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Calls for solidarity have been an ubiquitous feature in the response to the COVID-19 pandemic. However, we know little about how people have thought of and practised solidarity in their everyday lives since the beginning of the pandemic. What role does solidarity play in people’s lives, how does it relate to COVID-19 public health measures and how has it changed in different phases of the pandemic? Situated within the medical humanities at the intersection of philosophy, bioethics, social sciences and policy studies, this article explores how the practice-based understanding of solidarity formulated by Prainsack and Buyx helps shed light on these questions. Drawing on 643 qualitative interviews carried out in two phases (April–May 2020 and October 2020) in nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, The Netherlands, German-speaking Switzerland and the UK), the data show that interpersonal acts of solidarity are important, but that they are not sustainable without consistent support at the institutional level. As the pandemic progressed, respondents expressed a longing for more institutionalised forms of solidarity. We argue that the medical humanities have much to gain from directing their attention to individual health issues, and to collective experiences of health or illness. The analysis of experiences through a collective lens such as solidarity offers unique insights to understandings of the individual and the collective. We propose three essential advances for research in the medical humanities that can help uncover collective experiences of disease and health crises: (1) an empirical and practice-oriented approach alongside more normative approaches; (2) the confidence to make recommendations for practice and policymaking and (3) the pursuit of cross-national and multidisciplinary research collaborations.

Here we describe the LifeTime Initiative, which aims to track, understand and target human cells during the onset and progression of complex diseases, and to analyse their response to therapy at single-cell resolution. This mission will be implemented through the development, integration and application of single-cell multi-omics and imaging, artificial intelligence and patient-derived experimental disease models during the progression from health to disease. The analysis of large molecular and clinical datasets will identify molecular mechanisms, create predictive computational models of disease progression, and reveal new drug targets and therapies. The timely detection and interception of disease embedded in an ethical and patient-centred vision will be achieved through interactions across academia, hospitals, patient associations, health data management systems and industry. The application of this strategy to key medical challenges in cancer, neurological and neuropsychiatric disorders, and infectious, chronic inflammatory and cardiovascular diseases at the single-cell level will usher in cell-based interceptive medicine in Europe over the next decade., The LifeTime initiative is an ambitious, multidisciplinary programme that aims to improve healthcare by tracking individual human cells during disease processes and responses to treatment in order to develop and implement cell-based interceptive medicine in Europe.

In this Perspective, owing to an error in the HTML, the surname of author Alejandro López-Tobón of the LifeTime Community Working Groups consortium was indexed as ‘Tobon’ rather than ‘López-Tobón’ and the accents were missing. The HTML version of the original Perspective has been corrected; the PDF and print versions were always correct. © 2021, The Author(s).

The emissions from transport and residential sectors have significant shares in total emissions of Europe. In this study, we identified key priorities in support to the EU Macro-regional Strategies implementation based on an ex-ante assessment focusing on two EU macro-regions: Adriatic-Ionian (AIR) and Alpine (ALP). Firstly, we analysed how different sectors contribute to air pollution in the ALP and AIR regions and to predict future pollution levels under different emission scenarios such as Current Legislation (CLE), Maximum Technically Feasible Reduction (MTFR), and Climate Mitigation (CLIM) by using the TM5-FASST air quality and impact model. It was found that the residential sector is the main contributor to anthropogenic PM2.5 emissions and it will remain so also beyond 2050 under the CLE scenario while the transport sector remains the major contributor to NOx emissions until 2030, with a significant and growing contribution from shipping in the AIR region. Primary PM2.5 has almost reached its technical reduction limit but secondary PM2.5 still has a large reduction potential. MTFR measures on road transport and shipping emissions can generate an annual health benefit from PM2.5 and ozone of 750 (ALP) + 2950 (AIR) avoided premature mortalities in 2050 of which 64% from shipping emission reductions. The potential health benefits from all sectors under MTFR (ALP + AIR) amounts to 16, 800 avoided premature deaths annually in 2030 (3250 + 13550). The potential health benefits from Climate mitigation (ALP + AIR) amounts to 2200 avoided premature deaths annually in 2050 (620 + 1580), however CLIM policies due to fuel switch to biomass also cause air quality trade-off in the domestic sector leading to an estimated number of 360 extra premature deaths annually in 2050 in AIR. Secondly, the experts in the transport sector from these regions have pointed several areas of improvement. Increased intermodality, combining road, rail and maritime ship transport can have important benefits in both regions. In the ALP, moving from trucks to rail could considerably reduce the environmental impacts of transport by reducing emissions of CO2 and air pollutants and could help to solve traffic congestion problems. In the AIR, many countries use outdated technologies for on-road freight transport, causing large environmental impacts. A modal shift e.g. to electric rail or maritime shipping can thus give particularly large positive environmental benefits for this region. The potential drawbacks of a modal strengthening the role of railway and ship transport are primarily related to the increased complexity, the costs of the necessary infrastructures and the risk of increased air pollution in some port cities due to ship emissions. For traffic on roads, infrastructure development is a key element to move towards more sustainable transport. Electrification of road transport generates emissions reductions when the electricity generation is also clean and attention should be given to the charging infrastructure development. Fleet renewal of trucks and ships and use of cleaner fuels will contribute to clean growth in transport. However, fleet renewal is a costly measure and difficult to implement in poor countries ; consequently, the measures that proved to be effective in other countries may not be beneficial or even applicable in these countries. One important obstacle in implementing the provisions of EU macro-regional strategies is the disparity between countries within the macro-regions. Further, some countries in ALP and AIR are not part of EU and may present limitations in international trade and security agreements. Finally, the experts in the field highlighted the fact that bioenergy is an important opportunity for ALP and AIR regions. Because of potential environmental threats, its clean deployment is an issue to be carefully addressed through appropriate policies and regulatory acts. An example is the impact on regional air pollution of small and medium scale traditional appliances and domestic boilers. Improved efficiency and best available technologies need to be strongly supported with both market strategies and effective controls. On the other side of the supply chain, sustainable collection of feedstock has to be assured through the appropriate management of the forest stocks and accounting for the actual climate mitigation benefits, without forgetting the increasing demand of biomass from other industrial sectors in a bio-economy framework.

