This review of the meaningful data from 2021 on cervical, endometrial, and ovarian cancers aims to provide an update of the most clinically relevant studies presented at important oncologic congresses during the year [the American Society of Clinical Oncology (ASCO) Annual Meeting, the European Society for Medical Oncology (ESMO) Congress and the Society of Gynecologic Oncology (SGO) Annual Meeting]. Despite the underlying existence of the COVID-19 pandemic, the last year has been notable in terms of research, with significant and promising advances in gynecologic malignancies. Several major studies reporting the effects of innovative therapies for patients with cervical, endometrial, and ovarian cancers might change the medical practice in the future.

Knowledge regarding the influence of the microbial community in cancer promotion or protection has expanded even more through the study of bacterial metabolic products and how they can modulate cancer risk, which represents an extremely challenging approach for the relationship between intestinal microbiota and colorectal cancer (CRC). This review discusses research pro-gresses in the effect of bacterial dysbiosis from a metabolic point of view, particularly on the bio-chemical mechanisms of butyrate, one of the main short chain fatty acids (SCFAs) with an-ti-inflammatory and anti-tumor properties in CRC. Increased daily intake of omega-3 polyun-saturated fatty acids (PUFAs) significantly increases the density of bacteria that are known to produce butyrate. Omega-3 PUFAs have been proposed as a treatment to prevent gut microbiota dysregulation and lower the risk or progression of CRC.

Shiga-like toxin producing Escherichia coli (STEC) is a well-known cause of foodborne acute diarrheic diseases especially in children and the elderly. The potentially fatal complications associated with toxin production range from bloody diarrhoea and ischemic colitis to kidney failure, haemolytic-uremic syndrome (HUS) and colon perforation. We describe a case and literature review of STEC – induced colitis, highlighting the clinical features, and the necessary tools for the best diagnosis approach and management. Facing challenging differential diagnosis ranging from ischemic colitis, inflammatory bowel disease, to infectious process due to a pathogenic or opportunistic agent, we practiced a step-by-step exploration. Beginning with bacteriological investigation, imagistic screening, and colonoscopy, we could rule out some of initial suppositions and reach the final diagnosis, also considering the pathological results. Although antibiotics are not indicated in this pathology, our patient did receive antibiotics, given the risk of translocation and colon perforation, without associating any complications, as HUS or peritonitis. Detailed and rigorous investigations along with a multi-speciality team are required for a prompt medical support. Coping the symptoms and refraining from further complications are the mainstem of the treatment.

We develop an 1/n expansion method for the systematic approxi- mation of the solutions of classical spin systems (tri-dimensional vec- tors) which can describe general spin-spin interactions and phases with complex magnetization pattern. This method is applied to study the phase transitions observed in pyrochlore crystals (e.g. Gd₂ Ti₂ O₇ ) and the results have qualitative agreement with the experimental ones.

Fatal hemoptysis secondary to severe pulmonary veins stenosis is an exceptional late complication of radiofrequency ablation for atrial fibrillation. We report the case of a 53-year-old male with a history of atrial fibrillation treated by radiofrequency ablation and admitted in our center 6 months after the initial procedure because of aggravating dyspnea and fatigability. Transthoracic echocardiography showed moderate dilation of right heart cavities, severe pulmonary hypertension, and a turbulent flow in superior pulmonary veins. The cardiologist suspected pulmonary vein(s) stenosis and cardiac computed tomography (CT) angiography was performed with findings of severe stenosis of the right superior, right inferior and left inferior pulmonary veins, near-occlusion of the left superior pulmonary vein and the vein draining the apical segment of the right lower lobe. The CT scan also revealed soft tissue attenuation of the mediastinum posterior to the left atrium suggesting fibrosing mediastinitis together with parenchymal findings consistent with pulmonary venooclusive disease and an area of hemorrhagic infarction. Fatal hemoptysis occurred 3 days after the evaluation before any treatment was attempted. In conclusion, severe pulmonary stenosis remains a rare but severe complication of radiofrequency ablation. Prevention is the key element together with an early diagnosis as the entity is potentially life-threatening.

Background and Objectives: Renal cell carcinomas and upper tract urothelial carcinomas are types of malignancies that originate in the kidneys. Each of these examples shows an increasing trend in the frequency and the mortality rate. This study aims to comprehensively define carcinomas by analysing clinical, paraclinical, and histological aspects to predict aggressiveness and mortality. Materials and Methods: We conducted a retrospective investigation on a group of patients suspected with kidney cancers. Results: We identified 188 cases. We observed a higher mortality rate and older age in individuals with urothelial carcinomas. Anemia, acute kidney injury, hematuria and perineural invasion were the main risk factors that predicted their mortality. Tumour size in renal cell carcinomas correlates with the presence of necrosis and sarcomatoid areas. Factors that indicate a higher rate of death are older age, exceeding of the renal capsule, the lesion that includes the entire kidney, lymphovascular invasion, acute kidney injury, and anemia. Conclusions: Even if they originate at the renal level, and the clinical-paraclinical picture is similar, the histopathological characteristics make the difference. In addition, to these are added the previously mentioned common parameters that can represent important prognostic factors. In conclusion, the characteristics commonly identified in one type of cancer may act as risk factors for the other tumor. The detected data include threshold values and risk factors, making a significant contribution to the existing literature.

Background and Objectives: Stroke is a main leading cause for mortality and morbidity worldwide. Treat-ment of this pathology is still under development and its risk factors remain the main target to be reached. Therefore, we aim to determine the role of interleukin 1 beta in atheromatosis, as risk factor for stroke and the reole of this biomarker in stroke prognosis. Materials and Methods: The study conducted enrolled 56 patients diagnosed with ischemic stroke in the anterior (AVT) and posterior vascular territory (PVT). All patients had venous blood collected at admission and 7 days after the onset of the cerebral ischemia in order to determine plasma concentration for interleukin 1 beta. At the same time an extracranial carotid ultrasound was performed. Results: Interleukin 1 beta collected at admission was positively correlated with NIHSS at admission (Pearson index 0,424) and both measurements were corelated with carotid stenosis (Spearmen correlation index 0,529, respectively 0,653). Conclusion: Interleukin 1 beta could be a reliable biomarker for stroke prognosis and carotid atheromatosis development.

(1) Background: The prediction of cervical lesions evolution is a challenge for clinicians. The prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors for the prediction of progression, regression or persistence of cervical lesions in human papillomavirus (HPV)-infected patients; (2) Methods: This prospective study included HPV-positive patients with or without cervical lesions that underwent follow-up. Descriptive statistics and sensitivity analysis for individual or combined index tests were used for data analysis; (3) Results: The highest predictive performance for the progression of cervical lesions was achieved by a model that comprised a Pap smear suggestive of high-grade squamous intraepithelial lesion (HSIL), the presence of 16/18 HPV strains, a positive p16/Ki67 dual staining result along with the presence of at least 3 clinical risk factors, which had a sensitivity (Se) of 74.42%, a specificity of 97.92%, an area under the receiver operating curve (AUC) of 0.961, and an accuracy of 90.65%. The prediction of cervical lesions regression or persistence was modest; (4) Conclusions: Multiple testing or new biomarkers should be used to improve HPV-positive patient surveillance, especially for cervical lesion regression or persistence prediction.

Buildings have started to play a critical role in the stability and resilience of modern smart grids, leading to a refocusing of large scale energy management strategies from the supply side to the consumer side. When the buildings integrate local renewable energy generation in the form of renewable energy resources they become prosumers and this reflects into additional complexity into the operation of the interconnected complex energy systems. A class of methods of modelling the energy consumption patterns of the building have recently emerged as black-box input-output approaches with the ability to capture underlying consumption trends. These make use and require large quantities of quality data produces by non-deterministic processes underlying the energy consumption. We present an application of a class of neural networks, namely deep learning techniques for time series sequence modelling with the goal of accurate and reliable building energy load forecasting. The Recurrent Neural Network implementation uses Long Short-Term Memory layers in increasing density of nodes to quantify prediction accuracy. The case study is illustrated on four university buildings from temperate climates over one year of operation using a reference benchmarking dataset that allows replicable results. The obtained results are discussed in terms of accuracy metrics and computational and network architecture aspects and are considered suitable for further used in future in situ energy management at the building and neighbourhood levels.

Chemical substances such us CS-gas used in military operations are chemical compounds that present a series of peculiarities that affect the ecosystem by disrupting the ecological balance. This study evaluated the toxicological character of O-chlorobenzylidenemalonitrile (CBM), (substance present in CS-gas) on the algae Cholrella sp. and analyzed the toxicity limit and the response of the microorganism to the oxidative stress caused by this substance. In order to under-stand the toxicological mechanisms of CBM on algal culture, a series of parameters were analyzed such as: the cell growth curve, the average specific growth rate (µ), percent inhibition in yield(I%), dry cell weight (DCW), percent viability and productivity of algal biomass flocculation activity(FA), change in oxygen production. The content of chlorophyll pigments, was characterized by Fourier transform infrared spectroscopy (FTIR) fluorescence spectroscopy and analysis of the surface structure of algal cells by SEM spectroscopy. This study aims to provide fundamental data for understanding the toxicity of CBM to aquatic organisms and provides a basis for assessing the potential for impact on aquatic ecosystems. The results obtained could be taken into account in the management of the decontamination of the affected areas.

Study background and aims: Laparoscopic cholecystectomy is one of the most frequently performed interventions in departments of general surgery. One of the most important aims in achieving perioperative stability of these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact monitoring the depth of anesthesia through Entropy (state entropy – SE and response entropy -RE) has on the hemodynamic stability and on the doses of volatile anesthetic. Material and Methods: This is a prospective, observational, randomized, monocentric study carried out between January 2019 and December 2019 in the Clinic of Anesthesia and Intensive Care from the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups; patients in Group A (target group) received multimodal monitoring that included monitoring of standard parameters and of Entropy (SE and RE), while patients in Group B (control group) only received standard monitoring. Anesthetic dose in group A were optimized to achieve a target entropy of 40-60. Results: 68 patients met the inclusion criteria and were allocated to one of the two study groups, Group A (N=43) and Group B (N=25). There were no statistically significant differences identified between the two groups for both demographical and clinical data (p>0.05). Statistically significant differences have been identified for the number of hypotensive episodes (p = 0.011, 95% CI 0.1851 to 0.7042) and for the number of episodes of bradycardia (p < 0.0001, 95% CI 0.3296 to 0.7923). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI -0.3942 to 0.9047). Conclusions: The implementation of the multimodal monitoring protocol that includes the standard parameters and the measurement of Entropy for determining the depth of anesthesia (SE and RE) lead to a considerable improvement in perioperative hemodynamic stability. Optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient leads to a considerable decrease in drug consumption as well as to a lower incidence of hemodynamic side-effects.

Background: The modified Duke index derived from coronary computed tomography angiography (CCTA) was designed to predict cardiovascular outcomes based on the severity of coronary ste-nosis. However, it does not take into consideration the presence or severity of peri-coronary in-flammation. The peri-coronary fat attenuation index (FAI) is a novel imaging marker determined by CCTA which reflects the degree of inflammation in the coronary tree in patients with coronary artery disease. Purpose: To assess the association between the modified Duke index assessed by CCTA, cardiovascular risk factors and peri-coronary inflammation in the coronary arteries of pa-tients with coronary artery disease. Methods: One hundred seventy-two patients who underwent CCTA for typical angina were assigned into two groups based on the modified Duke index: group 1 – patients with low index ≤ 3 (n=107) and group 2 – patients with high index > 3 (n=65). Demo-graphic, clinical and CCTA data were collected for all patients, and FAI analysis of coronary in-flammation was performed. Results: Patients with increased values of the modified Duke index were significantly older compared to those with a low index (61.83 ± 9.89 vs. 64.78 ± 8.9; p = 0.002). No differences were found between the two groups in terms of gender distribution, hypertension, hypercholesterolemia or smoking history (all p > 0.5). The FAI score was significantly higher in patients from group 2, who presented a significantly higher score of inflammation compared to the patients in group 1, especially at the level of the right coronary artery (FAI score 20.85 ± 15.80 vs. 14.61 ± 16.66; p = 0.01 for the right coronary artery, 13.85 ± 8.04 vs. 10.91 ± 6.5; p = 0.01 for the circumflex artery, and 13.26 ±10.18 vs. 11.37 ± 8.84; p = 0.2 for the left anterior descending artery). CaRi-Heart® analysis identified a significantly higher risk of future events among patients with a high modified Duke index (34.84 % ± 25.86 % versus 16.87 % ± 15.80 %; p

This article presents a harmonic analysis of the stator currents of a squirrel-cage in-15 duction motor fed by a voltage source inverter with PWM space vector control (SV-PWM). The 16 influence of PWM switching frequency and dead time (dead-band) of controlled transistors on 17 THD and electromagnetic torque ripple is shown. The aim is to determine the lowest switching 18 frequency of the transistors for which the drive will operate correctly. Characteristics were de-19 termined as functions in the form of THD ( ), where the least square approximation was 20 used for stator current measurements when the PWM switching frequency is changed. The ap-21 proximations were realized for simulation and experimental results. To clarify the results, the 22 operation of hardware PWM circuits in microcontrollers was analyzed.

There is an international concern for reducing energy consumption and protecting the environment in the construction industry. The energy efficiency of a building depends on the thermal resistance of concrete, and utilizing concrete products with elevated thermal resistance can enhance this aspect. This study analyzes the impact of perlite, as an addition, on the physico-mechanical properties of concrete, with the aim of identifying perlite concrete products that will respond to the improvement of the heat transfer resistance of the building envelope. The study examines the effect of replacing different amounts of concrete aggregates with perlite in percentages of 10%, 20%, 30%, and 100%. The results show that substituting sand with perlite improves the thermal performance of concrete, but its mechanical properties are negatively affected. The research carried out highlighted that perlite can be successfully introduced in the production of concrete blocks used for external non-bearing wall panels, the outstanding feature being the reduction of energy consumption in buildings. Overall, the paper identifies an efficient and environmentally friendly way of using perlite in the construction industry, enhancing the energy efficiency of buildings while minimizing the environmental footprint caused by the construction industry.

Energy imports and the transition to renewable energy sources are of critical importance in the current geopolitical context, which necessitates concrete actions to tackle the energy crisis at the European Union level. The study aims to explore the impact of imported non-renewable energy resources on the EU-27 economy. It examines the correlations and causal relationships between GDP, GVA, R&amp;D investments, and energy imports from 2000 to 2021. Data normality was assessed using the Shapiro-Wilk test, while Pearson's test identified correlations between variables. Linear and multiple regression analyses were conducted to determine the effects of changes in independent variables on dependent variables. The study found a strong association between natural gas imports and GDP, with increases in GDP leading to a more than fourfold rise in imports. Furthermore, multiple regression analysis indicated that a 1% increase in R&amp;D investments results in a 2.21% decrease in fossil fuel imports in 91.7% of cases. This suggests that R&amp;D investments contribute to improved efficiency and the use of renewable energy sources.

This study explores the complexities involved in the extraction and purification of catechins, prominent bioactive compounds found in plant extracts and tea. It addresses challenges arising from the intricate molecular structure of catechins and their inherent variability across botanical sources. Despite these obstacles, catechins present significant potential, particularly in healthcare. Their potent antioxidant properties have been extensively investigated and associated with numerous health benefits, positioning them as promising therapeutic agents for combating chronic diseases. Furthermore, catechins have diverse applications across various industries, including food and beverage, cosmetics, agriculture, and materials science. This abstract emphasizes the importance of continued research and innovation in catechin extraction and utilization, which hold promise for advancing human health and technological progress across multiple domains.

Autistic spectrum disease (ASD) is an increasingly common diagnosis nowadays with a prevalence of 1-2% in most countries. Its complex causality – a combination of genetic, immune, metabolic and environmental factors - is translated into pleiomorphic developmental disorders of various severity, which have in common two main aspects: repetitive, restrictive behaviors, and difficulties in social interaction varying from awkward habits and verbalization to complete lack of interest from the ASD child for the outside world. The wide variety of ASD causes also makes it very difficult to find a common denominator – a disease biomarker and medication – and currently there is no commonly used diagnostic and therapeutic strategy besides clinical evaluation and psychotherapy.It is known that inflammation is present in a majority of ASD children, and blood inflammatory markers, together with metabolic, electrophysiological markers and imagistics are useful for ASD diagnostic validation and treatment; however, they tend to leave out a sizeable proportion of ASD kids who do not have such modifications. Genetic testing – whole exome sequencing or targeted profiling on about 500 ASD-linked genes- may also provide good insight into pathophysiology, however many times its results are more restrictive rather than offering additional therapeutic options.Here we describe a new biomarker for ASD - the neuron-specific enolase (NSE) - which was elevated above the normal clinical range (less than 16.3 ng/mL) in the vast majority of ASD kids tested in our study (40 of 41, or 97.5%). This finding opens up a new direction for diagnostic confirmation, dynamic evaluation and therapeutic intervention for ASD kids.

(1) Background: CTA has validated the use of pericoronary adipose tissue (PCAT) attenuation as a credible indicator of coronary inflammation and plays a crucial role in coronary artery disease (CAD). This study aimed to evaluate the long-term effects of high-dose statins on PCAT attenuation at coronary lesion sites and changes in plaque distribution; (2) Methods: Our prospective observational study included 52 patients (mean age 60.43) with typical chest pain, a low-to-intermediate likelihood of CAD, and documented atheromatous plaque through CCT. We utilized advanced features of the CaRi-Heart® and syngo.via Frontier® systems to assess coronary plaques and changes in PCAT attenuation; (3) Results: Changes in plaque morphology were investigated, revealing significant alterations. Notably, in mixed plaques, calcified portions increased (p &lt; 0.0001), while non-calcified plaque volume (NCPV) decreased (p = 0.0209). PCAT attenuation generally decreased after one year and remained low, indicating reduced inflammation in the following arteries: LAD (p = 0.0142), LCX (p = 0.0513), and RCA (p = 0.1249). The CaRi-Heart® risk also decreased significantly (p = 0.0041). Linear regression analysis demonstrated a correlation between increased PCAT attenuation and higher volumes of NCPV (p &lt; 0.0001, r = 0.3032) and lipid-rich plaque volume (p &lt; 0.0001, r = 0.3281); (4) Conclusions: Our study provides evidence that high-dose statin therapy significantly reduces CAD risk factors, inflammation, and plaque vulnerability, as evidenced by the notable decrease in PCAT attenuation, a critical indicator of plaque progression.

The article examines the relationship between household food waste and GDP in various European regions, aiming to determine how economic prosperity influences household food waste levels. Using comparative analysis of secondary and tertiary data, we developed a synthetic indicator (IpFW), to assess the interaction between GDP per capita and household food waste per capita. Despite expectations, higher GDP did not consistently correlate with lower food waste, challenging assumptions about economic prosperity and environmental stewardship. The research underscores the complex interplay between economic factors and food waste management, revealing no significant correlation even at regional levels. It also highlights the potential of e-commerce in enhancing food waste reduction strategies. E-commerce platforms can optimize food supply chains and consumer behavior, contributing to more sustainable consumption patterns. The conclusions call for a reevaluation of policies and suggest that integrating e-commerce could bolster efforts to manage food waste more effectively, aligning with the Sustainable Development Goals.

Anesthesia ensures the welfare of the animal, enables safe and effective procedures, and allows accurate data collection [1]. In clinical veterinary practice, proper training and expertise in anesthesia administration and monitoring are essential. Pigs are commonly used in medical and scientific research as models for studying various aspects of human health, physiology, and disease due to their physiological and anatomical similarities to humans [2–4]. Pigs are suitable experimental animals for many surgery techniques because they are similar in size to humans and have a short reproductive cycle. This makes them ideal for research concerning organ transplantation, cardiovascular surgery, and other procedures that require a large animal model. Pigs also have a similar anatomy to humans, which makes them a good choice for studying diseases and developing new treatments [5]. Sedation and premedication should be administered at the lowest dose to be effective with predictable results and reduced adverse effects, to ensure the safety of both the animal and the team involved in the procedure, with a fast onset and optimizing the induction and maintenance of anesthesia. The goal of induction is to achieve a safe and effective level of anesthesia that ensures the patient's safety and facilitates the research. Most of the time, inhalation anesthesia with endotracheal intubation is the ideal choice for maintenance., allowing efficient anesthetic management. The difficulties related to the endotracheal intubation of pigs can be overcome by knowing the anatomical peculiarities related to the species and the multiple methods cited in the literature. Effective analgesia tailored to the specific procedure, the pig's condition, and individual responses to medications should complete the maintenance and recovery protocols, reducing perioperative complications.

Background: Chronic lateral epicondylitis challenges the therapeutical approach; underlying mechanisms are incompletely understood; neuropathic pain and central and peripheral sensitization may explain the fact that botulinum toxin was found to play a role in pain and function management. Methods: We searched the literature for MeSH terms: lateral epicondylitis or synonyms and botulinum toxin. Results: We found 14 papers containing trials on botulinum toxin injection into the tendon or into the extensor muscles (particularly extensor carpi radialis brevis and extensor communis digitorum). We followed the administration pathways, doses, timing and side effects. Conclusion: With chronic course, the focus of the therapy shifts from the afflicted tendon to the inserting muscles, as muscle contracture may create a vicious loop to perpetuate and aggravate the disease. Doses, timing and side effects are discussed.

Although ovarian cystic teratoma is the most common ovarian tumor, complications are quite rare. However, it is important to be recognized by the radiologist in order to avoid inaccurately diagnosing them as malignant lesions. This case report describes a 61-year-old postmenopausal woman, who presented to the emergency room with abdominal pain following a minor blunt abdominal trauma. In this context, a CT scan was performed, which showed the presence of round, hypodense masses randomly distributed in the peritoneum, with coexisting ascites in moderate amount; ovarian carcinoma with peritoneal carcinomatosis was suspected. The patient was hospitalized and an MRI of the abdomen and pelvis was recommended for a more detailed lesion characterization. Following this examination, the patient was diagnosed with mature cystic ovarian teratoma complicated by rupture. Surgery was performed, and the outcome was favorable. The cases of ruptured cystic teratomas are rare, and to our knowledge, this is the first occurrence described in literature. Special attention must be paid when confronting with such a case in medical practice, since it can easily misdiagnosed as peritoneal carcinomatosis

The present state of the natural environment is significantly influenced by the construction sector. Due to the large amounts of consumed natural resources and materials as well as the high volume of emitted pollutants, the building industry is considered to have a key influence in achieving a global sustainable development. A considerable part of the ecological impact of the built environment is influenced by the energy consumed for creating appropriate indoor conditions as well as by the greenhouse gases that are emitted during the operation stage of a building’s life cycle. Therefore, the energy performances of existing buildings must be significantly improved in the near future. This paper analyzes the influence of the thermal insulation thickness of walls on the linear thermal transmittances and the heating demand of an existing building. The resulted values show that while increasing the insulation of the walls leads to a serious heat demand reduction, a deep renovation of the building cannot be achieved solely by using this solution.

The 22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal microdeletion disorder caused by hemizygous microdeletion of the long arm of chromosome 22. It is now known to have a heterogenous presentation that includes multiple additional congenital anomalies and later-onset conditions, such as gastrointestinal and renal abnormalities, autoimmune disease, variable cognitive delays, behavioral phenotypes and psychiatric illness. The purpose of our paper is to present the case of a fetus diagnosed with a rare and complex cardiac malformation (interrupted aortic arch (IAA) type B, large malalignment-type ventricular septal defect (VSD), pulmonary valve dysplasia, aberrant right subclavian artery (ARSA). The result of the genetic testing revealed 22q11.2 deletion and after genetic counselling the patient decided to continue the pregnancy. She was regularly followed until delivery which took place in Germany so that neonatal cardiac surgery could be performed in an experienced center for cardiac malformations. We emphasize on the ultrasound aspects regarding the cardiac anomaly and specific features of 22q11.2DS in a continuous manner from diagnosis until delivery.

Background and Objectives: Wilson disease (WD) is a disorder of copper metabolism caused by genetic muta-tions in the ATP7B gene which lead to the accumulation of copper in the body. The aim of the present study is to investigate the severity of WD in patients in Romania. Materials and Methods: This study was conducted us-ing an online questionnaire consisting of 32 questions in a group of patients suffering from Wilson disease. Results: The study included 67 people aged 7 to 56 with WD. The most common symptoms of the participants were hepatic and neurological in 22 cases (32.8%). The most common neurological symptom in the assessed cases was muscle stiffness (49.5%), followed by tremor (45%), and speech disorders (40.5%). The Kay-ser-Fleischer ring was present in 50.7% of the participants. The most commonly used drug treatment in the participants was D-penicillamine (77.61%). Conclusions: The severity of WD is based on many aspects, the most important being early diagnosis and access to treatment throughout the year. The prognosis is favorable with early diagnosis and treatment, but it is crucial to diagnose individuals before they develop major symp-toms. Therefore, advances in WD screening can lead to an earlier diagnosis and better results.

Cellular therapies have started an important new therapeutic direction for Autistic Spectrum Disease (ASD), and the ample diversity of ASD pathophysiology and the different types of cell therapies need an equally ample effort for studying the applicable ASD causes and the specific benefits of cell therapies via clinical studies.CORDUS Clinical Study is a crossover study in which autologous cord blood was administered intravenously to 56 patients between January 2019 and July 2023, and has compared its efficacy versus an individualized combination of supplements; both treatments were administered in a different sequence to all participants. Treatment efficacy was evaluated pre- and post- treatments by an independent psychotherapist with ATEC, Q-CHAT and a 16-item comparative table score, after interviews with the children’s parents and therapists.Cord blood was beneficial in the group of 3–7-year-old children (n=28; 3 out of 4 children – 78.57% - improved scores), but was much less effective in kids older than 8 years or with body weight of more than 35 kg (n=28; 1 out of 10 children improved scores). Individualized supplements were more efficacious than cord blood in 5 cases out of 28, while in 23 kids cord blood brought more improvement than supplements; 6 kids registered minor or no improvement. Statistically significant improvements were seen after cord blood infusion on areas such as verbalization and social interaction, but not on irritability or aggressive behavior; also ample individual differences were noted. No serious adverse reactions were noted during and after cord blood or supplement administration.

In this study, the effect of ZnO nanoparticles (Zn NPs) on the performance of epoxy resin composites was investigated. The new ZnO/epoxy resin composites were synthesized using halloysite nanotubes (HNT) and different types of ZnO nanoparticles (commercial ZnO and ZnO-ODTES). These ZnO nanoparticles were utilized for intending to enhance the interfacial bonding between the epoxy resin and the reinforcement. Various methods such as FTIR, TGA, DSC, TEM-EDX, and Nanoindentation analyses were used to prove that the ZnO nanoparticles can improve the properties of epoxy resin composites. The thermal properties of the epoxy resin composites were enhanced to a greater extent by the addition of ZnO NPS. DSC testing proved that the epoxy resin composites modified with ZnO NPS are more flexible and elastic than unmodified epoxy resin. It was seen that the epoxy resin modified with ZnO-ODTES shows a much improved hardness and penetration depth compared to the other samples. These findings can pave the way for the developing of ZnO-based marine coatings with improved properties.

The metastatic disease is a complex and sequential process that involves the migration of tumor cells from the primary site to distant areas. This metastatic pathway is not always predictable. Therefore, this paper presents three rare cases of unusual metastases, due to their primary site: two metastases of a clear cell renal cell carcinoma, one gingival and one nasal, as well as a mandibular metastasis of a hepatocellular carcinoma. In all cases, an incisional biopsy was performed in order to sign out the diagnosis. After microscopical examination of morphological Hematoxylin and Eosin stained slides, for all cases, immunohistochemical reactions were performed to support the primary tumor site. Two cases had a previous histopathological diagnosis of a primary tumor, while for the third case, the metastatic lesion represented the first manifestation of the neoplastic disease, with an unfavorable prognosis.

