporating additional immunostaining techniques to evaluate lymphatic differentiation and proliferative activity, particularly in identifying the occurrence of vascular malformations.

IntroductionInnate lymphoid cells (ILCs) have been implicated in multiple pathologic conditions, including atherogenesis, as documented in experimental mice studies, however, their role in atherosclerosis in humans remains unexplored.MethodsHere, we identify ILCs and their dynamics in early, advanced, and complicated human carotid- and aortic atherosclerotic plaques, using a multiplex immunohistochemical quadruple-staining technique with prototypic transcription factors T-bet, GATA3, or RORgt for identification of the ILC1, ILC2 and ILC3 subsets, respectively, in combination with lineage markers CD3, CD20/ CD79a and CD56 to exclude other lymphoid cell types. ILC subsets were quantified, and to put this in perspective, their numbers were expressed as percentage of the total number of infiltrated lymphoid cells and related to the frequency of conventional T cells, B cells, NK cells, and NKT cells. ResultsAll ILC subsets were present in every different stage of atherogenesis. ILC1s were the most abundant ILC subset, and their numbers significantly increased in the course of plaque development, but paradoxically, their relative frequency was reduced because of a higher increment of T cells and B cells. The numbers of ILC2s and ILC3s also gradually increased, but this trend did not achieve significance. T cell subsets always significantly outnumbered their ILC counterparts, except for the early lesions where the proportion of ILC1s was markedly higher, albeit not significant. DiscussionThe high abundance of ILC1s in the early stages and further significant enrichment in later stages, suggest they may participate in the initiation and development of atherogenesis, and thus, may represent a novel target to prevent or treat atherosclerosis.

Abstract Background Preoperative anemia is a frequent complication in pancreatic surgical patients, and it adversely affects morbidity, mortality, and postoperative red blood cell (RBC) transfusion rates. Iron deficiency (ID) is often the underlying cause of anemia and constitutes a modifiable risk factor. Methods Single-center, longitudinal prospective cohort study conducted between May 2019 and August 2022 at the University Medical Center Groningen in the Netherlands. Patients scheduled for pancreatic surgery were referred to the outpatient prehabilitation clinic for preoperative optimization of patient-related risk factors. Patients were screened for anemia ( 5 mg/L]). Intravenous iron supplementation (IVIS) (1,000 mg ferric carboxymaltose) was administered to patients with ID at the discretion of the consulting internist. Pre- and postoperative hemoglobin (Hb) levels were assessed, and perioperative outcomes were compared between patients receiving IVIS (IVIS-group) or standard care (SC-group). Results From 164 screened patients, preoperative anemia was observed in 55 (33.5%) patients, and in 23 (41.8%) of these patients, ID was the underlying cause. In 21 patients, ID was present without concomitant anemia. Preoperative IVIS was administered to 25 patients, out of 44 patients with ID. Initial differences in mean Hb levels (g/dL) between the IVIS-group and SC-group at the outpatient clinic and one day prior to surgery (10.8 versus 13.2, p

INRAE a mené une réflexion prospective collective sur les risques environnementaux dans une perspective inter- et transdisciplinaire inscrite dans le cadre des sciences de la durabilité. Les risques pour les sociétés, les écosystèmes et les milieux ont été considérés conjointement et de façon holistique. Cet article résume les quatre priorités scientifiques identifiées, exprimées de manière transverse. Une feuille de route pour atteindre ces objectifs est également proposée, incluant les ressources humaines, les infrastructures, l’animation scientifique et les partenariats. Ces conclusions devraient participer à la structuration de la recherche française et internationale, et constituer ainsi une contribution significative à l’effort requis par l’urgence environnementale actuelle.

Abstract Multiple sclerosis (MS) pathophysiology includes inflammation, demyelination and neurodegeneration, but the exact mechanisms of disease initiation and progression are unknown. A major feature of lesions is lack of myelin, which increases axonal energy demand and requires adaptation in number and size of mitochondria. Outside lesions, subtle and diffuse alterations are observed in normal appearing white matter (NAWM) and normal appearing grey matter (NAGM), including increased oxidative stress, reduced axon density and changes in myelin composition and morphology. On an ultrastructural level, only limited data is available on alterations in myelinated axons. We generated large scale 2D scanning transmission electron microscopy images (‘nanotomy’) of non-demyelinated brain tissue of control and progressive MS donors, accessible via an open-access online repository. We observed a reduced density of myelinated axons in NAWM, without a decrease in cross-sectional axon area. Small myelinated axons were less frequently and large myelinated axons were more frequently present in NAWM, while the g-ratio was similar. The correlation between axonal mitochondrial radius and g-ratio was lost in NAWM, but not in NAGM. Myelinated axons in control GM and NAGM had a similar g-ratio and radius distribution. We hypothesize that axonal loss in NAWM is likely compensated by swelling of the remaining myelinated axons and subsequent adjustment of myelin thickness to maintain their g-ratio. Failure of axonal mitochondria to adjust their size and fine-tuning of myelin thickness may render NAWM axons and their myelin more susceptible to injury. Graphical Abstract

We measured discards survival probabilities of thornback (Raja clavata) and spotted skate (Raja montagui) in tickler chain beam trawling (5 trips, n = 183 for thornback skate, n = 137 for spotted skate), pulse beam trawling (9 trips, n = 94 for thornback skate) and flyshoot fishieres (4 trips, n = 137 for thornback skate, n = 24 for spotted skate). Survival probabilities were measured by captive observation for 15 to 25 days post catch. All fishery operations were conducted in the southern North Sea (ICES division 27.4.c) and in the Eastern English Channel (ICES division 27.7.d) according to the regular commercial practices of the fishing vessels. Trips were spread out over the seasons to account for the effect of variable environmental and fishing conditions on discards survival. Operational and environmental conditions during sea trips were recorded. For beam trawling survival probabilities (95% CI) were 50% (43-57) for thornback and 44% (37-54) for spotted skate. For pulse trawling, survival probability of thornback skate was 54% (40-65). For flyshooting survival probabilities were higher: 80% (73-87) for thornback and 75% (60-94) for spotted skate. Survival probabilities were significantly affected by gear, catch processing time, water temperature, wave height and the interaction between water temperature and wave height. We found no evidence for effects of species and length on survival probability. Vitality class provides a useful qualitative prediction of survival probability within gear. These findings are relevant for the fisheries management of skates stocks in the North Sea and English Channel.

Introduction Patients with end-stage liver disease awaiting orthotopic liver transplantation (OLT) are generally classified as frail due to disease-related malnutrition and a progressive decline in musculoskeletal and aerobic fitness, which is associated with poor pre-OLT, peri-OLT and post-OLT outcomes. However, frailty in these patients may be reversable with adequate exercise and nutritional interventions.Methods and analysis Non-randomised clinical trial evaluating the effect of a home-based bimodal lifestyle programme in unfit patients with a preoperative oxygen uptake (VO2) at the ventilatory anaerobic threshold ≤13 mL/kg/min and/or VO2 at peak exercise ≤18 mL/kg/min listed for OLT at the University Medical Center Groningen (UMCG). The programme is patient tailored and comprises high-intensity interval and endurance training, and functional exercises three times per week, combined with nutritional support. Patients will go through two training periods, each lasting 6 weeks.The primary outcome of this study is the impact of the programme on patients’ aerobic fitness after the first study period. Secondary outcomes include aerobic capacity after the second study period, changes in sarcopenia, anthropometry, functional mobility, perceived quality of life and fatigue, incidence of hepatic encephalopathy and microbiome composition. Moreover, number and reasons of intercurrent hospitalisations during the study and postoperative outcomes up to 12 months post OLT will be recorded. Finally, feasibility of the programme will be assessed by monitoring the participation rate and reasons for non-participation, number and severity of adverse events, and dropout rate and reasons for dropout.Ethics and dissemination This study was approved by the Medical Research Ethics Committee of the UMCG (registration number NL83612.042.23, August 2023) and is registered in the Clinicaltrials.gov register (NCT05853484). Good Clinical Practice guidelines and the principles of the Declaration of Helsinki will be applied. Results of this study will be submitted for presentation at (inter)national congresses and publication in peer-reviewed journals.Trial registration number NCT05853484.

ABSTRACT: Background: Aortic wall shear stress (WSS) is a known predictor of ascending aortic growth in patients with a bicuspid aortic valve (BAV). The aim of this study was to study regional WSS and changes over time in BAV patients. Methods: BAV patients and age-matched healthy controls underwent four-dimensional (4D) flow cardiovascular magnetic resonance (CMR). Regional, peak systolic ascending aortic WSS, aortic valve function, aortic stiffness measures, and aortic dimensions were assessed. In BAV patients, 4D flow CMR was repeated after 3 years of follow-up and both at baseline and follow-up computed tomography angiography (CTA) were acquired. Aortic growth (volume increase of ≥5%) was measured on CTA. Regional WSS differences within patients’ aorta and WSS changes over time were analyzed using linear mixed-effect models and were associated with clinical parameters. Results: Thirty BAV patients (aged 34 years [interquartile range (IQR) 25–41]) were included in the follow-up analysis. Additionally, another 16 BAV patients and 32 healthy controls (aged 33 years [IQR 28–48]) were included for other regional analyses. Magnitude, axial, and circumferential WSS increased over time (all p 95th percentile of healthy controls increased from 21% (baseline 506/2400 regions) to 31% (follow-up 734/2400 regions) (p

The lower Triassic Main Buntsandstein Subgroup represents a promising, but high-risk geothermal play in the Netherlands. Although the gross thickness in boreholes locally exceeds 200 m, the spatial distribution, geometries and preservation of these sedimentary units remained uncertain due to the lack of seismic data with sufficient resolution and the sparse borehole network. This creates uncertainty in the quantification of the aquifer dimensions that is essential for the planning of geothermal operations.

BackgroundDaily and event-driven HIV pre-exposure prophylaxis (PrEP) with oral tenofovir-emtricitabine is highly effective to prevent HIV in men who have sex with men (MSM). PrEP care generally consists of in-clinic monitoring every 3 months that includes PrEP dispensing, counseling, and screening for HIV and sexually transmitted infections (STIs). However, the optimal frequency for monitoring remains undetermined. Attending a clinic every 3 months for monitoring may be a barrier for PrEP. Online-mediated PrEP care and reduced frequency of monitoring may lower this barrier. ObjectiveThe primary objective of this study is to establish the noninferiority of online PrEP care (vs in-clinic care) and monitoring every 6 months (vs every 3 months). The secondary objectives are to (1) examine differences between PrEP care modalities regarding incidences of STIs, HIV infection, and hepatitis C virus infection; retention in PrEP care; intracellular tenofovir-diphosphate concentration; and satisfaction, usability, and acceptability of PrEP care modalities; and (2) evaluate associations of these study outcomes with sociodemographic, behavioral, and psychological characteristics. MethodsThis study is a 2×2 factorial, 4-arm, open-label, multi-center, randomized, controlled, noninferiority trial. The 4 arms are (1) in-clinic monitoring every 3 months, (2) in-clinic monitoring every 6 months, (3) online monitoring every 3 months, and (4) online monitoring every 6 months. The primary outcome is a condomless anal sex act with a casual partner not covered or insufficiently covered by PrEP (ie, “unprotected act”) as a proxy for HIV infection risk. Eligible individuals are MSM, and transgender and gender diverse people aged ≥18 years who are eligible for PrEP care at 1 of 4 participating sexual health centers in the Netherlands. The required sample size is 442 participants, and the planned observation time is 24 months. All study participants will receive access to a smartphone app, which contains a diary. Participants are requested to complete the diary on a daily basis during the first 18 months of participation. Participants will complete questionnaires at baseline and 6, 12, 18, and 24 months. Dried blood spots will be collected at 6 and 12 months for assessment of intracellular tenofovir-diphosphate concentration. Incidence rates of unprotected acts will be compared between the online and in-clinic arms, and between the 6-month and 3-month arms. Noninferiority will be concluded if the upper limit of the 2-sided 97.5% CI of the incidence rate ratio is

