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The Progress in International Reading Literacy Study (PIRLS) was conducted in paper and online reading modes in 2016 using the same samples of students in a number of countries. Differences in reading literacy scores were found in several European countries. In some countries, the differences favored the electronic reading mode. Yet in others, the paper reading mode was favored. As the electronic reading mode differs substantially in the cognitive demands compared to the paper mode, it can be expected that the differences between the two modes are related to the variables related to technology: availability and access, general use, use for educational purposes in class or out-of-school, and self-efficacy with technology. This study investigates the Information and Communication Technology (ICT) factors related to the differences in paper and online reading in six European countries participating in both modes in PIRLS 2016. This study uses linear regression models as the application of multilevel modeling is not suitable because of the low between-school variances across countries. The results from this study show limited support for the relative effect that the student individual, school, and classroom ICT variables have on the differences between paper and electronic reading. Access to technology is related to mode differences only in Italy, and the use of computer devices in and out of school is related to the mode differences in Italy and Portugal. Student self-efficacy is related to the mode differences in Portugal and Slovenia. School resources show significant effects in Denmark (computers to students ratio) and Italy (instruction affected by digital resource shortages). None of the classroom variables showed any significant relationship in any of the countries. In addition, socio-economic status (which is proxied by the variable on home resources for learning) is a significant predictor in half of the countries. In addition to these findings, the general technological context within countries is discussed as part of an evaluation of the difference in reading in the two test delivery modes. The general uptake of technology in different social and economic aspects, as measured by the Digital Economy and Society Index (DESI), follows the differences between the two reading modes.

Erasmus mobility has become an important feature of higher education in Europe and beyond, with the potential to generate significant changes at individual, institutional and systemic levels. More than three decades after the foundation of this successful program, evaluations reveal that, despite notable progress, several aspects of the Erasmus student experience can be further improved. Based on the lived experiences of Erasmus alumni, in this article, we explore recurrent challenges that emerge in educational mobility and how they could be better addressed. Three key dimensions are identified in the qualitative accounts of former Erasmus students and analyzed in light of previous research: mobility preparation, institutional support for integration, and recognition of study abroad.

Computer-based test (CBT) and paper-based test (PBT) are two test modes to the test takers that have been widely adopted in the field of language testing or assessment over the last few decades. Due to the rapid development of science and technology, it is a trend for universities and educational institutions striving rather hard to deliver the test on a computer. Therefore, research on the comparison between these two test modes has attracted much attention to investigate whether the PBT could be completely replaced. At the same time, task difficulty is always a key element to reflect test takers' performances. Numerous studies have laid a solid foundation and guidance about the comparative study of test takers' performance on CBT and PBT, but there still remains a scarcity from the perspective of task difficulties with different Common European Framework of Reference for Languages (CEFR) task levels in particular. This study, therefore, compared the test takers' performance on both CBT and PBT across tasks with different CEFR levels. A total of 289 principal recommended high school test takers from Macau took the pilot Test of Academic English (TAE) at a local university. The results indicated that there was a difference between test takers' performance on different test modes across different CEFR levels, but only CEFR A2 level showed a statistically difference between CBT and PBT. And since science and technology are continuously developing, it is essential for the university to consider switching the test mode from PBT to CBT.

Purpose: To assess the extent of paper waste generated per year by instructions for use (IFUs) brochures included in intraocular lens (IOL) packaging in Europe and the U.S. Setting: Rothschild Foundation Hospital, Paris, France; Royal Free London NHS Foundation Trust; Center for Sight, London, United Kingdom. Design: Experimental study. Methods: A sample of IOLs were collected and each IFU was weighed. In addition, the cumulative weight of these brochures used in cataract surgeries performed annually in Europe and the U.S. was estimated, and the potential annual paper conservation that could be achieved if all manufacturers adopted electronic IFUs (e-IFUs) in Europe and the U.S. was determined. Results: The mean and standard deviation of the weight for overall IFUs, classic IFUs, and e-IFUs were 17.6 ± 13.8 g, 23.5 ± 13.2 g, and 2.9 ± 1.9 g, respectively. The estimated cumulative weight of paper generated from the IFUs accompanying implants used in European and U.S. cataract surgeries is 153 tons. If all manufacturers transition to e-IFUs, the cumulative weight saved would be 128 tons (-84%), equivalent to 120 tons of carbon dioxide equivalent and the preservation of more than 2000 trees annually. Conclusions: The classic IFUs in IOL packaging result in a significant amount of paper waste annually. Therefore, there is an urgent need for a rapid transition to e-IFU technology. The adoption of e-IFUs has already been authorized in Europe and the U.S., and it is crucial to expedite this process. [ABSTRACT FROM AUTHOR]

In this study we compare the titles of scientific letters and those of research papers published in the field of astrophysics in order to identify the possible differences and/or similarities between both genres in terms of several linguistic and extra-linguistic variables (length, lexical density, number of prepositions, number of compound groups, number of authors and number of countries mentioned in the paper bylines). We also carry out a cross-genre and cross-journal analysis of the referred six variables. Our main findings may be summarized as follows: (1) When compared to research paper titles, scientific letter titles are usually shorter, they have a lower lexical density, they include a higher number of prepositions per number of words and a lower number of compound groups per number of words, although they have more up to 4-word compound groups, i.e. the simplest ones. As a consequence, scientific letter titles include less information, which is also less condensed, than research paper titles. (2) The predominance of compound adjectives over compound nouns in the titles of both genres highlights the scientificity of astrophysical discourse. (3) In general terms, our data show a positive correlation between title length and the number of countries mentioned in the bylines for both genres. The positive correlation between title length and number of authors is only met in the case of research papers. In light of these findings, it may be concluded that scientific letters are a clear example of a timeliness and more "immediate" science, whereas research papers are connected to a more timeless and "elaborate" science. It may also be concluded that two different collaboration scenarios are intertwining on the basis of three separate geographic and linguistic publication contexts (Mainland Europe, The United Kingdom and The United States of North America).

The pulp and paper industry (PPI) has several opportunities to contribute to meeting prevailing climate targets. It can cut its own CO2 emissions, which currently account for 2% of global industrial fossil CO2 emissions, and it has an opportunity to produce renewable energy, fuels, and materials for other sectors. The purpose of this study is to improve understanding of the decarbonization prospects of the PPI. The study provides insights on the magnitude of needed annual renewal rates for several possible net-zero target years of industrial fossil CO2 emissions in the PPI and discusses decarbonization opportunities, namely, energy and material efficiency improvement, fuel switching, electrification, renewable energy production, carbon capture, and new products. The effects of climate policies on the decarbonization opportunities are critically evaluated to provide an overview of the current and future business environment of the European PPI. The focus is on Europe, but other regions are analyzed briefly to widen the view. The analysis shows that there are no major technical barriers to the fossil-free operation of the PPI, but the sector renovates slowly, and many new opportunities are not implemented on a large scale due to immature technology, poor economic feasibility, or unclear political environment. [ABSTRACT FROM AUTHOR]

Nowadays, a high percentage (> 50%) of the paper produced in Europe uses recovered paper (secondary fibers) as raw material. In order to improve the mechanical properties of the paper produced, different kinds of additives are usually incorporated into the paper. Emerging renewable materials based on agricultural or forest residues, such as cellulose nanomaterials, have recently proved good capacities as reinforcing agents for different applications. In this work, pulp from wheat straw with a content of cellulose nanomaterial has been produced and tested as a mechanical reinforcing agent for paper production. A soda semi-chemical process was applied for the delignification of straw, to produce pulp with high cellulose content. Posteriorly, pulps with cellulose nanofibers were obtained in a high-pressure homogenizer, applying three different pretreatments to the cellulose pulp (acid hydrolysis, enzymatic hydrolysis and thermal treatment with glycerol) in order to facilitate the obtention of cellulose nanomaterial. Handsheets of paper were prepared from two sources of secondary fiber (fluting paper and old corrugated containers), adding different percentages of wheat straw derivatives (0, 3.5, 5 and 7%). The fibers' morphology and the papers' mechanical properties were investigated. Noticeable improvement rates (up to 25%) were observed for some mechanical properties of paper containing nanocellulose produced after the enzymatic and acid pretreatments. The quality of the secondary fibers source also affected the improvement rates achieved, with higher percentage changes for the lower-quality recycled paper. [ABSTRACT FROM AUTHOR]

In this study, we carry out a qualitative and quantitative analysis of abbreviations in 300 randomly collected research paper titles published in the most prestigious European and US-based Astrophysics journals written in English. Our main results show that the process of shortening words and groups of words is one of the most characteristic and recurrent features in Astrophysics research paper titling construction. In spite of the convenience of abbreviations as a mechanism for word-formation, some of them may pose certain difficulties of understanding and/or misinterpretation because of their specificity, ambiguity, or overlapping. To overcome these difficulties, we propose a series of options which with no doubt would lead to a better interaction among the different branches of Astrophysics in particular and of science in general and would definitely improve how research is currently performed and communicated.

This study investigates the views of contemporary Muslim jurists about withdrawing treatment of the terminally ill. Its aim is threefold. Firstly, it analyses jurists' views concerning core themes within the process of withdrawing treatment. Secondly, it provides insight into fatwas about withdrawing treatment. Thirdly, it compares these views with current medical standards in Europe and the Atlantic world on withdrawing treatment. The data consisted of six papers by Muslim jurists presented at the conference of the Islamic Fiqh Council in 2015. We conducted a directed content analysis (DCA) through a predetermined framework and compiled an overview of all previous fatwas referred to in the papers, which are also analysed. The results show that the general consensus is that if health cannot be restored, treatment may be withdrawn at the request of the patient and/or his family or on the initiative of the doctor. The accompanying fatwa emphasizes the importance of life-prolonging treatment if this does not harm the patient. It becomes apparent in the fatwa that the doctor has the monopoly in decision-making, which is inconsistent with current medical standards in Europe. Managing disclosure in view of the importance of maintaining the hope of Muslim patients may challenge the doctor's obligation to share a diagnosis with them. [ABSTRACT FROM AUTHOR]

