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Introduction The identification of type 1 diabetes at an early presymptomatic stage has clinical benefits. These include a reduced risk of diabetic ketoacidosis (DKA) at the clinical manifestation of the disease and a significant reduction in clinical symptoms. The European action for the Diagnosis of Early Non-clinical Type 1 diabetes For disease Interception (EDENT1FI) represents a pioneering effort to advance early detection of type 1 diabetes through public health screening. With the EDENT1FI Master Protocol, the project aims to harmonise and standardise screening for early-stage type 1 diabetes and care.Methods and analysis Public health islet autoantibody screening is conducted in the Czech Republic, Denmark, Germany, Italy, Poland, Portugal, Sweden and the UK. Between November 2023 (start date) and October 2028 (planned end date), an estimated number of 200 000 children and adolescents aged 1–17 years are expected to be screened. Screening is performed in capillary blood, examining different islet autoantibodies (autoantibodies against insulin, glutamic acid decarboxylase-65, insulinoma-associated antigen-2 and/or zinc transporter-8). Positive screening results undergo confirmation through a second antibody method. A second (venous) blood sample is requested if at least two autoantibodies are detected, to confirm the autoantibody status. Children and adolescents with confirmed two or more autoantibodies are invited to metabolic staging (oral glucose tolerance test, haemoglobin A1c (HbA1c), random glucose, optionally continuous glucose monitoring); an educational programme and recommendations for monitoring are provided. The feasibility and acceptability of screening are evaluated by feedback questionnaires. Pseudonymised data is collated in the EDENT1FI Registry. Study outcomes include country-specific screening rates, prevalences of stage 1 and stage 2 type 1 diabetes, number in EDENT1FI Registry, proportion with DKA and symptoms at clinical diagnosis and median HbA1c.Ethics and dissemination Following the EDENT1FI Master Protocol, site-specific protocols are developed and approved by local ethics committees (Technical University of Munich, Medical Faculty, Nr. 70/14; Medizinische Hochschule Hannover, Nr. 9588_BO_S_2021; Technische Universität Dresden, Nr. BO-EK-356082020; Center for Sundhed Region Hovedstaden, Nr. H-22053116; Swedish Ethical Review Authority, Nr. 2023-00312-01; National Health Service Health Research Authority and Health Care Research Wales, IRAS (Integrated Research Application System) project ID 309252; Italian National Institute of Health, National ethics committee for clinical trials of public research bodies (EPR) and other national public institutions, Prot. PRE BIO CE Nr. 0059835; Charles University in Prague, Ethics Committee for Multi-Centric Clinical Trials of the University Hopital Motol and 2nd Faculty of Medicine, Nr. 1271/23; Bioethics Committee at the Medical University of Warsaw, Nr. 21/2024 and KB/6/R/2024; Associação Protectora dos Diabéticos de Portugal, Nr. 211/2024). Results are disseminated through peer-reviewed journals and conference presentations and will be shared openly.

Purpose: The study aims to examine the financial performance of air passenger carriers in the case of a developing country with transition economy like Bulgaria. It also examines both the main trends in the digital transformation processes of the aviation sector and the obstacles that hinder the widespread implementation of information and communication technologies in the sector. Methodology: Through regression modelling, it is identified which financial performance indicators most strongly influence the digital transformation process of air passenger carriers. Results: The results of the study show that Bulgarian aviation operators are not capable to cover their short-term liabilities and are strongly dependent on their creditors, especially in terms of exogenous shocks like COVID-19 pandemics, political crisis, ongoing military conflicts in Ukraine and uncertain business environment. The country ranks on last place according to the values of DESI index in comparison to EU average levels in terms of digital skills of transport workers, e-commerce, and deployment of ICT. Practical implications: The implications of the study could serve as basis for future research in the field of financial performance of other modes of transport or to be used for examining the air transport of countries with similar political and economic characteristics like Bulgaria. Paper type: Research paper

