Validation of a new prognostic model to predict short and medium-term survival in patients with liver cirrhosis

Background: MELD score and MELD score derivates are used to objectify and grade the risk of liver-related death in patients with liver cirrhosis. We recently proposed a new predictive model that combines serum creatinine levels and maximum liver function capacity (LiMAx®), namely the CreLiMAx risk score. In this validation study we have aimed to reproduce its diagnostic accuracy in patients with end-stage liver disease. Methods: Liver function of 113 patients with liver cirrhosis was prospectively investigated. Primary end-point of the study was liver-related death within 12 months of follow-up. Results: Alcoholic liver disease was the main cause of liver disease (n = 51; 45%). Within 12 months of follow-up 11 patients (9.7%) underwent liver transplantation and 17 (15.1%) died (13 deaths were related to liver disease, two not). Measures of diagnostic accuracy were comparable for MELD, MELD-Na and the CreLiMAx risk score as to power in predicting short and medium-term mortality risk in the overall cohort: AUROCS for liver related risk of death were for MELD [6 months 0.89 (95% CI 0.80–0.98) p < 0.001; 12 months 0.89 (95% CI 0.81–0.96) p < 0.001]; MELD-Na [6 months 0.93 (95% CI 0.85–1.00) p < 0.001 and 12 months 0.89 (95% CI 0.80–0.98) p < 0.001]; CPS 6 months 0.91 (95% CI 0.85–0.97) p < 0.01 and 12 months 0.88 (95% CI 0.80–0.96) p < 0.001] and CreLiMAx score [6 months 0.80 (95% CI 0.67–0.96) p < 0.01 and 12 months 0.79 (95% CI 0.64–0.94) p = 0.001]. In a subgroup analysis of patients with Child-Pugh Class B cirrhosis, the CreLiMAx risk score remained the only parameter significantly differing in non-survivors and survivors. Furthermore, in these patients the proposed score had a good predictive performance. Conclusion: The CreLiMAx risk score appears to be a competitive and valid tool for estimating not only short- but also medium-term survival of patients with end-stage liver disease. Particularly in patients with Child-Pugh Class B cirrhosis the new score showed a good ability to identify patients not at risk of death

Cognitive Impairment and Affective Disorders in Patients With Obstructive Sleep Apnea Syndrome

Sleep-related breathing disorders could be accompanied by or caused by a variety of medical conditions. They are considered to be a significant medical and social problem. Together with excessive daytime sleepiness, patients with obstructive sleep apnea experience neuropsychological symptoms such as anxiety, attention deficits, cognitive impairment, depressive symptoms and other psychological disturbances leading to social adjustment difficulties. Patients diagnosed with obstructive sleep apnea demonstrate a decline in a wide spectrum of cognitive abilities, including memory, attention, psychomotor speed, executive, verbal and visual-spatial skills. The aim of this study is to investigate the cognitive functioning and affective disorders among patients with obstructive sleep apnea syndrome and to examine the frequency and severity of cases in comparison with a control group consisting of healthy volunteers. Our research has shown that there is a relation between sleep apnea and cognitive impairments and affective changes. This relation can be explained by the direct effect of the syndrome on the patient, where the main connecting factor is the severity and the distribution of excessive daytime sleepiness. Along with treatment of the somatic medical condition, it is extremely important that the patient's mental state is treated as well.Trial Registration: 57/2013, Medical University - Sofia, Bulgaria

Meta-analysis of multidecadal biodiversity trends in Europe

Local biodiversity trends over time are likely to be decoupled from global trends, as local processes may compensate or counteract global change. We analyze 161 long-term biological time series (15-91 years) collected across Europe, using a comprehensive dataset comprising similar to 6,200 marine, freshwater and terrestrial taxa. We test whether (i) local long-term biodiversity trends are consistent among biogeoregions, realms and taxonomic groups, and (ii) changes in biodiversity correlate with regional climate and local conditions. Our results reveal that local trends of abundance, richness and diversity differ among biogeoregions, realms and taxonomic groups, demonstrating that biodiversity changes at local scale are often complex and cannot be easily generalized. However, we find increases in richness and abundance with increasing temperature and naturalness as well as a clear spatial pattern in changes in community composition (i.e. temporal taxonomic turnover) in most biogeoregions of Northern and Eastern Europe. The global biodiversity decline might conceal complex local and group-specific trends. Here the authors report a quantitative synthesis of longterm biodiversity trends across Europe, showing how, despite overall increase in biodiversity metric and stability in abundance, trends differ between regions, ecosystem types, and taxa.peerReviewe

Comparative Analysis of Some of the Payment Systems in European Union and Bulgaria

The article analyses part of the payment systems in Europe. The purpose is to overview their special features and the actual application of the payment services in comparative plan in the European Union and Bulgaria. The analysis includes the following payment systems: SWIFT, TARGET, EURO 1, STEP 1, EURO-Giro, MasterCard International, Visa International and the main Bulgarian payment system, operated by "Borika-Bankservice" AD (PLC). The process of integration of Bulgaria with the European payment infrastructures is taken into consideration. The focus is mainly on the payment systems of Bulgaria, Romania, Italy and Germany and for every country comparative values are represented via tables and graphics to visualize the research

Brief Overview of Payment Systems Operating on the Territory of Romania

The article analyses the payment systems in Romania, the purpose of which is to examine the features and the actual application of payment services in this country. The analyse covers: Introduction, Brief Overview of Payment Systems, Legal Framework. Attention is drawn at the payment resources only within the country. The focus and analytic part of the article falls mainly on to payment systems in Romania, for this purpose, graphs of individual systems are presented and subsystems to illustrate the study

Usporedba određenih hematoloških pokazatelja među trima vrstama porodice Columbidae.

Investigations into some haematological values in birds from three Columbidae species e.g. pigeons, (Columba livia domestica), collared doves (Streptopelia decaocto) and African collared doves, (Streptopelia roseogrisea) have been performed. In all three species, high haemoglobin concentrations, and respectively high red blood cell counts were observed. In S. decaocto the red blood cell count was extremely high, corresponding to the high haemoglobin levels. RBC values in both Streptopelia species were significantly higher than in domestic pigeons. Higher white blood cell counts were present in freely living collared doves versus both species living in captivity. The heterophils/lymphocytes ratio in African collared doves was the highest − 1.05, followed by the ratios of collared doves and domestic pigeons.Provedeno je istraživanje hematoloških vrijednosti triju vrsta ptica porodice Columbidae, i to goluba (Columba livia domestica), gugutke (Streptopelia decaocto) i sahelske gugutke (Streptopelia roseogrisea). U sve tri vrste ustanovljena je velika koncentracija hemoglobina i velik broj crvenih krvnih stanica. U gugutke je broj eritrocita bio iznimno velik, i odgovarao je velikoj razini hemoglobina. Broj eritrocita bio je u obje vrste roda Streptopelia veći nego u goluba. Veći broj bijelih krvnih stanica ustanovljen je u slobodno živućih gugutki u odnosu na one držane u zatočeništvu. Omjer heterofila i limfocita u sahelske gugutke bio je najveći (1,05), srednji u gugutke, a najmanji u goluba

Applying ant colony optimization metaheuristic to the DAG layering problem

This paper 1 presents the design and implementation of an Ant Colony Optimization based algorithm for solving the DAG Layering Problem. This algorithm produces compact layerings by minimising their width and height. Importantly it takes into account the contribution of dummy vertices to the width of the resulting layering