Dutch Population Research Articles

Primary postpartum hemorrhage in women with von Willebrand disease and carriers of hemophilia: a retrospective analysis

BackgroundBetween 2002 and 2011, the incidence of severe primary postpartum hemorrhage (PPH) in Dutch women with von Willebrand disease (VWD) and hemophilia carriers (HCs) was 8% vs 4.5% in the general population. ObjectivesTo determine the contemporary incidence of severe primary PPH in women with VWD and HCs. MethodsAll women with VWD or HCs who delivered between 2012 and 2017 were selected from all 6 Dutch hemophilia treatment centers. Data on patient and disease characteristics, peripartum hematologic and obstetric management, and outcomes were retrospectively collected. Incidence of severe primary (≥1000 mL of blood loss ≤24 hours after childbirth) and primary (≥500 mL within ≤24 hours after childbirth) PPH was compared with the (1) previous cohort and (2) general Dutch population and between (3) women with VWD and HCs with third-trimester coagulation activity levels <50 international units (IU)/dL vs ≥50 IU/dL and (4) women treated with vs without peripartum hemostatic prophylaxis. ResultsThree-hundred forty-eight deliveries (151 VWD, 167 hemophilia A, and 30 hemophilia B carriers) were included. The severe primary PPH incidence was 10% (36/348) and remained stable over time, whereas this incidence has increased in the general population (to 8%), leading to a similar risk (P = .17). Severe primary PPH risk was comparable between women with coagulation activity levels <50 and ≥50 IU/dL (11% [7/66] vs 10% [29/279]; odds ratio, 1.02; 95% CI, 0.43-2.44) and comparable between those with and those without prophylaxis (12% [11/91] vs 10% [25/254]; odds ratio, 1.26; 95% CI, 0.59-2.68). ConclusionSevere primary PPH in women with VWD and HCs remained stable and is comparable with the increasing prevalence in the general population. More research is needed to find the optimal pregnancy management strategy for safe delivery in VWD and HC.

The impact of baseline health factors on second primary cancer risk after radiotherapy for prostate cancer.

In evaluating second primary cancers (SPCs) following External Beam Radiotherapy (EBRT), the role of lifestyle factors is frequently not considered due to data limitations. We investigated the association between smoking, comorbidities, and SPC risks within EBRT-treated patients for localized prostate cancer (PCa). The study included 1,883 PCa survivors aged 50-79, treated between 2006 and 2013, with intensity-modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3D-CRT). Clinical data were combined with SPC and survival data from the Netherlands Cancer Registry with a 12-month latency period. Standardized Incidence Ratios (SIRs) were calculated comparing the EBRT cohort with the general Dutch population. To explore the effect of patient and treatment characteristics on SPCs we conducted a Cox regression analysis. Lastly, we estimated cumulative incidences of developing solid SPC, pelvis SPC, and non-pelvis SPC using a competing risk analysis. Significantly increased SIRs were observed for all SPC (SIR = 1.21, 95% confidence interval [CI]: 1.08-1.34), pelvis SPC (SIR = 1.46, 95% CI: 1.18-1.78), and non-pelvis SPC (SIR = 1.18, 95% CI [1.04-1.34]). Smoking status was significantly associated with pelvic and non-pelvic SPCs. Charlson comorbidity index (CCI) ≥ 1 (Hazard Ratio [HR] = 1.45, 95% CI: 1.10-1.91), cardiovascular disease (HR = 1.41, 95% CI: 1.05-1.88), and chronic obstructive pulmonary disease (COPD) (HR = 1.91, 95% CI: 1.30-2.79) were significantly associated with non-pelvis SPC. The proportion of active smoking numbers in the cohort was similar to the general population. We conclude that the presence of comorbidities in the EBRT population might be a relevant factor in observed excess non-pelvis SPC risk, but not for excess pelvis SPC risk.