Climate change not only affects weather conditions, patterns, and the frequency and severity of extreme weather events but also changes how governments spend money. Agriculture is an important sector of the European Union (EU), and it is projected to decrease by 16% by 2050, therefore a third of the EU budget has been spent on agricultural funding, adaptation, and climate action. The effect of climate change on agriculture is mixed and dependent on the country and its location. The southern EU is adversely affected while the northern EU is positively affected by the changes in weather patterns. The main goal of this paper is to gain insight regarding the effect that climate change has on public spending in relation to the agricultural sector of the EU, by using the pooled OLS and GMM methods. The study concluded that agriculture has a significant impact on public spending in the southern countries of the EU, where it represents a significant portion of the GDP. Inflation influences public spending in the whole EU region, the northern and southern countries of the EU. Rain has a moderately significant impact on public spending in the whole EU region. It is advised that governments maintain a controllable level of inflation using fiscal and monetary policy that will implicitly control public spending.

The aim of the paper is to analyze the experimental results of the influence of elevated temperatures and strain rate on the mechanical and structural properties of steel 42CrMo4. The experiments were based on uniaxial tension and compression tests at high temperatures between 700 °C and 1000 °C and strain rates range 0.0018 - 0.1 s^-1. The influence of temperature and strain rate on yield stress, strain to fracture, hardness, structural changes, and fracture characteristics were analyzed. Due to the dynamic recrystallization phenomenon present during the hot tensile tests, an increase in the flow stress is observed at the beginning of the deformation, after which it decreases until the fracture. By increasing the deformation temperature from 700 °C to 1000 °C, the tensile stress decreases significantly for all strain rates. The increase in the strain rate leads to the increase in the tensile stress. In compression tests by increasing the strain rate, the true strain is slightly increasing, but this depends on the temperature. The non-uniformity of deformations obtained at different values of the strain rate and temperature were also analyzed. Analysis by scanning electron microscopy showed the ductile behavior of the material. The degree of damage of the material caused by the presence of cavities increases by increasing the deformation temperature. For all the presented deformation conditions, the presence of the fracture through the ductile fracture mechanism was produced by the localized of necking and the coalescence of microvoids. By increasing the deformation temperature and reducing the strain rate, the fracture behavior of 42CrMo4 steel can be improved.

Background: Peritoneal sclerosis (PS) and its most severe form, encapsulating PS (EPS), are rare entities that can occur in various procedures (liver transplantation, intraperitoneal chemotherapy), secondary to medications ( beta-blockers); however, PS or EPS typically occur in patients undergoing peritoneal dialysis as a form of renal function substitution. Medical or surgical treatments can be applied, but morbidity and mortality have high rates . This condition typically presents clinically as an intestinal obstruction caused by the inclusion of the intestinal loops in the peritoneal fibrous membrane. Methods: Herein we present data from a single tertiary surgery center that has dedicated teams for patients receiving dialysis. In 12 years we analyzed a group of 63 patients admitted for catheter replacement/removal or for acute surgical pathology. In 5 cases (7,9%) we diagnosed EPS . Two patients with EPS presented with atypical abdominal pathologies requiring emergency surgery: one case of hemoperitoneum caused by a ruptured ovarian cyst and one case of uterine fibroids and metrorrhagia. Results: The definitive diagnoses were established intraoperatively and by analyzing the morpho-pathological changes of the peritoneum. The possible intraoperative challenges included laborious dissection, difficulties in restoring the correct anatomical landmarks, increased duration of the surgical intervention and a high rate of incidents and accidents Conclusions: The aim of the present study was to emphasize the possibility of other surgical pathologies overlapping with EPS, increasing the complexity of the surgical intervention. Also, we sought to determine whether there is a correlation between the morpho-pathological results of these patients who underwent emergency surgery and the common EPS morpho-pathological changes.

(1) Background: Thrombophilia is a tendency towards hypercoagulability, and it is increased by pregnancy, and peaking around delivery.; (2) Methods: 80 Eighty thrombophilia patients admitted for delivery between 1/10/2017 and 1/12/2021 were prospectively studied, together with 80 eighty age- and para-matched control patients. Patients were admitted for delivery at term by means of cesarean section. The inflammation indexes from the complete blood count values analysis, in during both the 24 hours before and the 24 hours after labor—, extracted from the hospital’s medical records—, were calculated, and then correlated with uterine involution.; (3) Results: In pregnant patients treated for thrombophilia patients, the patients who did not manage to have close their uterine cavity closed with in the first 24-48 hours had significantly higher SII and AISI inflammation indexes SII and AISI , than the onesthose who did manage to have their uterine cavity closed their uterine cavity. In pregnant patients treated for thrombophilia patients, MLR is higher in patients without the Rh factor than in those with the Rh factor. In non-thrombophilia patients, PLR was significantly higher as compared to treated thrombophilia patients. In non-thrombophilia patients, MCVL increased with age and, before labor, while SII and AISI increased with age, postpartum. ; (4) Conclusions: There may be an underlying inflammation state that persisted despite treatment in some pregnant thrombophilia pregnant patients.

Early discharge after childbirth has led to a rise in neonatal readmission, becoming a major concern in recent decades. Our research aimed to identify the risk factors and incidence of neonatal readmission, as well as explore preventive measures. Our study at the Clinical Hospital of Pediatrics in Ploiești, Romania included 108 neonates admitted during the neonatal period. This accounted for 2.06% of all admissions (5226). The most prevalent cases were malnutrition (25%), fever (20.3%) and bronchiolitis (17.5%). Diarrhea and infectious gastroenteritis were also observed (14.8%), along with acute rhinoconjunctivitis (9.2%) and late onset sepsis (3.7%). No deaths were recorded. The most significant characteristics identified were number of children (p&lt;0.001) and age at maternity discharge (p&lt;0.001). By following the prevention rules, malnutrition, feeding errors, and infections can be avoided. This includes practicing proper hand hygiene for both mothers and medical staff, as well as educating and demonstrating to mothers the benefits of breastfeeding. In addition, all newborns discharged from the maternity ward should benefit from follow-up at 7-10 days of life. Our results confirm the effectiveness of a multidisciplinary team and endorse promoting breastfeeding. Implementing quality control measures and regularly evaluating the surveillance program will help improve its effectiveness.

1) Background: The screening of preeclampsia (PE) and intrauterine growth restriction (IUGR) represents a constant challenge for obstetricians. The aim of this study was to determine and compare the predictive performance of 4 machine learning-based algorithms for the prediction of PE, IUGR, and their association in a cohort of singleton pregnancies; (2) Methods This prospective study was conducted at a tertiary maternity hospital in Romania, and included 210 pregnancies that underwent first trimester screening. We included clinical and paraclinical data into 4 machine learning-based algorithms decision tree (DT), naïve Bayes (NB), support vector machine (SVM), and random forest (RF), and calculated their predictive performance; (3) Results: RF performed the best when used to predict PE, IUGR, and its subtypes, as well as the association between PE and IUGR. The overall predictive performance of DT for all these disorders was inferior to RF, NB, and SVM. Both SVM and NB had similar accuracy for the prediction of PE, while NB performed better than SVM for the prediction of IUGR; (4) Conclusions: Machine-learning-based algorithms could be useful for the prediction of ischemic placental disease and need to be validated on large cohorts of patients.

Background: Diabetes mellitus is one of the most common endocrinopathies, estimated to affect about 5.4% of the world's population around 2025. It is thought that nearly a third of diabetic patients have some type of skin condition. Frequently, the cutaneous effects of this heterogeneous syndrome are accurately detected late in the progressive form of the disease. Methods: Skin fragments were harvested from adult white Wistar rats of both sexes, with the weight of 200 g, 12 weeks after streptozotocin diabetes was induced. In parallel with histopathological diagnosis by using hematoxylin and eosine staining, samples were processed by transmission electron microscopy technique and examined with a Philips CM100 microscope. Results: In the apparently macroscopically unchanged tegument, photon microscopy revealed both progressive thinning of the epidermis in the early stages of diabetes and a significant process of fibrosis and collagen hyalinization in the dermis. In addition, in the early stages, the electron microscopic study provided ultrastructural details characteristic of a senescent phenotype with reduced cell proliferation. Conclusions: The morphological changes in the skin may be the first signs of disruption of carbohydrate metabolism and in the case of established diabetes may reflect its progression and the efficacy of therapy.

Cryosurgery has emerged as a promising method for harvesting veins, but the suitability of these cryostripped veins as grafts remains a subject of investigation. This study delves into uncharted territory by conducting an immunohistochemical analysis and exploring the molecular aspects of venous samples obtained through cryostripping. Existing literature lacks comprehensive data on the components of varicose veins' walls, particularly in relation to protein expression. Furthermore, little is known about the proliferation rate of endothelial cells within varicose veins, which we scrutinize alongside an assessment of CD34 endothelial reactivity. Materials and Methods: Our study encompassed 109 samples procured using the cryostripping method, which involves catheterizing veins with a specialized probe cooled to -85°C. Molecular profiling of the intima and endothelium was conducted using two key markers: CD34 and Ki67. Results: Immunoreactivity for CD34 was discernible across all three layers of the varicose vein walls that were excised using cryostripping. Notably, the endothelial cell layer exhibited intense and uniform positivity in 36 out of the 109 samples under investigation. In contrast, the results regarding Ki67 expression, whether pertaining to the intima or endothelium, remain inconclusive. Conclusions: Our findings advocate for the utilization of CD34 as a reliable marker to assess the morphological and molecular integrity of excised venous specimens. As the use of cryosurgery-harvested veins as grafts gains traction, this research contributes valuable insights into their potential viability for transplantation, opening new avenues for further exploration in the field of vascular surgery.

Laboratory diagnosis of leishmaniasis remains a major challenge, demonstrating variable efficacy in detecting infected mammalian hosts. Thus, there is a great need for the accuracy of the identification of appropriate antigens to also improve diagnostic tests. This review brings to the fore the sensitivity of the balance in canine and human leishmaniasis, which greatly influences the progression of the disease and especially the diagnostic methods. The problem of diagnosis arises in asymptomatic leishmaniasis, since in these conditions the methods considered as reference in the diagnosis of leishmaniasis no longer show certainty, being influenced for the most part by the immune response of the host, which is different according to the presence of other associated diseases or even according to the breed, when we talk about dogs. Consequently, the diagnosis and surveillance of leishmaniasis cases remains an open topic, with the need for new methods adapted to the immunological status of the host.

The evaluation of spatial planning results, or outcomes, has been rather neglected by scholars and practitioners. The causes of this neglect are linked to the characteristics of the planning systems in use or difficulties in quantifying results. To advance the state of the art of outcome evaluation, this paper focuses on assessing the implementation of national spatial planning objectives in urban landscapes, through the use of an evaluation framework that makes use of spatially explicit information. The framework is built on four dimensions which reflect the main domains of spatial planning: efficient built-up development, conservation of agricultural land, landscape preservation, and human perception. Indicators capable of capturing landscape changes in both time and space are used to verify degree of conformance between adopted objectives and actual development patterns. We make use of spatially explicit data and assess whether and where landscape changes occurred, by integrating the framework into a multi-criteria analysis. In the present study, the framework is tested in two study areas in Switzerland and Romania, and the results are interpreted from the perspective of spatial planning approaches in the two countries. The efficiency and utility of the framework is demonstrated by its ability to provide valuable information facilitating improvement in the performance of planning processes, such as identifying where the implementation of objectives is less effective, and the domains of spatial planning that are affected. Our findings highlight that the distance between objectives and outcomes can be attributed to differences in countries’ spatial planning approaches, particularly regarding landscape preservation and management. Our study provides valuable insights for the integration of time series of spatial data into the evaluation procedure.

Type 2 Diabetes Mellitus (T2DM) is one of the most common metabolic disorders, with a major involvement of oxidative stress in its onset and progression. Pioglitazone (Pio) is an antidiabetic drug which primarily works by reducing insulin resistance while Curcumin (Cur) is powerful antioxidant with o important hypoglycemic effect, also. The both drugs are associated with several drawbacks, such as reduced bioavailability, a short half-life time (Pio) as well as instability and poor water solubility (Cur), which limit their therapeutic use. In order to overcome these disadvantages, a new co-delivery (Pio, Cur) nanosystem based chitosan (CS) (CS-Pio-Cur NPs), was developed, and characterized in reference with simple nanosystems (CS-Pio NPs, CS-Cur NPs). The developed CS-based NPs (CS-Pio-Cur NPs, CS-Pio NPs, CS-Cur NPs) were physico-chemical characterized in terms of particle size (PS), entrapment efficiency (EF%) and loading capacity (LC%). The CS-Pio-Cur NPs proved increased or similar values of EE (88.95% ± 7.79 for Cur; 94.83% ± 9.89 for Pio) and LC% (24.25 % ± 1.62 for Cur; 3.5% ± 0.98 for Pio), in reference with simple nanosystems, CS-Cur NPs (EE = 82.46% ± 1.74; LC = 20.34% ± 0.94) and CS-Pio NPs) (EE = 96.31% ± 0.68; LC = 4.11% ± 0.47), respectively. The identification of APIs (Cur, Pio) loaded into CS matrix was performed using FR-IR spectroscopy and for simultaneously quantification of APIs (Cur, Pio) released from CS-Pio-Cur NPs, a HLPC method was developed and validated. Based on release study performed in different simulated fluids (SGF, SIF, SCF) it can be appreciated that developed CS-APIs NPs have favorable pharmacokinetic profile with good release in gastrointestinal tract.

The current paper presents a case of a 33-year-old female with an uncommon localization of a leiomyoma in the oral cavity - the anterior palatal fibromucosa and the incisive papilla. The patient referred to the Oro-Maxillo-Facial Surgery Clinic of the Emergency City Hospital Timisoara, Romania accusing a slight discomfort in the act of mastication and the occurrence and persistence of a diastema between the upper central incisors, due to the presence of a tumoral mass located in the anterior palatal mucosa, between the upper central incisors, without any changes of the subjacent bone structure in the anterior hard palate visible on the cone beam computed tomography image (CBCT). The tumor was removed by a surgical excisional biopsy and a histopathological examination was performed using morphological Hematoxylin–Eosin (HE) staining and additional immunohistochemical (IHC) reactions, in order to confirm the diagnosis. On microscopic examination, there were found bundles of spindle cells with eosinophilic cytoplasm and vesicular nuclei, with finely granular chromatin. The immunohistochemically staining found positive results for smooth muscle actin (SMA) and desmin and negative result for vimentin. The treatment of choice for leiomyoma of the oral cavity is surgical excision with clear margins, followed by periodical clinical monitoring.

Congenital heart disease (CHD) is a prevalent congenital disorder diagnosed with high frequency, affecting approximately 0.8% to 1.2% of all live births. Research has demonstrated that the use of pulse oximetry and clinical examination as a screening tool for CHD diagnosis has proven extremely valuable. We conducted a retrospective longitudinal study over a 3-year period that involved screening 1188 newborns admitted to the NICU during the first 72 hours of life within this timeframe. 201 newborns were diagnosed with CHD. Almost all (n=198) had a positive screening test during the 72-hour period, while 3 had a negative screening test, but were later diagnosed using echocardiography. The prevalence rate was 16.67%. A confusion matrix was constructed with 198 true positives (TP), 3 false negatives (FN), no false positives (FP), and 987 true negatives (TN). The sensitivity of the screening test was 98.51%, while the specificity 100%, with no false positives. In our study, a total of 9 deaths occurred. Using the Kaplan-Meier method, the survival probability appeared to be slightly above 0.9 (95.5%), indicating that almost all patients survived past 72 hours after being diagnosed with CHD. Pulse oximetry is an effective, low cost and easy-to-use method and a useful tool to assess and lead to the diagnosis of CHD.

Background: Survival and outcome of extremely preterm (EP) infants have improved due to changes in the management of stabilization at birth and respiratory distress syndrome. Methods: In a retrospective study conducted at an academic perinatal level III center in Romania, we compared the effects of different protocols on the early outcomes of EP infants of two different periods (2008-2012 vs. 2018 vs. 2022). Two subgroups were studied in each period, based on gestational age (GA), 22-25 weeks, and 26-28 weeks, excluding those with significant congenital anomalies or missing data. Results: 270 EP infants were included in the study (121/149), with a mean GA 26.1±1.6/26.7±1.1 weeks. Significant improvements were found during period II regarding initial FiO2 (40% vs. 100%; &lt;0.001), nCPAP (55.7% vs. 19.0%; p&lt;0.001) at birth, early rescue surfactant administration (65.8% vs. 34.7%; p&lt;0.001), need of mechanical ventilation (58.4% vs. 98.3%; p&lt;0.001). Survival rates of EP infants significantly improved from 41.3% to 72.5%, particularly in the 26-28 weeks subgroup (63.8% to 83%). The frequency of severe IVH decreased in period II from 30.6% to 14.1%, while the rates of BPD were lower in period II (23.4% vs. 36.6%; p=0.045), in the 26-28 weeks subgroup. We found improvements but no significant differences in NEC, sepsis, PVL, ROP, or PDA frequencies. Conclusions: Using updated guidelines and protocols is crucial for improving outcomes.

Several strategies promote phyllosphere colonization by soil-born Trichoderma plant-beneficial strains. One of these is foliar spraying with suspensions containing large amounts of chlamydospores – spores with a thick cell wall structure that makes them highly resistant to harsh environmental conditions. Trichoderma biomass was produced by cultivation on cornmeal medium and compared by microscopic and thermogravimetric analysis with the biomass produced in potato dextrose broth. Both analyses revealed higher chlamydospores content and thicker mycelium in the fungal biomass produced on cornmeal medium. The Trichoderma suspension rich in chlamydospores was sprayed on bitter gourd (Momordica charantia) leaves at two concentration levels, 106 and 108 ufc/ml. The effect of these treatments on plant physiological parameters, leaf photosynthetic pigments, polyphenol and flavonoid contents, antioxidant activity of leaves and fruits and yield was compared to the control (plants sprayed with water) and to the experimental treatment sprayed with 108 ufc propagules produced in potato dextrose broth. The effect of chlamydospore-rich suspensions on plant physiological parameters was more pronounced and long-lasting compared with the other treatments. The treatment with chlamydospore-rich suspension enhanced the accumulation of polyphenols and flavonoids in the leaves and fruits and increased the antioxidant activity. The application of the foliar treatment with Trichoderma suspensions did not modify the cytocompatibility of the extracts from fruits determined on L929 cells.

The article presents comparative results from 5 categories of animals (4 samples originating from pigs, 2 from cows, 1 from chicken, 1 from ostriches, 1 from horses, samples quantified with A, B, C, D, E, F, G, H, I). These samples were collected from large, medium and small (family) farms. The results were validated by the biogas production generated by the respective samples, using the Automatic Methane Potential Test System (AMPTS II) bio-processor. The largest amounts of biogas (2,464.5 Nml, 2,262.0 Nml) were recorded for the samples from pig farms (Sample B and Sample D), whereas the lowest values were obtained in the case of Sample A (414.1 Nml) and Sample C (558.3 Nml). The heavy metals analyzed in the article are Zn, Cu, Fe, Mn, Ca, K, As. The results corroborate that the C/N ratio can also vary to values lower than 20-30, without affecting the biogas production process, and the heavy metal content must be known especially for the full management of the wastes. All final data presented in the article are based on repeated, triplicate experiments, with less as 2% deviation between data.

Using of the organic base tetramethylammonium hydroxides (TMAH) is a viable, cheap and fast route, for the MgZnAl-LDH type materials synthesis by both co-precipitation and mechano-chemical methods. TMAH provided several advantages as smaller quantity of water required in the washing step compared to the use of inorganic alkalis, prevention of LDH contamination with alkali cations, acting as template molecule in texture tailoring along with disadvantages as its presence in small quantities in the resulting layered materials. Regardless the use of organic / inorganic bases and co-precipitation / mechano-chemical methods, zincite stable phase was found in all the synthesized solids. The basicity of catalysts followed the trend: mixed oxides &gt; reconstructed &gt; parent LDH. The memory effect of LDH is supported only by the presence of Mg and Al cations, while Zn remains as zincite stable phase. The catalytic activities for Claisen-Schmidt condensation of benzaldehyde with cyclohexanone provided values higher than 90% after 2h, with a total selectivity in 2,6-dibenzylidenecyclohexanone, while in self-condensation of cyclohexanone no more than 7.29% after 5h. These behaviors depended on catalysts basicity as well as the planar rigidity of the compound.

In an increasingly changing world, critical thinking is one of the key skills that ensure organisations' competitive advantage. Thus, in higher education institutions there is an accelerating emphasis on developing critical thinking (CT) among students. This paper presents the results of three experimental courses (Pedagogy and didactics of financial accounting, Virtual Learning Environments in Economics, Business Communication), using a blended learning method, aimed at improving students' CT skills. The three courses were delivered by both higher education teachers and trainers from the labour market. After analysing the data from the three experimental courses, it will be possible to assess whether the intervention of labour market trainers contributed to the improvement of students' critical thinking skills, and, in particularly at the level of which components improvements have been identified.

The present paper introduces a new class of Stancu-Kantorovich operators constructed in the King sense. For this class of operators we establish some convergence results, error estimations theorems and graphical properties of approximation for the cases considered, namely, operators that preserve the test functions $e_{0}(x)=1$ and $e_{1}(x)=x$, $% e_{0}(x)=1$ and $e_{2}(x)=x^{2},$ as well as $e_{1}(x)=x$ and $e_{2}(x)=x^{2} $. The new class of operators introduced in this paper is a genuine generalization of the class introduced by Indrea et al. (see Indrea A., Indrea A., Pop O. A New Class of Kantorovich-Type Operators, Constructive Mathematical Analysis).

Birds are highly social and need pairing in order to increase their welfare. Most bird species are monomorphic, therefore, molecular sexing helps to provide appropriate welfare for birds. Moreover, early sex determination can be of great value for bird owners. The aim of this study was to demonstrate that sex identification in birds by molecular methods, using samples collected by minimally invasive methods is fast, efficient and accurate. A total of 100 samples (29 paired samples of feathers - oral swab and 14 tripled samples of feathers - oral swab - blood) from 43 birds were taken into study, as follows: wild birds (Falconiformes, Accipitriformes, landfowl – Galliformes, waterfowl– Anseriformes), companion birds (Passeriformes, Psittaciformes – large, medium and small size parrots). Amplification of CHD1-Z and CHD1-W genes was performed by conventional PCR. The results obtained from feathers were compared to those obtained from oral swabs and with those obtained from blood samples, where was the case. The obtained results show that all types of samples can be used for molecular sexing of all studied species of birds. According to our knowledge, the present study reports for the first time the molecular sex identification in: Red Siskin (Carduelis cucullata) and Goldfinch (Carduelis carduelis major). For higher accuracy, our recommendation is to use minimally invasive samples (swab-feathers) and to test both types of samples, for each bird, instead of blood samples.

In the last 20 years, the share of renewable energy sources in the production of electricity in the European Union has doubled, from about 15% to almost 35%. The main driver of this development has been the increase in the share of wind energy and solar photovoltaic energy. The authors aim to analyze the influencing factors that affect the energy transition process applied to nautical tourism, from polluting energy to renewable solar energy. The authors' research approach consists in using the framework offered by the energy transition process from the perspective of the socio-technical and economic approach, by applying the qualitative research method with a deductive approach. The tool used to achieve the objective was the semi-structured interview. The research unitarily, holistically, and specifically approaches the problem of energy transition from polluting sources to renewable ones offered by solar energy, in the case of nautical tourism with direct implications on the specific industry in the Netherlands. The research results are structured in the fields of technology, governance, economics, and user preferences. This research has the potential to provide support to find optimal solutions that encourage users to accelerate the energy transition process by adopting sustainable solutions for nautical tourism.

This study investigates the complex interplay between public sentiment, as captured through news titles and descriptions, and the stock prices of three major tech companies: Microsoft (MSFT), Tesla (TSLA), and Apple (AAPL). Leveraging advanced analytical methods including Pearson correlation, wavelet coherence, and regression analysis, this research probes the degree to which stock price fluctuations can be attributed to the polarity of media sentiment. The methodology combines statistical techniques to assess sentiment's predictive power on stock opening and closing prices, while wavelet coherence analysis unveils the temporal dynamics of these relationships. Results demonstrate a significant correlation between sentiment polarity and stock prices, with description polarity affecting Microsoft's opening prices, title polarity influencing Tesla's opening prices, and a positive impact of title polarity on Apple's closing prices. However, Tesla's stock showed no significant coherence, indicating a potential divergence in how sentiment affects stock behavior across companies. The study highlights the importance of sentiment analysis in forecasting stock market trends, revealing not only direct correlations but also lagged influences on stock prices. Despite its focus on large-cap tech firms, this research provides a foundational understanding of sentiment's financial implications, suggesting further investigation into smaller firms and other market sectors.

The rapid technological development of society determined increased demand for safe potable water and food resources. Unfortunately, this progress causes complex environmental pollution, that is continuously challenging the scholars’ community. Therefore, it is important to chemically analyze the food for a better understanding of pollution-spreading mechanisms. Our study is focused on food analysis originating from Vatra Dornei City, which belongs to Suceava County in the Bukovina region of Romania. It represents a well-known Romanian spa and ski resort in the northern parts of the Oriental Carpathians Mountains. The mountain region owns a lot of mineral resources, mainly consisting of mineral and sparkling waters, uranium, manganese, copper, pyrite, chalcopyrite, polymetallic ores, baryte, gold and silver-bearing orebodies, etc. The present contribution aims to point out the results obtained from the analysis of soil, water and food samples collected from the local markets. The food samples consisted of lettuce, spinach, apples, pork (smoked) chicken meat (raw), milk and cheese. Last year the survey was conducted over six months. The results highlighted that the mining activities carried out during time caused environmental pollution with uranium and heavy metals due to the waste heaps’ weathering phenomena and tailing ponds’ presence.

Background: Over the past years, there has been a rise in the incidence of type 1 diabetes, partic-ularly among younger individuals. This concerning trend has prompted investigations into po-tential contributing factors, with intestinal dysbiosis emerging as a likely culprit for the escalating annual rates of the disease; (2) Methods: We conducted a retrospective ecologic correlational study involving 37 children from the southern region of Romania between 2019-2021. All participants were within the first six months following the onset of the disease; (3) Results: In the microbiota of the patients we observed a dysbiosis marked by an overabundance of bacteria (Clostridium coccoides, Faecalibacterium, Bacterioides, Enterobacteriaceae) and fungi, compared to the healthy control group. The Spearman correlation revealed a positive association between the presence of Bacteroides (p=0.0442), Butyricicoccus (p=0.0164), and Clostridium leptum (p=0.0023) with recent diabetes onset. Furthermore, a significant correlation was observed between younger age at onset and the pres-ence of Butyricicoccus (p=0.019). The use of antibiotics in the month preceding admission was linked to the presence of fungi in the microbiota (Candida, p=0.0442); (4) Conclusions: The dysbiosis of Romanian type 1 diabetes children correlates with inflammation, more severe onset of the disease and other au-toimmune diseases.

Hepatocellular carcinoma is the most common primary malignant hepatic tumor and occurs most often in the setting of chronic liver disease. Liver transplantation is a curative treatment option and is an ideal solution because it solves the chronic underlying liver disorder while removing the malignant lesion. Because of organ shortages this treatment can only be applied to carefully selected patients according to clinical guidelines to minimize risk of recurrence. Artificial intelligence is an emerging technology with multiple applications in medicine with a predilection for domains that work with medical imaging like radiology. With the help of these technologies laborious tasks like segmentation can be automated and workflow in radiology departments can be improved. Other roles include in depth pixel-wise analysis of lesions by radiomics or deep learning in order to find new imaging criteria that allow better prediction of treatment response or risk of recurrence. Liver transplant is an ideal treatment for patients with hepatocellular carcinoma in the setting of chronic liver disease and artificial intelligence could provide solutions for improving the management of liver transplant candidates to improve survival.

In dermatological practice, disturbances of the skin microbiome are found in various infectious and inflammatory dermatoses featuring one or more skin lesions with loss of tissue, directly exposing skin layers to microbial invasions. Literature data on the incidence of cutaneous-onset sepsis are, however, scarce. This retrospective observational study assessed hospital admissions for primary skin lesions with vs. without bacterial infections and sepsis during 2020-2022 in the largest emergency hospital in NE Romania. Of 509 patients 441 had infected lesions, 78 had sepsis caused by venous ulcers microbial eczema cellulitis, superinfected bullous dermatoses, erysipelas, erythroderma. Cultured samples revealed S. aureus, P. aeruginosa, E. coli, with K. pneumoniae, S. β-hemolytic associated with sepsis even if rarer. Clinical manifestations included ulcerations, erosions, fissures, excoriations, bullae, vesicles, pruritus, tumefaction, edema, fever, chills, pain, adenopathy, mildly altered mental status. Underlying chronic heart failure, atrial fibrillation, anemia, type-1 diabetes mellitus were comorbidities associated with infection and sepsis. Significant associations and risk factors, including their combined effects, are discussed to draw attention to the need for further research and adequate management to prevent sepsis in adult patients of any age presenting with infected skin lesions (especially cellulitis) and comorbidities (especially type 1 diabetes mellitus and anemia).

This study conducts a comprehensive review of the integration of Hybrid Electric Turbochargers in mass-produced road vehicles. The primary objective is to inform the readers about the potential advantages and innovative applications of HETs. Employing a SWOT analysis, the research compares the performance of HETs on thermal engines versus traditional turbochargers and HETs on thermal engines versus HETs on hybrid engines based on a synthesis of multiple research findings. The study elucidates the fundamental mechanics of turbochargers, emphasizing their inherent benefits. Additionally, it introduces a novel approach with the integration of the hy-brid-electric turbocharger, demonstrating its capacity, supported by practical examples. The in-corporation of turbochargers with energy recovery mechanisms, including HETs, is shown to significantly contribute to emissions reduction. Moreover, the electric drive facilitates the utili-zation of hybrid turbines, particularly on low-displacement engines, resulting in enhanced effi-ciency, torque, and liter power. In conclusion, the research underscores the potential of HETs to substantially mitigate the environmental impact of the transportation sector by reducing emis-sions and conserving energy. Their ability to optimize the fuel efficiency and power output of internal combustion engines, coupled with the feasibility of downsized engines, positions HETs as an attractive option for both manufacturers and consumers. However, it is acknowledged that the implementation of HETs is in its early stages, necessitating further research to comprehensively understand their environmental impact. Despite this, the promising positive impact on the en-vironment designates HETs as a technology deserving close attention in the forthcoming years.

Mild TBI (mTBI) accounts for most TBI cases, the leading cause of morbidity and mortality worldwide. Despite their high incidence, mTBI pathophysiology remains largely unknown. Recent studies have shown that the inflammatory response is activated early after mTBI and can persist for several weeks or months. However, limited evidence on the utility of inflammatory biomarkers as predictors of clinical outcomes in mTBI was previously provided. Thus, this study aims to provide an overview of the current knowledge on the role of inflammation in the pathogenesis of mTBI and the potential of some inflammatory biomolecules as biomarkers of mTBI. Thus, it was shown that the increase of IL-6, TNF-α, and IL-1β plasma levels could be implicated in the development of the early post-concussion symptoms. On the other hand, the persistence of the increased plasmatic concentrations of IL-10 and IL-8 for as long as six months following the brain injury event could suggest chronic inflammation leading to neuroinflammation and late or persistent symptoms. In this context, our findings showed that the inflammatory biomarkers could be relevant in diagnosing or predicting recovery or long-term outcomes of mTBI.

Mechanistic models have been used for centuries to describe complex interconnected processes, including biological ones. As the scope of these models has widened, so have their computational demands. This complexity can limit their suitability when running many simulations or when real-time results are required. Surrogate machine learning models can be used to approximate the behaviour of complex mechanistic models, and once built, their computational demands are several orders of magnitude lower. This paper provides an overview of the relevant literature, both from an applicability and a theoretical perspective. For the latter, the paper focuses on the design and training of the underlying machine learning models. Application-wise, we show how machine learning surrogates have been used to approximate different mechanistic models. We present a perspective on how these approaches can be applied to models representing biological processes with potential industrial applications (e.g., metabolism and whole-cell modelling) and show why surrogate machine learning models may hold the key to making the simulation of complex biological models possible using a typical desktop computer.

Global warming and the global energy crisis are two major challenges humanity is currently confronting that are pressuring the scientific community to find efficient, low cost and environmentally sustainable solutions. Within this context, hydrogen has emerged as a clean and efficient energy carrier promising to replace the environmentally hazardous fossil fuels. The present study, of relevance to the water splitting domain, concerns the synthesis of two novel hybrid structures, based on perovskite materials functionalized with polyvinylpyrrolidone (PVP). The water electrolysis catalytic activity of these new materials was evaluated in a strongly alkaline medium. Perovskite-based modified electrodes were manufactured through four different procedures. The samples displayed electrocatalytic activity for the O2 evolution reaction and the most active electrode was the one obtained by drop-casting a mixture of LaMnO3:Ag/PVP, Carbon Black and Nafion on graphite support. The study is aimed at and succeeds in increasing the scientific database concerning the role of perovskite oxides in the water splitting field.

The objective of this research is to analyze metal elements like Na (sodium), Mg (magnesium), Al (aluminum), Si (silicon), Pb (lead), K (potassium), Ca (calcium), and Fe (iron) found in dust particles within two distinct areas from which the sampling has been done. First sampling was taken from the road verge of a highly trafficked road section, while the second sampling was done in a residential garden area 90 m away from the road. Several metal elements have been detected, with a high difference for Silicon Si, which present higher concentrations in the dust sampled from the road verge area. Pb has only been detected in the samples taken from the road verge, which could be explained by residual remnants from old lead gasoline, and wheel weights. Additionally, airborne particulate matter (PM) concentrations have been measured, during the same episode, in comparison between the road verge and the garden area, presenting a substantial difference in the concentration levels, deducing that dense vegetation is protecting and blocking a majority of airborne PM. A literature highlight of health effects of different metal elements and PM concentrations is presented.

Background and Objectives: The purpose of this study was to investigate whether early surfactant administration affects the status of ductus arteriosus (DA) in preterm infants ≤32 weeks of gestational age (GA) within 24 hours of birth. Materials and Methods: It is a prospective study conducted from March 15, 2022, to November 15, 2023, in a tertiary academic center. In-born infants ≤ 32 weeks of gestation (n = 88) were enrolled. The study group was further divided into surfactant (n=44) and non-surfactant (n=44) subgroups. Results: 76% of the preterm infants who received surfactant therapy (RRR = 0.839) recorded an increase in Kindler Score at 24 hours of life (1-RR = 1-0.24 = 76%). Surfactant administration was significantly associated with decreased pre-ductal diastolic pressure (29.9 mmHg vs. 34.8 mmHg, p=0.0231), post-ductal diastolic pressure (28.7 mmHg vs. 32.2 mmHg, p=0.0178) pre-ductal MAP (41.6 mmHg vs. 46.5 mmHg, p=0.0210) post-ductal MAP (41.0 mmHg vs. 45.3 mmHg, p=0.0336). There were no significant changes in ductus arteriosus parameters at 24 hours of life. Conclusions: Early surfactant administration does not affect the status of ductus arteriosus in preterm infants ≤32 weeks of gestational age at 24 hours of life.

Gangliosides are highly abundant in the human brain where they are involved in major biological events. In brain cancers, alterations of ganglioside pattern occur, some of which being correlated with the neoplastic transformation, while others with the tumor proliferation. Of all the techniques, mass spectrometry (MS) has proven to be one of the most effective in gangliosidomics, due to its ability to characterize heterogeneous mixtures and discover species with biomarker value. This review highlights the most significant achievements of MS in the analysis of gangliosides in human brain cancers. The first part presents the state-of-the-art in the MS development for discovery of ganglioside markers in primary brain tumors, with a particular emphasis on the ion mobility separation (IMS) MS and its contribution to the elucidation of the gangliosidome associated with aggressive tumors. The second part is focused on the MS of gangliosides in brain metastases, highlighting the ability of matrix-assisted laser desorption/ionization (MALDI)-MS, microfluidics-MS and tandem MS to decipher and structurally characterize species involved in the metastatic process. In the end, several conclusions and perspectives are presented, among which the need for development of a reliable software and a user-friendly structural database as a search platform in brain tumor diagnostics.

This study explores the potential of data science software solutions like Customer Relationship Management Software (CRM) for increasing the revenue generation of businesses. We focused on those businesses in Accommodation and Food Service sector across the European Union (EU). The investigation is contextualized within the rising trend of data-driven decision making, examining the potential correlation between data science application and business revenue. Employing a comprehensive evaluation of Eurostat datasets from 2014 to 2021, we used both univariate and multivariate analyses, we assessed e-commerce sales data across countries, focusing on the usage of big data and CRM tools. Big data utilization showed a clear, positive relationship with enhanced e-commerce sales. However, CRM tools exhibited a dualistic impact: while their use in marketing showed no significant effect on sales, their application in non-marketing functions had a negative correlation. These findings underscore the potential role of CRM and data science solutions in enhancing business performance in the EU's Accommodation and Food Service industry.

Background: This review aims to explore the regulatory mechanism of microglial exosomes, particularly focusing on the role of miR-124-3p, in modulating neuroinflammation and promoting neuronal repair following traumatic brain injury (TBI). Methods: Multiple studies investigating the impact of microglial exosomal miRNAs, specifically miR-124-3p, on injured neurons and brain microvascular endothelial cells (BMVECs) in the context of TBI were reviewed. Results: Animal models of TBI, in vitro cell culture experiments, RNA sequencing analysis, and functional assays were employed to elucidate the mechanisms underlying the effects of miR-124-3p-loaded exosomes on neuroinflammation and neuronal repair. The increased expression of miR-124-3p in microglial exosomes after TBI inhibited neuronal inflammation and promoted neurite outgrowth. This effect was achieved by promoting the anti-inflammatory M2 polarization of microglia, suppressing mTOR signaling through downregulation of PDE4B, and inducing autophagy in BMVECs. These actions collectively contributed to neuroprotection, reduced blood-brain barrier leakage, and improved neurologic outcomes in animal models of TBI. Conclusion: Microglial exosomes, particularly those carrying miR-124-3p, have emerged as promising candidates for therapeutic interventions in TBI. These exosomes exhibit neuroprotective effects, attenuate neuroinflammation, and promote neuronal repair and plasticity. Targeting miR-124-3p and utilizing microglial exosomes as therapeutic agents hold great potential for future clinical translation in TBI management. However, further research is required to fully elucidate the underlying mechanisms and optimize their delivery strategies for effective treatment in human TBI cases.

The per capita availability of freshwater resources on a global scale is gradually decreasing due to population growth, rapid urbanization, industrialization, and modern lifestyles. In this situation, wastewater management becomes a major concern. Conventional treatment processes used to treat wastewater discharges are not adequate for the advanced removal of pollutants, especially refractory organic pollutants, which are mainly organic compounds that are not easily biodegradable in the environment. The use of photocatalytic membrane reactors (PMRs) for tertiary wastewater treatment has attracted much interest in recent periods, and various configurations have been investigated. The performance of a PMR using an iron doped titanium photo catalyst and Polysulfone-based polymeric membrane for municipal wastewater treatment was evaluated under natural and simulated solar light. Obtained results proved that solar driven PMRs can remove organic loading (COD) with high efficiencies and may represent a suitable alternative for the tertiary treatment step of municipal wastewater.

Although a slightly radioactive element, thorium is considered very toxic because its various species, which reach the environment, can constitute an important problem for the health of the population. The present paper aims to expand the possibilities of using membrane processes in the removal, recovery and recycling of thorium from industrial residues reaching the municipal waste processing platforms. The paper includes a short introduction on the interest shown for this element, a weak radioactive metal, followed by highlighting of some common (domestic) uses. In a distinct but concise part, the bio-medical impact of thorium is presented. The classic technologies for obtaining thorium are concentrated in a single schema, and then the speciation of thorium is presented with an emphasis on the formation of hydroxo-complexes and complexes with common organic reagents. The determination of thorium has been highlighted both on the basis of its radioactivity, but especially through methods that call for extraction followed by an established electrochemical, spectral or chromatographic method. Membrane processes are presented based on the electrochemical potential difference, rapidly presenting barro-membrane processes, electrodialysis, liquid membranes and hybrid processes. A separate sub-chapter is devoted to proposals and recommendations for the use of membranes in order to achieve some progress in urban mining for the valorization of thorium.

Background: Endogenous Peptide Inhibitor of CXCR4 (EPI-X4) is a natural antagonist of the CXC chemokine receptor 4 (CXCR4). EPI-X4 is a 16-mer peptide that is released from human serum albumin (HSA) by acidic aspartic proteases such as Cathepsin D and E. Since human serum albumin (HSA) is an important medicinal substance we asked whether different pharmaceutical HSA products contain EPI-X4 which could have been generated during manufacturing and whether HSA can serve as a substrate for cathepsins despite of the presence of stabilizers like caprylate. Methods: Eight pharmaceutical HSA preparations representing all currently used fractionation technologies were analyzed. The previously described specific EPI-X4 ELISA was used for quantification; in vitro EPI-X4 generation by acidification in the presence or absence of cathepsins was followed by quantification with ELISA. Results: None of the pharmaceutical HSA preparations tested contained EPI-X4. Acidification of HSA did not generate EPI-X4. Addition of cathepsins D and E to acidified HSA yielded high concentrations of EPI-X4 in all HSA preparations, indistinguishable between individual products. Conclusion: Medicinal HSA preparations per se do not contain EPI-X4, but will replenish its precursor which can be cleaved to EPI-X4 in vivo, environmental conditions permitting.

Cancer is the most feared disease, with more than 1.6 million cases each year. Cancer can start almost anywhere in the human body, from the uncontrollable growth and multiplication of damaged cells. Cancerous tumors can spread into the human body (a process called metastasis) as a solid form usually, but the cancers of blood generally do not. Cancer treatment includes chemotherapy, surgery and radiations. In this article we will address inorganic compounds as a source of treatment, diagnosis, carriers of active substances.

