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Severe inflammation leading to organ dysfunction is the cornerstone of the pathophysiology of sepsis. Thus, from a theoretical point of view, rebalancing inflammation has the potential to improve patient outcomes. Methods: To better understand the clinical effectiveness of hemoadsorption in managing inflammation, we conducted an updated meta-analysis on the effects of CytoSorb in critically ill septic patients. Ten studies containing 715 patients (355 in the interventional group and 360 in the control group) have been included in the final analysis. Results: Statistical analysis demonstrated that the use of CytoSorb did not influence overall mortality (OR 0.95, 95% CI [0.58, 1.56], p = 0.85), but we observed a decreased mortality when comparing CytoSorb-treated patients with patients in the control group treated with continuous renal replacement therapy (CRRT) (OR 0.97, 95% CI [0.46, 0.98], p = 0.04). We also observed an increased mortality in patients in whom hemoadsorption was initiated earlier in the treatment course (OR 0.97, 95% CI [0.46, 0.98], p = 0.04). We did not observe any significant difference in either intensive care unit length of stay (p = 0.93) or between end-of-treatment severity scores in the two groups (p = 0.24). Conclusions: Although it has a high risk of bias, current evidence does not support the routine use of CytoSorb in critically ill septic patients. The addition of CytoSorb to CRRT may be associated with decreased survival as compared to CRRT alone, but future studies are needed to draw a definitive conclusion.

Post decompression syndrome (PDS) is a rare and life-threatening complication of pericardiocentesis, especially after rapid drainage of large amounts of pericardial fluid. We present the case of a 21-year-old man who presented with cardiac tamponade of unknown etiology. After preoperative optimization, surgical drainage of the pericardial effusion was performed and approximately 2500 mL of fluid was released over 30 min. The patient rapidly developed hemodynamic collapse with severe biventricular dysfunction, with a left ventricle ejection fraction of 15%. Vasopressor and inotropic support were initiated with Noradrenaline and Dobutamine, further escalated to Adrenaline and Levosimendan with no improvement in clinical and hemodynamic parameters. Considering the high doses of vasoactive drugs, rescue veno-arterial extracorporeal membrane oxygenation (V-A ECMO) was started within the first 24 h. After 10 days on V-A ECMO, the cardiac function slowly recovered, and the extracorporeal mechanical support was successfully weaned. The diagnosis of paraneoplastic PDS secondary to angiosarcoma was made and the patient was successfully discharged to the ward on the 24th day. In conclusion, far from being the last option in the management of PDS, V-A ECMO deserves early consideration for securing adequate myocardial and systemic perfusion, while the cardiac function recovers, but a risk-to-benefit assessment should be made by an experienced multidisciplinary team.

The development of the finite element method (FEM) combined block polynomial interpolation with the concepts of finite difference formats and the variation principle. Because of this combination, the FEM overcomes the shortcomings of traditional variation methods while maintaining the benefits of current variation methods and the flexibility of the finite difference method. As a result, the FEM is an advancement above the traditional variation methods. The purpose of this study is to experimentally highlight the thermal behavior of two stomatognathic systems, one a control and the other presenting orthodontic treatment by means of a fixed metallic orthodontic appliance, both being subjected to several thermal regimes. In order to sustain this experimental research, we examined the case of a female subject, who was diagnosed with Angle class I malocclusion. The patient underwent a bimaxillary CBCT investigation before initiating the orthodontic treatment. A three-dimensional model with fully closed surfaces was obtained by using the InVesalius and Geomagic programs. Like the tissues examined in the patient, bracket and tube-type elements as well as orthodontic wires can be included to the virtual models. Once it is finished and geometrically accurate, the model is exported to an FEM-using program, such as Ansys Workbench. The intention was to study the behavior of two stomatognathic systems (with and without a fixed metallic orthodontic appliance) subjected to very hot food (70 °C) and very cold food (−18 °C). From the analysis of the obtained data, it was concluded that, following the simulations carried out in the presence of the fixed metallic orthodontic appliance, significantly higher temperatures were generated in the dental pulp.

Acute liver failure is a life-threatening organ dysfunction with systemic organ involvement and is associated with significant mortality and morbidity unless specific management is undertaken. This meta-analysis aimed to assess the effects of intravenous N-acetylcysteine (NAC) on mortality and the length of hospital stay in patients with non-acetaminophen acute liver failure. Two hundred sixty-six studies from four databases were screened, and four randomized control trials were included in the final analysis. Our results could not demonstrate increased overall survival (OR 0.70, 95% CI [0.34, 1.44], p = 0.33) or transplant-free survival (OR 0.90, 95% CI [0.25, 3.28], p = 0.87) in patients treated with intravenous NAC. We observed an increased overall survival in adult patients treated with NAC (OR 0.59, 95% CI [0.35, 0.99], p = 0.05) compared to pediatric patients, but whether this is attributed to the age group or higher intravenous dose administered remains unclear. We did not observe a decreased length of stay in NAC-treated patients (OR −5.70, 95% CI [−12.44, 1.05], p = 0.10). In conclusion, our meta-analysis could not demonstrate any significant benefits on overall and transplant-free patient survival in non-acetaminophen ALF. Future research should also focus on specific etiologies of ALF that may benefit most from the use of NAC.

Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are essential fatty acids for the human body. Seafood and microalgae are the most important sources of omega-3 fatty acids. Supplementation with 200 mg/day of DHA during pregnancy and breastfeeding has been suggested for women and infants in countries with low seafood consumption. Maternal concentration of DHA and EPA was associated with concentration in cord blood and breast milk. High concentrations of DHA and EPA were identified at the level of retinal photoreceptors and neuronal cell membranes. It was observed that supplementation with DHA and EPA during pregnancy had beneficial effects on the neurological development of the fetus and infant by improving language, memory, attention, and hand coordination, affecting sleep patterns, and improving visual acuity. Beneficial effects on the development of the infant were also associated with the maternal intake of omega-3 fatty acids during breastfeeding. Supplementation with DHA and EPA may reduce the risk of preterm birth but also of preeclampsia in low-risk pregnancies. Women of childbearing age should have an intake of 250 mg/day of DHA + EPA from their diet or supplements. To reduce the risk of premature birth, pregnant women must additionally receive at least 100–200 mg of DHA every day. It is recommended that supplementation with omega-3 fatty acids starts before 20 weeks of pregnancy. Beneficial effects on the mother have been identified, such as the reduction of postpartum depression symptoms, the decrease of cardiovascular risk, and the anti-inflammatory role.

Abstract Background Video-assisted surgery has become an increasingly used surgical technique in patients undergoing major thoracic and abdominal surgery and is associated with significant perioperative respiratory and cardiovascular changes. The aim of this study was to investigate the effect of intraoperative pneumoperitoneum during video-assisted surgery on respiratory physiology in patients undergoing robotic-assisted surgery compared to patients undergoing classic laparoscopy in Trendelenburg position. Methods Twenty-five patients undergoing robotic-assisted surgery (RAS) were compared with twenty patients undergoing classic laparoscopy (LAS). Intraoperative ventilatory parameters (lung compliance and plateau airway pressure) were recorded at five specific timepoints: after induction of anesthesia, after carbon dioxide (CO2) insufflation, one-hour, and two-hours into surgery and at the end of surgery. At the same time, arterial and end-tidal CO2 values were noted and arterial to end-tidal CO2 gradient was calculated. Results We observed a statistically significant difference in plateau pressure between RAS and LAS at one-hour (26.2 ± 4.5 cmH2O vs. 20.2 ± 3.5 cmH2O, p = 0.05) and two-hour intervals (25.2 ± 5.7 cmH2O vs. 17.9 ± 3.1 cmH2O, p = 0.01) during surgery and at the end of surgery (19.9 ± 5.0 cmH2O vs. 17.0 ± 2.7 cmH2O, p = 0.02). Significant changes in lung compliance were also observed between groups at one-hour (28.2 ± 8.5 mL/cmH2O vs. 40.5 ± 13.9 mL/cmH2O, p = 0.01) and two-hour intervals (26.2 ± 7.8 mL/cmH2O vs. 54.6 ± 16.9 mL/cmH2O, p = 0.01) and at the end of surgery (36.3 ± 9.9 mL/cmH2O vs. 58.2 ± 21.3 mL/cmH2O, p = 0.01). At the end of surgery, plateau pressures remained higher than preoperative values in both groups, but lung compliance remained significantly lower than preoperative values only in patients undergoing RAS with a mean 24% change compared to 1.7% change in the LAS group (p = 0.01). We also noted a more significant arterial to end-tidal CO2 gradient in the RAS group compared to LAS group at one-hour (12.9 ± 4.5 mmHg vs. 7.4 ± 4.4 mmHg, p = 0.02) and two-hours interval (15.2 ± 4.5 mmHg vs. 7.7 ± 4.9 mmHg, p = 0.02), as well as at the end of surgery (11.0 ± 6.6 mmHg vs. 7.0 ± 4.6 mmHg, p = 0.03). Conclusion Video-assisted surgery is associated with significant changes in lung mechanics after induction of pneumoperitoneum. The observed changes are more severe and longer-lasting in patients undergoing robotic-assisted surgery compared to classic laparoscopy.

Acute liver failure represents a life-threatening organ dysfunction with high mortality rates and an urgent need for liver transplantation. The etiology of the disease varies widely depending on various socio-economic factors and is represented mainly by paracetamol overdose and other drug-induced forms of liver dysfunction in the developed world and by viral hepatitis and mushroom poisoning in less developed countries. Current medical care constitutes either specific antidotes or supportive measures to ensure spontaneous recovery. Although it has been proven to have beneficial effects in paracetamol-induced liver failure, N-acetylcysteine is widely used for all forms of acute liver failure. Despite this, few well-designed studies have been conducted on the assessment of the potential benefits, dose regimens, or route of administration of N-acetylcysteine in non-acetaminophen liver failure. This review aims to summarize the current evidence behind the use of this drug in different forms of liver failure.

Starting from the idea that the public-private partnership will become in the near future one of the main ways to finance major infrastructure works in Romania, nationally - regionally - locally, this article aims is to verify this hypothesis by analyzing the importance of the concept of publicprivate partnership at the international and national level. The analysis performed in this article take into consideration the degree to which it integrates the needs of the community and the interest of the private entities for partnership with public administration. In implementing their economic development plans, the governments of the countries face many challenges starting from the construction of the architecture of those infrastructure investments, continuing with their operationalization and last but not least regarding the securing of financing for the completion and for the project operation.

The importance of spinal reflexes is connected to the rehabilitation processes in neural prostheses and to the neuromuscular junction. In order to model neuron networks as electronic circuits, a simulation environment like LTSpice XVII or PSpice can be used to create a complete electronic description. There are four types of neurons employed in spinal reflexes: α-motoneurons, sensitive neurons, excitatory interneurons, and inhibitory interneurons. Many proposals have been made regarding methods that can be used for assimilating neurons using electronic circuits. In this paper, only a single internal model of a neuron is considered enough to simulate all four types of neurons implicated in the control loops. The main contribution of this paper is to propose the modeling of neurons using some electronic circuits designed either with a bipolar transistor or with CMOS transistors for the input and output of circuits stages. In this way, it is possible to mimic the neural pulses’ circulation along the loops of the spinal reflexes and to prove the accuracy of the simulation results with respect to the biological signals collected from the bibliographic materials.

Post-traumatic stress disorder (PTSD) is associated with deficits in cognitive flexibility, with evidence suggesting that these deficits may be a risk factor for the development of core PTSD symptoms. Understanding the neurophysiological substrate of this association could aid the development of effective therapies for PTSD. In this study, we investigated the relationship between post-traumatic stress severity (PTSS) in service members with combat exposure and the modulation of cortical oscillatory activity during a test of cognitive flexibility. Participants were assigned to three groups based on PTSS scores: low (well below a threshold consistent with a diagnosis of PTSD, n = 30), moderate (n = 32), and high (n = 29) symptom severity. Magnetoencephalography data were recorded while participants performed a cued rule-switching task in which two matching rules were repeated or switched across consecutive trials. Participants with high PTSS had longer reaction times for both switch and repeat trials, and showed evidence of sustained residual interference during repeat trials. During the cue-stimulus interval, participants with moderate and high PTSS showed higher relative theta power in switch trials over left dorsolateral prefrontal cortex (DLPFC). After test-stimulus onset, participants with high PTSS showed less suppression of beta band activity, which was present over multiple prefrontal, parietal, and temporal regions in switch trials, but it was confined to ventromedial prefrontal cortex in repeat trials. Higher theta band activity is a marker of effortful voluntary shifting of attention, while lower suppression of beta band activity reflects difficulties with inhibition of competing perceptual information and courses of action. These findings are consistent with a role for altered suppression of beta band activity, which can be due to less effective top-down bias signals exerted by DLPFC, in the etiology of cognitive flexibility deficits in PTSD.

Objective. This study aimed at identifying the stress and anxiety levels among physicians and nurses working in Romanian hospitals during the COVID-19 pandemic. Methods and Results. We conducted an online survey with a questionnaire completed by 169 healthcare providers aged between 25 and 69 years from COVID and non-COVID hospitals. There were 87.6% physicians and 12.4% nurses, with 61.5% women and 38.5% men. Clinicians experienced high levels of stress in 2.7% of the cases, medium stress in 68.9% of the cases, and low stress in 28.4% of the cases. Women experienced more stress (2.9% high level, 66.3% medium level) than men (1.5% high level, 64.6% medium level), while men are more anxious (73.8% high level, 26.2% medium level) than women (63.6% high level, 33.7% medium level). In both COVID and non-COVID healthcare providers, the stress score directly correlates with the anxiety score. Overall, during this period, the responders felt stressed and anxious (p=0.001). Conclusions. The COVID-19 pandemic is a strong reason for increased stress and anxiety among physicians and nurses. Men are more anxious and women more stressed. The stress and anxiety scores are different according to the hospital type.

The aim of this study is to determine the prevalence of malocclusions in a group of schoolchildren from both urban and rural areas of Gorj County, Romania. The study included 1007 schoolchildren aged between 6 and 14 years old, who were enrolled in randomly selected public schools from Gorj County. The data were collected from December 2019 to February 2020, based on the project „Educație pentru sănătate orală. Cercetări privind anomaliile dento-maxilare și leziunile odonto-parodontale la școlarii din Oltenia”, in which several institutions were involved. The study was interrupted before it was completed due to the COVID-19 pandemic outbreak. In data collection and centralization we used: Angle’s classification of malocclusions and the distribution of malocclusions according to gender, age groups and origin. We obtained a prevalence of 35.35% for malocclusions. Of the total number of schoolchildren with malocclusions, the highest prevalence was recorded for those included in Angle’s class I (60.37% for males and 65.63% for females). We found the highest prevalence of malocclusions in female gender (36.64%). Regarding the origin, there is a higher prevalence of malocclusions in urban areas (37.86%). Due to the strong impact of malocclusions on the quality of life, it is necessary to apply preventive measures to avoid psychological implications.

This paper approaches the impact of globalization on the monetary policy of the European Union by comparing the data available both on the official website of the World Bank and on the website of the European Union (Eurostat) in order to establish the global influences of inflation with how these indicators evolve with those at the level of the European Union. Also, the paper highlights the impact of globalization in economic life in terms of monetary policy of the European Union, as well as the degree of fulfillment of the objectives proposed within this policy. Thus, the most important indicators of monetary policy were analyzed, namely: the inflation rate, the interest rate, as well as the level of direct investments, as well as their evolution worldwide compared to the indicators from the European Union. To analyze the impact of globalization on these indicators I will use graphs that will reveal their evolution, and with their help I will determine the degree of influence of globalization. In this regard, I consider important to analyze how the indicators within the monetary policy of the European Union have evolved, as well as the contribution of globalization to the specific objectives of monetary policy so as to demonstrate that globalization influences both directly and indirectly the decisions that are taken within the monetary policy of the European Union for a more stable economy.

Introduction: The implementation of Patient Blood Management (PBM) in cardiac surgery has been shown to be effective in reducing blood transfusions and associated complications, as well as improving patient outcomes. Despite the potential benefits of PBM in cardiac surgery, there are several barriers to its successful implementation. Objectives: The main objectives of this study were to ascertain the impact of the national Romanian PBM recommendations on allogeneic blood product transfusion in cardiac surgery and identify predictors of perioperative packed red blood cell transfusion. Methods: As part of the Romanian national pilot programme of PBM, we performed a single-centre, retrospective study in a tertiary centre of cardiovascular surgery, including patients from two time periods, before and after the implementation of the national recommendations. Using coarsened exact matching, from a total of 1174 patients, 157 patients from the before group were matched to 169 patients in the after group. Finally, we built a multivariate regression model from the entire cohort to analyse independent predictors of PRBC transfusion in the perioperative period. Results: Although there was a trend towards a lower proportion of patients requiring PRBC transfusion in the “after” group compared to the “before” group (44.9%vs. 50.3%), it was not statistically significant. There was a significant difference between the “after” group and the “before” group in terms of fresh-frozen plasma (FFP) transfusion rates, with a lower percentage of patients requiring FFP transfusion in the “after” group compared to “before” (14.2%, vs. 22.9%, p = 0.04). This difference was also seen in the total perioperative FFP transfusion (mean transfusion 0.7 units in the “before” group, SD 1.73 vs. 0.38 units in the “after” group, SD 1.05, p = 0.04). In the multivariate regression analysis, age > 64 years (OR 1.652, 95% CI 1.17–2.331, p = 0.004), female sex (OR 2.404, 95% CI 1.655–3.492, p < 0.001), surgery time (OR 1.295, 95% CI 1.126–1.488, p < 0.001), Hb < 13 g/dl (OR 3.611, 95% CI 2.528–5.158, p < 0.001), re-exploration for bleeding (OR 3.988, 95% CI 1.248–12.738, p = 0.020), viscoelastic test use (OR 2.18, 95% CI 1.34–3.544, p < 0.001), FFP transfusion (OR 4.023, 95% CI 2.426–6.671, p < 0.001), and use of a standardized pretransfusion checklist (OR 8.875, 95% CI 5.496–14.332, p < 0.001) remained significantly associated with PRBC transfusion. The use of a preoperative standardized haemostasis questionnaire was independently associated with a decreased risk of perioperative PRBC transfusion (0.565, 95% CI 0.371–0.861, p = 0.008). Conclusions: Implementation of national PBM recommendations led to a reduction in FFP transfusion in a cardiac surgery centre. The use of a preoperative standardized haemostasis questionnaire is an independent predictor of a lower risk for PRBC transfusion in this setting.

The economic frauds have been categorized separately from other crimes and criminal activity due to the use of fraud (and often conspiracy) to commit the crimes. The white collar or financial criminal has the same motive for crime,but through official position, status, sophistication, or professional acumen is able to effect the crime without the use of violence. White-collar crime contains several clear components. Financial or white-collar crime has a depth and breadth that is all consuming. It has a global dimension in all societies and all economies, to a greater or lesser extent. Developed countries, the third world, and emerging democracies are all subject to illegal business practices and fraud undermines the efforts of funding agencies across the world.

The absorption of European funds is representing a phenomenon with strong implications in the European sphere, on the one hand, and within Romania’s capacity to access these funds, on the other hand. The capacity of absorption is “ a variable which is manifesting under different forms in the member states”, thing which determined the need to identify some individual solutions, designed and applied according to the specific needs of each country in regard to the removal of obstacles and of absorption difficulties of European money. The access of European funds results in the implementation of these funds, which contributes to regional development. The objective of this research is to evaluate the capacity of absorption in the area of funds demand, to identify the means of improving the capacity of absorption via the analysis of the identified theoretical aspects and their implementation at a practical level. Another research direction was represented by the analysis of the impact brought by the implementation of the projects conducted from the European funds over the local development, the planning and implementation of available resources, the EU payments towards Romania and the achievements and national level, so that it would be possible to create a strong correlation between the availability of funds and the needs of the public investments. The research’s results demonstrate that the absorption of the European funds is an elemental request posed by the development of the society in the context of European integration and by the development of the local autonomy as an insurance for the success of the local community development

Aim of the study The aim of our study was to determine and compare the prevalence and severity of acquired developmental defects of enamel (DDE) in a group of children coming from a rural area in Dolj County, Romania, aged between 3 and 19 years. Material and methods A total of 213 children were examined using the modified DDE Index, for screening studies. Their assessment included the clinical examination, performed by completing an excel document. Results The prevalence of DDE was 11.27%. Of the 5452 primary and permanent teeth examined, 49 (0.90%) had some form of DDE. Diffuse opacity was the most common type of DDE observed in primary teeth, while in permanent dentition, the number of the 2 forms of opacity was very similar. We did not find any hypoplasia. Conclusions DDE is currently increasing, having major implications for children’s lives, which makes it a significant public health problem.

Aim of the study The aim of our study was to determine and compare the prevalence and severity of acquired developmental defects of enamel (DDE) in a group of children coming from a rural area in Dolj County, Romania, aged between 3 and 19 years. Material and methods A total of 213 children were examined using the modified DDE Index, for screening studies. Their assessment included the clinical examination, performed by completing an excel document. Results The prevalence of DDE was 11.27%. Of the 5452 primary and permanent teeth examined, 49 (0.90%) had some form of DDE. Diffuse opacity was the most common type of DDE observed in primary teeth, while in permanent dentition, the number of the 2 forms of opacity was very similar. We did not find any hypoplasia. Conclusions DDE is currently increasing, having major implications for children’s lives, which makes it a significant public health problem.

The study initiated to elaborate the presence of this paper aimed to determine the degree of influence of the fertilization with green fertilizers on the height of the oil flax plants, in the specific conditions of Sibiu county, from the Transylvanian Plateau, between 2017 - 2018. It was found that due to the humidityexcess of June-July 2018, in that year there were vegetative growths (plant height) higher than in 2017; the largest growths were registered with the green fertilizer variants, followed by the mineral fertilization.

This paper highlights the role played by small and medium-sized enterprises in the development of the global economy. In essence, it is presented in the form of three chapters entitled suggestively. During the paper, I tried to touch on the main themes to demonstrate that these companies play an essential role in the economy. It is well known that SMEs are vital for economic health, both for high-income and lower-income countries worldwide. In terms of numbers, small and medium-sized businesses dominate the global business scene, although accurate and up-to-date data are difficult to obtain, estimates suggest that more than 95% of businesses worldwide are SMEs, accounting for about 60% of SMEs. employment in the private sector. SMEs are very important in creating jobs and contributing to GDP, but they are also an important source in the innovative system. In order to face the competition, the economic agents use many means, such as: reducing the expenses, improving the quality, renewing the offer, granting advantages to the buyer, etc. Other means would be the creation of tacit alliances between companies, partial mergers or the request to the state bodies to impose restrictions for foreign competitors.

The researches undertaken for the elaboration of the present paper aim the knowing of the influence of the green fertilizers on the production and the quality of the flaxseeds and the number of capsules, respectively. The paper seeks to find new technological options for limiting or replacing the mineral fertilization in the flex oil culture, under the specific conditions of Sibiu County, in Transylvania. It was found that in 2018, due to the rich pluviometric regime, there was a positive influence on the development of capsules, showing a distinctly significantly positive increase compared to the overall average of the experience, but they were much smaller in size, compared to 2017.

Background: Developmental defects of enamel (DDE) are frequently encountered in primary and permanent teeth, yet their etiology is not completely known. Enamel hypoplasia is considered a predisposing factor for early caries. The objective of this study was the evaluation of several risk factors potentially causing DDE and the possible association between DDE and dental caries. Methods: This study was performed on a group of 213 rural children from Romania. It combined a thorough dental examination for all children, and a questionnaire filled in by their mothers, regarding the evolution of their pregnancy and the child’s health status in the first years of life. Results: There was no statistically significant association between DDE presence and data regarding the evolution of pregnancy, mothers’ health status or children’s conditions during early childhood. There was a significant association between the use of amoxicillin, ibuprofen, and cephalosporin during the period of formation of permanent teeth, and one environmental factor (water source), and the presence of DDE (Chi Square, p < 0.05). Also, DDEs were associated with the presence of caries (Fisher, p = 0.001). Conclusions: Children who consumed water from private wells and children who received medication during early childhood developed more enamel defects, presenting a higher risk of caries development.

