• A new food-composition database for 437 polyphenols in 19,899 raw and prepared foods used to estimate polyphenol intakes in adults from 10 European countries.

      Knaze, Viktoria; Rothwell, Joseph A; Zamora-Ros, Raul; Moskal, Aurelie; Kyrø, Cecilie; Jakszyn, Paula; Skeie, Guri; Weiderpass, Elisabete; Santucci de Magistris, Maria; Agnoli, Claudia; et al. (2018-06-21)
      Accurate assessment of polyphenol intakes is needed in epidemiologic research in order to study their health effects, and this can be particularly challenging in international study settings.
    • A new method for fine-scale assessments of the average urban Heat island over large areas and the effectiveness of nature-based solutions.

      Lauwaet, D; de Nijs, T; Liekens, I; Hooyberghs, H; Verachtert, E; Lefebvre, W; de Ridder, K; Remme, R; Broekx, S (2019-03-12)
    • New paradigms for Salmonella source attribution based on microbial subtyping.

      Mughini-Gras, Lapo; Franz, Eelco; van Pelt, Wilfrid (2018-05)
      Microbial subtyping is the most common approach for Salmonella source attribution. Typically, attributions are computed using frequency-matching models like the Dutch and Danish models based on phenotyping data (serotyping, phage-typing, and antimicrobial resistance profiling). Herewith, we critically review three major paradigms facing Salmonella source attribution today: (i) the use of genotyping data, particularly Multi-Locus Variable Number of Tandem Repeats Analysis (MLVA), which is replacing traditional Salmonella phenotyping beyond serotyping; (ii) the integration of case-control data into source attribution to improve risk factor identification/characterization; (iii) the investigation of non-food sources, as attributions tend to focus on foods of animal origin only. Population genetics models or simplified MLVA schemes may provide feasible options for source attribution, although there is a strong need to explore novel modelling options as we move towards whole-genome sequencing as the standard. Classical case-control studies are enhanced by incorporating source attribution results, as individuals acquiring salmonellosis from different sources have different associated risk factors. Thus, the more such analyses are performed the better Salmonella epidemiology will be understood. Reparametrizing current models allows for inclusion of sources like reptiles, the study of which improves our understanding of Salmonella epidemiology beyond food to tackle the pathogen in a more holistic way.
    • A new selection method to increase the health benefits of CVD prevention strategies.

      Lagerweij, Ghizelda R; de Wit, G Ardine; Moons, Karel Gm; van der Schouw, Yvonne T; Verschuren, Wm Monique; Dorresteijn, Jannick An; Koffijberg, Hendrik (2018-01-01)
      Background Cardiovascular disease (CVD) prevention is commonly focused on providing individuals at high predicted CVD risk with preventive medication. Whereas CVD risk increases rapidly with age, current risk-based selection of individuals mainly targets the elderly. However, the lifelong (preventable) consequences of CVD events may be larger in younger individuals. The purpose of this paper is to investigate if health benefits from preventive treatment may increase when the selection strategy is further optimised. Methods Data from three Dutch cohorts were combined ( n = 47469, men:women 1:1.92) and classified into subgroups based on age and gender. The Framingham global risk score was used to estimate 10-year CVD risk. The associated lifelong burden of CVD events according to this 10-year CVD risk was expressed as quality-adjusted life years lost. Based on this approach, the additional health benefits from preventive treatment, reducing this 10-year CVD risk, from selecting individuals based on their expected CVD burden rather than their expected CVD risk were estimated. These benefits were expressed as quality-adjusted life years gained over lifetime. Results When using the current selection strategy (10% risk threshold), 32% of the individuals were selected for preventive treatment. When the same proportion was selected based on burden, more younger and fewer older individuals would receive treatment. Across all individuals, the gain in quality-adjusted life years was 217 between the two strategies, over a 10-year time horizon. In addition, when combining the strategies 5% extra eligible individuals were selected resulting in a gain of 628 quality-adjusted life years. Conclusion Improvement of the selection approach of individuals can help to reduce further the CVD burden. Selecting individuals for preventive treatment based on their expected CVD burden will provide more younger and fewer older individuals with treatment, and will reduce the overall CVD burden.
    • A New Statistical Method to Determine the Degree of Validity of Health Economic Model Outcomes against Empirical Data.

      Corro Ramos, Isaac; van Voorn, George A K; Vemer, Pepijn; Feenstra, Talitha L; Al, Maiwenn J (2017)
      The validation of health economic (HE) model outcomes against empirical data is of key importance. Although statistical testing seems applicable, guidelines for the validation of HE models lack guidance on statistical validation, and actual validation efforts often present subjective judgment of graphs and point estimates.
    • New Tobacco and Tobacco-Related Products: Early Detection of Product Development, Marketing Strategies, and Consumer Interest.

      Staal, Yvonne Cm; van de Nobelen, Suzanne; Havermans, Anne; Talhout, Reinskje (2018-05-28)
      A wide variety of new tobacco and tobacco-related products have emerged on the market in recent years.
    • Newborn blood spot screening for cystic fibrosis with a four-step screening strategy in the Netherlands.

      Dankert-Roelse, Jeannette E; Bouva, Marelle J; Jakobs, Bernadette S; Janssens, Hettie M; de Winter-de Groot, Karin M; Schönbeck, Yvonne; Gille, Johan J P; Gulmans, Vincent A M; Verschoof-Puite, Rendelien K; Schielen, Peter C J I; et al. (2018-08-23)
      Newborn screening for cystic fibrosis (NBSCF) was introduced in the Dutch NBS program in 2011 with a novel strategy.
    • Newborn Screening for Lysosomal Storage Diseases: A Concise Review of the Literature on Screening Methods, Therapeutic Possibilities and Regional Programs.

      Schielen, Peter C J I; Kemper, Evelien A; Gelb, Michael H (2017-06)
      Newborn screening for lysosomal storage diseases (LSDs) is increasingly being considered as an option. The development of analytical screening methods, of second-tier methods, and of therapeutic possibilities, are paving the way for routine screening for LSDs in the coming years. Here, we give a brief description of the current status quo, what screening methods are currently available or are in the pipeline, what is the current status of therapeutic possibilities for LSDs, what LSDs are the most obvious candidates for introduction in screening programs, and what LSDs are already part of regional or national pilot or routine screening programs worldwide.
    • Newborn screening for sickle cell disease in Europe.

      Daniel, Y; Elion, J; Allaf, B; Badens, C; Bouva, MJ; Brincat, I; Cela, E; Coppinger, C (2019-03-19)
    • Newborn screening for sickle cell disease in Europe: recommendations from a Pan-European Consensus Conference.

      Lobitz, Stephan; Telfer, Paul; Cela, Elena; Allaf, Bichr; Angastiniotis, Michael; Backman Johansson, Carolina; Badens, Catherine; Bento, Celeste; Bouva, Marelle J; Canatan, Duran; et al. (2018-10-18)
      Sickle Cell Disease (SCD) is an increasing global health problem and presents significant challenges to European health care systems. Newborn screening (NBS) for SCD enables early initiation of preventive measures and has contributed to a reduction in childhood mortality from SCD. Policies and methodologies for NBS vary in different countries, and this might have consequences for the quality of care and clinical outcomes for SCD across Europe. A two-day Pan-European consensus conference was held in Berlin in April 2017 in order to appraise the current status of NBS for SCD and to develop consensus-based statements on indications and methodology for NBS for SCD in Europe. More than 50 SCD experts from 13 European countries participated in the conference. This paper aims to summarise the discussions and present consensus recommendations which can be used to support the development of NBS programmes in European countries where they do not yet exist, and to review existing programmes.
    • Newly identified risk factors for MRSA carriage in The Netherlands.

      Lekkerkerk, W S N; Haenen, A; van der Sande, M A B; Leenstra, T; de Greeff, S; Timen, A; Tjon-A-Tsien, A; Richardus, J H; van de Sande-Bruinsma, N; Vos, M C (2017)
      To elucidate new risk factors for MRSA carriers without known risk factors (MRSA of unknown origin; MUO). These MUO carriers are neither pre-emptively screened nor isolated as normally dictated by the Dutch Search & Destroy policy, thus resulting in policy failure.
    • Next generation microbiological risk assessment-Potential of omics data for hazard characterisation.

      Haddad, Nabila; Johnson, Nick; Kathariou, Sophia; Métris, Aline; Phister, Trevor; Pielaat, Annemarie; Tassou, Chrysoula; Wells-Bennik, Marjon H J; Zwietering, Marcel H (2018-04-12)
      According to the World Health Organization estimates in 2015, 600 million people fall ill every year from contaminated food and 420,000 die. Microbial risk assessment (MRA) was developed as a tool to reduce and prevent risks presented by pathogens and/or their toxins. MRA is organized in four steps to analyse information and assist in both designing appropriate control options and implementation of regulatory decisions and programs. Among the four steps, hazard characterisation is performed to establish the probability and severity of a disease outcome, which is determined as function of the dose of toxin and/or pathogen ingested. This dose-response relationship is subject to both variability and uncertainty. The purpose of this review/opinion article is to discuss how Next Generation Omics can impact hazard characterisation and, more precisely, how it can improve our understanding of variability and limit the uncertainty in the dose-response relation. The expansion of omics tools (e.g. genomics, transcriptomics, proteomics and metabolomics) allows for a better understanding of pathogenicity mechanisms and virulence levels of bacterial strains. Detection and identification of virulence genes, comparative genomics, analyses of mRNA and protein levels and the development of biomarkers can help in building a mechanistic dose-response model to predict disease severity. In this respect, systems biology can help to identify critical system characteristics that confer virulence and explain variability between strains. Despite challenges in the integration of omics into risk assessment, some omics methods have already been used by regulatory agencies for hazard identification. Standardized methods, reproducibility and datasets obtained from realistic conditions remain a challenge, and are needed to improve accuracy of hazard characterisation. When these improvements are realized, they will allow the health authorities and government policy makers to prioritize hazards more accurately and thus refine surveillance programs with the collaboration of all stakeholders of the food chain.
    • Next generation physiologically based kinetic (NG-PBK) models in support of regulatory decision making

      Painie, A; Leonard, JA; Joossens, E; Desalegn, A; Heringa, MB (2018-12-03)
    • Next-Generation Multifunctional Carbon-Metal Nanohybrids for Energy and Environmental Applications.

