Van Assche Research Articles

Activation of the sympathetic nervous system, is it key to the developmental origins of enhanced cardiovascular risk?

the barker hypothesis or the theory of fetal programming proposes that undernutrition during fetal life slows fetal growth programming an increase in risk factors for cardiovascular disease ([10][1]). Numerous experimental models of undernutrition induced by protein restriction during gestation or

The wide-open doors to lexical access

The wide-open doors to lexical access

Role of Pelvic Magnetic Resonance Imaging for Evaluation of Disease Activity in Pediatric Patients With Perianal Crohnʼs Disease

Approximately one-third of the patients with Crohn's Disease have perianal involvement. Cessation of drainage from the orifices of the fistula is still been used widely as an indicator for cure in the pediatric population. However, recent literature has shown us that cessation of drainage is not equivalent to healing of a fistula. Contrast-enhanced pelvic Magnetic Resonance Imaging has been used to diagnose and monitor perianal Crohn's Disease. Adult studies have used various radiologic parameters (T2 hyperintensity, rectal wall thickening, bowel stratification, Percentage Increase in T2 hyperintensity etc.) and scores (Van Assche Score) to monitor perianal Crohn's Disease. However, similar studies are lacking in pediatric population. We performed a retrospective chart review of children under the age of 18 years at initial diagnosis who underwent contrast-enhanced pelvic MRI for perianal Crohn's disease. We analyzed a total of 44 pelvic MRI images. Of those, 29 were baseline images, performed at the time of diagnosis and 15 were follow up images (while on treatment). We also noted down clinical (fistula drainage) and laboratory (hemoglobin, hematocrit, albumin, ESR and CRP). We compared various radiological parameters and scores amongst the two groups. We also compared the correlation of the radiological parameters to laboratory values at the time of MRI. We found that amongst individual parameters, the PI (percentage increase in intensity on contrast enhancement compared to fat) [2], was significantly higher in the baseline group compared to treatment group {318.97 ± 116.81 vs. 246.15 ± 74.89 P = 0.021}. There was no significant difference amongst the other individual parameters (T2 hyperintensity, rectal wall thickening, Park's classification, St James classification, presence of abscesses). However, the MRI based scores suggested by Van Assche et al [1] (15.28 ± 3.82 vs10.47 ± 4.62, P = 0.002) and Horsthius et al [1] (21.34 ± 4.74 vs 14.87 ± 6.02, P = 0.001) were significantly higher in the baseline group compared to treatment group. Also, MRI scores by Horstheus et al showed significant positive correlation to ESR (Pearson co-efficient = 0.398, P = 0.012) and negative correlation to serum albumin (Pearson co-efficient = -0.558, P = 0.00), hemoglobin (Pearson co-efficient = -0.317, P = 0.016) and hematocrit. (Pearson co-efficient = -0.383, P = 0.016). Similar results were seen with the Van Assche score. Authors suggest that the use of radiological parameters and scores described above will help the pediatric gastroenterologist to better monitor treatment of perianal Crohn's disease. To the best of authors' knowledge; this is the first study in pediatric population which demonstrates the value of using the above radiological parameters and scores to monitor perianal Crohn's disease. References 1) Horsthuis K, de Ridder L, Smets AM, van Leeuwen MS, Benninga MA, Houwen RH, et al. Magnetic resonance enterography for suspected inflammatory bowel disease in a pediatric population. J Pediatr Gastroenterol Nutr. Nov; 51(5):603-9. 2) Villa C, Pompili G, Franceschelli G, Munari A, Radaelli G, Maconi G, et al. Role of magnetic resonance imaging in evaluation of the activity of perianal Crohn's disease. Eur J Radiol. Apr; 81(4):616-22.

