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The problem of estimation the friction torque in operating miniature ball bearings lubricated with oil or grease is a complex one. Generally, in an angular contact ball bearing (ACBB), various types of losses can appear including losses caused by kinematics in ball-race contacts (rolling, sliding and pivoting), losses between the cage and the balls and between the cage and the guiding race and losses generated by lubricant, especially at high speeds. In the miniature ACBB, the applied loads have generally low values, and some losses can be ignored. In these circumstances, the most important contribution to the increase in the losses in miniature ACBB is the presence of the lubricant. In normal rolling bearings, the lubricant has an important contribution to decrease the losses and increase the reliability in miniature ball bearing; the lubricant (oil or grease) leads to the increase in the losses compared to the dry or limit lubrication conditions. The catalogues of various rolling bearing companies have not provided more details referring to the friction losses in miniature ball bearings. In order to evaluate the total friction torque in the rolling bearings, some empirical complex relations are presented via the SKF methodology, which can be applied only to moderate and high loads applied to the rolling bearings. Other empirical relations are presented by the Schaeffler catalogue. Based on previous experiments, the authors determined the friction torque in a 7000C ACBB with the spin-down method. The experimental results were correlated with the results obtained via the theoretical model developed by Houpert for IVR lubrication conditions. The theoretical results evidenced that the hydrodynamic rolling resistance generated by the lubricant is the most important component of the friction torque for 7000C ACBB. The experimental and theoretical results were compared to the results obtained according to the SKF and Schaeffler relations. The experimental results and the results obtained with the Houpert model generally had higher values compared to the results obtained with the SKF and Schaeffler relations.

(1) Background: The widespread use of nanoparticles (NPs) implies their inevitable contact with living organisms, including aquatic microorganisms, making it essential to understand the effects and consequences of this interaction. Understanding the adaptive responses and biochemical changes in microalgae and cyanobacteria under NP-induced stress is essential for developing biotechnological strategies that optimize biomolecule production while minimizing potential toxicity. This study aimed to evaluate the interactions between various potentially toxic nanoparticles and the cyanobacterial strain Arthrospira platensis, focusing on the biological adaptations and biochemical mechanisms that enable the organism to withstand xenobiotic exposure. (2) Methods: The cyanobacterium Arthrospira platensis CNMN-CB-02 was cultivated under optimal laboratory conditions in the presence of CuNPs, CuONPs, ZnONPs, and TiO2NPs. Biochemical analyses were performed on the collected biomass. (3) Results: Various interactions between nanoparticles (NPs) and the cyanobacterial culture were identified, ranging from hormetic effects at low concentrations to evident toxic effects at high concentrations. NP toxicity was observed through the reduction in photosynthetic pigments and the disappearance of phycobiliproteins. Notably, NP toxicity was not always accompanied by increased malondialdehyde (MDA) levels. (4) Conclusions: Arthrospira platensis exhibits unique adaptive mechanisms under NP-induced stress, offering the potential for controlled NP applications in biotechnology. Future research should further explore the relationship between nanoparticle types and cyanobacterial responses to optimize biomolecule production.

Every day, a considerable number of new cybersecurity attacks are reported, and the traditional methods of defense struggle to keep up with them. In the current context of the digital era, where industrial environments handle large data volumes, new cybersecurity solutions are required, and intrusion detection systems (IDSs) based on artificial intelligence (AI) algorithms are coming up with an answer to this critical issue. This paper presents an approach for implementing a generic model of a network-based intrusion detection system for Industry 4.0 by integrating the computational advantages of the Nvidia Morpheus open-source AI framework. The solution is modularly built with two pipelines for data analysis. The pipelines use a pre-trained XGBoost (eXtreme Gradient Boosting) model that achieved an accuracy score of up to 90%. The proposed IDS has a fast rate of analysis, managing more than 500,000 inputs in almost 10 s, due to the application of the federated learning methodology. The classification performance of the model was improved by integrating a generative adversarial network (GAN) that generates polymorphic network traffic packets.

Organophosphate ester flame retardants (OPFRs) are ubiquitous organic pollutants in the environment and present an important preoccupation due to their potential toxicity to humans and biota. They can be found in various sources, including consumer products, building materials, transportation industry, electronic devices, textiles and clothing, and recycling and waste management. This paper presents the first survey of its kind in Romania, investigating the composition, distribution, possible sources, and environmental risks of OPFRs in five wastewater treatment plants (WWTPs) and the rivers receiving their effluents. Samples from WWTPs and surface waters were collected and subjected to extraction processes to determine the OPFRs using liquid chromatography with mass spectrometric detection. All the target OPFRs were found in all the matrices, with the average concentrations ranging from 0.6 to 1422 ng/L in wastewater, 0.88 to 1851 ng/g dry weight (d.w.) in sewage sludge, and 0.73 to 1036 ng/L in surface waters. The dominant compound in all the cases was tri(2-chloroisopropyl) phosphate (TCPP). This study observed that the wastewater treatment process was inefficient, with removal efficiencies below 50% for all five WWTPs. The environmental risk assessment indicated that almost all the targeted OPFRs pose a low risk, while TDCPP, TCPP, and TMPP could pose a moderate risk to certain aquatic species. These findings provide valuable information for international pollution research and enable the development of pollution control strategies.

Increasing evidence suggests that dalbavancin is an effective long-term treatment for ventricular assist device (VAD) infections, with various prolonged dosing regimens currently in use. This retrospective study aimed to assess dalbavancin pharmacokinetics in VAD patients and identify optimal, feasible dosing regimens for long-term suppressive outpatient therapy. Data from Heidelberg University Hospital’s VAD register were analyzed using non-linear mixed-effects modeling for pharmacokinetic analysis and dosing simulations (Lixoft®). The probability of target attainment (PTA) and cumulative fraction of response (CFR) were calculated for different protein-binding scenarios considering the minimum inhibitory concentration (MIC) distribution of Staphylococcus aureus. Using data from 13 patients with 38 blood samples, a two-compartment model best described the dalbavancin pharmacokinetics, with a typical value for clearance of 0.050 L/h, central volume of distribution of 6.5 L, and peripheral volume of 15.4 L. No covariates significantly improved the model fit. The observed protein binding varied between 96 and 98%. Dosing simulations demonstrated that 1500 mg every 3 weeks ensured the target attainment for stasis at MIC values of 0.125 mg/L (PTA ≥ 90%) up to a protein binding of 99%. Considering the CRF, longer dosing intervals up to 5 weeks might be possible. Depending on individual MICs and protein binding, a dalbavancin regimen of 1500 mg every 3 to 5 weeks therefore appears to be a valuable option for outpatient therapy of VAD infections. Therapeutic drug monitoring should be considered to manage inter-individual variability and to support clinicians in long-term treatments of subacute and chronic infections.

Although radiomics research has experienced rapid growth in recent years, with numerous studies dedicated to the automated extraction of diagnostic and prognostic information from various imaging modalities, such as CT, PET, and MRI, only a small fraction of these findings has successfully transitioned into clinical practice. This gap is primarily due to the significant methodological challenges involved in radiomics research, which emphasize the need for a rigorous evaluation of study quality. While many technical aspects may lie outside the expertise of most radiologists, having a foundational knowledge is essential for evaluating the quality of radiomics workflows and contributing, together with data scientists, to the development of models with a real-world clinical impact. This review is designed for the new generation of radiologists, who may not have specialized training in machine learning or radiomics, but will inevitably play a role in this evolving field. The paper has two primary objectives: first, to provide a clear, systematic guide to radiomics study pipeline, including study design, image preprocessing, feature selection, model training and validation, and performance evaluation. Furthermore, given the critical importance of evaluating the robustness of radiomics studies, this review offers a step-by-step guide to the application of the METhodological RadiomICs Score (METRICS, 2024)—a newly proposed tool for assessing the quality of radiomics studies. This roadmap aims to support researchers and reviewers alike, regardless of their machine learning expertise, in utilizing this tool for effective study evaluation.

Background: Stroke is the third leading cause of disability. Virtual reality (VR) has shown promising results in post-stroke rehabilitation. The VR TRAVEE system was designed for the neuromotor rehabilitation of the upper limb after a stroke and offers the ability to track limb movements by providing auditory feedback and visual augmentation. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), aligned with the International Classification of Functioning, Disability, and Health (ICF) principles, is a valid tool for measuring disability regardless of its cause. This study aimed to investigate the feasibility of the VR TRAVEE system in upper limb rehabilitation for stroke patients. Methods: A total of 14 stroke patients with residual hemiparesis were enrolled in the study. They underwent a 10-day program combining conventional therapy (CnvT) with VR rehabilitation. At baseline (T0), the upper limb was assessed using the Modified Ashworth Scale (MAS), active range of motion (AROM), and the Numeric Rating Scale (NRS) for pain. These assessments were repeated after the 10-day rehabilitation program (T1). Additionally, disability was measured using WHODAS 2.0 at T0 and again 30 days after completing the program. Results: Significant improvements were observed in AROM and MAS scores for the shoulder, elbow, wrist, and metacarpophalangeal joints, as well as in the reduction in shoulder pain (p ˂ 0.001). WHODAS scores decreased across all six domains, with a statistically significant improvement in the Cognition domain (p = 0.011). Conclusions: Combining CnvT with VR as a rehabilitation approach enhances motor function in the upper limb. This method has the potential to reduce disability scores and promote neuroplasticity.

Histoplasma capsulatum (H. capsulatum) is considered to be one of the most extensively spread dysmorphic fungi worldwide. Histoplasmosis primarily impacts patients with weakened immune systems and can result in a diverse range of clinical manifestations. In immunocompetent patients, the disease may manifest as a self-limiting or asymptomatic infection; however, in immunocompromised individuals, it can occur as a debilitating, disseminated disease. Diagnosing histoplasmosis may be challenging. A medical professional that specializes in treating endemic fungal illnesses is better able to assist with an accurate and timely diagnosis since they have a deeper grasp of these illnesses. Consequently, the process of diagnosing histoplasmosis might be difficult for less experienced physicians. The case presented is an example of the myriad faces that histoplasmosis can take on, mimicking other common infectious or malignant conditions, leading to extensive work-up and invasive procedures in establishing the diagnosis of this otherwise benign condition. We hereby report the case of disseminated histoplasmosis in a young immunocompetent female patient.

This case report describes an uncommon overlap syndrome between ankylosing spondylitis (AS) and amyotrophic lateral sclerosis (ALS). Initially, the patient was diagnosed with AS, for which he received various specific treatments, including TNF-α inhibitors. After five years of treatment with TNF-α inhibitor etanercept, the patient was referred for a full neurological assessment after he reported balance disturbances, postural instability, muscle weakness, and other neurological symptoms that indicated the presence of a neurological disorder. After a thorough investigation, the patient was diagnosed with ALS. This case report aims to contribute to the limited literature by providing a detailed case study regarding the crosstalk between AS and ALS while also exploring the potential underlying mechanisms and the possible link between TNF-α inhibitors therapy and ALS.

Acetone detection is of significant importance in various industries, from cosmetics to pharmaceuticals, bioengineering, and paints. Sensor manufacturing involves the use of different semiconductor materials as well as different metals for doping and functionalization, allowing them to achieve advanced or unique properties in different sensor applications. In the healthcare field, these sensors play a crucial role in the non-invasive diagnosis of various diseases, offering a potential way to monitor metabolic conditions by analyzing respiration. This article presents the synthesis method, using chemical solutions and rapid thermal annealing technology, to obtain Al-functionalized and Ni-doped copper oxide (Al/CuO:Ni) nanostructured thin films for biosensors. The nanocrystalline thin films are subjected to a thorough characterization, with examination of the morphological properties by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray diffraction (XRD) analysis. The results reveal notable changes in the surface morphology and structure following different treatments, providing insight into the mechanism of function and selectivity of these nanostructures for gases and volatile compounds. The study highlights the high selectivity of developed Al/CuO:Ni nanostructures towards acetone vapors at different concentrations from 1 ppm to 1000 ppm. Gas sensitivity is evaluated over a range of operating temperatures, indicating optimum performance at 300 °C and 350 °C with the maximum sensor signal (S) response obtained being 45% and 50%, respectively, to 50 ppm gas concentration. This work shows the high potential of developed technology for obtaining Al/CuO:Ni nanostructured thin films as next-generation materials for improving the sensitivity and selectivity of acetone sensors for practical applications as breath detectors in biomedical diagnostics, in particular for diabetes monitoring. It also emphasizes the importance of these sensors in ensuring industrial safety by preventing adverse health and environmental effects of exposure to acetone.

One of the primary sources of trace elements in the environment is wastewater used for irrigation. However, the effects of untreated wastewater containing high concentrations of chromium and zinc on vegetables and the potential human health risks associated with their consumption are poorly understood. This pot experiment aimed to address this research gap. The accumulation of chromium and zinc and their effect on the biochemical parameters of lettuce (Lactuca sativa) and green onion (Allium fistulosum L.) irrigated with untreated industrial effluents were assessed. The average concentrations of chromium and zinc in the edible parts of the vegetables ranged between 7.36 and 7.58 mg/kg dry weight and 59.8 and 833 mg/kg dry weight, respectively. The irrigation of the lettuce with the effluent containing zinc at a concentration of 2.95 mg/L led to a significant increase in the content of phenols and the antioxidant activity. A significant reduction in the chlorophyll content of the lettuce leaves and the antioxidant activity of the onion leaves was observed when the plants were irrigated with the effluent containing zinc at a concentration of 78 mg/L. No non-carcinogenic health risk from the intake of chromium and zinc was identified through the consumption of lettuce and green onion, primarily due to the fact that a smaller proportion of the total metal content was transferred to their edible parts.

