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The fear of falling behind has been a driving force of European integration. Historically, Europe's response to the looming angst of declining competitiveness has been more market-creation, not market-direction. Recently, however, Europe has – in the name of safeguarding Europe's technological sovereignty – taken on a much more active role in directing economic activity towards sectors and technologies deemed geopolitically or geoeconomically important. In this paper, we attempt to explain this 'geo-dirigiste' turn. We reconstruct the evolution of EU industrial policy through the lens of Europe's fear of falling behind, drawing not only on primary (including archival) and secondary sources, but also on original interviews and deep transfer learning applied to an original dataset of 66.548 documents. Focusing on Europe's changing technological and geopolitical context, its coalitional underpinnings, and the role of ideational politics, we document and explain the historic shift away from market-creation and towards supranational market-direction in EU industrial policy. [ABSTRACT FROM AUTHOR]

Background: Floodplains are biodiversity hotspots and provide numerous ecosystem services. In recent decades, however, 70–90% of Europe's floodplains have been structurally degraded. Accordingly, many (inter-)national programs aim to restore and protect floodplain ecosystems. The success of such measures also depends on the chemical contamination, especially of floodplain soils and sediments, which serve as sinks and sources for a variety of pollutants. In this study, we assess the current ecotoxicological status of a floodplain restoration site along the Main River (Frankfurt am Main, Germany) and estimate its development potential with respect to the influence of a local industrial plant and potential legacy contaminations. We therefore use in vitro effect-based methods (EBMs) testing for baseline toxicity, mutagenicity, dioxin-like and estrogenic activities, coupled with chemical analysis. Results: Of all water bodies analyzed, the overall toxicity was highest in two flood depressions. In the respective water phase, estrogenic activities exceeded the environmental quality standard and sediment samples were positive for all tested endpoints. Chemical analysis of these sediments revealed high concentrations of polycyclic aromatic hydrocarbons. Soil samples from frequently flooded areas showed the highest mutagenic potential for both frameshift and point mutations with and without metabolic activation. The industrial effluent showed baseline toxic, mutagenic, and dioxin-like activities, that were highly diluted in the Main River. In turn, most of the sediment samples downstream of the industrial discharge showed significantly elevated baseline toxic, estrogenic and dioxin-like activities as well as increased chemical contamination. Conclusion: Based on the results of this study, we rate the overall ecotoxicological status of a recently established tributary and groundwater-fed ponds as good, and identified two flood depressions near the Main River as hot spots of contamination. We assume that the observed mutagenicity in the floodplain soils is related to legacy contaminations from former aniline and azo dye production. In terms of the development potential of the floodplain restoration site, we emphasize considering the remobilization of pollutants from these soils and suppose that, in the long term, pollution of the Main River and the local industrial plant may negatively impact sediment quality in its tributaries. With this study, we confirmed the utility of in vitro EBMs for identifying chemically and ecotoxicologically relevant sites. [ABSTRACT FROM AUTHOR]

Studies often find gender differences in social networks in later life, but are these findings universal, or do they differ in various cultural contexts? To address this research gap, the current study examines the association between gender differences in social relationships and country-level gender-role attitudes. We combined data from the Survey of Health, Ageing and Retirement in Europe (SHARE) of individuals aged 50 years and older with country-level data on gender-role attitudes from the European Values Survey (EVS) for 15 European countries. We estimated a series of multivariate hierarchical regression models that predicted the size of the personal social network, its emotional closeness, and the proportion of the spouse, children, and friends in the network. The results indicated gender differences in social network characteristics. Women reported larger social networks and were more likely to have larger proportions of children and friends but smaller proportions of the spouse in their social networks. The magnitude of gender differences was associated with country-level gender-role attitudes. In countries with more egalitarian gender-role attitudes, women had larger networks with a larger proportion of friends compared to men. In countries with more traditional gender-role attitudes, women had larger proportions of their children and spouse in their social networks and had emotionally closer networks. Our findings suggest that the societal context and opportunity structures for social interactions play an important role in shaping the structure of women's and men's social relationships in later life. • We study the association between gender differences in social relationships and country-level gender-role attitudes. • Women had larger social networks, a larger share of children and friends but a smaller share of the spouse in the networks. • In countries with more egalitarian gender-role attitudes, women had larger networks with a larger share of friends. • In countries with more traditional gender-roles, women had a larger share of their children and spouse in their networks. • Our findings suggest that the societal context plays a role in shaping women's and men's late-life social relationships. [ABSTRACT FROM AUTHOR]

Within Europe's regulatory state, industrial policy has largely remained within national governments' remit. Yet, a plethora of new supra- and cross-national industrial policy initiatives have recently emerged whereby the Commission proactively engages in pan-European activities to foster innovation and economic development. This article brings the 'Developmental Network States' (DNS) literature into dialogue with EU integration scholarship to explain both the timing of EU industrial policy's rise since the mid-2010s and the variation in forms of EU integration of different industrial policy functions. Our analysis suggests that the Commission increasingly operates four major developmental functions akin to DNSs and aimed at promoting and protecting the single market. Neofunctionalist theories of EU integration explain these momentous shifts. The timing behind the rise of EU industrial policy is best explained as an interplay of functional, cultivated, and political spillovers, driven especially by the Franco-German realignment on pro-EU industrial policy positions since 2016. Variation in the governance forms of integrated EU industrial policy functions is instead explained in terms of the degree of pre-existing integration of extant policies, the low vs high politics nature of the policy domain and the types of externalities attached to the specific policy area. [ABSTRACT FROM AUTHOR]

Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) is associated with significant side effects. With the transition of PCa from a foudroyant course to a chronic disease, managing these side effects has become increasingly important. There is growing evidence that nutritional changes and physical activity are beneficial in these patients. Here we examine the impact of written patient information on the physical activity and dietary habits of PCa patients receiving ADT and behaviour changes between baseline and 1 year, in the open-label, non-interventional LEAN study. In total, 959 patients with advanced hormone-sensitive PCa requiring ADT with the Leuprorelin Sandoz® implant were included from January 2014 to July 2015 and followed for ≥ 12 months. At the start of the study, urologists received a questionnaire concerning the written information provided to patients regarding their disease, patient advocacy groups, diet and physical activity. Patients received a questionnaire on their dietary habits and physical activity at the start and end of the study. Urologists from 147 study centres and 540 patients responded to the questionnaires. While 69 % of these patients received disease-specific information, only 30 % and 17 % received information regarding nutrition and physical activity, respectively. The majority of urologists estimate that their patients rarely or never follow guidance on nutrition or physical activity, yet > 90 % of patients indicate they would make use of this information, if provided. Few patients showed behavioural changes between baseline and 1 year without evident differences between patients that received information and those that did not. [ABSTRACT FROM AUTHOR]

Aim: The burden of abdominal wound failure can be profound. Recent clinical guidelines have highlighted the heterogeneity of laparotomy closure techniques. The aim of this study was to investigate current midline closure techniques and practices for prevention of surgical site infection (SSI). Method: An online survey was distributed in 2021 among the membership of the European Society of Coloproctology and its partner societies. Surgeons were asked to provide information on how they would close the abdominal wall in three specific clinical scenarios and on SSI prevention practices. Results: A total of 561 consultants and trainee surgeons participated in the survey, mainly from Europe (n = 375, 66.8%). Of these, 60.6% identified themselves as colorectal surgeons and 39.4% as general surgeons. The majority used polydioxanone for fascial closure, with small bite techniques predominating in clean‐contaminated cases (74.5%, n = 418). No significant differences were found between consultants and trainee surgeons. For SSI prevention, more surgeons preferred the use of mechanical bowel preparation (MBP) alone over MBP and oral antibiotics combined. Most surgeons preferred 2% alcoholic chlorhexidine (68.4%) or aqueous povidone‐iodine (61.1%) for skin preparation. The majority did not use triclosan‐coated sutures (73.3%) or preoperative warming of the wound site (78.5%), irrespective of level of training or European/non‐European practice. Conclusion: Abdominal wound closure technique and SSI prevention strategies vary widely between surgeons. There is little evidence of a risk‐stratified approach to wound closure materials or techniques, with most surgeons using the same strategy for all patient scenarios. Harmonization of practice and the limitation of outlying techniques might result in better outcomes for patients and provide a stable platform for the introduction and evaluation of further potential improvements. [ABSTRACT FROM AUTHOR]

For decades, the EU's trade policy has been centred around open(ing) markets. Why, then, has the EU recently embraced open strategic autonomy as the conceptual cornerstone of its renewed trade policy? In this article, we argue that this move away from neoliberalism has to be understood against the background of a changing global environment. The geopoliticization of trade in particular has changed the Commission's view about how to best serve European interests (and values) but also provided an opening for neo‐mercantilist and socially oriented actors to challenge Europe's embedded neoliberal compromise. Using document analysis, interviews and discourse network analysis, we show how the Commission used open strategic autonomy as a coalition magnet to mobilize support for its new doctrine of qualified openness. Our paper contributes to understanding the ideational and coalitional politics behind the recent evolution of EU trade policy as well as broader debates around European autonomy and sovereignty. [ABSTRACT FROM AUTHOR]

Background: In light of rapid population ageing across Europe, maintaining a high level of wellbeing in old age is a priority for social policy. Research on macro-level influences on wellbeing in the older population is rare, especially regarding heterogeneous effects within different groups, such as persons with and without health limitations. Objective: The purpose of this study is to shed light on the following questions: Is the regional availability of care infrastructure crucial for the wellbeing in later life? If so, does the relevance of care infrastructure differ depending on an individual's health status? Methods: Data were drawn from wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) matched with data on the number of long-term care (LTC) beds on the regional level. We estimated multilevel regression models, including a cross-level interaction between individual health needs and regional LTC beds. Results: Our analyses show that the number of LTC beds is related to the wellbeing, as measured by overall life satisfaction, in the population aged 50 + years. The association is more pronounced for individuals with health limitations who might be in need of such infrastructure. Conclusions: Communities and local governments should ensure the necessary infrastructure for older individuals in need of care and help across different regions. The availability of formal care services may be perceived a "safety net" and thus improve wellbeing, but future studies need to investigate the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Simple Summary: Previously published data suggest anesthesiologic interventions during the perioperative period might play a major role in determining patient outcome after tumor surgery. However, only scarce data are available regarding this question in pediatric patients. This retrospective, multicenter study aimed to assess such a potential effect in pediatric patients undergoing cancer surgery for nephroblastoma. Data from 65 patients were analyzed. Intraoperative administration of erythrocyte concentrates was associated with a reduction in recurrence-free survival. The use of regional anesthesia or the choice of anesthetic had no effect. However, regional anesthesia was associated with fewer ICU transfers, a shortened hospital stay and a decreased postoperative neutrophil-to-lymphocyte ratio. The current study provides the first evidence for a possible association between anesthesia and outcome after pediatric cancer surgery. Children undergoing tumor surgery might therefore benefit from an optimized anesthetic regimen—including the use of regional anesthesia—and more restrictive blood transfusion management. Background: Recent data suggest that anesthesiologic interventions—e.g., the choice of the anesthetic regimen or the administration of blood products—might play a major role in determining outcome after tumor surgery. In contrast to adult patients, only limited data are available regarding the potential association of anesthesia and outcome in pediatric cancer patients. Methods: A retrospective multicenter study assessing data from pediatric patients (0–18 years of age) undergoing surgery for nephroblastoma between 2004 and 2018 was conducted at three academic centers in Europe. Overall and recurrence-free survival were the primary outcomes of the study and were evaluated for a potential impact of intraoperative administration of erythrocyte concentrates, the use of regional anesthesia and the choice of the anesthetic regimen. The length of stay on the intensive care unit, the time to hospital discharge after surgery and blood neutrophil-to-lymphocyte ratio were defined as secondary outcomes. Results: In total, data from 65 patients were analyzed. Intraoperative administration of erythrocyte concentrates was associated with a reduction in recurrence-free survival (hazard ratio (HR) 7.59, 95% confidence interval (CI) 1.36–42.2, p = 0.004), whereas overall survival (HR 5.37, 95% CI 0.42–68.4, p = 0.124) was not affected. The use of regional anesthesia and the choice of anesthetic used for maintenance of anesthesia did not demonstrate an effect on the primary outcomes. It was, however, associated with fewer ICU transfers, a shortened time to discharge and a decreased postoperative neutrophil-to-lymphocyte ratio. Conclusions: The current study provides the first evidence for a possible association between blood transfusion as well as anesthesiologic interventions and outcome after pediatric cancer surgery. [ABSTRACT FROM AUTHOR]

