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The growth of public expenditure worldwide has set the priority on assessment of trends and establishment of factors which generate the most significant public costs. The goal of the current study is to review the tendencies in public healthcare expenditures in Bulgaria and to analyze the influence of the demographic, economic, and healthcare system capacity indicators on expenditures dynamics. A retrospective, top-down, financial analysis of the healthcare system expenditures was performed. Datasets of the National Statistical Institute (NSI), National Health Insurance Fund (NHIF), and National Center of Public Health and Analysis (NCPHA) were retrospectively reviewed from2014–2019 to collect the information in absolute units of healthcare expenditures, healthcare system performance, demographics, and economic indicators. The research showed that increasing GDP led to higher healthcare costs, and it was the main factor affecting the cost growth in Bulgaria. The number of hospitalized patients and citizens in retirement age remained constant, confirming that their impact on healthcare costs was negligible. In conclusion, the population aging, average life expectancy, patient morbidity, and hospitalization rate altogether impacted healthcare costs mainly due to the multimorbidity of older people and the rising need for outpatient hospital services and medications.

Abstract Introduction: The present pilot study evaluates the quality of life of Bulgarian patients after a conventional hernia operation in which light or standard polypropylene hernia meshes were used. Materials and methods: Sixty-eight patients planned for recovery of primary or recurrent open hernia with implanted standard or lightweight polypropylene meshes were included in the study. Patients’ data were collected prospectively for a 5-month period (October 2017 - February 2018) on the basis of the case histories. The patients were interviewed using the EQ5D questionnaire and a visual analogue scale. Follow-up of each patient’s results was performed up to a year after surgery. Results: Three months after the operation, the patients reported only the presence of pain. On average, 24.5% of patients experienced mild pain and 20.3% - severe pain. In the standard mesh group, on average, the mild pain was 7.69%, swelling 3.84%, and foreign body sensation - 15.38% one year after the surgery. In the light mesh group the reported mild pain was 6.69%, pulling without pain - 13.33%, and foreign body sensation - 6.69%. There was no statistically significant difference in the pain level according to the used mesh, but in the group with implanted standard meshes, the reported problems prevailed. At the end of the survey period, the average score was 84.39±13.67. Conclusions: Hernia operation reduces pain 1 year after the procedure. The intensity of chronic pain one year after the surgery is relatively similar for both light and standard meshes in conventional inguinal hernia repair. The differences in the overall quality of life are insignificant in the long run. An individualized choice, based on the patients’ characteristics and safety of meshes, should be done by the healthcare specialists.

Volcanic rocks from deep-seated sources of the crust-mantle transition (CMT) are geochemically distinguished from those of ocean island basalts (OIB). Here, we report geochemical data on tectonic pseudotachylytes from the Main Sayan Fault (MSF) and volcanic rocks from the Kamar-Stanovoy Zone of Hot Transtension (KSZHT) that represent the deep-seated CMT magmatic sources in the central part of the Baikal Rift System (BRS). The tectonic generation of the KSZHT magmas between 18.1 and 11.7 Ma is compared with present-day seismogenic deformations in the middle-upper crust of the South Baikal Basin and adjacent Tunka Valley, where strong earthquakes are distributed along the Main Sayan and Primorye sutures of the Siberian paleocontinent. From a detail seismic tomography model and geological evidence, we infer that the KSZHT crust–mantle magmatic processes were due to delamination and lamination of a thickened root part of the South Baikal Orogen existed in the Late Cretaceous and Paleogene. In addition, we identify similar deep-seated CMT sources for melts erupted in the past 17 Ma from a delaminated root part of the East Hangay Orogen and adjacent Orkhon-Selenga Saddle in the southwestern BRS. We suggest that both in the central and in the southwestern BRS, the deep-seated CMT magma sources designate cooperative pull-to-axis and convergent effects created in the Japan-Baikal Geodynamic Corridor and in the Indo-Asian interactional region, respectively.

In the Wudalianchi volcanic field, eruptions started with low-Mg potassic lava flows 2.5&ndash, 2.0 Ma ago and later changed to both low- and moderate-Mg potassic compositions. Volcanic rocks from the Molabushan and Longmenshan volcanoes record an unusually wide range of Pb abundances (from 3.7 ppm to 21 ppm relative to predominant range of 10&ndash, 15 ppm). To determine the cause of these, we performed a comparative trace-element and Pb isotope study of rocks from these volcanoes and older lava flows. On a uranogenic lead diagram, older low-Mg lavas from lithospheric mantle sources plot on a secondary isochron with a slope corresponding to an age of 1.88 Ga. This contrasts with moderate-Mg volcanic rocks from the Molabushan cone, interpreted to have been derived from a recent convective mantle source, which define a flat linear pattern. Low-Mg rocks from the Molabushan flow have lead isotopic compositions that indicate mixed Gelaqiu and Molabu sources. Relative to rocks from the Molabushan cone, moderate-Mg lavas and slags from the East Longmenshan volcano have modified compositions characterized by Pb, S, and Ni abundances, Ni/Co, Ni/MgO ratios as well as 206Pb/204Pb, 207Pb/204Pb, 208Pb/204Pb, Ce/Pb, Th/Pb, and U/Pb ratios. We infer that the older Wudalianchi magmas were likely derived from a Paleoproterozoic lithospheric fragment, related to the evolved primordial mantle, and that later magmas were generated in the convecting mantle. These were influenced by segregation of small amounts of sulfides.

Propagation of sound in a medium where the rate of local heat addition is a function of gas density is analysed theoretically and the results are applied for modelling the experimentally observed effect of amplification of acoustic waves by an extended glow discharge in air. The model adequately describes the experimental dependences of the gain on the wave frequency and discharge power density and predicts that the amplification of sound by an unconfined glow discharge in air increases with discharge current density but does not change noticeably with gas pressure when the current density is kept constant. Quantitative estimates indicate that a gain of as high as 1 m−1 (or 9 dB for a 60 dB wave passing through 1 m of plasma) could be realized using a discharge in air with a current density of 100 mA cm−2.

This paper extends the recently reported one-dimensional model for sound propagation in glow discharge plasma to arbitrary mutual orientation of the plasma electric field and acoustic wave vectors. The results demonstrate that an acoustic wave in plasma may amplify, attenuate, or remain unchanged depending on the angle between these vectors and on the power input into the discharge. Quantitative evaluations indicate that for glow discharge plasma of a self-sustained discharge in air at the electric current densities of the order of 100 mA cm−2, a gain of as much as 1 m−1 at 0° angle between the vectors changes to similar strength attenuation for the 90° angle.