Predictive preventive personalized medicine Liver cancer is the fifth most common form of cancer worldwide [1], with an incidence rate almost equals the mortality rate and ranks 3 rd among causes of cancer related death [2]. The coexistence of two life threatening conditions, cancer and liver cirrhosis makes the staging challenging. However, there are some staging systems, e.g. the Barcelona staging system for Hepatocellular carcinoma (HCC) [3], that suggest treatment options and management. Whereas diagnosis in early stages gives hope for a curative outcome, the treatment regime for around 80 % [2] of the patients classified as severe stages only gears towards palliation [4]. An intra-arterial radiation approach, radioembolisation (RE) is ubiquitously applied as one of palliative approaches. Although, in general RE shows promising results in intermediate and advanced stage HCC [5], individual treatment outcomes are currently unpredictable. Corresponding stratification criteria are still unclear. We hypothesised that individual radioresistance/radiosensitivity may play a crucial role in treatment response towards RE strongly influencing individual outcomes. Further, HCC represents a highly heterogeneous group of patients which requires patient stratification according to clear criteria for treatment algorithms to be applied individually. Multilevel diagnostic approach (MLDA) is considered helpful to set-up optimal predictive and prognostic biomarker panel for individualised application of radioembolisation. Besides comprehensive medical imaging, our MLDA includes non-invasive multi-omics and sub-cellular imaging. Individual patient profiles are expected to give a clue to targeting shifted molecular pathways, individual RE susceptibility, treatment response. Hence, a dysregulation of the detoxification pathway (SOD2/Catalase) might indicate possible adverse effects of RE, and highly increased systemic activities of matrix metalloproteinases indicate an enhanced tumour aggressiveness and provide insights into molecular mechanisms/targets. Consequently, an optimal set-up of predictive and prognostic biomarker panels may lead to the changed treatment paradigm from untargeted "treat and wait" to the cost-effective predictive, preventive and personalised approach, improving the life quality and life expectancy of HCC patients. Keywords: Market access, Value, Strategy, Companion diagnostics, Cost-effectiveness, Reimbursement, Health technology assessment, Economic models, Predictive preventive personalized medicine Achieving and sustaining seamless "drug -companion diagnostic" market access requires a sound strategy throughout a product life cycle, which enables timely creation, substantiation and communication of value to key stakeholders [1, 2]. The study aims at understanding the root-cause of market access inefficiencies of companies by gazing at the "Rx-CDx" co-development process through the prism of "value", and developing a perfect co-development scenario based on the literature review and discussions with the ...
The World Health Organization has estimated that 450 million individuals live with mental disorders worldwide. In the last few years, a growing interest in research on the quality of life in chronically ill people could be observed. Further research generates new concepts and specific tools to measure the quality of life. Quality of life can be assessed using both generic and specific questionnaires. This allows for obtaining a quantitative result, which can be compared with studies in other patient populations. Currently, there are a variety of tools and questionnaires measuring the quality of life in patients, considering its various determinants. The most popular tools include Euro Quality of Life Questionnaire, Short-Form Health Survey and the World Health Organization Quality of Life-BREF. World Health Organization defines Quality of Life as an individual’s perception of their position in life in the context of the culture and value systems in which the patients live and concerning their goals, expectations, standards and concerns. Quality of life is increasingly used for the characterisation of disease and estimation the therapeutic efficiency. Evaluation and planning of activities designed to improve and maintain the patient’s quality of life require a holistic approach, taking into account psychological and medical aspects of the patient’s life. Several studies have shown that in the case of individuals with mental disorders, such as schizophrenia, bipolar disorder, depression and anxiety disorders, the assessment of quality of life is not only possible, but also desirable and even necessary.
The report concerns analysis of seasonal patterns of mortality for selected countries of Central and Eastern Europe, compared with France, Italy and Germany, based on monthly Eurostat data from 1999 to 2019. In the literature it is known that increase of mortality rates in winter is typical for the North Hemisphere. We show that there are similarities and differences in the pattern – both in the averages and volatility – of this increase in particular countries. To this aim the , and seasonality measures, known in the literature, were applied. The results are visualized in graphical and tabular form. In addition, significance of this seasonal variation is tested based on the regression with binary seasonal variables.
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