This study explores how EU integration, globalisation, and geopolitical disruptions have influenced scientific collaboration among European countries at different stages of EU membership. Specifically, it distinguishes between the EU-14, the EU-13, that joined the EU in 2004 or later, and EU candidate countries. Using Scopus article, the study analyses Relative Intensity of Collaboration (RIC) among EU member state, candidate countries and China, Latin America, the UK, the USA and Russia. Findings indicate increasing integration within European groups and with global partners, yet persistent hierarchical structures remain. EU-14 countries form the core of the network, exhibiting stable and cohesive collaboration, including with the UK despite Brexit. EU-13 countries occupy an intermediate position, showing moderate collaboration with EU-14 but stronger collaboration within their own group, with EU candidate countries and Russia. EU candidate countries demonstrate even weaker integration with EU-14, focusing on intra-group ties and links with EU-13 and Russia. RIC peaks in 2012 and 2018 for EU-13 and EU candidate countries correspond to Horizon 2020 and Horizon Europe cycles, highlighting the role of EU Framework Programmes. Collaboration with Russia increased following 2014 and only marginally declined after 2022. For EU-14, it exceeds collaboration with the USA. Collaboration with China remains limited due to network and cultural constraints, with similar intensity across all three groups. Overall, funding and policy initiatives are critical for stable international collaboration.
The paper studies the nowcasting of Euro area Gross Domestic Product (GDP) growth using mixed data sampling machine learning panel data regressions with both standard macro releases and daily news data. Using a panel of 19 Euro area countries, we investigate whether directly nowcasting the Euro area aggregate is better than weighted individual country nowcasts. Our results highlight the importance of the information from small- and medium-sized countries, particularly when including the COVID-19 pandemic period. The empirical analysis is supplemented by studying the so-called Big Four -- France, Germany, Italy, and Spain -- and the value added of news data when official statistics are lagging. From a theoretical perspective, we formally show that the aggregation of individual components forecasted with pooled panel data regressions is superior to direct aggregate forecasting due to lower estimation error.
This study investigates the impact of a fiscal policy spending shock on the economy of the Visegrad 4 countries. The impact is estimated with an SVAR model, and the calculations are based on 84 quarterly observations (1999Q1-2019Q4). The results suggest that fiscal expansion has a larger than usual impact in the V4 countries (except for Slovakia): the estimated long-term (5-year) cumulative spending multipliers are 0.81 for Czechia, 1.14 for Hungary, and 1.76 for Poland (the Slovakian multiplier has a value of -0.18, but it is not significant). The discussion section also connects higher spending multipliers with a higher share of VAT revenues, a higher debt ratio, higher foreign debt, and lower openness.
Until the 17th century, the Dutch coastal region of Zeeland ranked among Europe's most urbanized areas, driven by thriving international trade networks. People living in this time of flourishing economy benefitted enormously from it in terms of employment opportunities and working conditions, which were reportedly better than in the rest of the Low Countries. However, the rapid growth of Zeeland's urban centers likely presented increasing challenges for the population in terms of accessing essential resources, including food, clean water, and housing. In the 19th century, Zeeland's economy ultimately faced a significant downturn due to the decline in the maritime trade, leading to a substantial reduction in its urban population. Examining patterns of urbanization and economic histories that differ from the commonly studied thriving industrial contexts in bioarcheological research, as exemplified by Zeeland, is a crucial yet relatively underexplored facet in our efforts to understanding the human past. To address this gap, this study investigates the impact of urbanization on the health of Zeeland's inhabitants over time by analyzing nonspecific stress markers (i.e., cribra orbitalia, porotic hyperostosis, and linear enamel hypoplasia) and chronic maxillary sinusitis in a sample of 246 individuals from three urban sites dating from 1030 to 1800 CE. Our analysis of skeletal remains reveals significant differences in the prevalence of porotic hyperostosis, linear enamel hypoplasia, and sinusitis between the medieval and post‐medieval periods. These findings suggest that de‐urbanization and economic decline adversely affected the health and well‐being of the populations under study, influenced by factors such as working conditions and food availability. This study provides a new perspective on bioarcheological approaches to urbanization, shedding light on the intricate realities of urbanization in Zeeland and offering important insights into its complexities.
INTRODUCTION Poor adherence to anti-tuberculosis medication is a major barrier to its global control. Patient adherence to the standard anti-TB therapy (ATT) in developing countries has been estimated to be as low as 40%. Multiple factors influencing adherence to treatment are: Economic and structural factors such as homelessness, unemployment and poverty; patient related factors like ethnicity, gender, age, knowledge about TB, cultural belief systems, mental state etc. AIMS & OBJECTIVES: This study was planned with the aim to study the association between various socio-demographic factors with level of adherence to the daily regimen amongst newly diagnosed pulmonary TB patients at a tertiary care hospital in metropolitan city of Maharashtra. Additionally, we tried to determine the type of non-adherence along with reasons for it. METHOD ology: An interview based pre-tested and validated questionnaire was developed & used as data collection tool. Total 181 newly diagnosed, FDC naïve, drug sensitive pulmonary TB patients from DOT center of a tertiary care hospital were enrolled & interviewed for sociodemographic, treatment & adherence details. They were followed up at 2nd & 6th month of their treatment, i.e., IP & CP follow up. Their Nikshay portal data & TB treatment cards were accessed for information on treatment adherence. RESULTS Out of 181 patients, 110 (60.8%) were found to be adherent whereas 71 (39.2%) were found to be non-adherent. Among those non-adherent, 64 (90.9%) had treatment gaps (intermittent missed doses) & 7 (9.9%) showed discontinuation of treatment. Majority of these patients reported personal obligations & starting to feel better as the main reason for non-adherence (p < 0.0001). The sociodemographic factors that had significant impact on level of adherence were patients' age (p = 0.013); level of education (p = 0.035); family size (p = 0.018); family history of TB (p = 0.0001) & current smoking habit (p = 0.025). CONCLUSION It is evident from the study that socio-demographic factors do have a major impact on patients' levels of adherence to treatment. Family history of TB as well as sputum conversion at end of treatment/CP have been identified as independent risk factors among pulmonary TB patients who are non-adherent to treatment. Thus, ensuring robust availability of DBT & intensive tobacco cessation sessions for all diagnosed patients as well as strengthening system for making prophylaxis available for household & close contacts of patients can help in reducing impact of socio-demographic factors & improving adherence levels. RECOMMENDATIONS In-patient care option specifically during IP; regular dietary counseling to improve nutrition & help reduce drug side effects & use of alternate adherence technologies like facility-based DOT or Video Observed Therapy (VOT) wherever feasible can help to improve adherence levels for TB patients from all walks of life.
María Teresa García-Ordás, Natalia Arias, Carmen Benavides
et al.
COVID-19 disease has affected almost every country in the world. The large number of infected people and the different mortality rates between countries has given rise to many hypotheses about the key points that make the virus so lethal in some places. In this study, the eating habits of 170 countries were evaluated in order to find correlations between these habits and mortality rates caused by COVID-19 using machine learning techniques that group the countries together according to the different distribution of fat, energy, and protein across 23 different types of food, as well as the amount ingested in kilograms. Results shown how obesity and the high consumption of fats appear in countries with the highest death rates, whereas countries with a lower rate have a higher level of cereal consumption accompanied by a lower total average intake of kilocalories.
Carlos Cano‐Barbacil, M. Carrete, P. Castro-Díez
et al.
Invasive alien species have widespread impacts on native biodiversity and ecosystem services. Since the number of introductions worldwide is continuously rising, it is essential to prevent the entry, establishment and spread of new alien species through a systematic examination of future potential threats. Applying a three-step horizon scanning consensus method, we evaluated non-established alien species that could potentially arrive, establish and cause major ecological impact in Spain within the next 10 years. Overall, we identified 47 species with a very high risk (e.g. Oreochromis niloticus, Popillia japonica, Hemidactylus frenatus, Crassula helmsii or Halophila stipulacea), 61 with high risk, 93 with moderate risk, and 732 species with low risk. Many of the species categorized as very high or high risk to Spanish biodiversity are either already present in Europe and neighbouring countries or have a long invasive history elsewhere. This study provides an updated list of potential invasive alien species useful for prioritizing efforts and resources against their introduction. Compared to previous horizon scanning exercises in Spain, the current study screens potential invaders from a wider range of terrestrial, freshwater, and marine organisms, and can serve as a basis for more comprehensive risk analyses to improve management and increase the efficiency of the early warning and rapid response framework for invasive alien species. We also stress the usefulness of measuring agreement and consistency as two different properties of the reliability of expert scores, in order to more easily elaborate consensus ranked lists of potential invasive alien species.
Aim The purpose of this study was to describe the proportions of patients referred to and attending cardiac rehabilitation programmes in Europe and to compare lifestyle and risk factor targets achieved according to participation in a cardiac rehabilitation programme. Methods The EUROASPIRE IV cross-sectional survey was undertaken in 78 centres from 24 European countries. Consecutive patients aged <80 years with acute coronary syndromes and/or revascularization procedures were interviewed at least six months after their event. Results A total of 7998 patients (24% females) were interviewed. Overall, 51% were advised to participate in a cardiac rehabilitation programme and 81% of them attended at least half of the sessions; being 41% of the study population. Older patients, women, those at low socio-economic status or enrolled with percutaneous coronary intervention and unstable angina, as well as those with a previous history of coronary disease, heart failure, hypertension or dysglycaemia were less likely to be advised to follow a cardiac rehabilitation programme. People smoking prior to the recruiting event were less likely to participate. The proportions of patients achieving lifestyle targets were higher in the cardiac rehabilitation programme group as compared to the non-cardiac rehabilitation programme group: stopping smoking (57% vs 47%, p < 0.0001), recommended physical activity levels (47% vs 38%, p < 0.0001) and body mass index<30 kg/m2 (65% vs 61%, p=0.0007). However, there were no differences in the blood pressure, lipids and glucose control. Patients who attended a cardiac rehabilitation programme had significantly lower anxiety and depression scores and better medication adherence. Conclusions Only half of all coronary patients were referred and a minority attended a cardiac rehabilitation programme. Those attending were more likely to achieve lifestyle targets, had lower depression and anxiety, and better medication adherence. There is still considerable potential to further reduce cardiovascular risk by increasing uptake and fully integrating secondary prevention and cardiac rehabilitation to provide a modern preventive cardiology programme.
Hepatocellular carcinoma (HCC) is a global health challenge. Due to the high prevalence in low-income countries, hepatitis B virus (HBV) and hepatitis C virus infections remain the main risk factors for HCC occurrence, despite the increasing frequencies of non-viral etiologies. In addition, hepatitis D virus coinfection increases the oncogenic risk in patients with HBV infection. The molecular processes underlying HCC development are complex and various, either independent from liver disease etiology or etiology-related. The reciprocal interlinkage among non-viral and viral risk factors, the damaged cellular microenvironment, the dysregulation of the immune system and the alteration of gut-liver-axis are known to participate in liver cancer induction and progression. Oncogenic mechanisms and pathways change throughout the natural history of viral hepatitis with the worsening of liver fibrosis. The high risk of cancer incidence in chronic viral hepatitis infected patients compared to other liver disease etiologies makes it necessary to implement a proper surveillance, both through clinical-biochemical scores and periodic ultrasound assessment. This review aims to outline viral and microenvironmental factors contributing to HCC occurrence in patients with chronic viral hepatitis and to point out the importance of surveillance programs recommended by international guidelines to promote early diagnosis of HCC.
Brazil Counterfeiting of medicines, also known as “falsification” or “adulteration”, is the process in which the identity , origin, or history of genuine medicines are intentionally modified. Currently, counterfeit medicines are a global crisis that affects and is mostly caused by developing countries in Asia, Africa and Latin America. These countries lack strict law enforcement against this practice and have low-income populations with medicinal needs. Lately, the crisis has escalated, impacting developed countries as well, e.g., the US and the EU, mainly via the Internet. Despite this extension, some current laws aim to control and minimize the crisis’ magnitude. Falsification of medicines maintains an illegitimate supply chain that is connected to the legitimate one, both of which are extremely complex, making such falsification difficult to control. Furthermore, political and economic causes are related to the crisis’ hasty growth, causing serious consequences for individuals and public health, as well as for the economy of different countries. Recently, organizations, technologies and initiatives have been created to overcome the situation. Nevertheless, the development of more effective measures that could aggregate all the existing strategies into a large functioning network could help prevent the acquisition of counterfeit medicines and create awareness among the general population.
This article reviews the literature on comparative real wages in history that has emerged over the past two decades. Research has shown that unskilled men's real wages were higher in England and the Low Countries than in other parts of Europe and Asia from about 1720. Yet 18th‐ and 19th‐century real wages were even higher in the northern American colonies than they were in the European leaders, while those in Latin America were somewhere in the middle of the global wage ladder. This comparative picture is drawn on the basis of unskilled male day wages and various recent contributions focused on specific countries and time periods noting the variation in wage levels and trends for different groups of workers across urban and rural areas and labor contracts, varying days of labor per year, and the crucial and changing contributions of other family members. The latest research also highlights new ways to compute comparative cost‐of‐living indices. Building new datasets to take these issues into account in a new global comparative picture of long‐run real wages is a major area for future research.
