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This study is a follow-up to previous research conducted in 2012 on computer-assisted language testing (CALT) that applied a survey approach to investigate the use of technology in sign language testing worldwide. The goal of the current study was to replicate the 2012 study and to obtain updated information on the use of technology in sign language testing. Another goal was to broaden the scope of the previous study by also considering the use of automatic sign language recognition and production (by avatars) in applied testing scenarios through technologies that make use of artificial intelligence (AI). Thirty-two sign language testing professionals participated in the current study. The results of the survey confirm the findings from 2012, but also raise new issues for future research (trends) related to sign language testing, such as the use of automatic sign language recognition for automatic scoring and the problem of acquiring funding for developing and maintaining web-based sign language testing platforms.

Millennial-scale climate variations during the last glacial period, such as Dansgaard–Oeschger (DO) cycles and Heinrich events, have been extensively studied using ice core and marine proxy records. However, there is a limited understanding of the magnitude of these temperature fluctuations in continental regions, and questions remain about the seasonal signal of these climate events. This study presents a 60 000-year-long temperature reconstruction based on branched glycerol dialkyl glycerol tetraethers (brGDGTs) extracted from lake sediments from the Eifel Volcanic Field, Germany. brGDGTs are bacterial membrane-spanning lipids that are known to have a strong relationship with temperature, making them suitable for temperature reconstructions. We test several temperature calibration models on modern samples taken from soils and multiple maar lakes. We find a negative bias in brGDGT-based temperature estimates associated with water depth and anoxic conditions that can be corrected for by accounting for a brGDGT isomer that is only produced in anoxic conditions. The corrected temperature reconstruction correlates with proxy and climate model estimates of temperature spanning the same time period, validating the calibration approach we selected. However, millennial-scale variability is significantly dampened in the brGDGT record, and in contrast to other Northern Hemisphere climate records, during several Heinrich stadials, temperatures actually increase. We demonstrate that these apparent discrepancies can be explained by the unique seasonal response of the brGDGT paleothermometer to temperatures of months above freezing (TMAF). Our data support the view that warm-season temperatures in Europe varied minimally during the last glacial period and that abrupt millennial-scale events were defined by colder, longer winters. Our continuous high-resolution temperature reconstruction provides important information about the magnitude of seasonal climate variability during the last glacial period that can be used to test climate models and inform studies of paleoecological change. [ABSTRACT FROM AUTHOR]

Background: The demand for plasma products is growing, necessitating an increase in plasma collection by plasmapheresis. While the 20th edition of the European Guidelines permits plasma donors in Europe to donate with 96-h donation intervals, the potential short- and long-term consequences of high-frequency plasma donations on donor health remain unknown. This study aims to measure the effect of plasma donation frequency on plasma protein composition, including total serum protein (TSP) and immunoglobulin G (IgG), in Norwegian male blood donors. Methods: This randomized controlled trial (RCT) included 120 male blood donors who were randomized into two intervention groups and one control group: high-frequency plasma donors (HFPDs) who donated 650 mL of plasma 3 times every 2 weeks, whereas regular-frequency plasma donors (RFPDs) who donated 650 mL of plasma 1 time every 2 weeks. The control group consisted of whole blood donors. The primary outcomes are the concentrations of TSP and IgG. Discussion: The findings from this study may have implications for recommendations related to donor health and plasma donation frequencies and may contribute to supporting the strategic independence of plasma products in Norway and Europe without compromising donor health. Trial registration: ClinicalTrials.gov: NCT05179200. Registered December 20th, 2021. [ABSTRACT FROM AUTHOR]

This article provides an overview of the profiling of higher education programmes in Europe as part of the overall process of higher education reform in Europe over the past decade (2000-2012) and of the role of Tuning in this process. The article starts with a recall of the architecture and objectives of the change process, based on the interplay between the intergovernmental Bologna process (with a main focus on structural change), the European Union's parallel Agenda for the Modernisation of Higher Education (with a focus on policy change for the Union's main objectives: growth and jobs, mobility, recognition and attractiveness) and Tuning. The second part of the article provides some data about and examples of the method and importance of Tuning in stimulating and shaping the renovation of higher education programmes, with a focus on Tuning's initial geographical area (Europe) and a glimpse to other continents, in line with Europe's need to build up the visibility and attractiveness of its universities in the rest of the world. The final section is a retrospective and analytical reflection about the impact of Tuning on some key dimensions of the agenda for the modernisation of higher education in Europe; while acknowledging that the Tuning method and principles have not always been fully understood by higher education as well as governmental institutions, Tuning has made an outstanding contribution to such key aspects as the relevance, comparability and quality of programmes, the development of quality assurance and accreditation policies and agencies and the recognition of qualifications -- both within Europe and with partner countries in other parts of the world.

