• Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016: A Case Series and Epidemiologic Overview.

      Knoester, Marjolein; Helfferich, Jelte; Poelman, Randy; Van Leer-Buter, Coretta; Brouwer, Oebele F; Niesters, Hubert G M (2019-01-01)
    • A two arm randomized controlled trial comparing the short and long term effects of an elimination diet and a healthy diet in children with ADHD (TRACE study). Rationale, study design and methods.

      Bosch, Annick; Bierens, Margreet; de Wit, Ardine G; Ly, Verena; van der Velde, Jessica; de Boer, Heleen; van Beek, Gerry; Appelman, Danielle; Visser, Sacha; Bos, Lisa; et al. (2020-05-27)
    • Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018.

      Gassowski, Martyna; Michaelis, Kai; Wenzel, Jürgen J; Faber, Mirko; Figoni, Julie; Mouna, Lina; Friesema, Ingrid Hm; Vennema, Harry; Avellon, Ana; Varela, Carmen; et al. (2018-07)
      From January to June 2018, two ongoing hepatitis A outbreaks affected travellers returning from Morocco and cases in Europe without travel history, resulting in 163 patients in eight European countries. Most interviewed travel-related cases were unaware of the hepatitis A risk in Morocco. Molecular analysis revealed two distinct hepatitis A virus (HAV) strains (subgenotype IA DK2018_231; subgenotype IB V18-16428). Vaccination recommendations should be emphasised to increase awareness among non-immune travellers to Morocco and HAV-endemic countries.
    • Two years of aging influences the distribution and lability of metal(loid)s in a contaminated soil amended with different biochars.

      He, Erkai; Yang, Yuxi; Xu, Zibo; Qiu, Hao; Yang, Fan; Peijnenburg, Willie J G M; Zhang, Weihua; Qiu, Rongliang; Wang, Shizhong (2019-04-09)
      A two-year soil incubation experiment was performed to investigate the long-term impacts of biochars (kenaf core and sewage sludge biochar (KBC and SBC) pyrolyzed at 350 °C and 550 °C) on metal(loid)s immobilization. Both KBC and SBC can immobilize Pb and Cu in contaminated soil, whereas they showed little effects on the immobilization of Zn, Cd and As. Interactions between the biochar and soil during two-year aging changed the metal species on both soil and biochar particles. KB350 formed more biochar-mineral complexes and O-containing functional groups than KB550 and thus transferred more residual metal(loid)s to their reducible species. More metal(loid)s sorbed on the KB350 than KB550 after two-year aging. However, SBC changed the acid-soluble species of metal(loid)s into the residual species during the aging process, probably due to the release of phosphate. Upon aging, SB550 exhibited a more significant increase in the residual metal amount and more sorption of metal(loid)s on the biochar particles than SB350 due to sorption of organic carbon and formation of meta-kaolinite. A key finding of our study was that different biochars have contrasting impacts on metal speciation and lability upon 2-year aging. This should be considered in assessing the actual risk of biochar-amended soils.
    • A two-centre randomised trial of an additional early dose of measles vaccine: Effects on mortality and measles antibody levels.

      Fisker, Ane B; Nebie, Eric; Schoeps, Anja; Martins, Cesario; Rodrigues, Amabelia; Zakane, Alphonse; Kagone, Moubassira; Byberg, Stine; Thysen, Sanne M; Tiendrebeogo, Justin; et al. (2017-11-21)
      Besides protecting against measles, measles vaccine (MV) may have beneficial non-specific effects. We tested the effect of an additional early MV on mortality and measles antibody levels.
    • Uitbraak door norovirus genogroep I op de camping.

      van der Moeren, N; Raven, CFH (2019-11-03)
    • Een uitbraak met Campylobacter fetus na het eten van rauwmelkse schapenkaas : Hoe traceer je de bron van een uitbraak

      Koppenaal, H; Groenendijk, F; van den Berge, M; Verkade, E; Verduin, K; Zomer, A L; Duim, B; Wagenaar, J A; Tijsma, A S L; Spierenburg, M A H; et al. (2017-10-17)
      Campylobacter fetus is a species of gram-negative bacteria whose primary reservoir is the gastrointestinal tracts of cattle and sheep. Human infections are rare, though often invasive and sometimes fatal. In this paper, we studied an outbreak of six patients with a C. fetus infection and outlined their disease histories. In each case we were able to identify factors that led to a reduced resistance, including pre-existing illnesses and old age. Because of the unusually high number of patients that presented in a time period of only five months, the Community Health Services were commissioned to identify the source of infection. Using whole genome sequencing, we showed that 5 out of 6 patients belonged to the same cluster. This One Health approach resulted in the conclusion that the infection originated from unpasteurized sheep's milk processed into unripened cheese. Finally, various measures were put into place to prevent any further outbreaks.
    • Ultra-processed food consumption patterns among older adults in the Netherlands and the role of the food environment.

