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Augmented Reality in education can support students in a wide range of cognitive tasks–fostering understanding, remembering, applying, analysing, evaluating, and creating learning-relevant information more easily. It can help keep up engagement, and it can render learning more fun. Within the framework of a multi-year investigation encompassing primary and secondary schools across Europe, the ARETE project developed several Augmented Reality applications, providing tools for user interaction and data collection in the education sector. The project developed innovative AR learning technology and methodology, validating these in four comprehensive pilot studies, in total involving more than 2,900 students and teachers. Each pilot made use of a different Augmented Reality application covering specific subjects (English literacy skills, Mathematics and Geography, Positive Behaviour, plus, additionally, an Augmented Reality authoring tool applied in a wide range of subjects). In this paper, we introduce the datasets collected during the pilots, describe how the data enabled the validation of the technology, and how the approach chosen could enhance existing augmented reality applications in data exploration and modelling. [ABSTRACT FROM AUTHOR]

Background: ERTMS is an important project improving cross-border interoperability throughout Europe by a single rail signaling standard. One advantage following this development is a standardized radio signaling, which can be tracked by logging the data transfer using the ETCS protocol between Radio Block Center and train. This means that a broad spectrum of train driving can be analyzed in terms of for example driving behavior, signal planning and capacity in a new efficient way. Methods: In this paper a radio-based protocol method to achieve this, is presented and applied for studying braking characteristics in terms of meeting point design. The aim was to design, apply and validate a radio-based train data collection method to enable cost-efficient and avoid time-consuming train data collections. To enable comparison between the results from the suggested radio-based method and traditional methods, a verification measurement was performed. Three different alternatives of speed calculation were validated. These were based on: Train Position Report speed; calculation of average speed based on reported train position; processed reported train position forming the average speed. The best alternative was then applied to examine deceleration towards different signal targets at single-track meeting points. Results: The results from this study suggest that the ETCS Level 2 protocol is a feasible way to collect train dynamics data. The method is time saving when it comes to train driver behavior studies where several trains and drivers are needed to get significant results. Comparison with traditional GPS method suggest that the method is valid. Most promising is the alternative using processed train position. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the use of geospatial data for learning and in reporting projects undertaken by universities in Ontario, one on the collection of information for government statistics including raw data, and the role of data inconsistencies as barriers in the trans-national access to data in Europe.

Background: In order to conduct a probability business survey, a high quality sampling frame of enterprises is needed. Objectives: The goal of the paper is to investigate publicly available online businesses lists which can be used as sampling frames in business surveys in Croatia and to find out whether they have a satisfactory quality level. Methods/Approach: Publicly available businesses lists in Croatia are examined and their appropriateness for use in different modes of data collection as business sampling frames is inspected. The advantages and disadvantages of businesses lists are discussed and compared. Results: Overall 11 online businesses lists are considered as business sampling frames in the paper. The comparison analysis has shown that businesses lists from the government institutions are the best choice when business surveys are conducted face-to-face, by mail and/or by telephone. However, none of the observed businesses lists is good enough to be used in a business web survey. Conclusions: The research has shown that the publicly available online businesses lists are of a satisfactory level of quality only if traditional data collection modes are used. Unfortunately, they are not appropriate in business web surveys. Therefore, the development of a business register in Croatia is a prerequisite for conducting probability and representative business web surveys in the future. [ABSTRACT FROM AUTHOR]

This data paper describes the multinational Database of Flood Fatalities from the Euro-Mediterranean region FFEM-DB that hosts data of 2,875 flood fatalities from 12 territories (nine of which represent entire countries) in Europe and the broader Mediterranean region from 1980 to 2020. The FFEM-DB database provides data on fatalities' profiles, location, and contributing circumstances, allowing researchers and flood risk managers to explore demographic, behavioral, and situational factors, as well as environmental features of flood-related mortality. The standardized data collection and classification methodology enable comparison between regions beyond administrative boundaries. The FFEM-DB is expandable, regularly updated, publicly available, and with anonymized data. The key advantages of the FFEM-DB compared to existing datasets containing flood fatalities are its high level of detail, data accuracy, record completeness, and the large sample size from an extended area. [ABSTRACT FROM AUTHOR]

Study Question: How many twins are born in human populations and how has this changed over recent decades?Summary Answer: Since the 1980s, the global twinning rate has increased by a third, from 9.1 to 12.0 twin deliveries per 1000 deliveries, to about 1.6 million twin pairs each year.What Is Known Already: It was already known that in the 1980s natural twinning rates were low in (East) Asia and South America, at an intermediate level in Europe and North America, and high in many African countries. It was also known that in recent decades, twinning rates have been increasing in the wealthier parts of our world as a result of the rise in medically assisted reproduction (MAR) and delayed childbearing.Study Design, Size, Duration: We have brought together all information on national twinning rates available from statistical offices, demographic research institutes, individual survey data and the medical literature for the 1980-1985 and the 2010-2015 periods.Participants/materials, Setting, Methods: For 165 countries, covering over 99% of the global population, we were able to collect or estimate twinning rates for the 2010-2015 period. For 112 countries, we were also able to obtain twinning rates for 1980-1985.Main Results and the Role Of Chance: Substantial increases in twinning rates were observed in many countries in Europe, North America and Asia. For 74 out of 112 countries the increase was more than 10%. Africa is still the continent with highest twinning rates, but Europe, North America and Oceania are catching up rapidly. Asia and Africa are currently home to 80% of all twin deliveries in the world.Limitations, Reasons For Caution: For some countries, data were derived from reports and papers based on hospital registrations which are less representative for the country as a whole than data based on public administrations and national surveys.Wider Implications Of the Findings: The absolute and relative number of twins for the world as a whole is peaking at an unprecedented level. An important reason for this is the tremendous increase in medically assisted reproduction in recent decades. This is highly relevant, as twin deliveries are associated with higher infant and child mortality rates and increased complications for mother and child during pregnancy and during and after delivery.Study Funding/competing Interest(s): The contribution of CM was partially supported by the European Research Council (ERC) under the European Union's Horizon 2020 Research and Innovation Programme (grant No 681546, FAMSIZEMATTERS), Nuffield College, and the Leverhulme Trust. The contribution of GP was partially supported by the French Agence Nationale de la Recherche (grant No ANR-18-CE36-0007-07). The authors declare no conflict of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background: Accounting for patients' perspective has become increasingly important. Based on the Consumer Quality Index method (founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in six European countries.Method: The Consumer Quality Index was translated into the local language at the participating pilot sites using cross-translation. A minimum of 100 patients per site were surveyed through convenience sampling. Data from seven pilot sites in six countries was collected through an online and paper-based survey. Internal consistency was tested by calculating Cronbach's alpha and validity by means of cognitive interviews. Demographic factors were compared as possible influencing factors.Results: A total of 698 patients from six European countries filled the questionnaire. Cronbach's alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction significantly differed between the countries. We observed no difference in patient satisfaction for age, gender, education, and tumor type, but satisfaction was significantly higher in patients with a higher level of activation.Conclusion: This European Cancer Consumer Quality Index(ECCQI) showed promising scores on internal consistency (reliability) and a good internal validity. The ECCQI is to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level, it may enable healthcare providers to improve the quality of cancer care. [ABSTRACT FROM AUTHOR]

Institutions worldwide call for joint actions of multiple actors in partnerships to accelerate the transitions towards sustainable food systems and reach food security for everybody, allways. This requires insights into co-creating processes. Here, 52 European food system cases are analyzed. A methodology based on the game structure is used that permits standardizing data collection and extracting generic and cases-specific findings. Game building blocks correspond with key elements of co-creation processes, like defining mutually accepted objectives, engaging in types of activities, and efficient use of resources, boundary conditions, timings, and scales of operations. Results further indicate that different types of inclusive partnerships emerge, in which especially innovative private, including smallholders, and academic actors cocreate value, all contributing to sustainability. The public and civil society actors emerge as important initiators, enablers, and organizers of scales of interaction, allowing generating snowball effects. Findings lead to an adapted concept for co-creating partnerships in food systems and recommendations for the European Partnership on sustainable food systems. [ABSTRACT FROM AUTHOR]

Background Resilience of national health systems in Europe remains a major concern in times of multiple crises and as more evidence is emerging relating to the indirect effects of the COVID-19 pandemic on health care utilization (HCU), resulting from de-prioritization of regular, non-pandemic healthcare services. Most extant studies focus on regional, disease specific or early pandemic HCU creating difficulties in comparing across multiple countries. We provide a comparatively broad definition of HCU across multiple countries, with potential to expand across regions and timeframes. Methods Using a cross-country federated research infrastructure (FRI), we examined HCU for acute cardiovascular events, elective surgeries and serious trauma. Aggregated data were used in forecast modelling to identify changes from predicted European age-standardized counts via fitted regressions (2017–19), compared against post-pandemic data. Results We found that elective surgeries were most affected, universally falling below predicted levels in 2020. For cardiovascular HCU, we found lower-than-expected cases in every region for heart attacks and displayed large sex differences. Serious trauma was the least impacted by the COVID-19 pandemic. Conclusion The strength of this study comes from the use of the European Population Health Information Research Infrastructure's (PHIRI) FRI, allowing for rapid analysis of regional differences to assess indirect impacts of events such as pandemics. There are marked differences in the capacity of services to return to normal in terms of elective surgery; additionally, we found considerable differences between men and women which requires further research on potential sex or gender patterns of HCU during crises. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD), breast cancer (BC) and prostate cancer (PC) continue to be high in the research and innovation agenda of the European Commission (EC). This is due to their exceptionally large burden to the national health systems, the profound economic effects of opportunity costs attributable to decreased working ability, premature mortality and the ever-increasing demand for both hospital and home-based medical care. Over the last two decades, the EC has been steadily increasing both the number of proposals being funded and the amounts of financial resources being allocated to these fields of research. This trend has continued throughout four consecutive science funding cycles, namely framework programme (FP)5, FP6, FP7 and Horizon 2020 (H2020). We performed a retrospective assessment of the outputs and outcomes of EC funding in AD, BC and PC research over the 1999–2019 period by means of selected indicators. These indicators were assessed for their ability to screen the past, present and future for an array of causal relationships and long-term trends in clinical, epidemiological and public health sphere, while considering also the broader socioeconomic impact of funded research on the society at large. This analysis shows that public–private partnerships with large industry and university-based consortia have led to some of the most impactful proposals being funded over the analysed time period. New pharmaceuticals, small molecules and monoclonal antibodies alike, along with screening and prevention, have been the most prominent sources of innovation in BC and PC, extending patients' survival and enhancing their quality of life. Unlike oncology, dementia drug development has been way less successful, with only minor improvements related to the quality of supportive medical care for symptoms and more sensitive diagnostics, without any ground-breaking disease-modifying treatment(s). Significant progresses in imaging diagnostics and nanotechnology have been largely driven by the participation of medical device industry multinational companies. Clinical trials funded by the EC were conducted, leading to the development of brand-new drug molecules featuring novel mechanisms of action. Some prominent cases of breakthrough discoveries serve as evidence for the European capability to generate cutting-edge technological innovation in biomedicine. Less productive areas of research may be reconsidered as priorities when shaping the new agenda for forthcoming science funding programmes. [ABSTRACT FROM AUTHOR]

Purpose – This paper sets out to investigate the link between market orientation and manufacturing performance for small and medium enterprises in India. Design/methodology/approach – The paper collected the data for this research through intensive surveys of the CEOs or top managers of small and medium-sized enterprises in India. The paper utilized scales, well established in literature, and revalidated them for the Indian context. It also utilized confirmatory factor analysis for scale validation, and hierarchical regression analysis for testing the hypotheses. Findings – This study found a positive link between two sub-dimensions of market orientation – customer orientation and inter-functional coordination – and manufacturing performance. Competitor orientation, however, did not have a positive impact on manufacturing performance. Further, the paper found that firm resources and competitive intensity moderate the relationship between some of the sub-dimensions of market orientation and firm performance. Research limitations/implications – This study is particularly relevant for personnel involved in the manufacturing functions as it studies the effect of market orientation on manufacturing performance. It is high time that firms with manufacturing focus realize the value of market forces and revamp various production processes to be more responsive to market needs and demands. Originality/value – This research looks at manufacturing performance, rather than a firm's financial performance, and thereby helps in understanding the intervening processes that potentially lead to superior firm performance. It also identifies some important contingency factors, enriching the literature on market orientation. Finally, the empirical context of this research is quite novel and useful for European and other foreign firms trying to operate in emerging economies such as India. [ABSTRACT FROM AUTHOR]

Introduction: EURO-URHIS 2 aimed to collect comparable health indicators across a large number of urban areas (UAs) across Europe and Vietnam using four data collection tools. This paper outlines the process for the selection of indicators to be collected from routinely available sources, and the piloting of the data collection tool. Methods: A long-list of indicators potentially collectable from routinely available sources was generated by the EURO-URHIS 2 consortium. Key contacts from each UA completed an e-mail survey reporting for each indicator whether it could be collected using the given definition, an alternative definition or not at all. Additionally participants listed the 20 leading causes of death for their UAs from the Eurostat 65. Results were compiled to inform indicator selection for the main data collection phase. Results: Responses were received for 25 of 28 eligible UAs. Of the 29 proposed indicators, 55.1% (n = 16) were accepted without change, 24.1% (n = 7) were re-allocated to other data collection tools and 17.2% (n = 5) were accepted after a modification of the EURO-URHIS 2 definition. Discussion: This scoping exercise and piloting phase for the 'existing data tool' for the project was useful and informative. It provided detailed information on what could be collected, and an opportunity to modify indicator definitions to maximize response rates. These results are only applicable to those UAs returning results and cannot be generalized. Detailed interrogation of definitions is essential to this sort of data collection, and the process described was designed with cross-national comparability in mind. [ABSTRACT FROM AUTHOR]

Post-vaccine olfactory and gustatory disorders are very rare and were reported in patients who received influenza vaccines. In this article, we report 6 cases of post-coronavirus disease 2019 (COVID-19) vaccine olfactory and gustatory disorders in patients with negative nasal swabs. Precisely, olfactory and gustatory dysfunctions were reported in 5 and 1 patients, respectively. Sense disorders occurred after the first injection of AstraZeneca (n = 4) or the second injection of Pfizer (n = 2) vaccines. In 4 cases, the olfactory or gustatory disorder was confirmed with psychophysical evaluations. The duration of chemosensory dysfunction ranged from 4 to 42 days. None of the patient reported mid- or long-term olfactory or gustatory disorder. The occurrence of olfactory and gustatory dysfunctions in adults benefiting from COVID-19 vaccines is still rare but has to be known by otolaryngologists. [ABSTRACT FROM AUTHOR]

• The Shared Environmental Information System (SEIS) aim to expand the access to environmental data. • SEIS has had a significant and positive impact on the production and harmonisation of environmental indicators. • Data harmonization problems (e.g., data collection, definitions, and legislation) remain throughout the pan-European region. • Non-evidence-based policymaking highlight a disconnect between data production and data use. • Need to improve our understanding of the political and behavioural determinants of data use. Access to high-quality, timely and comparable data is a prerequisite for any effective decision-making process and having such data available for the environment is absolutely fundamental to efficient and evidence-based policymaking. This article reviews the establishment of a Shared Environmental Information System (SEIS) in Europe and Central Asia to improve our understanding of how environmental data value chains are being employed to produce, share and use reliable data on the environment and whether this data is used in policymaking. Three sources of data are utilised to analyse whether relevant environmental data and information are being drawn upon by policymakers, namely, the 2019 SEIS mid-term review, SEIS Factsheets and SEIS Gap Analysis Reports. The results reveal that the pan-European region still faces significant data harmonisation problems, owing in part to differences in types and methods of data collection, data definitions and legislation. Whilst problems in some individual country's participation have persisted since the launch of the SEIS initiative in the pan-European region, the development and successful piloting of the SEIS self-assessment framework is considered as evidence of positive progress. However, it remains difficult to adequately assess to what extent the data flows covered by this study impact on policymaking, nevertheless, the analysis serves to highlight the inter-linkages between environmental data flows, policymakers and environmental governance. In practical terms, the paper demonstrate a disconnect between data production and data use in policymaking and emphasises the need to both improve our understanding of the political determinants of data use and to further investigate how the uptake of environmental data and information can be facilitated in policymaking. [ABSTRACT FROM AUTHOR]

In the last decade, affective polarization (AP) has become an increasingly salient topic in both public discourse and political science. Several different measurement instruments have been developed to empirically capture this phenomenon. With the rising interest that affective polarization is now also enjoying in Europe, it has become of the utmost importance to assess what these different measures capture, and to what extent their application travels to different contexts. In this study we test several AP measures on a student population with various European nationalities. We assess their overlap and effectiveness in mapping AP, to help future research working towards greater empirical clarity, and making informed choices on which kind of measures to include in questionnaires and data collections. The results indicate that, while different items usually produce different point estimates and sometimes different answer patterns, the measurement of affective polarization appears relatively indifferent to the choice of items. [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]

Abstract This paper proposes transparency and reflexivity as two principles to be incorporated in initiatives wherein data from multiple national contexts are integrated. The necessity of these principles is derived from an ongoing study tasked with identifying and describing national bibliographic databases for research output within the social sciences and humanities (SSH) in Europe. The study is carried out within the context of the COST Action "European Network for Research Evaluation in Social Sciences and Humanities" (ENRESSH). Within ENRESSH, it is emphasised that national bibliographic databases can be instrumental in enhancing the visibility of research within SSH. Hence, one of the aims of ENRESSH is to identify and describe currently existing databases and eventually design a roadmap for a European database that would include data on research output within SSH from different European countries. The study shows that there are considerable challenges in merely acquiring a basic description of the content of databases embedded in different national contexts. To make sense of the content it is necessary to acknowledge the role of context in information systems. Emphasising context, as will be shown, it is possible to elucidate the nature of the encountered challenges as well as to highlight aspects to be incorporated in designs of research information systems. [ABSTRACT FROM AUTHOR]

Background: Existing evidence on the role of community health workers (CHWs) in primary healthcare originates primarily from the United States, Canada and Australia, and from low- and middle-income countries. Little is known about the role of CHWs in primary healthcare in European countries. This scoping review aimed to contribute to filling this gap by providing an overview of literature reporting on the involvement of CHWs in primary healthcare in WHO-EU countries since 2001 with a focus on the role, training, recruitment and remuneration. Methods: This systematic scoping review followed the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses, extension for Scoping Reviews. All published peer-reviewed literature indexed in PubMed, Web of Science, and Embase databases from Jan 2001 to Feb 2023 were reviewed for inclusion. Included studies were screened on title, abstract and full text according to predetermined eligibility criteria. Studies were included if they were conducted in the WHO-EU region and provided information regarding the role, training, recruitment or remuneration of CHWs. Results: Forty studies were included in this review, originating from eight countries. The involvement of CHWs in the WHO-EU regions was usually project-based, except in the United Kingdom. A substantial amount of literature with variability in the terminology used to describe CHWs, the areas of involvement, recruitment, training, and remuneration strategies was found. The included studies reported a trend towards recruitment from within the communities with some form of training and payment of CHWs. A salient finding was the social embeddedness of CHWs in the communities they served. Their roles can be classified into one or a combination of the following: educational; navigational and supportive. Conclusion: Future research projects involving CHWs should detail their involvement and elaborate on CHWs' role, training and recruitment procedures. In addition, further research on CHW programmes in the WHO-EU region is necessary to prepare for their integration into the broader national health systems. [ABSTRACT FROM AUTHOR]

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

(1) Alcohol consumption contributes to the development of numerous diseases and is a big organizational burden on emergency departments (EDs). (2) We examined data on alcohol-related ED admissions in Poznan, Poland between 1 April 2019 and 31 March 2022. A total of 2290 patients' records were collected and analysed. The main goal was to determine the impact that these visits had on the functioning of the ED and the hospital. (3) The alcohol-related admission rate was significantly higher in males (78.95% vs. 21.05%), and the median blood alcohol concentration (BAC) level was 2.60 (1.78–3.38) ‰. Most of the visits took place at weekends and in the evening. Patients with higher BAC tended to stay longer in the ED, but had a lower chance of being admitted. A majority of patients required radiology and laboratory testing, 20.44% needed psychiatric examination, and 19.69% suffered trauma, mainly to the head. (4) Injuries and mental problems were the most common medical emergencies. This study presents trends in alcohol-related ED attendances, examines reasons for visits, and makes an attempt to assess overall burden on EDs. [ABSTRACT FROM AUTHOR]

Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (n = 1), first change (n = 5), and after multiple changes (n = 2). Site of perforation was known in six (distal n = 3, proximal n = 2 and middle n = 1). Diagnosis was established by respiratory distress (n = 4), respiratory distress and sepsis (n = 2) and post-insertion chest X-ray (n = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. [ABSTRACT FROM AUTHOR]

The commonly accepted definition of sustainability considers the availability of relevant resources to make an activity feasible and durable while also recognizing users' support as an essential part of the social side of sustainability. IoT represents a disruption in the general scenario of computing for both users and professionals. The real expansion and integration of applications based on IoT depend on our capacity of exploring the necessary skills and professional profiles that are essential for the implementation of IoT projects, but also on the perception of relevant aspects for users, e.g., privacy, legal, IPR, and security issues. Our participation in several EU-funded projects with a focus on this area has enabled the collection of information on both sides of IoT sustainability through surveys but also by collecting data from a variety of sources. Thanks to these varied and complementary sources of information, this article will explore the user and professional aspects of the sustainability of the Internet of Things in practice. [ABSTRACT FROM AUTHOR]

This paper presents the findings of an exploratory study conducted with the aim of analysing the evolution of the use of Environmental Declarations as environmental communication tool in Europe. Previous research has been done in this field focused on analysing differences among Environmental Declaration Programmes, comparison of Product Category Rules and Environmental Declarations for specific product categories, etc. However, the knowledge of the factors affecting their demand from a company perspective is a key aspect for the Environmental Declaration Programmes managers, since it would allow them to orientate future strategies for increasing their implementation. After analysing the evolution of Product Category Rules and Environmental Product Declarations developed in the International EPD ® Programme, a survey was designed and distributed to companies that currently had Environmental Product Declarations in that programme. The collected information was related to: factors that led the company to choose the International EPD ® Programme as an environmental communication tool, communication channels through which companies came to know about the programme, the target public of the Environmental Product Declarations, whether or not companies intend to renew the current Environmental Product Declarations and the reasons for not doing so if that is the case, etc. Communicating objective information and improvement of the corporate identity of the company have been identified as the main factors for adopting International EPD ® Programme as environmental communication tool. On the contrary, the main weakness identified is the lack of knowledge about EPD programmes in general, by consumers. [ABSTRACT FROM AUTHOR]

In Europe, 20 to 40% of water is being wasted due to poor infrastructure, consumer negligence and lack of proper resource management. Effective and efficient management of water resources requires a holistic approach considering all the stages of water usage, which includes the application of ICT technologies that are capable of transmitting and analysing water data to deliver actionable insights to end-users. A primary requirement for ICT-based water innovations is the ability to collect and process water data from disparate locations. In this paper, we present a cloud-based cross-site data collection system, which is being developed as part of an EU funded research project named Waternomics. [ABSTRACT FROM AUTHOR]

