Biomechanical mechanisms underlying treatment effects of exercise therapy in patients with knee osteoarthritis: data from a randomized controlled trial

The aim of this paper is to briefly show the importance of the spatial organisation and of the temporal evolution of road transport in Belgium (freight, passengers). Attention is particularly put on the negative externalities produced by this transportation mode type (pollution, road damages, road accidents).L'objectif de cet article est de montrer brièvement l'importance de l'organisation spatiale et de l'évolution temporelle du transport routier de marchandises et de passagers en Belgique. Une attention particulière est portée aux externalités négatives produites par ce mode de transport (pollution, dégradations routières, accidents de la route).Het opzet van deze bijdrage bestaat erin om op een beknopte wijze het belang aan te tonen van de ruimtelijke organisatie en evolutie doorheen de tijd van het wegtransport in België (perso-nen zowel als vracht). Er is ook aandacht besteed aan negatieve externaliteiten veroorzaakt door dit type van transportmodus.Thomas Isabelle, Verhetsel Ann. Transport routier et mobilité durable : un état de la question pour la Belgique. In: Hommes et Terres du Nord, 1999/3. La Belgique. pp. 198-204

Definitiestudie afwegingskader : naar een klimaatbestendig Nederland : definitiestudie Fase 1, kaders voor afweging

Onzekerheid over (omvang en tempo van) de gevolgen van klimaatverandering vormt een essentieel punt bij beslissingen over de ruimtelijke inrichting. De mate waarin en de snelheid waarmee veranderingen optreden zijn niet precies bekend. Een afwegingskader geeft de overheid en de planontwikkelaar instrumenten in handen om de risico’s, de kansen, de kosten en de baten van klimaatadaptatie op verschillende onderscheiden thema’s inzichtelijk te maken. Afwegen: hoe doe je dat. Daarvoor wordt in drie stappen een kader voor gegeven

SUPPLEMENTARY TOOLS TO MEASURE AND UNDERSTAND THE FLOW IN THE CONTINUOUS CASTING MOULD

For the production of clean steel it is important to control the flow in the mould. A lot of modelling workhas already been done to study the flow behaviour in the mould. Measurements in the continuous castingmould are necessary to validate the modelling work, especially when multiphase flow is studied or whenelectromagnetic flow control systems are incorporated. For a few years, two measuring principles have beenused to study the flow behaviour at the meniscus in the mould at Corus IJmuiden No.2 BOS. The mainmethod is a simple flow measuring device, which consists of a refractory tube sealed at the bottom and fixedat a pivoting point at the top. The tube is submerged in the liquid steel in the mould. Measuring the resultinginclination angle reveals the flow direction and gives a measure of the velocity. In this way the effect of castingparameters on flow behaviour can be studied, such as the effect of the submersion depth of the SEN, the Arflowon the shrouding system (between the tundish and mould) and the change from double roll to single rollflow in the mould. Also, measurements are done with the ‘nail board’ method giving a snapshot of the flowdirection at multiple locations in the meniscus. An electromagnetic sensor was used to measure the multiphaseflow condition in the SEN. In this paper results of these measurements are shown and examples are comparedwith CFD calculations. A better understanding of the effect of casting parameters on the flow pattern in themould was obtained using these supplementary tools

The association between reduced knee joint proprioception and medial meniscal abnormalities using MRI in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort.

BACKGROUND: Osteoarthritis (OA) of the knee is characterized by pain and activity limitations. In knee OA, proprioceptive accuracy is reduced and might be associated with pain and activity limitations. Although causes of reduced proprioceptive accuracy are divergent, medial meniscal abnormalities, which are highly prevalent in knee OA, have been suggested to play an important role. No study has focussed on the association between proprioceptive accuracy and meniscal abnormalities in knee OA. OBJECTIVE: To explore the association between reduced proprioceptive accuracy and medial meniscal abnormalities in a clinical sample of knee OA subjects. METHODS: Cross-sectional study in 105 subjects with knee OA. Knee proprioceptive accuracy was assessed by determining the joint motion detection threshold in the knee extension direction. The knee was imaged with a 3.0 T magnetic resonance (MR) scanner. Number of regions with medial meniscal abnormalities and the extent of abnormality in the anterior and posterior horn and body were scored according to the Boston-Leeds Osteoarthritis Knee Score (BLOKS) method. Multiple regression analyzes were used to examine whether reduced proprioceptive accuracy was associated with medial meniscal abnormalities in knee OA subjects. RESULTS: Mean proprioceptive accuracy was 2.9degree + 1.9degree. Magnetic resonance imaging (MRI)-detected medial meniscal abnormalities were found in the anterior horn (78%), body (80%) and posterior horn (90%). Reduced proprioceptive accuracy was associated with both the number of regions with meniscal abnormalities (P < 0.01) and the extent of abnormality (P = 0.02). These associations were not confounded by muscle strength, joint laxity, pain, age, gender, body mass index (BMI) and duration of knee complaints. CONCLUSION: This is the first study showing that reduced proprioceptive accuracy is associated with medial meniscal abnormalities in knee OA. The study highlights the importance of meniscal abnormalities in understanding reduced proprioceptive accuracy in persons with knee OA. Copyright 2013 Osteoarthritis Research Society International. All rights reserve

Personalized versus standard cognitive behavioral therapy for fear of cancer recurrence, depressive symptoms or cancer-related fatigue in cancer survivors:Study protocol of a randomized controlled trial (MAtCH-study)

© 2021, The Author(s).Background: Fear of cancer recurrence, depressive symptoms, and cancer-related fatigue are prevalent symptoms among cancer survivors, adversely affecting patients’ quality of life and daily functioning. Effect sizes of interventions targeting these symptoms are mostly small to medium. Personalizing treatment is assumed to improve efficacy. However, thus far the empirical support for this approach is lacking. The aim of this study is to investigate if systematically personalized cognitive behavioral therapy is more efficacious than standard cognitive behavioral therapy in cancer survivors with moderate to severe fear of cancer recurrence, depressive symptoms, and/or cancer-related fatigue. Methods: The study is designed as a non-blinded, multicenter randomized controlled trial with two treatment arms (ratio 1:1): (a) systematically personalized cognitive behavioral therapy and (b) standard cognitive behavioral therapy. In the standard treatment arm, patients receive an evidence-based diagnosis-specific treatment protocol for fear of cancer recurrence, depressive symptoms, or cancer-related fatigue. In the second arm, treatment is personalized on four dimensions: (a) the allocation of treatment modules based on ecological momentary assessments, (b) treatment delivery, (c) patients’ needs regarding the symptom for which they want to receive treatment, and (d) treatment duration. In total, 190 cancer survivors who experience one or more of the targeted symptoms and ended their medical treatment with curative intent at least 6 months to a maximum of 5 years ago will be included. Primary outcome is limitations in daily functioning. Secondary outcomes are level of fear of cancer recurrence, depressive symptoms, fatigue severity, quality of life, goal attainment, therapist time, and drop-out rates. Participants are assessed at baseline (T0), and after 6 months (T1) and 12 months (T2). Discussion: To our knowledge, this is the first randomized controlled trial comparing the efficacy of personalized cognitive behavioral therapy to standard cognitive behavioral therapy in cancer survivors. The study has several innovative characteristics, among which is the personalization of interventions on several dimensions. If proven effective, the results of this study provide a first step in developing an evidence-based framework for personalizing therapies in a systematic and replicable way. Trial registration: The Dutch Trial Register (NTR) NL7481 (NTR7723). Registered on 24 January 2019