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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic, reaching almost one million death worldwide. At present standard treatment for coronavirus disease 2019 (COVID-19) is not well defined because the evidence, either from randomized or observational studies, with conflicting results, has led to rapid changes in treatment guidelines. Our aim was to narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and interpretation of the data by experts who are treating patients in the frontline setting. The panel conducted a detailed review of the literature and eventual press releases from randomized clinical trials for each possible available treatment. Inductive PubMed search waws performed for publications relevant to the topic, including all clinical trials conducted. The result was a flowchart with treatment indications for patients with COVID-19. After 6 months of a pandemic situation and before a possible second coronavirus wave descends on Europe, it is important to evaluate which drugs proved to be effective while also considering that results from many randomized clinical trials are still awaited. Indeed, among treatments for COVID-19, only glucocorticoids have resulted in an association with a significant decrease in mortality in published randomized controlled trials. New therapeutic strategies are urgently needed. [ABSTRACT FROM AUTHOR]

Background: The new European Medicines Agency (EMA) Clinical Trials Information System (CTIS), based on the Clinical Trials Regulation (CTR EU 536/2014), came into full effect on 31 January 2022 and was intended to provide an easier, more streamlined approach to the registration of clinical trials taking place in Europe. Using the experience gained on the new regulatory framework from three multi-national European clinical research studies of outbreak-prone infectious diseases, this article describes the advantages and shortcomings of the new clinical trial submission procedure. Methods: We report the time to approval, size of the application dossier, and number of requests for information (RFIs) for each study. We also explore the experience of each study within the regulatory framework and its use of CTIS to document the real-world, practical consequences of the system on individual studies. The study assesses the experience of three multi-country studies conducted in Europe working within the EU and non-EU regulatory environments. Results: While the time to regulatory and ethical approval has improved since the implementation of the new regulation, the timelines for approvals are still unacceptably slow, particularly for studies being conducted in the context of an evolving outbreak. Within the new regulatory approval procedure, there is evidence of conflicting application requirements, increased document burden, barriers to submitting important modifications, and debilitating technical hurdles. Conclusions: CTIS promised to lower the administrative bar, but unfortunately this has not been achieved. There are challenges that need to be urgently confronted and addressed for international research collaborators to effectively manage health crises in the future. While the value of multi-national outbreak research is clear, the limitations and delays imposed by the system, which raise challenging ethical questions about the regulation, are prejudicial to all clinical research, especially publicly funded academic studies. This report is relevant to both regulators and clinical researchers. It is hoped that these findings can help improve pan-European clinical trials, especially for the purpose of epidemic preparedness and response. Trial registration: This paper references experiences gained during management of three pan-European trials: EU-SolidAct's Bari-SolidAct (CT No. 2022-500385-99-00 - 15 March 2022) and AXL-SolidAct (CT No. 2022-500363-12-00 - 19 April 2022), and MOSAIC (CT No. 2022-501132-42-00 - 22 June 2022). [ABSTRACT FROM AUTHOR]

Air transport has been identified as one of the primary means whereby COVID-19 spread throughout Europe during the early stages of the pandemic. In this paper we analyse two categories of methods – dynamic network markers (DNMs) and network analysis-based methods – as potential early warning signals for detecting and anticipating COVID-19 outbreaks in Europe on the basis of accuracy regarding the daily confirmed cases. The analysis was carried out from 15 February 2020, around two weeks before the first COVID-19 cases appeared in Europe, and 1 May 2020, approximately two weeks after all the air traffic in Europe had been shut down. Daily European COVID-19 information sourced from the World Health Organization was used, whereas air traffic data from Flightradar24 has been incorporated into the analyses by means of four alternative adjacency matrices. Some DNMs have been discarded since they output multiple time series, which makes it very difficult to interpret their results. The only DNM outputting a single time series does not emulate the COVID-19 trend: it does not detect all the main peaks, which means that peak heights do not match up with the increase in the number of infected people. However, many combinations of network analysis based methods and adjacency matrices output good results (with high accuracy and 20-day advance forecasts), with only minor differences from one to another. The number of edges and the network density methods are slightly better when dynamic flight frequency information is used. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought many changes to social behaviours in Europe. One of its major consequences was the temporary closure of borders, which was introduced as a measure to prevent the uncontrolled pandemic spreading and involved internal Schengen borders. This has had a major impact in the way in which cross-border cooperation has been conducted in Europe, including the Czech-Polish borderland, as it dramatically restrained all flows across borders. In this paper, we evaluate the impact of the pandemic on five roles of cross-border cooperation: 1) as a multi-level governance form; 2) as a regional development tool; 3) as a para-diplomacy form; 4) as a post-conflict reconciliation tool; and 5) as Europe-building. We argue that the impacts of the pandemic complicated regional development and the Europe-building role of cross-border cooperation in the Czech-Polish borderland. The article envisages re-bordering processes also in the Czech-Polish borderland, but with important exceptions in the regions with a high level of cross-border integration, mainly in the Euroregion Těšínské Slezsko/Śląsk Cieszyński. The paper also calls for the elaboration of the guidelines for possible repeated (Schengen) border closures and proposes modifications of the INTERREG microprojects schemes, to keep them attractive also in times of expected cuts in public finances. [ABSTRACT FROM AUTHOR]

The outbreak of the COVID-19 global pandemic has strongly affected different issues of everyday life. The pandemic has changed consumer attitudes and behavior. Consequently, during COVID-19, businesses had to decide how to organize the advertising campaigns and what content should be addressed to consumers. Considering the limited number of articles concerning these issues, it seems important to evaluate the impact of the global health crisis on advertising messages in different countries. The main objective of this paper is to assess TV commercial campaigns implemented during the COVID-19 pandemic, including the specific epidemic situation in the selected countries. The research methodology was based on the observation, a qualitative method of collecting data obtained through monitoring the content of TV commercials aired during the afternoon, before or after the main news service. The research was conducted in May 2020 and in May 2021 in five selected European countries affected to varying degrees by the coronavirus pandemic. The research results allowed evaluation of the advertising messages in terms of their content and values exposed. The findings indicate that the number of COVID-related TV commercials is not correlated with the number of patients and deaths from COVID-19. The themes appearing the most often in the TV commercials in the studied period were the #StayAtHome idea, family and friends, the aspect of safety during the crisis, and brands' special offers. The tone of the advertisements was usually uplifting and hopeful, trying to cheer the stressed societies. From a theoretical perspective, the research results show the advertising strategy issues in specific conditions in different European countries. These findings concerning TV commercial strategy during a pandemic crisis could provide references for other countries, especially in Europe. The research results could be useful for marketing managers in developing strategies concerning the successful planning of TV commercials in crisis periods in European countries. [ABSTRACT FROM AUTHOR]

Previous studies have reported a decrease in air pollution levels following the enforcement of lockdown measures during the first wave of the COVID-19 pandemic. However, these investigations were mostly based on simple pre-post comparisons using past years as a reference and did not assess the role of different policy interventions. This study contributes to knowledge by quantifying the association between specific lockdown measures and the decrease in NO2, O3, PM2.5, and PM10 levels across 47 European cities. It also estimated the number of avoided deaths during the period. This paper used new modelled data from the Copernicus Atmosphere Monitoring Service (CAMS) to define business-as-usual and lockdown scenarios of daily air pollution trends. This study applies a spatio-temporal Bayesian non-linear mixed effect model to quantify the changes in pollutant concentrations associated with the stringency indices of individual policy measures. The results indicated non-linear associations with a stronger decrease in NO2 compared to PM2.5 and PM10 concentrations at very strict policy levels. Differences across interventions were also identified, specifically the strong effects of actions linked to school/workplace closure, limitations on gatherings, and stay-at-home requirements. Finally, the observed decrease in pollution potentially resulted in hundreds of avoided deaths across Europe. [ABSTRACT FROM AUTHOR]

Acromegaly embraces typical complications of a pituitary tumor as well as GH (growth hormone) and IGF1 (insulin-like growth factor) excess-related cardio-metabolic and oncologic conditions; and associated medical, surgical treatment or even radiotherapy issues. We point out a few particular aspects concerning acromegaly issues amid COVID-19 pandemic. The review includes only full length, English published papers. One of the most important complications of long standing, untreated or un-responsive to therapy acromegaly is related to respiratory and otorhinolaryngology issues like sleep apnea; this becomes an important aspect causing pulmonary complications in patients with active coronavirus infection. In subjects who are not going through a COVID-19 infection, but they had a prior diagnostic of acromegaly, two main aspects of medical and surgical practice were noted: a massive reduction of surgical volume during the first year of pandemic, mostly during peak months of high infection rate in general population and the introduction of tele (digital) health care systems, of different protocols and various platforms mostly depending of medical center, rather than country or even continent related protocols. Associated central adrenal insufficiency requires a particular attention if COVID-19 positive. The data directly targeting the endocrinologists amid pandemic are very limited. ACROCOVID is a 2021 study that was internationally conducted based on a questionnaire that was applied to 84 endocrinologists (67% of them in Europe); 33% of acromegalic individuals had a delay on procedure because of insufficient COVID-19 assays and 54% of them due to inefficient provision for neurosurgery. Secondary diabetes mellitus (with a potential worsening in some patients due to pasireotide LAR) is at high risk for COVID-19 infection; the level of glycated hemoglobin A1c seems a good predictor at onset of infectious disease. Acromegaly might associate osteoporosis; coronavirus infection aggravates bone loss due to oxidative stress, inflammatory status, cytokine release, immobilization, glucocorticoid use. Acromegaly field concerning pandemic changes represents a complex, still ongoing matter involving both patients and multidisciplinary practitioners. [ABSTRACT FROM AUTHOR]

Disease mapping seeks to represent the risk of a disease. This paper focuses on the spatial analysis of risk for pandemic COVID-19 in Europe and the Mediterranean. Morbidity and mortality data for 54 countries in ratio format were used. Two hypotheses were considered, the first one is that the data are homogeneous and the second one is that the ratios are defined in a heterogeneous manner requiring the stratification on the basis of covariables and the methodology of Jenks' intervals. Spatial risk models were applied as well as methods for the representation of clusters. The results show that the best representation is obtained with the Poisson-Gamma Model under stratification. The variations in the ratios are due to the individual policies of each country for the management of the pandemic. The cluster analysis shows that there is a high mortality process in Eastern Europe. The behavior of the pandemic should be evaluated in the space-time process as well as in other heterogeneous and highly unequal regions. [ABSTRACT FROM AUTHOR]

The current pandemic is sustained in dichotomies and distancing, as most of us awkwardly have recently experienced. Moreover, COVID-19 has definitely put the spotlight on social inequalities that are underpinning our society and it has highlighted the escalation of the state surveillance capability and new forms of oppression too. The discrimination ingrained in our societies, built on a historically defined regime of racialized oppression and structural disadvantage of racialized citizens and migrants, was produced well before the coronavirus, but it is now casting a different shade, reinforcing forms of exclusions, highlighting the pandemic as a political issue. Hence, this paper addresses a range of political perspectives of the lived experiences in and through social space with examples of narratives in language which capture the everyday political experiences of the pandemic within Europe. The kind of language used and its profound effect on the growing discourse regarding COVID-19 is the main focus in this paper. I here explore the intertwining of language and politics during the pandemic and bring out the countervailing narratives that seem to be in constant tension. I then ask where this takes us, not only in terms of scholarship and expansion of knowledge, but also with a pragmatic edge to it, trying to figure out how is it possible for us to achieve some sort of cognitive shift in our approach in order to learn from this challenge and from this new perspective. Methodologically, as well as looking at existing data, references to attitudes in general are made. A theoretical discussion on migration and language, and the kind of intersection between them, is offered, from the point of view of critical theory, before pointing to the metaphors used, the implications they allow, and how all these fit together, in the form of a concluding discussion. Metaphor or not, the power of language in its ramifications of articulations about the pandemic and the idea of distance underlines COVID-19 as a deeply political issue. [ABSTRACT FROM AUTHOR]

There a lot of review papers addressing specific COVID-19 research sectors, then devoted to specialists. This review provides an in-depth summary of the available information about SARS-CoV-2 and the corresponding disease (also known as COVID-19), with a multi-disciplinary approach. After the paper introduction, the first section treats the virological characteristics of SARS-CoV-2, the medical implications of the infection, and the human susceptivity. Great attention is devoted to the factor affecting the infection routes, distinguishing among the possible human-to-human, environmental-to-human, and pollution-to-human transmission mechanisms. The second section is devoted to reporting the impact of SARS-CoV-2 not only on the healthcare systems but also on the economy and society. The third section is devoted to non-pharmaceutical behaviours against COVID-19. In this context, this review section presents an analysis of the European second wave allowing not only to focalize the importance of some restrictions, but also the relevance of social acceptance of some measures. The data reassumed in this work are very useful for interdisciplinary researchers that work in a team to find the basic available information about all the aspects connected with this pandemic (from virus diffusion mechanism to health information, from economic and social impacts to measures to reduce the pandemic spread), with great attention to social acceptance of restriction measures and of vaccines (that currently results to be insufficient to achieve community immunity). Then, this review paper highlights the fundamental role of the trans-multi-disciplinary research that is devoted not only to understand the basics of the pandemic to propose solutions but has also the commitment to find strategies to increase population resilience. For this aim, the authors strongly suggest the establishment of an international health-care trans-multi-disciplinary workforce devoted to investigate, mitigate, and control also future viral events. [Display omitted] • COVID-19 is a highly transmissible disease that has spread all over the globe. • The interdisciplinary research strategy in pandemic has a basic role. • Some concerns due to the reported transmission mechanisms must be better investigated. • The social acceptance of vaccine and restriction measures must be improved. • A health-care multidisciplinary workforce for pandemic study should be established. [ABSTRACT FROM AUTHOR]

This paper contributes to the debate on Europe's modern economic growth using the statistical concept of long-range dependence. Different regimes, defined as periods between two successive endogenously estimated structural shocks, matched episodes of pandemics and war. The most persistent shocks occurred at the time of the Black Death and the twentieth century's world wars. Our findings confirm that the Black Death often resulted in higher income levels but reject the view of a uniform long-term response to the Plague. In fact, we find a negative impact on incomes in non-Malthusian economies. In the North Sea Area (Britain and the Netherlands), the Plague was followed by positive trend growth in output per capita and population, heralding the onset of modern economic growth and the Great Divergence in Eurasia. [ABSTRACT FROM AUTHOR]

Simple Summary: In 2020, many countries around the world went into lockdown to limit the spread of COVID-19, and many people substantially reduced their outdoor activity and began socially distancing to avoid infection. Such rapid and widespread changes in the lives of people all over the world must have an impact on the environment and wildlife. Most of the current pandemic–wildlife papers focus on changes in the movement and behavior of wild animals. These changes, although interesting and worth documenting, may be ephemeral and may not have any significant effect on wildlife in the long run; they may only show how our daily presence may limit the presence and behavior of animals. In this paper, we suggest that scientific interest should be directed toward more permanent changes in the functioning of wildlife. One such topic is the lower road mortality rates of animals during the lockdown. In this study, hedgehog roadkill levels during the lockdown were over 50% lower than in the pre-pandemic years. Reduced road mortality in the case of hedgehogs may mean tens of thousands of survivors nationwide. We hypothesize that this may result in a change in the demographic and genetic characteristics of the population of hedgehogs, and also help to stop the long-term decline in the number of hedgehogs in Europe. Globally, wildlife is affected by unprecedented changes related to the COVID-19 pandemic. In this paper, the lockdown effect on the traffic-related mortality in hedgehogs in an urban area was studied. Comparing the pre-pandemic (2018 and 2019) and pandemic (2020) years, we showed that hedgehog roadkill levels during the lockdown period were over 50% lower (which means a decrease greater than the decrease in road traffic in the same period measured by the number of accidents or the average number of vehicles per day). Based on literature data, we showed that this may mean at least tens of thousands of hedgehogs have survived on a national scale. We report the need to start intensive research on the possible demographic and genetic effects of this unique phenomenon. We also ask how stable the effect of the COVID-19 pandemic will be on wildlife and whether the lockdown (which is an anthropause) may reverse the negative trends in the decline in the number of wild species, including hedgehogs. [ABSTRACT FROM AUTHOR]

In light of the advancing energy transition and an increasing amount of intermittent renewable energy to be integrated, flexibility from distributed energy resources will be key. In this paper, the Italian UVAM (Unità Virtuali Abilitate Miste, i.e., virtually aggregated mixed units) project, one of the biggest pilots in Europe to serve this purpose, is critically reviewed and mapped after two years of operation. The pilot is analyzed on a global level as well as the individual participant level. Based on the extensive analysis of actual market data, different strategies of participating companies to obtain capacity in accordance with the pilot project's design are identified. Furthermore, the specific bidding strategies of individual participating units on the balancing market are outlined. Alongside this, the overall pilot project's market integration, in terms of offered and accepted bids, is depicted. The thorough data analysis, therefore, serves as an input and fundamental building block for future electricity market modeling. Comprehending specific data from the coronavirus disease 2019 (COVID-19) pandemic, provides insights for future high renewable-energy scenarios. Based on the analysis findings, valuable deliverables are devised for both policy-makers and decision-makers who aim to leverage the flexibility potential of distributed resources. [ABSTRACT FROM AUTHOR]