New insights in gastroesophageal reflux, esophageal function and gastric emptying in relation to dysphagia before and after anti-reflux surgery in children.

This item is under embargo for a period of 12 months from the date of publication, in accordance with the publisher's policy.In children with gastroesophageal reflux (GER) disease refractory to pharmacological therapies, anti-reflux surgery (fundoplication) may be a treatment of last resort. The applicability of fundoplication has been hampered by the inability to predict which patient may benefit from surgery and which patient is likely to develop post-operative dysphagia. pH impedance measurement and conventional manometry are unable to predict dysphagia, while the role of gastric emptying remains poorly understood. Recent data suggest that the selection of patients who will benefit from surgery might be enhanced by automated impedance manometry pressure-flow analysis (AIM) analysis, which relates bolus movement and pressure generation within the esophageal lumen

High prevalence of anelloviruses in vitreous fluid of children with seasonal hyperacute panuveitis.

Seasonal hyperacute panuveitis (SHAPU) is a potentially blinding ocular disease occurring in Nepal that principally affects young children. Random amplification of partially purified vitreous fluid (VF)-derived nucleic acid revealed the presence of human anelloviruses in VF of SHAPU patients. In a comparative study of patients with different ocular pathologies, SHAPU patients were at highest risk of harboring anelloviruses in their eyes. The majority of SHAPU patients had multiple anelloviruses in their VF. The ocular anellovirus load in SHAPU and non-SHAPU patients did not differ and no SHAPU-specific anellovirus variant was detected. Analysis of paired serum and VF samples from SHAPU and non-SHAPU patients showed that the anellovirus detected in VF samples most likely originated from the systemic viral pool during viremia, potentially through breakdown of the blood-ocular barrier. The detection of anelloviruses in VF samples of uveitis patients, profoundly so in SHAPU patients, is imperative and warrants elucidation of its clinical significance

Identification and Characterization of Two Novel Viruses in Ocular Infections in Reindeer

A thorough understanding of virus diversity in wildlife provides epidemiological baseline information about pathogens. In this study, eye swab samples were obtained from semi-domesticated reindeer (Rangifer tarandus tarandus) in Norway during an outbreak of infectious eye disease, possibly a very early stage of infectious keratoconjunctivitis (IKC). Large scale molecular virus screening, based on host nucleic acid depletion, sequence-independen

Inter- and intra-rater reliability of the Chicago Classification in pe-diatric high-resolution esophageal manometry recordings

This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'.Copyright © 2015 John Wiley & Sons, Inc. All rights reserved.Background The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Methods Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss’ kappa (κ) and intraclass correlation coefficient (ICC). Key Results Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45–0.82). Conclusions & Inferences Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia

Calicivirus from Novel Recovirus Genogroup in Human Diarrhea, Bangladesh

To identify unknown human viruses in the enteric tract, we examined 105 stool specimens from patients with diarrhea in Bangladesh. A novel calicivirus was identified in a sample from 1 patient and subsequently found in samples from 5 other patients. Phylogenetic analyses classified this virus within the proposed genus Recovirus

Innovatieproject Hondsbossche Duinen : Eindrapportage, definitief 01

In 2015 is de Hondsbossche en Pettemer Zeewering (HPZ) versterkt met 35 miljoen kubieke meter zand. Dit gebied heet nu de ‘Hondsbossche Duinen (HD)’. Het ontwerp bestaat uit een zachte ondiepe vooroever (strand) met verschillende soorten duinhabitats. Deze gekoppelde systemen voorzien in de primaire veiligheid en realiseren tegelijkertijd de gevraagde ruimtelijke kwaliteit. Hiermee is de aanleg van de Hondsbossche Duinen een mooi voorbeeld van ‘Bouwen met Natuur’. Deze methode is niet vanzelfsprekend, en het is daarom van belang om te meten of de werking van het ontwerp overeenkomt met de verwachtingen. Het opzetten van een aan de HPZ gekoppeld innovatieproject heeft ons in staat gesteld om te leren in hoeverre we in staat zijn vooraf geformuleerde (natuurlijke) ontwerpdoelstellingen daadwerkelijk te realiseren. Dit type inzichten is onontbeerlijk voor een snellere, betere en goedkopere uitvoering van volgende versterkingsprojecten en het beheer van gerealiseerde projecte

Genetic control of midbrain dopamine systems

The midbrain dopaminergic (mDA) system, organized in the substantia nigra compacta (SNc) and ventral tegmental area (VTA), regulates movement control and behavior as highlighted by the dramatic consequences of its degeneration in Parkinson’s disease and its implications in psychiatric and affective disorders. Therefore, the neurobiology, pharmacology and pathology of the mDA system have been investigated extensively for many years. A neuropathological enigma is posed by the selective degeneration of the SNc dopamine neurons in Parkinson's disease. Apparently, these neurons are selectively vulnerable to degeneration, since dopamine neurons of the VTA are largely spared. Although psychiatric and affective disorders are considered to have a genetic neurodevelopmental origin, little is known about the development of the mDA system and the underlying genetic cascades. We hypothesize that the difference in vulnerability between mDA neurons of the SNc and those of the VTA roots in the molecular make-up of these neurons, and originates from different differentiation routes during embryonic development. The aim of this thesis was therefore to establish a model for the genetic control regulating development and function of the mDA system and to investigate the role of Pitx3 within this model in relation to other regulatory genes, which together generate molecular cascades leading to the specific mDA phenotype. Our results suggest that mDA precursor cells undergo a multi-stage differentiation process, regulated in a spatiotemporal manner by specific transcription factors that are expressed during different phases of mDA development. At least two independent cascades are involved in establishing the dopaminergic neurotransmitter identity of mDA neurons. One cascade involves the nuclear hormone receptor Nurr1, required for induction of tyrosine hydroxylase (TH), the vesicular monoamine transporter type 2 (VMAT2) and the dopamine transporter. Another cascade involves a not yet identified factor required for the induction of L-aromatic amino acid decarboxylase (AADC). The homeodomain gene Pitx3 is involved in a neurotransmitter independent cascade essential for the development/survival of mDA neurons specifically located in the SNc. Pitx3-deficient mice display specific molecular and electrophysiological alterations, which may serve an adaptive strategy to compensate for the loss of dopaminergic innervation of the dorsal striatum in order to ensure appropriate in vivo functions of the animal. The position of the presumed mDA precursors in the diencephalon suggests that the neuroepithelial origin of mDA precursors might underlie the molecular mechanisms specifying the specific vulnerability of mDA subsets. As we start to understand consequences of inactivation of genes that are part of genetic programs involved in mDA development and function, one may speculate on their significance as candidate genes for association with dopamine-related mental disorders on the one hand, and on the other hand as tools to manipulate dopamine neurons in therapies aiming to rescue or replace mDA neurons in Parkinson’s disease. The identification of genes regulated by Pitx3 might open new avenues to unravel these mechanisms and might provide new insights into the selective degeneration of SNc mDA neurons in Parkinson's disease