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The Pannonian Plain is one of the centers of ragweed distribution in Europe. The province of Vojvodina (Serbia) is located on the southern part of the Pannonian Plain, representing a highly infested region. In this study, we have used the SILAM atmospheric dispersion model to simulate ragweed pollen concentrations during the season 2016 in the Vojvodina region. SILAM was tested with three different source maps of ragweed distribution in Vojvodina only (1) map used in operational SILAM, which was calibrated with the SILAM model and observations, (2) map derived using "top-down" approach with land cover data inventory, and (3) map obtained with "top-down" approach using crop classification from the satellite data. Additionally, the sensitivity studies were done using two modified maps to study the effect of the source strength and long-range transport. Results of simulations were validated with the bi-hourly, daily, and seasonal pollen concentrations measured at five stations in Vojvodina. Overall Pearson correlation coefficients were 0.51 (Map 1), 0.50 (Map 2), and 0.42 (Map 3), while debiased scores were 232.95 pollen m-3 (Map 1), 245.59 pollen m-3 (Map 2), and 258.24 pollen m-3 (Map 3). Even though Vojvodina is in the area of a major European source, regional transport of ragweed pollen from a few hundred kilometers of the surrounding area was important in explaining the presence of pollen in the afternoon hours, although it could not completely explain total pollen quantity. The results confirmed that it is vital to calibrate source maps using atmospheric dispersion model with the observed pollen data.This study empirically evaluated the effect of climate variability on the healthcare status and catastrophic health expenditure of the food crop farmers in Southwest, Nigeria. Cross-sectional data were sourced through a well-structured questionnaire and direct personal interview and used for the analysis. A multi-stage sampling technique was used to select 459 respondents, while descriptive statistics, multinomial logit and binary logistic regressions were used for the data analysis. Results revealed that farmers perceived increase in heavy rainfall, storms, floods, cases of ailments/diseases and pollutant concentration and decrease in food production. Creating sanitation programmes, planting of shade trees and use of medicine/herbs were the main adaptation strategies frequently used to combat the effects of climate change on their health. Self-medication was commonly used as a source of treatment, while age, education, income and climate variables were the main factors influencing preference to healthcare utilisation using multinomial logit regression. Selleck TGF-beta inhibitor Results of logistic regression revealed that education, marital status, dependants, female household, environmental sanitation, extreme weather events and elderly persons were the main determinants of catastrophic health expenditure in the area. Therefore, a robust synergy among meteorological forecast, health surveillance and better disaster management should be established among the farmers. This will help in guiding against diseases and extreme weather events and improve adaptive capacity.We investigated the effects of intraoperative parameters measured during pulmonary artery banding operations and pre-discharge parameters on the completion of Fontan procedures. Fifty consecutive patients with single-ventricle anomalies and unrestricted pulmonary blood flow who underwent a PAB operation in and were discharged from our hospital were retrospectively analyzed. Patients who underwent a Fontan operation, a Glenn shunt operation, or who were eligible for a Fontan procedure were defined as the "successful group." Patients who needed rebanding prior to a bidirectional Glenn shunt, patients who were not eligible for a Glenn shunt, and those underwent a takedown due to high pulmonary arterial pressure after implantation of a Glenn shunt were defined as the "failure-to-progress group." The successful group included 34 (68%) patients and the failure-to-progress group included 16 (32%) patients. The median age was 2 months (IQR 1-4 months). There was a statistically significant difference between the groups in terms of systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary arterial pressure/systemic arterial pressure after PAB (P = 0.01, 0.03, and 0.03, respectively). While the median gradient before discharge was 60 mm Hg (IQR 50-70 mm Hg) in the successful group, it was 47.5 mm Hg (IQR 45-63.7 mm Hg) in the failure-to-progress group (P = 0.05). Mortality was observed in one (2.9%) patient in the successful group and five (31.2%) patients in the failure-to-progress group (P = 0.04). Successful pulmonary arterial banding increases long-term survival. Adequate targets should be determined, efforts should be made to achieve these targets, and patients should be followed up closely in terms of rebanding when the targets are not reached.

To evaluate the efficacy and safety of intravitreal aflibercept (IVT-AFL) versus IVT-AFL plus rescue photodynamic therapy (IVT-AFL + rPDT) in the subgroup of Japanese patients with polypoidal choroidal vasculopathy (PCV) enrolled in the PLANET study.

A 96-week, double-masked, sham-controlled phase-3b/4 randomized clinical trial conducted at multiple centers from May 2014 to August 2016.

Patients with PCV (BCVA 73-24 ETDRS letters [20/40-20/320 Snellen]) received 3 initial monthly doses of IVT-AFL 2mg. At week 12, the patients were randomly assigned 11 to IVT-AFL + sham PDT or IVT-AFL + rPDT. Patients not requiring rescue received IVT-AFL every 8weeks; those requiring rescue received IVT-AFL monthly plus sham/active PDT. Following week 52, the treatment intervals could be extended > 8weeks.

The baseline demographics for the 159 Japanese patients were balanced. At week 96, the mean BCVA change was + 9.7 (IVT-AFL) versus + 9.5 letters (IVT-AFL + rPDT) (least-squares mean difference of -0.3; 95% CI, -3.7 to 3.1); the mean central subfield thickness reduction was -148.0µm versus -145.9µm. Overall, 17.1% of the patients required rescue PDT. At week 96, 25.0% (IVT-AFL) and 37.9% (IVT-AFL + rPDT) of the patients had complete polyp regression; 84.1% (IVT-AFL) and 88.4% (IVT-AFL + rPDT) of the patients had no evidence of active polyps. The mean number of injections (weeks 52-96) were 4.6 (IVT-AFL) and 4.5 (IVT-AFL + rPDT). Overall, 36.0% (IVT-AFL) and 33.8% (IVT-AFL + rPDT) of the patients experienced ocular treatment-emergent adverse events.

IVT-AFL monotherapy was efficacious for the treatment of Japanese patients with PCV, and the addition of rescue PDT did not show additional benefits.

IVT-AFL monotherapy was efficacious for the treatment of Japanese patients with PCV, and the addition of rescue PDT did not show additional benefits.

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