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Met de jaarlijkse residumeting monitort Tuinbranche Nederland de voortgang van de Ambitie gewasbeschermingsmiddelen in de sierteelt van de Nederlandse tuinretail 4.0. De monitoring is uitgevoerd bij tuincentra van Praxis, Welkoop, Intratuin, Hornbach, GRS Retail (inclusief GroenRijk), BijSTOX en BTC-retail. Het doel van dit rapport is om de Tuinbranche en de deelnemende retailers inzicht te geven in hoeverre zij voldoen aan de ambitie én waar zij zich nog kunnen verbeteren.

OBJECTIVE: Prevention of recurrent stroke in patients with embolic stroke of undetermined source (ESUS) is challenging. The advent of safer anticoagulation in the form of direct oral anticoagulants (DOACs) has prompted exploration of prophylactic anticoagulation for all ESUS patients, rather than anticoagulating just those with documented atrial fibrillation (AF). However, recent trials have failed to demonstrate a clinical benefit, while observing increased bleeding. We modeled the economic impact of anticoagulating ESUS patients without documented AF across multiple geographies. METHODS: CRYSTAL-AF trial data were used to assess ischaemic stroke event rates in ESUS patients confirmed AF-free after long-term monitoring. Anticipated bleeding event rates (including both minor and major bleeds) with aspirin, dabigatran 150 mg, and rivaroxaban 20 mg were sourced from published meta-analyses, whilst a 30% ischaemic stroke reduction for both DOACs was assumed. Cost data for clinical events and pharmaceuticals were collected from the local payer perspective. RESULTS: Compared with aspirin, dabigatran and rivaroxaban resulted in 17.9 and 29.9 additional bleeding events per 100 patients over a patient's lifetime, respectively. Despite incorporating into our model the proposed 30% reduction in ischaemic stroke risk, both DOACs were cost-additive over patient lifetime, as the costs of bleeding events and pharmaceuticals outweighed cost savings associated with the reduction in ischaemic strokes. DOACs added £5953-£7018 per patient (UK), €6683-€7368 (Netherlands), €4933-€9378 (Spain), AUD$5353-6539 (Australia) and $26,768-$32,259 (US) of payer cost depending on the agent prescribed. Additionally, in the U.S. patient pharmacy co-payments ranged from $2468-$12,844 depending on agent and patient plan. In all settings, cost-savings could not be demonstrated even when the modelling assumed 100% protection from recurrent ischaemic strokes, due to the very low underlying risk of recur

Vrijdag 9 april 2021, is deze brief verzonden naar de Informateur en de Fractievoorzitters van VVD, D66, CDA, CU, PvdA, GL en SP met de oproep om een aantal punten inzake biomassa te verankeren in het Regeerakkoord. De brief is ondertekend door een brede coalitie die werkt aan verstandige en hoogwaardige toepassing van biogrondstoffen (biomassa).

Wealth inequalities throughout Europe and the share of income and wealth of the upper percentiles of the most wealthy have been increasing the last couple of decades. This trend has been accompanied by a growing concern within the academic, political and societal debate, for the economic and societal consequences. A process that has increasingly gained attention in the academic and political debate as having a significant influence on the growing inequalities and concentration of wealth is the process of financialization. The research question or aim of this thesis has been to answer the question whether states have a moral urgency to fight this process of financialization. As theories of distributive justice can give moral guidance as to whether certain distributive patterns inherent to an economic framework are justifiable, to answer the research question, the effects of financialization were evaluated with different theories of distributive justice. This evaluation showed that financialization violates principles of distributive justice for all theories discussed. Furthermore, the thesis shows that for fighting financialization, states unavoidably have to cooperate on a supranational level. The thesis discusses the arguments for and against this form of cooperation and shows that the moral urgency for states to fight financialization, although on a supranational level, remains.

The Dutch Ministry of Agriculture, Nature and Food Quality has financially supported the research programme named “Total use of unrefined and unprocessed food(crops)”. The programme consisted of a number of projects and one of the projects was entitled “Control of Restrictive Supply Chains; biomarkers as indicator for shelf life” ( KB 33 002 011). The aim of the project is to build up knowledge needed to optimize and re-design restrictive supply chains of fruit, vegetables and flowers to avoid postharvest losses, maintain high resource use efficiency and connect consumer demands to production and supply chain restrictions. The objective of this project is to measure the production of volatiles in healthy and rotten (infected) potatoes and as such identify volatiles that may be used as a biomarker for rot development. A key aspect of the envisaged experimental design is to measure the development of these volatiles over time. This will give insight in the potential of this idea as an early detection method to avoid the further expansion of a rot infection during storage of potatoes. An experimental set up was built to allow the production of volatiles and respective sampling. The potatoes were placed in a glass jar and an air flow was applied. The volatiles were sampled and measured in the air flow. Three treatments were applied: potatoes wounded and infected with the bacteria Pectobacterium polaris, wounded potatoes (without infection) and healthy potatoes. Each treatment was applied in duplicate. The six glass jars with the potatoes were kept at room temperature for maximal 17 days and the production of volatiles was daily monitored. The volatiles in the out coming air were measured with a thermo-desorption GC, a PTR-ToF-MS and a GC-MS (via a SPME). In addition, the amount of oxygen consumed and carbon dioxide produced was also measured in the air flow with a CompactGC. The amount of infection was visually quantified (through the glass jar). The following has been

