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ObjectivesGiant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are age-associated inflammatory diseases that frequently overlap. Both diseases require long-term treatment with glucocorticoids (GCs), often associated with comorbidities. Previous population-based cohort studies reported that an unhealthier metabolic profile might prevent the development of GCA. Here, we report metabolic features before start of treatment and during treatment in patients with GCA and PMR.MethodsIn the Dutch GCA/PMR/SENEX (GPS) cohort, we analysed metabolic features and prevalence of comorbidities (type 2 diabetes, hypercholesterolaemia, hypertension, obesity and cataract) in treatment-naïve patients with GCA (n=50) and PMR (n=42), and compared those with the population-based Lifelines cohort (n=91). To compare our findings in the GPS cohort, we included data from patients with GCA (n=52) and PMR (n=25) from the Aarhus cohort. Laboratory measurements, comorbidities and GC use were recorded for up to 5 years in the GPS cohort.ResultsGlycated haemoglobin levels tended to be higher in treatment-naïve patients with GCA, whereas high-density lipoprotein, low-density lipoprotein and cholesterol levels were lower compared with the Lifelines population. Data from the Aarhus cohort were aligned with the findings obtained in the GPS cohort. Presence of comorbidities at baseline did not predict long-term GC requirement. The incidence of diabetes, obesity and cataract among patients with GCA increased upon initiation of GC treatment.ConclusionData from the GCA and PMR cohorts imply a metabolic dysregulation in treatment-naïve patients with GCA, but not in patients with PMR. Treatment with GCs led to the rise of comorbidities and an unhealthier metabolic profile, stressing the need for prednisone-sparing targeted treatment in these vulnerable patients.

Aesthetic finger prosthetics provide functional and cosmetic benefits. Good suspension of the prosthesis plays a role in the functional and aesthetic effects, and a loose fit can lead to rejection of the prosthetic. In this thesis, we will compare two different suspension techniques (the addition of ridges and the addition of a central tunnel) and their effect on prosthetic retention along with the effect of differing socket lengths. Method: Six finger prosthetics were fabricated with different techniques and lengths. The strength of suspension was evaluated using a novel approach. Results: Shorter sockets with more aggressive volume reduction resisted a mean maximum force of 9.25N, and the longer sockets resisted a mean force up till 32.66N. The prosthetic with a central tunnel and shorter socket resisted a mean force up till 46.04N. Ridges between short and long sockets had inconsistent readings. Conclusion: Whether ridges or central tunnel influenced suspension strength was inconclusive. How volume reductions were done had a notable effect on suspension. Prosthetics with a shorter socket provided a tighter fit and had better suspension. When adequate prosthetic fit was achieved, the central tunnel had an improved effect on suspension strength.

To limit greenhouse gas emissions, energy efficiency measures are applied at a large scale resulting in buildings becoming more airtight. Indoor environmental quality depends strongly on ventilation rates. Whilst controlled ventilation contributes to the reduced use of fossil fuel, too little ventilation increases the risk of health-damaging concentrations of pollutants in the indoor environment. There are three primary sources for pollutants indoors (1) ventilated outside air, (2) emissions from activities such as cooking and cleaning and (3) longitudinally emitted pollutants from people, building components and furnishings. Some accepted primary pollutants to assess indoor air quality are CO2, Volatile Organic Compounds (VOC) and OH. However, indoor chemistry studies indicate the presence of a great amount of complementary secondary pollutants with potentially health-damaging effects. Secondary pollutants indoors are the result of chemical reactions of pollutants with solar radiation as an energy source and ozone/other oxidants. Little is known about the type of resultant secondary pollutants and their effect on human health. One approach to assess the effect of secondary pollutants on indoor environmental quality is to integrate chemical box models with building simulation models, e.g. computational fluid dynamics. In this contribution, the authors provide an overview of the state of the art in integrated simulation models of air chemistry with building performance. A reduced-order case study will be presented comparing methods and identifying key parameters for indoor air quality, including selected secondary pollutants. Additionally, a conceptual framework is presented for assessing the impact of secondary pollutants on human health., CLIMA 2022 conference, 2022: CLIMA 2022 The 14th REHVA HVAC World Congress

The new Smart TinyLab (STL) for system integration in the building industry is a lab where building partners and construction-related companies can develop, test, validate and demonstrate their products in practice to be as energy-efficient as possible to contribute to formulated CO2 emission reduction targets. STL is located near the Saxion University of Applied Sciences in Enschede and has been operationalized since the spring of 2021. In the lab, one can simulate and assess quantitatively the effect of building products, HVAC components, smart technologies, user-related aspects and the outdoor climate on energy consumption and indoor climate conditions. The lab allows the comparison between theoretical and practical characteristics and energy consumption figures. Together with partners from the construction industry, innovative products, devices and systems in a simulation and field test environment have been tested and validated. During STL′s start-up phase other tiny twin-labs with outdoor setups in Europe were compared. Turning the lab in its entirety to face or be averted from direct sunlight makes STL rather unique in its kind.