The European Reference Network for rare liver diseases (ERN RARE-LIVER) is a Europe-wide network of paediatric and adult hepatologists from expert centres in close collaboration with patient advocates from the various disease-areas covered in our ERN. The ERN is focused on providing more equitable care across Europe and creates a network of both medical specialists and patient experts in rare liver disease. This position paper summarizes the achievements of the first year and plots the route for the near future for ERN RARE-LIVER, as discussed during a strategy meeting that took place 27 and 28 February 2018 in Nijmegen, the Netherlands. ERN RARE-LIVER has established itself as a group with experts, hospitals and patients. One of the tools to improve communication is the clinical patient management system (CPMS) that allows access to expert consultation by European physicians confronted with a patient with rare liver disease. ERN RARE-LIVER will function as the platform to improve healthcare by initiating registries, foster research efforts and coordinate development of clinical guidelines in Europe. [ABSTRACT FROM AUTHOR]

Background: A minority of European countries have participated in international comparisons with high level data on lung cancer. However, the nature and extent of data collection across the continent is simply unknown, and without accurate data collection it is not possible to compare practice and set benchmarks to which lung cancer services can aspire.Methods: Using an established network of lung cancer specialists in 37 European countries, a survey was distributed in December 2014. The results relate to current practice in each country at the time, early 2015. The results were compiled and then verified with co-authors over the following months.Results: Thirty-five completed surveys were received which describe a range of current practice for lung cancer data collection. Thirty countries have data collection at the national level, but this is not so in Albania, Bosnia-Herzegovina, Italy, Spain and Switzerland. Data collection varied from paper records with no survival analysis, to well-established electronic databases with links to census data and survival analyses.Conclusion: Using a network of committed clinicians, we have gathered validated comparative data reporting an observed difference in data collection mechanisms across Europe. We have identified the need to develop a well-designed dataset, whilst acknowledging what is feasible within each country, and aspiring to collect high quality data for clinical research. [ABSTRACT FROM AUTHOR]

• We use a machine learning (ML) approach to study energy poverty (EP) risk in Europe. • We produce an EP risk classifier with accuracies ranging from 60% to 75%. • Through ML we identify three EP predictors: income, household size, and floor area. • We suggest the presence of universal predictors complemented by contextual ones. • Increasing data collection efforts in Europe can improve EP policy research insights. In this paper we identify drivers for energy poverty in Europe using machine learning. The establishment of predictors for energy poverty valid across countries is a call made by many experts, since it could provide a basis to effectively target energy-poor households with adequate policy measures. We apply a "low income, high expenditure" framework that classifies households as being at risk of energy poverty to a dataset from a survey conducted at the household-level in 11 European countries with vastly different economies, cultures, and climates. A gradient boosting classifier is successfully trained on a set of socio-economic features hypothesized as predictors for energy poverty in this diverse set of countries. The classifier's internal model is analyzed, providing novel insights into the intricacies that underlie energy poverty. We find that besides the main driver - income - floor area and household size can be confirmed as predictors. Our results suggest the presence of universal predictors that are valid across Europe, and contextual ones that are governed by local characteristics. To facilitate advanced research into energy poverty in Europe, we recommend to increase and streamline household data collection efforts, both at the country- and EU-level. [ABSTRACT FROM AUTHOR]

The European Commission expects the use of biomass for energy in the EU to increase significantly between 2010 and 2020 to meet a legally binding target to cover at least 20% of EU's total energy use from renewable sources in 2020. According to estimates made by the member states of the EU, the direct supply of biomass from forests is expected to increase by 45% on a volume basis between 2006 and 2020 in response to increasing demand (Beurskens LWM, Hekkenberg M, Vethman P. Renewable energy projections as published in the national renewable energy action plans of the European Member states. ECN and EEA; 2011. http://https://www.ecn.nl/docs/library/report/2010/e10069.pdf [accessed 25.04.2014]; Dees M, Yousef A, Ermert J. Analysis of the quantitative tables of the national renewable energy action plans prepared by the 27 European Union Member States in 2010. BEE working paper D7.2. Biomass Energy Europe project. FELIS - Department of Remote Sensing and landscape information Systems, University of Freiburg, Germany; 2011). Our aims were to test the hypotheses that European private forest owners' attitudes towards supplying woody biomass for energy (1) can be explained by their responses to changes in prices and markets and (2) are positive so that the forest biomass share of the EU 2020 renewable energy target can be met. Based on survey data collected in 2010 from 800 private forest owners in Sweden, Germany and Portugal our results show that the respondents' attitudes towards supplying woody biomass for energy cannot be explained as direct responses to changes in prices and markets. Our results, furthermore, imply that European private forest owners cannot be expected to supply the requested amounts of woody biomass for energy to meet the forest biomass share of the EU 2020 renewable energy target, at least if stemwood is to play the important role as studies by Verkerk PJ, Anttila P, Eggers J, Lindner M, Asikainen A. The realisable potential supply of woody biomass from forests in the European Union. For Ecol Manag 2011;261: 2007-2015, UNECE and FAO. The European forest sector outlook study II 2010-2030. United Nations, New York and Geneva; 2011 [abbreviated to EFSOS II] and Elbersen B, Staritsky I, Hengeveld G, Schelhaas MJ, Naeff H, Böttcher H. Atlas of EU biomass potentials; 2012. Available from: http://www.biomassfutures.eu [accessed 14.10.2013] suggest. [ABSTRACT FROM AUTHOR]

[Display omitted] • HBM4EU aims to gather evidence on real human exposures to chemicals in Europe. • The process for developing epidemiological questionnaires within HBM4EU is described. • Challenges found during this process were addressed to support future research in HBM. • Procedures for questionnaires design should be standardised across HBM studies. • Readily accessible questionnaires will improve data collection in HBM studies. Designing questionnaires is a key point of epidemiological studies assessing human exposure to chemicals. The lack of validated questionnaires can lead to the use of previously developed and sub-optimally adapted questionnaires, which may result in information biases that affect the study's validity. On this ground, a multidisciplinary group of researchers developed a series of tools to support data collection within the HBM4EU initiative. The objective of this paper is to share the process of developing HBM4EU questionnaires, as well as to provide researchers with harmonized procedures that could help them to design future questionnaires to assess environmental exposures. In the frame of the work package on survey design and fieldwork of the HBM4EU, researchers carried out procedures necessary for the development of quality questionnaires and related data collection tools. These procedures consisted of a systematic search to identify questionnaires used in previous human biomonitoring (HBM) studies, as well as the development of a checklist and evaluation sheet to assess the questionnaires identified. The results of these evaluations were taken into consideration for the development of the final questionnaires. The main points covered by each of the sections included in HBM4EU questionnaires are described and discussed in detail. Additional tools developed for data collection in the HBM4EU (e.g. non-responder questionnaire, satisfaction questionnaire, matrix-specific questionnaire) are also addressed. Special attention is paid to the limitations faced and hurdles overcome during the process of questionnaire development. Designing questionnaires for use in HBM studies requires substantial effort by a multidisciplinary team to guarantee that the quality of the information collected meets the study's objectives. The process of questionnaire development described herein will contribute to improve the harmonization of HBM studies within the social and environmental context of the EU countries. [ABSTRACT FROM AUTHOR]

Abstract: Under the European Union Thematic Strategy for Soil Protection, the European Commission Directorate-General for the Environment (DG Environment) and the European Environmental Agency (EEA) have identified decline in soil organic matter and soil losses by erosion as priorities for the collection of policy-relevant soil data at European scale. To support EU policies related to soil conditions the data collected on corresponding indicators requires establishing agreed datasets for the EU Member States on these themes. In 2010, the Joint Research Centre of the European Commission (JRC), which is charged with the collection of soil data at European scale and hosts the European Soil Data Centre (ESDAC), conducted a project to collect data on soil organic carbon and soil erosion in Europe using the European Environment Information and Observation Network for soil (EIONET-SOIL). The data submitted by participating countries are their best estimate and represent an official point of view. The technical approach taken allows a country to easily update the records when new data become available. This paper presents the first results obtained from analyzing the soil organic carbon data submitted to EIONET-SOIL. The collected data were compared with the modelled data of the European topsoil organic carbon content developed at the JRC. The modelled data follow the general pattern of the geographic distribution of collected data, but show higher values compared to the EIONET-SOIL data. The important role of soil organic carbon (SOC) as an indicator of soil quality underlines the need for using common methods of sampling, analysing and reporting soil organic carbon to provide a standard product, such as EIONET-SOIL. [Copyright &y& Elsevier]

