Central Eastern European Region Research Articles

Spatial Inequalities in the Centre of Gravity in Central-Eastern Europe Based on the GVA and the Employment Rate

The issue of territorial disparities is an interesting subject of study in Europe, as there are significant socio-economic disparities between regions, which do not disappear over time, despite substantial levels of funding. The Central-Eastern European region is lagging significantly behind the EU as a whole and the Western regions, with significant intra-country differences. This study aims to examine six countries in the Central-Eastern European region in terms of county-level gross value added and employment rates, examining the convergence processes in the region. In addition to the growth rates of the regions, the study examines the emergence of sigma and beta convergence phenomena, as well as the importance of spatial spillover effects and neighbourhood relations in catching up. I investigate the probability that the spatial distribution of each indicator is heterogeneous, which I also illustrate by the change in the spatial centre of gravity. Convergence studies highlight the internal convergence of the region but also draw attention to the impact of different crises on inequalities.

Human Capital in the EU Member States from Central-Eastern Europe Region: Labour Market Context in 2022

Human Capital in the EU Member States from Central-Eastern Europe Region: Labour Market Context in 2022

Private banking market developments: Evidence from Hungary

Private banking institutions serve the financial sector’s wealthiest clientele via a dedicated value proposition. Based on the relevant tendencies and statistics, a remarkable expansion can be outlined since the mid-1990s. The aim of this study is to elaborate the Hungarian private banking market’s development as a case study. The paper also intends to add to the literature on this unique segment of the financial market. Based on the available statistics, the analysis primarily focuses on the Hungarian private banking market’s rapid development process. This can be underpinned by the clientele’s savings, number of accounts and respective segmentation limits of the institutions. Referring to the amount of savings, a correlation analysis indicates significant co-movements with specific social and economic variables. The growth rate of the Hungarian clientele’s savings outperformed the respective indicator in Western Europe during the review time period (2007–2020). The current paper also includes a section that summarises general challenges that private banking managers need to address during the development process. Generally, the literature on private banking can still be considered scarce, whereas there is a lack of studies on the Central-Eastern European region. The analysis of the Hungarian sector’s development path can serve with relevant information to any financial expert in the field.

Changes in Time to Initial Physician Contact and Cancer Stage Distribution during the COVID-19 Pandemic in Patients with Head and Neck Squamous Cell Carcinoma at a Large Hungarian Cancer Center.

The aim of our study was to compare the characteristics and time to initial physician contact in patients with head and neck squamous cell carcinoma (HNSCC) before and during the COVID-19 pandemic at a large Hungarian cancer center. This was a retrospective study of patients 18 years or older presenting at the regional cancer center of Pécs Clinical Center with HNSCC between 1 January 2017, and 15 March 2020 (the pre-COVID-19 period) and between 16 March 2020, and 13 May 2021 (the COVID-19 period). Demographic and clinical data were collected, and the time between initial symptom onset and initial physician contact (TTP) was determined. Descriptive and exploratory statistical analyses were performed. On average, the number of patients diagnosed with HNSCC per month during the pandemic decreased by 12.4% compared with the pre-COVID-19 period. There was a significant increase in stage I and stage II cancers (from 15.9% to 20.3% and from 12.2% to 13.8%, respectively; p < 0.001); a decrease in stage III and IVa,c cancers; and a significant increase in stage IVb cancers (from 6% to 19.9%; p < 0.001) during the pandemic. The median TTP increased during the pandemic from 43 to 61 days (p = 0.032). To our knowledge, this is the first study investigating the effect of COVID-19 on patients with HNSCC in the Central-Eastern European region. We found a bidirectional shift in cancer stages and increased TTP during the pandemic. Our findings highlight the necessity for more nuanced analyses of the effects of COVID-19.