In 2018, an upsurge in echovirus 30 (E30) infections was reported in Europe. We conducted a large-scale epidemiologic and evolutionary study of 1,329 E30 strains collected in 22 countries in Europe during 2016-2018. Most E30 cases affected persons 0-4 years of age (29%) and 25-34 years of age (27%). Sequences were divided into 6 genetic clades (G1-G6). Most (53%) sequences belonged to G1, followed by G6 (23%), G2 (17%), G4 (4%), G3 (0.3%), and G5 (0.2%). Each clade encompassed unique individual recombinant forms; G1 and G4 displayed >2 unique recombinant forms. Rapid turnover of new clades and recombinant forms occurred over time. Clades G1 and G6 dominated in 2018, suggesting the E30 upsurge was caused by emergence of 2 distinct clades circulating in Europe. Investigation into the mechanisms behind the rapid turnover of E30 is crucial for clarifying the epidemiology and evolution of these enterovirus infections. [ABSTRACT FROM AUTHOR]

Objective: This study analyses the gendered experiences of widowhood and its relation to depressive symptoms in four European regions. A special focus lies on the question whether loneliness and reduced financial contribute to the detrimental effect of widowhood on mental health.Methods: Using waves 5,6 and 7 of the Survey of Health. Ageing and Retirement in Europe (SHARE), this study estimates fixed-effects linear regression models for the effect of widowhood on depressive symptoms with and without adjustment for potential mediating factors.Results: There were no gender differences in the mental health consequences of widowhood irrespective of the regional context. Whereas loneliness was a major pathway through which widowhood exerts its negative consequences on mental health, reduced financial resources did not play a substiantial role. Moreover, the magnitude of the widowhood effect on depressive symptoms differed between European regions with stronger increases in Southern Europe. These regional differences were attenuated when accounting for inequalities in financial resources and loneliness.Discussion: The findings support Attachment Theory, which postulates that it's mainly the loss of such an emotionally strong tie as one's spouse that leads to psychological distress following widowhood. Moreover, one can conclude that some contexts in Europe provide conditions that buffer the negative effect of widowhood on mental health at least to some extent. [ABSTRACT FROM AUTHOR]

We provide a systematic country and age group comparison of the gender gap in several generic health indicators and more specific morbidity outcomes. Using data from the Survey of Health, Ageing and Retirement (SHARE), we examined the gender gap in the prevalence of poor self-rated health, chronic health conditions, activity limitations, multimorbidity, pain, heart attacks, diabetes, and depression in three age groups (50–64, 65–79, and 80+) based on linear probability models with and without adjustment for covariates. While women were typically disadvantaged regarding poor self-rated health, chronic health conditions, activity limitations, multimorbidity, pain, and depression, men had a higher prevalence of heart attacks and diabetes. However, the gender gap's magnitude and sometimes even its direction varied considerably with some age trends apparent. Regarding some health indicators, the gender gap tended to be higher in Southern and Eastern Europe than in Western and Northern Europe. All in all, the presence of a gender health gap cannot be regarded as a universal finding as the gap tended to widen, narrow or even reverse with age depending on the indicator and country. [ABSTRACT FROM AUTHOR]

Digitization of medicine requires systematic handling of the increasing amount of health data to improve medical diagnosis. In this context, the integration of the versatile diagnostic information, e.g., from anamnesis, imaging, histopathology, and clinical chemistry, and its comprehensive analysis by artificial intelligence (AI)-based tools is expected to improve diagnostic precision and the therapeutic conduct. However, the complex medical environment poses a major obstacle to the translation of integrated diagnostics into clinical research and routine. There is a high need to address aspects like data privacy, data integration, interoperability standards, appropriate IT infrastructure, and education of staff. Besides this, a plethora of technical, political, and ethical challenges exists. This is complicated by the high diversity of approaches across Europe. Thus, we here provide insights into current international activities on the way to digital comprehensive diagnostics. This includes a technical view on challenges and solutions for comprehensive diagnostics in terms of data integration and analysis. Current data communications standards and common IT solutions that are in place in hospitals are reported. Furthermore, the international hospital digitalization scoring and the European funding situation were analyzed. In addition, the regional activities in radiomics and the related publication trends are discussed. Our findings show that prerequisites for comprehensive diagnostics have not yet been sufficiently established throughout Europe. The manifold activities are characterized by a heterogeneous digitization progress and they are driven by national efforts. This emphasizes the importance of clear governance, concerted investments, and cooperation at various levels in the health systems.Key Points• Europe is characterized by heterogeneity in its digitization progress with predominantly national efforts. Infrastructural prerequisites for comprehensive diagnostics are not given and not sufficiently funded throughout Europe, which is particularly true for data integration.• The clinical establishment of comprehensive diagnostics demands for a clear governance, significant investments, and cooperation at various levels in the healthcare systems.• While comprehensive diagnostics is on its way, concerted efforts should be taken in Europe to get consensus concerning interoperability and standards, security, and privacy as well as ethical and legal concerns. [ABSTRACT FROM AUTHOR]

Severe tricuspid regurgitation (TR) is known to be associated with poor quality of life and increased risk of death when left untreated. We sought to report the 1-year clinical outcomes of subjects treated by tricuspid transcatheter edge-to-edge repair (TEER) with the TriClip system (Abbott Cardiovascular) in a contemporary real-world setting. The bRIGHT (An Observational Real-World Study Evaluating Severe Tricuspid Regurgitation Patients Treated With the Abbott TriClip Device) postapproval study is a prospective, single-arm, open-label, multicenter postmarket registry conducted at 26 sites in Europe, with central event adjudication and echocardiographic core-laboratory assessment. Enrolled subjects (n = 511) were elderly (79 ± 7 years) with significant comorbidities. A total of 88% had baseline massive or torrential TR, and 80% of subjects were in NYHA functional class III/IV. TR was reduced to moderate or less in 81% at 1 year. Significant improvements in NYHA functional class (21% to 75% I/II, P < 0.0001) and Kansas City Cardiomyopathy Questionnaire (KCCQ) score (19 ± 26-point improvement, P <0.0001) were observed at 1 year. One-year mortality was significantly lower in subjects who achieved moderate or lower TR at 30 days; however, there was no difference in mortality among subjects who achieved moderate, mild, or trace TR at 30 days. In addition to TR reduction at 30 days, baseline serum creatinine and baseline right ventricular tricuspid annular plane systolic excursion (RV TAPSE) were independently associated with mortality at 1 year (OR: 2.169; 95% CI: 1.494-3.147; P < 0.0001; OR: 0.636; 95% CI: 0.415-0.974; P = 0.0375). Mortality was not associated with baseline TR grade or with center volume. Tricuspid TEER using the TriClip system was safe and effective through 1 year for subjects with significant TR and advanced disease in a diverse real-world population. (An Observational Real-world Study Evaluating Severe Tricuspid Regurgitation Patients Treated With the Abbott TriClip Device [bRIGHT]; NCT04483089) [ABSTRACT FROM AUTHOR]

Highlights • Study of gendered patterns of depression in Europe's population aged 60–85 years. • Varying magnitude of the gender gap and depression prevalence in both women and men. • Part of the gender gap can be traced back to the unequal exposure to risk factors. • Socio-economic factors more important than psychosocial risks in some countries. • No differential vulnerability in countries with traditional gender ideologies. Abstract Background Few studies consider multiple pathways for explaining the gendered patterns of depression in Europe's aged population, although ageing is often associated with an increased exposure to risk factors for depression, and the relevance of these risk factors is likely to differ between countries. Methods Based on the Survey of Health, Ageing and Retirement in Europe (SHARE), we assess the relevance of gender inequalities in the exposure to psychosocial, socio-economic, and health-related factors for explaining the gender gap in depression. Further, we investigate the association between depressive symptoms and these explanatory variables by gender and analyse whether their relevance differs between countries. Results Both the prevalence of depression by gender and the magnitude of the gender gap were low in Northern Europe and rather high in Southern Europe. Part of the gender gap was explained by psychosocial, socio-economic, and health-related factors but significant gender differences remained. Health-related factors were of outstanding importance for explaining within-country variation in depressive symptoms for both women and men. With regard to psychosocial and socio-economic factors, the results were less clear. Conclusion The assessment of gender inequalities in depression and their determinants within different social policy contexts enables evidence-based interventions to reduce the gender gap and ensure high quality of life for older men and women. To that end, the reduction of health-related risk factors seems to be of utmost importance in all European countries, whereas interventions in the area of socio-economic and psychosocial risk factors should be gender- and context-specific. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Pericardial effusion/tamponade (PE/PT) is a rare but serious complication following left atrial appendage closure (LAAC). It may be speculated that LAA contraction during sinus rhythm (SR) exerts mechanical force on the device that eventually leads to PE. We sought to determine the incidence and predictors of PE following LAAC using Watchman with special emphasis on the underlying heart rhythm during implant. Methods and results: From 47 centers in 13 European countries 1,020 patients underwent LAAC and data on baseline rhythm were available from 1,010 patients (mean age 73 ± 9 years, 60% male, median CHA2DS2‐VASc = 4). Data were collected via electronic case report forms. A Cox proportional hazard model was calculated adjusting for multiple variables: age, gender, number of recaptures, and device oversizing. During implant, 41% and 59% of patients were in SR and atrial fibrillation (AF), respectively. PE/PT rate was significantly lower in patients implanted during AF at day 30 postimplant (n = 1; 0.2% vs. n = 6; 1.5%; P = 0.02). No PE requiring intervention occurred in the AF group compared to 5 events (1.2%) in the SR group (P = 0.01). While univariate analysis identified SR and gender as predictors for PE/tamponade, multivariate analysis only showed a statistical trend for both variables. Conclusion: The overall incidence of PE/PT was very low after LAAC using Watchman. Although SR was not identified as an independent predictor of PE/PT, all events requiring intervention occurred in patients with SR. It may be advisable to perform an extended echocardiographic follow‐up in that patient population. [ABSTRACT FROM AUTHOR]

Information on the Holocaust in the Borderlands: Interethnic Relations and the Dynamics of Violence in Occupied Eastern Europe, a conference that was held at the Institut für Zeitgeschichte in Munich, Germany from February 7-9, 2018 is presented. Topics discussed include political history of Europe, Europe in World War II and Holocaust.

While the energy generation system is changing towards the use of more renewable energies, the problem of how to deal with fluctuating energy supply is increasing. Smart appliances in households are often referenced as one possible solution, as their operation may be shifted in time and, thus, used to balance an unstable energy supply. The potential of such appliances has been studied to date mainly in pilot installations with a very limited number of participants or by making assumptions on what might be possible. With this work, a semi-representative approach for 12 European countries was used to assess actual consumer habits for the use of washing machines and dishwashers which then could be used to calculate average load profiles for those appliances depending on the time of the day. Using these profiles, it is strait forward to calculate how much load may be shifted by those appliances in a demand response application. This allows aggregators or energy utilities to assign clear financial benefits to the shifting potential of those appliances. Consumers use the shifting of appliance operation already today for various reasons. Investigating these reasons allows to learn already a lot about the flexibility of consumers. [ABSTRACT FROM AUTHOR]

This paper asks what insights the literature provides on divergence versus convergence of innovation paths in Europe and Asia. It contrasts the abundant literature on determinants of innovation paths with the scarcity of studies that are explicitly comparative across countries or continents. Implicit conclusions however emerge from several lines of work including evolutionary perspectives which stress differences in national conditions, and other perspectives which stress latecomer and globalisation effects. This paper distils and draws together the main conclusions on why innovation paths can be expected to diverge or converge. Its contribution lies in spelling out and bringing together implicit and explicit insights from a wide range of literatures. It also provides an analytical backdrop for some of the other papers in this special issue of Science and Public Policy which provide comparative empirical analyses of low carbon innovation paths. [ABSTRACT FROM AUTHOR]

Background: Informal caregivers are essential figures for maintaining frail elderly at home. Providing informal care can affect the informal caregivers' physical and psychological health and labour market participation capabilities. They need support to prevent caregiver burden. A variety of existing support measures can help the caregiver care for the elderly at home, but with some limitations. The objective of this review was to explore the experiences of informal caregivers caring for elderly in the community with the use of supportive policy measures in Belgium and compare these to the experiences in other European countries.Methods: An empirical qualitative case study research was conducted in five European countries (Belgium, The Netherlands, Luxembourg, France and Germany). Semi-structured interviews were conducted with informal caregivers and their dependent elderly. Interview data from the different cases were analysed. In particular data from Belgium was compared to data from the cases abroad.Results: Formal services (e.g. home care) were reported to have the largest impact on allowing the caregiver to care for the dependent elderly at home. One of the key issues in Belgium is the lack of timely access to reliable information about formal and informal services in order to proactively support the informal caregiver. Compared to the other countries, informal caregivers in Belgium expressed more difficulties in accessing support measures and navigating through the health system. In the other countries information seemed to be given more timely when home care was provided via care packages.Conclusion: To support the informal caregiver, who is the key person to support the frail elderly, fragmentation of information regarding supportive policy measures is an important issue of concern. [ABSTRACT FROM AUTHOR]

Identifying the geological and geographical origin of lithic raw materials is critical to effectively address prehistoric forager raw material economies and mobility strategies. Currently, Paleolithic archaeology in Belgium lacks a systematic sourcing strategy to effectively substantiate detailed interpretations of prehistoric hunter-gatherer behavioral change across time and space. This pilot study evaluates the potential to 'fingerprint' flint from the Mons Basin, western Belgium, using the laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) technique and a multivariate statistical analysis of 87 geological samples and 39 Gravettian period chipped stone artifacts. We reappraise two hypotheses raised by previous scholars based on visual raw material identification: (1) the Gravettian occupants of Maisières-Canal supplied themselves with 'black flint' from one single source; (2) the sites Rhens and Koblenz-Metternich yielded artifacts indicative of long-distance transfer of western Belgian flint into the German Rhineland, ca. 260 km from the primary source area. Our results demonstrate the validity of LA-ICP-MS data with flint and compositional data analysis for fingerprinting discrete geological formations from the Mons Basin. We suggest multiple source provisioning for Maisières-Canal. Geochemical characterization of other potential flint sources is required to validate the long-distance transfer hypothesis of western Belgian 'black flint' into the German Rhineland. [ABSTRACT FROM AUTHOR]

Washing machines in Europe have to comply with regulations fixed in the Energy Label and Ecodesign legislation. They require declaration of the specific consumption and performance values which are deduced as average values from tests on three different treatments. Detailed data about the individual tests are normally not available to the public but just kept in the technical documentation of the manufacturer. Within the ATLETE II project 62 washing machines were measured to verify their compliance with the declared value. As this was an EU funded project all data are now also publicly available. This set of detailed measured data was used first to get a deeper inside into the performances and consumption values of the specific parameters and second to see how different the approaches are between manufacturers to achieve the same or similar declaration values. Additionally it could be shown that there are significant differences between those programmes used for the declaration and those offered as "normal" programmes to the consumer. [ABSTRACT FROM AUTHOR]

Research utilizing human tissue and its removal at post-mortem has given rise to many controversies in the media and posed many dilemmas in the fields of law and ethics. The law often lacks clear instructions and unambiguous guidelines. The absence of a harmonized international legislation with regard to post-mortem medical procedures and donation of tissue and organs contributes to the complexity of the issue. Therefore, within the BrainNet Europe (BNE) consortium, a consortium of 19 European brain banks, we drafted an ethical Code of Conduct for brain banking that covers basic legal rules and bioethical principles involved in brain banking. Sources include laws, regulations and guidelines (Declarations, Conventions, Recommendations, Guidelines and Directives) issued by international key organizations, such as the Council of Europe, European Commission, World Medical Association and World Health Organization. The Code of Conduct addresses fundamental topics as the rights of the persons donating their tissue, the obligations of the brain bank with regard to respect and observance of such rights, informed consent, confidentiality, protection of personal data, collections of human biological material and their management, and transparency and accountability within the organization of a brain bank. The Code of Conduct for brain banking is being adopted by the BNE network prior to being enshrined in official legislation for brain banking in Europe and beyond. [ABSTRACT FROM AUTHOR]

