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In the present article was carried out a research of judicial practice and the procedural-criminal norms regarding the deadline for decalraing the appeal against the decisions of the appeal courts. The presented problem consists in the scientific substantiation and practical regarding of the way of applying in the legal provisions, the need tu meet the requirements of clarity and predictability of the rules regarding the term of appeal, through the lens of ECHR jurisprudence, national practice, including in relation to the amendments to the law from, as well as the analysis of the legislation, resulting in the substantiation of the respective conclusions. Through this study, we want to provoke further analysis and discussion on this topic.

Odată cu creșterea alarmantă a numărului de intervenții ablative în tratamentul bolii varicoase, aplicarea strategiilor safeno-menajante a devenit o necesitate actuală prin prisma semnificației venei safene în calitate de material autolog pentru o eventuală operație arterială reconstructivă. Noi am evaluat o serie clinică ce a inclus 194 de pacienţi (209 membre) cu varice primare ale extremităților inferioare, supuși intervențiilor chirurgicale flebologice cu prezervare safeniană. Articolul de față reflectă caracteristicile clinico-demografice ale bolnavilor și rezultatele investigațiilor imagistice preoperatorii, de rând cu efectele clinice precoce ale respectivelor tipuri de intervenții.

Studiul a urmărit evidențierea semnificației diagnostice a tromboelastografiei la 44 bolnavi adulți cu varicotromboflebită (VTF) acută, diagnosticată prin duplex scanare. Distribuția procesului trombotic a fost descrisă conform clasificării Verrel-Steckmeier, tipurile II și III fiind definite ca „VTF periostială”. Rezultatele cercetării mărturisesc despre faptul că intensificarea procesului de hemostază la pacienții cu VTF posedă preponderent caracter structural, datorită densității crescute a cheagului format. Pacienții cu VTF acută manifestă un statut hipercoagulant îndeosebi când masele trombotice sunt localizate periostial.

Abstract Background Acute mesenteric ischaemia (AMI) is a life-threatening disease where early diagnosis is critical to avoid morbidity and mortality from extensive irreversible bowel necrosis. Appropriate prediction of presence of bowel necrosis is currently not available but would help to choose the optimal method of treatment. The study aims to identify combinations of biomarkers that can reliably identify AMI and distinguish between potentially reversible and irreversible bowel ischaemia. Methods This is a prospective multicentre study. Adult patients with clinical suspicion of AMI (n = 250) will be included. Blood will be sampled on admission, at and after interventions, or during the first 48 h of suspicion of AMI if no intervention undertaken. Samples will be collected and the following serum or plasma biomarkers measured at Tartu University Hospital laboratory: intestinal fatty acid-binding protein (I-FABP), alpha-glutathione S-transferase (Alpha- GST), interleukin 6 (IL-6), procalcitonin (PCT), ischaemia-modified albumin (IMA), D-lactate, D-dimer, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) and lipopolysaccharide-binding protein (LBP). Additionally, more common laboratory markers will be measured in routine clinical practice at study sites. Diagnosis of AMI will be confirmed by computed tomography angiography, surgery, endoscopy or autopsy. Student’s t or Wilcoxon rank tests will be used for comparisons between transmural vs. suspected (but not confirmed) AMI (comparison A), confirmed AMI of any stage vs suspected AMI (comparison B) and non-transmural AMI vs transmural AMI (comparison C). Optimal cut-off values for each comparison will be identified based on the AUROC analysis and likelihood ratios calculated. Positive likelihood ratio > 10 (> 5) and negative likelihood ratio

Cystic echinococcosis is a zoonotic parasitic disease that affects the liver in more than 70% of cases, and there is still an underestimated incidence in endemic areas. With a peculiar clinical presentation that ranges from paucisymptomatic illness to severe and possibly fatal complications, quality imaging and serological studies are required for diagnosis. The mainstay of treatment to date is surgery combined with antiparasitic agents. The surgical armamentarium consists of open and laparoscopic procedures for selected cases with growing confidence in parenchyma-sparing interventions. Endoscopic retrograde cholangiopancreatography (ERCP) is extremely useful for the diagnosis and treatment of biliary fistulas. Recent relevant studies in the literature are reviewed, and two complex cases are presented. The first patient underwent open surgery to treat 11 liver cysts, and during the follow-up, a right pulmonary cyst was diagnosed that was treated by minimally invasive surgery. The second case is represented by the peritoneal rupture of a giant liver cyst in a young woman who underwent laparoscopic surgery. Both patients developed biliary fistulas that were managed by ERCP. Both patients exhibited a non-specific clinical presentation and underwent several surgical procedures combined with antiparasitic agents, highlighting the necessity of customized treatment in order to decrease complications and successfully cure the disease.

The present research deals with the issue of the prosecutor participation in criminal cases, in front of the court of appeal, with a comprehensive analysis of the legal provisions and both internal and international practice. This important problem is solved by a scientific analysis of the way in which the legal provisions regarding the participation of the prosecutor in criminal cases in court of appeal are applied in practice, and of the possible legal errors admitted in the prosecutors’ practice in republic of Moldova.

