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Animal welfare protection is a challenge for which policy-makers are demanding scientific-based evidence. Considering horses, the challenge is even greater, as their role in society varies from production to companion animals. This review aimed to describe the evolution and geographical distribution of horse welfare literature over the years, to identify the most studied research topics and to highlight the still present gaps in knowledge. A search on Scopus® bibliometric database was performed using different welfare-related keywords. Predetermined filters were posed on time range, language and subject area. A total of 6584 records were downloaded and screened retaining only the ones dealing with horse welfare and behavioural sciences. Descriptive statistics, text mining (TM) and topic analysis (TA) were performed on the abstract of 801 eligible records. The results showed the number of studies on horse welfare is exponentially increasing, especially in the European continent. 'Transport' was the most frequent word, but also 'behaviour' and 'pain' emerged. Nine topics were identified and covered different subject areas: stress analysis, pain assessment, equitation science, human–horse interactions, breeding management, transport, working equids and health. The evaluation of stress and pain, horse social behaviour and the human–horse relationship resulted to be the most studied aspects related to animal welfare. On the contrary, the concept of positive welfare and the welfare assessment at slaughter of horses were underrepresented, confirming the limited literature on these subjects. This review confirmed the growing impact of research on horse welfare and highlighted how some important areas still do not provide sufficient scientific evidence. Analysis of the literature related to horse welfare was performed using text analysis techniques to identify trends in words and research topics. Results showed that the literature on horse welfare has exponentially grown in the last 43 years, especially in Europe. The most studied topics were stress and pain, while studies on the welfare at slaughter and positive welfare indicators were scant. [ABSTRACT FROM AUTHOR]

We describe a new method for presenting and interpreting linear trends in health inequalities, and present a proof-of-concept analysis of inequalities in smoking among adolescents in Europe. We estimated the regression line of the assumed linear relationship between smoking prevalence in low– and high–socioeconomic status (SES) youth over time. Using simulation, we constructed a 95% confidence interval (CI) for the smoking prevalence in low-SES youth for when this would be 0% in high-SES youth, and we calculated the likelihood of eradicating smoking inequality (<5% for both low and high SES). This method was applied to data on adolescents aged 15–16 years (n  = 250,326) from 23 European countries, derived from the 2003–2015 European Survey Project on Alcohol and Other Drugs. Smoking prevalence decreased more slowly among low- than among high-SES adolescents. The estimated smoking prevalence was 9.4% (95% CI: 6.1, 12.7) for boys and 5.4% (95% CI: 1.4, 9.2) for girls with low SES when 0% with high SES. The likelihood of eradicating smoking inequality was <1% for boys and 37% for girls. We conclude that this novel methodological approach to trends in health inequalities is feasible in practice. Applying it to trends in smoking inequalities among adolescents in Europe, we found that Europe is currently not on track to eradicate youth smoking across SES groups. [ABSTRACT FROM AUTHOR]

Simple Summary: Many corvid species have adapted to live in urban regions. Studying their habitat needs and the similarities among them would allow us to predict species' responses to global changes. Such studies have not been widely done on generalist species capable of surviving in different environments. Here, we studied the habitat needs and spatial overlap of five corvid species in sixteen European cities. We found significant overlap in the habitats of the corvids, although some had different tendencies. Three species (the Carrion/Hooded Crow, Rook, and Eurasian Magpie) selected open habitats (grass or bare soil). The Eurasian Jay chose more forested areas, and the Western Jackdaw avoided areas with bare soil cover. The species that had similar habitat tendencies also had similar spatial distributions. Our results show that even corvids with different tendencies overlapped highly in their habitats, which means they can tolerate different environmental conditions in urban areas. Understanding habitat and spatial overlap in sympatric species of urban areas would aid in predicting species and community modifications in response to global change. Habitat overlap has been widely investigated for specialist species but neglected for generalists living in urban settings. Many corvid species are generalists and are adapted to urban areas. This work aimed to determine the urban habitat requirements and spatial overlap of five corvid species in sixteen European cities during the breeding season. All five studied corvid species had high overlap in their habitat selection while still having particular tendencies. We found three species, the Carrion/Hooded Crow, Rook, and Eurasian Magpie, selected open habitats. The Western Jackdaw avoided areas with bare soil cover, and the Eurasian Jay chose more forested areas. The species with similar habitat selection also had congruent spatial distributions. Our results indicate that although the corvids had some tendencies regarding habitat selection, as generalists, they still tolerated a wide range of urban habitats, which resulted in high overlap in their habitat niches and spatial distributions. [ABSTRACT FROM AUTHOR]

Background and Aims: Representative data on e‐cigarette use among European adolescents are scant. This study reports current vaping and tobacco smoking individual and country‐specific correlates among European students. Design: Cross‐sectional survey: 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) collecting data on risk behaviours on a representative sample of 16‐year‐old students. Setting: A total of 35 European countries, 25–30 with Tobacco Control Scale (TCS) and TCS components Participants: A total of 99 648 students (49.1% males) turning 16 years in the survey year. Measurements Data on current cigarette and e‐cigarette use were gathered through a self‐administered questionnaire which also collected socio‐demographics and individual and family characteristics. ESPAD data were integrated with country‐level data on TCS and selected TCS parameters to assess their association with the prevalence of current cigarette and e‐cigarette use. Findings Of the 99 648 participating students, 12.4% were current e‐cigarette users, from 5.5% in Serbia to 41.4% in Monaco; 19.3% current smokers, from 5.1% in Iceland to 32.4% in Italy. Compared with non‐users, current e‐cigarette users less frequently came from an average well‐off family [odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.80–0.90] and lived in countries with higher cigarette prices (OR = 0.71, 95% CI = 0.50–0.99), restrictive measures on tobacco advertising and promotion (OR = 0.79, 95% CI = 0.63–0.99) and intermediate implementation of tobacco control measures (OR = 0.57, 95% CI = 0.38–0.85). Current vapers were more frequently life ever smokers (OR = 7.31, 95% CI = 6.47–8.25), were early smokers (OR = 4.35, 95% CI = 3.66–5.17), males (OR = 1.61, 95% CI = 1.55–1.67), from non‐traditional families (OR = 1.43, 95% CI = 1.34–1.53), with relatively low parental education (OR = 1.15, 95% CI = 1.10–1.20). Compared with non‐smokers, current smokers had similar family characteristics to vapers, and were less likely to live in countries with higher cigarette prices (OR = 0.70, 95% CI = 0.49–0.99) and higher spending on public anti‐tobacco media campaigns (OR = 0.23, 95% CI = 0.10–0.50). Conclusions: E‐cigarette use among European adolescents is associated with weaker tobacco control measures, particularly on tobacco price, advertising and promotion. Besides preventing tobacco smoking, the adoption of governmental tobacco control policies in European countries also seems to contribute to the prevention of vaping among adolescents. [ABSTRACT FROM AUTHOR]

Background and Aims: Previous research has identified numerous risk and protective factors of adolescent problematic gaming (PG) at the individual and social levels; however, the influence of socio‐economic indicators on PG is less known. This study aimed to measure the contribution of individual and socio‐economic factors involved in PG risk among adolescents from 30 European countries. Design Multi‐level logistic regression analysis of survey data from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross‐sectional study using self‐administered anonymous questionnaires. Setting: Thirty European countries. Participants: A representative cohort of 15–16‐year‐old students (n = 88 998 students; males = 49.2%). Measurements The primary outcome measure was adolescents' (low and high) risk of PG. Individual key predictors included self‐report assessments of socio‐demographic characteristics, time spent gaming and family variables (parental regulation and monitoring, family support). Main country‐level predictors comprised Gini coefficient for economic inequalities and benefits for families and children (% gross domestic product), retrieved from international public data sets and national thematic reports. The data analysis plan involved multi‐level logistic regression. Findings Participants who reported stronger parental regulation [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.79–0.83] and higher family support (OR = 0.93, 95% CI = 0.91–0.95) reported lower risk of PG. At the country‐level, economic inequalities (OR = 1.05, 95% CI = 1.03–1.07) were positively associated with the risk of PG, while benefits for families and children (OR = 0.78, 95% CI = 0.70–0.89) were negatively correlated with the risk of PG. Conclusions: Supportive family environments, lower country‐level economic inequalities and higher government expenditures on benefits for families and children appear to be associated with a lower risk of problematic gaming among European adolescents. [ABSTRACT FROM AUTHOR]

Aim: We assessed the spatial distribution of four different types of avian specialization throughout Europe, identifying landscape features associated with specialization and quantifying where the Natura 2000 network intersects with areas of high avian specialization. Location: Europe. Time period: Present day. Taxa studied: European breeding birds. Methods: We used the European Atlas of breeding birds and four avian specialization measures (diet, foraging behaviour, foraging substrate and habitat). We calculated specialization richness and identified geographical hotspots for each of these ecological traits. We tested whether elevational gradient, landscape heterogeneity or dominant land use predicted each type of specialization richness. We determined which types of European protected areas are most associated with higher specialization richness. Results: Diet and foraging substrate specialists increased with elevation, whereas richness of foraging behavioural specialists decreased. There was a greater richness of dietary and habitat specialists in forests than in other environments. The Natura 2000 areas declared under Bird and both directives (Birds and Habitats) intersected with a high dietary, foraging substrate and habitat specialist richness. The richness of foraging behaviour specialists was high in Birds directive areas. Single and multiple hotspots of specialization were greater in protected than non‐protected areas. However, almost 30% of specialization hotspots did not intersect with protected areas. Main conclusions: Our findings suggest that higher levels of avian specialization in Europe are positively associated with elevation and forested land cover. Importantly, we found that the Natura 2000 network supports all types of avian ecological specialization, albeit mainly in areas declared under both directives. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 is a RNA coronavirus responsible for the pandemic of the Severe Acute Respiratory Syndrome (COVID-19). RNA viruses are characterized by a high mutation rate, up to a million times higher than that of their hosts. Virus mutagenic capability depends upon several factors, including the fidelity of viral enzymes that replicate nucleic acids, as SARS-CoV-2 RNA dependent RNA polymerase (RdRp). Mutation rate drives viral evolution and genome variability, thereby enabling viruses to escape host immunity and to develop drug resistance.Methods: We analyzed 220 genomic sequences from the GISAID database derived from patients infected by SARS-CoV-2 worldwide from December 2019 to mid-March 2020. SARS-CoV-2 reference genome was obtained from the GenBank database. Genomes alignment was performed using Clustal Omega. Mann-Whitney and Fisher-Exact tests were used to assess statistical significance.Results: We characterized 8 novel recurrent mutations of SARS-CoV-2, located at positions 1397, 2891, 14408, 17746, 17857, 18060, 23403 and 28881. Mutations in 2891, 3036, 14408, 23403 and 28881 positions are predominantly observed in Europe, whereas those located at positions 17746, 17857 and 18060 are exclusively present in North America. We noticed for the first time a silent mutation in RdRp gene in England (UK) on February 9th, 2020 while a different mutation in RdRp changing its amino acid composition emerged on February 20th, 2020 in Italy (Lombardy). Viruses with RdRp mutation have a median of 3 point mutations [range: 2-5], otherwise they have a median of 1 mutation [range: 0-3] (p value < 0.001).Conclusions: These findings suggest that the virus is evolving and European, North American and Asian strains might coexist, each of them characterized by a different mutation pattern. The contribution of the mutated RdRp to this phenomenon needs to be investigated. To date, several drugs targeting RdRp enzymes are being employed for SARS-CoV-2 infection treatment. Some of them have a predicted binding moiety in a SARS-CoV-2 RdRp hydrophobic cleft, which is adjacent to the 14408 mutation we identified. Consequently, it is important to study and characterize SARS-CoV-2 RdRp mutation in order to assess possible drug-resistance viral phenotypes. It is also important to recognize whether the presence of some mutations might correlate with different SARS-CoV-2 mortality rates. [ABSTRACT FROM AUTHOR]

Urban areas are expanding globally as a consequence of human population increases, with overall negative effects on biodiversity. To prevent the further loss of biodiversity, it is urgent to understand the mechanisms behind this loss to develop evidence‐based sustainable solutions to preserve biodiversity in urban landscapes. The two extreme urban development types along a continuum, land‐sparing (large, continuous green areas and high‐density housing) and land‐sharing (small, fragmented green areas and low‐density housing) have been the recent focus of debates regarding the pattern of urban development. However, in this context, there is no information on the mechanisms behind the observed biodiversity changes. One of the main mechanisms proposed to explain urban biodiversity loss is the alteration of predator–prey interactions. Using ground‐nesting birds as a model system and data from nine European cities, we experimentally tested the effects of these two extreme urban development types on artificial ground nest survival and whether nest survival correlates with the local abundance of ground‐nesting birds and their nest predators. Nest survival (n = 554) was lower in land‐sharing than in land‐sparing urban areas. Nest survival decreased with increasing numbers of local predators (cats and corvids) and with nest visibility. Correspondingly, relative abundance of ground‐nesting birds was greater in land‐sparing than in land‐sharing urban areas, though overall bird species richness was unaffected by the pattern of urban development. We provide the first evidence that predator–prey interactions differ between the two extreme urban development types. Changing interactions may explain the higher proportion of ground‐nesting birds in land‐sparing areas, and suggest a limitation of the land‐sharing model. Nest predator control and the provision of more green‐covered urban habitats may also improve conservation of sensitive birds in cities. Our findings provide information on how to further expand our cities without severe loss of urban‐sensitive species and give support for land‐sparing over land‐sharing urban development. [ABSTRACT FROM AUTHOR]

Owing to the lack of European legislative measures on cross-border transfer ofregistered offices, Member States currently retain their competence in this field. However, Member States are required to respect the fundamentalfreedoms of the EU internal market under the purview of the Court of Justice of the European Union (CJEU). The purpose of this article is to comment on the latest stage of this jurisprudential evolution through an analysis of the Polbud judgment. This case clarifies the regulatory context surrounding the transfer of a registered office within the internal market since it liberalises companies' cross-border mobility by accepting that the benefit of freedom of establishment does not require the pursuit of a genuine economic activity or the relocation of the real head office of the company. Finally, the practical and political consequences of the ruling complete the analysis. [ABSTRACT FROM AUTHOR]

Ovarian cancer is the fifth most common cause of cancer death in women in Europe. Despite the progress, almost 70% of the patients relapse. The standard treatment is cytoreductive surgery followed by platinum-taxane chemotherapy; in patients with a disseminated disease, one option is neoadjuvant chemotherapy with delayed surgery (ie, interval debulking surgery). The most important change in the last decades involved the schedule treatment and the addition of new drugs to first-line therapy. Because of the pathogenetic role of angiogenesis in solid-tumor growth and metastasis, research has been concentrated on anti-angiogenetic drug. Bevacizumab, the most promising anti-angiogenetic drug, is a humanized monoclonal IgG antibody that targets vascular endothelial growth factor receptor. It was approved on December 23, 2011 by the European Medicines Agency and on June 13, 2018 by the Food and Drug administration as first-line treatment in epithelial ovarian, fallopian tube, or primary peritoneal cancer stage III or IV in combination with carboplatin and paclitaxel. There are still some doubts, regarding the schedule, dosage, duration of the treatment, safety, and tolerability, both in first-line and in neoadjuvant chemotherapy treatments. This review tries to answer clinical practice questions and summarizes the evidence from Phase III studies, emerging data, and ongoing trials. [ABSTRACT FROM AUTHOR]

This paper aims to study the impact of digitalization on energy efficiency in Europe, where institutions are committed to promote both digital transformation and energy transition by implementing the European Twin Transition, ETT [1]. The paper starts by empirically analysing the state of play of the Twin Transition across European Member States (MS) by mapping the Digital Economy and Society Index (DESI), its sub-indices and the energy productivity. We then discuss the impact of the abovementioned digital indicators on energy productivity growth in 26 European MS during the period 2016–2020 by applying a system GMM model. The results show a significant and positive impact of digitalization on energy efficiency and relevant complementarities across diverse digitalization dimensions. This study contributes in an original manner to the literature by applying for the first time DESI and its sub-indices in a European twin transition analysis; moreover, empirical insights have important policy implications because all the variables considered are parts of the European policy targets. • This paper explores the impact of digitalization on energy efficiency. • A statistical investigation of twin transition across European MS is carried out. • DESI and its sub-indices have a positive and significant impact on energy productivity growth. • Potential complementarities exist among DESI sub-indices regarding their impact on energy productivity growth. [ABSTRACT FROM AUTHOR]

