European Regional Development Research Articles

Integration of Climate Change Strategies into Policy and Planning for Regional Development: A Case Study of Greece

Climate change presents a pressing challenge to regional development, impacting economies, environments, and societies across the globe. Europe, with its diverse regions and commitment to sustainability, serves as a unique case study for exploring the integration of climate change strategies into regional policy and planning. The purpose of this study is to analyze the integration of climate change strategies into policy and planning for regional development in Europe, especially in Greece. Data was collected from 270 environmental experts across Greece using a questionnaire. The results highlight the significance of regional economic growth (gross regional product), infrastructure quality, educational attainment, and a conducive business environment as key measures of regional development. Opportunities arising from climate change strategy integration are explored, revealing economic benefits, environmental opportunities, social enhancements, and technological advancements. These opportunities not only mitigate climate change’s adverse impacts but also foster innovation, economic growth, and community resilience. Successful integration can position regions as global leaders in sustainability and innovation. Correlation and regression analyses reveal that opportunities for integration and common climate change strategies positively influence regional development, while barriers exhibit a counterintuitive positive relationship. However, several barriers hinder integration efforts, including institutional fragmentation, resource constraints, conflicting political and economic priorities, and insufficient stakeholder engagement. This study sheds light on the intricate relationship between climate change, policy integration, and regional development in Greece. It supports the potential for regions to drive sustainability and innovation while navigating the challenges of climate change, ultimately contributing to a more resilient and prosperous future.

THE ROLE OF PUBLIC ADMINISTRATION IN THE DEVELOPMENT OF TERRITORIES

The article examines the role of state administration in the development of territories in Ukraine. The purpose of the article is to study the role of public management and administration in the development of functional types of territories of communities and regions of Ukraine according to the standards, tools of "Good democratic governance" and development practice of Ukrainian and European regional development, regulatory and legal regulation of territorial and cross-border cooperation, provision of equal opportunities for communities and regions of Ukraine regarding the organization of territorial and cross-border cooperation with communities and regions of the European Union. The main methods used in the article are methods of comparative analysis, methods of analysis and synthesis, as well as generalization. The use of the specified methods contributed to the achievement of the goal specified in the article. The authors of the article, based on their own experience, believe that this request from public administrations of new communities and regions of Ukraine for new concepts of local and regional development can be formed and implemented through the application of standards, identifying themselves as subjects of territorial and cross-border cooperation, creating innovative tools for managing their own development, increasing their own management competencies in the conditions crisis phenomena in economic and social policy. In order to strengthen the institutional capacity of public administrations of communities and territories of Ukraine in the implementation of actions to update local and regional policies based on the principles of effective governance of the Council of Europe to solve the above-mentioned problems of territorial development, the authors of the article propose to create educational programs to improve the qualifications of civil servants in matters of territorial and cross-border cooperation.

Identification of atrial complex electrograms by short-coupled extrastimuli in paroxysmal and persistent atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): - Health Council of the Andalusian Regional Government through the project "PI-0057-2017". - European Regional Development Fund/European Social Fund. Introduction Electrogram fractionation during atrial fibrillation (AF) and sinus rhythm have been studied as marker of atrial remodeling and potential target for ablation. Objective The aim of our study was to analyze the response to closely coupled atrial extrastimuli and try to identify areas of hidden slow conduction (HSC) that can promote reentry and AF maintenance in paroxysmal and persistent AF. Methods Twenty consecutive patients with paroxysmal AF and persistent AF (10:10) underwent first PVI procedure. During sinus rhythm triple short coupled extrastimuli was delivered. Locations showing double or highly fragmented electrograms in response to triple extrastimuli were defined as positive electrogram (HSC-EGM) (Figure 1). Increase in duration (delta) of the bipolar EGM was recorded. Two consecutive high-density maps were acquired using a multipolar catheter during AF, sinus and paced rhythms. Spatial correlation of HSC-EGM and complex atrial fractionation (CFAEs) during AF were evaluated. Results Patients with persistent AF showed a higher number and percentage of HSC-EGM than paroxysmal AF (13,9% vs 3,3%, p<0.001) (Figure 2). Delta of EGM duration was 53 ± 22 ms compared to 16 ± 14 ms in sites with a negative response (p<0.001). The number of HSC-EGM distinguished with extrastimuli was lower than that of CFAEs during AF (19 vs 56 per map, p<0.01). The reproducibility of the extension and distribution of HSC-EGM in the repeated maps was superior to that of the CFAEs. The distribution of the HSC-EGM was comparable with those found in the initial map (p=0,32), however, there were significant differences in the distribution of CFAEs between the first map and the remap (p=0.003). Conclusion HSC-EGM in response to triple extrastimuli are more frequent in persistent AF. This type of evoked response could reveal the presence of slow conduction areas and could be considered a potential target for ablation of persistent atrial fibrillation. More studies are needed to confirm this hypothesis.

Cardiovascular magnetic resonance derived biventricular strain in healthy adolescents: reference values and comparison between myocardial tagging and feature-tracking

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Instituto de Salud Carlos III (ISCIII) European Regional Development Fun/European Social Fund (A way to make Europe/Investing in your future). Background Strain measurements have demonstrated to be earlier and more sensitive markers of contractile dysfunction than ejection fraction (EF) alone. Myocardial tagging (MT) is considered the reference standard for CMR strain measurements, but its clinical application is limited because acquisition and analysis are laborious and time consuming. Feature-tracking (FT) CMR allows strain quantification using steady-state in free-precession (SSFP) sequence, which is obtained in routine CMR protocols, being easily applicable in clinical practice. Literature regarding reference strain values in pediatric populations is scarce and, to the best of our knowledge, there are no studies comparing FT and MT in healthy adolescents. Purpose To provide CMR strain reference values in healthy adolescents and compare FT to MT results. Methods A CMR study was performed in healthy adolescents enrolled in the "Early ImaginG Markers of unhealthy lifestyles in Adolescents" (EnIGMA) project using a 3-Tesla CMR scanner between March and October 2021. The imaging protocol included a cine SSFP to provide images for chamber size and function, including FT; and MT acquisitions using spatial modulation of magnetization (SPAMM) technique. Cine acquisitions included the entire left ventricular (LV) short axis and long-axis 4 chamber (4c)- and 2 chamber (2c)-views, while MT acquisitions included three short axis slices (basal, mid and apical) and long-axis 4c-view. Endo- and epicardial borders were manually contoured in the end-diastolic (ED) phase. A non-rigid, elastic algorithm was used for segmentation and registration for strain quantification. If tracking was suboptimal, the software only allowed adaptations of the contours on the ED image. Longitudinal (LS) and circumferential (CS) strains were obtained for the LV and right ventricle (RV). Results CMR scans were performed in 123 adolescents (64 girls, 52.0%) with a mean age of 16.0 years (standard deviation [SD]=0.4), a mean LVEF of 62.5% (SD=4.1) and a mean RVEF of 56.2% (SD=4.6). Reference percentiles (P) 3, 10, 25, 50, 90 and 97 for strain values by sex are provided in Figure 1. FT-measured LVLS and LVCS were higher in girls than in boys (-19.8 vs -17.8%, p<0.01; and -22.2 vs -21.0%, p<0.01; respectively), and these differences were confirmed with MT analysis. There were no consistent between-sex differences for RVLS and RVCS. Bland-Altman analyses showed reasonable agreement between FT and MT for LVLS, LVCS, RVLS and RVCS (Figure 2 A, B, C and D). Conclusions This study provided CMR derived reference values for left and right ventricle strain in adolescents aged 15 to 18 years. This work suggests that FT is a reasonably valid technique to measure LV and RV strain in this population. This information may be useful for diagnostic and prognostic implications in adolescent patients.

Safety and efficacy of intra-arterial bone marrow mononuclear cell transplantation in patients with acute ischaemic stroke in Spain (IBIS trial): a phase 2, randomised, open-label, standard-of-care controlled, multicentre trial