Severe tricuspid regurgitation (TR) is known to be associated with substantial morbidity and mortality. The authors sought to study the acute outcomes of subjects treated by tricuspid transcatheter edge-to-edge repair with the TriClip system (Abbott) in a contemporary, real-world setting. The bRIGHT (An Observational Real-World Study Evaluating Severe Tricuspid Regurgitation Patients Treated With the Abbott TriClip™ Device) postapproval study is a prospective, single-arm, open-label, multicenter, postmarket registry conducted at 26 sites in Europe. Echocardiographic assessment was performed at a core laboratory. Enrolled subjects were elderly (79 ± 7 years of age) with significant comorbidities. Eighty-eight percent had baseline massive or torrential TR, and 80% of subjects were in NYHA functional class III or IV. Successful device implantation occurred in 99% of subjects, and TR was reduced to ≤moderate at 30 days in 77%. Associated significant improvements in NYHA functional class (I/II, 20% to 79%; P < 0.0001) and Kansas City Cardiomyopathy Questionnaire score (19 ± 23 points improvement; P < 0.0001) were observed at 30 days. With baseline TR grade removed as a variable, smaller right atrial volume and smaller tethering distance at baseline were independent predictors of TR reduction to ≤moderate at discharge (OR: 0.679; 95% CI: 0.537-0.858; P = 0.0012; OR: 0.722; 95% CI: 0.564-0.924; P = 0.0097). Fourteen subjects (2.5%) experienced a major adverse event at 30 days. Transcatheter tricuspid valve repair was found to be safe and effective in treating significant TR in a diverse, real-world population. (An Observational Real-World Study Evaluating Severe Tricuspid Regurgitation Patients Treated With the Abbott TriClip™ Device [bRIGHT]; NCT04483089) [Display omitted] [ABSTRACT FROM AUTHOR]

Laundry washing has been extensively studied; laundry drying has been much less investigated. Nevertheless, there are indications that the drying process takes considerably more energy than the washing process. It is, therefore, the task of this study to gather European-wide consumer behaviour on washing and drying practices and to use this knowledge to estimate the energy consumption for the washing and drying processes. With an online questionnaire answered by over 2,000 households, the washing and drying behaviour of European consumers is analysed. The results also confirm the relevance of the drying process' energy consumption for countries where the drying is normally seen as 'done by the sun'! [ABSTRACT FROM AUTHOR]

Since the end of the last glacial period, European Mediterranean mountains have provided shelter for numerous species of Eurosiberian and Boreal origin. Many of these species, surviving at the southern limit of their range in Europe and surrounded by Mediterranean ones, are relatively intolerant to summer drought and are in grave danger of loss, as a result of increasingly long and frequent droughts in this region. This is the case of the Scots pine ( Pinus sylvestris) and the Austrian pine ( Pinus nigra ssp. salzmannii) which are found on Central Iberian Peninsula at the edge of their natural range. We used a tree ring network of these two species to reconstruct past variations in summer rainfall. The reconstruction, based upon a tree ring composite chronology of the species, dates back to 1570 (adjusted R = 0.49, P < 0.000001) and captures interannual to decadal scale variability in summer precipitation. We studied the spatial representativeness of the rainfall patterns and described the occurrence rate of extremes of this precipitation. To identify associations between macroclimatic factors and tree radial growth, we employed a principal component analysis to calculate the resultant of the relationship between the growth data of both species, using this resultant as a dependent variable of a multiple regression whose independent variables are monthly mean temperature and precipitation from the average records. Spatial correlation patterns between instrumental precipitation datasets for southern Europe and reconstructed values for the 1950-1992 period indicate that the reconstruction captures the regional signal of drought variability in the study region (the origin of this precipitation is convective: thermal low pressure zones induced in the inland northeastern areas of the Iberian Peninsula). There is a clear increase in the recurrence of extreme dry events as from the beginning of twentieth century and an abrupt change to drier conditions. There appears to be a tendency toward recurrent exceptionally dry summers, which could involve a significant change for the Eurosiberian refugee species. [ABSTRACT FROM AUTHOR]

Many researchers have investigated how barriers to technology integration affect the use of digital technologies in teaching and learning. However, the results have varied across educational contexts and countries. Large-scale assessment studies have described barriers only on a descriptive level instead of analyzing the effects of barriers on actual indicators of technology integration, such as technology use. Therefore, this study investigated the effects of barriers on technology use through the lens of the "will, skill, tool" model (WST model) in different European countries while taking the countries' technological development level into account. A regression analysis showed that barriers had only a minor impact on the frequency of technology use in the classroom in the large majority of countries. In accordance with theoretical expectations, we found country-specific patterns, with a higher negative impact of technological barriers in less technologically developed countries and teacher-belief related barriers prevalent in developed countries. These findings may help policy makers identify needed interventions in different contexts. • Barriers can be categorized according to the "will, skill, tool" model. • We investigated the impact of barriers to technology use in the classroom. • Barriers barely affected students' and teachers' technology use in the classroom. • Barriers' effects were moderated by countries' levels of technological development. [ABSTRACT FROM AUTHOR]

Based on evidence from nine countries (UK, Belgium, France, Germany, Italy, Poland, Croatia, Slovenia, and Ireland), this special issue analyses the fabrics of farm tourism in Europe. It identifies two main development trends: on one hand, a small scale and dispersed activities, at the other hand a product in response to tourist market demand. A brief overview of existing farm tourism practices in the European rural areas indicated an interesting interface between the forms and dimension of farm tourism embeddedness in local environment and at the same time, the ways and range of internationalization of farm tourism business [ABSTRACT FROM AUTHOR]

Cancer rehabilitation is a rapidly emerging and evolving medical field in both Europe and the United States, in large part because of increases in the number of cancer survivors. Although few argue with the need to restore function and quality of life to patients affected by cancer and its treatments, differences exist between European countries with regard to the funding, accessibility, and even the definition of cancer rehabilitation services. In the United States, there is tremendous variability in the provision of rehabilitation services resulting from a variety of factors, including a lack of highly trained cancer rehabilitation physicians and therapists as well as a lack of comprehensive cancer rehabilitation programs, even at the majority of top cancer centers. Although studies evaluating the effectiveness of rehabilitation programs in the cancer setting, particularly exercise, have influenced clinical decision-making in both Europe and the United States for some time, this emerging evidence base also is now starting to influence guideline and policy making. Coordinated research efforts are essential to establish a robust framework to support future investigation and establish shared initiatives. Determining the best way forward for cancer survivors will require investment in large-scale prospective cohort studies that sufficiently describe their rehabilitation needs through the continuum of the survivorship experience. Cancer 2013;119(11 suppl):2170-8. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

Despite the large-scale investments of both China and the EU in climate-change mitigation and renewable-energy promotion, the prevailing view on China-EU relations is one of conflict rather than cooperation. In order to evaluate the prospects of cooperation between China and the EU in these policy fields, empirical research has to go beyond simplistic narratives. This paper suggests a conceptual apparatus that will help researchers better understand the complexities of the real world. The relevant actors operate at different levels and in the public and private sectors. The main message of the paper is that combining the multilevel governance and value-chain approaches helps clarify the multiple relationships between these actors [ABSTRACT FROM AUTHOR]

The transition from hunting and gathering to agriculture in Europe is associated with demographic changes that may have shifted the human gene pool of the region as a result of an influx of Neolithic farmers from the Near East. However, the genetic composition of populations after the earliest Neolithic, when a diverse mosaic of societies that had been fully engaged in agriculture for some time appeared in central Europe, is poorly known. At this period during the Late Neolithic (ca. 2,800-2,000 BC), regionally distinctive burial patterns associated with two different cultural groups emerge, Bell Beaker and Corded Ware, and may reflect differences in how these societies were organized. Ancient DNA analyses of human remains from the Late Neolithic Bell Beaker site of Kromsdorf, Germany showed distinct mitochondrial haplotypes for six individuals, which were classified under the haplogroups I1, K1, T1, U2, U5, and W5, and two males were identified as belonging to the Y haplogroup R1b. In contrast to other Late Neolithic societies in Europe emphasizing maintenance of biological relatedness in mortuary contexts, the diversity of maternal haplotypes evident at Kromsdorf suggests that burial practices of Bell Beaker communities operated outside of social norms based on shared maternal lineages. Furthermore, our data, along with those from previous studies, indicate that modern U5-lineages may have received little, if any, contribution from the Mesolithic or Neolithic mitochondrial gene pool. Am J Phys Anthropol 2012. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The genetic and demographic impact of European contact with Native Americans has remained unclear despite recent interest. Whereas archeological and historical records indicate that European contact resulted in widespread mortality from various sources, genetic studies have found little evidence of a recent contraction in Native American population size. In this study we use a large dataset including both ancient and contemporary mitochondrial DNA to construct a high-resolution portrait of the Holocene and late Pleistocene population size of indigenous Americans. Our reconstruction suggests that Native Americans suffered a significant, although transient, contraction in population size some 500 y before the present, during which female effective size was reduced by ~50%. These results support analyses of historical records indicating that European colonization induced widespread mortality among indigenous Americans. [ABSTRACT FROM AUTHOR]

- The Siljan impact structure in Sweden is the largest confirmed impact structure in Western Europe. Despite this, the structure has been poorly studied in the past, and detailed studies of shock metamorphic features in the target lithologies are missing. Here, we present the results of a detailed systematic search for shock metamorphic features in quartz grains from 73 sampled localities at Siljan. At 21 localities from an area approximately 20 km in diameter located centrally in the structure, the orientations of 2851 planar deformation feature sets in 1179 quartz grains were measured. Observations of shatter cones outside of the zone with shocked quartz extend the total shocked area to approximately 30 km in diameter. The most strongly shocked samples, recording pressures of up to 20 GPa, occur at the very central part of the structure, and locally in these samples, higher pressures causing melting conditions in the affected rocks were reached. Pressures recorded in the studied samples decrease outwards from the center of the structure, forming roughly circular envelopes around the proposed shock center. Based on the distribution pattern of shocked quartz at Siljan, the original transient cavity can be estimated at approximately 32-38 km in diameter. After correcting for erosion, we conclude that the original rim to rim diameter of the Siljan crater was somewhere in the size range 50-90 km. [ABSTRACT FROM AUTHOR]

Analysis of 18 emerging European economies finds domestic financial reforms to be positively associated with net capital inflows. Controlling for standard determinants of capital flows, we find banking sector reforms in particular to be consistent with higher net financial inflows, whereas no such correlation is found for security market reforms or for indicators of financial depth. Additional net inflows are reaped by the EU accession countries. Countries with more reformed banking sectors receive significantly higher FDI and 'other' investment net inflows; this is also found for gross financial inflows, but not for gross outflows. [ABSTRACT FROM AUTHOR]

Globalization theory claims that the world becomes a small place. Distance is no longer relevant in world affairs. The relations between Europe and Australia provide an excellent case to test this theoretical assumption, because both entities share many social, cultural and economic characteristics while being located at the respective other end of the world. Accordingly the central questions of this essay are: What is the current state of the Euro-pean-Australian relations? Has globalization so far brought the two continents closer to-gether? What role does distance play in the interaction between Brussels and Canberra? To answer these questions the connections between the societies, markets and govern-ments of Europe and Australia are analysed, looking at patterns of migration, tourism, trade, investment and at the diplomatic relations. The findings suggest that globalization has so far not made geography as political category obsolete. Indeed in some aspects glo-balization even widened the gap between Europe and Australia. [ABSTRACT FROM AUTHOR]

This study explores how much the concept of globalization via the internet is transforming the occupation of journalists. This research relied on the expertise of online journalists from Latin America, North America and Europe through their participation in three sets of online focus groups. Our findings pointed to a perception by these specific online journalists of a compressed social distance between themselves and the audience, as well as a more compact time dimension impacting the news cycle. This study supports similar findings of the roles, responsibilities and resources of media workers in other digital occupations, where requirements of multitasking and adaptability are necessary. This exploratory study aims to serve as a foundation to explain how this online medium is evolving and how online journalists perform and operate within it. [ABSTRACT FROM AUTHOR]

