Has organ imaging using ultrasound arrived at the same level as cross-sectional imaging? At the annual conference of the German Society for Internal Medicine (DGIM), PD Dr Corinna Trenker presented new technological developments and their diagnostic significance. Despite numerous innovations such as multiparametric protocols and AI support, she made it clear that the human factor remains one of…
More than a decade of protection against the human papillomavirus (HPV): a new study confirms the long-term effectiveness of the HPV vaccine to prevent development of cervical cancer and pre-cancer.
After a bout of influenza or Covid, the risk of heart attack or stroke may rise dramatically, and chronic infections may increase the long-term risk of serious cardiovascular disease events.
The vaginal microbiome is a largely overlooked area of medicine that could dramatically improve outcomes for common infections, infertility and even cancer for millions of women, a new review finds.
Do laboratory tests using blood-based biomarkers (BBB) represent the next type of universally recommended screening tests for Alzheimer's disease (AD)? Experts curb the high expectations for this type of diagnostic tool.
Point-of-care diagnostics based on a combination of mobile-sized scanners and artificial intelligence (AI) are helping save the lives of women in low-resource settings. The AI technique is being applied in Kenya and Tanzania to deliver screening for cervical cancer – now the leading cause of cancer-related deaths in women in that region and a bigger cause of death than childbirth.
Infection with the human papillomavirus (HPV) is the most common cause for cervical cancers. Now, researchers have developed a promising therapeutic vaccine against precancerous lesions.
Analyses of self-tests for human papillomavirus (HPV) can be used to divide HPV-positive women into three risk groups, according to a new study. This could enhance cervical cancer screening.
A ‘mini-protein’ can deliver radiation doses directly to tumours without harming healthy tissues. The approach shows promise for the treatment of metastatic bladder cancer and other tumours.
A surgical technique called total mesometrial resection (TMMR) is associated with better outcomes than current treatments. A new study shows a significantly lower risk of disease recurrence and death.
A new test shows promise in making cervical cancer screening more accessible and less invasive by detecting oncoproteins of the human papillomavirus (HPV) in urine samples.
Although the Covid-19 pandemic is behind us, healthcare facilities continue to experience workflow challenges and resource constraints impacting women’s health and a patient’s ability to receive a timely diagnosis. Clinical specialties like breast radiology and cytology are especially susceptible to these issues and continue to experience backlogs, which impact their ability to deliver timely…
Scientists show that health registry data can be used to predict individual risks for the 20 most common cancer types. This could help to identify high-risk groups and enrol them for screenings.
Digital pathology brings benefits for sample management and optimisation, lets pathologists work on samples remotely: The UK Government has now approved the use of the technique for cancer samples.
Academic labs and biotech firms pioneer multi-cancer early detection with emerging technologies. Screening for multiple cancers with a simple blood or urinary draw could be a game-changer. Two research teams in particular have advanced the field.
New trial results suggest that a short course of induction chemotherapy prior to chemoradiation could reduce the rate of relapse and death among patients with locally advanced cervical cancer.
A new onco-therapeutic vaccine candidate against human papillomavirus (HPV)-induced cancers, such as cervical and oropharyngeal cancers, has shown promising results in the preclinical phase.
While screening programs for several of the commonest cancers are now well established, lung cancer screening has yet to reach anywhere near the same proportion of at-risk patients.
A second-generation lab test for early detection of cervical cancer is the most recent addition to Oncgnostics’ portfolio. In particular, the company’s solution will help women in countries with limited cancer screening. Moreover, new research on the early detection of vulval and vaginal cancer might soon enable the development of tests for these cancers.
Philips is an active participant in the new European Federation for Cancer Images consortium (EUCAIM) – a project launched in the run-up to World Cancer Day 2023.
Researchers at the University of Tokyo have used artificial DNA to target and kill cancer cells in a completely new way. The method showed promising results against various cancers in lab tests on mice.
Scientists have discovered that cervical cancer can be divided into 2 distinct molecular subgroups – one far more aggressive than the other – as part of the largest ‘omics’ study of its kind.
What if a test analysing cervical cells from a gynaecological swab could be used to detect four different female cancers at an early stage and also predict cancer risk over a healthy woman's lifetime? Researchers at the EUTOPS Institute in Innsbruck, Austria, are developing tests to do just that for breast, ovarian, cervical, and endometrial cancer detection.
