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Unemployment represents a negative phenomenon in almost all countries of the world. It is a complex phenomenon that has multiple causes and important economic and social-human consequences. This paper aims to analyze the correlation between the unemployment rate, respectively the number of unemployed persons and some of the influencing factors. Therefore, we identified the main influencing factors of unemployment in Romania based on an econometric model using the multiple linear regression. This model allows forecasting the future economic trends of the indicators highlighting the level of unemployment. The result showed that the growth rate of the Gross Domestic Product, the volume of foreign direct investments and the exports, as well as the inflation rate are significant factors influencing the unemployment.

Introduction Home-based, virtually-supported care models may represent the most efficient and scalable approach to delivering prehabilitation services. However, virtual approaches to prehabilitation are understudied. This manuscript describes the protocol for an internal pilot randomised controlled trial of a virtually-delivered, multimodal prehabilitation intervention.Methods and analysis We will conduct a pragmatic, individual patient, internal pilot randomised controlled trial of home-based, virtually supported, multimodal prehabilitation compared with standard perioperative care in adults undergoing elective, inpatient thoracic, abdominal, pelvic and vascular surgery at five Canadian hospitals. Participants will be partially blinded; clinicians and outcome assessors will be fully blinded. The intervention consists of 3–12 weeks of a home-based, multimodal (exercise, nutrition and psychosocial support) prehabilitation programme supported through an online platform. The primary feasibility outcomes and their progression targets are (1) monthly recruitment of>6 participants at each centre, (2) intervention adherence of>75%, (3) retention of>90% of participants at the patient-reported primary outcome point of 30-days after surgery and (4) elicitation of patient, clinician and researcher-identified barriers to our pragmatic trial. A sample size of 144 participants will be adequate to estimate recruitment, adherence and retention rates with acceptable precision. All participants will be followed to either death or up to 1 year. As an internal pilot, if no substantive changes to the trial or intervention design are required, pilot participant outcome data will migrate, unanalysed by allocation, to the future full-scale trial.Ethics and dissemination Ethical approval has been granted by Clinical Trials Ontario (Project ID: 4479) and our ethics review board (Protocol Approval #20230399–01T). Results will be disseminated through presentations at scientific conferences, peer-reviewed publications, partner organisations and engagement of social and traditional media.Trial registration number ClinicalTrials.gov identifier NCT06042491. Protocol, V.1.2, dated 6 June 2024.

The digital transformation of healthcare (eHealth) has been a longstanding priority on the European Union's agenda. However, the COVID-19 pandemic has demonstrably underscored the critical importance of eHealth solutions. This paper presents a response to this urgency by outlining approaches and solutions for online rehabilitation developed within the Erasmus+ joint project " Development of digital skills for online rehabilitation therapies/e-KINE" with the close collaboration and efforts of hospitals and higher education institutions from Turkey, Bulgaria, and Romania.

This paper proposes a presentation unfolding regular and semi-regular polyhedra. Regular polyhedra are convex polyhedra whose faces are regular and equal polygons, with the same number of sides, and whose polyhedral angles are also regular and equal. Semi-regular polyhedra are convex polyhedra with regular polygon faces, several types and equal solid angles of the same type. A net of a polyhedron is a collection of edges in the plane which are the unfolded edges of the solid. Modeling and unfolding Platonic and Arhimediene polyhedra will be using 3dsMAX program. This paper is intended as an example of descriptive geometry applications.

The paper presents some aspects theoretical and practical based on the finite element analysis and modelling of Geneva mechanism with four slots, using the CATIA graphic program. This type of mechanism is an example of intermittent gearing that translates a continuous rotation into an intermittent rotary motion. It consists of alternate periods of motion and rest without reversing direction. In this paper, some design parameters with specify a Geneva mechanism will be defined precisely such as number of driving cranks, number of slots, wheel diameter, pin diameter, etc. Finite element analysis (FEA) can be used for creating a finite element model (preprocessing) and visualizing the analysis results (postprocessing), and use other solvers for processing.