Background:Giant cell arteritis (GCA) is a granulomatous vasculitis that affects the large vessels, occurring in people over 50 years of age. GCA frequently overlaps with polymyalgia rheumatica (PMR), which affects the proximal joints in the shoulders and hips. Both GCA and PMR patients require long-term treatment with glucocorticoids (GCs). Investigation of new treatment options is required because many GCA and PMR patients experience GC-related adverse events. These include hypercholesterolemia, hypertension, diabetes mellitus, cataract, and infections.(1) Previous studies suggest that unhealthy metabolic features and a higher Body Mass Index (BMI) might be protective in the development of GCA (2). However, data are limited.Objectives:We aimed to elaborate more-in depth on the metabolic features, BMI and prevalence of comorbidities of GCA and PMR patients at the time of diagnosis and during treatment, to characterize patients for improved treatment options.Methods:This study included two independent cohorts: the GPS (Groningen) cohort, and the Aarhus cohort for validation of baseline data (Table 1). Patients in the GPS cohort were prospectively followed with visits at 3 months, 1, 2, and 5 years. Laboratory measurements, metabolic co-morbidities were assessed at every visit. At baseline, we assessed whether comorbidities and BMI predicted the duration of GC treatment.Table 1.Baseline characteristics. P-values were calculated with Mann-Whitney U test and Fischer Exact test. Numbers in bold: significance between HC and GCA/PMR patients from GPS cohort. *: significance between GCA and PMR of GPS cohort. a: significance between two cohorts.GCAGPS cohort (n=50)PMRGPS cohort (n=44)HCsGPS cohort (n=65)GCA Aarhus cohort(n=52)PMR Aarhus cohort(n=25)Age, median7173706768Female, %3526433213Follow-up duration in months, median4240NANANABMI, median24.326.625.42426.4Systolic BP (mmHg), median140140145135143Diastolic BP (mmHg), median79.5*808076.583HbA1c (mmol/mol), median4340394340CRP (mg/L), median544247653ESR (mm/h), median94*5797751Diabetes mellitus, %122312158Hypercholesterolemia, %2214171524Hypertension, %66a55603836Cataract, %141634NANAResults:Frequencies of metabolic features in GCA/PMR patients from the GPS cohort were not significantly different in comparison to healthy controls (HCs). Higher HbA1c levels were detected in GCA patients than in HCs. Data on metabolic features from the Aarhus cohort compared well with the GPS cohort data and thus validated these findings (Table 1). Next, the effect of co-existing co-morbidities on the clinical manifestations was investigated. GCA patients with cataract had reduced CRP and ESR whereas PMR patients with cataract had a higher ESR than patients without cataract (p=0,034). Analysis of GC treatment effect on co-morbidities revealed a significant increase in prevalence of diabetes (after 3 months) and cataract (after 5 years) compared to baseline. BMI was significantly higher after one year and five years of GC treatment. PMR patients with cataract at baseline required longer treatment with GCs (p=0.023). Presence of other metabolic features at the time of GCA or PMR diagnosis did not affect the treatment duration (Figure 1).Conclusion:Newly-diagnosed GCA and PMR patients did not appear to have a healthier metabolic profile than HCs. As expected, GC treatment resulted in the development of an unhealthier metabolic profile in GCA patients. In PMR patients, the presence of cataract at baseline was predictive for a prolonged treatment period which could be explained by higher ESR levels in PMR patients with cataract. Together, our findings emphasize the importance of novel GC sparing therapeutic agents and personalized medicine in GCA and PMR.References:[1]Buttgereit F,et al. Prevention of glucocorticoid morbidity in giant cell arteritis. Rheumatol (United Kingdom). 2018.[2]Ungprasert P, et al. Lower body mass index is associated with a higher risk of giant cell arteritis: A systematic review and meta-analysis. Ann Transl Med. 2015.Disclosure of Interests:Idil Esen: None declared, Philip Therkildsen: None declared, Berit Dalsgaard NIelsen: None declared, Anna van ‘t Ende: None declared, Annemieke Boots Consultant of: Grunenthal, Peter Heeringa: None declared, Ellen-Margrethe Hauge: None declared, Elisabeth Brouwer Speakers bureau: Roche, fees paid to UMCG, Yannick van Sleen: None declared