The intake of sugars is a trending topic in nutrition and health. For an evaluation of the sugar intake (comparison with existing guidelines), up-to-date information on the guidelines, dietary intake and trends in the intake is needed. The available information for European countries is presented in this review. The existing guidelines on the intake show that there is currently no consensus among the experts from different organizations. The differences are mainly due to the selection of the adverse health outcomes for which there is sufficient evidence. Data from national European surveys show that the mean proportion of energy coming from added sugars for most European population groups is below 10%, and that the trend in the intake seems to be downwards. There are, however, many serious uncertainties and assumptions needed for the assessment of the intake of sugars. For instance, the assessment reflects a short period of the lives of the respondents, the data collection in several surveys was conducted more than 10 years ago, and recent reformulations of the industry are not considered in the food composition tables. Due to the uncertainties regarding the assessment of the sugar intake in Europe, the information should be used prudently and with care. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) is an important global public health burden, where those injured by high-energy transfer (e.g., road traffic collisions) are assumed to have more severe injury and are prioritised by emergency medical service trauma triage tools. However recent studies suggest an increasing TBI disease burden in older people injured through low-energy falls. We aimed to assess the prevalence of low-energy falls among patients presenting to hospital with TBI, and to compare their characteristics, care pathways, and outcomes to TBI caused by high-energy trauma.Methods and Findings: We conducted a comparative cohort study utilising the CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) Registry, which recorded patient demographics, injury, care pathway, and acute care outcome data in 56 acute trauma receiving hospitals across 18 countries (17 countries in Europe and Israel). Patients presenting with TBI and indications for computed tomography (CT) brain scan between 2014 to 2018 were purposively sampled. The main study outcomes were (i) the prevalence of low-energy falls causing TBI within the overall cohort and (ii) comparisons of TBI patients injured by low-energy falls to TBI patients injured by high-energy transfer-in terms of demographic and injury characteristics, care pathways, and hospital mortality. In total, 22,782 eligible patients were enrolled, and study outcomes were analysed for 21,681 TBI patients with known injury mechanism; 40% (95% CI 39% to 41%) (8,622/21,681) of patients with TBI were injured by low-energy falls. Compared to 13,059 patients injured by high-energy transfer (HE cohort), the those injured through low-energy falls (LE cohort) were older (LE cohort, median 74 [IQR 56 to 84] years, versus HE cohort, median 42 [IQR 25 to 60] years; p < 0.001), more often female (LE cohort, 50% [95% CI 48% to 51%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001), more frequently taking pre-injury anticoagulants or/and platelet aggregation inhibitors (LE cohort, 44% [95% CI 42% to 45%], versus HE cohort, 13% [95% CI 11% to 14%]; p < 0.001), and less often presenting with moderately or severely impaired conscious level (LE cohort, 7.8% [95% CI 5.6% to 9.8%], versus HE cohort, 10% [95% CI 8.7% to 12%]; p < 0.001), but had similar in-hospital mortality (LE cohort, 6.3% [95% CI 4.2% to 8.3%], versus HE cohort, 7.0% [95% CI 5.3% to 8.6%]; p = 0.83). The CT brain scan traumatic abnormality rate was 3% lower in the LE cohort (LE cohort, 29% [95% CI 27% to 31%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001); individuals in the LE cohort were 50% less likely to receive critical care (LE cohort, 12% [95% CI 9.5% to 13%], versus HE cohort, 24% [95% CI 23% to 26%]; p < 0.001) or emergency interventions (LE cohort, 7.5% [95% CI 5.4% to 9.5%], versus HE cohort, 13% [95% CI 12% to 15%]; p < 0.001) than patients injured by high-energy transfer. The purposive sampling strategy and censorship of patient outcomes beyond hospital discharge are the main study limitations.Conclusions: We observed that patients sustaining TBI from low-energy falls are an important component of the TBI disease burden and a distinct demographic cohort; further, our findings suggest that energy transfer may not predict intracranial injury or acute care mortality in patients with TBI presenting to hospital. This suggests that factors beyond energy transfer level may be more relevant to prehospital and emergency department TBI triage in older people. A specific focus to improve prevention and care for patients sustaining TBI from low-energy falls is required. [ABSTRACT FROM AUTHOR]

Collecting and reporting data is a crucial aspect of in vitro fertilization (IVF) practice. During the following two decades after the first report of the European IVF-monitoring Consortium (EIM) on IVF data, the number of contributing countries increased gradually reaching nearly forty. For the first seven years of publication, between 2001 and 2007, Turkey did not provide IVF data to the European registry. Turkey first took part in the European registry in 2008 and thus also in the World registry. The addition of Turkish data to EIM was an important milestone, since Turkey appeared as the country with the sixth highest number of cycles, performing nearly eight percent of all European assisted reproductive technology (ART) cycles. Turkey continued contributing to the European registry for the following four years consecutively but after 2012 the input of Turkish IVF data stopped. Strikingly, between 2008-2012 Turkey became one of the main contributors to the registry with an ability to give a full report. So far, we do not have a complete European set of data and the number of cycles reported by European Society for Human Reproduction and Embryology (ESHRE) EIM can easily be said to be an underestimation of the actual number of cycles. IVF data from Turkey - a country having the 17th highest population in the World and appearing among the first six countries in Europe in terms of the number of ART cycles per year- will definitely contribute very much to ESHRE EIM database. It is now time to turn the tide and restart submitting Turkish data to European registry, but this time regularly and in a systematic method. Such an achievement will greatly contribute to the aim of EIM of achieving a complete data set. [ABSTRACT FROM AUTHOR]

Featured Application: Novel approach to wind fleet generator fault detection using Supervisory Control and Data Acquisition (SCADA) data and alarm logs. A hybrid health monitoring system for wind turbine generators is introduced. The novelty of this research consists in approaching a 115-wind turbine fleet by using the fusion of multiple sources of information. Analog SCADA data is analyzed through an autoencoder which allows to identify anomalous patterns within the input variables. Alarm logs are processed and merged to the anomaly detection output, creating a reliable health estimator of generator conditions. The proposed methodology has been tested on a fleet of 115 wind turbines from four different manufacturers located in various locations around Europe. The solution has been compared with other existing data modeling techniques offering impressive results on the fleet. An accuracy of 82% and a Kappa of 56% were obtained. The detailed methodology is presented using one of the available windfarms, composed of 13 onshore wind turbines rated 2 MW power. The rigorous evaluation of the results, the utilization of real data and the heterogeneity of the dataset prove the validity of the system and its applicability in an online operating scenario. [ABSTRACT FROM AUTHOR]

Aim: To ascertain the clinical profile and management of edoxaban in clinical practice. Materials & methods: Prospective, noninterventional postauthorization study of nonselected patients with atrial fibrillation treated with edoxaban from 12 European countries. Patients' baseline characteristics are presented. Results: A total of 13,638 patients (73.6 ± 9.5 years; 76.6/23.4% edoxaban 60/30 mg; CHA2DS2-VASc 3.1; 838 [6.1%] from Spain) were included. In Spain, the percentage of very elderly and fragile patients was greater and the risk of thromboembolism (CHA2DS2-VASc ≥2, 98.0 vs 87.3%; p < 0.001) and bleeding (HAS-BLED, 3.2 vs 2.7; p < 0.001) was greater in patients treated with edoxaban 30 mg. The proportion of patients taking edoxaban 30 mg was similar than in ENGAGE AF-TIMI 48. Conclusion: In Spain, patients treated with edoxaban were older and fragile. [ABSTRACT FROM AUTHOR]

