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Concept: Belgium

489

Almost 150 years after the first identification of Neandertal skeletal material, the cognitive and symbolic abilities of these populations remain a subject of intense debate. We present 99 new Neandertal remains from the Troisième caverne of Goyet (Belgium) dated to 40,500-45,500 calBP. The remains were identified through a multidisciplinary study that combines morphometrics, taphonomy, stable isotopes, radiocarbon dating and genetic analyses. The Goyet Neandertal bones show distinctive anthropogenic modifications, which provides clear evidence for butchery activities as well as four bones having been used for retouching stone tools. In addition to being the first site to have yielded multiple Neandertal bones used as retouchers, Goyet not only provides the first unambiguous evidence of Neandertal cannibalism in Northern Europe, but also highlights considerable diversity in mortuary behaviour among the region’s late Neandertal population in the period immediately preceding their disappearance.

Concepts: Belgium, Northern Europe, Neanderthal, Carbon-14, Psychology, Critical thinking, Radiocarbon dating, Isotope

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The Republic of Cyprus is the only country in the European Union (EU) whose health system is comprised of public and private sectors of relatively similar sizes. The division within the health system, combined with a lack of efficient payment mechanisms and monitoring systems, contributes to inequalities in access to care, and inefficient allocation and utilization of resources. In part to address these issues, a new General Health Insurance Scheme (GHIS), was proposed by stakeholders from the Cypriot government along with a team of international consultants in 1992 and eventually approved by the Parliament in 2001. However implementation of the GHIS has been repeatedly delayed since that time due to cost concerns. In 2012, following recommendations by the European Commission, the Cypriot Cabinet decided to recommit to the reform. In light of this development, the recent Cyprus application for accession to the EU support mechanism due to the economic crisis, and the international spotlight associated with Cyprus' EU Presidency, this article discusses the anticipated Cypriot health system reform-which is now slated to go into effect in 2016-and examines lessons from other countries.

Concepts: Belgium, President of the European Commission, Council of the European Union, Cyprus, Treaty of Lisbon, European Commission, European Council, European Union

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In 2002, the Belgian Act on Euthanasia came into effect, regulating the intentional ending of life by a physician at the patient’s explicit request. We undertook this study to describe trends in officially reported euthanasia cases in Belgium with regard to patients' sociodemographic and clinical profiles, as well as decision-making and performance characteristics.

Concepts: Life, Belgium, Death, Hospital, Patience, Doctor-patient relationship, Physician, Patient

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Thrombocytopenia is a very frequent disorder in the intensive care unit. Many etiologies should be searched, and therapeutic approaches differ according to these different causes. However, no guideline exists regarding optimum practices for these situations in critically ill patients. We present recommendations for the management of thrombocytopenia in intensive care unit, excluding pregnancy, developed by an expert group of the French-Language Society of Intensive Care (Societe de Reanimation de Langue Francaise (SRLF), the French Language Group of Paediatric Intensive Care and Emergencies (GFRUP) and of the Haemostasis and Thrombosis Study Group (GEHT) of the French Society of Haematology (SFH). The recommendations cover six fields of application: definition, epidemiology, and prognosis; diagnostic approach; therapeutic aspects; thrombocytopenia and sepsis; iatrogenic thrombocytopenia, with a special focus on heparin-induced thrombocytopenia; and thrombotic microangiopathy.

Concepts: Belgium, Louisiana, Medicine, French language

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To describe demographic and treatment characteristics of the Dutch vertically HIV-infected paediatric population from 1996 until 2012, and to investigate the long-term virological and immunological response to combination antiretroviral therapy (cART), with emphasis on the influence of age at cART initiation and initial CD4 counts.

