Dunes, above and beyond : The interactions between ecological and geomorphological processes during early dune development

Coastal dunes occur along the sandy shores of most continents where they serve as coastal defence against flooding, provide areas for recreation, store drinking water and harbour unique biodiversity. Coastal dunes and the services they provide are threatened by climate-induced sea-level rise. This threat may be mitigated by the spontaneous formation of new dunes, for example in combination with mega-nourishments aimed at increasing beach width. Coastal dunes form by the interaction between vegetation, wind and wave action. Persistent dune development begins with the establishment of vegetation on the beach: the vegetation traps the wind-blown sand, forming an embryo dune. Over time an embryo dune can develop into a bigger foredune, increasing coastal safety. The formation and development of embryo dunes into foredunes depend on the vegetation establishment on the beach, dune growth over summer and dune erosion during winter. Although vegetation succession and geomorphological processes are each well described, the interaction between ecological and geomorphological processes during embryo dune development are not well known. The thesis aimed at further exploring these interactions, using a combination of experiments and high-resolution dune monitoring to study the mechanisms underlying early dune development and their implications for mega-nourishment design. To explore whether soil salinity, salt spray or storms determine the vegetation limit of dune building plant species on the beach, we performed a field transplantation experiment and a glasshouse experiment with two dune building grasses Ammophila arenaria and Elytrigia juncea. In the field growth of grasses transplanted into four vegetation zones from sea to dune was monitored for over a year and the response of these species to salt spray and soil salinity was tested in a glasshouse experiment. In the field, the vegetation zones were associated with differences in summer soil salinity: zones with both species present were significantly less saline than zones with only E. juncea or the zones without any vegetation. However, in our experiments the transplanted A. arenaria performed equal or better than E. juncea in all vegetation zones, suggesting soil salinity did not limit species performance at the studied site. Both species showed severe winter mortality. In the glasshouse experiment, A. arenaria biomass decreased linearly with soil salinity, presumably as a result of osmotic stress. Elytrigia juncea showed a nonlinear response to soil salinity with an optimum at 0.75% soil salinity and a decrease in biomass at higher salt concentrations. Our findings suggest that soil salinity stress either takes place in winter during storm inundation, or that development of vegetated dunes is less sensitive to soil salinity than hitherto expected. To understand the boundary conditions for embryo dune development over a longer time period we explored the effects of beach morphology, meteorological conditions and sand nourishment on early dune development using a 30 year time series of aerial photographs and beach profile monitoring data. We concluded that 1) beach morphology is highly influential in determining the potential for new dune development, with wide beaches enabling development of larger embryo dune fields, 2) sand nourishments stimulate early dune development by increasing beach width, and 3) weather conditions and non-interrupted sequences of years without high-intensity storms determine whether progressive dune development will take place. Dune development is the result of the interaction between vegetation development and sedimentation and erosion processes. To disentangle the effects of vegetation characteristics and that of dune size we monitored a natural dune field of 8 hectares for one year using an Unmanned Aerial Vehicle (UAV) with a camera. By constructing a digital surface model and a geometrical corrected image (an orthomosaic) for each flight campaign we calculated changes in dune volume over summer and winter and related these changes to vegetation, dune size and degree of shelter. The dune growth over summer was mainly determined by dune size, whereas dune growth over winter was determined by vegetation characteristics. Degree of shelter determined whether dune growth was limited by storm erosion (exposed dunes) or sand supply (sheltered dunes). These results suggest that vegetation characteristic may be particularly important for resisting storm erosion and speeding up recovery after erosion. Embryo dunes have been hypothesised to facilitate development of species rich green beach vegetation in the sheltered location between the embryo dunes and the primary foredunes. To test this hypothesis we explored the relative impacts of abiotic soil conditions as affected by the geomorphological setting on the species richness and species turn-over of green beach vegetation. To this end we characterised the geomorphology and measured abiotic conditions and species composition of green beach vegetation along transects from beach to foredune. We found that the geomorphological setting influenced plant species composition indirectly by affecting soil salinity and rate of sand burial. We found that plant species richness declined less at sheltered conditions, where there was a build-up of organic matter and no sand burial. Our results further suggest a non-linear relationship between embryo dune volume and number of green beach species: embryo dunes can be a source of shelter, thus stimulating green beach development, but can also compete for space, reducing green beach development. The net effect of embryo dunes most likely depends on the sediment budget of the beach and storm intensity. Mega-nourishments are single large sand nourishments that are applied locally, and are expected to exist for about 20 years, providing opportunities for the development of embryo dunes and rare pioneer plant communities (green beach vegetation). We explored this potential by comparing growth and development of dune building species on natural beaches with the results of plant transplantation and monitoring data of two mega-nourishments: the low-elevated Hondsbossche Duinen and the high-elevated Sandmotor. Our results suggest that establishment of dune building species on high-elevated mega-nourishment proceed slower than on natural beaches due to dispersal limitation. Once vegetation has established however, embryo dune development on high-elevated mega-nourishments may proceed faster than natural beaches due to low salinity and protection against storm erosion. Development of dune-building vegetation on the low-elevated mega-nourishment Hondsbossche Duinen showed the same rate and pattern as that on a natural beach. The potential for embryo dune development on mega-nourishments is far bigger than the potential for green beach development, since green beach vegetation develops under a narrower range of abiotic conditions. Such abiotic conditions can develop behind the shelter of embryo dunes or foredunes at low beach elevations. In conclusion this thesis shows that, 1) the potential of embryo dune development depends on a large beach width and low storm erosion which determines the vegetation limit. 2) Embryo dune growth over summer is mainly determined by existing dune volume and sand supply. 3) Heavy storms limit embryo dune development during winter, although dune erosion can be mitigated by vegetation composition. 4) On accreting beaches which continuously provide area for the development of new embryo dunes green beach vegetation can develop. 5) The design of a mega-nourishment determines the potential for the development of embryo dunes and green beach vegetation. Our findings provide insights in the interaction between ecological and geomorphological processes that determine embryo dune development. This knowledge can help to obtain better predictions of embryo dune development under the threat of sea-level rise. </p

