SARS-COV-2 Infection in Children and Young People in Bulgaria - A Prospective, Single-Center, Cohort Study

Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.

Cardiovascular Risks Associated with Distance Learning in the Covid-19 Pandemic (Review Article)

Aim: the paper aims to analyze the new conditions of student self-isolation associated with the Covid-19 epidemic. Materials and methods. The paper is based on the theoretical analysis of domestic and foreign publications in the field of education with the use of information technologies over the past ten years and statistical data about morbidity and mortality of chronic non-communicable diseases (CNID) in Russia for the same period. Results. The features of distance learning are considered. The role of risk fac-tors in the development of CNID, including cardiovascular diseases, is indicated. Conclusions are drawn about the negative impact of the so-called "home schooling" on the health of university students, and op-tions are proposed to combat them and prevent the development of CNID with the use of information tech-nologies. Conclusion. The use of innovative methods for teaching physical education in universities (tele -medicine, Internet) will make it possible to attract more students to a healthy lifestyle (HLS) and develop their sports skills.

Application of Artificial Intelligence in Computer Gaming and Game Content

The paper focuses on the tools for applying artificial intelligence in the implementation of game content. The development of productive forces led to digitalization, further leading to the emergence of various goods and services via the Internet. New goods and services include computer games, music services, online cinemas, mobile applications, social services, etc. The COVID-19 pandemic and the self-isolation regime have expanded human needs for the benefits of digitalization in terms of the consumption of various Internet content, including gaming. The expansion of remote interaction under the pandemic comes into contact with objective economic realities—the introduction of elements of artificial intelligence and the spread of automation processes in the economy. Thus, science is updating the issue of studying the economic laws of the development of the game content market in the context of the introduction of artificial intelligence. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Study on patients with Clostridioides difficile infection during the COVID-19 pandemic in Bulgaria

One of the most pressing public health problems is the misuse of antibiotics, especially in industrialized countries. In addition to antibiotic resistance, a disease associated with this abuse is Clostridioides difficile infection (CDI). It is also a serious problem in long-term hospital treatment, as it often causes intra-hospital infections. The coronavirus disease 2019 (COVID-19) pandemic has also led to widespread misuse of antibiotics and prolonged hospitalizations. The aim of our study was to compare two groups of patients who developed CDI before and during the COVID-19 pandemic, respectively. A total of 246 CDI patients with an average age of 58 years were studied for the period of March-August 2021, who also recovered from COVID-19. They were compared with another group of CDI patients who had become ill in the period before COVID-19. We found an increase in CDI patients for the period of the COVID-19 pandemic by 21.95%. Patients with CDI associated with COVID-19 were older, with higher rates of neurologic, tumor and cardiovascular disease, and with metabolic syndrome. In the group with COVID-19 CDI, there was higher use of proton pump inhibitors, use of antibiotics and significantly higher use of corticosteroids. All these factors lead to the conclusion that increased caution is needed in patients with COVID-19 and that mandatory testing should be done for C. difficile infection at the onset of the diarrheal syndrome.

Clinical course and outcomes of COVID-19 infection in liver transplant recipients: single-center cross-sectional study