Smart Devices Require Skilled Users: Home Automation Performance Tests among the Dutch Population

The benefits obtained from home automation are promising and will become more pronounced as smart home technologies continue to develop. To achieve benefits, users require operational, data, and strategic skills to control and automate smart devices, retrieve and understand collected data, and make informed decisions. These skills were tested by providing assignments in a virtual test environment to 100 Dutch adult participants. The assignments were designed to measure different facets of all skills by using the functions, data, and automations of smart home devices. The results suggest that the Dutch adult population is not sufficiently skilled in using the smart home to its full potential; several skills related problems occurred in the tests. Furthermore, in terms of gender, age, and education, home automation further reinforces existing social-digital inequalities. Thus, earlier digital inequalities will remain present for some time, despite increasing device autonomy.

Sleep, event appraisal, and affect: An ecological momentary assessment study

BackgroundAppraisal theory posits that emotions result from cognitive appraisals of events and situations. Experimental work suggests that sleep influences cognitive processes and event appraisal, which the present study examines in real life. Poor sleep influences brain regions involved in the appraisal-to-emotion process, and tired participants showed more conservative appraisal and reported less positive and more negative affect. In the present study, we tested whether sleep duration and/or quality predicted more pleasant event appraisal and whether sleep moderated the association between event appraisal and affect. MethodsParticipants (N = 892) from the general Dutch population reported thrice daily on event appraisal and various emotions for 30 days and once daily on sleep duration and quality. We constructed multilevel models to account for the nested structure of our data (observations within participants). ResultsMultilevel regression analyses showed that on days when participants reported having slept longer and better than their average, their event appraisal was more positive. Subjective sleep duration and quality did not influence the relationship between event appraisal and affect. Hence, poor sleep predicted changes in cognitive functioning, as people appraised situations as more unpleasant. LimitationsWe measured subjective sleep duration and quality with two single items and focused on only pleasantness dimension of event appraisal. ConclusionsResults match perspectives on emotions as multicomponent systems involving appraisal processes. Understanding the elements of event appraisal may help unravel the detrimental effects of poor sleep on mental health and well-being.

Increased risk of atrial fibrillation with low cardiovascular health: life essential 8 in a dutch population

Abstract Introduction The American Heart Association (AHA) introduced the concept of Life’s Essential 8 (LE8) to measure and monitor cardiovascular health (CVH) to prevent cardiovascular diseases. Purpose This study examined the association between LE8 and the incidence of atrial fibrillation (AF). Methods In total, 37,807 participants from the population-based European Prospective Investigation Into Cancer and Nutrition-Netherlands (EPIC-NL) cohort were included. The components diet, physical activity, sleep health, nicotine exposure, body mass index, blood glucose, blood lipids, blood pressure were all given a score between 0 and 100 and an overall LE8 score was created by averaging the component scores. The overall LE8 score was categorized into low cardiovascular health (CVH, 0-49), moderate CVH (50-79), and high CVH (80-100). AF cases were obtained through linkage with registries. A Cox proportional hazards model adjusted for age, sex, education level, heart failure, coronary heart disease, and alcohol consumption, was used to assess the association between LE8 and AF. Results The mean age of participants was 49 years ± 12 years and 75% of participants were female. During a median follow-up of 15.3 years (interquartile range: 14.1 – 26.5 years), 833 AF cases (2.3%) were identified. Compared to the participants with a high CVH score (19.5%), participants with a low CVH score (5%) had a 2 times higher hazard for incident AF (hazard ratio (HR) 1.99 [95% confidence interval (95%CI) 1.49 – 2.65]). Furthermore, a decrease in the number of ideal components was associated with a higher risk for incident AF (HR 1.11 [95%CI 1.05 – 1.18]). Conclusions The results show that a worse CVH, indicated by a lower LE8 score, is associated with an increased risk for incident AF. Preventing AF could potentially be achieved by implementing the LE8 score in clinical practice. Especially since LE8 is a tool that is easy to interpret and can be applied by healthcare providers to encourage patients to make improvements in the risk factors for AF.

