European External Action Service

The dexamethasone suppression test (DST) is a key diagnostic tool for evaluating disorders of the hypothalamic-pituitary-adrenal (HPA) axis. Interpretation of DST results can be confounded by inadequate dexamethasone exposure due to pharmacokinetic variability or patient nonadherence. Simultaneous measurement of dexamethasone and cortisol by LC-MS/MS improves diagnostic accuracy by distinguishing true biological nonsuppression from insufficient drug exposure and prevents analytical interferences observed with cortisol immunoassays. A commercially available CE-IVD LC-MS/MS steroid panel (Chromsystems) was adapted for the simultaneous quantification of dexamethasone and cortisol in human plasma. The method was validated for linearity, accuracy, precision, selectivity, carry-over, matrix effects, and stability. Method comparison was performed using 26 clinical DST samples analyzed using immunoassay and external LC-MS testing. The proposed dexamethasone cutoff of 1.3 ng/mL (3.3 nmol/L) was evaluated in 62 patient samples. The method demonstrated excellent linearity, with intra- and interassay accuracy and precision within ±15% for both analytes. No relevant carry-over or matrix effects were observed. Agreement with reference methods was 91% ± 6% for cortisol and 95% ± 7% for dexamethasone. Among the 62 DST samples, 48 showed appropriate suppression [cortisol <18.12 ng/mL (<50 nmol/L)] with dexamethasone levels above the cutoff. In contrast, 3 samples with insufficient suppression [cortisol >48.6 ng/mL (134.1 nmol/L)] had subthreshold dexamethasone levels, whereas 11 samples showed elevated cortisol levels despite sufficient dexamethasone exposure, indicating possible HPA axis dysfunction. The proposed rapid and robust LC-MS/MS method enables reliable, simultaneous quantification of dexamethasone and cortisol. The assay supports accurate DST interpretation by identifying cases of pharmacokinetic variance or nonadherence.

Pesticides are compounds of major use in agriculture worldwide. Nevertheless, many pesticide chemicals are classified as endocrine disruptors and potentially carcinogens. Farmers and farmworkers are particularly exposed and are at high risk of developing health-related impairments. In Morocco, the lack of awareness towards pesticide hazards and the inappropriate application of safety measures might increase the exposure as well as the risks of health concerns. In this paper, we present the framework of a study designed to assess pesticide exposure among Moroccan farmers and farmworkers and to evaluate potential health effects, namely endocrine and epigenetic impacts. Human biological monitoring will be conducted to determine pesticide levels in urine following the development and validation of sensitive chromatography methods (SPE, UPLC-MS/MS). Biomarkers of exposure include a set of parent and metabolite pesticide compounds (organophosphates, pyrethroids, triazines and urea-based pesticides). Thyroid and reproductive hormones (TSH, T3, T4, FSH and LH) as well as global and specific DNA methylation markers (5-mC, 5-hmC, N6-mA, THRB and LHR) are selected as biomarkers of effects. This provides guiding steps and methods to perform reliable exposure evaluation and health impact assessment. This study aims to expand the current knowledge on the endocrine and epigenetic risks related to pesticides, especially in low- and middle-income countries.

This study evaluates the impact of Artificial Intelligence (AI) applications in power systems on energy security and to determine relevant policy implications. We use a mixed methods approach to analyze the benefits and risks associated with AI implementation on the European power grid, focusing on four key dimensions of energy security: availability, affordability, accessibility, and acceptability. We investigated the benefits of AI using PyPSA, a Python-based model of the European electricity system. Three AI applications were parametrized: load reduction, load shifting, and wind wake steering. We compared scenarios in which these AI applications are widely deployed against a baseline scenario without these applications to determine if AI improves energy security. The study also analyzes risks associated with AI deployment in the power grid. We developed a risk taxonomy centered around six high-level categories: cybersecurity, jurisdictional or sovereignty issues, unexplained or unexpected actions by the model, unethical or illegal decision-making, reliance and trust in decision-making, and supplier dependency and vendor lock-in. Additionally, we conducted a back-casting exercise with subject-matter experts to determine positive and negative future outcomes of AI deployment and identify actions to create positive outcomes and avoid negative ones. The paper presents a set of policy implications for AI on the European synchronous grid. We find that AI applications can improve energy security in power systems. In the scenarios we tested, behind-the-meter applications have a greater impact on energy security than front-of-meter applications. The results suggest that AI applications targeting energy consumption may significantly improve energy security metrics. Keywords: Energy Security, AI, Power Grid, European Electricity System

