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With student and staff wellbeing a growing concern, several authors have asked whether existing data might help institutions provide better support. By analogy with the established field of Learning Analytics, this might involve identifying causes of stress, improving access to information for those who need it, suggesting options, providing rapid feedback, even early warning of problems. But just investigating the possibility of such uses can create significant risks for individuals: feelings of creepiness or surveillance making wellbeing worse, inappropriate data visibility destroying trust, assessments or interventions becoming self-fulfilling prophecies. To help institutions decide whether and how to explore this area, and to reassure individuals that this is being done safely, we propose a Wellbeing Analytics Code of Practice. This starts from an existing Learning Analytics Code, confirms that its concerns and mitigations remain relevant, and adds additional safeguards and tools for the wellbeing context. These are derived from a detailed analysis of European and UK data protection law, extracting all rules and safeguards mentioned in relation to health data. We also develop context-specific tools for managing risk and evaluating data sources. Early feedback suggests that these documents will indeed increase confidence that this important area can be safely explored.

Objective: To gather research evidence on the association between diet and depression and anxiety among college students. Methods: Systematic searches were performed in CINAHL, PsycINFO, PubMed, and ScienceDirect databases to identify potentially relevant articles published between January 2000 and September 2020. Data were extracted from 21 selected studies. Results: Most of the cross-sectional studies found a positive association between diet and depression and anxiety; however, a few studies found inconsistent results. Moreover, several interventional studies demonstrated that a healthy diet (including consumption of fruit and vegetables) improved depression in the intervention group. Conclusions: The methodological limitations of cross-sectional studies to explain causality and the limited number of prospective interventional studies point to a pressing need to conduct more prospective, longitudinal, and randomized controlled trials to generalize the causal associations between diet and depression and anxiety. Further research is needed to investigate the biological mechanisms of nutrients' actions on anxiety and depression.

Objective: To synthesize peer-reviewed primary research exploring factors associated with perceived stress impacting post-secondary students' academic success. Methods: A systematic review identified research conducted in North America, Europe, and Australia in the last ten years across 12 databases. Results: Of the 6,214 references screened, 14 English articles published between 2011 and 2018 were deemed relevant. Subsequent analysis characterized articles by study design, location, population, factors with a statistically significant relationship with both perceived stress and academic success, and future research directions. Findings reveal a complex relationship among overlapping factors associated with perceived stress on academic success at both the intrapersonal (eg, academic, demographic, psychological, attitudinal, and behavioral characteristics) and interpersonal levels (eg, social capital). Conclusions: Further research should measure the association of the identified factors to inform areas where resources could be targeted within post-secondary institutions to prevent stress from unduly impacting students' educational outcomes.

The premise of this brief opinion piece is that the fundamental paradigm of education appeared with Plato. It is that there is a co-location in time and space of learners, teachers, and resources. The absence of any of these elements can lead to shortcomings in the meaning of the term "to be educated". Recent events such as COVID-19 demonstrate that the paradigm is subject to challenge but that its premises are firmly established. It is recognised that there are complex philosophical and theoretical arguments surrounding distance education debates. It is not possible in a short article like this to canvass all the possible philosophical positions that affect education. Pointers to these debates are referenced in the article. For the purpose of this article, "philosophy" is taken to mean that department of knowledge or study that deals with ultimate reality, or with the general causes and principles of things. More narrowly, it is the study of general principles of some particular branch of knowledge, experience, or activity--in this case, distance education or flexible learning. "Theory" is taken to mean a scheme or system of ideas or statements held as an explanation or account of a group of facts or phenomena.

Satisfaction with the detection process of autism and its determinants was investigated using data from the Autism Spectrum Disorder in the European Union (2015-2018) network. A total of 1342 family members, including 1278 parents, completed an online survey collecting information about their experience and satisfaction with the early detection of autism in their child. Overall, the level of satisfaction varied considerably from one respondent to another. Difficulty in finding information about detection services, lack of professional guidance and support in response to first concerns, finding a diagnostic service on one's own, and a delay of more than 4 months between the confirmation of concerns and the first appointment with a specialist were all experiences individually associated with greater odds of being less satisfied. Using a dominance analysis approach, we further identified professional guidance and support in response to first concerns as the most important predictor of the level of satisfaction. These findings highlight the aspects of the process that need to be improved to enhance the experience of the detection process and are therefore relevant to guide health administrations toward actions to be implemented to this effect.

University ranking systems are being implemented with the aim of assessing and comparing higher education institutions at a global level. Despite their being increasingly used, rankings are often strongly criticized for their social and economic implications, as well as for limitations in their technical implementation. One of these limitations is that they do not consider the specific characteristics of online education. This study used a participatory approach to define a set of criteria and indicators suitable to reflect the specific nature of distance education. This endeavour will help evaluate and rank online higher education institutions more appropriately than in current practice, where indicators are devised for traditional universities. To this end, several stakeholders and informants were involved in a Delphi study in an attempt to reach the broader higher education institutions (HEI) community. According to the study participants, apart from students' achievements and general quantitative measures of HEI performance, which are quite common in traditional ranking systems, teaching and student learning experience turned out to be the most important criteria. Student support, teacher support, technological infrastructure, research and organization were deemed middle ground criteria, while sustainability and reputation were regarded as the least important criteria.

Purpose: Networks and partnerships are commonly-used tools to foster knowledge sharing between actors and organisations in the Agricultural Knowledge and Innovation System (AKIS), but in Europe the policy emphasis on including users, such as farmers and foresters, is relatively recent. This paper assesses user involvement in a diverse set of European Union (EU)-funded and non-EU (formal and informal) multi-actor partnerships. Design/methodology/approach: A review of 200 projects and other partnerships including farmers and foresters, drawn from an integrated database of several thousand such examples, assessed the types of innovation challenges tackled, solutions proposed, innovation supported, parameters of actor participation and the expectations of success in each example. Findings: All the reviewed policy instruments, not just those funded in the frame of the EIP-AGRI, can be used to involve users in co-innovation in agriculture, forestry and related value chains. Practical implications: The EIP-AGRI is just one part of a complex matrix of multi-actor co-innovation activities involving farmers and foresters in Europe. Interlinking of innovation programmes and more effective targeting of these programmes at groups of actors, especially users, who are currently not sufficiently engaged are worthy aspirations. Theoretical implications: Any analysis of co-innovation involving users must recognise the existence of a multiplicity (projects, non-project activities, formal and informal) of multi-actor approaches. Originality/value: This research used a common methodology to review several forms of multi-actor partnerships involving users and other actors. Our data suggest that many of these are effective methods of supporting co-innovation and are, therefore, 'sharing the space' within the AKIS.

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents' opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child's age, delays in accessing services, and active stakeholders' participation when looking to improve services.

Purpose: The decision by the International Football Association Board in 2004 to approve the use of artificial surfaces in elite football (soccer) competitions remains controversial amongst many players, managers and coaching staff. The aim of this study was to conduct a comprehensive assessment of players' opinions to better understand the influence of playing surfaces on the game of football and identify factors that may contribute to differences of opinion. Method: Qualitative data were collected from 103 elite footballers and 21 coaching staff during a series of interviews and focus groups. A thematic analysis was conducted to identify patterns in the data. Results: Players considered that the type and condition of a playing surface influenced ball-surface interactions, game play, tactics/strategy, footwear selection, movement, risk of injury and fatigue. Together these influence a player's perception of the suitability of a surface and also their mindset, which could ultimately affect their performance. Conclusion: The majority of participants in this study expressed a higher preference for natural grass over artificial turf pitches. A perceived increased risk of injury on artificial turf remains a primary concern despite a lack of supporting evidence in research studies. To address this discrepancy, the reporting of muscle soreness and the effect of constant surface switching merit further consideration. Not all participants shared the same views and player characteristics such as age, surface experience, injury history and playing style/position were found to be potential factors that could account for differences in elite players' opinions regarding the surfaces used in football.

Purpose: The aim of this study was to examine the extent to which several workplace factors are implicated in school principals' well-being. Two job resources (i.e. participatory climate and collegial climate) and two job demands (i.e. barriers to professional learning and staff shortages) were investigated, along with two well-being outcomes (i.e. job satisfaction and occupational commitment). Interaction effects between the job resource and job demand variables were also tested. Design/methodology/approach: Data were from 5,951 principals in 22 Organization for Economic Co-operation and Development (OECD) countries that participated in the Teaching and Learning International Survey (TALIS) 2013. Path analysis of direct and interaction effects was tested, along with multigroup path analysis to determine any differences in results across nations. Findings: The results showed that staff shortages and collegial climate predicted job satisfaction. All of the job resources and demands predicted occupational commitment. In addition, one interaction effect was significant showing that a participatory climate was especially important for occupational commitment under conditions of high staff shortages. The findings were similar across the 22 countries. Originality/value: The study yields important knowledge about the cross-national salience of four job resources and demands that are associated with principals' well-being at work.

Contribution: This paper quantifies the phenomenon of more versus better research output in computing research education and elaborates on how the organizational variable known as cognitive distance plays a fundamental role in mediating such more versus better research output relation. Background: To improve the current educational system, investigation and quantification is needed of the "silos." Cognitive distance--a measure of the differences in background, culture, and expertise between collaborators--may be a factor influencing the lack of quality and variety in research outputs. Addressing this is a key enabler for fruitful collaboration. Research Question: Does collaboration with similarly expert researchers yield better research? Methodology: A quantitative survey provides baseline data for cognitive distance while publication data allowed creation of a co-authorship network between 123 researchers in a European computing research department. The network was analyzed through quantitative and qualitative research methods. Findings: Increased expertise overlaps across sub-fields of computing is a strong predictor for further collaboration (quantity), but research impact (quality) decreases with larger overlaps. This reveals an educational silo effect in doctoral computing education and, consequently, a flaw in the connected research output. The lack of a single, agreed way to evaluate research impact across sub-fields further hinders cross-departmental collaboration among doctoral students. Conclusion: Three recommendations emerge for policy makers and educational leaders: 1) departments should be cross-functional and focused on societal interests; 2) communities of practice should be created at the level of doctoral education and upward; and 3) departments should hold matchmaking and speed-meeting events regularly within and across institutions.

In the framework of the RECCAP2 initiative, we present the greenhouse gas (GHG) and carbon (C) budget of Europe. For the decade of the 2010s, we present a bottom‐up (BU) estimate of GHG net‐emissions of 3.9 Pg CO2‐eq. yr−1 (using a global warming potential on a 100 years horizon), which are largely dominated by fossil fuel emissions. In this decade, terrestrial ecosystems acted as a net GHG sink of 0.9 Pg CO2‐eq. yr−1, dominated by a CO2 sink that was partially counterbalanced by net emissions of CH4 and N2O. For CH4 and N2O, we find good agreement between BU and top‐down (TD) estimates from atmospheric inversions. However, our BU land CO2 sink is significantly higher than the TD estimates. We further show that decadal averages of GHG net‐emissions have declined by 1.2 Pg CO2‐eq. yr−1 since the 1990s, mainly due to a reduction in fossil fuel emissions. In addition, based on both data driven BU and TD estimates, we also find that the land CO2 sink has weakened over the past two decades. A large part of the European CO2 and C sinks is located in Northern Europe. At the same time, we find a decreasing trend in sink strength in Scandinavia, which can be attributed to an increase in forest management intensity. These are partly offset by increasing CO2 sinks in parts of Eastern Europe and Northern Spain, attributed in part to land use change. Extensive regions of high CH4 and N2O emissions are mainly attributed to agricultural activities and are found in Belgium, the Netherlands and the southern UK. We further analyzed interannual variability in the GHG budgets. The drought year of 2003 shows the highest net‐emissions of CO2 and of all GHGs combined. Plain Language Summary: We have synthesized the European budgets of carbon and the greenhouse gases (GHG) carbon dioxide, methane and nitrous oxide. This synthesis includes estimates of direct emissions from fossil fuel burning, industrial production, waste management and agriculture, as well as of sources and sinks in the terrestrial biosphere. Summing up the sources and sinks of the three GHGs, we estimate for the decade of the 2010s an average annual net‐emission of 3.9 billion tons of carbon dioxide equivalents. These net‐emissions are dominated by carbon dioxide from fossil fuel emissions (4.1 billion tons of carbon dioxide). In contrast, the terrestrial biosphere acts as a net sink of carbon dioxide, the effect of which is only partly counterbalanced by net emissions of methane and nitrous oxide. The net‐effect of the terrestrial biosphere's GHG budget is a sink of 0.9 billion tons of carbon dioxide equivalents per year. Over the last three decades, European GHG emissions have declined by 1.2 billion tons carbon dioxide equivalents per year, mainly due to reductions in fossil fuel emissions. However, the sink capacity of the terrestrial biosphere has diminished since the 2000s. Key Points: We provide a bottom‐up estimate of CO2, CH4, N2O emissions of 3.9 Pg CO2‐eq. yr−1 over Europe, 2010–2019Terrestrial ecosystems acted as a greenhouse gas net sink of 0.9 Pg CO2‐eq. yr−1, dominated by CO2 sinkNet‐greenhouse gas emissions decreased by ∼1/4 since the 1990s, but land carbon sink is weakening since the 2000s [ABSTRACT FROM AUTHOR]

The purpose of this paper is to throw light on sustained research-practice collaborations (called 'schemes' here) aimed at improving educational outcomes. The empirical work combines a survey of thirteen school-university knowledge-exchange schemes in six European countries, with four case studies drawn from these. Three theoretical models of knowledge use are employed to aid analysis of these cases. It is suggested that a judicious mix of the three perspectives helps in understanding what makes such collaborations successful. Stages in the cyclical process of improving practice through use of research are described, beginning with frank analysis of pre-existing ways of thinking and culminating in the challenge of altering established practice.

Lifecycle analysis was used to estimate well-to-wheel greenhouse gas (GHG) emissions associated with the production, transport, and use of oxygenated gasoline in Colombia, Japan, and France. The study evaluated fuel blends containing ethanol and/or ethyl tertiary-butyl ether (ETBE) that aligned with oxygen and octane specifications currently in place or under consideration for each country. For Colombia, fuel blends meeting a 3.7 wt.% oxygen specification were analyzed using ethanol sourced and produced in the U.S. from corn and in Colombia from sugarcane, and ETBE processed in the U.S. Gulf Coast. For Japan, blends with 1.3, 2.7 and 3.7 wt.% oxygen were analyzed using ethanol sourced and produced in the U.S. and Brazil, and ETBE processed in the U.S. Gulf Coast. For France, oxygenated gasoline blends with 3.7 to 8.0 wt.% oxygen content were analyzed with ethanol produced locally from corn, beet, and wood and imported sugarcane ethanol. Data were populated from both publicly available secondary data sources and new primary data developed for ETBE production in the U.S. and Europe. This study also accounted for distinct lifecycle emissions among gasoline components, focused on aromatic-rich reformate used to boost octane in non-oxygenated fuels. Across each country, results indicate that the replacement of reformate in ethanol-free (E0) gasoline with oxygenates up to 3.7 wt.% oxygen reduces lifecycle GHG emissions by 6–9%, with the highest GHG reduction provided when ETBE alone is used for oxygenate. For higher oxygen blends modeled for France, the highest GHG reduction (19%) was for a blend of 51 vol.% ETBE to achieve 8.0 wt.% oxygen, the equivalent of E23 (gasoline with 23 vol.% ethanol). Overall, displacing ethanol with ETBE to achieve a fixed oxygen level increased GHG benefits relative to ethanol-only blends, owing to the greater volume of the carbon-intensive reformate displaced. [ABSTRACT FROM AUTHOR]

Introduction: Psoriatic arthritis (PsA) is a complex, progressive, and often debilitating disease. Despite recent advances in treatment, numerous unmet needs in patient care persist. Rheumacensus is a multistakeholder, pan-European initiative designed to identify ways to elevate the standard of care (SoC) and treatment ambition for patients with PsA, using the perspectives of three key stakeholder groups: patients, healthcare professionals (HCPs) and payors. Methods: Rheumacensus followed three phases: an insights-gathering workshop to identify current unmet needs in PsA and an area of focus for the project, a modified Delphi process to gain consensus on improvements within the agreed area of focus, and a Consensus Council (CC) meeting which used consensus statements as inspiration to generate 'Calls to Action' (CTA)—practical measures which, if implemented, could elevate the SoC for patients with PsA. Results: The Rheumacensus CC consisted of four patient representatives, four HCPs and four payors. All 12 members completed all three Delphi e-consultations. The shared area of focus that informed the Delphi process was "patient empowerment through education on the disease and treatment options available, to enable patient involvement in management". Four key themes emerged from the Delphi process: patient empowerment, patient knowledge and sources of education, patient–HCP consultations, and optimal initial treatment. Statements within these themes informed 12 overarching CTA, which focus on the need for a multistakeholder approach to implementing a paradigm shift towards patient-centred care and improved outcomes for patients with PsA. Conclusion: Rheumacensus has identified shortcomings in the current SoC for patients with PsA and provides a foundation for change through practical CTA. It is hoped that all stakeholders will now take practical steps towards implementing these CTA across Europe to elevate the SoC for patients with PsA. Plain Language Summary: Inequalities in the care patients with psoriatic arthritis (PsA) receive can be mainly explained by poorly coordinated management due to a lack of disease and treatment knowledge. This report is about a programme called Rheumacensus which has the overall aim of improving the standard of care (SoC) for patients with PsA. Rheumacensus brings together the points of view of three key groups involved in the care of people with PsA: patients, payors and healthcare professionals (HCPs) from across Europe. Together, these three groups agreed to focus on patient empowerment through education on the disease and treatment options as a way to raise the SoC. Through a series of exercises—to agree on the current SoC and what needs to be improved—and group discussions, four themes were established which were used by the groups to help them suggest 'Calls to action' (CTA). The CTAs were ideas of how improvements could be made or what needs to be done to improve the care patients receive. The four themes were (1) patient empowerment, (2) patient knowledge, (3) patient–HCP consultation and (4) optimal initial treatment. In total, 12 CTAs were developed across these themes that provide direction and practical next steps which patients, payors and HCPs could take to drive change and make a real difference to patients by improving their care. [ABSTRACT FROM AUTHOR]

Over the past two decades, emerging literature has shaped the management of pericardial syndromes and has evolved abundantly towards the creation of European guidelines for the diagnosis and management of pericardial diseases. However, since the publication of the European guidelines in 2015, more data surrounding the management of pericardial syndromes have been published. Comprehensive reference materials with the most updated literature are warranted and can be pivotal in helping pharmacists make evidence-based and clinical decisions for patients diagnosed with pericardial syndromes. This compilation of key articles and guidelines will serve as a resource for pharmacists who are responsible for the care of patients with pericardial syndromes. [ABSTRACT FROM AUTHOR]

This article uses a Polanyian frame to place the plight of Roma in Europe in the context of an age of crisis, as evidenced by faltering neoliberal economies and a corresponding rise in xenophobia and extreme manifestations of nationalism. The situation of the Roma remains precarious, a situation exacerbated by the 2008 economic crises and the COVID-pandemic. Despite a number of social inclusion measures in recent decades, at the national and European level which target the Roma, Roma exclusion remains a serious challenge. The paper assesses why previous policy regimes failed but also reflects on what is the way forward in terms of inclusive policy frameworks. The article seeks to provide some answers to these questions with a vision of a Polanyian countermovement in the form of a New Social Europe predicated on redistribution, recognition and community action but also a re-envisioning of integration and transformative change in structural and cultural terms. [ABSTRACT FROM AUTHOR]

The relevance of investigating the distribution, biology, and role of zoophilic flies Hermetia illucens of the family Stratiomyidae in the occurrence of myiasis in mammals lies in the ability of these flies to parasitise animals, which poses a threat to their health and life. The purpose of this review was to analyse scientific research on the possible spread of Hermetia illucens flies as a potential pathogen of parasitic diseases in Ukraine. The study employed the methods of analysis, comparison, and synthesis of scientific sources. It was found that the natural habitat of these flies is the countries of South and North America with tropical and subtropical climates. However, these flies are also found in European countries, namely: Portugal, Spain, Malta, France, Albania, Croatia, Slovenia, and Switzerland. To intensify biotechnology in the agricultural sector, the larvae of Hermetia illucens flies are used as an ecological utiliser of organic agricultural residues. It is believed that the main reason for the emergence of Hermetia illucens flies in Europe is their importation into seaports and subsequent introduction into coastal areas. Considering the above, it is possible that Hermetia illucens flies may also appear in Ukraine (in the southwestern regions). Cases of larval parasitism of these flies in mammals have been established. They were mostly detected as parasites in the gastrointestinal tract. Their ability to cause typical enteric myiasis has been confirmed. Larval parasitism is non-specific: diarrhoea (faeces with blood and mucus), flatulence, vomiting, loss of consciousness, etc. The larvae can also parasitise under the skin, forming boils. A frequent cause of human infestation is the consumption of unwashed, overripe fruit and vegetables on which these flies lay their eggs. The results of the review can be used to develop methods for controlling the spread and reproduction of Hermetia illucens flies, as a species whose larvae are capable of parasitising mammals. [ABSTRACT FROM AUTHOR]

Introduction: Dolutegravir/lamivudine (DTG/3TC) and dolutegravir/rilpivirine (DTG/RPV) are fixed-dose, complete, single-tablet, two-drug regimens (2DRs) indicated for HIV-1. DTG/3TC is approved for antiretroviral therapy (ART)-naive people with HIV-1 and virologically suppressed individuals to replace current ART; DTG/RPV is indicated for virologically suppressed individuals as a switch option. Virologic efficacy and effectiveness of these DTG-based 2DRs have been demonstrated in phase 3 clinical trials and real-world cohorts, primarily from Europe. This study characterized real-world use of DTG-based 2DRs for HIV-1 treatment in the USA. Methods: TANDEM was a retrospective medical chart review across 24 US sites. Individuals aged ≥ 18 years who initiated DTG/3TC or DTG/RPV before September 30, 2020, with ≥ 6 months of follow-up were included. One cohort included ART-naive people who initiated DTG/3TC (n = 126), and two other cohorts included virologically suppressed (HIV-1 RNA < 50 copies/mL) people on stable ART regimens for ≥ 3 months before switch to either DTG/3TC (n = 192) or DTG/RPV (n = 151). Clinical characteristics, treatment history, and outcomes are described. Results: Virologically suppressed individuals were older than those who were ART-naive, and the ART-naive cohort had higher proportions of individuals assigned male at birth and of Hispanic ethnicity. The most common healthcare provider-reported reason for choosing a DTG-based 2DR was avoidance of long-term toxicities (25–33% across cohorts), followed by simplification/streamlining of treatment. Among ART-naive people on DTG/3TC, 94% achieved virologic suppression after initiation, and 83% maintained suppression at last follow-up; discontinuation rate was < 1%. Among cohorts who switched to DTG-based 2DRs, 96% maintained virologic suppression on DTG/3TC and 93% on DTG/RPV; 2% on DTG/3TC and 3% on DTG/RPV discontinued. Conclusion: Motivation for selecting DTG-based 2DRs was primarily driven by a desire to avoid or manage toxicities and simplify treatment. Results demonstrate that DTG/3TC and DTG/RPV are effective in real-world settings, with few discontinuations, reflecting data from clinical trials. [ABSTRACT FROM AUTHOR]

Background During the first year of life, 1 in 4 infants develops a symptomatic respiratory syncytial virus (RSV) infection, yet only half seek medical attention. The current focus on medically attended RSV therefore underrepresents the true societal burden of RSV. We assessed the burden of nonmedically attended RSV infections and compared with medically attended RSV. Methods We performed active RSV surveillance until the age of 1 year in a cohort (n = 993) nested within the Respiratory Syncytial Virus Consortium in EUrope (RESCEU) prospective birth cohort study enrolling healthy term-born infants in 5 European countries. Symptoms, medication use, wheezing, and impact on family life were analyzed. Results For 97 of 120 (80.1%) nonmedically attended RSV episodes, sufficient data were available for analysis. In 50.5% (49/97), symptoms lasted ≥15 days. Parents reported impairment in usual daily activities in 59.8% (58/97) of episodes; worries, 75.3% (73/97); anxiety, 34.0% (33/97); and work absenteeism, 10.8% (10/93). Compared with medically attended RSV (n = 102, 9 hospital admissions), Respiratory Syncytial Virus NETwork (ReSViNET) severity scores were lower (3.5 vs 4.6, P <.001), whereas duration of respiratory symptoms and was comparable. Conclusions Even when medical attendance is not required, RSV infection poses a substantial burden to infants, families, and society. These findings are important for policy makers when considering the implementation of RSV immunization. Clinical Trials Registration. ClinicalTrials.gov (NCT03627572). [ABSTRACT FROM AUTHOR]

Background Optimization of antimicrobial stewardship is key to tackling antimicrobial resistance, which is exacerbated by overprescription of antibiotics in pediatric emergency departments (EDs). We described patterns of empiric antibiotic use in European EDs and characterized appropriateness and consistency of prescribing. Methods Between August 2016 and December 2019, febrile children attending EDs in 9 European countries with suspected infection were recruited into the PERFORM (Personalised Risk Assessment in Febrile Illness to Optimise Real-Life Management) study. Empiric systemic antibiotic use was determined in view of assigned final "bacterial" or "viral" phenotype. Antibiotics were classified according to the World Health Organization (WHO) AWaRe classification. Results Of 2130 febrile episodes (excluding children with nonbacterial/nonviral phenotypes), 1549 (72.7%) were assigned a bacterial and 581 (27.3%) a viral phenotype. A total of 1318 of 1549 episodes (85.1%) with a bacterial and 269 of 581 (46.3%) with a viral phenotype received empiric systemic antibiotics (in the first 2 days of admission). Of those, the majority (87.8% in the bacterial and 87.0% in the viral group) received parenteral antibiotics. The top 3 antibiotics prescribed were third-generation cephalosporins, penicillins, and penicillin/β-lactamase inhibitor combinations. Of those treated with empiric systemic antibiotics in the viral group, 216 of 269 (80.3%) received ≥1 antibiotic in the "Watch" category. Conclusions Differentiating bacterial from viral etiology in febrile illness on initial ED presentation remains challenging, resulting in a substantial overprescription of antibiotics. A significant proportion of patients with a viral phenotype received systemic antibiotics, predominantly classified as WHO Watch. Rapid and accurate point-of-care tests in the ED differentiating between bacterial and viral etiology could significantly improve antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Introduction: Dementia is quite prevalent and among the leading causes of death worldwide. According to earlier research, diabetes may increase the possibility of developing dementia. However, the association between antidiabetic agents and dementia is not yet clear. This investigation examines the association between the use of sodium-glucose transporter 2 inhibitors (SGLT2i) and the risk of dementia in patients with diabetes. Methods: Up to April 18, 2023, four databases—Europe PMC, Medline, Scopus, and Cochrane Library—were searched for relevant literature. We included all studies that examine dementia risk in adults with diabetes who use SGLT2i. Random-effect models were used to compute the outcomes in this investigation, producing pooled odds ratios (OR) with 95% confidence intervals (CI). Results: Pooled data from seven observational studies revealed that SGLT2i use was linked to a lower risk of dementia in people with diabetes (OR 0.45, 95% CI 0.34–0.61; p < 0.00001, I2 = 97%). The reduction in the risk of dementia due to SGLT2i's neuroprotective effect was only significantly affected by dyslipidemia (p = 0.0004), but not by sample size (p = 0.2954), study duration (p = 0.0908), age (p = 0.0805), sex (p = 0.5058), hypertension (p = 0.0609), cardiovascular disease (p = 0.1619), or stroke (p = 0.2734). Conclusions: According to this research, taking SGLT2i reduces the incidence of dementia in people with diabetes by having a beneficial neuroprotective impact. Randomized controlled trials (RCTs) are still required in order to verify the findings of our research. [ABSTRACT FROM AUTHOR]

The field of South Asian studies, despite selective growth in the past couple of decades, urgently needs to double in size. Otherwise, it will be unable to meet an array of challenges—some long familiar to area studies, some new to the twenty-first-century world. If it cannot function as a field for the production of new knowledge, the humanities and social sciences will remain trapped by the theories and historical experience of other areas, above all Europe. [ABSTRACT FROM AUTHOR]

Species richness has been shown to decrease, and elevational range increase (the Rapoport effect), with elevation as a consequence of biotic and abiotic factors, but patterns are inconsistent across taxonomic groups. Despite being an important indicator taxon and a component of local communities, Orthoptera distributions at higher elevations in Europe remain unclear. We investigated the relationship of Orthoptera species richness and elevational range with elevation in the Pyrenees mountains, Europe. We conducted sweepnetting surveys supplemented by hand‐sampling, at 28 sites stratified by elevation, across three study areas. Using generalised linear models, we found that species richness declined with elevation. Elevation was an important predictor of species richness, but sampling effort and vegetation structure (height and cover) also contributed to estimates of species richness. Using a nonlinear regression to model the elevational range of species over the elevational gradient, we did not observe a Rapoport effect, with elevational range peaking at mid‐elevation instead. Smaller elevational ranges of species found at high elevations may be due to a combination of sampling over a restricted elevational range and the presence of specialist high‐elevation species. We argue that our findings are useful for understanding species distributions with elevation at the interface between local and regional scales. Clarifying the biotic and abiotic predictors of species distribution is important for informing conservation efforts and predicting consequences of climate change. [ABSTRACT FROM AUTHOR]