Concerns about plastic pollution and its toxicity towards animals and people are growing. Polystyrene (PS) is a plastic polymer highly produced in Europe for packaging purposes and building insulation amongst others. Whatever their source—illegal dumping, improper waste management, or a lack of treatment for the removal of plastic debris from wastewater treatment plants—PS products ultimately end up in the marine environment. Nanoplastics (<1000 nm) are the new focus for plastic pollution, gaining broad interest. Whether primary or secondary, their small size permits nanoparticles to cross cellular boundaries, consequently leading to adverse toxic effects. An in vitro assay of Mytilus galloprovincialis haemocytes exposed to 10 μg/L of polystyrene nanoplastics (PS-NPs; 50 nm) for 24 h was used to test cellular viability along with the luminescence inhibition (LC 50) of Aliivibrio fischeri bacteria to evaluate acute toxicity. Cellular viability of mussel haemocytes decreased significantly after a 24 h exposure and PS-NPs LC 50 range from 180 to 217, μg/L. In addition, a 28-day exposure of the marine bivalve M. galloprovincialis to PS-NPs (10 μg/L; 50 nm) was performed to evaluate the neurotoxic effects and the uptake of these plastic particles in three bivalve tissues (gills, digestive gland, and gonads). The ingestion of PS-NPs was time- and tissue-specific, suggesting that PS-NPs are ingested through the gills and then translocated through the mussel bloodstream, to the digestive gland and gonads where the highest amount of ingested PS-NPs was reported. Ingested PS-NPs may compromise the digestive glands' key metabolic function and impair mussels' gametogenic and reproductive success. Data on acetylcholinesterase inhibition and those previously obtained on a wide range of cellular biomarkers were elaborated through weighted criteria providing a synthetic assessment of cellular hazard from PS-NPs. [Display omitted] • LC 50 of polystyrene nanoplastics (nPS) range from 180 to 217 μg/L. • Ingestion of nPS during the 28 days of exposure is tissue- and time-specific. • Mussel gonads are the tissue with the highest ingested μg of nPS per wet weight. • Mussel haemocytes cellular viability decreased after in vitro exposure to 10 μg/L of nPS. • Neurotoxicity occurs in mussel gills. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: Although generally prohibited by national regulations, underage gambling has become popular in Europe, with relevant cross‐country prevalence variability. This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on‐/off‐line mode and to examine the association with individual and family characteristics and substance use. Design: Our study used data from the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross‐sectional study, a survey using self‐administered anonymous questionnaires. Setting: Thirty‐three European countries. Participants: Sixteen‐year‐old‐year‐old students (n = 93 875; F = 50.8%). Measurements: The primary outcome measure was prevalence of past‐year gambling activity. Key predictors comprised individual behaviours, substance use and parenting (regulation, monitoring and caring). Findings: A total of 22.6% of 16‐year‐old students in Europe gambled in the past year: 16.2% on‐line, 18.5% off‐line. High prevalence variability was observed throughout countries both for mode and types of game. With the exception of cannabis, substance use shows a higher association with gambling, particularly binge drinking [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.39–1.53), life‐time use of inhalants (OR = 1.57, 95% CI = 1.47–1.68) and other substances (OR = 1.78, 95% CI = 1.65–1.92)]. Among life habits, the following showed a positive association: truancy at school (OR = 1.26, 95% CI = 1.18–1.35), going out at night (OR = 1.32, 95% CI = 1.26–1.38), participating in sports (OR = 1.30, 95% CI = 1.24–1.37). A negative association was found with reading books for leisure (OR = 0.82%, 95% CI = 0.79–0.86), parents’ monitoring of Saturday night activities (OR = 0.81, 95% CI = 0.77–0.86) and restrictions on money provided by parents as a gift (OR = 0.89, 95% CI = 0.84–0.94). Conclusions: Underage gambling in Europe appears to be associated positively with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviours such as truancy, going out at night and active participation in sports, and is associated negatively with reading for pleasure, parental monitoring of evening activities and parental restriction of money. [ABSTRACT FROM AUTHOR]

Objective: The Animated Activity Questionnaire (AAQ) assesses activity limitations in patients with hip/knee osteoarthritis and consists of video animations; the patients choose the animation that best matches their own performance. The AAQ has shown good validity and reliability. This study aims to evaluate cross-cultural and construct validity of the AAQ.Methods: Cross-cultural validity was assessed using ordinal logistic regression analysis to evaluate differential item functioning (DIF) across 7 languages. Construct validity was assessed by testing correlations between the AAQ and a patient-reported outcome measure (PROM) and performance-based tests.Results: Data from 1,239 patients were available. Compared to the Dutch language (n = 279), none of the 17 items showed DIF in English (n = 202) or French (n = 193), 1 item showed uniform DIF in Spanish (n = 99) and Norwegian (n = 62), and 2 items showed uniform DIF in Danish (n = 201). In all these languages, the occurrence of DIF did not influence the total score, which remained comparable with the original Dutch version. For Italian (n = 203) versus Dutch, however, 6 items showed uniform DIF, and 1 item showed nonuniform DIF, indicating some problems with the cross-cultural validity between these countries. With regard to construct validity, the correlations with PROM (0.74) and performance-based tests (0.36-0.68) were partly as expected (>0.60).Conclusion: The AAQ, an innovative tool to measure activity limitations that can be placed on the continuum between PROMs and performance-based tests, showed a good overall cross-cultural validity, and seems to have great potential for international use in research and daily clinical practice in many European countries. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is the third most common cardiovascular disease. Real-life data on the clinical presentation, risk factors, diagnosis, and treatment of VTE in Italy and Europe are required to optimize the management of this disease. The PREFER in VTE registry, a prospective non-interventional real-life study, was designed to assess clinical characteristics and management of patients with VTE, use of health care resources, and on-treatment patient quality of life. Eligible consecutive patients with objectively diagnosed VTE were enrolled in the registry and followed up for 12 months. Between January and December 2013, 816 Italian and 1027 patients from 6 European countries other than Italy (European patients) were enrolled in the registry, and followed up until December 2014. Italian patients were the oldest (mean age 65.7 years) among the European patients. The Italian patients with a history of cancer were 24.6 % of whom 63.2 % had an active cancer (18.2 and 57.0 %, respectively, in Europe). Parenteral heparin was given, as initial treatment, in 73.8 % of Italian patients (66.4 % in Europe); VKA in combination with other treatments in 45.8 % (34.7 % in Europe); and VKA as the only anticoagulant treatment in 24.4 % (17.2 % in Europe). Of the Italian patients, 43.2 and 90.6 % of patients were hospitalized for deep vein thrombosis and pulmonary embolism, respectively; 65.4 % were admitted to the hospital through the emergency department. Following a real world approach, PREFER in VTE shows that the Italian patients, among and compared to the European patients, are the oldest, have a history of cancer more commonly, receive an initial treatment with heparin more commonly, and are more commonly hospitalized, particularly if affected by PE. [ABSTRACT FROM AUTHOR]

With the aim of reconstructing past distribution patterns of the genus Tilia in Europe from the Eemian interglacial to present, a number of over 2600 pollen and macrofossil records from the literature and from online databases have been examined. As for the Eemian, patterns inferred from pollen and supported by macrofossils reveal that Tilia was widespread and taxonomically diverse in Poland and adjacent regions, as well as in the East-European Plain, Britain, the Alpine region, and the Italian and Balkan Peninsulas. In the early Weichselian interstadials (MIS 5c and 5a) the range of lime was much reduced, but still with occurrences in the Baltic Countries, Poland and Ukraine, in addition to southern Europe. During the Last Glacial Maximum lime did not take part in the zonal ecosystems of Europe, but its lateglacial and postglacial spread reflects the multiple locations and taxonomical pattern of glacial refugia, which were not limited to southern and mid-altitude Europe, but also included micro- and cryptorefugia in NW France and possibly in the eastern Baltic region and other regions. Lime spread rapidly over Europe in the Early Holocene, reaching its maximum diffusion around 7000 cal BP. Afterwards, Tilia declined and even disappeared in some areas at the northern and southern boundaries of its range. The generalist species T. cordata proved to be the most successful lime species under the pre-industrial Holocene climate, and likewise is found to be the most tolerant lime to increasing drought stress caused by Global Warming. • Tilia spread and declined in Europe several times since the last interglacial. • Glacial refugia for lime were not limited to southern Europe. • The postglacial spread of lime reflects the multiple locations of glacial refugia. • The range of lime in western Europe contracted in the last 4000 years. [ABSTRACT FROM AUTHOR]

