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Klaassen E.M.M.,Maastricht University | Van De Kant K.D.G.,Maastricht University | Jobsis Q.,Maastricht University | Van Schayck O.C.P.,Maastricht University | And 9 more authors.
American Journal of Respiratory and Critical Care Medicine | Year: 2015

Rationale: A reliable asthma diagnosis is difficult in wheezing preschool children. Objectives: To assess whether exhaled biomarkers, expression of in flammation genes, and early lung function measurements can improve a reliable asthma prediction in preschool wheezing children. Methods: Two hundred two preschool recurrent wheezers (aged 2-4 yr) were prospectively followed up until 6 years of age. At 6 years of age, a diagnosis (asthma or transient wheeze) was based on symptoms, lung function, and asthma medication use. The added predictive value (area under the receiver operating characteristic curve [AUC]) of biomarkers to clinical information (assessed with the Asthma Predictive Index [API]) assessed at preschool age in diagnosing asthma at 6 years of age was determined with a validation set. Biomarkers in exhaled breath condensate, exhaled volatile organic compounds (VOCs), gene expression, and airway resistance were measured. Measurements and Main Results: At 6 years of age, 198 children were diagnosed (76 with asthma, 122 with transient wheeze). Information on exhaled VOCs significantly improved asthma prediction (AUC, 89% [increase of 28%]; positive predictive value [PPV]/negative predictive value [NPV], 82/83%), which persisted in the validation set. Information on gene expression of toll-like receptor 4, catalase, and tumor necrosis factor-α significantly improved asthma prediction (AUC, 75% [increase of 17%]; PPV/NPV, 76/73%). This could not be confirmed after validation. Biomarkers in exhaled breath condensate and airway resistance (pre- and post- bronchodilator) did not improve an asthma prediction. The combined model with VOCs, gene expression, and API had an AUC of 95% (PPV/NPV, 90/89%). Conclusions: Adding information on exhaled VOCs and possibly expression of inflammation genes to the API significantly improves an accurate asthma diagnosis in preschool children. Clinical trial registered with www.clinicaltrial.gov (NCT 00422747). Copyright © 2015 by the American Thoracic Society.


Rijkers G.T.,St Antonius Hospital Nieuwegein | Rijkers G.T.,Roosevelt Academy
Critical Care | Year: 2011

Probiotics are live micro-organisms with a health promoting effect. Because of their immunomodulating capacity as well as improvement of gut barrier function, probiotics have the capacity to prevent infectious complications in a variety of clinical settings. Now selected probiotics show potential for improving the clinical outcome of severe trauma patients. © 2011 BioMed Central Ltd.


Van Garderen M.,TU Eindhoven | Liotta G.,University of Perugia | Meijer H.,Roosevelt Academy
Information Processing Letters | Year: 2012

Let R and B be two sets of distinct points such that the points of R are coloured red and the points of B are coloured blue. Let G be a family of planar graphs such that for each graph in the family |R| vertices are red and |B| vertices are blue. The set R∪B is a universal point set for G if every graph GεG has a straight-line planar drawing such that the blue vertices of G are mapped to the points of B and the red vertices of G are mapped to the points of R. In this paper we describe universal point sets for meaningful classes of 2-coloured trees and show applications of these results to the coloured simultaneous geometric embeddability problem. © 2012 Elsevier B.V. All rights reserved.


Di Giacomo E.,University of Perugia | Didimo W.,University of Perugia | Liotta G.,University of Perugia | Meijer H.,Roosevelt Academy
Theory of Computing Systems | Year: 2011

In this paper we study non-planar drawings of graphs, and study trade-offs between the crossing resolution (i. e., the minimum angle formed by two crossing segments), the curve complexity (i. e., maximum number of bends per edge), the total number of bends, and the area. © 2010 Springer Science+Business Media, LLC.


Di Giacomo E.,University of Perugia | Didimo W.,University of Perugia | Liotta G.,University of Perugia | Meijer H.,Roosevelt Academy
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2010

We introduce and study (1 + ε)-EMST drawings, i.e. planar straight-line drawings of trees such that, for any fixed ε > 0, the distance between any two vertices is at least the length of the longest edge in the path connecting them. (1 + ε)-EMST drawings are good approximations of Euclidean minimum spanning trees. While it is known that only trees with bounded degree have a Euclidean minimum spanning tree realization, we show that every tree T has a (1 + ε)-EMST drawing for any given ε > 0. We also present drawing algorithms that compute (1 + ε)-EMST drawings of trees with bounded degree in polynomial area. As a byproduct of one of our techniques, we improve the best known area upper bound for Euclidean minimum spanning tree realizations of complete binary trees. © 2010 Springer-Verlag.


Rahut D.B.,South Asian University | Micevska Scharf M.,Leiden University | Micevska Scharf M.,Roosevelt Academy
Australian Journal of Agricultural and Resource Economics | Year: 2012

This article examines livelihood diversification strategies of rural households using survey data from the Himalayas. We present and explore an analytical framework that yields different activity choices as optimal solutions to a simple utility maximization problem. By classifying the range of activities of rural households into a few distinct categories based on their profitability and by considering portfolios of farm and non-farm activities, we provide novel insights into diversification behaviour of rural households. The evidence shows that while the poor are mainly agricultural labourers and work in the low-return non-farm sector, the better-off diversify in high-return non-farm activities. As expected, we find strong evidence that education plays a major role in accessing more remunerative non-farm employment. A somewhat less intuitive finding is that larger household size is associated with higher probability of diversification into the high-return non-farm sector. The finding that the farm size is not a constraint to diversification in lucrative non-farm employment is also surprising. Geographical location plays a role in diversification behaviour of rural households indicating the importance of local context. © 2012 The Authors. AJARE © 2012 Australian Agricultural and Resource Economics Society Inc. and Blackwell Publishing Asia Pty Ltd.


Wilhelmus M.M.M.,VU University Amsterdam | Verhaar R.,VU University Amsterdam | Andringa G.,VU University Amsterdam | Andringa G.,Roosevelt Academy | And 5 more authors.
Brain Pathology | Year: 2011

Parkinson's disease (PD) is characterized by the accumulation of α-synuclein aggregates and degeneration of melanized neurons. The tissue transglutaminase (tTG) enzyme catalyzes molecular protein cross-linking. In PD brain, tTG-induced cross-links have been identified in α-synuclein monomers, oligomers and α-synuclein aggregates. However, whether tTG and α-synuclein occur together in PD affected neurons remains to be established. Interestingly, using immunohistochemistry, we observed a granular distribution pattern of tTG, characteristic of melanized neurons in PD brain. Apart from tTG, these granules were also positive for typical endoplasmic reticulum (ER)-resident chaperones, that is, protein disulphide isomerase, ERp57 and calreticulin, suggesting a direct link to the ER. Additionally, we observed the presence of phosphorylated pancreatic ER kinase (pPERK), a classical ER stress marker, in tTG granule positive neurons in PD brain, although no subcellular colocalization of tTG and pPERK was found. Our data therefore suggest that tTG localization to granular ER compartments is specific for stressed melanized neurons in PD brain. Moreover, as also α-synuclein aggregates were observed in tTG granule positive neurons, these results provide a clue to the cellular site of interaction between α-synuclein and tTG. © 2010 International Society of Neuropathology.


Gitsels-van der Wal J.T.,VU University Amsterdam | Mannien J.,VU University Amsterdam | Ghaly M.M.,Leiden University | Verhoeven P.S.,Roosevelt Academy | And 3 more authors.
Midwifery | Year: 2014

Objective: to explore what role religious beliefs of pregnant Muslim women play in their decision-making on antenatal screening, particularly regarding congenital abnormalities and termination, and whether their interpretations of the religious doctrines correspond to the main sources of Islam. Design: qualitative pilot study using in-depth interviews with pregnant Muslim women. Setting: one midwifery practice in a medium-sized city near Amsterdam participated in the study. Participants: 10 pregnant Muslim women of Turkish origin who live in a high density immigrant area and who attended primary midwives for antenatal care were included in the study. Data collection and data analysis: to explore the role of religion in decision-making on antenatal screening tests, a topic list was constructed, including four subjects: being a (practising) Muslim, the view on unborn life, the view on disabled life and the view on termination. To analyse the interviews, open and axial coding based on the Grounded Theory was used and descriptive and analytical themes were identified and interpreted. Findings: all 10 interviewees stated that their faith played a role in their decision-making on antenatal screening, specific to the combined test. They did not consider congenital anomalies as a problem and did not consider termination to be an option in case of a disabled fetus. However, the Islamic jurisprudence considers that termination is allowed if the fetus has serious abnormalities, but only before 19 weeks plus one day of gestation. Key conclusions: religious convictions play a role regarding antenatal screening in pregnant Muslim women of Turkish origin. The interviewees did not consider a termination in case of an affected child. Women were unaware that within Islamic tradition there is the possibility of termination if a fetus has serious anomalies. Incomplete knowledge of religious doctrines may be influencing both decisions of antenatal screening and diagnostic tests uptake and of terminating a pregnancy for fetuses with serious anomalies. Implications for practise: counsellors should be aware of the role of religious beliefs in the decision-making process on antenatal screening tests. © 2013 The Authors.


Hanekamp J.C.,Roosevelt Academy | Bast A.,Roosevelt Academy | Calabrese E.J.,Roosevelt Academy
Critical reviews in food science and nutrition | Year: 2015

In this contribution, we show that current scientific methodologies used in nutrition science and by regulatory agencies, such as the randomized control trial, limit our understanding of nutrition and health as they are to crude to capture the subtle pleiotropic nature of most nutrients. Thereby, regulatory agencies such as the European Food Safety Authority curb the development of scientific knowledge and industrial innovations within the nutritional field. In order to develop insights into the health impact of certain food and food-components, we need to realize that health is adaptation set within a homeostatic range. Increased performance of health, i.e., the maximum stimulation of health, typically seems 30-60% greater than the control group, with a width of no more than about a factor of ten, clarifying the difficulty of documenting responses of food-endogenous components within the homeostatic range of healthy people. A strategy to record subtle responses of food components is the summation of procentual effects of relevant health outcomes. We illustrate this approach with the action of flavanols on vascular health, specifically endothelial function.


Rijkers G.,Roosevelt Academy
Pneumococcal Conjugate Vaccines | Year: 2012

Streptococcus pneumoniae (the pneumococcus) is a pathogen with significant disease implications, especially for the (very) young and the (very) old. It causes mucosal infections such as otitis media and pneumonia but also causes invasive diseases such as bacteremia and meningitis. In this book of seven chapters, international experts address the major challenges facing the current use and future development of pneumococcal conjugate vaccines - both from the scientific and the political standpoint. As such, the book comprises a comprehensive and up-to-date overview of this rapidly evolving field. © 2012 Future Medicine Ltd. All rights reserved.

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