Last Decade In Europe Research Articles

Sport activities for children and adolescents: the Position of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians 2023-Part 1. Pre-participation physical evaluation in young athletes.

The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.

Increasing numbers and improved overall survival of patients on kidney replacement therapy over the last decade in Europe: an ERA Registry study.

The aim of this study was to describe the trends in the incidence, prevalence and survival of patients on kidney replacement therapy (KRT) for end-stage kidney disease (ESKD) across Europe from 2008 to 2017. Data from renal registries in 9 countries and 16 regions that provided individual patient data to the ERA Registry from 2008 to 2017 were included. These registries cover 34% of the general population in Europe. Crude and standardized incidence and prevalence per million population (pmp) were determined. Trends over time were studied using Joinpoint regression. Survival probabilities were estimated using Kaplan-Meier analysis and hazard ratios (HRs) using Cox regression analysis. The standardized incidence of KRT was stable [annual percentage change (APC): -1.48 (-3.15; 0.21)] from 2008 (146.0 pmp) to 2011 (141.6 pmp), followed by a slight increase [APC: 1.01 (0.43; 1.60)] to 148.0 pmp in 2017, although trends in incidence varied across countries. This increase was primarily due to a rise in the incidence of KRT in men older than 65 years. Moreover, as a cause of kidney failure, diabetes mellitus is increasing. The standardized prevalence increased from 2008 (990.0 pmp) to 2017 (1166.8 pmp) [APC: 1.82 (1.75; 1.89)]. Patient survival on KRT improved in the time period 2011-13 compared with 2008-[adjusted HR: 0.94 (0.93; 0.95)]. This study showed an overall increase in the incidence and prevalence of KRT for ESKD as well as an increase in the KRT patient survival over the last decade in Europe.

University lecturers' perceptions of the role of English in their teaching

This paper describes international university lecturers’ perceptions about the role of English in their teaching. The lecturers (N=31) of a Finnish university, representing 20 nationalities, attended a pedagogical development course intended to enhance their understanding of communicative skills used in teaching and English-medium instruction (EMI). University programmes with EMI have tripled in the last decade in Europe (Richter, 2019), yet the focus of university lecturers is rarely on the language but on the content (Doiz & Lasagabaster, 2021). A pre-course written reflection task was used to determine how the lecturers defined communicative teaching and the role of EMI in their teaching. Post-course, following teaching demonstrations and peer feedback, the lecturers completed another reflective written task to examine if their approach to EMI had altered. The results indicate that most international university lecturers, both non-native and native speakers of English, pre-course viewed the role of EMI as minimal in their teaching as they expected students to be able to study their field in English. In the post-course analysis, however, many lecturers noted that they had become more conscious of their language use, rate of speech and clarity to be more mindful of their students studying in another language. The study suggests that university lecturers should increase awareness of their use of English in EMI to enhance the quality of their communication and teaching to support students’ learning in a second language.

Quality Evaluation of the Ready-to-Eat Avocado cv. Hass.

Consumer interest in avocado fruit has increased in the last decade in Europe. Nutritional and quality attributes affect the choice of these fruits, whose characteristics must also be maintained in the postharvest period. The preference regarding the feasibility of eating ripe fruits can assure and improve the success of the emerging marketing of avocados. The exposure of fruits to exogenous ethylene (C2H4) treatment can accelerate the process of fruit ripening. The aim of this work was at improving the existing knowledge about the quality traits of avocado cv. Hass fruits at the ready-to-eat stage. The most important qualitative traits (weight loss, dry matter content, hardness pulp, and external and internal fruit colour) were evaluated up to 96 hours, maintaining the fruit at two different temperatures, T1 (+8°C) and T2 (+17°C). A trained sensory panel was conducted at 96 hours to confirm the quality of avocado cv. Hass ripened with exogenous C2H4.

UEG position paper on pancreatic cancer. Bringing pancreatic cancer to the 21st century: Prevent, detect, and treat the disease earlier and better.

