TM5-FASST: a global atmospheric source-receptor model for rapid impact analysis of emission changes on air quality and short-lived climate pollutants

This paper describes, documents and validates the TM5-Fast Scenario Screening Tool (TM5-FASST), a global reduced-form air quality source-receptor model that has been designed to compute ambient pollutant concentrations as well as broad range of pollutant-related impacts, related to human health, agricultural crop production, and short-lived pollutant climate metrics, taking as input annual pollutant emission data aggregated at the national or regional level. The TM5-FASST tool, providing a trade-off between accuracy and applicability, is based on linearized emission-concentration sensitivities derived with the full chemistry-transport model TM5. The tool has been extensively applied in various recent critical studies. Although informal and fragmented validation has already been performed in various publications, this paper provides a comprehensive documentation of all components of the model and a validation against the full TM5 model. We find that the simplifications introduced in order to generate immediate results from emission scenarios are not compromising the validity of the output and as such TM5-FASST is proven to be a useful tool in science-policy analysis. Furthermore, it constitutes a suitable architecture for implementing the ensemble of source-receptor relations obtained in the frame of the HTAP modelling exercises, thus creating a link between the scientific community and policy-oriented users.JRC.C.5-Air and Climat

Adherence to antihypertensive drug treatment in Argentina: a multicenter study.Adherence to antihypertensive drugs in Argentina.

Adherence to antihypertensive medication is an important challenge that doctors often face in the treatment of hypertension. Good adherence is crucial to prevent cardiovascular complications. In consequence, the present study aimed at determining the prevalence of adherence to antihypertensive treatment and identifying associated clinical variables. A multicenter cross-sectional study was conducted in 12 cities of Argentina. A systematic sampling was performed in order to select patients with hypertension and under pharmacological treatment for at least 6 months. Physicians took three BP measurements, and the level of adherence was assessed using the self-administered Morisky questionnaire (MMAS-8). Participants were classified into three levels of adherence: high adherence—MMAS score of 8; medium adherence—MMAS scores of 6 to <8; and low adherence—MMAS scores of <6. A total of 1111 individuals (62 ± 12 years old, women 49.4%) were included in the present analysis; 159 (14.3%), 329 (29.6%) and 623 (56.1%) patients had low, medium, and high adherence, respectively. The prevalence of controlled hypertension increased only in high adherent patients: 42.8%, 42.2%, and 64.5% for low, medium, and high adherence groups, respectively. Similarly, systolic BP was lower only in the high adherence group. High educational level (OR 3.47, 95% CI 2.68-4.49) and diuretic treatment (OR 0.64, 95% CI 0.47-0.88) were independent predictors of high adherence. In conclusion, more than a half of treated hypertensive patients had a high level of adherence. These patients had lower BP values and higher control levels. A high educational level predicts high adherence.Fil: Espeche, Walter. Hospital San Martin de la Plata; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Salazar, Martin. Universidad Nacional de La Plata; Argentina. Hospital San Martin de la Plata; ArgentinaFil: Sabio, Rodrigo. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; ArgentinaFil: Diaz, Alberto Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Leiva Sisnieguez, Carlos Enrique. Universidad Nacional de La Plata; Argentina. Hospital San Martin de la Plata; ArgentinaFil: Olano, Daniel. Hospital San Martin de la Plata; ArgentinaFil: Balbin, Eduardo. Hospital San Martin de la Plata; ArgentinaFil: Renna, Nicolas Federico. Universidad Nacional de Cuyo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Grosse, Pedro. No especifíca;Fil: Flores, Roberto A.. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Medicas.; ArgentinaFil: Lagos, Ana C.. No especifíca;Fil: Ferrero, Pablo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; ArgentinaFil: Poppe, Silvia. Hospital Nacional Profesor Alejandro Posadas.; ArgentinaFil: Risso Patron, Facundo. No especifíca;Fil: Sotnieczuk Stasiuk, Victor D.. No especifíca;Fil: Valentini, Elina. No especifíca;Fil: Cardozo, Jose Ricardo. Hospital Justo Pereyra Aristóbulo del Valle; ArgentinaFil: Romano, Jose R.. Hospital de Formosa; ArgentinaFil: Parodi, Roberto. Universidad Nacional de Rosario. Facultad de Ciencias Médicas; ArgentinaFil: Carbajal, Horacio. Universidad Nacional de La Plata; Argentin

The observational clinical registry (cohort design) of the European Reference Network on Rare Adult Solid Cancers: The protocol for the rare head and neck cancers

Care for head and neck cancers is complex in particular for the rare ones. Knowledge is limited and histological heterogeneity adds complexity to the rarity. There is a wide consensus that to support clinical research on rare cancer, clinical registries should be developed within networks specializing in rare cancers. In the EU, a unique opportunity is provided by the European Reference Networks (ERN). The ERN EURACAN is dedicated to rare adults solid cancers, here we present the protocol of the EURACAN registry on rare head and neck cancers (ClinicalTrials.gov Identifier: NCT05483374). Study design Registry-based cohort study including only people with rare head and neck cancers. Objectives 1.To help describe the natural history of rare head and neck cancers; 2.To evaluate factors that influence prognosis; 3.To assess treatment effectiveness; 4.To measure indicators of quality of care. Methods Settings and participants It is an hospital based registry established in hospitals with expertise in head and neck cancers. Only adult patients with epithelial tumours of nasopharynx; nasal cavity and paranasal sinuses; salivary gland cancer in large and small salivary glands; and middle ear will be included in the registry. This registry won t select a sample of patients. Each patient in the facility who meets the above mentioned inclusion criteria will be followed prospectively and longitudinally with follow-up at cancer progression and / or cancer relapse or patient death. It is a secondary use of data which will be collected from the clinical records. The data collected for the registry will not entail further examinations or admissions to the facility and/or additional appointments to those normally provided for the patient follow-up. Variables Data will be collected on patient characteristics (eg. patient demographics, lifestyle, medical history, health status); exposure data (eg. disease, procedures, treatments of interest) and outcomes (e.g. survival, progression, progression-free survival, etc.). In addition, data on potential confounders (e.g. comorbidity; functional status etc.) will be also collected. Statistical methods The data analyses will include descriptive statistics showing patterns of patients and cancers variables and indicators describing the quality of care. Multivariable Cox s proportional hazards model and Hazard ratios (HR) for all-cause or cause specific mortality will be used to determine independent predictors of overall survival, recurrence etc. Variables to include in the multivariable regression model will be selected based on the results of univariable analysis. The role of confounding or effect modifiers will be evaluated using stratified analysis or sensitivity analysis. To assess treatment effectiveness, multivariable models with propensity score adjustment and progression-free survival will be performed. Adequate statistical (eg. marginal structural model) methods will be used if time-varying treatments/ confounders and confounding by indication (selective prescribing) will be present. Results The registry initiated recruiting in May 2022. The estimated completion date is December 2030 upon agreement on the achievement of all the registry objectives. As of October 2022, the registry is recruiting. There will be a risk of limited representativeness due to the hospital-based nature of the registry and to the fact that hospital contributing to the registry are expert centres for these rare cancers. Clinical Follow-up could also be an issue but active search of the life status of the patients will be guaranteed