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1. Normal mere exposure effect with impaired recognition in Alzheimer’s disease.

Author

Adam, A, Willems, S, and Van der Linden, M

Subjects
Neuroscience: Neuropsychology, Neuropsychology
Abstract

We investigated the mere exposure effect and the explicit memory in Alzheimer’s disease (AD) patients and elderly control subjects, using unfamiliar faces. During the exposure phase, the subjects estimated the age of briefly flashed faces. The mere exposure effect was examined by presenting pairs of faces (old and new) and asking participants to select the face they liked. The participants were then presented with a forced-choice explicit recognition task. Controls subjects exhibited above-chance preference and recognition scores for old faces. The AD patients also showed the mere exposure effect but no explicit recognition. These results suggest that the processes involved in the mere exposure effect are preserved in AD patients despite their impaired explicit recognition. The results are discussed in terms of Seamon et al.’s proposal (1995) that processes involved in the mere exposure effect are equivalent to those subserving perceptual priming. These processes would depend on extrastriate areas which are relatively preserved in AD patients.

Published
2002

6. Emergency department crowding in the Netherlands; evaluation of a real-time ambulance diversion dashboard.

Author

Baan-Kooman, E. C. M., Mol, S., van der Linden, M. C., Gaakeer, M. I., and de Ridder, V. A.

Subjects
DASHBOARDS (Management information systems), HOSPITAL emergency services, DESCRIPTIVE statistics, EMERGENCY medical services, EVALUATION of medical care, CROWDS, RESEARCH methodology
Abstract

Background: Emergency department (ED) crowding is a growing concern worldwide and associated with negative effects. In 2013, 68% of Dutch ED-managers experienced crowding on several days of the week. This resulted into the introduction in phases of an ambulance diversion dashboard, in order to influence ED input. Increasing numbers of Dutch EDs have implemented this dashboard, visualizing regional ambulance diversions by means of a traffic light. Methods: This is a descriptive study of a nationwide online survey of Dutch EDs, conducted between January and October 2023. It included both qualitative and quantitative questions. The outcomes and analysis are derived from descriptive data of respondents' experience of crowding as well as their usage and perceived effectiveness of the ambulance diversions dashboard. Results: At the time of the survey, 62 of 82 Dutch EDs (75.6%) actually used the dashboard, of which 56 EDs responded (90.3% response rate). 69.7% Of ED managers experienced ED crowding more than three times a week. Of the respondents using the dashboard, 52.8% reported it only occasionally alleviates ED inflow. The purported reasons are the limited number of patients affected by the red light (ambulance diversion) and the presence of regional crowding. The effects of the orange light (impending ambulance diversion) on ED input differ greatly among hospitals, mostly due to their own internal agreements. In accordance, many respondents (53.6%) expressed dissatisfaction with the resources available to them to alleviate crowding. Conclusion: After conducting a national survey, ED crowding is reported as a persisting nationwide problem with its prevalence largely unchanged since the introduction of the ambulance diversion dashboard. Most hospitals reported having insufficient resources to alleviate it. The effects of the ambulance diversion dashboard to decrease crowding are apparently limited because it affects a small portion of total ED presentations and because of the influence of regional crowding. The main function of the orange light is to increase ED throughput and output rather than reducing ED input. [ABSTRACT FROM AUTHOR]

Published
2025
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7. The use of an 'acclimatisation' heatwave measure to compare temperature-related demand for emergency services in Australia, Botswana, Netherlands, Pakistan, and USA.

Author

van der Linden, Naomi, Longden, Thomas, Richards, John R, Khursheed, Munawar, Goddijn, Wilhelmina MT, van Veelen, Michiel J, Khan, Uzma Rahim, and van der Linden, M Christien

Subjects
Humans, Heat Stress Disorders, Seasons, Acclimatization, Adolescent, Aged, Aged, 80 and over, Child, Child, Preschool, Emergency Service, Hospital, Emergency Medical Services, Botswana, California, Pakistan, Australia, Netherlands, Female, Male, Extreme Heat, Climate Change, and over, Preschool, Emergency Service, Hospital, General Science & Technology
Abstract

BACKGROUND:Heatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality. METHODS:Routinely collected time series data were obtained from 18 hospitals. Two separate thresholds (≥4 and ≥7) of the acclimatisation excess heat index (EHIaccl) were used to define "hot days". Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between hot days and other days, and threshold regression to determine which temperature thresholds correspond to large increases in ED attendances. FINDINGS:In all regions, increases in temperature that did not coincide with time to acclimatise resulted in increases in ED attendances, and the EHIaccl performed in a similar manner. During hot days in California and The Netherlands, significantly more children ended up in the ED, while in Pakistan more elderly people attended. Hot days were associated with more patient admissions in the ages 5-11 in California, 65-74 in Karachi, and 75-84 in The Hague. During hot days in The Hague, patients with psychiatric symptoms were more likely to die. The current study did not identify a threshold temperature associated with particularly large increases in ED demand. INTERPRETATION:The association between heat and ED demand differs between regions. A limitation of the current study is that it does not consider delayed effects or influences of other environmental factors. Given the association between heat and ED use, hospitals and governmental authorities should recognise the demands that heat can place on local health care systems. These demands differ substantially between regions, with Pakistan being the most heavily affected within our study sample.

Published
2019

9. Effecten van waterstofexplosies

Author

van der Linden, M, Wolting, AG, van der Linden, M, and Wolting, AG

Abstract

RIVM rapport:Gevaarlijke stoffen, zoals waterstof, kunnen branden of ontploffen. Voor de veiligheid van omwonenden kunnen gemeenten eisen stellen aan nieuwbouw als er in de buurt bedrijven liggen die met gevaarlijke stoffen werken. Dat geldt ook voor transportroutes van dit soort stoffen. Het RIVM beschrijft welke effecten te verwachten zijn bij een explosie van tanks waar waterstof in zit. De effecten zijn beschreven bij tanks van verschillende groottes. Op basis daarvan is berekend tot welke afstanden de opslag van waterstof en het transport ervan veilig zijn. Gemeenten en omgevingsdiensten hebben deze informatie nodig om veiligheidsmaatregelen te kunnen bedenken en kiezen. Zij beoordelen of extra veiligheidsmaatregelen nodig zijn, bijvoorbeeld door gebouwen sterker te maken of er een andere plek voor te kiezen. Ook kunnen gebouwen worden afgeschermd van branden of ontploffingen (explosies) door wallen of muren aan te leggen. Voor een goed advies is het nodig om te weten waartegen een maatregel moet beschermen. Het onderzoek beschrijft daarom wat explosies zijn, hoe een explosie van waterstof verloopt en welke schade explosies kunnen veroorzaken. De effecten zijn berekend met een internationaal model dat ook in Nederland wordt gebruikt. De rekenresultaten komen grofweg overeen met ervaringen met ongevallen met waterstof en veldproeven in de praktijk. In vergelijking met explosies van LNG(Liquefied Natural Gas) (aardgas) en LPG(Liquefied Petroleum Gas) (propaan) zijn de effecten van een waterstofexplosie zijn per kilo waterstof krachtiger. Toch is een ontploffing van een LNG of LPG-opslagtank krachtiger dan een explosie van een even grote tank waterstof. Dat komt omdat waterstof moeilijker is samen te persen. Daarom zit er in opslagtanks die even groot zijn minder kilo waterstof dan kilo LNG of LPG. Dit onderzoek is gedaan omdat het gebruik van waterstof relatief nieuw is en belangrijk is om de overgang van fossiele naar duurzame brandstof mogelijk te maken. Het RIVM heeft de i, Hazardous substances, like hydrogen, have the potential to ignite or explode. In consideration of residents' safety, municipalities may impose specific requirements on new construction projects in areas with nearby businesses handling such substances. This also extends to transportation routes used for these substances. RIVM outlines the expected effects of explosions involving tanks containing hydrogen, considering various tank sizes. Based on this, calculations have been used to determine safe distances for both storing and transporting hydrogen. Municipalities and environmental services rely on this data to develop and select suitable safety measures. They assess whether additional precautions, such as reinforcing buildings or choosing alternative locations, are necessary. Additionally, structures can be protected from fires or explosions by constructing barriers such as embankments or walls. To provide effective guidance, it is crucial to understand the potential threats that measures aim to mitigate. Therefore, the research explains the nature of explosions, the process of a hydrogen explosion and the resulting damages. Calculations are conducted using an international model that is also utilised in the Netherlands, offering results that align closely with hydrogen accident experiences and practical field trials. Comparatively, hydrogen explosions yield more powerful effects per kilogramme than those of LNG (natural gas) or LPG (propane). However, despite this, explosions from LNG or LPG storage tanks are more forceful than those from equally sized hydrogen tanks. This discrepancy arises from the difficulty in compressing hydrogen, resulting in fewer kilogrammes stored in hydrogen tanks compared to LNG or LPG tanks. This research serves to address the relatively new use of hydrogen, which is crucial for facilitating the transition from fossil fuels to sustainable alternatives. The insights gleaned from this study have been used by RIVM to produce a brochure foc

