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Vegetated buffer strips show variable capacity to reduce nutrient loading and sediment influx in ponds in two European countries
No full textEutrophication is a pervasive threat to freshwater ecosystems, and while the implementation of vegetated terrestrial buffer strips is increasingly promoted as a measure to reduce nutrient runoff into riverine systems, little is known on their effectiveness in protecting ponds in agricultural landscapes. We investigated the effect of buffer strip width on pond nutrient concentrations (TN, TP), the concentration of total suspended solids (TSS) and phytoplankton biomass (CHLa) using data from 34 ponds located on agricultural land in Belgium and Germany. We found a strong negative relation between buffer strip width and the concentrations of TN, TP and TSS in the German set of ponds. While even small buffer strips (5 m) can already be effective, our results also show that larger buffer strips are considerably more effective. In contrast, we did not find an association between buffer strip width and the concentrations of TN, TP and TSS in the Belgian ponds. This could be linked to differences in landscape characteristics, historical eutrophication and pond hydroperiod between both countries. In addition, we did not find evidence for an effect of buffer strips on phytoplankton biomass, which is likely reflecting the fact that, even with buffer strips, nutrient concentrations remained very high in the studied ponds.Funding
Open Access funding enabled and organized by Projekt DEAL. This work was supported by the PONDERFUL project (Grant No. H2020-LC-CLA-2019–2), funded by the European Union (H2020).
Acknowledgements
We thank Renee Van Dorst for her help during the field sampling and Mariana Meerhoff for the insightful discussions
Mechanisms of exercise limitation in heart failure with preserved ejection fraction and obesity: a case of engine-chassis mismatch
No full textObesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF), but its impact on limitations in peak oxygen uptake (Vo(2peak)) and its Fick determinants remains unclear. We assessed these factors in patients with obesity and patients without obesity with HFpEF, and non-HFpEF controls. Patients with HFpEF were subgrouped by body mass index [body mass index (BMI) >= 30 or < 30 kg/m(2)] into HFpEF with (HFpEF(Obese), n = 139) or without obesity (HFpEF(Nonobese), n = 317), and non-HFpEF controls (CON, n = 270). Cardiopulmonary exercise testing with simultaneous echocardiography assessed Vo(2peak), cardiac output (CO), stroke volume (SV), heart rate (HR), mean pulmonary artery pressure (mPAP) dynamics, and arterio-venous oxygen difference (a-vO(2)diff). HFpEF(Obese) tended to have higher absolute Vo(2peak) (+7%, P = 0.069), and significantly higher peak exercise CO and SV, with no differences in HR or a-vO(2)diff. Resting and exercise mPAP and mPAP/CO slopes did not differ between HFpEF obesity phenotypes. In contrast, bodyweight-indexed Vo(2peak) was markedly lower in HFpEF(Obese) (-23%) despite comparable indexed peak CO and SV. Regardless of HFpEF subgroup, Vo(2peak), central (CO, HR, mPAP) and peripheral factors (a-vO(2)diff) were markedly impaired in HFpEF versus CON (P < 0.05 for all). Therefore, although patients with HFpEF(Obese) have preserved absolute Vo(2peak) and cardiac reserve, bodyweight-indexing reveals that these adaptations are insufficient for the heightened metabolic and functional demands induced by obesity. Alternatively, several physiological HFpEF features are not exacerbated by obesity. This highlights the importance of incorporating weight loss alongside multicomponent therapeutic strategies to address exercise intolerance in HFpEF. NEW & NOTEWORTHY Patients with obesity with heart failure with preserved ejection fraction (HFpEF) have larger hearts and preserved cardiac reserve, but this was insufficient to maintain bodyweight-indexed Vo(2peak) at comparable levels to patients without obesity. Obesity did not exacerbate other HFpEF impairments, such as decreased oxygen extraction or elevated pulmonary pressures. This suggests weight loss may help to improve exercise intolerance in obese patients with HFpEF, but should be combined with other treatments to target all of the features that contribute to exercise intolerance in HFpEF.The authors thank the cardiology fellows who have contributed to performing the exams in the dyspnea clinic of Jessa Hospital (Hasselt, Belgium) over the years. In addition, the authors are grateful to the nurses for their vital paramedic support in the dyspnea clinic
De notaris als spiegel voor de testator bij opmaak van zijn woord dat klinkt na zijn dood! Hoe kunnen het rechtszekerheidsbeginsel en het zelfbeschikkingsbeginsel worden gewaarborgd bij het eigenhandig testament?