Computer‐guided implant therapy and soft‐ and hard‐tissue aspects. The Third EAO Consensus Conference 2012

The objectives of this working group were to update the existing knowledge base in computer-guided implant treatment (accuracy and clinical advantages), to search for scientific evidence on the need for keratinized tissue around implants, and to review recent literature in the search for new insights into ridge preservation after tooth extraction. The literature was systematically searched and critically reviewed. Four manuscripts were prepared, three systematic and one narrative review, that allowed the group to develop evidence-based conclusions, as well as clinical implications and recommendations for future research. The results and conclusions of the reviews were presented in the following papers: Van Assche et al. (2012) Accuracy of computer-aided implant placement. Hultin et al. (2012) Clinical advantages of computer-guided implant placement: a systematic review. Wennström & Derks (2012) Is there a need for keratinized mucosa around implants to maintain health and tissue stability? Wang & Lang () Ridge preservation after tooth extraction. The group's consensus statements, clinical implications and implications for future research are presented in this article.

Time-In-Remission Analysis of Adalimumab vs. Placebo for the Treatment of Ulcerative Colitis

Purpose: Previous research has reported clinical remission and response rates for the ULTRA 2 trial, showing the benefits of adalimumab (ADA) therapy in patients with moderate to severe ulcerative colitis (UC). However, the length of clinical remission and response, which is directly related to patients' daily quality of life, has not been reported. Using data from the ULTRA 2 trial, we compared the number of days in clinical remission, clinical response, Inflammatory Bowel Disease Questionnaire (IBDQ) remission, and serious adverse event (SAE)-adjusted days in clinical remission in ADA- and placebo (PBO)-treated patients in a post-hoc analysis. Methods: The study population included 494 who had previously failed or were currently failing steroids and/or immunosuppressants (including 40% of patients who had prior anti-tumor necrosis factor experience): 248 in the ADA group (160 mg/80 mg at Weeks 0/2 as induction followed by 40 mg every other week) and 246 in the PBO group. Clinical remission was defined by a Mayo (or partial Mayo) score ≤2 and no individual subscore >1. Clinical response was defined by a decrease in Mayo score ≥3 points (or partial Mayo score ≥2 points) and ≥30% from baseline, plus a decrease in rectal bleeding score ≥1 from baseline or an absolute rectal bleeding score ≤1. IBDQ remission was defined as an IBDQ score ≥170. Statistical significance between treatment groups was assessed by Student t-test for clinical remission, clinical response, and IBDQ remission. The number of SAE-adjusted days in clinical remission was calculated as the number of days in clinical remission minus the number of days with SAEs. A Wald test was used to compare SAE-adjusted days in clinical remission between the treatment groups. Results: During the double-blind period, ADA-treated patients spent significantly more days in clinical remission (61% more days), clinical response (42% more days), and IBDQ remission (32% more days) as well as significantly more SAE-adjusted days in clinical remission (68% more days) than did PBO-treated patients (Table).Table: Time in clinical remission, clinical response, and IBDQ remissionaConclusion: ADA therapy exhibited a benefit/risk profile superior to placebo for use in the treatment of moderate to severe UC. Disclosure: Gert Van Assche: Consultancy: PDL Biopharma, Sanofi-aventis, UCB. Financial support for research: Abbott, Ferring. Lecture fee(s): Janssen-Cilag, Schering-Plough. Andreas Lazar: Employee & Stockholder: Abbott Roopal B Thakkar: Employee & Stockholder: Abbott Mei Yang: Employee & Stockholder: Abbott Martha Skup: Employee & Stockholder: Abbott Parvez M Mulani: Employee & Stockholder: Abbott Jingdong Chao: Employee & Stockholder: Abbott William J Sandborn: Financial Support for Research: Abbott, Bristol-Myers Squibb, Centocor Ortho Biotech, Genentech, Millennium, Novartis, Pfizer, Shire, UCB, Warner Chilcott. Consultancy: ActoGeniX, Abbott, AGI Therapeutics, Albireo, Alfa Wassermann, AM-Pharma, Amgen, Anaphore, Astellas, Athersys, Atlantic Healthcare, Axcan, BioBalance, Celgene, Bristol-Myers Squibb, Celek, Cellerix, Centocor Ortho Biotech, ChemoCentryx, CoMentis, Cosmo Technologies, Cytokine PharmaSciences, Eagle, Eisai Medical Research, Elan, Eli Lilly, EnteroMedics, Ferring, Flexion, Funxional Therapeutics, Genentech, Given Imaging, GlaxoSmithKline, KaloBios, Merck Research Labs, Merck Serono, Novo Nordisk, Pfizer, Procter & Gamble, PurGenesis Technologies, Regeneron, Salient, Salix, Santarus, Schering-Plough, Shire, Sigmoid, Sirtris, SLA, Takeda, Tillotts, UCB, Vascular Biogenics, Viamet, Wyeth.

Therapeutic Drug Monitoring of Tumor Necrosis Factor Antagonists in Inflammatory Bowel Disease

Although tumor necrosis factor (TNF) antagonists have shown clear benefits over conventional treatments for inducing and maintaining clinical remission in both Crohn's disease and ulcerative colitis, a high proportion of patients lose response over time. Given the scarce alternative of treatments when treatment failure occurs, it is highly desirable to optimize both initial response and long-term continuation of TNF antagonists. One of the most well-characterized factors associated with loss of response to these agents is the development of immunogenicity, whereby the production of neutralizing antidrug antibodies accelerates drug clearance, leading to subtherapeutic drug concentrations and, ultimately, to treatment failure. However, other patient-related factors, such as sex and/or body size, and disease severity, including TNF burden and serum albumin concentration among others, also may influence the pharmacokinetics of these agents. Nevertheless, the evidence generated to date about these complex interactions is scarce, and further prospective studies evaluating their influence on the pharmacokinetics of TNF antagonists are needed. Drug adjustment empirically based on clinical symptoms often is inaccurate and may lead to suboptimal outcomes. Recent evidence shows that maintenance of an optimal therapeutic drug concentration is associated with improved clinical outcomes. Therefore, incorporation of therapeutic drug monitoring into clinical practice may allow clinicians to optimize treatment by maintaining effective drug concentrations over time.

Commentary: BMI and the need for adalimumab dose escalation in Crohn's disease – authors’ reply

We would like to clarify some of the questions raised by Van Assche et al.1 in response to our recently published article.2 We believe indeed that a real pharmacokinetic analysis is valuable to exclude confounders and is warranted in further research on this topic. However, our study was directed towards predictive factors before the start of adalimumab, and therefore anti-TNF levels were not included. Furthermore, we would like to note that patients stopped due to adverse events (21, 29%), loss of response (37, 51%), patients’ preferences (13, 18%), or unknown reasons (2, 3%), and no primary nonresponders were included. Of the patients who had dose escalation and were previously exposed to infliximab, 12 regained response 3 months after dose escalation, follow-up data were not available for three patients and in 12 patients, dose escalation was not effective. We agree with Van Assche et al. that further research is warranted. Declaration of personal interests: None. Declaration of funding interests: C. Janneke van der Woude has served as a speaker, a consultant and an advisory board member for MSD, Falk, Abbott and Shire, and has received research funding from Falk and Ferring.

The Politics of Distraction: Spectatorial Freedom and (dis)Enfranchisement in Toneelgroep's Roman Tragedies

The Politics of Distraction: Spectatorial Freedom and (dis)Enfranchisement in Toneelgroep's Roman Tragedies Natalie Corbett (bio) and Keren Zaiontz (bio) Written by William Shakespeare. Direction by Ivo Van Hove. Dramaturgy by Bart Van Den Eynde, Jan Peter Gerrits, and Alexander Schreuder. With Roeland Fernhout, Renée Fokker, Fred Goessens, Marieke Heebink, Chico Kenzari, Hans Kesting, Hugo Koolschijn, Hadewych Minis, Chris Nietvelt, Frieda Pittoors, Alwin Pulinckx, Halina Reijn, Eelco Smits, and Karina Smulders. Musicians include Bl!NDMAN: Ruben Cooman, Yves Goemaere, Ward De Ketelaere, and Hannes Nieuwlaet. Set and lighting design by Jan Versweyveld. Costume design by Lies Van Assche. Video by Tal Yarden. Music by Eric Sleichim. Produced by Toneelgroep Amsterdam. Co-production by Holland Festival (Amsterdam), La Monnaie (Bruxelles), Kaaitheatre (Bruxelles), Muziektheatre Transparant (Anvers), and BL!NDMAN (Bruxelles). Presented by Festival TransAmériques in Association with Monument National and Carrefour International de Théaˆtre de Québec, 28-30 May 2010. In the five-and-a-half-hour epic Roman Tragedies, staged by the prodigious Dutch ensemble Toneelgroep, Shakespeare's tragedies of Coriolanus, Julius Caesar, and Antony and Cleopatra are performed in a sequence that traces political history from the beginnings of democracy to the globalized world of international politics. The trilogy, billed as "Shakespeare that jumps straight from the headlines [...] hurled into the heart of the contemporary world" offers an updating that seeks to investigate the mechanisms of state power and the nature of "man [sic] as a political animal" (FTA). Key to this twenty-first century interpretation of Shakespeare's texts is the production's encouragement of audience engagement, which implicates spectators as the absent public that bears witness to ongoing political turbulence. Audiences that attended the North American premiere at the 2010 Festival TransAmérique experienced both exceptional physical duration and proximity to the event while circulating between (and within) the auditorium and the stage during timed breaks. Within the context of an international festival known for its contemporary theatre and dance, the dynamics of reception in Roman Tragedies are the proud insignia of the "avant-garde" or experimental performance traditions. The production adopts slightly condensed versions of Shakespeare's dramaturgical structures, employs well-established conventions of disruption, and incorporates a realist mode of acting. However, the true experimentality of Roman Tragedies lies in linking the direct participation of audiences to a political commentary that dramatizes the dangers of (and desire for) distraction in a hypermediated world. Jan Versweyveld's set design casts the play's epic actions within a modern, anonymous corporate environment, populated by blandly geometric Swedish sofas, potted plants, Plexiglas and ubiquitous television monitors. Modular configurations within the stage space function interchangeably as committee boardroom and private living room, highlighting the porousness between the public and private lives being staged. Camera operators relentlessly film the actors, whose images are projected onto the screens on stage and in the wings, simultaneously remediated as live news broadcasts. When actors exit the stage they often remain visible on the periphery; hair and makeup stations line the stage right wing, brushing up against one of the stage-side food vendors. The dynamic of constant visibility created by this aesthetic of surveillance highlights the two most significant alterations to the original Shakespeare texts. Although nothing has been added, all battles have been replaced by extended spectacular sequences of flashing lights and violent bombastic sound, and all scenes in which the citizens speak have been cut. By collapsing [End Page 117] the unfolding stratagems and defining events of major wars to their final outcomes—and by excising all record of public response to the momentous political events depicted—the edited script presents a narrative relentlessly focused on the psychology of those few individuals within the highest echelons of power. Stripped of the minutiae of developing action, the balanced causal chains of Shakespeare's tragedies are reshaped into contemporary portraits of political manoeuvring, backroom dealings and press conferences, private scandals, and public obfuscation. Click for larger view View full resolution Julius Caesar: Brutus addresses the masses in a press conference. On stage, audiences seated on sofas watch the television address on screen. (l-r): Renée Fokker, Eelco Smits, Jacob Derwig, and Marieke Heebink. Photo by Jan Versweyveld...

Adalimumab Improves Health-Related Quality of Life for 52 Weeks in Patients With Ulcerative Colitis

Introduction We investigated effects of adalimumab (ADA) maintenance therapy on health-related quality of life (HRQOL) through 52 weeks (wks) in patients (pts) with ulcerative colitis (UC). Methods 494 pts with moderate to severe UC (Mayo score, 6–12 points; endoscopic subscore, 2–3 points; anti–tumour necrosis factor [anti-TNF]–naive and anti-TNF–experienced [40.3%]) who had failed conventional therapy were enrolled in a 52-wk, randomised, double-blind, placebo (PBO)-controlled maintenance trial. ADA-treated pts received induction therapy (160/80 mg @ Wks 0/2) and 40-mg every-other-week (eow) maintenance therapy. Pts with inadequate response could switch to open-label eow therapy after Wk 12 and subsequently to weekly therapy. HRQOL was measured by Inflammatory Bowel Disease Questionnaire (IBDQ). Intent-to-treat population was analysed. IBDQ response rates were compared between treatment groups using Cochran-Mantel-Haenszel test stratified for prior anti-TNF use whereas χ 2 test was used in anti-TNF-naive pts. Non-responder imputation was used for response variables. For change of IBDQ scores, ANCOVA model with treatment and prior anti-TNF status as factors and baseline value as covariate was used. Missing values were imputed through last observation carried forward (LOCF). Results Significantly more ADA-treated pts were IBDQ responders (increase in IBDQ score ≥16 points from baseline) throughout Wks 8, 32, and 52 compared with PBO. Mean changes from baseline IBDQ scores were consistently greater for ADA- vs PBO-treated pts (Abstract PWE-253 table 1). In anti-TNF–naive pts, improvements from baseline for IBDQ were 34±38 and 22±37 at Wk 8 (p=0.002), 33±43 and 24±43 at Wk 32 (p=0.03), and 33±44 and 23±42 at Wk 52 (p=0.02) for ADA and PBO, respectively. IBDQ responder rates were 68% and 52% at Wk 8 (p=0.004), 42% and 27% at Wk 32 (p=0.006), 32% and 21% at Wk 52 (p=0.040) for ADA and PBO, respectively, among anti-TNF–naive pts. Conclusion For pts with moderate to severe UC who failed conventional therapy, ADA was more effective than PBO for inducing and maintaining improvements in HRQOL, as measured by IBDQ through 52 wks. Competing interests W Sandborn Grant/Research Support from: Abbott, Consultant for: Abbott, G Van Assche Grant/Research Support from: Abbott, R Thakkar Shareholder with: Abbott, Employee of: Abbott, A Lazar Shareholder with: Abbott, Employee of: Abbott, M Kron Shareholder with: Abbott, Employee of: Abbott, M Yang Shareholder with: Abbott, Employee of: Abbott, S Patel Shareholder with: Abbott, Employee of: Abbott, J Chao Shareholder with: Abbott, Employee of: Abbott, P Mulani Shareholder with: Abbott, Employee of: Abbott.

Endoscopy, but not as we know it

British Journal of Hospital MedicineVol. 72, No. 3 CorrespondenceEndoscopy, but not as we know itPhilip J Smith, Gavin W Sewell, Adam P LevinePhilip J SmithSearch for more papers by this author, Gavin W SewellSearch for more papers by this author, Adam P LevineSearch for more papers by this authorPhilip J Smith; Gavin W Sewell; Adam P LevinePublished Online:16 Aug 2013https://doi.org/10.12968/hmed.2011.72.3.174AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Binder V (1998) Genetic epidemiology in inflammatory bowel disease. Digestive Diseases 16(6): 351–5 Crossref, Medline, Google ScholarBrant SR (2010) Update on the heritability of inflammatory bowel disease: the importance of twin studies. Inflamm Bowel Dis 17(1): 1–5 Crossref, Google ScholarFranke A, McGovern DPB, Barrett JC et al. (2010) Genome-wide meta-analysis increases to 71 the number of confirmed Crohn’s disease susceptibility loci. Nat Genet 42(12): 1118–25 Crossref, Medline, Google ScholarManolio TA, Collins FS, Cox NJ et al. (2009) Finding the missing heritability of complex diseases. Nature 461(7265): 747–53 Crossref, Medline, Google ScholarVermeire S, Van Assche G, Rutgeerts P (2010) Role of genetics in prediction of disease course and response to therapy. World J Gastroenterol 16(21): 2609–15 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 1 March 2011Volume 72Issue 3ISSN (print): 1750-8460ISSN (online): 1759-7390 Metrics History Published online 16 August 2013 Published in print 1 March 2011 Information© MA Healthcare LimitedPDF download

Stretching the Limits in Crohn's Disease

Van Assche G, Thienpont C, D'Hoore A, et al. (Division of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium; Division of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium). Long-term outcome of endoscopic dilation in patients with Crohn's disease is not affected by disease activity or medical therapy. Gut 2010;59:320–324.

Fistulizing perianal Crohnʼs disease

The aim of the study was to assess perianal fistulas by magnetic resonance imaging (MRI) in patients with severe fistulizing Crohn's disease (CD) using maintenance antitumor necrosis factor alpha (TNF-α) therapy and to correlate MRI changes with clinical outcome. Perineal MRI before and after a 1-year scheduled anti-TNF-α maintenance therapy was performed in 20 patients (14 females; mean age = 33.7). The Van Assche score (i.e., number of fistulas, localization, and extension, importance of T2 hyperintensity, presence of abscess) was calculated. Fistula track contrast enhancement was also used. Clinical outcome was defined as no response, response, or remission. Response and remission were observed in respectively 40% and 35% of cases. The Van Assche score varied from 13.8 (7-20) to 6.13 (0-12) in patients with a response or remission (P < 0.05). The T2 hyperintensity follow-up value decreased in patients in response or remission (P < 0.01). T2 hyperintensity disappeared or decreased in 14 out of 15 patients in clinical response or remission as compared to one among the five nonresponding patients (P < 0.01). The decrease in Van Assche score and hyperintensity value was not significantly different in patients in remission compared to those with response. Only one patient in clinical remission had a persisting contrast enhancement on MRI, whereas contrast enhancement persisted in all other patients not in remission (P = 0.002). The clinical benefit of maintenance anti-TNF-α therapy in perianal CD is associated with a significant improvement of the Van Assche score, particularly T2 hyperintensity. The disappearance of contrast enhancement was the only semiological MR feature associated with remission.

Stability of linear systems with general sawtooth delay

It is well known that in many particular systems, the upper bound on a certain time-varying delay that preserves the stability may be higher than the corresponding bound for the constant delay. Moreover, sometimes oscillating delays improve the performance (Michiels, W., Van Assche, V. & Niculescu, S. (2005) Stabilization of time-delay systems with a controlled time-varying delays and applications. IEEE Trans. Automat. Control, 50, 493–504). Sawtooth delays τ with τ = 1 (almost everywhere) can posses this property (Louisell, J. (1999) New examples of quenching in delay differential equations having time-varying delay. Proceedigns of the 5th ECC, Karlsruhe, Germany). In this paper, we show that general sawtooth delay, where τ 6= 0 is constant (almost everywhere), also can posses this property. By the existing Lyapunov-based methods, the stability analysis of such systems can be performed in the framework of systems with bounded fast-varying delays. Our objective is to develop ‘qualitatively new methods’ that can guarantee the stability for sawtooth delay which may be not less than the analytical upper bound on the constant delay that preserves the stability. We suggest two methods. One method develops a novel input–output approach via a Wirtinger-type inequality. By this method, we recover the result by Mirkin (2007, Some remarks on the use of time-varying delay to model sample-and-hold circuits. IEEE Trans. Automat. Control, 52, 1109–1112) for τ = 1 and we show that for any integer τ , the same maximum bound that preserves the stability is achieved. Another method extends piecewise continuous (in time) Lyapunov functionals that have been recently suggested for the case of τ = 1 in Fridman (2010, A refined input delay approach to sampled-data control. Automatica, 46, 421–427) to the general sawtooth delay. The time-dependent terms of the functionals improve the results for all values of τ , though the most essential improvement corresponds to τ = 1.

