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Background: Abiraterone acetate plus prednisolone (herein referred to as abiraterone) or enzalutamide added at the start of androgen deprivation therapy improves outcomes for patients with metastatic prostate cancer. Here, we aimed to evaluate long-term outcomes and test whether combining enzalutamide with abiraterone and androgen deprivation therapy improves survival. Methods: We analysed two open-label, randomised, controlled, phase 3 trials of the STAMPEDE platform protocol, with no overlapping controls, conducted at 117 sites in the UK and Switzerland. Eligible patients (no age restriction) had metastatic, histologically-confirmed prostate adenocarcinoma; a WHO performance status of 0–2; and adequate haematological, renal, and liver function. Patients were randomly assigned (1:1) using a computerised algorithm and a minimisation technique to either standard of care (androgen deprivation therapy; docetaxel 75 mg/m 2 intravenously for six cycles with prednisolone 10 mg orally once per day allowed from Dec 17, 2015) or standard of care plus abiraterone acetate 1000 mg and prednisolone 5 mg (in the abiraterone trial) orally or abiraterone acetate and prednisolone plus enzalutamide 160 mg orally once a day (in the abiraterone and enzalutamide trial). Patients were stratified by centre, age, WHO performance status, type of androgen deprivation therapy, use of aspirin or non-steroidal anti-inflammatory drugs, pelvic nodal status, planned radiotherapy, and planned docetaxel use. The primary outcome was overall survival assessed in the intention-to-treat population. Safety was assessed in all patients who started treatment. A fixed-effects meta-analysis of individual patient data was used to compare differences in survival between the two trials. STAMPEDE is registered with ClinicalTrials.gov (NCT00268476) and ISRCTN (ISRCTN78818544). Findings: Between Nov 15, 2011, and Jan 17, 2014, 1003 patients were randomly assigned to standard of care (n=502) or standard of care plus abiraterone (n=501) in the abiraterone trial. Between July 29, 2014, and March 31, 2016, 916 patients were randomly assigned to standard of care (n=454) or standard of care plus abiraterone and enzalutamide (n=462) in the abiraterone and enzalutamide trial. Median follow-up was 96 months (IQR 86–107) in the abiraterone trial and 72 months (61–74) in the abiraterone and enzalutamide trial. In the abiraterone trial, median overall survival was 76·6 months (95% CI 67·8–86·9) in the abiraterone group versus 45·7 months (41·6–52·0) in the standard of care group (hazard ratio [HR] 0·62 [95% CI 0·53–0·73]; pinteraction=0·71) or between-trial heterogeneity (I 2 p=0·70). In the first 5 years of treatment, grade 3–5 toxic effects were higher when abiraterone was added to standard of care (271 [54%] of 498 vs 192 [38%] of 502 with standard of care) and the highest toxic effects were seen when abiraterone and enzalutamide were added to standard of care (302 [68%] of 445 vs 204 [45%] of 454 with standard of care). Cardiac causes were the most common cause of death due to adverse events (five [1%] with standard of care plus abiraterone and enzalutamide [two attributed to treatment] and one (

Background and Aims: MicroRNAs (miR) have altered expression in multiple autoimmune disorders including inflammatory bowel disease. The aim of the study was to assess the tissue and circulating miR-31, miR-200b, and miR-200c expression levels as potential biomarkers for intestinal disease activity in patients with Crohn’s disease (CD). Methods: The study included 45 patients with histopathological confirmed CD and active disease (defined as fecal calprotectin >50 μg/g and Simple Endoscopic Score (SES) of CD >3), and 21 subjects as controls for the validation cohort. Demographic and clinical data, biomarkers (fecal calprotectin), endoscopy data, the expression levels of miR-31, miR-200b, and miR-200c in tissue and serum were assessed (by RT-PCR). Receiver operating characteristic analysis was performed to assess the miR-31, miR-200b, and miR-200c expression levels as potential biomarkers for active CD. Results: Mean fecal calprotectin was 1540±890 μg/g. Mean SES-CD was 8.9±4.2. Tissue and circulating miR- 31 were significantly correlated with fecal calprotectin (r=0.81, r=0.83, p

Background: Single-use flexible ureteroscopes for urinary retention have been developed in recent years as an alternative to reusable ureteroscopes in order to eliminate the risk of cross-infections and to solve the primary limitations of traditional reusable flexible ureteroscopes for urinary retention. Methods: In this study, we evaluated and contrasted three of the most recent types of flexible ureteroscopes, including two digital reusable versions (Olympus URF-V and Olympus URF-V2) and one single-use model (Pusen Medi-calUscope UE3022), in both ex vivo and in vivo scenarios. The influence of a variety of instruments on the flow of irrigation and its deflection was investigated ex vivo. In the in vivo investigation, a total of 40 patients were treated with retrograde fURS utilizing URF-V, 20 patients were treated with URF-V2, and 20 patients were treated with single-use fURS. The visibility and maneuverability of each fURS were evaluated by the same urologist during the procedures, and the results were compared. Results: Intraoperatively, we compared the image quality of reusable (URF-V and URF-V2) and single-use fURS USCOPE UE3022 cameras and found that there was no statistically significant difference between the two types of camera. The score for maneuverability was the same (4.2) regardless of whether we used the UscopeUE3022 or the URF-V2, but it was significantly lower (3.8, p = 0.03) when we utilized the URF-V. Irrigation was about the same when utilizing reused scopes, whereas employing a single-use scope was more than fifty percent more effective. Conclusions: The findings of our research indicate that reusable and single-use fURs have visibility and maneuverability characteristics that are at least comparable to one another. The possibilities of the single-use type in terms of irrigation flow and deflection are superior.

Urolithiasis is a major health problem which is on the rise worldwide. New procedures and technological tools have arisen, providing the urologist with a vast arsenal of options for stone disease management. The goal of this narrative review is to summarize the most recent advancements and demonstrate their efficacy in reducing complications and increasing surgical efficacy. The latest modern advances in increasing stone rate after flexible ureteroscopy were included. The ureteral access sheet concept represents one of the most important parts in this procedure and new performances achieved in this field like suction and pressure control were evaluated. Another important aspect in flexible ureteroscopy is related to laser fibres. The latest achievements in Holmium and Thulium fibres were analysed and compared using both dusting and fragmenting techniques. After analysing these aspects, the conclusion was that suction improved visualization by removing "stone storm" and bleeding during the procedure and Thulium laser had the potential to become the new “gold standard” in the pursuit of obtaining a higher stone free rate.

The resource economy is currently a global priority and the preservation of the planet and its resources are becoming the main international objectives. In this regard, EU states must establish clear lines and long-term strategies. Also, the goal of developed countries must involve reducing emissions by 80-95% by 2050. The global economic context leads to an intense concern in the field of unconventional sources, with solar energy occupying an important place. Solar energy can be collected and transformed either into electricity using photovoltaic or thermal technologies, through the use of different types of solar thermal panels or through the use of hybrid panels (PV/T) Hybrid solar photovoltaic - thermal collectors, often known as PV/T are systems that simultaneously convert solar radiation into electricity and heat - operating in cogeneration. The paper includes experimental measurements and numerical analysis of a hybrid solar panel. A decrease in the surface of the panel was observed, thus an increase in electricity production by up to 6%. The original part is the experimental protocol used and the comparison of two solutions of energy production under the same conditions. The numerical campaign accompanies the experimental study and provide interesting data., CLIMA 2022 conference, 2022: CLIMA 2022 The 14th REHVA HVAC World Congress

Nowadays, the renewable energy sources have to be implemented in every new building. This paper describes the case study, and related simulations, of a university building in Romania, that has to become zero energy. Ground source heat pumps (GSHP) are ideal to be implemented in new buildings, being able to produce either heating and cooling. A good insulation is important too, to reduce the cooling and heating energetic needs. Asides active cooling, the passive cooling should be taken into account because it can lower the cooling consumption. For the domestic hot water (DHW), solar panels are taken into consideration to reduce at least 60-70% of the energy consumption, for DHW only. To be able to accomplish the goal of a near zero energy building, photovoltaic solar panels are taken into consideration, placed on the terrace of the building, the system being off-grid type. For all the dynamic simulations Designbuilder software was used, a powerful simulation tool which is able to model all renewable energy sources above mentioned. Also very detailed yearly energetic consumption is presented for all types of consumers from the building: heating, cooling, lighting, ventilation, heating, cooling and domestic hot water. Concerning ventilation, a recovery heat exchanger is used in simulations, having a 80% efficiency, also to reduce the energy consumption. The energy between building and heat pump is using fan coils in all the occupied areas,. Finally, regarding the results of the simulations, after a good insulation of the building and the implementation of the geothermal heat pump, heat recovery unit, solar thermal and solar photovoltaic solar panels, a zero energy building has been obtained. The simulated building had initially a poor energy efficiency, without proper insulation but also with old heating and cooling systems. For the characteristics of the soil measurements with thermal response test (TRT) method from Bucharest were used. Dynamical simulation is one of the best methods to simulate as accurate as possible energy consumption for several case studies, varying insulation type and thickness and different heating/cooling systems., CLIMA 2022 conference, 2022: CLIMA 2022 The 14th REHVA HVAC World Congress

Detunata Goală scree is a talus slope-rock glacier system characterized by persistent snow and ice during springtime and summer in spite of a mean annual air temperature of around +7°C. This is a porous talus made of andesitic basaltic columns affected by chimney circulation that seems to allow for a extrazonal permafrost of low altitude in a temperate climate much lower than the regional limit of alpine permafrost. In the postdoctoral project FrozenCORE electrical resistivity tomography (ERT) and seismic refraction tomography (SRT) were applied in October 2020 in order to check permafrost presence at the end of the warm season and to determine the internal structure of the deposit. The two methods indicated contradictory results, as ERT indicated a high resistive layer in the first 10-15 m while the SRT indicated a high velocity layer at depths greater than 15 m. A borehole was drilled in June 2021 in the coldest sector of the scree and the cores recovered indicated that: 1) the talus is relatively thin, less than 13 m; 2) the deposit has a low amount of ice, several lenses were found between 3 and 10 m each of at most a few centimeters thick; 3) the scree porosity is relatively low, much smaller than at the surface. A thermistor chain was installed in the borehole at depths according to the GTN-P recommendations for future monitoring of the temperatures in the underground. Ice samples were collected from the cores for isotopic analyses in order to check if the ice from the greater depths is older than the upper one assumed to be seasonal. The drilling indicated that ERT is a better method for assessing the stratigraphy of such talus deposits.

Introduction: Horseshoe kidney (HSK) is one of the most frequent renal malformations which appears to present an increased risk of stone formation caused by abnormal urine drainage. This study aims to compare the results of single-use flexible ureteroscopy (SUfURS) vs reusable devices (RfURS) with holmium laser in treating stones in HSK cases. Material and method: Between February 2017 and June 2021, 29 patients diagnosed with renal stone disease and horseshoe kidney were retrospectively analyzed. Subjects were divided into two groups: Group 1 (14 patients) undergoing SUfURS and Group 2 (15 patients) operated with RfURS devices. We analyzed the mean stone burden, operation time, stone free rate and complications. The surgical equipment was represented by the SUfURS PU3022 (Zhuhai Pusen Medical Technology) and RfURS URF-V2 (Olympus). Results: The two groups had a similar mean stone burden: 22 ± 6 mm (range 15-31 mm) for Group 1 and 24 ± 7 mm (range 16-30 mm) for Group 2. The average operative time was better for Group 1 (86 ± 17 min) vs Group 2 (89 ± 20 min). The stone-free status was similar for both groups after the first session (57.14% for Group 1 vs 53.33% for Group 2) and slightly in favor of Group 1 as compared to Group 2 (85.71% vs 73.33%, respectively) after the second session. The overall complication rate (Grades I, II and III) was almost similar in both groups, with a slightly prevalence for Group 1 (no major complications Grade IV and V). Conclusion:Flexible ureteroscopy represents an effective alternative treatment technique for large stones in kidney abnormalities. single-use flexible ureteroscopy can be successfully used to treat patients with genetically renal malformations and its results may be slightly better than those provided by using RfURS devices.

We analyzed the results of single-use flexible ureteroscopy (su-fURS) with the holmium laser in treating renal stones associated with ectopic pelvic kidney (EPK). The study retrospectively analyzed data of 11 patients diagnosed with EPK and stone disease who underwent su-fURS between May 2017 and November 2019. The analyzed surgical data included the mean operation time, stone-free and complication rates, as well as hospitalization period. Disposable digital flexible ureteroscopes were exclusively used. The mean age was 55, with a 1.2:1 male to female ratio. The mean stone burden was 30±9 mm (ranging from 17 to 49 mm). The mean calculi digitized surface area (DSA) was 299±56 mm2(ranging from 170 to 597 mm2). A ureteral access sheath was used in all 11 patients, and holmium laser lithotripsy was performed (dusting mode parameters: low energy – 0.5J, high frequency – 50 Hz, long pulse; pop-corn mode: high energy >1 J, medium frequency– 10–50 Hz, long pulse; fragmenting mode: high energy >1 J, low frequency

Multidisciplinary teams (MDTs) have been recommended as a key part of best cancer care for 25 years. Here, we set out the functions and approaches of MDTs and review their impact. Although the literature is patchy in quality, MDTs contribute to improving cancer care and outcomes. They must be well organized, efficient, and well led; work with sound and timely information; and communicate well within the team and with their patients. Patients need carefully prepared information to help them share in the decision-making process. MDTs will be improved by a series of ongoing innovative developments. Increasing information from molecular pathology will increase the precision of their decisions, although the technologies remain expensive and may not be accessible in all countries for some time. New point-of-care testing technologies will improve the quality and timeliness of testing. Good informatics is essential to deliver the information to patients and the MDT. MDTs should be research active, delivering clinical trials, and this should improve outcomes for all of their patients. Patient engagement and empowerment in MDTs should improve patient satisfaction and outcomes. Patient-reported outcome measures will improve MDTs' insights into their patients’ problems and symptoms and can improve patient outcomes.

BACKGROUND Men with high-risk non-metastatic prostate cancer are treated with androgen-deprivation therapy (ADT) for 3 years, often combined with radiotherapy. We analysed new data from two randomised controlled phase 3 trials done in a multiarm, multistage platform protocol to assess the efficacy of adding abiraterone and prednisolone alone or with enzalutamide to ADT in this patient population. METHODS These open-label, phase 3 trials were done at 113 sites in the UK and Switzerland. Eligible patients (no age restrictions) had high-risk (defined as node positive or, if node negative, having at least two of the following: tumour stage T3 or T4, Gleason sum score of 8-10, and prostate-specific antigen [PSA] concentration ���40 ng/mL) or relapsing with high-risk features (���12 months of total ADT with an interval of ���12 months without treatment and PSA concentration ���4 ng/mL with a doubling time of

This paper will introduce the need for research activities done by undergraduate, Master and PhD students as part of their engineering studies. The paper will present the students engaged in research activities supervised by the main author of this paper as a case study of our faculty. Student research activities are becoming an important part of the engineering educational program at the University of Craiova in the last years.

The paper presents the developed hardware and software framework for affective computing during laboratories classes. The paper addresses measurement of student's affective and cognitive states based on some sensors. It is useful to know the affective and cognitive state of the student, because the teaching staff can change the educational process in order to increase the motivation, attention and engagement of that student.

Objectives. The salary represents the price of the labour performed, at present, expressed in money. The labour can be performed either for one’s self, and it produces income, being called independent work, or for a third party, as dependent work, and it produces salary. The salary is simultaneously object of the contract, representing the consideration for the work and cause thereof, because, in order to earn it, the person is employed in work. In the specialty literature, it was claimed that the wage payment obligation is both an obligation to give and an obligation to make. Prior Work. I've tried to fiind the new regulation in this domain very important for those who practice labour law. Results. In the Romanian legislation, the enforcement of the court decisions in the matter of salary is viewed by the lawmaker with great care. Value. We think this article is a small step in the disclosure of the problem eraised by the romanian salary system.

This paper presents the research activities and results which have been obtained to develop robotic gloves and its control system to be used for post-stroke hand rehabilitation. The practical results for robotic gloves development are shown from a mechanical, sensorial and control point of view. This work is focused on developing a lightweight and low-cost robotic glove used by patients in order to regain their hand movements. Robotic glove tele-operation was implemented with a tele-operation glove, having attached blending sensors, or a mobile device (phone) with Android.

The paper presents the research work done for development of a lightweight and low-cost robotic glove that post-stroke patients can use to recover hand functionality. The work focused on two directions for the robotic glove structure (exoskeleton and wearable soft robotic glove) and on two types of recuperative actions (tele-operation and program based actions). Given the performance tests ran for the robotic gloves, better results were shown with the wearable soft robotic glove that could also be combined with Functional Electrical Stimulation in order to improve the post-stroke hand rehabilitation.

National Synchrotron Light Source II (NSLS-II) is a new state-of-the-art 3rd generation synchrotron. The NSLS-II facility is shielded up to 3 GeV electron beam energy at 500 mA. When the gas bremsstrahlung (GB) from the storage ring is scattered by the beamline components in the first optical enclosure (FOE), the scattered radiation will pose additional radiation hazard (bypassing primary GB collimators and stops) and challenge the FOE shielding. The scattered GB radiation hazard can be mitigated by supplementary shielding or with an exclusion zone downstream of the FOE.