OFFICIAL INFORMATION ON THE PREVENTION, PROPHYLAXIS, DIAGNOSIS AND TREATMENT OF MALARIA - A COMPARATIVE ANALYSIS BETWEEN THE REPUBLIC OF GREECE AND THE REPUBLIC OF BULGARIA

Malaria is still one of the most significant global viral diseases, causing more deaths than all other parasitic diseases. Prevention, chemoprophylaxis, opting for different non-drug methods and behaviors, procedures for arrivals from malaria-active areas, transmission dynamics, all diagnostic methods and treatment of malaria disease are at the heart of protecting the health of people traveling, staying and returning from malaria active areas. Our research summarizes all the steps, stages and roles of your organizations and medical specialists in the process of diagnosis, prophylaxis, prevention and treatment, as well as the similarities and differences in the legislation and organization of the health system in the Republic of Greece and the Republic of Bulgaria

Advancements in Malaria Pharmacotherapy in the Modern Period and the 21st Century

Malaria continues to be a highly significant global disease, accounting for a substantial number of cases, surpassing all other parasitic diseases worldwide. Despite efforts in prevention, chemoprophylaxis, and non-medicinal preventive measures, there are instances when living in malaria-prone regions necessitates confirmation of the disease through various diagnostic methods before commencing treatment. The primary objective is to safeguard the health of individuals traveling to, staying in, or returning from malaria-endemic areas.This study provides a comprehensive overview of the entire process of diagnosing and treating malaria, encompassing all steps, stages, roles, and specificities involved. The official recommendations and guidelines, including those integrated into the national legislation concerning malaria pharmacotherapy in the Republic of Bulgaria, are thoroughly analyzed, highlighting both commonalities and disparities

ROLE AND TRAINING OF STUDY NURSE AND STUDY COORDINATOR IN CONDUCTING CLINICAL TRIALS FOR THE DEVELOPMENT OF NEW MEDICATIONS

Clinical research is essential for the drugs development. While the responsibilities of principal investigator are clearly defined in the Guideline for Good clinical practice, the role of the other members of the study team are not well specified. Study nurses and study coordinators play a vital role in delivering clinical research, and ultimately improving patient care and treatment pathways. Duties could include: supporting a patient through their treatment as part of a clinical trial; preparing trial protocols and other trial-related documentation; helping to develop care pathways or regimens for patients; dealing with data collection; and co-ordinating the initiation, management and completion of the research; managing a team. In order to perform some of these obligations, additional training is required in many cases, which is not included in the course of general education of health care providers. However, the roles and responsibilities may vary based on study design, study phase, therapeutic area and study site where the trial is performed. In many countries, Medical universities, pharmaceutical companies, public health organizations and professional nurse organizations provide additional training courses and the health care providers are certified. In our research, we are trying to summarize the roles of medical professionals in the development of new medications and to provide information how additional trainings and education is organized and performed in Bulgaria, United Kingdom and USA

Jet stream position explains regional anomalies in European beech forest productivity and tree growth.

The mechanistic pathways connecting ocean-atmosphere variability and terrestrial productivity are well-established theoretically, but remain challenging to quantify empirically. Such quantification will greatly improve the assessment and prediction of changes in terrestrial carbon sequestration in response to dynamically induced climatic extremes. The jet stream latitude (JSL) over the North Atlantic-European domain provides a synthetic and robust physical framework that integrates climate variability not accounted for by atmospheric circulation patterns alone. Surface climate impacts of north-south summer JSL displacements are not uniform across Europe, but rather create a northwestern-southeastern dipole in forest productivity and radial-growth anomalies. Summer JSL variability over the eastern North Atlantic-European domain (5-40E) exerts the strongest impact on European beech, inducing anomalies of up to 30% in modelled gross primary productivity and 50% in radial tree growth. The net effects of JSL movements on terrestrial carbon fluxes depend on forest density, carbon stocks, and productivity imbalances across biogeographic regions

Identifying drivers of non-stationary climate-growth relationships of European beech.

