Investigations into the outer surface of pathogenic Treponema pallidum

Based on the assumption that a successful immune response to T. pallidum must, at least initially, be targetted against the outer membrane of the treponemes, the purpose of the study was to gain more insight in the accessibility of this membrane. The in vitro adherence of the treponemes to fibroblasts played a key role in the experimental studies. First, the relevance of the treponemal adherence in the in vivo infection was investigated as a part of histopathological studies. Second, since the adherence occurred at the surface of the treponemes, various factors that influenced the adherence were investigated. Third, the adherent treponemes could be used to study the accessibility of the treponemal outer membrane for anti-treponemal antibodies without the use of fixation. Sera of syphilis patients were used as the antibody source. In these patients the IgG response during the sequential stages of syphilis was characterized in order to exclude an overall immuno-suppression during this disease. Moreover, this characterization enabled the use of well-defined sera and their fractions in later studies

Musculoskeletal complaints and disability in a group of young adults with major congenital upper limb differences in The Netherlands

Purpose: To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. Materials and methods: Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. Results: Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups.Conclusions: MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitation The year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs. Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands. Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD. Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability.</p

Colonoscopy in Lynch syndrome: the need for a new quality score

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Milieueffecten van maatregelen gewasbescherming

In de in dit werkdocument beschreven modelstudie zijn berekeningen uitgevoerd over 15 teelten in de sectoren akkerbouw, vollegrondsgroenten, bloembollen fruitteelt en boomkwekerij. De milieueffectiviteit van de maatregelen is getoetst aan de hand van de reductie in Milieu Indicator Punten (MIP) voor de milieubelasting van oppervlaktewater door drift bij gewasbescherming (conform de toetsingsparameter in de Tussenevaluatie). Tevens is het effect op andere milieucompartimenten onderzocht. Voor de MIP-berekeningen is het Milieutechnisch en Economisch Bedrijfsmodel voor de Open Teelten (MEBOT) aangepast

Interventies in het aanbod van voedsel : aangrijpingspunten voor overheidsbeleid om het aanbod van gezonde voedselproducten structureel te verbeteren

In opdracht van de ministeries van LNV en VWS geeft dit rapport een aantal aanbod- en productgeoriënteerde interventies die door overheden toegepast kunnen worden om Nederlandse consumenten te verleiden tot gezonder eet- en leefgedrag. Achterliggend doel is om met kwalitatief beter voedsel en een beter consumptiepatroon een bijdrage te leveren aan de algemene gezondheidstoestan

A review of the dodo and its ecosystem: insights from a vertebrate concentration Lagerstätte in Mauritius

The dodo Raphus cucullatus Linnaeus, an extinct and flightless, giant pigeon endemic to Mauritius, has fascinated people since its discovery, yet has remained surprisingly poorly known. Until the mid-19th century, almost all that was known about the dodo was based on illustrations and written accounts by 17th century mariners, often of questionable accuracy. Furthermore, only a few fragmentary remains of dodos collected prior to the bird's extinction exist. Our understanding of the dodo's anatomy was substantially enhanced by the discovery in 1865 of subfossil bones in a marsh called the Mare aux Songes, situated in southeastern Mauritius. However, no contextual information was recorded during early excavation efforts, and the majority of excavated material comprised larger dodo bones, almost all of which were unassociated. Here we present a modern interdisciplinary analysis of the Mare aux Songes, a 4200-year-old multitaxic vertebrate concentration Lagerstätte. Our analysis of the deposits at this site provides the first detailed overview of the ecosystem inhabited by the dodo. The interplay of climatic and geological conditions led to the exceptional preservation of the animal and associated plant remains at the Mare aux Songes and provides a window into the past ecosystem of Mauritius. This interdisciplinary research approach provides an ecological framework for the dodo, complementing insights on its anatomy derived from the only associated dodo skeletons known, both of which were collected by Etienne Thirioux and are the primary subject of this memoir.publishedVersio

Long-term oncological outcomes of endoscopic full-thickness resection after previous incomplete resection of low-risk T1 CRC (LOCAL-study): study protocol of a national prospective cohort study

Background: T1 colorectal cancer (CRC) without histological high-risk factors for lymph node metastasis (LNM) can potentially be cured by endoscopic resection, which is associated with significantly lower morbidity, mortality and costs compared to radical surgery. An important prerequisite for endoscopic resection as definite treatment is the histological confirmation of tumour-free resection margins. Incomplete resection with involved (R1) or indeterminate (Rx) margins is considered a strong risk factor for residual disease and local recurrence. Therefore, international guidelines recommend additional surgery in case of R1/Rx resection, even in absence of high-risk factors for LNM. Endoscopic full-thickness resection (eFTR) is a relatively new technique that allows transmural resection of colorectal lesions. Local scar excision after prior R1/Rx resection of low-risk T1 CRC could offer an attractive minimal invasive strategy to achieve confirmation about radicality of the previous resection or a second attempt for radical resection of residual luminal cancer. However, oncologic safety has not been established and long-term data are lacking. Besides, surveillance varies widely and requires standardization. Methods/design: In this nationwide, multicenter, prospective cohort study we aim to assess feasibility and oncological safety of completion eFTR following incomplete resection of low-risk T1 CRC. The primary endpoint is to assess the 2 and 5 year luminal local tumor recurrence rate. Secondary study endpoints are to assess feasibility, percentage of curative eFTR-resections, presence of scar tissue and/or complete scar excision at histopathology, safety of eFTR compared to surgery, 2 and 5 year nodal and/or distant tumor recurrence rate and 5-year disease-specific and overall-survival rate. Discussion: Since the implementation of CRC screening programs, the diagnostic rate of T1 CRC is steadily increasing. A significant proportion is not recognized as cancer before endoscopic resection and is therefore resected through conventional techniques primarily reserved for benign polyps. As such, precise histological assessment is often hampered due to cauterization and fragmentation and frequently leads to treatment dilemmas. This first prospective trial will potentially demonstrate the effectiveness and oncological safety of completion eFTR for patients who have undergone a previous incomplete T1 CRC resection. Hereby, substantial surgical overtreatment may be avoided, leading to treatment optimization and organ preservation.Cellular mechanisms in basic and clinical gastroenterology and hepatolog