[SPA] En este trabajo analizamos la percepción de los estudiantes del Grado de Bioquímica, tras unas sesiones de “brainstorming”. La propuesta del equipo docente tenía como objetivo potenciar la participación del alumnado en equipo y mejorar su creatividad facilitando así los procesos de enseñanza-aprendizaje en la asignatura de Bioética y Biomedicina de la Universidad de Murcia. Hemos observado que era la primera vez que se aplicaba en estos alumnos esta técnica, a pesar de que el nuevo Espacio Europeo de Educación Superior (EEES) exige trabajar estas competencias en el alumnado para que les permitan posteriormente enfrentarse con éxito a su realidad profesional y personal. La mayoría de los alumnos encuestados valoraron muy positivamente la experiencia (70,6%). La eficacia de este método quedará contrastada con los resultados de la evaluación final de la asignatura que, dado que se basa en la capacidad de resolución de problemas y no en los conocimientos teórico-practico exclusivos, nos permitirá evaluar de forma objetiva nuestros resultados. El “brainstorming” es una estrategia de enseñanza-aprendizaje que permite por lo tanto mejorar la competencia del trabajo en equipo y el razonamiento crítico.

To identify the essential attributes of biopsychosocial rehabilitation for chronic low back pain in the working population. A concept analysis was conducted according to the 8-step method of Walker and Avant. This framework provides a clear concept and theoretical and operational definitions. Five databases were searched, followed by a systematic screening. Subsequently, attributes, illustrative cases, antecedents, consequences and empirical referents were formulated. Of the 3793 studies identified, 42 unique references were included. Eleven attributes were identified: therapeutic exercise, psychological support, education, personalization, self-management, participation, follow-up, practice standard, goal-setting, social support, and dietary advice. Subsequently, illustrative cases were described. Antecedents, such as motivation, preparedness and a multidisciplinary team, were found, together with consequences such as decreased pain, less sick-leave and increased function and work status. Finally, examples of empirical referents were given. This study identified the attributes that are necessary to develop biopsychosocial rehabilitation intervention programmes for chronic low back pain. The defined concept of biopsychosocial rehabilitation for chronic low back pain may serve as a solid base to further develop and apply interventions. Future research should focus on the objectification of biopsychosocial rehabilitation and conceptualization regarding how personalization is done.

Zeit in Istanbul lebten, von Mitgliedern der imperialen Elite über Studenten und Arbeitsmigranten bis hin zu Flüchtlingen, Deportierten und Sklaven.Ich betrachte Dynamiken, Diskurse und Praktiken von der Eroberung bis circa 1800,

Stress has been consistently linked to negative impacts on physical and mental health. More specifically, patients with chronic pain experience stress intolerance, which is an exacerbation or occurrence of symptoms in response to any type of stress. The pathophysiological mechanisms underlying this phenomenon remain unsolved. In this state-of-the-art paper, we summarised the role of the autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis, the two major stress response systems in stress intolerance. We provided insights into such mechanisms based on evidence from clinical studies in both patients with chronic pain, showing dysregulated stress systems, and healthy controls supported by preclinical studies, highlighting the link between these systems and symptoms of stress intolerance. Furthermore, we explored the possible regulating role for (epi)genetic mechanisms influencing the ANS and HPA axis. The link between stress and chronic pain has become an important area of research as it has the potential to inform the development of interventions to improve the quality of life for individuals living with chronic pain. As stress has become a prevalent concern in modern society, understanding the connection between stress, HPA axis, ANS, and chronic health conditions such as chronic pain is crucial to improve public health and well-being.