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As humanity reaches the 5.0 industrial revolution, education plays a critical role in boosting the quality of human resources. This paper reports bibliometric research on emerging TiP during 1993-2022 in the educational field to analyse its development on any level of education during the last three decades. This study employed a Scopus database. The findings are that the trend of TiP publication in educational fields has tended to increase every year during the past three decades and conference paper became the most published document type, the USA is the country which produces the most publications; "Students" being the most occurrences keyword and total link strength. The publication of the TiP is ranked to the Quartile 1, which implies that a publication with the cited performance is a publication with credibility because the publisher has a good reputation. Researchers can find the topics most relevant to other metadata sources such as Web of Science, Publish, and Perish.

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Organic farming systems have become widespread in recent decades due to their popularity with consumers and their beneficial effects on the environment and biodiversity. Through the increasing number of available studies from farm surveys and comparable results from long-term field trials, the various real existing forms and intensities of agricultural management were subjected to a closer examination in this review. In this paper, the mean characteristics and the range of variation in crop productivity, crop quality and soil fertility as well as the importance and the extent of environmental impacts are comparatively analyzed. From widespread cultivation systems and forms of nutrient management from Central Europe with a focus on Germany, the following fields of influence were investigated and conclusions for the future optimal design of organic cultivation methods were listed: site, soil conditions, climate, phases of conversion and consolidation, crop rotations and farm structures, application of organic and mineral fertilizer types. [ABSTRACT FROM AUTHOR]

Millennial-scale climate variations during the last glacial period, such as Dansgaard–Oeschger (DO) cycles and Heinrich events, have been extensively studied using ice core and marine proxy records. However, there is a limited understanding of the magnitude of these temperature fluctuations in continental regions, and questions remain about the seasonal signal of these climate events. This study presents a 60 000-year-long temperature reconstruction based on branched glycerol dialkyl glycerol tetraethers (brGDGTs) extracted from lake sediments from the Eifel Volcanic Field, Germany. brGDGTs are bacterial membrane-spanning lipids that are known to have a strong relationship with temperature, making them suitable for temperature reconstructions. We test several temperature calibration models on modern samples taken from soils and multiple maar lakes. We find a negative bias in brGDGT-based temperature estimates associated with water depth and anoxic conditions that can be corrected for by accounting for a brGDGT isomer that is only produced in anoxic conditions. The corrected temperature reconstruction correlates with proxy and climate model estimates of temperature spanning the same time period, validating the calibration approach we selected. However, millennial-scale variability is significantly dampened in the brGDGT record, and in contrast to other Northern Hemisphere climate records, during several Heinrich stadials, temperatures actually increase. We demonstrate that these apparent discrepancies can be explained by the unique seasonal response of the brGDGT paleothermometer to temperatures of months above freezing (TMAF). Our data support the view that warm-season temperatures in Europe varied minimally during the last glacial period and that abrupt millennial-scale events were defined by colder, longer winters. Our continuous high-resolution temperature reconstruction provides important information about the magnitude of seasonal climate variability during the last glacial period that can be used to test climate models and inform studies of paleoecological change. [ABSTRACT FROM AUTHOR]

Seven published and four new pollen records from well-dated sediment cores from six Pleistocene and Holocene maar structures located in the Eifel, Germany, are combined to a pollen stack that covers the entire last 132,000 years. This stack is complemented by new macroremain data from one additional sediment core. The pollen data included into the stack show consistently that the Eifel was covered by a dense forest during the Eemian, early Marine Isotope Stage (MIS) 3, and the Holocene. While other European records indeed indicate a warming, the early MIS 3 fully developed forest remains a unique feature in central European pollen records. Comparison to orbital parameters and insolation hints to warm and humid, however, not fully interglacial conditions, which are also visible in speleothem growth throughout Europe. With the cooling trend towards the glacial maxima of MIS 4 and 2, tree pollen declined, with recovering phases during MIS 5c and 5a, as well as during all MIS 3 interglacials. During the colder stadials, steppe vegetation expanded. For MIS 5 and 4, we defined six new landscape evolution zones based on pollen and macroremains. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the Coronavirus disease 2019(COVID-19) vaccine policies disparities and effectiveness in Germany, Denmark and Bulgaria, with a view to providing lessons for global vaccination and response to possible outbreak risks. Methods: This study analyzed big data through public information on the official websites of the Ministries of Health of the European Union, Germany, Denmark and Bulgaria and the official websites of the World Health Organization. We systematically summarized the COVID-19 vaccine policies of the three countries, and selected the following six indicators for cross-cutting vaccination comparisons: COVID-19 vaccine doses administered per 100 people, COVID-19 vaccination rate, the share of people with fully vaccinated, the share of people only partly vaccinated, cumulative confirmed COVID-19 cases per million, cumulative confirmed COVID-19 deaths per million. Meanwhile, we selected the following four indicators for measuring the effectiveness of COVID-19 vaccine policy implementation: daily cases per million, daily deaths per million, the effective reproduction rate (Rt), the moving-average case fatality rate (CFR). Results: Although these three EU countries had the same start time for vaccination, and the COVID-19 vaccine supply was coordinated by the EU, there are still differences in vaccination priorities, vaccination types, and vaccine appointment methods. Compared to Germany and Denmark, Bulgaria had the least efficient vaccination efforts and the worst vaccination coverage, with a vaccination rate of just over 30% as of June 2023, and the maximum daily deaths per million since vaccination began in the country was more than three times that of the other two countries. From the perspective of implementation effect, vaccination has a certain effect on reducing infection rate and death rate, but the spread of new mutant strains obviously aggravates the severity of the epidemic and reduces the effectiveness of the vaccine. Among them, the spread of the Omicron mutant strain had the most serious impact on the three countries, showing an obvious epidemic peak. Conclusions: Expanding vaccination coverage has played a positive role in reducing COVID-19 infection and mortality rates and stabilizing Rt. Priority vaccination strategies targeting older people and at-risk groups have been shown to be effective in reducing COVID-19 case severity and mortality in the population. However, the emergence and spread of new variant strains, and the relaxation of epidemic prevention policies, still led to multiple outbreaks peaking. In addition, vaccine hesitancy, mistrust in government and ill-prepared health systems are hampering vaccination efforts. Among the notable ones are divergent types of responses to vaccine safety issue could fuel mistrust and hesitancy around vaccination. At this stage, it is also necessary to continue to include COVID-19 vaccination in priority vaccination plans and promote booster vaccination to prevent severe illness and death. Improving the fairness of vaccine distribution and reducing the degree of vaccine hesitancy are the focus of future vaccination work. [ABSTRACT FROM AUTHOR]

The study presents DNA barcoding results of five families of Hymenoptera in Germany. DNA barcodes are provided for 24 of the 25 species of Gasteruption occurring in Central Europe, including 18 of the 19 species recorded from Germany. The genetic diversity was higher than expected, with five species exhibiting two or more Barcode Index Number (BINs), whereas BIN sharing occurred in four species. Gasteruption foveiceps Semenov, 1892, stat. nov. is removed from synonymy with G. nigrescens Schletterer, 1885 and treated as a distinct species. [ABSTRACT FROM AUTHOR]

Background: Developmental dysplasia of the hip (DDH) is a prevalent orthopaedic disorder in children, and screening methods vary across regions due to local health policies. The purpose of this review is to systematise the different ultrasound screening strategies for detecting DDH in newborns in Europe. Methods: Eligible studies from the PubMed, Embase, and Scopus databases, published between 1 January 2018 and 18 March 2023, were included. The inclusion criteria specified a European origin, a focus on newborn human patients, and information on ultrasound for DDH detection. Results: In total, 45 studies were included, covering 18 countries. Among them, six nations (Austria, Bosnia and Herzegovina, Poland, Slovenia, the Czech Republic, and Germany) perform universal ultrasound screening. The timing of the first ultrasound varies, with Austria and the Czech Republic within the 1st week, Bosnia and Herzegovina on the day of birth, Poland between 1 and 12 weeks, and Germany before the 6th week. The Graf method is the most popular ultrasound technique used. Conclusions: There is no consensus on the optimal DDH detection approach in Europe. Varied screening methods stem from epidemiological, cultural, and economic differences among countries. [ABSTRACT FROM AUTHOR]

We present WRF-Chem simulations over central Europe with a spatial resolution of 3 km × 3 km and focus on nitrogen dioxide (NO2). A regional emission inventory issued by the German Environmental Agency, with a spatial resolution of 1 km × 1 km, is used as input. We demonstrate by comparison of five different model setups that significant improvements in model accuracy can be achieved by choosing the appropriate boundary layer scheme, increasing vertical mixing strength, and/or tuning the temporal modulation of the emission data ("temporal profiles") driving the model. The model setup with improved vertical mixing is shown to produce the best results. Simulated NO2 surface concentrations are compared to measurements from a total of 275 in situ measurement stations in Germany, where the model was able to reproduce average noontime NO2 concentrations with a bias of ca. - 3 % and R=0.74. The best agreement is achieved when correcting for the presumed NOy cross sensitivity of the molybdenum-based in situ measurements by computing an NOy correction factor from modelled peroxyacetyl nitrate (PAN) and nitric acid (HNO3) mixing ratios. A comparison between modelled NO2 vertical column densities (VCDs) and satellite observations from TROPOMI (TROPOspheric Monitoring Instrument) is conducted with averaging kernels taken into account. Simulations and satellite observations are shown to agree with a bias of + 5.5 % and R=0.87 for monthly means. Lastly, simulated NO2 concentration profiles are compared to noontime NO2 profiles obtained from multi-axis differential optical absorption spectroscopy (MAX-DOAS) measurements at five locations in Europe. For stations within Germany, average biases of - 25.3 % to + 12.0 % were obtained. Outside of Germany, where lower-resolution emission data were used, biases of up to + 50.7 % were observed. Overall, the study demonstrates the high sensitivity of modelled NO2 to the mixing processes in the boundary layer and the diurnal distribution of emissions. [ABSTRACT FROM AUTHOR]

This study provides new evidence on factors relevant to the success of crowdfunding campaigns run in Europe between 2015 and 2017 on the most popular crowdfunding platforms in Germany/Austria - Kickstarter.com and Startnext.com. In particular, for this study, a sample of 10,514 campaigns from Germany and Austria for the first time serves as a basis for identifying the determinants of the level of projects' (over-)funding. For crowdfunding projects, an increase in a project's funding goal results in higher funding on both platforms, but this does not guarantee success, i.e. reaching the relevant funding goal. Projects with a higher success probability show lower funding goals, especially if launched on Startnext.com. In contrast, a longer duration negligibly increases the amount raised on Startnext and slightly decreases on Kickstarter. On Startnext, projects from the Art cluster have a higher chance to succeed, while those from the Technology cluster show smaller success probabilities as they regularly get less funding. On Kickstarter, projects from the Art, Technology, or Lifestyle field reach higher financing as compared to the Sustainability area. We show that the uncertainty about market size and project/founder quality leads to diverging over- and underfunding levels across platforms and industry clusters, which is of core importance to interested stakeholder groups. [ABSTRACT FROM AUTHOR]

Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries. [ABSTRACT FROM AUTHOR]

Internet usage is a salient developmental factor in adolescents' lives. Although relevant correlates of Internet use have been documented earlier, there is a lack of information on lower socioeconomic status groups. This is important, as these adolescents have increased risk of negative online experiences. The current survey aimed to explore Internet use and parental involvement amongst adolescents from areas of socio-economic disadvantage in 30 urban schools across five European countries. A total of 2594 students participated, of whom 90% were 14–16 years. Virtually all adolescents of socioeconomic disadvantage had Internet access, with 88.5% reporting spending more than two hours per day online, often on apps such as Instagram, Snapchat, and YouTube. Almost one-third of adolescents did not talk with their parents about their Internet use and almost two-thirds indicated that their parents were only a little or not interested in their Internet use. A consistent finding across countries was that girls more often talked with their parents about their Internet use and more often reported that their parents were interested in their Internet use than boys. The results suggest that parents have an important task in explicitly showing interest in their adolescents' Internet use, with special attention needed for boys. [ABSTRACT FROM AUTHOR]

Simple Summary: This opinion paper describes the regulatory hurdles for a clinical oncologist and physician scientist to activate an Investigator-Initiated Trial (IIT) before and after 2004 with German regulation as an example. Changes in legal framework with impacts on time and costs to activate a clinical trial are described. Evidence needed to reach the objective of higher patient safety and trial quality by European Union (EU) Clinical Trial Directive (CTD) 2001/20 is discussed. Shortly after the beginning of the year 2000, multiple legal changes with impacts on the regulatory framework of clinical trials became effective almost simultaneously. They included the European Union (EU) Clinical Trial Directive (CTD) 2001/20 followed by major changes in national drug laws, the change in the legal status of German University Hospitals (1998), and a new disease-related groups (DRG)-based reimbursement system for hospitals in Germany (2000). Together, these changes created enormous bureaucratic and financial inhibition of activation and conduct of academic investigator-initiated clinical trials (IIT). Examples for activating clinical trials in oncology before and after 2004 are outlined and discussed, focussing on extended time frames, the establishment of centralized responsibility structures and the exploding financial consequences. In addition, the evolution of trial numbers and the distribution of trial initiators between "commercial" and "academic" over time are discussed together with the occurrence of clinical registries. At the same time, progress in molecular biology led to a plethora of new targets for effective pharmacological therapy of life-threatening diseases such as cancer, and the overall number of clinical trials has not decreased. Yet, judging the regulatory and administrative hurdles between scientific study design and first-patient on trial before and after 2004 and weighing these against the lack of evidence that this regulation has achieved its goal to enhance patient safety and trial quality, the necessity to completely overhaul this CTD becomes obvious. A main goal of such an initiative should be to minimize bureaucracy. For the specific situation in Germany, relocation of responsibility and freedom to operate in University Hospitals and Medical Faculties back to the physician–scientists and reduction in interference by legal divisions should be a goal as well as increasing the public financial support for IITs. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. Methods: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. Results: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. Conclusions: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients. [ABSTRACT FROM AUTHOR]

Document Reviewers: Rudolf A. de Boer (CPG Review Coordinator) (Netherlands), P. Christian Schulze (CPG Review Coordinator) (Germany), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Elena Arbelo (Spain), Riccardo Asteggiano (Italy), Johann Bauersachs (Germany), Antoni Bayes-Genis (Spain), Michael A. Borger (Germany), Werner Budts (Belgium), Maja Cikes (Croatia), Kevin Damman (Netherlands), Victoria Delgado (Netherlands), Paul Dendale (Belgium), Polychronis Dilaveris (Greece), Heinz Drexel (Austria), Justin Ezekowitz (Canada), Volkmar Falk (Germany), Laurent Fauchier (France), Gerasimos Filippatos (Greece), Alan Fraser (United Kingdom), Norbert Frey (Germany), Chris P. Gale (United Kingdom), Finn Gustafsson (Denmark), Julie Harris (United Kingdom), Bernard Iung (France), Stefan Janssens (Belgium), Mariell Jessup (United States of America), Aleksandra Konradi (Russia), Dipak Kotecha (United Kingdom), Ekaterini Lambrinou (Cyprus), Patrizio Lancellotti (Belgium), Ulf Landmesser (Germany), Christophe Leclercq (France), Basil S. Lewis (Israel), Francisco Leyva (United Kingdom), AleVs Linhart (Czech Republic), Maja-Lisa Løchen (Norway), Lars H. Lund (Sweden), Donna Mancini (United States of America), Josep Masip (Spain), Davor Milicic (Croatia), Christian Mueller (Switzerland), Holger Nef (Germany), Jens-Cosedis Nielsen (Denmark), Lis Neubeck (United Kingdom), Michel Noutsias (Germany), Steffen E. Petersen (United Kingdom), Anna Sonia Petronio (Italy), Piotr Ponikowski (Poland), Eva Prescott (Denmark), Amina Rakisheva (Kazakhstan), Dimitrios J. Richter (Greece), Evgeny Schlyakhto (Russia), Petar Seferovic (Serbia), Michele Senni (Italy), Marta Sitges (Spain), Miguel Sousa-Uva (Portugal), Carlo G. Tocchetti (Italy), Rhian M. Touyz (United Kingdom), Carsten Tschoepe (Germany), Johannes Waltenberger (Germany/Switzerland) All experts involved in the development of these guidelines have submitted declarations of interest. These have been compiled in a report and published in a supplementary document simultaneously to the guidelines. The report is also available on the ESC website www.escardio.org/guidelines For the Supplementary Data which include background information and detailed discussion of the data that have provided the basis for the guidelines see European Heart Journal online., (© 2022 European Society of Cardiology This article has been co-published with permission in European Heart Journal (published by Oxford University Press on behalf of European Society of Cardiology) and European Journal of Heart Failure (published by John Wiley & Sons Ltd on behalf of European Society of Cardiology).)

This article highlights the results of an assessment of population dynamics in medium and small towns in Europe in the years 1875, 1880, 1890, and 1904. These data were presented by Alexander Georg Supan (1847-1920) in his "Lehrbuch der Geographie nach den Principien der neueren Wissenschaft für österreichische Mittelschulen und verwandte Lehranstalten sowie zum Selbstunterrichte" ("Textbook of Geography for Austrian Middle Schools and Related Institutions, as Well as Self-Instruction"), published in the second (1875), fourth (1880), seventh (1890), and eleventh (1904) editions. Particular emphasis is placed on the fact that over the last quarter of the 19th century, the number of medium-populated towns exceeded a fifth of all European cities while small towns comprised a tenth. The article presents the population dynamics of 131 medium-sized towns in Europe in 1875, 1880, 1890, and 1904. It also establishes that medium towns were more typical of Austria-Hungary and Germany than other European countries. [ABSTRACT FROM AUTHOR]

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

Objective: The development and current state of hemorrhagic fever with renal syndrome (HFRS) over the past 40 years are analyzed in this study, along with explored and discovered the hotspots and frontiers in the field, which serve as the foundation for future investigation., Methods: CiteSpace and VOSviewer analysis software were used to visually analyze the literature data on HFRS from 1980 to 2022, including the annual number of publications, countries and research institutions, authors, co-cited literature and keywords., Results: The number of pertinent papers published in the field of HFRS displayed an overall upward trend from 1980 to 2022. The United States, China, Germany, Sweden, and France are the top 5 countries in terms of publishing volume, with high intermediate centrality mainly concentrated in Europe and the United States. The top 10 co-occurring keywords were hemorrhagic fever, renal syndrome, infection, virus, epidemic, nephropathia epidemical, disease, hantavirus, outbreak, and transmission. According to keyword cluster analysis, there were 4 main research fields. In the HFRS-related study, there were mainly 21 notable keywords and "Korean hemorrhagic fever" had the highest hemorrhagic value (28.87)., Conclusion: The United States, China, Germany, Sweden and other countries attached great importance to the HFRS-related research. Moreover, the collaboration between authors and institutions in various collaborator clusters should be strengthened. In recent decades, investigations have focused on the study of viral infection and the clinical symptoms and pathophysiology of HFRS. Future research may concentrate on factors affecting host population distribution and density, such as vaccine development and meteorological factors pertaining to virus transmission., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Aim: The aim of the study was to test the psychometric properties of the Facilitative Student–Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries. Design: A multi‐country, cross‐sectional survey design was applied. Methods: A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha. Results: Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two‐factor construct explaining 47.7% of the total variance, identifying two sub‐scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two‐factor structure. The Cronbach alpha coefficients (0.8–0.9) indicated acceptable reliability of the scale. [ABSTRACT FROM AUTHOR]

Chernozems/Phaeozems are important agricultural resources and have been intensively used for millennia. However, their origin and age are still controversial. In Europe, the westernmost widespread Chernozem/Phaeozem area is located in Central Germany. In contrast to other German regions with anthropogenic Chernozems/Phaeozems, their natural origin is suggested in connection with intensive bioturbation. Yet, radiocarbon is unsuitable for decoding Chernozem/Phaeozem formation so this hypothesis remains untested, whereas single-grain luminescence dating allows to discriminate between different soil sub-processes and formation phases. We applied single-grain feldspar luminescence to a Central German Chernozem that was buried during the Bronze Age and subsequently protected from pedogenic processes. For the first time, we could directly determine timing and rate of Chernozem/Phaeozem formation in Central Europe by dating bioturbation as the dominant soil forming process. Accordingly, Chernozem/Phaeozem formation started at the latest in the Early Holocene prior to Neolithic settlement indicating a natural origin of Central German Chernozems/Phaeozems, and Chernozem/Phaeozem formation ceased around 6–5 ka when the regional climate became more humid. Our effective soil reworking rates show that earthworm bioturbation in Chernozems/Phaeozems is more intense than ant-dominated bioturbation, but significantly less intense than bioturbation by lugworms or ploughing. The latter effect allows to identify prehistoric ploughing in paleosols. [ABSTRACT FROM AUTHOR]

Wind-blown dust (WBD) emitted by the Earth's surface due to sandblasting can potentially have important effects on both climate and human health via interaction with solar and thermal radiation, reducing air quality. Apart from the main dust "centres" around the world, like deserts, dust can be emitted from partly vegetated mid- and high-latitude areas like Europe if certain conditions are suitable (strong winds, bare soil, reduced soil moisture, etc.). Using a wind-blown dust model (WBDUST) along with a chemical transport model (Comprehensive Air-quality model with Extensions, CAMx) coupled to a regional climate model (Weather Research and Forecasting, WRF), this study is one of the first to provide a model-based estimate of such emissions over Europe as well as the long-term impact of WBD emissions on the total particulate matter (PM) concentrations for the 2007–2016 period. We estimated average WBD emissions of about 0.5 and 1.5 Mgyr-1km-2 in fine and coarse modes. Maximum emissions occur over Germany, where the average seasonal fine- and coarse-mode emission flux can reach 0.5 and 1 gs-1km-2 , respectively. Large variability is seen in the averaged daily emissions with values of up to 2 gs-1km-2 for the coarse-mode aerosol on selected days. The WBD emissions increased the modelled winter PM 2.5 and PM 10 concentrations by up to 10 and 20 µgm-3 , respectively, especially over Germany, where the highest emissions occur. The impact on other seasons is lower. Much higher impacts are modelled, however, on selected days when occasionally the urban PM 2.5 and PM 10 concentrations are increased by more than 50 and 100 µgm-3. The comparison with measurements revealed that if WBD is considered, the summer biases are reduced; however, the winter PM is overestimated even more greatly (so the bias increases). We identified a strong overestimation of the modelled wind speed (the maximum daily wind is almost 2 times higher in WRF than the measured ones) suggesting that WBD emissions are also overestimated – hence the enhanced winter PM biases. Moreover, we investigated the secondary impacts of the crustal composition of fine WBD particles on secondary inorganic aerosol (SIA): sulfates (PSO 4), nitrates (PNO 3) and ammonium (PNH 4). Because the water pH value, and thus the uptake of the gaseous precursors of SIA, is perturbed and because the increased aerosol surface serves as an oxidation site, we modelled seasonal PSO 4 and PNO 3 concentrations increased by up to 0.1 µgm-3 and PNH 4 ones decreased by up to -0.05 µgm-3 , especially during winter. In terms of average daily impact, these numbers can, however, reach much larger values of up to 1–2 µgm-3 for sulfates and nitrates, while the decrease in ammonium due to WBD can reach -1 µgm-3 on selected days. The sensitivity test on the choice of the inorganic equilibrium model (ISORROPIA vs. EQuilibrium Simplified Aerosol Model V4, EQSAM) showed that if EQSAM is used, the impact on SIA is slightly stronger (by a few 10 %) due to larger number of cations considered for water pH in EQSAM. Our results have to be regarded as a first estimate of the long-term WBD emissions and the related effects on PM over Europe. Due to the strong positive wind bias and hence strong WBD emissions, we should consider these results as an upper bound. More sensitivity studies involving the impact of the driving meteorological fields, WBD model choice and the input data used to describe the land surface need to be carried out in future to better constrain these emissions. [ABSTRACT FROM AUTHOR]

Fodder maize cultivation under low mountain conditions in Central Europe presents obstacles for organic dairy farmers; low temperatures and high precipitation values in spring delay the juvenile development of maize, which leads to lower and fluctuating yields. Increasing the soil temperature during the critical growth phase of maize in spring is beneficial for maize cultivation. For this reason, 0.15 m high ridge-row cultivation (RCM) of maize was compared to a typical flat surface cultivation method (FCM) with 0.75 m row spacing in three environments (En) in 2017, 2018 and 2020 on-farm at low mountain sites in Germany. In the experiment, with randomised block design and one-factorial arrangement, soil temperature (ST) at 0.05 m soil depth at midday, field emergence (FE) 4, 8, 16 and 20 days after sowing (DAS), dry matter yields (DM) in every En and plant development and N, P, K content in En 2020 were investigated. RCM led to a significantly higher ST 4 DAS in every En, 12 and 20 days in 2018 and 8 and 16 DAS in 2020. RCM did not accelerate maize FE but positively impacted plant development and starch content. RCM generated a higher dry matter (DM) yield of whole maize plants and corn cobs, and a higher protein yield than FCM. RCM slightly increased the plant-available P and Mg content from 0 to 0.3 m and influenced significantly the mineral N content from 0 to 0.3 m at the beginning of grain development. RCM, a simple cultivation technique, demonstrated benefits for maize cultivation, particularly for climatically marginal locations in Germany. [ABSTRACT FROM AUTHOR]

The article highlights developments in public health in Europe as of October 2022. Topics mentioned include the acquisition of an operating grant by European Public Health Association from the European Commission, the lessons about health emergencies that can be learned from COVID-19 pandemic, and the advocacy of Association of Schools of Public Health in the European Region for public health.

