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Hypervirulent ribotypes (HVRTs) of Clostridioides difficile such as ribotype (RT) 027 are epidemiologically important. This study evaluated whether MALDI-TOF can distinguish between strains of HVRTs and non-HVRTs commonly found in Europe. Obtained spectra of clinical C. difficile isolates (training set, 157 isolates) covering epidemiologically relevant HVRTs and non-HVRTs found in Europe were used as an input for different machine learning (ML) models. Another 83 isolates were used as a validation set. Direct comparison of MALDI-TOF spectra obtained from HVRTs and non-HVRTs did not allow to discriminate between these two groups, while using these spectra with certain ML models could differentiate HVRTs from non-HVRTs with an accuracy >95% and allowed for a sub-clustering of three HVRT subgroups (RT027/RT176, RT023, RT045/078/126/127). MALDI-TOF combined with ML represents a reliable tool for rapid identification of major European HVRTs. [ABSTRACT FROM AUTHOR]

For higher sustainability in biomass production the use of new perennial species can lead to sustainable progress in the energy production and manufacturing industry. During the last decades, two different species of Silphium were discussed for biomass production. However, some questions regarding their cultivation and different uses are still to be answered. In this study, two accessions of Silphium perfoliatum L. and Silphium integrifolium Michx. were investigated during the year of establishment, and the first generative year for the phenotypic characteristics and suitability for cultivation, under Central European field conditions. Intra- and interspecific comparisons were made with special attention to their growth kinetics. While cup plant (S. perfoliatum) is well known as a potential biomass crop in Europe, silflower (S. integrifolium) is still unknown. In intraspecific comparison, S. integrifolium shows a more uniform development than S perfoliatum. In parallel, the development of S. perfoliatum accessions is temporally shifted, so that the S. perfoliatum accessions differ in the length of their phases of generative growth and onset of senescence in comparison to S. integrifolium. To make these results applicable, an improvement proposal was made to the existing BBCH scale for S. perfoliatum. In addition, an adaptation was conducted on S. integrifolium. [ABSTRACT FROM AUTHOR]

Cooperation in the delivery of public services is generally framed as desirable, but it is often hindered by serious collective action problems. The article compares inter-municipal cooperation in seven countries with different institutional settings. It investigates the rules of governance characterising these diverse institutional settings and assesses how they deal with the multiple principal problem. The authors find that in almost all cases, all participating municipalities are represented on the supervisory board of the cooperative entity. In contrast, in other less frequent case cooperation is frequently managed through a different tier of local government, thus circumventing the multiple principal problem affecting inter-municipal arrangements in the other countries. [ABSTRACT FROM AUTHOR]

Objectives: Multinational prevalence data on sarcopenia among generally healthy older adults is limited. The aim of the study was to assess prevalence of sarcopenia in the DO-HEALTH European trial based on twelve current sarcopenia definitions. Setting and Participants: This is an analysis of the DO-HEALTH study including 1495 of 2157 community-dwelling participants age 70+ years from Germany, France, Portugal, and Switzerland with complete measurements of the sarcopenia toolbox including muscle mass by DXA, grip strength, and gait speed. Measurements: The twelve sarcopenia definitions applied were Asian Working Group on Sarcopenia (AWGS1), AWGS2, Baumgartner, Delmonico, European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, EWGSOP2-lower extremities, Foundation for the National Institutes of Health (FNIH1), FNIH2, International Working Group on Sarcopenia in Older People (IWGS), Morley, and Sarcopenia Definitions and Outcomes Consortium (SDOC). Results: Mean age was 74.9 years (SD 4.4); 63.3% were women. Sarcopenia prevalence ranged between 0.7% using the EWGSOP2 or AWGS2 definition, up to 16.8% using the Delmonico definition. Overall, most sarcopenia definitions, including Delmonico (16.8%), Baumgartner (12.8%), FNIH1(10.5%), IWGS (3.6%), EWGSOP1 (3.4%), SDOC (2.0%), Morley (1.3%), and AWGS1 (1.1%) tended to be higher than the prevalence based on EWGSOP2 (0.7%). In contrast, the definitions AWGS2 (0.7%), EWGSOP2-LE (1.1%), FNIH2 (1.0%) — all based on muscle mass and muscle strength — showed similar lower prevalence as EWGSOP2 (0.7%). Moreover, most sarcopenia definitions did not overlap on identifying sarcopenia on an individual participant-level. Conclusion: In this multinational European trial of community-dwelling older adults we found major discordances of sarcopenia prevalence both on a population- and on a participant- level between various sarcopenia definitions. Our findings suggest that the concept of sarcopenia may need to be rethought to reliably and validly identify people with impaired muscle health. [ABSTRACT FROM AUTHOR]

Background and aim: Iron deficiency is associated with increased morbidity and mortality in older adults. However, data on its prevalence and incidence among older adults is limited. The aim of this study was to investigate the prevalence and incidence of iron deficiency in European community-dwelling older adults aged ≥ 70 years. Methods: Secondary analysis of the DO-HEALTH trial, a 3-year clinical trial including 2157 community-dwelling adults aged ≥ 70 years from Austria, France, Germany, Portugal and Switzerland. Iron deficiency was defined as soluble transferrin receptor (sTfR) > 28.1 nmol/L. Prevalence and incidence rate (IR) of iron deficiency per 100 person-years were examined overall and stratified by sex, age group, and country. Sensitivity analysis for three commonly used definitions of iron deficiency (ferritin < 45 μg/L, ferritin < 30 μg/L, and sTfR–ferritin index > 1.5) were also performed. Results: Out of 2157 participants, 2141 had sTfR measured at baseline (mean age 74.9 years; 61.5% women). The prevalence of iron deficiency at baseline was 26.8%, and did not differ by sex, but by age (35.6% in age group ≥ 80, 29.3% in age group 75–79, 23.2% in age group 70–74); P < 0.0001) and country (P = 0.02), with the highest prevalence in Portugal (34.5%) and the lowest in France (24.4%). As for the other definitions of iron deficiency, the prevalence ranged from 4.2% for ferritin < 30 µg/L to 35.3% for sTfR–ferritin index > 1.5. Occurrences of iron deficiency were observed with IR per 100 person-years of 9.2 (95% CI 8.3–10.1) and did not significantly differ by sex or age group. The highest IR per 100 person-years was observed in Austria (20.8, 95% CI 16.1–26.9), the lowest in Germany (6.1, 95% CI 4.7–8.0). Regarding the other definitions of iron deficiency, the IR per 100 person-years was 4.5 (95% CI 4.0–4.9) for ferritin < 45 µg/L, 2.4 (95% CI 2.2–2.7) for ferritin < 30 µg/L, and 12.2 (95% CI 11.0–13.5) for sTfR–ferritin index > 1.5. Conclusions: Iron deficiency is frequent among relatively healthy European older adults, with people aged ≥ 80 years and residence in Austria and Portugal associated with the highest risk. [ABSTRACT FROM AUTHOR]

Objectives: To assess if baseline iron deficiency, with or without anemia, is associated with incident infections over 3 years among community-dwelling older adults. Design: Prospective secondary analysis of DO-HEALTH, a 3-year randomized, double-blind controlled trial. Setting And Participants: 2157 community-dwelling adults age 70+ from 5 European countries with good cognitive function and mobility and no major health events in the 5 years prior to enrollment Measurements: Incident infections, their severity and type were recorded every 3 months throughout the 3-year follow-up. Iron deficiency was defined as soluble transferrin receptor (sTfR) levels > 28.1 nmol/l and anemia as hemoglobin levels < 120 g/l for women and 130 g/l for men. We applied negative binomial mixed effects regression models with random effects for countries, and controlling for treatment allocation, age, sex, body mass index, polypharmacy, number of comorbidities, smoking status, living situation, alcohol intake, frailty status, and physical activity levels. A pre-defined stratified analysis was performed to explore if the associations between iron deficiency and infections were consistent by baseline anemia status. Results: In total, 2141 participants were included in the analyses (mean age 74.9 years, 61.5% of women, 26.8% with iron deficiency). Across all participants, baseline iron deficiency was not associated with incident overall infections, but was associated with a 63% greater rate of incident severe infections requiring hospitalization (incidence rate ratio [IRR] 1.63, 95% Confidence Interval [CI] 1.11–2.41, p=0.01). This association was more pronounced among the 2000 participants who did not have anemia at baseline (IRR=1.80, 95% CI 1.20–2.69, p=0.005). Conclusion: Based on this prospective study among generally healthy European community-dwelling older adults, iron deficiency was not associated with the incidence rate of overall infections but may increase the incidence of severe infections. Intervention studies are needed to prove the causality of this observation. [ABSTRACT FROM AUTHOR]

Background: The longitudinal association between iron deficiency and inflammatory biomarkers levels has not been fully explored among relatively healthy older adults. Aims: To assess whether iron deficiency at baseline and at any yearly follow-up time point, with or without anemia, was associated with changes from baseline in high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels over 3 years. Methods: This is a post-hoc observational analysis of DO-HEALTH, a double-blind, randomized controlled trial including 2157 European community-dwelling adults age 70+. The outcomes were changes from baseline in hs-CRP and IL-6 levels, measured at 12, 24, and 36 months of follow-up. Iron deficiency was defined by soluble transferrin receptor levels > 28.1 nmol/L and baseline anemia by hemoglobin levels < 130 g/L for men and < 120 g/L for women. Results: In total, 2141 participants were included in the analyses (mean age: 74.9 years, 61.5% of women, 26.8% with iron deficiency). Baseline iron deficiency was associated with greater increase in IL-6 levels (mean difference in change: 0.52 ng/L, 95%CI 0.03–1.00, P =.04) over 3 years. Iron deficiency at any yearly time point was associated with higher increases in hs-CRP (mean difference in change: 1.62 mg/L, 95%CI 0.98–2.26, P <.001) and IL-6 levels (mean difference in change: 1.33 ng/L, 95%CI 0.87–1.79, P <.001) over 3 years. No significant interaction between iron deficiency and anemia was found, suggesting that the results are independent of the anemic status. Conclusions: These findings suggest that iron deficiency may play a role in low-grade chronic inflammation among relatively healthy older adults. [ABSTRACT FROM AUTHOR]

Solar energy is increasingly used to produce electricity in Europe, but the environmental impact of constructing and running solar parks (SP) is not yet well studied. Solar park construction requires partial vegetation removal and soil leveling. Additionally, solar panels may alter soil microclimate and functioning. In our study of three French Mediterranean solar parks, we analyzed:(1) effects of solar park construction on soil quality by comparing solar park soils with those of semi‐natural land cover types (pinewood and shrubland) and abandoned croplands (former vineyards); and (2) the effect of solar panels on soil microclimate, CO2 effluxes, and vegetation. We measured 21 soil properties of physical, chemical, and microbiological soil quality in one solar park and its surroundings to calculate integrated indicators of soil quality. We surveyed soil temperature and moisture, CO2 effluxes, and vegetation below and outside solar panels of three solar parks. Soil aggregate stability was reduced by SP construction resulting in a degradation of soil physical quality. Soil chemical quality and a general indicator of soil quality were lower in anthropogenic (SP and abandoned vineyards) than in semi‐natural (pinewood and shrubland) land cover types. However, differences between abandoned vineyards representing the preconstruction land cover type and solar parks were not significant. Solar panels reduced the soil temperature by 10% and soil CO2 effluxes by 50% but did not affect early successional plant communities. Long‐term monitoring is needed to evaluate the effects of solar panels on vegetation. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. Severe deficiency (serum 25(OH)D <30 nmol/L or 12 ng/mL) is found in >10% of Europeans. The European Calcified Tissue Society (ECTS) a dvises that the measurement of serum 25(OH) D be standardized, for example, by the Vitamin D Standardization Program. Risk groups include young children, adolescents, pregnant women, older people (especially the insti tutionalized) and non-Western immigrants. Consequences of vitamin D deficiency include mineralization defe cts and lower bone mineral density causing fractures. Extra-skeletal consequences may be muscle weakness, falls and acute respiratory infection, and are the subject of large ongoing clinical trials. The ECTS advises to improve vitamin D status by food fortification and the use of vitamin D supplements in risk groups. Fortification of foods by adding vitamin D to dairy products, bread and cereals can improve the vitamin D status of the whole population, but quality assurance monitoring is needed to prevent intoxication. Specific risk groups such as infants and children up to 3 years, pregnant women, older persons and non- Western immigrants should routinely receive vitamin D supplements. Future research should include genetic studies to better define individual vulnerability for vitamin D deficienc y, and Mendelian randomization studies to address the effect of vitamin D deficiency on long-term non-skeletal outcomes such as cancer. [ABSTRACT FROM AUTHOR]