Contributions of causes of death to differentials in life expectancy by internal migrant status in the Netherlands. A population register based study, 2015–2019

Important health differences exist in the context of international migration and residential mobility. Less is known about health differences regarding the medium-distance level of internal migration. This study examines life expectancy gaps between internal movers and stayers in the Netherlands and their underlying processes by assessing the contribution of different causes of death by age and sex. It uses individually-linked death counts and population exposures extracted from population registers, covering the native Dutch population aged 10+ from 2015 to 2019. The pooled data were disaggregated by causes-of-death group (neurodegenerative diseases, cardiovascular diseases, lifestyle-related mortality, external causes, and other causes), internal migrant status (movers and stayers, based on past 10-year residence in the 40 NUTS-3 [Nomenclature of Territorial Units for Statistics, level 3] regions), age, and sex. Comparing movers and stayers, we computed life expectancy at age 10 (e10), age- and cause-specific mortality risks, and applied decomposition methods to assess contributions of causes of death to e10 gaps. In the Netherlands in 2015–2019, e10 was lower for movers between NUTS-3 regions than stayers (males: 2.49 years; females: 3.51 years), due to excess mortality for movers at most ages. Movers only had a lower mortality than stayers at younger working ages (males: ages 20–44; females: ages 20–34). Mortality from neurodegenerative diseases and cardiovascular diseases were the largest contributors to the e10 gap, especially at ages 75+ and for females. Mortality from lifestyle-related and external causes of death contributed less, with the largest contributions for females aged 75–89 and males aged 45–69. The lower e10 of movers in the Netherlands is likely explained by health selection effects–in particular care-related moves as coping behaviour–rather than by causal effects through risk accumulation. Research focusing on regional or spatial heterogeneity of the mover-stayer health gap would be insightful to further understand these processes.

Social inequality and body mass differences in two post‐Medieval Dutch populations

AbstractAdult body mass is largely related to nutrition levels, which can be affected by external stressors, such as diet, environment, and disease. High‐status and low‐status groups likely had very different nutrition and stress experiences, which might result in differences in population's body mass. Since inequality between social statuses prevailed in Europe in the post‐Medieval period, did these differences result in body mass variations between high‐status and low‐status populations in the Netherlands? In order to answer this question, this research compared body size of two post‐Medieval urban skeletal collections with different social statuses from the Eusebius cemetery of two cemeteries of the 17th–19th centuries: the Arnhem and the Broerenkerk church of Zwolle, the Netherlands. Social statuses of the two collections are estimated based on the burial locations, grave goods, and historical records. Body mass was estimated using both femoral head diameter method and stature/bi‐iliac breadth method. Results have shown no statistically significant differences in body mass between the two samples. Therefore, this research suggests that inequality in post‐Medieval Dutch society did not result in observable population body mass differences in the skeletal collections of different social status groups. It cannot, however, prove that social inequality in populations did not impact body size or health more broadly.

SARS-CoV-2 Seroprevalence Trends in the Netherlands in the Variant of Concern Era: Input for Future Response.

To inform future response planning we aimed to assess SARS-CoV-2 trends in infection- and/or vaccine-induced immunity, including breakthrough infections, among (sub)groups, professions and regions in the Dutch population during the Variant of Concern (VOC)-era. In this prospective population-based cohort, randomly selected participants (n = 9985) aged 1-92 years (recruited early-2020) donated home-collected fingerstick-blood samples at six timepoints in 2021/2022, covering waves dominated by Alpha, Delta, and multiple Omicron (sub-)variants. IgG antibody assessment against Spike-S1 and Nucleoprotein was combined with vaccination- and testing data to estimate infection-induced (inf) and total (infection- and vaccination-induced) seroprevalence. Nationwide inf-seroprevalence rose modestly from 12% (95% CI 11-13) since Alpha to 26% (95% CI 24-28) amidst Delta, while total seroprevalence increased rapidly to 87% (95% CI 85-88), particularly in elderly and those with comorbidities (i.e., vulnerable groups). Interestingly, highest infection rates were noticeable among low/middle educated elderly, non-Western, those in contact professions, adolescents and young adults, and in low-vaccination coverage regions. Following Omicron emergence, inf-seroprevalence elevated sharply to 62% (95% CI 59-65) and further to 86% (95% CI 83-90) in late-2022, with frequent breakthrough infections and decreasing seroprevalence dissimilarities between most groups. Whereas > 90% of < 60-year-olds had been infected at least once, 30% of vaccinated vulnerable individuals had still not acquired hybrid immunity. Groups identified to have been infected disproportionally during the acute phase of the pandemic require specific attention in evaluation of control measures and future response planning worldwide. Furthermore, ongoing tailored vaccination efforts and (sero-)monitoring of vulnerable groups may remain important.

