Trends in AIDS-defining illnesses among people living with HIV in clinical care in Europe: results from the EuroSIDA multicentre cohort study (2003-24).

ABSTRACT This article investigates how standards materialise value judgments of infrastructural failure and success, shaping the legitimacy and political meaning of infrastructure projects. Focusing on the Budapest-Belgrade railway, a Chinese-financed project in Central Eastern and Southern Europe overlapping with EU infrastructure frameworks, the article examines the geopolitics of standard-setting, arguing that standards are instruments of power that define what counts as progress, success, or failure. Drawing on infrastructure studies and the political economy of failure, this study examines how competing technical, financial and ESG standards produce hybrid regulatory environments with fragmented authority and diffused responsibility, where standards shape the conditions under which failure takes form. Failure is not a causal outcome of standardisation, but competing standards organise infrastructures according to different logics and thresholds, making failure possible and intelligible. The analysis outlines how overlapping standards regimes became sites of geopolitical contestation, mobilised by EU, Chinese, Hungarian and Serbian actors to advance competing agendas, with Hungary and Serbia selectively aligning with different frameworks to pursue national priorities. In this way, infrastructural failure is not simply a technical outcome but a political one, revealing how geopolitical competition, regulatory fragmentation and uneven development are stabilised through evaluative practices that appear technical yet govern political futures.

ABSTRACT Discrimination against Roma people is pervasive throughout Europe and the role that online news media plays in reinforcing stereotypical portrayals has received limited attention. The study investigates the textual and visual framing of Roma people in Facebook posts of online news organizations in Western European (Italy, United Kingdom) and Central-Eastern European (Czech Republic and Slovakia) nations. The relationship between frames and audience engagement was also analyzed. The victimization frame and the threat visual frame were the most common in the sample, but significant differences between Western and Central-Eastern European countries emerged. The empowerment frame and the human interest visual frame generated significantly more likes while the crime and threat to society frames and the threat visual frame increased the number of shares and comments. Theoretically and methodologically this study offers a novel contribution in understanding how online news outlets in European nations frame Roma people and in providing insights on the role of social media users as gatekeepers.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are currently recommended as one of the four pillars of treatment in heart failure (HF) with reduced ejection fraction (HFrEF). Following the approval of dapagliflozin in 2020, real-world data are relevant for the medical community and payers. This study aimed to characterize the patient population with dapagliflozin initiated for HFrEF in clinical practice in 9 countries from Central Eastern Europe and the Baltic Area (CEE-BA). EVOLUTION-HF CEE-BA is a multicentre, multi-country, observational, longitudinal study conducted in 102 centres in Bulgaria, Croatia, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, and Slovenia. All treatment decisions were at the discretion of the patient's healthcare providers, based on the locally approved product information and routine clinical practice. Patients with type 1 diabetes, prior treatment with dapagliflozin or other SGLT2i, and initiation of dapagliflozin outside the approved HFrEF indication were excluded. The baseline period covered 12 months prior to dapagliflozin initiation, with prospective follow-up continuing up to 12 months or until loss to follow-up, death, or study discontinuation, whichever occurred first. Descriptive statistics and Kaplan-Meier methods were used. A total of 1131 patients with HFrEF were included in the full analysis set. Ischaemic aetiology was present in 52% of patients. The mean left ventricular ejection fraction was 32%. The most frequent comorbidities were atrial fibrillation (46%), type 2 diabetes (37%), and chronic kidney disease (29%). At the time of dapagliflozin initiation, 93% of patients received any combination of a renin-angiotensin-aldosterone system inhibitor (RAASi), beta-blocker (BB), or mineralocorticoid receptor antagonists (MRA). Of all patients, 60% received concomitantly all three classes plus dapagliflozin for their HFrEF. Except for dapagliflozin, which was administered as 10 mg/day, optimal doses were recorded for 14% for any RAASi, 17% for BB, and 25% for MRA. At 6- and 12-month follow-up, maintenance of dapagliflozin treatment was recorded in 95% and 96% of patients, respectively. The real-world median time to discontinuation of dapagliflozin has not been reached. The percentage of patients receiving all four classes recommended in HFrEF remained stable over the study period. Adverse events were reported spontaneously, as in routine clinical practice in each centre. This large non-interventional study provides a contemporary perspective of the treatments used in HFrEF over 1-year follow-up. Despite high dapagliflozin persistence rates, a low proportion of patients received complete guideline-directed medical therapy in optimal doses. Improvement of HF management decisions across the CEE-BA region is warranted.

