31 results on '"E Klaver"'
Search Results
2. The SpaTemp cohort: 168 nondysplastic Barrett's esophagus surveillance patients with and without progression to early neoplasia to evaluate the distribution of biomarkers over space and time
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K Konté, R.C. Mallant-Hent, J J Bergman, B.E. Schenk, C A Seldenrijk, E Klaver, L C Duits, G J A Offerhaus, R E Pouw, N F Frei, Mike Visser, Sybren L. Meijer, B. L. A. M. Weusten, F. J. W. Ten Kate, EJ Schoon, Gastroenterology and Hepatology, Graduate School, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, Pathology, Neurology, Amsterdam Neuroscience - Neurovascular Disorders, and Gastroenterology and hepatology
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medicine.medical_specialty ,Risk Stratification ,Esophageal Neoplasms ,Esophageal adenocarcinoma ,Adenocarcinoma ,Temporal ,Barrett Esophagus ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Spatial ,Esophageal Adenocarcinoma ,Temporal information ,business.industry ,Infant, Newborn ,Gastroenterology ,Mean age ,General Medicine ,Biomarker ,medicine.disease ,Barrett's Esophagus ,Dysplasia ,030220 oncology & carcinogenesis ,Barrett's esophagus ,Cohort ,Disease Progression ,Biomarker (medicine) ,030211 gastroenterology & hepatology ,Malignant progression ,business ,Biomarkers - Abstract
Summary The ReBus cohort is a matched nested case–control cohort of patients with nondysplastic (ND) Barrett’s esophagus (BE) at baseline who progressed (progressors) or did not progress (nonprogressors) to high-grade dysplasia (HGD) or cancer. This cohort is constructed using the most stringent inclusion criteria to optimize explorative studies on biomarkers predicting malignant progression in NDBE. These explorative studies may benefit from expanding the number of cases and by incorporating samples that allow assessment of the biomarker over space (spatial variability) and over time (temporal variability). To (i) update the ReBus cohort by identifying new progressors and (ii) identify progressors and nonprogressors within the updated ReBus cohort containing spatial and temporal information. The ReBus cohort was updated by identifying Barrett’s patients referred for endoscopic work-up of neoplasia at 4 tertiary referral centers. Progressors and nonprogressors with a multilevel (spatial) endoscopy and additional prior (temporal) endoscopies were identified to evaluate biomarkers over space and over time. The original ReBus cohort consisted of 165 progressors and 723 nonprogressors. We identified 65 new progressors meeting the same strict selection criteria, resulting in a total number of 230 progressors and 723 matched nonprogressors in the updated ReBus cohort. Within the updated cohort, 61 progressors and 107 nonprogressors (mean age 61 ± 10 years) with a spatial endoscopy (median level 3 [2–4]) were identified. 33/61 progressors and 50/107 nonprogressors had a median of 3 (2–4) additional temporal endoscopies. Our updated ReBus cohort consists of 230 progressors and 723 matched nonprogressors using the most strict selection criteria. In a subgroup of 168 Barrett’s patients (the SpaTemp cohort), multiple levels have been sampled at baseline and during follow-up providing a unique platform to study spatial and temporal distribution of biomarkers in BE.
- Published
- 2021
3. Research Data for Adherence to pre-set benchmark quality criteria to qualify as expert assessor of dysplasia in Barrett’s esophagus biopsies – towards digital review of Barrett’s esophagus
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MJ Van Der Wel, E Klaver, LC Duits, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW Ten Kate, K Biermann, LAA Brosens, M Doukas, C Huysentruyt, A Karrenbeld, G Kats-Ugurlu, JS Van Der Laan, G Van Lijnschoten, FCP Moll, AHAG Ooms, JG Tijssen, JJGHM Bergman, and SL Meijer
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FOS: Clinical medicine ,FOS: Biological sciences ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,110308 Geriatrics and Gerontology ,69999 Biological Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Research Data for Adherence to pre-set benchmark quality criteria to qualify as expert assessor of dysplasia in Barrett’s esophagus biopsies – towards digital review of Barrett’s esophagus by MJ van der Wel, E Klaver, LC Duits, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW ten Kate, K Biermann, LAA Brosens, M Doukas, C Huysentruyt, A Karrenbeld, G Kats-Ugurlu, JS van der Laan, G van Lijnschoten, FCP Moll, AHAG Ooms, JG Tijssen, JJGHM Bergman and SL Meijer in United European Gastroenterology Journal
- Published
- 2019
- Full Text
- View/download PDF
4. Supplemental material for Adherence to pre-set benchmark quality criteria to qualify as expert assessor of dysplasia in Barrett’s esophagus biopsies – towards digital review of Barrett’s esophagus
- Author
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MJ Van Der Wel, E Klaver, LC Duits, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW Ten Kate, K Biermann, LAA Brosens, M Doukas, C Huysentruyt, A Karrenbeld, G Kats-Ugurlu, JS Van Der Laan, G Van Lijnschoten, FCP Moll, AHAG Ooms, JG Tijssen, JJGHM Bergman, and SL Meijer
- Subjects
FOS: Clinical medicine ,FOS: Biological sciences ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,110308 Geriatrics and Gerontology ,69999 Biological Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental Material for Adherence to pre-set benchmark quality criteria to qualify as expert assessor of dysplasia in Barrett’s esophagus biopsies – towards digital review of Barrett’s esophagus by MJ van der Wel, E Klaver, LC Duits, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW ten Kate, K Biermann, LAA Brosens, M Doukas, C Huysentruyt, A Karrenbeld, G Kats-Ugurlu, JS van der Laan, G van Lijnschoten, FCP Moll, AHAG Ooms, JG Tijssen, JJGHM Bergman and SL Meijer in United European Gastroenterology Journal
- Published
- 2019
- Full Text
- View/download PDF
5. Supplementary Table 2 -Supplemental material for Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases
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MJ Van Der Wel, LC Duits, E Klaver, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW Ten Kate, JG Tijssen, JJGHM Bergman, and SL Meijer
- Subjects
FOS: Clinical medicine ,FOS: Biological sciences ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,110308 Geriatrics and Gerontology ,69999 Biological Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental material, Supplementary Table 2 for Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases by MJ van der Wel, LC Duits, E Klaver, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW ten Kate, JG Tijssen, JJGHM Bergman and SL Meijer in United European Gastroenterology Journal
- Published
- 2018
- Full Text
- View/download PDF
6. Supplementary Table 1 -Supplemental material for Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases
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MJ Van Der Wel, LC Duits, E Klaver, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW Ten Kate, JG Tijssen, JJGHM Bergman, and SL Meijer
- Subjects
FOS: Clinical medicine ,FOS: Biological sciences ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,110308 Geriatrics and Gerontology ,69999 Biological Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental material, Supplementary Table 1 for Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases by MJ van der Wel, LC Duits, E Klaver, RE Pouw, CA Seldenrijk, GJA Offerhaus, M Visser, FJW ten Kate, JG Tijssen, JJGHM Bergman and SL Meijer in United European Gastroenterology Journal
- Published
- 2018
- Full Text
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7. Late Breaking Poster Session Group III - Green LB TPS 2
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B. Skidmore, T. van der Molen, E. Klaver, Thecla M. Brakel, J. L. van der Velde, Marielouise Schuttelaar, M. Wubs, J.N.G. Oude Elbrink, Anthony E.J. Dubois, and B. M. J. Flokstra-de Blok
- Subjects
medicine.medical_specialty ,Clinical immunology ,business.industry ,Immunology ,Intervention group ,Primary care ,Test (assessment) ,Usual care ,Physical therapy ,Immunology and Allergy ,Medicine ,Management support ,Medical diagnosis ,business - Abstract
Background: Diagnosis and management of allergic patients are often performed exclusively by general practitioners (GPs). Because of the increasing prevalence of allergic diseases and because of the limited knowledge of GPs on allergy, an allergy management support system (AMSS) was developed. The aim of this study was to test the feasibility of an AMSS for primary care in a pilot study. Method: Using a randomized controlled design, GPs in the intervention group received AMSS advice in addition to sIgE test results and GPs in the control group performed usual care based on sIgE test results only. The AMSS advice was based on the AMSS history questionnaire completed by patients and sIgE test results. The AMSS advice included probable diagnoses and recommendations for management. AMSS advice was also formulated for patients in the control group for evaluative purposes only. Patients were included by GPs when ordering an sIgE test. GPs in both groups completed a short questionnaire on diagnosis and management at the time of inclusion (T1) and after sIgE test outcomes were known (T2). A total agreement score between GP and AMSS was calculated as the number of concordant diagnoses minus the number of false negative and false positive diagnoses. The AMSS was considered feasible when >70% of the AMSS advice was sent to the GP within 10 workdays of sIgE testing. Results: Of the 75 GPs that agreed to participate, 27 GPs (37%) included one or more patients in the study. Together they included 101 patients of which 66 (67%) completed the AMSS history questionnaire. The majority of the AMSS advice (93%) was sent back to the GP within 10 workdays after sIgE test results were known (mean (SD) 4.7 (4.0) workdays). GPs in the intervention group reported that the AMSS advice was complete and to-the-point in 80% of cases, agreed for the most part with the AMSS advice in 80% of cases and followed the AMSS advice for the most part in 71% of cases. The difference in total agreement scores on diagnosis (T2 minus T1), was significantly higher in the intervention group than in the control group (mean (SD) 0.9 (1.8); -0.8 (1.0); P
- Published
- 2015
8. Encapsulating distribution by remote objects
- Author
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E. Klaver, M. van Steen, M. Jansen, Patrick Verkaik, Andrew S. Tanenbaum, Computer Systems, Distributed Computer Systems, and Secure and Liable Computer Systems
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Middleware ,Flexibility (engineering) ,Mobile objects ,Computer science ,Distributed computing ,Scale (chemistry) ,Distributed object ,computer.software_genre ,Object (computer science) ,Computer Science Applications ,Distribution encapsulation ,Application areas ,Common Object Request Broker Architecture ,Middleware (distributed applications) ,Scalability ,Distributed objects ,SDG 14 - Life Below Water ,computer ,Software ,Information Systems - Abstract
Middleware for modern office environments and many other application areas needs to provide support for a myriad of different, highly mobile objects. At the same time, it should be able to scale to vast numbers of objects that may possibly be dispersed over a large wide-area network. The combination of flexibility and scalability requires support for object-specific solutions that is hardly addressed by current object-based systems such as CORBA. We have developed a middleware solution that seamlessly integrates traditional remote objects with physically distributed objects that can fully encapsulate their own distribution strategy. We describe how this integration takes place, and how it can be applied to existing systems such as CORBA. © 2001 Elsevier Science B.V.
- Published
- 2001
9. [A painful little finger after minor trauma]
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André R E, Klaver and Anand G, Menon
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Finger Phalanges ,Fractures, Cartilage ,Young Adult ,Treatment Outcome ,Splints ,Humans ,Female ,Chondroma - Abstract
A 23-year old woman visited the Emergency Room with a pathological fracture of her left fifth finger due to an enchondroma.
- Published
- 2009
10. [Studies on the hyperventilation syndrome. III. Pathophysiology]
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J D, Fortuyn, W, Groeneveld, E, Klaver-Król, H, Leenstra-Borsje, and A W, Teelken
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Tetany ,Neural Conduction ,Humans ,Hyperventilation ,Calcium ,Magnesium ,Carbon Dioxide - Published
- 1976
11. [Studies on the hyperventilation syndrome. II. Findings in patients on certain respiratory regulation mechanisms, muscular function and various blood electrolytes]
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P, Barkmeyer-Degenhart, J, Brandenburg, J D, Fortuyn, G W, van Floresteyn, W, Groeneveld, W, Kalkman-van de Lint, E, Klaver-Krol, H, Leenstra-Borsje, R, Peset, A W, Teelken, and M, Wiers-Mosman
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Muscles ,Physical Exertion ,Action Potentials ,Carbon Dioxide ,Electric Stimulation ,Phosphates ,Respiratory Function Tests ,Lactates ,Humans ,Hyperventilation ,Calcium ,Magnesium ,Fatigue ,Work of Breathing - Published
- 1976
12. Elevated insomnia symptom severity in university students: The role of sexual orientation and internalizing symptoms.
- Author
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Christensen KA, Seager van Dyk I, and Klaver E
- Abstract
Objectives: Sexual minority (SM) individuals experience a disproportionate health burden relative to their heterosexual peers; however, less is known about their experience of insomnia. Participants: The sample consisted of a subset of students, N = 1543, M
age = 21.25 years, SD = 3.95, in the 2019-2020 Healthy Minds Study. Adjusting for non-response weights, approximately 16.95% of the sample identified as a sexual minority. Methods: Participants completed measures of insomnia (Insomnia Severity Index) and psychopathology symptoms (PHQ-9 for depression and GAD-7 for generalized anxiety). Results: Sexual orientation was significantly positively associated with insomnia severity, such that SM students exhibited higher insomnia symptom severity, B = 1.71, SE = 0.35, p < .001, 95% CI [1.01, 2.40]. Including depression and anxiety symptom severity in the model completely attenuated this effect. Conclusions: Insomnia symptoms in SM students may be understood in the context of internalizing symptoms; however, study design precluded examining causal pathways.- Published
- 2023
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13. Key stakeholders' experiences and expectations of the care system for individuals affected by borderline personality disorder: An interpretative phenomenological analysis towards co-production of care.
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Friesen L, Gaine G, Klaver E, Burback L, and Agyapong V
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- Caregivers, Humans, Motivation, Borderline Personality Disorder psychology
- Abstract
Background: The diagnosis of borderline personality disorder (BPD) consists of extreme emotional dysregulation and long-term disability when left untreated. It is associated with ineffective use of health care systems and mismanaged care in emergency departments, which can result in a revolving door phenomenon of urgent system usage, poor treatment outcomes, or patients falling out of care entirely-all of which primarily affect patients with BPD as well as their caregivers and clinicians. This crisis must be addressed with a comprehensive understanding of key stakeholder perspectives on the challenges of the system and potential solutions., Objective: This study explored the perspectives of three key stakeholder groups (i.e., patients, clinicians, and caregivers) in relation to their experiences with and future expectations of the care system for those affected by BPD., Methods: Four patients with BPD, three generalist clinicians with experience treating BPD, and three caregivers of individuals with BPD participated in individual semi-structured interviews. Participants were asked about their experiences with the current healthcare system and their suggestions for improvement. Responses were analyzed using interpretative phenomenological analysis., Findings: In-depth analysis of the qualitative data revealed twelve shared themes and three themes that were unique to each key stakeholder group. These themes are discussed and used to inform recommendations for promising practices, policies, and training in this area., Conclusion: Findings support the importance of a comprehensive mental health system approach for improving the accessibility, effectiveness, and acceptability of the management and treatment of BPD., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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14. The Gray Area of Freezing of Gait Annotation: A Guideline and Open-Source Practical Tool.
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Cockx H, Klaver E, Tjepkema-Cloostermans M, van Wezel R, and Nonnekes J
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Background: Freezing of gait, a disabling episodic symptom, is difficult to assess as the exact begin- and endpoint of an episode is not easy to specify. This hampers scientific and clinical progress. The current golden standard is video annotation by two independent raters. However, the comparison of the two ratings gives rise to non-overlapping, gray areas., Objective: To provide a guideline for dealing with these gray areas., Methods/results: We propose a standardized procedure for handling the gray areas based on two parameters, the tolerance and correction parameter. Furthermore, we recommend the use of positive agreement, negative agreement, and prevalence index to report interrater agreement instead of the commonly used intraclass correlation coefficient or Cohen's kappa. This theoretical guideline was implemented in an open-source practical tool, FOGtool (https://github.com/helenacockx/FOGtool)., Conclusion: This paper aims to contribute to the standardization of freezing of gait assessment, thereby improving data sharing procedures and replicability of study results ., Competing Interests: This work was supported by the Operational Program European Regional Development Fund (OP ERDF) of the European Union under the “PROMPT” project (PROJ‐00872) and the “Nederlandse Organisatie voor Wetenschappelijk Onderzoek–Toegepaste en Technische wetenschappen” (NWO‐TTW) Crossover program under the Innovative NeuroTechnology for Society (INTENSE) project. The authors declare that they have no competing interests concerning the research related to this manuscript., (© 2022 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)
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- 2022
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15. Significant variation in histopathological assessment of endoscopic resections for Barrett's neoplasia suggests need for consensus reporting: propositions for improvement.
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van der Wel MJ, Klaver E, Pouw RE, Brosens LAA, Biermann K, Doukas M, Huysentruyt C, Karrenbeld A, Ten Kate FJW, Kats-Ugurlu G, van der Laan J, van Lijnschoten I, Moll FCP, Offerhaus GJA, Ooms AHAG, Seldenrijk CA, Visser M, Tijssen JG, Meijer SL, and Bergman JJGHM
- Subjects
- Consensus, Esophagoscopy, Humans, Adenocarcinoma, Barrett Esophagus surgery, Esophageal Neoplasms surgery
- Abstract
Endoscopic resection (ER) is an important diagnostic step in management of patients with early Barrett's esophagus (BE) neoplasia. Based on ER specimens, an accurate histological diagnosis can be made, which guides further treatment. Based on depth of tumor invasion, differentiation grade, lymphovascular invasion, and margin status, the risk of lymph node metastases and local recurrence is judged to be low enough to justify endoscopic management, or high enough to warrant invasive surgical esophagectomy. Adequate assessment of these histological risk factors is therefore of the utmost importance. Aim of this study was to assess pathologist concordance on these histological features on ER specimens and evaluate causes of discrepancy. Of 62 challenging ER cases, one representative H&E slide and matching desmin and endothelial marker were digitalized and independently assessed by 13 dedicated GI pathologists from 8 Dutch BE expert centers, using an online assessment module. For each histological feature, concordance and discordance were calculated. Clinically relevant discordances were observed for all criteria. Grouping depth of invasion categories according to expanded endoscopic treatment criteria (T1a and T1sm1 vs. T1sm2/3), ≥1 pathologist was discrepant in 21% of cases, increasing to 45% when grouping diagnoses according to the traditional T1a versus T1b classification. For differentiation grade, lymphovascular invasion, and margin status, discordances were substantial with 27%, 42%, and 32% of cases having ≥1 discrepant pathologist, respectively. In conclusion, histological assessment of ER specimens of early BE cancer by dedicated GI pathologists shows significant discordances for all relevant histological features. We present propositions to improve definitions of diagnostic criteria., (© The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2021
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16. Barrett's esophagus surveillance in a prospective Dutch multi-center community-based cohort of 985 patients demonstrates low risk of neoplastic progression.
- Author
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Klaver E, Bureo Gonzalez A, Mostafavi N, Mallant-Hent R, Duits LC, Baak B, Böhmer CJM, van Oijen AHAM, Naber T, Scholten P, Meijer SL, Bergman JJGHM, and Pouw RE
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Netherlands epidemiology, Population Surveillance, Precancerous Conditions pathology, Proportional Hazards Models, Prospective Studies, Registries, Risk Assessment, Risk Factors, Adenocarcinoma epidemiology, Adenocarcinoma pathology, Barrett Esophagus pathology, Disease Progression, Esophageal Neoplasms epidemiology, Esophageal Neoplasms pathology
- Abstract
Background and Aims: Barrett's esophagus (BE) is accompanied by an increased risk of developing esophageal cancer. Accurate risk-stratification is warranted to improve endoscopic surveillance. Most data available on risk factors is derived from tertiary care centers or from cohorts with limited surveillance time or surveillance quality. The aim of this study was to assess endoscopic and clinical risk factors for progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in a large prospective cohort of BE patients from community hospitals supported by an overarching infrastructure to ensure optimal surveillance quality., Methods: A well-defined prospective multicenter cohort study was initiated in six community hospitals in the Amsterdam region in 2003. BE patients were identified by PALGA search and included in a prospective surveillance program with a single endoscopist performing all endoscopies at each hospital. Planning and data collection was performed by experienced research nurses who attended all endoscopies. Endpoint was progression to HGD/EAC., Results: Nine hundred eighty-five patients were included for analysis. During median follow-up of 7.9 years (IQR 4.1-12.5) 67 patients were diagnosed with HGD (n = 28) or EAC (n = 39), progression rate 0.78% per patient-year. As a clinical risk factor age at time of endoscopy was associated with neoplastic progression (HR 1.05; 95% CI 1.03-1.08). Maximum Barrett length and low-grade dysplasia (LGD) at baseline were endoscopic predictors of progression (HR 1.15; 95% CI 1.09-1.21 and HR 2.36; 95% CI 1.29-4.33)., Conclusion: Risk of progression to HGD/EAC in a large, prospective, community-based Barrett's cohort was low. Barrett's length, LGD and age were important risk factors for progression. (www.trialregister.nl NTR1789)., (© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.)
- Published
- 2021
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17. The SpaTemp cohort: 168 nondysplastic Barrett's esophagus surveillance patients with and without progression to early neoplasia to evaluate the distribution of biomarkers over space and time.
- Author
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Frei NF, Konté K, Duits LC, Klaver E, Ten Kate FJ, Offerhaus GJ, Meijer SL, Visser M, Seldenrijk CA, Schoon EJ, Weusten BLAM, Schenk BE, Mallant-Hent RC, Bergman JJ, and Pouw RE
- Subjects
- Biomarkers, Disease Progression, Humans, Infant, Newborn, Adenocarcinoma, Barrett Esophagus, Esophageal Neoplasms diagnosis
- Abstract
The ReBus cohort is a matched nested case-control cohort of patients with nondysplastic (ND) Barrett's esophagus (BE) at baseline who progressed (progressors) or did not progress (nonprogressors) to high-grade dysplasia (HGD) or cancer. This cohort is constructed using the most stringent inclusion criteria to optimize explorative studies on biomarkers predicting malignant progression in NDBE. These explorative studies may benefit from expanding the number of cases and by incorporating samples that allow assessment of the biomarker over space (spatial variability) and over time (temporal variability). To (i) update the ReBus cohort by identifying new progressors and (ii) identify progressors and nonprogressors within the updated ReBus cohort containing spatial and temporal information. The ReBus cohort was updated by identifying Barrett's patients referred for endoscopic work-up of neoplasia at 4 tertiary referral centers. Progressors and nonprogressors with a multilevel (spatial) endoscopy and additional prior (temporal) endoscopies were identified to evaluate biomarkers over space and over time. The original ReBus cohort consisted of 165 progressors and 723 nonprogressors. We identified 65 new progressors meeting the same strict selection criteria, resulting in a total number of 230 progressors and 723 matched nonprogressors in the updated ReBus cohort. Within the updated cohort, 61 progressors and 107 nonprogressors (mean age 61 ± 10 years) with a spatial endoscopy (median level 3 [2-4]) were identified. 33/61 progressors and 50/107 nonprogressors had a median of 3 (2-4) additional temporal endoscopies. Our updated ReBus cohort consists of 230 progressors and 723 matched nonprogressors using the most strict selection criteria. In a subgroup of 168 Barrett's patients (the SpaTemp cohort), multiple levels have been sampled at baseline and during follow-up providing a unique platform to study spatial and temporal distribution of biomarkers in BE., (© The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
18. Performance of gastrointestinal pathologists within a national digital review panel for Barrett's oesophagus in the Netherlands: results of 80 prospective biopsy reviews.
- Author
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Klaver E, van der Wel M, Duits L, Pouw R, Seldenrijk K, Offerhaus J, Visser M, Ten Kate F, Biermann K, Brosens L, Doukas M, Huysentruyt C, Karrenbeld A, Kats-Ugurlu G, van der Laan J, van Lijnschoten I, Moll F, Ooms A, Tijssen J, Meijer S, and Bergman J
- Subjects
- Aged, Benchmarking, Biopsy, Esophagus pathology, Female, Gastrointestinal Tract pathology, Humans, Male, Middle Aged, Netherlands, Observer Variation, Prospective Studies, Barrett Esophagus pathology, Pathologists
- Abstract
Aims: The histopathological diagnosis of low-grade dysplasia (LGD) in Barrett's oesophagus (BO) is associated with poor interobserver agreement and guidelines dictate expert review. To facilitate nationwide expert review in the Netherlands, a web-based digital review panel has been set up, which currently consists of eight 'core' pathologists. The aim of this study was to evaluate if other pathologists from the Dutch BO expert centres qualify for the expert panel by assessing their performance in 80 consecutive LGD reviews submitted to the panel., Methods: Pathologists independently assessed digital slides in two phases. Both phases consisted of 40 cases, with a group discussion after phase I. For all cases, a previous consensus diagnosis made by five core pathologists was available, which was used as reference. The following criteria were used: (1) percentage of 'indefinite for dysplasia' diagnoses, (2) percentage agreement with consensus diagnosis and (3) proportion of cases with a consensus diagnosis of dysplasia underdiagnosed as non-dysplastic. Benchmarks were based on scores of the core pathologists., Results: After phase I, 1/7 pathologists met the benchmark score for all quality criteria, yet three pathologists only marginally failed the agreement with consensus diagnosis (score 68.3%, benchmark 69%). After a group discussion and phase II, 5/6 remaining aspirant panel members qualified with all scores within the benchmark range., Conclusions: The Dutch BO review panel now consists of 14 pathologists, who-after structured assessments and group discussions-can be considered homogeneous in their review of biopsies with LGD., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2021
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19. Radiofrequency ablation for low-grade dysplasia in Barrett's esophagus: long-term outcome of a randomized trial.
- Author
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Pouw RE, Klaver E, Phoa KN, van Vilsteren FG, Weusten BL, Bisschops R, Schoon EJ, Pech O, Manner H, Ragunath K, Fernández-Sordo JO, Fullarton G, Di Pietro M, Januszewicz W, O'Toole D, and Bergman JJ
- Subjects
- Disease Progression, Esophageal Neoplasms surgery, Follow-Up Studies, Humans, Precancerous Conditions surgery, Radiofrequency Ablation, Retrospective Studies, Treatment Outcome, Barrett Esophagus surgery, Catheter Ablation
- Abstract
Background and Aims: A prior randomized study (Surveillance versus Radiofrequency Ablation study [SURF study]) demonstrated that radiofrequency ablation (RFA) of Barrett's esophagus (BE) with confirmed low-grade dysplasia (LGD) significantly reduces the risk of esophageal adenocarcinoma. Our aim was to report the long-term outcomes of this study., Methods: The SURF study randomized BE patients with confirmed LGD to RFA or surveillance. For this retrospective cohort study, all endoscopic and histologic data acquired at the end of the SURF study in May 2013 until December 2017 were collected. The primary outcome was rate of progression to high-grade dysplasia (HGD)/cancer. All 136 patients randomized to RFA (n = 68) or surveillance (n = 68) in the SURF study were included. After closure of the SURF study, 15 surveillance patients underwent RFA based on patient preference and study outcomes., Results: With 40 additional months (interquartile range, 12-51), the total median follow-up from randomization to last endoscopy was 73 months (interquartile range, 46-85). HGD/cancer was diagnosed in 1 patient in the RFA group (1.5%) and in 23 in the surveillance group (33.8%) (P = .000), resulting in an absolute risk reduction of 32.4% (95% confidence interval [CI], 22.4%-44.2%) with a number needed to treat of 3.1 (95% CI, 2.3-4.5). Seventy-five of 83 patients (90%; 95% CI, 82.1%-95.0%) treated with RFA for BE reached complete clearance of BE and dysplasia. BE recurred in 7 of 75 patients (9%; 95% CI, 4.6%-18.0%), mostly minute islands or tongues, and LGD in 3 of 75 (4%; 95% CI, 1.4%-11.1%)., Conclusions: RFA of BE with confirmed LGD significantly reduces the risk of malignant progression, with sustained clearance of BE in 91% and LGD in 96% of patients, after a median follow-up of 73 months. (Clinical trial registration number: NTR1198.)., (Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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20. Bridging the Gap in Community Care for Patients With Borderline Personality Disorder: Protocol for Qualitative Inquiry Into Patient, Caregiver, and Clinician Perspectives on Service Gaps and Potential Solutions for Severe Emotion Dysregulation.
- Author
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Friesen L, Gaine G, Klaver E, Klingle K, Parmar D, Hrabok M, Kelland J, Surood S, and Agyapong V
- Abstract
Background: Borderline personality disorder (BPD) is characterized by severe emotion dysregulation that is often complicated by comorbid diagnoses, deliberate self-harm, and chronic suicidal ideation. Unfortunately, current care pathways for individuals with BPD are strained by limited resources, inadequate training, and an overuse of emergency departments and crisis teams. Such barriers result in delayed access to effective treatment, which increases risk of deterioration, disability, and morbidity. A first step toward addressing these limitations of the current care pathway is to understand key stakeholders' lived experiences in this pathway and their perspectives on potential solutions., Objective: The purpose of this paper is to present a protocol for a study that explores the lived experiences of the current care pathway from the perspectives of patients with BPD, as well as their caregivers and clinicians., Methods: A qualitative approach is most appropriate for the exploratory nature of the research objective. Accordingly, 3 to 6 patients with a diagnosis of BPD, 3 caregivers of individuals with BPD, and 3 clinicians of patients diagnosed with BPD will be invited to participate in individual, semistructured interviews that focus on service experiences., Results: It is anticipated that results will yield insight into the lived experiences of patients with BPD, caregivers, and clinicians and provide a better understanding of the perceived gaps in services and potential solutions. Results are expected to be available in 12 months., Conclusions: This paper describes a protocol for a qualitative study that seeks to understand the lived experiences and perspectives of key stakeholders (patients, caregivers, and clinicians) on the current care pathway for BPD. Results will provide a basis for future research in this area and will have the potential to inform training, practice, and policy., International Registered Report Identifier (irrid): DERR1-10.2196/14885., (©Laura Friesen, Graham Gaine, Ellen Klaver, Kirsten Klingle, Devashree Parmar, Marianne Hrabok, Jill Kelland, Shireen Surood, Vincent Agyapong. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.08.2020.)
