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Background: Health risks associated with the high consumption of sugar-sweetened beverages (SSBs) include overweight or obesity and their complications such as diabetes, as well as oral and dental decay, among others., Aim: The aim of the present statement is to inform health care professionals, parents, care-givers, teachers and school head teachers, stakeholders and governing bodies about the risks associated with drinking SSBs in infants, children and adolescents., Methods: We searched PubMed and the Cochrane databases for English language studies published from 2010 through October 1, 2018, for randomized clinical trials, meta-analyses, systematic reviews and observational studies (search terms are reported in eAppendix in the Supplement). We also manually searched the references of selected articles, reviews, meta-analyses and practice guidelines., Recommendations: Consumption of SSB by children and adolescents should be limited, and the consumption of water and other non-sweetened beverages should be promoted. Educational institutions such as nurseries, pre-schools and schools should offer unlimited access to drinking water, whereas the sale of SSBs should be banned., (© 2019 S. Karger AG, Basel.)

Exercise training (ET) and secondary prevention measures in cardiovascular disease aim to stimulate early physical activity and to facilitate recovery and improve health behaviours. ET has also been proposed for heart failure patients with a ventricular assist device (VAD), to help recovery in the patient's functional capacity. However, the existing evidence in support of ET in these patients remains limited. After a review of current knowledge on the causes of the persistence of limitation in exercise capacity in VAD recipients, and concerning the benefit of ET in VAD patients, the Heart Failure Association of the European Society of Cardiology has developed the present document to provide practical advice on implementing ET. This includes appropriate screening to avoid complications and then starting with early mobilisation, ET prescription is individualised to meet the patient's needs. Finally, gaps in our knowledge are discussed., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)

Fecal microbiota transplantation (FMT) is becoming part of the treatment algorithms against recurrent Clostridium difficile infection (rCDI) both in adult and pediatric gastroenterology practice. With our increasing recognition of the critical role the microbiome plays in human health and disease, FMT is also being considered as a potential therapy for other disorders, including inflammatory bowel disease (Crohn disease, ulcerative colitis), graft versus host disease, neuropsychiatric diseases, and metabolic syndrome. Controlled trials with FMT for rCDI have not been performed in children, and numerous clinical and regulatory considerations have to be considered when using this untraditional therapy. This report is intended to provide guidance for FMT in the treatment of rCDI in pediatric patients.

Abstract: The purpose of this study was to evaluate the potential of inorganic analysis techniques for the discrimination of document (multipurpose office) paper. A set of 25 different multipurpose office papers from the European market was used for comparison. It appeared that for the single techniques LA–ICP–MS had the highest overall discriminating power. Despite its lower sensitivity, XRF also showed good discriminating power but the correlation with LA–ICP–MS is high. The combination of LA–ICP–MS and IRMS provides a powerful and strongly discriminating set of techniques. [Copyright &y& Elsevier]

The current study aimed to identify and analyze the 100 most cited papers on the topic of nutraceuticals and functional foods. Scopus database was searched to extract bibliometric data. Two-thirds of the 100 most cited papers were reviews. Papers were mostly published in food science and nutrition journals, and one-third were published in seven journals, namely: British Journal of Nutrition (6), Critical Reviews in Food Science and Nutrition (6), Journal of Food Science (5), Trends in Food Science and Technology (5), American Journal of Clinical Nutrition (4), Food Chemistry (4) and Journal of Nutrition (4). Topics with high citation counts dealt with prebiotics, probiotics, antioxidants and phenolic content. Hot topics with over 1000 citations per paper include bifidobacterium (1147), colon (1032) and lipid metabolism (1013). The United States and Europe were major places of origin. These results can serve as a quick benchmarking reference for researchers or general public members., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