Background and Objectives: Sustained virologic responses (SVRs) lead to a decrease in portal hypertension, the regression of fibrosis, and the improvement in the hepatic synthesis of procoagulant and anticoagulant factors. We aimed to assess the influence of SVR on coagulation parameters in cirrhotic patients with HCV treated with DAAs. Methods: We performed a prospective study in the Institute of Gastroenterology and Hepatology Iasi, Romania, between January 2022 and February 2024. We included patients diagnosed with compensated and decompensated HCV-related liver cirrhosis, treated with direct antivirals (PrOD ± RBV or SOF/LED ± RBV) for 12/24 weeks. Blood samples for biochemical, immunological, and coagulation tests were collected at the baseline, end of treatment (EOT), and once sustained virological response had been achieved over a period of 12/24 weeks (SVR12/24). Results: We analyzed a group of 52 patients with HCV-related liver cirrhosis, predominantly female (68.0%), and the degree of severity of cirrhosis placed the patients mainly in Child–Pugh classes B (40%) and C (36%). All patients achieved SVRs. The MELD score decreased at EOT (13.48 ± 4.273; p = 0.001) and SVR (9.88 ± 2.774; p = 0.000), compared to the baseline (14.92 ± 4.707). The FibroScan values decreased at SVR (17.596 ± 3.7276; p = 0.000) compared to the baseline (26.068 ± 7.0954). For all common coagulation parameters (platelets, INR, PT, fibrinogen, aPTT), there was a trend towards improvement during treatment, including changes which were statistically significant for the majority of patients. Factor II was low at the baseline (75.40 ± 7.506) but increased at EOT (87.40 ± 9.587) and, later, at SVR (99.12 ± 11.695; p = 0.000). The FVIII values increased at the baseline (175.52 ± 16.414) and decreased at EOT (151.48 ± 13.703) and SVR (143.40 ± 13.937). The FvW values decreased during treatment (146.84 ± 9.428, at baseline; 141.32 ± 9.690, p = 0.000, at EOT; and 126.68 ± 17.960, at SVR). In regard to the anticoagulant factors (PC, PS, ATIII), a significant improvement was brought on by SVR. Advanced stages of liver disease showed the most diminished FII activity, while at the baseline and in Child–Pugh C patients we recorded the highest values of FVIII and FvW. Conclusions: Our study proved that the “reset” of coagulopathy might be due to the improvement in liver function due to viral eradication secondary to AAD therapy.

Background/Objectives: This study investigates the biocompatibility and physiological impacts of silver nanoparticles (AgNPs) functionalized with Spirulina protein extract (SPE) on laboratory rats. The objective was to assess and compare the systemic distribution, organ accumulation, and changes in hematological and biochemical parameters between biofunctionalized and non-functionalized silver nanoparticles. Methods: AgNPs were functionalized with SPE. Adult Wistar rats were administered these nanoparticles to assess their distribution across various organs using ICP-MS analysis. Hematological and biochemical markers were measured to evaluate systemic effects. Results: Functionalized silver nanoparticles demonstrated preferential accumulation in the brain, liver, and testicles, with significant clearance observed post-administration. The persistence of AgNPs SPE in reproductive organs was established. Hematological analysis revealed moderate changes, suggesting mild immune activation. Biochemical tests indicated transient increases in liver enzymes, signaling reversible hepatic stress. Conclusions: The biofunctionalization of AgNPs with Spirulina protein extract modifies the nanoparticles’ systemic behavior and organ distribution, enhancing their biocompatibility while inducing minimal physiological stress. These findings support the potential of Spirulina-based coatings to mitigate the toxicity and enhance the therapeutic efficacy of nanomedical agents.

The extensive development of nanotechnologies has allowed nanoparticles to impact living systems through different pathways. The effect of single exposure to high concentrations of silver and copper nanoparticles (50–200 mg/L) on Vaccinium myrtillus L. under field conditions was investigated. Nanoparticle uptake in different segments of Vaccinium myrtillus L. was assessed by applying inductively coupled plasma–atomic emission spectroscopy and a particle-induced X-ray emission technique. Copper nanoparticles mainly accumulated in the roots and leaves, while silver nanoparticles showed a higher affinity for the roots and berries. The nanoparticles’ effects on the pigments and antioxidant activity of the plant’s leaves were also evaluated. The possible human health risk associated with the consumption of nanoparticle-contaminated berries was assessed. The results indicated that the consumption of berries contaminated with nanoparticles presented a low risk for human health.

Background and Objectives: The rate of head and neck cancer (HNC) is expected to increase by 30% by 2030. However, there are many similarities between the symptomatology of a benign and a malign diagnosis; thus, a protocol for conducting a full head and neck examination is of high importance since the absence of adenopathy does not exclude a malignant diagnosis and also a favorable prognosis. Material and methods: The current study presents a retrospective study on 515 adult patients who underwent a biopsy for possible head and neck tumor pathology. Results: The patients identified with cancer were older than the rest of the group, with a higher developing trend in men than in women. However, the top 10 symptomatology patterns were identical in the malign and benign groups, meaning that new HNC may be missed due to the common symptomatology between benign and malign outcomes. Conclusions: The importance of a full ear, nose, and throat (ENT) examination may be of significant relevance for a proper diagnosis that can improve the overall prognosis of a patient with cancer. The absence of routine screening tests and screening guidelines for oral and pharyngeal cancers represents a significant barrier to secondary HNC prevention.

In the context of waters polluted with different high-risk contaminants, the development of efficient materials able to efficiently clean them is necessary. In the first part, the present review focuses on the ability of various types of magnetic layered double hydroxide materials to act as adsorbents for water contaminated mainly with heavy metals and dyes. Also, this paper reviews the ability of different magnetic layered double hydroxide materials to act as potential adsorbents for the treatment of wastewater contaminated with other types of pollutants, such as pharmaceutical products, phenolic compounds, phytohormones, and fungicides. In the second part, the applicability of the catalytic method for water depollution is explored. Thus, the use of simple or composite materials based on Fe3O4 is reviewed for the purpose of the catalytic degradation of organic compounds (dyes/phenols/pharmaceuticals). At the end, a review of multifunctional materials able to simultaneously neutralize different types of pollutants from wastewater is provided.

The objective of this study was to analyze the epidemiological links of the human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV-HCV coinfections to less studied types of transmission in certain populations. We performed an observational, prospective study on 903 patients aged between 15–87 years who took part in the Open Test Project. They were divided in two subgroups: general population vs. individuals from prisons who were questioned about multiple risk factors. A chi-square independence test was used to establish correlations between risk factors and results of screening tests. Logistic regression was used to calculate the probability of a reactive screening test based on each independent risk factor and age. HIV was very strongly associated with unprotected sexual intercourse with HIV-positive partners (the strongest association), unprotected sexual intercourse with sex workers, newly diagnosed sexually transmitted diseases (STDs), intravenous drug users (IDUs) and sharing injecting materials. In the case of HCV reactive tests, very strong associations have been established with IDUs (the strongest association), unprotected sex with IDUs and sharing injecting materials. Our study indicates the need for implementing targeted public health programs, tailored to the local epidemiology that can ultimately lead to micro-elimination of hepatitis and HIV infections in this area.

A paramagnetic A3B-type Mn(III)-porphyrin was synthesized and characterized by physical–chemical methods (UV-Vis, FT-IR, 1H-NMR spectroscopy). The obtained compound was tested as a sensitive material for the spectrophotometric and potentiometric detection of iodine species. Using UV-Vis spectroscopy, the triiodide anions could be detected with high precision in the concentration interval of 1.02 × 10−5 to 2.3 × 10−5 M, with an LOD of 9.44 × 10−6 M. The PVC-based electrode using DOP as a plasticizer showed a sensitivity toward iodide in a wide concentration range of 1.0 × 10−5 to 1.0 × 10−1 M, with an LOD of 8.0 × 10−6 M. Both methods are simple, low-cost, and efficient for the detection of iodine species in synthetic samples and pharmaceuticals.

We face significant environmental pollution problems due to various industries, such as the aluminum industry, which generates large amounts of red mud (RM) waste, or agriculture, in which case the use of pesticides creates huge water pollution problems. In this context, the present study offers a better perspective to originally solve both environmental issues. Thus, the main target of the study referred to using RM waste as a filler for preparing composite copolymer beads. Thereafter, this can achieve significant removal of water pollutants due to their adsorption/oxidation characteristics. As evidenced by the changes in chemical structure and composition, thermal stability, morphology, and porosity, RM was homogenously incorporated in poly(acrylonitrile-co-acrylic acid) beads prepared by wet phase inversion. The final assessment for the removal of pesticides by adsorption and oxidation processes was proven successful. In this regard, 2,4-dichlorophenoxyacetic acid was chosen as a model pollutant, for which an adsorption capacity of 16.08 mg/g composite beads was achieved.

Background and aims: Increases in both the prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity are closely related. Type 2 diabetes (T2DM) has been associated with metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis and hepatocellular carcinoma. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of T2DM and has an important role in weight loss. Also, it may represent a new therapeutic option for the treatment of MASH in obese diabetic patients. The main outcomes were changes from baseline in liver steatosis and fibrosis at week 24. Material and methods: A total of one hundred eighty-seven patients with T2DM were eligible for this prospective study; ninety-five subjects were treated with oral semaglutide, and ninety-two patients were treated with dapagliflozin as an add-on to metformin. All the subjects were evaluated using Vibration Controlled Transient Elastography (VCTE) from June to December 2022. Results: From our cohort, 54% of the patients were females, with a mean age of 59.92 ± 11.89 years and a mean body mass index (BMI) of 29.53 ± 5.33 kg/m2. Following a six-month medication period, we observed a substantial reduction in anthropometric measurements, including the BMI, waist circumference (WC), and waist-to-hip ratio (WtHr), in both groups. Regarding HbA1c, a notable decrease was observed in the semaglutide group (p < 0.001) when compared to the dapagliflozin group (p = 0.011). In addition, the liver stiffness measurement (LSM) according to VCTE improved significantly in the semaglutide group participants from 8.07 ± 2.90 kPa at baseline to 6.51 ± 3.09 kPa after medication (p < 0.001). Conclusion: The superior metabolic effects of semaglutide, correlated to dapagliflozin, may contribute to a more efficient decrease in hepatic stress and injury, leading to a substantial enhancement of liver function in T2DM patients. Further investigations conducted over an ideal timeframe are necessary to confirm the evidence presented in this study.

Drug information (DI) provided by hospital pharmacies aims to promote rational and safe drug therapy. While quality assessment for this task is recommended, more knowledge on the factors determining the quality is needed. We aimed to evaluate the impacts of different factors on the quality of DI provided by hospital pharmacies to healthcare professionals. Retrospectively, answers on fictitious enquiries about annual DI tests for German hospital pharmacies over five years were evaluated for content-related and structural requirements. Multivariate analysis was performed for the impact of the enquiry complexity, DI organization (specialized DI center; pharmacist responsible per day; DI on top of other routine tasks), and quality measures (second look; experience of answering pharmacist in DI/on ward; use of documentation database). In 2017–2021, 45, 71, 79, 118, and 122 hospital pharmacies participated. The enquiry complexity had a statistically significant impact on the content-related quality, with poor results for a higher complexity (years 2018/2021, OR 0.25/0.04, p < 0.01). The DI centers achieved better results regarding content-related quality than for a pharmacist responsible per day (OR 0.76/p = 0.65) or DI on top of routine tasks (OR 0.35/p = 0.02). The DI centers scored better in structural quality. The second look showed an overall trend of a better content-related and structural quality. In conclusion, specialized DI centers and second looks are recommended as quality-improving measures. Training for answering complex enquiries should be intensified.

The impact of fossil fuel utilisation in different combustion systems on climate change due to greenhouse gas accumulation in the atmosphere is rather evident. A part of these gases comes from the large engines used for propulsion in marine applications. In the continuous global effort made by engine manufacturers to mitigate this negative impact, one way is represented by the utilisation of alternative fuels such as biodiesel and methanol, based on dedicated research to fulfil the more stringent regulations concerning pollutant emissions issued by piston heat engines. In this study, a numerical investigation was conducted on a four-stroke large marine diesel engine (ALCO 16V 251C) at several engine speeds and full load conditions. Different blends of diesel–methanol and biodiesel B20–methanol with methanol mass fractions of 10% and 20% were considered for theoretical analysis in two techniques of methanol supply: direct injection mode of a blend of base fuel diesel/biodiesel B20 with methanol and injection of methanol after the intercooler, and direct injection of the base fuel. The results show that, if 10% in power loss can be acceptable, then for diesel–methanol 10%, in the direct injection technology, the NOx emission can be reduced up to 19%, but with a compromise of an 8% increase in SOOT emission, while for biodiesel B20–methanol 10%, with the same direct injection method, the NOx emissions increase by up to 58% with the benefit of reducing SOOT by up to 23% relative to the original diesel fuel operation. For a 20% methanol fraction in blend fuel, the drop in power is more than 10% regardless of the method of methanol supply and the base fuel, diesel, or B20 used.

Portal hypertension from chronic liver disease leads to the formation of collateral blood vessels called spontaneous portosystemic shunts (SPSS). These shunts may form from existing vessels or through neo-angiogenesis. Their location affects clinical outcomes due to varying risks and complications. This review summarizes current knowledge on SPSS, covering their clinical impact and management strategies. Recent data suggest that SPSS increases the risk of variceal bleeding, regardless of shunt size. The size of the shunt is crucial in the rising incidence of hepatic encephalopathy (HE) linked to SPSS. It also increases the risk of portopulmonary hypertension and portal vein thrombosis. Detecting and assessing SPSS rely on computed tomography (CT) and magnetic resonance imaging. CT enables precise measurements and the prediction of cirrhosis progression. Management focuses on liver disease progression and SPSS-related complications, like HE, variceal bleeding, and portopulmonary hypertension. Interventional radiology techniques such as balloon-occluded, plug-assisted, and coil-assisted retrograde transvenous obliteration play a pivotal role. Surgical options are rare but are considered when other methods fail. Liver transplantation (LT) often resolves SPSS. Intraoperative SPSS ligation is still recommended in patients at high risk for developing HE or graft hypoperfusion.

The biosorption and bioaccumulation of gadolinium by Arthospira platensis in batch experiments was examined. In biosorption experiments, the influence of pH, gadolinium concentration, time of contact and temperature on Arthospira platensis sorption capacity was investigated. The maximum biosorption capacity of 101 mg/g was attained at a pH of 3.0 and temperature of 20 °C. A pseudo-first-order model was applicable to describe the kinetics of the biosorption and the Freundlich model to explain the equilibrium of the process. In bioaccumulation experiments, besides the examination of the gadolinium uptake by Arthospira platensis, its effect on biomass productivity as well as the content of proteins, lipids, carbohydrates and pigments was assessed. The addition of gadolinium in the cultivation medium resulted in the increase in biomass productivity and the content of MDA and, at the same time, in the reduction in the amount of proteins and carbohydrates. The content of other monitored parameters did not change significantly. The water extracts obtained from Arthospira platensis showed a higher antiradical activity against the ABTS cation radical in comparison with ethanolic extracts. Arthospira platensis is of interest for the development of the technology of gadolinium-contaminated wastewater remediation.

The purpose of this study was to examine the influence of 10 and 20 nm nanoparticles (AgNPs) on the growth and biochemical composition of microalga Porphyridium purpureum CNMN-AR-02 in two media which differ by the total amount of mineral salts (MM1 with 33.02 g/L and MM2 with 21.65 g/L). Spectrophotometric methods were used to estimate the amount of biomass and its biochemical composition. This study provides evidence of both stimulatory and inhibitory effects of AgNPs on different parameters depending on the concentration, size, and composition of the nutrient medium. In relation to the mineral medium, AgNPs exhibited various effects on the content of proteins (an increase up to 20.5% in MM2 and a decrease up to 36.8% in MM1), carbohydrates (a decrease up to 35.8% in MM1 and 39.6% in MM2), phycobiliproteins (an increase up to 15.7% in MM2 and 56.8% in MM1), lipids (an increase up to 197% in MM1 and no changes found in MM2), antioxidant activity (a decrease in both media). The composition of the cultivation medium has been revealed as one of the factors influencing the involvement of nanoparticles in the biosynthetic activity of microalgae.

Nanoparticles, due to their extensive production and application, can have significant consequences for the environment, including soil and plant pollution. Therefore, it is very important to assess how nanoparticles will affect plants depending on the exposure pathways. The effect of gold nanoparticles in a concentration range of 1–100 mg/L on Mentha spicata L. during a 28-day experiment was investigated. Two routes of nanoparticles exposure were applied: root and foliar. Transmission electron microscopy was used to characterize nanoparticles and their effect on plant leaves’ ultrastructure. Gold content in soil and plant segments was determined using k0-neutron activation analysis. For root exposure, gold was mainly accumulated in soil (15.2–1769 mg/kg) followed by root systems (2.99–454 mg/kg). The maximum accumulation of gold in leaves (5.49 mg/kg) was attained at a nanoparticle concentration of 100 mg/L. Foliar exposure resulted in the maximum uptake of gold in leaves (552 mg/kg) and stems (18.4 mg/kg) at the highest applied nanoparticle concentration. The effect of nanoparticles on the Mentha spicata L. leaves’ biochemical composition was assessed. Nanoparticles affected the content of chlorophyll and carotenoids and led to an increase in antioxidant activity. Root exposure to gold nanoparticles resulted in an increase in the number of starch grains in chloroplasts and also suppressed the activity of the soil microbiota. Gold extraction from mint leaves into herbal infusion varied from 2 to 90% depending on the concentration of nanoparticles in the solution and the exposure route. The health risk as a result of gold exposure via herbal tea intake was assessed through estimated daily intake. The hazard quotient values were found to be less than the cutoff, indicating that a cup of tea infusion should not cause a serious impact to human health.

Background and Objectives: Our aim was to perform a retrospective analysis of the volume of cervical screening tests, the number of patients treated with an excision method, and the incidence of invasive and non-invasive cervical during a pandemic and pre-pandemic period of 24 months. Materials and Methods: The study compared 404 patients who underwent cervical cone biopsy for cervical cancer. The study examined patients’ specimens based on histopathological characteristics and categorized cervical lesions based on pap smear. Results: There was a statistically significant age difference between the two study periods. The mean difference was 32 years before the pandemic and 35 years during the pandemic (p-value > 0.05). The biggest patient loss ratio identified by age group was in the 50–59-year group, with a 14.53% loss in the pre-pandemic period and a 9.1% loss in the pandemic period. In the pandemic period, patients from rural areas presented in the clinical trial with a lower rate of 39.52% (83 patients) vs. 60.47% (127 patients) in urban areas. A higher percentage of patients experiencing cervicorrhagia as a clinical manifestation in the pandemic period vs. the pre-pandemic period, with an increase in more severe lesions in the pandemic period, had a statistical significance of 8% more newly diagnosed compared to the pre-pandemic period. Conclusions: The addressability of the patients during the COVID period was not affected in a drastic way in our study. We encountered a decrease in appointments in the age group of 50–59 years and a decrease in patients with rural residence. In our study, we found an increase in cervical bleeding as a reason for consultation in the pandemic period with a higher lesion degree, both on a pap smear and on a cervical biopsy.

Landiolol is an ultra-short-acting, selective β1-adrenergic receptor blocker that was originally approved in Japan for the treatment of intraoperative tachyarrhythmias. It has gained attention for its use in the management of tachyarrhythmias and perioperative tachycardia, especially atrial fibrillation for both cardiac and non-cardiac surgeries. It can be the ideal agent for heart rate control due to its high β1-selectivity, potent negative chronotropic effect, a limited negative inotropic potential, and an ultrashort elimination half-life (around 4 min); moreover, it may have a potential therapeutic effects for sepsis and pediatric patients. Landiolol seems to be superior to other short-acting and selective beta-blockers such as esmolol. This review aims to provide a comprehensive overview of landiolol, a new ultra-short-acting β1 selective antagonist, including its pharmacology, clinical applications, efficacy, safety profile, and future directions in research and clinical data.

In recent years, increasing interest has been accorded to polyester-based polymer microstructures, driven by their promising potential as advanced drug delivery systems. This study presents the preparation and characterization of new polymeric microparticles based on poly(ethylene brassylate-co-squaric acid) loaded with norfloxacin, a broad-spectrum antibiotic. Polymacrolactone was synthesised in mild conditions through the emulsion polymerization of bio-based and renewable monomers, ethylene brassylate, and squaric acid. The microparticles were obtained using the precipitation technique and subsequently subjected to comprehensive characterization. The impact of the copolymer/drug ratio on various properties of the new system was systematically evaluated, confirming the structure of the copolymer and the encapsulation of norfloxacin. The microspheres are approximately spherical and predominantly homogeneously distributed. The average hydrodynamic diameter of the microparticles falls between 400 and 2000 nm, a decrease that is observed with the increase in norfloxacin content. All samples showed good encapsulation efficiency and drug loading capacity, with the highest values obtained for microparticles synthesised using an equal ratio of copolymer and drug. In vitro drug release results disclose that norfloxacin molecules are released in a sustained biphasic manner for up to 24 h. Antimicrobial activity was also studied, with samples showing very good activity against E. coli and moderate activity against S. aureus and E. faecalis. In addition, HDFA human fibroblast cell cultures demonstrated the cytocompatibility of the microparticles.

Broncho-esophageal fistula (BEF) is a severe yet relatively rare connection between the bronchus and esophagus usually caused by esophageal and pulmonary malignancies. We present a case report of a 49-year-old man diagnosed with terminal lung carcinoma who developed a BEF. The thoracic computed tomography scan detected a mass in the left bronchi that partially covers and disrupts the bronchial contour in certain regions and extends to the esophageal wall. After thoroughly evaluating alternative treatment approaches, we opt for the stenting procedure due to the advanced stage of the tumor and the significantly diminished quality of life. The treatment involves the use of a partially covered metal stent that is known to exhibit lower potential to migrate. The treatment is highly successful, resulting in a significant enhancement of the patient’s quality of life, a lengthening in his survival, and the ability to pursue additional palliative treatment options. In contrast to the typical prosthesis implantation, our procedure uses a direct endoscopic visualization for the proximal deployment of a partially covered stent, offering a cost-effective and radiation-free alternative that can be particularly beneficial for BEF patients in facilities without radiology services.

Understanding the volatile flavor compounds present in commercial beverages is crucial for the food and beverage industries as these compounds significantly influence product perception and consumer acceptability. This paper aims to comprehensively analyze the composition of volatile organic compounds in various commercial beverages using targeted gas chromatographic–mass spectrometry (GC/MS) approaches. The study employs a screening method based on the Headspace-GC/MS technique to efficiently extract and identify volatile organic compounds found in commercial beverages. This methodology provides a rapid and reliable system for assessing the volatile profile of these beverages. The analysis reveals the presence of a total of 40 volatile organic compounds, including esters, terpenes/terpenoids, alkenes, aldehydes, aromatic hydrocarbons, and alcohols. Medium-chain esters were found to dominate the volatile profile of the beverages, suggesting a significant contribution to their fragrance and taste. This study offers valuable insights into the volatile profile of commercial beverages, creating awareness among consumers about the flavor components present in these products. By understanding the volatile composition, consumers can make informed choices regarding their beverage consumption. The comprehensive analysis provided by this research serves as a foundation for further studies related to flavor characterization and optimization in commercial beverages.

This study explores the potential utilization of walstromite (BaCa2Si3O9) as a foundational material for creating new bioceramics in the form of scaffolds through 3D printing technology. To achieve this objective, this study investigates the chemical–mineralogical, morphological, and structural characteristics, as well as the biological properties, of walstromite-based bioceramics. The precursor mixture for walstromite synthesis is prepared through the sol–gel method, utilizing pure reagents. The resulting dried gelatinous precipitate is analyzed through complex thermal analysis, leading to the determination of the optimal calcination temperature. Subsequently, the calcined powder is characterized via X-ray diffraction and scanning electron microscopy, indicating the presence of calcium and barium silicates, as well as monocalcium silicate. This powder is then employed in additive 3D printing, resulting in ceramic scaffolds. The specific ceramic properties of the scaffold, such as apparent density, absorption, open porosity, and compressive strength, are assessed and fall within practical use limits. X-ray diffraction analysis confirms the formation of walstromite as a single phase in the ceramic scaffold. In vitro studies involving immersion in simulated body fluid (SBF) for 7 and 14 days, as well as contact with osteoblast-like cells, reveal the scaffold’s ability to form a phosphate layer on its surface and its biocompatibility. This study concludes that the walstromite-based ceramic scaffold exhibits promising characteristics for potential applications in bone regeneration and tissue engineering.

The biological activity of Galium verum herba was exerted on various tumor cell lines with incredible results, but their potential effect on malignant melanoma has not been established yet. Therefore, the current study was structured in two directions: (i) the investigation of the phytochemical profile of diethyl ether (GvDEE) and butanol (GvBuOH) extracts of G. verum L. and (ii) the evaluation of their biological profile on A375 human malignant melanoma cell line. The GvDEE extract showed an FT-IR profile different from the butanol one, with high antioxidant capacity (EC50 of GvDEE = 0.12 ± 0.03 mg/mL > EC50 of GvBuOH = 0.18 ± 0.05 mg/mL). The GvDEE extract also showed antimicrobial potential, especially against Gram-positive bacteria strains, compared to the butanol extract, which has no antimicrobial activity against any bacterial strain tested. The results regarding the antitumor potential showed that both extracts decreased A375 cell viability largely (69% at a dose of 55 µg/mL of the GvDEE extract). Moreover, both extracts induce nuclear fragmentation by forming apoptotic bodies and slight chromatin condensation, which is more intense for GvDEE. Considering the results, one can state that the Galium verum herba possesses antitumor effects on the A375 human malignant melanoma cell line, a promising phytocompound for the antitumor approach to skin cancer.

Rare-earth elements are released into the aquatic environment as a result of their extensive use in industry and agriculture, and they can be harmful for living organisms. The effects of holmium(III), erbium(III), and gadolinium(III) when added to a growth medium in concentrations ranging from 10 to 30 mg/L on the accumulation ability and biochemical composition of Arthrospira platensis were studied. According to the results of a neutron activation analysis, the uptake of elements by cyanobacteria occurred in a dose-dependent manner. The addition of gadolinium(III) to the growth medium did not significantly affect the amount of biomass, whereas erbium(III) and holmium(III) reduced it up to 22% compared to the control. The effects of rare-earth elements on the content of proteins, carbohydrates, phycobiliproteins, lipids, β carotene, and chlorophyll a were evaluated. The studied elements had different effects on the primary biomolecule content, suggesting that holmium(III) and erbium(III) were more toxic than Gd(III) for Arthrospira platensis.

In light of the increasing resistance of pathogenic microorganisms to the action of antibiotics, essential oils extracted from plants with therapeutic activity provide a significant alternative to obtaining dressings for the treatment of skin wounds. The encapsulation of essential oils in an amphiphilic gel network allows better dispersion and preservation of hydrophobic bioactive substances while promoting their prolonged release. In this study, we focused on the development of a poly (vinyl alcohol) (PVA)/poly (ethylene brassylate-co-squaric acid) (PEBSA) platform embedded with thymol (Thy), and α-tocopherol (α-Tcp) as a co-drug structure with prospective use for the treatment and healing of skin wounds. The new complex bioactive system was prepared through repeated freeze–thaw processes. The influence of the composition on surface topography, hydrophilic/hydrophobic character, and in vitro interaction with simulated body fluids was evidenced. BALB/3T3 fibroblast cell culture demonstrated the cryogel scaffolds’ cytocompatibility. Tests on Wistar rats confirmed their biocompatibility, integration with host tissue, and the absence of inflammatory processes. The bioactive compound significantly enhanced the healing process of full-thickness excision wounds in a rat model. Further investigations on in vivo infection models would assess the potential of the PVA/PEBSA platform with dual bioactive activity for clinical antimicrobial and wound healing therapy.

Low-molecular-weight gelators (LMWGs) are compounds with an intrinsic tendency to self-assemble forming various supramolecular architectures via non-covalent interactions. Considering that the development of supramolecular assemblies through the synergy of molecules is not entirely understood at the molecular level, this study introduced a Fmoc-short peptide and four Fmoc-amino acids as building blocks for the self-assembly/co-assembly process. Hence, we investigated the formation of supramolecular gels starting from the molecular aggregation following two triggering approaches: solvent/co-solvent method and pH switch. The complex morphological analysis (POM, AFM, and STEM) offered an insight into the spontaneous formation of well-ordered nanoaggregates. Briefly, POM and AFM images demonstrated that self-assembled gels present various morphologies like dendrimer, spherulite, and vesicle, whereas all co-assembled supramolecular systems exhibit fibrillar morphologies as a result of the interaction between co-partners of each system. STEM study has confirmed that the molecules interact and join together, finally forming a fibrous network, an aspect seen in both self-assembled and co-assembled gels. XRD allowed the determination of the molecular arrangement. The study emphasized that the Fmoc motif protected the amino groups and facilitated gelation through additional π-π interactions.

Background and Objectives: Pain is the most prevalent symptom in cancer patients. There is a paucity of data regarding non-invasive brain stimulation (NIBS) for the treatment of chronic pain in patients with cancer. The purpose of this article is to review the techniques of NIBS and present the published experiences of the oncological population. Materials and Methods: Databases including MEDLINE, Scopus, Web of Science, and the Cochrane Library were searched for articles on cancer patients with pain that was managed with non-invasive brain stimulation techniques. We included articles in English that were published from inception to January 2023. As studies were limited in number and had different designs and methodologies, a narrative review was considered as the best option to integrate data. Results: Four studies focusing on transcranial magnetic stimulation, six articles on transcranial direct current stimulation, and three articles regarding cranial electric stimulation were found and reviewed. Conclusions: Data are limited and not robust. Further studies in this field are required. Guidelines on NIBS for non-malignant chronic pain conditions provide good premises for cancer-related chronic pain.

Magnetic nanoparticles (MPs) are emerging as powerful and versatile tools for biotechnology, including cancer research and theranostic applications. Stem cell-mediated magnetic particle delivery has been previously recognized as a modality to target sites of malignancies. Here, we propose the use of adipose-derived mesenchymal cells (ADSC) for the targeted delivery of Fe-Cr-Nb-B magnetic particles to human osteosarcoma (HOS) cells and magneto-mechanical actuation (MMA) for targeting and destroying HOS cells. We show that MPs are easily incorporated by ADSCs and HOS cells, as confirmed by TEM images and a ferrozine assay. MP-loaded ADSCs display increased motility towards tumor cells compared with their unloaded counterparts. MMA of MP-loaded ADSCs induces HOS destruction, as confirmed by the MTT and live/dead assays. MMA enables the release of the MPs towards cancer cells, producing a significant decrease (about 80%) in HOS viability immediately after application. In contrast, normal human dermal fibroblasts’ (NHDFs) viability exposed to similar conditions remains high, showing a differential behavior of normal and malignant cells to MP load and MMA exposure. Taken together, the method could derive successful strategies for in vivo applications in targeting and destroying malignant cells while protecting normal cells.

The incidence of neurodegenerative diseases, such as Alzheimer’s disease (AD), is continuously growing worldwide, which leads to a heavy economic and societal burden. The lack of a safe and effective causal therapy in cognitive decline is an aggravating factor and requires investigations into the repurposing of commonly used drugs. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new and efficient class of hypoglycemic drugs and, due to their pleiotropic effects, have indications that go beyond diabetes. There is emerging data from murine studies that SGLT2i can cross the blood–brain barrier and may have neuroprotective effects, such as increasing the brain-derived neurotrophic factor (BDNF), reducing the amyloid burden, inhibiting acetylcholinesterase (AChE) and restoring the circadian rhythm in the mammalian target of rapamycin (mTOR) activation. The current study investigates the effect of an SGLT2i and donepezil, under a separate or combined 21-day treatment on AD-relevant behaviors and brain pathology in mice. The SGLT2i canagliflozin was found to significantly improve the novelty preference index and the percentage of time spent in the open arms of the maze in the novel object recognition and elevated plus maze test, respectively. In addition, canagliflozin therapy decreased AChE activity, mTOR and glial fibrillary acidic protein expression. The results also recorded the acetylcholine M1 receptor in canagliflozin-treated mice compared to the scopolamine group. In the hippocampus, the SGLT2i canagliflozin reduced the microgliosis and astrogliosis in males, but not in female mice. These findings emphasize the value of SGLT2i in clinical practice. By inhibiting AChE activity, canagliflozin represents a compound that resembles AD-registered therapies in this respect, supporting the need for further evaluation in dementia clinical trials.

Owing to its antibacterial, anti-inflammatory, and antioxidant activities, in the last few years, lavender essential oil (LVO) has been used in medical applications as a promising approach for treating infected wounds. However, the practical applicability of LVO is limited by its high volatility and storage stability. This study aimed to develop a novel hybrid hydrogel by combining phytic acid (PA)-crosslinked sodium alginate (SA) and poly(itaconic anhydride-co-3,9-divinyl-2,4,8,10-tetraoxaspiro[5.5] undecane (PITAU) and evaluate its potential effectiveness as an antibacterial wound dressing after incorporating LVO. The influence of the mass ratio between SA and PITAU on the properties and stability of hydrogels was investigated. After LVO loading, the effect of oil addition to hydrogels on their functional properties and associated structural changes was studied. FTIR analysis revealed that hydrogen bonding is the primary interaction mechanism between components in the hybrid hydrogels. The morphology was analyzed using SEM, evidencing a porosity dependent on the ratio between SA and PITAU, while LVO droplets were well dispersed in the polymer blend. The release of LVO from the hydrogels was determined using UV-VIS spectroscopy, indicating a sustained release over time, independent of the LVO concentration. In addition, the hybrid hydrogels were tested for their antioxidant properties and antimicrobial activity against Gram-positive and Gram-negative bacteria. Very good antimicrobial activity was obtained in the case of sample SA_PITAU3+LVO10% against S. aureus and C. albicans. Moreover, in vivo tests showed an increased antioxidant effect of the SA_PITAU3+LVO10% hydrogel compared to the oil-free scaffold that may aid in accelerating the healing process of wounds.

The origin of the photoplethysmography (PPG) signal is a debatable topic, despite plausible models being addressed. One concern revolves around the correlation between the mechanical waveform’s pulsatile nature and the associated biomechanism. The interface between these domains requires a clear mathematical or physical model that can explain physiological behavior. Describing the correct origin of the recorded optical waveform not only benefits the development of the next generation of biosensors but also defines novel health markers. In this study, the assumption of a pulsatile nature is based on the mechanism of blood microcirculation. At this level, two interconnected phenomena occur: variation in blood flow velocity through the capillary network and red blood cell (RBC) shape deformation. The latter effect was qualitatively investigated in synthetic capillaries to assess the experimental data needed for PPG model development. Erythrocytes passed through 10 µm and 6 µm microchannel widths with imposed velocities between 50 µm/s and 2000 µm/s, according to real scenarios. As a result, the length and area deformation of RBCs followed a logarithmic law function of the achieved traveling speeds. Applying radiometric expertise on top, mechanical-optical insights are obtained regarding PPG’s pulsatile nature. The mathematical equations derived from experimental data correlate microcirculation physiologic with waveform behavior at a high confidence level. The transfer function between the biomechanics and the optical signal is primarily influenced by the vasomotor state, capillary network orientation, concentration, and deformation performance of erythrocytes.

Psoriasis is a chronic inflammatory skin condition, with genetic, epigenetic, environmental, and lifestyle factors contributing to its onset and recurrence. Severe psoriasis has a great impact on quality of life, which is similar to that of insulin-dependent diabetes, depression, and ischemic heart disease, but with a lower mortality. There is an overlap between the rising incidences of autoimmune diseases and obesity. In recent years, research has shown that there is an association between psoriasis and obesity. Psoriasis is linked to obesity in a two-way manner, as each can precipitate the development of the other. Several adipose tissue-secreted adipokines were shown to be elevated in obese psoriasis patients, exhibiting similar mechanisms of action to those underlying the pathogenesis of psoriasis. Excess body weight can influence not only the treatment response in psoriasis, but also the adverse events, leading to decreased patient compliance. Specific human microbiome patterns have been identified for obesity and psoriasis and could represent a future therapeutic target in selected individuals.

Objectives: To compare the follow-up results of a sacrospinous ligament fixation (SSLF) technique for laparoscopic bilateral fixation of the vagina to the iliopectineal ligament via a PVDF-mesh (laparoscopic pectopexy technique, LP) in terms of cure rate and postoperative complications rate. Material and methods: This prospective study included 160 patients diagnosed with pelvic organ prolapse stage II–IV according to the POP-Q system. Eighty-two patients (51.25%) underwent vaginal sacrospinous ligament fixation and seventy-eight patients (48.75%) underwent the laparoscopic pectopexy procedure. Results: The cure rate was high in both groups, 95.12% of the patients (78 out of 82) in the SSLF group and 93.59% of the patients (73 out of 78) in the LP group were cured post surgery, leading to an overall cure rate of 151 out of 160 patients. Pelvic pain was present in 5.00% of all patients, but was notably more frequent in the SSLF group (7, 8.54%) than in the LP group (1, 1.28%). Dyspareunia occurred in 4.37% of all patients, slightly more frequently in the SSLF group (6, 7.32%) than the LP group (1, 1.28%), but without significant difference. Conclusions: The laparoscopic pectopexy procedure has comparably positive follow-up results with the conventional sacrospinous ligament fixation procedure. Both SSLF and LP are effective in the treatment of pelvic organ prolapse, with favorable anatomical and subjective results, a high cure rate and low rates of serious postoperative complications.

