Centralization of pediatric surgical care in the Netherlands:Lessons learned

Centralization of care is a difficult process, as there are several stakeholders that are involved and should be heard. What can be the best option for a small group of patients may be detrimental to a larger group of patients that cannot be adequately treated close to home. The weighing of these factors is different in every environment. One universal rule however is: if you don't do it yourselves, others will do it for you. In the Netherlands, pediatric oncology, including surgery, is centralized in one center (Utrecht) with the help of several shared care centers scattered throughout the country for things that can be managed close to home. (c) 2021 Elsevier Inc. All rights reserved

Comparison of segmentation software packages for in-hospital 3D print workflow

Purpose: In-hospital three-dimensional (3D) printing of patient-specific pathologies is increasingly being used in daily care. However, the efficiency of the current conversion from image to print is often obstructed due to limitations associated with segmentation software. Therefore, there is a need for comparison of several clinically available tools. A comparative study has been conducted to compare segmentation performance of Philips IntelliSpace Portal(®) (PISP), Mimics Innovation Suite (MIS), and DICOM to PRINT(®) (D2P). Approach: These tools were compared with respect to segmentation time and 3D mesh quality. The dataset consisted of three computed tomography (CT)-scans of acetabular fractures (ACs), three CT-scans of tibia plateau fractures (TPs), and three CTA-scans of abdominal aortic aneurysms (AAAs). Independent-samples [Formula: see text]-tests were performed to compare the measured segmentation times. Furthermore, 3D mesh quality was assessed and compared according to representativeness and usability for the surgeon. Results: Statistically significant differences in segmentation time were found between PISP and MIS with respect to the segmentation of ACs ([Formula: see text]) and AAAs ([Formula: see text]). Furthermore, statistically significant differences in segmentation time were found between PISP and D2P for segmentations of AAAs ([Formula: see text]). There were no statistically significant differences in segmentation time for TPs. The accumulated mesh quality scores were highest for segmentations performed in MIS, followed by D2P. Conclusion: Based on segmentation time and mesh quality, MIS and D2P are capable of enhancing the in-hospital 3D print workflow. However, they should be integrated with the picture archiving and communication system to truly improve the workflow. In addition, these software packages are not open source and additional costs must be incurred

Who Sets the Aggressive Popularity Norm in Classrooms? It's the Number and Strength of Aggressive, Prosocial, and Bi-Strategic Adolescents

Previous work has shown that during adolescence, classrooms vary greatly in the extent to which aggression is rewarded with popularity (the ‘popularity norm’). Aggressive popularity norms may promote the proliferation of aggression and negatively affect the classroom climate. It is, however, unknown how these norms emerge in the first place. This longitudinal study therefore investigated whether aggressive popularity norms can be predicted by the classroom composition of students. We examined whether the prevalence of six student types - socially and non-socially dominant prosocial, aggressive, and bi-strategic adolescents (adolescents who are both highly prosocial and aggressive) - contributed to the norm by establishing a popularity hierarchy: strong classroom asymmetries in popularity. We collected peer-nominated data at three secondary schools in the Netherlands (SNARE-study; Nstudents = 2843; Nclassrooms = 120; 51.4% girls; Mage = 13.2). Classroom-level regression analyses suggest that the classroom percentage of socially dominant aggressive and bi-strategic students predicted higher aggressive popularity norms, both directly and by enhancing the classrooms’ popularity hierarchy. Instead, the presence of non-socially dominant aggressive students and socially dominant prosocial students contributed to lower aggressive popularity norms. Socially dominant prosocial students also buffered against the role of socially dominant aggressive adolescents in the aggressive popularity norm (moderation), but not against bi-strategic adolescents’ role. Our findings indicate that interventions aimed at reducing aggressive popularity norms should first and foremost take the composition of classrooms at the start of the school year into account; and should not only encourage prosocial behavior, but also actively discourage aggression

Archeologische prospectie met ingreep in de bodem Mechelen-Spuibeekstraat

Dit rapport werd ingediend bij het agentschap samen met een aantal afzonderlijke digitale bijlagen. Een aantal van deze bijlagen zijn niet inbegrepen in dit pdf document en zijn niet online beschikbaar. Sommige bijlagen (grondplannen, fotos, spoorbeschrijvingen, enz.) kunnen van belang zijn voor een betere lezing en interpretatie van dit rapport. Indien u deze bijlagen wenst te raadplegen kan u daarvoor contact opnemen met: [email protected]