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The work is structured on 5 parts. In the first part it is made reference to the theme's actuality in terms of the necessity to apply the technical diagnosis to the electric power transformers in order to ensure the corresponding level of electricity supply service. Onwards, it is specified the set of stress and state indicators, by presenting the calculation relations proposed by the authors for the stress indicators' assessment. The third part contains the model proposed for being used in order to assess the exceeding risk of normal values by the two sets of sizes. In the fourth part it is presented a synthesis of the obtained results, and in the last part the conclusions of the analysis are rendered. [ABSTRACT FROM AUTHOR]

This paper focuses on short-term forecast of electricity consumption of the industrial consumers using artificial neural networks. The paper is divided into six parts. The first part presents an introduction of the problem analysed. In the second part we present the database containing time series, with hourly average power of the analysed consumers. The following two parts contain a description of the programming environment, and that of the model used. Based on forecasts, conclusions are drawn in the paper. [ABSTRACT FROM AUTHOR]

The paper work puts grounds and gives details of the analysis regarding the environment impact of the thermal energy management systems of the urban centers. After presenting the high actuality context, it is presented succinct the characteristics that define the system which is the object of the studied case - the thermal energy management system (TEMS) of Oradea Municipality (OM). In order to stabilize the TEMS structure it is proposed to be applied an optimization model having the function to minimize the costs of producing thermal energy (TE) from primary resources (PR) accessible in the area and having as restrictions the environment impact, as in the maximum availability of the PR. Starting with the three possible scenario for the TEMS of the urban centers (centralized, decentralized and individual) and taking into account the reality of the TEMS analysis, in the paper work are given 8 plausible options of evolution in the next 20 years of TEMS of OM. The comparative analysis of the 8 versions it is made with taking into account the following: the environmental impact evaluated by the quantity of emissions, the TE production evolution and electric energy (EE), the global price of the penalization given by the emissions, the proportion: global environment impact/ total produced energy. The results reflect clear options of evolving of TEMS and provide the specialists with an approach methodology and a way of treating the evolving of TEMS so that it can obtain the structural and functional optimization of TEMS, at the same time with reducing the environment impact. [ABSTRACT FROM AUTHOR]

The paper has a structure in four parts. In the first part is justified the concern of the authors regarding the electric energy audit (EEA). In the second part are presented the synthesis of the work style in elaboration of EEA at S.C. CELESTICA ROMÂNIA S.A. The third part contains the synthesis of the results, as in the last part are given the conclusions obtained from analyzes. [ABSTRACT FROM AUTHOR]

The study synthetically presents the advantages that it has, in certain conditions, the solution of district heating compared to individual heating. To describe the energetic efficiency of these two heating solutions, a calculus of the global energetic efficiency is presented. The result of these calculations, processed in graphic form, reflects the cases which the adoption of district heating system is justified, a system in which the production of thermal and electric energy is realized in cogeneration. [ABSTRACT FROM AUTHOR]

The paper is structured in five parts. The first part studies the global and national framework of development of renewable energy sources. Part two contains the map of renewable energy potential on four components (solar, wind, geothermal and biomass) and the resulting map. The third part is intended to describe the technical solution of a solar geothermal solar hybrid system proposed by the authors to supply with heat the consumers in areas that have the two primary sources of energy. Part Four presents the results of the technical-economic analysis conducted with regard to the version of application of the geothermal solar hybrid system and the last part presents the conclusions of the analysis. [ABSTRACT FROM AUTHOR]

The paper gives a summary of operational reliability results carried out on medium voltage equipment (MVE) that are in Brasov SDEE management. The paper is structured in four parts. In the first part is made a brief presentation of MVE that are in Brasov SDEE . The second part present the important elements that characterize the MVE operational reliability study. Part three summarizes synthetical the results of the analysis. It presents the values of the MVE operational reliability indicators in the period under review (2003-2010). The comments are about defects types, number of events and their hierarchy. The last part presents the conclusiond of the analysis. [ABSTRACT FROM AUTHOR]

This paper presents an improved mathematical model, to calculate power and energy losses within asynchronous machine(ASM) which operates in harmonic regime(HR) and respectively the simulations done on presented model basis on technological lines(TL) composed by asynchronous motors with known characteristics, made in Romania. After a brief review of some aspects regarding operation of ASM in HR, in the second part of the paper is presented the algorithm and mathematical model applied on energetic performances simulation of ASM which operates in HR. The third part presents the result of simulations done based on mathematical model to a known structure power consumer, respectively S.C. „CONGIPS" S.A. from city of Oradea. The last part of the paper expresses the resulted conclusions of the analysis. [ABSTRACT FROM AUTHOR]

The work is structured on 5 parts. In the first part it is made reference to the theme's actuality in terms of the necessity to apply the technical diagnosis to the electric power transformers in order to ensure the corresponding level of electricity supply service. Onwards, it is specified the set of stress and state indicators, by presenting the calculation relations proposed by the authors for the stress indicators' assessment. The third part contains the model proposed for being used in order to assess the exceeding risk of normal values by the two sets of sizes. In the fourth part it is presented a synthesis of the obtained results, and in the last part the conclusions of the analysis are rendered. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the presence and distribution of calcium pyrophosphate (CPP) deposits in joints commonly affected by CPP deposition (CPPD) disease (acromio-clavicular, gleno-humeral, wrists, hips, knees, ankles, and symphysis pubis joints) using ultrasound (US)., Material and Methods: Thirty consecutive patients fulfilling McCarty diagnostic criteria for CPPD were consecutively enrolled in the study. The data registered using the US included the affected joints, the calcification site, and the pattern of calcification (thin hyperechoic bands, parallel to the surface of the hyaline cartilage, hyperechoic spots, and hyperechoic nodular or oval deposits). The presence of CPP crystals in knees was confirmed by polarized light microscopy examination of the synovial fluid and radiographs of the knees were performed in all patients., Results: In 30 patients, 390 joints were scanned, (13 joints in every patient). The mean±standard deviation number of joints with US CPPD evidence per patient was 2.93±1.8 (range 1-9). The knee was the most common joint involved both clinically and using US examination. The second US pattern (with hyperechoic spots) was the most frequent. Fibrocartilage calcifications were more common than hyaline calcification. Using radiography as reference method, the sensitivity and specificity of US for diagnosis CPPD in knees was 79.31%, 95CI(66.65%-88.83%), and 14.29%, 95CI(1.78%-42.81%), respectively., Conclusions: The knee is the most frequent joint affected by CPPD. The second ultrasound pattern is the most common. CPPD affects the fibrocartilage to a greater extent than the hyaline cartilage.

The paper has a structure of four parts. In the first part is justified the concern of the authors regarding the electric energy audit (EEA). In the second part are specified the Al alloy moulding machines that make the contour of the EEA. The third part contains a synthesis of the results, and in the last part are given the conclusions obtained from analyses [ABSTRACT FROM AUTHOR]

The paper has a structure of four parts. In the first part is justified the concern of the authors regarding the electric energy audit (EEA). In the second part are specified the entities and the work style in elaboration of EEA for an energetic consumer that produces pieces made of aluminium alloy. The third part contains the synthesis of the results, as in the last part are given the conclusions obtained from analyzes. [ABSTRACT FROM AUTHOR]

The paper is structured in five parts. In the first part is presented the actual state of preoccupations, principles and hypothesis applied by the authors, to evaluate the electric distribution networks efficiency (EDN). In the second part is presented the mathematical model for evaluation of the distortion and non-symmetrical regime (DNSR) its impact on the energetic performances of the electric transformer - that is the main equipment of EDN. The measurement in EDN and DNSR, viewing the affects of the power performances, makes the third part of the paper. There are denoted the mathematical absolute and relative values, of EDN efficiency in DNSR toward the reference regime (RR). In the fourth part are presented the results of the researches as well as the conclusions. [ABSTRACT FROM AUTHOR]

The paper is structured in five parts. In the first part is presented the specific issues of risk level evaluation. Part two consists of a bibliographical summary regarding the electromagnetic field (EMF), emphasizing EMF with industrial frequency. In the third part is given the methodology proposed and applied by the authors to make an assessment of risk level at which is exposed the human body in EMF. The fourth part includes the results summary, referring on the measured magnitudes and the values of risk level obtained by applying the proposed models. The results refer at two case studies conducted by the authors in public domain [ABSTRACT FROM AUTHOR]

The paper is structured in five parts. In the first part is evoked the importance of the topic and current concerns. In the second part are presented the general pattern of reliability of the relay - the core of the protection subsystems (SSP). In part three are presented the models for evaluation of the proposed development of the reliability of the SSP, based on the general model, given the structure of the SSP and their functions in urban medium voltage electrical networks (UMVEN). In part four are given the results of operational reliability evaluation for SSP as in the last part of the analysis the conclusions are presented [ABSTRACT FROM AUTHOR]

The paper is structured in five parts. The first part is evoked the importance of the topic and current concerns. In the second part are presented the general pattern of reliability of the relay - the core of the automation subsystem (SSA). In the third part are given the models for the proposed development reliability evaluation in SSA, based on the general model, for a given structure of SSA and their functions in urban medium voltage electric networks (UMVEN). In part four are given the results of operational reliability evaluation for SSA as in the last part of the analysis the conclusions are presented. [ABSTRACT FROM AUTHOR]

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A 46-year-old female patient presented with photosensitivity, symmetric arthritis, episodic plantar pain and strikingly redundant plantar skin folds, likely due to lipoatrophy after recurrent episodes of plantar panniculitis. In this context, leukopenia with lymphopenia, thrombocytopenia and positive antinuclear antibodies were revelatory for systemic lupus erythematosus. However, a small cerebriform plantar collagenoma, along with discrete dysmorphic features with downslanting palpebral fissures and mild right ptosis, second and third syndactyly and a larger first right toe since childhood, and early-onset bilateral ovarian cystadenoma, suggested a minimal Proteus syndrome. Genetic confirmation could not be performed. As adipose tissue dysregulation may be a feature of Proteus syndrome, the possible mechanisms leading to localized lipoatrophy in this setting are discussed. This case enlights intriguing links between adipogenesis, inflammation and dysmorphology. From a practical point of view, finding and treating an over-imposed inflammation could help limit damage in a hamartomatous syndrome.

Background: Recent research suggests that biomarkers may be useful in assessing disease activity, structural damage, and response to therapy in axial spondyloarthritis (axSpA). Our study aims at evaluating the relationship between inflammation and bone remodeling markers and variables assessing disease activity and functional disability in patients with axSpA., Methods: Serum levels of sclerostin, matrix metalloproteinase-3 (MMP-3), interleukin-17 (IL-17), and IL-23 were measured in 60 patients with axSpA and 20 healthy controls. Disease activity was evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Functional status was assessed by Bath Ankylosing Spondylitis Function Index (BASFI) and measures of spinal mobility., Results: Sclerostin levels were more elevated in axSpA patients with high disease activity than in those with low disease activity and in controls. They were significantly correlated with BASFI values (r = 0.29, p = 0.03) and measures of spinal mobility, but not with the classical markers of disease activity (BASDAI, ASDAS, CRP, and ESR). Although both MMP-3 and IL-17 levels were elevated in patients with active disease, they were not correlated with markers of disease activity or with functional disability. The levels of sclerostin, MMP-3, IL-17, and IL-23 were similar in axSpA patients and healthy controls., Conclusions: Elevated levels of sclerostin, MMP-3, and IL-17 were observed in axSpA patients with active disease, suggesting their potential role in assessing disease activity. In axSpA patients, sclerostin levels might be equally influenced by inflammation and level of physical activity. Further studies are required to confirm our findings in order to understand their clinical value.

Background: Our aim was to investigate the prevalence and clinical relevance of inherited complement and antibody deficiency states in a large series of patients with various autoimmune rheumatologic diseases (ARD) with juvenile onset., Methods: A total number of 117 consecutive patients from 2 tertiary referral hospitals were included in the study. All patients underwent genetic screening for type I C2 deficiency and C4 allotyping. Serum levels of immunoglobulin classes measured systematically throughout their regular medical care were recorded retrospectively., Results: Our cohort of patients included 84 with juvenile idiopathic arthritis (JIA), 21 with systemic lupus erythematosus (SLE), 6 with systemic vasculitis, 2 with juvenile scleroderma, 2 with idiopathic uveitis, 1 with mixed connective tissue disease and 1 with SLE/scleroderma overlap syndrome. We have found 16 patients with evidence of primary immunodeficiency in our series (13.7%), including 7 with C4 deficiency, 5 with selective IgA deficiency, 3 with C2 deficiency and 2 with unclassified hypogammaglobulinemia (one also presented C4D). Of the 84 patients with JIA, 4 (4.8%) had a complement deficiency, which was less prevalent than in the SLE cohort (23.8%), but all of them have exhibited an aggressive disease. Most of our patients with primary antibody deficiencies showed a more complicated and severe disease course and even the co-occurrence of two associated autoimmune diseases (SLE/scleroderma overlap syndrome and SLE/autoimmune hepatitis type 1 overlap)., Conclusions: Our findings among others demonstrate that complement and immunoglobulin immunodeficiencies need careful consideration in patients with ARD, as they are common and might contribute to a more severe clinical course of the disease.

This paper examines how two techniques of the Particle Swarm Optimization method (PSO) can be used to solve the Economic Power Dispatch (EPD) problem. The mathematical model of the EPD is a nonlinear one, PSO algorithms being considered efficient in solving this kind of models. Also, PSO has been successfully applied in many complex optimization problems in power systems. The PSO techniques presented here are applied to three case studies, which analyze power systems having four, six, respectively twenty generating units. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to compare and correlate US evaluation with clinical scores of the disease activity in patients with rheumatoid arthritis (RA) and concomitant fibromyalgia (FM)., Material and Methods: Ten patients diagnosed with RA according to the 2010 ACR/EULAR classification criteria and associated FM based on the ACR 1990 classification criteria and two control groups, one with RA (10 patients) and one with FM (10 patients), were included. Clinical assessment was performed and the disease activity scores were calculated. Synovial/tenosynovial hypertrophy, fluid collections in grey scale (GS), and Power Doppler (PD) US assessed by US in the 28 joints included in the disease activity score 28 (DAS28)., Results: GS US score and PD US scores were correlated with DAS28 only in patients with RA (Pearson r coefficients 0.3 and 0.5). Mean DAS28 score was significantly higher in the RA/FM group, compared to RA and FM (5.6 versus 4.6 versus 4.5, respectively). Patients with RA/FM had similar median US scores to RA patients, while in FM group significantly lower median US scores were detected (16 versus 9.5 versus 0 for GS US and 3.5 versus 1.5 versus 0 for PD US, respectively)., Conclusions: Disease activity scores should be interpreted with caution in patients with RA and FM. When available, US should be used to guide treatment decisions in patients with RA and FM.

Aim: To evaluate the metacarpophalangeal (MCP) joints (MCP2 and 5) in healthy subjects by ultrasonography (US) using a high frequency transducer (18 MHz) and to verify the interobserver agreement., Material and Methods: We enrolled 50 healthy volunteers (37 women, age between 30-58 years, mean age 41.7 years, divided into 3 groups according to age: 30-39, 40-49, and 50-58 years). The subjects were successively evaluated by 4 rheumatologists: 2 experienced (team A) and 2 beginners (team B) in US. Seven dorsal and palmar longitudinal scanning positions and a supplementary scan for MCP cartilage were performed. The bone surface (erosions, osteophytes), the intra-articular content (synovial thickening and vascularization, 4 grade scale), and the aspect of the metacarpal head cartilage were analyzed. The anterior palmar recess was measured. The time for examination was recorded., Results: Erosions were detected in 7% of joints by team A and 2% by team B (p<0.05, kappa agreement 0.567) in subjects over 40 years. The agreement by team A in the detection of the erosions was very good (kappa value 0.83). A moderate positive correlation was obtained between the presence of erosions and age (r= 0.401, p=0.004). Osteophytes were identified only on the dorsal scan in subjects over 50 years (in 3.5% of joints team A, 1.5% team B, p>0.05, kappa value 0.421). No grade 1 synovitis was observed by team A but 4 joints with grade 1 synovitis were identified by team B (p<0.05) from the dorsal scan. The dimensions of the palmar recess had large distribution (MCP 2 between 0.55-1.3 mm; MCP 5 between 0.6-1.2 mm). No statistical significant differences were obtained when comparing the dimensions of the two hands, the values obtained in age-groups (all p>0.05). No statistical significant correlations were obtained between the dimensions of palmar recess and the body mass index or dominant hand (all p>0.05). No pathological findings were found in the examination of the metacarpal head cartilage. Power Doppler investigation found the presence of grade 1 signal in 2.5% joints by team A and 1.5% by team B (p>0.05) only in the dorsal scans. The mean time for examination was 7.8+/-1.74 min in team A and 13.78+/-2.96 min in team B (p<0.05)., Conclusions: In healthy subjects pathological findings are occasionally encountered, especially erosions and osteophytes. Using an 18 MHz transducer the aspect of grade 1 synovitis was not encountered in healthy non-inflammatory MCP joints. There is a permanent need for standardized training and examination in musculoskeletal US.

This paper navigates the critical role of hydrogen in catalyzing a sustainable energy transformation. This review delves into hydrogen production methodologies, spotlighting green and blue hydrogen as pivotal for future energy systems because of their potential to significantly reduce greenhouse gas emissions. Through a comprehensive literature review and a bibliometric analysis, this study underscores the importance of technological advancements, policy support, and market incentives in promoting hydrogen as a key energy vector. It also explores the necessity of expanding renewable energy sources and international cooperation to secure a sustainable, low-carbon future. The analysis highlights the importance of scalable and cost-effective hydrogen production methods, such as solar-thermochemical and photo-electrochemical processes, and addresses the challenges posed by resource availability and geopolitical factors in establishing a hydrogen economy. This paper serves as a guide for policy and innovation toward achieving global sustainability goals, illustrating the essential role of hydrogen in the energy transition. [ABSTRACT FROM AUTHOR]

Systemic sclerosis is a systemic connective tissue disease whose main pathophysiological mechanism is a progressive fibrosis of internal organs and skin leading to thickening and induration. Blood vessels may also be involved. However, systemic scleroderma is not the only disease causing cutaneous sclerosis. There is a group of diseases that mimic scleroderma in their clinical presentation - these are scleroderma-like syndromes. A distinction can be made between syndromes of inflammatory/autoimmune, genetic, metabolic, toxic, drug-induced, occupational, paraneoplastic and syndromes caused by deposition disorders. In the following paper, we have reviewed the literature on scleroderma-like syndromes. We have outlined the factors predisposing to the development of each disease, its pathogenesis, clinical presentation, diagnostic and treatment process and the differences between each syndrome and systemic scleroderma. [ABSTRACT FROM AUTHOR]

This study presents a comprehensive analysis of utilizing TensorFlow Lite on mobile phones for the on-edge medical diagnosis of lung diseases. This paper focuses on the technical deployment of various deep learning architectures to classify nine respiratory system diseases using X-ray imagery. We propose a simple deep learning architecture that experiments with six different convolutional neural networks. Various quantization techniques are employed to convert the classification models into TensorFlow Lite, including post-classification quantization with floating point 16 bit representation, integer quantization with representative data, and quantization-aware training. This results in a total of 18 models suitable for on-edge deployment for the classification of lung diseases. We then examine the generated models in terms of model size reduction, accuracy, and inference time. Our findings indicate that the quantization-aware training approach demonstrates superior optimization results, achieving an average model size reduction of 75.59%. Among many CNNs, MobileNetV2 exhibited the highest performance-to-size ratio, with an average accuracy loss of 4.1% across all models using the quantization-aware training approach. In terms of inference time, TensorFlow Lite with integer quantization emerged as the most efficient technique, with an average improvement of 1.4 s over other conversion approaches. Our best model, which used EfficientNetB2, achieved an F1-Score of approximately 98.58%, surpassing state-of-the-art performance on the X-ray lung diseases dataset in terms of accuracy, specificity, and sensitivity. The model experienced an F1 loss of around 1% using quantization-aware optimization. The study culminated in the development of a consumer-ready app, with TensorFlow Lite models tailored to mobile devices. [ABSTRACT FROM AUTHOR]

Alkaptonuria is a rare disease with autosomal recessive inheritance and variable expression. The weight-bearing joint involvement and spondylitis-like vertebral changes occur only after the 3rd decade. Musculoskeletal ultrasonographic findings in alkaptonuria were only rarely described, consisting mainly into enthesopathy and non-synovial tendon degeneration. We present the case of a 50 years old man with alkaptonuria and discuss the ultrasonographic findings and the relationship of the disease with chondrocalcinosis. The tendinous and synovial aspect may be peculiar and it could therefore allow recognition and screening for alkaptonuria, along with clinical and radiologic data.

Objective: The present study aimed to assess the role of ultrasound (US) in the rapid classification of early rheumatoid arthritis (RA) by investigating whether the US features of inflammation and bone damage in early arthritis overlap with the actual clinical concept of classifying and identifying an aggressive disease., Methods: Patients with recent-onset arthritis of at least 1 peripheral joint of the hands and/or the feet were consecutively included in this study. Clinical examination, laboratory tests, the Disease Activity Score 28 (DAS28), and the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for RA were assessed for all patients. Medication with disease-modifying antirheumatic drugs was recorded. Ultrasound assessment was performed at the following anatomical sites: wrists, metacarpophalangeal joints 2 to 5, and metatarsophalangeal joints 2 to 5 for assessing the presence/absence of synovial hypertrophy, the presence/absence of power Doppler signal, and the presence/absence of bone erosions.The US features of inflammation and bone damage were analyzed in comparison with the DAS28, with the presence/absence of rheumatoid factor and anti-cyclic citrullinated peptide, with the fulfillment of the new 2010 ACR/EULAR classification criteria, and with the initiated disease-modifying antirheumatic drug. The prescription of methotrexate was considered a marker of an aggressive disease., Results: The US features of inflammation and bone damage correlated with the activity scores measured by the DAS28. The presence of US bone erosions overlapped with the presence of rheumatoid factor and anti-cyclic citrullinated antibodies. Synovial hypertrophy, intra-articular power Doppler signal, and bone erosions detected in at least 1 anatomical site were seen in patients fulfilling (77.7%) and in patients not fulfilling (72.7%) the 2010 ACR/EULAR classification criteria for RA. Synovial hypertrophy was found in at least 1 site in 83.3% and 58.8% of patients in whom methotrexate was prescribed and in whom methotrexate was not prescribed, respectively (P = 0.01). The US features were not correlated with the initiation of sulfasalazine or hydroxychloroquine. The patients presenting bone erosions received in significantly higher percentages the indication for methotrexate (50%) compared with sulfasalazine (20%), P = 0.03, or hydroxychloroquine (26%), P = 0.05., Conclusions: The US features of inflammation might be of help in classifying early arthritis patients despite the presence of the immune markers for RA. Together with the US features of bone damage, these might be used as an indicator of a more aggressive disease. The absence of correlation between the US findings of RA and the 2010 ACR/EULAR classification criteria indicates a possible independent contribution of US in the understanding of the future evolution of these patients.

The age at onset in early arthritis (EA) may influence the disease activity and its evolution. The aim of the current study is to identify possible differences regarding the "old" and the "new" classification criteria between patients with early-onset and late-onset early arthritis. The study included 64 patients. They were divided in two groups, according to the mean age: early-onset EA--less or equal than 45 years old (group A) and late-onset EA--over 45 years old (group B). The "old" criteria as well as the "new" ones were assessed for all patients, at the time of the first visit to the rheumatologist. The initiation of treatment with Methotrexate was used as "gold standard" to calculate the sensitivity and the specificity of both criteria. "New" criteria were fulfilled in 51% (A) and 72% of cases (B), while "old" criteria were fulfilled in 37% of patients (A) and 62% (B). Methotrexate was initiated in 82% of patients (B) and in 51% (A), p = 0.01. "New" criteria demonstrated a sensitivity of 77.7% (A) and 83.3% (B), while "old" criteria had a sensitivity of 50% (A) and 66.6% (B). Patients with late onset had significantly higher disease activity scores: 76% (B) versus 40% (A), p = 0.04. The sensitivity and the specificity of the "new" criteria for RA are comparable in patients with early-onset and late-onset EA, and the sensitivity of these criteria is increased compared to the "old" criteria. Patients with late onset fulfilling the "old" criteria had poor prognostic factors and higher disease activity at the time of diagnosis, which may have possible implications for the disease course.