Background. The novel coronavirus infection (COVID-19) pandemic has had a significant impact on all areas of health care system, including organ donation and transplantation. Despite this, there were no large Russian studies of COVID-19 course and outcomes in liver transplant recipients. The study purpose was to determine prevalence, clinical course, severity, outcomes of COVID-19, as well as to assess the safety and efficiency of vaccination for disease prevention in liver transplant recipients. Material and methods. 260 recipients (71% of all patients at risk of COVID-19 disease) who underwent liver transplantation at State Research Center – Burnasyan Federal Medical Biophysical Center from May 2010 to September 2021 were included in a single-center cross-sectional study. Data collection was performed during a telephone or face-to-face interview from September 6, 2021 to September 20, 2021. If patients were hospitalized with COVID-19, we also analyzed the results of laboratory and instrumental tests, other medical documentation. Results. By mid-September 2021, the incidence of COVID-19 after liver transplantation was 31% (75 cases in 260 recipients). Asymptomatic course was observed in 11 (15%) patients. Hospitalization was required in 18 (28%) cases. In one case, COVID-19 infection was the cause of death. Mortality and death rate in the study cohort were 1% (1/75) and 0.4% (1/260), respectively. Risk factors that statistically significantly increased the likelihood of infection with SARS-CoV-2 were contact with the patient (OR: 12.9;95% CI: 6.6 - 25.0) and non-compliance with nonspecific prophylaxis measures (OR: 2.0;95 % CI: 1.1 - 3.7). The recipient's age of 60 years or more significantly increased the risk of severe infection (OR 5.0;95% CI: 1.3 - 18.7). None of the immunosuppressive therapy regimens significantly increased the risk of severe disease. Tacrolimus monotherapy or in combination with other drugs reduced the risk of severe COVID-19 (OR: 0.2;95% CI: 0.1 - 0.95). Vaccination against SARS-CoV-2, which was performed in 42 (17%) recipients, did not cause serious adverse events and significantly reduced the risk of COVID-19 disease (OR: 7.2;95% CI: 1.7 - 31.3). The detection rate of specific IgG antibodies to SARS-CoV-2 was 94% in recipients who had undergone the disease and 45% among those vaccinated (p<0.001). The achieved level of herd immunity against COVID-19 in the analyzed cohort was 48%. Conclusion. Adult liver transplant recipients are not at an excessive risk of COVID-19 disease. Compliance with preventive measures and vaccination can significantly reduce the risks of infection and severe infection. There is no objective evidence that immunosuppressive therapy increases the risk of severe COVID-19 in liver transplant recipients. In the context of the ongoing COVID-19 pandemic, tacrolimus monotherapy may be considered as a safe regimen of maintenance immunosuppression. © Voskanyan S.E., Sushkov A.I., Rudakov V.S., Svetlakova D.S., Popov M.V., Pashkov A.N., Muktarzhan M., Lukianchikova A.S., 2022

CARDIOVASCULAR RISKS ASSOCIATED WITH DISTANCE LEARNING IN THE COVID-19 PANDEMIC (REVIEW ARTICLE)

Aim: the paper aims to analyze the new conditions of student self-isolation associated with the Covid-19 epidemic. Materials and methods. The paper is based on the theoretical analysis of domestic and foreign publications in the field of education with the use of information technologies over the past ten years and statistical data about morbidity and mortality of chronic non-communicable diseases (CNID) in Russia for the same period. Results. The features of distance learning are considered. The role of risk factors in the development of CNID, including cardiovascular diseases, is indicated. Conclusions are drawn about the negative impact of the so-called “home schooling” on the health of university students, and options are proposed to combat them and prevent the development of CNID with the use of information technologies. Conclusion. The use of innovative methods for teaching physical education in universities (telemedicine, Internet) will make it possible to attract more students to a healthy lifestyle (HLS) and develop their sports skills. © 2022 South Ural State University - Institute of Sport, Tourism and Service. All rights reserved.

Practical strategies to improve national competitiveness

Today, the global community is faced with a new vision of the economy that aims to coordinate public policies with the purpose of ensuring sustainable growth to facilitate economic recovery under the current conditions and after the COVID-19 pandemic. The purpose of the study is to create a basic typology of strategies to improve national competitiveness in the context of globalization. The research methodology includes a comparison of economic development models and strategies for different countries around the world and an analysis of data from international organizations. The benchmarking of national strategies is based on the measurements’ evaluation for three groups of the GCI index components. The originality of the study stems from the fact that it proposed choosing a strategy for the development of the national economy with account taken of the level of its economic development. The strengths and weaknesses of competitiveness in the profile of the economy are identified and, whereby, a strategy to increase national competitiveness is chosen, according to the results of this analysis. The results of the study showed that the American model of economic development is the most competitive one among the examined models. In addition, the paper shows that the application of practical strategies for social integration, as well as mergers and acquisitions, will contribute to enhancing the national competitiveness in the context of economic growth and raising the living standards of the population. The findings of this research provide practical guidance for related professionals attempting to choose a suitable public policy to form effective and holistic national strategies and monitor the country’s progress over time. © The Author(s) 2021.

Muscle mass index at the level Th12 vertebra as a prognostic factor for fatal outcome in the patients with pneumonia caused by SARS-CoV2

Purpose: To develop a methodology for determining the muscle mass index (MMI) at the level of Th12 based on the computed tomography of the chest;to estimate the impact of MMI on the outcome of the COVID19 patients as a prognostic factor. Material and methods: The medical data and computed tomography of the chest of 247 patients with confirmed pneumonia caused by SARS-Cov2 were used. A technique has been developed for determining MMI based on the cross-sectional area of paraspinal muscles at the level of the Th12 vertebra and the length of the thoracic spine. A correlation analysis of MMI calculated based on the length of the thoracic spine MMI(L) and height MMI(H) was performed. A statistical analysis of the differences of the MMI(L) in the groups of male and female patients with fatal outcome and recovered, as well as younger and older than 65 years were performed. Results: A strong correlation was found between the MMI calculated on the basis of the length of the thoracic spine and height (r = 0.861, p <0.001). The age threshold, which was associated with an increase in the likelihood of death, in men was 60 years (Se 77.3 %, Sp 60.5 %, PPV 51.5 %, NPV 83.1 %, Youden's index 0.378, area under ROC- curve 0.728), in women 65 years old (Se 72.2 %, Sp 68.6 %, PPV 49.1 %, NPV 85.5 %, Youden's index 0.408, the area under the ROC curve 0.734). The odds ratio of death when the age thresholds are exceeded was 5.2 for men (95 % CI: 2.3 - 12.0), for women - 5.7 (95 % CI: 2.4 - 13.4). MMI(L) 3.37cm2/m2 is a threshold value, below which the probability of death in male patients under 60 years increased 26.3 times (95 % CI: 4.8 - 143.0). In female patients, there was no statistically significant threshold value of MMI(L), which would be associated with a higher risk of death. Conclusion: MMI, calculated at the level Th12 on the basis of the length of the thoracic spine, can be reliably used as a tool to estimate sarcopenia associated muscle atrophy, if there is no anthropometric data. The MMI(D) less than 3.37 cm2/m2 is a strong predictor of death in men under 60 years of age. Further work is needed to study the effect of sarcopenia on the severity and outcome of COVID19 in female patients, taking into account comorbid conditions. © 2021 State Research Center, Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. All rights reserved.

DEVELOPING PROFESSIONAL AND COMMUNICATION SKILLS OF STUDENTS IN ENGINEERING DISCIPLINES

The article presents a study designed to develop professional and communication skills of students in the subject "Chemical Engineering" with German language teaching at the University of Chemical Technology and Metallurgy. During the application of the experimental model, the COVID crisis required switching to hybrid teaching. This brought a new focus on the teaching design in the 2019/2020 academic year. The research is based on self-regulated learning strategies. The collected data offer a tool for developing professional and foreign language skills. It aims to optimize the educational process in engineering disciplines, as well as to enhance the foreign language knowledge acquisition: bilingual learning materials for improving the specialized foreign language learning.

Balance of heat flows in autonomous bio-vegetation complex as basis for its design

Economic assessment, analysis and forecast of developing organic farming for the next ten years indicates the rapid growth of technologies for greenhouse vegetable growing in Russia. These positive trends are supported by factors such as worsening epidemiological situation in the world due to COVID-19 and transition to self-isolation of the majority of population, which requires providing healthy green products for a functional purpose. It is the need to strengthen the immune system that makes people consume vegetable products in accordance with the recommendations for rational consumption of vegetables that meet modern requirements for a healthy diet. To effectively solve the problem and in connection with the limitation of the imported products supply, the most rational solution is to modernize our domestic production of functional vegetable crops. The design of modern small-scale cultivation facilities makes it possible to ensure food security of various segments of the population living in any part of the Russian Federation. The structure autonomy and energy-saving technologies enable to operate the bio-vegetation complex all year round without being connected to an external power system. This is achieved due to the rational distribution of energy flows in the complex itself, and enables to efficiently operate it all the year round without serious additional financial costs for energy supply in the cold season. The paper presents energy-saving solutions and describes a thermophysical model of energy flows movement being an indispensable element in the design of such structures.