Deze uitspraak is een annotatie waard omdat het de eerste uitspraak is waarin de Afdeling bestuursrechtspraak van de Raad van State beoordeelt of een bestuursorgaan het openbaar maken van... Show moreDeze uitspraak is een annotatie waard omdat het de eerste uitspraak is waarin de Afdeling bestuursrechtspraak van de Raad van State beoordeelt of een bestuursorgaan het openbaar maken van informatie op grond van de Wet open overheid (Woo) mocht weigeren vanwege de zogenaamde i-grond. Deze uitzonderingsgrond is een relatieve uitzonderingsgrond. Het bepaalt dat het openbaar maken van informatie achterwege blijft voor zover het belang daarvan niet opweegt tegen het belang van het goed functioneren van de Staat, andere publiekrechtelijke lichamen of bestuursorganen. Deze uitzonderingsgrond is nieuw ten opzichte van de Wob en sinds de inwerkingtreding van de Woo is de vrees geuit dat deze grond een ‘duizenddingendoekje’ zou worden voor bestuursorganen om openbaarmaking te weigeren. Jurisprudentie van de Afdeling over deze grond is daarom van groot belang om de kaders van deze nieuwe uitzonderingsgrond duidelijk te krijgen. Uit de uitspraak blijkt (kort samengevat) dat (i) tijdsverloop in acht moet worden genomen bij het bepalen of het goed functioneren in het geding is; en (ii) een belangenafweging op het niveau van een document(onderdeel) moet plaatsvinden, tenzij sprake is van een crisis. Show less
Computer tomography (CT)-guided percutaneous core biopsies are currently the gold standard in diagnostic procedures for patients with bone lesions of unknown kind. CT-guided biopsies can lead to... Show moreComputer tomography (CT)-guided percutaneous core biopsies are currently the gold standard in diagnostic procedures for patients with bone lesions of unknown kind. CT-guided biopsies can lead to misdiagnosis or repetition of biopsies in case of small or heterogeneous lesions. We hypothesize that molecular image guidance could be used to optimize the biopsy strategy, by supporting the detection of heterogeneous lesions or lesions without radiographic substrate. To evaluate this hypothesis, we investigated if and how the addition of 2-deoxy-2-18F-fluoro-D-glucose-positron emission tomography (18F-FDG-PET)/CT could augment routine CT-guided bone biopsies. To this end, 106 patients who underwent a CT-guided bone biopsy between April 2019 and April 2020, obtained from either a vertebral or peripheral bone, were included. Patients were divided into 2 groups: 36 patients received an 18F-FDG-PET/CT scan prior to their CT-guided bone biopsy (PET group), while 70 patients only had a morphological CT scan (CT group). Histopathology was used to categorize biopsies into five subgroups (inconclusive, benign, malignant or infectious disease, or normal tissue). In the PET group, the number of conclusive biopsies was significantly higher compared to the CT group (N = 33/36 (92%) versus N = 53/70 (76%); p < 0.05). Furthermore, the number of first-try biopsies was lower in the PET group compared to the CT group (1.9 vs. 2.54, p = 0.051). In conclusion, 18F-FDG-PET/CT imaging significantly increased the success rate of first-try CT-guided bone biopsies by showing less inconclusive biopsies and misdiagnosis. Show less
Background: Clinical and echocardiographic results of valve repair for mitral regurgitation in the setting of atrial fibrillation are poorly studied. Methods: Between January 2008 and December 2020... Show moreBackground: Clinical and echocardiographic results of valve repair for mitral regurgitation in the setting of atrial fibrillation are poorly studied. Methods: Between January 2008 and December 2020, 89 patients underwent valve repair for mitral regurgitation in the setting of atrial fibrillation. Clinical and echocardiographic follow-up data were collected and studied. The primary composite endpoint consisted of all-cause mortality or hospitalization for heart failure. Results: Valve repair with true-sized annuloplasty was performed in 83 (93 %) and restrictive annuloplasty in 6 (7 %) patients. Early mortality occurred in 3 (3 %) and residual mitral regurgitation in 1 (1 %) patient. During a median follow-up of 5.4 years (interquartile range 3.4–9.5), 25 patients died, 6 due to end-stage heart failure. Ten patients were hospitalized for heart failure. The estimated event-free survival rate at 10 years was 48.2 % (95 % CI 33.5 %–62.9 %). Recurrent mitral regurgitation was observed in 14 patients and most often caused by leaflet tethering. When analyzed as a time-dependent variable, recurrent regurgitation was related to the occurrence of the primary endpoint (hazard ratio 3.192, 95 % CI 1.219–8.359, p = 0.018). On exploratory sub-analyses, no recurrent regurgitation was observed after restrictive annuloplasty or in patients with paroxysmal atrial fibrillation. Moreover, recurrent regurgitation was observed more often when signs of left ventricular impairment were present preoperatively. Conclusions: Despite good initial results, recurrent regurgitation was a frequent observation after valve repair for mitral regurgitation in atrial fibrillation and had an effect on heart failure related morbidity and mortality. Refinements in the timing of surgery and surgical technique might help improve outcomes. Show less
The environmental impact of traded plastic waste hinges on how it is treated. Existing studies often use domestic or scenario-based recycling rates for imported plastic waste, which is problematic... Show moreThe environmental impact of traded plastic waste hinges on how it is treated. Existing studies often use domestic or scenario-based recycling rates for imported plastic waste, which is problematic due to differences in recyclability and the fact that importers pay for it. We estimate the minimum required recycling rate (RRR) needed to break even financially by analysing import prices, recycling costs, and the value of recycled plastics across 22 leading importing countries and four plastic waste types during 2013–2022. Here we show that at least 63% of imported plastic waste must be recycled, surpassing the average domestic recycling rate of 23% by 40 percentage points. This discrepancy suggests that recycled plastics volumes from the global North-to-South trade may be underestimated. The country-specific RRR provided could enhance research and policy efforts to better quantify and mitigate the environmental impact of plastic waste trade. Show less
Purpose – The purpose of this paper is to present the learnings of a broker organization that started a new Population Health Management initiative in two regions in the Netherlands. The research... Show morePurpose – The purpose of this paper is to present the learnings of a broker organization that started a new Population Health Management initiative in two regions in the Netherlands. The research focusses on the role of the broker organization itself in supporting stakeholders in the region to adopt a new implementation strategy designed by the broker organisation itself. The basis of this model was to organize, finance and monitor differently to improve the overall health of the population. Design/methodology/approach – An action research approach was chosen to support the endeavours of the broker organization and to acquire practical knowledge on the role of a third-party in PHM implementation. Qualitative data were collected from documentary analysis, focus groups, logbooks and observational data from team meetings. Findings – The main result is that the role of the broker organization to implement PHM was subject to change during the more than two years of the research. Several themes emerged that influenced these role changes, both internal and external, showing the complexity of providing PHM implementation support as a third-party to regional stakeholders. Practical implications – We hypothesize that the role of a third-party changes depending on the maturity of the regional collaboration. The complexity of the transition in healthcare calls for constant adaptations, and thus learning and reflection, from all involved. Action research is a strong tool for this. Originality/value – This paper is one of the first to report on the role of a third-party in PHM implementation. The action research methodology offered the right amount of flexibility to adhere to the complexity of the context and provided rich insights. Show less
Spreafico, M.; Hazewinkel, A.-D.; Sande, M.A. J. van de; Gelderblom, A.J.; Fiocco, M. 2024
As cousins, we discovered a treasure trove of family papers, revealing the intricate relationship between precarity and privilege of our family from Salonica navigating the post-Ottoman transition.... Show moreAs cousins, we discovered a treasure trove of family papers, revealing the intricate relationship between precarity and privilege of our family from Salonica navigating the post-Ottoman transition. Recognising the potential of family history to provide a more intimate and complex historiography, this article offers our initial study of these family papers. By highlighting the challenges posed by the scarcity of such documents in Middle Eastern studies, emphasising women’s roles in preserving family memory and focussing on the interplay between personal and political domains, we identify the preparation of a family tree as a gendered and socioeconomic project of preserving the past and shaping the present. By tracing our family's origins, including unsettling discoveries, we address matters of identity and memory before embarking on our analysis. By reconstructing the biographies of two generations, we characterise the family’s socioeconomic struggle to sustain their precarious privilege amid shifting frontiers and along their journey from Ottoman Salonica to Kemalist Turkey. Ultimately, this article underscores the significance of family history as a transnational, intergenerational, intersectional and social history that enriches our understanding of the post-Ottoman transition through the lives of ordinary (and some extraordinary) Ottomans. Show less
The goal of the study was to describe the population pharmacokinetics of trimethoprim, sulfamethoxazole, and N-acetyl sulfamethoxazole in hospitalized patients. Furthermore, this study used the... Show moreThe goal of the study was to describe the population pharmacokinetics of trimethoprim, sulfamethoxazole, and N-acetyl sulfamethoxazole in hospitalized patients. Furthermore, this study used the model to optimize dosing regimens of cotrimoxazole for Pneumocystis jirovecii pneumonia and in patients with renal insufficiency or with continuous renal replacement therapy (CRRT). This was a retrospective multicenter observational cohort study based on therapeutic drug monitoring (TDM) data from hospitalized patients treated with cotrimoxazole. We developed two population pharmacokinetic (POPPK) models: a model of trimethoprim and an integrated model with both sulfamethoxazole and N-acetyl sulfamethoxazole concentrations. Monte Carlo simulations were performed to determine the optimal dosing regimen. A total of 348 measurements from 168 patients were available. The estimated glomerular filtration rate (eGFR) and CRRT were included as covariates on the clearance of all three compounds. Cotrimoxazole TID 1,920 mg and b.i.d. 2,400 mg led to sufficient exposure for infections with P. jirovecii in patients without renal insufficiency. To reach equivalent exposure, a dose reduction of 33.3% is needed in patients with an eGFR of 10 mL/minute/1.73 m2 and of 16.7% for an eGFR of 30 mL/minute/1.73 m2. N-acetyl sulfamethoxazole accumulates in patients with a reduced eGFR. CRRT increased the clearance of sulfamethoxazole, but not trimethoprim or N-acetyl sulfamethoxazole, compared with the median clearance in the population. Doubling the sulfamethoxazole dose is needed for patients on CRRT to reach equivalent exposure. Show less
Wastewater-based epidemiological surveillance at municipal wastewater treatment plants has proven to play an important role in COVID-19 surveillance. Considering international passenger hubs... Show moreWastewater-based epidemiological surveillance at municipal wastewater treatment plants has proven to play an important role in COVID-19 surveillance. Considering international passenger hubs contribute extensively to global transmission of viruses, wastewater surveillance at this type of location may be of added value as well. The aim of this study is to explore the potential of long-term wastewater surveillance at a large passenger hub as an additional tool for public health surveillance during different stages of a pandemic. Here, we present an analysis of SARS-CoV-2 viral loads in airport wastewater by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) from the beginning of the COVID-19 pandemic in Feb 2020, and an analysis of SARS-CoV-2 variants by whole-genome next-generation sequencing from Sep 2020, both until Sep 2022, in the Netherlands. Results are contextualized using (inter)national measures and data sources such as passenger numbers, clinical surveillance data and national wastewater surveillance data. Our findings show that wastewater surveillance was possible throughout the study period, irrespective of measures, as viral loads were detected and quantified in 98.6 % (273/277) of samples. Emergence of SARS-CoV-2 variants, identified in 91.0 % (161/177) of sequenced samples, coincided with increases in viral loads. Furthermore, trends in viral load and variant detection in airport wastewater closely followed, and in some cases preceded, trends in national daily average viral load in wastewater and variants detected in clinical surveillance. Wastewater-based epidemiology at a large international airport is a valuable addition to classical COVID-19 surveillance and the developed expertise can be applied in pandemic preparedness plans for other (emerging) pathogens in the future. Show less
As China’s internet has matured, from its initial web-based origins through innovative ‘2.0’ and ‘3.0’ innovations, so too have the community sentiments that criss-cross the People’s Republic of... Show moreAs China’s internet has matured, from its initial web-based origins through innovative ‘2.0’ and ‘3.0’ innovations, so too have the community sentiments that criss-cross the People’s Republic of China’s networked society. A perennial issue has been the question of how Chinese nationhood has been constructed and reproduced through digital technologies and how the evolving affordances of internet technology have contributed to China’s many nationalisms. This short essay reflects on this history. It discusses how early internet forums and blogs allowed users to coordinate their sense of Chineseness, how these processes later changed when communication moved to widely adopted microblogging platforms and what we can expect of the future, as China’s media environments shift their focus towards short-messaging applications and video-sharing platforms. What will happen to Chinese nationalisms as China’s platformisation enters its next phases? Show less
