HOGENT University of Applied Sciences and Arts

In recent years, great emphasis has been placed on the role of arterial stiffness in the development of cardiovascular diseases. Indeed, the assessment of arterial stiffness is increasingly used in the clinical assessment of patients. Although several papers have previously addressed the methodological issues concerning the various indices of arterial stiffness currently available, and their clinical applications, clinicians and researchers still report difficulties in selecting the most appropriate methodology for their specific use. This paper summarizes the proceedings of several meetings of the European Network for Non-invasive Investigation of Large Arteries and is aimed at providing an updated and practical overview of the most relevant methodological aspects and clinical applications in this area.

The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

The widespread popularity of density functional theory has given rise to an extensive range of dedicated codes for predicting molecular and crystalline properties. However, each code implements the formalism in a different way, raising questions about the reproducibility of such predictions. We report the results of a community-wide effort that compared 15 solid-state codes, using 40 different potentials or basis set types, to assess the quality of the Perdew-Burke-Ernzerhof equations of state for 71 elemental crystals. We conclude that predictions from recent codes and pseudopotentials agree very well, with pairwise differences that are comparable to those between different high-precision experiments. Older methods, however, have less precise agreement. Our benchmark provides a framework for users and developers to document the precision of new applications and methodological improvements.

Several theoretical views of automaticity are discussed. Most of these suggest that automaticity should be diagnosed by looking at the presence of features such as unintentional, uncontrolled/uncontrollable, goal independent, autonomous, purely stimulus driven, unconscious, efficient, and fast. Contemporary views further suggest that these features should be investigated separately. The authors examine whether features of automaticity can be disentangled on a conceptual level, because only then is the separate investigation of them worth the effort. They conclude that the conceptual analysis of features is to a large extent feasible. Not all researchers agree with this position, however. The authors show that assumptions of overlap among features are determined by the other researchers' views of automaticity and by the models they endorse for information processing in general.

Endothelial dysfunction plays a key role in the pathogenesis of diabetic vascular disease. The endothelium controls the tone of the underlying vascular smooth muscle through the production of vasodilator mediators. The endothelium-derived relaxing factors (EDRF) comprise nitric oxide (NO), prostacyclin, and a still elusive endothelium-derived hyperpolarizing factor (EDHF). Impaired endothelium-dependent vasodilation has been demonstrated in various vascular beds of different animal models of diabetes and in humans with type 1 and 2 diabetes. Several mechanisms of endothelial dysfunction have been reported, including impaired signal transduction or substrate availibility, impaired release of EDRF, increased destruction of EDRF, enhanced release of endothelium-derived constricting factors and decreased sensitivity of the vascular smooth muscle to EDRF. The principal mediators of hyperglycaemia-induced endothelial dysfunction may be activation of protein kinase C, increased activity of the polyol pathway, non-enzymatic glycation and oxidative stress. Correction of these pathways, as well as administration of ACE inhibitors and folate, has been shown to improve endothelium-dependent vasodilation in diabetes. Since the mechanisms of endothelial dysfunction appear to differ according to the diabetic model and the vascular bed under study, it is important to select clinically relevant models for future research of endothelial dysfunction.

AIMS: This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the widely cited 2019 report in presenting cardiovascular disease (CVD) statistics for the 57 ESC member countries. METHODS AND RESULTS: Statistics pertaining to 2019, or the latest available year, are presented. Data sources include the World Health Organization, the Institute for Health Metrics and Evaluation, the World Bank, and novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery. New material in this report includes sociodemographic and environmental determinants of CVD, rheumatic heart disease, out-of-hospital cardiac arrest, left-sided valvular heart disease, the advocacy potential of these CVD statistics, and progress towards World Health Organization (WHO) 2025 targets for non-communicable diseases. Salient observations in this report: (i) Females born in ESC member countries in 2018 are expected to live 80.8 years and males 74.8 years. Life expectancy is longer in high income (81.6 years) compared with middle-income (74.2 years) countries. (ii) In 2018, high-income countries spent, on average, four times more on healthcare than middle-income countries. (iii) The median PM2.5 concentrations in 2019 were over twice as high in middle-income ESC member countries compared with high-income countries and exceeded the EU air quality standard in 14 countries, all middle-income. (iv) In 2016, more than one in five adults across the ESC member countries were obese with similar prevalence in high and low-income countries. The prevalence of obesity has more than doubled over the past 35 years. (v) The burden of CVD falls hardest on middle-income ESC member countries where estimated incidence rates are ∼30% higher compared with high-income countries. This is reflected in disability-adjusted life years due to CVD which are nearly four times as high in middle-income compared with high-income countries. (vi) The incidence of calcific aortic valve disease has increased seven-fold during the last 30 years, with age-standardized rates four times as high in high-income compared with middle-income countries. (vii) Although the total number of CVD deaths across all countries far exceeds the number of cancer deaths for both sexes, there are 15 ESC member countries in which cancer accounts for more deaths than CVD in males and five-member countries in which cancer accounts for more deaths than CVD in females. (viii) The under-resourced status of middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, ablation procedures, device implantation, and cardiac surgical procedures. CONCLUSION: Risk factors and unhealthy behaviours are potentially reversible, and this provides a huge opportunity to address the health inequalities across ESC member countries that are highlighted in this report. It seems clear, however, that efforts to seize this opportunity are falling short and present evidence suggests that most of the WHO NCD targets for 2025 are unlikely to be met across ESC member countries.

