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The purposes of this paper are: to assess how comprehensive sexuality education (CSE) is implemented in schools in the World Health Organisation's European Region; and to investigate the evidence supporting its effectiveness. Data were collected in 2016-2017, using a validated questionnaire sent to representatives of governmental and nongovernmental institutions in 25 countries of the WHO European Region. The results demonstrated that, in nine countries, sexuality education can be classified as comprehensive; in ten countries it is non-comprehensive; in four countries there is no programme in place; and two countries were excluded from the analysis. In contrast to non-comprehensive sexuality education programmes, CSE programmes address a wider range of topics, including the social, emotional and interpersonal aspects of sexuality. Furthermore, teachers are more often trained to deliver sexuality education and participatory teaching methods are widely used. CSE programmes are more valued by pupils as a source of information on sexuality, based on national survey results. The availability of CSE programmes coincides with more effective contraceptive use and lower teenage fertility rates. However, more rigorous research is needed to establish a causal relationship between CSE and adolescent sexual and reproductive health indicators.

Objectives To characterize the genetic basis of azithromycin resistance in Escherichia coli and Salmonella collected within the EU harmonized antimicrobial resistance (AMR) surveillance programme in 2014–18 and the Danish AMR surveillance programme in 2016–19. Methods WGS data of 1007 E. coli [165 azithromycin resistant (MIC > 16 mg/L)] and 269 Salmonella [29 azithromycin resistant (MIC > 16 mg/L)] were screened for acquired macrolide resistance genes and mutations in rplDV , 23S rRNA and acrB genes using ResFinder v4.0, AMRFinder Plus and custom scripts. Genotype–phenotype concordance was determined for all isolates. Transferability of mef (C)- mph (G)-carrying plasmids was assessed by conjugation experiments. Results mph (A), mph (B), mef (B), erm (B) and mef (C)- mph (G) were detected in E. coli and Salmonella , whereas erm (C), erm (42), ere (A) and mph (E)- msr (E) were detected in E. coli only. The presence of macrolide resistance genes, alone or in combination, was concordant with the azithromycin-resistant phenotype in 69% of isolates. Distinct mph (A) operon structures were observed in azithromycin-susceptible (n  = 50) and -resistant (n  = 136) isolates. mef (C)- mph (G) were detected in porcine and bovine E. coli and in porcine Salmonella enterica serovar Derby and Salmonella enterica 1,4, [5],12:i:-, flanked downstream by IS CR2 or Tn As1 and associated with IncIγ and IncFII plasmids. Conclusions Diverse azithromycin resistance genes were detected in E. coli and Salmonella from food-producing animals and meat in Europe. Azithromycin resistance genes mef (C)- mph (G) and erm (42) appear to be emerging primarily in porcine E. coli isolates. The identification of distinct mph (A) operon structures in susceptible and resistant isolates increases the predictive power of WGS-based methods for in silico detection of azithromycin resistance in Enterobacterales. [ABSTRACT FROM AUTHOR]

Background: Around 20% of the population in Northern and Central Europe is affected by birch pollen allergy, with the major birch pollen allergen Bet v 1 as the main elicitor of allergic reactions. Together with its cross-reactive allergens from related trees and foods, Bet v 1 causes an impaired quality of life. Hence, new treatment strategies were elaborated, demonstrating the effectiveness of blocking IgG antibodies on Bet v 1-induced IgE-mediated reactions. A recent study provided evidence for the first time that Bet v 1-specific nanobodies reduce patients' IgE binding to Bet v 1. In order to increase the potential to outcompete IgE recognition of Bet v 1 and to foster cross-reactivity and cross-protection, we developed Bet v 1-specific nanobody trimers and evaluated their capacity to suppress polyclonal IgE binding to corresponding allergens and allergeninduced basophil degranulation. Methods: Nanobody trimers were engineered by adding isoleucine zippers, thus enabling trimeric formation. Trimers were analyzed for their cross-reactivity, binding kinetics to Bet v 1, and related allergens, and patients' IgE inhibition potential. Finally, their efficacy to prevent basophil degranulation was investigated. Results: Trimers showed enhanced recognition of cross-reactive allergens and increased efficiency to reduce IgE-allergen binding compared to nanobody monomers. Furthermore, trimers displayed slow dissociation rates from allergens and suppressed allergen-induced mediator release. Conclusion: We generated high-affine nanobody trimers that target Bet v 1 and related allergens. Trimers blocked IgE-allergen interaction by competing with IgE for allergen binding. They inhibited IgE-mediated release of biological mediators, demonstrating a promising potential to prevent allergic reactions caused by Bet v 1 and relatives. [ABSTRACT FROM AUTHOR]

Our aim was to measure the efficiency of tourist destinations of selected countries from Southern and Southeast Europe. In order to assess the impact of the Covid pandemic on the efficiency of separate destinations we evaluated two year-long timeframes - 2019 and 2021. However, we remained quite cautious in our final assessment, due to the specifics of the tourism sector’s recovery. The study object included 19 countries in Southern and Southeast Europe. In order to complete the set tasks, we went through two stages: first, we formed two separate groups of countries with relatively homogenous indicators (K-cluster), and then we evaluated their relative efficiency, by using the tourism revenue (DEA) as an outcome variable. [ABSTRACT FROM AUTHOR]

Economic costs of climate change are conventionally assessed at the aggregated global and national levels, while adaptation is local. When present, regionalised assessments are confined to direct damages, hindered by both data and models' limitations. This article goes beyond the aggregated analysis to explore direct and indirect economic consequences of sea level rise (SLR) at regional and sectoral levels in Europe. Using a dynamic computable general equilibrium model and novel datasets, we estimate the distribution of losses and gains across regions and sectors. A comparison of a high-end scenario against a no-climate-impact baseline suggests a GDP loss of 1.26% (€871.8 billion) for the whole EU&UK. Conversely our refined assessments show that some coastal regions lose 9.56–20.84% of GDP, revealing striking regional disparities. Inland regions grow due to the displaced demand from coastal areas, but the GDP gains are small (0–1.13%). While recovery benefits the construction sector, public services and industry face significant downturns. We show that prioritising recovery of critical sectors locally reduces massive regional GDP losses, at negligible costs to the overall European economy. Our analysis traces regional economic restructuring triggered by SLR, underscoring the necessity of region-specific adaptation policies that embrace uneven geographic impacts and unique sectoral profiles to inform resilient strategy design. [ABSTRACT FROM AUTHOR]

Numerous Eocene and Oligocene volcanic tuff layers within the Eastern, Central and Southern Europe sedimentary basins attest to extensive volcanic activity. Tephra dispersal of these tuffs covers areas of more than 1 000 000 km2, and the volume of erupted material to 1000s of cubic kilometers. The sources of the eruptions, however, remain unknown. Using precise 40Ar/39Ar and U-Pb radiometric dating, we correlate some of these tuff layers to three silicic Rhodope Massif Rupelian (early Oligocene) supereruptions dated at 33.2 Ma, 32.8 Ma and 31.6 Ma and named Dazhdovnitsa, Borovitsa and Perelik. Hence, these tuff layers can now be used as regional stratigraphic isochronous marker horizons for correlating, dating and synchronizing deposits and events in geologic and paleoenvironmental studies. [ABSTRACT FROM AUTHOR]

During the last few decades, bat lyssaviruses have become the topic of intensive molecular and epidemiological investigations. Since ancient times, rhabdoviruses have caused fatal encephalitis in humans which has led to research into effective strategies for their eradication. Modelling of potential future cross-species virus transmissions forms a substantial component of the recent infection biology of rabies. In this article, we summarise the available data on the phylogeography of both bats and lyssaviruses in Europe and the adjacent reg ions, especially in the contact zone between the Palearctic and Ethiopian realms. Within these zones, three bat families are present with high potential for cross-species transmission and the spread of lyssaviruses in Phylogroup II to Europe (part of the western Palearctic). The lack of effective therapies for rabies viruses in Phylogroup II and the most divergent lyssaviruses generates impetus for additional phylogenetic and virological research within this geographical region. [ABSTRACT FROM AUTHOR]

Background: Continuous androgen deprivation therapy ± first-generation non-steroidal antiandrogen was previously the standard-of-care for patients with metastatic castration-sensitive prostate cancer (mCSPC). Treatment intensification with novel hormonal therapy (NHT) or taxane chemotherapy is now approved and guideline-recommended for these patients. Methods: Physician-reported data on adult patients with mCSPC from the Adelphi Prostate Cancer Disease Specific Programme were analyzed descriptively. We evaluated real-world treatment trends for patients with mCSPC in 5 European countries (United Kingdom, France, Germany, Spain, and Italy) and the United States (US), looking at differences between patients initiating treatment in 2016-2018 and in 2019-2020. We also investigated treatment trends by ethnicity and insurance status in the US. Results: This study found that most patients with mCSPC do not receive treatment intensification. However, greater use of treatment intensification with NHT and taxane chemotherapy was observed in 2019-2020 than in 2016-2018 across 5 European countries. In the US, greater use of treatment intensification with NHT in 2019-2020 than in 2016-2018 was observed for all ethnicity groups and those with Medicare and commercial insurance status. Conclusions: As the number of patients with mCSPC who receive treatment intensification increases, more patients who progress to metastatic castration-resistant prostate cancer (mCRPC) will have been exposed to intensified treatments. Treatment options for patients with mCSPC and mCRPC overlap, suggesting that an unmet need will emerge for new therapies. Further studies are needed to understand optimal treatment sequencing in mCSPC and mCRPC. This study evaluated real-world metastatic castration-sensitive prostate cancer (mCSPC) treatment trends between 2016 to 2020 across a large, diverse patient population. The study also investigated whether treatment trends vary by ethnicity and insurance status. [ABSTRACT FROM AUTHOR]

