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Purpose: Our prospective international survey evaluated the impact of the early phase of the COVID-19 pandemic on the management gynaecological malignancies from the multidisciplinary physicians' perspective with particular focus on clinical infrastructures and trial participation. Methods: Our survey consisted of 53 COVID-related questions. It was sent to healthcare professionals in gynaecological oncology centres across Europe and Pan-Arabian region via the study groups and gynaecological societies from April 2020 to October 2020. All healthcare professionals treating gynaecological cancers were able to participate in our survey. Results: A total of 255 answers were collected from 30 countries. The majority (73%) of participants were gynaecological oncologists from university hospitals (71%) with at least an Intensive Care Unit with cardiopulmonary support available at their institutions. Most institutions continued to perform elective surgeries only for oncological cases (98%). Patients had to wait on average 2 weeks longer for their surgery appointments compared to previous years (range 0–12 weeks). Most cases that were prioritised for surgical intervention across all gynaecological tumours were early-stage disease (74%), primary situation (61%) and good ECOG status (63%). The radicality of surgery did not change in the majority of cases (78%) across all tumour types. During the pandemic, only 38% of clinicians stated they would start a new clinical trial. Almost half of the participants stated the pandemic negatively impacted the financial structure and support for clinical trials. Approximately 20% of clinicians did not feel well-informed regarding clinical algorithm for COVID-19 patients throughout the pandemic. Thirty percent stated that they are currently having trouble in providing adequate medical care due to staff shortage. Conclusion: Despite well-established guidelines, pandemic clearly affected clinical research and patientcare. Our survey underlines the necessity for building robust emergency algorithms tailored to gynaecological oncology to minimise negative impact in crises and to preserve access to clinical trials. [ABSTRACT FROM AUTHOR]

Lyophyllum consists of rare edible and medicinal mushrooms. Considering this group's economic and ecological significance, understanding its biodiversity could be strategically important. Our analysis involved an extensive examination of publicly available ITS sequences from NCBI-GenBank and fungal amplicon sequencing data obtained from NCBI-SRA. At a 98% sequence similarity level, we deliminated 88 Lyophyllum OTUs, 49 of which were not categorized as 'known species'. The diversity of Lyophyllum is predominantly concentrated in the Northern Hemisphere and tends to display endemic distribution, and Europe is particularly notable for its high diversity of Lyophyllum. Given the escalating volume of data produced by amplicon sequencing, employing the amplicon dataset can facilitate an accurate survey of species diversity in Lyophyllum taxonomy. By using data from amplicon datasets, the fieldwork time and research funding for taxonomists can be saved, thereby significantly advancing the progress of the entire field of biodiversity research. [ABSTRACT FROM AUTHOR]

Objective To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)]. Methods Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason. Results We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE <26 vs ≥26 weeks) (58% vs 71%, P  < 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) vs LOE (17%), P  < 0.001, while similar for the third TNFi (19% vs 13%, P  = 0.20). Conclusion A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE vs LOE. [ABSTRACT FROM AUTHOR]

Tillandsia species are plants from the Bromeliaceae family which display biomonitoring capacities in both active and passive modes. The bioaccumulation potential of Tillandsia aeranthos (Loisiel.) Desf. and Tillandsia bergeri Mez acclimated to Southern/Mediterranean Europe has never been studied. More generally, few studies have detailed the maximum accumulation potential of Tillandsia leaves through controlled experiments. The aim of this study is to evaluate the maximum accumulation values of seven metals (Co, Cu, Mn, Ni, Pb, Pt, and Zn) in T. aeranthos and T. bergeri leaves. Plants were immersed in different mono elemental metallic solutions of Co (II), Cu (II), Mn (II), Ni (II), Pb (II), Pt (IV), and Zn (II) ions at different concentrations. In addition, cocktail solutions of these seven metals at different concentrations were prepared to study the main differences and the potential selectivity between metals. After exposure, the content of these metals in the leaves were measured by inductively coupled plasma-optical emission spectrometry. Data sets were evaluated by a fitted regression hyperbola model and principal component analysis, maximum metal loading capacity, and thermodynamic affinity constant were determined. The results showed important differences between the two species, with T. bergeri demonstrating higher capacity and affinity for metals than T. aeranthos. Furthermore, between the seven metals, Pb and Ni showed higher enrichment factors (EF). T. bergeri might be a better bioaccumulator than T. aeranthos with marked selectivity for Pb and Ni, metals of concern in air quality biomonitoring. [ABSTRACT FROM AUTHOR]

Background: Hepatic disorders are often complex and multifactorial, modulated by genetic and environmental determinants. During the last years, the hepatic disease has been progressively established from early stages in life. The use of genetic risk scores (GRS) to predict the genetic susceptibility to a particular phenotype among youth has gained interest in recent years. Moreover, the alanine aminotransferase (ALT) blood biomarker is often considered as hepatic screening tool, in combination with imaging techniques. The aim of the present study was to develop an ALT‐specific GRS to help in the evaluation of hepatic damage risk in European adolescents. Methods: A total of 972 adolescents (51.3% females), aged 12.5–17.5 years, from the Healthy Lifestyle in Europe by Nutrition in Adolescence study were included in the analyses. The sample incorporated adolescents in all body mass index (BMI) categories and was divided considering healthy/unhealthy ALT levels, using sex‐specific cut‐off points. From 1212 a priori ALT‐related single nucleotide polymorphisms (SNPs) extracted from candidate gene selection, a first screening of 234 SNPs univariately associated was established, selecting seven significant SNPs (p <.05) in the multivariate model. An unweighted GRS (uGRS) was developed by summing the number of reference alleles, and a weighted GRS (wGRS), by multiplying each allele to its estimated coefficient. Results: The uGRS and wGRS were significantly associated with ALT (p <.001). The area under curve was obtained integrating BMI as clinical factor, improving the predictive ability for uGRS (.7039) and wGRS (.7035), using 10‐fold internal cross‐validation. Conclusions: Considering BMI status, both GRSs could contribute as complementary tools to help in the early diagnosis of hepatic damage risk in European adolescents. [ABSTRACT FROM AUTHOR]

