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The fire salamander (Salamandra salamandra and its relatives) is of increasing priority for ex situ conservation due to the spread of the fungal pathogen Batrachochytrium salamandrivorans in Europe. In captivity, the species may be maintained on a clinical paper-based or a naturalistic substrate, either of which has its own advantages and disadvantages. However, the impact of these two substrates on bacterial microbiotas within an enclosure and on the salamanders themselves is unknown. To investigate this, we maintained captive fire salamanders on either paper towels or a naturalistic substrate and quantified the culturable microbiotas of both substrates across the one-week lifespan of a paper towel and of the salamanders themselves over a six-month period. We found significant differences in the bacterial communities associated with the two substrates. Over a week-long period, there were major fluctuations in the community composition and abundance on paper towels while on the naturalistic substrate bacterial communities were relatively stable. The skin microbiota of salamanders were indistinguishable at the beginning of the study but after six months differed significantly between the two treatments, although the bacterial morphotypes present remained relatively similar compared with changes between substrates. These data show that husbandry protocols may have a strong influence on the culturable bacterial communities to which captive amphibians are exposed. Nevertheless, the animals were apparently able to maintain their own microbiota to a considerable degree. These findings should be borne in mind when determining husbandry protocols. Given the relative benefits of both types of enclosure, it is possible that a hybrid approach could be used whereby a small amount of naturalistic substrate is provided in a container within an otherwise clinical enclosure, to act as a bacterial reservoir. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is a long‐term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC‐HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs—in terms of quality of life—in European countries. [ABSTRACT FROM AUTHOR]

Although native to Australia, Eucalyptus species are found throughout Europe. At present, they are located mainly in the Iberian Peninsula and Eucalyptus globulus is the most commonly planted species. Climate forecasts anticipate an expansion of Eucalyptus to other regions of Europe. The fast growth of E. globulus, together with its resprouting ability and wood properties, has promoted the use of this species in the Iberian Peninsula. The total volume of E. globulus harvested there was close to 14 million m3 in 2019. Eucalyptus species represent the main source of raw material for the pulp and paper industries and provide an important source of income to non-industrial owners. Being exotic fast-growing trees, their expansion has also been associated with negative environmental impacts. The species therefore poses a series of challenges, while also generating opportunities. The objectives of this review paper are: (1) to summarize the importance of Eucalyptus plantations in Europe; (2) to analyse the opportunities and challenges of this genus in present and future plantations in Europe; (3) to assess to what extent forest management, at both stand and landscape levels, can reduce negative impacts; (4) to make policy and management recommendations that may support the use of this genus in other European regions. These aims are accomplished based on a thorough literature review, particularly focused on research developed in the Iberian Peninsula. [ABSTRACT FROM AUTHOR]

Around a third of the total population of Europe suffers from mental disorders. The use of electroencephalography (EEG) together with Machine Learning (ML) algorithms to diagnose mental disorders has recently been shown to be a prominent research area, as exposed by several reviews focused on the field. Nevertheless, previous to the application of ML algorithms, EEG data should be correctly preprocessed and prepared via Feature Engineering (FE). In fact, the choice of FE techniques can make the difference between an unusable ML model and a simple, effective model. In other words, it can be said that FE is crucial, especially when using complex, non-stationary data such as EEG. To this aim, in this paper we present a Systematic Mapping Study (SMS) focused on FE from EEG data used to identify mental disorders. Our SMS covers more than 900 papers, making it one of the most comprehensive to date, to the best of our knowledge. We gathered the mental disorder addressed, all the FE techniques used, and the Artificial Intelligence (AI) algorithm applied for classification from each paper. Our main contributions are: (i) we offer a starting point for new researchers on these topics, (ii) we extract the most used FE techniques to classify mental disorders, (iii) we show several graphical distributions of all used techniques, and (iv) we provide critical conclusions for detecting mental disorders. To provide a better overview of existing techniques, the FE process is divided into three parts: (i) signal transformation, (ii) feature extraction, and (iii) feature selection. Moreover, we classify and analyze the distribution of existing papers according to the mental disorder they treat, the FE processes used, and the ML techniques applied. As a result, we provide a valuable reference for the scientific community to identify which techniques have been proven and tested and where the gaps are located in the current state of the art. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between the environmental and economic performance of firms in the European paper manufacturing industry. It initially discusses possible functional relationships between environmental and economic performance rooted in different theoretical frameworks and links these to recent empirical and theoretical analyses of the Porter hypothesis. Following this, it reports the results of an empirical study carried out in the European paper industry. Findings fit better with ‘traditionalist’ reasoning about the relationship between environmental and economic performance, which predicts the relationship to be uniformly negative. In particular they confirm the necessity for a more differentiated view of the Porter hypothesis. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment. [ABSTRACT FROM AUTHOR]

