Background: Measures against COVID-19 in nursing homes affected not only clients but also staff. However, staff perspectives on the importance of these measures remain underexplored. Objective: To... Show moreBackground: Measures against COVID-19 in nursing homes affected not only clients but also staff. However, staff perspectives on the importance of these measures remain underexplored. Objective: To investigate measures related to staff during the COVID-19 pandemic, staff perspectives of important measures and the involvement of staff in deciding on these measures. Design: A qualitative study. Setting(s): We analysed minutes of nursing home outbreak teams in the Netherlands and conducted group meetings with Dutch nursing home staff in different positions, prioritizing measures and discussing staff' involvement in deciding on the measures. Participants were recruited purposefully. Participants: The minutes of 41 nursing home organizations were collected during March-November, 2020. Four group meetings were organized in the same period, each with 5 to 7 participants, resulting in 23 participants. Methods: The meeting minutes were analysed using qualitative content analysis, whereas reflexive thematic analysis was used for the group meeting data. The group meetings were conducted online and structured by the Nominal Group Technique to discuss the importance of measures for staff. Results: Measures implemented for staff focused on prevention of COVID-19 transmission, (suspension of) educational activities, testing, additional tasks and staffing capacity, promoting wellbeing, and other means of support. The implemented measures overlapped with the measures considered important by staff. In addition, staff considered measures on decision-making support and communication to be important. Staff prioritized the measures in the group meetings because they affected their well-being, workforce scheduling, decision-making, or infection prevention. Furthermore, the group meetings revealed that decision-making shifted from mainly implementing national measures to more context-adjusted decision-making in the staff's or clients' situations. Conclusions: We showed that although nursing home staff were not always involved in decisionmaking during the first COVID-19 wave, there was overlap between the measures implemented by the organizations and measures considered important by staff. We suggest that organizations Show less
Nanoplastics can cause severe malformations in chicken embryos. To improve our understanding of the toxicity of nanoplastics to embryos, we have studied their biodistribution in living chicken... Show moreNanoplastics can cause severe malformations in chicken embryos. To improve our understanding of the toxicity of nanoplastics to embryos, we have studied their biodistribution in living chicken embryos. We injected the embryos in the vitelline vein at stages 18–19. We injected polystyrene nanoparticles (PS-NPs) tagged with europium- or fluorescence. Their biodistribution was tracked using inductively-coupled plasma mass spectrometry on tissue lysates, paraffin histology, and vibratome sections analysed by machine learning algorithms. PS-NPs were found at high levels in the heart, liver and kidneys. Furthermore, PS-NPs crossed the endocardium of the heart at sites of epithelial-mesenchymal transformation; they also crossed the liver endothelium. Finally, we detected PS-NPs in the allantoic fluid, consistent with their being excreted by the kidneys. Our study shows the power of the chicken embryo model for analysing the biodistribution of nanoplastics in embryos. Such experiments are difficult or impossible in mammalian embryos. These findings are a major advance in our understanding of the biodistribution and tissue-specific accumulation of PS-NPs in developing animals. Show less
This article studies the use of the Bare Aorist in the Berber variety of Figuig, an oasis at the border of Morocco and Algeria. Like elsewhere in Berber, the Bare Aorist isused as a form that is... Show moreThis article studies the use of the Bare Aorist in the Berber variety of Figuig, an oasis at the border of Morocco and Algeria. Like elsewhere in Berber, the Bare Aorist isused as a form that is neutral as to aspect, whose interpretation is provided by context. It is shown that the major types of occurrence that were established for other varieties (Mauri2017) are also represented in Figuig Bare Aorists. Framed Aorists are found in main clauses that are preceded by a temporal/aspectual clause that provides the framing for its aspectual interpretation. With Chained Aorists, the framing is provided by verbs in preceding main clauses. It is shown, however, that Chained Aorists are subtly different in Figuig from the way they have been described for other varieties, as they mainly occur to express continuity at points where such a continuity is less expected. Show less
BackgroundWhen research evidence is limited, inconsistent, or absent, healthcare decisions and policies need to be based on consensus among interested stakeholders. In these processes, the... Show moreBackgroundWhen research evidence is limited, inconsistent, or absent, healthcare decisions and policies need to be based on consensus among interested stakeholders. In these processes, the knowledge, experience, and expertise of health professionals, researchers, policymakers, and the public are systematically collected and synthesised to reach agreed clinical recommendations and/or priorities. However, despite the influence of consensus exercises, the methods used to achieve agreement are often poorly reported. The ACCORD (ACcurate COnsensus Reporting Document) guideline was developed to help report any consensus methods used in biomedical research, regardless of the health field, techniques used, or application. This explanatory document facilitates the use of the ACCORD checklist.Methods and findingsThis paper was built collaboratively based on classic and contemporary literature on consensus methods and publications reporting their use. For each ACCORD checklist item, this explanation and elaboration document unpacks the pieces of information that should be reported and provides a rationale on why it is essential to describe them in detail. Furthermore, this document offers a glossary of terms used in consensus exercises to clarify the meaning of common terms used across consensus methods, to promote uniformity, and to support understanding for consumers who read consensus statements, position statements, or clinical practice guidelines (CPGs). The items are followed by examples of reporting items from the ACCORD guideline, in text, tables, and figures.ConclusionsThe ACCORD materials—including the reporting guideline and this explanation and elaboration document—can be used by anyone reporting a consensus exercise used in the context of health research. As a reporting guideline, ACCORD helps researchers to be transparent about the materials, resources (both human and financial), and procedures used in their investigations so readers can judge the trustworthiness and applicability of their results/recommendations. Show less
Rede uitgesproken door Prof. dr. Anton Jan van Zonneveld ter gelegenheid van zijn afscheid als hoogleraarNierziekten, in het bijzonder de experimentele vasculaire geneeskunde aan de Universiteit... Show moreRede uitgesproken door Prof. dr. Anton Jan van Zonneveld ter gelegenheid van zijn afscheid als hoogleraarNierziekten, in het bijzonder de experimentele vasculaire geneeskunde aan de Universiteit Leiden op vrijdag 31 mei 2024 Show less
Background: The risk of urinary tract infections (UTIs) is increased by unnecessary placement and prolonged use of urinary catheters. Aim: To assess whether inappropriate use of catheters and... Show moreBackground: The risk of urinary tract infections (UTIs) is increased by unnecessary placement and prolonged use of urinary catheters. Aim: To assess whether inappropriate use of catheters and catheter-associated UTI were reduced through patient participation. Methods: In this multicentre, interrupted time-series and before-and-after study, we implemented a patient-centred app which provides catheter advice for patients, together with clinical lessons, feedback via e-mails and support rounds for staff members. Data on catheter use and infections were collected during a six-month baseline and a six-month intervention period on 13 wards in four hospitals in the Netherlands. Dutch Trial Register: NL7178. Findings: Between June 25th, 2018 and August 1st, 2019, 6556 patients were included in 24 point-prevalence surveys, 3285 (50%) at baseline and 3271 (50%) during the intervention. During the intervention 249 app users and a median of seven new app users per week were registered (interquartile range: 5.5e13.0). At baseline, inappropriate catheter use was registered for 175 (21.9%) out of 798 catheters, compared to 55 (7.0%) out of 786 during the intervention. Time-series analysis showed a non-significant decrease of inappropriate use of 5.8% (95% confidence interval: e3.76 to 15.45; P ¼ 0.219), with an odds ratio of 0.27 (0.19e0.37; P < 0.001). Catheter-associated UTI decreased by 3.0% (1.3e4.6; P ¼ 0.001), with odds ratio 0.541 (0.408e0.716; P < 0.001). Show less
Predicting the development of rheumatoid arthritis (RA) in an early stage through magnetic resonance imaging (MRI) can initiate timely treatment and improve long-term patient outcomes. Although... Show morePredicting the development of rheumatoid arthritis (RA) in an early stage through magnetic resonance imaging (MRI) can initiate timely treatment and improve long-term patient outcomes. Although manual prediction is time-consuming and requires expert knowledge, automatic RA prediction has not been fully investigated. While standard models fail to achieve acceptable performance, we present a consistency-based deep learning framework to classify and predict RA automatically and precisely, including an output-standardized model, customized self-supervised pretraining and a loss function that is based on label consistency between original and augmented inputs. For training and evaluation, we used a database, containing 5945 MRI scans of carpal, metacarpophalangeal (MCP), and metatarsophalangeal (MTP) joints, from 2151 subjects obtained over a period of ten years. Four (three classification- and one prediction-) tasks were defined to distinguish two patient groups (with recent-onset arthritis and clinically suspect arthralgia) from healthy controls and RA from other arthritis patients within the recent-onset arthritis group, and predict RA development in a period of two years within the clinically suspect arthralgia group. The proposed method was evaluated with the area under the receiver operating curve (AUROC) on a separate test set, achieving mean AUROCs of 83.6%, 83.3%, and 69.7% in the three classification tasks, and 67.8% in the prediction task. This proves the existence of early signs of RA in MRI and the potential of a consistency-based deep learning model to detect these early signs and predict RA Show less
This contribution describes societies and institutes in the Netherlands that played key roles in scholarly research on the Ancient Near East and Egypt. Public interest followed academic... Show moreThis contribution describes societies and institutes in the Netherlands that played key roles in scholarly research on the Ancient Near East and Egypt. Public interest followed academic developments at a distance. Leading figures, almost all academics, are briefly discussed.After a promising start in the 19th century, development in Dutch Egyptology was mostly limited to religious studies. Assyriology was largely a side-interest for theologians. While other European countries founded national scholarly societies and financed grand expeditions, attention in the Netherland was mainly directed to the Dutch East-Indies, with Oriental studies mostly a function of colonial administration, in combination with Semitic languages (connected to Bible studies).During the first quarter of the 20th century, Oriental studies in the Netherlands were marked by proliferation and specialisation – albeit with a continued emphasis on language studies, and usually from a biblical perspective. The general public was not yet involved. The second quarter of the 20th century saw further diversification of the field, a failed marriage between Ancient Near Eastern and Classical studies, and a broadening audience.After World War II, the range of history, language studies, and archaeology fully developed in the Netherlands. Internationalisation, rising population and student numbers, and economic growth were instrumental. The fourth quarter of the 20th century was characterised by the definitive division between Middle and Far Eastern versus Ancient Near Eastern studies. State-funded research was the norm; the popular audience increased.In the first quarter of the 21st century (not comprehensively addressed in this contribution) state-funded research declined while modest private initiatives (societies of museum and excavation “friends”) can be observed. Show less
Beek, S.H. van de; Erdal, A.; Husebo, B.S.; Vislapuu, M.; Achterberg, W.P.; Caljouw, M.A.A. 2024
Objective: This study aims to identify whether pain and dementia-related behavior are associated withdifferent types of activities in nursing home residents, controlled for dementia severity.Design... Show moreObjective: This study aims to identify whether pain and dementia-related behavior are associated withdifferent types of activities in nursing home residents, controlled for dementia severity.Design: Cross-sectional baseline data from the multicomponent cluster randomized controlled COSMOS trial (acronymfor Communication, Systematic pain treatment,Medication review, Organization of activities, and Safety).Setting and Participants: A total of 723 patients from 33 Norwegian nursing homes with 67 units(clusters). Participants aged >= 65 years, with a life expectancy of >6 months, and with valid data onactivity were eligible for inclusion.Methods: Activity was operationalized in time (hours per week) and type (cognitive, social, physical, andno activity). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), painwith the Mobilization-Observation-Behavior-Intensity-Dementia-2 Pain Scale (MOBID-2), and behaviorwith the Neuropsychiatric Inventory Nursing Home version (NPI-NH). Analyses were performed usinglinear and logistic regression. Sensitivity analyses for dementia severity were performed to account foreffect modification.Results: A total of 289 participants were included (mean age 86.2 [SD 7.6]; 74% female). A higher painscore was associated with less time spent on activity in participants with severe dementia (estimate0.897, P = .043). A higher score for the NPI-NH mood cluster (depression and anxiety) was associatedwith a higher likelihood of participation in cognitive activities (odds ratio [OR], 1.073; P ¼ .039). Apathy(OR, 0.884; P = .041) and lack of inhibition (OR, 0.904; P = .042) were associated with a lower likelihoodof participation in social activities as well as no engagement in activities (apathy OR, 0.880; P = .042; lackof inhibition OR, 0.894; P = .034).Conclusion and Implications: Pain and dementia-related behavior may influence the participation inactivities in the nursing home. There is an urgent need to investigate what type of activity stimulatespeople in different stages of dementia. Show less
