European Study Research Articles

A commentary on 'Electrochemotherapy for advanced cutaneous angiosarcoma: A European register-based cohort study from the International Network for Sharing Practices of electrochemotherapy (InspECT)'.

A commentary on 'Electrochemotherapy for advanced cutaneous angiosarcoma: A European register-based cohort study from the International Network for Sharing Practices of electrochemotherapy (InspECT)'.

Negative interaction between democratization and economic development on changes in average life satisfaction: evidence from European countries between 1981 and 2022

ABSTRACT This study aimed to investigate the association between post-materialist values and subjective well-being in European countries, while examining the complex relationships between the diffusion of post-materialist values, economic development, and democratization. This study analyzed data from the European Values Study and World Values Survey between 1981 and 2022 using finite mixture models and fixed-effects models. The results show that the positive association between diffusing post-materialist values and changes in average life satisfaction was mediated by social changes, including economic development and democratization. However, a negative association between economic development and democratization emerged; although both were positively associated with changes in national life satisfaction, their associations could be offset by each other. This implies that while social change is intertwined with social values and subjective well-being, the relationships between them are highly intricate.

Comparative analysis of carotid artery stenting practice and outcomes across operator specialties: insights from a prespecified subanalysis of a large real-world patient cohort (ROADSAVER Study).

In contemporary clinical practice, carotid artery stenting (CAS) is increasingly becoming a multispecialty field, joining operators of various training backgrounds, which bring forth their unique expertise, patient management philosophies, and procedural preferences. The best practices and approaches, however, are still debated. Therefore, real-world insights on different operator preferences and related outcomes are of utmost value, yet still rather scarce in the available literature. Using the data collected in the ROADSAVER observational, European multicenter CAS study, a prespecified comparative analysis evaluating the impact of the operator's specialization was performed. We used major adverse event (MAE) rate at 30-day follow-up, defined as the cumulative incidence of any death or stroke, and its components as outcome measures. A total of 1965 procedures were analyzed; almost half 878 (44.7%) were performed by radiologists (interventional/neuro), 717 (36.5%) by cardiologists or angiologists, and 370 (18.8%) by surgeons (vascular/neuro). Patients treated by surgeons were the oldest (72.9±8.5), while radiologists treated most symptomatic patients (58.1%) and more often used radial access (37.2%). The 30-day MAE incidence achieved by cardiologists/angiologists was 2.0%, radiologists 2.5%, and surgeons 1.9%; the observed differences in rates were statistically not-significant (P=0.7027), even when adjusted for baseline patient/lesion and procedural disparities across groups. The corresponding incidence rates for death from any cause were 1.0%, 0.8%, and 0.3%, P=0.4880, and for any stroke: 1.4%, 2.3%, and 1.9%, P=0.4477, respectively. Despite the disparities in patient selection and procedural preferences, the outcomes achieved by different specialties in real-world, contemporary CAS practice remain similar when using modern devices and techniques.

SS05-02 Open issues around COVID-19 and work: Lessons learned from the literature and the European ORCHESTRA multicentric study on health workers

SS05-02 Open issues around COVID-19 and work: Lessons learned from the literature and the European ORCHESTRA multicentric study on health workers

Precranial artery calcification burden: a potential indicator of the clinical outcome of reperfusion in patients with acute large artery occlusion.

With mechanical thrombectomy (MT), we investigated the prognostic importance of aortic arch calcification (AoAC) and carotid sinus calcification (CaSC) for symptomatic intracerebral hemorrhage (sICH) and poor outcome in acute large artery occlusion (LAO). In this retrospective observational study, we calculated pre-cranial artery calcification burden (PACB) scores (burden score of AoAC and CaSC) using the AoAC grading scale score plus Woodcock visual score. The outcome measure was sICH per the European Cooperative Acute Stroke Study III definition. A 3-month modified Rankin scale score 3-6 was designated as poor outcome. Compared with patients who had PACB <3, those with PACB ≥3 showed substantially higher risks of sICH (odds ratio [OR] = 2.567, 95% confidence interval [CI] = 1.187-5.550) and poor outcome (OR = 4.777, 95% CI = 1.659-13.756). According to receiver operating characteristic (ROC) curves, adding PACB to the regression model enhanced the predictive value for poor outcome (area under the ROC curve [AUC]: 0.718 vs. 0.519, Z = 2.340) and in patients receiving MT (AUC: 0.714 vs. 0.584, Z = 2.021), independently. Factors related to PACB were consistent with common risk factors of systemic atherosclerosis. Low PACB scores indicated better prognosis. In patients with LAO following MT, PACB was useful in predicting sICH and poor clinical outcome.