Studiul a prevăzut evaluarea rezultatelor tratamentului ischemiei acute (IA) a extremităților la pacienții cu infecție cu coronavirus de tip nou (COVID-19). Lotul a inclus 62 pacienți; 67 extremități: superioare - 19 (28,3%), inferioare - 48 (71,6%). Repartizarea cazurilor în funcție de gradul IA (Rutherford): I - 7 (10,4%), IIA - 10 (14,9%), IIB - 34 (50,7%), III - 16 (23,8%). COVID-19 s-a confirmat prin testul polymerase chain reaction , la 45 (72,5%) pacienți fiind documentată afectarea pulmonară. Tratamentului chirurgical au fost supuși 50 (80,6%) pacienți; 52 membre. Rata amputațiilor pe durata spitalizării (9,4±9 zile) - 19,4%; rata decesului - 43,5%, fiind influențată semnificativ de prezența sau absența afectării pulmonare - 55,5% vs. 11,7% (P=0,002; testul χ²). Potențial predictiv al mortalității au manifestat biomarkerii: proteina C reactivă/albumina, trombocite/limfocite, fibrinogen/albumina. Către follow-upul de 21 (25%-75%IQR 19-28) luni supraviețuirea generală și fără amputații: 56,4% și 57,1%, corespunzător.

Rezumat. Ischemia acută reprezintă o stare critică, ce pune în pericol viabilitatea segmentului anatomic implicat, și survine atunci când există o diminuare bruscă a fluxului de sânge către o extremitate. Această condiție clinică necesită intervenție de urgență pentru a preveni evoluția către faza ireversibilă a procesului și potențiala pierdere a membrului. Studierea caracteristicilor clinico-demografice la pacienții cu ischemie acută este crucială pentru prevenirea, diagnosticarea și gestionarea eficientă a acestei afecțiuni. Abordarea curativă adaptată individual, cu selectarea strategiilor de management în funcție de datele clinice și comorbidități ar putea ameliora rezultatele tratamentului. Articolul de față reflectă caracteristicile clinice evaluate la 266 pacienți cu ischemie acută a extremităților supuși revascularizării urgente.

In the present article was carried out a research of judicial practice and the procedural-criminal norms regarding attributing the quality of successor of the deceased victim to the surviving spouse. The presented problem consists in the scientific substantiation and practical regarding of the way of applying in the legal provisions, which is not currently expressly provided for in art. 81 of the Criminal procedure code of the Republic of Moldova, as well as the analysis of the legislation, resulting in the substantiation of rigorous proposals in order to improve the legislation and jurisprudence. Through this study, we want to provoke further analysis and discussion on this topic.

The interplay of dynamical correlations and electronic ordering is pivotal in shaping phase diagrams of correlated quantum materials. In magic-angle twisted bilayer graphene, transport, thermodynamic, and spectroscopic experiments pinpoint a competition between distinct low-energy states with and without electronic order, as well as between localized and delocalized charge carriers. In this study, we utilize dynamical mean-field theory on the topological heavy fermion model of twisted bilayer graphene to investigate the emergence of electronic correlations and long-range order in the absence of strain. We contrast moment formation, Kondo screening, and ordering on a temperature basis and explain the nature of emergent correlated states based on three central phenomena: (i) the formation of local spin and valley isospin moments around 100 K, (ii) the ordering of the local isospin moments around 10 K preempting Kondo screening, and (iii) a cascadic redistribution of charge between localized and delocalized electronic states upon doping. At integer fillings, we find that low-energy spectral weight is depleted in the symmetric phase, while we find insulating states with gaps enhanced by exchange coupling in the zero-strain ordered phases. Doping away from integer filling results in distinct metallic states: a “bad metal” above the ordering temperature, where scattering off the disordered local moments suppresses electronic coherence, and a “good metal” in the ordered states with coherence of quasiparticles facilitated by isospin order. This finding reveals coherence from order as the microscopic mechanism behind the Pomeranchuk effect observed experimentally by Rozen et al. [Nature (London) 592, 214 (2021)NATUAS0028-083610.1038/s41586-021-03319-3] and by Saito et al. [Nature (London) 592, 220 (2021)NATUAS0028-083610.1038/s41586-021-03409-2]. Upon doping, there is a periodic charge reshuffling between localized and delocalized electronic orbitals leading to cascades of doping-induced Lifshitz transitions, local spectral weight redistributions, and periodic variations of the electronic compressibility ranging from nearly incompressible to negative. Our findings highlight the essential role of charge transfer, hybridization, and ordering in shaping the electronic excitations and thermodynamic properties in twisted bilayer graphene and provide a unified understanding of the most puzzling aspects of scanning tunneling spectroscopy, transport, and compressibility experiments.

Endocrine damage in infectious diseases (bacterial, viral) has been proven for a long time, confirming the disruption of the functions of most endocrine glands via the hypothalamic-pituitary-glandular axis. Endocrine activity takes place in tandem with the activity of the immune system. They inter-condition and influence each other, any change in one sector influencing the other (positively or negatively). Severe (critical), bacterial or viral infections go through the stage of SEPSIS, the background of which is the disruption (disorganization) of the host’s response to the infection. The mechanisms by which the endocrine glands are affected are multiple (direct, immunologically mediated, thrombotic) leading to multiple, morphological and functional lesions. The recovery of these injuries takes place over time, and permanent sequelae are possible. The recent pandemic caused by SARS-CoV-2, through the ways of manifestation and evolution of the diseases, justifies the interest regarding the endocrine damage in the SARS-CoV-2 infection, both in the acute and post-acute phase (long COVID evolves with symptoms, some newly appeared, which are also present in non-COVID endocrinopathies). Material. The arguments regarding the endocrine damage were extracted from the publications mentioned at the end of the work as bibliographic titles. The results highlight the endocrine damage in infections, especially in severe ones - and the impact on the immediate and late evolution of the illnesses. Conclusions. In order to understand the pathogenic, physio-pathological and clinical aspects of an infection, attention must be paid to the state of the endocrine system in correlation with the immune system, especially in patients receiving shorter or longer corticosteroid therapy.