Abstract Mutations in the bone morphogenetic protein receptor type 2 (bmpr2) gene and signaling pathway impairment are observed in heritable and idiopathic pulmonary arterial hypertension (PAH). In PAH, endothelial dysfunction is currently handled by drugs targeting the endothelin‐1 (ET‐1), nitric oxide (NO), and prostacyclin (PGI2) pathways. The role of angiogenesis in the disease process and the effect of PAH therapies on dysregulated angiogenesis remain inconclusive. We aim to investigate in vitro whether (i) bmpr2 silencing can impair angiogenic capacity of human lung microvascular endothelial cells (HLMVECs) and (ii) PAH therapies can restore them. The effects of macitentan (ET‐1), tadalafil (NO), and selexipag (PGI2), on BMPRII pathway activation, endothelial barrier function, and angiogenesis were investigated in bmpr2‐silenced HLMVECs. Stable bmpr2 silencing resulted in impaired migration and tube formation in vitro capacity. Inhibition of ET‐1 pathway was able to partially restore tube formation in bmpr2‐silenced HLMVECs, whereas none of the therapies was able to restore endothelial barrier function, no deleterious effects were observed. Our findings highlight the potential role of BMPRII signaling pathway in driving pulmonary endothelial cell angiogenesis. In addition, PAH drugs display limited effects on endothelial function when BMPRII is impaired, suggesting that innovative therapeutic strategies targeting BMPRII signaling are needed to better rescue endothelial dysfunction in PAH.

BackgroundMorbidity rates in pancreatic surgery are high, and frail patients with low aerobic capacity are especially at risk of complications and require prophylactic interventions. Previous studies of small patient cohorts receiving intra-abdominal surgery have shown that an exercise prehabilitation program increases aerobic capacity, leading to better treatment outcomes. ObjectiveIn this study, we aim to assess the feasibility of a home-based exercise prehabilitation program in unfit patients scheduled for pancreatic surgery on a larger scale. MethodsIn this multicenter study, adult patients scheduled for elective pancreatic surgery with a preoperative oxygen uptake (VO2) at the ventilatory anaerobic threshold ≤13 mL/kg/min or a VO2 at peak exercise ≤18 mL/kg/min will be recruited. A total of 30 patients will be included in the 4-week, home-based, partly supervised exercise prehabilitation program. The program comprises 25-minute high-intensity interval training on an advanced cycle ergometer 3 times a week. Training intensity will be based on steep ramp test performance (ie, a short-term maximal exercise test on a cycle ergometer), aiming to improve aerobic capacity. Twice a week, patients will perform functional task exercises to improve muscle function and functional mobility. A steep ramp test will be repeated weekly, and training intensity will be adjusted accordingly. Next to assessing the feasibility (participation rate, reasons for nonparticipation, adherence, dropout rate, reasons for dropout, adverse events, and patient and therapist appreciation) of this program, individual patients’ responses to prehabilitation on aerobic capacity, functional mobility, body composition, quality of life, and immune system factors will be evaluated. ResultsRecruitment for this study began in January 2022 and is expected to be completed in the summer of 2023. ConclusionsResults of this study will provide important clinical and scientific knowledge on the feasibility of a partly supervised home-based exercise prehabilitation program in a vulnerable patient population. This might ease the path to implementing prehabilitation programs in unfit patients undergoing complex abdominal surgery, such as pancreatic surgery. Trial RegistrationClinicalTrials.gov NCT05496777; https://classic.clinicaltrials.gov/ct2/show/NCT05496777 International Registered Report Identifier (IRRID)DERR1-10.2196/46526

Clearly enunciated speech (relative to conversational, plain speech) involves articulatory and acoustic modifications that enhance auditory–visual (AV) segmental intelligibility. However, little research has explored clear-speech effects on the perception of suprasegmental properties such as lexical tone, particularly involving visual (facial) perception. Since tone production does not primarily rely on vocal tract configurations, tones may be less visually distinctive. Questions thus arise as to whether clear speech can enhance visual tone intelligibility, and if so, whether any intelligibility gain can be attributable to tone-specific category-enhancing (code-based) clear-speech cues or tone-general saliency-enhancing (signal-based) cues. The present study addresses these questions by examining the identification of clear and plain Mandarin tones with visual-only, auditory-only, and AV input modalities by native (Mandarin) and nonnative (English) perceivers. Results show that code-based visual and acoustic clear tone modifications, although limited, affect both native and nonnative intelligibility, with category-enhancing cues increasing intelligibility and category-blurring cues decreasing intelligibility. In contrast, signal-based cues, which are extensively available, do not benefit native intelligibility, although they contribute to nonnative intelligibility gain. These findings demonstrate that linguistically relevant visual tonal cues are existent. In clear speech, such tone category-enhancing cues are incorporated with saliency-enhancing cues across AV modalities for intelligibility improvements.

In rheumatoid arthritis (RA), only a subset of patients develop irreversible bone destruction. Our aim was to identify a microRNA (miR)‐based osteoclast‐related signature predictive of erosiveness in RA. Seventy‐six adults with erosive (E) or nonerosive (NE) seropositive RA and 43 sex‐ and age‐matched healthy controls were recruited. Twenty‐five miRs from peripheral blood mononuclear cell (PBMC)‐derived osteoclasts selected from RNA‐Seq (discovery cohort) were assessed by qPCR (replication cohort), as were 33 target genes (direct targets or associated with regulated pathways). The top five miRs found differentially expressed in RA osteoclasts were either decreased (hsa‐miR‐34a‐3p, 365b‐3p, 374a‐3p, and 511‐3p [E versus NE]) or increased (hsa‐miR‐193b‐3p [E versus controls]). In vitro, inhibition of miR‐34a‐3p had an impact on osteoclast bone resorption. An integrative network analysis of miRs and their targets highlighted correlations between mRNA and miR expression, both negative (CD38, CD80, SIRT1) and positive (MITF), and differential gene expression between NE versus E (GXYLT1, MITF) or versus controls (CD38, KLF4). Machine‐learning models were used to evaluate the value of miRs and target genes, in combination with clinical data, to predict erosion. One model, including a set of miRs (predominantly 365b‐3p) combined with rheumatoid factor titer, provided 70% accuracy (area under the curve [AUC] 0.66). Adding genes directly targeted or belonging to related pathways improved the predictive power of the model for the erosive phenotype (78% accuracy, AUC 0.85). This proof‐of‐concept study indicates that identification of RA subjects at risk of erosions may be improved by studying miR expression in PBMC‐derived osteoclasts, suggesting novel approaches toward personalized treatment. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Introduction Short-term exercise prehabilitation programmes have demonstrated promising results in improving aerobic capacity of unfit patients prior to major abdominal surgery. However, little is known about the cardiac and skeletal muscle adaptations explaining the improvement in aerobic capacity following short-term exercise prehabilitation.Methods and analysis In this single-centre study with a pretest–post-test design, 12 unfit patients with a preoperative oxygen uptake (VO2) at the ventilatory anaerobic threshold ≤13 mL/kg/min and/or VO2 at peak exercise ≤18 mL/kg/min, who are scheduled to undergo hepatopancreatobiliary surgery at the University Medical Center Groningen (UMCG), the Netherlands, will be recruited. As part of standard care, unfit patients are advised to participate in a home-based exercise prehabilitation programme, comprising high-intensity interval training and functional exercises three times per week, combined with nutritional support, during a 4-week period. Pre-intervention and post-intervention, patients will complete a cardiopulmonary exercise test. Next to this, study participants will perform additional in-vivo exercise cardiac magnetic resonance (MR) imaging and phosphorus 31-MR spectroscopy of the quadriceps femoris muscle before and after the intervention to assess the effect on respectively cardiac and skeletal muscle function.Ethics and dissemination This study was approved in May 2023 by the Medical Research Ethics Committee of the UMCG (registration number NL83611.042.23, March 2023) and is registered in the ClinicalTrials.gov register. Results of this study will be submitted for presentation at (inter)national congresses and publication in peer-reviewed journals.Trial registration number NCT05772819.

Abstract Background Growing numbers of people with advanced illnesses who wish to die at home, a concurrent decline in the accessibility of professional home care, and policies aiming at prolonging work participation are increasing the reliance on family caregivers. This study aimed to describe trajectories in burden of working family caregivers who care for patients with a life-threatening illness, and identify factors in work and care that are related to changes in burden over time. Methods Semi-structured interviews were held in one to four rounds between July 2018 and November 2020 with 17 working family caregivers of patients with a life-threatening illness living at home. Transcripts were analysed as a single unit to create timelines per participant. Next, individual burden trajectories were created and grouped based on the course of burden over time. Factors related to changes in burden were analysed, as well as similarities and differences between the groups. Results It was common for family caregivers who combine work and end-of-life care to experience a burden. Two trajectories of caregiver burden were identified; caregivers with a persistent level of burden and caregivers with an increasing burden over time. Family caregivers with a persistent level of burden seemed to be at risk for burnout throughout the illness trajectory, but were often able to cope with the situation by making arrangements in care or work. Caregivers with an increasing burden were unable to make sufficient adjustments, which often resulted in burnout symptoms and sick leave. In both groups, burden was mostly related to aspects of the care situation. The emotional burden, a decreasing burden after death and a different view o n the trajectory in hindsight proved to be important overarching themes. Conclusions Providing care to a loved one nearing the end of life is often emotionally burdensome and intensive. To facilitate the combination of paid work and family care, and reduce the risk of burnout, more support is needed from employers and healthcare professionals during the illness trajectory and after death. Bereaved family caregivers also warrant more attention from their supervisors and occupational physicians in order to facilitate their return to work.

Abstract Background Many workplace health promotion programs (WHPPs) do not reach blue-collar workers. To enhance the fit and reach, a Citizen Science (CS) approach was applied to co-create and implement WHPPs. This study aims to evaluate i) the process of this CS approach and ii) the resulting WHPPs. Methods The study was performed in two companies: a construction company and a container terminal company. Data were collected by questionnaires, interviews and logbooks. Using the framework of Nielsen and Randall, process measures were categorized in the intervention, context and mental models. Interviews were transcribed and thematically coded using MaxQDA software. Results The involvement in the CS approach and co-creating the WHPPs was positively experienced. Information provision, sustained engagement over time and alignment with the workplace’s culture resulted in barriers in the CS process. As to the resulting WHPPs, involvement and interaction during the intervention sessions were particularly experienced in small groups. The reach was affected by the unfavorable planning off the WHPPs and external events of re-originations and the covid-19 pandemic. Discussion Continuous information provision and engagement over time, better alignment with the workplace’s culture and favorable planning are considered to be important factors for facilitating involvement, reach and satisfaction of the workers in a Citizen science approach to design and implement a WHPP. Further studies continuously monitoring the process of WHPPs using the CS approach could be helpful to anticipate on external factors and increase the adaptability. Conclusions Workers were satisfied with the involvement in WHPPs. Organizational and social cultural factors were barriers for the CS approach and its reach. Involvement and interaction in WHPPs were particularly experienced in small grouped sessions. Consequently, contextual and personal factors need be considered in the design and implementation of WHPPs with CS approach among blue-collar workers.

Philosophers conceptualized bullshit as persuasive communication that has no regard for truth, knowledge, or evidence. In psychology, research mostly investigated pseudo-profound bullshit, but no study has examined bullshit in the political context. In the present research, we operationalized political bullshit receptivity as endorsing vague political statements, slogans, and political bullshit programs. We investigated the relationship of these three measures with pseudo-profound bullshit, ideology (political ideology, support for neoliberalism), populism, and voting behavior. Three pre-registered studies conducted in early 2020 in the U.S., Serbia, and the Netherlands (total N = 534) yielded medium to high intercorrelations between political bullshit measures and pseudo-profound bullshit, and acceptable construct validity (hypothesized one-factor solution). A meta-analysis on these three studies showed that all political bullshit measures positively correlated with support for the free market, while only some positively correlated with social (political statements and programs) and economic conservatism (programs), and populism (programs). In the U.S., the Netherlands, and all countries combined, increased receptivity to political bullshit was associated with a higher probability to vote for right-wing candidates/parties (e.g., Trump in the U.S.). Overall, political bullshit receptivity showed to be a useful construct that opens avenues for research in broad and meaningless political communication.

Background: Intramuscular injection of botulinum toxin A (BTA) induces a temporary muscle paralysis. In patients with a ventral hernia, preoperative injection of BTA in the muscles of the lateral abdominal wall (LAW) leads to thinning and lengthening of these muscles, making fascial closure more likely. In many hernia centres, treatment with BTA prior to abdominal wall reconstruction has therefore become standard care. However, evidence on the optimal BTA strategy is lacking.Methods: In this single-centre retrospective study, we analysed a consecutive cohort of ventral hernia patients that underwent bilateral BTA injections prior to abdominal wall reconstruction with available CT before and after BTA. We only included patients that were treated with exactly 600 units of Dysport®, diluted into 120 mL of saline, via either two- or three injections on each side into all three LAW muscle layers. The primary outcome was the change in LAW muscle length and thickness, comparing CT measures from before BTA and 4–6 weeks after the injections.Results: We analysed 67 patients; 30 had received two injections bilaterally and 37 had received three injections bilaterally. Baseline data showed no significant differences in LAW muscle thickness or length between groups. In both groups, the median LAW muscle thickness decreased with 0.5 cm (p < 0.001). The LAW muscle length increased with 0.9 cm (p = 0.001) and 1.2 cm (p < 0.001) in the two- and three bilateral injection group, respectively. The BTA-induced changes in LAW thickness and length were not significantly different between both groups (p = 0.809 and p = 0.654, respectively).Discussion: When using the exact same dosage and distribution volume of BTA in patients with a complex abdominal wall defect, two injections bilaterally in the lateral abdominal wall muscles are as effective as three injections bilaterally.

Abstract Cells are exposed to oxidative stress and reactive metabolites every day. The Nrf2 signaling pathway responds to oxidative stress by upregulation of antioxidants like glutathione (GSH) to compensate the stress insult and re-establish homeostasis. Although mechanisms describing the interaction between the key pathway constituents Nrf2, Keap1 and p62 are widely reviewed and discussed in literature, quantitative dynamic models bringing together these mechanisms with time-resolved data are limited. Here, we present an ordinary differential equation (ODE) based dynamic model to describe the dynamic response of Nrf2, Keap1, Srxn1 and GSH to oxidative stress caused by the soft-electrophile diethyl maleate (DEM). The time-resolved data obtained by single-cell confocal microscopy of green fluorescent protein (GFP) reporters and qPCR of the Nrf2 pathway components complemented with siRNA knock down experiments, is accurately described by the calibrated mathematical model. We show that the quantitative model can describe the activation of the Nrf2 pathway by compounds with a different mechanism of activation, including drugs which are known for their ability to cause drug induced liver-injury (DILI) i.e., diclofenac (DCF) and omeprazole (OMZ). Finally, we show that our model can reveal differences in the processes leading to altered activation dynamics amongst DILI inducing drugs.

Abstract Background An integrated workplace health promotion program (WHPP) which targets multiple lifestyle factors at different levels (individual and organizational) is potentially more effective than a single component WHPP. The aim of this study is to describe the protocol of a study to tailor a European good practice of such an integral approach to the Dutch context and to evaluate its effectiveness and implementation. Methods This study consists of two components. First, the five steps of the Map of Adaptation Process (MAP) will be followed to tailor the Lombardy WHP to the Dutch context. Both the employers and employees will be actively involved in this process. Second, the effectiveness of the integrated Dutch WHPP will be evaluated in a clustered randomized controlled trial (C-RCT) with measurements at baseline, 6 months and 12 months. Clusters will be composed based on working locations or units - dependent on the organization’s structure and randomization within each organization takes place after baseline measurements. Primary outcome will be a combined lifestyle score. Secondary outcomes will be the separate lifestyle behaviors targeted, stress, work-life balance, need for recovery, general health, and well-being. Simultaneously, a process evaluation will be conducted. The study population will consist of employees from multiple organizations in different industry sectors. Organizations in the intervention condition will receive the integrated Dutch WHPP during 12 months, consisting of an implementation plan and a catalogue with activities for multiple lifestyle themes on various domains: 1) screening and support; 2) information and education; 3) adjustments in the social, digital or physical environment; and 4) policy. Discussion The MAP approach provides an appropriate framework to systematically adapt an existing WHPP to the Dutch context, involving both employers and employees and retaining the core elements, i.e. the catalogue with evidence-based activities on multiple lifestyle themes and domains enabling an integrated approach. The following process and effect evaluation will contribute to further insight in the actual implementation and effectiveness of the integrated WHP approach. Trial registration NTR (trialregister.nl ), NL9526. Registered on 3 June 2021.