Introduction: The total demand for freight transport in Europe has increased significantly in recent decades, but most of it has been handled by road transport. To fulfil the modal shift targets set in the EU White Paper 2011, it will be necessary to double rail's market share from today's 18 %, by 2050. Translating this into reality means rail will have to handle 3 to 4 times the cargo volume it does today. With this in mind, the paper develops a vision of an efficient rail freight system in 2050. Methodology: To achieve the above objective, the research applies literature survey and group discussion methodology and applying a system approach. Keeping on board the EU Transport White Paper 2011 modal shift targets, as well as future freight demand and customer requirements, the current research attempts to answer the following three critical questions: Results: The authors find that the service quality can be improved by better planning, application of appropriate ICT-systems and adoption of an integrated supply chain approach. A more customer-orientated service can also be achieved by further deregulation of rail. There is also an urgent need for a faster implementation of Rail Freight Corridors (RFC). As well as liner trains, future rail freight services should be offering end-point trains, with semi/ fully automated loading/unloading equipment in hub-terminals, as well as terminals at sidings to improve the availability of intermodal operation. Conclusion: To offer a competitive price and reliable service, a reduction in operating costs will be vital by implementing a number of measures, including operation of heavier and longer trains, wider loading gauge, higher average speed, and better utilisation of wagon space and all assets. This will bring increased capacity, as well as better timetable planning, signalling systems and infrastructure improvements. [ABSTRACT FROM AUTHOR]

Enzymatic pretreatment of cellulose is generally considered to be a new area of research, but in fact it was a standard step in European preindustrial papermaking between 1300 and 1800. Specialized handmade papers are routinely prepared in our Center for use in the care and conservation of rare books and manuscripts. Our attempts to replicate some of the early papers have led us to an investigation of retting (or fermentation) of hemp and cotton fiber as a pre-beating step. Results of twenty-two production runs show that increased fermentation time gives increased Canadian Standard Freeness and improved formation quality while permitting a decrease in beating time. [ABSTRACT FROM AUTHOR]

Background: Chronic nodular prurigo (CNPG) is a condition characterized by chronic itch, a prolonged scratching behaviour and the presence of pruriginous nodules. A comprehensive understanding of this condition, especially regarding its clinical characteristics and impact on quality of life is still lacking. Objectives: Aim of this pan‐European multicentre cross‐sectional study was to establish the clinical profile of CNPG, including its associated burden. Methods: Fifteen centres from 12 European countries recruited CNPG patients presenting at the centre or using the centres' own databases. Patients were asked to complete a questionnaire in paper or electronic format. Demography, current co‐morbidities, underlying disease, itch intensity, additional sensory symptoms, quality of life, highest burden and emotional experience of itch were assessed. Results: A total of 509 patients (210 male, median age: 64 years [52; 72]) were enrolled. Of these, 406 reported itch and CNPG lesions in the previous 7 days and qualified to complete the whole questionnaire. We recorded moderate to severe worst itch intensity scores in the previous 24 h. Scores were higher in patients with lower educational levels and those coming from Eastern or Southern Europe. Most patients experience itch often or always (71%) and report that their everyday life is negatively affected (53%). Itch intensity was considered to be the most burdensome aspect of the disease by 49% of the patients, followed by the visibility of skin lesions (21%) and bleeding of lesions (21%). The majority of patients was unaware of an underlying condition contributing to CNPG (64%), while psychiatric diseases were the conditions most often mentioned in association with CNPG (19%). Conclusions: This multicentre cross‐sectional study shows that itch is the dominant symptom in CNPG and reveals that the profile of the disease is similar throughout Europe. [ABSTRACT FROM AUTHOR]

The European Society of Radiology (ESR) established a Working Group on Value-Based Imaging (VBI WG) in August 2016 in response to developments in European healthcare systems in general, and the trend within radiology to move from volume- to value-based practice in particular. The value-based healthcare (VBH) concept defines 'value' as health outcomes achieved for patients relative to the costs of achieving them. Within this framework, value measurements start at the beginning of therapy; the whole diagnostic process is disregarded, and is considered only if it is the cause of errors or complications. Making the case for a new, multidisciplinary organisation of healthcare delivery centred on the patient, this paper establishes the diagnosis of disease as a first outcome in the interrelated activities of the healthcare chain. Metrics are proposed for measuring the quality of radiologists' diagnoses and the various ways in which radiologists provide value to patients, other medical specialists and healthcare systems at large. The ESR strongly believes value-based radiology (VBR) is a necessary complement to existing VBH concepts. The Society is determined to establish a holistic VBR programme to help European radiologists deal with changes in the evolution from volume- to value-based evaluation of radiological activities. Main Messages • Value-based healthcare defines value as patient's outcome over costs. • The VBH framework disregards the diagnosis as an outcome. • VBH considers diagnosis only if wrong or a cause of complications. • A correct diagnosis is the first outcome that matters to patients. • Metrics to measure radiologists' impacts on patient outcomes are key. • The value provided by radiology is multifaceted, going beyond exam volumes. [ABSTRACT FROM AUTHOR]

Our purpose is to study the effect of degradation processes on the optical response of ancient paper specimens. The paper samples under study originate from several European countries, date back to the XV and XVI centuries and show different states of degradation. Paper optical response is checked by reflectance spectroscopy in the wavelength range of 250–1100 nm. Similar spectral forms are shown by paper specimens displaying a broad range of widespread discoloration, of different manufacture, geographical origins and ages. A similar form is also observed by measuring foxing spots of several intensities on a single foxed sheet. Moreover, the entire spectra set shows a clear connection between the paper’s state of degradation and a monotonic transformation of the spectral curves, suggesting the existence of uniform degradation effects implied in the optical response of both foxed as well widespread discoloured papers. These results suggest for usage of optical reflectance as a general and non-destructive method for degradation calibration. [Copyright &y& Elsevier]

In 2018, the position paper 'Imaging the adult with congenital heart disease: a multimodality imaging approach' was published. The paper highlights, in the first part, the different imaging modalities applied in adult congenital heart disease patients. In the second part, these modalities are discussed more detailed for moderate to complex anatomical defects. Because of the length of the paper, simple lesions were not touched on. However, imaging modalities to use for simple shunt lesions are still poorly known. One is looking for structured recommendations on which they can rely when dealing with an (undiscovered) shunt lesion. This information is lacking for the initial diagnostic process, during repair and at follow-up. Therefore, this paper will focus on atrial septal defect, ventricular septal defect, and persistent arterial duct. Pre-, intra-, and post-procedural imaging techniques will be systematically discussed. This position paper will offer algorithms that might help at a glance. The document is prepared for general cardiologists, trainees, medical students, imagers/technicians to select the most appropriate imaging modality and to detect the requested information for each specific lesion. It might serve as reference to which researchers could refer when setting up a (imaging) study. [ABSTRACT FROM AUTHOR]

The content of 'O' and 'A' level papers on modern British and European History set by two GCE Examination Boards was analysed to find out what particular aspects of the past were emphasised and thus to throw light on the experience of history as a subject which was gained by the candidates. These papers, which are taken by the great majority of the candidates, were found to be dominated by political history, up to 77% of the questions being devoted to the affairs of governments and political leaders. Foreign politics was especially important in papers on European history reaching as high as 44% of the questions set and domestic politics was central to papers on British history attaining means in different groups of papers between 40 and 50%. At the end of the article the wisdom of the approach to school history evident in these papers is questioned. [ABSTRACT FROM AUTHOR]

The present study focuses on the implementation of a self - assessment procedure in a Physics class, extended during a seven weeks period in a European secondary level school. The researchers used three modes of assessment based on paper and pencil, computer-web and mobile devices respectively. The aim of the study is to investigate the effect of each mode of assessment on students' motivation and achievement. Analysis of pre- and post-motivation tests revealed a more positive motivational orientation of students towards computers and mobile devices as assessment delivery mediums. Also, student evaluation implemented after the phase of the experimental procedure showed a significant increase in learning achievement for low-achieving students who participated in the mobile-based and computer-based assessment. The positive effects of computers and mobile devices on students' learning motivation suggest that they can be used as a promising alternative to paper and pencil assessment procedures. [ABSTRACT FROM AUTHOR]

Background: Outcome measurement plays an increasing role in improving the quality, effectiveness, efficiency and availability of palliative care. Aim: To provide expert recommendations on outcome measurement in palliative care in clinical practice and research. Methods: Developed by a European Association for Palliative Care Task Force, based on literature searches, international expert workshop, development of outcome measurement guidance and international online survey. A subgroup drafted a first version and circulated it twice to the task force. The preliminary final version was circulated to wider expert panel and 28 international experts across 20 European Association for Palliative Care member associations and the European Association for Palliative Care Board of Directors and revised according to their feedback. The final version was approved by the European Association for Palliative Care Board for adoption as an official European Association for Palliative Care position paper. Results: In all, 12 recommendations are proposed covering key parameters of measures, adequate measures for the task, introduction of outcome measurement into practice, and national and international outcome comparisons and benchmarking. Compared to other recommendations, the White Paper covers similar aspects but focuses more on outcome measurement in clinical care and the wider policy impact of implementing outcome measurement in clinical palliative care. Patient-reported outcome measure feedback improves awareness of unmet need and allows professionals to act to address patients’ needs. However, barriers and facilitators have been identified when implementing outcome measurement in clinical care that should be addressed. Conclusion: The White Paper recommends the introduction of outcome measurement into practice and outcomes that allow for national and international comparisons. Outcome measurement is key to understanding different models of care across countries and, ultimately, patient outcome having controlled for differing patients characteristics. [ABSTRACT FROM AUTHOR]

In the last two decades the web expansion from web of things to web of thought presents a real provocation for governments across societies to achieve citizens' expectations. The transition from e-government to digital government from reactive to proactive service delivery mechanisms is one of the governments main challenges worldwide. The aim of this paper is to analyse the readiness of governments across Europe for the transition from the traditional e-government to digital government. In the paper the digital government is analyzed comparatively with the e-government and focusing on the main differences. [ABSTRACT FROM AUTHOR]

Reports on corporate changes and reorganization of Mondi Business Paper, formerly Anglo-American, a major papermaker company in Europe. Reasons behind the company's name change; Transformation in the paper and packaging group; Development of new company goals and policies.

Reports that three paper manufacturers have been visited by investigators of alleged anticompetitive activities in the European paper and forestry products sector. Norske Skog of Norway; Bemis Co. of Minnesota; Stora Enso of Finland.

Discusses the challenges facing the European paper industry and managing director Teresa Presas of the Confederation of European Paper Industries (CEPI). Reorganization of the CEPI to accommodate expansion of the European Union; Chemical legislation; Recycling targets; Future wood availability; Sustainability; Renewable energy sources; Emission trading directive.

Background: People with intellectual disabilities often present with unique challenges that make it more difficult to meet their palliative care needs. Aim: To define consensus norms for palliative care of people with intellectual disabilities in Europe. Design: Delphi study in four rounds: (1) a taskforce of 12 experts from seven European countries drafted the norms, based on available empirical knowledge and regional/national guidelines; (2) using an online survey, 34 experts from 18 European countries evaluated the draft norms, provided feedback and distributed the survey within their professional networks. Criteria for consensus were clearly defined; (3) modifications and recommendations were made by the taskforce; and (4) the European Association for Palliative Care reviewed and approved the final version. Setting and participants: Taskforce members: identified through international networking strategies. Expert panel: a purposive sample identified through taskforce members’ networks. Results: A total of 80 experts from 15 European countries evaluated 52 items within the following 13 norms: equity of access, communication, recognising the need for palliative care, assessment of total needs, symptom management, end-of-life decision making, involving those who matter, collaboration, support for family/carers, preparing for death, bereavement support, education/training and developing/managing services. None of the items scored less than 86% agreement, making a further round unnecessary. In light of respondents’ comments, several items were modified and one item was deleted. Conclusion: This White Paper presents the first guidance for clinical practice, policy and research related to palliative care for people with intellectual disabilities based on evidence and European consensus, setting a benchmark for changes in policy and practice. [ABSTRACT FROM AUTHOR]

Aim A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Background Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Design Discussion paper. Data sources A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. Discussion The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. Implications for nursing A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Conclusion Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. [ABSTRACT FROM AUTHOR]

On 9 July 2014 the European Commission published the White Paper 'Towards more effective EU merger control'. The White Paper takes stock of the working of the EU Merger Regulation 10 years after the last reform in 2004. It evaluates what degree of coherence and convergence has been achieved in the application of merger control rules and practices at the EU and at Member State level. The White Paper supports recent suggestions to move towards a 'European Merger Area', in which the Commission and national competition authorities (NCAs) apply the same rules to mergers and acquisitions, but does not make concrete proposals in that respect. However, the White Paper proposes amendments to the Merger Regulation in two main areas. First, in order to address an enforcement gap in EU competition law with respect to acquisitions of non-controlling minority shareholdings, the Commission should have the possibility to review certain minority stake transactions creating a 'competitively significant link' between the acquirer and the target, without however making all acquisitions of minority shareholdings subject to the prior notification obligation. Second, the system for referring merger cases between the Commission and NCAs should be streamlined in order to reduce the administrative burden on companies and better ensure that cases are being dealt with by the best placed competition authority. Additional proposals made by the White Paper relate to removing joint ventures established outside the European Economic Area (EEA) and with no effect on EEA markets from the scope of the Merger Regulation and alleviating notification obligations for certain categories of unproblematic mergers. [ABSTRACT FROM AUTHOR]

The article describes the revolutionary new ways of communicating the written word when moving from the Medieval to Modern period in Europe, primarily the use of paper and moveable typeface printing and how these catalysed important cultural developments. A similar revolution has taken place in the last 50 years with the development of the internet. The article looks at how scientific publishing has changed with electronic publishing, including the development of Open Access. The journal Heritage Science is placed into this context. Especially important for scientific journals in an era when anyone can post anything on a webpage, is maintaining standards through high quality refereeing which distinguishes formal scientific literature from informal websites. [ABSTRACT FROM AUTHOR]

Deep geological disposal aims to contain and isolate radioactive waste from the biosphere. Repository systems are made of multiple barriers working together, typically comprising the natural geological barrier provided by the repository host rock and its surroundings and an engineered barrier system. Due to their excellent properties for the confinement of contaminants, including low permeability, high sorption capacity, and swelling/self-sealing capacity, clayey materials are considered as engineered and/or natural barriers in most repository designs under development in Europe. During the lifetime of the repository, clay barriers will be exposed to perturbations, among which those are resulting from gas and heat production within the system. It is important to verify that these perturbations will not be detrimental to the good functioning of these barriers. In this paper, it is shown how the two EURAD R&D work packages, GAS and HITEC use a combination of experimental and modelling approaches to increase the understanding and predictability of the impact on clay barriers of the fundamental processes and their couplings related to gas and heat transport respectively, providing building blocks to support the evaluation of the robustness of the repository concepts. [ABSTRACT FROM AUTHOR]

In recent decades cancer care has seen improvements in the speed and accuracy of diagnostic procedures; the effectiveness of surgery, radiation therapy and medical treatments; the power of information technology; and the development of multidisciplinary, specialist-led approaches to care. Such innovations are essential if we are to continue improving the lives of cancer patients across Europe despite financial pressures on our healthcare systems. Investment in innovation must be balanced with the need to ensure the sustainability of healthcare budgets, and all health professionals have a responsibility to help achieve this balance. It requires scrutiny of the way care is delivered; we must be ready to discontinue practices or interventions that are inefficient, and prioritise innovations that may deliver the best outcomes possible for patients within the limits of available resources. Decisions on innovations should take into account their long-term impact on patient outcomes and costs, not just their immediate costs. Adopting a culture of innovation requires a multidisciplinary team approach, with the patient at the centre and an integral part of the team. It must take a whole-system and whole-patient perspective on cancer care and be guided by high-quality real-world data, including outcomes relevant to the patient and actual costs of care; this accurately reflects the impact of any innovation in clinical practice. The European CanCer Organisation is committed to working with its member societies, patient organisations and the cancer community at large to find sustainable ways to identify and integrate the most meaningful innovations into all aspects of cancer care. [ABSTRACT FROM AUTHOR]

Background Skin diseases constitute up to 40% of all notified occupational diseases in most European countries, predominantly comprising contact dermatitis, contact urticaria, and skin cancer. While insufficient prevention of work-related skin diseases (WRSD) is a top-priority problem in Europe, common standards for prevention of these conditions are lacking. Objective To develop common European standards on prevention and management of WRSD and occupational skin diseases (OSD). Method Consensus amongst experts within occupational dermatology was achieved with regard to the definition of minimum evidence-based standards on prevention and management of WRSD/OSD. Results By definition, WRSDs/OSDs are (partially or fully) caused by occupational exposure. The definition of OSD sensu stricto additionally includes diverging national legal requirements, with an impact on registration, prevention, management, and compensation. With the implementation of the classification of WRSD/OSD in the International Classification of Diseases (ICD) 11th Revision in future, a valid surveillance and comparability across countries will be possible. Currently, WRDS and OSD are still under-reported. Depending on legislation and regulations, huge differences exist in notification procedures in Europe, although notification is crucial to prevent chronic and relapsing disease. Facilities for early diagnosis, essential for individual patient management, should be based on existing guidelines and include a multidisciplinary approach. Patch testing is essential if contact dermatitis persists or relapses. Workplace exposure assessment of WRSD/OSD requires full labelling of product ingredients on material safety data sheets helping to identify allergens, irritants and skin carcinogens. Comparable standards in primary, secondary and tertiary prevention must be established in Europe to reduce the burden of WRSD/OSD in Europe. Conclusion The adoption of common European standards on prevention of WRSD/OSD will contribute to reduce the incidence of OSD and their socio-economic burden. [ABSTRACT FROM AUTHOR]

The growth model (GM) programme in comparative and international political economy attempts to do three things. First, it encourages a dialogue between international and comparative political economy research through creating a shared theoretical framework that moves beyond the methodological and ontological nationalism of traditional comparative research. Second, it draws upon post-Keynesian macroeconomics to emphasise the importance of domestic demand, credit debt, and macro-financial regimes in shaping the politics of advanced capitalism. Third, it draws attention to the dynamics of political conflict, coalition building and social agency in shaping country-specific GMs. Each paper in this special issue either directly or indirectly touches on these different aspects of the nascent GM research programme. But they do so with a particular focus on the comparative political economy of Europe. [ABSTRACT FROM AUTHOR]

This paper examines the impacts of transportation costs to the supply chain management of the Nordic paper industry from a transport geographic view point. The discussion is illustrated by complete cost management accounting data from one paper mill. The main research questions are: What are the transportation costs and how have they developed during the study period concerning the exports to the market? How have the supply chain costs developed? Do order size and transportation costs have any causality in cost per unit of paper? So far, the transportation costs concerning Finnish paper mills have been examined rather scantly. We perceive that transportation costs together with sales costs have crucial effects on the mill profits. The costs rise due to the spatial heterogeneity of the European market. In paper industry, the freight transportation costs have not decreased as in many other industries. The transaction of a small customer order can cost more than twice as much as a large one to the same export markets. In addition, the productivity of aged paper machines has not improved as expected, while the paper sales prices have decreased due to the continuous oversupply. In some geographical ranges, the location planning of paper industry may transform towards local production units near the market. [ABSTRACT FROM AUTHOR]

This document was developed by a group of over two dozen pain clinicians and investigators from Austria, Belgium, Denmark, France, Germany Ireland, Israel, Italy, The Netherlands, Norway. Poland, Portugal, Spain, Sweden, Switzerland and the United Kingdom and funded by an educational grant form Mundipharma International, Limited. The stated aim of the White Paper is to identify inequalities in government policies towards opioids that contribute to inadequate treatment of pain. It calls for their replacement with policies that will support doctors and patients in their efforts to relieve pain. [ABSTRACT FROM AUTHOR]

Aims This article explores the care British nurses provided to victims of typhus during the Second World War. Background Typhus is associated with poverty and overcrowding. During wars in the pre-antibiotic era, civilians were particularly susceptible to epidemics, which military governments feared would spread to their troops. Design This discussion paper draws on archival data from three typhus epidemics in the Second World War to examine the expert work of British nurses in caring for victims during these potential public health disasters. Data Sources The published sources for the paper include material from nursing and medical journals published between 1940-1947. Archival sources come from the National Archives in Kew, the Wellcome Library and the Army Medical Services Museum, between 1943-1945. Of particular interest is the correspondence with Dame Katharine Jones from nurses on active service overseas. Implications for Nursing Whilst epidemics of typhus are now rare, nurses in the present day may be required to care for the public in environments of extreme poverty and overcrowding, where life-threatening infectious diseases are prevalent. This article has demonstrated that it is possible for expert and compassionate nursing to alleviate suffering and prevent death, even when medical technologies are unavailable. Conclusion Expert and compassionate care, adequate nutrition and hydration and attention to hygiene needs are crucial when there are limited pharmacological treatments and medical technologies available to treat infectious diseases. The appreciation of this could have implications for nurses working in current global conflicts. [ABSTRACT FROM AUTHOR]

Aim This study examined the outputs of research papers in diabetes from 31 European countries between 2002 and 2013, and their funding. Methods Diabetes research papers in the Web of Science were identified by means of a filter based on journals and title words. For 2009-2013 papers, the funders were coded to show their sector and nationality. Results Europe published 40 547 diabetes papers in the 12 years between 2002 and 2013. Denmark, Sweden and Finland published the most relative to their wealth, but the UK published the most absolutely despite an apparently low burden (as measured by disability-adjusted life years). The largest source of funding was government (30%), followed by the non-profit sector (18%) and industry (13%). The European Commission supported 2.7% of papers, but more in Latvia (33%) and Estonia (16%). Based on an estimated cost per paper of €260 000, the annual research expenditure in Europe was approximately €986 million in 2013. Conclusions The European diabetes burden in disability-adjusted life years increased by one third between 2002 and 2012, but its output of research papers has decreased from 44% to 36% of the world total. This decrease needs to be reviewed in the context of European non-communicable disease research policy. [ABSTRACT FROM AUTHOR]

