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The Seine estuary is a typical model of a system in which phosphorus (P) inputs have been considerably reduced to reduce past eutrophication, with a parallel decrease in phytoplankton biomass. However, reducing P alone while concentrations of nitrate (N) remains high led to a dystrophic nutrient balance in the estuary (high N/P and N/Si). To identify the drivers of primary production and phytoplankton communities in the highly anthropised Seine estuary, sampling was performed along a 110-km stretch over a period of 3 years. Photosynthetic parameters were measured with a single turnover active fluorimeter and the phytoplankton community was assessed using a fluoroprobe and flow cytometry. The results revealed an annual primary production of 33 g C.m−2.y−1 which was largely controlled by light availability (turbidity) but also by nutrients in late spring and summer period. Massive blooms, not seen since 2002, were observed in a specific area of the estuary. None of the nutrients measured explained the particular location of the blooms but phytoplankton production and productivity indicators were higher in this specific zone excluding a biomass accumulation phenomenon. The local effect of tide slowdown increasing water residence time in this exact part of the estuary could explain the bloom area. The question thus arises: does phosphate play a role as a limiting nutrient? The diatom bloom led to total depletion of Si, but no clear limitation of P was observed. Nevertheless, the decrease in Si appears to have played a key role by triggering a succession from diatoms (microphytoplankton) to chlorophytes (nanophytoplankton) and hence affecting phytoplankton composition. The N/P balance appeared to be more important than the absolute concentration of P to explain the phytoplankton dynamics and the biomass decrease observed the last decades.

IntroductionWhile crucial to ensuring the production of accurate and high-quality data—and to avoid erroneous conclusions—data quality control (QC) in environmental monitoring datasets is still poorly documented.MethodsWith a focus on annual inter-laboratory comparison (ILC) exercises performed in the context of the French coastal monitoring SOMLIT network, we share here a pragmatic approach to QC, which allows the calculation of systematic and random errors, measurement uncertainty, and individual performance. After an overview of the different QC actions applied to fulfill requirements for quality and competence, we report equipment, accommodation, design of the ILC exercises, and statistical methodology specially adapted to small environmental networks (

The photoautotrophic, unicellular N2-fixer, Cyanothece, is a model organism that has been widely used to study photosynthesis regulation, the structure of photosystems, and the temporal segregation of carbon (C) and nitrogen (N) fixation in light and dark phases of the diel cycle. Here, we present a simple quantitative model and experimental data that together, suggest external dissolved inorganic carbon (DIC) concentration as a major limiting factor for Cyanothece growth, due to its high C-storage requirement. Using experimental data from a parallel laboratory study as a basis, we show that after the onset of the light period, DIC was rapidly consumed by photosynthesis, leading to a sharp drop in the rate of photosynthesis and C accumulation. In N2-fixing cultures, high rates of photosynthesis in the morning enabled rapid conversion of DIC to intracellular C storage, hastening DIC consumption to levels that limited further uptake. The N2-fixing condition allows only a small fraction of fixed C for cellular growth since a large fraction was reserved in storage to fuel night-time N2 fixation. Our model provides a framework for resolving DIC limitation in aquatic ecosystem simulations, where DIC as a growth-limiting factor has rarely been considered, and importantly emphasizes the effect of intracellular C allocation on growth rate that varies depending on the growth environment.

Considering the reported significant diazotrophic activities in open-ocean regions where primary production is strongly limited by phosphate, we explored the ability of diazotrophs to use other sources of phosphorus to alleviate the phosphate depletion. We tested the actual efficiency of the open-ocean, N2-fixer Crocosphaera watsonii to grow on organic phosphorus as the sole P source, and observed how the P source affects the cellular C, N, and P composition. We obtained equivalent growth efficiencies on AMP and DL-α-glycerophosphate as compared with identical cultures grown on phosphate, and survival of the population on phytic acid. Our results show that Crocosphaera cannot use all phosphomonoesters with the same efficiency, but it can grow without phosphate, provided that usable DOP and sufficient light energy are available. Also, results point out that organic phosphorus uptake is not proportional to alkaline phosphatase activity, demonstrating that the latter is not a suitable proxy to estimate DOP-based growth yields of organisms, whether in culture experiments or in the natural environment. The growth parameters obtained, as a function of the P source, will be critical to improve and calibrate mathematical models of diazotrophic growth and the distribution of nitrogen fixation in the global ocean.

Artificial Reefs (AR) show a wide diversity and vary in their construction materials, shape and purpose, as illustrated by the present analysis of 127 scientific papers. AR have been deployed for different purposes, including fisheries improvement, ecological restoration of marine habitats, coastal protection or purely scientific research. Statistical analyses using 67 variables allow us to characterize the design, objectives and monitoring strategies used for AR. An effectiveness indicator comprised of three categories (low, moderate and high) was adapted from previous studies and applied to the present dataset in terms of the objectives defined in each scientific paper. The effectiveness of various monitoring approaches was investigated and recommendations were formulated regarding environmental parameters and the assessment of ecological processes as a function of AR type. These analyses showed that inert materials like concrete associated with biomimetic designs increase the benefits of reefs to the local environment. This study also compared effectiveness between the different economic, ecological or scientific objectives of AR projects and reveals that fisheries projects showed the highest efficiencies but points out the weakness of environmental assessments for this type of project. In conclusion, the analyses presented here highlight the need to use a panel of complementary monitoring techniques, independently of the initial purpose of the artificial structures, to properly assess the impact of such structures on the local environment. It is recommended to adopt approaches that associate structural and functional ecology. An improved characterization of the role of AR should be integrated into future assessments, taking into account the complex framework of ecosystem structure and trophic relationships.

Background The first pillar of the UNAIDS 90-90-90 goal seeks to accurately identify persons living with HIV (PLHIV), a process that is predicated on facilities having the necessary HIV tests available to perform the task. In many rural settings, the identification of PLHIV is accomplished through a two-step process involving the sequential use of 2 separate rapid diagnostic tests (RDTs). Inadequate inventory of either test has ramifications for the success of HIV-related programs. The purpose of this study was to evaluate the inventory levels of HIV RDT kits at specific healthcare facilities in Zambézia province, Mozambique. Methods Using facility-level pharmacy stock surveillance data from October 2015 through September 2016, we assessed the inventory levels of HIV RDTs at 75 health facilities in 8 districts within Zambézia province, Mozambique. Using programmatically established categories (good, sufficient, threatened, or stockout), defined in conjunction with the provincial health authorities, descriptive statistics were performed to determine inventory control of HIV RDTs at the district and health facility levels. Monthly proportions of adequate (good + sufficient) inventory were calculated for each district to identify inventory trends over the evaluation period. To assess whether the proportion of inadequate stocks differed between RDT, a mixed-effects logistic regression was conducted, with inadequate inventory status as the outcome of interest. Results When viewed as a whole, the inventory of each test kit was reported as being at adequate levels more than 89% of the time across the 75 facilities. However, disaggregated analysis revealed significant variability in the inventory levels of HIV RDTs at the district level. Specifically, the districts of Inhassunge, Namacurra, and Pebane reported inadequate inventory levels (threatened + stockout), of one or both test kits, for more than 10% of the study period. In addition, a disparity between inventory levels of each test kit was identified, with the odds of reporting inadequate inventory levels of the confirmatory test (Uni-Gold™) being approximately 1.8-fold greater than the initial test (Determine™) (odds ratio: 1.82, 95% CI: 1.40-2.38). Conclusion As Test and Treat programs evolve, a significant emphasis should be placed on the “test” component of the strategy, beginning with assurances that health facilities have the adequate inventory of RDT necessary to meet the needs of their community. As national policy-makers rely predominantly on data from the upstream arm of the supply chain, it is unlikely the disparity between inventory levels of HIV RDTs identified at individual districts and specific health facilities would have been recognized. Moving forward, our findings point to a need for (1) renewed efforts reinforcing appropriate downstream forecasting of essential medicines and diagnostic tests in general and for Uni-Gold™ test kits specifically, and (2) simple metrics that may be routinely collected at all health facilities and which may then easily and quickly flow upstream so that policy-makers may optimally allocate resources.

Marine diazotrophs are a diverse group with key roles in biogeochemical fluxes linked to primary productivity. The unicellular, diazotrophic cyanobacterium Cyanothece is widely found in coastal, subtropical oceans. We analyze the consequences of diazotrophy on growth efficiency, compared to NO3–-supported growth in Cyanothece, to understand how cells cope with N2-fixation when they also have to face carbon limitation, which may transiently affect populations in coastal environments or during blooms of phytoplankton communities. When grown in obligate diazotrophy, cells face the double burden of a more ATP-demanding N-acquisition mode and additional metabolic losses imposed by the transient storage of reducing potential as carbohydrate, compared to a hypothetical N2 assimilation directly driven by photosynthetic electron transport. Further, this energetic burden imposed by N2-fixation could not be alleviated, despite the high irradiance level within the cultures, because photosynthesis was limited by the availability of dissolved inorganic carbon (DIC), and possibly by a constrained capacity for carbon storage. DIC limitation exacerbates the costs on growth imposed by nitrogen fixation. Therefore, the competitive efficiency of diazotrophs could be hindered in areas with insufficient renewal of dissolved gases and/or with intense phytoplankton biomass that both decrease available light energy and draw the DIC level down.

Unicellular nitrogen fixing cyanobacteria (UCYN) are abundant members of phytoplankton communities in a wide range of marine environments, including those with rapidly changing nitrogen (N) concentrations. We hypothesized that differences in N availability (N2 vs. combined N) would cause UCYN to shift strategies of intracellular N and C allocation. We used transmission electron microscopy and nanoscale secondary ion mass spectrometry imaging to track assimilation and intracellular allocation of 13C-labeled CO2 and 15N-labeled N2 or NO3 at different periods across a diel cycle in Cyanothece sp. ATCC 51142. We present new ideas on interpreting these imaging data, including the influences of pre-incubation cellular C and N contents and turnover rates of inclusion bodies. Within cultures growing diazotrophically, distinct subpopulations were detected that fixed N2 at night or in the morning. Additional significant within-population heterogeneity was likely caused by differences in the relative amounts of N assimilated into cyanophycin from sources external and internal to the cells. Whether growing on N2 or NO3, cells prioritized cyanophycin synthesis when N assimilation rates were highest. N assimilation in cells growing on NO3 switched from cyanophycin synthesis to protein synthesis, suggesting that once a cyanophycin quota is met, it is bypassed in favor of protein synthesis. Growth on NO3 also revealed that at night, there is a very low level of CO2 assimilation into polysaccharides simultaneous with their catabolism for protein synthesis. This study revealed multiple, detailed mechanisms underlying C and N management in Cyanothece that facilitate its success in dynamic aquatic environments.

BackgroundThere are few studies that characterize sex-related differences in HIV outcomes among adolescents and young adults (AYA) 15-24 years of age.MethodsWe conducted a retrospective cohort study among AYA who enrolled in a comprehensive HIV program in Mozambique between 2012-2016. We assessed patients by sex and pregnancy/lactation status, comparing time to combination antiretroviral therapy (ART) initiation using Cox proportional hazard models. We employed multivariable logistic regression to investigate pre- and post-ART retention. Patients were defined as 'retained pre-ART' if they attended at least 3 of 4 required visits or started ART in the 6 months after enrollment, and 'retained post-ART' if they had any ART pickup or clinical visit during the last 90 days of the one-year follow-up period.ResultsOf 47,702 patients in the cohort, 81% (n = 38,511) were female and 19% (n = 9,191) were male. Of the females, 57% (n = 21,770) were non-pregnant and non-lactating (NPNL) and 43% (n = 16,741) were pregnant or lactating (PL). PL (aHR 2.64, 95%CI:2.47-2.81) and NPNL females (aHR 1.36, 95%CI:1.30-1.42) were more likely to initiate ART than males. PL females had higher odds of pre-ART retention in care (aOR 3.56, 95%CI: 3.30-3.84), as did NPNL females (aOR 1.71, 95%CI: 1.62-1.81), compared to males. This was also true for retention post-ART initiation, with higher odds for both PL (aOR 1.78, 95%CI:1.63-1.94) and NPNL females (aOR 1.50, 95%CI:1.35-1.65) compared to males.ConclusionsPL females were most likely to initiate ART and remain in care post-ART in this AYA cohort, likely reflecting expansion of Option B+. Despite pregnancy and policy driven factors, we observed important sex-related disparities in this cohort. NPNL females were more likely to initiate ART and be retained in care before and after ART initiation than males. These data suggest that young males need targeted interventions to improve these important care continuum outcomes.

