Lessons from Flanders: drivers & pitfalls of cooperation on a business park

For almost ten years several companies located in De Zaubeek Business Park in Flanders have been collaborating with the goal of creating a more sustainable industrial zone. Many initiatives have been developed in this business park, many successful, but some clearly pointed to constraints that require action beyond the reach of the companies or the business association. The former chairman of the association has been involved in several of these initiatives and we asked him to tell his story

'Thunder Measure Vet Device' : een praktische en objectieve methode om de lichaamsconditie van melkvee te schatten

The scoring of the body condition at specific time points during the lactation cycle has proven to be essential in the nutritional management of modern dairy herds. The 'Thunder Measure (TM) Vet Device' has recently been developed by Ingenera SA, Switzerland to accurately and objectively measure the body condition score (BCS) of dairy cows in the field. Based on a smartphone app linked to a laser device, the system makes an analysis of three dorsal view photographs taken, for example, when cows are lined up in the feed alley. In the present study, the correlation and repeatability of the system were examined in comparison with the conventional visual measurement of BCS and ultrasonographic measurement of the backfat thickness (BFT). The conventional measurement of the BCS was done by a veterinary surgeon experienced in body condition scoring and by less experienced veterinary undergraduate students. The results obtained via the TM Vet Device were only moderately correlated with the BFT measurements (r=0.38, P<0.001), but were highly correlated (r=0.82, P<0.001) and showed good agreement with the BCS results obtained by the experienced veterinary surgeon. The BCS results obtained by the undergraduate students were highly variable, leading to a highly variable correlation with the results gathered using the TM Vet Device (r=0.23 (P<0.05) to r=0.74 (P<0.001)). The repeatability of the results obtained by the device was very high (91%). Only the repeatability of the results obtained by the experienced veterinarian (93%) and the BFT measurement (96%) were higher. In lean animals, some overscoring by the device was noted in comparison with the scores given by the experienced veterinary surgeon, although this overscoring diminished as the body condition score assigned by the veterinary surgeon increased. The ease to use and the accuracy of the results obtained allow the TM Vet Device to be considered a useful tool in the nutritional management of a modern dairy herd

Training curriculum in minimally invasive emergency digestive surgery : 2022 WSES position paper

Background Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. Methods This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. Results Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20-107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency. Conclusions Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.Peer reviewe