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Article ; Online: Time-resolved QA and brachytherapy applicator commissioning: Towards the clinical implementation.

Fonseca, Gabriel P / Voncken, Robert / Hermans, Joep / Verhaegen, Frank

2021 Volume 21, Issue 1, Page(s) 128–137

Abstract: Purpose: Brachytherapy has a busy workflow relying on manual steps to ensure accurate delivery of the treatment. Systematic treatment errors have been reported due to faulty equipment, inadequate quality assurance (QA) and applicator commissioning ... ...

Abstract	Purpose: Brachytherapy has a busy workflow relying on manual steps to ensure accurate delivery of the treatment. Systematic treatment errors have been reported due to faulty equipment, inadequate quality assurance (QA) and applicator commissioning methods. This study describes the use of a novel method, the Iridium Imaging System for QA (IrIS - QA), to automate and improve the applicator commissioning for HDR Methods and materials: A 3D printed holder attached to an Imaging Panel (IP) has been developed to: (1) acquire a high-definition projection of the applicator using the gamma rays of the Results: IrIS-QA is capable of measuring the dwell times with an accuracy better than 0.1 s and interdwell distances with submillimetre precision. The applicators tested in the study showed good agreement between planned and delivered dwell times and positions, with mean and maximum dwell position deviations below 0.5 mm and 1.3 mm, respectively. Dwell time measurements showed agreement superior to 0.05 s except for the first dwell position for which up to 0.15 s differences were observed. Conclusions: IrIS-QA is a compact system that includes many features necessary to improve the accuracy and efficiency of applicator commissioning and daily QA. No commercial system exists with similar capabilities. IrIS-QA is intended to replace current clinical procedures using film dosimetry.
MeSH term(s)	Brachytherapy/methods ; Film Dosimetry ; Humans ; Phantoms, Imaging ; Radiotherapy Dosage
Language	English
Publishing date	2021-10-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2098608-7
ISSN	1873-1449 ; 1538-4721
ISSN (online)	1873-1449
ISSN	1538-4721
DOI	10.1016/j.brachy.2021.08.003
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Article ; Online: Chest CT for triage during COVID-19 on the emergency department: myth or truth?

Hermans, Joep J R / Groen, Joost / Zwets, Egon / Boxma-De Klerk, Bianca M / Van Werkhoven, Jacob M / Ong, David S Y / Hanselaar, Wessel E J J / Waals-Prinzen, Lenneke / Brown, Vanessa

Emergency radiology

2020 Volume 27, Issue 6, Page(s) 641–651

Abstract: Purpose: We aimed to investigate the diagnostic performance of chest CT compared with first RT-PCR results in adult patients suspected of COVID-19 infection in an ED setting. We also constructed a predictive machine learning model based on chest CT and ... ...

Abstract	Purpose: We aimed to investigate the diagnostic performance of chest CT compared with first RT-PCR results in adult patients suspected of COVID-19 infection in an ED setting. We also constructed a predictive machine learning model based on chest CT and additional data to improve the diagnostic accuracy of chest CT. Methods: This study's cohort consisted of 319 patients who underwent chest CT and RT-PCR testing at the ED. Patient characteristics, demographics, symptoms, vital signs, laboratory tests, and chest CT results (CO-RADS) were collected. With first RT-PCR as reference standard, the diagnostic performance of chest CT using the CO-RADS score was assessed. Additionally, a predictive machine learning model was constructed using logistic regression. Results: Chest CT, with first RT-PCR as a reference, had a sensitivity, specificity, PPV, and NPV of 90.2%, 88.2%, 84.5%, and 92.7%, respectively. The prediction model with CO-RADS, ferritin, leucocyte count, CK, days of complaints, and diarrhea as predictors had a sensitivity, specificity, PPV, and NPV of 89.3%, 93.4%, 90.8%, and 92.3%, respectively. Conclusion: Chest CT, using the CO-RADS scoring system, is a sensitive and specific method that can aid in the diagnosis of COVID-19, especially if RT-PCR tests are scarce during an outbreak. Combining a predictive machine learning model could further improve the accuracy of diagnostic chest CT for COVID-19. Further candidate predictors should be analyzed to improve our model. However, RT-PCR should remain the primary standard of testing as up to 9% of RT-PCR positive patients are not diagnosed by chest CT or our machine learning model.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; COVID-19 Testing ; COVID-19 Vaccines ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/epidemiology ; Emergency Service, Hospital ; Female ; Humans ; Machine Learning ; Male ; Middle Aged ; Netherlands/epidemiology ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/epidemiology ; Prospective Studies ; Radiography, Thoracic/methods ; SARS-CoV-2 ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods ; Triage
Chemical Substances	COVID-19 Vaccines ; Covid-19 aAPC vaccine
Keywords	covid19
Language	English
Publishing date	2020-07-20
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-020-01821-1
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Article ; Online: Chest CT for triage during COVID-19 on the emergency department

