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Background: Acute respiratory infections can trigger acute myocardial infarction. We aimed to quantify the association between laboratory-confirmed influenza infection and acute myocardial infarction, particularly in patients with and without known coronary artery disease. Methods: This observational, registry-based, self-controlled case series study evaluated the association between laboratory-confirmed influenza infection and occurrence of acute myocardial infarction. Laboratory records on respiratory virus polymerase chain reaction (PCR) testing from 16 laboratories across the Netherlands were linked to national mortality, hospitalization, medication, and administrative registries. Influenza infection was defined as a positive PCR test result. Acute myocardial infarction was defined as a registered diagnostic code for either acute myocardial infarction hospitalization or death. Using a self-controlled case series method, we then compared the incidence of acute myocardial infarction during the risk period (days 1 to 7 after influenza infection) versus the control period (1 year before and 51 weeks after the risk period). Results: Between 2008 and 2019, we identified 158,777 PCR tests for influenza in the study population; 26,221 were positive for influenza, constituting 23,405 unique influenza illness episodes. A total of 406 episodes were identified with acute myocardial infarction occurring within 1 year before and 1 year after confirmed influenza infection and were included in analysis. Twenty-five cases of acute myocardial infarction occurred during the risk period versus 394 during the control period. The adjusted relative incidence of acute myocardial infarction during the risk period compared with the control period was 6.16 (95% confidence interval [CI], 4.11 to 9.24). The relative incidence of acute myocardial infarction in individuals without prior hospitalization for coronary artery disease was 16.60 (95% CI, 10.45 to 26.37) compared with 1.43 (95% CI, 0.53 to 3.84) for those with prior admission for coronary artery disease. Conclusions: Influenza infection was associated with an increased risk of acute myocardial infarction, especially in individuals without a prior hospitalization for coronary artery disease. (Funded by the Dutch Research Council [NWO].) [ABSTRACT FROM AUTHOR]

One of the obstacles to dealing with the social and ecological crises that obstruct the achievement of a culture of peace is silo thinking in global governance. A unidimensional mode of planning, silo thinking leads to decisions based on the area of expertise of a particular agency or intergovernmental organization and fails to recognize linkages between social, economic, and environmental factors. To promote a comprehensive way of thinking, this article proposes the notion of "sustainable communities" (SC) as a lens for envisioning and planning for a culture of peace that integrates these linkages concretely at the community level. To provide the conceptual background for the SC lens, a literature review of the manifestations of the sustainability revolution that have emerged in the last four decades will be provided. A description of the constituent characteristics of the SC lens and a discussion of its educational utility for peace educators will follow, concluding with some reflections on the way forward.

Argues that, despite decades of increasing scientific evidence on the public awareness of the state of the environment, the secondary education curricula has failed to respond. Discusses a back-to-basics model of secondary education. (CCM)

Background: In Dutch hospitals a six-point questionnaire is currently mandatory for risk assessment to identify carriers of multidrug-resistant organisms (MDROs) at the time of hospitalization. Presence of one or more risk factors is followed by pre-emptive isolation and microbiological culturing.Aim: To evaluate the yield of the universal risk assessment in identifying MDRO carriers upon hospitalization.Methods: A cross-sectional study was performed using routine healthcare data in a Dutch tertiary hospital between January 1st, 2015 and August 1st, 2019. MDRO risk assessment upon hospitalization included assessment of: known MDRO carriage, previous hospitalization in another Dutch hospital during an outbreak or a foreign hospital, living in an asylum centre, exposure to livestock farming, and household membership of a meticillin-resistant Staphylococcus aureus carrier.Findings: In total, 144,051 admissions of 84,485 unique patients were included; 4480 (3.1%) admissions had a positive MDRO risk assessment. In 1516 (34%) admissions microbiological screening was performed, of which 341 (23%) yielded MDRO. Eighty-one patients were categorized as new MDRO carriers, as identified through MDRO risk assessment, reflecting 0.06% (95% confidence interval: 0.04-0.07) of all admissions and 1.8% (1.4-2.2) of those with positive risk assessment. As a result, the number of 'MDRO risk assessments needed to perform' and individual 'MDRO questions needed to ask' to detect one new MDRO carrier upon hospitalization were 1778 and 10,420, respectively.Conclusion: The yield of the current strategy of MDRO risk assessment upon hospitalization is limited and it needs thorough reconsideration. [ABSTRACT FROM AUTHOR]

We describe four cases of eosinophilic cystitis in whom no specific cause could be found, and review the literature. Complaints at presentation included urgency, frequency, abdominal pain, and haematuria. In [...]

Reducing the duration of refueling outage is possible by optimizing the core design and the shuffling sequence. For both options software tools have been developed that have been applied to the three most recent cycles of the Borssele plant in the Netherlands. Applicability of the shuffling sequence optimization to boiling water reactors has been demonstrated by a comparison to a recent shuffle plan used in the Hatch plant located in the United States. Their uses have shown that both core design and shuffling sequence optimization can be exploited to reduce the time needed for reloading a core with an in-core shuffling scheme. Ex-core shuffling schemes for pressurized water reactors can still have substantial benefit from a core design using a minimized number of insert shuffles. [ABSTRACT FROM AUTHOR]