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Background The global COVID-19 pandemic has had a significant impact on the physical and mental health of people everywhere. The aim of the study is to understand how people living in 15 countries around the globe experience an unexpected crisis which threatens their health and that of loved ones, and how they make meaning of this disruption in their narratives. Methods Data were collected through an anonymous online survey during May–September 2020, which was during or just after the first wave of the COVID-19 pandemic, depending on the country. The questionnaire included demographic and three open-ended questions as prompts for stories about experiences during the initial months of the pandemic. The text was analyzed through inductive thematic content analysis and quantified for full sample description, demographic and subsequently international comparisons. Results The final qualitative dataset included stories from n = 1685 respondents. The sample was 73.6% women and 26.4% men. The mean age of participants was 39.55 years (SD = 14.71). The identified four groups of overarching themes were: The presence and absence of others; Rediscovering oneself; The meaning of daily life; Rethinking societal and environmental values. We discuss the prevalence of each theme for the sample as a whole and differences by demographic groups. The most prevalent theme referred to disruptions in interpersonal contacts, made meaningful by the increased appreciation of the value of relationships, present in (45.6%) of stories. It was more prevalent in the stories of women compared to men (χ² = 24.88, p = .001). Conclusions The paper provides a detailed overview of the methodology, the main themes identified inductively in the stories and differences according to select demographic variables. We identify several major ways of making meaning of the pandemic. The pandemic has impacted many aspects of people’s lives which give it meaning, no matter where they live.

International theoretical and empirical studies have shown that regional development and economic growth largely depend on spatial and non-spatial proximity of regions, which generates knowledge spillovers. We developed a methodological approach to measuring and visualising spatial and structural-technological proximity affecting regional knowledge spillovers. Moreover, we tested the techniques of the cartographic visualisation of the proximity of Russian regions. Further, we analysed foreign and domestic approaches to studying spatial and non-spatial proximity and obtained new results. We described the stages constituting a methodology for the quantitative assessment of different types of regional proximity. Additionally, we proposed a method for constructing a typology of regions based on the coefficients of the non-spatial proximity matrix, calculated according to the indicator “gross value added” for 15 sectors of the Russian National Classifier of Economic Activities (OKVED) for Russian regions. Using the data for the Novosibirsk region in 2005 and 2016, we applied methodological techniques for measuring and visualising geographical and structural-technological proximity (STB) of a region in relation to other constituent entities of the Russian Federation. The Novosibirsk region is located in the middle of the country and has a diversified structure of economic activities and science. For this particular region, there has been an increase in the likelihood of the emergence of knowledge spillover channels with various European regions of Russia and some regions of the Urals and the Far East. Proximity matrices can be used in econometric studies to test hypotheses about the impact of different forms of proximity on regional economic growth. Recommendations to enhance knowledge spillover coincide with the proposals to support the areas of innovative development stated in The Strategy of Spatial Development of the Russian Federation for the period until 2025.

Although genome-wide association studies have identified over 100 risk loci that explain ∼33% of familial risk for prostate cancer (PrCa), their functional effects on risk remain largely unknown. Here we use genotype data from 59,089 men of European and African American ancestries combined with cell-type-specific epigenetic data to build a genomic atlas of single-nucleotide polymorphism (SNP) heritability in PrCa. We find significant differences in heritability between variants in prostate-relevant epigenetic marks defined in normal versus tumour tissue as well as between tissue and cell lines. The majority of SNP heritability lies in regions marked by H3k27 acetylation in prostate adenoc7arcinoma cell line (LNCaP) or by DNaseI hypersensitive sites in cancer cell lines. We find a high degree of similarity between European and African American ancestries suggesting a similar genetic architecture from common variation underlying PrCa risk. Our findings showcase the power of integrating functional annotation with genetic data to understand the genetic basis of PrCa.

The mu1 opioid receptor gene, OPRM1, has long been a high-priority candidate for human genetic studies of addiction. Because of its potential functional significance, the non-synonymous variant rs1799971 (A118G, Asn40Asp) in OPRM1 has been extensively studied, yet its role in addiction has remained unclear, with conflicting association findings. To resolve the question of what effect, if any, rs1799971 has on substance dependence risk, we conducted collaborative meta-analyses of 25 datasets with over 28,000 European-ancestry subjects. We investigated non-specific risk for "general" substance dependence, comparing cases dependent on any substance to controls who were non-dependent on all assessed substances. We also examined five specific substance dependence diagnoses: DSM-IV alcohol, opioid, cannabis, and cocaine dependence, and nicotine dependence defined by the proxy of heavy/light smoking (cigarettes-per-day >20 vs. ≤ 10). The G allele showed a modest protective effect on general substance dependence (OR = 0.90, 95% C.I. [0.83-0.97], p value = 0.0095, N = 16,908). We observed similar effects for each individual substance, although these were not statistically significant, likely because of reduced sample sizes. We conclude that rs1799971 contributes to mechanisms of addiction liability that are shared across different addictive substances. This project highlights the benefits of examining addictive behaviors collectively and the power of collaborative data sharing and meta-analyses.

Balloon pulmonary valvuloplasty (BPVP) is the procedure of choice for the treatment of isolated pulmonary valve stenosis. Complications and failure of the procedure are more common in newborns and infants. Aim: To establish the effectiveness and safety of BPVP in newborns and infants. Material and methods: Ninety-one infants (11 newborns) with isolated pulmonary valve stenosis and mean age 171 ± 115 days were catheterized for BPVP between October 1986 and December 2016. BPVP was performed in 86 infants with a balloon catheter size 127±16% from the annulus dimension. The effectiveness (gradient right ventricle (RV) – pulmonary artery (PA) ≤ 35 mm Hg) and safety (lack of life–threatening complications, emergency surgery or death) of the procedure were assessed. Results: Transvalvular pressure gradient decreased from 82 ± 29 mm Hg to 29 ± 24 mm Hg (р = 0,0001) and RV pressure - from 101 ± 28 mm Hg to 52 ± 24 mm Hg (p = 0,0001). BPVP was effective in 61 infants (70,9%), mainly in those with lower initial gradient, RV pressure and less signifi cant infundibular obstruction. There were no children with hemodynamically signifi cant postprocedural pulmonary insuffi ciency. Complications were observed in 16 of the infants catheterized for BPVP (17,6%). In 5 of the children (5,5%), minor (transient) complications arose and were overcome by conservative means. Major complications were observed in 11 infants (12,1%): rhythm and conductive disorders (critical bradycardia, supraventricular/ventricular tachycardia, complete atrioventricular block) in 6 children, hemopericardium or severe right ventricular outfl ow tract rupture – in 5. The evolution was favorable after intensive treatment in 6 children with major complications, two children were sent for emergency surgery (2,2%) and death occurred in 3 of the children associated with the procedure (3,3%). The procedure was interrupted and BPVP was not performed in fi ve of the catheterized children (5,5%), all with severely dysplastic valve. Conclusion: BPVP is effective and comparatively safe procedure under the age of 1 year. Newborns, children with severely dysplastic valve and suprasystemic RV pressure are the most at-risk.

Globally, the diffuse goiter affects more than 10% of the population and in some regions is endemic. Thyroid nodules are found in approximately 5% of the population using the oldest method for thyroid examination – palpation. When performing ultrasound screening, this percentage increases significantly and reaches between 20 and 75% of the total population. Thyroid carcinoma is a rare malignancy and accounts for up to 1% of all malignant tumors. It is the most common endocrine cancer and is clinically manifested as a thyroid nodule. Somatic mutations play an important role in its development. Differentiation of benign and malignant thyroid nodules is of great importance due to the different therapeutic approach. Therefore, new diagnostic tools are sought to help distinguish the two. Despite the progress in our knowledge of carcinogenesis in recent years, a number of key issues still remain unanswered. The establishment of new rare somatic mutations can improve pre-surgical diagnosis and optimize post-operative strategies for the treatment of thyroid carcinoma. Next-generation sequencing (NGS) allows for extensive mutation and genome rearrangements tracking. The results obtained with NGS provide the basis for the development of new approach for systematic genetic screening, at prevention, early diagnosis, accurate prognosis, and targeted therapy of this disorder.

BACKGROUND: Obesity is a major health problem in modern society and its prevalence throughout the world has reached the epidemic level. The unfavorable outcomes of obesity are associated with a high risk of numerous diseases due to metabolic disorders. Finding of diagnostic criteria for early detection of obesity is a priority in biomedical research. Therefore, of particular interest is the new visceral obesity marker – lipid accumulation product (LAP). Meanwhile, to date, the reference values for LAP are not defined, and data on sex- and age-related changes are contradictory. AIMS: The aim of this study was to determine the variation range, sex and age differences in LAP values in healthy subjects. MATERIALS AND METHODS: The study was conducted on apparently healthy subjects (455 men and 286 women) aged 20–59 years selected at routine examinations at the base of the central clinic in Arkhangelsk. Examination of subjects consisted of physical examination with measurement of anthropometric and clinical parameters, filling out a questionnaire, and evaluation of serum lipid levels. RESULTS: The LAP values in the subjects varied in a wide range (0.5–156.5 cm×mmol/l in men; 0.4 to 116.2 cm×mmol/l in women), but at the same they in 75% of the participants did not exceed 30 cm×mmol/l. Sex differences in LAP with the prevalence of values in men were observed in the age groups up to 40 years old, later they disappeared. LAP in men and women increased with age, but these changes were unequal. The LAP values increased to reach a plateau in men up to 30 years of age and in women up to 40 years of age. CONCLUSIONS: LAP is a combined index that simultaneously reflects distribution of adipose tissue and changes in blood lipids, and is considered a marker of obesity associated with the risk of metabolic disorders. This study was the first to determine the variation range, sex differences and age dynamics for LAP in the apparently healthy subjects.

There are hypotheses that crossbreeding increases precocity, milk production and fertility of ewes, improves quality of wool with decrease in the amount of wool clip and shearing frequency from two to one time a year, and increases the growth rate of young sheep. Thus, the direction of sheep productivity turns towards increasing lamb production. Studied were quantitative and qualitative changes in the production character of Pechora-Ostfriesian crossbreeds for justification of their breeding and further use in the selection process. The objects for the study were ewes, suckling lambs and growing young sheep of the Pechora breed group and Pechora-Ostfriesian crossbreeds of the first generation of the experimental herd of L. A. Kaneva peasant farm in the Ust-Tsilma district of the Komi Republic. For the comparative analysis, data from primary zootechnical record and valuations for 2016-20 years were used. All measurements were performed in accordance with approved conventional methods. Crossbred sheep of the first generation were significantly more precocious, they had their first lambing 164 days earlier. The wool fineness of crossbreeds has increased to 56-60 quality, and the fleece evenness to 100 %, while twice reducing the cost of shearing. There is a tendency to increase the average daily gain in live weight of Pechora-Ostfriesian young sheep at the age of three to seven months by 17.4 g, or 18.1 %. The studies have shown that crossbreeding had not led to increase in the fecundity and milk production of ewes. However, the production of live weight gain per ewe per year was higher in crossbreeds by 4.4 kg, which suggests the prospects of crossing.

Unbalanced atrioventricular septal defect is seen by 10-15% of the patients with this congenital heart disease and poses serious challenges for the treating physicians regarding the choice of the most suitable operative intervention. The forms with moderate degree of unbalance between the two ventricles, especially when the size of the left ventricle is considered borderline, make the choice between two-ventricle correction and single-ventricle palliation quite difficult. The most important factor when judging the degree of unbalance is not the size of the ventricles but rather the redistribution of blood flow. The use of different echocardiographic measurements could contribute to the more precise determination of the indications for one of the two surgical strategies with resulting improvement of patient outcome.

Abstract Objective This study piloted a European technical protocol for conducting chronic hepatitis C prevalence surveys in the general population. The pilot study took place in the Bulgarian city of Stara Zagora in 2018, and results of setting up, conducting and evaluating the survey are presented. Results A probability-based sample of the general adult population was drawn from the local population registry, stratified by age and sex. A sample size of 999 was calculated, and accounting for 50% non-response, 1998 registered invitation letters were sent. Venous blood samples and questionnaire data were collected by the Regional Health Inspectorate in Stara Zagora. Blood samples were tested for anti-HCV, and if reactive for RNA. 252 (21.6%) of the participants were included in the study. Mean age and sex distribution differed between the participants (55.9 years, 60.3% females) and the total sample (48.9 years, 53.4%). The weighted chronic HCV prevalence among participants was 0.9% [95% CI 0.2–4.2%]. The approach of only sending registered letters contributed to a low response rate, and more efforts are needed to reduce non-response, especially among men and younger age groups. Results of the evaluation were integrated in the final technical protocol.

Laryngeal squamous cell carcinoma is a common malignancy in men. Bulgaria is one of the countries in Europe with the highest incidence and mortality rates of the aggressive, severe disease of laryngeal cancer. Proven etiological factors are the abuse of tobacco and alcohol beverages. Despite the progress of technologies of multimodal medical treatment, survival rates have not reached satisfactory levels. Over the last few decades, scientific and clinical research data have led to a growing interest in exploring potential biomarkers. In the last years, non-coding RNAs have become promising biomarkers. They are important key regulators in both normal and tumour specific biological processes as well as in the response to environmental factors and treatment, including chemo- and radiotherapy. Studies have shown ectopic expression of a number of ncRNAs in laryngeal cancer. Published data provide evidence of the lncRNAs and miRNAs that could help us better understand complex carcinogenesis in laryngeal cancer and would provide reliable diagnostic, prognostic and predictive biomarkers.

The process of neoangiogenesis is one of the classic hallmarks of a cancer. Its intricate mechanisms have long been one of the major domains in cancer research and a hope for a therapeutic breakthrough. Last decade a new subgroup of non-coding RNA molecules was reported called microRNAs. Literally hundreds of new molecules in this class are being uncovered as pivotal regulators in virtually all intracellular processes. The aim of this study is to classify and review those microRNA molecules that have a role in the processes of tumor angiogenesis and map their places in the regulatory framework of the classical proangiogenic genes and their canonical cascades.

Introduction: Toxocariasis is a zoonotic helminth infection with difficult diagnosis. Determination of specific IgG antibodies alone does not allow to establish the disease stage and to evaluate the treatment efficacy. Therefore it is necessary to identify additional markers that will assist the diagnosis. The purpose of our study was to identify and monitor eosinophil cationic protein (ECP) levels in patients with toxocariasis confirmed by serology and to compare our data with the literature to determine the relevance of this protein as an indicator for recent infection and the effectiveness of the therapy. Material and methods: ELISA (CUSABIO) commercial kit was used for determination of ECP concentration. Sixty serum samples were studied from individuals previously tested and confirmed for toxocariasis by the presence of specific anti-Toxocara IgG antibodies in ELISA (Toxocara IgG Rbiopharm) and the presence of specific bands in Western blot as confirmatory test (LD BIO). Twenty serum samples from clinically healthy blood donors were used as a control group. Results: The mean concentration of serum ECP in the patients with toxocariasis was significantly higher than in clinically healthy subjects. Seventy-two percent of patients affected by toxicariasis showed increased serum concentration of ECP. However, no statistically significant differences were observed in terms of age (p = 0.451) and sex (p = 0.682) of the patients or clinical form of the disease. ECP levels among patients with visceral toxocariasis were relatively higher (mean 22.99 ng / ml ± 13.16 SD) in comparison to those with ocular involvement (15.60 ng/ml ± 9.92 SD). Correlation between the presence of peripheral eosinophilia and the concentration of serum ECP was not also established. Conclusion: Data from our study give us reason to believe that serum levels of ECP could serve as an additional marker indicating recent infection, especially in patients without marked increase in the blood eosinophils.

This paper studies a Fog Radio Access Network (F-RAN) architecture that utilises the increasing storage and device-to-device communication capacities of users' smart devices (referred to as F-UEs) in order to reduce the time that the central processing unit (referred to as BBU) has to spend to serve these F-UEs and thus, increases the system's capacity. Indeed, these F-UEs can employ these capacities in cooperatively serving each other's file requests, as long as the F-UEs have the files in their storage, rather than always receiving them through the BBU. In addition, network coding (NC) can be employed to minimize the communications among the F-UEs and from the BBU to further offload the BBU resources and reduce the energy consumed in F-UEs' cooperation. This paper develops an algorithm for scheduling the file encoding and transmissions both among half-duplex F-UEs and from the BBU to minimise the consumed time-frequency resources from the BBU given constraints on the energy consumed by each F-UE for their cooperation to help preserve their battery life. The influence of the energy constraint on BBU offloading is investigated and the performance of the system under a variety of settings is evaluated through extensive simulations. The benefit of using NC is shown and the ability of the F-UEs to transmit with different power levels is also studied and shown to considerably impact the number of cooperating F-UEs and the BBU offloading.

This paper reports the first description of the crystal structure and crystal chemical features of fluorcarletonite, a new mineral from the Murun potassium alkaline complex (Russia), obtained by means of single-crystal and powder X-ray diffraction (XRD), electron microprobe analysis (EMPA), thermogravimetry (TG), differential scanning calorimetry (DSC), and Fourier transform infrared (FTIR) spectroscopy. The crystal structure of fluorcarletonite, KNa4Ca4Si8O18(CO3)4(F,OH)⚫ H2O, a rare phyllosilicate mineral, contains infinite double-silicate layers composed of interconnected four- and eight-membered rings of SiO4 tetrahedra and connected through the interlayer K-, Na- and Ca-centered polyhedra and CO3 triangles. The X-ray diffraction analysis confirms the mineral to be tetragonal, P4∕mbm, a=13.219(1) Å, c=16.707(2) Å, V=2919.4(6) Å3 (powder XRD data), a=13.1808(5) Å, c=16.6980(8) Å, V=2901.0(3) Å3 (single-crystal XRD data, 100 K). The EMPA (average from 10 analyses) gave the following composition (wt %): SiO2 44.1(6), CaO 20.0(3), Na2O 11.1(3), K2O 4.5(2), F 1.3(5), TiO2 0.1(1) and Al2O3 0.03(3). The TG–DSC analysis confirmed the presence of H2O and CO2 (weight losses of 1.17 % and 14.9 %, respectively). The FTIR spectrum acquired in the range from 4000 to 400 cm−1 reveals the presence of H2O, CO3 and OH groups. The average formula of fluorcarletonite calculated from the results of EMPA and crystal structure refinement is K1.04Na3.89Ca3.87Ti0.01Si7.99Al0.01O18(CO3)3.86(F0.72OH0.28)⚫1.11H2O.

The role and place of costs policy in the modern system of financial regulation of budgetary institutions is defined. The priorities facing the national system of budgetary institutions are identified, taking into account the need to strengthen its effectiveness and efficiency, including in the part: creating conditions for increasing the economic independence of budgetary institutions based on the replacement of estimated funding for end-to-end budgeting; updating the institutional mechanisms for financing and co-financing of socially important services; increased transparency and publicity of activities; introducing a system for evaluating the quality of services provided; introduction of an institution of effective public financial control at all stages of the management cycle, starting with planning. A methodology for evaluating the socio-economic costs efficiency of budgetary institutions is proposed, including the definitions of relative fiscal autonomy and of the decentralization level of the system of financing for the network of budgetary institutions, which can be used to characterize the compositional structure of financial policy in the sphere of costs. The role of fiscal decentralization in financing the costs of social development is defined. The specifics of use of the program-targeted method in financing the activities of budgetary institutions are characterized. Ways to improve the cost efficiency of budgetary institutions in the spheres of education and public health are suggested.

