Bulgarian Population Research Articles

Status and Numbers of the Brown Bear (Ursus arctos L.) in Bulgaria.

Until recently, the Bulgarian bear population (Ursus arctos L.) was considered one of the significant ones in Europe and one of the few with more than 500 bears. While the numbers of some neighboring populations may be increasing, the Bulgarian population has been on a downward trend since the early 1990s. The probable numbers of the species at the end of the 1980s was about 700-750 individuals. Calculations based on field data from national monitoring and statistical analysis show probable numbers in Bulgaria in 2020 of about 500 individuals (data for the autumn state). This decline is mostly related to poaching due to weaker control activity, the reduction of forest areas and habitat fragmentation. The preservation of the Bulgarian population, which, together with the other Balkan populations and the Apennine bear, has a unique gene pool, is particularly important from the point of view of preserving the biodiversity of the species in Europe.

Adherence to biological therapies in patients with rheumatoid arthritis: a retrospective cohort study.

The advent of biologic disease-modifying antirheumatic drugs has dramatically changed the comprehensions of treatment and long-term prognosis in patients with rheumatoid arthritis. The potent therapeutic results can only be achieved if the patients adhere to prescribed medications. The objective of this study was to estimate the impact of age, gender, duration of the disease, concomitant Methotrexate therapy, prior exposure to biologic agents, disease activity, functional capacity, and health-related quality of life on adherence to biologic treatment among Bulgarian population with rheumatoid arthritis. This was a retrospective observational cohort study that included 179 patients. At the baseline visit and subsequent follow-up assessments at 6, 12, 24 and 36months, patients were interviewed by a physician and underwent physical examinations. We monitored the changes in disease activity, functional capacity and health-related quality of life on each time point. Univariate and multivariate binary logistic regression was used to determine the prognostic value of possible predictors of treatment adherence. Our findings showed that only DAS28 score [odd ratio (OR) = 1.174; 95% CI 1.74-2.362] and HAQ score (OR 2.803; 95% CI 1.428-5.503) remained significant for the treatment adherence throughout the study period. The adherence to the biologic disease-modifying anti-rheumatic drugs among Bulgarian patients with rheumatoid arthritis is suboptimal. A multifaceted and comprehensive knowledge of the influencing factors can be useful for the development of different strategies that can improve treatment adherence.

Impact of baseline anemia on the short- and long-term prognosis of patients presenting with non-ST-elevation myocardial infarction

Anaemia at admission is a known predictor of death in patients with myocardial infarction with ST-elevation (STEMI). Data on the effect of anaemia on the prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI) is less readily available. Purpose: We aimed to evaluate the frequency of anaemia in a Bulgarian tertiary centre NSTEMI patient population, and its effect on the immediate and extended prognosis of the patients. Methods: We performed ambispective analysis of 138 consecutive patients with NSTEMI, and anaemia was defi ned as haemoglobin at admission below 120 g/L for females and below 130 g/L for males. Results: There was no signifi cant difference in the frequencies of standard risk factors between patients with and without anaemia. Anaemic patients tended to be older, with lower body mass index and worse kidney function. Patients with baseline anaemia tended to have higher GRACE risk scores and a larger size of the realised myocardial infarction as judged by maximal reached troponin I. There was no signifi cant difference in interventional treatment in both groups. Median hospital stay was signifi cantly longer in anaemic patients and was marked by more complications. Despite a lack of increase in inhospital bleeding and no difference in treatment with oral antiaggregants, patients with anaemia received haemotransfusion treatment more often. Mortality rate was higher in anaemic patients both during the index hospitalization and during the follow up. Conclusion: Anaemia at admission is associated with an increased risk of both in hospital cardiovascular complications and after dehospitalisation all-cause mortality in patients with NSTEMI and should be considered as an additional risk factor in the global risk assessment of patients.

Polymorphic Variant rs11206510 in PCSK9 and Risk of Coronary Artery Disease in Bulgarians

Abstract Objective The aim of this study was to investigate the potential association of rs11206510 in PCSK9 gene with coronary artery disease (CAD) and myocardial infarction (MI) in Bulgarians. Materials and Methods The current analysis included 261 patients with angiographically documented CAD (153 with MI and 108 without MI) and 496 population – based controls. Genomic DNA was extracted from venous blood samples. The selected polymorphism was genotyped by TaqMan SNP Genotyping Assay. The genotype and allele frequencies were compared between cases and controls using χ2 test. Results In this study, the presence of the T allele of rs11206510 in the PCSK9 gene was found to be associated with elevated risk for MI in patients with already existing myocardial ischemia (allele T, OR1.78,CI95:1.16-2.73, p = 0.007). The result was enhanced in the male subgroup (allele T, OR1.74, CI95:1.02-2.96, p = 0.038). Also, we found reduced risk of CAD (without MI) for T allele (OR0.70, CI95:0.49-0.99, p = 0.04). This trend was stronger in the male subgroup (OR0.56, CI95:0.35-0.90, p = 0.02). There was not any relationship of the studied genetic variant with the levels of total cholesterol, triglycerides, low density lipoproteins and high-density lipoproteins, or with systolic and diastolic blood pressure values. Conclusion Our study found a difference in the frequencies of rs11206510 genotypes and alleles in the PCSK9 gene between cases and controls, and the relationship of the investigated polymorphism to the risk of cardiac injury in the Bulgarian population was demonstrated. Further investigations with a larger number of cases and controls will be needed in order to evaluate a possible association between this variant and CAD/MI in Bulgarians.

Bulgarian public opinion survey for risk perception including radon and suggestions for communication

The paper reviews and analyses the results of STEAM survey of the Bulgarian population. A Survey and the preparation of a questionnaire were initiated within the framework of the IAEA Project RER9153 “Enhancing the Regional Capacity to Control Long-Term Risks to the Public due to radon in Dwellings and Workplaces”. The survey includes 1003 respondents from the Bulgarian adult population 18+. The main conclusions are:The health of the Bulgarian people is mostly assessed as satisfactory (38.7%) and all respondent considers a person's health better than the people's health as a whole. The main risk factors that can affect the health of Bulgarians are: Stress; Unhealthy nutrition; Smoking; Polluted air/dust; Health system - difficult access, improper treatment; Economic situation - low income; Alcohol; Lack of physical activity. Risks such as Environment; Working place and Lifestyle (harmful habits) are below 10%. The general awareness of radon and associated risks with it is very low among the Bulgarian adult population: 78% know nothing or very little about the health risks of radon. Almost half of the population doesn't know if home radon testing is a priority for them. About 30% of Bulgarians think that there is no point in testing the home they live in since they always maintain good ventilation. The population does not recognize the National Radiation Protection and Public Health Authorities as a trusted source of health risk information. The internet and social media are the main sources of information regarding health risks. The most important result that should be taken into account when building a new communication strategy is the fact that nearly 40% of the respondents declare that they are informed about health risks by general practitioners (GP), and the trust in them is over 50%.

HEALTH LITERACY: A CALL FOR ACTION FOR A JUST AND EGALITARIAN SOCIETY

Health Literacy Survey -2019 (HLS19) undertook a two-year extensive comparative survey in 17 European countries whose results demonstrated that while health literacy levels have risen, there is vast room for improvement. 36% of the Bulgarian population has poor or unsatisfactory level of health literacy (very difficult/ difficult range answers). This means that more than a 1/3 of Bulgarian citizens are facing hurdles when presented with health or healthcare related issues to deal with which inexorably affects their quality of life and potential. To society this means that there is a measurable inequality between those with high and low health literacy that is evidenced by social gradient. Thus, low health literacy has direct effect on perpetuating health inequalities which in turn affects social justice and attainment of human development and flourishing. HL is closely associated with social determinants of health and poor health/ outcomes due to low literacy is as an injustice that needs to be addressed systematically from broad policy perspective. It is an injustice as studies demonstrate that HL is a modifiable factor that has a direct positive effect on improving well-being, reducing absenteeism, and triggering economic and social progress. The purpose of the project is to analyze available literature, draft and test questionnaires, analyze results in order to gain better understanding of the health literacy needs of Bulgarian population and to better inform public health policies and implement targeted evidence based interventions. Improved health literacy will lead to more effective and efficient healthcare utilization contributing to better patient outcome and optimal use of health and medical resources. In fact, the WHO Shanghai Declaration (2016) declared health literacy a critical determinant of health and established the direct link between adequate health literacy and achievement of Sustainable development goals.