Personalised screening, data-driven aproaches: In a dedicated press conference in Paris, French oncologists presented promising research that might bring hope for many cancer patients.
Delivering a drug directly inside a lesion using minimally invasive procedures opens up new perspectives for patients and medical teams. At ECR Overture, experts looked at how to best join forces to advance the field of interventional oncology.
Model tumour systems could help explain whether pressure differences can push cancer cells into their surroundings – a basic mechanism behind metastasis.
Scientists have discovered a means of identifying the risk of breast and ovarian cancer by measuring epigenetic changes in cervical samples from over a thousand women.
Researchers have identified a mechanism that impairs the proliferation of cancer cells and induces their death without affecting healthy cells. This could lead to improved cancer treatment.
Artificial intelligence (AI) is changing our healthcare systems. It can help us detect diseases earlier, improve patient care and reduce healthcare costs. However, there is still a lack of trust, of rules and safety regulations and of broad data pools. How can we use AI successfully in healthcare systems and what role will it play in the future?
Final results from a study of a blood test that can detect more than 50 types of cancer have shown that it is accurate enough to be rolled out as a multi-cancer screening test among people at higher risk of the disease, including patients aged 50 years or older, without symptoms. In a paper published in the cancer journal Annals of Oncology, researchers report that the test accurately detected…
Experts from Sweden, Finland and Kenya are using digital microscopy combined with Artificial Intelligence (AI) to deliver a rapid and effective cervical screening service to rural locations in Kenya. The project sees AI and digital diagnostics bridge the gap between low-resource settings and the availability of centralised AI-enhanced expertise and pathology services, located in larger cities in…
Emerging technologies can screen for cervical cancer better than Pap smears and, if widely used, could save lives both in developing nations and parts of countries, like the United States, where access to health care may be limited. In Biophysics Reviews, by AIP Publishing, scientists at Massachusetts General Hospital write advances in nanotechnology and computer learning are among the…
The impact of Covid-19 has been devastating; countless lives lost, millions of infections worldwide, health systems overwhelmed and economies rapidly shrinking. Screening, such as for breast or cervical cancer, is an area particularly affected, with numerous appointments delayed.
Researchers have called on European policymakers to make adequate resources available to tackle pancreatic cancer, a disease that is almost invariably fatal and where little progress has been made over the past 40 years. In the latest predictions for cancer deaths in the EU and UK for 2021, published in the cancer journal Annals of Oncology, researchers led by Carlo La Vecchia (MD), a professor…
Working with colleagues from Germany and the US, researchers at Leipzig University have achieved a breakthrough in research into how cancer cells spread. In experiments, the team of biophysicists led by Professor Josef Alfons Käs, Steffen Grosser and Jürgen Lippoldt demonstrated for the first time how cells deform in order to move in dense tumour tissues and squeeze past neighbouring cells. The…
The advent of digital pathology is offering a unique opportunity to develop computerized image analysis methods to diagnose disease and predict outcomes for cancer patients from histopathology tissue sections. Such advances can help predict risk of recurrence, disease aggressiveness and long-term survival, according to a leading expert in the field, Professor Anant Madabhushi from Case Western…
Hundreds of thousands of cervical cancer cases per year could be prevented through widespread vaccinations for human papillomavirus (HPV) and annual pap smear tests, says an expert at a top American hospital, Cleveland Clinic, marking Cervical Cancer Awareness Month in January. Dr. Robert DeBernardo, Section Head of Gynecologic Oncology and Vice Chair Subspecialty Care for Women’s Health at…
An autoimmune side effect of immune checkpoint inhibitor (ICI) drugs could signal improved control of kidney cancer, according to a new study by researchers in UT Southwestern's Kidney Cancer Program (KCP).
Researchers have found that a class of commonly-used heart drugs may also improve patients’ responses to anti-cancer immunotherapies called PD(L)1 inhibitors, according to preliminary findings to be presented at the 32th EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics.
Smoking is strongly linked to lower use of cancer screening services by women, and more advanced disease once cancer is diagnosed, new research reveals. Tobacco use is falling in many parts of the world, but it’s falling less rapidly among women than it is among men. And lung cancer remains the leading cause of cancer death among women, say the researchers. The evidence also suggests that women…
Researchers have developed a novel three-dimensional imaging system to diagnose cervical cancer faster, non-invasively and more efficiently than conventional methods.