Pilot clinical trials have shown the safety of intra-arterial bone marrow mononuclear cells (BMMNCs) in stroke. However, the efficacy of different doses of intra-arterial BMMNCs in patients with acute stroke has not been tested in a randomised clinical trial. We aimed to show safety and efficacy of two different doses of autologous intra-arterial BMMNC transplantation in patients with acute stroke. The IBIS trial was a multicentre phase 2, randomised, controlled, investigator-initiated, assessor-blinded, clinical trial, in four stroke centres in Spain. We included patients (aged 18-80 years) with a non-lacunar, middle cerebral artery ischaemic stroke within 1-7 days from stroke onset and with a National Institutes of Health Stroke Scale score of 6-20. We randomly assigned patients (2:1:1) with a computer-generated randomisation sequence to standard of care (control group) or intra-arterial injection of autologous BMMNCs at one of two different doses (2 × 106 BMMNCs/kg or 5 × 106 BMMNCs/kg). The primary efficacy outcome was the proportion of patients with modified Rankin Scale scores of 0-2 at 180 days in the intention-to-treat population, comparing each BMMNC dose group and the pooled BMMNC group versus the control group. The primary safety endpoint was the proportion of serious adverse events. This trial was registered at ClinicalTrials.gov, NCT02178657 and is completed. Between April 1, 2015, and May 20, 2021, we assessed 114 patients for eligibility. We randomly assigned 77 (68%) patients: 38 (49%) to the control group, 20 (26%) to the low-dose BMMNC group, and 19 (25%) the high-dose BMMNC group. The mean age of participants was 62·4 years (SD 12·7), 46 (60%) were men, 31 (40%) were women, all were White, and 63 (82%) received thrombectomy. The median NIHSS score before randomisation was 12 (IQR 9-15), with intra-arterial BMMNC injection done a median of 6 days (4-7) after stroke onset. The primary efficacy outcome occurred in 14 (39%) patients in the control group versus ten (50%) in the low-dose group (adjusted odds ratio 2·08 [95% CI 0·55-7·85]; p=0·28), eight (44%) in the high-dose group (1·89 [0·52-6·96]; p=0·33), and 18 (47%) in the pooled BMMNC group (2·22 [0·72-6·85]; p=0·16). We found no differences in the proportion of patients who had adverse events or dose-related events, but two patients had a groin haematoma after cell injection in the low-dose BMMNC group. Intra-arterial BMMNCs were safe in patients with acute ischaemic stroke, but we found no significant improvement at 180 days on the mRS. Further clinical trials are warranted to investigate whether improvements might be possible at different timepoints. Instituto de Salud Carlos III co-funded by the European Regional Development Fund/European Social Fund, Mutua Madrileña, and the Regional Ministry of Health of Andalusia.

Entropy approach for managing the socio-economic development of the region

The article is focused on actual theories and approaches for managing the socio-economic development of the region. And also strengths and weaknesses of the actual theories and approaches of regional development are shown. The article studies the specifics of regional development in Europe, the USA, the Russian Federation and the countries of Central Asia. Entropy approach to study the economic phenomena and processes is offered as an integrated one. It is shown that all actual approaches to regional development can be explained under the entropy approach as special cases. Opportunities for practical application of entropy approach for managing the socio-economic development of the region are shown. As well as the strengths and weaknesses of the entropy approach and the opportunities for its further development are pointed out

Dynamics of multimorbidity and frailty, and their contribution to mortality, nursing home and home care need: A primary care cohort of 1 456 052 ageing people.

SummaryBackgroundPrevalence of both multimorbidity and frailty increases with age, but more evidence is needed to elucidate their relationship and their association with other health-related outcomes. We analysed the dynamics of both conditions as people age and calculate the associated risk of death, nursing home admission, and need for home care.MethodsData were drawn from the primary care electronic health records of a longitudinal cohort of people aged 65 or older in Catalonia in 2010–2019. Frailty and multimorbidity were measured using validated instruments (eFRAGICAP, a cumulative deficit model; and SNAC-K, respectively), and their longitudinal evolution was described. Cox regression models accounted for the competing risk of death and adjusted by sex, socioeconomical status, and time-varying age, alcohol and smoking.FindingsWe included 1 456 052 patients. Prevalence of multimorbidity was consistently high regardless of age, while frailty almost quadrupled from 65 to 99 years. Frailty worsened and also changed with age: up to 84 years, it was more related to concurrent diseases, and afterwards, to frailty-related deficits. While concurrent diseases contributed more to mortality, frailty-related deficits increased the risk of institutionalisation and the need for home care.InterpretationThe nature of people’s multimorbidity and frailty vary with age, as does their impact on health status. People become frailer as they age, and their frailty is more characterised by disability and other symptoms than by diseases. Mortality is most associated with the number of comorbidities, whereas frailty-related deficits are associated with needing specialised care.FundingInstituto de Salud Carlos III through PI19/00535, and the PFIS Grant FI20/00040 (Co-funded by European Regional Development Fund/European Social Fund).

Regional technological capabilities and green opportunities in Europe

The goal of the paper is to elaborate an empirical overview of green technological development in European regions. This is a timely pursuit considering the ambitious commitments stipulated in the recent European Green Deal to achieve climate neutrality by 2050. Our analysis is organised in three steps. First, we map the geographical distribution of innovative activities in Europe and profile regions in terms of technological capabilities. Second, we elaborate a metric to identify regions’ green innovation potential. Third, we check whether possessing a comparative advantage in specific, green and non-green, technological domains is associated with a region’s capacity to develop green technologies.

Universities and smart specialisation in less developed European regions: an evidence-based overview

This paper aims to review the evidence demonstrating the role of universities in the knowledge diffusion function for Smart Specialisation strategies. It is not new if many experts question whether Smart Specialisation will apply equally in all regions, plus the reason that the study of the role of universities in Smart Specialisation still needs much attention. Through this evidence-based literature review, I have identified three main points that support the role of universities for Smart Specialisation in less developed regions of Europe, including resources in regional innovation systems, public sector investment support for RandD, and strong bonds of the Triple Helix actors.

POLAND'S ENERGY SECURITY IN THE CONTEXT OF EU ENVIRONMENTAL INITIATIVES

The current conditions of global development actualize the need for political actors to form a high level of energy security. It expands the state's ability to ensure the sustainability of economic development and the ability to withstand likely threats. The issue of energy security and sovereignty are key on the agenda of the EU, which seeks to implement a strategy of global leadership. The environmental modernization of the EU energy sector and each member state must comply with the main goal of «The European Green Deal», which is to reduce carbon emissions by 55% before 2030. The subject of the study is the substance and peculiarities of the formation of energy security in Poland. The aim of the study is to analyze the mechanisms of energy security of Poland in the context of EU environmental initiatives. Research methodology: systematic approach, method of analysis and comparison. The issue of energy security is recognized as key in achieving sustainable economic development in Poland. The content and basic principles of state energy security are presented in the National Security Strategy and detailed in the Energy Policy. Among the main directions of ecological modernization of the energy sector the following have been identified: efficient consumption of national energy resources; modernization of the energy sector and infrastructure; diversification of natural gas, oil, liquid fuel supplies; optimization of energy market functioning; construction of nuclear power plants; expansion of alternative energy sources; modernization of heating and co-generation energy systems; increasing energy efficiency. Polish officials have emphasized the need for a three-phase energy transition, involving a reduction in the production and use of coal, a gradual increase in the share of natural gas and the expansion of opportunities to use energy from alternative sources. The modernization of Poland's energy sector correlates with the implementation of «The European Green Deal» and other EU environmental initiatives. Energy sovereignty is secured through domestic and foreign financial assistance. The National Fund for Environmental Protection and Water Management of Poland attracts investments in environmental projects related to the development of geothermal energy and improvement of infrastructure energy efficiency. EU special funds (European Regional Development Fund/European Social Fund, Cohesion Fund, Just Transition Fund and Modernization Fund) provide funding for national or regional projects aimed at the comprehensive modernization of the Polish energy sector and the implementation of commitments to achieve climate neutrality. Poland pursues an active policy of cooperation in the energy sphere with other states – Denmark, Lithuania, Latvia, and Estonia. Projects such as "Baltic Pipe" and "The Baltic Synchronisation Project" are in the active implementation phase. The results of the study: energy security is a key factor in the sustainability of economic development of Poland, the implementation of the modernization of the national energy complex correlates with the EU environmental initiatives, which contributes to the attraction of domestic and foreign investment, as well as the resources of public diplomacy.