The indirect costs of human papillomavirus-related cancer in Central and Eastern Europe: years of life lost and productivity costs

Background Human papilloma virus (HPV) is a common cause of several types of cancer, including head and neck (oral cavity, pharynx, oropharynx, hypopharynx, nasopharynx, and larynx), cervical, vulval, vaginal, anal, and penile cancers. As HPV vaccines are available, there is potential to prevent HPV-related disease burden and related costs. Method A model was developed for nine Central Eastern European (CEE) countries (Bulgaria, Croatia, Czechia, Hungary, Poland, Romania, Serbia, Slovakia, Slovenia). This model considered cancer patients who died from 11 HPV-related cancers (oropharynx, oral cavity, nasopharynx, hypopharynx, pharynx, anal, larynx, vulval, vaginal, cervical, and penile) in 2019. Due to data limitations, Bulgaria only included four cancer types. The model estimated the number of HPV-related deaths and years of life lost (YLL) based on published HPV-attributable fractions. YLL was adjusted with labor force participation, retirement age and then multiplied by mean annual earnings, discounted at a 3% annual rate to calculate the present value of future lost productivity (PVFLP). Results In 2019, there were 6,832 deaths attributable to HPV cancers resulting in 107,846 YLL in the nine CEE countries. PVFLP related to HPV cancers was estimated to be €46 M in Romania, €37 M in Poland, €19 M in Hungary, €15 M in Czechia, €12 M in Croatia, €10 M in Serbia, €9 M in Slovakia, €7 M in Bulgaria and €4 M in Slovenia. Conclusions There is a high disease burden of HPV-related cancer-related deaths in the CEE region, with a large economic impact to society due to substantial productivity losses. It is critical to implement and reinforce public health measures with the aim to reduce the incidence of HPV-related diseases, and the subsequent premature cancer deaths. Improving HPV screening and increasing vaccination programs, in both male and female populations, could help reduce this burden.

Oral health's role in diabetes risk: a cross-sectional study with sociodemographic and lifestyle insights.

Diabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship. Data were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson's chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings. The study identified 'Bad' self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model's stability and predictive accuracy for diabetes. Enhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches.

Social and Political Actors in the Czech Media Discourse on Ph.D. – A Content Analysis

Aim/Purpose: This paper presents an in-depth analysis of the media portrayal of Ph.D. programs in the Czech Republic. Specifically, it explores how doctoral study programs, their students, and the Ph.D. degree are represented across various topics and social actors over an 18-month period. Background: The societal perception of Ph.D. studies, especially at the postgraduate level, is significantly shaped by media representations, including their connections to science, academia, and broader social life. Therefore, it is crucial to investigate the portrayal of the Ph.D. phenomenon in the media. The Czech Republic provides a relevant use case because of Central Eastern European (CEE) settings and amplified media coverage. The main factors are several political and social influences and governmental discussions regarding the legality of and against precarious conditions. Methodology: This study utilizes a qualitative method of conventional and directed content analysis to thematically categorize a corpus of 456 articles on Czech news platforms. A subset of these articles (thematic cluster about study conditions) undergoes further analysis to identify represented social actors. The results are clustered and interpreted using examples from the dataset. The instances of studied phenomena are quantified to provide an enumerated representation of individual themes and social actors. Contribution: The author contributes to research on doctoral studies by expanding the existing knowledge through media content analysis within the social constructivist paradigm. Moreover, the CEE region, often overlooked in doctoral studies and science communication research, is highlighted here. Finally, this article enriches the understanding of public relations strategies for higher-education institutions by focusing on earned media channels as opposed to solely owned ones. Findings: The analysis leads to the determination of 10 thematic clusters that can be succinctly categorized into four main areas: “Ph.D. Title,” “University Life,” “Study Conditions,” and “Controversial Issues.” The latter two categories are notably politicized, a fact underscored by the actor analysis, which shows a predominance of political figures in the media coverage. An unexpected result of the research is the significant underrepresentation of student voices in the analyzed sample of media outputs, except for those doctoral students who also hold positions such as student initiative chairs. Additionally, comparing the results to previous research on doctoral studies, it can be argued that many of the critical topics discussed by the research community, such as mental health issues or diversity of the student cohort, are not equally represented in media portrayals. Recommendations for Practitioners: Practitioners, especially communication professionals from higher education institutions and research centers, can leverage these insights to refine their communication strategy. This can help counterbalance prevailing media narratives and provide a more representative portrayal of study programs, focusing on areas currently underrepresented in media discourse. Recommendation for Researchers: Researchers from other regions are encouraged to conduct similar studies using the presented framework to map the representation of Ph.D. in respective media outlets. It is advisable to consider the local context in the interpretative phase of the content analysis, as demonstrated in this study. Impact on Society: The findings elucidate the role of the Ph.D. within the national media landscape of higher education, potentially influencing policymakers, journalists, and science communication professionals to reconsider their approaches to media discourse. Lastly, as hinted above, science communication professionals can benefit from the results in terms of future development of media outreach strategy with a focus on targeted topics. Future Research: The presented work would benefit from a broader, multinational comparison and also a complementary audience analysis to understand how Ph.D. students and possible applicants interpret these messages and whether they correlate with their attitudes.

Who Participates in Participatory Budgeting? Unravelling of Who Shows Up

Abstract Participatory budgeting (PB) is often described as one of the most successful instruments for participation, engaging people in decision-making, and prioritising where to allocate public money. It has travelled in the form of comprehensive administrative reforms and politically neutral devices to improve governance, especially when arriving to Europe and the Central Eastern European region (CEE). Recently, it was brought to light that PB development in the CEE region was undoubtedly different from the original case; instead of resulting in radical changes to increase activities in favour of marginalised groups, it results only in small changes. This work presents a single case study of the Czech city Brno; information consisting of age, gender, education, economic activity, and preferences of all the PB participants was collated for five years, from its inception in 2017 till 2021. In this case, we observe and analyse the particularities of the participant group, not only in static terms of one year but also drafting a trend on how the participatory base developed throughout the five years. Both desk and field research were employed to gather data. The turnout at PB voting does not copy the general demographic composition of Brno’s residents. Results show that some segments are represented by PB voters with higher proportions, making them more involved in deciding which projects in the city are to be executed using PB. In this way, the description of data-gathering in Brno contributes to the methodology of quantitative data gathering, which might be expanded to other CEE cities in order to elaborate comparisons in the future.

Impact of EU sanctions on trade in engineering products between Russia and Central-Eastern European countries: An applied econometric approach

Aim. To assess the impact of Western European sanctions on trade cooperation between Russia and Central-Eastern European (CEE) countries in the machine-building sector.Objectives. Statistical analysis of the dynamics of Russia’s trade relations with CEE countries in the field of mechanical engineering under current sanctions conditions; construction of an econometric model for regression analysis of the impact of Western European sanctions on trade in mechanical engineering products; identification of key trends and problems in trade and economic cooperation between Russia and the CEE region in the mechanical engineering sector in 2021–2023.Methods. The authors used such research methods as statistical and econometric analysis, syntax, description, graphical modeling.Results. The results obtained in the course of econometric analysis indicate that the impact of Western European sanctions on the main indicators of trade in engineering industry products between the Russian Federation (RF) and CEE countries was ambiguous. European Union (EU, EU) sanctions had a greater impact on CEE countries’ export flows than on RF exports to the region.Conclusions. The current sanctions conditions have determined an unfavorable medium-term trend in trade relations in the mechanical engineering sector between Russia and the CEE region. The trade and economic indicators analyzed in this article are the main determinants of econometric analysis that affect the interaction between Russia and CEE countries in the machine-building sector. During the studied period of 2021-2022 the volume of mutual investments showed a negative effect, industrial production had a positive impact on trade in engineering products.

A new perspective on thermal aspects of physical chemistry and materials science in Central-Eastern Europe region

A new perspective on thermal aspects of physical chemistry and materials science in Central-Eastern Europe region

Real-world outcomes of immunotherapy with or without chemotherapy in first-line treatment of advanced non-small cell lung cancer.

Immunotherapy alone (mono-IT) or combined with chemotherapy (chemo-IT) has recently become the cornerstone of first-line treatment for advanced non-small cell lung cancer (NSCLC) patients. Here, real-world outcomes of first-line mono-IT and chemo-IT of advanced NSCLC treated within routine clinical practice at a single academic center in the Central Eastern European (CEE) region are presented. A total of 176 consecutive patients with advanced NSCLC treated with mono-IT (118 patients) or chemo-IT (58 patients) were included. At the participating institution, all medical data relevant for providing oncology care are collected prospectively and in a standardized manner using purposely created pro-forms. Adverse events (AEs) were recorded and graded according to Common Terminology Criteria for Adverse Events (CTCAE). The Kaplan-Meier method was used to estimate median overall survival (mOS) and median duration of treatment (mDOT). The 118 patients in the mono-IT cohort had a median age of 64 years, most were male (59%), 20% had ECOG PS ≥2, and 14% had controlled CNS metastases at baseline. With a median follow-up time (mFU) of 24.1 months, the mOS was 19.4 months (95% CI, 11.1-27.6), and the mDOT was 5.0 months (95% CI, 3.5-6.5). The 1-year OS was 62%. The 58 patients in the chemo-IT cohort had a median age of 64 years, most were male (64%), 9% had ECOG PS ≥2, and 7% had controlled CNS metastases at baseline. With a mFU of 15.5 months, the mOS was 21.3 months (95% CI, 15.9-26.7), and the mDOT was 12.0 months (95% CI, 8.3-15.6). The 1-year OS was 75%. Adverse events of severe grade were recorded in 18% and 26% of patients, and immunotherapy discontinuation due to AEs occurred in 19% and 9% in the mono-IT and chemo-IT groups, respectively. No treatment-related deaths were recorded. The results from the present real-world observational study from a CEE country suggest similar effectiveness and safety of first-line mono-IT and chemo-IT in patients with advanced NSCLC to those observed in randomized clinical trials. However, continuous follow-up will offer better insight into the magnitude of long-term benefits in routine clinical practice.

