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1. Quality of Public Communication, as a Determinant of Romanian Citizens’ Trust in Public Institutions

Author

Andrei Marcel Manole, Alexandra Sima, Cristian Mieila, and Mihaela Hortensia Hojda

Subjects
public institutions, communication, open data, information, Electronic computers. Computer science, QA75.5-76.95, Economic theory. Demography, HB1-3840, Economics as a science, HB71-74
Abstract

While the phrase ‘public service’ commonly refers to public bodies based on legal principles, it can also be understood as the services rendered to the public. Therefore, fostering the relationship of trust between services and citizens – as the users of these public services – involves thinking very finely about attracting audiences and the interactions between users and politicians through public communication, regardless of the channel used. The low use of open data and information in public action translates into a poor level of trust towards public institutions in Romania, with no clear vision to urgently improve the situation. In order to change the architecture of the data of public interest, the central institutions must act towards the citizen’ environment choice and therefore, will improve the public trust in institutions.

Published
2024
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2. Use of a Micronutrient Cocktail to Improve Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Adults with Obesity: A Randomized, Double-Blinded Pilot Clinical Trial

Author

Iulia Teodora Perva, Iulia Elena Simina, Renata Bende, Alexandru Cătălin Motofelea, Adela Chirita Emandi, Nicoleta Andreescu, Alexandra Sima, Adrian Vlad, Ioan Sporea, Cristian Zimbru, Paul Calin Tutac, Maria Puiu, and Mihai Dinu Niculescu

Subjects
5-MTHF, betaine, choline, omega-3 fatty acids, vitamin B12, metabolic syndrome, Medicine (General), R5-920
Abstract

Background and Objectives: The goal of this study was to assess the impact of supplementation with a combination of nutrients on metabolic-dysfunction-associated steatotic liver disease (MASLD)-related liver parameters, and other parameters related to metabolic syndrome in adults with obesity. These measurements included anthropometric and lipid profiling, and FibroScan technology (controlled attenuation parameter (CAP) and transient elastography (TE) values). Materials and Methods: A double-blind, placebo-controlled pilot clinical trial was conducted over a three-month treatment period. Adults with metabolic syndrome and obesity were allocated to receive either a cocktail of nutrients with defined daily dosages (5-MTHF, betaine, alpha-linolenic acid, eicosapentaenoic acid, choline bitartrate, docosahexaenoic acid, and vitamin B12) or a placebo. The participants were evaluated at the start and the end of the three-month treatment period. Results: A total of 155 participants entered the study, comprising 84 in the treatment group and 71 in the placebo group. The administration of the nutritional supplement resulted in a notable reduction in both CAP and TE scores when compared to the placebo group. The treatment group exhibited a mean reduction in CAP of 4% (p < 0.05) and a mean reduction in TE of 7.8% (p < 0.05), indicative of a decline in liver fat content and fibrosis. Conclusions: The supplementation over a period of three months led to a significant amelioration of liver fibrosis and steatosis parameters in adults with metabolic syndrome and obesity. These findings suggest that this supplementation regimen could be a beneficial adjunct therapy for improving liver health in adults with obesity-induced MASLD.

Published
2024
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3. Readjustments in Public Institutions due to Covid-19 Pandemic and the Communication Effects in Dâmbovița County Council

Author

Alexandra Sima (Nițoi) and Georgiana - Daniela Vasile (Vlad)

Subjects
covid-19, public institutions, health crisis, communication, grounded theory, Business, HF5001-6182, Economics as a science, HB71-74
Abstract

The entire globe is facing challenging times, due to an invisible threat named Covid-19. This virus that has generated a worldwide health crisis is forcing all levels of administration to work in an environment of uncertainty and to cut access to priority sectors like health, education, economy and social life, considering the challenges it poses. This pandemic has a very divergent local and regional impact and a strong territorial dimension, with major consequences for citizens, businesses and public institutions. This article explores the authorities’ response to the crisis, with particular examples from the impact upon Dâmbovița County Council, by examining the efforts and good practices that are being made to tackle the pandemic and the remodeling of the local communication management.

Published
2020

4. Practical Applicability of the ISARIC-4C Score on Severity and Mortality due to SARS-CoV-2 Infection in Patients with Type 2 Diabetes

Author

Oana Albai, Mirela Frandes, Alexandra Sima, Bogdan Timar, Adrian Vlad, and Romulus Timar

Subjects
SARS-CoV-2 infection, ISARIC-4C score, diabetes mellitus, risk, severity, mortality, Medicine (General), R5-920
Abstract

Background and objectives. There is a bidirectional relationship between SARS-CoV-2 infection and diabetes mellitus (DM), as people with DM are more vulnerable, and SARS-CoV-2 infections worsen the prognosis in these patients. The main purpose of the study was to evaluate the application validity of the ISARIC-4C score in patients confirmed with SARS-CoV-2 infection. Materials and Methods. The study included 159 patients previously known to have type 2 DM and confirmed positive for SARS-CoV-2 infection. We analyzed the concordance between the clinical evaluation of the patients and the ISARIC-4C score. Results. The mortality rate in hospitalized patients was 25.15%. The mortality risk was higher for ISARIC-4C values >14 than in the opposite group (63.93% vs. 31.24%; p < 0.001). The area under the curve (AUC) of the mortality score was 0.875 (95% CI: 0.820–0.930; p < 0.001), correctly classifying 77.36% of the cohort. A cut-off value of >14 had a sensitivity of 87.80% (95% CI: 87.66–87.93), specificity 73.72% (95% CI: 73.48–73.96), positive predictive value 53.73% (95% CI: 53.41–54.04), and negative predictive value 94.56% (95% CI: 94.5–94.62). The Cox regression model showed that the length of hospitalization (LH) was significantly influenced by body mass index, lung impairment, and aspartate aminotransferase, increasing the hazards, while lower HbA1c and lower SatO2 significantly decreased the hazards. Conclusions. ISARIC-4C score estimates the likelihood of clinical deterioration and the mortality risk in patients hospitalized with type 2 DM and positive for SARS-CoV-2, being useful in assessing the prognosis from the onset, as well as in developing therapeutic strategies.

Published
2022
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5. Intake Differences between Subsequent 24-h Dietary Recalls Create Significant Reporting Bias in Adults with Obesity

Author

Costela Lacrimioara Serban, Adela Chirita-Emandi, Iulia Teodora Perva, Alexandra Sima, Nicoleta Andreescu, Salomeia Putnoky, Mihai Dinu Niculescu, and Maria Puiu

Subjects
training bias, order of 24-h recalls, exacerbating underreporting, weekend–weekday differences, low quality diet, nutrient intakes, Technology, Engineering (General). Civil engineering (General), TA1-2040, Biology (General), QH301-705.5, Physics, QC1-999, Chemistry, QD1-999
Abstract

In depth understanding of the dietary patterns of individuals with obesity is needed in practice and research, in order to support dietitians and physicians in the design and implementation of nutritional management. We aimed to analyze the consistency of energy, macro-, and micronutrient reported intakes in four non-consecutive 24-h dietary recalls from 388 adults with obesity using information collected in the NutriGen Study (ClinicalTrials.gov, NCT02837367). Significant decreases were identified for reported energy and several, macro- and micronutrient intakes, between the first and subsequent 24-h recalls. Significant differences of reported intakes were identified in sensitivity analyses, suggesting that the first recall (also the only one performed on site, face-to-face) might be a point of bias. A comparison of the differences in intakes between weekend and weekday, after adjustment for false discovery rate were non-statistically significant either in male, females, or in total. To overcome this potential bias, studies should be carefully conducted, starting from the design phase, through to the analysis and interpretation phases of the study. Prior to averaging specific intakes across all sessions of reporting, a preliminary analysis must be conducted to identify if a certain time point had significant differences from all other time points and overview potential sources of bias: reporting bias, training bias, or behavioral changes could be responsible for such differences.

Published
2022
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6. Increased Incidence of Type 1 Diabetes during the COVID-19 Pandemic in Romanian Children

Author

Adrian Vlad, Viorel Serban, Romulus Timar, Alexandra Sima, Veronica Botea, Oana Albai, Bogdan Timar, and Mihaela Vlad

Subjects
type 1 diabetes, COVID-19, incidence, Medicine (General), R5-920
Abstract

Background and Objective: It is known that several viruses are involved in the pathogenesis of type 1 diabetes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the β-cells, as well, and thus lead to an increase in the incidence of type 1 diabetes. Material and Methods: The Romanian National Organization for the Protection of Children and Adolescents with Diabetes (ONROCAD) has collected information regarding new cases of type 1 diabetes in children aged 0 to 14 years from all over the country since 1996 and has computed the incidence of type 1 diabetes in this age group. Results: We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years (mean yearly increase was 5.1% in the period 1996–2015 and 0.8% in the interval 2015–2019). The proportion of newly diagnosed cases was significantly higher in the second half of 2020 compared to the second half of the previous years (57.8 vs. 51%, p < 0.0001). Conclusions: All these aspects suggest the role that SARS-CoV-2 could have in triggering pancreatic autoimmunity. To confirm this, however, collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed.

Published
2021
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7. Evaluation of the Relapse Risk and Survival Rate in Patients with Hodgkin Lymphoma: A Monocentric Experience

Author

Ovidiu Potre, Monica Pescaru, Alexandra Sima, Ioana Ionita, Raluca Tudor, Ema Borsi, Miruna Samfireag, and Cristina Potre

Subjects
Hodgkin lymphoma, relapse risk, ABVD, BEACOPP, event free survival, Medicine (General), R5-920
Abstract

Background and objectives: Hodgkin lymphoma (HL) is characterized by the presence of malignant Reed Sternberg cells. Although the current curability rate in patients with HL has increased, up to 30% of those in the advanced stages and 5% to 10% of those in limited stages of the disease, relapse. According to the studies, the relapse risk in HL decreases after 2 years. The purpose of this study is to evaluate the relapse risk and event free survival (EFS) in patients with HL treated with Doxorubicin, Bleomycin, Vinblastine and Dacarbazine (ABVD), or treated with Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone (BEACOPP) regimens. Material and methods: In an observational, consecutive-case scenario, 71 patients (median age 32 years; range 16 to 80 years) diagnosed within a 4-year timeframe were enrolled; all patients were treated according to standards of care. The average follow-up duration was 26 months. Results: The risk of relapse, in patients older than 40 years, decreased after 1 year, OR = 0.707 (95% CI 0.506 to 0.988), and 2 years, OR = 0.771 (95% CI 0.459 to 1.295), respectively. Patients in the advanced stages had a higher International Prognostic Score (IPS) (score ≥ 4). The overall survival at 2 years was 57.74% and the disease-specific survival at 2 years was 71.83%. Regardless, the chemotherapy regimen and the EFS time, advanced stage, high IPS and bulky disease were still associated with an increased relapse risk in patients with HL. Conclusions: The use of ABVD chemotherapy regimen followed by 2 years EFS was associated with a reduced relapse risk.

Published
2021
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8. Improvement of Platelet Respiration by Cell–Permeable Succinate in Diabetic Patients Treated with Statins

Author

Vlad Florian Avram, Anca Mihaela Bîna, Alexandra Sima, Oana Maria Aburel, Adrian Sturza, Ovidiu Burlacu, Romulus Zorin Timar, Danina Mirela Muntean, Eskil Elmér, and Octavian Marius Crețu

Subjects
platelets, diabetes, statins, cell–permeable succinate (NV118), mitochondria, high–resolution respirometry, Science
Abstract

Diabetes mellitus (DM) is the most severe metabolic disease that reached the level of a global pandemic and is associated with high cardiovascular morbidity. Statins are the first–line lipid–lowering therapy in diabetic patients with or without a history of atherosclerotic disease. Although well tolerated, chronic treatment may result in side effects that lead to treatment interruption. Mitochondrial dysfunction has emerged as a central pathomechanism in DM– and statin–induced side effects. Assessment of mitochondrial respiration in peripheral platelets has been increasingly used as a mirror of organ mitochondrial dysfunction. The present study aimed to assess the: (i) changes in mitochondrial respiration elicited by statins in patients with type 2 DM and (ii) the effects of cell–permeable succinate (NV118) on respiratory parameters in platelets harvested from these patients. No significant changes were found in global mitochondrial respiration of intact platelets isolated from diabetic patients treated with either atorvastatin or rosuvastatin. Similarly, no significant changes in mitochondrial respiration of permeabilized platelets were found between diabetic patients treated with atorvastatin and healthy controls. Acute ex vivo administration of NV118 significantly improved respiration in isolated platelets. These results prompt further research on the role of permeable succinate as a therapeutic alternative for improving mitochondrial function in metabolic pathologies and point to the role of peripheral platelets as a potential biomarker of treatment response.

Published
2021
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11. Intelligent energy management based on SCADA system in a real Microgrid for smart building applications

Author

Domenico Luca Carnì, Erfan Shirdare, Behin Adelmanesh, Catalina Alexandra Sima, Luigi Martirano, and Mostafa Kermani

Subjects
intelligent energy management system, communication protocols, microgrid, real-time controller, smart building, supervisory control and data acquisition, Renewable Energy, Sustainability and the Environment, Computer science, business.industry, Energy management, Energy engineering, Automotive engineering, law.invention, Energy management system, SCADA, law, Electrical network, Microgrid, business, Modbus, Building automation
Abstract

Energy management is one of the main challenges in Microgrids (MGs) applied to Smart Buildings (SBs). Hence, more studies are indispensable to consider both modeling and operating aspects to utilize the upcoming results of the system for the different applications. This paper presents a novel energy management architecture model based on complete Supervisory Control and Data Acquisition (SCADA) system duties in an educational building with an MG Laboratory (Lab) testbed, which is named LAMBDA at the Electrical and Energy Engineering Department of the Sapienza University of Rome. The LAMBDA MG Lab simulates in a small scale a SB and is connected with the DIAEE electrical network. LAMBDA MG is composed of a Photovoltaic generator (PV), a Battery Energy Storage System (BESS), a smart switchboard (SW), and different classified loads (critical, essential, and normal) some of which are manageable and controllable (lighting, air conditioning, smart plugs operating into the LAB). The aim of the LAMBDA implementation is making the DIAEE smart for energy saving purposes. In the LAMBDA Lab, the communication architecture consists in a complex of master/slave units and actuators carried out by two main international standards, Modbus (industrial serial standard for electrical and technical monitoring systems) and Konnex (an open standard for commercial and domestic building automation). Making the electrical department smart causes to reduce the required power from the main grid. Hence, to achieve the aims, results have been investigated in two modes. Initially, the real-time mode based on the SCADA system, which reveals real daily power consumption and production of different sources and loads. Next, the simulation part is assigned to shows the behavior of the main grid, loads and BESS charging and discharging based on energy management system. Finally, the proposed model has been examined in different scenarios and evaluated from the economic aspect.

Published
2021

12. Metformin Treatment: A Potential Cause of Megaloblastic Anemia in Patients with Type 2 Diabetes Mellitus

Author

Alexandra Sima, Oana Albai, Bogdan Timar, Diana Paun, Romulus Timar, and Deiana Roman

Subjects
Pharmacology, Abdominal pain, medicine.medical_specialty, Anemia, business.industry, Methylmalonic acid, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, medicine.disease, Cobalamin, Gastroenterology, Metformin, chemistry.chemical_compound, chemistry, Internal medicine, Internal Medicine, medicine, Vitamin B12, medicine.symptom, Megaloblastic anemia, business, medicine.drug
Abstract

Introduction Vitamin B12 (cobalamin) deficiency is a frequent cause of megaloblastic anemia, manifested through various symptoms. Screening for this deficiency can be justified in case of patients with one or more risk factors present from the following: gastric resections, inflammatory bowel disease, use of metformin over a prolonged period of time, administration of proton pump inhibitors or H2 histamine receptor blockers for more than 12 months and in case of adults over 75 years of age. One method of determining vitamin B12 deficiency is measuring its serum levels, as well as performing measurements of serum levels of methylmalonic acid and homocysteine levels, which experience an increase in the early stages of vitamin B12 deficiency. Clinical case We bring to your attention, the case of a 62 years old patient diagnosed with Type 2 Diabetes Mellitus in 2015 that presented in the emergency room in October 2019 with an altered general condition, nausea, vomiting, abdominal pain, palpitation, and dyspnea. Treatment with metformin was initiated from the diagnosis of Type 2 Diabetes Mellitus, four years before. Investigations established the diagnosis of megaloblastic anemia by vitamin B12 deficiency. The symptoms disappeared after the injection of vitamin B12. Conclusion Periodical dosing of vitamin B12 should be performed in the case of patients with Type 2 Diabetes Mellitus treated with metformin, especially if they associate anemia and/or peripheral diabetic polyneuropathy.

Published
2020

13. Techno-economic assessment of university energy communities with on/off microgrid

Author

Catalina Alexandra Sima, Claudia Laurenta Popescu, Mihai Octavian Popescu, Mariacristina Roscia, George Seritan, and Cornel Panait

Subjects
Renewable Energy, Sustainability and the Environment, Settore ING-IND/09 - Sistemi per l'Energia e L'Ambiente, Energy communities, Optimization of energy systems, Planning of energy systems, Renewable energy sources, University campus
Published
2022

14. Social behavior analysis for improving the positive energy transition

Author

Catalina Alexandra Sima, Mariacristina Roscia, and Vasile Sebastian Dancu

Subjects
Positive transition, Social analysis, Renewable Energy, Sustainability and the Environment, Settore ING-IND/09 - Sistemi per l'Energia e L'Ambiente, Energy communities, Renewable energy sources, Survey campaign
Published
2022

15. Dynamics of Epicardiac Fat and Heart Function in Type 2 Diabetic Patients Initiated with SGLT-2 Inhibitors

Author

Adrian Vlad, Alexandra Sima, Laura Diaconu, Mircea Munteanu, Raluca Lupusoru, Bogdan Timar, Adina Braha, Romulus Timar, Daniela Cipu, Alin Albai, and Lucian Vasiluta

Subjects
Pharmacology, Cardiac function curve, medicine.medical_specialty, Ejection fraction, medicine.diagnostic_test, business.industry, Diastole, Adipose tissue, 030209 endocrinology & metabolism, Computed tomography, Type 2 diabetes, 030204 cardiovascular system & hematology, medicine.disease, Epicardial fat, 03 medical and health sciences, 0302 clinical medicine, Heart failure, Internal medicine, Internal Medicine, medicine, Cardiology, business
Abstract

Purpose The aim of this study was to assess the dynamics of epicardiac adipose tissue (EAT) thickness and total volume as well as that of systolic and diastolic dysfunction in a group of patients with type 2 diabetes (T2D) after initiation of sodium glucose co-transporter 2 (SGLT 2) inhibitors therapy. Patients and methods This prospective, observational study included 53 patients with T2D who received SGLT-2 inhibitors for 24 weeks. In all patients, echocardiographic screening for EAT, systolic and diastolic dysfunction and non-contrast computed tomography scans were performed, both before and after 24 weeks of SGLT-2 inhibition. Imagistic evaluation was followed by the association's analysis between the dynamics of EAT and heart function, as well as the patient's clinical and biological parameters. We considered a decrease or increase of more than 10% in EAT as being clinically significant. Results The mean volume of EAT decreased significantly after SGLT 2 inhibition (37.8±17.2 vs. 20.7±7 cm3; p

Published
2019

16. Increased Incidence of Type 1 Diabetes during the COVID-19 Pandemic in Romanian Children

Author

Viorel Serban, Bogdan Timar, Adrian Vlad, Veronica Botea, Mihaela Vlad, Romulus Timar, Oana Albai, and Alexandra Sima

Subjects
Background information, Pediatrics, medicine.medical_specialty, Medicine (General), Coronavirus disease 2019 (COVID-19), Adolescent, type 1 diabetes, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.disease_cause, Article, Autoimmunity, R5-920, Diabetes mellitus, Pandemic, Medicine, Humans, Child, Pandemics, Type 1 diabetes, business.industry, Romania, SARS-CoV-2, Incidence (epidemiology), Incidence, COVID-19, General Medicine, medicine.disease, Diabetes Mellitus, Type 1, business
Abstract

Background and Objective: It is known that several viruses are involved in the pathogenesis of type 1 diabetes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the β-cells, as well, and thus lead to an increase in the incidence of type 1 diabetes. Material and Methods: The Romanian National Organization for the Protection of Children and Adolescents with Diabetes (ONROCAD) has collected information regarding new cases of type 1 diabetes in children aged 0 to 14 years from all over the country since 1996 and has computed the incidence of type 1 diabetes in this age group. Results: We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years (mean yearly increase was 5.1% in the period 1996–2015 and 0.8% in the interval 2015–2019). The proportion of newly diagnosed cases was significantly higher in the second half of 2020 compared to the second half of the previous years (57.8 vs. 51%, p &lt, 0.0001). Conclusions: All these aspects suggest the role that SARS-CoV-2 could have in triggering pancreatic autoimmunity. To confirm this, however, collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed.

Published
2021

17. Evaluation of the Relapse Risk and Survival Rate in Patients with Hodgkin Lymphoma: A Monocentric Experience

Author

Ioana Ionita, Ema Borsi, Miruna Samfireag, Raluca Tudor, Cristina Potre, Alexandra Sima, Monica Pescaru, and Ovidiu Potre

Subjects
BEACOPP, Oncology, Adult, Vincristine, medicine.medical_specialty, Medicine (General), Adolescent, medicine.medical_treatment, Dacarbazine, relapse risk, Procarbazine, Vinblastine, Article, Disease-Free Survival, Bleomycin, Young Adult, R5-920, Recurrence, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, event free survival, Survival rate, Cyclophosphamide, Aged, Aged, 80 and over, business.industry, ABVD, General Medicine, Middle Aged, Chemotherapy regimen, Hodgkin Disease, Survival Rate, Treatment Outcome, Doxorubicin, business, Hodgkin lymphoma, medicine.drug
Abstract

Background and objectives: Hodgkin lymphoma (HL) is characterized by the presence of malignant Reed Sternberg cells. Although the current curability rate in patients with HL has increased, up to 30% of those in the advanced stages and 5% to 10% of those in limited stages of the disease, relapse. According to the studies, the relapse risk in HL decreases after 2 years. The purpose of this study is to evaluate the relapse risk and event free survival (EFS) in patients with HL treated with Doxorubicin, Bleomycin, Vinblastine and Dacarbazine (ABVD), or treated with Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone (BEACOPP) regimens. Material and methods: In an observational, consecutive-case scenario, 71 patients (median age 32 years, range 16 to 80 years) diagnosed within a 4-year timeframe were enrolled, all patients were treated according to standards of care. The average follow-up duration was 26 months. Results: The risk of relapse, in patients older than 40 years, decreased after 1 year, OR = 0.707 (95% CI 0.506 to 0.988), and 2 years, OR = 0.771 (95% CI 0.459 to 1.295), respectively. Patients in the advanced stages had a higher International Prognostic Score (IPS) (score ≥ 4). The overall survival at 2 years was 57.74% and the disease-specific survival at 2 years was 71.83%. Regardless, the chemotherapy regimen and the EFS time, advanced stage, high IPS and bulky disease were still associated with an increased relapse risk in patients with HL. Conclusions: The use of ABVD chemotherapy regimen followed by 2 years EFS was associated with a reduced relapse risk.

Published
2021

19. Updates in the prevention of diabetes complications

Author

Universitatea de Medicină și Farmacie „Victor Babeș', Timișoara, România, Alexandra Sima, and Adrian Vlad

Subjects
medicine.medical_specialty, business.industry, Diabetes mellitus, medicine, General Medicine, Intensive care medicine, medicine.disease, business
Published
2019

20. Improvement of Platelet Respiration by Cell–Permeable Succinate in Diabetic Patients Treated with Statins

Author

Romulus Timar, Oana M. Aburel, Eskil Elmér, Adrian Sturza, Ovidiu Burlacu, Vlad Florian Avram, Danina Muntean, Octavian M. Crețu, Alexandra Sima, and Anca Mihaela Bîna

Subjects
0301 basic medicine, Atorvastatin, 030204 cardiovascular system & hematology, Mitochondrion, Pharmacology, Article, General Biochemistry, Genetics and Molecular Biology, statins, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Respiration, cell–permeable succinate (NV118), Medicine, Platelet, Rosuvastatin, Respiratory system, lcsh:Science, Ecology, Evolution, Behavior and Systematics, diabetes, business.industry, Paleontology, medicine.disease, mitochondria, high–resolution respirometry, 030104 developmental biology, Space and Planetary Science, platelets, lcsh:Q, business, Ex vivo, medicine.drug
Abstract

Diabetes mellitus (DM) is the most severe metabolic disease that reached the level of a global pandemic and is associated with high cardiovascular morbidity. Statins are the first–line lipid–lowering therapy in diabetic patients with or without a history of atherosclerotic disease. Although well tolerated, chronic treatment may result in side effects that lead to treatment interruption. Mitochondrial dysfunction has emerged as a central pathomechanism in DM– and statin–induced side effects. Assessment of mitochondrial respiration in peripheral platelets has been increasingly used as a mirror of organ mitochondrial dysfunction. The present study aimed to assess the: (i) changes in mitochondrial respiration elicited by statins in patients with type 2 DM and (ii) the effects of cell–permeable succinate (NV118) on respiratory parameters in platelets harvested from these patients. No significant changes were found in global mitochondrial respiration of intact platelets isolated from diabetic patients treated with either atorvastatin or rosuvastatin. Similarly, no significant changes in mitochondrial respiration of permeabilized platelets were found between diabetic patients treated with atorvastatin and healthy controls. Acute ex vivo administration of NV118 significantly improved respiration in isolated platelets. These results prompt further research on the role of permeable succinate as a therapeutic alternative for improving mitochondrial function in metabolic pathologies and point to the role of peripheral platelets as a potential biomarker of treatment response.

Published
2021
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21. Considerations regarding the risk of integrity – Romanian developments within the European framework

Author

Mirela Roxana Bărbulescu, Florian Iancu, Anda-Ileana Necula, Mihai Mieilă, Alexandra Sima, and Georgiana Vlad

Subjects
Value (ethics), business.industry, Corruption, Process (engineering), media_common.quotation_subject, 050901 criminology, 05 social sciences, corruption measurements, United Nations Convention against Corruption, Abuse of power, integrity risks, lcsh:Social Sciences, lcsh:H, Risk analysis (engineering), 0502 economics and business, media_common.cataloged_instance, 0509 other social sciences, European union, Human resources, business, 050203 business & management, Risk management, media_common, european framework on corruption
Abstract

In the process of risk management process implementation and deployment within the organizations, both public and private, the applicable standards outline the role played the human resources, as the key issue in this respect. Following the standards and the practice in the field, the integrity risks are considered within the framework of a holistic approach. The paper tries to introduce and address the main features of the integrity risks, considering the European approach, based on the quantitative and qualitative measurement through some specific indicators. Besides, the joint-approaches of the developments in the legal framework, and the other international bodies involved in regulation of the field, namely the Organization for Economic Cooperation and Development and the United Nations Convention against Corruption are outlined. In addition, the public perception indicators regarding the integrity are presented through the comparative examination of the local findings amongst the other European countries and averages, pointing out the specific evolutions. The conclusions highlight the favourable changes and some of the actions required as prerequisites for necessary further improvements. Research background: Defined as the abuse of power oriented towards gain of private benefits, the corruption is a phenomenon that affects the economies and the fair distribution of welfare. Although there is a regulatory framework both at national and international levels, measuring of corruption remains a difficult task, as it often relies on public perception. Purpose of the article: The objectives consist in identification and assessment of integrity risks, besides the implementation of the adequate control tools, in order to ensure their proper monitoring. Methods: Employing the data from the international surveys and indexes used in measurement of the corruption perception, and considering the applicable legal framework, there are examined both the specific trends in Romania, compared to the general developments in the European Union . Findings Value added: Amid a general improvement trend, there are highlighted some slight backward steps and the necessary actions for future improvements. Considering the weak parts specific to the perception surveys, besides their further usage, results the necessity of fostering the using of special designed indexes, which rely, in addition, on aspects that mainly remain out of public perception.

Published
2021

22. Metformin alleviates monoamine oxidase-related vascular oxidative stress and endothelial dysfunction in rats with diet-induced obesity

Author

Octavian M. Crețu, Daniel Malița, Danina Muntean, Rodica Lighezan, Loredana N. Ionica, Raluca Soșdean, Ovidiu Burlacu, Adrian Sturza, Alexandra Sima, Anca Mihaela Bîna, and Laura Gaiță

Subjects
Male, medicine.medical_specialty, Monoamine oxidase, Clinical Biochemistry, medicine.disease_cause, Downregulation and upregulation, Internal medicine, Diabetes mellitus, medicine, Animals, Hypoglycemic Agents, Obesity, Vascular Diseases, Endothelial dysfunction, Molecular Biology, Monoamine Oxidase, Aorta, chemistry.chemical_classification, Reactive oxygen species, business.industry, Cell Biology, General Medicine, medicine.disease, Metformin, Rats, Disease Models, Animal, Oxidative Stress, Endocrinology, chemistry, Endothelium, Vascular, business, Oxidative stress, medicine.drug, Myograph
Abstract

In the past decade, monoamine oxidase (MAO) with 2 isoforms, MAO-A and B, has emerged as an important source of mitochondrial reactive oxygen species (ROS) in cardio-metabolic pathologies. We have previously reported that MAO-related oxidative stress mediates endothelial dysfunction in rodent models of diabetes and diabetic patients; however, the role of MAO in the vascular impairment associated to obesity has not been investigated so far. Metformin (METF), the first-line drug in the therapy of type 2 diabetes mellitus, has been reported to elicit vasculoprotective effects via partially elucidated mechanisms. The present study was purported to assess the effects of METF on MAO expression, ROS production and vasomotor function of aortas isolated from rats with diet-induced obesity. After 24 weeks of high calorie junk food (HCJF) diet, isolated aortic rings were prepared and treated with METF (10 μM, 12 h incubation). Measurements of MAO expression (quantitative PCR and immune histochemistry), ROS production (spectrometry and immune-fluorescence) and vascular reactivity (myograph studies) were performed in rat aortic rings. MAO expression was upregulated in aortic rings isolated from obese rats together with an increase in ROS production and an impairment of vascular reactivity. METF decreased MAO expression and ROS generation, reduced vascular contractility and improved the endothelium-dependent relaxation in the diseased vascular preparations. In conclusion, METF elicited vascular protective effects via the mitigation of MAO-related oxidative stress in the rat model of diet-induced obesity.

Published
2020

24. Factors Associated with the Remission of Type 1 Diastolic Dysfunction after Dapagliflozin Treatment in Patients with Type 2 Diabetes

Author

Laura Diaconu, Adina Braha, Alexandra Sima, Lucian Vasiluță, Alin Albai, Daniela Cipu, Bogdan Timar, and Romulus Timar

Subjects
medicine.medical_specialty, endocrine system diseases, lcsh:Medicine, Renal function, heart failure, Type 2 diabetes, 030204 cardiovascular system & hematology, type 1 diastolic dysfunction, Article, liver steatosis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, 030212 general & internal medicine, Dapagliflozin, Glycemic, liver fibrosis, Ejection fraction, business.industry, lcsh:R, General Medicine, dapagliflozin, medicine.disease, chemistry, Heart failure, business, Body mass index
Abstract

Patients with type 2 diabetes (T2DM) are at high risk of developing cardiovascular disease and heart failure (HF), both with preserved and reduced ejection fraction of the left ventricle. Previous research demonstrated that dapagliflozin treatment is associated with the remission of type 1 diastolic dysfunction (DD1) in patients with T2DM. The main aim of this study was to evaluate the possible baseline predictors associated with the remission of DD1 in patients with T2D after one year of dapagliflozin treatment. In this prospective and observational study, 45 patients with T2DM were evaluated before and after one year of treatment with 10 mg dapagliflozin daily added to their background therapy. In the studied group, 73.3% (33/45) of the patients had DD1 at baseline. The primary outcome of this research was DD1 remission. DD1 remission was associated with improvement of liver stiffness, an increase in estimated glomerular filtration rate (eGFR), and a decrease in hemoglobin A1c (HbA1c). Independent predictors for the remission of DD1 were a more than 0.4 kPa difference in the initial stiffness score and the 1-year assessment fibrosis score and a duration of diabetes &le, 8 years. Age, body mass index (BMI), or patient weight after one year did not influence the DD1 outcome. Patients with a T2DM duration of less than eight years have the additional benefit of DD1 remission associated with dapagliflozin treatment beyond the conventional benefits such as improvements in glycemic control, cardiovascular, renal, and hepatic risk reductions. In patients with T2DM, the remission of DD1 was associated with decrease of liver stiffness.

Published
2020
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25. Ordered 24-Hrs Recalls Associate with Systematic and Order-Specific Differences in Reported Energy and Carbohydrate Intakes by Individuals with Obesity: A methodological Approach in A Cross-Sectional Study

Author

Alexandra Sima, Mihai D. Niculescu, Iulia Teodora Perva, Salomeia Putnoky, Nicoleta Andreescu, Maria Puiu, Adela Chirita-Emandi, and Costela Lacrimioara Serban

Subjects
Order (business), Cross-sectional study, Environmental health, medicine, medicine.disease, Obesity, Mathematics
Abstract

Background. In depth understanding of dietary patterns of individuals with obesity is needed in practice and research, in order to support dietitians and physicians in the design and implementation of nutritional management. We aimed to analyze the consistency of energy, macro- and micronutrients reported intakes in four non-consecutive 24-hrs dietary recalls using information collected in the NutriGen Study (ClinicalTrials.gov, NCT02837367).Methods. Data included reported food intakes from 388 adults who completed four 24-hrs recalls. Results. Analyses indicated a significant decrease between the first and subsequent evaluations in regard to energy and several nutrients, with a systematic decrease in reporting energy and carbohydrates for the second evaluation. When excluding the second 24-hrs recall from the average, this new evaluation induced significant increases in the averages for reported energy, carbohydrates, and almost all micronutrients, indicating that the second recall is a point of controversy for whether to be included or not in further analyses.Conclusion. This study identified systematic differences in energy and carbohydrate reporting in the second recall, when four ordered 24-hour recalls were administered to adults with obesity. More studies are needed to identify the source of these differences, in order to ascertain whether reporting, training bias, or behavioral changes are responsible for such differences, and whether a time point with systematic differences should be included or not in further analyses.

