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This paper studies a pickup and delivery routing problem for fourth‐party logistics providers. The problem aims to schedule routes of vehicles to pick up orders from suppliers and deliver them to factory locations considering multiple time windows at suppliers and factory locations, a non‐conventional cost structure, and certain factory dock constraints. We formulate the problem as a mathematical model and develop an efficient algorithm based on the adaptive large neighborhood search to solve the problem. The algorithm incorporates several heuristics to efficiently explore the search space for optimal solutions. The algorithm is refined through extensive statistical experiments to optimize the performances of the heuristics and to tune the parameters of the algorithm. The mathematical model and algorithm are evaluated on several problem instances based on a real case study in Europe. The numerical results demonstrate that the solution algorithm consistently obtains near‐optimal solutions to real‐sized problem instances. [ABSTRACT FROM AUTHOR]

Introduction: Current legislation leaves Oral Health Professional (OHP) education open to wide interpretation and may result in significant variation in educational practice and resultant professional attributes across Europe. Data regarding the current state of OHP education across Europe is limited. The aim of Part 1 of this series is to provide programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education., Methods: A 91-item questionnaire was developed following the Delphi method. The questionnaire and the Articulate glossary of OHP education terms were developed concurrently to facilitate a common understanding of language. Piloting was performed in multiple stages and included institutions internal and external to the research group. The questionnaire was uploaded online and converted to a data hub, allowing dental schools to control their own data and update the data provided whenever they wish. All ADEE member schools (n = 144) were invited to provide data. Forty questions relating to school details, Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education were included in this part of the series., Results: Seventy-one institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education is presented including programme length, funding, languages and fees, student numbers and demographics, student admission and selection processes and permission to practice after graduation., Conclusion: This series of papers, as far as the authors are aware, are the first attempts to build a comprehensive picture of the current state of OHP education in Europe. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe., (© 2024 The Authors. European Journal of Dental Education published by John Wiley & Sons Ltd.)

Introduction: Oral health professional (OHP) education is likely to vary across Europe in accordance with an EU directive that is open to broad interpretation. It is not clear how OHP curricula are structured or delivered across Europe. The objectives of Part 2 of this paper series are: (i) to provide an overview of common practices in curriculum structure, the availability of facilities, staffing (faculty) and quality assurance processes and (ii) to consider how the existing programme structures align to stakeholder guidance documents., Methods: A total of 27 questions from a 91-item questionnaire were used for this manuscript. The questionnaire was developed following the Delphi method to establish consensus from a group of experts. Members of the research team and colleagues from other countries in Europe completed a multi-step piloting process. An online data hub was created to allow the respondents to be data controllers and respond to the questionnaire. ADEE member schools (n = 144) were invited to provide data., Results: Totally, 71 institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Data on curriculum approaches, teaching methods, integration of topics of interest, clinical education, staff-student ratios, access to facilities and new technologies, teaching staff (faculty) and quality assurance processes are presented for Primary Dental Degree Programmes., Conclusion: To the best of our knowledge, this series of papers are the first attempts to provide a comprehensive overview of OHP education in Europe. Results showed that the majority of European dental programmes are engaged in providing innovative and scientifically grounded education in order to develop quality future OHPs. Nevertheless, significant variability in the delivery of clinical education across the European OHP schools was notable in this dataset. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe., (© 2024 The Authors. European Journal of Dental Education published by John Wiley & Sons Ltd.)

There is a large body of literature demonstrating a social gradient in health and increasing evidence of an association between social deprivation and diabetes complications. Diabetic kidney disease (DKD) increases mortality in people with diabetes. Socioeconomic deprivation is increasingly recognized as a modifier of risk factors for kidney disease but also an independent risk factor itself for kidney disease. This may not be truly appreciated by clinicians and warrants further attention and exploration. In this review we explore the literature to date from Europe on the relationship between social deprivation and DKD. The majority of the studies showed at least an association with microalbuminuria, an early marker of DKD, while many showed an association with overt nephropathy. This was seen across many countries in Europe using a variety of different measures of deprivation. We reviewed and considered the mechanisms by which deprivation may lead to DKD. Health related behaviors such as smoking and suboptimal control of risk factors such as hypertension, hyperglycemia and elevated body mass index (BMI) accounts for some but not all of the association. Poorer access to healthcare, health literacy, and stress are also discussed as potential mediators of the association. Addressing deprivation is difficult but starting points include targeted interventions for people living in deprived circumstances, equitable roll out of diabetes technology, and flexible outpatient clinic arrangements including virtual and community‐based care. [ABSTRACT FROM AUTHOR]

Motivated by the growing prominence of fertility incentivisation and long‐term child development in European family policymaking, this paper examines the distribution of financial support for parents over the course of childhood and between birth orders in Europe. We use the term 'older‐oriented age bias' to refer to support that is more generous for older children and the term 'younger‐oriented age bias' for more generous support for younger children. Similarly, we refer to distribution patterns tilted towards later birth orders as 'later‐oriented parity bias' and to those that favour earlier birth orders as 'earlier‐oriented parity bias'. Based on a list of four classical policy functions of financial support for parents (child cost compensation, fertility incentivisation, child poverty reduction, and child development), we formulate six (sets of) hypotheses for the age and parity distribution of financial support for parents. To assess these distribution patterns, we examine monthly financial support (allowance‐ and tax‐based) for the first four birth orders at child ages 2, 9, and 17 in low‐income and middle‐income households across 28 European countries as of January 2021. We find that European welfare states typically provide more generous support for younger children, while the support distribution in terms of birth orders depends on pre‐support household income. We also find considerable cross‐country heterogeneity, with fertility incentivisation and (especially) child development being reflected by more countries than child cost compensation and poverty reduction. Our analysis sheds light on previously underexplored trends and implications in the design of financial support for parents in Europe. [ABSTRACT FROM AUTHOR]

Background: There are few studies on bullying in skin diseases. Persons with skin diseases are especially prone to bullying., Objectives: This component of the project 'Bullying among Dermatologic Patients' aimed to study the prevalence and nature of bullying in patients with skin diseases from different countries and age groups., Methods: Data were collected from participants of international social media groups for patients with skin diseases, in-patients and out-patients with skin diseases, and parents of children with skin diseases from six European countries. School and university students from Poland and Ukraine were asked to answer the question: Have you been bullied because of skin problems?, Results: Bullying was reported in 1016 patients with 36 different skin diseases. Prevalence of self-reported and parental-reported bullying was quite heterogeneous among different countries In total, self-reported bullying was noted by 25.6% of patients with skin diseases during face-to-face consultations, by 63.7% of respondents from international patients' groups and by 12.2% of school and university students. Parental-reported bullying was detected in 34.5% of 3-4 years old children with skin diseases. The peak of bullying prevalence occurred between the ages of 13 and 15. The most prevalent forms of bullying were verbal abuse and social isolation. Physical abuse was the least often reported form of bullying. Only 33.2% of participants talked to anyone about being bullied. Negative long-term effects of bullying were reported by 63% of respondents., Conclusions: Skin disease-related bullying was reported by patients in all centres of the project. The main manifestations of bullying were similar in different countries and among patients with different skin diseases. International activities aimed to decrease or prevent skin disease-related bullying in different age groups are needed. These activities should be multidirectional and target teachers, parents of classmates and classmates of children with skin diseases, patients' parents and patients themselves., (© 2023 European Academy of Dermatology and Venereology.)

This paper discusses the historical and social origins of the bifurcation in the political institutions of China and Western Europe. An important factor, recognized in the literature, is that China centralized state institutions very early on, while Europe remained politically fragmented for much longer. These initial differences, however, were amplified by the different social organizations (clans in China, corporate structures in Europe) that spread in these two societies at the turn of the first millennium AD. State institutions interacted with these organizations, and were shaped and influenced by this interaction. The paper discusses the many ways in which corporate organizations contributed to the emergence of representative institutions and gave prominence to the Rule of Law in the early stages of state formation in Europe, and how specific features of lineage organizations contributed to the consolidation of the Imperial regime in China. This publication follows on from the Economica Phillips 2022 lecture presented by Professor Guido Tabellini on 01 December 2022. [ABSTRACT FROM AUTHOR]

We document the spiral of populism in Europe and the direct and indirect role of economic insecurity shocks. Using survey data on individual voting, we make two contributions to the literature. (i) Economic insecurity shocks have a significant impact on the populist vote share, directly as demand for protection, and indirectly through the induced changes in trust and attitudes. (ii) A key consequence of increased economic insecurity is a drop in turnout. The impact of this largely neglected turnout effect is substantial: conditional on voting, when economic insecurity increases, almost 40% of the induced change in the vote for a populist party comes from the turnout channel. This paper is part of the Economica 100 Series. Economica, the LSE "house journal" is now 100 years old. To commemorate this achievement, we are publishing 100 papers by former students, as well as current and former faculty. Tommaso Sonno obtained his PhD from the LSE and is a CEP Associate. luigi Guiso obtained his MSc from the LSE and is a fellow at the CEP. [ABSTRACT FROM AUTHOR]

The seed‐endophytic bacterial community is a potentially beneficial and heritable fraction of the plant microbiome. Its utilization as a sustainable crop improvement strategy could be especially valuable for species such as hemp, where production is being scaled up and new challenges will be faced in managing crop productivity and health. However, little is known about the makeup and variation of the hemp seed microbiome. This study profiled the endophytic bacterial communities harboured by 16 hemp cultivars sourced from commercial suppliers in Europe. A 16S rDNA amplicon sequencing approach identified 917 amplicon sequence variants across samples. Taxonomic classification of sequences revealed 4 phyla and 87 genera to be represented in the dataset. Several genera were widespread while some were specific to one or a few cultivars. Flavobacterium, Pseudomonas, and Pantoea were notable in their high overall abundance and prevalence, but community composition was variable and no one taxon was universally abundant, suggesting a high degree of flexibility in community assembly. Taxonomic composition and alpha diversity differed among cultivars, though further work is required to understand the relative influence of hemp genetic factors on community structure. The taxonomic profiles presented here can be used to inform further work investigating the functional characteristics and potential plant‐growth‐promoting traits of seed‐borne bacteria in hemp. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide an update on the development of the long‐term relative poverty rate in Europe. We use European Statistics on Income and Living Conditions data (EU‐SILC) for 26 European countries between 2009 and 2018. In addition to describing the development of long‐term poverty, we also analyse the drivers of poverty on the country level via fixed effects panel regression analysis. We are particularly interested in how economic growth, employment rates, social expenditure, and short‐term poverty rates are related to long‐term poverty. Overall, the results show that long‐term poverty has increased in 13 out of 26 countries, but was unchanged or decreased in 13 countries. Gross domestic product growth is not related to the development of long‐term poverty. However, we find that male employment and social welfare expenditure reduce poverty rates. Furthermore, short‐term poverty is negatively associated with long‐term poverty. Hence, short‐term poverty and long‐term poverty rather substitute than complement each other. [ABSTRACT FROM AUTHOR]

Stabilisers are an integral part of a propellant composition. They are essential for ensuring the chemical stability of nitrate‐ester based propellants, preventing oxidation, chain scission and uncontrolled heat generation. Progress is being made, especially in Europe, with REACh legislation (1907/2006) to use more environmentally‐friendly compounds. New stabilisers with a greener environmental profile and producing less toxic daughter products have been investigated by several groups, and several compounds demonstrated even better performances – more chemical stability and therefore longer shelf lives than formulations with the currently‐used stabilisers. Additionally, the good efficiencies and lower toxicities of the daughter products of the "green" stabilisers are also evaluated. This paper is a continuation of our previous work and demonstrates that for industrially‐manufactured propellants, that the tests performed by four different entities validate the stability and compatibility of the propellants, investigated previously on a laboratory scale, providing the community with safer formulations for the environment and health. [ABSTRACT FROM AUTHOR]

Precipitation projections in transient climate change scenarios have been extensively studied over multiple climate model generations. Although these simulations have also been used to make projections at specific Global Warming Levels (GWLs), dedicated simulations are more appropriate to study changes in a stabilizing climate. Here, we analyze precipitation projections in six multi‐century experiments with fixed atmospheric concentrations of greenhouse gases, conducted with the UK Earth System Model and which span a range of GWLs between 1.5 and 5°C of warming. Regions are identified where the sign of precipitation trends in high‐emission transient projections is reversed in the stabilization experiments. For example, stabilization reverses a summertime precipitation decline across Europe. This precipitation recovery occurs concurrently with changes in the pattern of Atlantic sea surface temperature trends due to a slow recovery of the Atlantic Meridional Overturning Circulation in the stabilization experiments, along with changes in humidity and atmospheric circulation. Plain Language Summary: Climate model projections consistently predict that summer precipitation over Europe is expected to decline in the future as global temperatures rise under continued global warming. In our study, we use new climate model simulations that simulate a world where atmospheric concentrations of greenhouse gases are no longer increasing and the rise in global temperatures has slowed down. We show that the summer rainfall decline across Europe can, to some extent, be reversed if global temperatures were to stabilize. This has important implications for adaptation and planning decisions, particularly in so‐called climate change "hot‐spots" such as the Mediterranean. Key Points: Climate stabilization experiments show significant differences in projected precipitation compared to high‐emission transient scenariosNorthern European and Mediterranean projected summer drying is partially reversedEuropean summer precipitation changes are consistent with the atmospheric response to Atlantic SST changes [ABSTRACT FROM AUTHOR]