A RETROSPECTIVE STUDY OF OUR NINE YEARS OF EXPERIENCE WITH ABNORMAL PLACENTATION — RISK FACTORS AND PREGNANCY OUTCOMES

Purpose: Placenta previa and morbidly adherent placenta are life-threatening conditions that necessitate close monitoring during pregnancy and can result in increased ante- and intrapartum complications. This study aims to evaluate the frequency of placental disorders in our population, reveal the impact of the known risk factors on maternal morbidity, and study new predisposing conditions and their effects on pregnancy outcomes. Materials and Methods: We performed a single-centered retrospective study in which we analyzed 330 women diagnosed with abnormal placentation—placenta previa and placenta accreta spectrum (PAS). We included all the women that gave birth at Nadezhda Hospital, from March 2013 to August 2021. We processed the data using the chi-square test, Cramer's V test, and cross-section analysis. Results: The frequency of placenta previa in our population is higher than the worldwide reported data. We were unable to demonstrate the connection between previous uterine manipulations (c-section, D&C, operative hysteroscopy, etc.) and the occurrence of higher-grade placenta previa in our population. However, the more surgeries performed, the more complications during pregnancy and delivery occur (antepartum bleeding, increased blood loss, surgical management of postpartum hemorrhage, peripartum hysterectomy). Pregnancies following assisted reproductive techniques (ART) are at a three-times higher risk of placenta previa. Endometriosis determines a greater risk of developing an abnormally adherent placenta. Conclusion: More prospective studies need to be performed to define the exact risk factors for abnormal placentation that affect the Bulgarian population. A better understanding of the condition will lead to better management of higher-risk pregnancies, thus reducing maternal and fetal morbidity.

The Pleasure to Smile: A Review Article

Most people find happiness by making money, eating good food, or spending time with friends. Epicurean philosophy provides an explanation of what makes people happy and how to experience joy and pleasure in life. Gossipiboma is a rare complication that can occur due to human negligence. Gossipiboma’s form as a complication of inflammatory reaction to a surgical sponge or a laparotomy pad left mistakenly in the body of the patient after a surgical procedure. The term Gossipiboma is a combination of two words from two different languages; Gossypium a Latin word which mean cotton and boma a Kiswahili word which means plan of concealment. Their incidence is reported to be 1 in 1000 to 1500 surgery. We present here a case of a 67-year-old male who had a history of right-sided Percutaneous Nephrolithotomy (PCNL) five years back. No immediate post procedure complications occurred however the patient presented to the Outpatient Department (OPD) with left flank pain and his Computed Tomography (CT) scan was done which showed an organized Gossipiboma.Most people find happiness by making money, eating good food, or spending time with friends. Epicurean philosophy provides an explanation of what makes people happy and how to experience joy and pleasure in life. It focuses on the absence of pain as the path to happiness and advocates leading a simple lifestyle. There are people in the world who are happy just because they live and they live much longer without cancer, cardiovascular or other social important diseases. The material measurability of the timelessness in which we live does not exist, and the virtues have preserved them above all as human beings. They have the ability to enjoy the simple things in life, which in most cases are not financially commensurate. The connection between the beauty of the smile, positive health and longevity has been consciously sought. All aspects of the life of the Bulgarian population are outlined, which are positive and could lead them out of the black rankings for morbidity and mortality in Europe and the world. Questions are raised related to the health and activity of long-lived and centenarians and what in the modern way of life turn this trend into a negative one.

