Ruimte voor onzekerheid:interactie tussen actoren in de dynamiek van infrastructuurplanning

In spatial planning, there is an increasing awareness that uncertainty must be taken into account in decision-making. At the same time, it appears to be difficult to include uncertainty in decision-making due to the interaction between policymakers and other actors, and because of a changing environment during the decision-making process. This research examines the way policy makers deal with uncertainty in infrastructure planning under the influence of the aforementioned factors. To this end, the decision-making process for three area-oriented infrastructure projects is analyzed: the redevelopment of Airport Twente, the construction of a bypass of the IJssel River near Kampen, and the redevelopment of the provincial road N340 Zwolle-Ommen. The research shows that in their efforts to keep the decision-making process manageable, policymakers continue to strive for uncertainty reduction. They adapt their handling of uncertainty only gradually to their changing environment, and seem to do so mainly for opportunistic reasons or when they are forced to do so. In response to these efforts of policymakers for uncertainty reduction, opponents try to increase uncertainties so that alternatives are considered. The resulting 'contested community' makes it difficult to arrive at a broadly supported area-oriented infrastructure plan. On the basis of this research, it is recommended to break through the pattern of 'action-reaction' between policymakers and opponents in dealing with uncertainty through an early open dialogue and through 'joint fact-finding' in which there is room for uncertainty

Comparable low-level mosaicism in affected and non affected tissue of a complex CDH patient

In this paper we present the detailed clinical and cytogenetic analysis of a prenatally detected complex Congenital Diaphragmatic Hernia (CDH) patient with a mosaic unbalanced translocation (5;12). High-resolution whole genome SNP array confirmed a low-level mosaicism (20%) in uncultured cells, underlining the value of array technology for identification studies. Subsequently, targeted Fluorescence In-Situ Hybridization in postmortem collected tissues demonstrated a similar low-level mosaicism, independently of the affected status of the tissue. Thus, a higher incidence of the genetic aberration in affected organs as lung and diaphragm cannot explain the severe phenotype of this complex CDH patient. Comparison with other described chromosome 5p and 12p anomalies indicated that half of the features presented in our patient (including the diaphragm defect) could be attributed to both chromosomal areas. In contrast, a few features such as the palpebral downslant, the broad nasal bridge, the micrognathia, microcephaly, abnormal dermatoglyphics and IUGR better fitted the 5p associated syndromes only. This study underlines the fact that low-level mosaicism can be associated with severe birth defects including CDH. The contribution of mosaicism to human diseases and specifically to congenital anomalies and spontaneous abortions becomes more and more accepted, although its phenotypic consequences are poorly described phenomena leading to counseling issues. Therefore, thorough follow-up of mosaic aberrations such as presented here is indicated in order to provide genetic counselors a more evidence based prediction of fetal prognosis in the future

Whole genome comparison of donor and cloned dogs

Cloning is a process that produces genetically identical organisms. However, the genomic degree of genetic resemblance in clones needs to be determined. In this report, the genomes of a cloned dog and its donor were compared. Compared with a human monozygotic twin, the genome of the cloned dog showed little difference from the genome of the nuclear donor dog in terms of single nucleotide variations, chromosomal instability, and telomere lengths. These findings suggest that cloning by somatic cell nuclear transfer produced an almost identical genome. The whole genome sequence data of donor and cloned dogs can provide a resource for further investigations on epigenetic contributions in phenotypic differences.close0

Congenital Diaphragmatic hernia – a review

Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes. Delivery of infants with CDH is recommended close to term gestation. Immediate management at birth includes bowel decompression, avoidance of mask ventilation and endotracheal tube placement if required. The main focus of management includes gentle ventilation, hemodynamic monitoring and treatment of pulmonary hypertension followed by surgery. Although inhaled nitric oxide is not approved by FDA for the treatment of PPHN induced by CDH, it is commonly used. Extracorporeal membrane oxygenation (ECMO) is typically considered after failure of conventional medical management for infants ≥ 34 weeks’ gestation or with weight >2 kg with CDH and no associated major lethal anomalies. Multiple factors such as prematurity, associated abnormalities, severity of PPHN, type of repair and need for ECMO can affect the survival of an infant with CDH. With advances in the management of CDH, the overall survival has improved and has been reported to be 70-90% in non-ECMO infants and up to 50% in infants who undergo ECMO

