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CT angiography might be a suitable procedure to avoid arterial puncture in combined intracavitary and interstitial brachytherapy for cervical cancer curatively treated with combined chemoradiation and brachytherapy boost. Data in the literature about this technique are scarce. We introduced this method and collected brachytherapy data from patients treated in our department between May 2021 and April 2024. We analyzed the applicator subtype, needle insertion (planned versus implanted), implanted depth and the role of CT angiography in selecting needle trajectories and insertion depths. None of the patients managed through this protocol experienced atrial puncture and consequent hemorrhage. Needle positions were accurately selected with the aid of CT angiography with proper coverage of brachytherapy targets and avoidance of organs at risk. CT angiography is a promising method for guiding needle insertion during interstitial brachytherapy. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) is a chronic metabolic disorder marked by hyperglycemia due to defects in insulin secretion, action, or both, with a global prevalence that has tripled in recent decades. This condition poses significant public health challenges, affecting individuals, healthcare systems, and economies worldwide. Among its numerous complications, ocular surface disease (OSD) is a significant concern, yet understanding its pathophysiology, diagnosis, and management remains challenging. This review aims to explore the epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and management strategies of diabetes-related OSD. The ocular surface, including the cornea, conjunctiva, and associated structures, is vital for maintaining eye health, with the lacrimal functional unit (LFU) playing a crucial role in tear film regulation. In DM, changes in glycosaminoglycan metabolism, collagen synthesis, oxygen consumption, and LFU dysfunction contribute to ocular complications. Persistent hyperglycemia leads to the expression of cytokines, chemokines, and cell adhesion molecules, resulting in neuropathy, tear film abnormalities, and epithelial lesions. Recent advances in molecular research and therapeutic modalities, such as gene and stem cell therapies, show promise for managing diabetic ocular complications. Future research should focus on pathogenetically oriented therapies for diabetic neuropathy and keratopathy, transitioning from animal models to clinical trials to improve patient outcomes. [ABSTRACT FROM AUTHOR]

The aim of this paper consists in providing a general overview of the notion of intellectual capital as a key to maximizing the corporate performance. Following the researches carried out, we present the delimitations of the intellectual capital in relation with human capital, relational capital and structural capital. In terms of its measurement, we focus on a question which could be a solid base for the next studies: “Can intellectual capital be evaluated?” In this regard, a number of methods (direct and methods based on assets returns), generic model and individual company models were presented, concluding in this way with a hierarchy in terms of utility and their importance.

This research comes to empirical investigate whether the country‟s levels of corruption may be explained by some behavioral factors such as culture, tax morale, trust, religion or happiness. For this purpose, a cross-countries survey of 148 countries is used. The findings document that power distance, trust in legal system, happiness and religion are the most important behavioral determinants of the corruption, explaining about 50 % from the level of corruption around the world. A higher power distance, a lower level of trust in legal system, a lower level of happiness (measured by subjective well-being) and a higher level of religiosity conduct to a higher level of corruption. The findings are important for the policy-makers in order to include the non-economic factors in the analysis of corruption behavior of the people belong to a country, and thus to adopt the most appropriate decisions to fight against this phenomenon.

With the recent increase in the occurrence of severe weather phenomena, the development of accurate weather nowcasting is of paramount importance. Among the computational methods that are used to predict the evolution of weather, deep learning techniques offer a particularly appealing solution due to their capability for learning patterns from large amounts of data and their fast inference times. In this paper, we propose a convolutional network for weather forecasting that is based on radar product prediction. Our model (NeXtNow) adapts the ResNeXt architecture that has been proposed in the computer vision literature to solve the spatiotemporal prediction problem. NeXtNow consists of an encoder–decoder convolutional architecture, which maps radar measurements from the past onto radar measurements that are recorded in the future. The ResNeXt architecture was chosen as the basis for our network due to its flexibility, which allows for the design of models that can be customized for specific tasks by stacking multiple blocks of the same type. We validated our approach using radar data that were collected from the Romanian National Meteorological Administration (NMA) and the Norwegian Meteorological Institute (MET) and we empirically showed that the inclusion of multiple past radar measurements led to more accurate predictions further in the future. We also showed that NeXtNow could outperform XNow, which is a convolutional architecture that has previously been proposed for short-term radar data prediction and has a performance that is comparable to those of other similar approaches in the nowcasting literature. Compared to XNow, NeXtNow provided improvements to the critical success index that ranged from 1% to 17% and improvements to the root mean square error that ranged from 5% to 6%.

Beta-thalassemia (BTH), a recessively inherited haemoglobin (Hb) disorder, causes iron overload (IO), extra-medullary haematopoiesis and bone marrow expansion with major clinical impact. The main objective of this review is to address endocrine components (including aspects of reproductive health as fertility potential and pregnancy outcome) in major beta-thalassemia patients, a complex panel known as thalassemic endocrine disease (TED). We included English, full-text articles based on PubMed research (January 2017–June 2022). TED includes hypogonadism (hypoGn), anomalies of GH/IGF1 axes with growth retardation, hypothyroidism (hypoT), hypoparathyroidism (hypoPT), glucose profile anomalies, adrenal insufficiency, reduced bone mineral density (BMD), and deterioration of microarchitecture with increased fracture risk (FR). The prevalence of each ED varies with population, criteria of definition, etc. At least one out of every three to four children below the age of 12 y have one ED. ED correlates with ferritin and poor compliance to therapy, but not all studies agree. Up to 86% of the adult population is affected by an ED. Age is a positive linear predictor for ED. Low IGF1 is found in 95% of the population with GH deficiency (GHD), but also in 93.6% of persons without GHD. HypoT is mostly pituitary-related; it is not clinically manifested in the majority of cases, hence the importance of TSH/FT4 screening. HypoT is found at any age, with the prevalence varying between 8.3% and 30%. Non-compliance to chelation increases the risk of hypoT, yet not all studies confirmed the correlation with chelation history (reversible hypoT under chelation is reported). The pitfalls of TSH interpretation due to hypophyseal IO should be taken into consideration. HypoPT prevalence varies from 6.66% (below the age of 12) to a maximum of 40% (depending on the study). Serum ferritin might act as a stimulator of FGF23. Associated hypocalcaemia transitions from asymptomatic to severe manifestations. HypoPT is mostly found in association with growth retardation and hypoGn. TED-associated adrenal dysfunction is typically mild; an index of suspicion should be considered due to potential life-threatening complications. Periodic check-up by ACTH stimulation test is advised. Adrenal insufficiency/hypocortisolism status is the rarest ED (but some reported a prevalence of up to one third of patients). Significantly, many studies did not routinely perform a dynamic test. Atypical EM sites might be found in adrenals, mimicking an incidentaloma. Between 7.5–10% of children with major BTH have DM; screening starts by the age of 10, and ferritin correlated with glycaemia. Larger studies found DM in up to 34%of cases. Many studies do not take into consideration IGF, IGT, or do not routinely include OGTT. Glucose anomalies are time dependent. Emerging new markers represent promising alternatives, such as insulin secretion-sensitivity index-2. The pitfalls of glucose profile interpretation include the levels of HbA1c and the particular risk of gestational DM. Thalassemia bone disease (TBD) is related to hypoGn-related osteoporosis, renal function anomalies, DM, GHD, malnutrition, chronic hypoxia-induced calcium malabsorption, and transplant-associated protocols. Low BMD was identified in both paediatric and adult population; the prevalence of osteoporosis/TBD in major BTH patients varies; the highest rate is 40–72% depending on age, studied parameters, DXA evaluation and corrections, and screening thoracic–lumbar spine X-ray. Lower TBS and abnormal dynamics of bone turnover markers are reported. The largest cohorts on transfusion-dependent BTH identified the prevalence of hypoGn to be between 44.5% and 82%. Ferritin positively correlates with pubertal delay, and negatively with pituitary volume. Some authors appreciate hypoGn as the most frequent ED below the age of 15. Long-term untreated hypoGn induces a high cardiovascular risk and increased FR. Hormonal replacement therapy is necessary in addition to specific BTH therapy. Infertility underlines TED-related hormonal elements (primary and secondary hypoGn) and IO-induced gonadal toxicity. Males with BTH are at risk of infertility due to germ cell loss. IO induces an excessive amount of free radicals which impair the quality of sperm, iron being a local catalyser of ROS. Adequate chelation might improve fertility issues. Due to the advances in current therapies, the reproductive health of females with major BTH is improving; a low level of statistical significance reflects the pregnancy status in major BTH (limited data on spontaneous pregnancies and growing evidence of the induction of ovulation/assisted reproductive techniques). Pregnancy outcome also depends on TED approach, including factors such as DM control, adequate replacement of hypoT and hypoPT, and vitamin D supplementation for bone health. Asymptomatic TED elements such as subclinical hypothyroidism or IFG/IGT might become overt during pregnancy. Endocrine glands are particularly sensitive to iron deposits, hence TED includes a complicated puzzle of EDs which massively impacts on the overall picture, including the quality of life in major BTH. The BTH prognostic has registered progress in the last decades due to modern therapy, but the medical and social burden remains elevated. Genetic counselling represents a major step in approaching TH individuals, including as part of the pre-conception assessment. A multidisciplinary surveillance team is mandatory.

