Search Results (19,093)

Circulation of pool water via a treatment plant is critical for maintaining pool water in a condition that is a safe and attractive for bathers. It is also one of the pool operations that is most costly in terms of energy used and associated carbon footprint. In this study, we compare and contrast circulation rate guidelines developed for the UK and for other northern and southern European countries and, where possible, provide an explanation of the underlying rationale. We focus on the management of turbidity-forming material and Cryptosporidium oocysts. We reveal that the parameters used to assess safe operational bathing load are relatively consistent across Europe, based on physical space requirements for bathing and other constraints such as lifeguarding. Circulation rate, on the other hand, is based on either rule-based turnover times, or a more flexible approach based on the volume of water to be treated per bather. The latter offers scope for innovation and energy savings, with the proviso that safe water is maintained for bathers. The guidance in several countries suggests reducing circulation rate when the pool is not being used by bathers. We conclude that a more progressive risk-based approach to pool management, building on these findings, offers significant opportunities for pool operators to run pools better and should be a priority for future research. Full article

Lyme borreliosis (LB), the most common European tick-borne disease, can manifest as an erythema migrans (EM) rash or as disseminated LB. The prospective Burden of Lyme Disease (BOLD) study evaluated the frequency of LB clinical manifestations, including signs, symptoms, and treatment patterns in 14 healthcare practices in endemic regions of six European countries: the Czech Republic, Germany, Poland, Slovakia, Slovenia, and Sweden. Between April 2021 and December 2022, patients with suspected LB were evaluated using predefined case definitions that were applied by investigators to identify medically attended LB cases. Enrolled cases were interviewed about their symptoms. Among the 797 LB cases, 615 (77.2%) had EM and 182 (22.8%) had disseminated disease; 154 of the disseminated cases had Lyme arthritis (LA), five had Lyme neuroborreliosis, and three had Lyme carditis. Geographically, the proportion of disseminated disease varied by country, from 1.1% in Slovenia to 78.0% in Slovakia. Overall, 76.3% of all LB cases in Slovakia were LA. Antibiotic use varied by country, although every country prescribed doxycycline. The frequency of LB manifestations varied substantially between countries. EM was the most common manifestation in all countries except Slovakia, where LA was most common. This study underscores the need for improved prevention strategies. Full article

Pertussis, caused by Bordetella pertussis, remains a public health concern despite long-standing vaccination programs. After a marked decline during the COVID-19 pandemic, a resurgence was observed in Europe and Italy, with a sharp increase in 2024. This study describes pertussis epidemiological trends in the Tuscany Region (Italy) from 2019 to 2024 to identify high-risk groups and inform prevention strategies. A retrospective population-based analysis was conducted using cases reported to the national surveillance system (PREMAL). Incidence rates were calculated using ISTAT population data, and demographic, temporal, and clinical characteristics were analyzed. Overall, 669 cases were reported (mean annual incidence rate: 3.03/100,000 (IC 95% 2.47–3.59; period incidence rate: 18.2/100,000 (IC 95% 16.81–19.56)), with 89% occurring in 2024 (16.34/100,000 (IC 95% 15.03–17.65)). No sex differences were observed, and most cases were reported in Central Tuscany (64%). Children under 15 years accounted for 87% of cases. The highest incidence was observed among 10–14-year-olds, while infants < 1 year, particularly those under 4 months, showed the highest burden in narrower age strata. Hospitalizations occurred in 12.6% of cases, decreasing substantially in 2024. The 2024 resurgence likely reflects waning immunity, disruptions to routine vaccinations during the pandemic, and reduced pathogen circulation in previous years due to containment and isolation measures related to the pandemic. Strengthening surveillance and improving booster and maternal vaccination coverage are essential to protect vulnerable populations. Full article

Background: Tourists often travel within their own country or abroad for business, leisure or to receive planned healthcare. However, they are often not prepared for unexpected medical emergencies that occur far from home. Seeking emergency healthcare during travel may pose various barriers and challenges to tourists. Aims: This systematic review aimed to identify the challenges and barriers tourists face while seeking emergency healthcare during travel. Methods: A comprehensive search was performed in PubMed, Scopus, Web of Science and ScienceDirect from 1st January 1995 to 31 October 2025. The review included studies focusing on tourists who sought emergency healthcare abroad. Due to the methodological heterogeneity of the studies making meta-analysis impossible, a narrative synthesis of the results was conducted. The review protocol was registered with PROSPERO (ID CRD420251156975). Results: From 608 initial titles (603 from database searches and 5 additional from similar articles), 10 studies were selected—5 cross-sectional and 5 retrospective. Most (7/10) were conducted in Asian countries, while others were conducted in Europe (1), the U.S.A. (1) and multiple countries (1). The participant number ranged from 37 to 2333. All studies included both genders, apart from one that focused exclusively on pregnant women. The most common challenges identified were language and cultural barriers, limited access to healthcare services in terms of appropriateness and timeliness of care and financial and insurance coverage issues. Conclusions: The findings underscore that tourists face multiple barriers when seeking emergency healthcare abroad, resulting in negative tourist travel experiences. Once identified, specific strategies should be adopted to improve accessibility and the overall quality of care for tourists. Full article