This study provides a regional picture of long‐term changes in Atlantic salmon growth at the southern edge of their distribution, using a multi‐population approach spanning 49 years and five populations. We provide empirical evidence of salmon life history being influenced by a combination of common signals in the marine environment and population‐specific signals. We identified an abrupt decline in growth from 1976 and a more recent decline after 2005. As these declines have also been recorded in northern European populations, our study significantly expands a pattern of declining marine growth to include southern European populations, thereby revealing a large‐scale synchrony in marine growth patterns for almost five decades. Growth increments during their sea sojourn were characterized by distinct temporal dynamics. At a coarse temporal resolution, growth during the first winter at sea seemed to gradually improve over the study period. However, the analysis of finer seasonal growth patterns revealed ecological bottlenecks of salmon life histories at sea in time and space. Our study reinforces existing evidence of an impact of early marine growth on maturation decision, with small‐sized individuals at the end of the first summer at sea being more likely to delay maturation. However, each population was characterized by a specific probabilistic maturation reaction norm, and a local component of growth at sea in which some populations have better growth in some years might further amplify differences in maturation rate. Differences between populations were smaller than those between sexes, suggesting that the sex‐specific growth threshold for maturation is a well‐conserved evolutionary phenomenon in salmon. Finally, our results illustrate that although most of the gain in length occurs during the first summer at sea, the temporal variability in body length at return is buffered against the decrease in post‐smolt growth conditions. The intricate combination of growth over successive seasons, and its interplay with the maturation decision, could be regulating body length by maintaining diversity in early growth trajectories, life histories, and the composition of salmon populations. [ABSTRACT FROM AUTHOR]

Variability in the North Atlantic Oscillation (NAO) has contributed to the recent multidecadal trends observed in European climate, especially to trends in winter precipitation over Northern Europe. However, the current generation of coupled climate models struggle to reproduce the NAO's contribution to multidecadal trends, which has important implications for deriving constraints based on the comparison of observed and modeled trends. An observational constraint based on attribution results, both with and without the contribution of variability associated with the NAO, is applied to projections of Northern European precipitation and temperature, and observed NAO variability is shown to lead to a constraint that overestimates future forced changes. Only after removing the NAO variability is the observed climate change consistent with model simulations, and a tighter, unbiased observational constraint based on the forced signal (without the NAO) can be applied to future projections. Plain Language Summary: The observed precipitation and temperature across Northern Europe in winter has been increasing over the past several decades. However, the magnitude of this trend is generally not well reproduced by the latest set of global climate models. A part of the observed increase in precipitation can be related to the variability in the North Atlantic Oscillation (NAO), which is a large‐scale pattern of sea level pressure in the North Atlantic region that varies in strength each season and year, and is strongly linked to temperature and precipitation patterns across Europe, particularly in winter. In this study, we show that if the variability related to the NAO is first removed from the precipitation time series, from both the observations and the model simulations, the difference between the long‐term observed and modeled trends in precipitation is reduced. Removing the NAO variability also has an impact on the difference in observed and modeled trends in temperature. This has important implications for approaches that use the difference in observations and model simulations as a way of constraining future projections of climate change. Key Points: Variability in the North Atlantic Oscillation (NAO) has contributed to the recent multidecadal trends observed in European climateThe suite of current comprehensive global models (CMIP6) struggle to reproduce the NAO's contribution to multidecadal trendsRemoving the NAO from both observations and models provides a tighter, unbiased constraint, which can then be applied to model projections [ABSTRACT FROM AUTHOR]

Purpose: Increasing potassium intake, especially in populations with low potassium intake and high sodium intake, has emerged as an important population-level intervention to reduce cardiovascular events. Current guideline recommendations, such as those made by the World Health Organisation, recommend a potassium intake of > 3.5 g/day. We sought to determine summary estimates for mean potassium intake and sodium/potassium (Na/K) ratio in different regions of the world. Methods: We performed a systematic review and meta-analysis. We identified 104 studies, that included 98 nationally representative surveys and 6 multi-national studies. To account for missingness and incomparability of data, a Bayesian hierarchical imputation model was applied to estimating summary estimates of mean dietary potassium intake (primary outcome) and sodium/potassium ratio. Results: Overall, 104 studies from 52 countries were included (n = 1,640,664). Mean global potassium intake was 2.25 g/day (57 mmol/day) (95% credible interval (CI) 2.05–2.44 g/day), with highest intakes in Eastern and Western Europe (mean intake 3.53g/day, 95% CI 3.05–4.01 g/day and 3.29 g/day, 95% CI 3.13–3.47 g/day, respectively) and lowest intakes in East Asia (mean intake 1.89 g/day; 95% CI 1.55–2.25 g/day). Approximately 31% (95% CI, 30–41%) of global population included have an estimated potassium intake > 2.5 g/day, with 14% (95% CI 11–17%) above 3.5 g/day. Conclusion: Global mean potassium intake (2.25 g/day) falls below current guideline recommended intake level of > 3.5 g/day, with only 14% (95% CI 11–17%) of the global population achieving guideline-target mean intake. There was considerable regional variation, with lowest mean potassium intake reported in Asia, and highest intake in Eastern and Western Europe. [ABSTRACT FROM AUTHOR]

In the policy period following the Lisbon Strategy of 2000, European governments increasingly regard universities, and the research they produce, as key to enhancing economic performance. With this heightened respect for the value of university-based research, comes an impatience to see returns on the public investments made. We analyze how policy is being used to influence the academic research process through the evaluations and funding allocation that accompany public funding. This paper features examples from the European Union and recent policy developments in two nation states to investigate how policy seeks to enhance the non-academic impacts of academic research.

Early energy analyses of agriculture revealed that behind higher labor and land productivity of industrial farming, there was a decrease in energy returns on energy (EROI) invested, in comparison to more traditional organic agricultural systems. Studies on recent trends show that efficiency gains in production and use of inputs have again somewhat improved energy returns. However, most of these agricultural energy studies have focused only on external inputs at the crop level, concealing the important role of internal biomass flows that livestock and forestry recirculate within agroecosystems. Here, we synthesize the results of 82 farm systems in North America and Europe from 1830 to 2012 that for the first time show the changing energy profiles of agroecosystems, including livestock and forestry, with a multi-EROI approach that accounts for the energy returns on external inputs, on internal biomass reuses, and on all inputs invested. With this historical circular bioeconomic approach, we found a general trend towards much lower external returns, little or no increases in internal returns, and almost no improvement in total returns. This "energy trap" was driven by shifts towards a growing dependence of crop production on fossil-fueled external inputs, much more intensive livestock production based on feed grains, less forestry, and a structural disintegration of agroecosystem components by increasingly linear industrial farm managements. We conclude that overcoming the energy trap requires nature-based solutions to reduce current dependence on fossil-fueled external industrial inputs and increase the circularity and complexity of agroecosystems to provide healthier diets with less animal products. [ABSTRACT FROM AUTHOR]