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- 2020
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21. The Amsterdam ReBus progressor cohort: identification of 165 Barrett's surveillance patients who progressed to early neoplasia and 723 nonprogressor patients.
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Duits LC, Klaver E, Bureo Gonzalez A, Boerwinkel DF, Ten Kate FJW, Offerhaus GJA, Meijer SL, Visser M, Seldenrijk CA, Krishnadath KK, Schoon EJ, Weusten BLAM, Mallant-Hent RC, Pouw RE, and Bergman JJGHM
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma metabolism, Adult, Aged, Barrett Esophagus diagnosis, Barrett Esophagus metabolism, Case-Control Studies, Disease Progression, Esophageal Neoplasms diagnosis, Esophageal Neoplasms metabolism, Esophagoscopy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Precancerous Conditions diagnosis, Precancerous Conditions metabolism, Retrospective Studies, Adenocarcinoma pathology, Barrett Esophagus pathology, Biomarkers, Tumor metabolism, Esophageal Neoplasms pathology, Precancerous Conditions pathology
- Abstract
Patient selection is suboptimal in most studies focused on identifying biological markers for neoplastic progression in Barrett's esophagus (BE). This study aims to describe a stringently selected community-based case-control cohort of non-dysplastic BE (NDBE) patients who progressed to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) and BE patients who never progressed to be used for future biomarker studies. We identified all patients referred for endoscopic work-up of BE neoplasia at three tertiary referral centers for treatment of BE neoplasia between 2000 and 2013. We performed a detailed registration of any endoscopic surveillance history before neoplastic progression. Controls were selected from a retrospective BE surveillance registration in 10 community hospitals. A total of 887 patients were referred for endoscopic work-up of BE neoplasia. Based on predefined selection criteria, we identified 165 progressor patients (82% men; mean age 55 years ± 10.4) with a baseline endoscopy demonstrating NDBE > 2 years before neoplastic progression. Using the same predefined selection criteria, 723 nonprogressor patients (67% men; mean age 57 years ± 11.3) with >2 years of endoscopic surveillance were identified. Median length of the BE segment was 5 cm (IQR 4-7) in progressors and 4 cm (IQR 2-6) in controls. Median duration of surveillance was 89 months (IQR 54-139) in progressors and 76 months (IQR 47-116) in nonprogressors. Paraffin embedded biopsies are available for biomarker research in all patients. Ethical approval was obtained and material transfer agreements were signed with all 58 contributing pathology labs. This is the largest community-based case-control cohort of BE patients with and without progression to early neoplasia. The stringent selection criteria and the availability of paraffin embedded biopsy specimens make this a unique cohort for biomarker studies., (© The Author(s) 2018. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2019
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22. Adherence to pre-set benchmark quality criteria to qualify as expert assessor of dysplasia in Barrett's esophagus biopsies - towards digital review of Barrett's esophagus.
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van der Wel MJ, Klaver E, Duits LC, Pouw RE, Seldenrijk CA, Offerhaus G, Visser M, Ten Kate F, Biermann K, Brosens L, Doukas M, Huysentruyt C, Karrenbeld A, Kats-Ugurlu G, van der Laan JS, van Lijnschoten G, Moll F, Ooms A, Tijssen JG, Bergman J, and Meijer SL
- Subjects
- Barrett Esophagus diagnosis, Biopsy, Cell Transformation, Neoplastic, Guideline Adherence, Humans, Internet, Microscopy methods, Netherlands, Observer Variation, Risk Factors, Barrett Esophagus pathology, Benchmarking, Esophagus pathology, Pathologists standards
- Abstract
Background: Dysplasia assessment of Barrett's esophagus biopsies is associated with low observer agreement; guidelines advise expert review. We have developed a web-based review panel for dysplastic Barrett's esophagus biopsies., Objective: The purpose of this study was to test if 10 gastrointestinal pathologists working at Dutch Barrett's esophagus expert centres met pre-set benchmark scores for quality criteria., Methods: Ten gastrointestinal pathologists twice assessed 60 digitalized Barrett's esophagus cases, enriched for dysplasia; then randomised (7520 assessments). We tested predefined benchmark quality criteria: (a) percentage of 'indefinite for dysplasia' diagnoses, benchmark score ≤14% for all cases, ≤16% for dysplastic subset, (b) intra-observer agreement; benchmark score ≥0.66/≥0.39, (c) percentage agreement with 'gold standard diagnosis'; benchmark score ≥82%/≥73%, (d) proportion of cases with high-grade dysplasia underdiagnosed as non-dysplastic Barrett's esophagus; benchmark score ≤1/78 (≤1.28%) assessments for dysplastic subset., Results: Gastrointestinal pathologists had seven years' Barrett's esophagus-experience, handling seven Barrett's esophagus-cases weekly. Three met stringent benchmark scores; all cases and dysplastic subset, three met extended benchmark scores. Four pathologists lacked one quality criterion to meet benchmark scores., Conclusion: Predefined benchmark scores for expert assessment of Barrett's esophagus dysplasia biopsies are stringent and met by some gastrointestinal pathologists. The majority of assessors however, only showed limited deviation from benchmark scores. We expect further training with group discussions will lead to adherence of all participating gastrointestinal pathologists to quality criteria, and therefore eligible to join the review panel.
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- 2019
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23. Selective inhibition of N-linked glycosylation impairs receptor tyrosine kinase processing.
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Klaver E, Zhao P, May M, Flanagan-Steet H, Freeze HH, Gilmore R, Wells L, Contessa J, and Steet R
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- Animals, Cell Membrane metabolism, Endoplasmic Reticulum metabolism, Furin metabolism, Glycosylation, HEK293 Cells, Hexosyltransferases metabolism, Humans, Membrane Proteins metabolism, Polysaccharides metabolism, Proprotein Convertase 5 metabolism, Proteomics, Receptor Protein-Tyrosine Kinases metabolism, Receptor, Insulin metabolism, Protein Processing, Post-Translational, Receptor Protein-Tyrosine Kinases antagonists & inhibitors
- Abstract
Global inhibition of N-linked glycosylation broadly reduces glycan occupancy on glycoproteins, but identifying how this inhibition functionally impacts specific glycoproteins is challenging. This limits our understanding of pathogenesis in the congenital disorders of glycosylation (CDG). We used selective exo-enzymatic labeling of cells deficient in the two catalytic subunits of oligosaccharyltransferase - STT3A and STT3B - to monitor the presence and glycosylation status of cell surface glycoproteins. We show reduced abundance of two canonical tyrosine receptor kinases - the insulin receptor and insulin-like growth factor 1 receptor (IGF-1R) - at the cell surface in STT3A -null cells, due to decreased N-linked glycan site occupancy and proteolytic processing in combination with increased endoplasmic reticulum localization. Providing cDNA for Golgi-resident proprotein convertase subtilisin/kexin type 5a (PCSK5a) and furin cDNA to wild-type and mutant cells produced under-glycosylated forms of PCSK5a, but not furin, in cells lacking STT3A. Reduced glycosylation of PCSK5a in STT3A -null cells or cells treated with the oligosaccharyltransferase inhibitor NGI-1 corresponded with failure to rescue receptor processing, implying that alterations in the glycosylation of this convertase have functional consequences. Collectively, our findings show that STT3A-dependent inhibition of N-linked glycosylation on receptor tyrosine kinases and their convertases combines to impair receptor processing and surface localization. These results provide new insight into CDG pathogenesis and highlight how the surface abundance of some glycoproteins can be dually impacted by abnormal glycosylation., Competing Interests: Competing interestsThe authors declare no competing or financial interests., (© 2019. Published by The Company of Biologists Ltd.)
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- 2019
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24. Late-onset Sepsis in Preterm Infants Can Be Detected Preclinically by Fecal Volatile Organic Compound Analysis: A Prospective, Multicenter Cohort Study.
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Berkhout DJC, van Keulen BJ, Niemarkt HJ, Bessem JR, de Boode WP, Cossey V, Hoogenes N, Hulzebos CV, Klaver E, Andriessen P, van Kaam AH, Kramer BW, van Lingen RA, Schouten A, van Goudoever JB, Vijlbrief DC, van Weissenbruch MM, Wicaksono AN, Covington JA, Benninga MA, de Boer NKH, and de Meij TGJ
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- Belgium, Female, Humans, Infant, Newborn, Male, Netherlands, Prospective Studies, Spectrum Analysis methods, Diagnostic Tests, Routine methods, Feces chemistry, Infant, Premature, Neonatal Sepsis diagnosis, Volatile Organic Compounds analysis
- Abstract
Background: The intestinal microbiota has increasingly been considered to play a role in the etiology of late-onset sepsis (LOS). We hypothesize that early alterations in fecal volatile organic compounds (VOCs), reflecting intestinal microbiota composition and function, allow for discrimination between infants developing LOS and controls in a preclinical stage., Methods: In 9 neonatal intensive care units in the Netherlands and Belgium, fecal samples of preterm infants born at a gestational age ≤30 weeks were collected daily, up to the postnatal age of 28 days. Fecal VOC were measured by high-field asymmetric waveform ion mobility spectrometry (FAIMS). VOC profiles of LOS infants, up to 3 days prior to clinical LOS onset, were compared with profiles from matched controls., Results: In total, 843 preterm born infants (gestational age ≤30 weeks) were included. From 127 LOS cases and 127 matched controls, fecal samples were analyzed by means of FAIMS. Fecal VOCs allowed for preclinical discrimination between LOS and control infants. Focusing on individual pathogens, fecal VOCs differed significantly between LOS cases and controls at all predefined time points. Highest accuracy rates were obtained for sepsis caused by Escherichia coli, followed by sepsis caused by Staphylococcus aureus and Staphylococcus epidermidis., Conclusions: Fecal VOC analysis allowed for preclinical discrimination between infants developing LOS and matched controls. Early detection of LOS may provide clinicians a window of opportunity for timely initiation of individualized therapeutic strategies aimed at prevention of sepsis, possibly improving LOS-related morbidity and mortality.
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- 2019
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25. Validation of a biomarker panel in Barrett's esophagus to predict progression to esophageal adenocarcinoma.
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Eluri S, Klaver E, Duits LC, Jackson SA, Bergman JJ, and Shaheen NJ
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- Aged, Area Under Curve, Barrett Esophagus complications, Barrett Esophagus pathology, Biomarkers, Tumor genetics, Biopsy, Case-Control Studies, DNA Mutational Analysis, Disease Progression, Female, Humans, Hyperplasia genetics, Loss of Heterozygosity, Male, Microsatellite Instability, Middle Aged, Predictive Value of Tests, ROC Curve, Reference Values, Adenocarcinoma genetics, Barrett Esophagus genetics, Esophageal Neoplasms genetics, Esophagus pathology, Neoplasm Proteins analysis, Risk Assessment statistics & numerical data
- Abstract
In a prior study, baseline mutational load (ML) predicted progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in Barrett's esophagus (BE) with an area under the curve (AUC) of 0.95. We aimed to validate the test characteristics of this predictive biomarker panel using crude DNA lysates in a larger well-characterized cohort. We performed a nested case-control study of BE patients from three tertiary referral centers in the Netherlands. Cases had baseline nondysplastic BE (NDBE) and developed HGD/EAC ≥ 2 years later. Controls were matched 2:1, had baseline NDBE, and no progression. Polymerase chain reaction (PCR)-based mutational analysis was performed on crude lysates from formalin-fixed, paraffin-embedded tissue. ML was calculated from loss of heterozygosity (LOH) and microsatellite instability (MSI) at 10 genomic loci. Receiver operator characteristic (ROC) curves were created to assess the diagnostic utility of various cutoffs of ML for progression. Of 159 subjects, 58 were progressors and 101 were nonprogressors, there was no difference in mean ML in preprogression tissue in progressors and nonprogressors (ML = 0.73 ± 0.69 vs. ML = 0.74 ± 0.61, P = 0.93). ROC curves showed poor discrimination of ML in predicting progression with AUC of 0.50 at ML ≥ 1. AUC did not vary with different ML cut-points. The utility of the ML to stratify BE patients for risk of progression was not confirmed in this study. The etiology for discrepancies between this and prior studies showing high predictiveness is likely due to the use of crude lysates in this study, but requires further investigation.
