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De invasieve plant Alsemambrosia blijft zich uitbreiden in Nederland, waardoor het risico op gezondheidsklachten voor hooikoortspatiënten verder toeneemt. Deze plant komt nu vooral voor in particuliere tuinen, maar staat in andere Europese landen ook bekend als een schadelijk onkruid voor de akkerbouw. Wat kunnen we verwachten en wat is ertegen te doen?

[EN] Despite the rise in published evidence of deep-marine bottom current processes and associated deposits there are still very few documented outcrop examples. Herein are reported results of a contourite channel system related to the late Miocene palaeo-Mediterranean Outflow Water in the Rifian Corridor, Morocco. This work aims to unravel the sedimentary evolution and facies distribution based on the study of large morphological features related to contourite channels and their subsequent sandstone dominated infill sequences. It was found that the channel evolution and facies distribution are related to spatiotemporal changes in flow characteristics of the palaeo-Mediterranean Outflow Water. The recognized channel facies distribution correlates well with previously established bedform stability diagrams. Erosion and upper-stage flow regime bedforms are associated with the most vigorous bottom currents, generally related to its core. Laterally, following the decrease in flow velocity towards the adjacent drift, bedforms comprise dunes, lower-stage plane bedforms and more heterolithic facies. Similar facies changes are also observed down-channel, related to a decrease in flow velocities resulting from turbulent mixing of water masses, associated decreases in density gradients and the subsequent deceleration due to gravity. Results of this work have been used to propose a three-dimensional facies model for channelized sandy contourites. This study contributes to understanding contourite systems, thus benefitting oceanographic and climatic reconstructions as well as aiding the predictability of contourite channel systems for industry geoscience applications.

01 augustus 2023, Contains fulltext : 296058.pdf (Publisher’s version ) (Open Access), During the COVID-19 pandemic, public groups mobilised themselves in civil-society engagement practices (CSEPs) aiming to improve or suggest alternative epidemic management. This study explores the motivation to establish CSEPs and their perceived contributions to epidemic management, to gain insight whether integrating views of CSEPs could add value. A systematic online search was executed to identify CSEPs focused on COVID-19 management between January 2020 and January 2022 in the Netherlands. In order to create a comprehensible overview of the identified CSEPs, relevant characteristics were gathered and mapped, for example, local or national scope, subject of action and goals. A selection of CSEPs was interviewed between April and June 2022 to study their motivators to start the CSEPs and perceived contributions to management. The search resulted in the identification of 22 CSEPs, of which members of 14 CSEPs were interviewed. These members indicated several issues that motivated the start of their CSEP, namely; shortage of equipment, sense of solidarity, and a perceived lack of governmental action, lack of democratic values and lack in diversity of perspectives in epidemic management. All respondents believed to have contributed to policy or society, by influencing opinions, and occasionally by altering policy. However, respondents encountered obstacles in their attempts to contribute such as inability to establish contact with authorities, feeling unheard or undermined, and complications due to the interplay of political interests. In conclusion, CSEPs have fulfilled various roles such as providing alternative management policies, producing equipment, representing the needs of vulnerable populations, and supporting citizens and providing citizens with other viewpoints and information. The identified motivators to establish CSEPs in this study uncover room for improvements in policy. These insights, together with the identified perceived barriers of CSEPs, can be

De hooikoortsplant Alsemambrosia neemt nog steeds toe in Nederland. In 2022 was 60% van alle meldingen afkomstig uit particuliere tuinen. En dat is slecht nieuws voor iedereen die last heeft van hooikoorts, want deze plant bloeit laat en verlengt het hooikoortsseizoen met twee maanden. Voer je de vogels in je tuin? Check dan of Alsemambrosia opkomt, verwijder de plant en geef je waarneming door.

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Item does not contain fulltext, BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is developed to overcome lead-related complications and systemic infections, inherent to transvenous ICD (TV-ICD) therapy. The PRAETORIAN trial demonstrated that the S-ICD is non-inferior to the TV-ICD with regard to the combined primary endpoint of inappropriate shocks and complications. This prespecified secondary analysis evaluates all complications in the PRAETORIAN trial. METHODS AND RESULTS: The PRAETORIAN trial is an international, multicentre, randomized trial in which 849 patients with an indication for ICD therapy were randomized to receive an S- ICD (N = 426) or TV-ICD (N = 423) and followed for a median of 49 months. Endpoints were device-related complications, lead-related complications, systemic infections, and the need for invasive interventions. Thirty-six device-related complications occurred in 31 patients in the S-ICD group of which bleedings were the most frequent. In the TV-ICD group, 49 complications occurred in 44 patients of which lead dysfunction was most frequent (HR: 0.69; P = 0.11). In both groups, half of all complications were within 30 days after implantation. Lead-related complications and systemic infections occurred significantly less in the S-ICD group compared with the TV-ICD group (P < 0.001, P = 0.03, respectively). Significantly more complications required invasive interventions in the TV-ICD group compared with the S-ICD group (8.3% vs. 4.3%, HR: 0.59; P = 0.047). CONCLUSION: This secondary analysis shows that lead-related complications and systemic infections are more prevalent in the TV-ICD group compared with the S-ICD group. In addition, complications in the TV-ICD group were more severe as they required significantly more invasive interventions. This data contributes to shared decision-making in clinical practice.

Contains fulltext : 233481.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 237049.pdf (Publisher’s version ) (Open Access)

Een wereldwijd onderzoek toont aan dat meer pollen in de lucht geassocieerd is met meer coronabesmettingen. Het SARS-CoV-2-virus profiteert mogelijk van een verzwakte afweer door pollenblootstelling. Dit is niet alleen het geval bij hooikoortspatiënten, maar ook bij mensen die niet allergisch zijn.

Contains fulltext : 220613.pdf (Publisher’s version ) (Open Access), PURPOSE: Children with Down syndrome (DS) more often have strabismus, refractive errors, accommodative lags and reduced visual acuity (VA) than typically developing children. In this study, we compare the effects of bifocal glasses with those of unifocal glasses in children with DS. Changes in angle of strabismus, accommodation and refractive error were analysed in this paper. METHODS: In a multicentre randomized controlled trial, 119 children with DS, aged 2-16, were randomly allocated for bifocal or unifocal glasses (with full correction of refractive error in cycloplegia). The 15 centres, all in the Netherlands, followed the participants for 1 year. Changes in refractive error, accommodative accuracy, strabismus, binocularity and stereopsis were compared across 4 subsequent visits. RESULTS: Refractive errors and accommodative errors showed no significant change throughout the course of our study in either intervention group. The manifest angle of strabismus, however, reduced significantly in the bifocal group. This improvement was observed shortly after the children received their new correction (~6 weeks) (linear regression: t = 3.652, p < 0.001) and remained present in the final measurements after 1 year (linear regression: t = 3.604, p < 0.001). The percentage of children with positive binocularity and stereo tests showed no significant differences between the groups. CONCLUSION: Bifocals with full correction of refractive error reduce the manifest angle of strabismus within a few weeks. No effects on accommodation, refractive error, stereopsis and binocularity occurred over the course of 1 year.

Contains fulltext : 225390.pdf (Publisher’s version ) (Open Access), BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (ICD) was designed to avoid complications related to the transvenous ICD lead by using an entirely extrathoracic placement. Evidence comparing these systems has been based primarily on observational studies. METHODS: We conducted a noninferiority trial in which patients with an indication for an ICD but no indication for pacing were assigned to receive a subcutaneous ICD or transvenous ICD. The primary end point was the composite of device-related complications and inappropriate shocks; the noninferiority margin for the upper boundary of the 95% confidence interval for the hazard ratio (subcutaneous ICD vs. transvenous ICD) was 1.45. A superiority analysis was prespecified if noninferiority was established. Secondary end points included death and appropriate shocks. RESULTS: A total of 849 patients (426 in the subcutaneous ICD group and 423 in the transvenous ICD group) were included in the analyses. At a median follow-up of 49.1 months, a primary end-point event occurred in 68 patients in the subcutaneous ICD group and in 68 patients in the transvenous ICD group (48-month Kaplan-Meier estimated cumulative incidence, 15.1% and 15.7%, respectively; hazard ratio, 0.99; 95% confidence interval [CI], 0.71 to 1.39; P = 0.01 for noninferiority; P = 0.95 for superiority). Device-related complications occurred in 31 patients in the subcutaneous ICD group and in 44 in the transvenous ICD group (hazard ratio, 0.69; 95% CI, 0.44 to 1.09); inappropriate shocks occurred in 41 and 29 patients, respectively (hazard ratio, 1.43; 95% CI, 0.89 to 2.30). Death occurred in 83 patients in the subcutaneous ICD group and in 68 in the transvenous ICD group (hazard ratio, 1.23; 95% CI, 0.89 to 1.70); appropriate shocks occurred in 83 and 57 patients, respectively (hazard ratio, 1.52; 95% CI, 1.08 to 2.12). CONCLUSIONS: In patients with an indication for an ICD but no indication for pacing, the subcutaneous ICD was noninferi

