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Background: It is hypothesised that community-acquired pneumonia (CAP) patients with more severe disease or inflammation might benefit more from adjunctive corticosteroid treatment. Neutrophil count, lymphocyte count and neutrophil-lymphocyte ratio (NLR) have been associated with inflammation and disease severity in CAP. We investigated the interaction between these parameters and adjunctive dexamethasone effects on clinical outcomes in CAP. Methods: We conducted a post hoc analysis of the randomised placebo-controlled Santeon-CAP trial (n = 401), which showed a positive effect of adjunctive oral dexamethasone on length of stay (LOS) in CAP patients. White blood cell (WBC) count, neutrophil count, NLR (highest tertile vs. lowest two tertiles) and lymphocyte count (lowest tertile vs. highest two tertiles) were examined as potential effect modifiers of treatment with dexamethasone on LOS (primary outcome) and ICU-admission, 30-day mortality and hospital readmission. Results: WBC differential counts were available for 354 patients. The effect of dexamethasone on LOS was more pronounced in high WBC count, high neutrophil count or high NLR subgroups (difference in median LOS of 2 days versus zero days in the reference subgroups, p for interaction < 0.05). There was no effect modification for the other outcomes. Patients with low WBC and low neutrophil counts did not benefit from dexamethasone, while hospital readmission rate was higher in those treated with dexamethasone (6% vs. 11%). Conclusions: WBC count and/or neutrophil might be easily available biomarkers to guide selection of CAP patients who are more likely to benefit from adjunctive dexamethasone treatment. Future prospective trials are needed to confirm this predictive potential.

Contains fulltext : 251573.pdf (Publisher’s version ) (Open Access) OBJECTIVE: The Dutch Surgical Aneurysm Audit (DSAA) initiative was established in 2013 to monitor and improve nationwide outcomes of aortic aneurysm surgery. The objective of this study was to examine whether outcomes of surgery for intact abdominal aortic aneurysms (iAAA) have improved over time. METHODS: Patients who underwent primary repair of an iAAA by standard endovascular (EVAR) or open surgical repair (OSR) between 2014 and 2019 were selected from the DSAA for inclusion. The primary outcome was peri-operative mortality trend per year, stratified by OSR and EVAR. Secondary outcomes were trends per year in major complications, textbook outcome (TbO), and characteristics of treated patients. The trends per year were evaluated and reported in odds ratios per year. RESULTS: In this study, 11 624 patients (74.8%) underwent EVAR and 3 908 patients (25.2%) underwent OSR. For EVAR, after adjustment for confounding factors, there was no improvement in peri-operative mortality (aOR [adjusted odds ratio] 1.06, 95% CI 0.94 - 1.20), while major complications decreased (2014: 10.1%, 2019: 7.0%; aOR 0.91, 95% CI 0.88 - 0.95) and the TbO rate increased (2014: 68.1%, 2019: 80.9%; aOR 1.13, 95% CI 1.10 - 1.16). For OSR, the peri-operative mortality decreased (2014: 6.1%, 2019: 4.6%; aOR 0.89, 95% CI 0.82 - 0.98), as well as major complications (2014: 28.6%, 2019: 23.3%; aOR 0.95, 95% CI 0.91 - 0.99). Furthermore, the proportion of TbO increased (2014: 49.1%, 2019: 58.3%; aOR 1.05, 95% CI 1.01 - 1.10). In both the EVAR and OSR group, the proportion of patients with cardiac comorbidity increased. CONCLUSION: Since the establishment of this nationwide quality improvement initiative (DSAA), all outcomes of iAAA repair following EVAR and OSR have improved, except for peri-operative mortality following EVAR which remained unchanged.

