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There are no established training pathways for hepato-pancreato-biliary (HPB) surgery in Europe. This study aims to overview the current status of fellowship training from both fellows' and institutions' perspectives. A web-based snapshot survey was distributed to all members of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) to reach for former fellows and program directors of European HPB surgery fellowships held between 2013 and 2023. A total of 37 fellows and 13 program directors replied describing 32 different programs in 13 European countries. The median (range) age at fellowship start was 34 (30–45 years). Fellowship duration was most commonly one (36 %) or two (40 %) years. Fellowships were funded in 70 % and fellows were required to learn a new language in 27 %. Most fellows performed between none and 10 pancreatic (68 %), major (67 %) and minor (60 %) liver resections as 1st surgeon, while the number of operations performed as 1st assistant were more heterogeneous. Program directors estimated a higher number of operations performed by fellows as first surgeons. The percentage of procedures performed minimally invasively did not exceed 10 %. There is substantial heterogeneity between HPB fellowship programs in Europe. A wider standardization of clinical curriculum, including minimally invasive surgery, is desirable. [ABSTRACT FROM AUTHOR]

Background: FitBack is an international network established to support the creation of physical fitness monitoring and surveillance systems for children and adolescents across Europe. Aims: As a part of the greater scope of the FitBack European project, the FitBack web portal was designed and tailored for various target groups, such as teachers, health professionals, policy makers, parents, and youths, with the aim to promote their physical and health literacy. Methods: The FitBack web portal is a free and multilingual online resource, and two of its webpages were evaluated: "Make interactive report" was evaluated by 78 secondary school students and 27 physical education teachers, and "10 steps to design a physical fitness monitoring system" by 14 physical activity promotion policy makers. Validated scales and open-ended questions were used to collect both quantitative and qualitative responses. Results: 'Good'-to-'excellent' scores emerged for user experience (5.43–6.36 out of 7) and webpage usability (3.70–4.27 out of 5). Qualitative feedback highlighted positive comments and cues on how to improve website features. Conclusions: Results indicate that the current FitBack web portal is a clear and user-friendly mobile health tool, which includes relevant information on how to use and implement youth physical fitness monitoring and surveillance systems. [ABSTRACT FROM AUTHOR]

Purpose: The article investigates whether variety of democracy affects the probability to employ public subsidies for credit support by small- and medium-sized enterprises (SMEs) led by female entrepreneurs. Design/methodology/approach: Building on the literature on democracy and on gender differences, it leverages a large firm- and country-level dataset (SAFE) of 31 democracies in Europe (EU and non-EU) over the 2009–2014 period by using probit models and instrumental variable approaches. Findings: Results from the different econometric techniques and samples suggest that variety of democracy affects female-led SMEs in using public subsidies for credit support. The evidence is robust to endogeneity concerns. Research limitations/implications: The empirical evidence presents a time frame limitation. At the same time, SAFE is the only database that supplies information about the gender of firms and public subsidies for credit support, rendering it the only resource that allows the test of the hypothesis proposed. The article therefore offers insights for scholars to revisit our results in future studies that make use of datasets with a longer time span – when they will become available. Originality/value: To the best of the authors' knowledge, the article is the first to study the effect of democracy on female entrepreneurial behavior in the use of public subsidies for credit support. [ABSTRACT FROM AUTHOR]

Systemic light-chain (AL) amyloidosis is a rare and debilitating disease. Advances have been made in new treatments in recent years, yet real-world data on the management of the disease are scarce. EMN23 is a retrospective, observational study of patients who initiated first-line treatment in 2004–2018 in Europe, presenting the demographics, clinical characteristics, treatment patterns, and outcomes, from 4480 patients. Regimens based on bortezomib were the most frequently used as first-line therapy; only 6.2% of the patients received autologous stem cell transplant. Hematologic responses improved post-2010 (67.1% vs 55.6% pre-2010). The median overall survival (OS) was 48.8 (45.2–51.7) months; 51.4 (47.3–57.7) months pre-2010 and 46.7 (41.3–52.2) months post-2010. Early mortality was 13.4% and did not improve (11.4% vs 14.4% pre- and post-2010); furthermore, it remained high in patients with advanced cardiac disease (over 39% for stage IIIb). There was a significant improvement for stage IIIa (14.2 vs 30.7 months, p = 0.0170) but no improvement for stage IIIb patients (5.0 vs 4.5 months). This European real-world study of AL-amyloidosis emphasizes the unmet needs of early diagnosis, and the lack of improvement in survival outcomes of the frail stage IIIb population, despite the introduction of new therapies in recent years. [ABSTRACT FROM AUTHOR]

Nowadays, there is an urgent necessity for breakthrough technologies able to reduce process complexity and to lower costs to make the biomass-based biodiesel supply chain competitive. This paper presents an innovative methodology for the identification of secondary biomass potentials for biofuel production. The methodology, divided into four steps, defines the criteria that allow identification of promising scenarios of biomass supply chains for commercial application of innovative technologies. The model set up a scoring procedure based on carbon emission avoidance, efficient resource exploitation and sustainability indexes. Applying the four levels of analysis (biomass availability, suitability analysis, regionalization and multi-criteria analysis), the cereal straw supply chains in four European districts (Scandinavian, Hanseatic, Central European and Mediterranean) have been identified and grouped in 18 biomass supply regional clusters (BSRCs). The clusters represent the most promising hotspots where biomass availability, logistics and feedstock requirements for a novel conversion technology meet. Central European and Mediterranean districts are those with the highest cereal straw bioeconomic potentials which allow mono-feedstock supply chains and relatively high capacity of a conversion technology at 200 MWth and beyond. Central Europe has an overall bioeconomic potential of 16.249 kt (232.359 TJ) distributed over 36 regions and organized in 12 BSRCs. The Mediterranean district has an overall bioeconomic potential of 3541 kt (50.630 TJ) distributed over nine regions and organized in four BSRCs. [ABSTRACT FROM AUTHOR]

In the last few years, the sudden outbreak of COVID-19 caused by SARS-CoV-2 proved the crucial importance of understanding how emerging viruses work and proliferate, in order to avoid the repetition of such a dramatic sanitary situation with unprecedented social and economic costs. West Nile Virus is a mosquito-borne pathogen that can spread to humans and induce severe neurological problems. This RNA virus caused recent remarkable outbreaks, notably in Europe, highlighting the need to investigate the molecular mechanisms of its infection process in order to design and propose efficient antivirals. Here, we resort to all-atom Molecular Dynamics simulations to characterize the structure of the 5 ′ -untranslated region of the West Nile Virus genome and its specific recognition by the human innate immune system via oligoadenylate synthetase. Our simulations allowed us to map the interaction network between the viral RNA and the host protein, which drives its specific recognition and triggers the host immune response. These results may provide fundamental knowledge that can assist further antivirals' design, including therapeutic RNA strategies. [ABSTRACT FROM AUTHOR]

Endometrial carcinoma is the most common gynecological cancer in Europe, with 130,000 new cases per year, and the incidence has been rising with aging and increased obesity of the population. Most women with endometrial cancer will present with early-stage disease, with a tumor confined to the uterus and without metastasis, and the first approach is surgery. Approximately 10% to 15% of these patients have a metastatic nodal disease, which is why guidelines have always emphasized the importance of lymphadenectomy to stratify the risk and tailor adjuvant treatment. However, comprehensive lymphadenectomy is related to significant morbidity and seems not to improve either progression-free or overall survival in these patients. Lymphatic mapping with sentinel lymph node biopsy has emerged as an alternative and an optimal compromise instead of systematic lymphadenectomy. This review presents the current evidence supporting sentinel lymph node biopsy in patients with endometrial cancer. [ABSTRACT FROM AUTHOR]

Europe experienced excess mortality from February through June, 2020 due to the COVID-19 pandemic, with more COVID-19-associated deaths in males compared to females. However, a difference in excess mortality among females compared to among males may be a more general phenomenon, and should be investigated in none-COVID-19 situations as well. Based on death counts from Eurostat, separate excess mortalities were estimated for each of the sexes using the EuroMOMO model. Sex-differential excess mortality were expressed as differences in excess mortality incidence rates between the sexes. A general relation between sex-differential and overall excess mortality both during the COVID-19 pandemic and in preceding seasons were investigated. Data from 27 European countries were included, covering the seasons 2016/17 to 2019/20. In periods with increased excess mortality, excess was consistently highest among males. From February through May 2020 male excess mortality was 52.7 (95% PI: 56.29; 49.05) deaths per 100,000 person years higher than for females. Increased male excess mortality compared to female was also observed in the seasons 2016/17 to 2018/19. We found a linear relation between sex-differences in excess mortality and overall excess mortality, i.e., 40 additional deaths among males per 100 excess deaths per 100,000 population. This corresponds to an overall female/male mortality incidence ratio of 0.7. In situations with overall excess mortality, excess mortality increases more for males than females. We suggest that the sex-differences observed during the COVID-19 pandemic reflects a general sex-disparity in excess mortality. [ABSTRACT FROM AUTHOR]

Introduction: Lung cancer is the leading cause of cancer-related death in Europe and the US. Isolated metastases to skeletal muscle and the mandible are very uncommon.Case Presentation: This report presents two cases. Case 1 concerns a 45-year-old Caucasian woman affected by muscle metastasis of the right thigh from non-small-cell lung cancer. Case 2 concerns a 61-year-old Caucasian man affected by mandible metastasis from non-small-cell lung cancer. Both metastases were detected by diagnostic imaging studies. Both patients were treated with radiation therapy with palliative and antalgic intent.Conclusion: Radiation therapy was effective and well tolerated in both cases. Both our patients are alive, with follow-up of 18 months and five months, respectively. [ABSTRACT FROM AUTHOR]

The article reports on topics which were discussed at a three day meeting on the future of clinical pharmacology in Europe which was held in June of 2012 in Sicily, Italy. Topics included the training of pharmacology professionals, funding for pharmacology education and the promotion of clinical pharmacology. The event was attended by clinical pharmacologists from 19 different European countries.

The introduction of mass vaccination against Varicella-Zoster-Virus (VZV) is being delayed in many European countries because of, among other factors, the possibility of a large increase in Herpes Zoster (HZ) incidence in the first decades after the initiation of vaccination, due to the expected decline of the boosting of Cell Mediated Immunity caused by the reduced varicella circulation. A multi-country model of VZV transmission and reactivation, is used to evaluate the possible impact of varicella vaccination on HZ epidemiology in Italy, Finland and the UK. Despite the large uncertainty surrounding HZ and vaccine-related parameters, surprisingly robust medium-term predictions are provided, indicating that an increase in HZ incidence is likely to occur in countries where the incidence rate is lower in absence of immunization, possibly due to a higher force of boosting (e.g. Finland), whereas increases in HZ incidence might be minor where the force of boosting is milder (e.g. the UK). Moreover, a convergence of HZ post vaccination incidence levels in the examined countries is predicted despite different initial degrees of success of immunization policies. Unlike previous model-based evaluations, our investigation shows that after varicella immunization an increase of HZ incidence is not a certain fact, rather depends on the presence or absence of factors promoting a strong boosting intensity and which might or not be heavily affected by changes in varicella circulation due to mass immunization. These findings might explain the opposed empirical evidences observed about the increases of HZ in sites where mass varicella vaccination is ongoing. [ABSTRACT FROM AUTHOR]

Abstract: How much do hoteliers actually make use of dynamic pricing strategies? We collected data on the price of a single room booked in advance (from three months to a single day), from almost 1000 hotels in eight European capital cities. Pricing strategies were analyzed by means of descriptive statistics, box plots and econometric panel data techniques. The empirical results show that the inter-temporal pricing structure primarily depends on the type of customer, the star rating and the number of suppliers with available rooms. [Copyright &y& Elsevier]

Objective To study the association between exposure to transportation noise and blood pressure (BP) reduction during nighttime sleep. Methods 24-h ambulatory BP measurements at 15-min intervals were carried out on 149 persons living near four major European airports. Noise indicators included total and source-specific equivalent indoor noise, total number of noise events, annoyance scores for aircraft and road traffic nighttime noise. Long-term noise exposure was also determined. Multivariate linear regression analysis was applied. Results The pooled estimates show that the only noise indicator associated consistently with a decrease in BP dipping is road traffic noise. The effect shows that a 5 dB increase in measured road traffic noise during the study night is associated with 0.8% (-1.55, -0.05) less dipping in diastolic BP. Noise from aircraft was not associated with a decrease in dipping, except for a nonsignificant decrease noted in Athens, where the aircraft noise was higher. Noise from indoor sources did not affect BP dipping. Conclusions Road traffic noise exposure may be associated with a decrease in dipping. Noise from aircraft was not found to affect dipping in a consistent way across centres and indoor noise was not associated with dipping. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that typically occurs during childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typical onset in the first years of life and with a 10- 30% prevalence among young children. AD prevalence in adolescence has been estimated around 5-15% in European countries. AD persists from childhood through adolescence in around 40% of cases and some risk factors have been identified: female sex, sensitization to inhalant and food allergens, allergic asthma and/or rhinoconjunctivitis, the practice of certain jobs. During adolescence, AD mainly appears on the face and neck, often associated with overinfection by Malassezia, and on the palms and soles. AD persistence during adolescence is correlated with psychological diseases such as anxiety; moreover, adolescents affected by AD might have problems in the relationship with their peers. Stress and the psychological problems represent a serious burden for adolescents with AD and cause a significant worsening of the patients' quality of life (QoL). The pharmacological treatment is similar to other age groups. Educational and psychological approaches should be considered in the most severe cases. [ABSTRACT FROM AUTHOR]

The author comments on the direct-to-consumer information in Europe. He argued that the main issue in analyzing the role that pharmaceutical industry could have in the direct information to patients is of having clear definitions and distinction between information and advertising. He states that the European Commission should improve the range, availability, clarity and quality of independent and unbiased information in Europe.

The author comments on the European VitreoRetinal Society (EVRS). He relates his experience practicing vitreoretinal surgery back in the late 1980s. He states the teaching philosophy of EVRS. He announces that the annual symposium of the EVRS will be held in Prague, Czech Republic in September 2008.

Abstract: A recent analysis of the Xerocomus subtomentosus complex in Europe using rDNA-ITS sequence data distinguished four taxa in Europe. Two of these corresponded to the established taxa X. subtomentosus and X. ferrugineus, and a new taxon, X. chrysonemus, was described. The fourth taxon was noted but left undescribed owing to lack of material. Here, we describe this taxon as X. silwoodensis sp. nov. X. silwoodensis is a rare but widespread taxon known from single sites in Italy and Spain, and three in the UK. The features of X. silwoodensis basidiomes are very similar to other members of the complex but the pileus colours tend to show richer red–brown tones and the stipe often radicates deeply into the substrate. The taxon also exhibits a strong preference for associating with Populus species, whereas the other taxa are associated with either Quercus (X. chrysonemus) or generalists on broadleaved hosts (X. subtomentosus) or conifers and broadleaved trees (X. ferrugineus). Microscopically, the spore characteristics of X. silwoodensis are similar to the recently described X. chrysonemus, but differ significantly from both X. subtomentosus and X. ferrugineus. X. silwoodensis is probably overlooked due to the resemblance to other taxa within the complex. The present study on the identification and description of X. silwoodensis should reduce the confusion associated with the identification of taxa within this species complex and lead to a more accurate assessment of the geographic distribution and conservation needs of the taxa. [Copyright &y& Elsevier]

Cities are central to the economic and social development of European society, not only because over 80% of European citizens live in urban areas, but also because cities are at the same time centres of production, innovation, employment, and culture, and loci of segregation, deprivation, and ethnic conflict. The emergence of a European-wide urban policy, has given new impetus to the need for comparable indicators of the quality of life to monitor development and policy implementation. This paper reviews the literature on quality of life indicators, and argues that traditional measures of the quality of life need to be supplemented with two new dimensions that reflect more recent postmodernist thinking about the composition of urban landscapes, and the contribution to the quality of life of the emerging information society. We argue that the challenges of building appropriate indicators reflecting these new dimensions are considerable, even in urban environments so rich in information systems and data sources, if they are to qualify as 'digital cities'. There are difficulties in finding common workable definitions of the indicators themselves, as well as definitions of the relevant populations, including city residents, and users. By raising these issues and suggesting possible avenues for addressing these challenges we contribute to a much-needed debate on how to define such indicators, which is the prerequisite for their development and use. [ABSTRACT FROM AUTHOR]

Treatment outcomes of patients with cardiac stage Ill light chain (AL) amyloidosis remain poorly studied. Such cases have been excluded from most clinical studies due to perceived dismal prognosis. We report treatment outcomes of 346 patients with stage III AL amyloidosis from the United Kingdom, Italy, Germany, and Greece. Median overall survival (OS) was 7 months with OS at 3, 6, 12, and 24 months of 73%, 55%, 46%, and 29%, respectively; 42% died before first response evaluation. On an intention-to-treat basis, the overall hematologic response rate was 33%, including a complete response rate of 12%. OS rates at 12 and 24 months, respectively, for 201 response evaluable patients were 88% and 85% for complete responders, 74% and 53% for partial responders, and 39% and 22% for nonresponders. Forty-five percent of responders achieved an organ response. Aminoterminal fragment of brain-type natriuretic peptide (NT-proBNP) >8500 ng/L and systolic blood pressure (SBP) <100mm Hg were the only factors that independently impacted OS and identified an especially poor prognosis subgroup of patients with a median OS of only 3 months. Outcome and organ function of stage III AL amyloidosis without very elevated NT-proBNP and low SBP is improved by a very good hematologic response to chemotherapy. [ABSTRACT FROM AUTHOR]