      Pinho, Maria Gabriela M; Lakerveld, Jeroen; Harbers, Marjolein C; Sluijs, Ivonne; Vermeulen, Roel; Huss, Anke; Boer, Jolanda M A; Verschuren, W M Monique; Brug, Johannes; Beulens, Joline W J; et al. (2020-11-24)
    • Uncertainty propagation in atmospheric dispersion models for radiological emergencies in the pre- and early release phase: summary of case studies.

      van korsakissok, I; Perillat, R; Andranopoulos, S; Bedwell, P; Berge, E; Charnock, T; Geertsema, G; Gering, F; Tomas, JM (2020-06-23)
    • Uncovering Distinct Primary Vaccination-Dependent Profiles in Human Specific CD4+ T-Cell Responses Using a Novel Whole Blood Assay.

      Lambert, Eleonora E; Corbière, Véronique; van Gaans-van den Brink, Jacqueline A M; Duijst, Maxime; Venkatasubramanian, Prashanna Balaji; Simonetti, Elles; Huynen, Martijn; Diavatopoulos, Dimitri D; Versteegen, Pauline; Berbers, Guy A M; et al. (2020-05-15)
      To advance research and development of improved pertussis vaccines, new immunoassays are needed to qualify the outcome of Bordetella pertussis (Bp) specific CD4+ T-cell differentiation. Here, we applied a recently developed whole blood assay to evaluate Bp specific CD4+ T-cell responses. The assay is based on intracellular cytokine detection after overnight in vitro Bp antigen stimulation of diluted whole blood. We show for the first time that CD4+ T-cell memory of Th1, Th2, and Th17 lineages can be identified simultaneously in whole blood. Participants ranging from 7 to 70 years of age with different priming backgrounds of whole-cell pertussis (wP) and acellular pertussis (aP) vaccination were analyzed around an acellular booster vaccination. The assay allowed detection of low frequent antigen-specific CD4+ T-cells and revealed significantly elevated numbers of activated and cytokine-producing CD4+ T-cells, with a significant tendency to segregate recall responses based on primary vaccination background. A stronger Th2 response hallmarked an aP primed cohort compared to a wP primed cohort. In conclusion, analysis of Bp specific CD4+ T-cell responses in whole blood showed separation based on vaccination background and provides a promising tool to assess the quantity and quality of CD4+ T-cell responses induced by vaccine candidates.
    • Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews.

      Fournet, N; Mollema, L; Ruijs, W L; Harmsen, I A; Keck, F; Durand, J Y; Cunha, M P; Wamsiedel, M; Reis, R; French, J; et al. (2018-01-30)
      Despite effective national immunisation programmes in Europe, some groups remain incompletely or un-vaccinated ('under-vaccinated'), with underserved minorities and certain religious/ideological groups repeatedly being involved in outbreaks of vaccine preventable diseases (VPD). Gaining insight into factors regarding acceptance of vaccination of 'under-vaccinated groups' (UVGs) might give opportunities to communicate with them in a trusty and reliable manner that respects their belief system and that, maybe, increase vaccination uptake. We aimed to identify and describe UVGs in Europe and to describe beliefs, attitudes and reasons for non-vaccination in the identified UVGs.
    • Underreporting of meningococcal disease incidence in the Netherlands: results from a capture-recapture analysis based on three registration sources with correction for false positive diagnoses.

      Greeff, Sabine C de; Spanjaard, Lodewijk; Dankert, Jacob; Hoebe, Christian J P A; Nagelkerke, Nico J D; Melker, Hester E de (2006-05-10)
      In order to come to a reliable evaluation of the effectiveness of the chosen vaccination policy regarding meningococcal disease, the completeness of registrations on meningococcal disease in the Netherlands was estimated with the capture-recapture method. Data over 1993-1998 were collected from (A) mandatory notifications (n = 2926); (B) hospital registration (n = 3968); (C) laboratory surveillance (n = 3484). As the standard capture-recapture method does not take into account false positive diagnoses, we developed a model to adjust for the lack of specificity of our sources. We estimated that 1363 cases were not registered in any of the three sources in the period of study. The completeness of the three sources was therefore estimated at 49% for source A, 67% for source B and 58% for source C. After adjustment for false positive diagnoses, the completeness of source A, B, and C was estimated as 52%, 70% and 62%, respectively. The capture-recapture methods offer an attractive approach to estimate the completeness of surveillance sources and hence contribute to a more accurate estimate of the disease burden under study. However, the method does not account for higher-order interactions or presence of false positive diagnoses. Being aware of these limitations, the capture-recapture method still elucidates the (in)completeness of sources and gives a rough estimate of this (in)completeness. This makes a more accurate monitoring of disease incidence possible and hence attributes to a more reliable foundation for the design and evaluation of health interventions such as vaccination programs.
    • Understanding a national increase in COVID-19 vaccination intention, the Netherlands, November 2020-March 2021.

      Sanders, Jet G; Spruijt, Pita; van Dijk, Mart; Elberse, Janneke; Lambooij, Mattijs S; Kroese, Floor M; de Bruin, Marijn
    • Understanding conflicting views of endocrine disruptor experts: a pilot study using argumentation analysis

      Clahsen, SCS; van Klaveren, HS; Vermeire, TG; van Kamp, I; Garssen, B; Piersma, AH; Lebret, E (2019-01-28)
    • Understanding correlates of neighborhood aesthetic ratings: A European-based four city comparison.

      Zijlema, WL; Triguero-Mas, M; Cirach, M; Gidlow, C; Kruize, H; Grazuleviciene, R; Nieuwenhuijsen, MJ; Litt, JS (2019-12-12)
    • Understanding Dissolution Rates via Continuous Flow Systems with Physiologically Relevant Metal Ion Saturation in Lysosome.

      Keller, Johannes G; Peijnenburg, Willie; Werle, Kai; Landsiedel, Robert; Wohlleben, Wendel (2020-02-12)
      Dissolution rates of nanomaterials can be decisive for acute in vivo toxicity (via the released ions) and for biopersistence (of the remaining particles). Continuous flow systems (CFSs) can screen for both aspects, but operational parameters need to be adjusted to the specific physiological compartment, including local metal ion saturation. CFSs have two adjustable parameters: the volume flow-rate and the initial particle loading. Here we explore the pulmonary lysosomal dissolution of nanomaterials containing the metals Al, Ba, Zn, Cu over a wide range of volume flow-rates in a single experiment. We identify the ratio of particle surface area (SA) per volume flow-rate (SA/V) as critical parameter that superimposes all dissolution rates of the same material. Three complementary benchmark materials-ZnO (quick dissolution), TiO2 (very slow dissolution), and BaSO4 (partial dissolution)-consistently identify the SA/V range of 0.01 to 0.03 h/cm as predictive for lysosomal pulmonary biodissolution. We then apply the identified method to compare against non-nanoforms of the same substances and test aluminosilicates. For BaSO4 and TiO2, we find high similarity of the dissolution rates of their respective nanoform and non-nanoform, governed by the local ion solubility limit at relevant SA/V ranges. For aluminosilicates, we find high similarity of the dissolution rates of two Kaolin nanoforms but significant dissimilarity against Bentonite despite the similar composition.
    • Unifying the functional diversity in natural and cultivated soils using the overall body-mass distribution of nematodes.

      Mulder, Christian; Maas, Rob (2017-11-28)
      Sustainable use of our soils is a key goal for environmental protection. As many ecosystem services are supported belowground at different trophic levels by nematodes, soil nematodes are expected to provide objective metrics for biological quality to integrate physical and chemical soil variables. Trait measurements of body mass carried out at the individual level can in this way be correlated with environmental properties that influence the performance of soil biota.
    • Universal risk assessment upon hospital admission for screening of carriage with multidrug-resistant microorganisms (MDRO) in a Dutch tertiary care centre (2016 - 2019).

      van Hout, Denise; Bruijning-Verhagen, Patricia C J; Blok, Hetty; Troelstra, Annet; Bonten, Marc J M (2020-12-18)
      We performed a cross-sectional study 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 methicillin-resistant Staphylococcus aureus carrier.
    • Unknown makes unloved-A case study on improving integrated health and social care in the Netherlands using a participatory approach.

      Lette, Manon; Boorsma, Marijke; Lemmens, Lidwien; Stoop, Annerieke; Nijpels, Giel; Baan, Caroline; de Bruin, Simone (2020-03-01)