Background: Tanacetum parthenium (L.) Sch.Bip. (T. parthenium) is an aromatic perennial plant belonging to the Asteraceae family, also known as feverfew. It is widely distributed in various regions of Europe and other parts of the world. The plant has a rich background in the traditional medicine of many nations and has been used as a remedy for fever, pain, inflammation, asthma, rheumatism, menstrual disorders, etc. Methods: GC–MS analysis was conducted to determine the chemical composition of the isolated essential oil (EO). Using the method proposed by Litchfield and Wilcoxon, the average lethal dose (LD50) of the EO on Wistar rats was determined for two routes of administration: oral (p.o.) and intraperitoneal (i.p.). The subacute toxicity of the EO was also tested by oral administration of a daily dose of 1.0 g/kg body weight (BW) for 28 days. The toxicity of the EO was evaluated by observing and evaluating changes in behavior, body weight, basic hematological and serum biochemical parameters, and histopathological changes of the internal organs. Results: Thirty-seven volatile organic compounds representing 94.58% of the total oil composition were tentatively detected in the obtained T. parthenium EO. The dominant compounds were camphor (45.47%), trans-chrisantenyl acetate (21.65%), camphene (9.48%), and cis-isogeraniol (5.42%). The results showed that the EO was not toxic when administered in acute oral doses. The acute mean lethal dose for intraperitoneal administration was LD50 i.p. = 2.13 g/kg BW. In the subacute study involving administration of an oral dose of EO for 28 days, there were a number of changes in the hematological and serum biochemical parameters of the blood compared with the control group of animals. However, no symptoms of toxicity, changes in the body weight of the rats, death, or pathological changes in the histological indicators of the examined organs—brain, heart, stomach, liver, spleen and kidney—were found. Extrapolating the results obtained from the rat experiments, we can state that the EO is safe for use in doses below 1 g/kgBW for a period not exceeding one month. [ABSTRACT FROM AUTHOR]

European tourism suffered the greatest crisis on record in 2020-2021 following an unprecedented health, social and economic emergency with the outbreak of the COVID-19 pandemic and quarantine restrictions. Thus, the aim of the article is to investigate the impact of COVID-19 on international trade in tourism services in Europe, as well as determining the development trends of international trade in tourism services in the regions of Europe and EU countries in the pre- and post-coronavirus period. To achieve the goal of the scientific research a quantitative research method, literature review method, retrospective analysis, statistical analysis has been used. In the study, secondary data of the international tourist arrivals in Europe, export/import of tourism services by European regions and EU in the pre-coronavirus and post-coronavirus period has been analyzed. The following trends have been identified: 1) an undulating trend in tourism exports in Europe in general, and European regions in particular, characterized by regional differentiation; 2) an alternation of peaks and troughs in the volume of imports of tourism services in Europe and a reversal of the main upward downward trend in all regions of Europe in 2020; 3) a differentiation of the response of European regions to the challenges of 2020 - regions with a passive trade balance showed a reduction in the deficit, while regions with an active trade balance, on the contrary, reduced its surplus; 4) a differentiation of the share of import/export of tourism services of total trade in services by regions of Europe with a gradual upward trend and a rapid downward trend break in 2020. [ABSTRACT FROM AUTHOR]

Insights into subnational environmental impacts and the underlying drivers are scarce, especially from a consumption‐based perspective. Here, we quantified greenhouse gas (GHG) emissions and land‐based biodiversity losses associated with final consumption in 162 regions in the European Union in 2010. For this purpose, we developed an environmentally extended multi‐regional input–output (MRIO) model with subnational European information on demand, production, and trade structures subdivided into 18 major economic sectors, while accounting for trade outside Europe. We employed subnational data on land use and national data on GHG emissions. Our results revealed within‐country differences in per capita GHG and land‐based biodiversity footprints up to factors of 3.0 and 3.5, respectively, indicating that national footprints may mask considerable subnational variability. The per capita GHG footprint increased with per capita income and income equality, whereas we did not find such responses for the per capita land‐based biodiversity footprint, reflecting that extra income is primarily spent on energy‐intensive activities. Yet, we found a shift from the domestic to the foreign part of the biodiversity footprints with rising population density and income. Because our analysis showed that most regions are already net importers of GHG emissions and biodiversity losses, we conclude that it is increasingly important to address the role of trade in national and regional policies on mitigating GHG emissions and averting further biodiversity losses, both within and outside the region itself. To further increase the policy relevance of subnational footprint analyses, we also recommend the compilation of more detailed subnational MRIO databases including harmonized environmental data. [ABSTRACT FROM AUTHOR]

The purposes of this paper are: to assess how comprehensive sexuality education (CSE) is implemented in schools in the World Health Organisation's European Region; and to investigate the evidence supporting its effectiveness. Data were collected in 2016–2017, using a validated questionnaire sent to representatives of governmental and nongovernmental institutions in 25 countries of the WHO European Region. Theresults demonstrated that, in nine countries, sexuality education can be classified as comprehensive; in ten countries it is non-comprehensive; in four countries there is no programme in place; and two countries were excluded from theanalysis. In contrast to non-comprehensive sexuality educationprogrammes, CSE programmes address a wider range of topics, including the social, emotional and interpersonal aspects of sexuality. Furthermore, teachers are more often trained to deliver sexuality education and participatory teachingmethods are widely used. CSE programmes are more valued by pupils as a source of information on sexuality, based on national survey results. The availability of CSE programmes coincides with more effective contraceptive use andlower teenage fertility rates. However, more rigorous research is needed to establish a causal relationship between CSE and adolescent sexual and reproductive health indicators. [ABSTRACT FROM AUTHOR]

The tourism industry has a priority for the economic development of many countries in the world. The growing importance of the tourism industry, however, puts tourist destinations in front of a new challenge, which is terrorism. Starting from the new realities, this study explores the link between the risk of terrorism and the income from international tourism in Europe and the United States. The survey is a panel one and includes 37 countries. The empirical analysis is based on the regression crosssection analysis and the Granger Causality tests. The conclusion that is being made is that the risk of terrorism, respectively the terrorism, does not impact negatively on the tourism and the incomes from international tourism. The main argument is that the terrorism has its' creatively - destructive effect, which acts as an allocation of uncertainty in the different geographic regions, that are revised as a system of tourist destinations. [ABSTRACT FROM AUTHOR]

Introduction: The impact of bleeding for women with bleeding disorders (WBD) is of increasing focus and importance. Despite this, optimal management strategies are unclear and knowledge gaps persist. Aim: To examine practices and define research priorities on diagnosis and management of WBD in Europe. Methods: An electronic survey on clinical management of WBD was sent to 136 European haemophilia treatment centres (HTCs), including open questions on knowledge gaps and research priorities. Results: Fifty‐nine HTCs from 12 Western (WE) and 13 Central/Eastern European (CEE) countries completed the survey. Less than half runs a joint clinic (24 HTCs, 42%). Most centres without a joint clinic have a named obstetrician (81%) and/or gynaecologist (75%) available for collaboration. Overall 18/54 (33%) European HTCs do not offer preimplantation genetic diagnosis. Third trimester amniocentesis to guide obstetric management is available 28/54 HTCs (52%), less frequent in CEE compared to WE countries (5/17 vs 23/37, P =.03). 53% of HTCs (28/53) reported that only 0%‐25% of WBD seek medical advice for heavy menstrual bleeding (HMB). An algorithm managing acute HMB in WBD is lacking in 22/53 (42%) HTCs. The main reported knowledge and research gaps are lack of awareness & education on WBD among patients and caregivers, optimal diagnostic strategies and effective multidisciplinary management of pregnancy & HMB. Conclusion: Joint clinics, prenatal diagnostics and algorithms for managing acute HMB are lacking in many European HTCs. HMB may be an underestimated issue. This survey highlights the need to prioritize improvement of knowledge and patient care for WBD across Europe. [ABSTRACT FROM AUTHOR]

The use of feed additives to improve the efficiency of growth and/or eggs production, prevent disease and improve feed utilization is a strategy to improve the efficiency of the poultry industry. Feed additives may not enter the market in Europe unless authorisation has been given following a scientific evaluation. The use and development of enzymes, phytogenics, prebiotics and probiotics has gained momentum in poultry feeding. The enzymes widely used by the industry are the non-starch polysaccharidases that cleave the non-starch polysaccharides in viscous cereals, microbial phytases that target the phytatecomplexes in plant ingredients. Proteases are of interest to improve protein and amino acid digestibility, particularly in very young animals. Phytogenics are an alternative to in-feed antibiotics to prevent the risk of developing pathogens and also to satisfy consumer demand for a food chain free of drugs. Probiotic feed additives generally consist of one single strain or a combination of several strains of bacteria, Bacillus spores or yeasts species. Prebiotics are non-digestible food ingredients, such as fructo-oligo-saccharides, xylo-oligo-saccharides, mannan-oligo-saccharides and galacto-oligo-saccharides that are also used in feeds to protect poultry against pathogens. Future research needs to be directed towards understanding how combinations of these additives can be used to improve the effi ciency of poultry production. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is characterized by deterioration of the joints and associated with considerable pain and disability. OA is a chronic disease that requires intervention with both non-pharmacological and pharmacological treatment modalities and, inevitably, disease progression may necessitate successive treatments throughout the course of the disease. There is increasing data on the shortfalls of current pharmacological treatment of OA, and safety concerns associated with analgesic therapy use in OA arising from increasing evidence of gastrointestinal, cardiovascular, hepatic and renal adverse events with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Consequently, symptomatic slow-acting drugs for OA (SYSADOAs) may now be considered as a first-line treatment for knee OA, with a particular emphasis placed on the outstanding benefit: risk ratio of pharmaceutical-grade glucosamine and chondroitin sulfate formulations. In this short communication we review recent publications concerned with the safety of paracetamol, NSAIDs and SYSADOAs. Greater understanding of the benefits and limitations of current medications will lead to better disease management in OA. Furthermore, adherence to guideline recommendations across Europe and internationally, such as those from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), will promote evidence-based medicine and patient-centric care, ultimately leading to greater physician and patient satisfaction. [ABSTRACT FROM AUTHOR]

The spread of early farming across Europe from its origins in Southwest Asia was a culturally transformative process which took place over millennia. Within regions, the pace of the transition was probably related to the particular climatic and environmental conditions encountered, as well as the nature of localized hunter-gatherer and farmer interactions. The establishment of farming in the interior of the Balkans represents the first movement of Southwest Asian livestock beyond their natural climatic range, and widespread evidence now exists for early pottery being used extensively for dairying. However, pottery lipid residues from sites in the Iron Gates region of the Danube in the northern Balkans show that here, Neolithic pottery was being used predominantly for processing aquatic resources. This stands out not only within the surrounding region but also contrasts markedly with Neolithic pottery use across wider Europe. These findings provide evidence for the strategic diversity within the wider cultural and economic practices during the Neolithic, with this exceptional environmental and cultural setting offering alternative opportunities despite the dominance of farming in the wider region. [ABSTRACT FROM AUTHOR]

