Initial results from Phase 2 of the international urban energy balance model comparison

Urban land surface schemes have been developed to model the distinct features of the urban surface and the associated energy exchange processes. These models have been developed for a range of purposes and make different assumptions related to the inclusion and representation of the relevant processes. Here, the first results of Phase 2 from an international comparison project to evaluate 32 urban land surface schemes are presented. This is the first large-scale systematic evaluation of these models. In four stages, participants were given increasingly detailed information about an urban site for which urban fluxes were directly observed. At each stage, each group returned their models' calculated surface energy balance fluxes. Wide variations are evident in the performance of the models for individual fluxes. No individual model performs best for all fluxes. Providing additional information about the surface generally results in better performance. However, there is clear evidence that poor choice of parameter values can cause a large drop in performance for models that otherwise perform well. As many models do not perform well across all fluxes, there is need for caution in their application, and users should be aware of the implications for applications and decision making

Multi-year interlaboratory exercises for the analysis of illicit drugs and metabolites in wastewater:development of a quality control system

Thirty-seven laboratories from 25 countries present the development of an inter-laboratory testing scheme for the analysis of seven illicit drug residues in standard solutions, tap- and wastewater. Almost 10 000 concentration values were evaluated: triplicates of up to five samples and 26 laboratories per year. The setup was substantially improved with experiences gained across the six repetitions (e.g. matrix type, sample conditions, spiking levels). From this, (pre-)analytical issues (e.g. pH adjustment, filtration) were revealed for specific analytes which resulted in formulation of best-practice protocols for inter-laboratory setup and analytical procedures. The results illustrate the effectiveness of the inter-laboratory setup to assess laboratory performance in the framework of wastewater-based epidemiology. The exercise proved that measurements of laboratories were of high quality (>80% satisfactory results for six out of seven analytes) and that analytical follow-up is important to assist laboratories in improving robustness of wastewater-based epidemiology results

Minimally invasive treatments of uterine fibroids

This thesis assesses clinical results and technical developments of two minimally invasive treatments for symptomatic uterine fibroids: uterine artery embolization (UAE) and magnetic resonance-guided high intensity focused ultrasound (MR-HIFU). Part I: Uterine artery embolization The results of a survey on UAE practice in Europe are described. Respondents from 24 countries were included. Most centers had 5-10 years of experience with UAE, and performed 10-50 procedures per year. For better implementation of UAE in clinical practice, collaboration between referring gynecologists and interventional radiologists is mandatory. We describe the clinical results of UAE assessed up to five years post-treatment in 100 women. Continued symptom relief was observed in 72%. Twenty-three women underwent additional major because of insufficient symptom relief, formation of new fibroids or complications. Ninety percent was (very) satisfied with UAE treatment and its result. Predictors of treatment failure were lack of improvement in symptoms of bleeding or pain at 1-year follow-up, and volume reduction of the dominant fibroid. We assessed the effects of UAE on psychological and sexual well-being in 141 women. Sexual and psychological well-being both improved significantly after UAE. Thirty-four percent reported an increase in sexual activity after UAE. The percentage of women reporting problems with sexual functioning concerning lubrication, orgasm, or pain during sexual activity decreased by respectively 7%, 36% and 14%. The total score on the SCL-90 decreased significantly indicating a decrease in emotional and somatic concerns. Part II: Volumetric magnetic resonance-guided high intensity focused ultrasound MR-HIFU treatment with a point-by-point ablation technique has been used for uterine fibroid treatment since 2004. In 2009 a new volumetric technique was introduced. We present the results of the first clinical trial assessing safety and technical feasibility of this approach. Treatments were performed on an outpatient basis, and tolerated well. No serious adverse events were reported and recovery was fast. Treatment efficacy is an important issue to address during MR-HIFU treatment, since uterine fibroids are large resulting in long treatment times. We present the first experience of targeted vessel ablation, resulting in almost total fibroid devascularization. There was a reduction in fibroid related symptoms, and an increase in quality of life. Volume reduction ranged from 31-59%. Non-contrast agent dependent methods to visualize the non-perfused volume may sometimes be preferred for evaluation of the result after MR-HIFU treatment for uterine fibroids. We describe the results of a study investigating the use of different b-value combinations for diffusion weighted MR imaging (DWI) and apparent diffusion coefficient (ADC) mapping for evaluation of treatment results. There is a significant decrease in the ADC of treated fibroid tissue when low b-values were used. When higher b-values were used, we found a significant increase in ADC. In summary this thesis explored the clinical results and technical feasibility of UAE and MR-HIFU as minimally invasive treatment options for symptomatic uterine fibroids. Adequate selection of the best suitable candidates for each treatment in a multidisciplinary approach by both gynecologists and radiologists needs future research