Facing the energy transition, Dutch social housing corporations are expected to fulfil a pioneering role in realising fossil fuel free and CO2 neutral dwellings and neighbourhoods. However, given the high current costs of retrofitting dwellings to net zero energy, housing corporations are searching diligently for alternative, more affordable, renovation strategies. A Thermal Compartmentation renovation concept has been developed, in which retrofitting efforts are concentrated on the living spaces in dwellings. By means of co-heating tests, the quality of the thermal shell of three retrofitted case objects has been evaluated. It is found that both the airtightness and the heat loss coefficient (HLC) improved significantly as a result of the renovation. As would be expected, the realised ‘warm compartments’ show a better thermal performance than the entire dwellings. Although the measurements and subsequent analyses have confirmed the impact of the renovation measures on the buildings’ thermal performance, additional research targeting the inhabited dwellings is necessary to draw up final conclusions on the potential of the Thermal Compartmentation renovation concept.

Background and Objectives Blood can be infectious if it is donated shortly before infection with hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) becomes detectable. Lookback exercises may detect infection in recipients of pre-seroconversion donations. This study provides an analysis of the Dutch lookback exercises in the years 2000 through 2006. Materials and Methods All lookback procedures, triggered by 50 repeat donors seroconverting for HBV (n = 32), HCV (n = 3), HIV (n = 14) and HBV + HIV (n = 1), were analysed. Recipients and archived samples of the 96 implicated donations were tested. Results For 76 donations, a stored sample was available for HBV, HCV, or HIV PCR testing, revealing two HBV-DNA-positive pre-seroconversion donations. Ninety-three lookback procedures were initiated, to which 91 of 93 hospitals responded. In 87 of 91 cases, the implicated blood product had been administered. In 39 of 87 cases, the recipient was tested, revealing one HIV and two HBV infections. The HIV infection was considered pre-existent. The two HBV-positive patients received components from the donation of which the repository sample tested positive for HBV-DNA. Components of the second HBV-positive pre-seroconversion donation had not been administered. Conclusion Among 39 recipients of pre-seroconversion donations, 2 (5%) were found HBV infected by transfusion. The labour-intensive lookback procedures did not reveal any conclusive transmissions additional to the infections detected by PCR testing of repository pre-seroconversion samples.

G-CSF/dexamethasone stimulated donor derived granulocyte transfusion (GTX) has been shown in non-randomized studies to be a useful co-therapy in immune-compromised patients unresponsive to conventional antimicrobial treatments. Reports of GTX are however usually single institution adult experiences. Substantiated pediatric data, other than in neonates, is less common.

Blood can be infectious if it is donated shortly before infection with hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) becomes detectable. Lookback exercises may detect infection in recipients of pre-seroconversion donations. This study provides an analysis of the Dutch lookback exercises in the years 2000 through 2006.All lookback procedures, triggered by 50 repeat donors seroconverting for HBV (n=32), HCV (n=3), HIV (n=14) and HBV + HIV (n=1), were analysed. Recipients and archived samples of the 96 implicated donations were tested.For 76 donations, a stored sample was available for HBV, HCV, or HIV PCR testing, revealing two HBV-DNA-positive pre-seroconversion donations. Ninety-three lookback procedures were initiated, to which 91 of 93 hospitals responded. In 87 of 91 cases, the implicated blood product had been administered. In 39 of 87 cases, the recipient was tested, revealing one HIV and two HBV infections. The HIV infection was considered pre-existent. The two HBV-positive patients received components from the donation of which the repository sample tested positive for HBV-DNA. Components of the second HBV-positive pre-seroconversion donation had not been administered.Among 39 recipients of pre-seroconversion donations, 2 (5%) were found HBV infected by transfusion. The labour-intensive lookback procedures did not reveal any conclusive transmissions additional to the infections detected by PCR testing of repository pre-seroconversion samples.