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The lack of a good foundation ground layer in some areas that could be used for construction proposes is a common problem all over the world. Today, more and more researches are focused on finding new solutions to improve the soil parameters in order to obtain a stabilized foundation layer. Finding an optimal admixture between the local soils, needed for construction purposes, hydraulic binders and the precise amount of water, may be the future of a revolutionary discovery in this field. The experimental study based on the admixture of a sandy silty clay with hydraulic binders from the Viacalco© [1] range, produced by Carmeuse Romania, in a percentage of 2%, 4% and 6% led to a significant improvement of the geotechnical parameters of the soil. The aim of this experimental study is to determine the optimal binder mixture in order to improve local soils and to obtain low investment costs.

A bending body design of the Air Force Finner projectile was investigated as a maneuver technology with two different simulation methodologies, KESTREL and Cart3D, as well as an optimization algorithm. A strictly bent nose configuration was selected for focused investigation, the results of which informed the setup and execution of the optimization studies. The optimization studies identified similar optimal configurations—all strictly bent body configurations—for each Mach number investigated (2.0, 2.5 and 3.0). The strictly bent nose configuration was simulated in coupled Navier-Stokes trajectory simulations, which found up to 60 g of maneuver authority. Strictly bent nose and strictly bent body configurations as well as hybrid options were found to have similar performance with niche advantages in different ways that could be selected as control technology for extreme maneuvers.

IntroductionSleep disturbances can occur as a result of major stressful events. Additionally, research evidence suggests that COVID-19 pandemic may have negatively impacted the quality of sleep among various populations. However, individuals respond differently to the stress, uncertainty and social isolation related with COVID-19 pandemic.ObjectivesThis study aimed to explore the changes in sleep quality and pattern among voluntary psychiatric patients visiting our clinic in Romania during COVID-19 pandemic.MethodsWe implemented a cross-sectional study over a period of 3 months, utilizing a Romanian-translated version of the Pittsburgh Sleep Quality Index (PSQI) which was administered through Google Forms web application. Participants lacking digital skills were provided with guidance for completing the questionnaire. Informed consent was obtained prior to participating in this study and data anonymity and confidentiality were ensured.ResultsAmong a total of 98 responders, 63% reported a global PSQI score greater than 5, indicating poor sleep. Approximately 25% of participants subjectively marked their sleep as either fairly bad or very bad. When analysing the 7 components of PSQI, our participants struggled most with long sleep latency. About a third of participants reported using sleep medication (both prescription and over-the-counter) three or more times a week within the past month.ConclusionsConsidering the fact that the current situation is likely to evolve for an unknown period of time, there is a dire need to assess the effect of prolonged adjustments in daily routine and their impact on the sleep and the quality of life of our patients.

This paper describes seminal work for using tools from fractional calculus on modelling geometry and dynamical nonlinear effects in a mimicked lung tumour setup. A device and methodology are tailored to verify the hypothesis that presence of tumour in lung will affect the frequency dependent respiratory impedance. The data is analysed in terms of detection and quantification of nonlinear distortion in two situations mimicked by the proposed setup: a normal lung and a tumorous lung. Results indicate the feasibility of this research direction and the paper outlines the opportunities at hand.

IntroductionPsychosocial interventions for Alzheimer’s dementia (AD) may increase patients quality of life and overall functioning, while it decreases caregivers burden. Therefore psychotherapies represent an important component of the case management, beside pharmacological approaches.ObjectivesTo review the current psychotherapeutic options available for patients diagnosed with AD, that may be added to their ongoing pharmacological treatment.MethodsA literature review was conducted through main electronic databases, and papers published between January 2000 and August 2020 were included in the analysis.ResultsCognitive stimulation therapy is based on general cognitive abilities training, with an accent over the social interaction, and it has been associated with significant improvement when compared to wait list or standard care. Reminiscence therapy, usually administered in a group format, focuses on past experinces, triggered by photos, newspaper fragments, music tunes etc., and according to a meta-analysis it may increase communicational, cognitive, and affective abilities. Validation therapy is based on a very empathic communication and tries to acknowledge patients perspective over the world, but the data to support its efficacy is limited for AD. Multisensorial stimulation is based on the assumption that stimuli deprivation is involved in the onset of anxiety, restlessness, insomnia etc, and may lead to short-term non-cognitive symptoms. Music therapy, art therapy, and animal-assisted therapy are also indicated, but more trials are needed to confirm their efficacy.ConclusionsA large number of psychotherapeutic interventions are explored for AD patients, but most of them have low levels of evidence.

