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Van Vliet MM, Schoenmakers S, Haug B, Willemsen S, Steegers-Theunissen RPM. Paternal age and first trimester placental size and growth: The Rotterdam Periconceptional Cohort. Placenta 2024; 150:1-7. [PMID: 38537411 DOI: 10.1016/j.placenta.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 05/04/2024]
Abstract
INTRODUCTION Despite a noticeable trend of delayed fatherhood, less is known about the impact of paternal age on the paternally programmed placenta. We hypothesize that paternal aging affects seminal quality and as such induces ageing-related epigenetic alterations that influence placental growth. Our main aim is to investigate associations between paternal age and first trimester (vascular) placental growth trajectories. METHODS Pregnant women were enrolled before 10 weeks of gestation in the Rotterdam Periconceptional Cohort (Predict study). Placental volumes (PV) and utero-placental vascular volumes (uPVV) were measured at 7, 9, and 11 weeks gestation. Associations between paternal age and PV and uPVV were investigated using linear mixed models and the maximum likelihood ratio test to test non-linear relationships. We adjusted for gestational age, fetal sex, parental smoking and maternal age, BMI, education and parity, and stratified for conception mode. RESULTS From 808 pregnancies we obtained 1313 PV and from 183 pregnancies 345 uPVV measurements. We show no associations between paternal age and PV (p = 0.934) and uPVV (p = 0.489) in our total population or in pregnancies conceived naturally (PV p = 0.166; uPVV p = 0.446) and after IVF/ICSI (PV p = 0.909; uPVV p = 0.749). For example, PV was 0.9% smaller (95% CI -5.7%-7.1%) in fathers aged 40 compared to 30 years old at 9 weeks gestation in the total study population. DISCUSSION We are not demonstrating a significant impact of paternal age on first trimester placental growth in a tertiary care population. Given the trend of increasing paternal age, our study should be repeated in the general population.
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Affiliation(s)
- M M Van Vliet
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Developmental Biology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - S Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - B Haug
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - S Willemsen
- Department Biostatistics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Nieuwenhuyzen-de Boer GM, Aamran H, van den Berg CB, Willemsen S, Piek JMJ, Reesink-Peters N, Maliepaard M, van Doorn HC, Polinder S, van Beekhuizen HJ. Cytoreductive Surgery with the PlasmaJet Improved Quality-of-Life for Advanced Stage Ovarian Cancer Patients. Cancers (Basel) 2023; 15:3947. [PMID: 37568763 PMCID: PMC10416900 DOI: 10.3390/cancers15153947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Knowledge of quality-of-life after cytoreductive surgery is important to counsel patients with advanced-stage epithelial ovarian cancer prior to surgery. The aim of this study was to determine whether the use of the PlasmaJet Surgical device during cytoreductive surgery has an effect on the quality-of-life of patients with advanced epithelial ovarian cancer. METHODS Data included in this prospective observational study were derived from the PlaComOv study, in which patients with advanced epithelial ovarian cancer were randomly assigned to have cytoreductive surgery with or without adjuvant use of the PlasmaJet. Quality-of-life was measured before surgery and one, six, 12, and 24 months after surgery with three questionnaires: the EORTC QLQ-C30, QLQ-OV28, and EQ-5D-5L. RESULTS Between 2018 and 2020, 326 patients were enrolled in the trial. The overall response rate was high, with the lowest response rate at 24 months of 77%. At 6 months, quality-of-life was higher in the intervention group (95%CI 0.009; 0.081, p = 0.045). At 12 months, quality-of-life was higher in the intervention group with fewer symptoms of fatigue, appetite loss, and diarrhea (95%CI 0.6; 10,0, p = 0.027); similarly, patients in the intervention group reported a better body image (95%CI -14.2; -3.0, p = 0.003) and a higher score on the visual analog scale (95%CI 1.99; 11.15, p = 0.005). At 24 months postoperatively, no further difference was found between the two groups except for pain (95%CI -12.9; -0.8, p = 0.027) and body image (95%CI -13.808; -0.733, p = 0.029). A higher quality-of-life in the intervention group was partially explained by the mediator 'surgery outcome'. CONCLUSIONS This study demonstrated knowledge of patients' quality-of-life until two years after cytoreductive surgery. The use of the PlasmaJet Surgical device during cytoreductive surgery leads to a higher quality-of-life than conventional surgery with electrocoagulation alone. Even after adjustment for the mediator of surgical outcome, a higher quality-of-life was seen in patients who had surgery with the use of the PlasmaJet device.
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Affiliation(s)
- Gatske M. Nieuwenhuyzen-de Boer
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (H.A.); (C.B.v.d.B.); (M.M.); (H.C.v.D.); (H.J.v.B.)
- Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, 3318 AT Dordrecht, The Netherlands
| | - Hanane Aamran
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (H.A.); (C.B.v.d.B.); (M.M.); (H.C.v.D.); (H.J.v.B.)
| | - Caroline B. van den Berg
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (H.A.); (C.B.v.d.B.); (M.M.); (H.C.v.D.); (H.J.v.B.)
- Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, 3318 AT Dordrecht, The Netherlands
| | - Sten Willemsen
- Department of Epidemiology, Erasmus MC, 3015 GD Rotterdam, The Netherlands;
- Department of Biostatistics, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Jurgen M. J. Piek
- Department of Obstetrics and Gynecology, Catharina Cancer Institute, 5623 EJ Eindhoven, The Netherlands;
| | - Nathalie Reesink-Peters
- Department of Obstetrics and Gynecology, Medisch Spectrum Twente, 7512 KZ Enschede, The Netherlands;
| | - Marianne Maliepaard
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (H.A.); (C.B.v.d.B.); (M.M.); (H.C.v.D.); (H.J.v.B.)
| | - Helena C. van Doorn
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (H.A.); (C.B.v.d.B.); (M.M.); (H.C.v.D.); (H.J.v.B.)
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands;
| | - Heleen J. van Beekhuizen
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (H.A.); (C.B.v.d.B.); (M.M.); (H.C.v.D.); (H.J.v.B.)
