The relational geometry of the port-city interface : case studies of Amsterdam, the Netherlands, and Ghent, Belgium

The aim of this paper is to operationalize a relational approach to the study of port-city interfaces. A relational approach allows for the analysis of how actors are connected, transact, and assign meaning and value to regional development. Much of the literature on port-city interfaces has primarily focussed on late 20th century transformation processes at the urban waterfront. This fails to appreciate the often-continued presence of port activity within cities and falls short in understanding how the development agendas of port cities are relationally constituted. In this paper, first we argue that the port-city interface is a relational geometry through which heterogeneous flows of actors, assets, and structures are coupled. Second, we present an analytical framework capable of operationalizing such relational approach. The contemporary relational geometries in the bio-based sectors within the port cities of Amsterdam and Ghent are taken as starting points. Analysing these reveal how different coupling mechanisms result in particular development trajectories of the port city, setting the scene for future coupling mechanisms. This paper concludes with a discussion on the value of a relational approach to the study of port-city interfaces

Variability in hospital costs of adult spinal deformity care

Objective: To calculate the total clinical hospital cost of the Adult Spinal Deformity (ASD) care trajectory, to explain cost variability by patient and surgery characteristics, and to identify areas of process improvement opportunities. Summary of background data: ASD is associated with a high financial and clinical burden on society. ASD care thus requires improved insights in costs and its drivers as a critical step toward the improvement of value, i.e., the ratio between delivered health outcome and associated costs. Methods: Patient characteristics and surgical variables were collected following ethical approval in a cohort of 139 ASD patients, treated between December, 2014 and January, 2018. Clinical hospital costs were calculated, including all care activities, from initial consultation to 1 year after initial surgery (excl. overhead) in a university hospital setting. Multiple linear regression analysis was performed to analyze the impact of patient and surgical characteristics on clinical costs. Results: 75.5% of the total clinical hospital cost (€27,865) was incurred during initial surgery with costs related to the operating theatre (80.3%), nursing units (11.9%), and intensive care (2.9%) being the largest contributors. 57.5% of the variation in total cost could be explained in order of importance by surgical invasiveness, age, coronary disease, single or multiple-staged surgery, and mobility status. Revision surgery, unplanned surgery due to complications, was found to increase average costs by 87.6% compared with elective surgeries (€ 44,907 (± € 23,429) vs. € 23,944 (± € 7302)). Conclusion: This study identified opportunities for process improvement by calculating the total clinical hospital costs. In addition, it identified patient and treatment characteristics that predict 57.5% of cost variation, which could be taken into account when developing a payment system. Future research should include outcome data to assess variation in value.The KU Leuven grant (C24/17/095) funds were received in support of this work

From planning the port/city to planning the port-city : exploring the economic interface in European port cities

In last three decades, planning agencies of most ports have institutionally evolved into a (semi-) independent port authority. The rationale behind this process is that port authorities are able to react more quickly to changing logistical and spatial preferences of maritime firms, hence increasing the competitiveness of ports. Although these dedicated port authorities have proven to be largely successful, new economic, social, and environmental challenges are quickly catching up on these port governance models, and particularly leads to (spatial) policy ‘conflicts’ between port and city. This chapter starts by assessing this conflict and argue that the conflict is partly a result of dominant—often also academic—spatial representations of the port city as two separate entities. To escape this divisive conception of contemporary port cities, this chapter presents a relational visualisation method that is able to analyse the economic interface between port and city. Based on our results, we reflect back on our proposition and argue that the core challenge today for researchers and policy makers is acknowledging the bias of port/city, being arguably a self-fulfilling prophecy. Hence, we turn the idea of (planning the) port/city conflicts into planning the port-city’s strengths and weaknesses

Catch-up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence

Aim To investigate growth patterns and anthropometrics in former extremely low birth weight (ELBW, <1000 g) children and link these outcomes to neurocognition and body

Ubiquitinome Profiling Reveals <i>in Vivo</i> UBE2D3 Targets and Implicates UBE2D3 in Protein Quality Control

Ubiquitination has crucial roles in many cellular processes, and dysregulation of ubiquitin machinery enzymes can result in various forms of pathogenesis. Cells only have a limited set of ubiquitin-conjugating (E2) enzymes to support the ubiquitination of many cellular targets. As individual E2 enzymes have many different substrates and interactions between E2 enzymes and their substrates can be transient, it is challenging to define all in vivo substrates of an individual E2 and the cellular processes it affects. Particularly challenging in this respect is UBE2D3, an E2 enzyme with promiscuous activity in vitro but less defined roles in vivo. Here, we set out to identify in vivo targets of UBE2D3 by using stable isotope labeling by amino acids in cell culture–based and label-free quantitative ubiquitin diGly proteomics to study global proteome and ubiquitinome changes associated with UBE2D3 depletion. UBE2D3 depletion changed the global proteome, with the levels of proteins from metabolic pathways, in particular retinol metabolism, being the most affected. However, the impact of UBE2D3 depletion on the ubiquitinome was much more prominent. Interestingly, molecular pathways related to mRNA translation were the most affected. Indeed, we find that ubiquitination of the ribosomal proteins RPS10 and RPS20, critical for ribosome-associated protein quality control, is dependent on UBE2D3. We show by Targets of Ubiquitin Ligases Identified by Proteomics 2 methodology that RPS10 and RPS20 are direct targets of UBE2D3 and demonstrate that the catalytic activity of UBE2D3 is required to ubiquitinate RPS10 in vivo. In addition, our data suggest that UBE2D3 acts at multiple levels in autophagic protein quality control. Collectively, our findings show that depletion of an E2 enzyme in combination with quantitative diGly-based ubiquitinome profiling is a powerful tool to identify new in vivo E2 substrates, as we have done here for UBE2D3. Our work provides an important resource for further studies on the in vivo functions of UBE2D3.Dutch Ministry of Health KWF-NKI2012- 5305Dutch Cancer Society 11369/2017-

Minimally Invasive Coronary Revascularisation Surgery: A Focused Review of the Available Literature

Minimally invasive coronary revascularisation was originally developed in the mid 1990s as minimally invasive direct coronary artery bypass (MIDCAB) grafting is a less invasive approach compared to conventional coronary artery bypass grafting (CABG) to address targets in the left anterior descending coronary artery (LAD). Since then, MIDCAB has evolved with the adoption of a robotic platform and the possibility to perform multivessel bypass procedures. Minimally invasive coronary revascularisation surgery also allows for a combination between the benefits of CABG and percutaneous coronary interventions for non-LAD lesions – a hybrid approach. Hybrid coronary revascularisation results in fewer blood transfusions, shorter hospital stay, decreased ventilation times and patients return to work sooner when compared to conventional CABG. This article reviews the available literature, describes standard approaches and considers topics, such as limited access procedures, indications and patient selection, diagnostics and imaging, techniques, anastomotic devices, hybrid coronary revascularisation and outcome analysis

Unbinned Deep Learning Jet Substructure Measurement in High Q2Q^2 ep collisions at HERA

The radiation pattern within high energy quark- and gluon-initiated jets (jet substructure) is used extensively as a precision probe of the strong force as well as an environment for optimizing event generators with numerous applications in high energy particle and nuclear physics. Looking at electron-proton collisions is of particular interest as many of the complications present at hadron colliders are absent. A detailed study of modern jet substructure observables, jet angularities, in electron-proton collisions is presented using data recorded using the H1 detector at HERA. The measurement is unbinned and multi-dimensional, using machine learning to correct for detector effects. All of the available reconstructed object information of the respective jets is interpreted by a graph neural network, achieving superior precision on a selected set of jet angularities. Training these networks was enabled by the use of a large number of GPUs in the Perlmutter supercomputer at Berkeley Lab. The particle jets are reconstructed in the laboratory frame, using the $k_{\mathrm{T}}$ jet clustering algorithm. Results are reported at high transverse momentum transfer $Q^2>150$ GeV${}^2$, and inelasticity $0.2 < y < 0.7$. The analysis is also performed in sub-regions of $Q^2$, thus probing scale dependencies of the substructure variables. The data are compared with a variety of predictions and point towards possible improvements of such models.Comment: 33 pages, 10 figures, 8 table