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Therapeutic plasmapheresis is a therapeutic procedure in which the patient's blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.Therapeutic plasmapheresis is an urgent procedure that can reduce morbidity and mortality in critically ill patients. This justifies that 37% of patients started the technique before the diagnostic confirmation. The indications for plasmapheresis and the choice of replacement solution were in agreement with the guidelines. Despite the risk of bleeding, no haemorrhagic complications were recorded.Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.Introdução: A plasmaferese terapêutica é um procedimento em que o sangue passa por um circuito extracorpóreo que separa o plasma dos outros componentes do sangue. O plasma removido é substituído por soluções de reposição. Os estudos sobre a utilização de plasmaferese terapêutica no doente crítico são escassos. O objetivo do estudo foi rever todas as sessões de plasmaferese realizadas no serviço de Medicina Intensiva do Hospital Beatriz Ângelo. Material e Métodos: Estudo observacional retrospetivo de todos os doentes admitidos no serviço de Medicina Intensiva entre abril de 2012 e março de 2019. Foram selecionados os doentes submetidos a plasmaferese e excluídas as sessões realizadas fora do serviço de Medicina Intensiva. Resultados: No período de estudo foram incluídos 46 doentes. A maioria eram homens (n = 29; 63%) com uma idade mediana de 53 anos. Os diagnósticos mais frequentes foram pancreatite secundária a hipertrigliceridemia, vasculite, anemia hemolítica autoimune e síndrome hemolítica urémica atípica. Foram realizadas 198 sessões de plasmaferese no serviço de Medicina Intensiva. As soluções de substituição mais utilizadas foram plasma fresco congelado (34,4%), albumina/cristalóide (24,2%) e albumina/plasma (19,2%). As complicações mais comuns foram alterações hidroeletrolíticas (84; 42,4%), e distúrbios da coagulação/plaquetas (65; 32,8%). Em nenhum dos casos a técnica teve que ser interrompida por complicações relacionadas com o doente. Discussão: A plasmaferese terapêutica é um procedimento urgente capaz de reduzir a morbilidade e mortalidade no doente crítico. Isto justifica que 37% dos doentes tenham iniciado a técnica antes da confirmação diagnóstica. As indicações e soluto de reposição escolhido foram de acordo com as recomendações. Apesar do risco hemorrágico, nenhuma complicação desta natureza foi reportada. Conclusão: A plasmafere terapêutica é uma técnica complexa que requer treino específico. As indicações são diversas e algumas não consensuais. As complicações foram frequentes, mas não condicionaram morbilidade associada.

Mobile malware are malicious programs that target mobile devices. They are an increasing problem, as seen in the rise of detected mobile malware samples per year. The number of active smartphone users is expected to grow, stressing the importance of research on the detection of mobile malware. Detection methods for mobile malware exist but are still limited. In this paper, we provide an overview of the performance of machine learning (ML) techniques to detect malware on Android, without using privileged access. The ML-classifiers use device information such as the CPU usage, battery usage, and memory usage for the detection of 10 subtypes of Mobile Trojans on the Android Operating System (OS). We use a real-life dataset containing device and malware data from 47 users for a year (2016). We examine which features, i.e. aspects, of a device, are most important to monitor to detect (subtypes of) Mobile Trojans. The focus of this paper is on dynamic hardware features. Using these dynamic features we apply state-of-the-art machine learning classifiers: Random Forest, K-Nearest Neighbour, and AdaBoost. We show classification results on different feature sets, making a distinction between global device features, and specific app features. None of the measured feature sets require privileged access. Our results show that the Random Forest classifier performs best as a general malware classifier: across 10 subtypes of Mobile Trojans, it achieves an F1 score of 0.73 with a False Positive Rate (FPR) of 0.009 and a False Negative Rate (FNR) of 0.380. The Random Forest, K-Nearest Neighbours, and AdaBoost classifiers achieve F1 scores above 0.72, an FPR below 0.02 and, an FNR below 0.33, when trained separately to detect each subtype of Mobile Trojans., Comment: 14 pages content, 22 pages total, to be published in ACM DTRAP (currently in last revision phase)

Purpose To explore the anatomy, etiopathogenesis, diagnosis and classification, current evidence on intervention and the surgical management of orbital roof fractures and defects (ORFD) for oculoplastic surgeons presented with such cases. Methods A review of the current literature through the MEDLINE database using the following search terms: "orbital roof fracture (+treatment/management)," "orbital roof defect (+treatment/management)," "orbital roof erosion (+treatment/management)," "orbital roof repair," "orbital roof," "orbital fracture," "pediatric orbital roof (defect/fracture/erosion)," "orbital anatomy," and "orbital roof anatomy" was conducted. As relatively little has been published on this topic, inclusion criteria were broad and peer-reviewed articles judged to be of clinical importance, relevant to the aims of this review, were included. Non-English abstracts were also included if relevant. Year of publication was not a strict exclusion criterion, and older articles were judged for their suitability based on clinical importance and relevance to current practice. Additional references were obtained from citations in key articles and recommendations from the coauthors based on their areas of expertise. Results The etiopathogenesis of ORFD varies. Classification systems have been formulated to guide management decisions and can range from conservative management to complex neurosurgery. Eyelid approaches have also been described. This review provides a summary of the evidence for each and a management framework oculoplastic surgeons can use when presented with ORFD. Conclusion Oculoplastic surgeons can be involved, either alone or as part of a multidisciplinary team, in the management of ORFD, and for some, conduct orbital approach reconstructive surgery.

Introduction: Calcitonin measurement is important for the diagnosis and monitoring of medullary thyroid carcinoma. Unfortunately, in clinical practice, different detection systems assays are used in the follow-up of the patients, which can be misleading. Objective: To identify the correction factor for calcitonin measurement on two different immunoanalysers: DiaSorin-LiaisonXL (immunochemiluminescence) and CobasE601 (electro-immunochemiluminescence). Methods: We selected 89 registered CT samples (28-from men; 61-from women), that were analysed on CobasE601 with reported values between 0.5 pg/ml and 2812 pg/ml (128.5±513.98). These CT samples were selected randomly to cover as wide a range of values as possible, and represented either basal CT (n=38) or selected from CT stimulation tests (n=51). Samples were evaluated subsequently on DiaSorin-LiaisonXL. All patients gave their informed consent. Results: Between the two assays a segmented linear correlation was noted. We identified the following general linear regression equation: 1.108x+19.337 (p Conclusions: Calcitonin correction factors are highly important in the dynamic follow up of a patient suffering from medullary thyroid carcinoma when different detection systems assays are used to determine calcitonin. We identified the correction factors for calcitonin determination between two different frequently used chemiluminescence immunoanalysers: DiaSorin-LiaisonXL and CobasE601. However, it is strongly advisable to use the same analyser in order to establish biochemical evolution of calcitonin.

Oncological diseases are the most common cause of death worldwide, it is estimated that 25% of the population will face the diagnosis of cancer during life. Phytochemicals such as cannabinoids (CBs) have been used in various branches of medicine for their properties, and the discovery of the anti-tumor, anti-emetic and anti-inflammatory effects of some of these substances has encouraged their use in oncology. Phytocannabinoids, cannabidiol (CBD) and Δ-9-tetra-hydrocannabinol (THC), have numerous anti-emetic, analgesic, orexigenic, anti-inflammatory / immunosuppressive pharmacodynamic effects. In recent years, studies have been aimed at evaluating their efficacy as antineoplastic agents. Much in vivo and in vitro research has demonstrated the efficacy of CBs on certain tumor cell lines, highlighting their potential role in the complementary treatment of cancer. This paper suggests that exploring the molecular mechanisms induced by CBs in cancer cells may contribute to the development of effective treatments in oncological diseases.

Any initial product started from a more or less flexible idea, or a patented idea transposed into a manufactured product. This idea takes a new development following the study of the marketing market, analysis studies and all we need for technological opportunity, outlining at the same time stage by stage the prototype concept. The prototype variant is again subjected to a systemic analysis that defines and optimizes the final product, as well as the technological flow associated with the entire manufacturing process applied on the concept. The paper proposes a synthesis analysis on innovative conceptual design. The case study presented in this paper shows a reserch study applied on the industrial product for which the patent was obtained, respectively a double compartmented thermos container [17].

The new coronavirus pandemic has brought into the light-on top of the strain it put on the medical services around the world-a variety of ethical issues in relation to how the treatment is being administered to the patients. Understanding the priority of treating COVID-19 patients, we still ask ourselves how effective these antiviral/immunomodulatory molecules are recommended by national/international protocols and which is the benefit/risk ratio in different categories of patients. To solve these dilemmas, we present the case of a 36-year-old patient, admitted to our clinic in April 2020, with mild symptomatic SARS-CoV-2 infection. Given the suggestive clinical and paraclinical elements, we recommended treatment with lopinavir/ ritonavir according to national protocol, and we explained to patient the benefits of this treatment, as well as the possible side effects. The patient refused this treatment, but later accepted an alternative therapy, hydroxychloroquine. The evolution of clinical and paraclinical parameters allowed the patient to be discharged after 19 days. This apparently simple and solvable medical case becomes complicated when the patient complained about the violation of her rights and of certain articles from deontological code. Beyond the elements of subjectivism, it is necessary an ethical approach of this problem. After 9 months of pandemics, we can say that some anti-COVID -19 therapies have proven a practical effectiveness and others have been partially invalidated by clinical trials and removed from the guidelines, but can we say every information regarding anti - SARS-CoV-2 medication is absolutely clear or that ethical aspects are solved?

The main objective of inserting dental implants in various clinical situations is to avoid mobile prosthetic restorations or to obtain a better stability. In this way, patients are offered increased comfort and better integration of prosthetic restorations into the stomatognathic complex. The purpose of this case presentation is to highlight a case of complex oral rehabilitation in which the Sky Fast and Fixed system (Bredent GmbH, Senden, Germany) was chosen, in the case of maxillary restoration, thus avoiding a mobile prosthetic restoration. The result demonstrates a superior aesthetic rehabilitation than the initial situation, obtaining a significant improvement from the first treatment session.

The aim of this study was to identify by classification and regression tree (CART) analysis groups of patients with different survival patterns in a population of patients with heart failure and reduced left ventricular ejection fraction (HFrEF) by using standard methods of heart function assessment, as well as well as utilizing non-traditional approaches for determining hydration and nutritional status in HF patients—lung ultrasonography (LUS) and bioimpedance spectroscopy (BIS) analysis. Eligible patients with a left ventricular ejection fraction (LVEF) below 45% were identified via the daily echocardiography assessments. LUS was performed with patients in the supine position, for a total of 28 sites per complete examination. The hydration state and the body composition were assessed using a portable whole-body BIS device. Our study included 151 patients (69.2% males) with a mean age of 67.1 years. During the follow-up 53 (35.1%) patients died. Using the CART algorithm, we identified five groups based on serum sodium, the severity of NYHA class, serum urea and systolic blood pressure. When comparing the two models, the model derived from the CART analysis showed better predictive power than the conventional Cox model (c-index 0.790, 95% CI 0.723–0.857 vs. 0.736, 95%CI 0.664–0.807, p

The more frequent meteorological anomalies and climate changes push us to consider green sustainable energy as a chance to slow down such issues. Thus, we should introspect the correlations between indicators over time and understand the underneath of their meaning. Large volumes of data regarding energy are provided by Eurostat and other official data sources that require data analytics to extract valuable insights from energy indicators and indices to better understand the dynamics towards a green energy transition of the European Union State Members (EU-SM). In this paper, we analyze several energy indicators calculated for a 12-year time span with statistics and machine learning techniques, such as an unsupervised clustering algorithm with Self-Organizing Maps (SOM). Grouping the EU-SM by energy indicators from the beginning years to the end of the analyzed interval reveals differences and similarities in their efforts, shifted trends, influencing power and tendencies towards a green energy transition. The results of our analyses can be further used to assess the efficiency of stimuli for green energy generation and improve the policymakers’ strategies.

The coronavirus disease 2019 (COVID-19) has seen a violent and fast spread worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a predominantly respiratory transmission through droplets and aerosol with serious implications for dental settings. This article is based on recent research, guidelines issued by relevant authorities, as well as on the authors’ experience acquired through their involvement in setting up an emergency dental care hub in Cluj-Napoca, Romania, during the COVID-19 lockdown. The present article aims to provide a brief description of COVID-19 implications in dental office and to recommend preventive protocols for dental practitioners to ensure a safe and healthful workplace. The recommendations for infection control presented in this article address the specific risks of exposure to SARS-CoV-2. The article provides a special customized guideline covering patient triage and entrance into the dental practice, personnel protection, dental treatment, and after-treatment management. The implementation of strict preventive measures has been found to be efficient in the prevention of SARS-CoV-2 contamination because no infections have been reported among our staff or patients. COVID-19 is a major emergency worldwide marked by a rapid evolution and warranting a need for further assessment of the implications of COVID-19 outbreak in dental practice.

The port operation services have developed a specific framework of business processes of which model is commonly defined by the peculiar logistic activities provided for goods handling in stevedoring operations or for storage, stowage, unitization, or processing operations with added value alongside the flow of the supply chain. In the last decades the port services have been enlarged and diversified not only on extensive basis but intensively also, having on its ground new methods of business processes modelling in completion to the updated equipment and technologies. In this context, the port development is calling for a higher level of social and environmental responsibility, the quality management standards becoming very important for a successful business on sustainable development perspective. Due to its excessive diversification, the quality management framework has been considerable diversified, making difficult the recognition of all the required procedures and standards, to be acquired and implemented on different areas of port logistic functions and processes. The authors’ main purpose for this paperwork was to identify and to depict the most relevant processes, actively pursued in the stevedoring operations, as to further draw a synoptic panel of applied quality management standards, in order to serve the sustainable efforts in harmonizing the business practices in compliance with the social, environmental and public responsibility imperatives.

In according with the situation created by the pandemics of the world [4,6,7,8,9,10], the Covid-19 viruses were affected the all fields of activity from the all domains, like as: industrial domains, tourism, commercial, even of the educational system at all levels [1,2]. In this context our university, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, it had to move from the classical educational system to approach of the new online modular system. This forced adaptation presents a lots of problems, especially of the all specializations within the Faculty of Engineering and Information Technology, where there are practical activities that involve laboratories with practical execution they cannot be performed by the online system. After an experience gained of almost 4 months of online activity, more several negative aspects are configured to be analyzed in order to find constructive solutions for optimizing the online educational system [1]. The present paper proposes to identification of a questionnaire addressed for the students as well as to the teachers from the Faculty of Engineering and Information Technology of UMFST “G.E.Palade” of Tg.Mures. Following the analysis of the all results of the questionnaire, the deficiencies of the problems raised by the technical disciplines that require phisicals practical applications in laboratory classes will be identified, respectively new directions for the development of modular online education will be identified representing the only alternative of the onsite classic education in this situation.

This article presents an experimental arrangement which, using 3-D numerical modeling, aims to study biomedical effects using subnanosecond pulsed electric fields (PEFs). As part of a major effort into developing contactless technology, the final aim of this study is to determine conditions of the applied PEFs (number of pulses, strength, pulse repetition frequency) able to produce electropermeabilization. The arrangement uses a pulsed power generator producing voltage impulses with an amplitude of up to 20 kV on a 50- $\Omega $ matched load, with a rise time of 100 ps and a duration of 600 ps. During the preliminary study reported here, samples containing E. Coli were exposed to PEFs in a 4-mm standard electroporation cuvette, allowing the application of a peak electric field strength of up to 60 kV/cm. The studies were facilitated by detailed 3-D electromagnetic modeling of the electric field distribution generated by voltage impulses inside the system. Due to the nature of tests, the numerical analysis played an essential role in the interpretation of results. Preliminary biological results reported in this study are very encouraging, showing that trains of 5000 to 50 000 pulses applied at a pulsed repetition frequency of 200 Hz (maximum PRF) can efficiently induce E. Coli electropermeabilization.

The aim of this study was to produce a prognostic model to help predict posttransplant survival in patients transplanted with grade-3 acute-on-chronic liver failure (ACLF-3). Patients with ACLF-3 who underwent liver transplantation (LT) between 2007 and 2017 in 5 transplant centers were included (n = 152). Predictors of 1-year mortality were retrospectively screened and tested on a single center training cohort and subsequently tested on an independent multicenter cohort composed of the 4 other centers. Four independent pretransplant risk factors were associated with 1-year mortality after transplantation in the training cohort: age ≥53 years (P = .044), pre-LT arterial lactate level ≥4 mml/L (P = .013), mechanical ventilation with PaO2 /FiO2 ≤ 200 mm Hg (P = .026), and pre-LT leukocyte count ≤10 G/L (P = .004). A simplified version of the model was derived by assigning 1 point to each risk factor: the transplantation for Aclf-3 model (TAM) score. A cut-off at 2 points distinguished a high-risk group (score >2) from a low-risk group (score ≤2) with 1-year survival of 8.3% vs 83.9% respectively (P

