An International Consensus List of Potentially Clinically Significant Drug-Drug Interactions in Older People

Objectives: We aimed to establish an explicit list of potentially clinically significant drug-drug interactions (DDIs) in people aged ≥65 years. Design: A preliminary list of potentially clinically significant DDIs was compiled, based on 154 DDIs identified from literature review. Subsequently, a 2-round online Delphi survey was undertaken with a multidisciplinary expert panel. A consensus meeting and a final round were conducted to validate the final DDI list and the scope of information provided. Setting and Participants: Twenty nine experts, including geriatricians and clinical pharmacists from 8 European countries. Measures: For each DDI, in the first 2 rounds, experts were asked to score the severity of potential harm on a 5-point Likert-type scale. DDIs were directly included on the final list if the median score was 4 (major) or 5 (catastrophic). DDIs with a median score of 3 (moderate) were discussed at a consensus meeting and included if ≥75% of participants voted for inclusion in the final round. Results: Consensus was achieved on 66 potentially clinically significant DDIs (28 had a median score of 4/5 and 48 of 3 in the Delphi survey). Most concerned cardiovascular, antithrombotic, and central nervous system drugs. The final list includes information on the mechanism of interaction, harm, and management. Treatment modification is recommended for three-quarters of DDIs. Conclusion and Implications: We validated a list of potentially clinically significant DDIs in older people, which can be used in clinical practice and education to support identification and management of DDIs or to assess prevalence in epidemiologic and intervention studies

Harmonised statistics and maps of forest biomass and increment in Europe

Forest biomass is an essential resource in relation to the green transition and its assessment is key for the sustainable management of forest resources. Here, we present a forest biomass dataset for Europe based on the best available inventory and satellite data, with a higher level of harmonisation and spatial resolution than other existing data. This database provides statistics and maps of the forest area, biomass stock and their share available for wood supply in the year 2020, and statistics on gross and net volume increment in 2010–2020, for 38 European countries. The statistics of most countries are available at a sub-national scale and are derived from National Forest Inventory data, harmonised using common reference definitions and estimation methodology, and updated to a common year using a modelling approach. For those counties without harmonised statistics, data were derived from the State of Europe’s Forest 2020 Report at the national scale. The maps are coherent with the statistics and depict the spatial distribution of the forest variables at 100 m resolution.JRC.D.1 - Forests and Bio-Econom

Climate warming and atmospheric deposition affect seed viability of common juniper (Juniperus communis) via their impact on the nutrient status of the plant

Global environmental change is increasingly affecting species worldwide. One of the emblematic casualties among plants in several European countries is common juniper (Juniperus communis). Many populations of common juniper throughout its distribution range are declining. The relative lack of viable seed production, resulting in low probabilities for successful natural regeneration, is one of the main reasons for this decline. Climate warming and elevated atmospheric depositions have been shown to negatively affect seed viability of common juniper, but our understanding of the underlying mechanisms remains scarce. One possible pathway is via changes in the plant nutrient status that, in turn, may affect seed viability. Here we took advantage of large-scale gradients in climate and atmospheric depositions between central Sweden and northern Spain, and analysed foliar nutrient concentrations and stoichiometry and seed viability in 20 juniper populations spread across Europe. Our results show that increasing temperatures can negatively affect needle N and P concentrations while enhanced potentially acidifying depositions resulted in lower foliar N and Ca concentrations. Needle C:N ratios increased with higher temperature, acidifying depositions and precipitation. By linking these patterns to seed viability, we found that low needle P, Ca and Mg concentrations were related to low seed viability. Thus, a shortage of these key elements during seed development and seed nutrient storage, can lead to anomalies and seed abortion. These findings help to explain the low seed viability of juniper in Europe and may help to assist land managers to take urgently needed conservation actions