Effectiveness of continuous glucose monitoring during diabetic pregnancy (GlucoMOMS trial); a randomised controlled trial

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Sociaal-economische gevolgen van een totaal verbod van pulsvisserij voor de Nederlandse visserijsector

Deze nota beschrijft de omvang van de pulsvisserij in Nederland, en de sociaal-economische gevolgen wanneer de Nederlandse pulskotters moeten omschakelen naar de boomkorvisserij. De pulsvloot is voor de Nederlandse visserij van groot belang. Als alle pulskotters omschakelen naar boomkor resulteert dat in een forse verlaging van het economisch rendement. Bij lagere schol- en tongprijzen en hogere brandstofprijzen, vergelijkbaar met die in de periode 2012-2014, zou het gemiddelde nettoresultaat nihil zijn. In deze situatie zal de helft van de kotters zelfs een negatief resultaat behalen. Deze afname van de financiële resultaten heeft de volgende effecten op de economie van de visserij: door de negatieve resultaten zal de continuïteit van bedrijven in het geding komen, door de lage deellonen zal het moeilijk zijn gekwalificeerde bemanning aan boord te krijgen, door de afname van het financiële resultaat zal er minder of geen ruimte meer zijn voor vervanging en vernieuwin

Wind op Zee : bepaling van de waarde van geplande windparkgebieden voor de visserij

De ontwikkeling van windparken in de Noordzee heeft economische consequenties voor de visserij. In deze notitie is met behulp van de historische visserijpatronen in de periode 2010-2017 de waarde van de bestaande en geplande windmolenparkgebieden tot 2030 in het Nederlandse deel van de Noordzee voor de visserij bepaald. Daarbij is ook rekening gehouden met de cumulatieve effecten van andere ruimteclaims op de Noordzee op de waarde van deze gebieden. De visserij-activiteiten in de geplande windmolenparkgebieden droegen in de periode 2010-2017 gemiddeld 1.52 mln. euro per jaar bij aan de bruto toegevoegde waarde van de Nederlandse kottervisserij. Dit was 1,36% van de totale bruto toegevoegde waarde van de Nederlandse kottersector en 2,65% van de totale bruto toegevoegde waarde van de Nederlandse kottersector op het Nederlands Continentaal Plat (NCP). De bijdrage varieerde van 1,0 tot 2,5 mln. euro per jaar. Voor individuele schepen was de variatie van de bijdrage uit de geplande windmolenparkgebieden aan de inkomsten veel hoger (0-17%). Het toekomstig belang van de gesloten en te sluiten windmolenparkgebieden voor de visserij wordt mede bepaald door de toekomstige ontwikkelingen in ecologie van de Noordzee, de beleidsmatige en de sociaaleconomische context. Bij sluiting van alle geplande natuurgebieden en windmolenparken in zowel het Nederlandse deel als het buitenlandse deel van de Noordzee zal de bijdrage van de windmolengebieden aan de bruto toegevoegde waarde van de Nederlandse kottersector toenemen tot maximaal 1,57% en bij een 'harde Brexit' tot maximaal 1,93%. De waarde van de gebieden voor de visserij is niet gelijk aan het economisch effect van sluiting van de gebieden voor de visserij. Een nadere analyse van de gedragsveranderingen in de visserij bij sluiting van de gebieden en de resulterende effecten op de kosten en inkomsten is nodig om hier uitsluitsel over te kunnen geven. Gezien alle gebiedsbeperkingen en hun invloed op buitenlandse visserijen, is het daarbij van belang het internationale perspectief niet uit het oog te verliezen

Continuous glucose monitoring metrics and pregnancy outcomes in insulin-treated diabetes : A post-hoc analysis of the GlucoMOMS trial

Funding Information: BWM is supported by a NHMRC investigatorgrant (GNT1176437) and BWM reports consultancy, travel support and research funding from Merck. All other authors declare no conflict of interest. The GlucoMOMS trial was funded by ZonMw, the Dutch Organisation for Health Research and Development, project number 80‐82310‐97‐11157. Continuous Glucose Monitors were purchased at a discount price at Medtronic®, Heerlen, The Netherlands. Neither ZonMw nor Medtronic had a role in study design, data collection, data analysis, data interpretation, or writing of the reports of either the original study or the current post hoc analysis. 10 Publisher Copyright: © 2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.Peer reviewedPublisher PD

Temporizing management vs immediate delivery in early-onset severe preeclampsia between 28 and 34 weeks of gestation (TOTEM study) : An open-label randomized controlled trial

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The decline of mussel aquaculture in the European Union: causes, economic impacts and opportunities