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Leung T, Schoenmakers S, Willemsen S, van Rossem L, Dinnyes A, Rousian M, Steegers-Theunissen RP. The Effect of an eHealth Coaching Program (Smarter Pregnancy) on Attitudes and Practices Toward Periconception Lifestyle Behaviors in Women Attempting Pregnancy: Prospective Study. J Med Internet Res 2023; 25:e39321. [PMID: 36719733 PMCID: PMC9929732 DOI: 10.2196/39321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Lifestyle behaviors during the periconception period contribute to achievement of a successful pregnancy. Assessment of attitudes and practices toward these modifiable behaviors can aid in identifying gaps in unhealthy lifestyle behaviors with impact on intervention effectiveness. OBJECTIVE This study investigates the effectiveness of coaching by the eHealth program Smarter Pregnancy during the periconception period on improvement of attitudes and practices toward fruit and vegetable intake and smoking in women attempting pregnancy through assisted reproductive technology (ART) or natural conception. METHODS Women attempting pregnancy through ART (n=1060) or natural conception (n=631) were selected during the periconception period. The intervention groups, conceived through ART or naturally, received Smarter Pregnancy coaching for 24 weeks, whereas the control group conceived through ART and did not receive coaching. Attitudes and practices at baseline and follow-up periods were obtained from self-administered online questionnaire provided by the program. Attitudes were assessed in women with unhealthy behaviors as their intention to increase their fruit and vegetable intake and to quit smoking using a yes/no question. Outcomes on practices, suggesting effectiveness, included daily fruit (pieces) and vegetable (grams) intake, and if women smoked (yes/no). Changes in attitudes and practices were compared at 12 and 24 weeks with baseline between the ART intervention and ART control groups, and within the intervention groups between ART and natural conception. Changes in practices at 12 and 24 weeks were also compared with baseline between women with negative attitude and positive attitude within the intervention groups: ART and natural conception. Analysis was performed using linear and logistic regression models adjusted for maternal confounders and baseline attitudes and practices. RESULTS The ART intervention group showed higher vegetable intake and lower odds for negative attitudes toward vegetable intake after 12 weeks (βadj=25.72 g, P<.001; adjusted odds ratio [ORadj] 0.24, P<.001) and 24 weeks of coaching (βadj=23.84 g, P<.001; ORadj 0.28, P<.001) compared with ART controls. No statistically significant effect was observed on attitudes and practices toward fruit intake (12 weeks: P=.16 and .08, respectively; 24 weeks: P=.16 and .08, respectively) and smoking behavior (12 weeks: P=.87; 24 weeks: P=.92). No difference was observed for the studied attitudes and practices between the ART intervention and natural conception intervention groups. Women with persistent negative attitude toward fruit and vegetable intake at week 12 showed lower fruit and vegetable intake at week 24 compared with women with positive attitude (βadj=-.49, P<.001; βadj=-30.07, P<.001, respectively). CONCLUSIONS The eHealth Smarter Pregnancy program may improve vegetable intake-related attitudes and practices in women undergoing ART treatment. Women with no intention to increase fruit and vegetable intake had less improvement in their intakes. Despite small changes, this study demonstrates again that Smarter Pregnancy can be used to improve vegetable intake, which can complemented by blended care that combines face-to-face and online care to also improve fruit intake and smoking behavior.
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Affiliation(s)
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Andras Dinnyes
- BioTalentum Ltd, Godollo, Hungary.,Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Godollo, Hungary
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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van Zundert S, van der Padt S, Willemsen S, Rousian M, Mirzaian M, van Schaik R, Steegers-Theunissen R, van Rossem L. Periconceptional Maternal Protein Intake from Animal and Plant Sources and the Impact on Early and Late Prenatal Growth and Birthweight: The Rotterdam Periconceptional Cohort. Nutrients 2022; 14:nu14245309. [PMID: 36558467 PMCID: PMC9785913 DOI: 10.3390/nu14245309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Plant-based diets continue to rise in popularity, including among women of reproductive age, while consequences for pregnancy outcomes have hardly been studied. During pregnancy, maternal diet is the only source of proteins for the developing fetus. Hence, we investigated the effects of periconceptional maternal animal and plant protein intake on prenatal growth and birthweight. 501 pregnancies were included from the prospective Rotterdam Periconceptional Cohort. Embryonic growth was depicted by crown-rump length (CRL) and embryonic volume (EV) at 7, 9 and 11 weeks using 3D ultrasound scans. Estimated fetal weight (EFW) at 20 weeks and birthweight were retrieved from medical records and standardized. Multivariable mixed models were used for CRL and EV trajectories, and linear regression for EFW and birthweight. A 10 g/day higher maternal animal protein intake was positively associated with increased embryonic growth (CRL: β = 0.023 √mm, p = 0.052; EV: β = 0.015 ∛cm, p = 0.012). A positive association, albeit non-significant, was found between maternal animal protein intake and EFW, and birthweight. No clear associations emerged between maternal plant protein intake and prenatal growth and birthweight, with effect estimates close to zero. In conclusion, maternal animal protein intake during the periconception period was positively associated with early and late prenatal growth and birthweight, while no associations were found between maternal plant protein intake and prenatal growth and birthweight.
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Affiliation(s)
- Sofie van Zundert
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Simone van der Padt
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Mina Mirzaian
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Ron van Schaik
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Régine Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Correspondence:
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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5
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Brons PE, Nieuwenhuyzen-de Boer GM, Ramakers C, Willemsen S, Kengsakul M, van Beekhuizen HJ. Preoperative Cancer Antigen 125 Level as Predictor for Complete Cytoreduction in Ovarian Cancer: A Prospective Cohort Study and Systematic Review. Cancers (Basel) 2022; 14:cancers14235734. [PMID: 36497218 PMCID: PMC9740757 DOI: 10.3390/cancers14235734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/11/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The tumor marker ‘cancer antigen 125’ (CA-125) plays a role in the management of women with advanced stage ovarian cancer. This study aims to describe the predictive value of pre-treatment CA-125 level and the reduction after neoadjuvant chemotherapy (NACT) on surgical outcome. Methods: A systematic review and a prospective clinical study were performed. Multiple databases were searched from database inception to April 2022. The clinical study is part of a randomized controlled trial named “PlaComOv-study”. A regression analysis was performed to demonstrate correlations between preoperative CA-125 levels, CA-125 reduction after NACT, and surgical outcome. Results: Fourteen relevant articles were analyzed of which eleven reported that lower preoperative CA-125 levels were associated with a higher probability of complete cytoreduction. In the clinical study, 326 patients with FIGO stage IIIB-IV ovarian cancer who underwent CRS were enrolled from 2018 to 2020. Patients who underwent interval CRS with preoperative CA-125 levels ≤35 kU/L had higher odds of achieving complete CRS than patients with CA-125 level >35 kU/L (85% vs. 67%, OR 2.79, 95%CI 1.44−5.41, p = 0.002). In multivariable analysis with presence of ascites and peritoneal carcinomatosis, normalized preoperative CA-125 did not appear as a significant predictor for complete CRS. Conclusions: In literature, preoperative CA-125 levels ≤35 kU/L were associated with a significant higher percentage of complete CRS in univariable analysis. According to our cohort study, preoperative CA-125 level ≤35 kU/L cannot independently predict surgical outcome either for primary or interval CRS.
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Affiliation(s)
- Puck E. Brons
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Gatske M. Nieuwenhuyzen-de Boer
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, 3318 AT Dordrecht, The Netherlands
- Correspondence: ; Tel.: +31-611151898
| | - Christian Ramakers
- Department of Clinical Chemistry, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Sten Willemsen
- Department of Epidemiology, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Malika Kengsakul
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi 11120, Thailand
| | - Heleen J. van Beekhuizen
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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Mulder ST, Omidvari AH, Rueten-Budde AJ, Huang PH, Kim KH, Bais B, Rousian M, Hai R, Akgun C, van Lennep JR, Willemsen S, Rijnbeek PR, Tax DM, Reinders M, Boersma E, Rizopoulos D, Visch V, Steegers-Theunissen R. Dynamic Digital Twin: Diagnosis, Treatment, Prediction, and Prevention of Disease During the Life Course. J Med Internet Res 2022; 24:e35675. [PMID: 36103220 PMCID: PMC9520391 DOI: 10.2196/35675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
A digital twin (DT), originally defined as a virtual representation of a physical asset, system, or process, is a new concept in health care. A DT in health care is not a single technology but a domain-adapted multimodal modeling approach incorporating the acquisition, management, analysis, prediction, and interpretation of data, aiming to improve medical decision-making. However, there are many challenges and barriers that must be overcome before a DT can be used in health care. In this viewpoint paper, we build on the current literature, address these challenges, and describe a dynamic DT in health care for optimizing individual patient health care journeys, specifically for women at risk for cardiovascular complications in the preconception and pregnancy periods and across the life course. We describe how we can commit multiple domains to developing this DT. With our cross-domain definition of the DT, we aim to define future goals, trade-offs, and methods that will guide the development of the dynamic DT and implementation strategies in health care.
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Affiliation(s)
- Skander Tahar Mulder
- Pattern Recognition Lab, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | - Amir-Houshang Omidvari
- Department of Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Pei-Hua Huang
- Department of Medical Ethics and Philosophy, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ki-Hun Kim
- Department of Industrial Engineering, Pusan National University, Busan, Republic of Korea
| | - Babette Bais
- Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Melek Rousian
- Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Rihan Hai
- Web Information Systems Group, Mathematics and Computer Science, Technical University of Delft, Delft, Netherlands
| | - Can Akgun
- Web Information Systems Group, Mathematics and Computer Science, Technical University of Delft, Delft, Netherlands
- Bioelectronics Section, Department of Microelectronics, Faculty of Electrical Engineering, Technical University Delft, Delft, Netherlands
| | | | - Sten Willemsen
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
| | - Peter R Rijnbeek
- Department of Medical Informatics, Erasmus Medical Center, Rotterdam, Netherlands
| | - David Mj Tax
- Pattern Recognition Lab, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | - Marcel Reinders
- Pattern Recognition Lab, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Valentijn Visch
- Industrial Design, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
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Schmitz E, Matos Fialho P, Günther L, Trümmler J, Willemsen S, Vomhof M, Icks A, Lang A, Kuss O, Weyers S, Pischke CR. Evaluation der Auswirkungen der gemeindebasierten komplexen
Intervention „10.000 Schritte Düsseldorf“ in zwei
Städten in Nordrhein-Westfalen: Replikationsstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- E Schmitz
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - P Matos Fialho
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - L Günther
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - J Trümmler
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - S Willemsen
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - M Vomhof
- Heinrich-Heine-Universität Düsseldorf, Institut
für Versorgungsforschung und Gesundheitsökonomie,
Düsseldorf, Deutschland
- Leibniz Zentrum für Diabetes-Forschung an der
Heinrich-Heine-Universität Düsseldorf, Institut für
Versorgungsforschung und Gesundheitsökonomie, Düsseldorf,
Deutschland
- Deutsches Diabetes Zentrum, Düsseldorf,
Deutschland
| | - A Icks
- Heinrich-Heine-Universität Düsseldorf, Institut
für Versorgungsforschung und Gesundheitsökonomie,
Düsseldorf, Deutschland
- Leibniz Zentrum für Diabetes-Forschung an der
Heinrich-Heine-Universität Düsseldorf, Institut für
Versorgungsforschung und Gesundheitsökonomie, Düsseldorf,
Deutschland
- Deutsches Diabetes Zentrum, Düsseldorf,
Deutschland
| | - A Lang
- Deutsches Diabetes Zentrum, Institut für Biometrie und
Epidemiologie, Düsseldorf, Deutschland
| | - O Kuss
- Deutsches Diabetes Zentrum, Institut für Biometrie und
Epidemiologie, Düsseldorf, Deutschland
- Heinrich-Heine-Universität Düsseldorf, Centre for
Health and Society, Düsseldorf, Deutschland
| | - S Weyers
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - CR Pischke
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
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Nieuwenhuyzen-de Boer GM, Hofhuis W, Reesink-Peters N, Willemsen S, Boere IA, Schoots IG, Piek JMJ, Hofman LN, Beltman JJ, van Driel WJ, Werner HMJ, Baalbergen A, van Haaften-de Jong AMLD, Dorman M, Haans L, Nedelcu I, Ewing-Graham PC, van Beekhuizen HJ. ASO Visual Abstract: The Role of Adjuvant Use of the PlasmaJet® Device During Cytoreductive Surgery for Advanced-Stage Ovarian Cancer—Results of the PlaComOv-Study, a Randomized, Controlled Trial in the Netherlands. Ann Surg Oncol 2022. [DOI: 10.1245/s10434-022-11820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Nieuwenhuyzen-de Boer GM, Hofhuis W, Reesink-Peters N, Willemsen S, Boere IA, Schoots IG, Piek JMJ, Hofman LN, Beltman JJ, van Driel WJ, Werner HMJ, Baalbergen A, van Haaften-de Jong AMLD, Dorman M, Haans L, Nedelcu I, Ewing-Graham PC, van Beekhuizen HJ. Adjuvant Use of PlasmaJet Device During Cytoreductive Surgery for Advanced-Stage Ovarian Cancer: Results of the PlaComOv-study, a Randomized Controlled Trial in The Netherlands. Ann Surg Oncol 2022; 29:4833-4843. [PMID: 35552938 PMCID: PMC9246793 DOI: 10.1245/s10434-022-11763-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/27/2022] [Indexed: 11/18/2022]
Abstract
Objective Standard surgical treatment of advanced-stage ovarian carcinoma with electrosurgery cannot always result in complete cytoreductive surgery (CRS), especially when many small metastases are found on the mesentery and intestinal surface. We investigated whether adjuvant use of a neutral argon plasma device can help increase the complete cytoreduction rate. Patients and Methods 327 patients with FIGO stage IIIB–IV epithelial ovarian cancer (EOC) who underwent primary or interval CRS were randomized to either surgery with neutral argon plasma (PlasmaJet) (intervention) or without PlasmaJet (control group). The primary outcome was the percentage of complete CRS. The secondary outcomes were duration of surgery, blood loss, number of bowel resections and colostomies, hospitalization, 30-day morbidity, and quality of life (QoL). Results Complete CRS was achieved in 119 patients (75.8%) in the intervention group and 115 patients (67.6%) in the control group (risk difference (RD) 8.2%, 95% confidence interval (CI) –0.021 to 0.181; P = 0.131). In a per-protocol analysis excluding patients with unresectable disease, complete CRS was obtained in 85.6% in the intervention group and 71.5% in the control group (RD 14.1%, 95% CI 0.042 to 0.235; P = 0.005). Patient-reported QoL at 6 months after surgery differed between groups in favor of PlasmaJet surgery (95% CI 0.455–8.350; P = 0.029). Other secondary outcomes did not differ significantly. Conclusions Adjuvant use of PlasmaJet during CRS for advanced-stage ovarian cancer resulted in a significantly higher proportion of complete CRS in patients with resectable disease and higher QoL at 6 months after surgery. (Funded by ZonMw, Trial Register NL62035.078.17.) Trial Registration Approved by the Medical Ethics Review Board of the Erasmus University Medical Center Rotterdam, the Netherlands, NL62035.078.17 on 20-11-2017. Recruitment started on 30-1-2018. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-022-11763-2.
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Affiliation(s)
- G M Nieuwenhuyzen-de Boer
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. .,Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
| | - W Hofhuis
- Department of Obstetrics and Gynecology, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands
| | - N Reesink-Peters
- Department of Obstetrics and Gynecology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - S Willemsen
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
| | - I A Boere
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - I G Schoots
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J M J Piek
- Department of Obstetrics and Gynecology, Catharina Cancer Institute, Eindhoven, The Netherlands
| | - L N Hofman
- Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - J J Beltman
- Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - W J van Driel
- Department of Gynecology, Center of Gynecological Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H M J Werner
- Department of Obstetrics and Gynecology, GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A Baalbergen
- Department of Obstetrics and Gynecology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | | | - M Dorman
- Department of Obstetrics and Gynecology, Bravis Hospital, Bergen op Zoom, The Netherlands
| | - L Haans
- Department of Obstetrics and Gynecology, Haags Medical Centre, The Hague, The Netherlands
| | - I Nedelcu
- Department of Obstetrics and Gynecology, Groene Hart Hospital, Gouda, The Netherlands
| | - P C Ewing-Graham
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - H J van Beekhuizen
- Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
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10
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van Noort-van der Spek IL, Stipdonk LW, Goedegebure A, Dudink J, Willemsen S, Reiss IKM, Franken MCJP. Are multidisciplinary neurodevelopmental profiles of children born very preterm at age 2 relevant to their long-term development? A preliminary study. Child Neuropsychol 2021; 28:437-457. [PMID: 34727843 DOI: 10.1080/09297049.2021.1991296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To identify distinctive multidisciplinary neurodevelopmental profiles of relatively healthy children born very preterm (VPT) and describe the longitudinal course of these profiles up to age 10. At 2 years of corrected age, 84 children born VPT underwent standardized testing for cognitive, language, speech, motor, behavioral, and auditory nerve function. These data were submitted to factor and cluster analysis. Sixty-one of these children underwent cognitive, language, and behavioral assessment again at age 10. Descriptive statistics were used to analyze longitudinal trajectories for each profile. Four neurodevelopmental profiles were identified at age 2. Profile 1 children (n = 22/26%) had excellent cognitive-language-motor function, normal behavioral and auditory nerve function, but showed an unexpected severe decline up to age 10. Profile 2 children (n = 16/19%) had very low behavioral function, low cognitive-language-motor function, and accelerated auditory nerve function. Their scores remained low up until age 10. Profile 3 children (n = 17/20%) had delayed auditory nerve function, low behavioral function, and slightly lower cognitive-language-motor function. They showed the most increasing trajectory. Profile 4 children (n = 29/35%) had very low cognitive-language-motor function, normal behavioral and auditory nerve function, but showed wide variation in their trajectory. Our preliminary study showed that a multidisciplinary profile-oriented approach may be important in children born VPT to improve counseling and provide targeted treatment for at risk children. High performers at age 2 may not be expected to maintain their favorable development. Behavioral problems might negatively impact language development. Delayed auditory nerve function might represent a slow start and catch-up development.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Lottie W Stipdonk
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.,Division of Neonatology, Department of Pediatrics, UMCU-Wilhelmina Children's Hospital, Utrecht, Netherlands
| | - Sten Willemsen
- Department of Biostatistics, Erasmus Medical University Center, Rotterdam, Netherlands
| | - Irwin K M Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
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11
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van der Windt M, Schoenmakers S, Willemsen S, van Rossem L, Steegers-Theunissen R. Optimizing the Periconception Lifestyle of Women With Overweight Using a Blended Personalized Care Intervention Combining eHealth and Face-to-face Counseling (eFUSE): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e28600. [PMID: 34477561 PMCID: PMC8449297 DOI: 10.2196/28600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/23/2023] Open
