Clinical outcomes of heart-team-guided treatment decisions in high-risk patients with aortic valve stenosis in a health-economic context with limited resources for transcatheter valve therapies.

Transcatheter aortic valve implantation (TAVI) is the preferred treatment modality for patients with severe aortic stenosis at high or prohibitive risk for surgical aortic valve replacement (SAVR). We aimed to evaluate real-world outcomes after treatment according to the decisions of the multidisciplinary heart team in a Belgian health-economic context. Four hundred and five high-risk patients referred to a tertiary centre between 1 March 2008 and 31 December 2015 were screened and planned to undergo SAVR, TAVI or medical treatment (MT).

Re-induction using whole cell melanoma vaccine genetically modified to melanoma stem cells-like beyond recurrence extends long term survival of high risk resected patients - updated results.

Background: AGI-101H is an allogeneic gene modified whole cell therapeutic melanoma vaccine, evaluated in over 400 melanoma patients in the adjuvant and therapeutic settings. We present updated long-term survival results from two single-arm, phase II adjuvant trials (Trial 3 and Trial 5) with the focus on treatment beyond recurrence of the disease.

Methods: Patients with resected high-risk melanoma (stage IIIB-IV) were enrolled to Trial 3 (n = 99) and Trial 5 (n = 97).

Human papillomavirus detection in urine: Effect of a first-void urine collection device and timing of collection.

Great interest has been directed towards the use of first-void (FV) urine as a liquid biopsy for high-risk HPV DNA testing. The aim of this study was to investigate the potential effect of a first generation FV urine collection device on the detection of HPV DNA and to assess if the concentration of HPV DNA varies between FV urine collected in the morning and those collected later during the day. In this prospective cohort study, 33 self-reported HPV-positive women participated.

The burden of common variable immunodeficiency disorders: a retrospective analysis of the European Society for Immunodeficiency (ESID) registry data.

Background: Common variable immunodeficiency disorders (CVID) are a group of rare innate disorders characterized by specific antibody deficiency and increased rates of infections, comorbidities and mortality. The burden of CVID in Europe has not been previously estimated. We performed a retrospective analysis of the European Society for Immunodeficiencies (ESID) registry data on the subset of patients classified by their immunologist as CVID and treated between 2004 and 2014.

How to quantify animal activity from radio-frequency identification (RFID) recordings.

Automated animal monitoring via radio-frequency identification (RFID) technology allows efficient and extensive data sampling of individual activity levels and is therefore commonly used for ecological research. However, processing RFID data is still a largely unresolved problem, which potentially leads to inaccurate estimates for behavioral activity. One of the major challenges during data processing is to isolate independent behavioral actions from a set of superfluous, nonindependent detections.

Body fluid volume homeostasis is abnormal in pregnancies complicated with hypertension and/or poor fetal growth.

Objectives: To evaluate body water volumes and cardiac output in each trimester of pregnancies complicated with hypertension and/or poor fetal growth, relative to uncomplicated pregnancy.

Methods: In this semi-longitudinal cohort study, a standardised non-invasive maternal hemodynamics assessment in first, second or third trimester was performed in 1068 women with uncomplicated pregnancy (UP), 75 with early onset (EPE) and 117 with late onset preeclampsia (LPE), 139 with gestational hypertension (GH), 129 with small for gestational age (SGA) neonates and 43 with essential hypertension (EH). Women with hypertension or SGA were included prior to onset of symptoms or at diagnosis of disease; 46% of women (758/1631) were assessed in ≥ 2 trimesters.

Multidisciplinary data infrastructures in multiple sclerosis: Why they are needed and can be done!

Personalized treatment is highly desirable in multiple sclerosis (MS). We believe that multidisciplinary measurements including clinical, functional and patient-reported outcome measures in combination with extensive patient profiling can enhance personalized treatment and rehabilitation strategies. We elaborate on four reasons behind this statement: (1) MS disease activity and progression are complex and multidimensional concepts in nature and thereby defy a one-size-fits-all description, (2) functioning, progression, treatment, and rehabilitation effects are interdependent and should be investigated together, (3) personalized healthcare is based on the dynamics of system biology and on technology that confirms a patient's fundamental biology and (4) inclusion of patient-reported outcome measures can facilitate patient-relevant healthcare.

The influence of ethnicity on disease outcome in patients with chronic hepatitis B infection.

Since the cultural diversity in Western Europe is growing, this study assessed whether foreign-born chronic hepatitis B (CHB) patients have more cirrhosis than Dutch- or Belgian-born patients, with a main focus on the Turkish population. Baseline characteristics (eg, socioeconomic status [SES]), biological characteristics, and disease outcome (eg, cirrhosis) were collected for all patients. Between December 2009 and January 2015, 269 CHB patients participated from the outpatient departments of three hospitals in the Netherlands, Belgium, and Turkey.

Surrogate endpoints in advanced sarcoma trials: a meta-analysis.

Background: Alternative endpoints to overall survival (OS) are frequently used to assess treatment efficacy in randomized controlled trials (RCT). Their properties in terms of surrogate outcomes for OS need to be assessed. We evaluated the surrogate properties of progression-free survival (PFS), time-to-progression (TTP) and time-to-treatment failure (TTF) in advanced soft tissue sarcomas (STS).

The linear no-threshold model is less realistic than threshold or hormesis-based models: An evolutionary perspective.

The linear no-threshold (LNT) risk model is the current human health risk assessment paradigm. This model states that adverse stochastic biological responses to high levels of a stressor can be used to estimate the response to low or moderate levels of that stressor. In recent years the validity of the LNT risk model has increasingly been questioned because of the recurring observation that an organism's response to high stressor doses differs from that to low doses.

Factors associated with use of restraints on older adults with home care: A secondary analysis of a cross-sectional survey study.

Background: Although there is evidence that use of restraints in home care is increasing, research into the factors associated with restraints in this setting is scarce.

Objective: To gain insight into the factors associated with restraints in older adults receiving home care.

Design: A secondary analysis of a cross-sectional survey about restraint use in home care.

Unplanned Readmission prevention by Geriatric Emergency Network for Transitional care (URGENT): protocol of a prospective single centre quasi-experimental study.

Background: International guidelines recommend adapting the classic emergency department (ED) management model to the needs of older adults in order to ameliorate post-ED outcomes among this vulnerable group. To improve the care for older ED patients and especially prevent unplanned ED readmissions, the URGENT care model was developed.

Methods: The URGENT care model is a nurse-led, comprehensive geriatric assessment based care model in the ED with geriatric follow-up after ED discharge.

Correlated gamma frailty models for bivariate survival time data.

Frailty models have been developed to quantify both heterogeneity as well as association in multivariate time-to-event data. In recent years, numerous shared and correlated frailty models have been proposed in the survival literature allowing for different association structures and frailty distributions. A bivariate correlated gamma frailty model with an additive decomposition of the frailty variables into a sum of independent gamma components was introduced before.

Assessing the relationship between epidemic growth scaling and epidemic size: The 2014-16 Ebola epidemic in West Africa.

We assess the relationship between epidemic size and the scaling of epidemic growth of Ebola epidemics at the level of administrative areas during the 2014-16 Ebola epidemic in West Africa. For this purpose, we quantify growth scaling parameters from the ascending phase of Ebola outbreaks comprising at least 7 weeks of epidemic growth. We then study how these parameters are associated with observed epidemic sizes.

The retrospective study of 93 patients with transmigration of mandibular canine and a comparative analysis with a control group.

Objectives: The aim of this study was to evaluate characteristics of patients with unilateral transmigration of a mandibular canine in the largest study group presented until now.

Materials And Methods: The study group consisted of 93 patients with unilateral transmigration of mandibular canine; the control group included 85 non-affected patients. Type of transmigration, status of deciduous and permanent canines, prevalence of missing teeth, class of occlusion, and space conditions were assessed to draw comparisons between groups.

Perceptions, attitudes, and practices of French junior physicians regarding antibiotic use and resistance.

Objectives: To assess the perceptions, attitudes, and practices of French junior physicians regarding antibiotic use and resistance, and then to identify the characteristics of junior physicians associated with appropriate practices of antibiotic use.

Method: European junior physicians received an email invitation to complete a 49 item web questionnaire between September 2015 and January 2016. We present the French data.

Measures for concordance and discordance with applications in disease control and prevention.

Bivariate binary response data appear in many applications. Interest goes most often to a parameterization of the joint probabilities in terms of the marginal success probabilities in combination with a measure for association, most often being the odds ratio. Using, for example, the bivariate Dale model, these parameters can be modelled as function of covariates.

Assessing inference of the basic reproduction number in an SIR model incorporating a growth-scaling parameter.

The standard mass action, which assumes that infectious disease transmission occurs in well-mixed populations, is popular for formulating compartmental epidemic models. Compartmental epidemic models often follow standard mass action for simplicity and to gain insight into transmission dynamics as it often performs well at reproducing disease dynamics in large populations. In this work, we formulate discrete time stochastic susceptible-infected-removed models with linear (standard) and nonlinear mass action structures to mimic varying mixing levels.

Cord blood leptin and insulin levels in association with mitochondrial DNA content.

Background: The developmental origins of health and disease theory states that a disturbance in the early life environment can contribute to disease risk in later life. Leptin and insulin are anorectic hormones involved in energy homeostasis and are crucial for foetal growth. Disturbances in the levels of these hormones contribute to obesity and diabetes.

Modeling the impact of changes in day-care contact patterns on the dynamics of varicella transmission in France between 1991 and 2015.

Annual incidence rates of varicella infection in the general population in France have been rather stable since 1991 when clinical surveillance started. Rates however show a statistically significant increase over time in children aged 0-3 years, and a decline in older individuals. A significant increase in day-care enrolment and structures' capacity in France was also observed in the last decade.

High prevalence of epilepsy in onchocerciasis endemic health areas in Democratic Republic of the Congo.

Background: A high prevalence of epilepsy has been observed in many onchocerciasis endemic regions. This study is to estimate the prevalence of active epilepsy and exposure to Onchocerca volvulus infection in a rural population in Ituri province, Democratic Republic of Congo.

Methods: In August 2016, a community-based cross-sectional study was conducted in an onchocerciasis endemic area in the rural health zone of Logo, Ituri Province.

Legal framework of antimicrobial stewardship in hospitals (LEASH): a European Society of Clinical Microbiology and Infectious Diseases (ESCMID) cross-sectional international survey.

Antimicrobial stewardship (AMS) is the cornerstone activity in the combat against antimicrobial resistance. In order to ensure sustainable deployment and development of AMS, a strategic and regulatory framework needs to be provided by national healthcare authorities. Experts from 32 European countries, Israel and Turkey were invited to participate in a cross-sectional internet-based survey from October 2016 to May 2017 on the legal framework and mandatory components (structures, activities) of AMS in hospitals, i.

Reusable endoscopic water bottles: is daily renewal really necessary?

Most guidelines recommend replacing endoscopic water bottles at least daily with newly sterilized or high-level disinfected water bottles. All these recommendations, however, are mainly based on expert opinions and outbreak reports. We tested the water quality from water bottles used in a gastrointestinal endoscopy unit where water bottles were used up to five days.