DOT-tunnel onder het Groene Hart

Dit eerste deelrapport is toegespitst op de analyse van het boor- en bouwproces van een DOT-tunnel onder Nederlandse omstandigheden. Het afstudeeronderzoek heeft als titel "DOT-tunnel onder Het Groene Hart haalbaarheidsstudie van een Double-a-Tube tunnel onder Nederlandse omstandigheden" en heeft, namens DHV Milieu en Infrastructuur, plaatsgevonden bij de Projectorganisatie HSL-Zuid, projectbureau boortunnel. Het afstudeeronderzoek is uitgevoerd in opdracht van de Faculteit Civiele Techniek van de Technische Universiteit Delft en is begeleid door een afstudeercommissie. De afstudeercommissie bestaat uit prof.drs.ir. J.K. Vrijling (vakgroep waterbouwkunde, Civiele Techniek), prof.ir. E. Horvat (sectie Ondergronds Bouwen, Civiele Techniek), ir. H.K.T. Kuijper (vakgroep waterbouwkunde, Civiele Techniek), ir. H. Burger (DHV Milieu en Infrastructuur) en ir. M.P. Oude Essink (Bouwdienst Rijkswaterstaat) . Het doel van dit afstudeeronderzoek is het onderzoeken van de haalbaarheid van een DOT-tunnel onder Nederlandse omstandigheden en specifiek voor de HSL-Zuid boortunnel onder Het Groene Hart. In deelrapport I is een analyse gemaakt van het boor- en bouwproces van een DOT-tunnel. Het tweede deelrapport is toegespitst op de boortunnel onder het Groene Hart en bevat de specifieke uitwerking van een haalbaarheidstudie van de DOT-tunnel in vergelijking met het Referentie Ontwerp. Het derde deelrapport bevat de gedetailleerde afleiding van de verschillende modelleringen en risico-analyses, die zijn gebruikt in het eerste deelrapport. In dit laatste deelrapport is ook de overige achtergrond informatie te vinden. Om de haalbaarheid van een DOT-tunnel te onderzoeken onder de Nederlandse omstandigheden is een analyse gemaakt van het boor- en bouwproces. Aangezien de DOT-tunnel zijn afkomst ontleent aan de cirkelvormige tunnels is aangegeven in hoeverre er een analogie kan worden getrokken tussen beide tunnelvormen en boormethodes, maar vooral waar niet. De tunnelboormachine heeft een aantal aanpassingen ondergaan als gevolg van het boor- en bouwproces van DOT-tunnels, waaronder een aantal aanpassingen van de machine, zoals speciale erectoren, het segment expansion device, het segment holding device, de rolling control jacks (DOT-schild), een beveiliging voor het elkaar raken van de graafwielen (DOT-schild) en de face-collapse detector (MFschild). Het bouwen van een DOT-tunnel is complexer dan een cirkelvormige tunnel door de verschillende typen segmenten. Dit blijkt eens te meer uit de technologie die is ontwikkeld (speciale erectoren, segment expansion device, segment holding device) om beschadiging van de segmenten bij inbouwen zoveel mogelijk te voorkomen. Het beheersen van het roteren van het schild om de x-as (rolling) verdient extra aandacht aangezien de niet-ronde vorm van de tunnel het niet toelaat dat de tunnel teveel roteert omdat anders het Profiel van Vrije Ruimte in het geding komt. Pitching en yawing treden nauwelijks op en zijn goed in de hand te houden. Overall kan worden geconcludeerd dat een DOT-tunnel haalbaar is onder Nederlandse omstandigheden. Hierbij verdient het de aanbeveling om de volgende aspecten nader te onderzoeken: Het toetsen van de berekeningen voor de steundruk van niet-cirkelvormige tunnels aan de hand van fysisch onderzoek door middel van of geocentrifuge-proeven of aan de hand van praktijkvoorbeelden; De grondvervormingen bij een DOT-tunnel door bijvoorbeeld een modellering in Plaxis; de krachtswerking in en op de lining van een DOT-tunnel.Hydraulic EngineeringCivil Engineering and Geoscience

Room for uncertainty in infrastructure planning

An increasingly dynamic environment and engaged society necessitates decision makers in infrastructure planning to adopt adaptive and participative planning approaches and give room to uncertainty in planning and decision making. In planning, individual actors belonging to a group of like-minded actors may attempt to influence decision-making about planning proposals. They do so by using a mix of instruments such as research, participation, agreements, and so on. To gain greater insight into the processes of interactions between decision makers and other relevant actors in planning, the planning of three infrastructure cases – a road upgrade, an airport runway redevelopment, and a river bypass in the Netherlands – was studied in-depth each covering a period of 20 years. Interestingly, a couple of overarching patterns regarding dealing with uncertainty in planning and decision-making appeared from the study. Decision makers continuously strive for ‘certainification’, and do so by deploying authority-based instruments. Indeed, they keep doing so, even if the the result obtained is opposite of that which was desired. Certainification i.e., decision makers striving for reducing uncertainties, often results in a reaction of ‘decertainification’ from opponents. It seems as if decision makers strengthen the latter’s own opposition. And when decision makers actually do give room for uncertainties through adopting an adaptive approach, other actors often demand less uncertainty; driving decision makers back to their thirst for certainification. To overcome this continuous loop, an arena and institutional setting should be created in which actors from different advocacy coalitions are involved in open dialogue to better balance the perceived uncertainties of all stakeholders