Stephané Roze,1 Jayne Smith-Palmer,2 Simona de Portu,3 Alexis Delbaere,3 Bonnie de Brouwer,4 Harold W de Valk5 1HEVA HEOR, Lyon, France; 2Ossian Health Economics and Communications, Basel, Switzerland; 3Medtronic International Trading Sàrl, Tolochenaz, Switzerland; 4Medtronic Trading NL, Heerlen, the Netherlands; 5Leiden University Medical Center, Leiden, the Netherlands Aim: The aim of this study was to perform a cost-effectiveness analysis to establish the cost-effectiveness of sensor-augmented pump therapy (SAP) with automated insulin suspension vs continuous subcutaneous insulin infusion (CSII) alone in patients with type 1 diabetes in the Netherlands.Patients and methods: The analysis was performed using the IQVIA CORE Diabetes Model (CDM) in two different patient cohorts: one with suboptimal glycemic control at baseline (mean age 27 years, mean baseline HbA1c 8.0% [64 mmol/mol]) and the other at increased risk of hypoglycemic events (mean age 18.6 years, mean baseline HbA1c 7.5% [58 mmol/mol]). Clinical input data were sourced from published literature, and the analysis was performed from the societal perspective.Results: In patients with suboptimal baseline glycemic control, SAP improved quality-adjusted life expectancy by 1.77 quality-adjusted life years (QALYs) vs CSII (15.54 QALYs vs 13.77 QALYs) with higher lifetime costs (EUR 189,855 vs EUR 150,366), resulting in an incremental cost-effectiveness ratio (ICER) of EUR 22,325 per QALY gained. In this cohort, sensitivity analyses showed that the influence of SAP on fear of hypoglycemia (FoH) and baseline HbA1c were key drivers of results. In patients at increased risk of hypoglycemia, the gain in quality-adjusted life expectancy with SAP vs CSII was 2.16 QALYs (16.70 QALYs vs 14.53 QALYs) with higher lifetime costs (EUR 204,013 vs EUR 171,032) leading to an ICER of EUR 15,243 per QALY gained. In this patient group, findings were most sensitive to changes in assumptions relating to the i

Mixing is a very important physical mechanism in lakes, since it is strongly connected to turbulence. Turbulence has a direct influence on thermal stratification and biological processes. This study used in-situ observations to investigate the seasonal variability of mixing in northern Lake Garda (Italy). The in-situ observations were made using a vertical microstructure profiler (MicroCTD, Rockland Scientific International), which measured temperature, conductivity, turbidity, chlorophyll-a concentrations and vertical shear. These measurements were performed on a monthly basis, starting in March 2017, for a whole year. Four different stations were monitored at the same time. Three of them were forming a cross section perpendicular to lake's main axis, which is oriented in a northeast-southwest direction. The fourth station was located further to the south. Additionally, measurements of meteorological variables were obtained from nearby meteorological ground stations. The combination of all these measurements made it possible to quantify which external forcing mechanisms had the most influence on the dynamics occurring in the lake throughout the year. It was found that throughout the year the surface buoyancy flux is the most important source of Turbulent Kinetic Energy (TKE), except during occasional extreme wind events, which caused significant amounts of TKE to be produced. Observations suggested the development of a secondary circulation, after persistent, unidirectional winds, causing coastal up-/downwelling along the narrow and deep part of the lake. It was found that a transition period from negative to positive buoyancy fluxes in the months September and October marked a transition in the wind climate and caused the development of an unstable boundary layer in the air above the lake. This transition period was accompanied by a second algal bloom and was the onset of Mixed Layer deepening. During the months December until March a continuous cooling of the upp

Contains fulltext : 174666.pdf (publisher's version ) (Closed access), BACKGROUND & AIMS: Gluten-free diet is the keystone of coeliac disease treatment. Despite adherence, some patients continue to suffer from symptoms that negatively influence health-related quality of life (HRQoL). Therefore we performed a systematic review and meta-analysis to assess the effect of gluten-free diet on HRQoL in coeliac disease. We specifically sought for determinants that negatively influenced HRQoL. METHODS: We systematically searched PubMed, EMBASE, CINAHL, PsycINFO and Cochrane Library for studies assessing HRQoL in untreated or treated adults using validated HRQoL-questionnaires from 1960 to September 2015, comparing HRQoL: (1) before and after gluten-free diet initiation or (2) in patients and non-coeliac controls. RESULTS: We included eighteen studies and sixteen were suitable for meta-analysis. Gluten-free diet significantly improves HRQoL, for psychological general well-being (PGWB)-Total (mean difference (MD) 7.34, 95% confidence interval (CI) [1.96; 12.72]; p = 0.008), SF-36 Mental Component Score (MCS) (MD 7.37, 95% CI [1.84; 12.90]; p = 0.009) and SF-36 Physical Component Score (PCS) (MD 5.72, 95% CI [1.50; 9.95]; p = 0.008). Treated patients had similar HRQoL compared with controls for PGWB-Total (MD -0.72, 95% CI [-2.71; 1.27]; p = 0.48), but significantly lower levels for SF-36 MCS (MD -4.09, 95% CI [-6.17; -2.01]; p = 0.0001) and PCS (MD -4.57, 95% CI [-6.97; -2.17]; p = 0.0002). Symptom-detected gluten-free diet adhering patients have lower HRQoL compared with screening-detected patients (MD -3.73, 95% CI [-6.77;-0.69]; p = 0.02) Strict adhering patients have better HRQoL compared with non-strict adhering patients for SF-36 MCS (MD 7.70, 95% CI [4.61; 10.79]; p < 0.00001) and for SF-36 PCS (MD 3.23, 95% CI [1.33; 5.14]; p = 0.0009). CONCLUSIONS: Gluten-free diet significantly improves but does not normalize HRQoL in adults with coeliac disease. Dietary adherence improves HRQoL. Better (self-reported) dietary adherence results in highe

To investigate the scale structure and psychometrics of the EORTC chemotherapy-induced peripheral neuropathy module (QLQ-CIPN20).Using confirmatory factor analyses (CFA), we tested two hypothesized scale structure models of the QLQ-CIPN20 in 473 patients with non-small cell lung cancer, 281 patients with heterogeneous cancer diagnoses, and 500 patients with colorectal cancer. We also modeled the two hypothesized models as bi-factor models. These included a general factor, in addition to the specific domain factors. Additional models were investigated with exploratory factor analysis (EFA). Known groups validity was evaluated where justified.CFA could not confirm the two hypothesized models (Model 1: CFI < 0.926; TLI < 0.914; RMSEA > 0.077 and Model 2: CFI < 0.906; TLI < 0.887; RMSEA > 0.105) in any of the three samples. Including a general factor to these two hypothesized models to produce a bi-factor model also did not yield satisfactory results. Using EFA, we identified four different factor structures in the three samples that were unstable due to cross loadings of the items. When scoring the QLQ-CIPN20 as a simple, additive checklist evidence was found for known groups validity in the first two samples based on Common Toxicity Criteria (CTC-AE), and in the third sample based on exposure to CIPN-inducing chemotherapy.Neither CFA nor EFA yielded support for a stable subscale structure for the QLQ-CIPN20. Scoring the questionnaire as a simple additive checklist results in acceptable validity.

Purpose: To investigate the scale structure and psychometrics of the EORTC chemotherapy-induced peripheral neuropathy module (QLQ-CIPN20). Methods: Using confirmatory factor analyses (CFA), we tested two hypothesized scale structure models of the QLQ-CIPN20 in 473 patients with non-small cell lung cancer, 281 patients with heterogeneous cancer diagnoses, and 500 patients with colorectal cancer. We also modeled the two hypothesized models as bi-factor models. These included a general factor, in addition to the specific domain factors. Additional models were investigated with exploratory factor analysis (EFA). Known groups validity was evaluated where justified. Results: CFA could not confirm the two hypothesized models (Model 1: CFI < 0.926; TLI < 0.914; RMSEA > 0.077 and Model 2: CFI < 0.906; TLI < 0.887; RMSEA > 0.105) in any of the three samples. Including a general factor to these two hypothesized models to produce a bi-factor model also did not yield satisfactory results. Using EFA, we identified four different factor structures in the three samples that were unstable due to cross loadings of the items. When scoring the QLQ-CIPN20 as a simple, additive checklist evidence was found for known groups validity in the first two samples based on Common Toxicity Criteria (CTC-AE), and in the third sample based on exposure to CIPN-inducing chemotherapy. Conclusions: Neither CFA nor EFA yielded support for a stable subscale structure for the QLQ-CIPN20. Scoring the questionnaire as a simple additive checklist results in acceptable validity.