The environmental impact of the Dutch health-care sector beyond climate change: an input-output analysis.

Background: Studies suggest that the Dutch health-care sector is responsible for 4-8% of the national carbon footprint, but the environmental footprint of this sector beyond climate change is not well understood. Therefore, we aimed to estimate the environmental footprint of the Dutch health-care sector for a range of environmental impact categories.

Methods: In this input-output analysis, we used Exiobase (version 3), which contains data on global trade flows and their associated environmental impact, in combination with health-care expenditure data from Statistics Netherlands.

Chemical pollution imposes limitations to the ecological status of European surface waters.

Aquatic ecosystems are affected by man-made pressures, often causing combined impacts. The analysis of the impacts of chemical pollution is however commonly separate from that of other pressures and their impacts. This evolved from differences in the data available for applied ecology vis-à-vis applied ecotoxicology, which are field gradients and laboratory toxicity tests, respectively.

Species sensitivity distributions for use in environmental protection, assessment, and management of aquatic ecosystems for 12 386 chemicals.

The present study considers the collection and use of ecotoxicity data for risk assessment with species sensitivity distributions (SSDs) of chemical pollution in surface water, which are used to quantify the likelihood that critical effect levels are exceeded. This fits the European Water Framework Directive, which suggests using models to assess the likelihood that chemicals affect water quality for management prioritization. We derived SSDs based on chronic and acute ecotoxicity test data for 12 386 compounds.

Incidence, risk factors, and outcome of transfusion-associated circulatory overload in a mixed intensive care unit population: a nested case-control study.

Background: The objective of this study was to determine the incidence, risk factors, and outcome of transfusion-associated circulatory overload (TACO) in a cohort of mixed intensive care unit patients and to compare risk factors with those for cardiac overload in the absence of transfusion.

Study Design And Methods: In a retrospective cohort study, patients who developed TACO were compared using multivariate analysis of two control groups: patients without pulmonary deterioration who received transfusion and patients who developed circulatory overload in the absence of transfusion.

Results: TACO was diagnosed in 66 of 1140 patients who received transfusions (5.

Atypical E2Fs inhibit tumor angiogenesis.

Atypical E2F transcription factors (E2F7 and E2F8) function as key regulators of cell cycle progression and their inactivation leads to spontaneous cancer formation in mice. However, the mechanism of the tumor suppressor functions of E2F7/8 remain obscure. In this study we discovered that atypical E2Fs control tumor angiogenesis, one of the hallmarks of cancer.

Identification and ranking of environmental threats with ecosystem vulnerability distributions.

Responses of ecosystems to human-induced stress vary in space and time, because both stressors and ecosystem vulnerabilities vary in space and time. Presently, ecosystem impact assessments mainly take into account variation in stressors, without considering variation in ecosystem vulnerability. We developed a method to address ecosystem vulnerability variation by quantifying ecosystem vulnerability distributions (EVDs) based on monitoring data of local species compositions and environmental conditions.

Method selection for sustainability assessments: The case of recovery of resources from waste water.

Sustainability assessments provide scientific support in decision procedures towards sustainable solutions. However, in order to contribute in identifying and choosing sustainable solutions, the sustainability assessment has to fit the decision context. Two complicating factors exist.

Synergistic functions of E2F7 and E2F8 are critical to suppress stress-induced skin cancer.

E2F transcription factors are important regulators of the cell cycle, and unrestrained activation of E2F-dependent transcription is considered to be an important driver of tumor formation and progression. Although highly expressed in normal skin and skin cancer, the role of the atypical E2Fs, E2F7 and E2F8, in keratinocyte homeostasis, regeneration and tumorigenesis is unknown. Surprisingly, keratinocyte-specific deletion of E2F7 and E2F8 in mice did not interfere with skin development and wound healing.

Definition and use of Solution-focused Sustainability Assessment: A novel approach to generate, explore and decide on sustainable solutions for wicked problems.

This paper introduces Solution-focused Sustainability Assessment (SfSA), provides practical guidance formatted as a versatile process framework, and illustrates its utility for solving a wicked environmental management problem. Society faces complex and increasingly wicked environmental problems for which sustainable solutions are sought. Wicked problems are multi-faceted, and deriving of a management solution requires an approach that is participative, iterative, innovative, and transparent in its definition of sustainability and translation to sustainability metrics.

Growth and development after oesophageal atresia surgery: Need for long-term multidisciplinary follow-up.

Survival rates in oesophageal atresia patients have reached over 90%. In long-term follow-up studies the focus has shifted from purely surgical or gastrointestinal evaluation to a multidisciplinary approach. We reviewed the literature on the long-term morbidity of these patients and discuss mainly issues of physical growth and neurodevelopment.

Definition and applications of a versatile chemical pollution footprint methodology.

Because of the great variety in behavior and modes of action of chemicals, impact assessment of multiple substances is complex, as is the communication of its results. Given calls for cumulative impact assessments, we developed a methodology that is aimed at expressing the expected cumulative impacts of mixtures of chemicals on aquatic ecosystems for a region and subsequently allows to present these results as a chemical pollution footprint, in short: a chemical footprint. Setting and using a boundary for chemical pollution is part of the methodology.

Computer aided analysis of breast MRI enhancement kinetics using mean shift clustering and multifeature iterative region of interest selection.

Purpose: To evaluate automatic characterization of a breast MR lesion by its spatially coherent region of interest (ROI).

Materials And Methods: The method delineated 247 enhancing lesions using Otsu thresholding after manually placing a sphere. Mean Shift Clustering subdivided each volume, based on features including pharmacokinetic parameters.

Preparation and medical outcomes of Nepalese staff and porters compared with foreign nationals on the Annapurna trekking circuit.

This cross-sectional study investigates preparedness and medical problems in Nepalese staff and porters compared with foreign nationals trekking at altitude in the Nepal Himalaya. 331 Nepalese and 338 foreign nationals in 61 trekking groups were surveyed over 4 weeks on the Annapurna trekking circuit. Foreign nationals reported that 92% of trekking groups received altitude illness information and carried a medical kit.

In vivo transcription of the Epstein-Barr virus (EBV) BamHI-A region without associated in vivo BARF0 protein expression in multiple EBV-associated disorders.

The in vivo expression of the Epstein-Barr virus (EBV) BamHI-A rightward transcripts (BARTs) as well as the putative BART-encoded BARF0 and RK-BARF0 proteins in various EBV-associated malignancies was investigated. RT-PCRs specific for the different splice variants of the BARTs and both a nucleic acid sequence-based amplification assay and an RT-PCR specific for the BARF0 ORF were used. Abundant transcription of BARTs was found in EBV-associated Hodgkin's lymphomas, Burkitt's lymphomas (BL), T-cell non-Hodgkin's lymphomas, post-transplant lymphoproliferative disorders, AIDS-related lymphomas and gastric carcinomas.