JAK-inhibitors are small molecules blocking the JAK-STAT pathway that have proven effective in the treatment of different immune-mediated diseases in adults and juvenile idiopathic arthritis (JIA).Aim of StudyTo evaluate the safety and efficacy of tofacitinib in children with different rheumatic diseases.Material and MethodsWe extracted information from 24 children with the following diagnosis: JIA (n = 15), undifferentiated systemic autoinflammatory diseases (SAIDs) (n = 7), and juvenile dermatomyositis (JDM) (n = 2) who have been treated with tofacitinib for a period of longer than 6 months. The treatment outcomes were classified according to the opinion of the attending physicians as having a complete response (CR), i.e., the absence of disease activity, or a partial response (PR)—a significant improvement of symptoms and disease activity, or no response (NR)—no changes in disease activity.ResultsCR was achieved in 10/24 patients; 7/15 among JIA patients, 1/2 among JDM patients, 4/7 among SAID patients, and PR in 5/15 of JIA, 1/2 of JDM, and 3/7 of SAID patients. Three non-responders with JIA discontinued tofacitinib. Corticosteroids were successfully tapered off in 11/14 patients and discontinued in 2/14 patients. Four patients had side effects not requiring treatment discontinuation: liver enzyme elevation (n = 2), hypercholesterolemia (n = 1), lymphadenitis (n = 1).ConclusionJAK-inhibitors are effective new therapies for the treatment of multiple immune-mediated diseases. Our experience has shown the best results in patients with JIA and JIA-associated alopecia, and type I interferonopathies. More data from randomized controlled clinical trials are needed to use JAK-inhibitors safely in pediatric rheumatic diseases.

Zinc oxide and titanium dioxide semiconductor photocatalysts have been widely utilized in the last few decades for water treatment because of their high photocatalytic efficiency. Recently, a lot of researchers have focused on the improvement of the photocatalytic properties of catalysts through modifying and co-modifying them with different metals and nonmetals. These co-catalytic ions improve the photocatalytic activity of ZnO and TiO2 by reducing its energy band gap. This might be useful in wastewater treatment for the photocatalytic degradation of organic contaminants. In this study, we prepared semiconductor films that were surface-modified with Ag co-catalyst layers via the photo-fixation of Ag (I) ions with varied concentrations (10−2–10−4 M) in the water phase under UV illumination for the first time. The photocatalytic behavior was evaluated by the degradation of malachite green and methylene blue under UV and visible light irradiation. The ZnO/Ag and TiO2/Ag samples showed a faster degradation of malachite green compared to methylene blue due to the formation of stable intermediates by the reaction of OH radicals with the triarylmethane dye (C=C bond) during the photocatalysis. The co-catalytic-silver-modified films had a higher photocatalytic efficiency in comparison with the pure nanostructures. The dye photodegradation rate constants increased in the following order: pure films < films modified with Ag, 10−4 M < films modified with Ag10−3 M < films modified with Ag10−2 M. The Ag modification and the heterojunction of the composites contributed to trapping and transfer of the electrons. Therefore, the photogenerated charges had a longer lifetime, resulting in a strengthened photocatalytic ability of the ZnO/Ag and TiO2/Ag films.

YAG:Ce ceramics by the direct action of an electron beam with 1.4 MeV energy were synthesized on a mixture of a stoichiometric composition of Y, Al, and Ce oxides without adding any substances to facilitate the process. The synthesis is realized in a time less than 1 s. The main structural phase of the obtained ceramics is YAG and YAP can be additional. The luminescence characteristics of the synthesized samples, the excitation, luminescence, decay time, and pulsed cathodoluminescence spectra, are similar to those known for YAG:Ce phosphors. The conversion efficiency of the excitation energy into the luminescence of the samples reaches 60–70% of those used for the manufacture of LED phosphors. The set of processes that determine the rate and efficiency of radiation synthesis differs from those occurring during thermal methods by the existence of a high degree of the initial compositions’ ionization under the influence of a radiation flux and a high probability of the decay of electronic excitations into short-lived radiolysis products.

Gesneriaceae plant family is comprised of resurrection species, namely Boea hygrometrica and Paraboea rufescens, that are native to the Southeast Asia and Haberlea rhodopensis, Ramonda myconi, and Ramonda serbica, which are mainly found in the Balkan Peninsula. Haberlea rhodopensis is known to be able to survive extreme and prolonged dehydration. Study was carried out after the dried plant Haberlea rhodopensis Friv. had been hydrated and had reached its fresh state. Two juice samples were collected from the plant blossom: The first sample was prepared with 1% filtered water through a patented EVOdrop device. Then the sample was saturated with hydrogen with EVOdrop booster to a concentration of 1.2 ppm, pH = 7.3, ORP = −390 mV. This first sample was prepared with filtered tap water from Sofia, Bulgaria. The second sample, which was a control one, was developed with tap water from Sofia, Bulgaria, consisting of 1% solutions of Haberlea rhodopensis. A study revealed that during the drying process in H. rhodopensis the number of free water molecules decreases, and water dimers are formed. The aim of our study was to determine the number of water molecules in clusters in 1% solutions of hydrated H. rhodopensis plants. Results were analyzed according to the two types of water used in the experiment. Th EVOdrop device is equipped with an ultranano membrane and rotating jet nozzle to create a vortex water and saturation thanks to a second device EVObooster to obtain hydrogen-rich water. In the current study Hydrogen-rich water is referred to as Hydrogen EVOdrop Water (HEW). Research was conducted using the following methods—spectral methods non-equilibrium energy spectrum (NES) and differential non-equilibrium energy spectrum (DNES), mathematical models, and study of the distribution of water molecules in water clusters. In a licensed Eurotest Laboratory, the research of tap water before and after flowing through the EVOdrop device was proven. Studies have been carried out on the structuring of water molecule clusters after change of hydrogen bond energies. The restructuring comes with rearrangement of water molecules by the energy levels of hydrogen bonds. Local extrema can be observed in the spectrum with largest amount of water molecules. The structural changes were tested using the NES and DNES spectral methods. The conducted research proved that the application of EVOdrop device and EVObooster changes the parameters of water to benefit hydration and health.

Background. Human toxocariasis is a zoonotic disease in which the human being is an accidental host. The broad distribution of its definitive hosts determines the presence of the disease worldwide. Demographic factors, the way and standard of living, the existence of domestic animals in the household and their infestation are important for the epidemiology of the infection and determine the differences in reported seroprevalence. Data on the prevalence of toxocariasis in our country are limited. In this regard, the aim of the present study is to determine the seroprevalence of this parasitic infection among healthy individuals, in three regions of Bulgaria (Plovdiv, Stara Zagora and Smolyan). Material and Methods. Serum samples obtained from 247 individuals were tested by enzyme-linked immunosorbent assay (ELISA) for anti-Toxocara IgG antibodies. Results. Positive results were found in 26 (10.5%) of them, which indicated the presence of an asymptomatic form of the disease in our country. We found different seropositivity rates in the studied districts of the country. Conclusions. Performing immunological tests among various groups of the population is of great importance for the early detection of Toxocara infection, as well as for determining the main factors for the spread of the disease.

No Abstract

The value of video-based self-assessment in enhancing surgical skills is uncertain. This study investigates the feasibility and estimates sample size for a full-scale randomized controlled trial to evaluate the effectiveness of video-based self-assessment to improve surgical performance of laparoscopic cholecystectomy in trainees. This parallel pilot randomized controlled trial included general surgery trainees performing supervised laparoscopic cholecystectomy randomized 1:1 to control (traditional intraoperative teaching) or intervention group (traditional teaching plus video-based self-assessment). Operative performance was measured by the attending surgeon blinded to group assignment at the time of surgery using standardized assessment tools (Global Operative Assessment of Laparoscopic Skills and Operative Performance Rating System). The intervention group had access to their video recordings on a web-based platform for review and self-assessment using the same instruments. The primary outcome for the estimation of sample size was the difference in faculty-assessed final operative performance (third submitted case). Feasibility criteria included >85% participation, >85% adherence to case submission and >85% completion of self-assessment. Of 37 eligible trainees approached, 32 consented and were randomized (86%). There were 16 in the intervention group, 15 in the control group (55% male, 55% junior trainees), and 1 was excluded for protocol violation. Twenty-four (75%) of participants submitted 3 cases. Thirteen trainees (81%) accessed the platform and completed 26 (63.2%) case self-assessments. Fifty-five trainees per arm will be needed to power a full-scale laparoscopic cholecystectomy with Global Operative Assessment of Laparoscopic Skills and 130 trainees per arm with Operative Performance Rating System as the assessment tool. This pilot study contributes important data to inform the design of an adequately powered randomized controlled trial of video-based self-assessment to improve trainee performance of laparoscopic cholecystectomy. Although a priori trial feasibility criteria were not achieved, automated video capture and storage could significantly improve adherence in future trials. [ABSTRACT FROM AUTHOR]

The aim of this work was to investigate the electrical activity of the athletes’ hearts with different types of the left ventricular remodeling, as well as a control group of untrained people, by the body surface potential mapping before and immediately after exercising. The study of the heart’s electric field in athletes of the same sex, age and sport qualification, but different sport disciplines, showed that the reaction of the heart to physical activity is reflected in different changes of the amplitude-temporal characteristics of the extremes on the body’s surface in athletes with eccentric and concentric myocardial remodeling.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The aim of the present study was to reveal the characteristics of an Enterobacter cloacae complex isolate producing DHA-1 AmpC enzyme recovered from a patient hospitalized in St Marina Hospital, Varna.Materials and methods: Susceptibility testing, conjugation experiments, isoelectric focusing, PCR and sequencing were carrying out.Results: Of 176 Enterobacter spp. isolates only one isolate was positive for blaDHA. The sequencing revealed the presence of blaDHA-1 and blaCTX-M-3. The antimicrobial susceptibility testing showed higher resistance rates to almost all beta-lactams (ceftazidime, cefotaxime, cefepime, amoxicillinclavulanic acid, piperacillin/tazobactam), tobramycin, gentamycin, trimethoprim/sulphomethoxazole and quinolones (ciprofloxacin and levofloxacin). The isolate was susceptible to imipenem, meropenem and amikacin. The isoelectric focusing showed a band at pI 5.4 without ceftazidime and cefotaxime activity; a band at pI 7.8 with cefoxitin activity and another - with pI 8.4 with cefotaxime activity. Conjugation experiments were successful only for blaCTX-M-3 carrying determinants. Conclusions: To the best of our knowledge this is the first report of DHA-1 producing isolate in Bulgaria. The emergence of DHA-1 producing E. cloacae complex demonstrates the possibility for further dissemination of the gene encoding this enzyme. Infectious control measures are needed for the prevention of this phenomenon.

In this article, updated approach to assess the impact of fiscal decentralization on economic development is offered. The relationship between the proper level of fiscal decentralization and economic growth for 27 advanced and emerging economies in Europe from 1992 to 2017 was evaluated using panel data. In the EU members, Belarus, Georgia and Ukraine expenditures decentralization was more essential than revenue decentralization. The vast majority of the counties from Central and Eastern Europe have increased the level of fiscal decentralization since 1992. It was found that revenue decentralization was associated with lower growth rates, while expenditures decentralization could slightly encourage economic development. The overall decentralization indicator adversely affected the growth, but that interconnection was not robust. The empirical investigation showed significant role of demographic structure and sustainability to ensure economic development. The authors propose the statements for the local authorities to develop the methodical bases of the fiscal policy’s design. In the survey, a balanced approach to the tax and public spending policy’s preparation and planning is presented.

Obesity is a grave medical and social problem causing significant hazards for human health due to frequent occurrence of grave concomitant diseases. Visceral obesity is considered to be the most hazardous. Contemporary diagnostics which allows to reveal visceral obesity both during screening examinations of people who are considered to be conditionally healthy and in patients who suffer from cardiovascular diseases is becoming a very promising trend both in primary and secondary prevention. The review focuses on an up-to-date marker used to detect visceral obesity, namely, lipid accumulation product or LAP. This index was first introduced by Kahn H.S. in 2005 and is calculated on the basis of two variables, waist circumference (cm) and fasting concentration of triglycerides (mmol/l). When a biochemical and an anthropometric parameter are applied simultaneously to calculate LAP, it allows not only to assess how fats are distributed in a body but also to reflect functional state of fat tissues. LAP index is widely used as a marker showing there are metabolic disorders in a body (metabolic syndrome, diabetes, resistance to insulin, or nonalcoholic fatty liver disease) and as a cardiovascular diseases predictor. Besides, LAP index, when used to identify obesity phenotype, allows to assign people with overweight into a "metabolically healthy" category or "metabolically ill" one and to reveal patients suffering from metabolic obesity among people with normal body weight. A lot of research revealed that LAP index had a very good diagnostic and predictive potential as regards metabolic and cardiovascular diseases and was a more precise marker of cardio-metabolic risks than conventional anthropometric parameters. The review highlights LAP value ranges, its sex and age peculiarities, as well as a character and an extent to which LAP values change in case of certain diseases. It also dwells on advantages and drawbacks of LAP practical application.

The methodological bases of formation and implementation of budget policy in the countries with developed and transformational economies are disclosed, taking into account their level of development, peculiarities of institutional composition, and cyclicality. It is defined that the stimulating effect of budget policy on the processes of socio-economic development in the form of accelerated growth of intellectual and physical capital can be found only in the case of a rational scientific substantiation of procedures and ways of implementation of budget policy. The theoretic-applied provisions on the budget regulation are systematized and generalized. The basic principles of formation of budget policy include: scientific validity, systematicity and consistency, institutional certainty, adaptability, transparency. The need to improve institutional provision for the system of public finance management is substantiated. The role of both the medium- and the forward-looking budget planning and forecasting in the sustainable economic growth is defined. The institutional limitations to the implementation of the relevant practices are substantiated. The conceptual bases of improving the budget policy in the context of improving the level of public well-being are determinated. The need for institutional transformation of the budget doctrine of the State is specified.

urpose: to evaluate the epidemiological relationship between 3rd generation cephalosporin resistant Enterobacter cloacae blood isolates collected from patients in the University Hospital in Varna city during the period March 2014 and January 2017 and to characterize the ESBLs production in these isolates. Materials and methods: a total of 47 consecutive (nonduplicate) 3rd generation cephalosporin resistant isolates of Enterobacter cloacae, obtained from blood samples of patients admitted in different wards in Varna University Hospital, were investigated. Antimicrobial susceptibility to set of antimicrobial agents was tested by disc diffusion method and Phoenix (BD), and the results were interpreted according to EUCAST guidelines 2017. Identification of ESBL encoding genes was performed by PCR and sequencing. Isolates were genotyped by ERIC PCR. Results: The antimicrobial susceptibility in the whole collection of isolates, shown in decreasing order, is as follows: amikacin, 97.8% < levofloxacin, 76.6% < trimethoprime/ sulphometoxazole, 40.4% < ciprofloxacin, 19% < gentamicin, 8.4% < cefepime, 4.2% < piperacillin/ tazobactam, tobramycin, 2.1%. Multidrug resistance was detected in 70.2% of the isolates. The most widespread enzyme was CTX-M-15, found in 95.5% (n=43). Nine different ERIC types were detected. The dendrogram of similarity revealed three main clones of E. cloacae: Clone I, comprising two closely related subclones (ERIC type A and Aa) (similarity coefficient 0.92), was predominant, detected in Haematology (n=9), Haemodialysis (n=8), ICU (n=6), Cardio surgery (n=3), Pulmonology (n=4) and Gastroenterology (n=1); Clones II (ERIC type C) and III were presented by 5, and 3 isolates with identical profiles, obtained from patients, hospitalized in different wards. The ERIC profiles K, L, M and P, were found in single isolates only and were interpreted as sporadic. Conclusions: multi-drug resistance in E. cloacae was associated with successful intrahospital dissemination of three CTX-M-15 producing E. cloacae clones. Clone I was predominant, demonstrating high cross-transmission, epidemic and invasive potential. BlaCTX-M-15 was identified as a major mechanism of resistance to 3rd generation cephalosporins in E. cloacae.

Abstract Background The importance of blood lipids in the pathogenesis of sudden sensorineural hearing loss (SSNHL) is widely discussed in the literature. However, the published results that hyperlipidaemia causes hearing problems are contradictory. The objective of this study was to establish whether increased lipid levels affect the risk of idiopathic SSNHL. Methods A case-controlled study was conducted of 27 patients with idiopathic SSNHL and 24 healthy control subjects. All of the subjects underwent complete audiological examination. The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo) A-I, apoB and apoE were measured with commercially available kits (Chronolab Systems, Spain). Several clinical ratios and indices of lipid metabolism were calculated. Results Detailed analysis of lipid metabolism in patients with idiopathic SSNHL has shown that disturbances in auditory function are associated with increased atherogenicity of the lipid profile. However, there were no significant differences in the conventional parameters of lipid metabolism (TC, TG and HDL-C) between patients with idiopathic SSNHL and subjects in the control group. Higher values of the apoB/apoA-I ratio, atherogenic index of plasma (AIP) and atherogenic index (ATH index) in patients with SSNHL indicated increased atherogenicity of the lipid profile. Binary logistic regression analysis showed that of these three indices, only higher values of the ATH index were significantly associated with an increased risk of idiopathic SSNHL. Conclusions The ATH index can be used as a marker indicating the risk of idiopathic SSNHL when the conventional lipid indices are still normal.

Similarities in cancers can be studied to interrogate their etiology. Here, the authors use genome-wide association study summary statistics from six cancer types based on 296,215 cases and 301,319 controls of European ancestry, showing that solid tumours arising from different tissues share a degree of common germline genetic basis.

The original version of this Article contained an error in the spelling of the author Manuela Gago-Dominguez, which was incorrectly given as Manuela G. Dominguez. This has now been corrected in both the PDF and HTML versions of the Article.

The relationship between telecommunications infrastructure and economic activity is under discussion in many scientific papers. Most of the authors use for research and analysis the Jipp curve. A lot of doubts about the correctness of the Jipp curve appear in terms of applying econometric models. The aim of this study is a review of the Jipp curve, refining the possibility of its application in modern conditions. The methodology used in the study is based on dynamic econometric models, including tests for nonstationarity and tests for causality. The focus of this study is directed to methodological problems in measuring the local density types of telecommunication networks. This study offers a specific methodology for assessing the Jipp law, through VAR-approach and Granger causality tests. It is proved that mechanical substitution of time-series data: momentary aggregated variables (such as the number of subscribers of a telecommunication network at the end of the year) and periodically aggregated variables (such as GDP) in the Jipp’s curve is methodologically wrong. Researchers have to reconsider the relationship set in the Jipp’s curve by including additional variables that characterize the Telecommunications sector and the economic activity in a particular country within a specified time period. GDP per capita should not be regarded as a single factor for the local density of telecommunications infrastructure. New econometric models studying the relationship between the investments in telecommunications infrastructure and economic development may be not only linear regression models, but also other econometric models. New econometric models should be proposed after testing and validating with sound economic theory and econometric methodology. A previous version of this paper is published in Bulgarian language in the Economics and Computer Science journal in 2016. Due to great interest to it from different researchers, it is translated into English, revised and slightly shortened.