The future performance of the widely abundant European beech (Fagus sylvatica L.) across its ecological amplitude is uncertain. Although beech is considered drought-sensitive and thus negatively affected by drought events, scientific evidence indicating increasing drought vulnerability under climate change on a cross-regional scale remains elusive. While evaluating changes in climate sensitivity of secondary growth offers a promising avenue, studies from productive, closed-canopy forests suffer from knowledge gaps, especially regarding the natural variability of climate sensitivity and how it relates to radial growth as an indicator of tree vitality. Since beech is sensitive to drought, we in this study use a drought index as a climate variable to account for the combined effects of temperature and water availability and explore how the drought sensitivity of secondary growth varies temporally in dependence on growth variability, growth trends, and climatic water availability across the species' ecological amplitude. Our results show that drought sensitivity is highly variable and non-stationary, though consistently higher at dry sites compared to moist sites. Increasing drought sensitivity can largely be explained by increasing climatic aridity, especially as it is exacerbated by climate change and trees' rank progression within forest communities, as (co-)dominant trees are more sensitive to extra-canopy climatic conditions than trees embedded in understories. However, during the driest periods of the 20th century, growth showed clear signs of being decoupled from climate. This may indicate fundamental changes in system behavior and be early-warning signals of decreasing drought tolerance. The multiple significant interaction terms in our model elucidate the complexity of European beech's drought sensitivity, which needs to be taken into consideration when assessing this species' response to climate change

No Future Growth Enhancement Expected at the Northern Edge for European Beech due to Continued Water Limitation.

With ongoing global warming, increasing water deficits promote physiological stress on forest ecosystems with negative impacts on tree growth, vitality, and survival. How individual tree species will react to increased drought stress is therefore a key research question to address for carbon accounting and the development of climate change mitigation strategies. Recent tree-ring studies have shown that trees at higher latitudes will benefit from warmer temperatures, yet this is likely highly species-dependent and less well-known for more temperate tree species. Using a unique pan-European tree-ring network of 26,430 European beech (Fagus sylvatica L.) trees from 2118 sites, we applied a linear mixed-effects modeling framework to (i) explain variation in climate-dependent growth and (ii) project growth for the near future (2021-2050) across the entire distribution of beech. We modeled the spatial pattern of radial growth responses to annually varying climate as a function of mean climate conditions (mean annual temperature, mean annual climatic water balance, and continentality). Over the calibration period (1952-2011), the model yielded high regional explanatory power (R2 = 0.38-0.72). Considering a moderate climate change scenario (CMIP6 SSP2-4.5), beech growth is projected to decrease in the future across most of its distribution range. In particular, projected growth decreases by 12%-18% (interquartile range) in northwestern Central Europe and by 11%-21% in the Mediterranean region. In contrast, climate-driven growth increases are limited to around 13% of the current occurrence, where the historical mean annual temperature was below ~6°C. More specifically, the model predicts a 3%-24% growth increase in the high-elevation clusters of the Alps and Carpathian Arc. Notably, we find little potential for future growth increases (-10 to +2%) at the poleward leading edge in southern Scandinavia. Because in this region beech growth is found to be primarily water-limited, a northward shift in its distributional range will be constrained by water availability

СЪСТРАДАТЕЛНО ЛЕЧЕНИЕ. РЕГУЛАТОРНА РАМКА В БЪЛГАРИЯ. РОЛЯТА НА МЕДИЦИНСКИЯ ПЕРСОНАЛ ЗА ДОСТЪП ДО ЛЕКАРСТВА ЗА СЪСТРАДАТЕЛНА УПОТРЕБА

<p>Изследването има за цел да установи комплексното разбиране на специфичните изисквания и характеристики на клиничните изпитвания с медицински изделия. Медицинските изделия все повече се разработват и използват за диагностициране, лечение и предотвратяване на заболявания и наранявания. Провеждането на клинични изпитвания за медицински изделия обаче представя уникални предизвикателства в сравнение с тези за фармацевтичните продукти. Материали и методи: Изследването включва подробно изучаване на добрата клинична практика за дизайна, провеждането, записването и докладването на клинични изследвания, провеждани при хора, с цел оценка на клиничната ефективност и безопасност на медицинските изделия, описани в международния стандарт ISO14155. Резултати: Изпитванията на медицински изделия минават през три фази: пилотна фаза (определяща предварителните данни за безопасност и ефективност с малък брой участници със заболяване или състояние (10-30) за няколко месеца). Основна фаза, която определят ефективността и безопасността с по-голям брой участници със заболяване или състояние (150- 1000) за 1-5 години. И изследвания след одобрение, които събират дългосрочни данни и данни за безопасност в реалния живот и от регистри. Изследванията на медицински изделия често са по-скъпи поради по-високата цена на устройството, застраховката и допълнителните разходи за процедури. Най-съществените разлики между изследванията на лекарства и изделия са в следните категории: изискванията за кандидатстване за клинични изпитвания на медицински изделия, включително класификация на риска и клас изделие, дефиниции за сериозни нежелани реакции / странични ефекти, докладване, срокове и влияние на изделието, изисквания за съпътстваща медикаментозна терапия и нуждата от дългосрочно наблюдение, което може да продължи повече от пет години. Заключение: Разбирането на уникалните предизвикателства и специфичните изисквания за провеждане на клинични изпитвания с медицински изделия е от съществено значение за напредъка на здравните технологии и подобряването на грижите за пациентите. Ключови думи: медицински изделия, клинични изпитвания, основни разлики, фази, предизвикателства</p&gt

