Dit briefadvies maakt eerst kort de balans op van twee jaar oorlog. Vervolgens constateert de Raad dat de westerse consensus brozer wordt, dat er kantelpunten in zicht zijn en dat een langdurige... Show moreDit briefadvies maakt eerst kort de balans op van twee jaar oorlog. Vervolgens constateert de Raad dat de westerse consensus brozer wordt, dat er kantelpunten in zicht zijn en dat een langdurige patstelling dreigt. De vraag naar een adequate Nederlandse opstelling dient zich aan, ook voor de nieuw aan te treden regering. Het adviesrapport benadrukt de noodzaak van onverminderde Nederlandse en Europese steun aan Oekraïne en geeft aan dat Nederland zich proactiever moet voorbereiden op verschillende scenario’s voor de oorlog in Oekraïne en actief dient te streven naar de meest wenselijke uitkomsten, waaronder een overwinning voor Oekraïne of een sterke onderhandelingspositie voor het land.Het advies bespreekt daarna zes thema’s in meer detail: 1) de Europese veiligheidsarchitectuur; 2) de Europese defensie-industrie; 3) het perspectief op Oekraïens EU-lidmaatschap; 4) Oekraïne’s wederopbouw; 5) de gevolgen van de oorlog voor het mondiale Zuiden; en 6) weerbaarheid en draagvlak. Deze bespreking leidt tot een korte conclusie en een zestal aanbevelingen. Show less
Hesselmans, S.; Meiland, F.J.M.; Adam, E.; Cruijs, E. van de; Vonk, A.; Oost, F. van; ... ; Meinders, E.R. 2023
Purpose: People with intellectual disabilities often show challenging behaviour, which can manifest itself in self-harm or aggression towards others. Real-time monitoring of stress in clients with... Show morePurpose: People with intellectual disabilities often show challenging behaviour, which can manifest itself in self-harm or aggression towards others. Real-time monitoring of stress in clients with challenging behaviour can help caregivers to promptly deploy interventions to prevent escalations, ultimately to improve the quality of life of client and caregiver. This study aimed to assess the impact of real-time stress monitoring with HUME, and the subsequent interventions deployed by the care team, on stress levels and quality of life. Materials and methods: Real-time stress monitoring was used in 41 clients with intellectual disabilities in a long-term care setting over a period of six months. Stress levels were determined at the start and during the deployment of the stress monitoring system. The quality of life of the client and caregiver was measured with the Outcome Rating Scale at the start and at three months of use. Results: The results showed that the HUME-based interventions resulted in a stress reduction. The perceived quality of life was higher after three months for both the clients and caregivers. Furthermore, interventions to provide proximity were found to be most effective in reducing stress and increasing the client's quality of life. Conclusions: The study demonstrates that real-time stress monitoring with the HUME and the following interventions were effective. There was less stress in clients with an intellectual disability and an increase in the perceived quality of life. Future larger and randomized controlled studies are needed to confirm these findings. Show less
Vries, S. de; Oost, F. van; Smaling, H.; Knegt, N. de; Cluitmans, P.; Smits, R.; Meinders, E. 2023
People with severe intellectual disabilities (ID) could have difficulty expressing their stress which may complicate timely responses from caregivers. The present study proposes an automatic... Show morePeople with severe intellectual disabilities (ID) could have difficulty expressing their stress which may complicate timely responses from caregivers. The present study proposes an automatic stress detection system that can work in real-time. The system uses wearable sensors that record physiological signals in combination with machine learning to detect physiological changes related to stress. Four experiments were conducted to assess if the system could detect stress in people with and without ID. Three experiments were conducted with people without ID (n = 14, n = 18, and n = 48), and one observational study was done with people with ID (n = 12). To analyze if the system could detect stress, the performance of random, general, and personalized models was evaluated. The mixed ANOVA found a significant effect for model type, F(2, 134) = 116.50, p < .001. Additionally, the post-hoc t-tests found that the personalized model for the group with ID performed better than the random model, t(11) = 9.05, p < .001. The findings suggest that the personalized model can detect stress in people with and without ID. A larger-scale study is required to validate the system for people with ID. Show less
Vries, S. de; Haaksma, M.L.; Józwiak, K.; Schaapveld, M.; Hodgson, D.C.; Lugtenburg, P.J.; ... ; Leeuwen, F.E. van 2023
PURPOSEPrevious efforts to predict absolute risk of treatment-related cardiovascular diseases (CVDs) have mostly focused on childhood cancer survivors. We aimed to develop prediction models for... Show morePURPOSEPrevious efforts to predict absolute risk of treatment-related cardiovascular diseases (CVDs) have mostly focused on childhood cancer survivors. We aimed to develop prediction models for risk of coronary heart disease (CHD) and heart failure (HF) for survivors of adolescent/adult Hodgkin lymphoma (HL).METHODSFor model development, we used a multicenter cohort including 1,433 5-year HL survivors treated between 1965 and 2000 and age 18-50 years at HL diagnosis, with complete data on administered chemotherapy regimens, radiotherapy volumes and doses, and cardiovascular follow-up. Using cause-specific hazard models, covariate-adjusted cumulative incidences for CHD and HF were estimated in the presence of competing risks of death because of other causes than CHD and HF. Age at HL diagnosis, sex, smoking status, radiotherapy, and anthracycline treatment were included as predictors. External validation for the CHD model was performed using a Canadian cohort of 708 HL survivors treated between 1988 and 2004 and age 18-50 years at HL diagnosis.RESULTSAfter a median follow-up of 24 years, 341 survivors had developed CHD and 102 had HF. We were able to predict CHD and HF risk at 20 and 30 years after treatment with moderate to good overall calibration and moderate discrimination (areas under the curve: 0.68-0.74), which was confirmed by external validation for the CHD model (areas under the curve: 0.73-0.74). On the basis of our model including prescribed mediastinal radiation dose, 30-year risks ranged from 4\% to 78\% for CHD and 3\% to 46\% for HF, depending on risk factors.CONCLUSIONWe developed and validated prediction models for CHD and HF with good overall calibration and moderate discrimination. These models can be used to identify HL survivors who might benefit from targeted screening for CVD and early treatment for CVD risk factors. Show less
Mast, D.; Broekens, D.J.; Vries, S. de; Verbeek, F.J. 2023
The Participant Journey Map (PJM) provides structured insight into participation with interactive play in (semi-) public environments. It supports understanding of participants’ behavior and was... Show moreThe Participant Journey Map (PJM) provides structured insight into participation with interactive play in (semi-) public environments. It supports understanding of participants’ behavior and was developed based on experiences with previously developed playful interfaces, related research and expert interviews. We apply the PJM to interactive playful museum exhibits and evaluate and refine it based on its usage in a situated context. We observed 672 play sessions with 6 interactive playful museum exhibits. The observation data was visualized and analyzed using the PJM. This study shows that the PJM provides a realistic representation of participant behaviour, can be used to identify stagnations and progressions in participation flow, and support identification of influencing design and contextual factors. With this paper we contribute by presenting the PJM as a well-grounded, valuable and realistic framework for evaluating and understanding participation with situated interactive play, based on post-hoc evaluation of multiple interfaces with many users. Show less
Mouwenda, Y.D.; Ongwe, M.E.B.; Sonnet, F.; Stam, K.A.; Labuda, L.A.; Vries, S. de; ... ; Yazdanbakhsh, M. 2021
Two hookworm vaccine candidates, Na-GST-1 and Na-APR-1, formulated with Glucopyranosyl Lipid A (GLA-AF) adjuvant, have been shown to be safe, well tolerated, and to induce antibody responses in a... Show moreTwo hookworm vaccine candidates, Na-GST-1 and Na-APR-1, formulated with Glucopyranosyl Lipid A (GLA-AF) adjuvant, have been shown to be safe, well tolerated, and to induce antibody responses in a Phase 1 clinical trial (Clinicaltrials.gov NCT02126462) conducted in Gabon. Here, we characterized T cell responses in 24 Gabonese volunteers randomized to get vaccinated three times with Na-GST-1 and Na-APR-1 at doses of 30 mu g (n = 8) or 100 mu g (n = 10) and as control Hepatitis B (n = 6). Blood was collected pre- and post-vaccination on days 0, 28, and 180 as well as 2-weeks after each vaccine dose on days 14, 42, and 194 for PBMCs isolation. PBMCs were stimulated with recombinant Na-GST-1 or Na-APR-1, before (days 0, 28 and 180) and two weeks after (days 14, 42 and 194) each vaccination and used to characterize T cell responses by flow and mass cytometry. A significant increase in Na-GST-1 -specific CD4(+) T cells producing IL-2 and TNF, correlated with specific IgG antibody levels, after the third vaccination (day 194) was observed. In contrast, no increase in Na-APR-1 specific T cell responses were induced by the vaccine. Mass cytometry revealed that, Na-GST-1 cytokine producing CD4(+) T cells were CD161(+) memory cells expressing CTLA-4 and CD40-L. Blocking CTLA-4 enhanced the cytokine response to Na-GST-1.In Gabonese volunteers, hookworm vaccine candidate, Na-GST-1, induces detectable CD4(+) T cell responses that correlate with specific antibody levels. As these CD4(+) T cells express CTLA-4, and blocking this inhibitory molecules resulted in enhanced cytokine production, the question arises whether this pathway can be targeted to enhance vaccine immunogenicity.Author summaryTwo hookworm vaccine candidate (Na-GST-1 and Na-APR-1) have been tested in Gabonese and found to be safe and to induce antibody response. We aimed to study the cellular immune responses among vaccinated and unvaccinated volunteers. We found that Na-GST-1 induced CD4(+) T cell responses (IL-2, TNF) among the vaccinated volunteers that received the high vaccine dose (100 ug). Furthermore Na-GST-1 specific memory T cells were found to express the inhibitory molecule CTLA-4. These responses was not observed in those who received the low dose of the Na-GST-1 vaccine, or those who received Na-APR-1 or HBV. By blocking CTLA-4, we observed an increase in TNF production. Our data suggest that an intervention involving blockage of the CTLA-4 molecule in the vaccinated could be beneficial in endemic settings where vaccine responses have been shown to be lower compared to non-endemic settings. Show less
Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate... Show moreNature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants. Show less
Vries, S. de; Schaapveld, M.; Janus, C.P.M.; Daniels, L.A.; Petersen, E.J.; Maazen, R.W.M. van der; ... ; Leeuwen, F.E. van 2021
Background: Few studies have examined the impact of treatment-related morbidity on long-term, cause-specific mortality in Hodgkin lymphoma (HL) patients. Methods: This multicenter cohort included... Show moreBackground: Few studies have examined the impact of treatment-related morbidity on long-term, cause-specific mortality in Hodgkin lymphoma (HL) patients. Methods: This multicenter cohort included 4919 HL patients, treated before age 51 years between 1965 and 2000, with a median follow-up of 20.2 years. Standardized mortality ratios, absolute excess mortality (AEM) per 10 000 person-years, and cause-specific cumulative mortality by stage and primary treatment, accounting for competing risks, were calculated. Results: HL patients experienced a 5.1-fold (AEM = 123 excess deaths per 10000 person-years) higher risk of death due to causes other than HL. This risk remained increased in 40-year survivors (standardized mortality ratio = 5.2, 95% confidence interval [CI] = 4.2 to 6.5, AEM = 619). At age 54 years, HL survivors experienced similar cumulative mortality (20.0%) from causes other than HL to 71-year-old individuals from the general population. Whereas HL mortality statistically significantly decreased