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The purpose of this article is to investigate and analyze the practices of scientific management within the County Departments of Sports and Youth (CDSY) in Romania. Conducted through a comprehensive research endeavor spanning from January to June 2022, the study utilized a standardized questionnaire as its primary instrument for data collection, distributed among CDSY directors. A notable finding from the study indicates that a significant proportion of respondents (44.9%) perceive notable disparities in the normative-functional elements governing the National Sports System in Romania compared to international standards. Moreover, the majority (51%) consistently adhere to regulatory acts, while a substantial portion (69.4%) underscore the importance of strict adherence to internal regulations in strategy formulation. Furthermore, an overwhelming majority (88.9%) acknowledge the substantial influence of available resources on strategy development, with collaboration with authorities primarily occurring through direct communication channels. Respondents prioritize multiple objectives (44.9%), affirm the necessity of various competencies (53.1%), and identify a lack of human and financial resources (59.2%) as the most significant obstacle. Notable achievements highlighted in the study include the improvement of the county's sports performance (53.1%). Respondents also believe that setting clear and realistic objectives (38.8%) is pivotal to enhancing CDSY management, while considerations in formulating strategies emphasize trends in the sports domain (42.9%) and the specific needs of the local sports community (42.9%). Overall, this research contributes to the understanding and promotion of more efficient practices in managing sports and youth departments within Romania's counties. [ABSTRACT FROM AUTHOR]

Background and Objectives: The risk of developing glycemic dysregulation up to overt diabetes mellitus (DM) after an episode of acute pancreatitis (AP) is increasingly being analyzed. We aimed to assess the changes in serum glucose levels associated with the first episode of AP, as well as the impact of dysglycemia on outcomes such as the severity of inflammation, the length of hospitalization, mortality, and the persistence of hyperglycemia at follow-up. Materials and Methods: All patients experiencing their first episode of AP, who presented to the Emergency Room (ER) between 1 January 2020 and 31 December 2023, were retrospectively included. On-admission serum glucose and peak serum glucose during hospitalization were the biological markers used to assess glucose metabolism impairment, and they were correlated with outcomes of AP. Results: Our study included 240 patients, 46.67% (112 patients) having a biliary etiology for an AP flare. Patients with COVID-19-associated AP exhibited the highest on-admission and peak serum glucose levels (244.25 mg/dL and 305.5 mg/dL, respectively). A longer hospital stay was noted in patients with peak serum glucose levels of ≥100 mg/dL (9.49 days) compared to normoglycemic patients (6.53 days). Both on-admission and peak glucose levels were associated with elevated CRP levels during hospitalization. A total of 83.78% of patients who received antibiotics exhibited on-admission hyperglycemia, and 72.07% had peak serum glucose levels of ≥100 mg/dL. The presence of hyperglycemia at follow-up was associated with both on-admission and peak serum glucose levels of ≥100 mg/dL, as well as with a longer stay, higher CRP levels, and antibiotic use during index admission. Conclusions: On-admission hyperglycemia predicts a higher inflammatory response in patients at the first episode of AP, while the presence of hyperglycemia during hospitalization is associated with imaging and biological severity and longer hospitalizations, indicating a more severe disease course. Both on-admission and peak in-hospital hyperglycemia were identified as risk factors for sustained hyperglycemia at follow-up. [ABSTRACT FROM AUTHOR]

It is imperative to comprehend the determinants shaping entrepreneurial intent, especially during pivotal junctures when individuals are navigating career decisions. This research endeavors to scrutinize the entrepreneurial intent of university students, with a specific focus on the sports domain, and examine the potential impact of their involvement in sports activities on said entrepreneurial intent. The participants comprised 415 students from the academic sports domain in four cities in Romania (Pitesti, Alba-Iulia, Cluj-Napoca, and Sibiu). They were administered a 35-item questionnaire and subsequently categorized into four groups based on their sports background: individuals and team sports participants with a competitive history, amateur athletes, and non-practitioners. The questionnaire demonstrated strong internal consistency (Cronbach's alpha coefficient = 0.755). A test of homogeneity across criteria such as competitive sports involvement, type of competitive sports, and engagement in amateur sports revealed significant differences in five out of 45 comparisons. Furthermore, this study employs an explanatory approach to elucidate the distinctions among athletes, amateur, and non-athlete students in academic sports programs regarding: comfort and security in workplace stability, embracing risk-taking for gains, proactive problem-solving, expectations from superiors, work ethic and goal orientation, workload and productivity relationship, task completion and challenge acceptance, work avoidance and problem management, work-life balance prioritization, openness to personal development, parallels between sports and business strategies, taking initiative and responsibility, entrepreneurial determination, comfort zone preference and adaptation after sports career. [ABSTRACT FROM AUTHOR]

Circulating cell-free DNA (ccfDNA) quantity correlates with the clinical characteristics and prognosis of various cancer types. We investigated whether ccfDNA levels and the neutrophil-to-lymphocyte ratio (NLR) have prognostic value in patients with pancreatic ductal adenocarcinoma (PDAC). Peripheral blood was collected from 82 patients with PDAC prior to any diagnostic procedure or the administration of chemotherapy. Plasma DNA was isolated, and ccfDNA concentration and NLR were determined. We found that ccfDNA levels were correlated with age and tumor burden. Moreover, higher values of NLR (≥3.31) were linked with worse overall survival (OS) (4 vs. 10 months; log rank p = 0.011), and an elevated ccfDNA concentration (≥25.79 ng/mL) was strongly associated with shorter OS (4 vs. 8 months; log rank p = 0.009). According to the results of the multivariable Cox regression analysis, the baseline concentration of ccfDNA was an independent prognostic factor for OS (HR 0.45, 95% CI 0.21–0.97, p = 0.041). Furthermore, the combination of ccfDNA levels with NLR greatly enhanced the prognostic accuracy of PDAC patients. Our study demonstrates that ccfDNA concentration and NLR are independent predictors of survival in PDAC. Subsequent studies should validate this combination as a prognostic indicator in PDAC patients and assess its utility for guiding therapeutic decisions. [ABSTRACT FROM AUTHOR]