Prediction of nonresectability using the updated Predictive Index value model assessed by imaging and surgery in tubo-ovarian cancer: a prospective multicenter ISAAC study

BackgroundA laparoscopy-based scoring system was developed by Fagotti et al (Fagotti or Predictive Index Value (PIV)score) based on the intraoperative presence or absence of carcinomatosis on predefined sites. Later, the authors updated the PIV score calculated only in the absence of one or both absolute criteria of non-resectability (mesenteric retraction and miliary carcinomatosis of the small bowel) (updated PIV model). ObjectiveThe aim was to demonstrate the non-inferiority of ultrasound to other imaging methods (contrast enhanced computed tomography (CT) and whole-body diffusion-weighted (WB DWI)/MRI) in predicting non-resectable tumor (defined as residual disease>1 cm) using the updated PIV model in patients with tubo-ovarian cancer. The agreement between imaging and intraoperative findings as a reference was also calculated. Study designThis was a European prospective multicenter observational study. We included patients with suspected tubo-ovarian carcinoma who underwent preoperative staging and prediction of non-resectability at ultrasound, CT, WB-DWI/MRI and surgical exploration. The predictors of non-resectability were suspicious mesenteric retraction and/or miliary carcinomatosis of the small bowel or if absent, a PIV>8 (updated PIV model). The PIV score ranges from 0 to 12 according to the presence of disease in six predefined intra-abdominal sites (great omentum, liver surface, lesser omentum/stomach/spleen, parietal peritoneum, diaphragms, bowel serosa/mesentery). The reference standard was surgical outcome, in terms of residual disease>1 cm, assessed by laparoscopy and/or laparotomy. The area under the receiver operating characteristic curve (AUC) to assess the performance of the methods in predicting non-resectability was reported. Concordance between index tests at detection of disease at six predefined sites and intraoperative exploration as reference standard was also calculated using Cohen’s kappa. ResultsThe study was between 2018 and 2022 in five European gynecological oncology centers. Data from 242 patients having both mandatory index tests (ultrasound and CT) were analyzed. 145/242 (59.9%) patients had no macroscopic residual tumor after surgery (R0) (5/145 laparoscopy and 140/145 laparotomy) and 17/242 (7.0%) had residual tumor ≤1cm (R1) (laparotomy). In 80/242 patients (33.1%), the residual tumor was >1 cm (R2), 30 of them underwent laparotomy and maximum surgery was carried out and 50/80 underwent laparoscopy and cytoreduction was not feasible in all of them.After excluding 18/242 (7.4%) patients operated on but not eligible for extensive surgery, the predictive performance of three imaging methods was analyzed in 167 women. The AUCs of all methods in discriminating between resectable and non-resectable tumor was 0.80 for ultrasound, 0.76 for CT, 0.71 for WB-DWI/MRI and 0.90 for surgical exploration. Ultrasound had the highest agreement (Cohen’s kappa ranging from 0.59 to 0.79) compared to CT and WB-DWI/MRI to assess all parameters included in the updated PIV model. ConclusionsUltrasound showed non-inferiority to CT and to WB-DWI/MRI in discriminating between resectable and non-resectable tumor using the updated PIV model. Ultrasound had the best agreement between imaging and intraoperative findings in the assessment of parameters included in the updated PIV model. Ultrasound is an acceptable method to assess abdominal disease and predict non-resectability in patients with tubo-ovarian cancer in the hands of specially trained ultrasound examiners.

3-year safety and efficacy results of PreserFlo™ Microshunt in glaucoma patients: A multicentre European cohort study

PurposeTo report three-year outcomes of a multicenter cohort undergoing Preserflo Microshunt surgery (PFMS). DesignRetrospective cohort study MethodsRetrospective review of 100 consecutive eyes (91 patients) undergoing PFMS from four tertiary-referral glaucoma centers. Primary outcome were success rates. Secondary outcomes included: intraocular pressure (IOP), best-corrected visual acuity, medication, complications and postoperative interventions. Results100 eyes of 91 patients were included. Qualified and complete success rates (95 % CI) were 80 % (72–87 %) and 56 % (47–65 %) for Criterion A (IOP≤21 mmHg), 75 % (67–83 %) and 55 % (46–65 %) for Criterion B (IOP≤18 mmHg), 44 % (31–50 %) and 39 % (30–49 %) for Criterion C (IOP≤15 mmHg) and 10 % (5–16 %) and 10 % (5–16 %) for Criterion D (IOP≤12 mmHg) respectively. Mean IOP decreased from 23.8 mmHg to 14.1 mmHg (reduction of 35.3 %) after 36 months with a reduction of IOP-lowering agents from 2.52 (0 – 4) to 0.69 (0 – 3). 7 eyes (7 %) needed additional glaucoma surgery. Of these, 3 eyes underwent a glaucoma drainage device and 4 eyes had a trabeculectomy.36 eyes received additional procedures after PFMS implantation. Of these, 14 eyes (14 %) underwent a surgical revision and 12 eyes (12 %) a bleb needling procedure.The complication rate was low: 1 eye developed corneal decompensation and underwent a DMEK after 24 months. 1 eye had a conjunctival erosion requiring a revision surgery. 2 eyes developed a postoperative uveitis that was treated with topical steroids and resolved without further damage. There were no hypotony-related complications. ConclusionsPFMS surgery is a safe and effective procedure for reducing IOP and pressure-lowering therapy.

Pertempuran Rusia-Uthmaniyah 1877-1878 dan Impaknya terhadap Muslim Bulgaria The Battle of Russo-Ottoman 1877-1878 and Its Impact on Muslims in Bulgaria

The fierce battle that broke out in history between Russia and Ottoman in 1877–1878 was an attempt to solve the problems faced by the Ottoman administration in the Balkans. This is mainly related to accusations that the Ottoman government cannot protect Christians in Bosnia-Herzegovina. Ironically, Russia's victory did not lead to the resolution of the conflict in Bosnia-Herzegovina. Instead, it negatively impacted Muslims in the Balkans, especially in Bulgaria. This article will analyse the social effects of the war on Bulgaria's Muslim minority. This article uses a qualitative method called content analysis to evaluate British official documents and records collected from the British National Archives and the University of London, specifically from the School of Slavonic and East European Studies. The result shows that the Russo-Ottoman War of 1877 was not intended to give justice to the Christian community under the Ottoman empire; on the contrary, it was a strategy used by Russia and the Bulgarian government to eliminate the Muslim minority in Bulgaria.

Ethylene Oxide Hemoglobin Adducts in Cord Blood and Offspring's Size at Birth: The NewGeneris European Cohort Study.

Prenatal ethylene oxide exposure may have adverse effects on fetal development. We examined the relationships between ethylene oxide hemoglobin (Hb) adduct levels and offspring's size at birth in a prospective European mother-child study. This study included 1106 singletons from the NewGeneris project (2006-2010) with ethylene oxide Hb adducts measured in cord blood. We examined the relationships between adduct levels and offspring's size at birth among all infants and separately among infants of nonsmokers, using linear regression models for birth weight and birth head circumference and logarithmic binomial regression models for small for gestational age. We examined potential interactions between CYP2E1 single nucleotide polymorphisms in cord blood and the effects of ethylene oxide Hb adduct levels on offspring birth size. Higher quartiles of adduct levels as a measure of exposure were associated with decreasing birth weight and head circumference in the overall population. Compared to infants in the lowest quartile, those in the highest quartile exhibited lower birth weight (-70.73 g, 95% confidence interval = -141.16, -0.30) and reduced head circumference (-0.30 cm, 95% confidence interval = -0.58, -0.02). We observed similar, albeit less pronounced, patterns among infants of nonsmokers. There was no evidence of an association between ethylene oxide Hb adducts and risk of small for gestational age, nor consistent evidence of an interaction with CYP2E1 polymorphisms on the association between EO Hb adduct levels and offspring's size at birth. Results suggest that higher ethylene oxide Hb adduct levels in cord blood are associated with a reduction in offspring birth size.

Beyond meta-studies: Learnings from a large multi-site primary dataset on non-tangible benefits of nature-based solutions

Nature-Based Solutions (NBS) are growing in popularity as approaches for, among others, the reduction of hydro-meteorological risks. However, their uptake is still slow despite the recognition of their role in enabling a smarter, more systemic, and faster adaptation to climate change. Uncertainties regarding the valuation and subsequent economic feasibility of NBS are deemed to be a substantial barrier to their uptake. The monetary valuation of the non-tangible benefits of NBS (e.g., increased recreation and enhanced biodiversity) is seen as a plausible strategy to get closer to providing a holistic assessment. However, the quantification of these non-tangible benefits is often not integrated into economic assessments of NBS, partly as methods that can be replicated across sites have been lacking. This situation risks leading to inconsistent and/or biased valuations, which may negatively influence or delay the prioritization of NBS. Thus, our study aims to collect primary data on the non-tangible benefits of NBS across different European study sites and to identify patterns in how the different types and contexts of NBS influence people's valuation. We applied a contingent valuation survey to six different peri‑urban NBS study sites, where the focus is on the reduction of hydro-meteorological risks. The target of the survey was the general public, and we used willingness-to-pay questions to quantify the value given by the respondents to the NBS. Our results highlighted that people value the multiple benefits of NBS, and positively react to implementations improving nature across all sites. Moreover, similar variables seem to influence the value attributed to NBS across sites, with income and personal preferences ranking highly among them. These insights indicate that decision-makers and NBS-planners can learn more broadly from past experiences from a variety of (cultural) contexts, which can assist in delivering more targeted and multi-functional NBS.

Influence of frailty on cardiovascular events and mortality in patients with Chronic Obstructive Pulmonary Disease (COPD): Study protocol for a multicentre European observational study.

Frailty is a clinical state that increases susceptibility to minor stressor events. The risk of frailty is higher in chronic conditions, such as Chronic Obstructive Pulmonary Disease (COPD). Recent studies on COPD have shown that patients living with frailty have an increased risk of mortality. The presence of cardiovascular diseases or conditions are common in COPD and may increase the risk of death. This protocol describes a European prospective cohort study of community-based people, in a stable condition with diagnosis of COPD (as defined by GOLD guidelines) across hospitals in Italy and UK. Frailty prevalence will be assessed using the Clinical Frailty Scale. At 1- and 2-year follow up, primary outcome will be the impact of frailty on the number of cardiovascular events; secondary outcomes: the influence of frailty on cardiovascular mortality, all-cause mortality, and deaths due to COPD. For the primary outcome a zero-inflated Poisson regression will compare the number of cardiovascular events at 1 year. Secondary outcomes will be analysed using the time to mortality. This multicentre study will assess the association between frailty and cardiovascular events and mortality in population with COPD. Data collection is prospective and includes routine clinical data. This research will have important implications for the management of patients with COPD to improve their quality of care, and potentially prognosis. NCT05922202 (www.clinicaltrials.gov).

Modern Russia in collective consciousness of the country’s inhabitants

The article explores collective consciousness as a theoretical construct, a type of social consciousness and as real attitude of the population towards Russia at the emotional and rational levels. It shows that modern collective consciousness in Russia is a product of mass culture, which actualized during modernization of the Russian society in the economic, political, cultural and everyday spheres of life. Today, it is influenced by mass and high-tech communications, while also reflecting the life experience of different generations. The research methodology is based on the interpretation of collective consciousness as the averaged consciousness of the whole mass of individuals in social groups; it erases individual differences, human characteristics, which in any single case may not be the same as collective consciousness, but impart collective consciousness a qualitative diversity. Empirically, the research is based on representative mass surveys – the Seventh Wave of the Russian Values and Interests Monitoring (Summer 2023), Russian Survey of Young Russian Adults (June 2020), European Social Study (ESS 2018–2019). The research attempts to determine whether the Russian mentality is more emotional than rational towards their “lesser motherland” or birthplace, their oblast/republic/krai, Russia as a country and the author suggests that these properties of mentality constitute characteristics of such a complex psychological phenomenon as Russian patriotism. The article reveals a growing rational perception of the problems of society with outspoken criticism amid high levels of emo tional attitude of the respondents to the country and “lesser motherland”. Such is the evaluation of Russia’s attractive and unattractive characteristics and the importance of civil rights and liberties, among which the rights that ensure people’s basic modern life-supporting needs, such as employment, education, property, security and protection by law, were ranked first with more than 90% of respondents stating their support. There is also a cohort of young people aged 18–24, for whom political rights and democratic freedoms, enshrined in the Russian Constitution, become more important compared to other cohorts.

