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Re-emergence of pertussis despite high vaccination coverage in western countries, results in increased risk for severe and even fatal pertussis among newborns. For this reason, late 2015 the Dutch Health Council (HC) advised to offer 3rd trimester pertussis vaccination to pregnant women. At the start of the maternal pertussis programme late 2019, the maternal Tdap was advised from 22w of gestation onwards. Preterms, accounting for 8% of newborns in the Netherlands, are at highest risk for severe pertussis leading to prolonged hospital and intensive care admissions and sometimes death. Recently, it has become evident that despite 3rd trimester vaccination, preterms remain at high risk because the vaccination is likely given too late for sufficient antibody transfer. For this vulnerable group 2nd trimester vaccination may offer better protection because of extended time for antibody transfer. To date, most countries recommend 3rd trimester vaccination to protect young, not yet (fully) vaccinated infants. Data from England show 91% effectiveness against infant pertussis after maternal Tetanus- diphtheria -acellular Pertussis (Tdap) vaccination in the 3rd trimester. Studies focussing on preterms and protection after maternal vaccination are scarce. Two observational studies reported on effectiveness and antibody levels in cord blood of 2nd trimester vaccination in term infants. While one study showed significantly higher antibody levels after 2nd trimester vaccination (13-25 gestational weeks; GW), another study showed decreased effectiveness of 2nd trimester (<27 GW) vaccination. Only one study concerned antibody transfer in preterms and reported higher antibody levels after 2nd (n=37) than after 3rd (n=48) trimester vaccination. Aiming to contribute to setting optimal vaccine strategy of maternal pertussis vaccination in the Netherlands and elsewhere and particular for the most vulnerable group of preterms, we propose a study that compares pertussis antibody levels in preterms and terms after 2nd trimester maternal vaccination. We can compare these to data we have on 3rd trimester Tdap in terms. In addition to adequate antibody levels, success of 2nd trimester vaccination depends on acceptance of this strategy by pregnant women and professionals. Our primary endpoint is IgG anti-pertussis toxin (Pt) antibody concentration in preterms and terms at 2m of age, Pt is considered the most relevant antibody for protection against clinical pertussis. Secondary endpoints are e.g. pertussis specific antibody concentrations in preterms and terms in cord blood and in women at delivery. Determinants of acceptance of 2nd trimester maternal vaccination are also a secondary endpoint. Antibody concentrations will be assessed in serum, using a fluorescent bead-based multiplex immunoassay, with required blood volume of minimal 100µl. For the survey on acceptance, we aim to have 4 groups of 100 women each, i.e. women who are pregnant for the 1st time, women who already gave birth and in both groups women with and without a known increased risk of preterm delivery. For the immunogenicity part, we aim to have at least 60 preterms and 60 terms, as this is, according to experts, the minimum number to enable good comparisons. Pregnant women will be offered 2nd trimester pertussis vaccination. Both among acceptors and non-acceptors acceptance of 2nd trimester vaccination will be assessed. Women are first asked to participate in the acceptance part after the 1st antenatal visit to a midwife or obstetrician. They fill in a questionnaire to assess behavioral determinants and beliefs that underlie acceptance of 2nd trimester maternal vaccination. Only after this consent, women will be asked to participate in the immunogenicity part. Hereby, women will receive Tdap after they have the 20w standard anomaly ultrasound scan (20-24 GW). Vaccinated women will be followed until delivery. All preterms and a random selection of 60 terms, all of vaccinated mothers, will be followed until 2m of age, i.e. just before start of the NIP. By including both women in primary and secondary antenatal care, we aim to enrich our study population with women who are at increased risk for preterm delivery, as these women are usually seen by an obstetrician. Data from our study will determine whether 2nd trimester Tdap leads to sufficient Pt antibodiy concentration in terms and preterms compared to 3rd trimester vaccination. Furthermore, we will have knowledge about obstacles for acceptance and can tailor information for all pregnant women to overcome these. Finally, given that in near future besides pertussis other maternal vaccines are likely to become available for prevention of severe disease in newborns (RSV, GBS), in particular in preterms, this study generates essential knowledge for future vaccine policy of maternal vaccines.