Abstract Background Persistent pain is a common yet debilitating complication after breast cancer surgery. Given the pervasive effects of this pain disorder on the patient and healthcare system, post-mastectomy pain syndrome (PMPS) is becoming a larger population health problem, especially as the prognosis and survivorship of breast cancer increases. Interventions that prevent persistent pain after breast surgery are needed to improve the quality of life of breast cancer survivors. An intraoperative intravenous lidocaine infusion has emerged as a potential intervention to decrease the incidence of PMPS. We aim to determine the definitive effects of this intervention in patients undergoing breast cancer surgery. Methods PLAN will be a multicenter, parallel-group, blinded, 1:1 randomized, placebo-controlled trial of 1,602 patients undergoing breast cancer surgery. Adult patients scheduled for a lumpectomy or mastectomy will be randomized to receive an intravenous 2% lidocaine bolus of 1.5 mg/kg with induction of anesthesia, followed by a 2.0 mg/kg/h infusion until the end of surgery, or placebo solution (normal saline) at the same volume. The primary outcome will be the incidence of persistent pain at 3 months. Secondary outcomes include the incidence of pain and opioid consumption at 1 h, 1–3 days, and 12 months after surgery, as well as emotional, physical, and functional parameters, and cost-effectiveness. Discussion This trial aims to provide definitive evidence on an intervention that could potentially prevent persistent pain after breast cancer surgery. If this trial is successful, lidocaine infusion would be integrated as standard of care in breast cancer management. This inexpensive, widely available, and easily administered intervention has the potential to reduce pain and suffering in an already afflicted patient population, decrease the substantial costs of chronic pain management, potentially decrease opioid use, and improve the quality of life in patients. Trial registration This trial has been registered on clinicaltrials.gov (NCT04874038, Dr. James Khan. Date of registration: May 5, 2021).

In current global market, competition manufactures are forced to use different strategies to increase productivity and gain a competitive advantage. Any producer search possibilities of reducing the price/unit without compromising the functionality of the product and the quality expected by the client. This article is based on a case study of the injection process of a part used in the assembly of horizontal refrigerators. Discrepancy between supply and demand must be solved for the company has no delivery delays. In order to find efficient solutions for the process optimization it is necessary to examine step by step the entire production cycle.

Lighting fittings creates the sensations, the atmosphere and the feelings: an inspired choice can contribute decisively to the creation of great images in terms of interior design to a room. Either we talk about classic or modern luminaires, lamps or chandeliers, luxury or normal, only our imagination limits us to use ingenious light. Diversity desk lamp market is so big that it's hard to bring something innovative, but a rigorous analysis on the needs of people in terms of lighting, result in the development of products with forms of increasingly strange but that draw the attention of many. The purpose of this article is to develop a product design type unidiretional lamp equipped with remote this will fulfill the aim of the design, namely ‘product’. The directional lamp proposed is a luminaire with unique design, equipped with the latest characteristics.

This paper discusses two models with load approaches to model the distribution is prescribed by the Eurocodes: in the first model, each axle load point is represented by three forces, with 50% of the axle load acting on the sleeper located underneath the axle and 25 % on the two adjacent sleepers. In the second model, the three point forces is distributed through further sleepers and the ballast with the height to width ratio of the 4: 1.

In general, people have different preferences, develop different passions for some objects more or less useful for them and their purposes. Today, in the whole world, there are hundreds of thousands of household appliances, each and every one of them with a specific use and a specific value. Because of high tech and futurist vision of the designers, today we can find a large variety of models for household appliances. For that matter we created a new device – Mini Sandwich Maker, presented here in this paper. Our device has some resemblance with other devices but also differentiates from them by its uniqueness and innovative features, perfectly adjusted to the new requirements of the market.

Dopamine axons are the only axons known to grow during adolescence. Here, using rodent models, we examined how two proteins, Netrin-1 and its receptor, UNC5C, guide dopamine axons toward the prefrontal cortex and shape behaviour. We demonstrate in mice (Mus musculus) that dopamine axons reach the cortex through a transient gradient of Netrin-1-expressing cells – disrupting this gradient reroutes axons away from their target. Using a seasonal model (Siberian hamsters; Phodopus sungorus) we find that mesocortical dopamine development can be regulated by a natural environmental cue (daylength) in a sexually dimorphic manner – delayed in males, but advanced in females. The timings of dopamine axon growth and UNC5C expression are always phase-locked. Adolescence is an ill-defined, transitional period; we pinpoint neurodevelopmental markers underlying this period.

