Evolution of neuromodulation for lower urinary tract dysfunction:past, present and future

This dissertation describes the results of treating chronic bladder problems using sacral neuromodulation (SNM). Chronic bladder problems such as an overactive bladder or non-obstructive bladder voiding dysfunction are often difficult and pose a challenge to the urologist. Most patients are treated with physiotherapy, medication or a combination of both. If the problem persists, radical treatments such as operations to increase the size of the bladder or replace it entirely are sometimes performed. These are major operations with potentially significant complications. This was a reason to go looking for a less invasive therapy: SNM.This PhD research shows that SNM is a safe and effective therapy for patients who do not respond to the standard therapy for chronic bladder problems. Many improvements have been made over the years, the result of which is that SNM has become a minimally invasive treatment that delivers good results

Coupled surface to deep Earth processes: Perspectives from TOPO-EUROPE with an emphasis on climate- and energy-related societal challenges

Understanding the interactions between surface and deep Earth processes is important for research in many diverse scientific areas including climate, environment, energy, georesources and biosphere. The TOPO-EUROPE initiative of the International Lithosphere Program serves as a pan-European platform for integrated surface and deep Earth sciences, synergizing observational studies of the Earth structure and fluxes on all spatial and temporal scales with modelling of Earth processes. This review provides a survey of scientific developments in our quantitative understanding of coupled surface-deep Earth processes achieved through TOPO-EUROPE. The most notable innovations include (1) a process-based understanding of the connection of upper mantle dynamics and absolute plate motion frames; (2) integrated models for sediment source-to-sink dynamics, demonstrating the importance of mass transfer from mountains to basins and from basin to basin; (3) demonstration of the key role of polyphase evolution of sedimentary basins, the impact of pre-rift and pre-orogenic structures, and the evolution of subsequent lithosphere and landscape dynamics; (4) improved conceptual understanding of the temporal evolution from back-arc extension to tectonic inversion and onset of subduction; (5) models to explain the integrated strength of Europe's lithosphere; (6) concepts governing the interplay between thermal upper mantle processes and stress-induced intraplate deformation; (7) constraints on the record of vertical motions from high-resolution data sets obtained from geo-thermochronology for Europe's topographic evolution; (8) recognition and quantifications of the forcing by erosional and/or glacial-interglacial surface mass transfer on the regional magmatism, with major implications for our understanding of the carbon cycle on geological timescales and the emerging field of biogeodynamics; and (9) the transfer of insights obtained on the coupling of deep Earth and surface processes to the domain of geothermal energy exploration. Concerning the future research agenda of TOPO-EUROPE, we also discuss the rich potential for further advances, multidisciplinary research and community building across many scientific frontiers, including research on the biosphere, climate and energy. These will focus on obtaining a better insight into the initiation and evolution of subduction systems, the role of mantle plumes in continental rifting and (super)continent break-up, and the deformation and tectonic reactivation of cratons; the interaction between geodynamic, surface and climate processes, such as interactions between glaciation, sea level change and deep Earth processes; the sensitivity, tipping points, and spatio-temporal evolution of the interactions between climate and tectonics as well as the role of rock melting and outgassing in affecting such interactions; the emerging field of biogeodynamics, that is the impact of coupled deep Earth – surface processes on the evolution of life on Earth; and tightening the connection between societal challenges regarding renewable georesources, climate change, natural geohazards, and novel process-understanding of the Earth system

Web-based return of individual patient-reported outcome results among patients with lymphoma:Randomized controlled trial

BACKGROUND: There has been a cultural shift toward patient engagement in health, with a growing demand from patients to access their results. OBJECTIVE: The Lymphoma Intervention (LIVE) trial is conducted to examine the impact of return of individual patient-reported outcome (PRO) results and a web-based self-management intervention on psychological distress, self-management, satisfaction with information, and health care use in a population-based setting. METHODS: Return of PRO results included comparison with age- and sex-matched peers and was built into the Patient-Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship registry. The self-management intervention is an adaptation of a fully automated evidence-based intervention for breast cancer survivors. Patients with lymphoma who completed the web-based questionnaire were equally randomized to care as usual, return of PRO results, and return of PRO results plus self-management intervention. Patients completed questionnaires 9 to 18 months after diagnosis (T0; n=227), 4 months (T1; n=190), 12 months (T2; n=170), and 24 months (T3; n=98). RESULTS: Of all invited patients, 51.1% (456/892) responded and web-based participants (n=227) were randomly assigned to care as usual (n=76), return of PRO results (n=74), or return of PRO results and access to Living with lymphoma (n=77). Return of PRO results was viewed by 76.7% (115/150) of those with access. No statistically significant differences were observed for psychological distress, self-management, satisfaction with information provision, and health care use between patients who received PRO results and those who did not (P>.05). Use of the self-management intervention was low (2/76, 3%), and an effect could therefore not be determined. CONCLUSIONS: Return of individual PRO results seems to meet patients’ wishes but had no beneficial effects on patient outcome. No negative effects were found when individual PRO results were disclosed, and the return of individual PRO results can therefore be safely implemented in daily clinical practice. TRIAL REGISTRATION: Netherlands Trial Register NTR5953; https://www.trialregister.nl/trial/5790 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-017-1943-

Decision-making regarding antibiotic therapy duration: An observational study of multidisciplinary meetings in the intensive care unit