No full textOm af te wijken van de wettelijke erfopvolging kan in België een testament worden opgemaakt om over de goederen “om niet” te beschikken voor na de dood. Indien het eigenhandig testament als testeervorm wordt gekozen, moet het geschrift volledig door de testator zelf worden handgeschreven, gedagtekend en gehandtekend. Deze drie vormvereisten worden voorgeschreven op straffe van nietigheid. Deze thesis onderzoekt of het zelfbeschikkingsbeginsel en het rechtszekerheidsbeginsel bij deze testeervorm worden gewaarborgd. Naast een analyse van het Belgische recht wordt een rechtsvergelijkend onderzoek gevoerd met Nederland, Schotland en Frankrijk. Deze rechtsvergelijking dient als inspiratiebron met als doel aanbevelingen te formuleren om het zelfbeschikkingsbeginsel en het rechtszekerheidsbeginsel bij het eigenhandig testament in België te waarborgen. Zo wordt het opstellen van rechtsgeldige testamenten bevorderd waardoor de uiterste wil van de testator wordt gerespecteerd en uitgevoerd
Fiscale rechter hoeft afloop van fiscale strafzaak niet af te wachten om betwisting op te lossen
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Safety and efficacy of 6% hydroxyethyl starch in patients undergoing major surgery The randomised controlled PHOENICS trial
No full textBACKGROUND Hydroxyethyl starch (HES) is often used for maintaining vascular volume during major surgery. Long-term high-dose HES in septic patients promotes renal injury, whereas meta-analyses of current HES products in surgical patients do not show such effects. OBJECTIVE We studied if the peri-operative use of HES is noninferior to crystalloids in terms of acute kidney injury. Secondary outcome was the noninferiority of HES on worsening of renal injury and/or the incidence of a composite endpoint of major complications and mortality until postoperative day 90. DESIGN Randomised double-blind trial in patients undergoing elective abdominal surgery with expected blood loss at least 500 ml. SETTING Multicentre trial at 53 study sites in 10 European countries. PATIENTS One thousand nine hundred and eighty-five (HES 977, crystalloid-only 981) patients aged 40 to 85 years with ASA status II-III. INTERVENTION Either 6% HES 130/0.4 or a crystalloid solution. Dosing was guided by mean arterial pressure and/or routine haemodynamic variables. MAIN OUTCOME MEASURE Change from pre-operative to lowest cystatin C-based eGFR during the first 3 postoperative days. Key secondary outcome was a composite endpoint of mortality and major postoperative complications after 90 days. RESULTS Mean change in eGFR from baseline to minimum was -3.4 +/- 17.7 ml min-1 1.73 m-2 in HES patients and -1.0 +/- 17.1 ml min-11.73 m-2 in crystalloid-only patients (P < 0.001 for noninferiority). The key secondary endpoint occurred in 35% of patients in each group. There were no clinically relevant differences in any safety endpoint including 90-day renal function. Any cause mortality-difference until the end of 1-year follow-up was not significantly different (8.6% in HES and 10.1% in crystalloid patients). CONCLUSION Peri-operative use of HES was noninferior to crystalloids in short-term renal function or a composite of mortality and major complications at 90 days. PHOENICS provides robust evidence that peri-operative in-label use of HES is well tolerated.Assistance with the study: the authors appreciate substantial assistance from Sylvia Daemen and the European Society of Anaesthesiology and Intensive Care academic clinical research organisation. They also thank Daniel I. Sessler, Andreas Hoeft (deceased), Donat Spahn and Edward J. Macha for their service on the trial’s Data Safety Monitoring Board. Financial support and sponsorship: Fresenius Kabi Deutschland GmbH (sponsor, editing of the protocol, financial support, drug supply, data analysis, writing of the article), and B. Braun Melsungen AG (co-sponsor, editing of the protocol, financial support). Collaborators: http://links.lww.com/EJA/B230. Conflicts of interest: in general, all participating investigators received fees for patients and study drugs from Fresenius Kabi and B. Braun Melsungen. Further, the authors declare the following conflicts of interest
A systematic PRISMA review of traffic crashes, risk factors, determinants of risk behaviors, and interventions among motorcycle taxi riders