This paper introduces the Electronic Repository of Greater Poland Oaths, eROThA (1386–1446), a digitisation project of a diplomatic edition of mediaeval land court oaths recorded in Latin and Old Polish, resulting in a small, lightly tagged specialised bilingual corpus. We present the background, aims, design and methodology of the project. We also discuss the problems and limitations entrenched in turning a printed diplomatic edition into a machine-readable diplomatic edition equipped with a new interpretative layer that is sensitive to the switches between Latin and Old Polish. In addition to the automatic annotation of code-switched items on the basis of typographic characteristics of the printed edition, flexible coding of recurrent language and discourse boundary phenomena has been introduced manually to account for linguistically ambiguous or neutral forms. The project offers a fully multilingual corpus, as well as customised Polish-only and Latin-only datasets, and enables filtered metadata searches in the online front-end. Overall, the report presents a methodology for constructing multilingual corpora in the context of legal cultures in medieval Central Europe that may be extrapolated to datasets originating in other periods and regions. [ABSTRACT FROM AUTHOR]

We survey 54 corporate Commercial Paper (CP) issuers from 11 European countries in order to analyse the perceived benefits and obstacles of internet platforms for issuing CP in Europe. The lack of a joint initiative of large CP issuers, close relations to banks and the fact that liquidity is scattered over separate domestic CP markets are felt to be the main obstacles to the establishment of a European CP platform. Responses reveal consensus that an internet platform would increase flexibility but show divergent opinions about the effect on other criteria. Corporate issuers expect their own issuance activity as well as the overall market volume to increase within the next 5 years. The establishment of an internet-based issuance platform is considered to be likely. [ABSTRACT FROM AUTHOR]

Economic regulation is an instrument of the state or other institutions to correct market failures, rectify the business environment, or protect consumers. Regulation can be a major driver of innovation, and it has proven to be so in the past. On the other hand, there are also documented cases of ineffective regulation due to information delays or shortcomings in government decision-making. The complexity of the impact of regulatory changes on innovation can currently be observed in the medical device market in Europe. Regulation (EU) 2017/745 whose main idea is to ensure greater safety and health protection for consumers, is a challenge for originator, manufacturer, mostly small and medium-sized enterprises. The regulation is associated with an increase in the cost of developing and maintaining the product on the market. We can now gradually begin to analyze whether it can be ranked among those that have become drivers of innovation. [ABSTRACT FROM AUTHOR]

Analyzes the model of the flexible firm in eight British and Finnish paper mills. Flexibility and employment patterns in the contemporary paper industry; Effects of peripherilization of employment on a capitally-intensive environment; Reliance of employers on highly-skilled, experienced, full-time workers to operate advanced machinery.

Traumatic wounds are one of the most common problems leading people to the Emergency Department (ED), accounting for approximately 5,4 % of all the visits, and up to 24 % of all the medical lawsuits. In order to provide a standardized method for wound management in the ED, we have organized a workshop, involving several Italian and European experts. Later, all the discussed statements have been submitted for external validation to a multidisciplinary expert team, based on the so called Delphi method. Eight main statements have been established, each of them comprising different issues, covering the fields of wound classification, infectious risk stratification, tetanus and rabies prophylaxis, wound cleansing, pain management, and suture. Here we present the results of this work, shared by the Academy of Emergency Medicine and Care (AcEMC), and the World Society of Emergency Surgery (WSES). [ABSTRACT FROM AUTHOR]

The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire ‘cancer journey’. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care. [ABSTRACT FROM AUTHOR]