Cancer risks for other sites in addition to breast in CHEK2 c.1100delC families

PurposeFemale CHEK2 c.1100delC heterozygotes are eligible for additional breast surveillance because of an increased breast cancer risk. Increased risks for other cancers have been reported. We studied whether CHEK2 c.1100delC is associated with an increased risk for other cancers within these families. MethodsIncluding 10,780 individuals from 609 families, we calculated standardized incidence rates (SIRs) and absolute excess risk (AER, per 10,000 person-years) by comparing first-reported cancer derived from the pedigrees with general Dutch population rates from 1970 onward. Attained-age analyses were performed for sites in which significant increased risks were found. Considering the study design, we primarily focused on cancer risk in women. ResultsWe found significant increased risks of colorectal cancer (CRC; SIR = 1.43, 95% CI = 1.14-1.76; AER = 1.43) and hematological cancers (SIR = 1.32; 95% CI = 1.02-1.67; AER = 0.87). CRC was significantly more frequent from age 45 onward. ConclusionA significantly increased risk of CRC, and hematological cancers in women was found, starting at a younger age than expected. Currently, colorectal surveillance starts at age 45 in high-risk individuals. Our results suggest that some CHEK2 c.1100delC families might benefit from this surveillance as well; however, further research is needed to determine who may profit from this additional colorectal surveillance.

Mandatory activation of welfare recipients: Less time, less crime?

This paper investigates the effect of a mandatory activation program on crime. Although the effects of ALMPs on labor market outcomes are often assessed, theorized effects on crime are seldom analyzed. We exploit age-based policy variation and estimate a regression discontinuity model, using individual-level administrative data on the entire Dutch population around a 27-year-old age threshold. The results show a 12% reduction in crime among non-natives, a relatively vulnerable group. Our findings suggest that crime is mainly reduced on weekdays, which points towards incapacitation as the underlying causal mechanism. Due to program participation, individuals have less time to commit crime.

Extreme genetic depletion upon postglacial colonization hampers determining the provenance of introduced palmate newt populations

Abstract MtDNA barcoding is regularly applied to determine the provenance of invasive species. Variation in spatial genetic structuring across a species’ range, typically high within glacial refugia and low in postglacially colonized areas, influences the precision of this approach. The palmate newt (Lissotriton helveticus) has been introduced north of its native range inside the Netherlands. We conduct mtDNA barcoding to try and retrace the origin of the introduced localities. A large increase in sample size, particularly focusing on temperate Europe, emphasizes that the palmate newt shows practically no genetic variation outside the Iberian Peninsula glacial refugium. While we find a haplotype previously only known from the Iberian Peninsula inside the native range in Belgium, the haplotype present in the introduced Dutch populations occurs widely throughout the native range north of the Iberian Peninsula. Although mtDNA barcoding can be a powerful tool in invasion biology, the palmate newt case exposes its limitations.

Translocated wild birds are predisposed to learn songs of their ancestral population

Population differences in socially learned mating signals like oscine birdsong are particularly vulnerable to breakdown through dispersal.1 Despite this challenge, geographic variation in learned signals is ubiquitous.2 A proposed explanation for this pattern is that birds express predispositions to selectively learn and produce population-typical songs.3,4,5 While experimental studies on lab-reared birds have shown the existence of within-species learning predispositions,6,7,8,9,10 it remains unclear whether and how learning predispositions influence song acquisition in the wild. Here, we investigated innate song learning predispositions in wild pied flycatchers (Ficedula hypoleuca) by measuring the songs of individuals translocated as eggs from a Dutch population to a breeding population in Sweden. We compared the songs of the adult males hatched from these translocated eggs with those from the ancestral and receiving populations. Songs of translocated males closely resemble the local Swedish songs to which they were exposed during development, supporting the importance of social learning. However, translocated males selectively learned those local Swedish song elements that sound the most "Dutch-like." As a result, their songs are significantly shifted toward those of the ancestral Dutch population. This suggests that innate learning predispositions track ongoing song evolution in wild populations of pied flycatchers. We propose that as songs continue to diverge over time, this coevolutionary relationship between song and learning predispositions may contribute to the emergence of incipient pre-mating barriers.