Aim The process of urbanization can lead to specialist species being replaced by generalist species in space and time, increasing similarity among bird communities. This phenomenon is termed biotic homogenization and is directly related to taxonomic and functional diversity. However, the effects of urbanization on phylogenetic diversity remain unclear. Our study addresses the effects of the process of urbanization on the evolutionary distinctiveness (a quantitative measure of the genetic or evolutionary uniqueness of species) of bird communities. Location Europe. Methods Mixed models were used to compare the effects of urbanization on the evolutionary distinctiveness of bird communities in rural and urban environments in six different European cities from different ecoregions. Results Our study presents unique large-scale evidence of a negative impact of urban environments on the evolutionary uniqueness of birds. Compared with bird communities in rural environments, bird communities in urban environments have lower average evolutionary distinctiveness in all countries, independent of ecoregion, and these values are unrelated to the taxonomic diversity present in each country. Main conclusions Our findings provide important information on the spectrum of effects on global biodiversity of changes in land use related to the process of urbanization. Therefore, urban environments are a factor of concern for maintaining diversity across the tree of life of birds, and we suggest that urbanization planning could help buffer against extreme loss of phylogenetic diversity caused by this process. [ABSTRACT FROM AUTHOR]

In the framework of theWorld Meteorological Organisation's Sand and Dust Storm Warning Advisory and Assessment System, we evaluated the predictions of five state-of-the-art dust forecast models during an intense Saharan dust outbreak affecting western and northern Europe in April 2011. We assessed the capacity of the models to predict the evolution of the dust cloud with lead times of up to 72 h using observations of aerosol optical depth (AOD) from the AErosol RObotic NETwork (AERONET) and the Moderate Resolution Imaging Spectroradiometer (MODIS) and dust surface concentrations from a ground-based measurement network. In addition, the predicted vertical dust distribution was evaluated with vertical extinction profiles from the Cloud and Aerosol Lidar with Orthogonal Polarization (CALIOP). To assess the diversity in forecast capability among the models, the analysis was extended to wind field (both surface and profile), synoptic conditions, emissions and deposition fluxes. Models predict the onset and evolution of the AOD for all analysed lead times. On average, differences among the models are larger than differences among lead times for each individual model. In spite of large differences in emission and deposition, the models present comparable skill for AOD. In general, models are better in predicting AOD than near-surface dust concentration over the Iberian Peninsula. Models tend to underestimate the longrange transport towards northern Europe. Our analysis suggests that this is partly due to difficulties in simulating the vertical distribution dust and horizontal wind. Differences in the size distribution and wet scavenging efficiency may also account for model diversity in long-range transport. [ABSTRACT FROM AUTHOR]

To develop criteria for the classification of macrophage activation syndrome (MAS) in patients with systemic juvenile idiopathic arthritis (JIA). A multistep process, based on a combination of expert consensus and analysis of real patient data, was conducted. A panel of 28 experts was first asked to classify 428 patient profiles as having or not having MAS, based on clinical and laboratory features at the time of disease onset. The 428 profiles comprised 161 patients with systemic JIA-associated MAS and 267 patients with a condition that could potentially be confused with MAS (active systemic JIA without evidence of MAS, or systemic infection). Next, the ability of candidate criteria to classify individual patients as having MAS or not having MAS was assessed by evaluating the agreement between the classification yielded using the criteria and the consensus classification of the experts. The final criteria were selected in a consensus conference. Experts achieved consensus on the classification of 391 of the 428 patient profiles (91.4%). A total of 982 candidate criteria were tested statistically. The 37 best-performing criteria and 8 criteria obtained from the literature were evaluated at the consensus conference. During the conference, 82% consensus among experts was reached on the final MAS classification criteria. In validation analyses, these criteria had a sensitivity of 0.73 and a specificity of 0.99. Agreement between the classification (MAS or not MAS) obtained using the criteria and the original diagnosis made by the treating physician was high (κ=0.76). We have developed a set of classification criteria for MAS complicating systemic JIA and provided preliminary evidence of its validity. Use of these criteria will potentially improve understanding of MAS in systemic JIA and enhance efforts to discover effective therapies, by ensuring appropriate patient enrollment in studies. [ABSTRACT FROM AUTHOR]

• Species presence/absence patterns can estimate wide-scale metacommunity diversity. • Land-sparing urban areas had more rare species than land-sharing areas across Europe. • A land-sharing development type can increase the number of common bird species. • City geographical locations explained core and satellite species number variations. Species richness is a widely used proxy for patterns of biodiversity variation in metacommunities. However, deeper analyses require additional metrics, such as the occupancy-frequency distributions (SOFD) of different local communities. The SOFD patterns indicate the number of shared species between study sites; therefore, they can provide new insights into the current debate on how to create more biodiversity-friendly cities. Breeding birds were counted from 593 point-count stations located in five 500 m × 500 m squares in land-sharing (LSH; low-density built areas interspersed with green spaces) and five similar nearby squares in land-sparing (LSP; densely built-up with set-aside, large-sized, continuous green spaces) landscapes in nine cities across Europe. High beta-diversity (with over 42% of the 103 species detected being restricted to a single city and only 7% found in all studied cities) showed the uniqueness of cities at the continental scale. Urban bird metacommunities followed the unimodal-satellite SOFD pattern at the European continental scale but a bimodal symmetric or asymmetric distribution at the city-level scale, suggesting that many common species occur in cities on a smaller scale. The LSP urban areas followed a unimodal satellite SOFD pattern with numerous rare species. In contrast, the LSH areas fit several types of bimodal SOFD patterns equally well, where communities share several common species. The findings also highlight the need to use multi-scale approaches to analyze the effects of LSH-LSP urban designs on urban bird diversity. [ABSTRACT FROM AUTHOR]

As mathematical modeling of wastewater treatment plants has become more common in research and consultancy, a mismatch between education and requirements for model-related jobs has developed. There seems to be a shortage of skilled people, both in terms of quantity and in quality. In order to address this problem, this paper provides a framework to outline different types of model-related jobs, assess the required skills for these jobs and characterize different types of education that modelers obtain "in school" as well as "on the job". It is important to consider that education of modelers does not mainly happen in university courses and that the variety of model related jobs goes far beyond use for process design by consulting companies. To resolve the mismatch, the current connection between requirements for different jobs and the various types of education has to be assessed for different geographical regions and professional environments. This allows the evaluation and improvement of important educational paths, considering quality assurance and future developments. Moreover, conclusions from a workshop involving practitioners and academics from North America and Europe are presented. The participants stressed the importance of non-technical skills and recommended strengthening the role of realistic modeling experience in university training. However, this paper suggests that all providers of modeling education and support, not only universities, but also software suppliers, professional associations and companies performing modeling tasks are called to assess and strengthen their role in training and support of professional modelers. [ABSTRACT FROM AUTHOR]

The article focuses on the European Global and Regional Earth-System Monitoring Using Satellite (GEMS) project which is funded within the Global Monitoring for Environment and Security (GMES) framework, initiated by the European Commission (EC) and European Space Agency (ESA) in Europe. The primary objective of the European GEMS project is to develop a comprehensive monitoring and forecasting system for atmospheric composition on both global and regional scales from the combined expertise of research communities in Europe. It highlights the advantage of satellite remote sensing on the influence of anthropogenic emissions in atmosphere composition on a global scale. It explores the detailed structure and progress of the project since March 2005.

Europe has a very rich and diversified cultural heritage of art works, including buildings, monuments and objects of all sizes, involving a great variety of materials. The continuous discovery of new art works opens the problem of their authentication. Advanced analytical techniques can be fundamental to understand the way of life, the culture and the technical and intellectual know-how of the artists. Indeed, the authentication of an art work involves the identification of the used materials, their production techniques and procedures used for the work realization. It is possible to know the origin and provenance of materials, including the location of the natural sources. Advanced analytical techniques also help one to understand degradation processes, corrosion, weathering, and preservation-conservation protocols. In this paper we present a painting attributed to Domenico Ghirlandaio. Ghirlandaio is a well-known artist of fifteenth century who contributes to the apprenticeship of Michelangelo Buonarroti. The study of the pigments used in this painting, which belongs to a private collection, has been supported mainly by means of laboratory two-dimensional X-ray microdiffraction (μXRD2). The possibility to obtain information about not only the phase, but also microstructure allows one to extract interesting consideration and to obtain evidence of the painter’s style and intention. [ABSTRACT FROM AUTHOR]

The “vascular surgery” (VS) specialty in Europe, as elsewhere, was created as a side branch of General Surgery. At the time, only a few reconstructive procedures were possible and extensively applied, but many “firsts” were performed in Europe, from carotid endarterectomy to graft repair of an abdominal aortic aneurysm. Some of our old Masters were proud to practice vascular procedures so effectively for bowel, kidney or thoracic surgery. Technology with its progressive achievements in materials, instruments and methodologies, as well as medical applications of several principles of physics and clinical use of biological discoveries and pharmacological research with the introduction of new drugs, led to rapid and incredible developments in VS. Hence, in the late 1960s in the universities it began to be recognized as a well-defined discipline and a specific specialty. [Copyright &y& Elsevier]

Background and aim: Despite recent publications, practitioners remain unfamiliar with the current terminology related to the placebo and nocebo phenomena observed in clinical trials and practice, nor with the factors that modulate them. To cover the gap, the European Headache Federation appointed a panel of experts to clarify the terms associated with the use of placebo in clinical trials. Methods: The working group identified relevant questions and agreed upon recommendations. Because no data were required to answer the questions, the GRADE approach was not applicable, and thus only expert opinion was provided according to an amended Delphi method. The initial 12 topics for discussion were revised in the opinion of the majority of the panelists, and after a total of 6 rounds of negotiations, the final agreement is presented. Results/recommendations: Two primary and mechanism-based recommendations are provided for the results of clinical trials: [1] to distinguish the placebo or nocebo response from the placebo or nocebo effect; and [2] for any favorable outcome observed after placebo administration, the term "placebo response" should be used, and for any unfavorable outcome recorded after placebo administration, the term "nocebo response" should be used (12 out of 17 panelists agreed, 70.6% agreement). The placebo or nocebo responses are attributed to a set of factors including those that are related to the medical condition (e.g. natural history, random comorbidities, etc.), along with idiosyncratic ones, in which the placebo or nocebo effects are attributed to idiosyncratic, or nonspecific mechanisms, exclusively (e.g. expectation, conditioning, observational learning etc.). To help investigators and practitioners, the panel summarized a list of environmental factors and idiosyncratic dynamics modulating placebo and nocebo effects. Some of them are modifiable, and investigators or physicians need to know about them in order to modify these factors appropriately to improve treatment. One secondary recommendation addresses the use of the terms "placebo" and "nocebo" ("placebos" and "nocebos" in plural), which refer to the triggers of the placebo/nocebo effects or responses, respectively, and which are inert agents or interventions that should not be confused with the placebo/nocebo responses or effects themselves (all panelists agreed, 100% agreement). Conclusion: The working group recommends distinguishing the term response from effect to describe health changes from before to after placebo application and to distinguish the terms placebo(s) or nocebo(s) from the health consequences that they cause (placebo/nocebo responses or effects). [ABSTRACT FROM AUTHOR]

In this study, we propose a novel strategy for identifying potential hotspots of avian roadkills in Europe. The proposed approach combines information about the spatial distribution of bird species at a comparatively higher risk of roadkill with data on road density. First, using a large dataset collected from several European studies and reports, we extracted the frequency of occurrence of bird casualties for 209 breeding bird species recorded in roadkill events. We standardized the relative frequency of roadkill from 0 (species never recorded in bird casualties' reports) to 1 (species with the higher number of roadkill's), obtaining a continuous variable that indicates the potential risk of roadkill species by species. Second, using published data on the spatial distribution of breeding bird species in Europe, we calculated the cumulative risk of roadkill in each bird assemblages, by considering the sum of the values estimated for each species in the previous step. Third, we calculated the road density in each spatial unit. Finally, we elaborate a forecasting map of potential avian roadkill-risk across Europe, by combining the data on road density and cumulative roadkill risk of bird communities. The tool proposed can help to identify potential hotspots at different spatial scales where the risk of avian roadkill is high, offering the possibility to improve conservation measures in road planning. Briefly, the prediction of where there is aligned convergence between communities with highly ranked species and landscapes with dense road networks can be used in procedures modelling wildlife-car collisions, for transportation mitigation projects. • Using road casualties from 9 European countries we estimated the bird's roadkill probability. • We calculated a cumulative risk of roadkill considering the species in the communities. • We combined community cumulative risk of roadkill with road density across the continent. • We elaborated a forecasting map of avian roadkill-risk in Europe to estimate hotspots. [ABSTRACT FROM AUTHOR]

Most manufacturing and process industries require compressed air to such an extent that in Europe, for instance, about 10% of the total electrical energy consumption of industries is due to compressed air systems (CAS). However, energy efficiency in compressed air production and handling is often ignored or underestimated, mainly because of the lack of awareness about its energy consumption, caused by the absence of proper measurements on CAS in most industrial plants. Therefore, any effective energy saving intervention on generation, distribution and transformation of compressed air requires proper energy information management. In this paper we demonstrate the importance of monitoring and controlling energy performance in compressed air generation and use, to enable energy saving practices, to enhance the outcomes of energy management projects, and to obtain additional benefits for non-energy-related activities, such as operations, maintenance management and energy accounting. In particular, we propose a novel methodology based on measured data, and baseline definition through statistical modelling and control charts. The proposed methodology is tested on a real compressed air system of a pharmaceutical manufacturing plant in order to verify its effectiveness and applicability. [ABSTRACT FROM AUTHOR]

In 1958, the Union Européene des Médecins Spécialistes (UEMS), or European Union (EU) of Medical Specialists the European Union, was founded by the professional organizations of medical specialists in Europe. Among the objectives of the UEMS are to promote the highest level of patient care in the EU and to promote the harmonization of high-quality training programs within the various specialities throughout the EU. Within the 38 Specialist Sections of the UEMS are the European Boards, which are the working groups of the Specialist Sections. In 2005 Vascular Surgery was recognized as a separate and independent Section, a monospecialty, within the UEMS. The efforts of the UEMS are directed at facilitating the free exchange of training and work of trainees and medical specialists between EU countries. This situation, in combination with large differences in requirements and length of training in vascular surgery within the EU, stresses the importance of harmonization in training and certification in vascular surgery within the EU. For that reason, the European Board of Vascular Surgery has organized voluntary examinations yearly since 1996. The candidates who pass qualify as “Fellow of the European Board of Vascular Surgery” (FEBVS) since 2005. The first part of the examination evaluates the eligibility of the candidate (Certificate of Completion of Specialist Training, training center, logbook). The second part is a viva voce assessment that includes (1) case analyses, (2) a review of a scientific article, (3) an overall assessment, (4) a technical skills, and (5) an endovascular skills assessment. To pass the examination, the candidates must achieve a 67% success rate in each part of the examination. During the last 10 years, approximately 75% of the candidates have successfully taken the examination. In the near future the Section and Board, in close collaboration with the vascular societies in the EU, will develop a European vascular surgical syllabus and curriculum that will further harmonize and professionalize the training and certification of vascular surgery in Europe. [Copyright &y& Elsevier]

• We performed a literature review about bird's roadkill from 9 European countries. • We tested the phylogenetic signal of the frequency of roadkill across bird species. • Rate of roadkill of birds is not correlated with the evolutionary distinctiveness score. • Birds most frequently killed in the roads were Blackbird, House Sparrow, and European Robin. Through an extensive literature review and using a large dataset collected from several European studies, we explored the frequency of occurrence of road bird casualties. First, we modelled the inter-specific variation in roadkill' frequency across the avian phylogeny, testing for phylogenetic signal. Then, we explored the association between frequency of roadkill and some avian traits and evolutionary distinctiveness score of species. The rate of roadkill did not show a phylogenetic signal, indicating that the incidence of avian casualties is independent of the phylogenetic position of species. The incidence of roadkill was unrelated to the evolutionary distinctiveness, distribution range size, type of diet, or period of activity of species, but was slightly negatively associated with the species' body mass. This result implies that roadkill is a form of anthropogenic mortality widely generalized concerning avian phylogeny. We highlight that roadkill mitigation measures could benefit from incorporating peculiarities of local or regional avifauna. [ABSTRACT FROM AUTHOR]

National programs that reduce adolescent cannabis use warrant renewed attention in light of current discussions to reform cannabis legislation, including the possibility of legalization for recreational use. This study measures the size of a decrease in a country's prevalence of adolescent cannabis use that accompanies a decrease in its prevalence of adolescents who had ever smoked a cigarette. Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD), which is a collaborative effort of more than 40 European countries to surveil adolescent substance use. This study uses data from the seven survey administrations in 1995, 1999, 2003, 2007, 2011, 2015, and 2019. The main analysis is a fixed-effect regression analysis of country-level, four-year changes in adolescent lifetime cannabis use prevalence on country-level, four-year changes in adolescent lifetime cigarette use prevalence. Decreases in the national prevalence of adolescents who had ever smoked a cigarette were accompanied by decreases half as large in national prevalence of adolescent lifetime cannabis use. For European countries considering the legalization of adult recreational cannabis use, tobacco control can offer a tool to help counter potential increases in cannabis use among adolescents. [ABSTRACT FROM AUTHOR]

Abstract Hirayama disease is a rare neurological disease affecting primarily men in the second to third decades. To date there are only few reports from Italy. We report the case of three young basketball players who presented with clinical, electrophysiological and MRI findings suggestive for Hirayama disease. Although the pathophysiology of the disease is still unknown, several hypotheses have been suggested and two of these are the disproportionate growth of cervical spine and cervical cord/roots during adolescence and the chronic traumatism. We think that, in our cases, the height of basketball players combined with the constant stress caused by the sport, could have contributed to the development of the Hirayama disease. With this report we would stress the importance to be careful to consider this pathology in order to avoid misdiagnosis predictive of poor prognosis in young patients. Highlights • About Hirayama disease there are only few case reports from Europe. • This is the first case series of Hirayama disease in agonists athletes. • Sport might have caused sustained trauma and neck flection favoring the disease. [ABSTRACT FROM AUTHOR]

