Electronic Prescription: The Attitude of Pharmacists After Its Introduction in Bulgaria

Electronic health care, as a global trend, entered Bulgaria as well. Since June 1, 2021, the prescription and dispensing of medicines, medical devices, and foods for special medical purposes, paid in full or in part by the National Health Insurance Fund (NHIF), is carried out only with an electronic prescription. The e–prescription is a medical document that is issued by a doctor with the help of medical software that is integrated into the National Health Information System. The goal is to make patients, doctors, and pharmacists as comfortable as possible and to make fewer mistakes when prescribing and dispensing medicines.Aim: To study and analyze the pharmacist's opinion on their work with electronic prescriptions one year after their introduction in Bulgaria.Methods and materials: Documentary method, sociological method, statistical method.Results: The majority of pharmacists—82.7%—share that the introduction of electronic prescription has facilitated their work in dispensing medicines, medical devices, and foods for special medical purposes, paid in full or in part by the NHIF. 71.2% of the respondents report making fewer mistakes when filling out electronic prescriptions in comparison to paper prescription forms

Synergistic integration of optical and microwave satellite data for crop yield estimation

Developing accurate models of crop stress, phenology and productivity is of paramount importance, given the increasing need of food. Earth observation (EO) remote sensing data provides a unique source of information to monitor crops in a temporally resolved and spatially explicit way. In this study, we propose the combination of multisensor (optical and microwave) remote sensing data for crop yield estimation and forecasting using two novel approaches. We first propose the lag between Enhanced Vegetation Index (EVI) derived from MODIS and Vegetation Optical Depth (VOD) derived from SMAP as a new joint metric combining the information from the two satellite sensors in a unique feature or descriptor. Our second approach avoids summarizing statistics and uses machine learning to combine full time series of EVI and VOD. This study considers two statistical methods, a regularized linear regressionand its nonlinear extension called kernel ridge regression to directly estimate the county-level surveyed total production, as well as individual yields of the major crops grown in the region: corn, soybean and wheat. The study area includes the US Corn Belt, and we use agricultural survey data from the National Agricultural Statistics Service (USDA-NASS) for year 2015 for quantitative assessment. Results show that (1) the proposed EVI-VOD lag metric correlates well with crop yield and outperforms common single-sensor metrics for crop yield estimation; (2) the statistical (machine learning) models working directly with the time series largely improve results compared to previously reported estimations; (3) the combined exploitation of information from the optical and microwave data leads to improved predictions over the use of single sensor approaches with coefficient of determination R 2 ≥ 0.76; (4) when models are used for within-season forecasting with limited time information, crop yield prediction is feasible up to four months before harvest (models reach a plateau in accuracy); and (5) the robustness of the approach is confirmed in a multi-year setting, reaching similar performances than when using single-year data. In conclusion, results confirm the value of using both EVI and VOD at the same time, and the advantage of using automatic machine learning models for crop yield/production estimation

THE COMMUNICATIVE SKILLS IN ENGLISH LANGUAGE AND THEIR FOMRATION IN THE PRIMARY SCHOOL

The formation of English language communicative skills in the primary education is a very thematic subject that has its particularities. In an early stage of the child`s life, children accept their foreign language learning as a game, which implies a similar way of organizing the learning process to acquire knowledge and skills. It is curiosity that forces the elementary students to explore the reality of the environment, the objects and, with the help of the game, gain new knowledge. Children's communicative skills at this period evolve through simulations, role plays, songs, ready constructive phrases, and situations. A key factor in the level of learning remains the child`s personal activity and engagement in the process. This provokes our search for opportunities to stimulate precisely this motivated activity

Effects of the EU Common Agricultural Policy on the Development of Farms

The results of a study are outlined here, aiming at assessment of the effects of EU CAP measures and tools on farms of various structures and degrees of specialization, on the grounds of a comparative analysis. The study is based on three surveys, carried out in 2007 and 2008; on data on the economic results of the monitored farms, listed in the Agricultural and Accounting Information Management System; and on official statistical information. It covers the effect of each CAP measure and tool on the structural changes, the levels of revenues, productivity and effectiveness of the industries, market orientation, farm cooperation and integration processes.

Direct Payments and Development of Agricultural Companies in Bulgaria

The study discusses an extremely actual problem of the expected changes in the state and development perspectives of the agricultural companies under the influence of the already negotiated support mechanisms by the Common Agricultural Policy (CAP) of EU. Using the developed methodological approach and based on analysis is outlined the influence, which the direct payments will have on the economic state and sustainability of the agricultural companies, and the incomes of rural households. The study is carried out by typology of the agricultural companies, in order to count the different impact and the multi-directional effect of the CAP implementation. The directions of restructuring of the agricultural companies depending on their specialization, size and juridical status are also outlined.

Developmental brain lipidomics is influenced by postnatal chlorpyrifos exposure and APOE genetic background in mice

Lipids are a major component of the brain, and are involved in structural and neurodevelopmental processes such as neuro- genesis, synaptogenesis and signaling. Apolipoprotein E (apoE) is the main lipoprotein involved in lipid transport in the brain. The apoE isoforms can determine vulnerability to the toxic effects of the pesticide chlorpyrifos (CPF), which can interfere with normal neurodevelopment. We aimed to study the effects of postnatal exposure to CPF and of the APOE genotype on the lipid composition of the brain at early ages. For it, we used apoE3 and apoE4 targeted-replacement (TR) male mice, as well as wild-type C57BL/6. The mice were orally exposed to 1 mg/kg/day of CPF on postnatal days 10-15 and, four hours after the treatment, we obtained samples to assess the cerebral lipid composition. Differences between APOE genotypes were found in the cerebral lipid profile in the postnatal period. ApoE4-TR mice exhibited higher lipid concentrations compared to the other groups in most of the cases. CPF exposure led to a decrease in cholesteryl ester and triglyceride concentrations, while modulating the levels of phosphatidylcholine species based on the apoE isoform. Specifically, CPF treatment decreased the concentration of some species of this lipid (PC30:0, PC31:0, PC32:2, PC36:5, PC40:4 and PC40:5) in C57BL/6 mice exposed to CPF, increased (PC31:0 and PC37:6) in apoE3-TR exposed mice while exposed apoE4-TR mice remained unal- tered. These results provide further insights into the lipid composition of the brain at early ages, and how it can be modulated by environmental and genetic factors

Health-Related Quality of Life following Surgery for Native and Prosthetic Valve Infective Endocarditis

Objectives: The objective of this study was to compare the long-term outcomes and health-related quality of life (HRQOL) of patients following surgery for infective native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). Methods: We retrospectively identified 633 consecutive patients who had undergone surgery for infective endocarditis at our center between January 2005 and October 2018. The patients were interviewed, and the SF-36 survey was used to assess the HRQOL of survivors. Propensity score matching (2:1) was performed with data from a German reference population. Multivariable analysis incorporated binary logistic regression using a forward stepwise (conditional) model. Results: The median age of the cohort was 67 (55–74) years, and 75.6% were male. Operative mortality was 13.7% in the NVE group and 21.6% in the PVE group (p = 0.010). The overall survival at 1 year was 88.0% and was comparable between the groups. The physical health summary scores were 49 (40–55) for the NVE patients and 45 (37–52) for the PVE patients (p = 0.043). The median mental health summary scores were 52 (35–57) and 49 (41–56), respectively (p = 0.961). On comparison of the HRQOL to the reference population, the physical health summary scores were comparable. However, significant differences were observed with regard to the mental health summary scores (p = 0.005). Conclusions: Our study shows that there are significant differences in the various domains of HRQOL, not only between NVE and PVE patients, but also in comparison to healthy individuals. In addition to preoperative health status, it is important to consider the patient’s expectations regarding surgery. Further prospective studies are required

Molecular Epidemiology of Rotavirus in Central and Southeastern Europe▿

A surveillance network was implemented by the Istituto Superiore di Sanità of Rome in collaboration with laboratories of virology in Czech Republic, Slovenia, Croatia, Albania, and Bulgaria. About 1,500 rotavirus-positive stool samples were collected from children with severe gastroenteritis admitted to hospitals or outpatient wards between 2004 and 2006. The G and P genotypes were determined by reverse transcription-nested PCR. Significant differences were found in the geographical distributions of rotavirus genotypes between countries participating in the study. The prevalence of “common” G/P combinations, G1P[8], G3P[8], G4P[8], and G2P[4], ranged between 50 and 85%. The G9 genotype, which is emerging worldwide, was identified in 2 to 35% of all samples depending on the country. Unusual combinations, such as G1 or G4 associated with P[4] or G2 with P[8], which may have arisen by reassortment between human strains, were found in samples from 3 to 20% of patients. The uncommon genotypes G8P[8] and G10P[6], which may have an animal origin, were also identified. Double infections with two rotavirus strains were observed in between 1.7 and 14% of cases studied. Our findings might implicate challenges for rotavirus vaccine implementation in a wide geographic area of the Balkans and Central-Eastern Europe and underscore the importance of extensive strain surveillance for success in vaccine development