Acute gastroenteritis is one of the most common diseases in children and an important cause of morbidity and mortality worldwide. No specific treatment is available; therefore, management is exclusively symptomatic. Xyloglucan has been approved in Europe as a class IIa medical device for restoration of the physiological functions of the intestinal wall. Our objective was to assess efficacy and safety of xyloglucan for the treatment of acute gastroenteritis in children. We performed a triple‐blind, randomized placebo‐controlled clinical trial in four primary care centers and one continued care hospital center. The study population comprised children with acute gastroenteritis aged >3 months and <5 years. Our primary endpoint was time (in hours) of resolution of diarrhea, defined as the time to resolution of stool consistency (Bristol Stool Form Scale ≤5 or Amsterdam Stool Form Scale B or C) or time until deposition frequency resumes to normality, whichever occurred first. We also recorded intravenous rehydration, hospitalization, stools per day, Vesikari scale, vomiting, relapse, weight loss, drugs prescribed, and adverse events. Eighty children were included in the intention‐to‐treat population (43 xyloglucan and 37 placebo) and 74 (93%) in the per‐protocol population. Time to resolution of diarrhea was similar in both groups with (median, 95% CI) 24, 17–24 h in the xyloglucan group versus 24, 19–24 h in the placebo group, p =.680. Significant differences were observed for patients with moderate‐to‐severe diarrhea (Vesikari scale ≥9): xyloglucan group (20 [15–24] h) versus placebo group (85 [51–120] h) (p =.04). No other significant differences were found. Xyloglucan can be considered safe and other studies should be performed to confirm the usefulness in patients with moderate‐to‐severe diarrhea. [ABSTRACT FROM AUTHOR]

Background: The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health among European adolescents. Methods: Data from the HELENA study were used. Usual dietary intake was assessed using two 24-h dietary recalls and adherence to the EAT-Lancet diet was assessed using the Planetary Health Diet Index (PHDI), a 16-component index that ranges from 0 to 150 points. Cardiovascular health was assessed through the seven-component Ideal Cardiovascular Health (ICH) score: never smoked, eutrophic body mass index, moderate-to-vigorous physical activity, healthy dietary pattern, low blood pressure, low fasting plasma glucose, and low total cholesterol. Total ICH score was categorized into ideal (5–7) and non-ideal (0–4). Results: A 10-point increment in the PHDI was associated with a lower probability of a non-ideal ICH status (OR 0.84, [95% CI: 0.75, 0.94]) among European adolescents, after adjusting for age, sex, socio-economic status, and total energy intake. Furthermore, a 10-point increment in the PHDI was associated with lower probability of high blood pressure (OR: 0.87 [0.79, 0.96]) and a lower probability of high blood cholesterol (OR: 0.88 [0.78, 0.99]). Conclusion: Our study suggests that a higher PHDI may be associated with a better cardiovascular health status among European adolescents. [ABSTRACT FROM AUTHOR]

Immigration has become a key demographic component in developed European nations. At the same time, many countries have seen an increase in immigration from non-European origins and more diversified migrant flows. In most population projections, however, immigrants are considered an almost homogenous population. This study utilizes a population microsimulation projection model (QuantMig-Mic) for 31 European countries that includes place of birth as a source of heterogeneity for components that could impact population size, age structures, and economic dependency ratios. We simulated different scenarios from 2020 to 2060 in which the birth regions of future immigrant flows were changed drastically compared to recent trends. Our results showed that major shifts in the origin of immigration flows toward Europe would impact the spatial distribution of the population in the continent and therefore—at the local level—the population size of some countries. We found that the age structure would be only marginally affected and that shifts in the composition of immigration flows would not significantly alter the increasing age dependency ratio. Moreover, even in the countries most impacted in terms of population size, no scenario led to notable changes in the total labor force participation rate or in the educational structure of the labor force. [ABSTRACT FROM AUTHOR]

Purpose: The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be assessed. Thus, we aimed to evaluate the relative validity of the PHDI in European adolescents. Methods: We used cross-sectional data from 1804 adolescents (12.5–17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The PHDI (0–150 points) was calculated based on dietary intake data from two non-consecutive 24-h dietary recalls. Associations between the PHDI and usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet were evaluated using multivariable-adjusted mixed-effects linear regression models. Results: Higher PHDI score was associated with greater intakes of nutrients predominantly from plant-source foods, such as vegetable protein, vitamin E, and folate and with lower intake of nutrients predominately from animal-source foods, such as total and saturated fat, cholesterol, and animal protein. Furthermore, a higher PHDI score was also positively associated with plasma β-carotene, vitamin C, vitamin D, folate, and ferritin concentrations, while negatively associated with trans-fatty acids concentration. Moreover, higher PHDI was related to a greater adherence to the Mediterranean dietary pattern. Conclusions: The PHDI showed good relative validity among adolescents in the HELENA study. Hence, future research should assess adherence to the PHDI and long-term health outcomes. [ABSTRACT FROM AUTHOR]

Intra-Annual Density Fluctuations (IADFs) are an important wood functional trait that determine trees' ability to adapt to climatic changes. Here, we use a large tree-ring database of 11 species from 89 sites across eight European countries, covering a climatic gradient from the Mediterranean to northern Europe, to analyze how climate variations drive IADF formation. We found that IADF occurrence increases nonlinearly with ring width in both gymnosperms and angiosperms and decreases with altitude and age. Recently recorded higher mean annual temperatures facilitate the formation of IADFs in almost all the studied species. Precipitation plays a significant role in inducing IADFs in species that exhibit drought tolerance capability, and a growth pattern known as bimodal growth. Our findings suggest that species with bimodal growth patterns growing in western and southern Europe will form IADFs more frequently, as an adaptation to increasing temperatures and droughts. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, several hospitals have incorporated MRI equipment managed directly by their cardiology departments. The aim of our work is to determine the total cost per test of both CT and MRI in the setting of a Cardiology Department of a tertiary hospital. Materials and Methods: The process followed for estimating the costs of CT and MRI tests consists of three phases: (1) Identification of the phases of the testing process; (2) Identification of the resources consumed in carrying out the tests; (3) Quantification and assessment of inputs. Results: MRI involves higher personnel (EUR 66.03 vs. EUR 49.17) and equipment (EUR 89.98 vs. EUR 33.73) costs, while CT consumes higher expenditures in consumables (EUR 93.28 vs. EUR 22.95) and overheads (EUR 1.64 vs. EUR 1.55). The total cost of performing each test is higher in MRI (EUR 180.60 vs. EUR 177.73). Conclusions: We can conclude that the unit cost of each CT and MRI performed in that unit are EUR 177.73 and EUR 180.60, respectively, attributable to consumables in the case of CT and to amortization of equipment and staff time in the case of MRI. [ABSTRACT FROM AUTHOR]

Background: As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. Methods: Data from 6'635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. Results: In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. Conclusions: Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making. [ABSTRACT FROM AUTHOR]

