An Interoperable Clinical Cardiology Electronic Health Record System - a standards based approach for Clinical Practice and Research with Data Reuse

Currently in hospitals, several information systems manage, very often autonomously, the patient’s personal, clinical and diagnostic data. This originates a clinical information management system consisting of a myriad of independent subsystems which, although efficient in their specific purpose, make the integration of the whole system very difficult and limit the use of clinical data, especially as regards the reuse of these data for research purposes. Mainly for these reasons, the management of the Genoese ASL3 decided to commission the University of Genoa to set up a medical record system that could be easily integrated with the rest of the information system already present, but which offered solid interoperability features, and which could support the research skills of hospital health workers. My PhD work aimed to develop an electronic health record system for a cardiology ward, obtaining a prototype which is functional and usable in a hospital ward. The choice of cardiology was due to the wide availability of the staff of the cardiology department to support me in the development and in the test phase. The resulting medical record system has been designed “ab initio” to be fully integrated into the hospital information system and to exchange data with the regional health information infrastructure. In order to achieve interoperability the system is based on the Health Level Seven standards for exchanging information between medical information systems. These standards are widely deployed and allow for the exchange of information in several functional domains. Specific decision support sections for particular aspects of the clinical life were also included. The data collected by this system were the basis for examples of secondary use for the development of two models based on machine learning algorithms. The first model allows to predict mortality in patients with heart failure within 6 months from their admission, and the second is focused on the discrimination between heart failure versus chronic ischemic heart disease in the elderly population, which is the widest population section served by the cardiological ward

Parameter-free Molecular Super-Structures Quantification in Single-Molecule Localisation Microscopy

Understanding biological function requires the identification and characterization of complex patterns of molecules. Single-molecule localization microscopy (SMLM) can quantitatively measure molecular components and interactions at resolutions far beyond the diffraction limit, but this information is only useful if these patterns can be quantified and interpreted. We provide a new approach for the analysis of SMLM data that develops the concept of structures and super-structures formed by interconnected elements, such as smaller protein clusters. Using a formal framework and a parameter-free algorithm, (super-)structures formed from smaller components are found to be abundant in classes of nuclear proteins, such as heterogeneous nuclear ribonucleoprotein particles (hnRNPs), but are absent from ceramides located in the plasma membrane. We suggest that mesoscopic structures formed by interconnected protein clusters are common within the nucleus and have an important role in the organization and function of the genome. Our algorithm, SuperStructure, can be used to analyze and explore complex SMLM data and extract functionally relevant information

Евалуација на болничка фармација – фармацевтска грижа и услуги

Здравствената стратегија на Република Македонија која е донесена во 2021 година и проектирана до 2030 година е фокусирана на: организација на здравствената заштита, (квалитет, планирање и човечки ресурси), финансирање и фармацевтски услуги. Имајќи го предвид последниот приоритет, дефинирани се општите принципи за воспоставување фармацевтски услуги, како и улогата на фармацевтите во терапевтското управување со лекови, самолекувањето и промоцијата на здравјето. Целта е да се идентификуваат квалитетот и стандардите на болничката фармација врз основа на фармацевтската нега и услуги во болничките аптеки во Република Северна Македонија. За таа цел беше подготвен структуриран прашалник и истиот беше доставен по електронски пат, по пошта и/или директно до фармацевтите од 15 болнички аптеки, од кои 11 беа централни и 4 од терциерна здравствена заштита. Прашалникот беше распореден во неколку дела и тоа: пристап до податоците за пациентот и улогата на фармацевтот во терапевтското управување со лекови, пристап до информациите за лекови, достапност и комуникација со информативните центри за лекови, комуникација со центарот за несакани реакции, компетентност на персоналот, континуирана едукација и професионален развој. Прашањата беа одговорени со внесување на една од трите опции: А (имплементирана), Б (делумно имплементирана) и В (не имплементирана). Врз основа на резултатите добиени од прашалникот кои укажуваат на делумно спроведување на добрата фармацевтска пракса и фармацевтска грижа во болничките аптеки, евидентна е потребата од подобрување на болничката фармација, особено во доменот со едукација и советување на пациентите

Predicting the outcome of heart failure against chronic-ischemic heart disease in elderly population – Machine learning approach based on logistic regression, case to Villa Scassi hospital Genoa, Italy

Totally 167 patients were admitted at cardiology ward in Villa Scassi hospital, Genoa, Italy. We worked with two control groups: heart failure 59 patients (mean age: 71.37 ± 13.27 years) and chronic-ischemic heart disease 108 patients (mean age: 68.85 ± 11.3 years). Nine parameters: Hb, Serum Creatinine, LDL, HDL, Triglycerides, ALT, AST, hs-cTnI, CRP were evaluated onset to hospitalization. We aimed to identify significant independent predictors relative to the outcome of heart failure versus chronic-ischemic heart disease and select combination of biochemical parameters in logistic regression-based model that would provide on average excellent discrimination to the outcome of heart failure versus chronic-ischemic heart disease in elderly population

Pharmacoeconomic analysis of parenteral therapy consumption in hospital pharmacy at Clinical Hospital – Stip

Improper management of drugs and medical devices is a complex problem at all health care levels. A study conducted in 2016 in which were included 35 hospitals in Poland (Religioni, 2016), was the basis for developing a drug management system. This study showed that most managers, including pharmacists (62.86%) have no knowledge for the principles of drug management optimization. Only 20% of them used pharmacoeconomic analysis and 25% did not use any analysis. 77% of the respondents selected the drugs based on the lowest price

Teachers' Toolkit in Civic Education - Primary School

The YESI teacher's tool book is a guide for primary school teachers that includes 36 training sessions on Children's Rights, Human Rights, Diversity, Social Inclusion, Identity, Active Citizenship and Involvement. The book is a result of a collective effort by the “Prosveta - Sofia” Foundation and its partners, and was created with the input and participation of volunteer teachers from Bulgaria, Greece, Portugal, and Serbia, who piloted the materials with their students and provided feedback for improvement. The book utilizes dramatic activities, artistic creations, and electronic games to engage students in learning about these topics.info:eu-repo/semantics/publishedVersio

Употреба на диодниот ласер во френектомија– приказ на случај

Цел: Пациент со дијагноза frenulum tecto labii superior, покрај потребата од соодветна ортодонтска терапија, имаше индикација за френулектомија на горен лабијален френулум, со сите услови за примена на диоден ласер во тераписки цели. Материјал и метод: За реализација на поставената цел, корекција на горен лабијалниот френулум беше користен диоден ласер со употреба само на површинска анаестезија. Целата процедура опфати две посети: во првата направен е план на терапијата, додека во втората извршена е френектомијата. Резултати: По седум дена од интервенцијата направен е контролен преглед, при што беше оценета и утврдена целосна консолидацијата на меките ткива

Two randomized trials of effect of live attenuated influenza vaccine on pneumococcal colonization

The human nasopharynx is frequently colonized by Streptococcus pneumoniae (the pneumococcus), serving as the reservoir for transmission, a state which necessarily precedes invasive pneumococcal infection. Influenza infection increases pneumococcal colonization density and dysregulates host immune responses, increasing the risk of secondary bacterial pneumonia and death

New EU-scale environmental scenarios until 2050 – scenario process and initial scenario applications

Understanding uncertainties and risks can be considered to be the main motivation behind environmental scenario studies to assess potential economic, environmental, social or technical developments and their expected consequences for society and environment. The scenario study presented in this paper was designed to contribute to the question of how natural capital and ecosystem services may evolve in Europe under different socio-environmental conditions. The study was conducted as part of OpenNESS, an on-going EU FP7 research project. We present the iterative participatory scenario process, the storylines and drivers, examples for regional applications, as well as initial feedback from stakeholders. In a participatory iterative approach four scenarios were developed for the period to 2050, involving regional and EU-level users and stakeholders. Subsequently, scenarios were successfully contextualised and applied in regional place-based studies under widely differing socio-environmental conditions. Regional teams used different approaches to adapt storylines and drivers to the regional contexts. In an internal evaluation process among regional stakeholders some participants expressed concerns about the scenario method. Suggestions are made how to overcome these limitations. However, most participants approved the scenario method, especially in terms of provoking discussions, and confirmed the usefulness and applicability of the approach

Genome-wide association study identifies 32 novel breast cancer susceptibility loci from overall and subtype-specific analyses.

Breast cancer susceptibility variants frequently show heterogeneity in associations by tumor subtype1-3. To identify novel loci, we performed a genome-wide association study including 133,384 breast cancer cases and 113,789 controls, plus 18,908 BRCA1 mutation carriers (9,414 with breast cancer) of European ancestry, using both standard and novel methodologies that account for underlying tumor heterogeneity by estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status and tumor grade. We identified 32 novel susceptibility loci (P < 5.0 × 10-8), 15 of which showed evidence for associations with at least one tumor feature (false discovery rate < 0.05). Five loci showed associations (P < 0.05) in opposite directions between luminal and non-luminal subtypes. In silico analyses showed that these five loci contained cell-specific enhancers that differed between normal luminal and basal mammary cells. The genetic correlations between five intrinsic-like subtypes ranged from 0.35 to 0.80. The proportion of genome-wide chip heritability explained by all known susceptibility loci was 54.2% for luminal A-like disease and 37.6% for triple-negative disease. The odds ratios of polygenic risk scores, which included 330 variants, for the highest 1% of quantiles compared with middle quantiles were 5.63 and 3.02 for luminal A-like and triple-negative disease, respectively. These findings provide an improved understanding of genetic predisposition to breast cancer subtypes and will inform the development of subtype-specific polygenic risk scores