Roman Tragedies , and: Coriolanus , and: Julius Caesar , and: Antony and Cleopatra (review)

Reviewed by: Roman Tragedies, and: Coriolanus, and: Julius Caesar, and: Antony and Cleopatra Sarah K. Scott Roman Tragedies Presented by Toneelgroep Amsterdam at the Barbican International Theatre Events 2009, London, England. November 20–22, 2010. Directed by Ivo van Hove. Translated by Tom Kleijn. Scenography and Lighting by Jan Versweyveld. Video by Tal Yarden. Music and Sound by Eric Sleichim. Costumes by Lies van Assche. Coriolanus Roeland Fernhout (Cominius), Renée Fokker (Tribune of the People), Fred Goessens (Menenius), Janni Goslinga (Virgilia), Marieke Heebink (First Senator), Fedja van Huêt (Coriolanus), Chico Kenzari (Aufidius), Chris Nietvelt (Anchorman), Frieda Pittoors (Volumnia), Alwin Pulinckx (Brutus), and Eelco Smits (Sicinius). Julius Caesar Roeland Fernhout (Brutus/Lucius), Renée Fokker (Cassius), Fred Goessens (Lepidus), Janni Goslinga (Calpurnia), Marieke Heebink (Casca), Chico Kenzari (Anchorman), Hans Kesting (Antony), Hugo Koolschijn (Julius Caesar), Hadewych Minis (Octavius Caesar), Eelco Smits (Decius), and Karina Smulders (Portia, Lucius). Antony and Cleopatra Roeland Fernhout (Thidias), Fred Goessens (Lepidus), Janni Goslinga (Diomedes), Marieke Heebink (Charmian), Fedja van Huêt (Agrippa), Chico Kenzari (Enobarbus), Hans Kesting (Antony), Hugo Koolschijn (Proculeius), Hadewych Minis (Octavius Caesar), Chris Nietvelt (Cleopatra), Frieda Pittoors (Iras), Alwin Pulinckx (Dolabella), Eelco Smits (Ventidius), and Karina Smulders (Octavia). Toneelgroep Amsterdam’s Roman Tragedies, part of the Barbican International Theatre Events (BITE) 2009 season, was a provocative, ambitious production conflating and reimagining Shakespeare’s Coriolanus, Julius Caesar, and Antony and Cleopatra to create a chronicle of emerging populist Roman rule which traced public and private forms of ambition and power. Premiering in Amsterdam in 2007 and staged a year later at [End Page 347] the 2008 Avignon Festival, the London staging of the play was the Dutch company’s Barbican debut and its first production in London after a ten-year absence. The smart set-design, modern-dress costuming, and brilliant music complimented superb ensemble acting and a carefully crafted script to produce a deftly layered, visually stimulating study that vitalized the historical past by depicting, somewhat chaotically, political clashes of the present. Running time was approximately five-and-a-half hours with brief scene changes of three to ten minutes in lieu of an intermission. Actors delivered dialogue in Dutch. Click for larger view View full resolution Chris Nietvelt as Cleopatra and Hans Kesting as Antony (above), with (from left to right) Eelco Smits as Ventidius, Chris Nietvelt as Cleopatra, Marieke Heebink as Charmian, Jacob Derwig as Thidias, Hans Kesting as Antony, Janni Goslinga as Diomedes, Frieda Pittoors as Iras, Alwin Pulinckx as Dolabella, Barry Atsma as Enobarbus, Fedja van Huêt as Agrippa, and Hadewych Minis as Octavius Caesar (below) in Toneelgroep Amsterdam’s production of Antony and Cleopatra, directed by Ivo van Hove. Photo courtesy of Jan Versweyveld. A sleek, visually impressive contemporary set design used the entire Barbican stage to create an open-plan modern conference center. The audience was invited to watch the action on the stage amongst barrel-shaded accent lights, mushroom-colored modular sofas and stuffed chairs, coffee tables, and office planters. Numerous plasma-screen televisions delivered live and recorded images. Additional common areas were located to the far sides of the set, including makeup and first aid stations, a Toneelgroep [End Page 348] Amsterdam information area, and a bar and café serving London Pride and Pad Thai, among other fare. A space was also dedicated to a computer that was connected to a red LED display that ran English surtitles underneath the screen above the proscenium. The audience was invited to type messages that were then transmitted to the display, which meant that a good amount of jocular commentary was delivered when the surtitles were not running. Such messages, often distracting and gratuitous, included the following: “Apparently all Dutch men are gorgeous. I’m moving to Amsterdam” and “Take off your shirt Aufidius.” Click for larger view View full resolution Fedja van Huêt as Coriolanus (above), with (from left to right) Marieke Heebink as First Senator, Renée Fokker as Tribune of the People, Barry Atsma as Aufidius, and Jacob Derwig as Cominius (below) in Toneelgroep Amsterdam’s production of Coriolanus, directed by Ivo van Hove. Photo courtesy of Jan Versweyveld. The production favored the use of technology and media over the presentation...