8th World Conference on Photovoltaic Energy Conversion; 1645-1648, The AgroFossilFree project promotes fossil-energy-free technologies and strategies (FEFTS) in the agricultural sector by integrating various stakeholder initiatives and disseminating knowledge on FEFTS in agriculture. Applications boosting RES integration in important agricultural sectors, notably solar technology, are given considerable attention. The project's main goal is to create a platform where farmers, advisors, academics, business partners, and other stakeholders may discover pertinent information about FEFTS in agriculture. The AgroFossilFree initiative works to reduce the use of fossil fuels in all aspects of farming, which supports the EU Green Deal and Farm to Fork strategies. By encouraging the productive sharing of novel technologies, it helps to bridge the gap between the available FEFTS and common agricultural practices throughout the EU. By facilitating the effective flow of innovative information and ideas amongst stakeholders, it contributes to close the gap between the available FEFTS and common EU agricultural practices, thus European agriculture could become more environmentally, socioeconomically, and energetically sustainable. The European agricultural sector can support and abide by policies to reduce the use of fossil energy, the relevant legal and regulatory frameworks, and sustainable food production practices with the help of the knowledge that is gathered, classified, and presented to actors in the agricultural field. This article provides an update on the European Commission founded AgroFossilFree project.

The EU H2020 project REPLACE (Contract No. 847087) aims to boost the phase-out of inefficient and old heating and cooling systems by targeting consumers, investors/owners as well as intermediaries (installers, plumbers, and chimney sweepers) and helps them to make independently informed decisions. All activities proposed by REPLACE aim to inform and motivate consumers to replace their old and inefficient HC appliances with better, greener alternatives with the benefit of monetary savings and improvements in air-quality, comfort, safety, and security of supply. REPLACE also addresses fuel poverty and reduces the risk of a heating crisis by supporting the use of regional renewable energy sources (such as solar, ambient heat or biomass) and equipment produced in the EU (biomass boilers, heat pumps, solar collectors, DH equipment)., Proceedings of the 30th European Biomass Conference and Exhibition, 9-12 May 2022, Online, pp. 449-452

The AgroFossilFree project supports Fossil-Energy-Free Technologies and Strategies (FEFTS) in agriculture by coordinating several stakeholder actions and providing information on FEFTS in agriculture. Thereby, special emphasis is placed on applications promoting RES integration in major agricultural sectors, particularly biomass. The core objective of the project is to set-up an online platform where farmers, advisors, researchers, industrial partners and other actors can find useful information on FEFTS in agriculture. The AgroFossilFree project contributes to the High Level EU Strategies (i.e. EU Green Deal and Farm to Fork strategy) by aiming to decrease the use of fossil energy in any farming process. It also contributes to closing the gap between the available FEFTS and the everyday EU agricultural practices by promoting the effective exchange of novel ideas and exchanging information between stakeholders. If this gap closes, European agriculture could become more sustainable with minimum energy, environmental and socioeconomic impacts. With the knowledge that is collected, classified, and presented to actors in the agricultural field, the European agricultural sector can promote and comply with fossil energy use reduction policies, the related legal and regulatory frameworks and sustainable food production practices. This paper presents the status of the AgroFossilFree project which is funded by the European Commission's Horizon 2020 program., Proceedings of the 30th European Biomass Conference and Exhibition, 9-12 May 2022, Online, pp. 402-405

The DiBiCoo project (dibicoo.org) supports the European biogas/biomethane industry and the biogas development in developing and emerging countries by preparing markets for the export of sustainable biogas/biomethane technologies from Europe to developing and emerging countries. This is achieved by the development and application of innovative digital and non-digital support and matchmaking tools and actions, by knowledge transfer and capacity building as well as by the preparation of demo cases up to the prefeasibility stage. This will increase the share of renewable energies, both in Europe and in importing countries. This paper addresses biogas-relevant framework conditions in the importing and exporting countries, the status of research and development needs of biogas technologies in the importing countries as well as export opportunities for European countries., Proceedings of the 30th European Biomass Conference and Exhibition, 9-12 May 2022, Online, pp. 19-23

