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2. Change in Microstructure and Magnetic Properties of Transition Metal Nitride Thin Films by Substrate Temperature

Author

Kamp, M., Voß, L., Bichel, T., Hicke, M., Schürmann, U., Kienle, L., Magjarevic, Ratko, Series Editor, Ładyżyński, Piotr, Associate Editor, Ibrahim, Fatimah, Associate Editor, Lackovic, Igor, Associate Editor, Rock, Emilio Sacristan, Associate Editor, Tiginyanu, Ion, editor, Sontea, Victor, editor, and Railean, Serghei, editor

Published
2020
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5. IDDSI-konforme Rezepte mit oralen Kontrastmitteln für die radiologische Dysphagiediagnostik

Author

Voß, L, Ihrke, M, Beck, A, Mürbe, D, Voß, L, Ihrke, M, Beck, A, and Mürbe, D

Abstract

Hintergrund: Die Videoflouroskopie des Schluckaktes (VFSS) gilt neben der flexiblen endoskopischen Schluckuntersuchung (FESU) als Goldstandard in der Diagnostik von Dysphagien. Die individuelle Kostformempfehlung sollte bei der Behandlung von Dysphagiepatienten nach der International Dysphagia Diet Standardization Initiative (IDDSI) erfolgen. Ziel dieser Studie war es, standardisierte röntgendichte Texturstufen für die VFSS zur Reproduktion der IDDSI Level 0-7 in unterschiedlichen Konstellationen verschiedener Kontrast- und Andickungsmittel zu erzeugen, um valide Ergebnisse der VFSS im Hinblick auf die Schlucksicherheit und -effizienz zu erlangen.Material und Methoden: Die verschiedenen Rezepturen wurden mithilfe von IDDSI-Testmethoden bestimmt und ihre radiologischen Eigenschaften mithilfe eines Philips MultiDiagnost Eleva-Durchleuchtungssystems und zwei verschiedener flüssiger Kontrastmittel untersucht (bariumhaltiges (Micropaque®) u. jodbasiertes (Telebrix®)).Ergebnisse: Die Homogenität der Rezepte nahm mit zunehmenden IDDSI-Werten ab, der Kontrast war für eine videofluoroskopische Untersuchung für alle IDDSI-Level ausreichend. Die Opazität unterschied sich zwischen den Kontrastmitteln auf Barium- und Jodbasis nicht signifikant.Diskussion: IDDSI ist eine evidenzbasierte Einteilung von Texturen, die von internationalen Interessengruppen entwickelt wurde. Es besteht Kritik an den Beschreibungen der Texturlevel, da sie andere wichtige Eigenschaften wie die Fließeigenschaften, die Interaktionen der Schleimhautoberflächen als auch die Speichelzusammensetzung, nicht berücksichtigt. Die Reproduzierbarkeit der Rezepte ist möglicherweise limitiert, da die Proben ohne weitere apparative technische Geräte hergestellt wurden, um ihre Anwendbarkeit in verschiedenen Umgebungen zu erleichtern. Zudem ist die weltweite Verfügbarkeit der verwendeten Kontrastmittel nicht gewährleistet. Standardisierte, kommerziell verfügbare Stimuli für alle IDDSI-Level wären ideal, sind jedoch nic

Published
2024

7. Multi-agency response to childhood sexual abuse : a case study that explores the role of a specialist centre

Author

Voss, L., Rushforth, Helen, and Powell, Catherine

Subjects
610, HN Social history and conditions. Social problems. Social reform, RJ101 Child Health. Child health services
Abstract

This study explores the role of a specialist centre in responding to actual or suspected childhood sexual abuse. Children, families and professionals from several agencies are required to navigate an intricate journey when abuse is suspected to have occurred. Through the application of case study research methods in which a specialist centre forms ‘the case’, the complexities of the journey are explored. The literature review highlights the emergent nature of ‘knowledge’ about specialist children’s centres. To inform the research study, papers that focus on children and families’ experience of the multiagency response, the rate of positive medical findings on examination and their relationship with criminal justice outcomes are examined. The available literature relating to the nursing role in responding to child sexual abuse is also reviewed. This case study comprises three data sets: 1) Sixty children (0-17 years) who attended the Centre following suspected sexual abuse were ‘tracked’ to ascertain reasons for referral, type of examination undertaken and outcomes in terms of health status, social care input and criminal justice actions. 2) Semi structured interviews with 16 professionals (paediatricians, nurses, police officers and social workers) in which their perceptions of the centre were explored. 3) Analysis of patient and parent/carer satisfaction questionnaires. Medical examination rarely confirmed abuse had occurred and only 13% of cases were pursued within criminal justice systems. However, 66% of children had an identified health need that required professional follow up. Interviews demonstrated that professionals believed the Centre provided a ‘child friendly’ facility that enhanced multiagency co-operation, but challenges associated with the principles of multiagency working were identified. Patient questionnaires demonstrated positive views of the care received by those who completed them. Findings from the three data sets are presented as the child’s journey through a complex series of events in a case study ‘story’. The study demonstrates the way in which professionals may be distracted by the medico-legal demands of the ‘system’. Children’s active participation in decision making should be promoted when actual or suspected abuse has occurred and a combined approach by multi-agency professionals, based on the individual needs of each child, is advocated not only during attendance at the specialist centre but also during a follow up period. Where abuse is not confirmed, children may benefit from continued care from health professionals. Nursing has the potential to adopt a greater leadership role in achieving the required change.

Published
2015

9. IDDSI-compliant recipes containing oral contrast agents for radiological dysphagia diagnostics.

Author

Ihrke, M., Beck, A., Mürbe, D., and Voß, L. J.

Subjects
CONTRAST media, ENDOSCOPY, DEGLUTITION disorders
Abstract

Videofluoroscopic swallowing study (VFSS), alongside flexible endoscopic evaluation of swallowing, represents the gold standard for diagnosing swallowing disorders and to determine severity, pathophysiology, and effective interventions, including texture modification. The clinical swallowing examination and assessment supplements these instrumental methods and serves as the basis for the modules of swallowing diagnostics. The adaptation of food and drink consistencies in dysphagia management has become widespread. For valid results of a VFSS with respect to confirming swallowing safety and efficiency of different liquid and food consistencies and textures, the use of uniform recipes containing radio-opaque contrast media is important. Our goal was to identify recipes that would produce consistencies that conform to the liquid and food levels of 0--7, as defined by the International Dysphagia Diet Standardization Initiative (IDDSI), with barium- and iodine-based contrast media, xanthan gum-based thickeners, and other edible components, which also show sufficient contrast on VFSS. In this study, we determined the different recipes using IDDSI testing methods and explored their radiological characteristics using a Philips MultiDiagnost Eleva fluoroscopy system and two different fluid contrast agents: barium- (Micropaque®) and iodine-based (Telebrix®). All recipes showed sufficient contrast on fluoroscopy and could be visualized in the amounts used for swallowing examinations. They were practical and easy to implement in terms of production and availability of the components. The homogeneity of the recipes diminished with higher IDDSI levels, which represent transitional food, but appeared still sufficient for fluoroscopic examination. The opacity did not significantly differ between the barium- and iodine-based contrast media. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Implementation of Combined Lifestyle Interventions for Children with Overweight or Obesity: Experiences of Healthcare Professionals in Multiple Communities.

Author

Saat, J.J.E.H., Naumann, Elke, Fransen, G.A.J., Voss, L., Velden, K. van der, Assendelft, W.J.J., Saat, J.J.E.H., Naumann, Elke, Fransen, G.A.J., Voss, L., Velden, K. van der, and Assendelft, W.J.J.

Abstract

Item does not contain fulltext, BACKGROUND: To counteract children with obesity, different protocols for combined lifestyle interventions (CLIs) are implemented by healthcare providers (HCPs). To understand the effects of CLI, we studied the implementation process, facilitators and barriers experienced by HCPs. METHODS: A multiple case study design in which community-based CLIs (n = 4), implemented in a total of ten different communities, are conceptualized as a "case". Qualitative data were collected via group interviews among HCPs (n = 48) regarding their implementation protocol, their network involvement and the adoption of the CLI in a community. Transcripts were coded and analysed using ATLAS.ti. RESULTS: Barriers were the absence of a proper protocol, the low emphasis on the construction of the network and difficulty in embedding the CLI into the community. Funding for these activities was lacking. Facilitating factors were the involvement of a coordinator and to have everyone's role regarding signalling, diagnosis, guidance and treatment clearly defined and protocolled. HCPs suggested adding certain professions to their team because they lacked expertise in parenting advice and providing mental support to children. CONCLUSIONS: Carrying out and adapting the content of the CLI to the community was experienced as easier compared to the management of the organizational aspects of the CLI. For these aspects, separate funding is essential. In the future, mapping the characteristics of a community will help to clarify this influence on the implementation even better.

Published
2023

19. Monte Carlo transport analysis to assess intensity dependent response of a carbon-doped GaN photoconductor.

Author

Milestone, W., Guo, D., Sanati, M., Dowling, K. M., Hau-Riege, S., Voss, L. F., Conway, A., and Joshi, R. P.

Subjects
FAST multipole method, MONTE Carlo method, ELECTRON transport, SPACE charge
Abstract

Evaluation of the photoresponse in wurtzite GaN photoconductive switches is presented based on kinetic Monte Carlo simulations. The focus is on electron transport physics and assessment of high frequency operation. The roles of GaN band structure, Pauli exclusion, and treatment of internal fields based on the fast multipole method are all comprehensively included. The implementation was validated through comparisons of velocity-field characteristics for GaN with computational results in the literature. Photocurrent widths of less than ∼7 ps for the 1 μm device can be expected, which translates into a 100 GHz upper bound. Photocurrent pulse compression below the laser full width at half maxima at high applied fields are predicted based on the interplay of space-charge effects and the negative differential velocity characteristics of GaN. [ABSTRACT FROM AUTHOR]

Published
2021
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21. 1100: Grenzeloze landschappen voor de voorouders

Author

Louwen, A.J., Heerma van Voss, L., Bouras, N., Hart, M. 't, Heiden, M. van der, and Lucassen, L.

Subjects
Urnfields, Ancestors, Late Bronze Age, Social Landscapes
Abstract

Since the early twentieth Century, urnfields play an important part in Europe's (pre)history books. Traditionally, these cremation grave cemeteries are regarded as a typical Central European phenomenon which gradually found its way to NW-Europe. However, recent studies into radiocarbon dates associated with Bronze Age cremation graves in NW-Europe (in this chapter specifically in The Netherlands) start to paint a different picture as it rather seems that cremation as a way of dealing with a dead body developed much more autonomously in NW-Europe and that the role of ancestors in the (Late) Bronze Age landscape was a driving force behind this development.

Published
2022

22. 250.000: de allereerste bewoners van ‘Nederland’

Author

Dusseldorp, G.L., Raczynski-Henk, Y., Amkreutz, L., Heerma van Voss, L., Bouras, N., t'Hart, M., Heijden, M. van der, Lucassen, L., Heerma van Voss, L., Bouras, N., t'Hart, M., Heijden, M. van der, and Lucassen, L.

Abstract

De afgelopen 20 jaar wordt steeds duidelijker hoe de eerste Europeanen eruitzagen en dat die mensen waarschijnlijk al vanaf 800.000 jaar geleden sporadisch in onze streken komen. Uitgerekend in Nederland is een vindplaats opgegraven die een uniek kijkje in de wereld van die vroegste Europeanen geeft. Die vindplaats, Maastricht-Belvédère, staat internationaal in alle handboeken, maar in Nederland kent niemand haar. Je kan er bijna tot op de seconde nauwkeurig een episode reconstrueren in het leven van mensen die hier 250.000 jaar geleden leefden. Een beeld van een voor ons vrijwel onvoorstelbare manier van leven verschijnt, waarin geleidelijk een aantal prominente menselijke kenmerken verschijnen, zoals complexe planning en de ontwikkeling van verfijnde technologische snufjes. Daaruit wordt duidelijk dat die hele vroege ‘Nederlanders’ alleen vanuit een pan-Europees perspectief begrepen kunnen worden.

Published
2022

23. 1985: eerste wereld hoeren congres in Amsterdam

Author

Pluskota, M., Lucassen, L., Heerma van Voss, L., ’t Hart, M., van der Heijden, M., Bouras, N., Lucassen, L., Heerma van Voss, L., ’t Hart, M., van der Heijden, M., and Bouras, N.

Published
2022

24. Carrier recombination parameters in diamond after surface boron implantation and annealing.

Author

Grivickas, P., Ščajev, P., Kazuchits, N., Mazanik, A., Korolik, O., Voss, L. F., Conway, A. M., Hall, D. L., Bora, M., Subačius, L., Bikbajevas, V., and Grivickas, V.

Subjects
DIAMOND surfaces, PUMP probe spectroscopy, SURFACE recombination, BORON isotopes, BORON, DIAMONDS
Abstract

An optical pump–probe technique was used to detect spatial distribution of carrier lifetimes across the thickness of a high-quality diamond device structure. Two samples with as-received and boron implanted surfaces were compared to assess the role of implantation and related processing on carrier recombination mechanisms. It was found that the two implanted surfaces show very different behaviors despite undergoing the same treatment. At one of the surfaces, carrier lifetimes remained relatively unchanged, indicating surface recombination rates in the 102–103 cm/s range. At the other surface, carrier lifetimes were almost a magnitude lower and correlated with the locally detected nitrogen vacancy defect that was attributed to the elevated concentration of residual nitrogen. [ABSTRACT FROM AUTHOR]

Published
2020
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26. Whole genome sequencing and molecular epidemiology of paediatric Staphylococcus aureus bacteraemia

Author

Campbell, AJ, Mowlaboccus, S, Coombs, GW, Daley, DA, Al Yazidi, LS, Phuong, LK, Leung, C, Best, EJ, Webb, RH, Voss, L, Athan, Eugene, Britton, PN, Bryant, PA, Butters, CT, Carapetis, JR, Ching, NS, Francis, J, Hung, TY, Nourse, C, Ojaimi, S, Tai, A, Vasilunas, N, McMullan, B, Bowen, AC, Blyth, CC, Campbell, AJ, Mowlaboccus, S, Coombs, GW, Daley, DA, Al Yazidi, LS, Phuong, LK, Leung, C, Best, EJ, Webb, RH, Voss, L, Athan, Eugene, Britton, PN, Bryant, PA, Butters, CT, Carapetis, JR, Ching, NS, Francis, J, Hung, TY, Nourse, C, Ojaimi, S, Tai, A, Vasilunas, N, McMullan, B, Bowen, AC, and Blyth, CC

Published
2022

27. Stimmverbesserung bei glottaler Schlussinsuffizienz nach Polyacrylamid-Hydrogel-Injektionsglottoplastik

Author

Voß, L, Mürbe, D, Mainka, A, Voß, L, Mürbe, D, and Mainka, A

Abstract

Hintergrund: Eine glottale Schlussinsuffizienz kann durch diverse Ursachen wie ein- (UVFP), beidseitige Stimmlippenparesen, -atrophien, -narben oder Defektsituationen entstehen.Etablierte Therapieverfahren, wie z.B. die Injektionsglottoplastik (IGP) zielen darauf ab die Phonation, Sprechdyspnoe, Deglutition sowie Tätigkeiten mit Aktivierung der Bauchpresse zu verbessern. Durch die Medialisierung und Auffüllung der Stimmlippen wird hier ein verbesserter Glottisschluss angestrebt wodurch u.a. für die Phonation eine höhere Regularität und Symmetrie im Schwingungsverhalten erwartet wird.Bereits etablierte Füllmaterialien unterscheiden sich u.a. in der Härte, Viskosität sowie Resorbierdauer.Bislang steht als langwirksame Therapieoption v.a. das Calciumhydroxylapatit zur Verfügung. Die Wirksamkeit ist jedoch auf ca. 9 Monate begrenzt. In Abgrenzung dazu ist der langwirksame Polyacrylamid-Hydrogel-Filler (PAAH) nicht resorbierbar. Die weichere Konsistenz und die permanente Wirksamkeit lassen im Vergleich zum Calciumhydroxylapatit bessere und langanhaltendere stimmliche Ergebnisse erwarten.Material und Methoden: Diese retrospektive Analyse vergleicht die präoperativ gewonnenen mit den bis zu 24 Monaten postoperativen Untersuchungsbefunden nach erfolgter IGP mit PAAH (Aquamid® Reconstruction). Die stroboskopischen Untersuchungsbefunde wurden nach einem Protokoll von Poburka et al. bewertet. Auditiv-perzeptiv und akustisch erfolgte die Stimmbeurteilung nach den international verwendeten Parametern (SPL, F0max, DSI, Jitter, MPT, SUM, MSL, RBH). Für die subjektive Stimmbeurteilung wurden standardisierte Fragebögen (VHI-9i) von 30 PatientInnen ausgewertet.Ergebnisse: Es zeigten sich endoskopisch, akustisch und subjektiv gebesserte Untersuchungsbefunde postoperativ mit stabilen, sicheren und langwirksamen Befunden über einen Zeitraum von 18 Monaten hinaus (MW: 9,7 Monate). Unter den PatientInnen ergab sich eine Indikation zur operativen Revision mit Reduktion des eingebrachten Vo

Published
2022

28. Joods bezit. Van onteigening tot rechtsherstel

Author

Heerma van Voss, L., Bouras, N., Oprel, M.O., Meurs, W.P. van, Heerma van Voss, L., Bouras, N., Oprel, M.O., and Meurs, W.P. van

Abstract

Item does not contain fulltext

Published
2022

30. Sport en mensenrechten. Argentinië 1978

Author

Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Reef, P.R., Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., and Reef, P.R.

