Urban dunes : Towards BwN design principles for dune formation along urbanized shores

Sandy shores worldwide suffer from coastal erosion due to a lack of sediment input and sea-level rise. In response, coastal sand nourishments are executed using ‘Building with Nature’ techniques (BwN), in which the sand balance is amplified and natural dynamics are instrumental in the redistribution of sand, cross- and alongshore. These nourishments contribute to the growth of beaches and dunes, serving various design objectives (such as flood safety, nature, and recreation). Nevertheless, human interference (such as buildings and traffic) along urbanized sandy shores may have significant, yet poorly understood, effects on beach and dune development. Better insight is required into the interplay of morphological, ecological and urban processes to support Aeolian BwN processes for dune formation and contribute to the sustainable design of urbanized coastal zones. This paper aims to bridge the gap between coastal engineering and urban design by formulating design principles for BwN along urbanized sandy shores, combining nourishments, natural dune formation and urban development on a local scale to strengthen the coastal buffer. The first part of the paper analyses sedimentation processes in the (built) sea-land interface and identifies spatial mechanisms that relate coastal occupation to dune formation. Hence a preliminary set of design principles is derived by manipulating wind-driven sediment transport for BwN dune formation after nourishment. In the second part of the paper, these principles are applied and contextualized in two case-studies to compare their capability for BwN in different coastal profiles: the vast, rural, geomorphologically high dynamic profile of a mega-nourishment (Sand Motor); versus the compact, highly urbanized, profile(s) of a coastal resort (Noordwijk). Conclusions reflect on the applicability of BwN design principles within different coastal settings (dynamics, urbanity) and spatial arrangements facilitating BwN dune formation

Nonfatal reinfarction as an independent riskfactor for subsequent mortality in post-myocardial infarction patients

Pericas, Enric;Ordóñez, Estrell

Partner notification and partner treatment for chlamydia: Attitude and practice of general practitioners in the Netherlands; a landscape analysis

Background: Chlamydia prevalence remains high despite scaling-up control efforts. Transmission is not effectively interrupted without partner notification (PN) and (timely) partner treatment (PT). In the Netherlands, The follow-up of partners is not standardized and may depend on GPs' time and priorities. We investigated current practice and attitude of GPs towards PN and PT to determine the potential for Patient-Initiated Partner Treatment, which is legally not supported yet. Methods: Multiple data-sources were combined for a landscape analysis. Quantitative data on (potential) PT were obtained from prescriptions in the national pharmacy register (2004-2014) and electronic patient data from NIVEL-Primary Care Database (PCD) and from STI consultations in a subgroup of sentinel practices therein. Furthermore, we collected information on current practice via two short questionnaires at a national GP conference and obtained insight into GPs' attitudes towards PN/PT in a vignette study among GPs partaking in NIVEL-PCD. Results: Prescription data showed Azithromycin double dosages in 1-2% of cases in the pharmacy register (37.000 per year); probable chlamydia-specific repeated prescriptions or double dosages of other antibiotics in NIVEL-PCD (115/1078) could not be interpreted as PT for chlamydia with certainty. STI consultation data revealed direct PT in 6/100 cases, via partner prescription or double doses. In the questionnaires the large majority of GPs (>95% of 1411) reported to discuss PN of current and ex-partner(s) with chlamydia patients. Direct PT was indicated as most common method by 4% of 271 GPs overall and by 12% for partners registered in the same practice. Usually, GPs leave further steps to the patients (83%), advising patients to tell partners to get tested (56%) or treated (28%). In the vignette study, 16-20% of 268 GPs indicated willingness to provide direct PT, depending on patient/partner profile, more (24-45%) if patients would have the chance to notify their partner first. Conclusion: GPs in the Netherlands already treat some partners of chlamydia cases directly, especially partners registered in the same practice. Follow-up of partner notification and treatment in general practice needs more attention. GPs may be open to implement PIPT more often, provided there are clear guidelines to arrange this legally and practically

Having Fun in Learning Formal Specifications

There are many benefits in providing formal specifications for our software. However, teaching students to do this is not always easy as courses on formal methods are often experienced as dry by students. This paper presents a game called FormalZ that teachers can use to introduce some variation in their class. Students can have some fun in playing the game and, while doing so, also learn the basics of writing formal specifications in the form of pre- and post-conditions. Unlike existing software engineering themed education games such as Pex and Code Defenders, FormalZ takes the deep gamification approach where playing gets a more central role in order to generate more engagement. This short paper presents our work in progress: the first implementation of FormalZ along with the result of a preliminary users' evaluation. This implementation is functionally complete and tested, but the polishing of its user interface is still future work

