Inequalities in the access to medical-diagnostic services in outpatient medical practice in Northeastern Bulgaria

IntroductionTerritorial inequality in health-care services is an important problem worldwide. A complete study of the correlation between the inequalities and the territorial disproportion of the health services is required, as this will ensure a scientifically based model for improvement of the access to health services. The aim of the current work is to analyze the patients` satisfaction with the territorial distribution of medical-diagnostic services and to prepare a cartogram of the observed differences in the northeastern region of Bulgaria.Material and methodsBetween July and September 2015 we studied 502 patients from 30 municipalities situated in Northeastern Bulgaria about their opinion for the number of accessible medical diagnostic laboratories. We also drew a visual presentation of the spatial distribution of medical diagnostic laboratories in the region.ResultsLaboratories in Northeastern Bulgaria are unequally distributed and mainly concentrated in the regional centers and larger towns. Accordingly, most of the patients living up to 3 km from a medical diagnostic laboratory were satisfied from the number of available labs, while people living 3-10 km apart thought that laboratories are not enough.ConclusionThe main reason for health inequalities in Bulgaria is the territorial imbalance between health care units. The increased need of health care and social assistance requires new resources to provide laboratory services via mobile lab offices and home visits. A better infrastructure of the outpatient health care in Northeastern Bulgaria and new players in the lab service market will assure equal access and favorable concurrent environment

Preference for laboratory test results notification among different healthcare players in Northeastern Bulgaria

IntroductionAs continuously growing number of people is using online sources for health information and services, the concept of eHealth is progressively developing and is a high-priority topic for the European Union. The absence of centralized internet-based eHealth platform in Bulgaria results in deficiency in the information exchange among physicians and other healthcare providers. The question about the readiness and the attitude towards eHealth concept among all participants in the health care system in Bulgaria still remains to be clarified and the purpose of the current study is to assess the opinion of health care providers and consumers about the electronic way of receiving laboratory test results. We also try to explore the existing preference trend in relation to the socio-demographic characteristics of the studied population.Material and methodsIn the current work, we investigated the needs and recommendations of 1039 patients, laboratory stuff and out-of-hospital general practitioners in the Northeastern Bulgaria (regions Varna, Dobrich and Shumen).ResultsThe results show that laboratory results are preferred in electronic form and there is a significant need for better online communication between different participants in the healthcare system. In this context, we also summarize a model for improvement in the interaction among healthcare providers.ConclusionThe actual opportunities for online communication provoke active participation of all players in the health service market and require a novel model of communication among healthcare providers

Epstein-Barr virus - molecular basis for malignant transformation

Epstein-Barr (EBV) is a widespread virus which can be detected in more than 90% of world population. Primary EBV infection during adolescence and adultness results in infectious mononucleosis, while in children it is usually asymptomatic. EBV is responsible for different malignant forms of B-cell or epithelial cancers, such as Hodgkin's and non-Hodgkin`s lymphoma, Burkitt's lymphoma, post-transplant lymphoproliferative disorders, nasopharyngeal carcinoma, hairy leukoplakia and HIV-associated lymphomas. Evidence exists that infection with EBV is also linked with a higher risk of hepatocellular and gastric cancers, as well as autoimmune diseases.EВV shows two alternative life cycles - latent and lytic. After the primary infection, the virus remains in B lymphocytes in latency, while the lytic infection takes place predominantly in the epithelial cells and can last for months with constant virus release in saliva and nasopharyngeal secretion. Unlike other herpes viruses, development of oncological diseases is linked with the latent cycle, as a result of immune response‘s failure to control latently infected cells.With the present work we try to concisely review the current knowledge about mechanisms of EBV pathogenesis in humans and to summarize recent findings in the field

Impact of RNA degradation on gene expression profiling

<p>Abstract</p> <p>Background</p> <p>Gene expression profiling is a highly sensitive technique which is used for profiling tumor samples for medical prognosis. RNA quality and degradation influence the analysis results of gene expression profiles. The impact of this influence on the profiles and its medical impact is not fully understood. As patient samples are very valuable for clinical studies, it is necessary to establish criteria for the RNA quality to be able to use these samples in later analysis.</p> <p>Methods</p> <p>To investigate the effects of RNA integrity on gene expression profiling, whole genome expression arrays were used. We used tumor biopsies from patients diagnosed with locally advanced rectal cancer. To simulate degradation, the isolated total RNA of all patients was subjected to heat-induced degradation in a time-dependent manner. Expression profiling was then performed and data were analyzed bioinformatically to assess the differences.</p> <p>Results</p> <p>The differences introduced by RNA degradation were largely outweighed by the biological differences between the patients. Only a relatively small number of probes (275 out of 41,000) show a significant effect due to degradation. The genes that show the strongest effect due to RNA degradation were, especially, those with short mRNAs and probe positions near the 5' end.</p> <p>Conclusions</p> <p>Degraded RNA from tumor samples (RIN > 5) can still be used to perform gene expression analysis. A much higher biological variance between patients is observed compared to the effect that is imposed by degradation of RNA. Nevertheless there are genes, very short ones and those with the probe binding side close to the 5' end that should be excluded from gene expression analysis when working with degraded RNA. These results are limited to the Agilent 44 k microarray platform and should be carefully interpreted when transferring to other settings.</p

PROMICON Deliverable D6.1 Project branding and communication channels setup and running (logo, promotional materials, website, templates, social media)

As a foundation of the future communication activities, a set of dissemination and branding tools and materials is crucial to be established within the first months of the project. Accordingly, a project logo and website were developed in the first 4 months of the PROMICON life-cycle, which form the backbone of both project branding and public visibility. In addition, various dissemination materials such as a PROMICON brochure and a poster were produced in high quality print versions for rising awareness at events. All of the materials can be found on the media center section of the website and are available to anyone interested. Document templates were also produced and made available to the consortium, in order to facilitate future dissemination and reporting activities such as letters, milestone and deliverable reports, as well as PowerPoint presentations. Accounts have been also set in two major social media channels, Twitter and Facebook, to ensure the widest possible impact and outreach of PROMICON related results, news and events, and to engage the interested parties in a virtual community. The long‐term impact of the project's results will be secured by maintaining the website for a total of 9 years – 4 years of the project duration and additional 5 years after the end of the PROMICON life-cycle

D6.12 Website and Branding

The main goals of WP6 Dissemination, exploitation and social transformation tools, are to establish and maintain a distinct project identity, as well as to maximise the impact of project results by marketing and communicating them to stakeholders and the broader public. To ensure the efficient communication, Pensoft has developed a number of promotional materials reflecting the REST-COAST corporate identity, as well as a project website

Strengthening the 2018 EU Bioeconomy Strategy through Microbiome Analysis and Synthetic Microbial Consortia Technologies

The 2018 EU Bioeconomy Strategy aims to create a sustainable, circular, and low-emissions economy, based on the use of renewable biological resources. The strategy focuses on the development of new biobased products and markets, the promotion of sustainable and efficient use of resources, and the support of research, innovation, and skills development in the bioeconomy sector. The main objectives of the strategy are to: - Accelerate the deployment of bio-based products and services to reduce Europe’s dependence on fossil fuels and promote the transition to a circular economy; - Optimise the use of renewable biological resources to ensure food security, while also protecting the environment and biodiversity; - Promote sustainable and efficient use of natural resources, reduce waste, and minimize greenhouse gas emissions; - Develop innovative, sustainable, and competitive bio-based industries and value chains that create jobs and support economic growth, particularly in rural areas; - Support research, innovation, and skills development in the bioeconomy sector to drive technological advancements, enhance the competitiveness of the EU’s bio-based industries, and address societal challenges such as climate change, food security, and public health. The EU Horizon 2020 PROMICON project is a pioneering initiative that directly addresses the objectives of the 2018 EU Bioeconomy Strategy. By focusing on the production of biopolymers, energy carriers, feedstocks, and antimicrobial molecules from natural microbiomes, the project is promoting the sustainable production and use of renewable biological resources while also supporting research and innovation in the bioeconomy sector

Analýza dvou konvektivních bouří s využitím polarimetrických X-pásmových radarových a satelitních dat