To evaluate whether the extent of cardiac damage in severe aortic stenosis (AS) might be associated with the occurrence of conduction system disorders after TAVI. A total of 153 symptomatic patients with severe AS who had a TAVI were categorized before the procedure according to the extent of cardiac damage: stage 1 (13.5%): no or LV damage; stage 2 (58.8%): left atrial/mitral valve damage, atrial fibrillation (AF); stage 3 (27.7%): low-flow state, pulmonary vasculature/tricuspid valve/RV damage. After TAVI, 34% of patients exhibited LBBB and 10% high-degree atrioventricular block (HD-AVB). No patient in group 1 developed HD-AVD whereas new LBBB was frequent in groups 2 and 3. Twenty-one patients presented with resolutive paroxysmal AF with a higher rate for each group increment (group 1: n=0, 0%; group 2: n=11,15.7%; group 3: n=10, 30.3%) (p = 0.012). Patients in group 3 had the higher rate of permanent pacemaker implantation (PPMI) (group 1: n=1, 6.3%; group 2: n=7,10%; group 3: n=9, 27.3%) (p=0.012). No patient in group 1 died during the hospital stay. In conclusion, cardiac damage staging of AS might help identify patients at higher risk of conduction disorders and PPMI requirement after TAVI.

Microplastic pollution represents an emerging problem of great interest in the public domain in the last decade; in addition, it overlaps with another delicate problem - pollution with pharmaceutical products that can have negative effects on the environment and people, even in small amounts. The main purpose of this study was to assess the biochemical and behavioral effects of exposure of adult zebrafish (Danio rerio) to polyethylene (PE), polypropylene (PP) and valproic acid (VPA), respectively to their mixtures - possible situations in natural aquatic environments. In terms of behavioral responses, sociability appears to be more impaired in the PP group after 5 days of exposure. The mechanisms affected are more those of swimming performance than of sociability. Even more, VPA increases presence in the arm with conspecifics but decreases mobility and locomotion, indicating a possible anxiety mechanism. The mixtures decrease the aggressiveness, especially in the case of the PE+VPA group, where it reaches a super low level compared to the control, which could endanger the species in nature. Regarding the anxiogenic effect, PP and PE act differently, if PE has an anxiogenic effect, on the opposite side is the PP group, which shows a bolder and more agitated behavior. All four variants showed behavioral changes indicative of toxicity from the first dose.

Background: Clozapine (CLZ) use is precarious due to its neurological, cardiovascular, and hematological side effects; however, it is the gold standard in therapy-resistant schizophrenia (TRS) in adults and is underused. Objective: to examine the most recent CLZ data on (a) side effects concerning (b) recent pharmacological mechanisms, (c) therapy benefits, and (d) the particularities of the COVID-19 pandemic. Data sources: a search was performed in two databases (PubMed and Web of Science) using the specific keywords "clozapine" and "schizophrenia," "side effects," "agranulocytosis," "TRS," or "bipolar affective disorder (BAF)" for the last ten years. Study eligibility criteria: clinical trials on adults with acute symptoms of schizophrenia or related disorders. Results: We selected 37 studies, randomized controlled trials (RCTs), and clinical case series (CCS), centered on six main topics in the search area: (a) CLZ in schizophrenia, (b) CLZ in bipolar disorder, (c) side effects during the clozapine therapy, (d) CLZ in pregnancy, (e) CLZ in early-onset schizophrenia, and (f) CLZ therapy and COVID-19 infection. Limitations: We considered RCTs and CCS from two databases, limited to the search topics. Conclusions and implications of key findings: (a) Clozapine doses should be personalized for each patient based on pharmacogenetics testing when available; the genetic vulnerability postulates predictors of adverse reactions' severity; patients with a lower genetic risk could have less frequent hematological monitoring; (b) CLZ-associated risk of pulmonary embolism imposes prophylactic measures for venous thromboembolism; (c) convulsive episodes are not an indication for stopping treatment; the plasma concentration of clozapine is a better side effect predictor than the dosage; (d) COVID-19 infection may enhance clozapine toxicity, generating an increased risk of pneumonia. Therapy must be continued with proper monitoring of the white blood count, and the clozapine dose decreased by half until three days after the fever breaks; psychiatrists and healthcare providers must act together. Background: Clozapine (CLZ) use is precarious due to its neurological, cardiovascular, and hematological side effects; however, it is the gold standard in therapy-resistant schizophrenia (TRS) in adults and is underused. Objective: to examine the most recent CLZ data on (a) side effects concerning (b) recent pharmacological mechanisms, (c) therapy benefits, and (d) the particularities of the COVID-19 pandemic. Data sources: a search was performed in two databases (PubMed and Web of Science) using the specific keywords "clozapine" and "schizophrenia," "side effects," "agranulocytosis," "TRS," or "bipolar affective disorder (BAF)" for the last ten years. Study eligibility criteria: clinical trials on adults with acute symptoms of schizophrenia or related disorders. Results: We selected 37 studies, randomized controlled trials (RCTs), and clinical case series (CCS), centered on six main topics in the search area: (a) CLZ in schizophrenia, (b) CLZ in bipolar disorder, (c) side effects during the clozapine therapy, (d) CLZ in pregnancy, (e) CLZ in early-onset schizophrenia, and (f) CLZ therapy and COVID-19 infection. Limitations: We considered RCTs and CCS from two databases, limited to the search topics. Conclusions and implications of key findings: (a) Clozapine doses should be personalized for each patient based on pharmacogenetics testing when available; the genetic vulnerability postulates predictors of adverse reactions' severity; patients with a lower genetic risk could have less frequent hematological monitoring; (b) CLZ-associated risk of pulmonary embolism imposes prophylactic measures for venous thromboembolism; (c) convulsive episodes are not an indication for stopping treatment; the plasma concentration of clozapine is a better side effect predictor than the dosage; (d) COVID-19 infection may enhance clozapine toxicity, generating an increased risk of pneumonia. Therapy must be continued with proper monitoring of the white blood count, and the clozapine dose decreased by half until three days after the fever breaks; psychiatrists and healthcare providers must act together.

The recovery and recycling of metals that generate toxic ions in the environment is of particular importance, especially when these are tungsten and, in particular, thorium. The radioactive element thorium has unexpectedly accessible domestic applications (filaments of light bulbs and electronic tubes, welding electrodes, working alloys containing aluminum and magnesium), which lead to its appearance in electrical and electronic waste from municipal waste management platforms. The current paper proposes the simultaneous recovery of waste containing tungsten and thorium from welding electrodes. The simultaneous recovery is done by applying a hybrid membrane electrolysis technology coupled with nanofiltration. An electrolysis cell with sulphonated polyether–ether–ketone membranes (sPEEK) and a nanofiltration module with chitosan-polypropylene membranes (C–PHF–M) are used to carry out the hybrid process. The analysis of welding electrodes led to a composition of: W (tungsten) 89.4%; Th 7.1%; O2 2.5% and Al 1.1%. Thus, the parameters of the electrolysis process were chosen according to the speciation of the three metals suggested by the superimposed Pourbaix diagrams. At a constant potential of 20.0 V and an electrolysis current of 1.0 A, the pH is varied and the possible composition of the solution in the anodic workspace is analyzed. Favorable conditions for both electrolysis and nanofiltration were obtained at pH from 6 to 9, when the soluble tungstate ion, the aluminum hydroxide and solid thorium dioxide were formed. Through a first nanofiltration, the tungstate ion is obtained in the permeate, and thorium dioxide and aluminum hydroxide in the concentrate. By adding a pH 13 solution over the two precipitates, the aluminum is solubilized as sodium aluminate which will be found after the second nanofiltration in permeate, the thorium dioxide remaining integrally (within an error of ±0.1ppm) on the C–PHF–M membrane.

In this paper, the extraction of essential oil (EO) from thyme by consecutive use of ultrasound and microwave treatments is presented. The aim of the study was to apply an ultrasound pre-treatment of thyme leaves to enhance the thymol content and the extraction yield of the EO obtained by microwave-assisted hydro-distillation (MWHD). Compared with the conventional hydro-distillation (CHD), the consecutive use of ultrasound and microwave treatments resulted in a 72% lower extraction time. When the ultrasound pre-treatment (using the ultrasonic processor with an amplitude of 70%) was applied, the EO content was 23% higher compared to the extraction without pre-treatment. The EO samples were analyzed by GC/MS. The results showed that the major component, thymol, varied from 43.54% (by CHD) to 65.94% (by consecutive use of ultrasound and microwave treatments).

The removal of metal ions by biosorption on inexpensive materials is still a challenge for environmental engineering research. In this study, marine green algae biomass (Ulva lactuca sp.) and the biochars obtained from this biomass, at 320 C (BC-320) and 550 C (BC-550), were used as biosorbents for the removal of Cu(II) ions from aqueous solution. In addition to comparing the biosorption capacities, the determination of the thermodynamic parameters allows the choice of the most suitable material for the biosorption processes. The experimental results, obtained for Cu(II) ions biosorption on each biosorbent (algae biomass (AB), BC-320 and BC-550), at three different temperatures (10, 30 and 50 C) were analyzed using Langmuir and Freundlich isotherm models, while pseudo-first order, pseudo-second order and intra-particle diffusions models were used to model the kinetic data. The biosorption of Cu(II) ions is best described by the Langmuir model and the pseudo-second kinetic model, regardless of the type of biosorbent. The maximum biosorption capacity (qmax, mg/g) depends on the temperature, but also on the type of biosorbent, and follow the order: BC-320 &lt; AB &lt; BC-550. Using the experimental isotherms, the thermodynamic parameters (G0, H0 and S0) for the biosorption of Cu(II) ions on each biosorbent were calculated. The analysis of the obtained values constitutes the main arguments in choosing BC-550 as the most effective biosorbent for the removal of Cu(II) ions from aqueous media.

Pancreatic ductal adenocarcinoma (PDAC) is the most common malignant tumor of the pancreas, carrying a poor prognosis, in most cases patients being diagnosed in a nonresectable stage. Image-based artificial intelligence (AI) models implemented in tumor detection, segmentation and classification could improve diagnosis with better treatment options and increased survival. This review included papers published in the last 5 years and describes the current trends in AI algorithms used in PDAC. We analyzed the applications of AI in detection of PDAC, segmentation of the lesion and classification algorithms used in differential diagnosis, prognosis, and histopathological and genomic prediction. The results show lack of multi-institutional collaboration and stresses the need for bigger datasets in order for AI models to be implemented in a clinically relevant manner.

The purpose of this paper is to develop a phytosociological, ecological, cytogenetic, eco-protective and economic study of the vegetation of the wetland ecosystems in the Vlădeasa Massif built by the phytocoenoses of the association Carici echinatae-Sphagnetum (Balázs 1942) Soó 1955. In order to attain the aim and objectives put forward we carried out 10 phytocoenological surveys (surveys) in the phytocoenoses of the ecosystems during the optimal vegetation periods related to the summer-serotinal season in the timeframe 2020-2021. The taxonomically inventoried species were included in an association table by the criteria of their belonging to the basic coenotaxa of the association, alliance, order, vegetation class. The outcomes of the phytocoenosis research of the vegetation of the wetland ecosystems were processed, analysed, interpreted based on tables, histograms, diagrams, regarding the numerical and percentage weight of the species in the ecological categories of bioforms, phytogeographic elements (geoelements) and cytogenetic elements. The ecological behaviour of the species confined in ecosystems was also analysed by their relationship with ecological factors, edaphic soil moisture, air temperature and chemical reaction of the soil. The current state of ecosystems, potential threats, sustainable conservation of biodiversity, dynamics of phytocenoses, economic and scientific relevance were also subjected to research. The results obtained in the surveyed territory were analysed and compared numerically and as percentage with the data provided by two reference scientific works belonging to authors who independently carried out research with a similar topic in two different geographical regions of the Western Carpathians.

The COVID-19 pandemic struck unexpectedly, emergency services and chronic care institutions, including dialysis centers, were overloaded. An important problem was the care of positive COVID patients, but also the care of chronically dialyzed patients who presented emergencies. In our Hospital, which has become a COVID support for dialysis patients with severe forms of the disease, we had to care for PD patients with dialysis-related emergencies. We presented 2 cases of patients managed on an outpatient basis or 1 day hospitalization, treated successfully and without compromising the quality of the care provided. We used remote monitoring, we worked in a multidiscipli-nary team, we shortened the hospitalization of patients (and implicitly the risk of contact). In pandemic conditions, the advantage of PD was represented by the possibility of patient isolation, so that in the first 6 months of the pandemic, we recorded no deaths in this category of patients. In case of hemodialysis patients, in-fection and mortality rates were high. Although we expected an increase in the number of peritoneal dialysis patients in the post-pandemic period, this did not happen. We continue to plead for the popularization of the PD method among patients and doctors, which has proven its advantages under the conditions of the pandemic.

Background/Objectives: Peritoneal dialysis as a form of renal function sub-stitution is not as widespread as hemodialysis. However, it has recognized advantages such as preservation of the residual renal func-tion, no need for vascular access , can be performed at home, but requires a proper in-sertion of a peritoneal dialysis (PD) catheter and maintaining its patency. Methods: We presented a 10-year retrospective study on a group of 133 patients hos-pitalized for peritoneal dialysis catheter insertion/replacement. We routinely implant the catheter laparoscopically, but there were cases in which the insertion was performed open route. We analyzed the patient group by age and gender criteria, number of complications and time when they appeared, duration of surgical intervention and the surgical technique used (126 were performed laparoscopically and 7 were inserted via open route). The open technique was performed mainly in patients with contraindications of general anesthesia. Results: We encountered a number of 23 complications in 18 patients, in only 1 case the patient was switched to permanent hemodialysis (at his own wish). We highlighted in the study the indisputable advantages of laparoscopy, supported by the results obtained: correct placement of the catheter, the possibility of adhesiolysis, preservation of the peritoneal surface through minor op-erative trauma, low number of complications(bleeding, migration, hernia 0,8%, leakage 4%, lower than those found in the literature). Even if infection was the most frequent complication (peritonitis 35%, catheter exit site infection 30.4%), only 1 case appered in the pretraining period. All complications were managed by medical treatment or by temporary cessation of peritoneal lavage, except of two cases that required reimplantation of the catheter. Conclusions: Laparoscopic catheter insertion for PD is a safe method, with reduced post-procedural complications, thus ensuring a long duration of the functionality of the catheter.