Reported adverse drug reactions during the use of inhaled steroids in children with asthma in the Netherlands

Objective: Inhaled corticosteroids (ICS) are widely used in the treatment of asthma. We studied the suspected adverse drug reactions (sADRs) reported during the use of ICS in the Netherlands. Methods: In the Netherlands, health professionals and patients can report suspected ADRs to the Pharmacovigilance Centre Lareb. All reported sADRs on ICS were categorised and assessed as to whether these were likely to be associated with use of the steroid. Age and gender adjusted Reported Odds Ratios (RORs) and Naranjo Scores (NS) were computed for sADRs reported more than 3 times. Results: Since 1984, sADRs of ICS were reported in 89 children (mean age 6 years), 48 (54%) were boys. Suspected drugs were fluticasone in 46 children (52%), budesonide in 21 (24%), and beclomethasone in 22 cases (24%). Psychiatric symptoms were reported in 19 children (21%; ROR 3.8, NS 3.6), growth retardation in 6 children (7%; ROR 47.8, NS 3.0) and rashes in 6 cases (7%; ROR 0.7, NS 2.4). There were 7 reports (8%; ROR 2.1, NS 3.4) concerning abnormalities of the teeth, 4 reports of alopecia (4%; ROR 3.3, NS 3.5), and 3 reports of hirsutism and hypertrichosis (NS 4.0). Non-fatal adrenal insufficiency was reported once. Conclusion: Alteration of behaviour was the most frequently reported sADR. There are more indications that alterations of behaviour could be a real sADR of ICS. Non-fatal adrenal insufficiency was the only reported possible life threatening sADR. The association of hypertrichosis and teeth abnormalities after ICS in children has not been reported in the literature before

Numbers of spontaneous reports:How to use and interpret?

Due to the high intensity of the COVID-19 vaccination campaigns and heightened attention for safety issues, the number of spontaneous reports has surged. In the Netherlands, pharmacovigilance centre Lareb has received more than 100,000 reports on AEFI associated with Covid-19 vaccination. It is tempting to interpret absolute numbers of reports of AEFIs in signal detection. Signal detection of spontaneously reported adverse drug reaction, has its origin in case-by-case analysis where all case reports are assessed by clinically qualified assessors. The concept of clinical review of cases - even if only a few per country - followed by sharing concerns of suspicions of potential adverse reactions again proved the strength of the system. Disproportionality analysis can be useful in signal identification, and comparing reported cases with expected based on background incidence can be useful to support signal detection. However, they cannot be used without an in-depth analysis of the underlying clinical data and pharmacological mechanism. This in-depth analysis has been performed, and is ongoing, for the signal of vaccine-induced immune thrombotic thrombocytopenia (VITT) in relation to the AstraZeneca and Janssen Covid-19 vaccines (4, 5). Although no frequency or incidence rates, reporting rates can provide an impression of the occurrence of the event. But the unknown underreporting should also be part of this context. To quantify the incidence rates, follow-up epidemiological studies are needed

Exoten in het zoete water in de afgelopen eeuw

Het aantal exoten in het zoete water is de afgelopen decennia sterk toegenomen. Vele macrofauna, vissen en waterplanten hebben zich hier gevestigd door menselijk toedoen, zoals de handel in planten en vissen voor vijvers, het uitzetten van vissen voor sportvissers, de aanleg van het Main-Donaukanaal en het lozen van ballastwater. Tussen deze soortgroepen bestaan verschillen in de belangrijkste manier van introductie en landen van herkomst. In dit artikel wordt ingegaan op de toename van nieuwe soorten vissen, macrofauna en waterplanten in het zoete water. Bijna een derde van de Nederlandse vissoorten is momenteel uitheems. Enkele soorten hebben een negatief effect op hetecosysteem of leiden tot kosten voor de waterschappen

Session E8: Fish Migration Possibilities in the Netherlands; State of the Art (Barriers, Solutions, Monitoring)

Abstract: Measures to restore fish migration is gaining a major boost in the Netherlands since the Water Framework Directive, Benelux Regulation and Eel Directive are operational. Water managers, responsible for a good ecological status, are working hard to reach free fish migration in their waters. Currently, 1.124 measures are realized at barriers like weirs, pumping stations, sluices and culverts. 2.745 barriers are identified. Since 2000, there is a strong development of measures and new techniques. These results are based on a study “The Netherlands living with Fish Migration”, that was started in 2008. Target of this study was the evaluation of the progress in approach of measures and to gather information on improvement of fish migration in the Netherlands. Within this project a database was created with the prioritized barriers and measures for fish migration. This data is supplied by the water managers. Every four years water managers are asked for an update and an evaluation is carried out. In this presentation the results are discussed, with focus on type of barrier, solutions and intensity of monitoring carried out by the water managers. Also an overview of planning, with respect to WFD targets, is given. A map is created of for migratory fish accessible inland waters in up- and downstream direction. Database and maps are good medium for exchanging knowledge between water managers and other stakeholders

Post-Menopausal Vaginal Hemorrhage Related to the Use of a Hop-Containing Phytotherapeutic Product

Two 54-year-old women developed abdominal cramps and vaginal hemorrhage as a result of endometrial hyperplasia during treatment with a hop-containing phytotherapeutic product (MenoCool®) for post-menopausal complaints. The women used the hop-containing phytotherapeutic product (418 mg of hop per tablet) twice daily (1 and 0.5 tablets by both patient A and B). Patient A developed abdominal cramps and vaginal hemorrhage after 2 months of use. After gynecological examination, she was diagnosed with endometrial hyperplasia. The patient was treated with a curettage. The hop-containing phytotherapeutic product was discontinued, and the patient recovered. Patient B developed abdominal pain/cramps and vaginal hemorrhage after 5 months of use. A cervix smear, internal examination, and ultrasound were performed. Due to the thickness of the endometrium, a pipelle endometrial biopsy was performed. Results showed no indication for cervix cancer. The use of MenoCool®was ceased; follow-up information received from the patient shortly thereafter indicated that she had almost entirely recovered from the abdominal pain/cramps and vaginal hemorrhage. Hop (Humulus lupulus) has phytoestrogenic properties that may be the cause of endometrial hyperplasia and subsequent vaginal hemorrhage. A Naranjo assessment score of 5 was obtained for both cases, indicating a probable relationship between the patient’s endometrial proliferation and subsequent vaginal hemorrhage and their use of the suspect drug

Patient preferences and expectation for feedback on adverse drug reaction reports submitted in Ghana

Background: Personalized feedback received for spontaneous adverse drug reaction (ADR) reports serves as motivation for future reporting and the effectiveness of the feedback is dependent on the medium used in delivering the information. Objective: Explore expectation for feedback from patients on ADR reports submitted to the National Pharmacovigilance Centre (NPvC) in Ghana and the preferred medium for receiving the feedback information. Methods: Cross-sectional study using structured questionnaire administered through face-to-face interview from August to September 2016 to patients selected by convenience sampling. Pearson chi-square (§2) or Fisher's exact test was used to determine associations between background variables such as age, gender and level of education. Results: The response rate was 86.7% (n=442). Of the participants interviewed, 96.5% expected to receive feedback for ADR reports submitted. Age and level of education were the two variables significantly associated with patients' expectation for feedback.The preferred medium for receiving feedback in decreasing order of preference were, telephone call (60.4%), mobile phone short messaging services (23.0%), email (8.3%), face-to-face meeting (3.4%), personalized letter (3.4%) and publication in a newsletter (1.4%). Conclusion: Patients' expectation for receiving feedback for ADR reports submitted to the NPvC is in line with modern trends in communication. NPvC should explore these alternatives for providing feedback to patients. This study is limited to what patients' expectations and preferences were for receiving feedback on ADR reports submitted, additional study to further explore the type of information patients expect to be contained in the feedback will be useful to National Pharmacovigilance Centres. Funding: None declared

Legislation and current developments in adverse drug reaction reporting in Mongolia:how far are we?

Monitoring adverse drug reactions is a vital issue to ensure drug safety and to protect the general public from medication-related harmful effects. In order to properly monitor drug safety, a regulatory system needs to be in place as well as an infrastructure that allows for analyzing national and international safety data. In Mongolia, adverse drug reaction (ADR) reporting activities have been implemented in the past decade. During this period, the basic structure and legal basis of an adverse drug reaction monitoring system was established. Because of the fragmented but growing healthcare system and the complexity of pharmaceutical issues in Mongolia, a sustainable process for the development of the adverse drug reaction reporting system is a key issue. The aim of this article is to disclose the Mongolian situation for the rest of the world and to share experiences on how an ADR reporting system can be developed towards a higher and more advanced level to contribute to both national and international drug safety issues. In this article, we review the features of the Mongolian health care and pharmaceutical systems, as well as the current development of the adverse drug reaction reporting system