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Background: Micro-credentials are increasingly considered a key mechanism through which to empower learners by enabling flexible upskilling and reskilling. Despite their apparent importance for higher education institutions (HEIs) and learners, empirical research is limited. More needs to be understood, particularly about the ways in which micro-credentials can shape institutional practice and provide benefits to learners. Purpose: Using a foresight approach, this study sets out to explore the potential for micro-credential adoption in relation to national and international policy initiatives and rapidly developing technologies. Its intention is to offer findings of interest internationally, particularly to those involved in strategic activities around micro-credentials. Methods: A four-step Delphi study approach was used to explore how micro-credentials may shape higher education (HE) in the next 5-10 years. Educational experts undertook a consensus-building activity utilising workshops and surveys: (1) initial identification of enabling factors (i.e. drivers) and beneficial outcomes (i.e. impacts) of micro-credentials; (2) prioritisation based on importance; (3) identification of enabling factors considered essential for each beneficial outcome and (4) analysis of the extent to which micro-credentials might be accepted in HE, with participants reflecting on the importance of the previously identified enablers and outcomes for alternative scenarios. Findings: The analysis sheds light on three alternative possible futures for micro-credentials. Expert consensus indicated that the potential of micro-credentials lies especially among educational institutions and the networks of institutions innovating beyond, and within, traditional study offerings and programmes. Future wide-scale adoption of micro-credentials was considered unpredictable, due to external factors at the ecosystem level, and beyond institutions' own strategies and control. Conclusion: The findings suggest that, for the successful uptake of micro-credentials, the same benefits do not need to accrue for institutions and learners: a 'one-size-fits-all' approach is not necessary or optimal. In order for the wider-scale influence of micro-credentials to be felt, there is a need for considerable international and national strategy development and implementation to overcome a variety of policy- and technology-related barriers that HEIs cannot influence or tackle on their own.

Simple Summary: Clear cell renal cell carcinoma is a kidney cancer with high incidence rates in the western world. There is an increasing research base fueling the modern application of therapy to treat this cancer. Despite the traditional surgical interventions available for treatment, more is now understood about its metastases and optimal treatment strategies. The treatment of clear cell renal cell carcinoma is quickly advancing to ensure that patients receive personalized cancer therapy specific to their solid tumor. While surgical interventions remain the dominant treatment modality, adjuvant drug therapies have shown promising results, especially for patients with advanced disease. Clear cell renal cell carcinoma is the most common form of kidney cancer, accounting for 75% of malignant kidney tumors, and is generally associated with poor patient outcomes. With risk factors including smoking, obesity, and hypertension, all of which have a high prevalence in the United States and Europe, as well as genetic factors including tuberous sclerosis complex and Von Hippel–Lindau syndrome, there is an increasing need to expand our present understanding. The current clear cell renal cell carcinoma knowledge is outdated, with obsolete diagnostic criteria and moderately invasive surgical treatments still prevailing, partially ascribed to its resistance to chemotherapy and radiation therapy. The standard of treatment relies on surgical intervention, including radical nephrectomy and partial nephrectomy, while more recent treatments target neoplastic growth pathways and immune regulation checkpoints. [ABSTRACT FROM AUTHOR]

Mini publics have become cornerstones of the European Union's Future of Europe (FoE) initiative. However, weaknesses in their designs bring their political influence into question. Often-unsystematic in design, they fail to strengthen participants' understandings of the issues under evaluation and induce silo-thinking and the formation of pseudo-preferences. These come at a cost to informed and deliberatively deduced recommendations which speak to underlying functional/operational technicalities which fundamentally determine the form and delivery of policy interests. Guided by the adage that form follows function, this paper argues that mini publics pertaining to the FoE must primarily encourage participants to think about the ways policies are made in the EU before they formulate policy recommendations. To do this, they must consider the EU's overall form (or prospective forms). Utilising data from focus group analysis, the paper demonstrates that scenario (vignette) models are conducive to strengthening participants' understandings of both existing and alternative EU forms, and their functional consequences for EU policies, thus enabling them to formulate concrete and potentially deliverable policy recommendations. Subsequently, the paper encourages organisers of relevant mini-publics to employ the European Commission's 'Five Scenarios for the FoE' as entry-points to strengthen the deliberative quality and democratic outputs of such exercises. [ABSTRACT FROM AUTHOR]

Purpose: A relevant literature review suggests that today's children are increasingly immersing themselves in ubiquitous technologies, including interactive media and digital games. Therefore, this paper aims to investigate the primary school students' intrinsic and extrinsic motivations toward learning via gameplay through their mobile devices, at home and at school. Design/methodology/approach: This study was carried out among primary school students in a small European state. It used valid and reliable measures that comprised the technology acceptance model's key constructs. However, the empirical investigation also explored the students' perceived enjoyment and social influences, as plausible antecedents for their behavioral intention to engage with the educational applications (apps). Findings: The findings reported that there were strong correlations between the students' perceived usefulness of the mobile technologies and their behavioral intention to use them for their learning. The results also indicated that there was no significant relationship between the perceived ease of use and the children's enjoyment in engaging with the educational apps that were used at school. Originality/value: To the best of the authors' knowledge, there is no other study in academia that has explored the children's technology acceptance, normative pressures and their intrinsic motivations to use mobile learning technologies in the context of primary education. Therefore, this contribution opens future research directions, as this study can be replicated in other contexts.