Background: Outpatient palliative care effectively alleviates symptom burden in advanced cancer patients, yet data from Central–Eastern Europe remain scarce. This retrospective study examined changes in revised Edmonton Symptom Assessment Scale (ESAS) scores from initial outpatient palliative consultation to first follow-up in Hungarian cancer patients, assessing clinically meaningful improvement and inter-symptom associations. Methods: Revised ESAS scores from 119 patients attending an outpatient palliative care clinic (2017–2020) were analyzed using paired baseline and first follow-up assessments (7–30 days). Symptom changes (Time 2–Time 1) were evaluated using Wilcoxon signed-rank tests. Clinically meaningful improvement was assessed with minimal clinically important difference thresholds (0.5× baseline SD). Sankey diagrams visualized symptom transitions, and multivariable linear regression examined inter-symptom associations. Results: Baseline pain was highest (mean 6.29, median 7), followed by fatigue, sleep disorder, and impaired well-being. At follow-up, significant reductions were observed in pain (mean 4.52, p = 0.001), nausea, dyspnea, constipation, sleep disorder, depression, and anxiety (all p < 0.05). Sankey diagrams showed shifts from severe to mild/moderate pain (50% to 24%) and constipation. Clinically meaningful improvement occurred in pain, nausea, and constipation, with 59–65% achieving ≥1-point pain reduction. Regression analyses showed that pain reduction was associated with concurrent improvements in sleep disorder (β = 0.31), depression (β = 0.20), fatigue (β = 0.20), and anxiety (β = 0.14), while dyspnea reduction was associated with concurrent improvements in depression (β = 0.22) and anxiety (β = 0.14). Conclusions: Outpatient palliative care in Hungarian cancer patients resulted in clinically meaningful symptom reductions, particularly pain and dyspnea. Improvements in these core symptoms were associated with concurrent improvements in other symptom domains, underscoring the clinical relevance of inter-symptom associations and supporting early, integrated outpatient palliative care and symptom cluster-based management.

Carpathian obsidian exchange and social connectivity in eastern central Europe between the 7th and 3rd millennia BCE

Sealed surfaces limit bird diversity, whereas tall structures may support abundance of some species, while both filter traits in urban landscapes

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This study assessed diet quality, nutrition, and psychosomatic knowledge, supplement use, and health-information sources among Polish adolescents and young adults, with emphasis on age-related differences and the role of social media. A cross-sectional, anonymous online survey (October 2025–January 2026) was conducted in Poland (final analytical sample: n = 478; adolescents 15–19 years vs. young adults 20–30 years). Of 591 individuals who accessed the survey, 478 were included in the final analytical sample. Diet quality was estimated from FFQ data using KomPAN-derived indices (pHDI-10, nHDI-14, DQI). Nutrition knowledge (0–25 points), psychosomatic/gut–brain indicators, supplementation, and information sources were analysed using χ2/Fisher tests and Mann–Whitney U tests with effect sizes. The primary outcomes measured were dietary supplement use and excess body weight (BMI ≥ 25 kg/m2). Multivariable logistic regression examined predictors of supplement use and BMI ≥ 25 kg/m2. Overall diet quality was low to moderate, with limited intake of whole grains, legumes, and fish, and common nutrition misconceptions. Social media was the most frequently indicated source of diet/supplement information and was independently associated with more frequent supplement use (OR = 2.29; 95% CI: 1.43–3.64). Adolescents reported lower whole-grain intake and more misconceptions than young adults. Predictors of BMI ≥ 25 kg/m2 included male sex (OR = 2.46; 95% CI: 1.46–4.15), lower education, and lower nutrition knowledge, while age showed a non-linear positive association with excess body weight. Polish adolescents and young adults show gaps between declared pro-health attitudes and actual diet quality/competencies. Social media reliance appears particularly linked to product-oriented behaviours (supplementation). Prevention should strengthen nutrition and food safety education, digital health literacy, and professional guidance on supplementation, especially in adolescents. Our findings suggest that social media is a primary driver for dietary supplementation among Polish youth, more so than objective nutrition knowledge. While diet quality is linked to weight status, the relationship is complex. These results may inform future public health interventions targeting digital health literacy to promote balanced nutrition and safe supplementation practices.

This opinion piece recounts experiences of an educator teaching analogue and digital games in Poland, focusing on challenges that are regionally specific set to the Central Eastern European region. More than an autoethnographically conceived account, the piece functions as an act of witnessing certain inescapable facets of daily life at university in Poland. These challenges included structural, institutional, financial, and mental-health related issues that affect scholars and students alike. The piece is written to be an honest reckoning with the exigencies of university teaching, intended as a counterweight to a culture of strategic communication that overemphasises success stories, partly to raise the appeal of a particular educational institution, partly to generate self-perceived individual agency in the face of much larger structural forces that are less conducive to excellence.

ABSTRACT This article argues that the Gramscian notion of the collective organic intellectual offers a fruitful way to analyse the recent legitimisation of state intervention in Eastern Central Europe, foregrounding how the EBRD develops and disseminates appropriate knowledge. It analyses the ongoing contradictions between the historically stated position of the EBRD on the withdrawal of the state and its recently recalibrated perspective in the context of the new state capitalism. The EBRD reorganises what constitutes policy common sense in a time of rapid and diverse new challenges to attempt to secure the hegemony of transnational capital. The argument is deployed across five sections. First, it shows how regional development banks have become vital actors in the new state capitalism. Second, it unpacks how collective organic intellectuals disarticulate old social formations and rework new ones. Sections three and four explore two different periods, before and after 2021, of the EBRD’s position on the state as a key intellectual and policy prescription. The final section of the paper brings the analysis up to date, assessing recent documents in the debate about the state. The paper concludes with reflections on the trajectory of European development finance and the potential of the COI framing.

First multi-individual Neanderthal mitogenomes from north of the Carpathians.

Background/Objectives: Dietary supplements (DSs) are widely available on the pharmaceutical market. Their consumption frequency has been observed to increase over the years, especially with age. To the best of our knowledge, this is the first study in Poland and Central-Eastern Europe to analyze the use of dietary supplements (DSs) based on a nationally representative, random sample of the elderly population. Methods: We examined 5987 individuals aged 60 years and older to assess the prevalence and types of DSs they use, with particular attention to socio-economic factors associated with their consumption. It also aimed to determine whose recommendations were followed when choosing supplements. Results: The percentage of individuals taking any DSs was 32.1% (95% CI: 29.8-34.4), with a higher proportion among women (38.7% (95% CI: 35.7-41.7)) compared to men (22.8% (95% CI: 20.6-25.1)). A multivariable analysis showed that DSs were more likely to be used by individuals with higher education (Prevalence Ratio (PR) 1.74 (95% CI: 1.47-2.06) for individuals with higher education vs. those with primary education). A link between age and DSs consumption was also observed, with the highest consumption rates found among those in their 80s (PR 1.46 (95% CI: 1.30-1.63) vs. the 60-69 age group). The most commonly used ingredients were vitamins, taken by 76.2% (95% CI: 73.6-78.9) of respondents, minerals (55.9% (95% CI: 52.8-59)), and plant-based preparations (45.0% (95% CI: 42-48)). Although DSs were most often used based on a doctor's recommendation (58.5% (95% CI: 54.5-62.6)), over a third of patients initiated their use independently. Conclusions: This significant proportion of individuals taking dietary supplements in Poland, often without consultation with healthcare professionals, suggests that these products may be used in the absence of objective indications, which may be associated with adverse effects and potential drug-supplement interactions. This represents an important implication for clinicians, who should always extend the medical history to include information on DSs use. The findings also highlight the need to strengthen regulatory frameworks to ensure the safe use of these products and to optimally protect the health of older adults.

ABSTRACT Research question: We investigate whether the state-funded construction and renovation of football stadia results in sustained attendance growth, addressing a significant gap in European sport management literature, particularly regarding Central-Eastern Europe. Hungary presents a unique research context due to its extensive government-funded stadium redevelopment program. Research methods: Utilising match-level attendance and stadium capacity data from Hungary’s top two football divisions (NB I and NB II) covering the 2005/06–2023/24 seasons, we apply a difference-in-differences (DID) methodology. Clubs that received new stadia (treatment group) are compared against clubs without stadium renovations (control group), employing two-way fixed effects and advanced DID-imputation techniques to robustly isolate causal impacts on attendance and stadium utilisation rates. Results and Findings: The findings reveal a significant ‘honeymoon’ increase in attendance immediately following the opening of new stadia, lasting approximately five seasons. However, stadium utilisation rates show no lasting improvement beyond the initial season. Results demonstrate considerable variation across clubs. Unlike some Western European contexts, the novelty effect observed in Hungary closely resembles that found in North American leagues, reflecting the limited commercial incentives for clubs in fully state-funded projects. Implications: This research provides crucial insights into the implications of public stadium funding models, suggesting that fully taxpayer-financed projects may lead to suboptimal long-term outcomes, characterised by temporary attendance boosts and persistent underutilisation. The findings underscore the necessity of complementary fan engagement strategies and incentive-aligned financing structures to ensure sustainable attendance growth and effective use of public resources in sport infrastructure projects.

Building and managing university-external stakeholder relations in regional innovation ecosystems (RIE) has been a challenge for European higher education institutions. How does a Central Eastern European mid-range university sustain such relations, and what factors promote and hinder their effective operation? Using multimethod qualitative research and the Regional Innovation Impact model, our data shed light on the operating conditions of the ’RII Delivery Space’, confirming such promoting factors as supply-demand match, actors’ relevant resources, openness and trust between key people, esp. alumni, while low proactivity, divergent interests, distrust among RIE actors, shortage of personnel, a different educational profile and path dependency impede collaborations. This questions the effectiveness of university contributions to the regional innovation ecosystem, despite a well-institutionalised partner management system with strong personal relations, and underlines meaningful communication and ongoing trust-building as key promoting factors. The findings endorse the regional innovation paradox in Europe, divergent RIE actor interests, and the time and capacity barriers listed in the European and Central Eastern European higher education literature. However, the lack of proactivity and the need for wider communication among RIE actors are specific to this case.

The Early–Middle Upper Palaeolithic transition in Eastern Central Europe across MIS3–2 and the Bodrogkeresztúr–Henye site, NE Hungary

A monument to socialist industrialisation or a tool for creating urban development? Rehabilitation of former industrial tram lines (FITL) in Central-Eastern Europe after socialist industrialisation in the context of transit oriented development

Skin-related neglected tropical diseases (NTDs) pose a public health threat, yet despite the establishment of related Sustainable Development Goals (SDGs), systematic analyses of skin-related NTDs SDGs progress are limited. To measure the progress and project attainment to 2030 of the skin-related NTDs SDGs and to explore potential associated factors. The disability-adjusted life-years (DALYs) data of 6 skin NTDs, including cutaneous and mucocutaneous leishmaniasis, fungal skin diseases, leprosy, lymphatic filariasis, onchocerciasis, and scabies, were extracted from the Global Burden of Disease Foresight Visualization study. The general population and 2 vulnerable subpopulations, school-aged children and women of childbearing age, were analyzed. Data were collected from December 2024 to August 2025, and data were analyzed from March to August 2025. Based on the World Health Organization strategic framework, the progress toward the 2030 skin-related NTDs SDGs targeting a 75% reduction in DALYs from 2020 levels was evaluated. The Skin NTDs SDG Index was developed to quantify the progress to meet the target at the national level and evaluate the role of socioeconomic and health care factors and the COVID-19 pandemic. Globally, between 2020 and 2030, DALYs were estimated to increase for cutaneous and mucocutaneous leishmaniasis, fungal skin diseases, scabies, and onchocerciasis and decrease for lymphatic filariasis and leprosy. Only a limited number of countries were on track to meet the target, with 11 countries projected to achieve the skin-related NTDs SDGs for 1 type of skin-related NTD. The novel Skin NTDs SDG Index revealed substantial national variation in progress, with the highest in Central Europe, Eastern Europe, and Central Asia and lowest in Sub-Saharan Africa. Government health spending per total health spending was a crucial factor for better progress. The COVID-19 pandemic showed complex roles for different skin NTDs in the short term and the long term. Analyses of 2 vulnerable subpopulations revealed divergent trends, with DALYs declining in school-aged children but rising in women of childbearing age, accompanied by unique index distribution patterns. In this study, the progress toward attaining the skin-related NTDs SDGs targets has been largely insufficient. Regional inequalities, influenced by health spending levels, the COVID-19 pandemic, and vulnerable group disparities, pose major challenges. Targeted action and sustained health investment are urgently needed.

The Golden Horde, the northwestern extension of the Mongol Empire ruled by Genghis Khan's descendants, holds a pivotal place in the history of Central Eurasia and Eastern Europe. Consequently, understanding the genetic legacy of Genghis Khan and his lineage has long been of both academic and public interest, especially concerning the hypothesized association of his Y-chromosome with haplogroup C3*. Here, we present ancient DNA data from four archaeological individuals-three males and one female-from medieval elite mausoleums of the Golden Horde in the Ulitau region of Kazakstan. Our genomic analyses reveal that the three male individuals are paternally related and share the Y-chromosome haplogroup C3*, confirming the association between the Y-chromosome haplogroup C3* and the Mongol Empire, supporting the long-standing hypothesis about the genetic legacy of Mongols. Additionally, our findings demonstrate that the Golden Horde elites primarily derive their genomes from Ancient Northeast Asians (ANA), with an additional ancestral component from either Ancient North Eurasians (ANE) or a Berel Scythian related population, e.g., the Kipchaks. Archaeological evidence, in turn, sheds light on a medieval population undergoing religious and cultural transition, offering insights into the societal changes experienced by Mongolian conquerors. Furthermore, through constructing an Identity by Descent (IBD) network, we successfully identify medieval relatives of these individuals on the Mongolian Plateau, linking genetic data to broader population dynamics. In essence, this study provides ancient DNA evidence that advances our understanding of the genetic background of the Mongolian elites and the population dynamics in Central Eurasia.

Laryngeal cancer remains a global health concern. Using Global Cancer Observatory (GLOBOCAN) 2022 data, we conducted a cross-sectional study, calculated age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) with the Segi-Doll standard, assessed human development index (HDI) correlations, and projected burden to 2050. In 2022, there were 189.2 thousand new cases and 103.4 thousand deaths worldwide; ASIR was 1.9/100 000 and ASMR 1.0/100 000. Males had higher burden than females (ASIR 3.5 vs. 0.5; ASMR 1.9 vs. 0.2 per 100 000). Medium-HDI countries had the highest ASIR (2.5/100 000) and ASMR (1.6/100 000), while lower-HDI countries experienced higher mortality burdens. South Central Asia, Eastern Asia, and Eastern Europe reported the highest cases and deaths, while the Caribbean had the highest ASIR (4.3/100 000) and ASMR (2.2/100 000). India and China had the highest cases and deaths, whereas Cuba reported the highest ASIR (8.3/100 000) and ASMR (4.0/100 000). Incidence peaked at ages 80-84 and mortality at greater than or equal to 5; Chad showed the youngest peak age. From 1990 to 2021, ASIR and ASMR declined overall but varied by gender and age. By 2050, 49.5% countries are projected to increases, especially in Asia and Africa, highlighting the need for targeted prevention strategies. Priority regions for intervention include South Central Asia, Eastern Asia, and Eastern Europe, with older males and populations in low-HDI countries being particularly vulnerable. Targeted strategies should consider local risk factors and healthcare accessibility.

This article introduces the MoPEI (Mechanisms of Precarious Economic Incorporation) framework, a conceptual-analytical tool for explaining how refugees are steered into precarious labor through the relational and layered intersections of multiple mechanisms. Considering the labor market realities of Central and Eastern Europe, MoPEI identifies six such mechanisms – structural constraints, temporal and legal ambiguity, migration infrastructures, semi-compliance, normative pressures, and bounded agency – and models their interplays using network analysis. We apply this framework to a case study of forcibly displaced Ukrainians in Czechia, where our evidence points to their substantial engagement in informal, semi-formal, and precarious economic activities alongside rapid labor market entry. Drawing on two waves of survey data (2022, 2023) and focus group discussions, our findings demonstrate how the MoPEI mechanisms interact to facilitate and institutionalize precarious incorporation, shaped by entrenched brokerage practices, weak protection, limited agency, and structural disadvantages. In doing so, MoPEI addresses the limits of fragmented and thematically specific explanations by offering a relational account of how precarious incorporation is co-produced.