The formation of ice in clouds is an important process in mixed-phase clouds, and the radiative properties and dynamical developments of clouds strongly depend on their partitioning between the liquid and ice phases. In this study, we investigated the sensitivities of the cloud phase to the ice-nucleating particle (INP) concentration and thermodynamics. Moreover, passive satellite retrieval algorithms and cloud products were evaluated to identify whether they could detect cloud microphysical and thermodynamical perturbations. Experiments were conducted using the ICOsahedral Nonhydrostatic (ICON) model at the convection-permitting resolution of about 1.2 km on a domain covering significant parts of central Europe, and they were compared to two different retrieval products based on Spinning Enhanced Visible and InfraRed Imager (SEVIRI) measurements. We selected a day with multiple isolated deep convective clouds, reaching a homogeneous freezing temperature at the cloud top. The simulated cloud liquid pixel fractions were found to decrease with increasing INP concentration, both within clouds and at the cloud top. The decrease in the cloud liquid pixel fraction was not monotonic and was stronger in high-INP cases. Cloud-top glaciation temperatures shifted toward warmer temperatures with an increasing INP concentration by as much as 8 ∘ C. Moreover, the impact of the INP concentration on cloud-phase partitioning was more pronounced at the cloud top than within the cloud. Furthermore, initial and lateral boundary temperature fields were perturbed with increasing and decreasing temperature increments from 0 to ±3 and ±5 K between 3 and 12 km, respectively. Perturbing the initial thermodynamic state was also found to systematically affect the cloud-phase distribution. However, the simulated cloud-top liquid pixel fraction, diagnosed using radiative transfer simulations as input to a satellite forward operator and two different satellite remote-sensing retrieval algorithms, deviated from one of the satellite products regardless of perturbations in the INP concentration or the initial thermodynamic state for warmer subzero temperatures while agreeing with the other retrieval scheme much better, in particular for the high-INP and high-CAPE (convective available potential energy) scenarios. Perturbing the initial thermodynamic state, which artificially increases the instability of the mid- and upper-troposphere, brought the simulated cloud-top liquid pixel fraction closer to the satellite observations, especially in the warmer mixed-phase temperature range. [ABSTRACT FROM AUTHOR]

Data from existing monitoring schemes point to a global crisis of butterflies across Europe, with habitat loss/degradation, climate change and chemical pollution as the main drivers of decline.The existing butterfly time series from Western Europe come from densely populated, relatively flat areas. However, population trends from less populated areas, such as mountain ranges in the south of Europe, have been less studied, despite these areas harbouring one of the highest butterfly biodiversity of the continent.Here, we analyse trends for butterfly populations in a Southwestern Europe mountain range (Picos de Europa, Northwest Spain), for the last 9 years (2013–2021), across an altitudinal gradient (80–2000 m). We show that this region, protected as National Park more than 100 years ago, is nonetheless under a great threat, with a decline in butterfly abundance of, on average, 5.7% per year (45.7% cumulative decline in the last 9 years).Species at higher elevations are faring worse than those at low elevations and communities at mid‐elevations (below the tree line) are changing towards higher abundance of species with a preference from closed habitats. Combined effects of amplified climate change in mountains and habitat loss, due to abandonment of traditional management, appear to be affecting both individual species and community composition of butterflies in our study area. [ABSTRACT FROM AUTHOR]

Subseasonal‐to‐seasonal (S2S) forecasts span the prediction range of weeks to 2–3 months ahead, bridging the gap between medium‐range and seasonal weather forecasts. There has been growing interest in S2S forecasts in recent years, largely because of the many potential uses of forecasts spanning these timescales. However, the skill of S2S forecasts beyond the first 2 weeks or so is poor, potentially limiting the usability of these forecasts. We show in this study that when considering accumulated temperatures, there is in fact good forecasting skill over Europe for accumulation periods up to 30 days ahead. Using a set of S2S hindcasts, we show using both a deterministic and a probabilistic measure of skill that the accumulated 2‐metre temperature forecasts out to 30 days are skilful over most of Europe. In summer, South West Europe has highest skill, while in winter North East Europe has highest skill. As an example application of such forecasts, we also evaluate the skill for summer cooling degree‐days (CDD) and winter heating degree‐days (HDD). For 30‐day winter HDD, there is good skill in all four European regions; for 30‐day summer CDD, the skill is limited in North West Europe, but still good in other regions. [ABSTRACT FROM AUTHOR]

This study bridged pharmacokinetic, efficacy, and safety clinical trial data from Japan to a Western population using real‐world evidence (RWE) to investigate the antibody–drug conjugate trastuzumab deruxtecan (T‐DXd) in the treatment of human epidermal growth factor receptor 2 (HER2)‐positive advanced gastric cancer. Using population pharmacokinetic and exposure–response (efficacy/safety) models, exposure–efficacy data from 117 patients and exposure–safety data from 158 patients in Japan who received T‐DXd 6.4 mg/kg as second‐line or later treatment were bridged to RWE including covariate information from 25 Western patients with HER2‐positive gastric cancer who received second‐line or later T‐DXd treatment. Pharmacokinetic simulations indicated that intact T‐DXd and released drug (DXd) steady‐state exposures were comparable between Western patients and patients from Japan; the Western/Japan ratio of exposure medians ranged from 0.82 (T‐DXd steady‐state minimum concentration) to 1.18 (DXd steady‐state maximum concentration). Exposure–efficacy simulations estimated a confirmed objective response rate of 28.6% (90% confidence interval, 20.8‐38.4) in real‐world Western patients versus 40.1% (90% confidence interval, 33.5‐47.0) in patients from Japan, possibly because of checkpoint inhibitor use in 4% versus 30% of patients, respectively. Western patients had a higher estimated rate of serious adverse events than patients from Japan (42.2% vs 34.6%); however, the rate of interstitial lung disease was lower (less than 10%) in Western patients. Overall, T‐DXd was predicted to have meaningful clinical activity and a manageable safety profile in Western patients with HER2‐positive gastric cancer. Using RWE, bridging analysis supported US approval of T‐DXd 6.4 mg/kg in advanced gastric cancer before a clinical trial was completed in Western patients. [ABSTRACT FROM AUTHOR]

Construction projects using emerging bio-based materials have been realized over the past ten to fifteen years within Europe. Bio-based buildings utilize properties of natural materials to regulate internal environments, particularly fluctuations in temperature and relative humidity. Despite individual exemplar projects demonstrating functional performance and long-term operational cost savings, there hasn't been a proliferation of commercial or domestic bio-based projects. With a growing shift towards circular economy construction, bio-based buildings could be readily adopted to meet this development. This study evaluates barriers faced by bio-based materials, making the upscaling of production and a breakthrough into mainstream construction challenging. Evaluation was achieved through senior professionals with experience in bio-based construction participating in semi-structured interviews based on core categories of finance, knowledge, and policy. Challenges include the upscaling of production by manufacturers of emerging materials, inconsistencies in life cycle assessment, material certification and accreditation, vested interests in the construction industry, and concerns regarding initial costs, availability, and knowledge of products. Potential solutions for upscaling bio-based construction are identified and include increased case studies, positive legislation, regional economic regeneration, the wellness agenda, long-term economic sustainability, and engagement with established construction companies. This insight has informed the procurement process, material evaluation, and adoption of policy. [ABSTRACT FROM AUTHOR]

The demand for wood in Europe is expected to increase in the coming decades. However, any theoretical maximum supply will be affected by sustainability constraints, the motivations of forest owners and regional factors, such as incentives, species and assortments. However, the influence of these factors on supply is changeable. In this study, we quantify what might be realistically available as additional wood supply from currently existing European forests, based on a combination of results of the forest resource model EFISCEN-Space and a literature review of national supply projections. Wood mobilization scenarios for 10 representative Model Regions in Europe that assume forest owners and managers in the simulated regions will adapt their behaviour to alternative behaviour as recorded from other regions were projected with the EFISCEN-Space model. The realistic additional potential based on the literature review is 90 million m3 yr−1. This potential should be attainable within 10–20 years. However, the simulations in the Model Regions found potentials to be lower in 7 out of 10 cases as compared with the country they are located in. On average, the model regions reached less than half of the potential as compared with the literature review. This suggests that the realistic additional potential at the European scale may well be lower if all mobilization barriers are taken into account in more detail, but also highlights the uncertainty surrounding these estimates. We conclude from the analyses that although there are large differences in potential between regions and the analysis method employed, there are no 'hotspots' where a large pool of accessible wood can be quickly mobilized using existing infrastructure for nearby industries. An increase in harvest would therefore only be possible with a large effort that spans the whole chain, from forest owners' behaviour to capacity building, financial incentives and matching resources to harvesting capacity. The additionally available wood can most likely only be mobilized against higher marginal costs and will thus only become available in times of higher stumpage prices. The largest potential lies in privately owned forests which often have a fragmented ownership but will most likely be able to supply more wood, though mostly from deciduous species. In the long term (more than 20 years), additional wood, compared with the amounts we found for short term, can only be made available through investments in afforestation, forest restoration, improved forest management and more efficient use of raw material and recycled material. [ABSTRACT FROM AUTHOR]

Service continuity entails establishing an observable and explainable continuum between customer experience and service operations. Such continuum is currently established manually, via service customer management operations (such as service incident management (IM)) often resulting in time‐consuming, human‐detrimental, and error‐prone activities. Conversely, artificial intelligence (AI) is rapidly emerging as an automated enabler towards handling the discontinuities in the aforementioned critical business tasks. Consequently, the emerging topic of AI‐driven incident management (AIIM) addresses practices and tools to resolve incidents by means of AI‐enabled organizational processes and methodologies. Our conjecture is that AIIM could reduce unplanned interruptions of service and let customers resume their work as quick as possible. While several techniques were presented in the literature to automatically identify the problems described in incident tickets by customers, this article focuses on the qualitative analysis and feature extraction off of the provided descriptions. When an incident ticket does not describe properly the problem, the analyst must ask the customer for additional details which could require several long‐lasting interactions. This article proposes ACQUA , an AIIM approach to automatically assess the quality of ticket descriptions with the goals of removing the need of additional communications and guiding the customers to properly describe the incident. A preliminary evaluation of ACQUA was performed on a dataset provided by a large bank in Europe, showing promising results and a boost of 13% in ticket resolution times and connected service continuity. [ABSTRACT FROM AUTHOR]

Inequalities in relative age distribution have previously been demonstrated to influence participation and performance achievements in Masters athletes. The purpose of the present study was to examine the participation- and performance-related constituent year effect among Masters athletes (N = 2,474) from the European Masters Track and Field Championships across subdisciplines and age. The results indicated that a participation-related constituent year effect was observed. The likelihood of participation was significantly higher for athletes in their first year of any 5-year age category (χ2 = 149.8, p <.001) and decreased significantly when they were in the fourth or fifth year. The results also indicated a performance-related constituent year effect. Masters athletes in their first year won significantly more medals than expected based on observed participation rate (χ2 = 23.39, p <.001). We compare our results with the existing literature and discuss potential mechanisms for this constituent year effect. [ABSTRACT FROM AUTHOR]

The influence of cultural background on the soundscape experience in public spaces has been widely acknowledged. However, most studies have not used standardized protocols for soundscape perception data collection, nor have they gathered large datasets across different regions of the world to investigate possible cultural differences. This study explored the relationships between soundscape descriptors, perceived dominance of sound sources, and overall soundscape qualities and whether these relationships differ across world regions. A database of over 2000 soundscape surveys was collected in situ in outdoor public spaces in Europe and China. Results highlighted differences in how European and Chinese participants perceived the pleasantness and dominance of different sound sources. Specifically, the positive correlation between perceived pleasantness and natural sounds was stronger for European participants. For Chinese participants, vibrant soundscapes were positively correlated with perceived dominance of natural sounds, whereas in Europe, they were associated more with human-generated sounds. Perceived loudness had a greater effect on the appropriateness dimension for the Chinese sample than that for the European sample. This study provides a deeper understanding of how the geographical/cultural context can influence soundscape perception in public spaces and suggests that such country-specific factors should be considered when designing urban soundscapes. [ABSTRACT FROM AUTHOR]