Objectives Our study described how the WHO intra-action review (IAR) methodology was operationalised and customised in three Western Balkan countries and territories and the Republic of Moldova and analysed the common key findings to inform analyses of the lessons learnt from the pandemic response.Design We extracted data from the respective IAR reports and performed a qualitative thematic content analysis to identify common (between countries and territories) and cross-cutting (across the response pillars) themes on best practices, challenges and priority actions. The analysis involved three stages, namely: extraction of data, initial identification of emerging themes and review and definition of the themes.Setting IARs were conducted in the Republic of Moldova, Montenegro, Kosovo and the Republic of North Macedonia between December 2020 and November 2021. The IARs were conducted at different time points relative to the respective pandemic trajectories (14-day incidence rate ranging from 23 to 495 per 100 000).Results Case management was reviewed in all the IARs, while the infection prevention and control, surveillance and country-level coordination pillars were reviewed in three countries. The thematic content analysis identified four common and cross-cutting best practices, seven challenges and six priority recommendations. Recommendations included investing in sustainable human resources and technical capacities developed during the pandemic, providing continuous capacity-building and training (with regular simulation exercises), updating legislation, improving communication between healthcare providers at all levels of healthcare and enhancing digitalisation of health information systems.Conclusions The IARs provided an opportunity for continuous collective reflection and learning with multisectoral engagement. They also offered an opportunity to review public health emergency preparedness and response functions in general, thereby contributing to generic health systems strengthening and resilience beyond COVID-19. However, success in strengthening the response and preparedness requires leadership and resource allocation, prioritisation and commitment by the countries and territories themselves.

The superconducting magnet energy storage (SMES) has become an increasingly popular device with the development of renewable energy sources. The power fluctuations they produce in energy systems must be compensated with the help of storage devices. A toroidal SMES magnet with large capacity is a tendency for storage energy because it has great energy density and low stray field. A key component in the creation of these superconducting magnets is the material from which they are made. The present work describes a comparative numerical analysis with finite element method, of energy storage in a toroidal modular superconducting coil using two types of superconducting material with different properties bismuth strontium calcium copper oxide (BSCCO) and yttrium barium copper oxide (YBCO). Regarding the design of the modular torus, it was obtained that for a 1.25 times increase of the critical current for the BSCCO superconducting material compared with YBCO, the dimensions of the BSCCO torus were reduced by 7% considering the same stored energy. Also, following a numerical parametric analysis, it resulted that, in order to maximize the amount of energy stored, the thickness of the torus modules must be as small as possible, without exceeding the critical current. Another numerical analysis showed that the energy stored is maximum when the major radius of the torus is minimum, i.e., for a torus as compact as possible.

Диагностическая ценность C-реактивного белка (CРБ) и Д-димеров при остром варикотромбофлебите (ВТФ) была изучена в когорте из 45 пациентов; женщины – 60%, средний возраст – 59 (25-75% IQR 48-64) лет. У пациентов с CРБ в пределах нормы частота ВТФ II-III-го типа (по Verrel-Steckmeier) составила 4% против 25% – у пациентов с CРБ ≥10 мг/л; а скорость роста тромба была в 2 раза ниже – 2,33 (25-75% IQR 0,74-8,18) см3/день и 5,74 (25-75% IQR 1,82-15,02) см3/день, соответственно (P=0,07 в обоих случаях). У больных с CРБ ≥10 мг/л была выявлена большая площадь кожной гиперемии и перивенозного инфильтрата мягких тканей по сравнению с наблюдениями с нормальными значениями CРБ: 153,2 (25-75% IQR 49,35-248,8) против 48,4 (25-75% IQR 40,45-85,7) см2 и 86,25 (25-75% IQR 26,08-131,3) против 32,35 (25-75% IQR 17,95-52,33) см2, P=0,05 и 0,06 соответственно. Уровень Д-димеров при ВТФ II-III-го типа превышал соответствующий показатель при ВТФ I-го типа и изолированном тромбозе варикозных притоков: 876 (25-75% IQR 611-1637) нг/мл против 395 (25-75% IQR 216-710) нг/мл (p

Obiective. Boala venoasă cronică, la momentul actual, reprezintă una dintre cele mai frecvente cauze ale spitalizărilor în secțiile de profil chirurgical, datorită incidenței sale înalte și a unui spectru vast de manifestări clinice. Multitudinea variantelor hemodinamice ale refluxului venos, ce determină tabloul clinic și modificările trofice la pacienții cu boală venoasă cronică, explică, totodată, și existența diferitor tehnici chirurgicale, care au ca scop corecția dereglărilor hemodinamice în funcție de tipul refluxului patologic, și nu neapărat se bazează pe lichidarea definitivă a trunchiului safenian. Un loc aparte îl ocupă intervențiile chirurgicale cu prezervarea venelor safene, care și-au demonstrat avantajele la o anumită categorie de pacienți. Scopul lucrării este efectuarea unui review-ul narativ asupra tipurilor și sistemelor de clasificare ale refluxului venos în boala venoasă cronică și rolul acestora în selectarea tacticii chirurgicale de tratament. Material și metode. A fost efectuată o căutare structurată, în bazele de date electronice Google Scholar, PubMed, HINARI și ResearchGate, fiind luate în considerare articolele relevante, care se referă la descrierea tulburărilor hemodinamice în boala venoasă cronică, publicate în ultimii 13 ani. Termenii de căutare (în limba engleză) utilizați au fost: „varicose veins”, „chronic venous insufficiency”, „hemodynamic disorders in chronic venous insufficiency”, „types of hemodynamic disorders”, „chronic venous disease - quality of life”, „techniques of treatment for varicose veins”, „preservation of saphenous veins”, „CHIVA”, „ASVAL”. Concluzii. Reieșind din tipul dereglărilor hemodinamice și profilul clinic al pacientului, devine posibilă selectarea unei strategii chirurgicale potrivite, particulară fiecărui caz – cu sau fără păstrarea trunchiului safen, și care ar asigura o eficiență terapeutică pe termen lung la pacienții cu boală venoasă cronică.

În lipsa unui suport științific suficient către moment, selectarea opțiunii și a modalității de tratament în cazurile de tromboză venoasă superficială acută survenită la pacienții cu maladie varicoasă a membrelor inferioare se face deseori empiric. Drept consecință, rata de progresie a maselor trombotice spre sistemul venos profund depășește uneori 30%. Lucrarea de față reflectă compilativ datele literaturii de specialitate cu referință la metodele de tratament mai frecvent utilizate și rezultatele clinice ale acestora la contingentul menționat de bolnavi.

Purpose: Management of superficial vein thrombosis (SVT) in patients with varicose veins (VV) is not currently standardized. We performed a survey aimed to demonstrate patterns in the management of SVT in the Republic of Moldova. Materials and Methods : : This was a descriptive study whereby members of the National Surgical Society were asked to complete an online questionnaire. In the questionnaire, multiple-choice questions were supplemented with four clinical vignettes of real patients with SVT. Results : : The questionnaire was completed by 102 participants (31.1% response rate). In the treatment of SVT, duplex ultrasound was routinely used by 74.5% of respondents, and anticoagulants were used by 70.5%. The full therapeutic dose of anticoagulants was recommended by 63.3% of surgeons, intermediate dose by 21.1%, and prophylactic dose by 15.6%. Only 50% of respondents were prescribed anticoagulants for 1 month or more. In case of surgical intervention for SVT, crossectomy and stripping were performed by 84.0% of surgeons, while isolated crossectomy by 10.7%. In all clinical vignettes, the majority of respondents opted for urgent surgical treatment. The rate of proponents of surgery varied from 43% in cases of isolated thrombosis of tributaries, and up to 72.5% in cases of thrombosis up to the sapheno-femoral junction. Conclusion : : Management of patients with SVT and VV in the Republic of Moldova is far from standardized. Prescribed doses of anticoagulants, as well as the duration of anticoagulation are highly variable and often contradict the recommendations of current guidelines. Urgent crossectomy and stripping dominate the pattern of current therapeutic approaches.

Acest protocol a fost elaborat de către grupul de lucru al Ministerului Sănătăţii, Muncii și Protecției Sociale al Republicii Moldova (MSMșiPS RM), constituit din specialiştii Catedrei Chirurgie Generală şi Semiologie nr.3 a USMF „Nicolae Testemiţanu”. Protocolul clinic naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind diagnosticul și tratamentul trombozei venoase profunde la adulţi şi va servi drept bază pentru elaborarea protocoalelor clinice instituţionale, reieșind din asigurarea tehnico-materială a fiecărei instituții. La recomandarea MSMșiPS RM, pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în Protocolul Clinic Naţional.

Acest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii, Muncii și Protecției Sociale al Republicii Moldova (MSMPS), constituit din specialiştii Catedrei chirurgie generală şi semiologie nr.3 a Universităţii de Stat de Medicină şi Farmacie (USMF) „Nicolae Testemiţanu”, Agenției Naționale pentru Sănătate Publică şi ai IMSP Spitalului Clinic Municipal (SCM) nr.1 din Chişinău. Protocolul clinic naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind infecţia plăgii postoperatorii (de situs chirurgical) şi va servi drept bază pentru elaborarea protocoalelor clinice instituţionale. La recomandarea MSMPS, pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în Protocolul clinic naţional.

Obiective. Scopul lucrării a fost de a analiza datele și dovezile din sursele existente de literatură, cu privire la diagnosticul ischemiei acute non-traumatice a extremităților. Materiale și metode. Au fost analizate publicații științifice, ce prezintă dovezi privind diagnosticul ischemiei acute non-traumatice a extremităților. În calitate de surse de căutare au fost utilizate bazele de date Google Scholar și PubMed. Cuvintele cheie utilizate în căutare au fost “diagnosis” , “non-traumatic”, “acute limb ischemia”. Rezultate. Au fost identificate 25 publicații științifice ce reflecta dovezi actuale referitor la diagnosticul ischemiei acute non-traumatice a extremităților. Concluzii. Diagnosticul ischemiei acute a extremităților, precum și evaluarea severității acesteia, la momentul actual, rămâne a fi bazat pe examinarea clinică minuțioasă a pacientului. Implementarea în practica clinică a unor tehnici suplimentare (examen CW-Doppler, termografie) poate contribui la obiectivizarea semnelor ischemiei și reducerea ratei erorilor diagnostice. Metode de imagistică vasculară non-invazivă și, în primul rând, ultrasonografia duplex, oferă informații cruciale pentru selectarea metodelor de revascularizare, însă impactul real și eficiența acestora necesită evaluarea în mai multe studii prospective, realizate în condițiile sistemelor medicale diferite. Determinarea corelațiilor dintre nivelul biomarcherilor inflamației și ischemiei tisulare cu rezultatele tratamentului ischemiei acute a extremităților reprezintă un domeniu de perspectivă pentru cercetări științifice.

We report our initial experience in off-label use of the double-layer micromesh (DLM) Roadsaver® stent for the hybrid treatment of a fusiform popliteal artery aneurism complicated by distal embolization and chronic limb threatening ischemia in a COVID-19-positive young male. A 36-year-old male patient was admitted with chronic limb threatening ischemia of the left lower limb. The duplex ultrasound and computer tomography angiography (CTA) demonstrated a fusiform popliteal artery aneurism with a maximal diameter of 14 mm and distal occlusion of peroneal and both tibial arteries. Urgent hybrid intervention was performed, starting with an open thrombectomy from the distal posterior tibial artery via a retromalleolar access followed by percutaneous deployment of the DLM Roadsaver® stent (Terumo, Tokyo, Japan) for the exclusion of the popliteal artery aneurism. The flow diverting effect was observed immediately with contrast stagnation in the asymmetrical part of the aneurism sac (grade C2 of the O’Kelly-Marotta flow diversion scale). The procedure was uneventful, with the regaining of an adequate foot perfusion and palpable pulse at the posterior tibial artery. On the 2nd postoperative day, the patient was diagnosed with a symptomatic form of COVID-19 infection and transferred to a dedicated facility. At a one-month follow-up, the patient had no symptoms of limb ischemia and CTA showed complete thrombosis of the aneurism sac, absence of endoleaks, and patency of the treated arterial segment. This case demonstrates the possibility of off-label use of the DLM Roadsaver® stent for hybrid treatment of popliteal artery aneurism complicated by distal embolization and critical limb ischemia.

Polypoid lesions of the gallbladder represent the frequent problem of modern abdominal surgery. These lesions have very different histology from pseudolesion to cancer of the gallbladder. Majority of patients with gallbladder polyps have asymptomatic evolution. Intermittent pain may appear in the right upper quadrant, similar to gallstone disease, with or without cholecystitis, or there might be nonspecific symptoms. For the diagnosis of this pathology, different methods can be used – transabdominal ultrasound, endoscopic ultrasound, computerized tomography, retrograde endoscopic colangiopancreatography, nuclear magnetic resonance. At present, ultrasound remains the most sensitive and useful method for the diagnosis of the gallbladder polyps. The most important problem is the preoperative appreciation of the possible malignancy of the polyp. At present, standardized treatment accepted unanimously of this pathology does not exist. If surgery is indicated, the gold standard is laparoscopic cholecystectomy. In case of malignancy or its suspicion the surgery volume becomes bigger and includes liver resection and, if necessary, limfadenodisection.

The importance of varroosis control in a natural and sustainable way is crucial for beekeeping, having in view the varroa mite impact on honey bee health. In the last years, we developed a highly effective procedure for treating varroa in capped brood using volatile organic acids. This procedure can be applied at any moment of the active season as it uses organic substances. Taking into account the necessity to drastically reduce the level of varroa infestation in colonies before winter bee rearing, we developed a relatively simple pilot study to preliminarily test the impact of spring treatments on varroa infestation level in brood, to be evaluated in summer when, naturally, the population of mites increases. To test the hypothesis, two experimentally treated groups and a control group were used. The treatment consisted of brushing all capped brood with formic acid of 65% concentration in one and two applications. The obtained results show very significant differences between the treated and control groups in terms of infested cell percentages evaluated in the July–August period. Consequently, the spring treatments could be an important tool in limiting the varroa mite multiplication, but further experiments are necessary to test and adapt them to different local conditions.

The honey bee (Apis mellifera) is an ecologically and economically important species that provides pollination services to natural and agricultural systems. The biodiversity of the honey bee is being endangered by the mass import of non-native queens. In many locations, it is not clear how the local populations have been affected by hybridisation between native and non-native bees. There is especially little information about temporal changes in hybridisation. In Romania, A. m. carpatica naturally occurs, and earlier studies show that there are two subpopulations separated by the Carpathian Mountains. In this study, we investigated how the arrangement of veins in bees’ wings (venation) has changed in Romanian honey bees in the last four decades. We found that in the contemporary population of Romanian bees, there are still clear differences between the intra- and extra-Carpathian subpopulations, which indicates that natural variation among honey bees is still being preserved. We also found significant differences between bees collected before and after 2000. The observed temporal changes in wing venation are most likely caused by hybridisation between native bees and non-native bees sporadically introduced by beekeepers. In order to facilitate conservation and the monitoring of native Romanian bees, we developed a method facilitating their identification.

Honeybees (Apis mellifera L.) are excellent biosensors that can be managed to collect valuable information about environmental contamination. The main objective of the present study was to design and apply an integrative protocol to monitor honeybee colony activity and sample collection by using electronic technologies combined with classical methods in order to evaluate the exposure of honeybees to the neonicotinoids that are used in melliferous intensive crops. The monitored honeybee colonies were especially prepared and equipped to maximize their chances to collect representative samples in order to express, as well as possible, the pesticide residues that existed in the targeted crops. The samples of honey, pollen and honeybees were collected, preserved and prepared to fulfill the required quality and quantity criteria of the accredited laboratories. In total, a set of fifty samples was collected from fields, located in different areas of intensive agriculture in Romania, and was analyzed for five neonicotinoids. The obtained results show that 48% of the total analyzed samples (n = 50) contained one or more detected or quantified neonicotinoid residues. The main conclusion is that the proposed approach for sample collection and preparation could improve the evaluation methodologies for analyzing honeybees’ exposure to pesticides.

Introduction: Although saphenofemoral junction aneurysms are not so rare, only scarce of the published cases reported thrombosis of the aneurysmal sac and saphenous trunk. Presentation of case: A 65-year-old male with varicose disease, developed acute ascending superficial vein thrombosis of the left greater saphenous vein, involving the 6-cm saphenofemoral junction aneurysm. The patient underwent common femoral vein thrombectomy, aneurysm removal, and greater saphenous vein excision with uneventful postoperative course. Conclusion: Thrombosed giant saphenofemoral junction aneurysms require emergent surgical intervention aimed at preventing potential progression to deep vein thrombosis and pulmonary embolism.

Background and Aims: Infection with hepatitis A virus is still one of the most common causes of hepatitis worldwide. The clinical manifestation of acute hepatitis A (AHA) in adults can vary greatly, ranging from asymptomatic infection to severe and fulminant hepatitis. The aim of this study was to describe the demographic, clinical characteristics, laboratory features and hospital outcome of adult patients with AHA over a consecutive period of 4 years within an area from Eastern European country. Methods: Two hundred and two adult patients diagnosed with AHA were retrospective, observational and analytic analized over a period of 4 years. Based on prothrombin time less than 50, the study group was stratified in medium (79.2%) and severe forms (20.8%). We investigated the clinical, laboratory and epidemiological features. Statistical analysis were applied to compare the medium and severe forms of AHA. Results: Most patients (72.7%) were younger than 40 years. The main symptoms included: dyspepsia (72.07%), jaundice (86.63%), asteno-adynamia (86.72%), and flu-like symptoms (53.46%). The hemorrhagic cutaneous-mucous manifestations (6.93%) associated with the severe forms of AHA (OR =12.19, 95%CI -3.59 - 41.3, p =0.001). We found statistically significant differences for PT (p

One of the main trends that characterize contemporary economic life, itself necessitated by competitive market mechanisms, but also the limited resources, is to cut costs. Given this reality, each trader must understand the complex process of reducing costs and enhancing competitiveness is the key, which depends on ensuring profitability development and marketing activities. The paper develops the concept of production process for pieces made on machine tools, explaining how it should be the identification and planning of production processes based on batch size pieces.

În articol sunt examinate unele concepte şi interpretări în ceea ce priveşte sursele şi începuturile reale ale gândirii filosofice româneşti: particularităţile ideologiei filosofice româneşti, unele aspecte ale gândirii filosofice „daco-getice”, elemente de mentalitate mitologică, idei filosofice în gândirea populară (noţiuni de folclor, etnografie, etno-psihologie, legende, proverbe), cultura tradiţională, în general. THE CONCEPTS AND INTERPRETATIONS ON THE SOURCES AND ORIGINS OF THE ROMANIAN PHYLOSOPHICAL THINKINGIn the article there are examined some concepts and interpretations concerning the sources and the real beginnings of the Romanian philosophical thinking: the peculiarities of the Romanian philosophical ideology, some aspects of the “daco-getian” philosophical thinking, elements of mythological mentality, philosophic ideas in popular thinking (notions from folklore, ethnography, ethno-psychology, legends, proverbs), traditional culture in general.

n the paper is developed a new control strategy for the adjustable speed drives. The strategy consists in the energetic optimal control of the dynamic regimes as starting, stopping and reversing. The main developed problems: formulation of energetic optimal problem, solution, experimental results via simulation and some considerations concerning the use of the control. The optimal developed solution can be applied for the both AC and DC drives, but only for linear systems.

Background: Aneurysmal subarachnoid hemorrhage (SAH) predominantly affects women, accounting for 65% of cases. Women have a 1.3 times higher relative risk than men, with the incidence rising particularly in women aged 55-85 years. Women also have a higher prevalence of unruptured intracranial aneurysms (IAs), especially after the age of 50 years, and are at greater risk of aneurysm growth and rupture. This study aimed to isolate the influence of sex on rupture rate, bleeding severity, functional outcomes, and complications by using a matched cohort, while also examining the impact of sex on aneurysm localization and multiplicity. Methods: We utilized a retrospectively collected database of 300 patients with 511 IAs. Inclusion criteria included the availability of clinical data and 3D angiography for semi-automatic reconstruction of IA morphology. Female patients and their IA were matched with male patients according to clinical parameters and 21 morphological characteristics using an interactive visual exploration tool for multidimensional matching. Results: Contrary to previously published results, our study found no significant sex differences in rupture rates or vasospasm rates between male and female patients. The severity of SAH, functional outcomes, and complications such as hydrocephalus were also similar in women and men. However, women exhibited a higher prevalence of multiple aneurysms and distinct localization patterns. Conclusions: This study underscores the complex role of sex in IA development and rupture. Although sex-specific biological factors influence aneurysm characteristics, they do not necessarily translate into differences in clinical outcomes. Further research is needed to explore these factors and their impact on aneurysm development and management.

Glioblastoma (GBM) is the most commonly occurring and most aggressive primary brain tumor. Transcriptomics-based tumor subtype classification has established the mesenchymal lineage of GBM (MES-GBM) as cancers with particular aggressive behavior and high levels of therapy resistance. Previously it was show that Trihexyphenidyl (THP), a market approved M1 muscarinic receptor-targeting oral drug can suppress proliferation and survival of GBM stem cells from the classical transcriptomic subtype. In a series of in vitro experiments, this study confirms the therapeutic potential of THP, by effectively suppressing the growth, proliferation and survival of MES-GBM cells with limited effects on non-tumor cells. Transcriptomic profiling of treated cancer cells identified genes and associated metabolic signaling pathways as possible underlying molecular mechanisms responsible for THP-induced effects. In vivo trials of THP in immunocompromised mice carry orthotopic MES-GBMs showed moderate response to the drug. This study further highlights the potential of THP repurposing as an anti-cancer treatment regimen but mode of action and d optimal treatment procedures for in vivo regimens need to be investigated further., Competing Interests: Authors JA and WW were employed by Experimental Pharmacology and Oncology Berlin-Buch GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Du, Sanin, Shi, Huang, Nickel, Vargas-Toscano, Huo, Nickl-Jockschat, Dumitru, Hu, Duan, Sandalcioglu, Croner, Alcaniz, Walther, Berndt and Kahlert.)

Cranial operations are associated with a high risk of postoperative intracranial hemorrhage (pICH) and venous thromboembolic events, along with increased mortality and morbidity. With the use of acetylsalicylic acid (ASA) for prophylaxis becoming more prevalent, the risk of bleeding when ASA is administered preoperatively is unknown, as are the effects of discontinuation upon the occurrence of thromboembolic events, especially in societies with aging demographics. To address these questions, a retrospective analysis was performed using medical records and radiological images of 1862 patients subjected to brain tumor surgery over a decade in our department. The risk of pICH was compared in patients with metastases receiving ASA treatment versus patients not receiving ASA treatment. The occurrence of venous thromboembolic events after surgery was also evaluated. The study group consisted of 365 patients with different types of brain metastases. In total, 20 patients suffered pICH and 7 of these were associated with clinical neurological deterioration postoperatively. Of the 58 patients who took ASA preoperatively, 2 patients experienced pICH, compared with 5 patients in the non-ASA impact group ( p = 0.120). Patients who took ASA were not at significantly higher risk of pICH and therefore a worse outcome compared to the group without ASA. Therefore, these data suggest that in patients at high cardiovascular risk, ASA can be safely continued during elective brain tumor surgery.

Background : In routine medical practice, patients are increasingly using ASA for primary and secondary prevention. Although many of these patients discontinue ASA prior to elective intracranial surgery, there are limited data to support whether perioperative ASA use raises the risk of postoperative hemorrhage. This study aimed to investigate the implications of continuing or stopping ASA around the time of surgery in patients with intracranial meningiomas, focusing on postoperative hemorrhage and thromboembolic events. Methods : For this purpose, medical records and radiological images of 1862 patients who underwent cranial neurosurgical procedures for brain tumors over a decade at our neurosurgical institute were retrospectively analyzed. The risk of postoperative hemorrhage was evaluated by comparing meningioma patients who received ASA treatment with those who did not. Furthermore, we investigated other factors that influence postoperative hemorrhage and thromboembolic events, particularly in patients receiving ASA treatment. Results : A total of 422 patients diagnosed with meningiomas underwent surgical intervention. Among the patients who received ASA preoperatively, 4 out of 46 (8.69%) experienced postoperative hemorrhage requiring surgical intervention, whereas the same complication occurred in only 4 out of 376 patients (1.06%) in the non-ASA group ( p = 0.007). There was no significant difference in the incidence of thromboembolic events between the two groups. Conclusions : Our analysis revealed an increased risk of postoperative hemorrhage in patients using ASA.

The surgical management of anterior communicating artery aneurysms (AcomA) is challenging due to their deep midline position and proximity to complex skull base anatomy. This study compares the pterional craniotomy with the interhemispheric approach based on the specific aneurysm angulation. A total of 129 AcomA cases were analyzed, with 50 undergoing microsurgical clipping via either the pterional or interhemispheric approach. All selected cases had computed tomography-angiography with sagittal imaging slices and 2D-angiography. Using an interactive tool, 14 cases treated via the interhemispheric approach were matched with 14 cases approached pterionally based on clinical and morphological parameters, emphasizing intracranial aneurysm (IA) dome angulation relative to the frontal skull base. Outcomes included IA occlusion, temporary clipping incidence, intraoperative rupture, postoperative strokes, hemorrhages, hydrocephalus, vasospasm, and patient functionality. Matched cohorts had consistent demographics. Both approaches resulted in similar IA occlusion rates, but the interhemispheric approach led to improved clinical outcomes, measured by the modified Rankin Scale. It also had a lower incidence of hydrocephalus and reduced need for permanent ventriculoperitoneal shunt placement. Vasospasms and postoperative infarction rates were comparable between the groups. Our findings suggest potential advantages of the interhemispheric approach in managing AcomA, depending on aneurysm angulation. Despite a small sample size, the results highlight the importance of customized surgical decision-making based on the unique traits of each aneurysm and the surgeon's expertise., (© 2024. The Author(s).)

Postoperative wound infections are a prevalent concern among the hospital-associated infections in Europe, leading to prolonged hospital stays, increased morbidity and mortality, and substantial patient burdens. Addressing the root causes of this complication is crucial, especially given the rising number of spine surgeries due to aging populations., Methods: A retrospective analysis was conducted on a cohort of 3019 patients who underwent lumbar spine surgery over a decade in our department. The study aimed to assess the predictors of wound healing disorders, focusing on laboratory values, particularly inflammatory parameters., Results: Of the 3019 patients, 2.5% (N = 74) experienced deep or superficial wound healing disorders, showing the significant correlation between C-reactive protein (CRP) levels and these disorders ( p = 0.004). A multivariate analysis identified several factors, including age, sex, hypertension, diabetes, cardiac comorbidity, surgical duration, dural injury, and blood loss, as being correlated with wound healing disorders., Conclusion: Demographic factors, pre-existing conditions, and perioperative variables play a role in the occurrence of adverse effects related to wound healing disorders. Elevated CRP levels serve as an indicator of increased infection risk, though they are not a definitive diagnostic tool for wound healing disorders.

This study determined the expression of five novel biomarker candidates in IDH wild-type glioblastoma (GBM) tissues compared to non-malign brain parenchyma, as well as their prognostic relevance for the GBM patients' outcomes. The markers were analysed by immunohistochemistry in tumour tissues (n = 186) and healthy brain tissues (n = 54). The association with the patients' overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier and log-rank test. The prognostic value of the markers was determined using multivariate Cox proportional hazard models. AGTRAP, DIVERSIN, cytoplasmic NEDD8 (NEDD8c) and RRM1 were significantly overexpressed in tumour tissues compared to the healthy brain, while the opposite was observed for ALKBH3. AGTRAP, ALKBH3, NEDD8c and RRM1 were significantly associated with OS in univariate analysis. AGTRAP and RRM1 were also independent prognostic factors for OS in multivariate analysis. For PFS, only AGTRAP and NEDD8c reached significance in univariate analysis. Additionally, AGTRAP was an independent prognostic factor for PFS in multivariate models. Finally, combined analysis of the markers enhanced their prognostic accuracy. The combination AGTRAP/ALKBH3 had the strongest prognostic value for the OS of GBM patients. These findings contribute to a better understanding of the GBM pathophysiology and may help identify novel therapeutic targets in this type of cancer.

Progesterone Receptor Membrane Component 1 (PGRMC1) is a tumour-promoting factor in several types of cancer but its role in brain tumours is poorly characterized thus far. Our study aimed to determine the effect of PGRMC1 on glioblastoma (GBM) pathophysiology using two independent cohorts of IDH wild-type GBM patients and stable knockdown GBM models. We found that high levels of PGRMC1 significantly predicted poor overall survival in both cohorts of GBM patients. PGRMC1 promoted the proliferation, anchorage-independent growth, and invasion of GBM cells. We identified Integrin beta-1 (ITGB1) and TCF 1/7 as potential members of the PGRMC1 pathway in vitro. The levels of ITGB1 and PGRMC1 also correlated in neoplastic tissues from GBM patients. High expression of PGRMC1 rendered GBM cells less susceptible to the standard GBM chemotherapeutic agent temozolomide but more susceptible to the ferroptosis inducer erastin. Finally, PGRMC1 enhanced Interleukin-8 production in GBM cells and promoted the recruitment of neutrophils. The expression of PGRMC1 significantly correlated with the numbers of tumour-infiltrating neutrophils also in tissues from GBM patients. In conclusion, PGRMC1 enhances tumour-related inflammation and promotes the progression of GBM. However, PGRMC1 might be a promising target for novel therapeutic strategies using ferroptosis inducers in this type of cancer.

Purpose: Evaluation of extravascular, microscope integrated OCT (iOCT) as an in vivo imaging modality of cerebral blood vessels and as an intraoperative imaging method., Methods: Microscope integrated optical coherence tomography of major cerebral arteries (n = 13) and superficial sylvian veins (n = 5) and one incidental cerebral vasospasm (n = 1) in (n = 10) patients. Post procedural analysis of OCT volume scans, microscopic images and videos during the time of scan as well as measurements of the diameter of vessel walls and its layers with an accuracy of 7.5 μm., Results: iOCT was feasible during vascular microsurgical procedures. In all scanned arteries a clear delineation of the physiological three layered vessel wall composition could be achieved. Pathological arteriosclerotic alterations of cerebral artery walls could precisely be demonstrated. Major superficial cortical veins conversely presented a mono layered composition. First in vivo measurements of vascular mean diameters were possible. Cerebral artery walls showed a diameter of 296 μm, tunica externa 78 μm, media 134 μm and interna 84 μm., Conclusion: For the first time the microstructural composition of cerebral blood vessels could be illustrated in vivo. Due to an outstanding spatial resolution a clear definition of physiological and pathological characteristics was possible. Therefore, microscope integrated optical coherence tomography holds promise for basic research in the field of cerebrovascular arteriosclerotic diseases and for intraoperative guidance during microvascular surgery., Competing Interests: OptoMedical Technologies GmbH, Maria-Goeppert-Straße 9, 23562 Lübeck, Schleswig Holstein, Deutschland supported the study with free equipment for iOCT. This does not alter the adherence to PLOS ONE policies on sharing data and materials. The authors declare no employment, remunerated consultancy, involvements in patents, products in development or marketed products linked to this company. The authors have nothing further to disclose and no further competing interests., (Copyright: © 2023 Hartmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)