No children, no DSS, no students : online adverts and “property guardianship”

Purpose: Those seeking a new place to live – especially in the private rented sector – now head online to do so. The platforms they use and adverts they see are an important source of information about the properties they will occupy and how their owners’ seek to project them. This paper aims to argue for the importance of property adverts as a source of data, using “property guardianship” to illustrate the value in the approach. Design/methodology/approach: The study draws on an analysis of 503 advertisements published on SpareRoom.co.uk – a leading property search engine – in July 2018. Findings: The authors put forward four key areas of findings. The first two look at legal understanding, dealing with the context, the advertisement provides for eventual occupation (the “process of construction”) and any indications they provide of legal elements of occupation (“diagnostics”). The final two deal with the broader positioning of the sector, analysing the practice of excluding prospective occupiers, such as the widespread inclusion of “no Department of Social Security” seen elsewhere in the private rented sector, and how the adverts project a certain lifestyle to their viewer. Research limitations/implications: The findings demonstrate that further research into property advertisements would be valuable, particularly into other sub-markets in the private-rented sector, such as student accommodation and “professional” lets. Originality/value: This study is the only analysis of property guardian advertisements and the first dedicated study of private rented sector advertisements in the UK

The face of Property Guardianship : Online property advertisements, categorical identity and googling your next home

This paper examines the phenomenon of “property guardianship” in England, focusing on property guardians’ entry into this precarious sector and the reality of their occupation. Drawing on data from a survey of 217 London-based property guardians and an analysis of 512 online property guardian advertisements, we examine: (i) how property guardian advertisements construct this form of accommodation as a destination for young people unable to afford private rented accommodation, and (ii) whether this image meets the reality of day-to-day occupation in the sector. We argue that these advertisements reveal tensions between the presentation of this form of accommodation – billed as a solution to the precarity caused by the lack of housing affordability for young renters – and the precariousness experienced by those living in the sector

VAF Vooronderzoek 'Verzameling audiovisuele data' : actieplan

Policy report for the Flemish Audiovisual Fund (Vlaams Audiovisueel Fonds/VAF) exploring the future data collection strategies for investigating the Flemish/Belgian audiovisual sector within a European and international context

Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies:a report from the EPICOVIDEHA registry

Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093–0.732) and obesity (aOR 0.105, 95%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).</p

MOLNUPIRAVIR COMPARED TO NIRMATRELVIR/RITONAVIR FOR COVID-19 IN HIGH-RISK PATIENTS WITH HAEMATOLOGICAL MALIGNANCY IN EUROPE. A MATCHED-PAIRED ANALYSIS FROM THE EPICOVIDEHA REGISTRY

Introduction: Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections, which reduce both hospitalization and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, while molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir, because it displays less frequent drug-drug interactions and contraindications. A caveat connected to molnupiravir derives from the mode of action inducing viral mutations. In clinical trials on patients without haematological malignancy, mortality rate reduction of molnupiravir appeared less pronounced than that of nirmatrelvir/ritonavir. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, we here assess the effectiveness of molnupiravir compared to nirmatrelvir/ritonavir in our cohort of patients with haematological malignancies. Methods: Clinical data of patients treated either with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and baseline haematological malignancy severity to controls treated with nirmatrelvir/ritonavir. Results: A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (IQR 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 57% (n=66) of the patients had controlled baseline haematological malignancy, 13% (n=15) stable, and 30% (n=35) had active disease at COVID-19 onset in each of the groups. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of vaccinated patients was observed in both groups (molnupiravir n=77, 66% vs nirmatrelvir/ritonavir n=87, 75%), those treated with nirmatrelvir/ritonavir had more often received four doses (n=27, 23%) as compared to patients treated with molnupiravir (n=5, 4%, p&lt;0.001). No differences were detected in COVID-19 severity (p=0.39) or hospitalization (p=1.0). No statistically significant differences were identified in overall mortality rate (p=0.78) or in survival probability (d30 p=0.19, d60 p=0.67, d90 p=0.68, last day of follow up p=0.68). In all patients, deaths were either attributed to COVID-19 or the infection contributed to death as per treating physician's judgement. Conclusions: In high-risk patients with haematological malignancies and COVID-19, molnupiravir showed rates of hospitalization and mortality comparable to those of nirmatrelvir/ritonavir in this matched-pair analysis. Molnupiravir appears to be a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy

Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan-Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448-4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619-8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093-0.732) and obesity (aOR 0.105, 95%CI 0.014-0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p&nbsp;=&nbsp;0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223)

Age, Successive Waves, Immunization, and Mortality in Elderly COVID-19 Haematological Patients: EPICOVIDEHA Findings

Introduction: elderly patients with haematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection impact in different age groups remains unstudied in detail. Methods: We analysed elderly patients (age groups: 65-70, 71-75, 76-80 and &gt;80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with haematological malignancy. results: the study included data from 3,603 elderly patients (aged 65 or older) with haematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves.tThe 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukaemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. Conclusions: These data underscore the heterogeneity of elderly haematological patients, highlight the different impact of COVID waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts

Het gebruik van marginale donoren voor longtransplantatie. Een klinische en experimentele studie.

SUMMARY Lung transplantation has become the standard treatment for well selected patients suffering from any form of end-stage pulmonary disease.The number of lung transplantations performed worldwide augments each year with more patients referred as a result of a better post transplant outcome. Consequently, the number of patients on the waiting list is increasing just like waiting time and deaths on the waiting list. In order to attenuate the problem of donor shortage, it is necessary to search for alternative lung donors, such as extended criteria donors (ECDs). In a first clinical study, we found that the profile of the multiple-organ donor (MOD) changed in nearly two decades to older age, fewer traumatic brain deaths, and longer ventilation time. The number of referred potential MODs increased by 80%, resulting in only a small increase in effective MOD organs (+17%), mainly because of medical contraindications. A larger proportion of livers, lungs, and pancreases but fewer percentages of kidneys and hearts were transplanted.In a second clinical study we found a lung donor acceptance rate of 34% in our centre, significantly higher than in other transplant centers. This results from relaxing our lung donor criteria since the year 2000. The number of lung transplants in our center thereby doubled by accepting ECDs. This policy did not negatively influence our short-term results after lung transplantation.In the experimental part of this project, an acute lung injury (ALI) model was developed in pigs. Lung injury was initially induced by lipopolysaccharides (LPS) and latterly gastric juice (GJ) since abnormalities on x-ray, low oxygenation and aspiration are the most important reasons to decline lungs in our donors. LPS instillation caused inflammation with more cells in broncho-alveolar lavage (BAL), changes on CT, and histology. However, no physiologic changes occurred necessary to measure functional improvement during ex vivo lung perfusion (EVLP). Instillation of GJ in pig lungs caused ALI with impaired oxygenation and increased inflammation in BAL, on histology, and on imaging. Therefore, this model of ALI was chosen to evaluate lungs during EVLP.In a next study, we demonstrated that EVLP of lungs injured by gastric aspiration is feasible for at least two hours. Our results show that lungs already damaged do not significantly deteriorate during EVLP. This model provides an opportunity to evaluate and potentially recondition donor lungs. In a last series of experiments we showed that preemptive donor treatment with steroids, but not macrolides improved gas exchange independently from its anti-inflammatory activity.Further studies are needed to find new treatment strategies to improve the quality of donor lungs ex vivo if we want to increase the number of patients whose life can be saved with lung transplantation.TABLE OF CONTENTS Dankwoord 7 List of Abbreviations 11 I. Introduction and Aims 13 II. Clinical studies 25 Chapter 1 27 Change in donor profile influenced the percentage of organs transplanted from multiple-organ donors. Chapter 2 37 The number of lung transplants can be safely doubled using extended criteria donors; a single-center review. III. Experimental studies 57 Chapter 3 59 A porcine model of acute lung injury by instillation of LPS. Chapter 4 87 A porcine model of acute lung injury by instillation of gastric fluid. Chapter 5 111 A model of ex vivo perfusion of porcine donor lungs injured by gastric aspiration: a step towards pretransplant reconditioning. Chapter 6 133 Preemptive therapy with steroids but not macrolides improves gas exchange in injured donor lungs. IV. General discussion and future perspectives 153 Summary 165 Samenvatting 167 Curriculum vitae 169 List of publications 171nrpages: 173status: publishe