No full textMotorcycle taxi riders (MTRs) are a disproportionately high-risk occupational group for road traffic crashes (RTCs) and injuries (RTIs), raising significant public health, social, and economic concerns in low- and middle-income countries (LMICs). This review is the first PRISMA-compliant synthesis focused exclusively on MTRs, distinguishing them from commuters or delivery riders. It synthesizes evidence on reported crashes, risk factors, behavioral determinants of risky riding, and safety interventions. A PRISMA-compliant search across four databases yielded 651 articles, of which 56 met the inclusion criteria. Reported crash rates varied between 25.8 % and 78.6 %, with common injuries including fractures, head trauma, and soft-tissue damage. The main risk factors were speeding, alcohol and substance use, mobile phone distractions, and non-use of helmets, often exacerbated by demographic pressures such as youth, low income, and limited education. While most included studies were conducted in Africa, research from South Asia (Pakistan, India, Bangladesh, Vietnam) highlights risky motorcycling. However, it rarely isolates MTRs, underscoring a persistent geographic and occupational gap. Effective interventions included a Nigerian health education program that raised safety awareness from 21 % to 82 % and Uganda’s SafeBoda initiative, which reduced crashes by 39 %. The evidence underscores the urgent need for tailored interventions that combine rider education, behavior change strategies, protective gear, enforcement, and policies addressing income insecurity and informality. These
efforts are crucial not only for reducing morbidity and mortality but also for limiting wider socioeconomic costs in LMICs
Association between black carbon exposure and neurocognitive outcomes in 4 to 6 year old children from a peri-urban area of Cochabamba, Bolivia
No full textBlack Carbon (BC), een verontreinigende stof afkomstig van verbranding, is in verband gebracht met neurodegeneratie en
cognitieve achteruitgang. Hoewel 58% van de Latijns-Amerikaanse bevolking in gebieden woont die groter zijn dan de WHO-lucht kwaliteitsrichtlijnen blijft de impact van BC op de cognitie van kinderen onderbelicht. In Bolivia is PM2,5 dat wel niet gereguleerd, en de concentraties in Cochabamba variëren van 50 tot 120 µg/m³, wat wijst op aanzienlijke Blootstelling aan BC. Deze studie beoordeelde de associatie tussen BC-niveaus in de urine en cognitief prestaties bij kinderen van 4–6 jaar in Cochabamba. Deelnemers (n = 55; 30 jongens, 25 meisjes; gemiddelde leeftijd = 5,27 ± 1,01 jaar) werden gerekruteerd via huis-aan-huisgezondheidsenquêtes en een mobiele eenheid. De meeste waren Quechua (74,5%) en leefde in armoede (72,73%); 13 hadden geen formeel onderwijs genoten. Levensstijl, sociaal-economische factoren en gedrag werden geregistreerd via een vragenlijst. Cognitie werd beoordeeld met behulp van een cultureel aangepaste snelle beoordeling van cognitieve stoornissen en eye-tracking. Tijd bekeken (Tv%) op de juiste antwoorden diende als maatstaf voor de cognitieve belasting op zes domeinen. Urine BC (deeltjes/ml) werd gemeten via omgekeerde laserscanmicroscopie (gemiddelde = 106.971.136; SD = 168.163.890). Lineaire regressie liet geen significante associatie zien met totaal Tv% (β = -0,0066, p = 0,773). Op kwantiel gebaseerde g-berekeningen brachten echter significante negatieve associaties in h
Impact van opvoeding op de ondernemersidentiteit van next-gen ondernemers binnen familiebedrijven.
No full textHet onderzoek is uitgevoerd om een leemte in de literatuur op te vullen door te verkennen welke impact opvoeding heeft op de ondernemersidentiteit (EI) als eigendom van de volgende generatie (next-gen) bestuurders binnen familiebedrijven. Met een kwalitatieve Grounded Theory-benadering zijn semi-gestructureerde interviews afgenomen met vijf next-gen bestuurders en hun vijf respectievelijke opvoeders (vaders) in Vlaamse familiebedrijven. De resultaten tonen vier belangrijke gelijkenissen in de opvoeding: een ondersteunende en vrije opvoedingsstijl, vrijheid in studie- en carrièrekeuze (zonder druk om in het bedrijf te stappen), het meegeven van fundamentele normen en waarden, en een vroege, vaak onbewuste, blootstelling aan het familiebedrijf (door nabijheid, participatie en observatie). Hoewel de ondernemersidentiteit van elke next-gen uniek is en geen exacte kopie vormt van die van de opvoeder, is er wel een sterke 'identity fit' met het familiebedrijf zelf, voornamelijk dankzij de vroege blootstelling en de daaruit voortkomende intrinsieke passie. De studie bevestigt de cruciale rol van familiale rolmodellen (waarbij zowel vaders als moeders van invloed zijn, ongeacht hun zakelijke betrokkenheid) en de overdracht van normen en waarden in de vorming van de ondernemersidentiteit van de next-gen, en nuanceert eerdere aannames over een potentieel belemmerende verplichting door te benadrukken dat juist vrijheid in keuze leidde tot instroom