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71 results on '"Oldenbeuving, A"'

1. The Impact of Nursing Delirium Preventive Interventions in the ICU A Multicenter Cluster-randomized Controlled Clinical Trial

Author: Paul J. T. Rood, Marieke Zegers, Dharmanand Ramnarain, Matty Koopmans, Toine Klarenbeek, Esther Ewalds, Marijke S. van der Steen, Annemarie W. Oldenbeuving, Michael A. Kuiper, Steven Teerenstra, Eddy Adang, Lex M. van Loon, Annelies Wassenaar, Hester Vermeulen, Peter Pickkers, Mark van den Boogaard, Danie Pretorius, Femke van der Horst, Albertus Beishuizen, and Marga Hoogendoorn
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Nonpharmacological interventions, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Critical Care and Intensive Care Medicine, Disease cluster, behavioral disciplines and activities, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, parasitic diseases, mental disorders, medicine, 030212 general & internal medicine, Intensive care medicine, Intervention program, Critically ill, business.industry, nervous system diseases, Clinical trial, 030228 respiratory system, Preventive intervention, Delirium, medicine.symptom, business
Abstract: Rationale: Delirium is common in critically ill patients and is associated with deleterious outcomes. Nonpharmacological interventions are recommended in current delirium guidelines, but their effe...
Published: 2021

2. Lossless 1×4 Silicon Photonic ROADM based on a Monolithic Integrated Erbium Doped Waveguide Amplifier on a Si3N4 platform

Author: Sonia M. Garcia Blanco, Ruud M. Oldenbeuving, Christos Vagionas, Nikos Pleros, Theoni Alexoudi, Chris G. H. Roeloffzen, Konstantinos Fotiadis, Ioannis Roumpos, Jinfeng Mu, Meindert Dijkstra, Apostolos Tsakyridis, Themistoklis Chrysostomidis, A. Manolis, Konstantinos Vyrsokinos, Paulus W. L. van Dijk, Optical Sciences, and MESA+ Institute
Subjects: Topology (electrical circuits), Optical Switching, 02 engineering and technology, Waveguide (optics), Optical Amplifiers, Wavelength Routing, 020210 optoelectronics & photonics, ROADM, Wavelength-division multiplexing, Optical fiber amplifiers, Optical fiber networks, Silicon Photonics, 0202 electrical engineering, electronic engineering, information engineering, Optical switches, 22/1 OA procedure, Physics, Silicon photonics, Optical add-drop multiplexers, business.industry, Photonic integrated circuit, Single-mode optical fiber, Optical Networks, Atomic and Molecular Physics, and Optics, Optical waveguides, Net gain, Wavelength division multiplexing, Optoelectronics, Channel spacing, Optical losses, business
Abstract: During the past years, incorporating ptical Circuit Switches (OCS) in high-bandwidth optical interconnects has outlined the critical challenges of achieving ultra-low fiber-to-fiber losses (FtF) and constantly decreasing costs for Photonic Integrated Circuits (PICs). This work aims to simultaneously satisfy both the low-loss and low-cost requirements by bringing two of the most successful example-technologies in the history of optics, i.e. EDFAs and ROADMs to a common Si3N4 platform. In particular, the proof-of-concept operation of a lossless four-port Silicon Photonic (SiPho) ROADM is experimentally presented for the first time based on two PIC prototypes on a Si3N4 platform, including a monolithic-integrated 5.9cm-long spiral Al2O3:Er3+ Erbium Doped Waveguide Amplifier (EDWA) with 15 dB signal enhancement capabilities and a lattice MZI-interleaver ROAM layout with 100 GHz channel spacing. Considering an ultra-low 2.55 dB FtF loss of the ROADM along with 0.5 dB loss for each of the two coupling-interfaces between the Si3N4 and Al2O3:Er3+ waveguide layers, a cumulative loss of 3.55 dB is obtained, which can be compensated by the 3.6 dB net gain provided by the EDWA to four incoming WDM signals of -1.7 dBm/channel. Lossless wavelength-routing operation is validated at up to 240 Gb/s WDM (460Gb/s) data traffic, while the cascadability of the proposed device is benchmarked in a realistic two-stage optical bus topology with 10 km single mode fiber that selectively routes 425Gb/s WDM data channels to any of its eight Drop output ports. This work forms the first demonstration of lossless ROADM operation exclusively on SiPho technology, highlighting a promising roadmap for large scale SiPho switching matrices and more complex PICs co-integrated with EDWAs.
Published: 2022

3. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study

Author: Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., Van Der Naalt J., CENTER-Tbi Invest Participants, Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen, M. C., Polinder, S., Lingsma, H. F., Maas, A. I. R., Menon, D., Steyerberg, E. W., Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzo, P., Bauerfeind, U., Beer, R., Belda, F. J., Bellander, B. -M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L. S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Buckova, V., Calappi, E., Cameron, P., Carbayo, L. G., Carise, E., Carpenter, C., Castano-Leon, A. M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Coburn, M. C., Coles, J., Cooper, J. D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Della Corte, F., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Duliere, G. -L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V. L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzen, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P. A., Grossi, F., Gruen, R. L., Gupta, D., Haagsma, J. A., Hadzic, E., Haitsma, I., Hartings, J. A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P. J., Haberg, A. K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J., Jones, K., Kalala, J. -P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A. G., Kolumban, B., Kompanje, E., Kondziella, D., Koskinen, L. -O., Kovacs, N., Kalovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Macdonald, S., Macfayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Marechal, H., Mastelova, D., Mattern, J., Mcmahon, C., Melegh, B., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Muhlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyiradi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P. M., Patruno, A., Payen, J. -F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Pili, F. S., Pirinen, M., Ples, H., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorcikova, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D. L., Ruiz De Arcaute, F., Rusnak, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlosser, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R. F., Schwendenwein, E., Scholl, M., Sir, O., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E. L., Stanworth, S., Stegemann, K., Steinbuchel, N., Stevens, R., Stewart, W., Stocchetti, N., Sundstrom, N., Synnot, A., Szabo, J., Soderberg, J., Taccone, F. S., Tamas, V., Tanskanen, P., Tascu, A., Taylor, M. S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J. -F. L., Tudora, C. M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vande Vyvere, T., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P. M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vamos, Z., Wade, D., Wang, K. K. W., Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, M. K. L., Ylen, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., De Lange, S., De Ruiter, G. C. W., Den Boogert, H., Van Dijck, J., Van Essen, T. A., Van Heugten, C., Van Der Jagt, M., Van Der Naalt, J., Commission of the European Communities, Molecular Neuroscience and Ageing Research (MOLAR), Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, and Public Health
Subjects: Questionnaires, Comparative Effectiveness Research, Critical Care and Emergency Medicine, Medical Doctors, Neurologi, Health Care Providers, CENTER-TBI Investigators and Participants, lcsh:Medicine, Poison control, Occupational safety and health, Diagnostic Radiology, Geographical Locations, 0302 clinical medicine, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Brain Damage, Longitudinal Studies, Prospective Studies, Israel, lcsh:Science, Tomography, Trauma Medicine, Multidisciplinary, Radiology and Imaging, traumatic brain injury, Trauma center, Hospitals, 3. Good health, Europe, Hospitalization, Professions, Intensive Care Units, Neurology, Research Design, Intracranial pressure monitoring, Medical emergency, Engineering sciences. Technology, Research Article, medicine.medical_specialty, Imaging Techniques, Traumatic brain injury, General Science & Technology, Concordance, Comparative effectiveness research, Neuroimaging, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Physicians, Injury prevention, MD Multidisciplinary, medicine, Humans, Treatment Guidelines, Survey Research, Health Care Policy, business.industry, lcsh:R, Biology and Life Sciences, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, ta3124, Computed Axial Tomography, Health Care, Health Care Facilities, Family medicine, People and Places, lcsh:Q, Population Groupings, business, 030217 neurology & neurosurgery, Neuroscience
Abstract: © 2016 Cnossen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.
Published: 2020

4. Flip-Chip Integration of InP to SiN Photonic Integrated Circuits

Author: Dimitri Geskus, A. Sigmund, F. M. Postma, Lennart Wevers, Rene Heideman, Ronald Dekker, Martin Moehrle, Karl-Otto Velthaus, Kerstin Worhoff, Martin Schell, Ruud M. Oldenbeuving, Richard Mateman, Michael Theurer, Frederik Schreuder, and Publica
Subjects: Materials science, Silicon photonics, business.industry, Photonic integrated circuit, Optical power, 02 engineering and technology, Chip, Waveguide (optics), Atomic and Molecular Physics, and Optics, Semiconductor laser theory, 020210 optoelectronics & photonics, 0202 electrical engineering, electronic engineering, information engineering, Optoelectronics, business, Flip chip, Tunable laser
Abstract: We present our hybrid InP to SiN TriPleX integration interface with a novel alignment technique and its application to complex photonic integrated circuits. The integration interface comprises vertical alignment stops, which simplify the alignment process and allow for array integration with the same simplicity as for single dies. Horizontal alignment is carried out by utilizing optical backscatter reflectometry to get an active feedback signal without the need to operate the chip. Thus, typical contacting limitations of active flip-chip alignment are overcome. By using this method, we demonstrate the integration of InP DFB lasers with more than 60 mW of optical power coupled to a SiN waveguide with an averaged coupling loss of -2.1 dB. The hybrid integration process is demonstrated for single dies as well as full arrays. We evaluate the feasibility of the assembly process for complex photonic integrated circuits by integrating an InP gain chip to a SiN TriPleX external cavity. The process proves to be well suited and allows monitoring chip quality during assembly. A fully functional hybrid integrated tunable laser is fabricated, which is capable of full C-band tuning with optical output power of up to 60 mW.
Published: 2020

5. Ring resonator enhanced mode-hop-free wavelength tuning of an integrated extended-cavity laser

Author: Peter J. M. van der Slot, E.J. Klein, Albert van Rees, Klaus J. Boller, Youwen Fan, Dimitri Geskus, Ruud M. Oldenbeuving, and Laser Physics & Nonlinear Optics
Subjects: Materials science, FOS: Physical sciences, Physics::Optics, Applied Physics (physics.app-ph), 02 engineering and technology, Ring (chemistry), 01 natural sciences, law.invention, 010309 optics, Laser linewidth, Resonator, law, 0103 physical sciences, Physics::Atomic Physics, Diode, Range (particle radiation), business.industry, Physics - Applied Physics, 021001 nanoscience & nanotechnology, Laser, Atomic and Molecular Physics, and Optics, Wavelength, Optical cavity, Optoelectronics, 0210 nano-technology, business, Physics - Optics, Optics (physics.optics)
Abstract: Extending the cavity length of diode lasers with feedback from Bragg structures and ring resonators is highly effective for obtaining ultra-narrow laser linewidths. However, cavity length extension also decreases the free-spectral range of the cavity. This reduces the wavelength range of continuous laser tuning that can be achieved with a given phase shift of an intracavity phase tuning element. We present a method that increases the range of continuous tuning to that of a short equivalent laser cavity, while maintaining the ultra-narrow linewidth of a long cavity. Using a single-frequency hybrid integrated InP-Si3N4 diode laser with 120 nm coverage around 1540 nm, with a maximum output of 24 mW and lowest intrinsic linewidth of 2.2 kHz, we demonstrate a six-fold increased continuous and mode-hop-free tuning range of 0.22 nm (28 GHz) as compared to the free-spectral range of the laser cavity., Comment: 12 pages, 7 figures
Published: 2020

6. Post Intensive Care Syndrome (PICS): an overview of the definition, etiology, risk factors, and possible counseling and treatment strategies

Author: Brenda L. Den Oudsten, Dharmanand Ramnarain, Annemarie W. Oldenbeuving, Sjaak Pouwels, Jolanda De Vries, and Emily Aupers
Subjects: TERM COGNITIVE IMPAIRMENT, Counseling, endocrine system, medicine.medical_specialty, MECHANICALLY VENTILATED PATIENTS, family, Critical Care, PICS, Critical Illness, RESPIRATORY-DISTRESS-SYNDROME, Post-intensive care syndrome, ACUTE LUNG INJURY, law.invention, ICU survivors, POSTTRAUMATIC-STRESS-DISORDER, Quality of life (healthcare), PICS-F, QUALITY-OF-LIFE, law, Risk Factors, Pandemic, Global health, medicine, Humans, Pharmacology (medical), Intensive care medicine, Socioeconomic status, business.industry, SARS-CoV-2, General Neuroscience, COVID-19, UNIT SURVIVORS, Cognition, psychosomatic impairments, biochemical phenomena, metabolism, and nutrition, Intensive care unit, Etiology, FUNCTIONAL DISABILITY, Neurology (clinical), business, CRITICALLY-ILL PATIENTS
Abstract: INTRODUCTION: Post-intensive care syndrome (PICS) has only recently been recognized as a new clinical entity in patients surviving their intensive care unit (ICU) stay due to critical illness. With increasing survival rates of ICU patients worldwide, there is a rising interest regarding post-ICU recovery. AREAS COVERED: First, based on the current literature a definition is provided of PICS, including the domains of impairments that comprise PICS along with the etiology and risk factors. Second, preventive measures and possible treatment strategies integrated in the follow-up care are described. Third, the authors will discuss the current SARS-Cov-2 pandemic and the increased risk of PICS in these post-ICU patients and their families. EXPERT OPINION: PICS is a relatively new entity, which not only encompasses various physical, cognitive, and psychological impairments but also impacts global health due to long-lasting detrimental socioeconomic burdens. Importantly, PICS also relates to caregivers of post-ICU patients. Strategies to reduce this burden will not only be needed within the ICU setting but will also have to take place in an interdisciplinary, multifaceted approach in primary care settings. Additionally, the SARS-Cov-2 pandemic has a high burden on post-ICU patients and their relatives.
Published: 2021

7. Flip-Chip Integration of InP and SiN

Author: Ronald Dekker, Rene Heideman, Frederik Schreuder, Kerstin Worhoff, Ruud M. Oldenbeuving, A. Sigmund, Richard Mateman, Karl-Otto Velthaus, F. M. Postma, Dimitri Geskus, Lennart Wevers, Martin Moehrle, Michael Theurer, Martin Schell, and Publica
Subjects: Coupling, Materials science, business.industry, Interface (computing), Physics::Optics, Optical power, 02 engineering and technology, Chip, Laser, Waveguide (optics), Atomic and Molecular Physics, and Optics, Electronic, Optical and Magnetic Materials, law.invention, 020210 optoelectronics & photonics, law, Hardware_INTEGRATEDCIRCUITS, 0202 electrical engineering, electronic engineering, information engineering, Optoelectronics, Electrical and Electronic Engineering, Photonics, business, Flip chip
Abstract: We present an interface for hybrid flip-chip integration of InP-based laser sources to silicon-nitride-based photonic platforms. The design enables efficient high optical power coupling over a wide temperature range. The optical modes of laser and SiN chip are expanded using integrated tapers allowing for high alignment tolerance. The chips comprise physical alignment stops for vertical alignment. In the horizontal direction, the integration interface is optimized for active and/or visual alignment with high precision using precise visual alignment marks. The hybrid integrated chip shows a waveguide coupled optical power of more than 40 mW and can operate at elevated temperatures up to 85 °C.
Published: 2019

8. Narrow-linewidth hybrid-integrated semiconductor lasers by exploiting feedback from Si3N4 circuits

Author: Jesse Mak, Edwin J. Klein, Ronald Dekker, Ruud M. Oldenbeuving, Marcel Hoekman, Cornelis A. A. Franken, Albert van Rees, Youwen Fan, Chris G. H. Roeloffzen, Klaus-Jochen Boller, Rob E. M. Lammerink, Peter J.M. van der Slot, Carsten Fallnich, Douwe Geuzebroek, Dimitri Geskus, Jörn P. Epping, Laser Physics & Nonlinear Optics, and MESA+ Institute
Subjects: Optical amplifier, Materials science, business.industry, Physics::Optics, Laser, law.invention, Semiconductor laser theory, Laser linewidth, Resonator, Semiconductor, law, Filter (video), Optoelectronics, business, Electronic circuit
Abstract: Hybrid integration of semiconductor optical amplifiers with frequency-selective feedback circuits, implemented using low-loss Si3N4 waveguides, enables robust chip-sized lasers with outstanding properties. Deploying ring resonators as a tunable feedback filter provides single-mode operation over a wide wavelength range. Moreover, these rings resonantly enhance the cavity length, which results in ultra-narrow intrinsic linewidth, as low as 40 Hz. Here, we present an overview on state-of-the-art developments regarding these lasers. We compare linewidth and tuning results for different feedback circuit configurations. Finally, we report on the first demonstration of a hybrid-integrated semiconductor laser that operates in the visible wavelength range.
Published: 2021

9. Lossless silicon photonic ROADM based on a Si3N4 platform and a monolithically integrated Erbium Doped Amplifier

Author: Ruud M. Oldenbeuving, Apostolos Tsakyridis, P. W. L. van Dijk, C. Vagionas, Ioannis Roumpos, SM Garcia Blanco, N. Pleros, Theoni Alexoudi, Themistoklis Chrysostomidis, Meindert Dijkstra, Konstantinos Fotiadis, Chris G. H. Roeloffzen, A. Manolis, Konstantinos Vyrsokinos, Jinfeng Mu, Optical Sciences, and MESA+ Institute
Subjects: Amplified spontaneous emission, Silicon photonics, Materials science, Silicon, business.industry, Amplifier, Doping, (060.2360), 22/2 OA procedure, chemistry.chemical_element, Data_CODINGANDINFORMATIONTHEORY, wavelength routing, Erbium, chemistry, Wavelength-division multiplexing, Hardware_INTEGRATEDCIRCUITS, Optoelectronics, Stimulated emission, business, (060.4265) Networks, (130.4815) Optical Switching devices
Abstract: The first demonstration of a lossless four-port silicon photonic ROADM-node based on a monolithic-integrated spiral Al2O3:Er3+ Erbium Doped Waveguide Amplifier and MZI-interleaver layout on a Si3N4 platform is presented, routing a 4×50Gb/s WDM data-traffic capacity.
Published: 2021

10. Biomarkers for Traumatic Brain Injury: Data Standards and Statistical Considerations

Author: J. Russell Huie, Stefania Mondello, Christopher J. Lindsell, Luca Antiga, Esther L. Yuh, Elisa R. Zanier, Serge Masson, Bedda L. Rosario, Adam R. Ferguson, Opeolu Adeoye, Neeraj Badjatia, Kim Boase, Yelena Bodien, M. Ross Bullock, Randall Chesnut, John D. Corrigan, Karen Crawford, Ramon Diaz-Arrastia, Sureyya Dikmen, Ann-Christine Duhaime, Richard Ellenbogen, V. Ramana Feeser, Brandon Foreman, Raquel Gardner, Etienne Gaudette, Joseph Giacino, Dana Goldman, Luis Gonzalez, Shankar Gopinath, Rao Gullapalli, J. Claude Hemphill, Gillian Hotz, Sonia Jain, Frederick Korley, Joel Kramer, Natalie Kreitzer, Harvey Levin, Joan Machamer, Christopher Madden, Geoffrey T. Manley, Alastair Martin, Thomas McAllister, Michael McCrea, Randall Merchant, Pratik Mukherjee, Lindsay Nelson, Laura B. Ngwenya, Florence Noel, David Okonkwo, Daniel Perl, Ava Puccio, Miri Rabinowitz, Claudia Robertson, Jonathan Rosand, Angelle Sander, David Schnyer, Seth Seabury, Murray Stein, Sabrina Taylor, Nancy Temkin, Arthur Toga, Alex Valadka, Mary Vassar, Paul Vespa, Kevin Wang, John K. Yue, Ross Zafonte, Cecilia Ackerlund, Hadie Adams, Vanni Agnoletti, Judith Allanson, Krisztina Amrein, Norberto Andaluz, Nada Andelic, Lasse Andreassen, Audny Anke, Azasevac Antun, Anna Antoni, Hilko Ardon, Kaspars Auslands, Philippe Azouvi, Maria Luisa Azzolini, Camelia Baciu, Rafael Badenes, Ronald Bartels, Pál Barzó, Ursula Bauerfeind, Romuald Beauvais, Ronny Beer, Francisco Javier Belda, Bo Michael Bellander, Antonio Belli, Rémy Bellier, Habib Benali, Thierry Benard, Maurizio Berardino, Luigi Beretta, Christopher Beynon, Federico Bilotta, Harald Binder, Erta Biqiri, Morten Blaabjerg, Hugo den Boogert, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Lozano Guillermo Carbayo, Marco Carbonara, Elsa Carise, K. Carpenter, Ana M. Castaño León, Francesco Causin, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Maryse Cnossen, Mark Coburn, Jonathan Coles, Lizzie Coles-Kemp, Johnny Collett, Jamie D. Cooper, Marta Correia, Amra Covic, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot Fizelier, François Damas, Pierre Damas, Helen Dawes, Véronique De Keyser, Francesco Della Corte, Bart Depreitere, Godard C.W. de Ruiter, Dula Dilvesi, Shenghao Ding, Diederik Dippel, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy Loup Dulière, Heiko Engemann, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Junfeng Feng, Kelly Foks, Francesca Fossi, Gilles Francony, Ulderico Freo, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Karin Geleijns, Pradeep George, Alexandre Ghuysen, Lelde Giga, Benoit Giraud, Ben Glocker, Jagos Golubovic, Pedro A. Gomez, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Asta Kristine Håberg, Bram Jacobs, Iain Haitsma, Jed A. Hartings, Raimund Helbok, Eirik Helseth, Daniel Hertle, Astrid Hoedemaekers, Stefan Hoefer, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Stefan Jankowski, Mike Jarrett, Bojan Jelaca, Ji yao Jiang, Kelly Jones, Konstantinos Kamnitsas, Mladen Karan, Ari Katila, Maija Kaukonen, Thomas Kerforne, Riku Kivisaari, Angelos G. Kolias, Bálint Kolumbán, Erwin Kompanje, Ksenija Kolundzija, Daniel Kondziella, Lars Owe Koskinen, Noémi Kovács, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Christian Ledig, Rolf Lefering, Valerie Legrand, Jin Lei, Leon Levi, Roger Lightfoot, Hester Lingsma, Dirk Loeckx, Angels Lozano, Andrew I.R. Maas, Stephen MacDonald, Marc Maegele, Majdan Marek, Sebastian Major, Alex Manara, Geoffrey Manley, Didier Martin, Leon Francisco Martin, Costanza Martino, Hugues Maréchal, Armando Maruenda, Alessandro Masala, Julia Mattern, Charles McFadyen, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Cristina Morganti Kossmann, Davide Mulazzi, Holger Mühlan, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, Quentin Noirhomme, József Nyirádi, Mauro Oddo, Annemarie Oldenbeuving, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Adriana Patruno, Jean François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Floury Sébastien Pili, Matti Pirinen, Horia Ples, Maria Antonia Poca, Suzanne Polinder, Inigo Pomposo, Jussi Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Ruben Real, Veronika Rehorčíková, Jonathan Rhodes, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Gerwin Roks, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Marco Sacchi, Barbara Sahakian, Juan Sahuquillo, Oliver Sakowitz, Francesca Sala, Renan Sanchez Porras, Janos Sandor, Edgar Santos, Luminita Sasu, Davide Savo, Nadine Schäffer, Inger Schipper, Barbara Schlößer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Michael Schöll, Charlie Sewalt, Özcan Sir, Toril Skandsen, Lidwien Smakman, Dirk Smeets, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Nicole Steinbüchel, Ana Stevanovic, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Fabio Silvio Taccone, Riikka Takala, Viktória Tamás, Päivi Tanskanen, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Ralph Telgmann, Guido Teodorani, Alice Theadom, Matt Thomas, Dick Tibboel, Christos Tolias, Jean Flory Luaba Tshibanda, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Gregory Van der Steen, Mathieu van der Jagt, JV de Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Julia Van Waesberghe, Audrey Vanhaudenhuyse, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Giacinta Vizzino, Carmen Vleggeert Lankamp, Victor Volovici, Daphne Voormolen, Peter Vulekovic, Zoltán Vámos, Derick Wade, Kevin K.W. Wang, Lei Wang, Lars Wessels, Eveline Wiegers, Eno Wildschut, Guy Williams, Lindsay Wilson, Maren K.L. Winkler, Stefan Wolf, Peter Ylén, Alexander Younsi, Menashe Zaaroor, Frederik Zeiler, Yang Zhihui, Agate Ziverte, Fabrizio Zumbo, Huie, J Russell, Mondello, Stefania, Lindsell, Christopher J, Antiga, Luca, Yuh, Esther L, Zanier, Elisa R, Masson, Serge, Rosario, Bedda L, Ferguson, Adam R (Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Participants and Investigators), Beretta, Luigi, Huie, J, Mondello, S, Lindsell, C, Antiga, L, Yuh, E, Zanier, E, Masson, S, Rosario, B, Ferguson, A, Citerio, G, and Molecular Neuroscience and Ageing Research (MOLAR)
Subjects: Traumatic, 030506 rehabilitation, Data Interpretation, Data management, data sharing, TERMINAL HYDROLASE-L1, Big data, Poison control, 0302 clinical medicine, Brain Injuries, Traumatic, TBI, Medicine, Biomarker discovery, Common Data Elements, traumatic brain injury, Injuries and accidents, Statistical, Reference Standards, NET RECLASSIFICATION INDEX, Data Interpretation, Statistical, Biomarker (medicine), biomarker, 0305 other medical science, Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Investigators, CT, The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Investigators, medicine.medical_specialty, Physical Injury - Accidents and Adverse Effects, Clinical Sciences, Context (language use), Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Traumatic Brain Injury (TBI), Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Participants and Investigators, 03 medical and health sciences, MICROARRAY, Special Section: Statistical Methods in Tbi Research, Humans, biomarkers, Intensive care medicine, Traumatic Head and Spine Injury, Neurology & Neurosurgery, business.industry, Information Dissemination, OUTCOME PREDICTION, Neurosciences, COMMON DATA ELEMENTS, Precision medicine, Brain Disorders, DIFFUSE AXONAL INJURY, Data sharing, Good Health and Well Being, Brain Injuries, DISCOVERY, TRACK, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Contains fulltext : 238746.pdf (Publisher’s version ) (Closed access) Recent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quantities of high-throughput and high-content data. Management, curation, analysis, and evidence synthesis of these data are not trivial tasks. In this review, we discuss data management concepts and statistical and data sharing strategies when dealing with biomarker data in the context of TBI research. We propose that application of biomarkers involves three distinct steps-discovery, evaluation, and evidence synthesis. First, complex/big data has to be reduced to useful data elements at the stage of biomarker discovery. Second, inferential statistical approaches must be applied to these biomarker data elements for assessment of biomarker clinical utility and validity. Last, synthesis of relevant research is required to support practice guidelines and enable health decisions informed by the highest quality, up-to-date evidence available. We focus our discussion around recent experiences from the International Traumatic Brain Injury Research (InTBIR) initiative, with a specific focus on four major clinical projects (Transforming Research and Clinical Knowledge in TBI, Collaborative European NeuroTrauma Effectiveness Research in TBI, Collaborative Research on Acute Traumatic Brain Injury in Intensive Care Medicine in Europe, and Approaches and Decisions in Acute Pediatric TBI Trial), which are currently enrolling subjects in North America and Europe. We discuss common data elements, data collection efforts, data-sharing opportunities, and challenges, as well as examine the statistical techniques required to realize successful adoption and use of biomarkers in the clinic as a foundation for precision medicine in TBI.
Published: 2021

11. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research

Author: Maas, A, Menon, D, Adelson, P, Andelic, N, Bell, M, Belli, A, Bragge, P, Brazinova, A, Büki, A, Chesnut, R, CITERIO, GIUSEPPE, Coburn, M, Cooper, D, Crowder, A, Czeiter, E, Czosnyka, M, Diaz arrastia, R, Dreier, J, Duhaime, A, Ercole, A, Van Essen, T, Feigin, V, Gao, G, Giacino, J, Gonzalez lara, L, Gruen, R, Gupta, D, Hartings, J, Hill, S, Jiang, J, Ketharanathan, N, Kompanje, E, Lanyon, L, Laureys, S, Lecky, F, Levin, H, Lingsma, H, Maegele, M, Majdan, M, Manley, G, Marsteller, J, Mascia, L, Mcfadyen, C, Mondello, S, Newcombe, V, Palotie, A, Parizel, P, Peul, W, Piercy, J, Polinder, S, Puybasset, L, Rasmussen, T, Rossaint, R, Smielewski, P, Söderberg, J, Stanworth, S, Stein, M, Von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Synnot, A, Te Ao, B, Tenovuo, O, Theadom, A, Tibboel, D, Videtta, W, Wang, K, Williams, W, Wilson, L, Yaffe, K, Adams, H, Agnoletti, V, Allanson, J, Amrein, K, Andaluz, N, Anke, A, Antoni, A, Van As, A, Audibert, G, Azaševac, A, Azouvi, P, Azzolini, M, Baciu, C, Badenes, R, Barlow, K, Bartels, R, Bauerfeind, U, Beauchamp, M, Beer, D, Beer, R, Belda, F, Bellander, B, Bellier, R, Benali, H, Benard, T, Beqiri, V, Beretta, L, Bernard, F, Bertolini, G, Bilotta, F, Blaabjerg, M, Den Boogert, H, Boutis, K, Bouzat, P, Brooks, B, Brorsson, C, Bullinger, M, Burns, E, Calappi, E, Cameron, P, Carise, E, Castaño león, A, Causin, F, Chevallard, G, Chieregato, A, Christie, B, Cnossen, M, Coles, J, Collett, J, Della Corte, F, Craig, W, Csato, G, Csomos, A, Curry, N, Dahyot fizelier, C, Dawes, H, Dematteo, C, Depreitere, B, Dewey, D, Van Dijck, J, Đilvesi, Đ, Dippel, D, Dizdarevic, K, Donoghue, E, Duek, O, Dulière, G, Dzeko, A, Eapen, G, Emery, C, English, S, Esser, P, Ezer, E, Fabricius, M, Feng, J, Fergusson, D, Figaji, A, Fleming, J, Foks, K, Francony, G, Freedman, S, Freo, U, Frisvold, S, Gagnon, I, Galanaud, D, Gantner, D, Giraud, B, Glocker, B, Golubovic, J, Gómez López, P, Gordon, W, Gradisek, P, Gravel, J, Griesdale, D, Grossi, F, Haagsma, J, Håberg, A, Haitsma, I, Van Hecke, W, Helbok, R, Helseth, E, Van Heugten, C, Hoedemaekers, C, Höfer, S, Horton, L, Hui, J, Huijben, J, Hutchinson, P, Jacobs, B, Van Der Jagt, M, Jankowski, S, Janssens, K, Jelaca, B, Jones, K, Kamnitsas, K, Kaps, R, Karan, M, Katila, A, Kaukonen, K, De Keyser, V, Kivisaari, R, Kolias, A, Kolumbán, B, Kolundžija, K, Kondziella, D, Koskinen, L, Kovács, N, Kramer, A, Kutsogiannis, D, Kyprianou, T, Lagares, A, Lamontagne, F, Latini, R, Lauzier, F, Lazar, I, Ledig, C, Lefering, R, Legrand, V, Levi, L, Lightfoot, R, Lozano, A, Macdonald, S, Major, S, Manara, A, Manhes, P, Maréchal, H, Martino, C, Masala, A, Masson, S, Mattern, J, Mcfadyen, B, Mcmahon, C, Meade, M, Melegh, B, Menovsky, T, Moore, L, Morgado Correia, M, Morganti kossmann, M, Muehlan, H, Mukherjee, P, Murray, L, Van Der Naalt, J, Negru, A, Nelson, D, Nieboer, D, Noirhomme, Q, Nyirádi, J, Oddo, M, Okonkwo, D, Oldenbeuving, A, Ortolano, F, Osmond, M, Payen, J, Perlbarg, V, Persona, P, Pichon, N, Piippo karjalainen, A, Pili floury, S, Pirinen, M, Ple, H, Poca, M, Posti, J, Van Praag, D, Ptito, A, Radoi, A, Ragauskas, A, Raj, R, Real, R, Reed, N, Rhodes, J, Robertson, C, Rocka, S, Røe, C, Røise, O, Roks, G, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossi, S, Rueckert, D, De Ruiter, G, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Salvato, G, Sánchez porras, R, Sándor, J, Sangha, G, Schäfer, N, Schmidt, S, Schneider, K, Schnyer, D, Schöhl, H, Schoonman, G, Schou, R, Sir, Ö, Skandsen, T, Smeets, D, Sorinola, A, Stamatakis, E, Stevanovic, A, Stevens, R, Sundström, N, Taccone, F, Takala, R, Tanskanen, P, Taylor, M, Telgmann, R, Temkin, N, Teodorani, G, Thomas, M, Tolias, C, Trapani, T, Turgeon, A, Vajkoczy, P, Valadka, A, Valeinis, E, Vallance, S, Vámos, Z, VARGIOLU, ALESSIA, Vega, E, Verheyden, J, Vik, A, Vilcinis, R, Vleggeert lankamp, C, Vogt, L, Volovici, V, Voormolen, D, Vulekovic, P, Vande Vyvere, T, Van Waesberghe, J, Wessels, L, Wildschut, E, Williams, G, Winkler, M, Wolf, S, Wood, G, Xirouchaki, N, Younsi, A, Zaaroor, M, Zelinkova, V, Zemek, R, Zumbo, F, Citerio, G, Vargiolu, A, Zumbo, F., Maas, Andrew I R, Menon, David K, Adelson, P David, Andelic, Nada, Bell, Michael J, Belli, Antonio, Bragge, Peter, Brazinova, Alexandra, Büki, Andrá, Chesnut, Randall M, Citerio, Giuseppe, Coburn, Mark, Cooper, D Jamie, Crowder, A Tamara, Czeiter, Endre, Czosnyka, Marek, Diaz-Arrastia, Ramon, Dreier, Jens P, Duhaime, Ann-Christine, Ercole, Ari, van Essen, Thomas A, Feigin, Valery L, Gao, Guoyi, Giacino, Joseph, Gonzalez-Lara, Laura E, Gruen, Russell L, Gupta, Deepak, Hartings, Jed A, Hill, Sean, Jiang, Ji-yao, Ketharanathan, Naomi, Kompanje, Erwin J O, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Levin, Harvey, Lingsma, Hester F, Maegele, Marc, Majdan, Marek, Manley, Geoffrey, Marsteller, Jill, Mascia, Luciana, Mcfadyen, Charle, Mondello, Stefania, Newcombe, Virginia, Palotie, Aarno, Parizel, Paul M, Peul, Wilco, Piercy, Jame, Polinder, Suzanne, Puybasset, Loui, Rasmussen, Todd E, Rossaint, Rolf, Smielewski, Peter, Söderberg, Jeannette, Stanworth, Simon J, Stein, Murray B, von Steinbüchel, Nicole, Stewart, William, Steyerberg, Ewout W, Stocchetti, Nino, Synnot, Anneliese, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Tibboel, Dick, Videtta, Walter, Wang, Kevin K W, Williams, W Huw, Wilson, Lindsay, Yaffe, Kristine, InTBIR Participants, Investigator, Beretta, Luigi, InTBIR Participants Investigators, Menon, David [0000-0002-3228-9692], Czosnyka, Marek [0000-0003-2446-8006], Ercole, Ari [0000-0001-8350-8093], Newcombe, Virginia [0000-0001-6044-9035], Smielewski, Peter [0000-0001-5096-3938], Apollo - University of Cambridge Repository, Maas A.I.R., Menon D.K., David Adelson P.D., Andelic N., Bell M.J., Belli A., Bragge P., Brazinova A., Buki A., Chesnut R.M., Citerio G., Coburn M., Jamie Cooper D., Tamara Crowder A., Czeiter E., Czosnyka M., Diaz-Arrastia R., Dreier J.P., Duhaime A.-C., Ercole A., van Essen T.A., Feigin V.L., Gao G., Giacino J., Gonzalez-Lara L.E., Gruen R.L., Gupta D., Hartings J.A., Hill S., Jiang J.-Y., Ketharanathan N., Kompanje E.J.O., Lanyon L., Laureys S., Lecky F., Levin H., Lingsma H.F., Maegele M., Majdan M., Manley G., Marsteller J., Mascia L., McFadyen C., Mondello S., Newcombe V., Palotie A., Parizel P.M., Peul W., Piercy J., Polinder S., Puybasset L., Rasmussen T.E., Rossaint R., Smielewski P., Soderberg J., Stanworth S.J., Stein M.B., von Steinbuchel N., Stewart W., Steyerberg E.W., Stocchetti N., Synnot A., Te Ao B., Tenovuo O., Theadom A., Tibboel D., Videtta W., Wang K.K.W., Huw Williams W., Wilson L., Yaffe K., Adams H., Allanson J., Coles J., Hutchinson P.J., Kolias A.G., Sahakian B.J., Stamatakis E., Williams G., Agnoletti V., Martino C., Masala A., Teodorani G., Zumbo F., Amrein K., Ezer E., Kolumban B., Kovacs N., Melegh B., Nyiradi J., Sorinola A., Vamos Z., Andaluz N., Anke A., Frisvold S.K., Antoni A., van As A.B., Figaji A., Audibert G., Azasevac A., Dilvesi D., Golubovic J., Jelaca B., Karan M., Kolundzija K., Negru A., Vulekovic P., Azouvi P., Azzolini M.L., Beretta L., Baciu C., Beqiri V., Chevallard G., Chieregato A., Sacchi M., Badenes R., Belda F.J., Bilotta F., Lozano A., Barlow K.M., Schneider K.J., Bartels R., den Boogert H., Hoedemaekers C., Sir O., Bauerfeind U., Lefering R., Schafer N., Beauchamp M., Gravel J., Beer D., Beer R., Helbok R., Hofer S., Bellander B.-M., Nelson D., Bellier R., Benard T., Carise E., Dahyot-Fizelier C., Giraud B., Benali H., Bernard F., Bertolini G., Masson S., Blaabjerg M., Rosenlund C., Schou R.F., Boutis K., Bouzat P., Francony G., Manhes P., Payen J.-F., Brooks B., Dewey D., Emery C.A., Freedman S., Kramer A., Brorsson C., Koskinen L.-O., Sundstrom N., Bullinger M., Burns E., Calappi E., Ortolano F., Cameron P., Castano-Leon A.M., Gomez Lopez P.A., Lagares A., Causin F., Freo U., Persona P., Rossi S., Christie B., Cnossen M., Dippel D., Foks K., Haagsma J.A., Haitsma I., Huijben J.A., van der Jagt M., Nieboer D., Volovici V., Voormolen D.C., Collett J., Dawes H., Esser P., van Heugten C., Della Corte F., Grossi F., Craig W., Csato G., Csomos A., Curry N., Dematteo C., Meade M., Depreitere B., van Dijck J., de Ruiter G.C.W., Vleggeert-Lankamp C., Dizdarevic K., Donoghue E., Gantner D., Murray L., Trapani T., Vallance S., Duek O., Lazar I., Duliere G.-L., Marechal H., Dzeko A., Eapen G., Jankowski S., English S., Fergusson D., Osmond M., Fabricius M., Kondziella D., Feng J., Hui J., Fleming J., Latini R., Gagnon I., Ptito A., Galanaud D., Glocker B., Kamnitsas K., Ledig C., Rueckert D., Gordon W.A., Gradisek P., Griesdale D., Haberg A.K., van Hecke W., Smeets D., Verheyden J., Vyvere T.V., Helseth E., Roe C., Roise O., Horton L., Jacobs B., van der Naalt J., Janssens K., De Keyser V., Menovsky T., Van Praag D., Jones K.M., Kaps R., Katila A., Posti J., Takala R., Kaukonen K.-M., Kivisaari R., Piippo-Karjalainen A., Raj R., Tanskanen P., Kutsogiannis D., Kyprianou T., Lamontagne F., Lauzier F., Moore L., Turgeon A., Legrand V., Levi L., Zaaroor M., Lightfoot R., Macdonald S., Major S., Vajkoczy P., Wessels L., Winkler M.K.L., Wolf S., Manara A., Thomas M., Mattern J., Sakowitz O., Vogt L., Younsi A., McFadyen B., McMahon C., Correia M.M., Morganti-Kossmann M.C., Rosenfeld J.V., Muehlan H., Schmidt S., Mukherjee P., Noirhomme Q., Oddo M., Okonkwo D.O., Oldenbeuving A.W., Roks G., Schoonman G.G., Perlbarg V., Pichon N., Pili-Floury S., Pirinen M., Ples H., Poca M.A., Radoi A., Sahuquillo J., Ragauskas A., Rocka S., Real R.G.L., Telgmann R., Reed N., Rhodes J., Robertson C., Rosand J., Rosenthal G., Salvato G., Sanchez-Porras R., Sandor J., Sangha G., Schnyer D., Schohl H., Skandsen T., Stevanovic A., van Waesberghe J.V., Stevens R.D., Taccone F.S., Taylor M.S., Zelinkova V., Temkin N., Tolias C.M., Valadka A.B., Valeinis E., Vargiolu A., Vega E., Vik A., Vilcinis R., Wildschut E., Wood G., Xirouchaki N., Zemek R., Maas, A, Menon, D, Adelson, P, Andelic, N, Bell, M, Belli, A, Bragge, P, Brazinova, A, Büki, A, Chesnut, R, Citerio, G, Coburn, M, Cooper, D, Crowder, A, Czeiter, E, Czosnyka, M, Diaz arrastia, R, Dreier, J, Duhaime, A, Ercole, A, Van Essen, T, Feigin, V, Gao, G, Giacino, J, Gonzalez lara, L, Gruen, R, Gupta, D, Hartings, J, Hill, S, Jiang, J, Ketharanathan, N, Kompanje, E, Lanyon, L, Laureys, S, Lecky, F, Levin, H, Lingsma, H, Maegele, M, Majdan, M, Manley, G, Marsteller, J, Mascia, L, Mcfadyen, C, Mondello, S, Newcombe, V, Palotie, A, Parizel, P, Peul, W, Piercy, J, Polinder, S, Puybasset, L, Rasmussen, T, Rossaint, R, Smielewski, P, Söderberg, J, Stanworth, S, Stein, M, Von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Synnot, A, Te Ao, B, Tenovuo, O, Theadom, A, Tibboel, D, Videtta, W, Wang, K, Williams, W, Wilson, L, Yaffe, K, Adams, H, Agnoletti, V, Allanson, J, Amrein, K, Andaluz, N, Anke, A, Antoni, A, Van As, A, Audibert, G, Azaševac, A, Azouvi, P, Azzolini, M, Baciu, C, Badenes, R, Barlow, K, Bartels, R, Bauerfeind, U, Beauchamp, M, Beer, D, Beer, R, Belda, F, Bellander, B, Bellier, R, Benali, H, Benard, T, Beqiri, V, Beretta, L, Bernard, F, Bertolini, G, Bilotta, F, Blaabjerg, M, Den Boogert, H, Boutis, K, Bouzat, P, Brooks, B, Brorsson, C, Bullinger, M, Burns, E, Calappi, E, Cameron, P, Carise, E, Castaño león, A, Causin, F, Chevallard, G, Chieregato, A, Christie, B, Cnossen, M, Coles, J, Collett, J, Della Corte, F, Craig, W, Csato, G, Csomos, A, Curry, N, Dahyot fizelier, C, Dawes, H, Dematteo, C, Depreitere, B, Dewey, D, Van Dijck, J, Đilvesi, Đ, Dippel, D, Dizdarevic, K, Donoghue, E, Duek, O, Dulière, G, Dzeko, A, Eapen, G, Emery, C, English, S, Esser, P, Ezer, E, Fabricius, M, Feng, J, Fergusson, D, Figaji, A, Fleming, J, Foks, K, Francony, G, Freedman, S, Freo, U, Frisvold, S, Gagnon, I, Galanaud, D, Gantner, D, Giraud, B, Glocker, B, Golubovic, J, Gómez López, P, Gordon, W, Gradisek, P, Gravel, J, Griesdale, D, Grossi, F, Haagsma, J, Håberg, A, Haitsma, I, Van Hecke, W, Helbok, R, Helseth, E, Van Heugten, C, Hoedemaekers, C, Höfer, S, Horton, L, Hui, J, Huijben, J, Hutchinson, P, Jacobs, B, Van Der Jagt, M, Jankowski, S, Janssens, K, Jelaca, B, Jones, K, Kamnitsas, K, Kaps, R, Karan, M, Katila, A, Kaukonen, K, De Keyser, V, Kivisaari, R, Kolias, A, Kolumbán, B, Kolundžija, K, Kondziella, D, Koskinen, L, Kovács, N, Kramer, A, Kutsogiannis, D, Kyprianou, T, Lagares, A, Lamontagne, F, Latini, R, Lauzier, F, Lazar, I, Ledig, C, Lefering, R, Legrand, V, Levi, L, Lightfoot, R, Lozano, A, Macdonald, S, Major, S, Manara, A, Manhes, P, Maréchal, H, Martino, C, Masala, A, Masson, S, Mattern, J, Mcfadyen, B, Mcmahon, C, Meade, M, Melegh, B, Menovsky, T, Moore, L, Morgado Correia, M, Morganti kossmann, M, Muehlan, H, Mukherjee, P, Murray, L, Van Der Naalt, J, Negru, A, Nelson, D, Nieboer, D, Noirhomme, Q, Nyirádi, J, Oddo, M, Okonkwo, D, Oldenbeuving, A, Ortolano, F, Osmond, M, Payen, J, Perlbarg, V, Persona, P, Pichon, N, Piippo karjalainen, A, Pili floury, S, Pirinen, M, Ple, H, Poca, M, Posti, J, Van Praag, D, Ptito, A, Radoi, A, Ragauskas, A, Raj, R, Real, R, Reed, N, Rhodes, J, Robertson, C, Rocka, S, Røe, C, Røise, O, Roks, G, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossi, S, Rueckert, D, De Ruiter, G, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Salvato, G, Sánchez porras, R, Sándor, J, Sangha, G, Schäfer, N, Schmidt, S, Schneider, K, Schnyer, D, Schöhl, H, Schoonman, G, Schou, R, Sir, Ö, Skandsen, T, Smeets, D, Sorinola, A, Stamatakis, E, Stevanovic, A, Stevens, R, Sundström, N, Taccone, F, Takala, R, Tanskanen, P, Taylor, M, Telgmann, R, Temkin, N, Teodorani, G, Thomas, M, Tolias, C, Trapani, T, Turgeon, A, Vajkoczy, P, Valadka, A, Valeinis, E, Vallance, S, Vámos, Z, Vargiolu, A, Vega, E, Verheyden, J, Vik, A, Vilcinis, R, Vleggeert lankamp, C, Vogt, L, Volovici, V, Voormolen, D, Vulekovic, P, Vande Vyvere, T, Van Waesberghe, J, Wessels, L, Wildschut, E, Williams, G, Winkler, M, Wolf, S, Wood, G, Xirouchaki, N, Younsi, A, Zaaroor, M, Zelinkova, V, Zemek, R, Zumbo, F, Pediatric Surgery, Intensive Care, and Public Health
Subjects: medicine.medical_specialty, EVIDENCE-BASED MEDICINE, Treatment outcome, Poison control, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], EMERGENCY-DEPARTMENT VISITS, Review, PLACEBO-CONTROLLED TRIAL, Middle income country, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, 0302 clinical medicine, Intensive care, Brain Injuries, Traumatic, Journal Article, medicine, traumatic barin injury, Humans, 030212 general & internal medicine, Clinical care, Neurologic disease, Psychiatry, DIAGNOSTIC MANAGEMENT STRATEGIES, business.industry, RANDOMIZED CONTROLLED-TRIAL, ACUTE SUBDURAL-HEMATOMA, SEVERE HEAD-INJURY, ROAD TRAFFIC INJURIES, brain injury, Hospital care, 3. Good health, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Brain Injuries, Health care cost, PATIENT-REPORTED OUTCOMES, Human medicine, Neurology (clinical), business, Humanities, 030217 neurology & neurosurgery, GLASGOW COMA SCALE
Abstract: Executive summary A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world’s population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs). It has been estimated that TBI costs the global economy approximately $US400 billion annually. Deficiencies in prevention, care, and research urgently need to be addressed to reduce the huge burden and societal costs of TBI. This Commission highlights priorities and provides expert recommendations for all stakeholders— policy makers, funders, health-care professionals, researchers, and patient representatives—on clinical and research strategies to reduce this growing public health problem and improve the lives of people with TBI. The epidemiology of TBI is changing: in high-income countries, the number of elderly people with TBI is increasing, mainly due to falls, while in LMICs, the burden of TBI from road traffic incidents is increasing. Data on the frequency of TBI and TBI-related deaths and on the economic impact of brain trauma are often incomplete and vary between countries. Improved, accurate epidemiological monitoring and robust healtheconomic data collection are needed to inform healthcare policy and prevention programmes. Highly developed and coordinated systems of care are crucial for management of patients with TBI. However, in practice, implementation of such frameworks varies greatly and disconnects exist in the chain of care. Optimisation of systems of care should be high on the policy agenda and could yield substantial gains in terms of both patient outcomes and costs to society. TBI is a complex condition, and strong evidence to support treatment guidelines and recommendations is scarce. Most multicentre clinical trials of medical and surgical interventions have failed to show efficacy, despite promising preclinical results. At the bedside, treatment strategies are generally based on guidelines that promote a one-size-fits-all approach and are insufficiently targeted to the needs of individual patients. Attempts to individualise treatment are challenging owing to the diversity of TBI, and are hampered by the use of simplistic methods to characterise its initial type and severity. Advances in genomics, blood biomarkers, magnetic resonance imaging (MRI), and pathophysiological monitoring, combined with informatics to integrate data from multiple sources, offer new research avenues to improve disease characterisation and monitoring of disease evolution. These tools can also aid understanding of disease mechanisms and facilitate targeted treatment strategies for individual patients. Individualised management in the postacute phase and evaluation of the effectiveness of treatment and care processes depend on accurate quantification of outcomes. In practice, however, the use of simplistic methods hinders efforts to quantify outcomes after TBI of all severities. Development and validation of multidimensional approaches will be essential to improve measurement of clinical outcomes, for both research and patient care. In particular, we need to find better ways to characterise the currently under-recognised risk of long-term disabling sequelae in patients with relatively mild injuries. Prognostic models are important to help clinicians to provide reliable information to patients and relatives, and to facilitate comparative audit of care between centres and countries. There is an urgent need for further development, validation, and implementation of prognostic models in TBI, particularly for less severe TBI. This multitude of challenges in TBI—encompassing systems of care, clinical management, and research strategy—demands novel approaches to the generation of new evidence and its implementation in clinical practice. Comparative effectiveness research (CER) offers opportunities to capitalise on the diversity of TBI and systems of care and enables assessment of therapies in real-world conditions; high-quality CER studies can provide strong evidence to support guideline recommendations. The global challenges posed by TBI necessitate global collaborations and a change in research culture to endorse broad data sharing. This Commission covers a range of topics that need to be addressed to confront the global burden of TBI and reduce its effects on individuals and society: epidemiology (section 1); health economics (section 2); prevention (section 3); systems of care (section 4); clinical management (section 5); characterisation of TBI (section 6); outcome assessment (section 7); prognosis (section 8); and new directions for acquiring and implementing evidence (section 9). Table 1 summarises key messages from the Commission and provides recommendations to advance clinical care and research in TBI. We must increase awareness of the scale of the challenge posed by TBI. If we are to tackle the individual and societal burden of TBI, these efforts need to go beyond a clinical and research audience and address the public, politicians, and other stakeholders. We need to develop and implement policies for better prevention and systems of care in order to improve outcomes for individuals with TBI. We also need a commitment to substantial long-term investment in TBI research across a range of disciplines to determine best practice and facilitate individualised management strategies. A combination of innovative research methods and global collaboration, and ways to effectively translate progress in basic and clinical research into clinical practice and public health policy, will be vital for progress in the field.
Published: 2017

12. Accuracy in prediction of long-term functional outcome in patients with traumatic axonal injury: a comparison of MRI scales

Author: Guus G. Schoonman, Marleen Maria van Eijck, Annemarie W. Oldenbeuving, Martin Willy Herklots, Gerwin Roks, J. P. Peluso, Joukje van der Naalt, Jolanda De Vries, Molecular Neuroscience and Ageing Research (MOLAR), Medical and Clinical Psychology, and Language, Communication and Cognition
Subjects: 030506 rehabilitation, medicine.medical_specialty, Traumatic brain injury, Neuroscience (miscellaneous), Diffuse Axonal Injury, Outcome (game theory), outcome prediction, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Brain Injuries, Traumatic, Developmental and Educational Psychology, medicine, Humans, In patient, Traumatic axonal Injury, Retrospective Studies, business.industry, traumatic brain Injury, Diffuse axonal injury, medicine.disease, Magnetic Resonance Imaging, humanities, Axons, Term (time), Neurology (clinical), 0305 other medical science, Outcome prediction, business, human activities, 030217 neurology & neurosurgery, MRI
Abstract: Purpose: Functional outcome prediction for patients with traumatic axonal injury (TAI) is not highly related to the MRI classifications. The aim of this study was to assess the accuracy in predicting functional outcome in patients with TAI with several MRI scoring methods and to define the most accurate method.Methods: Patients with TAI (2008–2014) confirmed on MRI Results: A total of 124 patients with TAI were included, medium follow-up 52 months. The AUC for the Gentry classification was 0.64. All tested methods were poor predictors for functional outcome, except for the 6-location score (area under the curve: 0.71). No method was significantly better than the Gentry classification.Conclusion: The Gentry classification for TAI correlates with functional outcome, but is a poor predictor for the long-term functional outcome. None of the other tested methods was significantly better.
Published: 2020

13. Hybrid integrated silicon nitride lasers

Author: Epping, Jörn P., Leinse, Arne, Oldenbeuving, Ruud M., Visscher, Ilka, Geuzebroek, Douwe, Geskus, Dimitri, Rees, Albert van, Boller, Klaus J., Theurer, Michael, Möhrle, Martin, Schell, Martin, Roeloffzen, Chris G. H., Heideman, René G., Witzigmann, Bernd, Osiński, Marek, Arakawa, Yasuhiko, and Laser Physics & Nonlinear Optics
Subjects: Materials science, Hybrid integration, 02 engineering and technology, 01 natural sciences, law.invention, TriPleX™, 010309 optics, chemistry.chemical_compound, Resonator, Laser linewidth, law, Ultra-narrow linewidth tunable hybrid integrated lasers indium phosphide InP TriPleX™ ultra-low loss long cavity with a wavelength-selective tunable filter C-band, Vernier filters, 0103 physical sciences, Indium Phosphide, business.industry, Vernier scale, Photonic integrated circuit, 021001 nanoscience & nanotechnology, Laser, external cavity laser, Photonic Integrated Circuits, chemistry, Silicon nitride, Filter (video), Indium phosphide, Optoelectronics, 0210 nano-technology, business
Abstract: Ultra-narrow linewidth tunable hybrid integrated lasers are built from a combination of indium phosphide (InP) and silicon nitride-based TriPleX™. By combining the active functionality of InP with the ultra-low loss properties of the TriPleX™ platform narrow linewidth lasers in the C-band are realized. The InP platform is used for light generation and the TriPleX™ platform is used to define a long cavity with a wavelength-selective tunable filter. The TriPleX™ platform has the ability to adapt mode profiles over the chip and is extremely suitable for mode matching to the other platforms for hybrid integration. The tunable filter is based on a Vernier of micro-ring resonators to allow for single-mode operation, tunable by thermo-optic or stress-induced tuning. This work will show the operational principle and benefits of the hybrid lasers and the state of the art developments in the realization of these lasers. High optical powers ( >100 mW) are combined with narrow linewidth (< 1 kHz) spectral responses with tunability over a large (>100 nm) wavelength range and a low relative intensity (< -160 dB/Hz).Ultra-narrow linewidth tunable hybrid integrated lasers are built from a combination of indium phosphide (InP) and silicon nitride-based TriPleX™. By combining the active functionality of InP with the ultra-low loss properties of the TriPleX™ platform narrow linewidth lasers in the C-band are realized. The InP platform is used for light generation and the TriPleX™ platform is used to define a long cavity with a wavelength-selective tunable filter. The TriPleX™ platform has the ability to adapt mode profiles over the chip and is extremely suitable for mode matching to the other platforms for hybrid integration. The tunable filter is based on a Vernier of micro-ring resonators to allow for single-mode operation, tunable by thermo-optic or stress-induced tuning. This work will show the operational principle and benefits of the hybrid lasers and the state of the art developments in the realization of these lasers. High optical powers ( >100 mW) are combined with narrow linewidth (< 1 kHz) spectral responses with tunability over a large (>100 nm) wavelength range and a low relative intensity (< -160 dB/Hz).
Published: 2020

14. High power integrated laser for microwave photonics

Author: Ilka Visscher, Robert Grootjans, Rene Heideman, Jörn P. Epping, Chris G. H. Roeloffzen, Dimitri Geskus, and Ruud M. Oldenbeuving
Subjects: Materials science, High power lasers, business.industry, dBm, 02 engineering and technology, Laser, 7. Clean energy, 01 natural sciences, law.invention, Power (physics), 010309 optics, Laser linewidth, 020210 optoelectronics & photonics, law, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Optoelectronics, Tunable semiconductor lasers with a narrow linewidth have found a wide range of important applications, reaching from coherent communications High power integrated laser for microwave photonics active InP components such as gain sections, modulators, and detectors with passive silicon nitride-based TriPleX enabling low loss optical signal processing, business, Microwave photonics
Abstract: Tunable semiconductor lasers with a narrow linewidth have found a wide range of important applications, reaching from coherent communications, remote optical sensing such as Lidar to arising applications such as microwave photonics (MWP). Especially, integrated microwave photonics [1,2] aims to achieve RF-to-RF signal processing in the optical domain with a small footprint while offering wide bandwidths. Recently, we developed a hybrid integrated photonic platform [3] based on active InP components such as gain sections, modulators, and detectors with passive silicon nitride-based TriPleX enabling low loss optical signal processing due to its low propagation losses (< 0.1 dB/cm). The combination of these two platforms enables fully integrated RF-to-RF analog photonic links (APL). The link gain of an APL quadratically depends on the sensitivity of the modulator, responsivity of the photodetector (PD) as well as the optical power at the receiving PD [2]. Therefore, to achieve an efficient APL with a high link gain an optical input power of typically more than 20 dBm is needed. Furthermore, high optical powers can keep the noise figure at a minimum by making the use of additional amplifiers obsolete. However, so far current hybrid as well as heterogeneously integrated lasers lack sufficient optical power to achieve such efficient APLs. Here, we present, to the best of our knowledge, the first hybrid integrated laser consisting of more than one InP gain sections sharing a common laser mirror. The resulting on-chip power of 20.7 dBm using two gain sections at a pump current of twice 300 mA is the highest optical power of a hybrid integrated laser to date. Furthermore, the laser shows a low intrinsic linewidth of 320 Hz as well as a low relative intensity noise ( The scheme and a photograph of the dual-gain section hybrid integrated laser is shown in Fig.1 (a) and (b), respectively. The laser comprises of two InP reflective semiconductor optical amplifier (RSOA) chips and a low-loss TriPleX frequency selective mirror chip. The frequency selective mirror is based on a well-known principle of Vernier mirror with two micro-resonators of slightly different length and, hence, free-spectral ranges of 208 GHz and 215 GHz. To achieve a higher optical output power the mirror chip is coupled to two individual InP RSOAs with a length of 700 μm instead of one [4]. The coupling losses from the InP RSOAs to TriPleX laser cavity are estimated to be about 1 dB. Each of the RSOAs has an individual electrical connection to apply a pump current. On the TriPleX chip, thermo-optic tuners are used to set the frequency selective mirror, to control the phases of the RSOAs within the cavity, two tunable Mach-Zehnder couplers are used to combine both output coupling of the cavity and the power in the output waveguide. The output waveguides are coupled to a fiber array with standard polarization maintaining fibers with a coupling loss of 0.5 dB.
Published: 2020

15. Patients with Diffuse Axonal Injury Can Recover to a Favorable Long-Term Functional and Quality of Life Outcome

Author: Jolanda De Vries, Gerwin Roks, Guus G. Schoonman, Mariska A. C. de Jongh, Annemarie W. Oldenbeuving, Joukje van der Naalt, Marleen Maria van Eijck, J. P. Peluso, Medical and Clinical Psychology, and Molecular Neuroscience and Ageing Research (MOLAR)
Subjects: Male, PROGNOSIS, PREDICTION, IMPACT, Diffuse Axonal Injury, Outcome (game theory), Cohort Studies, 0302 clinical medicine, Quality of life, Risk Factors, Brain Injuries, Traumatic, TBI, 030212 general & internal medicine, HRQL, SCALE, QOLIBRI, Aged, 80 and over, Glasgow Outcome Scale, Diffuse axonal injury, Middle Aged, GOSE, Female, Cohort study, Adult, medicine.medical_specialty, Prognostic variable, Adolescent, Traumatic brain injury, TRAUMATIC BRAIN-INJURY, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Aged, LESIONS, business.industry, DAI, Recovery of Function, medicine.disease, CORPUS-CALLOSUM, Cross-Sectional Studies, Closed head injury, Quality of Life, MODERATE, Neurology (clinical), business, CLOSED-HEAD INJURY, 030217 neurology & neurosurgery, LONGITUDINAL MRI
Abstract: Functional outcome and quality of life are difficult to predict in patients with diffuse axonal injury (DAI) after traumatic brain injury (TBI). The primary aim of this cross-sectional cohort study was to assess the long-term functional outcome in patients with DAI and to identify prognostic factors. Second, health-related quality of life (HRQL) at long-term follow-up was assessed. Patients >= 16 years of age with TBI and DAI (admitted 2008-2014) were included. Clinical and imaging data were collected. The primary outcome parameter was the Glasgow Outcome Scale Extended (GOSE) at long-term follow-up. Second, the HRQL was assessed with the Quality Of Life after Brain Injury (QOLIBRI) questionnaire. DAI was diagnosed in 185 patients. Long-term functional outcome was obtained in 134 patients (72%), median follow-up was 54 months (range 14-100); and 51% had a favorable outcome (GOSE 6-8). Independent prognostic factors were age, pupillary reaction, Hb, DAI grading, and return of consciousness ≤7 days. Sixty-two percent had a good HRQL, after a median follow-up of 57 months (range 14–100) with age as an independent prognostic factor. More than half of patients with DAI had a favorable functional outcome and a good HRQL at long-term follow-up. Also in patients with a DAI grade 3, a favorable outcome was seen. HRQL is a clinically relevant outcome measure because it reflects perceived outcome by patients. Independent prognostic variables for functional outcome were factors obtained in the acute phase after injury, whereas age was an independent prognostic factor for HRQL.
Published: 2018

16. Low-Loss Si3N4 TriPleX Optical Waveguides: Technology and Applications Overview

Author: Meryem Benelajla, Klaus J. Boller, Ronald Dekker, Albert van Rees, Rene Heideman, Robert Grootjans, Chris G. H. Roeloffzen, Denys Marchenko, Youwen Fan, Paulus W. L. van Dijk, Marcel Hoekman, Ilka Visscher, Caterina Taballione, R. B. Timens, Lennart Wevers, Leimeng Zhuang, Dimitri Geskus, David Marpaung, Andrea Alippi, Yang Liu, Jörn P. Epping, Kerstin Worhoff, Ruud M. Oldenbeuving, Edwin J. Klein, Erik Schreuder, Caterina Taddei, Arne Leinse, Douwe Geuzebroek, and Laser Physics & Nonlinear Optics
Subjects: Optical fiber, Computer science, Optical communication, Physics::Optics, 02 engineering and technology, Integrated circuit, 01 natural sciences, Waveguide (optics), Optical filters, law.invention, 010309 optics, Resonator, 020210 optoelectronics & photonics, law, Beam steering, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Electrical and Electronic Engineering, Optical filter, Electronic circuit, Optical communications, business.industry, Photonic integrated circuit, Integrated optics, Atomic and Molecular Physics, and Optics, Optical waveguides, Optoelectronics, business, lasers
Abstract: An overview of the most recent developments and improvements to the low-loss TriPleX Si3N4 waveguide technology is presented in this paper. The TriPleX platform provides a suite of waveguide geometries (box, double stripe, symmetric single stripe, and asymmetric double stripe) that can be combined to design complex functional circuits, but more important are manufactured in a single monolithic process flow to create a compact photonic integrated circuit. All functionalities of the integrated circuit are constructed using standard basic building blocks, namely straight and bent waveguides, splitters/combiners and couplers, spot size converters, and phase tuning elements. The basic functionalities that have been realized are: ring resonators and Mach–Zehnder interferometer filters, tunable delay elements, and waveguide switches. Combination of these basic functionalities evolves into more complex functions such as higher order filters, beamforming networks, and fully programmable architectures. Introduction of the active InP chip platform in a combination with the TriPleX will introduce light generation, modulation, and detection to the low-loss platform. This hybrid integration strategy enables fabrication of tunable lasers, fully integrated filters, and optical beamforming networks.
Published: 2018

17. Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

Author: Van Veen E., Van Der Jagt M., Cnossen M. C., Maas A. I. R., De Beaufort I. D., Menon D. K., Citerio G., Stocchetti N., Rietdijk W. J. R., Van Dijck J. T. J. M., Kompanje E. J. O., Ackerlund C., Adams H., Agnoletti V., Allanson J., Amrein K., Andaluz N., Andelic N., Andreassen L., Antun A., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Azzolini M. L., Baciu C., Badenes R., Bartels R., Barzo P., Bauerfeind U., Beauvais R., Beer R., Francisco J. B., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Den Boogert H., Bouzat P., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Calappi E., Calvi M. R., Cameron P., Lozano G. C., Carbonara M., Carise E., Carpenter K., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Coburn M., Coles J., Coles-Kemp L., Collett J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., De Ruiter Godard C. W., Dilvesi D., Ding S., Dippel D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., Geleijns K., George P., Ghuysen A., Giga L., Giraud B., Glocker B., Golubovic J., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hoedemaekers A., Hoefer S., Horton L., Huijben J., Hutchinson P. J., Haberg A. K., Jacobs B., Jankowski S., Jarrett M., Jelaca B., Jiang J. -Y., Jones K., Kamnitsas K., Karan M., Katila A., Kaukonen M., Kerforne T., Kivisaari R., Kolias A. G., Kolumban B., Kolundzija K., Kondziella D., Koskinen L. -O., Kovacs N., Lagares A., Lanyon L., Laureys S., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., MacDonald S., Maegele M., Majdan M., Major S., Manara A., Manley G., Didier M., Martin L. F., Martino C., Maruenda A., Marechal H., Masala A., Mattern J., McFadyen C., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Muraleedharan V., Murray L., Muhlan H., Nair N., Negru A., Nelson D., Newcombe V., Nieboer D., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Floury S. P., Pirinen M., Ples H., Poca M. A., Polinder S., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Real R., Rehorcikova V., Rhodes J., Ripatti S., Rocka S., Roe C., Roise O., Roks G., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Porras R., Sandor J., Santos E., Sasu L., Savo D., Schaffer N., Schipper I., Schlosser B., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Steinbuchel N., Stevanovic A., Stevens R., Stewart W., Steyerberg E. W., Sundstrom N., Synnot A., Taccone F. S., Takala R., Tamas V., Tanskanen P., Taylor M. S., Te Ao B., Tenovuo O., Telgmann R., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Trapani T., Tudora C. M., Vajkoczy P., Vallance S., Valeinis E., Van Der Steen G., Van Der Naalt J., Van Essen T. A., Van Hecke W., Van Heugten C., Van Praag D., Vyvere T. V., Van Waesberghe J., Vanhaudenhuyse A., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Voormolen D., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wessels L., Wildschut E., Williams G., Wilson L., Winkler M. K. L., Wolf S., Ylen P., Younsi A., Zaaroor M., Zhihui Y., Ziverte A., Zumbo F., Intensive Care, Public Health, van Veen, Ernest, van der Jagt, Mathieu, Cnossen, Maryse C., Maas, Andrew I R, de Beaufort, Inez D., Menon, David K., Citerio, Giuseppe, Stocchetti, Nino, Rietdijk, Wim J R, van Dijck, Jeroen T J M, Kompanje, Erwin J O (CENTER-TBI investigators and participants), Beretta, Luigi, Apollo - University of Cambridge Repository, Ragauskas, Arminas, Rocka, Saulius, Vilcinis, Rimantas, „Springer' grupė, Neurokirurgian yksikkö, Clinicum, Van Veen E., Van Der Jagt M., Cnossen M.C., Maas A.I.R., De Beaufort I.D., Menon D.K., Citerio G., Stocchetti N., Rietdijk W.J.R., Van Dijck J.T.J.M., Kompanje E.J.O., Ackerlund C., Adams H., Agnoletti V., Allanson J., Amrein K., Andaluz N., Andelic N., Andreassen L., Antun A., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Azzolini M.L., Baciu C., Badenes R., Bartels R., Barzo P., Bauerfeind U., Beauvais R., Beer R., Francisco J.B., Bellander B.-M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Den Boogert H., Bouzat P., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Calappi E., Calvi M.R., Cameron P., Lozano G.C., Carbonara M., Carise E., Carpenter K., Castano-Leon A.M., Causin F., Chevallard G., Chieregato A., Coburn M., Coles J., Coles-Kemp L., Collett J., Cooper J.D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., De Ruiter Godard C.W., Dilvesi D., Ding S., Dippel D., Dixit A., Donoghue E., Dreier J., Duliere G.-L., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V.L., Feng J., Foks K., Fossi F., Francony G., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., Geleijns K., George P., Ghuysen A., Giga L., Giraud B., Glocker B., Golubovic J., Gomez P.A., Grossi F., Gruen R.L., Gupta D., Haagsma J.A., Haitsma I., Hartings J.A., Helbok R., Helseth E., Hertle D., Hoedemaekers A., Hoefer S., Horton L., Huijben J., Hutchinson P.J., Haberg A.K., Jacobs B., Jankowski S., Jarrett M., Jelaca B., Jiang J.-Y., Jones K., Kamnitsas K., Karan M., Katila A., Kaukonen M., Kerforne T., Kivisaari R., Kolias A.G., Kolumban B., Kolundzija K., Kondziella D., Koskinen L.-O., Kovacs N., Lagares A., Lanyon L., Laureys S., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., MacDonald S., Maegele M., Majdan M., Major S., Manara A., Manley G., Didier M., Martin L.F., Martino C., Maruenda A., Marechal H., Masala A., Mattern J., McFadyen C., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Muraleedharan V., Murray L., Muhlan H., Nair N., Negru A., Nelson D., Newcombe V., Nieboer D., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P.M., Patruno A., Payen J.-F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Floury S.P., Pirinen M., Ples H., Poca M.A., Polinder S., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Real R., Rehorcikova V., Rhodes J., Ripatti S., Rocka S., Roe C., Roise O., Roks G., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Porras R., Sandor J., Santos E., Sasu L., Savo D., Schaffer N., Schipper I., Schlosser B., Schmidt S., Schoechl H., Schoonman G., Schou R.F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Steinbuchel N., Stevanovic A., Stevens R., Stewart W., Steyerberg E.W., Sundstrom N., Synnot A., Taccone F.S., Takala R., Tamas V., Tanskanen P., Taylor M.S., Te Ao B., Tenovuo O., Telgmann R., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J.-F.L., Trapani T., Tudora C.M., Vajkoczy P., Vallance S., Valeinis E., Van Der Steen G., Van Der Naalt J., Van Essen T.A., Van Hecke W., Van Heugten C., Van Praag D., Vyvere T.V., Van Waesberghe J., Vanhaudenhuyse A., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P.M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Voormolen D., Vulekovic P., Vamos Z., Wade D., Wang K.K.W., Wang L., Wessels L., Wildschut E., Williams G., Wilson L., Winkler M.K.L., Wolf S., Ylen P., Younsi A., Zaaroor M., Zhihui Y., Ziverte A., Zumbo F., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Psychiatrie & Neuropsychologie, Menon, David [0000-0002-3228-9692], Ročka, Saulius, Molecular Neuroscience and Ageing Research (MOLAR), CENTER-TBI Investigators, van Veen, E, van der Jagt, M, Cnossen, M, Maas, A, de Beaufort, I, Menon, D, Citerio, G, Stocchetti, N, Rietdijk, W, van Dijck, J, and Kompanje, E
Subjects: Neurology, Internationality, Traumatic/complications, brain death, ethics, postmortem organ donation, traumatic brain injury, ventricular drainage, withdrawing life-sustaining measures, GUIDELINES, Critical Care and Intensive Care Medicine, 0302 clinical medicine, Traumatic brain injury, Trauma Centers, WORLDWIDE, Surveys and Questionnaires, Brain Injuries, Traumatic, Response rate (survey), Brain death, VDP::Medical disciplines: 700::Clinical medical disciplines: 750, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Tissue and Organ Procurement/legislation & jurisprudence, POLICIES, Europe, VARIABILITY, Neurosurgery, Clinical evaluation, medicine.medical_specialty, Tissue and Organ Procurement, Withdrawing life-sustaining measure, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, Neurological assessment, medicine, Humans, Organ donation, Ethics, Postmortem organ donation, Ventricular drainage, Withdrawing life-sustaining measures, Ethic, business.industry, Research, Brain Injuries, Traumatic/complications, 3112 Neurosciences, 030208 emergency & critical care medicine, ADULTS, lcsh:RC86-88.9, Traumatic brain injury, Brain death, Ethics, Postmortem organ donation, Withdrawing life-sustaining measures, Ventricular drainage, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Trauma Centers/organization & administration, Brain Injuries, Emergency medicine, Human medicine, business, 030217 neurology & neurosurgery, Regional differences
Abstract: Source at https://doi.org/10.1186/s13054-018-2241-4. Licensed CC BY-NC-ND 4.0. Background: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. Methods: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). Results: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time. Conclusions: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.
Published: 2018

