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Deep geological disposal aims to contain and isolate radioactive waste from the biosphere. Repository systems are made of multiple barriers working together, typically comprising the natural geological barrier provided by the repository host rock and its surroundings and an engineered barrier system. Due to their excellent properties for the confinement of contaminants, including low permeability, high sorption capacity, and swelling/self-sealing capacity, clayey materials are considered as engineered and/or natural barriers in most repository designs under development in Europe. During the lifetime of the repository, clay barriers will be exposed to perturbations, among which those are resulting from gas and heat production within the system. It is important to verify that these perturbations will not be detrimental to the good functioning of these barriers. In this paper, it is shown how the two EURAD R&D work packages, GAS and HITEC use a combination of experimental and modelling approaches to increase the understanding and predictability of the impact on clay barriers of the fundamental processes and their couplings related to gas and heat transport respectively, providing building blocks to support the evaluation of the robustness of the repository concepts. [ABSTRACT FROM AUTHOR]

The article describes the revolutionary new ways of communicating the written word when moving from the Medieval to Modern period in Europe, primarily the use of paper and moveable typeface printing and how these catalysed important cultural developments. A similar revolution has taken place in the last 50 years with the development of the internet. The article looks at how scientific publishing has changed with electronic publishing, including the development of Open Access. The journal Heritage Science is placed into this context. Especially important for scientific journals in an era when anyone can post anything on a webpage, is maintaining standards through high quality refereeing which distinguishes formal scientific literature from informal websites. [ABSTRACT FROM AUTHOR]

Economic regulation is an instrument of the state or other institutions to correct market failures, rectify the business environment, or protect consumers. Regulation can be a major driver of innovation, and it has proven to be so in the past. On the other hand, there are also documented cases of ineffective regulation due to information delays or shortcomings in government decision-making. The complexity of the impact of regulatory changes on innovation can currently be observed in the medical device market in Europe. Regulation (EU) 2017/745 whose main idea is to ensure greater safety and health protection for consumers, is a challenge for originator, manufacturer, mostly small and medium-sized enterprises. The regulation is associated with an increase in the cost of developing and maintaining the product on the market. We can now gradually begin to analyze whether it can be ranked among those that have become drivers of innovation. [ABSTRACT FROM AUTHOR]

This paper seeks to analyze the development of rural tourism in Europe and the tourist specifics of countries with renowned destinations, focusing on the impact of COVID-19 from 2019 to 2022 and its influence on tourism trends. By utilizing data and documentation from the pandemic period, we aim to identify emerging trends in Europe and evaluate the sector's ability to recover to pre-pandemic levels. The analysis and conclusions are inevitably shaped by the COVID-19 pandemic period, with its effects compared against specified parameters. The statistical analysis, utilizing specific indices, shows that the pandemic had a negative impact on tourism activities, resulting in significant declines and underscoring the sector's vulnerability during crises. [ABSTRACT FROM AUTHOR]

Cardiac computed tomography (CT) was initially developed as a non-invasive diagnostic tool to detect and quantify coronary stenosis. Thanks to the rapid technological development, cardiac CT has become a comprehensive imaging modality which offers anatomical and functional information to guide patient management. This is the second of two complementary documents endorsed by the European Association of Cardiovascular Imaging aiming to give updated indications on the appropriate use of cardiac CT in different clinical scenarios. In this article, emerging CT technologies and biomarkers, such as CT-derived fractional flow reserve, perfusion imaging, and pericoronary adipose tissue attenuation, are described. In addition, the role of cardiac CT in the evaluation of atherosclerotic plaque, cardiomyopathies, structural heart disease, and congenital heart disease is revised. [ABSTRACT FROM AUTHOR]

Traumatic wounds are one of the most common problems leading people to the Emergency Department (ED), accounting for approximately 5,4 % of all the visits, and up to 24 % of all the medical lawsuits. In order to provide a standardized method for wound management in the ED, we have organized a workshop, involving several Italian and European experts. Later, all the discussed statements have been submitted for external validation to a multidisciplinary expert team, based on the so called Delphi method. Eight main statements have been established, each of them comprising different issues, covering the fields of wound classification, infectious risk stratification, tetanus and rabies prophylaxis, wound cleansing, pain management, and suture. Here we present the results of this work, shared by the Academy of Emergency Medicine and Care (AcEMC), and the World Society of Emergency Surgery (WSES). [ABSTRACT FROM AUTHOR]

The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire ‘cancer journey’. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care. [ABSTRACT FROM AUTHOR]

In Europe mainly at winter season the PM levels exceed air quality limits, which correlated with the operation of solid-fired boilers. More and more people are returning to using these devices due to energy shortage caused by the pandemic and regional conflicts. In addition, the phenomena of co-burning fuels and municipal waste in residential boilers in primarily fuel poverty households increases further the amount of pollutants in the atmosphere. This study aims to correlate the quantity and quality of air pollutants with the type of fuel (wood and wastes) burned. Combustion experiments were conducted using oak fuel mixed with three waste groups: (1) plastics (PP, HDPE, PET); (2) textiles (polyester—PES, cotton—COT); and (3) papers (cardboard—CARD, glossy coated paper—GCP, 84C/PAP). The addition of waste to wood fuel altered the morphology of emitted particles. While waste burning doesn't always increase particle quantity, it significantly raises PAH concentrations. A strong relationship exists between waste type, particle morphology, and PAH quality, where with lower molecular weight PAHs linked to tar agglomerates and higher ones to soot agglomerates with inorganic crystals. [ABSTRACT FROM AUTHOR]

This consensus paper provides a framework for grading of severity of cardiovascular magnetic resonance (CMR) imaging-based assessment of chamber size, function, and aortic measurements. This does not currently exist for CMR measures. Differences exist in the normal reference values between echocardiography and CMR along with differences in methods used to derive these. We feel that this document will significantly complement the current literature and provide a practical guide for clinicians in daily reporting and interpretation of CMR scans. This manuscript aims to complement a recent comprehensive review of CMR normal value publications to recommend cut-off values required for severity grading. Standardization of severity grading for clinically useful CMR parameters is encouraged to lead to clearer and easier communication with referring clinicians and may contribute to better patient care. To this end, the European Association of Cardiovascular Imaging (EACVI) has formed this expert panel that has critically reviewed the literature and has come to a consensus on approaches to severity grading for commonly quantified CMR parameters. [ABSTRACT FROM AUTHOR]

This article describes how papermaking emerged in medieval Europe displacing the traditional centers of the industry within the Muslim world. Ibn Marzūq al-Hafīd, a Muslim scholar, issued a fatwa on the permissibility of using European paper under Islamic law. The author contends the text illuminates Islam's evolving relationship with a developing Europe.

The article presents the authors' views in response to a comment on their paper "Patterns of Low and Lowest-Low Fertility in Europe," published in a 2004 issue of the journal "Population Studies." In their comment, the critics have argued that the cohort-fertility analysis in the aforesaid paper is weak on theoretical grounds and the empirical analysis is incomplete. The authors affirm that they agree with the comment that, as a society, the Netherlands differs from Southern Europe and even more from Central and Eastern Europe. Nevertheless, from a contemporary global perspective, these differences should not be overemphasized. They say that in their analyses, they used the Netherlands as a reference case of a country with an extraordinary pattern of late childbearing that is not associated with lowest-low fertility levels. However, the critics believe that these unusual characteristics invalidate the use of the Dutch example in the paper. So, this criticism is misconceived. It is precisely the unusualness of the fertility pattern in the Netherlands that makes it a useful reference point in the study of low and lowest-low fertility.

OBJECTIVE:: To investigate the methods and results used and conclusions found in available published papers on childhood overweight and obesity in Europe. SURVEYS:: This paper compares the two available published papers on the prevalence of child and adolescent overweight and obesity in Europe. The first paper was published in November 2003 and was based on 20 previously conducted surveys performed from 1992 to 2001. The other paper was published in January 2004 and was based on data from the WHO collaborative survey‘Health Behaviour in School Children’, which collected the data in 1997-1998 within a period of 9 months. Height and weight were included as optional questions and 13 European countries, Israel and United States participated. METHODS:: In both papers, body mass index (BMI) was used. In the first paper, measured BMI was used and prevalence of overweight was calculated using IOTF cutoff points. In the other paper, overweight and obesity prevalences were calculated from self-reported height and weight using an internal study reference standard. RESULTS:: The first paper found a north-south trend in overweight in Europe, whereas the second found a more equal distribution of overweight in European children. Thus, overweight was significantly increased among 13?y olds of both sexes in Finland, Ireland, and Greece, and in Portuguese girls. Among 15?y olds, the prevalence of overweight was significantly increased in Greek boys, and in Danish and Portuguese girls. On the contrary, in Lithuania, there was a significantly low prevalence of overweight among both ages and both sexes. CONCLUSION:: Critical reviews of the results of the two published papers show that the year of data collection, methods and use of appropriate statistics are of critical importance for the conclusion drawn from comparative epidemiological surveys on the prevalence of overweight.International Journal of Obesity (2004) 28, S10-S15. doi:10.1038/sj.ijo.0802822 [ABSTRACT FROM AUTHOR]

Focuses on options for reforming European governance. White Paper of the European Commission.

The article is a conference report on the topic of violence and its control in early modern Europe. The report highlights that recent studies have challenged the assumption that pre-modern society was chaotic and irreparably violent, instead showing that conflicts were often regulated by specific social rules or customs. The conference featured panels on various themes related to violence, including gender-based violence, criminal justice, political violence, and collective violence. The report concludes that the conference successfully addressed the complex topic of interpersonal violence and its control, and further research on the subject is warranted. [Extracted from the article]

The forest sector is vital in Europe, providing economic and social benefits to communities. However, this sector is also responsible for some environmental impacts, and it is crucial to ensure that these impacts do not outweigh the benefits described. For this reason, this paper proposes an environmental and economic assessment of three forest wood products – uncoated woodfree paper, natural cork stoppers, and particle boards. The life cycles of these products were modeled using foreground data and a life cycle assessment was conducted to determine the environmental impacts associated with these three life cycles. For the economic assessment, the net present value method was adopted. From the results, it is possible to conclude that the utilization of 1 ha of forest land for 100 years to plant Eucalyptus globulus used in the production of uncoated woodfree paper generates the least environmental impact per euro. A sensitivity analysis was conducted to determine the reliability of the results achieved given the uncertainty associated with the data used to model the three life cycles. The same critical impact categories and the same critical life cycle stage (raw materials' extraction) were identified for the three systems under study. Given these similarities, an effort must be made by the forest sector to reduce the impacts of these categories and this life cycle stage. To assist on this task, a set of generic and industry-specific recommendations is provided for companies operating in the forest sector. • An environmental and economic assessment of three forest wood products is performed. • The life cycle assessment methodology and the net present value method are used. • The production of uncoated woodfree paper generates the least environmental impact per euro of NPV. • Using sensitivity analysis, the results were found to be reliable. • Recommendations for different stakeholders in the forest sector are provided. [ABSTRACT FROM AUTHOR]

