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Using the EU-SILC 2008 module on over-indebtedness and financial exclusion, this paper analyses how perceived future-orientated economic insecurity alters individual self-assessed health (SAH), once controlling for past and current financial situation in a range of European countries. Those effects differ by gender and by country. Our results also suggest that country characteristics explain a larger part of the unknown variability of individual levels of SAH than individual-household characteristics. Thus, our findings might be of help in designing the most effective policies intended to alleviate the individual welfare costs of perceived financial insecurity provoked by upcoming business-cycle downturns. • There is a significant effect of past financial strain on current levels of self-assessed health (scarring effect). • Perceived future-orientated economic insecurity alters individual self-assessed health (loss aversion). • Those effects differ by gender and by country. • Country characteristics explain a larger part of the unknown variability of self-assessed health. • The importance of country characteristics varies by gender, being more relevant for females. [ABSTRACT FROM AUTHOR]

In Europe, an increasing number of human milk banks (HMBs) collect donor human milk to feed preterm infants when their mother's milk is not available or not enough. Moreover, donor milk is a bridge to breastfeeding, with positive clinical and psychological advantages for both mother and infant. Italy, with 41 HMBs actively operating in 2022, has the highest number of HMBs in Europe. The process of human milk donation is complex, so activity of HMBs must be regulated according to well-established rules. The present recommendations have been prepared as a tool to standardize the organization, management, and procedures of HMBs operating in Italy and to determine the minimal essential requirements to establish new HMBs. This article covers all the aspects of human milk donation and human milk banking, including general recommendations, donor recruitment and screening, expression, handling and storage of donor human milk, milk screening, and milk treatment (pasteurization). A pragmatic approach was taken to drafting the recommendations. Items for which there was consensus or robust published evidence on which to base recommendations were included. When there were differences that could not be resolved by reference to published research, a statement of explanation based on the expert opinion of the authors (all members of the Italian Association of Human Milk Banks) was included. Implementation of these recommendations can contribute to promotion of breastfeeding. [ABSTRACT FROM AUTHOR]

Background and purpose: The European Federation of Neurological Associations (EFNA), in partnership with the NeuroCOVID‐19 taskforce of the European Academy of Neurology (EAN), has investigated the impact of the first wave of the COVID‐19 pandemic on individuals with neurological diseases, as well as the hopes and fears of these patients about the post‐pandemic phase. Methods: An EFNA‐EAN survey was available online to any person living with a neurological disorder in Europe. It consisted of 18 items concerning the impact of the first wave of the COVID‐19 pandemic on the medical care of people with neurological disorders, and the hopes and fears of these individuals regarding the post‐pandemic phase. Results: For 44.4% of the 443 survey participants, the overall care of their neurological disease during the pandemic was inappropriate. This perception was mainly due to significant delays in accessing medical care (25.7%), insufficiently reliable information received about the potential impact of COVID‐19 on their neurological disease (49.6%), and a substantial lack of involvement in their disease management decisions (54.3%). Participants indicated that their major concerns for the post‐pandemic phase were experiencing longer waiting times to see a specialist (24.1%), suffering from social isolation and deteriorating mental well‐being (23.1%), and facing delays in clinical trials with disinvestment in neuroscience research (13.1%). Conclusions: Despite the great efforts of health services to cope with the first wave of the COVID‐19 pandemic, individuals with neurological conditions feel they have been left behind. These findings provide invaluable insights for improving the care of patients with neurological disorders in the further course of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Comparative studies of genetic diversity and population structure can shed light on the ecological and evolutionary factors governing host–parasite interactions. Even though invasive parasites are considered of major biological importance, little is known about their adaptative potential when infesting the new hosts. Here, the genetic diversification of Varroa destructor, a novel parasite of Apis mellifera originating from Asia, was investigated using population genetics to determine how the genetic structure of the parasite changed in distinct European populations of its new host. To do so, mites infesting two categories of hosts in four European regions were compared: (a) adapted hosts surviving through means of natural selection, thereby expected to impose strong selective pressure on the mites, and (b) treated host populations, surviving mite infestations because acaricides are applied, therefore characterized by a relaxed selection imposed by the host on the mites. Significant genetic divergence was found across regions, partially reflecting the invasion pattern of V. destructor throughout Europe and indicating local adaptation of the mite to the host populations. Additionally, varying degrees of genotypic changes were found between mites from adapted and treated colonies. Altogether, these results indicate that V. destructor managed to overcome the genetic bottlenecks following its introduction in Europe and that host‐mediated selection fostered changes in the genetic structure of this mite at diverse geographic scales. These findings highlight the potential of parasites to adapt to their local host populations and confirm that adaptations developed within coevolutionary dynamics are a major determinant of population genetic changes. [ABSTRACT FROM AUTHOR]

Pollution of aquatic bodies by pharmaceutical compounds is an emerging environmental problem because these drugs are extensively used in animal and human medicine. Ibuprofen, 2-[4-(2-methylpropyl)phenyl] propanoic acid, is the non-steroidal anti-inflammatory drug mainly present both in wastewater and in rivers and lakes in Europe. Despite this environmental emergency is giving rise a great interest in the scientific community, literature about the effects of ibuprofen on microalgae is scarce. A previous work on the freshwater microalga Scenedesmus rubescens had shown some morpho-physiological effects caused by treatment with 62.5, 250 and 1000 µg L−1 ibuprofen. In this paper, we presented the results of treatment with ibuprofen at the same concentrations, ranging from environmental levels up to higher values, on Chlamydomonas reinhardtii (P.J.L. Dangeard). Ibuprofen effects on the alga were assayed through analyses of growth curve. Moreover, analyses of cell morphology, ultrastructure, and photosynthetic pigments were performed. The first effect of drug was the stimulation of the microalga growth. In addition, following exposure to ibuprofen, cells exhibited morphological and ultrastructural alterations, the latter ones consisting of starch granules and both in vacuolar and cytoplasmatic inclusions. On the contrary, chlorophyll and carotenoids amounts, were not affected by drug treatment. [ABSTRACT FROM AUTHOR]

Background and purpose: Although the main clinical features of COVID‐19 infection are pulmonary, several associated neurological signs, symptoms and diseases are emerging. The incidence and characteristics of neurological complications are unclear. For this reason, the European Academy of Neurology (EAN) core COVID‐19 Task Force initiated a survey on neurological symptoms observed in patients with COVID‐19 infection. Methods: A 17‐question online survey was made available on the EAN website and distributed to EAN members and other worldwide physicians starting on 9 April 2020. Results: By 27 April 2020, proper data were collected from 2343 responders (out of 4199), of whom 82.0% were neurologists, mostly from Europe. Most responders (74.7%) consulted patients with COVID‐19 mainly in emergency rooms and in COVID‐19 units. The majority (67.0%) had evaluated fewer than 10 patients with neurological manifestations of COVID‐19 (neuro COVID‐19). The most frequently reported neurological findings were headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%) and psychomotor agitation (26.7%). Encephalopathy and acute cerebrovascular disorders were reported at 21.0%. Neurological manifestations were generally interpreted as being possibly related to COVID‐19; they were most commonly recognized in patients with multiple general symptoms and occurred at any time during infection. Conclusion: Neurologists are currently and actively involved in the management of neurological issues related to the COVID‐19 pandemic. This survey justifies setting up a prospective registry to better capture the prevalence of patients with neuro COVID‐19, neurological disease characteristics and the contribution of neurological manifestations to outcome. [ABSTRACT FROM AUTHOR]

After the negative effect of the recent financial crisis on public finances in many countries, it is of a great interest to study attitudes towards taxation to identify effective policies to enhance public support for taxation and welfare programs. In this paper, we analyze empirically people's attitudes towards taxation in European countries. In particular, we test whether the perception about benefit fraud may produce different effects on preferences over the size of the welfare state along the income distribution. Moreover, we test if contextual variables are relatively more relevant than individual characteristics in determining attitudes towards taxation. Using different data sources for many EU countries in 2008, we contrast those hypotheses taking advantage of multilevel techniques. Our results suggest that policies targeting the deterrence of benefit fraud such as higher penalties and more frequent benefit investigations, increase the high earners' willingness to pay taxes and then the size of the welfare state. We also find that contextual characteristics explain a larger variance of attitudes toward taxation than individual characteristics, suggesting that the same policy for all UE countries might be not a good strategy. [ABSTRACT FROM AUTHOR]

Objective: This research note aimed to analyze the scientific productivity trends 2015–2019, focusing on the top 30 universities in Europe and United States and on the top 30 private companies—as classified in the SCImago Institutions Ranking. Our hypothesis is that private companies are gaining an increasingly prominent role in the research field, while academia is losing its predominance. Results: From 2015 to 2019, all universities in Europe and the United States lost positions in the scientific production ranking, while private companies gained positions. These trends seem to be driven mainly by the scientific productivity sub-indicator "Innovation". These data suggest that the role private companies will play in the future will not be limited to support research economically or influence it from "outside". Private companies have taken a path that may lead them to directly control all stages of production/communication of knowledge, including research—a role once bestowed on universities. Our data, although preliminary, seem to suggest that, at present, academia risks losing its predominance in the research field. This scenario deserves attention because of the threats it may pose to the independence of research and its role in supporting human equity and sustainable health for all. [ABSTRACT FROM AUTHOR]

The article presents the society is judged by how it treats its children and the protection of children and the punishment of adults are often conflated. Topics include the logic is clearly demonstrated European countries to systematically separate children from their mothers who have recently returned from Jihadist regions, the separation is justified by the need to protect the babies from their mother, and the hypothetical risk cannot justify methodically separating them from their mothers.