Purpose: Antibiotic therapy is commonly prescribed longer than recommended in intensive care patients (ICU). We aimed to provide insight into the decision-making process on antibiotic therapy duration in the ICU. Methods: A qualitative study was conducted, involving direct observations of antibiotic decision-making during multidisciplinary meetings in four Dutch ICUs. The study used an observation guide, audio recordings, and detailed field notes to gather information about the discussions on antibiotic therapy duration. We described the participants' roles in the decision-making process and focused on arguments contributing to decision-making. Results: We observed 121 discussions on antibiotic therapy duration in sixty multidisciplinary meetings. 24.8% of discussions led to a decision to stop antibiotics immediately. In 37.2%, a prospective stop date was determined. Arguments for decisions were most often brought forward by intensivists (35.5%) and clinical microbiologists (22.3%). In 28.9% of discussions, multiple healthcare professionals participated equally in the decision. We identified 13 main argument categories. While intensivists mostly used arguments based on clinical status, clinical microbiologists used diagnostic results in the discussion. Conclusions: Multidisciplinary decision-making regarding the duration of antibiotic therapy is a complex but valuable process, involving different healthcare professionals, using a variety of argument-types to determine the duration of antibiotic therapy. To optimize the decision-making process, structured discussions, involvement of relevant specialties, and clear communication and documentation of the antibiotic plan are recommended

Greenland surface mass-balance observations from the ice-sheet ablation area and local glaciers

Glacier surface mass-balance measurements on Greenland started more than a century ago, but no compilation exists of the observations from the ablation area of the ice sheet and local glaciers. Such data could be used in the evaluation of modelled surface mass balance, or to document changes in glacier melt independently from model output. Here, we present a comprehensive database of Greenland glacier surface mass-balance observations from the ablation area of the ice sheet and local glaciers. The database spans the 123 a from 1892 to 2015, contains a total of similar to 3000 measurements from 46 sites, and is openly accessible through the PROMICE web portal (http://www.promice.dk). For each measurement we provide X, Y and Z coordinates, starting and ending dates as well as quality flags. We give sources for each entry and for all metadata. Two thirds of the data were collected from grey literature and unpublished archive documents. Roughly 60% of the measurements were performed by the Geological Survey of Denmark and Greenland (GEUS, previously GGU). The data cover all regions of Greenland except for the southernmost part of the east coast, but also emphasize the importance of long-term time series of which there are only two exceeding 20 a. We use the data to analyse uncertainties in point measurements of surface mass balance, as well as to estimate surface mass-balance profiles for most regions of Greenland

Coupled surface to deep Earth processes: Perspectives from TOPO-EUROPE with an emphasis on climate- and energy-related societal challenges

Understanding the interactions between surface and deep Earth processes is important for research in many diverse scientific areas including climate, environment, energy, georesources and biosphere. The TOPO-EUROPE initiative of the International Lithosphere Program serves as a pan-European platform for integrated surface and deep Earth sciences, synergizing observational studies of the Earth structure and fluxes on all spatial and temporal scales with modelling of Earth processes. This review provides a survey of scientific developments in our quantitative understanding of coupled surface-deep Earth processes achieved through TOPO-EUROPE. The most notable innovations include (1) a process-based understanding of the connection of upper mantle dynamics and absolute plate motion frames; (2) integrated models for sediment source-to-sink dynamics, demonstrating the importance of mass transfer from mountains to basins and from basin to basin; (3) demonstration of the key role of polyphase evolution of sedimentary basins, the impact of pre-rift and pre-orogenic structures, and the evolution of subsequent lithosphere and landscape dynamics; (4) improved conceptual understanding of the temporal evolution from back-arc extension to tectonic inversion and onset of subduction; (5) models to explain the integrated strength of Europe's lithosphere; (6) concepts governing the interplay between thermal upper mantle processes and stress-induced intraplate deformation; (7) constraints on the record of vertical motions from high-resolution data sets obtained from geo-thermochronology for Europe's topographic evolution; (8) recognition and quantifications of the forcing by erosional and/or glacial-interglacial surface mass transfer on the regional magmatism, with major implications for our understanding of the carbon cycle on geological timescales and the emerging field of biogeodynamics; and (9) the transfer of insights obtained on the coupling of deep Earth and surface processes to the domain of geothermal energy exploration. Concerning the future research agenda of TOPO-EUROPE, we also discuss the rich potential for further advances, multidisciplinary research and community building across many scientific frontiers, including research on the biosphere, climate and energy. These will focus on obtaining a better insight into the initiation and evolution of subduction systems, the role of mantle plumes in continental rifting and (super)continent break-up, and the deformation and tectonic reactivation of cratons; the interaction between geodynamic, surface and climate processes, such as interactions between glaciation, sea level change and deep Earth processes; the sensitivity, tipping points, and spatio-temporal evolution of the interactions between climate and tectonics as well as the role of rock melting and outgassing in affecting such interactions; the emerging field of biogeodynamics, that is the impact of coupled deep Earth – surface processes on the evolution of life on Earth; and tightening the connection between societal challenges regarding renewable georesources, climate change, natural geohazards, and novel process-understanding of the Earth system

Increased Sensory Processing Atypicalities in Parents of Multiplex ASD Families Versus Typically Developing and Simplex ASD Families

Recent studies have suggested that sensory processing atypicalities may share genetic influences with autism spectrum disorder (ASD). To further investigate this, the adolescent/adult sensory profile (AASP) questionnaire was distributed to 85 parents of typically developing children (P-TD), 121 parents from simplex ASD families (SPX), and 54 parents from multiplex ASD families (MPX). After controlling for gender and presence of mental disorders, results showed that MPX parents significantly differed from P-TD parents in all four subscales of the AASP. Differences between SPX and MPX parents reached significance in the Sensory Sensitivity subscale and also in subsequent modality-specific analyses in the auditory and visual domains. Our finding that parents with high genetic liability for ASD (i.e., MPX) had more sensory processing atypicalities than parents with low (i.e., SPX) or no (i.e., P-TD) ASD genetic liability suggests that sensory processing atypicalities may contribute to the genetic susceptibility for ASD