Millennial-scale climate variations during the last glacial period, such as Dansgaard–Oeschger (D/O) cycles and Heinrich events, have been extensively studied using ice core and marine proxy records. However, there is a limited understanding of the magnitude of these temperature fluctuations in continental regions, and questions remain about the seasonal signal of these climate events. This study presents a 60,000-year long temperature reconstruction based on branched glycerol dialkyl glycerol tetraethers (brGDGTs) extracted from lake sediments from the Eifel volcanic field, Germany. brGDGTs are bacterial membrane lipids that are known to have strong relationship with temperature, making them suitable for temperature reconstructions. We test several temperature calibration models on modern samples taken from soils and multiple maar lakes. We find a bias associated with water depth and anoxic conditions that can be corrected for by accounting for a brGDGT isomer that is only produced in anoxic conditions. The corrected temperature reconstruction correlates with proxy and model temperature record spanning the same time period, validating the calibration model. However, millennial-scale variability is significantly dampened in the brGDGT record, and in contrast to other northern hemisphere climate records, during several Heinrich stadials, temperatures actually increase. We demonstrate that these apparent discrepancies can be explained by the unique seasonal response of the brGDGT paleothermometer to temperatures of months above freezing (TMAF). Our data support the view that warm season temperatures in Europe varied minimally during the last glacial period, and that abrupt millennial-scale events were defined by colder, longer winters. Our continuous high-resolution temperature reconstruction provides important information about the magnitude of seasonal climate variability during the last glacial period that can be used to test climate models and inform studies of paleoecological change. [ABSTRACT FROM AUTHOR]

The sub-basalt domain of the Norwegian continental shelf (NCS) is one of the last remaining hydrocarbon exploration frontiers in Europe. While there is an established geological and tectonic framework, little has been published that addresses the remaining hydrocarbon exploration risks/uncertainties. Unlike the Faroe Shetland Basin and Rockall Trough, at the time of writing, there are currently no industry-drilled sub-basalt well penetrations on the Norwegian continental shelf. Numerous potential Mesozoic sub-basalt hydrocarbon plays exist on the NCS but, due to the lack of industry-drilled sub-basalt penetrations, there is a perceived large exploration risk. By using cross-border analogues, basin modelling workflows and integration of available seismic data the main uncertainties across the NCS are outlined including charge timing, structural definition, and details of reservoir presence. Generically the Late Cretaceous and Middle Jurassic intervals are potential plays which may be present on the Norwegian Margin. However, there is considerable uncertainty on their depth and preservation. Although significant challenges and uncertainties remain, the authors believe that the integration of well results, consideration of basin modelling driven heat flow estimates and new 3D seismic data may open sub-basalt opportunities for a new exploration frontier on the NCS. Thematic collection: This article is part of the New learning from exploration and development in the UKCS Atlantic Margin collection available at https://www.lyellcollection.org/topic/collections/new-learning-from-exploration-and-development-in-the-ukcs-atlantic-margin [ABSTRACT FROM AUTHOR]

More than 20 years ago, acrylamide was added to the list of potential carcinogens found in many common dietary products and tobacco smoke. Consequently, human biomonitoring studies investigating exposure to acrylamide in the form of adducts in blood and metabolites in urine have been performed to obtain data on the actual burden in different populations of the world and in Europe. Recognizing the related health risk, the European Commission responded with measures to curb the acrylamide content in food products. In 2017, a trans-European human biomonitoring project (HBM4EU) was started with the aim to investigate exposure to several chemicals, including acrylamide. Here we set out to provide a combined analysis of previous and current European acrylamide biomonitoring study results by harmonizing and integrating different data sources, including HBM4EU aligned studies, with the aim to resolve overall and current time trends of acrylamide exposure in Europe. Data from 10 European countries were included in the analysis, comprising more than 5500 individual samples (3214 children and teenagers, 2293 adults). We utilized linear models as well as a non-linear fit and breakpoint analysis to investigate trends in temporal acrylamide exposure as well as descriptive statistics and statistical tests to validate findings. Our results indicate an overall increase in acrylamide exposure between the years 2001 and 2017. Studies with samples collected after 2018 focusing on adults do not indicate increasing exposure but show declining values. Regional differences appear to affect absolute values, but not the overall time-trend of exposure. As benchmark levels for acrylamide content in food have been adopted in Europe in 2018, our results may imply the effects of these measures, but only indicated for adults, as corresponding data are still missing for children. [ABSTRACT FROM AUTHOR]

This paper presents recent innovations implemented in the LaRiMiT (Landslide Risk Mitigation Toolbox) webtool. These include an innovative methodology for utilising experts' scoring of landslide risk mitigation measures directly within the decision support tool, and updating of the tool's database over structural measures to include many nature-based solutions (NBS) for mitigating landslide risk. Landslides are a common and treacherous natural hazard, and due to the effect of climate change on the frequency and intensity of extreme weather events, climate-driven landslides are expected to become more frequent. This negative trend is a driving factor for developing decision-support solutions for risk mitigation, and the LaRiMiT toolbox and the expert scoring methodology presented in this article contribute to meeting these needs. Selecting suitable structural measures is complicated due to factors such as site-specific conditions, local knowledge and resources, socio-economic constraints, and environmental considerations. LaRiMiT uses user-input attributes of site-specific slope movements combined with expert scoring of the suitability of various mitigation solutions to identify and select appropriate mitigation measures from an extensive database of structural solutions. While the LaRiMiT database initially included only conventional (grey) solutions relying on traditional methods, it has been recently expanded to include nature-based solutions (NBS), which are sustainable techniques for managing erosion and mitigating shallow landslides using vegetation and the use of natural materials. NBS and conventional solutions can also be combined to provide hybrid solutions. The proposed methodology for implementing expert scoring is dynamic and iterative, consisting of statistical pooling of experts' scores collected via online surveys, and consolidating these into an expert scoring utility embedded in the LaRiMiT web portal engine. An initial application of this methodology has been tested by surveying a set of landslides experts, mostly in Europe, and applying it to the structural measures database in the LaRiMiT tool. Although the number of experts in this initial application is limited, dynamic updating of the scoring allows the tool to continuously improve as additional experts contribute. [ABSTRACT FROM AUTHOR]

Introduction: Biologics were approved for the treatment of advanced colorectal cancer (CRC) based on favorable benefit-risk-assessments from randomized controlled trials (RCTs), but evidence on their use in the real-world setting is scarce. Based on descriptive analyses we therefore aimed to assess characteristics and survival of CRC patients treated with biologics using large healthcare databases from three European countries (Netherlands, Italy, Germany). Methods: We included CRC patients treated with a biologic in 2010 or 2014 and characterized them regarding age, sex, comorbidities, and absolute survival. Results: Among 4,758 patients, the mean age ranged from 64.8 to 66.8 years, the majority was male, and comorbidities used as exclusion criteria in RCTs were coded in up to 30% of these patients. The proportion of bevacizumab users decreased between 2010 (72–93%) and 2014 (63–85%). In 2014, the absolute 12-month survival in new users was 64% (95% CI 51–77%), 56% (30–80%), and 61% (58–63%) in the Dutch, Italian, and German database, respectively, varying by age and comorbidity. Conclusions: Our study suggests that in the real-world setting, CRC patients treated with biologics are older and less selected regarding comorbidities compared to patients in RCTs, potentially explaining the relatively low 12-month survival we found. Treatment decisions in the real-world setting may require careful evaluation given that the risk-benefit ratio may vary depending on age and co-existing conditions. [ABSTRACT FROM AUTHOR]

Despite its vernacular names (e.g. 'woodlice') Isopoda is a group with mostly aquatic species, with most species living in marine environments. The fossil record for isopods compared to other groups of Eucrustacea is relatively sparse. This applies even more for the Triassic. While in the Jurassic Isopoda is relatively well represented by fossils, only eight species have previously been described from the Triassic. In this study three new species of Isopoda are described from two field sites in Europe: Obtusotelson summesbergeri sp. nov. and Discosalaputium aschauerorum sp. nov. from Polzberg (Gaming, Lower Austria, Austria) and Gelrincola winterswijkensis sp. nov. from Winterswijk (Gelderland, Netherlands). All three new species are interpreted as representatives of Scutocoxifera (ingroup of Isopoda). The species Gelrincola winterswijkensis sp. nov. is further interpreted to be a representative of Cymothoida (ingroup of Scutocoxifera). Most of the oldest fossils of Isopoda belong to Phreatoicidea, which is supposed to be the sistergroup to all remaining Isopoda. Nowadays, Phreatoicidea is a small relic group, its representatives living in freshwater environments. The new species herein presented contribute to our understanding of the diversity of Isopoda in the Triassic and support the assumption that the transition from a dominance of Phreatoicidea towards the dominance of the remaining lineages of Isopoda happened quite early (likely prior to the Triassic). [ABSTRACT FROM AUTHOR]

Background: Several environmental contaminants were shown to possibly influence fetal growth, generally from single exposure family studies, which are prone to publication bias and confounding by co-exposures. The exposome paradigm offers perspectives to avoid selective reporting of findings and to control for confounding by co-exposures. We aimed to characterize associations of fetal growth with the pregnancy chemical and external exposomes.Methods: Within the Human Early-Life Exposome project, 131 prenatal exposures were assessed using biomarkers and environmental models in 1287 mother-child pairs from six European cohorts. We investigated their associations with fetal growth using a deletion-substitution-addition (DSA) algorithm considering all exposures simultaneously, and an exposome-wide association study (ExWAS) considering each exposure independently. We corrected for exposure measurement error and tested for exposure-exposure and sex-exposure interactions.Results: The DSA model identified lead blood level, which was associated with a 97 g birth weight decrease for each doubling in lead concentration. No exposure passed the multiple testing-corrected significance threshold of ExWAS; without multiple testing correction, this model was in favour of negative associations of lead, fine particulate matter concentration and absorbance with birth weight, and of a positive sex-specific association of parabens with birth weight in boys. No two-way interaction between exposure variables was identified.Conclusions: This first large-scale exposome study of fetal growth simultaneously considered >100 environmental exposures. Compared with single exposure studies, our approach allowed making all tests (usually reported in successive publications) explicit. Lead exposure is still a health concern in Europe and parabens health effects warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: Pregnant women and children are especially vulnerable to exposures to food contaminants, and a balanced diet during these periods is critical for optimal nutritional status. Objectives: Our objective was to study the association between diet and measured blood and urinary levels of environmental contaminants in mother–child pairs from six European birth cohorts (n=818 mothers and 1,288 children). Methods: We assessed the consumption of seven food groups and the blood levels of organochlorine pesticides, polybrominated diphenyl ethers, polychlorinated biphenyls (PCBs), per- and polyfluoroalkyl substances (PFAS), and heavy metals and urinary levels of phthalate metabolites, phenolic compounds, and organophosphate pesticide (OP) metabolites. Organic food consumption during childhood was also studied. We applied multivariable linear regressions and targeted maximum likelihood based estimation (TMLE). Results: Maternal high (=4?times/week) versus low (<2?times/week) fish consumption was associated with 15% higher PCBs [geometric mean (GM) ratio=1.15; 95% confidence interval (CI): 1.02, 1.29], 42% higher perfluoroundecanoate (PFUnDA) (GM?ratio=1.42; 95% CI: 1.20, 1.68), 89% higher mercury (Hg) (GM?ratio=1.89; 95% CI: 1.47, 2.41) and a 487% increase in arsenic (As) (GM?ratio=4.87; 95% CI: 2.57, 9.23) levels. In children, high (=3?times/week) versus low (<1.5?times/week) fish consumption was associated with 23% higher perfluorononanoate (PFNA) (GM?ratio=1.23; 95% CI: 1.08, 1.40), 36% higher PFUnDA (GM?ratio=1.36; 95% CI: 1.12, 1.64), 37% higher perfluorooctane sulfonate (PFOS) (GM?ratio=1.37; 95% CI: 1.22, 1.54), and >200% higher Hg and As [GM?ratio=3.87 (95% CI: 1.91, 4.31) and GM?ratio=2.68 (95% CI: 2.23, 3.21)] concentrations. Using TMLE analysis, we estimated that fish consumption within the recommended 2–3 times/week resulted in lower PFAS, Hg, and As compared with higher consumption. Fruit consumption was positively associated with OP metabolites. Organic food consumption was negatively associated with OP metabolites. DISCUSSION: Fish consumption is related to higher PFAS, Hg, and As exposures. In addition, fruit consumption is a source of exposure to OPs. [ABSTRACT FROM AUTHOR]

Abstract Many European regulatory agencies solely rely upon historical data to set the allowed cost of equity for electricity and gas network operators. Under current capital market conditions, this approach often produces biased estimates. It should therefore be replaced or complemented by alternative approaches which are readily available. Whether alternative approaches such as forward-looking models will gain ground depends on legal proceedings at the German Federal Supreme Court. [ABSTRACT FROM AUTHOR]

Cloud computing combines established computing technologies and outsourcing advantages into a new ICT paradigm that is generally expected to foster productivity and economic growth. However, despite a series of studies on the drivers of cloud adoption, evidence of its economic effects is lacking, possibly because many of the datasets on cloud computing are of insufficient size and often lack a time dimension as well as precise definitions of cloud computing, thus making them unsuitable for rigorous quantitative analysis. To overcome these limitations, we propose a proxy variable for cloud computing usage— cloud adaptiveness —based on survey panel data from European firms. Observations based on a descriptive analysis suggest three important aspects for further research. First, cloud studies should be conducted at the industry level as cloud computing adaptiveness differs widely across industry sectors. Second, it is important to know what firms do with cloud computing to understand the economic mechanisms and effects triggered by this innovation. And third, cloud adaptiveness is potentially correlated to a firm’s position in the supply chain and thus the type of output it produces as well as the market in which it operates. Our indicator can be employed to further analyze the effects of cloud computing in the context of firm heterogeneity. [ABSTRACT FROM AUTHOR]

This paper presents the features of an online test framework for a receptive skills test that has been adapted, based on a British template, into different sign languages. The online test includes features that meet the needs of the different sign language versions. Features such as usability of the test, automatic saving of scores, and score reporting have been implemented. The background information of the children and the test results are saved in a secure databank. When consent has been granted, these data can be used for cross-linguistic research in the future. This will not only help us to broaden our understanding of deaf children's sign language development, but will also help us to further improve sign language testing. Furthermore, implications for research and practice will be discussed. [ABSTRACT FROM AUTHOR]

The article provides information on response of patients on data sharing including health care professionals and health care system. Topics discussed include patient transfers property rights and requirement for trials, independence of research groups and analysis from data scientists, and interaction with clinicians.

Research arising from self-determination theory (SDT; Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior.Psychological Inquiry, 11(4), 227–268) indicates that the quality of the social interactions between athletes and coaches, and athletes' ensuing psychological responses, are critical determinants of intentions to drop out of youth sport. Little is known regarding whether these processes hold across countries. Grounded in SDT, this study tested the invariance of a model predicting youth sport dropout across five European countries. Seven thousand seven hundred and sixty-nine grassroots players (6641 males, 1020 females (Mage = 11.56, SD = 1.40) from youth soccer teams in five countries (England, France, Greece, Norway, and Spain) completed a questionnaire tapping perceptions of coach-provided autonomy support, basic psychological need satisfaction (i.e. autonomy, competence and relatedness), soccer enjoyment, and intentions to drop out of soccer in the next season. Data were analysed using structural equation modelling. The hypothesised model (autonomy support → basic needs → enjoyment → intentions to drop out of soccer) showed an acceptable fit to the data and provided evidence of configural factor loading and structural path invariance across the five countries. This study supports the applicability of the basic needs theory model as a framework to understand the determinants of drop out intentions in sport among European youth across national boundaries. Findings highlight a potential avenue for intervention that could impact children's enjoyment of, and intentions to continue, playing soccer; namely, interventions that specifically target autonomy supportive coaching. [ABSTRACT FROM AUTHOR]