Materials based on platinum metals with very good catalytic activity were tested in the reduction of p–nitrophenol (pNP) to p–aminophenol (pAP). The majority of presented catalytic materials are based on the adsorption of p–nitrophenol on the surface of the catalyst simultaneously with molecular hydrogen, coming from sodium borohydride in an aqueous medium, which reduces it. In the present paper, a catalytic material based on osmium dispersed in n–decanol or n–dodecanol is presented, which also works as an emulsion membrane, for the absorption of p–nitrophenol and molecular hydrogen at the n–alcohol aqueous solution interface. The hydrogenation of p–nitrophenol is carried out in a reaction and separation column in which the acid receiving phase emulsion is dispersed in the osmium nanodispersion, in n–alcohols. This emulsion circulates from the base of the column to its upper part in co-current or counter-current with the source phase consisting of p–nitrophenol and sodium borohydride. Experiments show that the circulation of counter-current phases is superior to that in co-current, and the emulsion based on n–decanol is more efficient than the one based on n–dodecanol. The increase in the pH difference between the source and receiving phases leads to the increase in the conversion of p–nitrophenol to p–aminophenol. The efficiency of separation of the reaction product in the receiving phase is lower than the conversion at the same operating time. The apparent catalytic rate constant (kapp) of the new catalytic material based on the emulsion membrane with nanodispersion of osmium nanoparticles (0.1×10−3 for n–dodecanol and 0.9×10−3 for n-decanol) is lower by an order of magnitude compared to those based on adsorption on catalysts from platinum metal group. The advantage of the tested membrane catalytic material is that it extracts p–aminophenol in the acid receiving phase. The paper proposes a mechanism of the studied reduction system.

The Metabolic Food Waste [MFW (kg of food)], first time developed in 2016 as a new indicator by Serafini and Toti, indicates the amount of food consumed over the nutritional requirements and the impact of this overconsumption on the environment. It is necessary to identify the causes and to develop potential methods to prevent and reduce MFW, at the same time with increasing consumer awareness about unsustainable diets and changing diet habits toward more environmentally conscious consumption patterns. By analysing and corroborating external data available for food waste, nutritional requirements, environmental impact of food waste and consumer behaviour, we identified as primary causes for MFW the lack of nutritional education and little understanding of the nutritional requirements amongst all categories of consumers, no access to appropriate food resources or reduced availability of fresh produced food. We conclude that for the quantification of the negative impact of MFW on both the environment and human health, we need a decisive action to raise consumer awareness for healthy and sustainable diets, together with an uniform worldwide distribution of the nutritious food.

Canine mammary tumors represent one of the leading malignant pathology in female dogs, displaying the importance of efficient therapeutic findings, beside the golden standard surgery, able to limit the development of the disease. Studies in human cancers demonstrated that Doxorubicin presents a good effect in different biological processes like apoptosis, autophagy, cell cycle, cell invasion and epithelial to mesenchymal transition. Our study following the effects of Doxorubicin on two canine mammary cancer cell lines P114 and CMT-U27, showing an inhibitory effect in cell proliferation and an expression alteration of the EMT related genes.

The research is focusing on analyzing the concentrations of particulate matter (PM) next to a highly congested road section, with 39,900 as a maximum number of vehicles per 24 h, in the vicinity of Timisoara, Romania. Concentrations have been measured in multiple episodes using two different measurement methods, gravimetric and dynamic light scattering, showing a disperse range of PM concentrations. Presence of metal particles in the samples have been analyzed using an electron microscope. Additionally, impact on human health is described by evaluating results for inhalable, thoracic, and alveolar sized particles.

Atrial fibrillation (AF) is a common arrhythmia associated with various risk factors and significant morbidity and mortality. This article presents findings from a study involving 115 patients with permanent AF. The study examined demographics, risk factors, associated pathologies, complications, and anticoagulant therapy. The results showed a slight predominance of AF in males, with the highest incidence in individuals aged 75 and above. Common risk factors included arterial hypertension, dyslipidaemia, diabetes mellitus type 2, and obesity. Comorbidities such as congestive heart failure, mitral valve regurgitation, and pulmonary disorders were prevalent among the patients. Major complications included congestive heart failure, stroke, and myocardial infarction. Thromboembolic and bleeding risk assessment using CHAD2DS2-VASc and HAS-BLED scores demonstrated a high thromboembolic risk in all patients. The majority of patients were receiving novel oral anticoagulants (NOACs) before admission, while NOACs were also the most prescribed antithrombotic therapy at discharge. The study highlights the importance of risk factor management and appropriate anticoagulant therapy in AF patients to reduce complications and improve outcomes.

(1) Background: This study aimed to evaluate the implications of IL-31 in the pathogenesis of chronic spontaneous urticaria (CSU) and to assess the differences that occur between its serum values compared to controls. Additionally, the serum IL-31 levels were measured alongside other clinical and paraclinical parameters identified in the patients to understand its immunological importance in this skin disease and to determine if it could potentially serve as a therapeutic target in CSU in the future. (2) Methods: The serum levels of IL-31 were estimated in 50 patients diagnosed with CSU according to the international guidelines. Additionally, 38 controls who had not experienced any episodes of urticaria during their lifetime were included. (3) Results: Our data have shown higher serum levels of IL-31 in CSU patients compared to controls. A correlation between the serum level of IL-31 and other inflammatory markers, such as ERS, CRP, or serum eosinophils and total IgE was not identified. On the other hand, statistically significant differences were found in IL-31 serum values in UCS patients depending on the severity of the disease, its impact on the patients' quality of life, the severity of itching, and the response to H1 antihistamines. (4) Conclusions: In the present study, IL-31 did not change directly with non-specific inflammation, nor with eosinophilic inflammation or atopy. However, its expression was modified in CSU depending on major characteristics of the disease: severity, pruritus, and response to H1 antihistamines. The focus on the pathogenesis of CSU is of indisputable significance since any additional information in understanding the mechanisms of this disease can open doors to new therapeutic targets. This is particularly important considering that the available therapies are deficient, incomplete, and the remaining symptoms are uncontrolled in many cases.

Background: Alongside their long-term effects - post-concussion syndrome (PCS) - mild traumatic brain injuries (mTBI) are significant public health concerns. Currently, there is a lack of reliable biomarkers for diagnosing and monitoring mTBI and PCS. Exosomes are small extracellular vesicles secreted by cells that have recently emerged as a potential source of biomarkers for mTBI and PCS due to their ability to cross the blood-brain barrier and reflect the pathophysiology of brain injury. This study aimed to investigate the role of salivary exosomal biomarkers in mTBI and PCS. Methods: A systematic review using the PRISMA guidelines was conducted, and studies were selected based on their relevance to the topic. Results: Studies have shown that exosomal tau, phosphorylated tau (p-tau), amyloid beta (Aβ), and microRNAs (miRNAs) are potential biomarkers for mTBI and PCS. Specifically, elevated levels of exosomal tau and p-tau have been associated with mTBI and PCS, as well as with repetitive mTBI. Dysregulated exosomal miRNAs have also been observed in individuals with mTBI and PCS. Additionally, exosomal Prion cellular protein (PRPc), coagulation factor XIII (XIIIa), synaptogyrin-3, IL-6, and aquaporins have been identified as promising biomarkers for mTBI and PCS. Conclusion: Salivary exosomal biomarkers have the potential to serve as non-invasive and easily accessible diagnostic and prognostic tools for mTBI and PCS. Further studies are needed to validate these biomarkers and to develop standardized protocols for their use in clinical settings. Salivary exosomal biomarkers can improve the diagnosis, monitoring, and treatment of mTBI and PCS, leading to improved patient outcomes.

(1) Background: Thrombophilia is a tendency towards hypercoagulability, and it is increased by pregnancy, peaking around delivery. Research question: does thrombophilia stimulate the in-flammatory state of the patient, already suppressed by pregnancy? (2) Methods: Eighty thrombo-philia patients admitted for delivery between 1/10/2017 and 1/12/2021 were prospectively stud-ied, together with eighty age- and para-matched control patients. Patients were admitted for de-livery at term by means of cesarean section. The inflammation indexes from the complete blood count values analysis during both the 24 hours before and after labor—extracted from the hospi-tal’s medical records—were calculated and then correlated with uterine involution. (3) Results: Except for the PLR, most of the numerous inflammation indexes studied were not significantly different in treated thrombophilia patients, before and after delivery, compared to non-thrombophilia patients. Only when we split the patients, based on the uterine haematometra in the first 24-48 hours postpartum, we found out that the few treated thrombophilia patients with haematometra (14 with haematometra out of 79 with treated thrombophilia) had elevated SII and AISI antepartum. In pregnant patients treated for thrombophilia, MLR is higher in pa-tients without the Rh factor than in those with the Rh factor. In non-thrombophilia patients, MCVL and NLPR increased with age and before labor, while SII and AISI increased with age postpartum. (4) Conclusions: Thrombophilia did not stimulate the inflammatory state of the pa-tient, already suppressed by pregnancy.

Neonatal mortality remains a public health concern and timely identification and prompt intervention in the delivery room could improve the outcome in neonatal morbidity and mortality. We performed a retrospective study to help us finding the profile of the high-risk newborn regarding the need for NICU admission, necessary to establish a protocol regarding the mobilization of human and material resources for the urgent management of these situations. All deliveries and neonates born in Maternity of Bihor County Emergency Clinical Hospital from Romania were reviewed, including relevant maternal, foetal and perinatal data to identify risk factors that result in birth of newborns needing resuscitation at birth between 2012-2019. The number of births showed a downward trend but around 90% of the births were on term. The incidence of neonatal emergencies is increasing, the most frequently were respiratory, sepsis and other infections, cardiovascular emergencies, and extreme prematurity. It is noted that in 2021 the incidence of these neurological emergencies increased by three times compared to previous years. The neonatal and maternal risk factors associated with admission to the NICU were mother's age over 35 years, low level of education, second/more gestation, weight under 2500 g, Apgar score under 7, premature rupture of membranes, macrosomia and mother's infectious pathology. Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.

: Background and objectives: One of the most severe symptoms of extrapulmonary tuberculosis (TBEP) is tuberculous meningitis (TBM) which is linked to significant morbidity and high mortality. It is well recognized that HIV-positive people are more likely to develop TBEP, including TBM, especially if they have severe immunodeficiencies. Material and methods: We conducted a retrospective clinical study based on hospital medical records of the diagnosed patients with HIV/AIDS and Tuberculous Meningitis in North-eastern Romania, hospitalized at "Sf. Parascheva" Clinical Hospital of Infectious Diseases from Iasi. We aim to highlight the profile and the caracteristics of the HIV/AIDS and Tuberculous Meningitis coinfection cases. The time frame under study was from January 1st, 2010, to December 1st, 2022. Results: Our Center has a total number of patients on record of 1692. Patients co-infected with HIV- TB were 195 of which 19 cases were HIV- TBM coinfection and it was more common in women. From this total, 6 cases were late presenters and 13 patients were already in the center's records with a deficient immunological viral status, non-compliant, and non-adherent to antiretroviral therapy. The average age in the study group was 27 years old. The mean admission day number was 17.73 days. CSF findings (qualitative and quantitaitve examination, biochemestry) were in accordance with the literature. Conclusions: The key to the management of the HIV-positive patient is the multidisciplinary approach and access to antiretroviral therapy. We must find and eliminate obstacles affecting patients and the healthcare system. In order to increase ART uptake among HIV-infected TB patients and to put an end to the TB and HIV epidemics.

Abstract: Congenital hyperinsulinism (CHI) is a rare disorder of glucose metabolism and is the most common cause of severe and persistent hypoglycemia (hyperinsulinemic hypoglycemia, HH) in the neonatal period and childhood. Most cases are caused by mutations in the ABCC8 and KCNJ11 genes that encode the ATP-sensitive potassium channel (KATP). We present the correlation between genetic heterogeneity and the variable phenotype in patients with early-onset hyperinsulinemic hypoglycemia caused by ABCC8 gene mutations. In the first patients, which presented persistent severe hypoglycemia since the first day of life, molecular genetic testing revealed the presence of a homozygous mutation in the ABCC8 gene [deletion in the ABCC8 gene c.(2390+1_2391-1)_(3329+1_3330- 1)del] correlated with a diffuse form of hyperinsulinism (the parents being healthy heterozygous carriers). In the second patient, the onset was on the third day of life with severe hypoglycemia, and genetic testing identified a heterozygous mutation in the ABCC8 gene c.1792C&gt;T (p.Arg598*) inherited on the paternal line, which led to the diagnosis of focal form of hyperinsulinism. To locate the focal lesions, (18)F-DOPA (3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine) PET/CT was recommended (an investigation that cannot be carried out in the country), but the parents refused to carry out the investigation abroad. In this case, early surgical treatment could have been curative. In addition, the second child also presented secondary adrenal insufficiency requiring replacement therapy. At the same time, she developed early recurrent seizures that required antiepileptic treatment. We emphasize the importance and of molecular genetic testing for diagnosis, management and genetic counseling in patients with HH.

The risk of developing cardiovascular diseases (CVD) in patients suffering from rheumatoid arthritis (RA) is 1.5 times higher compared to the general population. The objective of this retrospective study was to determine the type of cardiovascular complications that can appear in patients with rheumatoid arthritis. Reducing the cardiovascular risk, through an aggressive management of the traditional and non-traditional risk factors, is another objective of this study. Early diagnosis and initiation of therapeutic measures to reduce the progression rate of rheumatoid arthritis, while also maintaining an active lifestyle, are the most important problems in young patients. We included a number of 200 patients with rheumatoid arthritis, presenting various stages of disease, concomitant with cardiovascular complications. The incidence by gender was higher in women, while men presented a higher incidence of traditional and non-traditional cardiovascular risk factors. All the patients presented an atherogenic coefficient over 2, indicating a significant risk of atherogenesis. An increased incidence of coronary artery disease was found in men. The patients presented cardiac arrhythmias, especially in the active stage of the condition, while the incidence of atrial fibrillation was higher in women. The active stage of the disease was evaluated using inflammatory biomarkers (ESR, PCR). ESR is not a specific tool for diagnosing the disease, but its important role in monitoring the activity of RA should not be ignored. Moreover, ESR has a significant role in monitoring the evolution and determining the prognostic of congestive heart failure. A target treatment prescribed a target treatment to reduce inflammation and prevent exacerbations was prescribed for all patients. However, in daily clinical practice, the screening for RA is poorly done. Thus, patients are often undiagnosed, while the risk factors are not assessed. In conclusion, even nowadays, RA patients continue to present an increased risk of developing CVD.

