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This article deals with the transnational relations between Moluccans in the Netherlands and the Moluccas. Former Moluccan colonial soldiers and their families were forced to go to the Netherlands because of political developments in Indonesia after the transfer of sovereignty in 1949. They hoped to return soon to an independent South Moluccan Republic but, more than seventy years later, they still live in the Netherlands. This article first describes how and why Moluccans came to the Netherlands and began to build a community. At the very beginning, the foundations for a transnational relationship were laid through village-based organizations and political organizations. After decades living in exile, the political dimension of the transnational relation assumed great prominence for most Moluccans, later to make place for a more varied transnational relation. The political ideal changed and its priority on the Moluccan “public agenda” dropped until in 1999 a new conflict flared up in the Moluccas. A renewed, altered political transnational relation emerged. The transnational relationship also simultaneously developed in more diverse ways, via development projects, cultural exchange, and the like. By this time, the position of Moluccans in the Moluccas in this transnational relation had also changed.

Epidermolytic ichthyosis (EI) is a type of congenital ichthyosis, characterized by erythema and blistering at birth followed by hyperkeratosis. EI is caused by pathogenic variants in the genes KRT1 and KRT10, encoding the proteins keratin 1 (KRT1) and keratin 10 (KRT10), respectively, and is primarily transmitted by autosomal‐dominant inheritance, although recessive inheritance caused by nonsense variants in KRT10 is also described. The keratins form a network of intermediate filaments and are a structural component of the cytoskeleton, giving strength and resilience to the skin. We present three cases of mild EI caused by pathogenic KRT10 variations in the L12 linker domain. To our knowledge, this is the first time L12 linker domain pathogenic variants are identified in KRT10 for EI. The aim of this study was to identify gene variants for patients with EI in KRT1 or KRT10. To establish the pathogenicity of the found variations in KRT10, we evaluated all patients and available family members clinically. Genetic analyses were performed using Sanger sequencing. Vectors containing wild‐type or mutated forms of KRT10 were transfected into HaCaT cells and analyzed by high‐resolution confocal microscopy. Genetic analysis of KRT10 identified a heterozygous de novo variant c.910G>A p.(Val304Met) in family 1, a familial heterozygous variant c.911T>C p.(Val304Ala) in family 2, and a familial heterozygous variant c.917T>C p.(Met306Thr) in family 3. All identified missense variants were located in the L12 linker domain of KRT10. In vitro study of aggregate formation of the missense variants in KRT10 only showed a very mild and not quantifiable aggregate formation in the KRT10 network, compared with the wild‐type sequence. We report three different novel missense variants in the L12 linker domain of KRT10 in patients with an atypical, milder form of EI resembling peeling skin syndrome. [ABSTRACT FROM AUTHOR]

One of the major challenges associated with e-textiles is the connection between flexible fabric-integrated wires and rigid electronics. This work aims to increase the user experience and mechanical reliability of these connections by foregoing conventional galvanic connections in favor of inductively coupled coils. The new design allows for some movement between the electronics and the wires, and it relieves the mechanical strain. Two pairs of coupled coils continuously transmit power and bidirectional data across two air gaps of a few millimeters. A detailed analysis of this double inductive link and associated compensation network is presented, and the sensitivity of the network to changing conditions is explored. A proof of principle is built that demonstrates the system’s ability to self-tune based on the current–voltage phase relation. A demonstration combining 8.5 kbit/s of data transfer with a power output of 62 mW DC is presented, and the hardware is shown to support data rates of up to 240 kbit/s. This is a significant improvement of the performance of previously presented designs.

Abstract Background The substitution of healthcare is a way to control rising healthcare costs. The Primary Care Plus (PC+) intervention of the Dutch ‘Blue Care’ pioneer site aims to achieve this feat by facilitating consultations with medical specialists in the primary care setting. One of the specialties involved is dermatology. This study explores referral decisions following dermatology care in PC+ and the influence of predictive patient and consultation characteristics on this decision. Methods This retrospective study used clinical data of patients who received dermatology care in PC+ between January 2015 and March 2017. The referral decision following PC+, (i.e., referral back to the general practitioner (GP) or referral to outpatient hospital care) was the primary outcome. Stepwise logistic regression modelling was used to describe variations in the referral decisions following PC+, with patient age and gender, number of PC+ consultations, patient diagnosis and treatment specialist as the predicting factors. Results A total of 2952 patients visited PC+ for dermatology care. Of those patients with a registered referral, 80.2% (N = 2254) were referred back to the GP, and 19.8% (N = 558) were referred to outpatient hospital care. In the multivariable model, only the treating specialist and patient’s diagnosis independently influenced the referral decisions following PC+. Conclusion The aim of PC+ is to reduce the number of referrals to outpatient hospital care. According to the results, the treating specialist and patient diagnosis influence referral decisions. Therefore, the results of this study can be used to discuss and improve specialist and patient profiles for PC+ to further optimise the effectiveness of the initiative.

Abstract Sjögren‐Larsson syndrome (SLS) is a rare inborn error of lipid metabolism. The syndrome is caused by mutations in the ALDH3A2 gene, resulting in a deficiency of fatty aldehyde dehydrogenase. Most patients have a clearly recognizable severe phenotype, with congenital ichthyosis, intellectual disability, and spastic diplegia. In this study, we describe two patients with a remarkably mild phenotype. In both patients, males with actual ages of 45 and 61 years, the diagnosis was only established at an adult age. Their skin had been moderately affected from childhood onward, and both men remained ambulant with mild spasticity of their legs. Cognitive development, as reflected by school performance and professional career, had been unremarkable. Magnetic resonance spectroscopy of the first patient was lacking the characteristic lipid peak. We performed a literature search to identify additional SLS patients with a mild phenotype. We compared the clinical, radiologic, and molecular features of the mildly affected patients with the classical phenotype. We found 10 cases in the literature with a molecular proven diagnosis and a mild phenotype. Neither a genotype‐phenotype correlation nor an alternative explanation for the strikingly mild phenotypes was found. New biochemical techniques to study the underlying metabolic defect in SLS, like lipidomics, may in the future help to unravel the reasons for the exceptionally mild phenotypes. In the meantime, it is important to recognize these mildly affected patients to provide them with appropriate care and genetic counseling, and to increase our insights in the true disease spectrum of SLS.

Abstract Schnitzler’s syndrome is an auto-inflammatory disorder which is characterized by two mandatory features: an urticarial rash and a monoclonal gammopathy. Although the pathophysiology of this syndrome is not yet fully understood, a role for interleukin-1 seems apparent. While this presumed link between interleukin-1 and the monoclonal gammopathy is not yet elucidated, a mutual factor in pathophysiology however seems likely. Here we present a novel hypothesis of a shared pathophysiologic mechanism between Schitzler’s syndrome and monoclonal gammopathy.

This article presents a novel smart sensor garment with integrated miniaturized inertial measurements units (IMUs) that can be used to monitor lower body kinematics during daily training activities, without the need of extensive technical assistance throughout the measurements. The smart sensor tights enclose five ultra-light sensor modules that measure linear accelerations, angular velocities, and the earth magnetic field in three directions. The modules are located at the pelvis, thighs, and shanks. The garment enables continuous measurement in the field at high sample rates (250 Hz) and the sensors have a large measurement range (32 g, 4,000°/s). They are read out by a central processing unit through an SPI bus, and connected to a centralized battery in the waistband. A fully functioning prototype was built to perform validation studies in a lab setting and in a field setting. In the lab validation study, the IMU data (converted to limb orientation data) were compared with the kinematic data of an optoelectronic measurement system and good validity (CMCs >0.8) was shown. In the field tests, participants experienced the tights as comfortable to wear and they did not feel restricted in their movements. These results show the potential of using the smart sensor tights on a regular base to derive lower limb kinematics in the field.

