A new disposal strategy for the Western Scheldt, conciliating port accessibility and nature preservation

In 1999, Flanders and the Netherlands agreed to set up a common strategy for managing the Scheldt estuary. In 2002, both parties signed a memorandum of understanding in which was defined a “Long Term Vision” strategy and its objectives. One of these is the preservation in the Western Scheldt of a dynamic flood and ebb channel network, the so-called “multi-channel system”. The present trend, a continuation of past natural morphological evolutions combined with human interference (land reclamation and polder building, dredging and other river works) may jeopardise this objective.<p>An expert team appointed by the Antwerp Port Authority stated the need for morphological management, aiming at steering the estuarine morphology. In a first phase, sediment from dredging works could be used to reshape eroded sandbars where needed, in order for the flood and ebb flows to continue maintaining the multiple channels.<p>Since 2002, this new disposal strategy is being investigated as a pilot project on the Walsoorden sandbar in the Western Scheldt. An extended research was conducted in 2002 and 2003, combining several tools: desk studies with maps on the historical morphological changes, field measurements, physical scale model tests and numerical models. As a result of the research work executed at Flanders Hydraulics Research, it was concluded that none of the results contradicted the feasibility of the new disposal strategy at the Walsoorden sandbar, although final judgement would only be possible after the execution of an in situ disposal test.<p>At the end of 2004, 500.000 m³ of sand was disposed during one month with a diffuser in relatively shallow water at the seaward end of the Walsoorden sandbar. The experiment was thoroughly monitored, morphological as well as ecological. One year after the execution of the in situ disposal test, it was concluded that from morphological viewpoint the test was a success. The ecological monitoring revealed no significant negative changes in trends due to the disposal test.<p>In 2006 a new disposal test was executed, using the traditional dumping (“clapping”) technique with hopper dredgers. Due to practical limitations, the disposal (again 500.000 m³) was spread over 3 months. The new experiment was again thoroughly monitored. Due to larger currents in the disposal area, a higher percentage of the material was transported towards the Walsoorden sandbar. This morphological evolution was seen as positive within the objectives of the disposal strategy. From ecological viewpoint again no significant negative changes in trends have been identified.<p>Due to the success of both in situ tests, the strategy of morphological disposal will be included in the dredging and disposal operations for the future deepening of the navigation channel. This new disposal strategy will introduce benefits for both the economy (deepening and maintenance of the fairway) and the ecology (keeping the sediment in the estuary, creating new valuable areas without endangering the multiple channel system). Therefore further research work has been carried out in 2007-2008 on how to embed this strategy in the future dredging and disposal policy and the possible use of the strategy on other locations. During execution (planned to start in 2009) an intensive monitoring programme will monitor the morphological and ecological effects of the disposed sediments, allowing adjusting the strategy if necessary. However, this is only part of a morphological management of the estuary, which would also have to include morphological dredging and modifying the hard bordering at some locations

A new disposal strategy for the Western Scheldt, conciliating port accessibility and nature preservation

In 1999, Flanders and the Netherlands agreed to set up a common strategy for managing the Scheldt estuary. In 2002, both parties signed a memorandum of understanding in which was defined a “Long Term Vision” strategy and its objectives. One of these is the preservation in the Western Scheldt of a dynamic flood and ebb channel network, the so-called “multi-channel system”. The present trend, a continuation of past natural morphological evolutions combined with human interference (land reclamation and polder building, dredging and other river works) may jeopardise this objective.An expert team appointed by the Antwerp Port Authority stated the need for morphological management, aiming at steering the estuarine morphology. In a first phase, sediment from dredging works could be used to reshape eroded sandbars where needed, in order for the flood and ebb flows to continue maintaining the multiple channels.Since 2002, this new disposal strategy is being investigated as a pilot project on the Walsoorden sandbar in the Western Scheldt. An extended research was conducted in 2002 and 2003, combining several tools: desk studies with maps on the historical morphological changes, field measurements, physical scale model tests and numerical models. As a result of the research work executed at Flanders Hydraulics Research, it was concluded that none of the results contradicted the feasibility of the new disposal strategy at the Walsoorden sandbar, although final judgement would only be possible after the execution of an in situ disposal test.At the end of 2004, 500.000 m3 of sand was disposed during one month with a diffuser in relatively shallow water at the seaward end of the Walsoorden sandbar. The experiment was thoroughly monitored, morphological as well as ecological. One year after the execution of the in situ disposal test, it was concluded that from morphological viewpoint the test was a success. The ecological monitoring revealed no significant negative changes in trends due to the disposal test.In 2006 a new disposal test was executed, using the traditional dumping (“clapping”) technique with hopper dredgers. Due to practical limitations, the disposal (again 500.000 m3) was spread over 3 months. The new experiment was again thoroughly monitored. Due to larger currents in the disposal area, a higher percentage of the material was transported towards the Walsoorden sandbar. This morphological evolution was seen as positive within the objectives of the disposal strategy. From ecological viewpoint again no significant negative changes in trends have been identified.Due to the success of both in situ tests, the strategy of morphological disposal will be included in the dredging and disposal operations for the future deepening of the navigation channel. This new disposal strategy will introduce benefits for both the economy (deepening and maintenance of the fairway) and the ecology (keeping the sediment in the estuary, creating new valuable areas without endangering the multiple channel system). Therefore further research work has been carried out in 2007-2008 on how to embed this strategy in the future dredging and disposal policy and the possible use of the strategy on other locations. During execution (planned to start in 2009) an intensive monitoring programme will monitor the morphological and ecological effects of the disposed sediments, allowing adjusting the strategy if necessary. However, this is only part of a morphological management of the estuary, which would also have to include morphological dredging and modifying the hard bordering at some locations

A first phase in the habitat classification for the Zeeschelde: Bed form classification

Within the scope of the long term vision of the Schelde Estuary and the Development Outline 2010 low dynamic intertidal and shallow water areas are considered to be of high ecological value. Little is known about the occurrence of such valuable reas in the Schelde Estuary, nor are the physical and morphological processes which determine the occurrence of these areas fully understood. Based on the results and recommendations of a 2008-2009 research project in the Westerschelde, a new research project was defined to determine relationships between abiotic (bedforms, hydrodynamics, sediment) and biotic (benthos) characteristics in the Zeeschelde (Belgium) and to set up a classification of deep and undeep subtidal areas. A first phase in the habitat classification comprises of the analysis of bed form occurrence and the setup of a bed form classification based on multibeam echo sounding data. Results show within the different sub areas a variation in bed forms going from hard bed layers to no bed forms to ripples (H ~ 0,1 to 0,3 m | L ~ 10 m) and smaller dunes (H ~ 0,5 to 1 m | L ~ 15 to 25 m). On-going research investigates relationships between the bed form characteristics and flow and sediment characteristics. Preliminary results

Luminal narrowing after percutaneous transluminal coronary angioplasty. A study of clinical, procedural, and lesional factors related to longterm angiographic outcome

Background. The renarrowing process after successful percutaneous transluminal coronary angioplasty (PTCA) is now believed to be caused by a response-to-injury vessel wall reaction. The magnitude of this process can be assessed by the change in minimal lumen diameter (MLD) at follow-up angiography. The aim of the present study was to find independent patient-related, lesion-related, and procedure-related risk factors for this luminal narrowing process. A model that accurately predicts the amount of luminal narrowing could be an aid in patient or lesion selection for the procedure, and it could improve assessment of medium-term (6 months) prognosis. Modification or control of the identified risk factors could reduce overall restenosis rates, and it could assist in the selection of patients at risk for a large loss in lumen diameter. This population could then constitute the target population for pharmacological intervention studies. Methods and Results. Quantitative angiography was performed on 666 successfully dilated lesions at angioplasty and at 6-month follow-up. Multivaria

Improving hand hygiene compliance in nursing homes: Protocol for a cluster randomized controlled trial (HANDSOME Study)