Abstract
Background Maternal overweight has a substantial impact on reproductive, maternal, pregnancy, and neonatal outcomes with long-term and transgenerational health consequences. Interventions that aim to optimize periconception maternal lifestyle can improve maternal and fetal health during pregnancy and throughout the life course. However, it remains difficult to change and adopt adequate lifestyle behaviors. We hypothesize that additional psychological therapy targeting cognitive and affective factors substantially contribute to the effectiveness of these interventions. Objective The proposed study aims to examine the feasibility and effectiveness of a blended personalized periconception lifestyle care intervention with additional psychological therapy aimed at women with a BMI≥25 and who are contemplating pregnancy or are already pregnant (≤12 weeks) in reducing inadequate lifestyle behaviors and improving early and late pregnancy outcome. Methods The eHealth and Face-to-face Counseling (eFUSE) study follows a single-center two-arm randomized controlled trial design at the Erasmus MC, University Medical Center, with a multicenter regional referral. The female patients with overweight (BMI≥25), together with their male partner, will be stratified by pregnancy status (preconception vs pregnant) and randomized to receive either the blended personalized periconception lifestyle care intervention with additional psychological therapy (n=313) or usual care (n=313). The primary outcome is a change in the lifestyle risk score (between baseline and 24 weeks) between the randomization arms (difference in differences). Secondary outcomes include measurements defined as most relevant by the International Consortium for Health Outcomes Measurement, including behavioral determinants, patient satisfaction, provider feasibility, and maternal pregnancy and neonatal complications. Results The study will be open for recruitment from Fall 2021 onward. Data collection is expected to be completed by the beginning of 2023, and the results are expected to be published by Fall 2023. Conclusions This study will evaluate the feasibility and effectiveness of a blended periconception lifestyle intervention with additional psychological therapy, aimed at women with a BMI≥25. Positive results of this innovative care approach will be used for implementation in routine medical care of all women with overweight, with the ultimate aim to improve clinical outcomes of these high-risk pregnancies. Trial Registration Netherlands Trial Register NL9264; https://www.trialregister.nl/trial/9264 International Registered Report Identifier (IRRID) PRR1-10.2196/28600
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Affiliation(s)
- Melissa van der Windt
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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12
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Mulders A, Reijnders I, Koster W, Kropman A, Koning A, Willemsen S, Steegers E, Steegers-Theunissen R. First-trimester maternal haemodynamic adaptation to pregnancy and the impact on placental and fetal development, and birth outcomes: an observational cohort study. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Van Duijn L, Steegers-Theunissen R, Baart E, Willemsen S, Laven J, Rousian M. O-216 Culture medium used in IVF-treatment impacts post-implantation embryonic growth and developmental trajectories in a sex-specific manner. Hum Reprod 2021. [DOI: 10.1093/humrep/deab128.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What is the (sex-specific) impact of two different culture media used in in vitro fertilization (IVF) treatment on post-implantation growth and development?
Summary answer
Embryos, especially males, cultured in SAGE 1-Step grow and morphologically develop faster in the first trimester, when compared to those cultured in Vitrolife G-1 PLUS.
What is known already
Increasing success rates after IVF can be attributed to several advancements, such as improved culture conditions. Culture media are of special interest, as they supply the embryo with essential nutrients and have previously been shown to impact birthweight. Moreover, IVF pregnancies are associated with an increased male:female ratio. However, it is unknown if culture media also have an impact prenatally. Therefore, our aim is to study the (sex-specific) impact of two different culture media (SAGE 1-Step and Vitrolife G-1 PLUS) used in IVF treatment on first-trimester embryonic growth and development, and fetal outcomes.
Study design, size, duration
Women with a viable singleton pregnancy were included before 10 weeks of gestation in the Rotterdam Periconception Cohort, an ongoing prospective tertiary hospital-based study, conducted since November 2009.
Participants/materials, setting, methods
A total of 879 pregnancies were included; 153 after culture in Vitrolife G-1 PLUS, 251 after culture in SAGE 1-Step and 475 naturally conceived. First-trimester growth and development, defined by serial crown-rump length (CRL), embryonic volume (EV) and Carnegie stages measurements were performed using state-of-the-art imaging techniques. Secondary outcomes included second trimester estimated fetal weight (EFW) and birth outcomes, and were retrieved from medical records.
Main results and the role of chance
Linear mixed model analyses, adjusted for gestational age and maternal characteristics, showed that embryos cultured in SAGE 1-Step grow faster than those cultured in Vitrolife G-1 PLUS (βEV 0.030 ∛cm3 (95%CI 0.008-0.052), p=0.007). CRL and Carnegie stages were not statistically different between culture media. After stratification for fetal sex, similar results were observed for male embryos (βEV 0.048 ∛cm3 (95%CI 0.015-0.081), p=0.005), but not for female embryos. EFW and birth outcomes were comparable between culture media in the total population and after stratification for fetal sex. Embryos cultured in SAGE 1-Step also grow faster than those conceived naturally (βEV 0.033 ∛cm3 (95%CI 0.006-0.060), p=0.018). This association was also most pronounced in male embryos (βEV 0.066 ∛cm3 (95%CI 0.024-0.108), p=0.002).
Limitations, reasons for caution
Although this study has a prospective design, its observational character does not exclude residual confounding. Furthermore, the external validity of this explorative study is limited, since participants were recruited from a tertiary university hospital.
Wider implications of the findings
Culture in SAGE 1-Step culture medium is associated with faster first-trimester growth and development, especially in male embryos. This may be the result of altered susceptibility to preimplantation environmental stressors. Further research should focus on the (sex-specific) impact of culture media on postnatal development and the susceptibility to non-communicable diseases.
