BACKGROUND: Estimates for dead space ventilation have been shown to be independently associated with an increased risk of mortality in the acute respiratory distress syndrome and small case series of COVID-19-related ARDS.METHODS: Secondary analysis from the PRoVENT-COVID study. The PRoVENT-COVID is a national, multicenter, retrospective observational study done at 22 intensive care units in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The aim was to quantify the dynamics and determine the prognostic value of surrogate markers of wasted ventilation in patients with COVID-19-related ARDS.RESULTS: A total of 927 consecutive patients admitted with COVID-19-related ARDS were included in this study. Estimations of wasted ventilation such as the estimated dead space fraction (by Harris-Benedict and direct method) and ventilatory ratio were significantly higher in non-survivors than survivors at baseline and during the following days of mechanical ventilation (p < 0.001). The end-tidal-to-arterial PCO2 ratio was lower in non-survivors than in survivors (p < 0.001). As ARDS severity increased, mortality increased with successive tertiles of dead space fraction by Harris-Benedict and by direct estimation, and with an increase in the VR. The same trend was observed with decreased levels in the tertiles for the end-tidal-to-arterial PCO2 ratio. After adjustment for a base risk model that included chronic comorbidities and ventilation- and oxygenation-parameters, none of the dead space estimates measured at the start of ventilation or the following days were significantly associated with 28-day mortality.CONCLUSIONS: There is significant impairment of ventilation in the early course of COVID-19-related ARDS but quantification of this impairment does not add prognostic information when added to a baseline risk model.TRIAL REGISTRATION: ISRCTN04346342. Registered 15 April 2020. Retrospectively registered.
MULTIFILE
BACKGROUND: Estimates for dead space ventilation have been shown to be independently associated with an increased risk of mortality in the acute respiratory distress syndrome and small case series of COVID-19-related ARDS.METHODS: Secondary analysis from the PRoVENT-COVID study. The PRoVENT-COVID is a national, multicenter, retrospective observational study done at 22 intensive care units in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The aim was to quantify the dynamics and determine the prognostic value of surrogate markers of wasted ventilation in patients with COVID-19-related ARDS.RESULTS: A total of 927 consecutive patients admitted with COVID-19-related ARDS were included in this study. Estimations of wasted ventilation such as the estimated dead space fraction (by Harris-Benedict and direct method) and ventilatory ratio were significantly higher in non-survivors than survivors at baseline and during the following days of mechanical ventilation (p < 0.001). The end-tidal-to-arterial PCO2 ratio was lower in non-survivors than in survivors (p < 0.001). As ARDS severity increased, mortality increased with successive tertiles of dead space fraction by Harris-Benedict and by direct estimation, and with an increase in the VR. The same trend was observed with decreased levels in the tertiles for the end-tidal-to-arterial PCO2 ratio. After adjustment for a base risk model that included chronic comorbidities and ventilation- and oxygenation-parameters, none of the dead space estimates measured at the start of ventilation or the following days were significantly associated with 28-day mortality.CONCLUSIONS: There is significant impairment of ventilation in the early course of COVID-19-related ARDS but quantification of this impairment does not add prognostic information when added to a baseline risk model.TRIAL REGISTRATION: ISRCTN04346342. Registered 15 April 2020. Retrospectively registered.
MULTIFILE
We are at the start of the research group ‘Entrepreneurship in Transition’,which is an initiative of Hanze University of Applied Sciences andAlfa-college to conduct research and valorise knowledge about therelationship between entrepreneurship and education, entrepreneurialsuccess factors, retail and succession.In the research group, students of vocational education (mbo), university ofapplied sciences (hbo), staff and other partners involved, study the dynamics ofentrepreneurship in the northern region of the Netherlands. Our goal is to contribute to a sustainable social, cultural and economic healthy region through research and practises. An important parameter for the research group is the concept of explorative space. In short is this a space where people and organisations are encouraged and welcomed to explore their potentialities and find ways to actualise them. This booklet is written as a metaphorical travel journey, it shows how the research group will move in the years to come. I present the crew, the vision and the ways we work. The last months have been busy, since we have already prepared and started this shared journey. During our preparations, we have made initial choices about travel companions , potential routes, visions on the trip, and the work ahead. Naturally, theteam will make alterations, variations, and harmonisations over the course of the trip.
The AR in Staged Entertainment project focuses on utilizing immersive technologies to strengthen performances and create resiliency in live events. In this project The Experiencelab at BUas explores this by comparing live as well as pre-recorded events that utilize Augmented Reality technology to provide an added layer to the experience of the user. Experiences will be measured among others through observational measurements using biometrics. This projects runs in the Experience lab of BUas with partners The Effenaar and 4DR Studio and is connected to the networks and goals related to Chronosphere, Digireal and Makerspace. Project is powered by Fieldlab Events (PPS / ClickNL)..
The latest IPCC Report (2022) provided by the UN shows us that, to guarantee a safe future for upcoming generations, we must change how we lead our lives on several levels. However, the increasing urgency to act and behave in a way that is not damaging the climate is bringing many psychological concerns to young generations. Worldwide reports are demonstrating how the issue of eco-anxiety is increasing daily, and how young people are feeling more hopeless than ever. Climate change has become a climate crisis, and individuals are experiencing pressure and fear incessantly (Marks et al., 2021). We, as Climate Streamers, have often found ourselves in this situation as well, but rather than freezing, we decided to take this challenge and think of solutions. Therefore, with the support of Breda University of Applied Sciences, the Performatory community, the BUas Startup Support Team, and outside mentors, we created Climate Streamers Foundation: a new youth-led non-profit organisation and a movement working towards a more inclusive and less polarised climate action. By working with leisure elements and a positive and appreciative approach, we want to give back hope, voice and power to the youth and inspire each other genuinely and sustainably. The purpose of this application is to allow us to elaborate a feasibility study concerning our MVP (minimum viable product), the card game, and boost the overall concept. We intend to implement the researched data to improve the design and sales management. The card game aims to stimulate appreciative conversations by giving space to players to express their opinions and personal stories and it is designed so everyone can play it, regardless of background and knowledge. After giving 200 games in production, we launched the card game in July 2022.
DISCO aims at fast-tracking upscaling to new generation of urban logistics and smart planning unblocking the transition to decarbonised and digital cities, delivering innovative frameworks and tools, Physical Internet (PI) inspired. To this scope, DISCO will deploy and demonstrate innovative and inclusive urban logistics and planning solutions for dynamic space re-allocation integrating urban freight at local level, within efficiently operated network-of-networks (PI) where the nodes and infrastructure are fixed and mobile based on throughput demands. Solutions are co-designed with the urban logistics community – e.g., cities, logistics service providers, retailers, real estate/public and private infrastructure owners, fleet owners, transport operators, research community, civil society - all together moving a paradigm change from sprawl to data driven, zero-emission and nearby-delivery-based models.
