Mesh-related complications and recurrence after ventral mesh rectopexy with synthetic versus biologic mesh:a systematic review and meta-analysis

BACKGROUND: Ventral mesh rectopexy (VMR) is a widely accepted surgical treatment for rectal prolapse. Both synthetic and biologic mesh are used. No consensus exists on the preferred type of mesh material. The aim of this systematic review and meta-analysis was to establish an overview of the current literature on mesh-related complications and recurrence after VMR with synthetic or biologic mesh to aid evidence-based decision making in preferred mesh material. METHODS: A systematic search of the electronic databases of PubMed, Embase and Cochrane was performed (from inception until September 2020). Studies evaluating patients who underwent VMR with synthetic or biologic mesh were eligible. The MINORS score was used for quality assessment. RESULTS: Thirty-two studies were eligible after qualitative assessment. Eleven studies reported on mesh-related complications including 4001 patients treated with synthetic mesh and 762 treated with biologic mesh. The incidence of mesh-related complications ranged between 0 and 2.4% after synthetic versus 0–0.7% after biologic VMR. Synthetic mesh studies showed a pooled incidence of mesh-related complications of 1.0% (95% CI 0.5–1.7). Data of biologic mesh studies could not be pooled. Twenty-nine studies reported on the risk of recurrence in 2371 synthetic mesh patients and 602 biologic mesh patients. The risk of recurrence varied between 1.1 and 18.8% for synthetic VMR versus 0–15.4% for biologic VMR. Cumulative incidence of recurrence was found to be 6.1% (95% CI 4.3–8.1) and 5.8% (95% CI 2.9–9.6), respectively. The clinical and statistical heterogeneity was high. CONCLUSIONS: No definitive conclusions on preferred mesh type can be made due to the quality of the included studies with high heterogeneity amongst them

Composition and teaching quality characteristics in schools for secondary education:Results from secondary analyses on the Dutch OECD-TALIS 2013 data

The current study presents the results of secondary analyses on the Dutch data in the Teaching and Learning International Survey (TALIS) from the OECD. Using multi-level regression analyses, job satisfaction, teaching quality characteristics as well as need for professional development are investigated in schools that vary according to composition. The results show that teachers in schools with relatively large percentages of students from low socio-economic backgrounds are less satisfied with their profession, they show lower levels of self-efficacy and less positive student-teacher relationships. In schools with relatively large percentages of students who have a different home language than the language of instruction, the results show no relationships with job satisfaction and the educational quality characteristics. The results also show that teachers in schools with low SES pupils and pupils with different home languages have more need for professional development in the area of diversity and this is especially true for beginning teachers. The study ends with recommendations for future research and educational practice.</p

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Schoolcompositie en kenmerken van docentkwaliteit op VO-scholen. Resultaten van secundaire analyses op de Nederlandse data in het OESO-TALIS 2013 bestand.

In deze studie worden de resultaten gerapporteerd van secundaire analyses op de Nederlandse data van het Teaching and Learning International Survey (TALIS) onderzoek van de OESO. Onderzocht werd of schoolcompositie en ervaring een verband hadden met werktevredenheid, kenmerken van docentkwaliteit en behoefte aan professionalisering op het gebied van diversiteit. Uit de resultaten blijkt dat docenten op scholen met relatief veel leerlingen met een lage sociaaleconomische achtergrond, minder tevreden zijn met hun beroep, minder vertrouwen i

Cyclic diguanylic acid behaves as a host molecule for planar intercalators

AbstractCyclic ribodiguanylic acid, c-(GpGp), is the endogenous effector regulator of cellulose synthase. Its three-dimensional structure from two different crystal forms (tetragonal and trigonal) has been determined by X-ray diffraction analysis at 1 Å resolution. In both crystal forms, two independent c-(GpGp) molecules associate with each other to form a self-intercalated dimer. A hydrated cobalt ion is found to coordinate to two N7 atoms of adjacent guanines, forcing these two guanines to destack with a large dihedral angle (32°), in the dimer of the tetragonal form. This metal coordination mechanism may be relevant to that of the anticancer drug cisplatin. Moreover, c-(GpGp) exhibits unusual spectral properties not seen in any other cyclic dinucleotide. It interacts with planar organic intercalator molecules in ways similar to double helical DNA. We propose a cage-like model consisting of a tetrameric c-(GpGp) aggregate in which a large cavity (‘host’) is generated to afford a binding site for certain planar intercalators (‘guests’)