Developments in testing methods for use in risk assessment with the new EFSA guidance document

The new guidance of EFSA will result in a more complex, but a substantially more comprehensive risk assessment for pollinators. The guidance document suggests the implementation of a tiered risk assessment scheme. Each tier ensures that the appropriate level of protection, set by the risk managers, is achieved. For the lower tiers, a number of laboratory studies are required which include the use of non-validated test methods. The on-going activities of ICPPR in this area are recognised by EFSA. The guidance also includes a number of new requirements for the design of field studies. It is acknowledged that some of them are very challenging, especially to ensure the required exposure level and the statistical robustness. However, it is worth noting that those requirements are scientifically sound and are necessary to properly satisfy the protection goals. The guidance document provides recommendations that will assist in addressing those requirements. There is a need for field studies to be more exact and much more controlled in the future.Keywords: EFSA, guidance, bee, pollinator, exposure, statisti

The Role of CXCR3 and Associated Chemokines in the Development of Atherosclerosis and During Myocardial Infarction

The chemokine receptor CXCR3 and associated CXC chemokines have been extensively investigated in several inflammatory and autoimmune diseases as well as in tumor development. Recent studies have indicated the role of these chemokines also in cardiovascular diseases. We aimed to present current knowledge regarding the role of CXCR3-binding chemokines in the pathogenesis of atherosclerosis and during acute myocardial infarction

Risk assessment of pesticides and other stressors in bees: Principles, data gaps and perspectives from the European Food Safety Authority

Current approaches to risk assessment in bees do not take into account co-exposures from multiple stressors. The European Food Safety Authority (EFSA) is deploying resources and efforts to move towards a holistic risk assessment approach of multiple stressors in bees. This paper describes the general principles of pesticide risk assessment in bees, including recent developments at EFSA dealing with risk assessment of single and multiple pesticide residues and biological hazards. The EFSA Guidance Document on the risk assessment of plant protection products in bees highlights the need for the inclusion of an uncertainty analysis, other routes of exposures and multiple stressors such as chemical mixtures and biological agents. The EFSA risk assessment on the survival, spread and establishment of the small hive beetle, Aethina tumida, an invasive alien species, is provided with potential insights for other bee pests such as the Asian hornet, Vespa velutina. Furthermore, data gaps are identified at each step of the risk assessment, and recommendations are made for future research that could be supported under the framework of Horizon 2020. Finally, the recent work conducted at EFSA is presented, under the overarching MUST-B project ("EU efforts towards the development of a holistic approach for the risk assessment on MUltiple STressors in Bees") comprising a toolbox for harmonised data collection under field conditions and a mechanistic model to assess effects from pesticides and other stressors such as biological agents and beekeeping management practices, at the colony level and in a spatially complex landscape. Future perspectives at EFSA include the development of a data model to collate high quality data to calibrate and validate the model to be used as a regulatory tool. Finally, the evidence collected within the framework of MUST-B will support EFSA's activities on the development of a holistic approach to the risk assessment of multiple stressors in bees. In conclusion, EFSA calls for collaborative action at the EU level to establish a common and open access database to serve multiple purposes and different stakeholders

Analysis of background variability of honey bee colony size

In the context of the definition of specific protection goals for bees, risk managers asked EFSA to provide scientific background to support them in their decision‐making process about what needs to be protected and to what extent. The risk managers indicated that the derivation of a threshold of acceptable effects on colony size based on their variability was the preferred option for honey bees. This approach assumes that when evaluating a pesticide, the magnitude of acceptable effects should be set within the range of the background variability of colonies not exposed to pesticides. In this report EFSA used the BEEHAVE model to assess background variability of colony size in 19 EU environmental scenarios covering a range of geographical, climatic and beekeeping conditions. A comparison was made between the model outcome and the measurements performed on control groups of experimental field studies. The analysis of the background variability presented in this document should support risk managers in defining a threshold for colony size reduction that is considered acceptable

Developmental perspectives on Europe

The crisis of 2008–2009 has ended, stockmarkets skyrocketed in 2012–2013, while growth of the real sector remained sluggish in Europe. This article attempts to explain the latter puzzle. Analyzing long term factors, the costs of short-termism in crisis management become obvious. The limitations of EU as a growth engine are highlighted

Diabeteses hypertoniás betegek vérnyomáscsökkentő kezelésének hazai gyakorlata | Domestic practice of antihypertensive treatment of diabetic hypertensive patients

A magasvérnyomás-betegségben szenvedő betegek 20-25%-ánál fordul elő társbetegségként diabetes mellitus. Az együttes megjelenés a cardiovascularis kockázat jelentős növekedésével jár, így a különféle szakmai ajánlások különösen nagy figyelmet fordítanak a diabeteses betegek antihipertenzív kezelésére. A cukorbeteg esetében ajánlott <140/85 Hgmm-es vérnyomáscélérték eléréséhez általában gyógyszeres kombinációs terápia szükséges, amelynek alapját angiotenzinkonvertálóenzim-gátlónak vagy angiotenzinreceptor-blokkolónak kell képeznie. Ezeket lehet/kell kombinálni neutrális anyagcserehatással rendelkező kis dózisú, elsősorban tiazidszerű diuretikummal, kalciumcsatorna-blokkolóval, vagy tovább lehet bővíteni béta-blokkolóval, imidazolin-I1-receptor-agonistával, illetve az alfa-1-adrenoceptor-blokkolóval. A hazai gyakorlatban egyértelműen megmutatkoznak az evidenciákon alapuló ajánlások iránymutatásai, hiszen a betegek jelentősebb része kedvező anyagcserehatásokkal rendelkező angiotenzinkonvertálóenzim-gátló+indapamid, valamint angiotenzinkonvertálóenzim-gátló+kalciumcsatorna-blokkoló kombinációs terápiában részesül, azonban a diabetogén potenciállal bíró hidroklorotiazidot tartalmazó angiotenzinkonvertálóenzim-gátló, valamint angiotenzinreceptor-blokkoló fix kombinációk alkalmazása is még mindig elterjedt. Hasonlóképpen érdekes gyakorlati terápiás szokások figyelhetők meg a kevésbé differenciált béta-blokkolók alkalmazásánál, ahol a harmadik generációs carvedilol és nebivolol még mindig kisebbségben vannak. Orv. Hetil., 2014, 155(43), 1695–1700. | Diabetes mellitus as comorbidity is present in 20–25% of patients suffering from high blood pressure. Because simultaneous presence of these two diseases results in a significant increase of cardiovascular risk, various guidelines focus greatly on the anti-hyperintensive treatment of patients with diabetes. Combined drug therapy is usually required to achieve the blood pressure target value of <140/85 mmHg defined for patients with diabetes, which must be based on angiotensin converting enzyme-inhibitors or angiotensin receptor blockers. These can be/must be combined with low dose, primarily thiazid-like diuretics, calcium channel blockers with neutral metabolic effect, and further options include the addition of beta blockers, imidazolin-l-receptor antagonists, or alpha-1-adrenoreceptor blockers. Evidence-based guidelines are obviously present in local practice. Although most of the patients receive angiotensin converting enzyme-inhibitor+indapamid or angiotensin converting enzyme-inhibitor+calcium channel blocker combined therapy with favorable metabolic effects, yet the use of angiotensin converting enzyme-inhibitors containing hidrochlorotiazide having diabetogenic potencial, and angiotensin receptor blocker fixed combinations is still widespread. Similarly, interesting therapeutic practice can be observed with the use of less differentiated beta blockers, where the 3rd generation carvediolol and nebivolol are still in minority. Orv. Hetil., 2014, 155(43), 1695–1700

Impact of the Coronavirus Epidemic on Local Social and Healthcare Services through the Example of a Hungarian City

This paper analyses the impacts of the globally disruptive COVID-19 pandemic, and local responses to the above challenges, more specifically, the operation of services under the state of emergency through the example of Győr. With the outbreak of the pandemic, state and municipal stakeholders responsible for public service provision became the focus of public attention. Their capacity to provide quick, efficient and firm action in response to novel situations and challenges was constrained by the internal operational deficiencies of large care systems, notably, undersupply in human and financial resources and the absence of flexibility and speed in various domains of state and municipal administration. Experience shows that full compliance with government measures and regulations was indispensable for the elaboration of local responses and good practices. In Győr, despite the municipality’s reputation for the high standard operation of health and social care services in the framework of its mandatory and voluntary functions and the presence of advanced care systems, tremendous human resources were required to tackle the emergency situation. This paper provides a detailed discussion of the relevant locally implemented practices and measures