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Policy recommendations based on unit labour costs (ULC) indices can lead to undesirable and counterproductive policies, because they do not reveal possible distortions in the base year. In this paper, we discuss the problems with the ULC-current account relation and provide an alternative measure for relative wage costs called Wage Competitive index (WCI) based on the assumption of convergence of the returns on capital. We show how to calculate it and that it is more efficient than traditional ULC and REER indicators. The implication is that policymakers should not focus on nominal wage setting only, but also more broadly on all factors which affect the return on capital. This implies that the well-known Rehn – Meidner rule , which underlies the Macroeconomic Dialogue should be modified. [ABSTRACT FROM AUTHOR]

Many systemic treatment options are available for advanced breast cancer, including endocrine therapy, chemotherapy, anti-human epidermal growth factor receptor 2 (HER2) therapy, and other targeted agents. Recently, everolimus, a mammalian target of rapamycin (mTOR) inhibitor, combined with exemestane, an aromatase inhibitor, has been approved in Europe and the USA for patients suffering from estrogen receptor-positive, HER2-negative advanced breast cancer previously treated by a nonsteroidal aromatase inhibitor, based on the results of BOLERO-2 (Breast cancer trials of OraL EveROlimus). This study showed a statistically significant and clinically meaningful improvement in median progression-free survival. Results concerning the impact on overall survival are expected in the near future. This clinically oriented review focuses on the use of mTOR inhibitors in breast cancer. Results reported with first-generation mTOR inhibitors (ridaforolimus, temsirolimus, everolimus) are discussed. The current and potential role of mTOR inhibitors is reported according to breast cancer subtype (estrogen receptor-positive HER2-negative, triple-negative, and HER2-positive ER-positive/negative disease). Everolimus is currently being evaluated in the adjuvant setting in high-risk estrogen receptor-positive, HER2-negative early breast cancer. Continuing mTOR inhibition or alternatively administering other drugs targeting the phosphatidylinositol-3-kinase/protein kinase B-mTOR pathway after progression on treatments including an mTOR inhibitor is under evaluation. Potential biomarkers to select patients showing a more pronounced benefit are reviewed, but we are not currently using these biomarkers in routine practice. Subgroup analysis of BOLERO 2 has shown that the benefit is consistent in all subgroups and that it is impossible to select patients not benefiting from addition of everolimus to exemestane. Side effects and impact on quality of life are other important issues discussed in this review. Second-generation mTOR inhibitors and dual mTOR-phosphatidylinositol-3-kinase inhibitors are currently being evaluated in clinical trials. [ABSTRACT FROM AUTHOR]

The sustainability of public debt is interpreted as the result of the interaction of fiscal policy with the economic environment, and not as a statistical concept as in most of the recent literature. If debt is not to explode over time, policymakers have to respond to the changing conditions in the macroeconomic environment. This article defines the conditions that will ensure compliance of fiscal policy with the intertemporal budget constraint in the context of Europe's fiscal policy rules. The empirical part of the article reveals that European public debt is sustainable in this respect, but questions regarding long-run liquidity requirements remain unresolved. [ABSTRACT FROM AUTHOR]

Europe's economic governance is not only highly complex, but also increasingly inefficient and therefore unsustainable in the long run. This conclusion is reached from the theory of collective action and the difficulties in democratic legitimacy. The solution would be the creation of a European government accountable to European citizens. [ABSTRACT FROM AUTHOR]

Assesses the quantitative traits and random amplified polymorphic DNA variations on Norway spruce in Europe. Description of the natural variability of the coniferous species; Use of random decamer primers in performing DNA amplification; Analysis of the quantitative traits by unweighted pair group method arithmetic average cluster analysis.

Serious infections associated with intravascular catheters are common. The available data suggests there are likely to be more than 500 000 cases of catheter-associated bloodstream infections occurring annually in Western Europe and the USA. These may be associated with as many as 100 000 deaths. The pathophysiology of this common condition is still not fully elucidated. With catheters that are in place for short periods (a few days), microbial migration down the outer surface of the device to the intravascular tip predominates. For catheters that are in place for longer periods, migration occurs more often via the internal lumen. After being in place for more than 8 days, nearly all central vein catheters will have microorganisms embedded in a biofilm within the catheter lumen. In some catheters, microorganisms will proliferate to sufficient numbers for systemic sepsis to result. The occurrence and rate of this proliferation is dependent on microbial virulence factors, host factors, and characteristics of the catheter. Diagnosis of intravascular device-associated sepsis remains problematic because the pathophysiology of the condition changes with time and because standard culture techniques rarely detect organisms embedded in biofilms. The semiquantitative roll method on blood agar remains in common use because of its simplicity. However, the method only samples the external surface of the catheter. For catheters that have been in place for extended periods of time, methods that better sample the internal lumen, such as sonication and quantitative broth methods, should be developed and used. [ABSTRACT FROM AUTHOR]

The article discusses the association between human deaths and third-generation cephalosporin use in poultry in Europe. Escherichia coli is cited as the most common bacterium to cause invasive disease in humans. It was found that in the Netherlands, infections in humans with third-generation cephalosporin-resistant Escherichia coli (G3CREC) derived from poultry sources were linked to 21 additional deaths.

The disease spectrum caused by Clostridium difficile infection ranges from antibiotic-associated diarrhoea to life-threatening clinical manifestations such as pseudomembranous colitis. C. difficile infection is precipitated by antimicrobial therapy that causes a disruption of the normal colonic microbiota, predisposing to C. difficile intestinal colonisation. The pathogenicity of C. difficile is mediated by two exotoxins, TcdA and TcdB, both of which damage the human colonic mucosa and are potent cytotoxic enzymes. C. difficile must first be implanted in the gut and attach to epithelial cells, which are protected by a layer of dense mucus. Confirmed and putative accessory virulence factors that could play a role in adherence and intestinal colonisation have been identified and include proteolytic enzymes and adhesins. Recently, the epidemiology of C. difficile infection has radically changed and an increased incidence is associated with outbreaks in North America and Europe. Several reports suggest that disease severity is increasing to include sepsis syndrome and toxin megacolon. Elderly, debilitated patients in hospitals and nursing homes are particularly vulnerable. A hypervirulent, epidemic strain has been associated with the changing epidemiology and severity of disease. Here, we review the characteristics of the epidemic NAP1, PCR ribotype 027 C. difficile strain that could explain its hypervirulence and epidemic spread.