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The term of tourist product, as it was understood in the first decade after December, has undergone an important change of meaning, in the age of today’s tourist. The simple outings in nature are replaced by trekking and cycle tourism tours, the classical mountain climbing by sport climbing, via ferrata, rafting and canyoning, wandering through caves by speotourism and the list may continue. Finally, we realize that the era of speed and the Internet brings along a paradigm change in terms of the tourist offer: adaptation to the need for adrenaline is done through extreme sports and adventure tourism services. The present study aims to highlight some recreational and leisure, sportive and adventure activities: caving tourism, mountain climbing, sport climbing, via ferrate, mountain hiking, cyc le tourism, zip line and rafting, all happening in Pădurea Craiului Mountains. If the above assertion seems generally valid, this area is perfectly in line with the trends, the tourism operators offer the most diverse activities, to meet the growing demand of new tourist products.

The three types of neurofibromatosis, namely type 1, type 2, and schwannomatosis, are generally associated with various benign tumors affecting the skin and the nervous system. On rare occasions, especially in patients with neurofibromatosis type 1 (NF1), malignant neoplasms may also be present, several of them possessing a more aggressive course than in individuals without this syndrome. As such, a clear delineation between the three variants of neurofibromatosis is crucial to establish the correct diagnosis and management, as well as predict the neoplasm-related outcomes. Neurofibromin, the principal product of the NF1 gene, is a potent inhibitor of cellular proliferation, having been linked to several key signaling pathways involved in tumor growth. Therefore, it may provide a useful therapeutic target for tumor management in these patients. In this article, we want to present the association between deficiency of neurofibromin and the consequences of the lack of this protein leading to different kinds of malignant tumors. The therapy is still uncertain and most therapeutic options are in development or clinical trials.

Background and Objectives: Local and distant relapse (LR, DR) in breast cancer vary according to its molecular subtypes, with triple-negative breast cancer (TNBC) being the most aggressive. The surgical resection margin width (SRMW) for breast-conserving surgery (BCS) has been intensely debated, especially for the aforementioned subtype. The aim of this study was to examine the impact of SRMW on LR following BCS in TNBC patients. Materials and Methods: We conducted a retrospective study including all patients with TNBC for whom BCS was performed between 2005 and 2014. Results: Final analysis included a total of 92 patients, with a median tumor size of 2.5 cm (range 0–5 cm) and no distant metastasis at the time of diagnosis. A total of 87 patients had received neoadjuvant and/or adjuvant chemotherapy, and all patients had received adjuvant whole-breast radiotherapy. After a median follow-up of 110.7 months (95% CI, 95.23–126.166), there were 5 local recurrences and 8 regional/distant recurrences with an overall LR rate of 5.4%. The risk of LR and DR was similar between groups of patients with several SRMW cut-off values. Conclusions: Our study supports a safe “no ink on tumor” approach for TNBC patients treated with BCS.

The present study aims to highlight different issues related to: the evolution, repartition and dynamics of the Romanian football (League I) between 1989 – 2016 by using an analytical approach, from singular to particular, from the team (seen as a basic cell in football) to location, county, development regions, historical region and country (seen as administrative units that support football). The importance of the study emerges from the explanatory and logical approach, from the mechanisms that contributed to the development and consolidation of the Romanian football (League I), in close correlation with the postcommunist socio-economic transformations which have defined each administrative unit involved as part of the Romanian national state.

The paper presents the characteristics of snow cover in Muntele Băişorii resort expressed on the basis of analyzing the data from meteorological observation from Băişoara station during 1961-2007 and processed on the basis of classic methodology used in climatological studies. Analyzing the values of the main parameters characterizing the snow cover was found that it enables and promotes winter tourism activities, that is why we have proposed new types of winter tourist activities such as ski touring, which would help diversify and increase the tourist flow in the resort.

No doubt, in the last years we are witness to maintain supported to make improvements in content and form of the Educational Program from domain of Physical Education and Sports in our country. These searches are concentrate in two great direction: 1. for identifying new instruments resources to increase the attractiveness of lessons and physical education and sports. 2. for improving bio-motor potential in young children. To achieve these two points we developed a project for the children enrolled in the “Brassai Samuel” High School of Cluj-Napoca, in the period 01.10.2013-1.06. 2014, entitled “Strategies to approach physical training in school children by applying aikido exercises in physical activities in the classroom”. This pilot experiment is part of a research project entitled "Diversifying educational exercise (martial arts) in children of 9-10 years of age to improve health”. Groups were formed with 3rd and 4th grades pupils. The children who attended these classes were 9 and 10 years old. The number of participants (N) being enrolled was 40 (boys), tests were applied to 10 children, 5 per each group (experiment and control), with the consent of their parents. REZUMAT. Implementarea Aikido în programul de activități fizice la elevii de 9-10 ani. Fără îndoială, în ultimii ani asistăm la o încercare susținută de a aduce îmbunătățiri în conținutul și forma Programei de învățământ, în domeniul Educației Fizice și Sportului din țara noastră. Aceste căutări se focusează, atât pentru identificarea unor noi instrumente și mijloace cu care să creștem atractivitatea lecțiilor și a activităților de educație fizică și sport, dar și pentru îmbunătățirea potențialului biomotric al elevilor de vârstă mică. Astfel, am implementat în cadrul Liceului ”Brassai Samuel”, din Cluj Napoca, în perioada 01.10.2013 – 01.06.2014, proiectul „Strategii de abordare a pregătirii fizice la elevii de vârstă școlară mică prin aplicarea exercițiilor aikido în cadrul activităților fizice la clasă”. Cuvinte-cheie: programa școlară. activitate fizică, aikido, test, indice, corelație, tineri.