Published
2020

26. Screening for Liver Fibrosis and Steatosis in a Large Cohort of Patients with Type 2 Diabetes Using Vibration Controlled Transient Elastography and Controlled Attenuation Parameter in a Single-Center Real-Life Experience

Author

Ioan Sporea, Alexandra Sima, Victor Baldea, Alina Popescu, Raluca Lupusoru, Ruxandra Mare, Romulus Timar, Silviu Nistorescu, Roxana Sirli, and Adina Braha

Subjects
medicine.medical_specialty, Waist, endocrine system diseases, type 2 diabetes mellitus, lcsh:Medicine, Type 2 diabetes, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, Fibrosis, Internal medicine, steatosis, Medicine, Prospective cohort study, liver fibrosis, business.industry, lcsh:R, Fatty liver, Type 2 Diabetes Mellitus, nutritional and metabolic diseases, General Medicine, FibroScan measurements, medicine.disease, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Steatosis, business, Transient elastography
Abstract

Background: Type 2 diabetes mellitus (T2DM), obesity, hyperlipidemia, and hypertension are considered risk factors for developing non-alcoholic fatty liver disease (NAFLD). This study aims to assess steatosis and fibrosis severity in a cohort of T2DM patients, using vibration controlled transient elastography (VCTE) and controlled attenuation parameter (CAP). Material and method: We performed a prospective study in which, in each patient, we aimed for 10 valid CAP and liver stiffness measurements (LSM). To discriminate between fibrosis stages, we used the following VCTE cut-offs: F &ge, 2&ndash, 8.2 kPa, F &ge, 3&ndash, 9.7 kPa, and F4 - 13.6 kPa. To discriminate between steatosis stages, we used the following CAP cut-offs: S1 (mild) &ndash, 274 dB/m, S2 (moderate) &ndash, 290dB/m, S3 (severe) &ndash, 302dB/m. Results: During the study period, we screened 776 patients, 60.3% had severe steatosis, while 19.4% had advanced fibrosis. Female gender, BMI, waist circumference, elevated levels of AST, total cholesterol, triglycerides, blood glucose, and high LSM were associated with severe steatosis (all p-value &lt, 0.05). BMI, waist circumference, elevated levels of AST, HbA1c, and CAP were associated with advanced fibrosis (all p-values &lt, 0.05). Conclusion: Higher BMI (obesity) comprises a higher risk of developing severe steatosis and fibrosis. Individualized screening strategies should be established for NAFLD according to different BMI.

Published
2020
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27. Low Carb Diet – To Love or to Hate?

Author

Alexandra Sima

Subjects
03 medical and health sciences, 0302 clinical medicine, RC581-951, business.industry, Medicine, Specialties of internal medicine, 030209 endocrinology & metabolism, 030212 general & internal medicine, Religious studies, business
Published
2018

28. Association between coping mechanisms and adherence to diabetes-related self-care activities: a cross-sectional study

Author

Mihai Gafencu, Ion Papava, Bogdan Andor, Deiana Roman, Alin Albai, and Alexandra Sima

Subjects
Coping (psychology), 020205 medical informatics, type 2 diabetes mellitus, Cross-sectional study, Population, Medicine (miscellaneous), 030209 endocrinology & metabolism, 02 engineering and technology, Disease, 03 medical and health sciences, Social support, 0302 clinical medicine, Diabetes mellitus, 0202 electrical engineering, electronic engineering, information engineering, medicine, diabetes prognosis, education, Pharmacology, Toxicology and Pharmaceutics (miscellaneous), Original Research, education.field_of_study, business.industry, Health Policy, Type 2 Diabetes Mellitus, medicine.disease, coping, diabetes self-management, Patient Preference and Adherence, Cohort, glycemic control, business, Social Sciences (miscellaneous), Clinical psychology
Abstract

Alin Albai,1 Alexandra Sima,1 Ion Papava,2 Deiana Roman,1 Bogdan Andor,3 Mihai Gafencu4 1Second Department of Internal Medicine, 2Department of Neurosciences, 3Department of Orthopedics, 4Department of Pediatrics, Victor Babeş University of Medicine and Pharmacy, Timisoara, Romania Abstract: In the overall management of the most chronic diseases, including diabetes mellitus (DM), adherence to recommended disease-related self-care activities is of paramount importance. The diagnosis and presence of a chronic disease may be considered a difficult and stressful situation in life, a situation in which coping mechanisms are psychological processes developed at a conscious level to manage these situations. This study aimed to explore the possible relationship between the dominance of one of the four major coping styles and adherence to diabetes-related self-care activities (DRSCAs) in the population of patients with type 2 DM (T2DM). In a cross-sectional consecutive-case population-based study design, 126 patients previously diagnosed with T2DM were enrolled. Coping mechanisms were evaluated using the Cope scale inventory, which identifies the dominant coping mechanism: problem-, emotion-, social support-, or avoidance-focused. The quality of DRSCA was evaluated using the summary of diabetes self-care activities questionnaire, in which a higher score was associated with improved adherence. In the study cohort, 45 patients (35.7%) had problem-focused coping, 37 (29.4%) had emotion-focused coping, 32 (25.4%) social support-focused coping, and 12 (9.5%) had avoidance-focused coping. Patients with emotion-focused coping had the highest level (P=0.02) of DRSCA (median 44 points), followed by patients with social support-focused coping (median 40 points) and problem-focused coping (median 36 points), while patients with avoidance-focused coping had the lowest SDSCA total score (33 points). The type of dominant coping mechanism has a significant impact on the quality of the DRSCA measures implemented by the patient to manage their diabetes. Patients with emotion-focused and social support-focused coping styles tend to have significantly increased adherence to DRSCA scores, while patients with other dominant coping styles are less interested in managing their disease. Keywords: coping, type 2 diabetes mellitus, diabetes self-management, glycemic control, diabetes prognosis&nbsp

Published
2017

29. Integrating Energy Storage Systems and Transmission Expansion Planning in Renewable Energy Sources Power Systems

Author

Catalina Alexandra Sima, Claudia Laurenta Popescu, Gheorghe Lazaroiu, and Mihai Octavian Popescu

Subjects
Computer science, business.industry, 020209 energy, Automatic frequency control, Load Shedding, ComputerApplications_COMPUTERSINOTHERSYSTEMS, 02 engineering and technology, 021001 nanoscience & nanotechnology, Investment (macroeconomics), Energy storage, Automotive engineering, Renewable energy, Electric power system, Electric power transmission, Transmission (telecommunications), 0202 electrical engineering, electronic engineering, information engineering, 0210 nano-technology, business
Abstract

Energy storage systems (ESS) are more and more used in power systems where renewable energy sources (RES) are integrated. ESS can participate in frequency control and also represents a flexible solution to supply the demands in power systems. The mathematical model presented in this paper minimizes the investment costs, load shedding costs and generation costs, concomitant with integrating ESS and building new transmission lines if the capacity of the existing ones is not sufficient.

Published
2019

30. Assessment of Nutritional Intakes in Individuals with Obesity under Medical Supervision. A Cross-Sectional Study

Author

Adrian Vlad, Alexandra Sima, Corina Marcela Hogea, Iulia Teodora Perva, Georgiana Nicolae, Romulus Timar, Costela Lăcrimioara Șerban, Maria Puiu, Alin Albai, Adela Chiriță-Emandi, Mihai D. Niculescu, and Salomeia Putnoky

Subjects
Adult, Male, 030309 nutrition & dietetics, Cross-sectional study, Health, Toxicology and Mutagenesis, lcsh:Medicine, Nutritional Status, Context (language use), Recommended Dietary Allowances, Article, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Vitamin D and neurology, Humans, Medicine, Micronutrients, Obesity, 030212 general & internal medicine, Aged, 0303 health sciences, Romania, Nutritional epidemiology, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Middle Aged, adequate intake, medicine.disease, Micronutrient, Diet, obese adult, nutritional epidemiology, Cross-Sectional Studies, Dietary Reference Intake, Female, Energy Intake, business, Body mass index, dietary reference intake
Abstract

People with obesity in Romania are often under medical supervision, which is aimed to decrease body weight and treat accompanying metabolic disorders and cardiovascular implications. However, there is limited information regarding the implementation of dietary recommendations in adults with obesity. We aimed to evaluate the prevalence of reaching the recommended intakes of macro- and micro-nutrients in adults with obesity under medical supervision. Individuals with obesity, recruited in the context of a study with a larger scope (NutriGen ClinicalTrials.gov NCT02837367), who were under medical supervision underwent four 24 h recalls in order to assess daily food intakes. Macro- and micro-nutrient intakes were computed, and the prevalence of reaching recommended dietary allowances (RDAs) for each nutrient was calculated. The majority of subjects did not meet the recommended intakes for most nutrients. Energy from fat exceeded the threshold of 35% recommended intake, even in the lowest quartile of energy intake. The micronutrients with less than 5% of individuals reaching the RDAs were vitamin D, vitamin E, fluoride, and omega-3 fatty acids for both males and females, and choline, magnesium, and potassium in females. The burden of inadequate nutrition in individuals with obesity should be acknowledged and properly addressed within efforts to reduce obesity rates and associated disorders.

Published
2019
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31. Dynamics of Epicardiac Fat and Heart Function in Type 2 Diabetic Patients Initiated with SGLT-2 Inhibitors

Author

Adina, Braha, Bogdan, Timar, Laura, Diaconu, Raluca, Lupusoru, Lucian, Vasiluta, Alexandra, Sima, Adrian, Vlad, Mircea, Munteanu, Alin, Albai, Daniela, Cipu, and Romulus, Timar

Subjects
epicardiac fat, heart failure, diastolic dysfunction, Original Research
Abstract

Purpose The aim of this study was to assess the dynamics of epicardiac adipose tissue (EAT) thickness and total volume as well as that of systolic and diastolic dysfunction in a group of patients with type 2 diabetes (T2D) after initiation of sodium glucose co-transporter 2 (SGLT 2) inhibitors therapy. Patients and methods This prospective, observational study included 53 patients with T2D who received SGLT-2 inhibitors for 24 weeks. In all patients, echocardiographic screening for EAT, systolic and diastolic dysfunction and non-contrast computed tomography scans were performed, both before and after 24 weeks of SGLT-2 inhibition. Imagistic evaluation was followed by the association’s analysis between the dynamics of EAT and heart function, as well as the patient’s clinical and biological parameters. We considered a decrease or increase of more than 10% in EAT as being clinically significant. Results The mean volume of EAT decreased significantly after SGLT 2 inhibition (37.8±17.2 vs. 20.7±7 cm3; p

Published
2019

32. RESs Integration and Transmission Expansion Planning Considering Load Shedding Costs

Author

Catalina Alexandra Sima, Gheorghe Lazaroiu, Mihai Octavian Popescu, and Claudia Laurenta Popescu

Subjects
Electric power system, Mathematical optimization, Transmission (telecommunications), Linear programming, business.industry, Computer science, Load Shedding, Disconnection, Investment (macroeconomics), business, Renewable energy
Abstract

In this paper, Generation and Transmission Expansion Planning problem is applied to a fictive network considering a stochastic approach. The mathematical model presented is a mixed-integer linear programming problem (MILP) where losses are neglected. The objective function of the mathematical model is minimizing the generation costs, the investment costs and the load shed cost. The paper highlights the importance of the load shed cost values that represents the penalty that must be paid for the disconnection of a demand. The chosen costs are used in real power system expansions in Romania in 2018.

Published
2019

33. Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial

Author

Hertzel C Gerstein, Helen M Colhoun, Gilles R Dagenais, Rafael Diaz, Mark Lakshmanan, Prem Pais, Jeffrey Probstfield, Fady T Botros, Matthew C Riddle, Lars Rydén, Denis Xavier, Charles Messan Atisso, Leanne Dyal, Stephanie Hall, Purnima Rao-Melacini, Gloria Wong, Alvaro Avezum, Jan Basile, Namsik Chung, Ignacio Conget, William C Cushman, Edward Franek, Nicolae Hancu, Markolf Hanefeld, Shaun Holt, Petr Jansky, Matyas Keltai, Fernando Lanas, Lawrence A Leiter, Patricio Lopez-Jaramillo, Ernesto German Cardona Munoz, Valdis Pirags, Nana Pogosova, Peter J Raubenheimer, Jonathan E Shaw, Wayne H-H Sheu, Theodora Temelkova-Kurktschiev, Mercedes Abella, Andrea Alebuena, Sandra Almagro, Eduardo Amoroso, Paula Anadon, Elizabeth Andreu, Guillermo Aristimuño, Maria Arzadun, Maria Barbieri, Raul Barcudi, Ines Bartolacci, Gabriel Bolobanich, Anselmo Bordonava, Miguel Bustamante Labarta, Betina Bustos, Alberto Caccavo, Alejandra Camino, Maria Cantero, Maria Carignano, Luis Cartasegna, Marcela Cipullo, Víctor Commendatore, Victoria Conosciuto, Osvaldo Costamagna, Claudia Crespo, Jose Cuello, Carlos Cuneo, Sandra Cusimano, Sofia Dean, Claudio Dituro, Andrea Dominguez, Miguel Farah, Alberto Fernandez, Florencia Fernandez, Adriana Ferrari, Patricia Flammia, Jose Fuentealba, Karina Beatriz Gallardo, Celso Garcia, Ruben Garcia Duran, Marcelo Garrido, Rodolfo Gavicola, Claudio Gerbaudo, Graciela Gilli, Ana Paula Giotto, Pedro Godoy Bolzán, Oscar Gomez Vilamajo, Fernando Guerlloy, Cristian Guridi, Narcisa Gutierrez Garrido, Eduardo Hasbani, Sonia Hermida, Miguel Hominal, Adrian Hrabar, Adrián Ingaramo, Alejandra Izzicupo, Mario Krynski, Mariana Lagrutta, Paulina Lanchiotti, Maria Langhe, Veronica Leonard, Javier Llanos, Ricardo Lopez Santi, Jorge Lowenstein, Cecilia Luquez, Ignacio Mackinnon, Melina Mana, Sara Manzur, Javier Marino, Carolina Martella, Roger Martinez, Re Matias, Javier Matkovich, Monica Meritano, Oscar Montaña, María Mulazzi, Juan Ochoa, Gustavo Paterlini, María Pelagagge, Maria Elena Peralta Lopez, Aldo Prado, Lorena Pruyas, Martín Racca, Carola Ricotti, Carolina Rodriguez, Mariano Romero Vidomlansky, Ricardo Ronderos, Ana Laura Sadowski, Jorgelina Sala, Alejandro Sánchez, Andrea Santoro, Lilia Schiavi, Mariano Sein, Virginia Sernia, Leonardo Serra, Maximiliano Sicer, Tomas Smith, Leonardo Soso, Georgina Sposetti, Andrea Steinacher, Jorge Stival, Jorge Tedesco, Hugo Tonin, Mauro Tortolo, Maria Ulla, Julio Vallejos, Marisa Vico, Luciana Virgillito, Virginia Visco, Daniel Vogel, Florencia Waisman, César Zaidman, Noemi Zucchiatti, Imran Badshah, Neale Cohen, Peter Colman, David Colquhoun, Timothy Davis, Spiros Fourlanos, Greg Fulcher, Jane Hamlyn, Cilla Haywood, Samantha Hocking, Maeve Huchinson, William Jeffries, Mervyn Kyl, Clement Lo, PeakMann Mah, Ashley Makepeace, Dolly Marope, Natalie Nanayakkar, Alison Nankervis, Neil Palmer, Barbara Palolus, Satish Pillai, Sarah Price, Joseph Proietto, Anne Reutens, Natassia Rodrigo, Abdul Sheikh, Greg Smith, Michelle So, Georgia Soldatos, Bronwyn Stuckey, Priya Sumithran, Helena Teede, Parind Vora, Lyn Williams, Eduardo Abib, Christiani Adão Poço, Érica Ferreira Alves, Janaina Andreatta Bernardi Barea, Livia Avezum Oliveira, Denise Ludovico da Costa de Castro, Ivan Correa da Cruz, Midiã Costa, Ivan Cruz, Sidney Cunha, Marco Antonio Vieira Da Silva, Renata de Carvalho Camara Bona, Bruna de Paula, Freddy Eliaschewitz, Guilherme Fazolli, Carlos Alberto Ferreira Filho, Jose Fortes, Cesar França, Denise Reis Franco, Paulo Roberto Genestreti, Flavio Giorgeto, Rodrigo Marques Gonçalves, Michele Elka Grossman, Ana Claudia Henrique Marcelino, Mauro Hernandes, Ana Horta, Cristiano Jaeger, Midia Kaneblai, Cecilia Kauffman Rutenberg, Jose Francisco Kerr Saraiva, Maria Angelica Lemos, Lilia Maia, Euler Roberto Manenti, Mariana Marques, Cynthia Melissa Valerio, Rodrigo Moreira, Flávia Mothé, Osana Maria Mouco, Philip Moura, José Carlos Moura Jorge, Carlos Nakashima, Marcelo Nakazone, Thiago Napoli, Cristiane Nunes, Joao Eduardo Nunes Salles, Karla Oliveira, Marcela Oliveira, Gracielly de Souza Pantano, Fabio Petri, Leonardo Piazza, Andreia Carla Pires, Patricia Pizzato, Sergio Prata, Dalton Precoma, Rafael Rech, Gilmar Reis, Heleno Reis, Elisabete Resende, Jose Ribas Fortes, Sylka Rodovalho, Fabio Rossi dos Santos, Joao Eduardo Salles, Célia Regina Sampaio, Thiago Santos, Vanessa Santos dos Santos, Tulio Silva e Quadros, Daniel Silveira, Katia Nunes Siqueira, M Teireira, Marcelo Uehara, C Valerio, Henrique Vianna, Maria Helena Vidotti, Guilherme de Lima Visconti, Maria Teresa Zanella, Viktoriya Andreeva, Radoslav Borisov, Nikolay Botushanov, Georgi Dimitrov, Kameliya Dimova, Tsvetan Dragoychev, Valentina Grigorova, Valentina Gushterova, Ivaylo Ivanov, Tatyana Kocelova, Dimo Kurktschiev, Milena Miletieva, Neli Nenkova-Gugusheva, Ralitsa Pancheva, Maria Pavlova, Dimitar Raev, Vesela Spasova, Anastas Stoikov, Dimitar Troev, Todor Yanev, Mariana Yoncheva-Mihaylova, Alexander Abitbol, Buki Ajala, Abdullh Alguwaihes, Jean-Luc Ardilouze, Nahla Aris-Jilwan, Amel Arnaout, Ronnie Aronson, Nadeem Aslam, Sandra Babin, Jean-Patrice Bailargeon, Allan Bailey, Harpreet Bajaj, Christian Beauchesne, Sorin Beca, Andre Belanger, Alan Bell, Diego Bellabarba, Lori Berard, Brian Berenbaum, Vincent Bergeron, Joseph Berlingieri, Frédéric Bernier, Phoebe Bishara, David Blank, Ian Blumer, Suzanne Brault, Donald Breton, André Carpentier, James Cha, Prakash Chandra, Jean-Louis Chiasson, James R Conway, Ghyslaine Couture, Nathalie Couture, Gilles Dagenais, Dyotirmoy Datta, Giuseppe D'Ignazio, Richard Dumas, Didier Fay, Andre Frechette, Louise Frenette, Daisy Fung, Nathalie Gagnon, Meri Galter, Jean Garon, Jean Sebastien Gauthier, Christian Geadah, Jeremy Gilbert, Ronald Girard, Ronald Goldenberg, Loren David Grossman, Nikhil Gupta, Jean-Pierre Halle, Marie-France Hivert, Ghislaine Houde, Robyn Houlden, Irene Hramiak, Ted Jablonski, Akshay Jain Jain, Hasnain Khandwala, Munish Khosla, C Lachance, Emilie Laflamme, Marie-France Langlois, Luc Larivee, Joanne Liutkus, Heather Lochnan, Saleem Malik, Charlotte McDonald, Pravinsagar Mehta, John Mihailidis, Alain Milot, Priya Narula, Patrice Nault, Arun Nayar, William Nisker, Gilles Ouellet, Jean Palardy, Minta Patel, Terri Paul, Sue Pedersen, Patrice Perron, Marie-Hélène Pesant, Paul Poirier, Marie-Claude Poulin, Zubin Punthakee, Waheed Rehman, Stuart Ross, P Sagar, Nouhad Saliba, Sam Sandler, Alicia Schiffrin, Robert Schlosser, Anila Seth-Sharma, Mark Sherman, David Sionit, Tharsan Sivakumar, Juan Soto, Eric St-Amour, Oren Steen, Jack Sussman, Adam Telner, Sheldon Tobe, David-Yaw Twum-Barima, Audrey Van Zanten, Nicole VanRossum, Jonathan Vecchiarelli, Rick Ward, John Wessengel, Stanley Weisnagel, Igor Wilderman, Vincent Woo, Natalia Yakubovich, Jean-Francois Yale, Zeina Yared, Monica Acevedo, Maria Loreto Aguirre, Andres Aizman, Maria Soledad Barroso, Leonardo Cobos, Alfredo Danin Vargas, Barbara Descalzi, Gonzalo Godoy, Elio Grumberg, Rodolfo Lahsen, Gladys Larenas, Eugenia Ortiz, Javier Paredes, Sergio Potthoff, Eva Retamal, Luis Rojas, Manuel Salgado, Claudio Santibanez, Carmen Solis, Benjamin Stokins, Jose Accini, Javier Acebedo, Lina Maria Agudelo Baena, Soraya Alarcon, Juliana Angel, Edgar Arcos, M Aroca Martinez, Leonor Atuesta, Jose Balaguera, Doris Ballestas, Sandra Isabel Barrera, Rosmy Barrios Reyes, Adolfo Bayona, Andres Bermudez, Diego Zarate Bernal, Marco Blanquicett, Victor Bravo, Wendy Bueno, Alvaro Burbano Delgado, Alberto Cadena, Andres Cadena, Sandra Caicedo, Carlos Celemin, Ricardo Consuegra, Cristhian Contreras Pimienta, Kelly Johenis Corredor, Carlos Cure, Lizeth Dayana De La Hoz Rueda, Erika Delgado, Sarahy Diaz, Marta Diego, Anabell Donado, William Encinales Sanabria, Juliana Escobar, Gillian Escorcia, Leonardo Forero, Laura Fuentes, Maria Garcia, Henry Garcia Lozada, Luis Garcia Ortiz, Angela Giraldo, Laura Gomez Gonzalez, Javier Granada, Corina Gutierrez, Natalia Henao, Edwin Hernandez, Olga Maria Herrera Uejbe, Juan Diego Higuera Cobos, Jaime Ibarra Gómez, Edwin Hernandez Jaimes, Monica Jaramillo, Nicolas Jaramillo, Carlos Jaramillo Gomez, Monica Jaramillo Sanchez, Ivonne Jarava Durán, Catalina Lopez Ceballos, Claudia Madrid, Elias María Amastha, Jennifer Mercado, Dora Ines Molina, Jessica Molina Soto, Carlos Montoya, Alexander Morales, Carolina Muñoz, Luis Alejandro Orozco, Oscar Osorio, Jorge Mario Palmera Sanchez, Adwar Peña, Jose Perez, Juan Perez Agudelo, Germán Pérez Amador, Carlos Pertuz, Irina Posada, Carlos Puerta, Adalberto Quintero, Diana Quiroz, Carmen Rendon, Alberto Reyes, Alvaro Reyes, Diana Ripoll, Carlos Rivera, Maria Rocha, Jose F Rodriguez, Kervis Asid Rodriguez Villanueva, Javier Emilio Rodriguez Zabala, Sindy Rojas, Maria Romero, Ricardo Rosero, Angelica Rocio Rosillo Cardenas, Lina Rueda, Gregorio Sanchez, Tatiana Sanchez, Arístides Sotomayor Herazo, Monica Suarez, Mariana Torres, Freddy Trujillo, Miguel Urina, Lazaro Van Strahlen, Carlos Velandia, Carolina Velasquez Guzman, Elizabeth Velazquez, Tatiana Vidal Prada, Juan Pablo Yepez Alvaran, Diego Zarate, Jana Andelova, Radka Benesova, Barbara Buzova, Vladimir Cech, Ida Chodova, Miroslav Choura, Antonin Dufka, Andrea Gamova, Jakub Gorgol, Tomas Hala, Hana Havlova, Dagmar Hlavkova, Petra Horanska, Juliana Ilcisin-Valova, Petra Jenickova, Ondrej Jerabek, Ilona Kantorova, Katerina Kolomaznikova, Iva Kopeckova, Miroslava Kopeckova, Karel Linhart, Tomas Linhart, Jan Malecha, Emilia Malicherova, Dana Neubauerova, Martina Oznerova, Radan Partys, Eva Pederzoliova, Maria Petrusova, Vera Prymkova, Eva Racicka, Ida Reissova, Eva Roderova, Libor Stanek, Alena Striova, Dana Svarcova, Petr Svoboda, Emilia Szeghy Malicharova, Jan Urge, Ladislav Vesely, Bedich Wasserburger, Hilde Wasserburgerova, Emil Zahumensky, Vaclav Zamrazil, Hasan Alawi, Ernestos Anastasiadis, Elisabeth Axthelm, Tasso Bieler, Christina Buhrig, Elizaveta Degtyareva, Frank Dellanna, Karl-Michael Derwahl, Stephan Diessel, Barbara Dogiami, Kirsten Dorn-Weitzel, Monika Ernst, Grit Faulmann, Baerbel Fetscher, Thomas Forst, Gabriele Freyer-Lahres, Klaus Funke, Xenia Ganz, Christiane Gleixner, Christoph Hanefeld, Sven Heinrichs, Stephanie Helleberg, Elena Henkel, Gerd Ruediger Hetzel, Caren Hoffmann, Frohmut Jacob, Stephan Jacob, Franziska John, Antonius Jonczyk, Wolfram Kamke, Christiane Klein, Martina Kleinhardt, Werner Kleophas, Christine Kosch, Kristin Kreutzmann, Achim Kühn, Young Hee Lee-Barkey, Alexander Lier, Sarah Maatouk, Joachim Minnich, Michael Mitry, Ilona Muessig, Diana Nicula, Martina Niemann, Joerg Nothroff, Petra Ott, Andreas Pfuetzner, Andreas Pfützner, Frank Pistrosch, Wildgard Pohl, Zdenka Prochazkova, Marlena Retkowska, Heiko Rosin, Daniela Sachsenheimer, Holger Samer, Mazin Sanuri, Axel Schaefer, Frank Schaper, Erik-Delf Schulze, Marita Schulze, Martina Schumann, Thomas Segiet, Veronika Sowa, Hans-Detlev Stahl, Franziska Steinfeldt, Madlen Teige, Bjoern Trieb, Diethelm 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Hyun Kim, Pum-Joon Kim, Soon-Kil Kim, Yong-Seok Kim, Young Kwon Kim, Yoon Seok Koh, Hyuck Moon Kwon, Byoung Kwon Lee, Byung-Wan Lee, Jin Bae Lee, Myoung-Mook Lee, Young-Mee Lim, Pil Ki Min, Jong Sung Park, Jongsuk Park, Keun Ho Park, Sungha Park, Wook Bum Pyun, Se Joong Rim, Dong-Ryeol Ryu, Hong-Seog Seo, Ki Bae Seung, Dong-Ho Shin, Doo Sun Sim, Young Won Yoon, Ilze Andersone, Kristine Babicka, Inga Balcere, Roberts Barons, Inguna Capkovska, Kristine Geldnere, Inese Grigane, Baiba Jegere, Ilze Lagzdina, Lija Mora, Sigita Pastare, Rota Ritenberga, Janina Romanova, Inta Saknite, Natalja Sidlovska, Jelena Sokolova, Sandra Steina, Iveta Strizko, Dace Teterovska, Brigita Vizina, Lina Barsiene, Gintare Belozariene, Laura Daugintyte-Petrusiene, Nijole Drungiliene, Nijole Garsviene, Ala Grigiene, Vytautas Grizas, Virginija Jociene, Dalia Kalvaitiene, Jugeta Kaupiene, Jurate Kavaliauskiene, Dalia Kozloviene, Ilona Lapteva, Birute Maneikiene, Jolanta Marcinkeviciene, Vaidilija Markauskiene, Salomeja Meiluniene, Almantas Norkus, Rita Norviliene, Vladimiras Petrenko, Ruta Radzeviciene, Gintare Sakalyte, Gediminas Urbonas, Skaiste Urbutiene, Donatas Vasiliauskas, Dzilda Velickiene, Carlos Aguilar, Marco Alcocer, Juan Antonio Avalos-Ramirez, Ramiro Banda-Elizondo, Rubria Bricio-Ramirez, Karla Cardenas Mejia, Francisco Cavazos, Jesus Chapa, Erika Cienfuegos, Astrid De la Peña, Gilberto de la Peña Topete, Manuel Odin De los Rios Ibarra, Daniel Elias, Claudia Flores-Moreno, Pedro Garcia Hernandez, Luis Gerardo Gonzalez, Rosa Linda Guerra Moya, Arturo Guerra-Lopez, Raymundo Hernandez Baylon, Carolina Herrera Colorado, Marisol Herrera-Marmolejo, Neri Islas-Palacios, Esteban Lopez, Fernando Lopez, Agustin Lopez Alvarado, Rosa Isela Luna Ceballos, Enrique Morales Villegas, Gualberto Moreno-Virgen, Rosa Linda Parra Perez, Sara Pascoe Gonzalez, Irving Peralta-Cantu, Roopa Previn, Rosa Ramirez, Rubria Ramirez, Maria Guadalupe Ramos Zavala, Monica Rodriguez, Rocio Salgado-Sedano, Ana Claudia Sanchez-Aguilar, Edith Santa Rosa Franco, Leobardo Sauque-Reyna, Rodrigo Suarez Otero, Ivonne Torres, Enrique Velarde-Harnandez, Juan Villagordoa, Efrain Villeda-Espinoza, Jorge Vital-Lopez, Cristian Jair Zavala- Bello, John Baker, Elaine Barrington-Ward, Thomas Brownless, Richard Carroll, Simon Carson, Michelle Choe, Andrew Corin, Brian Corley, Richard Cutfield, Neelam Dalaman, Paul Dixon, Paul Drury, Keith Dyson, Chris Florkowski, Monica Ford, William Frengley, Colin Helm, Colin Katzen, Jane Kerr, Manish Khanolkar, David Kim, Renata Koops, Jeremy Krebs, Robert Leikis, Kwan Low, Alison Luckey, Richard Luke, Susan Macaulay, Rodney Marks, Catherine McNamara, Dean Millar-Coote, Steven Miller, Naomi Mottershead, James Reid, Narcisa Robertson, Ian Rosen, David Rowe, Ole Schmiedel, Russell Scott, Jeffrey Sebastian, Davitt Sheahan, Victoria Stiebel, Ian Ternouth, Chris Tofield, Dirk Venter, Michael Williams, Miles Williams, Fiona Wu, Simon Young, Malgorzata Arciszewska, Anna Bochenek, Piotr Borkowski, Przemyslaw Borowy, Tomasz Chrzanowski, Edward Czerwinski, Marek Dwojak, Agnieszka Grodzicka, Izabela Janiec, Joanna Jaruga, Ewa Krystyna Jazwinska-Tarnawska, Krystyna Jedynasty, Danuta Juzwiak-Czapiewska, Jadwiga Karczewicz-Janowska, Jan Konieczny, Marek Konieczny, Marek Korol, Maciej Kozina, Ewa Krzyzagorska, Ewa Kucharczyk-Petryka, Roman Laz, Anna Majchrzak, Zdzislawa Mrozowska, Michal Mularczyk, Elzbieta Nowacka, Jadwiga Peczynska, Robert Petryka, Radoslaw Pietrzak, Dorota Pisarczyk-Wiza, Aleksandra Rozanska, Zofia Ruzga, Emilia Rzeszotarska, Malgorzata Sacha, Marzenna Sekulska, Anna Sidorowicz-Bialynicka, Teresa Stasinska, Agnieszka Strzelecka-Sosik, Teresa Swierszcz, Katarzyna Miroslawa Szymkowiak, Olga Turowska, Krystyna Wisniewska, Maciej Wiza, Iwona Wozniak, Katarzyna Zelazowska, Bernadetta Ziolkowska-Gawron, Danuta Zytkiewicz-Jaruga, Adrian Albota, Carmina Alexandru, Rodica Avram, Cornelia Bala, Diana Barbonta, Roxana Barbu, Daniela Braicu, Nicoleta Calutiu, Doina Catrinoiu, Anca Cerghizan, Alina Ciorba, Anca Craciun, Rodica Doros, Livia Duma, Ancuta Dumitrache, Ioana Ferariu, Anca Ferician Moza, Alexandrina Ghergan, Gheorghe Ghise, Mariana Graur, Mihaela Gribovschi, Bogdan Mihai, Laura Mihalache, Madalina Mihalcea, Nicoleta Mindrescu, Magdalena Morosanu, Andrea Morosoanu, Maria Mota, Anca Moza, Valerica Nafornita, Narcisa Natea, Simona Nicodim, Cristina Nita, Adriana Onaca, Mircea Onaca, Cristina Pop, Lavinia Pop, Amorin Popa, Alexandrina Popescu, Luchiana Pruna, Gabriela Roman, Mihaela Rosu, Alexandra Sima, Doina Sipciu, Carmen Narcisa Sitterli-Natea, Iosif Szilagyi, Minodora Tapurica, Adrian Tase, Adriana-Carmen Tutescu, Luminita Vanghelie, Ioana Verde, Adrian Vlad, Mihaela Zarnescu, Roman Akhmetov, Irina Allenova, Irina Avdeeva, Oksana Baturina, Irina Biserova, Nikolay Bokovin, Irina Bondar, Natalia Burova, Galina Chufeneva, Elena Chumachek, Marina Demidova, Alexander Demin, Vera Drobysheva, Irina Egorova, Lev Esenyan, Ekaterina Gelig, Sergey Gilyarevsky, Maria Golshmid, Arseniy Goncharov, Anastasia Gorbunova, Ivan Gordeev, Vera Gorelysheva, Tatiana Goryunova, Irina Grebenshchikova, Roman Ilchenko, Maria Ivannikova, Saule Karabalieva, Juliya Karpeeva, Elena Khaykina, Zhanna Kobalava, Irina Kononenko, Oxana Korolik, Anna Korshunova, Victor Kostenko, Irina Krasnopevtseva, Ludmila Krylova, Polina Kulkova, Irina Kuzmina, Alla Ledyaeva, Sergey Levashov, Natalia Lokhovinina, Vadim Lvov, Narine Martirosyan, Sergey Nedogoda, Rostislav Nilk, Yulia Osmolovskaya, Alexey Panov, Olga Paramonova, Ekaterina Pavlova, Elena Pekareva, Nina Petunina, Svetlana Ponamareva, Galina Reshedko, Alla Salasyuk, Malvina Sepkhanyan, Alexandr Serebrov, Olesya Shabelnikova, Andrey Skvortsov, Olga Smirnova, Oxana Spiridonova, Svetlana Strogova, Evgeny Taratukhin, Sergey Tereschenko, Lubov Trukhina, Olga Tsarkova, Vera Tsoma, Farid Tumarov, Natalya Tyan, Tatiana Tyurina, Svetlana Villevalde, Elena Yankovaya, Ludmila Zarutskaya, Elena Zenkova, Aysha Badat, Frederik Bester, Suzanne Blignaut, Dirk Blom, Susan Booysen, Warren Boyd, Brigitte Brice, Susan Brown, Lesley Burgess, Reina Cawood, Kathleen Coetzee, Hillet Conradie, Tanja Cronje, Douwe de Jong, Graham Ellis, Shaunagh Emanuel, Ingrid Engelbrecht, Sharne Foulkes, Done Fourie, Gilbert Gibson, Thirumani Govender, Sumayah Hansa, Allana Colleen Hemus, Firzana Hendricks, Marshall Heradien, Chantelle Holmgren, Zaheer Hoosain, Emile Horak, Johannes Howard, Ignatius Immink, E. Janari, Daksha Jivan, Karl Klusmann, Weik Labuschagne, Yen-yu Lai, Gulam Latiff, J. Lombaard, Hanlie Lottering, Ronel Meeding, Shirley Middlemost, Haroon Mitha, Ismail Mitha, Sandile Mkhwanazi, Rajendran Moodley, Almeri Murray, Dany Musungaie, Yasmin Osman, Kirsten Peacey, Larisha Pillay-Ramaya, Catharina Pretorius, Hans Prozesky, Mahomed Sarvan, E Scholtz, Attila Sebesteny, Bianca Skinner, Michael Skriker, M Smit, Anna-Marie Stapelberg, Nicolaas Swanepoel, Dorothea Urbach, Dina van Aswegen, Francois van Zyl, Louis Van Zyl, Esme Venter, Shahid Wadvalla, Jeffrey Wing, Karen Wolmarans, Cristina Abreu, Pilar Aguilà, Eva Aguilera, Nuria Alonso, Carmen Alvarez, Priscila Cajas, Jose Carlos Castro, Roger Codinachs, Jose Contreras, Maria Jose Coves, Carmen Fajardo, Juan Carlos Ferrer, Neus Font, Mar Garcia, Maria Apolonia Gil, Fernando Gomez, Lluis Alberto Gomez, Jose Gonzalbez, Jose Luis Griera, Luís Masmiquel, Didac Mauricio, Silvia Narejos Perez, Juana Ana Nicolau, Olga Noheda Contreras, Josefina Olivan, Josefina Olivares, Emilio Ortega, Silvia Pellitero, Salvador Pertusa, Ferran Rius, Irene Rodriguez, Carlos Sánchez-Juan, Dolores Santos, Berta Soldevila, David Subias, Manel Terns, Carlos Trescoli, Judith Vilaplana, Alicia Villanueva, Jaan Albo, Kjell Antus, Mattias Axelsson, Lisa Bergström, Emil Binsell-Gerdin, Kurt Boman, Fabian Botond, Annika Dotevall, Anna Graipe, C Jarnet, Jessica Kaminska, Anders Kempe, Michael Korhonen, Carina Linderfalk, Bo Liu, Karl Ljungstroem, Karl Ljungström, Lennart Malmqvist, Linda Mellbin, Thomas Mooe, Peter Nicol, Anders Norrby, Ake Ohlsson, Annika Rosengren, Jan Saaf, Staffan Salmonsson, Olof Strandberg, Karl-Axel Svensson, Bengt-Olov Tengmark, Georgios Tsatsaris, Anders Ulvenstam, Peter Vasko, Chwen-Tzuei Chang, Hsin-Mei Chang, Jung-Fu Chen, To-Pang Chen, Ming-Min Chung, Chia-Po Fu, Te-Lin Hsia, Shih-Che Hua, Ming-Chun Kuo, Chia-ln Lee, I-Te Lee, Kae-Woei Liang, Shih Yi Lin, Chieh-Hsiang Lu, Wen-Ya Ma, Dee Pei, Feng-Chih Shen, Ching-Chieh Su, Shuo-Wei Su, Tsai-Sung Tai, Wan-Ni Tsai, Yi-Ting Tsai, Shih-Chen Tung, Jun-Sing Wang, Hui-I Yu, Ahmed Al-Qaissi, Vijayaraman Arutchelvam, Stephen Atkin, Simon Au, Myint Myint Aye, Stephen Bain, Cristina Bejnariu, Patrick Bell, Deepak Bhatnagar, Rudy Bilous, Neil Black, Ursula Brennan, Barbara Brett, Jana Bujanova, Elaine Chow, Andrew Collier, Amanda Combe, Christopher Courtney, Hamish Courtney, James Crothers, Patrick Eavis, Jackie Elliott, Salvatore Febbraro, Jim Finlayson, Rajiv Gandhi, Sharon Gillings, Jonathan Hamling, Roy Harper, Tim Harris, Kahal Hassan, Simon Heller, Alison Jane, Zeeshan Javed, Tim Johnson, Stephen Jones, Adele Kennedy, David Kerr, Brian Kilgallon, Judith Konya, John Lindsay, Lina Lomova-Williams, Helen Looker, David MacFarlane, Sandra Macrury, Iqbal Malik, Rory McCrimmon, Douglas McKeith, John McKnight, Biswa Mishra, Racha Mukhtar, Ciara Mulligan, Maurice O'Kane, Tolu Olateju, Ian Orpen, Tristan Richardson, Desmond Rooney, Shorsha Bae Ross, Thozhukat Sathyapalan, Naveen Siddaramaiah, Lee Euan Sit, Jeffrey Stephens, Frances Turtle, Ammar Wakil, Emma Walkinshaw, Asem Ali, Robert Anderson, Richard Arakaki, Omar Aref, Mehrdad Kevin Ariani, David Arkin, Salomon Banarer, George Barchini, Arti Bhan, Kelley Branch, Donald Brautigam, Stephen Brietzke, Maridez Brinas, Yudit Brito, Casey Carter, Kimberely Casagni, Sabina Casula, Simon Chakko, Seth Charatz, Dale Childress, Lisa Chow, Malgorzata Chustecka, Subha Clarke, Lisa Cohen, Barry Collins, Gildred Colon Vega, Angel Comulada-Rivera, Gregorio Cortes-Maisonet, Matthew Davis, Jose de Souza, Cyrus Desouza, Mary Dinnan, Bobbi Duffy-Hidalgo, Barbara Dunn, Julia Dunn, Marshall Elman, James Felicetta, Stuart Finkelstein, David Fitz-Patrick, Hermes Florez, Alan Forker, Wayne Fowler, Sonja Fredrickson, Zachary Freedman, Brooke Gainey Narron, Kristin Gainey-Ferree, Michael Gardner, Christian Gastelum, Stephen Giddings, Eve Gillespie, Michael Paul Gimness, Gary Goldstein, Maria Gomes, Nelson Gomez, Timothy Gorman, Ketan Goswami, Arthur Graves, Scott Hacking, Charles Hall, Lenita Hanson, Sherman Harman, David Heber, Robert Henry, Janette Hiner, Irl Hirsch, Priscilla Hollander, Thomas Hooker, Barry Horowitz, Laura Hoste, Loli Huang, Minh Huynh, Dan Hyman, Soha Idriss, Ali Iranmanesh, Dennis Karounos, Moti Kashyap, Lois Katz, William Kaye, Yevgeniy Khaiton, Romesh Khardori, Timothy Kitchen, Andrew Klein, Wendi Knffem, Mikhail Kosiborod, Nicola Kreglinger, Davida Kruger, Anubhav Kumar, Ivan Laboy, Patricia Larrabee, Laura Larrick, Donna Lawson, Mike Ledet, James Lenhard, James Levy, George Li, Zhaoping Li, David Lieb, April Limcolioc, Jane Lions-Patterson, Daniel Lorber, Daniel Lorch, Michael Lorrello, Peter Lu, Kathryn Jean Lucas, Siu-Ling Ma, Michael MacAdams, Michelle Magee, Alexander Magno, Aparna Reddy Mahakala, Jennifer Marks, Anthony McCall, William McClanahan, Carole McClary, Lydia Melendez, John Melish, Deanna Michaud, Christopher Miller, Neil Miller, Pablo Mora, Marriyam Moten, Sunder Mudaliar, Gregory Myrick, Puneet Narayan, Mike Nassif, Karena Neri, Tabitha Newton, Patricia Niblack, Philip Nicol, Ebenezer Nyenwe, A. Ola Odugbesan, Yolanda Okorocha, Ramón Ortiz Carrasquillo, Kwame Osei, Coromoto Palermo, Hiren Patel, Krishna Patel, Cindy Pau, Michael Perley, Sanford Plevin, Elena Plummer, Richard Powell, Mohammed Qintar, Rex Rawls, John Reyes-Castano, Lillian Reynolds, Robert Richards, Julio Rosenstock, Caroline Rowe, Jahandar Saleh, Sony Sam, Alfredo Sanchez, Donald Sander, Bruce Sanderson, Virginia Savin, Elizabeth Seaquist, Jayendra Shah, Serena Shi, Vijay Shivaswamy, Tammi Shlotzhauer, David Shore, Bobbie Skukowski, Kyaw Soe, Vesna Solheim, Joseph Soufer, Helmut Steinberg, Jaime Steinsapir, Phillip Tarkington, Debra Thayer, Stephen Thomson, James Thrasher, Joseph Tibaldi, Jeff Tjaden, Oberto Tores, Dace Trence, Subbulaxmi Trikudanathan, Jagdeesh Ullal, Gabriel Uwaifo, Anthony Vo, Kenny Vu, Damandeep Walia, Karen Weiland, Fred Whitehouse, Thomas Wiegmann, Kathleen Wyne, Alan Wynne, Kevin Yuen, Joel Zaretzky, James Zebrack, Franklin Zieve, William Zigrang, and Everest

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Recombinant Fusion Proteins, Placebo-controlled study, Glucagon-Like Peptides, 030204 cardiovascular system & hematology, Placebo, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Double-Blind Method, law, Internal medicine, Medicine, Albuminuria, Humans, Hypoglycemic Agents, Diabetic Nephropathies, 030212 general & internal medicine, Renal replacement therapy, Aged, Intention-to-treat analysis, business.industry, Hazard ratio, General Medicine, Middle Aged, medicine.disease, Immunoglobulin Fc Fragments, Diabetes Mellitus, Type 2, Creatinine, Dulaglutide, Female, business, medicine.drug, Kidney disease, Glomerular Filtration Rate
Abstract

Digital, Background: Two glucagon-like peptide-1 (GLP-1) receptor agonists reduced renal outcomes in people with type 2 diabetes at risk for cardiovascular disease. We assessed the long-term effect of the GLP-1 receptor agonist dulaglutide on renal outcomes in an exploratory analysis of the REWIND trial of the effect of dulaglutide on cardiovascular disease. Methods: REWIND was a multicentre, randomised, double-blind, placebo-controlled trial at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo and followed up at least every 6 months for outcomes. Urinary albumin-to-creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFRs) were estimated from urine and serum values measured in local laboratories every 12 months. The primary outcome (first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes), secondary outcomes (including a composite microvascular outcome), and safety outcomes of this trial have been reported elsewhere. In this exploratory analysis, we investigate the renal component of the composite microvascular outcome, defined as the first occurrence of new macroalbuminuria (UACR >33·9 mg/mmol), a sustained decline in eGFR of 30% or more from baseline, or chronic renal replacement therapy. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01394952. Findings: Between Aug 18, 2011, and Aug 14, 2013, 9901 participants were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). At baseline, 791 (7·9%) had macroalbuminuria and mean eGFR was 76·9 mL/min per 1·73 m2 (SD 22·7). During a median follow-up of 5·4 years (IQR 5·1-5·9) comprising 51 820 person-years, the renal outcome developed in 848 (17·1%) participants at an incidence rate of 3·5 per 100 person-years in the dulaglutide group and in 970 (19·6%) participants at an incidence rate of 4·1 per 100 person-years in the placebo group (hazard ratio [HR] 0·85, 95% CI 0·77-0·93; p=0·0004). The clearest effect was for new macroalbuminuria (HR 0·77, 95% CI 0·68-0·87; p, Ciencias Médicas y de la Salud

Published
2019

34. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial

Author

Hertzel C Gerstein, Helen M Colhoun, Gilles R Dagenais, Rafael Diaz, Mark Lakshmanan, Prem Pais, Jeffrey Probstfield, Jeffrey S Riesmeyer, Matthew C Riddle, Lars Rydén, Denis Xavier, Charles Messan Atisso, Leanne Dyal, Stephanie Hall, Purnima Rao-Melacini, Gloria Wong, Alvaro Avezum, Jan Basile, Namsik Chung, Ignacio Conget, William C Cushman, Edward Franek, Nicolae Hancu, Markolf Hanefeld, Shaun Holt, Petr Jansky, Matyas Keltai, Fernando Lanas, Lawrence A Leiter, Patricio Lopez-Jaramillo, Ernesto German Cardona Munoz, Valdis Pirags, Nana Pogosova, Peter J Raubenheimer, Jonathan E Shaw, Wayne H-H Sheu, Theodora Temelkova-Kurktschiev, Mercedes Abella, Andrea Alebuena, Sandra Almagro, Eduardo Amoroso, Paula Anadon, Elizabeth Andreu, Guillermo Aristimuño, Maria Arzadun, Maria Barbieri, Raul Barcudi, Ines Bartolacci, Gabriel Bolobanich, Anselmo Bordonava, Miguel Bustamante Labarta, Betina Bustos, Alberto Caccavo, Alejandra Camino, Maria Cantero, Maria Carignano, Luis Cartasegna, Marcela Cipullo, Víctor Commendatore, Victoria Conosciuto, Osvaldo Costamagna, Claudia Crespo, Jose Cuello, Carlos Cuneo, Sandra Cusimano, Sofia Dean, Claudio Dituro, Andrea Dominguez, Miguel Farah, Alberto Fernandez, Florencia Fernandez, Adriana Ferrari, Patricia Flammia, Jose Fuentealba, Karina Beatriz Gallardo, Celso Garcia, Ruben Garcia Duran, Marcelo Garrido, Rodolfo Gavicola, Claudio Gerbaudo, Graciela Gilli, Ana Paula Giotto, Pedro Godoy Bolzán, Oscar Gomez Vilamajo, Fernando Guerlloy, Cristian Guridi, Narcisa Gutierrez Garrido, Eduardo Hasbani, Sonia Hermida, Miguel Hominal, Adrian Hrabar, Adrián Ingaramo, Alejandra Izzicupo, Mario Krynski, Mariana Lagrutta, Paulina Lanchiotti, Maria Langhe, Veronica Leonard, Javier Llanos, Ricardo Lopez Santi, Jorge Lowenstein, Cecilia Luquez, Ignacio Mackinnon, Melina Mana, Sara Manzur, Javier Marino, Carolina Martella, Roger Martinez, Re Matias, Javier Matkovich, Monica Meritano, Oscar Montaña, María Mulazzi, Juan Ochoa, Gustavo Paterlini, María Pelagagge, Maria Elena Peralta Lopez, Aldo Prado, Lorena Pruyas, Martín Racca, Carola Ricotti, Carolina Rodriguez, Mariano Romero Vidomlansky, Ricardo Ronderos, Ana Laura Sadowski, Jorgelina Sala, Alejandro Sánchez, Andrea Santoro, Lilia Schiavi, Mariano Sein, Virginia Sernia, Leonardo Serra, Maximiliano Sicer, Tomas Smith, Leonardo Soso, Georgina Sposetti, Andrea Steinacher, Jorge Stival, Jorge Tedesco, Hugo Tonin, Mauro Tortolo, Maria Ulla, Julio Vallejos, Marisa Vico, Luciana Virgillito, Virginia Visco, Daniel Vogel, Florencia Waisman, César Zaidman, Noemi Zucchiatti, Imran Badshah, Neale Cohen, Peter Colman, David Colquhoun, Timothy Davis, Spiros Fourlanos, Greg Fulcher, Jane Hamlyn, Cilla Haywood, Samantha Hocking, Maeve Huchinson, William Jeffries, Mervyn Kyl, Clement Lo, PeakMann Mah, Ashley Makepeace, Dolly Marope, Natalie Nanayakkar, Alison Nankervis, Neil Palmer, Barbara Palolus, Satish Pillai, Sarah Price, Joseph Proietto, Anne Reutens, Natassia Rodrigo, Abdul Sheikh, Greg Smith, Michelle So, Georgia Soldatos, Bronwyn Stuckey, Priya Sumithran, Helena Teede, Parind Vora, Lyn Williams, Eduardo Abib, Christiani Adão Poço, Érica Ferreira Alves, Janaina Andreatta Bernardi Barea, Livia Avezum Oliveira, Denise Ludovico da Costa de Castro, Ivan Correa da Cruz, Midiã Costa, Ivan Cruz, Sidney Cunha, Marco Antonio Vieira Da Silva, Renata de Carvalho Camara Bona, Bruna de Paula, Freddy Eliaschewitz, Guilherme Fazolli, Carlos Alberto Ferreira Filho, Jose Fortes, Cesar França, Denise Reis Franco, Paulo Roberto Genestreti, Flavio Giorgeto, Rodrigo Marques Gonçalves, Michele Elka Grossman, Ana Claudia Henrique Marcelino, Mauro Hernandes, Ana Horta, Cristiano Jaeger, Midia Kaneblai, Cecilia Kauffman Rutenberg, Jose Francisco Kerr Saraiva, Maria Angelica Lemos, Lilia Maia, Euler Roberto Manenti, Mariana Marques, Cynthia Melissa Valerio, Rodrigo Moreira, Flávia Mothé, Osana Maria Mouco, Philip Moura, José Carlos Moura Jorge, Carlos Nakashima, Marcelo Nakazone, Thiago Napoli, Cristiane Nunes, Joao Eduardo Nunes Salles, Karla Oliveira, Marcela Oliveira, Gracielly de Souza Pantano, Fabio Petri, Leonardo Piazza, Andreia Carla Pires, Patricia Pizzato, Sergio Prata, Dalton Precoma, Rafael Rech, Gilmar Reis, Heleno Reis, Elisabete Resende, Jose Ribas Fortes, Sylka Rodovalho, Fabio Rossi dos Santos, Joao Eduardo Salles, Célia Regina Sampaio, Thiago Santos, Vanessa Santos dos Santos, Tulio Silva e Quadros, Daniel Silveira, Katia Nunes Siqueira, M Teireira, Marcelo Uehara, C Valerio, Henrique Vianna, Maria Helena Vidotti, Guilherme de Lima Visconti, Maria Teresa Zanella, Viktoriya Andreeva, Radoslav Borisov, Nikolay Botushanov, Georgi Dimitrov, Kameliya Dimova, Tsvetan Dragoychev, Valentina Grigorova, Valentina Gushterova, Ivaylo Ivanov, Tatyana Kocelova, Dimo Kurktschiev, Milena Miletieva, Neli Nenkova-Gugusheva, Ralitsa Pancheva, Maria Pavlova, Dimitar Raev, Vesela Spasova, Anastas Stoikov, Dimitar Troev, Todor Yanev, Mariana Yoncheva-Mihaylova, Alexander Abitbol, Buki Ajala, Abdullh Alguwaihes, Jean-Luc Ardilouze, Nahla Aris-Jilwan, Amel Arnaout, Ronnie Aronson, Nadeem Aslam, Sandra Babin, Jean-Patrice Bailargeon, Allan Bailey, Harpreet Bajaj, Christian Beauchesne, Sorin Beca, Andre Belanger, Alan Bell, Diego Bellabarba, Lori Berard, Brian Berenbaum, Vincent Bergeron, Joseph Berlingieri, Frédéric Bernier, Phoebe Bishara, David Blank, Ian Blumer, Suzanne Brault, Donald Breton, André Carpentier, James Cha, Prakash Chandra, Jean-Louis Chiasson, James R Conway, Ghyslaine Couture, Nathalie Couture, Gilles Dagenais, Dyotirmoy Datta, Giuseppe D'Ignazio, Richard Dumas, Didier Fay, Andre Frechette, Louise Frenette, Daisy Fung, Nathalie Gagnon, Meri Galter, Jean Garon, Jean Sebastien Gauthier, Christian Geadah, Jeremy Gilbert, Ronald Girard, Ronald Goldenberg, Loren David Grossman, Nikhil Gupta, Jean-Pierre Halle, Marie-France Hivert, Ghislaine Houde, Robyn Houlden, Irene Hramiak, Ted Jablonski, Akshay Jain Jain, Hasnain Khandwala, Munish Khosla, C Lachance, Emilie Laflamme, Marie-France Langlois, Luc Larivee, Joanne Liutkus, Heather Lochnan, Saleem Malik, Charlotte McDonald, Pravinsagar Mehta, John Mihailidis, Alain Milot, Priya Narula, Patrice Nault, Arun Nayar, William Nisker, Gilles Ouellet, Jean Palardy, Minta Patel, Terri Paul, Sue Pedersen, Patrice Perron, Marie-Hélène Pesant, Paul Poirier, Marie-Claude Poulin, Zubin Punthakee, Waheed Rehman, Stuart Ross, P Sagar, Nouhad Saliba, Sam Sandler, Alicia Schiffrin, Robert Schlosser, Anila Seth-Sharma, Mark Sherman, David Sionit, Tharsan Sivakumar, Juan Soto, Eric St-Amour, Oren Steen, Jack Sussman, Adam Telner, Sheldon Tobe, David-Yaw Twum-Barima, Audrey Van Zanten, Nicole VanRossum, Jonathan Vecchiarelli, Rick Ward, John Wessengel, Stanley Weisnagel, Igor Wilderman, Vincent Woo, Natalia Yakubovich, Jean-Francois Yale, Zeina Yared, Monica Acevedo, Maria Loreto Aguirre, Andres Aizman, Maria Soledad Barroso, Leonardo Cobos, Alfredo Danin Vargas, Barbara Descalzi, Gonzalo Godoy, Elio Grumberg, Rodolfo Lahsen, Gladys Larenas, Eugenia Ortiz, Javier Paredes, Sergio Potthoff, Eva Retamal, Luis Rojas, Manuel Salgado, Claudio Santibanez, Carmen Solis, Benjamin Stokins, Jose Accini, Javier Acebedo, Lina Maria Agudelo Baena, Soraya Alarcon, Juliana Angel, Edgar Arcos, M Aroca Martinez, Leonor Atuesta, Jose Balaguera, Doris Ballestas, Sandra Isabel Barrera, Rosmy Barrios Reyes, Adolfo Bayona, Andres Bermudez, Diego Zarate Bernal, Marco Blanquicett, Victor Bravo, Wendy Bueno, Alvaro Burbano Delgado, Alberto Cadena, Andres Cadena, Sandra Caicedo, Carlos Celemin, Ricardo Consuegra, Cristhian Contreras Pimienta, Kelly Johenis Corredor, Carlos Cure, Lizeth Dayana De La Hoz Rueda, Erika Delgado, Sarahy Diaz, Marta Diego, Anabell Donado, William Encinales Sanabria, Juliana Escobar, Gillian Escorcia, Leonardo Forero, Laura Fuentes, Maria Garcia, Henry Garcia Lozada, Luis Garcia Ortiz, Angela Giraldo, Laura Gomez Gonzalez, Javier Granada, Corina Gutierrez, Natalia Henao, Edwin Hernandez, Olga Maria Herrera Uejbe, Juan Diego Higuera Cobos, Jaime Ibarra Gómez, Edwin Hernandez Jaimes, Monica Jaramillo, Nicolas Jaramillo, Carlos Jaramillo Gomez, Monica Jaramillo Sanchez, Ivonne Jarava Durán, Catalina Lopez Ceballos, Claudia Madrid, Elias María Amastha, Jennifer Mercado, Dora Ines Molina, Jessica Molina Soto, Carlos Montoya, Alexander Morales, Carolina Muñoz, Luis Alejandro Orozco, Oscar Osorio, Jorge Mario Palmera Sanchez, Adwar Peña, Jose Perez, Juan Perez Agudelo, Germán Pérez Amador, Carlos Pertuz, Irina Posada, Carlos Puerta, Adalberto Quintero, Diana Quiroz, Carmen Rendon, Alberto Reyes, Alvaro Reyes, Diana Ripoll, Carlos Rivera, Maria Rocha, Jose F Rodriguez, Kervis Asid Rodriguez Villanueva, Javier Emilio Rodriguez Zabala, Sindy Rojas, Maria Romero, Ricardo Rosero, Angelica Rocio Rosillo Cardenas, Lina Rueda, Gregorio Sanchez, Tatiana Sanchez, Arístides Sotomayor Herazo, Monica Suarez, Mariana Torres, Freddy Trujillo, Miguel Urina, Lazaro Van Strahlen, Carlos Velandia, Carolina Velasquez Guzman, Elizabeth Velazquez, Tatiana Vidal Prada, Juan Pablo Yepez Alvaran, Diego Zarate, Jana Andelova, Radka Benesova, Barbara Buzova, Vladimir Cech, Ida Chodova, Miroslav Choura, Antonin Dufka, Andrea Gamova, Jakub Gorgol, Tomas Hala, Hana Havlova, Dagmar Hlavkova, Petra Horanska, Juliana Ilcisin-Valova, Petra Jenickova, Ondrej Jerabek, Ilona Kantorova, Katerina Kolomaznikova, Iva Kopeckova, Miroslava Kopeckova, Karel Linhart, Tomas Linhart, Jan Malecha, Emilia Malicherova, Dana Neubauerova, Martina Oznerova, Radan Partys, Eva Pederzoliova, Maria Petrusova, Vera Prymkova, Eva Racicka, Ida Reissova, Eva Roderova, Libor Stanek, Alena Striova, Dana Svarcova, Petr Svoboda, Emilia Szeghy Malicharova, Jan Urge, Ladislav Vesely, Bedich Wasserburger, Hilde Wasserburgerova, Emil Zahumensky, Vaclav Zamrazil, Hasan Alawi, Ernestos Anastasiadis, Elisabeth Axthelm, Tasso Bieler, Christina Buhrig, Elizaveta Degtyareva, Frank Dellanna, Karl-Michael Derwahl, Stephan Diessel, Barbara Dogiami, Kirsten Dorn-Weitzel, Monika Ernst, Grit Faulmann, Baerbel Fetscher, Thomas Forst, Gabriele Freyer-Lahres, Klaus Funke, Xenia Ganz, Christiane Gleixner, Christoph Hanefeld, Sven Heinrichs, Stephanie Helleberg, Elena Henkel, Gerd Ruediger Hetzel, Caren Hoffmann, Frohmut Jacob, Stephan Jacob, Franziska John, Antonius Jonczyk, Wolfram Kamke, Christiane Klein, Martina Kleinhardt, Werner Kleophas, Christine Kosch, Kristin Kreutzmann, Achim Kühn, Young Hee Lee-Barkey, Alexander Lier, Sarah Maatouk, Joachim Minnich, Michael Mitry, Ilona Muessig, Diana Nicula, Martina Niemann, Joerg Nothroff, Petra Ott, Andreas Pfuetzner, Andreas Pfützner, Frank Pistrosch, Wildgard Pohl, Zdenka Prochazkova, Marlena Retkowska, Heiko Rosin, Daniela Sachsenheimer, Holger Samer, Mazin Sanuri, Axel Schaefer, Frank Schaper, Erik-Delf Schulze, Marita Schulze, Martina Schumann, Thomas Segiet, Veronika Sowa, Hans-Detlev Stahl, Franziska Steinfeldt, Madlen Teige, Bjoern Trieb, Diethelm Tschoepe, Peter Uebel, Bernd Warken, Ingo Weigmann, Klaus Weyland, Klara Wilhelm, Timea Balo, Miklos Balsay, Ilona Bende, Katalin Bezzegh, Zita Birkus, Barbara Buday, Melinda Csomai, Laszlo Deak, Eniko Dezso, Peter Faludi, M Faluvegi, Ilona Fazekas, Agota Feher, Csaba Fejer, Ervin Finta, Agnes Fulcz, Zsolt Gaal, Mihaly Gurzo, Krisztina Hati, Gabriella Herczeg, Ildiko Jozsef, Marta Juhasz, Katalin Keltai, Laszlo Koranyi, Eniko Kulcsar, Krisztina Kun, Andrea Laczko, Botond Literáti-Nagy, Izabella Mezo, Margit Mileder, I Moricz, Károly Nagy, Bela Nagybaczoni, Csaba Nemeth, Agnes Oze, Jozsef Pauer, Eva Peterfai, Bela Polocsanyi, Ferenc Poor, István Reiber, Csaba Salamon, Julia Sebestyen, Ildiko Torok, Marianna Tuu, Andrea Varga, Viktor Vass, Chul Min Ahn, Chulwoo Ahn, Park ByungWon, Hyuk-Jae Chang, Kiyuk Chang, Eui-Young Choi, Han Seok Choi, Jin-Wook Chung, Bum- Kee Hong, Young Joon Hong, Min Su Hyon, Myung Ho Jeong, Shinae Kang, Byeong-Keuk Kim, Ji-Hyun Kim, Ju Han Kim, Kee-Sik Kim, Moo Hyun Kim, Pum-Joon Kim, Soon-Kil Kim, Yong-Seok Kim, Young Kwon Kim, Yoon Seok Koh, Hyuck Moon Kwon, Byoung Kwon Lee, Byung-Wan Lee, Jin Bae Lee, Myoung-Mook Lee, Young-Mee Lim, Pil Ki Min, Jong Sung Park, Jongsuk Park, Keun Ho Park, Sungha Park, Wook Bum Pyun, Se Joong Rim, Dong-Ryeol Ryu, Hong-Seog Seo, Ki Bae Seung, Dong-Ho Shin, Doo Sun Sim, Young Won Yoon, Ilze Andersone, Kristine Babicka, Inga Balcere, Roberts Barons, Inguna Capkovska, Kristine Geldnere, Inese Grigane, Baiba Jegere, Ilze Lagzdina, Lija Mora, Sigita Pastare, Rota Ritenberga, Janina Romanova, Inta Saknite, Natalja Sidlovska, Jelena Sokolova, Sandra Steina, Iveta Strizko, Dace Teterovska, Brigita Vizina, Lina Barsiene, Gintare Belozariene, Laura Daugintyte-Petrusiene, Nijole Drungiliene, Nijole Garsviene, Ala Grigiene, Vytautas Grizas, Virginija Jociene, Dalia Kalvaitiene, Jugeta Kaupiene, Jurate Kavaliauskiene, Dalia Kozloviene, Ilona Lapteva, Birute Maneikiene, Jolanta Marcinkeviciene, Vaidilija Markauskiene, Salomeja Meiluniene, Almantas Norkus, Rita Norviliene, Vladimiras Petrenko, Ruta Radzeviciene, Gintare Sakalyte, Gediminas Urbonas, Skaiste Urbutiene, Donatas Vasiliauskas, Dzilda Velickiene, Carlos Aguilar, Marco Alcocer, Juan Antonio Avalos-Ramirez, Ramiro Banda-Elizondo, Rubria Bricio-Ramirez, Karla Cardenas Mejia, Francisco Cavazos, Jesus Chapa, Erika Cienfuegos, Astrid De la Peña, Gilberto de la Peña Topete, Manuel Odin De los Rios Ibarra, Daniel Elias, Claudia Flores-Moreno, Pedro Garcia Hernandez, Luis Gerardo Gonzalez, Rosa Linda Guerra Moya, Arturo Guerra-Lopez, Raymundo Hernandez Baylon, Carolina Herrera Colorado, Marisol Herrera-Marmolejo, Neri Islas-Palacios, Esteban Lopez, Fernando Lopez, Agustin Lopez Alvarado, Rosa Isela Luna Ceballos, Enrique Morales Villegas, Gualberto Moreno-Virgen, Rosa Linda Parra Perez, Sara Pascoe Gonzalez, Irving Peralta-Cantu, Roopa Previn, Rosa Ramirez, Rubria Ramirez, Maria Guadalupe Ramos Zavala, Monica Rodriguez, Rocio Salgado-Sedano, Ana Claudia Sanchez-Aguilar, Edith Santa Rosa Franco, Leobardo Sauque-Reyna, Rodrigo Suarez Otero, Ivonne Torres, Enrique Velarde-Harnandez, Juan Villagordoa, Efrain Villeda-Espinoza, Jorge Vital-Lopez, Cristian Jair Zavala- Bello, John Baker, Elaine Barrington-Ward, Thomas Brownless, Richard Carroll, Simon Carson, Michelle Choe, Andrew Corin, Brian Corley, Richard Cutfield, Neelam Dalaman, Paul Dixon, Paul Drury, Keith Dyson, Chris Florkowski, Monica Ford, William Frengley, Colin Helm, Colin Katzen, Jane Kerr, Manish Khanolkar, David Kim, Renata Koops, Jeremy Krebs, Robert Leikis, Kwan Low, Alison Luckey, Richard Luke, Susan Macaulay, Rodney Marks, Catherine McNamara, Dean Millar-Coote, Steven Miller, Naomi Mottershead, James Reid, Narcisa Robertson, Ian Rosen, David Rowe, Ole Schmiedel, Russell Scott, Jeffrey Sebastian, Davitt Sheahan, Victoria Stiebel, Ian Ternouth, Chris Tofield, Dirk Venter, Michael Williams, Miles Williams, Fiona Wu, Simon Young, Malgorzata Arciszewska, Anna Bochenek, Piotr Borkowski, Przemyslaw Borowy, Tomasz Chrzanowski, Edward Czerwinski, Marek Dwojak, Agnieszka Grodzicka, Izabela Janiec, Joanna Jaruga, Ewa Krystyna Jazwinska-Tarnawska, Krystyna Jedynasty, Danuta Juzwiak-Czapiewska, Jadwiga Karczewicz-Janowska, Jan Konieczny, Marek Konieczny, Marek Korol, Maciej Kozina, Ewa Krzyzagorska, Ewa Kucharczyk-Petryka, Roman Laz, Anna Majchrzak, Zdzislawa Mrozowska, Michal Mularczyk, Elzbieta Nowacka, Jadwiga Peczynska, Robert Petryka, Radoslaw Pietrzak, Dorota Pisarczyk-Wiza, Aleksandra Rozanska, Zofia Ruzga, Emilia Rzeszotarska, Malgorzata Sacha, Marzenna Sekulska, Anna Sidorowicz-Bialynicka, Teresa Stasinska, Agnieszka Strzelecka-Sosik, Teresa Swierszcz, Katarzyna Miroslawa Szymkowiak, Olga Turowska, Krystyna Wisniewska, Maciej Wiza, Iwona Wozniak, Katarzyna Zelazowska, Bernadetta Ziolkowska-Gawron, Danuta Zytkiewicz-Jaruga, Adrian Albota, Carmina Alexandru, Rodica Avram, Cornelia Bala, Diana Barbonta, Roxana Barbu, Daniela Braicu, Nicoleta Calutiu, Doina Catrinoiu, Anca Cerghizan, Alina Ciorba, Anca Craciun, Rodica Doros, Livia Duma, Ancuta Dumitrache, Ioana Ferariu, Anca Ferician Moza, Alexandrina Ghergan, Gheorghe Ghise, Mariana Graur, Mihaela Gribovschi, Bogdan Mihai, Laura Mihalache, Madalina Mihalcea, Nicoleta Mindrescu, Magdalena Morosanu, Andrea Morosoanu, Maria Mota, Anca Moza, Valerica Nafornita, Narcisa Natea, Simona Nicodim, Cristina Nita, Adriana Onaca, Mircea Onaca, Cristina Pop, Lavinia Pop, Amorin Popa, Alexandrina Popescu, Luchiana Pruna, Gabriela Roman, Mihaela Rosu, Alexandra Sima, Doina Sipciu, Carmen Narcisa Sitterli-Natea, Iosif Szilagyi, Minodora Tapurica, Adrian Tase, Adriana-Carmen Tutescu, Luminita Vanghelie, Ioana Verde, Adrian Vlad, Mihaela Zarnescu, Roman Akhmetov, Irina Allenova, Irina Avdeeva, Oksana Baturina, Irina Biserova, Nikolay Bokovin, Irina Bondar, Natalia Burova, Galina Chufeneva, Elena Chumachek, Marina Demidova, Alexander Demin, Vera Drobysheva, Irina Egorova, Lev Esenyan, Ekaterina Gelig, Sergey Gilyarevsky, Maria Golshmid, Arseniy Goncharov, Anastasia Gorbunova, Ivan Gordeev, Vera Gorelysheva, Tatiana Goryunova, Irina Grebenshchikova, Roman Ilchenko, Maria Ivannikova, Saule Karabalieva, Juliya Karpeeva, Elena Khaykina, Zhanna Kobalava, Irina Kononenko, Oxana Korolik, Anna Korshunova, Victor Kostenko, Irina Krasnopevtseva, Ludmila Krylova, Polina Kulkova, Irina Kuzmina, Alla Ledyaeva, Sergey Levashov, Natalia Lokhovinina, Vadim Lvov, Narine Martirosyan, Sergey Nedogoda, Rostislav Nilk, Yulia Osmolovskaya, Alexey Panov, Olga Paramonova, Ekaterina Pavlova, Elena Pekareva, Nina Petunina, Svetlana Ponamareva, Galina Reshedko, Alla Salasyuk, Malvina Sepkhanyan, Alexandr Serebrov, Olesya Shabelnikova, Andrey Skvortsov, Olga Smirnova, Oxana Spiridonova, Svetlana Strogova, Evgeny Taratukhin, Sergey Tereschenko, Lubov Trukhina, Olga Tsarkova, Vera Tsoma, Farid Tumarov, Natalya Tyan, Tatiana Tyurina, Svetlana Villevalde, Elena Yankovaya, Ludmila Zarutskaya, Elena Zenkova, Aysha Badat, Frederik Bester, Suzanne Blignaut, Dirk Blom, Susan Booysen, Warren Boyd, Brigitte Brice, Susan Brown, Lesley Burgess, Reina Cawood, Kathleen Coetzee, Hillet Conradie, Tanja Cronje, Douwe de Jong, Graham Ellis, Shaunagh Emanuel, Ingrid Engelbrecht, Sharne Foulkes, Done Fourie, Gilbert Gibson, Thirumani Govender, Sumayah Hansa, Allana Colleen Hemus, Firzana Hendricks, Marshall Heradien, Chantelle Holmgren, Zaheer Hoosain, Emile Horak, Johannes Howard, Ignatius Immink, E. Janari, Daksha Jivan, Karl Klusmann, Weik Labuschagne, Yen-yu Lai, Gulam Latiff, J. Lombaard, Hanlie Lottering, Ronel Meeding, Shirley Middlemost, Haroon Mitha, Ismail Mitha, Sandile Mkhwanazi, Rajendran Moodley, Almeri Murray, Dany Musungaie, Yasmin Osman, Kirsten Peacey, Larisha Pillay-Ramaya, Catharina Pretorius, Hans Prozesky, Mahomed Sarvan, E Scholtz, Attila Sebesteny, Bianca Skinner, Michael Skriker, M Smit, Anna-Marie Stapelberg, Nicolaas Swanepoel, Dorothea Urbach, Dina van Aswegen, Francois van Zyl, Louis Van Zyl, Esme Venter, Shahid Wadvalla, Jeffrey Wing, Karen Wolmarans, Cristina Abreu, Pilar Aguilà, Eva Aguilera, Nuria Alonso, Carmen Alvarez, Priscila Cajas, Jose Carlos Castro, Roger Codinachs, Jose Contreras, Maria Jose Coves, Carmen Fajardo, Juan Carlos Ferrer, Neus Font, Mar Garcia, Maria Apolonia Gil, Fernando Gomez, Lluis Alberto Gomez, Jose Gonzalbez, Jose Luis Griera, Luís Masmiquel, Didac Mauricio, Silvia Narejos Perez, Juana Ana Nicolau, Olga Noheda Contreras, Josefina Olivan, Josefina Olivares, Emilio Ortega, Silvia Pellitero, Salvador Pertusa, Ferran Rius, Irene Rodriguez, Carlos Sánchez-Juan, Dolores Santos, Berta Soldevila, David Subias, Manel Terns, Carlos Trescoli, Judith Vilaplana, Alicia Villanueva, Jaan Albo, Kjell Antus, Mattias Axelsson, Lisa Bergström, Emil Binsell-Gerdin, Kurt Boman, Fabian Botond, Annika Dotevall, Anna Graipe, C Jarnet, Jessica Kaminska, Anders Kempe, Michael Korhonen, Carina Linderfalk, Bo Liu, Karl Ljungstroem, Karl Ljungström, Lennart Malmqvist, Linda Mellbin, Thomas Mooe, Peter Nicol, Anders Norrby, Ake Ohlsson, Annika Rosengren, Jan Saaf, Staffan Salmonsson, Olof Strandberg, Karl-Axel Svensson, Bengt-Olov Tengmark, Georgios Tsatsaris, Anders Ulvenstam, Peter Vasko, Chwen-Tzuei Chang, Hsin-Mei Chang, Jung-Fu Chen, To-Pang Chen, Ming-Min Chung, Chia-Po Fu, Te-Lin Hsia, Shih-Che Hua, Ming-Chun Kuo, Chia-ln Lee, I-Te Lee, Kae-Woei Liang, Shih Yi Lin, Chieh-Hsiang Lu, Wen-Ya Ma, Dee Pei, Feng-Chih Shen, Ching-Chieh Su, Shuo-Wei Su, Tsai-Sung Tai, Wan-Ni Tsai, Yi-Ting Tsai, Shih-Chen Tung, Jun-Sing Wang, Hui-I Yu, Ahmed Al-Qaissi, Vijayaraman Arutchelvam, Stephen Atkin, Simon Au, Myint Myint Aye, Stephen Bain, Cristina Bejnariu, Patrick Bell, Deepak Bhatnagar, Rudy Bilous, Neil Black, Ursula Brennan, Barbara Brett, Jana Bujanova, Elaine Chow, Andrew Collier, Amanda Combe, Christopher Courtney, Hamish Courtney, James Crothers, Patrick Eavis, Jackie Elliott, Salvatore Febbraro, Jim Finlayson, Rajiv Gandhi, Sharon Gillings, Jonathan Hamling, Roy Harper, Tim Harris, Kahal Hassan, Simon Heller, Alison Jane, Zeeshan Javed, Tim Johnson, Stephen Jones, Adele Kennedy, David Kerr, Brian Kilgallon, Judith Konya, John Lindsay, Lina Lomova-Williams, Helen Looker, David MacFarlane, Sandra Macrury, Iqbal Malik, Rory McCrimmon, Douglas McKeith, John McKnight, Biswa Mishra, Racha Mukhtar, Ciara Mulligan, Maurice O'Kane, Tolu Olateju, Ian Orpen, Tristan Richardson, Desmond Rooney, Shorsha Bae Ross, Thozhukat Sathyapalan, Naveen Siddaramaiah, Lee Euan Sit, Jeffrey Stephens, Frances Turtle, Ammar Wakil, Emma Walkinshaw, Asem Ali, Robert Anderson, Richard Arakaki, Omar Aref, Mehrdad Kevin Ariani, David Arkin, Salomon Banarer, George Barchini, Arti Bhan, Kelley Branch, Donald Brautigam, Stephen Brietzke, Maridez Brinas, Yudit Brito, Casey Carter, Kimberely Casagni, Sabina Casula, Simon Chakko, Seth Charatz, Dale Childress, Lisa Chow, Malgorzata Chustecka, Subha Clarke, Lisa Cohen, Barry Collins, Gildred Colon Vega, Angel Comulada-Rivera, Gregorio Cortes-Maisonet, Matthew Davis, Jose de Souza, Cyrus Desouza, Mary Dinnan, Bobbi Duffy-Hidalgo, Barbara Dunn, Julia Dunn, Marshall Elman, James Felicetta, Stuart Finkelstein, David Fitz-Patrick, Hermes Florez, Alan Forker, Wayne Fowler, Sonja Fredrickson, Zachary Freedman, Brooke Gainey Narron, Kristin Gainey-Ferree, Michael Gardner, Christian Gastelum, Stephen Giddings, Eve Gillespie, Michael Paul Gimness, Gary Goldstein, Maria Gomes, Nelson Gomez, Timothy Gorman, Ketan Goswami, Arthur Graves, Scott Hacking, Charles Hall, Lenita Hanson, Sherman Harman, David Heber, Robert Henry, Janette Hiner, Irl Hirsch, Priscilla Hollander, Thomas Hooker, Barry Horowitz, Laura Hoste, Loli Huang, Minh Huynh, Dan Hyman, Soha Idriss, Ali Iranmanesh, Dennis Karounos, Moti Kashyap, Lois Katz, William Kaye, Yevgeniy Khaiton, Romesh Khardori, Timothy Kitchen, Andrew Klein, Wendi Knffem, Mikhail Kosiborod, Nicola Kreglinger, Davida Kruger, Anubhav Kumar, Ivan Laboy, Patricia Larrabee, Laura Larrick, Donna Lawson, Mike Ledet, James Lenhard, James Levy, George Li, Zhaoping Li, David Lieb, April Limcolioc, Jane Lions-Patterson, Daniel Lorber, Daniel Lorch, Michael Lorrello, Peter Lu, Kathryn Jean Lucas, Siu-Ling Ma, Michael MacAdams, Michelle Magee, Alexander Magno, Aparna Reddy Mahakala, Jennifer Marks, Anthony McCall, William McClanahan, Carole McClary, Lydia Melendez, John Melish, Deanna Michaud, Christopher Miller, Neil Miller, Pablo Mora, Marriyam Moten, Sunder Mudaliar, Gregory Myrick, Puneet Narayan, Mike Nassif, Karena Neri, Tabitha Newton, Patricia Niblack, Philip Nicol, Ebenezer Nyenwe, A. Ola Odugbesan, Yolanda Okorocha, Ramón Ortiz Carrasquillo, Kwame Osei, Coromoto Palermo, Hiren Patel, Krishna Patel, Cindy Pau, Michael Perley, Sanford Plevin, Elena Plummer, Richard Powell, Mohammed Qintar, Rex Rawls, John Reyes-Castano, Lillian Reynolds, Robert Richards, Julio Rosenstock, Caroline Rowe, Jahandar Saleh, Sony Sam, Alfredo Sanchez, Donald Sander, Bruce Sanderson, Virginia Savin, Elizabeth Seaquist, Jayendra Shah, Serena Shi, Vijay Shivaswamy, Tammi Shlotzhauer, David Shore, Bobbie Skukowski, Kyaw Soe, Vesna Solheim, Joseph Soufer, Helmut Steinberg, Jaime Steinsapir, Phillip Tarkington, Debra Thayer, Stephen Thomson, James Thrasher, Joseph Tibaldi, Jeff Tjaden, Oberto Tores, Dace Trence, Subbulaxmi Trikudanathan, Jagdeesh Ullal, Gabriel Uwaifo, Anthony Vo, Kenny Vu, Damandeep Walia, Karen Weiland, Fred Whitehouse, Thomas Wiegmann, Kathleen Wyne, Alan Wynne, Kevin Yuen, Joel Zaretzky, James Zebrack, Franklin Zieve, William Zigrang, and Everest

Subjects
Male, medicine.medical_specialty, Recombinant Fusion Proteins, Population, Placebo-controlled study, Glucagon-Like Peptides, Myocardial Infarction, Type 2 diabetes, 030204 cardiovascular system & hematology, Placebo, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Double-Blind Method, law, Internal medicine, medicine, Humans, Hypoglycemic Agents, 030212 general & internal medicine, education, Aged, education.field_of_study, business.industry, Semaglutide, Hazard ratio, General Medicine, Middle Aged, medicine.disease, Immunoglobulin Fc Fragments, Stroke, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Dulaglutide, Female, business, medicine.drug
Abstract

Digital, Background Three different glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular outcomes in people with type 2 diabetes at high cardiovascular risk with high glycated haemoglobin A1c (HbA1c) concentrations. We assessed the effect of the GLP-1 receptor agonist dulaglutide on major adverse cardiovascular events when added to the existing antihyperglycaemic regimens of individuals with type 2 diabetes with and without previous cardiovascular disease and a wide range of glycaemic control. Methods This multicentre, randomised, double-blind, placebo-controlled trial was done at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo. Randomisation was done by a computer-generated random code with stratification by site. All investigators and participants were masked to treatment assignment. Participants were followed up at least every 6 months for incident cardiovascular and other serious clinical outcomes. The primary outcome was the first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes (including unknown causes), which was assessed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT01394952. Findings Between Aug 18, 2011, and Aug 14, 2013, 9901 participants (mean age 66·2 years [SD 6·5], median HbA1c 7·2% [IQR 6·6–8·1], 4589 [46·3%] women) were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). During a median follow-up of 5·4 years (IQR 5·1–5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants at an incidence rate of 2·7 per 100 person-years in the placebo group (hazard ratio [HR] 0·88, 95% CI 0·79–0·99; p=0·026). All-cause mortality did not differ between groups (536 [10·8%] in the dulaglutide group vs 592 [12·0%] in the placebo group; HR 0·90, 95% CI 0·80–1·01; p=0·067). 2347 (47·4%) participants assigned to dulaglutide reported a gastrointestinal adverse event during follow-up compared with 1687 (34·1%) participants assigned to placebo (p, Ciencias Médicas y de la Salud

Published
2019

35. Electric Power’s Seasons

Author

Catalina Alexandra Sima, Claudia Laurenta Popescu, and Mihai Octavian Popescu

Subjects
Electricity generation, Wind power generation, Geography, business.industry, Economic geography, Electricity, Electric power, Duration (project management), business, Human resources, Renewable energy
Abstract

The evolution of electricity in Romania took place in the last century. This paper presents the development of electricity sector in a seasonal evolution form. This approach has a cyclical character and highlights options for the future. The main stages of evolution, with a duration of several decades each, are associated with the four seasons: winter, spring, summer and autumn. The similarity features relate to the quantitative and qualitative ways of electricity production evolution, which is in line with the technological development level of a country. The conclusions highlight the idea of proactive rational action with regard to ensuring in the future the necessary human resources.

Published
2019

36. Increasing RESs Share Using Generation and Transmission Expansion Planning - Stochastic Approach

Author

Gheorghe Lazaroiu, Catalina Alexandra Sima, Monica Alexandru, Mihai Octavian Popescu, and Claudia Laurenta Popescu

Subjects
Mathematical optimization, Wind power, Linear programming, business.industry, Computer science, Stochastic process, 020209 energy, 02 engineering and technology, Investment (macroeconomics), Renewable energy, Electric power system, Electric power transmission, 020401 chemical engineering, Transmission (telecommunications), 0202 electrical engineering, electronic engineering, information engineering, 0204 chemical engineering, business
Abstract

In this paper, the Generation and Transmission Expansion Planning problem is solved considering a stochastic approach. The problem is applied on a fictive power system that is similar to a real system where renewable energy sources (RESs) - wind power plants - are considered for possible integration. The optimal solution of the problem determines the number and location of the new transmission lines that are possible to be built. In addition, the capacity and location of the new wind generating units (WPP) are determined. The mathematical model is a mixed-integer linear programming problem (MILP) in which losses are neglected.

Published
2019

38. A Deterministic Approach for Generation Expansion Planning Optimization

Author

Virgil Dumbrava, George Cristian Lazaroiu, Catalina Alexandra Sima, and Mihnea Costoiu

Subjects
Marginal cost, Mathematical optimization, Operator (computer programming), Electric power transmission, Linear programming, Computer science, 020209 energy, 0202 electrical engineering, electronic engineering, information engineering, Electricity market, Production (economics), Point (geometry), 02 engineering and technology, Energy system
Abstract

The Generation Expansion Planning (GEP) problem is applied on a real energy system located in south-east of Romania, where meteorological conditions are favorable for wind farms integration. In this paper, the point of view of independent system operator that optimizes the operation of the considered system is presented. An optimization mathematical model that solves GEP problem is presented. The independent system operator can stimulate investors to build new generation systems. The mathematical model is a mixed-integer linear programming (MILP) model that is solved with a deterministic approach and it is composed by two problems: a primal problem (named GEP problem) and a dual problem (clearing of the electricity market problem). Primal-dual formulation is used to replace market-clearing problems with its primal constraints. The electricity market is considered to be competitive and each producer sells his capacity at marginal costs.

Published
2018

39. Case studies from selected countries – Romania and Italy

Author

George Cristian Lazaroiu, Catalina-Alexandra Sima, Federica Foiadelli, Morris Brenna, Michela Longo, and Virgil Dumbrava

Subjects
Distribution (number theory), Computer science, business.industry, media_common.quotation_subject, chemistry.chemical_element, Protection system, Reliability engineering, Electric power system, chemistry, Control system, Computer data storage, Islanding, Lithium, Function (engineering), business, media_common
Abstract

The analysis of various storage systems case studies in Italy and Romania was conducted. In Italy, the results from collaboration with Enel Distribution for black start function with a storage system with lithium batteries were presented. In this way, in case of a black-out, the energizing of an area of the medium-voltage power system can be achieved in an islanding operation way. A dynamic model for presenting the entire system was elaborated and through RTDS simulations considering the protection and control systems was achieved.

Published
2018

40. Deterministic Approach for Generation and Transmission Expansion Planning

Author

Catalina Alexandra Sima, George Cristian Lazaroiu, Virgil Dumbrava, Cornel Panait, and Mariacristina Roscia

Subjects
Optimization, Mathematical optimization, Control and Optimization, Wind power generation, Sustainability and the Environment, Linear programming, Computer science, Energy Engineering and Power Technology, Time horizon, Investment (macroeconomics), Renewable energy sources, System requirements, Generation expansion planning, Transmission expansion planning, Fuel Technology, Electrical and Electronic Engineering, Renewable Energy, Electric power transmission, Settore ING-IND/33 - Sistemi Elettrici per L'Energia, Transmission (telecommunications), Production (economics)
Abstract

In this paper, the Generation and Transmission Expansion Planning (G&TEP) problem, considering two case studies, is analyzed. In the first case, the GEP and TEP problems are considered separately, while in the second GEP and TEP problems are solved together, thus G&TEP problem appears. The objective function of the mixed-integer linear programming (MILP) problem is minimizing the expected generation costs, load-shedding costs and investment costs. The planner can modify the presented mathematical model in order to satisfy any other system requirements considering G&TEP problem. The approach presented in this paper is a deterministic static one. The investment decision is considered to be made at the beginning of the planning horizon.

Published
2018

41. Methylene blue alleviates endothelial dysfunction and reduces oxidative stress in aortas from diabetic rats

Author

Adrian Sturza, Mariana G. Roșca, Alexandra Sima, Danina Muntean, Romulus Timar, Andreea Privistirescu, and Oana Duicu

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Physiology, medicine.disease_cause, Diabetes Mellitus, Experimental, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Physiology (medical), Diabetes mellitus, Internal medicine, medicine, Animals, Endothelial dysfunction, Rats, Wistar, Pharmacology, chemistry.chemical_classification, Reactive oxygen species, Chemistry, General Medicine, medicine.disease, Pathophysiology, Rats, Methylene Blue, Oxidative Stress, 030104 developmental biology, Endocrinology, Vasoconstriction, 030220 oncology & carcinogenesis, Endothelium, Vascular, medicine.symptom, Reactive Oxygen Species, Methylene blue, Oxidative stress, Experimental diabetes
Abstract

Endothelial dysfunction and the related increase in reactive oxygen species (ROS) production are important events in the pathophysiology of diabetes mellitus (DM). Methylene blue (MB) has been systematically investigated for its protective effects against refractory hypotension and mitochondrial dysfunction. We have previously demonstrated that MB improved mitochondrial respiration and partially decreased oxidative stress in diabetic rat hearts. The present study was aimed to investigate whether MB modulates vascular function and ROS production in thoracic aortic rings isolated from rats with streptozotocin-induced DM (after 4 weeks of hyperglycemia). The effects of MB (0.1 μM, 30 min ex vivo incubation) on vascular reactivity in organ chamber (phenylephrine-induced contraction, acetylcholine-induced relaxation) and H2O2production (assessed by ferrous iron xylenol orange oxidation assay) were investigated in vascular preparations with intact endothelium and after denudation. DM elicited a significant alteration of vascular function: increased contractility to phenylephrine, attenuation of acetylcholine-dependent relaxation, and augmented H2O2generation. Ex vivo incubation with MB partially reversed all these changes (by approximately 70%) in vascular segments with intact endothelial layer (but not in denuded vessels). In conclusion, MB might be useful in alleviating endothelial dysfunction and mitigating endothelial oxidative stress, observations that clearly require further investigation in the setting of cardiometabolic disease.

Published
2018

42. Time trends, regional variability and seasonality regarding the incidence of type 1 diabetes mellitus in Romanian children aged 0-14 years, between 1996 and 2015

Author

Adrian Vlad, Viorel Serban, Anders Green, Sören Möller, Mihaela Vlad, Bogdan Timar, Alexandra Sima, and on behalf of the ONROCAD Study Group

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, Type 1 diabetes mellitus, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Age groups, children, 030225 pediatrics, medicine, Humans, Child, Type 1 diabetes, Time trends, business.industry, Romania, seasonality, Incidence, Incidence (epidemiology), Infant, Seasonality, medicine.disease, Confidence interval, Diabetes Mellitus, Type 1, Child, Preschool, Pediatrics, Perinatology and Child Health, Geographic regions, incidence, Female, Original Article, Seasons, business, 030217 neurology & neurosurgery
Abstract

Objective: The incidence of type 1 diabetes mellitus in children is highly variable in the world. The aim of our study was to: 1) analyze the evolution of the incidence of childhood type 1 diabetes in Romania between 1996 and 2015, and: 2) to search for differences amongst age groups, gender, geographic regions and month of diagnosis. Methods: Data on all new cases of type 1 diabetes, aged

Published
2018

43. Fibrosis and steatosis in type 2 diabetes mellitus patients evaluated with transient elastography and controlled attenuation parameter

Author

Alexandra Sima, Silviu Nistorescu, Roxana Sirli, Romulus Timar, Alina Popescu, Ruxandra Mare, and Ioan Sporea

Subjects
medicine.medical_specialty, Acoustics and Ultrasonics, Radiological and Ultrasound Technology, business.industry, Biophysics, Type 2 Diabetes Mellitus, medicine.disease, Gastroenterology, Obesity, Liver stiffness, Fibrosis, Internal medicine, Cohort, medicine, Radiology, Nuclear Medicine and imaging, Steatosis, business, Viral hepatitis, Transient elastography
Abstract

The aim of the study was to assess the severity of liver fibrosis and steatosis in a cohort of type 2 diabetic patients, using non-invasive Methods: Transient Elastography (TE) and Controlled Attenuation Parameter (CAP). Material and Method: The study included 704 type 2 diabetic patients prospectively randomized, evaluated in the same session by means of TE and CAP (FibroScan, EchoSens) to assess both liver fibrosis and steatosis. Reliable liver stiffness measurements (LSM) were defined as the median value of 10 LSM with an IQR/median 300 db/m. Results: Out of 704 diabetics screened we excluded those with associated viral hepatitis, those with an AUDIT-C score ≥ 8 and those with unreliable LSM. The final analysis included 485 subjects (54.3% women, mean age 60 ± 9.5; mean BMI = 31.6 ± 6.1 kg/m2) with reliable LSM. 32.1% of patients had obesity grade I, 17.9 % had obesity grade II and 8.9% had obesity grade III (IMC ≥ 40 kg/m2). Mild, moderate and severe steatosis by means of CAP was found in 15.6%, 15.6 % and 59.3% cases, respectively. The median CAP values of patients with mild, moderate and severe steatosis were 260 db/m, 287.5 db/m and 354 db/m. Clinically relevant fibrosis was detected by means of TE in 19.6% (95/485) of subjects. Conclusion: In our group, 59.3% of diabetic patients had severe steatosis by means of CAP. Regarding the liver fibrosis, we found that 19.6% of them had severe fibrosis (TE ≥ 10.1kPa), suggesting the need for further assessment.

Published
2019

44. A hybrid system implementation for residential cluster

Author

George Cristian Lazaroiu, Catalina Alexandra Sima, Mihai Tirsu, and Virgil Dumbrava

Subjects
Wind power, business.industry, Photovoltaic system, Fossil fuel, ComputerApplications_COMPUTERSINOTHERSYSTEMS, computer.software_genre, Wind speed, Automotive engineering, Simulation software, Renewable energy, Hybrid system, Computer data storage, Environmental science, business, computer
Abstract

In the current situation, when conventional energy based on fossil fuel combustion are polluting and time-limited, there is an increasing emphasis on the exploitation of non-polluting renewable sources. At both global and European levels, particular attention is paid to the use of renewable energy sources, encouraging, through various projects, the progressive change from the use of fossil fuels to the use of renewable technologies. In this paper, the hybrid power generation system that supplies a residential district using solar panels, wind turbines, generating set, storage system and a converter is analyzed. Simulation software is used to introduce the renewable sources type, the batteries and the generator type, as well as the data of the wind speed and the daily solar radiation system and to design the power supply system.

Published
2017

45. Stochastic programming approach for TEP optimization considering RES integration in electricity market

Author

George Cristian Lazaroiu, Philippe Duquenne, Dario Zaninelli, Mariacristina Roscia, Catalina Alexandra Sima, Virgil Dumbrava, Centre National de la Recherche Scientifique - CNRS (FRANCE), Institut National Polytechnique de Toulouse - Toulouse INP (FRANCE), Université Toulouse III - Paul Sabatier - UT3 (FRANCE), University Politechnica of Bucharest (ROMANIA), Politecnico di Milano (ITALY), Università degli Studi di Bergamo - UniBG (ITALY), Laboratoire de Génie Chimique - LGC (Toulouse, France), Institut National Polytechnique de Toulouse - INPT (FRANCE), University Politechnica Bucuresti, Università degli studi di Bergamo (UniBG), Politecnico di Milano [Milan] (POLIMI), Laboratoire de génie chimique [ancien site de Basso-Cambo] (LGC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), and Université Fédérale Toulouse Midi-Pyrénées

Subjects
[SPI.OTHER]Engineering Sciences [physics]/Other, Energie électrique, Mathematical optimization, Computer science, Total cost, 020209 energy, Reliability (computer networking), Stochastic programming, Energy Engineering and Power Technology, Power system reliability, 02 engineering and technology, 7. Clean energy, Renewable energy sources, Nonlinear programming, Electric power system, Mathematical model, Electricity market, Autre, 0202 electrical engineering, electronic engineering, information engineering, Decision support optimization, Renewable Energy, Sustainability and the Environment, [SPI.NRJ]Engineering Sciences [physics]/Electric power, Production, Reliability, Electric power transmission, Settore ING-IND/33 - Sistemi Elettrici per L'Energia, Power transmission lines, Programming, Transmission expansion planning, Stochastic optimization, Renewable Energy, Sustainability and the Environment, Investment
Abstract

International audience; Transmission expansion planning (TEP) is helping the system operator to decide the optimal solution for building new lines and in the same time to increase the reliability and safety of the existing power system. The proposed problem is a mixed-integer nonlinear programming problem (MINLP) and it is solved using stochastic programming. Stochastic programming is applied when uncertain environment occurs, in this case the uncertain environment refers to the production of renewable energy sources (RES) and its dependence on the short-term weather conditions. Stochastic Optimization weights all scenarios considered in this paper in order to obtain an expected total cost. The expected total cost includes the cost associated with the construction of new transmission lines, generation cost and load shedding cost.

Published
2017

46. Optimizing DISCOs planning for networks with distributed energy resources

Author

Catalina Alexandra Sima, George Cristian Lazaroiu, Virgil Dumbrava, Mihnea Costoiu, and Sonia Leva

Subjects
Consumption (economics), Mathematical optimization, Engineering, Optimization problem, Environmental Engineering, business.industry, 020209 energy, Distributed energy resources, Energy Engineering and Power Technology, 02 engineering and technology, Grid, Sizing, DISCOs, Industrial and Manufacturing Engineering, Renewable energy, Investment minimization, Distributed generation, 0202 electrical engineering, electronic engineering, information engineering, Production (economics), Electricity, Optimized planning, Electrical and Electronic Engineering, business
Abstract

This paper deals with distribution companies (DISCOs) point of view on opportunities of optimizing investments planning and operation costs, considering possible increase and geographical displacement of high consumption buses, increasing the consumption at different time instants in other buses, by optimally installing and sizing distributed energy resources. The optimization problem is sizing and locating the distributed energy resources within the grid. The results are used for minimizing the planning and operation costs associated with power losses, and for preserving the voltage level in all the nodes within the admissible limits. We want to compare the value of the investment costs needed to strengthen the distribution network due to the problems caused by the increase in the electricity consumption, with the value of the economic losses caused by the drastic reduction of the electricity purchased and transited through the network. In all moments, a perfect balance between generation and consumption, including the various operating states of the storage units, must be ensured. Optimal power flow is performed for determining the susceptible nodes and lines for reinforcement. The stochastic charging time of storage and electric vehicles supply, as well as the production from renewable sources will be also considered.

Published
2017

47. Transmission expansion planning optimization for improving RES integration on electricity market

Author

Virgil Dumbrava, Catalina Alexandra Sima, and George Cristian Lazaroiu

Subjects
Engineering, business.industry, 020209 energy, Reliability (computer networking), Photovoltaic system, 02 engineering and technology, Environmental economics, Grid, Investment (macroeconomics), Renewable energy, Transport engineering, Electric power system, Electric power transmission, 0202 electrical engineering, electronic engineering, information engineering, Electricity market, business
Abstract

To accommodate the intermittent renewable energy sources in existing power systems, the expansion of networks, storage integration, back-up capacities and efforts for a flexible consumption are required, otherwise grid can be overloaded. The transmission expansion planning (TEP) has the purpose to ensure two important objectives: economic trade and engineering reliability. TEP can increase the competitiveness of the market participants, providing the reliability and safety of the power grid. In this paper, TEP problem is formulated for establishing the optimal decisions in a large real network with classical generators and high share of RES to minimize load-shedding costs and to facilitate energy exchange between consumers and producers. The analysis results were obtained considering the variation of investment budget for a certain number of new transmission lines.

Published
2017

48. Nonalcoholic fatty liver disease: a frequent condition in type 2 diabetic patients

Author

Mihaela Rosu, Roxana Sirli, Alexandra Sima, Adrian Vlad, Alina Popescu, Romulus Timar, Bogdan Timar, Isabel Dan, and Ioan Sporea

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Hyperlipidemias, Comorbidity, Type 2 diabetes, Gastroenterology, Young Adult, Liver disease, Age Distribution, Insulin resistance, Non-alcoholic Fatty Liver Disease, Risk Factors, Internal medicine, Diabetes mellitus, Nonalcoholic fatty liver disease, Prevalence, medicine, Humans, Obesity, Sex Distribution, medicine.diagnostic_test, Romania, business.industry, Fatty liver, General Medicine, medicine.disease, Diabetes Mellitus, Type 2, Abdominal ultrasonography, Female, Steatosis, business
Abstract

Nonalcoholic fatty liver disease represents an excessive fat accumulation in the liver of patients with no other liver disease and no history of alcohol abuse. It is associated with insulin resistance, being more prevalent in obesity and type 2 diabetes. Our aim was to assess the prevalence of fatty liver and nonalcoholic steatohepatitis in patients with type 2 diabetes and to evaluate the influence of obesity on its prevalence. We included 348 type 2 diabetes patients (age: 18–65 years), without a history of liver disease or alcohol abuse. We assessed demographical data, medical history, physical examination, blood tests, and abdominal ultrasonography. The prevalence of liver steatosis in our group was 87.1 %, with no significant differences between men and women. Patients with steatosis had higher abdominal circumference, body mass index (BMI; p = 0.001), and serum triglyceride (p

Published
2014

49. Autoimmune polyglandular syndrome type 2 - a case report

Author

Adrian Vlad, Alexandra Sima, Diana Bănică, Ramona Frăţilă, and Romulus Timar

Subjects
medicine.medical_specialty, endocrine system diseases, lcsh:Specialties of internal medicine, business.industry, autoimmune polyglandular syndrome, Dermatology, autoimmune diabetes, chronic autoimmune thyroiditis, lcsh:RC581-951, Endocrinology diabetology, Medicine, Autoimmune Polyglandular Syndrome Type 2, business, celiac disease
Abstract

Autoimmune polyglandular syndromes are characterized by the association of two or more autoimmune diseases. They are classified into two major subtypes, each having its own characteristics. The autoimmune polyglandular syndrome type 2 is defined by the presence of at least two of the following diseases: Addison’s disease, type 1 diabetes mellitus and thyroid autoimmune disease. Other autoimmune diseases belonging to the autoimmune polyglandular syndrome type 2 are: primary hypogonadism, myasthenia gravis, celiac disease, pernicious anemia, alopecia, vitiligo. We are going to present the case of a patient, aged 40, with diabetes mellitus (probably latent autoimmune diabetes of the adult), chronic autoimmune thyroiditis and celiac disease.

Published
2014

50. Prevalence of Urinary Tract Infections in Diabetic Patients

Author

Teodora Chiţă, Adrian Vlad, Bogdan Timar, Alexandra Sima, Patricia Sabo, Romulus Timar, and Monica Licker

Subjects
medicine.medical_specialty, business.industry, Urinary system, Urine, urologic and male genital diseases, medicine.disease, Asymptomatic, female genital diseases and pregnancy complications, Surgery, Exact test, Diabetes clinic, Internal medicine, Diabetes mellitus, medicine, Population study, medicine.symptom, business, Asymptomatic bacteriuria
Abstract

Background and aims: There is evidence that patients with diabetes have an increased risk of asymptomatic bacteriuria and urinary tract infections (UTIs). UTI is the most common bacterial infection in diabetic patients. The aim of this study was to assess the prevalence of UTIs among hospitalized diabetic patients and to identify the most frequent bacteria responsible for UTI. Material and methods: The study population included 1470 diabetic patients (847 women and 623 men), admitted to the Diabetes Clinic of the Emergency Clinical County Hospital Timişoara, between January and December 2012. We collected patients’ personal history data and performed urine cultures. For statistical analysis we used Graph Pad Prism 5; the significance of the difference between the percentage values was assessed using Fisher’s exact test. Results: From the total number of patients, 158 had positive urine cultures, meaning 10.7%. Out of the total number of 158 UTIs, 124 (78.4%) were asymptomatic bacteriuria. The most frequent bacteria involved in UTI was Escherichia coli (68.9%). Conclusion: UTIs are frequent in diabetic patients. Because of the great proportion of asymptomatic forms among diabetic patients, the urine culture should be performed in all hospitalized patients with diabetes.

Published
2013

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