Phase I dose-escalation single centre clinical trial to evaluate the safety of infusion of memory T cells as adoptive therapy in COVID-19 (RELEASE)

BackgroundEffective treatments are still needed to reduce the severity of symptoms, time of hospitalization, and mortality of COVID-19. SARS-CoV-2 specific memory T-lymphocytes obtained from convalescent donors recovered can be used as passive cell immunotherapy.MethodsBetween September and November 2020 a phase 1, dose-escalation, single centre clinical trial was conducted to evaluate the safety and feasibility of the infusion of CD45RA− memory T cells containing SARS-CoV-2 specific T cells as adoptive cell therapy against moderate/severe cases of COVID-19. Nine participants with pneumonia and/or lymphopenia and with at least one human leukocyte antigen (HLA) match with the donor were infused. The first three subjects received the lowest dose (1 × 105 cells/kg), the next three received the intermediate dose (5 × 105 cells/kg) and the last three received the highest dose (1 × 106 cells/kg) of CD45RA− memory T cells. Clinicaltrials.gov registration: NCT04578210.FindingsAll participants’ clinical status measured by National Early Warning Score (NEWS) and 7-category point ordinal scales showed improvement six days after infusion. No serious adverse events were reported. Inflammatory parameters were stabilised post-infusion and the participants showed lymphocyte recovery two weeks after the procedure. Donor microchimerism was observed at least for three weeks after infusion in all patients.InterpretationThis study provides preliminary evidence supporting the idea that treatment of COVID-19 patients with moderate/severe symptoms using convalescent CD45RA− memory T cells is feasible and safe.FundingClinical Trial supported by Spanish Clinical Research Network PT17/0017/0013. Co-funded by European Regional Development Fund/European Social Fund. CRIS CANCER Foundation Grant to AP-M and Agencia Valenciana de Innovación Grant AVI-GVA COVID-19-68 to BS.

Differential miRNA plasma profiles associated with the spontaneous loss of HIV‐1 control: miR‐199a‐3p and its potential role as a biomarker for quick screening of elite controllers

Differential miRNA plasma profiles associated with the spontaneous loss of HIV‐1 control: miR‐199a‐3p and its potential role as a biomarker for quick screening of elite controllers

POS0048 SEROPREVALENCE OF ANTI-SARS-COV-2 ANTIBODIES IN RHEUMATIC PATIENTS TREATED WITH BIOLOGICAL AND TARGETED THERAPY LIVING IN LOMBARDY, ITALY (MAINSTREAM PROJECT)

Background:Emerging observational data have shown that rheumatic patients seem not to be more susceptible to SARS-CoV-2 infection neither to worse outcomes. However, the true prevalence of COVID19 is still unknown due to the high proportion of subclinical infection. In this scenario, measuring the seroprevalence of SARS-CoV-2 may be crucial to improve the knowledge about the impact of COVID19 in rheumatic patients.Objectives:To estimate in a COVID19 high-endemic area (Lombardy, Italy) the prevalence of anti-SARS-CoV-2 antibodies in a large cohort of patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) treated with biologic (b-) or targeted synthetic (ts-) disease modifying drugs (DMARDs).Methods:A seroprevalence cross-sectional study was conducted in the period between 4th May and 16th June 2020, including patients with confirmed RA or SpA treated with b- or tsDMARDs. Patients were tested for anti-SARS-CoV-2 IgG, IgM and IgA antibodies against main viral antigens (nucleoprotein [N], spike 1 [S1], receptor-binding domain [RBD]) using ELISA. These data were compared with those observed in the healthy population in the same period and region. Patients also answered a questionnaire on history of symptoms consistent with COVID19, risk factors and comorbidities. Serological response to RBD was evaluated according to symptom severity (asymptomatic, minor, or major [respiratory and fever >37.5°C] symptoms).Results:The study population included 300 patients (62% females, mean age 53 years, 20% over 65 years old) diagnosed with RA (56%), psoriatic arthritis (23%), or ankylosing spondylitis (21%), treated with anti-TNF (57%), abatacept (20%), anti-IL6 (11%), or JAK inhibitors (5%). Four patients (1.3%) referred a prior diagnosis of COVID19 defined by nasopharyngeal swab. Immunoglobulin titers were evaluated resulting in 9%, 13.6%, and 13.3% positive patients for IgG, IgM and IgA, respectively (Table 1), with no significant difference to the healthy population. Among seropositive patients, 55.3% were asymptomatic, 16% had minor and 19.6% major symptoms, 7.1% were hospitalized. No deaths or admission to intensive care units occurred. IgM, IgG and IgA titers to RBD were higher in patients with both minor and major symptoms compared with asymptomatic ones (Figure 1). No differences were found between seronegative and seropositive patients in relation to age, sex, rheumatic diagnosis, and treatments with b- or tsDMARDs. A relative lower risk of seropositivity was observed in patients receiving concomitant methotrexate (RR 0.49, 95% CI 0.25-0.94; p 0.04), while an increased risk was associated with obesity (RR 2.33, 95% CI 1.26-3.79; p 0.019) and presence of at least 2 comorbidities (RR 1.94, 95% CI 1.11-3.15; p 0.037). Corticosteroids use was numerically more frequent in seropositive than seronegative patients (18% vs 14%).Conclusion:This study confirms that, even in a cohort of rheumatic patients, the spread of SARS-CoV-2 infection is much greater than that observed by capturing only swab-diagnosed COVID19 cases. The underlying rheumatic disease and ongoing therapy with b/ts-DMARDs do not seem to impact SARS-CoV-2 antibody positivity, which conversely seems to be proportional to the intensity of COVID19 symptoms and less frequent in patients receiving concomitant methotrexate. The project was co-financed by Lombardy Region 2014-2020 Regional Operational Programme under the European Regional Development Fund.Table 1.Prevalence of specific anti-SARS-CoV-2 antibodies.AntibodiesPosivite(n)Seroprevalence (%)(95% CI)IgG279%(6.2 – 12.7)IgG anti-N268.6%(5.9 – 12.3)IgG anti-RBD206.6%(4.3 – 10)IgG anti-S1186%(3.8 – 9.2)IgM4113.6%(10.2 – 18)IgM anti-N3511.6%(8.5 – 15.7)IgM anti-RBD258.3%(5.7 – 12)IgA4013.3%(9.9 – 17.6)IgA anti-N3712.3%(9.0 – 16.5)IgA anti-RBD258.3%(5.7 – 12)IgG+IgM237.6%(5.1 – 11.2)IgG+IgM+IgA227.3%(4.9 – 10.5)IgG+IgA248%(5.4 – 11.6)IgG/IgM/IgA5618.6%(14.6 – 23.4)Figure 1.Antibody levels (S/Co) against SARS-CoV-2 RBD.Disclosure of Interests:None declared.

Detection of new-onset atrial fibrillation in heart failure patients using daily non-invasive ECG monitoring in the TIM-HF2 telemedicine trial

Abstract Background Heart failure (HF) and atrial fibrillation (AF) impair the prognosis when they occur concomitantly. Recent telemedical studies suggest that HF patients with AF may derive a greater benefit from telemedicine care but the results are inconsistent. The rate of newly detected AF in HF patients by daily non-invasive electrocardiogram (ECG) monitoring is unknown and a possible influence on the outcome of remote patient management (RPM) remains unclear. Purpose We aimed to investigate the detection of new atrial fibrillation in patients assigned to RPM in comparison to patients assigned to usual care (UC) in the TIM-HF2 trial. Methods The prospective, multicentre and controlled TIM-HF2 trial randomised 1538 patients (765 RPM, 773 UC). All patients had a 12-channel ECG at baseline and after one year at the final study visit. Patients who were assigned to RPM additionally transmitted a daily ECG to the telemedical centre (TMC). We excluded all patients with pacemaker including implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy (CRT) in the baseline ECG, leaving 879 patients for analysis (RPM: 442 and UC: 437). The patients were stratified into patients with SR and patients with AF according to the rhythm documented at baseline. The primary endpoint of this analysis was newly documented AF within one year after randomisation. We analysed the daily to the telemedical centre transmitted ECGs of patients assigned to RPM with the documented rhythm status of the ECGs performed at the final study visit of patients assigned to UC. Results 569 patients had SR and 310 patients had AF at baseline. The proportion of patients with AF was nearly the same in the RPM (159, 36.0%) and the UC (151, 34.6%) group. 68 patients (24.0%) were detected with new atrial fibrillation in the RPM group compared to 22 patients (7.8%) in the UC trial arm during the one-year follow-up (p<0.001, number needed to screen 6). Conclusion In patients with heart failure and daily ECG transmission, atrial fibrillation was detected three times more frequently in comparison to usual care within one year. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The TIM-HF2 study was supported by a research grant of the German Federal Ministry of Education and Research (grant numbers 13KQ0904A, 13KQ0904B, 13KQ1104A). The TIM-HF2 study was a part of the research and development project “Gesundheitsregion der Zukunft Nordbrandenburg – Fontane” (Fontane). The Fontane system was developed in private–public partnership (PPP) supported by research and development grants from the German Federal Ministry of Education and Research, the European Regional Development, and the Federal State Brandenburg.

Neurogenesis similarities in different human adult stem cells

This work has been funded by Instituto de Salud Carlos III through the project “RD16/001/0010” (Co-funded by European Regional Development Fund/European Social Fund) “Investing in your future”) and Spanish MINECO/AEI/FEDER (SAF2017-83702-R).

CORRIGENDUM

CorrigendumCORRIGENDUMPublished Online:20 Jul 2020https://doi.org/10.1152/ajprenal.zh2-8697-corr.2020Original articleMoreSectionsPDF (18 KB)Download PDFDownload PDFPlus ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInEmail Moreno JM, Tapia A, Martinez CM, Reverte V, Oltra L, Llinas MT, Salazar FJ. Sex-dependent differences in the adverse renal changes induced by an early in life exposure to a high-fat diet. Am J Physiol Renal Physiol 316: F332–F340, 2019. First published December 5, 2018; doi:10.1152/ajprenal.00394.2018.—In this article, the GRANTS section should read as follows:This work was supported by the Subdirección General de Proyectos de Investigación of Ministerio de Economía y Competitividad, Spain (BFU2013-49098-R), the Instituto de Salud Carlos III (PI16/01556) (co-funded by European Regional Development Fund/European Social Fund “A way to make Europe/Investing in your future”) and Fondos Feder, and Fundación Séneca from Comunidad Autónoma of Murcia (19422/PI/14).This article has no references to display. Previous Back to Top FiguresReferencesRelatedInformationRelated articlesSex-dependent differences in the adverse renal changes induced by an early in life exposure to a high-fat diet 01 Feb 2019American Journal of Physiology-Renal Physiology More from this issue > Volume 319Issue 2August 2020Pages F256-F256 Copyright & PermissionsCopyright © 2020 the American Physiological Societyhttps://doi.org/10.1152/ajprenal.zh2-8697-corr.2020PubMed32686976History Published online 20 July 2020 Published in print 1 August 2020 PDF download Metrics Downloaded 359 times

Experience in implementing the European Union’s regional investment policy to attract foreign direct investments

The article reviews the investment policy of the Eurozone regions in relation to foreign direct investments (hereinafter-FDI). A quantitative assessment of FDI in the global aspect and at the level of the European Union has been given. It has been determined that both global FDI flows and at the level of the EU economy decreased at the end of 2018. The rating of the Eurozone countries by the level of FDI for 2018, the leaders of which are Germany, Ireland and France, is given. The FDI market by type of economic activity has been analysed. It has been revealed that a large share of the market is made up of sales and marketing (up to 40%) and production sector (up to 30%). In more detail the trends in the investment policy of those countries that recorded a sharp growth or a sharp decline in FDI have been highlighted, namely, France, Germany, Spain, Belgium, Poland and Ireland. The main factors that negatively affect the investment situation in the European Union have been emphasized, including: General political instability, threats of global protectionism, high levels of public debt in a number of countries, fiscal reform and US economic policy, and others. At the end, taking into account the current problems in the EU, recommendations have been formulated to activate the investment policy in the field of FDI at the level of this regional Association, aimed at promoting its socio-economic development. The main focus of investment policy development in the EU countries should be on aspects that promote macroeconomic and political stability, create a favorable business environment and create a reliable legal framework. In addition, it is extremely important to carry out structural reforms in the financial sector: to reduce the budget deficit and public debt in a number of countries. In conclusion, it is emphasized that by implementing an investment policy in accordance with the current needs of the Eurozone economy, it is possible to reduce the gap in the development of European regions and create an integrative and stronger economic Union.

Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial

There is no proven specific pharmacological treatment for patients with the acute respiratory distress syndrome (ARDS). The efficacy of corticosteroids in ARDS remains controversial. We aimed to assess the effects of dexamethasone in ARDS, which might change pulmonary and systemic inflammation and result in a decrease in duration of mechanical ventilation and mortality. We did a multicentre, randomised controlled trial in a network of 17 intensive care units (ICUs) in teaching hospitals across Spain in patients with established moderate-to-severe ARDS (defined by a ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen of 200 mm Hg or less assessed with a positive end-expiratory pressure of 10 cm H2O or more and FiO2 of 0·5 or more at 24 h after ARDS onset). Patients with brain death, terminal-stage disease, or receiving corticosteroids or immunosuppressive drugs were excluded. Eligible patients were randomly assigned based on balanced treatment assignments with a computerised randomisation allocation sequence using blocks of 10 opaque, sealed envelopes to receive immediate treatment with dexamethasone or continued routine intensive care (control group). Patients in the dexamethasone group received an intravenous dose of 20 mg once daily from day 1 to day 5, which was reduced to 10 mg once daily from day 6 to day 10. Patients in both groups were ventilated with lung-protective mechanical ventilation. Allocation concealment was maintained at all sites during the trial. Primary outcome was the number of ventilator-free days at 28 days, defined as the number of days alive and free from mechanical ventilation from day of randomisation to day 28. Secondary outcome was all-cause mortality 60 days after randomisation. All analyses were done according to the intention-to-treat principle. This study is registered with ClinicalTrials.gov, NCT01731795. Between March 28, 2013, and Dec 31, 2018, we enrolled 277 patients and randomly assigned 139 patients to the dexamethasone group and 138 to the control group. The trial was stopped by the data safety monitoring board due to low enrolment rate after enrolling more than 88% (277/314) of the planned sample size. The mean number of ventilator-free days was higher in the dexamethasone group than in the control group (between-group difference 4·8 days [95% CI 2·57 to 7·03]; p<0·0001). At 60 days, 29 (21%) patients in the dexamethasone group and 50 (36%) patients in the control group had died (between-group difference -15·3% [-25·9 to -4·9]; p=0·0047). The proportion of adverse events did not differ significantly between the dexamethasone group and control group. The most common adverse events were hyperglycaemia in the ICU (105 [76%] patients in the dexamethasone group vs 97 [70%] patients in the control group), new infections in the ICU (eg, pneumonia or sepsis; 33 [24%] vs 35 [25%]), and barotrauma (14 [10%] vs 10 [7%]). Early administration of dexamethasone could reduce duration of mechanical ventilation and overall mortality in patients with established moderate-to-severe ARDS. Fundación Mutua Madrileña, Instituto de Salud Carlos III, The European Regional Development's Funds, Asociación Científica Pulmón y Ventilación Mecánica.

The Impact of AL-TI-B Grain-Refiners from Different Manufacturers on Wrought AL-alloy

1. This work was supported by A Republic of Slovenia, Ministry of Education, Science and Sport and by European Commission, European Regional Development. This work was made in a frame of program Materials and Technologies for New Applications (MARTINA, grand number: C3330-16-529008).

(Re-)producing bioassemblages: positionalities of regional bioeconomy development in Finland

ABSTRACTBioeconomy is a new political and economic buzzword that frames many proposed pathways to sustainable regional development in Europe, particularly in rural, biomass rich areas. Dissected by research into various strands, visions, shades of “green” and presented by bioeconomy stakeholders through regional examples and self-promoting bio-clusters, the socio-spatial processes of regional assemblages are often ignored in these accounts. Based on a prominent Finnish example, this case study employs the concept of bioassemblage to display the socio-spatial positionalities of regional bioeconomy development in the places of materialisation. Furthermore, it ties the spatial (re-)production of bioassemblages to their role as bioeconomy policy translation loops and consequently provides insights into the processes of bioeconomy policy mobility, translation and mutation. Examining the positionalities in a bioassemblage presents a complex and frequently shifting local environment accompanied by unequal power topologies and means of territorialisation. Shallow policy narratives create problematic mismatches between the “best-practices” employed by policy makers and regional bioeconomy materialisation in the places themselves. While the study makes no assumption on the sustained future of bioeconomy development, it shows that current processes enable the externalisation of risks at industrial sites, restrict wider participation and discredit the important role of institutional actors in development.