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Acoustic telemetry (AT) has emerged as a valuable tool for monitoring aquatic animals in both European inland and marine waters over the past two decades. The European Tracking Network (ETN) initiative has played a pivotal role in promoting collaboration among AT researchers in Europe and has led to a significant increase in the number of tagged and observed aquatic animals in transboundary European waters. While AT benefits decision‐making and delivers essential data to management bodies, its potential for management decision‐making mechanisms has yet to be fully harnessed. We reviewed existing research, studies, and organisational initiatives related to aquatic animal tracking and their utility in fisheries management in European waters. We found that AT has already contributed to many aspects of fisheries management, such as improved understanding of stock dynamics, identification of critical habitats, assessment of migration routes, and evaluation of the effectiveness of conservation measures. However, broader utilisation of tracking technologies is needed. By leveraging the full potential of AT, managers can make more informed decisions to protect, restore, and sustainably manage European waters and creatures that live therein. [ABSTRACT FROM AUTHOR]

[Display omitted] • Individual foxes spreading Echinococcus multilocularis were tracked using copro-sampling. • Over 4 years, 45 foxes were identified from a collection of 124 genotyped fox faecal samples. • One-third of individual E. multilocularis- infected foxes deposited two-thirds of the positive faecal samples. • Three fox genetic clusters were highlighted, with one clustering two-thirds of the positive faeces. • Female foxes had a higher average number of multiple-stool deposits compared with males. Key parasite transmission parameters are difficult to obtain from elusive wild animals. For Echinococcus multilocularis , the causative agent of alveolar echinococcosis (AE), the red fox is responsible for most of the environmental contamination in Europe. The identification of individual spreaders of E. multilocularis environmental contamination is crucial to improving our understanding of the ecology of parasite transmission in areas of high endemicity and optimising the effectiveness of prevention and control measures in the field. Genetic faecal sampling appears to be a feasible method to gain information about the faecal deposition of individual animals. We conducted a 4 year faecal sampling study in a village that is highly endemic for E. multilocularis, to assess the feasibility of individual identification and sexing of foxes to describe individual infection patterns. Individual fox identification from faecal samples was performed by obtaining reliable genotypes from 14 microsatellites and one sex locus, coupled with the detection of E. multilocularis DNA, first using captive foxes and then by environmental sampling. From a collection of 386 fox stools collected between 2017 and 2020, tested for the presence of E. multilocularis DNA, 180 were selected and 124 samples were successfully genotyped (68.9%). In total, 45 unique individual foxes were identified and 26 associated with at least one sample which tested positive for E. multilocularis (Em (+)). Estimation of the population size showed the fox population to be between 29 and 34 individuals for a given year and 67 individuals over 4 years. One-third of infected individuals (9/26 Em (+) foxes) deposited 2/3 of the faeces which tested positive for E. multilocularis (36/60 Em (+) stools). Genetic investigation showed a significantly higher average number of multiple stools for females than males, suggesting that the two sexes potentially defecated unequally in the studied area. Three partially overlapping clusters of fox faeces were found, with one cluster concentrating 2/3 of the total E. multilocularis -positive faeces. Based on these findings, we estimated that 12.5 million E. multilocularis eggs were produced during the study period, emphasizing the high contamination level of the environment and the risk of exposure faced by the parasite hosts. [ABSTRACT FROM AUTHOR]

Existing research on welfare chauvinism, which involves preferences about the inclusion or exclusion of immigrants in welfare programmes, often overlooks individual preferences regarding immigration policy openness (the number of immigrants allowed into a country). This article posits that these two dimensions should be considered together. The reason is that the implications of including or excluding migrants in welfare programmes vary significantly depending on whether a country admits few or many immigrants. Utilizing data from two waves of the European Social Survey across 23 European countries, we develop a typology of individual stances that encapsulate attitudes towards both immigration policy openness and immigrant inclusion in the welfare state. Our analysis reveals that the distribution of these stances varies considerably across European nations. We further examine how the probability of endorsing one of these typologies correlates with individual socio-economic characteristics, especially education. We find that higher education levels are linked to a higher likelihood of supporting either a combination of openness and inclusion or, to a lesser extent, openness paired with welfare exclusion. Additionally, more exclusionary attitudes are observed in countries where welfare usage by migrants is higher. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ornithology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The 6/04 standard of the European and Mediterranean Plant Protection Organisation (EPPO) on the safe use of biological control is a decision-support scheme (DSS) for the import and release of biological control agents in Europe. It was recently developed by the Joint EPPO/International Organisation of Biological Control (IOBC) Panel on Biological Control Agents. The DSS can be used to assess the potential environmental impacts of biological control agents. It is valid for different types of biological control: classical and augmentative biological control of invertebrates, pathogens and weeds. However, the DSS is not yet widely implemented in Europe and, during preliminary trials, it was found that its broad range of usages could lead to some confusion or misunderstandings, as well as requiring unnecessary information in some cases. Thus, the scheme was modified to specifically assess classical biological control against plant pests, i.e. the introduction of exotic natural enemies of plant pests for establishment and long-term control. The new version of the scheme was then tested on two parasitoids that are presently being released in Europe, the figitid Ganaspis cf. brasiliensis against the spotted wing drosophila Drosophila suzukii and the mymarid Cleruchoides noackae against the Eucalyptus bronze bug Thaumastocoris peregrinus. Both parasitoids were successfully assessed with the new version of the DSS. No major issues were encountered during the assessments and most questions were answered with low levels of uncertainty. Both assessments concluded that the parasitoids were safe to release in the impact assessment areas, with positive impacts exceeding negative impacts. Suggestions for potential improvements are provided. [ABSTRACT FROM AUTHOR]