This paper sheds new light on the assessment of firm networks via multiple directorships in terms of corporate firm performance. Using a large sample of European listed firms in the period from 2003 to 2011 and system GMM we find a significant compensation effect on corporate firm performance for the initial negative effect of horizontal multiple directorships by product market competition. In markets with effective competition, horizontal multiple directorships turn out to be an efficient mechanism to increase firm performance and thus assure competitive advantages. By contrast, linkages between up- and downstream firms have no significant influence on financial performance, irrespective of the level of competition intensity. [ABSTRACT FROM AUTHOR]

Stakeholder theory has thus far received limited attention in the context of entrepreneurship education and university management. This paper addresses this research gap by examining the collaboration of stakeholders from the entrepreneurial ecosystem in entrepreneurship education at European higher educational institutions (HEIs). We contribute to existing research by combining literature streams from the fields of entrepreneurship education, entrepreneurial ecosystems and stakeholder theory. Empirical research is based on a cross-case analysis of 20 HEIs from 19 different European countries. Data sources include next to secondary data and observation a total 216 interviews with entrepreneurship education stakeholders at these 20 HEIs. The results of the case studies are further validated through an independent peer group and through 14 interviews with international experts in entrepreneurship education. Based on this data, an overview of the key external stakeholder groups of the entrepreneurial ecosystem of HEIs and their forms of involvement in entrepreneurship education is provided. Furthermore, the strength and coordination of stakeholder collaboration and the overall approaches to stakeholder management are discussed. This analysis results in the development of a set of propositions on stakeholder involvement in the context of entrepreneurship education at HEIs. The findings of this paper highlight the importance of stakeholder collaboration from the entrepreneurial ecosystem at HEIs. Implications of the findings for entrepreneurship educators and university management are ultimately discussed along with suggestions for further research. [ABSTRACT FROM AUTHOR]

The article "Mediterranean Herpetology - Excursions to the Reptiles of Southern Europe" introduces the book by Werner and Yvonne Lantermann. The book describes their research trips to the habitats of lizards, snakes, turtles, skinks, and agamas in the southern part of Europe. It also provides information on preparing for such trips and analyzing observations. The book is aimed at reptile enthusiasts, reptile keepers, and nature travelers looking for destinations to visit. It includes a detailed bibliography and can be ordered through w.lantermann@arcor.de. [Extracted from the article]

EU agriculture is currently in transition from conventional crop protection to integrated pest management ( IPM). Because biocontrol is a key component of IPM, many European countries recently have intensified their national efforts on biocontrol research and innovation (R&I), although such initiatives are often fragmented. The operational outputs of national efforts would benefit from closer collaboration among stakeholders via transnationally coordinated approaches, as most economically important pests are similar across Europe. This paper proposes a common European framework on biocontrol R&I. It identifies generic R&I bottlenecks and needs as well as priorities for three crop types (arable, vegetable and perennial crops). The existing gap between the market offers of biocontrol solutions and the demand of growers, the lengthy and expensive registration process for biocontrol solutions and their varying effectiveness due to variable climatic conditions and site-specific factors across Europe are key obstacles hindering the development and adoption of biocontrol solutions in Europe. Considering arable, vegetable and perennial crops, a dozen common target pests are identified for each type of crop and ranked by order of importance at European level. Such a ranked list indicates numerous topics on which future joint transnational efforts would be justified. © 2016 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Highlights: [•] Deposited nitrogen was retained in 25 out of 27 Central European forest canopies. [•] Tree and shrub diversity increased canopy retention of nitrogen. [•] Complementarity is also important for aboveground nitrogen use. [•] Biodiversity effects in forests are co-determined by regional and habitat effects. [ABSTRACT FROM AUTHOR]

Summary: On September 29, 2011, acknowledged experts in the field of vitamin D, mainly European, were brought together in order to discuss the recent scientific advances in relation to vitamin D: the current requirements and associations with various health outcomes. In this article, the discussions resulting from the meeting are summarized. Introduction: Several groups at risk for developing vitamin D insufficiency have been identified. Accordingly, reviews indicate that a significant percentage of the population worldwide have serum 25-hydroxyvitamin D levels below 50 nmol/l. In addition to the role of vitamin D in bone health, recent studies suggest that it may play a pivotal role in other systems, e.g., the cardiovascular system, pancreas, muscle, immune system and brain. Most evidence, however, is obtained from observational studies and yet inconclusive. Methods: To exchange and broaden knowledge on the requirements for vitamin D and its effect on various health outcomes, a workshop entitled 'Vitamin D Expert Meeting: Do we get enough?', was organized. Results: Despite low vitamin D levels worldwide, consensus on the definition of deficiency is not yet reached. In order to define cut-off points for vitamin D whilst taking into account extraskeletal health effects, randomized controlled trials in these fields are warranted. The experts do emphasize that there is evidence to suggest an important role for vitamin D in the maintenance of optimal bone health at all ages and that vitamin D supplementation, in most studies co-administered with calcium, reduces fracture risk in the senior population. Conclusion: To reach a serum 25-hydroxyvitamin D level of 50 nmol/l older adults aged ≥65 years are therefore recommended to meet a mean daily vitamin D intake of 20 μg (800 IU), which is best achieved with a supplement. [ABSTRACT FROM AUTHOR]

AbstractObjective:The ACTION (Assessment of Cost and ouTcomes of chemotherapy In an Observational setting) study investigated associations between chemotherapy, patient/disease characteristics and outcomes in advanced non-small cell lung cancer (NSCLC) patients in clinical practice.Research design and methods:Chemonaïve NSCLC patients from five European countries were observed for 18 months from initiation of first-line chemotherapy; care was at the physicians discretion.Main outcome measures:Survival and associated prognostic factors were estimated using Kaplan–Meier methods and a Cox proportional hazards model, respectively. Cluster analyses of baseline patient characteristics were also performed. Toxicity data were not considered in these analyses.Results:A total of 975 eligible patients with NSCLC (Stage IIIb/IV) were enrolled and provided baseline and response data; cluster analysis was performed on 829 patients and survival data were available from 906 patients. In first-line treatment, a 39.8 response rate, a 39.5 1-year survival rate and unadjusted median survival of 9.3 months were observed. Prognostic factors for survival included performance status (PS), number of metastatic organs, gender and age. Five patient clusters were identified, highlighting patient heterogeneity in terms of baseline condition and age. PS was maintained or improved throughout first-line and second-line chemotherapy in half the patients receiving these treatments.Conclusions:ACTION provides valuable information about patient population, disease characteristics, treatment choices, prescribing patterns and outcomes in routine clinical practice in advanced NSCLC in Europe. Our findings suggest that maintenance of PS after first and subsequent lines of chemotherapy, and survival rates may both be higher than previously anticipated. Our results also showed an association between age and survival, which suggests that age should not exclude patients from receiving chemotherapy if they meet all other eligibility criteria. [ABSTRACT FROM AUTHOR]

In this paper, we analyse the appropriateness of monitoring approaches for the observation of inner-city reurbanization processes. Reurbanization is conceptualized here as a process of long-term stabilization of inner-city areas by both a readiness of present residents to stay and an influx of new residents. It has been recently re-set on the top of the European urban research agenda since non-growth has proved to be a major path of future development for many European cities. Recent research evidence across Europe underscores the fact that reurbanization depends much on local settings of institutional, socio-economic and infrastructural factors. To foster a clearer understanding of the nature and dynamics of local reurbanization, to assess its extent and progress and, what is more, to help practitioners to shape sustainable policy initiatives appropriate to the respective context, reurbanization needs to be observed over the long term. The complex character of reurbanization sets new challenges for monitoring approaches and indicator-based tools. Due to the genuine relation of the present debate on reurbanization to the phenomenon of non-growth or the return of the compact city, the focus in this paper is set on demographic development trends and their impact on inner-city change. In this vein, our paper presents a monitoring design and a respective newly developed indicator set for reurbanization which focuses more on the initial recognition of reurbanization than on its long-term stability. Methodically, chances and limits of the integration of household-related indicators and qualitative knowledge on reurbanization into monitoring tools are highlighted. Empirical and statistical evidence is taken from a recently completed EU FP 5 research project and from municipal surveys. [ABSTRACT FROM AUTHOR]

The open method of co-ordination (OMC) can contribute to the co-ordinated modernization of the national systems of employment and social protection in Europe, if it is institutionalized in a relatively stable way at the European level and if the European processes can influence effectively the national reform strategies. The first challenge was met successfully by the bureaucratization, codification and formalization of some co-ordination processes at the European level. These processes can be interpreted as the institutionalization of a social field. The second challenge refers to the need for an effective coupling between the European and the national arenas. Currently, the most important way of coupling these two social fields is based on mutual learning. Given the limitations of such a predominantly cognitive coupling, the Commission can either enforce the ‘national ownership’ of the co-ordination processes, improve the mutual learning processes or strengthen the strategic (‘financial incentives’) and normative (‘legal obligations’) forms of coupling between the European and national social fields. [ABSTRACT FROM AUTHOR]

This paper presents the results of a metallographic examination of Eneolithic and Early Bronze Age axes from the Northalpine region of central Europe. During this period, different types of copper were in use: arsenical copper, Fahlerz copper and tin bronze. We examine if and to what extent the different properties of the metals used were known to prehistoric metalworkers and actively manipulated in the production of the axes. The development of methods of casting and smithing is discussed. Both aspects contribute to our understanding of the nature of prehistoric technological change. During the Early Bronze Age of the Northalpine region, different traditions of early metallurgy can be identified, which differ in their use of Fahlerz copper, their attitude towards tin alloying and the use made of tin bronze in the production of the axes. These traditions can only be adequately described by reference to both composition—that is, access to different types of copper as well as tin—and knowledge of the production techniques provided by metallographic data. [ABSTRACT FROM AUTHOR]

Looks at KUKA Robot Group's cooperation with universities and research institutes in Europe. KUKA's evaluation criteria for research projects; Factors determining the success of a research project from a commercial point of view; KUKA's focus on the development of graphical programming techniques under the Advanced Man-machine-Interfaces for Robotics Applications (AMIRA) project.

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The MTU MCFC program is carried out by a European consortium comprising the German companies MTU Friedrichshafen GmbH, Ruhrgas AG and RWE Energie AG as well as the Danish company Energi E2 S/A. MTU acts as consortium leader. The company shares a license and technology exchange agreement with Fuel Cell Energy Inc., Danbury, CT, USA (formerly Energy Research Corp., ERC). The program was started in 1990 and covers a period of about 10 years. The highlights of this program to date are:

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) isolates of clonal complex 398 (CC398) are frequently found in Europe, and recent studies highlighted the importance of mobile genetic element (MGE) exchange for host adaptation of this lineage. Of note, one of the MGEs commonly found in human S. aureus isolates, the immune evasion cluster (IEC) harboring bacteriophage Sa int 3, is very rarely found in LA-MRSA CC398 isolates obtained from farm animals, but more frequently found in LA-MRSA CC398 that were retransmitted to humans. Here, we analyzed with a set of S. aureus CC398 isolates harboring/lacking φSa int 3 how this MGE affects (i) phagocytosis of CC398 isolates by polymorphonuclear neutrophils (PMNs), and (ii) hemolysis of human and livestock-derived erythrocytes. Isolates lacking φSa int 3 were more efficiently phagocytosed by human PMNs in whole blood phagocytosis assays than isolates harboring this bacteriophage, irrespective of their origin. Notably, a similar effect was observed when equine blood was utilized, but not detected with porcine blood. Integration of φSa int 3 into LA-MRSA CC398 strains lacking this MGE confirmed these findings, as φSa int 3-harboring recipients were again less efficiently ingested by PMNs in equine and human blood than their parental strains. Integration of φSa int 3 strongly reduced the hemolytic potential of the culture supernatants against human-derived erythrocytes, and to a smaller extent also against porcine-derived erythrocytes, while φSa int 3 integration only slightly affected the hemolytic capacities against equine-derived red blood cells. The significant protective effect of φSa int 3 against phagocytosis by equine PMNs suggests that the host specificity of the IEC components might be broader than currently assumed. [ABSTRACT FROM AUTHOR]