Summary: Background: The frequency of family meals has been suggested as a protective factor against obesity among children. Objective: This study aimed to investigate the cross‐sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes (T2D) across six European countries. Methods: 989 parent–child dyads (52% girls and 72% mothers) were included. Participants completed validated measures to assess the frequency of family meals and anthropometrics. Multivariable regression models were applied to examine the longitudinal associations between family meals frequency and overweight/obesity in children. Logistic regression was performed to predict the odds of having overweight/obesity depending on changes in family meals frequency over a two‐year follow‐up period. Analyses were stratified for children's sex. Results: High frequency of family breakfasts and/or dinners was inversely associated with children's BMI in boys and girls at T2. Results showed decreased odds of overweight/obesity at follow‐up among both boys (OR = 0.65; 95% CI 0.41, 0.96) and girls (OR = 0.53; 95% CI 0.31, 0.87) who consumed minimum of three times family breakfasts and/or family dinners a week at baseline. An increase in family breakfasts and/or dinners frequency was associated with lower odds of overweight/obesity in both boys and girls at follow‐up. Conclusion: A high frequency of family breakfasts and/or dinners but not lunch during childhood is associated with lower odds of overweight/obesity development in children from families at high risk of T2D. The promotion of family meals could help in preventing the development of overweight/obesity among children. [ABSTRACT FROM AUTHOR]

The forest-based sector plays a significant role in supporting Europe on its pathway towards a more integrated and bio-based circular economy. Beyond the supply of timber, forest ecosystems offer a wide range of products and services beneficial to human wellbeing. Non-wood forest products (NWFPs) play an integral role in provisioning forest ecosystem services and constitute a huge portfolio of species from various taxonomic kingdoms. As diverse as the resources themselves is the list of end-products that may be derived from raw non-wood materials. Multiple value-chains of NWFPs provide benefits to actors across all stages of the supply chain. Forest management has not yet directed full attention towards NWFPs, since timber production remains the main management objective, although multi-purpose management is recognised as a key principle of the sector's sustainability paradigm. Lack of knowledge of the socio-economic relevance of NWFPs for European societies and diverse property rights frameworks increase the complexity in forest-based decision making additionally. In this study, the future potential of 38 NWFPs for diversifying the forest bioeconomy is investigated by means of multi-criteria analysis, including stakeholder interaction and expert involvement. The results for six case studies in different biogeographical zones in Europe indicate the latent opportunities NWFPs provide to forest owners who are willing to focus their management on the joint production of wood and non-wood resources as well as their value networks. This study intends to unravel perspectives for forest owners in particular, as they often represent principal decision makers in forest ecosystem management, act as main suppliers of NWFP raw materials, and thus can be understood as key stakeholders in a forest bioeconomy. Even though regional perspectives differ, due to varying socio-economic and ecological environments, there is huge potential to strengthen the economic viability of rural areas. Furthermore, sustainable co-production may foster the ecological integrity of forest ecosystems across Europe. Results show that wild mushrooms constitute the most widespread opportunity to increase additional income from forest management, but the most promising NWFPs can be found in the tree product, understorey plant and animal origin categories. [ABSTRACT FROM AUTHOR]

Objective: To examine the parental food consumption and diet quality and its associations with children's consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations.Design: Cross-sectional study using Feel4diabetes FFQ.Setting: Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children's food consumption after consideration of potential confounders.Participants: 2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6-8 years.Results: Parental food consumption was significantly associated with children's intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children's intake of 'fruit' (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and 'vegetables' (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their 'snacks' consumption (boys: β = -0·143, P < 0·05; girls: β = -0·186, P < 0·01).Conclusion: The present study suggests an association between parental food consumption and diet quality and children's food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research. [ABSTRACT FROM AUTHOR]

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

Background: Methyldibromo glutaronitrile (MDBGN) was one of the most frequent and relevant allergens found in patch testing at the beginning of this century. In 2008, this preservative was banned from cosmetics in Europe and ever since the prevalence of contact allergy to MDBGN has progressively decreased. Despite that gradual decline, MDBGN is still patch‐tested in most baseline series. This study assessed the frequency of MDBGN sensitization, epidemiological characteristics of allergic patients, and the relevance of positive patch tests in a nationwide Spanish registry (REIDAC). Patients and methods: We evaluated consecutively patch‐tested patients in all participating centres. Using these data, we calculated the proportion of patients with positive patch tests to MDBGN from June 2018 to June 2020 and evaluated the relevance of the positive patch tests. Results: One hundred and fourteen out of 5072 (2.24 %) tested patients were sensitized to MDBGN. Clinical current relevance was confirmed in only one case. Conclusion: Although the frequency of contact allergy to MDBGN remains high, no clinical significance was found in most of these patients (5072 tests needed to obtain one relevant positive result). The clinical usefulness of this allergen seems weak and its continued inclusion in the European baseline series is questionable. [ABSTRACT FROM AUTHOR]

Background: Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age. Methods: A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA). Results: Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life. Discussion and conclusions: The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle. [ABSTRACT FROM AUTHOR]

Multiple scattering of parallel cylinders with arbitrary cross section is computed using the T-matrix of each single scatterer and the general translational matrix for cylindrical waves. Usually, the recommended golden rule to compute the translational matrix is Graf’s addition theorem. However, this approach cannot be properly implemented for some geometries, such as in a two-cylinder case when the center of one of them falls within the minimum circular cylinder that circumscribes the other one. In order to overcome this limitation, a transformation between cylindrical waves and plane waves, followed by propagation of the latter, is proposed. The new approach succeeds due to an adequate truncation of the evanescent plane wave spectrum. This strategy is demonstrated by studying the scattering of three infinite elliptic metallic cylinders for different electrical sizes and observing the convergence of the results as a function of the truncated spectrum. Finally, to conclusively show the interest and applicability of the approach, two more complex problems are treated: a group of infinite elliptic metallic cylinders where two different sizes are combined and a practical real-life filter in substrate integrated waveguide (SIW) technology, including several groups of rectangular dielectric cylinders. [ABSTRACT FROM AUTHOR]

To date, few data on how the COVID-19 pandemic and restrictions affected children's physical activity in Europe have been published. This study examined the prevalence and correlates of physical activity and screen time from a large sample of European children during the COVID-19 pandemic to inform strategies and provide adequate mitigation measures. An online survey was conducted using convenience sampling from 15 May to 22 June, 2020. Parents were eligible if they resided in one of the survey countries and their children aged 6–18 years. 8395 children were included (median age [IQR], 13 [10–15] years; 47% boys; 57.6% urban residents; 15.5% in self-isolation). Approximately two-thirds followed structured routines (66.4% [95%CI, 65.4–67.4]), and more than half were active during online P.E. (56.6% [95%CI, 55.5–57.6]). 19.0% (95%CI, 18.2–19.9) met the WHO Global physical activity recommendation. Total screen time in excess of 2 h/day was highly prevalent (weekdays: 69.5% [95%CI, 68.5–70.5]; weekend: 63.8% [95%CI, 62.7–64.8]). Playing outdoors more than 2 h/day, following a daily routine and being active in online P.E. increased the odds of healthy levels of physical activity and screen time, particularly in mildly affected countries. In severely affected countries, online P.E. contributed most to meet screen time recommendation, whereas outdoor play was most important for adequate physical activity. Promoting safe and responsible outdoor activities, safeguarding P.E. lessons during distance learning and setting pre-planned, consistent daily routines are important in helping children maintain healthy active lifestyle in pandemic situation. These factors should be prioritised by policymakers, schools and parents. To our knowledge, our data provide the first multi-national estimates on physical activity and total screen time in European children roughly two months after COVID-19 was declared a global pandemic. Only 1 in 5 children met the WHO Global physical activity recommendations. Under pandemic conditions, parents should set pre-planned, consistent daily routines and integrate at least 2-hours outdoor activities into the daily schedule, preferable on each day. Schools should make P.E. lessons a priority. Decision makers should mandate online P.E. be delivered by schools during distance learning. Closing outdoor facilities for PA should be considered only as the last resort during lockdowns. [ABSTRACT FROM AUTHOR]