BackgroundPancreatic ductal adenocarcinoma is the deadliest cancer worldwide with a 98% loss‐of‐life expectancy and a 30% increase in the disability‐adjusted life years during the last decade in Europe. The disease cannot be effectively prevented nor being early detected. When diagnosed, 80% of patients have tumors that are in incurable stages, while for those who undergo surgery, 80% of patients will present with local or distant metastasis. Importantly, chemotherapies are far from being effective.ObjectivePancreatic cancer represents a great challenge and, at the same time, a huge opportunity for advancing our understanding on the basis of the disease, the molecular profiles, that would lead to develop tools for early detection and effective treatments, thus, boosting patient survival.ResultsResearch on pancreatic cancer has being receiving little or minimal funds from European funding bodies. UEG is calling for public‐private partnerships that would effectively fund research on pancreatic cancer.ConclusionThis would increase our understanding of this disease and better treatment, through pan‐European efforts that take advantage of the strong academic European research landscape on pancreatic cancer, and the contribution by the industry of all sizes.

Hepatitis E virus (HEV) genotype 3 diversity: Identification of a novel HEV subtype in wild boar in Central Italy.

In the last decade in Europe, the number of autochthonous cases of hepatitis E has significantly increased. Most of the cases arise from foodborne infections caused by the zoonotic hepatitis E virus (HEV) genotypes HEV-3 and HEV-4. Several human cases have been linked to consumption of raw or undercooked animal products of both pork (liver sausages) and wild boar meat. In this study, the occurrence of HEV infection was investigated in 611 livers and 88 paired lungs from wild boars collected during the hunting seasons of 2016-2020 in the Umbria-Marche Apennines (Central Italy). Using real-time reverse transcription polymerase chain reaction, 15 liver samples (2.45%) and one lung sample were found to be positive for HEV RNA. The phylogenetic tree built on the partial ORF2 gene revealed that the detected HEV strains belonged to HEV-3f (n=5), HEV-3e (n=1) and HEV-3c (n=1) subtypes. Interestingly, 8 strains were genetically placed in a different cluster, further away from all other subtypes. To corroborate this finding, four complete genomes were obtained by next generation sequencing. The full genome of the HEV strains clustered together with another wild boar strain previously detected in Southern Italy in 2015 but the strains were divergent from all the HEV-3 strains classified in any subtype defined so far. Thus, these strains represent a novel subtype that might have originated in Italy, which we have tentatively named HEV-3n.

It's Not Only Size That Matters: Determinants of Estonia's E-Governance Success

User data fuel the digital economy, while individual privacy is at stake. Governments react differently to this challenge. Estonia, a small Baltic state, has become a role model for the renewal of the social contract in times of big data. While e-governance usage has been growing in many parts of Europe during the last ten years, some regions are lagging behind. The Estonian example suggests that online governance is most accepted in a small state, with a young population, trustworthy institutions and the need of technological renewal. This work examines the development of e-governance usage (citizens interacting digitally with the government) during the last decade in Europe from a comprehensive cross-country perspective: size, age and trust are relevant for the usage of digital government services in Europe. However, the quality of past communication infrastructure is not related to e-governance popularity.

It's not only size that matters: determinants of Estonia's e-governance success

User data fuel the digital economy, while individual privacy is at stake. Governments react differently to this challenge. Estonia, a small Baltic state, has become a role model for the renewal of the social contract in times of big data. While e-governance usage has been growing in many parts of Europe during the last ten years, some regions are lagging behind. The Estonian example suggests that online governance is most accepted in a small state, with a young population, trustworthy institutions and the need of technological renewal. This work examines the development of e-governance usage (citizens interacting digitally with the government) during the last decade in Europe from a comprehensive cross-country perspective: Size, age and trust are relevant for the usage of digital government services in Europe. However, the quality of past communication infrastructure is not related to e-governance popularity.

“We are not the language police”: Comparing multilingual EMI programmes in Europe and Asia

English medium instruction (EMI) in higher education has rapidly increased over the last decade in Europe and Asia. However, this expansion has far outstripped research and many key questions remain unanswered. This study addresses a number of those questions related to roles and conceptualisations of English and other languages in multilingual university settings. Data is presented from an exploratory mixed‐methods (121 questionnaire responses and 12 interviews with lecturers and students), comparative study of higher education institutes in the UK, Austria and Thailand. Findings showed a move from monolingual orientations at management level, mixed responses to multilingualism in ideologies and beliefs, to extensive multilingualism and complexity in practices. Furthermore, unexpected similarities between the UK and Thailand as regards language proficiency and content learning were found.

New Insights into the Occurrence and Toxin Profile of Ciguatoxins in Selvagens Islands (Madeira, Portugal).

Ciguatoxins (CTXs), endemic from tropical and subtropical regions of the Pacific and Indian Ocean and the Caribbean Sea, have caused several human poisonings during the last decade in Europe. Ciguatera fish poisonings (CFP) in Madeira and Canary Islands appear to be particularly related with consumption of fish caught close to Selvagens Islands, a Portuguese natural reserve composed of three small islands that harbor high fish biomass. In this study, fish specimens considered as potential vectors of CTXs were caught in Madeira and Selvagens archipelagos for toxins determination via sensitive liquid chromatography with tandem mass spectrometry detection (LC–MS/MS). CTXs were found in most of the fish samples from Selvagens and none from Madeira. Caribbean ciguatoxin-1 (C-CTX1) was the only toxin congener determined, reaching the highest value of 0.25 µg C-CTX1 kg−1 in a 4.6 kg island grouper (Mycteroperca fusca). This study indicates that a diversity of fish from different trophic levels contains CTXs, Selvagens appear to be one of the most favorable locations for CTXs food web transfer and finally, this study highlights the need of further research based on intensive environmental and biological sampling on these remote islands.

Nonsurgical therapies for resected and unresected pancreatic cancer in Europe and USA in 2003-2014: a large international population-based study.

The role of chemotherapy in the treatment of pancreatic cancer (PaC) has been well-established, while radiation plays ambiguous roles. This international large-scale population-based study aimed to investigate the real-world application of chemotherapy and radiotherapy for resected and unresected PaC in Europe and USA. Population-based data from multiple European national cancer registries and the US Surveillance, Epidemiology and End Results (SEER)-18 database during 2003-2014 were analyzed. Temporal trends and geographical variations in the application rates of chemotherapy and radiotherapy were quantified using age standardization. Associations of treatment with demographic and clinical characteristics were assessed using multivariable logistic regression. A total of 141,533 PaC patients were analyzed. From 2003-2005 to 2012-2014, chemotherapy administration rates increased in most countries and more strongly among resected patients, while radiation rates were generally low with a slight decline or no obvious trend. In 2012-2014, 12.5% (Estonia) to 61.7% (Belgium) of resected and 17.1% (Slovenia) to 56.9% (Belgium) of unresected patients received chemotherapy. Radiation was administered in 2.6% (Netherlands) to 32.6% (USA) of resected and 1.0% (USA) to 6.0% (Belgium) of unresected patients. Strong temporal and geographical variations were observed. Patterns and strengths of associations of treatment administration with various demographic and clinical factors differed substantially between resected and unresected cancers and varied greatly across countries. Conclusively, administration of chemotherapy but not radiotherapy for PaC increased during the last decade in Europe and USA. Treatment rates were low and the uptake strongly varied across countries, highlighting the need for standardization in PaC treatment to improve patient care.

Home treatment of acute pulmonary embolism: state of the art in 2018.

Historically, because of the necessity of parenteral anticoagulation, patients with acute pulmonary embolism are hospitalized until stable oral anticoagulation is achieved. Despite improvements in prognostic risk stratification and the introduction of the direct oral anticoagulants, home treatment is still not widely applied. Main advantages of home treatment involve improvement of quality of life and significant healthcare cost reduction. In this review, we summarized recent published data on home treatment of patients with acute pulmonary embolism. Although a significant decrease in mean duration of hospital admission for pulmonary embolism has been demonstrated over the last decade in Europe, most pulmonary embolism patients are currently hospitalized while they might be treated in an outpatient setting. In recent years, five major studies have been performed, in which the decision to initiate home treatment was based on the Hestia criteria in most patients. Over 98% of patients treated at home had an uncomplicated course. Home treatment of acute pulmonary embolism is suggested to be feasible and safe in 30-55% of all patients. Results of ongoing trials will provide more insight in the optimal strategy to select patients with pulmonary embolism who are eligible for home treatment and likely will result in more widespread application of this practice.

Recasting Pensions in Europe: Policy Challenges and Political Strategies to Pass Reforms

Recasting Pensions in Europe: Policy Challenges and Political Strategies to Pass Reforms

Responding to New Psychoactive Substances in the European Union: Early Warning, Risk Assessment, and Control Measures.

New psychoactive substances (NPS) are drugs that are not controlled by the United Nations international drug control conventions of 1961 and 1971 but that may pose similar threats to public health. Many of them are traded as "legal" replacements to controlled drugs such as cannabis, heroin, benzodiazepines, cocaine, amphetamines, and 3,4-methylenedioxymethamphetamine (MDMA). Driven by globalization, there has been a large increase in the availability and, subsequently, harms caused by these substances over the last decade in Europe. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is monitoring more than 670 NPS that have appeared on Europe's drug market in the last 20years, of which almost 90% have appeared in the last decade. While some recent policy responses have been successful in reducing availability and sales of these substances in some settings - such as "legal highs" and "research chemicals" sold openly in the high street and online - and there are signs that growth in the market is slowing, new challenges have emerged. This includes monitoring a growing number of highly potent substances - including 179 synthetic cannabinoid receptor agonists and 28 fentanils - that can pose a high risk of life-threatening poisoning to users and can cause explosive outbreaks. This chapter briefly traces the origins of NPS, provides an overview of the situation in Europe, and discusses the work of the EMCDDA as part of a legal framework of early warning, risk assessment, and control measures that allows the European Union to rapidly detect, assess, and respond to public health and social threats caused by these substances.

Forestry applications of UAVs in Europe: a review

ABSTRACTUnmanned aerial vehicles (UAVs) or remotely piloted aircraft systems are new platforms that have been increasingly used over the last decade in Europe to collect data for forest research, thanks to the miniaturization and cost reduction of GPS receivers, inertial navigation system, computers, and, most of all, sensors for remote sensing.In this review, after describing the regulatory framework for the operation of UAVs in the European Union (EU), an overview of applications in forest research is presented, followed by a discussion of the results obtained from the analysis of different case studies.Rotary-wing and fixed-wing UAVs are equally distributed among the case studies, while ready-to-fly solutions are preferred over self-designed and developed UAVs. Most adopted technologies are visible-red, green, and blue, multispectral in visible and near-infrared, middle-infrared, thermal infrared imagery, and lidar.The majority of current UAV-based applications for forest research aim to inventory resources, map diseases, classify species, monitor fire and its effects, quantify spatial gaps, and estimate post-harvest soil displacement.Successful implementation of UAVs in forestry depends on UAV features, such as flexibility of use in flight planning, low cost, reliability and autonomy, and capability of timely provision of high-resolution data.Unfortunately, the fragmented regulations among EU countries, a result of the lack of common rules for operating UAVs in Europe, limit the chance to operate within Europe’s boundaries and prevent research mobility and exchange opportunities. Nevertheless, the applications of UAVs are expanding in different domains, and the use of UAVs in forestry will increase, possibly leading to a regular utilization for small-scale monitoring purposes in Europe when recent technologies (i.e. hyperspectral imagery and lidar) and methodological approaches will be consolidated.