In a new study, researchers from the University of Copenhagen have discovered two important functions of a protein called RTEL1 during cell division. The researchers hope that the new knowledge will help to find new cancer treatments. One of the body's most important processes is cell division, which occurs throughout life. Normal cells only have a limited number of divisions, while in cancer…
The publication of the results of the Dutch-Belgian lung cancer screening trial (NELSON) supports recent calls to introduce lung cancer screening programmes throughout Europe. In light of the scientific evidence, lung cancer screening should be firmly embedded in any initiative launched by the European Commission and the Member States in the fight against cancer. As the leading cause of death…
Computed tomography (CT) plays an increasingly important role in assessing pelvic disease, particularly when patients present with acute abdominal pain. In addition, radiomic approaches on CT are being developed to increase the characterisation of ovarian cancer for optimising treatment planning.
Researchers at Cardiff University have discovered a new type of killer T-cell that offers hope of a “one-size-fits-all” cancer therapy. T-cell therapies for cancer - where immune cells are removed, modified and returned to the patient’s blood to seek and destroy cancer cells - are the latest paradigm in cancer treatments. The most widely-used therapy, known as CAR-T, is personalised to each…
September: Basel, Switzerland: ‘Intelligent Health 2019’, a conference dedicated to artificial intelligence (AI) in medicine, underlined the growing interest by the rising number of attendees – 1,400 in 2018, its first year, to 2,027 this year. With examples of AI use from around the world, the common thread throughout was how AI can serve humankind by enabling better understanding of…
Early childhood life in the womb is particularly sensitive to the effects of environmental pollutants. A team from Empa and the University of Vienna has now for the first time been able to show how a pollutant from contaminated food – the environmental estrogen zearalenone – spreads in the womb and is metabolized into harmful metabolites. Xenoestrogens are absorbed through the environment,…
Researchers at Leipzig University and Leipzig University Hospital (UKL) have discovered that tumour growth and tissue invasion by cancer cells can be predicted based on the ontogenetic distance between tissues.
Researchers from Northwestern University are using Argonne supercomputers to advance the development of an optical microscopy technique that can predict and quantify cancer risks at extremely early stages. The basic principle driving Allen Taflove’s computational electrodynamics research — which bears the potential to transform how we diagnose, and possibly treat, various forms of cancer —…
The World Health Organisation's (WHO) Essential Medicines List and List of Essential Diagnostics are core guidance documents that help countries prioritize critical health products that should be widely available and affordable throughout health systems. Now, updated versions of the two lists have been published, focusing on cancer and other global health challenges, with an emphasis on effective…
Nurses’ knowledge of cancer and screening processes varies significantly across the globe – potentially resulting in unnecessary deaths where knowledge falls short – new research reports. It is therefore vitally important to assess varying levels of knowledge in nurses across the world, a new study led by researchers from the University of Surrey reports.
Vaccinating schoolboys against the potentially deadly human papillomavirus (HPV) could dramatically reduce head and neck cancers in men, according to research involving the University of Strathclyde. The two-year project studied 235 patients in Scotland with head and neck cancer and found that 78% of people with head and neck cancers were men, while HPV was present in 60% of the cancers. This…
The majority of women who undergo surgery for suspected ovarian cancer do not have cancer. A novel blood test developed by researchers at Uppsala University and the Sahlgrenska Academy, University of Gothenburg, now offers the possibility of more precise diagnostics without the need for surgery. This could lead to a reduction in unnecessary surgery and to earlier detection and treatment for…
Shahid Umar, PhD, researcher with The University of Kansas Cancer Center, has dedicated two decades of his scientific exploration to better grasp the connection between colon cancer and the human microbiome. Called the “forgotten organ,” the microbiome comprises trillions and trillions of microbes, including bacteria, fungi and viruses, in our body.
The pill could be blurring your social judgement ‒ but perhaps not enough so you'd notice. By challenging women to identify complex emotional expressions like pride or contempt, rather than basic ones like happiness or fear, scientists have revealed subtle changes in emotion recognition associated with oral contraceptive pill (OCP) use. Published in Frontiers in Neuroscience, their study found…
A research team led by Tufts University engineers has developed a non-invasive method for detecting bladder cancer that might make screening easier and more accurate than current invasive clinical tests involving visual inspection of bladder. In the first successful use of atomic force microscopy (AFM) for clinical diagnostic purposes, the researchers have been able to identify signature features…
Test results are denoted by a colour change and could be further analysed by a smartphone app, making it attractive as a point-of-care diagnostic device.
Hitachi’s Fusion imaging combining MRI and Real-time Virtual Sonography (RVS) showing a cervix lesion with color Doppler Fusion imaging techniques are being trialled to help advance the diagnosis of cervical cancer and endometrial cancer.
The recently opened Uterine Repair Center (URC) in VUmc (Amsterdam) serves women suffering non-cancerous gynaecological disorders, such as myomas, adenomyosis (endometriosis of the uterus), niches (caesarean scar defects) or congenital uterine abnormalities. Gynaecologist Professor Judith Huirne leads the clinic – but has greater aspirations.
Two new systems developed by Hologic Inc. recently received the European CE Mark: The MyoSure Manual and the Brevera Breast Biopsy System with CorLumina Imaging Technology.
Using self-sampling followed by HPV testing, more than twice as many women at risk of developing cervical cancer could be identified and offered preventive treatment. This is shown by researchers at Uppsala University in the first randomised study in the world comparing two ways of identifying cervical cancer, published in the British Journal of Cancer.
A powerful genome editing tool can be deployed as an ace DNA detective, able to sniff out DNA snippets that signal viral infections, cancer, or even defective genes. This genetic detective, developed in the laboratory of Howard Hughes Medical Institute (HHMI) Investigator Jennifer Doudna at the University of California, Berkeley, uses the genome-slicing system known as CRISPR. By combining the…
No woman should die from cervical cancer. Indeed, cervical cancer is the deadliest, yet most preventable gynecologic malignancy. According to the American Cancer Society, there are 13,000 new cases of invasive cervical cancer leading to 4,100 cancer-related deaths each year in the United States. Unfortunately, many of these deaths could have been prevented with either regular screening with Pap…
A novel vaccine against cancer-causing human papillomaviruses (HPV) is intended to help raise vaccination rates especially in developing countries. To this end, scientists from the German Cancer Research Center (DKFZ) in Heidelberg are developing a completely new vaccination concept based on a low-cost vaccine that protects from almost all known oncogenic HPV types. The project has now been…
Hybrid imaging is still a leading topic in radiology – underlined by the 14 related sessions held during the 29th European Congress of Radiology (ECR 2017) held in Vienna, this March. Those sessions focused on the combination of radiological and nuclear medical imaging procedures that aim to visualise morphology as well as function, structure and metabolism of an organ or region of interest.
A pioneering diagnostic device identifies more abnormal cells on the cervix than standard colposcopy, according to data published in two European clinical papers.
At the MEDICA 2016 IMMS is presenting its first approaches for the personalized diagnostics of cancer using a prototype device. It was developed in the three-year research project INSPECT which started in June 2016.
No self-respecting TV crime series is without a pathologist – but the fictitious pathologist who incessantly solves crimes has little to do with reality.
Around 25 treatments for seriously ill patients with specific cancers listed on England’s National Health Service’s Cancer Drug Fund are to be removed. This large change is likely to affect patients with cancers of the breast, bowel, prostate, blood, upper gastrointestine, brain and central nervous system, as well as gynaecological cases. Report: Mark Nicholls
As part of the MEDICA 2015, the world’s largest medical trade fair with almost 5,000 exhibitors from 70 nations, the “MEDICA App COMPETITION” for the best medical app has been held live for the fourth time already.
Using the Arietta V70 from Hitachi, a French diagnostic imaging team is rewriting the book on obstetrics and gynaecology. Entitled the ‘Atlas d’échographie de fusion en gynécologie obstétrique’, the new edition by Jean-Marc Levaillant MD, and colleagues from the diagnostic imaging centres at the Bicêtre and Créteil hospitals in Paris, will be published before the end of 2015.