Concepts: Afrikaner, Dutch language, Belgium, Antiretroviral drug, Medicine, Dutch people, Netherlands

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OBJECTIVE: Lycopene is a potent antioxidant, and it has been suggested that intake of tomatoes and tomato products containing lycopene is associated with a decreased risk of various chronic diseases. The aim of the present study was to evaluate the distribution of dietary lycopene intake in the Belgian population and to determine the most important contributors to lycopene intake. DESIGN: Cross-sectional study. SETTING: National food consumption data from the Belgian Food Consumption Survey (BFCS) 2004 were used for the intake assessment. Determination of the lycopene content in foods was performed with HPLC-UV. Individual food consumption data were multiplied by the actual mean concentrations of lycopene per food. SUBJECTS: Individuals (n 3083) aged 15 years and older participated in the study and provided two 24 h recalls. RESULTS: The mean lycopene intake among Belgian adults was 4·1 (sd 2·3) mg/d or 0·059 (sd 0·033) mg/kg body weight per d. Lycopene intake among men (4·6 (sd 2·6) mg/d) was higher than among women (3·6 (sd 2·1) mg/d), and was higher in the younger compared with the older age groups. Cis-lycopene intake represented about one-third of the total lycopene intake. Tomatoes and tomato products (43 %) and sauces and ready-to-eat meals containing tomato sauces (41 %) were the main contributors to lycopene intake in Belgium. CONCLUSIONS: The lycopene intake of the Belgian adult population was comparable to intakes reported in neighbouring countries and was below the acceptable daily intake.

Concepts: Tomato sauce, Salsa, Belgium, Ketchup, Tomato, Food, Nutrition, Lycopene

26

Experience with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in a pioneer hospital resulted in a treatment protocol that has become the standard in the Netherlands. Outcome of CRS and HIPEC was reviewed to assure differences between the pioneer phase and the period wherein the Dutch HIPEC protocol was clinically implemented.

Concepts: South Africa, Standardization, Afrikaner, Belgium, Dutch language, Dutch people, Netherlands

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With the increasing awareness of post intensive care syndrome and the unbridled development of post-ICU clinics in the Netherlands, guidelines for ICU after care are needed. The purpose of this study was to develop recommendations for the set-up of post-ICU clinics.

Concepts: Belgium, South Africa, Suriname, Germany, Kingdom of the Netherlands, Dutch people, Dutch language, Netherlands

22

The Netherlands is well known for their high bicycle use. We used the Health Economic Assessment Tool and life table calculations to quantify the population-level health benefits from Dutch cycling levels. Cycling prevents about 11 000 deaths each year, and Dutch people have half-a-year-longer life expectancy because of cycling. These health benefits correspond to more than 5% of the Dutch gross domestic product. Our study confirmed that investments in bicycle-promoting policies (e.g., improved bicycle infrastructure and facilities) will likely yield a high cost-benefit ratio in the long term. (Am J Public Health. Published online ahead of print June 11, 2015: e1-e3. doi:10.2105/AJPH.2015.302724).

Concepts: South Africa, Belgium, Demography, Afrikaner, Health care, Dutch people, Netherlands

21

Fecal microbiome variation in the average, healthy population has remained under-investigated. Here, we analyzed two independent, extensively phenotyped cohorts: the Belgian Flemish Gut Flora Project (FGFP; discovery cohort; N = 1106) and the Dutch LifeLines-DEEP study (LLDeep; replication; N = 1135). Integration with global data sets (N combined = 3948) revealed a 14-genera core microbiota, but the 664 identified genera still underexplore total gut diversity. Sixty-nine clinical and questionnaire-based covariates were found associated to microbiota compositional variation with a 92% replication rate. Stool consistency showed the largest effect size, whereas medication explained largest total variance and interacted with other covariate-microbiota associations. Early-life events such as birth mode were not reflected in adult microbiota composition. Finally, we found that proposed disease marker genera associated to host covariates, urging inclusion of the latter in study design.

Concepts: Medical statistics, Experimental design, Dutch people, Dutch language, Belgium, Scientific method, Gut flora, Feces