BACKGROUND & AIMS: :Marteilia refringens is one of the most significant pathogens of bivalve molluscs. Previous sequencing of the small subunit ribosomal RNA gene of M. refringens isolates derived from the infected mussels (Mytilus edulis and Mytilus galloprovinciallis) and the oyster (Ostrea edulis) in Europe did not reveal genetic polymorphisms despite indications from epizootiological data that distinct types may exist. We investigated the existence of polymorphisms in the internal transcribed spacer region of the ribosomal RNA genes. The sequences of this region proved to be clearly dimorphic among Marteilia from five sampling sites. The distribution of the two genetic types, named "O" and "M", appeared to be linked to the host species, oysters and mussels, respectively. We therefore support the recognition of two species of Marteilia in Europe and propose that the "O" type corresponds to M. refringens and the "M" type to M. maurini.

背景与目标： ：Marterilia refringens是双壳软体动物最重要的病原体之一。尽管从流行病学数据表明可能存在不同类型的感染，但欧洲感染的贻贝（Mytilus edulis和Mytilus galloprovinciallis）和牡蛎（Ostrea edulis）分离的致盲支气单胞菌小亚基核糖体RNA基因的先前测序未揭示遗传多态性。 。我们调查了核糖体RNA基因的内部转录间隔区中多态性的存在。在五个采样点的Marteilia中，该区域的序列被证明是明显二态的。两种遗传类型的分布，分别命名为“ O”和“ M”，似乎分别与宿主物种牡蛎和贻贝有关。因此，我们支持欧洲对两种Marteilia物种的认可，并建议“ O”类型对应于麻黄分枝杆菌，“ M”类型对应于毛利尼分枝杆菌。

BACKGROUND & AIMS: :This article synthesizes diverse official reports, statistics, and scientific papers that present demographic, economic, environmental, and social trends impacting on the health and quality of life of citizens living in European cities. A literature review led to the identification of some key challenges including an aging society, migration flows, inequalities in health, global change, and risk behaviors that should be addressed in order to promote urban health. Other challenges, such as food production and consumption, are also relevant, but not included. Cities that have participated in one or more of the phases of the WHO European Healthy Cities Network have implemented a number of policies, programs, and measures to deal with the challenges discussed in this article. Some contributions are presented to illustrate how health and quality of life in urban areas can be promoted by local authorities.

背景与目标： ：本文综合了各种官方报告，统计数据和科学论文，介绍了人口统计，经济，环境和社会趋势，这些趋势对居住在欧洲城市的公民的健康和生活质量产生了影响。文献综述导致确定了一些关键挑战，包括老龄化社会，移民流动，健康方面的不平等，全球变化以及为促进城市健康而应解决的风险行为。其他挑战，例如粮食生产和消费，也具有相关性，但并未包括在内。参加了世卫组织欧洲健康城市网络一个或多个阶段的城市已经实施了许多政策，规划和措施来应对本文中讨论的挑战。提出了一些意见，以说明地方当局如何促进城市地区的健康和生活质量。

BACKGROUND & AIMS: :After 1970 the preexisting gap in population health between democratic Europe and communist countries became even more prominent. While in the democratic Europe there was a progressive rise in life expectancy associated with the decline in ischaemic heart disease (IHD), the trend on the other side of the iron curtain was exactly reverse. After the fall of communism in 1989 population health in the post-communist central Europe (CE) rapidly signalled a favourable recovery. This biphasic trend in post-communist countries is very remarkable. Most remarkably the decline in IHD mortality started soon after the demise of totality, even before the modernization of health care (new more effective medications and diagnostic technology), public campaign against smoking and improved supply of protective nutrients got chance to attain an important role. The decades-long psychosocial depression of communism was rapidly replaced with a promise of a better future. It is generally accepted that psychosocial factors are powerfool tools in the pathogenesis of IHD.