Patch testing is the only clinically applicable diagnostic method for Type IV allergy. The availability of Type IV patch test (PT) allergens in Europe, however, is currently scarce. This severely compromises adequate diagnostics of contact allergy, leading to serious consequences for the affected patients. Against this background, the European Society of Contact Dermatitis (ESCD) has created a task force (TF) (i) to explore the current availability of PT substances in different member states, (ii) to highlight some of the unique characteristics of Type IV vs. other allergens and (iii) to suggest ways forward to promote and ensure availability of high‐quality patch testing substances for the diagnosis of Type IV allergies throughout Europe. The suggestions of the TF on how to improve the availability of PT allergens are supported by the ESCD, the European Academy of Allergy and Clinical Immunology, and the European Academy of Dermatology and Venereology and intend to provide potential means to resolve the present medical crisis. [ABSTRACT FROM AUTHOR]

Diagnosing immediate drug hypersensitivity reactions (IDHRs) can pose a significant challenge and there is an urgent need for safe and reliable tests. Evidence has emerged that the basophil activation test (BAT), an in vitro assay that mirrors the in vivo response, can be a complementary test for many drugs. In this position paper, members of Task Force (TF) "Basophil activation test in the evaluation of Drug Hypersensitivity Reactions" from the European Academy of Allergy and Clinical Immunology (EAACI) present the data from a survey about the use and utility of BAT in IDHRs in Europe. The survey results indicate that there is a great interest for using BAT especially for diagnosing IDHRs. However, there are still main needs, mainly in the standardization of the protocols. Subsequently consensus‐based recommendations were formulated for: (i) Technical aspects of BAT in IDHRs including type of sample, management of drugs, flow cytometry protocols, interpretation of the results; and (ii) Drug‐specific aspects that should be taken into account when performing BAT in relation to betalactams, neuromuscular blocking agents, fluoroquinolones, chlorhexidine, opioids, radio contrast media, chemotherapeutics, biological agents, nonsteroidal anti‐inflammatory drugs, COVID vaccine, and excipients. Moreover, aspects in the evaluation of pediatric population have also been considered. All this indicates that BAT offers the clinician and laboratory a complementary tool for a safe diagnostic for IDHRs, although its place in the diagnostic algorithm depends on the drug class and patient population (phenotype, geography, and age). The standardization of BAT is important for generalizing this method beyond the individual laboratory. [ABSTRACT FROM AUTHOR]

Psychodermatology is a subspecialty of dermatology that is of increasing interest to dermatologists and patients. The case for the provision of at least regional psychodermatology services across Europe is robust. Psychodermatology services have been shown to have better, quicker and more cost‐efficient clinical outcomes for patients with psychodermatological conditions. Despite this, psychodermatology services are not uniformly available across Europe. In fact many countries have yet to establish dedicated psychodermatology services. In other countries psychodermatology services are in development. Even in countries where psychodermatolgy units have been established, the services are not available across the whole country. This is especially true for the provision of paediatric psychodermatology services. Also whilst most states across Europe are keen to develop psychodermatology services, the rate at which this development is being implemented is very slow. Our paper maps the current provision of psychodermatology services across Europe and indicates that there is still very much more work to be done in order to develop the comprehensive psychodermatology services across Europe, which are so crucial for our patients. [ABSTRACT FROM AUTHOR]

In Southeast Europe countries (SEE) asset declarations are a strong, yet currently under-utilised instrument for preventing corruption and illicit financing among civil servants, and in particular among politically exposed persons (PEP). The media and civil society, along with international organisations, continuously investigate and report on the evident gaps between the living standards of politicians and their families on the one side and what they officially declare to the public as assets and income on the other. All SEE countries have in place a legal framework regulating asset declarations as part of their anti-corruption toolboxes. However, these regulations are rarely enforced in a consistent manner, and instead mostly result in short-lived annual scandals or occasional repression campaigns against political opponents. The aim of the present Note is to raise awareness of the public and decision makers about the loopholes in the procedures for verifying asset declarations and penalising irregularities in them and offer solutions for more efficient verifications in order to increase the liability of institutions and enhance the rule of law. [ABSTRACT FROM AUTHOR]

The purpose of the paper is to present the issues relating to methods of transport and commercial process management and support in logistics. Moreover, it will describe shipping actions in relation to the conflicts in Europe and worldwide. The study follows the work plan described as follows: The first chapter comprises an overview, logistics function, and classification of strategies in a logistics project. The second chapter includes information about the review and selection of methods of logistics project management. The third chapter pertains to the application of solutions restoring an old form of value stream mapping, known as the brown book exercise or the brown paper method. The fourth chapter refers to the aspects and solutions used in logistics project management in the hard times of logistic service market operations. Finally, the fifth chapter specifies the forms of trust management as the methods supporting logistics project management. [ABSTRACT FROM AUTHOR]

The current challenge facing the European pulp and paper industry is how to materialize the transformation to a bio-economy, as well as to realize the necessary new green innovations. The risks, costs and constraints of doing business will increase, thereby further intensifying competition, but at the same time new business opportunities will open up. This study adopts a three-round dissensus-based Delphi approach in order to explore our key research question of how the pulp and paper industry may change strategically, and what is the potential for value creation in the year 2030. According to our expert panel, the main drivers of competitiveness in 2030 will include energy and material efficiency, sustainability, as well as new innovations in products to serve customer needs better. According to the projected 2030 scenario, the pulp and paper industry will produce more diversified products, focus on higher value-added, and aim at consumer segments with higher environmental awareness. On average, 40 percent of the turnover will according to the panel come from genuinely new products. Strategic cross-sectorial partnerships will have a key role in making this big leap, while simultaneously acknowledging the changing needs of sustainability-conscious customers and other stakeholders. [ABSTRACT FROM AUTHOR]

A chronological synopsis of the history of the technology used in experimental and testing work relating to artillery pieces is presented. The period covered is from the mid-seventeenth century up to the Cold War era of the mid-twentieth century. Although the focus is on the development of ballistics measurement in Britain, there are important links to related work in continental Europe. The locus for much of what is described is the Royal Artillery proof and experimental range at Shoeburyness and the key individuals and groups of men and women who worked there. There are longitudinal connections between the very earliest technologies of mechanical chronometry, with paper screens and paper-based calculations, and the later technology where timings, screens and calculations had all become electronic. [ABSTRACT FROM AUTHOR]

Purpose: Frequent renegotiations within public-private partnership (PPP) have been recognised and affect project efficiency. Literature has focussed on diverse issues associated with renegotiation within PPP, especially in Latin America and Europe. However, a systematic summary what they have already provided appears lacking. Thus, the paper aims to conduct a critical review of publications concerning PPP renegotiation and explore the status quo, future interests and gaps in research. Design/methodology/approach: This study carried out a four-phase literature review research framework to identify the quality PPP-renegotiation articles published from 2003 to 2020. Assessing the full articles for eligibility by providing a structured summary including: background; objectives; data sources; study appraisal; results; limitations; conclusions and implications of key findings. After that, filtering papers associated with PPP renegotiation in terms of the structured summary, and a total of 60 research papers were selected in the database of web of science and Scopus for review. Findings: Methods adopted by researchers, research topics and theoretical foundations of PPP renegotiation research in different disciplines were identified through content analysis. Amongst the popular research topics identified were renegotiation factors, the outcomes with renegotiations, the framework to deal with renegotiations and contract design dealing with renegotiation based on rigid or flexible contracts. Originality/value: This study contributes to the current body of PPP knowledge by revealing the research trend in the past 20 years. It also points out the directions that the renegotiations of PPP research may go towards in the future. Moreover, this study is very valuable in understanding how governments and concessionaires effectively handle renegotiations. [ABSTRACT FROM AUTHOR]

• EFIM publishes a position paper about Environment Degradation and Climate Change. • Health industry should reduce its ecological footprint. • Internists should be involved in policy decisions related to climate change. • Internists must be active agents in advocating sustainable practices for the environment. • Internists should be role models in the adoption of environmentally friendly behavior. The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians — as advocates of the patients, but also as citizens — have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour. [ABSTRACT FROM AUTHOR]

The building sector contributes to 40% of the total final energy consumption and 36% of CO2 emissions in Europe, and these are set to increase in the coming years. International directives are pushing towards a decarbonisation roadmap to improve the quality of cities and the health of citizens. Buildings have a potentially central role in terms of energy transition as a means to produce and save energy. Photovoltaic shading devices (PVSDs) protect buildings from direct solar radiation and overheating while producing renewable electricity onsite and increasing the users' thermal comfort. Even though the potential of the PVSD is considerable, the sector is still unexplored, and few studies on the topic are available in the literature. This systematic review aims to present an exhaustive overview of the current literature on state-of-the-art PVSDs by analysing the scientific framework in terms of the status of the research. It presents a performance-based approach focusing on innovative products, PVSD design strategies, and energetic performance in distinct climate conditions and configurations. In particular, 75 articles and about 250 keywords were identified, selected, and analysed. The literature review serves as a basis for further R&D activities led by both the industrial and the academic sectors. [ABSTRACT FROM AUTHOR]

The pulp and paper industry in Europe produces over 11 million tons of waste per year. Given high landfill operational costs, thermal coprocessing with biomass may be a viable management and valorisation option for such wastes. In this work, the analysis of biomass (wood sawdust), mixture of primary and secondary pulp mill sludge and their respective blends (50 wt.%, 60 wt.%, 70 wt.% of sludge) was assessed by thermogravimetric analysis. One of the possibilities to ensure valorisation of paper pulp mill sludge is its combustion in the form of pellets containing a different amount of sludge. Production of pellets samples was realised on laboratory experimental device. The measurements showed that increasing the content of paper sludge in the produced pellets reduced the calorific value and increased the ash content. This research deals also with the effect of paper sludge on the ash melting temperatures. The results indicated that a higher content of paper sludge in the pellets increased the ash melting temperatures. This advantage of paper sludge can be utilized in co-combustion of biomass with a low ash melting temperature. [ABSTRACT FROM AUTHOR]

This article shows how companies can circumvent competition legislation by developing new informal ways of cooperation. We focus on the case of the Nordic pulp and paper industry which was particularly eager to set up cartels. Scholars analysing this sector can utilise exceptionally rich sources that reveal how industrialists reacted to the introduction and development of European competition policies. The article shows that companies defended their collusive practices by making them less transparent and more informal than before, a change that did not automatically lessen their effectiveness. Tougher competition policies also encouraged industrialists to create new giant companies. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a critical stage of rapid biological, emotional and social change and development. Adolescents and young adults (AYA) with asthma and allergies need to develop the knowledge and skills to self‐manage their health independently. Healthcare professionals (HCP), parents and their wider network play an essential role in supporting AYA in this process. Previous work showed significant limitations in transition care across Europe. In 2020, the first evidence‐based guideline on effective transition for AYA with asthma and allergies was published by EAACI. Aim: We herein summarize practical resources to support this guideline's implementation in clinical practice. Methods: For this purpose, multi‐stakeholder Task Force members searched for resources in peer review journals and grey literature. These resources were included if relevant and of good quality and were pragmatically rated for their evidence‐basis and user friendliness. Results: Resources identified covered a range of topics and targeted healthcare professionals, AYA, parents/carers, schools, workplace and wider community. Most resources were in English, web‐based and had limited evidence‐basis. Conclusions: This position paper provides a valuable selection of practical resources for all stakeholders to support effective transitional care for AYA with asthma and allergies. Future research should focus on developing validated, patient‐centred tools to further assist evidence‐based transition care. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is coming into the field of nuclear medicine, and it is likely here to stay. As a society, EANM can and must play a central role in the use of AI in nuclear medicine. In this position paper, the EANM explains the preconditions for the implementation of AI in NM and takes position. [ABSTRACT FROM AUTHOR]

Invasive plant species can impede the establishment and growth of native plants and affect several ecosystem properties. These properties include soil cover, nutrient cycling, fire regimes, and hydrology. Controlling invasive plants is therefore a necessary, but usually expensive, step in restoring an ecosystem. The sustainability of materials with an emphasis on the use of local resources plays an important role in the circular economy. The use of alternative fibers from invasive plants promotes local production in smaller paper mills that offer the protection of local species and the reduction of waste and invasive plants. A synthesis of the literature is needed to understand the various impacts of invasive plants and their practical control in the context of papermaking applications and to identify associated knowledge gaps. To improve our understanding of the practical application of invasive species in the paper industry, we reviewed the existing literature on invasive plant species in the area of fiber production, printability, coating solution production, dyes, and extracts, and collected information on the major invasive plant species in Europe and the methods used for various applications. [ABSTRACT FROM AUTHOR]

This study focuses on the increased risk of high heat release and asphyxiation (toxic gas poisoning) in the event of a fire involving polyurethane (PU)- and MDF-based building materials, which are commonly used in buildings. Among them, polyurethane (PU) building materials are very commonly used in buildings, except in Europe and some other countries, due to their excellent thermal insulation performance. Still, problems of short-term heat release and the spread of toxic gases in the event of a fire continue to occur. To overcome these problems, researchers are actively working on introducing various flame retardants into building materials. Therefore, in this study, we produced a laboratory-sized (500 mm × 500 mm) plate-like flame-retardant board that can be utilized as a building material with a lower heat release rate and a lower toxicity index. The material was made by mixing expanded graphite and ceramic binder as flame retardants in a material that is formulated based on the cellulose of waste paper, replacing the existing building materials with a hot-press method. According to the ISO-5660-1 test on the heat release rate of the plate-like flame-retardant board, the Total Heat Release (THR) value was 2.9 (MJ/m2) for 10 min, showing an effect of reducing the THR value by 36.3 (MJ/m2) compared to the THR value of 39.2 (MJ/m2) of the specimen made using only paper. In addition, the toxicity index of the flame-retardant board was checked through the NES (Naval Engineering Standards)-713 test. As a result, the test specimen showed a toxicity index of 0.7, which is 2.4 lower than the toxicity index of 3.1 of MDF, which is utilized as a conventional building material. Based on the results of this study, the cellulose fire-retardant board showed the effect of reducing the heat release rate and toxicity index of building materials in a building fire, which reduces the risk of rapid heat spread and smoke toxicity. This has the potential to improve the evacuation time (A-SET) of evacuees in fires. It is also important to show that recycling waste paper and utilizing it as the main material for building materials can be an alternative in terms of sustainable development. [ABSTRACT FROM AUTHOR]

The European Universities Initiative (EUI), created by the European Commission in 2017, is a recent novel phenomenon within the European Union policy toolkit that explicitly targets the development of transnational cooperation in higher education (HE). To date, the EUI counts 44 European university alliances, involving around 340 HE institutions. In this paper, we argue that the EUI can be seen as a case of a transnational institution building process representing a potentially significant structural reform for European higher education. Anchored in new institutionalism, we explore the regulative, normative, and cultural-cognitive dimensions of the EUI. Methodologically, this study analyzes the perspectives of European policy actors (n = 4), a set of policy documents (n = 13) and the mission statements of the EUI's partnerships funded before 2022 (n = 41). The results show that the EUI emerges as the 'next level of cooperation' in European HE since it aims to transform European cooperation (regulative dimension), to create and diffuse a new model for European HE following a challenge-based approach (normative dimension), and to work as a way to reinforce and institutionalize European and global scripts for European HE (cultural-cognitive dimension).

The report of the medical laboratory is the final result of the complex analytical activity that requires technology, automation, organization and competence. The content of the report has been defined since 2015, but the application of the legislative requirements is still incomplete. The need for interoperability of the medical laboratory reports in order to be easily accessible and understandable throughout Europe, increases the requirements for the development of standards for reporting of test names, units of measurement, qualitative expressions. The adoption of LOINC codes may improve interoperability, but the codes have to be used correctly and a stewardship from Scientific Societies is needed. The laboratory reports are moving from paper to electronic format, and this should help the readability and simplicity favoring the interpretation, but the increasing amount of data and information may make them more difficult to read. This aspect together with the rapid development of new analytical technologies increases the need for interpretative comments, that should be clear, avoid acronyms or excessive technical terms and tackle the real relevant aspects. Being the final product of our activity, the report deserves more attention from our profession. [ABSTRACT FROM AUTHOR]

This research employs Artificial Neural Networks (ANN) to develop predictive models for biodegradable municipal waste at both European and national levels. Leveraging socio-demographic and economic data spanning 25 years across 17 European Union (EU) countries, the models aim to forecast biodegradable waste generation over a five-year period. The primary objective is to examine the influence of socio-demographic and economic factors on waste generation. According to the study's findings, it is anticipated that by 2025, the 17 EU countries will produce approximately 67.4 million tons of mixed municipal waste (MMW), 14.7 million tons of municipal paper and cardboard waste (PCW), 6.4 million tons of municipal wood waste (WW), and approximately 0.6 million tons of municipal textile waste (TW). This substantial volume underscores the pressing need for robust infrastructure covering collection, processing, recycling, and disposal mechanisms. The ANN model demonstrated impressive predictive capabilities for MMW, PCW, WW, and TW. Test predictions spanning 2020 to 2025 revealed R2 values ranging between 0.965 and 0.998 during the training phase for the output variables. [ABSTRACT FROM AUTHOR]

Background and purpose: This position paper makes recommendations following an audit of care provided to people presenting with a seizure to emergency departments (EDs) in Europe. Methods: Participating countries were asked to include five hospitals agreeing to identify 50 consecutive seizure patients presenting to their ED between 1 August 2016 and 31 August 2017. Anonymous data were collected to a web database. Where quoted, percentages are mean site values and ranges are the 10th–90th centile. Results: Data were collected on 2204 ED visits (47 sites, up to six per country, across 15 countries): 1270 (58%) known epilepsy, 299 (14%) previous blackouts but no epilepsy diagnosis, 634 (29%) with a first seizure. Wide variability was identified for most variables. Of those with known epilepsy, 41.2% (range 26.2%–59.6%) attended the ED in the previous 12 months, but only 64.7% (range 37.2%–79.8%) had seen an epilepsy specialist in the previous 12 months. 67.7% (range 34.0%–100%) were admitted, 53.1% to a neurology ward (range 0.0%–88.9%). Only 37.5% first seizure patients (range 0.0%–71.4%) were given advice about driving. Conclusions and recommendations: It is recommended that in Europe guidance is agreed on the management and onward referral of those presenting to the ED with a seizure; a referral process is created that can be easily implemented; it is ensured that the seizure services receive referrals and see the patients within a short time period; and a simple system is developed and implemented to allow continuous monitoring of key indices of epilepsy care. [ABSTRACT FROM AUTHOR]

The trajectory of biological research may be affected by historical factors (such as locations of influential researchers) as well as by underlying biological dimensions (such as species diversity and location of potential study taxa). Such influences on research focus can be clarified by examining the topics of published papers. Based on 93,816 scientific papers published on snake biology since 1804 (from Web of Science), we found a nonrandom distribution of research output among snake clades, fields of research, and geographic locations and strong changes through time in overall research effort as well as in the foci of that work. Snakes have been the subject of more scientific papers than other lineages of reptiles, but research on turtles has been increasing faster, and research effort per species has been higher for smaller reptile lineages. Studies on systematics and taxonomy dominated snake research until the mid-20th century, when the field was overtaken by studies of venoms, ecology, morphology, and physiology. Colubrids and Vipers have been the most intensively studied taxa, reflecting a concentration of research on continents (Europe and the Americas) where these taxa are diverse and abundant. Research effort on Vipers (Viperidae) increased around 1920, reflecting advances in antivenom and radiotelemetry technology. Blindsnakes (Scolecophidia) and smaller families remain relatively neglected in absolute terms. The numbers of papers per species are 10-fold greater for North American and European snakes than those in most other regions. We attribute these nonrandom patterns to temporal and spatial variation in research priorities, methods, and availability of scientific infrastructure. [ABSTRACT FROM AUTHOR]

The European Water Framework Directive (WFD) is one of the most analyzed environmental legislations in the scientific literature, influencing the water management in some non-European countries. The WFD has the strong ambition of achieving a good ecological status of water bodies across all river basins in Europe. However, the advances towards sustainable management are falling far behind the planned schedule. The emphasis of the Directive is focused on water quality rather than on water quantity. The advances during the last quarter of the century since its inception have been strong on urban and industrial point pollution, but not on agricultural non-point pollution that remains high and even increases in major basins. Water quantity aspects have been mostly left aside in the Directive, despite the fact that water scarcity is a serious problem in Southern European countries, and will become more critical with climate change in most basins across Europe. Some policy measures of the WFD need to be reformed, in particular measures for abating agricultural pollution, and new measures for addressing water scarcity. The narrow focus of the WFD on water pricing to solve at the same time issues of financing, water allocation and efficiency, environment, opportunity costs and pollution abatement, should be broadened. The challenge is giving more emphasis to command & control and collective action instruments, and designing combinations of instruments adapted to sectoral and spatial locations in basins. This overhaul of the water policy instruments by the European Commission will be needed to advance in the sustainable management of river basins in Europe. [ABSTRACT FROM AUTHOR]

Golden everlasting paper daisies (Xerochrysum , Gnaphalieae, Asteraceae) were some of the earliest Australian native plants to be cultivated in Europe. Reputedly a favourite of Napoléon Bonaparte and Empress Joséphine, X. bracteatum is thought to have been introduced to the island of St Helena in the South Atlantic during Napoléon's exile there. Colourful cultivars were developed in the 1850s, and there is a widely held view that these were produced by crossing Xerochrysum with African or Asian Helichrysum spp. Recent molecular phylogenetic analyses and subtribal classification of Gnaphalieae cast doubt on this idea. Using single-nucleotide polymorphism (SNP) data, we looked for evidence of gene flow between modern cultivars, naturalized paper daisies from St Helena and four Xerochrysum spp. recorded in Europe in the 1800s. There was strong support for gene flow between cultivars and X. macranthum. Paper daisies from St Helena were genotypically congruent with X. bracteatum and showed no indications of ancestry from other species or from the cultivars, consistent with the continuous occurrence of naturalized paper daisies introduced by Joséphine and Napoléon. We also present new evidence for the origin of colourful Xerochrysum cultivars and hybridization of congeners in Europe from Australian collections. [ABSTRACT FROM AUTHOR]

This position paper aims to increase awareness among primary care practitioners and policymakers about the specific and complex health needs of people who experience incarceration. We focus on the importance of primary care and of continuity of care between prison and community. We highlight what is known from the literature on the health of people who experience incarceration, on the organisation of prison health care, and on the role of primary care both during and after detention. We present three case descriptions of detainees' encounters with the organisation of prison health care in three European countries. Finally, we describe the position that the European Forum for Primary Care takes. Prisoners and ex-prisoners have a worse physical and mental health compared with a cross-section of the population. However, access to good quality treatment and care is often worse than in the outside situation. In particular, well-organised primary care in the prison context could benefit prisoners and, indirectly, society at large. Moreover, continuity of care between the community and the prison situation needs improvement. [ABSTRACT FROM AUTHOR]

The enormous popularity of decorated industrial wall and floor tiles in Europe in the years 1840–1940 is strongly linked to the standardization, technical quality, and aesthetic variety of the products that were well marketed through often lavishly colored trade catalogues. More than the study of existing tile schemes in interiors, a systematic study of these trade catalogues leads to a better understanding of the general use of tile in the nineteenth- and twentieth-century interior. They inform us about factories and offer invaluable information on the technical and aesthetic evolution of tiles. They help us to date the designs and acquire a better knowledge of changes in taste in applying them. They are also a valuable source for documenting differences and similarities between factories and countries in matters of tile design and reveal opportunities to better understand the global export success or stylistic influence of many European factories in other countries on the continent as well as overseas. In this paper a general and theoretical approach is elucidated by referring to concrete cases based on a research collection of more than 600 tile catalogues from all over the world. [ABSTRACT FROM AUTHOR]

Purpose: To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods: Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results: Twenty-four sections on HNC-specific OD topics. Conclusion: This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers. [ABSTRACT FROM AUTHOR]

Genetic cardiomyopathies are disorders of the cardiac muscle, most often explained by pathogenic mutations in genes encoding sarcomere, cytoskeleton, or ion channel proteins. Clinical phenotypes such as heart failure and arrhythmia are classically treated with generic drugs, but aetiology-specific and targeted treatments are lacking. As a result, cardiomyopathies still present a major burden to society, and affect many young and older patients. The Translational Committee of the Heart Failure Association (HFA) and the Working Group of Myocardial Function of the European Society of Cardiology (ESC) organized a workshop to discuss recent advances in molecular and physiological studies of various forms of cardiomyopathies. The study of cardiomyopathies has intensified after several new study setups became available, such as induced pluripotent stem cells, three-dimensional printing of cells, use of scaffolds and engineered heart tissue, with convincing human validation studies. Furthermore, our knowledge on the consequences of mutated proteins has deepened, with relevance for cellular homeostasis, protein quality control and toxicity, often specific to particular cardiomyopathies, with precise effects explaining the aberrations. This has opened up new avenues to treat cardiomyopathies, using contemporary techniques from the molecular toolbox, such as gene editing and repair using CRISPR-Cas9 techniques, antisense therapies, novel designer drugs, and RNA therapies. In this article, we discuss the connection between biology and diverse clinical presentation, as well as promising new medications and therapeutic avenues, which may be instrumental to come to precision medicine of genetic cardiomyopathies. [ABSTRACT FROM AUTHOR]

This paper reports on the recent activity of the pan‐European consensus of the ADEE Special Interest Group for Pre‐Clinical Operative Skills. Following the previous recommendations from the group, and in order to support teachers and to harmonise the delivery of skills training across Europe, a more formal curriculum relating to pre‐clinical operative skills needs to be created. This paper reports European consensus surrounding the categorisation (level of importance, and difficulty) of basic operative dental clinical skills within the undergraduate curriculum and provides recommendations relating to session structure and timing of curricular elements for basic operative dental clinical skills teaching. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop bio-based adhesives that can be used for various packaging papers. In addition to commercial paper samples, papers produced from harmful plant species in Europe, such as Japanese Knotweed and Canadian Goldenrod, were used. In this research, methods were developed to produce bio-based adhesive solutions in combinations of tannic acid, chitosan, and shellac. The results showed that the viscosity and adhesive strength of the adhesives were best in solutions with added tannic acid and shellac. The tensile strength with adhesives of tannic acid and chitosan was 30% better than with commercial adhesives and 23% for combinations of shellac and chitosan. For paper from Japanese Knotweed and Canadian Goldenrod, the most durable adhesive was pure shellac. Because the surface morphology of the invasive plant papers was more open and had numerous pores compared to the commercial papers, the adhesives penetrated the paper structure and filled the voids. There was less adhesive on the surface and the commercial papers achieved better adhesive properties. As expected, the bio-based adhesives also showed an increase in peel strength and exhibited favorable thermal stability. In summary, these physical properties support the use of bio-based adhesives use in different packaging applications. [ABSTRACT FROM AUTHOR]

Background: The WHO definition of palliative care includes bereavement support as integral to palliative care, yet a previous survey of bereavement support in palliative care in Europe has shown a range of service responses to loss. A rigorous approach to agreeing and implementing a palliative care bereavement framework was required. Aim: The aim of this study was to develop consensus on best-practice recommendations for bereavement care principles, structures, processes and delivery based on current practice and evidence. Design: In accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building five-round Delphi technique was performed. A scoping review of research literature informed drafting of 54 statements by the EAPC Bereavement Task Force. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ⩾80% agreement were defined as essential items and 75%–79% agreement were defined as desirable items. Items with a consensus rating <75% were revised during the process. Setting/participants: The Delphi study was carried out by an expert panel among membership organisations of the European Association for Palliative Care. Results: In total, 376 email requests to complete Delphi questionnaire were distributed with a response rate of 23% (n = 87) and a follow-up response-rate of 79% (n = 69). Of the initial 54 statements in six dimensions, 52 statements were endorsed with 26 essential statements and 26 desirable statements. Conclusions: The six dimensions and 52 statements agreed through this Delphi study clarify a coherent direction for development of bereavement services in palliative care in Europe. [ABSTRACT FROM AUTHOR]

European pharmaceutical companies have a legal requirement to provide non-promotional Medical Information (MI) services to support healthcare professionals (HCPs) who are using their medicinal products. While the industry has self-regulating bodies with established Codes of Practice, these mainly focus on promotional messaging and commercial activities. In the absence of similar frameworks for MI, such services struggle to understand how to meet HCP digital expectations, often in fear of breaching the promotional codes. This is limiting access to the wealth of non-promotional patient-focussed information held within the industry. Meanwhile, a large volume of unregulated, low-quality information can be readily found on the internet. To understand the current status, the Medical Information Leaders in Europe (MILE) industry association performed a benchmarking survey which explored the online MI service provision of 13 mid-large pharmaceutical companies across Europe. This highlighted a great diversity in approach in terms of geographical coverage and content. Visibility and access for HCPs is complex, compromising online engagement and website utilisation. This MILE position paper highlights the critical need to establish a clear governance model, which empowers pharmaceutical company MI functions to provide unbranded, non-promotional, medicinal product information sources to support HCP online information needs. It is essential to build confidence, transparency and trust by establishing a practical quality framework with principles and standards for online MI services for HCPs. [ABSTRACT FROM AUTHOR]

Background: The EAPC White Paper addresses the issue of spiritual care education for all palliative care professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and education; as well as national and local curricula development groups. Methods: Early in 2018, preliminary draft paper was written by members of the European Association for Palliative Care (EAPC) spiritual care reference group inviting comment on the four core elements of spiritual care education as outlined by Gamondi et al. (2013) in their paper on palliative care core competencies. The preliminary draft paper was circulated to experts from the EAPC spiritual care reference group for feedback. At the second stage feedback was incorporated into a second draft paper and experts and representatives of national palliative care organizations were invited to provide feedback and suggest revisions. The final version incorporated the subsequent criticism and as a result, the Gamondi framework was explored and critically revised leading to updated suggestions for spiritual care education in palliative care. Results: The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care. The revised spiritual care education competencies for all palliative care providers are accompanied by the best practice models and research evidence, at the same time being sensitive towards different development stages of the palliative care services across the European region. Conclusions: Better education can help the healthcare practitioner to avoid being distracted by their own fears, prejudices, and restraints and attend to the patient and his/her family. This EAPC white paper encourages and facilitates high quality, multi-disciplinary, academically and financially accessible spiritual care education to all palliative care staff. [ABSTRACT FROM AUTHOR]