Rapid diagnosis and treatment application in the early stages of H. pylori infection plays an important part in inhibiting the transmission of this infection as this bacterium is involved in various gastric pathologies such as gastritis, gastro-duodenal ulcer, and even gastric neoplasia. This review is devoted to a quick overview of conventional and advanced detection techniques successfully applied to the detection of H. pylori in the context of a compelling need to upgrade the standards of the diagnostic methods which are currently being used. Selecting the best diagnostic method implies evaluating different features, the use of one or another test depending on accessibility, laboratories equipment, and the clinical conditions of patients. This paper aims to expose the diagnosis methods for H. pylori that are currently available, highlighting their assets and limitations. The perspectives and the advantages of nanotechnology along with the concept of nano(bio)sensors and the development of lab-on-chip devices as advanced tools for H. pylori detection, differentiation, and discrimination is also presented, by emphasizing multiple advantages: simple, fast, cost-effective, portable, miniaturized, small volume of samples required, highly sensitive, and selective. It is generally accepted that the development of intelligent sensors will completely revolutionize the acquisition procedure and medical decision in the framework of smart healthcare monitoring systems.

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic's overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania. [ABSTRACT FROM AUTHOR]

This systematic review critically evaluates the impact of systemic treatments on outcomes and quality of life (QoL) in patients with RAS-positive stage IV colorectal cancer, with studies published up to December 2023 across PubMed, Scopus, and Web of Science. From an initial pool of 1345 articles, 11 relevant studies were selected for inclusion, encompassing a diverse range of systemic treatments, including panitumumab combined with FOLFOX4 and FOLFIRI, irinotecan paired with panitumumab, regorafenib followed by cetuximab ± irinotecan and vice versa, and panitumumab as a maintenance therapy post-induction. Patient demographics predominantly included middle-aged to elderly individuals, with a slight male predominance. Racial composition, where reported, showed a majority of Caucasian participants, highlighting the need for broader demographic inclusivity in future research. Key findings revealed that the addition of panitumumab to chemotherapy (FOLFOX4 or FOLFIRI) did not significantly compromise QoL while notably improving disease-free survival, with baseline EQ-5D HSI mean scores ranging from 0.76 to 0.78 and VAS mean scores from 70.1 to 74.1. Improvements in FACT-C scores and EQ-5D Index scores particularly favored panitumumab plus best supportive care in KRAS wild-type mCRC, with early dropout rates of 38–42% for panitumumab + BSC. Notably, cetuximab + FOLFIRI was associated with a median survival of 25.7 months versus 16.4 months for FOLFIRI alone, emphasizing the potential benefits of integrating targeted therapies with chemotherapy. In conclusion, the review underscores the significant impact of systemic treatments, particularly targeted therapies and their combinations with chemotherapy, on survival outcomes and QoL in patients with RAS-positive stage IV colorectal cancer, and the need for personalized treatment. [ABSTRACT FROM AUTHOR]

This systematic review evaluates the effectiveness of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in assessing quality of life improvements among patients with heart failure (HF) undergoing various forms of exercise training rehabilitation, including telemedicine and in-person modalities, across all stages of HF, irrespective of ejection fraction (EF) and clinical status. The aim was to collate evidence from studies employing the KCCQ as a measure of quality of life (QoL). A comprehensive search strategy was implemented across PubMed, Scopus, and Embase databases, adhering to the PRISMA guidelines, including literature up until October 2023. Inclusion criteria encompassed studies on patients diagnosed with HF undergoing exercise training rehabilitation assessed by KCCQ. Nine articles met the inclusion criteria, involving a total of 3905 patients from various global locations and conducted between 2012 and 2022. Results indicated significant heterogeneity in exercise interventions and patient characteristics. Notably, high-intensity interval training (HIIT) showed a marked improvement in KCCQ scores (from 68.0 to 80.0) compared to moderate continuous training (MCT) and control groups, underscoring its potential for enhancing QoL. Additionally, a significant improvement in the 6-min walking test (6MWT) outcomes was observed, with an average increase of 106 m (95% CI: 60, 152) in one study, reflecting physical capacity enhancements. However, the difference in KCCQ scores between intervention and control groups was not statistically significant in several studies. In conclusion, the KCCQ's effectiveness is highlighted by its ability to detect clinically meaningful improvements in QoL across diverse exercise modalities, including HIIT and MCT, tailored to the specific needs of HF populations. The consistent correlation between KCCQ score improvements and enhanced physical outcomes, such as the 6MWT, supports its reliability in capturing the nuanced benefits of exercise interventions on patient well-being. [ABSTRACT FROM AUTHOR]

This study delves into the effectiveness of digital marketing strategies in promoting local agricultural and food products in Romania, certified with European Union quality schemes. By examining consumer profiles, preferences, and their awareness of EU quality labels, the research uncovers the motivations driving purchasing decisions and the influence of digital marketing on these choices. Utilizing quantitative methods, including a comprehensive survey across 903 respondents, the study identifies four distinct consumer segments: Eco-Advocates, Les Connaisseurs, Price-Sensitives, and Traditionalists. These segments exhibit unique behaviors and attitudes toward certified products. The research highlights the potential of digital marketing to significantly alter consumer behavior toward EU-certified products, underscoring the importance of tailored communication strategies. It contributes to the understanding of consumer segmentation in the context of European Union quality schemes, providing valuable insights for policymakers, marketers, and producers. The findings advocate for enhanced digital marketing efforts to increase awareness and appreciation of these certified products, thereby supporting the broader objectives of quality and certification in the European agricultural and food product sector. [ABSTRACT FROM AUTHOR]

Changes have their sources in external or internal factors and may only produce a slight adjustment from a functional and structural point of view or may lead to a redesign of its essence. Efficiency refers to the ability to identify the most appropriate services, the use of appropriate technologies and the introduction of the best procedure. The only way to reduce environmental impacts is technological innovation and companies should consider the challenge of sustainable development by investing in the R&D sector. This paper involves treating two key concepts, innovation as a pillar of the environment for sustainable development and competitiveness. In this context, special attention is given to sustainable innovation. The beneficial effect of applying eco-innovation cannot be achieved without the existence of technological capacity. Adopting eco- efficient technologies involve substantial costs and requires a strong learning process based on R&D. So we considered it necessary to analyze the impact of the R&D sector on the eco-innovation based on econometric model, using linear regression. The analysis confirms the dependence of eco-innovation on R&D spending and in order to demonstrate the validity of this result we used the Eviews program.

Diabetic retinopathy is a well-known complication of diabetes, a major cause of vision loss worldwide. Purpose. The present study investigates the correlation between hypertension and evolution of diabetic retinopathy in patients with type II diabetes. Materials and methods. We conducted a prospective study between June and December 2016, on 24 patients hospitalized in Ophthalmology Clinic, Emergengy University Hospital Bucharest, with AO: diabetic retinopathy and arterial hypertension under medical treatment. Patients were evaluated at baseline, 2 months, 4 months and 6 months through comprehensive eye examination and measuring the value of blood pressure (BP). Comparative data were analyzed in patients with compensated hypertension (BP = 150 mmHg). Results. Of the 24 patients, 15 had values offset BP (group A) and 9 associated hypertension subcompensated (group B). In group A proportion of patients (at baseline) with diabetic retinopathy absent or nonproliferative was higher than patients in group B (47% vs. 22%, p = 0.052995019518117). Patients in group B had a higher tendency to record an evolution of diabetic retinopathy (in group B, 55.55% of patients had a progression, and in group A, only 26.66%). onclusions. Incomplete therapeutic control of hypertension may affect the retinal microvasculature impacting the progression of diabetic retinopathy. Maintaining a strict control of systolic BP of permanent value below 140 mmHg should be part of the patient management guide of the diabetic patient in order to prevent ophthalmic complications with major risk of vision loss.

Most research concerning creativity refers to the scientific and technical field. Progress can be achieved in short term by applying in practice of the stock of existing information, but on long-term implementation of the same stock that has not yet been enhanced with new products, results in the termination of economic and social progress. Creativity consists in finding new in any field or activity and presupposes the availability for change. Creativity thus becomes an essential factor of technical progress, and its stimulation programs lead to improved performance. The existence of a broad range of methods and techniques aimed at developing creative capacity allows their use depending on the requirements of each activity, which increases their effectiveness. An efficient economic system involves its continuous modification to proceed in relation to market requirements. Therefore, in order to prove effective creativity must manifest itself in a natural setting formed, mainly from the activities of scientific research and technological development (C&D), through creative excellence and which constitutes a key factor of the whole social and economic system.

This study assessed the learning perception of undergraduate medical students on three types of teaching (classical/online/hybrid), in relation to coping strategies, stress, and social support, in the context of the SARS-CoV-2 pandemic. Additionally, we explored gender differences and the perceived usefulness of teaching. 201 students (48 men, 153 women; mean age = 22.900, SD = 2.830) participated in the study. They answered a Multidimensional Scale of Perceived Social Support, a Brief Cope Scale, a Student-life Stress Inventory, a visual analog scale for usefulness, and a survey collecting their perceptions about learning across teaching types. Results point out a preference for classical teaching, followed by the hybrid and online formats. Online teaching was identified as more advantageous in terms of time management and seeking information. Denial and substance use were statistically associated with poor communication, bad time using, and impaired learning. Both stress and social support had ambivalent associations with learning perceptions. Gender differences were limited to behavioral disengagement and higher social support perceived by women. Although classical teaching was globally perceived as the most useful, online teaching was considered desirable by male urban respondents. These data may contribute to the strategic growth and refinement of web-based teaching methods in medical universities.

Short-term quantitative precipitation forecast is a challenging topic in meteorology, as the number of severe meteorological phenomena is increasing in most regions of the world. Weather radar data is of utmost importance to meteorologists for issuing short-term weather forecast and warnings of severe weather phenomena. We are proposing AutoNowP, a binary classification model intended for precipitation nowcasting based on weather radar reflectivity prediction. Specifically, AutoNowP uses two convolutional autoencoders, being trained on radar data collected on both stratiform and convective weather conditions for learning to predict whether the radar reflectivity values will be above or below a certain threshold. AutoNowP is intended to be a proof of concept that autoencoders are useful in distinguishing between convective and stratiform precipitation. Real radar data provided by the Romanian National Meteorological Administration and the Norwegian Meteorological Institute is used for evaluating the effectiveness of AutoNowP. Results showed that AutoNowP surpassed other binary classifiers used in the supervised learning literature in terms of probability of detection and negative predictive value, highlighting its predictive performance.

This article aimed to quantify the characteristics of antiparasitic drug treatment coalescent to surgical treatment in hepatic hydatid cyst. The therapeutic management of hepatic hydatid disease is not yet standardized, hence the absence of the ideal technique with applicability in a specific situation and whose outcome is permanently the same. Hydatid pathology is remarkably heteromorphic in terms of location in the human body but also in terms of the anatomopathological transformations it produces. Hepatic hydatid cyst is a pathology far from being eradicated in developing countries, while in most developed countries, this disease is an exodus. Therefore, the discovery of the most suitable, effective and appropriate therapeutic means, which have rapid, effective and safe applicability, belongs to those who are still struggling with this pathology. Therefore the motivation and responsibility for finding the most effective, adapted and appropriate therapeutic means, which successfully pass the test of speed of cure, belongs to those who are still facing the liver disease. [ABSTRACT FROM AUTHOR]

Prolactinomas are interesting pituitary neuroendocrine tumors (PitNET). Of all PitNETs, prolactinomas account for 30-50%, usually affecting women between the ages of 20 and 50 years old. We aim to introduce a challenging case of PitNET-related menstrual cycle anomalies across a case study type of report. The lady in her 40s was only late diagnosed with a prolactin producing PitNET after experiencing years of normal menstrual cycles, but also its disturbances and prior therapy with oral contraceptives. Secondary amenorrhea represents a common element that is found during the evaluation done by endocrinologists and obstetricians/ gynecologists. Hyperprolactinemia should be taken into consideration as an alternative differential diagnosis. The treatment of this disorder can be essential for these women to have regular menses, and a good collaborative team is required. [ABSTRACT FROM AUTHOR]

This study explores the trends and limitations of research on the Common Agricultural Policy (CAP) in relation to agriculture, economy, and the environment, using a bibliometric analysis based on Web of science data. Employing co-citation maps and collaborative networks among authors and institutions, the study highlights a fragmented literature characterized by high thematic specialization and a low level of interconnectedness among researchers, hindering the development of a coherent and integrated framework. A detailed analysis of author collaborations and co-citation networks provides a clear view of the intellectual structure of the field and the ways ideas and research have been interconnected and developed over time. Additionally, the examination of highly cited articles and works has revealed not only the current gaps in research but also opportunities for future investigations. For instance, most studies have focused on the effects of Common Agricultural Policy (CAP) funding on the environment, biodiversity, farmer behaviour, and the economic outcomes of the agricultural sector. However, they have largely overlooked a comprehensive understanding of how these interactions simultaneously influence all three dimensions: economic, environmental, and agricultural. This highlights a significant opportunity for research to explore more complex and integrated connections between CAP funding and its impact on these three pillars, considering the recent evolution and changes in the global economic landscape. [ABSTRACT FROM AUTHOR]

Analyzing the soybean productions obtained at the national level in recent years, it has been observed that they are increasingly higher from year to year. This aspect reflects the growing interest of farmers in cultivating this plant. This work highlights how the climatic conditions in the year 2023 and the quantity of fertilizers applied influenced the development of soybean plants as well as the bean production. The experiment was conducted in three different agricultural areas in Romania, using four soybean varieties, and the fertilizers were applied in two different quantities. Throughout the vegetation period, several biometric measurements were taken, and the results of the experiment revealed how the climate of the selected regions, as well as the rate of applied fertilizers, influenced the development of the plants and the yields obtained. [ABSTRACT FROM AUTHOR]