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Background/Objectives: To develop a deep learning model for esophageal motility disorder diagnosis using high-resolution manometry images with the aid of Gemini. Methods: Gemini assisted in developing this model by aiding in code writing, preprocessing, model optimization, and troubleshooting. Results: The model demonstrated an overall precision of 0.89 on the testing set, with an accuracy of 0.88, a recall of 0.88, and an F1-score of 0.885. It presented better results for multiple categories, particularly in the panesophageal pressurization category, with precision = 0.99 and recall = 0.99, yielding a balanced F1-score of 0.99. Conclusions: This study demonstrates the potential of artificial intelligence, particularly Gemini, in aiding the creation of robust deep learning models for medical image analysis, solving not just simple binary classification problems but more complex, multi-class image classification tasks.

PurposeThe study aims to examine the impact of the wave of seismic activity in the northern region of Oltenia (Gorj County, Romania) in February 2023 and the belief in ‘fake news’ (circulated regarding causality, manifestations, and future developments of the seismic activity) on the quality of life of the affected population. It was considered opportune to conduct this study, given the novelty of such a situation, as the mentioned geographical area is not known to have a high seismic risk.MethodsThe study was built based on the questionnaire to which 975 respondents, present/residing in Gorj County during the earthquakes and at least 14 days after, and with a minimum age of 18 years, responded. The data was collected between February 27, 2023, and March 31, 2023, at a reasonable time interval from the recording of the first seismic event in the region, assuming that the respondents’ opinions regarding the negative impact of seismic events on societal life are well crystallized. The aim was to obtain information and analyze it in order to establish the respondents’ perception regarding the negative effects of seismic activity and the elements of “fake news” promoted in this context on the quality of life of individuals in the region.ResultsOur study indicates that individuals who are not concerned, due to their disbelief in “fake news” information, about the possibility of new strong earthquakes in the mentioned area feel the best physically, having an average satisfaction level of 82.80 (with a standard deviation of 19.70) on the WHOQOL-BREF scale. On the other hand, those who believed in the fake news experienced the lowest levels of psychological well-being, with an average satisfaction of 60.80 (and a standard deviation of 21.98). The WHOQOL-BREF is an instrument that assesses the quality of life across four distinct domains, and this study emphasizes the importance of accurate and trustworthy information for people’s well-being.ConclusionThe results of the study highlight that the quality of life indicators of people in the geographic area affected by the wave of seismic movements are negatively impacted due to the release of “fake news” in the public domain regarding the cause of seismic movements in Gorj county (and the previous earthquakes in Turkey) and their future manifestations and developments (the possibility of high magnitude seismic movements), as well as the lack of information provided by the public authorities on the issue at hand (causes, effects, future manifestations, management measures).

Objectives. The incidence of acute cholecystitis increases with age, when patients usually associate additional comorbidities. Such comorbidities and the late presentation to the doctor make the treatment more complex, associating higher rates of complications. The present study aims to evaluate the methods of diagnosis and treatment applied to a group of older patients with acute cholecystitis. Materials and Methods. 585 patients were enrolled in the study between 2019 and 2023. The inclusion criteria in the study were represented by the presence of the diagnosis of acute cholecystitis in patients over 65 years of age, while patients who presented complex locoregional pathologies (trauma, cancer, etc.) were excluded. Results. In about 91% of cases, acute cholecystitis was determined by gallstones. 61.19% of cases benefited from laparoscopic cholecystectomy, the rest of the patients requiring additional procedures or open surgery. Morbidity and mortality were not significantly influenced, but some of the patients required complex interventions and longer hospital stay. Conclusions. The clinical manifestations of acute cholecystitis can be diminished in some of the elderly patients (neurological disorders, diabetes, immunosenescence, etc.), being initially appreciated as mild forms. Later it is found (by imaging or intraoperatively) that these are much more severe forms, which often require a customized therapeutic approach.

Cereals, as the world’s most consumed food, face challenges related to nutrient quality due to climate change and increased production impacting soil health. In this study, we investigated the vitamin and mineral content, polyphenols, and antioxidant activity in cereals from Western Romania, analyzing whole and hulled wheat, rye, oat, and soybeans before and after heat treatment. Samples from 2022 crops were processed into dough and subjected to 220 °C for 30 min. The results reveal that, despite efforts to optimize nutrient content, cereals, particularly after heat processing, exhibited lower vitamin and mineral levels than the recommended daily intake. The decrease in polyphenols and antioxidant capacity was notable, with rye flour experiencing the largest decline (15%). Mineral analysis showed copper levels in decorticated wheat decreased by 82.5%, while iron in rye decreased by 5.63%. Soy flour consistently displayed the highest calcium, magnesium, and potassium levels, whereas oat flour had the highest zinc and copper levels before and after heat processing. The study highlights the concerningly low vitamins and minerals contents in cereals, as well as in the final products reaching consumers in the Western part of Romania, and contributes to the assessment of measures that are meant to improve the contents of these minerals.

