Southern Eastern Europe Research Articles

Knowledge, Attitudes, and Practices Regarding Cervical Cancer Awareness and Prevention in Southern Eastern Europe: A Narrative Review

This narrative review examines the knowledge, attitudes, and practices (KAP) related to cervical cancer across Southeastern Europe, with a focus on disparities in awareness, prevention efforts, and healthcare access. A comprehensive search of PubMed over the past 12 years was conducted to assess gaps in KAP regarding cervical cancer and human papillomavirus (HPV) prevention. The findings revealed significant gaps in KAP, including limited knowledge about cervical cancer risk factors, inadequate attitudes toward screening, and poor preventive practices, such as low participation in screening programs and HPV vaccine uptake. Economic challenges and inconsistent healthcare communication further hinder progress. The review emphasizes the need for targeted public health strategies, focusing on improving education, social mobilization, and access to essential services. Further research is necessary to address sociocultural and economic factors contributing to these gaps and to develop tailored interventions suited to the region's diverse populations.

Revision of the Festuca marginata “group” (Festuca sect. Festuca, Poaceae) in Southern Europe, with special reference to France, Italy and Greece

ABSTRACT The Festuca marginata group includes several taxa of glaucous, thick-leaved fescues with three sclerenchyma strands, first described by Hackel as Festuca ovina subsp. laevis, which are common in the Euro-Mediterranean area. Ten different taxa (species and subspecies) are currently recognized in this group. Nevertheless, taxonomical works typically have only a local (mostly national) scope, and the recognized taxa show only few or negligible morphological differences, making their separate taxonomic status doubtful. Here we provide morphological, karyological, and genetic analysis (ISSR, flow cytometry) of the Festuca marginata group based on populations in a larger geographical scale including Central and Southern-Eastern Europe. We found that most of the local taxa are difficult to definitively distinguish and we suggest the whole group be treated as a single species, Festuca marginata, with two subspecies reflecting major differences in morphology and genome size between the Greece subsp. heldreichii and the remaining European populations, referred to as subsp. marginata.

Burials of the Beginning of the Early Iron Age in the Mounds of Southern Eastern Europe (Metastructure of Sites)

Burials of the Beginning of the Early Iron Age in the Mounds of Southern Eastern Europe (Metastructure of Sites)

Decarbonisation Policies in the Residential Sector and Energy Poverty: Mitigation Strategies and Impacts in Central and Southern Eastern Europe

The decarbonisation policies for the EU building stock can improve living conditions, including thermal comfort and lower energy bills. However, these measures may impose financial burdens on low-income households, reducing their disposable income and exacerbating their vulnerability. The current study investigates the impact of decarbonisation policies on the EU’s building stock, with a specific focus on Minimum Energy Performance Standards (MEPS), the new Emissions Trading System (ETS2) for buildings, and the phase-out of fossil heating systems. By employing a linear, static latest version of Microsoft Excel (Microsoft 365)-based model and analyzing Eurostat data, this study quantifies the effects of these policies on energy consumption, costs, and necessary investments. Moreover, the study emphasizes their implications for low-income groups using vulnerability indicators. The findings demonstrate that a combination of MEPs, ETS2, and phasing out fossil heating systems effectively reduces energy consumption and costs across most countries. However, implementing ETS2 alone may lead to energy reduction and discomfort for low-income groups without addressing underlying demand-side issues. To address this, this study recommends the implementation of more ambitious MEPs or the provision of additional funding alongside ETS2. The phase-out of fossil fuel boilers emerges as the most cost-effective measure in the medium to long term. While MEPS and the phase-out of fossil fuel boilers improve living conditions, they also impose upfront cost burdens and reduce disposable income for low-income households. Therefore, high subsidy rates and supportive policies are necessary to ensure equitable access to investments. The main recommendations include (a) shifting financing to renewable heating systems for low-income households by 2025, addressing cost issues and policies favouring gas boilers; (b) implementing high-funding rate subsidies for energy efficiency in low-income households before 2025, with technical guidance; (c) prioritising the Energy Efficiency First principle in planning to avoid additional emissions or higher costs for low-income households; and (d) considering the energy behaviour of low-income groups in regulations, employing a combination of policies to achieve desired outcomes and ensure thermal comfort.

THE OLDEST TRANSPORT ARTERY OF SCYTHIA (Lower Hypanis — middle course of Borysthenes Track)

The article examines the connection between the archaeological sites of the pre-Scythian and Scythian times and the key watersheds of Right Bank Ukraine, as routes of potential overland communications that used to move goods in ancient times. One of the impetuses for turning to this topic was the discovery of four archaic amphorae (one whole from Klazomenai, others from Lesbos) at the recently discovered Khotynets hillfort in Poland, which is located in the extreme west of the country of the Early Iron Age hillforts of southern Eastern Europe. These finds of amphora containers in the area of Vyshnia and San valleys convincingly testify that trade caravans could reach this distant region from the Black Sea coast using only the land route. For its time, land communications were optimal, as they provided relatively reliable movement with a heavy load, along a path practically devoid of sharp descents and ascents.
 Key attention in the article is given to one of the most ancient routes that connected the northern coast of the Black Sea with settlement structures in the Middle Dnieper region. The extreme points in this transport system were pre-Scythian hillforts — Dykii Sad located at the confluence of the Ingul and Southern Bug rivers and its potential northern partner Subotivske in the Tiasmin basin. During the Scythian rule in the Black Sea steppes, this route continued to be actively used. However, over time, the final trade terminals changed, and the route of trade caravans remained. Merchants from Olbia and the harbors of the northern coast of the Black Sea used the eastern edge of the Southern Bug basin as a reliable route to the fortified settlement structures of the forest-steppe Right Bank, among them Matronynske and the Trakhtemyrivske hillforts.
 Given the shallow depths near the coast of Olbia, the authors consider the harbour of the little-explored ancient hillfort of Hlyboka Prystan as a likely place for unloading sea vessels with a deep draft. From this harbour opened a convenient way to the hillforts of the Forest Steppe, just using the oldest transport artery of Scythia.

Shell platforms and dwelling structures: spatial structure of the archaeological layer of the early Neolithic Rakushechnii Yar site

The Rakushechny Yar site is one of the key Early Neolithic sites of southern Eastern Europe. The lithological strata, which preserved the cultural layers of Neolithic- Eneolithic, reach a thickness of more than 6 m. Remains of various structures attributed to Early Neolithic were identified – platforms with Unio shells surrounded by stake pits, shell piles with numerous kitchen remains and artefacts, pits with Unio shells deposited within several horizons. Another type includes the remains of structures marked by rows of post and stake pits, some of which may relate to fishing gear. Dwelling structures are represented by the remains of buildings with clay floors. Analysis of the distribution of artifacts and ecofacts and plans of individual layers on the basis of analysis of archival materials made it possible to identify different types of household and residential structures, outline the boundaries of artifact accumulations, describe the location of objects in the cultural layer, reconstruct functional zones, identify stable complexes of different categories and material groups. Spatial analysis of the archival material, taking into account the results of recent years of field research, shows a change in the development pattern of the coastal zone from small-scale household areas, sometimes paved with shells, with pits to residential complexes.

Трансформация декора от предскифской к раннескифской упряжи: смена мировоззренческих образов

The article considers the transformation of ornament on the elements of horse equipment from the final stage of the pre-Scythian period to the beginning of the early Scythian. At the finale, classical Novocherkassk stage of the pre-Scythian period, some dramatic changes in art take place. In the traditional environment of pre-Scythian geometric art of southern Eastern Europe at the beginning of the 7th century BC, an absolutely alien system of zoomorphic images-signs is suddenly introduced. These changes occur against the background of the emergence of new types of bridle sets and some categories of weapons of Central Asian-Siberian origin, which form the “Zhabotin” military-horseman assemblage, fundamentally different from the previously existing “Novocherkassk”. As a result, it launches the process of fundamental changes in the social code of various groups of the pre-Scythian population of southern Eastern Europe. “Novocherkassk-Zhabotin” syncretic assemblage appears, some elements of which can be traced in the archaeological sites of the Kelermes stage of the early Scythian period not earlier than the last quarter of the 7th century BC.

ОСНОВЫ ХРОНОЛОГИИ И ПЕРИОДИЗАЦИИ ИСТОРИИ ЗЕМЕЛЬ ДОНБАССА В СРЕДНИЕ ВЕКА. ЧАСТЬ 2

The authors propose a periodization of the history of the Donbas lands during the High and Late Middle Ages. The beginning of a large cycle of migration processes caused by the invasion of the Oghuz tribes invasion was a marker of the High Middle Ages in the region. The demographic crisis at the end of the 14th century is considered as a marker of the beginning of the Late Middle Ages. Generally, the Middle Ages come to an end at the late 16th century when the southern borders of the Muscovite state were systematically moving further into the steppe. Particular attention should be paid to the characteristics of the regional features of the transitional periods from the Late Middle Ages to the Modern Era: there was a change in the vector of ethnic and political dominance in the middle and lower reaches of the Seversky Donets. Conditional periods and epochs, identified according to ethno-cultural and political criteria, are as close as possible to the existing conventional periodization. The proposed local model of the periodization of the history of the Donbas lands largely does not coincide with the periodization of the history of the neighboring regions of southern Eastern Europe. The elaboration of subdivided periodization permits us to more accurately reflect the features of the historical process in the region as parts of global history. Civilization criteria of periodization become more significant in the transition from the characteristics of epochs to the characteristics of specific periods. Migration processes are an important criterion for distinguishing between different epochs. Economic and ethnopolitical processes are of decisive importance for identifying periods of local history. A distinctive feature of the evolution of the lifestyle of medieval nomads was the trend towards sedentarization, the increase in the complexity of the food supply, and the development of sedentary settlement strategies. The principles of elaborating the periodization, tested in this study, can be used in discussing the problems of periodization of global history. Discussion of variants for periodization of local history leads to the improvement of the necessary conceptual apparatus. In the context of the periodization of the history of Donbas, the term “Middle Ages” is largely a conditional concept, different from the classical model.

Multifarious Trajectories in Plant-Based Ethnoveterinary Knowledge in Northern and Southern Eastern Europe.

Over the last century in the European context, animal production has been transformed by the dynamics of centralization and decentralization due to political and economic factors. These processes have influenced knowledge related to healing and ensuring the welfare of domestic animals. Therefore, our study aimed to document and compare current and past ethnoveterinary practices, and to identify trajectories in ethnoveterinary knowledge in study regions from both northern and southern Eastern Europe. In the summers of 2018 and 2019, we conducted 476 interviews, recording the use of 94 plant taxa, 67 of which were wild and 24 were cultivated. We documented 452 use reports, 24 of which were related to the improvement of the quality or quantity of meat and milk, while the other 428 involved ethnoveterinary practices for treating 10 domestic animal taxa. Cattle were the most mentioned target of ethnoveterinary treatments across all the study areas, representing about 70% of all use reports. Only four plant species were reported in five or more countries (Artemisia absinthium, Hypericum spp., Linum usitatissimum, Quercus robur). The four study regions located in Northern and Southern Eastern Europe did not present similar ethnoveterinary knowledge trajectories. Bukovinian mountain areas appeared to hold a living reservoir of ethnoveterinary knowledge, unlike the other regions. Setomaa (especially Estonian Setomaa) and Dzukija showed an erosion of ethnoveterinary knowledge with many uses reported in the past but no longer in use. The current richness of ethnoveterinary knowledge reported in Bukovina could have been developed and maintained through its peculiar geographical location in the Carpathian Mountains and fostered by the intrinsic relationship between the mountains and local pastoralists and by its unbroken continuity of management even during the Soviet era. Finally, our results show some patterns common to several countries and to the veterinary medicine promoted during the time of the Soviet Union. However, the Soviet Union and its centralized animal breeding system, resulted in a decline of ethnoveterinary knowledge as highly specialized veterinary doctors worked in almost every village. Future research should examine the complex networks of sources from where farmers derive their ethnoveterinary knowledge.

Свідчення ал-Мас‘уді і “Худуд ал-‘алам” про народи Півдня Східної Європи

Свідчення ал-Мас‘уді і “Худуд ал-‘алам” про народи Півдня Східної Європи

No research for the decisionally-impaired mentally ill: a view from Montenegro

BackgroundMany of the important elements of a valid informed consent – comprehension, voluntariness, and capacity – can be compromised or unmet in the context of psychiatric research. The inability to protect their own interests puts mentally ill subjects at an increased likelihood of being wronged or harmed and makes them particularly vulnerable in the context of clinical research. Therefore, they are due extra protection. Sometimes, these additional safeguards can significantly limit the possibilities for research involving subjects deemed unable to consent due to their mental illness. Montenegro, a middle-income country in Southern-Eastern Europe, goes so far in their policy to protect these subjects from harms of research, as to ban all biomedical research on mentally ill persons who are unable to provide consent.Main bodyMental health research is often neglected and very low on the list of health research priorities, especially in low- and middle-income countries. Despite the fact that mental health disorders are among leading causes of disability, the need for evidence-based services and interventions for those affected remains unmet.To exclude all members of a certain group of subjects seems extremely restrictive and unnecessary. Such a policy is discriminatory and unethical, because it inflicts further harms and exclusion of those patients from participation in society. This unjust exclusion policy obstructs research of certain psychiatric disorders and implies that new treatments for conditions that directly affect these incapacitated subjects will not be developed.ConclusionsScientific and clinical development must not be precluded by overly restrictive, discriminatory and unjust practices, such as the normative ban on research on decisionally-impaired mentally ill subjects. Rather, there should be a regulative framework that ensures that those who cannot consent for themselves are respected and protected in research, the anticipated benefits maximized, risks minimized, their autonomy recognized and extended. These patient-subjects must be appropriately included unless there is a clear and compelling rationale and justification that inclusion is inappropriate with respect to the health of the participants or the purpose of the research.

Birth seasonality of childhood central nervous system tumors: Analysis of primary data from 16 Southern-Eastern European population-based registries.

Season of birth, a surrogate of seasonal variation of environmental exposures, has been associated with increased risk of several cancers. In the context of a Southern-Eastern Europe (SEE) consortium, we explored the potential association of birth seasonality with childhood (0-14 years) central nervous system (CNS) tumors. Primary CNS tumor cases (n = 6,014) were retrieved from 16 population-based SEE registries (1983-2015). Poisson regression and meta-analyses on birth season were performed in nine countries with available live birth data (n = 4,987). Subanalyses by birth month, age, gender and principal histology were also conducted. Children born during winter were at a slightly increased risk of developing a CNS tumor overall [incidence rate ratio (IRR): 1.06, 95% confidence intervals (CI): 0.99-1.14], and of embryonal histology specifically (IRR: 1.13, 95% CI: 1.01-1.27). The winter peak of embryonal tumors was higher among boys (IRR: 1.24, 95% CI: 1.05-1.46), especially during the first 4 years of life (IRR: 1.33, 95% CI: 1.03-1.71). In contrast, boys <5 years born during summer seemed to be at a lower risk of embryonal tumors (IRR: 0.73, 95% CI: 0.54-0.99). A clustering of astrocytomas was also found among girls (0-14 years) born during spring (IRR: 1.23, 95% CI: 1.03-1.46). Although the present exploratory results are by no means definitive, they provide some indications for age-, gender- and histology-related seasonal variations of CNS tumors. Expansion of registration and linkage with cytogenetic reports could refine if birth seasonality is causally associated with CNS tumors and shed light into the complex pathophysiology of this lethal disease.

Імперія русів: передісторія і початки становлення

Background: The article attempts to study the processes of political consolidation of Slavic tribes in the IV–VIII centuries, to establish the main factors that influenced the formation of the early Slavic states; trace the prehistory of Rus’ and determine the beginnings of the Rus’ empire. Purpose: To identify a set of medieval sources for studying the history of the early Slavic states, to analyze the information of medieval writers about the Slavs and Rus’ people, their early state formations and titles of rulers to help establish the nature and degree of state-building processes. Analysis of written sources shows that the first reports of the early Slavic states appear in the Byzantine chronicles in the VI century during the era of the Great Migration, when large-scale migration in the Balkans formed large Slavic regions and Slavic expansion was a serious threat to the territories of the empire. Arab authors begin to mention the Slavs and Rus’ people later, in the VII–VIII centuries, during the beginning of Arab expansion within Byzantium and the development of international trade between Europe and the Arab East in which the Slavs played a leading role. According to sources the formation of Rus’ in southern Eastern Europe was preceded by the formation of large military-political associations of the Slavs - the unions of the Ants and Dulibs, Greater Croatia. Here as in the Baltic Pomerania and the Danube, they originated in the Slavic areas through which international trade routes passed. International trade contributed to the development of cities, strengthened the process of political consolidation and became an important factor in the formation of the early Slavic states and the formation of the Rus’ empire. Its territorial core was the Middle Dnieper region through which passed the routes connecting the north and south of the continent, as well as the transcontinental trade route between the European West and the Arab East. The establishment of control over water and land international routes was the main reason for the expansion of the Rus’ people which resulted in the formation of the largest European empire in the Middle Ages. Keywords: migrations of the Slavs, early Slavic states, the Ant Union, the Dulib Union, international trade routes, Rus’ people, Rus’ empire.