背景与目标： ：1970年以后，欧洲民主国家和共产主义国家之间在人口健康方面的先天不足变得更加突出。尽管在民主的欧洲，与缺血性心脏病（IHD）下降相关的预期寿命正在逐步增加，但铁幕的另一面却恰好相反。 1989年共产主义垮台后，中共后欧洲国家（CE）的人口健康状况迅速好转。后共产主义国家的这种两相性趋势非常显着。最显着的是，IHD死亡率的下降在总体灭绝后不久就开始了，甚至在医疗保健现代化（新的更有效的药物和诊断技术）出现之前，公众反吸烟运动和保护性营养素供应的增加也有机会发挥重要作用。共产主义长达数十年的社会心理压抑迅速被美好未来的希望所取代。人们普遍认为，心理社会因素是IHD发病机制中的傻瓜工具。

BACKGROUND & AIMS: GOAL, SCOPE AND BACKGROUND:One of the burning problems of our industrial society is the high consumption of water and the high demand for clean drinking water. Numerous approaches have been taken to reduce water consumption, but in the long run it seems only possible to recycle waste water into high quality water. It seems timely to discuss alternative water remediation technologies that are fit for industrial as well as less developed countries to ensure a high quality of drinking water throughout Europe. MAIN FEATURES:The present paper discusses a range of phytoremediation technologies to be applied in a modular approach to integrate and improve the performance of existing wastewater treatment, especially towards the emerging micro pollutants, i.e. organic chemicals and pharmaceuticals. This topic is of global relevance for the EU. RESULTS:Existing technologies for waste water treatment do not sufficiently address increasing pollution situation, especially with the growing use of organic pollutants in the private household and health sector. Although some crude chemical approaches exist, such as advanced oxidation steps, most waste water treatment plants will not be able to adopt them. The same is true for membrane technologies. DISCUSSION:Incredible progress has been made during recent years, thus providing us with membranes of longevity and stability and, at the same time, high filtration capacity. However, these systems are expensive and delicate in operation, so that the majority of communities will not be able to afford them. Combinations of different phytoremediation technologies seem to be most promising to solve this burning problem. CONCLUSIONS:To quantify the occurrence and the distribution of micropollutants, to evaluate their effects, and to prevent them from passing through wastewater collection and treatment systems into rivers, lakes and ground water bodies represents an urgent task for applied environmental sciences in the coming years. RECOMMENDATIONS:Public acceptance of green technologies is generally higher than that of industrial processes. The EU should stimulate research to upgrade existing waste water treatment by implementing phytoremediation modules and demonstrating their reliability to the public.

背景与目标： 目标，范围和背景：我们工业社会迫在眉睫的问题之一是水的高消耗和对清洁饮用水的高需求。已经采取了许多方法来减少水的消耗，但是从长远来看，似乎只有将废水循环利用为高质量水的可能性。讨论适合工业和欠发达国家的替代水修复技术以确保整个欧洲的高质量饮用水似乎是时候了。
主要特征：本文讨论了一系列以模块方法应用的植物修复技术，以整合和改善现有废水处理的性能，尤其是针对新兴的微污染物，即有机化学品和制药。该主题对欧盟具有全球意义。
结果：现有的废水处理技术不足以解决日益严重的污染状况，尤其是随着私人住户和卫生部门对有机污染物使用的增加。尽管存在一些粗化学方法，例如高级氧化步骤，但大多数废水处理厂将无法采用它们。膜技术也是如此。
讨论：近年来取得了令人难以置信的进步，从而为我们提供了长寿命和稳定的膜，同时又提供了高过滤能力。但是，这些系统昂贵且操作精密，因此大多数社区将无法负担得起。结合不同的植物修复技术似乎最有希望解决这一迫在眉睫的问题。
结论：量化微污染物的发生和分布，评估其影响，防止其通过废水收集和处理系统进入河流，湖泊和地下水体，是未来几年应用环境科学的紧迫任务。
建议：绿色技术的公众接受度通常高于工业流程。欧盟应通过实施植物修复模块并向公众展示其可靠性来刺激研究，以提高现有废水处理水平。