The initial clinical manifestation of acute mesenteric ischemia poses a diagnostic challenge, often leading to delays in identification and subsequent surgical intervention, contributing to adverse outcomes. Serum biomarkers, offering insights into the underlying pathophysiology, hold promise as prognostic indicators for acute mesenteric ischemia. This systematic review comprehensively explores the role of blood biomarkers in predicting clinical outcomes during follow-up for patients with mesenteric ischemia. A thorough literature search across the PubMed, Cochrane Library, and EMBASE databases yielded 33 relevant publications investigating the efficacy of serum biomarkers in predicting outcomes for mesenteric ischemia. Numerous studies underscore the utility of blood biomarkers in swiftly and accurately differentiating between causes of mesenteric ischemia, facilitating a prompt diagnosis. Elevated levels of specific biomarkers, particularly D-dimers, consistently correlate with heightened mortality risk and poorer clinical outcomes. While certain serum indicators exhibit substantial potential in associating with mesenteric ischemia, further research through rigorous human trials is imperative to enhance their consistent predictive ability during the follow-up period. This study underscores the diagnostic and prognostic significance of specific biomarkers for mesenteric ischemia, emphasizing the necessity for standardized procedures in future investigations.

Background: Small bowel disorders present a diagnostic challenge due to the limited accessibility of the small intestine. Accurate diagnosis is made with the aid of specific procedures, like capsule endoscopy or double-ballon enteroscopy, but they are not usually solicited and not widely accessible. This study aims to assess and compare the diagnostic effectiveness of enteroscopy and video capsule endoscopy (VCE) when combined with artificial intelligence (AI) algorithms for the automatic detection of small bowel diseases. Materials and methods: We performed an extensive literature search for relevant studies about AI applications capable of identifying small bowel disorders using enteroscopy and VCE, published between 2012 and 2023, employing PubMed, Cochrane Library, Google Scholar, Embase, Scopus, and ClinicalTrials.gov databases. Results: Our investigation discovered a total of 27 publications, out of which 21 studies assessed the application of VCE, while the remaining 6 articles analyzed the enteroscopy procedure. The included studies portrayed that both investigations, enhanced by AI, exhibited a high level of diagnostic accuracy. Enteroscopy demonstrated superior diagnostic capability, providing precise identification of small bowel pathologies with the added advantage of enabling immediate therapeutic intervention. The choice between these modalities should be guided by clinical context, patient preference, and resource availability. Studies with larger sample sizes and prospective designs are warranted to validate these results and optimize the integration of AI in small bowel diagnostics. Conclusions: The current analysis demonstrates that both enteroscopy and VCE with AI augmentation exhibit comparable diagnostic performance for the automatic detection of small bowel disorders.

Background: Constipation-predominant irritable bowel syndrome (IBS-C) is a common gastrointestinal disorder characterized by abdominal pain and altered bowel habits. Conventional treatments for IBS-C often provide limited efficiency, leading to an increasing interest in exploring herbal remedies. This systematic review aims to evaluate the efficacy and safety of herbal remedies in the management of IBS-C. Materials and Methods: A comprehensive search of PubMed, MEDLINE, Embase, Scopus, and the Cochrane Library was conducted to identify relevant studies published up to July 2023 and data extraction was performed independently by two reviewers. Results: Overall, the included studies demonstrated some evidence of the beneficial effects of herbal remedies on IBS-C symptoms, including improvements in bowel frequency, stool consistency, abdominal pain, and quality of life. However, the heterogeneity of the interventions and outcome measures limited the ability to perform a meta-analysis. Conclusion: This systematic review suggests that herbal remedies may have potential benefits in the management of IBS-C. However, the quality of evidence is limited, and further well-designed, large-scale RCTs are needed to establish the efficacy and safety of specific herbal remedies for IBS-C. Clinicians should exercise caution when recommending herbal remedies and consider individual patient characteristics and preferences.

Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. Various dietary factors have been implicated in the pathogenesis and management of IBS symptoms. This systematic review aims to evaluate the effects of polyphenols, minerals, fibers, and fruits on the symptoms and overall well-being of individuals with IBS. Materials and Methods: A comprehensive literature search was conducted in several electronic databases, including PubMed, Scopus, and Web of Science. Studies published up until July 2023 were included. Results: The selected studies varied in terms of study design, participant characteristics, intervention duration, and outcome measures. Overall, the findings suggest that dietary interventions involving polyphenols, minerals, fibers, and fruits can have a positive impact on IBS symptoms. Dietary fiber supplementation, particularly soluble fiber, has been associated with reduced bloating and enhanced stool consistency. Conclusions: This systematic review provides evidence supporting the beneficial effects of polyphenols, minerals, fibers, and fruits in IBS patients. These dietary components hold promise as complementary approaches for managing IBS symptoms. However, due to the heterogeneity of the included studies and the limited number of high-quality randomized controlled trials, further well-designed trials are warranted to establish the optimal dosages, duration, and long-term effects of these interventions. Understanding the role of specific dietary components in IBS management may pave the way for personalized dietary recommendations and improve the quality of life for individuals suffering from this complex disorder.

Epidermolysis bullosa (EB) is a rare, serious genetic disease, incurable through the current means. Apart from this initial definition, there was later some ease in the definition of the disease, including the manifestations of toxic epidermal necrolysis and Stevens Johnson syndrome in this entity. In medical practice, there are cases that do not overlap with the description in the literature, thus the treatment must be adapted and personalized to the particularities. We present the case of a female new-born, with "de novo" mutation for the early-onset antenatal epidermolysis and our personalized therapeutic management, based on collagen from bovine corneas by enzymatic process. The histological examination showed that the collagen membranes serve as a support for the epithelial cells that formed a surface monolayer after 48 hours. Therefore. this case report shows that collagen-based biomaterials could be used to accelerate the dermal-epidermal healing in various conditions of the child, such as Stevens Johnson syndrome, bullous epidermolysis and widespread burns.

Background and Objectives: The development of liver fibrosis as a consequence of continuous inflammation represents a turning point in the evolution of chronic liver diseases. The recent developments of artificial intelligence (AI) applications show a high potential for improving the accuracy of diagnosis, involving large sets of clinical data. For this reason, the aim of this systematic review is to provide a comprehensive overview of current AI applications and analyze the accuracy of these systems to perform an automated diagnosis of liver fibrosis. Materials and Methods: We searched PubMed, Cochrane Library, EMBASE, and WILEY databases using predefined keywords. Articles were screened for relevant publications about AI applications capable of diagnosing liver fibrosis. Exclusion criteria were animal studies, case reports, abstracts, letters to the editor, conference presentations, pediatric studies, studies written in languages other than English, and editorials. Results: Our search identified a total of 24 articles analyzing the automated imagistic diagnosis of liver fibrosis, out of which six studies analyze liver ultrasound images, seven studies analyze computer tomography images, five studies analyze magnetic resonance images, and six studies analyze liver biopsies. The studies included in our systematic review showed that AI-assisted non-invasive techniques performed as accurately as human experts in detecting and staging liver fibrosis. Nevertheless, the findings of these studies need to be confirmed through clinical trials to be implemented into clinical practice. Conclusions: The current systematic review provides a comprehensive analysis of the performance of AI systems in diagnosing liver fibrosis. Automatic diagnosis, staging, and risk stratification for liver fibrosis is currently possible considering the accuracy of the AI systems, which can overcome the limitations of non-invasive diagnosis methods.

PurposeThe study aims to highlight the behavior of people in a state in the vicinity of a military conflict zone. Specifically, it highlights the psychological behavior of Romanian citizens after the invasion of Ukraine by the Russian Federation. It was considered appropriate to carry out this study, given the novelty of such a situation, since, after the end of the Second World War, Europe has no longer faced major problems of insecurity caused by armed conflicts of this magnitude.MethodsThe study was based on the questionnaire applied to a number of 1,193 people with permanent residence in Romania and a minimum age of 18 years. The data were collected in the beginning phase of the invasion of Ukraine by the troops of the Russian Federation, i.e. between March 1–17, 2022. The aim was to obtain information that would allow the observation of re-spondents' opinions on the conflict in Ukraine and its potential escalation, and on the other hand, to allow the assessment of quality of life, using the WHQOL-BREEF measurement instrument.ResultsBased on the results of the study, the highest average satisfaction among the four domains of WHOQOL-BREF is represented by the “Psychological” domain, of the category of people with the lowest fear about a potential future war between Romania and the Russian Federation (83.62 ± 17.48). On the contrary, the lowest average is represented by the “Environment” domain, for the category of persons who do not feel protected by the fact that Romania is a NATO member state (61.77 ± 20.96).ConclusionsThe results of the study show that the indices of the quality of life of the people in Romania, as a state in the proximity of a military conflict with the potential to escalate, are negatively influenced by the fears of people who believe that the war in Ukraine will escalate into a regional or global conflict, or that the Russian Federation is going to use its nuclear arsenal against Ukraine or another NATO member state.