Problem Statement and Approach: This study assessed managers' perceptions of their ability to devise independent strategies within the County Directorate for Sport and Youth (CDSY) programs. The study's objective is to identify the pivotal independent variables influencing their activity reports. By analyzing correlations between dependent and independent variables, this study evaluates the strength and direction of these associations and their consequent impact on the dependent variable. This comprehensive examination provides valuable insights into managers' perspectives on the development of independent strategies within the plans and projects of the CDSY. Material and methods: Conducted between January and June 2022, this research follows a confirmatory approach. It involves a systematic documentation review, preliminary research, and the formulation of a questionnaire specifically designed for directors of CDSY. [ABSTRACT FROM AUTHOR]

Background & Aims: Non‐selective β‐blockers (NSBBs) and endoscopic variceal‐ligation (EVL) have similar efficacy preventing first variceal bleeding. Compensated and decompensated cirrhosis are markedly different stages, which may impact treatment outcomes. We aimed to assess the efficacy of NSBBs vs EVL on survival in patients with high‐risk varices without previous bleeding, stratifying risk according to compensated/decompensated stage of cirrhosis. Methods: By systematic review, we identified RCTs comparing NSBBs vs EVL, in monotherapy or combined, for primary bleeding prevention. We performed a competing‐risk, time‐to‐event meta‐analysis, using individual patient data (IPD) obtained from principal investigators of RCTs. Analyses were stratified according to previous decompensation of cirrhosis. Results: Of 25 RCTs eligible, 14 failed to provide IPD and 11 were included, comprising 1400 patients (656 compensated, 744 decompensated), treated with NSBBs (N = 625), EVL (N = 546) or NSBB+EVL (N = 229). Baseline characteristics were similar between groups. Overall, mortality risk was similar with EVL vs. NSBBs (subdistribution hazard‐ratio (sHR) = 1.05, 95% CI = 0.75–1.49) and with EVL + NSBBs vs either monotherapy, with low heterogeneity (I2 = 28.7%). In compensated patients, mortality risk was higher with EVL vs NSBBs (sHR = 1.76, 95% CI = 1.11–2.77) and not significantly lower with NSBBs+EVL vs NSBBs, without heterogeneity (I2 = 0%). In decompensated patients, mortality risk was similar with EVL vs. NSBBs and with NSBBs+EVL vs. either monotherapy. Conclusions: In patients with compensated cirrhosis and high‐risk varices on primary prophylaxis, NSBBs significantly improved survival vs EVL, with no additional benefit noted adding EVL to NSBBs. In decompensated patients, survival was similar with both therapies. The study suggests that NSBBs are preferable when advising preventive therapy in compensated patients. [ABSTRACT FROM AUTHOR]

Background & Aims: Colorectal cancer (CRC) is the third cause of cancer-related death worldwide. Screening programs can reduce CRC mortality rates by up to 60%. In line with the European Union recommendations, Romania started the first four regional pilot screening programs in 2020 (the ROCCAS II projects). This study reports the interim screening performance indicators. Methods: People aged 50 to 74 years were invited to the screening program. General practitioners (GPs) evaluated CRC risk based on a survey. High-risk or symptomatic individuals were referred directly to colonoscopy. The average risk participants received a fecal immunochemical test (FIT). Positive cases were invited to colonoscopy. Three regions were screened using the OC-SENSOR® (South-Muntenia, Bucharest-Ilfov, South-East) and one region (South-West) used the FOB GOLD®. The data was collected in the ROCCAS screening electronic registry. The following FIT parameters were evaluated: rates of return, invalidity, positivity, and colonoscopy acceptance rate according to age group, gender, region of provenience, and vulnerability status. Results: We included all cases screened between January 1, 2022 and September 30, 2023. In total, 168,958 people received the FIT test within the projects. The global FIT return rate was 90%. Factors associated with a higher return rate were female gender (90.77% vs 88.83%, p<0.0001), vulnerable status (91.23% vs 88.83%; p<0.00001), and rural residence (91.84% vs 88.42%, p<0.00001). The overall positivity rate was 5.75%. It was higher in males (7.64% vs 4.57% in females, p<0.00001) and progressively increased with the age group. The total invalid FIT rate was 5.87%, significantly lower for OC-SENSOR® (2.24%) than for the FOB GOLD® (13.6%). The overall acceptability rate for colonoscopy was 51.3%. Conclusions: According to our preliminary data, GP's participation in the pilot programs ensured adequate adherence to screening through FIT. The rate for FIT return and positivity were acceptable for both tests, while the invalid rate was much higher in FOB GOLD® compared to the OC-SENSOR®. Moreover, colonoscopy acceptance needs to be improved. Our preliminary analysis revealed the screening performance indicators meet the EU recommendations and fulfill the premises for national-level expansion of the program starting in 2024. [ABSTRACT FROM AUTHOR]