БЪЛГАРСКА ЕЗИКОВА ИСТОРИЯ ОТ ЮЖНИТЕ РОДОПИ. ИСТОРИЧЕСКА АНТРОПОНИМИЯ И ДИАЛЕКТНИ ОСОБЕНОСТИ ОТ ГОВОРА НА С. ЧАЛЪБА (ГРЦ. ΣΜΙΓΑΔΑ), ГЮМЮРДЖИНСКО

The Bulgarian Southern Rhodope dialects spoken in the region of Komotini (Greece) have not yet been properly studied. Not much is known about the history of the old local Bulgarian-speaking villages. This article presents historical and anthropo-nymic data from the village of Chalaba (Greek: Smigadа) in the Komotini region, Greece. According to these data, its population was exclusively Bulgarian Christian in the 16th century. The paper provides an analysis of the historical anthroponymy of the village. Such a study is particularly important with a view to the peripheral regions of the Bulgarian linguistic area, such as the Rhodopes and Western Thrace, whose local Bulgarian population was assimilated after a large part of it had been forced to adopt the Muslim faith. The comparison with 16th-century anthroponymic data from other regions of Western Thrace and the Southern Rhodopes, provided in the article, helps to reconstruct the anthroponymic picture of the Bulgarian population in this part of the Bulgarian linguistic territory. In addition, the paper presents the main features of the local Bulgarian dialect.

Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population.

Renal arterial anatomy has a great clinical importance during surgical and endovascular procedures. However, comprehensive data on renal arterial variations in the Bulgarian population has not yet been provided. The aim of this study was to conduct a detailed research about the normal anatomy and variations of the renal arteries in the Bulgarian population. Five hundred sixty-one patients underwent contrast-enhanced multidetector computed tomography scans for the period 2016-2021. The images were retrospectively reviewed. Number, branching pattern, origin level and course of the renal arteries were noted. Data were categorized on the basis of laterality, gender and symmetry. Only 46.3% of the patients exhibited normal renal arterial anatomy. Variations were observed in 301 patients (53.7%). The most common variant was the presence of accessory renal arteries (ARA), discovered in 41.2% of the subjects. There was no significant difference based on gender and laterality (p > 0.05). Hilar ARA (72.6%) were significantly more common than polar ARA (p < 0.001). The most common origin location of the main renal arteries and ARA was the aorta, followed by the common iliac arteries. Early division was observed in 21.7% of the patients, significantly more common on the right. Precaval course was found in 0.5% of the right main renal arteries and in 30% of ARA and the difference was significant (p < 0.001). These results show novel insight into the prevalence of renal arterial variations in the Bulgarian population. Anatomic renal vasculature variants are common therefore awareness is crucial for the success of surgical and interventional procedures.

ВІДГОМІН СЕЛЯНСЬКОЇ КАТАСТРОФИ: КОЛЕКТИВІЗАЦІЯ ТА ГОЛОДОМОР В ІСТОРИЧНІЙ ПАМ’ЯТІ ПРИАЗОВСЬКИХ БОЛГАР

The article explores the socio-economic transformations of the 1920s and 1930s in a Bulgarian village in the Northern Azov region, drawing on oral histories. It elucidates the mechanism behind the construction of the "collectivization" image in the historical memory of Ukrainian Bulgarians. The thesis posits the existence of a distinct corpus of oral narratives as an alternative historical and cultural model, contrasting with the official Soviet narrative of "modernization". The narrative portrays the disintegration of the peasant community and the instigation of an atmosphere of mistrust and fear, as recounted in personal stories. The study identifies historical memory narratives about violent collectivization as influential in shaping a complex of socially significant personal stories among Bulgarians in the Northern Azov region. Moreover, by integrating documentary evidence on collectivization and the Holodomor in southern Ukraine, the article highlights the informational potential of oral historical sources. Specifically, it reconstructs the primary stages of the Soviet authorities' defragmentation of peasant society through economic and non-economic pressures. The authors illustrate the process of forming and actively navigating the informational environment among the Bulgarian population in the Northern Azov region, depicting verbal images of collectivization functionaries/activists and the "silent mass" of victims of the economic system's collapse during the Holodomor. The article also delves into the phenomenon of emotional and cultural conflict within the historical memory structure, particularly concerning "Komsomol" functionaries. This investigation considers the respondents' narrative structuring and the establishment of cause-and-effect relationships. Conclusively, the authors assert that the transmission of past images to the younger generation occurred with corresponding emotional and value attitudes, particularly towards disarmament, collectivization, and the Holodomor. These attitudes were notably reinvigorated during the 1990s-2000s, influenced by socio-political and economic transformations.