The acute development and the accumulation of chyle into the peritoneal space is a rare condition and one needs to be able to distinguish it from chylous ascites, which is most commonly chronic and associated with related diseases. It is frequently idiopathic and additionally, clinical and imaging findings are nonspecific. In almost all cases, the diagnosis is made intraoperatively during laparoscopy or laparotomy, most diagnostic procedures being indicated by acute complaints pertaining to the abdomen. A 23-year-old man was admitted to the Emergency Department with abdominal pain, with right iliac fossa tenderness and peritonism. Laparoscopy was performed due to acute abdomen findings. Further exploration revealed chylous effusion with milky-like fluid. The peritoneal lavage and the insertion of drains were subsequent to the careful inspection of the cavity. The biochemical analysis of the peritoneal fluid was an important aid which provided the diagnosis of chylous peritonitis due to acute pancreatitis.

Although the COVID-19 pandemic has held the spotlight over the past years, the antimicrobial resistance (AMR) phenomenon continues to develop in an alarming manner. The lack of strict antibiotic regulation added to the overuse of antimicrobials fueled the AMR pandemic. This paper aims to analyze and identify the impact of the COVID-19 pandemic on antibiotic resistance patterns of Enterococcus spp. The study was designed as a retrospective observational study. Enterococcus spp. infections data were collected from one academic hospital in Cluj-Napoca, Romania over 18 months. A statistical analysis was performed to compare antibiotic resistance phenotypes identified. We recorded an increase in the isolation rates of Enterococcus spp. strains, from 26 isolates (26.53%) during Period A (November 2020–April 2021) to 42 strains (42.85%) during Period C (November 2021–April 2022). The number of strains with resistance to vancomycin increased from 8 during Period A to 17 during Period C. Of the total 36 strains with resistance to vancomycin, 25 were identified as E. faecium. SARS-CoV-2 patients (n = 29) proved to be at risk to develop an E. faecium co-infection (n = 18). We observed that strains with resistance to ampicillin (n = 20) and vancomycin (n = 15) are more often isolated from these patients. All changes identified in our study are to be considered in the light of COVID-19 pandemic, highlighting the threatening AMR phenomenon in Romania. Further studies should be performed to quantify the worldwide effects of these pandemics.

We aimed at evaluating the prognostic capacity of the inflammatory indices derived from routine complete blood cell counts in two groups of patients with acute pancreatitis from two different time periods, before and during the COVID-19 pandemic, when a high incidence of complications with surgical risk and mortality was found. Two new markers were introduced: the mean corpuscular volume to lymphocyte ratio (MCVL) and the cumulative inflammatory index (IIC), which were calculated at a baseline in the two groups of patients. Of the already established markers, none of them managed to effectively predict the complications with surgical risk and mortality, with a decrease of less than 50% in specificity in the peri-COVID group. The MCVL had the best prediction of complications with surgical risk in both the pre-COVID and peri-COVID groups, validated it as an independent factor by multivariate analysis. The IIC had the best prediction of mortality in both periods and was proven to be an independent factor by multivariate analysis. As the IIC predicted death best, we tested the occurrence of death and found that patients with PA who had an IIC > 12.12 presented a risk of death 4.08 times higher in the pre-COVID group and 3.33 times higher in the peri-COVID group. The new MCVL and IIC independent markers had a superior sensitivity and specificity in predicting surgical risk complications and, respectively, mortality in the group of patients with acute pancreatitis during the COVID-19 pandemic, which makes them widely applicable in populations with modified immune and inflammatory status. Conclusions: In patients with acute pancreatitis, MCVL has a significant predictive value regarding complications with surgical risk (abscess, necrosis, and pseudocyst), and the IIC has a significant predictive value for mortality.