18. Determination of the feasibility of a multicomponent intervention program to prevent delirium in the Intensive Care Unit: A modified RAND Delphi study

Author: Wassenaar, Annelies, van den Boogaard, Mark, Schoonhoven, Lisette, Pickkers, Peter, Beishuizen, Albertus, van den Bergh, Walter M., Hoogendoorn, Marga E., Königs, Marc, Kuiper, Michael A., Müller, Marcella C.A., Oldenbeuving, Annemarie W., Schuurmans, Marieke J., Simons, Koen S., Slooter, Arjen J.C., van der Steen, Marijke, Vreeswijk, Ralph, van der Woude, Meta, and Other Research
Subjects: Adult, Male, medicine.medical_specialty, Delphi Technique, Delphi method, Psychological intervention, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Emergency Nursing, Critical Care Nursing, law.invention, Likert scale, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Nonprobability sampling, 03 medical and health sciences, 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, law, Nursing Interventions Classification, Medicine, Humans, 030212 general & internal medicine, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Delirium, 030208 emergency & critical care medicine, medicine.disease, Intensive care unit, Cognitive training, Intensive Care Units, Physical therapy, Feasibility Studies, Female, Medical emergency, medicine.symptom, business
Abstract: Background Delirium is common in Intensive Care Unit (ICU) patients and associated with poor outcome. In non-ICU patients a multicomponent intervention program with non-pharmacological interventions has shown to reduce delirium. Currently, there is insufficient evidence regarding the effects of such a program in ICU patients. We developed a draft program based on a review. As most studies were conducted in non-ICU patients, the feasibility of the program in ICU patients needs to be assessed before investigating its effectiveness. Objectives To determine experts’ opinion and to achieve group consensus on the feasibility and completeness of the multicomponent intervention program for ICU patients. Methods A modified RAND/UCLA Appropriateness Method Delphi study was used. A total of 38 experts were selected following purposive sampling. Round one informed the experts about the draft program and asked for their opinion about its feasibility and completeness. In round two the experts were asked to reconsider their opinion based on changes made, and to rank the interventions in order of importance. The feasibility was scored using a 9-point Likert scale. A disagreement index (DI) and panel median were calculated to determine the level of agreement. Results During Delphi round one 100% of the questionnaires was completed, during round two 79%. After two rounds the experts agreed on the feasibility of the interventions targeting sleep deprivation (panel median 7.00, DI 0.26), immobility (panel median 8.00, DI 0.22), visual and hearing impairment (panel median 8.00, DI 0.19), and cognitive impairment (panel median 8.00, DI 0.23), except for cognitive training (panel median 5.00, DI 0.52). Conclusions During this study a feasible multicomponent intervention program to prevent ICU delirium was developed based on expert consensus. As no consensus was reached on cognitive training, a pilot study is planned to determine the feasibility of cognitive training in the ICU.
Published: 2017

19. Hybrid integrated semiconductor lasers with silicon nitride feedback circuits

Author: Carsten Fallnich, Ronald Dekker, Robert Grootjans, Ruud M. Oldenbeuving, Jesse Mak, Dimitri Geskus, Youwen Fan, David Marpaung, Edwin J. Klein, Peter J. M. van der Slot, Marcel Hoekman, Ilka Visscher, Rob E. M. Lammerink, Jörn P. Epping, Rene Heideman, Cornelis A. A. Franken, Albert van Rees, Chris G. H. Roeloffzen, Klaus J. Boller, and Arne Leinse
Subjects: Semiconductor laser, Materials science, Hybrid integration, FOS: Physical sciences, Applied Physics (physics.app-ph), 02 engineering and technology, InP semiconductor optical amplifier, 7. Clean energy, 01 natural sciences, Laser frequency comb, Semiconductor laser theory, law.invention, 010309 optics, chemistry.chemical_compound, Laser linewidth, 020210 optoelectronics & photonics, Dual-wavelength laser, law, 0103 physical sciences, Low-loss Si3N4 waveguides, 0202 electrical engineering, electronic engineering, information engineering, Radiology, Nuclear Medicine and imaging, Narrow intrinsic linewidth, Instrumentation, Integrated photonic circuits, Electronic circuit, Diode, business.industry, Physics - Applied Physics, Laser, Atomic and Molecular Physics, and Optics, Semiconductor, Silicon nitride, chemistry, Optoelectronics, Photonics, business, Optics (physics.optics), Physics - Optics
Abstract: Hybrid integrated semiconductor laser sources offering extremely narrow spectral linewidth as well as compatibility for embedding into integrated photonic circuits are of high importance for a wide range of applications. We present an overview on our recently developed hybrid-integrated diode lasers with feedback from low-loss silicon nitride (Si3N4 in SiO2) circuits, to provide sub-100-Hz-level intrinsic linewidths, up to 120 nm spectral coverage around 1.55 um wavelength, and an output power above 100 mW. We show dual-wavelength operation, dual-gain operation, laser frequency comb generation, and present work towards realizing a visible-light hybrid integrated diode laser., 25 pages, 16 figures
Published: 2019

20. Broadband Continuously Tuneable Delay Microwave Photonic Beamformer for Phased Array Antennas

Author: Ilka Visscher, Chris G. H. Roeloffzen, Paul van Dijk, Lennart Wevers, Andrea Alippi, Edwin J. Klein, Jörn P. Epping, Marcel Hoekman, Paul Kapteijn, Ruud M. Oldenbeuving, Dimitri Geskus, R. B. Timens, Rene Heideman, Caterina Taddei, Arne Leinse, Robert Grootjans, Ronald Dekker, and Rick Heuvink
Subjects: Beamforming, Materials science, business.industry, Phased array, Interface (computing), 020208 electrical & electronic engineering, Physics::Optics, 020206 networking & telecommunications, 02 engineering and technology, True time delay, chemistry.chemical_compound, Silicon nitride, chemistry, Broadband, 0202 electrical engineering, electronic engineering, information engineering, Indium phosphide, Optoelectronics, Photonics, business, Computer Science::Information Theory
Abstract: In this paper a microwave photonic broadband true time delay (TTD) continuously tuneable beamformer module for phased array antenna applications is presented. This microwave photonics beamformer is based on the hybrid integration of Indium Phosphide and Silicon Nitride chips. This paper features results from the latest transmit microwave photonic beamformer based on a completely integrated photonic assembly interface.
Published: 2019

21. A 5G C-RAN Architecture for Hot-Spots: OFDM based Analog IFoF PHY and MAC Layer Design

Author: P. W. L. van Dijk, Nikos Pleros, Pavlos Maniotis, Amalia Miliou, Ruud M. Oldenbeuving, C. Vagionas, George Kalfas, Agapi Mesodiakaki, Charoula Mitsolidou, and Chris G. H. Roeloffzen
Subjects: Radio access network, Orthogonal frequency-division multiplexing, business.industry, Network packet, Computer science, Physical layer, 020206 networking & telecommunications, 02 engineering and technology, Remote radio head, 020210 optoelectronics & photonics, PHY, Wavelength-division multiplexing, 0202 electrical engineering, electronic engineering, information engineering, business, Computer hardware, C-RAN
Abstract: Centralized Radio Access Network (C-RAN) comprises one of the main technologies for high capacity and low latency fronthauling in 5G networks. In this paper, we propose and evaluate an optical fronthaul 5G C-RAN architecture that targets to meet the bandwidth, latency and energy requirements of high traffic hot-spot areas. The proposed architecture employs Intermediate-Frequency-over-Fiber (IFoF) signal generation by Photonic Integrated Circuit (PIC) Wavelength Division Multiplexing (WDM) optical transmitters at the Base-Band Unit (BBU), while a novel design of Reconfigurable Optical Add-Drop Multiplexers (ROADMs) is used at the Remote Radio Head (RRH) site. An aggregate capacity up to 96 Gb/s has been reported by employing two WDM links with 4-band Orthogonal Frequency Division Multiplexing (OFDM) 64-QAM 0.5 Gbaud signals, showing error vector magnitude performance within the acceptable 8% limit. The physical layer evaluation of the proposed fronthaul is also extended with the evaluation of the network throughput and mean packet delay latency, using a Medium Transparent-Medium Access Control (MT-MAC) protocol, which employs gated service indicating latencies below 10ms.
Published: 2019

22. Actively Aligned Flip-Chip Integration of InP to SiN Utilizing Optical Backscatter Reflectometry

Author: Karl-Otto Velthaus, Rene Heideman, Ronald Dekker, Martin Schell, Kerstin Worhoff, Ruud M. Oldenbeuving, F. M. Postma, A. Sigmund, Richard Mateman, Michael Theurer, Dimitri Geskus, Lennart Wevers, Frederik Schreuder, and Martin Moehrle
Subjects: Materials science, Backscatter, business.industry, Optoelectronics, business, Reflectometry, Flip chip
Published: 2019

23. High power, tunable, narrow linewidth dual gain hybrid laser

Author: Ruud M. Oldenbeuving, Ilka Visscher, Robert Grootjans, Jörn P. Epping, Dimitri Geskus, Chris G. H. Roeloffzen, and Rene Heideman
Subjects: Laser linewidth, Materials science, business.industry, law, Optoelectronics, Thermal management of electronic devices and systems, business, Laser, Dual (category theory), Power (physics), law.invention
Abstract: We present the first hybrid integrated laser with two gain sections coupled to one tunable cavity. The resulting laser has a output power of up to 85 mW and an intrinsic linewidth of 320 Hz.
Published: 2019

24. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury

Author: Cnossen, Maryse C., Huijben, Jilske A., van der Jagt, Mathieu, Volovici, Victor, van Essen, Thomas, Polinder, Suzanne, Nelson, David, Ercole, Ari, Stocchetti, Nino, Citerio, Giuseppe, Peul, Wilco C., Maas, Andrew I. R., Menon, David, Steyerberg, Ewout W., Lingsma, Hester F., Adams, Hadie, Alessandro, Masala, Allanson, Judith, Amrein, Krisztina, Andaluz, Norberto, Andelic, Nada, Andrea, Nanni, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Ardon, Hilko, Audibert, Gérard, Auslands, Kaspars, Azouvi, Philippe, Baciu, Camelia, Bacon, Andrew, Badenes, Rafael, Baglin, Trevor, Bartels, Ronald, Barzó, Pál, Bauerfeind, Ursula, Beer, Ronny, Belda, Francisco Javier, Bellander, Bo-Michael, Belli, Antonio, Bellier, Rémy, Benali, Habib, Benard, Thierry, Berardino, Maurizio, Beretta, Luigi, Beynon, Christopher, Bilotta, Federico, Binder, Harald, Biqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Bouzat, Pierre, Bragge, Peter, Brazinova, Alexandra, Brehar, Felix, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Bucková, Veronika, Calappi, Emiliana, Cameron, Peter, Carbayo, Lozano Guillermo, Carise, Elsa, Carpenter, Keri, Castaño-León, Ana M., Causin, Francesco, Chevallard, Giorgio, Chieregato, Arturo, Cooper, M., Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Covic, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Damas, François, Damas, Pierre, Dawes, Helen, De Keyser, Véronique, Corte, Francesco Della, Depreitere, Bart, Ding, Shenghao, Dippel, Diederik, Dizdarevic, Kemal, Dulière, Guy-Loup, Dzeko, Adelaida, Eapen, George, Engemann, Heiko, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Feng, Junfeng, Foks, Kelly, Fossi, Francesca, Francony, Gilles, Frantzén, Janek, Freo, Ulderico, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gao, Guoyi, Geleijns, Karin, Ghuysen, Alexandre, Giraud, Benoit, Glocker, Ben, Gomez, Pedro A., Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Hadzic, Ermin, Haitsma, Iain, Hartings, Jed A., Helbok, Raimund, Helseth, Eirik, Hertle, Daniel, Hill, Sean, Hoedemaekers, Astrid, Hoefer, Stefan, Hutchinson, Peter J., Håberg, Kristine Asta, Jacobs, Bram, Janciak, Ivan, Janssens, Koen, Jiang, Ji-Yao, Jones, Kelly, Kalala, Jean-Pierre, Kamnitsas, Konstantinos, Karan, Mladen, Karau, Jana, Katila, Ari, Kaukonen, Maija, Keeling, David, Kerforne, Thomas, Ketharanathan, Naomi, Kettunen, Johannes, Kivisaari, Riku, Kolias, Angelos G., Kolumbán, Bálint, Kompanje, Erwin, Kondziella, Daniel, Koskinen, Lars-Owe, Kovács, Noémi, Kálovits, Ferenc, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lauritzen, Martin, Lecky, Fiona, Ledig, Christian, Lefering, Rolf, Legrand, Valerie, Lei, Jin, Levi, Leon, Lightfoot, Roger, Loeckx, Dirk, Lozano, Angels, Luddington, Roger, Luijten-Arts, Chantal, Macdonald, Stephen, Macfayden, Charles, Maegele, Marc, Majdan, Marek, Major, Sebastian, Manara, Alex, Manhes, Pauline, Manley, Geoffrey, Martin, Didier, Martino, Costanza, Maruenda, Armando, Maréchal, Hugues, Mastelova, Dagmara, Mattern, Julia, Mcmahon, Catherine, Melegh, Béla, Menovsky, Tomas, Morganti-Kossmann, Cristina, Mulazzi, Davide, Mutschler, Manuel, Mühlan, Holger, Negru, Ancuta, Neugebauer, Eddy, Newcombe, Virginia, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Oldenbeuving, Annemarie, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Patruno, Adriana, Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Pichon, Nicolas, Piilgaard, Henning, Piippo, Anna, Floury, Sébastien Pili, Pirinen, Matti, Ples, Horia, Pomposo, Inigo, Psota, Marek, Pullens, Pim, Puybasset, Louis, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Rehorcíková, Veronika, Rhodes, Jonathan, Richardson, Sylvia, Ripatti, Samuli, Rocka, Saulius, Rodier, Nicolas, Roe, Cecilie, Roise, Olav, Roks, Gerwin, Romegoux, Pauline, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rostalski, Tim, Rueckert, Daniel, de Ruiz, Arcaute Felix, Rusnák, Martin, Sacchi, Marco, Sahakian, Barbara, Sahuquillo, Juan, Sakowitz, Oliver, Sala, Francesca, Sanchez-Pena, Paola, Sanchez-Porras, Renan, Sandor, Janos, Santos, Edgar, Sasse, Nadine, Sasu, Luminita, Savo, Davide, Schipper, Inger, Schlößer, Barbara, Schmidt, Silke, Schneider, Annette, Schoechl, Herbert, Schoonman, Guus, Rico, Frederik Schou, Schwendenwein, Elisabeth, Schöll, Michael, Sir, Özcan, Skandsen, Toril, Smakman, Lidwien, Smeets, Dirk, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stegemann, Katrin, Steinbüchel, Nicole, Stevens, Robert, Stewart, William, Sundström, Nina, Synnot, Anneliese, Szabó, József, Söderberg, Jeannette, Taccone, Fabio Silvio, Tamás, Viktória, Tanskanen, Päivi, Tascu, Alexandru, Taylor, Mark Steven, Ao Braden, Te, Tenovuo, Olli, Teodorani, Guido, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Tshibanda, Jean-Flory Luaba, Tudora, Cristina Maria, Vajkoczy, Peter, Valeinis, Egils, Hecke, Wim Van, Praag, Dominique Van, Dirk, Van Roost, Vlierberghe, Eline Van, Vyvere, Thijs vande, Vanhaudenhuyse, Audrey, Vargiolu, Alessia, Vega, Emmanuel, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Vizzino, Giacinta, Vleggeert-Lankamp, Carmen, Vulekovic, Peter, Vámos, Zoltán, Wade, Derick, Wang, Kevin K. W., Wang, Lei, Wildschut, Eno, Williams, Guy, Willumsen, Lisette, Wilson, Adam, Wilson, Lindsay, Winkler, Maren K. L., Ylén, Peter, Younsi, Alexander, Zaaroor, Menashe, Zhang, Zhiqun, Zheng, Zelong, Zumbo, Fabrizio, de Lange, Stefanie, de Ruiter, Godard C. W., den Boogert, Hugo, van Dijck, Jeroen, van Heugten, Caroline, van der Naalt, Joukje, Cnossen, Maryse C., Huijben, Jilske A., Van der Jagt, Mathieu, Volovici, Victor, Van Essen, Thoma, Polinder, Suzanne, Nelson, David, Ercole, Ari, Stocchetti, Nino, Citerio, Giuseppe, Peul, Wilco C., Maas, Andrew I. R., Menon, David, Steyerberg, Ewout W., Lingsma, Hester F., on behalf of the CENTER-TBI, Investigator, Beretta, Luigi, Cnossen, M, Huijben, J, van der Jagt, M, Volovici, V, van Essen, T, Polinder, S, Nelson, D, Ercole, A, Stocchetti, N, Citerio, G, Peul, W, Maas, A, Menon, D, Steyerberg, E, Lingsma, H, Molecular Neuroscience and Ageing Research (MOLAR), Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Commission of the European Communities, CENTER-TBI Investigators, Medical Informatics, Public and occupational health, Ragauskas, Arminas, Ročka, Saulius, Vilcinis, Rimantas, Public Health, Intensive Care, Neurosurgery, CENTER-TBI investigators, Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzó, P., Bauerfeind, U., Beer, R., Belda, F.J., Bellander, B.M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L.S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Bučková, V., Calappi, E., Cameron, P., Lozano, G.C., Carise, E., Carpenter, K., Castaño-León, A.M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Cnossen, M., Coburn, M., Coles, J., Cooper, J.D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Corte, F.D., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Dulière, G.L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V.L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzén, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P.A., Grossi, F., Gruen, R.L., Gupta, D., Haagsma, J.A., Hadzic, E., Haitsma, I., Hartings, J.A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P.J., Håberg, A.K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J.Y., Jones, K., Kalala, J.P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A.G., Kolumbán, B., Kompanje, E., Kondziella, D., Koskinen, L.O., Kovács, N., Kálovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Andrew, IRM, MacDonald, S., MacFayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Maréchal, H., Mastelova, D., Mattern, J., McMahon, C., Melegh, B., Menon, D., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Mühlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyirádi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P.M., Patruno, A., Payen, J.F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Floury, S.P., Pirinen, M., Ples, H., Polinder, S., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorčíková, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D., de Arcaute, F.R., Rusnák, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlößer, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R.F., Schwendenwein, E., Schöll, M., Sir, Ö., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E., Stanworth, S., Stegemann, K., Steinbüchel, N., Stevens, R., Stewart, W., Steyerberg, E.W., Stocchetti, N., Sundström, N., Synnot, A., Szabó, J., Söderberg, J., Taccone, F.S., Tamás, V., Tanskanen, P., Tascu, A., Taylor, M.S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J.L., Tudora, C.M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vyvere, T.V., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P.M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vámos, Z., Wade, D., Wang, KKW, Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, MKL, Ylén, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., de Lange, S., de Ruiter, GCW, den Boogert, H., van Dijck, J., van Essen, T.A., van Heugten, C., van der Jagt, M., van der Naalt, J., Rocka, Saulius, „Springer' grupė, Apollo - University of Cambridge Repository, Centre of Excellence in Complex Disease Genetics, Department of Mathematics and Statistics, Institute for Molecular Medicine Finland, Biostatistics Helsinki, Aarno Palotie / Principal Investigator, University of Helsinki, Neurokirurgian yksikkö, Clinicum, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, Genomics of Neurological and Neuropsychiatric Disorders, and Statistical and population genetics
Subjects: Neurology, Letter, IMPACT, Critical Care and Intensive Care Medicine, Intracranial hypertension, 0302 clinical medicine, Traumatic brain injury, Clinical Protocols, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Longitudinal Studies, Prospective Studies, Prospective cohort study, Comparative effectiveness research, Survey, Comparative, effectiveness research, Intracranial pressure, Response rate (survey), Medicine (all), Head injury, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 11 Medical And Health Sciences, Orvostudományok, 3. Good health, Europe, Neurosurgery, medicine.medical_specialty, Critical Care, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], PRESSURE, Klinikai orvostudományok, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, ICP, ICU, medicine, MANAGEMENT, Humans, Monitoring, Physiologic, business.industry, MORTALITY, Research, 3112 Neurosciences, HEAD-INJURY, 030208 emergency & critical care medicine, lcsh:RC86-88.9, CARE, medicine.disease, Emergency & Critical Care Medicine, nervous system diseases, traumatic brain injury, comparative effectiveness research, survey, Emergency medicine, Physical therapy, Dentistry (all), MODERATE, Human medicine, business, 030217 neurology & neurosurgery, EUROPEAN-BRAIN
Abstract: Background No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. Methods A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Results The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%). Conclusions Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research. Electronic supplementary material The online version of this article (doi:10.1186/s13054-017-1816-9) contains supplementary material, which is available to authorized users.
Published: 2017

25. Optically Integrated InP–Si$_3$ N$_4$ Hybrid Laser

Author: Rene Heideman, Marcel Hoekman, Ronald Dekker, Jörn P. Epping, Chris G. H. Roeloffzen, Youwen Fan, Peter J. M. van der Slot, Klaus J. Boller, Ruud M. Oldenbeuving, Faculty of Science and Technology, and Laser Physics & Nonlinear Optics
Subjects: lcsh:Applied optics. Photonics, Materials science, Relative intensity noise, 02 engineering and technology, semiconductor lasers, Waveguide (optics), Semiconductor laser theory, law.invention, Resonator, Laser linewidth, 020210 optoelectronics & photonics, Optics, law, 0202 electrical engineering, electronic engineering, information engineering, lcsh:QC350-467, Electrical and Electronic Engineering, Range (particle radiation), Tunable lasers, business.industry, Vernier scale, lcsh:TA1501-1820, Laser, Atomic and Molecular Physics, and Optics, Optoelectronics, business, waveguide devices, lcsh:Optics. Light
Abstract: We describe the first demonstration and characterization of an optically integrated InP-Si3 N4 hybrid laser. The laser is formed by integration of an InP-based reflective semiconductor optical amplifier with a InP-Si3 N4 based feedback waveguide circuit. The circuit comprises a frequency selective and tunable Vernier mirror composed of two microring resonators with slightly different radii. A wide tuning range of more than 43 nm is achieved via the thermo-optic effect. The typical side mode suppression ratio is 35 dB. The narrowest linewidth achieved is about 90 kHz, and the relative intensity noise is less than -135 dBc/Hz.
Published: 2016

26. Hybrid integrated InP-Si3N4 diode laser with a 40-Hz intrinsic linewidth

Author: Ruud M. Oldenbeuving, Jesse Mak, Youwen Fan, Albert van Rees, Chris G. H. Roeloffzen, Dimitri Geskus, Marcel Hoekman, Peter J. M. van der Slot, Klaus J. Boller, and Laser Physics & Nonlinear Optics
Subjects: Materials science, business.industry, Physics::Optics, 02 engineering and technology, 021001 nanoscience & nanotechnology, Laser, 7. Clean energy, 01 natural sciences, Atomic and Molecular Physics, and Optics, Metrology, law.invention, 010309 optics, Laser linewidth, Optics, law, 0103 physical sciences, Laser power scaling, Photonics, 0210 nano-technology, business, Tunable laser, Diode, Electronic circuit
Abstract: We demonstrate a hybrid integrated and widely tunable diode laser with an intrinsic linewidth as narrow as 40 Hz, achieved with a single roundtrip through a low-loss feedback circuit that extends the cavity length to 0.5 meter on a chip. Employing solely dielectrics for single-roundtrip, single-mode resolved feedback filtering enables linewidth narrowing with increasing laser power, without limitations through nonlinear loss. We achieve single-frequency oscillation with up to 23 mW fiber coupled output power, 70-nm wide spectral coverage in the 1.55 μm wavelength range with 3 mW output and obtain more than 60 dB side mode suppression. Such properties and options for further linewidth narrowing render the approach of high interest for direct integration in photonic circuits serving microwave photonics, coherent communications, sensing and metrology with highest resolution.
Published: 2020

27. Characterization of hybrid InP-TriPleX photonic integrated tunable lasers based on silicon nitride (Si3N4/SiO2) micro ring resonators for optical coherent system

Author: Rene Gerrit Heideman, C.G.H. Roeloffzen, Colm Browning, D.H. Geuzebroek, Klaus J. Boller, Roelof Bernardus Timens, D. Geskus, Youwen Fan, Marcel Hoekman, Yi Lin, Liam P. Barry, R.M. Oldenbeuving, and Laser Physics & Nonlinear Optics
Subjects: Materials science, micro ring resonator, Silicon photonics, Optical ring resonators, 02 engineering and technology, 7. Clean energy, 01 natural sciences, Noise (electronics), law.invention, 010309 optics, chemistry.chemical_compound, Laser linewidth, 020210 optoelectronics & photonics, law, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Electrical and Electronic Engineering, Tunable lasers, business.industry, Laser, Atomic and Molecular Physics, and Optics, Silicon nitride, chemistry, Optoelectronics, Photonics, business, Tunable laser
Abstract: We demonstrate detailed characterization results of a hybrid InP-TriPleX photonic integrated tunable laser based on silicon nitride micro ring resonators. A tuning range of 50 nm across the C-band, side-mode suppression ratio (SMSR) > 50dB, high output power (~10 dBm), linewidth of
Published: 2018

28. The use of the PSH-AM in patients with diffuse axonal injury and autonomic dysregulation: A cohort study and review

Author: Marleen Maria van Eijck, Guus G. Schoonman, Jolanda De Vries, Gerwin Roks, Annemarie W. Oldenbeuving, and Marlou O.P. Sprengers
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Traumatic brain injury, Diffuse Axonal Injury, Critical Care and Intensive Care Medicine, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Autonomic dysregulation, Humans, In patient, Paroxysmal sympathetic hyperactivity, Aged, Netherlands, Retrospective Studies, business.industry, Vital Signs, Incidence (epidemiology), Incidence, Diffuse axonal injury, 030208 emergency & critical care medicine, Length of Stay, Middle Aged, medicine.disease, Intensive Care Units, Logistic Models, 030228 respiratory system, Autonomic Nervous System Diseases, Cohort, Female, business, Cohort study
Abstract: Purpose 1) To determine the clinical expression and consequences of autonomic dysregulation in patients with diffuse axonal injury (DAI), and 2) to study the use of the “paroxysmal sympathetic hyperactivity assessment measure” (PSH-AM). Methods Patients clinically diagnosed with autonomic dysregulation were selected from a cohort involving 116 patients with DAI. We studied the incidence of autonomic features, treatment, and outcome. In addition a systematic review was performed. Results Autonomic dysregulation was diagnosed in 19 of 116 (16.4%). Lower age (OR 0.95) and higher DAI grade (OR 7.2) were risk factors for autonomic dysregulation. Autonomic dysregulation was associated with an unfavourable outcome (OR 5.6) and a longer ICU and hospital stay. On the PSH-AM 57.9% (n = 11) scored a probable paroxysmal sympathetic hyperactivity (PSH), 36.8% (n = 7) scored possible, and 5.2% (n = 1) scored unlikely. The review yielded 30 articles. The incidence of autonomic dysregulation after TBI varied from 7.7–32.6% (mean 13.5%). TBI patients with autonomic dysregulation had a longer ICU stay and poorer outcome. Conclusion Patients with DAI and autonomic dysregulation had a longer ICU stay and a poorer outcome compared to patients without autonomic dysregulation. The PSH-AM is a potential valuable tool to determine the likelihood of autonomic dysregulation.
Published: 2018

29. Automatic Delay Tuning of a Novel Ring Resonator-based Photonic Beamformer for a Transmit Phased Array Antenna

Author: Michel Verhaegen, Laurens Bliek, R. B. Timens, Chris G. H. Roeloffzen, Ilka Visscher, Sander Wahls, Caterina Taddei, and Ruud M. Oldenbeuving
Subjects: Beamforming, Computer science, Phased array, Optical ring resonators, FOS: Physical sciences, 02 engineering and technology, Applied Physics (physics.app-ph), 7. Clean energy, 01 natural sciences, law.invention, 010309 optics, Resonator, 020210 optoelectronics & photonics, law, 0103 physical sciences, Broadband, 0202 electrical engineering, electronic engineering, information engineering, Electronic engineering, Computer Science::Information Theory, business.industry, Bandwidth (signal processing), Physics - Applied Physics, Chip, Atomic and Molecular Physics, and Optics, Photonics, business
Abstract: We present a novel photonic beamformer for a fully integrated transmit phased array antenna, together with an automatic procedure for tuning the delays in this system. Such an automatic tuning procedure is required because the large number of actuators makes manual tuning practically impossible. The antenna system is designed for the purpose of broadband aircraft-satellite communication in the Ku-band to provide satellite Internet connections on board the aircraft. The goal of the beamformer is to automatically steer the transmit antenna electronically in the direction of the satellite. This is done using a mix of phase shifters and tunable optical delay lines, which are all integrated on a chip and laid out in a tree structure. The Ku-band has a bandwidth of 0.5 GHz. We show how an optical delay line is automatically configured over this bandwidth, providing a delay of approximately 0.4 ns. The tuning algorithm calculates the best actuator voltages based on past measurements. This is the first time that such an automatic tuning scheme is used on a photonic beamformer for this type of transmit phased array antenna. We show that the proposed method is able to provide accurate beamforming (< 11.25{\deg} phase error over the whole bandwidth) for two different delay settings., Comment: Copyright 2019 IEEE
Published: 2018
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30. Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial

Author: Celine S. Gathier, Walter M. van den Bergh, Mathieu van der Jagt, Bon H. Verweij, Jan Willem Dankbaar, Marcella C. Müller, Annemarie W. Oldenbeuving, Gabriel J.E. Rinkel, Arjen J.C. Slooter, Ale Algra, Jozef Kesecioglu, Irene C. van der Schaaf, Ruben Dammers, Diederik W.J. Dippel, Clemens M.F. Dirven, Fop van Kooten, Aad van der Lugt, Bert A. Coert, Janneke Horn, W. Peter Vandertop, Gus N. Beute, Bram van der Pol, Gerwin Roks, Willem Jan J. van Rooij, Menno Sluzewski, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Other departments, Other Research, Intensive Care Medicine, ANS - Neurovascular Disorders, Neurosurgery, ACS - Pulmonary hypertension & thrombosis, and Intensive Care
Subjects: Male, VASOSPASM, law.invention, Brain Ischemia, Brain ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, DEFICITS, PERFUSION, 030212 general & internal medicine, Advanced and Specialised Nursing, SCALE, Vasospasm, induced hypertension, Middle Aged, VOLUME EXPANSION, Anesthesia, SAFETY, Hypertension, delayed cerebral ischemia, Female, Cardiology and Cardiovascular Medicine, TRIPLE-H THERAPY, Adult, Subarachnoid hemorrhage, Clinical Neurology, 03 medical and health sciences, medicine, MANAGEMENT, Humans, Adverse effect, HYPERVOLEMIC THERAPY, Aged, Advanced and Specialized Nursing, business.industry, Case-control study, Intracranial Aneurysm, Subarachnoid Hemorrhage, medicine.disease, Relative risk, Case-Control Studies, randomized controlled trial, ARTERIAL-HYPERTENSION, Neurology (clinical), aneurysmal subarachnoid hemorrhage, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract: Background and Purpose— Induced hypertension is widely used to treat delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage, but a literature review shows that its presumed effectiveness is based on uncontrolled case-series only. We here report clinical outcome of aneurysmal subarachnoid hemorrhage patients with DCI included in a randomized trial on the effectiveness of induced hypertension. Methods— Aneurysmal subarachnoid hemorrhage patients with clinical symptoms of DCI were randomized to induced hypertension or no induced hypertension. Risk ratios for poor outcome (modified Rankin Scale score >3) at 3 months, with 95% confidence intervals, were calculated and adjusted for age, clinical condition at admission and at time of DCI, and amount of blood on initial computed tomographic scan with Poisson regression analysis. Results— The trial aiming to include 240 patients was ended, based on lack of effect on cerebral perfusion and slow recruitment, when 21 patients had been randomized to induced hypertension, and 20 patients to no hypertension. With induced hypertension, the adjusted risk ratio for poor outcome was 1.0 (95% confidence interval, 0.6–1.8) and the risk ratio for serious adverse events 2.1 (95% confidence interval, 0.9–5.0). Conclusions— Before this trial, the effectiveness of induced hypertension for DCI in aneurysmal subarachnoid hemorrhage patients was unknown because current literature consists only of uncontrolled case series. The results from our premature halted trial do not add any evidence to support induced hypertension and show that this treatment can lead to serious adverse events. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01613235.
Published: 2018

31. Narrow linewidth hybrid InP-TriPleX photonic integrated tunable laser based on silicon nitride micro-ring resonators

Author: Rene Heideman, Jialin Zhao, Ruud M. Oldenbeuving, Chris G. H. Roeloffzen, R. B. Timens, Dimitri Geskus, Liam P. Barry, Colm Browning, Yi Lin, Youwen Fan, Douwe Geuzebroek, Klaus J. Boller, and Laser Physics & Nonlinear Optics
Subjects: Materials science, business.industry, External cavity, 02 engineering and technology, Ring (chemistry), Laser, 01 natural sciences, law.invention, 010309 optics, chemistry.chemical_compound, Resonator, Laser linewidth, 020210 optoelectronics & photonics, Silicon nitride, chemistry, law, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Optoelectronics, Photonics, business, Tunable laser
Abstract: Detailed characterization of a hybrid integrated tunable laser based on micro-ring resonators shows a tuning range of 50 nm with ~40 kHz linewidth. The device demonstrates performance comparable with commercial external cavity lasers in 16QAM coherent system.
Published: 2018

32. Spectral linewidth analysis of semiconductor hybrid lasers with feedback from an external waveguide resonator circuit

Author: Klaus J. Boller, Jesse Mak, Rob E. M. Lammerink, P.J.M. van der Slot, Youwen Fan, Ruud M. Oldenbeuving, and Laser Physics & Nonlinear Optics
Subjects: Physics, business.industry, Physics::Optics, 02 engineering and technology, Laser, Atomic and Molecular Physics, and Optics, Power (physics), Semiconductor laser theory, law.invention, Laser linewidth, 020210 optoelectronics & photonics, Semiconductor, Optics, Transmission line, law, 0202 electrical engineering, electronic engineering, information engineering, Waveguide (acoustics), Photonics, business
Abstract: We present a detailed analysis of a semiconductor hybrid laser exploiting spectral control from an external photonic waveguide circuit that provides frequency-selective feedback. Based on a spatially resolved transmission line model (TLM), we have investigated the output power, emission frequency, and the laser spectral linewidth. We find that, if the feedback becomes weaker, the spectral linewidth is larger than predicted by previous models that are based on a modified mean-field approximation, even if these take a strong spatial variation of the gain into account. The observed excess linewidth is caused by additional index fluctuations that are associated with strong spatial gain variations.
Published: 2017

33. High Early Fluid Input After Aneurysmal Subarachnoid Hemorrhage: Combined Report of Association With Delayed Cerebral Ischemia and Feasibility of Cardiac Output-Guided Fluid Restriction

