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School classrooms within the EU are multilingual learning environments. The diversity of pupils in classrooms raises significant challenges for teachers, but to date, there are no data from large-scale surveys that compare views within and across European countries. A bespoke questionnaire was designed to examine views of current classroom learning environments with respect to the multilingualism. The questionnaire was piloted and subsequently completed by 2792 teachers across different European countries. Eleven countries provided sufficient data for analyses. Results from structural equation modelling showed that teachers' attitudes could be reliably measured across Europe with the use of carefully devised questionnaire, whose loading and factor structure remained invariant across countries. Teachers' views about multilingualism were most challenged by the numbers of children in their classes, not the percentage of multilingual pupils in the class. Countries differed in how they perceived multilingualism, with their differences leading to distinctive country clusters. Gender and education level (elementary vs. secondary) differences were also observed irrespective of country. These findings enhance our understanding of the role that the characteristics of teachers and their classrooms play in a multilingual setting across diverse European settings. The practical relevance of the results and new opportunities for teacher training are discussed.

With this article we honor the 60th anniversary issue of the "Journal of College Student Development "(JCSD) by tracing the reach, scope, and breadth of internationally focused articles published in the journal from January 2010 to April 2019. This time frame was selected as it reflects the journal Editor's decision to create a position for an Associate Editor for International Research and Scholarship. This decision supported ACPA--College Student Educators International's strategic commitments. During the time frame examined, 12.4% of the journal's published work consisted of pieces with an international perspective and/or resulting from research conducted in the postsecondary educational contexts of 26 countries, territories, or special administrative units.

Background: During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response. The objective of this study is to describe PHC indicators for disease surveillance and monitoring of COVID-19's impact in Europe. Methods: Descriptive, cross-sectional study employing data obtained through a semi-structured ad hoc questionnaire, which was collectively agreed upon by all participants. The study encompasses PHC settings in 31 European countries from March 2020 to August 2021. Keyinformants from each country answered the questionnaire. Main outcome: the identification of any indicator used to describe PHC COVID-19 activity. Results: Out of the 31 countries surveyed, data on PHC information were obtained from 14. The principal indicators were: total number of cases within PHC (Belarus, Cyprus, Italy, Romania and Spain), number of follow-up cases (Croatia, Cyprus, Finland, Spain and Turkey), GP's COVID-19 tests referrals (Poland), proportion of COVID-19 cases among respiratory illnesses consultations (Norway and France), sick leaves issued by GPs (Romania and Spain) and examination and complementary tests (Cyprus). All COVID-19 cases were attended in PHC in Belarus and Italy. Conclusions: The COVID-19 pandemic exposes a crucial deficiency in preparedness for infectious diseases in European health systems highlighting the inconsistent recording of indicators within PHC organizations. PHC standardized indicators and public data accessibility are urgently needed, conforming the foundation for an effective European-level health services response framework against future pandemics. [ABSTRACT FROM AUTHOR]

The article "From the Decline of the West to the Reinvention of Europe" by Hauke Ritz discusses the geopolitical challenge that Europe is facing. Ritz argues that Europe should no longer see itself as part of the West, but as an independent entity in order to be successful. He emphasizes the cultural identity of Europe and warns of the failure of the West in the face of new global powers. Ritz offers on 264 pages philosophically challenging questions and insights for the reinvention of Europe. [Extracted from the article]

Dusty cirrus clouds are extended optically thick cirrocumulus decks that occur during strong mineral dust events. So far they have mostly been documented over Europe associated with dust-infused baroclinic storms. Since today's global numerical weather prediction models neither predict mineral dust distributions nor consider the interaction of dust with cloud microphysics, they cannot simulate this phenomenon. We postulate that the dusty cirrus forms through a mixing instability of moist clean air with drier dusty air. A corresponding sub-grid parameterization is suggested and tested in the ICOsahedral Nonhydrostatic model with Aerosol and Reactive Trace gases (ICON-ART). Only with the help of this parameterization is ICON-ART able to simulate the formation of the dusty cirrus, which leads to substantial improvements in cloud cover and radiative fluxes compared to simulations without this parameterization. A statistical evaluation over six Saharan dust events with and without observed dusty cirrus shows robust improvements in cloud and radiation scores. The ability to simulate dusty cirrus formation removes the linear dependency on mineral dust aerosol optical depth from the bias of the radiative fluxes. For the six Saharan dust episodes investigated in this study, the formation of dusty cirrus clouds is the dominant aerosol–cloud–radiation effect of mineral dust over Europe. [ABSTRACT FROM AUTHOR]

Background and aim: Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic. Methods: Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care. Results: Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom's follow-up was performed mainly by PHC. Conclusion: PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals. [ABSTRACT FROM AUTHOR]

Aim: Latitudinal clines in dietary specialization and range size are used to explain biodiversity distributions at large spatial scales, such as the latitudinal diversity gradient. The aim of this study was to test whether dietary breadth (as a dimension of niche breadth) and range size decrease towards lower latitudes in a species‐rich clade of herbivorous insects as predicted by the latitude–niche breadth hypothesis and Rapoport's rule, respectively. We also aimed to study whether these species characteristics are positively linked with each other as stated by the niche breadth–range size hypothesis. Location: Europe (35–71° N). Time period: Present‐day. Major taxa: Geometrid moths (Lepidoptera: Geometridae). Methods: For every species, we compiled information on latitudinal distribution and host‐plant use based on available literature and online sources. We estimated the level of fundamental dietary specialization of each species while accounting for phylogenetic relationships among the host plants used. We also reconstructed a phylogeny including all studied moth taxa, in order to control for phylogenetic dependence in species characteristics. Phylogenetic least squares (PGLS) analyses were used to test each of our hypotheses. Results: We analysed 631 species of geometrids (85.2% of taxa within the biogeographical region) and found strong support for the latitude–niche breadth hypothesis and for Rapoport's rule. Fundamental dietary breadth was also found to be positively related to latitudinal range size, which supports the niche breadth–range size hypothesis. These results were retained when the subfamilies Ennominae and Larentiinae were analysed separately. Main conclusions: Our findings indicate that latitudinal clines in range size and fundamental dietary breadth covary in European geometrid moths and are likely to be drivers of increased species richness towards lower latitudes. This supports the idea that both characteristics should be studied simultaneously in order to unveil mechanisms structuring biodiversity patterns at the macroecological scale. [ABSTRACT FROM AUTHOR]

Background and Objective: Influenza-like illness (ILI) leads to a substantial disease burden every winter in Europe; however, oseltamivir is not frequently prescribed to ILI patients in the primary-care setting. An open-label, multi-country, multi-season, randomised controlled trial investigated the effectiveness of oseltamivir for treating ILI in 15 European countries. We aimed to evaluate whether patients presenting with ILI in primary care and being managed with the addition of oseltamivir to usual care had lower average direct and indirect costs compared to patients with usual care alone. Methods: Resource use data were extracted from participants' daily diaries. Itemised country-specific unit costs were collected through official tariffs, pharmacies or literature. Costs were converted to 2018 values. The null hypothesis was tested based on one-sided credible intervals (CrIs) obtained by bootstrapping. Base-case analysis estimated direct cost and productivity losses using itemised costed resource use and the human capital approach. Scenario analyses with self-reported spending rather than itemised costing were also performed. Results: Patients receiving oseltamivir (N = 1306) reported fewer healthcare visits, medication uses, hospital attendances and paid-work hours lost than the other patients (N = 1298). Excluding the oseltamivir cost, the average direct costs were lower in patients treated with oseltamivir from all perspectives, but these differences were not statistically significant (perspective of patient: €17 [0–95% Crl: 16–19] vs. €24 [5–100% Crl: 18–29]; healthcare provider: €37 [28–67] vs. €44 [25–55]; healthcare payers: €54 [45–85] vs. €68 [45–81]; and society: €423 [399–478] vs. €451 [390–478]). Scenario and age-group analyses confirmed these findings, but with some between-country differences. Conclusion: The average direct and indirect costs were consistently lower in patients treated with oseltamivir than in patients without from four perspectives (excluding the oseltamivir cost). However, these differences were not statistically significant. [ABSTRACT FROM AUTHOR]

Objectives: To assess the admission prevalence of third-generation cephalosporin-resistant Enterobacterales (3GCREB) and to assess whether risk factors vary by β-lactamase genotype.Methods: Adult patients were recruited within 72 h of admission to general wards of six university hospitals in 2014 and 2015. Rectal swabs were screened for 3GCREB and isolates were analysed phenotypically and genotypically. Patients were questioned on potential risk factors. Multivariable analyses were performed to identify risk factors for 3GCREB colonization and for specific β-lactamases.Results: Of 8753 patients screened, 828 were 3GCREB positive (9.5%). Eight hundred and thirteen isolates were available for genotyping. CTX-M-15 was the most common ESBL (38.0%), followed by CTX-M-1 (22.5%), CTX-M-14 (8.7%), CTX-M-27 (7.5%) and SHV-ESBL (4.4%). AmpC was found in 11.9%. Interestingly, 18 Escherichia coli isolates were AmpC positive, 12 of which (67%) contained AmpC on a gene of plasmid origin [CMY (n = 10), DHA (n = 2)]. Risk factors for 3GCREB colonization varied by genotype. Recent antibiotic exposure and prior colonization by antibiotic-resistant bacteria were risk factors for all β-lactamases except CTX-M-14 and CTX-M-27. Travel outside Europe was a risk factor for CTX-M-15 and CTX-M-27 [adjusted OR (aOR) 3.49, 95% CI 2.88-4.24 and aOR 2.73, 95% CI 1.68-4.43]. A previous stay in a long-term care facility was associated with CTX-M-14 (aOR 3.01, 95% CI 1.98-4.59). A preceding hospital stay in Germany increased the risk of CTX-M-15 (aOR 1.27, 95% CI 1.14-1.41), while a prior hospital stay in other European countries increased the risk of SHV-ESBL colonization (aOR 3.85, 95% CI 1.67-8.92).Conclusions: The detection of different ESBL types is associated with specific risk factor sets that might represent distinct sources of colonization and ESBL-specific dissemination routes. [ABSTRACT FROM AUTHOR]

The cold/wet anomaly of the 1310s ("Dantean Anomaly") has attracted a lot of attention from scholars, as it is commonly interpreted as a signal of the transition between the Medieval Climate Anomaly (MCA) and the Little Ice Age (LIA). The huge variability that can be observed during this decade, like the high interannual variability observed in the 1340s, has been highlighted as a side effect of this rapid climatic transition. In this paper, we demonstrate that a multi-seasonal drought of almost 2 years occurred in the Mediterranean between 1302 and 1304, followed by a series of hot, dry summers north of the Alps from 1304 to 1306. We suggest that this outstanding dry anomaly, unique in the 13th and 14th centuries, together with cold anomalies of the 1310s and the 1340s, is part of the climatic shift from the MCA to the LIA. Our reconstruction of the predominant weather patterns of the first decade of the 14th century – based on both documentary and proxy data – identifies multiple European precipitation seesaw events between 1302 and 1307, with similarities to the seesaw conditions which prevailed over continental Europe in 2018. It can be debated to what extent the 1302–1307 period can be compared to what is currently discussed regarding the influence of the phenomenon of Arctic amplification on the increasing frequency of persistent stable weather patterns that have occurred since the late 1980s. Additionally, this paper deals with socioeconomic and cultural responses to drought risks in the Middle Ages as outlined in contemporary sources and provides evidence that there is a significant correlation between pronounced dry seasons and fires that devastated cities. [ABSTRACT FROM AUTHOR]

Clouds and aerosols contribute the largest uncertainty to current estimates and interpretations of the Earth's changing energy budget. Here we use a new-generation large-domain large-eddy model, ICON-LEM (ICOsahedral Non-hydrostatic Large Eddy Model), to simulate the response of clouds to realistic anthropogenic perturbations in aerosols serving as cloud condensation nuclei (CCN). The novelty compared to previous studies is that (i) the LEM is run in weather prediction mode and with fully interactive land surface over a large domain and (ii) a large range of data from various sources are used for the detection and attribution. The aerosol perturbation was chosen as peak-aerosol conditions over Europe in 1985, with more than fivefold more sulfate than in 2013. Observational data from various satellite and ground-based remote sensing instruments are used, aiming at the detection and attribution of this response. The simulation was run for a selected day (2 May 2013) in which a large variety of cloud regimes was present over the selected domain of central Europe. It is first demonstrated that the aerosol fields used in the model are consistent with corresponding satellite aerosol optical depth retrievals for both 1985 (perturbed) and 2013 (reference) conditions. In comparison to retrievals from ground-based lidar for 2013, CCN profiles for the reference conditions were consistent with the observations, while the ones for the 1985 conditions were not. Similarly, the detection and attribution process was successful for droplet number concentrations: the ones simulated for the 2013 conditions were consistent with satellite as well as new ground-based lidar retrievals, while the ones for the 1985 conditions were outside the observational range. For other cloud quantities, including cloud fraction, liquid water path, cloud base altitude and cloud lifetime, the aerosol response was small compared to their natural variability. Also, large uncertainties in satellite and ground-based observations make the detection and attribution difficult for these quantities. An exception to this is the fact that at a large liquid water path value (LWP >200 g m -2), the control simulation matches the observations, while the perturbed one shows an LWP which is too large. The model simulations allowed for quantifying the radiative forcing due to aerosol–cloud interactions, as well as the adjustments to this forcing. The latter were small compared to the variability and showed overall a small positive radiative effect. The overall effective radiative forcing (ERF) due to aerosol–cloud interactions (ERFaci) in the simulation was dominated thus by the Twomey effect and yielded for this day, region and aerosol perturbation -2.6 W m -2. Using general circulation models to scale this to a global-mean present-day vs. pre-industrial ERFaci yields a global ERFaci of -0.8 W m -2. [ABSTRACT FROM AUTHOR]

