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Urosepsis is a life-threatening medical condition due to a systemic infection that originates in the urinary tract. Early diagnosis and treatment of urosepsis are critical to reducing mortality rates and preventing complications. Our study was aimed at identifying a fast and reliable method for early urosepsis diagnosis and severity assessment by combining prognostic scores such as SOFA and NEWS with ultrasound examination and serum markers PCT and NLR.

Sergiu Marian Cazacu,1,* Mircea Parscoveanu,2,* Dan Cartu,2,* Emil Moraru,2,* Ion Rogoveanu,1,* Bogdan Silviu Ungureanu,1,* Sevastita Iordache,1,* Dan Nicolae Florescu,1,* Vlad Florin Iovanescu,1,* Manuela Iuliana Dragomir3,* 1Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania; 2Surgery Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania; 3Public Health Management Department, University of Medicine and Pharmacy Craiova, Craiova, Romania*These authors contributed equally to this workCorrespondence: Sevastita Iordache, The University of Medicine and Pharmacy Craiova, Gastroenterology Department, 2-4, Petru Rares Street, Craiova, Dolj County, 200349, Romania, Tel +40722990012, Fax +40251426688, Email sevastita@gmail.comIntroduction: The neutrophil–lymphocyte ratio (NLR) has been suggested as a reliable marker for predicting inflammation progression and severity of acute pancreatitis, although the role of the NLR stratified by etiology is still insufficiently studied. However, the NLR’s role in mortality prediction was poorly evaluated in the literature.Patients and Methods: We performed a retrospective, cross-sectional study to analyze the role of NLR0 (at admission) and NLR48 (at 48 hours) in acute pancreatitis as compared with CRP, BISAP, SOFA, and modified CTSI (mCTSI) for the prediction of mortality and severe acute pancreatitis (SAP) in patients admitted into the Emergency Clinical County Hospital of Craiova during 48 months. The primary assessed outcomes were the rate of in-hospital mortality, the rate of persistent organ failure, and ICU admissions. We analyzed mortality prediction for all acute pancreatitis, for biliary, alcoholic, and hypertriglyceridemic acute pancreatitis, for severe forms, and for patients admitted to the ICU.Results: A total of 725 patients were selected; 42.4% had biliary acute pancreatitis, 27.7% had alcoholic acute pancreatitis, and 8.7% had hypertriglyceridemia-induced acute pancreatitis. A total of 13.6% had POF during admission. The AUC for NLR48 in predicting mortality risk and SAP was 0.81 and 0.785, superior to NLR0, CRP48, and mCTSI but inferior to BISAP and SOFA scores. The NLR48/NLR0 ratio did not add significantly to the accuracy. NLR0 and NLR48 performed poorly for mortality prediction in severe forms and in patients admitted to the ICU. NLR48 has good accuracy in our study for predicting death risk in biliary and alcoholic acute pancreatitis but not in hypertriglyceridemic acute pancreatitis.Conclusion: NLR48 was a good indicator in predicting mortality risk and severe forms in all patients with acute pancreatitis, but not of death in SAP and in patients admitted to ICU, with good accuracy for predicting death risk in biliary and alcoholic acute pancreatitis but not in hypertriglyceridemic acute pancreatitis.Keywords: acute pancreatitis, severe acute pancreatitis, neutrophil–lymphocyte ratio, BISAP score, SOFA score, C-reactive protein