Ambient measurements of nitryl chloride (ClNO 2) were performed at a rural site in Germany, covering three periods in winter, summer, and autumn 2019, as part of the JULIAC campaign (Jülich Atmospheric Chemistry Project) that aimed to understand the photochemical processes in air masses typical of midwestern Europe. Measurements were conducted at 50 m aboveground, which was mainly located in the nocturnal boundary layer and thus uncoupled from local surface emissions. ClNO 2 is produced at night by the heterogeneous reaction of dinitrogen pentoxide (N 2 O 5) on chloride (Cl -) that contains aerosol. Its photolysis during the day is of general interest, as it produces chlorine (Cl) atoms that react with different atmospheric trace gases to form radicals. The highest-observed ClNO 2 mixing ratio was 1.6 ppbv (parts per billion by volume; 15 min average) during the night of 20 September. Air masses reaching the measurement site either originated from long-range transport from the southwest and had an oceanic influence or circulated in the nearby region and were influenced by anthropogenic activities. Nocturnal maximum ClNO 2 mixing ratios were around 0.2 ppbv if originating from long-range transport in nearly all seasons, while the values were higher, ranging from 0.4 to 0.6 ppbv for regionally influenced air. The chemical composition of long-range transported air was similar in all investigated seasons, while the regional air exhibited larger differences between the seasons. The N 2 O 5 necessary for ClNO 2 formation comes from the reaction of nitrate radicals (NO 3) with nitrogen dioxide (NO 2), where NO 3 itself is formed by a reaction of NO 2 with ozone (O 3). Measured concentrations of ClNO 2 , NO 2 , and O 3 were used to quantify ClNO 2 production efficiencies, i.e., the yield of ClNO 2 formation per NO 3 radical formed, and a box model was used to examine the idealized dependence of ClNO 2 on the observed nocturnal O 3 and NO 2 concentrations. Results indicate that ClNO 2 production efficiency was most sensitive to the availability of NO 2 rather than that of O 3 and increased with decreasing temperature. The average ClNO 2 production efficiency was highest in February and September, with values of 18 %, and was lowest in December, with values of 3 %. The average ClNO 2 production efficiencies were in the range of 3 % and 6 % from August to November for air masses originating from long-range transportation. These numbers are at the high end of values reported in the literature, indicating the importance of ClNO 2 chemistry in rural environments in midwestern Europe. [ABSTRACT FROM AUTHOR]

With schools and universities closing across Europe, the COVID-19 lockdown left actors in the field of education battling with the unprecedented challenge of finding a meaningful way to keep the wheels of education turning online. The sudden need for digital solutions across the field of education resulted in the emergence of a variety of digital networks and collaborative online platforms. In this joint article from scholars around Europe, we explore the COVID-19 lockdowns of physical education across the European region, and the different processes of emergency digitalization that followed in their wake. Spanning perspectives from Italy, Germany, Belgium, and the Nordic countries, the article's five cases provide a glimpse of how these processes have at the same time accelerated and consolidated the involvement of various commercial and non-commercial actors in public education infrastructures. By gathering documentation, registering dynamics, and making intimations of the crisis as it unfolded, the aim of the joint paper is to provide an opportunity for considering the implications of these accelerations and consolidations for the heterogeneous futures of European education.

Pregnant refugees and new mothers are at high risk of developing mental health problems. Previous research has highlighted an increase in adverse pre‐, peri‐ and postpartum outcomes in refugee women and their newborns. This descriptive study aimed to present the characteristics and needs of refugee women who attended a psychosocial walk‐in clinic addressing pregnant refugees' and new mothers' maternity mental healthcare needs in a state registration and reception centre in Germany. We assessed all patients that consulted the clinic and received interventions during the first 28 weeks after it opened, collecting information on symptoms, diagnoses, attitudes towards and experience of pregnancy, birth, obstetric care and applied psychosocial interventions during consultations. Between November 2017 and May 2018, N = 120 pregnant refugees and new mothers attended the clinic. Most patients were diagnosed with post‐traumatic stress‐, adjustment‐ or depressive disorder. While 69.6% of the women reported physical and mental health problems during pregnancy, 87.4% experienced obstetric complications. Trauma‐informed and psychoeducational interventions were primarily used during counselling sessions. Our data underpin the glaring disparities in refugee maternal healthcare in Germany. Maternal care designed to meet the specific needs of pregnant refugees and mothers is essential. More targeted, evidence‐based and cost‐effective interventions are needed. Our psychosocial walk‐in clinic is a first step towards ensuring primary care delivery for refugee women during the particularly vulnerable period of pregnancy and early motherhood. [ABSTRACT FROM AUTHOR]

Objectives Burden of comorbidities are largely unknown in JIA. From 2000, national and international patient registries were established to monitor biologic treatment, disease activity and adverse events in patients with JIA. The aim of this analysis was to investigate in parallel, for the first time, three of the largest JIA registries in Europe/internationally—UK JIA Biologic Registers (BCRD/BSPAR-ETN), German biologic registers (BiKeR/JuMBO), multinational Pharmachild—to quantify the occurrence of selected comorbidities in patients with JIA. Methods Information on which data the registers collect were compared. Patient characteristics and levels of comorbidity were presented, focussing on four key conditions: uveitis, MAS, varicella, and history of tuberculosis. Incidence rates of these on MTX/biologic therapy were determined. Results 8066 patients were registered into the three JIA registers with similar history of the four comorbidities across the studies; however, varicella vaccination coverage was higher in Germany (56%) vs UK/Pharmachild (16%/13%). At final follow-up, prevalence of varicella infection was lower in Germany (15%) vs UK/Pharmachild (37%/50%). Prevalence of TB (0.1–1.8%) and uveitis (15–19%) was similar across all registers. The proportion of systemic-JIA patients who ever had MAS was lower in Germany (6%) vs UK (15%) and Pharmachild (17%). Conclusion This analysis is the first and largest to investigate the occurrence of four important comorbidities in three JIA registries in Europe and the role of anti-rheumatic drugs. Combined, these three registries represent one of the biggest collection of cases of JIA worldwide and offer a unique setting for future JIA outcome studies. [ABSTRACT FROM AUTHOR]

