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To develop evidence-based recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV) including giant cell arteritis (GCA) and Takayasu arteritis (TAK). European League Against Rheumatism (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound, MRI, CT and [18F]-fluorodeoxyglucose positron emission tomography (PET) in LVV. Based on evidence and expert opinion, the task force consisting of 20 physicians, healthcare professionals and patients from 10 EULAR countries developed recommendations, with consensus obtained through voting. The final level of agreement was voted anonymously. A total of 12 recommendations have been formulated. The task force recommends an early imaging test in patients with suspected LVV, with ultrasound and MRI being the first choices in GCA and TAK, respectively. CT or PET may be used alternatively. In case the diagnosis is still in question after clinical examination and imaging, additional investigations including temporal artery biopsy and/or additional imaging are required. In patients with a suspected flare, imaging might help to better assess disease activity. The frequency and choice of imaging modalities for long-term monitoring of structural damage remains an individual decision; close monitoring for aortic aneurysms should be conducted in patients at risk for this complication. All imaging should be performed by a trained specialist using appropriate operational procedures and settings. These are the first EULAR recommendations providing up-to-date guidance for the role of imaging in the diagnosis and monitoring of patients with (suspected) LVV.

BackgroundSince the publication of the European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) in 2009, several relevant randomised clinical trials and cohort analyses have been published, which have the potential to change clinical care and therefore supporting the need to update the original recommendations.MethodsUsing EULAR standardised operating procedures for EULAR-endorsed recommendations, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 13 countries. We modified existing recommendations and created new recommendations.ResultsThree overarching principles and 10 recommendations were formulated. We recommend that a suspected diagnosis of LVV should be confirmed by imaging or histology. High dose glucocorticoid therapy (40–60 mg/day prednisone-equivalent) should be initiated immediately for induction of remission in active giant cell arteritis (GCA) or Takayasu arteritis (TAK). We recommend adjunctive therapy in selected patients with GCA (refractory or relapsing disease, presence of an increased risk for glucocorticoid-related adverse events or complications) using tocilizumab. Methotrexate may be used as an alternative. Non-biological glucocorticoid-sparing agents should be given in combination with glucocorticoids in all patients with TAK and biological agents may be used in refractory or relapsing patients. We no longer recommend the routine use of antiplatelet or anticoagulant therapy for treatment of LVV unless it is indicated for other reasons.ConclusionsWe have updated the recommendations for the management of LVV to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice.

Understanding long-term coastal changes requires comprehensive records of morphological data spanning extended periods, ideally over multiple decades. Nevertheless, significant challenges arise from the restricted availability and accessibility of reliable data, especially in the case of complex coastal systems dominated by wave-current dynamics, such as ebb-tidal deltas (ETDs). This study introduces a new dataset for Tagus ETD in central Portugal, from 1845 to 1985 based on historic nautical charts available for the area. The data includes: (1) high-resolution bathymetric surfaces of ETD configuration for years 1845, 1879, 1893, 1929, 1939, 1960 and 1985; (2) shoreline position of three different indicators (Low-Water Line, High-Water Line and foredune dune seaward limit) at the adjacent coast for the same years; (3) rates-of-change for shoreline position of the High-Water Line indicator. Data also includes an uncertainty assessment for hydrographical and shoreline position information estimated from historic nautical charts. These data provide a valuable resource for describing, understanding, and modelling the long-term behaviour of ETDs not covered by other currently available datasets.

ObjectivesTo develop treat-to-target (T2T) recommendations in giant cell arteritis (GCA) and polymyalgia rheumatica (PMR).MethodsA systematic literature review was conducted to retrieve data on treatment targets and outcomes in GCA/PMR as well as to identify the evidence for the effectiveness of a T2T-based management approach in these diseases. Based on evidence and expert opinion, the task force (29 participants from 10 countries consisting of physicians, a healthcare professional and a patient) developed recommendations, with consensus obtained through voting. The final level of agreement was provided anonymously.ResultsFive overarching principles and six-specific recommendations were formulated. Management of GCA and PMR should be based on shared decisions between patient and physician recognising the need for urgent treatment of GCA to avoid ischaemic complications, and it should aim at maximising health-related quality of life in both diseases. The treatment targets are achievement and maintenance of remission, as well as prevention of tissue ischaemia and vascular damage. Comorbidities need to be considered when assessing disease activity and selecting treatment.ConclusionThese are the first T2T recommendations for GCA and PMR. Treatment targets, as well as strategies to assess, achieve and maintain these targets have been defined. The research agenda highlights the gaps in evidence and the need for future research.

Regional/national-scale information on coastline rates of change and trends is extremely valuable, but these studies are scarce. A widely accepted standardized methodology for analysing long-term coastline change has been difficult to achieve, but it is essential to conduct an integrated and holistic approach to coastline evolution and hence support coastal management actions. Additionally, databases providing knowledge on coastline evolution are of key importance to support both coastal management experts and users.The main objective of this work is to present the first systematic, national-scale and consistent long-term coastline evolution data of Portuguese mainland low-lying sandy coasts.The methodology used quantifies coastline evolution using a unique and robust coastline indicator (the foredune toe), which is independent of short-term changes.The dataset presented comprises (1) two polyline sets, mapping the 1958 and 2010 sandy beach–dune system coastline, both optimized for working at 1 : 50 000 scale or smaller; (2) one polyline set representing long-term change rates between 1958 and 2010, each estimated at 250 m; and (3) a table with minimum, maximum and mean of evolution rates for sandy beach–dune system coastline. All science data produced here are openly accessible at https://doi.pangaea.de/10.1594/PANGAEA.859136 and can be used in other studies.Results show beach erosion as the dominant trend, with a mean change rate of −0.24 ± 0.01 m year−1 for all mainland Portuguese beach–dune systems. Although erosion is dominant, this evolution is variable in signal and magnitude in different coastal sediment cells and also within each cell. The most relevant beach erosion issues were found in the coastal stretches of Espinho–Torreira and Costa Nova–Praia de Mira, Cova da Gala–Leirosa, and Cova do Vapor–Costa da Caparica. The coastal segments Minho River–Nazaré and Costa da Caparica adjacent to the coast exhibit a history of major human interventions interfering with the coastal system, many of which originated and maintained a sediment deficit. In contrast, the coastal segments Troia–Sines and Sines–Cape S. Vicente have experienced less intervention and show stable or moderate accretion behaviour.

ObjectivesTo update the evidence on imaging for diagnosis, monitoring and outcome prediction in large vessel vasculitis (LVV) to inform the 2023 update of the European Alliance of Associations for Rheumatology recommendations on imaging in LVV.MethodsSystematic literature review (SLR) (2017–2022) including prospective cohort and cross-sectional studies (>20 participants) on diagnostic, monitoring, outcome prediction and technical aspects of LVV imaging. Diagnostic accuracy data were meta-analysed in combination with data from an earlier (2017) SLR.ResultsThe update retrieved 38 studies, giving a total of 81 studies when combined with the 2017 SLR. For giant cell arteritis (GCA), and taking clinical diagnosis as a reference standard, low risk of bias (RoB) studies yielded pooled sensitivities and specificities (95% CI) of 88% (82% to 92%) and 96% (95% CI 86% to 99%) for ultrasound (n=8 studies), 81% (95% CI 71% to 89%) and 98% (95% CI 89% to 100%) for MRI (n=3) and 76% (95% CI 67% to 83%) and 95% (95% CI 71% to 99%) for fluorodeoxyglucose positron emission tomography (FDG-PET, n=4), respectively. Compared with studies assessing cranial arteries only, low RoB studies with ultrasound assessing both cranial and extracranial arteries revealed a higher sensitivity (93% (95% CI 88% to 96%) vs 80% (95% CI 71% to 87%)) with comparable specificity (94% (95% CI 83% to 98%) vs 97% (95% CI 71% to 100%)). No new studies on diagnostic imaging for Takayasu arteritis (TAK) were found. Some monitoring studies in GCA or TAK reported associations of imaging with clinical signs of inflammation. No evidence was found to determine whether imaging severity might predict worse clinical outcomes.ConclusionUltrasound, MRI and FDG-PET revealed a good performance for the diagnosis of GCA. Cranial and extracranial vascular ultrasound had a higher pooled sensitivity with similar specificity compared with limited cranial ultrasound.

Coastal zones are characterized by exceptional environmental, social, and economic importance, while, at the same time, being particularly vulnerable to climate-related changes [...]

Understanding long-term coastal evolution requires historical data, yet accessing reliable information becomes increasingly challenging for extended periods. While vertical aerial imagery has been extensively used in coastal studies since the mid-20th century, and satellite-derived shoreline measurements are now revolutionizing shoreline change studies, ground-based images, such as historical photographs and picture postcards, provide an alternative source of shoreline data for earlier periods when other datasets are scarce. Despite their frequent use for documenting qualitative morphological changes, these valuable historical data sources have rarely supported quantitative assessments of coastal evolution. This study demonstrates the potential of historical ground-oblique images for quantitatively assessing shoreline position and long-term change. Using Conceição-Duquesa Beach (Cascais, Portugal) as a case study, we analyze shoreline evolution over 92 years by applying a novel methodology to historical photographs and postcards. The approach combines image registration, shoreline detection, coordinate transformation, and rectification while accounting for positional uncertainty. Results reveal a significant counterclockwise rotation of the shoreline between the 20th and 21st centuries, exceeding estimated uncertainty thresholds. This study highlights the feasibility of using historical ground-based imagery to reconstruct shoreline positions and quantify long-term coastal change. The methodology is straightforward, adaptable, and offers a promising avenue for extending the temporal range of shoreline datasets, advancing our understanding of coastal evolution.

Efforts to control the spread of invasive alien species (IAS) in coastal dunes are essential to protect biodiversity and maintain the integrity of the ecosystem. However, the timing and extent of these control measures often do not consider their potential impact on dune morphodynamics. This study investigated how IAS control measures can affect sand dune mobility. Research involved monitoring short-term morphological and vegetation changes using close-range remote sensing along with historical wind data. Findings revealed that changes in vegetation cover significantly impacted dune system evolution, notably increasing sand mobility when IAS vegetation was removed. Considering the seasonal wind regime, dominated by offshore winds in the summer, removing vegetation during this period can promote seaward sediment transport, potentially resulting in sediment loss to the beach. These findings highlight the importance of understanding sediment mobility patterns when planning vegetation control actions within dune restoration strategies.

This article focuses on the links between academic research and educational practices, examining how practitioners use, contextualize, and co-construct research findings on digital skills. To explore these issues, firstly we present an education toolkit developed within a European research project and aligned with normative and substantive guidelines for science communication. Aiming to grasp the potentialities and limitations of the toolkit in action, we then explore the perceptions of teachers from two educational settings in Portugal who employed it in their classrooms. Subsequent focus groups evidenced overall positive feedback from teachers, complemented by practical tips to improve the usefulness of the toolkit and adherence to it by teachers and students, thus adding layers of knowledge to the performative dimension of an evidence-based resource and building bridges between the academic and professional worlds.