Worldwide, work-related injury and disease form a major challenge to employers, workers’ unions, governments, and most importantly workers themselves. To combat this, a broad range of occupational health interventions has been developed that are typically aimed at preventing work-related illnesses and disease, and/or improving return-to-work after sickness absence or work disability (1). As resources are restricted, however, decision-makers increasingly call upon advisors and researchers to demonstrate that occupational health interventions are not only effective but also efficient in terms of their resource implications (2). For instance, a qualitative assessment among decision-makers in the Ontario healthcare sector showed that financial information – mostly in the form of a business case – can be a key deciding factor of whether to go forward with implementation of an intervention or occupational health service (3). In the past decades, various economic studies have been performed in the area of occupational health. These studies can be roughly divided into: (i) studies assessing the cost of ill health among workers and (ii) economic evaluations of interventions (1). Economic evaluations typically assess the cost-effectiveness and/or return-on-investment of occupational health interventions by comparing their incremental costs to their additional effects expressed in terms of physical units and monetary values, respectively. In recent years, various examples of such studies have been published in The Scandinavian Journal of Work, Environment & Health. Russo et al (4), for example, reported on the development of a cost-estimation method for work-related stress, while Finnes et al (5) assessed the long-term cost-effectiveness of return-to-work interventions for mental disorder-related absence. In another example, Lutz et al (6) summarized and critically appraised the health economic evidence on worksite physical activity and/or nutrition programs. Despite these good examples, the methodological quality of many economic evaluations in occupational health is far from optimal (6–8). To illustrate, many economic evaluations used a wide variety of – sometimes invalid – methods for estimating productivity-related costs, few economic evaluations validly assessed and/or reported on the uncertainty surrounding their results, and the follow-up duration of many economic evaluations is relatively short (6–8). Even though various efforts have been made to improve the methodological quality of economic evaluations in occupational health [eg, (2)], three issues still warrant specific attention: (i) measurement and valuation of productivity-related costs, (ii) analysis of trial-based economic evaluations, and (iii) use of modelling techniques. In the following, we will discuss these issues in greater detail and give pointers on where occupational health can benefit from cooperating with other research fields. Challenges for economic evaluations in occupational health Productivity-related costs are often the central point of focus in both cost of illness studies and economic evaluations in occupation health. This is because the impact of (work-related) injury and disease on productivity-related costs is substantial (9). Hassard et al (10), for example, found that productivity-related costs accounted for 70–90% of the total societal cost of work-related stress. Unfortunately, however, measuring and valuing productivity losses is complex and is likely even further complicated by the broad range of methods available for doing so. To illustrate, sickness absence can be measured objectively using company records or subjectively using a broad range of self-reported questionnaires (e.g. WHO-HPQ, PRODISQ). To complicate matters even further, sickness absence days can be valued using various methodological approaches (eg, the human capital or friction cost approaches) and different kinds of unit prices (eg, actual wage rates, average income) (2, 9). Reduced productivity while being at work (ie, presenteeism), on the other hand, is typically measured using simple numeric rating scales and can again be valued using a wide variety of approaches and unit prices. Consequently, economic evaluations in occupational health are highly heterogeneous in terms of their productivity-related cost estimation methods and large differences exist across studies in terms of the validity and transparent reporting of applied methods (9). We therefore agree with other authors that guidelines should be developed for measuring and valuing productivity-related costs (9). These guidelines should be specific to the field of occupational health and ideally consider cross-country differences. This is important because methods that are appropriate for a certain economic perspective and/or country are not necessarily appropriate for other perspectives and/or countries. In the Netherlands, for example, the “Dutch manual for costing studies in healthcare” recommends to only include productivity losses that occur during the period employers need to replace a sick worker (ie, friction cost approach) (11), whereas – in practice – Dutch employers are obliged to pay ≥70% of their sick workers’ wages for the duration of two years. Hence, it is questionable whether the recommended friction cost approach is appropriate from the company perspective as well. Additionally, we would like to encourage future studies to assess the appropriateness of the simple numeric rating scales that are currently being used for estimating presenteeism costs, and/or whether presenteeism cost estimates are preferably based on more detailed and validated productivity questionnaires, such as the “Individual Work Performance Questionnaire” (12). If the latter is the case, research is needed to assess how to validly convert workers’ responses to such questionnaires into monetary values. Ideally, this is done using objective information on productivity outputs, for instance by systematic worksite observations (13). The statistical quality of many economic evaluations in occupational health is poor (9, 14). Amongst others, baseline imbalances, the skewed nature of cost data, and the clustering of data are often neglected. On top of that, missing data are frequently handled using inappropriate methods, such as a complete-case analysis, and some studies do not even report on the uncertainty surrounding their cost-effectiveness and/or return-on-investment estimates (8). Inappropriate statistical methods, however, can lead to incorrect results and/or conclusions, and hence a sub-optimal allocation of available occupational health resources (9, 14). Improving the statistical quality of economic evaluations in occupational health starts with the development of recommendations on how to analyze them appropriately, accompanied by the publication of tutorial papers and annotated software codes. Also, as extensive progress has been made concerning the statistical analysis of economic evaluations in other research fields [eg, (14–16)], the quality of economic evaluations in occupational health will also benefit from an increased collaboration with health economists, biostatisticians, and/or econometricians. In the present issue, Finnes et al (5) provide a good example of such a collaboration, which in turn resulted in a state-of-the-art economic evaluation from the occupational health as well as economic perspective. Most economic evaluations in occupational health are solely based on worker-level data (6–8). Possible limitations of such an approach are that worker-level data are typically only available for a restricted number of workers, relatively short follow-up durations, and a limited number of comparators. To deal with these issues, researchers could make use of analytic modelling where economic evaluations are conducted by synthesizing information from multiple sources (eg, using Markov models) (2). Analytic modelling might, for example, be used to extrapolate economic evaluation results beyond the follow-up of a trial. This may be particularly informative for occupational health interventions that are expected to impact costs and/or effects for an extensive period of time (eg, worksite health promotion programs). Analytic modelling might also be used when researchers want to compare a number of interventions and/or when they are confronted with a large number of uncertain variables. Mofidi et al (17) recently provided a good example of analytic modelling in occupational health by assessing the cost-effectiveness of seven different combinations of silica exposure reduction interventions, while simultaneously assessing the robustness of the study results to a broad range of uncertain factors. Again, as extensive progress concerning analytic modelling has taken place in other research fields [eg, (18)], occupational health researchers aiming to use such techniques will likely benefit from collaborating with other research fields. What to do next? Economic evaluations in occupational health are confronted with various scientific challenges that need to be addressed to improve their scientific rigor, and hence the validity of their results and conclusions. To tackle some of these challenges, we encourage researchers to develop guidance and recommendations concerning the measurement and valuation of productivity-related costs as well as the statistical analysis of economic evaluations and to increasingly collaborate with researchers from other fields (eg, when aiming to use analytic modelling techniques). References 1. Burdorf A. Economic evaluation in occupational health-its goals, challenges, and opportunities. Scand J Work Environ Health 2007;33(3):161-4. https://doi.org/10.5271/sjweh.1127 2. van Dongen JM, van Wier MF, Tompa E, Bongers PM, van der Beek AJ, van Tulder MW, et al. Trial-based economic evaluations in occupational health: principles, methods, and recommendations. J Occup Environ Med 2014;56(6):563-72. https://doi.org/10.1097/JOM.0000000000000165 3. van Dongen JM, Tompa E, Clune L, Sarnocinska-Hart A, Bongers PM, van Tulder MW, et al. Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector. Implement Sci 2013;8(1):1-12. https://doi.org/10.1186/1748-5908-8-57 4. Russo S, Ronchetti M, Di Tecco C, Valenti A, Jain A, Mennini FS, et al. Developing a cost-estimation model for work-related stress: An absence-based estimation using data from two Italian case studies. Scand J Work Environ Health 2021;47(4):318-27. https://doi.org/10.5271/sjweh.3948 5. Finnes A, Hoch JS, Enebrink P, Dahl J, Ghaderi A, Nager A, et al. Economic evaluation of return-to-work interventions for mental disorder-related sickness absence: two years follow-up of a randomized clinical trial. Scand J Work Environ Health – online first. https://doi.org/10.5271/sjweh.4012 6. Lutz N, Clarys P, Koenig I, Deliens T, Taeymans J, Verhaeghe N. Health economic evaluations of interventions to increase physical activity and decrease sedentary behavior at the workplace: a systematic review. Scand J Work Environ Health 2020;46(2):127-42. https://doi.org/10.5271/sjweh.3871 7. Grimani A, Bergström G, Casallas MIR, Aboagye E, Jensen I, Lohela-Karlsson M. Economic evaluation of occupational safety and health interventions from the employer perspective: A systematic review. J Occup Environ Med 2018;60(2):147-66. https://doi.org/10.1097/JOM.0000000000001224 8. van Dongen JM, Proper KI, van Wier MF, van der Beek AJ, Bongers PM, van Mechelen W, et al. A systematic review of the cost-effectiveness of worksite physical activity and/or nutrition programs. Scand J Work Environ Health 2012;38(5):393-408. https://doi.org/10.5271/sjweh.3275 9. Steel J, Godderis L, Luyten J. Productivity estimation in economic evaluations of occupational health and safety interventions: a systematic review. Scand J Work Environ Health 2018;44(5):458-74. https://doi.org/10.5271/sjweh.3715 10. Hassard J, Teoh KR, Visockaite G, Dewe P, Cox T. The cost of work-related stress to society: A systematic review. J Occup Health Psychol 2018;23(1):1-17. https://doi.org/10.1037/ocp0000069 11. Versteegh M, Knies S, Brouwer W. From good to better: new Dutch guidelines for economic evaluations in healthcare. Pharmacoeconomics 2016;34(11):1071-4. https://doi.org/10.1007/s40273-016-0431-y 12. Koopmans L, Bernaards C, Hildebrandt V, van Buuren S, van der Beek AJ, de Vet HC. Development of an individual work performance questionnaire. Int J Product Perform Manag 2013;62(1):6-28. https://doi.org/10.1108/17410401311285273 13. Meerding WJ, IJzelenberg W, Koopmanschap MA, Severens JL, Burdorf A. Health problems lead to considerable productivity loss at work among workers with high physical load jobs. J Clin Epidemiol 2005;58(5):517-23. https://doi.org/10.1016/j.jclinepi.2004.06.016 14. Mutubuki EN, El Alili M, Bosmans JE, Oosterhuis T, J Snoek F, Ostelo RWJG, et al. The statistical approach in trial-based economic evaluations matters: get your statistics together! BMC Health Serv Res 2021;21(1):475. https://doi.org/10.1186/s12913-021-06513-1 15. Gomes M, Grieve R, Nixon R, Edmunds WJ. Statistical methods for cost-effectiveness analyses that use data from cluster randomized trials: a systematic review and checklist for critical appraisal. Med Decis Making 2012;32(1):209-20. https://doi.org/10.1177/0272989X11407341 16. Faria R, Gomes M, Epstein D, White IR. A guide to handling missing data in cost-effectiveness analysis conducted within randomised controlled trials. Pharmacoeconomics 2014;32(12):1157-70. https://doi.org/10.1007/s40273-014-0193-3 17. Mofidi A, Tompa E, Mortazavi SB, Esfahanipour A, Demers PA. A probabilistic approach for economic evaluation of occupational health and safety interventions: a case study of silica exposure reduction interventions in the construction sector. BMC Public Health 2020;20(1):1-12. https://doi.org/10.1186/s12889-020-8307-7 18. Krijkamp EM, Alarid-Escudero F, Enns EA, Jalal HJ, Hunink MM, Pechlivanoglou P. Microsimulation modeling for health decision sciences using R: a tutorial. Med Decis Making 2018;38(3):400-22. https://doi.org/10.1177/0272989X18754513

Abstract Background Sedentary behavior is associated with an increased risk of morbidity and mortality. To reduce occupational sitting time of office workers, the multi-component intervention ‘Dynamic Work’ was implemented in a Dutch insurance company. Although the results showed no significant reductions in sitting time, associations were found between higher levels of implementation and reductions in sitting time. Building upon these findings, this qualitative study aimed to identify barriers and facilitators from an organizational perspective for the implementation of Dynamic Work. In addition, we explored differences in barriers and facilitators between departments with a low, middle and high level of implementation. Methods In total, eighteen semi-structured interviews were conducted with two Dynamic Work coordinators, three occupational physiotherapists who delivered the intervention, and thirteen department managers. All participants were purposively sampled. The data was coded in Atlas.ti and a thematic analysis was performed guided by The Integrated Checklist of Determinants (TICD). Results Implementation factors were related to the organization; working culture and financial support facilitated implementation. Factors related to the implementing department mainly hindered implementation, i.e. lack of information at start of the project, late delivery of Dynamic Work equipment, large group sizes, employee’s workload and work tasks, and an ongoing reorganization. The facilitating role of managers was experienced as both enabling and hindering. The pre-existing familiarity of the occupational physiotherapists with the departments and alignment amongst the three implementers facilitated implementation. Yet, the non-obligatory nature of the intervention as well as limited availability and technical problems of equipment did not support implementation. Conclusions Various barriers and facilitators influenced the implementation of the Dynamic Work intervention, where the key role of the department manager, late delivery of dynamic work equipment and groups sizes varied between low and high implementing departments. These results can contribute to developing and improving implementation strategies in order to increase the effectiveness of future occupational health interventions. Trial registration The study protocol was registered on April 14, 2017 in the ClinicalTrials.gov Protocol Registration and Results System under registration number NCT03115645 .