In this study, findings concerned with the association of self-reported global self-esteem, vitality and athletes' moderate-to-vigorous physical activity (MVPA) in young soccer players and the generalisability of these associations across different European populations are presented. After listwise exclusion of missing cases and the elimination of cases reporting less than a week of intensive physical activity, the sample of this analysis included 6796 athletes from France (N = 974), Greece (N = 1416), Norway (N = 1051), Spain (N = 2175) and England (N = 1180). Results from multi-sample structural equation modelling analyses provided evidence of invariance across countries for factor loadings and structural covariances, but not for intercepts and means. Across the five countries, MVPA corresponded positively to global self-esteem and vitality, and global self-esteem and vitality had a high positive correlation. The findings imply that the employed measures have the same meaning across the five countries, but scale scores cannot be compared across countries. The results also provide initial support to the generalisability of the assumption that the positive association of MVPA and well-being is evident across different European populations. [ABSTRACT FROM AUTHOR]

Severe floods triggered by intense precipitation are among the most destructive natural hazards in Alpine environments, frequently causing large financial and societal damage. Potential enhanced flood occurrence due to global climate change would thus increase threat to settlements, infrastructure, and human lives in the affected regions. Yet, projections of intense precipitation exhibit major uncertainties and robust reconstructions of Alpine floods are limited to the instrumental and historical period. Here we present a 2500-year long flood reconstruction for the European Alps, based on dated sedimentary flood deposits from ten lakes in Switzerland. We show that periods with high flood frequency coincide with cool summer temperatures. This wet-cold synchronism suggests enhanced flood occurrence to be triggered by latitudinal shifts of Atlantic and Mediterranean storm tracks. This paleoclimatic perspective reveals natural analogues for varying climate conditions, and thus can contribute to a better understanding and improved projections of weather extremes under climate change. [ABSTRACT FROM AUTHOR]

The recent emphasis in Europe on sustainable energy differs from the North American emphasis on fossil fuels as secure and low-cost energy source. Priorities and policies to meet energy security, sustainability and competitiveness goals started to diverge between the transatlantic partners. New alliances formed to address changing market realities, climate change concerns and access to energy in poorer countries. Shale gas and renewables emerged as potential game changers. Instead of driving the transatlantic energy partnership apart, the pursuit of different alliances, policies and technologies explores complementary pathways to meet common goals. The sustained, public and private commitment in the USA to develop and scale up shale gas technology and Europe's leadership in renewable market transformation provide win-win outcomes for transatlantic as well as global energy cooperation. [ABSTRACT FROM PUBLISHER]

A commercial immunoassay for antibodies to the C6 antigen of Borrelia burgdorferi was evaluated against an IgG in-house ELISA in combination with a Western blot assay to examine 104 samples of serum from 53 healthy Bernese mountain dogs, which were suspected to have a breed predisposition to Lyme borreliosis, and 55 samples from 30 healthy large-breed longhair dogs. The two test methods correlated in 125 (79 per cent) of the samples with an agreement of kappa=0·571 (P<0·001). In comparison with the in-house ELISA in combination with a Western blot, the sensitivity and specificity of the C6 test were 81 per cent and 77 per cent respectively. The agreement between the tests was better with the samples from the Bernese mountain dogs (k=0·681) than with the samples from the control dogs (k=0·347). [ABSTRACT FROM AUTHOR]

We assessed incidence and mortality of colorectal cancer (CRC) at various ages among women and men in 38 European countries. The ages at which defined levels of incidence and mortality were reached varied between 9 and 17 years between countries. This variation requires consideration in the definition of screening guidelines. [ABSTRACT FROM AUTHOR]

The article discusses the incidence of congenital malformation and epigenetic disease in children conceived by assisted reproductive technology (ART) in North America and Europe. Clinical studies and meta-analysis support a 30% to 40% increase in the rate of birth defects among children conceived through ART. Epigenetic changes which are alterations of DNA function without change in the sequence, are established during two critical periods surrounding fertilization and implantation.

Focuses on the evaluation of quality of higher education in Europe and the impact of the Bologna Declaration, signed in June 1999 by European ministers, on the European higher education area. Drawback of the Bologna Declaration; Limitations of national system in evaluating quality of education; Problems faced by European countries in quality assurance and accreditation of higher education.