Published
2024

12. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Author

Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., Loveridge R., Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., and Loveridge R.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation. Methods: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic—from March 1 to Sept 13, 2020—at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing. Findings: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46–60]) were included in the study. Median ECMO duration was 15 days (IQR 8–27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients

Published
2023

19. Vrijgave van terreinen na werkzaamheden met radioactiviteit. Mogelijkheden voor dosiscriteria

Author

Dekkers, F, van Dillen, T, van der Linden, M, Rosenbaum, CENM, Dekkers, F, van Dillen, T, van der Linden, M, and Rosenbaum, CENM

Abstract

RIVM rapport:De Nederlandse overheid houdt toezicht op locaties waar wordt gewerkt met radioactiviteit. Denk aan kerncentrales en verschillende soorten industrieën, zoals voor olie en gas. Mensen die op zo’n locatie werken of er in de buurt zijn, mogen niet aan te veel straling worden blootgesteld. Nadat de werkzaamheden met radioactiviteit zijn gestopt, blijft de overheid toezicht houden op het terrein. Dat komt doordat daar misschien nog radioactiviteit in of op de grond kan zitten. Dit toezicht kan alleen stoppen als de hoeveelheid radioactiviteit aan bepaalde voorwaarden voldoet. Dit noemen we vrijgave. Het terrein kan dan worden gebruikt voor een ander doel, bijvoorbeeld om bedrijven of woningen te plaatsen. In de Nederlandse wet- en regelgeving is nog niet vastgelegd aan hoeveel straling mensen via zo'n vrijgegeven terrein mogen worden blootgesteld. Daar is namelijk geen dosiscriterium voor. Het ministerie van Infrastructuur en Waterstaat (IenW(Infrastructuur en Waterstaat)) heeft het RIVM daarom gevraagd in kaart te brengen welke mogelijkheden er zijn om een dosiscriterium te bepalen. Het uitgangspunt hierbij is dat de dosis na vrijgave van een terrein zo laag is ‘als redelijkerwijs mogelijk is’. Hiervoor heeft het RIVM gekeken welke criteria in het buitenland worden gebruikt. Landen blijken hiervoor verschillende doses te gebruiken. Daarvan zouden de meeste ook in Nederland kunnen worden gebruikt. Het RIVM en IenW willen in ieder geval dat een dosiscriterium voor Nederland aansluit bij internationale regelgeving en adviezen van internationale stralingsbeschermingsorganisaties. Het International Atomic Energy Agency (IAEA(International Atomic Energy Agency)) geeft een ruimte van waarden waar een dosiscriterium binnen zou moeten vallen: 10 tot 300 microsievert per jaar. Lager dan 10 microsievert per jaar is waarschijnlijk niet redelijk. Hierbij is rekening gehouden met sociale en economische overwegingen. Bij een dosiscriterium boven 300 microsievert per jaar is er geen ga, The Dutch Government supervises sites where practices involving radioactive materials take place. Examples include nuclear power plants and oil, natural gas and other industrial facilities. People who work at such sites or spend time in their vicinity must not be exposed to excessive radiation. After the practices involving radioactive materials at a site have ended, the government continues to supervise the site. This is because the soil or subsoil may still contain radioactive material. Regulatory control can only be lifted if radiation levels meet established criteria. This is called ‘release’. The site can then be redesignated for commercial, industrial, residential or other use. The Netherlands does not currently have a law or regulation that specifies the dose that people may incur as a consequence of the presence of radiation at a released site. No dose criterion currently exists. The Ministry of Infrastructure and Water Management therefore asked RIVM to identify options for establishing such a dose criterion. The basic principle should be that upon release of the site the dose is ‘as low as reasonably achievable’. RIVM has reviewed criteria currently used in other countries. Different countries apply different doses. Most of these could also be used in the Netherlands. The Ministry and RIVM want the dose criterion used in the Netherlands to be consistent with international regulations and guidelines issued by global radiation protection agencies. The International Atomic Energy Agency (IAEA) recommends a dose criterion in the range of 10– 300 microsievert per year. Lower than 10 microsievert per year is unlikely to be reasonable, taking into account social and economic factors. A dose criterion above 300 microsievert per year does not guarantee sufficient protection for humans. A dose criterion must also be practicable: it must be possible to conduct measurements to determine whether the criterion is being met. Calculations show that a strict dose criterion

Published
2023

20. The impact of prehospital blood sampling on the emergency department process of patients with chest pain: a pragmatic non-randomized controlled trial

Author

Van Nieuwkerk, Johan L. (author), Van Der Linden, M. Christien (author), Verheul, Rolf J. (author), Van Loon-Van Gaalen, Merel (author), Janmaat, Marije (author), van der Linden, N. (author), Van Nieuwkerk, Johan L. (author), Van Der Linden, M. Christien (author), Verheul, Rolf J. (author), Van Loon-Van Gaalen, Merel (author), Janmaat, Marije (author), and van der Linden, N. (author)

Abstract

BACKGROUND: In patients with chest pain who arrive at the emergency department (ED) by ambulance, venous access is frequently established prehospital, and could be utilized to sample blood. Prehospital blood sampling may save time in the diagnostic process. In this study, the association of prehospital blood draw with blood sample arrival times, troponin turnaround times, and ED length of stay (LOS), number of blood sample mix-ups and blood sample quality were assessed. METHODS: The study was conducted from October 1, 2019 to February 29, 2020. In patients who were transported to the ED with acute chest pain with low suspicion for acute coronary syndrome (ACS), outcomes were compared between cases, in whom prehospital blood draw was performed, and controls, in whom blood was drawn at the ED. Regression analyses were used to assess the association of prehospital blood draw with the time intervals. RESULTS: Prehospital blood draw was performed in 100 patients. In 406 patients, blood draw was performed at the ED. Prehospital blood draw was independently associated with shorter blood sample arrival times, shorter troponin turnaround times and decreased LOS (P<0.001). No differences in the number of blood sample mix-ups and quality were observed (P>0.05). CONCLUSION: For patients with acute chest pain with low suspicion for ACS, prehospital blood sampling is associated with shorter time intervals, while there were no significant differences between the two groups in the validity of the blood samples., Policy Analysis

Published
2023
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21. Ziritaxestat, a novel autotaxin inhibitor, and lung function in idiopathic pulmonary fibrosis

