Search

Tuberculosis (TB) is a multisystemic contagious disease produced by Mycobacterium tuberculosis complex bacteria (MTBC), with a prevalence of 65:100,000 inhabitants in Romania (six times higher than the European average). The diagnosis usually relies on the detection of MTBC in culture. Although this is a sensitive method of detection and remains the “gold standard”, the results are obtained after several weeks. Nucleic acid amplification tests (NAATs), being a quick and sensitive method, represent progress in the diagnosis of TB. The aim of this study is to assess the assumption that NAAT using Xpert MTB/RIF is an efficient method of TB diagnosis and has the capacity to reduce false-positive results. Pathological samples from 862 patients with TB suspicion were tested using microscopic examination, molecular testing and bacterial culture. The results show that the Xpert MTB/RIF Ultra test has a sensitivity of 95% and a specificity of 96.4% compared with 54.8% sensitivity and 99.5% specificity for Ziehl–Neelsen stain microscopy, and an average of 30 days gained in the diagnosis of TB compared with bacterial culture. The implementation of molecular testing in TB laboratories leads to an important increase in early diagnostics of the disease and the prompter isolation and treatment of infected patients.

Efficacy of donated COVID-19 convalescent plasma (dCCP) is uncertain and may depend on antibody titers, neutralizing capacity, timing of administration, and patient characteristics.In a single-center hypothesis-generating prospective case-control study with 1:2 matched dCCP recipients to controls according to disease severity at day 1, hospitalized adults with COVID-19 pneumonia received 2 × 200 ml pathogen-reduced treated dCCP from 2 different donors. We evaluated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in COVID-19 convalescent plasma donors and recipients using multiple antibody assays including a Coronavirus antigen microarray (COVAM), and binding and neutralizing antibody assays. Outcomes were dCCP characteristics, antibody responses, 28-day mortality, and dCCP -related adverse events in recipients.Eleven of 13 dCCPs (85%) contained neutralizing antibodies (nAb). PRT did not affect dCCP antibody activity. Fifteen CCP recipients and 30 controls (median age 64 and 65 years, respectively) were enrolled. dCCP recipients received 2 dCCPs from 2 different donors after a median of one hospital day and 11 days after symptom onset. One dCCP recipient (6.7%) and 6 controls (20%) died (p = 0.233). We observed no dCCP-related adverse events. Transfusion of unselected dCCP led to heterogeneous SARS CoV-2 antibody responses. COVAM clustered dCCPs in 4 distinct groups and showed endogenous immune responses to SARS-CoV-2 antigens over 14-21 days post dCCP in all except 4 immunosuppressed recipients.PRT did not impact dCCP anti-virus neutralizing activity. Transfusion of unselected dCCP did not impact survival and had no adverse effects. Variable dCCP antibodies and post-transfusion antibody responses indicate the need for controlled trials using well-characterized dCCP with informative assays.

Empiric antibiotic treatment for bloodstream infection (BSI) after haematopoietic cell transplantation (HCT) in the era of antimicrobial resistance is challenging. We conducted a nested project in the Swiss Transplant Cohort Study 09/2009 to 10/2018 assessing BSI incidence, pathogen distribution and antimicrobial resistance. Cox proportional hazards models were fitted to detect factors associated with BSI and outcome. We included 1 364 adults (61.1% male) receiving 1 432 HCTs complicated by 676 BSIs in 451 (33%) patients. Cumulative incidence of BSI was 20.5% (95%CI 18.4 – 22.7) until day 100 after the first HCT. Gram-positive pathogens, mostly coagulase-negative staphylococci, dominated (454, 58.1%). Production of extended-spectrum beta-lactamases and quinolone-resistance were observed in 41/195 (21%) and 81/195 (41.5%) of Enterobacterales, respectively. Carbapenem-resistance was documented in 10/49 (20.4%) of Pseudomonas aeruginosa isolates. Multivariable cox regression analysis within the first-year post-transplant identified male gender, comorbidities, myeloablative regimen, acute graft-versus-host disease grade III/IV and haematological progression/relapse after HCT as independent risk factors for BSI. One-year mortality was 26.6% with BSI modeled as a time-dependent covariable independent risk factor for mortality. To conclude, BSI remains a frequent complication after HCT, with stable rates of antibiotic resistance in BSI-causing pathogens in Switzerland. BSI was a major contributor to mortality.

This research paper reviews the topic of corruption, in a comparative approach of the public and private sector in Romania, considering the wider background of the European Union. Based on the findings of a survey performed by the authors, we advance strategies and recommendations for both the public and business management, in order to align their views with the premises of ethical administration.

Rationale This study aimed to describe cardiopulmonary function during exercise 3 months after hospital discharge for COVID-19 and compare groups according to dyspnea and intensive care unit (ICU) stay. Methods Participants with COVID-19 discharged from five large Norwegian hospitals were consecutively invited to a multicentre, prospective cohort study. In total, 156 participants (mean age 56.2 years, 60 females) were examined with a cardiopulmonary exercise test (CPET) 3 months after discharge and compared to a reference population. Dyspnea was assessed using the modified Medical Research Council dyspnea scale (mMRC). Results Peak oxygen uptake (V̇O2), Oxygen uptake was reduced in one-third of the participants 3 months after hospitalisation for COVID-19. The most common exercise limitation was deconditioning. Circulatory limitations to exercise were more common than ventilatory limitations.