Routine reaction to approaching disruptions in tokamaks (i.e. sudden current quenches) is currently restricted to machine protection, which obviously remains a basic requirement for ITER and DEMO. However, in future fusion devices, high performance discharge time itself will be very valuable. The ultimate mission is to actively avoid approaching disruptions at an early stage in general, and sustain the discharge whenever possible. To achieve this, the knowledge of the various disruption root causes and the corresponding chain of events towards a disruption, i.e. the disruption path, is vital. For each considered path, physics-based sensors and adequate actuators have to be identified and a hierarchical and specific handling strategy has to be developed. Early detection and reaction facilitates the efficiency of the actuators and enhances the chance for a full recovery. For some disruption paths, experiments have been performed at ASDEX Upgrade and TCV. Disruptions were provoked in ASDEX Upgrade by a high ?N-limit in hybrid scenarios, by a ne-limit both in L and H-modes, and in TCV by impurity injection in ELMy H-modes. For these example discharges, this new approach has been implemented. Based on the gained insight, path-specific strategies will be further developed about sensors (e.g. still rotating modes or radiation rise), actuators (e.g. ECCD at q=2 surface for mode stabilisation or rotating resonant magnetic perturbations for mode entrainment) and their limitations. The hierarchy of action should be discharge recovery to full performance, continuation with a less disruption-prone back-up scenario, controlled discharge termination and in the worst case disruption mitigation. Present ideas on how these schemes can lead to a generalized concept of early handling of approaching disruptions in present devices and their use as a blueprint for ITER and DEMO will be presented.

Background: Patients undergoing liver transplantation for hepatocellular carcinoma within the Milan criteria (single tumour ≤5 cm in size or ≤3 tumours each ≤3 cm in size, and no macrovascular invasion) have an excellent outcome. However, survival for patients with cancers that exceed these criteria remains unpredictable and access to transplantation is a balance of maximising patients' chances of cure and organ availability. The aim of this study was to explore the survival of patients with tumours that exceed the Milan criteria, to assess whether the criteria could be less restrictive, enabling more patients to qualify as transplant candidates, and to derive a prognostic model based on objective tumour characteristics, to see whether the Milan criteria could be expanded. Methods: Data on patients who underwent transplantation for hepatocellular carcinoma despite exceeding Milan criteria at different centres were recorded via a web-based survey completed by specialists from each centre. The survival of these patients was correlated retrospectively with the size of the largest tumour nodule, number of nodules, and presence or absence of microvascular invasion detected at pathology. Contoured multivariable regression Cox models produced survival estimates by means of different combinations of the covariates. The primary aim of this study was to derive a prognostic model of overall survival based on tumour characteristics, according to the main parameters used in the Tumour Node Metastasis classification. The secondary aim was the identification of a subgroup of patients with hepatocellular carcinoma exceeding the Milan criteria, who achieved a 5-year overall survival of at least 70%-ie, similar to the outcome expected for patients who meet the Milan criteria. Findings: Over a 10-month period, between June 25, 2006, and April 3, 2007, data for 1556 patients who underwent transplantation for hepatocellular carcinoma were entered on the database by 36 centres. 1112 patients had hepatocellular carcinoma exceeding Milan criteria and 444 patients had hepatocellular carcinoma shown not to exceed Milan criteria at post-transplant pathology review. In the group of patients with hepatocellular carcinomas exceeding the criteria, the median size of the largest nodule was 40 mm (range 4-200) and the median number of nodules was four (1-20). 454 of 1112 patients (41%) had microvascular invasion and, for those transplanted outside the Milan criteria, 5-year overall survival was 53·6% (95% CI 50·1-57·0), compared with 73·3% (68·2-77·7) for those that met the criteria. Hazard ratios (HR) associated with increasing values of size and number were 1·34 (1·25-1·44) and 1·51 (1·21-1·88), respectively. The effect was linear for size, whereas for number of tumours, the effect tended to plateau above three tumours. The effect of tumour size and number on survival was mediated by recurrence (b=0·08, SE=0·12, p=0·476). The presence of microvascular invasion doubled HRs in all scenarios. The 283 patients without microvascular invasion, but who fell within the Up-to-seven criteria (hepatocellular carcinomas with seven as the sum of the size of the largest tumour [in cm] and the number of tumours) achieved a 5-year overall survival of 71·2% (64·3-77·0). Interpretation: More patients with hepatocellular carcinoma could be candidates for transplantation if the current dual (yes/no) approach to candidacy, based on the strict Milan criteria, were replaced with a more precise estimation of survival contouring individual tumour characteristics and use of the up-to-seven criteria. Funding: Specific funding was not used to do this study. © 2009 Elsevier Ltd. All rights reserved

The 1996 European directive on ambient has implemented regulatory monitoring of the PM10 mass concentration. The EN 12341 standard describes the European reference method (gravimetry). Any other method having demonstrated its equivalence to this reference can be carried out. France uses the Partisol Plus (TEI) as its national gravimetry reference method. For monitoring, the French networks (AASQA) use MP 101 RST radiometry Gauge (Environnement SA) and microbalance TEOM-FDMS (TEI). The European commission asked for a feed-back from the field. As a consequence, JRC Ispra is having a tour, sharing two weeks intercomparison exercises with each member country. Such a campaign has been carried out in France in March 2008. Participants have been JRC Ispra, the French National Laboratory (INERIS and EMD), and the Paris local Network (AIRPARIF). Results will be presented and commented, La surveillance à travers l'Europe de la concentration massique des PM10 dans l'air ambiant extérieur a été rendue obligatoire par la directive Cadre de 1996 et la directive Fille associée de 1999. La méthode de référence à appliquer par les Etats Membres a été définie : il s'agit de la méthode manuelle gravimétrique décrite en détail dans la norme EN 12341. Toute technique alternative est jugée recevable sous réserve d'une démonstration d'équivalence par rapport à la méthode de référence. Lors des exercices d'équivalence nationaux, le dispositif français utilise le préleveur séquentiel sur filtres à bas débit Partisol Plus comme méthode gravimétrique de référence. En ce qui concerne la surveillance quotidienne des PM10, les AASQA utilisent la jauge radiométrique MP101M RST (société Environnement SA) et la microbalance TEOM-FDMS (société TEI). La Commission Européenne a souhaité disposer de données permettant de comparer la manière avec laquelle les différents pays membres assurent cette surveillance quotidienne. De ce fait, le JRC Ispra a entrepris un " tour d'Europe " consistant à mener, dans chaque pays membre, un exercice d'intercomparaison de deux semaines. Un tel exercice a été mené en France en mars 2008, impliquant d'un part le JRC, et d'autre part à la fois un représentant local du pays d'accueil (ici, AIRPARIF, réseau de surveillance de l'Ile de France), et le laboratoire national de référence (ici le LCSQA / INERIS et LCSQA / EMD). Les résultats obtenus seront présentés et commentés.

Transjugular liver biopsy (TJLB) is considered an inferior biopsy, used when percutaneous liver biopsy (PLB) is contraindicated. According to recent literature, specimens with 6 complete portal tracts (CPTs) are needed for histological diagnosis of chronic liver disease but 11 CPTs to reliably stage and grade. Mean CPT number in PLB series is 7.5; more passes increase complications. Sixty-four series reporting 7649 TJLBs were evaluated for quality of specimen and safety. Major indications were coagulation disorders and/or ascites. Success rate was 96.8%. Fragmentation rate was 34.3%, not correlating with length or diagnostic adequacy. With a mean of 2.7 passes, mean CPT number was 6.8. Histological diagnosis was achieved in 96.1% of TJLBs, correlating with length (p=0.007) and CPT number (p=0.04). Tru-Cut specimens had a mean CPT number of 7.5 and, compared to Menghini specimens, were longer (p16-G) provided significantly longer and less fragmented specimens. Minor and major complication rates were 6.5% and 0.56%, respectively, and increased in children, but not with additional passes. In adults, mortality was 0.09% (haemorrhage 0.06%; ventricular arrhythmia 0.03%). TJLB is safe, providing specimens qualitatively comparable to PLB, and may improve further using > or = 18-G Tru-Cut needle and >3 passes. J Hepatol

Inventories for global aerosol and aerosol precursor emissions, and auxiliary information, have been collected, assessed and prepared for the year 2000 (present-day conditions) and for the year 1750 (pre-industrial conditions). These global datasets establish a reference for input in global modeling, when simulating the aerosol impact on climate with state-of-the-art aerosol component modules. These modules stratify aerosol by type, distinguishing among dust, seasalt, sulfate, organic matter and soot. The datasets are also intented to serve as systematic constraints in sensitivity studies of the AeroCom initiative, which aims to evaluate uncertainties in aerosol global modeling. The datasets comprise daily size-resolved emissions of sea-salt and dust and monthly-to-yearly emissions for all other currently known emissions of natural and anthropogenic aerosol (precursors). The emissions are a reference dataset for aerosol modeling in the coming years and benchmark the emissions according to our knowledge in the year 2004.