Antler Comb Production in the Settlement at Suceagu-Rădaia (Cluj County). A Contribution to the Study of the Cultural Contacts at the Beginnings of the Migration Period

The authors are presenting the antler combs discovered as part of the rural settlement at Suceagu – Rădaia, Cluj County. From the very beginning of the archaeological research, the numerous fragments of processed antler pointed towards the presence of a workshop similar to those already known at Bârlad – “Valea Seacă” or from other contemporary settlements in the Central-Eastern European region. The typological classification of the combs discovered here illustrated the presence of three types of combs having a single row of teeth and semi-circular handle, as well as double-sided combs. Of great significance is the zoomorphic decoration present on one of the combs belonging to one of the combs having a single row of teeth and semi-circular handle. The association of combs with a single row of teeth with double-sided ones represents a chronological as well as a cultural “marker” for the Early Migration period, other known analogies pointing towards the area of the Late Roman Pannonian Limes. Double-sided combs are found in a small number in the Sântana de Mureș – Černjachov environment, the chronology of these types of combs, as well as of other small finds identified in the Suceagu – Rădaia settlement, accounting for the presence of antler comb workshops here, during the chronological stages D1-D2. The presence of a production centre for double-sided combs at Pericei, a site positioned beyond the north-western limes of the former province of Dacia Porolissensis, represents a milestone that marks a possible route for cultural influences reaching towards the settlement at Suceagu – Rădaia. To conclude, the present study illustrates the existence of a cultural mixture between the local Sântana de Mureș – Černjachov milieu with northern cultural influences coming from the environment of the Germanic federates in the area of the Pannonian limes. Such a complex phenomenon should have its beginnings around AD 400, at a time when the important cultural environments of the Sântana de Mureș – Černjachov and Przeworsk cultures are starting to fade out of their existence. Mediation between the areas of southern Poland and north-western Transylvania took place, as indicated by the spatial distribution of numerous metal or ceramic artefacts through settlements in eastern Slovakia and north-eastern Hungary, areas that acted as real bridgeheads over the Carpathian Basin.

War in Ukraine: A power play between Democracy and Authoritarianism

This article provides an analytical discussion of the crisis of democracy and the rise of authoritarianism in the context of the Russia-Ukraine War. Some of the fundamental aspects of the post-Cold War international order are addressed in this respect, including emerging powers, anti-Westernism, authoritarianism, and new threats in international relations. It is argued that the post-Cold War period brought both stability and instability to the global world order. On the one hand, the United States' victory in the ideological conflict between the East and the West led to the dominance of the Western system and its influence in the Middle East and Central Eastern European region with the call for democracy. On the other hand, the growing intervention of the US in intra-state disputes through the deployment of NATO has become a major concern to Russia and many other nations along the eastern border. This intensified anti-Western sentiment in emerging countries, with the rise of many Authoritarian governments. Many of the conflicts that the world has witnessed since the end of the Cold War are the result of such anti-Western feelings. This resulted at the beginning of a new era of war and conflict on a global scale. Russia's war in Ukraine is one of the recent examples. Russia is attempting to maintain its sphere of influence to avoid joining NATO and the West, regardless of the cost or repercussions of the war. As a result of these conflicts between great powers, several new powers emerged, resulting in a multi-polar world order. Today, it is emphasized that the ability and willingness of great powers to cooperate in addressing these dangers will determine the course of the world.