Background: With an increasing number of cardiac implantable electronic devices (CIEDs), there has been a paralleled increase in demand for transvenous lead extraction (TLE). Cardiac surgeons (CS) and cardiologists perform TLE; however, data comparing the two groups of operators is scarce. Objective: We compared the outcomes of TLE performed by cardiologists and CS from six European lead extraction units. Method: Data was collected retrospectively of 2205 patients who had 3849 leads extracted (PROMET) between 2005 and 2018. Patient demographics and procedural outcomes were compared between the CS and cardiologist groups, using propensity score matching. A multivariate regression analysis was also performed for variables associated with 30‐day mortality. Results: CS performed the majority of extractions (59.8%), of leads with longer dwell times (90 [57–129 interquartile range (IQR)] vs. 62 [31–102 IQR] months, CS vs. cardiologists, p <.001) and with pre‐dominantly non‐infectious indications (57.4% vs. 50.2%, CS vs. cardiologists, p <.001). CS achieved a higher complete success per lead than the cardiologists (98.1% vs. 95.7%, respectively, p <.01), with a higher number of minor complications (5.51% vs. 2.1%, p <.01) and similar number of major complications (0.47% vs. 1.3%, p =.12). Thirty‐day mortality was similarly low in the CS and cardiologist groups (1.76% vs. 0.94%, p =.21). Unmatched data multivariate analysis revealed infection indication (OR 6.12 [1.9–20.3], p <.01), procedure duration (OR 1.01 [1.01–1.02], p <.01) and CS operator (OR 2.67, [1.12–6.37], p =.027) were associated with 30‐day mortality. Conclusion: TLE by CS was performed with similar safety and higher efficacy compared to cardiologists in high and medium‐volume lead extraction centers. [ABSTRACT FROM AUTHOR]

• Target analysis and suspect screening of 311 new psychoactive substances in wastewater. • One of the largest study in Europe (12 cities, 7 countries) performed in the last years. • Synthetic cathinones and arylcyclohexyamines were most stable in wastewater. • Fentanyl, norfentanyl and 15 new psychoactive substances found in wastewater. • The highest mass loads were for 3-methylmethcathinone, especially during weekends. Wastewater-based epidemiology (WBE) can provide objective and timely information on the use of new psychoactive substances (NPS), originally designed as legal alternatives of internationally controlled drugs. NPS have rapidly emerged on the global drug market, posing a challenge to drug policy and constituting a risk to public health. In this study, a WBE approach was applied to monitor the use of more than 300 NPS, together with fentanyl and its main metabolite norfentanyl, in influent wastewater collected from 12 European cities during March-June 2021. Quantitative and qualitative analysis of NPS in composite 24 h influent wastewater samples were based on solid phase extraction and liquid chromatography-mass spectrometry. In-sample stability tests demonstrated the suitability of most investigated biomarkers, except for a few synthetic opioids, synthetic cannabinoids and phenetylamines. Fentanyl, norfentanyl and eight NPS were quantified in influent wastewater and at least three substances were found in each city, demonstrating their use in Europe. N,N-dimethyltryptamine and 3-methylmethcathinone (3-MMC) were the most common NPS found, with the latter having the highest mass loads (up to 24.8 mg/day/1000 inhabitants). Seven additional substances, belonging to five categories of NPS, were identified in different cities. Spatial trends of NPS use were observed between cities and countries, and a changing weekly profile of use was observed for 3-MMC. WBE is a useful tool to rapidly evaluate emerging trends of NPS use, complementing common indicators (i.e. population surveys, seizures) and helping to establish measures for public health protection. [Display omitted] [ABSTRACT FROM AUTHOR]

Extensive and semi-extensive production based on local swine breeds such as Majorcan Black Pig, Cinta Senese, Gascon, Krškopolje and Turopolje is becoming extremely rare and on the verge of disappearing in Europe. In this context, the main aim of this study was to assess the potential feasibility of marketing strategies to act as guidelines for stakeholders along the supply chain to create and improve added value and match market demands. The sustainability of five production systems was evaluated together with 60 stakeholders representing five local swine breeds, using a World Café (WC) method combined with an Analytical Hierarchical Process (AHP). The results showed that the proposed strategies could differ slightly depending on each system, while the product strategy was a common marketing priority for most of the stakeholders and represented all the systems evaluated. Diversifying production toward quality, innovative products, enhanced standardization, and quality labeling or seals of guarantee, such as the protected geographical indication or the protected designation of origin, would contribute to the sustainability of these chains. Advertising the storytelling of the meat products and emphasizing their healthier properties were also considered as positive strategies. To this effect, promotion should involve improving knowledge of the local systems and raising the profile of the meat products via public relations (networks, web pages, food and gastronomic events, workshops and so on) in the Hotels, Restaurants and Catering (HORECA) sector, stores selling top-quality products and local food shops. Better showcasing of these products and keeping the price in the premium segment would indirectly help the primary sector. By way of conclusion, other more developed local swine systems could be strong competitors, hence it is extremely important to effectively identify and trace all autochthonous swine breed products throughout the production chain. Furthermore, the entire chain must place greater emphasis on grazing (extensive or semi-extensive), the origin of the swine and their meat products. However, of utmost importance is cooperation between farms, firms and institutions. [ABSTRACT FROM AUTHOR]

Software development for data reduction and analysis at large research facilities is increasingly professionalized, and internationally coordinated. To foster software quality and sustainability, and to facilitate collaboration, representatives from software groups of European neutron and muon facilities have agreed on a set of guidelines for development practices, infrastructure, and functional and non-functional product properties. These guidelines have been derived from actual practices in software projects from the EU funded consortium 'Science and Innovation with Neutrons in Europe in 2020' (SINE2020), and have been enriched through extensive literature review. Besides guiding the work of the professional software engineers in our computing groups, we hope to influence scientists who are willing to contribute their own data treatment software to our community. Moreover, this work may also provide inspiration to scientific software development beyond the neutron and muon field. [ABSTRACT FROM AUTHOR]

Background: Several environmental contaminants were shown to possibly influence fetal growth, generally from single exposure family studies, which are prone to publication bias and confounding by co-exposures. The exposome paradigm offers perspectives to avoid selective reporting of findings and to control for confounding by co-exposures. We aimed to characterize associations of fetal growth with the pregnancy chemical and external exposomes.Methods: Within the Human Early-Life Exposome project, 131 prenatal exposures were assessed using biomarkers and environmental models in 1287 mother-child pairs from six European cohorts. We investigated their associations with fetal growth using a deletion-substitution-addition (DSA) algorithm considering all exposures simultaneously, and an exposome-wide association study (ExWAS) considering each exposure independently. We corrected for exposure measurement error and tested for exposure-exposure and sex-exposure interactions.Results: The DSA model identified lead blood level, which was associated with a 97 g birth weight decrease for each doubling in lead concentration. No exposure passed the multiple testing-corrected significance threshold of ExWAS; without multiple testing correction, this model was in favour of negative associations of lead, fine particulate matter concentration and absorbance with birth weight, and of a positive sex-specific association of parabens with birth weight in boys. No two-way interaction between exposure variables was identified.Conclusions: This first large-scale exposome study of fetal growth simultaneously considered >100 environmental exposures. Compared with single exposure studies, our approach allowed making all tests (usually reported in successive publications) explicit. Lead exposure is still a health concern in Europe and parabens health effects warrant further investigation. [ABSTRACT FROM AUTHOR]

We conducted a severe acute respiratory syndrome coronavirus 2 antibody seroprevalence study among >2,000 domestic cats from 4 countries during the first coronavirus disease wave in Europe. We found 4.4% seroprevalence using a virus neutralization test and 4.3% using a receptor-binding domain ELISA, demonstrating probable human-to-cat transmission. [ABSTRACT FROM AUTHOR]

Natural gas can be temporarily stored in a variety of underground facilities, such as depleted gas and oil fields, natural aquifers and caverns in salt rocks. Being extensively monitored during operations, these systems provide a favourable opportunity to investigate how pressure varies in time and space and possibly induces/triggers earthquakes on nearby faults. Elaborate and detailed numerical modelling techniques are often applied to study gas reservoirs. Here we show the possibilities and discuss the limitations of a flexible and easily formulated tool that can be straightforwardly applied to simulate temporal pore-pressure variations and study the relation with recorded microseismic events. We use the software POEL (POroELastic diffusion and deformation) which computes the poroelastic response to fluid injection/extraction in a horizontally layered poroelastic structure. We further develop its application to address the presence of vertical impermeable faults bounding the reservoir and of multiple injection/extraction sources. Exploiting available information on the reservoir geometry and physical parameters, and records of injection/extraction rates for a gas reservoir in southern Europe, we perform an extensive parametric study considering different model configurations. Comparing modelled spatiotemporal pore-pressure variations with in situ measurements, we show that the inclusion of vertical impermeable faults provides an improvement in reproducing the observations and results in pore-pressure accumulation near the faults and in a variation of the temporal pore-pressure diffusion pattern. To study the relation between gas storage activity and recorded local microseismicity, we applied different seismicity models based on the estimated pore-pressure distribution. This analysis helps to understand the spatial distribution of seismicity and its temporal modulation. The results show that the observed microseismicity could be partly linked to the storage activity, but the contribution of tectonic background seismicity cannot be excluded. [ABSTRACT FROM AUTHOR]

Background Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by Chlamydia trachomatis (CT) serovars L1, L2, and L3 and is endemic among men who have sex with men (MSM) in Europe. We evaluated weekly oral azithromycin 1 g for 3 weeks as a treatment for LGV proctitis. Methods This is an open clinical trial with convenience allocation according to treating physician preferences. Adults with clinical proctitis received a single dose of 1 g of intramuscular ceftriaxone and were subsequently allocated to receive (i) doxycycline 100 mg twice daily for 21 days (Doxycycline group) or (ii) azithromycin 1 g orally once weekly for 3 weeks (Azithromycin group). LGV cure (primary endpoint) was defined as resolution of symptoms at week 6 (clinical cure, LGV-CC), with an additional supporting negative rectal polymerase chain reaction (PCR) at week 4 (microbiological cure, LGV-MC), if available. Results One hundred and twenty-five individuals with LGV clinical proctitis were included. All were MSM, and 96% were living with human immunodeficiency virus (HIV). Eighty-two were in the Azithromycin group, and 43 were in the Doxycycline group. LGV cure on a modified intention-to-treat analysis (primary endpoint), occurred in 80 of 82 (98%) in the Azithromycin group versus 41 of 43 (95%) in the Doxycycline group (treatment difference [95% confidence interval {CI}] 2.2% [−3.2, 13.2]). LGV-MC occurred in 70 of 72 (97%) vs 15 of 15 (100%) in the Azithromycin group and Doxycycline group, respectively (treatment difference [95% CI] −2.8% [−9.6; 17.7]). Adverse events were similar in both treatment groups. Conclusions Our findings support extended azithromycin dosing as an alternative treatment option for symptomatic LGV proctitis and provides the rationale for future randomized trials. [ABSTRACT FROM AUTHOR]

Understanding the interaction between genotype performance and the target environment is the key to improving genetic gain, particularly in the context of climate change. Wheat production is seriously compromised in agricultural regions affected by water and heat stress, such as the Mediterranean basin. Moreover, wheat production may be also limited by the nitrogen availability in the soil. We have sought to dissect the agronomic and physiological traits related to the performance of 12 high-yield European bread wheat varieties under Mediterranean rainfed conditions and different levels of N fertilization during two contrasting crop seasons. Grain yield was more than two times higher in the first season than the second season and was associated with much greater rainfall and lower temperatures. However, the nitrogen effect was rather minor. Genotypic effects existed for the two seasons. While several of the varieties from central/northern Europe yielded more than those from southern Europe during the optimal season, the opposite trend occurred in the dry season. The varieties from central/northern Europe were associated with delayed phenology and a longer crop cycle, while the varieties from southern Europe were characterized by a shorter crop cycle but comparatively higher duration of the reproductive period, associated with an earlier beginning of stem elongation and a greater number of ears per area. However, some of the cultivars from northern Europe maintained a relatively high yield capacity in both seasons. Thus, KWS Siskin from the UK exhibited intermediate phenology, resulting in a relatively long reproductive period, together with a high green area throughout the crop cycle. [ABSTRACT FROM AUTHOR]

The oldest-old population is increasing in Europe, and greater focus is placed on promoting mental well-being (MWB) in this population. The European Welfare Models and Mental Wellbeing in Final Years of Life project aims to develop a better understanding of how best to promote positive MWB in the oldest-old population. Using a resources approach, the present study aimed to provide empirical evidence about the structure of MWB in the 80 + year age group and to compare this with the structure of MWB in the old (65–79 years) and adult (18–64 years) population. Twenty-eight items reflecting a focus on positive aspects of MWB were selected from the European Social Survey data (24 countries). After application of an exploratory approach using Exploratory Structural Equation Modelling, five- and six-factor model solutions were found to be statistically appropriate, and the results are consistent with the most widely studied dimensions of MWB. Despite specific differences in the factor models and item loadings, evaluation of formal invariance showed that dimensions built in the same way are comparable across age groups. Although explorative and not conclusive, the results of this study contribute insights into the multidimensional structure of MWB in the oldest-old population and provide a starting point for further research on promoting MWB in the later stages of life. [ABSTRACT FROM AUTHOR]

Aim: Our aim is to demonstrate that a healthy diet might reduce the relation between adiposity and inflammation, whereas an unhealthy diet may increase the effect of adiposity on inflammatory biomarkers. Methods: In 618 adolescents (13–17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake determined by a self-administered computerized 24-h recall. A 9-point Mediterranean diet score and an antioxidant-rich diet score were used as dietary parameters and tested as moderator. Total body fat was represented by the sum of six skinfold thicknesses and central adiposity by waist circumference. A set of inflammation-related biomarkers was used as outcome: a pro/anti-inflammatory interleukins ratio, TGFβ-1, C-reactive protein, TNF-α, 3 cell adhesion molecules, and 3 types of immune cells; gamma-glutamyltransferase (GGT) and homocysteine were used as cardiovascular disease risk biomarkers, and alanine transaminase (ALT) as liver dysfunction biomarker. Multiple linear regression analyses tested moderation by diet in the adiposity-inflammation association and were adjusted for age, sex, country, puberty, socioeconomic status. Results: Both the Mediterranean and antioxidant-rich diet, and overall and central adiposity, were important in the moderation. Diet was a significant protective moderator in the effect of adiposity on the pro/anti-inflammatory interleukins ratio, TGFβ-1, GGT, and ALT. Conclusion: In conclusion, in some cases, a diet rich in antioxidants and essential nutrients may attenuate the concentration of inflammatory biomarkers caused by adiposity, whereas a poor diet appears to contribute to the onset of early oxidative stress signs. [ABSTRACT FROM AUTHOR]

Objective: Adherence and inhaler technique are often suboptimal in asthma and chronic obstructive pulmonary disease (COPD). New inhalers have been developed to improve these determinants of treatment effectiveness. We assessed treatment adherence, satisfaction, and ease of use of DuoResp® Spiromax® among SPRINT study participants. Methods: The Phase IV SPRINT study was conducted in 10 European countries. Asthma and COPD patients were receiving a fixed-dose combination of inhaled corticosteroid (ICS) and long-acting β2-agonist (LABA), delivered via various inhalers including DuoResp Spiromax. DuoResp Spiromax users self-assessed adherence using the 8-item Morisky Medication Adherence Scale (MMAS-8®), and ease of use and satisfaction using 10-point scales, during a single physician's office visit. Results: Of 1661 (asthma: n = 1101; COPD: n = 560) SPRINT study participants, 342 (asthma: n = 235; COPD: n = 107) received DuoResp Spiromax prior to inclusion. Overall, 72.5% of DuoResp Spiromax users reported medium or high adherence (MMAS-8 score ≥6). Mean (standard deviation [SD]) satisfaction score for DuoResp Spiromax was 8.9 (1.6). Almost all (98.8%) DuoResp Spiromax users were at least satisfied with their inhaler; 85.4% were very satisfied. Mean (SD) ease of use score for DuoResp Spiromax was 9.1 (1.3). Conclusions: Asthma and COPD patients using DuoResp Spiromax reported moderate-to-high medication adherence, were very satisfied with their inhaler and found it easy to use. [ABSTRACT FROM AUTHOR]

Introduction: The latest American College of Cardiology and American Heart Association (ACC/AHA) Guidelines for high blood pressure in adults bring changes with lower cut-off points, creating socioeconomic issues in low and middle income countries. It is necessary to consider the changes that would have the adherence to these new guidelines in diagnosis and hypertension (HTN) control with ambulatory blood pressure monitoring (ABPM), the gold standard for hypertension diagnosis. Aim: To describe the changes in hypertension diagnosis and control according to the latest ACC/AHA guidelines, the European Society of Cardiology and European Society of Hypertension (ESC/ESH) and Latin-America Society of Hypertension (LASH) guidelines. Methods: Cross-sectional, descriptive, retrospective study of all patients who have had an ABPM during June 2017 and June 2018 according to cut-off points established by the ACC/AHA Guidelines compared to the ESC/LASH Guidelines. Results: 1957 patients evaluated with ABPM were included; median age was 57 years, 55% were female. The difference in diagnosis by 24-h ABPM, day-time, and night-time cycle was 21%, 42%, and 24% higher applying ACC/AHA guidelines vs ESC/ESH guidelines. There were no significant differences regarding the history of HTN, gender, and age in the circadian pattern. Conclusion: If the measured value of blood pressure in the 24-h ABPM is taken into account, it would necessary to intervene pharmacologically 21.5% more individuals according to the ACC/AHA guidelines in our population, Individualization is awarded. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association of lipoprotein lipase (LPL) polymorphisms with cardiovascular disease (CVD) risk factors in European adolescents, along with the influence of physical activity on these associations. Methods: A total of 13 LPL polymorphisms were genotyped in 1.057 European adolescents (12‐18 years old) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross‐Sectional Study. Serum lipids, glucose, insulin, and leptin (LEP) levels were measured and a CVD risk score was computed. We also measured body weight and height, waist and hip circumferences, and triceps and subscapular skinfold thickness. Physical activity was objectively measured by accelerometry for 7 days. Results: The rs1534649, rs258, rs320, and rs328 polymorphisms were associated with several CVD risk factors (ie, body mass index, triglycerides [TG], LEP, and cholesterol/high‐density lipoprotein [HDL], low‐density lipoprotein [LDL]/HDL, TG/HDL ratios). TG and TG/HDL were associated with haplotype blocks 3 (rs282, rs285 polymorphisms) and 4 (rs3126, rs320, rs328, rs10099160 polymorphisms), being the latter also associated with the CVD risk score. Physical activity modulated the association of adiposity with rs1534649 and rs258 polymorphisms. Conclusions: Polymorphisms rs1534649, rs258, rs320 and rs328, and two haplotypes of LPL were significantly associated with CVD risk factors in European adolescents. Higher levels of moderate to vigorous physical activity may attenuate the effects of rs1534649 and rs258 polymorphisms on adiposity. [ABSTRACT FROM AUTHOR]

