Meteorological forcing, and corresponding hydrological model input and output used in the paper: The impact of hydrological model structure on the simulation of extreme runoff events.

The datasets used in Van Kempen et al., 2021 are included in this repository. These files consist of the original meteorological forcing, hydrological model input and hydrological model output. The README provides a description of the set-up of these datasets

The impact of hydrological model structure on the simulation of extreme runoff events

Hydrological extremes affect societies and ecosystems around the world in many ways, stressing the need to make reliable predictions using hydrological models. However, several different hydrological models can be selected to simulate extreme events. A difference in hydrological model structure results in a spread in the simulation of extreme runoff events. We investigated the impact of different model structures on the magnitude and timing of simulated extreme high- and low-flow events by combining two state-of-the-art approaches: a modular modelling framework (FUSE) and large ensemble meteorological simulations. This combination of methods created the opportunity to isolate the impact of specific hydrological process formulations at long return periods without relying on statistical models. We showed that the impact of hydrological model structure was larger for the simulation of low-flow compared to high-flow events and varied between the four evaluated climate zones. In cold and temperate climate zones, the magnitude and timing of extreme runoff events were significantly affected by different parameter sets and hydrological process formulations, such as evaporation. In the arid and tropical climate zones, the impact of hydrological model structures on extreme runoff events was smaller. This novel combination of approaches provided insights into the importance of specific hydrological process formulations in different climate zones, which can support adequate model selection for the simulation of extreme runoff events

Azolla along a phosphorus gradient: biphasic growth response linked to diazotroph traits and phosphorus-induced iron chlorosis

Contains fulltext : 189958.pdf (publisher's version ) (Open Access)8 p

Meteorological forcing, and corresponding hydrological model input and output used in the paper: The impact of hydrological model structure on the simulation of extreme runoff events.

The datasets used in Van Kempen et al., 2021 are included in this repository. These files consist of the original meteorological forcing, hydrological model input and hydrological model output.The README provides a description of the set-up of these datasets. </div

Timeliness of immunisations in preterm infants in the Netherlands

Background: In the Netherlands, preterm infants receive the immunisations at the same chronological age as recommended for term infants without correction for gestational age (GA). The aim of this paper was to describe the timeliness of the routine Dutch national immunisation schedule in preterm infants in their first year of life and to evaluate possible determinants of delay.Methods: Preterm infants were prospectively recruited between October 2015 and October 2017 and stratified according to GA (Results: Timely start of immunisation occurs in 60.5% of preterm infants in the Netherlands. The proportion of infants receiving the first immunisation on time was lowest for the group with GAConclusion: These findings indicate that start of immunisations was often delayed in prematures and differs for different GA groups, being lowest (37%) in infants</p

The CareWell-primary care program: design of a cluster controlled trial and process evaluation of a complex intervention targeting community-dwelling frail elderly

Contains fulltext : 109717.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: With increasing age and longevity, the rising number of frail elders with complex and numerous health-related needs demands a coordinated health care delivery system integrating cure, care and welfare. Studies on the effectiveness of such comprehensive chronic care models targeting frail elders show inconclusive results. The CareWell-primary care program is a complex intervention targeting community-dwelling frail elderly people, that aims to prevent functional decline, improve quality of life, and reduce or postpone hospital and nursing home admissions of community dwelling frail elderly. METHODS/DESIGN: The CareWell-primary care study includes a (cost-) effectiveness study and a comprehensive process evaluation. In a one-year pragmatic, cluster controlled trial, six general practices are non-randomly recruited to adopt the CareWell-primary care program and six control practices will deliver 'care as usual'. Each practice includes a random sample of fifty frail elders aged 70 years or above in the cost-effectiveness study. A sample of patients and informal caregivers and all health care professionals participating in the CareWell-primary care program are included in the process evaluation. In the cost-effectiveness study, the primary outcome is the level of functional abilities as measured with the Katz-15 index. Hierarchical mixed-effects regression models / multilevel modeling approach will be used, since the study participants are nested within the general practices. Furthermore, incremental cost-effectiveness ratios will be calculated as costs per QALY gained and as costs weighed against functional abilities. In the process evaluation, mixed methods will be used to provide insight in the implementation degree of the program, patients' and professionals' approval of the program, and the barriers and facilitators to implementation. DISCUSSION: The CareWell-primary care study will provide new insights into the (cost-) effectiveness, feasibility, and barriers and facilitators for implementation of this complex intervention in primary care. TRIAL REGISTRATION: The CareWell-primary care study is registered in the ClinicalTrials.gov Protocol Registration System: NCT01499797

Rotavirus Vaccine Safety and Effectiveness in Infants With High-Risk Medical Conditions.

OBJECTIVES: Rotavirus vaccination has 87% to 100% effectiveness against severe rotavirus acute gastroenteritis (AGE) in healthy infants in high-income countries. Little is known whether infants with medical risk conditions (MRCs) are equally protected and if the vaccine is equally well tolerated. We conducted a quasi-experimental prospective multicenter before-after cohort study to assess the vaccine effectiveness (VE) and safety profile of the human rotavirus vaccine (HRV) among MRC infants that required prolonged or frequent postnatal care. METHODS: The Netherlands has no national rotavirus immunization program, but HRV was implemented in routine care for MRC infants in 13 Dutch hospitals. Participants in the before and after cohort, HRV unvaccinated and vaccinated, respectively, were followed for occurrence of (rotavirus) AGE. VE of at least 1 dose was estimated by using time-to-event analysis for severe rotavirus AGE. Vaccine-related serious adverse event (AEs) after HRV were retrieved systematically from medical charts. Solicited AEs after vaccinations were prospectively collected and compared between vaccination time points with or without HRV. RESULTS: In total, 1482 high-risk infants with MRC were enrolled, including 631 in the before and 851 in the after cohorts; 1302 infants were premature (88.3%), 447 were small for gestational age (30.2%), and 251 had at least 1 congenital disorder (17.0%). VE against severe rotavirus AGE was 30% (95% confidence interval [CI]: -36% to 65%). Overall, the observed number of rotavirus hospitalizations was low and not significantly different between the cohorts (2 and 2, respectively). The rate of vaccine-related serious AE was 0.24 per 100 vaccine doses. The adjusted risk ratio for any AE after HRV vaccination compared with other routine vaccinations was 1.09 (95% CI: 1.05 to 1.12) for concomitant administration and 0.91 (95% CI: 0.81 to 0.99) for single HRV administration. Gastrointestinal AEs were 10% more frequent after HRV. CONCLUSIONS: In contrast to previous findings among healthy term infants, in routine use, HRV offered limited protection to vulnerable medical risk infants. HRV is generally well tolerated in this group in single administration, but when coadministered with routine vaccines, it is associated with higher risk of (mostly gastrointestinal) AE. Our study highlights the importance of studying vaccine performance in subgroups of medically vulnerable infants

Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

© The Author(s) 2022.Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8–6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis