Search

Soft tissue sarcomas are defined as relatively rare, wide-ranging mesenchymal tumors that present several forms of aggressive behavior. In order to improve the therapeutic result and thus the patient's prognosis, reliable diagnostic and evaluation tools are needed, capable of establishing the evolutive pattern of each patient. Materials and Methods. An analytical observational study was conducted in the period 2016-2023 in the Orthopedics Department of the Bucharest University Emergency Hospital, on patients diagnosed with soft tissue sarcoma. Data such as sex, age, site, size, depth, histotype, grade and margin status, vessel or bone involvement, adenopathies, adjuvant therapy, clinical findings, etc., were analyzed. Diagnosis included immunohistochemistry after macroscopic pathological findings were carefully reviewed by a dedicated pathologist. A molecular study was performed to increase the accuracy of diagnosis, prognosis and clinical management of selected sarcomas. Results. In adult soft tissue sarcomas, histotype has been reported to be a significant predictor of overall survival. In terms of survival rate, vascular invasion appears to be a significant pathological factor for progression in extremity STS. Even though the local control of the disease has improved, the development of systemic metastases seems to be largely influenced by the biological characteristics of the tumor. Conclusions. Significant prognostic factors for the likelihood of a lower survival and death rate are tumor size, tumor depth, histology type, and vascular invasion. The results of the study support and complement the literature data, thus improving the understanding of the prognosis of soft tissue sarcomas.

One of the problems of the oil industry is the accumulation of sludge at the bottom of crude oil storage tanks. Oil sludge obtained from crude oil storage tanks is a semi-solid waste. It is actually a complex emulsion made up of numerous petroleum hydrocarbons, water and solid particles or mineral impurities from the rock. Oil sludge is generated during the storage of crude oil production, but also during the transportation, storage, and refining of crude oil. Through its nature - organic and inorganic, dark brown / black in color and semi-fluid physical state - it is a very dangerous waste, as it includes many poisonous substances, such as: polycyclic aromatic hydrocarbons, xylene, benzene, ethyl benzene, toluene, but also metals heavy. Therefore, oil sludge deposition is a dynamic, long-term, and ever-changing process. The authors, under the auspices of AOȘR and AGIR, present - through this scientific paper - a modern technology used for the successful cleaning of oil sludge from crude oil storage tanks and, obviously, it can be a recommendation for organizations in the oil industry

With this article, we propose to analyse the way in which the implementation of the measures to reduce the budget deficit was decided in Romania. Thus, we are particularly concerned with the provisions of Law no. 296/2023 on some fiscal-budgetary measures to ensure Romania's long-term financial sustainability, a normative act that at first glance positions itself correctly towards its recipients, but on closer reading, has the potential to generate negative effects, at least with regard to economic operators with state capital that can be considered profitable. We will analyse, for example, the bans imposed, in relation to their generality, without taking into account the long-term effects, and here we have in mind the fluctuation and ageing of staff, but also the lack of any means of encouraging production. However, as long as employees are aware that the company has made a profit, if it is not reflected at the salary level (bonuses, meal vouchers), even though this has happened in previous years, they will become dissatisfied, with the direct consequence being a drop in productivity and, implicitly, in the current year's profit. That is why, having analysed the above-mentioned normative act, we have come to the conclusion that it needs to be amended, at least with regard to some measures, especially those related to the granting of bonuses at salary level. We admit that measures to reduce the budget deficit are necessary, but this cannot be achieved by imposing bans that apply to different categories of recipients, without taking into account possible, well-justified exceptions. If the legislation does not change, surely memoranda will be formulated regarding the exemption of the economic operators concerned from the total/partial application, as the case may be, of the provisions of Law no. 296/2023.

Combination therapies in metastatic hormone-sensitive prostate cancer (mHSPC), which include the addition of an androgen receptor signaling inhibitor and/or docetaxel to androgen deprivation therapy, have been a game changer in the management of this disease stage. However, these therapies come with their fair share of toxicities and side effects. The goal of this observational study is to report drug-related adverse events (AEs), which are correlated with systemic combination therapies for mHSPC. Determining the optimal treatment option requires large cohorts to estimate the tolerability and AEs of these combination therapies in “real-life” patients with mHSPC, as provided in this study. We use a network of databases that includes population-based registries, electronic health records, and insurance claims, containing the overall target population and subgroups of patients defined by unique certain characteristics, demographics, and comorbidities, to compute the incidence of common AEs associated with systemic therapies in the setting of mHSPC. These data sources are standardised using the Observational Medical Outcomes Partnership Common Data Model. We perform the descriptive statistics as well as calculate the AE incidence rate separately for each treatment group, stratified by age groups and index year. The time until the first event is estimated using the Kaplan-Meier method within each age group. In the case of episodic events, the anticipated mean cumulative counts of events are calculated. Our study will allow clinicians to tailor optimal therapies for mHSPC patients, and they will serve as a basis for comparative method studies.

Incidence of acute kidney injury (AKI) remained relatively stable over the last decade and the adjusted risks for it and mortality are similar across different continents and regions. Also, the mortality of septic-AKI can reach 70% in critically-ill patients. These sole facts can give rise to a question: is there something we do not understand yet?Currently, there are no specific therapies for septic AKI and the treatment aims only to maintain the mean arterial pressure over 65 mmHg by ensuring a good fluid resuscitation and by using vasopressors, along with antibiotics. On the other hand, there is an increased concern about the different hemodynamic changes in septic AKI versus other forms and the link between the gut microbiome and the severity of septic AKI. Fortunately, progress has been made in the form of administration of pre- and probiotics, short chain fatty acids (SCFA), especially acetate, and also broad-spectrum antibiotics or selective decontaminants of the digestive tract in a successful attempt to modulate the microbial flora and to decrease both the severity of AKI and mortality.In conclusion, septic-AKI is a severe form of kidney injury, with particular hemodynamic changes and with a strong link between the kidney and the gut microbiome. By modulating the immune response we could not only treat but also prevent severe forms. The most difficult part is to categorize patients and to better understand the key mechanisms of inflammation and cellular adaptation to the injury, as these mechanisms can serve in the future as target therapies. Resumen: La incidencia de la lesión renal aguda (LRA) se ha mantenido relativamente estable a lo largo de la última década, con unos riesgos ajustados de padecer y morir a consecuencia de esta enfermedad similares en los distintos continentes y regiones. La mortalidad asociada a la LRA secundaria a sepsis puede llegar a 70% en los pacientes que se encuentran en estado crítico. Estos hechos, por sí mismos, deben llevarnos a plantearnos la siguiente pregunta: ¿se nos escapa algo que aún no comprendemos?Actualmente no se dispone de terapias específicas para la LRA secundaria a sepsis y el tratamiento se centra únicamente en mantener la presión arterial media por encima de los 65 mmHg mediante una rehidratación adecuada, vasopresores y antibióticos. Asimismo, cada vez existe mayor interés por las diferentes alteraciones hemodinámicas que se producen en comparación con otras formas de la enfermedad, así como por la relación existente entre el microbioma intestinal y la gravedad. Afortunadamente, se ha avanzado notablemente en la forma en la que se administran los prebióticos y los probióticos, los ácidos grasos de cadena corta (AGCC), especialmente el acetato, los antibióticos de amplio espectro o los detoxificantes selectivos del tracto digestivo, en un intento exitoso de modular la flora microbiana y disminuir tanto la gravedad de la LRA como su mortalidad.En conclusión, la LRA secundaria a sepsis es una forma grave de lesión renal que provoca unos cambios hemodinámicos específicos y en la que se observa una estrecha relación entre la función renal y el microbioma intestinal. La modulación de la respuesta inmunitaria no solo permitiría tratar esta enfermedad, sino también prevenir las formas graves de la misma. La parte más difícil de este enfoque radica en clasificar correctamente a los pacientes y comprender mejor los mecanismos clave de la inflamación y la adaptación celular a la lesión, ya que estos pueden convertirse en futuras dianas terapéuticas.

This paper presents an in-depth analysis of a Quantum-inspired Multi-objective Optimization Algorithm (QMOA) applied to a unique problem: maximizing trading profits while minimizing energy costs. Previous investigations have explored the profitability of Bitcoin, yet our research delves into its relationship with energy costs. Regarding the trade-offs, the Pareto analysis reveals that trading profit and energy cost do not strongly inversely correlate. The range of outcomes shows a relatively uniform trading profit (from 1.302,85 to 1.310,22$), but a broader variation in energy costs (from 1.141,66 to 5.657,94$). While the trading profit remains stable, there is a wide array of options for minimizing energy cost, which is influenced by various constraints and market conditions. Solutions tend to cluster more in areas of higher energy costs. However, the variability in energy costs offers Bitcoin miners choices, allowing them to tailor strategies, whether that involves prioritizing energy efficiency, profit maximization or striking a balance.

The main objective of the paper is to reveal a few aspects related to combustion quality of a diesel engine fueled in diesel-gas mode with diesel fuel and compressed natural gas. The total amount of heat released per cycle will be higher when the engine is fueled in dual-fuel mode due to higher LHV and because of the gaseous state of CNG. For low and medium loads the total quality of heat released per cycle will increase with 10 % and for higher loads it will reach levels with 25 % higher. The heat release rate of the preformed mixture will double its value for low and medium loads and will reach thresholds up to 3.5 times higher (interval −15; −5°CA); admitting CNG into cylinder will help the preformed mixture to reach stoichiometric values and thus improving the fast combustion phase. Fueling the engine in dual fuel mode with diesel fuel and CNG will have a negative effect on the maximum heat release rate; there will be a 10 % drop in maximum HRR for low loads when the energetic substitution coefficient reaches 36 % and 14 % at high loads when the xc is 26 %. The gaseous state and a higher LHV of CNG will have a good impact on indicated mean effective pressure for all studied regimes when the engine is fueled in DG mode: for low and medium loads 30 % and for high loads 20 % increase will be recorded. Gaseous state of CNG will lead to a higher percentage of preformed mixture and thus the fast combustion phase will extend for longer periods for all studied regimes when the engine is fueled in DG mode (20 % longer for low and medium loads and 30 % for high loads). The diffusive combustion phase will become shorter due to a lower quantity of the main dose when CNG is injected into the intake manifold (10–15 % shorter for low loads and 7 % at high loads).

At the beginning of 1900, Romanian-Bulgarian relations were very tense, being fuelled by both the incidents at the Southern border and the attacks that took place on the Romanian territory, thus, on the agenda of the Romanian politicians, the problem of the Aromanians from the Balkan Peninsula and Macedonia, the province coveted by Bulgarians, Greeks and Serbs, where comitagii gangs, the antarti and the cetnic fought both for the liberation of the countrymen from Ottoman rule and with the Turkish troops. In this context, assassination came to be used as a weapon against opponents, being present in Romania, Bulgaria, Serbia and Greece. At the end of the 19th century, Romanian society was suddenly awakened to reality, facing the consequences of the barbaric manner in which one of these revolutionary secret committees acted, whose anarchist subcommittee was established in Bucharest – nowadays we frequently use the phrase terrorist cell for something similar. Thus, it received the mission to commit several bombings on the Romanian territory, as well as the assassination of King Carol I and Romanian dignitaries, while, at the Southern border, the Romanian border guards reported daily incidents at the common border whose purpose was to destabilize and maintain a tense state on the conventional demarcation line between Romania and Bulgaria.

Acupuncture has shown promise as a therapeutic option in temporomandibular disorders (TMD). Its benefits include pain relief, reduction of muscle tension and improvement of jaw function. Several alternative approaches, including dry needling and laser acupuncture, were also reported to improve TMD symptoms. This review aims to summarise the most recent studies available on these alternative therapies for TMD. An electronic literature search was conducted in 3 databases, PubMed, Web of Science, and Scopus, in order to identify articles on acupuncture, dry needling, or laser acupuncture. Search development, process, and two-step article selection were conducted by independent researchers. Data was extracted regarding study characteristics, population characteristics, acupuncture points or techniques used, and assessment methods for diagnosis and effects. Out of 431 identified results, 20 were selected for inclusion. We identified 11 studies on acupuncture, 3 studies on laser acupuncture and 6 studies on dry needling. Most studies showed improvement of TMD symptoms post-intervention, assessed by pain scales and maximum mouth opening. Overall, most studies showed promising results for acupuncture as an alternative, minimally invasive treatment method for TMD. When compared to controls or placebo, acupuncture, and related techniques result in significant relief of TMD symptoms.

