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Die angebotsseitigen Preisschübe seit Mitte des Jahres 2021 haben Sorgen vor der Entstehung einer Lohn-Preis-Spirale geweckt und neue Runden korporatistischer Konzertierung auf den Plan gerufen. Wir argumentieren auf Grundlage einer sektoralen und ländervergleichend angelegten Betrachtung der produktivitätsbereinigten Arbeitskostenauftriebe zwischen der Gründung der Währungsunion und dem Eintritt in die Pandemiekrise, dass Deutschland aufgrund der Kumulation sektoraler lohndämpfender Eigenschaften ein unwahrscheinlicher Fall für eine Lohn-Preis-Spirale ist. Da diese Eigenschaften aber nicht typisch für alle Eurozonenländer, sondern vielmehr exzeptionell sind, könnten im Euroraum länderspezifische, unterschiedlich ausgeprägte Lohn-Preis-Spiralen entstehen. Die Verstetigung unterschiedlicher Inflationsniveaus würde die Eurozone vor eine schwere Belastungsprobe stellen. The supply-side price surges since mid-2021 have raised concerns about the emergence of a wage-price spiral and therefore prompted new rounds of corporatist concertation. We conduct a sector-based analysis of productivity-adjusted labour cost increases between the establishment of monetary union and the emergence of the pandemic crisis, and compare the German results internationally. We argue that Germany, due to its accumulation of sectoral wage-repressing characteristics, is a rather unlikely case for a wage-price spiral. However, as these characteristics are not typical for all euro area countries but rather exceptional, country specific and differently sized wage-price spirals could emerge within the euro area. The perpetuation of different inflation levels would put the eurozone under severe stress. 1. Einleitung 2. Die Entwicklung der deutschen Arbeitskosten im internationalen Vergleich 3. Sektorale Entwicklungen 4. Die geringe Wahrscheinlichkeit der Entstehung einer Lohn-Preis-Spirale 5 Fazit: Das deutsche Muster im Kontext der europäischen Währungsunion Literatur

This paper analyzes the role of public sector wage-setting (PSWS) in Mediterranean countries before and after the Eurozone crisis. Extant literature suggests public sector wage inflation to be the norm in these countries due to the lack of institutional preconditions for wage restraint and the role of PSWS in shoring up the publicly financed domestic demand-led growth regime. Yet, the cases of France, Italy, Portugal and Spain do not to neatly fit these predictions, showing instead notable cross-country and intra-country diachronic variation. We provide an alternative account by treating PSWS as fiscal policy under EMU. Variation in PSWS outcomes before the Eurozone crisis is best explained in terms of the institutions governing PSWS. In France and Portugal, PSWS is highly centralized at the national level, and a strong Finance Ministry plays a central role in the oversight of PSWS to ensure budgetary discipline. To the contrary, Italy and Spain underwent processes of disorganized decentralization of PSWS through the 1990s and 2000s, leading to fragmented – and often clientelist – practices resulting in disorderly inflationary wage increases across the country. After the sovereign debt crisis, all countries relied on restrictive PSWS to support internal devaluation and fiscal adjustment, though with different intensity related to the country-specific problem load and external constraints. Introduction Public sector wage-setting in Southern Europe: The missing institutional preconditions for wage restraint PSWS in Mediterranean countries before and after the Eurozone crisis More than just wages: The role of PSWS as fiscal and economic policymaking within the EMU economic governance Research design and logic of case selection The political economy of PSWS within Mediterranean growth regimes before the Eurozone crisis The political economy of PSWS within Mediterranean Growth Regimes after the Eurozone crisis Conclusions Footnote References Appendix

La presenza di turismo internazionale ha agito da palliativo per le economie dei Paesi dell'Europa meridionale, ma l'eccessiva dipendenza dal settore turistico comporta insidie sulle quali occorre riflettere tempestivamente.

Background INSTIs have become a pillar of first-line ART. Real-world data are needed to assess their effectiveness in routine care. Objectives We analysed ART-naive patients who started INSTI-based regimens in 2012–19 whose data were collected by INTEGRATE, a European collaborative study including seven national cohorts. Methods Kaplan–Meier analyses assessed time to virological failure (VF), defined as one viral load (VL) ≥1000 copies/mL, two consecutive VLs ≥50 copies/mL, or one VL ≥50 copies/mL followed by treatment change after ≥24 weeks of follow-up, and time to INSTIs discontinuation (INSTI-DC) for any reason. Factors associated with VF and INSTI-DC were explored by logistic regression analysis. Results Of 2976 regimens started, 1901 (63.9%) contained dolutegravir, 631 (21.2%) elvitegravir and 444 (14.9%) raltegravir. The 1 year estimated probabilities of VF and INSTI-DC were 5.6% (95% CI 4.5–6.7) and 16.2% (95% CI 14.9–17.6), respectively, and were higher for raltegravir versus both elvitegravir and dolutegravir. A baseline VL ≥100 000 copies/mL [adjusted HR (aHR) 2.17, 95% CI 1.55–3.04, P 3 drugs versus 3 drugs (aHR 2.73, 95% CI 1.55–4.79, P Conclusions This large multi-cohort study indicates high effectiveness of elvitegravir- or dolutegravir-based first-line ART in routine practice across Europe.

The return of tourists to southern Europe’s squeezed resorts is not an unmixed blessing.

„Wie werden sich die Löhne in Deutschland in den kommenden Jahren entwickeln?“, fragte das Dezernat Zukunft jüngst. Donato Di Carlo und Martin Höpner haben geantwortet und warnen vor der Verstetigung unterschiedlicher Inflationsraten im Euroraum.

Tra le varie forme narrative, negli ultimi anni si sta diffondendo l’uso del cosiddetto “storytelling digitale”, ovvero uno strumento attraverso il quale lo studente può raccontarsi e ritrovare tutti gli elementi caratterizzanti un’esperienza didattica vissuta. Il contributo si propone l'obiettivo di valutare in termini di soddisfazione e percezione del proprio apprendimento, la ricaduta dell’esperienza narrativa da parte degli studenti universitari che hanno frequentato a distanza nel primo semestre dell’anno accademico 2020-21, il corso di Docimologia previsto al secondo anno (cattedra M-Z) del Corso di Studi in Scienze della Formazione Primaria, attraverso l’impiego dello storytelling digitale come strumento narrativo-riflessivo che combina l’uso di immagini e suoni. Abbiamo chiesto agli studenti di realizzare uno storytelling digitale al fine di esplicitare ed esplorare il momento particolare e singolare di vita universitaria che stavano vivendo. Durante la prima parte dell’anno accademico 2020-21, è stato realizzato uno studio di tipo qualitativo attraverso la realizzazione di un’attività di focus group online durante lo svolgimento del corso di Docimologia. I 94 studenti tra i 18 e i 33 anni che hanno preso parte alla nostra ricerca hanno sottolineato come attraverso l’esperienza della pratica narrativa e riflessiva e quindi dello storytelling digitale abbiano avuto la possibilità di ricostruire un percorso, di prendere posizione rispetto a quel percorso, di proiettarsi nel futuro professionale. Among the various narrative forms, in recent years, the use of the so-called "digital storytelling" is spreading. It is a tool through which students may tell and find all the elements characterizing their learning/teaching experience. The aim of this study is to evaluate satisfaction and perception of the learning process via the fallout of the narrative experience by university students who attended remotely Docimology classes in the first semester of the academic year 2020-21 (second academic year of the Course of Studies in Primary Education Sciences Group M-Z), through the use of digital storytelling as a narrative-reflexive tool that combines the use of images and sounds. Students were asked to create digital storytelling in order to explain and explore the peculiar moment of university life they were experiencing. During the first part of the 2020-21 academic year, a qualitative study was carried out through an online focus group activity run during the course. The 94 students, between the age of 18 and 33, who took part in our research, underlined how they had the opportunity to reconstruct a path, to take a position on that path, to project themselves into the professional future, thanks to the digital storytelling practice and the narrative/reflective potential it provided.

La valutazione per l’apprendimento (assessment for learning) e la valutazione come apprendimento (assessment as learning) sono concetti che recentemente hanno assunto un ruolo centrale nella letteratura sull’argomento. Il contributo illustra, dopo una esplicitazione delle caratteristiche dei due approcci, un’esperienza di valutazione per l’apprendimento e come apprendimento in Università. La ricerca si propone di descrivere come 125 studenti del corso di Laurea Magistrale di Scienze della Formazione Primaria dell’Università di Palermo partecipino abitualmente al processo di valutazione e percepiscano l’utilità della valutazione formativa e i benefici del ricevere feedback. I dati raccolti sulla percezione della valutazione e dei feedback ricevuti, mostrano che le pratiche di insegnamento universitario utilizzate hanno permesso agli studenti universitari di acquisire alti livelli di soddisfazione e un’alta percezione delle competenze auto-valutative legati alle esperienze in DAD. Assessment for learning and assessment as learning have recently taken on a central role in the literature on the subject. Having analyzed the characteristics of these two approaches, this paper reports on an assessment experience for and as learning in higher education. The study was carried out with 125 students of the master's degree course in Primary Education Sciences at University of Palermo and it aims to describe how these students habitually participate in the assessment process and perceive the usefulness of educational assessment and the benefits of receiving feedback. The data collected on the perception of evaluation and feedback reveal that university teaching practices have allowed students to acquire assessment skills and high levels of satisfaction related to distance learning experiences.

Total cell-associated HIV-1 DNA is a surrogate marker of the HIV-1 reservoir, however, certified systems for its quantification are not available. The Italian HIV DNA Network was launched to validate HIV-1 DNA quantification methods in use at University and Hospital labs. A quality control panel including HIV-1 DNA standards, reconstructed blood samples (RBSs) and DNA from different HIV-1 subtypes was blindly tested by 12 participating labs by quantitative real-time PCR (n = 6), droplet digital PCR (n = 3) or both (n = 3). The median 95% hit rate was 4.6 (3.7–5.5) copies per test and linearity in the tested range was excellent (R2 = 1.000 [1.000–1.000]). The median values obtained across labs were 3,370 (2,287–4,245), 445 (299–498), 59 (40–81) and 7 (6–11) HIV-1 DNA copies, for the 3,584, 448, 56 and 7-copy standards, respectively. With RBSs, measured values were within twofold with respect to the median in two thirds of cases. HIV-1 subtypes were missed (CRF01_AE by 3 labs) or underestimated by > 1 log (subtypes A, C, D, F by one lab; CRF01_AE by one lab; CRF02_AG by one lab). The overall performance was excellent with HIV-1 DNA standards, however detection of different HIV-1 subtypes must be improved.

Production of high-energy lipids by microalgae may provide a sustainable, renewable energy source that can help tackle climate change. However, microalgae engineered to produce more lipids usually grow slowly, leading to reduced overall yields. Unfortunately, tools that enable the selection of cells based on growth while maintaining high biomass production, such as well-plates, water-in-oil droplet emulsions, and nanowell arrays do not provide production-relevant environments that cells experience in scaled-up cultures (e.g. bioreactors or outdoor cultivation farms). As a result, strains that are developed in the lab often do not exhibit the same beneficial phenotypic behavior when transferred to industrial production. Here we introduce PicoShells, picoliter-scale porous hydrogel compartments, that can enable >100,000 individual cells to be compartmentalized, cultured in production-relevant environments, and selected based on growth and biomass accumulation traits using standard flow cytometers. PicoShells consist of a hollow inner cavity where cells are encapsulated, and a porous outer shell that allows for continuous solution exchange with the external environment so that nutrients, cell-communication factors, and cytotoxic cellular byproducts can transport freely in and out of the inner cavity. PicoShells can also be placed directly into shaking flasks, bioreactors, or other production-relevant environments. We experimentally demonstrate that Chlorella sp. and Saccharomyces cerevisiae grow to significantly larger colony sizes in PicoShells than in water-in-oil droplet emulsions (P < 0.05). We have also demonstrated that PicoShells containing faster biomass accumulating Chlorella clonal colonies can be selected using a fluorescence-activated cell sorter and re-grown. Using the PicoShell process, we select a Chlorella population that accumulates biomass 8% faster than does an un-selected population after a single selection cycle.

Reactions performed in uniform microscale volumes have enabled numerous applications in the analysis of rare entities (e.g. cells and molecules), however, sophisticated instruments are usually required to form large numbers of uniform compartments. Here, uniform aqueous droplets are formed by simply mixing microscale multi-material particles, consisting of concentric hydrophobic outer and hydrophilic inner layers, with oil and water. The particles are manufactured in batch using a 3D printed device to co-flow four concentric streams of polymer precursors which are polymerized with UV light. The size of the particles is readily controlled by adjusting the fluid flow rate ratios and mask design; whereas the cross-sectional shapes are altered by microfluidic nozzle design in the 3D printed device. Once a particle encapsulates an aqueous volume, each “dropicle” provides uniform compartmentalization and customizable shape-coding for each sample volume to enable multiplexing of uniform reactions in a scalable manner. We implement an enzymatically-amplified affinity assay using the dropicle system, yielding a detection limit of

Background The endovascular treatment of wide-neck bifurcation aneurysms can be challenging and often requires the use of adjunctive techniques and devices. Methods We report our first experience of using a waffle-cone technique adapted to the Woven Endoluminal Bridge (WEB) device in a large-neck basilar tip aneurysm, suitable in cases where the use of Y stenting or other techniques is limited due to anatomic restrictions. Results The procedure was complete, and angiographic occlusion of the aneurysm was achieved 24 hours post treatment, as confirmed by digital subtraction angiography. No complications occurred. Conclusions The case reported here was not suitable for Y stenting or deployment of the WEB device alone, due to the small caliber of both posterior cerebral arteries and their origin at the neck level. The main advantage of this technique is that both devices have a controlled detachment system and are fully independent. To our knowledge, this technique has not been reported previously and this modality of treatment has never been described in the literature.

Component: C 1.3 Support for Member States' implementation of Maritime Spatial Planning Sub‐component: C 1.3.6. Establish Case Studies on Approaches to MSP Implementation Case Study #4 Strait of Sicily (Italy-Malta) The SIMWESTMED case study for Malta is focused on the Malta - Sicily marine waters, bordering the south of Sicily and the north of the Maltese Islands. The study area (9420 km2) features portions of internal, territorial and international waters, continental shelf areas, Malta’s Contiguous Zone and Malta’s Fisheries Management Conservation Zone. After a thorough refinement of information on legal/planning status, environmental conditions and uses and acquisition of fine scale spatial data, available approaches and toolsets (http://data.adriplan.eu/tools4msp/) were used to identify MSP issues for the area, conflicts among uses and their cumulative effects on the marine environment, proper analysis of land-sea interactions, and elaborate recommendations for transboundary MSP. Results and stakeholders engagement were used for the proposal of integrated sectoral measures, with the identification of possible management objectives, plan proposals and recommendations., This report/document was produced as part of the SIMWESTMED Project (Grant Agreement N0. EASME/EMFF/2015/1.2.1.3/02/SI2.742101). PROJECT: Supporting Implementation of Maritime Spatial Planning in the Western Mediterranean region (SIMWESTMED) Competition for maritime space – for renewable energy equipment, aquaculture and other uses – has highlighted the need to manage our waters more coherently. Maritime spatial planning (MSP) works across borders and sectors to ensure human activities at sea take place in an efficient, safe and sustainable way. That is why the European Parliament and the Council have adopted a legislation to create a common framework for maritime spatial planning in Europe. The Directive 2014/89/EU of the European Parliament and of the Council of 23 July 2014 (said Maritime Spatial Planning Directive) establishes a framework in order to reduce conflicts between sectors and create synergies between different activities, to encourage investment – by creating predictability, transparency and clearer rules, to increase cross-border cooperation – between EU countries to develop energy grids, shipping lanes, pipelines, submarine cables and other activities, but also to develop coherent networks of protected areas, and to protect the environment – through early identification of impact and opportunities for multiple use of space. The SIMWESTMED project (Supporting Implementation of Maritime Spatial Planning in the Western Mediterranean region) is an EU/DG Mare co-funded cross-border project. It was launched on 1st of January 2017 and involves Spain, France, Italy and Malta, while these countries had just designated their Competent Authorities and transposed the Maritime Spatial Planning (MSP) Directive. SIMWESTMED aims to support the implementation of the MSP Directive in the waters of Spain, France, Italy and Malta, as well as to establish cross-border cooperation mechanisms between these Member States, to contribute to the coherence of their marine spatial plans to be established by 2021. The action ran until 31st of December 2018 and was based on a partnership of public bodies of the countries and two international organisations. It was composed of CEDEX, IEO, AFB, CEREMA, Shom, CORILA and its affiliated entities IUAV and CNR-ISMAR, MIT, IMELS, PA, CPMR, UNEP-MAP and its affiliated entity UNEP-MAP/PAP-RAC. Shom acted as coordinator. The objectives of the SIMWESTMED project were addressed through a variety of activities and desktop or case studies. They are dedicated to identifying the methodology steps, and explore the challenges and opportunities of the MSP implementation in the Western Mediterranean area, including thus related to transboundary issues (Ecosystem based approach, marine policies, Barcelona Convention, Land Sea Interactions, geographical scale of the plans, data interoperability, tools to support MSP). The project led to a multiplicity of outputs including overviews of MSP relevant information related to the countries and on more focus areas, to a number of interviews and meetings where stakeholder views were collected to feed the reasoning, and to guidelines and good practices to be shared at a national and transnational level with marine stakeholders, scientists as well as planners, administrations and authorities. In addition, SIMWESTMED permitted a lot of progression internally in the countries and regarding transboundary cooperation. It led to establish and develop new dialogues and to connect the technical or scientific actors, the stakeholders, the administrations of the countries of a same sea basin, and the administrations within the countries, including the representative of Regions. It allowed to better understand Maritime Spatial Planning mechanisms, to share knowledge and as such reached to build capacities, which is of importance as there is such a need in the Mediterranean area compared to more Northern countries. The project also permitted to address topics which have never been addressed before. The involvement of some countries in SIMWESTMED and in the EU-DG Mare "brother" projects SUPREME, SIMNORAT and SIMCelt was useful for them to develop a global vision with their neighbours through the East and West side of the Mediterranean and in the Atlantic sea basin. At the end of this exercise, it is stated the need of pursuing the work and dialogue in particular through common tools, but at this stage, the SIMWESTMED has constituted a common knowledge and background. Disclaimer: The contents and conclusions of this report, including the maps and figures, do not imply the expression of any opinion or endorsement of the participating partners concerning the legal status of any country, territory, area, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The depiction and use of boundaries, geographic names and related data shown on maps included in this report are not warranted to be error free nor do they imply official endorsement or acceptance by any of the participating partners. This report is a working document and may rely on data from sources external to the SIMWESTMED project Consortium and, in addition to this, it may contain some information gaps. Neither the European Commission or Executive Agency for Small and Medium-sized Enterprises nor UN Environment/MAP Barcelona Convention Secretariat may be held responsible for any use that may be made of the information contained in this report.

The European Union has already devoted its attention to the reality of early childhood for years and through the European Commission Network on Childcare (ECNC) had developed recommendations and documents that stress the importance of preschool education, seen as a key tool for a good cultural, cognitive, physical and emotional development of children, and at the same time as a necessary condition for guaranteeing equal opportunities among citizens right from the start (Silva, Freschi & Caselli, 2018). The European pillar of social rights' (2017) establishes that all children have the right to education and care in early childhood at sustainable costs and of good quality. With the Legislative Decree n. 65/2017 Italian children's education finds itself re-evaluating the educational and scholastic child path, intended as an essential prerequisite for promoting unitary and harmonious development, aiming to highlight the importance of careful planning of educational and didactic action at nursery. Moreover, today it is right to consider the parent as a partner in the educational and growth planning of the child, right from the nursery school. This can finally open the door to an idea of participatory and co-responsible education between the public of the institution and the private of the family, finalizing the centers for children (0-3 years) to the quality of the educational service designed in an eminently pedagogical perspective.

Germany’s political economy has undergone a substantial transformation. After having been held up as the “sick man of Europe” at the turn of the century, it is now considered, depending on the point of view, either an “economic superstar” or a bulky elephant in the European Economic and Monetary Union (EMU). At the core of Germany’s transformation there lies a prolonged trajectory of wage restraint. The observation from which this dissertation takes off is that, since the mid-1990s, the most pronounced trajectory of wage restraint can be observed in the German public sector rather than the export sector. Yet very little is known about the political economy of public sector wage setting. What explains Germany’s trajectory of public sector wage restraint vis-à-vis its EMU peers? Through a triangulation of interviews with key policy actors, archival and secondary sources, the dissertation shows historically and analytically that Germany’s trajectory is the result of the public employers’ necessity to pursue consolidation in the face of an ever tighter fiscal space. This necessity was/is not homogeneously distributed among the German public employers. It is mediated by the institutional structures of the German semisovereign state. Germany is a fragmented polity characterized by an asymmetric fiscal federalism system. Tax legislation is centralized within the Federation’s remits while administrative expenditures are mostly a prerogative of sub-national governments. Public employers’ revenues are thus constrained by the lack of fiscal autonomy. The incapacity to manipulate revenues at will urges them to rein in the fiscal costs of public sector wage setting. Within this constellation, the public employers are semisovereign state actors in that they share the political authority to adopt public sector wage policies with other centres of power over which they have no control. But the structure of the politico-administrative system is such that the bulk of the public sector wage bill is footed by sub-national employers. This creates conflicts of interest among the public employers. “Together we rule divided we stand” tells the story of a political misalignment within the public employers’ historical coalition. For forty years, public employers’ unity had ensured centralized and encompassing wage bargaining in the German public sector. The deficits caused by reunification first, slow growth and the Red-Green’s tax reform later dealt a blow to the finances of public employers. Before acceding EMU, in 1996, the public employers united had to push for public sector wage restraint to bring the deficit below the Maastricht’s 3% vincolo esterno. Had the employers not pursued restraint fiercely before the 1997 fiscal year, Germany would have most likely not qualified for EMU. In the 2000s the public employers grew politically divided and took different paths. Given their disproportional personnel costs, the Länder pulled out of the public employers’ bargaining coalition and opted for the institutionalization of their own Länder-level collective bargaining. Simultaneously, in the fiscal federalism reform they successfully claimed back the legislative competence to regulate their civil servants’ pay and careers. The federal and municipal employers remained together within a new joint collective bargaining framework. The double process of institutional and constitutional reforms has now led to the institutionalization of a low-wage equilibrium characterized by consensus-based joint decision making. This is, however, an institutional equilibrium in which public wages can only be set as a lowest common denominator taking into consideration the poorer employers’ ability to pay. These state institutional structures, I claim, currently hamper Germany’s capacity to inflate its economy via public sector wage/fiscal inflation in order to ensure a more symmetric adjustment in the post-crisis EMU. The dissertation shows that restraint is not the result of a state capture by a dominant export sector’s elite. Nor is it imposed via export-led pattern bargaining. The public employers were the protagonists and their interests were primarily fiscal in nature. In hoping to bring the public employers within the radar of CPE scholars, the dissertation suggests that the state matters but it is not a monolithic bloc capable of unitary action. What characterizes governments in their function of public employers is rather their internal dividedness, with which they must come to terms in order to “act” as wage setters. List of Figures List of Tables List of Abbreviations Acknowledgements Setting the Scene Introduction The argument of the dissertation Plan of the dissertation Part I. Public employers as semisovereign state actors. Toward a state-centred institutionalist framework for the study of public sector wage setting Chapter 1. Wage policies in EMU’s public sectors 1.1 Defining wage policy options in the context of the EMU macroeconomic regime 1.2 The importance of wage policy in the EMU 1.3 The puzzle of Germany’s public sector wage restraint 1.4 Brief excursus on defining the public sector Chapter 2. Methodological strategy of the dissertation 2.1 Logic of case selection: Germany as both an extreme and crucial case 2.2 Methodology: a two-step process tracing approach 2.3 Nature, origin and storage of the utilised sources Chapter 3. Casting the net widely: Germany’s public sector wage restraint and the study of wage determination in the social sciences 3.1 Economics 3.2 Interests-based Comparative Political Economy 3.3 Industrial Relations 3.4 Institutionalist Comparative Political Economy 3.5 Testing the rival hypothesis: does export-led pattern bargaining explain wage restraint in the German public sector? Chapter 4. Toward a state-centred institutionalist framework for the study of public sector wage setting 4.1 Foundations of theory-guided process tracing: state-centred institutionalism as an alternative theoretical approach 4.2 Together we rule, divided we stand: public employers as semisovereign state actors 4.3 Public employees and the political deterrence power 4.4 The state as an institutional contextualisation: a four-tier analytical framework for the study of public sector wage setting 4.5 Wage policy requires fiscal politics Part 2. From reunification to a new institutional equilibrium: the trajectory of wage restraint in the German public sector Chapter 5. The German institutional setting in the early 1990s 5.1 The politico-administrative structure of the state 5.2 Public Sector employment relations and the system of interest representation 5.3 The fiscal constitution of the state 5.4 Legal and fiscal watchdogs Chapter 6. The 1990s. Die Blühenden Landschaften hit the vincolo esterno 6.1 Reunification and the loss of fiscal and wage discipline (1990-1993) 6.2 Public sector wage restraint in the face of budget deficits (1994-1997) 6.3 Analysis of the 1990s Chapter 7. The 2000s. The double Länder offensive: institutional and constitutional reforms of public sector wage setting 7.1 Wage restraint in the context of institutional reforms of the wage bargaining structure 7.2 Competitive federalism and civil service’s wage differentiation in the context of constitutional reforms 7.3 Analysis of the 2000s Chapter 8. “Die öffentlichen Kassen sind immer leer“, even in the age of prosperity 8.1 A new institutional equilibrium in the German public sector Conclusions Public employers as semisovereign state actors and the political economy of public sector wage restraint in Germany The fiscal mechanism of public sector wage restraint: wider implications for CPE theory and policy making in the EMU List of references Appendix A: list of interviewees Appendix B: dates of the signature of selected sectoral collective bargaining agreements

Viremia copy-years (VCY) is associated with mortality and disease outcome prediction. This study evaluated the association of VCY with virological failure (VF), defined as a plasma viral load (pVL)400 copies/mL, and with single levels of viremia.Eight hundred and fifty antiretroviral therapy (ART)-treated patients with pVL37 copies/mL [target not detected or target detected (TD)] or37, but less than 200 copies/mL (low-level viremia), and at least 6-pVL measures during 54 months of follow-up were selected. VCY was calculated individually over the follow-up as the area under pVL curve. Pearson's χ test was used to analyze differences in VCY quartiles distribution between groups.Higher VCY values were detected in patients with low-level viremia {294 copy-years [interquartile range (IQR): 99-1870]} than in TD [52 copy-years (IQR: 53-153)] and target not detected groups [19 copy-years (IQR: 8-54)]. VCY was also significantly different between patients with undetectable viremia and patients with basal pVL TD (P0.001). Pearson's χ test revealed a significant association between VCY and basal levels of viremia (P0.0001). In addition, the risk of VF rose with increasing VCY (Hazard ratio 1.01, 95% confidence interval: 1.01 to 1.02).This study revealed the association of VCY with VF and with single levels of viremia suggesting that, despite the success of ART, minimal residual viremia may cause the cumulative viral burden to rise. Full viral load suppression during ART is crucial to limit the increase in VCY.

Background: Doravirine is a novel HIV-1 NNRTI recently shown to be non-inferior to both darunavir/ritonavir and efavirenz in combination therapy with two NRTIs in treatment-naive patients. Doravirine has an in vitro resistance profile that is distinct from other NNRTIs and retains activity against viruses containing the most frequently transmitted NNRTI mutations. Objectives: The aim of this study was to examine the prevalence of doravirine resistance-associated mutations in HIV-1-infected treatment-naive patients in Europe. Methods: From 2010 to 2016, 9764 treatment-naive patients were tested for NNRTI antiretroviral drug resistance by bulk sequencing in Greece, Italy and France. We studied the prevalence of doravirine resistance-associated mutations previously identified in vitro: V106A/M, V108I, Y188L, V190S, H221Y, F227C/L/V, M230I/L, L234I, P236L, Y318F and K103N/Y181C. Results: Among 9764 sequences, 53.0% and 47.0% of patients had B and non-B subtypes, respectively. Overall, the presence of at least one doravirine resistance-associated mutation (n " 137; 1.4%) or the K103N/Y181C mutations (n " 5; 0.05%) was very rare. The most prevalent mutations were V108I (n " 62; 0.6%), Y188L (n " 18; 0.2%), H221Y (n " 18; 0.2%) and Y318F (n " 23; 0.2%). The frequency of doravirine resistance-associated mutations was similar between B and non-B subtypes. In comparison, the prevalence of rilpivirine, etravirine, nevirapine and efavirenz resistance was higher whatever algorithm was used (ANRS: 8.5%, 8.1%, 8.3% and 3.9%, respectively; Stanford: 9.9%, 10.0%, 7.5% and 9.4%, respectively). Conclusions: The prevalence of doravirine resistance-associated mutations is very low in antiretroviral-naive patients. These results are very reassuring for doravirine use in naive patients. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Background: HBsAg immune-escape mutations can favor HBV-transmission also in vaccinated individuals, promote immunosuppression-driven HBV-reactivation, and increase fitness of drug-resistant strains. Stop-codons can enhance HBV oncogenic-properties. Furthermore, as a consequence of the overlapping structure of HBV genome, some immune-escape mutations or stop-codons in HBsAg can derive from drug-resistance mutations in RT. This study is aimed at gaining insight in prevalence and characteristics of immune-associated escape mutations, and stop-codons in HBsAg in chronically HBV-infected patients experiencing nucleos(t)ide analogues (NA) in Europe. Methods: This study analyzed 828 chronically HBV-infected European patients exposed to ≥ 1 NA, with detectable HBV-DNA and with an available HBsAg-sequence. The immune-associated escape mutations and the NA-induced immune-escape mutations sI195M, sI196S, and sE164D (resulting from drug-resistance mutation rtM204 V, rtM204I, and rtV173L) were retrieved from literature and examined. Mutations were defined as an aminoacid substitution with respect to a genotype A or D reference sequence. Results: At least one immune-associated escape mutation was detected in 22.1% of patients with rising temporal-trend. By multivariable-analysis, genotype-D correlated with higher selection of ≥ 1 immune-associated escape mutation (OR[95%CI]:2.20[1.32-3.67], P = 0.002). In genotype-D, the presence of ≥ 1 immune-associated escape mutations was significantly higher in drug-exposed patients with drug-resistant strains than with wild-type virus (29.5% vs 20.3% P = 0.012). Result confirmed by analysing drug-naïve patients (29.5% vs 21.2%, P = 0.032). Strong correlation was observed between sP120T and rtM204I/V (P < 0.001), and their co-presence determined an increased HBV-DNA. At least one NA-induced immune-escape mutation occurred in 28.6% of patients, and their selection correlated with genotype-A (OR[95%CI]:2.03[1.32-3.10],P = 0.001). Finally, stop-codons are present in 8.4% of patients also at HBsAg-positions 172 and 182, described to enhance viral oncogenic-properties. Conclusions: Immune-escape mutations and stop-codons develop in a large fraction of NA-exposed patients from Europe. This may represent a potential threat for horizontal and vertical HBV transmission also to vaccinated persons, and fuel drug-resistance emergence. © 2018 The Author(s).