Prepared by

1 Introduction to the case................................................................................................... 3 1.1 Water management: A case of intrinsic cross-border relationships........................... 3 1.2 Spatial planning and water management: two separate policy domains?.................

Selection of provenances to adapt tropical pine forestry to climate change on the basis of climate analogs

Pinus patula and Pinus tecunumanii play an important role in the forestry sector in the tropics and subtropics and, in recent decades, members of the International Tree Breeding and Conservation Program (Camcore) at North Carolina State University have established large, multi-site provenance trials for these pine species. The data collected in these trials provide valuable information about species and provenance choice for plantation establishment in many regions with different climates. Since climate is changing rapidly, it may become increasingly difficult to choose the right species and provenance to plant. In this study, growth performance of plantings in Colombia, Brazil and South Africa was correlated to the degree of climatic dissimilarity between planting sites. Results are used to assess the suitability of seed material under a changing climate for four P. patula provenances and six P. tecunumanii provenances. For each provenance, climate dissimilarities based on standardized Euclidean distances were calculated and statistically related to growth performances. We evaluated the two methods of quantifying climate dissimilarity with extensive field data based on the goodness of fit and statistical significance of the climate distance relation to differences in height growth. The best method was then used as a predictor of a provenance change in height growth. The provenance-specific models were used to predict provenance performance under different climate change scenarios. The developed provenance-specific models were able to significantly relate climate similarity to different growth performances for five out of six P. tecunumanii provenances. For P. patula provenances, we did not find any correlation. Results point towards the importance of the identification of sites with stable climates where high yields are achievable. In such sites, fast-growing P. tecunumanii provenances with a high but narrow growth optimum can be planted. At sites with climate change of uncertain direction and magnitude, the choice of P. patula provenances, with greater tolerance towards different temperature and precipitation regimes, is recommended. Our results indicate that the analysis of provenance trial data with climate similarity models helps us to (1) maintain plantation productivity in a rapidly changing environment; and (2) improve our understanding of tree species’ adaptation to a changing climate

Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia

BACKGROUND: With an incidence of less than 5%, type II paraesophageal hernias are one of the less common types of hiatal hernias. We report a case of a perforated prepyloric gastric ulcer which, due to a type II hiatus hernia, drained into the mediastinum. CASE PRESENTATION: A 61-year old Caucasian man presented with acute abdominal pain. On a conventional x-ray of the chest a large mediastinal air-fluid collection and free intra-abdominal air was seen. Additional computed tomography revealed a large intra-thoracic air-fluid collection with a type II paraesophageal hernia. An emergency upper midline laparotomy was performed and a perforated pre-pyloric gastric ulcer was treated with an omental patch repair. The patient fully recovered after 10 days and continues to do well. CONCLUSION: Type II paraesophageal hernia is an uncommon diagnosis. The main risk is gastric volvulus and possible gastric torsion. Intrathoracic perforation of gastric ulcers due to a type II hiatus hernia is extremely rare and can be a diagnostic and treatment challenge

Europese integratie en de Nederlandse ruimtelijke ordening

Political Science; European Unio

Soluble adhesion molecules as markers for sepsis and the potential pathophysiological discrepancy in neonates, children and adults

Sepsis is a severe and life-threatening systemic inflammatory response to infection that affects all populations and age groups. The pathophysiology of sepsis is associated with aberrant interaction between leukocytes and the vascular endothelium. As inflammation progresses, the adhesion molecules that mediate these interactions become shed from cell surfaces and accumulate in the blood as soluble isoforms that are being explored as potential prognostic disease biomarkers. We critically review the studies that have tested the predictive value of soluble adhesion molecules in sepsis pathophysiology with emphasis on age, as well as the underlying mechanisms and potential roles for inflammatory shedding. Five soluble adhesion molecules are associated with sepsis, specifically, E-selectin, L-selectin and P-selectin, intercellular adhesion molecule-1 and vascular cell adhesion molecule-1. While increased levels of these soluble adhesion molecules generally correlate well with the presence of sepsis, their degree of elevation is still poorly predictive of sepsis severity scores, outcome and mortality. Separate analyses of neonates, children and adults demonstrate significant age-dependent discrepancies in both basal and septic levels of circulating soluble adhesion molecules. Additionally, a range of both clinical and experimental studies suggests protective roles for adhesion molecule shedding that raise important questions about whether these should positively or negatively correlate with mortality. In conclusion, while predictive properties of soluble adhesion molecules have been researched intensively, their levels are still poorly predictive of sepsis outcome and mortality. We propose two novel directions for improving clinical utility of soluble adhesion molecules: the combined simultaneous analysis of levels of adhesion molecules and their sheddases; and taking age-related discrepancies into account. Further attention to these issues may provide better understanding of sepsis pathophysiology and increase the usefulness of soluble adhesion molecules as diagnostic and predictive biomarkers

Effect of long-term physical activity and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury: a systematic review

Objective: To evaluate the effect of long-term physical activity (PA) and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury (SCI)