Filling the EU information deficit mitigates negative EU attitudes among the least knowledgeable. Evidence from a population-based survey experiment

ABSTRACT The cognitive mobilisation thesis suggests that increasing knowledge on the European Union (EU) would lead to increased support for the institution. We test this with a strategic case whereby we provide information on the EU’s subsidiarity principle to the citizenry of a small member state and examine whether it mitigates negative EU attitudes. In an original, pre-registered, population-based survey experiment conducted with members of a panel representative of the Dutch population, respondents were assigned randomly to a control group or a treatment: a professionally produced information video mimicking EU communications. Along with estimating the overall treatment effects, based on extant literature we assess whether these effects are moderated by the respondents’ prior EU knowledge and level of populist attitudes. Consistent with the information deficit theory, we find that information provision decreases negative attitudes among the least knowledgeable. We discuss the implications of our findings and provide suggestions for further research.

Dutch cardio-oncology cohort: Incident cardiovascular disease predisposes to a higher cancer mortality rate.

Cardiovascular disease (CVD) and cancer are the two leading causes of death worldwide. Given their high prevalence, it is important to understand the disease burden of cancer mortality in CVD patients. We aimed to evaluate whether patients with incident CVD have a higher risk of malignancy-related mortality, compared to the general population without CVD. We performed a national population-based cohort study selecting patients with incident CVD in the Netherlands between 01 April 2000 and 31 December 2005. A reference cohort was selected from the Dutch population using age, sex and ethnicity. Mortality follow-up data were evaluated after data linkage of national registries from Statistics Netherlands until 31 December 2020. A total of 2,240,879 individuals were selected with a mean follow-up of 12 years (range 0.4-21.0), of which 738,666 patients with incident CVD with a mean age of 71 ± 15 years. Malignancy mortality per 1000 person years was 84 for the reference group and 118 for patients with CVD, with the highest rate of 258 in patients with heart failure. Patients with CVD had a higher malignancy mortality risk, compared to the reference group: HR 1.35 (95%CI 1.33-1.36). Highest risks were observed in patients with venous diseases (HR 2.27, 95%CI 2.17-2.36) and peripheral artery disease (HR 1.87, 95%CI 1.84-2.01). Results show that CVD predisposes to a higher cancer mortality rate. Of all CVD subtypes, HF patients have the highest cancer mortality rate and the hazards were highest in patients with venous diseases and peripheral artery disease.

Health-Related Quality of Life and Fatigue in Children with Pompe Disease

ObjectivePompe disease is an inheritable metabolic myopathy caused by the deficiency of the lysosomal enzyme acid-⍺-glucosidase. The aim of this study was to investigate self-reported and parent-reported health related quality of life (HR-QOL) and fatigue in children with Pompe disease. Study designIn this cross-sectional study, the validated child health questionnaire (CHQ) and PedsQol multidimensional fatigue scale (PedsQol MFS) were used to respectively measure (both self-reported and parent-reported) HR-QOl and fatigue in children with Pompe disease. ResultsIn total, 24 Pompe patients with a median age of 9.6 years [IQR: 7.7-11.9], 14 had classic infantile Pompe disease. Self-reported HR-QOL was comparable to the healthy Dutch population on most domains, classic infantile patients scored mainly lower on physical functioning. Parents of classic infantile patients reported a significantly lower HR-QOL of their children on 9 domains, parents of non-classic patients on 5 domains.Self-reported fatigue levels in children with classic infantile Pompe disease were increased for 2 of 3 domains compared to healthy peers, fatigue in non-classic infantile Pompe patients did not differ. Parents of classic infantile patients reported higher levels of fatigue in all 3 domains compared to healthy children, whereas parents of childhood onset children scored higher on the cognitive fatigue domain. ConclusionChildren with Pompe disease report comparable HR-QOL on most domains compared to healthy peers. Contrarily, parent-reported HR-QOL was substantially lower on most domains compared to references values. As expected in relation to disease severity, unfavorable effects on HR-QOL and fatigue were more pronounced in classic infantile Pompe patients.