Hermans, Joep J. R. / Groen, Joost / Zwets, Egon / Boxma-De Klerk, Bianca M. / Van Werkhoven, Jacob M. / Ong, David S. Y. / Hanselaar, Wessel E. J. J. / Waals-Prinzen, Lenneke / Brown, Vanessa

Emergency Radiology ; ISSN 1070-3004 1438-1435

myth or truth?

2020

Keywords	Radiology Nuclear Medicine and imaging ; Emergency Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
DOI	10.1007/s10140-020-01821-1
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Article: Chest CT for triage during COVID-19 on the emergency department: myth or truth?

Hermans, Joep J R / Groen, Joost / Zwets, Egon / Boxma-De Klerk, Bianca M / Van Werkhoven, Jacob M / Ong, David S Y / Hanselaar, Wessel E J J / Waals-Prinzen, Lenneke / Brown, Vanessa

Emerg Radiol

Abstract: PURPOSE: We aimed to investigate the diagnostic performance of chest CT compared with first RT-PCR results in adult patients suspected of COVID-19 infection in an ED setting. We also constructed a predictive machine learning model based on chest CT and ... ...

Abstract	PURPOSE: We aimed to investigate the diagnostic performance of chest CT compared with first RT-PCR results in adult patients suspected of COVID-19 infection in an ED setting. We also constructed a predictive machine learning model based on chest CT and additional data to improve the diagnostic accuracy of chest CT. METHODS: This study's cohort consisted of 319 patients who underwent chest CT and RT-PCR testing at the ED. Patient characteristics, demographics, symptoms, vital signs, laboratory tests, and chest CT results (CO-RADS) were collected. With first RT-PCR as reference standard, the diagnostic performance of chest CT using the CO-RADS score was assessed. Additionally, a predictive machine learning model was constructed using logistic regression. RESULTS: Chest CT, with first RT-PCR as a reference, had a sensitivity, specificity, PPV, and NPV of 90.2%, 88.2%, 84.5%, and 92.7%, respectively. The prediction model with CO-RADS, ferritin, leucocyte count, CK, days of complaints, and diarrhea as predictors had a sensitivity, specificity, PPV, and NPV of 89.3%, 93.4%, 90.8%, and 92.3%, respectively. CONCLUSION: Chest CT, using the CO-RADS scoring system, is a sensitive and specific method that can aid in the diagnosis of COVID-19, especially if RT-PCR tests are scarce during an outbreak. Combining a predictive machine learning model could further improve the accuracy of diagnostic chest CT for COVID-19. Further candidate predictors should be analyzed to improve our model. However, RT-PCR should remain the primary standard of testing as up to 9% of RT-PCR positive patients are not diagnosed by chest CT or our machine learning model.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #655453
Database	COVID19

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Article ; Online: Effect of N-acetylcysteine on pain in daily life in patients with sickle cell disease: a randomised clinical trial.

British journal of haematology

2017 Volume 182, Issue 3, Page(s) 444–448

MeSH term(s)	Acetylcysteine/adverse effects ; Acetylcysteine/pharmacology ; Acetylcysteine/therapeutic use ; Adolescent ; Adult ; Anemia, Sickle Cell/drug therapy ; Anemia, Sickle Cell/pathology ; Antioxidants ; Child ; Female ; Humans ; Male ; Medication Adherence ; Pain/prevention & control ; Treatment Outcome ; Young Adult
Chemical Substances	Antioxidants ; Acetylcysteine (WYQ7N0BPYC)
Language	English
Publishing date	2017-06-23
Publishing country	England
Document type	Letter ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.14809
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Article ; Online: Ventricular fibrillation waveform characteristics differ according to the presence of a previous myocardial infarction: A surface ECG study in ICD-patients.

Bonnes, Judith L / Thannhauser, Jos / Hermans, Mathilde C / Westra, Sjoerd W / Oostendorp, Thom F / Meinsma, Gjerrit / de Boer, Menko Jan / Brouwer, Marc A / Smeets, Joep L R M

Resuscitation

2015 Volume 96, Page(s) 239–245

Abstract: Background: Characteristics of the ventricular fibrillation (VF) waveform reflect arrest duration and have been incorporated in studies on algorithms to guide resuscitative interventions. Findings in animals indicate that VF characteristics are also ... ...

Abstract	Background: Characteristics of the ventricular fibrillation (VF) waveform reflect arrest duration and have been incorporated in studies on algorithms to guide resuscitative interventions. Findings in animals indicate that VF characteristics are also affected by the presence of a previous myocardial infarction (MI). As studies in humans are scarce, we assessed the impact of a previous MI on VF characteristics in ICD-patients. Methods: Prospective cohort of ICD-patients (n=190) with defibrillation testing at the Radboudumc (2010-2013). VF characteristics of the 12-lead surface ECG were compared between three groups: patients without a history of MI (n=88), with a previous anterior (n=47) and a previous inferior MI (n=55). Results: As compared to each of the other groups, the mean amplitude and amplitude spectrum area were lower, for an anterior MI in lead V3 and for an inferior MI in leads II and aVF. Across the three groups, the bandwidth was broader in the leads corresponding with the infarct localisation. In contrast, the dominant and median frequencies only differed between previous anterior MI and no history of MI, being lower in the former. Conclusions: The VF waveform is affected by the presence of a previous MI. Amplitude-related measures were lower and VF was less organised in the ECG-lead(s) adjacent to the area of infarction. Although VF characteristics of the surface ECG have so far primarily been considered a proxy for arrest duration and metabolic state, our findings question this paradigm and may provide additional insights into the future potential of VF-guided resuscitative interventions.
MeSH term(s)	Aged ; Algorithms ; Defibrillators, Implantable ; Electromyography/methods ; Female ; Follow-Up Studies ; Heart Arrest/epidemiology ; Heart Arrest/etiology ; Heart Arrest/therapy ; Heart Rate/physiology ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Infarction/complications ; Myocardial Infarction/physiopathology ; Netherlands/epidemiology ; Prognosis ; Prospective Studies ; Survival Rate/trends ; Ventricular Fibrillation/complications ; Ventricular Fibrillation/physiopathology ; Ventricular Fibrillation/therapy
Language	English
Publishing date	2015-11
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2015.08.014
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Article ; Online: Infection with multiple viruses is not associated with increased disease severity in children with bronchiolitis.

Brand, H Kim / de Groot, Ronald / Galama, Joep M D / Brouwer, Marianne L / Teuwen, Karin / Hermans, Peter W M / Melchers, Willem J G / Warris, Adilia

Pediatric pulmonology

2011 Volume 47, Issue 4, Page(s) 393–400

Abstract: Background: The clinical relevance of parallel detection of multiple viruses by real-time polymerase chain reaction (RT-PCR) remains unclear. This study evaluated the association between the detection of multiple viruses by RT-PCR and disease severity ... ...

Abstract	Background: The clinical relevance of parallel detection of multiple viruses by real-time polymerase chain reaction (RT-PCR) remains unclear. This study evaluated the association between the detection of multiple viruses by RT-PCR and disease severity in children with bronchiolitis. Methods: Children less than 2 years of age with clinical symptoms of bronchiolitis were prospectively included during three winter seasons. Patients were categorized in three groups based on disease severity; mild (no supportive treatment), moderate (supplemental oxygen and/or nasogastric feeding), and severe (mechanical ventilation). Multiplex RT-PCR of 15 respiratory viruses was performed on nasopharyngeal aspirates. Results: In total, 142 samples were obtained. Respiratory Syncytial virus (RSV) was the most commonly detected virus (73%) followed by rhinovirus (RV) (30%). In 58 samples (41%) more than one virus was detected, of which 41% was a dual infection with RSV and RV. In RSV infected children younger than 3 months, disease severity was not associated with the number of detected viruses. Remarkably, in children older than 3 months we found an association between more severe disease and RSV mono-infections. Conclusion: Disease severity in children with bronchiolitis is not associated with infection by multiple viruses. We conclude that other factors, such as age, contribute to disease severity to a larger extent.
MeSH term(s)	Bronchiolitis/virology ; Female ; Humans ; Infant ; Male ; Picornaviridae Infections/diagnosis ; Picornaviridae Infections/virology ; Prospective Studies ; Respiratory Syncytial Virus Infections/diagnosis ; Respiratory Syncytial Virus Infections/virology ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus/isolation & purification ; Severity of Illness Index
Keywords	covid19
Language	English
Publishing date	2011-09-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.21552
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Article: Adhesion molecule expression in local-macrophage-depleted rats bearing orthotopic corneal allografts.

Slegers, Tanja P A M / van der Veen, Gerard / Hermans, L Joep A / Broersma, Lidy / van Rooijen, Nico / Völker-Dieben, Hendrika J / van Rij, Gabriel / van der Gaag, Ruth

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie

2003 Volume 241, Issue 5, Page(s) 432–438

Abstract: Background: Rejection of corneal grafts is dependent on influx of T lymphocytes and macrophages. This process is partly regulated by adhesion molecules. Earlier investigations showed that corneal graft rejection in rats could be prevented by clodronate ... ...

Abstract	Background: Rejection of corneal grafts is dependent on influx of T lymphocytes and macrophages. This process is partly regulated by adhesion molecules. Earlier investigations showed that corneal graft rejection in rats could be prevented by clodronate liposomes that selectively eliminate macrophages. In the present study the effect of macrophage depletion on adhesion molecule expression after corneal allotransplantation was investigated. Methods: Orthotopic corneal allografts were performed, after which rats received subconjunctival injections with clodronate liposomes or remained untreated. On various postoperative days, grafted rats were killed and mid-eye sections were stained for expression of ICAM-1 (CD54) and beta(2)-integrins (CD18 and CD11b/c). Results: In the clodronate liposome-treated group grafts were not rejected, while in untreated rats grafts had a mean survival time of 12 days. During the first postoperative days a slightly enhanced expression of ICAM-1 in the conjunctiva and allografted cornea of clodronate liposome-treated recipients was seen. On day 12, however, ICAM-1 expression was markedly downregulated in the allografts of this treated group. The expression of beta(2)-integrins was also significantly decreased in the allografts and recipient corneas of treated rats at this time point. Conclusion: Prolonged corneal graft survival in rats, obtained via local depletion of macrophages, correlates with diminished expression of adhesion molecules.
MeSH term(s)	Animals ; CD18 Antigens/metabolism ; Clodronic Acid/administration & dosage ; Cornea/metabolism ; Corneal Transplantation ; Down-Regulation ; Graft Survival ; Intercellular Adhesion Molecule-1/metabolism ; Liposomes ; Macrophages/drug effects ; Macrophages/physiology ; Male ; Rats ; Rats, Inbred F344 ; Transplantation, Homologous
Chemical Substances	CD18 Antigens ; Liposomes ; Clodronic Acid (0813BZ6866) ; Intercellular Adhesion Molecule-1 (126547-89-5)
Language	English
Publishing date	2003-05
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	8435-9
ISSN	1435-702X ; 0721-832X
ISSN (online)	1435-702X
ISSN	0721-832X
DOI	10.1007/s00417-003-0665-1
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Article ; Online: Strengthening the diagnostic capacity to detect Bio Safety Level 3 organisms in unusual respiratory viral outbreaks.

van Asten, Liselotte / van der Lubben, Mariken / van den Wijngaard, Cees / van Pelt, Wilfrid / Verheij, Robert / Jacobi, Andre / Overduin, Pieter / Meijer, Adam / Luijt, Dirk / Claas, Eric / Hermans, Mirjam / Melchers, Willem / Rossen, John / Schuurman, Rob / Wolffs, Petra / Boucher, Charles / Bouchier, Charles / Schirm, Jurjen / Kroes, Louis /

Leenders, Sander / Galama, Joep / Peeters, Marcel / van Loon, Anton / Stobberingh, Ellen / Schutten, Martin / Koopmans, Marion

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

2009 Volume 45, Issue 3, Page(s) 185–190

Abstract: Background: Experience with a highly pathogenic avian influenza outbreak in the Netherlands (2003) illustrated that the diagnostic demand for respiratory viruses at different biosafety levels (including BSL3), can increase unexpectedly and dramatically.! ...

Abstract	Background: Experience with a highly pathogenic avian influenza outbreak in the Netherlands (2003) illustrated that the diagnostic demand for respiratory viruses at different biosafety levels (including BSL3), can increase unexpectedly and dramatically. Objectives: We describe the measures taken since, aimed at strengthening national laboratory surge capacity and improving preparedness for dealing with diagnostic demand during outbreaks of (emerging) respiratory virus infections, including pandemic influenza virus. Study design: Academic and peripheral medical-microbiological laboratories collaborated to determine minimal laboratory requirements for the identification of viruses in the early stages of a pandemic or a large outbreak of avian influenza virus. Next, an enhanced collaborative national network of outbreak assistance laboratories (OAL) was set up. An inventory was made of the maximum diagnostic throughput that this network can deliver in a period of intensified demand. For an estimate of the potential magnitude of this surge demand, historical counts were calculated from hospital- and physician-based registries of patients presenting with respiratory symptoms. Results: Number of respiratory physician-visits ranged from 140,000 to 615,000 per month and hospitalizations ranged from 3000 to 11,500 per month. The established OAL-network provides rapid diagnostic response with agreed quality requirements and a maximum throughput capacity of 1275 samples/day (38,000 per month), assuming other routine diagnostic work needs to be maintained. Conclusions: Thus surge demand for diagnostics for hospitalized cases (if not distinguishable from other respiratory illness) could be handled by the OAL network. Assessing etiology of community acquired acute respiratory infection however, may rapidly exceed the capacity of the network. Therefore algorithms are needed for triaging for laboratory diagnostics; currently this is not addressed in pandemic preparedness plans.
MeSH term(s)	Communicable Disease Control/methods ; Containment of Biohazards/methods ; Disease Outbreaks/prevention & control ; Humans ; Influenza, Human/diagnosis ; Influenza, Human/epidemiology ; Influenza, Human/virology ; Laboratories ; Netherlands ; Orthomyxoviridae/classification ; Orthomyxoviridae/isolation & purification ; Respiratory Tract Diseases/epidemiology ; Respiratory Tract Diseases/virology ; Virus Diseases/diagnosis ; Virus Diseases/epidemiology ; Virus Diseases/virology ; Viruses/classification ; Viruses/isolation & purification
Language	English
Publishing date	2009-07
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1446080-4
ISSN	1873-5967 ; 1386-6532
ISSN (online)	1873-5967
ISSN	1386-6532
DOI	10.1016/j.jcv.2009.05.024
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