6,672 results match your criteria: "Julius Center for Health Sciences and Primary Care[Affiliation]"

Background/objectives: Traditional food markets are essential in urban food environments in Kenya and other low- and middle-income countries (LMICs). They provide affordable fresh food, particularly for low-income urban communities, and are vital places of livelihoods and local economic activities. Despite their importance, associations between market-related factors and diet quality for vendors and consumers are underexplored.

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Gut microbiome and immune checkpoint inhibitor toxicity.

Eur J Cancer

January 2025

Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, PO box 85500, Utrecht 3584 CX, the Netherlands. Electronic address:

Background: Multiple studies have suggested that gut microbiome may influence immune checkpoint inhibitor (ICI) efficacy, but its association with immune-related adverse events (irAEs) is less well studied. In this prospective cohort study, we assessed whether gut microbiome composition at start, or changes during ICI, are associated with severe irAEs.

Methods: Stool samples of cancer patients treated with anti-PD-1 ± anti-CTLA-4 were analyzed using 16S rRNA gene sequencing and metagenomic shotgun sequencing.

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Background: Existing risk evaluation tools underperform in predicting intensive care unit (ICU) admission for patients with the Coronavirus Disease 2019 (COVID-19). This study aimed to develop and evaluate an accurate and calculator-free clinical tool for predicting ICU admission at emergency room (ER) presentation.

Methods: Data from patients with COVID-19 in a nationwide German cohort (March 2020-January 2023) were analyzed.

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Shared governance in hospitals promotes the inclusion of nurses' expertise, knowledge and skills in organisational processes, and nurses increasingly fulfil positions in organisational hierarchies. However, incorporating nursing expertise in strategic governance structures might be complicated, as these structures are primarily linked to managerial and biomedical expertise. Drawing on a Foucauldian perspective on knowledge and power, intertwined and embedded in everyday (inter)actions, we study how newly appointed directors of nursing challenge these dominant 'modes of knowing'.

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The TRIPOD-LLM reporting guideline for studies using large language models.

Nat Med

January 2025

Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA.

Large language models (LLMs) are rapidly being adopted in healthcare, necessitating standardized reporting guidelines. We present transparent reporting of a multivariable model for individual prognosis or diagnosis (TRIPOD)-LLM, an extension of the TRIPOD + artificial intelligence statement, addressing the unique challenges of LLMs in biomedical applications. TRIPOD-LLM provides a comprehensive checklist of 19 main items and 50 subitems, covering key aspects from title to discussion.

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Purpose: Patients with metastatic colorectal cancer (mCRC) undergoing systemic treatment often experience toxicities. Although exercise may improve physical fitness and quality of life and counteract treatment toxicity, knowledge in patients with mCRC is limited. The ongoing randomized controlled AMICO trial evaluates the effects of supervised exercise on clinical outcomes.

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Effectiveness of bi-monthly long-acting injectable cabotegravir and rilpivirine as maintenance treatment for HIV-1 in the Netherlands: results from the Dutch ATHENA national observational cohort.

Lancet HIV

January 2025

Stichting HIV Monitoring, Amsterdam, Netherlands; Department of Infectious Diseases, Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands.

Background: Real-world data showing the long-term effectiveness of long-acting injectable cabotegravir and rilpivirine are scarce. We assessed the effectiveness of cabotegravir and rilpivirine in all individuals who switched to cabotegravir and rilpivirine in the Netherlands.

Methods: We used data from the ATHENA cohort, an ongoing observational nationwide HIV cohort in the Netherlands.

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Purpose: Real-world evidence (RWE) is increasingly considered in regulatory and health technology assessment (HTA) decision-making, though perspectives on its relevance may vary. Expanding on a recent review regarding regulatory decisions, this study aimed to identify factors influencing the need for RWE in HTA decision-making, confirm and enrich factors with stakeholder views, and evaluate similarities and differences between regulatory and HTA needs.

Methods: Previous scoping review methodology was used to identify factors influencing the need for RWE in HTA decision-making.

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The primary practice of healthcare artificial intelligence (AI) starts with model development, often using state-of-the-art AI, retrospectively evaluated using metrics lifted from the AI literature like AUROC and DICE score. However, good performance on these metrics may not translate to improved clinical outcomes. Instead, we argue for a better development pipeline constructed by working backward from the end goal of positively impacting clinically relevant outcomes using AI, leading to considerations of causality in model development and validation, and subsequently a better development pipeline.

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Views and opinions of the general public about the reimbursement of expensive medicines in the Netherlands.

PLoS One

January 2025

Department of Public Health, Healthcare Innovation & Evaluation and Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Objectives: Solidarity-based healthcare systems are being challenged by the incremental costs of new and expensive medicines for cancer and rare diseases. To regulate reimbursement of such drugs, the Dutch government introduced a policy instrument known as the Coverage Lock (CL) in 2015. Little is known about the public opinion regarding such policy instruments and their consequences, i.

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Duration of Antibiotic Treatment for Foot Osteomyelitis in People with Diabetes.

Antibiotics (Basel)

December 2024

Division of Infectious Diseases, Department Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.

The optimal antimicrobial treatment duration for diabetes-related foot osteomyelitis (DFO) currently needs to be determined. We systematically reviewed the effects of short and long treatment durations on outcomes of DFO. We performed a systematic review searching Cochrane, CENTRAL, MEDLINE, Embase, and CINAHL Plus from inception up to 19 January 2024.

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Advancing District Nursing Care Through a Learning Healthcare System: A Viewpoint on Key Requirements.

Healthcare (Basel)

December 2024

Research Centre for Healthy and Sustainable Living, Faculty of Health Care, University of Applied Sciences Utrecht, 3584 CS Utrecht, The Netherlands.

The increasing complexity of healthcare needs driven by an ageing population places pressure on district nursing care. Many vulnerable older adults prefer to remain at home, requiring care coordinated with general practitioners and other professionals. This demand for integrated care is further challenged by a shortage of nursing professionals and the lack of standardised approaches to measure care quality.

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Extraintestinal pathogenic (ExPEC) causes invasive disease (IED), including bacteraemia and (uro)sepsis, resulting in a high disease burden, especially among older adults. This study describes the epidemiology of IED in England (2013-2017) by combining laboratory surveillance and clinical data. A total of 191 612 IED cases were identified.

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Understanding Parkinson's: The microbiome and machine learning approach.

Maturitas

December 2024

Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Universiteitsweg 99, Utrecht 3508 TB, the Netherlands.

Objective: Given that Parkinson's disease is a progressive disorder, with symptoms that worsen over time, our goal is to enhance the diagnosis of Parkinson's disease by utilizing machine learning techniques and microbiome analysis. The primary objective is to identify specific microbiome signatures that can reproducibly differentiate patients with Parkinson's disease from healthy controls.

Methods: We used four Parkinson-related datasets from the NCBI repository, focusing on stool samples.

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Immune checkpoint inhibitor (ICI) treatment has proven successful for advanced melanoma, but is associated with potentially severe toxicity and high costs. Accurate biomarkers for response are lacking. The present work is the first to investigate the value of deep learning on CT imaging of metastatic lesions for predicting ICI treatment outcomes in advanced melanoma.

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Cesarean section: One procedure, varied techniques. Detailed observations of 1013 first cesarean sections in a tertiary hospital in Ghana.

Int J Gynaecol Obstet

December 2024

Department of Obstetrics, Birth Center Wilhelmina Children Hospital, Division Woman and Baby, University Medical Center, Utrecht, The Netherlands.

Objective: Cesarean sections (CS) are among the most performed surgical procedures in the world. Small variations in surgical techniques could have a significant impact on a global scale, for example, in postoperative complications. In the present study we aimed to observe and audit every single step used during first time CS.

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Psychosocial and cognitive determinants of 10-year depressive symptom trajectories in patients with cardiovascular disease: The SMART-Medea Study.

J Affect Disord

December 2024

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands; Amsterdam Public Health, Aging & Later life, and Personalized Medicine, Amsterdam, the Netherlands; Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of General Practice, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address:

Background: Middle-aged and older adults presenting clinically relevant depressive symptoms are often undiagnosed. Understanding the determinants of late-life depressive symptoms could improve prognosis. Further, individuals with manifest cardiovascular disease (CVD) are at an increased risk of depression.

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Objective: During the COVID-19 pandemic, dynamic factors such as governmental policies, improved treatment and prevention options and viral mutations changed the incidence of outcomes and possibly changed the relation between predictors and outcomes. The aim of the present study was to assess whether the dynamic context of the pandemic influenced the predictive performance of mortality predictions over time in older patients hospitalised for COVID-19.

Study Design And Setting: The COVID-OLD study, a multicentre cohort study in the Netherlands, included COVID-19 patients aged 70 years and older hospitalised during the first (early 2020), second (late 2020), third (late 2021) or fourth wave (early 2022).

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Air pollution exposure disparities among ethnic groups in high-income countries: A scoping review.

Environ Res

December 2024

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Background: The adverse health effects of air pollution are well-established. Previous reviews have highlighted disparities in air pollution exposure between minoritized ethnic groups and majoritized ethnic groups. However, these reviews primarily focused on proximity to pollution sources rather than objectively measured concentrations.

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Background And Aims: Sub-Saharan Africa drives global HIV-related mortality, and patients continuously present with advanced HIV disease (AHD) at diagnosis. We describe prevalence, predictors, and treatment outcomes in HIV clients with AHD.

Methods: We systematically reviewed PUBMED, SCOPUS, Web of Science, JSTOR, and CINAHL for relevant studies conducted in Sub-Saharan Africa from 2010 to 2022.

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Purpose: Although total dietary protein intake has been associated with bladder cancer (BC) risk, the effect of the origin (plant or animal) and the substitutions remain to be understood. This study aimed to investigate the effect of total dietary protein, animal-based protein, plant-based protein, and their substitutions with each other on the risk of BC using a pooled analysis of 10 cohort studies.

Methods: The study was conducted within the "BLadder cancer Epidemiology and Nutritional Determinants" (BLEND) study, including 10 prospective cohort studies from several European countries, the United Kingdom, and the United States.

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Atrial fibrillation (AF) remains the most common cardiac arrhythmia worldwide and is associated with significant morbidity and mortality. The European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) have recently released the 2024 guidelines for the management of AF. This review highlights 10 novel aspects of the ESC/EACTS 2024 Guidelines.

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The network theory of psychopathology posits that mental disorders are systems of mutually reinforcing symptoms. This framework has proven highly generative but does not specify precisely how any specific mental disorder operates as such a system. Cognitive behavioral theories of mental disorders provide considerable insight into how these systems may operate.

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Country-Specific Roadmaps for Scaling Up Integrated Care in Belgium, Slovenia, and Cambodia - Lessons Learned from the SCUBY Project.

Int J Integr Care

December 2024

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

Introduction: The SCUBY project aimed to provide knowledge on the scaling-up of an Integrated Care Package (ICP) for type 2 diabetes and hypertension across three distinct health systems (Cambodia, Slovenia, and Belgium). Here, we analyse the different elements of the country-specific scale-up roadmaps to identify similarities and differences, and share lessons learned.

Methods: Thematic analysis was used to derive crucial roadmap elements from key SCUBY documents (n = 20), including policy briefs, interim reports, research outputs, and consortium meeting notes.

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The Need for a Cancer Exposome Atlas: A Scoping Review.

JNCI Cancer Spectr

December 2024

Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

Background: Despite advances in understanding genetic susceptibility to cancer, much of cancer heritability remains unidentified. At the same time, the makeup of industrial chemicals in our environment only grows more complex. This gap in knowledge on cancer risk has prompted calls to expand cancer research to the comprehensive, discovery-based study of non-genetic environmental influences, conceptualized as the "exposome.

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