Trial registration number
N/A
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Affiliation(s)
- L Van Duijn
- Erasmus MC- University Medical Centre, Obstetrics and Gynaecology, Rotterdam, The Netherlands
| | - R Steegers-Theunissen
- Erasmus MC- University Medical Centre, Obstetrics and Gynaecology, Rotterdam, The Netherlands
| | - E Baart
- Erasmus MC- University Medical Centre, Obstetrics and Gynaecology- Division of Reproductive Endocrinology and Infertility, Rotterdam, The Netherlands
| | - S Willemsen
- Erasmus MC- University Medical Centre, Obstetrics and Gynaecology and Department of Biostatistics, Rotterdam, The Netherlands
| | - J Laven
- Erasmus MC- University Medical Centre, Obstetrics and Gynaecology - Division of Reproductive Endocrinology and Infertility, Rotterdam, The Netherlands
| | - M Rousian
- Erasmus MC- University Medical Centre, Obstetrics and Gynaecology, Rotterdam, The Netherlands
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14
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Ng KYB, Steegers-Theunissen R, Willemsen S, Wellstead S, Cheong Y, Macklon N. Smartphone-based lifestyle coaching modifies behaviours in women with subfertility or recurrent miscarriage: a randomized controlled trial. Reprod Biomed Online 2021; 43:111-119. [PMID: 34053852 DOI: 10.1016/j.rbmo.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
RESEARCH QUESTION Is an online lifestyle coaching platform more effective at modifying periconceptional behaviours than standard advice offered by the UK National Health Service (NHS)? DESIGN Women with subfertility or recurrent miscarriage were recruited to a two-centre randomized controlled trial. They were randomized to either the online lifestyle coaching platform Smarter Pregnancy (intervention) or periconceptional advice provided by NHS websites (control). Participants completed a lifestyle questionnaire at baseline, 6, 12, 18 and 24 weeks, and the results were used to tailor lifestyle coaching in the intervention group. At baseline, 12 and 24 weeks, composite risk scores (CRS) were calculated. A lower CRS corresponds to a healthier lifestyle. RESULTS Of the 400 women recruited, 262 women were randomized (131 in each arm). At 12 weeks, a reduction in CRS (includes risk score for intake of folic acid, vegetables and fruits, smoking and alcohol) was observed in the intervention versus control arms. After correcting for baseline, the difference in the CRS between intervention and control was -0.47 (95% CI -0.97 to 0.02) at 12 weeks and -0.32 (95% CI -0.82 to 0.15) at 24 weeks. A statistically significant reduction in lifestyle risk scores was found in women with a body mass index (BMI) of 25 kg/m2 or above compared with those with a BMI below 25kg/m2. The odds of being pregnant at 24 weeks was increased in the intervention versus control (OR 2.83, 95% CI 0.35 to 57.76). CONCLUSIONS The Smarter Pregnancy coaching platform is more effective in delivering lifestyle advice and modulating behaviours to support women with a history of subfertility or recurrent miscarriage than standard online NHS advice.
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Affiliation(s)
- Ka Ying Bonnie Ng
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; Department of Obstetrics and Gynaecology, Princess Anne Hospital, Room F86, Level F, Coxford Road, Southampton SO16 5YA, UK.
| | - Régine Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Susan Wellstead
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; Department of Obstetrics and Gynaecology, Princess Anne Hospital, Room F86, Level F, Coxford Road, Southampton SO16 5YA, UK
| | - Ying Cheong
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; Department of Obstetrics and Gynaecology, Princess Anne Hospital, Room F86, Level F, Coxford Road, Southampton SO16 5YA, UK
| | - Nick Macklon
- Reprohealth, Zealand University Hospital, University of Copenhagen, Denmark; London Women's Clinic, London, UK
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15
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Vermeulen MJ, Burkhardt W, Fritze A, Roelants J, Mense L, Willemsen S, Rüdiger M. Reference Charts for Neonatal Cranial Volume Based on 3D Laser Scanning to Monitor Head Growth. Front Pediatr 2021; 9:654112. [PMID: 34123964 PMCID: PMC8192695 DOI: 10.3389/fped.2021.654112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Postnatal brain growth is an important predictor of neurodevelopmental outcome in preterm infants. A new reliable proxy for brain volume is cranial volume, which can be measured routinely by 3-D laser scanning. The aim of this study was to develop reference charts for normal cranial volume in newborn infants at different gestational ages starting from late preterm for both sexes. Methods: Cross-sectional cohort study in a German university hospital, including singleton, clinically stable, neonates born after 34 weeks of gestation. Cranial volume was measured in the first week of life by a validated 3-D laser scanner. Cranial volume data was modeled to calculate percentile values by gestational age and birth weight and to develop cranial volume reference charts for girls and boys separately. Results: Of the 1,703 included infants, 846 (50%) were female. Birth weights ranged from 1,370 to 4,830 grams (median 3,370). Median cranial volume ranged from 320 [interquartile range (IQR) 294-347] ml at 34 weeks to 469 [IQR 442-496] ml at 42 weeks and was higher in boys than in girls. Conclusions: This study presents the first reference charts of cranial volume which can be used in clinical practice to monitor brain growth between 34 and 42 weeks gestation in infants.
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Affiliation(s)
- Marijn Jorien Vermeulen
- Division of Neonatology, Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Wolfram Burkhardt
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany
| | - Anne Fritze
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany
| | - Jorine Roelants
- Division of Neonatology, Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Lars Mense
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany
| | - Sten Willemsen
- Division of Biostatistics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mario Rüdiger
- Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Medizinische Fakultät der Technischen Universität, Dresden, Germany.,Saxonian Center for Feto-Neonatal Health, Technische Universität Dresden, Dresden, Germany
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16
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Abstract
Background Lymphatic insufficiency might play a significant role in the pathophysiology
of lipoedema. Liposuction is up to now the best treatment. As liposuction is
invasive, the technique could destruct parts of the lymphatic system and by
this aggravate the lymphatic component and/or induce lymphoedema. We
investigated the function of the lymphatic system in lipoedema patients
before and after tumescent liposuction and thus whether tumescent
liposuction can be regarded as a safe treatment. Methods Lymphoscintigraphy was performed to quantify the lymph outflow of 117
lipoedema patients. Mean clearance percentages of radioactive protein loaded
after 1 min with respect to the total injected dose and corrected for decay
of the radiopharmaceutical in the subcutaneous lymphatics were used as
functional quantitative parameters as well as the clearance percentages and
inguinal uptake 2 h post injection. The results of lymphatic function in
lipoedema patients were compared with values obtained from normal healthy
volunteers. We also compared 50 lymphoscintigraphies out of the previous 117
lipoedema patients before and six months after tumescent liposuction. Results In 117 lipoedema patients clearance 2 h post injection in the right and left
foot was disturbed in 79.5 and 87.2% respectively. The inguinal uptake 2 h
post injection in the right and left groin was disturbed in 60.3 and 64.7%
respectively. In 50 lipoedema patients mean clearance and inguinal uptake
after tumescent liposuction were slightly improved, 0.01 (p = 0.37) versus
0.02 (p = 0.02), respectively. This is statistically not relevant in
clearance. Conclusion Lipoedema legs have a delayed lymph transport. Tumescent liposuction does not
diminish the lymphatic function in lipoedema patients, thus tumescent
liposuction can be regarded as a safe treatment.