In Europe mainly at winter season the PM levels exceed air quality limits, which correlated with the operation of solid-fired boilers. More and more people are returning to using these devices due to energy shortage caused by the pandemic and regional conflicts. In addition, the phenomena of co-burning fuels and municipal waste in residential boilers in primarily fuel poverty households increases further the amount of pollutants in the atmosphere. This study aims to correlate the quantity and quality of air pollutants with the type of fuel (wood and wastes) burned. Combustion experiments were conducted using oak fuel mixed with three waste groups: (1) plastics (PP, HDPE, PET); (2) textiles (polyester—PES, cotton—COT); and (3) papers (cardboard—CARD, glossy coated paper—GCP, 84C/PAP). The addition of waste to wood fuel altered the morphology of emitted particles. While waste burning doesn't always increase particle quantity, it significantly raises PAH concentrations. A strong relationship exists between waste type, particle morphology, and PAH quality, where with lower molecular weight PAHs linked to tar agglomerates and higher ones to soot agglomerates with inorganic crystals. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to indicate a framework for exploiting the potential role of assistive technology (AT) in supporting care and participation of people with disabilities and elderly people through appropriate service delivery systems (SDS). The paper is based on the findings of the AAATE/EASTIN workshop "Service Delivery Systems on Assistive Technology in Europe" (held in Copenhagen on May 21-22, 2012, under the patronage of the Danish EU Presidency), on the roadmaps indicated by the previous HEART Study published in 1995 by the European Commission, and on a consensus process within the Board of the AAATE (Association for Advancement of Assistive Technology in Europe) and the EASTIN Association (European Assistive Technology Information Network). The first chapter Background) discusses the reasons why a position paper on this issue was deemed useful; it also summarises the key themes of the Copenhagen workshop and recalls the HEART Study. The second chapter (The scope of an AT SDS), discusses the concept of assistive solutions - intended as individualised interventions providing users with appropriate environmental facilitators (AT products, personalised environmental modifications, personal assistance) to overcome disability and enable participation in all aspects of life - and the mission of a SDS - ensuring that all people with disabilities can access appropriate assistive solutions that are able to support autonomy in their life environment. The paper also points out that AT service delivery policies should be well coordinated with accessibility policies i.e. those related to infrastructural interventions ensuring that the mainstream environment, products and services are usable by all people, including those with reduced function or who depend on assistive technology. The third chapter (Basic features of an AT SDS) discusses why public SDS are needed for AT, what the main AT SDS models are, and how a SDS process can be described and monitored in terms of quality. The discussion is organised into answers to eight recurring questions: 1) Are assistive technology products going to disappear in the future, due to the embodiment of accessibility features in mainstream products; 2) Why shouldn't assistive technology products be dealt with as common consumer goods, purchased directly by users without the intermediation of service delivery systems; 3) Are there different approaches for AT service delivery; 4) When can a medical model, or a social model, or a consumer model be considered appropriate; 5) Independently of the model and the Country or Region, is it possible to identify common steps in the service delivery process; 6) How does each step influence the costs and the outcomes of the whole process; 7) How can the SDS process be monitored by quality indicators; and 8) How can information support the service delivery process. The last chapter (Some recommendations) provides a number of useful recommendations for those who are engaged in the design, development and implementation of AT SDS policies. The recommendations are clustered round the six SDS quality indicators suggested by the HEART Study: Accessibility, Competence, Coordination, Efficiency, Flexibility, User Influence. [ABSTRACT FROM AUTHOR]

This consensus paper provides a framework for grading of severity of cardiovascular magnetic resonance (CMR) imaging-based assessment of chamber size, function, and aortic measurements. This does not currently exist for CMR measures. Differences exist in the normal reference values between echocardiography and CMR along with differences in methods used to derive these. We feel that this document will significantly complement the current literature and provide a practical guide for clinicians in daily reporting and interpretation of CMR scans. This manuscript aims to complement a recent comprehensive review of CMR normal value publications to recommend cut-off values required for severity grading. Standardization of severity grading for clinically useful CMR parameters is encouraged to lead to clearer and easier communication with referring clinicians and may contribute to better patient care. To this end, the European Association of Cardiovascular Imaging (EACVI) has formed this expert panel that has critically reviewed the literature and has come to a consensus on approaches to severity grading for commonly quantified CMR parameters. [ABSTRACT FROM AUTHOR]

The purpose of this contribution is to discuss the extent of the Union's competence to adopt a comprehensive instrument of substantive contract law in light of the options set forth in the Commission's 2010 Green Paper on European contract law, with a view to exploring the limits of, and the relationship between, certain prominent Treaty provisions in the debate -- namely, Articles 114, 115, 81, 169 and 352 TFEU (ex Articles 95, 94, 65, 153 and 308 EC, respectively) -- and the roles played by the principles of subsidiarity and proportionality in guiding the exercise of Union competence inside, as well as outside, the EU decision-making process. Moreover, given the reference to certain American techniques in the Green Paper, this contribution seeks to facilitate discussion of the comparative dimensions of the constitutional assessment of contract law in the European Union and the United States. [ABSTRACT FROM AUTHOR]

The focus of this paper is on how the state sets up discriminatory structures, how immigrants work out ways of managing those structures and how in this process they construct flexible and innovative identities. Two main issues are explored. The first is the relationship between state control and exclusion and immigrant resistance. The paper shows how, despite increased surveillance and digital nets mounted by European states to keep immigrants out of their territory, the British state is ambivalent towards irregular immigrants. At the same time, it is in the interstices of ambiguity that immigrants, by buying, renting and borrowing documents, have found ways through their networks and communities to resist or get around exclusionary and contradictory regulations. Second, the paper is concerned with the construction of innovative and flexible identities. The research reveals how immigrants occupy rebellious spaces and construct identities in difficult situations at the intersection of self and structure. [ABSTRACT FROM AUTHOR]

The article focuses on the White Paper on damage actions for breach of Articles 81 and 82 EC published by the European Commission in Europe on April 2, 2008. The published White Paper features a comprehensive recommendation to help victims of competition law infringements abuses in claiming full compensation for the damages that they suffered. The White Paper aspires to strengthen and improve the private implementation of Articles 81 and 82 of the EC Treaty. It also tries to simplify the primary goals of antitrust enforcement framework and facilitate whether the antitrust enforcement framework in the European Union (EU) obtain those goals, if not, it offers an optimal and effective substitute.