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<p>Datasets used for the manuscript: <em>Long-term wastewater monitoring of SARS-CoV-2 viral loads and variants at the major international passenger hub Amsterdam Schiphol Airport: a valuable addition to COVID-19 surveillance</em></p> <p><em>pandemic_daily_passenger_counts.tsv</em>: An overview of daily passenger arrival counts at Amsterdam Schiphol Airport per continent of origin during the study period 16-02-2020 - 04-09-2022</p> <p><em>pre-pandemic_daily_passenger_averages.tsv: </em>An overview of mean daily passenger arrival counts at Amsterdam Schiphol Airport in the pre-pandemic period 2017-2019.</p> <p><em>viral_load_data.tsv: </em>Flow-corrected viral load (# particles per 24h) in samples taken at the wastewater treatment plant of Amsterdam Schiphol Airport.</p> <p><em>wastewater_variant_frequencies.tsv: </em>SARS-CoV-2 lineage estimates in samples taken at the wastewater treatment plant of Amsterdam Schiphol Airport, analyzed using whole-genome tiled amplicon sequencing.</p>
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De VCP geeft inzicht in wat, waar en wanneer Nederlanders eten en drinken en vergelijkt dit met de Richtlijnen goede voeding en voedingsnormen van de Gezondheidsraad. Het RIVM bracht dit in kaart op basis van het voedingspatroon van ongeveer 3.500 kinderen en volwassenen in de periode 2019-2021.
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Deze kaart toont de gemodelleerde concentratie roet (µg EC/m³) voor 2013, op basis van rekenpunten uit de monitoringstool van het nsl. Deze vlakdekkende kaart van Nederland heeft een resolutie van 25 meter.
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For English, see below De klachten van een infectie met het coronavirus SARS-CoV-2 lijken steeds meer op de klachten van andere luchtwegvirussen. Daarom kijken we voor het zicht op luchtweginfecties niet meer naar COVID-19-achtige klachten maar naar algemene klachten bij acute luchtweginfecties. Het monitoren van klachten volgens de oude definitie stopt per 8 november 2023. Het percentage deelnemers aan Infectieradar met klachten die passen bij een acute luchtweginfectie ligt iets hoger dan dat van COVID-19-achtige klachten omdat keelpijn en neusverkoudheid niet in de definitie van COVID-19-achtige klachten zaten en wel in de algemene definitie van klachten bij luchtweginfectie. Beschrijving bestand: Dit bestand bevat de volgende percentages: - (1) percentage deelnemers met Covid-19-achtige klachten in Infectieradar - (2) 7-daags gemiddelde van (1) naar rapportagedatum van de wekelijkse vragenlijst. Het bestand is als volgt opgebouwd: • Eén record per rapportagedatum Het bestand wordt een keer in de week geüpdatet, maar alleen gegevens van volledig afgeronde dagen worden weergegeven. Iedere week op dinsdag worden er zeven nieuwe dagen (dinsdag tot en met maandag) aan het bestand toegevoegd. Vanaf 6 september 2023 wordt dit bestand wekelijks op woensdag geüpdatet. De data wordt met terugwerkende kracht bijgewerkt voor de andere dagen. Beschrijving van de variabelen: Version: versienummer van de dataset. Wanneer de inhoud van de dataset structureel wordt gewijzigd (dus niet de dagelijkse update of een correctie op record niveau), zal het versienummer aangepast worden (+1) en ook de corresponderende metadata in RIVMdata (data.rivm.nl). Date_of_report: Datum en tijd waarop het databestand is aangemaakt door het RIVM. Date_of_statistics: Datum waarop de wekelijkse vragenlijst is ingestuurd. Perc_covid_symptoms: Percentage deelnemers in Infectieradar dat in de week voor de [Date_of_statistics] Covid-19-achtige klachten heeft gerapporteerd. Covid-19-achtige klachten zijn koorts, hoesten, kortademigheid, verlies van reuk of verlies van smaak. MA_perc_covid_symptoms: Het zevendaags lopende gemiddelde (moving average/MA) van [Perc_covid_symptoms]. Dit gemiddelde wordt op de middelste dag weergegeven. Voor de eerste 3 en de laatste 3 dagen in de dataset is deze waarde leeg, omdat deze dagen niet in het midden van een 7 daagse periode liggen. Vanaf 24 november 2022 zijn de analyses van Infectieradar met terugwerkende kracht aangepast. Hierdoor zijn er minimale verschillen in de resultaten die voor deze datum gepubliceerd waren. -------------------------------------------------------------------------------- Covid-19 Percentage of participants with COVID-19-like complaints in Infectieradar per reporting date The symptoms of an infection with the SARS-CoV-2 coronavirus are increasingly similar to the symptoms of other respiratory viruses. That is why we no longer look at COVID-19-like complaints to monitor