Injecting drug use: Gendered risk

BackgroundResearch demonstrates gender related differences in drug-use practices and risk behaviours. Females’ structural vulnerability stemming from traditional gender roles and gender-power relations may enhance their propensity to experience injecting related risk. In this paper we explore gender differences in injection practices at the initiation event, during the first year of injecting and in the most recent 12-month period, to inform more effective harm reduction strategies. MethodsData used in this study were drawn from the Global Drug Survey 2015. The study employs chi-square and logistic regression to assess gender differences in injection behaviours in a sample of current injectors residing in six global regions: North-West Europe; Southern Eastern Europe; North America. South America and Oceania. ResultsFemales were more likely than males to report being injected by an intimate partner at initiation (OR = 4.4, 95%CI: 2.2–8.8), during the first year of injecting (OR = 4.8, 95% CI: 2.4–9.3) and in the most recent 12-month period (OR = 2.5, 95%CI: 1.0–6.2). Females reported greater difficulties accessing sterile equipment (X2(2,N = 453) = 8.2, p = 0.02) and were more likely to share injecting equipment than males (X2(1,N = 463) = 3.9, p = 0.05). ConclusionsOur findings highlight females’ continued dependence on their intimate partner to administer the injection into the first year of their injecting career. Females remained more likely than males to rely on intimate partners for injection during the most recent 12-month period. Females report greater difficulties in sourcing sterile equipment and are more likely to share injecting equipment. We suggest that these findings reflect the broader social structure in which females are disempowered through traditional gender roles and the lack of gender appropriate harm reduction services.

Malignant central nervous system tumors among adolescents and young adults (15‐39 years old) in 14 Southern‐Eastern European registries and the US Surveillance, Epidemiology, and End Results program: Mortality and survival patterns

Unique features and worse outcomes have been reported for cancers among adolescents and young adults (AYAs; 15-39 years old). The aim of this study was to explore the mortality and survival patterns of malignant central nervous system (CNS) tumors among AYAs in Southern-Eastern Europe (SEE) in comparison with the US Surveillance, Epidemiology, and End Results (SEER) program. Malignant CNS tumors diagnosed in AYAs during the period spanning 1990-2014 were retrieved from 14 population-based cancer registries in the SEE region (n = 11,438). Age-adjusted mortality rates were calculated and survival patterns were evaluated via Kaplan-Meier curves and Cox regression analyses, and they were compared with respective 1990-2012 figures from SEER (n = 13,573). Mortality rates in SEE (range, 11.9-18.5 deaths per million) were higher overall than the SEER rate (9.4 deaths per million), with decreasing trends in both regions. Survival rates increased during a comparable period (2001-2009) in SEE and SEER. The 5-year survival rate was considerably lower in the SEE registries (46%) versus SEER (67%), mainly because of the extremely low rates in Ukraine; this finding was consistent across age groups and diagnostic subtypes. The highest 5-year survival rates were recorded for ependymomas (76% in SEE and 92% in SEER), and the worst were recorded for glioblastomas and anaplastic astrocytomas (28% in SEE and 37% in SEER). Advancing age, male sex, and rural residency at diagnosis adversely affected outcomes in both regions. Despite definite survival gains over the last years, the considerable outcome disparities between the less affluent SEE region and the United States for AYAs with malignant CNS tumors point to health care delivery inequalities. No considerable prognostic deficits for CNS tumors are evident for AYAs versus children. Cancer 2017;123:4458-71. © 2017 American Cancer Society.

Personal life and working conditions of trainees and young specialists in clinical microbiology and infectious diseases in Europe: a questionnaire survey

The purpose of this investigation was to assess the balance between the personal and professional lives of trainees and young European specialists in clinical microbiology (CM) and infectious diseases (ID), and determine differences according to gender, country of training, workplace and specialty. The Steering Committee of the Trainee Association of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) devised a questionnaire survey consisting, beyond the demographic questions, of nine yes/no questions, 11 Likert scale self-evaluations and one open-response item on parenthood, working conditions, quality of life, alcohol consumption and burnout. This anonymous survey in English was held between April and July 2015 among European CM/ID trainees and young specialists (<3 years after training completion). Responses from 416 participants with a mean age of 32 years [standard deviation (SD) 5 years] were analysed. Females and physicians from Northern/Western Europe (NWE) benefit more from paternity/maternity leaves even during training than their counterparts. Among all respondents, only half of breastfeeding mothers enjoyed the benefit of working hours flexibility. Only two-thirds of respondents found their working environment stimulating. In comparison to colleagues from other parts of Europe, trainees and young specialists from Southern/Eastern Europe (SEE) had less frequent regular meetings with mentors/supervisors and head of departments where trainees’ issues are discussed. Also, physicians from SEE were more frequently victims of workplace mobbing/bullying in comparison to those from other regions. Finally, multivariate analysis showed that female gender, SEE region and ID specialty were associated with burnout feelings. Female gender and country of work from SEE largely determine satisfactory working conditions, the possibility of parenthood leaves, amount of leisure time, mobbing experiences and burnout feelings among European CM/ID trainees and young specialists.

Incidence, time trends and survival patterns of childhood pilocytic astrocytomas in Southern-Eastern Europe and SEER, US.

Pilocytic astrocytomas (PA) comprise the most common childhood central nervous system (CNS) tumor. Exploiting registry-based data from Southern and Eastern Europe (SEE) and SEER, US, we opted to examine incidence, time trends, survival and tentative outcome disparities of childhood PA by sociodemographic and clinical features. Childhood PA were retrieved from 12 SEE registries (N = 552; 1983-2014) and SEER (N = 2723; 1973-2012). Age-standardized incidence rates (ASR) were estimated and survival was examined via Kaplan-Meier and Cox regression analysis. ASR of childhood PA during 1990-2012 in SEE was 4.2/106, doubling in the USA (8.2/106). Increasing trends, more prominent during earlier registration years, were recorded in both areas (SEE: +4.1 %, USA: +4.6 %, annually). Cerebellum comprised the most common location, apart from infants in whom supratentorial locations prevailed. Age at diagnosis was 1 year earlier in SEE, whereas 10-year survival was 87 % in SEE and 96 % in SEER, improving over time. Significant outcome predictors were age <1year at diagnosis diagnosis (hazard ratio, HR [95% confidence intervals]: 3.96, [2.28-6.90]), female gender (HR: 1.38, [1.01-1.88]), residence in SEE (HR: 4.07, [2.95-5.61]) and rural areas (HR: 2.23, [1.53-3.27]), whereas non-cerebellar locations were associated with a 9- to 12-fold increase in risk of death. The first comprehensive overview of childhood PA epidemiology showed survival gains but also outcome discrepancies by geographical region and urbanization pointing to healthcare inequalities. The worse prognosis of infants and, possibly, females merits further consideration, as it might point to treatment adjustment needs, whereas expansion of systematic registration will allow interpretation of incidence variations.

Survival trends in childhood chronic myeloid leukaemia in Southern-Eastern Europe and the United States of America

AimTo assess trends in survival and geographic disparities among children (0–14 years) with chronic myeloid leukaemia (CML) before and after the introduction of molecular therapy, namely tyrosine kinase inhibitors (TKIs) in Southern-Eastern European (SEE) countries and the USA. MethodsWe calculated survival among children with CML, acute lymphoblastic (ALL) and acute myeloid leukaemia (AML) in 14 SEE (1990–2014) cancer registries and the U.S. Surveillance, Epidemiology and End Results Program (SEER, 1990–2012). We used Kaplan–Meier curves and multivariate Cox regression models to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). ResultsAmong 369 CML cases, substantial improvements were noted in 2-year survival during the post-TKI (range: 81–89%) compared to pre-TKI period (49–66%; HR: 0.37, 95% CI: 0.23–0.60). Risk of death was three times higher for <5-year-old children versus those aged 10–14 years (HR: 3.03, 95% CI: 1.85–4.94) and 56% higher for those living in SEE versus SEER (HR: 1.56, 95% CI: 1.01–2.42). Regardless of geographic area and period of TKI administration, however, age seems to be a significant determinant of CML prognosis (pre-TKI period, HR0–4y: 2.71, 95% CI: 1.53–4.79; post-TKI period, HR0–4y: 3.38, 95% CI: 1.29–8.85). Noticeably, post-TKI survival in CML overall approximates that for ALL, whereas therapeutic advancements for AML remain modest. ConclusionRegistry data show that introduction of molecular therapies coincides with revolutionised therapeutic outcomes in childhood CML entailing dramatically improved survival which is now similar to that in ALL. Given that age disparities in survival remain substantial, offering optimal therapy to entire populations is an urgent priority.

Assessing the effect of agricultural land abandonment on bird communities in southern-eastern Europe

Agricultural land abandonment is recognized as a major environmental threat in Europe, being particularly pronounced in south-eastern Europe, where knowledge on its effects is limited. Taking the Balkan Peninsula as a case study, we investigated agricultural abandonment impact on passerine communities at regional level. We set up a standard methodology for site selection (70 sites) and data collection, along a well-defined forest-encroachment gradient that reflects land abandonment in four countries: Albania, Bulgaria, Croatia and Greece. Regardless the different socio-economic and political histories in the Balkans that led to diverse land abandonment patterns in space and time, rural abandonment had a consistent negative effect on bird communities, while regional-level analysis revealed patterns that were hidden at local level. The general trends were an increase of forest-dwelling bird species at the expense of farmland birds, the decline of overall bird species richness, as well as the decline of Species of European Conservation Concern (SPECs) richness and abundance. Many farmland bird species declined with land abandonment, whereas few forest species benefited from the process. In conclusion, our results support CAP towards hampering rural land abandonment and preserving semi-open rural mosaics in remote upland areas, using a suite of management measures carefully tailored to local needs. The maintenance of traditional rural landscapes should be prioritized in the Balkans, through the timely identification of HNV farmland that is most prone to abandonment. We also suggest that coordinated transnational research is needed, for a better assessment of conservation options in remote rural landscapes at European scale, including the enhancement of wild grazers' populations as an alternative in areas where traditional land management is rather unlikely to be re-established.

Childhood central nervous system tumours: Incidence and time trends in 13 Southern and Eastern European cancer registries

AimFollowing completion of the first 5-year nationwide childhood (0–14years) registration in Greece, central nervous system (CNS) tumour incidence rates are compared with those of 12 registries operating in 10 Southern–Eastern European countries. MethodsAll CNS tumours, as defined by the International Classification of Childhood Cancer (ICCC-3) and registered in any period between 1983 and 2014 were collected from the collaborating cancer registries. Data were evaluated using standard International Agency for Research on Cancer (IARC) criteria. Crude and age-adjusted incidence rates (AIR) by age/gender/diagnostic subgroup were calculated, whereas time trends were assessed through Poisson and Joinpoint regression models. Results6062 CNS tumours were retrieved with non-malignant CNS tumours recorded in eight registries; therefore, the analyses were performed on 5191 malignant tumours. Proportion of death certificate only cases was low and morphologic verification overall high; yet five registries presented >10% unspecified neoplasms. The male/female ratio was 1.3 and incidence decreased gradually with age, apart from Turkey and Ukraine. Overall AIR for malignant tumours was 23/106 children, with the highest rates noted in Croatia and Serbia. A statistically significant AIR increase was noted in Bulgaria, whereas significant decreases were noted in Belarus, Croatia, Cyprus and Serbia. Although astrocytomas were overall the most common subgroup (30%) followed by embryonal tumours (26%), the latter was the predominant subgroup in six registries. ConclusionChildhood cancer registration is expanding in Southern–Eastern Europe. The heterogeneity in registration practices and incidence patterns of CNS tumours necessitates further investigation aiming to provide clues in aetiology and direct investments into surveillance and early tumour detection.