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

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

Using a satellite swarm for building a space-based radio telescope for low frequencies

In radio astronomy, as in astronomy in general, a wide range of frequencies is observed as each spectral band o_ers a unique window to study astrophysical phenomena. In the recent years, new observatories have been designed and built at the extreme limits of the radio spectrum. For the low frequencies several Earth-based radio telescopes are constructed at this moment. In the Netherlands, the Low Frequency Array (LOFAR) is being constructed at this moment and will be operational later this year. LOFAR observes the sky between 30 and 240 MHz. Observing at even lower frequencies is very interesting, but, due to the inuence of the Earth's ionosphere this is not possible from Earth. Thus, the only option to observe low frequencies is a telescope in spac

De laag-vertrouwensamenleving: de maatschappelijke impact van COVID-19 in Amsterdam, Den Haag, Rotterdam & Nederland.

The politics and administration of institutional chang

OLFAR - orbiting low frequency array; using a satellite swarm for building a space-based radio telescope for low frequencies

In radio astronomy, as in astronomy in general, a wide range of frequencies is observed as each spectral band offers a unique window to study astrophysical phenomena. In the recent years, new observatories have been designed and built at the extreme limits of the radio spectrum. For the low frequencies several Earth-based radio telescopes are constructed at this moment. In the Netherlands, the Low Frequency Array (LOFAR) is being constructed at this moment and will be operational later this year. LOFAR observes the sky between 30 and 240 MHz. Observing at even lower frequencies is very interesting, but, due to the influence of the Earth’s ionosphere this is not possible from Earth. Thus, the only option to observe low frequencies is a telescope in space

Generation of representative primary virus isolates from blood plasma after isolation of HIV-1 with CD44 MicroBeads

Infection of cell cultures with cell-free virus isolated from HIV-infected patients is notoriously difficult and results in a loss of viral variation. Here, we describe viral sequences from PBMC, U87.CD4.CCR5 and U87.CD4.CXCR4 cell cultures and compare them to those from blood plasma from 12 patients from whom virus particles were isolated using CD44 MicroBeads. In both PBMC and U87.CD4.CCR5 cultures, 66% of the plasma viral strains were retrieved after culturing. In addition, coreceptor use was predicted based on the env-V3 sequence and tested in U87.CD4 cells expressing either CCR5 or CXCR4. Recovery was lower for the CXCR4-using viruses. Only 50% of the virus clusters predicted to use CXCR4 could be retrieved from cell cultures, while 71% of CCR5-using strains were found in U87.CCR5 cultures. Therefore, isolation of primary viruses with CD44 MicroBeads results in a good representation in cell culture of the in vivo divergence

Driving pressure during general anesthesia for open abdominal surgery (DESIGNATION) : study protocol of a randomized clinical trial

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index <= 40 kg/m(2), scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which Delta P is lowest. In both groups of the trial, V-T is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events. Discussion DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery