Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases:a nationwide population-based propensity score-matched study

Background: In colorectal liver metastases (CRLM) patients, combination of liver resection and ablation permit a more parenchymal-sparing approach. This study assessed trends in use of combined resection and ablation, outcomes, and overall survival (OS). Methods: This population-based study included all CRLM patients who underwent liver resection between 2014 and 2022. To assess OS, data was linked to two databases containing date of death for patients treated between 2014 and 2018. Hospital variation in the use of combined minor liver resection and ablation versus major liver resection alone in patients with 2–3 CRLM and ≤3 cm was assessed. Propensity score matching (PSM) was applied to evaluate outcomes. Results: This study included 3593 patients, of whom 1336 (37.2%) underwent combined resection and ablation. Combined resection increased from 31.7% in 2014 to 47.9% in 2022. Significant hospital variation (range 5.9–53.8%) was observed in the use of combined minor liver resection and ablation. PSM resulted in 1005 patients in each group. Major morbidity was not different (11.6% vs. 5%, P = 1.00). Liver failure occurred less often after combined resection and ablation (1.9% vs. 0.6%, P = 0.017). Five-year OS rates were not different (39.3% vs. 33.9%, P = 0.145). Conclusion: Combined resection and ablation should be available and considered as an alternative to resection alone in any patient with multiple metastases.</p

The impact of teachers’ self-efficacy and classroom externalising problem behaviours on emotional exhaustion:Between- and within-person associations

Teaching can be a challenging profession, which puts teachers at high risk for developing burnout symptoms, such as emotional exhaustion. In this study we aim to investigate the interplay between classroom externalising problem behaviours (as a job demand), teachers’ self-efficacy (as a job resource) and emotional exhaustion over a school year. Conducting three measurements during a school year among 103 Dutch primary education teachers, we examine the sensitivity for, and the individual development of, emotional exhaustion. Findings show that emotional exhaustion, classroom externalising problem behaviours, and teachers’ self-efficacy are stable constructs in teachers. Traditional (between-person) cross-lagged panel models indicate that teachers with low levels of self-efficacy are more likely to develop emotional exhaustion during the school year, compared to their colleagues. We found no evidence that teachers confronted with classroom externalising problem behaviours were more likely to develop emotional exhaustion. Random intercept (within-person) cross-lagged panel models indicate that teachers with high levels of classroom externalising problem behaviours do not show increased emotional exhaustion at a later time point. For self-efficacy and emotional exhaustion, we could not estimate the within-person model due to limited variance in the variables. Implications of these findings and suggestions for further research were discussed.</p

The Effects of COVID-19 Policies on Consumer Spending in Norway

We examine the effect of COVID-19 policies on consumer spending using bankcard transactions from Norway. Exploiting variation in COVID-19 policies over time and across space in the four largest municipalities, we investigate the heterogeneity of policy effects in their number and type. First, we document that the number of restrictions is negatively correlated with spending and exhibits decreasing marginal effects. Second, restrictions do not affect all types of spending equally: restrictions tend to have larger impacts on the sector in which they are targeted. Finally, we find suggestive evidence from a difference-in-differences estimation that supports a causal interpretation of our results.</p

Impact of left ventricular ejection fraction on 10-year mortality in the SYNTAX trial

Backgrounds: The impact of reduced left ventricular ejection fraction (LVEF) on very long-term prognosis following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) has been debated. The aim of this study was to investigate the impact of LVEF at baseline on 10-year mortality in the SYNTAX trial. Methods: Patients (n = 1800) were categorized into three sub-groups: reduced (rEF ≤ 40 %), mildly reduced (mrEF 41–49 %), and preserved LVEF (pEF ≥ 50 %). The SYNTAX score 2020 (SS-2020) was applied in patients with LVEF&lt;50 % and ≥ 50 %. Results: Ten-year mortalities were 44.0 %, 31.8 %, and 22.6 % (P &lt; 0.001) in patients with rEF (n = 168), mrEF (n = 179), and pEF (n = 1453). Although no significant differences were observed, the mortality with PCI was higher than with CABG in patients with rEF (52.9 % vs 39.6 %, P = 0.054) and mrEF (36.0 % vs. 28.6 %, P = 0.273), and comparable in pEF (23.9 % vs. 22.2 %, P = 0.275). Calibration and discrimination of the SS-2020 in patients with LVEF&lt;50 % were poor, whilst they were reasonable in those with LVEF≥50 %. The proportion of patients eligible for PCI who had a predicted equipoise in mortality with CABG was estimated to be 57.5 % in patients with LVEF≥50 %. CABG was safer than PCI in 62.2 % of patients with LVEF&lt;50 %. Conclusions: Reduced LVEF was associated with an increased risk of 10-year mortality in patients revascularized either surgically or percutaneously. Compared to PCI, CABG was safe revascularization in patients with LVEF≤40 %. In patients with LVEF≥50 % individualized 10-year all-cause mortality predicted by SS-2020 was helpful in decision-making whilst the predictivity in patients with LVEF&lt;50 % was poor.</p

