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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]

Spinal dysraphism (SD) or spina bifida (SB) is a congenital deformity that results from embryonic neural tube closure failure during fetal development. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. This paper aims to evaluate the role of the physical and rehabilitation medicine (PRM) physician and PRM practice for children and adults with spinal dysraphism. A systematic literature review and a consensus procedure involved all European countries delegates represented in the UEMS PRM section through a Delphi process. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The professional role of the PRM physician requires specific expertise in the treatment of patients with SD to plan, lead and monitor the rehabilitation process in an interdisciplinary setting and to participate in the assessment of the needs of these patients in the transitional phase from childhood to adulthood, with particular attention to the activity limitation and participation restriction.

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., (© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Management of datasets that include health information and other sensitive personal information of European study participants has to be compliant with the General Data Protection Regulation (GDPR, Regulation (EU) 2016/679). Within scientific research, the widely subscribed'FAIR' data principles should apply, meaning that research data should be findable, accessible, interoperable and re-usable. Balancing the aim of open science driven FAIR data management with GDPR compliant personal data protection safeguards is now a common challenge for many research projects dealing with (sensitive) personal data. In December 2020 a workshop was held with representatives of several large EU research consortia and of the European Commission to reflect on how to apply the FAIR data principles for environment and health research (E&H). Several recent data intensive EU funded E&H research projects face this challenge and work intensively towards developing solutions to access, exchange, store, handle, share, process and use such sensitive personal data, with the aim to support European and transnational collaborations. As a result, several recommendations, opportunities and current limitations were formulated. New technical developments such as federated data management and analysis systems, machine learning together with advanced search software, harmonized ontologies and data quality standards should in principle facilitate the FAIRification of data. To address ethical, legal, political and financial obstacles to the wider re-use of data for research purposes, both specific expertise and underpinning infrastructure are needed. There is a need for the E&H research data to find their place in the European Open Science Cloud. Communities using health and population data, environmental data and other publicly available data have to interconnect and synergize. To maximize the use and re-use of environment and health data, a dedicated supporting European infrastructure effort, such as the EIRENE research infrastructure within the ESFRI roadmap 2021, is needed that would interact with existing infrastructures., (Copyright © 2022. Published by Elsevier Ltd.)

The studies reported here examined differences in user behaviour when presented with a low-fidelity paper prototype compared to fully operational product, and evaluated the effectiveness of different types of enhanced labelling of controls. In the first study with a paper prototype, 30 users of high-pressure washers were asked to choose the settings of the temperature control for different cleaning objects, comparing standard with information-enriched control labelling. In the second study, 34 users operated a real high-pressure washer with different forms of control labelling. The results of both studies provided evidence for some benefits of an information-enriched control labelling over traditional temperature-centred controls labelling. Furthermore, a comparative analysis of the data of the two studies suggested that low-fidelity paper prototypes may have to be used with caution. Therefore, designers need to be aware that the behavioural effects induced by different design modifications may be overestimated when using paper prototypes. The implications of the findings are discussed within the framework of an enlarged concept of fidelity.

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]

Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that affects both upper and lower motor neurons and is fatal in its course. This evidence-based position paper represents the official position of the UEMS PRM Section. The aim of the paper is to define the role of the physical and rehabilitation medicine (PRM) physician and PRM professional practice for people with ALS. A systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The responsibility of the PRM physician is functional assessment of persons with ALS and delivering the optimal and most effective PRM program of care. The rehabilitation program of patients with ALS should be delivered and monitored by the multiprofessional team, with the PRM physician as principal coordinator.

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]