Background Mutations in BRCA1/2 genes are involved in the pathogenesis of breast and ovarian cancer. Inactivation of these genes can also be mediated by hypermethylation of CpGs in the promoter regions. Aim of this study was to analyse the clinical impact of BRCA1 promoter gene methylation status in a homogenous cohort of high-grade serous ovarian cancer (HGSOC) patients. Methods The cohort included 257 primary HGSOC patients treated by cytoreduction and platinum-based chemotherapy. DNA was extracted from fresh frozen tissue samples. BRCA1 gene promoter methylation rate was assessed using polymerase chain reaction (PCR). Results 14.8% of patients presented hypermethylation within a selected region of the BRCA1 promoter. The rate of hypermethylation was significantly higher in younger patients (20.8% hypermethylation in the age group > 58years versus 8.7% hypermethylation in the age group >58years; p=0.008). Optimal tumour debulking could be reached in 63% of patients, without significant differences in the extent of residual disease with respect to the methylation status. No impact of BRCA1 gene promoter methylation status on progression free- and overall-survival rates was found. No significant differences within BRCA1 promoter methylation status between primary and metastatic tissue could be observed. These results on BRCA1 promoter methylation status were also confirmed in a subgroup of 107 patients found negative for BRCA1 exon 11 mutations. Conclusions Our data suggest that BRCA1 methylation determines the earlier onset of HGSOC. Furthermore our study supports the idea that BRCAness is not only due to mutations but also to epigenetic changes in BRCA1 promoter gene. [ABSTRACT FROM AUTHOR]

Background: Cut-offs on self-report depression screening tools are designed to identify many more people than those who meet criteria for major depressive disorder. In a recent analysis of the European Health Interview Survey (EHIS), the percentage of participants with Patient Health Questionnaire-8 (PHQ-8) scores ≥10 was reported as major depression prevalence., Objective: We used a Bayesian framework to re-analyse EHIS PHQ-8 data, accounting for the imperfect diagnostic accuracy of the PHQ-8., Methods: The EHIS is a cross-sectional, population-based survey in 27 countries across Europe with 258 888 participants from the general population. We incorporated evidence from a comprehensive individual participant data meta-analysis on the accuracy of the PHQ-8 cut-off of ≥10. We evaluated the joint posterior distribution to estimate the major depression prevalence, prevalence differences between countries and compared with previous EHIS results., Findings: Overall, major depression prevalence was 2.1% (95% credible interval (CrI) 1.0% to 3.8%). Mean posterior prevalence estimates ranged from 0.6% (0.0% to 1.9%) in the Czech Republic to 4.2% (0.2% to 11.3%) in Iceland. Accounting for the imperfect diagnostic accuracy resulted in insufficient power to establish prevalence differences. 76.4% (38.0% to 96.0%) of observed positive tests were estimated to be false positives. Prevalence was lower than the 6.4% (95% CI 6.2% to 6.5%) estimated previously., Conclusions: Prevalence estimation needs to account for imperfect diagnostic accuracy., Clinical Implications: Major depression prevalence in European countries is likely lower than previously reported on the basis of the EHIS survey., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ.)

The cultivation of GMPs in Europe raises many questions about the environmental risks, in particular about their ecological impact on non-target organisms and on soil properties. The aim of a multidisciplinary group engaged in a LIFE+project (MAN-GMP-ITA) was to validate and improve an existing environmental risk assessment (ERA) methodology on GMPs within the European legislative framework on GMOs. Given the impossibility of evaluating GMO impact directly, as GMPs are banned in Italy, GMPs have not been used at any stage of the project. The project thus specifically focused on the conditions for the implementation of ERA in different areas of Italy, with an emphasis on some sensitive and protected areas located in the North, Centre, and South of the country, in order to lay the necessary baseline for evaluating the possible effects of a GMP on soil communities. Our sub-group carried out soil analyses in order to obtain soil health and fertility indicators to be used as baselines in the ERA model. Using various methods of chemical, biochemical, functional and genetic analysis, our study assessed the changes in diversity and functionality of bacterial populations, and arbuscular mycorrhizal fungi. The results show that plant identity and growth, soil characteristics, and field site climatic parameters are key factors in contributing to variation in microbial community structure and diversity, thus validating our methodological approach. Our project has come to the conclusion that the uneven composition and biological-agronomical quality of soils need to be taken into consideration in a risk analysis within the framework of ERA for the release of genetically modified plants., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: The current US official position, since DSM-III, is that panic attacks represent the hallmark of panic disorder and play a major role in the development of the agoraphobic syndrome. The more favoured view in the European tradition is that neurotic personality and/or prodromal features such as mild depression and excessive worries precede the illness., Method: We studied 126 consecutive cases of panic disorder with or without agoraphobia by DSM-III-R criteria, evaluated by relevant structured and semi-structured interviews., Results: We provide evidence that characterological and prodromal antecedents represent a putative phobic-anxious temperamental substrate occurring in at least 30% of our sample. This temperament consists of three or more of the following traits: (1) increased sympathetic activity with repeated sporadic and isolated autonomic manifestations; (2) marked fear of illness; (3) hypersensitivity to separation; (4) difficulty to leave familiar surroundings; (5) marked need for reassurance; (6) oversensitivity to drugs and substances. Our data further suggest that these attributes are of familial origin, as a result of which the illness tends to declare itself earlier., Limitation: The present investigation is largely correlational without a prospective component; however, the key validating familial data were obtained blindly., Conclusion: Our data support a pathogenetic model whereby genetic diathesis unfolds from subclinical to clinical manifestations along temperamental, panic, phobic and avoidant patterns. We submit that the delineation of the phobic-anxious temperament will be useful in more completely charting the life course of the panic-agoraphobic spectrum; avoidant and dependent (Axis II) patterns appear more distal in the pathogenetic chain and, in many cases, can be conceptualized to be epiphenomenal to the disease process.