Abstract The central European countries Germany, Switzerland, Austria, and Luxemburg are confronted with a variety of individual problems concerning health care. After an analysis of problems which are shared by all the countries, these individual aspects are analyzed. In Germany there has been a rapid structural change of psychiatric care in the last 30 years. Although there was a broad movement to deinstitutionalize patients with chronic psychiatric disorders who need long-term care, there are still too many psychiatric beds in large psychiatric hospitals and still missing psychiatric departments in general hospitals in some areas. In Austria the process of deinstitutionalization has been delayed but a general survey of the health care system by the government led to an acceleration of this process in recent years. Due to historical reasons, the mental health care system in Switzerland is not easily comparable with the ones in the other two countries. Deinstitutionalization mainly means reduction of beds in the existing psychiatric hospitals rather than a structural change with a conversion to psychiatric departments in general hospitals. Luxemborg is a good example of the fact that economical factors are not the only aspects influencing development in psychiatric care. Psychiatric care is not community based, centralized, separated from medical care, and the supply system concerning complementary outpatients institutions is underrepresented. Thus, in all the countries the process of deinstitutionalization has still not come to a satisfying level. This is not only due to the economically difficult situation in the recent past. A change can only be expected when the opinions about modern principles of psychiatric care receive more weight in general society and with their political representatives. [ABSTRACT FROM AUTHOR]

Discusses student mobility between Europe and the United States and the long-standing academic ties and flows between European and American universities. Historical information; Developments in Europe that contributed to the academic community's focus on cooperation and mobility and universities within Europe; Stimulation of overall demand for mobility.

Background: Perfluoroalkyl substances (PFAS) are man-made fluorinated chemicals, widely used in various types of consumer products, resulting in their omnipresence in human populations. The aim of this study was to describe current PFAS levels in European teenagers and to investigate the determinants of serum/plasma concentrations in this specific age group.Methods: PFAS concentrations were determined in serum or plasma samples from 1957 teenagers (12-18 years) from 9 European countries as part of the HBM4EU aligned studies (2014-2021). Questionnaire data were post-harmonized by each study and quality checked centrally. Only PFAS with an overall quantification frequency of at least 60% (PFOS, PFOA, PFHxS and PFNA) were included in the analyses. Sociodemographic and lifestyle factors were analysed together with food consumption frequencies to identify determinants of PFAS exposure. The variables study, sex and the highest educational level of household were included as fixed factors in the multivariable linear regression models for all PFAS and each dietary variable was added to the fixed model one by one and for each PFAS separately.Results: The European exposure values for PFAS were reported as geometric means with 95% confidence intervals (CI): PFOS [2.13 μg/L (1.63-2.78)], PFOA ([0.97 μg/L (0.75-1.26)]), PFNA [0.30 μg/L (0.19-0.45)] and PFHxS [0.41 μg/L (0.33-0.52)]. The estimated geometric mean exposure levels were significantly higher in the North and West versus the South and East of Europe. Boys had significantly higher concentrations of the four PFAS compared to girls and significantly higher PFASs concentrations were found in teenagers from households with a higher education level. Consumption of seafood and fish at least 2 times per week was significantly associated with 21% (95% CI: 12-31%) increase in PFOS concentrations and 20% (95% CI: 10-31%) increase in PFNA concentrations as compared to less frequent consumption of seafood and fish. The same trend was observed for PFOA and PFHxS but not statistically significant. Consumption of eggs at least 2 times per week was associated with 11% (95% CI: 2-22%) and 14% (95% CI: 2-27%) increase in PFOS and PFNA concentrations, respectively, as compared to less frequent consumption of eggs. Significantly higher PFOS concentrations were observed for participants consuming offal (14% (95% CI: 3-26%)), the same trend was observed for the other PFAS but not statistically significant. Local food consumption at least 2 times per week was associated with 40% (95% CI: 19-64%) increase in PFOS levels as compared to those consuming local food less frequently.Conclusion: This work provides information about current levels of PFAS in European teenagers and potential dietary sources of exposure to PFAS in European teenagers. These results can be of use for targeted monitoring of PFAS in food. [ABSTRACT FROM AUTHOR]

