Purpose The purpose of this research was to explore women’s experiences after breast surgery with scar characteristics and symptoms, and its impact on their health-related quality of life (HRQOL). Material andmethods A qualitative study using semi-structured face-to-face interviewswas conducted among women following prophylactic, oncologic, or reconstructive breast surgery in the Netherlands. A directed content analysis was performed using guiding themes. Themes were “physical and sensory symptoms,” “impact of scar symptoms,” “personal factors,” “impact of scar interventions,” and “change over time.” Results The study population consisted of 26 women after breast surgery. Women experienced a wide range of symptoms like adherence, stiffness, pain, and uncomfortable sensations. Scar characteristics as visibility, location, texture, and size, influenced satisfaction with their appearance. The impact of scar symptoms is reflected in physical, social, emotional, and cognitive functioning, thereby affecting HRQOL. The experienced impact on HRQOL depended on several factors, like personal factors as the degree of acceptance and environmental factors like social support. Conclusion Women can experience a diversity of scar characteristics and symptoms, which play a central role in the perceived impact on HRQOL. Since scarring can have a considerable impact on HRQOL, scarring after prophylactic, oncologic and reconstructive breast surgery should be given more attention in clinical practice and research. Implications for Cancer Survivors Considering scarring as a common late effect after breast surgery and understanding the variety of experiences, which could impact HRQOL of women, can be beneficial in sufficient information provision, expectation management, and informed decision making.
Purpose: This research aimed to explore factors associated with patient-reported breast and abdominal scar quality after deep inferior epigastric perforator (DIEP) flap breast reconstruction (BR). Material and Methods: This study was designed as a descriptive cross-sectional survey in which women after DIEP flap BR were invited to complete an online survey on breast and abdominal scarring. The online survey was distributed in the Netherlands in several ways in order to reach a diverse population of women. Outcomes were assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Additional items were assessed with a numeric rating scale (NRS). Results: A total of 248 women completed the survey. There was a statistically significant worse POSAS scar appraisal for the abdominal scar compared with the breast scar. The vast majority of women reported high scores on at least one scar characteristic of their breast scar or ab- dominal scar. Overall, color, stiffness, thickness, and irregularity scored higher than pain and itching. Women were only moderately positive about the size, noticeability, location, and the information provided regarding scarring. Conclusion: It is crucial to address the inevitability of scars in patient education before a DIEP flap BR, with a particular focus on the abdominal scar, as women experience abdominal scars significantly worse than their breast scars. Providing more information on the experience of other women and the expected appearance will contribute to having realistic expectations while allowing them to make well-informed decisions.
The assessment of the out-of-plane response of unreinforced masonry (URM) buildings with cavity walls has been a popular topic in regions such as Central and Northern Europe, Australia, New Zealand, China and several other countries.Cavity walls are particularly vulnerable as the out-of-plane capacity of each individual leaf is significantly smaller than the one of a solid wall. In the Netherlands, cavity walls are characterized by an inner load-bearing leaf of calcium silicate bricks, and by an outer veneer of clay bricks that has only aesthetic and insulation functions. The two leaves are typically connected by means of metallic ties. This paper utilizes the results of an experimental campaign conducted by the authors to calibrate a hysteretic model that represents the axial cyclic response of cavity wall tie connections. The proposednumerical model uses zero-length elements implemented in OpenSees with the Pinching4 constitutive model to account for the compression-tension cyclic behaviour of the ties. The numerical model is able to capture important aspects of the tie response such as the strength degradation, the unloading stiffness degradation and the pinching behaviour. The numerical modelling approach in this paper can be easily adopted by practitioner engineers who aim to model the wall ties more accurately when assessing the structures against earthquakes.
Thermoset materials find use in almost all industrial sectors, especially where lightweight, stiffness, resistance and dimensional stability are key performance requirements. However, traditional thermosets suffer from several drawbacks: they are made of fossil-based non-reversible polymers and toxic monomers; more importantly, thermosetting materials are virtually neither recyclable nor reprocessable, due to their crosslinked microstructure. Currently, most thermoset materials are incinerated or accumulated in landfills at the end of their life. Landfill waste degrades to liquids known as landfill leachates that lead to health and environmental problems. A significant part of these wastes originate from thermoset materials used in paints, coatings, sealants and adhesives applied as a thin film to all sorts of surfaces. These unrecyclable materials contribute to nano- and microplastic formation. Despite many efforts in the past years in this context, substantial further developments are required. Production of thermosets from biobased feedstocks using safe and sustainable-by-design approaches is therefore crucial to address the well-being of people and to have a healthy planet.SMARTCASE aims to develop safe and circular carbohydrate-derived reactive polyester resins for coatings, adhesives, sealants and elastomers for application in the building and interior sectors. The new two-component (‘2K’) formulations are designed to replace currently used fossil-based epoxy and urethane resins by biobased and GHS-label-friendly alternatives. This not only improves the safety of workers and end-users of these materials, but also reduces the dependency on fossil resources and facilitates the transition towards abundantly available biobased raw materials.A new class of biobased polyesters resins and thermosets will be designed in SMARTCASE using safe and sustainable by design approaches allowing for more sustainable and feasible end-of-life options. Biobased polyesters in general meet the requirements of circularity, as they can be efficiently recycled back to their monomers at end-of-life. Accordingly, the recycling and degradation behavior of the developed formulations under thermal, mechanical and chemical conditions and their biodegradation will be studied. Hence, the output of the project contributes to the main goals of the NGF BioBased Circular program.The project follows a value-cycle approach with a multi-disciplinary and balanced consortium of industrial representatives from every part of the value chain, from carbohydrate feedstock suppliers to resin formulators and end users. This enables a system innovation instead of a (single) product innovation. The following results are expected within 10 years (mostly by the end of the project ): - Sustainable feedstock platform for novel biobased (BB) platform chemicals- Access to novel monomers and building blocks- Access to safe and novel polyester-based resin components- Access to high performance, safe and circular thermoset formulations- Scale-up of the best thermoset formulations- Validated performance of novel thermoset formulations in industrial applications- Sustainable and circular-by-design thermoset formulations with defined end-of-life solutions - Data on LCA, TEA, toxicity and sustainability- Engaged stakeholders and effective dissemination of project outcomes By ensuring these results are implemented by industrial partners both during and after the project, they will benefit not only stakeholders, chemical industries, and consortium partners but also the general public.