BACKGROUND: Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. METHODS: Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. RESULTS: 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. CONCLUSION: 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.

Abstract Technological Pedagogical Content Knowledge (TPACK) has been introduced as a conceptual framework for the knowledge base teachers need to effectively teach with technology. The framework stems from the notion that technology integration in a specific educational context benefits from a careful alignment of content, pedagogy and the potential of technology, and that teachers who want to integrate technology in their teaching practice therefore need to be competent in all three domains. This study is a systematic literature review about TPACK of 55 peer‐reviewed journal articles (and one book chapter), published between 2005 and 2011. The purpose of the review was to investigate the theoretical basis and the practical use of TPACK. Findings showed different understandings of TPACK and of technological knowledge. Implications of these different views impacted the way TPACK was measured. Notions about TPACK in subject domains were hardly found in the studies selected for this review. Teacher knowledge (TPACK) and beliefs about pedagogy and technology are intertwined. Both determine whether a teacher decides to teach with technology. Active involvement in (re)design and enactment of technology‐enhanced lessons was found as a promising strategy for the development of TPACK in (student‐)teachers. Future directions for research are discussed.

Abstract BACKGROUND Black soldier fly larvae are converters of organic waste into edible biomass, of which the composition may depend on the substrate. In this study, larvae were grown on four substrates: chicken feed, vegetable waste, biogas digestate, and restaurant waste. Samples of prepupae and substrates were freeze‐dried and proximate, amino acid, fatty acid and mineral analyses were performed. RESULTS Protein content of prepupae varied between 399 and 431 g kg −1 dry matter ( DM ) among treatments. Differences in amino acid profile of prepupae were small. On the other hand, the ether extract ( EE ) and ash contents differed substantially. Prepupae reared on digestate were low in EE and high in ash (218 and 197 g kg −1 DM , respectively) compared to those reared on vegetable waste (371 and 96 g kg −1 DM , respectively), chicken feed (336 and 100 g kg −1 DM , respectively) and restaurant waste (386 and 27 g kg −1 DM , respectively). Prepupal fatty acid profiles were characterised by high levels of C12 :0 in all treatments. CONCLUSION Since protein content and quality were high and comparable for prepupae reared on different substrates, black soldier fly could be an interesting protein source for animal feeds. However, differences in EE and ash content as a function of substrate should be considered. © 2016 Society of Chemical Industry

Inflammasomes are a set of intracellular protein complexes that enable autocatalytic activation of inflammatory caspases, which drive host and immune responses by releasing cytokines and alarmins into circulation and by inducing pyroptosis, a proinflammatory cell death mode. The inflammasome type mediating these responses varies with the microbial pathogen or stress factor that poses a threat to the organism. Since the discovery that polymorphisms in inflammasome genes are linked to common autoimmune diseases and less frequent periodic fever syndromes, inflammasome signaling has been dissected at the molecular level. In this review, we present recently gained insight on the distinct inflammasome types, their activation and effector mechanisms, and their modulation by microbial virulence factors. In addition, we discuss recently gained knowledge on the role of deregulated inflammasome activity in human autoinflammatory, autoimmune, and infectious diseases.

Trajectory inference has radically enhanced single-cell RNA-seq research by enabling the study of dynamic changes in gene expression. Downstream of trajectory inference, it is vital to discover genes that are (i) associated with the lineages in the trajectory, or (ii) differentially expressed between lineages, to illuminate the underlying biological processes. Current data analysis procedures, however, either fail to exploit the continuous resolution provided by trajectory inference, or fail to pinpoint the exact types of differential expression. We introduce tradeSeq, a powerful generalized additive model framework based on the negative binomial distribution that allows flexible inference of both within-lineage and between-lineage differential expression. By incorporating observation-level weights, the model additionally allows to account for zero inflation. We evaluate the method on simulated datasets and on real datasets from droplet-based and full-length protocols, and show that it yields biological insights through a clear interpretation of the data.