Author

Maher, TM, Ford, P, Brown, KK, Costabel, U, Cottin, V, Danoff, SK, Groenveld, I, Helmer, E, Jenkins, RG, Milner, J, Molenberghs, G, Penninckx, B, Randall, MJ, Van Den Blink, B, Fieuw, A, Vandenrijn, C, Rocak, S, Seghers, I, Shao, L, Taneja, A, Jentsch, G, Watkins, TR, Wuyts, WA, Kreuter, M, Verbruggen, N, Prasad, N, Wijsenbeek, MS, Chambers, D, Chia, M, Corte, T, Glaspole, I, Goh, N, Holmes, M, Malouf, M, Thien, F, Veitch, E, Bondue, B, Dahlqvist, C, Froidure, A, Slabbynck, H, Wuyts, W, Cartagena Salinas, C, Feijoó Seoane, R, Martínez, V, Maturana, R, Pavie Gallegos, J, Rosenblut, A, Silva, R, Undurraga Pereira, A, Doubkova, M, Pauk, N, Plackova, M, Sterclova, M, Bendstrup, E, Shaker, SB, Titlestad, I, Budweiser, S, Grohé, C, Koschel, D, Prasse, A, Weber, M, Wirtz, H, Antoniou, K, Daniil, Z, Gaga, M, Papakosta, D, Izumi, S, Okamoto, M, Guerreros Benavides, A, Iberico Barrera, C, Peña Villalobos, AM, Campo Ezquibela, A, Cifrian Martinez, JM, Fernandez Fabrellas, E, Leiro, V, Molina-Molina, M, Nieto Barbero, A, Sellares Torres, J, Valenzuela, C, Cheng, S-L, Kuo, P-H, Lee, K-Y, Sheu, C-C, Gunen, H, Mogulkoc Bishop, N, Nayci, S, Adamali, H, Bianchi, S, Chaudhuri, N, Gibbons, M, Hart, S, Molyneaux, P, Parfrey, H, Saini, G, Spencer, LG, Wiscombe, S, Antin-Ozerkis, D, Bascom, R, Belperio, J, Britt, E, Fitzgerald, J, Gomez Manjarres, D, Gotfried, M, Gupta, N, Hotchkin, D, Kaye, M, Kreider, M, Kureishy, S, Lacamera, P, Lancaster, L, Lasky, J, Lorch, D, Mannem, H, Morrow, L, Moua, T, Nambiar, A, Raghu, G, Raj, R, Ramaswamy, M, Reddy, R, Russell, T, Scholand, MB, Shea, B, Suliman, S, Swigris, J, Thavarajah, K, Tolle, L, Tomic, R, Warshoff, N, Wesselius, L, Yung, G, Bergna, M, De Salvo, M, Fernandez Acquier, M, Rodriguez, A, Saez Scherbovsky, P, Assayag, D, Dhar, A, Khalil, N, Morisset, J, Provencher, S, Ryerson, C, Shapera, S, Bourdin, A, Crestani, B, Lebargy, F, Reynaud-Gaubert, M, Bonella, FT, Claussen, M, Hammerl, P, Karagiannidis, C, Keller, C, Randerath, W, Stubbe, B, Csánky, E, Medgyasszay, B, Muller, V, Adir, Y, Bar-Shai, A, Berkman, N, Fink, G, Kramer, M, Shitrit, D, Bargagli, E, Gasparini, S, Harari, S, Ravaglia, C, Richeldi, L, Vancheri, C, Ebina, M, Fujita, M, Ichikado, K, Inoue, Y, Ishikawa, N, Kato, M, Kawamura, T, Kondoh, Y, Nishioka, Y, Ogura, T, Owan, I, Saito, T, Sakamoto, N, Sakamoto, K, Shirai, M, Suda, T, Tomii, K, Chung, MP, Jeong, SH, Park, CS, Park, JS, Song, JW, Uh, S-T, Chavarria Martinez, U, Montano Gonzalez, E, Ramirez, A, Selman Lama, ME, Bresser, P, Kramer, H, Mostard, R, Nossent, E, Veltkamp, M, Wijsenbeek, M, Beckert, L, Chang, CL, Veale, A, Wilsher, M, Bednarek, M, Gasior, G, Jasieniak-Pinis, G, Jassem, E, Mroz, R, Piotrowski, W, Abdullah, I, Ambaram, A, Irusen, E, Van der Linden, M, Van Zyl-Smit, R, Williams, P, Allen, J, Averill, F, Belloli, E, Brown, A, Case, A, Chaudhary, S, Criner, G, DeBoer, K, Dilling, D, Dorf, J, Enelow, R, Ettinger, N, Feldman, J, Gibson, K, Golden, J, Hamblin, M, Hunninghake, G, Karunakara, R, Kim, H, Luckhardt, T, Menon, P, Morrison, L, Oldham, J, Patel, N, Schmidt, S, Strek, M, Summer, R, Sussman, R, Tita, J, Veeraraghavan, S, Whelan, T, and Zibrak, J

Abstract

Importance There is a major need for effective, well-tolerated treatments for idiopathic pulmonary fibrosis (IPF). Objective To assess the efficacy and safety of the autotaxin inhibitor ziritaxestat in patients with IPF. Design, Setting, and Participants The 2 identically designed, phase 3, randomized clinical trials, ISABELA 1 and ISABELA 2, were conducted in Africa, Asia-Pacific region, Europe, Latin America, the Middle East, and North America (26 countries). A total of 1306 patients with IPF were randomized (525 patients at 106 sites in ISABELA 1 and 781 patients at 121 sites in ISABELA 2). Enrollment began in November 2018 in both trials and follow-up was completed early due to study termination on April 12, 2021, for ISABELA 1 and on March 30, 2021, for ISABELA 2. Interventions Patients were randomized 1:1:1 to receive 600 mg of oral ziritaxestat, 200 mg of ziritaxestat, or placebo once daily in addition to local standard of care (pirfenidone, nintedanib, or neither) for at least 52 weeks. Main Outcomes and Measures The primary outcome was the annual rate of decline for forced vital capacity (FVC) at week 52. The key secondary outcomes were disease progression, time to first respiratory-related hospitalization, and change from baseline in St George’s Respiratory Questionnaire total score (range, 0 to 100; higher scores indicate poorer health-related quality of life). Results At the time of study termination, 525 patients were randomized in ISABELA 1 and 781 patients in ISABELA 2 (mean age: 70.0 [SD, 7.2] years in ISABELA 1 and 69.8 [SD, 7.1] years in ISABELA 2; male: 82.4% and 81.2%, respectively). The trials were terminated early after an independent data and safety monitoring committee concluded that the benefit to risk profile of ziritaxestat no longer supported their continuation. Ziritaxestat did not improve the annual rate of FVC decline vs placebo in either study. In ISABELA 1, the least-squares mean annual rate of FVC decline was –124.6 mL (95% CI, −178.0 to −71.2 mL) with 600 mg of ziritaxestat vs –147.3 mL (95% CI, −199.8 to −94.7 mL) with placebo (between-group difference, 22.7 mL [95% CI, −52.3 to 97.6 mL]), and –173.9 mL (95% CI, −225.7 to −122.2 mL) with 200 mg of ziritaxestat (between-group difference vs placebo, −26.7 mL [95% CI, −100.5 to 47.1 mL]). In ISABELA 2, the least-squares mean annual rate of FVC decline was –173.8 mL (95% CI, −209.2 to −138.4 mL) with 600 mg of ziritaxestat vs –176.6 mL (95% CI, −211.4 to −141.8 mL) with placebo (between-group difference, 2.8 mL [95% CI, −46.9 to 52.4 mL]) and –174.9 mL (95% CI, −209.5 to −140.2 mL) with 200 mg of ziritaxestat (between-group difference vs placebo, 1.7 mL [95% CI, −47.4 to 50.8 mL]). There was no benefit with ziritaxestat vs placebo for the key secondary outcomes. In ISABELA 1, all-cause mortality was 8.0% with 600 mg of ziritaxestat, 4.6% with 200 mg of ziritaxestat, and 6.3% with placebo; in ISABELA 2, it was 9.3% with 600 mg of ziritaxestat, 8.5% with 200 mg of ziritaxestat, and 4.7% with placebo. Conclusions and Relevance Ziritaxestat did not improve clinical outcomes compared with placebo in patients with IPF receiving standard of care treatment with pirfenidone or nintedanib or in those not receiving standard of care treatment. Trial Registration ClinicalTrials.gov Identifiers: NCT03711162 and NCT03733444

Published
2023

22. The impact of prehospital blood sampling on the emergency department process of patients with chest pain

Author

van Nieuwkerk, Johan L., van der Linden, M. Christien, Verheul, Rolf J., Gaalen, Merel van Loon-van, Janmaat, Marije, and van der Linden, Naomi

Subjects
Emergency medical services, Hospital, Crowding, Emergency Medicine, Blood specimen collection, Original Article, Emergency services, Troponin
Abstract

BACKGROUND: In patients with chest pain who arrive at the emergency department (ED) by ambulance, venous access is frequently established prehospital, and could be utilized to sample blood. Prehospital blood sampling may save time in the diagnostic process. In this study, the association of prehospital blood draw with blood sample arrival times, troponin turnaround times, and ED length of stay (LOS), number of blood sample mix-ups and blood sample quality were assessed. METHODS: The study was conducted from October 1, 2019 to February 29, 2020. In patients who were transported to the ED with acute chest pain with low suspicion for acute coronary syndrome (ACS), outcomes were compared between cases, in whom prehospital blood draw was performed, and controls, in whom blood was drawn at the ED. Regression analyses were used to assess the association of prehospital blood draw with the time intervals. RESULTS: Prehospital blood draw was performed in 100 patients. In 406 patients, blood draw was performed at the ED. Prehospital blood draw was independently associated with shorter blood sample arrival times, shorter troponin turnaround times and decreased LOS (P0.05). CONCLUSION: For patients with acute chest pain with low suspicion for ACS, prehospital blood sampling is associated with shorter time intervals, while there were no significant differences between the two groups in the validity of the blood samples.

Published
2023

24. Age is the main determinant of COVID-19 related in-hospital mortality with minimal impact of pre-existing comorbidities, a retrospective cohort study

Author

Henkens, M. T. H. M., Raafs, A. G., Verdonschot, J. A. J., Linschoten, M., van Smeden, M., Wang, P., van der Hooft, B. H. M., Tieleman, R., Janssen, M. L. F., ter Bekke, R. M. A., Hazebroek, M. R., van der Horst, I. C. C., Asselbergs, F. W., Magdelijns, F. J. H., Heymans, S. R. B., Al-Ali, A. K., Al-Muhanna, F. A., Al-Windy, N. Y. Y., Almubarak, Y. A., Alnafie, A. N., Alshahrani, M., Alshehri, A. M., Anthonio, R. L., Aujayeb, A., ten Berg, J. M., van Boxem, A. J. M., Captur, G., Caputo, M., Charlotte, N., Dark, P., de Sutter, J., Delsing, C. E., Dorman, H. G. R., Drost, J. T., Emans, M. E., Ferreira, J. B., Gabriel, L., van Gilst, W. H., Groenemeijer, B. E., Haerkens-Arends, H. E., van der Harst, P., Hedayat, B., van der Heijden, D. J., Hellou, E., Hermanides, R. S., Hermans-van Ast, J. F., van Hessen, M. W. J., van Ierssel, S. H., Jewbali, L. S., Kearney, M. T., van Kesteren, H. A. M., Kietselaer, B. L. J. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van Erp, J. M., van der Linden, M. M. J. M., Linssen, G. C. M., Macias Ruiz, R., Martens, F. M. A. C., McCann, G. P., van der Meer, P., Meijs, M. F. L., Messiaen, P., Monraats, P. S., Montagna, L., Moriarty, A., Mosterd, A., Nierop, P. R., van Ofwegen-Hanekamp, C. E. E., Pinto, Y. M., Poorhosseini, H., Prasad, S., Redón, J., Reidinga, A. C., Ribeiro, M. I. A., Ripley, D. P., Salah, R., Saneei, E., Saxena, M., Schaap, J., Schellings, D. A. A. M., Schut, A., Shafiee, A., Shore, A. C., Siebelink, H. J., Smits, P. C., Pisters, R., Tessitore, E., Tieleman, R. G., Timmermans, P., Tio, R. A., Tjong, F. V. Y., den Uil, C. A., van Craenenbroeck, E. M., van Veen, H. P. A. A., Veneman, T., Verschure, D. O., de Vries, J. K., van de Wal, R. M. A., van de Watering, D. J., Westendorp, I. C. D., Westendorp, P. H. M., Weytjens, C., Wierda, E., Williams, B., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Cardiology, ACS - Heart failure & arrhythmias, CAPACITY-COVID collaborative consortium, Cardiologie, RS: Carim - H02 Cardiomyopathy, MUMC+: DA KG Lab Centraal Lab (9), Klinische Neurowetenschappen, MUMC+: HZC Med Staf Spec Klinische Neurofys (9), RS: MHeNs - R3 - Neuroscience, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H04 Arrhythmogenesis and cardiogenetics, MUMC+: MA Med Staf Artsass Cardiologie (9), RS: Carim - V04 Surgical intervention, Intensive Care, MUMC+: MA Medische Staf IC (9), MUMC+: MA Intensive Care (3), Interne Geneeskunde, and MUMC+: MA Alg Interne Geneeskunde (9)

Subjects
Male, SARS-CoV-2, COVID-19, Comorbidity, Hospitalization, Risk Factors, Humans, Mediation analysis, Female, Hospital Mortality, Human medicine, Geriatrics and Gerontology, Mortality, Aged, Retrospective Studies, Netherlands
Abstract

Background Age and comorbidities increase COVID-19 related in-hospital mortality risk, but the extent by which comorbidities mediate the impact of age remains unknown. Methods In this multicenter retrospective cohort study with data from 45 Dutch hospitals, 4806 proven COVID-19 patients hospitalized in Dutch hospitals (between February and July 2020) from the CAPACITY-COVID registry were included (age 69[58–77]years, 64% men). The primary outcome was defined as a combination of in-hospital mortality or discharge with palliative care. Logistic regression analysis was performed to analyze the associations between sex, age, and comorbidities with the primary outcome. The effect of comorbidities on the relation of age with the primary outcome was evaluated using mediation analysis. Results In-hospital COVID-19 related mortality occurred in 1108 (23%) patients, 836 (76%) were aged ≥70 years (70+). Both age 70+ and female sex were univariably associated with outcome (odds ratio [OR]4.68, 95%confidence interval [4.02–5.45], OR0.68[0.59–0.79], respectively;both pp Conclusions Age is the main determinant of COVID-19 related in-hospital mortality, with negligible mediation effect of pre-existing comorbidities. Trial registration CAPACITY-COVID (NCT04325412)

Published
2022
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26. ECMO for COVID-19 patients in Europe and Israel

Author

Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Zangrillo, A, Pieri, M, Nardelli, P, Fominskiy, E, Landoni, G, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V. L., De Piero M. E., Belohlavek J., Delnoij T., van der Horst I., Miranda D. R., van der Linden M., van der Heijden J. J., Scholten E., van Belle-van Haren N., Lagrand W., de Jong S., Candura D., Maas J., van den Berg M. J. G., Malfertheiner M., Dreier E., Mueller T., Boeken U., Akhyari P., Lichtenberg A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Mariani S., Thielmann M., Brenner T., Benk C., Czerny M., Kalbhenn J., Maier S., Schibilsky D., Staudacher D. L., Henn P., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Zacharowski K., Lotz G., Sonntagbauer M., Kersten A., Karagiannidis C., Schafer S., Fichte J., Hopf H. -B., Samalavicius R., Lorini L., Ghitti D., Grazioli L., Loforte A., Baiocchi M., Checco E. D., Pacini D., Meani P., Cappai A., Russo C. F., Bottiroli M., Mondino M., Ranucci M., Fina D., Ballotta A., Scandroglio A. M., Zangrillo A., Pieri M., Nardelli P., Fominskiy E., Landoni G., Fanelli V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Urbino R., Livigni S., Degani A., Raffa G., Pilato M., Martucci G., Arcadipane A., Chiarini G., Latronico N., Cattaneo S., Puglia C., Reina G., Sponga S., Livi U., Foti G., Giani M., Rona R., Avalli L., Bombino M., Costa M. C., Carozza R., Donati A., Piciche M., Favaro A., Salvador L., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Gamberini E., Russo E., Benni M., Agnoletti V., Rociola R., Milano A. D., Grasso S., Civita A., Murgolo F., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Carelli S., Grieco D. L., Antonelli M., Ramoni E., Di Nardo M., Maisano F., Bettex D., Weber A., Grunenfelder J., Consiglio J., Hansjoerg J., Haenggi M., Agus G., Doeble T., Zenklusen U., Bechtold X., Stockman B., De Backer D., Giglioli S., Meyns B., Vercaemst L., Herman G., Meersseman P., Vandenbriele C., Dauwe D., Vlasselaers D., Raes M., Debeuckelaere G., Rodrigus I., Biston P., Piagnerelli M., Peperstraete H., Germay O., Vandewiele K., Vandeweghe D., Witters I., Havrin S., Bourgeois M., Taccone F. S., Nobile L., Lheureux O., Brasseur A., Creteur J., Defraigne J. -O., Misset B., Courcelle R., Timmermans P. J., Lehaen J., Frederik B., Riera J., Castro M. A., Gallart E., Martinez-Martinez M., Argudo E., Garcia-de-Acilu M., de Pablo Sanchez R., Ortiz A. B., Cabanes M. -P. F., Higa K. O., Cassina A. M., Berbel D. O., Sanchez-Salado J. C., Arnau B. -L., de Gopegui P. R., Ricart P., Sandoval E., Veganzones J., Millan P., de la Sota P., Santa Teresa P., Alcantara S., Alvarez J. D., Gonzalez A. V., Lopez M., Gordillo A., Naranjo-Izurieta J., Costa R. G., Albacete Moreno C. L., de Ayala J. A., Blanco-Schweizer P., Andres N. H., Boado V., Martinez J. M. N., Casal V. G., Garcia E. F., Martin-Villen L., Climent J. C., Pinto L. F., Leprince P., Lebreton G., Juvin C., Schmidt M., Pineton M., Folliguet T., Saiydoun G., Gaudard P., Colson P., Obadia J. -F., Pozzi M., Fellahi J. L., Yonis H., Richard J. C., Parasido A., Verhoye J. -P., Flecher E., Ajrhourh L., Nesseler N., Mansour A., Guinot P. -G., Zarka J., Besserve P., Makhoul M., Bolotin G., Kassif Y., Soufleris D., Schellongowski P., Bonaros N., Krapf C., Ebert K., Mair P., Kothleutner F., Kowalewsky M., Christensen S., Pedersen F. M., Balik M., Blaha J., Lips M., Otahal M., Camporota L., Daly K., Agnew N., Barker J., Head L., Garcia M., Ledot S., Aquino V., Lewis R., Worthy J., Noor H., Scott I., O'Brien S., Conrick-Martin I., Carton E., Gillon S., Flemming L., Broman L. M., Grins E., Ketskalo M., Tsarenko S., Popugaev K., Minin S., Kornilov I., Skopets A., Kornelyuk R., Turchaninov A., Gorjup V., Shelukhin D., Dsouki Y. E., Sargin M., Kaygin M. A., Liana S., Puss S., Soerensen G., Magnus R., Kanetoft M., Watson P., Redfors B., Krenner N., Velia Antonini M., Barrett N. A., Belliato M., Davidson M., Finney S., Fowles J. -A., Halbe M., Hennig F., Jones T., Pinto L., Smith J., Roeleveld P., Swol J., Lorusso, R, Combes, A, Coco, V, De Piero, M, Belohlavek, J, Delnoij, T, van der Horst, I, Miranda, D, van der Linden, M, van der Heijden, J, Scholten, E, van Belle-van Haren, N, Lagrand, W, de Jong, S, Candura, D, Maas, J, van den Berg, M, Malfertheiner, M, Dreier, E, Mueller, T, Boeken, U, Akhyari, P, Lichtenberg, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Mariani, S, Thielmann, M, Brenner, T, Benk, C, Czerny, M, Kalbhenn, J, Maier, S, Schibilsky, D, Staudacher, D, Henn, P, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Zacharowski, K, Lotz, G, Sonntagbauer, M, Kersten, A, Karagiannidis, C, Schafer, S, Fichte, J, Hopf, H, Samalavicius, R, Lorini, L, Ghitti, D, Grazioli, L, Loforte, A, Baiocchi, M, Checco, E, Pacini, D, Meani, P, Cappai, A, Russo, C, Bottiroli, M, Mondino, M, Ranucci, M, Fina, D, Ballotta, A, Scandroglio, A, Zangrillo, A, Pieri, M, Nardelli, P, Fominskiy, E, Landoni, G, Fanelli, V, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Urbino, R, Livigni, S, Degani, A, Raffa, G, Pilato, M, Martucci, G, Arcadipane, A, Chiarini, G, Latronico, N, Cattaneo, S, Puglia, C, Reina, G, Sponga, S, Livi, U, Foti, G, Giani, M, Rona, R, Avalli, L, Bombino, M, Costa, M, Carozza, R, Donati, A, Piciche, M, Favaro, A, Salvador, L, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Gamberini, E, Russo, E, Benni, M, Agnoletti, V, Rociola, R, Milano, A, Grasso, S, Civita, A, Murgolo, F, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Carelli, S, Grieco, D, Antonelli, M, Ramoni, E, Di Nardo, M, Maisano, F, Bettex, D, Weber, A, Grunenfelder, J, Consiglio, J, Hansjoerg, J, Haenggi, M, Agus, G, Doeble, T, Zenklusen, U, Bechtold, X, Stockman, B, De Backer, D, Giglioli, S, Meyns, B, Vercaemst, L, Herman, G, Meersseman, P, Vandenbriele, C, Dauwe, D, Vlasselaers, D, Raes, M, Debeuckelaere, G, Rodrigus, I, Biston, P, Piagnerelli, M, Peperstraete, H, Germay, O, Vandewiele, K, Vandeweghe, D, Witters, I, Havrin, S, Bourgeois, M, Taccone, F, Nobile, L, Lheureux, O, Brasseur, A, Creteur, J, Defraigne, J, Misset, B, Courcelle, R, Timmermans, P, Lehaen, J, Frederik, B, Riera, J, Castro, M, Gallart, E, Martinez-Martinez, M, Argudo, E, Garcia-de-Acilu, M, de Pablo Sanchez, R, Ortiz, A, Cabanes, M, Higa, K, Cassina, A, Berbel, D, Sanchez-Salado, J, Arnau, B, de Gopegui, P, Ricart, P, Sandoval, E, Veganzones, J, Millan, P, de la Sota, P, Santa Teresa, P, Alcantara, S, Alvarez, J, Gonzalez, A, Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Costa, R, Albacete Moreno, C, de Ayala, J, Blanco-Schweizer, P, Andres, N, Boado, V, Martinez, J, Casal, V, Garcia, E, Martin-Villen, L, Climent, J, Pinto, L, Leprince, P, Lebreton, G, Juvin, C, Schmidt, M, Pineton, M, Folliguet, T, Saiydoun, G, Gaudard, P, Colson, P, Obadia, J, Pozzi, M, Fellahi, J, Yonis, H, Richard, J, Parasido, A, Verhoye, J, Flecher, E, Ajrhourh, L, Nesseler, N, Mansour, A, Guinot, P, Zarka, J, Besserve, P, Makhoul, M, Bolotin, G, Kassif, Y, Soufleris, D, Schellongowski, P, Bonaros, N, Krapf, C, Ebert, K, Mair, P, Kothleutner, F, Kowalewsky, M, Christensen, S, Pedersen, F, Balik, M, Blaha, J, Lips, M, Otahal, M, Camporota, L, Daly, K, Agnew, N, Barker, J, Head, L, Garcia, M, Ledot, S, Aquino, V, Lewis, R, Worthy, J, Noor, H, Scott, I, O'Brien, S, Conrick-Martin, I, Carton, E, Gillon, S, Flemming, L, Broman, L, Grins, E, Ketskalo, M, Tsarenko, S, Popugaev, K, Minin, S, Kornilov, I, Skopets, A, Kornelyuk, R, Turchaninov, A, Gorjup, V, Shelukhin, D, Dsouki, Y, Sargin, M, Kaygin, M, Liana, S, Puss, S, Soerensen, G, Magnus, R, Kanetoft, M, Watson, P, Redfors, B, Krenner, N, Velia Antonini, M, Barrett, N, Belliato, M, Davidson, M, Finney, S, Fowles, J, Halbe, M, Hennig, F, Jones, T, Smith, J, Roeleveld, P, Swol, J, Lorusso R., Combes A., Coco V. L., De Piero M. E., Belohlavek J., Delnoij T., van der Horst I., Miranda D. R., van der Linden M., van der Heijden J. J., Scholten E., van Belle-van Haren N., Lagrand W., de Jong S., Candura D., Maas J., van den Berg M. J. G., Malfertheiner M., Dreier E., Mueller T., Boeken U., Akhyari P., Lichtenberg A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Mariani S., Thielmann M., Brenner T., Benk C., Czerny M., Kalbhenn J., Maier S., Schibilsky D., Staudacher D. L., Henn P., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Zacharowski K., Lotz G., Sonntagbauer M., Kersten A., Karagiannidis C., Schafer S., Fichte J., Hopf H. -B., Samalavicius R., Lorini L., Ghitti D., Grazioli L., Loforte A., Baiocchi M., Checco E. D., Pacini D., Meani P., Cappai A., Russo C. F., Bottiroli M., Mondino M., Ranucci M., Fina D., Ballotta A., Scandroglio A. M., Zangrillo A., Pieri M., Nardelli P., Fominskiy E., Landoni G., Fanelli V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Urbino R., Livigni S., Degani A., Raffa G., Pilato M., Martucci G., Arcadipane A., Chiarini G., Latronico N., Cattaneo S., Puglia C., Reina G., Sponga S., Livi U., Foti G., Giani M., Rona R., Avalli L., Bombino M., Costa M. C., Carozza R., Donati A., Piciche M., Favaro A., Salvador L., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Gamberini E., Russo E., Benni M., Agnoletti V., Rociola R., Milano A. D., Grasso S., Civita A., Murgolo F., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Carelli S., Grieco D. L., Antonelli M., Ramoni E., Di Nardo M., Maisano F., Bettex D., Weber A., Grunenfelder J., Consiglio J., Hansjoerg J., Haenggi M., Agus G., Doeble T., Zenklusen U., Bechtold X., Stockman B., De Backer D., Giglioli S., Meyns B., Vercaemst L., Herman G., Meersseman P., Vandenbriele C., Dauwe D., Vlasselaers D., Raes M., Debeuckelaere G., Rodrigus I., Biston P., Piagnerelli M., Peperstraete H., Germay O., Vandewiele K., Vandeweghe D., Witters I., Havrin S., Bourgeois M., Taccone F. S., Nobile L., Lheureux O., Brasseur A., Creteur J., Defraigne J. -O., Misset B., Courcelle R., Timmermans P. J., Lehaen J., Frederik B., Riera J., Castro M. A., Gallart E., Martinez-Martinez M., Argudo E., Garcia-de-Acilu M., de Pablo Sanchez R., Ortiz A. B., Cabanes M. -P. F., Higa K. O., Cassina A. M., Berbel D. O., Sanchez-Salado J. C., Arnau B. -L., de Gopegui P. R., Ricart P., Sandoval E., Veganzones J., Millan P., de la Sota P., Santa Teresa P., Alcantara S., Alvarez J. D., Gonzalez A. V., Lopez M., Gordillo A., Naranjo-Izurieta J., Costa R. G., Albacete Moreno C. L., de Ayala J. A., Blanco-Schweizer P., Andres N. H., Boado V., Martinez J. M. N., Casal V. G., Garcia E. F., Martin-Villen L., Climent J. C., Pinto L. F., Leprince P., Lebreton G., Juvin C., Schmidt M., Pineton M., Folliguet T., Saiydoun G., Gaudard P., Colson P., Obadia J. -F., Pozzi M., Fellahi J. L., Yonis H., Richard J. C., Parasido A., Verhoye J. -P., Flecher E., Ajrhourh L., Nesseler N., Mansour A., Guinot P. -G., Zarka J., Besserve P., Makhoul M., Bolotin G., Kassif Y., Soufleris D., Schellongowski P., Bonaros N., Krapf C., Ebert K., Mair P., Kothleutner F., Kowalewsky M., Christensen S., Pedersen F. M., Balik M., Blaha J., Lips M., Otahal M., Camporota L., Daly K., Agnew N., Barker J., Head L., Garcia M., Ledot S., Aquino V., Lewis R., Worthy J., Noor H., Scott I., O'Brien S., Conrick-Martin I., Carton E., Gillon S., Flemming L., Broman L. M., Grins E., Ketskalo M., Tsarenko S., Popugaev K., Minin S., Kornilov I., Skopets A., Kornelyuk R., Turchaninov A., Gorjup V., Shelukhin D., Dsouki Y. E., Sargin M., Kaygin M. A., Liana S., Puss S., Soerensen G., Magnus R., Kanetoft M., Watson P., Redfors B., Krenner N., Velia Antonini M., Barrett N. A., Belliato M., Davidson M., Finney S., Fowles J. -A., Halbe M., Hennig F., Jones T., Pinto L., Smith J., Roeleveld P., and Swol J.