Changing Landscapes but Ingrained Power Relations? The Green Promise of the COVID-19 Pandemic, the (Un)sustainability of the Fashion Industry, and the Central-Eastern European Production Background

Abstract The COVID-19 pandemic turned the spotlight on the inequalities and the vulnerability of the global supply chains. It showed the serious dependency and the asymmetrical power relations among the stakeholders of the fashion industry. The relocation tendencies – as fashion brands are trying to break up with Asia and move production closer – have already started, and the pandemic can give a boost to it. The Central-Eastern European region can be a possible destination. The shorter supply chains are not just a tool for resilience but are told to serve sustainability as well. My hypothesis is that even though the geography of fashion industry is changing, power relations are not, and the crisis caused by the coronavirus pandemic has even increased dependency among the different players. Power relations are important among the region’s production and the clients if relocation is to work out, as there is need for inclusive, fair, and decent employment, which is rarely guaranteed by fashion brands. Without it, sustainability cannot be achieved. In this paper, I focus on the examination of socio-economic processes in contemporary fashion such as the relocation tendencies and the power relations among the stakeholders, mainly fashion brands and production companies as subcontractors of the fashion industry. Especially, I examine profit and risk as factors within the relations. The critical essay uses literature review and document analysis to investigate a possible change in the current role of power relations and to examine the hypothesis.

On the relationship between digitalization and the national smart economy model to achieve strategies of innovative progress

Modern economic processes are influenced by the digitalization and globalization of production processes. The consequence of this has been the emergence of the concept of a smart economy, which is actively implemented in the advanced countries of the world. The article aims to analyze the relationship between digitalization and the national model of a smart economy to achieve the strategies of the innovation process. The main methods of research were general scientific (analysis, synthesis) and special methods of economic knowledge (forecasting, methods of analytical work organization, collection of materials, and their processing). The results define the prospects for the development of a smart economy (primarily, the Internet of Things), determine the level of digitalization of the economy of individual countries of Central and Eastern Europe, attempt to form a model of development and interaction of digitalization and smart economy. A special role in today's production processes is played by the Internet of Things (IIoT), the use of which may have powerful prospects for global GDP. At the same time, the countries of the Eastern European region are experiencing difficulties on this path, as there is a lack of specialists at the appropriate level, and the educational facilities are not able to cover this deficit. It is indicated that further digitalization of the economy will have an impact on the growth of export orientation and competitiveness of the economies of the region (based on the example of Bulgaria). An important element of this process is to encourage enterprises to modernize their production base, adapting business models to modern digital transformations. In conclusion, it is concluded that the Central-Eastern European region lacks investments in the smart economy, which can be remedied by deepening the implementation of national and regional strategies and the cooperation of the authorities, businesses, and academia.

Semmelweis Caring University Model Program Based on the Development of a Center of Preventive Services: Health for All Employees at a University Occupational Setting.

The leadership of the Semmelweis University as a leading institution of higher education in Hungary and the Central Eastern European region within the area of medicine and health sciences has decided to reflect on the unfavorable public health situation in the country as well as the deteriorating health behavior and health status indicators in the Hungarian population by the development of an occupational setting-based personalized public health model program targeting its about 8500 employees. Based on its infrastructure and human resources the core element of the program is the establishment of the Center of Preventive Services (CPS) with units providing health risk assessment for each employee, and whenever necessary consultation with medical specialist in preventive medicine and public health, as well as counseling with dietician, physiotherapist and/or health psychologist. The service providers are the staff members of the relevant faculties in collaboration with partner primary and occupational care physicians. The units of the CPS can also serve as practical training sites for students at various levels of medical and health sciences training, and strongly contribute to the development and improvement of their skills to be able for working as a team in service provision. The employees are not only beneficiaries of health risk assessment and screening repeated on a regular basis and adequate interventions at the right time, but they also serve as a sample for a longitudinal cohort study and further ad hoc surveys for defining and implementing interventions to support health protection, disease prevention and healthy aging among them.

Genetic effects on educational attainment in Hungary.

IntroductionEducational attainment is a substantially heritable trait, and it has recently been linked to specific genetic variants by genome‐wide association studies (GWASs). However, the effects of such genetic variants are expected to vary across environments, including countries and historical eras.MethodsWe used polygenic scores (PGSs) to assess molecular genetic effects on educational attainment in Hungary, a country in the Central Eastern European region where behavioral genetic studies are in general scarce and molecular genetic studies of educational attainment have not been previously published.ResultsWe found that the PGS is significantly associated with the attainment of a college degree as well as the number of years in education in a sample of Hungarian study participants (N = 829). PGS effect sizes were not significantly different when compared to an English (N = 976) comparison sample with identical measurement protocols. In line with previous Estonian findings, we found higher PGS effect sizes in Hungarian, but not in English participants who attended higher education after the fall of Communism, although we lacked statistical power for this effect to reach significance.DiscussionOur results provide evidence that polygenic scores for educational attainment have predictive value in culturally diverse European populations.

