Simlandscape: serious gaming in participatory spatial planning

In an attempt to improve support for contemporary spatial planning practice, Simlandscape has been developed. In this document the development of Simlandscape as serious game in digital form is described. In its current state, Simlandscape exists in two methodological forms; as an analogue game and as a planning support system using GIS for research and design. The game focuses on simulation of plan processes and on the resulting transformation of areas involved. Players interact with an analogue area model. The planning support system focuses on design and evaluation of plan scenarios and the data handling and presentation accompanying this process. A major challenge now is to integrate, upgrade and digitize components of the analogous game with the planning support system. Several interesting components (practical and scientific) of this project are identified and are discussed

Diabetes, atherosclerosis, and stenosis by AI

OBJECTIVEThis study evaluates the relationship between atherosclerotic plaque characteristics (APCs) and angiographic stenosis severity in patients with and without diabetes. Whether APCs differ based on lesion severity and diabetes status is unknown.RESEARCH DESIGN AND METHODSWe retrospectively evaluated 303 subjects from the Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia (CREDENCE) trial referred for invasive coronary angiography with coronary computed tomographic angiography (CCTA) and classified lesions as obstructive (≥50% stenosed) or nonobstructive using blinded core laboratory analysis of quantitative coronary angiography. CCTA quantified APCs, including plaque volume (PV), calcified plaque (CP), noncalcified plaque (NCP), low-density NCP (LD-NCP), lesion length, positive remodeling (PR), high-risk plaque (HRP), and percentage of atheroma volume (PAV; PV normalized for vessel volume). The relationship between APCs, stenosis severity, and diabetes status was assessed.RESULTSAmong the 303 patients, 95 (31.4%) had diabetes. There were 117 lesions in the cohort with diabetes, 58.1% of which were obstructive. Patients with diabetes had greater plaque burden (P = 0.004). Patients with diabetes and nonobstructive disease had greater PV (P = 0.02), PAV (P = 0.02), NCP (P = 0.03), PAV NCP (P = 0.02), diseased vessels (P = 0.03), and maximum stenosis (P = 0.02) than patients without diabetes with nonobstructive disease. APCs were similar between patients with diabetes with nonobstructive disease and patients without diabetes with obstructive disease. Diabetes status did not affect HRP or PR. Patients with diabetes had similar APCs in obstructive and nonobstructive lesions.CONCLUSIONSPatients with diabetes and nonobstructive stenosis had an association to similar APCs as patients without diabetes who had obstructive stenosis. Among patients with nonobstructive disease, patients with diabetes had more total PV and NCP.Cardiolog

Colorectal liver metastases: Surgery versus thermal ablation (COLLISION) - a phase III single-blind prospective randomized controlled trial

Background: Radiofrequency ablation (RFA) and microwave ablation (MWA) are widely accepted techniques to eliminate small unresectable colorectal liver metastases (CRLM). Although previous studies labelled thermal ablation inferior to surgical resection, the apparent selection bias when comparing patients with unresectable disease to surgical candidates, the superior safety profile, and the competitive overall survival results for the more recent reports mandate the setup of a randomized controlled trial. The objective of the COLLISION trial is to prove non-inferiority of thermal ablation compared to hepatic resection in patients with at least one resectable and ablatable CRLM and no extrahepatic disease. Methods: In this two-arm, single-blind multi-center phase-III clinical trial, six hundred and eighteen patients with at least one CRLM (≤3cm) will be included to undergo either surgical resection or thermal ablation of appointed target lesion(s) (≤3cm). Primary endpoint is OS (overall survival, intention-to-treat analysis). Main secondary endpoints are overall disease-free survival (DFS), time to progression (TTP), time to local progression (TTLP), primary and assisted technique efficacy (PTE, ATE), procedural morbidity and mortality, length of hospital stay, assessment of pain and quality of life (QoL), cost-effectiveness ratio (ICER) and quality-adjusted life years (QALY). Discussion: If thermal ablation proves to be non-inferior in treating lesions ≤3cm, a switch in treatment-method may lead to a reduction of the post-procedural morbidity and mortality, length of hospital stay and incremental costs without compromising oncological outcome for patients with CRLM. Trial registration:NCT03088150 , January 11th 2017

Simlandscape : serious gaming in gebiedsplanning

Hoe betrek je burgers en professionals bij gebiedsontwikkeling zonder luchtkastelen te bouwen en zonder dat iedereen in het eigen straatje blijft denken? Met Simlandscape kunnen betrokkenen zelf ontwikkelingsopties voor een ruraal of urbaan gebied ontwerpen, visualiseren en evalueren

Simlandscape: serious gaming in participatory spatial planning

In an attempt to improve support for contemporary spatial planning practice, Simlandscape has been developed. In this document the development of Simlandscape as "serious game" in digital form is described. In its current state, Simlandscape exists in two methodological forms; as an analogue game and as a planning support system using GIS for research and design. The game focuses on simulation of plan processes and on the resulting transformation of areas involved. Players interact with an analogue area model. The planning support system focuses on design and evaluation of plan scenarios and the data handling and presentation accompanying this process. A major challenge now is to integrate, upgrade and digitize components of the analogous game with the planning support system. Several interesting components (practical and scientific) of this project are identified and are discussed