Mid‐tropospheric deep depressions in summer over the North Atlantic are shown to have strongly increased in the eastern and strongly decreased in the western North Atlantic region. This evolution is linked to a change in baroclinicity in the west of the North Atlantic ocean and over the North American coast, likely due to the increased surface temperature there. Deep depressions in the Eastern North Atlantic are linked to a temperature pattern typical of extreme heat events in the region. The same analysis is applied to a sample of CMIP6 model outputs, and no such trends are found. This study suggests a link between the observed increase of summer extreme heat events in the region and the increase of the number of Atlantic depressions. The failure of CMIP6 models to reproduce these events can consequently also reside in an incorrect reproduction of this specific feature of midlatitude atmospheric dynamics. Plain Language Summary: Extreme temperatures events in Western Europe have been rising fast, and current global climate models are not able to reproduce this excess. There are different hypotheses to explain this discrepancy. One is that the large‐scale atmospheric dynamics, responsible for the local weather, is not correctly represented by the models: indeed, the frequency and amplitude of some specific weather phenomena have been shown to be insufficiently reproduced, especially in summer. Here, we study one such phenomenon, namely the transient deep depressions, or extratropical cyclones, that travel across the Atlantic basin. A significant large increase of the number of these events is found in summer in the region of the North Atlantic off the western European coast. Depressions in that region are accompanied by high temperatures in continental western Europe. An ensemble of state of the art climate models are also analyzed and none of them is able to correctly reproduce the frequency of deep depressions nor their large trend, which suggests a common origin with the insufficient prediction of western European extreme heat events. Great caution should be used when analyzing climate change predictions in the region, and even more so when studying changes in complex dynamical phenomena. Key Points: Deep depression occurrences have significantly increased over the eastern side, and decreased over the western side of the North AtlanticDeep depressions are linked to high surface temperature patterns in western continental Europe but have little impact on the mean warmingGlobal Climate Models fail to reproduce the observed trends in deep depressions correctly [ABSTRACT FROM AUTHOR]

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

Tree regeneration is a key process in forest dynamics, particularly in the context of forest resilience and climate change. Models are pivotal for assessing long‐term forest dynamics, and they have been in use for more than 50 years. However, there is a need to evaluate their capacity to accurately represent tree regeneration. We assess how well current models capture the overall abundance, species composition, and mortality of tree regeneration. Using 15 models built to capture long‐term forest dynamics at the stand, landscape, and global levels, we simulate tree regeneration at 200 sites representing large environmental gradients across Central Europe. The results are evaluated against extensive data from unmanaged forests. Most of the models overestimate recruitment levels, which is compensated only in some models by high simulated mortality rates in the early stages of individual‐tree dynamics. Simulated species diversity of recruitment generally matches observed ranges. Models simulating higher stand‐level species diversity do not feature higher species diversity in the recruitment layer. The effect of light availability on recruitment levels is captured better than the effects of temperature and soil moisture, but patterns are not consistent across models. Increasing complexity in the tree regeneration modules is not related to higher accuracy of simulated tree recruitment. Furthermore, individual model design is more important than scale (stand, landscape, and global) and approach (empirical and process‐based) for accurately capturing tree regeneration. Despite the mismatches between simulation results and data, it is remarkable that most models capture the essential features of the highly complex process of tree regeneration, while not having been parameterized with such data. We conclude that much can be gained by evaluating and refining the modeling of tree regeneration processes. This has the potential to render long‐term projections of forest dynamics under changing environmental conditions much more robust. [ABSTRACT FROM AUTHOR]

Reflexive commitments tend to be lacking, particularly from the perspective of early career scholars. This is particularly true in relation to published research, but evident in doctoral studies exploring teachers work. Using principles of phenomenological reflexivity, this methodological paper explores the critical incidents that have come to shape a qualitative, ethnographical case study before entering the field. Key findings highlight four implications for novice researchers: an engagement with critical independent reflection, critical friendship, skills development through academic modules and reflexive reading, and communities of practice. The paper calls for continued attention to the methodological framing of research, particularly during and after entering the field. [ABSTRACT FROM AUTHOR]

Background and purpose: Neurology residency programmes, which were first established at the beginning of the 20th century, have become mandatory all over Europe in the last 40–50 years. The first European Training Requirements in Neurology (ETRN) were published in 2005 and first updated in 2016. This paper reports the most recent revisions of the ETRN. Methods: Members of the EAN board performed an in depth revision of the ETNR 2016‐version, which was reviewed by members of the European Board and Section of Neurology of the UEMS, the Education and Scientific Panels, the Resident and Research Fellow Section and the Board of the EAN, as well as the presidents of the 47 European National Societies. Results: The new (2022) ETRN suggest a 5‐year training subdivided in three phases: a first phase (2 years) of general neurology training, a second phase (2 years) of training in neurophysiology/neurological subspecialties and a third phase (1 year) to expand clinical training (e.g., in other neurodisciplines) or for research (path for clinical neuroscientist). The necessary theoretical and clinical competences as well as learning objectives in diagnostic tests have been updated, are newly organized in four levels and include 19 neurological subspecialties. Finally, the new ETRN require, in addition to a programme director, a team of clinician‐educators who regularly review the resident's progress. The 2022 update of the ETRN reflects emerging requirements for the practice of neurology and contributes to the international standardization of training necessary for the increasing needs of residents and specialists across Europe. [ABSTRACT FROM AUTHOR]

This paper explores the implementation of grand spatial planning narratives such as the compact city and polycentricity in planning practice. The effects of overlapping scales on the application of spatial imaginaries in metropolitan space are examined. Using post‐socialist space, the research enriches the geographical context of metropolitan studies. On the basis of a spatial analysis of metropolitan form and centrality and a textual analysis of the relevant spatial plans of three Czech metropolitan areas, the key features in efforts of planning polycentric and compact metropolitan areas are identified as "Administrative blindness", "(De)centralization ambiguity", and "Reactive passivity". By identifying the limits of translating spatial visions into the practical language of statutory regional and land‐use plans, the paper contributes to the debate on the effectiveness of metropolitan planning based on the specific context of Central Europe. [ABSTRACT FROM AUTHOR]

Identification of archeological fish remains requires the use of comparative reference materials, generally in the form of disarticulated fish skeletons. Photographic or illustrative atlases provide an additional resource for the analysis of fish remains. Photographic resources exist for many marine species and for specific geographic regions, whereas freshwater European species have not been covered in great detail. Here, we present a photographic atlas for the bones of freshwater and migratory fish commonly recovered from archeological sites in Central Europe, alongside a discussion of the difficulties and considerations for the analysis of freshwater fish remains. The atlas also highlights the morphological similarity of many species and the interpretive limits of freshwater fish assemblages. The atlas aims to act as an accessible and user‐friendly resource, which can be used for basic identification purposes when access to physical collections is not possible, to supplement pre‐existing collections, or for training purposes. This paper acts as a platform from which the full atlas can be downloaded. [ABSTRACT FROM AUTHOR]

The Wound‐QoL assesses the impact of chronic wounds on patients' health‐related quality of life (HRQoL). A 17‐item and a shortened 14‐item version are available. The Wound‐QoL‐17 has been validated for multiple languages. For the Wound‐QoL‐14, psychometric properties beyond internal consistency were lacking. We aimed to validate both Wound‐QoL versions for international samples representing a broad range of European countries, including countries for which validation data had yet been pending. Patients with chronic wounds of any aetiology or location were recruited in Austria, Lithuania, the Netherlands, Poland, Slovakia, Spain, Switzerland and Ukraine. Psychometric properties were determined for both Wound‐QoL versions for the overall sample and, if feasible, country‐wise. We included 305 patients (age 68.5 years; 52.8% males). Internal consistency was high in both Wound‐QoL‐17 (Cronbach's α: 0.820–0.933) and Wound‐QoL‐14 (0.779–0.925). Test–retest reliability was moderate to good (intraclass correlation coefficient: 0.618–0.808). For Wound‐QoL‐17 and Wound‐QoL‐14, convergent validity analyses showed highest correlations with global HRQoL rating (r = 0.765; r = 0.751) and DLQI total score (r = 0.684; r = 0.681). Regarding clinical data, correlations were largest with odour (r = −0.371; r = −0.388) and wound size (r = 0.381; r = 0.383). Country‐wise results were similar. Both Wound‐QoL versions are valid to assess HRQoL of patients with chronic wounds. Due to its psychometric properties and brevity, the Wound‐QoL‐14 might be preferrable in clinical practice where time is rare. The availability of various language versions allows for the use of this questionnaire in international studies and in clinical practice when foreign language patients are being treated. [ABSTRACT FROM AUTHOR]

The drought resilience of forest ecosystems is generally believed to depend on the dominant tree species' hydraulic traits. These traits define the maximum water transport capacity and the degree of vulnerability to hydraulic failure of a tree species. This work evaluates the effect of the intraspecific variability of hydraulic traits on the simulated tree water use in the Community Land Model (CLM, version 5.0). We selected two contrasting broadleaved tree species and performed a series of numerical experiments by modifying the parameters of the plant vulnerability curve and the maximum xylem hydraulic conductance accounting for the variability within each species. Our prescribed parameter sets represent vulnerable and resistant tree responses to the water deficit. At sites with an ample water supply, the resistant configuration simulates reduced water stress and increased transpiration compared to the vulnerable configuration. Meanwhile, the model results are counter‐intuitive at temporarily dry sites when water availability is the limiting factor. The numerical experiments demonstrate the emergent role of the maximum xylem conductance as a modulator of the plant water use strategy and the simulated transpiration within the model. Using the default value for maximum xylem conductance, the model tends to overestimate the early summer transpiration at drier sites, forcing the vegetation to experience unrealistic water stress later in the year. Our findings suggest that the parameterization of maximum xylem conductance is an important yet unresolved problem in the CLM and similar land surface models. Plain Language Summary: The survival of trees in drought conditions depends on their ability to adapt to water scarcity. Part of this adaptation is characterized by specific plant traits, which are an important component of Land Surface Models and largely determine the relationship between soil moisture and canopy gas exchange. Our study explores how the variability of specific plant traits of individual tree species may affect the selected model's ability to reproduce the water use observed in forest stands in Europe. For climates with a pronounced summer dry period, we found that the default model settings overestimated the vegetation water use in the early growing season, when water is abundant, resulting in severe water stress and underestimated transpiration as the dry season progressed. We specifically demonstrate that a rarely considered plant trait, representing the maximum water transport capacity, plays an essential role in controlling the magnitude of simulated water use and that adjustments to this parameter greatly help to reproduce the vegetation water use observed in seasonally dry climates. Key Points: We explore the impact of the intraspecific variability of plant hydraulic traits on the simulated transpiration by Community Land Model 5.0We find that a choice of plant hydraulic traits that reproduces observed plant transpiration also reduces simulated water stressWe demonstrate the critical role of the maximum xylem conductance in the model and its dependency on factors other than vegetation type [ABSTRACT FROM AUTHOR]

Flood risks are increasing in Europe, and the EU Floods Directive is one of the main efforts to implement and harmonize effective flood risk governance and management among member states. At the same time, the ongoing shift from mere flood protection to multi‐functional flood risk governance calls for increased collaboration among a diversity of actors, typically with varying interests and responsibilities. In this study, we analyze the actor networks unfolding from flood risk management plans to visualize the diversity of roles and connections between actors participating in flood risk management measures. We introduce a new framework for analyzing flood risk management plans and related actor networks using Social Network Analysis and test it in the context of Finland. The framework helps to visualize the diversity of networks for different flood risk management strategies. The analysis also reveals the central roles that different types of actors—including those outside the public sector—occupy in the network. The findings suggest that Social Network Analysis can be used in the context of EU flood risk governance and that flood risk management plans offer an excellent opportunity for comparative governance studies in the EU. [ABSTRACT FROM AUTHOR]

In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000-2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012-2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta-analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self-reported prevalence was 0.8% (95% CI 0.5-1.1) for hazelnut and 0.4% (0.2-0.9) for walnut. The point self-reported prevalence was 4.0% (2.9-5.2) for hazelnut, 3.4% (2.0-4.9) for Brazil nut, 2.0% (1.1-2.9) for almond, and 1.8% (1.1-2.5) for walnut. Point prevalence of food challenge-confirmed TNA was 0.04% (0.0-0.1) for hazelnut and 0.02% (0.01-0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions., (© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Across Europe, countries are reducing CO 2 emissions and energy demand by lowering the temperature in public office buildings. These measures affect men and women unequally because the latter prefer and, indeed, perform better under higher temperatures than the standard temperature. Lowering the temperature thus further increases an already existing inequality. We show that the philosophical literature on discrimination provides an interesting theoretical approach to understanding such measures. On prominent understandings of what discrimination is, the policy would be considered direct discrimination against women if it could be shown to reflect a broader inattentiveness to the needs of women in society. Alternatively, and more straightforwardly, the policies can be considered indirect discrimination because of their disparate effects on men and women. The final part of the paper shows that the policies are also wrong for the reasons it is often argued that discrimination is wrong-to wit, that it harms or disrespects those who are discriminated against. The final section suggests a range of measures to offset the discriminatory aspects of the policy., (© 2023 The Authors. Bioethics published by John Wiley & Sons Ltd.)

Background: The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so‐called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade. Methods: Six databases were searched for studies published 2012–2021. Random‐effects meta‐analysis was performed to derive pooled prevalence of allergy to each food. Results: Twenty‐seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self‐reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)‐verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self‐reported peach allergy was 0.2%–3.2%, while the range for FC‐verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self‐reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively. Conclusion: Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so‐called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment. [ABSTRACT FROM AUTHOR]

Aim: This paper introduces the Surveillance of Cerebral Palsy in Europe (SCPE) classification of events contributing to postneonatally acquired cerebral palsy, presents its interrater reliability, and describes the cases identified in the SCPE database. Method: The development of the classification, based on literature review and expert discussions, resulted in six main categories and 19 subcategories. The first chronological event designated as the primary event was mainly reported. Interrater reliability was assessed through online exercise providing 24 clinical vignettes representing single/complex pathways. Percent agreement and Gwet's AC1 index of reliability were estimated. Primary events were described using data of 221 children born between 2008 and 2012. Results: Thirty‐nine professionals (21 registries) participated in the reliability exercise. Substantial overall agreement was reached (0.75), with some contrast between complex (0.48, moderate agreement) and single events involved (0.89, almost perfect). The distribution of primary events showed that 32.1% were infections (category A), 23.1% head injuries (B), 15.4% related to surgery or medical interventions (C), 13.1% cerebrovascular accidents (D), 9.1% hypoxic brain damaging events of other origins (E), and 7.2% miscellaneous (F). Interpretation: This classification allows all the events involved to be recorded while consistently reporting the primary event, and may be used in different settings. What this paper adds: A standardized classification enables the description of the events contributing to postneonatal cerebral palsy (CP).The first chronological event in complex pathway leading to CP is coded.Category choice and coding of the primary event identify preventable situations.The detailed 2‐level classification is easy to use in various settings.Substantial overall interrater reliability shows that main categories can be consistently differentiated. [ABSTRACT FROM AUTHOR]