Understanding the dynamics of microphytobenthos biomass and photosynthetic performances in intertidal ecosystems will help advance our understanding of how trophic networks function in order to optimize ecological management and restoration projects. The main objective of this study was to investigate microphytobenthic biomass and photosynthetic performances as a function of the sedimentary and environmental variabilities in the range of intertidal habitats in the downstream Seine estuary (Normandy, France). Our results highlight higher biomass associated with more stratified biofilms and better photosynthetic performances in areas characterized by a sand/mud mixture (40-60% of mud) compared to pure sand or pure mud environments. This type of sediment probably offers an efficient trade-off between the favorable characteristics of the two types of sediments (sand and mud) with respect to light penetration and nutrient accessibility. Moreover, the large quantities of exopolysaccharides produced in sand/mud mixtures emphasizes the functional role played by microphytobenthos in promoting sediment stability against erosion. This allows us to show that despite the strong increase in sand content of the downstream Seine estuary, intertidal flats are still productive since microphytobenthic biomass, photosynthetic performances and exopolysaccharides secretion are highest in sand-mud mixtures. This study also underlines the impact of ecosystem modifications due to human disturbance and climate change on the dynamics of key primary producers in estuaries.

An experimental artificial structure was deployed in March 2014 on the intertidal zone of the Bay of Seine (eastern part of the English Channel), at intervals of one year until April 2018, i.e., from February 2015 onwards, two blocks were collected in April each year. This study provides an inventory of sessile and motile invertebrates living on the artificial hard-bottom and describes the stages of colonization and succession during the four-year study. A total of 84 taxa were identified including 13 sessile and 71 motile taxa. For the sessile fauna, only two taxa Balanus crenatus and Mytilus edulis had colonised the blocks in 2014, and the Taxonomic Richness (TR) was relatively stable during the next three years (between 8 and 10 taxa). The TR of the motile fauna showed an increase between 2014 (5 taxa) and 2015 (34 taxa), and then decreased from 54 taxa in 2017 to 29 taxa in 2018. The abundance of the sessile fauna was very high in 2014 due to the rapid settlement of the barnacle Balanus crenatus, which remained the dominant species throughout the study. Another barnacle Perforatus perforatus, the blue mussel Mytilus edulis and three ascidians including two non-indigenous species Perophora japonica and Corella eumyota, and Molgula sp. were also among the dominant taxa of the sessile fauna. In April 2014, the dominant motile taxa was the decapod Carcinus maenas juvenile, then in 2015 the fauna became dominated by pioneer taxa such as the amphipod of the genus Monocorophium and the tanaid Zeuxo holdichi. A reduction of mean abundance was observed in the last three years of the study, combined with diversification of the dominant species especially those of small size such as Peracarida. The study shows that the colonization of such blocks deployed on oyster tables in the intertidal zone is efficient to test the ability of building material to be colonized in this transition zone.

AIM:To assess the factors associated with lower rate of caesarean deliveries in the South of France, based on the characteristics and organisation of the region's 40 maternity facilities and the characteristics of the practitioners in these facilities. METHOD:A retrospective study from 1 January 2012 to 31 December 2015. Data were collected by the Mediterranean network and a declarative survey was completed by each maternity facility in the region to study factor which could be associated with lower caesarean rate by univariate and multivariate analysis. RESULTS:250 564 women gave birth during this period, of which 55 097 by caesarean section. The mean caesarean delivery rate over the four years was 22.0%. The rate was significantly higher in private maternity facilities [23.9% (21.9%- 25.8%), p

We conducted a microcosm experiment aimed at studying the interactive effects of high CO2, nutrient loading and irradiance on the metabolism of a planktonic community sampled in the Western Mediterranean near the coast of Málaga. Changes in the metabolism of phytoplankton and bacterioplankton were observed for 7 d under 8 treatment conditions, representing the full factorial combinations of 2 levels each of CO2, nutrient concentration and solar radiation exposure. The initial plankton sample was collected at the surface from a stratified water column, indicating that phytoplankton were naturally acclimated to high irradiance and low nutrient concentrations. Nutrient addition combined with high irradiance resulted in a significant increase in primary production. Nitrate uptake by phytoplankton was also stimulated under high nutrient conditions. High nutrients, high irradiance and the combination of low CO2 and high irradiance positively affected bacterial production. Light was the main factor affecting the respiration rates of the community, which were higher at the high light level. After 7 d of incubation, nutrient loading was the only factor that significantly affected the amount of particulate organic carbon (POC) accumulated in the microcosms. Therefore, the changes in metabolic rates produced at high CO2 had no effect on net production of particulate organic matter. If these results are extrapolated to the natural environment, it could be hypothesized that high levels of CO2 will have a limited impact on biological pump activity in the northern Alboran Sea since it is assumed that POC export towards deeper layers determines the potential for carbon sequestration.

