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... Show moreBackground: 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. Show less
Loosli, F.; Rasmussen, K.; Rauscher, H.; Cross, R.; Bossa, N.; Peijnenburg, W.J.G.M.; ... ; Kammer, F. von der 2022
Allergic rhinitis is an inflammation in the nose caused by overreaction of the immune system to allergens in the air. Managing allergic rhinitis symptoms is challenging and requires timely... Show moreAllergic rhinitis is an inflammation in the nose caused by overreaction of the immune system to allergens in the air. Managing allergic rhinitis symptoms is challenging and requires timely intervention. The following are major questions often posed by those with allergic rhinitis: How should I prepare for the forthcoming season? How will the season's severity develop over the years? No country yet provides clear guidance addressing these questions. We propose two previously unexplored approaches for forecasting the severity of the grass pollen season on the basis of statistical and mechanistic models. The results suggest annual severity is largely governed by preseasonal meteorological conditions. The mechanistic model suggests climate change will increase the season severity by up to 60%, in line with experimental chamber studies. These models can be used as forecasting tools for advising individuals with hay fever and health care professionals how to prepare for the grass pollen season. Show less
Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society... Show moreLittle is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg.m(-2) (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 mu g.day(-1) between those from Slovenia versus Poland when starting anti-interleukin (IL)5 antibody and from 772 to 1344 mu g.day(-1) in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries. Show less
Physicochemical properties of chemicals affect their exposure, toxicokinetics/fateand hazard, and for nanomaterials, the variation of these properties results in a wide variety ofmaterials with... Show morePhysicochemical properties of chemicals affect their exposure, toxicokinetics/fateand hazard, and for nanomaterials, the variation of these properties results in a wide variety ofmaterials with potentially different risks. To limit the amount of testing for risk assessment,the information gathering process for nanomaterials needs to be efficient. At the same time,sufficient information to assess the safety of human health and the environment should beavailable for each nanomaterial. Grouping and read-across approaches can be utilised tomeet these goals. This article presents different possible applications of grouping andread-across for nanomaterials within the broader perspective of the MARINA RiskAssessment Strategy (RAS), as developed in the EU FP7 project MARINA. Firstly,nanomaterials can be grouped based on limited variation in physicochemical properties tosubsequently design an efficient testing strategy that covers the entire group. Secondly,knowledge about exposure, toxicokinetics/fate or hazard, for example via properties suchas dissolution rate, aspect ratio, chemical (non-)activity, can be used to organise similarmaterials in generic groups to frame issues that need further attention, or potentially toread-across. Thirdly, when data related to specific endpoints is required, read-across can beconsidered, using data from a source material for the target nanomaterial. Read-acrosscould be based on a scientifically sound justification that exposure, distribution to thetarget (fate/toxicokinetics) and hazard of the target material are similar to, or less than, thesource material. These grouping and read-across approaches pave the way for better use ofavailable information on nanomaterials and are flexible enough to allow future adaptationsrelated to scientific developments. Show less
