The political discourse of the European Parliament, enlargement, and the construction of a European identity, 1962 - 2004

This thesis explores the European Parliament's construction of European identity in enlargement discourse between 1962 and 2004. It focuses on the idea of "Europe" a constructed by the European Parliament over the past 50 years, analysing both the way which MEPs discuss the idea of Europe and European identity and also looking through the lens at the development of what has so far been a largely neglected institution in the historiography of European integration. The European Parliament is a common subject of political science studies, which often focus on the dynamics of party politics and elections. European identity is also a ubiquitous subject of many political science, sociological, and historical works. Historians of European integration, however, have dedicated little attention to either. This work thus places itself at the intersection of the literature on the idea of European identity, the European Parliament, and European enlargement. The thesis makes a contribution to the understanding of the historical development of a European identity discourse with the enlargement context, showing how one amongst the Community institutions attempted to legitimise the expansion and continuation of the process of European integration through the discursive construction of a European idea. It traces the main themes that emerge over the years out of this construction, from political identity to historical narratives and cultural elements, analysing how MEPs develop these different bases if identity in different enlargement contexts. It then looks at Turkey as a special case study of an enlargement that is still underway and explores the identity themes that emerge from the discourse surrounding this open-ended process. Ultimately, the thesis also shows that the European Parliament, thus far overlooked in the historiography of European integration, is in fact worthy of closer scrutiny as an institution in its own right

Exacerbations of bronchiectasis

Bronchiectasis presents a significant challenge due to its rising prevalence, associated economic burden and clinical heterogeneity. This review synthesises contemporary understanding and literature of bronchiectasis exacerbations, addressing the transition from stable state to exacerbations, underlining the importance of early and precise recognition, rigorous severity assessment, prompt treatment, and prevention measures, as well as emphasising the need for strategies to assess and improve early and long-term patient outcomes. The review highlights the interplay between stable state phases and exacerbations in bronchiectasis, introducing the concept of “exogenous and endogenous changes in airways homeostasis” and the “adapted island model” with a particular focus on “frequent exacerbators”, a group of patients associated with specific clinical characteristics and worse outcomes. The pathophysiology of exacerbations is explored through the lens of microbial and nonmicrobial triggers and the presence and the activity of comorbidities, elaborating on the impact of both exogenous insults, such as infections and pollution, and endogenous factors such as inflammatory endotypes. Finally, the review proposes a multidisciplinary approach to care, integrating advancements in precision medicine and biomarker research, paving the way for tailored treatments that challenge the traditional antibiotic paradigm.</p

Effects of warmer and drier climate conditions on plant composition and biomass production in a Mediterranean shrubland community

The last IPCC report predicts warmer and drier conditions for the future European climate and the Mediterranean basin could be highly sensible to future climatic change. In order to investigate how the forecast more stressing factors could affect Mediterranean shrubland ecosystems, an appropriate manipulation of the microclimate was carried out in an area covered by Mediterranean maquis aimed at extending the drought period and increasing the night-time temperature. Soil cover, plant growth, litterfall, leaf water status, and leaf nutritional status were monitored over three growing seasons. The manipulation altered the microclimate according to common scenarios, increasing mean annual night-time air temperature by about 1 °C and mean annual temperature by about 0.5 °C, and decreasing precipitation between 6-46% of the total rainfall during the growing seasons. A general increase of vegetation cover was observed in the whole community during the three years of experimentation. This positive temporal pattern was mainly observed in control and warming treatment, whereas in the drought treatment it was less evident. At species-specific level, a clear negative effect of drought treatment was observed for C. monspeliensis percentage cover. Shoot elongation was not significantly affected by the warming treatment. A significant negative effect of drought treatment was noticed in the 2001-2002 and 2002-2003 growing seasons. An increase of N and P concentrations in the drought treatment in Cistus was observed and it can be explained by the reduced shoot growth induced by the water shortage that we had observed in the same treatment. The absence of a concentration effect on the other two species could be the signal of the different behaviour with regard to a drier climate, and therefore could be a symptom of future change in species composition. We underline the need of longterm observation, because of the different responses of plants in the short and long- term conditions

Una Nuova area sperimentale di lungo termine, per lo studio degli effetti dell'incremento della temperatura e del periodo di aridità in formazioni di sclerofille mediterranee

A new long-term experimental area for studying the effects of climate warming and seasonal drought on a Mediterranean shrubland community. Global changes, such as land use changes, altered atmosphere composition, and climate changes, have been altering the functioning of ecosystems with possible impacts on the degree of biodiversity. Temperature and water availability are the two main determinants of the functional processes of terrestrial ecosystems. Climatic changes could have strong effects on vulnerable ecosystems as Mediterranean shrublands/garrigue/maquis, where the growth and survival of the plants are strictly dependent on the drought and to the high summer temperature. Furthermore, other pressures, such as grazing and wildfires, occur frequently in the Mediterranean area. In order to assess the impacts of the temperature increase and precipitation reduction on Mediterranean shrublands, a new experimental area was established in Sardinia at the Porto Conte forest, Alghero (SS). A system of automatic roofs covers 6 experimental plots (20 m2), in order to simulate an increase of temperature during the night (3 plots) or to intercept the precipitations during a 2-3 months period (3 plots). Three additional plots are used as control. All the observations were conducted in other five European shrubland ecosystems, according to common protocols developed in the context of the European project VULCAN (www.vulcanproject.com). The studies of the different ecological and physiological processes are organised in working packages (Plant, Soil, Fauna, Water) and integrated in a risk assessments evaluation. The aim of this paper is to analyse the first two years of data, to demonstrate the microclimatic modifications induced by the experimental system

Optimising recruitment in clinical trials for progressive multiple sclerosis: observational analysis from the MS-SMART and MS-STAT2 randomised controlled trials

BACKGROUND: Slower than planned recruitment is a major factor contributing to the delay or failure of randomised controlled trials to report on time. There is a limited evidence base regarding the optimisation of recruitment strategies. Here we performed an observational review of our experience in recruitment for two large randomised controlled trials for people with secondary progressive multiple sclerosis. We aimed to explicitly determine those factors which can facilitate trial recruitment in progressive neurodegenerative disease. METHODS: Recruitment data from the sequential MS-SMART [NCT01910259] and MS-STAT2 [NCT03387670] UK randomised controlled trials was reviewed from the largest recruiting site, University College London (UCL). The trial population was similar which allowed comparison over the two recruitment periods of 2015-2016 and 2018-2021. This included sources of referral, progress through stages of recruitment, reasons for participant ineligibility and the impact of publicity events upon recruitment. RESULTS: In MS-SMART, 18% of patients contacted were enrolled, compared to 27% for MS-STAT2. Online registration of interest portals provided the greatest number of referrals (76% in MS-SMART, and 51% in MS-STAT2), with publicity in national media outlets producing a demonstrable increase in the number of potential participants. The introduction of an online self-screening questionnaire for MS-STAT2 resulted in 67% of potential participants (3080 of 4605) automatically determining their own ineligibility. In both studies, however, around 60% of those directly telephoned to discuss the study were not eligible, with difficulties related to travel to trial visits, or excluded medication, being the most common issues. Eighty-four percent of those deemed potentially eligible following telephone calls were enrolled in the MS-STAT2 study, compared to only 55% for MS-SMART. CONCLUSIONS: Through a detailed review of recruiting participants at the largest centre into two large randomised controlled trials with similar entry criteria, we have identified a number of approaches that may improve recruitment efficiency. We highlight here the importance of mandatory online self-screening questionnaires, a coordinated publicity campaign, and simple interventions such as eligibility checklists and appointment reminders. Recruitment approaches should be further assessed through a studies within a trial (SWAT) design. TRIAL REGISTRATION: MS-SMART: NCT01910259 ; registered July 2013 and MS-STAT2: NCT03387670 ; registered Jan 2018

Evaluating the causal impact of individual alcohol licensing decisions on local health and crime using natural experiments with synthetic controls.

BACKGROUND AND AIMS: Given the costs of alcohol to society, it is important to evaluate whether local alcohol licensing decisions can mitigate the effects of alcohol misuse. Robust natural experiment evaluations of the impact of individual licensing decisions could potentially inform and improve local decision-making. We aimed to assess whether alcohol licensing decisions could be evaluated at small spatial scale by using a causal inference framework. DESIGN: Three natural experiments. SETTING AND PARTICIPANTS: Three English local areas of 1000-15 000 people each. INTERVENTION AND COMPARATOR: The case study interventions were (i) the closure of a nightclub following reviews; (ii) closure of a restaurant/nightclub following reviews and (iii) implementation of new local licensing guidance (LLG). Trends in outcomes were compared with synthetic counterfactuals created using Bayesian structural time-series. MEASUREMENTS: Time-series data were obtained on emergency department admissions, ambulance call-outs and alcohol-related crime at the Lower or Middle Super Output geographical aggregation level. FINDINGS: Closure of the nightclub led to temporary 4-month reductions in antisocial behaviour (-18%; 95% credible interval - 37%, -4%), with no change in other outcomes. Closure of the restaurant/nightclub did not lead to measurable changes in outcomes. The new licensing guidance led to small reductions in drunk and disorderly behaviour (nine of a predicted 21 events averted), and the unplanned end of the LLG coincided with an increase in domestic violence of two incidents per month. CONCLUSIONS: The impact of local alcohol policy, even at the level of individual premises, can be evaluated using a causal inference framework. Local government actions such as closure or restriction of alcohol venues and alcohol licensing may have a positive impact on health and crime in the immediate surrounding area

SARS-CoV-2, influenza A/B and respiratory syncytial virus positivity and association with influenza-like illness and self-reported symptoms, over the 2022/23 winter season in the UK: a longitudinal surveillance cohort

Background Syndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses. Methods We estimated the positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK community cohort (COVID-19 Infection Survey), using negative-binomial generalised additive models. We estimated associations between test positivity and each of the symptoms and influenza vaccination, using adjusted logistic and multinomial models. Results Swabs taken at 32,937/1,352,979 (2.4%) assessments tested positive for SARS-CoV-2, 181/14,939 (1.2%) for RSV and 130/14,939 (0.9%) for influenza A/B, varying by age over time. Positivity and incidence peaks were earliest for RSV, then influenza A/B, then SARS-CoV-2, and were highest for RSV in the youngest and for SARS-CoV-2 in the oldest age groups. Many test positives did not report key symptoms: middle-aged participants were generally more symptomatic than older or younger participants, but still, only ~ 25% reported ILI-WHO and ~ 60% ILI-ECDC. Most symptomatic participants did not test positive for any of the three viruses. Influenza A/B-positivity was lower in participants reporting influenza vaccination in the current and previous seasons (odds ratio = 0.55 (95% CI 0.32, 0.95)) versus neither season. Conclusions Symptom profiles varied little by aetiology, making distinguishing SARS-CoV-2, influenza and RSV using symptoms challenging. Most symptoms were not explained by these viruses, indicating the importance of other pathogens in syndromic surveillance. Influenza vaccination was associated with lower rates of community influenza test positivity

SARS-CoV-2, influenza A/B and respiratory syncytial virus positivity and 1 association with influenza-like illness and self-reported symptoms, over the 2022/23 winter season in the UK: a longitudinal surveillance cohort

Background Syndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses. Methods We estimated the positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK community cohort (COVID-19 Infection Survey), using negative-binomial generalised additive models. We estimated associations between test positivity and each of the symptoms and influenza vaccination, using adjusted logistic and multinomial models. Results Swabs taken at 32,937/1,352,979 (2.4%) assessments tested positive for SARS-CoV-2, 181/14,939 (1.2%) for RSV and 130/14,939 (0.9%) for influenza A/B, varying by age over time. Positivity and incidence peaks were earliest for RSV, then influenza A/B, then SARS-CoV-2, and were highest for RSV in the youngest and for SARS-CoV-2 in the oldest age groups. Many test positives did not report key symptoms: middle-aged participants were generally more symptomatic than older or younger participants, but still, only ~ 25% reported ILI-WHO and ~ 60% ILI-ECDC. Most symptomatic participants did not test positive for any of the three viruses. Influenza A/B-positivity was lower in participants reporting influenza vaccination in the current and previous seasons (odds ratio = 0.55 (95% CI 0.32, 0.95)) versus neither season. Conclusions Symptom profiles varied little by aetiology, making distinguishing SARS-CoV-2, influenza and RSV using symptoms challenging. Most symptoms were not explained by these viruses, indicating the importance of other pathogens in syndromic surveillance. Influenza vaccination was associated with lower rates of community influenza test positivity

Enlargement and the Historical Origins of the European Community's Democratic Identity, 1961–1978

This article examines how and when democracy entered the discursive politics of the European Community to become one of the fundamental tenets of European political identity – and in the process influenced how decision-makers approached the question of enlargement. Building on multiple archival sources, the article traces how all three Community institutions (Commission, Council and European Parliament) legitimised the expansion and continuation of the process of European integration through the discursive construction of democracy. It focuses on the debates elicited by the attempts of southern European countries to accede to the EEC in the 1960s and 1970s

Post-stroke inhibition of induced NADPH oxidase type 4 prevents oxidative stress and neurodegeneration

Ischemic stroke is the second leading cause of death worldwide. Only one moderately effective therapy exists, albeit with contraindications that exclude 90% of the patients. This medical need contrasts with a high failure rate of more than 1,000 pre-clinical drug candidates for stroke therapies. Thus, there is a need for translatable mechanisms of neuroprotection and more rigid thresholds of relevance in pre-clinical stroke models. One such candidate mechanism is oxidative stress. However, antioxidant approaches have failed in clinical trials, and the significant sources of oxidative stress in stroke are unknown. We here identify NADPH oxidase type 4 (NOX4) as a major source of oxidative stress and an effective therapeutic target in acute stroke. Upon ischemia, NOX4 was induced in human and mouse brain. Mice deficient in NOX4 (Nox4(-/-)) of either sex, but not those deficient for NOX1 or NOX2, were largely protected from oxidative stress, blood-brain-barrier leakage, and neuronal apoptosis, after both transient and permanent cerebral ischemia. This effect was independent of age, as elderly mice were equally protected. Restoration of oxidative stress reversed the stroke-protective phenotype in Nox4(-/-) mice. Application of the only validated low-molecular-weight pharmacological NADPH oxidase inhibitor, VAS2870, several hours after ischemia was as protective as deleting NOX4. The extent of neuroprotection was exceptional, resulting in significantly improved long-term neurological functions and reduced mortality. NOX4 therefore represents a major source of oxidative stress and novel class of drug target for stroke therapy