Type 1 diabetes treatment stands at a crucial and exciting crossroad since the 2022 U.S. Food and Drug Administration approval of teplizumab to delay disease development. In this article, we discuss four major conceptual and practical issues that emerged as key to further advancement in type 1 diabetes research and therapies. First, collaborative networks leveraging the synergy between the type 1 diabetes research and care community members are key to fostering innovation, know-how, and translation into the clinical arena worldwide. Second, recent clinical trials in presymptomatic stage 2 and recent-onset stage 3 disease have shown the promise, and potential pitfalls, of using immunomodulatory and/or β-cell protective agents to achieve sustained remission or prevention. Third, the increasingly appreciated heterogeneity of clinical, immunological, and metabolic phenotypes and disease trajectories is of critical importance to advance the decision-making process for tailored type 1 diabetes care and therapy. Fourth, the clinical benefits of early diagnosis of β-cell autoimmunity warrant consideration of general population screening for islet autoantibodies, which requires further efforts to address the technical, organizational, and ethical challenges inherent to a sustainable program. Efforts are underway to integrate these four concepts into the future directions of type 1 diabetes research and therapy. Article Highlights: We discuss four key emphasis areas to pursue the ongoing acceleration of progress in type 1 diabetes research and care. Collaborations and communications should continue and expand between the research and care communities. Further clinical development of disease-modifying therapies is key. Identification of biomarkers of type 1 diabetes heterogeneity is needed for better disease stratification. Type 1 diabetes screening programs should be implemented in the general population. [ABSTRACT FROM AUTHOR]

The transition to open data practices is straightforward albeit surprisingly challenging to implement largely due to cultural and policy issues. A general data sharing framework is presented along with two case studies that highlight these challenges and offer practical solutions that can be adjusted depending on the type of data collected, the country in which the study is initiated, and the prevailing research culture. Embracing the constraints imposed by data privacy considerations, especially for biomedical data, must be emphasized for data outside of the United States until data privacy law(s) are established at the Federal and/or State level.

The study is focused on the possibilities and restrictions for the development of the transport sector of EU member-states with GDP per head significantly lower than the EU average levels, because of the introduction of the European Green Deal. For the purposes of the research, there are used the methods of quantitative and qualitative analysis, as well as statistical analysis. In the publication, it is examined also the status quo of the European transport system in accordance with the provisions of the European Green Deal and the European policies for the development of the transport sector till 2030 and 2050. Special attention is paid to the energy dependence of the transport modes on fossil fuels, as well as the level of digitalization of the transport sector, the obstacles for operation of sustainable multimodal transportation services and the danger of imperfect market structures emergence in the field of transport in the less developed regions in EU.

Purpose: The study aims to examine the financial performance of air passenger carriers in the case of a developing country with transition economy like Bulgaria. It also examines both the main trends in the digital transformation processes of the aviation sector and the obstacles that hinder the widespread implementation of information and communication technologies in the sector. Methodology: Through regression modelling, it is identified which financial performance indicators most strongly influence the digital transformation process of air passenger carriers. Results: The results of the study show that Bulgarian aviation operators are not capable to cover their short-term liabilities and are strongly dependent on their creditors, especially in terms of exogenous shocks like COVID-19 pandemics, political crisis, ongoing military conflicts in Ukraine and uncertain business environment. The country ranks on last place according to the values of DESI index in comparison to EU average levels in terms of digital skills of transport workers, e-commerce, and deployment of ICT. Practical implications: The implications of the study could serve as basis for future research in the field of financial performance of other modes of transport or to be used for examining the air transport of countries with similar political and economic characteristics like Bulgaria. Paper type: Research paper. [ABSTRACT FROM AUTHOR]

The article aims to analyze the effects of the pandemic related to COVID-19 on the process of digitalization of human resources in the management of infrastructure sites in the field of transport sector. It also discusses the dilemma between goal #8 of the UN SDG for high employment of the population and digitalization of the processes and human resource management. They will require using only highly qualified personnel and less human factor. Those processes can increase labour productivity and economic growth at the cost of negative effects on total demand, social inequality, and employment. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to use a discrete-choice experiment methodology to understand the relative importance of the attributes of screening tests for type 1 diabetes among parents and pediatricians in the U.S.Research Design and Methods: Online surveys presented hypothetical screening test profiles from which respondents chose their preferred test profile. Survey attributes were based on likely screening test options and included the mode of administration, where and when the test was conducted, the type of education and monitoring available to lower the risk of diabetic ketoacidosis (DKA), and whether a treatment was available that would delay onset of insulin dependence. Data were analyzed using random-parameters logit models.Results: Parents placed the highest relative importance on monitoring programs that could reduce the risk of DKA to 1%, followed by treatment to delay onset of insulin dependence by 1 or 2 years, and, finally, avoiding a $50 out-of-pocket cost. Pediatricians placed equal importance on monitoring programs that reduced a patient's risk of DKA to 1% and on avoiding a $50 out-of-pocket cost for the screening test, followed by the option of a treatment to delay the onset of insulin dependence. The mode of administration and location and timing of the screening were much less important to parents and pediatricians.Conclusions: Parents and pediatricians preferred screening tests that were accompanied by education and monitoring plans to reduce the risk of DKA, had available treatment to delay type 1 diabetes, and had lower out-of-pocket costs. [ABSTRACT FROM AUTHOR]

In the last years the main objective of most of the European strategic documents concerns establishment of sustainable and competitive transport system while promoting the development of secure, safe, reliable, energy effective and environmentally friendly transport modes such as inland waterway transport. The free capacity of European inland waterways provides opportunities for transportation with no traffic jams in the living areas; oversized and bulk cargoes, less green house gas emissions, compared to the road transport. Thanks to the development of the information and communication technologies (ICT) much more innovative vessels, which are economically efficient and environmentally friendly are used. Improving the technical specifications of Danube river fleet is of great importance for the development of the transport sector in the separate countries in the region. This fact is also proved by the growth rate of the inland waterway modal split during the last 5 years in the West-European countries such as Germany (12.6%), France (4.3%), United Kingdom (13.4%), Austria (5.1%), the Netherlands (39.1%) (EUROSTAT, 2016) compared to the road and rail transport. In this regard the main objective of the current study is to analyze, as an example of Bulgaria, the development trends of Danube river fleet and as a result the specifics of its management will be revealed. The following economic indicators are analyzed: Danube fleet performance, number and capacity of vessels, coefficient of capacity usage and average stay of ships at ports for handling activities. These indicators allow the strengths and weaknesses, as well as the threats and opportunities of river fleet to be assessed and also measures for its development to be proposed. The proposed model for analysis could be successfully used for studying the specifics of river fleet of other countries with transitional economies. [ABSTRACT FROM AUTHOR]

The paper is devoted to the study of the efficiency of economic activity of inland ports at the Bulgarian section of the Danube River. In this regard a system of economic indicators (cargo turnover of Bulgarian river ports; total revenues; average number of persons employed; average stay of a vessel at inland ports; average wage costs and investment costs for maintenance and development of Bulgarian inland ports) will be analyzed. In the study is proposed a model for evaluation of the efficiency of ports traditional and complementary services. It is composed a rectangular matrix that reveals the correlations between indicating factors and performance indicators. As a result of the analysis are summarized the problems that hinder the economic activity of Bulgarian river ports and their superstructure and key measures for their development are proposed. [ABSTRACT FROM AUTHOR]

Purpose: Qualitative interviews were conducted and a survey instrument was developed to inform the implementation of a general population screening program for T1D in children and to quantify screening-test attributes relevant to parents and physicians in the United States. Methods: Semi-structured qualitative interviews were conducted with parents and physicians to understand views on general population screening for T1D and identify important attributes of screening programs. Using the results, a discrete-choice experiment (DCE) survey instrument was developed to quantify preferences over multiple options. The survey was pretested using interviews to confirm attribute relevance and respondent comprehension. Results: In the qualitative interviews (10 parents, 10 physicians), test accuracy and the availability of treatments to delay onset or lessen T1D-associated health risks ranked as important. Parents' concerns included the need for venipuncture and the cost of the test. Physicians' concerns included the emotional impact of positive results on families and test reimbursement. A DCE survey was developed with 5 attributes covering when, where, and how the sample for screening is obtained; cost; monitoring and education to reduce the risk of DKA; and availability of an optional treatment to delay T1D. In the pretest interviews (15 parents, 15 pediatricians), the relevance of the attributes was confirmed. The pretest sample placed the most value on reducing the risk of DKA and the availability of a treatment to delay T1D onset. Low cost and convenience were considered key to widespread adoption by pediatricians. Conclusions: Two sets of interviews confirmed an interest in general population T1D screening, but follow-up treatment for a positive result was the key driver for acceptance. The survey will be administered to 1,000 parents and 500 pediatricians to quantify the importance of screening attributes with the goal of informing the implementation of a general population T1D screening program. Disclosure: J.L. Dunne: None. J. Sutphin: Other Relationship; Self; Multiple Companies. J.S. Bushman: None. B. Fontanals-Cirera: None. J.R. Coulter: Other Relationship; Self; Multiple companies. C.T. Hutton: None. A. Koralova: Research Support; Spouse/Partner; Bristol-Myers Squibb Company. C.M. Ervin: Other Relationship; Self; Multiple companies. C. Mansfield: Other Relationship; Self; Multiple companies. Funding: JDRF; The Leona M. and Harry B. Helmsley Charitable Trust [ABSTRACT FROM AUTHOR]