As part of an International Agency for Research on Cancer (IARC) international epidemiological study of workers in the pulp and paper industry, previously unpublished exposure measurements were assembled in a database. This article summarizes the results of 3,873 measurements carried out in the production departments of paper and paperboard mills and recycling plants in 12 countries. In the paper and paperboard mills, most of the agents were measured in the pulping and refining departments and in on-machine coating and winding of paper/paperboard. Exposures to asbestos, carbon monoxide, formaldehyde, fungal spores, bacteria, nitrogen dioxide, minerals dusts, paper dust, sulphuric acid and different solvents sometimes exceeded exposure limit values. In the re-pulping and de-inking departments of recycling plants high exposures to formaldehyde, fungal spores, bacteria and paper dust were observed. High exposures to asbestos, bioaerosols, carbon monoxide and paper dust were found in many departments; ammonia, formaldehyde, mineral and paper dust and solvents were found in coating machines; and diphenyl and polychlorobiphenyls (PCBs) were found in some special circumstances. Measurements in the newsprint and uncoated paper machine departments revealed only a few elevated exposures. In nearly all departments, measurements of epichlorohydrin, PCBs, sulphur dioxide, hydrogen sulphide and mercaptans tended to be low, often even below their detection limits. In spite of some uncertainties in the measurement data, the study provides new insights into the level and variation of occupational exposures of production workers in the paper and paperboard industry.

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The article reports on the issue regarding the way to understand the market changes in order to sustain profitable growth in the coated paper industry. Accordingly, Dow Chemical Co. is one example of coated paper company that should maintain techniques on how to sustain company's growth. Dow has created a forecasting model to assists coated paper businesses in North America, Europe and Asia in terms of determining the global imports and exports in the future.

Discusses how paper recovery is growing in Europe. Net trade in recovered paper from 1990 to 2010; Trends in recycling rates of paper and paperboard; Raw material consumption structure in paper and paperboard manufacturing in Western Europe in 2002; Effort by Confederation of European Paper Industries to encourage legislators to promote the separate collection of wastepaper, as well as trying to educate the authorities at all levels that recovered paper is not a waste product.

The manufacture of paper generates significant quantities of wastewater; as high as 60 m3/tonne of paper produced. The raw wastewaters from paper and board mills can be potentially very polluting. Indeed, a recent survey within the UK industry has found that their chemical oxygen demands can be as high as 11000 mg/l. This paper reviews the processes involved in paper making and examines the effects which they could have on the environment. It also evaluates the treatment processes which are used to minimise these effects. In line with the majority of UK practice, it focuses mainly on aerobic biological treatment and, in particular, on the activated sludge process. This means that there is an in-depth discussion about the problems associated with filamentous bacteria and sludge "bulking". The paper also discusses the way in which anaerobic digestion can be applied to the treatment of liquid wastes from the manufacture of paper.

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]

Cerebral palsy (CP) is a group of the most common developmental disorders affecting movement and posture of the body, causing activity limitations and participation restrictions. The motor disorders of persons with CP are often accompanied by disturbances of sensation, cognition, communication and perception. The symptoms of CP are very diverse and persons with CP are usually presented with a mixed type of symptoms. The non-progressive disturbances can be attributed to disorders that were developed during pregnancy, birth and/or infant stage. The aim of this study was to improve physicians' professional practice of Physical and Rehabilitation Medicine for persons with cerebral palsy in order to improve their functionality, social and community integration, and to reduce activity limitations and/or participation restrictions. A systematic review of the literature including an 18-year period and consensus procedure by means of a Delphi process was performed and involved the delegates of all European countries represented in the Union of European Medical Specialists Physical and Rehabilitation Medicine (UEMS PRM) Section. As the result of a Consensus Delphi procedure, 74 recommendations are presented together with the systematic literature review. The PRM physician's role for persons with cerebral palsy is to lead and coordinate the multiprofessional team, working in an interdisciplinary way. They should propose and manage the complex but individual PRM program developed in conjunction with other health professionals, medical specialists and importantly in agreement with the patient, their family and care giver. This should be, according to the specific medical diagnosis to improve patients' health, functioning, social and education status, considering all impairments, comorbidities and complications, activity limitations and participation restrictions. This evidence-based position paper is representing the official position of The European Union through the UEMS PRM Section and designates the professional role of PRM physicians in persons with cerebral palsy.

Muscular dystrophies present a group of inherited degenerative disorder that are characterized by progressive muscular weakness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. The aim of the paper is to evaluate the role of the physical and rehabilitation medicine (PRM) physician and PRM practice for people with muscular dystrophies. A systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. The systematic literature review is reported together with thirty-three recommendations resulting from the Delphi procedure. The role of the PRM physician is to assess the functional status of persons with muscular dystrophy and to plan, monitor and lead PRM program in an interdisciplinary setting within a multiprofessional team.