Background: Global dementia policies advocate for early or timely diagnosis, yet evidence on benefits or harms remains limited. This systematic review evaluates quantitative evidence comparing outcomes of early versus late and timely versus untimely dementia diagnoses. Methods: Following PRISMA guidelines, the protocol was registered on PROSPERO. Comprehensive searches of PsycINFO, Medline, Embase, SCOPUS, and CINAHL were conducted without date restrictions. Eligible studies defined diagnostic timing and examined associations with outcomes for people with dementia and/or carers. Quality was appraised using the QuADS tool, and data were narratively synthesised. Results: Four studies (2018–2021) met inclusion criteria, encompassing 37,341 individuals with dementia and 1409 carers across Europe and the United States. Three studies investigated early versus late diagnosis; one assessed perceived timeliness. Definitions varied. Evidence of benefit was limited: one study reported a 9–23% reduction in mortality risk for early diagnosis. Another found that carers perceiving the diagnosis as untimely experienced greater and more persistent emotional distress. No significant associations were observed for cognitive or functional decline, hospitalisation, or emergency department attendance. Conclusions: Despite strong policy endorsement, empirical evidence on benefits of early or timely dementia diagnosis remains scarce, geographically narrow, and methodologically constrained. Future longitudinal studies explicitly defining diagnostic timing and incorporating psychosocial and contextual factors are needed to clarify potential benefits or harms for people with dementia and their carers. Full article

Artificial intelligence is already being used in the administration of Justice, with various applications assisting judges in resolving cases. In particular, in criminal Justice, these applications include predictive Justice and decision-making assistance through the assessment of facts, as well as the classification of criminals into risk groups. This article examines the current regulatory and ethical framework (AI Act, Council of Europe Convention on AI, CEPEJ Ethical Charter, UNESCO and OECD principles) and develops a regulatory approach to the use of AI systems by judges and prosecutors. The methodology is based on a doctrinal analysis of international, EU, and professional ethical literature, as well as on a synthesis of principles of judicial conduct (Bangalore Principles, Magna Carta of Judges). To strike a balance between the rules of governing system use and judicial ethics, the article proposes a consistent framework of ethical principles (legitimacy, transparency, accountability, integrity, human oversight, prohibition of discrimination) and introduces a practical “line of reasoning” with key questions that judges should consider before and during the use of intelligent tools (risks, bias, proportionality, understanding of the algorithm, and impact on judicial judgment). The article concludes that AI may improve the efficiency of the justice system only when included inside a strong ethical framework and specialized training, guaranteeing that final judicial decisions remain solely human and fully aligned with the rule of law. Full article

The consolidation of artificial intelligence (AI) is transforming the journalistic sector, to the point that its ethical dimension is being altered. However, the mission and values of the media in the face of the current emergence of generative artificial intelligence (GenAI) have barely been explored. Bearing this in mind, it is important to understand not only how journalists perceive AI, but also to examine the role that the media assign to themselves and the audience’s participation in this context. This research explores the roles defined by a sample of leading media outlets (n = 21) in seven countries in Western Europe and North America: France, Germany, Italy, Spain, the United Kingdom, Canada, and the United States. To this end, a discursive content analysis is applied to three newspapers (printed or digital) per country. The findings reflect differences between countries and media outlets, within a common trend of prioritizing responsibility as the primary editorial value, followed by truthfulness. We also found scant direct references to AI regulation, alongside the development of participatory interactivity within readership established by the media outlet. Furthermore, greater participation of audiences was observed in publicly funded publications, granting audiences a deliberative role. Full article

Gastrointestinal indolent B-cell lymphomas (GI-iBCLs) are a group of low-grade, slowly progressive malignancies, accounting for approximately 1–4% of all gastrointestinal tumors. They represent the most common type of extranodal indolent B-cell lymphoma. Their clinical presentation often overlaps with that of benign inflammatory conditions, posing diagnostic challenges. In recent years, the incidence of GI-iBCL has been increasing in Asia and Europe, while advances in molecular pathology have facilitated more precise classification. This review systematically summarizes recent progress in understanding the epidemiology, clinical features, pathogenesis, pathological characteristics, treatment, and prognosis of GI-iBCLs, with a specific focus on mucosa-associated lymphoid tissue (MALT) lymphoma and duodenal-type follicular lymphoma (DTFL). We also discuss critical issues such as the risk of histological transformation, treatment optimization for refractory cases, the potential of molecular markers, and the evolving landscape of precision medicine. Full article

Red clover (Trifolium pratense L.) is a crop used as a forage that possesses an exceptional nutritional profile and digestibility. Unfortunately, this crop has low seed yield. Within the framework of the “Legume Generation” EC-funded project, our team aimed to investigate the role of foliar boron application on pollen viability and pollen tube development, and to assess its overall effect on red clover cultivation. Plants of six commercial diploid red clover cultivars, Nika 11, Sofia 52, AberClaret, Milvus, Global, and S123, were field-grown and boron-treated by spraying with the commercial product “Lebasol”, 11% active water-soluble boron. To reach our purpose, the transcript levels of genes related to flower, pollen, and pollen tube development and boron transport were measured by qRT-PCR; pollen grain viability and count were assessed microscopically. For this research, eight genes were selected: Auxin Response factor (TprARF17); TprAPETALA3; Walls are thin (TprWAT1 and TprWAT2); NIPs genes (Nodulin Intrinsic Protein) TprNIP4;2, TprNIP7;1, TprNIP5;1, and TprNIP6;1. Additionally, total nitrogen content in leaves detached from field-grown boron-treated and untreated plants was assessed and compared with the expression levels of two TprNIP5;1 and TprNIP6;1 transporters. The fresh and dry biomass weight from the first and second cuts was evaluated, as well as the seed collected from the red clover plants. Seed germination percentage and vigor of seedlings were examined in vitro for both boron-treated and untreated groups of two specific cultivars. Collected data confirm that foliar application of boron affects pollen viability and plant development of red clover in the cultivation conditions of South East Europe. Full article

There is no doubt that food safety is important for public health and also no doubt stakeholders from farm to fork, including consumers, need to ensure that food remains safe. In Europe, foodborne outbreaks often occur in consumers’ homes, highlighting the importance of research on consumer food safety that leads to interventions. This article reports findings from a part of the Consumer Food Safety Study in Slovenia on the topics of thawing, heat treatment of food, keeping hot food hot and leftovers. A validated online questionnaire was designed using the Matrix of Consumer Food Safety and was completed by 1621 adults. The study assessed consumer food safety knowledge, attitudes and food-handling practices using descriptive statistics, and analyzed how knowledge, attitudes, and practices are interconnected using structural equation modeling. For the most part, participants showed good knowledge, positive attitudes and safe practices, but improvements are needed on thawing methods, use of kitchen thermometers, keeping heat-treated food hot at above 63 °C, and safe cooling and labeling of leftovers. Structural equation modeling in a variety of ways found that (1) knowledge affects attitudes, (2) knowledge affects practices, and (3) attitudes affect practices—emphasizing the importance of including all three aspects in public health food safety interventions. This study offers useful insights and directions for future research and development of public health programs. Full article

Within the project “Small-scale grants for biodiversity actors in South-East Europe 2023–2025”, whose main mission is the collection of local varieties and populations, a fundamental question arises: “Why are ‘ancestral’ maize varieties and populations still cultivated?” To answer this question, we conducted a comprehensive set of investigations on 14 maize (Zea mays L.) varieties and populations and on one hybrid, collected from the historical regions of Romania—Transylvania, Moldova, Oltenia and Muntenia. The studies combine quantitative, qualitative and computational methods and focused on energy consumption associated with maize cultivation; maize grain production and related agronomic characteristics; the content of energy macronutrients (protein, fat, starch) and energy elements (CHNS-O, ash, moisture); and nutritional and thermal energy values (upper and lower) of whole cornmeal. The sustainability of the cultivation of local maize varieties was also evaluated based on the energy balance and the energy efficiency ratio. The results demonstrated that the cultivation of “ancestral” maize varieties and populations is sustainable, because the amount of energy obtained, expressed in kJ ha⁻¹, as nutritional energy (24,740,195.04–90,287,743.07), higher heating energy (55,162,983.798–193,374,572.55) and lower heating energy (32,329,465.37–113,906,753.63), is greater than the amount of energy consumed for the establishment and maintenance of these crops (1,742,798.75–19,524,555.05). Full article

Underground gas storage (UGS) in salt caverns is increasingly important for a flexible and secure energy supply and for stabilizing the gas market. However, cavern operations can induce surface ground movements that must be monitored to safeguard infrastructure integrity and environmental compatibility. This research analyzes horizontal (W–E) and vertical ground movements above the cavern field Gronau-Epe in northwestern Germany, using radar interferometry (InSAR), specifically the SBAS (Small Baseline Subset) approach, combined with clustering and multi-criteria analysis. The study was conducted in cooperation between Uniper Energy Storage GmbH, the Research Center for Post Mining at THGA Bochum, and the company EFTAS. Freely available Copernicus Sentinel 1 data were integrated with public soil maps and operational storage information. A multistage workflow quantified deformation patterns, classified coherent deformation zones via clustering, and evaluated geological and technical drivers using multi-criteria analysis to better distinguish operational (primary) from overburden (secondary) influences. Results reveal long term deformation trends closely linked in time and space to injection/withdrawal cycles. Locally confined vertical and horizontal movements near caverns are attributed to salt convergence triggered by cyclic pressure changes, but they are linked to (hydro)geological and pedological factors. The developed approach shows strong monitoring potential in addition to classic mine surveying. Full article

Urban Air Mobility (UAM) introduces new safety challenges as small unmanned aircrafts begin to operate at high density in complex urban environments. Traditional air traffic management (ATM) systems developed for manned aviation are unable to accommodate the autonomy, mission diversity, and dynamic obstacle conditions typical of low-altitude operations. This review examines recent research on mid-air collision risk and airspace safety modeling for UAM and identifies key challenges in adapting existing safety concepts to small-scale and autonomous flight. The study compares international management frameworks of the United States, Europe, and China. Then analyzes representative airspace structures such as Free, Layered, Zoned, and Pipeline configurations. It further reviews deterministic and probabilistic separation models, geometric and optimization-based avoidance strategies, and structured airspace approaches such as the virtual-tube concept for coordinated swarm navigation. The findings highlight the lack of integrated models that couple human, energy, and communication factors into quantitative risk assessment. The paper concludes by outlining future research needs in uncertainty modeling, digital-twin simulation, and interoperability to support safe and scalable UAM development. Full article

Tularemia is a plague-like, potentially fatal zoonosis caused by the coccobacillus Francisella tularensis. It was discovered at the beginning of the last century in the United States and was soon recognized in Japan and in the former Soviet Union as the cause of clinical conditions that had been known for one and two centuries, respectively. More than 250 animal species are susceptible to infection, with rodents and lagomorphs serving as key reservoirs, and several vectors may transmit the disease, mainly ticks and mosquitoes. Humans are incidental hosts and are infected primarily by two F. tularensis subspecies, tularensis and holarctica: the former is more severe and is found almost exclusively in North America, whereas the latter is distributed throughout the Northern Hemisphere, mainly in Europe and Asia. Tularemia is highly infectious; therefore, diagnostic cultures should be handled in biosafety level 3 laboratories. Nevertheless, interhuman transmission is exceedingly rare. Although tularemia is relatively uncommon, it shows a re-emerging pattern at the global level, particularly in Europe. As with plague, mitigation may be more effectively achieved through a One Health approach. Neither approved vaccines nor therapeutic antibodies are currently available, whereas aminoglycoside, tetracycline, and quinolone antibiotics are effective. Owing to its high infectivity, its ease of transmission by inhalation, its clinical severity, with a prolonged and debilitating course, and its potential lethality, F. tularensis has long been considered a potential biological weapon, particularly if antibiotic-resistant strains were used. Although natural antibiotic resistance has not been described to date, research programs aimed at obtaining resistant strains have been conducted. It has been suggested that the disease was already present in the Middle East during the second millennium BC; should this hypothesis be confirmed by paleogenomic studies, plague and tularemia would have coexisted for more than three millennia, with plague masking the less severe tularemia. Many challenges related to tularemia are still unresolved. Full article

Land-use change associated with scattered (isolated) housing in the countryside remains largely underestimated in conventional European land-use datasets due to spatial resolution and minimum mapping unit constraints. This study quantifies low-density urban sprawl at the building level in Cyprus for the period 1993–2022, both within and outside Special Protection Areas (SPAs) of the Natura 2000 network. Situating the analysis within a broader Mediterranean EU planning context, the paper examines how local spatial patterns reflect wider development trajectories, including tourism-driven growth and second-home demand. Results reveal a fivefold increase in isolated housing outside development planning zones, from 2440 units in 1993 to 12,640 in 2022 (+418%). Significant increases occurred within agricultural zones (Γ: +568%) and even in protection zones (Z1: +438%). Within SPAs, isolated houses rose from 341 to 1556 (+356%), while total building premises within these areas increased from 955 to 3649 (+282%), indicating statistically significant encroachment. Although Natura 2000 designation appears to have moderated development rates compared to the broader countryside, it has not prevented sprawl. The findings demonstrate substantial cumulative impacts on landscapes, ecosystems, and land-use planning objectives, highlighting the urgent need for stricter regulation of dispersed houses and auxiliary buildings both within protected and non-protected rural areas. Full article