Expected Long-Term Labour Market Resilience and the European Union’s Perceived Role Results of an Online Policy Delphi

The 2008 crisis highlighted how fragile the labour markets of the European Union’s member states were, while it also directed attention to the eventual further deepening of integration as a potential solution. Nevertheless, employment and labour market policy competences are still on the national level with relatively low EU intervention. In a recent study, we explored the role of the EU in facilitating potential policy solutions with regards to labour market resilience until 2030. The study focused on labour market experts’ opinion, coming from different European countries; and took form of an online Policy Delphi Survey combined with backcasting to predict the importance and feasibility of policies concerning future challenges. The most important policies considered to be best suited to deal with the main challenges of the labour market in the EU until 2030 are education, investment in human and social capital and improvement of social policies and protection, including migration policy. The research revealed a systematic gap between the importance and feasibility of relevant solutions

A magyarországi wellness-szállodák marketingkommunikációjának új trendjei

“Pihenni bárhol tud! Nálunk újjászületik!” – szól a Caramell Premium Resort szálloda hívószava, amely a hotel minden megjelenésekor felbukkan, s amely a turisztikai szolgáltató vendégekért való küzdelmének egyik eszköze. De mégis hol, milyen új eszközökön keresztül juttathatók el ezen szlogenek a potenciális látogatókhoz? A tanulmány a magyarországi wellness-szállodák marketingkom­munikációjában megjelenő online eszközök rendszerezésére vállalkozik. A központi vonatkoztatási keret ellenére azonban e technikák használhatósága minden bizonnyal más, akár nem turisztikai jellegű termékekre is kiterjed

A magyarországi wellness-szállodák marketingkommunikációjának új trendjei

“Pihenni bárhol tud! Nálunk újjászületik!” – szól a Caramell Premium Resort szálloda hívószava, amely a hotel minden megjelenésekor felbukkan, s amely a turisztikai szolgáltató vendégekért való küzdelmének egyik eszköze. De mégis hol, milyen új eszközökön keresztül juttathatók el ezen szlogenek a potenciális látogatókhoz? A tanulmány a magyarországi wellness-szállodák marketingkom­munikációjában megjelenő online eszközök rendszerezésére vállalkozik. A központi vonatkoztatási keret ellenére azonban e technikák használhatósága minden bizonnyal más, akár nem turisztikai jellegű termékekre is kiterjed

Long-Term Prognostic Significance of Three-Dimensional Speckle-Tracking Echocardiography-Derived Left Ventricular Twist in Healthy Adults—Results from the MAGYAR-Healthy Study

Background: The left ventricular (LV) rotational mechanics are of particular importance in the function of the LV. The rotational movement is the consequence of the arrangement of the subepicardial and subendocardial muscle fibers. These muscle fibers are perpendicular to each other, their contraction creates a characteristic motion. The aim of the present study was to examine the prognostic impact of LV twist assessed by three-dimensional speckle-tracking echocardiography (3D-STE) in healthy circumstances. Methods: 302 healthy adults participated in the study, 181 subjects were excluded due to certain reasons (LV could not be analysed during 3D-STE, subjects were unidentifiable, or lost to follow-up). 121 subjects were involved in the final analysis (mean age of 33.1 ± 12.3 years, 75 males), who were willing to be examined on a voluntary basis. Results: During a mean follow-up of 7.93 ± 4.21 years, 11 healthy adults suffered a cardiovascular event including 2 cardiac deaths. Using receiver operating characteristic analysis, LV twist ≥14.65 degrees as assessed by 3D-STE proved to be significantly predictive regarding the cardiovascular event-free survival (area under the curve 0.70, specificity 70%, sensitivity 65%, p = 0.028). Subjects with LV twist ≥14.65 degrees had higher basal and apical rotations and a significantly higher ratio of these individuals developed cardiovascular events compared to cases with LV twist <14.65 degrees. Subjects with cardiovascular events had lower LV global longitudinal strain, higher basal LV rotation and twist and the ratio of subjects with LV twist ≥14.65 degrees was elevated as compared to cases without events. Conclusions: 3D-STE-derived LV twist independently predicts future cardiovascular events in healthy adults

Long-Term Prognostic Impact of Three-Dimensional Speckle-Tracking Echocardiography-Derived Left Ventricular Global Longitudinal Strain in Healthy Adults—Insights from the MAGYAR-Healthy Study

Introduction. Three-dimensional (3D) speckle-tracking echocardiography (STE) combines the advantages of STE and volumetric 3D echocardiography, which shows the left ventricle (LV) in 3D during the cardiac cycle and is also suitable for accurate strain measurements in addition to volumetric assessments using the same virtual 3D LV cast. The present study aimed to confirm the prognostic impact of 3DSTE-derived LV global longitudinal strain (GLS) in healthy adults during a 12-year follow-up period. Patients and methods. The current study comprised 124 healthy individuals with a mean age of 31.0 ± 11.7 years (64 males) at the time of complete two-dimensional Doppler echocardiography (2DE) and 3DSTE. Results. During a mean follow-up of 8.01 ± 4.12 years, 10 healthy individuals suffered cardiovascular events, including 2 cardiac deaths. Using ROC analysis, 3DSTE-derived LV-GLS ≥ 14.77% was found to be a significant predictor for cardiovascular event-free survival (sensitivity 70%, specificity 71%, area under the curve 76%, p = 0.007). Using 2DE, higher LV end-diastolic and end-systolic volumes, a larger LV end-systolic diameter and a lower LV ejection fraction could be detected in subjects with LV-GLS < 14.77% as compared to cases with LV-GLS ≥ 14.77%. Subjects with events had thicker interventricular septa, a larger LV mass and lower 3DSTE-derived LV-GLS and a higher ratio of cases had LV-GLS < 14.77%. From subjects with LV-GLS < 14.77%, seven individuals (18%) had events. Multivariate regression analysis identified age and LV-GLS as independent predictors of event-free survival. Conclusions. 3DSTE-derived LV-GLS is a strong independent predictor of cardiovascular survival in healthy adults