BACKGROUND: Word frequency is the most important variable in language research. However, despite the growing interest in the Chinese language, there are only a few sources of word frequency measures available to researchers, and the quality is less than what researchers in other languages are used to. METHODOLOGY: Following recent work by New, Brysbaert, and colleagues in English, French and Dutch, we assembled a database of word and character frequencies based on a corpus of film and television subtitles (46.8 million characters, 33.5 million words). In line with what has been found in the other languages, the new word and character frequencies explain significantly more of the variance in Chinese word naming and lexical decision performance than measures based on written texts. CONCLUSIONS: Our results confirm that word frequencies based on subtitles are a good estimate of daily language exposure and capture much of the variance in word processing efficiency. In addition, our database is the first to include information about the contextual diversity of the words and to provide good frequency estimates for multi-character words and the different syntactic roles in which the words are used. The word frequencies are freely available for research purposes.

The aim of this review is to give a comprehensive overview of the current knowledge on plant metabolites of mycotoxins, also called masked mycotoxins. Mycotoxins are secondary fungal metabolites, toxic to human and animals. Toxigenic fungi often grow on edible plants, thus contaminating food and feed. Plants, as living organisms, can alter the chemical structure of mycotoxins as part of their defence against xenobiotics. The extractable conjugated or non-extractable bound mycotoxins formed remain present in the plant tissue but are currently neither routinely screened for in food nor regulated by legislation, thus they may be considered masked. Fusarium mycotoxins (deoxynivalenol, zearalenone, fumonisins, nivalenol, fusarenon-X, T-2 toxin, HT-2 toxin, fusaric acid) are prone to metabolisation or binding by plants, but transformation of other mycotoxins by plants (ochratoxin A, patulin, destruxins) has also been described. Toxicological data are scarce, but several studies highlight the potential threat to consumer safety from these substances. In particular, the possible hydrolysis of masked mycotoxins back to their toxic parents during mammalian digestion raises concerns. Dedicated chapters of this article address plant metabolism as well as the occurrence of masked mycotoxins in food, analytical aspects for their determination, toxicology and their impact on stakeholders.

Abstract This paper revisits and extends our earlier work (in 2005) in the pages of this journal. We argue that there is a need for more fine‐grained understanding of the country context along two dimensions: (1) institutional development and (2) infrastructure and factor market development. Specifically, we propose an enriched typology of emerging economies with a focus on mid‐range emerging economies, which are positioned between traditional emerging economies and newly developed economies. Then we examine new multinationals from these mid‐range emerging economies that have internationalized both regionally and globally. We outline directions for further research based on this typology in terms of (1) government influence, (2) resource orchestration, (3) market entry, and (4) corporate governance regarding the internationalization strategy of these emerging multinationals from mid‐range economies.

Abstract Systematic assessments of species extinction risk at regular intervals are necessary for informing conservation action 1,2 . Ongoing developments in taxonomy, threatening processes and research further underscore the need for reassessment 3,4 . Here we report the findings of the second Global Amphibian Assessment, evaluating 8,011 species for the International Union for Conservation of Nature Red List of Threatened Species. We find that amphibians are the most threatened vertebrate class (40.7% of species are globally threatened). The updated Red List Index shows that the status of amphibians is deteriorating globally, particularly for salamanders and in the Neotropics. Disease and habitat loss drove 91% of status deteriorations between 1980 and 2004. Ongoing and projected climate change effects are now of increasing concern, driving 39% of status deteriorations since 2004, followed by habitat loss (37%). Although signs of species recoveries incentivize immediate conservation action, scaled-up investment is urgently needed to reverse the current trends.

Executive Overview Entrepreneurship has become firmly established as a legitimate scholarly discipline. For entrepreneurship to influence managerial practice and public policy, however, we believe there needs to be a substantive shift in the focus, content, and methods of entrepreneurship research. We discuss ways this shift could occur, highlighting the need to recognize the multiple dimensions of entrepreneurial activities—and the importance of examining the heterogeneous aspects of context and factoring them into future theory building and testing efforts—and delineating the microfoundations of entrepreneurship. We also discuss how to strengthen the link between entrepreneurship research and public policy.