Spinal cord stimulation

### Key points Chronic pain conditions that fail to improve with conventional medical management (CMM) are a significant burden for the individual and society. While the initial cost of spinal cord stimulation (SCS) is considered high, both its clinical and cost-effectiveness are now well established. The position of SCS in the treatment algorithm has progressed, and for specific neuropathic and ischaemic pain conditions, there is moderate to strong evidence supporting its use. Melzack and Wall presented the Gate Control Theory of Pain in 1965. They proposed that transmission of pain signals could be regulated at the level of the dorsal horn by inhibitory interneurones activated by A-fibres. In 1967, Shealy and colleagues1 proposed that electrical stimulation of these A-fibres in the dorsal columns (DCs) could activate the inhibitory interneurones in the dorsal horn and influence pain transmission. A bipolar plate was placed directly over the spinal cord in cancer patients. They called it ‘Dorsal Column Stimulation’. In more recent years, it has been called SCS. The early interventions were effective, but were associated with multiple complications. The techniques have evolved to less invasive percutaneous lead insertion with multiple electrodes in the epidural space. More advanced implantable pulse generators (IPGs) and programmable systems have led to improved effectiveness and versatility. This is reflected by a steady increase in the implantation rates over the last decade in Europe and the USA. Neuromodulation techniques are also indicated …

The effect of various high-frequency powerful vibration (HFPV) types on fouling control of hollow fiber membrane elements in a small pilot-scale SMBR system

During the last decade in Europe, membrane bioreactor (MBR) systems have been proven to be a very efficient technique for municipal and industrial wastewater treatment (WWT). The most obvious appeal of the MBR technology is that it produces a stable and excellent effluent quality and eliminates the need for good sludge settleability, as it is one of the basic requirements in conventional WWT plants. Due to both the compact footprint and the great potential for automation, MBR plants ensure precise control of the sludge residence time and the mixed liquor suspended solids, which are basic operating parameters. The above results in: (a) the reduction of the required reactor size, (b) the promotion of the evolution of specific nitrifying bacteria, and finally, (c) the production of less sludge. However, the effluent rate of MBRs is limited, mainly because of the membrane fouling effect. Membrane fouling is probably the most critical problem of the submerged membrane bioreactors (SMBRs), and the applied techniques to avoid this problem have as a drawback the high energy that is needed and finally the production of chemical wastes. A lot of lab studies have been published concerning the impact of mechanical action on the removal of foulants from the membranes (e.g. vibration, buck-pulse, and ultrasound). The scope of this study is to examine the feasibility of high-frequency powerful vibration (HFPV) technique, as an alternative cleaning method, applied on fouled membrane elements in a continuous operated small pilot-scale SMBR unit, treating a novel synthetic wastewater (SWW). In this work, the implementation of various HFPV types (using commercial pneumatic vibrators) on identical, parallel hollow fiber (HF) fouled membranes, showed the following: (a) a repetitive pattern for transmembrane pressure and flux values vs. time; (b) the ability to select the proper vibration type according to the fouling extend on membranes; (c) the efficiency of this technique on membrane cleaning, in a membrane module system. After HFPV implementation, this system tends to have similar behavior with that of using new membrane modules. The HFPV technique seems to be very promising with respect to energy savings, compared to conventional air cleaning systems in SMBRs because it contributes to a low air-scouring operation due to the periodic and proper HFPV implementation. Moreover, this technique copes with the handling of membrane fouling in SMBRs units, using continuous MBR operating mode.

Prevalence of Abdominal Aortic Aneurysm in Men Aged 65–74 Years in a Metropolitan Area in North-East Spain

A declining prevalence of AAA and a shift in the distribution towards the older population have been observed during the last decade in Europe. The aim was to estimate the current screening prevalence of AAA in men aged 65-74 years in a metropolitan area in north-east Spain and to identify associated risk factors. A cross sectional prevalence study in men registered in L'Hospitalet Primary Healthcare Services (Barcelona, Spain) was performed. There were 619 randomly selected subjects (expected prevalence of aneurysm, 5%; accuracy of estimation, ±2%; loss to follow up, 30%). Exclusion criteria were life expectancy <1 year, limited quality of life, previous diagnosis of AAA, prior aorto-femoral surgery, and non-Caucasian. The following were measured: internal diameter of the infrarenal abdominal aorta using ultrasound, cardiovascular risk factors, personal (heart disease, stroke, peripheral vascular disease) and family history (AAA), physical examination, and blood tests. We estimated the prevalence and 95% confidence interval of AAA, and used logistic regression analysis to identify risk factors for AAA. Among the 651 individuals included in the analysis the prevalence of aneurysm was 2.30% (95% CI, 1.30-3.77%). In the regression analysis, AAA was associated with smoking (0-10, 11-20, or >20 cigarettes/day), diagnosis of myocardial infarction, and being taller than the median (165cm). The current screening prevalence of AAA among men aged 65-74 years in a metropolitan area in north-east Spain is similar to that in northern Europe. Smoking, myocardial infarction, and height were associated with the presence of AAA.

Hepatitis E Virus in Human: The Current Status in Europe

Background: An increasing number of human hepatitis E virus (HEV) infections have been described in the last decade in Europe. In this review, we described the serological data concerning the general population and particular group of patients (i.e immunocompromised patients, pig farmers in different European countries). HEV genotype distribution and anti-HEV therapies are described in the second part of the review. Results: HEV antibody prevalence ranged from 1.3% (blood donors in Italy) to 21.5% (blood donors in Serbia). Only one paper described a seroprevalence of 52% found in blood donors of Toulouse; in this study an assay WANTAI (Wantai Biological Pharmacy, PE2-assay; Beiying, China) with high sensitivity was used. A study carried out in the Netherlands showed that pig veterinarians had a higher anti-HEV IgG prevalence than non-pig veterinarians (11% vs 6%), confirming that pigs represent an important source of HEV infection. Genotypes 3c, 3e, 3f are the main genotypes diffused in Europe, however, sporadic cases of autochthonous genotype 4 have been described in several countries (Spain, France, and Italy). Several cases of fulminant hepatitis E, all related to genotype 3, have been described. Conclusion: The data reported in this review suggests that hepatitis E virus a wide spread infection, even in industrialized countries. The serum prevalence varies greatly, depending on the geographic areas considered and the population studied. Moreover, the seroprevalence may be due to the diagnostic assay used for the detection of antibodies.

Land Use Dataset Collection And Publication Based On Lucas And Hilucs

Abstract Spatial data have become very important phenomena within the last decade in Europe due to a strong support from the political spectrum with regard to related legislation and resulting in financial support to several research, educational, and enlargement projects. INSPIRE (Infrastructure for Spatial Information in the European Community) Directive indeed defines the principles for the harmonization of spatial data infrastructure in the European community, including Land Use and Land Cover data themes. INSPIRE defines a methodology on how to transform datasets to common data models, but it does not cover the process of data collection and update, because it is out of its scope. Evaluation of the Land Use dataset derived from remote sensing products complemented by fieldworks has been realized since 2006 by Eurostat within the LUCAS (Land Use and Cover Area frame Survey) project. The work presented in this paper follows the LUCAS fieldwork methodology, which was applied during the fieldwork in July 2014 in the City of Zagreb (Croatia), to use at the local (municipal) geoportal level. The surveying groups collected point features with the following data type attributes: Land Use codes defined by HILUCS (Hierarchical INSPIRE Land Use Classification System) and optional Land Cover codes defined by LUCAS classification. In addition, photographs representing the observed areas were collected by cameras embedded in the mobile GIS platforms. An update of original topological layer was performed and Web GIS components for sharing the newly developed datasets were implemented. The results presented provide a suitable proposal for fieldworks methodology and updates of a land use database in line with the INSPIRE directive applicable at a local spatial data infrastructure level.