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Flexible launch vehicle modes contribute to the deterioration of its stability performance. For this reason, their influence must be considered when designing and validating appropriate solutions for its automatic control system. The first three bending modes are the most relevant for control system design and analysis. Next, considerations regarding the elastic modes of the Vega actuator, used in the simulations performed throughout this study, are presented. The IMU (Inertial Measurement Unit) measurements providing attitude angles and angular rates are strongly corrupted by the local elastic deformations resulting from structural flexibility. These measurements are fed back to the TVC (Thrust Vector Control) system which controls the pitch and the yaw motion of the vehicle. The design methodology for this control system is based on an ℒ1 adaptive technique incorporating a Butterworth filter guarantees good stability performances for wide variations of the launcher’s dynamics parameters.

The main objective of this paper consists in the analysis and design of distributed control systems for multi-agent systems simultaneous with various types of disturbances attenuation. The distributed structures refer to those structures for which the control laws depend only on neighbouring agents states, more precisely, communication between certain agents is missing. The design approach is based on the definition of a H∞ type cost function for the entire system, a frequently used method, especially for aerospace applications with a single agent. As a case study, a flight formation consisting of four agents with identical dynamics is used, whose time evolutions are analysed according to the effects of different communication networks failures.

Scientists and food producers are studying the potential of utilizing different by-products as highly nutritious food components to meet consumers’ growing demand for healthier and natural goods. Beetroot belongs to the Amaranthaceae family and is highly rich in antioxidants, specifically phenolics and betalains with excellent health properties. The peel of red beetroot, which is generally discarded, has a high concentration of bioactive phytochemicals (betalains, dietary fibers). These compounds are well-known for their strong antioxidant effects, improving cardiovascular health, reducing oxidative stress, and enhancing immunological function. Incorporating red beetroot peel (RBP) powder into whey-fruit-based beverages is a promising method to improve nutritional content and sensory attractiveness. This study investigated the influence of adding RBP to whey-fruit-based beverages, specifically examining its effects on physicochemical and phytochemical characteristics, antioxidant capacity, color, microbiological, and rheological attributes, and consumer preference. The RBP extract exhibited high amounts of total polyphenols (1239.35 ± 0.51 mg GAE/100 g dw) and antioxidant activity (90.02 ± 0.22%). The findings indicated that RBP had a notable impact on the antioxidant capacity (16.38 ± 0.37 μmol TE/g dw for BRBP1, 26.69 ± 0.10 μmol TE/g dw for BRBP3, 36.75 ± 0.31 μmol TE/g dw for BRBP6) of the beverages and enhanced their color without negatively impacting their sensory characteristics. The dynamic oscillatory rheological measurements revealed that beverage supplementation with increasing amounts of RBP obtained stronger networks with solid-like viscoelastic behavior. Using RBP powder as a natural food ingredient in whey-fruit-based beverages enhances their nutritional value and promotes sustainable food processing by making use of by-products from the food industry into innovative food options.

A few images on journalism and its actors in the Sahel, and specifically Mali, that are shaped by the media itself, are presented. These images, identified in articles that capitalize on the challenges of political, social, and cultural crisis, as well as the risks that a journalist takes when reporting and writing on the realities and events he observes in Sahel, are supposed to shape the power of the media to bring change at an epistemological level in the society it unpacks and depicts. This epistemological metamorphosis is seen as a turning of a page in the history of crises and the proposal herein is to see what type of change this turning refers to, re-launching critical perspectives on the new powers or non-powers of journalists and journalism to inform, create and maintain a critical resistance meant to leave a relevant sign in the history, through deconstruction and management of crises communication, that would finally assure the durable control of crises, exercised by an informed and empowered society with the scope to overcome crises at a pragmatic and epistemic level. The analysis is qualitative and intends to invite the reader to more reflection on the interdependencies between the reality, the journalistic reality, and the journalist’s power or non-power to coin the two. Crises whose management from the point of view of public awareness and truth knowledge is compromised by a second-level crisis affecting the journalists, the leaders of the civil society, and broadly the media, who have concomitant powers and non-powers to change the perception of the public on the first level crises to such a point that, in the holistic interpretation of the term, this management of crisis through deflection should be considered a new page turned in the history of crises.

Objectives. As weight modification during the COVID-19 pandemic was reported in several circumstances, we aimed to assess the body composition changes using bio impedance in patients with type 2 diabetes mellitus (T2DM) during this period. Materials and Methods. We conducted an observational, retrospective study, from January 2021- June 2021, in two outpatient clinics, enrolling all patients with T2DM and SARS-CoV2 infection that presented for evaluation after the infection. Blood tests (serum creatinine, urea, blood glucose, lipid profile, transaminases, HbA1c) were available before the onset of infection as well as at an interval of 1-3 months post-infection. Results. From a total of 118 patients, 101 subjects were eligible, 50.5% males. 68.6% had a mild form of SARS-CoV2 infection. There is a significant decrease in mean weight (91.9 ± 26.00 kg before and 90.00 ± 23.00 kg after infection vs. control, p

