Bulgaria’s new voting reforms risk undermining the country’s electoral process

A recent amendment to Bulgaria’s electoral system has resulted in increased voting restrictions for Bulgarians living abroad, who can now only cast their ballots in diplomatic missions. Drawing on data from the Electoral Integrity Project, Andrea Fumarola and Nikolay Marinov assess what the new rules may mean for the country’s democracy

The 2021 Bulgarian election: a ‘QAnon turn’ for Eastern European politics?

One of the key stories from Bulgaria’s parliamentary election on 4 April was the rise of a new party led by talk show host and musician Slavi Trifonov, which finished in second place. Nikolay Marinov and Maria Popova write that the election underlined the existence of a new ‘conspiracy cleavage’ in Eastern European politics. Journalists ... Continue

The role of carboxylesterase enzymes in capecitabine therapy

Introduction: Capecitabine (CAP) is an oral antineoplastic pro-drug, whose initial step of activation is carboxylesterase (CES) dependent. The main conversion of CAP to 5-DFCR occurs in the liver by CES1 and a minor part - in the gastrointestinal tract (GIT) by CES2. Usually, the enteral pro-drug activation is associated with the appearance of fluoropyrimidine GIT toxicity, which may be dose-limiting and life-threatening for the patient. Thus, it is important to clear out the factors that could influence on the activity of both CES isozymes.Aim: The aim of the present study was to present the mechanism of hydrolysis, sources of variability and modulation possibilities of CESs, that could affect the treatment with CAP.Materials and Methods: A systematic review of the scientific databases in PubMed, Science Direct and Google Scholar was conducted.Results: The literature data showed up to 89% inter-individual variability in the plasma content of CAP and its metabolites. It was also established that factors, such as genetic polymorphisms, age, gender, and diseases, are responsible for these variabilities. Enzyme inhibitors and inductors, on the other hand, are among the factors that could be controlled and used as reliable modulators for CAP therapy. In fact, some authors found that the inhibition of CAP hydrolysis at CES2 level could reduce the common GIT toxicity and improve the bioavailability of the pro-drug.Conclusion: In accordance with the individual patient, the CES activity modulation approach could be used for the enhancement of the CAP therapeutic index. However, further detailed in vivo researches are needed to achieve categorical and applicable results

Does social media promote civic activism? A field experiment with a civic campaign

Social media may help civil society organize and mobilize for different campaigns. However, the extent to which social media campaigns simply recruit like-minded individuals as compared to exerting a causal impact on joiners' attitudes is difficult to disentangle. We test both the organizational and transformative potential of a civil society campaign in a randomized field experiment deployed via Facebook or an email newsletter in collaboration with a Bulgarian environmental campaign. As expected, we find that Bulgarian Facebook users who are active in pro-environmental groups, and those who decide to follow the campaign, are more highly educated than those who decide to stay at the sidelines. Moreover, beliefs in the effectiveness of civic society, character traits and prior activism systematically predict whether a Bulgarian Facebook user decides to join the cause on Facebook, or subscribe to the email newsletter. In contrast, we find little evidence that the campaign affected opinions, knowledge, or self-reported behavior. We conclude that social media campaigns that are commonplace among civil society organizations are effective at selecting activist-types, but changing the views and behaviors of the broader social media population may be more difficult than assumed

The place of kinesiotherapy in the complex rehabilitation of muskuloskeletal dysfunctions (presentation of a clinical case)

Мускулно-скелетните дисфункции включват всички нарушения във функцията на опорно-двигателния апарат вследствие на травматични, ревматологични, ортопедични и неврологични заболявания, a също и последиците от тях. Болестта на Шоерман-Мау е представител на тази група заболявания и се среща в предпубертета или пубертета, по-често при момичетата. Протича с увеличаване на нормалната гръдна кифоза и с намаляване или изчезване на поясната лордоза. Заболяването се развива бавно, засяга възрастта от 10 до 17 години, с продължителност 1-2 години.Болестта на Шоерман-Мау има много голямо социално и медицинско значение, тъй като поради нарушенията в растежа на гръбначния стълб тя е най-честата причина за структурните деформации на гръбначния стълб. В зависимост от локализацията и изразеността на промените тя води до увеличена, ниско лежаща, гръдна кифоза, дорзолумбална кифоза, a при лумбална изява води до плосък гръб, което гарантира мускулно-скелетна дисфункция в различна степен. В процеса на рехабилитация особено място заема лечебната физкултура, която цели корекция на кривините и засилване на паравертебралната мускулатура.Целта на настоящия доклад е да се представи клиничен случай, който да проследи ефекта на кинезитерапията при пациент с мускулно-скелетни дисфункции на гръбначния стълб. Пациентът е мъж на 20-годишна възраст с продължителност на заболяването 2 години, с оплаквания от чести болки в тораколумбалната област под формата на бодежи и невъзможност да заема тилен лег.Muskuloskeletal dysfunction includes all disorders of the function of the muskuloskeletal system as a result of traumatic, rheumatic, orthopedic and neurological diseases, and the their consequences. The Scheuermann - Mau disease is a representative of this group of diseases and occurs in the prepubertal period or in puberty. It is more common in girls. It proceeds with an increase in the normal thoracic kyphosis and decrease or disappearance of lumbar lordosis. The disease develops slowly affecting individuals at an age from 10 to 17 years, lasting 1-2 years. Scheuermann‘ s disease has a great social and medical importance due to impairing the growth of the spine. It is the most common cause for structural deformations of the spine. Depending on the location and the severity of the changes, it leads to increased, low-lying, thoracic kyphosis, dorsolumbar kyphosis. In its lumbar expression, it leads to flat back, which guarantees musculoskeletal dysfunction in varying degrees. In the process of rehabilitation, healing gymnastics occupies a particularly important place. It aims to achieve a correction of the curves and strengthening of the paravertebral musculature. The purpose of this report is to present a case from the practice, which tracks the effect of kinesitherapy in a patient with musculoskeletal dysfunctions of the spine. The patient is a 20-year-old man with a disease duration of two years, with frequent complaints of pain in the thoracolumbar region, in the form of pricking and inability to lie on his back

Economic Evaluation of the Implementation of Policy Actions in the Field of Energy Efficiency

This paper presented an analytical tool, based on the cost-benefit analysis instrument, intended to be used to estimate both the financial and economic impacts related to the implementation of policy actions and/or projects (interventions) in the field of energy efficiency. The proposed guidelines are intended to provide relevant information and guidance on why and how to conduct financial and economic assessment to a relatively large number of institutions involved in the preparation and appraisal of energy efficiency actions Keywords: Economic, Evaluation, Policy, Energy, Efficiency JEL Classifications: P18; Q51; Q58 DOI: https://doi.org/10.32479/ijeep.771

Palliative large bowel resections. Impact of the laparoscopic approach

INTRODUCTION: Nowadays colorectal cancer (CRC) incidence rate increases in the Western world. The lack of effective screening programs results in diagnosis of advanced cases in our country. Combination of hematogenic, peritoneal or systemic CRC dissemination with present or potential complications from local disease is not an exception. The decision for palliative resection is not easy and is a matter of balance be­tween potential risks of operative intervention and advances due to local tumour resection. Positive aspects of the laparoscopic approach are important in planning of these interventions. The aim of this study is to as­sess the indications for laparoscopic palliative large bowel resections in the literature available and to share our own experience.PATIENTS AND METHODS: During a two-year period, in the HPB and General Surgery Clinic, Acibadem City Clinic, Tokuda Hospital of Sofia, six laparoscopic palliative colon resections were performed. In the all cases, multiple liver metastases were diagnosed without possibility of liver resection. The early periopera­tive results were analyzed.RESULTS: Four left colon resections were performed with primary anastomosis due to high-level large bow­el obstruction and two right colectomies were done for primary tumour bleeding. Three patients were over 77 years old and presented with comorbidity. Average hospital stay was 5,6 days. No perioperative compli­cations were observed.CONCLUSION: Minimal surgical trauma, short recovery period and well-defined indications are important features in the process of planning of palliative large bowel resections in patients with disseminated CRC. The objective is to reduce risks of complications connected with primary tumour and to assure a good pa­tient`s quality of life. Scr Sci Med 2017; 49(3): 27-3

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis