Het klieven van de buigpees bij ulcera van de tenen

Meer dan 25% van alle diabetische voetproblemen wordt veroorzaakt door ulcera. De genezingskans met een conservatief beleid is laag, waarbij ruim tweederde van de ulcera na twintig weken nog niet genezen is. Ondanks dat de recidiefkans en de amputatiekans afnemen bij een multidisciplinaire aanpak van diabetische voetulcera, worden voor beiden nog percentages van boven de 80% gerapporteerd. Meer dan 50% van alle diabetische voetulcera bevindt zich ter hoogte van de tenen. Bij een groot deel hiervan ligt een anatomische standsafwijking (klauw- of hamerteen) aan ten grondsla

Synergistic Effects of Six Chronic Disease Pairs on Decreased Physical Activity: The SMILE Cohort Study

Little is known about whether and how two chronic diseases interact with each other in modifying the risk of physical inactivity. The aim of the present study is to identify chronic disease pairs that are associated with compliance or noncompliance with the Dutch PA guideline recommendation and to study whether specific chronic disease pairs indicate an extra effect on top of the effects of the diseases individually. Cross-sectional data from 3,386 participants of cohort study SMILE were used and logistic regression analysis was performed to study the joint effect of the two diseases of each chronic disease pair for compliance with the Dutch PA guideline. For six chronic disease pairs, patients suffering from both diseases belonging to these disease pairs in question show a higher probability of noncompliance to the Dutch PA guideline, compared to what one would expect based on the effects of each of the two diseases alone. These six chronic disease pairs were chronic respiratory disease and severe back problems; migraine and inflammatory joint disease; chronic respiratory disease and severe kidney disease; chronic respiratory disease and inflammatory joint disease; inflammatory joint disease and rheumatoid arthritis; and rheumatoid arthritis and osteoarthritis of the knees, hips, and hands

Arc Spaces and Rogers-Ramanujan Identities

Arc spaces have been introduced in algebraic geometry as a tool to study singularities but they show strong connections with combinatorics as well. Exploiting these relations we obtain a new approach to the classical Rogers-Ramanujan Identities. The linking object is the Hilbert-Poincar\'e series of the arc space over a point of the base variety. In the case of the double point this is precisely the generating series for the integer partitions without equal or consecutive parts.Comment: 23 pages, introduction rewritten and inaccuracies correcte

Disease Combinations Associated with Physical Activity Identified: The SMILE Cohort Study

In the search of predictors of inadequate physical activity, an investigation was conducted into the association between multimorbidity and physical activity (PA). So far the sum of diseases used as a measure of multimorbidity reveals an inverse association. How specific combinations of chronic diseases are associated with PA remains unclear. The objective of this study is to identify clusters of multimorbidity that are associated with PA. Cross-sectional data of 3,386 patients from the 2003 wave of the Dutch cohort study SMILE were used. Ward's agglomerative hierarchical clustering was executed to establish multimorbidity clusters. Chi-square statistics were used to assess the association between clusters of chronic diseases and PA, measured in compliance with the Dutch PA guideline. The highest rate of PA guideline compliance was found in patients the majority of whom suffer from liver disease, back problems, rheumatoid arthritis, osteoarthritis, and inflammatory joint disease (62.4%). The lowest rate of PA guideline compliance was reported in patients with heart disease, respiratory disease, and diabetes mellitus (55.8%). Within the group of people with multimorbidity, those suffering from heart disease, respiratory disease, and/or diabetes mellitus may constitute a priority population as PA has proven to be effective in the prevention and cure of all three disorders

The safety of physically separated cycle tracks compared to marked cycle lanes and mixed traffic conditions in Amsterdam

Bicycle infrastructure is utilised to improve cycling safety and encourage bicycle use as a sustainable and healthy transport mode. This study sets out to assess whether providing physically separated cycle tracks along distributor roads, as prescribed in Dutch design guidelines and the Sustainable Safety vision, yields the expected safety benefits for cyclists. Therefore the safety of physically separated cycle tracks is compared to marked or painted cycle lanes and to mixed traffic conditions at distributor roads with a speed limit of 50 km/h in Amsterdam in the Netherlands. The study also includes the presence of the risk factors curbside parking and trams. Since police records are known to underreport single bicycle crashes and other crashes without a motor vehicle involved, ambulance records are used in this study instead. Also, both motor vehicle volumes as well as cyclists counts are taken into account in the crash analysis. By doing so, this study aims to address two weaknesses of previous research, i.e. the lack of control for exposure of cyclists and the use of police recorded crashes which miss the majority of bicycle crashes without motor vehicles.  Results show that, controlled for kilometres travelled by bicycle and by motor vehicle, 50-60% less bicycle crashes occur on distributor roads with cycle tracks compared to those with cycle lanes. Curbside parking and trams are related to an increased likelihood of bicycle crashes, a difference of a factor 2 and 1.7-2 respectively. The authors therefore recommend to favour physically separated cycle tracks over cycle lanes and to take out curbside parking from the cross section as this presents the possibility to introduce cycle tracks in existing cross sections and mitigate an important risk factor concurrently