Abstract: Background: In 2007, the European Society of Physical and Rehabilitation Medicine (ESPRM) established the European Physical and Rehabilitation Medicine Journal Network (EPRMJN) with a view to increase scientific knowledge among physical and rehabilitation medicine (PRM) specialists and to foster collaboration among the national, regional (multinational) and European PRM journals. In this connection, this paper gives the readers of national and regional, and European PRM journals a complete overview of the European Journal of Physical and Rehabilitation Medicine (EJPRM), the official ESPRM journal, and a review of the papers published in 2008. Methods: The evolution of the EJPRM in the last five years was analyzed, and the papers published in 2008 were systematically reviewed and classified by content and discussed. Results: The EJPRM is listed in PubMed and Current Contents; at now the unofficial 2008 Impact Factor is 1.14, like the Impact Factor, also the independent SCImago Journal Rate and Cites per Doc (two years) have increased steadily since 2005. The EJPRM published 72 papers in 2008, with a well balanced coverage of different rehabilitation topics. The rejection rate is around 40%; the review and publication times are 1.2 and 10.0 months, respectively. The published papers are presented here by topic, highlighting multi-journal initiatives (such as the EPRMJN and the Euro-American Focus with the American Journal of PRM), monographic Special Sections, systematic Cochrane PRM reviews, original papers and case reports, and other contents including the Internet Bookshelf. Conclusion: This paper represents the start of the EPRMJN collaborative efforts to increase scientific knowledge among PRM specialists in Europe, independently of the language in which papers are published. [Copyright &y& Elsevier]

Marcel Duchamp used twine to create a web-like space around the art exhibited in First Papers of Surrealism (1942), simultaneously crafting an engaging exhibition design and a distinctly innovative artwork. The impact of this exhibition design has been well explored. Where its status as an artwork is concerned, however, little attention has been given to the relevance the twine would have had in relation to the war in autumn 1942. No publications address the specific context of aerial warfare that this paper investigates. Through visual analogy, references to recent wartime events in the accompanying exhibition catalogue, and a consideration of the material (guncotton) used to make the work, this article builds the case that Duchamp's web echoed images from war-torn Europe. Duchamp brought the exterior landscapes of aerial warfare in Europe inside the stately mansion hosting the exhibition, thereby transforming the offices of the Coordinating Council of French Relief Societies into a landscape of nocturnal air raids and ground-to-air artillery. In this way, Duchamp's "twine" merits consideration as a work to rival Pablo Picasso's mural Guernica (1937), which appeared in a peripatetic array of international exhibitions from 1937 to 1943 promoting political statements to oppose war and fascism. By contrast, the references to war entangled in Duchamp's twine were subtler--if no less explosive. [ABSTRACT FROM AUTHOR]

This article describes how papermaking emerged in medieval Europe displacing the traditional centers of the industry within the Muslim world. Ibn Marzūq al-Hafīd, a Muslim scholar, issued a fatwa on the permissibility of using European paper under Islamic law. The author contends the text illuminates Islam's evolving relationship with a developing Europe.

The article presents the authors' views in response to a comment on their paper "Patterns of Low and Lowest-Low Fertility in Europe," published in a 2004 issue of the journal "Population Studies." In their comment, the critics have argued that the cohort-fertility analysis in the aforesaid paper is weak on theoretical grounds and the empirical analysis is incomplete. The authors affirm that they agree with the comment that, as a society, the Netherlands differs from Southern Europe and even more from Central and Eastern Europe. Nevertheless, from a contemporary global perspective, these differences should not be overemphasized. They say that in their analyses, they used the Netherlands as a reference case of a country with an extraordinary pattern of late childbearing that is not associated with lowest-low fertility levels. However, the critics believe that these unusual characteristics invalidate the use of the Dutch example in the paper. So, this criticism is misconceived. It is precisely the unusualness of the fertility pattern in the Netherlands that makes it a useful reference point in the study of low and lowest-low fertility.

OBJECTIVE:: To investigate the methods and results used and conclusions found in available published papers on childhood overweight and obesity in Europe. SURVEYS:: This paper compares the two available published papers on the prevalence of child and adolescent overweight and obesity in Europe. The first paper was published in November 2003 and was based on 20 previously conducted surveys performed from 1992 to 2001. The other paper was published in January 2004 and was based on data from the WHO collaborative survey‘Health Behaviour in School Children’, which collected the data in 1997-1998 within a period of 9 months. Height and weight were included as optional questions and 13 European countries, Israel and United States participated. METHODS:: In both papers, body mass index (BMI) was used. In the first paper, measured BMI was used and prevalence of overweight was calculated using IOTF cutoff points. In the other paper, overweight and obesity prevalences were calculated from self-reported height and weight using an internal study reference standard. RESULTS:: The first paper found a north-south trend in overweight in Europe, whereas the second found a more equal distribution of overweight in European children. Thus, overweight was significantly increased among 13?y olds of both sexes in Finland, Ireland, and Greece, and in Portuguese girls. Among 15?y olds, the prevalence of overweight was significantly increased in Greek boys, and in Danish and Portuguese girls. On the contrary, in Lithuania, there was a significantly low prevalence of overweight among both ages and both sexes. CONCLUSION:: Critical reviews of the results of the two published papers show that the year of data collection, methods and use of appropriate statistics are of critical importance for the conclusion drawn from comparative epidemiological surveys on the prevalence of overweight.International Journal of Obesity (2004) 28, S10-S15. doi:10.1038/sj.ijo.0802822 [ABSTRACT FROM AUTHOR]

Where is European space science heading? The ‘Green Paper on European Space Policy’ served as the main background document for a European-wide consultation process on space-related issues which took place in 2003, but none of the 12 questions posed in that document specifically addressed nor recognised the role of fundamental research in underpinning any policy for space. As a result of that consultation, this approach was partly corrected in the European Commission''s ‘White Paper’ on space, but uncertainties remain. Involvement in first-class science is absolutely essential for the promotion of European interests and leadership, as it imparts a strong strategic drive to its technological and industrial system. This article discusses the contents of the White Paper and attempts to suggest lines of action concerning space science in relation with the strategy laid out in that document. [Copyright &y& Elsevier]