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This study analyzes both the perceptions and the preferences of Romanian registrants of .ro domain names, a fundamental element of Romania’s national digital identity. Through a quantitative approach, with the help of an online survey, we have collected the responses of 50 registrants, users who have registered at least one .ro domain in their lifetime. The study analyzes factors such as ease of registration process, the reasons of choosing .ro domains, preference over other TLD and the general perception of the .ro extension. The study shows the importance of .ro domain names as a powerful online marketing tool for online branding, regional competitiveness and increasing user’s trust while also providing some insight into the decision-making process regarding domain registration. These conclusions contribute to a better understanding of the advantages of ccTLD’s, having relevant implications for companies, individuals and digital marketing professionals interested in optimizing strategies on the local online market.

Online reviews are an important and powerful element of digital marketing, influencing consumer decisions and the reputation of products and services. This study analyzes the behavior of Romanian consumers in writing online reviews, with a particular focus on the "J shaped distribution", characterized by the preponderance of extreme ratings (5 stars or 1 star) and a limited representation of moderate reviews (2, 3 or 4 stars ). The results provide valuable insights into the motivations and preferences of Romanian consumers, contributing to a deeper understanding of the dynamics of online reviews. The study also highlights the role of moderated reviews in strengthening consumer trust and supporting informed decision-making. These conclusions address both the academic literature and digital marketing professionals, providing practical directions for effectively managing online reviews and increasing consumer engagement.

Background: Pericardial/atrial oesophageal fistula (PEF/AEF) is the most feared complication of cardiac atrial fibrillation (AF) ablation. Without urgent surgical treatment, most cases of this infrequent complication rapidly prove fatal. Case report: We present an uncommon case of a 60-year-old male who had undergone an AF ablation 2 weeks prior and presented with chest pain. Following diagnosis and treatment of ST-elevation myocardial infarction (STEMI), a small pericardial effusion was noticed on computed tomography (CT) scan. Despite an initially reassuring hospital course, rapid decompensation and expansion of his purulent pericardial effusion led to his death within 24 hours of presentation. A post-mortem review of his CT imaging revealed an inconspicuous PEF. Conclusions: It is essential to maintain a high suspicion of PEF/AEF in patients presenting after AF ablation with suggestive symptoms, such as fever, chest pain/odynophagia, and neurological deficits. CT chest is the most common diagnostic modality and surgical correction is the treatment of choice.

Diabetic retinopathy (DR), a leading cause of vision impairment worldwide, is characterized by progressive damage to the retina due to prolonged hyperglycemia. Despite advances in treatment, current interventions largely target late-stage vascular complications, leaving underlying neurodegenerative processes insufficiently addressed. This article explores the crucial role in neuronal survival, axonal growth, and synaptic plasticity and the neuroprotective potential of Brain-Derived Neurotrophic Factor (BDNF) as a therapeutic strategy for enhancing retinal resilience in DR. Furthermore, it discusses innovative delivery methods for BDNF, such as gene therapy and nanocarriers, which may overcome the challenges of achieving sustained and targeted therapeutic levels in the retina, focusing on early intervention to preserve retinal function and prevent vision loss.

Purpose: This review aims to analyze the diagnostic methods used to evaluate inferior vestibular nerve neuritis. Methods: We performed an electronic search on the PubMed database for clinical studies investigating the diagnostic techniques used for inferior vestibular nerve neuritis. Results: We initially identified 114 records in our search. After applying the inclusion and exclusion criteria, we narrowed it down to 12 studies. These studies collectively examined a total of 642 patients diagnosed with vestibular nerve neuritis, 64 of whom had inferior vestibular neuritis. Conclusions: The inferior vestibular neuritis is an unfrequent form of vestibular neuritis, often misdiagnosed. The diagnosis of inferior vestibular neuritis (IVN) is based on clinical history and vestibular testing, specifically reduced posterior canal gain on video head impulse test (vHIT), absent cervical VEMP (cVEMP), normal caloric responses, and preserved ocular VEMP (oVEMP). This review highlights the gaps in current diagnostic strategies and emphasizes the need for integrating advanced vestibular testing methods to enhance diagnostic accuracy for inferior vestibular nerve neuritis. Future studies should address the standardization of diagnostic protocols to facilitate broader clinical application.