The European Human Biomonitoring Initiative (HBM4EU) is coordinating and advancing human biomonitoring (HBM). For this purpose, a network of laboratories delivering reliable analytical data on human exposure is fundamental. The analytical comparability and accuracy of laboratories analysing flame retardants (FRs) in serum and urine were investigated by a quality assurance/quality control (QA/QC) scheme comprising interlaboratory comparison investigations (ICIs) and external quality assurance schemes (EQUASs). This paper presents the evaluation process and discusses the results of four ICI/EQUAS rounds performed from 2018 to 2020 for the determination of ten halogenated flame retardants (HFRs) represented by three congeners of polybrominated diphenyl ethers (BDE-47, BDE-153 and BDE-209), two isomers of hexabromocyclododecane (α-HBCD and γ-HBCD), two dechloranes (anti-DP and syn-DP), tetrabromobisphenol A (TBBPA), decabromodiphenylethane (DBDPE), and 2,4,6-tribromophenol (2,4,6-TBP) in serum, and four metabolites of organophosphorus flame retardants (OPFRs) in urine, at two concentration levels. The number of satisfactory results reported by laboratories increased during the four rounds. In the case of HFRs, the scope of the participating laboratories varied substantially (from two to ten) and in most cases did not cover the entire target spectrum of chemicals. The highest participation rate was reached for BDE-47 and BDE-153. The majority of participants achieved more than 70% satisfactory results for these two compounds over all rounds. For other HFRs, the percentage of successful laboratories varied from 44 to 100%. The evaluation of TBBPA, DBDPE, and 2,4,6-TBP was not possible because the number of participating laboratories was too small. Only seven laboratories participated in the ICI/EQUAS scheme for OPFR metabolites and five of them were successful for at least two biomarkers. Nevertheless, the evaluation of laboratory performance using Z-scores in the first three rounds required an alternative approach compared to HFRs because of the small number of participants and the high variability of experts' results. The obtained results within the ICI/EQUAS programme showed a significant core network of comparable European laboratories for HBM of BDE-47, BDE-153, BDE-209, α-HBCD, γ-HBCD, anti-DP, and syn-DP. On the other hand, the data revealed a critically low analytical capacity in Europe for HBM of TBBPA, DBDPE, and 2,4,6-TBP as well as for the OPFR biomarkers. • The HBM4EU QA/QC programme showed the state of play in FR biomonitoring in Europe. • Four rounds of ICI/EQUAS were performed for ten HFRs and four OPFRs biomarkers. • The highest number of successful laboratories was for BDE-47 and BDE-153. • The analytical capacity for HBM of OPFR biomarkers was lower than for HFRs. [ABSTRACT FROM AUTHOR]

[Display omitted] • A wide range of pre- and postnatal environmental exposures affects child behavior. • The exposome includes outdoor, indoor, chemical, lifestyle and social exposures. • Maternal tobacco smoke and car traffic increased behavioural problems in children. • Child sleep, healthy diet and higher family social capital reduced symptoms. • Child exposure to lead, copper, indoor air pollution, increased symptoms. Environmental exposures in early life influence the development of behavioral outcomes in children, but research has not considered multiple exposures. We therefore aimed to investigate the impact of a broad spectrum of pre- and postnatal environmental exposures on child behavior. We used data from the HELIX (Human Early Life Exposome) project, which was based on six longitudinal population-based birth cohorts in Europe. At 6–11 years, children underwent a follow-up to characterize their exposures and assess behavioral problems. We measured 88 prenatal and 123 childhood environmental factors, including outdoor, indoor, chemical, lifestyle and social exposures. Parent-reported behavioral problems included (1) internalizing, (2) externalizing scores, using the child behavior checklist (CBCL), and (3) the Conner's Attention Deficit Hyperactivity Disorder (ADHD) index, all outcomes being discrete raw counts. We applied LASSO penalized negative binomial regression models to identify which exposures were associated with the outcomes, while adjusting for co-exposures. In the 1287 children (mean age 8.0 years), 7.3% had a neuropsychiatric medical diagnosis according to parent's reports. During pregnancy, smoking and car traffic showing the strongest associations (e.g. smoking with ADHD index, aMR:1.31 [1.09; 1.59]) among the 13 exposures selected by LASSO, for at least one of the outcomes. During childhood, longer sleep duration, healthy diet and higher family social capital were associated with reduced scores whereas higher exposure to lead, copper, indoor air pollution, unhealthy diet were associated with increased scores. Unexpected decreases in behavioral scores were found with polychlorinated biphenyls (PCBs) and organophosphate (OP) pesticides. Our systematic exposome approach identified several environmental contaminants and healthy lifestyle habits that may influence behavioral problems in children. Modifying environmental exposures early in life may limit lifetime mental health risk. [ABSTRACT FROM AUTHOR]