Extracellular vesicles (EV) are emergent therapeutic effectors that have reached clinical trial investigation. To translate EV-based therapeutic to clinic, the challenge is to demonstrate quality, safety, and efficacy, as required for any medicinal product. EV research translation into medicinal products is an exciting and challenging perspective. Recent papers, provide important guidance on regulatory aspects of pharmaceutical development, defining EVs for therapeutic applications and critical considerations for the development of potency tests. In addition, the ISEV Task Force on Regulatory Affairs and Clinical Use of EV-based Therapeutics as well as the Exosomes Committee from the ISCT are expected to contribute in an active way to the development of EV-based medicinal products by providing update on the scientific progress in EVs field, information to patients and expert resource network for regulatory bodies. The contribution of our work group "Extracellular Vesicle translatiOn to clinicaL perspectiVEs - EVOLVE France", created in 2020, can be positioned in complement to all these important initiatives. Based on complementary scientific, technical, and medical expertise, we provide EV-specific recommendations for manufacturing, quality control, analytics, non-clinical development, and clinical trials, according to current European legislation. We especially focus on early phase clinical trials concerning immediate needs in the field. The main contents of the investigational medicinal product dossier, marketing authorization applications, and critical guideline information are outlined for the transition from research to clinical development and ultimate market authorization., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Florence Gazeau, Amanda Karine Andriola Silva, Claire Wilhelm and Gabriel Rahmi are co-founders of the spin-off Evora Biosciences. Amanda Karine Andriola Silva and Claire Wilhelm are co-founders of the spin-off EverZom. Max Piffoux is consultant and owns stocks in the spin-off Evora Biosciences and in the spin-off EverZom., (Copyright © 2021 Elsevier B.V. All rights reserved.)

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.

Aims: To examine the current status of care and needs of adult congenital heart disease (ACHD) services in the Central and South Eastern European (CESEE) region., Methods and Results: We obtained data regarding the national ACHD status for 19 CESEE countries from their ACHD representative based on an extensive survey for 2017 and/or 2018. Thirteen countries reported at least one tertiary ACHD centre with a median year of centre establishment in 2007 (interquartile range 2002-2013). ACHD centres reported a median of 2114 patients under active follow-up with an annual cardiac catheter and surgical intervention volume of 49 and 40, respectively. The majority (90%) of catheter or surgical interventions were funded by government reimbursement schemes. However, all 19 countries had financial caps on a hospital level, leading to patient waiting lists and restrictions in the number of procedures that can be performed. The median number of ACHD specialists per country was 3. The majority of centres (75%) did not have ACHD specialist nurses. The six countries with no dedicated ACHD centres had lower Gross Domestic Product per capita compared to the remainder (P = 0.005)., Conclusion: The majority of countries in CESEE now have established ACHD services with adequate infrastructure and a patient workload comparable to the rest of Europe, but important gaps still exist. ACHD care is challenged or compromised by limited financial resources, insufficient staffing levels, and reimbursement caps on essential procedures compared to Western Europe. Active advocacy and increased resources are required to address the inequalities of care across the continent., (© 2020 European Society of Cardiology.)

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]

Examines the impact of factor input prices, output market size and agglomeration effects on the choice of location for investment projects in Europe's paper industry. Wastepaper recovery and utilization rate; Forest resources and wastepaper recovery distribution.

Waste paper, an essential substitute for wood and other plant-based fibers in paper making, is an indispensable part of the circular economy; yet, the impacts of China's ban on global waste paper cycles have not been well understood. We modeled the evolution of the global waste paper trade network during 1995-2019. We found that the cumulative trade volume of global waste paper reached 1010 million tons in the last 25 years and showed a downward trend since 2015. The global import center of waste paper experienced a transfer from Europe to East Asia and then to Southeast Asia. The ban has stimulated some developed countries to reduce the exports of unsorted waste paper since 2017, but for many major importers their changes in waste paper trade patterns were related to waste paperboard, which was not banned by China, suggesting that this import change trend may be inevitable and irrespective of China's ban. Besides, India has replaced China to become a new import hub of unsorted waste paper. Our results lay a foundation for exploring the evolution of the future global solid waste cycle under the background of zero import of solid waste increasingly implemented by China and many other developing countries.