Bohn Stafleu van Loghum (Netherlands)

Plant communities are often dispersal‐limited and zoochory can be an efficient mechanism for plants to colonize new patches of potentially suitable habitat. We predicted that seed dispersal by ungulates acts as an ecological filter – which differentially affects individuals according to their characteristics and shapes species assemblages – and that the filter varies according to the dispersal mechanism (endozoochory, fur‐epizoochory and hoof‐epizoochory). We conducted two‐step individual participant data meta‐analyses of 52 studies on plant dispersal by ungulates in fragmented landscapes, comparing eight plant traits and two habitat indicators between dispersed and non‐dispersed plants. We found that ungulates dispersed at least 44% of the available plant species. Moreover, some plant traits and habitat indicators increased the likelihood for plant of being dispersed. Persistent or nitrophilous plant species from open habitats or bearing dry or elongated diaspores were more likely to be dispersed by ungulates, whatever the dispersal mechanism. In addition, endozoochory was more likely for diaspores bearing elongated appendages whereas epizoochory was more likely for diaspores released relatively high in vegetation. Hoof‐epizoochory was more likely for light diaspores without hooked appendages. Fur‐epizoochory was more likely for diaspores with appendages, particularly elongated or hooked ones. We thus observed a gradient of filtering effect among the three dispersal mechanisms. Endozoochory had an effect of rather weak intensity (impacting six plant characteristics with variations between ungulate‐dispersed and non‐dispersed plant species mostly below 25%), whereas hoof‐epizoochory had a stronger effect (eight characteristics included five ones with above 75% variation), and fur‐epizoochory an even stronger one (nine characteristics included six ones with above 75% variation). Our results demonstrate that seed dispersal by ungulates is an ecological filter whose intensity varies according to the dispersal mechanism considered. Ungulates can thus play a key role in plant community dynamics and have implications for plant spatial distribution patterns at multiple scales. Synthesis Plant communities are often dispersal‐limited and zoochory can be an efficient mechanism for plants to colonize new patches of potentially suitable habitat. Our analysis is the first synthesis of ungulate seed dispersal that compares characteristics from both non‐dispersed and dispersed diaspores, distinguishing the three zoochory mechanisms ungulates are involved in: endozoochory, hoof‐epizoochory and fur‐epizoochory. We confirmed that seed dispersal by ungulates is an ecological filter whose intensity increases from endozoochory, then hoof‐epizoochory to finally fur‐epizoochory. By filtering seed traits through dispersal, ungulates can thus play a key role in plant community dynamics and have implications for plant spatial distribution patterns at multiple scales.

Construction clients exert direct and indirect influences on the potential of construction projects to generate innovative solutions. Understanding their innovation adoption behaviour is thus crucial for the successful diffusion of new ideas. Although it is acknowledged that clients can support as well as suppress construction innovation, little is known about the circumstances that form their innovation adoption behaviour. On the basis of a client classification scheme and three cases of innovative construction projects in the Netherlands, the factors that constitute the adoption decision environment of professional public clients were investigated. A key finding is that professional public clients will adopt a new idea if they perceive that it performs better in meeting social requirements than traditional solutions, without compromising the client's social responsibilities. This perception is formed only if public professional clients rely on project-independent knowledge in order to cope with the project-dependent uncertainty. The diversity of construction clients in terms of needs, experiences and motivations largely influences the potential of construction innovations to be implemented. Moreover, innovating firms need to address the complex decision environment of construction clients more consciously. Dans le secteur de la construction, les clients exercent des influences directes et indirectes sur la capacité des projets de construction à générer des solutions innovantes. Il est essentiel de bien comprendre leur comportement en ce qui concerne l'adoption d'innovations pour la bonne diffusion d'idées nouvelles. Bien que l'on admette que les clients puissent également contribuer à la suppression de l'innovation dans la construction, on connaît peu les circonstances qui façonnent leur comportement lorsqu'il s'agit d'adopter des innovations. Sur la base d'un système de classement des clients et de trois cas de projets de construction novateurs aux Pays-Bas, on a étudié les facteurs qui constituent l'environnement dans lequel les clients professionnels du secteur public prennent leur décision d'adopter des innovations. Selon un résultat intéressant, les clients professionnels du secteur public adoptent une idée nouvelle s'ils ressentent qu'elle répondra mieux à des exigences sociales que les solutions traditionnelles, sans compromettre leurs responsabilités sociales. Cette perception n'existe que si les professionnels du secteur public s'appuient sur une connaissance indépendante du projet pour répondre à l'incertitude qui dépend du projet. La diversité des clients du secteur de la construction en termes de besoin, d'expériences et de motivations a une influence importante sur la capacité du secteur de la construction à mettre en œuvre des innovations. De plus, les entreprises innovantes ont besoin d'aborder de façon plus consciente l'environnement décisionnel complexe des clients du secteur de la construction. Mots clés: comportement du client, clients du secteur de la construction, environnement décisionnel, innovation, secteur public, innovation technologique