IntroductionMindfulness-based cognitive therapy (MBCT) is a third wave cognitive-behavioral therapy (CBT) that incorporates meditation exercises in the classical, structured intervention. Mindfulness has been associated with psychological well-being, and certain symptoms that occur in major depressive disorder (MDD), e.g. worries, ruminations, ideas of incapacity or self-devaluation, are considered potential targets for MBCT.ObjectivesTo evaluate the current level of evidence for the MCBT efficacy in MDD.MethodsA literature serach was performed in the main electronic databases, targeting clinical trials that evaluated in a randomized manner the efficacy of MCBT versus active comparators or placebo in patients with MDD.ResultsMBCT was efficient in a 10-week randomized controlled trial (RCT) versus standard treatment, and it decreased ruminations, increased patients quality of life, mindfulness abilities, and self-compassion. In another randomized, 8-week RCT, MBCT prevented relapses in MDD, with similar rates when compared to psychoeducation and standard treatment. A 26-month follow-up study evidenced the persistence of symptoms improvement detected after 12 months of the trial, when compared to active control group and treatment as usual. MCBT was compared to cognitive therapy in a randomized 8-week trial, and both treatments had similar efficacy in MDD relapse prevention.ConclusionsMCBT may be an useful adjuvant to the current treatment in acute MDD, but it may also decrease the risk of relapse after psychotherapy termination.

Background The professional9s monopoly on knowledge about disease and its treatment is something gone now, in the era of internet and patient consumerism. In addition, the interest of rheumatologists (and the interest of the society, too) shifted toward early recognition of the disease and early arthritis clinics. Education is definitely one of the solutions to increase the awareness of potential patients regarding rheumatic diseases. However most of rheumatic diseases are not very frequent in the population that raise the problem of cost efficacy of the education process. Per Eliot Freidson9s view, the members of every community of whatever kind share some cultural understandings about disease, treatment, and cure. The lay community network could be considered an instrument for dissemination of proper knowledge regarding health and could help to earlier recognition of a sign of disease related to early arthritis. Objectives To identify the opportunity of using lay network for early arthritis referral. In addition, we intended to identify the most suitable vectors from this network to be used for education and dissemination of medical knowledge. Methods 48 rheumatic patients (mean age (SD): 50.8 (14,7)) consecutively admitted in one tertiary clinic have been invited to answer to a structured questionnaire. Sex ratio (M: F) was 1:2, average disease duration 7.7 (8.3) years. Results In 28.3% cases the first sign of disease was noticed not by the patient but by somebody else, for 36.7% a delay of several months to one year was declared between first sign of disease and professional examination, 71.7% use to discuss bout health problems with their lay network (often and very often), 76.1% consider them able to give pertinent advices regarding the disease they suffer from, 45,7% are ready to act as an education vector and 41,3% are ready to participate in additional education programs. They interest in such activity is not related to gender, education level or work status. Conclusions Lay network referral could be a powerful instrument to reduce the duration between onset of rheumatic symptoms and medical visit, to increase the awareness regarding rheumatic disease, to reduce the cost of health education. Health professionals should understand how to use these networks. References Freidson, Eliot. 1960. “Client Control and Medical Practice.” American Journal of Sociology 65:374–82. Barley, Stephen R., and Gideon Kunda. 2004. Gurus, Hired Guns, and Warm Bodies: Itinerant Experts in a Knowledge Economy. Princeton, NJ: Princeton University Press. Disclosure of Interest None declared

The formation of secondary flow structures due to the interaction of an array of three finite span synthetic jets with a crossflow was investigated experimentally over a finite swept-back wing (NACA 4421, AR=4, sweep angle of 30 deg, Reynolds number of 1×105). Stereoscopic particle image velocimetry data were collected in the midspan section of the wing, where the effects of the jets’ combinations and their blowing ratios were analyzed based on the three-dimensional flowfield using time- and phase-averaged statistics. The focus of the present work was to capture the formation and advection of secondary flow structures in the vicinity of the synthetic jets for different combinations of jets, including 1) only the center jet activated, 2) two synthetic jets off the middle jet activated, and 3) all three synthetic jets actuated. An angle of attack of 13.5 deg was selected, in which the boundary layer was either attached (in the vicinity of the middle jet) or partially separated (in the vicinity of the jet cl...