Background: Phytocarriers are advanced drug delivery systems that use biocompatible and biodegradable materials to enhance the efficacy, stability, and bioavailability of natural products. The sea buckthorn (Hippophae rhamnoides L.) berry extract is rich in essential fatty acids and antioxidants, including vitamin C, vitamin E, and anthocyanins, which contribute to its wide-ranging health benefits. In this study, we assessed the morphology, intracellular delivery, and anti-inflammatory effect of sodium cholate (NaC) and sodium deoxycholate (NaDC)-based phytocarriers loaded with ethanolic extract from sea buckthorn berries (sea buckthorn carrier nanostructures, further defined as phytocarriers). Methods: Negative and electron cryo-microscopy were used to analyze hollow and loaded nanocarriers. The cyto-compatibility of nanocarriers was assessed by endpoint (LDH and MTS) and real-time cell assays, on both human fibroblasts (HS27) and human normal monocytes (SC). The anti-inflammatory effect of hollow and loaded nanocarriers was tested by multiplexing. Results: The negative and electron cryo-microscopy analyses showed that NaC-based phytocarriers were spherical, whilst NaDC-based phytocarriers were predominantly polymorphic. Moreover, the NaDC-based phytocarriers frequently formed large lipid networks or “plaques”. Although 24 h cytotoxicity testing showed both types of nanocarriers are biocompatible with human fibroblasts and monocytes, based on a long-term real-time assay, NaDC delayed fibroblast proliferation. NaC sea buckthorn phytocarriers did not impair fibroblast proliferation in the long term and they were uptaken by cells, as shown by hyperspectral microscopy. NaC nanocarriers and NaC sea buckthorn phytocarriers induced an anti-inflammatory effect, lowering IL-8 cytokine production in normal human monocytes as soon as 4 h of treatment lapsed. Conclusions: NaC-derived phytocarriers loaded with sea buckthorn alcoholic extract are a cell-compatible delivery system with anti-inflammatory properties.

In the context of current energy consumption and CO2 emissions, the impact of buildings is highly significant. In the quest for sustainable building management, the concept of digital twins emerges as a transformative technology, offering unprecedented capabilities for enhancing energy efficiency and reducing carbon footprints. This article explores the application of digital twins in the built environment, emphasizing their role in achieving significant energy and environmental benefits. Beginning with a brief discussion introducing the concept of digital twins, the article highlights their critical importance in modern building management and their potential to revolutionize sustainability practices. It then examines the role of IoT and AI in enabling advanced aspects of digital twin technology, including its technological functionalities. A comparative analysis of different simulation tools and methodologies follows, providing a comprehensive overview of how digital twins can be utilized to optimize building performance.

Mechanical ventilation is a critical intervention for intubated patients suffering from respiratory complications, such as excess mucus accumulation in the trachea, which can obstruct airflow. In this study, we investigate the impact of a Fresubin-water emulsion (1g/50ml), simulating mucus, on airflow resistance in a square-profile tube representing a simplified tracheal segment. The hypothesis predicate that the emulsion will increase airflow resistance under mechanical ventilation, mimicking the obstructive effects of mucus in patients. A computational fluid dynamics (CFD) analysis was employed to evaluate the airflow characteristics within the tube, focusing on velocity profiles and pressure drop. The results confirmed that the viscoelastic properties of the emulsion significantly altered airflow behavior, producing non-uniform velocity distributions and an elevated pressure gradient along the tube. These findings suggest that the emulsion effectively replicates the behavior of mucus in the trachea, offering valuable insights for improving mechanical ventilation strategies in patients with respiratory obstructions.

The energy efficiency of building and building systems is one of the main focus of the European countries determined to lower their impact on CO2 emissions with ambitions certain targets until 2030 and 2025. This includes the implementation of nearly zero-energy building (nZEB) standards and the widespread adoption of renewable energy sources. This paper aims to study the implementation of different strategies and renovation packages on an existing building in Bucharest, Romania, thus reducing primary energy consumption with up to 56% and CO2 specific emissions with up to 73%.

The incidence rate of cutaneous melanoma is on the rise worldwide, due to increased exposure to UV radiation, aging populations, and exposure to teratogen agents. However, diagnosis is more precise, and the increased number of new cases is related to the improved diagnosis tools. Despite better early diagnosis and better therapies, melanoma has remained a significant public health challenge because of its aggressive behavior and high potential for metastasis. In 2020, cutaneous melanoma constituted approximately 1.3% of all cancer deaths that occurred within the European Union, thereby highlighting the necessity for effective prevention, timely diagnosis, and sustainable treatment measures, especially as a growing number of cases occur among younger patients. Melanoma is regarded as one of the most inflamed cancers due to its high immune cell presence and strong response to immunotherapy, fueling the need for development of immune-driven innovative treatments. Approved therapies, including immune checkpoint inhibitors (e.g., anti-PD-1 and anti-CTLA-4), have notably improved survival rates in melanoma. However, the limitations of the PD-1/PD-L1 and CTLA-4 axes inhibitors, such as low response rates, treatment resistance, and toxicity, have driven the need for continued research and advancements in treatment strategies. Current clinical trials are exploring various combinations of immune checkpoint inhibitors with costimulatory receptor agonists, chemotherapy, targeted therapies, and other immunotherapies, with the goal of improving outcomes and reducing side effects for melanoma patients. Emerging approaches, including adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) and oncolytic virotherapy, are showing promise. While CAR-T cell therapy has been less successful in melanoma compared to blood cancers, ongoing research is addressing challenges like the tumor microenvironment and antigen specificity. This review provides an overview of the requirement for advances in these medications, to mark a significant step forward in melanoma management, set to bring a fresh breath of hope for patients.

Choanal atresia is a congenital condition characterized by the obstruction of the posterior nasal apertures. It can present as unilateral or bilateral and is associated with significant morbidity, particularly in neonates. This review provides a comprehensive overview of the diagnosis and management of choanal atresia. We discuss the epidemiology, etiology, and pathogenesis, emphasizing the developmental and genetic factors involved. Clinical presentation varies with age, and diagnosis typically involves a combination of clinical examination and imaging techniques. Management strategies have evolved, with a focus on surgical intervention. Various surgical techniques, including transnasal endoscopic and transpalatal approaches, are explored. Postoperative care and long-term outcomes are critical components of patient management. We also address current controversies in treatment and future directions for research. Understanding choanal atresia's complexities is essential for improving patient outcomes and advancing therapeutic options. [ABSTRACT FROM AUTHOR]