Systemic AL amyloidosis is one of the differential diagnosis of chronic musculoskeletal disease, especially when swollen and painful joints is associated with claw hands. Ultrasound evaluation is a good diagnosis tool, showing a characteristic joint and tendon involvement and assisting in guided biopsy procedure. We report a 55 year old caucasian woman, diagnosed for two years with RA without improvement under different DMARDs, admitted for fixed flexion contractures of both hands ("claw hands"), worsening pain and swelling of small joints of hands and feet, elbows and shoulders. Pad shoulder sign and bilateral anterior wrist and elbow pads, macroglossia, thickened skin of fingers and ecchymotic rashes on forearm and around eyes were observed. Ultrasound examinations showed subdeltoid and bicipitoradial bursitis, presence of inhomogeneous hypoechoic material around bicipital tendons and tenosinovitis of the extensor tendons of the hand, and synovial thickening of elbow and shoulder joints. Complete analysis of the bone marrow biopsy and biopsy specimens from subacromial bursa were positive for AL amyloidosis.

Inflammation of synovium is one of the hallmarks of rheumatoid arthritis (RA). Analysis of synovial tissue has increased our understanding of RA pathogenesis, aided in identifying potential therapeutic targets and has been used in the response and mechanistic evaluation of antirheumatic treatments. In addition, studies are ongoing, aimed at the identification of diagnostic and prognostic biomarkers in the synovium. This paper outlines the currently used procedures for sampling and processing of synovial tissue, and presents a standardised recommendation to support multicentre translational research.

Objectives: To compare the diagnosis of shoulder impingement syndrome (SIS) established by clinical and ultrasonographic examination and to evaluate the value of clinical tests for SIS as well as for rotator cuff pathology., Methods: One hundred patients with periathrophatia scapulohumeralis entered the study, including 64 females and 36 males aged between 20-84 years (mean 56.8 and 57.5, respectively). Clinical and ultrasonographic examinations were carried out by independent observers, a rheumatologist and a musculoskeletal-trained sonographer. Clinical tests for SIS and for each of the tendons of the rotator cuff, as well as static and dynamic ultrasonographic examinations were performed for both shoulders. Findings were compared and statistically analyzed., Results: The Hawkins test (72.2%) proved to be the most sensitive clinical test for the identification of SIS and the Neer test (95.3%) was the most specific one. When four tests were simultaneously positive, the specificity for the diagnosis was 98.5% but the sensitivity decreased to 40.3%. Jobe's test indicated supraspinatus involvement with a specificity of 90% but it was not able to disclose the type of lesions. The sensitivity and specificity of the tests aiming to elicit infraspinatus tendon pathology were of low value whereas those addressing subscapularis tendon involvement were rather of moderate value. SIS was clinically correctly diagnosed in 80.5% of cases, but its characteristic stages were poorly recognized (stage I 50%, stage II 70%, and stage III 30.7%)., Conclusions: Although clinical tests are insufficient for clinical diagnosis, the examination of the patient still plays an important role in rotator cuff disorders. Ultrasonography should be used for all patients suffering from painful shoulder in order to improve the diagnosis.

Systemic sclerosis is a systemic connective tissue disease whose main pathophysiological mechanism is a progressive fibrosis of internal organs and skin leading to thickening and induration. Blood vessels may also be involved. However, systemic scleroderma is not the only disease causing cutaneous sclerosis. There is a group of diseases that mimic scleroderma in their clinical presentation - these are scleroderma-like syndromes. A distinction can be made between syndromes of inflammatory/autoimmune, genetic, metabolic, toxic, drug-induced, occupational, paraneoplastic and syndromes caused by deposition disorders. In the following paper, we have reviewed the literature on scleroderma-like syndromes. We have outlined the factors predisposing to the development of each disease, its pathogenesis, clinical presentation, diagnostic and treatment process and the differences between each syndrome and systemic scleroderma. [ABSTRACT FROM AUTHOR]

This document discusses the increasing interest in sustainability across various domains in Romania, including education, agriculture, hydrology, culture, heritage, construction, energy, waste management, healthcare, economics, public transportation, border regions, textile industry, and rural areas. The document highlights specific research studies conducted by scholars from the University of Oradea, covering a wide range of topics related to sustainability. The articles provide valuable insights into the complex relationship between education, research, innovation, and sustainability, and offer diverse perspectives on achieving sustainability in different sectors. This collection of articles is a valuable resource for library patrons conducting research on sustainability in Romania. [Extracted from the article]