We investigate experiences of misrecognition through comparative focus groups with headscarf-wearing Muslim women students in France (N = 46) and in the Netherlands (N = 32). In both countries, women reported experiencing misrecognition across four interrelated dimensions: (1) totalising misrecognition, having their Muslim identity highlighted at the expense of other group affiliations; (2) membership misrecognition, having their national belonging denied; (3) content misrecognition, having negative characteristics associated with their religious identity, and (4) invisibility, having their voices unheard in society and/or their identities excluded from (public) professions. Participants conceptualised misrecognition as a product of deficient intergroup (Muslims vs. non-Muslims) contact and as being worse in France. French women felt relatively more invisible in the public sphere than their Dutch counterparts and perceived politicians across the political spectrum as an important source of misrecognition. These findings suggest that misrecognition is present in Europe, and potentially worse in France, raising the question about what measures might be taken to counter this form of group-based exclusion.

A spectrophotometric method is demonstrated for refractive index and thickness determination of thin and ultrathin metallic films. The method involves a three-layer stack where the metallic layer of interest is deposited on an opaque Si wafer coated with SiO2. This stack creates oscillations in the reflectance spectrum, which are highly sensitive to the index of the metallic film, allowing precise determination of the index of layers down to 1 nm. Experimental index values are given for Ag and Au over the wavelength range of 370–835 nm. These results are correlated with Atomic force microscopy (AFM) images of the films, which reveal dramatic changes in structure for layers of different thickness.

Introduction Acute mechanical thrombectomy is the preferred treatment for large vessel occlusion related stroke. Histopathological research on the obtained occlusive embolic thrombus may provide information regarding the etiology and pathology of the lesion to predict prognosis and propose possible future acute ischemic stroke therapy. Methods A total of 75 consecutive patients who presented to the Amphia Hospital with acute large vessel occlusion related stroke and underwent mechanical thrombectomy were included in the study. The obtained thrombus materials were subjected to standard histopathological examination. Based on histological criteria they were considered fresh (1 day old). Patients were followed for two years for documentation of all-cause mortality. Results Thrombi were classified as fresh in 40 patients (53%) and as older in 35 patients (47%). Univariate Cox regression analysis showed that thrombus age, National Institutes of Health Stroke Scale at hospital admission and patient age were associated with long-term mortality (p

OBJECTIVES: This study aims to provide insight into (i) how the combination of paid work and family care is longitudinally associated with gender-related differences in depressive symptoms and (ii) the role of work characteristics in this association. METHODS: Data were derived from STREAM, a Dutch prospective cohort study of older workers aged 45–64 years. Respondents were included if they were employed in at least one measurement between 2015 and 2017 (N=12 447). Mixed-models were applied to disentangle between-person (BP) and within-person (WP) effects of family caregiving on depressive symptoms. Analyses were stratified by gender. Work characteristics (social support, autonomy, emotional and mental workload) were separately added to the multivariable models. RESULTS: For older employees, family caregiving was positively associated with depressive symptoms between and within persons for both women [BP B=0.80, 95% confidence interval (CI) 0.52–1.08; WP B=0.32, 95% CI 0.08–0.56] and men (BP B=0.75, 95% CI 0.45–1.05; WP B=0.25, 95% CI 0.01–0.48). Social support at work reduced the adverse effect of family care on depressive symptoms for women (BP) and men (BP and WP). Emotional workload partly explained the effect of family care for both women and men (BP). CONCLUSIONS: The longitudinal association between family care and mental health was similar for male and female employees. Resources at work (ie, social support) could protect caregiving employees against depressive symptoms. More research is needed regarding the relative impact of the care context compared to the work context of working family caregivers.

OBJECTIVES: Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. METHODS: A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. RESULTS: We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.87–1.15] and females (HR 0.95, 95% CI 0.82–1.09). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 15% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.15, 95% CI 0.88–1.49). CONCLUSIONS: While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.