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Driebergen-Rijsenburg, Netherlands

Bredie S.J.H.,Radboud University Nijmegen | Jong M.C.,Louis Bolk Institute
Journal of Cardiovascular Pharmacology | Year: 2012

BACKGROUND: Medicinal treatment of vasospastic Raynaud phenomenon is limited to primarily vasodilator medicines. OBJECTIVE: To explore the possible beneficial effects and tolerability of 120 mg two times a day of Ginkgo Biloba special extract EGb 761 in patients suffering from Raynaud disease (RD) (primary Raynaud phenomenon). METHODS: In a placebo-controlled, double-blind, pilot study, 41 patients with RD were randomized to either the active treatment group (EGb 761, n = 21) or placebo group for 10 weeks, after an initial 2-week run-in phase. The primary efficacy variables were self-reported changes of the frequency, duration, and severity of vasospastic attacks between the placebo-controlled run-in phase and the end of the study. RESULTS: Most of the patients were female, and both groups were perfectly matched with respect to demographic characteristics. The frequency of daily attacks reduced from 3.6 ± 2.3 to 2.4 ± 2.6 (-33%) in the EGb 761 group and from 2.9 ± 2.0 to 2.0 ± 1.8 (-31%) in the placebo group with no significant difference according to the ordinary least squares test (P = 0.3564). Furthermore, no significant differences were found with respect to the duration and severity of vasospastic attacks between the EGb 761 and placebo groups (P = 0.4392 and P = 0.7187, respectively). In all, 17 adverse events (AEs) were reported, 6 AEs from 5 patients in the EGb 761 group and 11 AEs from 8 patients in the placebo group. Serious AEs did not occur. CONCLUSION: EGb 761 treatment showed an excellent safety profile in patients with RD but could not demonstrate a statistically significant reduction in clinically relevant symptoms compared with placebo. Copyright © 2012 by Lippincott Williams &Wilkins. Source


Erisman J.W.,Louis Bolk Institute
Philosophical transactions of the Royal Society of London. Series B, Biological sciences | Year: 2013

The demand for more food is increasing fertilizer and land use, and the demand for more energy is increasing fossil fuel combustion, leading to enhanced losses of reactive nitrogen (Nr) to the environment. Many thresholds for human and ecosystem health have been exceeded owing to Nr pollution, including those for drinking water (nitrates), air quality (smog, particulate matter, ground-level ozone), freshwater eutrophication, biodiversity loss, stratospheric ozone depletion, climate change and coastal ecosystems (dead zones). Each of these environmental effects can be magnified by the 'nitrogen cascade': a single atom of Nr can trigger a cascade of negative environmental impacts in sequence. Here, we provide an overview of the impact of Nr on the environment and human health, including an assessment of the magnitude of different environmental problems, and the relative importance of Nr as a contributor to each problem. In some cases, Nr loss to the environment is the key driver of effects (e.g. terrestrial and coastal eutrophication, nitrous oxide emissions), whereas in some other situations nitrogen represents a key contributor exacerbating a wider problem (e.g. freshwater pollution, biodiversity loss). In this way, the central role of nitrogen can remain hidden, even though it actually underpins many trans-boundary pollution problems. Source


Kooreman P.,University of Tilburg | Baars E.W.,Leiden University | Baars E.W.,Louis Bolk Institute
European Journal of Health Economics | Year: 2012

Background Health economists have largely ignored complementary and alternative medicine (CAM) as an area of research, although both clinical experiences and several empirical studies suggest cost-effectiveness of CAM. Objective To explore the cost-effectiveness of CAM compared with conventional medicine. Methods A dataset from a Dutch health insurer was used containing quarterly information on healthcare costs (care by general practitioner (GP), hospital care, pharmaceutical care, and paramedic care), dates of birth and death, gender and 6-digit postcode of all approximately 150,000 insurees, for the years 2006-2009. Data from 1913 conventional GPs were compared with data from 79 GPs with additional CAM training in acupuncture (25), homeopathy (28), and anthroposophic medicine (26). Results Patients whose GP has additional CAM training have 0-30% lower healthcare costs and mortality rates, depending on age groups and type of CAM. The lower costs result from fewer hospital stays and fewer prescription drugs. Discussion Since the differences are obtained while controlling for confounders including neighborhood specific fixed effects at a highly detailed level, the lower costs and longer lives are unlikely to be related to differences in socioeconomic status. Possible explanations include selection (e.g. people with a low taste for medical interventions might be more likely to choose CAM) and better practices (e.g. less overtreatment, more focus on preventive and curative health promotion) by GPs with knowledge of complementary medicine. More controlled studies (replication studies, research based on more comprehensive data, cost-effectiveness studies on CAM for specific diagnostic categories) are indicated. © The Author(s) 2011. Source


Doesburg P.,Louis Bolk Institute | Nierop A.F.M.,Muvara bv
Computers and Electronics in Agriculture | Year: 2013

Crystallization patterns emerge when an aqueous dihydrate Copper chloride (CuCl2{dot operator}2H2O) solution in the presence of organic additives (juices/extracts) is crystallized on a glass plate. The emerging patterns are additive-specific and reflect physiological processes like maturation and ageing, the effect of processing, feeding regime and production system in a broad range of agricultural products. The patterns and their underlying structures are evaluated visually by means of defined morphological criteria and by means of computerized image analysis, respectively. The currently applied texture analysis algorithm reflects the spatial linear relationships between grey-scale values of the scanned crystallization structures, rendering the zero point arbitrary and constraining data analysis to the ordinal scale. Furthermore the algorithm is non-consistent with the physically defined geometric properties of the crystallization structures. In this article the development of a structure analysis algorithm is described and discussed which allows a quantification of the crystallization structures by computing 15 width-, and length-parameters, introducing a non-arbitrary zero-point and an equidistant scale which permits all statistical measures. The algorithm is applied to crystallization structures produced from carrot samples which shows it reflects the monotonic relation between physically defined geometric properties of the crystallization structures and laboratory procedure parameters influencing the overall morphological features of the crystallization structures. For instance the nucleation time, which is the time elapsed prior to initial nucleation of the crystallization structure, and the circular region of interest (ROI) around the geometric center of the glass plate used in image analysis evaluation. It is concluded that this structure analysis algorithm is a valuable addition to the image evaluation tools applicable for crystallization investigations of agricultural products, augmenting the image analysis with a non-arbitrary zero point and an equidistant scale which permits all statistical measures. © 2012 Elsevier B.V. Source


Galloway J.N.,University of Virginia | Leach A.M.,University of Virginia | Bleeker A.,Energy Research Center of the Netherlands | Erisman J.W.,Louis Bolk Institute | Erisman J.W.,VU University Amsterdam
Philosophical Transactions of the Royal Society B: Biological Sciences | Year: 2013

Nitrogen over the ages! It was discovered in the eighteenth century. The following century, its importance in agriculture was documented and the basic components of its cycle were elucidated. In the twentieth century, a process to provide an inexhaustible supply of reactive N (Nr; all N species except N2) for agricultural, industrial and military uses was invented. This discovery and the extensive burning of fossil fuels meant that by the beginning of the twenty-first century, anthropogenic sources of newly created Nr were two to three times that of natural terrestrial sources. This caused a fundamental change in the nitrogen cycle; for the first time, there was the potential for enough food to sustain growing populations and changing dietary patterns. However, most Nr created by humans is lost to the environment, resulting in a cascade of negative earth systems impacts-including enhanced acid rain, smog, eutrophication, greenhouse effect and stratospheric ozone depletion, with associated impacts on human and ecosystem health. The impacts continue and will be magnified, as Nr is lost to the environment at an even greater rate. Thus, the challenge for the current century is how to optimize the uses of N while minimizing the negative impacts. © 2013 The Author(s) Published by the Royal Society. All rights reserved. Source

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