Prevalence of sensitization to the predatory mite Amblyseius cucumeris as a new occupational allergen in horticulture

Background: Protection against thrips, a common pest in bell pepper horticulture is effectively possible without pesticides by using the commercially available predatory mite Amblyseius cucumeris (Ac). The prevalence of sensitization to Ac among exposed greenhouse employees and its clinical relevance was studied. Methods: Four hundred and seventytwo employees were asked to fill in a questionnaire and were tested on location. Next to RAST, skin prick tests (SPTs) were performed with common inhalant allergens, the storage mite Tyrophagus putrescentiae (Tp) which serves as a temporary food source during the cultivation process and Ac. Furthermore, nasal challenge tests with Ac were carried out in 23 sensitized employees. Results: SPTs positive to Ac were found in 109 employees (23%). Work-related symptoms were reported by 76.1%. Sensitization to Tp was found in 62 employees of whom 48 were also sensitized to Ac. Immunoglobulin (Ig)E-mediated allergy to inhalant allergens appeared to be an important risk factor for sensitization to Ac. Employees with rhinitis symptoms showed a significantly higher response to all Ac doses during the nasal challenge test compared with employees without rhinitis symptoms. Conclusions: The predatory mite Ac is a new occupational allergen in horticulture which can cause an IgE-mediated allergy in exposed employees. It is biologically active on the mucous membranes of the nose and therefore clinically relevant for the development of work-related symptoms

Three-line modelling of the Terschelling supply

In the framework of the NOURTEC project experimental nourishments have been executed. The NOURTEC project is an EU-research project in the scope of the program for Marine Science and Technology (Mast II). NOURTEC stands for Innovative Nourishment Techniques Evaluation. Full-scale experiments have been carried out in three different countries (Denmark, Germany and the Netherlands). Different nourishment techniques have been applied (i.e. shoreface nourishments and beach nourishments). In the period May to November 1993 a shoreface nourishment was carried out at the coast of Terschelling (the Netherlands). An extensive monitoring program has accompanied this exercise. This study is about the simulation of the evolution of the nourishment with a three-line model. The basic idea of line modelling is that the magnitude of cross-shore transport is proportional to the deviation from the equilibrium shape of the cross-shore proflle. For the modelling the cross-shore profile is schematised in zones. Each zone is characterised by "a line which represents the sediment volume of the zone. Also longshore dispersion is taken into account. Coastal constants which quantify the magnitude of transport in cross and longshore direction have been determined. For that purpose use was made of the available wave and bathymetric data. A study was made of the behaviour of the coast prior to the nourishment. The autonomous behaviour was taken into account for determining the shoreface nourishment behaviour. A comparison between measured development and calculations with the three linemodel shows that there are similarities but also considerable differences. One of the difficulties is how to distinguish between autonomous proflle development and profile development caused by the nourishment. The behaviour of the nourishment is partly understood by the model runs. The calculated development of the upper zone is very similar to the measured development. The results for the middle zone are less good. The three-line model will in principle predict symmetrical proflle development in longshore direction in case of an alongshore symmetrical supply. From observations it is clear that the nourishment is moving eastward. This can not be modelled with the present three-line model. The differences between measured and calculated development in the lower zone are also considerable. The research has yielded an increased insight in the complex behaviour of the shoreface nourishment along the coast of Terschelling.Hydraulic EngineeringCivil Engineering and Geoscience

Modellering morfodynamisch gedrag van de Drempel van Hansweert

Onderdeel van dit project is het simuleren van het morfologisch gedrag van ren van de drempels, de Drempel van Hansweert, met een morfologisch computermodel. Dit verslag beschrijft de eerste van twee fasen van dit projekt waarin de modelbouw en de simulatie van de huidige situatie wordt beschreven. In de tweede fase zullen diverse beheersalternatieven met elkaar vergeleken worden. Met behulp van het computermodel DELFT2D-MOR van het Waterloopkundig Laboratorium is er een model van de Westerschelde gemaakt. DELFT2D-MOR is een 2DH-morfologisch model (2DH =2 dimensionaal horizontaal). Met behulp van dit model zijn de waterbeweging, het sedimenttransport en de bodemontwikkeling op en rondom de Drempel van Hansweert gesimuleerd. Het model is gecalibreerd en geverifieerd met behulp van meetgegevens. De berekende debieten en waterstanden komen goed overeen met gemeten waarden. Berekeningen van het initiele sedimenttransport laten een netto sedimenttransport richting de drempel zien hetgeen overeenkomt met de praktijk. Een tweetal morfologische berekeningen zijn in deze eerste fase gemaakt, namelijk een berekening van de autonome ontwikkeling (geen menselijke ingrepen) en een simulatie van de huidige baggerstrategie. Er is hierbij gebruik gemaakt van een morfologisch getij om de rekentijd van het model te beperken. Berekende en gemeten erosie- en sedimentatiegebieden komen in het algemeen redelijk goed overeen. De berekeningen blijken minder aanzanding te geven op de drempel dan mocht worden verwacht op basis van meetgegevens. Een vergelijking tussen de simulatie van de autonome ontwikkeling en de simulatie van de huidige baggerstrategie laat zien dat er netto meer aanzanding op de drempel optreedt als er gebaggerd wordt. Door het baggerwerk wordt de drempel meer op overdiepte gehouden en zal sneller aanzanden. Vanwege de complexiteit van dit soort berekeningen mogen de resultaten als good worden beschouwd.Hydraulic EngineeringCivil Engineering and Geoscience

Assessing Quantitative Comparisons of Health and Social Care Between Countries

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Effect of submerged breakwater on profile development

This study is part of a Human Capital and Mobility Project called 'Dynamics of Beaches'. This project is a co-operation of six European universities which work together in solving some unknown aspects of a submerged breakwater by means of model experiments. Several agreements about the experiments were made between the partners. These agreements consider the layout of the breakwater, the wave conditions and the initial bottom profile. In this report the effect of a submerged breakwater on hydro- and morphodynamics has been investigated. In order to do this, six similar (2DV) tests with and without a scale model of a submerged breakwater and with a movable bed were performed in the Lange Speurwerkgoot (= wave flume) of the Laboratory of Fluid Mechanics at DUT. By means of varying wave height and wave period the influence of these parameters on hydro- and morphodynamics can be investigated. For these purposes wave heights, flow velocities, sediment concentrations and bottom profiles were measured at several locations in place and time. The following topics are discussed in this report: -profile development -wave height development -velocity distributions -sediment concentration distributions -sediment transport rates -comparison with Unibest-TC The experiments show that profile development is less pronounced in case of a breakwater present. However, it does not prevent the sediment to cross the breakwater in a seawards direction. Due to the presence of the breakwater, wave heights are reduced landwards of it. Seawards, the presence of a breakwater leads to an increase of wave heights. The breakwater also decreases the time-average velocities landwards of the breakwater. Furthermore, a comparison between the sediment transport based on measured profiles and the sediment transport based on multiplification of time-average sediment concentrations and time-average velocities shows that the last method leads to an overprediction of the sediment transport. Comparing measured profile development and wave height development with values calculated by a computer program called Unibest-TC shows that this program still has significant shortcomings in modelling the effects of a submerged breakwater.Hydraulic EngineeringCivil Engineering and Geoscience

Comparison of Tightly Controlled Dose Reduction of Biologics With Usual Care for Patients With Psoriasis A Randomized Clinical Trial

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Health Economic Consequences of a Tightly Controlled Dose Reduction Strategy for Adalimumab, Etanercept and Ustekinumab Compared with Standard Psoriasis Care: A Cost-utility Analysis of the CONDOR Study

Contains fulltext : 229433.pdf (publisher's version ) (Open Access)A dose reduction strategy for adalimumab, etanercept and ustekinumab in patients with psoriasis who have stable and low disease activity has recently been compared with usual care in the CONDOR study (CONtrolled DOse Reduction) of biologics in patients with psoriasis with low disease activity. The aim of the current study was to perform a cost-utility analysis with a 12-month time horizon alongside this trial, using prospectively measured healthcare costs and quality-adjusted life years, based on Short-Form Six-Dimension utilities. Bootstrap analys-es were used to calculate the decremental cost-utility ratio and the incremental net monetary benefit. The dose reduction strategy resulted in a mean cost saving of €3,820 (95th percentile -€3,099 to -€4,509) per patient over a period of 12 months. There was an 83% chance that dose reduction would result in a reduction in quality adjusted life years (mean -0.02 (95th percentile -0.06 to 0.02). In conclusion, dose reduction of biologics resulted in substantial cost savings with an acceptable reduction in quality of life

Female patients are less satisfied with biological treatment for psoriasis and experience more side-effects than male patients: results from the prospective BioCAPTURE registry

Item does not contain fulltextBACKGROUND: Female sex has been reported as a predictor for treatment discontinuation with biological therapies for psoriasis, although reasons remain unclear. It can be hypothesized that lower satisfaction with biological treatment in women might add to the lower drug survival rates. OBJECTIVES: To identify possible differences in satisfaction with biological treatment between female and male patients using the Treatment Satisfaction Questionnaire for Medication (TSQM). METHODS: Data of psoriasis patients treated with biologics were obtained from the prospective, multicentre, daily-practice BioCAPTURE registry. Longitudinal TSQM data were analysed by linear mixed models. Relevant patient characteristics were incorporated as possible confounding factors. Post hoc analysis of adverse events was performed in order to investigate differences between sexes. RESULTS: We included 315 patients with 396 corresponding treatment episodes (137 adalimumab, 90 etanercept, 137 ustekinumab, 24 secukinumab and 8 infliximab). Almost forty per cent of the patients were female. Women had significantly lower baseline PASI scores (P = 0.01). Longitudinal analyses demonstrated lower TSQM scores for 'side-effects' (P = 0.05) and 'global satisfaction' (P = 0.01) in female patients compared with male patients over 1 year of treatment. Women reported more relevant adverse events in the context of biologic treatment compared to men (rate ratio 1.79; P < 0.001), with more fungal (rate ratio 2.20; P = 0.001) and herpes simplex infections (rate ratio 3.25; P = 0.005). CONCLUSIONS: This study provides a prospective, longitudinal analysis of treatment satisfaction with biologics in female and male patients with psoriasis. Women were slightly less satisfied with treatment regarding side-effects and global satisfaction. Differences in treatment satisfaction and side-effects might add to the fact that women discontinue biological treatments more often