This paper uses a sample of private sector male workers from the European Community Household Panel to examine the wage effects of educational mismatches across segments of the earnings distribution in 12 countries. We consider two types of mismatch, overqualification and skills mismatches. By differentiating between quantiles, we discriminate between groups of workers with different unobservable earnings conditions. We find that the detrimental effects of skill mismatches on wages are larger than those of overqualification in most segments of the earnings distribution. Moreover, we find that the pay penalty of educational mismatch tends to be higher among workers with higher unconditional wages. This finding suggests that the mismatch phenomenon entails wage losses over and above those attributable to unobservable earnings determinants, including ability and skills possessed by workers. [ABSTRACT FROM AUTHOR]

This paper discusses several key issues regarding the current European economic and financial Great Crisis, which essentially is a twin sovereign debt and banking crisis. The shift of the recent world financial crisis into a European sovereign debt crisis is tackled by analyzing how via the banking system the financial contagion was extended from the US to Europe. The explanation focuses on the imbalances of European Monetary Union (EMU) countries balance-of-payments. The European crisis has shown that it can spread quickly among closely integrated economies, either through the trade channel or the financial channel, or both. In this context, TARGET2 payment system of EMU countries became crucial, reflecting funding stress in the banking systems of crisis-hit European countries. The paper concludes that, in the medium term, a successful crisis resolution requires more political integration, which should include a fiscal union and a banking union. However, in the short run, a prompt recovery is essential to get out of trouble, and this requires that surplus countries (particularly Germany) expand aggregate demand and let domestic wages and the ensuing inflation rate increase. [ABSTRACT FROM AUTHOR]

Abstract: The EU 7th Framework Project FAST20XX [1] aimed to enlarge the foundations of suborbital high-speed transportation in a wide variety of fields. One of the key issues of this project was to outline a desirable regulatory framework that would best serve the interests of all European stakeholders in this new activity. The US Federal Aviation Administration (FAA) has issued a series of requirements for operators of commercial suborbital flights under the 2004 Commercial Space Launch Amendments Act (CSLAA), enabling the corresponding market to develop. These regulations were initially valid until 2012 but have now been extended until 2015. In Europe, practical and successful attempts to fly experimental vehicles of this kind do not yet exist. However, several developments indicate that it is becoming urgent to pay attention to this potential new industry and find ways to regulate it in a safe yet flexible manner. Although the European Aviation Safety Agency (EASA) explored the possibility in 2008 to prepare for a certification approach under the concept of “Suborbital Aeroplanes” (SoA), this initiative was put on hold in 2011, and a final decision by the European Commission is still pending. This paper highlights some of the research performed by the authors towards the establishment of a roadmap for future regulation of suborbital flight in Europe. In particular, it will present results of a survey carried out among stakeholders, including operators and manufacturers of vehicles, spaceports, national and European regulators, insurers and brokers, consultants, users and lobbyists. The paper also presents results from the workshop on the future regulatory framework for suborbital flights in Europe, which was co-organised by the present authors and held in Brussels in October 2012. [Copyright &y& Elsevier]

This study advances research on the structural dimension in the predominantly individual-oriented field of poverty studies by evaluating to what extent cross-national differences in population and structural characteristics can explain the differences in poverty outcomes by gender. To facilitate an approach that integrates individual and structural context dimensions, the paper takes advantage of multilevel techniques to test gender differences in the risk of being poor, entering into poverty, and exiting from poverty among seventeen European countries. The analysis covers single-adult households, drawing on data from the European Union Statistics on Income and Living Conditions (EU-SILC) for the years 2007–8. The study concludes that structural effects, such as welfare state policies, labor market characteristics, level of inequality, and the level of women's empowerment in the country, seem to be more relevant than individual effects in explaining differences in the gender poverty gap among countries. [ABSTRACT FROM AUTHOR]