Natural range shifts offer the opportunity to study the phenotypic and genetic changes contributing to colonization success. The recent range shift of the Southern small white butterfly (Pieris mannii) from the South to the North of Europe offers a prime example to examine a potential dispersal syndrome in range‐expanding individuals. We compared butterflies from the core and edge populations using a multimodal approach addressing behavioral, physiological, and morphological traits related to dispersal capacity. Relative to individuals from the core range (France), individuals from the edge (Germany) showed a higher capacity and motivation to fly, and a higher flight metabolic rate. They were also smaller, which may enhance their flight maneuverability and help them cope with limited resource availability, thereby increasing their settlement success in novel environments. Altogether, the behavioral, physiological, and morphological differences observed between core and edge populations in P. mannii suggest the existence of a dispersal syndrome in range‐expanding individuals. Whether these differences result from genetic and/or phenotypic responses remains, however, to be determined. [ABSTRACT FROM AUTHOR]

Global warming is affecting the phenological cycles of plants and animals, altering the complex synchronization that has co‐evolved over thousands of years between interacting species and trophic levels. Here, we examined how warmer winter conditions affect the timing of budburst in six common European trees and the hatching of a generalist leaf‐feeding insect, the spongy moth Lymantria dispar, whose fitness depends on the synchrony between egg hatch and leaf emergence of the host tree. We applied four different temperature treatments to L. dispar eggs and twig cuttings, that mimicked warmer winters and reduced chilling temperatures that are necessary for insect diapause and bud dormancy release, using heated open‐top chambers (ambient or +3.5°C), and heated greenhouses (maintained at >6°C or >10°C). In addition, we conducted preference and performance tests to determine which tree species the larvae prefer and benefit from the most. Budburst success and twig survival were highest for all tree species at ambient temperature conditions, whereas it declined under elevated winter temperature for Tilia cordata and Acer pseudoplatanus, likely due to a lack of chilling. While L. dispar egg hatch coincided with budburst in most tree species within 10 days under ambient conditions, it coincided with budburst only in Quercus robur, Carpinus betulus, and, to a lesser extent, Ulmus glabra under warmer conditions. With further warming, we, therefore, expect an increasing mismatch in trees with high chilling requirements, such as Fagus sylvatica and A. pseudoplatanus, but still good synchronization with trees having low chilling requirements, such as Q. robur and C. betulus. Surprisingly, first instar larvae preferred and gained weight faster when fed with leaves of F. sylvatica, while Q. robur ranked second. Our results suggest that spongy moth outbreaks are likely to persist in oak and hornbeam forests in western and central Europe. [ABSTRACT FROM AUTHOR]

Wind energy resource assessment typically requires numerical modeling at fine resolutions, which is computationally expensive for multi‐year timescales. Increasingly, unsupervised machine learning techniques are used to identify representative weather patterns that can help simulate long‐term behavior. Here we develop a novel wind energy workflow that combines the weather patterns from unsupervised clustering with a numerical weather prediction model (WRF) to obtain efficient long‐term predictions of wind farm power and downstream wakes, which provide a good approximation to full WRF simulations at vastly reduced computational cost. We use ERA5 reanalysis data and compare clustering on low altitude pressure and wind velocity, a more relevant variable for wind resource assessment. We also compare varying domain sizes for the clustering. A WRF simulation is run at each cluster center and the results aggregated into a long‐term prediction using a novel post‐processing technique. We consider two case study regions and show that our long‐term predictions achieve good agreement with a year of WRF simulations in 2% of the computational time. Moreover, clustering over a Europe‐wide domain produces good agreement for predicting wind farm power output, but clustering over smaller domains is required for downstream wake predictions which agree with the year of WRF simulations. Our approach facilitates multi‐year predictions of power output and downstream farm wakes, by providing a fast, reliable, and flexible methodology applicable to any global region. Moreover, this constitutes the first tool to help mitigate effects of wind energy loss downstream of wind farms. Plain Language Summary: With the need to transition to renewable energy, wind energy is becoming increasingly important. However, the build‐out of wind farms must be carefully planned, not least because entire wind farms extracting energy from the atmosphere cause large scale wind velocity deficits downstream. Wind energy resource assessment typically relies on numerical models, but these are computationally expensive to run for the multi‐year predictions required for sustainable development. It is therefore common to use a smaller set of weather conditions that are representative of a longer period. Here, we develop such a workflow based on identifying characteristic weather patterns using a clustering technique from the machine learning literature. Based on the characteristic patterns identified, we perform a small number of short numerical model experiments, one for each weather pattern. By applying a novel post‐processing technique to combine the outputs from these experiments, we obtain predictions of wind farm power and downstream wakes over the original multi‐year period, using just 2% of the computation time required by a purely numerical modeling approach. Our workflow thus constitutes a fast, reliable, and flexible methodology that is applicable to any global region, which can be used for the sustainable development of wind energy. Key Points: Fast, reliable and flexible method for long‐term wind energy resource assessment using only six short‐term simulationsEvaluation of suitable variables and domain sizes for deriving weather patternsWeather prediction model is combined with clustering method for energy prediction [ABSTRACT FROM AUTHOR]

If unauthorized resource use is prevented, managing marine resources by allocating property rights may match economic and environmental conservation incentives. However, because of the developing exploitation of marine resources and accompanying pollution, species' living conditions in Europe's waters are changing more quickly than before. By considering the roles of fisheries productivity, intellectual property rights, intellectual capital rights, market size, governance, and economic growth from 1990 to 2022, this paper aims to investigate the dynamic effect of property rights factors on the sustainability of the fisheries industry in 27 European countries. At higher quantiles, the findings showed a significant positive association between governance and fisheries sustainability adopting a new method, the MMQR with fixed effects, the Method of Moments Quantile Regression. In addition, in EU27 nations, the impact of intellectual property rights was favorable and statistically significant from the first to ninth quantiles. The findings show that the EU14 developed nations have more excellent governance and intellectual capital rights than the EU13 developing countries, significantly benefiting fisheries sustainability. In the same way that market size and economic growth condense fisheries sustainability in EU14 developed and EU13 developing countries, it has been discovered that intellectual property rights do the same across all quantiles, supporting the growth hypothesis for fisheries‐producing countries. The findings specifically show that the beneficial solid impact of intellectual property rights, market size, and economic development on the sustainability of fisheries is more significant in EU13 developing nations than in EU14 developed countries. These results provide policymakers with helpful information for promoting property rights aspects in EU14 and EU13 nations via effective green technologies in the fisheries sector to meet sustainable development objectives. [ABSTRACT FROM AUTHOR]

