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Background: The application of nanomaterials (NMs) and nano-enabled products (NEPs) across many industries has been extensive and is still expanding decades after first being identified as an emerging technology. Additive manufacturing has been greatly impacted and has seen the benefits of integrating NMs within products. With the expansion of nanotechnology, there has been a need to develop more adaptive and responsive methods to ascertain risks and ensure technology is developed safely. The Safe(r)-by-Design (SbD) concept can be used to establish safe parameters and minimise risks during the materials' lifecycle, including the early stages of the supply chain. Exposure monitoring has advanced in recent years with the creation of standardised protocols for occupational exposure assessment of nano-objects and their aggregates and agglomerates (NOAA)., Methods: To aid in the development of an online SbD-supporting platform by the EU-funded project SAbyNA, we adopt a Europe Standard for monitoring release of NOAA to identify if a greater release of NOAA is associated with incorporation of NMs within NEPs compared to a polymer matrix alone. Case studies included filaments of polypropylene (PP) with nano-Ag or polycarbonate (PC) with single-walled carbon nanotubes (SWCNTs). NMs were received in masterbatch, and therefore previously modified to align with SbD interventions. Results were collected in line with European Standard recommendations: monitoring particle concentrations using direct reading instruments (DRI), sampling for offline chemical and morphological analysis, and collecting contextual information., Results and Discussion: Based on the criteria described in the European standard (BS EN 17058), data from both case studies identified that inhalation exposure relating to NM was "unlikely". Despite this, during the production of the SWCNT-PC filaments, some noteworthy observations were made, including several DRI activity measurements shown to be higher than background levels, and material morphologically similar to the reference SWCNT/polymeric masterbatch observed in offline analysis. The data collected during this campaign were used to discuss choices available for data interpretation and decision-making in the European Standard for monitoring release of NOAA and also to facilitate the development of SAbyNA's user-friendly industry platform for the SbD of NMs and NEPs., Competing Interests: CC, DM, and DL were employed by LATI Industria Termoplastici S.p.A., Italy, a company which develops and produces thermoplastic compounds for high performance applications. JH was employed by Ricardo. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 McLean, Hanlon, Salmatonidis, Galea, Brooker, Citterio, Magni, Vázquez-Campos, Lotti and Boyles.)

The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in diagnostic endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in diagnostic EUS. This curriculum is set out in terms of the prerequisites prior to training; the recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1:  Trainees should have achieved competence in upper gastrointestinal endoscopy before training in diagnostic EUS. 2:  The development of diagnostic EUS skills by methods that do not involve patients is advisable, but not mandatory, prior to commencing formal training in diagnostic EUS. 3:  A trainee's principal trainer should be performing adequate volumes of diagnostic EUSs to demonstrate maintenance of their own competence. 4:  Training centers for diagnostic EUS should offer expertise, as well as a high volume of procedures per year, to ensure an optimal level of quality for training. Under these conditions, training centers should be able to provide trainees with a sufficient wealth of experience in diagnostic EUS for at least 12 months. 5:  Trainees should engage in formal training and supplement this with a range of learning resources for diagnostic EUS, including EUS-guided fine-needle aspiration and biopsy (FNA/FNB). 6:  EUS training should follow a structured syllabus to guide the learning program. 7:  A minimum procedure volume should be offered to trainees during diagnostic EUS training to ensure that they have the opportunity to achieve competence in the technique. To evaluate competence in diagnostic EUS, trainees should have completed a minimum of 250 supervised EUS procedures: 80 for luminal tumors, 20 for subepithelial lesions, and 150 for pancreaticobiliary lesions. At least 75 EUS-FNA/FNBs should be performed, including mostly pancreaticobiliary lesions. 8:  Competence assessment in diagnostic EUS should take into consideration not only technical skills, but also cognitive and integrative skills. A reliable valid assessment tool should be used regularly during diagnostic EUS training to track the acquisition of competence and to support trainee feedback. 9:  A period of supervised practice should follow the start of independent activity. Supervision can be delivered either on site if other colleagues are already practicing EUS or by maintaining contacts with the training center and/or other EUS experts. 10:  Key performance measures including the annual number of procedures, frequency of obtaining a diagnostic sample during EUS-FNA/FNB, and adverse events should be recorded within an electronic documentation system and evaluated., Competing Interests: A. Badaoui has received a consultancy from DEKRA Certification BV (2023). P. Fusaroli has participated in an advisory board for Olympus (2023). J.-W. Poley has received consultancy, travel, and speaker’s fees from Cook Endoscopy (2010 to 2022) and Boston Scientific (2012 to 2022), and consultancy and travel fees from Mediglobe GmbH (2022 to present). R. Gincul has provided EUS workshops for Ipsen (2022) and Olympus (2023) and has received sponsorship from Celltrion (2023) and Abbvie (2023). R. Sadik has received lecture fees from Cook Medical (2011 to present), Boston Scientific (2020 to present), and Olympus (2022 to present).L. Czako, A. Gines, T. Hucl, M. Kahaleh, E. Kalaitzakis, M.C. Petrone, L. Sosa Valencia, S. Teles de Campos, T. Tham, L. van Driel, and L. Vandeputte declare that they have no conflict of interest., (European Society of Gastrointestinal Endoscopy. All rights reserved.)

In the nanosafety projects funded by the European Commission a large amount of data has been generated on hazard and exposure for a variety of engineered nanomaterials (ENMs) and nano-enabled products (NEPs). However, not all the data generated has been published, nor has all the data been stored in an organised manner (e. g. database) which makes it very difficult for researchers, industry and other stakeholders to use it. This paper provides an inventory of NEPs studied in each of these projects, including relevant information on the NEPs, the life-cycle stages evaluated for each of them and an overview of the projects, which can be used for identifying areas in which there might be data gaps. The purpose of analyzing the nanosafety research done on NEPs was to provide an overview of the products studied compare to what can realistically be found in the market (i.e. the exposure relevant materials that workers, consumers and the environment may be exposed to). The analysis done in all the projects included in the inventory allowed the identification of the need to increase the number of studies with well-established commercialized NEPs, such as ENMs used in tyres or sunscreens. In addition, it was found that, in general, there was a correlation of the different ENMs studied with their respective production relevance (i.e. production volumes), except for silver, which was vastly over-represented, and on the other hand carbon black, which was under-represented. Addittionally, there is a need to improve accessibility to relevant and high quality data produced in all these projects to provide transparency and support to different stakeholder needs., (Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.)

Introduction: This paper is an adapted translation of recommendations on telestroke provided by the European Stroke Organization. Lack of stroke specialists determines that many European rural areas remain underserved. Use of telemedicine in stroke care has shown to be safe, increase use of evidence-based therapy and enable coverage of large areas of low population density. An aim of the study is to summarise the following recommendations of the Telestroke Committee of the European Stroke Organization on the setup of telestroke networks in Europe: Hospitals participating in telestroke networks should be chosen according to criteria that include population density, transportation distance, geographic specifics and in-hospital infrastructure and professional resources. Three hospital categories are identified to be part of a hub-and-spoke network: (1) the Telemedicine Stroke Centre (an European Stroke Organization stroke centre or equivalent with specific infrastructure and setup for network and telemedicine support), (2) the telemedicine-assisted stroke Unit (equivalent to an European Stroke Organization stroke unit but without 24 h onsite stroke expertise) and (3) the telemedicine-assisted stroke ready hospital (only covering hyperacute treatment in the emergency department and transferring all patients for further treatment).