The H2Accelerate Collaboration [ FCB, January 2021, p3 ] has released the first in a series of white papers supporting the use of hydrogen in long-haul trucking in Europe. The paper was published on its new website, which will serve as a hub for the evidence base developed by the partnership to demonstrate the benefits of hydrogen-powered trucking and the support needed to facilitate its wide-scale rollout. [ABSTRACT FROM AUTHOR]

The article presents the authors' comments on the paper entitled, "Patterns of Low and Lowest-Low Fertility in Europe," by Francesco C. Billari and Hans-Peter Kohler, published in a 2004 issue of the journal "Population Studies." In their comment, the authors argue that the original authors' comparison of cohort-fertility patterns in the lowest-low fertility countries of Southern, Central, and Eastern Europe with Dutch cohort patterns is weak on theoretical grounds and that the empirical analysis is incomplete. The empirical analysis demonstrates that in the young cohorts of Southern, Central, and Eastern Europe, childbearing may very well decline below the levels observed in the Netherlands and in other West European countries. This is already happening in Southern Europe. Moreover, the childbearing surplus in early adulthood is evaporating, and the recuperation that would be needed for completed cohort fertility in these countries to remain above that of many West European countries is of such magnitude that it is doubtful whether it could occur.

Type 2 diabetes mellitus (T2DM) is common in patients with heart failure (HF) and associated with considerable morbidity and mortality. Significant advances have recently occurred in the treatment of T2DM, with evidence of several new glucose-lowering medications showing either neutral or beneficial cardiovascular effects. However, some of these agents have safety characteristics with strong practical implications in HF [i.e. dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RA), and sodium-glucose co-transporter type 2 (SGLT-2) inhibitors]. Regarding safety of DPP-4 inhibitors, saxagliptin is not recommended in HF because of a greater risk of HF hospitalisation. There is no compelling evidence of excess HF risk with the other DPP-4 inhibitors. GLP-1 RAs have an overall neutral effect on HF outcomes. However, a signal of harm suggested in two small trials of liraglutide in patients with reduced ejection fraction indicates that their role remains to be defined in established HF. SGLT-2 inhibitors (empagliflozin, canagliflozin and dapagliflozin) have shown a consistent reduction in the risk of HF hospitalisation regardless of baseline cardiovascular risk or history of HF. Accordingly, SGLT-2 inhibitors could be recommended to prevent HF hospitalisation in patients with T2DM and established cardiovascular disease or with multiple risk factors. The recently completed trial with dapagliflozin has shown a significant reduction in cardiovascular mortality and HF events in patients with HF and reduced ejection fraction, with or without T2DM. Several ongoing trials will assess whether the results observed with dapagliflozin could be extended to other SGLT-2 inhibitors in the treatment of HF, with either preserved or reduced ejection fraction, regardless of the presence of T2DM. This position paper aims to summarise relevant clinical trial evidence concerning the role and safety of new glucose-lowering therapies in patients with HF. [ABSTRACT FROM AUTHOR]

Focuses on the financial limitations of establishing massive conventional forces to defend Western Europe, while highlighting the relation between the 1952 British Global Strategy Paper (GSP) and the Eisenhower New Look of 1953. What was emphasized by both papers; Basis for the North Atlantic Treaty Organization (NATO); Information on the factors which influenced the GSP; Recommendations made by the GSP.

The paper by ESMO “The current and future role of the medical oncologist in the professional care for cancer patients: a position paper by the European Society for Medical Oncology (ESMO)” conveys some important key messages for the whole oncology community. A working group (WG) involving 21 oncology and related societies would like to comment on the ESMO position paper from a multidisciplinary perspective. The letter focuses on the concept of multidisciplinarity and how collaboration is the ideal situation for the best care of patients: the guidance to the patient must be given in accordance with agreements based on the outcome of discussions within the multidisciplinary team. The commentary therefore wants to highlight those statements that the working group shares and supports, identifying the common ground from where to start a constructive dialogue. [ABSTRACT FROM AUTHOR]

The article describes the values, vision, mission and aims of the Association of Schools of Public Health in the European Region (ASPHER). The mission and objectives of ASPHER include promotion of education, research and service in the field of public health to create a dynamic academic and practical educational infrastructure, promotion of public awareness, policy, and support for mentoring academic environments, and promotion of peer review in research to raise standards in public health.

The article features the life and works of Robert Hertz. It notes that Hertz was known as a socialist activist, a nationalist soldier and an ethnographer of Europe. He was a member of Jean Jaures' socialist party and participated in World War I. It also notes that Hertz made an account about Saint Besse wherein he views that religious practices are the key contributor to social identity.

