Should equity in health be target number 1?

Policy measures to reduce socioeconomic health differences (SEHD) must be preceded by an analysis of the possibilities and desirability of a reduction. This paper argues that it is necessary to pursue equality in health, conceived as equal opportunities to achieve health. This principle is justified as part of the principle of maximizing individual freedom of choice, and requires that everyone has the opportunity to be as healthy as possible. By means of this principle a distinction can be made between unjust, unavoidable, and acceptable health inequalities. The determinants of SEHD which lead to inequalities considered unjust must be subject to policy. These are living conditions (physical and social environment and health care) and conditions of choice (e.g. the knowledge of an individual about the health risks of a certain behaviour). Even if SEHD are considered inequities, sometimes conflicting interests will make it difficult to propose a health policy to redress these inequities. These are partly the consequence of the intersectoral character of a policy aimed at equality of opportunities to attain health, in which the importance of health has to be weighed against other goals. Moreover the impact of such a policy on the individual free choice has to be critically weighed. Finally in the context of health care policy, conflicts between the principle of equality and maximizing health can be expected

Dissection and manipulation of antigen-specific T cell responses

T cells recognize pathogen-derived antigens and are crucial for fighting pathogens such as viruses and bacteria. In addition, T cells are able to recognize and attack certain types of tumors, in particular virally induced tumors. In this thesis we aimed 1) to obtain more insight into antigen-specific T cell responses and 2) to study how antigen-specific T cell responses can be improved. For the first aim we generated new tools that by enabling the visualization of antigen-specific CD4+ and CD8+ T cells allow the study of the dynamics of antigen-specific T cell responses in time throughout an ongoing immune response (chapter 2). In addition, we developed a novel technique that enables the study of family relationships between different T cell populations. This technique for instance allows us to determine whether two different types of effector T cell populations arise from the same or different pool(s) of na_ve T cells (chapter 5). For the second aim, we analyzed whether antigen-specific T cell responses can be manipulated by providing increased costimulation in the form of constitutive triggering of CD27 (chapter 3) or by generating CD4+ T cells that are modified by the introduction of MHC class I restricted TCRs (chapter 4).UBL - phd migration 201

Aerodynamic analysis of Ampyx’s airborne wind energy system

Besides classical horizontal and vertical axis wind turbines, alternative ways to harvest wind energy are currently being explored. One promising concept is represented by airborne wind energy systems. Different airborne wind energy concepts have been ideated and investigated over the past few decades. The work reported here focuses on the concept being developed by Ampyx Power that basically generates power using a tethered airplane which drives a generator on the ground. The aim of the work reported here is to develop and compare design calculations for such a power plane. In this study a comparison was made between steady and unsteady RANS CFD calculations from SU2 and OpenFOAM. Subsequently, using the data from the CFD calculation two different power prediction models were developed and compared, one using 2D CFD data with the free vortex code AWSM and the other using the same data with a nonlinear lifting line approach to model the power plane in its figure eight flying trajectory. Overall, comparisons show that for all practical angles of attack, as well as a range of flap angles, that 2D CFD results agree extremely well between both solvers. The 3D CFD results show <20% differences on the computed total forces, despite achieving good agreement on the relative force contributions across the power plane. A very good agreement has also been established between the power prediction models

Patient-reported aesthetic outcomes of upper blepharoplasty:a randomized controlled trial comparing two surgical techniques

It is not yet established whether additional orbicularis oculi muscle excision leads to better patient-reported aesthetic outcomes (PRO) compared to a skin-only resection blepharoplasty. A double-blind randomized controlled trial of upper blepharoplasty, with or without muscle excision, was performed on 54 White European patients who assessed the procedure via PRO. FACE-Q questionnaires covering eyes in general, upper eyelids, forehead and eyebrows, overall face, age appearance appraisal, age appraisal, social functioning, satisfaction with the outcome, and adverse effects were completed preoperatively and at 6 and 12 months after upper blepharoplasty. The Patient and Observer Scar Assessment Scale was used to assess scarring. The FACE-Q scores for skin-only and skin/muscle upper blepharoplasty were similar regarding the upper eyelids, forehead and eyebrows, overall face, patient perceived aging and age, social functioning, and satisfaction with the results, and also increased for both procedures with time. The FACE-Q score regarding the eyes in general was higher in the skin-only group at the 12-month follow-up. Scarring and adverse effects did not differ between the groups. Additional muscle resection does not seem to influence patient satisfaction. Thus, when performing an upper blepharoplasty, there is no need for additional muscle resection as a routine procedure to improve patient satisfaction

Final results from the EU project AVATAR: aerodynamic modelling of 10 MW wind turbines

This paper presents final results from the EU project AVATAR in which aerodynamic models are improved and validated for wind turbines on a scale of 10 MW and more. Special attention is paid to the improvement of low fidelity engineering (BEM based) models with higher fidelity (CFD) models but also with intermediate fidelity free vortex wake (FVW) models. The latter methods were found to be a good basis for improvement of induction modelling in engineering methods amongst others for the prediction of yawed cases, which in AVATAR was found to be one of the most challenging subjects to model. FVW methods also helped to improve the prediction of tip losses. Aero-elastic calculations with BEM based and FVW based models showed that fatigue loads for normal production cases were over predicted with approximately 15% or even more. It should then be realised that the outcome of BEM based models does not only depend on the choice of engineering add-ons (as is often assumed) but it is also heavily dependent on the way the induced velocities are solved. To this end an annulus and element approach are discussed which are assessed with the aid of FVW methods. For the prediction of fatigue loads the so-called element approach is recommended but the derived yaw models rely on an annulus approach which pleads for a generalised solution method for the induced velocities