’We have nothing to hide’:Legitimacy narratives, researcher positionality and the ethics of accessing the Dutch deportation apparatus

This article presents a reflection on the contentious access negotiations involved in researching the Dutch deportation apparatus. Previous studies described how hostility towards researchers and the opacity within migration control regimes more generally lead to difficulties for conducting academic research. This article instead relies on a self-reflexive account of two successful access negotiations to question what acquiring access tells us about the workings of migration control, and what consequences entering into a relationship with powerful actors has for academic knowledge production. I argue that granting access as such serves an important function for the deportation apparatus, as it helps to legitimise state power and assert their moral authority. By selectively facilitating access and enabling scrutiny by researchers, journalists and the wider public, I argue that the deportation apparatus strategically performs transparency and “voluntary accountability.

Kroniek van het Europees strafrecht

Waar de vorige kroniek van het Europees strafrecht (voorjaar 2020) nog kon aanvangen met de constatering dat er in de jaren daarvoor niet veel nieuwe Europese wetgeving tot stand was gekomen, zijn de kaarten heel anders geschud voor de periode waarop deze kroniek ziet. In deze periode is niet alleen behoorlijk veel nieuwe wetgeving tot stand gekomen, er is ook een fors aantal wetsvoorstellen ingediend. De ontwikkelingen betreffen voornamelijk het materiële strafrecht (milieucriminaliteit, corruptie), waarbij ook sprake is van een uitbreiding van bevoegdheden (deze omvat nu ook de overtreding van EU-sancties). Daarnaast is er nieuwe wetgeving (in de maak) voor de samenwerking in strafzaken (e-evidence, overdracht van strafvervolging). Het belangrijkste verschil met het moment waarop de vorige kroniek verscheen is misschien wel dat inmiddels goed zichtbaar is dat de ontwikkeling van het Nederlandse strafrecht en strafprocesrecht voor een steeds belangrijker deel plaatsvindt op EU-niveau

A vehicle routing problem with multiple service agreements

We consider a logistics service provider which arranges transportation services to customers with different service agreements. The most prominent feature of this service agreement is the time period in which these customers send their orders and want to retrieve delivery information. After customers place their orders, they require information about the driver and an early indication of the arrival times. At the moment, this information needs to be provided. The order information of other customers with a different service agreement that needs to be serviced in the same period might still be unknown. Ultimately all customers have to be planned, constrained by the information provided to the customers in the earlier stage. In this paper, we investigate how the logistic service provider plans its routes and communicates the driver and arrival time information in the phase where not all customers are known (stage 1). Once all customer orders are known (stage 2), the final routes can be determined, which adhere to the already communicated driver and arrival time information from stage 1, minimizing total routing cost. For this problem, an exact algorithm is presented. This problem is solved using a novel tractable branch-and-bound method and re-optimization in stage 2. Detailed results are presented, showing the improvements of using re-optimization. We show that integrating the planning of the customers with the different service agreements leads to significant cost savings compared to treating the customers separately (as is currently done by most logistics service providers).</p

Robin Sequence:Clinical implications and functional outcomes following (non-) surgical management

Robin Sequence (RS) is a congenital craniofacial abnormality characterized by mandibular hypoplasia, glossoptosis, and varying degrees of upper airway obstruction. The interaction between the various etiological causes, the great variability in clinical expression, and the lack of a uniform definition continuously pose challenges to clinicians. The aim of this thesis is to gain another step towards a better understanding of this complex and challenging condition by focusing on the clinical characteristics and functional outcomes regarding airway, feeding, swallowing, and growth in patients with RS. In this way, we attempt to add valuable information to the current knowledge of RS and therefore contribute to an improved quality of care for these patients