44197 research outputs found
Sort by
Impact van waterstandsfluctuaties op de stabiliteit van oevers in het Albertkanaal tussen sluizen Olen en Wijnegem
No full textDeze masterproef onderzoekt de impact van waterstandsfluctuaties in het Albertkanaal op de stabiliteit van oevers en kaaimuren tussen de sluizen van Olen en Wijnegem. Door klimaatverandering nemen extreme droogte en neerslag toe, wat leidt tot grotere afwijkingen van het streefpeil. Dit kan de structurele stabiliteit van kaaimuren beïnvloeden. Het doel is om na te gaan in welke mate deze fluctuaties een risico vormen voor hun integriteit.
Het traject tussen de sluizen van Olen en Wijnegem is geïnventariseerd. Er werden 10 veel voorkomende scenario’s geselecteerd die vervolgens voor vijf verschillende kanaalpeilen getest werden: streefpeil (9,70 m TAW), absolute maximum (10,02 m TAW), absolute minimum (9,20 m TAW), verhoogd peil (9,90 m TAW) en verlaagd peil (9,52 m TAW). Deze waterstanden zijn afgeleid uit een onzekerheidsanalyse van de meetreeks van de waterstanden van de afgelopen 16 jaar. De scenario’s zijn opgesteld en gesimuleerd in D-Sheet Piling, waarin alle kaaimuureigenschappen zijn ingevoerd. Voor elk scenario werden zowel de UGT- en GGT-waarden als de stabiliteit van de ankers gesimuleerd.
Zeven van de tien gesimuleerde scenario’s voldoen aan de huidige ontwerpeisen voor de geteste waterstanden. In drie scenario’s wordt niet aan alle criteria voldaan. Twee daarvan zijn globaal stabiel en kunnen na bodemverbetering met zwaardere materialen alsnog voldoen. Het derde scenario vertoont kritieke resultaten en voldoet slechts nipt aan de GGT-eisen. Hier is het aanbrengen van een nieuwe damwandconstructie vereist
The problem with hospitalization endpoints in heart failure trials
No full textMost early trials for heart failure (HF) assessed the effect of therapies on haemodynamic parameters, functional capacity and symptoms. Methodological limitations of these trials, as well the discovery that improvements in symptoms do not always correlate with better outcomes, 1 resulted in the inclusion of cardiovascu-lar safety as a mandated trial endpoint. The near parallel discovery that neurohormonal blockade could improve survival led to a paradigm in which new treatments received regulatory approval on this basis. As prognosis improved with successive therapies, event rates in clinical trials declined, meaning ever-larger sample sizes were required (Figure 1). Further confounding the situation, participant profiles have shifted from a population of younger people with a single condition, to one which is older and increasingly multimorbid. With this has come an increasing contribution of non-cardiovascular events, which dilute the treatment effect of HF specific therapies. 2 Why hospitalizations matter A hospitalization for HF is a significant event, commonly followed by a permanent decline in quality of life, functional status, and independence. This might result from direct harms of the hospitalization itself or simply reflect the progression of the underlying HF syndrome. Hospitalizations are not only the costliest component of HF care but, given its high and increasing prevalence , also form a large proportion of overall healthcare expenditure. Regulatory bodies and guideline committees now consider reducing hospitalizations a valid reason to recommend treatments , and so capturing and reporting these data in HF trials is essential. So, what's the problem? Problem 1: Hospitalizations are different from other endpoints Whilst hospitalizations (and their causes) are more difficult to assess than total mortality, preventing both death and hospitalization are important to patients. Including hospitalization events within composite endpoints is, therefore, a legitimate strategy to provide a broader assessment of treatment effects, whilst also having the advantage of increasing statistical power. Nevertheless , in time-to-first or first-and-recurrent event analyses, hospitalization events are regarded as being equally important to death although intuitively, this makes no sense. Whilst balancing the relative importance of mortality and hospitalization endpoints is challenging, this conflict is limited if the direction of the effect is concordant. Discordant endpoints complicate trial interpretation. In FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure), reductions in worsening HF events were not corroborated by reductions in cardiovascular death or total mortality. 