Antibiotic resistance (AR) is a naturally occurring phenomenon with the capacity to render useless all known antibiotics in the fight against bacterial infections. Although bacterial resistance appeared before any human life form, this process has accelerated in the past years. Important causes of AR in modern times could be the over-prescription of antibiotics, the presence of faulty infection-prevention strategies, pollution in overcrowded areas, or the use of antibiotics in agriculture and farming, together with a decreased interest from the pharmaceutical industry in researching and testing new antibiotics. The last cause is primarily due to the high costs of developing antibiotics. The aim of the present review is to highlight the techniques that are being developed for the identification of new antibiotics to assist this lengthy process, using artificial intelligence (AI). AI can shorten the preclinical phase by rapidly generating many substances based on algorithms created by machine learning (ML) through techniques such as neural networks (NN) or deep learning (DL). Recently, a text mining system that incorporates DL algorithms was used to help and speed up the data curation process. Moreover, new and old methods are being used to identify new antibiotics, such as the combination of quantitative structure-activity relationship (QSAR) methods with ML or Raman spectroscopy and MALDI-TOF MS combined with NN, offering faster and easier interpretation of results. Thus, AI techniques are important additional tools for researchers and clinicians in the race for new methods of overcoming bacterial resistance.

Although it has been shown in numerous studies that immunization of the population by vaccination is the most effective way to protect against smallpox or other polioviruses, the anti-vaccination public rhetoric recorded during the COVID-19 pandemic is likely to influence the populations acceptance of vaccination against newly emerging viruses. This fact influenced our decision to study the vaccination of the Romanian population against the virus that causes monkeypox, aiming to identify the degree of compliance regarding the decision related to vaccination acceptance/non-acceptance/hesitation, based on the survey of a representative sample of respondents. The study is based on an online questionnaire completed between 1 July and 31 July 2022 by 820 individuals, aged 18 years or above, with a permanent residency in Romania. The study was undertaken in order to observe the attitudes of the respondents regarding the acceptance, refusal, or hesitation of vaccination against monkeypox. The sociological data resulting from the application of the questionnaire on 820 people highlighted that 97.16% were vaccinated with the vaccines of the national mandatory scheme and 53.32% were vaccinated with the optional vaccines (rotavirus vaccine, anti-hepatitis A, meningococcal vaccine, etc.). Although 47.13% of respondents considered monkeypox to be a real problem facing humanity today, only 26.37% of those surveyed expressed their fear of becoming infected, and 29.30% were willing to immunize themselves against the virus by vaccination. Only 19.59% of respondents believed that the monkeypox disease will generate a new global pandemic, while 31.86% considered pandemics to be a human security issue, and 30.28% expressed their desire to accept a reduction in some rights and freedoms, in the short term, for the adoption of institutional measures to combat a possible pandemic caused by monkeypox. The study clearly highlights the fact that monkeypox is perceived as a threat to the health of the population, with relatively low acceptance of conspiracy theories regarding its origins/manifestation/consequences among respondents (between 21.7% and 28.9%). The vaccination of the population against monkeypox is strongly influenced by the validity of the results obtained over time, in the vaccination campaigns against the smallpox virus (vaccine found in the mandatory vaccination scheme in Romania until 1979). We believe that the negative public rhetoric regarding the COVID-19 vaccination is likely to negatively influence monkeypox vaccination. Although specialized studies and practical results showed that the immunization of the population through vaccination represents an important vector in the prevention/management of pandemic-type issues, we believe that a national pro-vaccination campaign, based on scientific evidence, can lead the population to accept vaccination when the epidemiological context requires it. We also believe that a culture of health security needs to be developed among citizens to raise awareness of the role of vaccines as an important vector in the field of population health.

RESEARCH AND SCIENCE TODAY is a biannual science journal established in 2011. The journal is an informational platform that publishes assessment articles and the results of various scientific research carried out by academics. We provide the authors with the opportunity to create and/or perfect their science writing skills. Thus, each issue of the journal (two per year and at least two supplements) will contain professional articles from any academic field, authored by domestic and international academics. The goal of this journal is to pass on relevant information to undergraduate, graduate, and post-graduate students as well as to fellow academics and researchers; the topics covered are unlimited, considering its multi-disciplinary profile. Regarding the national and international visibility of Research and Science Today, it is indexed in over 30 international databases (IDB) and is present in over 200 online libraries and catalogues; therefore, anybody can easily consult the articles featured in each issue by accessing the databases or simply the website.

Crisis periods such as the COVID-19 pandemic may reshape consumers’ behavior and challenge all food chain actors on how to assure and better respond to consumers’ needs and wants. This study aimed to reveal the main concerns of consumers related to food consumption during the COVID-19 pandemic and to identify factors that may influence their behavior. An online survey was performed among 859 Romanian consumers. The Principal Component Analysis revealed five factors: ecofriendly, socio-economic aspects, food waste, plant-based food, and easily accessible food, which affected consumers’ food behavior during the COVID-19 pandemic. It was noticed that females tended to be more preoccupied with the socio-economic aspects and food waste components, compared to males. At the same time, older people were more concerned about the ecofriendly, socio-economic aspects and health concerns, compared with the younger group, the differences being statistically significant. These insights provide information on crucial aspects that shape consumers’ behavior during crisis periods.

Functional dyspepsia represents one of the most common and prevalent disorders of the brain–gut interaction, with a large number of widespread risk factors being identified. With an intricate pathogenesis and symptomatology, it heavily impacts the quality of life and, due to the limited efficacy of traditional pharmacological agents, patients are likely to seek other medical and non-medical solutions to their problem. Over the last few years, significant research in this domain has emphasized the importance of various psychological therapies and nutritional recommendations. Nevertheless, a correlation has been established between functional dyspepsia and food intolerances, with more and more patients adopting different kinds of exclusion diets, leading to weight loss, restrictive eating behaviour and an imbalanced nutritional state, further negatively impacting their quality of life. Thus, in this systematic review, we aimed at analysing the impact and efficiency of certain exclusion diets undertook by patients, more precisely, the gluten-free diet and the low-FODMAP diet.

The global prevalence of vitamin D deficiency is more than 20%, and the main causes include insufficient intake, reduced absorption, abnormal metabolism, or resistance to its effects. The levels of serum vitamin D appear to influence cardiovascular risk, and the mechanism involved is linked to the transient outward current and the ultrarapid delayed rectifier K+ current densities, activated through the nuclear vitamin D receptor and Akt pathway. A significant number of studies have correlated vitamin D deficiency with an increased risk of developing cardiac arrhythmias and sudden cardiac death. For this reason, the purpose of this review is to analyze the relation between vitamin D deficiency and the pathogenesis of cardiac arrhythmias. Atrial fibrillation, increased QT interval, and QT dispersion were the most common findings associated with vitamin D deficiency. Due to the heterogeneity among existing studies, further research is necessary to confirm the existing data and to analyze its relationship with other types of arrhythmias.

Wine, one of the world’s oldest and most popular beverages, has a distinct variety matching a diverse base of consumers worldwide. The study was conducted in two counties of Romania in order to identify consumers’ perception towards wine consumption, as well as the driving factors behind wine consumption and the decision process of choosing a certain type of wine. Thus, four factors were identified through principal component analysis: intrinsic cues and consumers’ experience, extrinsic cues and origin, notoriety and the label and package of the wine, correlating them with the socio-demographic characteristics of our respondents. It might be concluded that the intrinsic cues and consumer experience ranked highest among the priorities of the participants between 35 and 45 years old when choosing a certain type of wine. Additionally, notoriety was more valued by people with higher income, and people with experience in the domain inclined to pay more for a bottle of wine.

Purpose: Once vaccination against COVID-19 was also possible for children over 12 years of age, parents/legal guardians had to give their consent for their vaccination. It is a crucial moment, given the large number of infected people in Romania and the fact that these children are a source of transmission of the virus in the community. The refusal or hesitation of the parents/legal guardians, regarding the agreement for the vaccination of the children, determined us to focus on this subject, wishing, based on the questioning of as many parents as possible, to extract the reasons underlying these decisions. Methods: This study is designed to observe the attitudes of parents/legal guardians regarding the refusal, hesitation, or acceptance of vaccination of children. The persons targeted to answer the questionnaire had to meet three conditions: to be at least 21 years old, to have a stable residence in Romania, and to be parents/legal guardians of at least one child under 18 years of age. The questionnaire was applied online to a number of 581 parents/legal guardians, being structured to obtain socio-demographic data and other categories of data that allow us to analyze their views on vaccinating children. Results: Sociological data resulting from the application of the questionnaire on 581 parents/legal guardians show that 183 (31.5%) adults and 140 (24.1%) children got infected with COVID-19. The total number of respondents shows that only 411 (70.7%) adults and 185 (31.8%) children are vaccinated. Conclusions: From the analysis of the data obtained through the questionnaire, following the application of the Kendall and Spearman statistical analysis tests, it is found that there is a strong link between participants’ trust/distrust in “fake news” information and their decision to vaccinate their children.