Let's talk about sex! Why should healthcare professionals address sexual distress in breast cancer patients and survivors?

PurposeSexual distress impacts the quality of life (QoL) of breast cancer patients but is often overlooked in standard care pathways. This study evaluated the prevalence and factors of sexual distress among Dutch breast cancer patients, compared them to the general population, and explored how sexual distress is discussed in clinical settings from the perspectives of patients and healthcare professionals (HCPs). MethodsQuestionnaires containing the Female Sexual Distress Scale (FSDS) and demographic variables were distributed to women with breast cancer. The effect of breast cancer on sexual distress was assessed with a Mann-Whitney U test. Multivariable linear regression was used to analyze variables associated with FSDS. The Sexuality Attitudes and Beliefs Survey (SABS) was sent to HCPs. ResultsBreast cancer patients reported significantly higher sexual distress compared to a Dutch non-breast cancer cohort, respectively 16.38 (SD 11.81) and 23.35 (SD 11.39). Factors associated with higher sexual distress were psychological comorbidities, the body image scale, and being diagnosed >10 years ago. Sexual distress was not discussed as often as patients needed. Barriers to addressing sexual distress were time constraints, HCPs’ confidence in their ability to address sexual distress, and uncertainty about who is responsible for initiation. ConclusionsBreast cancer patients showed significantly higher sexual distress compared to the Dutch population. However, it was not frequently addressed in the consultation room. While some barriers have been identified, this study highlights the importance of further exploring obstacles to integrating discussions about sexual distress into routine care to improve QoL of breast cancer patients.

Politicians' high-status signals make less-educated citizens more supportive of aggression against government: A video-vignette survey experiment.

Various branches of the literature suggest that exposure to the high-status appearances and lifestyles of politicians in contemporary "diploma democracies" affects the attitudes and behavior of less-educated citizens because it confronts them with their lower status in the political domain. Informed by this, we theorize that such exposure inspires docility (a lower subjective social status, weaker feelings of political entitlement) and revolt (anger, more support for aggression against government). To investigate this, we conducted an original, pre-registered, video-vignette survey experiment among a representative sample of the Dutch population. While our findings likely generalize to other liberal democracies, the Dutch context is suitable to test our theorizing because low-status and high-status appearances and lifestyles are found across the political arena, irrespective of politicians' substantive positions or use of populist rhetoric. Each less-educated respondent (n=1390) was presented with a professionally produced video of an actor playing the part of a fictitious politician. This politician signaled either a low or a high status via his appearance and lifestyle. The potentially confounding factors of his substantive positions and populist rhetoric were randomized and controlled for. We find that exposure to the high-status politician increased less-educated citizens' support for aggression against the government. Through exploratory analyses, we assess how the responses of docility and revolt are interrelated, and how they are shaped by less-educated citizens' economic status.

Age-specific reference scores for the PISQ-12 on female sexual functioning in the Netherlands: a retrospective population-based survey.

