Apple production and apple value chains in Europe

This paper presents an overview of the apple sector in nine major apple producing countries in Europe, in order to assess factors for the competitiveness of the national apple value chains and identify challenges for the future development of the sector. Based on international and national statistical data and expert assessment, key characteristics of apple production and value chains are analyzed. For each country, a brief description of the development of apple production and acreage over the past ten years, farm size distribution, level of production technology and main market channels is presented, followed by a discussion of differences and similarities. Results show a diverse picture of the apple sectors in Europe. Similarities are observed in the existence of regional production clusters and a generally small farm size. Differences are found in the technology level, with a broad range of very traditional extensive production systems up to highly intensified orchards with high tree density. All countries experienced high fluctuation in apple production quantities over the past years, mainly due to weather events, particularly spring frost and drought, and climate risks are expected to increase in the future, leading to increasing costs for mitigation measure

Failed hypospadias in paediatric patients

Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs ranges from 5-70%, but the actual incidence of failed hypospadias is unknown as complications can become apparent many years after surgery and series with lifelong follow-up data do not exist. Moreover, little is known about uncomplicated repairs that fail in terms of patient satisfaction. Risk factors for complications include factors related to the hypospadias (severity of the condition and characteristics of the urethral plate), the patient (age at surgery, endocrine environment, and wound healing impairment), the surgeon (technique selection and surgeon expertise), and the procedure (technical details and postoperative management). The most important factors for preventing complications are surgeon expertise (number of cases treated per year), interposition of a barrier layer between the urethroplasty and the skin, and postoperative urinary drainage. Major complications associated with failed hypospadias include residual curvature, healing complications (preputial dehiscence, glans dehiscence, fistula formation, and urethral breakdown), urethral obstruction (meatal stenosis, urethral stricture, and functional obstruction), urethral diverticula, hairy urethra, and penile skin deficiency