Objective: To compare HOPE and NRP in liver transplantation from cDCD. Summary of Background Data: Liver transplantation after cDCD is associated with higher rates of graft loss. Dynamic preservation strategies such as NRP and HOPE may offer safer use of cDCD grafts. Methods: Retrospective comparative cohort study assessing outcomes after cDCD liver transplantation in 1 Swiss (HOPE) and 6 French (NRP) centers. The primary endpoint was 1-year tumor-death censored graft and patient survival. Results: A total of 132 and 93 liver grafts were transplanted after NRP and HOPE, respectively. NRP grafts were procured from younger donors (50 vs 61 years, P < 0.001), with shorter functional donor warm ischemia (22 vs 31 minutes, P < 0.001) and a lower overall predicted risk for graft loss (UK-DCD-risk score 6 vs 9 points, P < 0.001). One-year tumor-death censored graft and patient survival was 93% versus 86% (P = 0.125) and 95% versus 93% (P = 0.482) after NRP and HOPE, respectively. No differences in non-anastomotic biliary strictures, primary nonfunction and hepatic artery thrombosis were observed in the total cohort and in 32 vs. 32 propensity score-matched recipients Conclusion: NRP and HOPE in cDCD achieved similar post-transplant recipient and graft survival rates exceeding 85% and comparable to the benchmark values observed in standard DBD liver transplantation. Grafts in the HOPE cohort were procured from older donors and had longer warm ischemia times, and consequently achieved higher utilization rates. Therefore, randomized controlled trials with intention-to-treat analysis are needed to further compare both preservation strategies, especially for high-risk donor-recipient combinations.

Many prognostic factors for HL have been proposed in the past and some of these were included in several prognostic scores. Tumor stage and spread, age, gender and various biological parameters are considered to have an effect on disease evolution, with the prognostic scores stratifying patients into risk groups and guiding the course of treatment. In the present study we have enrolled 54 patients with Hodgkin�s lymphoma admitted in the Hematology Department within the City Emergency Clinical Hospital Timisoara over a 4-year period. We aimed to see if a statistically significant correlation can be made between hemoglobin, white blood cell, lymphocyte, eosinophil, monocyte and platelet levels at the time of diagnosis on the one hand, and response to treatment and patients� survival, on the other hand. Patients� response to treatment was evaluated according to Cheson criteria, with best response to the combination of ABVD(doxorubicin C27H29NO11, bleomycin C55H84N17O21S3, vinblastine C46H58N4O9, dacarbazine C6H10N6O) and radiation therapy. Response to treatment was also influenced by eosinophil levels at diagnosis and this has effects on survival. Finally, lymphocyte and platelet levels at diagnosis correlated with survival times in our study group. Therefore, eosinophil, lymphocyte and platelet levels at diagnosis could be considered as prognostic factors for HL, although further studies are needed to validate our findings.

Air pollution is a serious problem in many heavily populated and industrialized areas in the world. It affects vegetation, and also human health. The diversification of emission sources, among them vehicles, industrial processes, waste burnings and fuel storage, creates zones with different species and concentrations of air pollutants. In this paper was studied the excessive accumulation of toxic metals such as Al, Cr, Ni, Zn, Pb in vegetation as a risk factor for ecosystem and also for human health. The purpose of the study was to establish an optimal method of determination for toxic elements accumulation in leaves, using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). These results made to suppose that, visible and analyzed responses of in in-situ exposed bio monitors compared with heavy metal accumulation depended on the atmospheric situation during the period of exposure, which could assess the efficiency of biomonitoring programs in the region. The advantage of this study consists in new and appropriate approach using a friendly methodology for air monitoring and favoring the development of a circular and sustainable economy.

The paper proposes the presentation of some aspects for the development of a mini-education campaign and especially for raising the awareness of the rural population about the initiative that needs to be taken from the lower level - of the individual households - to stop the degradation of the essential elements of life and the development of the activities human beings in the perspective of sustainable development. The case study presents the results of a questionnaire applied in the rural area in order to establish a strategy for the management of rural waste.

The present paper is a comparative study at a local level and the respondents are students studying engineering at the University of Medicine, Pharmacy, Science and Technology of Târgu Mureș and who would like to have a career in the technical field. Soft skills are increasingly important for the recruiter. In addition to technical subjects, there is a need for other subjects as well which could develop the students’ communication skills, teamwork, leadership and empathy. During the communication courses of the 2018-2019 academic year, the authors attempted to introduce new teaching methods so that students could develop different abilities within the instrumental, interpersonal or systemic competences. The purpose of this study is to identify how the situation improved as compared to previous year’s results. An important element of this study is the fact that the applied questionnaires also represented a way to make young people aware that communication can be taught, that it is a basic element in any interview, but also in later promotions in a company.

The electrode erosion and lifetime performance of a compact and repetitively triggered field distortion spark gap switch were studied at a repetitive frequency rate of 30 Hz, a peak current of 8.5 kA, and a working voltage of ±35 kV when the switch was filled with a gas mixture of 30% SF6 and 70% N2 at a pressure of 0.3 MPa. The variations of the time-delay jitter and the self-breakdown voltage were both studied for the whole service lifetime of the spark gap switch. The morphology of both the electrodes and the plate insulator, before and after the service lifetime tests, is also analyzed. The results show that during these tests, the time-delay jitter is basically synchronized with the self-breakdown voltage jitter, and both undergo firstly a process of rapidly decreasing their values, then remaining stable, and finally and gradually increasing after 70 000 pulses. The change in the electrode surface roughness (i.e., surface profile) is caused by erosion and chemical deposits in the switch cavity, which are mainly the two factors that affect the time-delay jitter of the switch. Tip protrusions on the electrode surface, due to electrode erosion, contribute to reducing the time-delay jitter. However, due to chemical reactions, fluorides and sulfides are deposited on the switch components, as well as metal particles caused by electrode erosion sputtering. Slowly, after a large number of shots, all these phenomena affect the self-breakdown performance resulting in an increased self-breakdown voltage jitter, which also causes the time-delay jitter to increase. Although there are a number of reasons that contribute to the deterioration of the performance of the switch, it is fortunate that if a switch suffering a degraded performance is reassembled, with the electrodes mechanically polished and all the components cleaned, the optimal performance of the switch can be restored. If maintenance work is carried out regularly to preserve the condition of the switch’s inner components, the service lifetime of the switch can be prolonged.

Starting from one of the main objectives of constitution of Oradea Metropolitan Area (O.M.A.) namely to ensure the continuous increase of live quality, the aim of the study is the highlight and analysis of high value natural resources, natural reserves and Natura 2000 sites and also to ensure the quality of environmental factors for the touristic use. The importance of protection and conservation of some natural elements also results from the fact that the surface of natural reserves within O.M.A. increases from 6.25% of overall surface of natural reserves of Bihor county, prior the integration in the E.U., to 24.3% after the European integration, after the implementation of Natura 2000 ecological network. One can identify nine Natura 2000 sites within O.M.A., which includes two SPA and seven SCI sites. The analysis of the environmental factors (air, surface and underground waters) shows that the physical and chemical parameters are within the legal range without threatening the communities and the natural resources with touristic potential.

Introduction. Approximately 12 million children die every year in developing countries and one third of these deaths are caused by pneumonias. The assessment of radiological changes in dynamics owns a major role in establishing the diagnosis of staphylococcal pneumonia. The aim of this paper was to underline the diagnostic and treatment difficulties in a child with staphylococcal pneumonia. Case report. We present the case of a 2 years and 6-month-old male patient admitted in our clinic for hyperpyrexia, productive cough, rhinorrhea and anorexia. The clinical exam at admission pointed out influenced general status, pale ailing face, pallor, fever, productive cough, rhinorrhea, diminished breath sound on the right side, oxygen saturation 97% and anorexia, while de blood tests revealed severe leukocytosis with neutrophilia, anemia, and severely increased inflammatory biomarkers. The chest X-ray showed an opacity within the right inferior lobe. The blood culture was negative. We initiated symptomatic and antibiotic treatment (Ceftriaxone), but due to the unfavorable evolution, the control chest X-ray showed a consolidation area within the right inferior lobe and secluded basal pleural effusion as well as on the right lateral side. We performed also a chest computed tomography (CT), noticing a pneumonic process within two segments of the inferior right lobe, several grouped pneumatocele below the pleura, associating within both lungs areas of lobular hyperinflation. Thus, we raised the suspicion of staphylococcal pneumonia, and we initiated Vancomycin by vein, with favorable evolution. Conclusions. Staphylococcal pneumonia is a well-defined and described pathology in the literature, but still remains a contemporary pathology imposing multiple difficulties related to the diagnosis and management in pediatric patients.

This paper presents a synthesis of research carried out by authors on local materials used in construction over time in South Eastern Romania. The earth in various forms and technologies has been a perfectible building material that by technologies and specific procedures confers resistance and structural stability. For the research the authors have selected a few specific types of buildings detailing on structural compliance, their sustainability and the factors that led to the depreciation of the building.

International audience; Powerful subsonic underwater discharges are used as a tool in various industrial applications. The aim of this article is to find the essential design parameters required for a pulsedpower system to efficiently drive such discharges. Using different capacitor banks and electrode geometries, a large number of studies were conducted in an effort to better understand the phenomenology of the discharge. Without developing a numerical model for the underwater plasma discharge, the phenomenological studies clearly demonstrated that the maximum pressure that can be generated depends on the discharge current, the distance between the electrodes, and the characteristic time of the discharge. The results of this work will allow the design of efficient pulsed-power-driven strong pressure impulse systems.

