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Healthcare is an activity of great humanitarian and social importance. Good health is a right of every human being, an asset and a source of economic and social stability. The health status of the population is crucial for reducing poverty and at the same time contributes to sustainable territorial development. Despite the established principles of accessibility and equality in the use of medical assistance and the existence of a valid health card, our research has shown that the population has different access to facilities and centers for medical assistance at the regional and local level. The localization and concentration of healthcare facilities and all other elements of the healthcare system in the studied Nomenclature of territorial units for statistics (NUTS) 3 area—the Kyustendil region, Bulgaria—are tied to the largest ities in the region and the administrative centers of the municipalities. This poses a problem for the population from the remote settlements of the district, which has considerable difficulties in obtaining medical care even in emergency cases and in accessing specialized hospitals, laboratories, etc. The geographical characteristics of the area have a significant impact on the time needed to cover the distance between the villages and the towns where the health facilities are located. Hence the specific case study to solve this problem at the local and regional level. The conducted research tries to solve this case study, which was made in the studied area, but is also relevant for many other areas in Bulgaria. It is important to note that the Kyustendil region has very good indicators of health infrastructure and supply of health professionals, which make it one of the leading places in Bulgaria. However, part of the population of the district has very difficult access to the healthcare system, which is the main reason for the higher premature mortality due to diseases, especially among the population living in the villages. An in-depth spatial analysis of the territorial location of all elements of the health system and the provision of specialist doctors was carried out. The results obtained are visualized through graphics and a map created with GIS software.

To evaluate the association between asymptomatic hyperuricemia, renal damage and cardiovascular events and to investigate whether the presence of monosodium urate (MSU) deposits in the joints is related to more advanced renal changes and increased cardiovascular risk.

Introduction: Intimate partner violence (IPV) is a public health problem that impacts approximately one in three women worldwide in their lifetime. The purpose of the study was to explore the lived experiences of women teachers and violence in Kenya. It also explores the intersection between intimate partner violence, HIV risk, and gender inequality. Method: Data were collected through two focus groups of a total of 15 women teachers. We recruited women ages 21-44 from two geographically diverse urban and rural schools. The data were analyzed using a thematic analysis method to identify text themes and meaning patterns. Results: Three contextual experiences emerged: socio-cultural influences of gender norms, masculinity and patriarchy; uneven power dynamics; and institutionalized gender inequality. Discussion: Findings suggest that education alone is not sufficient to end GBV. Comprehensive and gender transformative governmental policy approaches are needed to mitigate GBV in Kenya.

Objective: To report the development and performance of 2 distinct deep learning models trained exclusively on retinal color fundus photographs to classify Alzheimer disease (AD). Patients and Methods: Two independent datasets (UK Biobank and our tertiary academic institution) of good-quality retinal photographs derived from patients with AD and controls were used to build 2 deep learning models, between April 1, 2021, and January 30, 2024. ADVAS is a U-Net–based architecture that uses retinal vessel segmentation. ADRET is a bidirectional encoder representations from transformers style self-supervised learning convolutional neural network pretrained on a large data set of retinal color photographs from UK Biobank. The models’ performance to distinguish AD from non-AD was determined using mean accuracy, sensitivity, specificity, and receiving operating curves. The generated attention heatmaps were analyzed for distinctive features. Results: The self-supervised ADRET model had superior accuracy when compared with ADVAS, in both UK Biobank (98.27% vs 77.20%; P

Introduction: The present study reports the first clinical experience with subcostal uniportal VATS (suVATS) compared with the conventional lateral uniportal VATS (luVATS) approach. Patients and Methods: All patients who underwent suVATS between January 2019 and April 2020 were included. Patients who had undergone luVATS for similar indications were included as the control group. The data were prospectively and retrospectively analysed. Results: The suVATS group included 38 patients with a mean age of 61 (30–83) years. The luVATS group included 33 patients (mean age, 69 years; range: 46–89 years). An intercostal block was performed intraoperatively in the luVATS group. Local infiltration under anaesthesia was performed around the incision in the suVATS group. The duration of the surgery was significantly longer in the suVATS group. However, the chest tube treatment and hospital stay duration were significantly shorter in the suVATS group. The routinely recorded Visual Analogue Scale scores on the first post-operative day and the day of discharge were significantly lower in the suVATS group. Conclusion: Subcostal uniportal VATS enables a shorter drainage treatment duration and hospital stay and significantly reduces post-operative pain. Thus, a faster patient recovery can be achieved.

Many swimming protists travel by actuating whip-like flagella to generate thrust. While many organisms’ flagella have been observed to have hair-like protrusions called mastigonemes, the function of these mastigonemes is not known. In particular, however, although theory, numerics, and some experiments suggest that mastigonemes can initiate the reversal in direction of thrust generated relative to the direction of traveling waves propagated along flagella, other experiments have found that they do not have hydrodynamic effects. Thus, it remains unclear whether mastigonemes have a hydrodynamic effect and function; additionally, any hydrodynamic effects may be species-dependent, which calls for the investigation of additional species. In this work, we report experimental observations of the cryptophyte C. paramecium that obtain their cell body, flagellar, and mastigoneme geometries, as well as their swimming kinematics and behavior. We then use the observed geometries and kinematics to numerically simulate swimming trajectories for a particularly well-characterized reorientation event, with and without various configurations of the mastigonemes. The comparison of numerical and experimental results shows that a configuration of mastigonemes in the beating plane best reproduces the observed reorientation dynamics, suggesting that in C. paramecium, although mastigonemes do not lead to gross changes in motility, such as thrust reversal, they do exert important quantitative effects.

Abstract Spontaneous symmetry breaking and emergent polar order are each of fundamental importance to a range of scientific disciplines, as well as generating rich phase behaviour in liquid crystals (LCs). Here, we show the union of these phenomena to lead to two previously undiscovered polar liquid states of matter. Both phases have a lamellar structure with an inherent polar ordering of their constituent molecules. The first of these phases is characterised by polar order and a local tilted structure; the tilt direction processes about a helix orthogonal to the layer normal, the period of which is such that we observe selective reflection of light. The second new phase type is anti-ferroelectric, with the constituent molecules aligning orthogonally to the layer normal. This has led us to term the phases the $${{{{{\rm{Sm}}}}}}{{{{{{\rm{C}}}}}}}_{{{{{{\rm{P}}}}}}}^{{{{{{\rm{H}}}}}}}$$ Sm C P H and SmAAF phases, respectively. Further to this, we obtain room temperature ferroelectric nematic (NF) and $${{{{{\rm{Sm}}}}}}{{{{{{\rm{C}}}}}}}_{{{{{{\rm{P}}}}}}}^{{{{{{\rm{H}}}}}}}$$ Sm C P H phases via binary mixture formulation of the novel materials described here with a standard NF compound (DIO), with the resultant materials having melting points (and/or glass transitions) which are significantly below ambient temperature. The new soft matter phase types discovered herein can be considered as electrical analogues of topological structures of magnetic spins in hard matter.

Objectives. This paper delves into the significance of media literacy for PR professionals, especially during crises. Ineffective media communication and poor strategic planning can erode trust, weaken stakeholder relations, and lead to social media crises and a loss of public legitimacy. Materials and Methods. The Cision Global State of Media Report (2022) reveals a decline in media trust and highlights journalists’ preferences for multimedia content. This study examines two crisis situations in Bulgaria: 1) NEXO, a leading digital asset management institution accused of fraud in the USA, and 2) TELUS International Bulgaria’s content moderation issues on Facebook. The focus is on communication techniques like official statements, press releases, and media interviews. The communication techniques used for media relations, like official statements, open letters, press releases, press conferences, and media interviews, are considered for the purposes of this publication. Results. There’s a noticeable gap in research on PR professionals’ media and digital literacy. The NEXO case underscores the challenge journalists face in understanding crises in specialized sectors and the importance of PR specialists in conveying complex information. The TELUS case highlights failures in crisis communication, ineffective diversion tactics, and improper handling of accusations. Conclusions. PR professionals must prioritize the media and journalists during significant public crisies. While media communication practices are evolving in the digital age, the relationship between journalists and PR experts is crucial, yet strained by factors like mistrust and poor communication. Both parties play a pivotal role in shaping public discourse during crisies and have an ethical duty to provide clarity to society.

Aim: The aim of this study was to assess the usefulness of bioimpedance analysis in fluid status evaluation in patients with sepsis and septic shock admitted to the adult ICU. Materials and methods: This is a prospective, observational, clinician-blind study. The inclusion criteria were a diagnosis of sepsis at admission to ICU, a stay in ICU of at least 72 hours, and the first BIA measurement to be conducted within the first three hours of ICU admission. We took whole-body BIA measurements upon admission and every 24 hours thereafter for at least four consecutive measurements. All enteral and parenteral fluids administered to the patients were recorded, as well as the loses through drains, tubes, aspiration, and urine. The cumulative fluid balance (CFB) was calculated every 24 hours. Results: A total of 51 patients with a mean age of 62 years were included in the final analysis. CFB gradually increased during the first 72 hours of ICU stay from 2003±1331 mL at 24 hours to 3680±2368 mL at 48 hours and 5217±2642 mL at 72 hours. There was a statistically significant positive correlation between the increase in CFB and the increase in total body water, extracellular water, and overhydration. The daily changes of vector length and impedance ratio, as well as the overall 72-hour changes showed statistically significant correlation with the CFB. Conclusion: Bioimpedance analysis is a non-invasive, easy-to-use, inexpensive, portable, and fast tool for fluid status assessment. In critically ill septic patients it can be a useful tool in fluid therapy management.

Pityriasis lichenoides is a rare inflammatory skin condition presenting with diffuse red-brown papules with evolution polymorphism and mica-like crust on older skin lesions. We present a 60-year-old female patient with pityriasis lichenoides chronica that manifested ten days after streptococcal pharyngitis. Initially, palpable purpura appeared on the lower extremities and later, erythematous-squamous papules and plaques appeared at the site of the palpable purpura and on the upper limbs and trunk. The patient had no history of hematological malignancy, viral hepatitis, kidney involvement, systemic rheumatic disease, or ANCA-associated vasculitis. After administration of methylprednisolone 20 mg for one month and an antimalarial agent (hydroxychloroquine 200 mg, 1 tablet bid) for three months, the skin lesions subsided without recurrence.

The large amount of excess adipose tissue affects negatively every single step of the assisted reproductive treatment process – from the controlled ovarian hyperstimulation (COH) to obstetric complications and health consequences for the fetus. A number of scientific data show correlation between impaired clinical pregnancy rates (CPR) and obese patients maintaining high body mass index (BMI). The debate whether high proportion of body fat negatively affects oocyte quality or only impacts endometrial receptivity remains open.

Loop-mediated isothermal amplification (LAMP) has received increased attention as a sensitive and fast molecular technique that could be applied at the site of need. The LAMP has been shown to specifically detect a variety of bacterial and viral infections as a promising point-of-care (POC) test. LAMP has recently demonstrated sensitivity and specificity comparable to or nearly equal to polymerase chain reaction in SARS-CoV-2 detection. The main advantages of LAMP are its application in low-income or remote areas where there are no specialized laboratories or molecular specialists. In the following mini-review we discuss the potential of LAMP as a POC molecular diagnostic method. Moreover, we summarized its validated application and future challenges.

Abstract Background Autism Spectrum Disorder (ASD) is a group of neurodevelopmental disorders with higher incidence in males and is characterized by atypical verbal/nonverbal communication, restricted interests that can be accompanied by repetitive behavior, and disturbances in social behavior. This study investigated brain mechanisms that contribute to sociability deficits and sex differences in an ASD animal model. Methods Sociability was measured in C58/J and C57BL/6J mice using the 3-chamber social choice test. Bulk RNA-Seq and snRNA-Seq identified transcriptional changes in C58/J and C57BL/6J amygdala within which DMRseq was used to measure differentially methylated regions in amygdala. Results C58/J mice displayed divergent social strata in the 3-chamber test. Transcriptional and pathway signatures revealed immune-related biological processes differ between C58/J and C57BL/6J amygdala. Hypermethylated and hypomethylated genes were identified in C58/J versus C57BL/6J amygdala. snRNA-Seq data in C58/J amygdala identified differential transcriptional signatures within oligodendrocytes and microglia characterized by increased ASD risk gene expression and predicted impaired myelination that was dependent on sex and sociability. RNA velocity, gene regulatory network, and cell communication analysis showed diminished oligodendrocyte/microglia differentiation. Findings were verified using Bulk RNA-Seq and demonstrated oxytocin’s beneficial effects on myelin gene expression. Limitations Our findings are significant. However, limitations can be noted. The cellular mechanisms linking reduced oligodendrocyte differentiation and reduced myelination to an ASD phenotype in C58/J mice need further investigation. Additional snRNA-Seq and spatial studies would determine if effects in oligodendrocytes/microglia are unique to amygdala or if this occurs in other brain regions. Oxytocin’s effects need further examination to understand its’ potential as an ASD therapeutic. Conclusions Our work demonstrates the C58/J mouse model’s utility in evaluating the influence of sex and sociability on the transcriptome in concomitant brain regions involved in ASD. Our single-nucleus transcriptome analysis elucidates potential pathological roles of oligodendrocytes and microglia in ASD. This investigation provides details regarding regulatory features disrupted in these cell types, including transcriptional gene dysregulation, aberrant cell differentiation, altered gene regulatory networks, and changes to key pathways that promote microglia/oligodendrocyte differentiation. Our studies provide insight into interactions between genetic risk and epigenetic processes associated with divergent affiliative behavior and lack of positive sociability.

African swine fever is a transmissible virus impacting wild and domestic swine populations. In Europe, it is non-native and the recently introduced genotype affects wild boar populations with occasional outbreaks in domestic pigs. The ability to predict short-term spatial dynamics of this disease will greatly improve our ability to control and limit future spread of the virus. The BioDT disease outbreaks prototype, currently in development, implements an individual-based landscape-level mechanistic model as a digital twin aimed at providing informed support for management decisions in response to the spread of African swine fever in European wild boar populations.

Purpose: This article presents the theoretical framework, research design, methodology, and main findings of the comparative measurement of ethical-moral competences of 15-year-old upper secondary students in Shanghai, under the ETiK-International-Shanghai project. Design/Approach/Methods: By dividing the ethical-moral competences into the categories of basic ethical-moral knowledge, ethical-moral judgment competence, and competence in developing ethical-moral action plans, a survey of 2,036 students was conducted, using a reliable and valid testing instrument. Findings: In general, 15-year-olds from homes with more educational resources perform higher in all three scales across all countries taken under consideration in our study. Furthermore, school practices, teaching, as well as quantity and quality of instruction play a very important role in the moral education process and especially in developing students' proficiency levels of ethical-moral knowledge, reasoning competence, as well as students' high abilities in developing moral action plans. When relevant educational background factors are held constant, Chinese students show lower average scores on basic ethical-moral knowledge and moral judgment competence. With exception of the tested Vienna students, all other European samples scored better than the Chinese students--also on the test for developing ethical-moral action plans. However, Chinese students are especially able to display outstanding empathy when dealing with suffering, misfortune, and sorrow, as well as in their willingness to help others. Originality/Value: The findings of this article can foster thinking about which topics should be further discussed to improve the ethical-moral knowledge and competences of Chinese students and highlight requirements for the further development of moral education in China at the levels of teaching, curriculum, teacher education, and research.

Introduction: Children with Cerebral Palsy (CP) encounter substantial nutritional challenges that impair their health and quality of life. Despite the importance of nutrition in managing CP and the recognition of physiological, behavioral, and social causes of malnutrition, research on the effectiveness of individualized nutritional interventions developed and supported by multidisciplinary teams is scarce. Aim: The study will evaluate the impact of an individualized nutritional intervention developed and supported by a multidisciplinary team on the anthropometric outcomes and overall health of children with CP. Methods: A single-center, randomized controlled trial, conducted at the Medical University of Varna, Bulgaria, will enroll 100 children aged 2–12 years and diagnosed with CP. Participants will be randomly assigned to either an intervention group, receiving comprehensive structured dietary assessment and individualized nutrition plan developed by a multidisciplinary team of experts, or to a standard care group. Outcomes assessed will focus on anthropometric measures of nutritional status, but also include health outcomes, child development and clinical assessments, and quality of life indicators. Ethics: Ethical approval for this study has been obtained from the Medical Ethics Committee at the Medical University of Varna (Protocol No. 134 dated 20.07.2023). Conclusion: This study will assess the benefits of a multidisciplinary, individualized nutritional intervention for children with CP. The findings will have implications for clinical guidelines and interventions aiming to improve their care and quality of life.

In this article we discuss achievement badges as a way to motivate students’ learning process. We present an experiment that includes two groups of students, enrolled in an online mathematics course for a one-month period. The article illustrates the results and effects of using badges in e-learning.

Abstract Background The purpose of this study was to interrogate brain iron accumulation in participants with acute post-traumatic headache (PTH) due to mild traumatic brain injury (mTBI), and to determine if functional connectivity is affected in areas with iron accumulation. We aimed to examine the correlations between iron accumulation and headache frequency, post-concussion symptom severity, number of mTBIs, and time since most recent TBI. Methods Sixty participants with acute PTH and 60 age-matched healthy controls (HC) underwent 3T magnetic resonance imaging including quantitative T2 * maps and resting-state functional connectivity imaging. Between group T2 * differences were determined using T-tests (p

Abstract Heavy maternal alcohol drinking during pregnancy has been associated with altered neurodevelopment in the child but the effects of low-dose alcohol drinking are less clear and any potential safe level of alcohol use during pregnancy is not known. We evaluated the effects of prenatal alcohol on reward-related behavior and substance use in young adulthood and the potential sex differences therein. Participants were members of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) prenatal birth cohort who participated in its neuroimaging follow-up in young adulthood. A total of 191 participants (28–30 years; 51% men) had complete data on prenatal exposure to alcohol, current substance use, and fMRI data from young adulthood. Maternal alcohol drinking was assessed during mid-pregnancy and pre-conception. Brain response to reward anticipation and reward feedback was measured using the Monetary Incentive Delay task and substance use in young adulthood was assessed using a self-report questionnaire. We showed that even a moderate exposure to alcohol in mid-pregnancy but not pre-conception was associated with robust effects on brain response to reward feedback (six frontal, one parietal, one temporal, and one occipital cluster) and with greater cannabis use in both men and women 30 years later. Moreover, mid-pregnancy but not pre-conception exposure to alcohol was associated with greater cannabis use in young adulthood and these effects were independent of maternal education and maternal depression during pregnancy. Further, the extent of cannabis use in the late 20 s was predicted by the brain response to reward feedback in three out of the nine prenatal alcohol-related clusters and these effects were independent of current alcohol use. Sex differences in the brain response to reward outcome emerged only during the no loss vs. loss contrast. Young adult men exposed to alcohol prenatally had significantly larger brain response to no loss vs. loss in the putamen and occipital region than women exposed to prenatal alcohol. Therefore, we conclude that even moderate exposure to alcohol prenatally has long-lasting effects on brain function during reward processing and risk of cannabis use in young adulthood.

This review elucidates the role of dietary factors in influencing myokine secretion, complementing the recognized benefits of physical activity on metabolic health. While exercise is known to positively modulate myokines, contributing to their health-promoting effects, an exploration into how diet affects these critical cytokines remains sparse. Through analysis of the literature, this work identifies dietary patterns that markedly affect myokine levels, underscoring the complex relationship between nutrition and myokine activity. The investigation reveals that specific dietary approaches can profoundly alter myokine secretion, suggesting an essential avenue for combined dietary and exercise interventions to optimize health outcomes. These insights highlight the need for further detailed study into diet-induced myokine modulation.

Abstract Background Frailty is a suggested consequence of ageing, but with a variety of different definitions the understanding of what it means to be frail is challenging. There is a common belief that frailty results in a reduction of physical functioning and ability and therefore is likely to significantly affect a person’s quality of life. The aim of this study was to explore the understanding of older people about the meaning of frailty and the potential consequences of being classified as frail. Methods This paper forms a secondary analysis of a process evaluation of a complex intervention that was embedded within the individually randomised Home-based Extended Rehabilitation of Older people (HERO) trial. A maximum variation, purposive sampling strategy sought to recruit participants with a wide range of characteristics. Data collection included observations of the delivery of the intervention, documentary analysis and semi-structured interviews with participants. Thematic analysis was used to make sense of the observational and interview data, adopting both inductive and deductive approaches. Results Ninety three HERO trial participants were sampled for the process evaluation with a total of 60 observational home visits and 35 interviews were undertaken. There was a wide range in perceptions about what it meant to be classified as frail with no clear understanding from our participants. However, there was a negative attitude towards frailty with it being considered something that needed to be avoided where possible. Frailty was seen as part of a negative decline that people struggled to associate with. There was discussion about frailty being temporary and that it could be reduced or avoided with sufficient physical exercise and activity. Conclusion Our study provides insight into how older people perceive and understand the concept of frailty. Frailty is a concept that is difficult for patients to understand, with most associating the term with an extreme degree of physical and cognitive decline. Having a label of being “frail” was deemed to be negative and something to be avoided, suggesting the term needs to be used cautiously. Trial registration ISRCTN 13927531. Registered on April 19, 2017.

In the period from 1955 to 1992, uranium ore was mined and processed in the Mesta River basin around the village of Eleshnitsa, region of Razlog. The ore processing plant was built and a tailings storage facility was built next to it. In the period 2002–2006, the tailings storage was reclaimed, and in 2011–2012 the ore mines were also reclaimed. For the treatment of drainage water, a treatment plant was built in the valley of Valchoto Dere River, a left tributary of the Mesta River. The radiological monitoring carried out by the Basin Directorate “West Aegean Sea Region” reveals a generally good quality of the surface waters in terms of the content of uranium and radium (226Ra) outside the area of the former uranium mining and the tailings storage facility. In this area, in some years a high content of natural uranium was found, with concentrations from 0.54 to 67.40 mg/l on average per year. The values significantly exceed (by 1.8 to 224.6 times) the norm regulated in the regulation for radiation protection and safety from the liquidation of the consequences of uranium mining. The spread of uranium is limited to a small area shortly downstream from the sources of contamination, but the potential risk to the local ecosystem should not be neglected. Radium, in contrast to uranium, has concentrations below the permissible limits in the twelve years studied. Its content varied from 0.025 to 0.11 Bq/l on average annually. The results show that the Mesta River near the border with the Republic of Greece is not contaminated with the studied radionuclides.

The aim of the present study was to investigate in-depth the dietary intake of vitamin D of subjects with different BMI in relation to serum vitamin D status. The survey covered 264 individuals, aged 19 to 60 years. Vitamin D deficiency was found in 33.3% of the participants and 40.2% showed evidence of insufficient vitamin D intake. It was established that the daily average dietary intake of vitamin D among the whole group of subjects was 6.6 μg/day (women – 5.6 μg/day, men – 10.4 μg/day). We found significant correlations between daily average dietary intake of vitamin D and weight, % body fat, fat mass, visceral fat (in women), muscle and fat-free mass, and height-adjusted indices: fat mass index and fat-free mass index, total body water and some metabolic variables (basal insulin and high sensitivity C-reactive protein). The survey revealed that the dietary intake of vitamin D of the respondents was insufficient.

A new type of virus, SARS-CoV-2, has spread globally throughout the world. The COVID-19 epidemic rapidly spread worldwide. The health care system, society and medical professionals have prepared to adapt, train and resist the increased psychosocial pressure. In this situation, the role and place of medical professionals has become noticeably more prominent, and the psychosocial stress of the work environment has increased its impact – progressing to high levels of harmful intensity towards the medical professionals. Focusing within the borders of Bulgaria, it can be argued that the initial two waves of high levels of COVID-19 prevalence were difficult and critical to overcome. The aim of our study is to investigate the impact of psychosocial stress on the functional status examined with the response of arterial blood pressure of nurses, practicing long-term care in hemodialysis clinics and centers during exposure to COVID-19 pandemic. A study was conducted on the subjective assessment of psychological and social risk factors, and arterial systolic and diastolic blood pressure in 2018-2019 (pre-COVID-19 period) and 2020 (COVID-19 period), respectively. The methods used were the NIOSH questionnaire – to assess psychosocial stress at work and to measure blood pressure with a sphygmomanometer. The results showed that the expansion of psychosocial risks from the work environment impacted on the functional status of nurses, with an increase in the level of social support and systolic blood pressure during the COVID-19 compared to the pre-COVID-19 period, and a decrease in the level of control when comparing the same periods. We will monitor and observe these effects with concern in order to respond in a timely manner with effective and practical strategies, policies and programs to counter and prevent psychosocial stress in the workplace. One of the outlined guiding goals and trends for this will be to both preserve and prolong the work life of nurses and to reposition them as a key and significant group for the healthcare system.

In the 2021 WHO classification of Tumors of the Central Nervous System, additional molecular characteristics have been included, defining the following adult-type diffuse glioma entities: Astrocytoma IDH-mutant, Oligodendroglioma IDH-mutant and 1p/19q-codeleted, and Glioblastoma IDH-wildtype. Despite advances in genetic analysis, precision oncology, and targeted therapy, malignant adult-type diffuse gliomas remain ''hard-to-treat tumors'', indicating an urgent need for better diagnostic and therapeutic strategies.In the last decades, miRNA analysis has been a hotspot for researching and developing diagnostic, prognostic, and predictive biomarkers for various disorders, including brain cancer. Scientific interest has recently been directed towards therapeutic applications of miRNAs, with encouraging results.Databases such as NCBI, PubMed, and Medline were searched for a selection of articles reporting the relationship between deregulated miRNAs and genetic aberrations used in the latest WHO CNS classification.The current review discussed the recommended molecular biomarkers and genetic aberrations based on the 2021 WHO classification in adult-type diffuse gliomas, along with associated deregulated miRNAs. Additionally, the study highlights miRNA-based treatment advancements in adults with gliomas.

Ziziphus jujuba has been used since ancient times in traditional Eastern medicine. It is widely cultivated in numerous countries between the tropical and temperate climatic zones due to its high ecological plasticity and resilience to adverse weather. The different classes of chemical compounds contained in the plant are the reason for its medicinal properties. Research shows that every part of Ziziphus jujuba, the leaves, fruits and seeds, demonstrate therapeutic properties. This review focuses on the chemical composition in order to establish the relationship between the plant and its clinical use. Various biological effects are summarized and discussed: anticancer, anti-inflammatory, immunostimulating, antioxidant, hepatoprotective, gastrointestinal, etc. Apart from medicinal uses, the fruits of Ziziphus jujuba are edible and used in fresh and dried form. This literature review reveals possible medical applications of Ziziphus jujuba and its great potential for improving the diet of people in areas where the plant is abundant.

Rosai-Dorfman (RDD) is a rare histiocytic syndrome with variable clinical characteristics and extranodal involvement in more than 43% of the patients. This mini-review presents an overview of the literature on Rosai-Dorfman disease. The histological features and the current understanding of the management and prognosis are discussed. A case of a 61-year-old patient with a rare diagnosis of Rosai-Dorfman disease is also presented, as well as the process of its setting and treatment. The diagnosis is set by extensive radiologic and interventional procedures, including multiple biopsies, morphological examinations, and imaging techniques. Most important for the diagnosis appeared to be the pathology showing characteristic features of Rosai-Dorfman disease in the intra-abdominal lymph nodes performed twice showing characteristic extensive fibrosis. In addition, multiple dilated sinuses were filled with macrophages and histiocytes while the immunohistochemical examination pointed very likely to RDD with increased amount of plasma cells.

ABSTRACTPurified subunit viral antigens are weakly immunogenic and stimulate only the antibody but not the T cell-mediated immune response. An alternative approach to inducing protective immunity with small viral peptides may be the targeting of viral epitopes to immunocompetent cells by DNA and protein-engineered vaccines. This review will focus on DNA and protein-generated chimeric molecules carrying engineered fragments specific for activating cell surface co-receptors for inducing protective antiviral immunity. Adjuvanted protein-based vaccine or DNA constructs encoding simultaneously T- and B-cell peptide epitopes from influenza viral hemagglutinin, and scFvs specific for costimulatory immune cell receptors may induce a significant increase of anti-influenza antibody levels and strong CTL activity against virus-infected cells in a manner that mimics the natural infection. Here we summarize the development of several DNA and protein chimeric constructs carrying influenza virus HA317–41 fragment. The generated engineered molecules were used for immunization in intact murine and experimentally humanized NSG mouse models.

Abstract The growing sector of dairy industry in Bulgaria leads to large waste stream formation with high pollution variation, which require specific treatment application. In the present research different fractions and wash waters from the production of kashkaval and white brined cheese, milk curd, strained yoghurt manufactured in three medium-type Bulgarian milk processing plants were studied. The basic indicators for wastewater quality: total solids (TS), total suspended solids (TSS), active reaction, fat, oil and grease (FOG), 5-day biological oxygen demand (BOD5), chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) were analysed by standard procedures. The obtained results indicate that kashkaval whey from the sheep’s milk processing was the most contaminated effluent, reaching COD more than 68,000 mg O2/dm3 and BOD5 - up to 37,000 mg O2/dm3. Such high concentrated wastewaters can be treated only by anaerobic methods. Secondary cheese whey (SCW) has less impurities than cheese whey, but its soluble milk fractions are difficult to biodegrade, resulting in BOD5:COD ratio lower than 0.40. Application of membrane technologies in milk co-product processing remove totally FOG from the SCW, where BOD5 and COD values are around 950 and 2.500 mg O2/dm3, respectively. However, the TN concentration in it is not enough to apply directly aerobic utilization. This method is the most appropriate for washing waters, which occupy both the largest volume and the cleanest fractions of all milk effluents. Future combinations of different dairy wastewaters will show the best utilization protocol for each of the milk processing plant.