Although obesity is a frequently formulated diagnosis at all ages, due to the long-term projection of the consequences of this condition in children it is a real public health problem. The etiology of obesity is multiple and its complexity requires a multidisciplinary medical approach from which the psychological component cannot be omitted. Thus, diseases such as diabetes, dyslipidemias, cardiovascular diseases, sleep apnea syndrome, non-alcoholic fatty liver or neoplasia are encountered with a higher incidence in this category of individuals. During the COVID-19 pandemic, the isolation and, consequently, the reduction of access to ways of performing physical exercise increased the balance between caloric intake and caloric consumption resulting in the accumulation of surplus calories in the form of adipose tissue. The purpose of the present work is to emphasize the interest manifested by the medical scientific world regarding obesity in the pediatric population, in the pre-pandemic period, during the pandemic period and one year after its’ end (2018-2023). We performed systematic review of clinical studies on obesity in the pediatric population, including 98 articles published in the PubMed database. The number of studies published during the pandemic period (53) vs the number of studies published ex-pandemic (45), corresponds to a ratio of 1.17:1 in favor of the first. Obesity remains a research topic of major interest in early life, regardless of the coexistence of COVID-19.

In recent years, companies worldwide have faced a rapid pace of digitization and automation, which has led to change and adaptation of business models. From this point of view, new technologies have revolutionized the field of accounting and auditing, having both positive and negative effects on companies and employees. This paper highlights how changes brought about by technological progress influence the accounting and auditing profession and the role of other factors in this direction, using a qualitative method based on semi-structured interviews. The study results show that the benefits are visible at the company level. However, certain obstacles still exist, such as employees' resistance to change, the size of the initial costs or the systems used. On the other hand, professionals expect some entry-level jobs to disappear. Instead, other opportunities will be available for practitioners in the field. In this sense, universities will have a unique role in training the new generations by developing skills for the digital age. The present study may be of interest to researchers examining related issues. From a practical point of view, this paper could be helpful to professionals as it highlights several current needs of the business environment due to the impact of technological innovations.

This article delves into the complexities of consumer behavior, offering an analysis of traditional and modern behavioral models to understand purchasing decisions. It begins with presentation of the Marshallian, Pavlovian, Freudian, and Veblenian models, which focus on economic, psychological, and social influences. Subsequently, the study explores contemporary frameworks like the Nicosia, Engel-Kollat-Blackwell, and Bettman models, highlighting their contributions to comprehending the consumer decision-making process in a dynamic market environment. By integrating insights from various models, the article underscores the significance of understanding consumer psychology, external stimuli, and individual roles in purchase activities. This review aims to equip marketers with the knowledge to devise effective strategies that address current market challenges and enhance consumer satisfaction and organizational profitability.

Patient-prosthesis mismatch (PPM) is the situation in which the area of an artificial valve is smaller than that of a healthy native valve it replaces. By this definition, all artificial valves demonstrate PPM, but large observational studies and several meta-analyses suggest that it is present in 30-50% of patients after surgical aortic valve replacement (SAVR). PPM has an impact on outcomes only when the indexed aortic valve area (AVAi) is ≤0.85cm2/m2 (moderate PPM) or 0.65cm2/m2 (severe PPM), particularly in patients with reduced LVEF. In transcatheter aortic valve replacement, the prevalence of PPM may be as low as 0.1%, and its impact on hard outcomes is not clear. We present a review of the relevant literature together with a framework for the differential diagnosis of increased pressure gradient and reduced area in prosthetic aortic valves and different strategies to reduce the risk of PPM with SAVR.

The title compound, bis[μ-2,2′-(4H-1,2,4-triazole-3,5-diyl)diacetato]bis[diaquacopper(II)] dihydrate, [Cu2(C6H5N3O4)2(H2O)4]·2H2O, is a dinuclear octahedral CuII triazole-based complex. The central copper atoms are hexa-coordinated by two nitrogen atoms in the equatorial positions, two equatorial oxygen atoms of two carboxylate substituents in position 3 and 5 of the 1,2,4-triazole ring, and two axial oxygen atoms of two water molecules. Two additional solvent water molecules are linked to the title molecule by O—H...N and O...H—O hydrogen bonds. The crystal structure is built up from the parallel packing of discrete supramolecular chains running along the a-axis direction. Hirshfeld surface analysis suggests that the most important contributions to the surface contacts are from H...O/O...H (53.5%), H...H (28.1%), O...O (6.3%) and H...C/C...H (6.2%) interactions. The crystal studied was twinned by a twofold rotation around [100].

This study aims to present the main guidelines published by the Bucharest Stock Exchange regarding the general principles of corporate governance, as well as an analysis of the level of compliance with them by listed companies. Thus, the authors have developed a three-level corporate governance index by means of which the level of compliance with the guidelines published by the BVB can be measured. Following the analysis, the authors conclude that the score obtained by the analysed companies is positive, based on their level of compliance with most of the guidelines presented by the BVB. Moreover, companies in the Premium category have a higher level of compliance with the guidelines of the Code of Corporate Governance than other companies listed on the regulated market. From the perspective of future research, the authors aim to investigate whether corporate governance can influence a company’s financial performance.

Background/Objectives: Retinopathy of Prematurity (ROP) remains a leading cause of vision impairment in premature infants, especially those with Respiratory Distress Syndrome (RDS) necessitating respiratory support. This study aimed to identify correlations between plasma levels of Insulin-like Growth Factor 1 (IGF1) and Tumor Necrosis Factor-alpha (TNF-alpha), and the risk of developing ROP. Additionally, it explored the association of ROP severity grades with plasma levels of glucose, lactate dehydrogenase (LDH), creatin phosphokinase (CPK), and other biomarkers, aiming to uncover predictive markers for ROP risk and severity in this population. Methods: This prospective study included premature neonates admitted with RDS requiring respiratory support, conducted over 18 months at the Neonatal Intensive Care Unit of the Louis Turcanu Emergency Clinical Hospital for Children, Timisoara. Plasma levels of IGF1 and TNF-alpha were measured on days 1 and 14 post-birth, alongside the initial assessment of glucose, LDH, and CPK levels. Results: Significant correlations were observed between lower gestational age and elevated LDH levels on day 7–10 (rho = −0.341, p = 0.0123) and between TNF-alpha levels at 2 weeks and ROP severity (rho = 0.512, p = 0.0004). Elevated IGF1 levels were protective against ROP, with Beta coefficients of 0.37 (p = 0.0032) for the first collection and 0.32 (p = 0.0028) for the second, suggesting their potential as biomarkers for ROP risk assessment. Higher levels of TNF-alpha at 2 weeks were associated with an increased risk of ROP (Beta = −0.45, p = 0.0014), whereas higher IGF1 levels offered protective effects against ROP, with Beta coefficients of 0.37 (p = 0.0032) for the first collection and 0.32 (p = 0.0028) for the second. Elevated LDH levels on day 7–10 post-birth were linked to an increased risk of ROP (Beta = 0.29, p = 0.0214). Conclusions: These findings highlight the potential of IGF1 and TNF-alpha as predictive biomarkers for ROP, offering avenues for early intervention and improved management strategies in this high-risk group.

Due to the increasing impacts of climate change on flood management, it is vital to implement effective flood mitigation measures. Economic factors significantly influence the feasibility and speed of these implementations. Evaluations must go beyond just the implementation costs. This paper introduces tools and methods for incorporating environmental economics into flood risk management at various scales, from urban areas to entire river basins. Comprehensive analysis should include social, environmental, direct, and indirect factors. Despite the variability in flood mitigation costs across different economies, the methods discussed are highly adaptable. Data limitations for appraisal tools like Multicriteria Analysis (MCA) and Cost-Benefit Analysis (CBA) can be addressed through expert judgment, qualitative assessment, or using GDP-proportional data for cost estimation. This approach utilizes databases from experienced countries, making the methods adaptable to different contexts.

In the title complex, [U(C10H7N3O3)O2(CH3OH)]n, the UVI cation has a typical pentagonal–bipyramidal environment with the equatorial plane defined by one N and two O atoms of one doubly deprotonated 2-[5-(2-hydroxyphenyl)-1H-1,2,4-triazol-3-yl]acetic acid ligand, a carboxylate O atom of the symmetry-related ligand and the O atom of the methanol molecule [U—N/Oeq 2.256 (4)–2.504 (5) Å]. The axial positions are occupied by two oxide O atoms. The equatorial atoms are almost coplanar, with the largest deviation from the mean plane being 0.121 Å for one of the O atoms. The benzene and triazole rings of the tetradentate chelating–bridging ligand are twisted by approximately 21.6 (2)° with respect to each other. The carboxylate group of the ligand bridges two uranyl cations, forming a neutral zigzag chain reinforced by a strong O—H...O hydrogen bond. In the crystal, adjacent chains are linked into two-dimensional sheets parallel to the ac plane by C/N—H...N/O hydrogen bonding and π–π interactions. Further weak C—H...O contacts consolidate the three-dimensional supramolecular architecture. In the solid state, the compound shows a broad medium intensity LMCT transition centred around 463 nm, which is responsible for its red colour.

