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Background: The European Water Framework Directive foresees the establishment of emission inventories for micropollutants (MP) to facilitate an evidence-based development of mitigation measures. Regionalized pathway analysis constitutes a moderately data-intensive approach to quantify the contribution of different pathways to the total pollution of surface waters. So far, only few European member states have created an inventory that includes diffuse pathways. The fundamental basis to enable it is an accessible, well-structured and harmonized database with data on the concentration of MPs in multiple compartments, such as soils, groundwater, atmospheric deposition and urban systems. Combined with the water and suspended substance balance in river basins, such data enables the estimation of emission loads via specific pathways. In the Danube River Basin, but in general in Europe, a public data management platform with such scope and criteria is still lacking. Results: We collected and harmonized MP measurements across multiple compartments and countries together with key metadata, harmonized and combined them into a new database. The resulting tool, available for download, facilitates the assessment of current data availability, in terms of quantity and quality. For example, while the majority of available data stems from groundwater and surface water, other highly relevant compartments are scarcely represented. By examining differences in MP concentration level across compartments, the database can lead to understand the relevance of specific emission pathways and thus to prioritize data-retrieval and calculation efforts in modelling applications. Selected examples show how to exploit the metadata associated to the measurements to extrapolate the results to regions not covered by specific monitoring programmes. For example, PFAS concentrations in treated wastewater show significant dependence on the design capacity of the treatment plant. Conclusions: This study showcases how such database can support the setup of emission inventories, guide data providers and national authorities in prioritizing the allocation of resources for new surveys and in optimizing their national data collection and management systems. The process tested showed a great need for enhanced data literacy across countries and institutions to increase data availability and quality to secure the exploitation of the full information potential generated via monitoring programmes. [ABSTRACT FROM AUTHOR]

The existing plant trait databases' applicability is limited for studies dealing with the flora and vegetation of the eastern and central part of Europe and for large-scale comparisons across regions, mostly because their geographical data coverage is limited and they incorporate records from several different sources, often from regions with markedly different climatic conditions. These problems motivated the compilation of a regional dataset for the flora of the Pannonian region (Eastern Central Europe). PADAPT, the Pannonian Dataset of Plant Traits relies on regional data sources and collates data on 54 traits and attributes of the plant species of the Pannonian region. The current version covers approximately 90% of the species of the region and consists of 126,337 records on 2745 taxa. By including species of the eastern part of Europe not covered by other databases, PADAPT can facilitate studying the flora and vegetation of the eastern part of the continent. Although data coverage is far from complete, PADAPT meets the longstanding need for a regional database of the Pannonian flora. [ABSTRACT FROM AUTHOR]

Named entity recognition (NER) is a widely used text-mining and natural language processing (NLP) subtask. In recent years, deep learning methods have superseded traditional dictionary- and rule-based NER approaches. A high-quality dataset is essential to fully leverage recent deep learning advancements. While several gold-standard corpora for biomedical entities in abstracts exist, only a few are based on full-text research articles. The Europe PMC literature database routinely annotates Gene/Proteins, Diseases, and Organisms entities. To transition this pipeline from a dictionary-based to a machine learning-based approach, we have developed a human-annotated full-text corpus for these entities, comprising 300 full-text open-access research articles. Over 72,000 mentions of biomedical concepts have been identified within approximately 114,000 sentences. This article describes the corpus and details how to access and reuse this open community resource. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to evaluate the baseline data of women with breast cancer (BC) undergoing treatment in an intercontinental comparison. Methods: This study included 99,571 women with BC from Europe (70,834), Asia (18,208), and Latin America (10,529) enrolled between 2017 and 2021, based on data from IQVIA's Oncology Dynamics database. This source is supplied with information by means of a cross-sectional partially retrospective survey collecting anonymized data on inpatients and outpatients treated by a representative panel of oncologists. A multivariable logistic regression model was used to investigate the probability of metastases. Results: The data available in Asia (98%) and Latin America (100%) were hospital data, while in Europe, patients were treated both in hospitals and in office-based practices (62%, 38%). The mean age in Asia and Latin America (57 ± 13) was lower than in Europe (61 ± 13; p < 0.001). Lobular BC was diagnosed twice as often in Europe compared to Asia and Latin America (15.2%, 9.8%, 8.0%). The number of patients with metastasized hormone receptor-positive (HR +) BC was significantly higher in Europe and Latin America than in Asia (76%, 68%; p < 0.001). The highest number of women with metastasized BC was reported in Europe (26% compared to 14% and 20%, respectively, in Asia and Latin America). Across the continents, the percentage of women with BC who experienced metastases was 51–61% for bone, 30–39% for lung and 25–32% for liver, followed by 3–6% for skin and 3% for brain. Conclusion: Women with BC treated in Europe tend to be significantly older and more likely to develop metastases than women in Asia and Latin America, except for lung metastases. [ABSTRACT FROM AUTHOR]

Droughts evolve in space and time without following borders or pre-determined temporal constraints. Here, we present a new database of drought events built with a three-dimensional density-based clustering algorithm. The chosen approach is able to identify and characterize the spatio-temporal evolution of drought events, and it was tuned with a supervised approach against a set of past global droughts characterized independently by multiple drought experts. About 200 events were detected over Europein the period 1981-2020 using SPI-3 (3-month cumulated Standardized Precipitation Index) maps derived from the ECMWF (European Centre for Medium-range Weather Forecasts) 5th generation reanalysis (ERA5) precipitation. The largest European meteorological droughts during this period occurred in 1996, 2003, 2002 and 2018. A general agreement between the major events identified by the algorithm and drought impact records was found, as well as with previous datasets based on pre-defined regions. [ABSTRACT FROM AUTHOR]

Quantitative estimation of seismic risk over a region requires both an underlying probabilistic seismic hazard model and a means to characterise shallow site response over a large scale. The 2020 European Seismic Risk Model (ESRM20) builds on the 2020 European Seismic Hazard Model (ESHM20), requiring additional information to firstly parameterise the local site condition across all of Europe, and subsequently determine its influence on the prediction of seismic ground motion. Initially, a harmonised digital geological database for Europe is compiled, alongside a model of topographic/bathymetric elevation and a database of 30 m averaged shearwave velocity measurements ( V S 30 ), in order to produce separate 30 arc-second maps of inferred V S 30 based on topography and on geology. We then capitalise on a large database of seismic recording stations in Europe for which site-to-site ground motion residuals ( δ S 2 S S ) have been determined with respect to the shallow crustal ground motion model used in the ESHM20. These residuals allow us to incorporate site amplification functions into the European GMM calibrated upon either observed or inferred V S 30 , or on the European geology and topography models. We present the resulting pan-European seismic site amplification model and assess its impact on seismic hazard and risk compared against other approaches. The new site amplification model fulfils the requirements of the ESRM20 and, providing uncertainty is fully propagated, yields estimates of seismic hazard and risk at a large space scale that may be comparable to other methods often applied at local/urban scale where better-constrained site information is available. [ABSTRACT FROM AUTHOR]

Rare diseases (RDs) bear a significant challenge to individuals, healthcare systems, and societies. The European reference network on Rare BONe diseases (ERN BOND) is committed to improving multidisciplinary, patient-centred care for individuals with rare bone and mineral diseases (RBMDs). Its affiliated project, the European registries for rare bone and mineral conditions (EuRR-Bone) collects data using two different platforms, an electronic surveillance system (e-REC) that captures the occurrence of RBMDs and the Core Registry, a platform with the infrastructure for collecting Core data fields and longitudinal generic and condition-specific information. With emerging registries and the overlap with other ERNs, it is key to maintain the capability of the platforms to adapt to the needs of the network and the community whilst adhering to quality and FAIR (findable, accessible, interoperable, and reusable) principles. This binomial ensures long-term sustainability and potential advances in the care pathway of RBMDs whilst promoting good practice standards within Europe and beyond. [ABSTRACT FROM AUTHOR]

This paper presents recent innovations implemented in the LaRiMiT (Landslide Risk Mitigation Toolbox) webtool. These include an innovative methodology for utilising experts' scoring of landslide risk mitigation measures directly within the decision support tool, and updating of the tool's database over structural measures to include many nature-based solutions (NBS) for mitigating landslide risk. Landslides are a common and treacherous natural hazard, and due to the effect of climate change on the frequency and intensity of extreme weather events, climate-driven landslides are expected to become more frequent. This negative trend is a driving factor for developing decision-support solutions for risk mitigation, and the LaRiMiT toolbox and the expert scoring methodology presented in this article contribute to meeting these needs. Selecting suitable structural measures is complicated due to factors such as site-specific conditions, local knowledge and resources, socio-economic constraints, and environmental considerations. LaRiMiT uses user-input attributes of site-specific slope movements combined with expert scoring of the suitability of various mitigation solutions to identify and select appropriate mitigation measures from an extensive database of structural solutions. While the LaRiMiT database initially included only conventional (grey) solutions relying on traditional methods, it has been recently expanded to include nature-based solutions (NBS), which are sustainable techniques for managing erosion and mitigating shallow landslides using vegetation and the use of natural materials. NBS and conventional solutions can also be combined to provide hybrid solutions. The proposed methodology for implementing expert scoring is dynamic and iterative, consisting of statistical pooling of experts' scores collected via online surveys, and consolidating these into an expert scoring utility embedded in the LaRiMiT web portal engine. An initial application of this methodology has been tested by surveying a set of landslides experts, mostly in Europe, and applying it to the structural measures database in the LaRiMiT tool. Although the number of experts in this initial application is limited, dynamic updating of the scoring allows the tool to continuously improve as additional experts contribute. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to describe ultra-processed food and drinks (UPFDs) consumption, and associations with intake of total sugar and dietary fibre, and high BMI in adults across Europe. Methods: Using food consumption data collected by food records or 24-h dietary recalls available from the European Food Safety Authority (EFSA) Comprehensive European Food Consumption Database, the foods consumed were classified by the level of processing using the NOVA classification. Diet quality was assessed by data linkage to the Dutch food composition tables (NEVO) and years lived with disability for high BMI from the Global Burden of Disease Study 2019. Bivariate groupings were carried out to explore associations of UPFDs consumption with population intake of sugar and dietary fibre, and BMI burden, visualised by scatterplots. Results: The energy share from UPFDs varied markedly across the 22 European countries included, ranging from 14 to 44%, being the lowest in Italy and Romania, while the highest in the UK and Sweden. An overall modest decrease (2–15%) in UPFDs consumption is observed over time, except for Finland, Spain and the UK reporting increases (3–9%). Fine bakery wares and soft drinks were most frequently ranked as the main contributor. Countries with a higher sugar intake reported also a higher energy share from UPFDs, as most clearly observed for UPF (r = 0.57, p value = 0.032 for men; and r = 0.53, p value = 0.061 for women). No associations with fibre intake or high BMI were observed. Conclusion: Population-level UPFDs consumption substantially varied across Europe, although main contributors are similar. UPFDs consumption was not observed to be associated with country-level burden of high BMI, despite being related to a higher total sugar intake. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76–0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38–0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58–2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4–13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies. [ABSTRACT FROM AUTHOR]

The taxonomic status of the genus Bythotrephes Leydig (Crustacea: Cladocera) has been debated since the second half of the XIX century. The most widespread view of recent decades has been that Bythotrephes is a monotypic genus, which was support by preliminary molecular data. However, the recent detailed morphological revision of this genus clearly distinguishes at least seven species. Therefore, we performed a multi-lake survey in Central Europe to give new insight into the taxonomic status of Bythotrephes by combining genetic analysis with traditional morphology-based taxonomy. Based on the morphology we identified two species in Central Europe, B. brevimanus and B. lilljeborgi, as well as hybrid forms. For the genetic analysis, we used newly obtained 113 sequences of mtDNA COI gene of the 535-bp length Bythotrephes from Central Europe and sequences downloaded from GenBank. There were no significant differences between all analyzed sequences, which supports the hypothesis that Bythotrephes is a monotypic genus, with only one highly polymorphic species. On the other hand, the results of our work could point out that the COI gene is insufficient to evaluate the taxonomic status of Bythotrephes. Nonetheless, we have identified 29 new haplotypes of mtDNA COI, and one which was the same as the haplotype found in North America and Finland. Furthermore, this haplotype was the source variant from which most other haplotypes were derived. [ABSTRACT FROM AUTHOR]

Around fifteen thousand fieldworkers annually count breeding birds using standardized protocols in 28 European countries. The observations are collected by using country-specific and standardized protocols, validated, summarized and finally used for the production of continent-wide annual and long-term indices of population size changes of 170 species. Here, we present the database and provide a detailed summary of the methodology used for fieldwork and calculation of the relative population size change estimates. We also provide a brief overview of how the data are used in research, conservation and policy. We believe this unique database, based on decades of bird monitoring alongside the comprehensive summary of its methodology, will facilitate and encourage further use of the Pan-European Common Bird Monitoring Scheme results. Measurement(s) population Technology Type(s) Count Factor Type(s) time scale • geographic location Sample Characteristic - Organism Aves Sample Characteristic - Location Europe Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.13240760 [ABSTRACT FROM AUTHOR]

Background: Huntington's Disease (HD) is a hereditary neurodegenerative disorder which affects individuals' ability to walk, talk, think, and reason. Onset is usually in the forties, there are no therapies currently available that alter disease course, and life expectancy is 10-20 years from diagnosis. The gene causing HD is fully penetrant, with a 50% probability of passing the disease to offspring. Although the impacts of HD are substantial, there has been little report of the quality of life of people with the condition in a manner that can be used in economic evaluations of treatments for HD. Health state utility values (HSUVs), used to calculate quality-adjusted life-years (QALYs), are the metric commonly used to inform such healthcare policy decision-making.Objectives: The aim was to report HSUVs for HD, with specific objectives to use European data to: (i) describe HSUVs by demographic and clinical characteristics; (ii) compare HSUVs of people with HD in the UK with population norms; (iii) identify the relative strength of demographic and clinical characteristics in predicting HSUVs.Methods: European Huntington's Disease Network REGISTRY study data were used for analysis. This is a multi-centre, multi-national, observational, longitudinal study, which collects six-monthly demographic, clinical, and patient-reported outcome measures, including the SF-36. SF-36 scores were converted to SF-6D HSUVs and described by demographic and clinical characteristics. HSUVs from people with HD in the UK were compared with population norms. Regression analysis was used to estimate the relative strength of age, gender, time since diagnosis, and disease severity (according to the Total Function Capacity (TFC) score, and the UHDRS's Motor score, Behavioural score, and Cognition score) in predicting HSUVs.Results: 11,328 questionnaires were completed by 5560 respondents with HD in 12 European countries. Women generally had lower HSUVs than men, and HSUVs were consistently lower than population norms for those with HD in the UK, and dropped with increasing disease severity. The regression model significantly accounted for the variance in SF-6D scores (n = 1939; F [7,1931] = 120.05; p < 0.001; adjusted R-squared 0.3007), with TFC score, Behavioural score, and male gender significant predictors of SF-6D values (p < 0.001).Conclusion: To our knowledge, this is the first report of HSUVs for HD for countries other than the UK, and the first report of SF-6D HSUVs described for 12 European countries, according to demographic and clinical factors. Our analyses provide new insights into the relationships between HD disease characteristics and assessment of health-related quality of life in a form that can be used in policy-relevant economic evaluations. [ABSTRACT FROM AUTHOR]

Purpose: Knowledge about polyphenols intakes and their determinants among adolescents might be helpful for planning targeted prevention strategies at an early age. Methods: In the European multicenter cross-sectional HELENA study of 2006–2007, 2428 subjects (47% boys) had data on dietary intake of polyphenols from 2 non-consecutive 24 h recalls via linking with the Phenol-Explorer database. Differences by sex, age, country, BMI, maternal education, paternal education, family affluence, smoking status, alcohol use, and physical activity were explored by linear regression. Results: Median, lower and upper quartiles of polyphenol intakes were 326, 167 and 564 mg/day, respectively. Polyphenol intake was significantly higher in the oldest (16–17.49 years), girls, non-Mediterranean countries, lowest BMI, highest paternal education, and alcohol consumers. Main food contributors were fruit (23%, mainly apple and pear, i.e., 16.3%); chocolate products (19.2%); and fruit and vegetable juices (15.6%). Main polyphenol classes were flavonoids (75–76% of total) and phenolic acids (17–19% of total). The three most consumed polyphenols were proanthocyanidin polymers (> 10 mers), hesperidin, and proanthocyanidin 4–6 oligomers. Conclusion: The current study provided for the first time numbers on the total polyphenol intake and their main food sources in a heterogeneous group of European adolescents. Major differences with adult populations are the lower polyphenol consumption and the major food sources, such as chocolate and biscuits. The discussed determinants and polyphenol types already point to some important population groups that need to be targeted in future public health initiatives. [ABSTRACT FROM AUTHOR]

Objectives Food marketing to children is pervasive and linked to increased preference and intake of unhealthy foods. The World Health Organization (WHO) developed the only multi-country nutrient criteria, and Chile recently released the world's most comprehensive regulation to identify foods that should not be marketed to children. Our objective was to examine the proportion of US packaged food and beverage products eligible for marketing to children under the WHO Europe Nutrient Profile Model (NPM) and the 2019 Chilean regulation. Methods Data for this study are from Label Insight's 2017 Open Access branded food database. Each product was assigned to one of 13 food categories, and nutritional content compared to both the NPM and Chilean criteria. The proportion of US products meeting criteria for marketing to children using both schemes was examined overall and by category. Agreement between the two criteria was examined using Cohen's Kappa. Results Of 17,740 US products, 21% were eligible to be marketed to children using the WHO criteria and 26% using the Chilean criteria. 'Egg and egg products' and 'Seafood' had the highest proportion of products eligible for marketing to children under both schemes. 'Confectionery' and 'Snack foods' had the lowest proportion eligible. Conclusions for practice The WHO NPM and Chilean criteria both restrict less healthy items from being marketed to children. Regulatory agencies in the US developing policies should consider the implementation of nutrient criteria to restrict the marketing of less healthy foods and beverages to children and adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Hypersensitivity reactions (HSRs) are among the known adverse events of intravenous (i.v.) iron products. Of these, particularly severe HSRs such as anaphylaxis are of great clinical concern due to their life-threatening potential.Methods: This was a retrospective pharmacoepidemiological study with a case-population design evaluating the number of reported severe HSRs following administration of the two i.v. iron products-ferric carboxymaltose and iron (III) isomaltoside 1000-in relation to exposure in European countries from January 2014 to December 2017. Exposure to both products was estimated using IQVIA MIDAS sales data in European countries. Information on spontaneously reported severe HSRs was obtained from and analysed separately for the two established safety surveillance databases EudraVigilance and VigiBase™ using the MedDRA® Preferred Terms anaphylactic reaction, anaphylactic shock, anaphylactoid reaction and anaphylactoid shock associated with administration of either product.Results: Between 2014 and 2017, the reporting rate of severe HSRs per 100,000 defined daily doses (100 mg dose equivalents of iron) varied from 0.3 to 0.5 for ferric carboxymaltose and from 2.4 to 5.0 for iron (III) isomaltoside 1000. The reporting rate ratio for iron (III) isomaltoside 1000 versus ferric carboxymaltose was between 5.6 (95% CI 3.5-9.0) and 16.2 (95% CI 9.4-27.8).Conclusions: Findings suggest that iron (III) isomaltoside 1000 is associated with a higher reporting rate of severe HSRs related to estimated exposure than ferric carboxymaltose in European countries. Future research investigating the occurrence of severe HSRs associated with i.v. ferric carboxymaltose and iron (III) isomaltoside 1000 is needed to broaden the evidence for benefit-risk assessment. [ABSTRACT FROM AUTHOR]

Background: Vaccine price is one of the most influential parameters in economic evaluations of HPV vaccination programmes. Vaccine tendering is a cost-containment method widely used by national or regional health authorities, but information on tender-based HPV vaccine prices is scarce.Methods: Procurement notices and awards for the HPV vaccines, published from January 2007 until January 2018, were systematically retrieved from the online platform for public procurement in Europe. Information was collected from national or regional tenders organized for publicly funded preadolescent vaccination programmes against HPV. The influence of variables on the vaccine price was estimated by means of a mixed-effects model.Findings: Prices were collected from 178 procurements announced in 15 European countries. The average price per dose for the first-generation HPV vaccines decreased from €101.8 (95% CI 91.3-114) in 2007 to €28.4 (22.6-33.5) in 2017, whereas the average dose price of the 9-valent vaccine in 2016-2017 was €49.1 (38.0-66.8). Unit prices were, respectively, €7.5 (4.4-10.6) and €34.4 (27.4-41.4) higher for the 4-valent and 9-valent vaccines than for the 2-valent vaccine. Contract volume and duration, level of procurement (region or country), per capita GDP and number of offers received had a significant effect on vaccine price.Interpretation: HPV vaccine procurement is widely used across Europe. The fourfold decrease in the average tender-based prices compared to list prices confirms the potential of tendering as an efficient cost-containment strategy, thereby expanding the indications for cost-effective HPV vaccination to previously ineligible target groups. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the international CORE project was to explore the databases of the existing hernia registries and compare them in content and outcome variables.Methods: The CORE project was initiated with representatives from all established hernia registries (Danish Hernia Database, Swedish Hernia Registry, Herniamed, EuraHS, Club Hernie, EVEREG, AHSQC) in March 2015 in Berlin. The following categories were used to compare the registries: initiation and funding, data collection and use for certification of hernia centers, patient data and data protection, operative data, registration of complications and follow-up data.Results: The Danish Hernia Database is the only one to qualify as a genuine national registry where participation is compulsory for entry of all procedures by all surgeons performing a hernia operation. All other registries have to be considered as voluntary and completeness of data depends upon the participating hospitals and surgeons. Only the Danish Hernia Database and the Swedish Hernia Registry are publicly funded. All other registries are reliant on financial support from the medical technology industry. As an incentive for voluntary participation in a hernia registry, hospitals or surgeons are issued a certificate confirming that they are taking part in a quality assurance study for hernia surgery. Due to data protection and privacy regulations, most registries are obliged or have chosen to enter their patient data anonymously or coded. The Danish Hernia Database and Swedish Hernia Registry utilize a national personal patient code. In the Herniamed Registry, patient data are saved in a coded and anonymous format after obtaining the patient's informed consent.Conclusion: Despite the differences in the way data are collected for each of the listed hernia registries, the data are indispensable in clinical research. [ABSTRACT FROM AUTHOR]

Educational attainment is a key factor for understanding why some individuals migrate and others do not. Compulsory schooling laws, which determine an individual's minimum level of education, can potentially affect migration. We test whether and how increasing the length of compulsory schooling influences migration of affected cohorts across European countries, a context where labor mobility is essentially free. We construct a novel database that includes information for 31 European countries on compulsory education reforms passed between 1950 and 1990. Combining this data with information on recent migration flows by cohorts, we find that an additional year of compulsory education reduces the number of individuals from affected cohorts who migrate in a given year by 9 %. Our results rely on the exogeneity of compulsory schooling laws. A variety of empirical tests indicate that European legislators did not pass compulsory education reforms as a reaction to changes in emigration rates or educational attainment. [ABSTRACT FROM AUTHOR]

Background: Some reports have suggested an association between dopamine agonists and hiccups, involuntary contractions that merit full clinical attention because they can be very debilitating. Many drugs frequently used to treat hiccups are formally contraindicated in Parkinson's disease due to their liability to worsen motor symptoms, making the treatment of hiccups problematic in this disease. The objective of the present study was to analyze all spontaneous reports of hiccups from the European Pharmacovigilance Database in patients with Parkinson's disease and/or on dopaminergic drugs. Finally, we sought to identify evidence-based recommendations on the management of hiccups in Parkinson's disease. Methods: We searched for all reports of hiccups in the European Pharmacovigilance Database (EudraVigilance) and calculated proportional reporting ratios for dopamine agonists and hiccups. We reviewed the literature on Parkinson's disease, dopamine agonists, and hiccups, searching for specific treatment recommendations for hiccups in this disease. Results: Both rotigotine and pramipexole fulfilled the criteria to generate a safety signal. We found 32 and 13 cases of hiccups associated with dopamine agonists in EudraVigilance and the literature, respectively. There were no specific recommendations for the management of hiccups in Parkinson's disease in the clinical guidelines consulted. Conclusions: We have found evidence that rotigotine and pramipexole are associated with the appearance of hiccups and that this adverse reaction occurs predominantly in males. Given the scarce information available, specific recommendations are needed in clinical guidelines for the adequate management of hiccups in Parkinson's disease. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to determine the prevalence of tuberculosis (TB), the number needed to screen (NNS), and the diagnostic accuracy of chest X-ray (CXR) screening to detect active pulmonary TB during the 2015 European refugee crisis.Materials and Methods: We evaluated data of all refugees who underwent CXR screening in a single-centre of one German metropolitan area in 2015. We determined the prevalence of TB, NNS, and accuracy of CXR to detect active pulmonary TB. Reference method for active TB was the database of all definite TB cases registered at the Department of Public Health.Results: A total of 17,487 immigrants underwent single-centre CXR screening in 2015; prevalence of definite pulmonary TB was 0.103%. The NNS for detecting one case of active pulmonary TB was 1749. CXR had a sensitivity of 55.6% [95% confidence interval (CI) 30.8-78.5%) and a specificity 98.3% (CI 98.1-98.5%) to reveal one case of active TB.Conclusion: Our single-centre study indicates that chest X-ray screening for TB during the 2015 European refugee crisis was of low yield due the low prevalence of TB and high number needed to screen, thus implicating the need for improved screening algorithms adapted to the overwhelming number of refugees.Key Points: • Prevalence of pulmonary tuberculosis (TB) among refugees in 2015 was low (0.103%). • The number needed to screen to detect one case of active pulmonary TB was 1749. • Tuberculosis X-ray screening resulted in a low sensitivity and high specificity. • Tuberculosis X-ray screening during the European refugee crisis is of low yield. • Improved screening algorithms are needed due to the overwhelming the number of refugees. [ABSTRACT FROM AUTHOR]

This scoping review summarizes and analyzes relevant studies related to the evidence published on undocumented immigrant women's access to and utilization of health and social services in Spain. Scientific literature was identified by entering search terms in seven electronic databases which combined retrieved health sciences peer-reviewed articles (Pubmed, Embase, CINAHL Plus and Scopus) and grey literature databases (Europa OpenGrey, DART-Europe and Google Scholar) published between 2004 and 2014 and written in Spanish or in English presenting data about Spain. Those that fulfill the inclusion criteria were selected after a blind peer reviewed process when pertinence and quality was debated. A total of 16 publications were included, the main topics being socio-cultural differences in the access and utilization of social and health services and barriers faced by immigrant women. None of the studies focused exclusively on undocumented women, hence further research is needed in this area. [ABSTRACT FROM AUTHOR]

There are currently no effective pharmacological agents available to stop or prevent the progression of Huntington's disease (HD), a rare hereditary neurodegenerative disorder. In addition to psychiatric symptoms and cognitive impairments, HD causes progressive motor disturbances, in particular choreiform movements, which are characterized by unwanted contractions of the facial muscles, trunk and extremities. Management of choreiform movements is usually advised if chorea interferes with daily functioning, causes social isolation, gait instability, falls, or physical injury. Although drugs to reduce chorea are available, only few randomized controlled studies have assessed the efficacy of these drugs, resulting in a high variety of prescribed drugs in clinical practice. The current pharmacological treatment options to reduce chorea in HD are outlined in this review, including the latest results on deutetrabenazine, a newly developed pharmacological agent similar to tetrabenazine, but with suggested less peak dose side effects. A review of the existing literature was conducted using the PubMed, Cochrane and Medline databases. In conclusion, mainly tetrabenazine, tiapride (in European countries), olanzapine, and risperidone are the preferred first choice drugs to reduce chorea among HD experts. In the existing literature, these drugs also show a beneficial effect on motor symptom severity and improvement of psychiatric symptoms. Generally, it is recommended to start with a low dose and increase the dose with close monitoring of any adverse effects. New interesting agents, such as deutetrabenazine and pridopidine, are currently under development and more randomized controlled trials are warranted to assess the efficacy on chorea severity in HD. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the demographics, injury patterns, and outcomes following major trauma between Alpine skiing, snowboarding, and sledding winter sports. Methods: An international population-based prospective trauma database (TraumaRegister DGU) was analyzed for demographic data, types and severity of injuries [body regions, Injury Severity Score (ISS)], early physiology [Glasgow Coma Scale (GCS), blood pressure, body temperature], rescue modality, surgical care, length of stay, and major complications (shock, multiple organ failure mortality). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Results: A total of 243 winter sport athletes with major trauma were identified (1993-2012), and subjects were divided into Alpine skiers ( n = 174), snowboarders ( n = 29), and sledders ( n = 40). Athletes were predominantly male and presented hypothermic at emergency room arrival, despite a large proportion of air rescue (77 %). Alpine skiing was associated with higher injury severity (ISS 20.8 ± 14.0, p = 0.010) when compared with snowboarding (ISS 18.7 ± 14.0) and sledding (ISS 13.8 ± 9.5). Snowboarding was associated with the highest pre-hospital intubation rate (40.9 %, p = 0.007), despite comparable GCS values and prevalence of loss of consciousness at scene. The injury patterns were different between the three groups. Skiing was associated with head (47.1 %), chest (40.2 %, p = 0.047), and spinal injuries (40.9 %, p = 0.022). Snowboarding was associated with the highest percentage of upper extremity trauma. Sledders had the highest prevalence of facial and lower extremity trauma. Conclusions: Alpine skiing, snowboarding, and sledding result in different injury patterns and affect various age groups. Our data suggest an increased risk for chest and spinal injuries in Alpine skiers. Due to high-energy injury mechanisms, all three winter sports involve a risk of severe multiple trauma. While all athlete groups required a high rate of emergency surgery procedures, the observed in-hospital mortality from winter sports remains low. [ABSTRACT FROM AUTHOR]

Background/Objectives: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort. Methods: Dietary data at baseline were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing. Results: Mean total polyphenol intake was the highest in Aarhus-Denmark (1786 mg/day in men and 1626 mg/day in women) and the lowest in Greece (744 mg/day in men and 584 mg/day in women). When dividing the subjects into three regions, the highest intake of total polyphenols was observed in the UK health-conscious group, followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5-56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1-61.7 %). Coffee, tea, and fruits were the most important food sources of total polyphenols. A total of 437 different individual polyphenols were consumed, including 94 consumed at a level >1 mg/day. The most abundant ones were the caffeoylquinic acids and the proanthocyanidin oligomers and polymers. Conclusion: This study describes the large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries. [ABSTRACT FROM AUTHOR]