This article discusses two cases of palmoplantar keratoderma, a skin condition characterized by thickened and hardened skin on the palms and soles. The patients presented with linear distribution of verrucous and keratotic plaques on their hands, feet, and other areas of the body. Genetic analysis revealed pathogenic variants in the HRAS gene, which is associated with various skin disorders. The article suggests that the clinical presentation of HRAS-associated nevus (HAN) can vary widely, from isolated linear palmoplantar keratoderma to widespread lesions covering the skin in a mosaic pattern. [Extracted from the article]

BackgroundCardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. Early diagnosis is of pivotal importance for patients with cardiac arrhythmias and ischemia to minimize the consequences like strokes and myocardial infarctions. The chance of capturing signals of arrhythmias or ischemia is substantially high when a 12-lead electrocardiogram (ECG) can be recorded at the moment when a patient experiences the symptoms. However, until now, available diagnostic systems (Holter monitors and other wearable ECG sensors) have not enabled patients to record a reliable 12-lead ECG at home. ObjectiveThe objective of this project was to develop a user-friendly system that enables persons with cardiac complaints to record a reliable 12-lead ECG at home to improve the diagnostic process and, consequently, reduce the time between the onset of symptoms and adequate treatment. MethodsUsing an iterative design approach, ECGraph was developed. The system consists of an ECG measurement system and a mobile app, which were developed with the help of several concept tests. To evaluate the design, a prototype of the final design was built and a final technical performance test and usability test were executed. ResultsThe ECG measurement system consists of a belt and 4 limb straps. Ten wet Ag/AgCl electrodes are placed in the belt to optimize skin-electrode contact. The product is controlled via an app on the mobile phone of the user. Once a person experiences symptoms, he or she can put on the belt and record ECGs within a few minutes. Short instructions, supported by visualizations, offer guidance during use. ECGs are sent wirelessly to the caregiver, and the designated expert can quickly interpret the results. Usability tests with the final prototype (n=6) showed that the participants were able to put on the product within 8 minutes during first-time use. However, we expect that the placement of the product can be executed faster when the user becomes more familiar with the product. Areas of improvement focus mainly on confidence during product use. In the technical performance test, a 12-lead ECG was made and reproduced 6 times. ConclusionsWe developed a new 12-lead ECG system for home use. The product is expected to be more user-friendly than current hospital ECG systems and is designed to record more reliable data than current ECG systems for home use, which makes it suitable for expert interpretation. The system has great potential to be incorporated into an outpatient practice, so that arrhythmias and ischemia can be diagnosed and treated as early as possible.

This article explores post-colonial memories about street traders among individuals who lived in the former colony of the Dutch East Indies. It argues that these narratives romanticize the relationship between Europeans and indigenous peoples. Street vendors are also used to differentiate between periods within colonial and post-colonial history. The nostalgic representation of interracial contact between Europeans and traders is contrasted with representations of other figures such as the Japanese and the nationalist. A recurring feature of these representations is the ability of Europeans to speak with street traders and imagine what they wanted and needed. The traders are remembered as a social type that transgressed politics and represented the neutrality of the economic sphere as a place for shared communication. The article concludes that the figure of the street vendor contributes to the nostalgic reinvention of the colony but is also used in narratives to differentiate between and mark changes across the colonial and post-colonial periods.

Recognition of the war experience in Southeast Asia in the Netherlands was not easy. The Indisch community, those who had to leave the Netherlands East Indies after decolonization, did not feel that their war experience was accepted. Following the story of one man, a former POW, this article shows how unorthodox ways of protesting were used to command respect and acknowledgement. The arena for these actions was not only the Indisch monument in the Netherlands, but also the War cemetery in Thailand. The former Dutch POW ended up in a dispute with the Australian caretaker of that cemetery over the specific location of a camp. Both men, however, were motivated by the same urge to find the exact locations of camps along the Burma railway. The story of this POW shows how important official recognition is on a personal level.