respiratory infections, but at general complaints consistent with acute respiratory infections. Monitoring complaints according to the old definition will stop on November 8, 2023. The percentage of Infection Radar participants with complaints consistent with an acute respiratory infection is slightly higher than that of COVID-19-like complaints because sore throat and nasal colds are not included in the definition of COVID-19-like complaints and are included in the general definition of complaints consistent with respiratory infections. File description: This file contains the following percentages: - (1) percentage of participants with Covid-19-like complaints in Infectieradar - (2) 7-day average of (1) per reporting date of the weekly questionnaire. The file is structured as follows: • One record per reporting date The file is updated once a week, but only data from fully completed days is displayed. Every week on Tuesday, seven new days (Tuesday through Monday) are added to the file. From September 6, 2023, this file will be updated weekly on Wednesdays. The data is retroactively updated for the other days. Description of the variables: Version: version number of the dataset. When the content of the dataset is structurally changed (so not the daily update or a correction at record level), the version number will be adjusted (+1) and also the corresponding metadata in RIVMdata (data.rivm.nl). Date_of_report: Date and time on which the data file was created by the RIVM. Date_of_statistics: Date on which the weekly questionnaire was submitted. Perc_covid_symptoms: Percentage of participants in Infectieradar who reported Covid-19-like symptoms in the week before the [Date_of_statistics]. Covid-19-like complaints are fever, cough, shortness of breath, loss of smell or loss of taste. MA_perc_covid_symptoms: The 7-day moving average (MA) of [Perc_covid_symptoms]. This average is shown on the middle day. For the first 3 and last 3 days in the dataset, this value is empty, because these days are not in the middle of a 7-day period. From November 24, 2022, the analyzes of Infectieradar have been adjusted retroactively. As a result, there are minimal differences in the results published before this date.
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Genexpressie in muizen na infectie met RSV
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Deze kaart toont de gemodelleerde concentratie fijn stof (µg pm10/m³) voor 2013 op basis van rekenpunten uit de monitoringstool van het nsl. Deze vlakdekkende kaart van Nederland heeft een resolutie van 25 meter.
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Verschillende soorten niet-genotoxisch carcinogenen, getest in primaire hepatocyten
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Genexpressie in keratinocyten na blootstelling aan sensibiliserende of irriterende stoffen
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The dataset “Impact of HIV strategies for MSM” contains data obtained from an agent-based model. The model follows the sexual life of 20,000 men who have sex with men (MSM) in the Netherlands. Via sexual contacts, men may get infected with HIV or N. Gonorrhoeae (NG). The model simulates sexual behaviour, demography, and the course of HIV or NG infection (for those who have been infected). The data from the model are therefore data of “fictitious” (simulated) individuals, not of real individuals. The course of HIV infection was modelled using data from the national database of HIV-positive individuals in the Netherlands (Source: Stichting HIV Monitoring). Parameters relating to sexual behaviour were obtained from data from the Amsterdam Cohort Study and the Network Study among MSM in Amsterdam. The model was calibrated to data on annual HIV diagnoses in 2008-2014 (from Stichting HIV Monitoring) and gonorrhoea positivity in 2009-2014 (data obtained from the National Database of STI Clinics in the Netherlands (SOAP)). Model outcomes include the annual numbers of MSM getting infected with HIV; HIV-positive MSM getting diagnosed, entering care, or starting treatment; MSM developing AIDS; MSM getting infected with NG; MSM treated for gonorrhoea; HIV tests, NG tests, etc. With the model, we calculated these numbers for the years 2018-2027, for the situation with the current testing rates and without PrEP. Subsequently we calculated these numbers with increased HIV/STI testing: a small, a moderate, and a high increase in testing among all MSM or only among MSM in specific subgroups of MSM. Finally, the calculations were repeated accounting for a nationwide PrEP programme for MSM at high risk to acquire HIV.