Sergiu Marian Cazacu,1,* Adina Turcu-Stiolica,2,* Dan Nicolae Florescu,1,* Bogdan Silviu Ungureanu,1,* Vlad Florin Iovanescu,1,* Carmen Daniela Neagoe,3,* Daniela Elena Burtea,1,* Amelia Valentina Genunche-Dumitrescu,3,* Taina Elena Avramescu,4,* Sevastita Iordache1,* 1Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Dolj County, Romania; 2Biostatistics Department, University of Medicine and Pharmacy Craiova, Dolj County, Romania; 3Internal Medicine Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Dolj County, Romania; 4Individual Sports, and Medical Disciplines Departments, University of Craiova, Dolj County, Romania*These authors contributed equally to this workCorrespondence: Carmen Daniela Neagoe, Tel +40723767106, Email dananeagoe2014@gmail.com; daniela.neagoe@umfcv.roBackground: In upper gastrointestinal bleeding (UGIB), admissions after normal working hours and during weekends may be associated with increased mortality.Aim: To assess the evolution of the after-hours and weekend effects during the COVID-19 pandemic as a result of progressive improved management despite management challenges during the pandemic.Methods: We performed an observational study of patients admitted for UGIB at a tertiary academic center between March 2020 and December 2021, compared to the corresponding timeframe before the pandemic. Admissions were assessed based on regular hours versus after-hours and weekdays versus weekends. We stratified patients based on demographic data, etiology, prognostic scores, the time between symptom onset and admission, as and between admission and endoscopy. The outcomes included mortality, rebleeding rate, the requirement for surgery and transfusion, and hospitalization days.Results: 802 cases were recorded during the pandemic, and 1006 cases before the pandemic. The overall mortality rate was 12.33%. Patients admitted after hours and during weekends had a higher mortality rate compared to those admitted during regular hours and weekdays (15.18% versus 10.22%, and 15.25% versus 11.16%), especially in cases of non-variceal bleeding. However, the difference in mortality rates was reduced by 2/3 during the pandemic, despite the challenges posed by COVID-19 infection. This suggests that there was an equalization effect of care in UGIB, regardless of the admission time. The differences observed in mortality rates for after-hours and weekend admissions seem to be primarily related to a higher proportion of patients who did not undergo endoscopy, while the proportion of severe cases remained similar. Blood requirements, hospital days, and rebleeding rate were similar between the two groups.Conclusion: Admissions during weekends and after-hours have been associated with increased mortality, particularly in cases of non-variceal bleeding. However, the impact of this association was significantly reduced during the pandemic.Keywords: gastrointestinal bleeding, after-hours care, COVID-19 pandemic

The morphological evolution of InGaN/GaN multiple-quantum wells (MQWs) grown by metalorganic chemical vapor deposition has been examined by atomic force microscopy and cross-sectional transmission electron microscopy. We have determined that GaN barrier growth at low temperature (∼800 °C) in a H[sub 2]-free environment results in a microstructure that consists of not only V-defects, but also inclusions embedded within V-defects that originate at the first InGaN-to-GaN growth interface. Propagation of the inclusions results in progressive deterioration of the surface morphology and reduced MQW thermal stability as quantum-well periods are added. Raising the GaN barrier growth temperature to 900°C or adding H[sub 2] suppresses inclusion propagation entirely and preserves two-dimensional step-flow growth mode, resulting in superior morphology and higher thermal stability. [ABSTRACT FROM AUTHOR]

We report details of the calculation of the lattice thermal conductivity κ in wurtzite GaN. Numerical simulations are performed for n-type wurtzite GaN with different density of silicon dopants, point defects and threading dislocations. Using the material specific model we verified the experimentally observed linear decrease of the room-temperature thermal conductivity with the logarithm of the carrier density n. The decrease was attributed mostly to the increased phonon relaxation on dopants. Our calculations show that the increase in the doping density from 10[sub 17] to 1018 cm[sub -3] leads to about a factor of 2 decrease in thermal conductivity from 1.77 W/cm K to 0.86 W/cm K. We have also established that the room-temperature thermal conductivity in GaN can be limited by dislocations when their density is high, e.g., N[sub D] > 10[sup 10] cm[sup -2]. The obtained results are in good agreement with experimental data. The developed calculation procedure can be used for accurate simulation of self-heating effects in GaN-based devices. [ABSTRACT FROM AUTHOR]

We have measured high spatial/depth resolution (2–3 μm) thermal conductivity (κ) at 300 K before and after plasma-induced effects on two series of n-GaN sapphire (0001) samples fabricated by hydride vapor phase epitaxy using scanning thermal microscopy. The sample thicknesses were 50±5 μm for one set and 25±5 μm for the second. The carrier concentrations were ∼8×10[sup 16] cm[sup -3] and ∼1.5×10[sup 17] cm[sup -3], respectively, as determined by Hall effect measurements. The thermal conductivity before treatment was similar to that previously reported for hydride vapor phase epitaxy material with comparable carrier concentration and thickness [D. I. Florescu et al., J. Appl. Phys. 88, 3295 (2000)]. Damage was induced by ion-beam processing the samples under constant Ar[sup +] gas flow and pressure for a fixed period of time (5 min), with the dc bias voltage (V[sub dc]) being the only variable processing parameter (125–500 V). The thermal conductivity near the surface, κ, was found to exhibit a linear decrease with V[sub dc] in the investigated range after this procedure. A second process was then applied in order to remove some damage. In this case the samples were processed under a constant mixture of Cl[sub 2] and Ar[sup +] gas flow and V[sub dc][sup ′] of 50 V. For the samples with V[sub dc] in the range 125 V

Measures the high resolution thermal conductivity and Raman spectra of hydride vapor phase epitaxy grown n-GaN/sapphire. Thermal conductivity; Raman spectroscopy; Improvement of thermal conductivity with the increase in film thickness.

Petrica Popa,1,* Sevastita Iordache,1,* Dan Nicolae Florescu,1,* Vlad Florin Iovanescu,1,* Alexandru Vieru,2 Valentin Barbu,2 Maria-Cristina Bezna,3,* Dragos Ovidiu Alexandru,4,* Bogdan Silviu Ungureanu,1,* Sergiu Marian Cazacu1,* 1Gastroenterology Department, University of Medicine and Pharmacy Craiova, Craiova, Dolj County, Romania; 2Gastroenterology Department, Clinical Emergency County Hospital Craiova, Craiova, Dolj County, Romania; 3Cardiology Department, Clinical Emergency County Hospital Craiova, Craiova, Romania; 4Department of Medical Informatics and Statistics, University of Medicine and Pharmacy Craiova, Craiova, Dolj County, Romania*These authors contributed equally to this workCorrespondence: Dan Nicolae Florescu, University of Medicine and Pharmacy Craiova, Gastroenterology Department, Petru Rares Street No. 2-4, Craiova, Dolj County, 200349, Romania, Tel +40723377004, Fax +40251426688, Email nicku.dan@gmail.comIntroduction: During the last few years, a progressive higher proportion of patients have had upper gastrointestinal bleeding (UGIB) related to antithrombotic therapy. The introduction of direct oral anticoagulant (DOAC) and COVID-19 pandemic may change the incidence, mortality, and follow-up, especially in patients at high risk of bleeding.Patients and Methods: We studied the use of anti-thrombotic therapy (AT) in patients with upper gastrointestinal bleeding for 5 years (January 2017–December 2021) including Covid-19 pandemic period (March 2020–December 2021). We analyzed mortality rate, rebleeding rate and need for transfusion in patients with AT therapy compared with those without AT therapy and risk factors for mortality, and also the incidence of gastrointestinal bleeding in patients admitted for COVID-19 infection.Results: A total of 824 patients were admitted during Covid-19 pandemic period and 1631 before pandemic period; a total of 426 cases of bleeding were recorded in patients taking antithrombotic therapy and the frequency of antithrombotic therapy in patients with UGIB was higher in pandemic period (24.39% versus 13.8%). Unadjusted mortality was 12.21%, similar with patients with no antithrombotic treatment but age-adjusted mortality was 9.62% (28% lower). The rate of endoscopy was similar but fewer therapeutic procedures were required. Mean Hb level was 10% lower, and more than 60% of patients required blood transfusion.Conclusion: Mortality was similar compared with patients with no antithrombotic therapy, fewer therapeutic endoscopies were performed and similar rebleeding rate and emergency surgery were noted. Hb level was 10% lower and a higher proportion of patients required blood transfusions. Mortality was higher in DOAC treatment group compared with VKA patients but with no statistical significance. The rate of upper gastrointestinal bleeding in Covid-19 positive hospitalized cases was 0.58%. The mortality risk in multivariate analysis was associated with GB score, with no endoscopy performed, with obscure and variceal bleeding and with LMWH versus VKA therapy.Keywords: Covid-19, direct oral anticoagulant therapy, acenocoumarol, antithrombotic therapy, upper gastrointestinal bleeding