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy which shows unparalleled therapeutic resistance due to its genetic and cellular heterogeneity, dense stromal tissue, and... Show morePancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy which shows unparalleled therapeutic resistance due to its genetic and cellular heterogeneity, dense stromal tissue, and immune-suppressive tumour microenvironment. Oncolytic virotherapy has emerged as a new treatment modality which uses tumour-specific viruses to eliminate cancerous cells. Non-human primate adenoviruses of the human adenovirus B (HAdV-B) species have demonstrated considerable lytic potential in human cancer cells as well as limited preexisting neutralizing immunity in humans. Previously, we have generated a new oncolytic derivative of the gorilla-derived HAdV-B AdV-lumc007 named ‘GoraVir’. Here, we show that GoraVir displays oncolytic efficacy in pancreatic cancer cells and pancreatic-cancer-associated fibroblasts. Moreover, it retains its lytic potential in monoculture and co-culture spheroids. In addition, we established the ubiquitously expressed complement receptor CD46 as the main entry receptor for GoraVir. Finally, a single intratumoural dose of GoraVir was shown to delay tumour growth in a BxPC-3 xenograft model at 10 days post-treatment. Collectively, these data demonstrate that the new gorilla-derived oncolytic adenovirus is a potent oncolytic vector candidate that targets both pancreatic cancer cells and tumour-adjacent stroma. Show less
MRI systems have a thin conducting layer placed between the gradient and RF coils, this acts as a shield at the RF-frequency, minimizing noise coupled into the experiment, and decreasing the... Show moreMRI systems have a thin conducting layer placed between the gradient and RF coils, this acts as a shield at the RF-frequency, minimizing noise coupled into the experiment, and decreasing the coupling between the RF and gradient coils. Ideally, this layer should be transparent to the gradient fields to reduce eddy currents. In this work the design of such a shield, specifically for low-field point-of-care Halbach based MRI devices, is discussed. A segmented double layer shield is designed and constructed based on eddy current simulations. Subsequently, the performance of the improved shield is compared to a reference shield by measuring the eddy current decay times as well as using noise measurements. A maximum reduction factor of 2.9 in the eddy current decay time is observed. The segmented shield couples in an equivalent amount of noise when compared to the unsegmented reference shield. Turbo spin echo images of a phantom and the brain of a healthy volunteer show improvements in terms of blurring using the segmented shield. Show less
This book focuses on the general right of suspension regulated in article 6:52 et seq. of the Dutch Civil Code. The author pays attention, among other things, to the requirements for the power to... Show moreThis book focuses on the general right of suspension regulated in article 6:52 et seq. of the Dutch Civil Code. The author pays attention, among other things, to the requirements for the power to suspend, including the coherence criterion (Dutch: samenhangcriterium), which is also the central requirement. The author explains that this criterion is not a measure of judgment or criterion to be judged by itself, but the existence of sufficient coherence between mutual obligations to justify suspension is rather a conclusion that follows the application of the coherence criterion. The author also discusses how the general right of suspension is exercised. Under circumstances, that exercise may be unacceptable. This involves weighing the interests involved in that exercise. Procedural aspects of the general right of suspension are also discussed, including the dictum. The author discusses that under circumstances an order for gradual performance fits a defense of suspension better than a rejection of the claim. The author makes this concrete using many examples mainly from case law. This book is therefore relevant for both law and legal practice. Show less
Dental calculus. This small, hard, inconspicuous substance that forms on the teeth of humans and animals contains a surprising amount of information about our lives. During its formation and growth... Show moreDental calculus. This small, hard, inconspicuous substance that forms on the teeth of humans and animals contains a surprising amount of information about our lives. During its formation and growth as a living biofilm, it accumulates a wide variety particles, especially bacteria and food debris.What makes this so interesting to archaeologists is that, when plaque hardens and forms dental calculus, these particles become trapped and well-protected against removal and degradation during hundreds to thousands of years, preserving a picture of past activities.The major problem—one of the major problems, for there are several—one of the many major problems is that this picture was never a complete picture of a lifetime of activities, and that picture fades over time. We know that these problems exist and that they limit our interpretations of past activities. What we need to do is approach these problems at a fundamental level. In my dissertation I introduce a protocol for growing artificial dental calculus. Working with a very controlled model allows me to explore the influence of a wide range of factors that may affect the uptake of particles into dental calculus, and better explain why and how our picture is incomplete. Show less