Over a period of 5 years, the Innovative Medicines Initiative PROTECT (Pharmacoepidemiological Research on Outcomes of Therapeutics by a European ConsorTium) project has addressed key research questions relevant to the science of safety signal detection. The results of studies conducted into quantitative signal detection in spontaneous reporting, clinical trial and electronic health records databases are summarised and 39 recommendations have been formulated, many based on comparative analyses across a range of databases (e.g. regulatory, pharmaceutical company). The recommendations point to pragmatic steps that those working in the pharmacovigilance community can take to improve signal detection practices, whether in a national or international agency or in a pharmaceutical company setting. PROTECT has also pointed to areas of potentially fruitful future research and some areas where further effort is likely to yield less. [ABSTRACT FROM AUTHOR]

The article presents a study on the impact of multimorbidity on the frequency of participation of older people in Europe in social leisure activities. Topics include the use of data from the European Project on Osteoarthritis (EPOSA), the concept of multimorbidity, and the individual and environmental factors that predict social leisure activity participation among the elderly. It also discusses the continuity theory of Robert Atchley.

The European framework surrounding clinical trials on medicinal products for human use is going to change as demonstrated by the large debate at European institutional level. One of the major challenges is to overcome the lack of harmonisation of clinical trial procedures among countries. This aspect is gaining more and more importance, considering the increasing number of multicentre and multinational studies. In this work, the actual European rules governing the Clinical Trial Application have been analysed throughout the different steps including the registration of the trial in the European database; the preparation of documents to be submitted and their contents; the preparation of documents related to the information and consent process; the submission to competent bodies. Specific issues related to paediatric research and trials involving non EU/EEA countries have been addressed as well. Results reveal that the European legislation offers a well defined set of European rules covering different aspects of a Clinical Trial Application. However, these are not suitable to meet the challenges from multicentre and multinational clinical studies. A stronger set of rules, such as is available in a composite European Regulation has been adopted and is expected to harmonise practices and enable sponsors to carry out well conducted trials. But will the new regulation overcome the existing criticisms of Directive 2001/20/EC? [ABSTRACT FROM AUTHOR]

Purpose: The European 'Healthy Lifestyle in Europe by Nutrition in Adolescence' (HELENA) project evaluated two different approaches to harmonize the matching procedures between 24-h recall data and food composition databases. In the first approach, the 24-h recall data were linked to the local/national food composition databases using standardized procedures, while in the second approach, the 24-h recall data were linked to the German BLS database which includes a larger food list. The aim of this paper was to compare the intakes of energy and eight nutrient components calculated via both approaches. Methods: Two non-consecutive 24-h recalls were performed in 1268 adolescents. Energy, carbohydrates, proteins, fat, fiber, water, alcohol, calcium and vitamin C were calculated via the two approaches at individual level. Paired samples t test and Pearson's correlations were used to compare the mean intakes of energy and the eight mentioned nutrients and to investigate the possible associations between the two approaches. Results: Small but significant differences were found between the intakes of energy and the eight food components when comparing both approaches. Very strong and strong correlations (0.70-0.95) were found between both methods for all nutrients. Conclusion: The dietary intakes obtained via the two different linking procedures are highly correlated for energy and the eight nutrients under study. [ABSTRACT FROM AUTHOR]

Introduction/purpose: In adult scoliosis surgery (AS) delineation of risk factors contributing to failure is important to improve patient care. Treatment goals include deformity correction resulting in a balanced spine and horizontal lowest instrumented vertebra (LIV) in fusions not ending at S1. Therefore, the study objectives were to determine predictors for deformity correction, complications, revision surgery, and outcomes as well as to determine predictors of postoperative evolution of the LIV-take-off angle (LIV-TO) and symptomatic adjacent segment disease (ASD).Methods: The authors performed a retrospective analysis of 448 patients who had AS surgery. Patients' age averaged 51 years, BMI 26, and follow-up of 40 months. According to the SRS adult scoliosis classification, 51 % of patients had major lumbar curves, 24 % each with single thoracic or double major curves. 54 % of patients had stable vertebra at L5 and 34 % of patients had fusion to S1. The mean number of posterior fusion levels was eight and implant density 73 %. Among standard radiographic measures of deformity the LIV-TO was assessed on neutral and bending/traction-films (bLIV-TO). Clinical outcomes were assessed in 145 patients with degenerative-type AS using validated measures (ODI, COMI and SF-36). Prediction analysis was conducted with stepwise multiple regression analyses.Results: Preoperative thoracic curve (TC) was 53° and 33° at follow-up. Preoperative lumbar curve (LC) was 43° and 24° at follow-up. Curve flexibility was low (TC 34 %/LC 38 %). TC-correction (38 %) was predicted by preoperative TC (r = 0.9) and TC-flexibility (r = 0.8). LC-correction (50 %) was predicted by preoperative LC (r = 0.8), LC-flexibility (r = 0.8) and screw density (r = 0.7). Preoperative LIV-TO was 18.2° and at follow-up 9.4° (p < 0.01). 20 % of patients had a non-union (18 % at L5-S1). The risk for non-union at L5-S1 increased with age (p = 0.04), low screw density (p = 0.03), and postoperative sagittal imbalance [(T9-tilt (p = 0.01), C7-SVA (p = 0.01), LL (p = 0.01) and PI-LL mismatch (p = 0.01)]. 32 % of patients had revision surgery. Risk for revision was increased in fusions to S1 (p < 0.01), increased BMI (p < 0.01), sagittal imbalance (C7-SVA, p < 0.01), age (p = 0.02), and disc wedging distal to the LIV (p < 0.01). To a varying extent, clinical outcomes negatively correlated (p < 0.05) with revision, ASD, perioperative complications, age, low postoperative TC- and LC-correction, and sagittal and coronal imbalance at follow-up (C7-SVA, PT, and C7-CSVL). 59 patients had ASD, which correlated with preoperative and postoperative sagittal and coronal parameters of deformity. In a multivariate model, preoperative bLIV-TO (p < 0.01) and preoperative LIV-TO (p < 0.01) demonstrated the highest predictive strength for follow-up LIV-TO.Conclusion: In the current study, the magnitude of deformity correction in the sagittal and coronal planes was shown to have significant impact on radiographic and clinical outcomes as well as revision rates. Findings indicate that risks for complications might be reduced by restoration of sagittal balance, appropriate deformity correction and advanced lumbosacral fixation. The use of preoperative LIV-TO and LIV-TO on bending/traction-films were shown to be useful for surgical planning, selection of the LIV and prediction of follow-up-TO, respectively. Parameters of sagittal balance rather than coronal deformity predicted ASD. [ABSTRACT FROM AUTHOR]

