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Ruxandra Mare,1,2 Ioan Sporea,1,2 Mirela Tomescu,3 Gheorghe Nicușor Pop,3 Andrei Vitel,3 Alina Popescu,1,2 Silviu Nistorescu,1 Roxana Sirli1,2 1Department of Internal Medicine II, Gastroenterology and Hepatology Unit, Advanced Research Center in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Regional Center of Research in Advanced Hepatology, Academy of Medical Science, Timisoara, Romania; 3Department VI of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Roxana Sirli, Department of Internal Medicine II, Gastroenterology and Hepatology Unit, Advanced Research Center in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania, Tel +40723537039, Fax +40723537039, Email roxanasirli@gmail.comIntroduction: Many of the patients presenting with metabolic syndrome (MetS) also have liver steatosis (NAFLD) and some of them could develop liver fibrosis.Purpose: To develop a simple score that could rule out fibrosis, especially significant fibrosis (F≥ 2) and could be used in daily practice in patients with MetS, in order to identify patients at risk.Patients and Methods: A total of 204 patients with MetS were prospectively enrolled. Evaluation of liver fibrosis was made using Vibration Controlled Transient Elastography while evaluation of steatosis was achieved using ultrasound (US).Results: Out of 204 patients with MetS, 179 patients (87.7%) had reliable liver stiffness measurements and 22.9% (41/179) had F ≥ 2. To formulate the fibrosis predicting score, all clinical variables associated with F ≥ 2 in the univariate analysis were considered in a multivariate regression model. According to the power of correlation, by consensus, we attributed 1 point for BMI > 31.4 kg/m2, 1 point for female gender, 1 point for HDLc < 47mg/dL, 1 point for mild steatosis at US, 1.5 point for moderate and 2 points for severe steatosis.Conclusion: At an optimal cut-off value of < 3.5, our score could be used to rule-out the risk for developing at least significant fibrosis with a high negative predictive value (NPV 89.2%) in patients with MetS.Keywords: metabolic syndrome, liver steatosis, liver fibrosis, liver elastography

Tudor Parvanescu,1 Andrei Vitel,1 Ioan Sporea,2 Ruxandra Mare,2 Bogdan Buz,1 Diana Aurora Bordejevic,1 Mirela Cleopatra Tomescu,1 Sergiu Florin Arnautu,3 Vlad Ioan Morariu,1 Ioana Mihaela Citu1 1Cardiology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 3Department of Neurology, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Diana Aurora BordejevicCardiology Department, Victor Babe” University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timisoara, RomaniaTel +40 734600550Fax +40 256220636Email aurora.bordejevic@umft.roBogdan BuzCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timisoara, RomaniaTel +40 756346910Email buzbogdan93@gmail.comPurpose: The constitutive elements of the metabolic syndrome (MetS) are linked with both non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. Controlled attenuation parameter (CAP), and vibration controlled transient elastography (VCTE), are able to detect and quantify NAFLD, while conventional and two-dimensional speckle tracking echocardiography (2D-STE) is capable to identify subclinical changes in cardiac function. We wanted to evaluate whether there is any correspondence between left ventricular (LV) diastolic dysfunction and different degrees of liver steatosis and fibrosis in MetS subjects with NAFLD.Patients and Methods: A total of 150 adult subjects having MetS and a normal left ventricular (LV) systolic function were recorded in the study, while 150 age- and sex- matched adults without MetS were enrolled as controls. NAFLD was established by VCTE and CAP. The left heart systolic and diastolic function was evaluated by conventional and 2D-ST echocardiography. Left atrial (LA) stiffness was calculated as the ratio between the E/A ratio and the LA reservoir-strain.Results: In univariate regression analysis, the variables associated with LV diastolic dysfunction in MetS patients were: liver steatosis grade ≥ 2, liver fibrosis grade ≥ 2, the longitudinal LA peak strain during the reservoir phase, the LA strain rate during ventricular contraction and the LA stiffness. In multivariate logistic regression, two variables were selected as independent predictors of LV diastolic dysfunction, namely the liver stiffness (P=0.0003) and the LA stiffness (P< 0.0001). LA stiffness predicted subclinical LV diastolic dysfunction in MetS patients with a sensitivity of 45% and a specificity of 96% when using a cut-off value > 0.38, and was significantly correlated with liver steatosis stage ≥ 2 and liver fibrosis stage ≥ 2.Conclusion: The present study confirms the association between liver stiffness, LA stiffness and LV diastolic dysfunction in MetS patients. Our study suggests that liver elastography and 2D-STE should become habitual assessments in MetS patients.Keywords: metabolic syndrome, strain and strain‑rate imaging, left atrial stiffness, left ventricular diastolic dysfunction, liver elastography, liver steatosis and fibrosis

