Over revalidatie

REDE UITGESPROKEN BIJ DE AANVAARDING VAN HET AMBT VAN GEWOON LECTOR IN DE REVALIDATIE AAN DE MEDISCHE FACULTEIT ROTTERDAM OP WOENSDAG 15 NOVEMBER 197

Can we afford this? The capability to make financial decisions in individuals with and without cognitive impairment

In order to make (clinical) decisions about the financial decision-making (FDM) capability (i.e., the ability to manage or direct the management of one’s finances) of an individual, the assessment of FDM should be conducted carefully and comprehensively. For this, new FDM tests and questionnaires have been developed. The aim of the current thesis is to systematically and comprehensively study the FDM capability of individuals with and without cognitive dysfunctions. The thesis focuses on the effects of normal aging on FDM capability and explores the FDM capability of individuals with neurodegenerative diseases (NDDs) and adults with attention-deficit/hyperactivity disorder (ADHD). In summary, evidence has been found that patients with NDDs and adults with ADHD are more likely to show FDM-capability problems than healthy individuals. The severity of cognitive impairment seems to be related to the degree of problems with FDM in these patients. Numeracy was most consistently found as significant predictor of aspects of FDM capability. Furthermore, evidence has been found that processing speed, working memory and verbal memory are positively related to the ability to make (adequate) financial decisions. Besides cognition, several contextual factors, such as age, level of education or personality, seem to play a role and relate to aspects of the FDM capability of an individual in a negative (or positive) way. The FDM test battery showed adequate divergent validity and reliability. More research is, however, needed in order to increase the predictive value of the FDM tests and questionnaires

Using Sentinel Species to Understand the Distribution, Fate and Effects of Perfluoroalkyl Acids in Wildlife

This dissertation addresses perfluoroalkyl acid (PFAA) profiles in American alligators, Mozambique tilapia, and Striped mullet in relation to various parameters including sex, season, disease (i.e. pansteatitis), and fecundity. This dissertation hypothesizes that PFAA are affected by sex, season, and health (pansteatitis), but conversely that PFAAs also affect health (fecundity). To address sex and season, PFAA levels were assessed in alligator plasma across Florida and South Carolina (n = 125, years 2012 - 2015) including an in depth look at alligators at Merritt Island (n = 229, years 2008 – 2009). At these sites, PFAAs revealed sex-based differences for a number of the PFAAs investigated but did not reveal seasonality in PFAAs in alligator plasma. To address the effect of health on PFAAs, a population of Mozambique tilapia affected by an environmentally-derived inflammatory disease (pansteatitis) were investigated. Contrary to our hypothesis that diseased tilapia would have higher levels of PFAAs, healthy tilapia maintained higher PFAA levels in the liver, kidney, and plasma compared to diseased tilapia (p-value \u3c 0.05), but despite being contrary to the hypothesis, results still suggests health status affects PFAA profile in tilapia. To address PFAA effect on health, PFAA levels and fecundity measures were investigated in wild-caught, Striped mullet liver from Merritt Island to further assess if the measured levels of PFAA could affect fecundity. Results revealed higher PFAA were not correlated to reduced fecundity. However, changes in stages of oocyte development correlated with changes in liver PFAAs. Of the PFAAs with significant changes by sub-stage, the carboxylic acids (PFOA, PFNA, and PFTRiA) increased in the liver with increasing sub- stage of oocyte development while the sulfonic acid and its precursor (PFOS and PFOSA, respectively) decreased in the liver with increasing stage of oocyte development. This is a unique finding and suggests PFAAs change location of compartmentalization as mullet progress towards spawning. This results also show that in addition to PFAAs changing with sex, and disease, PFAA profile in a wildlife species (striped mullet) also change with oocyte development during spawning. Overall, this dissertation determines that sex, health status, and reproductive status (oocyte development prior to spawning) are all factors that have the potential to influence PFAA profiles in a number of wildlife species

Prostate cancer screening in Europe and Asia

Prostate cancer (PCa) is the second most common cancer among men worldwide and even ranks first in Europe. Although Asia is known as the region with the lowest PCa incidence, it has been rising rapidly over the last 20 years mostly due to the introduction of prostate-specific antigen (PSA) testing. Randomized PCa screening studies in Europe show a mortality reduction in favor of PSA-based screening but coincide with high proportions of unnecessary biopsies, overdiagnosis and subsequent overtreatment. Conclusive data on the value of PSA-based screening and hence the balance between harms and benefits in Asia is still lacking. Because of known racial variations, Asian countries should not directly apply the European screening models. Like in the western world also in Asia, new predictive markers, tools and risk stratification strategies hold great potential to improve the early detection of PCa and to reduce the worldwide existing negative aspects of PSA-based PCa screening

Contemporary population structure and historical demography of sailfish (Istiophorus platypterus) in the Atlantic Ocean

The Atlantic sailfish (Istiophorus platypterus) is considered over-fished in U.S. waters. Furthermore, preliminary analyses of abundance indicate that a decline in biomass has occurred. While seminal studies have provided useful baseline data about intra- and inter-oceanic variation within sailfish, such studies may have underestimated the amount of genetic variability as a result of small sample sizes and the poor resolution of restriction fragment length polymorphism data. We used 263 base pairs from the hypervariable mitochondrial control region and fragment polymorphisms from five microsatellite loci to assess the contemporary population structure between eastern (n = 30) and western (n = 192) Atlantic sailfish stocks. We failed to reject the hypothesis of panmixia in Atlantic sailfish; however, higher levels of genetic variation were observed within the eastern Atlantic sailfish, and the nature of this difference needs to be investigated further. Having found no evidence of transatlantic differentiation, we pooled the Atlantic samples (n = 222) and compared them to a sample from the eastern Pacific (n = 22) and rejected the null hypothesis, concluding that sailfish from separate ocean basins do not share a common gene pool. We also found evidence of a recent sudden expansion of Clade I (the ubiquitous clade found in both Atlantic and Pacific Oceans) sailfish into the Atlantic that appears to have occurred between 164000 and 351000 years ago, coinciding with interglacial periods during the Pleistocene. This study also presents the first evidence of a recent sudden expansion of sailfish into the eastern Pacific, roughly 85400 to 173000 years ago, following a period when cooling in the eastern Pacific would have restricted the sailfish range to the warmer waters of the western Indo-Pacific. We emphasize that sailfish from this region of the Pacific are phenotypically distinct from those in the rest of the species' range and encourage further studies in order to determine if the eastern Pacific sailfish population should be managed as a separate stock