Published
2021

28. Peatland restoration based on a landscape (palaeo)ecological system analysis (LESA): the case of Aamsveen, eastern Netherlands

Author

Sevink, J., Van der Linden, M., Jansen, A., and Ecosystem and Landscape Dynamics (IBED, FNWI)

Abstract

The Dutch Aamsveen lies in a glacial basin in the Dutch-German border area. It consists of remnants of a cross-border raised bog and a lagg with degrading species-rich basiphilous plant communities. Farther west, the Glanerbeek drains the footslope at the edge of the basin and adjacent lagg. For the Netherlands, this is a rare wetland ecosystem and an important Natura 2000 area, but it is threatened by ongoing degradation. A spatiotemporal landscape ecological system analysis (LESA), including extensive palaeoecological research, showed the fundamental role of the interplay between infiltrating acid bog water that gradually acquires basic cations from the underlying base rich sediments as it flows laterally towards the lagg, where it seeps up, and the (lesser) influx of base rich surficial groundwater from the ice-pushed ridge in the west. Anthropogenic disturbance of this interplay has led to serious system degradation. The results of this LESA served to develop an integrated management plan at landscape level, instead of habitat level plans as is usual in the context of Natura 2000. This study illustrates the relevance of a spatiotemporal LESA for the recovery and sustainable management of such complex, dynamic systems.

Published
2022

29. Effect van risicoreducerende maatregelen op het plaatsgebonden risico van LPG-tankstations

Author

van der Linden, M and Stam, G

Subjects
RIVM rapport 2021-0184
Abstract

Auto’s die op autogas (LPG) rijden kunnen tanken bij LPG-tankstations. Vanwege de veiligheid moet er voldoende afstand zijn tussen een LPGtankstation en woningen in de buurt. Deze afstanden staan in de Revi (Regeling Externe Veiligheid Inrichtingen) en zijn gebaseerd op berekeningen van het RIVM. Het RIVM heeft de afstanden tussen LPGtankstations en woningen nu opnieuw berekend. In dit onderzoek gaat het specifiek over een onderdeel daarvan: de veiligheid wanneer de tankauto’s de LPG-reservoirs op het station vullen. Tot nu toe ging het RIVM bij de berekeningen uit van twee veiligheidsmaatregelen voor de tankauto’s die LPG vervoeren: een hittewerende coating en een verbeterde vulslang. De coating is een laag op de tank die de tankauto beschermt tegen brand. De verbeterde vulslang breekt minder snel als het LPG uit de tankauto wordt gepompt. De kans op een ongeluk is kleiner wanneer een tankauto de twee maatregelen heeft ingevoerd, maar de maatregelen zijn niet verplicht. De afstanden zijn daarom berekend voor tankauto’s met en zonder de veiligheidsmaatregelen. Zo wordt duidelijk wat het effect is van de maatregelen op de afstand tussen een LPG-tankstation en woningen. Naar verwachting hebben de meeste Nederlandse LPG-tankauto’s de coating en verbeterde vulslang. Uit de berekeningen blijkt dat de afstand tussen een LPG-tankstation en woningen groter moet zijn als een tankauto een van de twee of geen maatregelen heeft uitgevoerd. Zonder de maatregelen kunnen de afstanden meer dan twee keer zo groot zijn. Hoe groot deze afstand precies moet zijn, wordt bepaald door het aantal keren dat de LPGtankauto het LPG-reservoir op het tankstation bijvult. Het ministerie van Infrastructuur en Waterstaat (IenW) bepaalt uiteindelijk welke afstanden in de Revi staan. Het RIVM raadt IenW aan om de afstanden die gebaseerd zijn op nieuwe berekeningen te gebruiken in de wet- en regelgeving. Een aanpassing van de wet- en regelgeving kan nodig zijn vanwege een uitspraak van het Europese Hof van Justitie over veiligheidsmaatregelen bij LPG-tankauto’s. Het onderzoek is in opdracht van het ministerie van IenW gedaan.

Published
2022

31. Aanbevelingen voor het tweede Nederlandse nationale programma voor het beheer van radioactief afval en verbruikte splijtstoffen

Author

van der Linden, M, Velsma, M, Boudewijns, LHA, van der Linden, M, Velsma, M, and Boudewijns, LHA

Abstract

RIVM rapport:Straling wordt voor veel verschillende toepassingen gebruikt. Niet alleen om energie mee te maken in kerncentrales, maar ook voor behandelingen van mensen met kanker. Hierbij kan radioactief afval ontstaan. Dit afval wordt in Nederland veilig opgeslagen en beheerd om mens en milieu te beschermen. Lidstaten van de Europese Unie zijn verplicht om een nationaal programma op te stellen om te beschrijven hoe zij radioactief afval veilig beheren. Dit programma moet het nationale beleid en de uitvoering ervan volgens bepaalde eisen beschrijven. Het eerste Nederlandse programma, uit 2016, moet uiterlijk in 2025 zijn bijgewerkt. Als voorbereiding hierop heeft het ministerie van Infrastructuur en Waterstaat het RIVM gevraagd om te adviseren waar de beschrijving van het programma kan worden verbeterd. Het RIVM adviseert om duidelijker en gedetailleerder te beschrijven hoe Nederland het beleid in de praktijk uitvoert. Dit is namelijk een van de eisen. Dat betekent bijvoorbeeld beter beschrijven wat nodig is voor een veilig beheer, wie hiervoor verantwoordelijk is, wat dat kost en wie deze kosten betaalt. Ook kan duidelijker worden beschreven hoe deze onderdelen met elkaar samenhangen. De programma’s van Frankrijk en Zweden zijn goede voorbeelden voor het nieuwe programma. Het RIVM heeft in dit onderzoek naar zes landen gekeken: België, Duitsland, Finland, Frankrijk, het Verenigd Koninkrijk en Zweden. Deze landen zijn gekozen omdat ze, net als Nederland, verbruikte splijtstof beheren, en omdat hun programma’s in het Engels zijn geschreven. Het RIVM keek alleen naar de inhoud van de programma’s en niet hoe ze zijn uitgevoerd., Radiation has a wide variety of applications. Among other things, it is converted into energy in nuclear power stations or used to treat cancer patients. These processes may lead to the production of radioactive waste. The Netherlands stores and manages this waste safely to protect both humans and the environment. European Union Member States have a duty to prepare a national programme in which they describe how they manage radioactive waste safely. This programme must describe the national policy and its implementation in accordance with a number of requirements. The first Dutch programme, which dates from 2016, must be updated by 2025. In preparation, the Ministry of Infrastructure and Water Management has asked RIVM to recommend ways to improve the description of the programme. RIVM has recommended a clearer and more detailed description of how the Netherlands implements its policy in practice. This is in line with one of the requirements. Among other things, this should involve a better description of what is needed for safe management, who is responsible, how much it costs and who pays for it. The programme should also describe more clearly how these elements relate to each other. The programmes adopted by France and Sweden are useful examples for the new programme. RIVM considered the programmes of six countries: Belgium, Germany, Finland, France, the United Kingdom and Sweden. These countries were chosen because they manage spent fuel, like the Netherlands does, and because their programmes are written in English. RIVM only looked at the content of the programmes, not at their implementation.

Published
2022

32. Neolithic Human Diet Based on Studies of Coprolites from the Swifterbant Culture Sites, the Netherlands: Synthesis - Human versus community diet

Author

Kubiak-Martens, L. (author), van der Linden, M. (author), Hardy, K. (author), Mackay, H. (author), Ngan-Tillard, D.J.M. (author), Shillito, L.- M. (author), Zeiler, J.T. (author), Kubiak-Martens, L. (author), van der Linden, M. (author), Hardy, K. (author), Mackay, H. (author), Ngan-Tillard, D.J.M. (author), Shillito, L.- M. (author), and Zeiler, J.T. (author)

Abstract

The aim of this final chapter is to integrate the results obtained from the multi-disciplinary study applied to a series of coprolites from the Late Mesolithic and Early Neolithic Swifterbant Culture sites, to determine their role as a source of information about the prehistoric dietary tradition and health. The study of coprolites provides a unique opportunity to reconstruct the most complete spectrum of the foods that were consumed in the past, both as cooked meals as well as foods that were eaten raw. In addition to the food remains, coprolites also contain intestinal parasites which affected the health of prehistoric populations. Coprolite studies can also provide information about palaeoenvironmental conditions through the types of microfossils and macrofossils they contain., Geo-engineering

Published
2022

33. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

Author

Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., Zoet-Nugteren, S. K., Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., and Zoet-Nugteren, S. K.

Abstract

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n= 1545 vs. 15.9%; n= 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P <0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization. [GRAPHICS] .

Published
2022

34. Neolithic Human Diet Based on Studies of Coprolites from the Swifterbant Culture Sites, the Netherlands: Synthesis - Human versus community diet

Author

Kubiak-Martens, L., van der Linden, M., Hardy, K., Mackay, H., Ngan-Tillard, D.J.M., Shillito, L.- M., Zeiler, J.T., Kubiak-Martens, Lucy, and van der Linden, Marjolein

Abstract

The aim of this final chapter is to integrate the results obtained from the multi-disciplinary study applied to a series of coprolites from the Late Mesolithic and Early Neolithic Swifterbant Culture sites, to determine their role as a source of information about the prehistoric dietary tradition and health.The study of coprolites provides a unique opportunity to reconstruct the most complete spectrum of the foods that were consumed in the past, both as cooked meals as well as foods that were eaten raw. In addition to the food remains, coprolites also contain intestinal parasites which affected the health of prehistoric populations. Coprolite studies can also provide information about palaeoenvironmental conditions through the types of microfossils and macrofossils they contain.

Published
2022

41. Nature of cobalt species during the in situ sulfurization of Co(Ni)Mo/Al2O3 hydro­desulfurization catalysts

Author

Al Samarai, M., van Oversteeg, C.H.M., Delgado Jaime, M.U., Weng, Tsu Chien, Sokaras, Dimosthenis, Liu, B., van der Linden, M., van der Eerden, A.M.J., Vogt, E.T.C., Weckhuysen, B.M., de Groot, F.M.F., Sub Inorganic Chemistry and Catalysis, and Inorganic Chemistry and Catalysis

Subjects
Nuclear and High Energy Physics, Materials science, CoMoS structure, chemistry.chemical_element, resonant inelastic X-ray scattering (RIXS), hydro­treating catalysts, 02 engineering and technology, Heterogeneous catalysis, 01 natural sciences, Ion, Catalysis, Instrumentation, X-ray absorption spectroscopy, Radiation, Valence (chemistry), Scattering, 010401 analytical chemistry, 021001 nanoscience & nanotechnology, Research Papers, 0104 chemical sciences, Nickel, heterogeneous catalysis, chemistry, Physical chemistry, 0210 nano-technology, Cobalt, hydro­desulfurization (HDS) catalyst systems
Abstract

From 1s X-ray absorption and 1s3p resonant inelastic X-ray scattering, the valence, coordination and symmetry of cobalt ions were tracked in two cobalt-promoted molybdenum oxide precursors of the hydro­desulfurization catalyst system., The evolution in local structure and electronic properties of cobalt was investigated during in situ sulfurization. Using a combination of 1s X-ray absorption (XAS) and 1s3p resonant inelastic X-ray scattering (RIXS), the valence, coordination and symmetry of cobalt ions were tracked in two cobalt-promoted molybdenum oxide precursors of the hydro­desulfurization catalyst system, namely Co–Mo/Al2O3 and Co–Ni–Mo/Al2O3. Extended X-ray absorption fine structure shows that the Co—O bonds were replaced with Co—S bonds as a function of reaction temperature. The cobalt K pre-edge intensity shows that the symmetry of cobalt was modified from Co3+ O h and Co2+ O h to a Co2+ ion where the inversion symmetry is broken, in agreement with a square-pyramidal site. The 1s3p RIXS data revealed the presence of an intermediate cobalt oxy-sulfide species. This species was not detected from XAS and was determined from the increased information obtained from the 1s3p RIXS data. The cobalt XAS and RIXS data show that nickel has a significant influence on the formation of the cobalt oxy-sulfide intermediate species prior to achieving the fully sulfided state at T > 400°C.

Published
2019

46. A genetic cluster of MDR Enterobacter cloacae complex ST78 harbouring a plasmid containing bla VIM-1 and mcr-9 in the Netherlands

Author

Hendrickx, Antoni P. A., Debast, Sylvia, Pérez-Vázquez, María, Schoffelen, Annelot F., Notermans, Daan W., Landman, Fabian, Wielders, Cornelia C. H., Cañada Garcia, Javier E., Flipse, Jacky, de Haan, Angela, Witteveen, Sandra, van Santen-Verheuvel, Marga, de Greeff, Sabine C., Kuijper, Ed, Schouls, Leo M., Maijer-Reuwer, A., Leversteijn-van Hall, M. A., Kluytmans, J. A. J. W., Spijkerman, I. J. B., van Dijk, K., Halaby, T., Zwart, B., Diederen, B. M. W., Voss, A., Dorigo-Zetsma, J. W., Ott, A., Oudbier, J. H., van der Vusse, M., Vlek, A. L. M., Buiting, A. G. M., Bode, L., Paltansing, S., van Griethuysen, A. J., den Reijer, M., van Trijp, M., van Elzakker, E. P. M., Muller, A. E., van der Linden, M. P. M., van Rijn, M., Wolfhagen, M. J. H. M., Waar, K., Kolwijck, E., Silvis, W., Schulin, T., Damen, M., Dinant, S., van Mens, S. P., Melles, D. C., Cohen Stuart, J. W. T., van Ogtrop, M. L., Overdevest, I. T. M. A., van Dam, A. P., Wertheim, H., Frénay, H. M. E., Sinnige, J. C., Mattsson, E. E., Bosboom, R. W., Stam, A., de Jong, E., Roescher, N., Heikens, E., Steingrover, R., Troelstra, A., Bathoorn, E., Trienekens, T. A. M., van Dam, D. W., de Brauwer, E. I. G. B., Stals, F. S., Government of Netherlands, Medical Microbiology and Infection Prevention, AII - Inflammatory diseases, Elderly care medicine, APH - Aging & Later Life, AII - Infectious diseases, Nursing, APH - Health Behaviors & Chronic Diseases, and Experimental Immunology

Subjects
0301 basic medicine, Carbapenem, biology, Brief Report, 030106 microbiology, Broth microdilution, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Meropenem, Microbiology, 03 medical and health sciences, 030104 developmental biology, Plasmid, AcademicSubjects/MED00290, Colistin, medicine, Multilocus sequence typing, AcademicSubjects/MED00740, AcademicSubjects/MED00230, Enterobacter cloacae, Etest, medicine.drug
Abstract

Background Carbapenemases produced by Enterobacterales are often encoded by genes on transferable plasmids and represent a major healthcare problem, especially if the plasmids contain additional antibiotic resistance genes. As part of Dutch national surveillance, 50 medical microbiological laboratories submit their Enterobacterales isolates suspected of carbapenemase production to the National Institute for Public Health and the Environment for characterization. All isolates for which carbapenemase production is confirmed are subjected to next-generation sequencing. Objectives To study the molecular characteristics of a genetic cluster of Enterobacter cloacae complex isolates collected in Dutch national surveillance in the period 2015–20 in the Netherlands. Methods Short- and long-read genome sequencing was used in combination with MLST and pan-genome MLST (pgMLST) analyses. Automated antimicrobial susceptibility testing (AST), the Etest for meropenem and the broth microdilution test for colistin were performed. The carbapenem inactivation method was used to assess carbapenemase production. Results pgMLST revealed that nine E. cloacae complex isolates from three different hospitals in the Netherlands differed by Conclusions The EclCluster-013 reported here represents an MDR E. cloacae complex ST78 strain containing an IncH12 plasmid carrying both the blaVIM-1 carbapenemase and the mcr-9 colistin resistance gene.

Published
2021
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49. Meet- en bemonsteringsmethoden voor radioactieve materialen

Author

van der Linden, M and Cats, KH

Subjects
RIVM rapport 2021-0121
Abstract

Bij sommige handelingen kunnen materialen overblijven die licht radioactief zijn, bijvoorbeeld bij industriële processen of na behandelingen in ziekenhuizen. Het is dan belangrijk om te weten of de materialen als radioactief afval moeten worden afgevoerd of mogen worden hergebruikt. Daarom moet met metingen worden bepaald of de radioactiviteit niet te hoog is. Soms is het niet mogelijk om het hele materiaal te meten, bijvoorbeeld bij grote voorwerpen, of een grote berg puin. Dan worden daar monsters van genomen. Het RIVM heeft op een rij gezet met welke methode radioactiviteit in materialen kan worden bemonsterd en gemeten. Er staan namelijk geen duidelijke voorschriften voor meten en bemonsteren in de Nederlandse wet- en regelgeving over stralingsbescherming. Ook geldt er sinds 2018 nieuwe, strengere, regelgeving voor radioactiviteit in materialen. Het RIVM heeft dit onderzoek gedaan in opdracht van de Autoriteit Nucleaire Veiligheid en Stralingsbescherming (ANVS). Het RIVM heeft elke methode om radioactief afval te meten of te bemonsteren beschreven en kort samengevat. Daarnaast heeft het een stappenplan gemaakt. Hierin staat waar bij de metingen rekening mee moet worden gehouden om het afval te kunnen vrijgeven voor hergebruik. Ondernemers kunnen het overzicht en het stappenplan gebruiken om hun afval goed te verwerken. Ten slotte blijkt uit het overzicht voor welke situaties nog geen geschikte methode bestaat. Door de strengere wetgeving is vaker andere, meestal dure, laboratoriumapparatuur nodig die lagere hoeveelheden radioactiviteit kan meten. Verder kan het lastig zijn om de radioactiviteit te meten. Bijvoorbeeld als het afval bestaat uit verschillende soorten materialen. Of als de concentraties zo laag zijn dat ze dicht bij het toegestane hoeveelheid liggen.

Published
2021
Full Text
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50. Rapid SARS-CoV-2 whole-genome sequencing and analysis for informed public health decision-making in the Netherlands

Author

Oude Munnink, Bas B., Nieuwenhuijse, David F., Stein, Mart, O’Toole, Áine, Haverkate, Manon, Mollers, Madelief, Kamga, Sandra K., Schapendonk, Claudia, Pronk, Mark, Lexmond, Pascal, van der Linden, Anne, Bestebroer, Theo, Chestakova, Irina, Overmars, Ronald J., van Nieuwkoop, Stefan, Molenkamp, Richard, van der Eijk, Annemiek A., GeurtsvanKessel, Corine, Vennema, Harry, Meijer, Adam, Rambaut, Andrew, van Dissel, Jaap, Sikkema, Reina S., Timen, Aura, Koopmans, Marion, Oudehuis, G. J. A. P. M., Schinkel, Janke, Kluytmans, Jan, Kluytmans-van den Bergh, Marjolein, van den Bijllaardt, Wouter, Berntvelsen, Robbert G., van Rijen, Miranda M. L., Schneeberger, Peter, Pas, Suzan, Diederen, Bram M., Bergmans, Anneke M. C., van der Eijk, P. A. Verspui, Verweij, Jaco J., Buiting, Anton G. N., Streefkerk, Roel, Aldenkamp, A. P., de Man, P., Koelemal, J. G. M., Ong, D., Paltansing, S., Veassen, N., Sleven, Jacqueline, Bakker, Leendert, Brockhoff, Heinrich, Rietveld, Ariene, Slijkerman Megelink, Fred, Cohen Stuart, James, de Vries, Anne, van der Reijden, Wil, Ros, A., Lodder, Esther, Verspui-van der Eijk, Ellen, Huijskens, Inge, Kraan, E. M., van der Linden, M. P. M., Debast, S. B., Naiemi, N. Al, Kroes, A. C. M., Damen, Marjolein, Dinant, Sander, Lekkerkerk, Sybren, Pontesilli, Oscar, Smit, Pieter, van Tienen, Carla, Godschalk, P. C. R., van Pelt, Jorien, Ott, Alewijn, van der Weijden, Charlie, Wertheim, Heiman, Rahamat-Langendoen, Janette, Reimerink, Johan, Bodewes, Rogier, Duizer, Erwin, van der Veer, Bas, Reusken, Chantal, Lutgens, Suzanne, Hermans, Mirjam, Wever, P., Leenders, A., ter Waarbeek, Henriette, Hoebe, Christian, Medical Microbiology and Infection Prevention, AII - Infectious diseases, Virology, RS: CAPHRI - R4 - Health Inequities and Societal Participation, and Med Microbiol, Infect Dis & Infect Prev

Subjects
0301 basic medicine, medicine.medical_specialty, Molecular biology, Clinical Decision-Making, Pneumonia, Viral, Genome, Viral, medicine.disease_cause, Disease cluster, General Biochemistry, Genetics and Molecular Biology, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Environmental health, Pandemic, Epidemiology, medicine, Humans, Author Correction, Pandemics, Netherlands, Coronavirus, Respiratory tract diseases, Whole Genome Sequencing, biology, SARS-CoV-2, Transmission (medicine), Public health, COVID-19, Outbreak, Genomics, General Medicine, biology.organism_classification, 3. Good health, 030104 developmental biology, Geography, ZIKA, 030220 oncology & carcinogenesis, VIRUS, Public Health, Coronavirus Infections
Abstract

In late December 2019, a cluster of cases of pneumonia of unknown etiology were reported linked to a market in Wuhan, China1. The causative agent was identified as the speciesSevere acute respiratory syndrome-related coronavirusand was named SARS-CoV-2 (ref. 2). By 16 April the virus had spread to 185 different countries, infected over 2,000,000 people and resulted in over 130,000 deaths3. In the Netherlands, the first case of SARS-CoV-2 was notified on 27 February. The outbreak started with several different introductory events from Italy, Austria, Germany and France followed by local amplification in, and later also outside, the south of the Netherlands. The combination of near to real-time whole-genome sequence analysis and epidemiology resulted in reliable assessments of the extent of SARS-CoV-2 transmission in the community, facilitating early decision-making to control local transmission of SARS-CoV-2 in the Netherlands. We demonstrate how these data were generated and analyzed, and how SARS-CoV-2 whole-genome sequencing, in combination with epidemiological data, was used to inform public health decision-making in the Netherlands. Metastava project.

Published
2020

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