In both the Geo and BIM domains, it is widely acknowledged that the integration of geo-data and BIM-data is beneficial and a crucial step in facing the multi-disciplinary challenges of our built environment. The result of this integration – broadly termed as GeoBIM – has a range of potential uses from district study to road safety. However, from the data perspective, this integration raises the question of how to integrate very detailed design and construction data from the BIM domain with contextual geospatial data (both 2D and 3D) that model a very diverse range of aspects of the wider built and natural environment.This paper reports work carried out during the second phase of the EuroSDR GeoBIM project, which sets out to understand the general status of GeoBIM across Europe with particular focus from a National Mapping and Cadastral Agency perspective. The first phase of the project reviewed the current status of GeoBIM in participating countries and identified the need for specific detailed use cases to overcome both the lack of awareness and the lack of understanding of the potential of GeoBIM. We present both an update on the current status of GeoBIM, and additional details of one of the selected use cases relating to planning/development permits. For the latter, we have been able to develop a detailed workflow highlighting specific data exchange points within the process to issue a development permit, allowing a more in-depth identification of both the roles and data needs at each stage. [ABSTRACT FROM AUTHOR]

Background: The development of new genetic testing methods and the approval of the first treatments raises questions regarding when and how to perform screening for inherited neuromuscular conditions. Screening directives and access to the different techniques is not uniform across Europe. The patient advisory board of the European reference network for rare neuromuscular diseases (NMD) conducted a qualitative study to understand the state of play of screening for inherited NMD in Europe and patients' needs.Results: We collected answers from 30 patient organisations (POs) from 18 European countries. Fifteen acknowledge the existence of pre-implantation genetic diagnosis in their country. Regarding prenatal screening, we had 25 positive answers and 5 negative ones. Twenty-four POs mentioned that newborn screening was available in their country. We had some contradictory answers from POs from the same country and in some cases; diseases said to be part of the screening programmes were not hereditary disorders. Twenty-eight organisations were in favour of screening tests. The reasons for the two negative answers were lack of reimbursement and treatment, religious beliefs and eventual insurance constrains. Most POs (21) were in favour of systematic screening with the option to opt-out. Regarding the timing for screening, "at birth", was the most consensual response. The main priority to perform screening for NMDs was early access to treatment, followed by shorter time to diagnostic, preventive care and genetic counselling.Conclusions: This is the first study to assess knowledge and needs of POs concerning screening for NMDs. The knowledge of POs regarding screening techniques is quite uneven. This implies that, even in communities highly motivated and knowledgeable of the conditions they advocate for, there is a need for better information. Differences in the responses to the questions "how and when to screen" shows that the screening path depends on the disease and the presence of a disease modifying treatment. The unmet need for screening inherited NMDs should follow an adaptive pathway related to the fast moving medical landscape of NMDs. International coordination leading to a common policy would certainly be a precious asset tending to harmonize the situation amongst European countries. [ABSTRACT FROM AUTHOR]

The article is a conference report on a virtual conference titled "After the Feud? Dispute Settlement Between Custom and Law in Early Modern Europe." The conference explored the role of feuds and traditional customs in conflict resolution during the early modern period in Europe. The conference included presentations on topics such as the role of customs and law in dispute settlement, the gendered and emotional aspects of feuds, and the use of duels as a form of conflict resolution. The report highlights the importance of fruitful discussions and commends the organization of the conference. [Extracted from the article]

The suitability of industrial hemp (IH) as a source of fibres for European industrial-scale papermaking, including, in particular, European kraft pulp mills (EKMPs) (i.e., plants producing the predominant amount of virgin pulps in Europe), was discussed, considering the causal, cultivation, technological, and application aspects of this issue. The work showed that there are generally premises for using straw from nonwood crops in European papermaking. As for the IH, it was found that IH stalks are the best IH fibrous raw material for EKMPs. There are a few cultivation factors favouring the use of IH stalks in them and a few, though important (e.g., small cultivation areas), factors not conducive to this use. Most technological factors favour the use of IH stalks in EKPMs, apart from the large differences in the length of the IH bast and woody-core fibres. The analysis of application factors indicates lower usefulness of IH stalks than wheat, rye or triticale straws, stalks of Miscanthus × giganteus, Virginia mallow, and kenaf. This is due to the much greater availability of these cereal straws than IH and less variation in the fibre length of cereal straws, Miscanthus × giganteus, Virginia mallow, and kenaf than in IH stalks. The main conclusion from the conducted query is the statement that the presence of IH varieties with fibre lengths more similar to wood would reduce the number of technological and application factors unfavourable to their use in EKPMs and increase the competitiveness of hemp straw vs. wood as a raw material for European large-scale papermaking. [ABSTRACT FROM AUTHOR]

Explores the maintenance goals and practices at 18th-century paper mills in Europe. Survey of paper manufacture; Influence of technologies; Pervasive operate-to-failure style; Regular minor repairs; Postponed major renovations; Rational choices in market context; Weakness of mills; Annual maintenance spending; Estimated lifespan of the equipment of a paper mill.

Purpose: Gene therapy brings opportunities to discover cures for diseases for which there are no adequate treatments. As most gene therapies target rare diseases, several challenges are associated with their clinical development, such as limited population size, lack of established clinical pathways for development, and sometimes the absence of validated endpoints. The objective of this study was to systematically review and evaluate the methodology and design of European clinical trials (CTs) utilising gene therapy medicinal products (GTMPs). Methods: A systematic search of online CT databases was performed using keywords to identify CTs conducted with GTMPs in Europe, published from 1 January 1995 to 31 July 2019. Results: The search identified 1571 CTs, of which 199 were identified as published articles. A total of 159 CTs remained following the elimination of duplicated CTs, non-gene therapy trials, and those conducted outside Europe. Of these, only nine CTs were randomised, double-blind, with or without parallel groups, and placebo-controlled. Conclusions: The analysed randomised CTs were conducted in accordance with Good clinical practice with low risk of bias across domains. Only one CT was identified with some concerns of bias due to lack of information regarding the randomisation process and changes in protocol. [ABSTRACT FROM AUTHOR]

Background: Service providers throughout Europe have identified the need to define how high-quality community-based mental health care looks to organize their own services and to inform governments, commissioners and funders. In 2016, representatives of mental health care service providers, networks, umbrella organizations and knowledge institutes in Europe came together to establish the European Community Mental Health Services Provider (EUCOMS) Network. This network developed a shared vision on the principles and key elements of community mental health care in different contexts. The result is a comprehensive consensus paper, of which this position paper is an outline. With this paper the network wants to contribute to the discussion on how to improve structures in mental healthcare, and to narrow the gap between evidence, policy and practice in Europe. Main text: The development of the consensus paper started with an expert workshop in April 2016. An assigned writing group representing the workshop participants built upon the outcomes of this meeting and developed the consensus paper with the input from 100 European counterparts through two additional work groups, and two structured feedback rounds via email. High quality community-based mental health care: 1) protects human rights; 2) has a public health focus; 3) supports service users in their recovery journey; 4) makes use of effective interventions based on evidence and client goals; 5) promotes a wide network of support in the community and; 6) makes use of peer expertise in service design and delivery. Each principle is illustrated with good practices from European service providers that are members of the EUCOMS Network. Conclusions: Discussion among EUCOMS network members resulted in a blueprint for a regional model of integrated mental health care based upon six principles. [ABSTRACT FROM AUTHOR]

The article seeks to advance understanding of the involvement of transnational student associations in European governance of higher education policies within the European Union (EU) and the European Higher Education Area (EHEA). Specifically, the article explores the mechanisms for interest intermediation that exist for transnational student associations in both policy arenas. Three transnational student associations stand out in terms of their involvement: European Students' Union (ESU), Erasmus Student Network (ESN) and European Students' Forum (AEGEE). The findings point to two distinct models of student interest intermediation in European policy-making. Within the EU, the European Commission interacts with all three transnational student associations; however, ESU and ESN participate in more expert and working groups. The roles afforded to each association in relation to the European Commission are demarcated and functionally differentiated. Within EHEA, in neo-corporatist fashion, ESU, as a representative platform of national student unions, holds representational monopoly. In the EHEA and the EU, the involvement of transnational student associations in policy-making can be attributed to the evolving nature of transnational governance regimes in which participation of transnational student associations not only brings expertise to but also aids the legitimacy of the policy processes and outcomes.

Background: Genetic epidemiology deals with the aetiology, distribution and control of disease in groups of relatives, and with inherited causes of disease in populations. The main goal of this overview, part of the collaborative study SPHERE (Strengthening Public Health Research in Europe) was to have an up-to-date, detailed summary of the available information for epidemiologists and researchers on the present status of genetic epidemiology in Europe. Methods: The PubMed literature search engine was used to recruit papers published in Europe (EU15, EU + 10 and non-EU countries) in this field restricted to the time period of 1 January 1987 and 31 December 2004. Results: The number of publications increased significantly in Europe in the period analysed, however, the publication activity was restricted mainly to EU15 countries, with only sporadic papers from EU + 10 countries. Research areas studied are slightly different in Europe and in the USA with a larger emphasis on cancer, mental disease and behavioural disease genetic epidemiology in Europe. Conclusion: The aim must be to develop research to support policy in this important field as is already seen in the United States. [ABSTRACT FROM AUTHOR]

To ensure the precise dimensioning and effective testing of drivetrain components, it is crucial to have a thorough understanding of customer requirements, with a particular emphasis on customer stress on these components. An accurate interpretation of customer data is essential for determining representative customer requirements, such as load collectives. The automobile industry has faced challenges in analyzing large amounts of customer driving data to obtain representative load collectives as target values in durability design. However, due to technical limitations and cost constraints, collecting data from a large sample size is not feasible. The ongoing digitalization of the automotive industry, driven by an increasing number of connected vehicles, enhances data-based and customer-oriented development. This paper investigates representative customer load collectives using cloud data from over 40,000 customer vehicles to lay the groundwork for realizing robust requirement engineering. A systematic method for analyzing big data on the cloud was introduced. The derived component-specific damage distribution from these collectives adopts a unique approach, utilizing the 1% vehicle term instead of the common 1% customer term to represent typical customer stress. This study shows that the driven mileage and the number of vehicles are crucial factors in 1% vehicle analysis. An analysis of the characteristics of the 1% vehicle is conducted, followed by an exploration to determine the required vehicle quantity for obtaining stable results. The shape parameter of the damage distribution determines the necessary number of vehicles for a reliable conclusion. Additionally, a comparative analysis of market-specific customer requirements between the US and Europe is presented, and real usage differences in customer operations are explained using an operating point frequency heatmap. The information presented in this paper provides valuable input for optimizing durability design and conducting efficient, customer-oriented tests, resulting in significant reductions in development time and costs. [ABSTRACT FROM AUTHOR]