Aim: Lack of electronic assessment of medication lists in electronic health records is a barrier for more generalized use of potentially inappropriate medications (PIM) lists, designed for older adults. The aim was to construct a European repository of explicit criteria on PIM, suitable for electronic assessment. Methods: PIM description, medication information, clinical information and level of evidence was entered. Criteria with unclear medication specifications were excluded. Too complex criteria were divided for more operable use. Results: We selected three lists: the European Union (7)-PIM (2015), STOPP/START (2014) and Beers criteria (2015). After exclusion and division, from 641 original criteria of the three PIM-lists, a total of 650 criteria were entered (n = 282 from European Union (7)-PIM, n = 201 from Beers and n = 167 from the STOPP/START list). Identification of the medication was possible with the Anatomical Therapeutic Chemical Classification System for practically all criteria, except for 23 (3.5%). From all criteria, 63.9% required only medication-related information. In 55.7% of the criteria, identification of the active substance(s) was the only medication data requirement and 8.2% required additional information (dose, duration, route of administration). From all criteria, 36.1% required clinical information, from which 17.8% requested disease information only, and 18.3% required additional information (indication, history of diseases, laboratory results or severity of diseases). Conclusions: It was feasible to enter most of the original criteria of the three PIM lists into a repository of electronically applicable criteria. In the future, developers of new PIM lists should take into account semantic interoperability and consider the suitability of the criteria for electronic use. [ABSTRACT FROM AUTHOR]

The purpose of this research is to quantitatively compare everyday situational experience around the world. Local collaborators recruited 5,447 members of college communities in 20 countries, who provided data via a Web site in 14 languages. Using the 89 items of the Riverside Situational Q-sort (RSQ), participants described the situation they experienced the previous evening at 7:00 p.m. Correlations among the average situational profiles of each country ranged from r = .73 to r = .95; the typical situation was described as largely pleasant. Most similar were the United States/Canada; least similar were South Korea/Denmark. Japan had the most homogenous situational experience; South Korea, the least. The 15 RSQ items varying the most across countries described relatively negative aspects of situational experience; the 15 least varying items were more positive. Further analyses correlated RSQ items with national scores on six value dimensions, the Big Five traits, economic output, and population. Individualism, Neuroticism, Openness, and Gross Domestic Product yielded more significant correlations than expected by chance. Psychological research traditionally has paid more attention to the assessment of persons than of situations, a discrepancy that extends to cross-cultural psychology. The present study demonstrates how cultures vary in situational experience in psychologically meaningful ways. [ABSTRACT FROM AUTHOR]

In this paper, an investigation was carried out on some organochlorine pesticides in water samples collected from the Prut River on the segment Costesti-Stinca - Giurgiulesti during March 2016. The studies were conducted at the Institute of Zoology, Laboratory of Hydrobiology and Ecotoxicology, Academy of Sciences of Moldova. The quantitative analysis of sample extractions was carried out in conformity with the EPA 8081A method at gas chromatograph Clarus 500 with a capillary column Elite CLP (30m×0.32mm ID, 0.50 μm film) and ECD detector. Among 17 studied pollutants, three compounds (γ-BHC, 4.4'-DDE, 4.4'-DDD) were detected. The concentration of γ-BHC ranged from 0.116 to 0.144 μg/l; of 4.4'-DDE ranged from 0.129 to 0.187 and 4.4'-DDE was detected in only one sample site - Costesti-Stinca - in concentration of 0.362 μg/l. [ABSTRACT FROM AUTHOR]

Background: Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. Methods: Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. Results: The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group' s involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Conclusion: Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include representatives of vulnerable communities which could help to build a dialogue and present the problem from multiple perspectives. [ABSTRACT FROM AUTHOR]

Background: We aimed to assess the current state of PKU screening and management in the region of southeastern Europe. Methods: A survey was performed involving all identified professionals responsible for the PKU management in the 11 countries from South-Eastern region of Europe (Albania, Bulgaria, Bosnia and Herzegovina, Croatia, Kosovo, Macedonia, Moldova, Montenegro, Romania, Serbia, Slovenia). The questionnaire was designed to assess the characteristics regarding PKU management in three main areas: nation-wide characteristics, PKU screening, and characteristics of the PKU management in the responding centre. It consisted of 56 questions. The distribution and collection of the questionnaires (via e-mail) was taking place from December 2013 to March 2014. Results: Responses from participants from 11 countries were included; the countries cumulative population is approx. 52.5 mio. PKU screening was not yet introduced in 4 of 11 countries. Reported PKU incidences ranged from 1/7325 to 1/39338 (and were not known for 5 countries). National PKU guidelines existed in 5 of 11 countries and 7 of 11 countries had PKU registry (registries included 40 to 194 patients). The number of PKU centers in each country varied from 1 to 6. Routine genetic diagnostics was reported in 4 of 11 countries. Most commonly used laboratory method to assess phenylalanine levels was fluorometric. Tetrahydrobiopterine was used in only 2 of 11 countries. Most frequently, pediatricians were caring for the patients. Dietitian was a member of PKU team in only 4 of 11 countries, while regular psychological assessments were performed in 6 of 11 countries. Patient's PKU society existed in 7 of 11 countries. Conclusions: The region of southeastern Europe was facing certain important challenges of PKU screening and management. Neonatal PKU screening should be introduced throughout the region. Furthermore, PKU management was falling behind internationally established standards-of-care in many aspects. [ABSTRACT FROM AUTHOR]