Author: Mervyn D.I. Vergouwen, Mohamud Egal, Hester F. Lingsma, Leonie J.M. Vergouw, Mathieu van der Jagt, Bas Bergmans, Jan Bakker, Diederik W.J. Dippel, Peter W. A. Willems, Annemarie W. Oldenbeuving, Intensive Care, Neurology, and Public Health
Subjects: Male, Cardiac output, Subarachnoid hemorrhage, Hemodynamics, Critical Care and Intensive Care Medicine, law.invention, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Humans, hypervolemia, Cardiac Output, Retrospective Studies, Original Research, business.industry, 030208 emergency & critical care medicine, Middle Aged, Subarachnoid Hemorrhage, Water-Electrolyte Balance, medicine.disease, Intensive care unit, Confidence interval, Preload, Logistic Models, 030228 respiratory system, fluid management, Anesthesia, Cohort, delayed cerebral ischemia, Feasibility Studies, Fluid Therapy, transpulmonary thermodilution, Female, aneurysmal subarachnoid hemorrhage, Hypervolemia, business
Abstract: Background: Guidelines on the management of aneurysmal subarachnoid hemorrhage (aSAH) recommend euvolemia, whereas hypervolemia may cause harm. We investigated whether high early fluid input is associated with delayed cerebral ischemia (DCI), and if fluid input can be safely decreased using transpulmonary thermodilution (TPT). Methods: We retrospectively included aSAH patients treated at an academic intensive care unit (2007-2011; cohort 1) or managed with TPT (2011-2013; cohort 2). Local guidelines recommended fluid input of 3 L daily. More fluids were administered when daily fluid balance fell below +500 mL. In cohort 2, fluid input in high-risk patients was guided by cardiac output measured by TPT per a strict protocol. Associations of fluid input and balance with DCI were analyzed with multivariable logistic regression (cohort 1), and changes in hemodynamic indices after institution of TPT assessed with linear mixed models (cohort 2). Results: Cumulative fluid input 0 to 72 hours after admission was associated with DCI in cohort 1 (n=223; odds ratio [OR] 1.19/L; 95% confidence interval 1.07-1.32), whereas cumulative fluid balance was not. In cohort 2 (23 patients), using TPT fluid input could be decreased from 6.0 ± 1.0 L before to 3.4 ± 0.3 L; P = .012), while preload parameters and consciousness remained stable. Conclusion: High early fluid input was associated with DCI. Invasive hemodynamic monitoring was feasible to reduce fluid input while maintaining preload. These results indicate that fluid loading beyond a normal preload occurs, may increase DCI risk, and can be minimized with TPT.
Published: 2017

34. Enhanced coverage though optical beamforming in fiber wireless networks

Author: Chris G. H. Roeloffzen, Rene Heideman, Ruud M. Oldenbeuving, Arne Leinse, R. B. Timens, Ilka Dove, Caterina Taddei, Jörn P. Epping, Paul van Dijk, and Dimitri Geskus
Subjects: Beamforming, Phased array, Computer science, business.industry, Conformal antenna, Beam steering, 02 engineering and technology, Antenna array, 020210 optoelectronics & photonics, Interference (communication), 0202 electrical engineering, electronic engineering, information engineering, Electronic engineering, Antenna (radio), Photonics, business
Abstract: Integrated microwave photonics (IMWP) is a novel field in which the fast-paced progress in integrated, on-chip, optics is harnessed to provide breakthrough performances in well-established microwave photonic processing functions, which are traditionally realized using discrete optoelectronic components. A field where IMWP can have a strong impact is the one of Antenna Arrays for 5G networks. Such arrays offer a number of attractive characteristics, including a conformal array profile, electronic beamforming (beam shaping and beam steering), interference nulling and the capability to generate multiple antenna beams simultaneously. In many cases, however, the performance of a phased array is limited by the characteristics of the beamforming network (BFN) used. It is generally desired to realize beamformers with broad instantaneous bandwidth, continuous amplitude, and delay tunability while, at the same time, capable of feeding large arrays. This, however, is very challenging to achieve using only electronics. For this reason, in the last few years, an increasing amount of research has been directed to beamforming in the optical domain using, integrated microwave photonics solutions. Besides antenna array applications, opportunities for cost effective use of IMWP in switched delay lines has become feasible due to the continuous improvement of optical chips, particularly the achieved record-low propagation losses in Si 3 N 4 /SiO 2 -based-chips combined with the high integration density.
Published: 2017

35. 290 Hz intrinsic linewidth from an integrated optical chip-based widely tunable InP-Si3N4 hybrid laser

Author: Klaus J. Boller, Rene Heideman, Chris G. H. Roeloffzen, Marcel Hoekman, Ronald Dekker, Dimitri Geskus, Youwen Fan, Ruud M. Oldenbeuving, and Laser Physics & Nonlinear Optics
Subjects: Optical amplifier, Materials science, business.industry, Photonic integrated circuit, Physics::Optics, 02 engineering and technology, Laser, Distributed Bragg reflector, Waveguide (optics), law.invention, Semiconductor laser theory, Laser linewidth, 020210 optoelectronics & photonics, Optics, law, 0202 electrical engineering, electronic engineering, information engineering, Optoelectronics, Physics::Atomic Physics, business, Tunable laser
Abstract: Widely tunable, narrow linewidth diode lasers have found a wide range of important applications, from terrestrial ones, such as fiber-optic communications [1] or optical sensing [2], to applications in space, for instance in atomic clocks [3]. Monolithic diode lasers for such tasks, i.e., distributed feedback (DFB) lasers and distributed Bragg reflector (DBR) lasers, approach their limits since they typically show either a small tuning range [4] or large spectral linewidths at the MHz level [5]. In contrast, these limitations are not present in hybrid lasers. In such lasers, the gain from a semiconductor optical amplifier chip is receiving spectrally filtered feedback from a second chip fabricated from dielectric material. The second chip carries an integrated-optical waveguide circuit with which highly selective filtering and a long photon lifetime can be realized.
Published: 2017

36. Prospective Evaluation of Noninvasive HeadSense Intracranial Pressure Monitor in Traumatic Brain Injury Patients Undergoing Invasive Intracranial Pressure Monitoring

Author: Stylianos Mourtzoukos, Walid Moudrous, Annemarie W. Oldenbeuving, Guus G. Schoonman, Oliver Ganslandt, Martin Willy Herklots, and Gerwin Roks
Subjects: Adult, Male, medicine.medical_specialty, Intracranial Pressure, Traumatic brain injury, Mean difference, Prospective evaluation, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Millimeter of mercury, Subarachnoid Hemorrhage, Traumatic, 030202 anesthesiology, Brain Injuries, Traumatic, medicine, Cerebral Hemorrhage, Traumatic, Humans, Prospective Studies, Intracranial pressure, Aged, Monitoring, Physiologic, Minimal risk, business.industry, musculoskeletal, neural, and ocular physiology, Intracranial pressure monitor, Equipment Design, Middle Aged, medicine.disease, nervous system diseases, Anesthesia, Intracranial pressure monitoring, Surgery, Female, Neurology (clinical), Radiology, Intracranial Hypertension, business, 030217 neurology & neurosurgery
Abstract: Background Currently, intracranial pressure (ICP) is measured by invasive methods with a significant risk of infectious and hemorrhagic complications. Because of these high risks, there is a need for a noninvasive ICP (nICP) monitor with an accuracy similar to that of an invasive ICP (iICP) monitor. Objective We sought to assess prospectively the accuracy and precision of an nICP monitor compared with iICP measurement in severe traumatic brain injury (TBI) patients. Methods Participants were ICP-monitored patients who had sustained TBI. In parallel with the standard invasive ICP measurements, nICP was measured by the HeadSense HS-1000, which is based on sound propagation. The device generated an acoustic signal using a small transmitter, placed in the patient's ear, and picked up by an acoustic sensor placed in the other ear. The signal is then analyzed using proprietary algorithms, and the ICP value is calculated in millimeter of mercury (mm Hg). Results Analysis of 2911 paired iICP and nICP measurements from 14 severe TBI patients showed a good accuracy of the nICP monitor indicated by a mean difference of 0.5 mm Hg. The precision was also good with a standard deviation of 3.9 mm Hg. The Pearson r correlation was 0.604 ( P Conclusions The HeadSense HS-1000 nICP monitor seems sufficiently accurate to measure the ICP in severe TBI patients, is patient friendly, and has minimal risk of complications.
Published: 2017

37. Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury

Author: Huijben, Jilske A., Wiegers, Eveline J. A., Polinder, Suzanne, Steyerberg, Ewout W., van der Jagt, Mathieu, Lingsma, Hester F., Delphi panel, Aries, Marcel, Badenes, Rafael, Beishuizen, Albertus, Bilotta, Federico, Chieregato, Arturo, de Keizer, Nicolette F., Cingolani, Emiliano, Citerio, Giuseppe, Cnossen, Maryse, Coburn, Mark, Coles, Jonathan P., Delargy, Mark, Depreitere, Bart, Ercole, Ari, Flaatten, Hans, Golyk, Volodymyr, Maas, Andrew I. R., Grauwmeijer, Erik, Haitsma, Iain, Helbok, Raimund, Hoedemaekers, Cornelia, Jacobs, Bram, Jellema, Korné, Koskinen, Lars-Owe D., Maegele, Marc, Delgado, Maria Cruz Martin, Menon, David, Møller, Kirsten, Moreno, Rui, Nelson, David, Oldenbeuving, Annemarie W., Payen, Jean-Francois, Pejakovic, Jasmina, Ribbbers, Gerard M., Rossaint, Rolf, Schoonman, Guus Geurt, Steiner, Luzius A., Stocchetti, Nino, Taccone, Fabio Silvio, Takala, Riikka, Tenovuo, Olli, Valeinis, Eglis, van den Bergh, Walter M., van Essen, Thomas, van Leeuwen, Nikki, Verhofstad, Michael H. J., Vos, Pieter E., Wilson, Lindsay, Lecky, Fiona, Cnossen, Maryse C., Delphi Panel, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Medische Staf IC (9), Citerio, Giuseppe [0000-0002-5374-3161], Apollo - University of Cambridge Repository, Huijben, J, Wiegers, E, de Keizer, N, Maas, A, Menon, D, Ercole, A, Citerio, G, Lecky, F, Wilson, L, Cnossen, M, Polinder, S, Steyerberg, E, van der Jagt, M, Lingsma, H, Medical Informatics, APH - Methodology, APH - Quality of Care, APH - Digital Health, Public Health, Rehabilitation Medicine, Neurosurgery, and Surgery
Subjects: Quality management, NEUROTRAUMA EFFECTIVENESS RESEARCH, Delphi Technique, Quality indicator, Delphi method, CHILDREN, Quality indicators, Critical Care and Intensive Care Medicine, GUIDELINES, law.invention, 0302 clinical medicine, Traumatic brain injury, law, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine, Registries, media_common, computer.programming_language, OUTCOMES, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Trauma registry, Benchmarking, Intensive care unit, Quality Improvement, 3. Good health, Europe, Intensive Care Units, HOSPITAL-CARE, OF-CARE, Medical emergency, Life Sciences & Biomedicine, Anestesi och intensivvård, media_common.quotation_subject, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Likert scale, 03 medical and health sciences, ADHERENCE, Critical Care Medicine, Intensive care, General & Internal Medicine, Quality indicators, Benchmarking, Traumatic brain injury, Intensive care unit, Trauma registry, Quality of care, MANAGEMENT, Humans, Quality (business), VALIDITY, Expert Testimony, Quality Indicators, Health Care, Quality of Health Care, Quality care, Science & Technology, Anesthesiology and Intensive Care, business.industry, Research, Quality of care, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Human medicine, business, computer, Delphi
Abstract: Background We aimed to develop a set of quality indicators for patients with traumatic brain injury (TBI) in intensive care units (ICUs) across Europe and to explore barriers and facilitators for implementation of these quality indicators. Methods A preliminary list of 66 quality indicators was developed, based on current guidelines, existing practice variation, and clinical expertise in TBI management at the ICU. Eight TBI experts of the Advisory Committee preselected the quality indicators during a first Delphi round. A larger Europe-wide expert panel was recruited for the next two Delphi rounds. Quality indicator definitions were evaluated on four criteria: validity (better performance on the indicator reflects better processes of care and leads to better patient outcome), feasibility (data are available or easy to obtain), discriminability (variability in clinical practice), and actionability (professionals can act based on the indicator). Experts scored indicators on a 5-point Likert scale delivered by an electronic survey tool. Results The expert panel consisted of 50 experts from 18 countries across Europe, mostly intensivists (N = 24, 48%) and neurosurgeons (N = 7, 14%). Experts agreed on a final set of 42 indicators to assess quality of ICU care: 17 structure indicators, 16 process indicators, and 9 outcome indicators. Experts are motivated to implement this finally proposed set (N = 49, 98%) and indicated routine measurement in registries (N = 41, 82%), benchmarking (N = 42, 84%), and quality improvement programs (N = 41, 82%) as future steps. Administrative burden was indicated as the most important barrier for implementation of the indicator set (N = 48, 98%). Conclusions This Delphi consensus study gives insight in which quality indicators have the potential to improve quality of TBI care at European ICUs. The proposed quality indicator set is recommended to be used across Europe for registry purposes to gain insight in current ICU practices and outcomes of patients with TBI. This indicator set may become an important tool to support benchmarking and quality improvement programs for patients with TBI in the future. Electronic supplementary material The online version of this article (10.1186/s13054-019-2377-x) contains supplementary material, which is available to authorized users.
Published: 2019

38. An early prediction of delirium in the acute phase after stroke

Author: Gerwin Roks, L.J. Kappelle, Annemarie W. Oldenbeuving, P L M de Kort, J F van Eck van der Sluijs, and Tranzo, Scientific center for care and wellbeing
Subjects: Adult, Male, medicine.medical_specialty, Infections, Logistic regression, Sensitivity and Specificity, Severity of Illness Index, Risk Factors, Internal medicine, medicine, Humans, Cognitive decline, Prospective cohort study, Stroke, Aged, Aged, 80 and over, Framingham Risk Score, business.industry, Age Factors, Area under the curve, Neuropsychology, Delirium, Middle Aged, Prognosis, medicine.disease, Editorial Commentary, Psychiatry and Mental health, Logistic Models, Physical therapy, Female, Surgery, Neurology (clinical), medicine.symptom, Cognition Disorders, business
Abstract: Background We developed and validated a risk score to predict delirium after stroke which was derived from our prospective cohort study where several risk factors were identified.Methods Using the β coefficients from the logistic regression model, we allocated a score to values of the risk factors. In the first model, stroke severity, stroke subtype, infection, stroke localisation, pre-existent cognitive decline and age were included. The second model included age, stroke severity, stroke subtype and infection. A third model only included age and stroke severity. The risk score was validated in an independent dataset.Results The area under the curve (AUC) of the first model was 0.85 (sensitivity 86%, specificity 74%). In the second model, the AUC was 0.84 (sensitivity 80%, specificity 75%). The third model had an AUC of 0.80 (sensitivity 79%, specificity 73%). In the validation set, model 1 had an AUC of 0.83 (sensitivity 78%, specificity 77%). The second had an AUC of 0.83 (sensitivity 76%, specificity 81%). The third model gave an AUC of 0.82 (sensitivity of 73%, specificity 75%). We conclude that model 2 is easy to use in clinical practice and slightly better than model 3 and, therefore, was used to create risk tables to use as a tool in clinical practice.Conclusions A model including age, stroke severity, stroke subtype and infection can be used to identify patients who have a high risk to develop delirium in the early phase of stroke.
Published: 2013

39. Narrow-linewidth widely tunable hybrid external cavity laser using Si3N4/SiO2 microring resonators

Author: J. P. Epping, Ruiqiang Ji, Shengmeng Fu, Jialin Zhao, Li Zeng, R. M. Oldenbeuving, R. Dekker, Klaus-Jochen Boller, Rene Heideman, Marcel Hoekman, and Youwen Fan
Subjects: External cavity laser, Materials science, business.industry, 02 engineering and technology, chemistry.chemical_compound, Resonator, Wavelength, Laser linewidth, 020210 optoelectronics & photonics, Optics, Silicon nitride, chemistry, Electron optics, 0202 electrical engineering, electronic engineering, information engineering, Optoelectronics, business, Tunable laser
Abstract: We report on the characteristics of a tunable hybrid external cavity laser using silicon nitride microring resonators. A wavelength tuning range covering from 1530nm to 1580nm is demonstrated with a side mode suppression ratio larger than 45dB. Typical linewidth values are 65kHz.
Published: 2016

40. Delirium in Acute Stroke: A Review

Author: P. L. M. de Kort, Annemarie W. Oldenbeuving, L. J. Kappelle, Gerwin Roks, and B.P.W. Jansen
Subjects: medicine.medical_specialty, media_common.quotation_subject, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Risk Factors, Perception, mental disorders, Severity of illness, medicine, Humans, 030212 general & internal medicine, Psychiatry, Stroke, media_common, Acute stroke, business.industry, Delirium, Cognition, Prognosis, medicine.disease, 030227 psychiatry, Neurology, Acute Disease, Consciousness, medicine.symptom, business
Abstract: Background Delirium is a complex neuropsychiatric syndrome characterized by disturbances of consciousness, attention, cognition, and perception. It may be the presenting feature of acute stroke, but more often it complicates the clinical course in the early stage of rehabilitation. Summary of review Risk factors for delirium are older age, pre-existing cognitive decline, metabolic disturbances, infections, and polypharmacy. Recognition of delirium in patients with stroke is important because of its association with a longer stay in the hospital, a poor functional outcome, and an increased risk of developing dementia. The diagnosis may be difficult because of the fluctuating course and the neurological deficits that are caused by the stroke. Nonpharmacological preventive measures, early identification, and additional medical intervention are the key measures in the management of delirium after stroke. Conclusion This review describes incidence, risk factors, pathophysiology, diagnostic tools, and management of delirium in patients with a recent stroke.
Published: 2007

41. Integrated optical beamformers

Author: Chris G. H. Roeloffzen, Ruud M. Oldenbeuving, P. W. L. van Dijk, R. B. Timens, and I. Dove
Subjects: Beamforming, Materials science, Phased-array optics, Interference (communication), business.industry, Phased array, Photonic integrated circuit, Beam steering, Conformal antenna, Electronic engineering, Photonics, business
Abstract: Microwave photonics (MWP) is an emerging field in which the radio signals are generated, distributed, processed and analysed using the strength of photonics. It is a disruptive technology which enables various functionalities which are not feasible in only the microwave or electronic domain. A particular aspect that has gained a significant interest recently is the use of photonic integrated circuit (PIC) technology in this field, i.e., integrated microwave photonics (IMWP) [1, 2, 3]. A field where IMWP can have a strong impact is the one of phased array antennas (PAA) for next generation mobile (5G) and Satcom networks. Such arrays offer a number of attractive characteristics, including a conformal array profile, beamforming (beam shaping and beam steering), interference nulling and the capability to generate multiple antenna beams simultaneously. In many cases, however, the performance of a phased array is limited by the static characteristics of the beamforming network (BFN) used. It is generally desired to realize beamformers with broad instantaneous bandwidth, continuous amplitude and delay tunability and, at the same time, capable of feeding large arrays. This, however, is very challenging to achieve using electronics only.
Published: 2015

42. Effects of Induced Hypertension on Cerebral Perfusion in Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial

Author: Celine S. Gathier, Jan Willem Dankbaar, Mathieu van der Jagt, Bon H. Verweij, Annemarie W. Oldenbeuving, Gabriel J.E. Rinkel, Walter M. van den Bergh, Arjen J.C. Slooter, Ale Algra, Gus N. Beute, Bert A. Coert, Ruben Dammers, Diederik W.J. Dippel, Clemens M.F. Dirven, Janneke Horn, Marcella C. Müller, Jozef Kesecioglu, Fop van Kooten, Aad van der Lugt, Bram van der Pol, Gerwin Roks, Willem J. van Rooij, Irene C. van der Schaaf, Menno Sluzewski, W. Peter Vandertop, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Other departments, ANS - Amsterdam Neuroscience, Neurosurgery, AII - Amsterdam institute for Infection and Immunity, Intensive Care Medicine, Intensive Care, Neurosciences, and Epidemiology
Subjects: Adult, Male, Subarachnoid hemorrhage, hypertension, subarachnoid hemorrhage, Ischemia, Aneurysm, Ruptured, Brain Ischemia, Brain ischemia, Norepinephrine, medicine, Humans, Vasoconstrictor Agents, Cerebral perfusion pressure, Aged, Advanced and Specialized Nursing, Cerebral infarction, business.industry, Intracranial Aneurysm, Middle Aged, medicine.disease, cerebral infarction, Cerebral Angiography, Treatment Outcome, Blood pressure, Cerebral blood flow, Cerebrovascular Circulation, Anesthesia, randomized controlled trial, Linear Models, Female, Neurology (clinical), arterial pressure, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Perfusion, CT
Abstract: Background and Purpose— The presumed effectiveness of induced hypertension for treating delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is based on uncontrolled case-series only. We assessed the effect of induced hypertension on cerebral blood flow (CBF) in aneurysmal subarachnoid hemorrhage patients with delayed cerebral ischemia in a randomized clinical trial. Methods— Aneurysmal subarachnoid hemorrhage patients were randomized to induced or no induced hypertension (control group) at delayed cerebral ischemia onset. CBF was assessed, blinded for treatment allocation, with computed tomographic perfusion in standardized predefined regions at delayed cerebral ischemia onset and after 24 to 36 hours of study treatment. Mean arterial blood pressure was compared between groups (linear mixed model). The primary outcome measure was the difference in change in overall CBF (Mann–Whitney U test). Results— Mean arterial blood pressure was, on average, 12 mm Hg (95% confidence interval, 8.6–14.5) higher in the hypertension group (n=12) than in the control group (n=13). Change in overall CBF (mL/100g per s) was −8.5 (range, −42 to 30) in the control group and 0.1 (range, −31–43) in the hypertension group ( P =0.25). Conclusions— Change in overall CBF did not differ to a statistically significant extent between the groups. Based on our results, 225 to 250 patients per group are needed to find a statistically significant difference in change in overall CBF between induced hypertension and no hypertension. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT0161323.
Published: 2015

43. Integrated optical beamformers

Author: I. Dove, Caterina Taddei, Ruud M. Oldenbeuving, Chris G. H. Roeloffzen, R. B. Timens, P. W. L. van Dijk, and Laser Physics & Nonlinear Optics
Subjects: Computer science, business.industry, iMWP, Photonic integrated circuit, Hybrid integration, Photodiode, law.invention, law, Modulation, Electronic engineering, Optoelectronics, Integrated optics, Photonics, Optical beamforming, business, Realization (systems), Microwave photonics
Abstract: This paper discusses the challenges towards the realization of the integrated microwave photonic beamformer based on hybrid integration between InP and TriPleX Si3N4/SiO2.
Published: 2015

44. A compact and reconfigurable silicon nitride time-bin entanglement circuit

Author: Xiang Zhang, Andri Mahendra, Chunle Xiong, Rene Heideman, Philip H. W. Leong, Benjamin J. Eggleton, David Marpaung, Jiakun He, Chris G. H. Roeloffzen, Chang-Joon Chae, Marcel Hoekman, Arne Leinse, Duk-Yong Choi, P. W. L. van Dijk, Caterina Taddei, Ruud M. Oldenbeuving, Faculty of Science and Technology, and Laser Physics & Nonlinear Optics
Subjects: Computer science, Computation, ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION, FOS: Physical sciences, Physics::Optics, Quantum entanglement, Noise (electronics), chemistry.chemical_compound, Computer Science::Hardware Architecture, Photon entanglement, Interference (communication), Photonic Chip, Quantum information, Quantum information science, Quantum Physics, business.industry, TheoryofComputation_GENERAL, Chip, Atomic and Molecular Physics, and Optics, Electronic, Optical and Magnetic Materials, Silicon nitride, chemistry, Optoelectronics, Photonics, business, Quantum Physics (quant-ph)
Abstract: Photonic chip based time-bin entanglement has attracted significant attention because of its potential for quantum communication and computation. Useful time-bin entanglement systems must be able to generate, manipulate and analyze entangled photons on a photonic chip for stable, scalable and reconfigurable operation. Here we report the first time-bin entanglement photonic chip that integrates time-bin generation, wavelength demultiplexing and entanglement analysis. A two-photon interference fringe with an 88.4% visibility is measured (without subtracting any noise), indicating the high performance of the chip. Our approach, based on a silicon nitride photonic circuit, which combines the low-loss characteristic of silica and tight integration features of silicon, paves the way for scalable real-world quantum information processors., 4 pages, 5 figures
Published: 2015

45. The influence of APACHE II score on the average noise level in an intensive care unit: an observational study

Author: Munhum Park, Pieter C. Vos, Annemarie W. Oldenbeuving, Björn N. S. Vlaskamp, AG Armin Kohlrausch, and Human Technology Interaction
Subjects: medicine.medical_specialty, APACHE II, Names of the days of the week, business.industry, Regression analysis, Environmental exposure, Acoustics, Environmental Exposure, Length of Stay, Intensive care unit, law.invention, Noise, Intensive Care Units, Anesthesiology and Pain Medicine, law, Intensive care, Emergency medicine, Noise, Occupational, Medicine, Humans, Regression Analysis, Observational study, business, APACHE, Research Article
Abstract: Background Noise levels in hospitals, especially in intensive care units (ICUs) are known to be high, potentially affecting not only the patients’ well-being but also their clinical outcomes. In an observational study, we made a long-term measurement of noise levels in an ICU, and investigated the influence of various factors on the noise level, including the acute physiology and chronic health evaluation II (APACHE II) score. Methods The average noise level was continuously measured for three months in all (eight) patient rooms in an ICU, while the patient data were also registered, including the APACHE II score. The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events. For the patients with LOS ≥4 days, the average noise levels in the first four days were analyzed, and regression models were established using the stepwise search method based on the Akaike information criterion. Results Features identified in the 24-hour trends (n = 55) agreed well with the daily routine events in the ICU, where regular check-ups raised the 10-minute average noise level by 2~3 dBA from the surrounding values at night, and the staff shift changes consistently increased the noise level by 3~5 dBA. When analyzed in alignment with the patient’s admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient’s recovery. Regression analysis showed that the APACHE II score, room location, gender, day of week and the ICU admission type could explain more than 50 % of the variance in the daily average noise level, LAeq,24h. Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points. Conclusions Patient’s initial health condition is one important factor that influences the acoustic environment in an ICU, which needs to be considered in observational and interventional studies where the noise in healthcare environments is the subject of investigation.
Published: 2015

46. Evaluation of an intranasal house dust mite provocation model as a tool in clinical research

Author: Paul G.H. Mulder, N. B. Oldenbeuving, Wytske J. Fokkens, Alex KleinJan, P. Lumley, E. J. J. de Groot, C. M. van Drunen, Other departments, Ear, Nose and Throat, Amsterdam institute for Infection and Immunity, Otorhinolaryngology and Head and Neck Surgery, Pulmonary Medicine, and Epidemiology
Subjects: Adult, Male, Allergy, medicine.medical_specialty, Nasal Provocation Tests, Rhinitis, Allergic, Perennial, Time Factors, Adolescent, medicine.medical_treatment, Immunology, Provocation test, Mucous membrane of nose, Nasal provocation test, Fluticasone propionate, Leukocyte Count, Animals, Humans, Immunology and Allergy, Medicine, Eosinophilia, Administration, Intranasal, House dust mite, Mites, biology, business.industry, Reproducibility of Results, Dust, Middle Aged, medicine.disease, biology.organism_classification, Dermatology, Androstadienes, Eosinophils, Nasal Mucosa, Nasal spray, Fluticasone, Female, medicine.symptom, business, medicine.drug
Abstract: Background: As a result of the all-year-round exposure to house dust mite (HDM), perennial rhinitis patients never have a clear symptom-free period. In this study, we investigated whether, despite these symptoms, we can still use nasal HDM provocations to study perennial allergic rhinitis and the effects of treatment. Methods: In a parallel-group study, after 1 week treatment with either fluticasone propionate aqueous nasal spray (FPANS) or placebo, 20 patients, allergic to HDM, registered symptoms (nasal obstruction, rhinorrhoea, sneezing, pruritus and eye symptoms) using three different scoring methods [Lebel, categorical and visual analogue scale (VAS)] and peak nasal inspiratory flow (PNIF) after HDM provocations. Provocations were performed with 1000 biological units/ml and 24 h later with 10 000 biological units/ml of HDM. Before and after the provocations, nasal mucosa biopsies were taken for immunohistochemical staining to determine the number of eosinophils. Results: House dust mite provocations resulted in an increase in symptoms and a decrease in PNIF. Even at high-dose provocation, the FPANS group registered significantly lower symptoms than the placebo group for nasal blockage, sneezing, eye symptoms, and PNIF in both early and late phases. FPANS also suppressed rhinorrhoea during the late phase and the influx of eosinophils in the lamina propria. Conclusion: Despite the high background of symptoms, allergic responses can be induced in this perennial rhinitis model. The VAS score seems most suited to detect these changes and the suppression of symptoms by 7 days of FPANS treatment. Epithelial eosinophilia at baseline was correlated positively with the severity of the reaction after the first provocation.
Published: 2005

47. Delirium in the Acute Phase After Stroke and the Role of the Apolipoprotein E Gene

Author: L.J. Kappelle, P. L. M. de Kort, Annemarie W. Oldenbeuving, C M van Duijn, Gerwin Roks, and Epidemiology
Subjects: Adult, Male, Apolipoprotein E, medicine.medical_specialty, Time Factors, Apolipoprotein E4, Population, behavioral disciplines and activities, Cohort Studies, Atrophy, Internal medicine, mental disorders, medicine, Humans, Genetic Predisposition to Disease, Prospective Studies, education, Stroke, Aged, Netherlands, Aged, 80 and over, education.field_of_study, business.industry, Incidence, Incidence (epidemiology), Delirium, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Psychiatry and Mental health, Anesthesia, Female, Geriatrics and Gerontology, medicine.symptom, business
Abstract: Objective: To study the association between the epsilon 4 allele of apolipoprotein E (APOE epsilon 4) and delirium in a stroke population. Methods: 527 consecutive stroke patients were screened for delirium during the first week of admission with the confusion assessment method. In three hundred fifty-three patients genomic DNA isolation was available. Results: The incidence of delirium after stroke in the 353 patients was 11.3%. There was no association between APOE epsilon 4 and delirium. Even after adjustment for IQCODE, stroke localization, stroke subtype, stroke severity, infection, and brain atrophy no association was found (odds ratio: 0.9; 95% confidence interval: 0.4-2.1). Delirium did not last longer in patients with an APOE epsilon 4 allele compared to patients without an APOE epsilon 4 allele (median: 5.6 days [range: 1-21] versus median: 4.6 days [range: 1-15], p = 0.5). Conclusion: There was no association between the presence of an APOE epsilon 4 allele and the occurrence of delirium in the acute phase after stroke.
Published: 2013

48. A patient with acute liver failure and extreme hypoglycaemia with lactic acidosis who was not in a coma: causes and consequences of lactate-protected hypoglycaemia

Author: Matthew L. Goodwin, G. Oldenbeuving, Dirk Reijngoud, R. Sayilir, James R. McDonald, L. B. Gladden, and Maarten W. N. Nijsten
Subjects: Blood Glucose, Male, medicine.medical_specialty, Brain damage, Critical Care and Intensive Care Medicine, chemistry.chemical_compound, Internal medicine, medicine, Humans, Lactic Acid, Acetaminophen, Coma, Glycogen, business.industry, Liver failure, Analgesics, Non-Narcotic, Liver Failure, Acute, Middle Aged, medicine.disease, Cori cycle, Hypoglycemia, Liver Transplantation, Anesthesiology and Pain Medicine, Endocrinology, Gluconeogenesis, chemistry, Lactic acidosis, Acidosis, Lactic, medicine.symptom, Energy source, business, Follow-Up Studies
Abstract: Lactate can substitute for glucose as a metabolic substrate. We report a patient with acute liver failure who was awake despite a glucose level of 0.7 mmol/l with very high lactate level of 25 mmol/l. The hypoglycaemia+hyperlactataemia combination may be considered paradoxical since glucose is the main precursor of lactate and lactate is reconverted into glucose by the Cori cycle. Literature relevant to the under-lying mechanism of combined deep hypoglycaemia and severe hyperlactataemia was assessed. We also assessed the literature for evidence of protection against deep hypoglycaemia by hyperlactataemia. Four syndrome demonstrating hypoglycaemia + hyperlactataemia were found: 1) paracetamol-induced acute liver failure, 2) severe malaria, 3) lymphoma and 4) glucose-6-phosphatase deficiency. An impaired Cori cycle is a key component in all of these metabolic states. Apparently the liver, after exhausting its glycogen stores, loses the gluconeogenic pathway to generate glucose and thereby its ability to remove lactate as well. Several patients with lactic acidosis and glucose levels below 1.7 mmol/l who were not in a coma have been reported. These observations and other data coherently indicate that lactate-protected hypoglycaemia is, at least transiently, a viable state under experimental and clinical conditions. Severe hypoglycaemia+hyperlactataemia reflects failure of the gluconeogenic pathway of lactate metabolism The existence of lactate-protected hypoglycaemia implies that patients who present with this metabolic state should not automatically be considered to have sustained irreversible brain damage. Moreover, therapies that aim to achieve hypoglycaemia might be feasible with concomitant hyperlactataemia.
Published: 2014

49. CRIT-Alternative narrow-passband waveguide filter for microwave photonic signal processors

Author: Chris G. H. Roeloffzen, Ruud M. Oldenbeuving, Klaus J. Boller, Leimeng Zhuang, Marcel Hoekman, Laser Physics & Nonlinear Optics, and Faculty of Science and Technology
Subjects: Physics, Waveguide filter, Silicon photonics, EWI-24888, business.industry, Bandwidth (signal processing), Reconfigurability, Physics::Optics, Atomic and Molecular Physics, and Optics, Electronic, Optical and Magnetic Materials, Resonator, Optics, Band-pass filter, IR-91420, Optoelectronics, METIS-299712, Electrical and Electronic Engineering, Optical filter, business, Passband
Abstract: This letter presents a novel use of a waveguide circuit consisting of a two-ring resonator-assisted asymmetrical Mach-Zehnder interferometer, which realizes a narrow-passband filter in the context of microwave photonics (MWP). The filter principle is an alternative to the coupled resonator induced transparency and features easy implementation and robust performance. In the experimental demonstration, such a circuit fabricated in SiO2/Si3N4 waveguide technology exhibits a narrow transmission window surrounded by a region of significant suppression. The transmission window features a -3-dB bandwidth of 1 GHz and a -20-dB bandwidth of 3.5 GHz, equivalently a 20-dB roll-off enhancement of three times as compared with a regular add-drop ring resonator. In addition, the investigated waveguide circuit features full reconfigurability based on tunable phase shifters and power couplers. This allows the proposed filter functionality to be combined with other functionalities in a common device, which is of high interest for the realization of flexible on-chip MWP signal processors.
Published: 2014

50. A hybrid semiconductor-glass waveguide laser

Author: Fan, Youwen, Oldenbeuving, Ruud, Klein, Edwin J., Lee, Chris J., Song, Hong, Khan, Muhammed R.H., Offerhaus, Herman L., van der Slot, Peter J.M., Boller, Klaus-J., Mackenzie, J.I., Jelinkova, H., Taira, T., Ahmed, M.A., Faculty of Science and Technology, Laser Physics & Nonlinear Optics, and Optical Sciences
Subjects: tunable laser, Materials science, 02 engineering and technology, 01 natural sciences, law.invention, 010309 optics, narrow linewidth, Laser linewidth, 020210 optoelectronics & photonics, Optics, law, Wavelength-division multiplexing, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Laser power scaling, Optical amplifier, Distributed feedback laser, business.industry, external feedback, Far-infrared laser, semiconductor, Laser, glass waveguide, microring resonator, Optoelectronics, business, Tunable laser
Abstract: We report on a novel type of laser in which a semiconductor optical amplifier (SOA) receives frequency-selective feedback from a glass-waveguide circuit. The laser we present here is based on InP for operation in the 1.55 μm wavelength range. The Si3N4/SiO2 glass waveguide circuit comprises two sequential high-Q ring resonators. Adiabatic tapering is used for maximizing the feedback. The laser shows single-frequency oscillation with a record-narrow spectral linewidth of 24 kHz at an output power of 5.7 mW. The hybrid laser can be tuned over a broad range of 46.8 nm (1531 nm to 1577.8 nm). Such InP-glass hybrid lasers can be of great interest in dense wavelength division multiplexing (DWDM) and as phase reference in optical beam-forming networks (OBFN). The type of laser demonstrated here is also of general importance because it may be applied over a huge wavelength range including the visible, limited only by the transparency of glass (400 nm to 2.35 μm). © (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Published: 2014

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