International marketing channels become more important every day. Channel member satisfaction is a key characteristic of healthy channel relationships. However, limited knowledge exists regarding satisfaction in international marketing channels. The present research involves a European context and investigates channel member satisfaction in international relationships and its consequences from the perspective of local channel members. Study I adopts a qualitative approach to establish a conceptualization of satisfaction. Study II tests a conceptual model based on a sample of 236 wholesalers involved in the international distribution of industrial goods. Empirical evidence supports (1) a seven-factor conceptualization of satisfaction, (2) main effects relating satisfaction to conflict, trust, and commitment in international channel relationships, (3) and partial moderating influence of two contextual variables, namely, competitive intensity and output control. doi:10.1300/J049v14n04_02 [ABSTRACT FROM PUBLISHER]

The Accreditation Subcommittee of the EBMT regularly publishes special reports on current practice of haemopoietic stem cell transplantation for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred since the first report was published in 1996. Haemopoietic stem cell transplantation today includes grafting with allogeneic and autologous stem cells derived from bone marrow, peripheral blood and cord blood. With reduced intensity conditioning regimens in allogeneic transplantation, the age limit has increased, permitting the inclusion of older patients. New indications have emerged such as autoimmune disorders and AL amyloidosis for autologous, and solid tumours for allogeneic transplants. The introduction of alternative therapies has challenged well-established indications such as imatinib for chronic myeloid leukaemia. An updated report with revised tables and operating definitions is presented here.Bone Marrow Transplantation (2006) 37, 439–449. doi:10.1038/sj.bmt.1705265; published online 30 January 2006 [ABSTRACT FROM AUTHOR]

Discusses the method of a Pan-European research project on e-catalog standards. Criteria for assessing the quality of e-business standards; Aim of the eCAT workshop launched by the European Committee for Standardization, Information and Communication Technologies; Level model of e-business standards; Electronic data interchange.

Presents an update on the efforts and events organized by the Association of the Advancement of Assistive Technology in Europe, as of winter 2004/2005.

Summary:A survey was carried out among EBMT centres to describe the current practice concerning intrathecal (i.t.) prophylaxis in allogeneic stem cell transplantation for malignant diseases in patients with no central nervous system (CNS) manifestations of the disease at any time. A total of 90 centres reported their practice: 42 centres (47%) never used pre-transplant i.t. prophylaxis as part of the conditioning, whereas 48 centres (53%) gave i.t. prophylaxis to selected groups. The main indications were acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), and lymphoma (53, 33, and 23%of all centres, respectively). Prophylaxis was usually given to all patients with ALL, but often restricted to high-risk patients in AML and lymphoma. Of the 90 centres, 29 (32%) gave prophylactic i.t. treatment after the transplantation, mainly for the same indications as pre-transplant. This survey illustrates the heterogeneity in the current practice of i.t. prophylaxis in allogeneic transplantation for malignant blood disorders in Europe. The documentation in the literature to support the use of i.t. prophylaxis as part of transplantation for malignant diseases in patients without preceding CNS involvement is sparse. Based on the rarity of isolated CNS relapse after allogeneic stem cell transplantation, EBMT does not recommend routine i.t. prophylaxis to patients without prior CNS involvement.Bone Marrow Transplantation (2005) 35, 121-124. doi:10.1038/sj.bmt.1704727 Published online 15 November 2004 [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the activity of daptomycin, a novel lipopeptide, against European Gram-positive isolates (n=1539). The MIC90-values of daptomycin against Staphylococcus aureus isolates was 0.25 mg/L, against Enterococcus faecalis 4 mg/L, against Enterococcus faecium 8 mg/L, 0.25 mg/L against Staphylococcus epidermidis, and 0.25 mg/L against Streptococcus pneumoniae. Daptomycin was equally potent against antibiotic-susceptible and resistant strains within a particular species. Based on a breakpoint of 1 mg/L for S. aureus and group A streptococci, all isolates tested were susceptible to daptomycin. Based on a breakpoint of 4 mg/L for vancomcyin-susceptible E. faecalis 99.7% of these isolates were susceptible to daptomycin. [Copyright &y& Elsevier]

Determines the toxin-gene profile heterogeneity among endemic invasive streptococcal isolates that circulated within a five-year period in European university hospitals. Use of multiplex polymerase chain reaction screening for profiling; Characterization of emm types by several different toxin-gene profiles; Key toxin gene non-random distribution.

Focuses on the role of intra-organizational performance measurement with concepts of supplier performance measurement. Practices of supplier evaluation in the area of logistics of vehicle manufacturers in Europe; Categories of roles of intra-organizational performance management.

Hematopoietic stem cell transplants (HSCTs) are considered the best treatment option for many hematological malignancies, and transplant numbers have increased five-fold during the last decade. Only a few controlled prospective studies are available, and different opinions prevail. Data from 118 167 HSCT (36% allogeneic, 64% autologous) collected within the EBMT activity survey from 1990 to 2001 were used to assess trends over time, transplant rates and coefficient of variation (CV) of transplant rates among European countries for acute myeloid leukemia (AML; 18.5%), acute lymphocytic leukemia (ALL; 12%), chronic myeloid leukemia (CML; 11.5%), myelodysplastic syndromes (MDS; 3%), lymphoproliferative disorders (LPS; 36.3%) and multiple myeloma (MM; 18.7%). Transplant rates increased in all countries and for all indications from 1990 to 2001 from 1.7-fold (CML) to 24.8-fold (MM). Transplant rates have declined for CML since 1999. Autologous HSCT are the preferred choice for LPS and MM, allogeneic HSCT for ALL and myeloid malignancies. CVs of less than 50% suggest consensus for allogeneic HSCT in AML, ALL, CML, MDS and NHL, for autologous HSCT in LPS and MM. These data give an overview of the current status of HSCT for hematological malignancies in Europe and provide objective information for health-care providers and patient counselling. [ABSTRACT FROM AUTHOR]

Studies the antifungal agent caspofungin, the first echinocandin that has been approved in the U.S. and Europe for the treatment of invasive aspergillosis. Key applications in the treatment of adult patients who are refractory to or intolerant of conventional amphotericin B; Implications on the study of mycoses.