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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]

Human mobility is a key component of large-scale spatial-transmission models of infectious diseases. Correctly modeling and quantifying human mobility is critical for improving epidemic control, but may be hindered by data incompleteness or unavailability. Here we explore the opportunity of using proxies for individual mobility to describe commuting flows and predict the diffusion of an influenza-like-illness epidemic. We consider three European countries and the corresponding commuting networks at different resolution scales, obtained from (i) official census surveys, (ii) proxy mobility data extracted from mobile phone call records, and (iii) the radiation model calibrated with census data. Metapopulation models defined on these countries and integrating the different mobility layers are compared in terms of epidemic observables. We show that commuting networks from mobile phone data capture the empirical commuting patterns well, accounting for more than 87% of the total fluxes. The distributions of commuting fluxes per link from mobile phones and census sources are similar and highly correlated, however a systematic overestimation of commuting traffic in the mobile phone data is observed. This leads to epidemics that spread faster than on census commuting networks, once the mobile phone commuting network is considered in the epidemic model, however preserving to a high degree the order of infection of newly affected locations. Proxies' calibration affects the arrival times' agreement across different models, and the observed topological and traffic discrepancies among mobility sources alter the resulting epidemic invasion patterns. Results also suggest that proxies perform differently in approximating commuting patterns for disease spread at different resolution scales, with the radiation model showing higher accuracy than mobile phone data when the seed is central in the network, the opposite being observed for peripheral locations. Proxies should therefore be chosen in light of the desired accuracy for the epidemic situation under study. [ABSTRACT FROM AUTHOR]

The author argues on the European Medicines Agency (EMA) that has received the first marketing authorization application (MAA) for the biosimilar monoclonal antibody (mAb). It informs that there are still questions regarding the registration and ongoing oversight of such products. It further informs that the effect of changes to manufacturing of a biosimilar or its reference product on biosimilar regulatory oversight are also the concerns.

Terrorist attacks on transportation networks have traumatized modern societies. With a single blast, it has become possible to paralyze airline traffic, electric power supply, ground transportation or Internet communication. How and at which cost can one restructure the network such that it will become more robust against a malicious attack? We introduce a new measure for robustness and use it to devise a method to mitigate economically and efficiently this risk. We demonstrate its efficiency on the European electricity system and on the Internet as well as on complex networks models. We show that with small changes in the network structure (low cost) the robustness of diverse networks can be improved dramatically whereas their functionality remains unchanged. Our results are useful not only for improving significantly with low cost the robustness of existing infrastructures but also for designing economically robust network systems. [ABSTRACT FROM AUTHOR]

Following the European Medicines Agency's (EMEA) Committee for Medicinal Products for Human Use (CHMP) developing rules for the European Union development of biosimilars such as recombinant somatropins and erythopoietins, discussions have formed concerning similar regulations for monoclonal antibodies (mAb). As mAbs are more complex molecules, there is some question as to whether the legislation is broad enough to encompass their regulation. Numerous challenges face the characterization of biosimilar mAbs , including post-translational modifications such as glycosylation and microheterogeneity. The technological requirements for biosimilar development are contrasted with those for generic drugs, and charts are presented.

This chapter continues one of the core themes of this book, by looking at perceptions of Europe, and of the European Union (EU), from the outside. The section offers a framework which helps to analyse selected news reporting surrounding European integration and the European Union in New Zealand. It investigates the ways in which the presentation of European Union related topics in New Zealand news media helps to shape public opinion relating to the conceptualisation of the EU as an international actor. The piece is based on an investigation of dominant media framings and angles of reporting of the European Union and of perceptions and representations of Europe in New Zealand. The chapter sits in a wider context of mutual perceptions - and misperceptions - across Asia and Europe. The focus of the argument lies on the ways in which meanings and understandings are formed and conveyed, in the context of the visibility of the European Union in selected New Zealand print media. [ABSTRACT FROM AUTHOR]

Despite strong political efforts in Europe, industrial small- and medium-sized enterprises (SMEs) seem to neglect adopting practices for energy efficiency. By taking a cultural perspective, this study investigated what drives the establishment of energy efficiency and corresponding practices in SMEs. Based on 10 ethnographic case studies and a quantitative survey among 500 manufacturing SMEs, the results indicate the importance of everyday employee behavior in achieving energy savings. The studied enterprises value behavior-related measures as similarly important as technical measures. Raising awareness for energy issues within the organization, therefore, constitutes an essential leadership task that is oftentimes perceived as challenging and frustrating. It was concluded that the embedding of energy efficiency in corporate strategy, the use of a broad spectrum of different practices, and the empowerment and involvement of employees serve as major drivers in establishing energy efficiency within SMEs. Moreover, the findings reveal institutional influences on shaping the meanings of energy efficiency for the SMEs by raising attention for energy efficiency in the enterprises and making energy efficiency decisions more likely. The main contribution of the paper is to offer an alternative perspective on energy efficiency in SMEs beyond the mere adoption of energy-efficient technology. [ABSTRACT FROM AUTHOR]

The authors discuss aspects of the clinical development status of advanced therapy medicinal products (ATMPs) in Europe in 2012. They say that few ATMPs, such as gene therapy medicinal products (GTMPs) and somatic cell therapy, reach more advanced regulatory certifications in Europe despite their success in animal studies. Furthermore, most sponsors of ATMP trials from 2004 to 2010, such as the academia and small businesses, have limited regulatory expertise and financial resources.