Background: Elevated rates of suicidal behavior were reported during the COVID-19 pandemic. However, information is scarce on patients' profiles during this period. Studies evoke the potential adverse effects of the mandatory lockdown, but they remain relatively speculative. Methods: We monitored fluctuations in suicide attempts (SA) in six European countries. We gathered data, retrospectively for under 18-year-old SA episodes (1 January 2018 to 31 December 2021), through records of psychiatric emergency services. We collected clinical profiles individually. We extracted environmental indicators by month, as provided by Oxford COVID-19 Government Response Tracker (OxCGRT). We used the Pruned Exact Linear Time (PELT) method to identify breakpoints in SA episodes reported for each country, and logistic regressions to estimate changes in patients' characteristics after the breakpoints. Finally, we used a univariate and multivariate negative binomial model to assess the link between SA and OxCGRT indicators, accounting for the delay (lag) between the interventions and their impact on SA. Results: The study comprised 2,833 children and adolescents (mean age = 15.1 years (SD 1.6); M: F sex-ratio = 1:5.4). A significant increase in SA was found either 6 or 10 months after the beginning of the pandemic, varying by country. Patients were more likely to be girls (aOR = 1.77 [1.34; 2.34]) and used SA methods "other than self-poisoning" (aOR = 1.34 [1.05; 1.7]). In the multivariate model, an association was found between SA and the contact tracing indicator with an 11 months delay, and the number of COVID-19 deaths with a 3-months delay. Conclusions: Findings confirmed a delayed increase in SA during the COVID-19 pandemic in children and adolescents as well as changes in patients' profiles. The duration and severity of the pandemic emerged as the strongest predictor in the rise of SA. If faced with a similar pandemic in the future, the gap between the onset of pandemic and the increase in suicide attempts presents an opportunity for prevention. [ABSTRACT FROM AUTHOR]

What are the country‐specific differences in the education of chemistry students across the EU? How do students' preferred careers change with the level of their qualifications? Do students have sufficient information to make good career choices? Which media are now considered most effective for job searches? What do students currently consider to be a successful career? Three Employment Surveys for European Chemists (ESEC1−ESEC3) were conducted between 2013 and 2020. The web‐based questionnaires were open to chemists from all countries. A total of 9747 responses were received. The reports for ESEC1 and ESEC2 are freely available.[1,2] Subsequent questionnaires have been continuously adapted to reflect the latest discussions in our societies. In particular, ESEC3 focused on students' careers. The results are reported here. Where results from earlier surveys are included, this is explicitly stated. Graduates of the last 15 years are particularly important for two reasons. They represent the largest group of ESEC participants, with 59 % of the responses, and they represent the labour market with the greatest future prospects. Their situation is of particular importance for real decisions about the chemistry labour market. For this reason, this report focuses exclusively on graduates of the last 15 years. [ABSTRACT FROM AUTHOR]

Introduction: The PRESERFLO™ MicroShunt (PMS) has been proven to significantly lower intraocular pressure (IOP) in patients with glaucoma and has been available for use since 2019. With increasing published evidence and growing experience of glaucoma surgeons, the aim of this modified Delphi panel was to build on the findings of a previous Delphi panel conducted in 2021 and provide further guidance on the role of the PMS to treat patients with glaucoma in Europe. Methods: Thirteen European glaucoma surgeons experienced in the PMS procedure participated in a 3-round modified Delphi panel. A targeted literature review and expert steering committee guided Round 1 questionnaire development. Consensus was pre-defined at a threshold of ≥ 70% of panellists selecting 'strongly agree'/'agree' or 'strongly disagree'/'disagree' for 6-point Likert scale questions or ≥ 70% selecting the same option for multiple or single-choice questions. Questions not reaching consensus were restated/revised for the next round, following guidance from free-text responses/scoping questions. Results: In total, 28% (n = 9/32), 52% (n = 16/31) and 91% (n = 10/11) of statements reached consensus in Rounds 1, 2 and 3, respectively. There was agreement that the PMS may be used in patients with pigmentary, post-trauma or post-vitrectomy glaucoma and for patients with uveitic glaucoma without active inflammation. The PMS may be more suitable for patients with contact lenses than other subconjunctival filtering surgeries, without eliminating bleb-associated risks. Consensus was reached that combining PMS implantation and phacoemulsification may be as safe as standalone PMS surgery, but further efficacy data are required. Following a late rise in IOP ≥ 4 months post-surgery, topical aqueous suppressant drops or bleb revision may be suitable management options. Conclusions: This Delphi panel builds on the considerations explored in the 2021 Delphi panel and provides further detailed guidance for glaucoma surgeons on the use of the PMS, reflecting the availability of novel evidence and surgical experience. Videos are available for this article. [ABSTRACT FROM AUTHOR]

The Common European Framework of Reference for Languages (CEFR) is widely used in setting language proficiency requirements, including for international students seeking access to university courses taught in English. When different language examinations have been related to the CEFR, the process is claimed to help score users, such as university admissions staff, to compare and evaluate these examinations as tools for selecting qualified applicants. This study analyses the linking claims made for four internationally recognised tests of English widely used in university admissions. It uses the Council of Europe's (2009) suggested stages of specification, standard setting, and empirical validation to frame an evaluation of the extent to which, in this context, the CEFR has fulfilled its potential to "facilitate comparisons between different systems of qualifications." Findings show that testing agencies make little use of CEFR categories to explain test content; represent the relationships between their tests and the framework in different terms; and arrive at conflicting conclusions about the correspondences between test scores and CEFR levels. This raises questions about the capacity of the CEFR to communicate competing views of a test construct within a coherent overarching structure.

