The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Holzbilanzen 2017 bis 2019 für die Bundesrepublik Deutschland

This working paper deals with wood balances for Germany for the years 2017, 2018 and 2019 and the updated timeseries for specific key figures. For the calculation the unit cubic meters of roundwood equivalent (m³(r)) is used as reference unit. The wood balance displays total supply and total use of wood and wood-based products. On the supply side, the wood balance comprises the annual fellings, the quantity of domestic recovered paper and recovered wood and the imports. The use side shows the exports and apparent domestic consumption. Changes in stocks of wood products are also recorded. The balance volume in 2017 accounts to 266.1 million m³(r), which equals an increase of 3.4 % compared to 2016. In 2018 a further increase of 2.1 % to a total of 271.8 million m³(r) can be reported. However, 2019 shows a decrease of 3.0 % to 263.5 million m³(r) according to pre-liminary trade data. Apparent domestic consumption increases in 2017 about 0.8 % compared to 2016. 2018 shows a decline of 2.1 % to 127.4 million m³(r) and 2019 (provisional) a further decrease of 3.7 % to 122.7 million m³(r). In 2018, 77.7 million m³(r) of domestic consumption accounted for wood products and 49.6 million m³(r) accounted for paper products

Holzbilanzen 2015 bis 2017 für die Bundesrepublik Deutschland und Neuberechnung der Zeitreihe der Gesamtholzbilanz ab 1995

Der vorliegende Arbeitsbericht enthält die Holzbilanzen der Bundesrepublik Deutschland für den Berichtszeitraum 2015 bis 2017 sowie eine Neuberechnung der Gesamtholzbilanz für den Zeitraum von 1995 bis 2017. Die Neuberechnung erfolgte, da mit diesem Bericht die Einschlagsrückrechnung des Thünen-Instituts für Internationale Waldwirtschaft und Forstökonomie die amtliche Statistik als Datenquelle für den Holzeinschlag ersetzt. Die Holzbilanzen für 2015 und 2016 sind auf Grundlage endgültiger Daten berechnet. Für 2017 basieren diese zum Teil auf vorläufigen Daten (z. B. Außenhandelsdaten des Statisti-schen Bundesamtes). Weiterhin sind die nach Warengruppen differenzierten Außenhandels-bilanzen sowie die fortgeschriebenen Zeitreihen ausgewählter Kennzahlen der Holzbilanzen dargestellt. Die Flussdiagramme veranschaulichen die Bedeutung der einzelnen Flussgrößen der Forst- und Holzwirtschaft für Deutschland

Holzmarktmodellierung - Szenarienbasierte Folgenabschätzung verschiedener Rohholzangebotssituationen für den Sektor Forst und Holz

Different interest groups have different demands and expectations regarding the use of our forests and its resources. Conflicting claims imply various options of action for forest future management. Depending on the forest management scheme, coniferous and non-coniferous wood supply is likely to differ in the short, medium, and long term. Changing wood supply will have consequences for the domestic woodworking industry. Within the framework of the joint research project „WEHAM-Szenarien“ (funded by the BMU and BMEL) a systematic policy impact analysis was undertaken. Within the scope of this study, three different combinations of forest management and wood use scenarios were considered. The objective of the present study was to quantify potential impacts of alternative forest treatment options and timber supply volumes on the wood products markets. For this purpose, a global wood products market model was applied. The partial equilibrium model simulated supply, demand, and price developments for 180 countries and 16 products. The amount of wood available for wood production under each scenario was derived from the results of the forest management and wood use scenarios. As expected, the wood supply potential substantially differs between the scenarios. The available raw wood was exogenously divided into energetic and material use potentials. It was also crucial to differentiate between coniferous and non-coniferous wood species. The basic distinction of the wood types reveals that the wood-based market may not face an abundance of raw wood in the decades under consideration. Rather, the German woodworking industry might face shortages in domestic raw material availability and may be forced to innovate or trade in order to meet raw material demands. The modelling results are always a product of the modelling environment and the underlying assumptions. However, our results highlight that both domestic coniferous and non-coniferous roundwood production for material use would increase until 2050 if not limited by the harvesting potential imposed by the forest management scenario. On the other hand, the raw wood potentials were not always completely used by the market. The production of non-coniferous wood resources lagged behind the potential in two out of three scenarios. Once harvested the major share of raw wood was demanded by the domestic woodworking industry. Independent of the domestic production level, the demand for coniferous wood outstripped the domestic supply in each of the three scenarios considered. Thus, the trend of increasing imports of coniferous imports continued in all scenarios. However, the import volumes varied in dependence of the production capacities in the woodworking sector. Thus shortages in domestic raw wood were mainly offset by a reduction of the production capacities while the output of the woodworking industry increased together with increasing raw wood availability for material use. Despite significant differences in raw wood production, the domestic consumption of semi-finished wood-based products was similar across three scenarios. However, increasing production outputs of the woodworking industry did not lead to an increasing use of wood products in the domestic markets. The additional production was largely exported. Either way, rising domestic demand for wood products in end-use sectors could also lead to an increase in future demand for semi-finished wood products in Germany. The other way round, limiting the supply of domestic raw wood could imply adverse socio-economic effects, which may include a reduction in the production activities of the domestic woodworking sector or an increase in imports of raw wood and wood products

Trade in wood‐based products in the EU27 – wood content and coverage by the current EUTR and the proposed regulation on deforestation‐free value chains

This working paper provides a detailed overview of the trade in wood-based or wood-containing products1 in the EU27 in 2020 and distinguishes products already under the scope of the EUTR and the proposed regulation of the European Commission on deforestation-free value chains, from products not in the scope of those two regulations. The study considers overall 769 products (according to the 8-digit product codes of the Combined Nomenclature) from the entire list of goods for international trade statistics, provided that some wood content can be assumed. Of these products, 348 are already in the scope of the EUTR. The remaining 421 products are considered, to assess their relevance in EU27 wood-based products trade. Therefore, trade values and quantities for each product are taken from EUROSTAT foreign trade data bases. To compare the wood content related to each product, trade quantities were converted into trade volumes of cubic meters of roundwood equivalents (RWE m³). The roundwood equivalent indicates how much raw wood is required to produce the respective wood-based product. Converting the trade volumes into this physical reference value also enables a raw material-related comparison of the traded products. The working paper presents three different trade flows, which all fall within the scope of the proposed new regulation for deforestation-free products: a) Imports of wood-based products from third countries into the EU27, b) exports to third countries from the EU27, and c) intra trade within the EU27 internal market (between EU Member States). Further, detailed information on data compilation, data gaps and uncertainties and conversion factors applied are given within this working paper

Verflechtungen der Forst-, Holz- und Papierwirtschaft mit den kritischen Infrastrukturen in Deutschland (KRITIS)

Against the background of measures against further spreading of SARS-CoV-2 and their effects in Germany, Europe and the world we analysed interdependences between wood sector and critical infrastructure (KRITIS) in Germany, which wood-based products are used in critical infrastructures and where relevant resources and semi-finished products for wood-based manufacturing originate from. Wood-based energy production, manufacture of wooden containers and containers of paper and paperboard, manufacture of household and sanitary goods and of toilet requisites are directly linked to sectors and branches of critical infrastructure in Germany. These directly linked branches of forestry, wood and paper industries receive inputs that cannot or only with difficulties be substituted with products of other branches. These are sawing and planing of wood, manufacture of veneer sheets and wood-based panels, manufacture of pulp and manufacture of paper and paperboard. These directly linked branches of forestry, wood and paper industries receive inputs that cannot or only with difficulties be substituted with products of other branches. These are sawing and planing of wood, manufacture of veneer sheets and wood-based panels, manufacture of pulp and manufacture of paper and paperboard. Energy is also an important sector of critical infrastructures. The definition of dedicated branches within this sector however, does not cover heat generation in private households. In Germany, about 0.9 million households use wood as the primary energy carrier. In terms of quantity, they are the most important user of wood energy. In contrast to heat generation in private households, electricity generation and heat generation in biomass power plants are covered by the definition of critical infrastructures in Germany. Dependence on imports of the identified branches of forestry, wood and paper industries strongly varies. Shares of net imports as related to domestic use are highest for chemical wood pulp and plywood. Net imports of roundwood, fibreboard, wood pulp and recovered paper are also significant. Effects of interrupted supply chains are difficult to assess. If net exports are high in certain branches, the reduction of these exports to compensate for reduced imports, may be an option. Flat pallets of wood play an important role in global transport and logistics. Interruption of commodity flows may also lead to a reduced availability of flat pallets and consequently to larger delays in transport. Goods for daily use in private households that are not directly vital but important for maintaining hygienic standards or, in a pandemic, for complying with additional rules, should be reviewed. It may be necessary to take them into account more strongly in future definitions of critical infrastructures

A systematic review of forest area development drivers estimated under the concepts of environmental Kuznets curve and forest transition hypothesis

Over the last 30 years, more than 150 different drivers of forest area development have been investigated in peer-reviewed statistical analysis of the environmental Kuznets curve for deforestation (EKCd) and the forest transition hypothesis (FTH). However, there is no synthesis which of these drivers significantly contribute to changes in forest land expansion, like deforestation and forest recovery. To fill this gap, we conducted a systematic review of the scientific literature dealing with statistical analysis of drivers of forest area development under the concepts of EKCd and FTH. We referred to peer-reviewed articles, preselected by the evidence and gap map of Tandetzki et al 2022 Environ. Res. Lett. 17 123005. From these selected articles we identified 85 relevant studies and extracted the applied model specifications. We found differences among studies in variable specifications of the dependent variable (expressions of forest area development) and the choice of independent variables (drivers) as well as in the choice of geographical scope and the concept used (EKCd and FTH). For further analysis, we extracted all drivers used to explain forest area development in the different studies and assigned them to 12 thematic categories (e.g. income factors or institutional factors). Our results show that the main underlying drivers of deforestation are related to income, demographics, trade, and institutional factors. The forest transition phenomenon is mainly described by drivers directly influencing forest area (e.g. expansion of agricultural land) and demographic trends. The heterogeneity and universality of the concepts of EKCd and FTH is not clearly evident even when separating different study groups. By isolating and discussing individual drivers of forest area development, our findings support future research dedicated to the analysis and projection of global forest area dynamics

Extent and costs of forest-based climate change mitigation in Germany: accounting for substitution

The objective of this study is to quantify the contribution of the German forestry to climate change mitigation and to calculate the associated costs at the national level. For that, the forest and harvested wood products carbon pools are considered as well as energy and material substitution. We compare five different scenarios, each referring to an alternative level of timber harvests (due to changing rotation lengths or setting aside of forest areas). The study shows that enhancing the use of wood products at the expense of other materials, such as steel, plastic or concrete, can have a substantial impact on the overall carbon balance