Abstract

Item does not contain fulltext

Published
2022

31. 205. De ogen van de legioenen

Author

Heerma van Voss, L., Bouras, N., 't Hart, M., Van der Heijden, M., Lucassen, L., Groen-Vallinga, M.J., Heerma van Voss, L., Bouras, N., 't Hart, M., Van der Heijden, M., Lucassen, L., and Groen-Vallinga, M.J.

Abstract

Item does not contain fulltext

Published
2022

32. 716. Friezen verslaan Karel Martel

Author

Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Meeder, S.M., Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., and Meeder, S.M.

Abstract

Item does not contain fulltext

Published
2022

33. 1382. Wonderen op reis

Author

Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Asperen, H. van, Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., and Asperen, H. van

Abstract

Item does not contain fulltext

Published
2022

34. 1983. Brussel ‘nekt’ RSV

Author

Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Kroeze, D.B.R., Keulen, S., Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Kroeze, D.B.R., and Keulen, S.

Abstract

Item does not contain fulltext

Published
2022

35. 1672. Het Rampjaar in Aleppo

Author

Heerma van Voss, L., Bouras, N., Baars, R.M., Bent, J.M.C. van den, Heerma van Voss, L., Bouras, N., Baars, R.M., and Bent, J.M.C. van den

Abstract

Item does not contain fulltext

Published
2022

36. 70. Marcia Procula verruilt Spanje voor Nederland

Author

Heerma van Voss, L., Bouras, N., 't Hart, M., Heijden, M. van der, Lucassen, L., Foubert, L.L., Heerma van Voss, L., Bouras, N., 't Hart, M., Heijden, M. van der, Lucassen, L., and Foubert, L.L.

Abstract

Item does not contain fulltext

Published
2022

38. 1640: Nederlanders op Barbados

Author

Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Tol, J.J.S. van den, Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., and Tol, J.J.S. van den

Abstract

Item does not contain fulltext

Published
2022

39. 1485. Omstreden beelden van Mohammed

Author

Heerma van Voss, L., Bouras, N., Berkel, M.L.M. van, Heerma van Voss, L., Bouras, N., and Berkel, M.L.M. van

Abstract

Item does not contain fulltext

Published
2022

40. 1602. De Nederlandse taal gaat overzee

Author

Heerma van Voss, L., Bouras, N., Sijs, N. van der, Heerma van Voss, L., Bouras, N., and Sijs, N. van der

Abstract

Item does not contain fulltext

Published
2022

41. The Staphylococcus aureus Network Adaptive Platform Trial Protocol: New Tools for an Old Foe

Author

Tong, S.Y.C., Mora, J., Bowen, A.C., Cheng, M.P., Daneman, N., Goodman, A.L., Heriot, G.S., Lee, T.C., Lewis, R.J., Lye, D.C., Mahar, R.K., Marsh, J., McGlothlin, A., McQuilten, Z., Morpeth, S.C., Paterson, D.L., Price, D.J., Roberts, J.A., Robinson, J.O., van Hal, S.J., Walls, G., Webb, S.A., Whiteway, L., Yahav, D., Davis, J.S., Anagnostou, N., Archuleta, S., Athan, E., Best, E., Bloomfield, M., Botheras, C., Bowen, A., Britton, P., Brown, K., Campbell, A., Carter, H., Cheng, M., Chew, K.L., Chong, R.L.M., Coombs, G., Daley, P., Davies, J., Davis, J., Dishon, Y., Dotel, R., Dunlop, A., Flack, F., Flanagan, K., Foo, H., Ghanem-Zoubi, N., Giulieri, S., Goodman, A., Grant, J., Gregson, D., Guy, S., Gwee, A., Hardy, E., Henderson, A., Heriot, G., Howden, B., Johnstone, J., Kalimuddin, S., de Kretser, D., Kwa, A., Lee, T., Legg, A., Lewis, R., Lumley, T., Lye, D., MacFadden, D., Mahar, R., Malhamé, I., Marks, M., Martinello, M., Matthews, G., McArthur, C., McKew, G., McMullan, B., Milliken, E., Morpeth, S., Murthy, S., Nourse, C., O’Sullivan, M., Paterson, D., Paul, M., Petersiel, N., Petrella, L., Price, D., Roberts, J., Rogers, B., Saville, B., Scheetz, M., Scheuerman, O., Schwartz, K., Smith, S., Snelling, T., Sommerville, C., Stewardson, A., Sud, A., Tong, S., Turner, T., van Hal, S., Vasilunas, N., Voss, L., Webb, R., Webb, S., Wilson, H., Wuerz, T., Tong, S.Y.C., Mora, J., Bowen, A.C., Cheng, M.P., Daneman, N., Goodman, A.L., Heriot, G.S., Lee, T.C., Lewis, R.J., Lye, D.C., Mahar, R.K., Marsh, J., McGlothlin, A., McQuilten, Z., Morpeth, S.C., Paterson, D.L., Price, D.J., Roberts, J.A., Robinson, J.O., van Hal, S.J., Walls, G., Webb, S.A., Whiteway, L., Yahav, D., Davis, J.S., Anagnostou, N., Archuleta, S., Athan, E., Best, E., Bloomfield, M., Botheras, C., Bowen, A., Britton, P., Brown, K., Campbell, A., Carter, H., Cheng, M., Chew, K.L., Chong, R.L.M., Coombs, G., Daley, P., Davies, J., Davis, J., Dishon, Y., Dotel, R., Dunlop, A., Flack, F., Flanagan, K., Foo, H., Ghanem-Zoubi, N., Giulieri, S., Goodman, A., Grant, J., Gregson, D., Guy, S., Gwee, A., Hardy, E., Henderson, A., Heriot, G., Howden, B., Johnstone, J., Kalimuddin, S., de Kretser, D., Kwa, A., Lee, T., Legg, A., Lewis, R., Lumley, T., Lye, D., MacFadden, D., Mahar, R., Malhamé, I., Marks, M., Martinello, M., Matthews, G., McArthur, C., McKew, G., McMullan, B., Milliken, E., Morpeth, S., Murthy, S., Nourse, C., O’Sullivan, M., Paterson, D., Paul, M., Petersiel, N., Petrella, L., Price, D., Roberts, J., Rogers, B., Saville, B., Scheetz, M., Scheuerman, O., Schwartz, K., Smith, S., Snelling, T., Sommerville, C., Stewardson, A., Sud, A., Tong, S., Turner, T., van Hal, S., Vasilunas, N., Voss, L., Webb, R., Webb, S., Wilson, H., and Wuerz, T.

Abstract

Staphylococcus aureus bloodstream (SAB) infection is a common and severe infectious disease, with a 90-day mortality of 15%–30%. Despite this, <3000 people have been randomized into clinical trials of treatments for SAB infection. The limited evidence base partly results from clinical trials for SAB infections being difficult to complete at scale using traditional clinical trial methods. Here we provide the rationale and framework for an adaptive platform trial applied to SAB infections. We detail the design features of the Staphylococcus aureus Network Adaptive Platform (SNAP) trial that will enable multiple questions to be answered as efficiently as possible. The SNAP trial commenced enrolling patients across multiple countries in 2022 with an estimated target sample size of 7000 participants. This approach may serve as an exemplar to increase efficiency of clinical trials for other infectious disease syndromes.

Published
2022

42. Whole genome sequencing and molecular epidemiology of paediatric Staphylococcus aureus bacteraemia

Author

Campbell, A.J., Mowlaboccus, S., Coombs, G.W., Daley, D.A., Al Yazidi, L.S., Phuong, L.K., Leung, C., Best, E.J., Webb, R.H., Voss, L., Athan, E., Britton, P.N., Bryant, P.A., Butters, C.T., Carapetis, J.R., Ching, N.S., Francis, J., Hung, T-Y, Nourse, C., Ojaimi, S., Tai, A., Vasilunas, N., McMullan, B., Bowen, A.C., Blyth, C.C., Campbell, A.J., Mowlaboccus, S., Coombs, G.W., Daley, D.A., Al Yazidi, L.S., Phuong, L.K., Leung, C., Best, E.J., Webb, R.H., Voss, L., Athan, E., Britton, P.N., Bryant, P.A., Butters, C.T., Carapetis, J.R., Ching, N.S., Francis, J., Hung, T-Y, Nourse, C., Ojaimi, S., Tai, A., Vasilunas, N., McMullan, B., Bowen, A.C., and Blyth, C.C.