The 2024 European Quality of Government Index (EQI) collects the opinions of 135,227 respondents in a total of 210 NUTS 1 and NUTS 2 regions in all EU 27 member state countries. This paper, first, presents the 2024 data and highlights some of the main results of this effort to understand citizens' perceptions, and personal experiences, of regional quality of government. Second, it compares the findings with the previous four rounds of the survey (starting in 2010), highlighting both the regions that are improving and those that show a declining trend in their quality of government. Third, the paper discusses the changes made to round 5 and other trends in the data over time, paying special attention to the comparison of EU citizens' perceptions and experiences of government before and after the Covid-19 pandemic. Compared to the improvements in corruption levels recorded in the 2021 study, we find that corruption levels have bounced back to more normal levels in post pandemic Europe [ABSTRACT FROM AUTHOR]

The paper introduces two emerging concepts of European Studies - Superstate Europe and Europe of nations. The two interpret the future of Europe in very different perspectives. While Superstate Europe envisions a political unification in which the supranational entity is becoming the main source of power, Europe of nations, on the contrary, tries to restore the member states' sovereignties over the EU. Thus, both framings have explicit political contents, and neither of them can be considered exclusively academic. Of course, in the field of European Studies this is not unprecedented. Nonetheless, the emergence of two such rival ideas is symbolizing the political polarization of the EU, as well as the politicization of European Studies. In its first section, the paper describes the general logic, main points, and basic inner-linkages of Superstate Europe and Europe of nations, and then in the second part it identifies their positions in the conceptual space of European Studies. This latter effort tries to reveal the relatedness of these framings to other European integration theories. The main finding of this meta-analysis is that Superstate Europe is more embedded conceptually, and this helps to better explain or criticize certain aspects of the idea, while Europe of nations can be considered more original in the sense of reflecting on the previously unaddressed challenge of proposing a disintegration theory among many European integration theories. [ABSTRACT FROM AUTHOR]

The population of patients with congenital heart disease (CHD) is continuously increasing with more and more patients reaching adulthood. A significant portion of these young adults will suffer from arrhythmias due to the underlying congenital heart defect itself or as a sequela of interventional or surgical treatment. The medical community will encounter an increasing challenge as even most of the individuals with complex congenital heart defects nowadays become young adults. Within the past 20 years, management of patients with arrhythmias has gained remarkable progress including pharmacological treatment, catheter ablation, and device therapy. Catheter ablation in patients with CHD has paralleled the advances of this technology in pediatric and adult patients with structurally normal hearts. Growing experience and introduction of new techniques like the 3D mapping systems into clinical practice have been particularly beneficial for this growing population of patients with abnormal cardiac anatomy and physiology. Finally, device therapies allowing maintanence of chronotropic competence and AV conduction, improving haemodynamics by cardiac resynchronization, and preventing sudden death are increasingly used. For pharmacological therapy, ablation procedures, and device therapy decision making requires a deep understanding of the individual pathological anatomy and physiology as well as detailed knowledge on natural history and long-term prognosis of our patients. Composing expert opinions from cardiology and paediatric cardiology as well as from non-invasive and invasive electrophysiology this position paper was designed to state the art in management of young individuals with congenital heart defects and arrhythmias. [ABSTRACT FROM AUTHOR]

Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. Outcome varies from full recovery to residual left ventricular systolic dysfunction and even death. Many women return to their physician to acquire information on their long-term prognosis, to seek medical advice regarding contraception, or when planning a subsequent pregnancy. This position paper summarizes current evidence for long-term outcome, risk stratification of further pregnancies and overall management. Based on the best available evidence, as well as the clinical experience of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy members, a consensus on pre- and postpartum management algorithms for women undergoing a subsequent pregnancy is presented. [ABSTRACT FROM AUTHOR]

Incunabula are printed materials created in Europe from the time of Johann Gutenberg's invention until 1500. Incunabula originate from the Latin language (lat. Incunabulum) and mean cradle or the beginning of something. In this paper, the representation of individual states and cities in the creation of incunabula is investigated and presented. The persons responsible for such development are also listed. Special attention is given to the presentation of Croatian incunabula. The mentioned works describe the characteristic features. Incunabula testify to a high level of culture, standards, and technological development of a particular area. The studied works reveal and confirm, as confirmed in this paper, the attitude of society towards literacy, education, and the national culture of each nation. This paper aims to comprehensively present the importance of incunabula for the development of European and Croatian culture, technological and comprehensive progress. [ABSTRACT FROM AUTHOR]

The paper analyzes household portfolio dynamics in Europe, focusing on the period from 2010 to 2017 using data from the European Central Bank's Household Finance and Consumption Survey (HFCS). The study examines the evolution of household portfolios after the 2008 financial crisis, with housing assets found to be one of the key drivers. On the aggregate level, the household portfolio remained stable between 2010 and 2017. Housing importance remained crucial during all the time and drove the majority of portfolio performance for households in 40-99 percentiles of the wealth distribution. With the evolution of household portfolios, age cohorts 45-54, 65 and older strengthen their positions by increasing the share of their owned assets in comparison to other age cohorts, which lost part of their shares. I conclude the paper with some stylized facts showing the relationship between home ownership, the share of portfolio in housing assets and wealth inequality between countries. The stylized facts provide evidence that household portfolios significantly concentrated in housing assets during the analyzed decade. Furthermore, the transition of households from renters to home owners contributed significantly to the changes in wealth inequality that occurred after the 2008 financial crisis. [ABSTRACT FROM AUTHOR]

This research is part of a wider framework of index literature studies that have been conducted in the past few years. Some of these have had a focus on specific remote sensing (RS) technologies, while others have tackled specific threats to cultural heritage and landscapes. By considering both damages to heritage sites and technologies used for documentation and the monitoring of such occurrences, this paper unveils the current trends on a global scale in the study of the threats to heritage caused by both human-induced and natural hazards. Papers published by Europe-based researchers over the last 20 years using RS and Earth Observation (EO) techniques were surveyed alongside recommendations and programmatic documents issued by institutions in charge of heritage protection and management of several countries in Europe. Around 300 documents, including scientific articles (published from 2000 until 2022) and Grey literature (from 2008 and 2022), were analysed. The data collection and analysis were undertaken by a working group that was intentionally composed to bring together diverse perspectives and expertise, i.e., requirements of heritage professionals using RS and EO technologies, knowledge on technologies and their use in the field, and expertise in methodology implementation to support heritage management. The results highlight the type of hazards considered the most and the geographical distribution of the archaeological sites and monuments targeted by these studies; the countries the researchers are affiliated with; the types of RS and specifically satellite-based technologies used (and hence the type of data used); the tendencies of satellite data usage—visual interpretation, image processing, employment of machine learning, and AI; the technologies most applied by public institutions and practitioners; and many others. Recommendations and future trajectories are then outlined to efficiently reframe discrepancies between types of damage that have received the greatest attention in the literature and the most impactful ones in terms of the number of sites damaged. [ABSTRACT FROM AUTHOR]

The report of an imaging procedure is a critical component of an examination, being the final and often the only communication from the interpreting physician to the referring or treating physician. Very limited evidence and few recommendations or guidelines on reporting imaging studies are available; therefore, an European position statement on how to report nuclear cardiology might be useful. The current paper combines the limited existing evidence with expert consensus, previously published recommendations as well as current clinical practices. For all the applications discussed in this paper (myocardial perfusion, viability, innervation, and function as acquired by single photon emission computed tomography and positron emission tomography or hybrid imaging), headings cover laboratory and patient demographics, clinical indication, tracer administration and image acquisition, findings, and conclusion of the report. The statement also discusses recommended terminology in nuclear cardiology, image display, and preliminary reports. It is hoped that this statement may lead to more attention to create well-written and standardized nuclear cardiology reports and eventually lead to improved clinical outcome. [ABSTRACT FROM AUTHOR]

As evidenced by the EU Floods Directive (2007/60/EC), flood management strategies in Europe have undergone a shift in focus in recent years. The goal of flood prevention using structural measures has been replaced by an emphasis on the management of flood risks using non-structural measures. One implication of this is that it is no longer public authorities alone who take responsibility for flood management. A broader range of stakeholders, who may experience the negative effects of flooding, also take on responsibility to protect themselves. Therefore, it is vital that information concerning flood risks are conveyed to those who may be affected in order to facilitate the self protection of citizens. Experience shows that even where efforts have been made to communicate flood risks, problems persist. There is a need for the development of new tools, which are able to rapidly disseminate flood risk information to the general public. To be useful, these tools must be able to present information relevant to the location of the user. Moreover, the content and design of the tool need to be adjusted to laypeople's needs. Dissemination and communication influences both people's access to and understanding of natural risk information. Such a tool could be a useful aid to effective management of flood risks. To address this gap, a Web-based Geographical Information System, (WebGIS), has been developed through the collaborative efforts of a group of scientists, hazard and risk analysts and managers, GIS analysts, system developers and communication designers. This tool, called "READY: Risk, Extreme Events, Adaptation, Defend Yourself", aims to enhance the general public knowledge of flood risk, making them more capable of responding appropriately during a flood event. The READY WebGIS has allowed for the visualization and easy querying of a complex hazard and risk database thanks to a high degree of interactivity and its easily readable maps. In this way, READY has enabled fast exploration of alternative flood scenarios or past calamitous events. Combined also with a system of graphic symbols designed ad hoc for communication of self-protection behaviors, it is believed READY could lead to an increase in citizen participation, informed discussion and consensus building. The platform has been developed for a site-specific application, i.e. the Basilicata Region, Italy, has been selected as pilot application area. The goal of the prototype is to raise citizen awareness of flood risks, and to build social capacity and enhanced resilience to flood events. [ABSTRACT FROM AUTHOR]

