PHYSIOTHERAPY FOR PATIENTS WITH ACUTE MYOCARDIAL INFARCTION TREATED WITH THROMBOLYSIS

Myocardial infarction is the leading cause of death and disability worldwide. Bulgaria has increased the incidence of this disease and the average age is about 50 years old and suffers mostly males. The latest data [4, 8, 9, 10] rehabilitation of these patients reflects favorably on the quality of life. Numerous studies have shown that early conducting of cardiorehabilitation recovery, prevent future vascular incident, improved control of risk factors and improves the quality of life for patients with cardiovascular diseases [1, 5, 6]. It is generally accepted that the basis of the rehabilitation program in patients with AMI and held the PCI are dosed exercise. It includes training, control of risk factors, psychological and social assistance and exercise of low and moderate intensity [2, 3, 7]. Aim of the study is study the effect of the application of a comprehensive program for physical therapy in patients with acute myocardial infarction treated with thrombolysis.  Article visualizations

Изследване на екологическите дадености и културни ресурси за развитие на туризма в селските райони на България и Китай

The research target is to analyse the development degree of the rural tourism in all its varieties in Bulgaria and China, its role for achievement of a sustainable and diversified development, as well as to assess the synergic effects of the protection and restoration of the ecologic and cultural wealth and to create a tourist product for a sustainable and viable rural development. The study was made on the base of a detailed examination of the existing Bulgarian and foreign literature in the area of the sustainable development of the tourism in rural areas. The elaborated methodology provides a reliable and complex assessment of the synergy of tourism development in rural communities on the conservation, the sustainable use of ecological and cultural resources, as well as the contribution to the overall development of the local economy. In the scientific literature and the contemporary scientific thought more attention is paid to the strengths, natural and other conditions to be turned into a driving force for preserving and vitalising rural communities. The tourism is conceived as a sector with a special promising opportunity for the development of these territories. The formation of a sustainable and recognisable tourist product in rural areas is based on multiple elements: climate, locality, sand, sea, landscape, infrastructure, hospitality, life quality, life style, health and regional specificity. For the aims of the study has been chosen two pilot municipalities in Bulgaria – Strelcha and Hissarya. Both municipalities are neighbouring geographically, but belonging to two different administrative regions – Pazardzhik and Plovdiv. The economies of the two pilot municipalities although similar, show several differences as a result of different reasons, analysed in-depth. One feature in common for both pilot regions and one of the most significant resource for the tourism development in these municipalities is the hot mineral springs. The research of the situation and the opportunity of hot water use enable making analysis of the effects and contributions of this resource for the regions. It is established that both in Bulgaria and in China, according to the particularities, similar in nature but different in form and specificity approaches have been applied to create a sustainable tourism product by creating tourist clusters based on the regional resources of the regions, which will lead to the utilisation of potential touristic capital. Wonderful prerequisites are available, which should be examined in a long-term outlook, for Bulgarian natural conditions, specific for rural areas, to become an attractive tourist product for the growing and increasingly developing demand of the Chinese tourist industry and of the rising flow of Chinese travellers

Изследване на екологическите дадености и културни ресурси за развитие на туризма в селските райони на България и Китай

The research target is to analyse the development degree of the rural tourism in all its varieties in Bulgaria and China, its role for achievement of a sustainable and diversified development, as well as to assess the synergic effects of the protection and restoration of the ecologic and cultural wealth and to create a tourist product for a sustainable and viable rural development. The study was made on the base of a detailed examination of the existing Bulgarian and foreign literature in the area of the sustainable development of the tourism in rural areas. The elaborated methodology provides a reliable and complex assessment of the synergy of tourism development in rural communities on the conservation, the sustainable use of ecological and cultural resources, as well as the contribution to the overall development of the local economy. In the scientific literature and the contemporary scientific thought more attention is paid to the strengths, natural and other conditions to be turned into a driving force for preserving and vitalising rural communities. The tourism is conceived as a sector with a special promising opportunity for the development of these territories. The formation of a sustainable and recognisable tourist product in rural areas is based on multiple elements: climate, locality, sand, sea, landscape, infrastructure, hospitality, life quality, life style, health and regional specificity. For the aims of the study has been chosen two pilot municipalities in Bulgaria – Strelcha and Hissarya. Both municipalities are neighbouring geographically, but belonging to two different administrative regions – Pazardzhik and Plovdiv. The economies of the two pilot municipalities although similar, show several differences as a result of different reasons, analysed in-depth. One feature in common for both pilot regions and one of the most significant resource for the tourism development in these municipalities is the hot mineral springs. The research of the situation and the opportunity of hot water use enable making analysis of the effects and contributions of this resource for the regions. It is established that both in Bulgaria and in China, according to the particularities, similar in nature but different in form and specificity approaches have been applied to create a sustainable tourism product by creating tourist clusters based on the regional resources of the regions, which will lead to the utilisation of potential touristic capital. Wonderful prerequisites are available, which should be examined in a long-term outlook, for Bulgarian natural conditions, specific for rural areas, to become an attractive tourist product for the growing and increasingly developing demand of the Chinese tourist industry and of the rising flow of Chinese travellers

Емпирично изследване на управлението на услугите на агроекосистемите в България

The study is a report from the second stage of the research project "Management of agro-ecosystem services", funded by the Agricultural Academy - https://maessbg.alle.bg The approach developed during the first stage for analysis, evaluation and improvement of the management system of the agro-ecosystem services in the country has been tested. A survey with agricultural producers identified the size and type of "produced" services of agro-ecosystems of different types, and the dominant forms, factors and efficiency of management of agro-ecosystem services. Primary micro-information was collected from managers of 162 "typical" farms of different legal type, size, production specialization, ecological and geographical location. The main agro-regions and basic agroecosystems (plain, mountainous, protected areas, non-favored areas, etc.) are covered, as well as 12 main specific agroecosystems and their agro-ecosystems - Western Stara Planina, Central Balkans, Danube Plain, Stara Planina, Northeast Fore-Balkans, Struma River Valley, Rhodopes, Pernik Basin, Radomir Field, Sredna Gora, Sub-Balkans, Thracian Lowland and Southeastern Bulgaria. By grouping and summarizing the collected primary information, the structure and volume of agro-ecosystem services in the country and in the main types of agro-ecosystems are identified - geographical, basic and specific ecosystems, subsectors of agricultural production, size and legal type of farming organization. Share of participating producers and degree of participation in storage and supply were used as proxy indicators for production volume of the respective types of holdings. The connection between the main characteristics of farm managers (gender, age, education, farming experience, etc.) and their knowledge and application of the concept of agro-ecosystem services has been established. The main domestic, market, contractual, collective, tripartite, etc. are identified. forms of management of agro-ecosystem services of different types in general and depending on the type of agro-ecosystem and the agricultural producer. An in-depth study of the predominant forms of management of basic agro-ecosystem services such as providing external access to the farm, biodiversity conservation, plant pollination, bioproduction, etc. has been established, and a link with specialization, location, etc. has been established. characteristics of holdings. The effectiveness of the various forms of management of agro-ecosystem services has been established by assessing the direct and additional costs associated with the supply and management of agro-ecosystem services, as well as the direct, additional and indirect effects of their supply. The main behavioral, economic, institutional, natural, etc. are identified. factors that stimulate or limit the "production" of agro-ecosystem services by farmers. The intentions of the agricultural producers related to the protection of ecosystems and ecosystem services in the near future have also been determined. An in-depth analysis of the development and efficiency of organic production as one of the main forms of supply of agro-ecosystem services by Bulgarian farms. A multifaceted analysis of soils has been made as part of Bulgaria's agri-environmental resource, on the example of rural areas in the South Central region. The possibilities for using the sludge from the wastewater treatment plants as a form of agro-eco-service in support of agriculture have been assessed. The use of the customer value category in the management of agro-ecosystem services is analyzed. Summarized conclusions and proposals for improving the approach to scientific analysis and guidelines for improving public policies and forms of public intervention, and individual, business and collective strategies and actions for effective management of agro-ecosystems and services of agro-ecosystems of different types have been prepared

Холистичен подход за дефиниране, оценяване и подобряване на конкурентоспособността на земеделските стопанства в България

The report presents the results of the first stage of the research project "Competitiveness of agricultural farms in Bulgaria" funded by the Agricultural Academy and implemented by a team from the Institute of Agrarian Economics, UNWE, NBU and IPAZR "N. Pushkarov ”in Sofia. A holistic framework for understanding, evaluating, and improving the competitiveness of agricultural holdings in Bulgaria has been elaborated. The achievements of the interdisciplinary New Institutional Economics, Theory of Economic Organizations, Theory of Competitiveness and other scientific methods such as: study of literature and experience, summary, synthesis, design, comparative and institutional analysis, multicriteria analysis, groupings, discrete structural analysis, value -measuring, qualitative analysis, expert evaluation, survey, Shift-share Analysis, VTOPSIS and statistical analysis, localization analysis, etc. Numerous publications and experience in the country and the world for understanding and assessing the competitiveness of agricultural holdings have been studied. On this basis, a (more) adequate definition of the competitiveness of the farm is given, it is justified that it has four equally important pillars (economic efficiency, financial capability, adaptability and sustainability), and a hierarchical system is developed to assess its level consisting of adequate criteria, indicators and reference values, and an approach to integration and interpretation. The new evaluation system is being experimented with, using survey information from managers of "typical" farms of different types, production specializations and geographical locations. The theoretical bases of business models are summarized and an innovative model of competitiveness of agricultural holdings is developed. An approach to assessing market and factor competitiveness has been adapted and tested in the dairy sector. The regional differences in the competitiveness of agriculture in the EU countries have been identified. The competitive positions and forms of management of alternative farms in the conditions of the Kovid pandemic are assessed. The peculiarities in determining the competitiveness of organic farms are highlighted. The advantages of strategic partnerships and network structures as a tool for increasing the competitiveness of small and medium farms were assessed. The possibilities of the "new" forms of marketing (green, niche, sustainable, etc.) and digitalization to increase the competitiveness of farms are assessed. A regional analysis of agricultural holdings and employees in the South Central region was made. Alternative forms of financing agriculture from banks and leasing companies to improve the competitiveness of farms have been assessed. Conclusions and recommendations for improving public policies and farming strategies have been prepared. The performed activity and the achieved results in terms of volume and quality fully correspond (and exceed) the planned for all tasks. More information can be obtained from the project website https://cfb.alle.bg

OCT angiography - new views of the retina

Introduction: Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging technique that generates volumetric angiography images in a matter of seconds. Thanks to a special processing OCTA can produce images of capillary-level blood flow in the retina and choroid in a few seconds. The project seeks a correlation between Flow Density and Structural and Functional Chang­es in patients with normal tension, hypertensive glaucoma and suspected glaucoma.Materials and Methods: The technology allows the deeper structures to be visualized and even low microvascular flow to be detected with high sensitivity. OCTA is a fast, non-invasive, 3-D alternative to fluorescein angiography. The main aim of the method is to detect inside layers and intravascular flow. This method has a rapid scanning and real time eye tracking system. OCTA can be used for a lot of ophthalmologic diseases such diabetic retinopathy, arterial and venous occlusions, glaucoma. In the project 50 patients were examined (91 eyes) grouped as glaucoma, normal tension, and suspected. Using the OCT, Angio OCT methods and experimental software the flow density of the papilla and peripapillary area were calculated.Results: OCTA is a technology which extracts the signal changes derived from vascular flow using multiple OCT B scans acquired at the same position. It demonstrates high sensitivity for the detec­tion of low blood flow in microvasculature. The tracking system detects eye movements and blinks in­stantaneously and modifies the scan position to ensure complete scanning of all areas. The project es­tablished a strong correlation between peripapillary vascular density and the conducted research, one between vascular density and structural and functional changes in the optic nerve.Conclusion: Standard OCT structural imaging reveals micron-scale morphological changes in the retina while OCTA detects functional impairment in retinal and choroidal vasculature at the capil­lary level. The OCTA gives a chance to discover what lies beneath the surface

Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030 : a modelling study

Background Hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality worldwide. In the European Union (EU), treatment and cure of HCV with direct-acting antiviral therapies began in 2014. WHO targets are to achieve a 65% reduction in liver-related deaths, a 90% reduction of new viral hepatitis infections, and 90% of patients with viral hepatitis infections being diagnosed by 2030. This study assessed the prevalence of HCV in the EU and the level of intervention required to achieve WHO targets for HCV elimination. Methods We populated country Markov models for the 28 EU countries through a literature search of PubMed and Embase between Jan 1, 2000, and March 31, 2016, and a Delphi process to gain expert consensus and validate inputs. We aggregated country models to create a regional EU model. We used the EU model to forecast HCV disease progression (considering the effect of immigration) and developed a strategy to acehive WHO targets. We used weighted average sustained viral response rates and fibrosis restrictions to model the effect of current therapeutic guidelines. We used the EU model to forecast HCV disease progression (considering the effect of immigration) under current screening and therapeutic guidelines. Additionally, we back-calculated the total number of patients needing to be screened and treated to achieve WHO targets. Findings We estimated the number of viraemic HCV infections in 2015 to be 3\ue2\u80\u88238\ue2\u80\u88000 (95% uncertainty interval [UI] 2\ue2\u80\u88106\ue2\u80\u88000\ue2\u80\u933\ue2\u80\u88795\ue2\u80\u88000) of a total population of 509\ue2\u80\u88868\ue2\u80\u88000 in the EU, equating to a prevalence of viraemic HCV of 0\uc2\ub764% (95% UI 0\uc2\ub741\ue2\u80\u930\uc2\ub774). We estimated that 1\ue2\u80\u88180\ue2\u80\u88000 (95% UI 1\ue2\u80\u88003\ue2\u80\u88000\ue2\u80\u931\ue2\u80\u88357\ue2\u80\u88000) people were diagnosed with viraemia (36\uc2\ub74%), 150\ue2\u80\u88000 (12\ue2\u80\u88000\ue2\u80\u93180\ue2\u80\u88000) were treated (4\uc2\ub76% of the total infected population or 12\uc2\ub77% of the diagnosed population), 133\ue2\u80\u88000 (106\ue2\u80\u88000\ue2\u80\u93160\ue2\u80\u88000) were cured (4\uc2\ub71%), and 57\ue2\u80\u88900 (43\ue2\u80\u88900\ue2\u80\u9367\ue2\u80\u88300) were newly infected (1\uc2\ub78%) in 2015. Additionally, 30\ue2\u80\u88400 (26\ue2\u80\u88600\ue2\u80\u9342\ue2\u80\u88500) HCV-positive immigrants entered the EU. To achieve WHO targets, unrestricted treatment needs to increase from 150\ue2\u80\u88000 patients in 2015 to 187\ue2\u80\u88000 patients in 2025 and diagnosis needs to increase from 88\ue2\u80\u88800 new cases annually in 2015 to 180\ue2\u80\u88000 in 2025. Interpretation Given its advanced health-care infrastructure, the EU is uniquely poised to eliminate HCV; however, expansion of screening programmes is essential to increase treatment to achieve the WHO targets. A united effort, grounded in sound epidemiological evidence, will also be necessary. Funding Gilead Sciences