Simple Summary: Multiple myeloma is a plasma cell cancer accounting for 10% of all blood malignancies, and the incidence of the disease has gradually increased over time. In recent decades, great progress has been made in understanding the disease biology, leading to an improvement in outcomes. However, despite the availability of several treatment options, multiple myeloma remains essentially incurable, and most patients eventually relapse. Efforts are being made to further improve the outcome of the patients with newly diagnosed and relapsed disease by developing new agents, especially T cell-directed therapies. Researchers also continue to test different drug combinations and sequences. This review article provides an overview of recent advances in the field. Multiple myeloma is biologically and clinically a complex and heterogeneous disease which develops late in life, with the median age at the time of initial diagnosis being 66 years. In 1975, Durie and Salmon developed the first broadly adopted staging system in multiple myeloma, and in the ensuing decades, the risk stratification tools have improved and now incorporate different parameters to better predict the prognosis and to guide the treatment decisions. The International Staging System (ISS) was initially developed in 2005, revised in 2015 (R-ISS), and again in 2022 (R2-ISS). Tremendous progress has been achieved in multiple myeloma therapy over the past 25 years with the approval of immunomodulatory drugs, proteasome inhibitors, and anti-CD38 monoclonal antibodies, resulting in a major paradigm shift. The dysfunction of the innate and adaptive immune system, especially in the T cell repertoire, represents a hallmark of multiple myeloma evolution over time, supporting the need for additional therapeutic approaches to activate the host's immune system and to overcome the immunosuppressive tumor microenvironment. Novel T cell-directed therapies include chimeric antigen receptor (CAR) T cell therapies and bispecific antibodies that leverage the immune system's T cells to recognize and attack the tumor cells. Second-generation anti-BCMA CAR T cell therapies and bispecific antibodies that bind the tumor antigen BCMA or GPRC5D onto myeloma cells and CD3 on the T cell's surface are currently available for the treatment of relapsed/refractory multiple myeloma. Despite impressive results obtained with currently approved treatments, multiple myeloma remains incurable, and almost all patients eventually relapse. Moreover, patients with extramedullary disease and plasma cell leukemia represent an unmet medical need that require additional strategies to improve the outcome. In this review, we provide an overview of the evolution of risk stratification and the treatment of multiple myeloma. [ABSTRACT FROM AUTHOR]

Purpose: This review aims to analyze the diagnostic methods used to evaluate inferior vestibular nerve neuritis. Methods: We performed an electronic search on the PubMed database for clinical studies investigating the diagnostic techniques used for inferior vestibular nerve neuritis. Results: We initially identified 114 records in our search. After applying the inclusion and exclusion criteria, we narrowed it down to 12 studies. These studies collectively examined a total of 642 patients diagnosed with vestibular nerve neuritis, 64 of whom had inferior vestibular neuritis. Conclusions: The inferior vestibular neuritis is an unfrequent form of vestibular neuritis, often misdiagnosed. The diagnosis of inferior vestibular neuritis (IVN) is based on clinical history and vestibular testing, specifically reduced posterior canal gain on video head impulse test (vHIT), absent cervical VEMP (cVEMP), normal caloric responses, and preserved ocular VEMP (oVEMP). This review highlights the gaps in current diagnostic strategies and emphasizes the need for integrating advanced vestibular testing methods to enhance diagnostic accuracy for inferior vestibular nerve neuritis. Future studies should address the standardization of diagnostic protocols to facilitate broader clinical application. [ABSTRACT FROM AUTHOR]

Background: Phytocarriers are advanced drug delivery systems that use biocompatible and biodegradable materials to enhance the efficacy, stability, and bioavailability of natural products. The sea buckthorn (Hippophae rhamnoides L.) berry extract is rich in essential fatty acids and antioxidants, including vitamin C, vitamin E, and anthocyanins, which contribute to its wide-ranging health benefits. In this study, we assessed the morphology, intracellular delivery, and anti-inflammatory effect of sodium cholate (NaC) and sodium deoxycholate (NaDC)-based phytocarriers loaded with ethanolic extract from sea buckthorn berries (sea buckthorn carrier nanostructures, further defined as phytocarriers). Methods: Negative and electron cryo-microscopy were used to analyze hollow and loaded nanocarriers. The cyto-compatibility of nanocarriers was assessed by endpoint (LDH and MTS) and real-time cell assays, on both human fibroblasts (HS27) and human normal monocytes (SC). The anti-inflammatory effect of hollow and loaded nanocarriers was tested by multiplexing. Results: The negative and electron cryo-microscopy analyses showed that NaC-based phytocarriers were spherical, whilst NaDC-based phytocarriers were predominantly polymorphic. Moreover, the NaDC-based phytocarriers frequently formed large lipid networks or "plaques". Although 24 h cytotoxicity testing showed both types of nanocarriers are biocompatible with human fibroblasts and monocytes, based on a long-term real-time assay, NaDC delayed fibroblast proliferation. NaC sea buckthorn phytocarriers did not impair fibroblast proliferation in the long term and they were uptaken by cells, as shown by hyperspectral microscopy. NaC nanocarriers and NaC sea buckthorn phytocarriers induced an anti-inflammatory effect, lowering IL-8 cytokine production in normal human monocytes as soon as 4 h of treatment lapsed. Conclusions: NaC-derived phytocarriers loaded with sea buckthorn alcoholic extract are a cell-compatible delivery system with anti-inflammatory properties. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR), a leading cause of vision impairment worldwide, is characterized by progressive damage to the retina due to prolonged hyperglycemia. Despite advances in treatment, current interventions largely target late-stage vascular complications, leaving underlying neurodegenerative processes insufficiently addressed. This article explores the crucial role in neuronal survival, axonal growth, and synaptic plasticity and the neuroprotective potential of Brain-Derived Neurotrophic Factor (BDNF) as a therapeutic strategy for enhancing retinal resilience in DR. Furthermore, it discusses innovative delivery methods for BDNF, such as gene therapy and nanocarriers, which may overcome the challenges of achieving sustained and targeted therapeutic levels in the retina, focusing on early intervention to preserve retinal function and prevent vision loss. [ABSTRACT FROM AUTHOR]

In approximately half of the recurrent spontaneous abortion (RSA) cases, the underlying cause is unknown. However, most unexplained miscarriages are thought to be linked to immune dysfunction. This review summarizes the current evidence regarding the immunological evaluations of patients with RSA, with potential implications for clinical research. The immune system plays a crucial role in the successful outcome of pregnancy, as it tolerates the semi-allogeneic fetus while offering protection to both the mother and fetus from pathogens. The maternal-fetal interface is the place where the crosstalk between various immune cells such as macrophages, dendritic cells, natural killer (NK) cells, and T cells takes place. An adequate balance is required between these immune cells for pregnancy to progress. In RSA, a dysregulation between these immune players is witnessed. For example, in RSA, NK cells are not increased but also undergo a change in their activity, manifested as cytotoxic decidual NK. Similarly, regulatory T cells, which are crucial for fostering a tolerant immune environment, are decreased in RSA women. Similarly, imbalances between T-helper (Th1, Th2, Th17) cell subsets have been implicated in RSA. Furthermore, the imbalance between pro-inflammatory M1 and anti-inflammatory M2 macrophage phenotypes has been documented, with studies indicating a predominance of M1 macrophages in RSA patients. Targeting immune imbalances with therapies such as immunoglobulin administration, TNF inhibitors, and anticoagulants may improve pregnancy outcomes in women with RSA. [ABSTRACT FROM AUTHOR]

The growing demand for plant-based protein and natural food ingredients has further fueled interest in exploring hemp seeds (Cannabis sativa L.) as a sustainable source of and nutrition. In addition to the content of proteins and healthy fats (linoleic acid and alpha-linolenic acid), hemp seeds are rich in phytochemical compounds, especially terpenoids, polyphenols, and phytosterols, which contribute to their bioactive properties. Scientific studies have shown that these compounds possess significant antioxidant, antimicrobial, and anti-inflammatory effects, making hemp seeds a promising ingredient for promoting health. Since THC (tetrahydrocannabinol) and CBD (cannabidiol) are found only in traces, hemp seeds can be used in food applications because the psychoactive effects associated with cannabis are avoided. Therefore, the present article reviews the scientific literature on traditional and modern extraction methods for obtaining active substances that meet food safety standards, enabling the transformation of conventional foods into functional foods that provide additional health benefits and promote a balanced and sustainable diet. Also, the identification methods of biologically active compounds extracted from hemp seeds and their bioactivity were evaluated. Mechanical pressing extraction, steam distillation, solvent-based methods (Soxhlet, maceration), and advanced techniques such as microwave-assisted and supercritical fluid extraction were evaluated. Identification methods such as high-performance liquid chromatography (HPLC) and mass spectrometry (MS) allowed for detailed chemical profiling of cannabinoids, terpenes, and phenolic substances. Optimizing extraction parameters, including solvent type, temperature, and time, is crucial for maximizing yield and purity, offering the potential for developing value-added foods with health benefits. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to elucidate the frequency and cytologic features of positive peritoneal washing cytology (PWC) in cervical gastric‐type adenocarcinoma (GAS) and to clarify the clinical significance of positive PWC. Methods: The authors analyzed cases from their institution between 1991 and 2023 in which patients underwent surgery and PWC. The study included 62 patients who had cervical GAS (1991–2023; including seven patients with adenocarcinoma in situ and 26, 15, nine, and five patients with International Federation of Gynecology and Obstetrics 2018 stage I, II, III, and IV disease, respectively) and 100 patients who had usual‐type endocervical adenocarcinoma (2007–2023; including 65, 15, and 20 patients with stage I, II, and III disease, respectively). The frequency of positive PWC results and cytologic features was assessed, and correlations between positive PWC results and clinicopathologic factors were examined, including prognosis, in the GAS group. Results: Positive PWC results were significantly more frequent in patients who had GAS at 24% (15 of 62 patients) compared with 7% (seven of 100 patients) in those who had usual‐type endocervical adenocarcinoma. The cytologic features of GAS included distinct cellular atypia (enlarged nuclei, nuclear irregularity) and frequent formation of spherical clusters (10 of 15 cases) without the golden‐yellowish mucus commonly seen in cervical smears. A positive PWC result in GAS was significantly correlated with larger tumor size, parametrium invasion, lymph node metastasis, and elevated carbohydrate antigen 19‐9 levels. In patients with stage I GAS, the PWC‐positive group had significantly shorter disease‐free survival and overall survival compared with the PWC‐negative group. Conclusions: Positive PWC findings are frequent in cervical GAS and are associated with pathologic factors indicative of tumor growth and progression. In patients who have stage I GAS, positive PWC results may indicate a poor prognosis, warranting further investigation. Positive intraoperative peritoneal washing cytology is more commonly identified in gastric‐type adenocarcinoma (GAS) of the cervix compared with the usual type of endocervical adenocarcinoma. In addition, positive peritoneal washing cytology is linked to earlier disease recurrence and shorter overall survival in patients who have stage I usual‐type endocervical adenocarcinoma, suggesting its potential as a predictive tool for postoperative outcomes. [ABSTRACT FROM AUTHOR]

The incidence rate of cutaneous melanoma is on the rise worldwide, due to increased exposure to UV radiation, aging populations, and exposure to teratogen agents. However, diagnosis is more precise, and the increased number of new cases is related to the improved diagnosis tools. Despite better early diagnosis and better therapies, melanoma has remained a significant public health challenge because of its aggressive behavior and high potential for metastasis. In 2020, cutaneous melanoma constituted approximately 1.3% of all cancer deaths that occurred within the European Union, thereby highlighting the necessity for effective prevention, timely diagnosis, and sustainable treatment measures, especially as a growing number of cases occur among younger patients. Melanoma is regarded as one of the most inflamed cancers due to its high immune cell presence and strong response to immunotherapy, fueling the need for development of immune-driven innovative treatments. Approved therapies, including immune checkpoint inhibitors (e.g., anti-PD-1 and anti-CTLA-4), have notably improved survival rates in melanoma. However, the limitations of the PD-1/PD-L1 and CTLA-4 axes inhibitors, such as low response rates, treatment resistance, and toxicity, have driven the need for continued research and advancements in treatment strategies. Current clinical trials are exploring various combinations of immune checkpoint inhibitors with costimulatory receptor agonists, chemotherapy, targeted therapies, and other immunotherapies, with the goal of improving outcomes and reducing side effects for melanoma patients. Emerging approaches, including adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) and oncolytic virotherapy, are showing promise. While CAR-T cell therapy has been less successful in melanoma compared to blood cancers, ongoing research is addressing challenges like the tumor microenvironment and antigen specificity. This review provides an overview of the requirement for advances in these medications, to mark a significant step forward in melanoma management, set to bring a fresh breath of hope for patients. [ABSTRACT FROM AUTHOR]