ConsExpo - Consumenten blootstellings- en opnamemodellen - Programma handleiding

Dit rapport is een handleiding voor het gebruik van ConsExpo 4.0, de opvolger van ConsExpo 3.0, een computer programma dat is ontwikkeld ter ondersteuning van de blootstellingsschatting van stoffen in consumentenproducten. Er is een grote verscheidenheid aan consumentenproducten, consumenten en wijzen waarop deze consumenten producten gebruiken. Gemeten blootstellingsniveaus aan stoffen in producten zijn niet altijd voorhanden. Bij afwezigheid van deze gegevens kan ConsExpo 4.0 gebruikt worden om blootstellingen te schatten voor verschillende blootstellingsscenario's. Het programma biedt een aantal algemeen toepasbare blootstellingsmodellen en een database met gegevens over blootstellingsfactoren. Tezamen bieden modellen en database een uitgangspunt van waaruit blootstelling van een specifiek product geschat kan worden. Daarnaast kan ConsExpo 4.0 inzicht geven in de factoren die de blootstellingsniveaus van stoffen in consumentenproducten beinvloeden door gebruik te maken van de mogelijkheden van gevoeligheidsanalyse en probabilistische berekeningen. Bij de ontwikkeling van ConsExpo 4.0 is speciaal aandacht besteed aan het verbeteren van de transparantie en de gebruikersvriendelijkheid van de software. Dit rapport geeft een overzicht van ConsExpo 4.0, een uitleg van de beschikbare blootstellings- en opname modellen en belangrijke informatie met betrekking tot het interpreteren van de blootstellingsschatting.This report provides guidance to the use of ConsExpo 4.0, successor to ConsExpo 3.0, a computer program that was developed to assist in the exposure assessment of compounds in non-food consumer products. The wide range of available consumer products is associated with an even wider variation in consumers and product use. Measured data on exposure to compounds in products is not always available. In the absence of these data, ConsExpo 4.0 can be used to estimate the exposure for different exposure scenarios. The program offers a number of generally applicable exposure models and a database with data on exposure factors for a broad set of consumer products. Together, database and models provide the tools to assess exposure for a wide range of consumer products, whereby only basic additional information on product composition and the physicochemical properties of the compound of interest are needed. Moreover, ConsExpo 4.0 can be used to obtain insight in the factors affecting exposure levels to compounds in consumer product by using the tools of sensitivity analysis and probabilistic calculation. In the development of the fourth version of the program special effort has been taken to improve transparency and ease of use of the software. This report provides an overview of ConsExpo 4.0, an explanation of the available exposure and uptake models in ConsExpo 4.0 and important notes on the interpretation of the exposure assessment.VW

Vergelijking van modellen om consumentenblootstelling te berekenen. Inventarisatie van mogelijke verbeteringen van ConsExpo

ConsExpo is een geschikt computerprogramma met rekenmodellen om de mate van blootstelling van mensen aan stoffen in consumentenproducten te schatten. Het programma kan verder verbeterd worden door bepaalde elementen uit andere bestaande rekenmodellen over te nemen. In ConsExpo wordt rekening gehouden met verschillende manieren van blootstelling: via de huid, via inhalatie en via orale opname. Bij het programma hoort een database, waarin standaardwaarden en blootstellingscenario's (wie wordt waar en hoe blootgesteld aan wat en hoe vaak) voor vele producttypen worden aangeboden (bijvoorbeeld cosmetica, verf, reinigingsmiddelen, ongediertebestrijdingsmiddelen en desinfectantia). De beschrijving van deze standaardwaarden en blootstellingscenario's wordt gerapporteerd in zogenoemde 'fact sheets'. Om ConsExpo verder te kunnen verbeteren is een vergelijking gemaakt met andere bestaande rekenmodellen. In de inventarisatie werd gekeken of deze modellen blootstellingscenario's, wiskundige methoden of andere aspecten bevatten die een nuttige aanvulling kunnen zijn voor ConsExpo. Uit de inventarisatie bleek dat ConsExpo zeer geschikt is om de blootstelling te schatten voor stoffen in consumentenproducten. In andere rekenmodellen werden namelijk geen blootstellingscenario's aangetroffen, die niet met ConsExpo berekend kunnen worden. Wel zijn er wiskundige methoden en andere elementen gevonden die voor ConsExpo van groot belang kunnen zijn. Zo kunnen sommige rekenmodellen blootstelling aan stoffen uit meerdere producten berekenen. De berekening van deze zogenaamde 'geaggregeerde blootstelling' zal mogelijk een rol gaan spelen in de risicoschatting van chemische stoffen onder de toekomstige wetgeving in de EU (REACH).ConsExpo is a suitable computer software programme with mathematical models for assessing the exposure of consumers to chemicals in consumer products. This tool can be further improved by adopting certain features from other existing consumer exposure modelling tools. In ConsExpo, different routes of exposure are taken into account, such as the route via the skin, and through inhalation and oral uptake. An important feature of ConsExpo 4.1 is that it contains a database with default values and standard exposure scenarios (who is exposed? where? how? and how often?) for a wide range of consumer product types. Examples include cosmetics, paint, cleaning products, pest control products and disinfectants. The default values and exposure scenarios are described in detail in fact sheets. ConsExpo was compared with other existing consumer modelling tools in an investigation to discover whether the tools contained any exposure scenarios, mathematical models or other features that might be useful for ConsExpo. The aim of the study was to find features that may improve this version (4.1). The investigation demonstrated that ConsExpo is very suitable for assessing exposure to chemicals in consumer products. The other tools did not contain any exposure scenarios for which assessment with ConsExpo is not possible. Nonetheless, a number of mathematical models and other software features have been found that may be of importance to ConsExpo. For example, some tools are capable of assessing exposure to a chemical in multiple products. Assessment of this so-called 'aggregate exposure' will possibly play an important role in the risk assessment of chemicals in future legislation in the EU (REACH).VW

Taping patients with clinical signs of subacromial impingement syndrome: the design of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Shoulder problems are a common complaint of the musculoskeletal system. Physical therapists treat these patients with different modalities such as exercise, massage, and shoulder taping. Although different techniques have been described, the effectiveness of taping has not yet been established. The aim of this study is to assess the effectiveness and cost-effectiveness of usual physical therapy care in combination with a particular tape technique for subacromial impingement syndrome of the shoulder compared to usual physical therapy care without this tape technique in a primary healthcare setting.</p> <p>Methods and design</p> <p>An economic evaluation alongside a randomized controlled trial will be conducted. A sample of 140 patients between 18 and 65 years of age with a diagnosis of subacromial impingement syndrome (SAIS) as assessed by physical therapists will be recruited. Eligible patients will be randomized to either the intervention group (usual care in combination with the particular tape technique) or the control group (usual care without this tape technique). In both groups, usual care will consist of individualized physical therapy care. The primary outcomes will be shoulder-specific function (the Simple Shoulder Test) and pain severity (11-point numerical rating scale). The economic evaluation will be performed using a societal perspective. All relevant costs will be registered using cost diaries. Utilities (Quality Adjusted Life Years) will be measured using the EuroQol. The data will be collected at baseline, and 4, 12, and 26 weeks follow-up.</p> <p>Discussion</p> <p>This pragmatic study will provide information about the effectiveness and cost-effectiveness of taping in patients presenting with clinical signs of SAIS.</p> <p>Trial registration</p> <p>Trial registration number: <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2575">NTR2575</a></p

A prediction model for underestimation of invasive breast cancer after a biopsy diagnosis of ductal carcinoma in situ: based on 2892 biopsies and 589 invasive cancers

Background: Patients with a biopsy diagnosis of ductal carcinoma in situ (DCIS) might be diagnosed with invasive breast cancer at excision, a phenomenon known as underestimation. Patients with DCIS are treated based on the risk of underestimation or progression to invasive cancer. The aim of our study was to expand the knowledge on underestimation and to develop a prediction model. Methods: Population-based data were retrieved from the Dutch Pathology Registry and the Netherlands Cancer Registry for DCIS between January 2011 and June 2012. Results: Of 2892 DCIS biopsies, 21% were underestimated invasive breast cancers. In multivariable analysis, risk factors were high-grade DCIS (odds ratio (OR) 1.43, 95% confidence interval (CI): 1.05–1.95), a palpable tumour (OR 2.22, 95% CI: 1.76–2.81), a BI-RADS (Breast Imaging Reporting and Data System) score 5 (OR 2.36, 95% CI: 1.80–3.09) and a suspected invasive component at biopsy (OR 3.84, 95% CI: 2.69–5.46). The predicted risk for underestimation ranged from 9.5 to 80.2%, with a median of 14.7%. Of the 596 invasive cancers, 39% had unfavourable features. Conclusions: The risk for an underestimated diagnosis of invasive breast cancer after a biopsy diagnosis of DCIS is considerable. With our prediction model, the individual risk of underestimation can be calculated based on routinely available preoperatively known risk factors (https://www.evidencio.com/models/show/1074)

Genome-enabled insights into the biology of thrips as crop pests

Background The western flower thrips, Frankliniella occidentalis (Pergande), is a globally invasive pest and plant virus vector on a wide array of food, fiber, and ornamental crops. The underlying genetic mechanisms of the processes governing thrips pest and vector biology, feeding behaviors, ecology, and insecticide resistance are largely unknown. To address this gap, we present the F. occidentalis draft genome assembly and official gene set. Results We report on the first genome sequence for any member of the insect order Thysanoptera. Benchmarking Universal Single-Copy Ortholog (BUSCO) assessments of the genome assembly (size = 415.8 Mb, scaffold N50 = 948.9 kb) revealed a relatively complete and well-annotated assembly in comparison to other insect genomes. The genome is unusually GC-rich (50%) compared to other insect genomes to date. The official gene set (OGS v1.0) contains 16,859 genes, of which ~ 10% were manually verified and corrected by our consortium. We focused on manual annotation, phylogenetic, and expression evidence analyses for gene sets centered on primary themes in the life histories and activities of plant-colonizing insects. Highlights include the following: (1) divergent clades and large expansions in genes associated with environmental sensing (chemosensory receptors) and detoxification (CYP4, CYP6, and CCE enzymes) of substances encountered in agricultural environments; (2) a comprehensive set of salivary gland genes supported by enriched expression; (3) apparent absence of members of the IMD innate immune defense pathway; and (4) developmental- and sex-specific expression analyses of genes associated with progression from larvae to adulthood through neometaboly, a distinct form of maturation differing from either incomplete or complete metamorphosis in the Insecta. Conclusions Analysis of the F. occidentalis genome offers insights into the polyphagous behavior of this insect pest that finds, colonizes, and survives on a widely diverse array of plants. The genomic resources presented here enable a more complete analysis of insect evolution and biology, providing a missing taxon for contemporary insect genomics-based analyses. Our study also offers a genomic benchmark for molecular and evolutionary investigations of other Thysanoptera species