Physiological monitoring in the complex multimorbid heart failure patient - Conclusions.

Comorbidities are increasingly recognized as crucial components of the heart failure syndrome. Main specific challenges are polypharmacy, poor adherence to treatments, psychological aspects, and the need of monitoring after discharge. The chronic multimorbid patient therefore represents a specific heart failure phenotype that needs an appropriate and continuous management over time. This supplement issue covers the key points of a series of meeting coordinated by the Heart Failure Association of the European Society of Cardiology (ESC), that have discussed the issues surrounding the effective monitoring of our ever more complex and multimorbid heart failure patients. Here, we present an overview of the complex issues from a healthcare delivery perspective

CHP or biofuel production in Europe?

In this study, the opportunity to invest in combined heat and power (CHP) plants and second-generation biofuel production plants in Europe is investigated. To determine the number and type of production plants, a mixed integer linear model is used, based on minimization of the total cost of the whole suply chain. Different policy scenarios are studied with varying values of carbon cost and biofuel support. The study focuses on the type of technology to invest in and the CO2 emission substitution potential, at constant energy prices. The CHP plants and the biofuel production plants are competing for the same feedstock (forest biomass), which is available in limited quantities. The results show that CP plants are preferred over biofuel production plants at high carbon costs (over 50 EUR/tCO2) and low biofuel support (below 10 EUR/GJ), whereas more biofuel production plants would be set up at high biofuel support (over 15 EUR/GJ), irrespective of the carbon cost. Regarding the CO2 emission substitution potential, the highest potential can be reached at a high carbon cost and low biofuel support. It is concluded that there is a potential conflict of interest between policies promoting increased use of biofuels, and policies aiming at decreased CO2 emissions

Potential stocks and increments of woody biomass in the European Union under different management and climate scenarios

BACKGROUND: Forests play an important role in the global carbon flow. They can store carbon and can also provide wood which can substitute other materials. In EU27 the standing biomass is steadily increasing. Increments and harvests seem to have reached a plateau between 2005 and 2010. One reason for reaching this plateau will be the circumstance that the forests are getting older. High ages have the advantage that they typical show high carbon concentration and the disadvantage that the increment rates are decreasing. It should be investigated how biomass stock, harvests and increments will develop under different climate scenarios and two management scenarios where one is forcing to store high biomass amounts in forests and the other tries to have high increment rates and much harvested wood. RESULTS: A management which is maximising standing biomass will raise the stem wood carbon stocks from 30 tC/ha to 50 tC/ha until 2100. A management which is maximising increments will lower the stock to 20 tC/ha until 2100. The estimates for the climate scenarios A1b, B1 and E1 are different but there is much more effect by the management target than by the climate scenario. By maximising increments the harvests are 0.4 tC/ha/year higher than in the management which maximises the standing biomass. The increments until 2040 are close together but around 2100 the increments when maximising standing biomass are approximately 50 % lower than those when maximising increments. Cold regions will benefit from the climate changes in the climate scenarios by showing higher increments. CONCLUSIONS: The results of this study suggest that forest management should maximise increments, not stocks to be more efficient in sense of climate change mitigation. This is true especially for regions which have already high carbon stocks in forests, what is the case in many regions in Europe. During the time span 2010-2100 the forests of EU27 will absorb additional 1750 million tC if they are managed to maximise increments compared if they are managed to maximise standing biomass. Incentives which will increase the standing biomass beyond the increment optimal biomass should therefore be avoided. Mechanisms which will maximise increments and sustainable harvests need to be developed to have substantial amounts of wood which can be used as substitution of non sustainable materials