Andrei Vitel,1,* Ioan Sporea,2 Ruxandra Mare,2 Christian Banciu,2 Diana-Aurora Bordejevic,1,* Tudor Parvanescu,1 Ioana Mihaela Citu,1 Mirela Cleopatra Tomescu1 1Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Gastroenterology Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania*These authors contributed equally to this workCorrespondence: Ioana Mihaela CituCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 nd Eftimie Murgu Square, Timisoara, RomaniaTel +40 724353666Fax +40 256220636Email ioanamihaela2010@gmail.comPurpose: The components of metabolic syndrome (MS) are risk factors for developing both cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). Strain (SI) and strain‑rate imaging (SRI) are able to recognize early changes in cardiac function. Vibration-controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) detect and quantify liver fibrosis and steatosis. We aimed to assess whether there is any correlation between liver fibrosis and steatosis and left ventricular (LV) dysfunction in MS patients.Patients and Methods: A total of 150 adults with MS were registered in the study. They were compared with a control group of 150 age- and sex-matched adults without MS. After the classic echocardiographic assessment of LV function, two-dimensional speckle echocardiography (2D-STE) was used to evaluate LV peak systolic strain (S) and peak systolic strain rate (SR), while liver steatosis and fibrosis were evaluated by VCTE and CAP.Results: LV diastolic dysfunction was significantly more frequent among the patients with MS. We found significant differences between the two groups regarding the presence of subtle LV systolic dysfunction, detected by reduced values of S and SR. The risk for LV diastolic dysfunction was 3.6 times higher in MS with severe steatosis and 8 times higher in patients with severe fibrosis, P< 0.0001. The risk for LV systolic dysfunction was double in MS with severe steatosis and 1.7 times higher in MS with severe fibrosis, P< 0.0001.Conclusion: In MS patients with normal LV ejection fraction, conventional echocardiography parameters identified diastolic LV dysfunction, while SI and SRI identified subtle impairment of systolic LV dysfunction. The presence of hepatic steatosis and fibrosis increases significantly the risk for cardiac dysfunction in MS patients (P< 0.0001).Keywords: metabolic syndrome, left ventricular function, strain and strain‑rate imaging, liver steatosis and fibrosis, liver elastography

The paper is structured in five parts. In the first part is evoked the importance and presented some aspects from stability theory. In the second part are presented the general model designed by the author with the principal loads. In part three are presented the model for evaluation taking into account the forces given by the wind loads. In part four are given the results obtained using an analytical method neglecting the forces given by the wind loads. Are calculated the dimensions of the diameter and also is verified the section. In part number five the authors presents the conclusions.

The paper presents the interdependence between photovoltaic and electric parameters of a solar thermoelectric cooler. It emphasises the importance of the solar radiation during two experiments made in the same day, in different weather conditions. Also, it is shown that while the photovoltaic power is directly dependent on the photovoltaic current intensity, the electric power varies along with the voltage. All these have great influence upon the battery – the main component responsible for the operation of the cooling hybrid system.

In this paper is presented the working principle of genetic algorithms used to dimension autonomous hybrid systems. It is presented a study case in which is dimensioned and optimized an autonomous hybrid system for a residential house located in Cluj-Napoca. After the autonomous hybrid system optimization is performed, it is achieved a reduction of the total cost of system investment, a reduction of energy produced in excess and a reduction of CO2 emissions.

Person-centredness is claimed to be one of the aims of healthcare, placing the person at the centre of healthcare (services). However, individual responsibility is expected and stressed in the implementation with limited structural support. This has led to the situation where despite the availability of HPV vaccination as the most beneficial preventive method, the coverage for girls aged 12â14 is below the recommended (>70%) rate. The objective of the research was to analyse structural constraints experienced by parents and service providers of the target group of girls regarding HPV vaccination under the circumstances of a global pandemic. Qualitative methods were used, namely in-depth interviews (n = 18) with nurses and midwives and three focus group interviews (n = 13) with parents of girls aged 12â14 years, as well as thematic textual analysis with the combination of inductive and deductive analysis methods. The research was granted ethical permission. The results outline that for parents the main challenge is the ability to find relevant supportive information for decision-making. For nurses, the challenge is to find appropriate ways to counsel and support parents and girls. The study revealed the lack of a country-wide strategy as one of the weak links in supporting the continuation of necessary preventive activities despite the external situation. Also, the skills of counselling and development of innovative communicative and educational digital tools that are target group specific yet also country- and culture-specific should be improved, as this may lead to more person-centred healthcare service for cervical cancer prevention.

Copyright of SHILAP Revista de Lepidopterologia is the property of Sociedad Hispano-Luso-Americana de Lepidopterologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Hubble Space Telescope UV Legacy Survey of Galactic Globular Clusters is providing a major breakthrough in our knowledge of globular clusters (GCs) and their stellar populations. Among the main results, we discovered that all the studied GCs host two main discrete groups consisting of first generation (1G) and second generation (2G) stars. We exploit the multiwavelength photometry from this project to investigate, for the first time, the Red Giant Branch Bump (RGBB) of the two generations in a large sample of GCs. We identified, with high statistical significance, the RGBB of 1G and 2G stars in 26 GCs and found that their magnitude separation as a function of the filter wavelength follows comparable trends. The comparison of observations to synthetic spectra reveals that the RGBB luminosity depends on the stellar chemical composition and that the 2G RGBB is consistent with stars enhanced in He and N and depleted in C and O with respect to 1G stars. For metal-poor GCs the 1G and 2G RGBB relative luminosity in optical bands mostly depends on helium content, Y. We used the RGBB observations in F606W and F814W bands to infer the relative helium abundance of 1G and 2G stars in 18 GCs, finding an average helium enhancement ΔY = 0.011 ± 0.002 of 2G stars with respect to 1G stars. This is the first determination of the average difference in helium abundance of multiple populations in a large number of clusters and provides a lower limit to the maximum internal variation of helium in GCs. [ABSTRACT FROM AUTHOR]