To examine the association between the baseline number of chronic diseases and multimorbidity with regard to the incidence of all and injurious falls over 3 years among European community-dwelling older adults. Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial. Multicenter trial with 7 European centers: Zurich, Basel, Geneva (Switzerland), Berlin (Germany), Innsbruck (Austria), Toulouse (France), and Coimbra (Portugal), including 2157 community-dwelling adults aged 70 years and older without any major health events in the 5 years prior to enrollment, sufficient mobility, and good cognitive status. The main outcomes were the number of all falls and injurious falls experienced over 3 years. The number of chronic diseases and multimorbidity, defined as the presence of 3 or more chronic diseases at baseline, were assessed with the Self-Administered Comorbidity Questionnaire by Sangha et al. Among the 2155 participants included in the analyses (mean age: 74.9 years, 62% were women, 52% were physically active more than 3 times a week), 569 (26.4%) had multimorbidity at baseline. Overall, each 1-unit increase in the baseline number of chronic diseases was linearly associated with a 7% increased incidence rate of all falls [adjusted incidence rate ratio (aIRR) 1.07, 95% CI 1.03-1.12, P <.001] and a 6% increased incidence rate of injurious falls (aIRR 1.06, 95% CI 1.02-1.11, P =.003). Baseline multimorbidity was associated with a 21% increased incidence rate of all falls (aIRR 1.21, 95% CI 1.07-1.37, P =.002) and a 17% increased incidence rate of injurious falls (aIRR 1.17, 95% CI 1.03-1.32, P =.02). Baseline number of prevalent chronic diseases and multimorbidity in generally healthy and active community-dwelling older adults were associated with increased incidence rates of all and injurious falls over 3 years. These findings support that multimorbidity may need consideration as a risk factor for falls, even in generally healthy and active older adults. [ABSTRACT FROM AUTHOR]

BACKGROUND: For decades, monitoring depth of anesthesia was mainly based on unspecific effects of anesthetics, for example, blood pressure, heart rate, or drug concentrations. Today, electroencephalogram-based monitors promise a more specific assessment of the brain function. To date, most approaches were focused on a 'head-to-head' comparison of either electroencephalogram- or standard parameter-based monitoring. In the current study, a multimodal indicator based on a combination of both electro encephalographic and standard anesthesia monitoring parameters is defined for quantification of 'anesthesia depth.' METHODS: Two hundred sixty-three adult patients from six European centers undergoing surgery with general anesthesia were assigned to 1 of 10 anesthetic combinations according to standards of the enrolling hospital. The anesthesia multimodal index of consciousness was developed using a data-driven approach, which maps standard monitoring and electroencephalographic parameters into an output indicator that separates different levels of anesthesia from awake to electroencephalographic burst suppression. Obtained results were compared with either a combination of standard monitoring parameters or the electroencephalogram-based bispectral index. RESULTS: The anesthesia multimodal index of consciousness showed prediction probability (PK) of 0.96 (95% CI, 0.95 to 0.97) to separate different levels of anesthesia (wakefulness to burst suppression), whereas the bispectral index had significantly lower PK of 0.80 (0.76 to 0.81) at corrected threshold P value of less than 0.05. At the transition between consciousness and unconsciousness, anesthesia multimodal index of consciousness yielded a PK of 0.88 (0.85 to 0.91). CONCLUSION: A multimodal integration of both standard monitoring and electroencephalographic parameters may more precisely reflect the level of anesthesia compared with monitoring based on one of these aspects alone. [ABSTRACT FROM AUTHOR]

European cities are characterized by increasing numbers of foreign-born and foreign-language speaking inhabitants. The resulting cultural and linguistic diversity presents a number of challenges to health-care services. This paper describes a European initiative aimed at improving hospitals' responses to the health-care needs of migrants and ethnic minorities. We summarise the current health situation of these groups, describe how the EU initiative began and how it led to the Amsterdam declaration, and conclude by outlining current developments.

Background: More than 20% of people living in Switzerland are immigrants, defined as people with foreign nationality. This study examines health disparities between the main immigrant groups in Switzerland and the majority Swiss population., Methods: Epidemiological analysis of the 2002 Swiss Health Survey (SHS): the SHS contains health-related information about 19,706 people who were randomly sampled from among people living in Switzerland. Bi-variate and multivariate analyses of six variables on self-reported health were performed., Findings: The data from the 2002 Swiss Health Survey provide some evidence of health disparities between Swiss people and immigrants. Although the self-reported health of "Northern immigrants" (people from Germany and France) does not differ significantly from that of the majority Swiss population, "Southern immigrants" (people from Italy, Former Yugoslavia, Portugal, Spain and Turkey) report lower levels of health in several areas. Lower levels of health are particularly likely to be reported by Italian men and women., Conclusion: The self-reported health of immigrants is currently inferior to that of the Swiss. If it is the position of the Swiss health care system to ensure equal health provision for all Swiss residents, including immigrant groups, and to strive for equal health outcomes for all, self-reported ill health among immigrants is a useful basis for health policy and planning.