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Nowadays, there is contrasting evidence between the ongoing continuing and widespread environmental degradation and the many means to implement environmental sustainability actions starting from good policies (e.g. EU New Green Deal, CAP), powerful technologies (e.g. new satellites, drones, IoT sensors), large databases and large stakeholder engagement (e.g. EIP‐AGRI, living labs). Here, we argue that to tackle the above contrasting issues dealing with land degradation, it is very much required to develop and use friendly and freely available web‐based operational tools to support both the implementation of environmental and agriculture policies and enable to take positive environmental sustainability actions by all stakeholders. Our solution is the S‐DSS LANDSUPPORT platform, consisting of a free web‐based smart Geospatial CyberInfrastructure containing 15 macro‐tools (and more than 100 elementary tools), co‐designed with different types of stakeholders and their different needs, dealing with sustainability in agriculture, forestry and spatial planning. LANDSUPPORT condenses many features into one system, the main ones of which were (i) Web‐GIS facilities, connection with (ii) satellite data, (iii) Earth Critical Zone data and (iv) climate datasets including climate change and weather forecast data, (v) data cube technology enabling us to read/write when dealing with very large datasets (e.g. daily climatic data obtained in real time for any region in Europe), (vi) a large set of static and dynamic modelling engines (e.g. crop growth, water balance, rural integrity, etc.) allowing uncertainty analysis and what if modelling and (vii) HPC (both CPU and GPU) to run simulation modelling 'on‐the‐fly' in real time. Two case studies (a third case is reported in the Supplementary materials), with their results and stats, covering different regions and spatial extents and using three distinct operational tools all connected to lower land degradation processes (Crop growth, Machine Learning Forest Simulator and GeOC), are featured in this paper to highlight the platform's functioning. Landsupport is used by a large community of stakeholders and will remain operational, open and free long after the project ends. This position is rooted in the evidence showing that we need to leave these tools as open as possible and engage as much as possible with a large community of users to protect soils and land. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The apolipoprotein E (APOE) ε4 allele is associated with high risk for Alzheimer's disease. It is unclear whether individual levels of the circulating apoE4 protein in ε4 carriers confer additional risk. Measuring apoE4 protein levels from dried blood spots (DBS) has the potential to provide information on genetic status as well as circulating levels and to include these measures in large survey settings. METHODS: We developed a multiplex immunoassay to detect apoE4 protein levels in DBS from 15,974 participants, aged 50+ from Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). RESULTS: The apoE4 protein signal was presented in two separable distributions. One distribution corresponded to carriers of at least one copy of the ε4 allele. Fieldwork cofounders affected protein levels but did not explain individual differences. DISCUSSION: Future research should investigate how genotype and apoE4 level interact with lifestyle and other variables to impact cognitive aging. [ABSTRACT FROM AUTHOR]

Butterflies are charismatic insects and have been well studied, particularly in Europe. They are disproportionately used in generating and testing hypotheses; on everything from general evolutionary processes, such as speciation or host association dynamics; to conservation‐related studies, such as climate change or habitat loss. Accurate lists of the larval foodplants for European butterflies are not readily available. Mistakes are propagated and information cannot be checked for accuracy. The level of evidence is unknown, and how usage varies between countries is poorly understood. The study consulted 1119 references to produce 19,488 records of larval foodplants for European butterflies. This resulted in 5589 larval host plant records for 464 European butterfly species, with multiple references, enabling information to be checked. Information was unavailable for 59 species. The level of evidence for each relationship shows the current state of knowledge. Significant issues were identified for 3.9% of records extracted from references due to mistakes, ambiguous or unknown plant names, distribution issues, resulting in information being lost. Plants with questionable distributions suggest either mis‐identification or species that have been split. Little is known about plant usage in Eastern Europe. The larval foodplants of many monophagous and Satyrinae butterflies are poorly studied. Only 63% of threatened 2010 Red Listed butterflies have reliable host plant records. The study has provided ecologists with a valuable resource, of a more accurate checklist of the larval foodplants for each European country. Why plant usage varies over a butterfly's distribution opens up some interesting research questions. [ABSTRACT FROM AUTHOR]

Background: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S) questionnaire. A large POSHA–S database has collected responses from over 20 000 people from 49 countries. Aims: The aim of this study was to use the POSHA‐S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents). Methods & Procedures: Data used in this study were extracted from selected, relevant studies that administered the POSHA–S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes. Outcomes & Results: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA–S database. Effect sizes were small for all comparisons. Conclusions & Implications: The effect of geographic region and culture may predict sex‐based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering. What this paper adds: What is already known on this subject: The research clearly indicates that attitudes toward stuttering vary according to geographical region. Less clear is whether mothers and fathers from geographically diverse backgrounds hold different attitudes toward stuttering and the extent to which parental status (being a parent, parent of a child who stutters or nonparent) affects attitudes toward stuttering. What this study adds: This study's findings confirm that geographical differences do influence attitudes toward stuttering. Male parents and nonparents tend to have equal or more positive attitudes toward stuttering in Middle Eastern samples, whereas non‐Middle Eastern female parents and nonparents tend to show hold more positive attitudes. What are the clinical implications of this work?: In addition to being culturally sensitive when working with parents of children who stutter, clinicians should also consider that mothers and fathers may have some differences in attitudes and behaviours toward their child's stuttering. These differences should be considered when designing treatment plans. It should also be noted that, despite statistical significance, the effect sizes in this study were low, suggesting that further research as well as close collaboration with parents of children who stutter is warranted. [ABSTRACT FROM AUTHOR]

Using a cross section of matched data from the employee and management questionnaires of the European Company Survey for 28 nations, this paper investigates the determinants of worker commitment and the potential contribution of commitment to establishment performance. An index of worker commitment is constructed from employer perceptions of the motivation of workers and their retention and absenteeism propensities, while the determinants of commitment are fashioned from observations taken from the worker representation side, ordered along dimensions such as perceived organizational trust and involvement. The commitment index is then linked to establishment performance outcomes. Key findings from the commitment equation are the positive role of trust in management, the quality of information exchanged, and the degree of worker representation influence in respect of major decisions taken by management. In turn, commitment emerges as a key correlate of establishment financial performance and labor productivity growth. Our supplemental sensitivity analysis is supportive of the interpretation of commitment as a driver of performance. [ABSTRACT FROM AUTHOR]

The nutritional adequacy of human milk (HM) from vegan/vegetarian mothers has been a matter of debate, and a variety of recommendations regarding the eligibility of these mothers as human milk donors exists. According to the latest evidence, HM from vegans/vegetarians is similar in its composition to that from omnivores, however, some differences may be observed regarding vitamin B12 and omega‐3 fatty acids concentrations. Maternal supplementation of these compounds has been proven effective in increasing their HM concentration. With this survey, we aimed to explore the practices currently in use in European human milk banks (HMBs) regarding potential donors following vegan/vegetarian diets. The online survey was distributed to European HMBs between January and July 2022. A total of 188 HMBs were contacted, and 118 replied (response rate 63%). Vegan and vegetarian mothers were recommended supplements of vitamin B12 to be accepted as donors in 27% and 26% of HMBs, respectively. Additional omega‐3 fatty acid supplementation was required in 8% HMBs. In the remaining HMBs, these mothers were either systematically excluded or included regardless of supplementation. The dosage of the recommended supplements was extremely variable. Fifty‐one percent of HMBs were following recommendations to guide their practice, national or local recommendations mainly. Great variability in European HMBs practices towards potential donors following vegan/vegetarian diets exists. Some of these practices can result in loss of donors and/or in potential nutritional deficiencies. Standardised evidence‐based recommendations on this issue and their implementation in daily HMB practice are needed. Key messages: There is significant variability among the practices of European human milk banks towards donors following a vegan or vegetarian diet.The majority of human milk banks follow no guidelines or local guidelines, rather than international ones.Some of the practices currently in use can result in the loss of potential donors and/or nutritional deficiencies for mothers, their babies, and potentially for recipients of donor human milk.Evidence‐based recommendations regarding the inclusion of these mothers in human milk donation and nutritional counselling are needed. [ABSTRACT FROM AUTHOR]