Cardiovascular Diseases (CVDs) are the world's leading cause of morbidity and mortality, being responsible for almost 17 million deaths each year. In Europe, let alone it is estimated that 20% of all citizens suffer from one form of CVD, namely cerebrovascular disease or heart failure and Coronary Artery Disease (CAD). Among the latter, Acute Coronary Syndrome (ACS) is of particular importance since it is deadly and, hence, requires a prompt diagnosis and immediate medical attention. Aiming to deal with prognostication and promote consistency in managing patients with ACS, the Global Registry of Acute Coronary Events (GRACE) risk score has been proposed. This tool is based on eight independent risk factors roughly accounting for 89.9% of prognostic information. Nevertheless, as some other risk factors, not included in GRACE, are also known to be important vectors in the stratification of patients, namely haemoglobin at admission, it is expected that by embedding additional risk factors information into GRACE it will lead to a better characterisation of a patient's risk. Making use of data-fusion techniques, the present work proposes a generalisable framework to improve the classification performance of GRACE in predicting the risk of death in the course of six months after an ACS event, while preserving its interpretability and applicability. Considering haemoglobin concentration at admission, as an additional risk factor, it is shown that the discrimination performance of new GRACE Plus score outperformed that of GRACE in a database of cohorts comprising 1506 patients admitted with ACS, showing a F-1 score of 0.6033 for GRACE Plus against 0.5828 for GRACE, which is corroborated by one-tailed t-test in terms of correct stratification of death and survival endpoints, namely, t = − 9. 1876 and p < 0. 001. • GRACE neglects the information associated with other relevant risk factors. • Haemoglobin at admission has the potential to increase GRACE predictive performance. • Data fusion techniques allow combining complementary information into a single model. • Machine learning can be used to correct GRACE, while preserving its interpretability. • GRACE++ promotes parsimonious resource management and patient' tailored treatments. [ABSTRACT FROM AUTHOR]

Estuaries are among the most sensitive systems to climate change. Previous studies have suggested that the Sado Estuary (Portugal) has decreasing trends for water temperature, which is uncommon in a global warming scenario. However, no long-term analysis regarding water column conditions has been conducted on this estuary to date. Therefore, the main aim of this study is to understand if and how the properties of this estuary have changed, considering a 34-year trend analysis and an assessment of their main drivers. Water temperature significantly decreased (up to 0.04 °C/year) along with chlorophyll a. Salinity increased and nutrients displayed an overall decrease. These trends were potentially driven by higher influence of upwelled water combined with a reduction of the river flow. Sado appears to have a lower vulnerability to climate change than other estuaries as it does not show a high sensitivity to changes in its water column physicochemical properties. [Display omitted] • Fully understanding how estuaries respond to climate change is still a challenge. • A 30-year observational database was used to study changes in the Sado Estuary. • The system appears to have a buffering role in the increase in water temperature. • Trends could have been induced by upwelling and changes in the river flow. • The Sado Estuary shows a lower vulnerability to climate change than other estuaries. [ABSTRACT FROM AUTHOR]

Purpose: Companies that wish to market a global brand need to develop a greater understanding of consumers' and potential consumers' susceptibility to global consumer culture (SGCC) with a view to standardizing/adapting their brand according to the desires and preferences of the consumers who belong to specific segments of global consumers. Thus, the aim of the study is to fill a joint segmentation research gap within and between countries based on seven dimensions of SGCC while classifying consumers according to the degree of belonging to specific and hybrid (global citizenship) segments. Design/methodology/approach: A questionnaire was applied online in English in five countries across the Americas and Europe resulting in a sample of 412 consumers. Based on the fuzzy C-means cluster analysis, the study segments the sample of consumers according to the degree of belonging to specific and global citizenship segments. Findings: Analysis of survey results show three groups; two distinct groups and a third with features of both, a distinct intersection group. These findings suggest that consumers in different countries develop beliefs and attitudes about global citizenship, and this perspective coincides with the characteristics of the intersection group. Consequently, the study shows that fragmentation of the needs of consumers exists within and between countries. Originality/value: This study contributes to the concept of global citizenship, helping managers of global brands improve their marketing strategy decisions by implementing strategies that are standardized or adapted to specific hybrid segments of consumers that transcend national borders. This study used a statistical method to measure the degree of belonging to each segment. [ABSTRACT FROM AUTHOR]

In the past, large, foliose and unbranched Halymenia-like plants from Europe were often identified as 'Halymenia latifolia', however recent taxonomic studies have shown that 'H. latifolia' was a catch-all name for at least three cryptic species: Neofolia rosea, Nesoia mediterranea, and the genuine H. latifolia, which has been transferred to the recently established genus Nesoia. In this study, we further refine the taxonomy of European Halymeniaceae by examining new collections of foliose taxa from the Mediterranean Sea and Macaronesia. Analyses of rbcL gene sequences showed that unbranched foliose Halymeniaceae from Europe can be separated into five species, including three previously described species in Neofolia (N. rosea) and Nesoia (N. latifolia and N. mediterranea) and two new species belonging to Halymenia (H. ballesterosii sp. nov.) and Nesoia (N. hommersandii sp. nov.). Halymenia ballesterosii is the only known unbranched foliose species in the genus from Europe and can be separated from morphologically similar species in Neofolia and Nesoia by protruding surface cells, two-celled carpogonial branches, a basal nutritive cell cluster in the carpogonial branch ampullae, and secondary connecting filaments issued from basal cells of ampullar filaments. Nesoia hommersandii differs from N. latifolia by the lack of swollen arms in medullary stellate cells and cystocarps that slightly protrude above the thallus surface. We expect that the species diversity of foliose Halymeniaceae may increase when more foliose plants are collected and examined from different locations in Europe. [ABSTRACT FROM AUTHOR]

Pinus pinea stands have been identified as one of the target species for agroforestry systems in Europe. Its fruit yield is of importance to the local development, especially in the Mediterranean basin, due to its highly nutritional kernels and its economic value. The objectives of this study were to analyze the relation between pine nut and kernel weight and its efficiencies in relation to cone and tree traits for different stand structures. The statistical analysis was carried out with correlation, multiple correlation analysis, hurdle-gamma regression, principal component and cluster analysis, with a dataset of about 3300 cones collected in four plots and 3 years. The results indicate that pine nut and kernel and its efficiencies depend on stand structure, year and tree characteristics. The principal component analysis and the cluster analysis enabled the identification of four groups of trees related to the pine nut and kernel efficiencies. The higher efficiencies per tree are attained in stands managed for fruit production, increasing with the decrease of the density. [ABSTRACT FROM AUTHOR]