Vaccination remains one of the most efficient strategies against infectious diseases, often being the best protection against infections such as hepatitis B, or influenza. European Hospital reports on expert reviews of vaccines in the pipeline and the potential of nanomedicine given during the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) annual meeting in…
An in-depth review of randomised trials on screening for breast, colorectal, cervical, prostate and lung cancers, published in the Journal of the Royal Society of Medicine, shows that the benefits of mammographic screening are likely to have been overestimated.
Although Romania joined the EU in 2007, only recently has its macroeconomic increases influenced a rise in a middle class and dented the country’s widespread poverty. However, development is still hampered by corruption and red tape in its commercial world. Report: Daniela Zimmermann/Brenda Marsh
The number of cancer patients in Germany continues to rise steadily. An increase in the number of newly diagnosed cases of 14% is expected by 2020 compared to 2008. Therefore early detection is increasingly the focus of attention.
‘Never-before-seen breakthroughs in diagnostic research and technology’ were revealed during July’s American Association for Clinical Chemistry meeting in Chicago, where up to 20,000 people packed in for research updates.
The 2013 turnover expected by German in vitro diagnostics producers are significantly lower compared to last year, according to a survey of members carried out by the German Diagnostics Industry Association (VDGH) presented in January at the Diagnostica Forum in Berlin.
Staging of cervical cancer is clinically based on a system developed by the International Federation of Gynaecology and Obstetrics (FIGO). The staging is clinical because the majority of cases occur in developing countries where access to MRI is limited, explains gynaecological radiologist Dr Evis Sala.
Hedvig Hricak, Chair of the Radiology Department at the Memorial Sloan-Kettering Cancer Center, New York, USA, describes emerging applications and potential trends in gynaecological cancer treatment described at the 15th International Symposium Crossing Barriers
In 1963 Greiner Bio-One came into being with the opening of the Greiner Labortechnik production centre for laboratory products in Nürtingen, Germany.
A dynamic new consortium was launched in October during the recent Innovation in Oncology event organised by the German Cancer Research Centre (DKFZ) with Heidelberg University Hospital.
Research in the field is booming thanks to newly arriving methods to identify gene sequences. Scientists are interested in a wide range of issues from disease-relevant variations of human genetic information to the detection of viral genetic material that supports therapies. Several highlights of current research were presented this spring at the 9th International Symposium on Molecular…
Current cervical cancer screening is time consuming and expensive, but now new breakthrough technology developed by European researchers should allow large-range screening by non-medical personnel with almost immediate results and at a much lower cost.
Data from the ATHENA (Addressing THE Need for Advanced HPV Diagnostics) USA registration trial, involving more than 47,000 women, demonstrate that two human papilloma virus genotypes, HPV 16 and HPV 18, can identify those women with cervical pre-cancer missed by cytologic examination with a Papanicolau (Pap) test.
A probe suitable for imaging soft tissue for use with the VivoSight Multi-Beam optical coherence tomography (OCT) imaging system has been launched by manufacturer Michelson Diagnostics. The probe enables in vivo imaging of oral and gynaecological tissue.
The overall potential benefits of human papillomavirus (HPV) vaccinations or frequent HPV screenings for women over the age of 41 are low, concludes a new study published online February 15 in the Journal of the National Cancer Institute. The study found that the rate of new infections preventable by vaccination declines with age. Furthermore, new infections among women at any age typically do…
"Cancer can be prevented too" is the theme of a new campaign being launched today in the lead up to World Cancer Day on 4th February, by the International Union Against Cancer (UICC). The campaign is backed by a new scientific report: 'Protection against cancer causing infections' which focuses on the nine infections that can lead to cancer.
The latest analysis of a vaccine’s safety, efficacy and immunogenicity indicates that Cervarix, a human papilloma virus (HPV) vaccine offers sustained protection for over six years against infection by viral types HPV-16 and HPV-18, most commonly associated with cervical cancer.
New research on deaths from cancer in Europe concludes that the key priority for continuing to reduce mortality is cutting tobacco smoking. The study shows that, while deaths for men from lung cancer in the EU have declined overall, by 17 % from 1995 to 2004, they rose by 27% for women over the same period. It also reveals other significant differences in the mortality between different EU…
Breast and cervical cancer together account for more than one quarter of all female cancer deaths worldwide, with the majority – including more than 85 % of all cervical cancer deaths – occurring in developing countries. However, a small number of highly effective programs demonstrate that much can be done to reduce risk and increase sustainable access to diagnosis and treatment for these…
The United Kingdom has a strong medical devices industry; more than 2,000 companies employ over 50,000 people and support the employment of many more in this field. About 200 of these medical manufacturers are at Medica this year, at various pavilions, including those representing Wales, Scotland and Northern Ireland. Among the UK exhibitors, Zilico Ltd is presenting, for the first time, a…
A global vaccination programme against human papilloma virus (HPV), to include boys as well as girls, could lead to eradication of the virus and virtual disappearance of cervical cancer, according to Nobel Prize winner, Professor Emeritus Harald zur Hausen (University of California, San Diego) after recently delivering a keynote lecture at the 16th International Meeting of the European Society of…
ECCO 15 – ESMO 34, the joint congress of the European CanCer Organisation (ECCO) and the European Society for Medical Oncology (ESMO), is Europe’s largest oncology meeting; the event drew to Berlin 15,000 participants from 120 countries this September, when more than 2,000 presentations were made. Among the presentations on prevention, treatment and survivorship, proteomics, biomarkers,…
New human papilloma virus (HPV) vaccine studies presented at the 16th International Meeting of the European Society of Gynaecological Oncology (ESGO) in Belgrade, Serbia, this week have confirmed sustained protection against precancerous cervical lesions in healthy young women, as well as beneficial effects for women previously treated for cervical, vulvar or vaginal precancers or genital warts.
A global vaccination programme against human papilloma virus (HPV), to include boys as well as girls, could lead to eradication of the virus and virtual disappearance of cervical cancer, predicted Nobel Prize winner, Professor Harald zur Hausen, after delivering the key-note lecture at the 16th International Meeting of the European Society of Gynaecological Oncology (ESGO) in Belgrade, Serbia,…
To date, there is insufficient knowledge as to the cause of this disease, or how to prevent it. We asked some of our EH correspondents to report on measures taken in their countries to ensure that men are made more aware of this disease and whether screening services are provided for early prostate cancer detection.
Early suspicions of cancer, either from clinical evidence or medical imaging, are often followed up on biopsy. However, the removal of tissue for histological analysis can be uncomfortable for patients.
German scientist Harald zur Hausen showed that oncogenic human papilloma virus (HPV) cause cervical cancer, the second most common cancer among women. Françoise Barré-Sinoussi and Luc Montagnier from France discovered HIV.
For individualised radiotherapy, high-precision delineation and characterisation of the tumour is critical. If highest radiation doses are delivered in a targeted fashion, the chance of tumour cell kill increases and tumour control probability is enhanced.
In the course of the `Interreg III´ Italian-Albanian collaborative project, which is financed by the European Union and the Italian Apulia region, an Albanian screening programme for breast and cervical tumours will be established. The initiative aims at improving the public health system of Albania, regarding the training and the technical equipment needed for such screening projects.
Researchers at A Seattle Children's Hospital Research Institute and Fred Hutchinson Cancer Research Center developed a tumor paint that will help surgeons see where a tumor begins and ends more precisely by illuminating the cancerous cells.
Celebrating his 71st birthday this year, Czech chemist Professor Antonin Holy will also be able to celebrate the launch of clinical testing of a drug to treat non-Hodgkins Lymphoma (NHL) and chronic lymphatic leukaemia (CLL) - adding another to his 60+ registered patents.
In Ireland, breast cancer is particularly virulent: 18.5% of all cancer related deaths among the women are due to breast cancer.
Scientists developed an easy and fast method to detect cervical cancer cells that especially can be adopted in developing countries. Using the lab facilities available in an Indian hospital, the researchers around Dr Nick Coleman of the Medical Research Council´s Cancer Cell Unit, compared a new cell staining technique to the standard slide searching method.
UK - Cervical cancer could be aggravated by a hormone-like molecule - prostaglandin - found in semen, according to a team of scientists led by Dr Henry Jabbour at the Medical Research Council's Human Reproductive Sciences Unit.
Health organisations and governments should seek solutions beyond their own borders.
The UK - In the 1990s, the nationally co-ordinated NHS Breast Screening Programme was already saving lives - a 21% fall in breast cancer mortality over the last decade and, with the cervical screening programme, this was viewed as among the best cancer screening programmes in the world. However, in that period, the country's cancer services, as a whole did not match up to those of other European…