Diabetic retinopathy (DR) and cataracts (CA) have an early onset in diabetes mellitus (DM) due to the redox imbalance and inflammation triggered by hyperglycemia. Plant-based therapies are characterized by low bioavailability in ocular tissues. The study aimed to investigate the effect of gold nanoparticles phytoreduced with Rutin (AuNPsR), as a possible solution. Insulin, Rutin, and AuNPsR, were administered to an early, six-week rat model of DR and CA. Oxidative stress (MDA, CAT, SOD) was assessed in serum and eye homogenates, and inflammatory cytokines (IL-1 beta, IL-6, TNF alpha) were quantified in ocular tissues. Fundus of retinal arterioles, retina histopathology and lens transmission electron microscopy (TEM), were also performed. DM was linked to constricted retinal arterioles, reduced endogen antioxidants, and eye inflammation. Histologically, retinal wall thickness decreased. TEM showed increased lens opacity and fiber disorganization. Rutin improved retinal arteriolar diameter, while reducing oxidative stress and inflammation. Retinas were moderately edematous. Lens structure was preserved on TEM. Insulin restored retinal arteriolar diameter, while increasing MDA, and amplifying TEM lens opacity. The best outcomes were obtained for AuNPsR, as it improved fundus appearance of retinal arterioles, decreased MDA formation and increased antioxidant capacity. Retinal edema and disorganization in lens fibers were still present.

Tomato is considered the most important vegetable crop worldwide. Improving the nutritional value of fruits must be based on sustainable production in terms of varieties and fertilization management. This study aimed to improve the nutritional value (total soluble solids, acidity, lycopene, β-carotene, polyphenols, macro and microelements) of two tomato varieties (‘Cristal’ and ‘Siriana’) under three fertilization types (NPK chemical fertilizer, chicken manure and biological fertilizer with microorganisms) for the greenhouse. Primary metabolism compounds do not vary significantly according to the type of fertilizer used. The results for the antioxidant compounds showed a better effect of biological fertilization compared to chemical fertilizer and control unfertilized. The tomato fruits from the local cultivar (‘Siriana’) are richer in nutritional compounds such as rutin, regardless of the type of fertilization, which denotes a good ability to adapt to crop conditions. Tomato cultivars reacted positively to microbiological fertilization compare to chemical, thus producing nutritious fruits under sustainable management. Tomato fruits were richer in the quality of microelement contents.

This article explores the relationship between metabolic syndrome and cardiovascular disease, providing a comprehensive overview of its risk factors and prevalence. Metabolic syndrome, characterized by a cluster of interconnected risk factors, significantly increases the likelihood of developing cardiovascular disease and type II diabetes. The study, conducted over a one-year period, involved 117 patients with ages between 30 to 79 years old. Various elements such as gender, age, education level, background, smoking, alcohol consumption, dietary aspects, physical activity, and their contribution in developing the metabolic syndrome, were analysed.Central adiposity and high blood pressure emerged as prominent elements of the condition. The findings underscore the importance of a healthy lifestyle in the prevention and management of metabolic syndrome. Encouraging regular physical activity, maintaining a balanced diet, rich in fresh vegetables and fruits, and avoiding harmful behaviours, such as smoking or alcohol consumption, are essential in reducing the risk of metabolic syndrome and its associated cardiovascular complications. The study highlights the need for public health initiatives, as well as individualized preventive strategies to combat the rising prevalence of metabolic syndrome. Through promoting awareness of its risk factors and implementing effective interventions, healthcare professionals can contribute to better cardiovascular health worldwide. Further research in this area will continue to enhance our understanding of the metabolic syndrome and refine preventive and therapeutic approaches for its management.

Malocclusions have a continuously increasing prevalence from a generation to another as a result of climate changes, soil, atmosphere and water pollution. All of these aspects have unfavorable consequences on the nutritional scheme. Thus, nutrition together with other etiopathogenic factors contribute to complex alterations in the somatic development of the entire organism and, implicitly, of the cephalic extremity. The study group included 4147 children from randomly selected schools from Vâlcea County, Romania. The aim of this study is to determine the prevalence of malocclusions in schoolchildren from Vâlcea County, Romania, according to the three main classes of malocclusions (according to Angle’s classification), age groups (from 6 to 10 years old and from 11 to 14 years old), gender (male and female) and place of origin (rural and urban). For Angle class I malocclusions we recorded the highest prevalence (48,78% from the total number of schoolchildren with malocclusions), followed by Angle class II malocclusions (45,85% from the total number of schoolchildren with malocclusions) and for Angle class III malocclusions we found the lowest prevalence (5,37% from the total number of schoolchildren with malocclusions).According to gender, we found the highest prevalence in female gender (29,90% from the total number of female subjects), while in male gender we recorded a prevalence of 27,70% from the total number of male subjects. Regarding the place of origin, there is a higher prevalence of malocclusions in the urban areas (29,16%). The study subgroup included 140 children randomly selected from the total number of subjects from the study group. They were included in a more advanced study. The aim is to find potential associations between the presence of malocclusions and various oral variables. Categorical variables were expressed as numerical values and percentages, and their association was evaluated with either the Chi-square test of association or homogeneity, or the Fisher Exact test. The acquired data were incorporated into a binomial logistic regression model to assess the likelihood of developing malocclusions in relation to the following variables: defective phonation, bruxism, frequency of teeth brushing, onychophagia, oral respiration, infantile deglutition, placing objects between the maxillaries, thumb sucking and salivary aspects. It is also aimed to compare the results obtained with similar ones from the specialized literature.

Abstract: Background: Neonatal sepsis continues to be one of the leading causes of mortality and morbidity, particularly in under development and underdeveloped countries. We aim to compare laboratory parameters between the early-onset sepsis (EOS) and non-EOS groups and to evaluate the association between TLR2- Arg753Gln, TLR4 -Asp299Gly, IL6-174G/C and IL10-1082G/A gene single nucleotide polymorphisms and EOS susceptibility in preterm newborns. Methods: Genotyping of the TLR2, TLR4, IL6 and IL10 polymorphisms was performed in 36 preterm neonates by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis (RFLP). Logistic regression analysis was used to test the associations between the studied gene polymorphisms and EOS susceptibility. Results: Statistically significant differences in gestational age and birth weight were observed between the two groups, preterm neonates with EOS having a lower mean of gestational age (weeks, 29.4 ± 2.8 versus 32.6 ± 1.1, p = 0.00002) and lower mean of birth weight (gr., 1342.1 ± 446.5 vs. 1984 ± 376.9) than preterm neonates without EOS. C-reactive protein (CRP) values measured at first day significantly increased in EOS group compared with non-EOS group (median, 95% CI: 0.80 [0.40, 1.15] versus 0.30 [0.02, 0.50]). Mean of neutrophils significantly decreased in the EOS preterm neonates (mean difference: 17.3%, 95% CI: [4.0%, 30.5%], p = 0.0126) and non-EOS group (mean difference: 20.8%, 95% CI: [1.8%, 39.9%, p = 0.0354) between the first day and 7th hospitalization day. The minor IL10-A1082 allele frequency was higher in the EOS group than in the nonEOS group (50% versus 25%) with a marginal statistical significance (p=0.0550). In the dominant model, the A/G + A/A variant genotype of IL10- 1082G/A polymorphism significantly increased the odds of EOS compared with GG genotype (OR= 5.25, p = 0.0322). Conclusions: The results of the current study suggests the IL10- 1082G/A gene polymorphism as significant risk factor for early onset sepsis development in preterm neonates.

Considering the worldwide impact of heart failure, it is crucial to develop approaches that can help us comprehend its root cause and make accurate predictions about its outcome. This is essential for lowering the suffering and death rates connected with this widespread illness. Cardiomyopathies frequently result from genetic factors, and the study of heart failure genetics is advancing quickly. Dilated cardiomyopathy (DCM) is the most prevalent kind of cardiomyopathy, encompassing both hereditary and nongenetic abnormalities. It is distinguished by the enlargement of the left ventricle or both ventricles, accompanied by reduced contractility. The discovery of the molecular origins and subsequent awareness of the molecular mechanism is broadening our knowledge of DCM development. Additionally, it emphasizes the complicated nature of DCM and the necessity to formulate several different strategies to address the diverse underlying factors contributing to this disease. Genetic variations that can be transmitted from one generation to another can be a significant contributor to causing family or isolated DCM. Genetic variation also plays a significant role in determining susceptibility for acquired triggers for DCM. The genetic causes of DCM can have a diverse range of phenotypic expressions. It is crucial to select the most probable patients to have advantages from genetic testing. The purpose of this research is to emphasize the significance of identifying genetic DCM, the crucial relationships between genotype and phenotype, and the usefulness of genetic testing in the therapeutic care of both those affected and their relatives. This approach is expected to gain importance once treatment is guided by genotype-specific advice and disease-modifying medications.

According to cancer death rates for women worldwide, this form of cancer ranks fourth after breast, bronchopulmonary, and colorectal cancer, affecting around 570,000 women annually. About 270,000 women each year pass away from this illness, 85% of them are from underdeveloped nations where cervical cancer claims more lives than any other kind of cancer. In Romania, cervical cancer ranks fourth in terms of death, behind breast, bronchopulmonary, and colorectal cancers, and second in terms of incidence, behind breast cancer. Endometriosis in the cervical region is quite uncommon. Only a tiny fraction of women had the condition upon diagnosis. It might be challenging to detect cervical endometriosis since it rarely manifests any symptoms or markers. Women who are asymptomatic can manage the condition expectantly; however, if the symptoms return often, surgery may be required. As many patients have concurrent diseases such fibroids, adenomyosis, ovarian cysts, and pelvic endometriosis, cervical endometriosis therapy appears to be straightforward. There ought to be surgical intervention. Symptomatic cervical endometriosis, such as irregular or post-coital bleeding, may be treated surgically using the LLETZ surgery or another cervical ablation approach. Background and Objectives: (1) To assess one's degree of knowledge on the signs, causes, and methods of preventing cervical cancer or cervical endometriosis, as well as screening for these conditions. (2) To ascertain how the responder behaves about cervical cancer screening and prevention, as well as endometriosis in the cervical region. Materials and Methods: A case report about cervical cancer or cervical endometriosis was conducted among a patient from Romania, Timisoara. Results: In this study, we report the patient with cervical endometriosis, although he was initially diagnosed with cervical cancer. Conclusions: Cervical cancer, a condition that can have serious repercussions on the patient's health, even if there is no clear picture of paraclinical investigations, to raise the suspicion of cervical endometriosis and not cervical cancer.

Quantum leaps advances in the single-molecule investigative science have been made possible over the past decades through the implication of nanopores, as versatile components on dedicated biosensors. Here, we employed the nanopore-tweezing technique to capture amino acid-functionalized, peptide-nucleic acids (PNA) with -hemolysin-based nanopores, and correlate the ensuing stochastic fluctuations of the ionic current through the nanopore with the composition and order of bases in the PNAs primary structure. We demonstrate that while the system enables detection of distinct bases on homopolymeric PNA or triplet bases on heteropolymeric strands, it also reveals rich insights into the conformational dynamics of the entrapped PNA within the nanopore, relevant for perfecting the recognition capability single-molecule sequencing.

Infective endocarditis is a rare and challenging diagnosis, Q fever endocarditis being a major cause of culture-negative endocarditis (IE). The presence of multiple cerebral microbleeds (CMBs) suggests a particular vascular frailty and could be correlated to potential emergence of a haemorrhagic stroke in IE. We report a case of a 45 years-old patient with Coxiella burnetii endocarditis, with a brainstem hemorrhage and cerebral MRI CMBs resembling those of CAA. However the systemic inflammatory tests, the splenic infarct and kidney pathology could not be explained by a variant of CAA, neither the normal initial cerebral CT scan when the patient had already the brainstem clinical signs without evidencing the hemorrhage. Transthoracic and transesophageal echocardiogram revealed only calcified bicuspid aortic valve with moderate stenosis and regurgitation, without any vegetations and the blood cultures on conventional media were negative. Serology for Coxiella burnetii was positive. Inclusion of CMBs as a new minor imaging criteria for infective endocarditis could upgrade the diagnosis in almost 50% of patients.

Sepsis still remains one of the most difficult conditions to diagnose as it presents unspecific clinical signs and symptoms, which makes early detection crucial. Our study aimed to enhance the accuracy of sepsis diagnosis by integrating multimodal monitoring technologies with traditional diagnostic methods. The research involved 121 newborns, comprising 39 cases of late-onset sepsis, 35 cases of early-onset sepsis, and 47 control subjects. Biosignals including pulse oximetry (PO), near-infrared spectroscopy (NIRS), and skin temperature (ST) were continuously monitored and an algorithm was developed using Python for identifying early signs of sepsis. The model demonstrated the ability to detect sepsis 6 to 48 hours in advance with an accuracy rate of 87.67% ± 7.42%. Sensitivity and specificity were recorded at 76% and 90%, respectively, with NIRS and ST having the most significant impact on predictive accuracy. Despite the promising results, limitations such as sample size, data variability, and potential biases were noted. The findings highlight the critical role of non-invasive biosensing methods in conjunction with traditional biomarkers and cultures, offering a robust framework for early sepsis detection and improved neonatal care. Further studies are recommended to validate these results across diverse clinical settings.

Driver drowsiness is one of the leading causes of traffic accidents. This paper proposes a new method for classifying driver drowsiness using deep convolution neural networks trained by wavelet scalogram images of electrocardiogram (ECG) signals. Three different classes were de-fined for drowsiness based on video observation of driving tests performed in a simulator for manual and automated modes. The Bayesian optimization method is employed to optimize the hyperparameters of the designed neural networks, such as the learning rate and the number of neurons in every layer. To assess the results of the deep network method, Heart Rate Variability (HRV) data is derived from the ECG signals, some features are extracted from this data, and finally, random forest and k-nearest neighbors (KNN) classifiers are used as two traditional methods to classify the drowsiness levels. Results show that the trained deep network achieves balanced accuracies of about 77% and 79% in the manual and automated modes, respectively. However, the best obtained balanced accuracies using traditional methods are about 62% and 64%. We conclude that designed deep networks working with wavelet scalogram images of ECG signals significantly outperform KNN and random forest classifiers which are trained on HRV-based features.