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This report provides guidance for Member states who plan to submit applications under the work programme 'CP-g-22-04.01 Direct grants to Member States' authorities'. The priority pathogens on which the coordinated surveillance under the grant initiative shall focus have been identified in a prioritisation exercise with Member States and ECDC. These are Crimean Congo haemorrhagic fever, echinococcosis, hepatitis E, highly pathogenic avian influenza (HPAI), influenza in swine, Lyme disease, Q-fever, Rift Valley fever, tick-borne encephalitis, West Nile fever and Disease X (Disease Y of animals). Surveillance activities (surveillance cards) have been proposed for these agents in this report. Member States should select one or more diseases from the list of priority diseases and then choose surveillance activities from the surveillance cards and modify them where needed, to reflect their national needs and situation. Member States can also design alternative surveillance activities for the priority infectious agents that may better fit the epidemiological situation in their country. Further, this report provides a section on surveillance perspectives that links infectious agents to different hosts, allowing Member States to consider the testing for multiple infectious agents in samples from a single host population, as well as sections providing guidance on surveillance in vectors and wildlife and for Disease X (Disease Y in animals). Member States are encouraged to develop cross-sectoral collaborations and the report provides guidance on cross-sectoral collaboration to help them. Finally, there is a roadmap providing an overall description of the steps in the process of developing a surveillance system in order to apply for the grant., (© 2023 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.)

There is a plethora of meat-borne hazards - including parasites - for which there may be a need for surveillance. However, veterinary services worldwide need to decide how to use their scarce resources and prioritise among the perceived hazards. Moreover, to remain competitive, food business operators - irrespective of whether they are farmers or abattoir operators - are preoccupied with maintaining a profit and minimizing costs. Still, customers and trade partners expect that meat products placed on the market are safe to consume and should not bear any risks of causing disease. Risk-based surveillance systems may offer a solution to this challenge by applying risk analysis principles; first to set priorities, and secondly to allocate resources effectively and efficiently. The latter is done through a focus on the cost-effectiveness ratio in sampling and prioritisation. Risk-based surveillance was originally introduced into veterinary public health in 2006. Since then, experience has been gathered, and the methodology has been further developed. Guidelines and tools have been developed, which can be used to set up appropriate surveillance programmes. In this paper, the basic principles are described, and by use of a surveillance design tool called SURVTOOLS (https://survtools.org/), examples are given covering three meat-borne parasites for which risk-based surveillance is 1) either in place in the European Union (EU) (Trichinella spp.), 2) to be officially implemented in December 2019 (Taenia saginata) or 3) only carried out by one abattoir company in the EU as there is no official EU requirement (Toxoplasma gondii). Moreover, advantages, requirements and limitations of risk-based surveillance for meat-borne parasites are discussed., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Slowing of the electroencephalogram (EEG) is frequent in Parkinson's (PD) and Alzheimer's disease (AD) and correlates with cognitive decline. As overlap pathology plays a role in the pathogenesis of dementia, it is likely that demented patients in PD show similar physiological alterations as in AD., Objective: To analyze distinctive quantitative EEG characteristics in early cognitive dysfunction in PD and AD., Methods: Forty patients (20 PD- and 20 AD patients with early cognitive impairment) and 20 normal controls (NC) were matched for gender, age, and education. Resting state EEG was recorded from 256 electrodes. Relative power spectra, median frequency (4-14 Hz), and neuropsychological outcome were compared between groups., Results: Relative theta power in left temporal region and median frequency separated the three groups significantly (p = 0.002 and p < 0.001). Relative theta power was increased and median frequency reduced in patients with both diseases compared to NC. Median frequency was higher in AD than in PD and classified groups significantly (p = 0.02)., Conclusion: Increase of theta power in the left temporal region and a reduction of median frequency were associated with presence of AD or PD. PD patients are characterized by a pronounced slowing as compared to AD patients. Therefore, in both disorders EEG slowing might be a useful biomarker for beginning cognitive decline.

The authors present a patient with refractory epilepsy who was treated with very high doses (up to 4 mg/min) of intravenous midazolam, phenytoin, carbamazepine, and other antiepileptics. Because it was known from the literature that the half-life of midazolam can increase at high dosage, the kinetics of midazolam (MDZ), 1'-hydroxymidazolam, and 4-hydroxymidazolam were assessed at steady state (dosage 1 mg/min) and after stopping treatment. Total body clearance of MDZ (33 L/kg) and intrinsic hepatic clearance (19 mL/min/kg) at steady state were both five to 10 times higher than after normal therapeutic doses, demonstrating hepatic cytochrome (CYP) 3A induction. Despite the high body clearance, the half-life of MDZ was in the range of 24 hours, approximately 10 times higher than after normal therapeutic doses. The volume of distribution at steady state was 33 L/kg, approximately 50 times higher than after normal therapeutic doses. The free fraction of MDZ was 58% at steady state, much higher than the 3% to 6% at normal therapeutic doses. The kinetics of intravenous MDZ is strongly dependent on its dose and on hepatic CYP3A activity. Even in patients with hepatic CYP3A induction, the half-life of MDZ increases with high doses as a result of a rise in its volume of distribution, which is a consequence of an increase in the free fraction of MDZ.

The authors describe a patient with known human immunodeficiency virus (HIV)-1 infection who presented with two generalized seizures and was found to have extensive white matter disease and a left/bilateral temporo-occipital focal slowing on electroencephalography (EEG). There were no magnetic resonance imaging (MRI) or cerebrospinal fluid (CSF) indications for opportunistic infection. Plasma viremia was controlled, whereas viral replication was uncontrolled in CSF. CSF-specific genotype-guided adaptation of the antiretroviral therapy in order to optimize central nervous system (CNS) penetration resulted in clinical improvement and normalization of MRI and EEG. Our case report illustrates the importance of individualized antiretroviral therapy in HIV infected patients with neurological complications.

Focal beta activity on scalp EEG is a rare seizure pattern that has most extensively been studied in patients undergoing evaluation for epilepsy surgery. However, ictal beta activity is uncommon beyond this population and has not been reported in human status epilepticus. We observed ictal focal beta activity as the predominant seizure pattern in a patient with refractory status epilepticus. Continuous left temporal beta activity clinically correlated with complex partial semiology on video-EEG.