Recent research on the pathogenesis of spondyloarthritis and related immune-mediated diseases associated with human leukocyte antigen class I molecule B27 (HLA-B27) has led to significant progress in terms of management and prognosis, with multiple treatments being constantly evaluated and implemented. Correlations between the genetic background of spondyloarthritis and inflammatory bowel diseases and the inflammatory processes involving gut microbiota have been established. This knowledge has allowed progress in pharmacological therapy. The role of diet in the pathogenesis and treatment of diseases pertaining to the HLA-B27 spectrum is of great significance, considering possible future applications in individualized medicine. Diet impacts the composition of gut microbiota, representing a substrate for the synthesis of metabolites affecting the mucosal immune system. Certain pro-inflammatory mediators, such as emulsifiers and microparticles, induce a more profound cytokine response, promoting inflammation. Numerous diets, including the low-starch diet, the Mediterranean diet, diets with low contents of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (low-FODMAP diets), gluten-free diets and fasting, have been analysed and correlated with patients’ symptomatology and dietary adherence. The aim of this review is to provide an extensive perspective on the diets available to patients with spondyloarthritis and related immune-mediated disorders.

Introduction. Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer. As no definite risk marker for anastomotic leakage after gastric resection was identified, we investigated the possible role of NLR. Methods. Peripheral blood count for neutrophils and lymphocytes was done at the patient’s admission. We retrospectively evaluated 204 gastric cancer patients, who underwent gastric resection, comparing the values of NLR between the group of patients with anastomotic leakage and those without complications. Results. Using the ROC curve, we found the cutoff value of NLR, which permitted the comparison of the group with low NLR, presenting increased NLR. The cutoff value for NLR was 3.54. Between the two groups, we could observe statistically significant differences in developing fistula (p < 0.01) and complications leading to death (p < 0.025). The odds ratio for patients with NLR greater than 3.54 to develop anastomotic leak was 17.62, compared to those with lower NLR. Conclusion. Peripheral blood NLR proved to be a predictor for anastomotic leakage.

Background: Esophageal varices, dilated submucosal veins in the lower esophagus, are commonly associated with portal hypertension, particularly due to liver cirrhosis. The high morbidity and mortality linked to variceal hemorrhage underscore the need for accurate diagnosis and effective management. The traditional method of assessing esophageal varices is esophagogastroduodenoscopy (EGD), which, despite its diagnostic and therapeutic capabilities, presents limitations such as interobserver variability and invasiveness. This review aims to explore the role of artificial intelligence (AI) in enhancing the management of esophageal varices, focusing on its applications in diagnosis, risk stratification, and treatment optimization. Methods: This systematic review focuses on the capabilities of AI algorithms to analyze clinical scores, laboratory data, endoscopic images, and imaging modalities like CT scans. Results: AI-based systems, particularly machine learning (ML) and deep learning (DL) algorithms, have demonstrated the ability to improve risk stratification and diagnosis of esophageal varices, analyzing vast amounts of data, identifying patterns, and providing individualized recommendations. However, despite these advancements, clinical scores based on laboratory data still show low specificity for esophageal varices, often requiring confirmatory endoscopic or imaging studies. Conclusions: AI integration in managing esophageal varices offers significant potential for advancing diagnosis, risk assessment, and treatment strategies. While promising, AI systems should complement rather than replace traditional methods, ensuring comprehensive patient evaluation. Further research is needed to refine these technologies and validate their efficacy in clinical practice. [ABSTRACT FROM AUTHOR]

Background/Objectives: To develop a deep learning model for esophageal motility disorder diagnosis using high-resolution manometry images with the aid of Gemini. Methods: Gemini assisted in developing this model by aiding in code writing, preprocessing, model optimization, and troubleshooting. Results: The model demonstrated an overall precision of 0.89 on the testing set, with an accuracy of 0.88, a recall of 0.88, and an F1-score of 0.885. It presented better results for multiple categories, particularly in the panesophageal pressurization category, with precision = 0.99 and recall = 0.99, yielding a balanced F1-score of 0.99. Conclusions: This study demonstrates the potential of artificial intelligence, particularly Gemini, in aiding the creation of robust deep learning models for medical image analysis, solving not just simple binary classification problems but more complex, multi-class image classification tasks. [ABSTRACT FROM AUTHOR]

