Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Developing a list of invasive alien species likely to threaten biodiversity and ecosystems in the European Union.

The European Union (EU) has recently published its first list of invasive alien species (IAS) of EU concern to which current legislation must apply. The list comprises species known to pose great threats to biodiversity and needs to be maintained and updated. Horizon scanning is seen as critical to identify the most threatening potential IAS that do not yet occur in Europe to be subsequently risk assessed for future listing. Accordingly, we present a systematic consensus horizon scanning procedure to derive a ranked list of potential IAS likely to arrive, establish, spread and have an impact on biodiversity in the region over the next decade. The approach is unique in the continental scale examined, the breadth of taxonomic groups and environments considered, and the methods and data sources used. International experts were brought together to address five broad thematic groups of potential IAS. For each thematic group the experts first independently assembled lists of potential IAS not yet established in the EU but potentially threatening biodiversity if introduced. Experts were asked to score the species within their thematic group for their separate likelihoods of i) arrival, ii) establishment, iii) spread, and iv) magnitude of the potential negative impact on biodiversity within the EU. Experts then convened for a 2-day workshop applying consensus methods to compile a ranked list of potential IAS. From an initial working list of 329 species, a list of 66 species not yet established in the EU that were considered to be very high (8 species), high (40 species) or medium (18 species) risk species was derived. Here, we present these species highlighting the potential negative impacts and the most likely biogeographic regions to be affected by these potential IAS

Invasive Alien Species - Prioritising prevention efforts through horizon scanning: ENV.B.2/ETU/2014/0016: Final report

The European Union Regulation (EU) 1143/2014 on invasive alien species (IAS) establishes an EU-wide framework for action to prevent, minimise and mitigate the adverse impacts of IAS on biodiversity and centres around the development of a list of IAS of EU Concern. The initial list of IAS of EU concern will be based on available risk assessments compliant with agreed minimum standards but horizon scanning is seen as critical to inform future updating of the list, in order to prioritise the most threatening new and emerging IAS. A workshop was held with the overarching aim of reviewing and validating an approach to horizon scanning to derive a ranked list of IAS which are likely to arrive, establish, spread and have an impact on biodiversity or related ecosystem services in the EU over the next decade. The agreed horizon scanning approach involved two distinct phases: i) Preliminary consultation between experts within five thematic groups to derive initial scores; ii) Consensus-building across expert groups including extensive discussion on species rankings coupled with review and moderation of scores across groups. The outcome of the horizon scanning was a list of 95 species, including all taxa (except microorganisms) within marine, terrestrial and freshwater environments, considered as very high or high priority for risk assessmentLe Règlement de l’Union Européenne (UE) 1143/2014 sur les espèces notices envahissantes (EEE) établit un cadre d’actions à l’échelle européenne pour prévenir, réduire au minimum et atténuer les impacts négatifs des EEE sur la biodiversité, et se concentre sur le développement d’une liste d’EEE de préoccupation européenne. La liste initiale d’EEE de préoccupation européenne est basée sur les analyses de risque disponibles conformes aux standards minimums reconnus. Mais l’horizon scanning est essentiel pour informer les mises à jour futures de la liste, dans le but de prioritiser les EEE nouvelles et émergentes les plus menaçantes. Un workshop a été organisé avec pour but général d’évaluer et de valider une approche d’horizon scanning en vue de produire une liste ordonnée d’EEE susceptibles d’arriver, de s’établir, de se disperser et de présenter un impact sur la biodiversité et les services écosystémiques associés dans l’UE durant la prochaine décennie. L’approche d’horizon scanning avalisée comprenait deux phases distinctes: i) Une consultation préliminaire entre experts au sein de cinq groups thématiques pour produire des scores initiaux ii) L’établissement de consensus au travers des groups d’experts incluant une discussion approfondie sur les classements des espèces, combinée à une évaluation et une modération des scores entre groupes. Le résultat de l’horizon scanning consistait en une liste de 95 espèces, comprenant tous les types taxonomies (excepté des microorganismes) au sein des environnements marins, terrestres et d’eau douce, et considérées comme étant de priorité très élevée à élevée pour la réalisation d’analyses de risqu

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings In 2016, there were 27.08 million (95% uncertainty interval [UI] 24.30-30.30 million) new cases of TBI and 0.93 million (0.78-1.16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55.50 million (53.40-57.62 million) and of SCI was 27.04 million (24 .98-30 .15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8.4% (95% UI 7.7 to 9.2), whereas that of SCI did not change significantly (-0.2% [-2.1 to 2.7]). Age-standardised incidence rates increased by 3.6% (1.8 to 5.5) for TBI, but did not change significantly for SCI (-3.6% [-7.4 to 4.0]). TBI caused 8.1 million (95% UI 6. 0-10. 4 million) YLDs and SCI caused 9.5 million (6.7-12.4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe