Task-related oxygen uptake and symptoms during activities of daily life in CHF patients and healthy subjects

Patients with chronic heart failure (CHF) have a significantly lower peak aerobic capacity compared to healthy subjects, and, may therefore experience more inconvenience during the performance of domestic activities of daily life (ADLs). To date, the extent to which task-related oxygen uptake, heart rate, ventilation and symptoms during the performance of ADLs in CHF patients is different than in healthy subjects remains uncertain. General demographics, pulmonary function, body composition and peak aerobic capacity were assessed in 23 CHF outpatients and 20 healthy peers. In addition, the metabolic requirement of five simple self-paced domestic ADLs was assessed using a mobile oxycon. Task-related oxygen uptake (ml/min) was similar or lower in CHF patients compared to healthy subjects. In contrast, patients with CHF performing ADLs consumed oxygen at a higher proportion of their peak aerobic capacity than healthy subjects (p < 0.05). For example, getting dressed resulted in a mean task-related oxygen uptake of 49% of peak aerobic capacity, while sweeping the floor resulted in a mean task-related oxygen uptake of 52% of peak aerobic capacity, accompanied by significantly higher Borg symptom scores for dyspnea and fatigue (p < 0.05). Patients with CHF experience use a higher proportion of their peak aerobic capacity, peak ventilation and peak heart rate during the performance of simple self-paced domestic ADL than their healthy peers. These findings represent a necessary step in improving our understanding of improving what troubles patients the most—not being able to do the things that they could when they were healthy

Synthesis of functional ‘polyolefins’: state of the art and remaining challenges

Functional polyolefins (i.e., polyethene or polypropene bearing functional groups) are highly desired materials, due to their beneficial surface properties. Many different pathways exist for the synthesis of these materials, each with its own advantages and drawbacks. This review focuses on those synthetic pathways that build up a polymer chain from ethene/propene and functionalised polar vinyl monomers. Despite many recent advances in the various fields of olefin polymerisation, it still remains a challenge to synthesise high molecular- weight copolymers with tuneable amounts of functional groups, preferably with consecutive insertions of polar monomers occurring in a stereoselective way. To overcome some of these challenges, polymerisation of alternative functionalised monomers is explored as well

National laboratory-based surveillance system for antimicrobial resistance: a successful tool to support the control of antimicrobial resistance in the Netherlands

An important cornerstone in the control of antimicrobial resistance (AMR) is a well-designed quantitative system for the surveillance of spread and temporal trends in AMR. Since 2008, the Dutch national AMR surveillance system, based on routine data from medical microbiological laboratories (MMLs), has developed into a successful tool to support the control of AMR in the Netherlands. It provides background information for policy making in public health and healthcare services, supports development of empirical antibiotic therapy guidelines and facilitates in-depth research. In addition, participation of the MMLs in the national AMR surveillance network has contributed to sharing of knowledge and quality improvement. A future improvement will be the implementation of a new semantic standard together with standardised data transfer, which will reduce errors in data handling and enable a more real-time surveillance. Furthermore, the

Molecular characteristics of carbapenemase-producing Enterobacterales in the Netherlands; results of the 2014–2018 national laboratory surveillance

Objectives: Carbapenem resistance mediated by mobile genetic elements has emerged worldwide and has become a major public health threat. To gain insight into the molecular epidemiology of carbapenem resistance in The Netherlands, Dutch medical microbiology laboratories are requested to submit suspected carbapenemase-producing Enterobacterales (CPE) to the National Institute for Public Health and the Environment as part of a national surveillance system. Methods: Meropenem MICs and species identification were confirmed by E-test and MALDI-TOF and carbapenemase production was assessed by the Carbapenem Inactivation Method. Of all submitted CPE, one species/carbapenemase gene combination per person per year was subjected to next-generation sequencing (NGS). Results: In total, 1838 unique isolates were received between 2014 and 2018, of which 892 were unique CPE isolates with NGS data available. The predominant CPE species were Klebsiella pneumoniae (n = 388, 43%), Escherichia coli (n = 264, 30%) and Enterobacter cloacae complex (n = 116, 13%). Various carbapenemase alleles of the same carbapenemase gene resulted in different susceptibilities to meropenem and this effect varied between species. Analyses of NGS data showed variation of prevalence of carbapenemase alleles over time with blaOXA-48 being predominant (38%, 336/892), followed by blaNDM-1 (16%, 145/892). For the first time in the Netherlands, blaOXA-181, blaOXA-232 and blaVIM-4 were detected. The genetic background of K. pneumoniae and E. coli isolates was highly diverse. Conclusions: The CPE population in the Netherlands is diverse, suggesting multiple introductions. The predominant carbapenemase alleles are blaOXA-48 and blaNDM-1. There was a clear association between species, carbapenemase allele and susceptibility to meropenem

Controlled Synthesis of Functional Copolymers with Blocky Architectures via Carbene Polymerization

We present our results obtained in the Rh-catalyzed carbene copolymerization of diazomethane and diazoesters as a new approach to functional polymer synthesis. Copolymerization reactions were successful, and high-<i>M</i>_w ethylene–acrylate type copolymers were obtained with a large variation in functional group content, which proved to be tunable by varying the monomer feed ratio and the way of addition. Polymer yields decrease strongly with increasing incorporation of diazomethane due to rapid β-hydride elimination. Sequential insertions of polar monomers were observed to a large extent, giving rise to copolymers with a blocky microstructure, which is a unique feature of this polymerization technique. The copolymer properties are demonstrated to be highly dependent on the functional group content and can therefore easily be varied in the window between the properties of both homopolymers

Controlled synthesis of functional copolymers with blocky architectures via carbene polymerization

We present our results obtained in the Rh-catalyzed carbene copolymerization of diazomethane and diazoesters as a new approach to functional polymer synthesis. Copolymerization reactions were successful, and high-Mw ethylene-acrylate type copolymers were obtained with a large variation in functional group content, which proved to be tunable by varying the monomer feed ratio and the way of addition. Polymer yields decrease strongly with increasing incorporation of diazomethane due to rapid β-hydride elimination. Sequential insertions of polar monomers were observed to a large extent, giving rise to copolymers with a blocky microstructure, which is a unique feature of this polymerization technique. The copolymer properties are demonstrated to be highly dependent on the functional group content and can therefore easily be varied in the window between the properties of both homopolymers