Tuberculosis (TB) is associated with 1.5 million deaths annually. There is a need exists to optimize both current as well as novel antibiotic combination treatment strategies to improve the... Show moreTuberculosis (TB) is associated with 1.5 million deaths annually. There is a need exists to optimize both current as well as novel antibiotic combination treatment strategies to improve the effectiveness and safety of treatments against TB. This PhD thesis has described how various quantitative pharmacology modeling approaches can contribute to the further development and optimization of both existing and novel therapies and treatment strategies against TB. Show less
Householder, J.E.; Wittmann, F.; Schöngart, J.; Piedade, M.T.F.; Junk, W.J.; Latrubesse, E.M.; ... ; Steege, H. ter 2024
Amazonia's floodplain system is the largest and most biodiverse on Earth. Although forests are crucial to the ecological integrity of floodplains, our understanding of their species composition and... Show moreAmazonia's floodplain system is the largest and most biodiverse on Earth. Although forests are crucial to the ecological integrity of floodplains, our understanding of their species composition and how this may differ from surrounding forest types is still far too limited, particularly as changing inundation regimes begin to reshape floodplain tree communities and the critical ecosystem functions they underpin. Here we address this gap by taking a spatially explicit look at Amazonia-wide patterns of tree-species turnover and ecological specialization of the region's floodplain forests. We show that the majority of Amazonian tree species can inhabit floodplains, and about a sixth of Amazonian tree diversity is ecologically specialized on floodplains. The degree of specialization in floodplain communities is driven by regional flood patterns, with the most compositionally differentiated floodplain forests located centrally within the fluvial network and contingent on the most extraordinary flood magnitudes regionally. Our results provide a spatially explicit view of ecological specialization of floodplain forest communities and expose the need for whole-basin hydrological integrity to protect the Amazon's tree diversity and its function. Show less
Zhang, L.; Cao, Z.; Sivertsen, G.; Kochetkov, D. 2024
Drawing on new data, Lin Zhang, Zhe Cao, Gunnar Sivertsen, and Dmitry Kochetkov explore how the conflict in Ukraine has changed Russian science and how international sanctions have played a minor... Show moreDrawing on new data, Lin Zhang, Zhe Cao, Gunnar Sivertsen, and Dmitry Kochetkov explore how the conflict in Ukraine has changed Russian science and how international sanctions have played a minor role compared to domestic politics in isolating Russian scientists. Show less
Cerebral Amyloid Angiopathy (CAA) is one of the main causes of intracerebral hemorrhage (ICH) in the elderly, and affects millions of people worldwide. CAA is caused by the deposition of the... Show moreCerebral Amyloid Angiopathy (CAA) is one of the main causes of intracerebral hemorrhage (ICH) in the elderly, and affects millions of people worldwide. CAA is caused by the deposition of the protein Amyloid-β in the walls of the cerebral and leptomeningeal vessels, which leads to vessel fragility and eventually rupture. CAA has a variable disease course and can present with a spectrum of symptoms. There is currently no cure for CAA, and certain diagnosis during life remains challenging.This thesis has used data from patients with hereditary and non-hereditary (sporadic) CAA to investigate novel clinical and radiological (MRI) markers of CAA, and has used them to formulate a pathophysiologic framework for the temporal ordering of disease processes in CAA. Our results provide new insights in the disease cascade, can aid in diagnosing the disease and have important implications for future clinical trial design, aiding in the identification and timing of candidates for disease-modifying treatments and the choice for the appropriate biomarkers to monitor treatment effect. CAA is a disease with a complex disease cascade and a large variety in disease course, both clinically and radiologically. However, it is just this variety that gives hope for the future: if we find what drives variability in CAA we might find ways for disease modification, prevention and treatment, and identification of in vivo biomarkers with specificity for CAA are a vital part of this search. Show less