Modelling studies and satellite retrievals do not agree on the amplitude and/or sign of the direct radiative perturbation from dust. Modelling studies have systematically overpredicted mineral dust absorption compared to estimates based upon satellite retrievals. In this paper we first point out the source of this discrepancy, which originates from the shortwave refractive index of dust used in models. The imaginary part of the refractive index retrieved from AERONET over the range 300 to 700 nm is 3 to 6 times smaller than that used previously to model dust. We attempt to constrain these refractive indices using a mineralogical database and varying the abundances of iron oxides (the main absorber in the visible). We first consider the optically active mineral constituents of dust and compute the refractive indices from internal and external mixtures of minerals with relative amounts encountered in parent soils. We then compute the radiative perturbation due to mineral aerosols for internally and externally mixed minerals for 3 different hematite contents, 0.9%, 1.5% and 2.7% by volume. These constant amounts of hematite allow bracketing the influence of dust aerosol when it is respectively an inefficient, standard and a very efficient absorber. These values represent low, central and high content of iron oxides in dust determined from the mineralogical database. Linke et al. (2006) determined independently that iron-oxides represent 1.0 to 2.5% by volume using x-Ray fluorescence on 4 different samples collected over Morocco and Egypt. Based upon values of the refractive index retrieved from AERONET, we show that the best agreement between 440 and 1020 nm occurs for mineral dust internally mixed with 1.5% volume weighted hematite. This representation of mineral dust allows us to compute, using a general circulation model, a new global estimate of mineral dust perturbation between –0.47 and –0.24 Wm−2 at the top of the atmosphere, and between –0.81 and –1.13 Wm−2 at the surface for both shortwave and longwave wavelengths. The anthropogenic dust fraction is thought to account for between 10 and 50% of the total dust load present in the atmosphere. We estimate a top of the atmosphere forcing between –0.03 and –0.25 Wm−2, which is markedly different that the IPCC range of –0.6 to +0.4 Wm−2 (IPCC, 2001). The 24-h average atmospheric heating by mineral dust during summer over the tropical Atlantic region (15° N–25° N; 45° W–15° W) is in the range +22 to +32 Wm−2 τ−1 which compares well with the 30±4 Wm−2 τ−1 measured by Li et al. (2004) over that same region. The refractive indices from Patterson et al. (1977) and from Volz (1973) overestimate by a factor of 2 the energy absorbed in the column during summer over the same region. This discrepancy is due to too large absorption in the visible but we could not determine if this is linked to the sample studied by Patterson et al. (1997) or to the method used in determining the refractive index.

Two methods of measuring primary production, modulated fluorimetry (PAM) and the traditional carbon incorporation method ((13)C), were compared in four phytoplankton species, two diatoms (Pseudo-nitzschia pungens and Asterionellopsis glacialis), and two dinoflagellates (Heterocapsa sp and Karenia mikimotoï), under N (nitrogen), P (phosphorus) and Si (silicon) limited semi-continuous culture. N and Si-limited cultures showed relatively high quantum efficiency of the PSII (Fv/Fm) values, confirming that Fv/Fm is not a good proxy for nutrient stress in balanced systems, whereas P limitation had a drastic effect on many physiological parameters. In all species, the physiological capacity of phytoplankton cells to acclimate to nutrient limitations led to changes in the cellular biochemical composition and the structure of the photosynthetic apparatus. The observed physiological responses were species and nutrient specific. The values of the chlorophyll-specific absorption cross section (a*) increased with nutrient limitation due to package effect, while the carbon/Chl a ratio was higher under N and P limitations. In diatoms, Si limitation did not affect photosynthesis confirming the uncoupling between Si and carbon metabolisms. In all four species and under all treatments, significant relationships were found between photosynthetic activities, ETR(Chl) (electron transport rate) and P(Chl) (carbon fixation rate) estimated using PAM measurements and (13)C incorporation, showing that the fluorescence technique can reliably be used to estimate carbon fixation by phytoplankton. The relationship between ETR(Chl) and P(Chl) can be described by the shape and the slope of the curve (ΦC.e). Linear relationships were found for dinoflagellates and P. pungens under all treatments. A decrease in ΦC.e was observed under N and P limitation probably due to structural damage to the photosynthetic apparatus. A. glacialis showed a logarithmic relationship in N and P limited conditions, due to the alternative electron flow which takes place to optimise photosynthetic performances under high light and/or nutrient stress.