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- 2018
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26. Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases.
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van der Wel MJ, Duits LC, Klaver E, Pouw RE, Seldenrijk CA, Offerhaus G, Visser M, Ten Kate F, Tijssen JG, Bergman J, and Meijer SL
- Abstract
Background: Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies., Objective: The aim of this study was to create benchmark quality criteria for future members., Methods: Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia. Each case contained all slides from one endoscopy (non-dysplastic BE (NDBE), n = 21; low-grade dysplasia (LGD), n = 20; high-grade dysplasia (HGD), n = 19). All cases were randomized and assessed twice followed by group discussions to create a consensus diagnosis. Outcome measures: percentage of 'indefinite for dysplasia' (IND) diagnoses, intra-observer agreement, and agreement with the consensus 'gold standard' diagnosis., Results: Mean percentage of IND diagnoses was 8% (3-14%) and mean intra-observer agreement was 0.84 (0.66-1.02). Mean agreement with the consensus diagnosis was 90% (95% prediction interval (PI) 82-98%)., Conclusion: Expert pathology review of BE requires the scoring of a limited number of IND cases, consistency of assessment and a high agreement with a consensus gold standard diagnosis. These benchmark quality criteria will be used to assess the performance of other pathologists joining our panel.
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- 2018
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27. Erectile dysfunction and the post war novel: The Sun Also Rises and In Country.
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Klaver E
- Subjects
- History, 20th Century, Humans, Male, Veterans psychology, Erectile Dysfunction, Medicine in Literature, Narration history
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- 2012
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28. Reduced insulin-like growth factor-I serum levels in formerly obese women subjected to laparoscopic-adjustable gastric banding or diet-induced long-term caloric restriction.
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Mitterberger MC, Mattesich M, Klaver E, Piza-Katzer H, and Zwerschke W
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- Cross-Sectional Studies, Female, Gastroplasty, Humans, Insulin-Like Growth Factor Binding Protein 3 blood, Insulin-Like Growth Factor Binding Protein 3 metabolism, Laparoscopy, Obesity, Morbid surgery, Postoperative Period, Time Factors, Caloric Restriction, Insulin-Like Growth Factor I analysis, Obesity, Morbid blood
- Abstract
Life-span extension in laboratory rodents induced by long-term caloric restriction correlates with decreased serum insulin-like growth factor-I (IGF-I) levels. Reduced activity of the growth hormone/IGF-I signaling system slows aging and increases longevity in mutant mouse models. In the present study, we show that long-term caloric restriction achieved by two different interventions for 4 years, either laparoscopic-adjustable gastric banding or reducing diet, leads to reduced IGF-I serum levels in formerly obese women relative to normal-weight women eating ad libitum. Moreover, we present evidence that the long-term caloric restriction interventions reduce fasting growth hormone serum levels. The present study indicates that the activity of the growth hormone/IGF-I axis is reduced in long-term calorically restricted formerly obese humans. Furthermore, our findings suggest that the duration and severity of the caloric restriction intervention are important for the outcome on the growth hormone/IGF-I axis in humans.
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- 2011
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29. Adipokine profile and insulin sensitivity in formerly obese women subjected to bariatric surgery or diet-induced long-term caloric restriction.
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Mitterberger MC, Mattesich M, Klaver E, Lechner S, Engelhardt T, Larcher L, Pierer G, Piza-Katzer H, and Zwerschke W
- Subjects
- Adiponectin blood, Adult, Bariatric Surgery, Body Mass Index, Caloric Restriction, Case-Control Studies, Cross-Sectional Studies, Female, Homeostasis, Humans, Insulin blood, Nicotinamide Phosphoribosyltransferase blood, Obesity therapy, Resistin blood, Triiodothyronine blood, Tumor Necrosis Factor-alpha blood, Insulin Resistance, Interleukin-6 blood, Leptin blood, Obesity blood, Retinol-Binding Proteins, Plasma analysis
- Abstract
To better understand the contribution of the fat mass to the effects of long-term caloric restriction in humans, we compared adipokine profile and insulin sensitivity in long-term calorically restricted formerly obese women (CRW) subjected to different interventions, bariatric surgery, or reducing diet, with age- and BMI-matched obese (OW) and normal-weight women (NW) eating ad libitum. Our key findings are that despite a considerably stronger weight loss induced by bariatric surgery, both long-term caloric restriction interventions improved insulin sensitivity to the same degree and led to significantly lower retinol-binding protein-4 and interleukin-6 serum levels than in OW, suggesting that lowering of these two adipokines contributes to the improved insulin sensitivity. Moreover, serum leptin was considerably lower in CRW than in OW as well as in NW, suggesting that CRW develop hypoleptinemia.
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- 2010
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30. [Studies on the hyperventilation syndrome. II. Findings in patients on certain respiratory regulation mechanisms, muscular function and various blood electrolytes].
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Barkmeyer-Degenhart P, Brandenburg J, Fortuyn JD, van Floresteyn GW, Groeneveld W, Kalkman-van de Lint W, Klaver-Krol E, Leenstra-Borsje H, Peset R, Teelken AW, and Wiers-Mosman M
- Subjects
- Action Potentials, Calcium blood, Carbon Dioxide metabolism, Electric Stimulation, Fatigue, Humans, Lactates pharmacology, Magnesium blood, Muscles physiopathology, Phosphates blood, Physical Exertion, Respiratory Function Tests, Work of Breathing, Hyperventilation physiopathology
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- 1976
31. [Studies on the hyperventilation syndrome. III. Pathophysiology].
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Fortuyn JD, Groeneveld W, Klaver-Król E, Leenstra-Borsje H, and Teelken AW
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- Calcium metabolism, Carbon Dioxide metabolism, Humans, Magnesium metabolism, Neural Conduction, Tetany etiology, Hyperventilation physiopathology
- Published
- 1976
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