Spatial Scenarios and the Lisbon Strategy

The European Union is changing significantly. It has recently been enlarged by 10 new Member States, decision-making about the European Constitution is going on, and it has set itself the target of becoming the most competitive economy in the world (Lisbon Strategy). The scenarios explore in an integrated way the territorial impacts of future changes in the economy, transport, rural development, environment, and other policy fields. They do not only concentrate on the territorial impacts of the trends and driving forces but also of the relevant EU Policies. The scenarios throw a light on the effectiveness of EU Policies and the synergies as well as conflicts they generate. By doing this they provide important insights in the conditions under which these trends, driving forces and policies will favour a balanced and polycentric territory and territorial cohesion within the enlarging European Union. These insights are relevant for recommendations on possible adjustments and/or changes of EU Policies.

Spatial Scenarios and the Lisbon Strategy

The European Union is changing significantly. It has recently been enlarged by 10 new Member States, decision-making about the European Constitution is going on, and it has set itself the target of becoming the most competitive economy in the world (Lisbon Strategy). The scenarios explore in an integrated way the territorial impacts of future changes in the economy, transport, rural development, environment, and other policy fields. They do not only concentrate on the territorial impacts of the trends and driving forces but also of the relevant EU Policies. The scenarios throw a light on the effectiveness of EU Policies and the synergies as well as conflicts they generate. By doing this they provide important insights in the conditions under which these trends, driving forces and policies will favour a balanced and polycentric territory and territorial cohesion within the enlarging European Union. These insights are relevant for recommendations on possible adjustments and/or changes of EU Policies

Vergelijking tussen Limousin x FH-kruislingen en FH- en MRIJ-stieren = Comparison between Limousin x Dutch Friesian crossbreds and Dutch Friesian and Meuse-Rhine-IJssel bulls

Op de proefboerderij De Vlierd en op het proefbedrijf van Wessanen BV te Wormerveer zijn een tweetal proeven uitgevoerd. Hierin zijn kalveren van kruisingsprodukten van Limousin x Fries-Hollands ( Li x FH) en van de Nederlandse rassen FH en MRIJ vergeleke

Scenario-ontwikkeling voor het natuurbeleid

De Natuurverkenning 2010-2040 is als scenariostudie uitgevoerd om te verkennen welke richtingen het natuurbeleid op termijn zou kunnen inslaan. Via de scenario-onderdelen worden beleidsmakers stap voor stap in het langetermijndenken meegenomen. Dit wordt versterkt doordat de onderdelen het karakter van kwalitatieve verhalen hebben gekregen, die bovendien toegankelijk zijn verbeeld en op onderdelen kwantitatief zijn uitgewerkt. Doordat beleidsmakers zelf in de verkenning hebben geparticipeerd is hun ontvankelijkheid ervoor vergroot. Over: natuurverkenning, scenariomethode, normatieve scenario's en stakeholderparticipati

Currarino's triad diagnosed in an adult woman.

_Purpose_ To report on a female patient diagnosed with Currarino's triad in adulthood. _Case report_ This case presents an adult patient with a medical history of a congenital anal atresia, a partial sacral agenesis, and a surgically treated ectopic anus. After a coincidentally observed presacral mass by MRI, due to unexplained constipation later in adulthood, Currarino's triad was suspected in this patient. This triad consists of anorectal malformation(s), sacrococcygeal defects and a presacral mass of various origin. Further investigation confirmed the mass to be a meningocele, and showed a tethered cord and a syrinx. _Conclusions_ In (young) patients with anorectal malformations, although having no other symptoms, further examination might be required to exclude Currarino's triad. Importance of early diagnosis and multidisciplinary assessment is recommended to establish adequate treatment if needed

Evaluation of an innovative evidence-guided PBL approach

AIM: To understand the experiences of students and problem-based learning (PBL) facilitators during an evidence-based curriculum change to a PBL programme within an undergraduate medical course in South West England. METHODS: Four novel PBL cases were designed and implemented, based on educational theory and evidence. Eight focus groups were undertaken with Year-1 and -2 students (n = 18) and PBL facilitators (n = 14) to explore the experiences of participants. Thematic analysis and conceptual abstraction led to insights into the intended and unintended consequences of the change. RESULTS: Participant responses to the change process were influenced by the perceived relevance and value of the change (e.g. benefit to student learning), which was shaped by individual beliefs and preferences (e.g. presumed purpose of PBL, relative value placed on different curriculum topics, and desire for uniform educational experience), and the wider education context (e.g. expectations of assessment). It appears that the three distinct elements must align for the changes to be received positively. We updated our PBL curriculum in response to new evidence DISCUSSION: This study describes how we updated our PBL curriculum in response to new evidence, and demonstrates the importance of communicating the pedagogic rationale behind changes, and meticulous planning, preparation and alignment, even in distant parts of the curriculum. Engaging with existing views and attitudes is an essential requirement for successful curriculum change

Fluid-structure interaction in blood flow capturing non-zero longitudinal structure displacement

We present a new model and a novel loosely coupled partitioned numerical scheme modeling fluid-structure interaction (FSI) in blood flow allowing non-zero longitudinal displacement. Arterial walls are modeled by a {linearly viscoelastic, cylindrical Koiter shell model capturing both radial and longitudinal displacement}. Fluid flow is modeled by the Navier-Stokes equations for an incompressible, viscous fluid. The two are fully coupled via kinematic and dynamic coupling conditions. Our numerical scheme is based on a new modified Lie operator splitting that decouples the fluid and structure sub-problems in a way that leads to a loosely coupled scheme which is {unconditionally} stable. This was achieved by a clever use of the kinematic coupling condition at the fluid and structure sub-problems, leading to an implicit coupling between the fluid and structure velocities. The proposed scheme is a modification of the recently introduced "kinematically coupled scheme" for which the newly proposed modified Lie splitting significantly increases the accuracy. The performance and accuracy of the scheme were studied on a couple of instructive examples including a comparison with a monolithic scheme. It was shown that the accuracy of our scheme was comparable to that of the monolithic scheme, while our scheme retains all the main advantages of partitioned schemes, such as modularity, simple implementation, and low computational costs

Contemporary frameless intracranial biopsy techniques: Might variation in safety and efficacy be expected?

Background: Frameless stereotactic neuronavigation has proven to be a feasible technology to acquire brain biopsies with good accuracy and little morbidity and mortality. New systems are constantly i

Beleidsboodschappen Natuurverkenning 2010-2040

Het natuurbeleid bevindt zich in een overgangsfase. Zowel rijk als provincies, maatschappelijke organisaties en het bedrijfsleven zijn op zoek naar verbetering van het bestaande natuurbeleid en hun positie daarbinnen. Het gaat daarbij niet alleen om natuurbeleid in de strikte zin, maar onder meer ook om het landschaps-, ruimtelijk, energie- en voedselbeleid. Dit artikel draagt bouwstenen voor die zoektocht aan op basis van vier kijkrichtingen die zijn ontwikkeld in de Natuurverkenning 2010-2040

Enhancement of drug oxidation and conjugation by carcinogens in different rat tissues

OBJECTIVE After endoscopic third ventriculostomy (ETV), some patients develop recurrent symptoms of hydrocephalus. The optimal treatment for these patients is not clear: repeat ETV (re-ETV) or CSF shunting. The goals of the study were to assess the effectiveness of re-ETV relative to initial ETV in pediatric patients and validate the ETV success score (ETVSS) for re-ETV. METHODS Retrospective data of 624 ETV and 93 re-ETV procedures were collected from 6 neurosurgical centers in the Netherlands (1998-2015). Multivariable Cox proportional hazards modeling was used to provide an adjusted estimate of the hazard ratio for re-ETV failure relative to ETV failure. The correlation coefficient between ETVSS and the chance of re-ETV success was calculated using Kendall's tau coefficient. Model discrimination was quantified using the c-statistic. The effects of intraoperative findings and management on re-ETV success were also analyzed. RESULTS The hazard ratio for re-ETV failure relative to ETV failure was 1.23 (95% CI 0.90-1.69; p = 0.20). At 6 months, the success rates for both ETV and re-ETV were 68%. ETVSS was significantly related to the chances of re-ETV success (tau = 0.37; 95% bias corrected and accelerated CI 0.21-0.52; p < 0.001). The c-statistic was 0.74 (95% CI 0.64-0.85). The presence of prepontine arachnoid membranes and use of an external ventricular drain (EVD) were negatively associated with treatment success, with ORs of 4.0 (95% CI 1.5-10.5) and 9.7 (95% CI 3.4-27.8), respectively. CONCLUSIONS Re-ETV seems to be as safe and effective as initial ETV. ETVSS adequately predicts the chance of successful re-ETV. The presence of prepontine arachnoid membranes and the use of EVD negatively influence the chance of success