Background: The diagnosis and management of the patients with chronic lymphoproliferative diseases have become dependent on immunological criteria. Flow cytometry immunophenotyping is used for rapid and specific diagnosis but there are cases when we are not facing a typical immunophenotype, so there is a constant need to find new markers and new combinations of markers that would allow the improvement and the development of our diagnosis. Aim: Our aim was to evaluate CD 200 expression in different B-cell chronic lymphoproliferative disorders. CD200 is a membrane glycoprotein belonging to the immunoglobulin superfamily and the over-expression of CD200 has been reported in a number of malignancies, including CLL, as well as on cancer stem cells. Methods: We analyzed the CD200 expression in 122 patients diagnosed with chronic lymphoproliferative disorders (100 patients with CLL, 10 patients with splenic marginal zone lymphoma (SMZL), 10 patients with MCL and 2 patients with hairy cell leukemia), in the Department of Hematology of the University Emergency Hospital, Bucharest. We performed immunophenotypical analysis of peripheral blood and bone marrow aspiration on BD FACS Calibur flowcytometer. Results: CD200 was brightly expressed in all 100 CLL patients (100%). In SMZL patients, CD200 was dim positive (40%-60%), in patients with HCL. CD200 was also bright positive (96% and 97%) and in patients with MCL CD200 was negative (1-10%); CD 200 was significantly higher in CLL patients compared with other B-cell chronic lymphoproliferative disorders. We found 14 patients with CD19, CD5 positive population and CD23- , but with high expression of CD 200. Cyclin D1 was negative on bone marrow biopsy in 13/14 of these patients. (1/14 patients were without bone marrow involvement); Conclusions: CD200 has a great impact in diagnosing B- chronic lymphoproliferative disorders, especially when we want to determine the origin of a CD19, CD5 positive population and distinguish between CLL and MCL. CD 23 is a reliable marker in those cases, but, as we showed, CD23 might have a lower specificity than CD200 for CLL. We added CD200 in our panels in order to diagnose chronic lymphoproliferative disorders, not to replace CD 23, but to improve and save time in our diagnostic process. The high expression of CD200 in CLL and HCL could open the option for new- targeted therapy (anti-CD200).

American Expressionists were a group of American artists who valued free expression of unconscious elements, combining emotional intense expressions with anti-figurative abstract style. Their main place of creative debates was Cedar Tavern in New York City, considered by art critics an important incubator of the Abstract Expressionism. Jackson Pollock, one of the most prominent figures of this movement, suspected of having bipolar disorder, abused alcohol during long periods of his life, for which he even underwent psychotherapy. Unfortunately, he died in a car accident while driving under influence, after decades of innovative work, during which he created a new painting method and produced compositions which are nowadays between the most expensive works of art. Mark Rothko also had periods of heavy drinking, and finally he died by cutting his arms with a razor. He is considered a genius, who created a completely new perspective over painting, and his works are also between the most expensive paintings in the world. Willem de Kooning was affected by alcoholism since his early years, and developed dementia, at least partially induced by abusive drinking. Although affected by neurocognitive disorder, he continued to produce amazingly creative paintings until his final years and in 2016 one of his works obtained the record for the most expensive painting ever sold. Using alcohol as a tool for increasing creativity risks to expose the creator to severe disorders or even death, the subject walking on a narrow line between sublimation of unconscious impulses and tragic resignation before them.Disclosure of interestThe presenting author was speaker for Bristol Myers Squibb and Servier, and participated in clinical research funded by Janssen Cilag, Astra Zeneca, Eli Lilly, Sanofi Aventis, Schering Plough, Organon, Bioline Rx, Forenap, Wyeth, Otsuka Pharmaceuticals, Dainippon Sumitomo.