Problematiek en perspectief in de veeteelt

Rede Wageninge

Teaching amimal breeding in the agricultural university at wageningen

International audienc

The Challenge of Hand Eczema:Pathogenesis, Treatment, and Burden of Disease

Hand eczema is a common condition in the general population. The pathogenesis is largely unknown. The first part of this thesis studied the pathogenesis of hyperkeratotic hand eczema. This subtype has a typical presentation with thick hyperkeratosis of the palms and differs from other subtypes of hand eczema. Immunofluorescence showed that multiple proteins (e.g. filaggrin) had different staining patterns. It is still questionable if hyperkeratotic hand eczema is a subtype of hand eczema or an own entity and future research is necessary. Part two focuses on different systemic treatments in severe hand eczema by drug survival studies. Drug survival is an outcome measure to evaluate long term potency of a treatment. Daily practice data of alitretinoin, acitretin, cyclosporine, methotrexate and azathioprine was retrospectively collected. Cyclosporine was, besides alitretinoin, the most valuable treatment option in severe chronic hand eczema. Furthermore showed these data that current systemic treatments are often limited by side effects and ineffectiveness. Part three explores the burden of disease in terms of health-related quality of life, treatment satisfaction and treatment adherence in chronic vesicular hand eczema. Severity affected both, quality of live as treatment satisfaction. Patients with systemic treatment had a higher treatment satisfaction compared with those using only topical treatment. Systemic treatment should therefore be more accessible in severe vesicular hand eczema. The last chapter of this thesis is a review about cost of illness. Total costs in hand eczema varies between €1311-€9742 per patient per year. Occupational costs formed the largest component of total costs

Doel en streven in de rundveefokkerij

Rede Wageninge

De invloed van erfelijkheid en milieu op de samenstelling van de melk bij Friese koeien en de praktische mogelijkheid van selectie op het eiwitgehalte

The milk composition of individual cows was studied especially as to protein content. In total 729 cows were tested including 238 dam-daughter pairs, 6 large progeny groups of bulls used in artificial insemination and 20 small progeny groups of bulls in natural service. Milk production, and fat, protein, casein, lactose and solids-not-fat were estimated during lactation.Environmental influences on milk production and composition were studied, e.g. lactation curve, month of calving, age of cow, duration of lactation. The average percentages fat and protein of individual cows were only slightly influenced and generally in the same direction by environmental factors.The variation in protein percentage (σ= 0.17) was smaller than that of fat (σ = 0.27) but this variation was still enough to permit successful selection on percentage protein.The protein percentage was positive correlated with fat content (r = +0.54). The percentage fat and protein were both largely determined by genetic factors (h 2= about 0.7). Taking account of the purpose for which milk was used, e.g. cheese production, especially protein was an economically important component of milk.Protein analysis on a large scale was cheap. For the Netherlands, and for Friesland in particular, it was definitely warranted to base payment for milk on percentages fat and protein and to select both on fat and protein

Experiences from daily practice of upadacitinib treatment on atopic dermatitis with a focus on hand eczema:Results from the BioDay registry

Background: Real-world data on the effectiveness of upadacitinib on atopic dermatitis (AD), hand eczema (HE) and HE in the context of AD are limited.Objectives: To evaluate the effectiveness and safety of upadacitinib on AD and on HE in patients with AD.Methods: This prospective observational cohort study includes clinical outcomes: Eczema Area and Severity Index (EASI), Investigator's Global Assessment (IGA), Hand Eczema Severity Index (HECSI), Photographic guide; and PROMs: average pruritus and pain Numeric Rating Scale (NRS) score of the past week, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Eczema, Dermatology Life Quality Index (DLQI), Atopic Dermatitis Control Tool (ADCT), Patient Global Assessment of Disease (PGAD), Quality Of Life Hand Eczema Questionnaire (QOLHEQ) at baseline, Week 4, and Week 16 of upadacitinib-treated patients. Adverse events were monitored during each visit.Results: Thirty-eight patients were included, of which 32 patients had HE. At Week 16, EASI-75 was achieved by 50.0%. Absolute cutoff score NRS-pruritus ≤4 was reached by 62.5%, POEM ≤7 by 37.5%, DLQI ≤5 by 59.4%, ADCT &lt;7 by 68.8%, and PGAD rating of at least ‘good’ by 53.1%. HECSI-75 was achieved by 59.3% and (almost) clear on the Photographic guide by 74.1%. The minimally important change in QOLHEQ was achieved by 57.9%. Sub-analysis in patients with concomitant irritant contact dermatitis showed no differences. Safety analysis showed no new findings compared to clinical trials.Conclusions: Upadacitinib can be an effective treatment for patients with AD and concomitant HE in daily practice. Future studies should focus on the effectiveness of upadacitinib on chronic HE, especially on the different etiological subtypes of HE, including HE in non-atopic individuals.</p

Coalition theories: empirical evidence for dutch municipalities

The paper analyzes coalition formation in Dutch municipalities. After discussing the main features of the institutional setting, several theories are discussed, which are classified as size oriented, policy oriented and actor oriented models. A test statistic is proposed to determine the predictive power of these models. The empirical analysis shows that strategic positions as well as some of the distinguished preferences are important in the setting of Dutch municipalities. Especially, the dominant minimum number principle yields highly significant results for coalition formations in the period 1978–1986