Alternaria Spores in the Air Across Europe: Abundance, Seasonality and Relationships with Climate, Meteorology and Local Environment

We explored the temporal and spatial variations in airborne Alternaria spore quantitative and phenological features in Europe using 23 sites with annual time series between 3 and 15 years. The study covers seven countries and four of the main biogeographical regions in Europe. The observations were obtained with Hirst-type spore traps providing time series with daily records. Site locations extend from Spain in the south to Denmark in the north and from England in the West to Poland in the East. The study is therefore the largest assessment ever carried out for Europe concerning Alternaria. Aerobiological data were investigated for temporal and spatial patterns in their start and peak season dates and their spore indices. Moreover, the effects of climate were checked using meteorological data for the same period, using a crop growth model. We found that local climate, vegetation patterns and management of landscape are governing parameters for the overall spore concentration, while the annual variations caused by weather are of secondary importance but should not be neglected. The start of the Alternaria spore season varies by several months in Europe, but the peak of the season is more synchronised in central northern Europe in the middle of the summer, while many southern sites have peak dates either earlier or later than northern Europe. The use of a crop growth model to explain the start and peak of season suggests that such methods could be useful to describe Alternaria seasonality in areas with no available observations

A comparative study of palladium-gold and palladium-tin catalysts in the direct synthesis of H2O2

Herein we evaluate the promotive effect of Au and Sn incorporation into supported Pd nanoparticles for the direct synthesis of H2O2 from molecular H2 and O2. The introduction of both secondary metal modifiers was found to result in a significant enhancement in catalytic performance, although, in the case of the PdSn system, it was identified that relatively large quantities of the secondary metal were required to rival the activity observed over optimal Au-containing formulations, with the 0.25%Pd-2.25%Sn/TiO2 catalyst offering comparable H2O2 synthesis rates to the optimised 0.25%Pd-0.25%Au/TiO2 formulation. The introduction of Sn was found to considerably improve Pd dispersion, correlating with an improvement in selective H2 utilisation. Notably, the optimal PdSn catalyst identified in this work achieves superior H2O2 selectivities compared to the PdAu analogue and is able to rival the performance of state-of-the-art materials

A comparative study of palladium-gold and palladium-tin catalysts in the direct synthesis of H2O2

Herein we evaluate the promotive effect of Au and Sn incorporation into supported Pd nanoparticles for the direct synthesis of H2O2 from molecular H2 and O2. The introduction of both secondary metal modifiers was found to result in a significant enhancement in catalytic performance, although, in the case of the PdSn system, it was identified that relatively large quantities of the secondary metal were required to rival the activity observed over optimal Au-containing formulations, with the 0.25%Pd–2.25%Sn/TiO2 catalyst offering comparable H2O2 synthesis rates to the optimised 0.25%Pd–0.25%Au/TiO2 formulation. The introduction of Sn was found to considerably improve Pd dispersion, correlating with an improvement in selective H2 utilisation. Notably, the optimal PdSn catalyst identified in this work achieves superior H2O2 selectivities compared to the PdAu analogue and is able to rival the performance of state-of-the-art materials

A numerical model of birch pollen emission and dispersion in the atmosphere. Description of the emission module

A birch pollen emission model is described and its main features are discussed. The development of the model is based on a double-threshold temperature sum model that describes the propagation of the flowering season and naturally links to the thermal time models to predict the onset and duration of flowering. For the flowering season, the emission model considers ambient humidity and precipitation rate, both of which suppress the pollen release, as well as wind speed and turbulence intensity, which promote it. These dependencies are qualitatively evaluated using the aerobiological observations. Reflecting the probabilistic character of the flowering of an individual tree in a population, the model introduces relaxation functions at the start and end of the season. The physical basis of the suggested birch pollen emission model is compared with another comprehensive emission module reported in literature. The emission model has been implemented in the SILAM dispersion modelling system, the results of which are evaluated in a companion paper

Towards optimal use of antithrombotic therapy of people with cancer at the end of life: a research protocol for the development and implementation of the SERENITY shared decision support tool Thrombosis Research

Background: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. Methods: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.Results: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. Conclusions: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers

Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

New oral anticoagulant agents continue to emerge on the market and their safety requires assessment to provide evidence of their suitability for clinical use. There-fore, we searched standard databases to summarize the English language literature on medicine-related problems (MRPs) of direct oral anticoagulants DOACs (dabigtran, rivaroxban, apixban, and edoxban) in the treatment of adults with atri-al fibrillation. Electronic databases including Medline, Embase, International Pharmaceutical Abstract (IPA), Scopus, CINAHL, the Web of Science and Cochrane were searched from 2008 through 2016 for original articles. Studies pub-lished in English reporting MRPs of DOACs in adult patients with AF were in-cluded. Seventeen studies were identified using standardized protocols, and two reviewers serially abstracted data from each article. Most articles were inconclusive on major safety end points including major bleeding. Data on major safety end points were combined with efficacy. Most studies inconsistently reported adverse drug reactions and not adverse events or medication error, and no definitions were consistent across studies. Some harmful drug effects were not assessed in studies and may have been overlooked. Little evidence is provided on MRPs of DOACs in patients with AF and, therefore, further studies are needed to establish the safety of DOACs in real-life clinical practice

Effect of insulin degludec versus sitagliptin in patients with type 2 diabetes uncontrolled on oral antidiabetic agents

AIM: The efficacy and safety of insulin degludec (IDeg), a new basal insulin with an ultra-long duration of action, was compared to sitagliptin (Sita) in a 26-week, open-label trial. METHODS: Insulin-naïve subjects with type 2 diabetes [n = 458, age: 56 years, diabetes duration: 7.7 years, glycosylated haemoglobin (HbA1c):8.9% (74 mmol/mol)] were randomized (1:1) to once-daily IDeg or Sita (100 mg orally) as add-on to stable treatment with 1 or 2 oral antidiabetic drugs (OADs). RESULTS: Superiority of IDeg to Sita in improving HbA1c and fasting plasma glucose (FPG) was confirmed [estimated treatment difference (ETD) IDeg–Sita for HbA1c: −0.43%-points [95% confidence interval (CI): −0.61; −0.24, p < 0.0001] and for FPG: −2.17 mmol/l (95% CI: −2.59; −1.74, p < 0.0001)]. HbA1c < 7% (<53 mmol/mol) was achieved by 41% (IDeg) versus 28% (Sita) of patients, estimated odds ratio IDeg/Sita: 1.60 (95% CI: 1.04; 2.47, p = 0.034). There was no statistically significant difference in the rate of nocturnal confirmed hypoglycaemia between IDeg and Sita [0.52 vs. 0.30 episodes/patient-year, estimated rate ratio (ERR): IDeg/Sita: 1.93 (95% CI: 0.90; 4.10, p = 0.09)]. Rates of overall confirmed hypoglycaemia were higher with IDeg than with Sita [3.1 vs. 1.3 episodes/patient-year, ERR IDeg/Sita: 3.81 (95% CI: 2.40; 6.05, p < 0.0001)]. IDeg was associated with a greater change in body weight than Sita [ETD IDeg–Sita: 2.75 kg (95% CI: 1.97; 3.54, p < 0.0001)]. The overall rates of adverse events were low and similar for both groups. CONCLUSIONS: In patients unable to achieve good glycaemic control on OAD(s), treatment intensification with IDeg offers an effective, well-tolerated alternative to the addition of a second or third OAD