3 Whilst this trial is widely viewed as 'positive' and potentially practice changing , comparable reductions in HF hospitalizations in DIG (Digi-talis Investigation Group) have been largely forgotten, perhaps in part due to the choice of all-cause mortality as this trial's primary endpoint. 4 Hierarchical clinical composite endpoints attempt to take account of how mortality, hospitalization and patient-reported outcomes differ in their relative importance, whilst also increasing statistical power and including more information relevant to patients. 5 However, subjective endpoints may dominate where event rates are low. In trials assessing tricuspid transcatheter edge-to-edge repair for right HF adverse clinical events were uncommon, and so the positive results were driven by unblinded quality-of-life assessments, which are challenging to assess since most scoring systems are influenced by comorbidities in this population. 6,7 The conflation of surrogate markers with mortalityS.S. is supported by a NIHR Clinical Lectureship. Conflict of interest: S.S. reports speaker’s fees and honoraria from AstraZeneca. N.M. reports speaker’s fees and honoraria from AstraZeneca, Novartis, BMS, Amgen, Cardiac Dimensions, Boehringer Ingelheim, Bayer and Novo Nordisk. K.K.W. reports speaker’s fees and honoraria from Medtronic, Abbott, Cardiac Dimensions, Novartis, BMS, Pfizer, Bayer, and unconditional research grants from Medtronic. All other authors have nothing to disclose
Fearing separation from capitalist paternity: A psychosocial analysis of revanchist anti-gender consumer activism against Disney
No full textDrawing on political readings of Freud, this paper probes the anxieties and fears driving anti-gender consumer activism, an emerging form of consumer politics in which a cisheteronormative subject defends his consumer privileges in the name of "the family." We examine how American anti-gender activists opposed Disney's shift from its conservative, family-oriented brand image. We argue that this campaign is driven by infantile fears of losing the ideo-affective guardianship conservative brands have historically offered to privileged consumer groups. These consumer activists aim to resolve this perceived threat of brand abandonment through anti-brand revenge. This study enriches current discourse-centric analyses of far-right consumer activism by probing its underlying psychosocial dynamics. Additionally, it contributes to scholarship on the marketing of the heteronormative family by revealing how conservative brands not merely disseminate family ideology but also function as paternal love objects themselves, satisfying infantile consumers' desires for attention, moral guidance, validation and protection.Funding
This work was supported by Fonds Wetenschappelijk Onderzoek [grant number 11H6522N].
The authors would like to thank Peter Fleming, Raza Mir, and Leslie Salzinger, as well as the members of UC Berkeley’s Right-Wing Studies Working Group, researchers from Radboud Gender & Diversity Studies, and the Critical Junior Scholars Network Belgium for their valuable comments on earlier versions of this article
INSIGHT: Bridging the Student-Teacher Gap in Times of Large Language Models
No full textThe rise of AI, especially Large Language Models, presents challenges and opportunities to integrate such technology into the classroom. AI has the potential to revolutionize education by helping teaching staff with various tasks, such as personalizing their teaching methods, but it also raises concerns, for example, about the degradation of student-teacher interactions and user privacy. Based on interviews with teaching staff, this paper introduces INSIGHT, a proof of concept to combine various AI tools to assist teaching staff and students in the process of solving exercises. INSIGHT has a modular design that allows it to be integrated into various higher education courses. We analyze students' questions to an LLM by extracting keywords, which we use to dynamically build an FAQ from students' questions and provide new insights for the teaching staff to use for more personalized face-to-face support. Future work could build upon INSIGHT by using the collected data to provide adaptive learning and adjust content based on student progress and learning styles to offer a more interactive and inclusive learning experience.This work was supported by the Special Research Fund (BOF) of Hasselt University (BOF24OWB28 and BOF23OWB31). This research was made possible with support from the MAXVR-INFRA project, a scalable and flexible infrastructure that facilitates the transition to digital-physical work environments. The MAXVR-INFRA project is funded by the European Union- NextGenerationEU and the Flemish Government
