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The Northeast Atlantic mackerel is an income breeder with indeterminate fecundity, spawning in multiple batches at optimal temperatures around 11°C in the upper water column during February–July along the continental shelf from 36–62°N. Based on macroscopic staging of gonads (N ∼62000) collected in 2004–2021, we detected an on-going extension of spawning activities into the Norwegian Sea feeding area (62–75°N), reaching stable levels around 2012 onwards. This poleward expansion increased as more fish entered the area, whilst the maximum proportions of spawners concurrently dropped from about 75 to 15% from May to July. Detailed histological examinations in 2018 confirmed the macroscopic results but clarified that 38% of the spawning-capable females in July terminated their spawning by atresia. We suggest that increased access to suitable spawning areas (≥10°C), following ocean warming from 2002 onwards, functions as a proximate cause behind the noticed expansion, whereas the ultimate trigger was the historic drop in body growth and condition about 10 years later. Driven by these energetic constraints, mackerel likely spawn in the direction of high prey concentrations to rebuild body resources and secure the future rather than current reproduction success. The ambient temperature that far north is considered suboptimal for egg and larval survival.

Item does not contain fulltext, Uitwerking centraal examen Latijn 2018 {Examenbundel voor VWO/gymnasium)

ECIR 2023, Item does not contain fulltext

RIVM rapport:De coronapandemie en de bestrijding daarvan hebben grote gevolgen gehad voor de samenleving en economie in Nederland. Het RIVM brengt enkele gevolgen hiervan in beeld als opstap naar een Maatschappelijke Baten en Kosten Analyse (MKBA(maatschappelijke kosten-batenanalyse)). Zo zijn scenario’s van strengere en minder strenge maatregelen vergeleken. Ook is voor het eerst een brug geslagen tussen economische- en ziektemodelleringen. Vooral is onderzocht wat bij mensen uit verschillende inkomensgroepen de effecten van de pandemie waren op ziekte en sterfte door corona, op uitgestelde zorg en op de onderwijsprestaties van kinderen. De MKBA moet nog verder ontwikkeld worden, maar het model levert nu al belangrijke inzichten op. Deze inzichten kunnen beleidsmakers bij een volgende gezondheidspandemie helpen om betere afwegingen te maken. Het is daarbij vooral belangrijk om te kijken naar de gevolgen voor verschillende bevolkingsgroepen. Zo blijkt dat de coronapandemie bestaande verschillen tussen inkomensgroepen groter heeft gemaakt. Meer mensen met een lager inkomen zijn overleden aan corona. Verder blijkt dat mensen met een lager inkomen zich minder vaak in teststraten hebben laten testen, maar vaker met corona in het ziekenhuis en op de intensive care terechtkwamen. Daarnaast blijkt dat zij vaak minder snel uitgestelde zorg konden ‘inhalen’ dan mensen met hogere inkomens. Ook is gekeken hoe verschillende bevolkingsgroepen gezondheid en welzijn waarderen. Mensen blijken meer waarde te hechten aan hun welzijn dan aan gezondheid. Met dit inzicht kunnen betere afwegingen worden gemaakt tussen maatregelen die de gezondheid bevorderen, maar het welzijn schaden. Veerkracht blijkt voor alle inkomensgroepen groepen heel belangrijk. Mensen met een lager inkomen halen hun veerkracht vooral uit hun directe omgeving. Bij een nieuwe epidemie is het daarom belangrijk om, naast het landelijke beleid, de lokale bevolking actief te betrekken. Dat kan door informatie te geven die de hele b, The coronavirus pandemic and the measures taken to control it have had serious consequences for Dutch society and the country’s economy. RIVM has mapped out some of these consequences in a study as a step towards a social cost-benefit analysis (SCBA). Among other things, this study compared scenarios with strict and less strict measures and linked economic modelling and disease modelling for the first time. The main focus of the study was on the effects of the pandemic on disease and mortality due to the coronavirus, on postponed care and on the scholastic performance of children for a variety of income groups. While the SCBA still requires further development, the model has already yielded some key insights. These insights will enable policymakers to make better-considered choices in the event of another pandemic, particularly when it comes to weighing the consequences for different population groups. For example, the study revealed that the coronavirus pandemic worsened the existing differences between income groups. Mortality due to the coronavirus was highest among lower income groups. Another finding was that those in lower income groups visited test lanes less often, but were hospitalised with the coronavirus and ended up in intensive care more often than others. Furthermore, they turned out to be slower at ‘catching up’ on postponed care than those in higher income groups. The study also looked at the differences between population groups in their valuation of health and well-being. It revealed that people value their well-being higher than their health. This insight makes it possible to make more carefully considered choices when it comes to measures that improve health, but harm well-being. Resilience was valued very highly by all income groups. Those in lower income groups mostly rely on their innermost circle for resilience. In the event of a new epidemic, it will therefore be vital not just to make national policy, but also to get the local population in

Background: Angina without angiographic evidence of obstructive coronary artery disease (ANOCA) is a highly prevalent condition with insufficient pathophysiological knowledge and lack of evidence-based medical therapies. This affects ANOCA patients prognosis, their healthcare utilization and quality of life. In current guidelines, performing a coronary function test (CFT) is recommended to identify a specific vasomotor dysfunction endotype. The NetherLands registry of invasive Coronary vasomotor Function testing (NL-CFT) has been designed to collect data on ANOCA patients undergoing CFT in the Netherlands. Methods: The NL-CFT is a web-based, prospective, observational registry including all consecutive ANOCA patients undergoing clinically indicated CFT in participating centers throughout the Netherlands. Data on medical history, procedural data and (patient reported) outcomes are gathered. The implementation of a common CFT protocol in all participating hospitals promotes an equal diagnostic strategy and ensures representation of the entire ANOCA population. A CFT is performed after ruling out obstructive coronary artery disease. It comprises of both acetylcholine vasoreactivity testing as well as bolus thermodilution assessment of microvascular function. Optionally, continuous thermodilution or Doppler flow measurements can be performed. Participating centers can perform research using own data, or pooled data will be made available upon specific request via a secure digital research environment, after approval of a steering committee. Conclusion: NL-CFT will be an important registry by enabling both observational and registry based (randomized) clinical trials in ANOCA patients undergoing CFT.

Objective: Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. Methods: Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. Results: Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score >56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). Conclusion: The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.