State‐of‐the‐art perovskite‐based electrocatalysts for zinc−air batteries (ZABs) may include one or more Critical Raw Materials (CRMs) like Co, Ru, and rare earth elements, for oxygen reduction/evolution reactions. Under the warnings described by the CRMs Act in Europe, future research in this field must limit the use of these elements, find more sustainable formulations, and better design/integration strategies to trade off costs, supply, and performances. In this benchmarking study, three main perovskites, i. e., LaNiO3‐δ (LNO), LaMnO3+δ (LMO), and LaMn0.5Ni0.5O3 (LMNO), are studied as quasi‐CRM‐free benchmarks and integrated with a novel gel electrolyte from a natural biopolymer in primary and secondary ZABs. By comparing literature performances based on the number of total/active site CRMs for the first time, these reference perovskites showed Zn utilizations >90 % in primary ZABs, with LMO and LMNO approaching 94 % at 2 mA/cm2, the highest result in the field. In secondary ZABs, LMO demonstrated limited cyclability (62 cycles), while LMNO had a moderate number of cycles (117 cycles) and the highest round‐trip efficiency (54.3 %), while LNO presented the lowest charge potential (2.04 V) and longer cyclability (455 cycles). This work demonstrates encouraging performance with fewer CRMs and proper integration in more sustainable ZABs, opening the way to future CRM‐free perovskites. [ABSTRACT FROM AUTHOR]

Aims: Studies assessing the impact of pharmacovigilance regulatory interventions often focus on the expected (or intended) outcomes, while any possible unintended impact may be overlooked. The update of the Good Pharmacovigilance Practice guideline in 2017 elaborated on impact assessment, emphasizing the need also to assess possible unintended impact. This systematic literature review investigated how often the unintended impact of regulatory interventions was considered in publications of studies investigating pharmacovigilance regulatory interventions in Europe., Methods: We conducted a systematic review of the literature on MEDLINE and EMBASE from 1 January 2012 to 28 February 2022 to identify publications that investigated the impact of regulatory interventions in Europe. The primary outcome of the study was the number of publications reporting assessments of unintended impact. In addition, we studied the characteristics of these publications, including the type of outcomes assessed, the analytical methods applied and the type of data used., Results: In total, 96 publications were included in the analysis. The unintended impact of pharmacovigilance regulatory interventions was investigated in 23 of 96 publications (24%). The drug classes most frequently studied in the publications assessing unintended impact of regulatory interventions were oral glucose-lowering drugs (n = 6, 26%), opioids (n = 4, 17%), antidepressants (n = 4, 17%) and antipsychotics (n = 3, 13%). The reported methods to assess the unintended impact were interrupted time series (n = 10, 43%) and descriptive statistics with or without significance testing (n = 2 [9%] and n = 9 [39%], respectively). The outcomes selected for unintended impact assessments included the use of other drugs (n = 16, 70%), health outcomes (n = 8, 35%) and behavioural changes (n = 4, 17%). Most of the publications reported on the use of electronic health record databases (n = 13, 57%) or claims databases (n = 13, 57%), while registries were used in 4 publications (17%)., Conclusion: The unintended impact of pharmacovigilance regulatory interventions was reported in only a quarter of identified publications. There was no apparent increase in attention to unintended impact assessments after the update of the Good Pharmacovigilance Practice guidelines., (© 2023 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

Aims: Insights into the current practice of direct-to-participant (DtP) supply of investigational medicinal product (IMP) in the context of clinical trials conducted in Europe are needed, as regulations are unharmonized. This study is set out to explore how DtP IMP supply has been employed in Europe and what the advantages and disadvantages and barriers and facilitators of its implementation are., Methods: We conducted semi-structured interviews with representatives from sponsor companies, courier services and site study staff involved in the IMP dispensing and delivery process in Europe. Interviews were conducted between May and November 2021, and data were analysed following thematic analysis., Results: Sixteen respondents participated in one of the 12 interviews. Respondents had experience with different models of DtP IMP supply including shipment from the investigative site, a central pharmacy (a depot under the control of a pharmacist) and a local pharmacy-aiming to reduce trial participation burden. The respondents indicated that investigative site-to-participant shipment is not affected by regulatory barriers, but could burden site staff. Shipment from central locations was considered most efficient, but possible regulatory barriers related to maintaining participants' privacy and investigator oversight were identified. The respondents indicated that the involvement of local pharmacies to dispense IMP can be considered when the IMP is authorized., Conclusions: Several DtP IMP supply models are implemented in clinical trials conducted in Europe. In this study, three main DtP IMP models were identified, which can be referenced when describing these approaches for regulatory approval., (© 2023 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

The Swan goose and Greylag goose are species of geese native to East Asia and Europe, respectively, and are widely believed to be the ancestors of Chinese and European domesticated geese. The Yili goose (YL) and European domestic geese originated from the Greylag goose, but the history of domestication is unclear. In this study, we sequenced and analyzed the genome of the YL goose and the Hortobagy goose to combine with other previously sequenced goose populations for in-depth analysis. The population genetic variations in Stone geese, East Zhejiang White Geese, Taihu geese and Zi geese were also identified and compared. The results showed that admixture gene flow existed in the YL geese population, which was introgressed by Chinese geese, suggesting that gene flow events were frequent and widespread among domesticated geese. Further selected sweep analysis identified candidate genes and metabolic pathways that may be related to the differences in morphology. Several genes such as TGFBR3L, CMYA5, FOXD1, ARHGEF28 and SUCLG2 are associated with growth, reproduction and fertility traits. The results of this study will help to understand the genetic characteristics of domestic geese and the genes affecting important traits and provide a basis for the improved breed of domestic geese., (© 2023 Stichting International Foundation for Animal Genetics.)

Background: Cesarean birth (CB) rates have increased over recent years with concerns over differences between these rates in migrant communities compared with the rates among women in their receiving country. This review aimed at summarizing the available literature regarding the incidence of CB among migrants in Europe., Methods: A systematic search of four electronic databases was carried out, including CINAHL, MEDLINE, Scopus, and Maternity and Infant Care. Identified studies were screened and their quality assessed. Meta-analysis was undertaken using Rev Man 5.4 where sufficient data were available. Otherwise, data were synthesized narratively., Results: From the 435 records identified in searches, 21 papers were included. Analysis shows that overall CB rates were significantly lower for Syrian refugee women compared with women in their receiving country (Turkey) and higher for Iranian migrants than women in their host country. Emergency CB rates were significantly higher for migrant women from "Sub Saharan Africa" and the "South East Asia, Asia and Pacific" region than rates in the receiving country. Statistical significance was not found between other populations., Conclusions: This review highlights differences between CB rates in certain migrant groups in comparison with women native to their host country, which merits further investigation for potential explanations. We also identified a need to standardize definitions and population groupings to enable more meaningful analysis. This review also highlights a substantial lack of data on CB rates between different population groups that could negatively impact the provision of care., (© 2023 The Authors. Birth published by Wiley Periodicals LLC.)