High-quality diagnosis of bloodstream infections (BSI) is important for successful patient management. As knowledge on current practices of microbiological BSI diagnostics is limited, this project aimed to assess its current state in European microbiological laboratories. We performed an online questionnaire-based cross-sectional survey comprising 34 questions on practices of microbiological BSI diagnostics. The ESCMID Study Group for Bloodstream Infections, Endocarditis and Sepsis (ESGBIES) was the primary platform to engage national coordinators who recruited laboratories within their countries. Responses were received from 209 laboratories in 25 European countries. Although 32.5% (68/209) of laboratories only used the classical processing of positive blood cultures (BC), two-thirds applied rapid technologies. Of laboratories that provided data, 42.2% (78/185) were able to start incubating BC in automated BC incubators around-the-clock, and only 13% (25/192) had established a 24-h service to start immediate processing of positive BC. Only 4.7% (9/190) of laboratories validated and transmitted the results of identification and antimicrobial susceptibility testing (AST) of BC pathogens to clinicians 24 h/day. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry from briefly incubated sub-cultures on solid media was the most commonly used approach to rapid pathogen identification from positive BC, and direct disc diffusion was the most common rapid AST method from positive BC. Laboratories have started to implement novel technologies for rapid identification and AST for positive BC. However, progress is severely compromised by limited operating hours such that current practice of BC diagnostics in Europe complies only partly with the requirements for optimal BSI management. [ABSTRACT FROM AUTHOR]

Central Europe has a vital and extensive meteorological research community comprising national weather services, universities, and research organizations and institutes. Nearly all of them are involved in the open scientific questions regarding clouds and precipitation processes. The research activities include observations (from in situ ground-based remote sensing radio soundings to satellite-based observations), model development on all scales (from direct numerical simulations to global climate models), and other activities. With Germany as an example our first objective is to show the large amount and the diversity of observations regarding clouds and precipitation. The goal is to give an overview of existing measurements and datasets to show the benefit of combining the different information from a variety of observations. Up to now the access to and the usage of these datasets from different sources was not straightforward, due to the issue of missing data and archiving standards for observational data. This then motivates our second objective, which is to introduce our solution for this issue—the novel Standardized Atmospheric Measurement Data archive (SAMD). SAMD is one of the outcomes of the German research initiative High Definition Clouds and Precipitation for Advancing Climate Prediction [HD(CP)2]. The goal of SAMD is an easy-to-use approach for both data producers and archive users. Therefore the archive provides observational data in the common Climate Forecast (CF) Conventions format and makes it available to the broader public. SAMD offers highly standardized quality-controlled data and metadata for a wide range of instruments, with open access, which makes this novel archive important for the research community. [ABSTRACT FROM AUTHOR]

Asian weather loach species of the genus Paramisgurnus and Misgurnus can have a great invasive potential. In Europe, several feral populations of Asian weather loach have been reported, many of them within the distribution range of the native European weather loach Misgurnus fossilis, a declining species of high conservation concern. Distinguishing the different exotic species of weather loach can be difficult for the non-expert, as their general morphology is very similar, the coloration patterns are highly variable and the morphological characteristics may become degraded after preservation. We present the first molecular genetic confirmation of the presence of the large-scale loach Paramisgurnus dabryanus in Europe, after analyzing two specimens from a small pond along the brook "Wörthlinger Bach" (Danube catchment) in southern Germany. Accurate species identification is crucial both in the context of monitoring and conserving endangered species, and in detection and prevention of biological invasions. Therefore, we suggest the standard use of genetic species assignment based on mitochondrial DNA barcoding in monitoring cryptic fish species complexes, especially during potentially cryptic biological invasions. [ABSTRACT FROM AUTHOR]

Background Cardiometabolic diseases (CMDs) are the number one cause of death. Selective prevention of CMDs by general practitioners (GPs) could help reduce the burden of CMDs. This measure would entail the identification of individuals at high risk of CMDs—but currently asymptomatic—followed by interventions to reduce their risk. No data were available on the attitude and the extent to which European GPs have incorporated selective CMD prevention into daily practice. Methods A survey among 575 GPs from the Czech Republic, Denmark, Greece, the Netherlands and Sweden was conducted between September 2016 and January 2017, within the framework of the SPIMEU-project. Results On average, 71% of GPs invited their patients to attend for CMD risk assessment. Some used an active approach (47%) while others used an opportunistic approach (53%), but these values differed between countries. Most GPs considered selective CMD prevention as useful (82%) and saw it as part of their normal duties (84%). GPs who did find selective prevention useful were more likely to actively invite individuals compared with their counterparts who did not find prevention useful. Most GPs had a disease management programme for individuals with risk factor(s) for cardiovascular disease (71%) or diabetes (86%). Conclusions Although most GPs considered selective CMD prevention as useful, it was not universally implemented. The biggest challenge was the process of inviting individuals for risk assessment. It is important to tailor the implementation of selective CMD prevention in primary care to the national context, involving stakeholders at different levels. [ABSTRACT FROM AUTHOR]

Aims: The present study aimed to determine the prognostic impact of resting heart rate (HR) and systolic blood pressure (SBP) in takotsubo syndrome (TTS).Methods and Results: Patients from the International Takotsubo Registry with complete data on HR and SBP were enrolled. We analysed all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) in tertiles of HR (<77 b.p.m., 77-94 b.p.m., >94 b.p.m.) and SBP (<119 mmHg, 119-140 mmHg, >140 mmHg). In addition, linear splines with interactions between HR and SBP were analysed. The risk of all-cause mortality was higher in the second HR tertile (1.89, 1.15-3.10; P = 0.012) and the third HR tertile (3.01, 1.90-4.79; P < 0.001) than in the first tertile. Similar effects were observed for MACCE. Low SBP was related to an increased risk of all-cause mortality (P < 0.001) and MACCE (P = 0.002). In a multivariable analysis of all-cause mortality, at HR >70 b.p.m., every 1 b.p.m. increase in HR was associated with a 1.7% increase (P < 0.001), and every 1 mmHg increase in SBP up to 130 mmHg was associated with a 2% risk reduction (P < 0.001). The risk of all-cause mortality thus was particularly elevated when low SBP occurred together with high HR.Conclusions: High HR and low SBP are associated with an increased risk of all-cause mortality in TTS. HR reduction might be worthy of being investigated as a therapeutic strategy for this condition and high HR and low SBP can be used to evaluate risk in this acute presentation of TTS.Clinical Trial Registration: ClinicalTrials.gov NCT01947621. [ABSTRACT FROM AUTHOR]