ELIXIR is a pan-European intergovernmental organisation for life science that aims to coordinate bioinformatics resources in a single infrastructure across Europe; bioinformatics training is central to its strategy, which aims to develop a training community that spans all ELIXIR member states. In an evidence-based approach for strengthening bioinformatics training programmes across Europe, the ELIXIR Training Platform, led by the ELIXIR EXCELERATE Quality and Impact Assessment Subtask in collaboration with the ELIXIR Training Coordinators Group, has implemented an assessment strategy to measure quality and impact of its entire training portfolio. Here, we present ELIXIR's framework for assessing training quality and impact, which includes the following: specifying assessment aims, determining what data to collect in order to address these aims, and our strategy for centralised data collection to allow for ELIXIR-wide analyses. In addition, we present an overview of the ELIXIR training data collected over the past 4 years. We highlight the importance of a coordinated and consistent data collection approach and the relevance of defining specific metrics and answer scales for consortium-wide analyses as well as for comparison of data across iterations of the same course. [ABSTRACT FROM AUTHOR]

Introduction: Quantitative imaging biomarkers are becoming usual in oncology for assessing therapy response. The harmonization of image quantitation reporting has become of utmost importance due to the multi-center trials increase. The NEMA image quality test is often considered for the evaluation of quantitation and is more accurate with a radioactive solid phantom that reduces variability. The goal of this project is to determine the level of variability among imaging centers if acquisition and imaging protocol parameters are left to the center's preference while all other parameters are fixed including the scanner type. Methods: A NEMA-IQ phantom filled with radioactive 68Ge solid resin was imaged in five clinical sites throughout Europe. Sites reconstructed data with OSEM and BSREM algorithms applying the sites' clinical parameters. Images were analyzed according with the NEMA-NU2-2012 standard using the manufacturer-provided NEMA tools to calculate contrast recovery (CR) and background variability (BV) for each sphere and the lung error (LE) estimation. In addition, a 18F-filled NEMA-IQ phantom was also evaluated to obtain a gauge for variability among centers when the sites were provided with identical specific instructions for acquisition and reconstruction protocol (the aggregate of data from 12 additional sites is presented). Results: The data using the 68Ge solid phantom showed no statistical differences among different sites, proving a very good reproducibility among the PET center models even if dispersion of data is higher with OSEM compared to BSREM. Furthermore, BSREM shows better CR and comparable BV, while LE is slightly reduced. Two centers exhibit significant differences in CR and BV values for the 18F NEMA NU2-2012 experiments; these outlier results are explained. Conclusion: The same PET system type from the various sites produced similar quantitative results, despite allowing each site to choose their clinical protocols with no restriction on data acquisition and reconstruction parameters. BSREM leads to lower dispersion of quantitative data among different sites. A solid radioactive phantom may be recommended to qualify the sites to perform quantitative imaging. [ABSTRACT FROM AUTHOR]

Research on regional linguistic variation typically involves data collection in the field. This process itself can take up several months if not years. In the present study we demonstrate how we can use web interactives in collaboration with media outlets for a fast gathering of regional, sociolinguistic data. In collaboration with SPIEGEL ONLINE and Tagesanzeiger, we developed a web interactive that predicts users' regional backgrounds from within German-speaking Europe. More than 1.9M people have participated in the interactive, more than 770K users have provided metadata. Said metadata allowed us to capture regional variation in language as of today, which we can compare to historical survey data–enabling us to track the evolution of German in Europe over the past 40 years. We report on regional levelling of lexical variants, a process which appears to be particularly prevalent in the northern parts of German-speaking Europe. We further found an effect of (former) national and regional borders on language use. This innovative paradigm allows us to collect sociolinguistic data of an unprecedented scale–at the same time it presents significant challenges, both of which–benefits and challenges–will be discussed in this contribution. [ABSTRACT FROM AUTHOR]

Aims: Female sex is considered an independent risk factor of transvenous leads extraction (TLE) procedure. The aim of the study was to evaluate the effectiveness of TLE in women compared with men.Methods and Results: A post hoc analysis of risk factors and effectiveness of TLE in women and men included in the ESC-EHRA EORP ELECTRa registry was conducted. The rate of major complications was 1.96% in women vs. 0.71% in men; P = 0.0025. The number of leads was higher in men (mean 1.89 vs. 1.71; P < 0.0001) with higher number of abandoned leads in women (46.04% vs. 34.82%; P < 0.0001). Risk factors of TLE differed between the sexes, of which the major were: signs and symptoms of venous occlusion [odds ratio (OR) 3.730, confidence interval (CI) 1.401-9.934; P = 0.0084], cumulative leads dwell time (OR 1.044, CI 1.024-1.065; P < 0.001), number of generator replacements (OR 1.029, CI 1.005-1.054; P = 0.0184) in females and the number of leads (OR 6.053, CI 2.422-15.129; P = 0.0001), use of powered sheaths (OR 2.742, CI 1.404-5.355; P = 0.0031), and white blood cell count (OR 1.138, CI 1.069-1.212; P < 0.001) in males. Individual radiological and clinical success of TLE was 96.29% and 98.14% in women compared with 98.03% and 99.21% in men (P = 0.0046 and 0.0098).Conclusion: The efficacy of TLE was lower in females than males, with a higher rate of periprocedural major complications. The reasons for this difference are probably related to disparities in risk factors in women, including more pronounced leads adherence to the walls of the veins and myocardium. Lead management may be key to the effectiveness of TLE in females. [ABSTRACT FROM AUTHOR]

Aims: The present study sought to determine predictors for success and outcomes of patients who underwent cardiac implantable electronic devices (CIED) extraction indicated for systemic or local CIED related infection in particular where complete lead removal could not be achieved.Methods and Results: ESC-EORP ELECTRa (European Lead Extraction ConTRolled Registry) is a European prospective lead extraction registry. Out of the total cohort, 1865/3510 (52.5%) patients underwent removal due to CIED related infection. Predictors and outcomes of failure were analysed. Complete removal was achieved in 1743 (93.5%) patients, partial (<4 cm of lead left) in 88 (4.7%), and failed (>4 cm of lead left) in 32 (1.8%) patients. Removal success was unrelated to type of CIED infection (pocket or systemic). Predictors for failure were older leads and older patients [odds ratio (OR) 1.14 (1.08-1.19), P < 0.0001 and OR 2.68 (1.22-5.91), P = 0.0146, respectively]. In analysis by lead, predictors for failure were: pacemaker vs. defibrillator removal and failure to engage the locking stylet all the way to the tip [OR 0.20 (0.04-0.95), P = 0.03 and OR 0.32 (0.13-0.74), P = 0.008, respectively]. Significantly higher complication rates were noted in the failure group (40.6% vs. 15.9 for partial and 8.7% for success groups, P < 0.0001). Failure to remove a lead was a strong predictor for in hospital mortality [hazard ratio of 2.05 (1.01-4.16), P = 0.046].Conclusion: A total of 6.5% of infected CIED patients failed attempted extraction. Only were >4 cm of lead remained resulted in higher procedural complications and mortality rates. [ABSTRACT FROM AUTHOR]

Background: Multi-mode data collection is widely used in surveys. Since several modes of data collection are successively applied in such design (e.g. self-administered questionnaire after face-to-face interview), partial nonresponse occurs if participants fail to complete all stages of the data collection. Although such nonresponse might seriously impact estimates, it remains currently unexplored. This study investigates the determinants of nonresponse to a self-administered questionnaire after having participated in a face-to-face interview. Methods: Data from the Belgian Health Interview Survey 2013 were used to identify determinants of nonresponse to self-administered questionnaire (n = 1,464) among those who had completed the face-to-face interview (n = 8,133). The association between partial nonresponse and potential determinants was explored through multilevel logistic regression models, encompassing a random interviewer effect. Results: Significant interviewer effects were found. Almost half (46.6%) of the variability in nonresponse was attributable to the interviewers, even in the analyses controlling for the area as potential confounder. Partial nonresponse was higher among youngsters, non-Belgian participants, people with a lower educational levels and those belonging to a lower income household, residents of Brussels and Wallonia, and people with poor perceived health. Higher odds of nonresponse were found for interviews done in the last quarters of the survey-year. Regarding interviewer characteristics, only the total number of interviews carried out throughout the survey was significantly associated with nonresponse to the self-administered questionnaire. Conclusions: The results indicate that interviewers play a crucial role in nonresponse to the self-administered questionnaire. Participant characteristics, interview circumstances and interviewer characteristics only partly explain the interviewer variability. Future research should examine further interviewer characteristics that impact nonresponse. The current study emphasises the importance of training and motivating interviewers to reduce nonresponse in multi-mode data collection. [ABSTRACT FROM AUTHOR]

In Europe, the monitoring and management of migration flows are high on the political agenda. Evidence-based monitoring calls for adequate data, which do not exist. The sources of data on international migration differ significantly between countries in Europe and the initiatives to improve data collection and produce comparable data, including new legislation, did not yield the expected outcome. Scientists have developed statistical models that combine quantitative and qualitative data from different sources to derive at estimates of migration flows that account for differences in definition, undercoverage, undercount and other measurement problems. Official statisticians are reluctant to substitute estimates for measurements. This article reviews the progress made over the last decades and the challenges that remain. It concludes with several recommendations for better international migration data/estimates. They range from improved cooperation between actors to innovation in data collection and modelling. [ABSTRACT FROM AUTHOR]

Aims: To describe the characteristics and assess the 1-year outcomes of hospitalized (HHF) and chronic (CHF) heart failure patients with chronic obstructive pulmonary disease (COPD) enrolled in a large European registry between May 2011 and April 2013.Methods and Results: Overall, 1334/6920 (19.3%) HHF patients and 1322/9409 (14.1%) CHF patients were diagnosed with COPD. In both groups, patients with COPD were older, more frequently men, had a worse clinical presentation and a higher prevalence of co-morbidities. In HHF, the increase in the use of heart failure (HF) medications at hospital discharge was greater in non-COPD than in COPD for angiotensin-converting enzyme inhibitors (+13.7% vs. +7.2%), beta-blockers (+20.6% vs. +11.8%) and mineralocorticoid receptor antagonists (+20.9% vs. +17.3%), thus widening the gap in HF treatment already existing between the two groups at admission. In CHF patients, there was a similar increase in the use of these medications after enrollment visit in the two groups, leaving a significant difference of 8.2% for beta-blockers in favour of non-COPD patients (89.8% vs. 81.6%, P < 0.001). At 1-year follow-up, the hazard ratios for COPD in multivariable analysis confirmed its independent association with hospitalizations both in HHF [all-cause: 1.16 (1.04-1.29), for HF: 1.22 (1.05-1.42)] and CHF patients [all-cause: 1.26 (1.13-1.41), for HF: 1.37 (1.17-1.60)]. The association between COPD and all-cause mortality was not confirmed in both groups after adjustments.Conclusions: COPD frequently coexists in HHF and CHF, worsens the clinical course of the disease, and significantly impacts its therapeutic management and prognosis. The matter should deserve greater attention from the cardiology community. [ABSTRACT FROM AUTHOR]

Study Question: To what extent do financial, demographic and cultural determinants explain the vast cross-national differences in ART treatments in Europe?Summary Answer: The normative cultural acceptance of ART is a major driver of ART treatments in Europe, above and beyond differences in country wealth, demographic aspects and religious composition.What Is Known Already: There are vast differences in the number of ART treatments across European countries, which are to some extent related to country affluence, regulation, and insurance coverage and costs. The role and impact of cultural and normative factors has not been explored in a larger cross-national comparison.Study Design, Size, Duration: A descriptive and comparative cross-national analysis of ART treatment prevalence in over 30 European countries in 2010, with the outcome defined as the total number of ART cycles per million women of reproductive age (15-44 years). Data is drawn from multiple sources (ICMART, US Census Bureau Library, World Bank, Barro-Lee Educational Attainment Dataset, IFFS Surveillance reports, European Values Study and World Religion Database).Participants/materials, Setting, Methods: Our sample includes data from 35 European countries, where we describe the associations between demographic and cultural factors and the prevalence of ART treatments. Bivariate correlation and ordinary least squares multiple regression analysis serves to establish the relationships between predictor variables and the number of ART treatments per million women aged 15-44 years in a country.Main Results and the Role Of Chance: A one-percent increase in national GDP is associated with 382 (95% CI: 177-587) additional ART procedures per million women of reproductive age, yet this effect is reduced to 99 (-92 to 290) treatments once cultural values and demographic factors are accounted for. In our fully adjusted model, normative cultural values measuring the acceptability of ART are the strongest predictor of ART usage, with a one-point increase of average approval in a country associated with 276 (167-385) additional ART treatments per million women of reproductive age.Limitations, Reasons For Caution: Findings are based on a cross-sectional, cross-national analysis, making formal tests of causality impossible and prohibiting inferences to the individual level.Wider Implications Of the Findings: Results indicate that reproductive health policy should openly acknowledge the importance of cultural norms in informally shaping and regulating the wider availability of ART treatment.Study Funding/competing Interest(s): Funding for this project was provided by the European Union's Seventh Framework Program (FP7 2007-2013) (No. 320116 Families and Societies), European Research Council for the SOCIOGENOME Consolidator Grant (ERC-2013-CoG-615603) and the Wellcome Trust Institutional Strategic Support Fund (all to M.C.M.). The authors have no conflicts of interest to declare.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Study Question: Are there any changes in the treatments involving ART and IUI initiated in Europe during 2013 compared with previous years?Summary Answer: An increase in the overall number of ART cycles resulting from a higher number of countries reporting data was evident, the pregnancy rates (PRs) in 2013 remained stable compared with those reported in 2012, the number of transfers with multiple embryos (3+) was lower than ever before yet the multiple delivery rates (DRs) remained unchanged, and IUI activity and success rates were similar to those of last years.What Is Known Already: Since 1997, ART data in Europe have been collected and reported in 16 manuscripts, published in Human Reproduction.Study Design, Size, Duration: Retrospective data collection of European ART data by the European IVF-monitoring Consortium for ESHRE. Data for cycles between 1 January and 31 December 2013 were collected from National Registers, when existing, or on a voluntary basis by personal information.Participants/materials, Settings, Methods: From 38 countries (+4 compared with 2012), 1169 clinics reported 686 271 treatment cycles including 144 299 of IVF, 330 367 of ICSI, 154 712 of frozen embryo replacement (FER), 40 244 of egg donation (ED), 247 of IVM, 9791 of PGD/PGS and 6611 of frozen oocyte replacements. European data on intrauterine insemination using husband/partner's semen (IUI-H) and donor semen (IUI-D) were reported from 1095 IUI labs in 22 countries. A total of 175 467 IUI-H and 43 785 IUI-D cycles were included.Main Results and the Role Of Chance: In 17 countries where all clinics reported to their ART register, a total of 374 177 ART cycles were performed in a population of around 310 million inhabitants, corresponding to 1175 cycles per million inhabitants (range, 235-2703 cycles per million inhabitants). For all IVF cycles, the clinical PRs per aspiration and per transfer were stable with 29.6% (29.4% in 2012) and 34.5% (33.8% in 2012), respectively. For ICSI, the corresponding rates also were stable with 27.8% (27.8% in 2012) and 32.9% (32.3% in 2012). In FER-cycles, the PR per thawing/warming increased to 27.0% (23.1% in 2012). In ED cycles, the PR per fresh transfer increased to 49.8% (48.4% in 2012), to 38.5% (35.9% in 2012) per thawed transfer, and to 46.4% for transfers after FOR (45.1% in 2012). The DRs after IUI remained stable at 8.6% (8.5% in 2012) after IUI-H and was slightly lower after IUI-D (11.1% versus 12.0% in 2012). In IVF and ICSI cycles, 1, 2, 3 and 4+ embryos were transferred in 31.4, 56.3, 11.5, and 1.0% of the cycles, respectively (corresponding numbers were 30.2, 55.4, 13.3 and 1.1% in 2012). The proportions of singleton, twin and triplet deliveries after IVF and ICSI (added together) were 82., 17.5 and 0.5%, respectively, resulting in a total multiple DR of 18.0% compared to 17.9% in 2012. In FER-cycles, the multiple DR was 12.8% (12.5% twins and 0.3% triplets), nearly the same as in 2012 (12.5, 12.2 and 0.3% respectively). Twin and triplet DRs associated with IUI cycles were 9.5%/0.6% and 7.5%/0.3%, following treatment with husband/donor semen, respectively.Limitations, Reasons For Caution: The method of reporting varies among countries, and registers from a number of countries have been unable to provide some of the relevant data such as initiated cycles and deliveries. As long as data are incomplete and generated through different methods of collection, the results should be interpreted with caution.Wider Implications Of the Findings: The 17th ESHRE report on ART shows a continuing expansion of the number of treatment cycles in Europe, with more than 685 000 cycles reported in 2013 and an increasing contribution to birth rate in many countries. However, the need to improve and standardize the national registries, and to establish validation methodologies, remains manifest.Study Funding/competing Interest(s): The study has no external funding; all costs are covered by ESHRE. There are no competing interests. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries.Methods and Results: Out of 500 patients with PPCM entered by 31 March 2016, we report on data of the first 411 patients with completed case record forms (from 43 countries) entered into this ongoing registry. There were marked differences in socio-demographic parameters such as Human Development Index, GINI index on inequality, and Health Expenditure in PPCM patients from ESC vs. non-ESC countries (P < 0.001 each). Ethnicity was Caucasian (34%), Black African (25.8%), Asian (21.8%), and Middle Eastern backgrounds (16.4%). Despite the huge disparities in socio-demographic factors and ethnic backgrounds, baseline characteristics are remarkably similar. Drug therapy initiated post-partum included ACE inhibitors/ARBs and mineralocorticoid receptor antagonists with identical frequencies in ESC vs. non-ESC countries. However, in non-ESC countries, there was significantly less use of beta-blockers (70.3% vs. 91.9%) and ivabradine (1.4% vs. 17.1%), but more use of diuretics (91.3% vs. 68.8%), digoxin (37.0% vs. 18.0%), and bromocriptine (32.6% vs. 7.1%) (P < 0.001). More patients in non-ESC vs. ESC countries continued to have symptomatic heart failure after 1 month (92.3% vs. 81.3%, P < 0.001). Venous thrombo-embolic events, arterial embolizations, and cerebrovascular accidents were documented in 28 of 411 patients (6.8%). Neonatal death rate was 3.1%.Conclusion: PPCM occurs in women from different ethnic backgrounds globally. Despite marked differences in socio-economic background, mode of presentation was largely similar. Embolic events and persistent heart failure were common within 1 month post-diagnosis and required intensive, multidisciplinary management. [ABSTRACT FROM AUTHOR]

Background: Substantial variations are still to be found in the strength of general practice/family medicine (GP/FM) across Europe regarding governance, workforce competence and performance, as well as academic development and position. Governments are encouraged by the WHO to secure high quality primary health care to their population, a necessity for reaching the goal "Health for all". The present study aimed at investigating the opinions of council members of the European Academy of Teachers in General Practice (EURACT) on necessary actions to strengthen the position of GP/FM in their country. Methods: The study used a mixed methods exploratory sequential design. EURACT representatives from 32 European countries first participated in brain-storming on how to strengthen GP/FM in Europe. Later, representatives from 37 countries were asked to individually score the relevance of the proposed actions for their country on a 9-point Likert scale. They were also asked to evaluate the status of GP/FM in their country on four dimensions. Results: Respondents from 30 European countries returned complete questionnaires. To build and secure GP/FM as an academic discipline comprising teaching and research was seen as essential, regardless the present status of GP/FM in the respective country. To build GP/FM as a specialty on the same level as other specialties was seen as important in countries where GP/FM held a strong or medium strong position. The importance of common learning objectives and a defined bibliography were stated by respondents from countries where GP/FM presently has a weak position. Conclusions: In order to strengthen GP/FM throughout Europe, EURACT and other professional organizations must establish common goals and share expertise between countries. To influence decision makers through information on cost-effectiveness of a GP/FM-based health care system is also important. [ABSTRACT FROM AUTHOR]

Background: Migrants in many European countries including Germany tend to utilize preventive measures less frequently than the majority population. Little is known about the dental health of migrants as well as about their oral health behaviour, particularly in the adult population. The aim of this study was to examine differences in the uptake of annual dental check-ups in adult migrants and non-migrants in Germany. Methods: We used data from the cross-sectional survey 'German Health Update 2010' conducted by the Robert Koch Institute (n = 22,050). Data from 21,741 German-speaking respondents with information on the use of dental check-ups was available, of which 3404 (15.7%) were migrants. Multiple logistic regression models were applied to adjust for demographic and socioeconomic confounders, including the place of residence as well as type of health insurance. Results: Migrants were generally younger, had a lower socioeconomic status and showed a lower utilization of dental check-ups. The unadjusted odds ratio (OR) for utilization was 0.67 (95%-CI = 0.61--0.73). After adjusting for demographic and socioeconomic confounders the chance only increased slightly (adjusted OR = 0.71; 95%-CI = 0.65--0.77). Conclusions: The analysis shows that migration status is associated with a reduced chance of attending dental checkups, independently of demographic and socioeconomic factors. The influence of other factors, such as type of health insurance and place of residence had also no influence on the association. Migrants are exposed to different barriers in the health care system, comprising the patient, provider and system level. Further studies need to examine the relevant barriers for the uptake of preventive dental services in order to devise appropriate migrant- sensitive measures of dental prevention. [ABSTRACT FROM AUTHOR]

Aims: Atrial fibrillation (AF) is commonly associated with a high risk of stroke, thromboembolism, and mortality. The 1-year follow-up of the EURObservational Research Programme-Atrial Fibrillation (EORP-AF) Pilot Registry demonstrated a high mortality but good outcomes with European Society of Cardiology guideline-adherent therapy. Whether these 'real-world' observations on patients managed by European cardiologists extend to 2 years remains uncertain.Methods and Results: In this report from the EORP-AF General Registry Pilot Phase, we provide data on the 2-year follow-up outcomes. Consistent with the 1-year follow-up report, only a small proportion of patients were symptomatic (24.9%), with minor differences between the different AF subtypes. Persistence of oral anticoagulant (OAC) therapy remains high at 2-years, with ∼80% of patients treated with OAC. The prescribing rates of non-vitamin K antagonist oral anticoagulants are progressively increasing (13.7% at 2 years). Rate and rhythm control approaches remained consistent across the entire follow-up observation. Overall mortality rates remained high, with 5.0% of patients dead during the 2-year follow-up, mostly due to cardiovascular causes (61.8%). Atrial fibrillation readmissions were frequent, particularly related to arrhythmias and heart failure. On multivariate analyses, any cardiovascular reason for admission rather than AF was significantly associated with increased mortality during the 2-year follow-up.Conclusion: In this 2-year follow-up report from EORP-AF, mortality rates with AF remain high from cardiovascular causes, despite the high prevalent use of OAC. Improved management strategies to reduce major adverse outcomes in AF patients are needed. [ABSTRACT FROM AUTHOR]

Background: National and international policy makers require data at the local level to inform evidence-based policy making and evaluate the impact of policies; however, much data are only published at national level. Data collected at local level could be used to create aggregate measures to help inform health policy. Methods: Interviews were conducted with representatives of governmental public health agencies in eight European countries to assess the availability of local data and the extent to which local data was used to help decision making in nine urban areas (UAs). Respondents commented on the barriers to the use of aggregate measures at the local level for health policy decision making. Results: In many of the cities data were available at UA level and in some cases at sub-urban level, however, aggregate measures using local data were rarely used to help inform decision making. The main reasons for this were; poor data quality, a lack of experience in the use of aggregate measures and communication barriers between policy makers and data analysts. A 'top down' approach to decision making also limited the use of local data in the decision making process. Conclusions: Health data are available at urban level within European cities but aggregate measures using these data are rarely used to inform health policy decision making at the local level. Improved communication between local public health data analysts could help increase the use of these data. [ABSTRACT FROM AUTHOR]