      Wang, Dengjun; Saleh, Navid B; Sun, Wenjie; Park, Chang Min; Shen, Chongyang; Aich, Nirupam; Peijnenburg, Willie J G M; Zhang, Wei; Jin, Yan; Su, Chunming (2019-07-02)
      Nanotechnology has unprecedentedly revolutionized human societies over the past decades and will continue to advance our broad societal goals in the coming decades. The research, development, and particularly the application of engineered nanomaterials have shifted the focus from "less efficient" single-component nanomaterials toward "superior-performance", next-generation multifunctional nanohybrids. Carbon nanomaterials (e.g., carbon nanotubes, graphene family nanomaterials, carbon dots, and graphitic carbon nitride) and metal/metal oxide nanoparticles (e.g., Ag, Au, CdS, Cu2O, MoS2, TiO2, and ZnO) combinations are the most commonly pursued nanohybrids (carbon-metal nanohybrids; CMNHs), which exhibit appealing properties and promising multifunctionalities for addressing multiple complex challenges faced by humanity at the critical energy-water-environment (EWE) nexus. In this frontier review, we first highlight the altered and newly emerging properties (e.g., electronic and optical attributes, particle size, shape, morphology, crystallinity, dimensionality, carbon/metal ratio, and hybridization mode) of CMNHs that are distinct from those of their parent component materials. We then illustrate how these important newly emerging properties and functions of CMNHs direct their performances at the EWE nexus including energy harvesting (e.g., H2O splitting and CO2 conversion), water treatment (e.g., contaminant removal and membrane technology), and environmental sensing and in situ nanoremediation. This review concludes with identifications of critical knowledge gaps and future research directions for maximizing the benefits of next-generation multifunctional CMNHs at the EWE nexus and beyond.
    • Next-Generation Sequence Analysis Reveals Transfer of Methicillin Resistance to a Methicillin-Susceptible Staphylococcus aureus Strain That Subsequently Caused a Methicillin-Resistant Staphylococcus aureus Outbreak: a Descriptive Study.

      Weterings, Veronica; Bosch, Thijs; Witteveen, Sandra; Landman, Fabian; Schouls, Leo; Kluytmans, Jan (2017-09)
      Resistance to methicillin in Staphylococcus aureus is caused primarily by the mecA gene, which is carried on a mobile genetic element, the staphylococcal cassette chromosome mec (SCCmec). Horizontal transfer of this element is supposed to be an important factor in the emergence of new clones of methicillin-resistant Staphylococcus aureus (MRSA) but has been rarely observed in real time. In 2012, an outbreak occurred involving a health care worker (HCW) and three patients, all carrying a fusidic acid-resistant MRSA strain. The husband of the HCW was screened for MRSA carriage, but only a methicillin-susceptible S. aureus (MSSA) strain, which was also resistant to fusidic acid, was detected. Multiple-locus variable-number tandem-repeat analysis (MLVA) typing showed that both the MSSA and MRSA isolates were MT4053-MC0005. This finding led to the hypothesis that the MSSA strain acquired the SCCmec and subsequently caused an outbreak. To support this hypothesis, next-generation sequencing of the MSSA and MRSA isolates was performed. This study showed that the MSSA isolate clustered closely with the outbreak isolates based on whole-genome multilocus sequence typing and single-nucleotide polymorphism (SNP) analysis, with a genetic distance of 17 genes and 44 SNPs, respectively. Remarkably, there were relatively large differences in the mobile genetic elements in strains within and between individuals. The limited genetic distance between the MSSA and MRSA isolates in combination with a clear epidemiologic link supports the hypothesis that the MSSA isolate acquired a SCCmec and that the resulting MRSA strain caused an outbreak.
    • A next-generation sequencing based method for determining genetic stability in Clostridium tetani vaccine strains.

      Pennings, Jeroen L A; Abachin, Eric; Uhlrich, Sylvie; Esson, Raphaël; Mallet, Laurent; Vandebriel, Rob J (2020-03-01)
    • Nieuw van de markt? Coronavirusuitbraak in Wuhan.

      Haagmans, BL; Timen, A; Koopmans, MPG (2020-03-24)
    • Nieuwe studie bevestigt: medicijnresten zijn een risico voor de waterkwaliteit

      Moermond, C; Montforts, M; Venhuis, B; Roex, E; Ouwerkerk, K (2020-12-14)
    • Nieuwe tbc-laboratoriumdiagnostiek in aantocht

      van Soolingen, D; Jajou, R; de Vries, G (2019-01-14)