Radicalization, as a violent form of extremism, is a growing problem for Europe. Currently, it is possible to find extreme ideologies regarding almost every topic such as religion, politics or sports. This problem, which ranges from personal identity conflicts to complex societal issues, has an impact on several people everyday, especially on youngsters. To confront this situation, the European Union found several initiatives, as a way to face this problem from a scientific perspective. Some of these initiatives face the problem trying to reduce radicalization by working on personal and social skills through education, in such a way the youngster's resilience is improved. This paper aims to present YoungRes, a European project whose goal is to improve the resilience of youngsters. To do so, it unifies an already created intervention — named Fortius — through the inclusion of video games in the learning process. This paper describes both: (1) how the Fortius program is modified to allow video games sessions and (2) the software architecture designed to allow students and educators to participate in YoungRes project. Finally, different suggestions to include in future versions of the game are discussed. [ABSTRACT FROM AUTHOR]

Good weed management relies on the proper timing of weed control practices in relation to weed emergence dynamics. Therefore, the development of models that predict the timing of emergence may help provide growers with tools to make better weed management decisions. The aim of this study was to validate and compare two previously published predictive empirical thermal time models of the emergence of Abutilon theophrasti growing in maize with data sets from the USA and Europe, and test the hypothesis that a robust and general weed emergence model can be developed for this species. Previously developed Weibull and Logistic models were validated against new data sets collected from 11 site‐years, using four measures of validation. Our results indicated that predictions made with the Weibull model were more reliable than those made with the Logistic model. However, Weibull model results still contained appreciable biases that prevent its use as a general model of A. theophrasti emergence. Our findings highlight the need to develop more accurate models if the ultimate goal is to make more precise predictions of weed seedling emergence globally to provide growers with universally consistent tools to make better weed management decisions. [ABSTRACT FROM AUTHOR]

Objective: Assess achievement of low-density lipoprotein cholesterol (LDL-C) targets in European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines.Design: Systematic literature review.Data Sources: Medline, EMBASE, Cumulated Index to Nursing and Allied Health Literature.Eligibility Criteria: Observational studies reporting LDL-C levels/target attainment, measured between 1 August 2006 to 31 August 2017, in European adults with established cardiovascular disease (CVD), diabetes with target organ damage, familial hypercholesterolaemia (FH) or 10-year risk of fatal CVD ≥ 5% (assessed by Systematic Coronary Risk Evaluation [SCORE]).Data Extraction and Synthesis: Two reviewers independently extracted relevant studies and assessed study quality using the Risk of Bias for Non-Randomised Studies-Interventions (ROBINS-I) tool. Primary outcome was the proportion of patients achieving LDL-C targets in the 2011/2016 ESC/EAS guidelines. Where available, patient characteristics were presented as means weighted by sample size. The proportions of patients achieving LDL-C targets in the 5 years before and after publication of the 2011 guidelines were compared using a chi-square test.Results: Across 81 eligible studies (303,534 patients), achievement of LDL-C < 1.8 mmol/L was poor among patients with established CVD (16%; range 9-56%) and at very high risk of CVD (SCORE ≥ 10% [18%; 14-25%]). In individuals with FH, SCORE 5-10%, or diabetes and target organ damage, LDL-C < 2.5 mmol/L was achieved by 15% (9-22%), 46% (21-55%) and 13% (6-34%), respectively. Comparing the 5 years before/after publication of the 2011 guidelines, target achievement increased significantly over time but remained suboptimal (LDL-C < 1.8, 22% versus 15%; LDL-C < 2.5, 68% versus 61%; both p < 0.001; established CVD group only).Conclusions: These data show suboptimal LDL-C control among European patients at high risk of CVD. Those at greatest overall risk (clinically established CVD or at least a 10% 10-year risk of fatal CVD) had the lowest achievement of 2011/2016 EAS/ESC LDL-C targets. With lower LDL-C targets advocated in 2019 ESC/EAS guidelines, this unmet need will increase.Protocol Registration: PROSPERO registration number; CRD77844. [ABSTRACT FROM AUTHOR]

Objectives: International spread has contributed substantially to the high prevalence of antimicrobial resistant (AMR) Neisseria gonorrhoeae infections worldwide. We compared the prevalence of AMR gonococcal isolates among native persons to foreign-born (reporting country different from country of birth) persons, and describe the epidemiological and clinical characteristics of foreign-born patients and their associations to AMR.Methods: We analysed isolates and patient data reported to the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) 2010-2014 (n=9529).Results: Forty-three per cent of isolates had known country of birth and 17.2% of these were from persons born abroad. Almost 50% of foreign-born were from the WHO European Region (13.1% from non-European Union [EU] and the European Economic Area [EEA] countries). Compared with isolates from natives, isolates from foreign-born had a similar level (p>0.05) of azithromycin resistance (7.5% vs 7.2%), ciprofloxacin resistance (50.0% vs 46.3%) and of decreased susceptibility to ceftriaxone (1.9% vs 2.8%); a lower rate of cefixime resistance (5.7% vs 3.6%, p=0.02), and a higher proportion of isolates producing penicillinase (8.4% vs 11.7%, p=0.02). Among isolates from persons born outside EU/EEA, the level of decreased susceptibility to ceftriaxone was higher (1.8% vs 3.5%, p=0.02), particularly in those from the WHO Eastern Mediterranean Region and non-EU/EEA WHO European countries (1.9% vs 9.6% and 8.7%, respectively, p<0.01). In multivariable analysis, foreign-born patients with AMR isolates were more likely to be from non-EU/EEA WHO European countries (adjusted OR [aOR]: 3.2, 95% CI 1.8 to 5.8), WHO Eastern Mediterranean countries (aOR: 1.8, 95% CI 1.1 to 3.3) and heterosexual males (aOR: 1.8, 95% CI 1.2 to 2.7).Conclusions: Importation of AMR strains remains an important threat in the EU/EEA. Research to improve understanding of sexual networks within foreign born and sexual tourism populations could help to inform effective tailor-made interventions. The Euro-GASP demonstrates the public health value of quality-assured surveillance of gonococcal AMR and the need for strengthened AMR surveillance, particularly in the non-EU/EEA WHO European Region. [ABSTRACT FROM AUTHOR]