The 1918 influenza pandemic was the deadliest respiratory pandemic of the 20th century and determined the genomic make-up of subsequent human influenza A viruses (IAV). Here, we analyze both the first 1918 IAV genomes from Europe and the first from samples prior to the autumn peak. 1918 IAV genomic diversity is consistent with a combination of local transmission and long-distance dispersal events. Comparison of genomes before and during the pandemic peak shows variation at two sites in the nucleoprotein gene associated with resistance to host antiviral response, pointing at a possible adaptation of 1918 IAV to humans. Finally, local molecular clock modeling suggests a pure pandemic descent of seasonal H1N1 IAV as an alternative to the hypothesis of origination through an intrasubtype reassortment. For archival pathogens, like pH1N1 Influenza A virus the causative agent of 1918/19 pandemic, only few whole genome sequences exist. Here, Patrono et al. provide one complete and two partial genomes from Germany and find variation in two sites in the nucleoprotein gene in pandemic samples compared to pre-pandemic samples, that are associated with resistance to host antiviral response, pointing at a possible viral adaptation to humans. [ABSTRACT FROM AUTHOR]

Assessing agricultural sustainability is one of the most challenging tasks related to expertise and support methodologies because it entails multidisciplinary aspects and builds on cultural and value-based elements. Thus, agricultural sustainability should be considered a social concept, reliable enough to support decision makers and policy development in a broad context. The aim of this manuscript was to develop a methodology for the assessment of the sustainability of soil improving cropping systems (SICS) in Europe. For this purpose, a decision tree based on weights (%) was chosen because it allows more flexibility. The methodology was tested with data from the SoilCare Horizon 2020 study site in Germany for the assessment of the impact of the integration of cover crops into the crop rotation. The effect on the environmental indicators was slightly positive, but most assessed properties did not change over the short course of the experiment. Farmers reported that the increase in workload was outweighed by a reputation gain for using cover crops. The incorporation of cover crops reduced slightly the profitability, due to the costs for seeds and establishment of cover crops. The proposed assessment methodology provides a comprehensive summary to assess the agricultural sustainability of SICS. [ABSTRACT FROM AUTHOR]

Background: Oral health, coupled with rising awareness on the impact that limited dental care coverage has on oral health and general health and well-being, has received increased attention over the past few years. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach. Methods: We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists. Results: Completed vignettes were received from 11 countries: Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different physical barriers to accessing dental care. The limited availability of contracted dentists (especially in rural areas) and the unequal distribution and lack of specialised dentists are major access barriers to public dental care. Conclusions: According to the results, statutory coverage of dental care varies across European countries, while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries, leading to high out-of-pocket spending. Socioeconomic status is thus a main determinant for access to dental care, but other factors such as geography, age and comorbidities can also inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care. [ABSTRACT FROM AUTHOR]

Teachers trained in one country are often not allowed to serve as teachers in another country because their teacher's license is not recognised as equivalent. The barriers these teachers have to overcome in order to work in their profession again are high and often require further (full) teacher training at the university. The paper provides insights into the conditions for teachers who participate in (re-)qualification programmes in Germany and Europe. By linking the theoretical concepts of a biographical approach to teacher professionalisation and transnationalisation in education, the results of an interview study with teachers who have participated in a programme for refugee teachers at a university in Germany are presented. The Grounded Theory analysis reconstructs the strategies of internationally educated teachers managing to keep up their hope to be able to work as teachers again and thus counter the formal de-professionalisation they are facing.

Commercial inoculants are often used to inoculate field-grown soybean in Europe. However, nodulation efficiencies in these areas are often low. To enhance biological nitrogen (N) fixation and increase domestic legume production, indigenous strains that are adapted to local conditions could be used to develop more effective inoculants. The objective of this study was to assess the ability of locally isolated Bradyrhizobium strains to enhance soybean productivity in different growing conditions of Northeast Germany. Three indigenous Bradyrhizobium isolates (GMF14, GMM36, and GEM96) were tested in combination with different soybean cultivars of different maturity groups and quality characteristics in one field trial and two greenhouse studies. The results showed a highly significant strain × cultivar interactions on nodulation response. Independent of the Bradyrhizobium strain, inoculated plants in the greenhouse showed higher nodulation, which corresponded with an increased N uptake than that in field conditions. There were significantly higher nodule numbers and nodule dry weights following GMF14 and GMM36 inoculation in well-watered soil, but only minor differences under drought conditions. Inoculation of the soybean cultivar Merlin with the strain GEM96 enhanced nodulation but did not correspond to an increased grain yield under field conditions. USDA110 was consistent in improving the grain yield of soybean cultivars Sultana and Siroca. On the other hand, GMM36 inoculation to Sultana and GEM96 inoculation to Siroca resulted in similar yields. Our results demonstrate that inoculation of locally adapted soybean cultivars with the indigenous isolates improves nodulation and yield attributes. Thus, to attain optimal symbiotic performance, the strains need to be matched with specific cultivars. [ABSTRACT FROM AUTHOR]

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Copyright of GMS Hygiene & Infection Control is the property of German Medical Science Publishing House gGmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The new spalacotheriid "symmetrodontan" Cifellitherium suderlandicum gen. et sp. nov. from the Barremian-Aptian of the Balve locality in northwestern Germany is the first record of spalacotheriids in Central Europe. The new taxon is based on one lower and two upper molars. Cifellitherium is similar to Spalacotherium, but differs by smaller stylocone and larger paraststyle on the upper molars, and a labially interrupted cingulid on the lower molar. The new dryolestid Minutolestes submersus gen. et sp. nov. is based on one lower and two upper molars of small size. Phylogenetic analysis revealed it as sister taxon of the clade comprising Laolestes, Krebsotherium, Dryolestes, and Guimarotodus. A dryolestid mandible with unevenly rooted molars and extremely worn down teeth cannot be attributed to Minutolestes submersus gen. et sp. nov. due to possessing molars twice as large in size. The mandible is assigned to a new dryolestid taxon, Beckumia sinemeckelia gen. et sp. nov., and has the dental formula 3i, 1c, 4p, 8m and a fully reduced Meckel's groove. The mandible lacks any trace of a coronoid or splenial. In the phylogenetic analysis, it appears as sister taxon of a clade comprising Achyrodon, Phascolestes, Crusafontia, and Hercynodon. The new mammals are the stratigraphically youngest European representatives of their clades. The late survival of Beckumia sinemeckelia gen. et sp. nov. and Minutolestes submersus gen. et sp. nov. is possibly the result of isolated evolution in an Early Cretaceous island environment. This finding of new spalacotheriid and dryolestid mammals from Central Europe adds to an emerging paleobiogeographic pattern that Europe was distinct from Asia in the constituents of mammalian faunas during the Barremian-Aptian. [ABSTRACT FROM AUTHOR]

Background: Though the disease burden of varicella in Europe has been reported previously, the economic burden is still unknown. This study estimated the economic burden of varicella in Europe in the absence of Universal Varicella Vaccination (UVV) in 2018 Euros from both payer (direct costs) and societal (direct and indirect costs) perspectives.Methods: We estimated the country specific and overall annual costs of varicella in absence of UVV in 31 European countries (27 EU countries, plus Iceland, Norway, Switzerland and the United Kingdom). To obtain country specific unit costs and associated healthcare utilization, we conducted a systematic literature review, searching in PubMed, EMBASE, NEED, DARE, REPEC, Open Grey, and public heath websites (1/1/1999-10/15/2019). The number of annual varicella cases, deaths, outpatient visits and hospitalizations were calculated (without UVV) based on age-specific incidence rates (Riera-Montes et al. 2017) and 2018 population data by country. Unit cost per varicella case and disease burden data were combined using stochastic modeling to estimate 2018 costs stratified by country, age and healthcare resource.Results: Overall annual total costs associated with varicella were estimated to be €662,592,061 (Range: €309,552,363 to €1,015,631,760) in Europe in absence of UVV. Direct and indirect costs were estimated at €229,076,206 (Range €144,809,557 to €313,342,856) and €433,515,855 (Range €164,742,806 to €702,288,904), respectively. Total cost per case was €121.45 (direct: €41.99; indirect: €79.46). Almost half of the costs were attributed to cases in children under 5 years, owing mainly to caregiver work loss. The distribution of costs by healthcare resource was similar across countries. France and Germany accounted for 49.28% of total annual costs, most likely due to a combination of high numbers of cases and unit costs in these countries.Conclusions: The economic burden of varicella across Europe in the absence of UVV is substantial (over 600 M€), primarily driven by caregiver burden including work productivity losses. [ABSTRACT FROM AUTHOR]

This section offers public health-related news briefs in Europe as of December 1, 2021. The World Health Organization (WHO) Global Air Quality Guidelines was launched in September 2021 offering updated air quality guideline (AQG) levels for six key air pollutants. The European Union (EU) vaccines strategy has led to the delivery of over 890 million COVID-19 vaccine doses to Member States, vaccinating over 290 million citizens. The 15th European Public Health Conference will be held in Germany.

Introduction: Cross-border mobility (CBM) to visit social network members or for everyday activities is an important part of daily life for citizens in border regions, including the Meuse-Rhine Euroregion (EMR: neighboring regions from the Netherlands, Belgium, and Germany). We assessed changes in CBM during the COVID-19 pandemic and how participants experienced border restrictions., Methods: Impact of COVID-19 on the EMR' is a longitudinal study using comparative cross-border data collection. In 2021, a random sample of the EMR-population was invited for participation in online surveys to assess current and pre-pandemic CBM. Changes in CBM, experience of border restrictions, and associated factors were analyzed using multinomial and multivariable logistic regression analysis., Results: Pre-pandemic, 82% of all 3,543 participants reported any CBM: 31% for social contacts and 79% for everyday activities. Among these, 26% decreased social CBM and 35% decreased CBM for everyday activities by autumn 2021. Negative experience of border restrictions was reported by 45% of participants with pre-pandemic CBM, and was higher (p < 0.05) in Dutch participants (compared to Belgian; aOR= 1.4), cross-border [work] commuters (aOR= 2.2), participants with cross-border social networks of friends, family or acquaintances (aOR= 1.3), and those finding the measures 'limit group size' (aOR= 1.5) and 'minimalize travel' (aOR= 2.0) difficult to adhere to and finding 'minimalize travel' (aOR= 1.6) useless., Discussion: CBM for social contacts and everyday activities was substantial in EMR-citizens, but decreased during the pandemic. Border restrictions were valued as negative by a considerable portion of EMR-citizens, especially when having family or friends across the border. When designing future pandemic control strategies, policy makers should account for the negative impact of CBM restrictions on their citizens., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 van Bilsen, Brinkhues, Hoebe, Stabourlos, Moonen, Demarest, Hanssen, van Loo, Savelkoul, Philippsen, van der Zanden and Dukers-Muijrers.)

Background: Short-term associations between heat and cardiovascular disease (CVD) mortality have been examined mostly in large cities. However, different vulnerability and exposure levels may contribute to spatial heterogeneity. This study assessed heat effects on CVD mortality and potential vulnerability factors using data from three European countries, including urban and rural settings., Methods: We collected daily counts of CVD deaths aggregated at the small-area level in Norway (small-area level: municipality), England and Wales (lower super output areas), and Germany (district) during the warm season (May-September) from 1996 to 2018. Daily mean air temperatures estimated by spatial-temporal models were assigned to each small area. Within each country, we applied area-specific Quasi-Poisson regression using distributed lag nonlinear models to examine the heat effects at lag 0-1 days. The area-specific estimates were pooled by random-effects meta-analysis to derive country-specific and overall heat effects. We examined individual- and area-level heat vulnerability factors by subgroup analyses and meta-regression, respectively., Results: We included 2.84 million CVD deaths in analyses. For an increase in temperature from the 75th to the 99th percentile, the pooled relative risk (RR) for CVD mortality was 1.14 (95% CI: 1.03, 1.26), with the country-specific RRs ranging from 1.04 (1.00, 1.09) in Norway to 1.24 (1.23, 1.26) in Germany. Heat effects were stronger among women [RRs (95% CIs) for women and men: 1.18 (1.08, 1.28) vs. 1.12 (1.00, 1.24)]. Greater heat vulnerability was observed in areas with high population density, high degree of urbanization, low green coverage, and high levels of fine particulate matter., Conclusion: This study provides evidence for the heat effects on CVD mortality in European countries using high-resolution data from both urban and rural areas. Besides, we identified individual- and area-level heat vulnerability factors. Our findings may facilitate the development of heat-health action plans to increase resilience to climate change., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

European countries more than ever face shifts towards aging societies with accompanying challenges for health and aged care services. Economic evaluation has mainly relied on health measures such as EQ-5D across populations and conditions. We want to know how well the EQ-5D performs in the target population to avoid bias to the disadvantage of older adults and care-dependents. Therefore, we aim to explore differences and similarities of EQ-5D-3L and EQ-5D-5L in comparison to the old-age specific WHOQOL-OLD instrument in a sample of older adults receiving aged care services. We collected data from n = 329 older adults (≥65 years) receiving aged care services in Germany; the majority was at least 80 years and had varying care needs. We assessed instruments' feasibility, test-retest reliability, instruments' association and sensitivity to known-group differences. In terms of feasibility and test-retest reliability both EQ-5D versions performed better than the WHOQOL-OLD. All measures differentiated well between groups based on aspects of general health and care levels. The analysis of relationship between measures indicated that EQ-5D and WHOQOL-OLD assess partially overlapping, but distinct constructs. We found no clear evidence of superiority of either EQ-5D version over the other. The EQ-5D-5L performed better in terms of test-retest reliability and stronger correlations with WHOQOL-OLD facets. We conclude that using the WHOQOL-OLD alongside EQ-5D in this sample added further information on different aspects of quality of life., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: OM and WG are members of the EuroQol Group and receive or have received research grants from the EuroQol Research Foundation. The views of the authors expressed in this paper do not necessarily reflect the views of the EuroQol Group. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Marten, Greiner. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

A cutmarked bear metatarsal and phalanx from the German open-air sites of Schöningen 12 II-1 and 12 B, respectively, correlated with the interglacial optimum of MIS 9 (ca. 320 ka), provide early evidence for the exploitation of bear skins. Archaeological sites with evidence of bear exploitation from the Lower Paleolithic are rare, with only Boxgrove (United Kingdom) and Bilzingsleben (Germany) yielding cutmarked bear bones indicating skinning. We interpret these finds as evidence for bear hunting and primary access since bear skins are best extracted shortly after the animal's death. The very thin cutmarks found on the Schöningen specimens indicate delicate butchering and show similarities in butchery patterns to bears from other Paleolithic sites. The Eurasian Lower Paleolithic record does not show any evidence for the exploitation of bear meat; only Middle Paleolithic sites, such as Biache-Saint-Vaast (France; ca. 175 ka) and Taubach (Germany; ca. 120 ka), yield evidence for the exploitation of both skin and meat from bear carcasses. Bear skins have high insulating properties and might have played a role in the adaptations of Middle Pleistocene hominins to the cold and harsh winter conditions of Northwestern Europe., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

With the increase in global geopolitical risks and the frequent occurrence of extreme climate in recent years, the electricity prices in Europe have shown large fluctuations. Electricity price has an important impact on the cost of production and living, while electricity demand will also affect other energy markets. A double-layer system based on the spillover effects from a systematic perspective is constructed in this paper to explore the connectedness between different electricity markets and other related energy markets in Europe, considering the impact of climate risks. The results show that there are certain spillover effects among electricity markets in different countries, with a temporary upward trend in the beginning of the Russia-Ukraine conflict, and the electricity markets in the UK and Germany have a more important role in Europe. There are two-way spillover effects between the electricity market and fossil fuel markets, carbon market and carbon emission. Since 2022, the electricity market is affected by gas prices, while it has a certain impact on carbon emissions. The heating degree day ( HDD ) has significant spillover effects on the electricity market and other energy markets, while the spillover effects of the cooling degree day ( CDD ) are relatively small.

The Water Framework Directive (WFD) aims to protect and improve water quality across Europe through an integrative and multi-level water governance approach. The goal is to ensure that water quality in Europe meets good ecological status by 2027. Whilst the WFD has been hailed as a cornerstone for governance innovation in water management, most EU member states (MS) still struggle to achieve good ecological status of their waters. The realignment to a multi-level governance structure under the WFD is discretionary, and has generated diversity in WFD multi-level governance implementation approaches and final governance arrangements across MS. This diversity may contribute to low goal achievement and weak compliance. This paper investigates how visual impressions of legislative structure across nine MS can illustrate and contribute to understanding the differences in multi-level implementation of WFD and associated water protection directives. We explore, in-depth, the drivers of visual differences in Portugal, Germany (Lower Saxony) and France. We hypothesise that many of the challenges of WFD implementation, and resulting governance arrangements can be explained in terms of the legacy effects of previous water governance choices. With this conceptual framework of investigating the history and legacy, we found the three in depth studies have had different starting points, paths, and end points in their water governance, with sticking points influencing the decision-making processes and compliance required by the WFD. Sticking points include the complexity of existing water governance structures, lobbying by different sectors, and the mandatory WFD timeline for implementation. Portugal had to resolve its focus on water infrastructure and engineering to enable a re-focus on water quality. France and Portugal experienced 'top down' governance at different points in time, slowing the shift to a multi-level governance system. Lower Saxony, representing just one of 16 federal state systems in Germany, highlighted the complex historic governance structures which cannot easily be restructured, generating a layering effect where new governance systems are fitted to old governance systems. We conclude that there is a need to implement a hybrid approach to water governance and WFD implementation including decentralisation (discretionary) to ensure collaboration and engagement of stakeholders at the local level. This hybrid governance system should run in parallel with a centralised (mandatory) governance and regulatory system to enable national environmental standards to be set and enforced. Such systems may provide the best of both worlds (bottom-up involvement of stakeholders meeting top-down goal achievements) and is worthy of further research., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)