BACKGROUND & AIMS: BACKGROUND:IPS has been demonstrated to increase return to open employment significantly in individuals with mental health problems in the US. Previous experience (e.g. with ACT) has demonstrated the sensitivity of complex community mental health interventions to local social and healthcare cultures. Europe has conditions of generally greater employment security than the US and varying (generally higher) unemployment rates and welfare benefits. Evidence of the effectiveness of IPS in these conditions, and its potential variation across them, would guide local policy and provide possible insights into its mechanism. METHODS:We conducted an RCT of IPS versus high-quality train-and-place vocational rehabilitation in six European centers with very different labor market and health and social care conditions. A sample of 312 individuals with psychotic illness was randomly allocated (50 per site). Inclusion criteria were a minimum of two years' illness duration, with at least one year of continuous unemployment and six months contact with their current mental health services. Follow-up was 18 months. The primary outcome was any open employment, and secondary outcomes included time to employment, duration of employment and hospital admission. FINDINGS:IPS was more effective than the Vocational Services for all vocational outcomes. 85 IPS patients (54.5%) worked for at least one day compared to 43 Vocational Service patients (27.6). They were significantly less likely to be rehospitalized. Local unemployment rates explained a significant amount of the variation in IPS effectiveness and both national economic growth and welfare systems influenced overall employment rates in both services. CONCLUSIONS:IPS doubles the access to work of people with psychotic illnesses, without any evidence of increased relapse. Its effectiveness is not independent of external circumstances, particularly local unemployment rates.

背景与目标： 背景：在美国，已证明IPS可以显着提高患有精神健康问题的个人的开放就业回报。先前的经验（例如，使用ACT）证明了复杂的社区心理健康干预措施对当地社会和医疗文化的敏感性。欧洲通常具有比美国更好的就业保障，并且失业率和福利待遇有所不同（通常更高）。在这些情况下，IPS的有效性及其在各个方面的潜在变化的证据将指导当地政策并提供对其机制的可能见解。
方法：我们在劳动力市场，卫生和社会护理条件截然不同的六个欧洲中心进行了IPS的RCT与高质量的火车和地方职业康复的比较。随机分配了312名精神病患者的样本（每个站点50个）。入选标准为至少两年的疾病持续时间，至少一年的持续失业和六个月的当前精神卫生服务。随访18个月。主要结局是任何公开就业，次要结局包括上班时间，就业时间和入院时间。
结果：在所有职业成果方面，IPS比职业服务局更有效。 85位IPS患者（54.5％）至少工作一天，而43位职业服务患者（27.6）。他们被再次住院的可能性大大降低。当地的失业率解释了IPS有效性的巨大差异，而且国家经济增长和福利体系都影响了这两种服务的总体就业率。
结论：IPS可以使精神病患者的工作机会增加一倍，而没有任何证据表明复发会增加。它的有效性并非独立于外部环境，尤其是当地的失业率。

BACKGROUND & AIMS: :Information about physician anaesthesiologist manpower in the countries of the European Union was collected from questionnaires sent to the delegates representing their respective countries on the European Board of Anaesthesiology. In the countries of the European Union and Switzerland and Norway 40,259 specialist anaesthesiologists are recorded. The number of anaesthesiologists in relation to population varies between as little as 4.4 and 4.6 (Ireland and UK) and as many as 15.6 (Italy), with a mean of 10.8/100,000 inhabitants. There are 11,610 physicians recorded in training in anaesthesiology. The ratio of trainees to specialists in the European Union countries was 28.8/100, varying from as low as 6.5 in France, to as high as 96.7 and 98/100 in Ireland and the UK respectively. These figures indicate a wide difference in the numbers of specialists and trainees between the European countries studied. However, the overall mean figure is close to that reported in the USA (9.2/100,000).

背景与目标： ：从发送给代表欧洲麻醉委员会代表各自国家的代表的调查表中收集了有关欧盟国家内医师麻醉师人力的信息。在欧洲联盟国家以及瑞士和挪威，记录了40,259名专业麻醉师。相对于人口而言，麻醉师的数量在4.4至4.6之间（爱尔兰和英国）到15.6（意大利）之间不等，平均为10.8 / 100,000居民。麻醉培训中记录了11,610位医生。欧盟国家的学员与专家的比例是28.8 / 100，从法国的6.5低到爱尔兰和英国的96.7和98/100。这些数字表明，所研究的欧洲国家之间的专家和受训人员数量差异很大。但是，总体平均数接近于美国报告的平均值（9.2 / 100,000）。

BACKGROUND & AIMS: :Bronchiectasis has been defined as the abnormal and permanent dilation of bronchi. It has a variety of causes and has traditionally been viewed as a condition that is irreversible, often progressive and associated with significant morbidity and mortality. In the past, patients had relatively advanced disease by the time the diagnosis was established. By using high-resolution computed tomography (HRCT) scanning of the chest, the potential now exists for the much earlier detection and treatment of children with lesser degrees of bronchial dilation and bronchial wall thickening than was previously possible. In some, the HRCT changes have been seen to improve or completely resolve. This calls into question exactly what now should be termed bronchiectasis and how the parents of children with such HRCT findings should be counselled about the likely prognosis and the necessary or desirable treatment options.

背景与目标： ：支气管扩张被定义为支气管的异常和永久性扩张。它有多种原因，传统上被认为是不可逆的疾病，通常是进行性疾病，并与高发病率和死亡率相关。过去，患者在确定诊断时就已经患有相对晚期的疾病。通过使用胸部的高分辨率计算机断层扫描（HRCT）扫描，现在存在着更早发现和治疗儿童的可能性，该儿童的支气管扩张程度和支气管壁增厚程度比以前可能的要小。在某些情况下，HRCT的变化可以改善或完全解决。这恰恰引起了人们的疑问，即现在应将其称为支气管扩张，以及应如何向具有此类HRCT发现的孩子的父母咨询可能的预后以及必要或理想的治疗选择。

BACKGROUND & AIMS: :Influenza and other respiratory infections, the most common cause of acute infectious disease in U.S adults, are also the leading cause of outpatient illness and a major cause of infectious disease hospitalization in U.S. military personnel. Although respiratory disease control is improved, epidemics continue to occur, and respiratory disease in military trainees continues to exceed that in U.S. civilian adults. Overall, Department of Defense utilization of the trivalent inactivated vaccine was much lower than anticipated during the 2004-2005 season. The slow start to the 2004-2005 influenza season resulted in a low demand for influenza immunization by the medically high-risk beneficiary population of the Department of Defense. Surveillance for influenza during the 2004-2005 season in U.S. Army Europe reached unprecedented heights, testing and confirming more cases than in any previous year.

背景与目标： ：流感和其他呼吸道感染是美国成年人急性传染病的最常见原因，也是门诊病人的主要病因，也是美国军事人员住院的传染病住院的主要原因。尽管呼吸道疾病的控制得到了改善，但流行病仍在继续发生，军事受训人员的呼吸道疾病继续超过美国平民成年人的呼吸道疾病。总体而言，美国国防部对三价灭活疫苗的利用率远低于2004-2005年度的预期。 2004年至2005年流感季节的缓慢启动导致国防部的医疗高风险受益人群对流感疫苗的需求较低。欧洲陆军在2004-2005赛季对流感的监测达到了前所未有的高度，测试和确诊的病例比去年任何时候都多。

BACKGROUND & AIMS: :This article presents an analysis of recent changes in the public-private mix in health care in eight European countries. The leading question is to what extent a process of privatization in health care can be observed. The framework for the analysis of privatization draws on the idea that there are multiple public/private boundaries in health care. The overall picture that emerges from our analysis is diverse, but there is evidence that health care in Europe has become somewhat more private. The growth of the public fraction in health care spending has come to an end since the 1980s, and in a few countries the private fraction even increased substantially. We also found some evidence for a shift from public to private in health care provision. Furthermore, there are signs of privatization in health care management and operations, as well as investments. Specific attention is spent on the identification of factors that push privatization forward and factors that work as a barrier to privatization.

背景与目标： ：本文介绍了八个欧洲国家/地区在医疗保健领域公私合营关系近期变化的分析。首要问题是在何种程度上可以观察到医疗保健私有化过程。分析私有化的框架基于这样一个想法，即医疗保健中存在多个公共/私人边界。我们的分析得出的总体情况是多种多样的，但是有证据表明，欧洲的医疗保健已经变得更加私人化了。自1980年代以来，医疗保健支出中公共比例的增长已经结束，在一些国家中，私人比例甚至大大增加了。我们还发现了一些证据，表明医疗保健服务从公共转向私人。此外，在医疗保健管理和运营以及投资方面有私有化的迹象。特别关注确定推动私有化的因素和阻碍私有化的因素。

BACKGROUND & AIMS: :The rise of life expectancy in Europe has been a very uneven process, both in time and space. This paper aims to identify instances in which major political conditions are likely to have influenced the rise of life expectancy, focusing on formation and dissolution of states and supranational blocs and on differences between political regimes (democratic vs. authoritarian non-communist and communist rule). Data on life expectancy, cause-specific mortality and political conditions were compiled from existing data sources. Possible relations between political conditions and life expectancy were studied by direct comparisons of changes in life expectancy in countries with different political conditions but similar starting levels of life expectancy. We found that formation and dissolution of states often went together with convergence and divergence of life expectancy, respectively, and that otherwise similar countries that did or did not become part of the Soviet bloc had distinctly different life expectancy trajectories. Democratically governed states had higher life expectancies than authoritarian states throughout the 20th century. The gap narrowed between 1920 and 1960 due to rapid catching up of infectious disease control in both non-communist and communist authoritarian states. It widened again after 1960 due to earlier and more rapid progress in democratic states against cardiovascular disease, breast cancer, motor vehicle accidents and other causes of death that have become amenable to intervention. We conclude that the history of life expectancy in Europe contains many instances in which political conditions are likely to have had a temporary or more lasting impact on population health. This suggests that there is scope for further in-depth studies of the impact of specific political determinants on the development of population health in Europe.

背景与目标： ：欧洲人的预期寿命的增长在时间和空间上都是一个非常不平衡的过程。本文旨在确定哪些主要政治条件可能影响预期寿命的增长的实例，重点关注国家和超国家集团的形成和解体，以及政治制度之间的差异（民主与专制的非共产主义和共产主义统治） 。预期寿命，因特定原因造成的死亡率和政治状况的数据是从现有数据源中收集的。通过直接比较政治条件不同但预期寿命起始水平相似的国家的预期寿命变化，研究了政治条件与预期寿命之间的可能关系。我们发现，国家的形成和解体通常分别与预期寿命的趋同和分歧同时发生，否则，成年或未成为苏联集团一部分的相似国家的预期寿命轨迹截然不同。在整个20世纪，民主统治的国家的预期寿命都比专制国家高。由于非共产主义和共产主义专制国家对传染病控制的迅速追赶，这种差距在1920年至1960年之间缩小了。 1960年以后，由于民主国家在抗击心血管疾病，乳腺癌，机动车事故和其他导致死亡的原因而需要干预的较早和更迅速的进展中，该疾病再次扩大。我们得出的结论是，欧洲的预期寿命历史包含许多情况，在这些情况下，政治状况可能会对人口健康产生暂时或更持久的影响。这表明，有必要进一步深入研究特定政治决定因素对欧洲人口健康发展的影响。

BACKGROUND & AIMS: :Introduction During a refugees' mass-gathering incident in Kos Island, Greece, Médecins Sans Frontières (MSF; Brussels, Belgium) teams provided emergency medical care. A case report of the event focusing on difficulties encountered by the interpreters during triage and emergency response was prepared. METHODS:Data collected during the event were reviewed from the patient's register and qualitative interviews were obtained from the MSF interpreters involved in the response. In addition, a description of the event and a literature review were included. RESULTS:Total consultations were 49 patients, mainly from Syria, with an average age of 25 years. During triage, 20 patients were tagged green with only minor injuries; 11 patients were tagged yellow, mostly due to heat exhaustion, but also a hypertensive crisis, a diabetic, a pregnant woman with abdominal pain, and a peptic ulcer exacerbation. The remaining 18 patients were tagged red and diagnosed with heat syncope, except from a case of epileptic seizures and an acute chest pain patient. Interpreters were insufficient in number to accompany each doctor and every nurse providing care during the event. In addition, they were constantly disturbed by both refugees and fellow medical team members demanding their service. Interpreters had to triage and prioritize where to go and for whom to interpret. CONCLUSION:Interpreters are an integral part of a proper refugee reception system. They should be included in authorities planning where mass gatherings of refugees are expected. Appropriate training may be needed for interpreters to develop skills useful in mass gatherings and similar prehospital settings in order to better coordinate with the medical team. Alexakis LC Papachristou A Baruzzi C Konstantinou A . The use of interpreters in medical triage during a refugee mass-gathering incident in Europe. Prehosp Disaster Med. 2017;32(6):684-687.

背景与目标： 简介：在希腊科斯岛的一个难民群众集会期间，无国界医生组织（无国界医生；比利时布鲁塞尔）的工作组提供了紧急医疗服务。编写了该事件的案例报告，重点讨论了口译员在分诊和应急响应过程中遇到的困难。
方法：从患者的病历中回顾了活动期间收集的数据，并从参与响应的MSF口译员那里进行了定性访谈。此外，还包括事件描述和文献综述。
结果：总共进行了49例患者的诊治，主要来自叙利亚，平均年龄为25岁。在分诊期间，有20名患者被标记为绿色，仅有轻伤。 11名患者被标记为黄色，主要是由于疲惫不堪，但也有高血压危机，糖尿病，孕妇腹痛和消化性溃疡加重。其余18名患者被标记为红色，并被诊断为热晕厥，除了癫痫发作和一名急性胸痛患者。活动期间，口译员的人数不足以陪伴每位医生和每位提供护理的护士。此外，他们不断受到难民和要求其服务的医疗队成员的困扰。口译员必须对去向何处以及为谁进行解释进行分类并确定优先级。
结论：口译员是适当的难民接待系统的组成部分。应将它们包括在计划进行难民大规模集会的当局中。口译人员可能需要进行适当的培训，以发展在群众聚会和类似的院前环境中有用的技能，以便更好地与医疗团队进行协调。 Alexakis LC Papachristou A Baruzzi C Konstantinou A。在欧洲发生的一次难民大规模集会事件中，在医疗分类中使用口译员。灾前灾难医学。 2017; 32（6）：684-687。

BACKGROUND & AIMS: :Fire blight, a bacteriosis of apple and pear, was assayed with molecular tools to associate its origin in Russia, Slovenia and south-eastern Austria with neighboring countries. The identification of all investigated strains was confirmed by MALDI-TOF mass spectroscopy except one. Independent isolation was verified by the level of amylovoran synthesis and by the number of short sequence DNA repeats in plasmid pEA29. DNA of gently lysed E. amylovora strains from Russia, Slovenia, Austria, Hungary, Italy, Spain, Croatia, Poland, Central Europe and Iran was treated with restriction enzymes XbaI and SpeI to create typical banding patterns for PFGE analysis. The pattern Pt2 indicated that most Russian E. amylovora strains were related to strains from Turkey and Iran. Strains from Slovenia exhibited patterns Pt3 and Pt2, both present in the neighboring countries. Strains were also probed for the recently described plasmid pEI70 detected in Pt1 strains from Poland and in Pt3 strains from other countries. The distribution of pattern Pt3 suggests distribution of fire blight from Belgium and the Netherlands to Central Spain and Northern Italy and then north to Carinthia. The PFGE patterns indicate that trade of plants may have introduced fire blight into southern parts of Europe proceeded by sequential spread.

背景与目标： ：使用分子工具分析了火疫病，一种苹果和梨的细菌病，将其起源于俄罗斯，斯洛文尼亚和奥地利东南部的东南欧与邻国联系起来。除一种外，所有研究菌株的鉴定均通过MALDI-TOF质谱法进行了确认。通过淀粉戊聚糖合成水平和质粒pEA29中短序列DNA重复序列的数量来验证独立的分离。用限制性内切酶XbaI和SpeI处理来自俄罗斯，斯洛文尼亚，奥地利，匈牙利，意大利，西班牙，克罗地亚，波兰，中欧和伊朗的温和裂解的支链球菌菌株的DNA，以创建典型的带谱用于PFGE分析。模式Pt2表明，大多数俄罗斯支链淀粉大肠杆菌菌株与来自土耳其和伊朗的菌株有关。来自斯洛文尼亚的菌株表现出模式Pt3和Pt2，都存在于邻国中。还针对新近描述的在波兰Pt1菌株和其他国家的Pt3菌株中检测到的质粒pEI70，对菌株进行了探测。模式Pt3的分布表明火疫病从比利时和荷兰分布到西班牙中部和意大利北部，再向北到克恩顿州。 PFGE模式表明，植物贸易可能通过顺序蔓延将火疫病引入了欧洲南部地区。