We recorded magnetoencephalography data during a visual recognition task in participants with combat exposure (n = 40, age: 41.2 ± 7.2 years) to investigate the relationship between the evoked brain activity, behavioral performance, and the severity of their post-traumatic stress symptoms assessed using the PTSD Check List for DSM V version (PCL-5). In an initial study session, participants were presented with a series of images of outdoor scenes and were instructed to study the images for an upcoming recognition test. In a subsequent session, the original images were shown intermixed with novel images while participants performed the recognition task. PCL-5 scores were negatively correlated with discrimination performance and with the recognition accuracy for original images. During the recognition session, higher PCL-5 scores were associated with reduced relative power of the evoked response to original images from 100 ms to 300 ms following the image onset over a distributed brain network including the bilateral inferior frontal gyri, left middle frontal gyrus, left supramarginal gyrus, right precuneus and the bilateral superior temporal gyri. These findings indicate that the lower recognition performance in participants with higher PTSD symptom severity is associated with altered cortical activity in brain regions that are known to play a role in the elaboration on visual cues that supports recollection.

Developmental defects of enamel (DDEs) are deviations from the normal appearance in terms of the quantity and quality of tooth enamel. They may be genetic or acquired. The most important DDEs are hypomineralization and hypoplasia. The aim of this study was to produce “in vivo” DDE in Wistar rats by administering amoxicillin to pregnant females and to highlight these lesions after sacrifice of the pups by macroscopic and microscopic examination and optical coherence tomography (OCT). Amoxicillin (100 mg/kg) was administered to two pregnant Wistar female rats for the production of DDEs. When the pups were 2 months old, they were sacrificed, and their jaws were harvested together with their teeth. The jaws were examined macroscopically, microscopically, and by OCT. Following the macroscopic and microscopic examination, it was established that four pups had a total of 42 DDE lesions. At the OCT examination, the hypomineralization was characterized by an intense, inhomogeneous OCT signal, and the hypoplasia was characterized by the absence of the signal. Administration of amoxicillin to pregnant females of Wistar rats resulted in DDEs in their offspring. The OCT examination confirmed the presence of these lesions in the teeth of rat pups.

This paper presents an overview of Sustainable Development in the European context and in particular about European policies in the field of the labor market. I have pointed that the accessibility of the funds of the Human Capital Operational Program (POCU), which have as main purpose the promotion of high-quality and long-term jobs for young people and disadvantaged people, with a view to combating economic development disparities and between Romania and the EU Member States.

We studied the relationship between electrophysiological markers of memory encoding, subsequent recognition performance, and severity of PTSD symptoms in service members with combat exposure (n = 40, age: 41.2 ± 7.2 years) and various levels of PTSD symptom severity assessed using the PTSD Check List for DSM V version (PCL-5). Brain activity was recorded using magnetoencephalography during a serial presentation of 86 images of outdoor scenes that were studied by participants for an upcoming recognition test. In a second session, the original images were shown intermixed with an equal number of novel images while participants performed the recognition task. Participants recognized 76.0% ± 12.1% of the original images and correctly categorized as novel 89.9% ± 7.0% of the novel images. A negative correlation was present between PCL-5 scores and discrimination performance (Spearman rs = –0.38, p = 0.016). PCL-5 scores were also negatively correlated with the recognition accuracy for original images (rs = –0.37, p = 0.02). Increases in theta and gamma power and decreases in alpha and beta power were observed over distributed brain networks during memory encoding. Higher PCL-5 scores were associated with less suppression of beta band power in bilateral ventral and medial temporal regions and in the left orbitofrontal cortex. These regions also showed positive correlations between the magnitude of suppression of beta power during encoding and subsequent recognition accuracy. These findings indicate that the lower recognition performance in participants with greater PTSD symptom severity may be due in part to ineffective encoding reflected in altered modulation of beta band oscillatory activity. Keywords: Post-traumatic stress disorder, Memory encoding, Beta band oscillations, Magnetoencephalography

We are reporting a case of a 36 year-old Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) positive hypertensive primigravida with postpartum uterine atony that required emergency subtotal hysterectomy at Saint John Hospital Bucur Maternity Bucharest. The maternity was designated as the Coronavirus Disease 2019 (COVID-19) Maternity for Bucharest and Ilfov County since March 2020. The patient was mildly symptomatic for SARS-CoV-2, infection confirmed with reverse transcription polymerase chain reaction (RT-PCR). The caesarean section was performed and a live male fetus was born, 2630 g and Apgar Score of 9 (the male fetus was negative for SARS-CoV-2). Postpartum hysterectomy with adnexal preservation was performed because of uterine atony. The postoperative evolution was favorable. The patient was discharged with her baby 10 days after birth. Given the limited resources, the placenta, the umbilical cord and the uterus were not tested for SARS-CoV-2. The pathology exam revealed that on the maternal side there were specific uterine atony lesions as well as endometrial and miometrial ischaemia. The placenta had nonspecific findings: chronic ischemic lesions with small villi, fibrin deposits in the materno-fetal interface. The peculiarity of the case is that we report the morphological findings of the placenta and uterus resulted from intrapartum uterine atonia in a patient with gestational arterial hypertension, premature birth and COVID-19. Further studies are required to characterize the pattern of such intricate conditions.

Patients with a history of mild traumatic brain injury (mTBI) and objective cognitive deficits frequently experience word finding difficulties in normal conversation. We sought to improve our understanding of this phenomenon by determining if the scores on standardized cognitive testing are correlated with measures of brain activity evoked in a word retrieval task (confrontational picture naming). The study participants (n=57) were military service members with a history of mTBI. The General Memory Index (GMI) determined after administration of the Rivermead Behavioral Memory Test, Third Edition, was used to assign subjects to three groups: low cognitive performance (Group 1: GMI≤87, n=18), intermediate cognitive performance (Group 2: 88≤GMI≤99, n=18), and high cognitive performance (Group 3: GMI≥100, n=21). Magnetoencephalography data were recorded while participants named eighty pictures of common objects. Group differences in evoked cortical activity were observed relatively early (within 200ms from picture onset) over a distributed network of left hemisphere cortical regions including the fusiform gyrus, the entorhinal and parahippocampal cortex, the supramarginal gyrus and posterior part of the superior temporal gyrus, and the inferior frontal and rostral middle frontal gyri. Differences were also present in bilateral cingulate cortex and paracentral lobule, and in the right fusiform gyrus. All differences reflected a lower amplitude of the evoked responses for Group 1 relative to Groups 2 and 3. These findings may indicate weak afferent inputs to and within an extended cortical network including association cortex of the dominant hemisphere in patients with low cognitive performance. The association between word finding difficulties and low cognitive performance may therefore be the result of a diffuse pathophysiological process affecting distributed neuronal networks serving a wide range of cognitive processes. These findings also provide support for a parallel processing model of lexical access. Keywords: Magnetoencephalography, Traumatic brain injury, Picture naming, Lexical retrieval, Attractor dynamics

Community-based organizations can mobilize citizens to adoption behaviors to ensure the transition to a sustainable economy. This paper evaluates social and economic impacts of community based initiatives in Romania, in two different domains: transport and waste. The sample for this paper includes two community-initiatives, one from the transport domain and the other one from the waste domain. It was analyzed 12 interviews five interviews with members and one interview with a stakeholder for each of the two initiatives, which was conducted during January -May 2015

The objective of this paper was aimed at understanding the importance of SMEs in the market economy as the economic engine continues to be the factor that motivates both business and human existence. The yield and quality of the results of a national economy depend largely on the ability to determine the creation and operation of a large number of businesses which provide products and services of quality, cost and reduced prices and quantities and of appropriate requirements domestic and foreign market. The article deals with the content and structure, activities that are specific to SMEs and how they operate in the market, and how these types of companies influence the economy of the European Union and Romania.

This analysis is based on the study of two interdisciplinary complex concepts: globalization and sustainability. In this complex, called globalization, sustainability is designed structure, formal, based on her idea of realizing sustainable development. Essentially, throughthe firm or enterprise we appoint a group of people, organized according to certain management requirements, economic, technological and legal, which starts and runsa complex of processes of work, often using certain means of work, reflected in products and services, for the purpose of obtaining a profit, as a general rule, as much as possible The globalization appearance marks the need for a comprehensive approach to environmental issues, defining the concepts of economic growth, sustainable development and investment explaining the distinction between economic growth and sustainable development. It also attests EU involvement by presenting their strategies for sustainable development.

BackgroundThe combination of electroporation with electrolysis (E2) has previously been introduced as a novel tissue ablation technique. E2 allows the utilization of a wide parameter range and may therefore be a suitable technology for development of tissue-specific application protocols. Previous studies have implied that it is possible to achieve big lesions in liver in a very short time. The goal of this study was to test a variety of electrode configurations for the E2 application to ablate large tissue volumes.Materials and methods27 lesions were performed in healthy porcine liver of five female pigs. Four, two and bipolar electrode-arrays were used to deliver various E2 treatment protocols. Liver was harvested approx. 20h after treatment and examined with H&E and Masson's trichrome staining, and via TUNEL staining for selective specimen.ResultsAll animals survived the treatments without complications. With four electrodes, a lesion of up to 35x35x35mm volume can be achieved in less than 30s. The prototype bipolar electrode created lesions of 50x18x18mm volume in less than 10s. Parameters for two-electrode ablations with large exposures encompassing large veins were found to be good in terms of vessel preservation, but not optimal to reliably close the gap between the electrodes.ConclusionThis study demonstrates the ability to produce large lesions in liver within seconds at lower limits of the E2 parameter space at different electrode configurations. The applicability of E2 for single electrode ablations was demonstrated with bipolar electrodes. Parameters for large 4-electrode ablation volumes were found suitable, while parameters for two electrodes still need optimization. However, since the parameter space of E2 is large, it is possible that for all electrode geometries optimal waveforms and application protocols for specific tissues will emerge with continuing research.

This article brings together environmental problems common to both public (EU, national government, regional or local) and private sector (beneficiaries etc.) of European Structural Funds to finance projects with major relevance in the development of new strategic investments. Article envisages the introduction of theoretical and practical application of models and analysis of a case study, being put into relief the main positive and negative aspects that contribute to the absorption and accessing European structural funds in Romania, for financing of investments for the development and improvement of the environment in Romania. The main objective of this research is to study the theoretical and practical aspects of the mechanism to finance investment projects of European structural funds for the environment.

This paper attempts to bring answers to some questions that are born , more quickly , on how Romania manages to cope with EU requirements . The paper does not claim to treat exhaustively the proposed issue , but attempts to present a balanced and understandable manner the decisive role that regional policy plays in the effective implementation of Europe 2020 , based of the situation in Romania. I chose to approach this subject as, besides being a very topical theme, which continues debate is a table of positioning Romania in the European context , not only economically , regional policy and strategy since 2020 applied to Romania's case highlights the disparities between our country and other parts of Europe

The paper goal is to integrate the software reliability into the general theory of the reliability, this thing being a natural approach, perfectly justified by the core concepts governing the two areas.

The investments represent the primordial factor for the strategy of the national economy development, of all branches and fields of activity, for the increase of the incomes, and a condition to arise the living standard. The directions and targets of economic research, in the existing stage give a special attention to the field of investment. The most frequent meaning for defining investments is that of expense or disposal of money sums at an initial moment in order to obtain subsequent effects, and numerous economists, from different countries, sought to render as many aspects as possible related to the content and mechanism of investment.

The article depicts bifront lines wars, which Romans had to wage during Marcus Aurelius’ and Lucius Verus’ reign (and after Verus’ death, only Marc Aurelius’ reign). After a long period of peace, Rome was then attacked by Parts and various tribes living on the North from Danube. The situation was complicated not only because of war, but also because of an epidemic spreading in the empire (the plague was driven from the Eat by Lucius Verus’ troops) and of increasing economic crisis. To repulse the danger, Marc Aurelius and Lucius Verus chose many innovative solutions, which had never been applied before or which were not very popular, although already known in the past. They decided, among others, to introduce the Caesar onto the frontline. They made some changes in a leadership style, created new legions, recruited new soldiers from these social categories, which usually did not serve in the army (slaves, gladiators), and – finally – introduced new fight techniques.

The risk and the uncertainty always accompany the economic activity everywhere; the rising phenomena and those of recession occur under the sign of uncertainty and of risk. Unlike uncertainty whose cause can be difficult to identify, and thus, difficult to quantify, the economic risk refers to a specified item which can be estimated by a law of probability, and, therefore, can be quantified through the probability of producing a certain event. Analyzing the problem of risk one must take into account the two important concepts which determine it: the expected value, the most probable effect in situations that repeat several times, and its degree, measured by the dispersion of some possible effects if a situation repeats.

