PurposeTo provide an overview of trauma system maturation in Europe.MethodsMaturation was assessed using a self-evaluation survey on prehospital care, facility-based trauma care, education/training... Show morePurposeTo provide an overview of trauma system maturation in Europe.MethodsMaturation was assessed using a self-evaluation survey on prehospital care, facility-based trauma care, education/training, and quality assurance (scoring range 3-9 for each topic), and key infrastructure elements (scoring range 7-14) that was sent to 117 surgeons involved in trauma, orthopedics, and emergency surgery, from 24 European countries. Average scores per topic were summed to create a total score on a scale from 19 to 50 per country. Scores were compared between countries and between geographical regions, and correlations between scores on different sections were assessed.ResultsThe response rate was 95%. On the scale ranging from 19 to 50, the mean (SD, range) European trauma system maturity score was 38.5 (5.6, 28.2-48.0). Prehospital care had the highest mean score of 8.2 (0.5, 6.9-9.0); quality assurance scored the lowest 5.9 (1.7, 3.2-8.5). Facility-based trauma care was valued 6.9 (1.4, 4.1-9.0), education and training 7.0 (1.2, 5.2-9.0), and key infrastructure elements 10.3 (1.6, 7.6-13.5). All aspects of trauma care maturation were strongly correlated (r > 0.6) except prehospital care. End scores of Northern countries scored significantly better than Southern countries (p = 0.03).ConclusionThe level of development of trauma care systems in Europe varies greatly. Substantial improvements in trauma systems in several European countries are still to be made, especially regarding quality assurance and key infrastructure elements, such as implementation of a lead agency to oversee the trauma system, and funding for growth, innovation and research. Show less
Mohamed, S.A.; Grewal, N.; Gittenberger-de Groot, A.C. 2018
This thesis describes research about the differentiation of human stem cells into cardiomyocytes (heart cells). During the differentiation process the stem cells become contractile myocytes... Show more This thesis describes research about the differentiation of human stem cells into cardiomyocytes (heart cells). During the differentiation process the stem cells become contractile myocytes that resemble the native heart cells. Nevertheless, the phenotype of these cardiomyocytes is comparable to a second trimester fetal heart cells. These thesis describes different approaches to induce maturity into the stem cell derived cardiomyocytes, such as changing the substrate stiffness, cell patterning and small molecule based medium. The maturation level achieved unveiled the contractile phenotype on cardiomyocytes derived from patients with hypertrophic cardiomyopathy. The end of this thesis describes a novel method to culture and expand multipotent cardiac progenitor cells. Show less
Freshwater eels (Anguilla spp.) intrigued scientists for centuries. Their life cycle involves for example two distinct larval stages and a long distance migration, which may cover thousands of... Show moreFreshwater eels (Anguilla spp.) intrigued scientists for centuries. Their life cycle involves for example two distinct larval stages and a long distance migration, which may cover thousands of kilometers. The farming of eels is still dependent on the influx of wild glass eels, because eels do not mature naturally in captivity due to strong neural inhibition. Since the 1980s, the glass eel influx of several eel species drastically declined. The European eel (A. anguilla) was recently enlisted by the IUCN as a critically endangered species; therefore there is an urgent call for eel management and artificial reproduction. Artificial reproduction may contribute to restoration of the eel population by releasing the current fishing pressures on the wild stocks, and allowing a sustainable eel aquaculture in the future. Although, artificial reproduction by applying hormone treatments is possible to some extent, success ra tes are still far from creating a sustainable aquaculture. This thesis focuses on the spawning migration, maturation and reproduction of eels. New tools are developed that may improve current artificial maturation and reproduction protocols for eel aquaculture. Show less
Infants born very prematurely (gestational age <32 weeks) are at risk of brain injury and neurodevelopmental problems. Imaging the preterm infant__s brain during the neonatal period, using... Show moreInfants born very prematurely (gestational age <32 weeks) are at risk of brain injury and neurodevelopmental problems. Imaging the preterm infant__s brain during the neonatal period, using cranial ultrasonography (cUS) and magnetic resonance imaging (MRI), is important. Our aim was to study and describe brain findings in very preterm infants using modern, high-quality imaging techniques. Part I reviews brain maturation and injury, and imaging thereof, in very preterm infants. Part II discusses our experience on neonatal cUS (Chapters 2-3) and MRI (Chapter 4), and addresses indications, technical aspects, protocols and safety. Part III gives an overview of findings (incidence and evolution) on frequent, sequential neonatal cUS and term-equivalent MRI (Chapter 5), and their relation with perinatal factors (Chapter 6). Part IV focuses on imaging of white matter (Chapters 7-9), describing both normal maturational phenomena and pathological changes and assessing the accuracy of cUS and MRI for these changes. Part V focuses on imaging of deep grey matter (Chapters 10-12), describing both normal maturational phenomena and pathological changes on cUS and assessing their relation with clinical and MRI findings. Part VI reviews the main findings and conclusions of this thesis, and discusses future perspectives and proposals for further research (Chapter 13). Show less
De Europese aal blijkt bij uitstek een langeafstandsspecialist te zijn. Dit is gebleken uit zwemtesten in 22 zwemtunnels. Het kost schieralen slechts 40% van de vetreserves om de 5500-km naar de... Show moreDe Europese aal blijkt bij uitstek een langeafstandsspecialist te zijn. Dit is gebleken uit zwemtesten in 22 zwemtunnels. Het kost schieralen slechts 40% van de vetreserves om de 5500-km naar de paaigronden in de Sargassozee te overbruggen, mogelijk zelfs in slechts drie-en-een-halve maand. Niet alleen dienen vetten als brandstof, ze zijn ook essentieel als energievoorraad voor de toekomstige larven. Het blijkt nu dat zwemmen de afzetting van de vetten in de eitjes op gang brengt. Door te zwemmen beginnen de eicellen van, vooral oudere, alen te ontwikkelen zodat ze kunnen afpaaien zodra ze in de Sargasso zijn aangekomen. De zwemblaasparasiet beschadigt echter de zwemblaas waardoor geïnfecteerde alen minder efficiënt zwemmen en al het vet waarschijnlijk is verbruikt voordat ze de Sargasso bereiken. Een andere verstorende factor zijn de in het vet opgeloste PCB's, die al in zeer lage doses de vroege ontwikkeling van embryo's onmogelijk blijken te maken. Deze twee factoren lijken een belangrijke oorzaak te zijn in de sterke afname van de wilde populatie. Het feit dat we met zwemmen een natuurlijke 'trigger' hebben gevonden van ontwikkeling van de eicellen en dat we in staat zijn geweest schieralen in gevangenschap tot reproductie te brengen biedt hoop voor toekomstige kweek. Show less