Stoneworts (Charales) are green algae that represent an important food resource for many waterbird species in Europe and elsewhere. Browsing avian herbivores (e.g. swan, goose, duck and coot species) consume Charales plant vegetative parts, by head‐dipping, up‐ending or diving. A lower fibre content and longer growing season may make Charales as attractive to such herbivores as sympatric submerged higher plant species in some circumstances. Charales respond to environmental stress (e.g. drought) by producing abundant diaspores, in the form of oospores (sexual) and bulbils (asexual), both rich in starch, generating abundant food for waterbirds at critical stages in their annual migratory cycles. Waterbirds feed on these by diving (e.g. common pochard Aythya ferina and red‐crested pochard Netta rufina) or by filtering from the water column (e.g. dabbling duck species), ensuring dispersal of sexually produced and vegetative diaspores locally (because of predator swamping) and remotely (through endo‐ and ectozoochorous dispersal by long‐distance migratory waterbirds). Greater invertebrate density and diversity associated with Charales canopies enhances their attractiveness over other submerged macrophyte beds to diving predators [e.g. tufted duck Aythya fuligula, common pochard and Eurasian coot Fulica atra (hereafter coot)]. Fish fry preying on these invertebrates use such vegetation as predator cover, in turn providing prey for avian piscivores such as grebes and cormorants. Abundant Charales contribute to maintaining a transparent water column due to canopy density, nutrient effects, dampening of sedimentation/remobilisation of suspended matter and nutrients and allelopathic effects on other plants (especially phytoplankton). Shallow, relatively eutrophic waters can flip between clear‐water high‐biodiversity (where Charales thrive) and turbid species‐poor depauperate stable states (lacking Charales). Shifts between turbid conditions and rich submerged Charales beds have profound elevating effects on aquatic diversity, to which waterbirds show rapid aggregative responses, making them ideal indicator species of ecological change; in the case of Charales specialists (such as red‐crested and common pochard), indicators of the presence and abundance of these plants. Large‐bodied colonial nesting birds (e.g. cormorants, gulls, heron and egrets) aggregating along lake shores contribute high N and P loadings to water bodies sensitive to such external and internal inputs and can cause local eutrophication and potential loss of Charales. Despite variation from complete seasonal removal of Charales biomass to undetectable grazing effects by herbivorous birds, evidence suggests little effect of avian grazing on biomass accumulation or the stability of community composition (under otherwise stable conditions), but we urge more research on this under‐researched topic. We also lack investigations of the relative foraging profitability of different Charales organs to waterbirds and the degree of viability of gyrogonites (fertilised and calcified oospores), vegetative bulbils and plant fragments after passage through the guts of waterbirds. We especially need to understand better how much the carbonate armour of these organs affects their viability/dispersal via waterbirds and urge more research on these neglected plants and their relationships and interactions with other organisms in the aquatic biota. [ABSTRACT FROM AUTHOR]

Background: The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health among European adolescents. Methods: Data from the HELENA study were used. Usual dietary intake was assessed using two 24-h dietary recalls and adherence to the EAT-Lancet diet was assessed using the Planetary Health Diet Index (PHDI), a 16-component index that ranges from 0 to 150 points. Cardiovascular health was assessed through the seven-component Ideal Cardiovascular Health (ICH) score: never smoked, eutrophic body mass index, moderate-to-vigorous physical activity, healthy dietary pattern, low blood pressure, low fasting plasma glucose, and low total cholesterol. Total ICH score was categorized into ideal (5–7) and non-ideal (0–4). Results: A 10-point increment in the PHDI was associated with a lower probability of a non-ideal ICH status (OR 0.84, [95% CI: 0.75, 0.94]) among European adolescents, after adjusting for age, sex, socio-economic status, and total energy intake. Furthermore, a 10-point increment in the PHDI was associated with lower probability of high blood pressure (OR: 0.87 [0.79, 0.96]) and a lower probability of high blood cholesterol (OR: 0.88 [0.78, 0.99]). Conclusion: Our study suggests that a higher PHDI may be associated with a better cardiovascular health status among European adolescents. [ABSTRACT FROM AUTHOR]

Our aim in this study was to examine the impact of fans (vs. no fans), geographical location of league, and team ability on home winning percentage (HW%) or home advantage (HA) in professional European basketball. Data were collected from five prestigious professional, national basketball leagues within Europe (Spain, Germany, Italy, Greece and Israel) across 16 regular seasons (2005-2006 to 2020-2021). We conducted comparisons between matches with and without fans, location of leagues, team ability (High, Medium, Low), and combinations of these factors via non-parametric tests (e.g., Mann-Whitney tests, Kruskal-Wallis). We found significantly greater HA during matches with fans for leagues in Germany (p =.001), Italy (p =.012) and Spain (p =.002). For matches with fans, HA and HW% were significantly different between several, but not all, leagues for high (p <.05), medium (p <.05) and low (p <.02) team abilities. In conclusion, HA and HW% were enhanced by spectator attendance, with this phenomenon varying by location/region and team ability. Consideration of these multiple contextual factors may assist coaches and sport organizations to develop key strategies for enhanced team success. [ABSTRACT FROM AUTHOR]

Research on geographies of knowledge sourcing examines the organizational structure of innovation activities within the firm, the mechanisms by which knowledge is extracted from various external sources and the geography of these different activities. We augment this literature by exploring knowledge sourcing within multi-plant firms operating in Europe. Analysis makes use of linked patent-firm data recording the location of knowledge production and its ownership. The results add value to existing research in three ways. First, the establishments of multi-plant firms are shown to produce different kinds of knowledge in different locations. Second, the patents generated within a firm's establishments are linked to the knowledge stocks of the regions where they operate, supporting a vision of geographical knowledge sourcing. Third, the complexity of knowledge produced within firms is positively related to the number of plants in which they innovate. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This paper investigates the place of pedagogy in language-in-education policy through an analysis of how the macro-level of government policy interacts with the micro-level of local educational practice. It argues that pedagogy is typically considered a micro-level activity and policy frequently devolves decision-making about pedagogy to micro-level agents. For this reason, pedagogy is often invisible in policy texts. Pedagogy becomes a concern for macro-level policy when micro-level practice is constructed as being a problem and policy seeks to intervene to reform practice. However, whether pedagogy is explicitly discussed in policy, it remains nonetheless relevant for policy implementation and ultimately for the success of policy change. The silence about pedagogy in policy texts may render invisible the capacity for pedagogical change at the micro-level and the capabilities and resources needed to effect change. The paper will examine these issues through an investigation of a series of language policy contexts in which pedagogy is either an explicit concern or it remains implicit.

Objective The ACR-EULAR Myositis Response Criteria (MRC) were developed as a composite measure using absolute percentage change in six core set measures (CSMs). We aimed to further validate the MRC by assessing the contribution of each CSM, frequency of strength vs extramuscular activity improvement, representation of patient-reported outcome measures (PROM), and frequency of CSM worsening. Methods Data from adult dermatomyositis/polymyositis patients in the rituximab (n  = 147), etanercept (n  = 14), and abatacept (n  = 19) trials, and consensus patient profiles (n  = 232) were evaluated. The Total Improvement Score (TIS), number of improving vs worsening CSMs, frequency of improvement with and without muscle-related CSMs, and contribution of PROM were evaluated by MRC category. Regression analysis was performed to assess contribution of each CSM to the MRC. Results Of 412 adults with dermatomyositis/polymyositis, there were 37%, 24%, 25%, and 14% with no, minimal, moderate, and major MRC improvement, respectively. The number of improving CSMs and absolute percentage change in all CSMs increased by improvement category. In minimal-moderate improvement, only physician-reported disease activity contributed significantly more than expected by MRC. Of patients with at least minimal improvement, 95% had improvement in muscle-related measures and a majority (84%) had improvement in PROM. Patients with minimal improvement had worsening in a median of 1 CSM, and most patients with moderate-major improvement had no worsening CSMs. Physician assessment of change generally agreed with MRC improvement categories. Conclusion The ACR-EULAR MRC performs consistently across multiple studies, further supporting its use as an efficacy end point in future myositis therapeutic trials. [ABSTRACT FROM AUTHOR]

This article showcases the outcomes of a comprehensive spatiotemporal dynamic analysis conducted in forest vegetation areas within the forest-steppe zone of the Central Russian Upland (eastern Europe), spanning the period from 1970 to 2020. This study utilized high-resolution data from the Corona satellite system from the year 1970 as well as satellite imagery from the ArcGIS World Imagery database. Soil properties and their changes were assessed based on the analysis of soil bulk density (930 samples), soil organic carbon features, pH, available phosphorus, and the composition of salt extracts (1362 samples). We collected and analyzed 3920 soil samples in the field to study the impact of shelterbelts on soil moisture over a period of two years. For six selected key sites with a total area of 1722 km2, it was found that over a 50-year period, the area covered by forest vegetation increased from 14% to 24%. This expansion was primarily due to the planting and growth of young shelterbelts in the 1970s–1980s as well as widening anti-erosion shelterbelts on slopes and gullies. The average linear growth rate of forest vegetation boundaries was found to be 23.5 m (4.7 m per decade) for the entire study area. The expansion was highest on west-facing slopes, which was attributed to the higher moisture content from windward atmospheric precipitation events. However, alongside the increase in forest cover, degradation was also observed, particularly in old-age shelterbelts, which was attributed to increased fragmentation and mortality. A gradual increase in the extent of shelterbelt degradation was observed from the northwest to the southeast within the forest-steppe region, corresponding to areas with a drier climate. Additionally, the impact of shelterbelts on soil properties and soil cover was analyzed using four key sites and using fields and laboratory research methods. We detected a lateral uptake of substances from plowed soils into the soils of shelterbelts and vertical uptake from deep layers. The two-year observations (2020 and 2021) of soil moisture during the growing season (May–September) in two climatically contrasting forest-steppe areas revealed a more intensive accumulation of soil moisture in fields west of shelterbelts compared to those to the east of them, particularly within the 10 m zone near the shelterbelts. This can be attributed to arable fields on the windward side receiving more moisture compared to the leeward side. The formation of striped microstructures in the soil cover that occurred under the shelterbelts and on adjacent arable lands was influenced by various factors such as microclimatic conditions, vegetation types, ecological conditions for soil fauna, and human-induced soil processing and transformation along the shelterbelt boundaries. Shelterbelts and their adjacent areas in agro-landscapes are considered to be self-developing natural–anthropogenic geosystems with their own organizational structure. Therefore, their study is recommended as an integral part of modern geographical zoning. [ABSTRACT FROM AUTHOR]

Bronchiectasis is a heterogeneous, neglected disease with few multicentre studies exploring the causes, severity, microbiology, and treatment of the disease across Europe. This aim of this study was to describe the clinical characteristics of bronchiectasis and compare between different European countries. EMBARC is an international clinical research network for bronchiectasis. We report on a multicentre, prospective, observational, non-interventional, cohort study (the EMBARC registry) conducted across 27 European countries and Israel. Comprehensive clinical data were collected from adult patients (aged ≥18 years) at baseline and annual follow-up visits using electronic case report form. Data from individual countries were grouped into four regions (the UK, northern and western Europe, southern Europe, and central and eastern Europe according to modified EU EuroVoc classification). Follow-up data were used to explore differences in exacerbation frequency between regions using a negative binomial regression model. Between Jan 12, 2015, and April 12, 2022, 16 963 individuals were enrolled. Median age was 67 years (IQR 57–74), 10 335 (60·9%) participants were female and 6628 (39·1%) were male. The most common cause of bronchiectasis in all 16 963 participants was post-infective disease in 3600 (21·2%); 6466 individuals (38·1%) were classified as idiopathic. Individuals with bronchiectasis experienced a median of two exacerbations (IQR 1–4) per year and 4483 (26·4%) patients had a hospitalisation for exacerbation in the previous year. When examining the percentage of all isolated bacteria, marked differences in microbiology were seen between countries, with a higher frequency of Pseudomonas aeruginosa and lower Haemophilus influenzae frequency in southern Europe, compared with higher H influenzae in the UK and northern and western Europe. Compared with other regions, patients in central and eastern Europe had more severe bronchiectasis measured by the Bronchiectasis Severity Index (51·3% vs 35·1% in the overall cohort) and more exacerbations leading to hospitalisations (57·9% vs 26·4% in the overall cohort). Overall, patients in central and eastern Europe had an increased frequency of exacerbations (adjusted rate ratio [RR] 1·12, 95% CI 1·01–1·25) and a higher frequency of exacerbations leading to hospitalisations (adjusted RR 1·71, 1·44–2·02) compared with patients in other regions. Treatment of bronchiectasis was highly heterogeneous between regions. Bronchiectasis shows important geographical variation in causes, microbiology, severity, and outcomes across Europe. European Union–European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative. For the Arabic, French, German, Greek, Hebrew, Irish, Russian and Spanish translations of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

The returns to schooling are estimated for 28 European and Central Asian countries using the Mincerian function. Our results show that while the public sector pays on average more than the private sector, the effect of education on earnings is stronger in the private sector. However, the returns to tertiary education are higher in the private sector. [ABSTRACT FROM AUTHOR]