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Affiliation(s)
- Chantalle B van de Pas
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.,Polikliniek de Blaak, Rotterdam, The Netherlands.,Kliniek De Medici, Blaricum, The Netherlands
| | | | | | - Sten Willemsen
- Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
| | - Roelf Valkema
- Department of Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Martino Neumann
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
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Kehrer A, Nijhuis THJ, Pesthy P, Willemsen S, Poublon R, van der Meulen JJJNM. Rotational Advancement in Cleft Nose Rhinoplasty - Buccal Mucosal Grafts Serve as a Powerful Tool. Cleft Palate Craniofac J 2018; 55:856-864. [PMID: 28072550 DOI: 10.1597/16-092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Our aim was to analyze our technique of a modified rotational advancement in conjunction with buccal mucosal grafts (BMGs) in a subgroup of severe cleft cases. DESIGN A retrospective clinical and photographic evaluation was conducted. Columella angle (CA) and tip projection (TPR) served as instruments in a photometric analysis. SETTING Academic university hospital and specialized craniofacial cleft center. PATIENTS At the time of the secondary rhinoplasty, 61 cleft patients were included, all 17 years or older. INTERVENTIONS Rotational advancement with usage of BMGs was performed in selected cases by a single surgeon. MAIN OUTCOME MEASURES Nasal symmetry and aesthetic appearance. RESULTS From 2003 to 2011, 29 unilateral severe cleft cases (group I) underwent a modified alar rotational advancement with BMGs. Group II, with 32 cases, represented patients without BMGs. Technique and management of BMGs were described in detail. The complication rate of donor and recipient site presented as very low. The CA was improved significantly in both groups. Also, TPR improved (not significantly) in group I. Using our technique, we considerably enhanced the aesthetic results and symmetry in secondary cleft rhinoplast. CONCLUSIONS Rotating the vestibular skin makes it possible to eliminate the traction of this skin on the repositioned alar cartilage, therefore achieving a more pleasing and stable nasal symmetry in secondary cleft rhinoplasty. Versatile BMGs close this gap, thus making them a powerful tool in the arsenal of the reconstructive cleft surgeon.
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18
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Klop B, Hartong S, Vermeer H, Schoofs M, Willemsen S, Van Den Bos E, Kofflard M. P636Risk of misclassification with a non-fasting lipid profile in secondary cardiovascular prevention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lesaffre E, Edelman M, Hanna N, Park K, Thatcher N, Willemsen S, Gaschler-Markefski B, Kaiser R, Manegold C. Statistical controversies in clinical research: futility analyses in oncology–lessons on potential pitfalls from a randomized controlled trial. Ann Oncol 2017; 28:1419-1426. [DOI: 10.1093/annonc/mdx042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Indexed: 11/13/2022] Open
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Runhaar J, van Middelkoop M, Reijman M, Willemsen S, Oei EH, Vroegindeweij D, van Osch G, Koes B, Bierma-Zeinstra SMA. Prevention of knee osteoarthritis in overweight females: the first preventive randomized controlled trial in osteoarthritis. Am J Med 2015; 128:888-895.e4. [PMID: 25818496 DOI: 10.1016/j.amjmed.2015.03.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 03/11/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND With accumulating knowledge on osteoarthritis development, the next step is to focus on possibilities for primary prevention. METHODS In a 2 × 2 factorial design, the effects of a diet-and-exercise program and of oral glucosamine sulfate (double blind and placebo-controlled) on the incidence of knee osteoarthritis were evaluated in a high-risk group of 407 middle-aged women with a body mass index ≥ 27 kg/m(2) without clinical signs of knee osteoarthritis at baseline (ISRCTN 42823086). Primary outcome was the incidence of knee osteoarthritis, defined as Kellgren & Lawrence grade ≥ 2, joint space narrowing of ≥ 1.0 mm, or clinical knee osteoarthritis (clinical and radiographic American College of Rheumatology criteria) after 2.5 years. RESULTS After 2.5 years, only 10% of all subjects were lost to follow-up, and 17% of all knees showed incident knee osteoarthritis. Accounting for the significant interaction between the interventions, no significant main effect of either intervention was found. Independently, both interventions alone showed indications of reduced knee osteoarthritis incidence (odds ratio [OR] 0.69; 95% CI, 0.39-1.21 for the diet-and-exercise program and OR 0.60; 95% CI, 0.31-1.12 for the glucosamine intervention). These effects were neutralized in subjects receiving both interventions (OR 0.97; 95% CI, 0.55-1.71). CONCLUSIONS No significant main effects of the diet-and-exercise program and of glucosamine sulfate were found on incident knee osteoarthritis. Nevertheless, this trial provides valuable insights for future trial design for preventive osteoarthritis studies.
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Affiliation(s)
- Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopaedics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sten Willemsen
- Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Edwin H Oei
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Gerjo van Osch
- Department of Orthopaedics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Bart Koes
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Orthopaedics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Crop MJ, Siemes C, Berendes P, van der Straaten F, Willemsen S, Levin MD. Influence of C-reactive protein levels and age on the value of D-dimer in diagnosing pulmonary embolism. Eur J Haematol 2013; 92:147-55. [DOI: 10.1111/ejh.12218] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Meindert Johannes Crop
- Department of Internal Medicine; Albert Schweitzer Hospital; Dordrecht the Netherlands
- Department of Internal Medicine; Erasmus Medical Center; Rotterdam the Netherlands
| | - Claire Siemes
- Department of Internal Medicine; Amphia Hospital Molengracht; Breda the Netherlands
| | - Paul Berendes
- Department of Clinical Chemistry; Albert Schweitzer Hospital; Dordrecht the Netherlands
| | | | - Sten Willemsen
- Department of Biostatistics; Erasmus Medical Center; Rotterdam the Netherlands
| | - Mark-David Levin
- Department of Internal Medicine; Albert Schweitzer Hospital; Dordrecht the Netherlands
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Bales D, van Beek N, Smits M, Willemsen S, Busschbach JJV, Verheul R, Andrea H. Treatment outcome of 18-month, day hospital mentalization-based treatment (MBT) in patients with severe borderline personality disorder in the Netherlands. J Pers Disord 2012; 26:568-82. [PMID: 22867507 DOI: 10.1521/pedi.2012.26.4.568] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Psychoanalytically oriented day hospital therapy, later manualized and named mentalization-based treatment (MBT), has proven to be a (cost-) effective treatment for patients with severe borderline personality disorder and a high degree of psychiatric comorbidity (BPD) in the United Kingdom (UK). As to yet it has not been shown whether manualized day hospital MBT would yield similar results when conducted by an independent institute outside the UK. We investigated the applicability and treatment outcome of 18-month, manualized day hospital MBT in the Netherlands by means of a prospective cohort study with 45 Dutch patients with severe BPD and a high degree of comorbid Axis I and Axis II disorders. Outcomes were assessed each six months. Symptom distress, social and interpersonal functioning, and personality pathology and functioning all improved significantly, with effect sizes between 0.7 and 1.7. Suicide attempts, acts of self-harm, and care consumption were also significantly reduced. The results indicate that MBT can effectively be implemented in an independent treatment institute outside the UK. This study also supports the clinical effectiveness of manualized day hospital MBT in patients with severe BPD and a high degree of psychiatric comorbidity.
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Affiliation(s)
- Dawn Bales
- Center of Psychotherapy De Viersprong, PO Box 7, 4660 AA Halsteren, The Netherlands.
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de Klerk BM, Willemsen S, Schiphof D, van Meurs JBJ, Koes BW, Hofman A, Bierma-Zeinstra SMA. Development of radiological knee osteoarthritis in patients with knee complaints. Ann Rheum Dis 2011; 71:905-10. [DOI: 10.1136/annrheumdis-2011-200172] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pel J, Does LVD, Boot F, Faber TD, Steen-Kant SVD, Willemsen S, Steen HVD. Effects of visual processing and congenital nystagmus on visually guided ocular motor behaviour. Dev Med Child Neurol 2011; 53:344-9. [PMID: 21166674 DOI: 10.1111/j.1469-8749.2010.03857.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to compare visually guided ocular motor behaviour in children with visual processing and/or motor deficits with an age-matched comparison group and an adult group. METHOD Visual stimuli were shown to 28 children with visual processing and/or motor deficits (11 females, 17 males; mean age 7y 5mo, SD 2y 9mo, range 2-14y;) and an age-matched comparison group of 213 typically developing children (115 females, 98 males; mean age 5y 8mo, SD 3y 5mo, range 0-12y). The adult group consisted of nine females and two males with (mean age of 24y 4mo, SD 4y 8mo). Individuals who had a likely diagnosis of cerebral visual impairment (CVI), an opticopathy with unknown location, nystagmus, glaucoma, or a cataract were included in the study. Exclusion criteria were a visual acuity below 0.2, a developmental age under 1 year, and the presence of brain tumours, autism, and anxiety disorders. Orientating eye movements to large cartoons were quantified using the reaction time to fixation (RTF) and gaze fixation area (GFA). A Mann-Whitney U test was used to compare the differences between groups and Bonferroni post-hoc testing was used to analyse age dependence of RTF and GFA values within the comparison group. RESULTS Individuals with CVI showed significantly prolonged RTF values; those with congenital nystagmus showed significantly increased GFA values. In the comparison group, RTF was significantly longer in children under the age of 2 years than in children aged 4 years and older (290 and 200 ms respectively; p < 0.001). No developmental change was found for GFA values. INTERPRETATION Increased RTF values in individuals with CVI relate to visual processing deficits. The data suggest that visually guided ocular motor responses mature during the first 3 years of life.
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Affiliation(s)
- Johan Pel
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.
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den Bakker MA, Willemsen S, Grünberg K, Noorduijn LA, van Oosterhout MFM, van Suylen RJ, Timens W, Vrugt B, Wiersma-van Tilburg A, Thunnissen FBJM. Small cell carcinoma of the lung and large cell neuroendocrine carcinoma interobserver variability. Histopathology 2010; 56:356-63. [PMID: 20459535 DOI: 10.1111/j.1365-2559.2010.03486.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To test the hypothesis that the published morphological criteria permit reliable segregation of small cell carcinoma of the lung (SCLC) and large cell neuroendocrine carcinoma (LCNEC) cases by determining the interobserver variation. METHODS AND RESULTS One hundred and seventy cases of SCLC, LCNEC and cases diagnosed as neuroendocrine lung carcinoma before LCNEC had been established as a diagnostic category were retrieved from the archives of the assessor's institutes. A representative haematoxylin and eosin section from each case was selected for review. Batches of cases were circulated among nine pathologists with a special interest in pulmonary pathology. Participants were asked to classify the cases histologically according to the 2004 World Health Organization (WHO) criteria. The diagnoses were collected and kappa values calculated. Unanimity of diagnosis was achieved for only 20 cases; a majority diagnosis was reached for 115 cases. In 35 cases no consensus diagnosis could be reached. There was striking variability amongst assessors in diagnosing SCLC and LCNEC. The overall level of agreement for all cases included in this study was fair (kappa=0.40). CONCLUSIONS Using non-preselected cases, the morphological WHO criteria for diagnosing SCLC and LCNEC leave room for subjective pathological interpretation, which results in imprecise categorization of SCLC and LCNEC cases.
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Affiliation(s)
- Michael A den Bakker
- Department of Pathology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
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Schouten BWV, Bohnen AM, Dohle GR, Groeneveld FPMJ, Willemsen S, Thomas S, Bosch JLHR. Risk factors for deterioration of erectile function: the Krimpen study. ACTA ACUST UNITED AC 2009; 32:166-75. [DOI: 10.1111/j.1365-2605.2007.00830.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Verghese ET, den Bakker MA, Campbell A, Hussein A, Nicholson AG, Rice A, Corrin B, Rassl D, Langman G, Monaghan H, Gosney J, Seet J, Kerr K, Suvarna SK, Burke M, Bishop P, Pomplun S, Willemsen S, Addis B. Interobserver variation in the classification of thymic tumours – a multicentre study using the WHO classification system. Histopathology 2008; 53:218-23. [DOI: 10.1111/j.1365-2559.2008.03088.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Scheuerer M, Heitsch M, Menter F, Egorov Y, Toth I, Bestion D, Pigny S, Paillere H, Martin A, Boucker M, Krepper E, Willemsen S, Muhlbauer P, Andreani M, Smith B, Karlsson R, Henriksson M, Hemstrom B, Karppinen I, Kimber G. Evaluation of computational fluid dynamic methods for reactor safety analysis (ECORA). Nuclear Engineering and Design 2005. [DOI: 10.1016/j.nucengdes.2004.08.049] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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