Organ donation for transplantation:a clinical study with emphasis on liver donation

The central theme of this thesis was the continuing organ shortage. Several factors have been held responsible for this shortage, including refusal of permission for organ donation by the next-of-kin, insufficient recognition of potential organ donors by the medical staff, and -unjustified- discard of donors by transplant teams either due to logistic reasons or because of medical reasons. Apart from the logistic reasons, we have explored these different causes for organ shortage. With respect to the problem of medical discard we have focused on the liver, because transplantation of a viable liver graft is an important prereguisite for patient survival due to the lack of extracorporeal liver support. In this chapter we will summarize and discuss the findings of the studies in the previous chapters. Finally, recommendations for the future are given. ... Zie: Summar

Reduction of artefacts caused by hip implants in CT-based attenuation-corrected PET images using 2-D interpolation of a virtual sinogram on an irregular grid

Purpose: Metallic prosthetic replacements, such as hip or knee implants, are known to cause strong streaking artefacts in CT images. These artefacts likely induce over- or underestimation of the activity concentration near the metallic implants when applying CT-based attenuation correction of positron emission tomography (PET) images. Since this degrades the diagnostic quality of the images, metal artefact reduction (MAR) prior to attenuation correction is required. Methods: The proposed MAR method, referred to as virtual sinogram-based technique, replaces the projection bins of the sinogram that are influenced by metallic implants by a 2-D Clough-Tocher cubic interpolation scheme performed in an irregular grid, called Delaunay triangulated grid. To assess the performance of the proposed method, a physical phantom and 30 clinical PET/CT studies including hip prostheses were used. The results were compared to the method implemented on the Siemens Biograph mCT PET/CT scanner. Results: Both phantom and clinical studies revealed that the proposed method performs equally well as the Siemens MAR method in the regions corresponding to bright streaking artefacts and the artefact-free regions. However, in regions corresponding to dark streaking artefacts, the Siemens method does not seem to appropriately correct the tracer uptake while the proposed method consistently increased the uptake in the underestimated regions, thus bringing it to the expected level. This observation is corroborated by the experimental phantom study which demonstrates that the proposed method approaches the true activity concentration more closely. Conclusion: The proposed MAR method allows more accurate CT-based attenuation correction of PET images and prevents misinterpretation of tracer uptake, which might be biased owing to the propagation of bright and dark streaking artefacts from CT images to the PET data following the attenuation correction procedur

Entrustable Professional Activities in Residency Programs – planning and scheduling issues

[EN] Residency programs allow residents, i.e., graduate physicians, to qualify for being a specialist in one of the medical disciplines. Their educational programme is strongly focusing on competencies and skills, but will incur a major change in the near future in order to introduce Entrustable Professional Activities (EPA’s). EPA’s focus on actual physician tasks and are assessed by supervisors in the clinic. The trust levels indicate whether trainees are ready for the next milestone, such as unsupervised practice, based on assessment of performance of those activities. EPA’s have not only effect on the internships and the assessment process, but also impact the planning and scheduling of the educational programmes, internships, patient care services, and co-operation between regional hospitals. This study examines the effect on the planning and scheduling process and proposes a framework for planning and scheduling in order to facilitate the organization of this type of educational programs. The main improvements have to be found in an improved regional coordination between the hospitals, a more leading role for the educational programme directors, and more intelligent planning and scheduling.Riezebos, J.; Van Der Zee, DJ.; Pruim, J. (2019). Entrustable Professional Activities in Residency Programs – planning and scheduling issues. En HEAD'19. 5th International Conference on Higher Education Advances. Editorial Universitat Politècnica de València. 891-899. https://doi.org/10.4995/HEAD19.2019.9274OCS89189

Goalkeeper in het basisonderwijs:een methode gericht op het ontwikkelen van zelfregulatieve vaardigheden binnen een les bewegingsonderwijs

​De lesmethode Goalkeeper stimuleert de ontwikkeling van zelfregulatieve vaardigheden bij leerlingen in het onderwijs. Zelfregulatie is een belangrijke ‘21st century skill’: het omvat vaardigheden zoals een doel stellen, plannen, monitoren, evalueren en reflecteren, die van belang zijn voor succes in diversie domeinen, zoals sport en leefstijl, maar ook in onderwijs en werk. ​Zelfregulatie is één van de centrale 21e -eeuwse vaardigheden in het curriculum van de toekomst. (SLO, 2014)  Het ontwikkelen van zelfregulatie vraagt echter om een andere lesinhoud en didactiek. De lesinhoud moet meer mogelijkheden bieden tot het maken van keuzes door de leerlingen. De didactiek moet meer ondersteunend zijn voor het aanleren van zelfregulatieve vaardigheden. De sportcontext is erg geschikt om zelfregulatie te ontwikkelen, omdat leerlingen hierin op korte termijn meetbare en concrete doelen kunnen stellen waar ze naartoe kunnen werken. Goalkeeper is een interventie die leerlingen o.a. in gymles en op het schoolplein de mogelijkheid biedt om zelfregulatievaardigheden te ontwikkelen en deze vervolgens toe te passen in het domein leefstijl

An EANM position paper on the application of artificial intelligence in nuclear medicine.

peer reviewedArtificial intelligence (AI) is coming into the field of nuclear medicine, and it is likely here to stay. As a society, EANM can and must play a central role in the use of AI in nuclear medicine. In this position paper, the EANM explains the preconditions for the implementation of AI in NM and takes position