Financial knowledge is necessary not only for consumers of banking products and services when purchasing products but also for the unbanked population when they have to decide how much to borrow or save to keep their monthly budget in a comfort zone and to meet medium and long-term financial goals

A direct measurement of the ground-state-to-ground-state electron-capture decay Q value of 95Tc has been performed utilizing the double Penning trap mass spectrometer JYFLTRAP. The Q value was determined to be 1695.92(13) keV by taking advantage of the high resolving power of the phase-imaging ion-cyclotron-resonance technique to resolve the low-lying isomeric state of 95Tc (excitation energy of 38.910(40) keV) from the ground state. The mass excess of 95Tc was measured to be −86015.95(18) keV/c2, exhibiting a precision of about 28 times higher and in agreement with the value from the newest Atomic Mass Evaluation (AME2020). Combined with the nuclear energy-level data for the decay-daughter 95Mo, two potential ultra-low Q-value transitions are identified for future long-term neutrino-mass determination experiments. The atomic self-consistent many-electron Dirac–Hartree–Fock–Slater method and the nuclear shell model have been used to predict the partial half-lives and energy-release distributions for the two transitions. The dominant correction terms related to those processes are considered, including the exchange and overlap corrections, and the shake-up and shake-off effects. The normalized distribution of the released energy in the electron-capture decay of 95Tc to excited states of 95Mo is compared to that of 163Ho currently being used for electron-neutrino-mass determination.

The concept of sustainable entrepreneurship is becoming an increasingly pivotal area of focus in the global effort to address a range of pressing challenges, including climate change, resource scarcity, and social inequality. Entrepreneurs who integrate economic, environmental, and social goals into their business models can serve as pivotal agents in achieving both profitability and societal well-being. Nevertheless, despite the growing interest in sustainable business models, entrepreneurs encounter considerable obstacles that impede the scalability and success of their ventures. This study focuses on the identification and analysis of the principal obstacles across five key dimensions: economic, regulatory, social, technological, and environmental. The aim of this research is to examine the difficulties encountered by those engaged in sustainable entrepreneurship and to suggest strategies for surmounting these challenges. Methodologically, the study employs a multi-dimensional approach, with each challenge examined through qualitative analysis. The economic challenges, including the high initial costs and difficulties in accessing funding, are identified as some of the most significant barriers. The presence of regulatory challenges, such as inconsistent environmental policies and the absence of governmental incentives, serves to further complicate the business landscape. Furthermore, social challenges, such as consumer reluctance to pay higher prices for sustainable products and resistance to adopting new, eco-friendly habits, also play a crucial role in hindering the success of sustainable ventures. Furthermore, the absence of access to sophisticated green technologies and the requisite expertise to deploy them constitutes a substantial technological impediment for entrepreneurs. The results of the study indicate the existence of several potential avenues for addressing these challenges. For example, the increasing consumer demand for environmentally friendly products and services, in conjunction with technological advancements, presents a substantial opportunity for sustainable entrepreneurship. The practical value of the research lies in its strategic recommendations, which encourage collaboration between policymakers, businesses, and investors. Such collaborative endeavours can facilitate the creation of an enabling environment for sustainable entrepreneurship, thereby reducing economic and regulatory burdens while simultaneously promoting technological advancements. In conclusion, the study emphasises the necessity of a coordinated approach in order to overcome the barriers faced by sustainable entrepreneurs. By capitalising on emerging opportunities and cultivating a supportive ecosystem, entrepreneurs can simultaneously achieve financial success and a positive impact on society and the environment.

Lesions of the cerebellopontine angle (CPA) are frequent and represent 6%–10% of all intracranial tumors. Acoustic neuromas, which are also called vestibular schwannomas, along with meningiomas are the two most frequent lesions and account for approximately 85%–90% of all CPA tumors. These benign lesions involving the middle ear comprise a diverse spectrum of local manifestations within the temporal bone. Despite their usually benign histopathological characteristics, these lesions may be locally destructive. Prompt diagnosis and treatment are therefore necessary to prevent progression of audiologic, vestibular, and facial nerve dysfunction, which may also be present. Because of the surgically formidable anatomical location of these tumors, curative resection often proves challenging. Treatment options include surgical resection, stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy (SRT), alone or in combination. Stereotactic radiosurgery is a minimally invasive option for management of skull base tumors. Brain stereotactic radiosurgery involves the use of precisely directed closed skull single fraction (one surgical session) radiation to create a desired radiobiologic response within the target with minimal effects to surrounding structures or tissues. Stereotactic radiosurgery is associated with a high rate of local tumor control and a low risk of neurologic complications for patients with skull base tumors. Stereotactic radiosurgery can be used as an up-front treatment or as an adjuvant therapy for patients with recurrent or residual tumor after surgical resection. The superior safety efficacy of stereotactic radiosurgery over microsurgery in small- to middle-sized vestibular schwannomas is demonstrated in worldwide comparative studies. Normal motor facial nerve function and serviceable hearing are more likely to be preserved with radiosurgery as compared with microsurgery. In very large schwannomas, a combined approach with a deliberate subtotal removal with functional monitoring of the facial nerve followed by radiosurgery of the remnant dramatically reduces the risk of facial palsy as compared with radical removal. Hypofractionation of radiosurgery (stereotactic radiotherapy or multisession radiosurgery) has failed until now to demonstrate any advantage over single-dose, high-precision radiosurgery. Literature has documented the cost savings benefit of stereotactic radiosurgery versus invasive surgical procedures and the lower risk potential of bleeding, anaesthesia problems, infections, and side effects which may result in transient or permanent disabilities from open surgery. At the same time, literature has demonstrated that the risk of radiation-associated intracranial malignancy after stereotactic radiosurgery was found to be similar to the risk of developing a malignant CNS tumour in the general population of the USA and some European countries as estimated by the CBTRUS and IARC data, respectively.

Clinical research to refine and minimize surgical interventions has continued to be one of the most important features of the neurosurgical development during the last half of the XX century. Prof. Lars Leksell, the inventor of the Gamma-Knife radiosurgery (GKRS), was a leader in stereotactic surgery. In addition, he coined the concept of radiosurgery more than 60 years ago. Leksell and his coworkers have defined the indications for radiosurgery and introduced stereotactic techniques into radiosurgery. Today, GKRS is one of the three generally accepted treatment modalities in the treatment of cerebral AVMs together with microsurgery and endovascular techniques. The authors present their experience in treating 461 patients harbouring cerebral AVMs with a Leksell Gamma-Knife unit between 2005 and 2023. The follow-up schedule was a MR examination performed 6 and 12 months after the treatment in order to define if a radiation induced oedema had developed or not, as this represents the beginning and the end of the timer period in which the complications usually occur. If a radiation induced oedema was visible and the patient asymptomatic, the oedema was not treated. After that, a MRI and a MRA examination after two years to define the timing of the angiogram are of need. If the 2-year MR suggests complete AVM occlusion, we always perform an angiogram to verify the occlusion, as we know that a small remnant cannot be definitely excluded by using MR examinations. If the 2-year MR examination reveals a persistent AVM nidus, we postpone the angiogram to 3 years after the treatment. Naturally, as for all patients, a neuroradiological examination can be prompted by clinical symptoms. The outcome of our patients following a GKRS in relation to their age can be summarized as follows: - AVMs in children: cure rate 86% at 24 months, cure rate 100% at 36 months; - AVMs in young adults: cure rate 81% at 24 months, cure rate 86% at 36 months; - AVMs in adults: cure rate 41% at 24 months, cure rate 82% at 36 months. Predilect areas for oedema were the Parietal lobe and the basal ganglia, and 5 of the 6 patients which developed it had AVMs in excess of 11 cm3. The probability for AVM obliteration is dependent of the dose to the AVM periphery, the volume of the nidus and its localization, best results being recorded in children.

Purpose Skull base meningiomas represent a very challenging pathology due to relatively difficult surgical access. In contrast, stereotactic radiosurgery (SRS) proved to be an effective and more secure treatment technique based on the greater accuracy in delivering precise focused radiation into the target, sparing at the same time healthy surrounding tissues. Methods and Results Our study, based on almost 20 years of experience in delivering SRS treatments using various models of Leksell Gamma-Knife units, reports a high tumor control rate for complex-shaped skull base meningiomas close to critical structures. We retrospectively evaluated the risk factors and complications after high-dose irradiation in patients undergoing single-fraction radiosurgery combined with clinical imaging criteria established using MRI scans (in T1 weighted imaging with gadolinium and the edema in T2 weighted sequences). The mean volume of the tumors was 18.6 cubic centimetres (only tumors with a volume in excess of 15 cubic centimetres were included in the study). The median administered marginal dose was 12.5 Gy. Mean imaging follow-up was 112 months. Tumor control rate was not influenced by sex, age, tumor site, neurological status of the patient or irradiated volume, even though larger meningiomas are associated with poor long-term local control in most published series. The long-term follow-up data indicates tumor control in 88,5% of patients after 10 years, with low incidence of complications. Conclusions Current practice shows a slight potential increase in the incidence of meningiomas, the superiority of the individual techniques needing to be confirmed in prospective and methodologically rigorous studies with at least 20 years of follow-up.

Purpose In the multimodal treatment of pituitary adenomas Radiosurgery is mainly used as a secondary treatment after the medical treatment and neurosurgery. Yet the Gamma Knife Treatment isn’t possible without some risks and complications. Material and Methods In this retrospective study 841 treatments were included. The patients were treated in the Radiotherapy Laboratory of the “Bagdasar-Arseni” Emergency Clinical Hospital, between 2004 and 2024, initially using a Gamma Knife 4C device, then a Gamma Knife Perfection and now an Esprit model. Most of the cases underwent surgery beforehand. The purpose of the treatment was tumor growth control and, in functioning adenomas, hormone hypersecretion control with the preservation of normal pituitary functions and the normal functioning of surrounding structures. Due to the treatment guidelines, we used during the treatments, very few complications occurred. There were 7 cases of hypopituitarism, 3 cases of oculomotor palsies, 6 cases of pituitary apoplexy. There were no recorded cases of significant optic neuropathy or carotid stenosis. Results and Conclusions The Gamma Knife treatment determined, in almost all cases, the stopping of tumor growth and in most cases a reduction in tumor volume. Complications (optic neuropathy, hypopituitarism, damage to the nerves inside the cavernous sinus) were very scarce. Gamma Knife Radiosurgery, if basic rules are followed, is an efficient and safe method in the treatment of pituitary adenomas.

Purpose In the treatment of nasopharyngeal carcinomas, a multimodal approach is always needed. The present study attempts to show the necessity and role of Gamma Knife Stereotactic Radiosurgery in the treatment of this kind of tumors. Material and Methods In this retrospective study, 34 patients were included. All had been previously treated with fractionate radiotherapy, but had local or intracranial recurrence at the time of the Gamma Knife treatment. The patients were treated in the Radiotherapy Laboratory of the Emergency Clinical Hospital “Bagdasar-Arseni”, between 2004 and 2024, initially using a Gamma Knife 4C device, then a Perfection and lately an Esprit model. The purpose of the treatments was total tumor destruction, but also, in a significant number of cases the treatment of debilitating symptoms: epistaxis, secondary trigeminal neuralgia, and oculomotor nerve palsies. Results and Conclusions The Gamma Knife treatment determined a significant prolongation of the life span and an improvement in the quality of life, without the occurrence of a significant number of complications. This treatment remains a palliative method, applicable only in selected cases, yet we consider that the number of Gamma Knife treated patients is very small, compared with the general incidence of this disease.

Sports anxiety is an important obstacle for athletes’ performance, negatively affecting their life satisfaction levels. Positive thinking skills can contribute to overcoming such negative conditions. This study explored the relationships between sport anxiety, positive thinking skills, and life satisfaction in male athletes. A total of 338 male athletes participated voluntarily, using convenience sampling. The study employed a relational survey model, and data were collected through the Sports Anxiety Scale-2, Positive Thinking Skills Scale, and Life Satisfaction Scale. Analyses, including Pearson’s correlation, were performed using the JAMOVI program, with mediation analysis verified through bootstrapping. Results indicated a negative correlation between sport anxiety and life satisfaction, and a positive correlation between positive thinking skills and life satisfaction. Moreover, positive thinking skills were found to moderate the relationship between sport anxiety and life satisfaction. These insights underscore the value of developing positive thinking skills to help athletes reduce anxiety and enhance their life satisfaction. Therefore, incorporating strategies to foster these skills in training programs could be crucial for improving athletes’ overall wellbeing.

Background There is strong interest in the evaluation of longer‐term outcome metrics for congenital heart diseases (CHDs); however, registries focus on postoperative metrics. Methods and Results Informed by user online discussion forums and scoping of national data, we selected sentinel CHDs and long‐term outcome metrics suitable for routine monitoring. We then developed sentinel CHD phenotypes and algorithms for identifying treatment pathway procedures using clinical codes. Finally, we calculated the metrics within a retrospective national cohort analysis. The 9 selected sentinel CHDs had a higher‐than‐average prevalence, typically involved surgery in infancy, and were associated with an increased risk of late mortality. The selected metrics of survival and reinterventions at 1, 5, and 10 years were both important and feasible. The cohort included 29 319 (41.3% of all operated CHD births) English and Welsh children born with sentinel CHDs in 2000 to 2022. Example metrics at age 10 years included: survival—hypoplastic left heart syndrome: 57.6% (95% CI, 54.9%–60.4%), functionally univentricular heart: 86.7% (95% CI, 84.6%–88.9%), transposition of the great arteries: 93.1% (95% CI, 92.2%–93.9%), pulmonary atresia: 81.0% (95% CI, 79.1%–82.9%), atrioventricular septal defect: 88.5% (95% CI, 87.5%–89.5%), tetralogy of Fallot: 95.1% (95% CI, 94.4%–95.8%), aortic stenosis: 94.4% (95% CI, 93.3%–95.6%), coarctation: 96.7% (95% CI, 96.2%–97.3%), and ventricular septal defect: 96.9% 95% CI, (96.4%–97.3%); and (2) cumulative incidence of reintervention—hypoplastic left heart syndrome : 54.5% (95% CI, 51.5%–57.3%), functionally univentricular heart: 57.3% (95% CI, 53.9%–60.5%), transposition of the great arteries: 20.9% (95% CI, 19.5%–22.3%), pulmonary atresia: 66.8% (95% CI, 64.2%–69.1%), atrioventricular septal defect: 21.6% (20.3%–23.0%), tetralogy of Fallot: 26.6% (95% CI, 25.2%–28.0%), aortic stenosis: 31.2% (95% CI, 28.8%–33.6%), coarctation: 19.8% (95% CI, 18.6%–21.1%), and ventricular septal defect: 6.1% (95% CI, 5.5%–6.8%). Conclusions It is feasible to report important long‐term outcomes of survival and reintervention for sentinel CHDs using routinely collected procedure records, adding value to national audit.

Introduction Saliva is a clear, watery fluid that is produced by the salivary glands in the mouth. It plays a crucial role in maintaining oral health and facilitating the process of digestion. The bacterial load in nighttime saliva can be influenced by factors such as oral hygiene practices, diet, and overall oral health. Aim of the study The aim of the study is to uncover the potential connection between the presence of Streptococcus mutans bacteria and the buffering capacity of saliva, and how this connection impacts the risk of dental caries in children with ages under 5 years old. Material and methods Three groups of young patients with ages between 3 and 5 years old were formed during the regular dental check-up, in the Pedodontics Clinic of the Faculty of Dental Medicine, UMFST “G.E. Palade”. From each of the we have collected the saliva early in the morning, without the children having their teeth brushed using special sterile plastic cups. We have tested the buffer effect of the saliva using specific test and for the determination of bacterial saliva parameters we used Karies Screen Test. Results Group A – 43 (40.18%), included children who presented at least 3 dental caries, group B – 37 (34.57%) of children had 1 or 2 carries, and the control group of children – 27 (25,23%), with intact dentition without carious processes. 39 (36.44%) children had high density of Streptococcus Mutans colonies > 10 units CFU/ml saliva form group A, 35 (32.71%) children presented low to medium density < 10 units CFU/ml saliva from group B and for the group control all 27 (25.23%) children presented very low density < 5 units CFU/ml saliva. The hights buffer capacity scores were obtained for the group control. Conclusions Children with higher buffer capacity in their saliva tend to exhibit better oral health, including a lower prevalence of dental caries. The buffering capacity of saliva plays a protective role by neutralizing acids produced by oral bacteria, such as Streptococcus mutans, thus

The restaurants are an excessive source of food waste, being critically influenced by the kitchen staff, waiters and consumers. The consumers’ plate waste is identified as a critical source of restaurant food waste (RFW). An alternative to minimize this RFW would be for customers to take home extra food in doggie-to-go-bags (takeaway containers). However, the existing social rules in numerous countries discourage consumers for asking for doggie-to-go-bags. In this research, it was surveyed a number of 200 costumers from Republic of Moldova in order to explore their opinion toward doggie-to-go-bags. Although surveyed consumers approve the doggie-to-go-bags, they are resistant to ask for doggie-to-go-bags (80% of them reported that there were not enough leftovers to justify a doggie-to-go-bag, 79% of them said that they usually eat all the food, while 49% were too embarrassed to ask for one).

The latest legislative amendments to Companies Law no. 31/1990 are expected to be well received by the business community, being described by the legislator, among others, as a relaxation of the conditions for registration and operation of the Limited Liability Company. Thus, significant changes concern the elimination of the minimum value of the share capital for this type of company, as well as the emphasis of the new provisions on the will of the shareholders regarding the transfer of shares, by removing the term of opposability to transfer provided in favour of third parties. Without claiming a thorough analysis of the matter, the article aims to highlight the most important aspects of these legislative changes.

Non-invasive prenatal testing (NIPT), since its introduction in 2011, has revolutionized prenatal screening, becoming widely used globally and replacing traditional screening methods in developed countries. The accuracy of NIPT in detecting aneuploidies is extremely high and there has been a recent trend towards improving NIPT for detecting microdeletion and microduplication syndromes, monogenic diseases, fetal sex determination, and RH genotyping. Significant progress has been made in molecular analysis techniques of fetal DNA, including methods such as massively parallel sequencing, RNA-based testing, digital PCR, and single nucleotide polymorphism analysis. We present the case of a 32-year-old patient who, at 12 weeks of gestation, had a non-invasive prenatal test result showing a maternal 22q11.2 deletion. Following genetic consultation, further investigations were conducted to stratify the fetal risk of inheriting the microdeletion syndrome. As a result, microarray CGH cytoarray from amniotic fluid was performed, and no 22q11.2 deletion was detected. In this case, complete elucidation of the origin of the deletion found in NIPT could not be achieved, as it would require arrayCGH testing for the mother, a test that was not performed due to financial reasons. Given the high rate of genetic syndromes with potential impact on fetal development and familial psychological impact, we wish to emphasize the necessity of financial support from the state to introduce non-invasive prenatal testing into the list of reimbursed analyses covered by health insurance. This would enable superior testing and, implicitly, genetic prevention of all pregnancies, facilitating appropriate risk stratification of pregnancies in our country.

This paper explores the complex interaction between AI and customs procedures, aiming to uncover the legal ramifications associated with the integration of AI technologies in this field. With the rapid advancement of AI, customs authorities worldwide are increasingly adopting automated systems to improve the efficiency, accuracy, and security of cross-border trade operations. However, as AI systems take on significant roles in decision-making processes traditionally overseen by humans, concerns regarding legality, accountability, and transparency become prominent. Through a thorough examination of existing legal frameworks, international agreements, and relevant case law related to AI implementation in customs procedures, this research conducts a comprehensive analysis. It seeks to shed light on the evolving legal landscape surrounding AI in customs operations through a comparative study of various regulatory approaches and interpretations. Additionally, the paper scrutinises emerging ethical considerations and policy challenges arising from AI adoption, emphasising the necessity for coherent legal frameworks that uphold fundamental rights while promoting innovation and facilitating trade. By synthesising legal, ethical, and practical viewpoints, this study contributes to a nuanced comprehension of the intricate dynamics influencing the legality of artificial intelligence in customs procedures.

Illegal activities and abusive practices can occur in any organisation, public or private, small or large. They can take many forms, such as corruption or fraud, unfair business practices or negligence. If no action is taken, they may cause serious damage to the public interest. A law itself gives the appearance of a safety instrument for situations in which an official public or contract employee intends to refuse the execution of an order that he considers illegal. Although this provision is theoretically included in the legislation, any employee who does not fulfils an order outside of legality was subject to a series of unsustainable behaviors that resulted in removal or withdrawal from the system. At this moment, in the Romanian landscape, we lack a culture of integrity whistleblowers, and those who find the strength to report they are seen rather as an exception and idealised as heroes of the system. Perhaps we could rather say that there is a culture strongly marked by the traumas of the past in terms of reporting. Starting from the culture of the country which, at the moment, discourages integrity whistleblowers, we note that, just as in the European directive that we were obliged to transpose, this proposed law encourages and prioritises internal reporting. We can understand the reasons behind this encouragement, however, in the Romanian context, we believe that the prioritisation of internal reporting can and must be corroborated with subsequent instrumentation actions a anonymous reports. Seen as a measure that comes to consecrate the modernism of the Romanian legal system, but also as a measure of the legislative maturity it has reached after countless reforms, the initiation of investigations regarding integrity whistleblowers has become a reality. What will be the impact on Romanian society? How will they integrate into the judicial system? What will be the value as proof?

The objective of this study was to identify and classify the spectrum of mutations found in the BRCA1 and BRCA2 genes associated with breast and ovarian cancer in female patients in Romania. Germline BRCA1 and BRCA2 mutations were investigated in a cohort of 616 female patients using NGS and/or MLPA methods followed by software-based data analysis and classification according to international guidelines. Out of the 616 female patients included in this study, we found that 482 patients (78.2%) did not have any mutation present in the two genes investigated; 69 patients (11.2%) had a BRCA1 mutation, 34 (5.5%) had a BRCA2 mutation, and 31 (5%) presented different type of mutations with uncertain clinical significance, moderate risk or a large mutation in the BRCA1 gene. Our investigation indicates the most common mutations in the BRCA1 and BRCA2 genes, associated with breast and ovarian cancer in the Romanian population. Our results also bring more data in support of the frequency of the c.5266 mutation in the BRCA1 gene, acknowledged in the literature as a founder mutation in Eastern Europe. We consider that the results of our study will provide necessary data regarding BRCA1 and BRCA2 mutations that would help to create a genetic database for the Romanian population.

Abstract Background Stereotactic ablative body radiotherapy (SABR) is an emerging treatment alternative for patients with localized low and intermediate risk prostate cancer patients. As already explored by some authors in the context of conventional moderate hypofractionated radiotherapy, focal boost of the index lesion defined by magnetic resonance imaging (MRI) is associated with an improved biochemical outcome. The objective of this phase II trial is to determine the effectiveness (in terms of biochemical, morphological and functional control), the safety and impact on quality of life, of prostate SABR with MRI guided focal dose intensification in males with intermediate and high-risk localized prostate cancer. Methods Patients with intermediate and high-risk prostate cancer according to NCCN definition will be treated with SABR 36.25 Gy in 5 fractions to the whole prostate gland with MRI guided simultaneous integrated focal boost (SIB) to the index lesion (IL) up to 50 Gy in 5 fractions, using a protocol of bladder trigone and urethra sparing. Intra-fractional motion will be monitored with daily cone beam computed tomography (CBCT) and intra-fractional tracking with intraprostatic gold fiducials. Androgen deprivation therapy (ADT) will be allowed. The primary endpoint will be efficacy in terms of biochemical and local control assessed by Phoenix criteria and post-treatment MRI respectively. The secondary endpoints will encompass acute and late toxicity, quality of life (QoL) and progression-free survival. Finally, the subgroup of high-risk patients will be involved in a prospective study focused on immuno-phenotyping. Discussion To the best of our knowledge, this is the first trial to evaluate the impact of post-treatment MRI on local control among patients with intermediate and high-risk prostate cancer undergoing SABR and MRI guided focal intensification. The results of this trial will enhance our understanding of treatment focal intensification through the employment of the SABR technique within this specific patient subgroup, particularly among those with high-risk disease, and will help to clarify the significance of MRI in monitoring local responses. Hopefully will also help to design more personalized biomarker-based phase III trials in this specific context. Additionally, this trial is expected to be incorporated into a prospective radiomics study focused on localized prostate cancer treated with radiotherapy. Trial registration Clinicaltrials.gov identifier: NCT05919524; Registered 17 July 2023. Trial Sponsor IRAD/SEOR (Instituto de Investigación de Oncología Radioterápica / Sociedad Española de Oncología Radioterápica). Study setting Clinicaltrials.gov identifier: NCT05919524; Registered 17 July 2023. Trial status Protocol version number and date: v. 5/ 17 May-2023. Date of recruitment start: August 8, 2023. Date of recruitment completion: July 1, 2024.