Unlocking the Benefits of Hybrid and Standalone Pervaporation for Sustainable Isopropanol Dehydration with HybSi® AR Membranes
No full textThis study presents the first combined techno-economic and environmental analysis of IPA dehydration using HybSi (R) membranes across three configurations, offering a low-emission alternative to conventional azeotropic distillation. The processes are simulated in Aspen Plus, and include two hybrid separation processes (i.e., distillation-pervaporation and distillation-pervaporation-distillation) and one standalone pervaporation process. The pervaporation module uses data from experiments that were performed using HybSi (R) AR membranes at 130 degrees C and two vacuum pressures (20 and 50 mbar). The separation processes were systematically compared using a comprehensive set of performance indicators covering technical, economic, and environmental aspects. A new cost-efficiency metric, COPCO, is introduced, alongside updated modeling under 2024 market conditions. The isopropanol recovery and water selectivity were >99.5% and >98.7%, respectively, in all pervaporation-based processes. It was found that the hybrid distillation-pervaporation process resulted in a 42% reduction in the levelized cost of the benchmark azeotropic distillation process, while standalone pervaporation resulted in a 38% reduction. The CO2 footprint was also reduced significantly in all cases, up to 86% in the case of standalone pervaporation compared to azeotropic distillation. The COPCO analysis revealed that the distillation-pervaporation configuration offers the highest cost-efficiency among the evaluated systems. Sensitivity analysis revealed that feed flow rate, average water flux, membrane module price, membrane lifetime, and steam price significantly impact the levelized cost. Lower vacuum pressure and feed water near the azeotropic composition enhance economic performance.This study is part of the INNOMEM project (H2020 grant agreement no. 862330). The authors would like to acknowledge the support from all the partners involved in the project
Erector Spinae Plane Block versus Intercostal Nerve Blocks in Uniportal Videoscopic-assisted Thoracic Surgery: A Multicenter, Double-blind, Prospective Randomized Placebo-controlled Trial
No full textBackground:Although intercostal nerve blocks are sometimes approached with caution due to concerns about potentially high local anesthetic uptake, they remain a valuable tool in specific clinical situations. On the other hand, the erector spinae plane block is currently often favored for its broader coverage and versatility. The hypothesis was that the intercostal nerve block, applied directly by surgeons under direct vision in patients undergoing uniportal video-assisted thoracoscopic surgery, might offer superior analgesia and fewer complications compared to the erector spinae plane block.Methods:In this multicenter, double-blind, placebo-controlled randomized trial, 100 patients undergoing uniportal thoracoscopic surgery (wedge excision or lobectomy) within an enhanced recovery program received either a surgical intercostal nerve block under thoracoscopic guidance or an ultrasound-guided erector spinae plane block, followed by 30 ml ropivacaine 0.5% (n = 50) or saline (n = 50). The primary outcome measured was 12-h morphine consumption postextubation. Secondary outcomes included 24-h morphine use, pain severity, rescue analgesia need, postoperative complications, and length of stay. Plasma levels of local anesthetics were also assessed.Results:The intercostal nerve block group had significantly lower mean 12-h morphine consumption compared to the erector spinae plane block group (10.9 mg vs. 17.6 mg; P = 0.0015), as well as lower mean 24-h consumption (18.7 mg vs. 26.7 mg; P = 0.018). Intercostal blocks also led to lower pain scores in the first 2 h postoperatively and a reduced need for rescue analgesia (16% vs. 40%; P = 0.0033). No differences were found in patient satisfaction, complications, or length of stay. Notably, the erector spinae plane block group showed higher systemic absorption of local anesthetics.Conclusions:For uniportal thoracoscopic surgery, intercostal nerve block significantly reduces morphine consumption and systemic anesthetic absorption compared to erector spinae plane block