Impact of a Multifactorial Educational Training on the Management of Preterm Infants in the Central-Eastern European Region.

Background: Differences in management and outcomes of extremely preterm infants have been reported across European countries. Implementation of standardized guidelines and interventions within existing neonatal care facilities can improve outcomes of extremely preterm infants. This study evaluated whether a multifactorial educational training (MET) course in Vienna focusing on the management of extremely preterm infants had an impact on the management of extremely preterm infants in Central-Eastern European (CEE) countries.Methods: Physicians and nurses from different hospitals in CEE countries participated in a two-day MET in Vienna, Austria with theoretical lectures, bedside teaching, and simulation trainings. In order to evaluate the benefit of the workshops, participants had to complete pre- and post-workshop questionnaires, as well as follow-up questionnaires three and twelve months after the MET.Results: 162 participants from 15 CEE countries completed the two-day MET at our department. Less invasive surfactant administration (LISA) was only used by 39% (63/162) of the participants. After the MET, 80% (122/152) were planning to introduce LISA, and 66% (101/152) were planning to introduce regular simulation training, which was statistically significantly increased three and twelve months after the MET. Thirty-six percent and 57% of the participants self-reported improved outcomes three and twelve months after the MET, respectively.Conclusion: Our standardized training in Vienna promoted the implementation of different perinatal concepts including postnatal respiratory management using LISA as well as regular simulation trainings at the participants' home departments. Moreover, our MET contributed to dissemination of guidelines, promoted best-practice, and improved self-reported outcomes.

Can Miscanthus Fulfill Its Expectations as an Energy Biomass Source in the Current Conditions of the Czech Republic?—Potentials and Barriers

Our article analyzes the main biological potentials and economic barriers of using Miscanthus as a new energy crop in agricultural practice in the Czech Republic and the Central-Eastern European region. We have used primary data from long-term field experiments and commercial plantations to create production and economic models that also include an analysis of competitive ability with conventional crops. Our results showed that current economic conditions favor annual crops over Miscanthus (for energy biomass) and that this new crop shows very good adaptation to the effects of climate change. Selected clones of Miscanthus × giganteus reached high biomass yields between 15–17 t DM ha−1 y−1 despite very dry and warm periods and low-input agrotechnology, and they have good potential to become important biomass crops for future bioenergy and the bioeconomy. Key barriers and factors are identified, including gene pool and agronomy improvement, change of subsidy policy (Common agriculture policy-CAP), climate change trends, and further development of the bioeconomy.

European Society of Cardiology Working Group on Adult Congenital Heart Disease and Study Group for Adult Congenital Heart Care in Central and South Eastern European Countries consensus paper: current status, provision gaps and investment required.

To examine the current status of care and needs of adult congenital heart disease (ACHD) services in the Central and South Eastern European (CESEE) region. We obtained data regarding the national ACHD status for 19 CESEE countries from their ACHD representative based on an extensive survey for 2017 and/or 2018. Thirteen countries reported at least one tertiary ACHD centre with a median year of centre establishment in 2007 (interquartile range 2002-2013). ACHD centres reported a median of 2114 patients under active follow-up with an annual cardiac catheter and surgical intervention volume of 49 and 40, respectively. The majority (90%) of catheter or surgical interventions were funded by government reimbursement schemes. However, all 19 countries had financial caps on a hospital level, leading to patient waiting lists and restrictions in the number of procedures that can be performed. The median number of ACHD specialists per country was 3. The majority of centres (75%) did not have ACHD specialist nurses. The six countries with no dedicated ACHD centres had lower Gross Domestic Product per capita compared to the remainder (P=0.005). The majority of countries in CESEE now have established ACHD services with adequate infrastructure and a patient workload comparable to the rest of Europe, but important gaps still exist. ACHD care is challenged or compromised by limited financial resources, insufficient staffing levels, and reimbursement caps on essential procedures compared to Western Europe. Active advocacy and increased resources are required to address the inequalities of care across the continent.