INTRODUCTION: Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact. The aim of this study was to describe the European hospitalized population with severe burn injury, including the incidence, etiology, risk factors, mortality, and causes of death. METHODS: The systematic literature search (1985 to 2009) involved PubMed, the Web of Science, and the search engine Google. The reference lists and the Science Citation Index were used for hand searching (snowballing). Only studies dealing with epidemiologic issues (for example, incidence and outcome) as their major topic, on hospitalized populations with severe burn injury (in secondary and tertiary care) in Europe were included. Language restrictions were set on English, French, and Dutch. RESULTS: The search led to 76 eligible studies, including more than 186,500 patients in total. The annual incidence of severe burns was 0.2 to 2.9/10,000 inhabitants with a decreasing trend in time. Almost 50% of patients were younger than 16 years, and ~60% were male patients. Flames, scalds, and contact burns were the most prevalent causes in the total population, but in children, scalds clearly dominated. Mortality was usually between 1.4% and 18% and is decreasing in time. Major risk factors for death were older age and a higher total percentage of burned surface area, as well as chronic diseases. (Multi) organ failure and sepsis were the most frequently reported causes of death. The main causes of early death (< 48 hours) were burn shock and inhalation injury. CONCLUSIONS: Despite the lack of a large-scale European registration of burn injury, more epidemiologic information is available about the hospitalized population with severe burn injury than is generally presumed. National and international registration systems nevertheless remain necessary to allow better targeting of prevention campaigns and further improvement of cost-effectiveness in total burn care.

Whole-genome sequencing of the seagrass Zostera, representing the first marine angiosperm genome to be fully sequenced, provides insight into the evolutionary changes associated with a transition to a marine environment in this angiosperm lineage. The seagrass Zostera marina, or eelgrass, is widely distributed throughout the Northern Hemisphere. It is therefore of considerable ecological importance but — as with other seagrasses — its coastal habitats are among the world's most threatened ecosystems. Jeanine Olsen and colleagues report the whole-genome sequence of Zostera. Their analyses provide insights into the evolutionary changes associated with the 'back to the sea' reverse evolutionary trajectory that has occurred in this angiosperm lineage, including the loss of the entire repertoire of stomatal genes, and the presence of sulfated cell-wall polysaccharides that are more macro-algal-like than plant-like. Seagrasses colonized the sea1 on at least three independent occasions to form the basis of one of the most productive and widespread coastal ecosystems on the planet2. Here we report the genome of Zostera marina (L.), the first, to our knowledge, marine angiosperm to be fully sequenced. This reveals unique insights into the genomic losses and gains involved in achieving the structural and physiological adaptations required for its marine lifestyle, arguably the most severe habitat shift ever accomplished by flowering plants. Key angiosperm innovations that were lost include the entire repertoire of stomatal genes3, genes involved in the synthesis of terpenoids and ethylene signalling, and genes for ultraviolet protection and phytochromes for far-red sensing. Seagrasses have also regained functions enabling them to adjust to full salinity. Their cell walls contain all of the polysaccharides typical of land plants, but also contain polyanionic, low-methylated pectins and sulfated galactans, a feature shared with the cell walls of all macroalgae4 and that is important for ion homoeostasis, nutrient uptake and O2/CO2 exchange through leaf epidermal cells. The Z. marina genome resource will markedly advance a wide range of functional ecological studies from adaptation of marine ecosystems under climate warming5,6, to unravelling the mechanisms of osmoregulation under high salinities that may further inform our understanding of the evolution of salt tolerance in crop plants7.

Abstract In this introductory article to the thematic issue, our aim is to discuss the state of the art in research on co-production of public services. We define co-production, for the purpose of this article rather narrowly, as the involvement of individual citizens and groups in public service delivery. We discuss the concept along three main research lines that emerge from the literature: what are the motives for co-production? How can co-production be organized effectively? What are the effects of co-production? Secondly, we also critically assess the state of the art and discuss some conceptual and methodological issues that are still open to debate. Thirdly, we propose some directions for future research: greater methodological diversity and the need for empirical and comparative research with a specific attention for theoretical advancement in co-production research.

Next to physical health problems and economic damage, the coronavirus disease 2019 (COVID-19) pandemic and associated lockdown measures taken by governments of many countries are expected to cause mental health problems. Especially for adolescents, who highly rely on social contacts with peers, the prolonged period of social isolation may have detrimental effects on their mental health. Based on the mood management theory, the current study examines if social media are beneficial for adolescents to cope with feelings of anxiety and loneliness during the quarantine. A survey study among 2,165 (Belgian) adolescents (13-19 years old) tested how feelings of anxiety and loneliness contributed to their happiness level, and whether different social media coping strategies (active, social relations, and humor) mediated these relations. Structural equation modeling revealed that feelings of loneliness had a higher negative impact on adolescents' happiness than feelings of anxiety. However, anxious participants indicated to use social media more often to actively seek for a manner to adapt to the current situation, and to a lesser extent as a way to keep in touch with friends and family. The indirect effect of anxiety on happiness through active coping was significantly positive. Participants who were feeling lonely were more inclined to use social media to cope with lacking social contact. However, this coping strategy was not significantly related to their happiness feelings. Humorous coping was positively related with feelings of happiness, but not influenced by loneliness or anxiety. To conclude, social media can be used as a constructive coping strategy for adolescents to deal with anxious feelings during the COVID-19 quarantine.