Purpose: Thinness in adolescence has not been studied as extensively as overweight or obesity. The aim of this study was to assess the prevalence, characteristics, and health impacts of thinness in a European adolescent population. Methods: This study included 2711 adolescents (1479 girls, 1232 boys). Blood pressure, physical fitness, sedentary behaviors, physical activity (PA), and dietary intake were assessed. A medical questionnaire was used to report any associated diseases. A blood sample was collected in a subgroup of the population. Thinness and normal weight were identified using the IOTF scale. Thin adolescents were compared with adolescents of normal weight. Results: Two hundred and fourteen adolescents (7.9%) were classified as being thin; the prevalence rates were 8.6% in girls and 7.1% in boys. Systolic blood pressure was significantly lower in adolescents with thinness. The age at the first menstrual cycle was significantly later in thin female adolescents than in those with normal weight. Upper-body muscular strength measured in performance tests and time spent in light PA were significantly lower in thin adolescents. The Diet Quality Index was not significantly lower in thin adolescents, but the percentage of adolescents who skipped breakfast was higher in adolescents with a normal weight (27.7% vs 17.1%). Serum creatinine level and HOMA-insulin resistance were lower and vitamin B12 level was higher in thin adolescents. Conclusions: Thinness affects a notable proportion of European adolescents with no physical adverse health consequences. [ABSTRACT FROM AUTHOR]

Introduction: The optimal approach and therapy method for the acardiac twin with a reverse arterial perfusion sequence has not yet been established. The aim of this study was to determine the clinical practice patterns among international fetal therapy units in their management of these cases. Methods: A survey was sent to fetal centers across the world via email between December 2020 and December 2021. Results: Responses were obtained from 77% contacted centers. The most frequent ultrasound variables used in the evaluation of twin reverse arterial perfusion sequence include echocardiographic assessment of the pump twin and umbilical artery Doppler waveforms in the acardiac and pump twins, in 90% and 80% of the centers, respectively. Most centers in Europe and Latin America propose an in utero intervention in all cases. Most centers in Europe and Latin America prefer interstitial laser ablation, whereas radiofrequency ablation (RFA) is preferred in North America. The earliest gestational age for an intervention is on mean 13 weeks in Europe, which is earlier than the other geographic areas (p = 0.001). Conclusions: Most centers agreed that antenatal evaluation should include echocardiography along with the UA Doppler waveform measurements, and the most frequently used interventions were interstitial laser ablation or RFA at a median between 14 and 26 weeks. [ABSTRACT FROM AUTHOR]

Land surface models (LSMs) use the atmospheric grid as their basic spatial decomposition because their main objective is to provide the lower boundary conditions to the atmosphere. Lateral water flows at the surface on the other hand require a much higher spatial discretization as they are closely linked to topographic details. We propose here a methodology to automatically tile the atmospheric grid into hydrological coherent units which are connected through a graph. As water is transported on sub-grids of the LSM, land variables can easily be transferred to the routing network and advected if needed. This is demonstrated here for temperature. The quality of the river networks generated, as represented by the connected hydrological transfer units, are compared to the original data in order to quantify the degradation introduced by the discretization method. The conditions the sub-grid elements impose on the time step of the water transport scheme are evaluated, and a methodology is proposed to find an optimal value. Finally the scheme is applied in an off-line version of the ORCHIDEE (Organising Carbon and Hydrology In Dynamic Ecosystems) LSM over Europe to show that realistic river discharge and temperatures are predicted over the major catchments of the region. The simulated solutions are largely independent of the atmospheric grid used thanks to the proposed sub-grid approach. [ABSTRACT FROM AUTHOR]

With the current expansion of vector-based research and an increasing number of facilities rearing arthropod vectors and infecting them with pathogens, common measures for containment of arthropods as well as manipulation of pathogens are becoming essential for the design and running of such research facilities to ensure safe work and reproducibility, without compromising experimental feasibility. These guidelines and comments were written by experts of the Infravec2 consortium, a Horizon 2020-funded consortium integrating the most sophisticated European infrastructures for research on arthropod vectors of human and animal diseases. They reflect current good practice across European laboratories with experience of safely handling different mosquito species and the pathogens they transmit. As such, they provide experience-based advice to assess and manage the risks to work safely with mosquitoes and the pathogens they transmit. This document can also form the basis for research with other arthropods, for example, midges, ticks or sandflies, with some modification to reflect specific requirements. [ABSTRACT FROM AUTHOR]

Life-history traits of eels display a high level of phenotypic plasticity in response to large-scale biogeographical drivers, as well as local conditions encountered during the continental phase. Here, we provided a biogeographical snapshot of the variability of life-history traits of eels (Anguilla anguilla), across a large proportion of their natural distribution range. Silver eels (n = 99) were collected across eleven European catchments to investigate how life-history traits vary along geographical and saline habitats, as it was inferred from the Sr:Ca ratio in otoliths. Among 13 life-history traits tested, 3 of them such as total length, body or liver weight were related to geographical coordinates. Overall, eels grow faster in southern Europe and migrate earlier suggesting that the silvering process is related to the local growth conditions more than fish age. The salinity profiles revealed by the otoliths' Sr:Ca ratios indicate that eels with a brackish life-history generally grow faster, reach larger size-at-age, and have a better condition than eels living in freshwater. This observation associated with the lower abundance of the sanguivorous swimbladder nematode, Anguillicola crassus, confirms the importance of brackish areas for sustaining the eel production. A large proportion of the observed variation of life-history traits remained unexplained by the biogeographical trends and salinity condition, which suggests that other drivers act at the catchment scale. [ABSTRACT FROM AUTHOR]

The atmospheric boundary layer (ABL) defines the volume of air adjacent to the Earth's surface for the dilution of heat, moisture, and trace substances. Quantitative knowledge on the temporal and spatial variations in the heights of the ABL and its sub-layers is still scarce, despite their importance for a series of applications (including, for example, air quality, numerical weather prediction, greenhouse gas assessment, and renewable energy production). Thanks to recent advances in ground-based remote-sensing measurement technology and algorithm development, continuous profiling of the entire ABL vertical extent at high temporal and vertical resolution is increasingly possible. Dense measurement networks of autonomous ground-based remote-sensing instruments, such as microwave radiometers, radar wind profilers, Doppler wind lidars or automatic lidars and ceilometers are hence emerging across Europe and other parts of the world. This review summarises the capabilities and limitations of various instrument types for ABL monitoring and provides an overview on the vast number of retrieval methods developed for the detection of ABL sub-layer heights from different atmospheric quantities (temperature, humidity, wind, turbulence, aerosol). It is outlined how the diurnal evolution of the ABL can be monitored effectively with a combination of methods, pointing out where instrumental or methodological synergy are considered particularly promising. The review highlights the fact that harmonised data acquisition across carefully designed sensor networks as well as tailored data processing are key to obtaining high-quality products that are again essential to capture the spatial and temporal complexity of the lowest part of the atmosphere in which we live and breathe. [ABSTRACT FROM AUTHOR]

Demonstrates inadequacy of "part-time farming," preferring "pluriactivity." Sets context for 10 papers on pluriactivity and agro-rural change in Western Europe. Outlines applied social science studies on the topic. Voices need for critical, policy-oriented studies in face of changing agricultural and social issues. (TES)

The year 2021 was critical for European football, as the COVID-19 pandemic led to financial problems that brought back the idea of top clubs creating a European Super League (ESL). This idea has been popular in the past, but its discussion in scientific literature has generally been brief and infrequent. Seen by some authors as the salvation of the industry and by others as a threat, this is a topic that promises not to disappear any time soon. Therefore, this bibliometric review intends to identify the trends and gaps in the literature, the directions followed in each work, and the networks between authors, as well as to highlight the main contributors. Such a review will help set out a future research agenda on this topic. [ABSTRACT FROM AUTHOR]

Background: Our aim is to describe and compare the profile and outcome of patients attending the ED with a confirmed COVID-19 infection with patients with a suspected COVID-19 infection. Methods: We conducted a multicentric retrospective study including adults who were seen in 21 European emergency departments (ED) with suspected COVID-19 between 9 March and 8 April 2020. Patients with either a clinical suspicion of COVID-19 or confirmed COVID-19, detected using either a RT-PCR or a chest CT scan, formed the C+ group. Patients with non-confirmed COVID-19 (C− group) were defined as patients with a clinical presentation in the ED suggestive of COVID-19, but if tests were performed, they showed a negative RT-PCR and/or a negative chest CT scan. Results: A total of 7432 patients were included in the analysis: 1764 (23.7%) in the C+ group and 5668 (76.3%) in the C− group. The population was older (63.8 y.o. ±17.5 vs. 51.8 y.o. +/− 21.1, p < 0.01), with more males (54.6% vs. 46.1%, p < 0.01) in the C+ group. Patients in the C+ group had more chronic diseases. Half of the patients (n = 998, 56.6%) in the C+ group needed oxygen, compared to only 15% in the C− group (n = 877). Two-thirds of patients from the C+ group were hospitalized in ward (n = 1128, 63.9%), whereas two-thirds of patients in the C− group were discharged after their ED visit (n = 3883, 68.5%). Conclusion: Our study was the first in Europe to examine the emergency department's perspective on the management of patients with a suspected COVID-19 infection. We showed an overall more critical clinical situation group of patients with a confirmed COVID-19 infection. [ABSTRACT FROM AUTHOR]

The article offers public health news briefs in Europe. The 15th European Public Health (EPH) Conference will be held in Berlin, Germany on November 9-12, 2022. Also cited are the public health priorities of the EPH Association (EPHA) to its members for the next five years, and updates to the Europe's Beating Cancer Plan that focuses on cancer screening.

This document is a correction notice for an article titled "Burden of Topical Treatments in Psoriasis and Preferred Criteria of Choice: A Survey-Based Evaluation of Patients in Europe." The correction includes changes to percentages displayed in tables, the legend for the tables, and the wording in various parts of the article. The correction also clarifies the proportion of males and females most affected by their topical treatments (TT) in their daily lives. The article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. [Extracted from the article]

On the 25 March 2017, leaders of the EU27 and European Union (EU) institutions ratified the Rome Declaration. They committed to invite citizens to discuss Europe's future and to provide recommendations that would facilitate their decision-makers in shaping their national positions on Europe. In response, citizens' dialogues on the future of Europe were instituted across the Union to facilitate public participation in shaping Europe. This paper explores Ireland's set of dialogues which took place during 2018. Although event organisers in Ireland applied a relatively atypical and more systematic and participatory approach to their dialogues, evidence suggests that Irelands' dialogues were reminiscent of a public relations exercise which showcased the country's commitment to incorporating citizens into the debate on Europe while avoiding a deliberative design which could have strengthened the quality of public discourse and the quality of public recommendations. Due to an absence of elite political will for a deliberative process, as well as structural weaknesses in design, participants' recommendations lacked any clear and prescriptive direction which could shape Ireland's national position on the future of Europe in any constructive or meaningful way. [ABSTRACT FROM AUTHOR]

Introduction: The implantation of the PRESERFLO™ MicroShunt (PMS) device has been shown to significantly lower increased intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG). However, guidelines on best practice for patient selection and pre-/peri-/postoperative care management are lacking. The aim of this modified Delphi panel was to achieve expert consensus on the role of the PMS to treat patients with glaucoma in Europe. Methods: Twelve European glaucoma surgeons experienced with the PMS procedure participated in a three-round modified Delphi panel. A targeted literature review and expert steering committee guided round 1 questionnaire development. Consensus was set at a pre-defined threshold of at least 70% of panellists selecting 'Strongly disagree'/'Disagree' or 'Strongly agree'/'Agree' for six–point Likert scale questions, or at least 70% selecting the same option for multiple-choice questions. Questions not reaching consensus were restated/revised for the next round, following guidance from free-text responses/scoping questions. Results: Consensus was achieved for 60.3% (n = 38/63), 60.0% (n = 18/30), and 100.0% (n = 11/11) of Likert/multiple-choice questions in rounds 1, 2, and 3, respectively. There was agreement that the PMS procedure is effective at reducing IOP in patients with high-tension POAG (greater than 21 mmHg). Although surgical techniques may vary slightly, consensus was reached on several points, including the importance of posterior application of mitomycin C (MMC). Panellists agreed that the PMS postoperative follow-up appointment schedule is reasonably predictable and mostly characterised by fewer visits than with trabeculectomy, particularly in the early phase. Although panellists agreed that combined cataract/PMS surgery and the use of non-MMC wound-healing modulators/antifibrotics during the procedure are possible, further data are needed to determine efficacy. Conclusion: The expert consensus reached in this panel will help inform best practice guidelines in the treatment of patients with glaucoma in Europe. Panellists also highlighted key areas for future research to improve understanding of the PMS in the treatment algorithm of glaucoma. [ABSTRACT FROM AUTHOR]

European eel is thought to be a symbol of the effects of global change on aquatic biodiversity. The species has persisted for millions of years and faced drastic environmental fluctuations thanks to its phenotypic plasticity. However, the species has recently declined to historically low levels under synergistic human pressures. Sublethal chemical contamination has been shown to alter reproductive capacity, but the impacts and required actions are not fully addressed by conservation plans. This paper proposes a modelling approach to quantify the effects of sublethal contamination by anthropogenic pollutants on the expression of life history traits and related fitness of the critically endangered European eel. Material and Methods: We sampled female silver eels from eight different catchments across Europe previously shown to be representative of the spectrum of environmental variability and contamination. We measured 11 fitness-related life history traits within four main categories: fecundity, adaptability and plasticity, migratory readiness, and spawning potential. We used machine learning in models to explore the phenotypic reaction (expression of these life history traits) according to geographical parameters, parasite burdens (the introduced nematode Anguillicoloides crassus) and anthropogenic contaminants (persistent organic pollutants (POPs) in muscular tissue and trace elements (TEs) in gonads, livers and muscles). Finally, we simulated, the effects of two management scenarios—contamination reduction and contamination increase—on the fecundity and recruitment. Results: Contamination in our sampling was shown to have a stronger control on life history traits than do geographic and environmental factors that are currently described in the literature. We modelled different contamination scenarios to assess the benefit of mitigation: these scenarios suggest that reducing pollutants concentrations to the lowest values that occurred in our sampling design would double the fecundity of eels compared to the current situation. Discussion: Remediation of contamination could represent a viable management option for increasing the resilience of eel populations, with much more effects than solely reducing fishing mortality. More broadly, our work provides an innovative way for quantitative assessment of the reaction norms of species' biological traits and related fecundity to contamination by organic and inorganic pollutions thus opening new management and conservation pathways to revert the erosion of biodiversity. [ABSTRACT FROM AUTHOR]

Convex hull pricing is a well-documented method for coping with the non-existence of uniform clearing prices in electricity markets with non-convex costs and constraints. We revisit primal and dual methods for computing convex hull prices, and discuss the positioning of existing approximation methods in this taxonomy. We propose a dual decomposition algorithm known as the Level Method and we adapt the basic algorithm to the specificities of convex hull pricing. We benchmark its performance against a column generation algorithm that has recently been proposed in the literature. We provide empirical evidence about the favorable performance of our algorithm on large test instances based on PJM and Central Europe. [ABSTRACT FROM AUTHOR]

We propose a chance-constrained formulation for the problem of dimensioning frequency restoration reserves on a power transmission network. We cast our problem as a two-stage stochastic mixed integer linear program, and propose a heuristic algorithm for solving the problem. Our model accounts for the simultaneous sizing of both upward and downward reserves, and uncertainty driven by imbalances, contingencies and available transmission capacity. Our core methodology is further adapted in order to minimize inter-zonal flows and in order to split reserve requirements between automatic and manual frequency restoration reserves. We apply our methodology to the problem of sizing reserves in the four load frequency control areas of the Swedish power system. We demonstrate the benefits of our method in terms of decreasing reserve requirements in the absence of reserve sharing, we analyze the spatial allocation of reserves, and we perform various sensitivity analyses. [ABSTRACT FROM AUTHOR]

To date, few data on how the COVID-19 pandemic and restrictions affected children's physical activity in Europe have been published. This study examined the prevalence and correlates of physical activity and screen time from a large sample of European children during the COVID-19 pandemic to inform strategies and provide adequate mitigation measures. An online survey was conducted using convenience sampling from 15 May to 22 June, 2020. Parents were eligible if they resided in one of the survey countries and their children aged 6–18 years. 8395 children were included (median age [IQR], 13 [10–15] years; 47% boys; 57.6% urban residents; 15.5% in self-isolation). Approximately two-thirds followed structured routines (66.4% [95%CI, 65.4–67.4]), and more than half were active during online P.E. (56.6% [95%CI, 55.5–57.6]). 19.0% (95%CI, 18.2–19.9) met the WHO Global physical activity recommendation. Total screen time in excess of 2 h/day was highly prevalent (weekdays: 69.5% [95%CI, 68.5–70.5]; weekend: 63.8% [95%CI, 62.7–64.8]). Playing outdoors more than 2 h/day, following a daily routine and being active in online P.E. increased the odds of healthy levels of physical activity and screen time, particularly in mildly affected countries. In severely affected countries, online P.E. contributed most to meet screen time recommendation, whereas outdoor play was most important for adequate physical activity. Promoting safe and responsible outdoor activities, safeguarding P.E. lessons during distance learning and setting pre-planned, consistent daily routines are important in helping children maintain healthy active lifestyle in pandemic situation. These factors should be prioritised by policymakers, schools and parents. To our knowledge, our data provide the first multi-national estimates on physical activity and total screen time in European children roughly two months after COVID-19 was declared a global pandemic. Only 1 in 5 children met the WHO Global physical activity recommendations. Under pandemic conditions, parents should set pre-planned, consistent daily routines and integrate at least 2-hours outdoor activities into the daily schedule, preferable on each day. Schools should make P.E. lessons a priority. Decision makers should mandate online P.E. be delivered by schools during distance learning. Closing outdoor facilities for PA should be considered only as the last resort during lockdowns. [ABSTRACT FROM AUTHOR]

Background and purpose: This position paper makes recommendations following an audit of care provided to people presenting with a seizure to emergency departments (EDs) in Europe. Methods: Participating countries were asked to include five hospitals agreeing to identify 50 consecutive seizure patients presenting to their ED between 1 August 2016 and 31 August 2017. Anonymous data were collected to a web database. Where quoted, percentages are mean site values and ranges are the 10th–90th centile. Results: Data were collected on 2204 ED visits (47 sites, up to six per country, across 15 countries): 1270 (58%) known epilepsy, 299 (14%) previous blackouts but no epilepsy diagnosis, 634 (29%) with a first seizure. Wide variability was identified for most variables. Of those with known epilepsy, 41.2% (range 26.2%–59.6%) attended the ED in the previous 12 months, but only 64.7% (range 37.2%–79.8%) had seen an epilepsy specialist in the previous 12 months. 67.7% (range 34.0%–100%) were admitted, 53.1% to a neurology ward (range 0.0%–88.9%). Only 37.5% first seizure patients (range 0.0%–71.4%) were given advice about driving. Conclusions and recommendations: It is recommended that in Europe guidance is agreed on the management and onward referral of those presenting to the ED with a seizure; a referral process is created that can be easily implemented; it is ensured that the seizure services receive referrals and see the patients within a short time period; and a simple system is developed and implemented to allow continuous monitoring of key indices of epilepsy care. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This systematic review and meta‐analysis reports the seroprevalence of SARS‐CoV‐2 antibodies among nurses. Background: With a growing body of literature reporting the positive serology for SARS‐CoV‐2 antibodies among healthcare workers, it remains unclear whether staff at the point of direct patient care are more prone to developing and transmitting the virus. Given nurses make up the majority of the global health workforce, outbreaks among these workers could severely undermine a health system's capability to manage the pandemic. We aimed to summarise and report the seroprevalence of SARS‐CoV‐2 antibodies among nurses globally. Design: Systematic review and meta‐analyses. Methods: This systematic review was developed, undertaken and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guideline. We searched the electronic medical literature databases: MEDLINE; CINAHL; and EMBASE for studies reporting the seroprevalence of SARS‐CoV‐2 antibodies among nursing staff. Studies that reported nursing specific data were included in this review. Study quality was evaluated using the Joanna Briggs Institute checklist for studies reporting prevalence data. Studies were stratified according to the World Health Organisation region classifications, and results were presented using forest plots and summary prevalence and variance was estimated using a random effects model. Results: Our electronic search identified 1687 potential studies, of which 1148 were screened for eligibility after duplicates were removed, and 51 of the studies were included in our meta‐analysis. The overall seroprevalence of SARS‐CoV‐2 antibodies among nurses was estimated to be 8.1% (95% CI 6.9%–9.4%) among the 60,571 participants included in the studies. Seropositivity was highest in the African region (48.2%, 95% CI 39.2%–57.3%), followed by the European region (10.3%, 95% CI 8.0%–12.5%), the Region of the Americas (8.4%, 95% CI 6.0%–10.7%), the South‐East Asia region (3.0%, 95% CI 0.00%–6.5%) and the Western Pacific region (0.5%, 95% CI 0.0%–1.0%). Pooled estimates were unable to be calculated in the Eastern Mediterranean region due to insufficient studies. Conclusion: The seroprevalence of SARS‐CoV‐2 antibodies among nurses is comparable to other healthcare workers, and possibly similar to the general population. Early adoption and adherence to personal protective equipment and social distancing measures could explain these similarities, meaning the majority of staff contracted the virus through community transmission and not in a healthcare setting. Relevance to clinical practice: Fear and uncertainty have been features of this pandemic, including among nurses. This meta‐analysis should provide some comfort to nurses that risks are similar to community exposure when adequate PPE is available and there is an adherence to infection control measures. [ABSTRACT FROM AUTHOR]

Analyzing hybrid zones allows insight into interactions between previously isolated lineages. The distributions of firebellied toads (Bombina bombina) and yellow-bellied toads (B. variegata) meet in the Carpathian Basin. We aimed to explore the genetic composition of a transient zone between the two sister species along a transect in the Carpathian foothill region. We collected 230 specimens from 21 locations and sampled them using buccal swabs. We used mitochondrial markers and designed a novel test based on the restriction of the nuclear Ncx-1 gene to distinguish between the two species and determine hybrid individuals. According to our results, the complete Börzsöny Hills and many locations in Krupinská Planina were colonized by B. bombina, including typical B. variegata habitats at higher elevations. However, in Krupinská Planina, the most remote sites still harbor B. variegata populations, often mixed with hybrid individuals. This pattern may indicate the northward and altitudinal range expansion of B. bombina. Our results warrant enhanced attention to hybrid zones, where introgression and other changes in the populations' genetic composition may reflect recent rapid environmental alterations. [ABSTRACT FROM AUTHOR]

Background: Previously, numerous case-control studies have highlighted variants responsible for Maturity onset diabetes of young (MODY). However, these studies have been conducted among diverse populations and hence yielded contradictory results. We, therefore, performed a meta-analysis to precisely find the association of SNPs with the disease for the HNF1A gene. Objective: Meta-analysis of clinically defined studies deciphering mutations in the HNF1A gene responsible for the development of MODY3 was conducted among various populations to determine associations using statistical approaches. Methods: The curation of 505 research articles published between the years 2000–2021 was carried out. Visualization of data-related protocols and statistical-analysis were conducted, which led to the identification of highly prevalent mutations among different populations (majorly Europe). Further comparison between the frequencies of the control (healthy population) and test (diseased population) dataset generated through curation was performed. Results: We identified nine MODY3 mutations (rs587776825, rs1169288, rs1800574, rs2464196, rs137853244, rs137853238, rs587780357, rs137853240 and rs137853243) at the genome-wide significance level (p < 5.0 × 10−8). The present study confirmed that the data does not follow a normal distribution. Further, the data was confirmed to be a more homogenous type with frequencies having a significant association with the disease. Conclusion: This meta-analysis found significant associations of mutations in HNF1A with MODY3, consistent with previous studies. Our findings should help elucidate the mutations in a compiled form responsible for causing MODY3. [ABSTRACT FROM AUTHOR]

The article discusses public health news briefs in Europe. The European Health Union launched the European Health Data Space (EHDS) health-specific data sharing framework that establishes common standards and practices. Also cited are the role of health care in fighting human trafficking, and the scheduled 16th European Public Health Conference in Dublin, Ireland in November 2023.