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Purposes: The aim of the study is to design and test a comprehensive technique based on strength training for posture correction. Materials and methods: This study was carried cohort of 37 men, aged 27,7±3,4 years old with kypholordotic posture. The program consisted of a set of exercises and exercises on a bicycle ergometer. The duration of the program was 16 weeks. Results were controlled by computer optical topography, motor tests, tests for strength endurance of abdominal muscles. For posture screening was used Posture Screen Mobile, motor tests, tests for strength endurance of abdominal muscles. Results: According to PSM, the indices of deviation of the lumbar spine decreased from 4,3 ± 0.5 to 2.0 ± 1,1 (p

Introduction: Vertebroplasty means the percutaneous introduction of polymethyl methacrylate into the vertebral bodies that have been weakened by osteoporosis or tumors. Many studies presenting the clinical experience with vertebroplasty and balloon kyphoplasty have been published in recent years. Some authors have reported a higher incidence of new fractures after balloon kyphoplasty and vertebroplasty. The natural course of osteoporosis progression, on the other hand, increases the risk of new fractures, increasing the total number of vertebral fractures. The Indications are:Vertebral compression fractures; Osteoporotic fractures; Metastatic bone tumors and the contraindications are: Infection of the fractured vertebra; Acute hemorrhagic diathesis; Known allergy to cement; Pregnancy Purpose: Our aim was to make a comparative analysis of the results after balloon kyphoplasty and vertebroplasty in patients with osteoporotic fractures of the thoracolumbar spine. Conclusion: Despite the statistically insignificant number of patients included in our series, our results emphasize the superiority of balloon kyphoplasia over vertebroplasia. The lack of complications and the immediate verticalization of our patients immediately after the end of the procedure makes us have more confidence in the balloon kyphoplasia procedure.

Orthopedic oncology surgery often requires, by its very nature, precise and often extensive resections of bone and soft tissue involved in or near the tumor mass. One of the most recent and promising innovations is represented by 3D printing technology, whose main advantage in this field of application is patient specificity, which is essential in an operation that requires high precision and maximum respect for the individuality of his bones and soft tissues. Material and methods: In the present report, we present a 4-year-old boy diagnosed with Ewing's sarcoma involving ¾ of the right tibia. In another medical facility, he was offered amputation. Our team decided to use the "3D printed tumor megaendoprosthesis, double growing, from the Czech company Prospon. For reinsertion of the muscle groups to the endoprosthesis, we used a LARS textile tube that was attached to the femoral and tibial components of the endoprosthesis. A vascular surgeon also participated in the team. The patellar ligament was reinserted to the tibial component, and myoplasty was additionally performed with the medial head of the m. gastrocnemius. Intraoperatively, we lengthened the lower limb by 1.5 cm to delay the upcoming staged lengthening. Results: The postoperative period was uneventful, with sutures removed on the 12th postoperative day. For 3 weeks, a tutor orthosis was placed. Active physiotherapy was started after removal of the orthosis 21 days after surgery. Conclusion: Our goal is to perform a total revision at the end of skeletal growth if possible and replace the current implant with a non-growing tumor megaendoprosthesis in the absence of near or distant metastases and long-term patient survival. Future expectations are that non-invasive lengthening mechanisms or a biological approach will be able to meet the special needs of this population.

In recent years, e-learning is increasingly being considered as a real alternative to traditional in many surgical specialties. In the present study, the concept of introducing an additional module for training in orthopedics and traumatology through mobile devices is presented and the need for the development and application of this and similar technologies to improve the results of the practical and theoretical training of medical students is motivated.

One of the main goals of sport activities, apart from improving the technical and tactical skills, general physical state, and etc., is building up and improving of personal qualities. Especially for studentssportsmen, mastering diverse professions, those qualities will not only support their sports career, but contribute to their future professional realization. A number of scientific researches prove the importance of personal qualities in these areas. Volitional qualities and personal anxiety are one of those defined as professionally significant. In this context, we have observed the level of development of the indicated qualities with male sportsmen, being a part of the representative basketball and volleyball UNWE teams and compared them. It would be needed to note that all students-sportsmen have their sports experience of five or more years. When studying the variability of volitional qualities and personal anxiety, the indicators for both studied contingents, are within the limits, defining them as relatively homogeneous. Exceptions are the volleyball players’ volitional qualities, whose results define the group as highly homogeneous. The average values of volitional indicator define students-sportsmen from both teams as personalities with "strong will", who can be relied on. Statistically significant differences when comparing the results were not found in both studied indications.

Purpose: To study the application of low-intensity physical veloergometric loads according to a special method in the system of rehabilitation of coronary heart disease patients (CHD) after coronary bypass (CB) at the hospital stage. Materials and Methods: We examined 84 patients (men) with CHD who underwent CB surgery: main group (n=52), the average age of 48.4 ± 0.8 years, the control group (n=32), the average age of 47.9 ± 1.11. All patients of the main group underwent exercises on a bicycle ergometer. The control group underwent rehabilitation without training but with a complex of therapeutic exercises. The following indicators are evaluated: the power of the threshold load in watt, Double product (DP), electrocardiography (ECG), heart rate (HR), respiratory rate (RR), blood pressure (BP). Results: Training sessions on a bicycle ergometer, according to a special technique, can be carried out as a method of rehabilitation at the stationary stage, rehabilitation center, at home. The best is the effect of training in the group of patients involved in the clinic before surgery and immediately after surgery with continued classes for a year. Conclusions: Analysis of the remote results shows that the use of physical training on this method makes it possible to improve the function of the myocardium and improve the prognosis of the disease.

Our aim was to present a rare case of tumor megaendoprosthetic replacement with restitution of the extensor mechanism of the knee via reattachment of the patellar tendon to the prosthesis and myoplasty with the medial head of gastrocnemius muscle.

With this report we decided to present the initial experience with the use of cement augmented screws in Cotrel-Dubousset fixation in cases of patients with degenerative spines in combination with severe osteoporosis. We present two patients who underwent treatment at UMHAT "Sv. Georgi ”, Plovdiv. The first is a 75-year-old woman who underwent right hip arthroplasty in 2002 with a Muller prosthesis. 14 years later (in 2016) due to implant ablation, a revision of the joint with a cementless, revision modular endoprosthesis of Metrimed was performed. In 2022, due to secondary degenerative scoliosis, the patient began to complain of pain in the lumbar spine, which required decompression and posterior fixation with cement augmented screws. The second patient was a 72 years old female and in September 2021 suffered an osteoporotic fracture at L4 level. Balloon kyphoplasty was performed at the same level. However, due to leakage of cement into the vertebral canal, it was necessary to decompress the canal and apply again the mentioned fixation system. The visual analog scale (VAS) was used to assess the effect of response to therapy. Both patients had no symptoms of nerve compression. Fenestrated screws were used in both cases.

Purpose: Adaptive stereotactic body radiation therapy (SBRT) for prostate cancer (PC) by the 1.5 T MR-linac currently requires online planning by an expert user. A fully automated and user-independent solution to adaptive planning (mCycle) of PC-SBRT was compared with user's plans for the 1.5 T MR-linac. Methods and Materials: Fifty adapted plans on daily magnetic resonance imaging scans for 10 patients with PC treated by 35 Gy (prescription dose [Dp]) in 5 fractions were reoptimized offline from scratch, both by an expert planner (manual) and by mCycle. Manual plans consisted of multicriterial optimization (MCO) of the fluence map plus manual tweaking in segmentation, whereas in mCycle plans, the objectives were sequentially optimized by MCO according to an a-priori assigned priority list. The main criteria for planning approval were a dose ≥95% of the Dp to at least 95% of the planning target volume (PTV), V33.2 (PTV) ≥ 95%, a dose less than the Dp to the hottest cubic centimeter (V35 ≤ 1 cm3) of rectum, bladder, penile bulb, and urethral planning risk volume (ie, urethra plus 3 mm isotropically), and V32 ≤ 5%, V28 ≤ 10%, and V18 ≤ 35% to the rectum. Such dose-volume metrics, plus some efficiency and deliverability metrics, were used for the comparison of mCycle versus manual plans. Results: mCycle plans improved target dose coverage, with V33.2 (PTV) passing on average (±1 SD) from 95.7% (±1.0%) for manual plans to 97.5% (±1.3%) for mCycle plans (P < .001), and rectal dose sparing, with significantly reduced V32, V28, and V18 (P ≤ .004). Although at an equivalent number of segments, mCycle plans consumed moderately more monitor units (+17%) and delivery time (+9%) (P < .001), whereas they were generally faster (–19%) in terms of optimization times (P < .019). No significant differences were found for the passing rates of locally normalized γ (3 mm, 3%) (P = .059) and γ (2 mm, 2%) (P = .432) deliverability metrics. Conclusions: In the offline setting, mCycle proved to be a trustable solution for automated planning of PC-SBRT on the 1.5 T MR-linac. mCycle integration in the online workflow will free the user from the challenging online-optimization task.

The normal functioning of the respiratory system is a leading factor, both for the survival of people caught in an aquatic environment in a marine casualty and for the effectiveness of the assistance activities. In view of this, in 2020 a team of researchers from Varna Medical University, the Naval Academy Varna and the Bulgarian Red Cross set out to study some physiological respiratory parameters and related anthropometric data of 51 individuals, 41 men and 10 women aged between 17 and 48 years of age. The subjects were divided into two groups: 1) trainees in the water rescue courses conducted at BRC-Varna and 2) 1st - year students of the Naval Academy. All participants in the study are non-smokers. The examination of the respiratory indicators is performed according to a standardized methodology with the same spirometer, which is able to measure and register over 30 indicators. Of these, three were analyzed in the present study: forced expiratory volume for 1 s (FEV1), forced vital capacity (FVC), and their FEV1/FVC percentage (Tiffeneau index). The results show that, according to anthropometric data, FVC and FEV1 are higher in water rescue trainees than in Naval Academy cadets. The Tiffeneau index is higher than the reference values ​​of the participants in both study groups, but the results are better in the group of naval cadets. As far as the functional capabilities of the respiratory system are essential for the activity of marine professionals, it can be assumed that the high results obtained from the spirometric examination of the participants from both groups are a prerequisite for higher efficiency of rescue operations and improvement of their personal safety. when working in a marine environment. The prospect is that after collecting a statistically significant amount of data combined with results obtained from other types of functional tests, to create better safety practices for people who are professionally engaged in maritime activities. As far as the functional capabilities of the respiratory system are essential for the activity of marine professionals, it can be assumed that the high results of the spirometric study in all study participants are a prerequisite for improving both their personal safety when working in the marine environment and for higher efficiency and success of rescue operations. The perspective is, after collecting a statistically significant volume of data and in combination with other functional studies, to create good practices to improve the safety systems of people in contact with the marine environment .

Often, in our daily round we hear expressions like „he is not concentrated enough“„he is not focused“, “he is very distracted“, and etc. All these expressions speak about the importance of quality attention, with its two forms – concentration and steadiness. Scientifically, these qualities are established as significant for a number of professions, and the good professional realization of people depends on their level of development. This is the one that motivated us to investigate these qualities with students - future economists from the UNWE and the possibility to establish the level of their development at the beginning of the educational year. We have set the task to compare these qualities between two groups of students – these from the educational groups on basketball from “Physical culture” subject and students from basketball representative team of the university. The average levels of concentration and steadiness of the attention of both aggregates have been investigated and established. The level of development and variability of indices of concentration and steadiness of attention with students has been defined. Values of the variation coefficient define the groups as comparatively homogeneous with both indications, excepting the steadiness of attention with basketball players, whose results for V% define the group as heterogeneous. Statistically reliable differences in the results have not been established on both investigated indications. Specific recommendations have been made for the future work with the educational groups and the representative basketball team of the UNWE, reporting the results got.

This is the first translation into Polish of the poem Skanderbeg of Grigor Stavrev Prličev. The translation was annotated with historical and literary notes.

Age-related macular degeneration is a leading cause of irreversible vision loss in individuals over 55 years of age worldwide. Conventionally, it is divided into two subtypes – dry (non-neovascular) and wet (neovascular) form. Neovascular age-related macular degeneration comprises only 10-15% of all patients but is responsible for more than 80% of blindness related to the disease. It requires early diagnosis and timely treatment. Fluorescein angiography is the current ‘gold standard’ for diagnosing neovascular forms. However, as an invasive procedure, it may be contraindicated in some circumstances and cause serious adverse effects. Optical coherence tomography-angiography is a relatively new, non-invasive and fast imaging modality gaining popularity in the diagnosis of age-related macular degeneration, especially for the neovascular form of the disease. It enables structural and functional information of blood vessels in the retina and choroid, without the need of an intravenous dye. In this study we present and discuss 3 cases of different subtypes of choroidal neovascularization secondary to neovascular age-related macular degeneration. All of them were examined by fluorescein angiography and optical coherence tomography-angiography. The results were qualitatively analyzed.

A method for the retrospective evaluation of the integrated activity concentration of 133Xe during radioxenon plumes and the moment of the plume’s center is proposed and explored by computer modeling. The concept is to use a specimen of polycarbonate material (a stack of Makrofol N foils of thickness 120 µm and 40 µm in 1 L non-hermetic Marinelly beaker) that is placed in the environment or in a controlled nuclear or radiopharmaceutical facility. On a regular basis or incidentally, the specimen may be retrieved and gamma spectrometry in two consecutive time intervals with durations of 8 h and 16 h is performed. To assess the performance of the method, 133Xe plumes of various integrated activity concentrations and with a duration of up to 10 h are simulated and analyzed, assuming that the measurement starts with a delay of up to one day after the moment of the plume center. It is found that the deviation between the estimates by the method and their true values are within a few percent. Depending on the delay, events of integrated 133Xe activity concentration 250–1000 Bq h m−3 might be qualitatively identified. At levels >10,000 Bq h m−3, the uncertainty of the quantitative estimates might be ≤10%.

In this article we present a web-based e-book used in educational context for teaching road safety to first grade students. The tool is a collection of situations that are presented in a game-based form. The players solve each situation in order to receive points. At the end of the course there is a final evaluation based on the training gaming situations. We use Unity game engine and WebGL for the development of the educational tool. In addition, the tool is cross-compiled for android mobile devices. We evaluate the learning effectiveness of the web-based tool via the t-test, analyze the results and draw conclusions. [ABSTRACT FROM AUTHOR]

Background: Mechanistic TCP (tumor control probability) models exist that account for possible re-sensitization of an initially hypoxic tumor during treatment. This phenomenon potentially explains the better outcome of a 28-day vs 14-day treatment schedule of HDR (high dose rate) brachytherapy of low- to intermediate-risk prostate cancer as recently reported. Methods: A TCP model accounting for tumor re-sensitization developed earlier is used to analyze the reported clinical data. In order to analyze clinical data using individual TCP model, TCP distributions are constructed assuming inter-individual spread in radio-sensitivity. Results: Population radio-sensitivity parameter values are found that result in TCP population values which are close to the reported ones. Using the estimated population parameters, two hypothetical regimens are investigated that are shorter than the ones used clinically. The impact of the re-sensitization rate on the calculated treatment outcome is also investigated as is the anti-hypothesis that there is no re-sensitization during treatment. Conclusions: The carried out investigation shows that the observed clinical data cannot be described without assuming an initially hypoxic state of the tumor followed by re-oxygenation and, hence, re-sensitization. This phenomenon explains the better outcome of the prolonged treatment schedule compared to shorter regimens based on the fact that prostate cancer is a slowly repopulating tumor.

CESEE countries have achieved substantial progress and their income and living standards have improved significantly since the beginning of transition. Nevertheless, convergence to high-income status is not assured. Strong demographic headwinds ahead and a subdued outlook for capital accumulation reinforce the need for productivity growth to converge to the income levels of advanced European countries. Better governance and institutions hold high promise to deliver the needed productivity growth, by spurring innovation, fostering competition, and retaining and attracting skilled workers. Keywords Convergence * Central and eastern Europe * Total factor productivity * Demographics * Innovation * Institutions JEL Classification E0 * E02 * E1, Introduction After a period of rapid income convergence across Central, Eastern, and Southeastern Europe (CESEE)' from the mid-1990s until the global financial crisis (GFC), convergence has slowed significantly. Now, with [...]