European Climate Foundation

Evaluation of a new individual wearable air purifier (Respiray Wear A+) for birch pollen, house dust mite (HDM), and cat-allergic rhinoconjunctivitis (ARC) patients in a standardized allergen exposure chamber (AEC). Eligible allergic patients were exposed to birch pollen, HDM raw material, and cat allergen in an AEC for 60 minutes without (V1) and with (V3) the use of the Respiray device. Nasal, ocular, bronchial, and other symptoms were rated by the patients every 10 minutes, and their wellbeing, peak nasal inspiratory flow (PNIF), and lung function parameters were assessed every 30 minutes. The primary endpoint was the change in the median of the total symptom score (TSS) at V3 compared to V1 at 60 minutes of exposure. The secondary endpoints consisted of the total nasal symptom score (TNSS) and total eye symptom score (TESS). 23 patients with birch pollen allergy, 37 patients with HDM allergy, and 41 patients with cat allergy were included in the analysis. Significant reduced symptom scores of ~49% were observed when using Respiray Wea A+ under birch pollen exposure (p<0.05) in the primary endpoint TSS (V3 2.43 compared to V1 4.78). An 48% reduction of symptoms was seen in TSS in case of HDM exposure (V3 3.59; V1 6.92, (t-test: p<0.01)) and the highest reduction of TSS (60%) under Respiray A+ using cat allergens (V3 2.95, V1 7.44, (t-test p<0.01) after 60 minutes of exposure. The personal wellbeing revealed clinically meaningful improvements over time in all three studies which manifested in a lower symptom increase during the final allergen exposures. The individual wearable air purifier Respiray Wear A+ protects significantly against airborne pollen, HDM, and cat allergens and may be a very useful device for avoiding indoor allergens in a new way.

Key Clinical MessageWhen fibrosis develops in Takayasu arteritis (TA), endovascular treatment may become necessary. A 63‐year‐old woman with TA underwent PTA with a nitinol‐structured (chocolate‐like) drug‐coated balloon (C‐DEB PTA). She remained in remission for >1 year. The case may foster research into the use of C‐DEB PTA in TA.

Is international cooperation to address climate change a matter of sharing a common burden between countries or of maximizing the benefits of preventing climate change damages? The perspective taken determines to a large extent the shape of international agreements. This chapter discusses the current international arrangements and how they work. The Climate Change Convention and its Kyoto Protocol in particular. It tries to make the complex international negotiation process and its outcomes understandable for non-specialists. It also discussed the ongoing negotiations on arrangements for the period after 2012, when the agreed actions under the Kyoto Protocol to reduce greenhouse gas emissions expire.Will these negotiations result in aggressive action to curb emissions worldwide, so that the worst impacts can be avoided? Or will political differences and North–South tensions lead to a delay in ambitious action and serious damages in the long term? What are the key issues and what are the prospects for agreement? These are issues discussed in this chapter.