541. Relationship between molecular pathogen detection and clinical disease in febrile children across Europe : a multicentre, prospective observational studyPriyen Shah, Marie Voice, Leonides Calvo-Bado, Irene Rivero Calle, Sophie Morris, Ruud Nijman, Claire Broderick, Tisham De, Mojca Kolnik, Katarina Vincek, Marko Pokorn, 2023, original scientific article Abstract: Background: The PERFORM study aimed to understand causes of febrile childhood illness by comparing molecular pathogen detection with current clinical practice. Methods: Febrile children and controls were recruited on presentation to hospital in 9 European countries 2016–2020. Each child was assigned a standardized diagnostic category based on retrospective review of local clinical and microbiological data. Subsequently, centralised molecular tests (CMTs) for 19 respiratory and 27 blood pathogens were performed. Findings: Of 4611 febrile children, 643 (14%) were classified as definite bacterial infection (DB), 491 (11%) as definite viral infection (DV), and 3477 (75%) had uncertain aetiology. 1061 controls without infection were recruited. CMTs detected blood bacteria more frequently in DB than DV cases for N. meningitidis (OR: 3.37, 95% CI: 1.92–5.99), S. pneumoniae (OR: 3.89, 95% CI: 2.07–7.59), Group A streptococcus (OR 2.73, 95% CI 1.13–6.09) and E. coli (OR 2.7, 95% CI 1.02–6.71). Respiratory viruses were more common in febrile children than controls, but only influenza A (OR 0.24, 95% CI 0.11–0.46), influenza B (OR 0.12, 95% CI 0.02–0.37) and RSV (OR 0.16, 95% CI: 0.06–0.36) were less common in DB than DV cases. Of 16 blood viruses, enterovirus (OR 0.43, 95% CI 0.23–0.72) and EBV (OR 0.71, 95% CI 0.56–0.90) were detected less often in DB than DV cases. Combined local diagnostics and CMTs respectively detected blood viruses and respiratory viruses in 360 (56%) and 161 (25%) of DB cases, and virus detection ruled-out bacterial infection poorly, with predictive values of 0.64 and 0.68 respectively. Interpretation: Most febrile children cannot be conclusively defined as having bacterial or viral infection when molecular tests supplement conventional approaches. Viruses are detected in most patients with bacterial infections, and the clinical value of individual pathogen detection in determining treatment is low. New approaches are needed to help determine which febrile children require antibiotics.
Keywords: molecular diagnostics, diagnostic, febrile illness, infectious disease, bacterial infection, viral infection, respiratory infection
Published in DiRROS: 17.11.2025; Views: 162; Downloads: 62
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542. Raising AWaRe-ness of antimicrobial stewardship challenges in pediatric emergency care : results from the PERFORM study assessing consistency and appropriateness of antibiotic prescribing across EuropeLaura Kolberg, Aakash Khanijau, Fabian Johannes Stanislaus Van der Velden, Jethro Adam Herberg, Tisham De, Rachel Galassini, Aubrey J. Cunnington, Victoria J. Wright, Marko Pokorn, Mojca Kolnik, 2024, original scientific article Abstract: Background: Optimization of antimicrobial stewardship is key to tackling antimicrobial resistance, which is exacerbated by overprescription of antibiotics in pediatric emergency departments (EDs). We described patterns of empiric antibiotic use in European EDs and characterized appropriateness and consistency of prescribing. Methods: Between August 2016 and December 2019, febrile children attending EDs in 9 European countries with suspected infection were recruited into the PERFORM (Personalised Risk Assessment in Febrile Illness to Optimise Real-Life Management) study. Empiric systemic antibiotic use was determined in view of assigned final “bacterial” or “viral” phenotype. Antibiotics were classified according to the World Health Organization (WHO) AWaRe classification. Results: Of 2130 febrile episodes (excluding children with nonbacterial/nonviral phenotypes), 1549 (72.7%) were assigned a bacterial and 581 (27.3%) a viral phenotype. A total of 1318 of 1549 episodes (85.1%) with a bacterial and 269 of 581 (46.3%) with a viral phenotype received empiric systemic antibiotics (in the first 2 days of admission). Of those, the majority (87.8% in the bacterial and 87.0% in the viral group) received parenteral antibiotics. The top 3 antibiotics prescribed were thirdgeneration cephalosporins, penicillins, and penicillin/β-lactamase inhibitor combinations. Of those treated with empiric systemic antibiotics in the viral group, 216 of 269 (80.3%) received ≥1 antibiotic in the “Watch” category. Conclusions: Differentiating bacterial from viral etiology in febrile illness on initial ED presentation remains challenging, resulting in a substantial overprescription of antibiotics. A significant proportion of patients with a viral phenotype received systemic antibiotics, predominantly classified as WHO Watch. Rapid and accurate point-of-care tests in the ED differentiating between bacterial and viral etiology could significantly improve antimicrobial stewardship.
Keywords: antimicrobial stewardship, pediatric emergency care, antibiotic prescription, AWaRe, infectious diseases
Published in DiRROS: 17.11.2025; Views: 115; Downloads: 83
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543. Sweet, fat and salty: snacks in vending machines in health and social care institutions in SloveniaUrška Rozman, Igor Pravst, Urška Pivk Kupirovič, Urška Blaznik, Primož Kocbek, Sonja Šostar-Turk, 2020, original scientific article Keywords: snacks, vending machines, social care institutions, health care institutions, Slovenia
Published in DiRROS: 17.11.2025; Views: 174; Downloads: 73
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544. Spatial distribution of uranium and thorium in the soils of North MacedoniaTrajče Stafilov, Robert Šajn, 2025, original scientific article Abstract: The aim of the study was to determine the spatial distribution and assess uranium and thorium contamination in the soils of North Macedonia. Topsoil samples (0–30 cm) were collected from 995 locations across the country on a 5 × 5 km grid. The soil samples were analysed by inductively coupled plasma–mass spectrometry (ICP-MS) using the total digestion method. The distribution of uranium and thorium in the soils is discussed according to the country’s 8 statistical regions, 15 major geological formations and 13 pedological units. The average uranium content is 2.1 mg/kg, ranging from <0.1 to 13 mg/kg (median 2.0 mg/kg), while the average thorium content is 9.3 mg/kg, ranging from 0.20 to 92 mg/kg (median 9.5 mg/kg). The spatial distribution patterns of U and Th in the soils of North Macedonia are very similar and are determined by geology (parent material and mineralisation). High uranium (2.9–13 mg/kg) and thorium (42–92 mg/kg) contents were found mainly in soils in the areas of Neogene and Palaeozoic igneous rocks and Neogene clastites (Pelagonian, East Macedonian zone), as well as in the Kratovo-Zletovo Massif in the north-eastern part of the country and in the Kožuf Mountains in the central and southern parts, where Neogene igneous rocks predominate. According to the pedological units, the hydromorphic soils (mean content of 2.9 mg/kg U and 12 mg/kg Th) in the valleys of the country’s main rivers, which predominate in the western part, were the richest for these elements.
Keywords: uranium, thorium, soil, statistical regions, geological formation, pedological units, North Macedonia
Published in DiRROS: 17.11.2025; Views: 102; Downloads: 32
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545. From plastic use in the construction and built environment to state-of-the-art circular economy solutions to combat microplastic pollutionKatja Turk, Gabriela Kalčíková, Anita Jemec Kokalj, Branka Mušič, 2025, review article Abstract: Plastics are widely used in the construction and building industry, accounting for 23.5% of European plastic consumption. They can replace traditional materials in various applications, including building insulation, piping, paints, adhesives, sealants, roofing, flooring, etc., serve as key components in various composites, and are indispensable for packaging materials and elements that facilitate the construction process itself. Despite their long lifespan, building materials inevitably degrade over time, releasing microplastics (MPs) that contribute to environmental pollution. According to some estimates, annual emissions of MPs in the European Union range from 0.7 to 1.8 Mt, with building paints identified as a dominant source, contributing between 231,000 and 863,000 tons per year. However, reported numbers vary significantly across studies, reflecting the substantial uncertainties still present in quantifying MPs. Now ubiquitous across ecosystems worldwide, MPs have become one of the most pressing concerns of the scientific community, leading to a rapid expansion of research in recent years. Yet less than 0.6% of studies focus on their presence in the construction and building sector, leaving this major industry largely overlooked. This review consolidates scattered knowledge by examining the applications of plastics in the construction and built environment and their role in microplastic generation throughout the materials' life cycle, from production and application to use and end-of-life management. It also examines MPs within the broader framework of sustainable development, particularly in the transition from a linear to a circular economy, where MPs could potentially be repurposed as secondary raw materials for new products. Particular emphasis is placed on recent research exploring the incorporation of MPs into construction materials, while highlighting state-of-the-art solutions that demonstrate their potential commercial viability. Moreover, this article raises awareness of the potential risks associated with such practices, offering authors’ critical perspective on existing research and emphasizing the need for a comprehensive evaluation of their impacts. By synthesizing the current state of knowledge, this review lays the groundwork for advancing future research, developing mitigation strategies, and fostering more sustainable material management in the construction and building sector.
Keywords: microplastics, building, construction, pollution, circular economy
Published in DiRROS: 17.11.2025; Views: 151; Downloads: 103
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546. Sustainable food supply in SloveniaSara Bele, Ben Moljk, Maja Kožar, Matej Bedrač, Ajda Bleiweis, Jure Brečko, Špela Pucihar, Tanja Travnikar, Jože Verbič, Barbara Zagorc, Barbara Bernard Vukadin, 2025, professional monograph Published in DiRROS: 17.11.2025; Views: 193; Downloads: 69
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548. Trajnostna oskrba s hrano v SlovenijiSara Bele, Ben Moljk, Maja Kožar, Matej Bedrač, Ajda Bleiweis, Jure Brečko, Špela Pucihar, Tanja Travnikar, Jože Verbič, Barbara Zagorc, Barbara Bernard Vukadin, 2025, professional monograph Published in DiRROS: 17.11.2025; Views: 193; Downloads: 83
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549. Guideline adherence in febrile children below 3 months visiting European Emergency Departments : an observational multicenter studyChantal D. Tan, Eline E. P. L. van der Walle, Clementien L. Vermont, Ulrich Von Both, Enitan D Carrol, Irini Eleftheriou, Marieke Emonts, Michiel Van der Flier, Ronald De Groot, Marko Pokorn, 2022, original scientific article Abstract: Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. There is practice variation in management due to differences in guidelines and their usage and adherence. We aimed to assess whether management in febrile children below 3 months attending European Emergency Departments (EDs) was according to the guidelines for fever. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0–18 years) attending twelve EDs in eight European countries. In febrile children below 3 months (excluding bronchiolitis), we analyzed actual management compared to the guidelines for fever. Ten EDs applied the (adapted) NICE guideline, and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment, and admission. We included 913 children with a median age of 1.7 months (IQR 1.0–2.3). Management per ED varied as follows: use of diagnostic tests 14–83%, antibiotic treatment 23–54%, admission 34–86%. Adherence to the guideline was 43% (374/868) for blood cultures, 29% (144/491) for lumbar punctures, 55% (270/492) for antibiotic prescriptions, and 67% (573/859) for admission. Full adherence to these four management components occurred in 15% (132/868, range 0–38%), partial adherence occurred in 56% (484/868, range 35–77%). Conclusion: There is large practice variation in management. The guideline adherence was limited, but highest for admission which implies a cautious approach. Future studies should focus on guideline revision including new biomarkers in order to optimize management in young febrile children.
Keywords: fever, children, pediatrics, guideline, emergency care
Published in DiRROS: 17.11.2025; Views: 136; Downloads: 68
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550. Impact of infection on proteome-wide glycosylation revealed by distinct signatures for bacterial and viral pathogensEsther Willems, Jolein Gloerich, Anouk Suppers, Michiel Van der Flier, 2023, original scientific article Abstract: Mechanisms of infection and pathogenesis have predominantly been studied based on differential gene or protein expression. Less is known about posttrans-lational modifications, which are essential for protein functional diversity. We applied an innovative glycoproteomics method to study the systemic prote-ome-wide glycosylation in response to infection. The protein site-specific glyco-sylation was characterized in plasma derived from well-defined controls and patients. We found 3862 unique features, of which we identified 463 distinct intact glycopeptides, that could be mapped to more than 30 different proteins. Statistical analyses were used to derive a glycopeptide signature that enabled significant differentiation between patients with a bacterial or viral infection. Furthermore, supported by a machine learning algorithm, we demonstrated the ability to identify the causative pathogens based on the distinctive host blood plasma glycopeptide signatures. These results illustrate that glycoproteomics holds enormous potential as an innovative approach to improve the interpreta-tion of relevant biological changes in response to infection.
Keywords: plasma, roles, glycoproteomics, biomarkers, profiles, children, glycome
Published in DiRROS: 17.11.2025; Views: 118; Downloads: 53
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