Nosocomial COVID-19 Incidence and Secondary Attack Rates among Patients of Tertiary Care Center, Zurich, Switzerland.

Of 1,118 patients with COVID-19 at a university hospital in Switzerland during October 2020-June 2021, we found 83 (7.4%) had probable or definite healthcare-associated COVID-19. After in-hospital exposure, we estimated secondary attack rate at 23.3%. Transmission was associated with longer contact times and with lower cycle threshold values among index patients.

Ecological Sustainability Assessment of Water Distribution for the Maintenance of Ecosystems, their Services and Biodiversity.

Water provision and distribution are subject to conflicts between users worldwide, with agriculture as a major driver of discords. Water sensitive ecosystems and their services are often impaired by man-made water shortage. Nevertheless, they are not sufficiently included in sustainability or risk assessments and neglected when it comes to distribution of available water resources. The herein presented contribution to the Sustainable Development Goals Clean Water and Sanitation (SDG 6) and Life on Land (SDG 15) is the Ecological Sustainability Assessment of Water distribution (ESAW-tool). The ESAW-tool introduces a watershed sustainability assessment that evaluates the sustainability of the water supply-demand ratio on basin level, where domestic water use and the water requirements of ecosystems are considered as most important water users. An ecological risk assessment estimates potential impacts of agricultural depletion of renewable water resources on (ground)water-dependent ecosystems. The ESAW-tool works in standard GIS applications and is applicable in basins worldwide with a set of broadly available input data. The ESAW-tool is tested in the Danube river basin through combination of high-resolution hydro-agroecological model data (hydrological land surface process model PROMET and groundwater model OpenGeoSys) and further freely available data (water use, biodiversity and wetlands maps). Based on the results, measures for more sustainable water management can be deduced, such as increase of rainfed agriculture near vulnerable ecosystems or change of certain crops. The tool can support decision making of authorities from local to national level as well as private enterprises who want to improve the sustainability of their supply chains.

The water-energy-food-ecosystem nexus in the Danube River Basin: Exploring scenarios and implications of maize irrigation.

The Water-Energy-Food-Ecosystem (WEFE) nexus concept postulates that water, energy production, agriculture and ecosystems are closely interlinked. In transboundary river basins, different sectors and countries compete for shared water resources. In the Danube River Basin (DRB), possible expansion of agricultural irrigation is expected to intensify water competition in the WEFE nexus, however, trade-offs have not yet been quantified. Here, we quantified trade-offs between agriculture, hydropower and (aquatic) ecosystems in the DRB resulting from maize irrigation when irrigation water was withdrawn from rivers. Using the process-based hydro-agroecological model PROMET, we simulated three maize scenarios for the period 2011-2020: (i) rainfed; (ii) irrigated near rivers without considering environmental flow requirements (EFRs); (iii) irrigated near rivers with water abstractions complying with EFRs. Maize yield and water use efficiency (WUE) increased by 101-125 % and 29-34 % under irrigation compared to rainfed cultivation. Irrigation water withdrawals from rivers resulted in moderate to severe discharge reductions and, without consideration of EFRs, to substantial EFR infringements. Annual hydropower production decreased by 1.0-1.9 % due to discharge reductions. However, the financial turnover increase in agriculture (5.8-7.2 billion €/a) was two orders of magnitude larger than the financial turnover decrease in hydropower (23.9-47.8 million €/a), making water more profitable in agriculture. Irrigation WUE was highest for EFR-compliant irrigation, indicating that maintaining EFRs is economically beneficial and that improving WUE is key to attenuating nexus water competition. Current maize production could be met on the most productive 35-41 % of current maize cropland under irrigation, allowing 59-65 % to be returned to nature without loss of production. Maize priority areas were on fertile lowlands near major rivers, while biodiversity priority areas were on marginal cropland of highest biodiversity intactness. Our quantitative trade-off analysis can help identifying science-based pathways for sustainable WEFE nexus management in the DRB, also in light of climate change.

Ash pollen allergy: reliable detection of sensitization on the basis of IgE to Ole e 1.

Background: Alongside hazel, alder and birch pollen allergies, ash pollen allergy is a relevant cause of hay fever during spring in the European region. For some considerable time, ash pollen allergy was not routinely investigated and its clinical relevance may well have been underestimated, particularly since ash and birch tree pollination times are largely the same. Ash pollen extracts are not yet well standardized and diagnosis is therefore sometimes unreliable. Olive pollen, on the other hand, is strongly cross-reactive with ash pollen and is apparently better standardized. Therefore, the main allergen of olive pollen, Ole e 1, has been postulated as a reliable alternative for the detection of ash pollen sensitization. Methods: To determine to what extent specific IgE against Ole e 1 in patients with ash pollen allergy is relevant, we included 183 subjects with ash pollen allergy displaying typical symptoms in March/April and positive skin prick test specific IgE against Ole e 1 (t224) and ash pollen (t25) and various birch allergens (Bet v 1, Bet v 2/v 4) in a retrospective study. Results: A significant correlation was seen between specific IgE against Ole e 1 and ash pollen, but also to a slightly lesser extent between IgE against Ole e 1 and skin prick test with ash pollen, the latter being even higher than IgE and skin prick test both with ash pollen. No relevant correlation was found with birch pollen allergens, demonstrating the very limited cross-reactivity between ash and birch pollen. Conclusion: It appears appropriate to determine specific IgE against Ole e 1 instead of IgE against ash pollen to detect persons with ash pollen allergy. Our findings may also support the idea of using possibly better standardized or more widely available olive pollen extracts instead of ash pollen extract for allergen-specific immunotherapy.