OBJECTIVES Patients with severe COVID-19 may be at risk of longer term sequelae. Long-term clinical, immunological, pulmonary and radiological outcomes of patients treated with anti-inflammatory drugs are lacking. METHODS In this single-centre prospective cohort study, we assessed 90-day clinical, immunological, pulmonary and radiological outcomes of hospitalised patients with severe COVID-19 treated with tocilizumab from March 2020 to May 2020. Criteria for tocilizumab administration were oxygen saturation 30/min, C-reactive protein levels >75 mg/l, extensive area of ground-glass opacities or progression on computed tomography (CT). Descriptive analyses were performed using StataIC 16. RESULTS Between March 2020 and May 2020, 50 (27%) of 186 hospitalised patients had severe COVID-19 and were treated with tocilizumab. Of these, 52% were hospitalised on the intensive care unit (ICU) and 12% died. Eleven (22%) patients developed at least one microbiologically confirmed super-infection, of which 91% occurred on ICU. Median duration of hospitalisation was 15 days (interquartile range [IQR] 10–24) with 24 days (IQR 14–32) in ICU patients and 10 days (IQR 7–15) in non-ICU patients. At day 90, 41 of 44 survivors (93%) were outpatients. No long-term adverse events or late-onset infections were identified after acute hospital care. High SARS-CoV-2 antibody titres were found in all but one patient, who was pretreated with rituximab. Pulmonary function tests showed no obstructive patterns, but restrictive patterns in two (5.7%) and impaired diffusion capacities for carbon monoxide in 11 (31%) of 35 patients, which predominated in prior ICU patients. Twenty-one of 35 (60%) CT-scans at day 90 showed residual abnormalities, with similar distributions between prior ICU and non-ICU patients. CONCLUSIONS In this cohort of severe COVID-19 patients, no tocilizumab-related long-term adverse events or late-onset infections were identified. Although chest CT abnormalities were highly prevalent at day 90, the majority of patients showed normal lung function. Trial registration ClinicalTrials.gov NCT04351503

In this work we studied the experimental validation of the model and finite element analysis for a single layer of composite materials reinforced with carbon (denoted as C), aramid (K) and carbon-aramid (C-K) fibers. In the literature there are not many details about the differences that arise between transversal and longitudinal characteristics of composite materials reinforced with fabric, compared to those with unidirectional fibers. In order to achieve carbon and aramid composites we used twill fabric and for carbon-aramid plain fabric, as shown in Figure 1.In order to observe the static behavior of the considered specimens, numerical simulations were carried out in addition to the experimental determination of the characteristics of these materials.Layered composites are obviously the most widespread formula for getting advanced composite structures. It allows a unique variety of material and structural combinations leading to optimal design in a wide range of applications [1,2].To design and verify ...

The influence of discontinuities is important for a correct determination of static and dynamic elastic characteristics of the material. In this paper we presented differences arising between the elastic modulus static and dynamic, laminated composite materials reinforced with carbon fiber, aramid and carbon-aramid, depending on the non-uniformity coefficient. For the study were determined static elastic modulus by carrying out traction tests and dynamic elastic modulus by determining the vibration frequency, on specimens of each type of material with and without discontinuities [1].The elastic properties of composite materials resistance and can be influenced by various defects that arise from technological manufacturing process. This is important for the production of large series of parts of fiber-reinforced composite material, the fibers in the matrix distribution is not uniform. Studies on the mechanical behavior of composites with random distribution of fabrics are made in [2].

In this paper it is studied the influence of discontinuities on elastic and mechanical properties of green composite materials (reinforced with fabric of cotton or hemp). In addition, it is studied the way variations of the volume f the reinforcement influences the elasticity modulus and the tensile strength for the studied composite materials.In order to appreciate the difference in properties between different areas of the composite material, and also the dimensions of the defective areas, we have introduced a relative uniformity coefficient with which the mechanical behavior of the studied composite is compared with a reference composite.To validate the theoretical results we have obtained we made some experiments, using green composites reinforced with fabric, with different imperfection introduced special by cutting the fabric.

Aceasta lucrare descrie modele alternative de guvernare electronica, in concordanta cu abordarile diferite ale guvernului In legatura cu posibilitatile oferite de ICT (suport pentru informatii, comunicare si interactiune, managementul cunostintelor). Mai precis, este vorba de o trecere in revista si o analiza a modelelor de guvernare dezvoltate de o initiativa internationala orientata spre cresterea si sustinerea utilizarii ICT (tehnologiile informatiei si comunicatiilor) in contextul guvernarii.

Guvernarea electronica a oraselor nu reprezinta un proces cu un singur stagiu sau un singur proiect. Acest concept implica stagii sau faze multiple de dezvoltare, faza finala insemnand o integrare deplina a serviciilor dincolo de granitele administrative si de stakeholderii urbani. Cu alte cuvinte, o operatie eficace de transformare a guvernarii oraselor pentru a raspunde mai bine necesitatilor cetatenilor si pentru a contribui la bunastarea comunitatii. Principalul scop al implementarii acestui concept este acela de a constitui un model de guvernare electronica a oraselor care sa faciliteze si sa sporeasca rolul si contributia tehnologiilor informatiei si comunicatiilor (TIC) la Indeplinirea principiilor Bunei Guvernari si obiectivelor procesului de luare a deciziilor in cadrul oraselor europene in contextul societatii bazate pe cunostinte.

In this material the authors presnts a new dimension of the organization leraning through the organization culture and the mentoring programmes.