Cystic echinococcosis (CE) is a neglected parasitic disease caused by the tapeworm Echinococcus granulosus. The aim of this study was to assess the epidemiological features of human cystic echinococcosis in patients from Western Romania. We retrospectively investigated the medical records of patients hospitalized with CE between 1 January 2007 and 1 September 2022. A total of 366 patients (range 18–90 years) were recorded. The number of hospitalized individuals was higher in patients aged 50–59 years (83/366, 22.7%), in females (194/366, 53%), and in residents of rural areas (225/366, 61.5%). The liver was the most common localization of the cysts (302/366, 82.5%). Ninety-eight patients (26.8%) presented complications, including biliary fistula, allergies, and infection of the cyst. Patients with complications had a longer mean hospital stay (15.7 ± 8.3 days) compared to patients without complications (11.5 ± 7.3 days) (p < 0.001). The results of this study revealed that patients diagnosed with CE required hospitalization and extended medical care, indicating that this zoonotic disease remains a significant public health problem in Western Romania. Public health authorities should enhance CE surveillance by implementing control programs and mandatory notification of new cases.

Thromboembolic (TE) risk scores used for atrial fibrillation (AF) patients do not include mitral annular calcification (MAC) as a potential indicator of vascular disease. This research evaluated the correlation between MAC and TE risk scores (CHADS2 and CHA2DS2-VASc). We compared TE risk score values and clinical and echocardiographic data in patients with and without MAC. We included, prospectively, 103 patients: 40.8% with AF, 83.5% with hypertension, 30.1% with type II diabetes mellitus, 79.6% with chronic heart failure, and 7.8% with a history of stroke. We identified MAC in 50.5% of patients. The mean CHADS2 and CHA2DS2-VASc scores were 2.56 ± 1.135 and 4.57 ± 1.61, respectively. In MAC patients, both scores tended to increase significantly compared with the control (2.88 ± 1.114 versus 2.24 ± 1.06, p = 0.005, and 5.21 ± 1.51 versus 3.92 ± 1.46, p < 0.001, respectively). The left ventricular ejection fraction negatively correlated with the presence of MAC (r = −0.254, p = 0.01). The presence of MAC was a risk factor for vascular disease (OR = 2.47, χ2 = 34.32, p < 0001). Conclusions: The presence of MAC is associated with greater TE risk scores and a higher risk of vascular disease. It appears that adding MAC as a vascular disease parameter to TE risk scores may have benefits for patients by improving their predictive value.

Background and Objectives: The clinical presentation and survival factors in patients with myeloma-related kidney impairment (MRKI) at diagnosis remain a topic of ongoing research, given the complex interplay between nephrology and hematology. To date, no studies have specifically reported outcomes for these patients in Eastern Europe. Materials and Methods: We conducted a retrospective, unicentric study of consecutive newly diagnosed patients with MRKI in our tertiary nephrology service in Romania between 2015 and 2020; follow-up extended until 1 September 2022, covering a study period of 90 months. Results: We identified 89 consecutive patients with MRKI (median age 66 years, 38% male, median eGFR 5 mL/min). The majority of patients had arterial hypertension (71%) and systemic atherosclerosis (58%), and the most frequent clinical features at presentation were asthenia (75%) and bone pain (51%). Light-chain-restricted myeloma was the most common type (55%), with kappa free light chain being more frequent (53%). Among the patients, 81% presented with acute kidney injury (AKI), and 38% required hemodialysis at diagnosis. During the study period, 65% of the patients died, and hypoalbuminemia and the need for hemodialysis at diagnosis were significantly associated with mortality in multivariate analysis. Conclusions: Patients with MRKI who present to the nephrologist more frequently exhibit light chain restriction and most often present with AKI, with one-third requiring hemodialysis at diagnosis. Moreover, hypoalbuminemia and the initiation of hemodialysis at diagnosis were significantly associated with increased mortality.

Melanoma, the tumor arising from the malignant transformation of pigment-producing cells—the melanocytes—represents one of the most severe cancer types. Despite their rarity compared to cutaneous melanoma, the extracutaneous subtypes such as uveal melanoma (UM), acral lentiginous melanoma (ALM), and mucosal melanoma (MM) stand out due to their increased aggressiveness and mortality rate, demanding continuous research to elucidate their specific pathological features and develop efficient therapies. Driven by the emerging progresses made in the preclinical modeling of melanoma, the current paper covers the most relevant in vitro, in vivo, and in ovo systems, providing a deeper understanding of these rare melanoma subtypes. However, the preclinical models for UM, ALM, and MM that were developed so far remain scarce, and none of them is able to completely simulate the complexity that is characteristic to these melanomas; thus, a continuous expansion of the existing library of experimental models is pivotal for driving advancements in this research field. An overview of the applicability of precision medicine in the management of rare melanoma subtypes is also provided.

Recently, research has greatly expanded the knowledge of the endocannabinoid system (ECS) and its involvement in several therapeutic applications. Cannabinoid receptors (CBRs) are present in nearly every mammalian tissue, performing a vital role in different physiological processes (neuronal development, immune modulation, energy homeostasis). The ECS has an essential role in metabolic control and lipid signaling, making it a potential target for managing conditions such as obesity and diabetes. Its malfunction is closely linked to these pathological conditions. Additionally, the immunomodulatory function of the ECS presents a promising avenue for developing new treatments for various types of acute and chronic inflammatory conditions. Preclinical investigations using peripherally restricted CBR antagonists that do not cross the BBB have shown promise for the treatment of obesity and metabolic diseases, highlighting the importance of continuing efforts to discover novel molecules with superior safety profiles. The purpose of this review is to examine the roles of CB1R and CB2Rs, as well as their antagonists, in relation to the above-mentioned disorders.

Background: Despite numerous advances that have aimed to increase the safety of endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP pancreatitis (PEP) still remains a major issue. We aimed to assess the rate of PEP as well as the relation to the cannulation techniques in our unit, a high-volume center in north-eastern Romania. Methods: ERCPs performed in our unit from March to August 2022 were retrospectively included. Data concerning demographic information, presence of difficult cannulation, the technique used for cannulation, as well as immediate complications, were gathered from the electronic database. Results: 233 ERCPs were included. PEP was diagnosed in 23 (9.9%) of cases. Precut sphincterotomy (PS), transpancreatic sphincterotomy (TPBS), and a combination of TPBS and PS were performed in 6.4%, 10.3%, and 1.7% of cases, respectively, while an Erlangen precut papillotomy was performed in one case. Both in patients with PS and TPBS the rate of PEP was 20%. When the two techniques were associated, the rate of PEP was 25%. TPBS and PS represented risk factors for PEP (OR 1.211 for a CI of 0.946–1.551, p = 0.041, and OR 1.124 for a CI of 0.928–1.361, p = 0.088, respectively). No PEP-associated deaths were found. Conclusions: Both PS and TPBS presented a similar risk of PEP.