Predominance of M2 macrophages in organized thrombi in chronic thromboembolic pulmonary hypertension patients

Chronic thromboembolic pulmonary hypertension (CTEPH) is a debilitating disease characterized by thrombotic occlusion of pulmonary arteries and vasculopathy, leading to increased pulmonary vascular resistance and progressive right-sided heart failure. Thrombotic lesions in CTEPH contain CD68+ macrophages, and increasing evidence supports their role in disease pathogenesis. Macrophages are classically divided into pro-inflammatory M1 macrophages and anti-inflammatory M2 macrophages, which are involved in wound healing and tissue repair. Currently, the phenotype of macrophages and their localization within thrombotic lesions of CTEPH are largely unknown. In our study, we subclassified thrombotic lesions of CTEPH patients into developing fresh thrombi (FT) and organized thrombi (OT), based on the degree of fibrosis and remodeling. We used multiplex immunofluorescence histology to identify immune cell infiltrates in thrombotic lesions of CPTEH patients. Utilizing software-assisted cell detection and quantification, increased proportions of macrophages were observed in immune cell infiltrates of OT lesions, compared with FT. Strikingly, the proportions with a CD206+INOS− M2 phenotype were significantly higher in OT than in FT, which mainly contained unpolarized macrophages. Taken together, we observed a shift from unpolarized macrophages in FT toward an expanded population of M2 macrophages in OT, indicating a dynamic role of macrophages during CTEPH pathogenesis.</p

Multiple subduction imprints in the mantle below Italy detected in a single lava flow

Post-collisional magmatism reflects the regional subduction history prior to collision but the link between the two is complex and often poorly understood. The collision of continents along a convergent plate boundary commonly marks the onset of a variety of transitional geodynamic processes. Typical responses include delamination of subducting lithosphere, crustal thickening in the overriding plate, slab detachment and asthenospheric upwelling, or the complete termination of convergence. A prominent example is the Western-Central Mediterranean, where the ongoing slow convergence of Africa and Europe (Eurasia) has been accommodated by a variety of spreading and subduction systems that dispersed remnants of subducted lithosphere into the mantle, creating a compositionally wide spectrum of magmatism. Using lead isotope compositions of a set of melt inclusions in magmatic olivine crystals we detect exceptional heterogeneity in the mantle domain below Central Italy, which we attribute to the presence of continental material, introduced initially by Alpine and subsequently by Apennine subduction. We show that superimposed subduction imprints of a mantle source can be tapped during a melting episode millions of years later, and are recorded in a single lava flow

Trends in sexually transmitted infections in the Netherlands, combining surveillance data from general practices and sexually transmitted infection centers

<p>Abstract</p> <p>Background</p> <p>Sexually transmitted infections (STI) care in the Netherlands is primarily provided by general practitioners (GPs) and specialized STI centers. STI surveillance is based on data from STI centers, which show increasing numbers of clients. Data from a GP morbidity surveillance network were used to investigate the distribution in the provision of STI care and the usefulness of GP data in surveillance.</p> <p>Methods</p> <p>Data on STI-related episodes and STI diagnoses based on ICPC codes and, for chlamydia, prescriptions, were obtained from GP electronic medical records (EMRs) of the GP network and compared to data from STI centers from 2002 to 2007. Incidence rates were estimated for the total population in the Netherlands.</p> <p>Results</p> <p>The incidence of STI-consultations and -diagnoses increased substantially in recent years, both at GPs and STI centers. The increase in consultations was larger than the increase in diagnoses; Chlamydia incidence rose especially at STI centers. GPs were responsible for 70% of STI-related episodes and 80-85% of STI diagnoses. STI centers attract relatively younger and more often male STI-patients than GPs. Symptomatic STIs like <it>Herpes genitalis </it>and genital warts were more frequently diagnosed at GPs and chlamydia, gonorrhea and syphilis at STI centers.</p> <p>Conclusions</p> <p>GPs fulfill an important role in STI care, complementary to STI centers. Case definitions of STI could be improved, particularly by including laboratory results in EMRs. The contribution of primary care is often overlooked in STI health care. Including estimates from GP EMRs can improve the surveillance of STIs.</p