ABSTRATC: In contrast to the increasing aquaculture production of mussels worldwide, production in the European Union (EU) has shown a decreasing trend over the last two decades. Aquaculture production of mussels in the EU peaked in the late 1990s at more than 600 000 tonnes; by 2016, production volume had dropped by 20% to 480 000 tonnes. As mussel production represents more than 1/3 of EU aquaculture production, this decrease is an important contributor to the stagnation of EU aquaculture. Previous studies have suggested diseases, lack of mussel seed (spat), and low profitability as the main causes of the EU mussel production decrease. In this study, we investigate how economic and environmental factors have contributed. Moreover, we examine if the different mussel production techniques (raft, longline, on-bottom, and "bouchot") have been differently affected, by analysing the economic performance and cost structure evolution for the period 2010-2016. We complement these results with a SWOT (strengths, weaknesses, opportunities, and threats) analysis of the EU mussel sector based on expert knowledge

Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)

Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre wit

10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study

ABSTRACT: BACKGROUND: Cardiovascular disease is the cause of death in 32% of women in the Netherlands. Prediction of an individual's risk for cardiovascular disease is difficult, in particular in younger women due to low sensitive and specific tests for these women. 10% to 15% of all pregnancies are complicated by hypertensive disorders, the vast majority of which develop only after 36 weeks of gestation. Preeclampsia and cardiovascular disease in later life show both features of "the metabolic syndrome" and atherosclerosis. Hypertensive disorders in pregnancy and cardiovascular disease may develop by common pathophysiologic pathways initiated by similar vascular risk factors. Vascular damage occurring during preeclampsia or gestational hypertension may contribute to the development of future cardiovascular disease, or is already present before pregnancy. At present clinicians do not systematically aim at the possible cardiovascular consequences in later life after a hypertensive pregnancy disorder at term. However, screening for risk factors after preeclampsia or gestational hypertension at term may give insight into an individual's cardiovascular risk profile. METHODS: Women with a history of preeclampsia or gestational hypertension will be invited to participate in a cohort study 2,5 years after delivery. Participants will be screened for established modifiable cardiovascular risk indicators. The primary outcome is the 10-year cardiovascular event risk. Secondary outcomes include differences in cardiovascular parameters, SNP's in glucose metabolism, and neonatal outcome. DISCUSSION: This study will provide evidence on the potential health gains of a modifiable cardiovascular risk factor screening program for women whose pregnancy was complicated by hypertension or preeclampsia. The calculation of individual 10-year cardiovascular event risks will allow identification of those women who will benefit from primary prevention by tailored interventions, at a relatively young age. Trail registration The HYPITAT trial is registered in the clinical trial register as ISRCTN08132825

Continuous glucose monitoring metrics and pregnancy outcomes in insulin-treated diabetes: A post-hoc analysis of the GlucoMOMS trial

Aim: To investigate the association between continuous glucose monitoring (CGM) metrics and perinatal outcomes in insulin-treated diabetes mellitus in pregnancy. Materials and Methods: In a post-hoc analysis of the GlucoMOMS randomized controlled trial, we investigated the association between the metrics of an offline, intermittent CGM, glycated haemoglobin (HbA1c) and perinatal outcomes per trimester in different types of diabetes (type 1, 2 or insulin-treated gestational diabetes mellitus [GDM]). Data were analysed using multivariable binary logistic regression. Outcomes of interest were neonatal hypoglycaemia, pre-eclampsia, preterm birth, large for gestational age (LGA) and Neonatal Intensive Care Unit (NICU) admission. The glucose target range was defined as 3.5–7.8 mmol/L (63–140 mg/dL). Results: Of the 147 participants (N = 50 type 1 diabetes, N = 94 type 2 diabetes/insulin-treated GDM) randomized to the CGM group of the GlucoMOMS trial, 115 participants had CGM metrics available and were included in the current study. We found that, in pregnancies with type 1 diabetes, a higher second trimester mean glucose was associated with LGA (odds ratio 2.6 [95% confidence interval 1.1–6.2]). In type 2 and insulin-treated gestational diabetes, an increased area under the curve above limit was associated with LGA (odds ratio 10.0 [95% confidence interval 1.4–72.8]). None of the CGM metrics were associated with neonatal hypoglycaemia, pre-eclampsia, shoulder dystocia, preterm birth and NICU admission rates for pregnancies complicated by any type of diabetes. Conclusion: In this study, in type 2 diabetes or insulin-treated GDM, the glucose increased area under the curve above limit was associated with increased LGA. In type 1 diabetes, the mean glucose was the major determinant of LGA. Our study found no evidence that other CGM metrics determined adverse pregnancy outcomes