Introduction Tranexamic acid (TXA) is an inexpensive and widely available medication that reduces blood loss and red blood cell (RBC) transfusion in cardiac and orthopaedic surgeries. While the use of TXA in these surgeries is routine, its efficacy and safety in other surgeries, including oncologic surgeries, with comparable rates of transfusion are uncertain. Our primary objective is to evaluate whether a hospital-level policy implementation of routine TXA use in patients undergoing major non-cardiac surgery reduces RBC transfusion without increasing thrombotic risk.Methods and analysis A pragmatic, registry-based, blinded, cluster-crossover randomised controlled trial at 10 Canadian sites, enrolling patients undergoing non-cardiac surgeries at high risk for RBC transfusion. Sites are randomised in 4-week intervals to a hospital policy of intraoperative TXA or matching placebo. TXA is administered as 1 g at skin incision, followed by an additional 1 g prior to skin closure. Coprimary outcomes are (1) effectiveness, evaluated as the proportion of patients transfused RBCs during hospital admission and (2) safety, evaluated as the proportion of patients diagnosed with venous thromboembolism within 90 days. Secondary outcomes include: (1) transfusion: number of RBC units transfused (both at a hospital and patient level); (2) safety: in-hospital diagnoses of myocardial infarction, stroke, deep vein thrombosis or pulmonary embolism; (3) clinical: hospital length of stay, intensive care unit admission, hospital survival, 90-day survival and the number of days alive and out of hospital to day 30; and (4) compliance: the proportion of enrolled patients who receive a minimum of one dose of the study intervention.Ethics and dissemination Institutional research ethics board approval has been obtained at all sites. At the completion of the trial, a plain language summary of the results will be posted on the trial website and distributed in the lay press. Our trial results will be published in a peer-reviewed scientific journal.Trial registration number NCT04803747.

Background/Objectives: Fibromyalgia (FM) affects up to 5% of the global population and is a leading cause of significant social and economic consequences. Higher health literacy leads to better understanding of treatment plans, improved self-care, and adherence to recommendations, enhancing overall quality of life. This study aims to determine whether different aspects of the disease are influenced by patients’ education level and literacy when applying the same therapy and to assess how patients’ perceptions of therapy outcomes vary over time based on their educational level. Methods: This study involved 140 fibromyalgia (FM) patients diagnosed using the 2016 ACR criteria, with 128 completing the study. Participants attended three visits over 28 weeks and were stratified into four groups based on educational level: Group 1—secondary school or less; Group 2—high school graduates; Group 3—college graduates; Group 4—university graduates. Patients were assigned to groups (n = 32, 32, 30, and 34, respectively) after the initial evaluation (T0). The treatment was assessed (T1) and followed up three months later (T2) to evaluate changes in functional status and quality of life. All patients underwent the same rehabilitation program, cognitive therapy, and kinesiotherapy. Results: Significant differences in disease impact on the patient’s life (FIQ total score) were observed between groups from the initial evaluation (p = 0.000). The overall FIQ score was notably affected by non-pharmacological therapy in patients with higher education. These differences continued to be significant even three months after the treatment ended (p = 0.000). Functional limitations were evident from the start (p = 0.000) and improved significantly post-treatment in patients with higher education (p = 0.000). However, subjective evaluations of disease impact (assessed by the first item of FIQ) did not consistently align with objective findings (hand grip strength). Functional limitations did not significantly differ in subjective evaluations (F1Q1) across educational levels (p = 0.045), and inverse correlations were noted between functional status and SF-12 well-being components. Conclusions: This study underscores that higher education enhances fibromyalgia management and functional outcomes, particularly when combined with non-pharmacological therapies. However, subjective perceptions may not always align with objective improvements, indicating that factors beyond education, such as personal and external influences, also impact disease management. Thus, improving health literacy through educational interventions could further benefit FM patients’ quality of life.

InGaN micro-LEDs (μ LEDs) with their potential high-volume applications have attracted substantial research interest in the past years. In comparison to other III–V semiconductors, InGaN exhibits a reduced susceptibility toward non-radiative surface recombination. However, efficiency degradation becomes more prominent as dimensions shrink to a few μ m or less. Due to the high surface-to-volume ratio of the miniaturized devices, the non-radiative recombination increases and reduces the internal quantum efficiency. While many groups focus on surface passivation to mitigate surface defects, the influence of crystallographic orientation of the μ LED sidewall on the efficiency remains unexplored. This study addresses this gap by investigating the impact of crystallographic orientation of the sidewalls on the emission properties of the μ LEDs. Hexagonal and elongated μ LEDs with dimensions as small as 3.5 μ m and sidewalls with crystallographically well-defined m- and a-planes were fabricated. Electrical and optical properties were investigated using photo- and electroluminescence. External quantum efficiency (EQE) is assessed based on well-known carrier recombination models. It can be shown that μ LED performance intrinsically depends on the crystallographic orientation of the sidewalls. Comparing hexagonal μ LED structures with a-plane and m-plane sidewalls, an increase in the EQE by 33 % was observed for structures with a-plane sidewalls, accompanied by reduction in the current density of the peak EQE by a nearly two orders of magnitude compared to structures with m-plane sidewalls. By analyzing the EQE characteristics at the μ LED center and near the sidewalls, the improvements can be directly attributed to the increased radiative recombination from sidewalls with a-plane orientation. [ABSTRACT FROM AUTHOR]

Significant gaps remain in the understanding of the etiology and pathogenesis of fibromyalgia (FM), and the COVID-19 pandemic has introduced even more unknowns. Social factors specific to that period, the viral infection itself, and/or vaccination are additional elements that can complicate the progression of the disease or the response to treatment. Aim: The primary hypothesis to be evaluated in this study is that an acute COVID-19 infection, even when considered recovered, may induce changes in the response to non-pharmacological treatment in FM patients, particularly concerning pain. Results: We included 128 patients diagnosed with FM before the pandemic began. The patients were divided based on their history of acute SARS-CoV-2 infection and COVID-19 vaccination status. All patients followed the same rehabilitation program (cognitive therapy, kinesitherapy). Perceived pain: The non-COVID-19 patient groups showed a statistically significant reduction in pain at the final evaluation compared to patients with a history of acute SARS-CoV-2 infection (p < 0.001). Algometric evaluation: Patients without COVID-19 infection and that were vaccinated exhibited the best improvement in pain threshold, both across evaluation times (p < 0.001) and compared to any of the other three groups studied (p < 0.001). Using the WHYMPI questionnaire, the same group of patients (those not having experienced acute COVID-19 and who were vaccinated) was the only group with a statistically significant improvement in pain severity (p = 0.009). In conclusion, to control and improve FM pain symptoms, in addition to appropriate medication, we propose paying additional attention to the history of acute SARS-CoV-2 infection and the COVID-19 vaccination status.

Background Dry weight (DW) adjustment in children on hemodialysis (HD) can be challenging. It relies on clinical evaluation and additional supports. Our aim was to study the benefits of cardiac biomarker assessment, in addition to the more commonly used technique, bioimpedance spectroscopy (BIS), and clinical signs for DW prescription in pediatric HD patients. Method Observational study including 41 children on HD in three pediatric HD centers in the Paris region. During one session, BIS was performed before the session and serum levels of BNP and NT-proBNP were analyzed before and after the session. Results Median pre-dialysis level of BNP was 87 ng/L [24-192] and NT-proBNP 968 ng/L [442-4828]. Cardiac biomarker levels showed positive correlation with the BIS hydration status evaluation (p = 0.004). The most appropriate cutoff for pre-dialysis BNP to detect significant overhydration (OH) was 165 ng/L (sensitivity 0.67, specificity 0.84). Based on the BIS evaluation, only 32% of patients with high blood pressure (BP) had OH, whereas in the normal BP group, 33% had significant OH. Conclusions DW prescription for children on HD should not only rely on clinical evaluation, particularly BP, but should also include additional helpful parameters. BIS is well-validated in children, but it has limitations in non-cooperative patients, and its cost can limit its use in some settings. Cardiac biomarkers, especially BNP, were well-correlated to hydration status evaluated by BIS, and thus could add valuable information for individual patient management and DW assessment. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information, Author(s): Antoine Mouche [sup.1] , Cyrielle Parmentier [sup.1] , Fatma Fendri [sup.1] , Claire Herbez-Rea [sup.1] [sup.2] , Anne Couderc [sup.3] , Laurène Dehoux [sup.3] , Marina Avramescu [sup.3] , [...]

Psychiatric disorders currently comprise more than 5% of the total disease burden worldwide, (1) a share that is expected to increase as familiarity with guidelines for diagnosis becomes more widespread [...]

Due to its variety of signs and symptoms, there have been numerous attempts to treat fibromyalgia (FM), but a cure has yet to be established. The aim of this study was to evaluate the effects of a complex kinetic therapy program and a combined physical modality program on pain and other common symptoms of FM. Patients and methods: A total of 78 female patients were included in this study; 39 subjects underwent a kinesiotherapy (KT) intervention (combining aerobic and Pilates exercises), and 39 participated in a physical modality (PM) program (including electrotherapy (TENS and low-laser therapy) and thermotherapy). Results: Regarding the parameter of pain assessment, kinesiotherapy demonstrated its superiority both during the treatment period and in the evaluation 3 months after therapy cessation. Both in terms of patient-reported pain (inter-group comparisons: p = 0.000 at T3) and the examination of tender points (inter-group comparisons: p = 0.000 at T3), as well as the algometric assessment, pain was alleviated by the two forms of applied kinetic therapy. The observed functional impairment was statistically significantly influenced (p = 0.001) at the end of the kinetic program application, while for the perceived functional impairment, neither therapy proved superiority over the other at any point of evaluation (inter-group comparisons: p = 0.715 at T3). Regarding the influence of the emotional consequences implied by fibromyalgia, neither the forms of kinesiotherapy nor the chosen physical modalities proved superiority at any point of evaluation (HAQ anxiety inter-group comparisons: p = 0.000 at T3). In conclusion, even though kinesiotherapy had superior influences on fibromyalgia pain in the studied group, the current research lends credence to the significance of non-pharmacological therapy in managing fibromyalgia. Participants demonstrated positive advancements in subjective and objective pain assessments, as well as improvements in functional and emotional well-being.

Metal nanoparticle phytosynthesis has become, in recent decades, one of the most promising alternatives for the development of nanomaterials using “green chemistry” methods. The present work describes, for the first time in the literature, the phytosynthesis of silver nanoparticles (AgNPs) using extracts obtained by two methods using the aerial parts of Marrubium vulgare L. The extracts (obtained by classical temperature extraction and microwave-assisted extraction) were characterized in terms of total phenolics content and by HPLC analysis, while the phytosynthesis process was confirmed using X-ray diffraction and transmission electron microscopy, the results suggesting that the classical method led to the obtaining of smaller-dimension AgNPs (average diameter under 15 nm by TEM). In terms of biological properties, the study confirmed that AgNPs as well as the M. vulgare crude extracts reduced the viability of human gingival fibroblasts in a concentration- and time-dependent manner, with microwave-assisted extracts having the more pronounced effects. Additionally, the study unveiled that AgNPs transiently increased nitric oxide levels which then decreased over time, thus offering valuable insights into their potential therapeutic use and safety profile.

The present work aims to study the possibilities of developing silver nanoparticles using natural extracts of grape pomace wastes originating from the native variety of Fetească Neagră 6 Șt. This study focused on investigating the influence of grape pomace extract obtained by two different extraction methods (classical temperature extraction and microwave-assisted extraction) in the phytosynthesis process of metal nanoparticles. The total phenolic content of the extracts was assessed using the spectrophotometric method with the Folin–Ciocâlteu reagent, while the identification and quantification of specific components were conducted through high-performance liquid chromatography with a diode array detector (HPLC-DAD). The obtained nanoparticles were characterized by UV–Vis absorption spectroscopy, X-ray diffraction (XRD), and transmission electron microscopy (TEM), along with assessing their antioxidant and antimicrobial properties against Gram-positive bacteria. The data collected from the experiments indicated that the nanoparticles were formed in a relatively short period of time (96 h) and, for the experimental variant involving the use of a 1:1 ratio (v/v, grape pomace extract: silver nitrate) for the nanoparticle phytosynthesis, the smallest crystallite sizes (from X-ray diffraction—4.58 nm and 5.14 nm) as well as spherical or semispherical nanoparticles with the lowest average diameters were obtained (19.99–23 nm, from TEM analysis). The phytosynthesis process was shown to enhance the antioxidant properties (determined using the DPPH assay) and the antimicrobial potential (tested against Gram-positive strains) of the nanoparticles, as evidenced by comparing their properties with those of the parent extracts; at the same time, the nanoparticles exhibited a selectivity in action, being active against the Staphylococcus aureus strain while presenting no antimicrobial potential against the Enterococcus faecalis strain.

Background and aim: The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis. Materials and methods: In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped–synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists. Results: Normal fidgety movements and a MOS-R of 20–24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9. Conclusion: Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped–synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.