We analyzed two convective storms that passed over or near the Milesovka meteorological observatory. The observatory is located at the top of a hill and has been recently equipped with a Doppler polarimetric X-band radar FURUNO WR2120 for cloud investigations. Our analysis was based mainly on Doppler polarimetric radar data measured in vertical cross-sections (RHI-Range-Height Indicator). Radar data was also used for classifying hydrometeors by a newly developed XCLASS (X-band radar CLASSification) algorithm. We also used rapid scan data measured by the geostationary satellite Meteosat Second Generation to validate radar measurements at the upper parts of storms. Although an attenuation correction was applied to the reflectivity and differential reflectivity measurements, the attenuation typical of X-band radars was noticeable. It was mainly manifested in the differential reflectivity, co-polar correlation coefficient and specific differential phase. Nevertheless, radar measurements can be used to analyze the internal cloud structure of severe convective storms. The XCLASS classification was developed by major innovation of a previously published algorithm. The XCLASS algorithm identifies seven types of hydrometeors: light rain, rain, wet snow, dry snow, ice, graupel, and hail. It uses measured horizontal and vertical radar reflectivity, specific differential phase, co-polar correlation coefficient, and temperature, and applies fuzzy logic to determine the type of hydrometeor. The new algorithm practically eliminates unrealistic results around and below the melting layer provided by the original algorithm. It identifies wet snow in more cases, and areas with individual hydrometeors have more realistic shapes compared to the original algorithm. The XCLASS algorithm shows reasonable results for the classification of hydrometeors and can be used to study the structure of convective storms.Analyzovali jsme dvě konvektivní bouře, které přešly nad nebo v blízkosti meteorologického objektu Milešovka (observatoř). Observatoř se nachází na vrcholu kopce a byla nedávno vybavena a Dopplerským polarimetrickým X-band radarem FURUNO WR2120 pro průzkum oblačnosti. Naše analýza byla založené především na Dopplerově polarimetrických radarových datech měřených ve vertikálních průřezech (RHI-Range-range height indikátor). Radarová data byla také použita pro klasifikaci hydrometeorů nově vyvinutým algoritmem XCLASS (X-band radar CLASSification). Použili jsme také data rychlého skenování měřená pomocí geostacionární družice Meteosat druhé generace (MSG) k ověření radarových měření v horní části bouřek. Ačkoli byla aplikována korekce útlumu na odrazivost, diferenciál měření odrazivosti byl patrný útlum typický pro radary v pásmu X. Bylo to hlavně projevující se v diferenciální odrazivosti, kopolárním korelačním koeficientu a na specifickém diferenciálu fáze. Nicméně radarová měření mohou být použita k analýze vnitřní struktury oblačnosti silné konvektivní bouře. Klasifikace XCLASS byla vyvinuta významnou inovací společnosti a dříve publikovaný algoritmus. Algoritmus XCLASS identifikuje sedm typů hydrometeorů: světlo déšť, déšť, mokrý sníh, suchý sníh, led, graupel a kroupy. Využívá měřenou horizontální a vertikální radarovou odrazivost, specifickou diferenciální fázi, kopolární korelační koeficient a teplotu a platí fuzzy logika k určení typu hydrometeoru. Nový algoritmus prakticky eliminuje nereálné výsledky kolem a pod tavicí vrstvou poskytnutou původním algoritmem. Identifikuje mokrý sníh ve více případech. Oblasti s jednotlivými hydrometeory mají oproti tomu realističtější tvary k původnímu algoritmu. Algoritmus XCLASS ukazuje rozumné výsledky pro klasifikaci hydrometeorů a lze je použít ke studiu struktury konvektivních bouří

Liquid biopsy: an innovative and reliable method for detecting not only somatic, but also germline mutations in patients with colorectal and non-small cell lung carcinoma

AbstractLiquid biopsy is a non-invasive method of detecting cancer-related mutations from circulating cell-free DNA (cfDNA) and has emerged as a promising alternative to traditional tissue biopsies. However, its utility has so far been limited to the detection of somatic mutations in cancer cells. Our study examined germline mutations that are associated with pharmacogenetics in 19 patients diagnosed with colorectal cancer and 12 patients with non-small cell lung carcinoma, utilizing the highly advanced and non-invasive technique of liquid biopsy, followed by subsequent next-generation sequencing for comprehensive analysis. Despite the relatively modest sample size of patients under consideration, our results indicated a noteworthy correlation between the presence of adverse effects and the identified germline mutations. We have identified the following mutations with significant implications for pharmacogenetics: MTHFR c.1286A > C, MTHFR c.665C > T, DPYD c.2194G > A, DPYD c.85C > T, XPC c.2815C > A, UMPS c.638G > C, SLC22A2 c.808T > G, EGFR c.1562G > A, ABCB1 2677 T > G, GSTP1 c.313A > G, ERCC2 c.2251A > C, and SLC19A1 c.80A > G. In addition, we observed various adverse drug reactions in our patient cohort, encompassing myelosuppression, hepatotoxicity, neurotoxicity and gastrointestinal toxicity. Liquid biopsy has the potential to revolutionize cancer diagnosis and treatment by detecting both somatic and germline mutations. The preliminary results of studies on germline mutations are promising, but further research is needed to address the remaining challenges and to establish the utility of liquid biopsy as a reliable diagnostic tool for germline mutations