Process-based vegetation models are widely used to predict local and global ecosystem dynamics and climate change impacts. Due to their complexity, they require careful parameterization and evaluation to ensure that projections are accurate and reliable. The PROFOUND Database (PROFOUND DB) provides a wide range of empirical data on European forests to calibrate and evaluate vegetation models that simulate climate impacts at the forest stand scale. A particular advantage of this database is its wide coverage of multiple data sources at different hierarchical and temporal scales, together with environmental driving data as well as the latest climate scenarios. Specifically, the PROFOUND DB provides general site descriptions, soil, climate, CO2 , nitrogen deposition, tree and forest stand level, and remote sensing data for nine contrasting forest stands distributed across Europe. Moreover, for a subset of five sites, time series of carbon fluxes, atmospheric heat conduction and soil water are also available. The climate and nitrogen deposition data contain several datasets for the historic period and a wide range of future climate change scenarios following the Representative Concentration Pathways (RCP2.6, RCP4.5, RCP6.0, RCP8.5). We also provide pre-industrial climate simulations that allow for model runs aimed at disentangling the contribution of climate change to observed forest productivity changes. The PROFOUND DB is available freely as a "SQLite" relational database or "ASCII" flat file version (at 10.5880/PIK.2020.006/; Reyer et al., 2020). The data policies of the individual contributing datasets are provided in the metadata of each data file. The PROFOUND DB can also be accessed via the ProfoundData R package (https://CRAN.R-project.org/package=ProfoundData ; Silveyra Gonzalez et al., 2020), which provides basic functions to explore, plot and extract the data for model set-up, calibration and evaluation. [ABSTRACT FROM AUTHOR]

Nuclear data and associated tools are critical elements of the nuclear energy industry and research, playing an essential role in the simulation of nuclear systems, safety and performance calculations and interpretation of the reactor instrumentation. Nuclear data improvement requires a combination of much different know-hows that are distributed over many small- and medium-sized institutions along Europe. The Euratom programs have facilitated the setup of pan European collaborations getting together the required experience inside the projects CHANDA, ERINDA and the JRC action EUFRAT. The paper describes the holistic and inclusive approach of these projects that have also worked together to coordinate the European nuclear data research capabilities to improve the facilities, detectors, models and evaluation, validation and simulation tools. It also shows examples of success histories and summary of results of these projects and of their impact on the EU nuclear safety and industry, together with an outlook to the future. [ABSTRACT FROM AUTHOR]

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This article discusses the economic dimensions of agroecological farming systems in Europe. It firstly theoretically elaborates the reasons why, and under what conditions, agroecological farming systems have the potential to produce higher incomes than farms that follow the conventional logic. This theoretical exposition is then followed by a presentation of empirical material from a wide range of European countries that shows the extent to which this potential is being realized. The empirical data draw upon different styles of farming that can be described as 'proto-agroecological': approaches to farming that are agroecological by nature, but which may not necessarily explicitly define themselves as agroecological. The empirical material that we present shows the huge potential and radical opportunities that Europe's, often silent, 'agroecological turn' offers to farmers that could (and should) be the basis for the future transformation of European agricultural policies, since agroecology not only allows for more sustainable production of healthier food but also considerably improves farmers' incomes. It equally carries the promise of re-enlarging productive agricultural (and related) employment and increasing the total income generated by the agricultural sector, at both regional and national levels. While we recognise that agroecology is a worldwide and multidimensional phenomenon we have chosen to limit this analysis to Europe and the economic dimension. This choice is made in order to refute current discourses that represent agroecology as unproductive and unprofitable and an option that would require massive subsidies. • Throughout Europe a range of proto-agroecological practices can be identified.. • Agroecology carries considerable economic potential: it sustains employment levels and increases incomers.. • The VA/GVP ratio helps to explain the strength of agroecological farming. • Agroecological farming is key to the much needed transformation of European agriculture. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers.Design: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5-17·5 years.Setting: Nine European countries.Participants: European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated.Results: Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05).Conclusions: zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents. [ABSTRACT FROM AUTHOR]

Process-based vegetation models are widely used to predict local and global ecosystem dynamics and climate change impacts. Due to their complexity, they require careful parameterization and evaluation to ensure that projections are accurate and reliable. The PROFOUND Database (PROFOUND DB) provides a wide range of empirical data to calibrate and evaluate vegetation models that simulate climate impacts at the forest stand scale. A particular advantage of this database is its wide coverage of multiple data sources at different hierarchical and temporal scales, together with environmental driving data as well as the latest climate scenarios. Specifically, the PROFOUND DB provides general site descriptions, soil, climate, CO2, nitrogen deposition, tree and forest stand-level, as well as remote sensing data for nine contrasting forest stands distributed across Europe. Moreover, for a subset of five sites, time series of carbon fluxes, atmospheric heat conduction, and soil water are also available. The climate and nitrogen deposition data contain several datasets for the historic period and a wide range of future climate change scenarios following the Representative Concentration Pathways (RCP2.6, RCP4.5, RCP6.0, RCP8.5). We also provide pre-industrial climate simulations that allow for model runs aimed at disentangling the contribution of climate change to observed forest productivity changes. The PROFOUND DB is available freely as a "SQLite" relational database or "ASCII" flat file version (at https://doi.org/10.5880/PIK.2019.008). The data policies of the individual, contributing datasets are provided in the metadata of each data file. The PROFOUND DB can also be accessed via the ProfoundData R-package (https://github.com/COST-FP1304-PROFOUND/ProfoundData), which provides basic functions to explore, plot, and extract the data for model set-up, calibration and evaluation. [ABSTRACT FROM AUTHOR]

The human exposome affects child development and health later in life, but its personal external levels, variability, and correlations are largely unknown. We characterized the personal external exposome of pregnant women and children in eight European cities. Panel studies included 167 pregnant women and 183 children (aged 6–11 years). A personal exposure monitoring kit composed of smartphone, accelerometer, ultraviolet (UV) dosimeter, and two air pollution monitors were used to monitor physical activity (PA), fine particulate matter (PM 2.5), black carbon, traffic-related noise, UV-B radiation, and natural outdoor environments (NOE). 77% of women performed the adult recommendation of ≥150 min/week of moderate to vigorous PA (MVPA), while only 3% of children achieved the childhood recommendation of ≥60 min/day MVPA. 11% of women and 17% of children were exposed to daily PM 2.5 levels higher than recommended (≥25μg/m3). Mean exposure to noise ranged from Lden 51.1 dB in Kaunas to Lden 65.2 dB in Barcelona. 4% of women and 23% of children exceeded the recommended maximum of 2 Standard-Erythemal-Dose of UV-B at least once a week. 33% of women and 43% of children never reached the minimum NOE contact recommendation of ≥30 min/week. The variations in air and noise pollution exposure were dominated by between-city variability, while most of the variation observed for NOE contact and PA was between-participants. The correlations between all personal exposures ranged from very low to low (Rho < 0.30). The levels of personal external exposures in both pregnant women and children are above the health recommendations, and there is little correlation between the different exposures. The assessment of the personal external exposome is feasible but sampling requires from one day to more than one year depending on exposure due to high variability between and within cities and participants. • The assessment of the personal external exposome is feasible. • Personal external exposures are above the health recommendations. • Personal external exposures are highly variable within person. • External exposure variability can bias health effects estimation. • There is little correlation between the different external exposures. [ABSTRACT FROM AUTHOR]

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