Annual Report of the Centre for Infectious Diseases Research, Diagnostics and Screening (IDS)

Veel (ziekenhuis)laboratoria sturen het te onderzoeken materiaal van patiënten naar het Centrum Infectieziekteonderzoek, diagnostiek en screening (IDS) van het RIVM. Dit betreft vooral bijzondere diagnostiek waarvoor de laboratoria zelf geen test in huis hebben. Ook komen patiëntmaterialen binnen om te monitoren of en in welke mate bepaalde ziekteverwekkende micro-organismen voorkomen. Soms worden de ziekteverwekkers zelf ingestuurd met de vraag of IDS deze wil karakteriseren. Met de verkregen resultaten houdt het RIVM er zicht op hoe vaak en waar bepaalde micro-organismen voorkomen. Op die manier kan het RIVM snel reageren op (plotselinge) ontwikkelingen op het gebied van infectieziekten. IDS beschrijft jaarlijks de resultaten om inzenders van patiëntmaterialen inzicht te geven in wat is gedaan aan diagnostiek, screening en onderzoek naar infectieziekten. De jaarrapportage 2015 beschrijft onder andere de bijdrage van IDS aan de ebola-diagnostiek in Sierra Leone. Zeven medewerkers hielpen ter plaatse door de laboratoriumdiagnostiek uit te voeren. Verder zijn bij IDS de eerste stappen gezet om de hielprikscreening uit te breiden, en wel met de screening op Severe combined immunodeficiency (SCID). Ook wordt toegelicht hoe het komt dat het griepvaccin in 2015 onvoldoende werkte. Een deel van de onder de bevolking circulerende influenzavirussen bleek af te wijken van de virussen die in het griepvaccin waren opgenomen. Het onderzoek bij IDS bestaat er vooral uit om innovatieve laboratoriumtesten te ontwikkelen, te verbeteren en in te zetten. Dit in het belang van de openbare gezondheidszorg. Bij veel van deze onderzoeken wordt een innovatieve methode gebruikt waarmee het hele genoom van een micro-organisme in kaart kan worden gebracht (Whole Genome sequencing).Many hospital and other laboratories send their patient materials to RIVM's Centre for Infectious Diseases Research, Diagnostics and Screening (IDS) for testing, particularly if special diagnostic procedures are required for which these laboratories lack the necessary testing facilities. Patient materials are also sent to IDS in order to monitor the incidence of specific pathogenic micro-organisms. In some cases the pathogens themselves are sent to IDS for characterization. The results obtained enable RIVM to keep track of where and how frequently specific micro-organisms occur, enabling RIVM to respond rapidly to any (sudden) developments relating to infectious diseases. IDS summarizes the results of these activities in an Annual Report to provide stakeholders with insight into infectious diseases research, diagnostics and screening. The topics covered in the Annual Report for 2015 include IDS's contribution to Ebola diagnostics in Sierra Leone. Seven staff members travelled to the West African nation to provide laboratory diagnostic assistance. In addition, IDS has taken initial steps to expand its heel prick screening programme to include Severe Combined Immune Deficiency syndrome (SCID). The report also explains why the Dutch flu vaccination programme was insufficiently effective in 2015. A part of the circulating influenza viruses in the human population was found to deviate from the viruses that were included in the flu vaccine. Research at IDS is mainly focused on developing, optimizing and implementing innovative laboratory tests that can help to improve public health. Much of its research uses Whole Genome Sequencing, an innovative laboratory process that determines the complete DNA sequence of a micro-organism's genome

Kaehler forms and cosmological solutions in type II supergravities

We consider cosmological solutions to type II supergravity theories where the spacetime is split into a FRW universe and a K\"ahler space, which may be taken to be Calabi-Yau. The various 2-forms present in the theories are taken to be proportional to the K\"ahler form associated to the K\"ahler space.Comment: 6 pages, LaTeX2

Performance-based financing as a health system reform : mapping the key dimensions for monitoring and evaluation

Peer reviewedPublisher PD

Assessing Communities of Practice in health policy : A conceptual framework as a first step towards empirical research

Peer reviewe

Pet-related bacterial zoonotic infections:Three cases of severe infections in the immunocompromised host

Pets can have many positive effects on their owners. However, close contact with pets offers optimal conditions for transmission of micro-organisms. Especially immunocompromised patients are at risk for zoonotic infections. Here we describe the diagnosis, microbiology and treatment of three patients with severe zoonotic infections with Helicobacter canis, Pasteurella multocida and Capnocytophaga canimorsus. With this case report we would like to emphasize the importance of awareness for pet-related zoonotic infections in immunocompromised patients

Tetranucleotide and Low Microsatellite Instability Are Inversely Associated with the CpG Island Methylator Phenotype in Colorectal Cancer

MSH3 gene or protein deficiency or loss-of-function in colorectal cancer can cause a DNA mismatch repair defect known as “elevated microsatellite alterations at selected tetranucleotide repeats” (EMAST). A high percentage of MSI-H tumors exhibit EMAST, while MSI-L is also linked with EMAST. However, the distribution of CpG island methylator phenotype (CIMP) within the EMAST spectrum is not known. Five tetranucleotide repeat and five MSI markers were used to classify 100 sporadic colorectal tumours for EMAST, MSI-H and MSI-L according to the number of unstable markers detected. Promoter methylation was determined using methylation-specific PCR for MSH3, MCC, CDKN2A (p16) and five CIMP marker genes. EMAST was found in 55% of sporadic colorectal carcinomas. Carcinomas with only one positive marker (EMAST-1/5, 26%) were associated with advanced tumour stage, increased lymph node metastasis, MSI-L and lack of CIMP-H. EMAST-2/5 (16%) carcinomas displayed some methylation but MSI was rare. Carcinomas with ≥3 positive EMAST markers (13%) were more likely to have a proximal colon location and be MSI-H and CIMP-H. Our study suggests that EMAST/MSI-L is a valuable prognostic and predictive marker for colorectal carcinomas that do not display the high methylation phenotype CIMP-H

Compactifications with S-Duality Twists

We consider generalised Scherk Schwarz reductions of supergravity and superstring theories with twists by electromagnetic dualities that are symmetries of the equations of motion but not of the action, such as the S-duality of D=4, N=4 super-Yang-Mills coupled to supergravity. The reduction cannot be done on the action itself, but must be done either on the field equations or on a duality invariant form of the action, such as one in the doubled formalism in which potentials are introduced for both electric and magnetic fields. The resulting theory in odd-dimensions has massive form fields satisfying a self-duality condition $dA \sim m*A$. We construct such theories in D=3,5,7.Comment: Latex, 26 pages. References adde

Goedel, Penrose, anti-Mach: extra supersymmetries of time-dependent plane waves

We prove that M-theory plane waves with extra supersymmetries are necessarily homogeneous (but possibly time-dependent), and we show by explicit construction that such time-dependent plane waves can admit extra supersymmetries. To that end we study the Penrose limits of Goedel-like metrics, show that the Penrose limit of the M-theory Goedel metric (with 20 supercharges) is generically a time-dependent homogeneous plane wave of the anti-Mach type, and display the four extra Killings spinors in that case. We conclude with some general remarks on the Killing spinor equations for homogeneous plane waves.Comment: 20 pages, LaTeX2