Background and Objectives: Although considerable research has been devoted to examining the distinctions between fresh and frozen embryo transfer regarding obstetric outcomes and rates of pregnancy success, there is still a scarcity of thorough analyses that specifically examine neonatal outcomes. The objective of our study was to provide an in-depth analysis of neonatal outcomes that occur after the transfer of fresh and frozen embryos (ET vs. FET) in IVF/ICSI cycles. Materials and Methods: Multiple databases (PubMed/MEDLINE, Cochrane Library, Web of Science, Wiley, Scopus, Ovid and Science Direct) were searched from January 1980 to February 2024. Two reviewers conducted the article identification and data extraction, meeting inclusion and exclusion criteria. The methodological quality was evaluated using the Newcastle–Ottawa Scale (NOS) or the revised Cochrane Risk of Bias Tool. The meta-analysis was performed using RevMan 5.4. Results: Twenty studies, including 171,481 participants in total, were subjected to qualitative and quantitative analyses. A significant increase in preterm birth rates was noted with fresh embryo transfer compared to FET in the overall IVF/ICSI population (OR 1.26, 95% CI 1.18–1.35, p < 0.00001), as well as greater odds of a low birth weight (OR 1.37, 95% CI 1.27–1.48, p < 0.00001) and small-for-gestational-age infants in this group (OR 1.81, 95% CI 1.63–2.00, p < 0.00001). In contrast, frozen embryo transfer can result in macrosomic (OR 0.59, 95% CI 0.54–0.65, p < 0.00001) or large-for-gestational-age infants (OR 0.64, 95% CI 0.60–0.69, p < 0.00001). No significant difference was observed regarding congenital malformations or neonatal death rates. Conclusions: This systematic review confirmed that singleton babies conceived by frozen embryo transfer are at lower risk of preterm delivery, low birthweight and being small for gestational age than their counterparts conceived by fresh embryo transfer. The data support embryo cryopreservation but suggest that elective freezing should be limited to cases with a proven indication or within the framework of a clinical study.

Cancer survivorship was recently identified as a prostate cancer (PCa) research priority by PIONEER, a European network of excellence for big data in PCa. Despite being a research priority, cancer survivorship lacks a clear and agreed definition, and there is a distinct paucity of patient-reported outcome (PRO) data available on the subject. Data collection on cancer survivorship depends on the availability and implementation of (validated) routinely collected patient-reported outcome measures (PROMs). There have been recent advances in the availability of such PROMs. For instance, the European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) is developing survivorship questionnaires. This provides an excellent first step in improving the data available on cancer survivorship. However, we propose that an agreed, standardised definition of (prostate) cancer survivorship must first be established. Only then can real-world data on survivorship be collected to strengthen our knowledge base. With more men than ever surviving PCa, this type of research is imperative to ensure that the quality of life of these men is considered as much as their quantity of life. Patient summary: As there are more prostate cancer survivors than ever before, research into cancer survivorship is crucial. We highlight the importance of such research and provide recommendations on how to carry it out. The first step should be establishing agreement on a standardised definition of survivorship. From this, patient-reported outcome measures can then be used to collect important survivorship data.

Wolcott-Rallison syndrome is a rare cause of permanent neonatal diabetes mellitus caused by mutations in the eukaryotic translation initiation factor 2 alpha kinase 3 gene (EIF2AK3). Individuals affected by this disorder have severe hyperglycemia, pancreatic failure, and bone abnormalities and are prone to severe and life-threatening episodes of liver failure. This report illustrates the case of a 2-month-old infant with extreme hyperglycemia and severe diabetic ketoacidosis. Acute management was focused on correcting severe acidosis. Further management aimed to obtain stable blood glucose levels, balancing the patient’s need for comfort and lack of distress with the clinicians’ need for adequate information regarding the patient’s glycemic control. Genetic testing of the patient and his parents confirmed the diagnosis. The follow-up for 18 months after diagnosis is detailed, illustrating both the therapeutic success of subcutaneous insulin therapy and the ongoing complications that patients with Wolcott-Rallison syndrome are subject to.

This research aims to identify the prevalence of failure for Birmingham Hip Prosthesis (BHR) in total hip arthroplasty and to analyze its reasons from biomaterials and biofunctional perspectives. We present our current analysis and tests on a series of different BHR-retrieved prostheses after premature failure. Relevant clinical data, such as X-ray investigations and intraoperative images for clinical case studies, were analyzed to better understand all factors involved in BHR prosthesis failure. A detailed analysis of the failures highlighted uneven cement distribution, overloading in certain areas, and void formation in the material. A closer investigation using microscopical techniques revealed the presence of a crack originating from the gap between the cement mantle and human bone. Additionally, scanning electron microscopy analyses were conducted as part of the investigation to examine bone cement morphology in detail and better understand the interactions at the interfaces between implant, cement, and bone. In conclusion, this research emphasizes the importance of surgical technique planning and the cementation procedure in the success rate of BHR prostheses. It also underscores the need to carefully evaluate patient characteristics and bone quality to minimize the risk of BHR prosthesis failure. The cementation procedure seems to be essential for the long-term functionality of the BHR prosthesis.

The species of the genus Euphrasia present important medicinal potential according to their traditional uses. However, few studies aim to sustain this fact by scientific evidence. The present study aimed to explore the phytochemical profile and investigate the antioxidant, antimicrobial and antiproliferative potential of E. officinalis subsp. pratensis Fr. (EO) and E. stricta J.P.Wolff ex J.F.Lehm (ES). The tested samples consisted of ethanolic extracts. The identification and quantification of phenolic compounds were performed using spectrophotometric and LC–MS/MS methods. The antioxidant capacity was evaluated using the DPPH, FRAP and xanthine oxidase methods. Antimicrobial properties were screened using disk diffusion, broth microdilution and anti-biofilm assays, while antiproliferative potential was assessed on a colorectal adenocarcinoma human cancer cell line (DLD-1). The LC–MS/MS analysis showed chlorogenic acid and rutin as the dominant constituents in the tested extracts. The antioxidant activity assays showed important capacity for both samples; in vitro antimicrobial and anti-biofilm properties were exhibited, especially against Gram-positive bacteria, and an important inhibitory potential was observed on the proliferation of the DLD-1 cell line. The findings in the present study contribute to the recommendation of EO and ES for the prevention and treatment of oxidative stress-related pathologies, cancer and microbial infections.

Myxofibrosarcoma (MFS), an aggressive soft tissue sarcoma, is one of the undifferentiated pleomorphic sarcomas; it has a low incidence, affecting people in the sixth to eighth decades of life. It usually involves the extremities and is painless with a slow-growing pattern. Based on the case of a 52-year-old female patient who presented with a painful, massive, rapid-growing, ulcerated tumor of the anterior surface of the left thigh, we performed a literature review regarding the current standard of care for patients with MFS. Computed tomography examination, followed by magnetic resonance imaging and surgical biopsy with histopathological examination, confirmed the diagnosis and the presence of lung and inguinal lymph node metastases. Due to the rapid-growing pattern and the local aggressiveness, our tumor board team recommended emergency excisional surgery, with subsequent reconstructive procedures followed by referral to an oncological center. This review emphasizes the importance of proper and rapid diagnosis, followed by multidisciplinary management, for MFS cases with atypical presentation and distal metastases to improve overall outcomes.

Diabetes mellitus is a complex, multifactorial, progressive condition with a variety of approved therapeutic options. The purpose of this study was to offer an overview of the authorized antidiabetic medicines (excluding insulin) compared with marketed products in seven European countries. Data were obtained from primary sources, including the websites of national authorities and directly from specialists in the countries of interest. The range of marketed medicines compared with the authorized group was assessed in terms of active pharmaceutical ingredients (>60% in Bulgaria, France, Serbia), brand names (>70% in Bulgaria, the Czech Republic, Romania, Serbia, Spain), pharmaceutical forms (>60% in all countries), strengths (>60% in Bulgaria, the Czech Republic, Romania, Serbia, Spain), marketing authorization holder (≥50% in all countries) and the status of medicine. Spain was found to have the highest number of products based on most of these attributes. Over 90% of authorized medicines had a pharmacy price in Serbia. Regarding the newer class of GLP-1 receptor agonists, a retail price for all approved substances was available in Bulgaria, Romania, Serbia, and Spain. Only one brand name with one concentration was found available for some agents, being susceptible to drug shortages: glibenclamide (Romania, Serbia, Spain), glipizide (the Czech Republic, Poland, Romania, Spain), glisentide (Spain), acarbose (the Czech Republic), sitagliptin (Bulgaria, Poland), vildagliptin (the Czech Republic, Poland) and saxagliptin (the Czech Republic, France, Romania, Serbia). An overview of the national and international therapeutic options may allow competent authorities and health professionals to take rapid measures in case of supply problems or health crises.