This paper presents some of the greatest treasures of Romania, undervalued both national and especially international – air and water valorified in three types of bioclimate determined by the natural layering of the relief (tonic-stimulant, sedativeindifferent and turn-applicant), plus two indoor bioclimates (saline and cave), 11 types of mineral waters, numerous lakes (fresh, brackish and salty), therapeutic mud (mud, minerals and peat), therapeutic gases (pits, Solfatara ). From ancient times until present more than 250 resorts have been created, both for local and general interest, and if we take into account locations with balnear conditions, the resorts of balnear interest will exceed 500 and thereby Romania can be a contender to certain countries with traditional tourist basins such as France, Germany, Spain, Italy, Greece etc.

Background: The COVID-19 pandemic disrupted the healthcare system and negatively affected the diagnosis and management of melanoma worldwide. The purpose of this study is to investigate the long-term effects of the COVID-19 pandemic on the diagnosis and prognosis of melanoma., Materials and Methods: This retrospective cohort study included histopathologically confirmed melanoma cases from March 2019 to February 2023 in Cluj and Bihor counties. Data from the post-COVID-19 period (March 2021 to February 2023) were compared to the pre-COVID-19 period (March 2019 to February 2020) and the COVID-19 period (March 2020 to February 2021). Patient characteristics, monthly diagnostics, histological subtypes, and key histological features were analyzed using statistical tests., Results: The number of melanoma cases diagnosed annually decreased by 31.37 and 23.75% in the first and second post-pandemic years, respectively, compared to pre-pandemic numbers. Diagnostic rates also decreased by 14.9 and 5.4% in the first and second post-pandemic years, respectively, compared to the pandemic period. Prognostic factors worsened in the post-pandemic period, with higher Breslow index and mitotic rate, and increased ulceration and thick melanomas compared to the pre-pandemic period., Conclusion: The COVID-19 pandemic had a long-lasting impact on the diagnosis of melanoma in Romania, resulting in advanced stages and unfavorable prognostic factors. Larger global studies are needed to comprehensively understand the pandemic's long-term effects on the diagnosis of melanoma., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Apostu, Vesa, Frățilă, Iancu, Bejinariu, Muntean, Șenilă, Baba, Secășan and Ungureanu.)

Background: Non-alcoholic fatty liver disease (NAFLD) is a fast-growing pathology around the world, being considered the most common chronic liver disease. It is diagnosed based on the presence of steatosis in more than 5% of hepatocytes without significant alcohol consumption. This review aims to provide a comprehensive overview of current studies of artificial intelligence (AI) applications that may help physicians in implementing a complete automated NAFLD diagnosis and staging., Methods: PubMed, EMBASE, Cochrane Library, and WILEY databases were screened for relevant publications in relation to AI applications in NAFLD. The search terms included: (non-alcoholic fatty liver disease OR NAFLD) AND (artificial intelligence OR machine learning OR neural networks OR deep learning OR automated diagnosis OR computer-aided diagnosis OR digital pathology OR automated ultrasound OR automated computer tomography OR automated magnetic imaging OR electronic health records)., Results: Our search identified 37 articles about automated NAFLD diagnosis, out of which 15 articles analyzed imagistic techniques, 15 articles analyzed digital pathology, and 7 articles analyzed electronic health records (EHC). All studies included in this review show an accurate capacity of automated diagnosis and staging in NAFLD using AI-based software., Conclusions: We found significant evidence demonstrating that implementing a complete automated system for NAFLD diagnosis, staging, and risk stratification is currently possible, considering the accuracy, sensibility, and specificity of available AI-based tools.

Introduction: The need for parathyroidectomy remains high in the group of patients on long-term dialysis with medically refractory secondary hyperparathyroidism (sHPT). We aim to compare the results after subtotal parathyroidectomies (sPtx) and total parathyroidectomies with autotransplant (tPtx + AT) performed for sHPT at a single referral centre., Material and Methods: This prospective study comparatively analysed sPtx and tPtx + AT performed in our department between February 2010 and December 2014. We followed-up both surgical techniques, with respect to the main clinical symptoms, laboratory data, mortality, and recurrent disease., Results: Forty-three patients on whom we performed 26 sPtx and 19 tPtx + AT were entered in the study. There were no statistically significant differences between groups as far as demographic and preoperative clinical data are concerned. We did not encounter postoperative mortality in either of the groups. The follow-up period was significantly longer for the sPtx group (p = 0.04). The immediate postoperative serum calcium levels were significantly lower in the tPtx + AT group (p = 0.009). Definitive hypoparathyroidism was encountered in two patients in the sPtx group (8.3%) and in one from the tPtx + AT group (5.26%). Four patients from the sPtx group (16.6%) and three from the tPtx + AT group (15.78%) died during the follow-up due to causes unrelated to parathyroidectomy. Overall we had two recurrences in the sPtx group and none in the tPtx + AT group (p = 0.57)., Conclusions: In our opinion both techniques have comparable results concerning the clinical and laboratory outcomes and rates of postoperative hypoparathyroidism, at least in short- and medium-term follow-up.