Robust Resource Allocation for MIMO Wireless Powered Communication Networks Based on a Non-Linear EH Model

In this paper, we consider a multiple-input multiple-output wireless powered communication network, where multiple users harvest energy from a dedicated power station in order to be able to transmit their information signals to an information receiving station. Employing a practical non-linear energy harvesting (EH) model, we propose a joint time allocation and power control scheme, which takes into account the uncertainty regarding the channel state information (CSI) and provides robustness against imperfect CSI knowledge. In particular, we formulate two non-convex optimization problems for different objectives, namely system sum throughput maximization and the maximization of the minimum individual throughput across all wireless powered users. To overcome the non-convexity, we apply several transformations along with a one-dimensional search to obtain an efficient resource allocation algorithm. Numerical results reveal that a significant performance gain can be achieved when the resource allocation is designed based on the adopted non-linear EH model instead of the conventional linear EH model. Besides, unlike a non-robust baseline scheme designed for perfect CSI, the proposed resource allocation schemes are shown to be robust against imperfect CSI knowledge

Old-growth forests in Bulgaria: distribution, characteristics and conservation issues

Natural diversity of relief, climate variability, geographical as well as historical reasons contribute to the presence of old-growth forest patches in various forest types in Bulgaria. For reasons of biodiversity protection, scientific studies and forest certification several projects aimed at locating and collecting data for old-growth forests in Bulgaria. Our aim is to summarize the available findings and contribute for a general map of these forests. The sources of data combine inventory data, including fieldwork collection of forest structure data by members of our team, and verification of satellite and aerial images. Most widely distributed old-growth forests in the country are Fagus sylvatica in the Balkan Range Mountains. Isolated patches of old oak forests were preserved in the lower mountains and lowlands. Coniferous forests were preserved on hardly accessible steep slopes or deep valleys in the high mountains in southern Bulgaria. Of them most impressive are Pinus peuce and Pinus heldreichii forests in the Pirin Mountains, Picea abies forests in Rila and Rhodopes Mts., Pinus nigra in the Rhodopes and beech-fir-spruce forests in isolated locations. There is also one Juniperus excelsa forest, which although affected in the past by selective logging and pasturing, still preserves the largest species locality on the Balkan Peninsula with trees often exceeding 150-200 years. Old-growth beech forests are characterized by numerous small-sized gaps. Dead wood amount largely varies depending of site condition and past disturbances but rarely exceeds 100 m3/ha. DBH distributions resemble a rotated sigmoidal curve (Zlatanov et al. 2013). Old-growth Picea-dominated forests are characterized by younger and older patches resulting from windthrows and rarely fires of various sizes. Dead wood often exceeds 70-100 m3/ha. DBH distribution is resembles J-reversed. Typical for old-growth pine forests in the Pirin Mts. is high number of live old and dead trees with DBH often exceeding 100 cm and age > 500. Most important disturbances were fires, avalanches and rarely windthrows (Panayotov et al. 2017). Numerous fire traces in old Pinus nigra forests show that they were shaped by periodic fires. However, present day fire exclusion and past management guide dynamics towards increase of deciduous species in the understory. The total amount of deadwood rarely exceeds 30-40 m3/ha. The biggest threat to old-growth forests in Bulgaria is logging, including the potentially desired sanitary fellings in National Parks. In few locations conflicts arise also from desires to expand tourist infrastructure in old-growth forests. References: 1. Panayotov et al., 2017. Abiotic disturbances in Bulgarian mountain coniferous forests - an overview. Forest Ecology and Management, 388:13-28 2. Zlatanov et al., 2013. Index for identification and evaluation of old-growth forests in Bulgaria. Forest science, 17-28peerReviewe