Cohort profile: Improved Pregnancy Outcomes via Early Detection (IMPROvED), an International Multicentre Prospective Cohort

Background Improved Pregnancy Outcomes via Early Detection (IMPROvED) is a multi-centre, European phase IIa clinical study. The primary aim of IMPROvED is to enable the assessment and refinement of innovative prototype preeclampsia risk assessment tests based on emerging biomarker technologies. Here we describe IMPROvED’s profile and invite researchers to collaborate. Methods A total of 4,038 low-risk nulliparous singleton pregnancies were recruited from maternity units in Ireland (N=1,501), United Kingdom (N=1,108), The Netherlands (N=810), and Sweden (N=619) between November 2013 to August 2017. Participants were interviewed by a research midwife at ~11 weeks (optional visit), ~15 weeks, ~20 weeks, ~34 weeks’ gestation (optional visit), and postpartum (within 72-hours following delivery). Findings to date Clinical data included information on maternal sociodemographic, medical history, and lifestyle factors collected at ~15 weeks’ gestation, and maternal measurements, collected at each study visit. Biobank samples included blood, urine, and hair collected at each study visit throughout pregnancy in all units plus umbilical cord/blood samples collected at birth in Ireland and Sweden. A total of 74.0% (N=2,922) had an uncomplicated pregnancy, 3.1% (N=122) developed preeclampsia, 3.6% (N=143) had a spontaneous preterm birth, and 10.5% (N=416) had a small for gestational age baby. We evaluated a panel of metabolite biomarkers and a panel of protein biomarkers at 15 weeks and 20 weeks’ gestation for preeclampsia risk assessment. Their translation into tests with clinical application, as conducted by commercial entities, was hampered by technical issues and changes in test requirements. Work on the panel of proteins was abandoned, while work on the use of metabolite biomarkers for preeclampsia risk assessment is ongoing. Future plans In accordance with the original goals of the IMPROvED study, the data and biobank are now available for international collaboration to conduct high quality research into the cause and prevention of adverse pregnancy outcomes.

Targeting muslims beyond Europe: preventing violent extremism and radicalisation in Kosovo

Ervjola Selenica is post-doc fellow and adjunct professor in Terrorism and Counterterrorism at the University of Bologna and associate research fellow at the University of Sussex. Previously, she was post-doc fellow at Scuola Normale Superiore (Firenze). She holds a PhD in International Studies (University of Trento), an MSc. in International Development Studies (University of Amsterdam), a BA in International Relations and Political Science (University of Bologna), and a PGDip on Peace and Conflict (Peace Research Institute Oslo). Her research interests include education, international interventions, conflict, global changes. She has published at The Journal of Contemporary European Studies, Italian Political Science Review/Rivista Italiana di Scienze Politiche, Critical Studies on Terrorism, Globalisation, Societies and Education, and Journal of Southeast European and Black Sea Studies. The paper analyses national and international interventions on preventing and countering violent extremism (P/CVE) and radicalisation in Kosovo and their underpinning rationales. The analysis seeks to understand how a country with a Muslim majority is targeted by P/CVE and counter-radicalisation policies. Furthermore, it seeks to understand whether these policies are informed by an understanding of violent extremism and radicalisation as underpinned by Islamic extremism and, if so, how they tackle and interact with the question of Islam in Kosovo. The article has found that P/CVE and counter-radicalisation policies in Kosovo are mainly externally driven and funded, rest upon the same preventative, anticipatory logic that has characterised similar policies implemented in EU member states, are informed by an understanding of violent extremism and radicalisation as ideological processes fuelled by radical Islam, and encompasses an all-societal approach combining hard and soft measures of prevention as those found in other EU and non-EU contexts.

Assessing the lack of diversity in genetics research across neurodegenerative diseases: A systematic review of the GWAS Catalog and literature.

The under-representation of non-European cohorts in neurodegenerative disease genome-wide association studies (GWAS) hampers precision medicine efforts. Despite the inherent genetic and phenotypic diversity in these diseases, GWAS research consistently exhibits a disproportionate emphasis on participants of European ancestry. This study reviews GWAS up to 2022, focusing on non-European or multi-ancestry neurodegeneration studies. We conducted a systematic review of GWAS results and publications up to 2022, focusing on non-European or multi-ancestry neurodegeneration studies. Rigorous article inclusion and quality assessment methods were employed. Of 123 neurodegenerative disease (NDD) GWAS reviewed, 82% predominantly featured European ancestry participants. A single European study identified over 90 risk loci, compared to a total of 50 novel loci in identified in all non-European or multi-ancestry studies. Notably, only six of the loci have been replicated. The significant under-representation of non-European ancestries in NDD GWAS hinders comprehensive genetic understanding. Prioritizing genomic diversity in future research is crucial for advancing NDD therapies and understanding. HIGHLIGHTS: Eighty-two percent of neurodegenerative genome-wide association studies (GWAS) focus on Europeans. Only 6 of 50 novel neurodegenerative disease (NDD) genetic loci have been replicated. Lack of diversity significantly hampers understanding of NDDs. Increasing diversity in NDD genetic research is urgently required. New initiatives are aiming to enhance diversity in NDD research.

Attitudes towards Homosexuality in Europe: Analysis of the European Values Study

Attitudes towards Homosexuality in Europe: Analysis of the European Values Study

Comparative accuracy of four guidelines to predict high-grade dysplasia or malignancy in surgically resected pancreatic intraductal papillary mucinous neoplasms: Small nuances between guidelines lead to vastly different results.

The guidelines regarding the management of intraductal papillary mucinous neoplasms (IPMNs) all have slightly different surgical indications for high-risk lesions. We aim to retrospectively compare the accuracy of four guidelines in recommending surgery for high-risk IPMNs, and assess the accuracy of elevated CA-19-9 levels and imaging characteristics of IPMNs considered high-risk in predicting malignancy or high-grade dysplasia (HGD). The final histopathological diagnosis of surgically resected high-risk IPMNs during 2013-2020 were compared to preoperative surgical indications, as enumerated in four guidelines: the 2015 American Gastroenterological Association (AGA), 2017 International Consensus, 2018 European Study Group, and 2018 American College of Gastroenterology (ACG). Surgery was considered "justified" if histopathology of the surgical specimen showed HGD/malignancy, or there was postoperative symptomatic improvement. Surgery was postoperatively justified in 26/65 (40.0%) cases. All IPMNs with HGD/malignancy were detected by the 2018 ACG and the combined (absolute and relative criteria) 2018 European guidelines. The combined ("high-risk stigmata" and "worrisome features") 2017 International guideline missed 1/19 (5.3%) IPMNs with HGD/malignancy. The 2015 AGA guideline missed the most cases (11/19, 57.9%) of IPMNs with HGD/malignancy. We found the features most-associated with HGD/malignancy were pancreatic ductal dilation, and elevated CA-19-9 levels. Following the 2015 AGA guideline results in the highest rate of missed HGD/malignancy, but the lowest rate of operating on IPMNs without these features; meanwhile, the 2018 ACG and the combined (absolute and relative criteria) 2018 European guidelines result in more operations for IPMNs without HGD/malignancy, but the lowest rates of missed HGD/malignancy in IPMNs.

Antihypertensive Drugs for the Prevention of Atrial Fibrillation: A Drug Target Mendelian Randomization Study.

We investigated the potential impact of antihypertensive drugs for atrial fibrillation (AF) prevention through a drug target Mendelian randomization study to avoid the potential limitations of clinical studies. Validated published single-nucleotide polymorphisms (SNPs) that mimic the action of 12 antihypertensive drug classes, including alpha-adrenoceptor blockers, adrenergic neuron blockers, angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, beta-adrenoceptor blockers, centrally acting antihypertensive drugs, calcium channel blockers, loop diuretics, potassium-sparing diuretics and mineralocorticoid receptor antagonists, renin inhibitors, thiazides and related diuretic agents, and vasodilators were used. We estimated, via their corresponding gene and protein targets, the downstream effect of these drug classes to prevent AF via systolic blood pressure using 2-sample Mendelian randomization analyses. The SNPs were extracted from 2 European genome-wide association studies for the drug classes (n=317 754; n=757 601) and 1 European genome-wide association study for AF (n=1 030 836). Drug target Mendelian randomization analyses supported the significant preventive causal effects of lowering systolic blood pressure per 10 mm Hg via alpha-adrenoceptor blockers (n=11 SNPs; odds ratio [OR], 0.34 [95% CI, 0.21-0.56]; P=2.74×10-05), beta-adrenoceptor blockers (n=17 SNPs; OR, 0.52 [95% CI, 0.35-0.78]; P=1.62×10-03), calcium channel blockers (n=49 SNPs; OR, 0.50 [95% CI, 0.36-0.70]; P=4.51×10-05), vasodilators (n=19 SNPs; OR, 0.53 [95% CI, 0.34-0.84]; P=7.03×10-03), and all 12 antihypertensive drug classes combined (n=158 SNPs; OR, 0.64 [95% CI, 0.54-0.77]; P=8.50×10-07) on AF risk. Our results indicated that lowering systolic blood pressure via protein targets of various antihypertensive drugs seems promising for AF prevention. Our findings inform future clinical trials and have implications for repurposing antihypertensive drugs for AF prevention.

The first national survey on cultural participation in Portugal: exploring social and professional backgrounds

ABSTRACT Portugal undertook the first national survey of cultural practices (2020) with support from the Calouste Gulbenkian Foundation. The present paper describes the contemporary cultural eclecticism in keeping with the analysis of key indicators for the cultural consumption of cinema, live performances, theatre, dance, circus, festivals, and local events. In line with previous European Survey conclusions, the first Portuguese National Survey results demonstrate how the younger and better educated, alongside those raised by educated parents, display “cultural omnivorism”. The main findings converge around how the influence of social backgrounds, positions in the professional structure and class identities, are shaping cultural consumption as pointed out by Reeves in his cross-national European study.

Multicentric Longitudinal Prospective Study in a European Cohort of MYO7A Patients: Disease Course and Implications for Gene Therapy.

We investigated the natural history of retinal dystrophy owing to variants in the MYO7A gene. Fifty-three patients (mean age, 33.6 ± 16.7years) with Usher syndrome owing to biallelic, mostly pathogenic, variants in MYO7A underwent baseline and two annual follow-up visits. Best-corrected visual acuity (BCVA), semiautomatic kinetic visual field, full-field electroretinogram, color fundus imaging, microperimetry, spectral-domain optical coherence tomography, and fundus autofluorescence were assessed. At baseline, all patients presented with decreased BCVA (66.4 ± 17.9 Early Treatment Diabetic Retinopathy score and 59.5 ± 21.7 Early Treatment Diabetic Retinopathy score, in the better- and worse-seeing eyes, respectively), restricted semiautomatic kinetic visual field (III4e area, 3365.8 ± 4142.1°2; 4176.4 ± 4400.3°2) and decreased macular sensitivity (9.7 ± 9.9dB; 9.0 ± 10.2dB). Spectral-domain optical coherence tomography revealed reduced central macular thickness (259.6 ± 63.0µm; 250.7 ± 63.3µm) and narrowed ellipsoid zone band width (2807.5 ± 2374.6µm; 2615.5 ± 2370.4µm). Longitudinal analyses (50 patients) showed a significant decrease of BCVA in better-seeing eyes, whereas no changes were observed in worse-seeing eyes for any parameter. BCVA, semiautomatic kinetic visual field (III4e and V4e) and macular sensitivity were related significantly to age at baseline. Hyperautofluorescent foveal patch (16 eyes [31.4%]) and abnormal central hypoautofluorescence (9 eyes [17.6%]) were significantly associated with worse morphological and functional read-outs compared with the hyperautofluorescent ring pattern (22 eyes [43.1%]). Our European multicentric study offers the first prospective longitudinal analysis in one of the largest cohorts of MYO7A patients described to date, confirming the slow disease progression. More important, this study emphasizes the key role of fundus autofluorescence patterns in retinal impairment staging and advocates its adoption as an objective biomarker in patient selection for future gene therapy clinical trials.