In 1984, Niklas Luhmann published Soziale Systeme in which he applies the idea of autopoiesis (= self-production) to social systems. Abstracted from its biological connotations, the concept of autopoiesis leads to a sharp distinction between different kinds of autopoietic organization, i.e. between life, consciousness and communication. According to Luhmann, the relationship between social systems and human beings cannot be adequately analysed except by taking into account that they are environments for one another. If this theoretical background is accepted, the concepts and theory of socialization need to be revised. Luhmann takes issues with classical notions such as internalization, inculcation, or 'socialization to the grounds of consensus' (Talcott Parsons). After a historical overview of social systems research and general systems theory, it is indicated how communications trigger further communications and realize the autopoiesis of social systems. In the second part of the article, the distinction between social systems and psychic systems is used to discuss issues crucial to socialization theory. Both a revision of the concept of socialization, and lines for an empirical research programme are proposed in accordance with Luhmann's theory of social systems.

Predicting brain pharmacokinetics is critical for central nervous system (CNS) drug development yet difficult due to ethical restrictions of human brain sampling. CNS pharmacokinetic (PK) profiles are often altered in CNS diseases due to disease-specific pathophysiology. We previously published a comprehensive CNS physiologically-based PK (PBPK) model that predicted the PK profiles of small drugs at brain and cerebrospinal fluid compartments. Here, we improved this model with brain non-specific binding and pH effect on drug ionization and passive transport. We refer to this improved model as Leiden CNS PBPK predictor V3.0 (LeiCNS-PK3.0). LeiCNS-PK3.0 predicted the unbound drug concentrations of brain ECF and CSF compartments in rats and humans with less than two-fold error. We then applied LeiCNS-PK3.0 to study the effect of altered cerebrospinal fluid (CSF) dynamics, CSF volume and flow, on brain extracellular fluid (ECF) pharmacokinetics. The effect of altered CSF dynamics was simulated using LeiCNS-PK3.0 for six drugs and the resulting drug exposure at brain ECF and lumbar CSF were compared. Simulation results showed that altered CSF dynamics changed the CSF PK profiles, but not the brain ECF profiles, irrespective of the drug's physicochemical properties. Our analysis supports the notion that lumbar CSF drug concentration is not an accurate surrogate of brain ECF, particularly in CNS diseases. Systems approaches account for multiple levels of CNS complexity and are better suited to predict brain PK.

Bachelor of Nursing 2020 is het nieuwe opleidingsprofiel voor de hbo-verpleegkundige, dat berekend is op de komende transities in de zorg. Uitgangspunt is de recente visie op gezondheid, waarin niet d

OBJECTIVE: To evaluate lung function and respiratory morbidity prospectively during the first year of life in patients with congenital diaphragmatic hernia and to study the effect of extracorporeal membrane oxygenation therapy. DESIGN: Prospective longitudinal cohort study. SETTING: Outpatient clinic of a tertiary-level pediatric hospital. PATIENTS: The cohort of 43 infants included 12 patients treated with extracorporeal membrane oxygenation. Evaluation was at 6 and 12 months; 33 infants were evaluated at both time points. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Maximal expiratory flow at functional residual capacity and functional residual capacity were measured with Masterscreen Babybody. Z-scores were calculated for maximal expiratory flow at functional residual capacity. Mean maximal expiratory flow at functional residual capacity values at 6 and 12 months were significantly below the expected values (mean z-score -1.4 and -1.5, respectively) without a significant change between both time points. Values did not significantly differ between extracorporeal membrane oxygenation and nonextracorporeal membrane oxygenation-treated patients. Functional residual capacity values were generally high, 47% were above the suggested normal range, and did not change significantly over time. Mean functional residual capacity values in extracorporeal membrane oxygenation-treated patients were significantly higher than in nonextracorporeal membrane oxygenation-treated patients (p = .006). The difference (5.1 mL/kg ± 1.8 SE) did not change significantly between the two time points. Higher mean airway pressure and longer duration of ventilation were associated with higher functional residual capacity. None of the perinatal characteristics was associated with maximal expiratory flow at functional residual capacity. Mean weight z-scores were significantly below zero at both time points (p < .001). Mean weight z-score in extracorporeal membrane oxygenation-treated patients were lower than in nonextracorporeal membrane oxygenation-treated patients (p = .046). CONCLUSIONS: Infants with congenital diaphragmatic hernia have decreased expiratory flows and increased functional residual capacity within the first year of life. Extracorporeal membrane oxygenation-treated patients with congenital diaphragmatic hernia may have more respiratory morbidity and concomitant growth impairment. Close follow-up beyond the neonatal period is therefore required.

The assessment of skin sensitisation is a key requirement in all regulated sectors, with the European Union's regulation of cosmetic ingredients being most challenging, since it requires quantitative skin sensitisation assessment based on new approach methodologies (NAMs). To address this challenge, an in-depth and harmonised understanding of NAMs is fundamental to inform the assessment. Therefore, we compiled a database of NAMs, and in vivo (human and local lymph node assay) reference data. Here, we expanded this database with 41 substances highly relevant for cosmetic industry. These structurally different substances were tested in six NAMs (Direct Peptide Reactivity Assay, KeratinoSens™, human Cell Line Activation Test, U-SENS™, SENS-IS, Peroxidase Peptide Reactivity Assay). Our analysis revealed that the substances could be tested without technical limitations, but were generally overpredicted when compared to reference results. Reasons for this reduced predictivity were explored through pairwise NAM comparisons and association of overprediction with hydrophobicity. We conclude that more detailed understanding of how NAMs apply to a wider range of substances is needed. This would support a flexible and informed choice of NAMs to be optimally applied in the context of a next generation risk assessment framework, ultimately contributing to the characterisation and reduction of uncertainty.

'Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding' published in 'Algemene Wet Bijzondere Ziektekosten'

The presence of serum antibodies is a biomarker of past infection. Instead of seroclassification aimed at measuring seroprevalence a population sample of serum antibody levels may be used to estimate the incidence of seroconversion. This article expands an earlier study into seroincidence estimation, employing models of the seroresponse that include probability of escaping infection, as well as nonexponential decay kinetics and different sources of noise. As previously, a constant force of infection is assumed. When the seroconversion rate is low, a substantial fraction of the population may not be old enough to have experienced any seroconversions, causing underestimation of seroconversion rates that may be substantial at young ages. A correction is given that can be shown to remove such age dependent bias. Simulation studies show that the updated models provide accurate estimates of seroconversion rates, but also that the presence of noise, when unaccounted for, may introduce considerable bias, especially at low (< 0.1/yr) seroconversion rates and young ages. The revised serocalculator scripts can be used to update the R package "seroincidence."

Pharmacometric models using lognormal distributions have become commonplace in pharmacokinetic-pharmacodynamic investigations. The extent to which it can be interpreted by traditional description of variability through the normal distribution remains elusive. In this tutorial, the comparison is made using formal approximation methods. The quality of the resulting approximation was assessed by the similarity of prediction intervals (PIs) to true values, illustrated using 80% PIs. Approximated PIs were close to true values when lognormal standard deviation (omega) was smaller than about 0.25, depending mostly on the desired precision. With increasing omega values, the precision of approximation worsens and starts to deteriorate at omega values of about 1. With such high omega values, there is no resemblance between the lognormal and normal distribution anymore. To support dissemination and interpretation of these nonlinear properties, some additional statistics are discussed in the context of the three regions of behavior of the lognormal distribution.

OBJECTIVE: Patients with functional somatic syndromes show reduced correspondence between induced physiological changes and self-reported symptoms in a rebreathing paradigm, as well as elevated symptoms unrelated to physiological changes after induction of negative affective states in an affective picture-viewing paradigm. Detailed results of both paradigms separately were published elsewhere. The main goal of the current report is to describe the relationship between the responses to these two paradigms measuring distortions in symptom perception in a well-described sample of patients with fibromyalgia and/or chronic fatigue syndrome. METHODS: Patients (N = 81) with fibromyalgia and/or chronic fatigue syndrome participated in a test session comprising four well-validated paradigms, including the picture-viewing and rebreathing paradigm. Using mixed model analyses, we tested whether the amount of affective modulation of symptom reporting was related to distorted perception of induced dyspnea. In an exploratory way, we assessed the role of several individual difference variables as moderators. RESULTS: There was no relationship between patients' amount of affective modulation of symptom reporting, as assessed with the picture paradigm, and level of distortion in dyspnea perception, as assessed with the rebreathing paradigm (effect of affective modulation in the subjective recovery from induced dyspnea: F1,70 = 0.16, p = .70; time by affective modulation interaction effect: F4,70 = 0.14, p = .97). CONCLUSIONS: Biased symptom reporting in one paradigm is unrelated to biased symptom reporting in the other paradigm, indicating that distortions in symptom perception in patients with functional somatic syndromes are not a trait-like, cross-situationally stable condition, but a versatile dysfunction that is context dependent.