Background: Hand hygiene compliance is considered the most (cost-)effective measure for preventing health care-associated infections. While hand hygiene interventions have frequently been implemented and assessed in hospitals, there is limited knowledge about hand hygiene compliance in other health care settings and which interventions and implementation methods are effective. Objective: This study aims to evaluate the effect of a multimodal intervention to increase hand hygiene compliance of nurses in nursing homes through a cluster randomized controlled trial (HANDSOME study). Methods: Nursing homes were randomly allocated to 1 of 3 trial arms: Receiving the intervention at a predetermined date, receiving the identical intervention after an infectious disease outbreak, or serving as a control arm. Hand hygiene was evaluated in nursing homes by direct observation at 4 timepoints. We documented compliance with the World Health Organization's 5 moments of hand hygiene, specifically before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The primary outcome is hand hygiene compliance of the nurses to the standards of the World Health Organization. The secondary outcome is infectious disease incidence among residents. Infectious disease incidence was documented by a staff member at each nursing home unit. Outcomes will be compared with the presence of norovirus, rhinovirus, and Escherichia coli on surfaces in the nursing homes, as measured using quantitative polymerase chain reaction. Results: The study was funded in September 2015. Data collection started in October 2016 and was completed in October 2017. Data analysis will be completed in 2020. Conclusions: HANDSOME studies the effectiveness of a hand hygiene intervention specifically for the nursing hom

Miltefosine Suppresses Inflammation in a Mouse Model of Inflammatory Bowel Disease

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Hand hygiene and glove use in nursing homes before and after an intervention

We investigated whether an intervention to improve hand hygiene compliance in nursing homes changed glove use. Hand hygiene compliance increased, but substitution of hand hygiene with gloves did not decrease. We observed a reduction of inappropriately unchanged gloves after exposure to body fluids. Clinical trials identifier: Netherlands Trial Register, trial NL6049 (NTR6188): Https://www.trialregister.nl/trial/6049

Search for DCC in 158A GeV Pb+Pb Collisions

A detailed analysis of the phase space distributions of charged particles and photons have been carried out using two independent methods. The results indicate the presence of nonstatistical fluctuations in localized regions of phase space.Comment: Talk at the PANIC99 Conference, June 9-16, 199

Present Status and Future of DCC Analysis

Disoriented Chiral Condensates (DCC) have been predicted to form in high energy heavy ion collisions where the approximate chiral symmetry of QCD has been restored. This leads to large imbalances in the production of charged to neutral pions. Sophisticated analysis methods are being developed to disentangle DCC events out of the large background of events with conventionally produced particles. We present a short review of current analysis methods and future prospects.Comment: 12 pages, 5 figures. Invited talk presented at the 13th International Conference on Ultrarelativistic Nucleus-Nucleus Collisions (Quark Matter 97), Tsukuba, Japan, 1-5 Dec 199

Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative

Background: The increasing sub-classification of cancer patients due to more detailed molecular classification of tumors, and limitations of current trial designs, require innovative research designs. We present the design, governance and current standing of three comprehensive nationwide cohorts including pancreatic, esophageal/gastric, and colorectal cancer patients (NCT02070146). Multidisciplinary collection of clinical data, tumor tissue, blood samples, and patient-reported outcome (PRO) measures with a nationwide coverage, provides the infrastructure for future and novel trial designs and facilitates research to improve outcomes of gastrointestinal cancer patients. Material and methods: All patients aged ≥18 years with pancreatic, esophageal/gastric or colorectal cancer are eligible. Patients provide informed consent for: (1) reuse of clinical data; (2) biobanking of primary tumor tissue; (3) collection of blood samples; (4) to be informed about relevant newly identified genomic aberrations; (5) collection of longitudinal PROs; and (6) to receive information on new interventional studies and possible participation in cohort multiple randomized controlled trials (cmRCT) in the future. Results: In 2015, clinical data of 21,758 newly diagnosed patients were collected in the Netherlands Cancer Registry. Additional clinical data on the surgical procedures were registered in surgical audits for 13,845 patients. Within the first two years, tumor tissue and blood samples were obtained from 1507 patients; during this period, 1180 patients were included in the PRO registry. Response rate for PROs was 90%. The consent rate to receive information on new interventional studies and possible participation in cmRCTs in the future was >85%. The number of hospitals participating in the cohorts is steadily increasing. Conclusion: A comprehensive nationwide multidisciplinary gastrointestinal cancer cohort is feasible and surpasses the limitations of classical study designs. With this initiative, novel and innovative studies can be performed in an efficient, safe, and comprehensive setting