A diabetes mellitus kapcsolata a depresszióval, a szorongással és az életminőséggel

Many studies demonstrated that psychological factors play an important role in the development and course of diabetes mellitus.The focus of our research, among the first in a Hungarian sample, was to examine depression and anxiety levels and diabetes-specific quality of life in people with type 2 diabetes, to explore gender differences, and to analyze the relationship of depression and anxiety with diabetes-specific quality of life.157 people diagnosed with type 2 diabetes (women: 58.6%, men: 40.1%) were assessed for levels of depression Center for Epidemiologic Studies Depression Scale - Hungarian version), anxiety (Spielberger's Trait Anxiety Questionnaire) and diabetes-specific quality of life (Audit of Diabetes-Dependent Quality of Life - Hungarian version).65% of subjects did not show depressive symptoms, but 56.1% showed moderate trait anxiety. More severe depressive symptoms (U = 1625, p<0.001) and higher trait anxiety (U = 1556, p<0.001) were significantly more frequent in women compared to men. Depressive symptom severity and trait anxiety were inversely and weakly correlated with diabetes-specific quality of life.In summary, the results suggest that the psychological state (depressive symptoms and anxiety) in patients with type 2 diabetes is associated with their diabetes-specific quality of life. Women with diabetes also have higher levels of depression and anxiety compared to men with diabetes.Psychological assessment of patients' depressive and anxiety symptoms and quality of life is recommended in the care of diabetic patients, and appropriate treatment is recommended as needed. This may improve patients' quality of life, therapeutic cooperation and disease prognosis. Orv Hetil. 2022; 163(45): 1789-1797

Peripheral Blood Stem Cell Mobilization and Engraftment after Autologous Stem Cell Transplantation with Biosimilar rhG-CSF

INTRODUCTION: Biosimilar versions of filgrastim [recombinant human granulocyte colony-stimulating factor (rhG-CSF)] are now widely available. To date, biosimilar rhG-CSF has demonstrated a comparable quality, safety and efficacy profile to the originator product (filgrastim [Neupogen((R))], Amgen Inc., CA, USA) in the prevention and management of neutropenia. Biosimilar rhG-CSFs have also been used to induce peripheral blood stem cell (PBSC) mobilization in patients undergoing autologous stem cell transplantation (AHSCT). The authors have examined the effectiveness of a biosimilar rhG-CSF (Zarzio((R)), Sandoz Biopharmaceuticals, Holzkirchen, Germany) in two retrospective studies across two medical centers in Hungary. METHODS: In Study 1, 70 patients with hematological malignancies scheduled to undergo AHSCT received chemotherapy followed by biosimilar rhG-CSF (2 x 5 mug) for facilitating neutrophil, leukocyte, and platelet engraftment. In study 2, 40 additional patients with lymphoid malignancies and planned AHSCT received chemotherapy followed by biosimilar rhG-CSF for PBSC mobilization. The effectiveness of treatment was assessed by the average yield of cluster of differentiation (CD) 34+ cells and the number of leukaphereses required. RESULTS: In Study 1 (patients undergoing AHSCT), the median age was 56 years and most patients were male (60%). The conditioning regimens were mainly high-dose melphalan (n = 41) and carmustine (BiCNU((R)), Bristol-Myers Squibb, NJ, USA), etoposide, cytarabine and melphalan BEAM (n = 21). Median times to absolute neutrophil and leukocyte engraftment were 9 (range 8-11 days) and 10 (8-12) days, respectively. Median time to platelet engraftment was 10.5 days (7-19 days). In Study 2, the patients' median age was 54 years and the majority (57.5%) were female. The median time interval between day 1 of mobilizing chemotherapy and first leukapheresis was 12 (9-27) days. In the autologous PBSC grafts, the median number of CD34+ cells harvested was 5.2 x 10(6)/kg (2.22-57.07 x 10(6)/kg). The median yield of CD34+ cells per leukapheresis product was 2.47 x 10(6)/kg. In total, 58 leukaphereses were performed in 40 successfully harvested patients. CONCLUSIONS: In line with previous studies with originator rhG-CSF, the findings of this study indicate that biosimilar rhG-CSF following AHSCT is effective and generally well tolerated in the engraftment setting. In addition, biosimilar rhG-CSF is comparable to the originator rhG-CSF in terms of kinetics of PBSC mobilization and yield of CD34+ cells. In conclusion, the authors have demonstrated that the use of biosimilar rhG-CSF is effective and safe in autologous PBSC mobilization and engraftment after AHSCT

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

A magyar nyugdíjreform

BaBibliogr.: fol. 77-79v