Primary production (PP) in the English Channel was measured using (13)C uptake and compared to the electron transport rate (ETR) measured using PAM (pulse amplitude modulated fluorometer). The relationship between carbon incorporation (P(obs)) and ETR was not linear but logarithmic. This result can be explained by alternative electron sinks at high irradiance which protect the phytoplankton from photoinhibition. A multi-parametric model was developed to estimate PP by ETR. This approach highlighted the importance of taking physicochemical parameters like incident light and nutrient concentrations into account. The variation in the ETR/P(obs) ratio as a function of the light revealed different trends which were characterized by three parameters (R(max), the maximum value of ETR/P(obs); E(Rmax), the light intensity at which R(max) is measured; γ the initial slope of the curve). Based on the values of these three parameters, data were divided into six groups which were highly dependent on the seasons and on the physicochemical conditions. Using the multi-parametric model which we defined by P(obs) and ETR measurements at low frequencies, the high frequency measurements of ETR enabled us to estimate the primary production capacity between November 2009 and December 2010 at high temporal and spatial scales.

Before the 2015 implementation of "Test and Start," the initiation of combination antiretroviral therapy (ART) was guided by specific CD4 cell count thresholds. As scale-up efforts progress, the prevalence of advanced HIV disease at ART initiation is expected to decline. We analyzed the temporal trends in the median CD4 cell counts among adults initiating ART and described factors associated with initiating ART with severe immunodeficiency in Zambézia Province, Mozambique. We included all HIV-positive, treatment-naive adults (age ≥ 15 years) who initiated ART at a Friends in Global Health (FGH)-supported health facility between September 2012 and September 2017. Quantile regression and multivariable logistic regression models were applied to ascertain the median change in CD4 cell count and odds of initiating ART with severe immunodeficiency, respectively. A total of 68,332 patients were included in the analyses. The median change in CD4 cell count under "Test and Start" was higher at +68 cells/mm3 (95% CI: 57.5–78.4) compared with older policies. Younger age and female sex (particularly those pregnant/lactating) were associated with higher median CD4 cell counts at ART initiation. Male sex, advanced age, WHO Stage 4 disease, and referrals to the health facility through inpatient provider-initiated testing and counseling (PITC) were associated with higher odds of initiating ART with severe immunodeficiency. Although there were reassuring trends in increasing median CD4 cell counts with ART initiation, ongoing efforts are needed that target universal HIV testing to ensure the early initiation of ART in men and older patients. [ABSTRACT FROM AUTHOR]

δ 15 N of annual ( Ulva sp., Porphyra sp.) and perennial intertidal seaweed species ( Chondrus crispus , Fucus sp.) collected on 17 sampling points along the French coast of the English Channel in 2012 and 2013 were assessed on their suitability as bioindicators of N pollution in coastal areas. A sine function applied for δ 15 N time series data showed for all the species the same seasonal trend with lowest δ 15 N values in April and highest in summer but with no significant interspecific differences of amplitude (α) and phase angle (ϕ). This model provides a useful tool for monitoring the inter-annual changes of N pollution. An interspecific variability of δ 15 N values was observed, probably due to their tolerance to emersion. An in vitro study for comparing the kinetic acquisition of the isotopic signal and N uptake mechanisms of each species underlined the influence of algal physiology on the δ 15 N interspecific variability. [ABSTRACT FROM AUTHOR]

The English Channel hosts a high density of human activities, which result in strong pressures and impacts on its marine ecosystem. The European Union's INTERREG programme funds projects to promote sustainable development through ecosystem-based management and the development of socio-economic services in the Channel region. An analysis of the themes studied during INTERREG IVA projects to date reveals both gaps that should be addressed in the future, as well as good practices that should be maintained and promoted. This analysis was used to provide advice and recommendations on knowledge gaps which may form the foundation of future projects for European programmes such as those in the next INTERREG project call (2015–2020). [ABSTRACT FROM AUTHOR]