Background Early diagnosis of knee osteoarthritis (OA) is important in managing this disease, but such an early diagnostic tool is still lacking in clinical practice. The purpose of this study was to develop diagnostic models for early stage knee OA based on the first 2-year clinical course after the patient’s initial presentation in primary care and to identify whether these course factors had additive discriminative value over baseline factors. Methods We extracted eligible patients’ clinical and radiographic data from the CHECK cohort and formed the first 2-year course factors according to the factors’ changes over the 2 years. Clinical expert consensus-based diagnosis, which was made via evaluating patients’ 5- to 10-year follow-up data, was used as the outcome factor. Four models were developed: model 1, included clinical course factors only; model 2, included clinical and radiographic course factors; model 3, clinical baseline factors + clinical course factors; and model 4, clinical and radiographic baseline factors + clinical and radiographic course factors. All the models were built by a generalized estimating equation with a backward selection method. Area under the receiver operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for assessing model discrimination. Delong’s method compared AUCs. Results Seven hundred sixty-one patients with 1185 symptomatic knees were included in this study. Thirty-seven percent knees were diagnosed as OA at follow-up. Model 1 contained 6 clinical course factors; model 2: 6 clinical and 3 radiographic course factors; model 3: 6 baseline clinical factors combined with 5 clinical course factors; and model 4: 4 clinical and 1 radiographic baseline factors combined with 5 clinical and 3 radiographic course factors. Model discriminations are as follows: model 1, AUC 0.70 (95% CI 0.67–0.74); model 2, 0.74 (95% CI 0.71–0.77); model 3, 0.77 (95% CI 0.74–0.80); and model 4, 0.80 (95% CI 0.77–0.82). AUCs of model 3 and model 4 were slightly but significantly higher than corresponding baseline-factor models (model 3 0.77 vs 0.75, p = 0.031; model 4 0.80 vs 0.76, p = 0.003). Conclusions Four diagnostic models were developed with “fair” to “good” discriminations. First 2-year course factors had additive discriminative value over baseline factors.

Rob Janssen,1 Emiel FM Wouters,2 Wim Janssens,3 Willeke F Daamen,4 Paul Hagedoorn,5 Hugo AJM de Wit,6 Jef Serré,3 Ghislaine Gayan-Ramirez,3 Frits ME Franssen,2 Niki L Reynaert,2 Jan H von der Thüsen,7 Henderik W Frijlink5 1Department of Pulmonary Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; 2Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; 3Laboratory of Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium; 4Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; 5Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy, Groningen, University of Groningen, Groningen, The Netherlands; 6Department of Clinical Pharmacy, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; 7Department of Pathology, Erasmus Medical Center, Rotterdam, The NetherlandsCorrespondence: Rob JanssenDepartment of Pulmonary Medicine, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, Nijmegen, SZ 6532, The NetherlandsEmail rob.janssen@cwz.nlAbstract: Current pharmacotherapy of chronic obstructive pulmonary disease (COPD) aims at reducing respiratory symptoms and exacerbation frequency. Effective therapies to reduce disease progression, however, are still lacking. Furthermore, COPD medications showed less favorable effects in emphysema than in other COPD phenotypes. Elastin fibers are reduced and disrupted, whereas collagen levels are increased in emphysematous lungs. Protease/antiprotease imbalance has historically been regarded as the sole cause of emphysema. However, it is nowadays appreciated that emphysema may also be provoked by perturbations in the sequential repair steps following elastolysis. Essentiality of fibulin-5 and lysyl oxidase-like 1 in the elastin restoration process is discussed, and it is argued that copper deficiency is a plausible reason for failing elastin repair in emphysema patients. Since copper-dependent lysyl oxidases crosslink elastin as well as collagen fibers, copper supplementation stimulates accumulation of both proteins in the extracellular matrix. Restoration of abnormal elastin fibers in emphysematous lungs is favorable, whereas stimulating pulmonary fibrosis formation by further increasing collagen concentrations and organization is detrimental. Heparin inhibits collagen crosslinking while stimulating elastin repair and might therefore be the ideal companion of copper for emphysema patients. Efficacy and safety considerations may lead to a preference of pulmonary administration of copper-heparin over systemic administration.Keywords: collagen, copper, desmosine, elastin, emphysema, fibulin-5, heparin, lysyl oxidase, lysyl oxidase-like protein 1, tropoelastin

38th European Photovoltaic Solar Energy Conference and Exhibition; 363-365, This short paper aims to show the application of four terminal perovskite-silicon tandem modules in indoor and outdoor applications with a six inch area. We demonstrate a 24.5 mW/cm2 bifacial tandem module which shows a 3 mW/cm2 gain with respect to monofacial use of the same tandem. In addition we show that bifacial tandems outperform identical monofacial tandems by over 25% in a 10% albedo environment. Lastly, we show our way forward with a new record tandem of 29.2%.

38th European Photovoltaic Solar Energy Conference and Exhibition; 1645-1649, The TRACER project supports a number of coal-intensive regions around Europe to design (or re-design) their Research and Innovation (R&I) strategies in order to facilitate their transition towards a sustainable energy system. The TRACER consortium consists of different target regions: South East Bulgaria, North West Bohemia - Czech Republic, Lusatian Lignite District - Germany, Western Macedonia - Greece, Upper Silesian Coalfield - Poland, West Region, Jiu Valley - Romania, Wales - UK, Kolubara - Serbia, Donetsk - Ukraine. Core activities of TRACER include the implementation of an EDP (Entrepreneurial Discovery Process) to mobilise a wide range of stakeholders in each target region to develop an appropriate governance structure and to bring regional stakeholders together to discuss and agree on a shared vision and priorities for coal transition. R&I strategies, industrial roadmaps and decision support tools will be developed jointly with key stakeholders of the TRACER target regions. Further TRACER activities include the identification and analysis of best practice examples of successful and ambitious transition processes in coal intensive regions, a detailed assessment of social, environmental and technological challenges, the elaboration of guidelines on how to mobilise investment as well as dedicated activities to stimulate R&I cooperation among coal intensive regions in Europe and beyond.

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The Upgrade DH project supports the upgrading and retrofitting process of DH systems in different climate regions of Europe, covering various countries: Bosnia-Herzegovina, Denmark, Croatia, Germany, Italy, Lithuania, Poland, and The Netherlands. The objective of the project is to initiate the upgrading process of concrete DH systems in each of the target countries, the so-called Upgrade DH demonstration cases (demo cases). The gained knowledge and experiences are further replicated to other European countries and DH systems (replication cases) in order to leverage the impact. Core activities of the Upgrade DH project include the collection of the best upgrading measures and tools, the support of the upgrading process for selected district heating networks, the organisation of capacity building measures about DH upgrading, financing and business models, as well as the development of national and regional action plans. In addition, an image raising campaign for modern DH networks is carried out in the Upgrade DH project. The outcome is the initiation of district heating upgrading process in the above-mentioned target countries and beyond. The present paper summarizes the results of the project, which is close to its finalization.

38th European Photovoltaic Solar Energy Conference and Exhibition; 1691-1693, The AgroFossilFree project is supporting Fossil-Energy-Free Technologies and Strategies (FEFTS) in agriculture by coordinating several stakeholder actions and by providing information on FEFTS in agriculture. Thereby, special emphasis is placed on applications of photovoltaics (PV) in agriculture. The core objective of the project is to set-up an online platform for farmers, advisors, researchers, industrial partners and other actors on which they can find useful information on FEFTS in agriculture. The AgroFossilFree project contributes to the High Level EU Strategies (i.e. EU Green Deal and Farm to Fork strategy) as it aims to decrease the use of fossil energy in any farming process. It also contributes to close the gap between the available FEFTS and the everyday EU agricultural practices by promoting effective exchange of novel ideas and by exchanging information between research, industry, extension services and the farming community. If this gap closes, European agriculture could become more sustainable with minimum energy, environmental and socioeconomic impacts. With the knowledge that is collected, classified and presented to actors in the agricultural field, the European agricultural sector is able to promote and comply with the fossil energy use reduction policies, the related legal and regulatory frameworks and sustainable food production practices. This paper presents the current status of the AgroFossilFree project which is funded by the Horizon 2020 Programme of the European Commission.