Het alloceren van vastgesteld globaal koolstofbudget

Abstract niet beschikbaarThe feasibility of an effective international response to anticipated climate change is dependent on the recognition of the present and historical inequities between developing and industrialized countries. Developing countries should be enabled and supported to continue their development towards higher standards of living in a fashion that is consistent with the sustainability of the global biosphere. This paper evaluates long-term climate strategies by which the burden of mitigating climate change by controlling CO2-emissions is shared equitably. Here we use as a possible criterion of equity, that every human being, past or future, is allowed to emit the same carbon quotum on an annual basis. Using such an interpretation of interregional and intergenerational equity we calculate the 'emission debts' and future regional per capita emission quota for the world-regions. The results show that past industrialisation has coincided with a large relative contribution of the rich regions to the rise in CO2-concentration, an estimated 40% for the EC and North America, which have built up an emission debt of 36 GtC and 75 GtC resp. using recent World Bank projections of population growth. The developing countries, however, have built up an emission credit of 24 GtC. These regional emission debts and credits increase the future per capita budget for the developing regions till 0.2 - 0.8 ton C/cap yearly, whereas North America and the EC end up with negative future carbon budgets. Even if the IPCC Business-as-Usual scenario is considered as reference, the future emission quota of most industrialized countries are lower than their present per capita emissions.DGM/

[Mondiale verandering en duurzame ontwikkeling: een modelperspectief voor de komende tien jaar.]

In this study the totality of changes on planet Earth, including all human interventions and alterations, is considered as constituting global change, a concept which is therefore broader than the concept of global environmental change. The latter only refers to the human-induced biophysical changes in the dynamics of the Earth system, while global change refers to changes in both the biophysical and the human system. In practice, the concept of global environmental change is a general umbrella term for a whole range of mutually dependent global environmental problems. Within the context of this research programme global change is, in contrast to earlier studies, considered from an integrated perspective. In this study the starting point is to consider the common causes, mechanisms and impacts of a number of coherent themes, functions and scales, and to translate this in terms of Pressure, State, Impact and Response (P-S-I-R approach). This is more in line with the universal principle of approaching environmentally related problems, which assumes that many of those problems are generic in nature

[Mondiale verandering en duurzame ontwikkeling: een modelperspectief voor de komende tien jaar.]

Abstract niet beschikbaarIn this study the totality of changes on planet Earth, including all human interventions and alterations, is considered as constituting global change, a concept which is therefore broader than the concept of global environmental change. The latter only refers to the human-induced biophysical changes in the dynamics of the Earth system, while global change refers to changes in both the biophysical and the human system. In practice, the concept of global environmental change is a general umbrella term for a whole range of mutually dependent global environmental problems. Within the context of this research programme global change is, in contrast to earlier studies, considered from an integrated perspective. In this study the starting point is to consider the common causes, mechanisms and impacts of a number of coherent themes, functions and scales, and to translate this in terms of Pressure, State, Impact and Response (P-S-I-R approach). This is more in line with the universal principle of approaching environmentally related problems, which assumes that many of those problems are generic in nature.RIV

Safe shortening of antibiotic treatment duration for complicated Staphylococcus aureus bacteraemia (SAFE trial): protocol for a randomised, controlled, open-label, non-inferiority trial comparing 4 and 6 weeks of antibiotic treatment

Introduction A major knowledge gap in the treatment of complicated Staphylococcus aureus bacteraemia (SAB) is the optimal duration of antibiotic therapy. Safe shortening of antibiotic therapy has the potential to reduce adverse drug events, length of hospital stay and costs. The objective of the SAFE trial is to evaluate whether 4 weeks of antibiotic therapy is non-inferior to 6 weeks in patients with complicated SAB.Methods and analysis The SAFE-trial is a multicentre, non-inferiority, open-label, parallel group, randomised controlled trial evaluating 4 versus 6 weeks of antibiotic therapy for complicated SAB. The study is performed in 15 university hospitals and general hospitals in the Netherlands. Eligible patients are adults with methicillin-susceptible SAB with evidence of deep-seated or metastatic infection and/or predictors of complicated SAB. Only patients with a satisfactory clinical response to initial antibiotic treatment are included. Patients with infected prosthetic material or an undrained abscess of 5 cm or more at day 14 of adequate antibiotic treatment are excluded. Primary outcome is success of therapy after 180 days, a combined endpoint of survival without evidence of microbiologically confirmed disease relapse. Assuming a primary endpoint occurrence of 90% in the 6 weeks group, a non-inferiority margin of 7.5% is used. Enrolment of 396 patients in total is required to demonstrate non-inferiority of shorter antibiotic therapy with a power of 80%. Currently, 152 patients are enrolled in the study.Ethics and dissemination This is the first randomised controlled trial evaluating duration of antibiotic therapy for complicated SAB. Non-inferiority of 4 weeks of treatment would allow shortening of treatment duration in selected patients with complicated SAB. This study is approved by the Medical Ethics Committee VUmc (Amsterdam, the Netherlands) and registered under NL8347 (the Netherlands Trial Register). Results of the study will be published in a peer-reviewed journal.Trial registration number NL8347 (the Netherlands Trial Register)

A highly virulent variant of HIV-1 circulating in the Netherlands.

We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log <sub>10</sub> increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence