When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of bone evaluation, consequently, results in poor reproducibility and may lead to under or over preparation of the site. Recently, an unconventional site preparation protocol was developed in which the decision of which instruments to use is dictated by insertion torque of the novel site preparation instrument (OsseoShaper ™ , Nobel Biocare AB, Gothenburg, Sweden). The aim of this study was to quantify the correlation of the site preparation torques of the new instrument with bone density and maximum implant insertion torques. In vitro and in vivo data showed strong linear correlation between site preparation torque and density and resulted in reliable implant insertion torques, respectively. From our analysis, we conclude that this new instrument and protocol has the potential to eliminate the need for additional intraoperative bone evaluation and may reduce the risk of inadequate preparation of the site due to the ability to serve as a predictor of the final implant insertion torque.profile combined with a cutting flute and unconventional site preparation protocol. Following the pilot drill, the osteotomy is shaped with an implant-specific single use instrument, OsseoShaper1 (OS1), without irrigation at low speed (25-100 rpm) using a motorized drill unit with a maximum torque setting of 40 Ncm (Figure 1). The OS1 torque, measured by a drill unit with real-time torque display, determines the workflow for implant placement. If the OS1 achieves the desired depth and position with less than 40 Ncm, the implant can be placed. If the OS1 torque reaches 40 Ncm before it reaches the planned position, the next instrument should be used to further shape the implant site.

Background: Medicinal plants are a rich source of antioxidant polyphenols and in particular flavonoids. Materials and methods: In the present study 5 Bulgarian medical plants and 5 food supplements, present at the Bulgarian market, are analyzed for their Total phenolic, Total flavonoids and selected individual flavonoids content. A HPLC method was developed and validated for simultaneous determination of (+)-catechin, (-)-epicatechin and rutin in plant and supplements, using PDA detection. Results: The results show that polyphenols in the selected food supplements are lower than those of the medical plants analyzed. Mentha piperita and Melissa officinalis have the highest polyphenols content (67.38 and 65.17 mg GAE/g; 54.59 and 57.76 mg RE/g respectively). Rutin was detected in all samples analyzed, reaching highest levels in Mentha piperita (7332.5 µg/g), followed by fruits of Sambucus nigra (2818.7 µg/g). Conclusion: The results of the study are a practical contribution to a more complete characterization of the polyphenolic composition in Bulgarian medicinal plants.

Background The current COVID-19 pandemic is a challenge for the health sector all over the world. According to WHO, stigma related to COVID-19 can lead to underreporting, increased exposure and low adherence to standard safety precautions thus complicating adequate responses to the pandemic. The purpose of our research was to analyze students' perceptions on issues related to the COVID-19 pandemic with a special focus on relevant ethical issues. Herein, we present results related to student's perceptions on stigmatization. Methods A web-based questionnaire was distributed among 715 students; medical students from Medical University -Sofia, Bulgaria and midwifery students from the University of Western Macedonia, Greece. It included 21 questions on socio-demographic characteristics, knowledge on the transmission, symptoms and treatment of COVID-19. The study was conducted between April and July 2020. All the students participated anonymously and voluntarily. Results Data collected show that the main reasons for stigma experience are the presence of cough or flu-like symptoms (67.4%) and travel from high-risk regions (72.6%). These perceptions were significantly higher among medical students (72.5% and 75.7%) compared to other specialties - midwives (59.1%, 67.6%). Asian origin, health professionals as first respondents and release from quarantine were also considered as significant stigma-related factors in about one-third of all participants, respectively. Conclusions Identification of the main public perceptions that may lead to stigmatization and discrimination of patients and vulnerable groups is important in a focused approach to counter its impact on societies. Providing up-to-date education to medical professionals, mitigating the spread of misinformation by real-time monitoring of digital resources, improving public literacy on COVID-19 and establishing a community-level dialogue through digital and social media platforms may raise awareness to reduce stigma. Key messages Long-term Public health strategies are required to combat misconceptions that perpetuate stigma, in order to achieve better outcomes and improved treatment, and protect mental health. As the global COVID-19 health emergency transforms into an unprecedented social crisis, special attention is necessary among vulnerable people to ensure social integrity.

Background In order contain COVID19 spread, states adopted measures that confer transient disruptions in human rights. WHO acknowledged early on, that human rights should be embraced as an integral compound of the public health approach to COVID19. The aim of our research was to demonstrate healthcare students' perceptions on restrictions imposed on human rights, as part of COVID19 response. Methods Our cross-sectional survey employed a web-based questionnaire distributed among 715 students from Bulgarian and Greek health sciences faculties. All respondents participated anonymously and voluntarily. Data was collected between April and July 2020. Data analysis was conducted using established statistical methods. Results Among respondents, nearly two thirds of Greek students (66%), would accept, either categorically or highly probably, the implementation of measures that may impact core human rights, as opposed to 53% of those of Bulgarian origin. Inability to assess and non-acceptance of compulsory restrictions, were significantly high among participants (33% to 45%), irrespective of nationality or field of studies. Conclusions Remarkable disparities observed, require further evaluation as to the causes associated with non-acceptance of measures enforced during a public health emergency. This preliminary study, illustrates that stakeholders should provide priority assistance to health sciences students that may, inter alia, be used to promote risk communication, enhance public engagement and allow the allocation of frontline healthcare resources. Education, involvement in clinical activities, decision-making and policy may be used to overcome any apprehensions, given that healthcare students are the qualified workforce in future public health crises. Participation of academic institutions in shared governance ensures transparency and scientific evidence to justify emergency measures to tackle public health threats, thereby affecting positively students' perceptions. Key messages Evidence-based resources and addressing transient human rights disruptions are important in maximizing healthcare students’ awareness and effective participation during the pandemic. All participating bodies should safeguard core principles of human rights and ensure that all measures taken are rational, proportional, non-discriminatory and grounded in applicable legal frameworks.

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