Urban waste heat recovery, in which low temperature heat from urban sources is recovered for use in a district heat network, has a great deal of potential in helping to achieve 2050 climate goals. For example, heat from data centres, metro systems, public sector buildings and waste water treatment plants could be used to supply 10% of Europe's heat demand. Despite this, at present, urban waste heat recovery is not widespread and is an immature technology. Based on interviews with urban waste heat stakeholders, investors interested in green investments, and experience from demonstrator projects, a number of recommendations are made. It is suggested that policy raising awareness of waste heat recovery, encouraging investment and creating a legal framework should be implemented. It is also recommended that pilot projects should be promoted to help demonstrate technical and economic feasibility. A pilot credit facility is suggested aimed at bridging the gap between potential investors and heat recovery projects. [ABSTRACT FROM AUTHOR]

This article investigates the tensions inherent in the 'speeding up' of methods of manufacturing paper by hand in Europe. Earlier in 1732, a dynamic administrator hoping to revive the fortunes of the small-paper maker centre near Clermont-Ferrand in France, facilitated the placing of an exceptional order by a Parishian printer. The contract was not large enough, but the high quality required for the luxury edition of the works of a great scholar offered a unique chance for paper makers to display their skills and renew their links with the capital's profitable markets. The mill owners, readily set to work, but they also immediatedly and repeatedly asked their protector to find an outlet for the paper that would inevitably remain after the best realms had left for Paris. The claim was legitimate not only because these paper makers were in need for assistance, but it was impossible for anyone engaged in that business to limit production to the finest paper only. Papers of different qualities inevitably accumulated on their sorting tables.

Offshore wind power is a valuable renewable energy source. However, the development of offshore wind farms is facing many challenges, including understanding their impacts on ecosystems and society, as well as knowledge gaps in research. In this study, a bibliometric analysis was performed with the aim of providing a comprehensive understanding of current global progress in offshore wind farm research. Three stages of development were considered for the analysis and comparison of research characteristics and outcomes. Based on the total number of scientific publications and the international collaboration ratio (ICR), Europe has been leading research in and the development of offshore wind power since the early 1990s. However, a fast-growing period of offshore wind farm development occurred after 2000, during which Europe and Asia in particular showed increases in ICR. The installation of offshore wind turbines may have non-negligible adverse impacts on marine ecosystems, especially in ecologically vulnerable regions or developing countries. Research and relevant studies should be integrated to investigate and reduce the ecological and environmental damage that results from offshore wind farm development. This paper presents a systematic evaluation of the global developmental trends in offshore wind farm research, which could help to characterize and guide future trends within this field. [ABSTRACT FROM AUTHOR]

Background The burden of mental health disorders in Europe is well above the world average and has increased from 11.5% to 13.9% of the total disease burden in 2000 and 2015. That from dementia has increased rapidly, and overtaken that from depression as the leading component. There have been no analyses of the research activity in Europe to combat this burden. Methodology We identified research papers in the Web of Science (WoS) with a complex mental health disorders filter based on title words and journal names in the years 2001-18, and downloaded their details for analysis. Results European mental health disorders research represented less than 6% of the total biomedical research. We estimate that research expenditure in Europe on mental health disorders amounted to about €5.4 billion in 2018. The Scandinavian countries, with Croatia and Estonia, published the most relative to their wealth, but the outputs of France and Romania were less than half the amounts expected. Discussion and conclusions The burden from mental health disorders is increasing rapidly in Europe, but research was only half what would have been proportional. Suicide & self-harm, and alcohol misuse, were also neglected by researchers, particularly since the latter also causes many physical burdens, such as foetal alcohol syndrome, interpersonal violence, and road traffic accidents. Other relatively neglected subjects are sexual disorders, obsessive compulsive disorder, post-traumatic stress disorder, attention-deficit hyperactivity and sleep disorders. There is an increasing volume of research on alternative (non-drug) therapies, particularly for post-traumatic stress and eating disorders, notably in Germany. [ABSTRACT FROM AUTHOR]

Rationale, aims and objective: Substituting outpatient hospital care with primary care is seen as a solution to decrease unnecessary referrals to outpatient hospital care and decrease rising healthcare costs. This systematic review aimed to evaluate the effects on quality of care, health and costs outcomes of substituting outpatient hospital care with primary care-based interventions, which are performed by medical specialists in face-to-face consultations in a primary care setting. Method: The systematic review was performed using the PICO framework. Original papers in which the premise of the intervention was to substitute outpatient hospital care with primary care through the involvement of a medical specialist in a primary care setting were eligible. Results: A total of 14 papers were included. A substitution intervention in general practitioner (GP) practices was described in 11 papers, three described a joint consultation intervention in which GPs see patients together with a medical specialist. This study showed that substitution initiatives result mostly in favourable outcomes compared to outpatient hospital care. The initiatives resulted mostly in shorter waiting lists, shorter clinic waiting times and higher patient satisfaction. Costs for treating one extra patient seemed to be higher in the intervention settings. This was mainly caused by inefficient planning of consultation hours and lower patient numbers. Conclusions: Despite the fact that internationally a lot has been written about the importance of performing substitution interventions in which preventing unnecessary referrals to outpatient hospital care was the aim, only 14 papers were included. Future systematic reviews should focus on the effects on the Triple Aim of substitution initiatives in which other healthcare professions than medical specialists are involved along with new technologies, such as e-consults. Additionally, to gain more insight into the effects of substitution initiatives operating in a dynamic healthcare context, it is important to keep evaluating the interventions in a longitudinal study design. [ABSTRACT FROM AUTHOR]