14 research outputs found
A review for Ralitsa Kostadinova’s book “Suspended sentence under Bulgarian Criminal Lawâ€
No full textThe review is dedicated to the monograph entitled “Suspended Sentence under Bulgarian Criminal Law†by Ralitsa Kostadinova. In the book the author has pointed her scientific research in an academic area, namely that of suspended sentence, which so far has not been subject of a thorough and in-depth scientific analysis in Bulgaria, but at the same time it is of great practical significance in particular with regard to the work of the judicial bodies. The monograph under review undoubtedly contributes to the criminal legal theory
Do sacubitril/valsartan affect neurocognitive function?
No full textSacubitril/valsartan is a new medication approved in 2015 for the treatment of New York Heart Association (NYHA) class II to IV heart failure with reduced ejection fraction. While the drug failed to meet the primary endpoint in patients with heart failure with preserved ejection fraction in the PARAGON-HF trial, improvements were noted in several secondary endpoints. Valsartan is an angiotensin receptor blocker and sacubitril is a neprilysin inhibitor. Neprilysin is an endopeptidase that degrades bradykinin, natriuretic peptides, and adrenomedullin. Neprilysin inhibition by sacubitril results in increased levels of vasoactive peptides, decreased vasoconstriction, sodium retention, and cardiovascular remodeling due to excessive neurohormonal stimulation in uncontrolled heart failure. Research has revealed that neprilysin inhibition may impact more than just cardiovascular targets. Neprilysin is an enzyme involved in the clearance of beta-amyloid peptides, proteins thought to contribute to development of Alzheimer dementia. Although pre-clinical and clinical studies have shown promising safety results, those studies have been heavily criticized for short monitoring time and targeted populations. In accordance with the requirements of the US Food and drug Administration (FDA), the ongoing Prospective Evaluation of Cognitive Function in Heart Failure: Efficacy and Safety of Entresto compared to Valsartan on Cognitive Function in Patients with Chronic Heart Failure and Preserved Ejection Fraction (PERSPECTIVE; NCT02884206) multicenter, randomized, double-blinded trial is assessing the long-term neurocognitive effects and safety of sacubitril/valsartan, and results are expected in early 2022
Рехоспитализация и смъртност при хронична сърдечна недостатъчност
No full textРАБОТНА ХИПОТЕЗА, ЦЕЛ И ЗАДАЧИ
РАБОТНА ХИПОТЕЗА:
Пациентите със СНмФИ имат сходство по отношение на етиология, клинични характеристики и прогноза с тези със СНрФИ, докато при СНзФИ прогнозата е по-благоприятна.
ЦЕЛ:
Да се анализират етиологията, рисковите фактори и придружаващите заболявания при пациенти със СНзФИ, СНмФИ, СНрФИ и да се установят факторите, асоциирани с честотата на рехоспитализации и смъртност в тези подгрупи СН.
ЗАДАЧИ:
1. Да се направи оценка на клиничните и ехокардиографски показатели, рисковите фактори, етиологията и коморбидностите при пациентите със СНзФИ, СНмФИ и СНрФИ.
2. Да се проведе едногодишно проследяване и да се установят факторите, свързани с честотата на рехоспитализации при пациентите в отделните подгрупи СН.
3. Да се направи вътрегрупов анализ и да се установят факторите, асоциирани със смъртността за петгодишен период на проследяване при пациентите със СНзФИ, СНмФИ и СНрФИ.
4. Да се направи анализ на честотата на рехоспитализации и смъртност при пациентите със СН (независимо от ФИ) на базата на предшестваща клапна сърдечна болест (с очаквана най-неблагоприятна прогноза).
5. Да се потърсят прогностични модели, идентифициращи показателите за повишен риск от рехоспитализации и смъртност при пациентите със СНзФИ, СНмФИ, СНрФИ, както и при тези със СН и клапна сърдечна болест
CASE OF A FEMALE PATIENT WITH ANKYLOSING SPONDYLITIS AND MULTIPLE ANEURYSMS
Full text linkAneurysms of the Valsalva sinuses are rare among cardiovascular disorders, with an incidence rate of 0.15%. Most cases are accidentally diagnosed or constated postmortem. Usually, this type of pathology is asymptomatic and might go undetected for a long time before the aneurism erupts. Patients with larger coronary aneurysms often complain of from chest pain, shortness of breath, and arrhythmia. Another extremely rare cardiovascular pathology is the aneurysm of the subclavian artery, which has a reported rate of 0.13%. Smaller subclavian aneurysms have no clinical manifestation, whereas larger ones cause murmur, pulsation phenomenons, neuropathic pain and ischemia of the upper limb due to compression of the brachial plexus and major vessels.
Herein, we report a rare case of a very large aneurisms involving all three coronary sinuses and the whole aortic root in combination with a bilateral giant subclavian aneurism. These findings were made during a routine cardiological examination and further hospitalizations of a 54-year-old woman with chest pain and high blood pressure complaints with known ankylosing spondylitis. Despite their rarity, aneurysms of the sinuses of Valsalva and subclavian arteries are of utmost clinical significance due to the life-threatening complications which might arise from their rupture. Furthermore, such aneurysms pose significant technical difficulties during angiographic procedures. Therefore, detailed knowledge of such pathologies is essential for correctly diagnosing and treating such patients
Web-application for Presentation of Bulgarian Language Heritage: Bilingual Digital Corpora and Dictionaries
Full text linkThe paper describes three software packages - the main components
of a software system for processing and web-presentation of Bulgarian language resources – parallel corpora and bilingual dictionaries. The author briefly presents current versions of the core components “Dictionary” and “Corpus” as well as the recently developed component “Connection” that links both “Dictionary” and “Corpus”. The components main functionalities are described as well. Some examples of the usage of the system’s web-applications are included
Online Dictionary - Tool for Preservation of Language Heritage
Full text linkThe paper aims to represent a bilingual online dictionary as a useful
tool helping preservation of the natural languages. The author focuses on the
approach that was taken to develop compatible bilingual lexical database for the
Bulgarian-Polish online dictionary. A formal model for the dictionary encoding
is developed in accordance with the complex structures of the dictionary entries. These structures vary depending on the grammatical characteristics of
Bulgarian headwords. The Web-application for presentation of the bilingual
dictionary is also describred
100 Years of International Justice – Time to consider a reform of the International Court of Justice
Full text linkThis article critically evaluates the current operational framework of the International Court of Justice. Citing political influence, weak enforcement of due process and other “ambiguities”, the article makes for a provocative piece on this international judicial body. The author scopes the various reform proposals tabled (from the subtle to the more “radical”), espousing those that include reforming: the election process of ICJ judges; the compulsory-jurisdiction of the court; and the relationship between the ICJ and the UN Security Council. She also offers her insight into how the mechanics of reform ought to take effect
A complementary understanding of residential energy demand, consumption and services
Full text linkThis chapter explores potential ways to implement, and benefits for policymaking of, the complementary use of two different types of modelling for analysing residential energy consumption and ethnographic research. The more traditional approach of techno-economic modelling is considered alongside agent-based modelling that incorporates both causal and intentional relationships; ethnographic approaches provide 'thick understanding' of the relationships between social and technical elements and the environment. In doing so, the chapter builds on real examples from academic-policy engagement in the EU on energy demand, consumption and services. We examine three myths of the role of modelling in policymaking and propose practical ways of employing different types of modelling in a complementary way to increase policymakers' understanding of residential energy demand, consumption and services. Finally, we make three concrete recommendations for developing future interdisciplinary work on integrating social and technical models for informing policy.Energy and Industr
Impact of demographic and professional factors on antibiotic prescription patterns in the post-COVID-19 era
Full text linkThis study examines self-reported changes in antibiotic prescribing practices among 222 physicians post-COVID-19, focusing on factors influencing these changes. The sample had a mean age of 47.7 years (SD = 11.1), with 62.2% female participants. Statistical analyses included Mann-Whitney U tests and logistic regression to identify predictors of prescribing changes. Physicians reporting changes were more likely to prescribe antibiotics due to patient demand (U = 2725, p < 0.001), time constraints (U = 3158, p < 0.01), concerns about complications (U = 2803, p < 0.01), and peer behavior (U = 3190, p < 0.01). Logistic regression revealed that age predicted changes in prescribing behavior (OR = 1.0831, p = 0.029), while professional experience (OR = 0.9274, p = 0.044) and additional specializations (OR = 0.3835, p = 0.023) were inversely related. Residence in villages showed a trend toward increased prescribing (OR = 7.8055, p = 0.097). These findings underscore the influence of demographic, professional, and geographic factors on antibiotic prescribing practices. Future research should investigate the long-term effects on antibiotic resistance and evaluate targeted interventions to address the identified drivers of prescribing behavior
Pro-Inflammatory Markers in Serum and Saliva in Periodontitis and Hypertension
No full textBackground and Objectives: Over the past few decades, a substantial body of evidence has linked periodontitis to systemic diseases—including hypertension—but the mechanisms underlying this association are not fully understood. This study aims to identify the factors that may mediate this relationship, including an analysis of the inflammatory biomarker NLRP3 and IL-1β levels in serum and saliva in patients with both diseases. Materials and Methods: This study included 108 individuals (mean age, 47.8 years, SD 12.8), 38.9% male and 61.1% female. The participants were divided into four groups: Group I—26 healthy participants; Group II—24 participants with periodontitis; Group III—26 participants with hypertension; and Group IV—32 participants with both periodontitis and hypertension. Clinical examinations were performed to diagnose hypertension and periodontitis, including a survey and blood tests in all patients. NLRP3 and IL-1β levels in serum and saliva were measured using ELISA. Results: Patients with periodontitis and hypertension were significantly older than those without these conditions (respectively, p < 0.001 and p < 0.001) and had more missing teeth (respectively, p < 0.001 and p = 0.037). Higher values were found in the periodontitis and hypertension group than in healthy individuals for VLDL (p = 0.001), triglycerides (p = 0.001), CRP (p = 0.003), WBC (p = 0.007), blood sugar (p = 0.002), total cholesterol (p = 0.003), and LDL (p = 0.010). Significantly higher levels of NLRP3 in saliva (p = 0.038) and serum (p = 0.021) were observed in patients with periodontitis than in those without periodontitis. Significant correlations were found between serum NLRP3 levels and the presence of hypertension (p = 0.001) and between saliva IL-1β levels and the presence of hypertension (p = 0.010). Serum NLRP3 levels demonstrated a predictive value for hypertension (AUC 0.693, 95% CI 0.590–0.796, and p = 0.001), with an established cutoff value of 0.68 ng/mL (sensitivity 0.623, specificity 0.630). Conclusions: The higher levels and correlations of pro-inflammatory markers in serum and saliva observed in patients with periodontitis and hypertension support the hypothesis of a relationship between these diseases, likely mediated by low-grade systemic inflammation