Contains fulltext : 203570.pdf (publisher's version ) (Open Access)

De taalontwikkeling is een belangrijk onderdeel voor de verdere sociale en cognitieve ontwikkeling van het jonge kind. Om optimale taalontwikkeling te laten plaatsvinden, speelt het opvoedgedrag van ouders een belangrijke rol. Twee aspecten van opvoedgedrag die belangrijk worden geacht, zijn moederlijke stimulatie en moederlijke warmte. De onderzoeksvraag die in deze thesis wordt onderzocht is: Wordt de relatie tussen moederlijke stimulering en taalvaardigheid van peuters versterkt door moederlijke warmte? Dit wordt onderzocht bij 123 moeders en hun peuter (36-42 maanden). Dit is onderzocht door het afnemen van de CECPAQ en de BAYLEY-III-NL. Uit de resultaten blijkt dat er geen sprake is van samenhang tussen warmte en taalvaardigheid, taalbegrip en taalproductie, eveneens is er geen samenhang gevonden tussen ouderlijke stimulatie en taalvaardigheid, taalbegrip en taalproductie. Tot slot is er geen relatie tussen stimulatie en taalontwikkeling en de versterking hiervan door warmte. Naar aanleiding van de resultaten van dit onderzoek wordt aanbevolen om vervolgonderzoek te doen, met een heterogene groep en andere meetinstrumenten op het gebied van stimulatie.

Contains fulltext : 154215.pdf (publisher's version ) (Open Access), BACKGROUND: The Control of Allergic Rhinitis and Asthma Test (CARAT) monitors control of asthma and allergic rhinitis. AIMS: To determine the CARAT's minimal clinically important difference (MCID) and to evaluate the psychometric properties of the Dutch CARAT. METHODS: CARAT was applied in three measurements at 1-month intervals. Patients diagnosed with asthma and/or rhinitis were approached. MCID was evaluated using Global Rating of Change (GRC) and standard error of measurement (s.e.m.). Cronbach's alpha was used to evaluate internal consistency. Spearman's correlation coefficients were calculated between CARAT, the Asthma Control Questionnaire (ACQ5) and the Visual Analog Scale (VAS) on airway symptoms to determine construct and longitudinal validity. Test-retest reliability was evaluated with intra-class correlation coefficient (ICC). Changes in pollen counts were compared with delta CARAT and ACQ5 scores. RESULTS: A total of 92 patients were included. The MCID of the CARAT was 3.50 based on GRC scores; the s.e.m. was 2.83. Cronbach's alpha was 0.82. Correlation coefficients between CARAT and ACQ5 and VAS questions ranged from 0.64 to 0.76 (P < 0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ5 and VAS scores ranged from 0.41 to 0.67 (P < 0.01). Test-retest reliability showed an ICC of 0.81 (P < 0.01) and 0.80 (P < 0.01). Correlations with pollen counts were higher for CARAT than for ACQ5. CONCLUSIONS: This is the first investigation of the MCID of the CARAT. The CARAT uses a whole-point scale, which suggests that the MCID is 4 points. The CARAT is a valid and reliable tool that is also applicable in the Dutch population.