Simple Summary Prostate cancer (PCa) represents a very important health problem worldwide. Used as the main screening method for almost four decades, PSA (Prostate Specific Antigen) has proven its limitations. In this review, the authors try to make an evaluation of the biomarkers commercially available and used to improve the PCa detection in patients with elevated PSA. The authors also present the current PCa screening and diagnosis protocols in Romania. Abstract The prostate is one of the most clinically accessible internal organs of the genitourinary tract in men. For decades, the only method of screening for prostate cancer (PCa) has been digital rectal examination of 1990s significantly increased the incidence and prevalence of PCa and consequently the morbidity and mortality associated with this disease. In addition, the different types of oncology treatment methods have been linked to specific complications and side effects, which would affect the patient’s quality of life. In the first two decades of the 21st century, over-detection and over-treatment of PCa patients has generated enormous costs for health systems, especially in Europe and the United States. The Prostate Specific Antigen (PSA) is still the most common and accessible screening blood test for PCa, but with low sensibility and specificity at lower values (

Background: Bladder cancer (urothelial cancer of the bladder) is the most common malignancy affecting the urinary system with an increasing incidence and mortality. Mouse models of bladder cancer should possess a high value of reproducibility, predictability, and translatability to allow mechanistic, chemo-preventive, and therapeutic studies that can be furthered into human clinical trials. Objectives: To provide an overview and resources on the origin, molecular and pathological characteristics of commonly used animal models in bladder cancer. Methods: A PubMed and Web of Science search was performed for relevant articles published between 1980 and 2021 using words such as: “bladder” and/or “urothelial carcinoma” and animal models. Animal models of bladder cancer can be categorized as autochthonous (spontaneous) and non-autochthonous (transplantable). The first are either chemically induced models or genetically engineered models. The transplantable models can be further subclassified as syngeneic (murine bladder cancer cells implanted into immunocompetent or transgenic mice) and xenografts (human bladder cancer cells implanted into immune-deficient mice). These models can be further divided—based on the site of the tumor—as orthotopic (tumor growth occurs within the bladder) and heterotopic (tumor growth occurs outside of the bladder).

International audience; In France, the program of controlled donation after circulatory death (cDCD) was established with routine use of in situ normothermic regional perfusion (NRP). There is currently no consensus on its optimal duration. The purpose was to assess the impact of NRP duration on liver graft function and biliary outcomes. One-hundred and fifty-six liver recipients from NRP-cDCD donors from six French centers between 2015 and 2019 were included. Primary endpoint was graft function assessed by early allograft dysfunction (EAD, according to Olthoff's criteria) and MEAF (model for early allograft function) score. Overall, three (1.9%) patients had primary non-function, 30 (19.2%) patients experienced EAD, and MEAF score was 7.3 (+/- 1.7). Mean NRP duration was 179 (+/- 43) min. There was no impact of NRP duration on EAD (170 +/- 44 min in patients with EAD vs. 181 +/- 42 min in patients without, P = .286). There was no significant association between NRP duration and MEAF score (P = .347). NRP duration did neither impact on overall biliary complications nor on non-anastomotic biliary strictures (overall rates of 16.7% and 3.9%, respectively). In conclusion, duration of NRP in cDCD donors does not seem to impact liver graft function and biliary outcomes after liver transplantation. A 1 to 4-h perfusion represents an optimal time window.

The environmentally friendly concept in terms of water quality represents a condition for developing hydropower plants all around the world. Since 2017, hydropower has represented more than 70% of all renewable energy production and it is essential for the integration of the other renewable sources of energy and for regulation of the grid. To maintain the “green” label concerning the dissolved oxygen level (6 mg DO/L), the energy suppliers should respond to environmental concerns about the operation of hydropower plants. In the context of sustainable development, the ecological degradation of rivers is unacceptable due to the implementation of a hydropower plant on the watercourse. For deep reservoirs or tropical regions, the oxygen level in the water downstream of the hydropower plants may be low and affect the aquatic life for many kilometers downstream. This paper presents a new aeration system for discharged water from hydropower plants that provides water aeration with minimum energy consumption. The influence of the aeration process on the turbine operation and efficiency is analyzed. Experimental measurements are carried out on site on a small Francis turbine. The influence of the aeration process on the turbine mechanical performances (vibration level and relative displacement) and hydraulic performances (turbine efficiency, power output, and pressure fluctuation) is analyzed. The results showed that the impact of the aeration device implementation and operation over the energetic characteristics of the turbine is in the efficiency measurements accuracy range. The aeration through this device did not influence the turbine operation (vibration, level, or pressure fluctuations).

Background Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of stroke, negatively affecting the patient's functional recovery and the quality of life. While pharmacological therapy has limited efficacy and important side effects, new appropriate treatments based on specific physiological mechanisms for PSD remain to be developed. Non-invasive brain stimulation (NIBS) techniques, modulating brain plasticity, might offer valid, alternative strategies. Methods We systematically searched four databases: MEDLINE, PsycARTICLES, PsycINFO and Web of Science, up to December 2017, using definite keywords, to identify studies on TMS and tDCS treatment for PSD. Results Seven studies met the inclusion criteria and the results indicate that both tDCS and rTMS are safe and have very low side effects. The reported positive results, suggesting that these methods can be considered effective therapeutic options, are questionable, and a general statement about their efficacy for PSD is premature due to small sample sizes, heterogeneous methodologies, lack of uniform diagnostic criteria, and divergent data. Limitations The selected articles suffer lack of information about quality of life and daily living performance measures; in addition, the number of randomized controlled trials is small. Conclusion (s) The aim of this review was to analyze current research in the clinical use of noninvasive brain stimulation (NIBS) in PSD treatment in order to verify whether there are alternative perspectives in the treatment of PSD. Given the present evidence, future research is needed to address methodological limitations and evaluate the long-term efficacy of these methods, alone and in combination with pharmacological treatment.

In order to develop a sustainable economy based on the efficient use of green energy resources, it is necessary to research and innovate systems such as wind turbines. In this paper, a new configuration for vertical axis wind turbines was proposed and numerically analyzed using CFD methods. The concept is based on solving the starting problem of lift-based vertical axis wind turbines. The new concept consists of three blades with different chords, arranged at different radii so that the interaction between the blades is reduced and the operation in the vortex wake is minimal, thus reducing the losses. Through comparing a classic case of an H-Darrieus wind turbine with the new concept, not only were satisfying results regarding the blade-to-blade interaction presented, but an increased efficiency of up to 10% was also observed. Among the presented results is the variation of the vorticity magnitude at different positions of the blades, thus, the concept’s blade-to-blade interaction is reduced. Conclusions drawn after the investigation are in favor of the proposed geometry and the concept should be pursued further.

Cutaneous basosquamous carcinoma is a variant of basal cell carcinoma that is characterized by histopathological features of both basal and squamous cell carcinoma. Due to its local invasiveness, high frequency of recurrence, and its metastatic potential, it is considered to be one of the most aggressive subtypes of basal cell carcinoma. We present the case of an 81-year-old male who was admitted to the hospital with incessant hemorrhage arising from a cutaneous tumor that later proved to be a basosquamous carcinoma. Due to the COVID-19 pandemic at the time, the patient did not seek medical attention as soon as the bleeding was observed, although he did present when the symptom increased in intensity and became incessant. To our knowledge, this is the first case report of a cutaneous basosquamous carcinoma that presents with a massive life-threatening hemorrhage tumor, thus endangering the patient's life. The clinical and histopathological features, the behavior and the treatment of cutaneous basosquamous carcinoma are further reviewed in this article.

Psoriasis is an immune-mediated chronic inflammatory skin disease with extracutaneous manifestations, that affects about 1–3% of the world’s population. The disease is not life-threatening, but the disability which comes with it is comparable to the disability caused by other serious chronic diseases, such as oncologic or cardiovascular disease. Several risk factors, such as infections, stress, smoking, excessive alcohol consumption and genetic predisposition have been involved in inducing psoriasis. Smoking status is a risk factor for many chronic diseases, including psoriasis. Moreover, recent studies have tried to answer the question of whether smoking also influences the response to biologic therapy in patients with psoriasis. Through the current study, our intention is to find out how smoking affects the response to biologic treatment. A hospital-based cross-sectional, observational, non-interventional, retrospective study of moderate and severe psoriasis patients receiving biologic treatment was developed. Two groups were defined based on smoking status: group 1 included smokers (more than 10 cigarettes/day) and former smokers, and group 2 included non-smokers. The data that resulted from the analysis of the cohort of patients demonstrate that smoking status does not affect the response of biologic therapy in patients with moderate and severe psoriasis.