Background and Objective: Spontaneous reporting systems (SRSs) remain the cornerstone of post-marketing drug safety surveillance despite their well-known limitations. Judicious use of other available data sources is essential to enable better detection, strengthening and validation of signals. In this study, we investigated the potential of electronic healthcare records (EHRs) to be used alongside an SRS as an independent system, with the aim of improving signal detection.Methods: A signal detection strategy, focused on a limited set of adverse events deemed important in pharmacovigilance, was performed retrospectively in two data sources-(1) the Exploring and Understanding Adverse Drug Reactions (EU-ADR) database network and (2) the EudraVigilance database-using data between 2000 and 2010. Five events were considered for analysis: (1) acute myocardial infarction (AMI); (2) bullous eruption; (3) hip fracture; (4) acute pancreatitis; and (5) upper gastrointestinal bleeding (UGIB). Potential signals identified in each system were verified using the current published literature. The complementarity of the two systems to detect signals was expressed as the percentage of the unilaterally identified signals out of the total number of confirmed signals. As a proxy for the associated costs, the number of signals that needed to be reviewed to detect one true signal (number needed to detect [NND]) was calculated. The relationship between the background frequency of the events and the capability of each system to detect signals was also investigated.Results: The contribution of each system to signal detection appeared to be correlated with the background incidence of the events, being directly proportional to the incidence in EU-ADR and inversely proportional in EudraVigilance. EudraVigilance was particularly valuable in identifying bullous eruption and acute pancreatitis (71 and 42 % of signals were correctly identified from the total pool of known associations, respectively), while EU-ADR was most useful in identifying hip fractures (60 %). Both systems contributed reasonably well to identification of signals related to UGIB (45 % in EudraVigilance, 40 % in EU-ADR) but only fairly for signals related to AMI (25 % in EU-ADR, 20 % in EudraVigilance). The costs associated with detection of signals were variable across events; however, it was often more costly to detect safety signals in EU-ADR than in EudraVigilance (median NNDs: 7 versus 5).Conclusion: An EHR-based system may have additional value for signal detection, alongside already established systems, especially in the presence of adverse events with a high background incidence. While the SRS appeared to be more cost effective overall, for some events the costs associated with signal detection in the EHR might be justifiable. [ABSTRACT FROM AUTHOR]

Introduction: Research on associations between medication use during pregnancy and congenital anomalies is significative for assessing the safe use of a medicine in pregnancy. Congenital anomaly (CA) registries do not have optimal information on medicine exposure, in contrast to prescription databases. Linkage of prescription databases to the CA registries is a potentially effective method of obtaining accurate information on medicine use in pregnancies and the risk of congenital anomalies.Methods: We linked data from primary care and prescription databases to five European Surveillance of Congenital Anomalies (EUROCAT) CA registries. The linkage was evaluated by looking at linkage rate, characteristics of linked and non-linked cases, first trimester exposure rates for six groups of medicines according to the prescription data and information on medication use registered in the CA databases, and agreement of exposure.Results: Of the 52,619 cases registered in the CA databases, 26,552 could be linked. The linkage rate varied between registries over time and by type of birth. The first trimester exposure rates and the agreements between the databases varied for the different medicine groups. Information on anti-epileptic drugs and insulins and analogue medicine use recorded by CA registries was of good quality. For selective serotonin reuptake inhibitors, anti-asthmatics, antibacterials for systemic use, and gonadotropins and other ovulation stimulants, the recorded information was less complete.Conclusion: Linkage of primary care or prescription databases to CA registries improved the quality of information on maternal use of medicines in pregnancy, especially for medicine groups that are less fully registered in CA registries. [ABSTRACT FROM AUTHOR]

Purpose: To examine patterns of outpatient and community antibiotic use among adults in five European countries. Methods: We used healthcare data of 28.8 million adults from six population-based ARITMO project databases to ascertain information on systemic antibiotic use in Denmark (2000-2008), the Netherlands (1999-2010), Italy (2000-2010), the UK (1996-2009), and Germany (2004-2008). We estimated overall, and age-group and sex specific antibiotic use as defined daily doses (DDD) per 1000 inhabitants per day. We computed annual age- and sex-standardized population prevalence of antibiotic use per 1000 persons-years (p-y) and the mean duration (in days) of antibiotic use. Results: The overall antibiotic use varied from 8.7 DDD per 1000 inhabitants per day in the UK to 18.1 DDD in Denmark, representing a 2.1-fold geographical variation. In all countries, prescribing was relatively high among individuals aged 15-19 years; lower in those aged 20-50 years; and then increased steadily reaching 41.8 DDD per 1000 inhabitants per day in individuals ≥85 years in Denmark. After age- and sex-standardization, prevalence of antibiotic use varied threefold from 160.2/1000 p-y in the UK to 421.1/1000 p-y in Italy. The ratio of broad- to narrow-spectrum penicillin, cephalosporin, and macrolide use varied from 0.6 in Denmark to 120.2 in Italy. Women used more antibiotics than men did in all countries. Across countries, the mean duration of antibiotic use varied 1.3 to 21.1-fold for different antibiotics. Conclusions: Antibiotic use is high in women and the elderly. Prescribing patterns vary substantially across European countries, both according to overall consumption, user prevalence, duration, and narrow- versus broad-spectrum antibiotics. [ABSTRACT FROM AUTHOR]

The motivation, history and status of coordination of education and training in nuclear- and radiochemistry in Europe are reviewed. The achievements of the Euratom FP7 project 'Cooperation In education in Nuclear CHemistry (CINCH)' are described. Attention is paid to the results of the survey of universities teaching nuclear chemistry and their respective curricula evaluation, to the plan to introduce the EuroMaster in nuclear- and radiochemistry quality label recognized and guaranteed by the European Association for Chemical and Molecular Sciences (EuCheMS), and to CINCH NucWik-an interactive database proposed and implemented as an open structure in the form of a 'Wiki'. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to ascertain acute liver injury (ALI) in primary care databases using different computer algorithms. The aim of this investigation was to study and compare the incidence of ALI in different primary care databases and using different definitions of ALI. Methods: The Clinical Practice Research Datalink (CPRD) in UK and the Spanish 'Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria' (BIFAP) were used. Both are primary care databases from which we selected individuals of all ages registered between January 2004 and December 2009. We developed two case definitions of idiopathic ALI using computer algorithms: (i) restrictive definition (definite cases) and (ii) broad definition (definite and probable cases). Patients presenting prior liver conditions were excluded. Manual review of potential cases was performed to confirm diagnosis, in a sample in CPRD (21 %) and all potential cases in BIFAP. Incidence rates of ALI by age, sex and calendar year were calculated. Results: In BIFAP, all cases considered definite after manual review had been detected with the computer algorithm as potential cases, and none came from the non-cases group. The restrictive definition of ALI had a low sensitivity but a very high specificity (95 % in BIFAP) and showed higher rates of agreement between computer search and manual review compared to the broad definition. Higher incidence rates of definite ALI in 2008 were observed in BIFAP (3.01 (95 % confidence interval (CI) 2.13-4.25) per 100,000 person-years than CPRD (1.35 (95 % CI 1.03-1.78)). Conclusions: This study shows that it is feasible to identify ALI cases if restrictive selection criteria are used and the possibility to review additional information to rule out differential diagnoses. Our results confirm that idiopathic ALI is a very rare disease in the general population. Finally, the construction of a standard definition with predefined criteria facilitates the timely comparison across databases. [ABSTRACT FROM AUTHOR]

Purpose: Drug utilization studies have applied different methods to various data types to describe medication use, which hampers comparisons across populations. The aim of this study was to describe the time trends in antidepressant prescribing in the last decade and the variation in the prevalence, calculated in a uniform manner, in seven European electronic healthcare databases. Methods: Annual prevalence per 10,000 person-years (PYs) was calculated for 2001-2009 in databases from Spain, Germany, Denmark, the United Kingdom (UK), and the Netherlands. Prevalence data were stratified according to age, sex, antidepressant type (selective serotonin re-uptake inhibitors [SSRIs] or tricyclic antidepressants [TCAs]) and major indications. Results: The age- and sex-standardized prevalence was lowest in the two Dutch (391 and 429 users per 10,000 PYs) and highest in the two UK (913 and 936 users per 10,000 PYs) populations in 2008. The prevalence in the Danish, German, and Spanish populations was 637, 618, and 644 users per 10,000 PY respectively. Antidepressants were prescribed most often in 20- to 60-year-olds in the two UK populations compared with the others. SSRIs were prescribed more often than TCAs in all except the German population. In the majority of countries we observed an increasing trend of antidepressant prescribing over time. Two different methods identifying recorded indications yielded different ranges of proportions of patients recorded with the specific indication (15-57 % and 39-69 % for depression respectively). Conclusion: Despite applying uniform methods, variations in the prevalence of antidepressant prescribing were obvious in the different populations. Database characteristics and clinical factors may both explain these variations. [ABSTRACT FROM AUTHOR]

MALDI-TOF MS profiling has proved to be efficient for arthropod identification at the species level. However, prior to entomological monitoring, the reference spectra database should cover relevant species. Here, 74 specimens were field-collected from 11 mosquito species captured in two distinct European areas and used either to increment our database or for blind tests. Misidentification was not noted, underlining the power of this approach. Nevertheless, three out of the 26 specimens used for the blind test did not reach the significant identification threshold value set, attributed to lower spectral quality. In the future, the quality control spectra parameters need to be defined to avoid not achieving significant threshold identification. [ABSTRACT FROM AUTHOR]

This paper presents the overall procedure followed in order to assemble the most recent pan-European strong-motion databank: Reference Database for Seismic Ground-Motion in Europe (RESORCE). RESORCE is one of the products of the SeIsmic Ground Motion Assessment (SIGMA; projet-sigma.com) project. RESORCE is intended to be a single integrated accelerometric databank for Europe and surrounding areas for use in the development and testing of ground-motion models and for other engineering seismology and earthquake engineering applications. RESORCE aims to contribute to the improvement of earthquake risk studies in Europe and surrounding areas. RESORCE principally updates and extends the previous pan-European strong-motion databank (Ambraseys et al. in Bollettino di Geofisica Teorica ed Applicata 45:113-129, ) with recently compiled Greek, Italian, Swiss and Turkish accelerometric archives. The updates also include earthquake-specific studies published in recent years. The current content of RESORCE includes 5,882 multi-component and uniformly processed accelerograms from 1,814 events and 1,540 strong-motion stations. The moment magnitude range covered by RESORCE is $$2.8 \le \hbox {M}_{\mathrm{w}} \le 7.8$$ . The source-to-site distance interval extends to 587 km and distance information is given by the common point- and extended-source distance measures. The paper presents the current features of RESORCE through simple statistics that also quantify the differences in metadata and strong-motion processing with respect to the previous version of the pan-European strong-motion databank. [ABSTRACT FROM AUTHOR]

Management of renal anemia in the large and at-risk population of non-dialysis chronic kidney disease (CKD) patients is a critical issue. In particular, definition of the optimal hemoglobin (Hb) target for therapy is controversial but highly warranted by physicians and patients worldwide. Recently, international clinical practice guidelines have recommended delayed initiation of erythropoiesis-stimulating agents (ESA) and lower Hb target levels during maintenance therapy. However, geographical differences in terms of ESA dose needed to achieve a given Hb value can be evidenced, with US patients showing higher prevalence of ESA resistance. On the other hand, non-US patients are often maintained in a higher Hb range by means of low ESA doses. This critical point has never been addressed. Nevertheless, outside of the US, translating the restrictive recommendations of new guidelines, which are essentially based on trials in US patients, can lead to negative effects, such as an increased need for a blood transfusion, and worsening of quality of life. In this article we provide a reappraisal of current recommendations on anemia management in non-dialysis CKD in light of the geographical differences in individual responsiveness to ESA. [ABSTRACT FROM AUTHOR]

To compile an inventory of European healthcare databases with potential to study long-term effects of methylphenidate (MPH) in patients with attention deficit hyperactivity disorder (ADHD). Potential databases were identified through expert opinion, the website of the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance, and literature search. An online survey was conducted among database providers/coordinators to ascertain the databases’ appropriateness for inclusion into the inventory. It included questions about database characteristics, sample size, availability of information on drug exposure, clinical data and accessibility. Forty-two databases from 11 countries were identified and their coordinators invited to participate; responses were obtained for 22 (52.4 %) databases of which 15 record ADHD diagnoses. Eleven had sufficient data on ADHD diagnosis, drug exposure, and at least one type of outcome information (symptoms/clinical events, weight, height, blood pressure, heart rate) to assess MPH safety. These were Aarhus University Prescription Database, Danish National Birth Cohort (Denmark); German Health Interview and Examination Survey for Children and Adolescents; Health Search Database Thales, Italian ADHD Register, Lombardy Region ADHD Database (Italy); Avon Longitudinal Study of Parents and Children, General Practice Research Database, The Health Improvement Network, QResearch (UK) and IMS Disease Analyzer (UK, Germany, France). Of the 20 databases with no responses, information on seven from publications and/or websites was obtained; Pedianet and the Integrated Primary Care Information database were considered suitable. Many European healthcare databases can be used for multinational long-term safety studies of MPH. Methodological research is underway to investigate the feasibility of their pooling and analysis. [ABSTRACT FROM AUTHOR]

The live, attenuated shingles (herpes zoster) vaccine Zostavax is approved in the EU for use in the prevention of herpes zoster and postherpetic neuralgia in adults aged ≥50 years. In adults aged ≥60 years, zoster vaccine reduced the burden of illness associated with herpes zoster, with reductions in the incidence of postherpetic neuralgia and herpes zoster, according to the results of the Shingles Prevention Study. Results of subsequent Short- and Long-Term Persistence Substudies indicate that the efficacy of zoster vaccine is maintained in the longer term, albeit with a gradual decline over time. In the Zostavax Efficacy and Safety Trial, zoster vaccine reduced the incidence of herpes zoster in adults aged 50-59 years. Findings of these studies are supported by the results of large, retrospective, cohort studies. Zoster vaccine was generally well tolerated, with injection-site adverse events being the most commonly reported adverse events. In conclusion, zoster vaccine provides an important opportunity to reduce the burden of illness associated with herpes zoster by reducing the incidence of herpes zoster and postherpetic neuralgia. [ABSTRACT FROM AUTHOR]

S-1 (Teysuno) is an oral anticancer agent comprising the 5-fluorouracil (5-FU) prodrug tegafur and targeted modulators, gimeracil and oteracil. S-1 in combination with cisplatin is a recommended first-line treatment for gastrointestinal cancers in Japan and has recently been approved in the EU for the treatment of advanced gastric cancer. This article reviews S-1 pharmacology from an EU perspective. In a randomized, open-label trial in 24 non-Asian countries in patients with advanced gastric cancer, there were no significant differences between S-1 plus cisplatin and 5-FU plus cisplatin groups in median overall survival (OS) [primary endpoint], progression-free survival or overall response rate. In a post hoc analysis of OS, S-1 plus cisplatin was noninferior to 5-FU plus cisplatin. There were no significant between-group differences in patient quality of life, according to the Functional Assessment of Cancer Therapy (Gastric) Trial Outcome Index, except that S-1 plus cisplatin recipients had a significantly longer time to worsening in physical well-being than 5-FU plus cisplatin recipients. Overall, S-1 plus cisplatin was better tolerated than 5-FU plus cisplatin, with significantly lower rates of haematological, some gastrointestinal tract and other adverse events, serious adverse events and deaths resulting from toxicity, along with significantly fewer haematological and renal function abnormalities. Compared with 5-FU, S-1 plus cisplatin recipients had significantly higher rates of hand-foot syndrome and hyperbilirubinaemia, although there were no between-group differences in the proportions of patients with increased liver enzymes. S-1 is a useful alternative to 5-FU for patients with advanced gastric cancer. [ABSTRACT FROM AUTHOR]

The implementation of the Water Framework Directive has required intense research in applied aquatic ecology in Europe, and thus created challenges for data management in international research projects. In the project Waterbodies in Europe: Integrative Systems to assess Ecological status and Recovery (WISER), biological and environmental data from rivers, lakes, transitional and coastal waters in 26 European countries were collated. More than one million records of biological observations were stored in the project's central database, representing phytoplankton, macrophytes, macroalgae, angiosperms, phytobenthos, invertebrates and fish. The central database includes new data from the WISER field campaign in lakes and transitional/coastal waters during 2009-2010 (more than 6,000 biological samples from 58 waterbodies in 14 countries). The purpose of this paper is to provide an overview of the data collated within WISER, in order to facilitate future re-use of these data by other scientists. More specifically, the objectives are to (1) describe the data management in WISER, (2) describe the structure and content of the WISER central database and (3) share experiences and give recommendations for data management in large ecological research projects. [ABSTRACT FROM AUTHOR]

Disparate ecological datasets are often organized into databases post hoc and then analyzed and interpreted in ways that may diverge from the purposes of the original data collections. Few studies, however, have attempted to quantify how biases inherent in these data (for example, species richness, replication, climate) affect their suitability for addressing broad scientific questions, especially in under-represented systems (for example, deserts, tropical forests) and wild communities. Here, we quantitatively compare the sensitivity of species first flowering and leafing dates to spring warmth in two phenological databases from the Northern Hemisphere. One-PEP725-has high replication within and across sites, but has low species diversity and spans a limited climate gradient. The other-NECTAR-includes many more species and a wider range of climates, but has fewer sites and low replication of species across sites. PEP725, despite low species diversity and relatively low seasonality, accurately captures the magnitude and seasonality of warming responses at climatically similar NECTAR sites, with most species showing earlier phenological events in response to warming. In NECTAR, the prevalence of temperature responders significantly declines with increasing mean annual temperature, a pattern that cannot be detected across the limited climate gradient spanned by the PEP725 flowering and leafing data. Our results showcase broad areas of agreement between the two databases, despite significant differences in species richness and geographic coverage, while also noting areas where including data across broader climate gradients may provide added value. Such comparisons help to identify gaps in our observations and knowledge base that can be addressed by ongoing monitoring and research efforts. Resolving these issues will be critical for improving predictions in understudied and under-sampled systems outside of the temperature seasonal mid-latitudes. [ABSTRACT FROM AUTHOR]

This study examines the predictors of birth outcomes among women of European and African ancestry and considers the birthplace of the babies' fathers (foreign born vs. native born) as a protective factor. This is a secondary data analysis of 146,431 singleton births among women of European and African ancestry, both native-born and foreign-born, in a 21 birth hospital region of Central New York State from 1996 to 2003. Foreign born fathers were found to have 15% fewer low birth weight infants than US-born fathers, after controlling for the race and birthplace of the mother, tobacco use and Medicaid. Although this secondary data analysis does not allow us to determine the social determinants of the better birth outcomes among infants of foreign born fathers, it does demonstrate that fathers matter and that foreign born fathers are associated with reduced low birth weight in their infants. [ABSTRACT FROM AUTHOR]

Advances in the understanding of the molecular basis of diseases have expanded the number of plausible therapeutic targets for the development of innovative agents in recent decades. However, although investment in pharmaceutical research and development (R&D) has increased substantially in this time, the lack of a corresponding increase in the output in terms of new drugs being approved indicates that therapeutic innovation has become more challenging. Here, using a large database that contains information on R&D projects for more than 28,000 compounds investigated since 1990, we examine the decline of R&D productivity in pharmaceuticals in the past two decades and its determinants. We show that this decline is associated with an increasing concentration of R&D investments in areas in which the risk of failure is high, which correspond to unmet therapeutic needs and unexploited biological mechanisms. We also investigate the potential variations in productivity with regard to the regional location of companies and find that although companies based in the United States and Europe differ in the composition of their R&D portfolios, there is no evidence of any productivity gap. [ABSTRACT FROM AUTHOR]

The European Ocean Biogeographic Information System-EurOBIS-is an integrated data system developed by the Flanders Marine Institute (VLIZ) for the EU Network of Excellence 'Marine Biodiversity and Ecosystem Functioning' (MarBEF) in 2004. Its principle aims are to centralise the largely scattered biogeographical data on marine species collected by European institutions and to make these quality-controlled data freely available and easily accessible. It is in essence a distributed system in which individual datasets go through a series of quality control procedures before they are integrated into one large consolidated database. EurOBIS is freely available online at , where marine biogeographical data-with a focus on taxonomy, temporal and spatial distribution-can be consulted and downloaded for analyses. Over the last 6 years, EurOBIS has collected 228 datasets contributed by more than 75 institutes, representing over 13.6 million distribution records of which almost 12.5 million records are species level identifications. It is now the largest online searchable public source of European marine biological data, holding biogeographical information on 26,801 species and 9,221 genera. EurOBIS acts as the European node of OBIS, the Ocean Biogeographic Information System of the Census of Marine Life (CoML). EurOBIS shares its data with OBIS, which in its turn shares its content with the Global Biodiversity Information Facility (GBIF). This article describes the status of the European Ocean Biogeographic Information System, identifies data gaps, possible applications, uses and limitations. It also formulates a strategy for the growth and improvement of the system and wants to appeal for more contributions. [ABSTRACT FROM AUTHOR]

im: Although working life issues are subject to European health monitoring schemes, not many routine data sources include information on occupations or working conditions. Additional in-depth analysis is therefore necessary for diseases with high public health impact. The aim of this paper is to introduce a multidimensional ranking procedure for priority setting of diseases based on European and national data. Subject and methods: Multidimensional ranking was carried out on ten disease-specific indicators. First, suitable data sources were identified and information on indicators was retrieved. Second, the diseases were sorted by their ranks according to each indicator. Third, all ranks were added to a rank sum. Finally, the diseases were sorted by their rank sum. Results: Diseases of the circulatory system account for the highest rank sum. The high public health impact is visible in regard to most criteria, particularly to mortality, hospital discharges, and costs. Diseases of the digestive system rank second mainly because of high ranks for hospital discharges and costs. The third place is assigned to diseases of the musculoskeletal system. Conclusion: A multidimensional ranking procedure has advantages when used for priority setting of diseases. The procedure leads to an overall rank as a summary measure for the public health impact but information for each indicator is still retrieved. Furthermore, the procedure uses ranks and is therefore scale invariant. However, ranking procedures do not lead to a selection of diseases but a rank order. So, there is still a decision rule required to determine which diseases are selected e.g. for in-depth health reporting. [ABSTRACT FROM AUTHOR]

We describe a palaeolimnological meta-database ('LakeCores') that includes information for lakes in Europe that have been cored for studies of recent environmental change. Only cores with intact mud-water interfaces and good chronologies for the last ~100-200 years are currently included. The information provided in the database includes the general characteristics of the lakes cored, the methods used for dating and analysis and the bibliographic source of the information selected. At present the database contains information on 1847 studies from 975 sites. Here we use the database to identify cores for which diatom-based pH and total phosphorus (TP) reconstructions have been derived and, from an inspection of the relevant papers, we compile summary data for the timing and extent of acidification and eutrophication of lakes across Europe. We show that there were few cases of acidification and eutrophication in Europe prior to about 1850, and therefore that conditions prior to 1850 can be used for reference with respect to current attempts to restore surface waters to 'good ecological status'. We also show the extent to which pH and TP levels have changed across the continent both for all lakes, and, in the case of TP, for lakes of different types covering a range of alkalinities, altitudes, water depths and surface areas. [ABSTRACT FROM AUTHOR]

Ratings of realism, masculinity, race, and racial stereotypy were collected on a set of computer-generated faces representing European, South East Asian, and African American ethnicities. To determine if these faces are processed in the same way as photographs of real faces, we demonstrated with these faces superior memory performance for upright faces over inverted faces (the face inversion effect). Further, in observers of European decent, we found both superior memory for European faces and a larger inversion effect for European than African American faces. Based on these results, we believe that this set of faces may be of use in perceptual investigations in which race is a critical manipulation. [ABSTRACT FROM AUTHOR]