We recommend that intestinal failure associated liver disease (IFALD) should be diagnosed by the presence of abnormal liver function tests and/or evidence of radiological and/or histological liver abnormalities occurring in an individual with IF, in the absence of another primary parenchymal liver pathology (e.g. viral or autoimmune hepatitis), other hepatotoxic factors (e.g. alcohol/medication) or biliary obstruction. The presence or absence of sepsis should be noted, along with the duration of PN administration. Abnormal liver histology is not mandatory for a diagnosis of IFALD and the decision to perform a liver biopsy should be made on a case-by-case basis, but should be particularly considered in those with a persistent abnormal conjugated bilirubin in the absence of intra or extra-hepatic cholestasis on radiological imaging and/or persistent or worsening hyperbilirubinaemia despite resolution of any underlying sepsis and/or any clinical or radiological features of chronic liver disease. Nutritional approaches aimed at minimising PN overfeeding and optimising oral/enteral nutrition should be instituted to prevent and/or manage IFALD. We further recommend that the lipid administered is limited to less than 1 g/kg/day, and the prescribed omega-6/omega-3 PUFA ratio is reduced wherever possible. For patients with any evidence of progressive hepatic fibrosis or overt liver failure, combined intestinal and liver transplantation should be considered., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: The first edition of the European position paper (EPP) on drug-induced sleep endoscopy (DISE) was published in 2014 with the aim to standardise the procedure, to provide an in-depth insight into the main aspects of this technique and to have a basis for future research. Since 2014, new studies have been published concerning new sedative agents or new insights into the pattern/levels of the obstruction depending on the depth of sedation. Therefore, an enlarged group of European experts in the field of sleep breathing disorders (SBD), including the most of the first DISE EPP main authors, has decided to publish an update of the European position paper on DISE, in order to include new evidence and to find a common language useful for reporting the findings of this endoscopic evaluation in adult population affected by SBD., Methods: The authors have evaluated all the available evidence reported in the literature and have compared experience among various departments in leading European centres in order to provide an update regarding the standardisation of the DISE procedure and an in-depth insight into the main aspects of this technique., Results: After the first European Position Consensus Meeting on DISE and its update, consensus was confirmed for indications, required preliminary examinations, where to perform DISE, technical equipment required, staffing, local anaesthesia, nasal decongestion, other medications, patient positioning, basics and special diagnostic manoeuvres, drugs and observation windows. So far, no consensus could be reached on a scoring and classification system. However, regarding this aim, the idea of an essential classification, such as VOTE with the possibility of its graded implementation of information and descriptions, seems to be the best way to reach a universal consensus on DISE classification at this stage. A common DISE language is mandatory, and attempts to come to a generally accepted system should be pursued., (© 2018 John Wiley & Sons Ltd.)

Over the last 70 years, pharmacotherapy in gout with urate-lowering drugs has consisted of four drugs only: In 1952, a mild uricosuric probenecid became available, the xanthine oxidase inhibitor Allopurinol in 1964, and the latter became the most frequently used urate-lowering drug worldwide; in the Eurozone, the uricosuric benzbromarone was welcomed in 1977. Only in 2002, the potent non-purine xanthine oxidase inhibitor febuxostat was introduced. In many countries, uricosurics such as probenecid and benzbromarone have not been available up to now, and these days, the new uricosuric lesinurad is the first uricosuric that may be introduced in these countries, which is the reason for describing the position this novel uricosuric deserves in treating gout. Recent literature will be shortly reviewed, and the current proposed position for lesinurad will be given as an aid for clinicians.

Conventional signals are maintained via social costs and commonly used in the animal kingdom to assess conspecifics' agonistic ability during disputes over resources. In the last decade, some experimental studies reported the existence of visual conventional signals in several social wasp species, being good rank predictors in different social contexts. Females of the social wasp Polistes gallicus do not cooperate to start nests but they often try to usurp conspecific nests. Here, we showed that the reproductive females of this species have variable facial colour patterns that function as conventional signals. Wasps with larger black spots on their clypeus are more likely to successfully overwinter, are larger, and are better at fighting and at holding a nest. Furthermore, in field experiments, resident foundresses rely on facial pattern to assess usurpers' fighting abilities, modulating their defence reaction accordingly, so that rivals with larger black spot receive more aggression than rivals with smaller or no black spots on the clypeus. Our study reveals that visual recognition abilities are widespread among paper wasps that, regardless of their social biology, face similar selective pressures within competitive contexts. [ABSTRACT FROM AUTHOR]

The pursuit of happiness as an issue in planning for towns in trans-Appalachian America was a prime requisite. It is the intent of this paper to illustrate that, while many of the towns were paper towns that were never actualised, they acted as a catalyst for immigrants seeking to escape the oppression of Europe. Visualised as a new Eden, and promising land ownership with liberty, they were an opiate so strong that even with numerous instances of fraud and deceit the settlers came. Their belief that they had indeed arrived at Eden was so strong that it transcended any and all difficulties. This belief has influenced the planning and development of towns in America up to and including modern times. As long as people believe that their living situation is what is meant for them, their pursuit of happiness is satisfied. They have found their Eden. [ABSTRACT FROM AUTHOR]

This paper discusses the relationship between environmental and economic performance and the influence of corporate strategies with regard to sustainability and the environment. After formulating a theoretical model, results are reported from an empirical analysis of the European paper manufacturing industry. New data are used to test hypotheses derived from the theoretical model, using environmental performance indices representing different corporate environmental strategy orientations. In particular, an emissions-based index largely reflecting end-of-pipe strategies and an inputs-based index reflecting integrated pollution prevention are distinguished. For the emissions-based index, a predominantly negative relationship between environmental and economic performance is found, whereas for the inputs-based index no significant link is found. This is consistent with the theoretical model, which predicts the possibility of different relationships. The results also show that for firms with pollution prevention-oriented corporate environmental strategies, the relationship between environmental and economic performance is more positive, thus making improvements in corporate sustainability more likely. Based on this last insight, managerial implications of this are discussed with regard to strategy choices, investment decisions and operations management.

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In this work, a detailed technical-economic analysis of a fluidized bed based waste-to-energy system for disposal of paper manufacturing sludges has been carried out. Specific reference is made to a case study represented by the largest plant in Italy producing recycled paper, with a daily sludge output of about 52t. The adopted plant has been sized for a nominal capacity of 140t per day also allowing the progressive elimination of sludges accumulated in a previously utilized landfill, giving a nominal electrical power output of 3.5MW. The main plant sections have been described and the adopted technical solutions have been outlined. A detailed process and equipment characterization has been carried out leading to a thorough evaluation of capital investment, operating costs and revenues. A differential analysis has been performed with respect to the alternative solution represented by the disposal of untreated sludges in an external landfill in order to highlight the savings obtainable. The economic profitability of the investment has been evaluated regarding several performance indices. The economic evaluation has been completed by a sensitivity and risk analysis in order to assess the effects of uncertainties in the economically significant parameters. Adopting most probable values, the savings obtained with the considered waste-to-energy system are evaluated in the 15--20 million Euro range during the estimated plant life of 15 years with a foreseen pay back time of 4 years. Moreover, many environmental benefits result such as the remediation of existing landfill, the avoidance of new landfills opening and very low air pollutants emissions.

The paper examines critically the dimension of empowerment in the European discourse, starting from some operational definitions used in official documents. The author analyses the shift in the European documents from 2000 to recent years, from a lifelong learning vision to an adult education approach, basically labour market-oriented, thus leaving aside the social cohesion and self-emancipatory dossiers. Against this background, a theoretical approach derived from the categories of transaction and reflexivity is suggested, setting out from the works of John Dewey. This paper investigates whether the categories of experience, problem posing and emancipation are more suitable for a long-term project on adult learning than the categories of activation, problem solving, and empowerment.

Paper-based materials, due to their availability, environmental benefits and high thermal properties, have already been implemented in several building envelope designs. However, most of them either did not optimise the use of the material or did not provide sufficient thermal insulation for use in permanent buildings. The presented research analyses six original paper-based building envelope core proposals, suitable for use in permanent buildings in temperate climate of Europe, in terms of thermal and environmental efficiency. Proposals include cores with embedded paper tubes structural elements, timber-cardboard studs and sandwich designs. The heat transfer coefficient of the envelopes was obtained for repeatable modules via 2D computer simulations (ThermCAD software), and the environmental impact was assessed for a representative square metre of the envelope via LCA analysis, based in ecoinvent 3.8 database. All analysed designs showed high thermal insulation properties and met the requirements for U max = 0.20 W/m2K, did not cause the risk of surface condensation, nor have excessive thermal bridges. The analysed building envelope designs based on embedded frame wall structure showed environmental superiority over conventional envelopes (timber frame and SIP panels). The research may serve as a proof of concept, for using paper-based building envelopes in sustainable architecture. [ABSTRACT FROM AUTHOR]

A game of war, chess was played and pictured in a time of war by men and women, Jews and non-Jews in hiding, in the ghettos, and even behind the barbed wire of the transit, concentration, and extermination camps across Nazi-occupied Europe. Throughout the Second World War, instead of "throwing the game" and giving up, victims of National Socialism devised ingenious ways to improvise chess sets out of found materials and detritus—carved wood, folded paper, etched tin, and modeled bread. They also drew and painted chess games to document and allegorize their lives in extremis. Through a close reading of chess artifacts and artworks, this article reveals how access to materials and time, status within camp hierarchies, ethnic and national identities, and wartime experiences impacted the various ways these groups used the game of chess under difficult playing conditions. Insisting upon the central role of creativity and play, it argues that both material artifacts and artwork inform our knowledge of how individuals living under Nazi oppression thought and felt. [ABSTRACT FROM AUTHOR]

Background: The Pontifical Academy for Life (PAV) is an academic institution of the Holy See (Vatican), which aims to develop and promote Catholic teachings on questions of biomedical ethics. Palliative care (PC) experts from around the world professing different faiths were invited by the PAV to develop strategic recommendations for the global development of PC ("PAL-LIFE group"). Design: Thirteen experts in PC advocacy participated in an online Delphi process. In four iterative rounds, participants were asked to identify the most significant stakeholder groups and then propose for each, strategic recommendations to advance PC. Each round incorporated the feedback from previous rounds until consensus was achieved on the most important recommendations. In a last step, the ad hoc group was asked to rank the stakeholders' groups by order of importance on a 13-point scale and to propose suggestions for implementation. A cluster analysis provided a classification of the stakeholders in different levels of importance for PC development. Results: Thirteen stakeholder groups and 43 recommendations resulted from the first round, and, of those, 13 recommendations were chosen as the most important (1 for each stakeholder group). Five groups had higher scores. The recommendation chosen for these top 5 groups were as follows: (1) Policy makers: Ensure universal access to PC; (2) Academia: Offer mandatory PC courses to undergraduates; (3) Healthcare workers: PC professionals should receive adequate certification; (4) Hospitals and healthcare centers: Every healthcare center should ensure access to PC medicines; and (5) PC associations: National Associations should be effective advocates and work with their governments in the process of implementing international policy framework. A recommendation for each of the remaining eight groups is also presented. Discussion: This white paper represents a position statement of the PAV developed through a consensus process in regard to advocacy strategies for the advancement of PC in the world. [ABSTRACT FROM AUTHOR]

The demand for reproducible research is on the rise in disciplines concerned with data analysis and computational methods. Therefore, we reviewed current recommendations for reproducible research and translated them into criteria for assessing the reproducibility of articles in the field of geographic information science (GIScience). Using this criteria, we assessed a sample of GIScience studies from the Association of Geographic Information Laboratories in Europe (AGILE) conference series, and we collected feedback about the assessment from the study authors. Results from the author feedback indicate that although authors support the concept of performing reproducible research, the incentives for doing this in practice are too small. Therefore, we propose concrete actions for individual researchers and the GIScience conference series to improve transparency and reproducibility. For example, to support researchers in producing reproducible work, the GIScience conference series could offer awards and paper badges, provide author guidelines for computational research, and publish articles in Open Access formats. [ABSTRACT FROM AUTHOR]

As heart failure with preserved ejection fraction (HFpEF) rises to epidemic proportions, major steps in patient management and therapeutic development are badly needed. With the current position paper we seek to update our view on HFpEF as a highly complex systemic syndrome, from risk factors and mechanisms to long-term clinical manifestations. We will revise recent advances in animal model development, experimental set-ups and basic and translational science approaches to HFpEF research, highlighting their drawbacks and advantages. Directions are provided for proper model selection as well as for integrative functional evaluation from the in vivo setting to in vitro cell function testing. Additionally, we address new research challenges that require integration of higher-order inter-organ and inter-cell communication to achieve a full systems biology perspective of HFpEF. [ABSTRACT FROM AUTHOR]

"Go to temples of science and ideas of Europe. Imitate the Tugendbund, 'the Union of Virtue', of which thousands of German youth are the members. Always keep the rule of 'Fit soul is in fit body' in mind" (Petrov, 2013, p. 72). This study aimed to show the similarities, in terms of expression, emphasis, and implication, in the about/mission/vision/goals/objectives of various science centers from around the world and in the basic themes derived from Snellman's statement above, namely, Science for all, Science Centers for all, and Human welfare that he made as a challenge to not only his people but to everyone. Document and content analyses were applied in the study. Within the scope of these analyses, this study investigated the about/mission/vision/goals/objectives sections of websites of science centers from around the world (Asia, Europe, Global, Latin America/The Caribbean, North America, Africa). From this investigation, similar basic themes, derived from Snellman's statement challenging his people/everyone to adopt this devotion to science, were found in the areas of i) expression in ASTC, CIMUSET/CSTM, CASC and SAASTEC; ii) emphasis in ECSITE, ASDC, ASCN and NSCF; and iii) implication in ASPAC, ASTEN, NCSM, ABCMC and Red-POP. These basic themes, as found in the about/mission/vision/goals/objectives of science centers, can, in effect, be narrowed down to the one theme of "cultural institutions will be a big part of human life" (Madsen 2017, p. 68) science centers in the global village (Touraine, 2016, p. 121) of the future.

The European Academy of Cancer Sciences (EACS) is an independent advisory body of well-recognised medical specialists and researchers striving to create a compelling interactive continuum of cancer research, from innovative basic research to implementation of state-of-the-art evidence-based cancer care and prevention. Achieving the above will entail bridging high-quality basic and preclinical cancer research to research on prevention, early detection and therapeutics as well as improving coordination of translational research efforts across Europe. The latter is expected to be expedited through quality assuring translational cancer research in Comprehensive Cancer Centres - entities that link research with the healthcare system - and networks of cancer research centres. Achieving a critical mass of expertise, resources and patients is crucial. Improving late translational research, which involves clinical studies to assess effectiveness, and added value for the health care is also a high priority. Both high-quality Big Data collections and the intelligent use of these data will promote innovation in cancer research and support outcomes research to assess clinical utility, quality of cancer care and long-term follow-up of treated patients. The EACS supports the mission-oriented approach recently proposed by the European Commission in Horizon Europe to deal with major challenges and would like to persuade the EU and its member states to formally launch a mission in cancer to boost and streamline the cancer research continuum in Europe. Building a coherent translational cancer research continuum with a focus on patients and individuals at risk will require, however, foresight as well as the extensive and continuous provision of evidence-based advice to inform policy., (© 2018 The Authors. Published by FEBS Press and John Wiley & Sons Ltd.)

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.

Background: Since there is sound evidence that communication skills training (CST) programs modify communication behavior of oncology clinicians, they have been widely implemented over the last decades. However, more recently, certain aspects of this training have been criticized., Methods: Based on this background, a call to re-launch a discussion about the future of CST led to the third European consensus meeting on communication in cancer care, organized by the Swiss Cancer League. During this meeting, which brought together European experts in the field of clinical communication and training of communication in the oncology setting, oncology clinicians, representatives of the European Society of Medical Oncology and a member of the European Oncology Nursing Society, the recommendations of the second European consensus meeting were updated and expanded., Results: The expanded recommendations recall the guiding principles of communication in cancer care, underline the important role of clinician's self-awareness, and of relational and contextual factors in clinical communication, and provide direction for the further development of communication training., Conclusion: This third European consensus meeting defines key elements for the development of a next generation of communication training for oncology clinicians.

: This ESH update was deemed necessary with the publication of new results of sham-controlled randomized blinded prospective trials with renal denervation (RDN). Proof of concept studies and first randomized trials (some were sham-controlled) displayed discrepant results about the efficacy of RDN. Three sham-controlled randomized trials of the 2.0 generation yielded now similarity in the average blood pressure decrease following RDN. Reduction of ambulatory blood pressure was approximately 5 to 7 mmHg and of office blood pressure 10 mmHg. Such a decrease in blood pressure by pharmacologic therapy has been found to be associated with lower incidence of cardiovascular events in particular with respect to heart failure and stroke by roughly 25%. Nevertheless, some questions about renal denervation are unanswered. The heterogeneity of the blood pressure-lowering response point to the clinical need to identify predictors for efficacy, and questions on long-term safety could not have been answered due to the short duration of the sham-controlled randomized clinical trials.

In endocrine diseases, hormonal changes, electrolyte abnormalities, and the deterioration of heart structure can lead to various arrhythmias. In diabetic patients, hypoglycemia, hyperglycemia, and hypokalemia can trigger arrhythmias, and diabetic cardiomyopathy can also cause electrical and structural remodeling to form substrates for arrhythmias. The risk of atrial fibrillation (AF) increases in hyperthyroidism; however, the prevalence of ventricular arrhythmias in hypothyroidism is higher. Besides AF and ventricular tachycardias, bradycardias and atrioventricular blocks can also be seen in pheochromocytoma due to the desensitization of adrenergic cardiovascular receptors. The correction of metabolic and electrolyte disturbances in patients with adrenal cortex disease should be the main approach in the prevention and treatment of arrhythmias. Early initiation of treatment in patients with acromegaly seems to decrease the development of cardiac remodeling and ventricular arrhythmia. Early and late after depolarizations due to hypercalcemia in hyperparathyroidism can lead to life-threatening ventricular arrhythmias. This elegant position paper provides important recommendations regarding prevention and treatment of arrhythmias for specific endocrine disorders.

Cannabis-based medicines are being approved for pain management in an increasing number of European countries. There are uncertainties and controversies on the role and appropriate use of cannabis-based medicines for the management of chronic pain. EFIC convened a European group of experts, drawn from a diverse range of basic science and relevant clinical disciplines, to prepare a position paper to empower and inform specialist and nonspecialist prescribers on appropriate use of cannabis-based medicines for chronic pain. The expert panel reviewed the available literature and harnessed the clinical experience to produce these series of recommendations. Therapy with cannabis-based medicines should only be considered by experienced clinicians as part of a multidisciplinary treatment and preferably as adjunctive medication if guideline-recommended first- and second-line therapies have not provided sufficient efficacy or tolerability. The quantity and quality of evidence are such that cannabis-based medicines may be reasonably considered for chronic neuropathic pain. For all other chronic pain conditions (cancer, non-neuropathic noncancer pain), the use of cannabis-based medicines should be regarded as an individual therapeutic trial. Realistic goals of therapy have to be defined. All patients must be kept under close clinical surveillance. As with any other medical therapy, if the treatment fails to reach the predefined goals and/or the patient is additionally burdened by an unacceptable level of adverse effects and/or there are signs of abuse and misuse of the drug by the patient, therapy with cannabis-based medicines should be terminated., Significance: This position paper provides expert recommendations for nonspecialist and specialist healthcare professionals in Europe, on the importance and the appropriate use of cannabis-based medicines as part of a multidisciplinary approach to pain management, in properly selected and supervised patients., (© 2018 European Pain Federation - EFIC®.)

The high prevalence of allergic diseases warrants for sufficient health care provisions available to patients with allergic diseases. Allergy care should be delivered by well‐trained specialists. However, the current status of allergy care is not well documented. For this reason a survey among European and a few non‐European countries was launched by the National Allergy Society Committee from the European Academy of Allergy and Clinical Immunology and the Union Européenne des Médecins Spécialistes section and board of Allergology. The survey shows that in the vast majority of countries allergy care services are available. However, a substantial heterogeneity is reported regarding recognition of the full specialty, the number of practicing specialists or subspecialists, and training aspects. Growth but also decline of specialty and subspecialties is reported. In addition, the survey gives insight in strengths, weaknesses, opportunities and threats in this field. It appears that the recognition of the full specialty determines strength as well as weakness. Aging of specialists combined with a decline in the number of trainees form a major threat. Opportunities are seen in creating awareness for allergy, focus on attracting young physicians. The conclusion is that harmonization of allergy services across Europe is needed. Investment in young doctors, creating new opportunities and lobbying for the full specialty is required. [ABSTRACT FROM AUTHOR]

Background: The European & Developing Countries Clinical Trials Partnership (EDCTP), like many other research funders, requires its grantees to make papers available via open access (OA). This article investigates the effect of publishing in OA journals and international collaboration within and between European and sub-Saharan African countries on citation impact and likelihood of falling into the top 1% and top 10% most cited papers in poverty-related disease (PRD) research., Methods: Disease-specific research publications were identified in the Web of Science™ and MEDLINE using Medical Subject Heading (MeSH) terms. Data on the open accessibility of scientific literature were derived from 1science oaFindr. Publication data, including relative citation counts, were extracted for 2003-2015. Regression models were applied to quantify the relationship between relative citations and presence in the 1% and top 10% most cited papers versus OA and international collaboration., Results: The results show that since 2003 papers on PRDs have become increasingly available in OA. Among all PRD areas, malaria research is most frequently published in OA and in international collaboration. The adjusted regression analyses show that holding other factors constant, publishing research in OA and in international collaboration has a significant and meaningful citation advantage over non-OA or non-international collaborative research. Publishing papers as part of a European-wide or European- sub-Saharan African collaboration increases research impact. In contrast, such collaboration advantage is not observed for research output involving sub-Saharan Africa only which seems to decrease research impact., Conclusions: Our results indicate that there is a real, measurable citation advantage for publishing PRD research in OA and international collaboration. However, the international collaboration advantage seems to be region-specific with increased research impact for European-wide and European-sub-Saharan African collaborations but a decrease in research impact of collaborations confined to sub-Saharan African research institutions. Further research is required to further verify this finding and to understand the underlying factors related to this observed decrease in research impact. To target future research capacity building activities in sub-Saharan Africa it is important to assess whether the observed decreased impact reflects the scientific competencies and geographic distribution of individual researchers or institutional-, national- or funder-specific research requirements., Competing Interests: JGB and MMM have no competing interests to declare. CT, GR, MD and DBS have the following interests to declare: CT, GR, MD and DBS are employed by Science-Metrix. Financial support was provided by Science-Metrix for the manuscript preparation (over and above the contracted study) in the form of salaries for CT, GR, MD and DBS. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.

Endoscopy is a central tool for the evaluation and management of inflammatory bowel disease (IBD). In the last few decades, gastrointestinal (GI) endoscopy has undergone significant technological developments including availability of pediatric-size equipment, enabling comprehensive investigation of the GI tract in children. Simultaneously, professional organization of GI experts have developed guidelines and training programs in pediatric GI endoscopy. This prompted the Porto Group on Pediatric IBD of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition to develop updated guidelines on the role of GI endoscopy in pediatric IBD, specifically taking into considerations of recent advances in the diagnosis, disease stratification, and novel therapeutic targets in these patients.

This paper reviews the current epidemiological data on peripheral artery disease (PAD) in Europe. Cardiovascular disease (CVD) burden is presented and PAD prevalence is discussed, as compared to coronary (CAD) and cerebrovascular (CeVD) diseases, in European Union (EU) countries and European continent countries. The article reviews PAD clinical manifestations, PAD diagnosis, risk factors for PAD incidence and progression, PAD prognosis and financial implications. CVD mortality is higher in women than in men and in European continent countries, as compared to EU countries. While CAD and CeVD have a lower prevalence in EU countries, as compared to the whole continent, PAD and other CVDs still have a higher prevalence in EU countries. PAD prevalence vary widely between countries, increases sharply with aging and has a relation with ethnicity. CVD comorbidities are high in PAD subjects and particularly high in those with critical limb ischemia. PAD prognosis is related to CAD and CeVD mortality, that are particularly high in critical limb ischemia. This review promotes the need for global awareness on PAD burden, stimulates PAD screening and emphasizes the importance of early diagnosis and treatment of PAD and associated cardiovascular comorbidities.