The sole diagram in On the Origin of Species is generally considered to be merely an illustration of Darwin's ideas, but such an interpretation ignores the fact that Darwin himself expressly stated that the diagram helped him to discover and express his ideas. This article demonstrates that developing the so-called "tree diagram" substantially aided Darwin's heuristics. This demonstration is based on an interpretation of the diagram and of 17 sketches found in Darwin's scientific papers. The key to this interpretation is the meaning that Darwin assigned to the graphic elements (points, lines, and spaces) he used to construct the preliminary sketches and the diagram. I argue that each of the sketches contributed to the shaping of Darwin's ideas and that, in their succession, each added new elements that ultimately resulted in the fully developed published diagram.

Het is een echt modewoord: 'artificial-intelligence', ofwel AI.Nu ook onze radiologen vervangen zullen gaan worden door computers kunnen de andere clinici niet achterblijven.Slimmer en vooral veel sneller zullen de computers worden.Niet alleen röntgenbeelden zullen spoedig door computers worden geïnterpreteerd, maar ook de operatiekamer zal worden overgenomen door gemotoriseerd materieel.De 'operatierobot', zoals we die nu kennen, lijkt voorlopig nog maar de eerste stap in een gestage verdringing van de mensenhand in de patiënt.Deze ontwikkeling is dan alleen mogelijk als we goede betrouwbare data hebben om de kennissystemen mee te voeden en te leren.Dankzij onze NVU-prostatectomieregistratie, die overigens heel accurate invoer bevat wanneer ze wordt vergeleken met de Prozib-data, zo bleek uit recente gegevens, hebben we beter inzicht in de prostatectomieresultaten.Nu ligt de uitdaging in het verder verbeteren

Vaccine hesitancy (VH) is an issue for healthcare students, influenced by safety concerns and misinformation. The need for better communication training and understanding sociocultural factors in VH was highlighted in a European University Alliance seminar. Practical exercises like simulation role-playing, interprofessional collaboration, and digital literacy may improve vaccine education.

The consumption of asparagus is associated with the production of malodorous urine with considerable interindividual variability (IIV). To characterize the urinary odor kinetics after consumption of asparagus spears, we conducted a study with consenting attendees from two American Society for Clinical Pharmacology and Therapeutics (ASCPT) meetings. Subjects were randomized to eat a specific number of asparagus spears, and then asked to report their urinary odor perception. Eighty-seven subjects were included in the final analysis. A mixed effect proportional odds model was developed that adequately characterized the dose-response relationship. We estimated the half-life of the asparagus effect on malodorous urine to be 4.7 hours (relative standard error (RSE) = 13.2%), and identified a dose-response slope term with good precision (24.3%). Age was found as the predictor of IIV in slope estimates. This study design and tools can be used as a demonstration "crowdsourcing" project for studying population kinetics in organizational and educational settings.

Dit werkboek biedt handvatten om met pedagogisch medewerkers in gesprek te gaan over hun werk. Het laat zien hoe je samen na kunt denken over de pedagogische taken van het kindcentrum. Het boek is geschreven voor pedagogen, begeleiders, coaches en leidinggevenden in de kinderopvang.

This essay raises the question why there is a difference between the way we treat animals and humans, when it comes to killing. The question is analysed with the help of two special cases. On the one hand, a non-autonomous patient whose suffering is immense and hopeless. On the other hand, an old dog that equally suffers badly. The differences and similarities are analysed and discussed from the perspective of ethical theory. The discussion includes an analysis of the taboo on killing humans and the possible biological explanation for this phenomenon. It is argued that overriding this taboo causes existential moral doubts. This burden can serve as a moral justification for operating (even) more cautiously in case of the human patient. The conclusion has an impact on both our dealings with animals and humans.

'Wet op de beroepen in de individuele gezondheidszorg' published in 'Algemene Wet Bijzondere Ziektekosten'

'Wet toelating zorginstellingen' published in 'Algemene Wet Bijzondere Ziektekosten'

'Wet marktordening gezondheidszorg' published in 'Algemene Wet Bijzondere Ziektekosten'