Since the late 1990s, a number of specialists have proposed a ‘multiple species model’ to explain the origins of behavioural modernity. This model establishes that most of the traits defining modern behaviour, including ornaments and art, are not exclusive to modern humans, but arose among anatomically ‘non-modern’ populations, like the late Neanderthals of Europe. This paper proposes that the emergence of this multiple species model is related to conceptual changes in the definitions of ‘Neanderthals’ and ‘art’. In the first place, Neanderthals, once characterized as apish creatures lacking intelligence, are now considered by many as complex cognitive people capable of modern behaviour, including the ability to create symbolic and artistic representations. In the second place, personal ornaments, once trivialized as ‘trinkets’, are recognized today as artistic representations and as symbolically valued as other prehistoric artworks. These redefinitions of Neanderthals and personal ornaments reflect not only the multiple species model but also some of the recent debates concerning the origins of symbolic behaviour. [ABSTRACT FROM AUTHOR]

Metastatic prostate cancer (mPCa) is one of the leading causes of cancer-related mortality in both the US and Europe. Androgen deprivation is the first-line therapy for mPCa; however, resistance to therapy inevitably occurs and the disease progresses to the castration resistant stage, which is uncurable. A definition of novel targeted therapies is necessary for the establishment of innovative and more effective protocols of personalized oncology. We employed genetically engineered mouse models of PCa and human samples to characterize the expression of the TRPM8 cation channel in both hormone naïve and castration resistant tumors. We show that Trpm8 expression marks both indolent (Pten-null) and aggressive (Pten/Trp53 double-null and TRAMP) mouse prostate adenocarcinomas. Importantly, both mouse and human castration-resistant PCa preserve TRPM8 protein expression. Finally, we tested the effect of TRPM8 agonist D-3263 administration in combination with enzalutamide or docetaxel on the viability of aggressive mouse PCa cell lines. Our data demonstrate that D-3263 substantially enhances the pro-apoptotic activity of enzalutamide and docetaxel in TRAMP-C1 e TRAMP-C2 PCa cell lines. To conclude, this study provides the basis for pre-clinical in vivo testing of TRPM8 targeting as a novel strategy to implement the efficacy of standard-of-care treatments for advanced PCa. [ABSTRACT FROM AUTHOR]

The poultry red mite (Dermanyssus gallinae) is the most important and common ectoparasite of laying hens in Europe. This haematophagous mite has been experimentally demonstrated to be a vector of Salmonella Enteritidis by acquiring bacteria through the blood meal or cuticular contact. We have evaluated another route of infection by orally inoculating chicks with mites previously infected by S. Enteritidis. Two methods of infecting the mites were tested: mites contaminated by cuticular contact or during the blood meal. After the washing of mites with paraformaldehyde, groups of 10 Salmonella-contaminated mites were inoculated individually into 1-day-old chicks. The titre of the inoculum suspension was evaluated by crushing mites and followed by bacteriological counting. It was 3×104 colony-forming units/chick and 2.7×106 colony-forming units/chick, respectively, for cuticular contact and orally mediated contamination of mites. Each bird was found to be positive 12 days post-inoculation. Salmonella colonized the intestinal tracts and invaded the livers and spleens. The caecal content concentration reached a mean level of S. Enteritidis of 8.5×104 most probable number (MPN) Salmonella/g. This experiment demonstrated the ability of mites to orally infect 1-day-old chicks with subsequent colonization and multiplication of Salmonella. Consequently, mites infected by S. Enteritidis constitute potential reservoir hosts of this bacterium, allowing it to persist in the poultry house as a source of infection for newly introduced animals. If contaminated mites are found in poultry facilities, effective red mite control should be performed before new batches are introduced into the facility. [ABSTRACT FROM AUTHOR]

This paper represents an expert view from Europe of future emerging technologies within the wind energy sector considering their potential, challenges, applications and technology readiness and how they might evolve in the coming years. These technologies were identified as originating primarily from the academic sector, some start-up companies and a few larger industrial entities. The following areas were considered: airborne wind energy, offshore floating concepts, smart rotors, wind-induced energy harvesting devices, blade tip-mounted rotors, unconventional power transmission systems, multi-rotor turbines, alternative support structures, modular high voltage direct current generators, innovative blade manufacturing techniques, diffuser-augmented turbines and small turbine technologies. The future role of advanced multiscale modelling and data availability is also considered. This expert review has highlighted that more research will be required to realise many of these emerging technologies. However, there is a need to identify synergies between fundamental and industrial research by correctly targeting public and private funding in these emerging technology areas as industrial development may outpace more fundamental research faster than anticipated. • A set of emerging technologies in the wind power sector was identified and studied. • For each technology, an analysis of the main advantages and challenges was made. • Potential for scaling each technology was identified. • Technology Readiness Levels and their development trends were assessed. [ABSTRACT FROM AUTHOR]

Background and purpose: Neurological disorders constitute a significant portion of the global disease burden, affecting >30% of the world's population. This prevalence poses a substantial threat to global health in the foreseeable future. A lack of awareness regarding this high burden of neurological diseases has led to their underrecognition, underappreciation, and insufficient funding. Establishing a strategic and comprehensive research agenda for brain‐related studies is a crucial step towards aligning research objectives among all pertinent stakeholders and fostering greater societal awareness. Methods: A scoping literature review was undertaken by a working group from the European Academy of Neurology (EAN) to identify any existing research agendas relevant to neurology. Additionally, a specialized survey was conducted among all EAN scientific panels, including neurologists and patients, inquiring about their perspectives on the current research priorities and gaps in neurology. Results: The review revealed the absence of a unified, overarching brain research agenda. Existing research agendas predominantly focus on specialized topics within neurology, resulting in an imbalance in the number of agendas across subspecialties. The survey indicated a prioritization of neurological disorders and research gaps. Conclusions: Building upon the findings from the review and survey, key components for a strategic and comprehensive neurological research agenda in Europe were delineated. This research agenda serves as a valuable prioritization tool for neuroscientific researchers, as well as for clinicians, donors, and funding agencies in the field of neurology. It offers essential guidance for creating a roadmap for research and clinical advancement, ultimately leading to heightened awareness and reduced burden of neurological disorders. [ABSTRACT FROM AUTHOR]

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

The author gives her opinion on the impact of declining financial investment on the field of scientific research in Europe. She discusses events such as the Sciences en Marche campaign to protest against budget cuts on research expenditure and declining employment opportunities in research. She provides an example of this situation by mentioning the 40% drop in expenditure on civilian research and development in Spain.

An abstract of the article "Healthcare Associated Infections (HAI) in Longterm Care Facilities in Europe," by M. L. Moro, B. Jans, K. Latour, E. Ricchizzi, B. Cookson, D. MacKenzie, M. Van de Mortel and J. Fabry is presented.

Background Genomic Observatories (GOs) are sites of long-term scientific study that undertake regular assessments of the genomic biodiversity. The European Marine Omics Biodiversity Observation Network (EMO BON) is a network of GOs that conduct regular biological community samplings to generate environmental and metagenomic data of microbial communities from designated marine stations around Europe. The development of an effective workflow is essential for the analysis of the EMO BON metagenomic data in a timely and reproducible manner. Findings Based on the established MGnify resource, we developed metaGOflow. metaGOflow supports the fast inference of taxonomic profiles from GO-derived data based on ribosomal RNA genes and their functional annotation using the raw reads. Thanks to the Research Object Crate packaging, relevant metadata about the sample under study, and the details of the bioinformatics analysis it has been subjected to, are inherited to the data product while its modular implementation allows running the workflow partially. The analysis of 2 EMO BON samples and 1 Tara Oceans sample was performed as a use case. Conclusions metaGOflow is an efficient and robust workflow that scales to the needs of projects producing big metagenomic data such as EMO BON. It highlights how containerization technologies along with modern workflow languages and metadata package approaches can support the needs of researchers when dealing with ever-increasing volumes of biological data. Despite being initially oriented to address the needs of EMO BON, metaGOflow is a flexible and easy-to-use workflow that can be broadly used for one-sample-at-a-time analysis of shotgun metagenomics data. [ABSTRACT FROM AUTHOR]

Background and purpose: Neurological disorders pose a profound unmet medical need for which new solutions are urgently needed. The consideration of both biological (sex) and socio‐cultural (gender) differences between men and women is necessary to identify more efficacious, safer and tailored treatments. Approaches for putting sex and gender medicine into practice have gathered momentum across Europe, but it is currently unclear to what extent they have been implemented in the field of neurology and neuroscience. Methods: We mapped current activities in research, funding and education aimed at integrating sex and gender consideration in neuroscience and neurology in Europe. We examined and analyzed data gathered from literature searches, policy documents and reports by the European Commission and national funding agencies, web‐based searches, Web of Science, and searches of project databases of funding agencies. An informative/non‐systematic search was performed for sections on policies and funding, education, and basic research, while a systematic literature and database review was conducted for quantitative analysis of research output and funded projects in terms of sex and gender analysis. Results: Our mapping shows that there is a growing interest in and attention given to sex and gender considerations in neurological fields, both from funding agencies and researchers. However, most activities, especially for education, are limited to the individual motivation of researchers and are not organically built within curricula and strategic research priorities. Conclusion: We recommend actions that might help increase the consideration of sex and gender specifically in the field of neuroscience and neurology. [ABSTRACT FROM AUTHOR]

Among the difficulties of living with β-thalassemia, patients frequently require blood transfusions and experience iron overload. As serum ferritin (SF) provides an indication of potential iron overload, we conducted a systematic literature review (SLR) to assess whether SF levels are associated with clinical and economic burden and patient-reported outcomes (PROs). The SLR was conducted on 23 April 2020 and followed by analysis of the literature. Dual-screening was performed at the title, abstract, and full-text levels using predefined inclusion and exclusion criteria. Ten studies identified by the SLR were eligible for inclusion in the analysis. Seven studies were conducted in Europe, and most were prospective or retrospective in design. The patient populations had a median age of 20.7–42.6 years, with a percentage of men of 38–80%. Sparse data were found on the correlation between SF levels and mortality, and hepatic, skeletal, and cardiac complications; however, in general, higher SF levels were associated with worsened outcomes. The bulk of the evidence reported on the significant association between higher SF levels and endocrine dysfunction in its many presentations, including a 14-fold increase in the risk of diabetes for patients with persistently elevated SF levels. No studies reporting data on PROs or economic burden were identified by the SLR. SF levels provide another option for prognostic assessment to predict a range of clinical outcomes in patients with β-thalassemia. [ABSTRACT FROM AUTHOR]

Objectives: Value-based healthcare (VBHC) aims at improving patient outcomes while optimizing the use of hospitals' resources among medical personnel, administrations, and support services through an evidence-based, collaborative approach. In this article, we present a blueprint for the implementation of VBHC in hospitals, based on our experience as members of the European University Hospital Alliance.Methods: The European University Hospital Alliance is a consortium of 9 large hospitals in Europe and aims at increasing the quality and efficiency of care to ultimately drive better outcomes for patients.Results: The blueprint describes how to prepare hospitals for VBHC implementation; analyzes gaps, barriers, and facilitators; and explores the most effective ways to turn patient pathways into a process that results in high-value care. Using a patient-centric approach, we identified 4 core minimum components that must be established as cornerstones and 7 organizational enablers to waive the barriers to implementation and ensure sustainability.Conclusion: The blueprint guides through pathway implementation and establishment of key performance indicators in 6 phases, which hospitals can tailor to their current status on their way to implement VBHC. [ABSTRACT FROM AUTHOR]

Data about the regulatory approaches to donor human milk (DHM) in European countries are lacking. The aim of this study is to describe the various regulations of DHM within European countries, to assess its legislative context and its impact in relation to donor milk banking. We performed a cross‐sectional survey using a semistructured online questionnaire addressing 29 national European milk‐banking representatives from June 2020 to February 2021. Representatives of 26 national DHM services participated in this study. The legal classification and regulatory status of DHM were defined in 9 out of 26 areas of jurisdiction (35%) as either food product (n = 6), product of human origin according to a blood, tissue, cell regulation (n = 2), or medicinal product (n = 1). In the remainder, DHM remains unclassified. Most legislations did not provide a comprehensive framework concerning DHM and costs to cover milk bank operations were rarely reimbursed. In general, the lack of national legislative governance and the actual legislative regulations in place do not support the use of DHM in European countries. National medical guidelines for the use of DHM have been issued in only 11 countries. The current number and distribution of milk banks (n = 239) within participating countries may not provide an equitable access to DHM for eligible infants. These findings could guide stakeholders aiming to establish a regulatory framework for DHM. Key messages: There is a lack of a legislative framework concerning the use of donor human milk in the majority of European countries.Available national legislative frameworks differed widely with gaps in the regulation of safety and quality of donor human milk, protection of donors and recipients, and cost recovery.Despite clearly demonstrated benefits and unequivocal recommendations for the use of donor human milk there is a lack of national guidance in many European countries. [ABSTRACT FROM AUTHOR]

Background: Provision of donor human milk is handled by established human milk banks that implement all required measures to ensure its safety and quality. Detailed human milk banking guidelines on a European level are currently lacking, while the information available on the actual practices followed by the European human milk banks, remains limited. The aim of this study was to collect detailed data on the actual milk banking practices across Europe with particular emphasis on the practices affecting the safety and quality of donor human milk. Materials and methods: A web-based questionnaire was developed by the European Milk Bank Association (EMBA) Survey Group, for distribution to the European human milk banks. The questionnaire included 35 questions covering every step from donor recruitment to provision of donor human milk to each recipient. To assess the variation in practices, all responses were then analyzed for each country individually and for all human milk banks together. Results: A total of 123 human milk banks completed the questionnaire, representing 85% of the European countries that have a milk bank. Both inter- and intra-country variation was documented for most milk banking practices. The highest variability was observed in pasteurization practices, storage and milk screening, both pre- and post-pasteurization. Conclusion: We show that there is a wide variability in milk banking practices across Europe, including practices that could further improve the efficacy of donor human milk banking. The findings of this study could serve as a tool for a global discussion on the efficacy and development of additional evidence-based guidelines that could further improve those practices. [ABSTRACT FROM AUTHOR]

Paleolithic art offers unique perspectives on prehistoric societies and cultures. It is also considered a key component of modern human behavior. Until recently, Paleolithic artworks were thought to be geographically restricted to a very few areas, especially southwestern Europe. Discoveries of art in other parts of Europe and other parts of the globe have challenged this vision, expanding the documented distribution of this important cultural phenomenon. As a consequence, there has been renewed interest in less well-known areas, with the goal of determining whether the current lack of art is a reflection of a past reality, the product of limited research, or a matter of preservation. One of these regions is the Balkan Peninsula, a key area for understanding Upper Paleolithic societies given its location at the crossroads of several migration routes into Europe. This article provides a comprehensive overview of the Paleolithic symbolic products, including both rock art and portable art from the Balkans. Recent research has led to new discoveries and insights into the symbolism of this long-neglected area. The present review, combining existing literature and new fieldwork, sheds new light on social and cultural interactions in this part of the continent and leads to a better understanding of its role within the European Upper Paleolithic cultural sphere. [ABSTRACT FROM AUTHOR]

Increasingly, professional bodies expect doctors to not only provide patient care but also educate students, trainees and patients. Few medical students, however, receive formal tuition in terms of the theory and practice of medical education. A curriculum restructure from an MBBS to a Doctor of Medicine (MD) program provided an opportunity to develop three Masters streams: Clinical research, Capstones and educational Professional Projects. This submission describes how one Australian medical school is preparing some students for their future roles as medical educators through MD Professional Projects. Framed by the 12 roles of the medical 'teacher', most students undertaking these projects take on Resource Developer (including simulation) and Assessor roles. For those choosing resource development (excluding simulation) or assessment, the Association for Medical Education (AMEE) Student Essential Skills in Medical Education (ESME) Course is compulsory. For those choosing educational research, the ESME Course is optional. By December 2020, four MD cohorts will have graduated with 69 students having undertaken educational MD Professional Projects, with fifty-one completing the ESME Course. MD students have created a range of resources for the curriculum, their colleagues and the local healthcare community. In addition to the expected learning we identified additional value-added outcomes for learners (e.g. skill development), the curriculum (e.g. areas of difficulty), academic supervisors' roles (e.g. role-modelling) and for the health care community (e.g. as expert reviewers). Engaging in scholarly activities such the ESME Course and developing learning resources not only provided MD students with a more in-depth theoretical knowledge in a range of clinical areas, but also developed skills that would prepare them for their future roles as medical educators. As supervisors, we identified the value these projects add to the broader health community as well as personal and professional benefits for ourselves. [ABSTRACT FROM AUTHOR]

The water-cooled lithium-lead breeding blanket is a candidate option for the European Demonstration Power Plant (DEMO) nuclear fusion reactor. This breeding blanket concept relies on the liquid lithium-lead as breeder-multiplier, pressurized water as coolant, and EUROFER as structural material. The current design is based on DEMO 2015 specifications and represents the follow-up of the design developed in 2015. The single-module-segment approach is employed. This is constituted by a basic geometry repeated along the poloidal direction. The power is removed by means of radial-toroidal (i.e., horizontal) water cooling tubes in the breeding zone. The lithium-lead flows in a radial-poloidal direction. On the back of the segment, a 100-mm-thick plate is in charge of withstanding the loads due to normal operation and selected postulated initiating events. Water and lithium-lead manifolds are designed and integrated with a consistent primary heat transport system, based on a reliable pressurized water reactor operating experience, and the lithium-lead system. Rationale and features of the single-module-segment water-cooled lithium-lead breeding blanket design are discussed and supported by thermo-mechanic, thermo-hydraulic, and neutronic analyses. Preliminary integration with the primary heat transfer system, the energy storage system, and the balance of plant is briefly discussed. Open issues, areas of research, and development needs are finally pointed out. @EUROfusion Consortium*, 2017. *For more details see http://www.euro-fusionscipub.org/disclaimer-copyright [ABSTRACT FROM AUTHOR]

PREMISE OF THE STUDY: Abiotic constraints act as selection filters for plant invasion in stressful habitats. Adaptive phenotypic plasticity and transgenerational effects play a major role in colonization of heterogeneous habitats when the scale of environmental variation is smaller than that of gene flow. We investigated how p lasticity and parental salinity conditions influence the performance of the invasive d ioecious shrub Baccharis halimifolia, which replaces heterogeneous estuarine communities in Europe with monospecific and continuous stands. METHODS: In tw o greenhouse experiments, we grew plants derived from seeds and cuttings collected throu gh interspersed patches differing in edaphic salinity from an invasive population. We estimated parental environmental salinity from leaf Na+ content in parental plants, and we measured fitness and ion homeostasis of the offspring grown in contrasting salinity conditions. KEY RESULTS: Baccharis halimifolia tolerates high salinity bu t experiences drastic biomass reduction at moderate salinity. At moderate salinity, responses to salinity are affected by the parental salinity: flowering initiation in seedlings and male cuttings is positively correlated with parental leaf Na+ content, and biomass is positively correlated with maternal leaf Na+ in female cuttings and seedlings. Plant height, leaf production, specific leaf area, and ionic homeostasis at the low part of the gradient are also affected by parental salinity, suggesting enhanced shoot growth as parental salinity increases. CONCLUSIONS: Our results support plasticity to salinity and transgenerational effects as factors with great potential to contributeto the invasive ability of B. halimifolia through estuarine communities of high conservation value. [ABSTRACT FROM AUTHOR]

Background: In Europe, Public Health Residents (PHR) have participated in the response against COVID-19.The pandemic has had a profound mental health (MH) impact on healthcare workers, but little evidence has been accrued about the Public Health (PH) workforce.The current study aims at assessing prevalence and risk factors for pandemic-related depression (D), anxiety (A) and stress (S). Methods: Between March 22 and April 11, 2021 we administered an online survey to PHR from France, Italy, Portugal and Spain, recruited through the national associations of PHR.We collected socio-demographic data and assessed changes in the working conditions due to COVID-19.We used the Depression Anxiety Stress Scales-21.Cut-off scores for D, A and S were: 9, 7, and 14.Multivariable logistic regression models were applied to determine risk factors for pandemic-related MH outcomes.Data analysis was performed with SPSS version 27. Results: 443 out of approximately 2000 PHR completed the survey, response rate: 22.15%. Most responders (n=226; 51%) were from Italy, 87 (19.6%) from Portugal, 74 (16.47%) from Spain and 56 (12.6%) from France. Median age: 29 years (IQR 25 33). Female/male ratio: 1.6. PHR above the cut-offs for D, A and S were: 60.5%, 43.1%, 61.2%.DASS-21 scores were 13.3 (± 10.27), 8.13 (± 7.79), 19.06 (± 9.71), respectively.Across the multivariable logistic regression models, the main identified predictors were: for D - the COVID-19 impact on PH training (OR 1.78, 95% CI [1.12-2.80], p=0.014); for A - the loss of research opportunities (OR 1.94, 95% CI [1.28-2.93], p=0.002) and for psychological S - the year of residency (last year vs other years of residency: OR 2.3, 95% CI [1.204.38], p=0.012). Conclusions: Our sample featured mild-to-moderate levels of prevalent D, A and moderate levels of psychological stress.Overall, the main risk factors associated with negative psychometric outcomes were training challenges, loss of research opportunities and residency seniority. Key messages: During the pandemic it is vital to increase knowledge and awareness about the impact of the health emergency on mental health in the Public Health workforce. It is important to deploy concrete efforts into building healthy work environments, guarantee adequate training and research opportunities for Public Health Residents. [ABSTRACT FROM AUTHOR]

Concerns for environmental quality and its impact on people's welfare are fundamental arguments for the adoption of environmental legislation in most countries. In this paper, we analyze the relationship between air quality and subjective well-being in Europe. We use a unique dataset that merges three waves of the European Social Survey with a new dataset on environmental quality including SO2 concentrations and climate in Europe at the regional level. We find a robust negative impact of SO2 concentrations on self-reported life satisfaction. [Copyright &y& Elsevier]

Abstract: The exploitation of ITER tokamak will require diagnostics for machine protection, inputs to plasma control systems, evaluation and analysis of plasma parameters and performances. The equatorial visible/infrared wide angle viewing system and the radial neutron camera are the two main diagnostics of Procurement Package 11 (PP11), one of the diagnostic procurements under the responsibility of Europe, which also contains Equatorial Port Plug 1 and seven other diagnostics supplied by Europe or other ITER partners and integrated in the same Port Plug. Significant progress has recently been made in the development of the equatorial visible/infrared wide angle viewing system and the radial neutron camera. This paper gives an overview of the major technical achievements on these two diagnostics and points out the urgent needed R&D activities. [Copyright &y& Elsevier]