The Bohemian Forest represents the most extensive continuous forest landscape in central Europe. Two neighbouring national parks (NP), the Bavarian Forest NP in Germany and the Šumava NP in Czechia, protecting the most valuable part of this area have been recognized as an important site for monitoring of effect of climate change on central European biodiversity and ecosystem structure. For long time, a hydrological monitoring program in the Große Ohe headwater catchment and complex monitoring of glacial lakes recently recovering from acidification were flagships of long-term transboundary research in the Bohemian Forest. Recently published results of biodiversity research in the Bavarian Forest NP and experiences with monitoring of mires in the Šumava NP supported a necessity of multidisciplinary and transboundary research. To improve the cooperation of both national parks, optimize methodologies, and coordinate research activities in the region a new Interreg project No. 26 "Silva Gabreta Monitoring - Implementation of transboundary monitoring of biodiversity and water regime" was jointly prepared. The aims and monitoring methodologies of three main project activities are presented in this paper: (i) monitoring of forest biodiversity, (ii) monitoring of mires, and (iii) monitoring of aquatic ecosystems. In addition, we briefly present several supplementary project activities and tasks, such as modelling of mesoclimatic conditions, monitoring of effect of deicing salt, project conference and common database. As well as sampling design, methods and strategies, and brief overview of the preliminary results are mentioned. [ABSTRACT FROM AUTHOR]

In light of offshore wind expansions in the North and Baltic Seas in Europe, further ideas on using offshore space for renewable-based energy generation have evolved. One of the concepts is that of energy islands, which entails the placement of energy conversion and storage equipment near offshore wind farms. Offshore placement of electrolysers will cause interdependence between the availability of electricity for hydrogen production and for power transmission to shore. This paper investigates the trade-offs between integrating energy islands via electricity versus hydrogen infrastructure. We set up a combined capacity expansion and electricity dispatch model to assess the role of electrolysers and electricity cables given the availability of renewable energy from the islands. We find that the electricity system benefits more from connecting close-to-shore wind farms via power cables. In turn, electrolysis is more valuable for far-away energy islands as it avoids expensive long-distance cable infrastructure. We also find that capacity investment in electrolysers is sensitive to hydrogen prices but less to carbon prices. The onshore network and congestion caused by increased activity close to shore influence the sizing and siting of electrolysers. • Distance to shore and investment in offshore electrolysis are mutually dependent. • Offshore electrolysis is more valuable for far-away energy islands. • Offshore grids are beneficial for large-scale offshore wind integration. • Electrolyser capacity is sensitive to hydrogen prices but less to carbon prices. • Onshore grid developments influence offshore development significantly. [ABSTRACT FROM AUTHOR]

The article discusses general structure and dynamics of the sports science research content as obtained from the analysis of 21998 European College of Sport Science abstracts belonging to 12 science topics. The structural analysis showed intertwined multidisciplinary and unifying tendencies structured along horizontal (scope) and vertical (level) axes. Methodological (instrumental and mode of inquiry) integrative tendencies are dominant. Theoretical integrative tendencies are much less detectable along both horizontal and vertical axes. The dynamic analysis of written abstracts text content over the 19 years reveals the contextualizing and guiding role of thematic skeletons of each sports science topic in forming more detailed contingent research ideas and the role of the latter in stabilizing and procreating the former. This circular causality between both hierarchical levels and functioning on separate characteristic time scales is crucial for understanding how stable research traditions self-maintain and self-procreate through innovative contingencies. The structure of sports science continuously rebuilds itself through use and re-use of contingent research ideas. The thematic skeleton ensures its identity and the contingent conceptual sets its flexibility and adaptability to different research or applicative problems. [ABSTRACT FROM PUBLISHER]

Information is provided on the Emmy Noether Research Group's conference titled "Futuring the Stars: Europe in the Age of Space" held at the Friedrich-Meinecke-Institut, Freie Universität Berlin in Berlin, Germany from March 17-19, 2016. Topics, including the history of space exploration during the 20th century, European astronautics, extraterrestrial life, space flight and the Cold War, are discussed.

Ancient DNA (aDNA) recovered from plague victims of the second plague pandemic (14th to 17th century), excavated from two different burial sites in Germany, and spanning a time period of more than 300 years, was characterized using single nucleotide polymorphism (SNP) analysis. Of 30 tested skeletons 8 were positive for Yersinia pestis-specific nucleic acid, as determined by qPCR targeting the pla gene. In one individual (MP-19-II), the pla copy number in DNA extracted from tooth pulp was as high as 700 gene copies/μl, indicating severe generalized infection. All positive individuals were identical in all 16 SNP positions, separating phylogenetic branches within nodes N07_N10 (14 SNPs), N07_N08 (SNP s19) and N06_N07 (s545), and were highly similar to previously investigated plague victims from other European countries. Thus, beside the assumed continuous reintroduction of Y. pestis from central Asia in multiple waves during the second pandemic, long-term persistence of Y. pestis in Europe in a yet unknown reservoir host has also to be considered. [ABSTRACT FROM AUTHOR]

Background: Current guidelines recommend that patients with Staphylococcus aureus bloodstream infection (SAB) are treated with long courses of intravenous antimicrobial therapy. This serves to avoid SAB-related complications such as relapses, local extension and distant metastatic foci. However, in certain clinical scenarios, the incidence of SAB-related complications is low. Patients with a low-risk for complications may thus benefit from an early switch to oral medication through earlier discharge and fewer complications of intravenous therapy. The major objective for the SABATO trial is to demonstrate that in patients with low-risk SAB a switch from intravenous to oral antimicrobial therapy (oral switch therapy, OST) is non-inferior to a conventional course of intravenous therapy (intravenous standard therapy, IST).Methods/design: The trial is designed as randomized, parallel-group, observer-blinded, clinical non-inferiority trial. The primary endpoint is the occurrence of a SAB-related complication (relapsing SAB, deep-seated infection, and attributable mortality) within 90 days. Secondary endpoints are the length of hospital stay; 14-day, 30-day, and 90-day mortality; and complications of intravenous therapy. Patients with SAB who have received 5 to 7 full days of adequate intravenous antimicrobial therapy are eligible. Main exclusion criteria are polymicrobial bloodstream infection, signs and symptoms of complicated SAB (deep-seated infection, hematogenous dissemination, septic shock, and prolonged bacteremia), the presence of a non-removable foreign body, and severe comorbidity. Patients will receive either OST or IST with a protocol-approved antimicrobial and are followed up for 90 days. Four hundred thirty patients will be randomized 1:1 in two study arms. Efficacy regarding incidence of SAB-related complications is tested sequentially with a non-inferiority margin of 10 and 5 percentage points.Discussion: The SABATO trial assesses whether early oral switch therapy is safe and effective for patients with low-risk SAB. Regardless of the result, this pragmatic trial will strongly influence the standard of care in SAB.Trial Registration: ClinicalTrials.gov NCT01792804 registered 13 February 2013; German Clinical trials register DRKS00004741 registered 4 October 2013, EudraCT 2013-000577-77 . First patient randomized on 20 December 2013. [ABSTRACT FROM AUTHOR]

Export of dissolved organic carbon from lakes and streams has increased throughout Europe and North America over the past several decades. One possible cause is altered deposition chemistry; specifically, decreasing sulfate inputs leading to changes in ionic strength and dissolved organic carbon solubility. To further investigate the relationship between deposition chemistry and dissolved organic carbon export in peatlands, a field experiment was conducted to compare the pore water chemistry and peat microbial enzyme activity of mesocosms receiving sulfate amendments to mesocosms receiving no additions. To consider how peatlands respond during recovery from increased inputs of sulfate, samples were also analyzed from an area of the same peatland that was previously amended with sulfate. Current additions of sulfate decreased dissolved organic carbon concentration and increased dissolved organic carbon aromaticity. Total dissolved phosphorus decreased in response to current sulfate amendments but was elevated in the area of the peatland recovering from sulfate amendment. The total dissolved phosphorus increase, which was reflected in microbial enzyme activity, may have shifted the system from P limitation to N limitation. This shift could have important consequences for ecosystem processes related to plant and microbial communities. It also suggests that the recovery from previous sulfate amendments may take longer than may be expected. [ABSTRACT FROM AUTHOR]

Objectives To determine the activity of oritavancin against methicillin-resistant staphylococci, vancomycin-resistant enterococci (VRE) and β-haemolytic streptococci recently isolated from acute bacterial skin and skin structure infections or bacteraemia in western Europe. Methods Forty-one centres in Spain (8), Italy (9), Germany (8), France (8) and the UK (8) submitted 866 isolates [204 methicillin-resistant Staphylococcus aureus (MRSA), 177 methicillin-resistant coagulase-negative staphylococci (MRCoNS), 101 VRE, 193 Streptococcus agalactiae and 191 Streptococcus pyogenes] that were collected during the first 6 months of 2011. These were re-identified and susceptibilities to oritavancin and comparators were determined. Results Oritavancin was very active against MRSA (MIC50/MIC90 0.03/0.06 mg/L), MRCoNS (0.06/0.12 mg/L), VRE (0.03/0.06 mg/L), S. agalactiae (0.03/0.06 mg/L) and S. pyogenes (0.06/0.25 mg/L). The highest oritavancin MIC observed was 0.25 mg/L (species were S. aureus, Staphylococcus epidermidis, Staphylococcus hominis, S. agalactiae, S. pyogenes and Enterococcus faecalis). Conclusions These data from recently collected Gram-positive bacteria in western Europe confirm the potent in vitro activity of oritavancin against a wide range of resistant MRSA, MRCoNS and VRE isolates, including ones resistant to newer agents. [ABSTRACT FROM PUBLISHER]

Background: Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. Methods: A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Results: Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Conclusions: Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised. [ABSTRACT FROM AUTHOR]

Climate change is already altering the magnitude and/or frequency of extreme events which will in turn affect plant fitness more than any change in the average. Although the fingerprint of anthropogenic warming in recent phenological records is well understood, the impacts of extreme events have been largely neglected. Thus, the temperature response of European phenological records to warm and cold spells was studied using the COST725 database. We restricted our analysis to the period 1951-2004 due to better spatial coverage. Warm and cold spells were identified using monthly mean ENSEMBLES temperature data on a 0.5° grid for Europe. Their phenological impact was assessed as anomalies from maps displaying mean onsets for 1930-1939. Our results clearly exhibit continental cold spells predominating in the period 1951-1988, especially during the growing season, whereas the period from 1989 onwards was mainly characterised by warm spells in all seasons. The impacts of these warm/cold spells on the onset of phenological seasons differed strongly depending on species, phase and timing. 'False' phases such as the sowing of winter cereals hardly reacted to summer warm/cold spells; only the sowing of summer cereals mirrored spring temperature warm/cold spells. The heading dates of winter cereals did not reveal any consistent results probably due to fewer warm/cold spells identified in the relevant late spring months. Apple flowering and the harvest of winter cereals were the best indicators of warm/cold spells in early spring and summer, also being spatially coherent with the patterns of warm/cold spells. [ABSTRACT FROM AUTHOR]

The article presents an analysis regarding the changes concerning the scope of the books from the creation of "The Making of Labour Law in Europe," to "The Transformation of Labour Law in Europe: A Comparative Study of 15 Countries 1945-2004." It examines the method used in the books, the transversal method which points out the common developments or trends in labor law between the end of the Second World War and 2004. Moreover, the disadvantages of comparative analysis are also examined.

Objectives This study determined excess mortality and length of hospital stay (LOS) attributable to bloodstream infection (BSI) caused by third-generation-cephalosporin-resistant Escherichia coli in Europe. Methods A prospective parallel matched cohort design was used. Cohort I consisted of patients with third-generation-cephalosporin-resistant E. coli BSI (REC) and cohort II consisted of patients with third-generation-cephalosporin-susceptible E. coli BSI (SEC). Patients in both cohorts were matched for LOS before infection with patients free of the respective BSI. Thirteen European tertiary care centres participated between July 2007 and June 2008. Results Cohort I consisted of 111 REC patients and 204 controls and cohort II consisted of 1110 SEC patients and 2084 controls. REC patients had a higher mortality at 30 days (adjusted odds ratio = 4.6) and a higher hospital mortality (adjusted hazard ratio = 5.7) than their controls. LOS was increased by 8 days. For SEC patients, these figures were adjusted odds ratio = 1.9, adjusted hazard ratio = 2.0 and excess LOS = 3 days. A 2.5 times [95% confidence interval (95% CI) 0.9–6.8] increase in all-cause mortality at 30 days and a 2.9 times (95% CI 1.2–6.9) increase in mortality during entire hospital stay as well as an excess LOS of 5 days (95% CI 0.4–10.2) could be attributed to resistance to third-generation cephalosporins in E. coli BSI. Conclusions Morbidity and mortality attributable to third-generation-cephalosporin-resistant E. coli BSI is significant. If prevailing resistance trends continue, high societal and economic costs can be expected. Better management of infections caused by resistant E. coli is becoming essential. [ABSTRACT FROM PUBLISHER]

A predominant problem in the US as well as in Europe is the imminent capacity shortage of major hub airports: Air traffic is assumed to increase significantly worldwide, while further runway extensions of airports are difficult because of residents' resistance and limited land space availability. However, the increasing market size also provides a potential for new aircraft concepts. What type of aircraft will meet best the future market requirements is a question arising. We show that currently discussed solutions to airport capacity problems are mostly not in line with market requirements and have therefore not the potential to alleviate the increasing capacity problems. We analyse to what extend an aeroplane with extreme short takeoff and landing (ESTOL) capability might be able to overcome these capacity problems and discuss resulting technical requirements. Subsequently we present some of the current technological challenges in this area of research and give an overview on ESTOL regional jet concepts that are currently investigated at Bauhaus Luftfahrt. [ABSTRACT FROM AUTHOR]

Introduced species inevitably experience novel selection pressures in their new environments as a result of changes in mutualist and antagonist relationships. While most previous work has examined how escape from specialist enemies has influenced herbivore or pathogen resistance of exotic species, post-introduction shifts in exotic dependence on mutualists have not been considered. In a common environment, we compared dependence on AM fungi of North American and European populations of Hypericum perforatum (St. John's Wort), a forb native to Europe. Introduced North American populations responded less to inoculation with AM fungi than did European populations. Root architecture was strongly correlated with mycorrhizal response, and introduced populations had finer root architecture than native populations. Finally, introduced populations exhibited decreased root and increased reproductive allocation relative to European populations, consistent with a transition to a weedier life history; however, biomass allocation patterns were uncorrelated with mycorrhizal response. These findings are the first demonstration of a genetically based reduction of mycorrhizal dependence and shift in root architecture in an introduced species. [ABSTRACT FROM AUTHOR]

Background: Forest management in Europe is committed to sustainability. In the face of climate change and accompanying risks, however, planning in order to achieve this aim becomes increasingly challenging, underlining the need for new and innovative methods. Models potentially integrate a wide range of system knowledge and present scenarios of variables important for any management decision. In the past, however, model development has mainly focused on specific purposes whereas today we are increasingly aware of the need for the whole range of information that can be provided by models. It is therefore assumed helpful to review the various approaches that are available for specific tasks and to discuss how they can be used for future management strategies. [ABSTRACT FROM PUBLISHER]

Investigates the sources, sinks and distribution patterns of volatile halogenated organic compounds (VHOC) in European estuaries. Correlation coefficients between selected VHOC; Comparison of international water quality requirements for selected VHOC; Salinity profiles.

Analyzes the methane concentrations along the salinity profiles in nine tidal estuaries in Europe. Surface water concentrations; Global estuarine flux of methane to the atmosphere; Median water-air methane gradient.

• Extended-spectrum beta-lactamase and carbapenem-resistant phenotypes significantly increased for Klebsiella pneumoniae • Carbapenem-resistant rates for Pseudomonas aeruginosa significantly increased from 2004–2012 to 2013–2018 • The highest carbapenem resistance was noted for Acinetobacter baumannii in 2013–2018 (32.3%) • Resistance rates for most organism groups were lowest in North-Western Europe Data on antimicrobial resistance (AMR) in the paediatric patient population are scarce. This study assessed the AMR rates and phenotype distribution of Gram-negative isolates in paediatric patients in Europe from 2004–2012 and 2013–2018. Isolates that were collected were stratified by age groups (< 1, 1–5, 6–12, and 13–17 years) and regions (North-Western, Eastern and Southern Europe). Minimal inhibitory concentrations (broth microdilution) were interpreted according to European Committee on Antimicrobial Susceptibility Testing guidelines. Resistance rates and phenotype prevalence were identified for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii, Pseudomonas aeruginosa , and Haemophilus influenzae. In the overall paediatric patient population (0–17 years), extended-spectrum beta-lactamase (ESBL) production significantly decreased (from 20.7% to 15.4%, P < 0.0001) in Escherichia coli , whereas it increased for Klebsiella pneumoniae (from 35.0% to 39.2%, P = 0.015). Carbapenem resistance was highest for Acinetobacter baumannii (32.3%) compared with Klebsiella pneumoniae (4.7%) and Pseudomonas aeruginosa (12.4%) in 2013–2018, and rates were significantly increased relative to 2004–2012. There was no change in resistance to beta-lactam antimicrobials for Haemophilus influenzae. The lowest resistance rates for most organism groups were observed in North-Western Europe. The results revealed a significant increase in Klebsiella pneumoniae isolates with an ESBL and carbapenem-resistance phenotype as well as in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa from 2004–2012 to 2013–2018. Conversely, a decrease in ESBL E. coli was observed. Continued surveillance and awareness of resistance in these bacteria causing serious infections is crucial for improving treatment quality in paediatric patients. [ABSTRACT FROM AUTHOR]

It is frequently asserted that there is a link between the nature of training provision within an organization and its success or failure. Within this approach is an assumption that training is simply a neutral tool to be applied to the benefit of all. This article challenges this approach, arguing that training is an issue that may be the subject of disagreement and conflict. Using evidence gained from managers and trade union representatives in health care services in France, Finland and the UK, it is argued that all aspects of training provision are best handled through traditional collective bargaining procedures. This suggests that there is a need to provide training for managers and union representatives to enable them to understand both tr aining issues and collective bargaining procedures. [ABSTRACT FROM AUTHOR]

Analyzes the temperature dependent development of spruce bark beetle Ips typographus in Europe. Development of the beetle by sandwich method; Calculation of lower developmental thresholds; Average days of adult development.

Focuses on the issues of medicine in Europe. Safety of medical electrical equipment; Treatment of tuberculosis; Contribution of poor blood pressure control to stroke.

• 21 850 Enterobacterales and 6156 Pseudomonas aeruginosa isolates from Europe, 2015–2017, were examined • 99.0% of Enterobacterales isolates were susceptible to ceftazidime-avibactam • 92.3% of Pseudomonas aeruginosa isolates were susceptible to ceftazidime-avibactam Between 2015–2017, 21 850 Enterobacterales isolates and 6156 Pseudomonas aeruginosa (P. aeruginosa) isolates were collected by 77 centers in 18 European countries as part of the International Network for Optimal Resistance Monitoring (INFORM) study (which was included into the Antimicrobial Testing Leadership and Surveillance [ATLAS] study in 2018). A central reference laboratory performed antimicrobial susceptibility testing using broth microdilution panels according to Clinical and Laboratory Standards Institute guidelines. The presence of β-lactamases was confirmed using multiplex PCR assays. Among Enterobacterales isolates, the highest rates of susceptibility were to ceftazidime-avibactam (99.0%; MIC 90 0.5 mg/L), meropenem (96.3%), amikacin (95.2%), and imipenem (92.8%). All Enterobacterales organisms were highly susceptible to colistin (≥ 94.6%), apart from Proteus mirabilis , which is intrinsically resistant to colistin. Susceptibility rates among ceftazidime-resistant isolates were 95.7% for ceftazidime-avibactam and 87.9% for colistin, and 78.5% and 71.1%, respectively, among carbapenemase-positive isolates. Colistin was the only agent with activity against metallo-β-lactamases (100% susceptibility) among Enterobacterales and P. aeruginosa isolates. Overall susceptibility rates among P. aeruginosa were highest to colistin (99.5%) and ceftazidime-avibactam (92.3%), and were similar to ceftazidime-resistant isolates for colistin (98.9%) and reduced to 66.2% for ceftazidime-avibactam. Susceptibility rates among multidrug-resistant P. aeruginosa isolates were 98.9% to colistin and 71.7% to ceftazidime-avibactam. Clinical isolates of Enterobacterales and P. aeruginosa collected from Europe, between 2015–2017, were highly susceptible to ceftazidime-avibactam, suggesting it is a useful alternative agent for patients whose treatment options may be limited. Persistent antimicrobial resistance requires continued surveillance and monitoring. [ABSTRACT FROM AUTHOR]

• Geological overview about Germany's largest known magmatic sulfide occurrence. • New geochronogical data for Devonian magmatism in the Northern Bohemian Massif. • Thermomechanical erosion of granodioritic wall-rock led to formation of sulfide-matrix breccias. • Ni-Cu exploration potential for Devonian gabbroic intrusions in Central Europe. Germany's largest known magmatic Ni-Cu-(PGE) sulfide enrichment is associated with the gabbroic Angstberg intrusion that is one of several small-scaled, Ni-Cu sulfide-bearing intrusions in the northern Bohemian Massif (Central European Variscan Belt). The intrusions are part of a Middle Devonian to Early Carboniferous, mafic-(ultramafic) magmatic system that emplaced within Cadomian granodiorites of the Lausitz Block. The Angstberg intrusion represents an exposed sub-vertical, dike-like body (320 × 60 m in plan view) and comprises olivine-gabbronorite, olivine-gabbro, gabbro, olivine-hornblende-gabbro, and hornblende-pyroxene-gabbro. The hornblende-bearing and hornblende-free lithologies originate from at least two variably fractionated basaltic parental magma batches which differ in their Ti, LREE, HREE and volatile contents. Fractionation probably took place in deeper-seated sections of the magmatic system, possibly within staging magma chamber(s). Overall enriched incompatible trace-element patterns suggest that the Angstberg lithologies are linked with intra-plate magmatism, likely associated with a transtensional setting in the course of the Variscan orogeny. The previously suggested Devonian age of the intrusion is confirmed by an 40Ar-39Ar biotite age of 373.4 ± 0.9 Ma for the olivine-gabbro. The magmatic sulfide mineralization is predominated by disseminated sulfides that are hosted in the olivine-richest parts of the olivine-gabbronorite and olivine-hornblende-gabbro lithologies. In addition, some sulfide-matrix breccias (up to 70 modal % sulfides) occur directly on the footwall contact of the intrusion to granodiorite. Both mineralization types are characterized by a predominance of pyrrhotite over pentlandite and chalcopyrite with minor secondary violarite and pyrite, and accessory PGE, Au, and Ag phases. Nickel-rich bismuthotellurides of the melonite–merenskyite solid-solution series and froodite are the most common platinum-group minerals. Disseminated sulfides are characterized by high Ni, moderate Cu, and low Pt and Pd tenors (∼4–9 wt% Ni, ∼2–6 wt% Cu, ∼200–800 ppb Pt, ∼200–1000 ppb Pd). Sulfide-matrix breccias feature comparable Ni, but lower Cu, Pt and Pd tenors (∼4–6 wt% Ni, ∼0.3–1 wt% Cu, ∼10–100 ppb Pt, ∼40–200 ppb Pd). Fractional crystallization and wall-rock assimilation of granodiorite are regarded as key factors for sulfide saturation in the magmas associated with the Angstberg intrusion. Sulfur isotope compositions of pyrrhotite-pentlandite-chalcopyrite assemblages (−1.4 to −0.2‰ VCDT) propose a mantle-origin of S, whereas addition of crustal S cannot be completely ruled out as the S isotope values of the sulfides overlap with those of the granodiorite (−7 to +4‰ VCDT). Olivine- and sulfide-textures suggest that disseminated sulfides likely originate from sulfide melts that were entrained in an olivine-rich crystal mush during magma rise to upper levels. The sulfide-matrix breccias also resulted from entrained sulfide melts, or from gravity-driven downward percolation of sulfide melts from stratigraphically higher, now-eroded levels. In both cases, the formation of sulfide-matrix breccias most likely was amplified by in-situ thermomechanical erosion of the granodioritic wall-rock, caused by flash-boiling of thermally dehydrating biotite. Despite spatial limitations of the mineralized zones and limited information about the architecture of the intrusions in the northern Bohemian Massif, the Angstberg intrusion, as well as other neighboring magmatic sulfide occurrences, may represent a new exploration target for Ni and Cu in Central Europe. [ABSTRACT FROM AUTHOR]

Abstract: Background: The aims of this study were: (1) to explore differences in primary care physicians'' self-perception of care provided for patients with cardiovascular diseases in Central and Eastern European countries; (2) to analyse the relationship between physicians'' characteristics and self-perceived care. Methods: A cross-sectional survey of 3000 primary care physicians randomly chosen from relevant registers in nine European countries was performed. Data were collected via anonymous questionnaire dedicated to care provided for patients with cardiovascular diseases. Results: Direct access to the basic additional tests essential in cardiovascular disease management was declared to be high. Considerable differences were found in the access to examinations requiring ultrasound techniques (p<0.01). For global risk assessment 68.2% of physicians reported the use of the Systematic Coronary Risk Evaluation and 33.8% the Framingham model (p<0.01). Nearly all physicians felt responsible for pharmacotherapy of hypertension but there were major differences related to treatment of diabetes mellitus type 2 and dyslipidemia. Relatively low numbers of family physicians/general practitioners would be prepared to start lipid lowering therapy with fibrates (12.5% in Estonia and 92.8% in Poland; p<0.01). Only a weak relationship was found between characteristics of physicians and their self-perceived performance. Conclusions: Primary care physicians from Central and Eastern Europe accept their responsibility for care of patients with cardiovascular diseases and declare good access to basic additional examinations. Differences in treatment of diabetes mellitus and dyslipidemia cannot be explained by the characteristics of physicians and the explanation probably lies with other factors such as organisational or financial ones. [Copyright &y& Elsevier]

Background: Antivirals are infrequently prescribed in European primary care for influenza-like illness, mostly because of perceived ineffectiveness in real world primary care and because individuals who will especially benefit have not been identified in independent trials. We aimed to determine whether adding antiviral treatment to usual primary care for patients with influenza-like illness reduces time to recovery overall and in key subgroups.Methods: We did an open-label, pragmatic, adaptive, randomised controlled trial of adding oseltamivir to usual care in patients aged 1 year and older presenting with influenza-like illness in primary care. The primary endpoint was time to recovery, defined as return to usual activities, with fever, headache, and muscle ache minor or absent. The trial was designed and powered to assess oseltamivir benefit overall and in 36 prespecified subgroups defined by age, comorbidity, previous symptom duration, and symptom severity, using a Bayesian piece-wise exponential primary analysis model. The trial is registered with the ISRCTN Registry, number ISRCTN 27908921.Findings: Between Jan 15, 2016, and April 12, 2018, we recruited 3266 participants in 15 European countries during three seasonal influenza seasons, allocated 1629 to usual care plus oseltamivir and 1637 to usual care, and ascertained the primary outcome in 1533 (94%) and 1526 (93%). 1590 (52%) of 3059 participants had PCR-confirmed influenza infection. Time to recovery was shorter in participants randomly assigned to oseltamivir (hazard ratio 1·29, 95% Bayesian credible interval [BCrI] 1·20-1·39) overall and in 30 of the 36 prespecified subgroups, with estimated hazard ratios ranging from 1·13 to 1·72. The estimated absolute mean benefit from oseltamivir was 1·02 days (95% [BCrI] 0·74-1·31) overall, and in the prespecified subgroups, ranged from 0·70 (95% BCrI 0·30-1·20) in patients younger than 12 years, with less severe symptoms, no comorbidities, and shorter previous illness duration to 3·20 (95% BCrI 1·00-5·50) in patients aged 65 years or older who had more severe illness, comorbidities, and longer previous illness duration. Regarding harms, an increased burden of vomiting or nausea was observed in the oseltamivir group.Interpretation: Primary care patients with influenza-like illness treated with oseltamivir recovered one day sooner on average than those managed by usual care alone. Older, sicker patients with comorbidities and longer previous symptom duration recovered 2-3 days sooner.Funding: European Commission's Seventh Framework Programme. [ABSTRACT FROM AUTHOR]

Extending from Northern America to Central China the Variscan belt is a Paleozoic Orogen exceptionally well endowed in magmatic-hydrothermal ore deposits, including skarn deposits. Yet, the genesis of fertile skarns and their distinction from barren equivalents in orogenic zones is only poorly constrained. Here, we present innovative U-Pb laser-ablation inductively-coupled-plasma mass-spectrometry geochronology of garnet from different skarns in the Erzgebirge, a classic metallogenic province in central Europe. Garnet ages obtained not only constrain the timing of fertile skarn formation and associated Sn, W, Fe, Zn, Cu and In mineralization, but also clearly distinguish these from barren skarn bodies. We show that barren skarns formed during times of peak regional metamorphism at ∼340 Ma whereas mineralized skarns are temporally associated with late-orogenic magmatism at ∼325-313 Ma as well as post-orogenic magmatism at ∼308-295 Ma. The recognition of discrete mineralization events associated with the largest and economically most important skarn deposits provides valuable insight into the punctuated evolution of magmatic-hydrothermal systems in ancient collisional orogens on a regional scale; this has important implications to direct future mineral exploration. • Origin and genesis of skarns in orogenic zones. • Geodynamic evolution of hydrothermal mineral systems in orogenic belts. • Innovative U-Pb LA-ICP-MS geochronology of garnet. • Implications for exploration targeting. [ABSTRACT FROM AUTHOR]

Abstract Variations in building activity reflect demographic, economic and social change during history. Tens of thousands of wooden constructions in Europe have been dendrochronologically dated in recent decades. We use the annually precise evidence from a unique dataset of 49 640 tree felling dates of historical constructions to reconstruct temporal changes in building activity between 1250 and 1699 CE across a large part of western and central Europe largely corresponding to the former Holy Roman Empire of the German Nation. Comparison with annual records of 9772 plague outbreaks shows that construction activity was significantly negatively correlated to the number of plague outbreaks, with the greatest decrease in construction following the larger outbreaks by three to four years after the start of the epidemics. Preceding the Black Death (1346–1353 CE) by five decades and the Great Famine (1315–1322 CE) by two decades, a significant decline in construction activity at c. 1300 CE is indicative of a societal crisis, associated with population stagnation or decline. Another dramatic decline in building activity coincides with the Thirty Years' War (1618–1648 CE) and confirms the devastating nature of this conflict. While construction activity was significantly lower during periods of high grain prices, no statistically robust relationship between the number of felling dates and past temperature or hydroclimate variations is found. This study demonstrates the value of dendrochronological felling dates as an indicator for times of crisis and prosperity during periods when documentary evidence is limited. Highlights • Reconstructing European building activity 1250–1699 CE from 49 640 tree felling dates. • Lower building activity coincided with more plague outbreaks and higher grain prices. • Reduced building activity during the Late Medieval Crisis (c. 1300–1415 CE). • Unprecedented decline in European building activity during the Thirty Years' War. [ABSTRACT FROM AUTHOR]

Recent clinical isolates of key Gram-negative and Gram-positive bacteria were collected in 2012 from hospitalised patients in medical centres in four European countries (France, Germany, Italy and Spain) and were tested using standard broth microdilution methodology to assess the impact of 4 mg/L avibactam on the in vitro activities of ceftazidime, ceftaroline and aztreonam. Against Enterobacteriaceae, addition of avibactam significantly enhanced the level of activity of these antimicrobials. MIC 90 values (minimum inhibitory concentration that inhibits 90% of the isolates) of ceftazidime, ceftaroline and aztreonam for Escherichia coli , Klebsiella pneumoniae , Enterobacter cloacae , Enterobacter aerogenes , Citrobacter freundii and Morganella morganii were reduced up to 128-fold or greater when combined with avibactam. A two-fold reduction in the MIC 90 of ceftazidime to 8 mg/L was noted in Pseudomonas aeruginosa isolates when combined with avibactam, whereas little effect of avibactam was noted on the MIC values of the test compounds when tested against Acinetobacter baumannii isolates. Avibactam had little effect on the excellent activity of ceftazidime, ceftaroline and aztreonam against Haemophilus influenzae. It had no impact on the in vitro activity of ceftazidime and ceftaroline against staphylococci and streptococci. This study demonstrates that addition of avibactam enhances the activities of ceftazidime, ceftaroline and aztreonam against Enterobacteriaceae and P. aeruginosa but not against A. baumannii. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18: 413-431 Abstract Plasmid-acquired carbapenemases in Enterobacteriaceae, which were first discovered in Europe in the 1990s, are now increasingly being identified at an alarming rate. Although their hydrolysis spectrum may vary, they hydrolyse most β-lactams, including carbapenems. They are mostly of the KPC, VIM, NDM and OXA-48 types. Their prevalence in Europe as reported in 2011 varies significantly from high (Greece and Italy) to low (Nordic countries). The types of carbapenemase vary among countries, partially depending on the cultural/population exchange relationship between the European countries and the possible reservoirs of each carbapenemase. Carbapenemase producers are mainly identified among Klebsiella pneumoniae and Escherichia coli, and still mostly in hospital settings and rarely in the community. Although important nosocomial outbreaks with carbapenemase-producing Enterobacteriaceae have been extensively reported, many new cases are still related to importation from a foreign country. Rapid identification of colonized or infected patients and screening of carriers is possible, and will probably be effective for prevention of a scenario of endemicity, as now reported for extended-spectrum β-lactamase (mainly CTX-M) producers in all European countries. [ABSTRACT FROM AUTHOR]