over the calendar period (P < .001), solid tumor mortality did not change in the most recent treatment era. Patients treated in 1989-2000 had lower 25-year cardiovascular disease mortality than patients treated in 1965-1976 (4.3% vs 5.7%; subdistribution hazard ratio = 0.65, 95% CI = 0.46 to 0.93). Infectious disease mortality was not only increased after splenectomy but also after spleen irradiation (hazard ratio = 2.81, 95% CI = 1.55 to 5.07). For stage I-II, primary treatment with chemotherapy (CT) alone was associated with statistically significantly higher HL mortality (P < .001 for CT vs radiotherapy [RT]; P = .04 for CT vs RT+CT) but lower 30-year mortality from causes other than HL (15.8%, 95% CI = 9.7% to 23.3%) compared with RT alone (36.9%, 95% CI = 34.0% to 39.8%, P = .001) and RT and CT combined (29.8%, 95% CI = 26.8% to 32.9%, P = .02). Conclusions: Compared with the general population, HL survivors have a substantially reduced life expectancy. Optimal selection of patients for primary CT is crucial, weighing risks of HL relapse and long-term toxicity. Show less
Waaijers, L.; Waltman, L.; Vries, S. de; Leeuwen, T.N. van; Eck, N.J. van 2021
Predatory journals pose a significant problem to academic publishing. In the past, a number of attempts have been made to identify them. This blog post presents a novel approach towards a predatory... Show morePredatory journals pose a significant problem to academic publishing. In the past, a number of attempts have been made to identify them. This blog post presents a novel approach towards a predatory-free academic publishing landscape: Bona Fide Journals. Show less
Béneker, T.; Boxtel, C. van; Drijvers, P.; Goedhart, M.; Graaff, R. de; Janssen, F.J.J.M.; Vries, S. de 2021
We propose a research direction into the role of the peak-end rule to engage people into Augmented Play Spaces (APS). The peak(s) and ending of an experience are defining moments for how an... Show moreWe propose a research direction into the role of the peak-end rule to engage people into Augmented Play Spaces (APS). The peak(s) and ending of an experience are defining moments for how an experience is remembered afterwards. An important factor contributing to the likelihood of engagement in an APS is a positive previous experience (with the same or a similar system). Show less
Hermans, C.M.L.; Vries, S. de; Jeurissen, L.; Kraan, J.; Oppedijk, B.; Duijn, A. van 2019
A conceptual model was developed, describing the short-term, medium and long-term effects of plants on the indoor climate and the health and well-being of people. The model was tested by means of... Show moreA conceptual model was developed, describing the short-term, medium and long-term effects of plants on the indoor climate and the health and well-being of people. The model was tested by means of intervention research at three companies and eight homes for the elderly. The effect of plants on the physical indoor climate was measured with sensors, the effect on the health and well-being of employees with questionnaires. In principle, a ‘Before After Control Impact’ approach was used at the locations. A control room and an intervention room were selected for each location. After a pre-measurement, plants were placed in the intervention room and up to three post-measurements were conducted. At the companies, significant effects were found on relative humidity (up), attractiveness of the workplace (more attractive), state of mind (more positive), satisfaction with own functioning (higher) and sickness absence reporting (less). The need for recovery after a working day showed a reversed effect (rising). No significant effects were found for the other variables in the model. Similar effects were not observed in the homes for the elderly. Possible reasons for the latter are: the small number of employees working in the same room (i.e., living room for clients), a low willingness amongst these employees to participate in the study (high work pressure), a high mobility amongst employees and working in both the intervention and the control room. Show less
Vries, S. de; Schaapveld, M.; Kardaun, J.W.P.F.; Bruin, K.H. de; Krol, A.D.G.; Lugtenburg, P.J.; ... ; Leeuwen, F.E. van 2018
