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Background and Purpose: This analysis examined the frequency of dural arteriovenous fistulae (dAVF) after cerebral venous thrombosis (CVT) in patients included in a randomized controlled trial comparing dabigatran etexilate with dose-adjusted warfarin (RE-SPECT CVT [A Clinical Trial Comparing Efficacy and Safety of Dabigatran Etexilate With Warfarin in Patients With Cerebral Venous and Dural Sinus Thrombosis]), who had systematic follow-up magnetic resonance (MR) imaging. Methods: RE-SPECT CVT was a Phase 3, prospective, randomized, parallel-group, open-label, multicenter, exploratory trial with blinded end point adjudication. We allocated patients with acute CVT to dabigatran 150 mg twice daily or dose-adjusted warfarin, for 24 weeks and obtained a standardized MR protocol including time-of-flight MR angiography, 3-dimensionalphase-contrast venography, and 3-dimensional contrast-enhanced MR venography at the end of the treatment period. A blinded adjudication committee assessed the presence of dAVF in a predefined substudy of the trial. Results: We analyzed development of dAVF in 112 of 120 randomized patients; 57 allocated to dabigatran and 55 to warfarin. For 3 (2.7%) of these 112 patients, quality of follow-up imaging was insufficient to evaluate dAVF. A dAVF (Borden I) was found in 1 patient (0.9%) allocated to warfarin; however, this dAVF was already present at baseline. The patient did not present with hemorrhage at baseline or during the trial and was asymptomatic at follow-up. Conclusions: Despite systematic imaging, we found no new dAVF 6 months after CVT. Routine follow-up cerebral MR angiography aiming to detect new dAVF 6 months after CVT has a very low yield. REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02913326.

As in other industries, firms in the construction industry need to become more client- and market-oriented. In the last decade, several initiatives have been taken to change the construction industry in that direction. The changes, however, seem to be slower than other industries and less forthcoming than projected. Old practices and patterns die hard. Fundamental changes in orientation, strategy and strategy deployment require shifts in the management paradigms (i.e. the 'frames of mind' that steer individual and collective behaviour). Management is seen as a crucial factor in these change processes, but can the new business be created by old management paradigms? Can the leaders in the construction industry shake off the old paradigms? An explorative quantitative study shows that the mainstream paradigm of construction industry leaders today is much as it was in the past: technology- and project-oriented. Acting out of this paradigm, issues as social-organizational change and strategic focus on the client - regarded as important for the industry - will probably not be addressed properly. Change initiatives could gain in success, when they create wider awareness of existence and persistence of incumbent and prevailing paradigms.Construction industry, innovation, paradigms, barriers to change, construction management,

d-Cycloserine (DCS), a partial NMDA receptor agonist, has been proposed as a cognitive enhancer to facilitate the extinction of drug-related memories. However, it is unknown whether there are individual differences in the efficacy of DCS. Here, we set out to investigate the influence of serotonin transporter (5-HTT) genotype on DCS treatment outcome and the underlying neural mechanism. To that end, we first determined the mRNA levels of several NMDA receptor subunits and observed a reduction in NR1/NR2C receptors in the ventromedial prefrontal cortex and nucleus accumbens of 5-HTT compared with 5-HTT rats. Based on this finding, we hypothesized a lower sensitivity to DCS in the 5-HTT rats. To test this, rats were trained in a cocaine-induced conditioned place preference (CPP) paradigm. A significant extinction of CPP was observed in 5-HTT rats receiving 1 mg/kg i.v. DCS, while a similar effect was found in the 5-HTT rats only after 5 mg/kg. Following CPP, we tested if DCS were able to reduce FosB/∆FosB protein expression, a molecular switch for cocaine-seeking behaviour. We observed an overall lower number of FosB/∆FosB positive cells in 5-HTT ventromedial prefrontal cortex and amygdala and an overall effect of DCS treatment on the number of positive cells in the nucleus accumbens. In conclusion, in this study, we show that the dosing of DCS to facilitate the extinction of cocaine-seeking behaviour is, at least partially, determined by 5-HTT genotype.