BACKGROUND & AIMS: BACKGROUND:The indications for prescribing malaria chemoprophylaxis lack a solid evidence base that results in subjectivity and wide variation of practice across countries and among professionals. METHODS:European experts in travel medicine, who are members of TropNetEurop, participated in a survey conducted using the Delphi method. This technique aims at evaluating and developing a consensus through iterations of questionnaires, controlled feedback, and statistical group responses. RESULTS:A first questionnaire, including questions about controversial issues in prescribing malaria prophylaxis, required responses on a visual scale between 1 and 10. The questionnaire included issues on problematic prescribing, characteristics of drugs, relevance of geography, and importance of insect bite prevention. The repeat questionnaire with the group response from the first round revealed an increasing consensus on most issues. A second survey considered 14 practical scenarios (including two internal standards) and investigated preferred choice of prophylaxis. A significant consensus was noted in 8 of 14 scenarios, which did not increase after a second round. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice, and a greater willingness to prescribe in northern and southern Europe than in central Europe. The second round showed a 9.5% change of opinion. CONCLUSIONS:The study shows that improving the evidence base on efficacy and tolerability and risk of malaria for prescribing chemoprophylaxis is needed as is further discussion across Europe to achieve harmonization of prescribing practice.

背景与目标： 背景：处方疟疾化学预防的指征缺乏扎实的证据基础，导致各国之间以及专业人员之间的主观性和广泛的实践差异。
方法：TropNetEurop的欧洲旅行医学专家参加了使用德尔菲方法进行的调查。该技术旨在通过问卷调查，受控反馈和统计组回复的迭代来评估和发展共识。
结果：第一份调查表，包括有关预防疟疾处方方面有争议的问题，需要在1到10的视觉范围内做出回应。该调查表包括有关处方问题，药物特性，地理相关性和昆虫叮咬预防重要性的问题。在第一轮的小组回答中，重复调查表显示出在大多数问题上的共识正在增加。第二次调查考虑了14种实际情况（包括两个内部标准），并调查了预防措施的首选。在14个场景中的8个场景中，人们注意到了一个重要共识，但在第二轮之后并没有增加。分析表明，按实践地区分组的偏好选择处方差异很大，北欧和南欧比中欧更愿意开处方。第二轮表明意见变动了9.5％。
结论：该研究表明，需要基于功效，耐受性和疟疾处方化学预防风险来改善证据，这在欧洲范围内需要进一步讨论以实现处方实践的统一。

BACKGROUND & AIMS: OBJECTIVES:: There are many differences in diet and lifestyle across Europe that may influence the development of the infant gut microbiota. This work aimed to assess the impact of geographic area, mode of delivery, feeding method, and antibiotic treatment on the fecal microbiota of infants from 5 European countries with different lifestyle characteristics: Sweden, Scotland, Germany, Italy, and Spain. PATIENTS AND METHODS:: Fecal samples from 606 infants (age 6 weeks) recruited within the European project INFABIO were analyzed by fluorescent in situ hybridization combined with flow cytometry using a panel of 10 rRNA targeted group- and species-specific oligonucleotide probes. Information on factors potentially affecting gut microbiota composition was collected with questionnaires and associations were evaluated with multivariate analyses. RESULTS:: The Bifidobacterium genus was predominant (40% average proportion of total detectable bacteria), followed by Bacteroides (11.4%) and enterobacteria (7.5%). Northern European countries were associated with higher proportions of bifidobacteria in infant feces, whereas a more diverse microbiota with more bacteroides characterized southern countries. Bifidobacteria dominated the microbiota of breast-fed infants, whereas formula-fed babies had significantly higher proportions of Bacteroides and members of the Clostridium coccoides and Lactobacillus groups. Newborns delivered by cesarean section or from mothers treated with antibiotics perinatally had lower proportions of Bacteroides and members of the Atopobium cluster. CONCLUSIONS:: Delivery mode and feeding method influenced the fecal microbiota of European infants at 6 weeks, as expected, but the effect of country of birth was more pronounced, with dominant bifidobacteria in northern countries and greater early diversification in southern European countries.

背景与目标： 目的：欧洲各地饮食和生活方式存在许多差异，可能会影响婴儿肠道菌群的发育。这项工作旨在评估地理区域，分娩方式，喂养方法和抗生素治疗对来自五个具有不同生活方式特征的欧洲国家（瑞典，苏格兰，德国，意大利和西班牙）的婴儿粪便微生物群的影响。
患者和方法：在欧洲INFABIO项目中招募的606名婴儿（6周龄）的粪便样本通过荧光原位杂交与流式细胞仪结合，使用一组10种靶向rRNA的组和种特异性寡核苷酸探针进行了分析。通过问卷收集有关可能影响肠道菌群组成的因素的信息，并通过多变量分析评估相关性。
结果：双歧杆菌属占主导地位（占总可检出细菌的平均比例为40％），其次是拟杆菌属（11.4％）和肠杆菌属（7.5％）。北欧国家婴儿粪便中双歧杆菌的比例较高，而南部国家则以细菌种类更多，种类更多的微生物群为特征。双歧杆菌占母乳喂养婴儿的微生物群，而配方奶喂养的婴儿中的拟杆菌，比例的Clostridium coccoides和Lactobacillus组的比例明显更高。剖宫产或围产期接受抗生素治疗的母亲所产的新生儿中，拟杆菌和拟声团成员的比例较低。
结论：分娩方式和喂养方式如预期的那样影响了欧洲婴儿在6周时的粪便菌群，但出生国的影响更为明显，北部国家的双歧杆菌占优势，而南部国家的早期多样化则更大。

BACKGROUND & AIMS: :Large outbreaks of hepatitis A have occurred in Denmark, Germany, the Netherlands, Norway, Spain, Sweden, and the United Kingdom during the period 1997-2005 affecting homosexual men. A collaborative study was undertaken between these countries to determine if the strains involved in these hepatitis A outbreaks were related genetically. The N-terminal region of VP1 and the VP1/P2A region of the strains were sequenced and compared. The majority of the strains found among homosexual men from the different European countries formed a closely related cluster, named MSM1, belonging to genotype IA. Different HAV strains circulated among other risk groups in these countries during the same period, indicating that specific strains were circulating among homosexual men exclusively. Similar strains found among homosexual men from 1997 to 2005 indicate that these HAV strains have been circulating among homosexual men for a long time. The homosexual communities are probably too small within the individual countries to maintain HAV in their population over time, whereas the homosexual communities across Europe are probably sufficiently large to sustain continued circulation of homologous HAV strains for years resulting in an endemic situation among homosexual men.

背景与目标： ：在1997-2005年期间，丹麦，德国，荷兰，挪威，西班牙，瑞典和英国发生了大规模的甲型肝炎暴发，影响了同性恋男子。这些国家之间进行了一项合作研究，以确定参与这些甲型肝炎暴发的菌株是否在遗传上相关。对菌株的VP1的N末端区域和VP1 / P2A区域进行测序和比较。在来自不同欧洲国家的同性恋男子中发现的大多数菌株形成了密切相关的簇，名为MSM1，属于基因型IA。在同一时期，这些国家的其他危险人群中传播的HAV株不同，这表明特定的株只在同性恋男性中传播。从1997年到2005年，在同性恋男子中发现了类似的毒株，这表明这些HAV毒株已经在同性恋男子中传播了很长时间。在各个国家中，同性恋社区可能太小，无法随时间维持其人群中的HAV；而整个欧洲的同性恋社区可能足够大，无法维持同性恋HAV毒株的持续流通长达数年，从而导致同性恋男子中的地方性流行。