The global mpox outbreak spanning 2022–2023 has affected numerous countries worldwide. In this study, we present the first report on the detection, whole‐genome sequence, and coinfection of the mpox virus and varicella zoster virus (VZV) from Pakistan. During April–May 2023, samples from 20 suspected cases of mpox were tested at the National Institutes of Health, Islamabad among which 4 tested positive. All four cases had a travel history of Saudi Arabia. All the suspected samples were processed by using a Zymo research kit for DNA extraction, followed by qRT‐PCR amplification by using a DaAn Gene detection kit for the mpox virus. Further, two of the positive samples with a low Ct value (<20) were subjected to whole‐genome sequencing using a metagenomic approach on the iSeq (Illumina) platform. The sequencing results revealed Clade IIb and genotype A.2.1 of MPXV, which clustered with viruses from Slovenia and the UK in July and June 2022, respectively. Our analysis identified two novel nonsynonymous substitutions in mpox virus, namely V98I in OPG046 and P600S in OPG109. Furthermore, we successfully retrieved the complete genome of VZV from the same sample, belonging to Clade 5. This study represents the first positive case of MPXV in Pakistan and the coinfection of mpox and VZV by using a metagenome approach providing insights into their complete genomes. Our results highlight the importance of surveillance at the point of entries, strengthening lab capacities including next‐generation sequencing, and using differential diagnosis for timely and accurate detection of mpox cases.
BACKGROUND The aim of current study is to assess the cross-sectional association of chronic non-communicable diseases (diabetes mellitus, arthritis, asthma, chronic lung disease, angina, and stroke) with both diagnosed and undiagnosed depression in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1, a study of adults in six low- and middle-income countries. METHODS A total of 41,810 participants, aged ≥ 18 years, were included. Depression status was assessed by standard methods derived from the World Mental Health Survey (WHH-CIDI). Undiagnosed depression was defined as a depressed person who did not report history of diagnosis/treatment for depression. Associations between depression/undiagnosed depression and chronic diseases, adjusting for country of residence, demographics and chronic diseases risk factors were assessed. RESULTS Depression was detected in 2508 (6.0%) cases, from whom 2098 (87%) were undiagnosed. Diabetes (Odds ratio:1.47[95%CI:1.24,1.75]), arthritis (2.14[1.82,2.52]), asthma (3.36[2.73,4.14]), chronic lung disease (3.74[3.10,4.51]), angina (3.20[2.66,3.85]), and stroke (3.14[2.55,3.86]) were associated with depression (p-values < 0.001). Being older, female, underweight, and having lower education, and lower income were positively associated with depression. The estimated odds ratios were similar for undiagnosed depression. LIMITATIONS Cross-sectional design of study prevent us to determine whether depression followed exposures in time. About 12% of the participant did not have data for depression status and were excluded from the study. CONCLUSIONS Most depression cases were undiagnosed. Depression/undiagnosed depression were strongly associated with chronic diseases; stronger than what has been reported in developed countries.
Mercury (Hg) pollution is an important environmental and public health issue that has garnered significant interest from policy makers and the global regulatory community. Consumption of seafood is the primary mechanism of methyl Hg (MeHg) exposure in humans, globally, and marine fish represent an important linkage between atmospheric dynamics, aquatic biogeochemistry and trophic transfer of this highly neurotoxic and easily assimilated form of Hg. Hg policies and management are highly interdisciplinary and at their foundation are relatively well established scientific principles related to Hg methylation, MeHg cycling and bioaccumulation, and subsequent trophic transfer to humans; however, certain fine-scale aspects of these processes remain poorly understood. After several years of intergovernmental negotiations the Minamata Convention on Mercury (MCM) entered into force in August 2017. Anthropogenic releases (water) and emissions (air) of Hg, human exposure, and environmental health are of considerable importance within the framework and policies outlined in the MCM. Additionally, the overall risk of Hg from artisanal and small-scale gold mining (ASGM) is considered a significant source of human exposure and commonly occurs in low and middle income countries, where miners use elemental Hg to extract gold from ore. Here I outline the history, evolution and progress of the MCM as it relates to the science-policy interface and offer a brief synthesis of the state of Hg science in the context of modeling, temporal assessments of Hg trends and global environmental change and ecosystem sensitivity.