Abstract

Objectives The role Staphylococcus aureus antimicrobial resistance genes and toxins play in disease severity, management and outcome in childhood is an emerging field requiring further exploration. Methods A prospective multisite study of Australian and New Zealand children hospitalised with S. aureus bacteraemia (SAB) occurred over 24 months (2017–2018). Whole genome sequencing (WGS) data were paired with clinical information from the ISAIAH cohort. Results 353 SAB isolates were sequenced; 85% methicillin-susceptible S. aureus ([MSSA], 301/353) and 15% methicillin-resistant S. aureus ([MRSA], 52/353). There were 92 sequence types (STs), most commonly ST5 (18%) and ST30 (8%), grouped into 23 clonal complexes (CCs), most frequently CC5 (21%) and CC30 (12%). MSSA comprised the majority of healthcare-associated SAB (87%, 109/125), with principal clones CC15 (48%, 11/21) and CC8 (33%, 7/21). Panton-Valentine leukocidin (PVL)-positive SAB occurred in 22% (76/353); predominantly MSSA (59%, 45/76), community-onset (92%, 70/76) infections. For community-onset SAB, the only microbiological independent predictor of poor outcomes was PVL positivity (aOR 2.6 [CI 1.0–6.2]). Conclusion From this WGS paediatric SAB data, we demonstrate the previously under-recognized role MSSA has in harbouring genetic virulence and causing healthcare-associated infections. PVL positivity was the only molecular independent predictor of poor outcomes in children. These findings underscore the need for further research to define the potential implications PVL-producing strains may have on approaches to S. aureus clinical management.

Published
2022

43. 1945. De Nederlander gepeild

Author

Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Meijer, F., Ploeg, S.J., Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, Lucassen, L., Meijer, F., and Ploeg, S.J.

Abstract

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Published
2022

44. Seroprevalence of Coxiella burnetii antibodies in wild deer populations in eastern Australia.

Author

Voss, L, Huaman, J, Pacioni, C, Tolpinrud, A, Helbig, K, Carvalho, TG, and Firestone, SM

Subjects
*DEER populations, *COXIELLA burnetii, *Q fever, *SEROPREVALENCE, *LIVESTOCK losses, *IMMUNOGLOBULINS
Abstract

Coxiella burnetii causes significant reproduction losses in livestock and the disease Q fever in humans. Transmission of C. burnetii is facilitated by the stability of the bacterium in the environment and the susceptibility of a variety of host species to infection. Consequently, inter‐species transmission occurs frequently through either direct or indirect contact. Wildlife may represent reservoirs of C. burnetii and could therefore be a source of infection for domestic animals. Understanding the prevalence of C. burnetii infections at the wildlife‐livestock interface is important for disease control. This study aimed to investigate the extent of C. burnetii exposure in wild deer in eastern Australia. Serum samples were obtained from 413 wild deer from seven regions in four eastern Australian states from 2017 to 2020. Antibodies were detected using a commercial Q fever antibody kit validated for ruminants. Seroprevalence of C. burnetii antibodies in deer was determined and true prevalence estimated, for each region. The overall seroprevalence of C. burnetii antibodies in wild deer was 3.4% (14 seropositive of 413 deer sampled) with true prevalence estimated to be 4.3% (95% credible interval: 0.6%, 10.9%). Seropositive deer were identified only in Queensland (7/108 seropositive) and northern New South Wales (7/120 seropositive). This geospatial distribution is consistent with seropositivity in other animal species and indicative of the level of C. burnetii in the environment. The low seroprevalence suggests that wild deer are unlikely to be a major reservoir species for C. burnetii in eastern Australia but may still be implicated in inter‐species transmission cycles. [ABSTRACT FROM AUTHOR]

Published
2023
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50. 1640. Nederlanders op Barbados

Author

Tol, J.J.S. van den, Heerma van Voss, L., Bouras, N., Hart, M. 't, Heijden, M. van der, and Lucassen, L.

Published
2022

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