Non-ST-elevation myocardial infarction in the Netherlands: room for improvement!

Aim To analyse non-ST-elevation myocardial infarction (NSTEMI) care in the Netherlands and to identify modifiable factors to improve NSTEMI healthcare. Methods This retrospective cohort study analysed hospital and pharmacy claims data of all NSTEMI patients in the Netherlands in 2015. The effect of percutaneous coronary intervention (PCI) during hospitalisation on 1-year mortality was investigated in the subcohort alive 4 days after NSTEMI. The effect of medical treatment on 1-year mortality was assessed in the subcohort alive 30 days after NSTEMI. The effect of age, gender and co-morbidities was evaluated. PCI during hospitalisation was defined as PCI within 72x202f;h after NSTEMI and optimal medical treatment was defined as the combined use of an aspirin species, P2Y(12) inhibitor, statin, beta-blocker and angiotensin converting enzyme inhibitor/angiotensin II receptor blocker, started within 30 days after NSTEMI. Results Data from 17,997 NSTEMI patients (age 69.6 (SDx202f;= 12.8) years, 64% male) were analysed. Of the patients alive 4 days after NSTEMI, 43% had a PCI during hospitalisation and 1-year mortality was 10%. In the subcohort alive 30 days after NSTEMI, 47% of patients were receiving optimal medical treatment at 30 days and 1-year mortality was 7%. PCI during hospitalisation (odds ratio (OR) 0.42; 95% confidence interval (CI) 0.37-0.48) and optimal medical treatment (OR 0.59; 95% CI 0.51-0.67) were associated with a lower 1-year mortality. Conclusion In Dutch NSTEMI patients, use of PCI during hospitalisation and prescription of optimal medical treatment are modest. As both are independently associated with a lower 1-year mortality, this study provides direction on how to improve the quality of NSTEMI healthcare in the Netherlands.Cardiolog

The Mid-infrared E-ELT Imager and Spectrograph (METIS)

METIS will be among the first generation of scientific instruments on the E-ELT. Focusing on highest angular resolution and high spectral resolution, METIS will provide diffraction limited imaging and coronagraphy from 3-14um over an 20"x20" field of view, as well as integral field spectroscopy at R ~ 100,000 from 2.9-5.3um. In addition, METIS provides medium-resolution (R ~ 5000) long slit spectroscopy, and polarimetric measurements at N band. While the baseline concept has already been discussed, this paper focuses on the significant developments over the past two years in several areas: The science case has been updated to account for recent progress in the main science areas circum-stellar disks and the formation of planets, exoplanet detection and characterization, Solar system formation, massive stars and clusters, and star formation in external galaxies. We discuss the developments in the adaptive optics (AO) concept for METIS, the telescope interface, and the instrument modelling. Last but not least, we provide an overview of our technology development programs, which ranges from coronagraphic masks, immersed gratings, and cryogenic beam chopper to novel approaches to mirror polishing, background calibration and cryo-cooling. These developments have further enhanced the design and technology readiness of METIS to reliably serve as an early discovery machine on the E-ELT.Comment: 18 pages, 14 figures, paper presented at the conference 'Astronomical Telescopes and Instrumentation' in Montreal (2014

Ecological studies in a man-made estuarine environment, the port of Rotterdam

Contains fulltext : 127521.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 17 april 2014Promotor : Siepel, H. Co-promotor : Velde, G. van der206 p

Inventarisatie van natuurontwikkelingsprojecten langs buitenlandse rivieren

Dit rapport presenteert de resultaten van een inventarisatie van natuurontwikkelingsprojecten langs buitenlandse rivieren. De inventarisatie is uitgevoerd in opdracht van Rijkswaterstaat RIZA te Arnhem in het kader van het onderzoeksprogramma RIV*MEANDER om de in het buitenland opgedane kennis over natuurontwikkeling langs de beneden- en middenloop van rivieren te inventariseren. De aandacht ging vooral uit naar de morfologische reactie van de rivier op ingrepen en naar de interactie tussen morfologie en ecologie. De aanleg van nevengeulen genoot een bijzondere belangstelling. De nadruk in deze inventarisatie ligt op grotere, vrij stromende rivieren. Regelmatig zijn echter ook (verwijzingen naar) herstelprojecten langs gestuwde rivier-trajecten en kleinere waterlopen opgenomen. In een eerste ronde zijn informatiebronnen opgespoord door personen en instanties te raadplegen (zie hoofdstuk 13) en literatuurbestanden uit te kammen. Tevens is gezocht op het internet. Na evaluatie van de gevonden gegevens zijn de projectbeschrijvingen in de hoofdstukken 2 t/m 10 opgesteld. Per land en per rivier wordt een overzicht gegeven van de lopende dan wel geplande natuurontwikkelings- en herstelprojecten. Het overzicht pretendeert geen volledigheid. Indien voorhanden zijn per rivier/ project o.a. de volgende gegevens opgenomen: - karakterisering van de rivier (stroomgebied; afvoer, grind/zand rivier, verhang; mate van regulering etc.); - locatie van project; - doelstelling van project; - beschrijving van ingreep/ maatregel; - plan / in uitvoering / uitgevoerd, jaar van uitvoering; - wordt er gemonitord en zo ja wat? - zo mogelijk: morfologisch en ecologisch effect tot nu toe

New threats of an old enemy: The distribution of the shipworm Teredo navalis L. (Bivalvia: Teredinidae) related to climate change in the port of Rotterdam area, the Netherlands

Contains fulltext : 92122.pdf (publisher's version ) (Closed access)18 p

Distribution, settlement, and growth of first-year individuals of the shipworm teredo navalis l. (bivalvia: Teredinidae) in the port of Rotterdam area, the netherlands

Contains fulltext : 91731.pdf (preprint version ) (Open Access)10 p

Long term anthropogenic changes and ecosystem service consequences in the northern part of the complex rhine-meuse estuarine system

Contains fulltext : 128092.pdf (preprint version ) (Open Access