Psychodermatology is a subspecialty of dermatology that is of increasing interest to dermatologists and patients. The case for the provision of at least regional psychodermatology services across Europe is robust. Psychodermatology services have been shown to have better, quicker and more cost-efficient clinical outcomes for patients with psychodermatological conditions. Despite this, psychodermatology services are not uniformly available across Europe. In fact many countries have yet to establish dedicated psychodermatology services. In other countries psychodermatology services are in development. Even in countries where psychodermatolgy units have been established, the services are not available across the whole country. This is especially true for the provision of paediatric psychodermatology services. Also whilst most states across Europe are keen to develop psychodermatology services, the rate at which this development is being implemented is very slow. Our paper maps the current provision of psychodermatology services across Europe and indicates that there is still very much more work to be done in order to develop the comprehensive psychodermatology services across Europe, which are so crucial for our patients., (© 2023 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)

Background: Cesarean birth (CB) rates have increased over recent years with concerns over differences between these rates in migrant communities compared with the rates among women in their receiving country. This review aimed at summarizing the available literature regarding the incidence of CB among migrants in Europe. Methods: A systematic search of four electronic databases was carried out, including CINAHL, MEDLINE, Scopus, and Maternity and Infant Care. Identified studies were screened and their quality assessed. Meta‐analysis was undertaken using Rev Man 5.4 where sufficient data were available. Otherwise, data were synthesized narratively. Results: From the 435 records identified in searches, 21 papers were included. Analysis shows that overall CB rates were significantly lower for Syrian refugee women compared with women in their receiving country (Turkey) and higher for Iranian migrants than women in their host country. Emergency CB rates were significantly higher for migrant women from "Sub Saharan Africa" and the "South East Asia, Asia and Pacific" region than rates in the receiving country. Statistical significance was not found between other populations. Conclusions: This review highlights differences between CB rates in certain migrant groups in comparison with women native to their host country, which merits further investigation for potential explanations. We also identified a need to standardize definitions and population groupings to enable more meaningful analysis. This review also highlights a substantial lack of data on CB rates between different population groups that could negatively impact the provision of care. [ABSTRACT FROM AUTHOR]

This paper aims to investigate how supporters perceive and react to environmental messages that call for reducing the environmental impact of sporting events. Based on prospect theory, we randomly provided 1423 supporters attending football events in Europe with (1) a negative (perceived loss for supporters), (2) a neutral (no perceived gain or loss) or a (3) a positive (perceived gain for supporters) environmental message and measured their attitudes towards the message, pro‐environmental behavioural intentions and perceived consumer effectiveness. Our results reveal that supporters show traits of collective behaviour during sports events that may lower the in‐stadium effectiveness of environmental messages. The environmental commitment of the favoured sports club increases the influence of green marketing on supporters with higher levels of environmental values and knowledge, but only when they depart from a collective identity. This paper contributes to green marketing literature revealing that modelling collective behaviours of members of groups exposed to highly emotional situations should be coordinated with information and awareness‐raising campaigns in everyday life. We also contribute to the prospect theory showing that loss aversion prevails in risk‐free conditions even though it does not directly shape supporters' behavioural intentions. [ABSTRACT FROM AUTHOR]

The production of cements with calcined clay is becoming increasingly important for the cement industry for ecological and economic reasons. Especially the combination of the cement constituents granulated blast furnace slag (S) and calcined clay (Q) next to Portland cement clinker (K) is very promising in terms of cement properties, durability and CO2 saving potential. Due to a lack of knowledge and experience, such KSQ cements have not yet been produced in Europe. With the help of design of experiments and statistical evaluation, both the influence of the cement composition and the reactivity of the clinker and calcined clays used on the cement and concrete properties were determined. For this purpose, a total of 64 different cement compositions consisting of at least 20 wt.% clinker (two different qualities), a maximum of 59 wt.% granulated blast furnace slag and a maximum of 49 wt.% calcined clay (two different qualities) were investigated. It could be shown that in a wide range of compositions, the production of KSQ cements of strength class 42,5 acc. EN 197‐1 is possible, whereby the water demand of the cements was mainly determined by the amount of calcined clay. Most of the corresponding concretes exhibited a high resistance to carbonation, chloride and freeze thaw attack. [ABSTRACT FROM AUTHOR]

The demand for resource saving and recycling of waste materials to achieve a circular economy is increasing. In Europe, nearly all blast furnace slag and fly ash are used as supplementary cementitious material. Furthermore, there is urgent need to reduce the CO2 emissions of building materials industry. Like in OPC‐based concretes, the reduction in the binder content by the use of fillers can be a way to reduce the CO2 emissions of alkali‐activated binders even further. Therefore, this study aims at the use of industrial residues as a filler in alkali‐activated materials to reduce the CO2 emissions of alkali‐activated binders. In this study, three industrial residues including municipal solid waste incineration ash (MSWIA), steel slag (SS) and ash formed by the thermal treatment of tar‐containing asphalt (EcoF) are used as fillers for alkali‐activated binders and are compared with fine quartz powder as an inert reference filler. The binder is ground granulated synthetic slag, which is replaced with the four filler materials at a 32 vol.% replacement level. The samples are reacted with 15 and 25 wt.% NaOH solution. The results show a potential advantage of using SS and EcoF as a filler in concrete as they exhibited a slightly higher compressive strength at all tested ages compared to quartz powder. [ABSTRACT FROM AUTHOR]

Concrete is a mass commodity with more than approx. 250 Mio. batches of concrete being produced every year in Europe alone. Despite this enormous repetition rate, both the quality inspection of the concrete raw materials as well as of the mixed concrete are still primarily batch‐based, relying on manual processes, thus hindering the application of modern process control schemes. The reasons for this lack are on the one hand to be seen in the lack of suitable sensor technologies and on the other hand in missing control algorithms. The paper at hand gives an overview on the current state of the art sensor technologies for both raw material as well as concrete properties measurement. Further, it outlines a pathway towards an online concrete process control. [ABSTRACT FROM AUTHOR]

Background: Anaphylaxis is a sudden multisystem allergic reaction which may result in a fatal outcome if not treated promptly. Guidelines worldwide suggest intramuscular adrenaline as the first‐line treatment for anaphylaxis outside a perioperative reaction. Adrenaline autoinjectors (AAIs) are widely used self‐administrable devices, especially in community settings. Different commercial AAIs have been authorized to be marketed in Europe. For an AAI to be efficacious, a rapid adrenaline delivery in patients, including those who are overweight or obese, resulting in an optimal cardiovascular (CV) response, is a key feature. AAIs are designed to achieve this requirement, which is reflected in their differing functional properties such as primary container selection, drug delivery mechanism (cartridge‐or syringe‐based), needle length, needle gauge, and adrenaline dose (150 μg, 300 μg, or 500 μg). However, the differences in functional properties across these devices may play a critical role in achieving these requirements as well as the differences in ergonomics in the handling of these devices. The purpose of this review: Considering the dynamic pharmacokinetic/pharmacodynamic (PK/PD) profiles of different AAIs marketed in Europe and their effect on adrenaline delivery, the expert panel, also serving as author for this paper have carried out a detailed analysis of the PK/PD profiles of four AAIs, namely, Anapen, Emerade, EpiPen, and Jext, to delineate the adrenaline delivery and their subsequent physiological effects on the backdrop of device characteristics, dose strength, and the skin‐to‐muscle distances of the participants. [ABSTRACT FROM AUTHOR]