Comprehensive embryo analysis of advanced maternal age–related aneuploidies and mosaicism by short comparative genomic hybridization

The short comparative genomic hybridization (short-CGH) method was used to perform a comprehensive cytogenetic study of isolated blastomeres from advanced maternal age embryos, discarded after fluorescent in situ hybridization (FISH) preimplantation genetic screening (PGS), detecting aneuploidies (38.5% of which corresponded to chromosomes not screened by 9-chromosome FISH), structural aberrations (31.8%), and mosaicism (77.3%). The short-CGH method was subsequently applied in one PGS, achieving a twin pregnancy.

Infliximab and Azathioprine for Crohn's Disease: A Super-Sonic Combination?

Infliximab and Azathioprine for Crohn's Disease: A Super-Sonic Combination?

Density of eigenvalues and its perturbation invariance in unitary ensembles of random matrices

We generally study the density of eigenvalues in unitary ensembles of random matrices from the recurrence coefficients with regularly varying conditions for the orthogonal polynomials. By using a new method, we calculate directly the moments of the density (which has been obtained in the work of Nevai and Dehesa, Van Assche and others on asymptotic zero distribution), and prove that scaling eigenvalues converge weakly, in probability and almost surely to the Nevai–Ullmann measure. Furthermore, we can prove that the density is invariant when the weight function is perturbed by a polynomial.

Convergent Interpolation to Cauchy Integrals over Analytic Arcs with Jacobi-Type Weights

We design convergent multipoint Pade interpolation schemes to Cauchy transforms of non-vanishing complex densities with respect to Jacobi-type weights on analytic arcs, under mild smoothness assumptions on the density. We rely on our earlier work for the choice of the interpolation points, and dwell on the Riemann-Hilbert approach to asymptotics of orthogonal polynomials introduced by Kuijlaars, McLaughlin, Van Assche, and Vanlessen in the case of a segment. We also elaborate on the $\bar\partial$-extension of the Riemann-Hilbert technique, initiated by McLaughlin and Miller on the line to relax analyticity assumptions. This yields strong asymptotics for the denominator polynomials of the multipoint Pade interpolants, from which convergence follows.

Do periodontopathogens disappear after full-mouth extraction?

Restricted accessAbstractFirst published online January 1, 2010Do periodontopathogens disappear after full-mouth extraction?N Van Assche, M Van Assche, […], M Pauwels, W Teughels, and M Quirynen+2-2View all authors and affiliationsVolume os17, Issue 1https://doi.org/10.1308/135576110790307825

On spectral polynomials of the Heun equation. I

The classical Heun equation has the form { Q ( z ) d 2 d z 2 + P ( z ) d d z + V ( z ) } S ( z ) = 0 , where Q ( z ) is a cubic complex polynomial, P ( z ) is a polynomial of degree at most 2 and V ( z ) is at most linear. In the second half of the nineteenth century E. Heine and T. Stieltjes initiated the study of the set of all V ( z ) for which the above equation has a polynomial solution S ( z ) of a given degree n . The main goal of the present paper is to study the union of the roots of the latter set of V ( z ) ’s when n → ∞ . We provide an explicit description of this limiting set and give a substantial amount of preliminary and additional information about it obtained using a certain technique developed by A.B.J. Kuijlaars and W. Van Assche.