Background and Objective: Gastritis represents one of the most prevalent gastrointestinal diseases and has a multifactorial etiology, many forms of manifestation, and various symptoms. Diagnosis of gastritis is made based on clinical, endoscopic, and histological criteria, and although it is a thorough process, many cases are misdiagnosed or overlooked. This systematic review aims to provide an extensive overview of current artificial intelligence (AI) applications in gastritis diagnosis and evaluate the precision of these systems. This evaluation could highlight the role of AI as a helpful and useful tool in facilitating timely and accurate diagnoses, which in turn could improve patient outcomes. Methods: We have conducted an extensive and comprehensive literature search of PubMed, Scopus, and Web of Science, including studies published until July 2024. Results: Despite variations in study design, participant numbers and characteristics, and outcome measures, our observations suggest that implementing an AI automatic diagnostic tool into clinical practice is currently feasible, with the current systems achieving high levels of accuracy, sensitivity, and specificity. Our findings indicate that AI outperformed human experts in most studies, with multiple studies exhibiting an accuracy of over 90% for AI compared to human experts. These results highlight the significant potential of AI to enhance diagnostic accuracy and efficiency in gastroenterology. Conclusions: AI-based technologies can now automatically diagnose using images provided by gastroscopy, digital pathology, and radiology imaging. Deep learning models exhibited high levels of accuracy, sensitivity, and specificity while assessing the diagnosis, staging, and risk of neoplasia for different types of gastritis, results that are superior to those of human experts in most studies. [ABSTRACT FROM AUTHOR]

The initial clinical manifestation of acute mesenteric ischemia poses a diagnostic challenge, often leading to delays in identification and subsequent surgical intervention, contributing to adverse outcomes. Serum biomarkers, offering insights into the underlying pathophysiology, hold promise as prognostic indicators for acute mesenteric ischemia. This systematic review comprehensively explores the role of blood biomarkers in predicting clinical outcomes during follow-up for patients with mesenteric ischemia. A thorough literature search across the PubMed, Cochrane Library, and EMBASE databases yielded 33 relevant publications investigating the efficacy of serum biomarkers in predicting outcomes for mesenteric ischemia. Numerous studies underscore the utility of blood biomarkers in swiftly and accurately differentiating between causes of mesenteric ischemia, facilitating a prompt diagnosis. Elevated levels of specific biomarkers, particularly D-dimers, consistently correlate with heightened mortality risk and poorer clinical outcomes. While certain serum indicators exhibit substantial potential in associating with mesenteric ischemia, further research through rigorous human trials is imperative to enhance their consistent predictive ability during the follow-up period. This study underscores the diagnostic and prognostic significance of specific biomarkers for mesenteric ischemia, emphasizing the necessity for standardized procedures in future investigations. [ABSTRACT FROM AUTHOR]

Cereals, as the world's most consumed food, face challenges related to nutrient quality due to climate change and increased production impacting soil health. In this study, we investigated the vitamin and mineral content, polyphenols, and antioxidant activity in cereals from Western Romania, analyzing whole and hulled wheat, rye, oat, and soybeans before and after heat treatment. Samples from 2022 crops were processed into dough and subjected to 220 °C for 30 min. The results reveal that, despite efforts to optimize nutrient content, cereals, particularly after heat processing, exhibited lower vitamin and mineral levels than the recommended daily intake. The decrease in polyphenols and antioxidant capacity was notable, with rye flour experiencing the largest decline (15%). Mineral analysis showed copper levels in decorticated wheat decreased by 82.5%, while iron in rye decreased by 5.63%. Soy flour consistently displayed the highest calcium, magnesium, and potassium levels, whereas oat flour had the highest zinc and copper levels before and after heat processing. The study highlights the concerningly low vitamins and minerals contents in cereals, as well as in the final products reaching consumers in the Western part of Romania, and contributes to the assessment of measures that are meant to improve the contents of these minerals. [ABSTRACT FROM AUTHOR]

Hashimoto's thyroiditis (HT) is the most frequently diagnosed thyroid disorder worldwide, characterized by hypothyroidy and thyroid autoimmunity. The fibrous variant accounts for a small number of cases. A 48 years old woman, with 20-years history of Hashimoto thyroiditis presented for a large recent goiter with compressive symptoms, in hypothyroidic state and with very high thyroid antibodies antithyroglobulin and antithyroperoxidase. Ultrasound and fine needle aspiration biopsy showed an enlargement of the thyroid gland with nonhomogeneous structure and trachea shifting posteriorly, Bethesda III. CT scan showed similar aspect of the thyroid gland with compression on the trachea and the left common jugular vein. Surgery was performed due to suspicion of malignancy and compression symptoms. Thyroidectomy was uneventful, but the patient developed hypoparathyroid symptoms postoperatively that resolved with high dose calcium, magnesium and vitamin D supplementation. The pathology report was consistent of Hashimoto's thyroiditis fibrous variant. This case report presents a rare case of the fibrous variant of Hashimoto's thyroiditis that is rarely taken under consideration in the preoperative setting as diagnosis is hard to establish with the usual algorithm of imaging and FNA biopsy. The multidisciplinary management in pre-and postoperative approach and evaluation are of utmost importance for successful management of such case. [ABSTRACT FROM AUTHOR]

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