Female sexual dysfunction is common in the general population, with age emerging as a significant determinant of sexual activity and functioning. To establish age-specific reference scores for the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in the general Dutch female population. A retrospective, cross-sectional, questionnaire-based study was conducted in the Netherlands. The study population comprised 2518 Dutch-speaking women aged ≥18years, representing a cross section of the general Dutch population. The PISQ-12 was used to assess sexual functioning in heterosexual women. The Groningen Defecation and Fecal Continence questionnaire was utilized to demonstrate demographic factors. We established age-specific reference scores for the PISQ-12 in the general Dutch population. Of the 2518 women, 1592 (63.2%) were sexually active and 926 (36.8%) were not. Further analysis focused on the sexually active group: we found a decrease in mean total PISQ scores, ranging from 38.34 among 18- to 34-year-olds to 36.98 among ≥65-year-olds. Older women scored lower in the behavior domain, specifically pertaining to sexual desire (P < .001) and sexual excitement (P <.001). They also had lower scores in the partner-related domain regarding partner problems of erection (P < .001) and orgasm perception (P < .001). With increasing age, negative emotional reaction scores were higher (P <.001). In the physical domain, we observed significantly different scores for pain during sexual intercourse (P < .001) and restrictions in sexual activity due to fear of urinary leakage (P < .001), with the lowest scores in the youngest group. These age-specific references scores of the PISQ-12 provide an overview of sexual functioning of a general population, which enables caregivers to assess and interpret patients' individual scores more accurately. We included only sexually active women in our subanalyses, potentially introducing selection bias for older women with better physical conditions. The study's strength lies in its extensive sample size, representing a cross section of the general Dutch population. Furthermore, the self-administered questionnaire approach helped minimize embarrassment and obtain realistic responses. Our study demonstrated age-specific PISQ-12 reference scores and highlighted associations between aging and diminishing scores of sexual desire, sexual excitement, erection problems, and orgasm perception, while women aged 18 to 34years reported the lowest scores for pain during intercourse and limited sexual activity due to fear of urinary leakage.

Distinct T cell responsiveness to different COVID-19 vaccines and cross-reactivity to SARS-CoV-2 variants with age and CMV status.

Accumulating evidence indicates the importance of T cell immunity in vaccination-induced protection against severe COVID-19 disease, especially against SARS-CoV-2 Variants-of-Concern (VOCs) that more readily escape from recognition by neutralizing antibodies. However, there is limited knowledge on the T cell responses across different age groups and the impact of CMV status after primary and booster vaccination with different vaccine combinations. Moreover, it remains unclear whether age has an effect on the ability of T cells to cross-react against VOCs. Therefore, we interrogated the Spike-specific T cell responses in healthy adults of the Dutch population across different ages, whom received different vaccine types for the primary series and/or booster vaccination, using IFNɣ ELISpot. Cells were stimulated with overlapping peptide pools of the ancestral Spike protein and different VOCs. Robust Spike-specific T cell responses were detected in the vast majority of participants upon the primary vaccination series, regardless of the vaccine type (i.e. BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, or Ad26.COV2.S). Clearly, in the 70+ age group, responses were overall lower and showed more variation compared to younger age groups. Only in CMV-seropositive older adults (>70y) there was a significant inverse relation of age with T cell responses. Although T cell responses increased in all age groups after booster vaccination, Spike-specific T cell frequencies remained lower in the 70+ age group. Regardless of age or CMV status, primary mRNA-1273 vaccination followed by BNT162b2 booster vaccination showed limited booster effect compared to the BNT162b2/BNT162b2 or BNT162b2/mRNA-1273 primary-booster regimen. A modest reduction in cross-reactivity to the Alpha, Delta and Omicron BA.1, but not the Beta or Gamma variant, was observed after primary vaccination. Together, this study shows that age, CMV status, but also the primary-booster vaccination regimen influence the height of the vaccination-induced Spike-specific T cell response, but did not impact the VOC cross-reactivity.

The Prevalence of Cancer in Dutch Female Patients with Idiopathic Scoliosis Compared with the General Population.

Background and Objectives: Epidemiological studies have demonstrated the potential oncogenic effects of cumulative radiation exposure, particularly during childhood. One group experiencing repeated exposure to radiation at an early age for multiple years is patients treated for idiopathic scoliosis (IS). This study aimed to determine the relationship between childhood radiological exposure and adult cancer prevalence in children treated for IS. Materials and Methods: Data from 337 predominantly female patients treated at our hospital between January 1981 and January 1995 were gathered and compared to the Dutch national cancer rates. The standardized prevalence ratios for cancer in IS patients were compared with the cancer prevalence rates from the general Dutch population. Results: The overall cancer prevalence in women was 5.0%, with no significant difference compared to the general population (p = 0.425). The results of this study do not suggest that female patients treated for idiopathic scoliosis during childhood have an increased risk of cancer later in life. Conclusion: Despite being the largest recent study in its field, the modest participant number limits its ability to draw conclusions. However, the detailed data collected over a long observation period, alongside data from a period with comparable radiation rates, contributes to refining clinical practice and laying the groundwork for future systematic reviews.