Background. Thrombotic complications may impact mortality and morbidity in chronic myeloproliferative neoplasms (MPNs) mainly polycythemia vera (PV) and essential thrombocythemia (ET). However, the underlying mechanisms involved are not clear, though abnormalities in blood viscosity, activated platelets and leukocytes, leukocytosis, hypercoagulability status may be risk factors for developing clinical vascular events. Presence of JAK2 V617F allele burden as well as serum thrombopoetin level are associated with increased risk of thrombosis. We sought to define risk factors for vascular complications (VC) in MPNs patients. Materials and methods. We prospectively included 25 MPNs patients with stroke or myocardial infarction and 18 MPNs patients without VC. To identify the patterns of platelet response in MPNs patients with or without VC, comparative platelet aggregation tests using ADP, collagen, epinephrine, ristocetin assessing amplitude, and slope were performed. The additional evaluated biomarkers were of major clinical and laboratory nature. Results. MPNs patients with VC exhibited higher Hb, higher number of leukocytes, larger platelet counts vs. MPNs patients without VC (Leukocytes 12280/mmc vs. 7195/mmc p=0.03; Hemoglobin (Hb) 15.45g/dl vs. 12.75g/dl, p=0.03; Hematocrit (Ht) 47.03 vs. 39.1, p=0.02). Count of platelets it is not very important. Arterial hypertension (52.63% vs. 4.34% OR 24.44, p = 0.0044) was the most prominent biomarker predicting VC. Platelet response was also different (amplitude curve: collagen 31.45 vs. 53.64, p = 0.03; ristocetin 61.25 vs. 41.5, p=0.03; slope curve collagen 82.4 vs. 46.65, p = 0.03, ristocetin 81.66 vs. 54.5, p=0.05) suggesting higher aggregation in MPN patients with VC. Conclusion. Arterial hypertension is an independent clinical predictor of VC in MPNs patients with arterial hypertension. High blood viscosity and impaired platelet response to collagen and ristocetin may serve as laboratory biomarkers for VC in such high-risk patients. Identifying prognostic biomarkers and their link to clinical outcomes in MPN patients is warranted.

Based on the critical analysis of the presently employed management of methane drainage systems operation in Jiu Valley collieries, the paper aims to assess the basic elements required to develop an automated monitoring and control system of these. The results obtained after studies and researches carried out also allowed formulating certain proposals regarding the modification of manual control procedures of methane drainage systems operation, in order to correlate them with the prescriptions of legislation requirements from countries having a well-developed mining industry. Putting in practice the mentioned proposals could have immediate and beneficial effects on increasing the methane drainage process efficiency, leading meanwhile to an improved working environment and, implicitly, to a higher level of occupational safety and health in Jiu Valley collieries.

This paper provides a critical review of the climate university literature. Higher education institutions have increased their climate initiatives among students and society. Climate changes is becoming more and more present in daily activities. Whether it is about carbon dioxide emissions or deforestation, the social and economic consequences of climate change are challenging for each country in the world. Of all the institutions, universities play the most important role in educating people regarding the negative effects of climate change. While some universities use their own resources for this cause, others write plans and attract European projects to fund climate change objectives. The aim of this paper is to review the latest insights on Climate University. For this purpose, the paper analysed a database of scientific papers extracted from the Web of Science. The results underline the decisive role that higher education institutions play in promoting the fight against the causes of climate change. Society must understand the challenges of climate change and further develop solutions to address them. The new insights offered by this paper may be worthwhile for different stakeholders interested in climate change issues.

The craft of painting icons on glass developed in the 17th century in Transylvania (Romania) following the spread of the news about the wooden icon of the weeping Mother of God in the church of Nicula. This news turned Nicula into a pilgrimage centre, and requests for reproductions of the icon led to the locals becoming glass painters. Because of the surplus of icons, some of the Nicula painters set up new icon-painting centres along the road to Brașov (to the south) and the other main trade routes of Transylvania. In order to highlight the potential for sustainable development associated with this craft and to stimulate the painting of icons in the traditional way, we conducted documentary research on the subject of icons on glass. This research revealed the local peculiarities of the icon painters’ workshops and their importance to the identity of the Romanian peasants in Transylvania. We also conducted a participatory observation carried out in Brasov, which revealed that the iconography courses in popular schools of arts and crafts were both a viable way of managing the relationship with the iconographic tradition and a means to capitalize on religious painting on glass as a cultural heritage resource. The research highlighted the way in which, to preserve the traditional dimension of the craft, it is useful to encourage students to use anonymous glass icons as models and to have limited involvement in model restoration.

In the COVID-19 and post-pandemic business environment, leveraging robust Internet of Things (IoT) security risk management strategies becomes of particular importance to IoT adopters. Thus, given that no research study was found to exclusively focus on the current state of IoT security risk management strategies in organizations, this article aims to support IoT security practitioners to peer benchmark and enhance their IoT security risk management strategies. In a nutshell, this study relies on a mixed methods research methodology, and its main contribution is the determination of the current state of the IoT security risk management strategies in the surveyed organizations relative to our IoT Security Risk Management Strategy Reference Model (IoTSRM2). Hence, this study entails designing and conducting a survey, analyzing survey responses, and reporting survey results based on our IoTSRM2 and proposed three-phased survey methodology. Furthermore, before discussing the related work, this article provides our survey results for the surveyed large and small-medium organizations, the surveyed large organizations, and the surveyed large Technology, Media, and Telecom (TMT) organizations. For instance, our results reveal that while most surveyed organizations perform IoT risk assessments and focus on IoT infrastructure resilience, they fail in strategizing IoT governance and risk management, among others.

Nowadays, Internet of Things (IoT) adoptions are burgeoning and deemed the lynchpin towards achieving ubiquitous connectivity. In this context, defining and leveraging robust IoT security risk management strategies are paramount for secure IoT adoptions. Thus, this study aims to support IoT adopters from any sector to formulate or reframe their IoT security risk management strategies to achieve robust strategies that effectively address IoT security issues. In a nutshell, this article relies on a mixed methods research methodology and proposes a reference model for IoT security risk management strategy. The proposed IoT security risk management strategy reference model (IoTSRM2) relies on the 25 selected IoT security best practices which are outlined using a proposed taxonomic hierarchy, and on the proposed three-phased methodology that consists of nine steps and outputs. The main contribution of this work is the proposed IoTSRM2 which consists of six domains, 16 objectives, and 30 prioritized controls. Furthermore, prior to providing the related work, this article provides a critical evaluation of selected informative references of IoTSRM2 based on their percentage-wise linkage to the IoTSRM2 domains and to the entire IoTSRM2. The findings of the critical evaluation illustrate, inter alia, the selected informative references that are the top three most and least linked to the entire IoTSRM2.

Epithelial-mesenchymal transition (EMT) is involved in physiologic processes such as embryogenesis and wound healing. A similar mechanism occurs in some tumors where cells leave the epithelial layer and gain mesenchymal particularities in order to easily migrate to other tissues. This process can explain the invasiveness and aggressiveness of these tumors which metastasize, by losing the epithelial phenotype (loss of E-cadherin, desmoplakin, and laminin-1) and acquiring mesenchymal markers (N-cadherin). Complex changes and interactions happen between the tumor cells and the microenvironment involving different pathways, transcription factors, altered expression of adhesion molecules, reorganization of cytoskeletal proteins, production of ECM-degrading enzymes, and changes in specific microRNAs. The purpose of this review is to determine particularities of the EMT process in the most common malignant cutaneous tumors (squamous cell carcinoma, basal cell carcinoma, and melanoma) which still have an increasingly high incidence. More studies are required on this topic in order to establish clear correlations. High costs related to skin cancer therapies in general as well as high impact on patients’ quality of life demand finding new, reliable prognostic and therapeutic markers with significant public health impact.

Se considera que los estudiantes aprenden igual o mejor en la web que en clases tradicionales. Sin embargo no abundan ensayos randomizados que brinden evidencia al respecto, especialmente en Argentina. Objetivo: Comparar el aprendizaje sobre tratamiento de la diabetes(TD)entre dos grupos de estudiantes avanzados de medicina, uno con clase tradicional y otro utilizando Internet. Materiales y métodos: 120 estudiantes de una Cátedra de Medicina de la Universidad Nacional del Nordeste, Argentina, contestaron un cuestionario con 20 preguntas sobre TD. Tres meses después, fueron randomizados en 2 grupos para participar en una clase o en un foro de Internet sobre (TD). Los estudiantes no conocían el objetivo del estudio. Todos utilizaron la misma bibliografía. La clase tuvo una duración de 2 horas, conectándose al mismo tiempo el grupo de Internet a un foro habilitado durante 48 hs. 70 horas después de finalizada la actividad realizaron el mismo cuestionario inicial sobre TD. Resultados: Fueron incluidos 107 estudiantes (13 fueron excluidos por no completar alguno de los 2 cuestionarios). La puntuación promedio del grupo clase, antes, fue de 8.30 ± 2.48 y después de 9.76 ± 2.17. El grupo Internet obtuvo una puntuación antes de 8.39 ± 2.14 y después de 9.76 ±2.8, p >0.10 en la comparación de los grupos. Conclusión: Se demuestra que el aprendizaje de un tema de terapéutica para estudiantes de medicina argentinos fue igualmente efectivo por Internet que con una clase convencional.It is not known if medical students can learn better or not with online methods than with traditional lectures. There are not many randomized studies that substantiate this belief, especially in Latin American settings. Purpose: To compare two different methods of learning diabetes’ treatments (DT) in two groups of advanced medical students. One group used an online forum, the other group a traditional lecture. Method: We conducted surveys among 120 medical students of the Northeastern National University of Argentina. The first survey was a questionnaire of 20 items about DT. The students were then randomized to two groups: one assigned to traditional lecture, and another assigned to an online Forum about DT. The students were not aware of the study’s purpose. The same guidelines were provided to both groups. Duration of the lecture was 2 hours. The group working online was connected at the same time to the Web forum for 48h. 70 hours after the lecture and the on line exposure all students repeated the initial questionnaire. Results: 107 students were included (13 were excluded because they didn’t complete one of the questionnaires). The average performance of the lecture’s group was 8.30+/-2.48 points before, and 9.76+/- 2.17 after the educational intervention. In the Web program group it was 8.39 +/- 2.14 points initially, and 9.76 +/- 2.8 after. The p was >0.10 comparing the lectures and the internet groups. Conclusion: Learning a therapeutic subject by Argentinean students was equally as effective with Web based learning as with traditional lectures.

Event tree analysis is an inductive method, which involves determining the events flowing from the failure of a component or part of the system. Starting from an initiator event or an origin failure, the event tree analysis allows the estimation of system deviation, taking into account in a systematic manner the functioning or failure of detection devices, alarm, prevention, protection or intervention. This paper follows the steps in determining the causes that led to a work accident through the Event Tree Analysis method. The construction of event tree analysis consists of graphical representation of operations which through a succession of decisions lead to an accident during maintenance of work equipment.

Se considera que los estudiantes aprenden igual o mejor en la web que en clases tradicionales. Sin embargo no abundan ensayos randomizados que brinden evidencia al respecto, especialmente en Argentina. Objetivo: Comparar el aprendizaje sobre tratamiento de la diabetes(TD)entre dos grupos de estudiantes avanzados de medicina, uno con clase tradicional y otro utilizando Internet. Materiales y métodos: 120 estudiantes de una Cátedra de Medicina de la Universidad Nacional del Nordeste, Argentina, contestaron un cuestionario con 20 preguntas sobre TD. Tres meses después, fueron randomizados en 2 grupos para participar en una clase o en un foro de Internet sobre (TD). Los estudiantes no conocían el objetivo del estudio. Todos utilizaron la misma bibliografía. La clase tuvo una duración de 2 horas, conectándose al mismo tiempo el grupo de Internet a un foro habilitado durante 48 hs. 70 horas después de finalizada la actividad realizaron el mismo cuestionario inicial sobre TD. Resultados: Fueron incluidos 107 estudiantes (13 fueron excluidos por no completar alguno de los 2 cuestionarios). La puntuación promedio del grupo clase, antes, fue de 8.30 ± 2.48 y después de 9.76 ± 2.17. El grupo Internet obtuvo una puntuación antes de 8.39 ± 2.14 y después de 9.76 ±2.8, p >0.10 en la comparación de los grupos. Conclusión: Se demuestra que el aprendizaje de un tema de terapéutica para estudiantes de medicina argentinos fue igualmente efectivo por Internet que con una clase convencional.