The decarbonization of the economy, for which the contribution of power systems is significant, is a growing trend in Europe and in the world. In order to achieve the Paris Agreement's ambitious environmental goals, a substantial increase in the contribution of renewable sources to the energy generation mix is required. This trend brings about relevant challenges as the integration of this type of sources increases, namely in terms of the distribution system operation. In this paper, the challenges foreseen for future power systems are identified and the most effective approaches to deal with them are reviewed. The strategies include the development of Smart Grid technologies (meters, sensors, and actuators) coupled with computational intelligence that act as new sources of data, as well as the connection of distributed energy resources to distribution grids, encompassing the deployment of distributed generation and storage systems and the dissemination of electric vehicles. The impact of these changes in the distribution system as a whole is evaluated from a technical and environmental perspective. In addition, a review of management and control architectures designed for distribution systems is conducted. This article is categorized under:Energy Infrastructure > Systems and InfrastructureEnergy Infrastructure > Economics and Policy [ABSTRACT FROM AUTHOR]

Since the introduction of the last equine broad-spectrum anthelmintic group in the 1980's, the investment in new drugs to control horse's parasites did not result in new advancements. These drugs allowed a very effective and extensive control of equine nematodes through successful interval dosing programs, firstly introduced in the 1960's. However, the widespread and indiscriminate use of anthelmintics in these intensive treatments have led to increasing resistance in the major equine nematodes. Reports of reduced effectiveness are virtually worldwide and repercussions in livestock production farms have already been seen. Based on recent questionnaires about horse farm practices, preventive measures and international recommendations, it is clear that most of them are still not being widely implemented. It is also clear that these recommendations are outdated and new approaches must be considered to correctly tackle this rapidly evolving issue in horse management, as more accurate diagnostic methods are currently available, such as Mini-FLOTAC. This article intends to do a general review of the history and current situation of anthelmintic resistance in horses, with emphasis in Europe, as well as, how to diagnose and delay or even prevent its further development, mentioning new methods of diagnostic and directions in which to develop research. [ABSTRACT FROM AUTHOR]

Soft tissue sarcomas are rare, but early, accurate diagnosis with subsequent appropriate treatment is crucial for the clinical outcome. The ESSR guidelines are intended to help radiologists in their decision-making and support discussion among clinicians who deal with patients with suspected or proven soft tissue tumors. Potentially malignant lesions recognized by ultrasound should be referred for magnetic resonance imaging (MRI), which also serves as a preoperative local staging modality, with specific technical requirements and mandatory radiological report elements. Radiography may add information about matrix calcification and osseous involvement. Indeterminate lesions, or lesions in which therapy is dependent on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist sarcoma center, where an interdisciplinary tumor group, with a specialized pathologist, radiologist, and the surgeon are involved. In sarcoma, a CT scan of the chest is mandatory. Additional staging modalities are entity-specific. There are no evidence-based recommendations for routine follow-up in surgically treated sarcomas. However, we would recommend regular follow-up with intervals dependent on tumor grade, for 10 years after the initial diagnosis. [ABSTRACT FROM AUTHOR]

We assess the cyclicality of current account balances for the period 2001Q1–2014Q4, focusing on Portugal and using Germany as a benchmark. We find that the cyclical component of the current account was positively explained by 3-month Euribor, but negatively by the financial crisis, systemic stress in Europe, employment and compensation of employees. Moreover, the noncyclical current account was positively affected by the period of the economic and financial adjustment programme and the terms of trade, but negatively influenced by financial integration. [ABSTRACT FROM AUTHOR]

We revisit Wagner’s law by function of government expenditure. Using data of 14 European countries between 1996 and 2013, we apply panel data and SUR methods to assess public expenditure–income elasticities. We find that some functions of government spending for a few countries (e.g. Austria, France, the Netherlands and Portugal) validate Wagner’s law. For the Netherlands, expenditures with environment protection increase more than proportionately to economic growth, and for France that is the case of spending in housing and community amenities. In addition, Greece is the only country where two public spending items react more than one to one to growth. [ABSTRACT FROM AUTHOR]

Risk assessments are mostly carried out based on available data, which do not reflect all data theoretically required by experts to answer them. This study aimed at developing a methodology to assess data availability, accessibility and format, based on a scoring system and focusing on two diseases: Venezuelan equine encephalomyelitis ( VEE), still exotic to Europe, and alveolar echinococcosis, caused by Echinococcus multilocularis ( EM), endemic in several Member States ( MSs). After reviewing 36 opinions of the EFSA- AHAW Panel on risk assessment of animal health questions, a generic list of needed data was elaborated. The methodology consisted, first, in implementing a direct and an indirect survey to collect the data needed for both case studies: the direct survey consisted in a questionnaire sent to contact points of three European MSs (Belgium, France and the Netherlands), and the organization of a workshop gathering experts on both diseases. The indirect survey, focusing on the three MSs involved in the direct survey plus Spain, relied on web searches. Secondly, a scoring system with reference to data availability, accessibility and format was elaborated, to, finally, compare both diseases and data between MSs. The accessibility of data was generally related to their availability. Web searches resulted in more data available for VEE compared to EM, despite its current exotic status in the European Union. Hypertext markup language and portable document files were the main formats of available data. Data availability, accessibility and format should be improved for research scientists/assessors. The format of data plays a key role in the feasibility and rapidness of data management and analysis, through a prompt compilation, combination and aggregation in working databases. Harmonization of data collection process is encouraged, according to standardized procedures, to provide useful and reliable data, both at the national and the international levels for both animal and human health; it would allow assessing data gaps through comparative studies. The present methodology is a good way of assessing the relevance of data for risk assessment, as it allows integrating the uncertainty linked to the quality of data used. Such an approach could be described as transparent and traceable and should be performed systematically. [ABSTRACT FROM AUTHOR]