While the idea of plurilingual competence is widely established theoretically and promoted in European language policies, it is not implemented in educational practice, where separate plurilingualism is still dominant. The idea of languages as autonomous entities is e.g. reflected in the Common European Framework of Reference for Languages (CEFR) scales. The paper introduces to the Framework of Reference for Pluralistic Approaches to Languages and Cultures (FREPA). Pluralistic approaches use teaching and learning activities involving several (i.e. more than one) varieties of language, e.g. the language(s) of schooling, foreign languages, regional, minority and migration languages. FREPA thereby offers tools to put the theoretical insights and language policies into practice. The article illustrates how pluralistic approaches, in recent years, have been used in the process of large-scale national and regional curriculum renewals in Austria, French-speaking Switzerland and Spain. By promoting plurilingual education on the macro-level and including languages that are still neglected in most European curricula, these countries make a key contribution to diminishing discrepancy between theory and practice. The three cases manifest the context specificity of language-planning decisions and support supra-level comparisons by defining the specific aims and contents of plurilingual education. Furthermore, the curricular implementations offer the possibility to discuss the implementation in actual classroom practice. [ABSTRACT FROM AUTHOR]

Rhizobium leguminosarum bv. trifolii is a soil-inhabiting bacterium that has the capacity to be an effective N-fixing microsymbiont of Trifolium (clover) species. R. leguminosarum bv. trifolii strain WSM1689 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from a root nodule of Trifolium uniflorum collected on the edge of a valley 6 km from Eggares on the Greek Island of Naxos. Although WSM1689 is capable of highly effective N-fixation with T. uniflorum, it is either unable to nodulate or unable to fix N with a wide range of both perennial and annual clovers originating from Europe, North America and Africa. WSM1689 therefore possesses a very narrow host range for effective N fixation and can thus play a valuable role in determining the geographic and phenological barriers to symbiotic performance in the genus Trifolium. Here we describe the features of R. leguminosarum bv. trifolii strain WSM1689, together with the complete genome sequence and its annotation. The 6,903,379 bp genome contains 6,709 protein-coding genes and 89 RNA-only encoding genes. This multipartite genome contains six distinct replicons; a chromosome of size 4,854,518 bp and five plasmids of size 667,306, 518,052, 341,391, 262,704 and 259,408 bp. This rhizobial genome is one of 20 sequenced as part of a DOE Joint Genome Institute 2010 Community Sequencing Program. [ABSTRACT FROM AUTHOR]

The dominant atmospheric circulation pattern that governs European summer climate is a blocking-like pattern over the British Isles that co-occurs with a low over southeastern Europe. The meridionally oriented configuration of this circulation pattern favours the intrusion of warm air over the northeastern Mediterranean during one mode and over northwestern Europe during its opposite mode. We present a summer temperature reconstruction (1768–2008) for the southeastern node of this teleconnection pattern. This reconstruction is based on maximum latewood density (MXD) measurements of 23 Pinus heldreichii trees from a high-elevation stand in the Pirin Mountains in Bulgaria. The temperature signal in trees from high-elevation, summer-dry regions is stronger in MXD measurements compared with tree-ring width data and our reconstruction reflects well interannual- to decadal-scale summer temperature fluctuations in the Balkans as instrumentally recorded over the twentieth century. Fluctuations in our Bulgarian reconstruction correspond to summer temperature variability in the Balkans, Italy, and the southern Carpathians, but opposing temperature variability patterns are manifested over the British Isles and southern Scandinavia. The strong and consistent anti-phase relationship between our reconstruction and a reconstruction of the summer North Atlantic Oscillation (sNAO) suggests that the sNAO pattern is a main driver of the teleconnection between summer temperatures in southeastern versus northwestern Europe. This teleconnection is most pronounced on interannual timescales and has been stable over the last two centuries. [ABSTRACT FROM AUTHOR]

Bulgaria is situated in a geopolitical crossroad. This creates opportunities that can be beneficial not only for the country, but also for the region and beyond. One of the spheres that Bulgaria can take advantage of is the development of energy projects. This can happen in two main directions: • By serving as an energy hub for the region and by distributing natural gas brought via pipelines from Russia and the East. • Exporting electricity produced in the upgraded production facilities as well as in the nuclear power plant in Belene at present under construction. The role Bulgaria could play in the energy market as key transit country is due mainly to two factors:• The geographical location at a crossroad that facilitates it being a mediator between Europe and Asia. • The present situation on the energy market that leads the European countries to seek alternative routes as well as suppliers for vital energy resources. Whether and how much Bulgaria is going to utilize its position is a matter of political will in the first place. The opportunities lying ahead and are ready to serve for the prosperity of the region. [ABSTRACT FROM AUTHOR]

The aim of the euro was to speed up the integration process and economic development in Europe. History of euro showed us that these optimistic goals have been only partly fulfilled. This modest result has several essential roots. Our research showed that Europe have not been and is even not today the optimal currency area. The architecture of the EMU was incomplete: in building up it was not given enough power to ECB, also were underestimated vitality national interests in member states. Therefore common interests in euro area were not enough protected. Last global financial and economic crisis showed clearly main weaknesses of euro and enforced to start to liquidate them. We conclude that resent reforms and enlargement of the EMU (Estonia) probably will strengthen this union. [ABSTRACT FROM AUTHOR]

This paper examines how the effectiveness of regulatory framework influences levels of sulphur emissions in a scenario where, to reduce its (emission-) tax payments, a polluting firm may under-report emissions level at the risk of being audited and fined. First, a model to explain how changes in regulatory framework (e.g., audit effectiveness) and transboundary spillovers affect both actual and reported emissions is developed. Then the theoretical predictions using data for 39 European countries from 1999 to 2003 are tested and inferences about true emission levels are made. The empirical analysis supports the theoretical predictions with significant implications for the interpretation of pollution data reported to international monitoring agencies. Countries with effective regulation are likely to have relatively high reported emissions of sulphur. But this should not automatically be interpreted as weak environmental performance, because their actual pollution levels are likely to be lower than in nations with less effective regulation. [ABSTRACT FROM AUTHOR]

Europe's initiative to reduce the emissions of harmful gases has significantly increased the integration of renewable sources into power networks, particularly wind power. Variable renewable sources pose challenges to sustain the balance between generation and demand. Thus, the need for ancillary services to cope with this problem has increased. In this regard, the integration of larger shares of wind generation would have a clear system benefit when wind generators are able to provide these ancillary services. This would also have implications for electricity markets, enabling these services from wind power plants. This article gives an overview of several European markets for frequency support (FS) services, also referred to as FS markets. It identifies the changes in national regulations of 10 European countries to standardize these services based on the ENTSO-E guidelines. However, most of the countries still use their national service definitions, which presents a problem for researchers to understand the national regulations in relation to the ENTSO-E guidelines. This article provides a classification of the national FS services under the definitions of the ENTSO-E guidelines to facilitate research on this topic. Furthermore, it highlights the main requirements for the market practices that would encourage the participation of wind power generation in the provision of these services. An estimation of the economic benefits for wind producers from the provision of FS services is provided as well to show a possible outcome if changes are not made in national policies. [ABSTRACT FROM AUTHOR]

The mycological properties of soil can offer information about ancient human-landscape interaction, including urbanization. This preposition has been confirmed in our study of the habitation deposits in the medieval Russian settlements (eighth to fourteenth centuries A.D.). The mycobiota of profiles of anthropogenically transformed soil of excavated medieval settlements were examined in different climate conditions in the European part of Russia. The fungal biomass and biomass structure were evaluated using luminescent microscopy. The isolation and enumeration of microfungi were performed using the method of serial dilutions of soil samples and plating them out on the number of solid media. The isolation of keratinolytic microfungi was performed by hear-bite technique. It was established that in ancient urban soils, the mycobiota may have properties different from those of zone fungal communities. The examined cultural layers of ancient settlements differ from the horizons of the surrounding natural soils because of a bigger rate of fungal spores in fungal biomass, more mosaic distribution of microfungal communities, different species composition and dominant microfungal species, increased incidence of some ecological, and trophic fungal groups (for example, keratinophilic, potentially pathogenic microfungi). The mycological characteristics of anthropogenic deposits in the excavated medieval settlements were found to be mainly similar to mycological properties of modern urban soils. These properties of habitation deposits can be interpreted as a kind of "soil mycological memory" of the ancient urban impact. Recommendations and perspectives Soil mycological characteristics could be used in paleoecological reconstructions and biomonitoring of urban impacts. [ABSTRACT FROM AUTHOR]

This paper addresses the role of the European Commission in driving the implementation process of the Markets in Financial Instruments Directive (MiFID -- 2004/39/EC) and its implementing measures. It provides a strategic, Europe-wide assessment of the key implementation challenges facing firms in the areas of client classification, suitability and appropriateness, best execution, inducements, transaction reporting and market transparency. The paper closes with remarks about the expected impacts of MiFID on the European capital markets, some of which can already be seen. [ABSTRACT FROM AUTHOR]

Starting with an overview of the design and impact of the original Marshall Plan, this article explores the question of why the EC/EU failed to set in motion a similar project for Eastern Europe - purposefully targeted massive foreign aid conditioned upon cooperation among the recipient countries that could have encouraged productive investment and regional integration. Three elements of the Marshall Plan played a crucial role in the making of post-war economic miracle in Western Europe - regional integration that laid the basis for self-sustaining growth, a developmental state, and a balance between free market policies and social cohesion. It was the absence of these three elements from the Western strategy for Eastern Europe that made the latter relapse to its peripheral status. Indeed, precisely the opposite pattern was transplanted onto this region - economic fragmentation, the progressive withdrawal of the state from various redistributive and social functions thus effectively limiting its role to that of a guardian of the free market, and an organization of social forces that favoured economic liberalism at the expense of social cohesion. Salient features of the contemporary Eastern European capitalism are high share of foreign ownership of industrial and financial assets, large and growing dependence on capital imports, and trade dependence. [ABSTRACT FROM AUTHOR]

The large fruit-tree tortrix Archips podana (Scopoli) is a widely distributed species in the whole of Europe. The species is variable in male genitalia. According to the different number and position of apical (A) and lateral (L) spikes on the aedeagus, .A, L, 2L, AL, A2L, and 0 (without spike) phenotypes were discriminated. To determine the variability of pheromone communication of A. podana, field trap tests were conducted in different habitats and geographical regions in Estonia (Uhti and Otepää), northwestern Russia (Velikie Luki, Pskov Region), and the North Caucasus (Krasnodar Territory). The optimum content of Z-11-tetradecenyl acetate in pheromone blend, calculated using the Gaussian curve, was on average 61.3 ± 1.3%. This is practically identical to the ratio of 60:40 in the mixture of (Z)- and (E)-11-tetradecen-1-yl acetates identified by Persoons et al. (1994, J. Insect Physiol., 20, 1181–1188). Experiments demonstrated that the optimal pheromone composition was the same in Krasnodar, where the L phenotype dominates, and in Velikie Luki and Estonia, where A phenotype males dominate. A deviation of attractive blend from optimum ratio causes a comparable decrease in trap catches for males of different aedeagus forms. The Caucasian subspecies with a lateral spike (male phenotype L), A. podana meridiana Kozl. et Esart., is placed in synonymy to nominotypical species in this paper. Calculation of pheromone communication parameters - channel width and optimal ratio - is an effective tool for ecochemical research and dispenser modelling. [ABSTRACT FROM AUTHOR]

Summary Background Variations in testing for Clostridium difficile infection can hinder patients' care, increase the risk of transmission, and skew epidemiological data. We aimed to measure the underdiagnosis of C difficile infection across Europe. Methods We did a questionnaire-based study at 482 participating hospitals across 20 European countries. Hospitals were questioned about their methods and testing policy for C difficile infection during the periods September, 2011, to August, 2012, and September, 2012, to August, 2013. On one day in winter, 2012–13 (December, 2012, or January, 2013), and summer, 2013 (July or August), every hospital sent all diarrhoeal samples submitted to their microbiology laboratory to a national coordinating laboratory for standardised testing of C difficile infection. Our primary outcome measures were the rates of testing for and cases of C difficile infection per 10 000 patient bed-days. Results of local and national C difficile infection testing were compared with each other. If the result was positive at the national laboratory but negative at the local hospital, the result was classified as undiagnosed C difficile infection. We compared differences in proportions with the Mann-Whitney test, or McNemar's test if data were matched. Findings During the study period, participating hospitals reported a mean of 65·8 tests (country range 4·6–223·3) for C difficile infection per 10 000 patient-bed days and a mean of 7·0 cases (country range 0·7–28·7) of C difficile infection per 10 000 patient-bed days. Only two-fifths of hospitals reported using optimum methods for testing of C difficile infection (defined by European guidelines), although the number of participating hospitals using optimum methods increased during the study period, from 152 (32%) of 468 in 2011–12 to 205 (48%) of 428 in 2012–13. Across all 482 European hospitals on the two sampling days, 148 (23%) of 641 samples positive for C difficile infection (as determined by the national laboratory) were not diagnosed by participating hospitals because of an absence of clinical suspicion, equating to about 74 missed diagnoses per day. Interpretation A wide variety of testing strategies for C difficile infection are used across Europe. Absence of clinical suspicion and suboptimum laboratory diagnostic methods mean that an estimated 40 000 inpatients with C difficile infection are potentially undiagnosed every year in 482 European hospitals. Funding Astellas Pharmaceuticals Europe. [ABSTRACT FROM AUTHOR]

Skin tumors are the most frequent malignancies in the white population worldwide and have reached the proportion of an epidemic disease. Since non-melanocytic skin cancers can be cured when timely detected, given that still malignant melanoma may have good prognosis if early diagnosed, and considering the key role of primary care in cancer screening advising and implementation, the international PACMeR study group (trial_01.3) adjourned SESy_Europe database in a version comprehensive of skin-malignancies screening indexing. The novel database provides standardized pre-codified translations of 2,331 parameters in eight languages (English, French, German, Greek, Italian, Romanian, Spanish and Turkish) and records the time elapsed from last skin examination, cause and frequency of skins examinations and stratifies skin cancer risk patterns by a systematic registering of risk factors. A comprehensive indexing of skin cancer screening practices among European countries may in fact turn helpful in programming future health policy and tailoring interventions. [ABSTRACT FROM AUTHOR]

During the course of the diffusion of Neolithic agro-pastoral societies across Europe, animal husbandry was adapted to local constraints and resources, involving changes in practices as well as in animal physiology. As a result, the timing of animal breeding was impacted, with consequences on the organization of agro-pastoral tasks and the seasonal availability of animal products. Past sheep birth seasonality can be investigated through the reconstruction of the seasonal cycle recorded in molars, based on the sequential analysis of stable oxygen isotope ratios (δ18O) in enamel. Modern sheep serve as comparative material to define the season of birth. In the present study, we provide new reference values for winter births in the sheep third molar (M3) using data from the modern Kemenez sheep herd. The dataset also includes paired upper and lower M3s in order to test the comparability of results obtained from both teeth. Results show a moderate shift in the isotopic record between upper and lower M3s. The consecutive difference in the assessment of the timing of birth is one month, on average. Additionally, we provide a new set of results for sheep from Nova Nadezhda (Bulgaria, early sixth millennium BC), combining upper and lower molars, in order to expand data relating to the earliest stages of the introduction of sheep to Europe. At Nova Nadezhda, sheep were born in late winter and spring, and the pattern of birth distribution does not indicate the control of sheep reproduction by separating males from females. When compared to previously published results at other Neolithic and Chalcolithic sites in the Balkans, corrected for the shift between upper and lower M3s, no latitudinal and chronological trend is observed between the Southern Balkans, Northern Balkans and Hungarian plains over the early sixth to the second half of the fifth millennia BC. This apparent uniformity for the length (3–4 months) and timing of the birth period could be challenged in the future by enlarged datasets. • The timing of animal breeding impacts greatly the farming calendar. • Past sheep birth seasonality can be investigated through isotope analysis in teeth. • Oxygen isotope sequences in sheep paired upper and lower molars are shifted. • Neolithic sheep in Europe gave birth over 2–4 months in late winter and spring. [ABSTRACT FROM AUTHOR]