Investigations on bovine herpesvirus 4 infections in cattle in Bulgaria

Cattle infected with BHV 4 show respiratory symptoms, gastrointestinal and postnatal genital disorders. The virus is a cofactor of bacterial infections. This paper reflects data on the prevalence of BHV 4 infections in several herds, among breeding animals and bulls from artificial insemination stations (AIS). One hundred and twenty six serum samples from bulls were investigated by MVNT and 45 (35.7%) were positive. Epizootiological and clinical studies on the prevalence of BHV 4 infections were limited to bovine farms with suspected infection with this virus. To establish seroconversion to the virus, double serum samples from 264 cattle – 165 native-born cows and 99 imported pregnant heifers were investigated by the microvirus neutralisation test (MVNT) and commercial ELISA for the detection of antibodies against BHV 4. Ninety-nine samples (37.5%) were positive in the MVNT and 110 samples (41.6%) – in ELISA. One out of the seven milk samples from cows with signs of mammary glands involvement was positive in the polymerase chain reaction (PCR) performed to detect the gB and Tk virus genes. Four of the ten whole blood samples from acutely ill animals were positive for BHV 4 DNA by PCR. The results of the present study confirmed that the BHV 4 circulated within the Bulgarian cattle population.

New Dictionary of One Archaic Bulgarian Dialect. [Rev.] Slavka Keremedchieva, Lilyana Vasileva. The Dictionary of one archaic Rhodope dialect ― the Ropka dialect. Sofia: Publishing house on BAN “Prof. Marin Drinov”, 2022. 284 p. ISBN 978-619-245-250-6

The review is devoted to the analysis of the new lexicographic work of the Bulgarian dialectologists of the Prof. L. Andreichin Institute of the Bulgarian Language. BAN, ―a dictionary of one archaic dialect of the Ropka region in the Western Rhodope Mountains. The book is a logical continuation of S. Keremedchieva’s 1993 monograph, which describes the grammar of this dialect. The dictionary significantly complements the understanding of it, which makes it the first comprehensive study of the Rhodope dialect at several linguistic levels: phonological, morphological and lexical. Due to its basic linguistic features, this dialect became a link between the Thracian and central Rhodope dialects, whose speakers, due to a number of geopolitical reasons and events, found themselves outside the borders of modern Bulgaria, in Greece and Turkey. The local Bulgarian population was mostly Islamized in the XVII century, and after the Liberation of Bulgaria in 1879–1882 and 1912, part of the families of Bulgarian Muslims from the villages of Pavelsko, Orekhovo and Studenets were resettled to Asia Minor, Turkey. According to one of the etymological versions of the origin of the name of the village Pavelsko, the fact of the existence here in the past of adherents of the Pavlikian heresy, whose center was the village of Pavelsko, is likely. This hypothesis is supported by numerous linguistic links between the Ropkа dialect and the Pavlikian dialect in Bulgaria. The Ropka dialect has accumulated features of a certain stage in the development of the Bulgarian language, preserving a number of its archaic features, including vocabulary and morphology. Despite the modern intensive changes taking place in everyday life, culture and language, the inhabitants of the Ropka region have preserved their ancestral memory and customs, songs and legends, melodious Rhodope dialect with its ancient features and inimitable architectonics. Rich authentic dialect material is a serious lexical database and a source for scientific research in various fields, including ethnolinguistics.

Historical and legal analysis of the census of the population in Bulgaria in the period 1879–2010

This article analyzes sixteen censuses of the Bulgarian population in the period from 1879 to 2010. This work provides information on the normative and bylaws regulating the organization and stages through which the population censuses pass during the considered periods. The article traces the migration processes from the end of the 19th century to the beginning of the 20th century in the Bulgarian state, as well as a number of historical events that had a serious impact on the structure of the population. Attention is paid to the waves of refugees observed in the 20s of the 20th century, as the latter brought enormous financial and economic consequences for Bulgaria. Data on birth rate, death rate and natural population growth are presented. The age composition and educational status of the enumerated population is studied, as well as the degree of urbanization during some of the enumerations of the Bulgarian population.

Prevalence of low bone mineral density at axial sites and fracture risk in Bulgarian population.

Osteoporosis is a common chronic disease characterized by low bone mineral density (BMD) and microarchitectural deterioration of the bone, which are associated with increased risk of fragility fractures. Currently the most popular tool is the fracture risk assessment model FRAX to calculate the 10-year probability of major osteoporotic fractures (MOF) and hip fractures (HF). To investigate the prevalence of low BMD at axial sites and fracture risk in Bulgarian population. We retrospectively analyzed dual energy X-ray absorptiometry (DXA) scan results of 12 478 subjects. Scan results included BMD and T-score assessments of lumbar spine and femoral neck. FRAX major osteoprotic fracture (MOF) and FRAX hip fracture (HF) were assessed in subjects between 40 and 90 years using BMD values. Of total 12478 subjects, 12119 were women and 359 were men. The mean age of the subjects was 61 years (yrs.) ± 10 yrs. The overall prevalence of low BMD at the lumbar spine was 6084/9336 subjects (65.2%). 3502/9336 subjects (37.5%) were considered as osteopenic and 2582/9336 subjects (27.7%) were considered as osteoporotic. The overall prevalence of low BMD at the femoral neck was 2036/3140 (64.8%). 1641/3140 subjects (52.3%) were classified as osteopenic and 395/3 140 subjects (12.6%) were classified as osteoporotic. The mean values of FRAX MOF and FRAX HF increased significantly with increasing the age interval. This study is the largest epidemiological research in Bulgaria up to date about the prevalence of low BMD at axial sites.

Metabolic Profiles, Genetic Diversity, and Genome Size of Bulgarian Population of Alkanna tinctoria

Alkanna tinctoria (L.) Tausch Boraginaceae is a medicinal plant whose root is used for its antimicrobial and anti-inflammatory properties. A. tinctoria roots have been subject to numerous studies. However, the aerial parts have been explored less. The objective of the present study was to compare the chemical profile of aerial parts and roots as well as the total alkannin content in roots of 11 populations of the species from different floristic regions of Bulgaria. Methanolic extracts from 22 samples were analyzed by GC/MS. Phenolic, fatty, and organic acids, sterols, polyols, fatty alcohols, and sugars were identified. Ononitol (4-O-methyl-myo-inositol) was found as the main compound in the aerial parts. The total alkannin content in the roots was evaluated by the spectrophotometric method and compared with that of the commercial product. Populations with high alkannin content and rich in other bioactive compounds were identified. A relatively low genetic diversity in the studied populations was observed. The present study is the first comprehensive study on metabolite profiles and genetic diversity of the Bulgarian populations of A. tinctoria. The occurrence of ononitol in the aerial parts of the species is reported for the first time, as well as the phenolic acid profiles of the species in both aerial parts and roots. The results showed that aerial parts of the plant are also promising for use as a source of valuable biologically active substances.

Children and Youth Participation: Attitudes of Children and Young People Towards Democracy

The attitudes of children and young people towards democracy define their participation in the social and political life, as well as their participation in the development of the public understanding of the democracy overall. Despite the fact that the children and young people between 15 and 24 are barely 10% from the Bulgarian population, their participation has a key influence on the national progress and the political processes. In the past years a low level of interest and participation in the democratic processes of the lower age groups is observed. This is the focus of the research, which uses data from the 10th edition of the European Social Survey for Bulgaria.

Quality of life of patients with acromegaly: comparison of different therapeutic modalities

ABSTRACT Background Acromegaly is a rare disease that significantly affects patients’ quality of life (QoL) – especially appearance, pain, depression, energy and vitality. The aim is to assess and compare the acromegaly patients’ QoL related to the type of pharmacotherapy using specific and generic QoL measuring instruments. Research design and methods A cross-sectional questionnaire-based study among 163 hospitalized acromegaly patients was conducted. QoL was measured by Acromegaly Quality of Life Questionnaire (AcroQol), Short-Form Health Survey (SF-36) and EQ-5D-3 L. Results Women had lower AcroQol values than men 50 vs. 66 (p < 0.05). Lower values for octreotide than octreotide + pegvisomant were found with all questionnaires: 57 vs. 67 AcroQol (p = 0.0405), 0.699 vs. 0.7586 EQ-5D (p = 0.0595) and 57.94 vs. 66.06 SF-36 scores (p > 0.093) . A significant correlation between AcroQoL, SF-36 and EQ-5D-3 L scores (rs> 0, р < 0.00001) was revealed. AcroQol, EQ-5D and SF-36 are reliable questionnaires applicable for Bulgarian population with acromegaly. Conclusion This pilot study confirmed that combination therapy which includes biological therapy is related to higher physical appearance AcroQol scores than nonbiological monotherapy – a conclusion which should be further confirmed.

Seasonality of Births and Marriages among Bessarabian Bulgarians in the 19th and Early 20th Centuries

The article looks at the seasonality of birth and marriage rates among the Bulgarian population in Bessarabia in the nineteenth – early twentieth centuries. The authors argue that the transition from traditional to modern models of reproduction is accompanied by a transformation in the religious identity of Bulgarians. The work demonstrates that starting a family with children becomes more secular and not as dependent on the practices of the church calendar taboos. The main determinants of marriage and birth seasonality are the mechanisms of migration and further adaptation to new conditions. The calculations reveal the levelling and relative uniformity in the distribution of births through the months of the year. These trends highlight the transition from the traditional to the modern model. The dependence on religious factors is gradually weakening while the agricultural work cycle becomes dominant. It evidences the pronounced secularization of the worldview and social practices.

Antimicrobial Resistance and Whole Genome Sequencing Analysis of Neisseria gonorrhoeae Isolates in Bulgaria, 2019

Neisseria gonorrhoeae is evolving into a superbug with resistance to previously and currently recommended antimicrobials for treatment of gonorrhoea, which creates a significant public health concern globally. Antimicrobial resistance (AMR) poses a great threat; it causes longer duration of illness and treatment, and increases health care costs and the social, psychological and financial burden to families and societies. In response to this worrying situation laboratory research should be strengthened with implementation of newer molecular methods for monitoring and detecting AMR, and evaluation of the correlation of obtained genetic data with corresponding phenotypes.&#x0D; This study aimed to implement whole genome sequencing analysis for the first time of N. gonorrhoeae isolates from Bulgaria and to acquire molecular epidemiological and AMR information linked with phenotypic resistance data.&#x0D; Although the tested strains were susceptible to current recommended dual therapy, genetic analysis showed the presence of several mutations responsible for reducing susceptibility to third generation cephalosporins, namely the presence of genotype G1407 strains in the Bulgarian population. Regarding previously recommended antimicrobials, penicillin resistance and intermediate sensitivity to tetracyclines was demonstrated in all strains, and fluoroquinolone resistance in two strains.&#x0D; The obtained results showed that the use of whole genome sequencing was feasible, could describe current circulating gonococcal strains and predict and infer transmission of antimicrobial resistance. Therefore, gonococcal infections prevention and control programmes will be aided to target interventions where needed and to revise treatment guidelines that will help improve patient care.