Drawing on an analysis of austerity reforms in Greece and Portugal during the sovereign debt crisis from 2009 onwards, we show how the nature of the linkages between parties and citizens shapes party strategies of fiscal retrenchment. We argue that parties which rely to a greater extent on the selective distribution of state resources to mobilize electoral support (clientelistic linkages) are more reluctant to agree to fiscal retrenchment because their own electoral survival depends on their ability to control state budgets to reward clients. In Greece, where parties relied extensively on these clientelistic linkages, austerity reforms have been characterized by recurring conflicts and disagreements between the main parties, as well as a fundamental transformation of the party system. By contrast, in Portugal, where parties relied less on clientelistic strategies, austerity reforms have been more consensual because fiscal retrenchment challenged to a lesser extent the electoral base of the mainstream parties. [ABSTRACT FROM AUTHOR]

The transition into the twenty-first century brought about important changes in society, including the areas of education and teaching. The establishment of the European Higher Education Area represents an effort to face these changes together in Europe. The changes in the teaching and learning models in higher education led to the institutional promotion of extensive interventions in order to alter the status quo that has prevailed for decades. The need for a cultural renewal of the teaching staff involved in higher education, attending to the centrality of student’s learning rather than knowledge per se, is also a challenge to be overcome. This study intends to highlight the central elements concerning the Bologna Process and the topics connecting the objectives and their intrinsic principles. This initial approach is the basis for the design of a proposal for monitoring the implementation of the Bologna Process in an institution of higher education in Portugal. The results suggest a proposal consistent with the needs in terms of monitoring the implementation of the Bologna Process. This proposal allows, in addition to static analysis relative to a specific academic year, dynamic analysis between academic years, uncovering best practices and areas for improvement. [ABSTRACT FROM PUBLISHER]

Objective The annual prevalence of antiepileptic drug ( AED) prescribing reported in the literature differs considerably among European countries due to use of different type of data sources, time periods, population distribution, and methodologic differences. This study aimed to measure prevalence of AED prescribing across seven European routine health care databases in Spain, Denmark, The Netherlands, the United Kingdom, and Germany using a standardized methodology and to investigate sources of variation. Methods Analyses on the annual prevalence of AEDs were stratified by sex, age, and AED. Overall prevalences were standardized to the European 2008 reference population. Results Prevalence of any AED varied from 88 per 10,000 persons (The Netherlands) to 144 per 10,000 in Spain and Denmark in 2001. In all databases, prevalence increased linearly: from 6% in Denmark to 15% in Spain each year since 2001. This increase could be attributed entirely to an increase in 'new,' recently marketed AEDs while prevalence of AEDs that have been available since the mid-1990s, hardly changed. AED use increased with age for both female and male patients up to the ages of 80 to 89 years old and tended to be somewhat higher in female than in male patients between the ages of 40 and 70. No differences between databases in the number of AEDs used simultaneously by a patient were found. Significance We showed that during the study period of 2001-2009, AED prescribing increased in five European Union ( EU) countries and that this increase was due entirely to the newer AEDs marketed since the 1990s. Using a standardized methodology, we showed consistent trends across databases and countries over time. Differences in age and sex distribution explained only part of the variation between countries. Therefore, remaining variation in AED use must originate from other differences in national health care systems. A PowerPoint slide summarizing this article is available for download in the Supporting Information section . [ABSTRACT FROM AUTHOR]

Copyright of Pharmacy Practice (1886-3655) is the property of Centro de Investigaciones y Publicaciones Farmaceuticas S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The intake of methyl-Hg and EPA + DHA through consumption of seafood in Europe as well as the associated probability of exceeding the provisional tolerable weekly intake (PTWI) and the recommended daily intake (RDI), respectively, were estimated by combining methyl-Hg and EPA + DHA contents in the five most consumed seafood species with hypothesized consumption distributions for eight European countries, chosen on the basis of size and representative significance. Two estimators were used: plug-in (PI) and tail estimation (TE). The latter was based on the application of the extreme value theory to the intakes distribution curves. Whereas contents data were collected from own database and published scientific papers, consumption data were obtained from statistical sources of the various countries. Seafood consumption levels varied considerably between countries, from 140 in the United Kingdom to 628.5 g/(person.week) in Iceland. The main consumed species were also different between countries. The probability of exceeding the methyl-Hg PTWI ranged from 0.04% in the United Kingdom to 9.61% in Iceland. Concerning the probability of exceeding the RDI of EPA + DHA, Iceland was third, after Portugal (66.05%) and Spain (61.05%) and the United Kingdom was the last (0.32%). While TE was most accurate for small probabilities, PI yielded best estimates for larger probabilities. [ABSTRACT FROM AUTHOR]

Using alternative approaches to determine fiscal episodes, I assess expansionary fiscal consolidations in Europe, via panel models for private consumption. There is some concurring evidence for several budgetary spending items while the asymmetric effects of fiscal episodes do not seem to be corroborated by the results. [ABSTRACT FROM AUTHOR]

We assess the sustainability of public finances in the EU-15 over the period 1970–2006 using stationarity and cointegration analysis. Specifically, we use panel unit root tests of the first and second generation allowing in some cases for structural breaks. We also apply modern panel cointegration techniques developed by Pedroni (Oxf Bull Econ Stat 61(1):653–670, ; Econom Theory 20(3):597–625, ), generalized by Banerjee and Carrion-i-Silvestre (Cointegration in panel data with breaks and cross-section dependence, European Central Bank, Working Paper 591, and Westerlund and Edgerton (Econ Lett 97(3):185–190, , to a structural long-run equation between general government expenditures and revenues. While estimations point to fiscal sustainability being an issue in some countries, fiscal policy was sustainable both for the EU-15 panel set, and within sub-periods (1970–1991 and 1992–2006). [ABSTRACT FROM AUTHOR]

We develop a general equilibrium endogenous growth model of a monetary union between two countries that differ in economic dimension and level of development. By solving transitional dynamics towards the steady state, we examine the impact of fiscal shocks that may lead to excessive deficits. Results suggest that the individual and the whole impact of such deficits depend on which country they occur. In such context, we argue that the small and less developed country should be allowed to temporarily run an excessive deficit, in order to improve economic convergence within the union. [ABSTRACT FROM AUTHOR]

The doubts and criticisms with regard to the fiscal discipline imposed by the Stability and Growth Pact (SGP) have been many and varied, and the SGP was revised as a result. The following paper evaluates the changes contained in the "new" SGP by considering the properties for ideal fiscal rules put forward by Kopits and Symansky. The analysis points towards a clear increase in flexibility together with the probable emergence of new enforcement problems. In this context, the need for new improvements within the European framework for the definition and implementation of national fiscal policies is discussed. [ABSTRACT FROM AUTHOR]

The uncertainties of climate change, weather variability and the over-exploitation of natural resources including water have meant that business-as-usual practices are untenable and new resource strategies are needed. The proceedings, in addition to the conference papers, included 3 keynote lectures from leading water experts in Europe and 2 industry sessions. We thank all the academic and industry keynote speakers and panellists, session chairs, strategic partners, policy and industry supporters and sponsors and reviewers for the conference proceedings. [Extracted from the article]

The production of canned fish has decreased in recent years; however, several European countries still consume large amounts of these products. It is well known that such products may contain some toxic metals such as mercury, cadmium and lead. in order to determine the level of these three elements in canned seafood, several products were analyzed (more than 1800 samples). The mean total mercury level was 0.12 ± 0.14 mg/kg wet weight, with the highest content found in canned tuna. However, such values did not exceed the proposed limit for tuna by EU (1.0 mg/kg). All analyzed samples showed lead levels lower than the indicated limits. On the other hand, a few samples (less than 2%) of canned tuna and squid exceeded the limit values proposed for cadmium, 0.1 and 1.0 mg/kg, respectively. Taking into account the way in which these products are consumed, it can be concluded that canned seafood products do not represent a risk in terms of human diet. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aims to understand if the threats to freshwater-dependent species identified by The International Union for Conservation of Nature Red List of Threatened Species are correctly supported by valid literature. The results show that 99% of threats are not supported by validated published scientific knowledge. This may lead to ineffective conservation and management plans. Funding to study and fill baseline knowledge gaps about threats should be a priority. Freshwater ecosystems are disproportionally important for biodiversity conservation, as they support more than 9% of known animal species while representing less than 1% of the Earth's surface. However, the vast majority of the threats (99%, or 826 out of 837) identified by the International Union for Conservation of Nature Red List of Threatened Species known to affect the 434 known freshwater-dependent fish and lampreys of Europe are not supported by validated published scientific knowledge. This general lack of information about freshwater-dependent fish and lamprey species may have deleterious effects on species conservation, and additional funding is required to fill baseline knowledge gaps. [ABSTRACT FROM AUTHOR]

Phytoplankton bloom phenology studies are fundamental for the understanding of marine ecosystems. Mismatches between fish spawning and plankton peak biomass will become more frequent with climate change, highlighting the need for thorough phenology studies in coastal areas. This study was the first to assess phytoplankton bloom phenology in the Western Iberian Coast (WIC), a complex coastal region in SW Europe, using a multisensor long-term ocean color remote sensing dataset with daily resolution. Using surface chlorophyll a (chl-a) and biogeophysical datasets, five phenoregions (i.e., areas with coherent phenology patterns) were defined. Oceanic phytoplankton communities were seen to form long, low-biomass spring blooms, mainly influenced by atmospheric phenomena and water column conditions. Blooms in northern waters are more akin to the classical spring bloom, while blooms in southern waters typically initiate in late autumn and terminate in late spring. Coastal phytoplankton are characterized by short, high-biomass, highly heterogeneous blooms, as nutrients, sea surface height, and horizontal water transport are essential in shaping phenology. Wind-driven upwelling and riverine input were major factors influencing bloom phenology in the coastal areas. This work is expected to contribute to the management of the WIC and other upwelling systems, particularly under the threat of climate change. [ABSTRACT FROM AUTHOR]

The current linear economic system has led Europe to unsustainable development, aggravating several issues, such as climate change, limitation of resources, and pollution. As a sustainable alternative, circular economy (CE) has been promoted around the world. This economic system allows for the maximization of a product's life, thus decreasing its environmental impact and increasing its value. The main goal of this work is to scrutinise the concepts of CE over time, from the beginning of the concept, to its implementation in Europe and its application in Portugal. In addition, the requirement for strategies that led to studies on regional urban metabolism are addressed. Another goal is to examine Portugal and see how the country is dealing with the implementation of strategies for CE, moving from concept to practice. This part of the work resulted in the creation of the REMET-UA model, a tool to assess the regional economic metabolism, which also has the potential to evaluate synergies of materials in terms of fluxes between regions, maximizing the amount of information available at this scale for municipalities and enterprises to be used, having taken into account the purpose of circular economy. The results showed that REMET-UA is fully operational and corresponds to the goal for which the model was made. Future developments have been identified and are underway to improve the model and bring it as close to reality as possible. [ABSTRACT FROM AUTHOR]

Background: Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management. The aim of this study is to explore lifestyle changes as well as the achievement of targets for risk factors in patients with established cardiovascular disease. Methods: Cross-sectional study conducted in primary care practices. The study was carried out in six European countries (Croatia, France, Portugal, Slovenia, Spain and Turkey). Patients with established cardiovascular disease (coronary heart disease and stroke) attended in primary care were selected and assessed from January to June 2016. Patients were recruited and assessed at the practice by research assistants between 6 months and 3 years after the event. Statistical comparisons were done with the unpaired two-sided Student's t-test for continuous variables and Chi-square test for categorical variables. Results: Nine hundred and seventy-three patients (32.4% females) were assessed. About 14% of them were smokers, 32% were physically inactive, and 30% had nutritionally poor eating behaviours. LDL cholesterol target value below 70 mg/dl was achieved in about 23% of patients, and in general, women were less cardio-protected by drugs than men. Conclusions: Many patients with established cardiovascular disease who attended in general practice still fail to achieve the lifestyle, risk factor, and therapeutic targets set by European guidelines. These results are relevant to general practitioners because these patients have a high risk of subsequent cardiovascular events, including MI, stroke, and death. [ABSTRACT FROM AUTHOR]

