Mapping rootable depth and root zone plant-available water holding capacity of the soil of sub-Saharan Africa

In rainfed crop production, root zone plant-available water holding capacity (RZ-PAWHC) of the soil has a large influence on crop growth and the yield response to management inputs such as improved seeds and fertilisers. However, data are lacking for this parameter in sub-Saharan Africa (SSA). This study produced the first spatially explicit, coherent and complete maps of the rootable depth and RZ-PAWHC of soil in SSA. We compiled georeferenced data from 28,000 soil profiles from SSA, which were used as input for digital soil mapping (DSM) techniques to produce soil property maps of SSA. Based on these soil properties, we developed and parameterised (pedotransfer) functions, rules and criteria to evaluate soil water retention at field capacity and wilting point, the soil fine earth fraction from coarse fragments content and, for maize, the soil rootability (relative to threshold values) and rootable depth. Maps of these secondary soil properties were derived using the primary soil property maps as input for the evaluation rules and the results were aggregated over the rootable depth to obtain a map of RZ-PAWHC, with a spatial resolution of 1 km2. The mean RZ-PAWHC for SSA is 74mm and the associated average root zone depth is 96 cm. Pearson correlation between the two is 0.95. RZ-PAWHC proves most limited by the rootable depth but is also highly sensitive to the definition of field capacity. The total soil volume of SSA potentially rootable by maize is reduced by one third (over 10,500 km3) due to soil conditions restricting root zone depth. Of these, 4800 km3 are due to limited depth of aeration, which is the factor most severely limiting in terms of extent (km2), and 2500 km3 due to sodicity which is most severely limiting in terms of degree (depth in cm). Depth of soil to bedrock reduces the rootable soil volume by 2500 km3, aluminium toxicity by 600 km3, porosity by 120 km3 and alkalinity by 20 km3. The accuracy of the map of rootable depth and thus of RZ-PAWHC could not be validated quantitatively due to absent data on rootability and rootable depth but is limited by the accuracy of the primary soil property maps. The methodological framework is robust and has been operationalised such that the maps can easily be updated as additional data become available

Validation of four LES and a vortex model against stereo-PIV measurements in the near wake of an actuator disc and a wind turbine

In this paper we report the results of a workshop organised by the Delft University of Technology in 2014, aiming at the comparison between different state-of-the-art numerical models for the simulation of wind turbine wakes. The chosen benchmark case is a wind tunnel measurement, where stereoscopic Particle Image Velocimetry was employed to obtain the velocity field and turbulence statistics in the near wake of a two-bladed wind turbine model and of a porous disc, which mimics the numerical actuator used in the simulations. Researchers have been invited to simulate the experimental case based on the disc drag coefficient and the inflow characteristics. Four large eddy simulation (LES) codes from different institutions and a vortex model are part of the comparison. The purpose of this benchmark is to validate the numerical predictions of the flow field statistics in the near wake of an actuator disc, a case that is highly relevant for full wind farm applications. The comparison has shown that, despite its extreme simplicity, the vortex model is capable of reproducing the wake expansion and the centreline velocity with very high accuracy. Also all tested LES models are able to predict the velocity deficit in the very near wake well, contrary to what was expected from previous literature. However, the resolved velocity fluctuations in the LES are below the experimentally measured values

Towards a European Health Research and Innovation Cloud (HRIC)

The European Union (EU) initiative on the Digital Transformation of Health and Care (Digicare) aims to provide the conditions necessary for building a secure, flexible, and decentralized digital health infrastructure. Creating a European Health Research and Innovation Cloud (HRIC) within this environment should enable data sharing and analysis for health research across the EU, in compliance with data protection legislation while preserving the full trust of the participants. Such a HRIC should learn from and build on existing data infrastructures, integrate best practices, and focus on the concrete needs of the community in terms of technologies, governance, management, regulation, and ethics requirements. Here, we describe the vision and expected benefits of digital data sharing in health research activities and present a roadmap that fosters the opportunities while answering the challenges of implementing a HRIC. For this, we put forward five specific recommendations and action points to ensure that a European HRIC: i) is built on established standards and guidelines, providing cloud technologies through an open and decentralized infrastructure; ii) is developed and certified to the highest standards of interoperability and data security that can be trusted by all stakeholders; iii) is supported by a robust ethical and legal framework that is compliant with the EU General Data Protection Regulation (GDPR); iv) establishes a proper environment for the training of new generations of data and medical scientists; and v) stimulates research and innovation in transnational collaborations through public and private initiatives and partnerships funded by the EU through Horizon 2020 and Horizon Europe

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Maternal antenatal orientations and mental health in pregnant and postpartum women

De transitie naar het moederschap is een complexe periode van biologische, psychologische en sociale veranderingen. De emoties, cognities en gedragingen van zwangere en postpartale vrouwen zijn daarom moeilijk te vatten in eenvoudige en samenhangende modellen. Desalniettemin beschrijft Raphael-Leff (2005), op basis van de psychoanalytische literatuur, haar klinische praktijk en kleinschalig kwalitatief onderzoek, vier clusters van emotionele, cognitieve en gedragsmatige expressies van onderliggende specifieke intrapsychische processen. In Hoofdstuk 1 van dit proefschrift beschrijven we de theorieën en bevindingen relevant voor het begrijpen van Raphael-Leff s werk, en geven we een gedetailleerde beschrijving van de vier maternale oriëntaties (de Facilitator, de Regulator, de Reciprocator en de Bipolaire of Confligerende oriëntatie) die we hier slechts kort beschrijven. Vrouwen die naar de Facilitator oriëntatie neigen voelen zich tijdens de zwangerschap en het postpartum doorgaans emotioneel verrijkt. De Facilitator laat zich in deze transitie dan ook volledig door de natuur leiden en tracht zich aan het ritme en de noden van de baby aan te passen. De Regulator benadert het moederschap eerder met een zekere afstandelijkheid. De zwangerschap en het verzorgen van de baby bedreigen voor haar immers een deel van haar persoonlijkheid en levensstijl waaruit ze veel voldoening haalt. In tegenstelling tot de Facilitator, tracht de Regulator dan ook haar gewone leven verder te zetten en verwacht ze dat de baby zich aan haar zal aanpassen. De Reciprocator is zich van bij het begin van haar zwangerschap bewust van haar ambivalentie met betrekking tot haar toestand: overgelukkig zwanger te zijn, maar evenzeer bezorgd omdat de zwangerschap onomkeerbare veranderingen in haar persoonlijke en sociale leven inzet. Kenmerkend voor deze moeders is de empathie, eerder dan identificatie en symbiose (Facilitator) of onthechting en socialisatie (Regulator). De Bipolaire moeder komt, in tegenstelling tot de Reciprocator moeder, niet tot een positieve integratie van de ambivalente gevoelens die de zwangerschap en het moederschap oproepen. In deze doctoraatsstudie beogen we een onderzoek naar de validiteit van het zwangerschapsspecifieke construct van maternale antenatale oriëntaties, en onderzoeken we de meerwaarde ervan voor het onderzoek naar de geestelijke gezondheid van zwangere en postpartale vrouwen. In Hoofdstuk 2 gaan we daarom na of zwangere vrouwen op een betrouwbare en valide wijze maternale oriëntatie gedifferentieerd kunnen worden. Daartoe onderzochten we de betrouwbaarheid, stabiliteit en construct validiteit van de Facilitator schaal en de Regulator schaal van Raphael-Leff s recentste meetinstrument: de Placental Paradigm Questionnaire (PPQ: Raphael-Leff, 2005). De interne consistentie van beide de schalen haalde, na itemreductie, een aanvaardbaar niveau. Een zwakke negatieve correlatie werd gevonden tussen beide schalen. Verder bleek de Facilitator schaal, vergeleken met de Regulator schaal, stabieler over het tweede en derde zwangerschapstrimester. Tevens werd de construct validiteit van de Facilitator schaal, en in mindere mate die van de Regulator schaal, ondersteund op basis van de correlaties met de Maternal Fetal Attachment Scale. Op basis van eerder onderzoek werden de scores op de twee continue schalen in een nominale variabele omgezet dat de vier hoger beschreven oriëntaties representeerde. De frequentieverdeling van deze maternale antenatale oriëntaties bleek slechts matig stabiel te zijn. De frequentieverdeling op basis van het nominale model in het derde trimester was vergelijkbaar met de frequentieverdelingen gevonden in andere studies. Tenslotte werd aangetoond dat primigravida en een geplande zwangerschap vaker met de Facilitator oriëntatie geassocieerd werden dan met een van de andere oriëntaties. Vrouwen met een voorgaande miskraam werden vaker met de Reciprocator oriëntatie geassocieerd. Hoofdstuk 3 beschrijft een studie naar de convergentie dan wel divergentie tussen het zwangerschapsspecifieke construct van maternale oriëntaties en de klassieke en generalistische constructen van persoonlijkheidstrekken (NEO-Five Factor Inventory), copingstijlen (Utrecht Coping Lijst) en gehechtheid (Relationship Questionnaire). Deze studie onderzocht in wezen ook de intrapersoonlijke determinanten van de maternale antenatale oriëntaties. Onze gegevens tonen aan dat het zwangerschapsspecifieke construct van maternale oriëntaties voor het grootste deel onafhankelijk is van de klassieke en generalistische constructen. De weinige associaties die gevonden werden waren eerder zwak maar ondersteunden wel inhoudelijk het construct van de maternale oriëntaties. De hoofdstukken 4 en 5 beschrijven studies naar de predictieve waarde van de maternale antenatale oriëntaties voor de verschillen in depressieve (Hoofdstuk 4) en angst (Hoofdstuk 5) symptomatologie tijdens de zwangerschap en het postpartum. Deze studies tonen aan dat, in aanvulling van de reeds goed gedocumenteerde predictoren (Neuroticisme, Extraversie, Depressieve coping), het model van maternale oriëntaties ook een beperkt maar significant deel van de variantie in maternale distress verklaart. Regulators, bijvoorbeeld, rapporteren hogere waarden voor zowel depressieve symptomatologie (Edinburgh Postnatal Depression Scale en Hospital Depression Scale) als voor maternale angst (zowel voor gegeneraliseerde angst - Hospital Anxiety Scale - als voor zwangerschap gerelateerde angsten - Pregnancy Related Anxiety Questionnaire). Facilitators daarentegen, vrezen voornamelijk de separatie met hun kind (Maternal Separation Anxiety Scale). Verder beschermde het idealisatie mechanisme van de Facilitator niet voor toegenomen depressieve symptomatologie en gegeneraliseerde angst. Bij deze bevindingen dienen we te benadrukken dat, als andere intrapsychische en sociodemografische variabelen in acht genomen worden, de maternale oriëntatie slechts voor een beperkt aandeel de variantie in de depressieve en angst symptomatologie verklaard. Hoofdstuk 6 beschrijft een studie naar de predictieve waarde van de maternale antenatale oriëntaties voor de verschillen in verwachtingen en ervaringen met betrekking tot de obstetrische outcome (inductie, episiotomie, analgetica, ... ). Aangetoond werd dat Facilitators, vergeleken met Regulators, meer intrapartale gevoelens van voldoening en minder gevoelens van distress verwachten. Na de bevalling rapporteerden Facilitators ook effectief meer intrapartale gevoelens van voldoening en minder gevoelens van distress. In één situatie echter, werd een interessant interactie-effect (modererend) gevonden. In overeenstemming met de klinische bevindingen van Raphael-Leff rapporteerden primipare Facilitators na een geassisteerde bevalling minder intrapartale gevoelens van voldoening dan na een spontane bevalling. Hoewel deze studie empirische evidentie biedt voor de klinische bevindingen van Raphael-Leff, dient te worden opgemerkt dat de variantie in de beleving van arbeid en bevalling voornamelijk door de obstetrische outcome en de maternale verwachtingen werd bepaald. In Hoofdstuk 7 van dit proefschrift worden de belangrijkste bevindingen van dit doctoraatsonderzoek samengevat. Tevens worden de beperkingen van dit onderzoek besproken en suggesties voor verder onderzoek aangereikt. Ook werden de klinische implicaties van dit onderzoek besproken. Algemeen kunnen we stellen dat Raphael-Leff een waardevolle onafhankelijke variabele is in het onderzoek naar de mentale gezondheid van zwangere en postpartale vrouwen. Toch is er ook meer onderzoek nodig naar de validiteit en de operationalisatie van de maternale oriëntaties. Klinisch biedt het model een geschikte basis om de emoties, cognities en gedragingen van aanstaande en nieuwe moeders bespreekbaar te maken, zowel in de eerstelijnszorg als in een gespecialiseerde psychotherapeutische context.status: publishe

Anxiety in Pregnant and Postpartum Women. An exploratory study of the role of maternal orientations

BACKGROUND: Little is known about why some women are anxious during pregnancy but not in the postpartum period, or vice versa. We aimed to determine the influence of maternal antenatal orientations (Raphael-Leff, J. (2005) Psychological Processes of Childbearing, London, The Anna Freud Centre.) on the prevalence of general anxiety symptoms and specific anxiety in pregnant and postpartum women. METHODS: Four hundred and three pregnant women participated in a longitudinal study and completed general (HADS-A) and specific (PRAQ, MSAS) anxiety questionnaires and measures of maternal antenatal orientations, personality traits, cognitive and behavioural coping styles and attachment. RESULTS: Higher scores on the neuroticism and regulator orientation scale consistently predicted higher scores on the general and pregnancy related anxiety measures. Also, an interaction effect was found between the regulator scale and the neuroticism scale on the general anxiety symptoms and pregnancy related anxiety. Finally, the facilitator orientation scale and the neuroticism scale, predicted maternal separation anxiety in the postpartum period. CONCLUSION: Women differ in the risk factors, the nature and timing of heightened anxiety during the transition to motherhood. The anxieties of women tending to the regulator orientation are pregnancy related, whereas women tending to the facilitator orientation fear the separation from their child in the postpartum period.status: publishe

Reliability and validity of the Dutch version of the Maternal Antenatal Attachment Scale

In this study, we investigated the psychometric qualities of the Dutch version of the Maternal Antenatal Attachment Scale (MAAS). In a monocentric prospective observational cohort study, 403 expectant mothers completed a booklet with questionnaires in the first (T1), second (T2), and third (T3) pregnancy trimesters. In addition to the MAAS (T1-T3), the following measures were used: the Marlowe-Crowne Social Desirability Scale (T1), the Parental Bonding Inventory (T1), the Relationship Questionnaire (T1) the Facilitator scale and the Regulator scale (T3), the Edinburgh Postnatal Depression Scale (T1-T3) and the Pregnancy Related Anxiety Questionnaire (T1-T3). In this study, the mean of the MAAS scales increased as the pregnancy progressed. Good internal reliabilities were found for the Total MAAS scale, the Quality subscale and the Preoccupation subscale. Small-to-moderate correlations were found with social desirability, maternal orientation, parental care and adult attachment. Maternal mood was weakly associated with the quality but not with the intensity of the maternal attachment feelings. Overall, our findings suggest that the Dutch version of the Maternal Antenatal Attachment Scale is a reliable and valid measure of the early emotional tie between a pregnant woman and her unborn child.status: publishe

Three self-report questionnaires of the early mother-to-infant bond: reliability and validity of the Dutch version of the MPAS, PBQ and MIBS

In this study, we investigated the reliability and validity of three self-report questionnaires measuring the early emotional bond between a mother and her newborn infant: the Maternal Postpartum Attachment Scale (MPAS), the Postpartum Bonding Questionnaire (PBQ) and the Mother-to-Infant Bonding Scale (MIBS). In a monocentric prospective observational cohort study, 263 mothers completed the MPAS, the PBQ and the MIBS at 8-12 and at 20-25 weeks postpartum. The participants also completed measures of mental health and, during their pregnancy, measures of recalled parental bonding, adult romantic attachment, antenatal attachment and social desirability. In our study, the internal reliabilities of the PBQ and the MPAS were high at 8-12 weeks postpartum but dropped significantly at 20-25 weeks postpartum. Moderately strong correlations between the scales of the PBQ, the MPAS and the MIBS supported their construct validity. Further, weak correlations were found with social desirability and adult attachment representations, whereas moderate correlations were found with antenatal feelings of attachment and antenatal attitudes to motherhood. Finally, maternal feelings of bonding were also moderately associated with maternal mood. Overall, our findings suggest that the MPAS, the PBQ and the MIBS provide a reliable and valid indication of the early emotional tie between a woman and her newborn infant.status: publishe

Depressive Symptomatology in Pregnant and Postpartum Women. An exploratory study of the role of maternal orientations

Little is known about how an expecting woman's view of pregnancy, the child, and motherhood relates to antenatal and postpartum depressive symptomatology. In this study, we investigated the influence of the maternal orientations, as described by Raphael-Leff (Psychological processes of childbearing. The Anna Freud Centre, London, 2005), on the prevalence of depressive symptoms in pregnant and postpartum women. Four hundred three pregnant women participated in a longitudinal study and completed the EPDS and the HADS-D in each pregnancy trimester and between 8 to 12 and 20 to 25 weeks postpartum. In addition, measures of maternal orientation (PPQ), personality (NEO-FFI), coping styles (UCL), adult attachment (RQ), and parental bonding (PBI) were completed antenatally. Bivariate and multivariate analyses revealed that Neuroticism and the Regulator orientation are positively associated with the EPDS and HADS-D in both pregnant and postpartum women. These associations decreased in strength but remained significant after controlling for previous responses on the EPDS and HADS-D. Small negative associations were found between the Facilitator orientation and the HADS-D scores during pregnancy and the early postpartum period. However, this association did not hold its statistical significance within the hierarchical multiple regression models. The maternal orientations have a small but significant and independent contribution in the variance of depressive symptomatology in pregnant and postpartum women.status: publishe