Due to the balanced nutritional value and abundance of bioactive compounds, seaweeds represent great candidates to be used as health-promoting ingredients by the food industry. In this field, Phaeophyta, i.e., brown macroalgae, have been receiving great attention particularly due to their abundance in complex polysaccharides, phlorotannins, fucoxanthin and iodine. In the past decade, brown algae and their extracts have been extensively studied, aiming at the development of well-accepted products with the simultaneous enhancement of nutritional value and/or shelf-life. However, the reports aiming at their bioactivity in in vivo models are still scarce and need additional exploration. Therefore, this manuscript revises the relevant literature data regarding the development of Phaeophyta-enriched food products, namely those focused on species considered as safe for human consumption in Europe. Hopefully, this will create awareness to the need of further studies in order to determine how those benefits can translate to human beings. [ABSTRACT FROM AUTHOR]

The impact of high-speed railways on routes with high air traffic density was investigated and analysed. The case considered was the Madrid-Barcelona route, which had the highest volume of air traffic in Europe, nearly 5 million passengers per year, prior to the opening of the high-speed railway line in February 2008. Demand and market share evolution is evaluated and a comparison is made with other cases and with the forecasts presented in a previous paper. The results show that, as forecast, with maximum speeds of 300 km/h, the high-speed market share in routes where air competition is very strong does not reach the levels usually obtained in previous European high-speed links where competition from air transport was less important. [ABSTRACT FROM AUTHOR]

Abstract: Since the discovery of Newcastle disease virus (NDV) in 1926, nine genotypes of class I viruses and ten of class II have been identified, representing a diverse and continually evolving group of viruses. The emergence of new virulent genotypes from global epizootics and the year-to-year changes observed in the genomic sequence of NDV of low and high virulence implies that distinct genotypes of NDV are simultaneously evolving at different geographic locations across the globe. This vast genomic diversity may be favored by the large variety of avian species susceptible to NDV infection and by the availability of highly mobile wild bird reservoirs. The genomic diversity of NDV increases the possibility of diagnostic failures, resulting in unidentified infections. Constant epidemiological surveillance and pro-active characterization of circulating strains are needed to ensure that the immunological and PCR reagents are effective in identifying NDV circulating worldwide. For example, in the United States, the widely used real-time reverse transcription polymerase chain reaction (RRT-PCR) matrix gene assay for the identification of NDV often fails to detect low virulence APMV-1 from waterfowl, while the RRT-PCR fusion gene assay, used to identify virulent isolates, often fails to detect certain virulent NDV genotypes. A new matrix-polymerase multiplex test that detects most of the viruses currently circulating worldwide and a modified fusion test for the identification of virulent pigeon viruses circulating in the U.S. and Europe have recently been developed. For newly isolated viruses with unknown sequences, recently developed random priming sequencing methods need to be incorporated into the diagnostic arsenal. In addition, the current system of classifying NDV into genotypes or lineages is inadequate. Here, we review the molecular epidemiology and recent diagnostic problems related to viral evolution of NDV and explain why a new system, based on objective criteria, is needed to categorize genotypes. [Copyright &y& Elsevier]

Ambient temperature has a substantial influence on the thermoregulation costs of small mammals due to their high surface-to-volume ratio. Shrews are among the smallest of mammals and have adopted different behavioral and physiological strategies to deal with cold temperatures. In this study, we assessed the use of an external heat source in the thermoregulatory strategy of two Crocidurinae species, Crocidura russula and C. suaveolens , and one Soricinae species, Sorex araneus. Crocidura russula inhabits western Europe and is better adapted to a Mediterranean climate; C. suaveolens inhabits central Europe; and S. araneus inhabits northern Europe and is better adapted to a Palearctic climate. We predicted that C. russula (most southern species) would spend larger amounts of time using an external heat source because it is the most cold-sensitive species, while S. araneus (most northern species) would spend less time using an external heat source or not respond to it. Shrews were experimentally tested in captivity inside a terrarium where they had access to a heat rock, which could be turned off (cold) or on (heated), depending on treatment. Our results confirmed our initial prediction: C. russula was the species that spent significantly more time on the heated rock, followed by C. suaveolens. Only a quarter of S. araneus individuals spent large amounts of time on the heat rock, which suggests this thermoregulation strategy is not generally adopted by this species, but may be rather associated with some individual personalities. We also analyzed the influence of the heat rock on rewarming from heterothermy, but heterothermy was not different between rock treatments. Overall, our results show that shrew species use external heat sources for thermoregulation according to their sensitivity to cold. • We compared the use of a heat rock by three shrew species. • Both Crocidura species basked for a longer time on the rock when heated. • Only 25% of Sorex araneus basked on the rock when heated. • Variance in basking time was higher when the rock was heated. • The heated rock did not influence heterothermy patterns. [ABSTRACT FROM AUTHOR]

Most pathogens start the process of infection at the mucosal surfaces and therefore the mucosal immune response plays an essential role in the course of the infection. Due to the Senegalese sole (Solea senegalensis Kaup) condition of flatfish, the present comparative study aimed to analyse several immune-related enzymes as well as the bactericidal activity in the skin mucus from ocular and blind sides. For this purpose, Senegalese sole juveniles were bath challenged with a sub-lethal dose of Tenacibaculum maritimum for 24 h and sampled at 1, 2 and 3 weeks. The haematological profile and immune-related parameters were also measured in plasma in order to evaluate the systemic immune response after T. maritimum challenge. Results from this study showed that most parameters tested increased in skin mucus of bath challenged fish compared to unchallenged ones. In contrast, the sub-lethal dose tested did not influence the haematological profile including peripheral numbers the different leucocyte types. No variations were observed in plasma lysozyme, peroxidase, protease and haemolytic complement activities between unchallenged and bath challenged fish. This study suggests that the studied innate immune-related molecules are constitutively present in both skin mucus sides but at different levels. Interestingly, the levels of most parameters measured were higher on the ocular side than on the blind side, possibly due to the higher exposure to invasion by waterborne microorganisms on this side. Therefore, the present study brings some insights regarding local immune responses after bacterial challenge in skin mucus from the ocular and blind sides in one of the most valuable flatfish species in southern Europe. Image 1 • Systemic and local immune responses of Senegalese sole bath-challenged with T. maritimum were evaluated. • A comparative study was carried out in skin mucus of Senegalese sole from ocular and blind sides. • Immune parameters increased in skin mucus of challenged fish compared to unchallenged ones. • At systemic level no variations were found between unchallenged and challenged groups. • The most parameters measured were higher on the ocular side than on the blind side. [ABSTRACT FROM AUTHOR]

Abstract: Capercaillie populations are declining in most of its distribution area and are especially vulnerable in southern Europe. There, the causes of decline have not been properly identified and conservation decisions are too frequently based on poor evidence. We analysed the trend of a relict capercaillie population in the Spanish Pyrenees on the basis of bird densities during the period 1989–2010, and we developed the first modelling exercise for the dynamics of a capercaillie population in southern Europe. We also explored management actions commonly used to enhance endangered prey species thought to be affected by hyperpredation: the release of captive-bred females, in varying numbers, the removal of predators and the combination of both actions, using available information from past captive-breeding experiments and from an ongoing experiment involving the removal of terrestrial mesopredators. The population was found to be declining at an annual rate of 4%. Restraining the unknown adult survival rate according to values reported in the literature, our modelling approach showed that recruitment (productivity+fledgling survival), rather than adult survival, was the demographic parameter to be improved as a result of management and, thus, most likely to increase the population growth rate. The removal of terrestrial mesocarnivores may lead to the stabilisation of the capercaillie population (lambda 0.99±0.06), through the improvement of productivity, although this result should be considered as preliminary. However, the most effective management strategy was the combination of predator removal together with the release of 15, 30 or 45 adult females per year. These strategies should be viewed as urgency measures and should be implemented in combination with other long-term measures, such as the reduction of forest density, which may influence predation rate and food availability, and the control of the numbers of wild ungulates, which could be subsidising mesopredators in the area. We also present the adaptive management framework which will allow the results obtained from our current modelling to be updated in the near future, what will reduce the uncertainty regarding the best conservation strategies to apply in this and other similar populations. [Copyright &y& Elsevier]

Abstract: The particulate carbon content of precipitation was investigated in samples collected at five background sites located over a west-east European transect, from the Azores, in the mid-Atlantic Ocean, to the Hungarian plain, in central Europe. Sampling was performed on an event basis and the particulate carbon (elemental carbon, EC, and water insoluble organic carbon, WIOC) content was concentrated on quartz filters for the subsequent analysis by a thermal optical method in order to separate the EC and WIOC fractions. The average EC concentrations range from low values at the Azores (2.8±4.3μgCL−1) and at the high mountain site of Sonnblick (5.2±3.7μgCL−1) to high values at the more inland sites of Schauinsland (28±38μgCL−1) and K-Puszta (24±24μgCL−1). The average WIOC concentrations range from 98±56μgCL−1 at the coastal site of Aveiro and 113±78μgCL−1 at the Azores to 358±194μgCL−1 at the continental site of K-Puszta. These results are discussed in terms of factors affecting the spatial distribution of particulate carbon, such as emissions from surrounding areas and prevalent meteorological conditions. EC is found to be a minor contributor to total particulate carbon present in rain and snow samples (from 2.5% to 15%). This is particularly true at the remotes sites, where the EC contribution to total particulate carbon is <6.5%, consistent with a negligible impact of anthropogenic combustions locally. The EC and WIOC scavenging ratios were estimated and compared with those of sulfate, also evaluated at the same sampling sites. The results indicated that EC is removed from the atmosphere by wet deposition less efficiently than WIOC, and in turn this species is removed less efficiently than sulfate. [Copyright &y& Elsevier]

The European sardine (Sardina pilchardus) is the most abundant and socio-economically important small pelagic fish species in Western Iberia Upwelling Ecosystem. As a result of a long series of low recruitments, sardine biomass off Western Iberia has greatly reduced since the 2000s. Recruitment of small pelagic fish is mainly dependent on environmental factors. In order to identify the key drivers of sardine recruitment, it is essential to understand its temporal and spatial variability. To achieve this goal, a comprehensive suite of atmospheric, oceanographic, and biological variables spanning 1998-2020 (22 years) were extracted from satellite datasets. These were then related to in situ recruitment estimates obtained from yearly spring acoustic surveys carried out along two different hotspots of sardine recruitment of the southern Iberian sardine stock (NW Portugal and Gulf of Cadiz). Sardine recruitment in Atlanto-Iberian waters appears to be driven by distinct combinations of environmental factors, although sea surface temperature was identified as the main driver in both regions. Physical conditions that favour larval feeding and retention, such as shallower mixed layers and onshore transport, were also seen to play a vital role in modulating sardine recruitment. Furthermore, high sardine recruitment in NW Iberia was associated with optimal conditions in the winter (January-February). In contrast, recruitment strength of sardine off the Gulf of Cadiz were associated with the optimal conditions during late autumn and spring. The results from this work provide valuable insights to further understand the dynamics of sardine off Iberia, with potential to contribute to the sustainable management of sardine stocks in Atlanto-Iberian waters, particularly under climate change., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Chronic constrictive pericarditis (CCP) is a disease that has multiple possible causes and is associated with variable clinical findings, depending on its severity. It develops insidiously, and in many cases, particularly in developed countries, no antecedent diagnosis can be found. These cases are termed idiopathic. Tuberculosis is the leading cause of constrictive pericarditis in developing nations but represents only a small minority in developed countries., Methods: Here the authors describe two different case reports where tuberculosis was the probable cause of CCP., Results: A 21-year-old man born in Cape Verde living in Europe for 4 years and a 24-year-old man born in Guiné Bissau were both admitted due to intense precordial pain and syncope after exertion. Interestingly both had fatigability, dyspnea, chest discomfort and palpitations on exertion, as well as progressive involuntary weight loss and decubitus cough. On physical examination they had tachycardia, jaundice, cachexia, elevated jugular venous pressure, hepatomegaly and ascites. Both electrocardiograms showed prominent P waves and chest X-ray showed bilateral pulmonary interstitial infiltrates and enlargement of the right cavities. Analytically, elevated bilirubin, leukopenia and thrombocytopenia was also found in both. Echocardiography revealed findings, in both cases, compatible with CCP including less common signs as annulus reversus and annulus paradoxus. Thoraco-abdomino-pelvic CT from both patients revealed chronic liver disease with congestion, pleural effusion, pericardial calcifications, ascites and massive mediastinal and abdominal adenopathies. Blood cultures and IGRA test were negative. However, given the presumptive diagnosis of tuberculosis (TB), anti-TB therapy was started. Despite the diagnosis of "end-stage" CCP with very high operative risk multidisciplinary team decided after informed consent, to perform total anterior pericardiectomy, that occurred without complications. Pericardial and mediastinal biopsies, pericardial/pleural fluid cultures/ immune-phenotyping were inconclusive. Anti- tuberculosis therapy was maintained. After surgery, the patients had a remarkable clinical improvement (NYHA I) that persisted in 6- month follow-up., Conclusion: These two case reports illustrate that despite the markedly elevated operative risk of pericardiectomy in "end-stage" forms of disease after patients informed consent must be a considered option. The other point to consider is that, despite rare, tuberculosis still is a possible diagnosis to consider in CCP in Portugal.

In May 2013, Italy declared a national outbreak of hepatitis A, which also affected several foreign tourists who had recently visited the country. Molecular investigations identified some cases as infected with an identical strain of hepatitis A virus subgenotype IA. After additional European Union/European Economic Area (EU/EEA) countries reported locally acquired and travel-related cases associated with the same outbreak, an international outbreak investigation team was convened, a European outbreak case definition was issued and harmonisation of the national epidemiological and microbiological investigations was encouraged. From January 2013 to August 2014, 1,589 hepatitis A cases were reported associated with the multistate outbreak; 1,102 (70%) of the cases were hospitalised for a median time of six days; two related deaths were reported. Epidemiological and microbiological investigations implicated mixed frozen berries as the vehicle of infection of the outbreak. In order to control the spread of the outbreak, suspected or contaminated food batches were recalled, the public was recommended to heat-treat berries, and post-exposure prophylaxis of contacts was performed. The outbreak highlighted how large food-borne hepatitis A outbreaks may affect the increasingly susceptible EU/EEA general population and how, with the growing international food trade, frozen berries are a potential high-risk food.

Background: For patients with asthma, COPD, or asthma-COPD overlap syndrome (ACOS), inter-country comparisons of seasonal changes in drug prescriptions are scarce or missing. Hence, we aimed to compare seasonal changes in prescription rates of long-acting beta-2-agonist (LABA) in four European countries., Methods: A common study protocol was applied to six health care databases (Germany, Spain, the Netherlands (2), and the UK (2)) to calculate age- and sex-standardized point prevalence rates (PPRs) of LABA-containing prescriptions by the 1st of March, June, September, and December of each year during the study period 2002-2009. Seasonal variation of PPRs was quantified using seasonal indexes (SIs; based on the ratio-to-moving-average-method) and SIs averaged over the study period (aSI) stratified by sex, age, and indication (asthma, COPD, or ACOS)., Results: There was a moderate seasonal change in LABA-containing prescriptions which was more pronounced in asthma or COPD patients compared to ACOS patients. For asthma and ACOS patients, highest seasonal variation was found for patients living in Spain (aSI: 87.3-110.7, aSI: 93.2-103.1) whereas for COPD highest seasonal variation was revealed for the NPCRD database (the Netherlands) (aSI: 92.2-105.6). Regarding age and sex, highest seasonal variation was found in Spanish boys under 10 years of age having a diagnosis of asthma., Conclusions: By applying a common analysis in six databases, we could observe moderate overall seasonal changes in LABA-containing prescription rates in patients with asthma, COPD, or ACOS., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background and Objectives: Steroid-resistant nephrotic syndrome is a rare kidney disease involving either immune-mediated or genetic alterations of podocyte structure and function. The rare nature, heterogeneity, and slow evolution of the disorder are major obstacles to systematic genotype-phenotype, intervention, and outcome studies, hampering the development of evidence-based diagnostic and therapeutic concepts. To overcome these limitations, the PodoNet Consortium has created an international registry for congenital nephrotic syndrome and childhood-onset steroid-resistant nephrotic syndrome., Design, Setting, Participants, & Measurements: Since August of 2009, clinical, biochemical, genetic, and histopathologic information was collected both retrospectively and prospectively from 1655 patients with childhood-onset steroid-resistant nephrotic syndrome, congenital nephrotic syndrome, or persistent subnephrotic proteinuria of likely genetic origin at 67 centers in 21 countries through an online portal., Results: Steroid-resistant nephrotic syndrome manifested in the first 5 years of life in 64% of the patients. Congenital nephrotic syndrome accounted for 6% of all patients. Extrarenal abnormalities were reported in 17% of patients. The most common histopathologic diagnoses were FSGS (56%), minimal change nephropathy (21%), and mesangioproliferative GN (12%). Mutation screening was performed in 1174 patients, and a genetic disease cause was identified in 23.6% of the screened patients. Among 14 genes with reported mutations, abnormalities in NPHS2 (n=138), WT1 (n=48), and NPHS1 (n=41) were most commonly identified. The proportion of patients with a genetic disease cause decreased with increasing manifestation age: from 66% in congenital nephrotic syndrome to 15%-16% in schoolchildren and adolescents. Among various intensified immunosuppressive therapy protocols, calcineurin inhibitors and rituximab yielded consistently high response rates, with 40%-45% of patients achieving complete remission. Confirmation of a genetic diagnosis but not the histopathologic disease type was strongly predictive of intensified immunosuppressive therapy responsiveness. Post-transplant disease recurrence was noted in 25.8% of patients without compared with 4.5% (n=4) of patients with a genetic diagnosis., Conclusions: The PodoNet cohort may serve as a source of reference for future clinical and genetic research in this rare but significant kidney disease., (Copyright © 2015 by the American Society of Nephrology.)

Background: Inhaled, long-acting beta-2-adrenoceptor agonists (LABA) have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology., Methods: A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2), and the UK (2)) to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs) of LABA-containing prescriptions from 2002-2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD)., Results: From 2002-2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%-185.1%). Highest PPRs were found in men ≥ 80 years old and women 70-79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with "asthma and COPD" but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age., Conclusions: Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries.